Drenaje peritoneal permanente en paciente con mesotelioma metástasico: ganancia en calidad de vida en paciente oncológica

We present the case of a 63-year-old female patient diagnosed with stage IV epithelial mesothelioma. During the progressive evolution of his illness, frequent evacuation paracentesis was required with regular visits to the Emergency Department. Given the situation, in September 2016, the Radiology and Pneumology Service of the PleurX® catheter was placed in the peritoneal cavity, at the level of the right iliac fossa. The patient presented good tolerance, without needing more paracentesis in the emergency room, and with great benefit in their quality of life.Presentamos el caso de una paciente, mujer de 63 años diagnosticada de mesotelioma epiteliode estadío IV. Durante la evolución progresiva de su enfermedad, fue precisando paracentesis evacuadoras frecuentes con correspondientes visitas habituales al servicio de Urgencias. Dada la situación, en Septiembre de 2016 se procedió a colocación por parte del Servicio de Radiología y Neumología de catéter PleurX® en cavidad peritoneal, a nivel de fosa ilíaca derecha. La paciente presentó buena tolerancia, sin necesidad de más paracentesis en urgencias, y con gran beneficio en su calidad de vida

Demographic, clinical, and functional determinants of antithrombotic treatment in patients with nonvalvular atrial fibrillation

Altres ajuts: Alliance Bristol-Myers Squibb/Pfizer.Background: This study assessed the sociodemographic, functional, and clinical determinants of antithrombotic treatment in patients with nonvalvular atrial fibrillation (NVAF) attended in the internal medicine setting. Methods: A multicenter, cross-sectional study was conducted in NVAF patients who attended internal medicine departments for either a routine visit (outpatients) or hospitalization (inpatients). Results: A total of 961 patients were evaluated. Their antithrombotic management included: no treatment (4.7%), vitamin K antagonists (VKAs) (59.6%), direct oral anticoagulants (DOACs) (21.6%), antiplatelets (6.6%), and antiplatelets plus anticoagulants (7.5%). Permanent NVAF and congestive heart failure were associated with preferential use of oral anticoagulation over antiplatelets, while intermediate-to high-mortality risk according to the PROFUND index was associated with a higher likelihood of using antiplatelet therapy instead of oral anticoagulation. Longer disease duration and institutionalization were identified as determinants of VKA use over DOACs. Female gender, higher education, and having suffered a stroke determined a preferential use of DOACs. Conclusions: This real-world study showed that most elderly NVAF patients received oral anticoagulation, mainly VKAs, while DOACs remained underused. Antiplatelets were still offered to a proportion of patients. Longer duration of NVAF and institutionalization were identified as determinants of VKA use over DOACs. A poor prognosis according to the PROFUND index was identified as a factor preventing the use of oral anticoagulation