Características y resultados de una serie de 59 pacientes con neumonía grave por COVID-19 ingresados en UCI / Characteristics and results of a series of 59 patients with severe pneumonia due to COVID-19 admitted in the ICU

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Complexity and uncertainty in the critical care of cancer patients in the era of immunotherapy and targeted therapies / Complejidad e incertidumbre en cuidados críticos para pacientes con cáncer en la era de la inmunoterapia y terapias dirigidas

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Intensive care in cancer patients in the age of immunotherapy and molecular therapies: Commitment of the SEOM-SEMICYUC / Cuidados intensivos en pacientes con cáncer en la era de la inmunoterapia y las terapias moleculares: el compromiso de la SEOM-SEMICYUC

Cancer patients are a vulnerable group exposed to numerous and serious risks beyond cancer itself. In recent years, the prognosis of these individuals has improved substantially thanks to several advances such as immunotherapy, targeted molecular therapies, surgical techniques, or developments in support treatment. This coincides with the prolonged survival of oncological patients admitted to the ICU due to critical complications, and under the supervision of intensivists. The time has therefore come to revisit the intensive care support of these patients, which poses new professional as well as organizational challenges. An agreement was signed in 2017 between the SEOM and SEMICYUC with the aim of improving the quality of care of cancer patients with critical complications. The initiative seeks to aid in decision-making, standardize criteria, decrease subjectivity, generate channels of communication, and delve deeper into the ethical and scientific aspects of these situations. This document sets forth the most important reasons that have led us to undertake this initiative

Los pacientes con cáncer constituyen un colectivo vulnerable expuesto a numerosos riesgos graves, más allá del cáncer en sí. En los últimos años, el pronóstico de estos individuos ha mejorado sustancialmente gracias a varios avances, como la inmunoterapia, las terapias moleculares específicas, las técnicas quirúrgicas o el desarrollo de los tratamientos de soporte. Esto se traduce en un aumento de la supervivencia de los pacientes oncológicos hospitalizados en la UCI y que son llevados por intensivistas. Por lo tanto, ha llegado el momento de revisar el apoyo de cuidados intensivos para estos pacientes, lo que plantea nuevos desafíos profesionales y de organización. En este marco, en 2017 se firmó un acuerdo entre la SEOM y la SEMICYUC con el objetivo de mejorar la calidad de la atención de pacientes oncológicos con complicaciones críticas. Esta iniciativa busca ayudar en la toma de decisiones, estandarizar criterios, disminuir la subjetividad, generar canales de comunicación y profundizar en los aspectos éticos y científicos de estas situaciones. Este documento establece las razones más importantes que nos han llevado a emprender esta iniciativa

Intensive care in cancer patients in the age of immunotherapy and molecular therapies: Commitment of the SEOM-SEMICYUC.

Cancer patients are a vulnerable group exposed to numerous and serious risks beyond cancer itself. In recent years, the prognosis of these individuals has improved substantially thanks to several advances such as immunotherapy, targeted molecular therapies, surgical techniques, or developments in support treatment. This coincides with the prolonged survival of oncological patients admitted to the ICU due to critical complications, and under the supervision of intensivists. The time has therefore come to revisit the intensive care support of these patients, which poses new professional as well as organizational challenges. An agreement was signed in 2017 between the SEOM and SEMICYUC with the aim of improving the quality of care of cancer patients with critical complications. The initiative seeks to aid in decision-making, standardize criteria, decrease subjectivity, generate channels of communication, and delve deeper into the ethical and scientific aspects of these situations. This document sets forth the most important reasons that have led us to undertake this initiative.

Prevalencia de EPOC entre la población fumadora de Colloto (Asturias) / Prevalence of COPD among the smoker population of Colloto (Asturias)

Objetivos. Conocer la prevalencia total y no conocida de EPOC en la población fumadora y ex-fumadora de 40 a 75 años en el área urbano-rural de Colloto, Asturias, y las diferencias según las distintas variables sociodemográficas. Pacientes y método. Estudio descriptivo transversal sobre 364 fumadores y ex-fumadores de ambos sexos de 40 a 75 años que acudían al consultorio de Colloto. Se realizó una historia clínica del hábito y examen físico detallados, y un estudio espirométrico completo para el diagnóstico y estadiaje. Resultados. La prevalencia de EPOC fue del 15,1% (IC 95% 11,7-19,4), sin diferencias entre sexos. Los factores asociados fueron la edad (pasando del 8,1 al 24,8% del primer al tercer terciles de edad) y el índice tabáquico (pasando del 8,4 al 24,8% del primer al tercer terciles del mismo), y como factor protector el índice de masa corporal. El hábito actual de consumo de tabaco no presentaba diferencias. El 48% de los diagnosticados por espirometría fueron nuevos diagnósticos. De los diagnosticados previamente de EPOC, en el 52% no se confirma el diagnóstico en la espirometría. El 14,8% de los EPOC se clasificaron como grave o muy grave. Conclusiones. La prevalencia obtenida es similar a la de otros estudios, siendo la mitad de los casos desconocidos. Deben estudiarse espirométricamente de rutina todos los fumadores, al menos desde 15 paquetesaño a partir de los 40 años, y en todos los pacientes que hayan sido fumadores a partir de los 65 años (AU)

Objectives. To know the total and unknown prevalence of COPD in the smoker and ex-smoker population of 40 to 75 years in the urban -rural area of Colloto, Asturias, and the differences according to the different sociodemographic variables. Patients and method. A descriptive cross-sectional study on 364 smokers and ex-smokers of both genders, 40 to 75 years old, who came to the medical facility of Colloto. A detailed clinical history on the habit and physical examination was obtained, as well as a complete spirometric study for the diagnosis and staging. Results. COPD prevalence was 15.1% (95% CI 11.7- 19.4), without differences between genders. Associated factors were age (going from 8.1 to 24.8% from its first to third terciles of age) and the smoking habit index (going from 8.4 to 24.8% from its first to the third terciles) and as protective factor, the body mass index. The current smoking consumption habit showed no differences. A total of 48% of those diagnosed by spirometry were new diagnoses. Of those previously diagnosed of COPD, the diagnosis was not confirmed in the spirometry in 52% and 14.8% of the COPD were classified as severe or very severe. Conclusions. The prevalence obtained is similar to that of other studies, half of the cases being unknown. All smokers should undergo routine spirometric studies, at least those smoking from 15 packs a year after the age of 40 and in all of those patients who have been smokers after the age of 65 (AU)