Título del artículo:

Sedación paliativa en cuidado domiciliario

Introduction: The palliative sedation at home is a management alternative in the control of refractory symptoms of people in end-of-life, reducing the suffering of the sick person and his/her family. Materials and methods: It’s a quantitative, descriptive, number of cases study, based on the review of clinical records of patients who received subcutaneous palliative sedation treatment as part of end-of-life care in a Palliative care home program in Bucaramanga, Colombia. It’s shown absolute and relative frequencies for qualitative variables, and measures of central tendency for quantitative variables. Results: Most patients presented dyspnea as only refractory symptom at the end-of-life, a combination of morphine and midazolam was used in most cases, and the average duration from the onset of sedation to death was 1.72 days. Discussion: Unlike other studies, the proportion of patients with oncological and non-oncological diseases was equivalent, the dyspnea continues to be the main at end-of-life, patient death occurred in less than 48 hours, which ratifies the indication for palliative sedation.

Acerca de la revista donde se publicó este artículo:

Medicina Paliativa

Título del artículo:

Delphi Consensus on the Use of Fenofibrate as Systemic Therapy for the Prevention of Diabetic Retinopathy Progression

Background: Diabetic retinopathy remains a leading cause of preventable blindness worldwide, yet screening and management practices vary widely. Evidence suggests that systemic therapies, including fenofibrate, may slow diabetic retinopathy progression, but their use is inconsistent across clinical settings. This study aimed to establish an evidence-informed consensus among endocrinology experts on the screening, diagnosis, and treatment of diabetic retinopathy, with a particular focus on recommendations for the use of systemic therapy to prevent disease progression. Methods: A modified three-round Delphi process was conducted with 19 endocrinology experts from diverse geographic regions. A core panel of 10 experts and an extended panel of 9 reviewed and rated 19 evidence-based statements. Consensus was defined as > 75% agreement. Results: All 19 statements achieved consensus, with 14 receiving > 80% agreement. The panel endorsed frequent diabetic retinopathy screening based on diabetes type and risk level, early initiation of fenofibrate in patients with mild to moderate non-proliferative diabetic retinopathy, and continued therapy to sustain retinal protection. Fenofibrate was recognized for its pleiotropic effects, and the experts agreed that the transient rise in serum creatinine with fenofibrate is not indicative of renal damage and should not prompt discontinuation. Conclusions: This consensus highlights the need for multidisciplinary care, coordinated pathways, and patient education in diabetic retinopathy care. It also offers unified, evidence-informed recommendations for endocrinologists for the early initiation of fenofibrate to reduce diabetic retinopathy progression. While further studies are needed, these findings offer a practical framework for improving diabetic retinopathy management globally.

Acerca de la revista donde se publicó este artículo:

Journal of Diabetes

Título del artículo:

Advancing Cardiac Rehabilitation in Latin America: INSIGHTS FROM A BIBLIOMETRIC REVIEW

Purpose: – This study, based on a bibliometric analysis in the field of cardiac rehabilitation in Latin America, aims to (1) describe the number of publications per year, journal, country affiliation, and contributing authors; (2) identify collaborative networks; and (3) determine emerging research trends. Review Methods: – A defined search strategy was implemented in Scopus for documents indexed up to September 2023. The retrieved records were analyzed using VantagePoint software (Search Technology, 15.2) to extract activity indicators (publication frequency, countries, institutions, and authors), relationship indicators (coauthorship among countries and authors), and research trends through author-included keywords in each article. Summary: – A total of 124 records were selected. The highest publication frequency was observed between 2019 and 2023, with Brazil and Canada leading in publication counts. Regarding international collaboration, studies were frequently coauthored by institutions in Brazil, Canada, Colombia, and the United States. Most records associated cardiovascular rehabilitation with cardiovascular diseases (coronary disease), exercise, and questionnaires. This investigation offers insights that are instrumental in shaping the trajectory of future studies by analyzing publication patterns and identifying potential collaborative partners in the region. Through a detailed examination of bibliometric data, it sets a foundation for advancing research agendas and fostering partnerships in cardiac rehabilitation within Latin America.

Acerca de la revista donde se publicó este artículo:

Journal of Cardiopulmonary Rehabilitation and Prevention

Título del artículo:

Recognising the family physician in asthma and COPD guidelines: a necessary step for effective primary care implementation

Asthma and chronic obstructive pulmonary disease (COPD) are the most prevalent chronic respiratory conditions globally, with management predominantly occurring in primary care settings. International guidelines from the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) have been instrumental in standardising care; however, these documents consistently use generic terminology such as “primary care physician” or “healthcare provider” without explicitly recognising the family physician as a distinct medical specialty. This omission creates a conceptual gap that may undermine guideline ownership, implementation fidelity, and coordinated care pathways—particularly in low- and middle-income countries where family physicians constitute the backbone of chronic respiratory disease management. This letter argues that explicit recognition of family physicians in future GINA and GOLD updates, alongside inclusion of family medicine representatives in guideline development committees and creation of implementation toolkits for primary care settings, would strengthen guideline relevance, enhance primary care engagement, and ultimately improve respiratory health outcomes worldwide.

Acerca de la revista donde se publicó este artículo:

Npj Primary Care Respiratory Medicine