Symptom clusters among the patients with carcinoma lung attending palliative care department: a retrospective analysis

Background: There is growing interest in the symptom cluster of these symptoms rather than single symptoms and has been commonly termed as respiratory distress cluster. So, we conducted this audit review with a goal to explore the prevalence of RDS among lung cancer patients and to find association between RDS and the histological type of lung cancer.Methods: A retrospective review of records of lung cancer patients referred to palliative care department at Tata medical center, Kolkata, India was done. The records of 6 months (July 2018 to December 2018) were reviewed and relevant details were noted down. Hospital management system of our institution was screened for all the lung cancer patients during the above said period. Demographic details and various symptoms like cough, breathlessness, fatigue and other symptoms were also noted. Histological diagnosis was also noted as per the records. Results: We found that 20.24% had cough with fatigue, 20.24% had cough with breathlessness, 25% had fatigue with breathlessness and 13.10% had cough, fatigue and breathlessness in the present study. The proportion of fatigue was significantly higher among the small cell type (75%) when compared to non small cell type (p=0.0425) The proportion of SxCl cough with fatigue was significantly higher among the small cell carcinoma (60%) when compared to other subtypes. (p=0.0467)Conclusions: Among symptom clusters, fatigue with breathlessness was the most common. The proportion of fatigue and fatigue with cough was significantly higher among small cell carcinomas when compared to non small cell carcinoma subtype.

Key requirements of a video-call system in a critical care department as discovered during the rapid development of a solution to address COVID-19 visitor restrictions

The COVID-19 pandemic necessitated stringent visitor restrictions in critical care departments worldwide, creating challenges in keeping family members connected to patients and clinical staff. Previous studies have examined how hospitals addressed this challenge by repurposing existing tele-ICU systems or by using personal smartphones as a workaround and have analyzed clinical and family feedback. This case report addresses the experience of rapidly implementing a video-call system in the critical care department of a tertiary referral hospital that had no prior video-call system in place, detailing the key requirements in that setting. The 24 requirements were identified via interviews and surveys to both clinical and technical professionals. The top requirements identified were sound and video quality, usability for clinical staff, call control by staff, and patient privacy. From tailoring a video-call solution for this setting, we learned that video-endpoint selection is a key design decision. The initial proposal was to use wireless tablets, but the selection of a large wired video-endpoint allowed us to better address the requirements in the critical care setting. This was based on several characteristics of the large wired video-endpoint, including: high-fidelity video and sound, with directional noise-cancelling; large touch-screen setup for minimal-click navigation; wired as well as wireless connectivity.

Socio-cultural direction in the social service of elderly citizens

The article presents the experience of socio-cultural work with elderly citizens in the conditions of a complex social service center, as well as the results of an empirical study conducted by the author, aimed at identifying the satisfaction rate of elderly citizens with leisure activities in the day care department. As a result, it was determined that the quality of services provided during the stay in the day care department is rated as high by the clients, which allows asserting the professionalism of the staff working with them; the clients tend to prefer those types of services that are aimed at maintaining health and well-being; the clients are satisfied with the material and technical equipment of the day care department; the clients want to see new types of services in the day care department and are ready to pay for them additionally. These services include going on excursions outside the city, lectures by specialists from medical institutions on various topics related to the health of the elderly and disabled, visiting the cinema, visiting the theater.

Hyponatremia in Cancer Patients Hospitalized in a Palliative Care Department: A Cross-Sectional Analysis

Introduction: Hyponatremia is frequent in cancer patients, as many studies carried out in these patients have shown. However, there are only a few studies carried out at the end of life and in palliative care. The aim of this study was to determine the prevalence of hyponatremia in cancer patients in the palliative care department of an oncology center and its association with survival.Material and Methods: The study included the first 300 patients hospitalized in the palliative care department in 2017. Survival was measured from the day of hospitalization until death.Results: Serum sodium was measured in 170 (59%) patients. The median serum concentration was 135 mmol/L (109 to 145). Among 91 (54%) patients, serum sodium was within the normal range, 59 (35%) had mild hyponatremia, 13 (8%) had moderate and seven (4%) had profound hyponatremia. The median survival was 13 days (1 to 1020). Serum sodium was not significantly associated with survival (p = 0.463). Regarding other variables, the Eastern Cooperative Oncology Group performance status was significantly associated with survival, while gender, age, primary cancer and number of metastatic sites were not.Discussion: Hyponatremia, mainly mild and moderate, was found in almost half of the patients included in this study. However, unlike other studies, hyponatremia was not associated with a poorer prognosis.Conclusion: Hyponatremia is common in cancer patients receiving palliative care but did not seem to influence survival.