Furosemida nebulizada como tratamiento en urgencias de la disnea en pacientes con cáncer terminal / Nebulized furosemide to treat breathlessness in emergency patients with advanced cancer

Tres pacientes con cáncer avanzado y crisis de disnea por diferentes causas fueron tratados con furosemida nebulizada en un servicio de urgencias hospitalario. Cuarenta miligramos de furosemida fueron nebulizados e inhalados en una sola administración. La disnea mejoró de forma importante en los dos pacientes con una funcionalidad del 50% o más medida con el Palliative Performance Status (PPS), que controló el episodio. No fue así en el tercer paciente con disnea en fase final de la vida. No se observaron efectos adversos en ninguno de los casos. La inhalación de furosemida nebulizada parece ser efectiva en el tratamiento de la disnea en pacientes con cáncer terminal y un PPS igual o mayor al 50%, pero esta observación requiere ser confirmada con estudios randomizados controlados (AU)

Three patients with advanced cancer and acute dyspnea for different reasons were treated with furosemide spray in a hospital emergency department. A single dose of 40 mg of nebulized furosemide was sprayed and inhaled in a single dose. Breathlessness improved significantly, bringing the episode under control, in patients with at least 50% of function according to the Palliative Performance Status (PPS) scale. However, furosemide did not improve the condition of apatient with end-stage dyspnea. No adverse effects were observed. Inhaling nebulized furosemide seems to be an effective treatment for breathlessness in patients with terminal cancer and a 50% PPS function assessment, although randomized controlled trials are needed to confirm this hypothesis (AU)

Application of biochemical and X-ray diffraction analyses to establish the postmortem interval.

The determination of the date of death from bone remains is of scientific interest but also has important legal implications. The establishment of the postmortem interval (PMI) is a very complex problem because of the great number of intrinsic factors that may alter the normal course of postmortem change, such as the age, sex, constitution and previous physiological and pathological states of the subject, and external factors. In order to evaluate the utility of X-ray diffraction and the measurement of some components in dating bone remains, a total of 69 long bones from 69 different cadavers (41 males, 28 females) with a mean age of 68 years (S.D.=17.6, range 12-97) were used. The bones were removed from cement tombs of Murcia Cemetery, where they had lain for documented times of between 7 and 54 years (S.D.=11.6, mean time 17.6 years). We have studied potassium, sulphur, nitrogen, urea, total protein, phosphorus, and some X-ray diffraction (XRD) parameters related to the degree of crystallinity of the mineral component in medullar and cortical bone zones to establish which of the two provides the most useful information for calculating the PMI. In the overall analysis of our data, we believe that the use of both XRD and biochemical analyses (especially of urea, potassium and sulphur) particularly in the cortical zone of the bone could be an alternative method for dating osseous remains.