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1.
BMJ Support Palliat Care ; 13(3): 291-297, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34475134

RESUMO

Due to the heterogenous nature of the palliative medicine patient population, assessment of benefit, and thus choice of appropriate patient for consideration of transfusion, can be challenging. This can be confounded by the use of both liberal and restrictive transfusion thresholds. The multifactorial nature of many symptoms of anaemia, particularly in patients with advanced malignancy, can further complicate. As such, there is a paucity of data supporting the subjective, objective and clinical benefit of red cell transfusion in the palliative medicine setting. This narrative review summarises the research and evidence surrounding the benefits of red cell transfusion, with a particular emphasis on the oncological, haematological and palliative medicine population. There is a lack of a validated, reproducible patient-reported outcome measures (PROM) to assess response to red cell transfusions in the palliative medicine population with outcome measures varying from objective improvement in haemoglobin level post-transfusion, to subjective response in primary symptom(s). Further investigation is required regarding the development of effective PROMs assessing response to red cell transfusion in the palliative medicine population, to ensure judicious use of this scarce and valuable resource.


Assuntos
Anemia , Hematologia , Medicina Paliativa , Humanos , Transfusão de Eritrócitos , Anemia/terapia , Transfusão de Sangue
2.
Artigo em Inglês | MEDLINE | ID: mdl-33619222

RESUMO

BACKGROUND: We report a case of using 3D printing to create a bespoke eye cover for an 18-year-old man with left maxillary alveolar rhabdomyosarcoma. Further, the patient had proptosis causing chemosis and subsequent conjunctival abrasions. This had been managed by taping a large dressing around the eye for a number of weeks previously. METHODS: A 3D scanner was used to capture the surface topography of the patients face. The data were imported into a CAD package and used as a guide to create a bespoke eye cover. The final design was 3D printed in a biocompatible material for use by the patient. RESULTS: The scan, modelling, and printing of the bespoke cover was completed successfully in less than 72 hours. CONCLUSION: 3D printing offers a method to create bespoke solutions for patients in palliative care to meet rare and difficult clinical challenges.

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