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Introduction: Red blood cell and platelet transfusion is a treatment used at the end of life for symptomatic relief. However, its benefits, as well as the survival time after transfusion, are debated. This study aims to determine the prevalence, clinical characteristics, whether or not patients received palliative care, and survival of these patients to guide future studies and facilitate decision-making.
Patients and methods: This was a descriptive, cross-sectional study with retrospective data collection. Sociodemographic, clinical, and diagnostic variables, as well as whether patients received palliative care, treatment, and complications, were included. All adult patients with solid organ cancer who received red blood cell and/or platelet transfusions in the last 6 months of life and were treated at a high-complexity hospital between 2019 and 2022 were included. Data were obtained through review and analysis of medical records after authorization from the institutional ethics committee and entered into the BDClinic platform. Univariate and bivariate analyzes were performed for each variable.

Results: A population of 234 patients who met the selection criteria was analyzed. The median age was 61.8 years, and 60% of the population were women. The most common cancer was gastrointestinal (42.74%). Early palliative care intervention was associated with 31.5% of all transfusions and a median survival of 20 days from the last red blood cell transfusion. Patients receiving palliative care exclusively had a median survival after transfusion of 18 days, the longest compared to the other groups.

Conclusions: The appropriateness of therapeutic measures such as transfusions is plausible with early intervention by palliative care, and this is a bioethical imperative that plays a crucial role to consider in the final phase of life.

Introduction: Palliative care enhance the quality of life for those dealing with a terminal illness. However, many people are unable to access this type of care, especially in Latin American countries. Therefore, the aim of this study is to determine the effect of an educational intervention program on palliative care among medical students.
Material and Method: This quasi-experimental study involved sixth-year students from the Faculty of Human Medicine at the Universidad Científica del Sur of any age and gender who wished to participate in the study. A previously translated and adapted questionnaire for undergraduate students in our country, originally from Japan, was used to measure the level of knowledge about palliative care among healthcare professionals. The sample was described using frequency tables for each variable pre- and post-test. Normality of the scores obtained in each section of questions was determined using the Shapiro-Wilk test, and since normal distribution was not found, these results were compared using the Wilcoxon test. Finally, a "score variation" variable was created to determine the association of gender, age, and learning type with this variation.
Results: A total of 37 students were evaluated in the study. The total post-intervention score improved significantly compared to the initial score. No association was found between the score variation (pre- and post-test) and age, gender, or learning style.
Discussion: The educational intervention demonstrated a favorable impact on the initial results. Compared to other studies, the educational intervention increased the participants' mastery of palliative care in all sections of questions, especially in "Palliative Care Symptomatology" and "Pharmacology." The incorporation of academic programs on palliative care in Peruvian universities is suggested.

Introduction:
Population aging and the increasing burden of chronic diseases have led to a growing demand for comprehensive healthcare. Palliative Care (PC) has become an essential component in relieving physical, emotional, and social suffering in patients with advanced chronic illnesses. This study aimed to evaluate mortality in hospitalized patients with chronic diseases requiring Palliative Care and to analyze factors associated with referral to specialized PC services.
Materials and Methods:
An ambispective cohort study was conducted at the American British Cowdray Medical Center in Mexico City between July 2024 and March 2025. Adult patients hospitalized in the Internal Medicine service with advanced chronic diseases and positive NECPAL criteria were included. The primary outcome was mortality (in-hospital or out-of-hospital). The main exposure variable was referral to the Palliative Care team. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with referral and mortality.
Results:
A total of 65 patients were included; 32 (49.2%) received a Palliative Care consultation. No significant differences were observed in age, sex, comorbidity burden, or NECPAL score between patients with and without referral. Overall mortality was 60%, predominantly in-hospital. Referral to Palliative Care was not independently associated with mortality. Family request for Palliative Care was the only factor significantly associated with referral (OR 9.83; 95% CI 1.13–85.2; p=0.038). Only 11% of patients had an advance directive.
Conclusions:
Despite a high prevalence of palliative care needs among hospitalized patients with advanced chronic diseases, referral to specialized Palliative Care services remains limited and largely driven by family request rather than standardized clinical criteria. These findings highlight the need to strengthen systematic identification strategies and medical education to promote timely integration of Palliative Care.

Objective: This study describes the utilization patterns of subcutaneous drug administration within the clinical research framework of palliative care focusing on patients treated at the University Hospital of Móstoles.
Patients and method: Conducted as a retrospective observational study, this investigation meticulously analyzed patient records in the admission regime between January 2022 and March 2023. Sociodemographic, clinical and data related to the use of the subcutaneous route were recorded. The data were analyzed using SPSS version 30.0. Global descriptive statistics were stratified according to whether the subcutaneous route was used. Data regarding the use of the subcutaneous route were further stratified based on whether patients had cancer.
Results: 297 patients were included. Subcutaneous route was used in 37.04 % of cases. Subcutaneous route use varied depending on the diagnosis, being more prevalent in patients with dementia (65.5 %), and was associated with non-cancer patients. The main reason was symptomatic control (68.2 % of cases), especially in cancer patients (76.6 %). A different profile of symptoms to be controlled was identified between cancer patients (pain, agitation, dyspnea) and non-cancer patients (dyspnea, agitation, secretions), although no significant differences were found either in the drugs used (mainly morphine chloride, butylscopolamine, midazolam and haloperidol) or in the use of the route (greater use of continuous perfusion).
Conclusions: Our results suggest a low use of the subcutaneous route in palliative patients in hospital settings, despite being considered an effective and safe therapeutic alternative for the management of palliative patients. Its predominant use was observed in non-cancer patients and for symptomatic control. Insufficient records of the location catheter placement and complications associated with the use of the route, as well as the retrospective collection of data, were important limitations of the study. This study lays the groundwork for further research in this field.

Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disease characterized by heterotopic ossification.
The article describes the case of a patient diagnosed at age 7, who exhibited numerous ossifications throughout his body. Despite receiving symptomatic treatment, the patient developed progressive stiffness. He required palliative care at home, but was unable to receive specialized treatment due to difficulties in mobilization.
This article highlights the family support and the care provided by primary and palliative care teams. It emphasizes the importance of comprehensive care for patients with FOP, focusing not only on treating physical symptoms but also on providing emotional support to patients and their families.

Malignant bowel obstruction (MBO) is a common complication in patients with advanced cancer, particularly ovarian cancer. Its management is complex and its prognosis remains poor. We present the case of a patient with stage IV serous carcinoma who developed an intestinal perforation complicated by extensive subcutaneous emphysema.

The end of life is a situation inherent to human beings, it can occur at any time throughout life; secondary to the evolution of chronic diseases that are accompanied by physical and psychological deterioration, which makes it necessary to understand care through competencies in health personal.
Objective: determine the association between the attitudes and knowledge of nursing staff about end-of-life care in Cartagena during the year 2022. Materials and methods: Quantitative, cross-sectional and analytical study. The sample consisted of 163 individuals selected in a non-probabilistic manner. A sociodemographic instrument was applied on knowledge and attitudes towards the terminally ill patient. Results: There were professionals (48.5%) and assistants (51.5%), aged between 19 and 29 years (49.7%), women (72.4%), single (41.7%), low strata (79.1%), who had worked in intensive care (72.4%), for 1 to 2 years (35.6%). Attitudes towards the terminally ill were good among professionals (82.3%) and assistants (81%). Knowledge in this regard was inadequate in professionals (69.6%) and assistants (84.5%). It was found that knowledge was correlated with behavioral attitudes (p <0.05). Conclusion: The Nursing staff had good attitudes and inadequate knowledge in relation to oxygen saturation, opioids and NSAIDs. However, it is worth highlighting the fact that both staff members are aware of issues related to sedation and suffering in the terminal phase.

Introduction
Within Compassionate Communities, "Death Cafés" are organized as community spaces where people gather to talk openly about death in order to normalize dialogue around this topic.
Objective
To assess the effectiveness of "A Coffee with You: Caring and Accompanying Until the End" as a tool for raising awareness about death and the end of life among different population groups and to compare the tool's implementation in different Spanish-speaking contexts.
Materials and Methods
An exploratory quantitative cross-sectional study in which a total of 372 participants in the "A Coffee with You: Caring and Accompanying Until the End" workshops conducted during 2023 (n=22) completed a survey. An ad hoc questionnaire was designed to assess participants' self-esteem and measure their emotional distress using the Distress Thermometer (DT).
Results
Through a factor analysis of all items, three dimensions were identified: 1) the usefulness, relevance, and effectiveness of talking about death, 2) the logistical issues associated with the dynamics, and 3) the management and development of the event. Participants positively rated the “A Coffee with You: Caring and Being with You Until the End” program, with high scores for most items, highlighting its effectiveness in breaking the taboo surrounding death (x̄ Spain = 4.71, x̄ Argentina = 4.92) and the personal resources provided by talking about this topic (x̄ Spain = 4.57, x̄ Argentina = 4.93). A significant but moderate reduction in psychological distress was observed.
Conclusions
The results demonstrate the potential of “A Coffee with You: Caring and Being with You Until the End” as a facilitator of both public awareness and the breaking of the social taboo surrounding death and the end-of-life proces

-Introduction: Neuropathic pain, common in paediatric patients with palliative needs, is difficult to manage, even more, when the enteral route is lost. In recent years, parenteral drugs have been used in the adult population to solve this problem. In Paediatrics there are no standardised indications.
-Main objective: to describe the evidence on the use of parenteral clonidine, lidocaine, ketamine and dexmedetomidine for the control of neuropathic pain in children with palliative needs.
-Materials and methods: Narrative review with systematic methodology of the literature from January 2014 and January 2025. Clinical trials, narrative reviews and descriptive studies in English and Spanish with population <18 years with neuropathic or chronic pain are included. The methodological quality of the included studies was assessed.
-Results: 20 articles were included out of an initial 2326. The unit of analysis consisted of 11 descriptive studies, 8 narrative reviews and 1 systematic review.
-Conclusions: there is insufficient quality evidence on the use of the four drugs for neuropathic pain control in the paediatric population. Neuropathic pain control and opioid sparing are prominent indications. The review has made it possible to suggest safe dosing intervals. Side effects of the drugs were mild and self-limited after dose adjustments. Each of the drugs has particularities to be taken into account in their use.