Search

Objective: to identify evidence in the literature about financial toxicity in cancer patients during chemotherapy treatment. Methods: this is a mini review with search in the following databases: Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Health Sciences Literature, National Library of Medicine and Scopus. Articles were surveyed from July 2018 to February 2019 using the following descriptors and Boolean operators: “financial toxicity” OR “financial difficulties” AND “cancer” AND “chemotherapy”. Results: the search totaled 64 articles. After exclusion of duplicates that did not meet the inclusion criteria, the final sample was composed of five articles published in 2013, 2015, 2017 and 2018. Financial difficulty caused by cancer treatment and its impact on quality of life was a frequent expression used in the studies. Conclusion: studies show that financial toxicity damages the quality of life of patients. A scarcity of studies on the subject was also observed, possibly because this is a new concept.

Patients with liver metastasis of colorectal cancer (CRC) experience important lifestyle changes that impair the quality of life (QoL). The use of instruments is important to assess the cancer patients' QoL. To develop a Brazilian translation of the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Colorectal Liver Metastases (QLQ-LMC21) questionnaire, and to investigate psychometric validity in patients with CRC with liver metastases, patients with liver metastasis from CRC answered the Brazilian versions of EORTC core Quality of Life Questionnaire-Core 30 (QLQ-C30) and the QLQ-LMC21 module, a demographic data questionnaire and a questionnaire to assess understanding against the translated QLQ-LMC21. Data collection was performed in three Southern hospitals in Brazil, from August 2017 to August 2019. Descriptive analyses and Spearman's correlation tests were performed for construct and criterion validity. The Cronbach's alpha test was performed to assess reliability. Significant values were

Objective: to evaluate the criterion validity and reliability of the Portuguese-Brazilian version of the Wound Quality of Life. Methods: methodological research with 100 participants. For criterion and reliability validation, the items in the Wound Quality of Life questionnaires were correlated with the Freiburg Life Quality Assessment Wound - Wound Version, using the Spearman correlation test and Cronbach’s alpha. Results: the validity of concurrent criteria had a strong magnitude (0.85) when correlated with the Freiburg Life Quality Assessment Wound; the internal consistency had a Cronbach’s alpha of 0.84. Conclusion: the validated questionnaire has good psychometric properties, is brief, easy to apply and reliable for assessing the quality of life of patients with wounds that are difficult to heal. Objetivo: avaliar a validade de critério e confiabilidade do Wound Quality of Life versão português-Brasil. Métodos: pesquisa metodológica com 100 participantes. Para a validação de critério e confiabilidade, foram correlacionados os itens dos questionários Wound Quality of Life com o Freiburg LifeQualityAssessment Wound – Versão Ferida, utilizando o teste de correlação de Spearman e o alfa de Cronbach. Resultados: a validade de critério concorrente teve forte magnitude (0,85) quando correlacionada com o Freiburg LifeQualityAssessment Wound; a consistência interna teve um alfa de Cronbach de 0,84. Conclusão: o questionário validado apresentou boas propriedades psicométricas, é breve, de fácil aplicação e confiável para avaliação da qualidade de vida de pacientes com feridas de difícil cicatrização.

Objetivo: avaliar os dominios que comprometem a qualidade de vida de pacientes com câncer avancado em tratamento quimioterapico paliativo e cuidado paliativo. Metodo: Trata-se de uma scoping review realizada de marco a maio de 2018, nas bases de dados CINAHL, LILACS, PubMed, Cuiden e na literatura cinzenta ( Google Scholar e referencias encontradas nos artigos analisados), utilizando os descritores “ palliative care ”,“ quality of life ”,“ emotionalcare ”, “ functional care ”,“sexual care”, “ physical care ”,“ social care ”,“ comfort care ”,“ spiritual care ”,“ palliative chemotherapy ” e “ cancer advanced ”. Foi realizada avaliacao da qualidade metodologica por meio do instrumento STROBE para estudos observacionais e o CONSORT para os ensaios clinicos. Resultados: Os nove artigos encontrados e analisados sao internacionais, publicados entre 2012 e 2016, com boa qualidade metodologica. Os dominios identificados foram os fisicos, sociais e emocionais; o internamento hospitalar e local de obito sao fatores que tambem comprometeram a qualidade de vida. Conclusao: os pacientes em quimioterapia paliativa possuem baixa qualidade de vida. Porem, a presenca de familiar e o acompanhamento concomitante com o servico de cuidados paliativos melhoram essa situacao. A avaliacao dos pacientes, com enfoque nestes dominios, permite a Enfermagem adotar estrategias para melhoraria da qualidade de vida.

Objetivou-se correlacionar as preocupações adicionais e o desempenho pessoal com a qualidade de vida geral/global dos pacientes adultos com câncer hematológico, hospitalizados para o transplante de células-tronco hematopoiéticas autólogo e alogênico.Estudo longitudinal, observacional e analítico, realizado em hospital público do sul do Brasil com 55 pacientes. A coleta de dados foi realizada entre setembro de 2013 e novembro de 2015. Foram utilizados os questionários sociodemográfico e clínico, Quality of Life Questionnarie Core-30 e o Functional Assessment of Câncer Therapy – Bone Marrow Transplant. Os dados foram avaliados com o auxílio do software Statística 7.0. A média de idade para o transplante autólogo foi de 45 anos, com predomínio do diagnóstico de mieloma múltiplo; para o alogênico foi de 31 anos com predomínio da leucemia. A qualidade de vida geral/global, o desempenho pessoal e as preocupações adicionais caracterizadas pela imagem corporal, fadiga, sexualidade e apetite apresentaram médias significativamente menores no período de pancitopenia em relação ao basal, com gradativa melhora no período pré-alta hospitalar. Conclui-se que o transplante é uma terapêutica com potencial papel de cura, no entanto, acarreta em impactos negativos nos domínios da qualidade de vida, desempenho pessoal, preocupações adicionais e na experiência de vida dos receptores.

The mechanisms underlying the pronociceptive effect of paradoxical sleep deprivation (PSD) are not known. In this study, we asked whether PSD increases tonic nociception in the formalin test, decreases the antinociceptive effect of morphine administered into the periaqueductal gray matter (PAG), and disrupts endogenous descending pain modulation. PSD for either 24 or 48 h significantly increased formalin-induced nociception and decreased mechanical nociceptive paw withdrawal threshold. The maximal antinociceptive effect induced by morphine (0.9-9 nmol, intra-PAG) was significantly decreased by PSD. The administration of a low dose of the GABAA receptor antagonist, bicuculline (30-300 pmol, intra-PAG), decreased nociception in control rats, but not in paradoxical-sleep-deprived ones. Furthermore, the administration of the cholecystokinin (CCK) 2 receptor antagonist, YM022 (0.5-2 pmol) in the rostral ventral medulla (RVM), decreased nociception in paradoxical-sleep-deprived rats but not in control ones. While a dose of the CCK 2 receptor agonist, CCK-8 (8-24 pmol intra-RVM), increased nociception in control rats, but not in paradoxical-sleep-deprived ones. In addition, the injection of lidocaine (QX-314, 2%, intra-RVM) decreased nociception in sleep-deprived rats, but not in control rats, while the lesion of the dorsolateral funiculus prevented the pronociceptive effect of PSD. Finally, PSD significantly increased c-Fos expression in the RVM. Therefore, PSD increases pain independently of its duration or of the characteristic of the nociceptive stimulus and decreases morphine analgesia at the PAG. PSD appears to increase pain by decreasing descending pain inhibitory activity and by increasing descending pain facilitatory activity.

As important as perceiving pain is the ability to modulate this perception in some contextual salient situations. The periaqueductal gray (PAG) is perhaps the most important site of endogenous pain modulation; however, little is known about dopaminergic mechanisms underlying PAG-mediated antinociception. In this study, we used a pharmacological approach to evaluate this subject. We found that µ-opioid receptor-induced antinociception (DAMGO, 0.3 μg) from PAG was blocked by the coadministration of either D1-like or D2-like dopaminergic antagonists (SCH23390, 2, 4, and 6 μg or raclopride, 2 and 4 μg, respectively) both in the tail-flick and in the mechanical paw-withdrawal test. A selective D2-like receptor agonist (piribedil, 6 and 12 μg into the PAG) induced antinociception in the mechanical paw-withdrawal test, but not in the tail-flick test. This effect was blocked by the coadministration of its selective antagonist (raclopride 4 μg), as well as by either a GABAA agonist (muscimol, 0.1 μg) or an opioid receptor antagonist (naloxone, 0.5 μg). A selective D1-like receptor agonist (SKF38393, 1, 5, and 10 μg into the PAG) induced a poor and transient antinociceptive effect, but when combined with piribedil, a potentiated antinociceptive effect emerged. None of these treatments affected locomotion in the open-field test. These findings suggest that µ-opioid antinociception from the PAG depends on dopamine acting on both D1-like and D2-like receptors. Selective activation of PAG D2-like receptors induces antinociception mediated by supraspinal mechanisms dependent on inhibition of GABAA and activation of opioid neurotransmission.