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Introduction:
Point-of-care ultrasound (POCUS) has become established as a diagnostic and therapeutic support tool in multiple specialties. In palliative care, its usefulness has been described primarily in the hospital setting, with limited evidence in the home setting, where rapid decision-making and the avoidance of unnecessary transfers are particularly relevant.
Objective: To describe the clinical indications for clinical ultrasound in home-based palliative care, the sociodemographic and functional characteristics of the patients in whom it is used, and to analyze its impact on therapeutic management and hospital referrals.
Methods: This was an observational, descriptive, and multicenter study conducted in Home-Based Palliative Care Support Teams (ESAPD) in the Community of Madrid. Patients over 18 years of age with advanced cancer receiving home-based care were included, and clinical ultrasound was performed according to professional criteria. Sociodemographic variables, clinical variables (ICD-10, Palliative Performance Scale), type and location of ultrasound scan, findings, therapeutic changes, and hospital referrals were collected. The analysis was descriptive.

Results: 285 ultrasound scans were performed over a six-month period by 15 physicians from 6 Palliative Care Services (ESAPD). The mean age of the patients was 79.2 years (SD: 13.95), 52% were women, and the median Palliative Performance Scale score was 50. The most frequent scans were abdominal (43.5%) and thoracic (22.8%). Pathological findings were identified in 67% of the ultrasound scans. After the ultrasound scan, a change in therapeutic approach occurred in 62% of cases, and hospital referrals were avoided in 70%.

Conclusions: Clinical ultrasound in home-based palliative care is a feasible and useful tool, integrated into clinical practice, that helps reduce diagnostic uncertainty, optimize therapeutic decision-making, and avoid unnecessary hospital transfers, prioritizing patient comfort and quality of life.

Introduction: Amyotrophic lateral sclerosis (ALS) is a multisystem neurodegenerative disease that affects health-related quality of life (HRQoL) and emotional well-being. International evidence has highlighted the impact of non-motor symptoms—particularly anxiety and depression—as significant determinants of HRQoL. In Uruguay, researchers have not yet systematized data on these aspects. Although researchers have widely established the association with depression, they have studied anxiety and other factors less extensively. We aimed to describe HRQoL, determine the frequency of anxiety and depression symptoms, and analyze their relationship in patients with ALS treated at a national reference center. Patients and methods: We conducted a descriptive, correlational, observational, and cross-sectional study with prospective data collection between July 2023 and August 2024, involving 39 patients with a confirmed diagnosis according to the Gold Coast criteria. We assessed HRQoL using the EuroQol-5D (EQ-5D-5L), functionality with the ALSFRS-R, and emotional symptoms with the HADS. Results:We found a median HRQoL of 0.76, lower than that of the general population. We observed a higher frequency of anxiety (56%) than depression (36%), with 33% of patients presenting mixed symptoms. Anxiety was more prevalent in patients with less than 6 months since diagnosis and in those with more than 12 months. HRQoL correlated positively with functionality and negatively with anxiety and depression; anxiety showed an inverse association with HRQoL (rs = −0.44; p < 0.005).Discussion:These findings reinforce the relevance of non-motor symptoms in the ALS experience and highlight the need for early psychological assessment and multidisciplinary interventions. Future studies should investigate the longitudinal progression of these factors throughout the disease course.

INTRODUCTION: Pediatric palliative care (PPC) focuses on the comprehensive management of incurable diseases or conditions in children, as well as providing support to families from diagnosis through bereavement. This care requires a multidisciplinary approach in which physicians and nurses play an essential role; therefore, it is imperative to acquire these competencies during their formative years. OBJECTIVE: To evaluate the knowledge and attitudes regarding pediatric palliative care among Nursing and Medicine students at a higher education institution in Cartagena (Colombia). MATERIALS AND METHODS: A quantitative, cross-sectional study was conducted, utilizing Chi-square tests for association analysis. From a total population of 496 nursing and medicine students, a simple random probability sample of 192 individuals was selected. Data collection was performed using a sociodemographic survey, the PPC knowledge assessment instrument developed by Garaycochea, and the pediatric palliative care attitude scale designed by Hilario. RESULTS AND DISCUSSION: The students were mainly female (71.9%), 21 - 22 years old (46.9%), urban (83.9%) and single (88%). Knowledge of pediatric palliative care was fair (66.1%), while attitudes were adequate (69.8%). The association between attitudes, knowledge and sociodemographic aspects of the students was confirmed (p<0.05). Nursing and medical students have regular knowledge, but a good attitude towards pediatric palliative care, a situation that should be taken advantage of by Higher Education Institutions for its inclusion in the curricula in order to train integral and competent professionals for the care of this population.

Editorial

Introduction: The palliative approach to non-oncological diseases is a relevant aspect in achieving the quality of life of patients; etiologies such as heart failure (HF) should receive this management even from the moment of diagnosis. The present work aimed to describe the integration of palliative care (PC) in the care of patients with HF in Colombia during the first half of 2022. Methodology: A descriptive cross-sectional quantitative study was designed that consisted of surveying health professionals immersed in the care of patients with HF classified by territorial nodes. The survey was designed based on indicators that evaluated the integration of PC in HF care in the Colombian context, related to the provision and referral of PC, patient empowerment, family approach, home care, multidisciplinarity, knowledge and holistic care. Results and discussion: It was found, according to the reviewed literature, that PC is almost nonexistent in the early stages of HF. The difficulty in accessing health services in some regions of the country, combined with the lack of training for palliative care professionals, are the main findings of the study. Conclusions: A low level of integration of PCs in HF in Colombia was evident, which calls for strengthening research and care work in this regard.

Introduction: In recent decades, scientific and technological advances have contributed to a reduction in pediatric mortality, accompanied by an increase in children surviving severe illnesses with complex sequelae. Many of these situations require Pediatric Palliative Care Units to ensure comprehensive and continuous care. In Spain, approximately 2,500 children die each year and up to 25,000 may require specific pediatric palliative care resources.

Material and methods: Epidemiological, observational, and descriptive cohort study comparing healthcare costs before and after implementation of the ADPAP program, initiated on June 1, 2022. The sample included children enrolled in the program who were also followed by the Pediatric Palliative Care Unit of the Complejo Hospitalario Universitario de Canarias, with healthcare expenditure data available for one year before and one year after implementation.

Results: Of the 70 patients included in the program, 17 had comparable data for both periods. The comparison of total mean costs per patient showed a statistically significant reduction after implementation (t = 3.11; p = 0.0067), with an average saving of €9,170.68 per patient. This represents total savings of €155,901.57 in the analyzed cohort.

Conclusion: The implementation of the ADPAP program proved economically efficient, reducing healthcare costs associated with hospital and primary care services. In a hypothetical extrapolation to a cohort of 70 patients with similar characteristics, annual savings could exceed €600,000, although this estimate should be interpreted cautiously. These findings suggest that coordinated pediatric home care from Primary Care may improve healthcare system efficiency and continuity of care for children with complex chronic conditions, reducing avoidable hospitalizations and optimizing the use of hospital resources.