IntroductionWorldwide, an estimated 40 million people are in need of palliative care each year, but only 14% receive it. The incidence of diabetes mellitus (DM) in patients receiving palliative care is higher than in the general population. This association is intended to grow as a result of the rising burden of DM worldwide, ageing populations and the improved overall survival time of several diseases over the last few decades. Recommendations for DM management in the context of palliative care are mainly based on expert opinion as there is a lack of suitable evidence base and randomised clinical trials in palliative care are scarce. The aim of our systematic review is to identify the best DM management practices in order to reduce important DM-related symptoms and acute complications in patients receiving palliative care.Methods and analysisThe authors will study the DM treatment and management literature, surveying the different approaches employed to treat adult palliative patients. Core health bibliographic databases will be searched from January 1990 to May 2019. Data sources will include Ovid MEDLINE, Embase, PubMed, Web of Sciences, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus, Cumulative Index to Nursing and Allied Health Literature and grey literature. Details regarding diet, oral and injectable glucose-lowering medicines, insulin regimens and blood glucose monitoring strategies will be evaluated. We defined the primary outcomes to compare between DM management approaches as the presence of symptoms (polyuria, polydipsia and polyphagia) and acute complications of DM (hypoglycaemia, hyperglycaemic hyperosmolar state and diabetic ketoacidosis), and secondary outcomes as hospital admissions and deaths due to DM-related complications, health-related quality of life and glycaemic control.Ethics and disseminationThe systematic review methodology does not require ethics approval due to the nature of the study design. The results of the systematic review will be published in a peer-reviewed journal and will be publicly available.PROSPERO registration numberCRD42018115772.

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Objective: To estimate the incidence and degree of acute radiodermatitis at the end and after the end of treatment in women with breast cancer undergoing hypofractionated radiotherapy. Methods: Observational, prospective, and longitudinal study, conducted between March 2019 and January 2020, in a radiotherapy outpatient clinic. Results: Thirty-two women participated in the study, among whom, in the last session of hypofractionated radiotherapy, 15 (46.9%) had radiodermatitis, erythema in 13 (40.6%), and wet peeling in 2 (6.3%). In the post-treatment evaluation, 27 (84.4%) had radiodermatitis, erythema in 17 (53.1%), dry peeling in 8 (25%), and wet peeling in 2 (6.3%). Conclusion: The general incidence of radiodermatitis after hypofractionated radiotherapy in women with breast cancer was 37.5%, erythema, 12.5%, and dry peeling, 25%. The development of care protocols for the management of radiodermatitis after treatment is of paramount importance.

Objectives: to identify the occurrence of oncology teaching in undergraduate nursing curricula. Methods: descriptive study, which data was obtained from curriculum and from Pedagogical Course Projects available on the websites from Brazilian public institutions, between June and July 2020. Results: 143 undergraduate nursing courses were identified. From them, 132 nursing courses (corresponding to 89 education institutions) had available the curriculum and/or Pedagogical Course Projects. Only 7 (5.3%) of them had oncology as a mandatory subject, 4 of them in the Midwest Region. Only 35 (26.5%) had elective subject in Oncology, most of them in the Northeast (45.7%). Conclusions: on third of nursing courses at public institutions has Oncology subject in the curriculum, which is few considering the high incidence and mortality from cancer in the country. The findings contribute for discussions, in curricular accommodation, on the relevance of oncology teaching in nursing curricula.

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Objetivo: Identificar posibles diagnósticos de enfermería relacionados con los efectos adversos de la quimioterapia antineoplásica en pacientes con cáncer.Método: Estudio cuantitativo, descriptivo, realizado en la consulta externa de quimioterapia de un hospital público, en Belo Horizonte, Minas Gerais, Brasil. Se incluyó a 70 pacientes en la muestra y se les entrevistó para obtener características sociodemográficas. Los datos clínicos y el protocolo de quimioterapia se obtuvieron del registro físico. Se identificaron posibles toxicidades y efectos adversos para cada protocolo de quimioterapia a través de un libro de texto y, posteriormente, se identificaron los diagnósticos de enfermería en la taxonomía de la North American Nursing Diagnosis Association International (NANDA-I), versión 2018-2020, y asociados toxicidades y efectos adversos.Resultados: El sitio primario más prevalente fue el colon y recto (30%) y la mama (30%). Todos los participantes estaban recibiendo quimioterapia con potencial toxicidad hematológica, gastrointestinal, cardiovascular y dermatológica. Se identificaron 36 diagnósticos de enfermería con base en NANDA-I, con mayor predominio de diagnósticos en el dominio de seguridad y protección, y en el dominio de eliminación e intercambio.Conclusión: La identificación de Diagnósticos de Enfermería basados en protocolos de quimioterapia permite proponer planes de atención individualizados para satisfacer las necesidades de los pacientes sometidos a quimioterapia, principalmente con un enfoque en prevenir la ocurrencia y minimizar los efectos adversos, cuando ya están presentes. chemotherapy in cancer patients.Method: Quantitative, descriptive study, performed at the chemotherapy ambulatory of a public hospital, in Belo Horizonte, Minas Gerais, Brazil. Seventy patients were included in the sample and interviewed to obtain sociodemographic characteristics. Clinical data and the chemotherapy protocol were obtained from the physical record. Possible toxicities and adverse effects were identified for each chemotherapy protocol through a textbook and, subsequently, nursing diagnoses were identified in the taxonomy of the North American Nursing Diagnosis Association International (NANDA-I), version 2018-2020, and associates toxicities and adverse effects.Results: The most prevalent primary site was colon and rectum (30%), and breast (30%). All participants were receiving chemotherapy with potential hematological, gastrointestinal, cardiovascular, and dermatological toxicity. Thirty-six nursing diagnoses were identified based on NANDA-I, with a greater predominance of diagnoses in the safety/protection domain, and the elimination and exchange domain.Conclusion: The identification of Nursing Diagnoses based on chemotherapy protocols allows the proposition of individualized care plans to meet the needs of patients undergoing chemotherapy, with a focus on preventing the occurrence and minimizing adverse effects, when already present. Objetivo: Identificar possíveis Diagnósticos de Enfermagem relacionados aos efeitos adversos da quimioterapia antineoplásica em pacientes com câncer.Método: Estudo quantitativo, descritivo, realizado no ambulatório de quimioterapia de um hospital público, de Belo Horizonte, Minas Gerais, Brasil. Setenta pacientes foram incluídos na amostra e entrevistados para obter características sociodemográficas. Os dados clínicos e o protocolo de quimioterapia foram obtidos no prontuário físico. As possíveis toxicidades e efeitos adversos foram identificados para cada protocolo de quimioterapia por meio de um livro texto e, posteriormente, foram identificados diagnósticos de enfermagem na taxonomia da North American Nursing Diagnosis Association International (NANDA-I), versão 2018-2020, e associados às toxicidades e efeitos adversos.Resultados: O sítio primário mais prevalente foi cólon e reto (30%), e mama (30%). Todos os participantes estavam recebendo quimioterapia com potencial toxicidade hematológica, gastrointestinal, cardiovascular e dermatológica. Foram identificados 36 DE com base no NANDA-I, com maior predominância de diagnósticos no domínio segurança e proteção, e no de eliminação e troca. Conclusão: A identificação dos Diagnósticos de Enfermagem baseados nos protocolos quimioterápicos permite a proposição de planos de cuidados individualizados para atender necessidades dos pacientes submetidos à quimioterapia, principalmente com foco na prevenção da ocorrência e minimização dos efeitos adversos, quando já presentes.

Objetivo: Identificar os cuidados de enfermagem descritos na literatura para o manejo das emergências oncológicas. Método: Revisão integrativa, cuja busca foi realizada nas bases de dados CINAHL, Cochrane, LILACS, PubMed, SCOPUS, Web of Science e Google Acadêmico. O risco de viés foi avaliado usando as ferramentas do Joanna Briggs Institute. O nível da evidência foi avaliado usando a escala do Oxford Centre for Evidence-Based Medicine. Resultados: Foram identificados 17 estudos abordando cuidados de enfermagem para o manejo de 9 emergências oncológicas, sendo as mais frequentes: hipercalcemia (n=4), síndrome de lise tumoral (n=3), síndrome da veia cava superior (n=3) e neutropenia febril (n=3). Os cuidados de enfermagem contemplam aspectos fisiológicos e psicológicos da doença. O risco de viés foi baixo a moderado na maioria dos estudos. Conclusão: Os estudos destacam cuidados integrais de observação e monitoramento do paciente. Conhecer os cuidados de enfermagem para emergências oncológicas são essenciais para melhorar a qualidade da assistência.

Although radiation therapy (RT) planning and execution techniques have evolved to minimize radiotoxicity to a considerable extent, adjacent tissues still receive a substantial dose of ionizing radiation, resulting in radiotoxicities that may limit patients’ quality of life. Depending on the location of tissue injury and the severity of the cellular response, there may also be a need to interrupt RT, thus interfering with the prognosis of the disease. There is a hypothesis that genetic factors may be associated with individual radiosensitivity. Recent studies have shown that genetic susceptibility accounts for approximately 80% of the differences in toxicity. The evolution of genomic sequencing techniques has enabled the study of radiogenomics, which is emerging as a fertile field to evaluate the role of genetic biomarkers. Radiogenomics focuses on the analysis of genetic variations and radiation responses, including tumor responses to RT and susceptibility to toxicity in adjacent tissues. Several studies involving polymorphisms have been conducted to assess the ability to predict RT-related acute and chronic skin toxicities, particularly in patients with breast and head and neck cancers. The purpose of this chapter is to discuss how radiogenomics can help in the management of radiotoxicities, particularly radiodermatitis.