Necesidad de cuidados continuos en personas con cáncer de pulmón avanzado / The Need for Continuous Care in People with Advanced Lung Cancer

Introducción: El cáncer de pulmón constituye un problema sanitario a nivel mundial, a pesar de los avances tecnológicos y terapéuticas en oncología, hay un alto porcentaje de personas que se diagnostican en estadios avanzados de la enfermedad, las cuales tienen una mayor demanda de cuidados continuos. Objetivo: Identificar la necesidad de cuidados continuos en personas con cáncer de pulmón avanzado. Métodos: Revisión sistemática realizada durante enero a julio del 2021. Se realizó análisis de contenido de documentos, que incluyó artículos originales y de revisión publicados desde 2010 hasta 2021 en las bases de datos SciELO, Google Scholar y Elsevier. Se elaboró la pregunta guía a través del acrónimo PICo. La estrategia de búsqueda se realizó mediante los descriptores en Ciencias de la Salud (DeCS) "Personal de enfermería", "Neoplasia de pulmón" y "cuidados de enfermería" y el operador booleano AND. Se utilizó el diagrama de flujo (PRISMA) para la formulación de la estrategia de búsqueda, se identificaron y revisaron 77 artículos, de los que fueron útiles 12 de la evolución de la categoría. Conclusiones: El análisis realizado referido a la necesidad de los cuidados continuos en personas con cáncer de pulmón avanzado permitió definición operativa de esta categoría, a partir de las características de esta entidad y la demanda que enfrentan los servicios de hospitalización y los profesionales de enfermería en correspondencia con la satisfacción de necesidades de estas personas, y permitió establecer un acercamiento en los referentes teóricos que sustentan el tema(AU)

Introduction: Lung cancer is a worldwide health problem; despite technological and therapeutic advances in oncology, there is a high percentage of people diagnosed in advanced stages of the disease, which have a greater demand for continuous care. Objective: To identify the need for continuous care in people with advanced lung cancer. Methods: A systematic review was conducted from January to July 2021. Document content analysis was performed, including original and review articles published from 2010 to 2021 in the SciELO, Google Scholar and Elsevier databases. The guiding question was elaborated using the acronym PICo. The search strategy was performed using the Health Sciences Descriptors (DeCS) Personal de enfermería [nursing personnel], Neoplasia de pulmón [lung neoplasia], and cuidados de enfermería [nursing care], together with the Boolean operator AND. The PRISMA flowchart was used for the formulation of the search strategy; 77 articles were identified and reviewed, of which 12 from the category evolution. Conclusions: The carried out analysis regarding the need for continuous care in people with advanced lung cancer allowed the operational definition of this category, based on the characteristics of this entity or the demand faced by hospitalization services and nursing professionals in correspondence with the satisfaction of needs of these people, as well as it allowed establishing an approach within the theoretical references that support the topic(AU)

Factores que influyen en la demora diagnóstica de la neoplasia de pulmón en egresados vivos / Factors that influence the diagnostic delay of lung neoplasia in patients discharged alive

Introducción: el cáncer de pulmón es el tumor maligno más frecuente en el mundo, en Cuba es la segunda causa de muerte, su pronóstico depende de diferentes factores entre ellos el intervalo entre el primer síntoma y el inicio del tratamiento. Objetivo: determinar los factores que influyen en la demora en el diagnóstico de los pacientes con neoplasia de pulmón. Métodos: se realizó un estudio descriptivo, retrospectivo y longitudinal de los pacientes egresados vivos con diagnóstico de neoplasia de pulmón en el Hospital Militar Dr. Carlos J. Finlay en el período comprendido entre enero 2016 a enero 2017. Resultados: la neoplasia de pulmón fue más frecuente en mayores de 50 años, del sexo masculino y con estrecha relación con el hábito de fumar, la falta de aire fue el principal síntoma por el que acudieron los pacientes después de un mes de inicio de la sintomatología. La estadía hospitalaria fue superior a los 20 días y se realizó el diagnóstico histológico en pocos pacientes. Conclusiones: la demora en el diagnóstico de la neoplasia de pulmón influye en su supervivencia, pues no se les puede realizar un tratamiento oncoespecífico(AU)

Introduction: lung cancer is the most frequent malignant tumor in the world, in Cuba it is the second cause of death, its prognosis depends on different factors including the interval between the first symptom and the start of treatment. Objective: to determine the factors that influence the delay in the diagnosis of patients with lung neoplasia. Methods: a descriptive, retrospective and longitudinal study of live patients with diagnosis of lung neoplasm was performed at the Military Hospital Dr. Carlos J. Finlay in the period from January 2016 to January 2017. Results: lung neoplasia was more frequent in men over 50 years of age, and with a close relationship with smoking, lack of air was the main symptom for which patients came after a month of onset of smoking symptomatology. The hospital stay was longer than 20 days and the histological diagnosis was made in a few patients. Conclusions: the delay in the diagnosis of lung neoplasia influences their survival, since they cannot be treated onco-specific(AU)

Cura local con apiterapia en una paciente con ántrax / Local cure with apitherapy in a patient with anthrax

Se describe el caso clínico de una paciente de 67 años de edad, quien ingresa en el en Servicio de Dermatología del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" con diagnóstico de ántrax en región posterosuperior del tórax. Se realiza necrectomía y radiografía simple de tórax que muestra un derrame pleural izquierdo de gran cuantía; por tanto, se traslada al Servicio de Neumología donde se le diagnostica neoplasia de pulmón. La infección de piel se trató con antimicrobianos de uso parenteral y curas locales con miel de abejas, así se logró la resolución total de la lesión.

The case report of a 67 years patient who was admitted in the Dermatology Service of "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital with diagnosis of anthrax in postero-superior region of the thorax is described. A necrectomy and simple x-ray of thorax are carried out that which show a significant left pleural effusion; therefore, he was transferred to the Pneumology Service where he is diagnosed with lung neoplasia. The skin infection was treated with antimicrobials of parenteral use and local cures with honey, thus, the total resolution of the lesion was achieved.

Reporte de un caso con taponamiento cardíaco como forma de presentación de cáncer de pulmón / Report of a Case with Cardiac Tamponade as a Presentation of Lung Cancer

El taponamiento cardíaco es un evento grave que requiere un rápido diagnóstico y tratamiento, sus causas no siempre son evidentes, aunque, los procesos neoplásicos y en particular los de pulmón, deben tenerse siempre en cuenta. El objetivo de este trabajo fue ejemplificar que el taponamiento cardíaco puede ser la forma de manifestación de un cáncer de pulmón. Se presentó un paciente de 58 años de edad, fumador por 45 años, portador de un taponamiento cardíaco, con antecedentes de derrame pericárdico previo y anemia, con disnea de esfuerzo, acompañado de tos seca. Se realizó pericardiotomia, drenando 2 750 ml de líquido serohemático. El proceder quirúrgico confirmó el diagnóstico etiológico de adenocarcinoma mixto moderadamente diferenciado de pulmón bilateral difuso, con metástasis en pericardio visceral y parietal. Las neoplasias producen con frecuencia derrames hemorrágicos o serohemáticos y taponamiento cardíaco, frecuentemente recidivantes tras la pericardiocentesis, como sucedió en este paciente.

The cardiac tamponade is a serious event that requires a quickly diagnose and treatment. Its causes not always are evident, even though, neoplastic processes and in particular the ones related to lungs, should be taken into account. The objective of this work was to provide that the cardiac tamponade could be a way that a lung cancer be manifested. A fifty eight -year- old patient, with a history of smoking for 45 years with a cardiac tamponade, history of previous pericardial stroke, anaemia and hacking cough was presented in this article. A pericardiotomy was performed to drain 2750 millilitres of serohematic fluid. The surgical procedure confirmed the existence of a mixed moderately differentiated, lung adenocarcinoma, with metastasis in the parietal and visceral pericardium. The neoplasia produce frequently hemorrhagic and serohematic bleeding, as well as cardiac tamponade, frequently after pericardiocenthesis, as occurred with this patient.

Profile of patients with lung cancer assisted at the National Cancer Institute, according to their smoking status, from 2000 to 2007 / Perfil dos pacientes com câncer de pulmão atendidos no Instituto Nacional de Câncer, segundo condição tabagística, 2000 a 2007

INTRODUCTION: Tobacco use is directly related to the future incidence of lung cancer. In Brazil, a growing tendency in age-adjusted lung cancer mortality rates was observed in recent years. OBJECTIVE: To describe the profile of patients with lung cancer diagnosed and treated at the National Cancer Institute (INCA) in Rio de Janeiro, Brazil, between 2000 and 2007 according to their smoking status. METHODS: An observational study was conducted using INCA's database of cancer cases. To assess whether the observed differences among the categories of sociodemographic variables, characterization of the tumor, and assistance - pertaining to smokers and non-smokers - were statistically significant, a chi-square test was applied. A multiple correspondence analysis was carried out to identify the main characteristics of smokers and non-smokers. RESULTS: There was a prevalence of smokers (90.5% of 1131 patients included in the study). The first two dimensions of the multivariate analysis explained 72.8% of data variability. Four groups of patients were identified, namely smokers, non-smokers, small-cell tumors, and tumors in early stages. CONCLUSION: Smoking cessation must be stimulated in a disseminated manner in the population in order to avoid new cases of lung cancer. The Tumors in Initial Stages Group stood out with greater chances of cure. .

INTRODUÇÃO: O consumo de tabaco está diretamente relacionado à incidência futura de câncer de pulmão. No Brasil foi observada uma tendência de crescimento da taxa de mortalidade ajustada por idade, para esta enfermidade nos últimos anos. OBJETIVO: Descrever o perfil dos pacientes com câncer de pulmão diagnosticados e atendidos no Instituto Nacional de Câncer (INCA), no Rio de Janeiro, Brasil, entre 2000 e 2007 segundo condição tabagística. MÉTODOS: Foi realizado um estudo observacional, utilizando dados do Registro Hospitalar de Câncer do INCA. Para avaliar se as diferenças observadas entre as categorias das variáveis sociodemográficas, de caracterização do tumor e da assistência - para fumantes e não fumantes - são estatisticamente significativas, foi aplicado o teste qui-quadrado. A análise de correspondência múltipla foi utilizada para identificar as características predominantes dos fumantes e não fumantes. RESULTADOS: Foi observado um predomínio de pacientes fumantes (90,5% dos 1131 incluídos no estudo). As duas primeiras dimensões da análise de correspondência múltipla explicaram 72,8% da variabilidade dos dados. Quatro grupos de pacientes foram identificados: fumantes, não fumantes, tumores de pequenas células e tumores em estádios iniciais. CONCLUSÕES: O estímulo à cessação do tabagismo deve ser realizado de forma disseminada na população para que novos casos de câncer de pulmão sejam evitados. Destaca-se o Grupo Tumores em Estádios Iniciais, que tem maiores chances de cura. .

The protective effects of green tea drinking and garlic intake on lung cancer, in a low cancer risk area of Jiangsu province, China / 中华流行病学杂志

Objective To understand the relationship between green tea drinking and/or garlic consumption and lung cancer.Methods A population-based case-control study was conducted in Ganyu county,Jiangsu province.Epidemiological data including demography,lifestyle,environmental exposures and dietary habits were collected by face-to-face interviews using a standardized questionnaire.Unconditional logistic regression was used to estimate adjusted odds ratios (OR) and their 95％ confidence intervals (CI) in both univariate and multivariate analyses.Results Both green tea drinking and garlic consumption were inversely associated with lung cancer and the adjusted ORs were:0.78 (95％CI:0.65-0.95) for green tea,0.79 (95％ CI:0.66-0.95) for garlic intake,and 0.69 (95％CI:0.53-0.89) for both,respectively.They also modified the associations of smoking,fried food intake and cooking oil under high-temperature with lung cancer as risk factors.Potential interactions were found between garlic or green tea and the risk factors of lung cancer.Conclusion Both green tea drinking and garlic consumption might serve as protective factors on lung cancer.

Endocarditis trombótica no bacteriana como manifestación paraneoplásica de adenocarcinoma pulmonar / Non bacterial thrombotic endocarditis as paraneoplastic manifestation of adenocarcinoma of the lung

La Endocarditis trombótica no bacteriana se caracteriza por la presencia de vegetaciones no infectadas en válvulas de corazón izquierdo que producen émbolos a cerebro y otros órganos. Las neoplasias comúnmente asociadas con esta entidad son el adenocarcinoma de pulmón, otros adenocarcinomas, linfomas, leucemias, mieloma, carcinoma de páncreas, estómago, mama, colon y cérvix. Presentamos un caso de Endocarditis trombótica no bacteriana en válvulas aórtica y mitral con embolias cerebrales, esplénicas y renal como primera manifestación de un adenocarcinoma pulmonar.

Non bacterial thrombotic endocarditis is characterized by the presence of non infected vegetation in aortic or mitral valves associated with systemic arterial emboli. Non-bacterial thrombotic endocarditis is a common complication of neoplastic diseases: adenocarcinoma of the lung, another adenocarcinomas, myeloma, lymphoma, leukemia, carcinoma of the pancreas, breast, cervix, colon and stomach. We report a case of non-bacterial thrombotic endocarditis localized in the aortic and mitral valves and systemic emboli as the first manifestation of adenocarcinoma of the lung.