RESUMO
La liberación del uso terapéutico de los opioides se ha hecho cada vez mas frecuente como una propuesta para mejorar la distribución de éstos en las instituciones de salud pública y privadas con el fin de garantizar su alcance a población que cursa con dolor. A pesar de esto, aún no se logra una distribución homogénea de estos recursos en la población requirente. El objetivo de este trabajo es dar a conocer el panorama actual de los opioides en México y algunos países sudamericanos.
The release of therapeutic opioid use is mentioned with increasing frequency as a proposal to improve their tion in Public and Private Health Care Institutions, in order to scope opioids to population who needs them. Although this, homogeneous distribution of opioids is not achieved. The aim of this paper is to present the current panorama of opioids in Mexico and Latin American countries
Assuntos
Humanos , Dor/tratamento farmacológico , Cuidados Paliativos/organização & administração , Manejo da Dor , Acesso a Medicamentos Essenciais e Tecnologias em Saúde , Analgésicos Opioides/provisão & distribuição , Analgésicos Opioides/uso terapêutico , Morfina/provisão & distribuição , Morfina/uso terapêuticoRESUMO
Admission to the intensive care unit (ICU) of a patient who has been grafted with hematopoietic stem cells is a serious event, but the role of the ICU in this setting remains controversial. Data were analyzed from patients who underwent autologous or allogeneic bone marrow transplantation at the Centro de Hematología y Medicina Interna de Puebla, México, between May 1993 and October 2014. In total, 339 patients were grafted: 150 autografts and 189 allografts; 68 of the grafted patients (20%) were admitted to the ICU after transplantation: 27% of the allografted and 11% of the autografted patients (p = 0.2). Two of 17 autografted patients (12%) and 5 of 51 allografted patients (10%) survived. All patients who required insertion of an endotracheal tube died, whereas 7 of 11 patients without invasive mechanical ventilation survived (p = 0.001). Only 10% of the grafted patients survived their stay in the ICU; this figure is lower than those reported from other centers and may reflect several facts, varying from the quality of the ICU support to ICU admission criteria to the initial management of all the grafts in an outpatient setting, which could somehow delay the arrival of patients to the hospital.