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Resumen Antecedentes La disnea constituye una de las principales causas de perdida de funcionalidad en el paciente con cancer. Las medidas farmacologicas consiguen una reduccion del sintoma, pero sin generalizar esa mejora a la funcionalidad. Proponemos la inclusion de un programa de rehabilitacion integral funcional. El objetivo del estudio fue comprobar la eficacia del programa en la mejora tanto de los niveles de autonomia como de disnea en pacientes con cancer. Metodos Estudio experimental, prospectivo, longitudinal, aleatorizado mediante un esquema paralelo de asignacion fija con grupo experimental y grupo control. El grupo de intervencion, ademas del tratamiento clinico convencional realizado en el grupo control, recibio el Programa de Rehabilitacion Funcional. Los resultados principales a medir fueron la funcionalidad (Barthel), los niveles de disnea (MRC) y la CVRS (Euro-QOL). Enmascaramiento con simple ciego, pero analisis estadistico realizado por personal ajeno al estudio. Resultados Muestra final de 113 individuos, 52 en el grupo control y 61 en el experimental, procedentes de la Unidad de Oncologia del Complejo Hospitalario Universitario de Salamanca. A nivel descriptivo buen balanceo entre grupos en edad, genero y diagnostico. Diferencias estadisticamente significativas entre los miembros de ambos grupos en los niveles de funcionalidad (p = 0,000), en los niveles de disnea (p = 0,001) y en los los sub-items pertenecientes al cuestionario Euro-QOL, salvo en el sub-item relacionado con el dolor (p = 0,311). No se observan efectos adversos importantes o efectos secundarios. Conclusiones Las intervenciones no farmacologicas de un programa de rehabilitacion integral funcional mejoran los niveles de funcionalidad y de disnea de los pacientes oncologicos.

Background: Of the many side effects suffered by cancer patients, those related to cognitive performance have become increasingly prominent in clinical practice. We know that chemotherapy generates a series of side effects, such as nausea and vomiting, alopecia, and so on, which can be counteracted by complementary medication. However, in the case of post-chemotherapy cognitive impairment, or chemo brain, these cannot be controlled with drug therapies. However, before any intervention can be considered, it is necessary to know exactly what cognitive impairment is being triggered. For this reason, we decided to study the cognitive status of breast cancer patients. Methods: analytical, prospective, three-measure longitudinal, intrasubject unifactorial, non-probabilistic and accidental assignment study. The sample came from the Medical Oncology Department at Hospital de Salamanca, in Spain. Cognitive function (Trail Making Test and Stroop Test) was established as the primary variable; the presence of sleep disorders (Insomnia Severity Index, ISI) and anaemia (haemoglobin levels in blood) were analysed as secondary variables, in addition to sociodemographic variables (age, stage, type of carcinoma, radiotherapy, menopause, social support network, marital status, years of schooling and employment status). Results: We recruited 151 individuals according to the selection criteria. We can confirm that factors including anaemia, menopause, patient support network and marital status, years of schooling, and employment status did affect the cognitive performance of the patients in active chemotherapy treatment in the study. In contrast, sleep disorders, age, radiotherapy treatment, stage of disease, and type of carcinoma did not affect the cognitive performance of the cancer patients. Conclusions: Chemotherapy does impact the cognitive performance of breast cancer patients.

Old age represents a social group that is undergoing continuous expansion. The aging population will be prone to chronic diseases and falls, which is a marker of frailty and a public health problem. This study aims to examine the relationship between living conditions and the prevalence of the risk of falls in older adults within the community. As an observational cross-sectional study, intentional sampling was carried out on residents of the metropolitan area over 75 years of age. The socio-demographic data of the subjects and their history of falls were collected. Additionally, the subjects were evaluated on the risk of falling, basic activities of daily living, such as walking and balance, fragility, and their fear of falling. The statistical analyses used were based on the Shapiro–Wilk test for normality, statistics of central tendency with description, mean (M) and dispersion, standard deviation (SD), bivariate contingency tables for studying the relationships between the variables, and the analysis of Pearson’s relational statistics (χ2). The comparisons of means were resolved by parametric or non-parametric routes. We obtained the following results: 1. The socio-demographic profile of our sample consisted of adults over 75 years of age, the majority of whom were overweight or obese women living in an urban area, specifically in an apartment, and receiving care; 2. Older people in the studied community had mild dependency and frailty, and were also at severe risk of falls; 3. The prevalence of falls was higher in women than in men in this study. Through these results, we confirmed the relationship between living conditions and the prevalence of risk of falls in older adults within the community.

Background: Dyspnea is one of the leading causes of loss of autonomy among patients with advanced cancer. The management of these symptoms relies exclusively on pharmacological measures.Aims: To as...

© The Author(s)., [Background]: The increase in the survival of oncology patients include multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. An implementation of the conventional clinical practice, developed through multimodal physical exercise and functional rehabilitation program intervention, may be useful in controlling dyspnoea. This study aims to evaluate the effects of a multimodal exercise and functional rehabilitation program on fatigue, pain, functional capacity, and quality of life in cancer patients with cancer-related asthenia. [Methods]: This is a protocol for an experimental, prospective, randomised study using a parallel, fixed assignment scheme, with an experimental group and a control group in patients from the oncology hospitalisation unit at the Salamanca University Hospital Complex in Spain, using consecutive sampling to select 50 participants with oncological asthenia who are hospitalised at the time of inclusion. After the baseline evaluation, the participants will be randomised into two groups. Both groups will receive standard clinical practice care and the normal health education program at discharge, but in addition, the participants assigned to the experimental group will also complete a multimodal exercise and functional rehabilitation program lasting one month. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of asthenia (FACT-An scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the attention and executive functions (Trail-Making Test), fear/avoidance of movement (TAMPA scale), pain (VAS scale), and body composition (waist, hip, brachial, thigh, wrist, and ankle circumferences). [Discussion]: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with asthenia. The current study addresses to improve the conventional clinical practice by proposing a multimodal physical exercise and functional rehabilitation program intervention, which will be implemented by an interdisciplinary team, to try to improve the autonomy of cancer patients with cancer-related asthenia., This study was funded by the Regional Health Management of Castile and León, Spain, with project file number 2181/A/2020, and has undergone peer-review by the funding body.

© The Author(s)., [Background]: Survival in cancer patients has increased exponentially in recent years, with multiple side effects caused by treatments. Cancer-related asthenia and dyspnea are among them, which represent a serious health problem, with considerable limitations and reduced quality of life. An implementation of the conventional clinical practice, developed through physical exercise, may be useful in controlling dyspnoea. This study aims to compare the effects of a comprehensive rehabilitation implementing a programme of multimodal physical exercise with a specific autonomy recovery programme, versus an isolated intervention using the physical exercise programme alone, on the functionality, physical performance and respiratory parameters in oncologycal patients with dyspnea. [Methods]: This is a protocol por an experimental, prospective, randomized, parallel-controlled clinical trial, with two arms design of fixed assignment with an experimental and control groups. It will conduct in the Oncology Hospitalisation Unit at the University Hospital Complex of Salamanca, using consecutive sampling to select 50 participants with oncological dyspnoea who are hospitalised at the time of inclusion. After baseline assessment, participants will be randomised into the groups. Experimental group will complete Comprehensive Rehabilitation with the autonomy recovery and the multimodal exercise programmes, and in the control group, only the multimodal exercise programme will be carried out. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of dyspnoea (MRC scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the oxygen saturation in the blood using pulse oximetry, fear/avoidance of movement with the Tampa Scale of Kinesiophobia (TSK), and the quality of life of the oncology patient (ECOG performance scale). [Discussion]: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with dyspnoea. Increase in the survival of patients with cancer includes multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. The current study addresses to improve the conventional clinical practice by proposing an integral, rehabilitative approach, to implement education and training for oncology patients with dyspnea to increase their quality of life.

Background: Oncology patients experience a large number of symptoms and, those referring to cognitive performance has an ever-increasing importance in clinical practice, due to the increase in survival rates and interest in the patient&rsquo, s quality of life. The studies reviewed showed that chemotherapy-related cognitive impairment might occur in 15 and 50% of oncology patients. The main objective of this research was to study the impact of chemotherapy on the cognitive function of patients with locoregional breast cancer. Method: Analytical, prospective, longitudinal study using three measures, unifactorial intrasubject design, non-probability, and random selection sampling. The sample comprised women newly diagnosed with locoregional breast cancer in stages I, II, IIIA who received chemotherapy at the University Hospital of Salamanca (Complejo Asistencial Universitario de Salamanca), randomly selected for three years. Semi-structured interviews were conducted, and anxiety and depression (Hospital Anxiety and Depression scale, HAD), quality of life (QLQ-BR23 scale) and the following cognitive variables were assessed&mdash, processing speed, attention, memory, and executive functions (subtests of the Wechsler Intelligence Scale and the Trail Making Test). Results: The final sample size included 151 participants, 23 were excluded. A decline in cognitive performance was observed in patients, which did not completely recover two months after chemotherapy was completed. Additionally, worse cognitive performance was observed in patients with anxious or depressive symptoms. There was a negative impact on the quality of life. Conclusion: Chemotherapy had an impact on the cognitive performance of oncology patients in most cognitive domains studied.

Background Dyspnoea is one of leading causes of loss of autonomy in patients with advanced-stage cancer. Pharmacological measures achieve a reduction of the symptom, but without generalizing this improvement to functionality. We propose the inclusion of a comprehensive functional rehabilitation programme. The purpose is to test the efficacy of an integral respiratory rehabilitation programme to improve autonomy levels and relieve cancer-related dyspnoea. Methods Experimental design, prospective, longitudinal, randomized study based on a parallel fixed allocation scheme using an experimental group and a control group. The intervention group participated in comprehensive functional rehabilitation, while the control group only received standard drug treatment. Single blind masking, but statistical analysis was performed by non-study personnel. Results Final sample of 113 individuals, 52 in the control group and 61 in the experimental group, from the Oncology Unit of the University Hospital Complex of Salamanca. Statistically significant differences (are observed) between the members of both groups in the levels of functionality (p = .000), in the levels of dyspnoea (p = .001) and in the sub-items of the Euro-QOL questionnaire, except in the sub-item related to pain (p = .311). No major adverse effects or side effects are observed. Conclusion Non-pharmacological interventions using a comprehensive functional rehabilitation programme improve functionality and relieve dyspnoea in cancer patients.

Resumen Fundamento y objetivo La astenia debida a la enfermedad oncologica es un fenomeno multifactorial, tratado habitualmente mediante farmacos. Estos tratamientos suelen controlar el sintoma, pero no consiguen mejorar la funcionalidad de los pacientes. En algunos pacientes pueden inducir o incluso aumentar los niveles de astenia. El objetivo principal de nuestro estudio ha sido comprobar la eficacia de un programa de rehabilitacion integral funcional en el control de la astenia relacionada con la enfermedad oncologica. Pacientes y metodos Este es un estudio experimental, prospectivo, longitudinal, aleatorizado mediante un esquema paralelo de asignacion fija con grupo experimental y grupo control, realizado con 192 pacientes del Servicio de Oncologia del Hospital Universitario de Salamanca. El grupo de intervencion, ademas de recibir tratamiento farmacologico, participo en un programa de rehabilitacion integral funcional. El grupo control solo recibio el tratamiento farmacologico habitual. Los resultados principales medidos fueron los niveles de astenia y la realizacion de actividades de la vida diaria mediante el cuestionario Perform y la escala triple EVA. Resultados Los pacientes del grupo experimental obtuvieron despues de la intervencion una importante disminucion en los niveles de astenia evaluada con el cuestionario PERFORM (puntuacion inicial del grupo experimental: 19,19; puntuacion inicial del grupo control: 20,98. Puntuacion final del grupo experimental: 36,12; puntuacion final del grupo control: 22,48). Estos resultados son estadisticamente significativos con respecto a los obtenidos por el grupo control (p Conclusiones Las intervenciones no farmacologicas de un programa de rehabilitacion integral funcional mejoran los niveles de astenia debida a la enfermedad oncologica: esto supone un incremento importante de sus actividades de la vida diaria.

Resumen Justificación: La revisión de la literatura pone de manifiesto el impacto negativo que la astenia tumoral tiene sobre la calidad de vida y recomienda utilizar además del tratamiento farmacológico para controlar el síntoma, otras terapias centradas en aumentar la autonomía. Nuestro objetivo ha sido comprobar la eficacia del “Programa de entrenamiento en la realización de las actividades de la vida diaria”, en la mejora de la Calidad de Vida Relacionada con la Salud (CVRS) de los pacientes oncológicos con astenia. Metodología: Estudio experimental, prospectivo, longitudinal, aleatorizado mediante un esquema paralelo de asignación fija con grupo experimental y grupo control. El instrumento de evaluación para medir la variable dependiente fue el cuestionario SF-12 v2. El estudio se realizó con 180 sujetos reclutados entre diciembre de 2013 y septiembre de 2015. Resultados: Después de la intervención encontramos diferencias estadísticamente significativas (p< 0,01) en todos los ítems de calidad de vida en los pacientes incluidos en el grupo experimental, exceptuando el ítem “dolor corporal” (p> 0,05). Sin embargo no hemos encontrado relación entre la edad y la mejora de la calidad de vida. Conclusiones: La utilización sistemática y controlada del “Programa de entrenamiento en la realización de las actividades de la vida diaria” mejora todos los niveles de CVRS de los pacientes oncológicos por lo que después de estos resultados nuestro último objetivo será la implementación de este programa y su utilización en nuestra práctica clínica diaria. Abstract Background: The review of the literature show a negative impact of the fatigue on quality of life and recommend, in addition of the use of traditional drug treatment to control symptoms, other therapies focused into improve the autonomy. Our aim is to test the efficacy of improving the levels of quality of life related to health (HRQOL) of cancer patients using a” daily activity training program” to control fatigue reported by the oncological disease. Methods/design: experimental, prospective, longitudinal and randomized study using a parallel fixed allocation scheme with experimental and control group. We used the SF-12 v2 questionnaire to measure HRQL. The study was conducted in 180 subjects recruited between December 2013 and September 2015. Results: We found statistically significant differences after intervention (p < 0.001) in all items related to quality of life in the experimental group patients, except for the item “bodily pain”(p> 0, 05). However, we found no relationship between age and improving of the quality of life. In summary systematic and controlled use of our “daily activity training program” improve all levels of quality of life related to health (HRQOL) of cancer patients. Therefore after these results our ultimate goal will be the implementation of this program and its use in our daily practice.

Objetivo: Determinar la influencia de la alteración del sabor y olor de los alimentos, secundaria al tratamiento antineoplásico, sobre la malnutrición, una de las complicaciones más comunes del enfermo oncológico. Metodología: Mediante una entrevista y el método de Valoración Subjetiva Global Generada por el Paciente (VSG-GP), se determinó la sintomatología y estado nutricional de 62 pacientes en tratamiento quimioterápico en el Hospital Universitario de Salamanca. Resultados: La desnutrición es frecuente (67,8%), y está relacionada con la pérdida de apetito y disminución de ingesta. Estos factores están en cierta medida influenciados por la distorsión gustativa, la cual es frecuente (62,9%). Los resultados muestran que determinados hábitos higiénico-dietéticos podrían prevenir el desarrollo de distorsiones sensoriales. Conclusión: Las aversiones alimentarias debidas a alteraciones del gusto parecen actuar indirectamente sobre el estado de desnutrición del paciente oncológico al ocasionar pérdida de apetito y disminución de ingesta. Objective: To determine the influence of taste and smell disorders, a side effect of antineoplastic treatments, on nutrition of oncologic patients, amongst whom malnutrition is one of the most common complications. Methods: 62 patients from University Hospital of Salamanca, receiving treatment with chemotherapy, were included in our study. To investigate the nutritional state and secondary symptoms of the therapy, we did an interview and used the Patient-Generated Subjective Global Assessment (PG-SGA) method. Results: Malnutrition is frequent (67.8%), and is related to the loss of appetite and reduced intake. These are observed to be influenced by taste disorder, which is also frequent among patients (62.9%). The results show that hygiene-dietetic habits could prevent the development of sensorial disorders. Conclusions: Food aversions due to taste disorders seem to indirectly affect the malnutrition status of oncologic patients by causing loss of appetite and reduced intake.