Hidratación por vía subcutánea en pacientes con cáncer avanzado / No disponible

Introducción: La vía subcutánea se emplea con frecuencia en enfermosde cáncer avanzado o ancianos para administrar medicación por víaparenteral. Sin embargo, la hidratación por vía subcutánea es excepcionalen nuestro medio aunque ya se está utilizando en algunos centros. Pretendemosconocer si es factible administrar hidratación subcutánea enenfermos oncológicos, las características de la técnica y las difi cultadesque se pueden presentar en su aplicación.Pacientes, material y métodos: Se incluyeron pacientes oncológicos concáncer avanzado con deshidratación o riesgo de padecerla de la Unidadde Medicina Paliativa del Hospital Grey Nuns, Edmonton (Canadá) y delHospital Universitario de Valladolid que recibieron hidratación subcutáneacon volumen y ritmo de infusión adaptados a cada enfermo.Resultados: Se realizaron 101 punciones en 33 pacientes (Edmonton24; Valladolid 9), con un total de 314 días de infusión. El volumen fue1.000 cc/día durante una mediana de 10 días (1 a 21 días) y un ritmode 20 a 400 cc/hora. El punto de infusión se cambió cada tres días (1a 15 días), principalmente por acumulación en zona de punción. Solodos enfermos precisaron asociar hialuronidasa a la solución utilizadapor absorción defi ciente. Hubo diferencias entre Hospitales en las característicasde los pacientes (peor pronóstico: grupo español) y tipo deinfusión (mayor volumen y duración: grupo canadiense). La incidenciade complicaciones fue similar similares en ambos grupos y en generalde carácter leve.Conclusión: La vía subcutánea para la hidratación de pacientesoncológicos terminal es sencilla y parece exenta de complicacionesimportantes(AU)

Introduction: Subcutaneous infusion allows the administration of parenteraltreatments. However, subcutaneous hydration is exceptional in ourenvironment. We developed this trial in order to assess the feasibilityof such hydration in cancer patients, the procedures and potentialcomplications.Patients, material and methods: We included dehydrated terminally illcancer patients and patients at risk of developing dehydration from thePalliative Care Unit of The Grey Nuns Hospital, Edmonton (Canada)and Hospital Universitario de Valladolid (Spain). They received subcutaneoushydration; the volume and rhythm of infusion were adaptedto each patient.Results: We performed 101 clyses in 33 patients (Edmonton 24; Valladolid9), with a total of 314 days of infusion. Volume infused was1,000 cc/day over a median of three days (1 to 21 days) and a rhythmof 20 cc/hour. Clyses were changed every three days (1 to 15 days),mainly because of fl uid retention in the puncture area. Two patientsrequired hyaluronidase. There were differences between Hospitals incharacteristics of patients (worse prognosis in the Spanish group) andconditions of infusion (higher volume and duration in Canadians). Theincidence of complications was low, being similar in both groups.Conclusions: Subcutaneous hydration of terminally ill cancer patients iseasy and seems to be free of severe complications(AU)

Heart metastases and superior vena cava syndrome.

Superior vena cava syndrome (SVCS) may be due to a tumour infiltrating the right atrium. We present two patients with SVCS. The first one was secondary to solitary atrial metastases of rectal adenocarcinoma and benefited from palliative chemotherapy. The second patient had a disseminated large cell B-cell lymphoma with rapid clinical complete response, but she eventually died after relapse.

Heart metastases and superior vena cava síndrome

Superior vena cava syndrome (SVCS) may be due to a tumour infiltrating the right atrium. We present two patients with SVCS. The first one was secondary to solitary atrial metastases of rectal adenocarcinoma and benefited from palliative chemotherapy. The second patient had a disseminated large cell B-cell lymphoma with rapid clinical complete response, but she eventually died after relapse (AU)

Diagnóstico simultáneo de adenocarcinoma y GIST gástricos / Synchronus diagnosis of gastric adeconocarcinoma and GIST

No disponible

[The follow-up of the cancer patient: how and when?]. / Seguimiento del paciente oncológico: cómo y cuándo?

The medical resources devoted to cancer patient follow-up are growing. However, intensive follow-up is not translated to any significant improvement survival in a majority of patients. A few neoplasias have an effective salvage therapy, and are worth having strict follow-up to diagnose earlier the recurrence. In many tumours, as breast cancer, an early diagnosis of recurrence does not imply an improvement on survival. Tumoral markers are able to detect the presence of tumour cells even before being clinically apparent and are routinely used in the follow-up of tumours; however, they do not seem to improve survival. The cost-benefit relation of multiple revision in cancer patients apparently cured is debated. No general consensus is achieved to define the best tests to follow-up cancer patients. The trend is to minimize the diagnostic tests and to recommend a clinical follow-up with anamnesis and physical exploration.