Caracterización clínica y demográfica de la población geriátrica en el servicio de oncología de un hospital universitario de Bogotá en un período de 12 meses

ilustraciones, gráficas, tablas

Autores:
Moreno Ladino, Ingrid Juliana
Tipo de recurso:
Fecha de publicación:
2022
Institución:
Universidad Nacional de Colombia
Repositorio:
Universidad Nacional de Colombia
Idioma:
spa
OAI Identifier:
oai:repositorio.unal.edu.co:unal/80972
Acceso en línea:
https://repositorio.unal.edu.co/handle/unal/80972
https://repositorio.unal.edu.co/
Palabra clave:
610 - Medicina y salud::616 - Enfermedades
Demography
Demografía
Cancer--Patients--Hospital care
Aged--Hospital care
Cancerosos-atención hospitalaria
Ancianos-Atención hospitalaria
Anciano
Cáncer
Oncología
Valoración geriátrica integral
Oncogeriatría
Adulto mayor
Elderly
Cancer
Oncology
Geriatrics
Comprehensive geriatric assessment
Oncogeriatrics
Rights
openAccess
License
Atribución-NoComercial-SinDerivadas 4.0 Internacional
id UNACIONAL2_d2fe46b30e6a4e4757bf19e22a750cff
oai_identifier_str oai:repositorio.unal.edu.co:unal/80972
network_acronym_str UNACIONAL2
network_name_str Universidad Nacional de Colombia
repository_id_str
dc.title.spa.fl_str_mv Caracterización clínica y demográfica de la población geriátrica en el servicio de oncología de un hospital universitario de Bogotá en un período de 12 meses
dc.title.translated.eng.fl_str_mv Clinical and demographic characterization of the geriatric population in the oncology service of a university hospital of Bogota in a period of 12 month
title Caracterización clínica y demográfica de la población geriátrica en el servicio de oncología de un hospital universitario de Bogotá en un período de 12 meses
spellingShingle Caracterización clínica y demográfica de la población geriátrica en el servicio de oncología de un hospital universitario de Bogotá en un período de 12 meses
610 - Medicina y salud::616 - Enfermedades
Demography
Demografía
Cancer--Patients--Hospital care
Aged--Hospital care
Cancerosos-atención hospitalaria
Ancianos-Atención hospitalaria
Anciano
Cáncer
Oncología
Valoración geriátrica integral
Oncogeriatría
Adulto mayor
Elderly
Cancer
Oncology
Geriatrics
Comprehensive geriatric assessment
Oncogeriatrics
title_short Caracterización clínica y demográfica de la población geriátrica en el servicio de oncología de un hospital universitario de Bogotá en un período de 12 meses
title_full Caracterización clínica y demográfica de la población geriátrica en el servicio de oncología de un hospital universitario de Bogotá en un período de 12 meses
title_fullStr Caracterización clínica y demográfica de la población geriátrica en el servicio de oncología de un hospital universitario de Bogotá en un período de 12 meses
title_full_unstemmed Caracterización clínica y demográfica de la población geriátrica en el servicio de oncología de un hospital universitario de Bogotá en un período de 12 meses
title_sort Caracterización clínica y demográfica de la población geriátrica en el servicio de oncología de un hospital universitario de Bogotá en un período de 12 meses
dc.creator.fl_str_mv Moreno Ladino, Ingrid Juliana
dc.contributor.advisor.spa.fl_str_mv Torres Espinosa, Catalina
dc.contributor.author.spa.fl_str_mv Moreno Ladino, Ingrid Juliana
dc.subject.ddc.spa.fl_str_mv 610 - Medicina y salud::616 - Enfermedades
topic 610 - Medicina y salud::616 - Enfermedades
Demography
Demografía
Cancer--Patients--Hospital care
Aged--Hospital care
Cancerosos-atención hospitalaria
Ancianos-Atención hospitalaria
Anciano
Cáncer
Oncología
Valoración geriátrica integral
Oncogeriatría
Adulto mayor
Elderly
Cancer
Oncology
Geriatrics
Comprehensive geriatric assessment
Oncogeriatrics
dc.subject.decs.eng.fl_str_mv Demography
dc.subject.decs.spa.fl_str_mv Demografía
dc.subject.lemb.eng.fl_str_mv Cancer--Patients--Hospital care
Aged--Hospital care
dc.subject.lemb.spa.fl_str_mv Cancerosos-atención hospitalaria
Ancianos-Atención hospitalaria
dc.subject.proposal.spa.fl_str_mv Anciano
Cáncer
Oncología
Valoración geriátrica integral
Oncogeriatría
Adulto mayor
dc.subject.proposal.eng.fl_str_mv Elderly
Cancer
Oncology
Geriatrics
Comprehensive geriatric assessment
Oncogeriatrics
description ilustraciones, gráficas, tablas
publishDate 2022
dc.date.accessioned.none.fl_str_mv 2022-02-14T16:00:05Z
dc.date.available.none.fl_str_mv 2022-02-14T16:00:05Z
dc.date.issued.none.fl_str_mv 2022-02-09
dc.type.spa.fl_str_mv Trabajo de grado - Especialidad Médica
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/masterThesis
dc.type.version.spa.fl_str_mv info:eu-repo/semantics/acceptedVersion
dc.type.content.spa.fl_str_mv Text
dc.type.redcol.spa.fl_str_mv http://purl.org/redcol/resource_type/TM
status_str acceptedVersion
dc.identifier.uri.none.fl_str_mv https://repositorio.unal.edu.co/handle/unal/80972
dc.identifier.instname.spa.fl_str_mv Universidad Nacional de Colombia
dc.identifier.reponame.spa.fl_str_mv Repositorio Institucional Universidad Nacional de Colombia
dc.identifier.repourl.spa.fl_str_mv https://repositorio.unal.edu.co/
url https://repositorio.unal.edu.co/handle/unal/80972
https://repositorio.unal.edu.co/
identifier_str_mv Universidad Nacional de Colombia
Repositorio Institucional Universidad Nacional de Colombia
dc.language.iso.spa.fl_str_mv spa
language spa
dc.relation.indexed.spa.fl_str_mv Bireme
dc.relation.references.spa.fl_str_mv R. Suzman and J. Beard, “WHO,Global Health and Aging,Technical Report,” Natl. Insititute Aging,National Institutes Heal., vol. 1, no. 4, pp. 273–277, 2011, doi: 11-7737.
WHO/FWC/ALC, “Informe mundIal sobre el envejecimiento y la salud,” Organ. Mund. la Salud, p. 31, 2015.
N. Denewet, S. De Breucker, S. Luce, B. Kennes, S. Higuet, and T. Pepersack, “Comprehensive geriatric assessment and comorbidities predict survival in geriatric oncology,” Acta Clin. Belgica Int. J. Clin. Lab. Med., vol. 71, no. 4, pp. 206–213, 2016, doi: 10.1080/17843286.2016.1153816.
de R. S. Hamaker ME, Buurman BM, van Munster BC, Kuper IM, Smorenburg CH, “The Value of a Comprehensive Geriatric Assessment for Patient Care in Acutely Hospitalized Older Patients with Cancer,” Oncologist, vol. 16, no. 10, pp. 1403–1412, 2011, doi: 10.1634/theoncologist.2011-0227.
M. C. White, D. M. Holman, J. E. Boehm, L. A. Peipins, M. Grossman, and S. Jane Henley, “Age and cancer risk: A potentially modifiable relationship,” Am. J. Prev. Med., vol. 46, no. 3 SUPPL. 1, pp. 1–16, 2014, doi: 10.1016/j.amepre.2013.10.029.
H. Wildiers et al., “International society of geriatric oncology consensus on geriatric assessment in older patients with cancer,” J. Clin. Oncol., vol. 32, no. 24, pp. 2595–2603, 2014, doi: 10.1200/JCO.2013.54.8347.
D. Swaminathan and V. Swaminathan, “Geriatric oncology: problems with under-treatment within this population,” Cancer Biol. Med., vol. 12, no. 4, pp. 275–283, 2015, doi: 10.7497/j.issn.2095-3941.2015.0081.
I. H. Rodenas and L. Balducci, “Cáncer y envejecimiento,” in Tratado de medicina geriátrica, 2020, pp. 1196–1204.
L. Decoster et al., “Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients: An update on SIOG recommendations,” Ann. Oncol., vol. 26, no. 2, pp. 288–300, 2015, doi: 10.1093/annonc/mdu210.
J. Overcash, N. Ford, E. Kress, C. Ubbing, and N. Williams, “Comprehensive geriatric assessment as a versatile tool to enhance the care of the older person diagnosed with cancer,” Geriatr., vol. 4, no. 2, pp. 1–13, 2019, doi: 10.3390/geriatrics4020039.
P. Caillet et al., “Optimal management of elderly cancer patients: Usefulness of the comprehensive geriatric assessment,” Clin. Interv. Aging, vol. 9, pp. 1645–1660, 2014, doi: 10.2147/CIA.S57849.
M. O. Cadena Sanabria, “Evaluación del instrumento VES-13, escala TITAN y dominios de la Valoracin Geriátrica Integral como predictores de complicaciones durante el tratamiento de ancianos con cáncer,” p. 55, 2012, [Online]. Available: http://www.bdigital.unal.edu.co/7696/.
K. Palmer and G. Onder, “Comprehensive geriatric assessment: Benefits and limitations,” Eur. J. Intern. Med., vol. 54, no. February, pp. e8–e9, 2018, doi: 10.1016/j.ejim.2018.02.016.
R. L. Siegel, K. D. Miller, H. E. Fuchs, and A. Jemal, “Cancer Statistics, 2021,” CA. Cancer J. Clin., vol. 71, no. 1, pp. 7–33, 2021, doi: 10.3322/caac.21654
Minisiterio de Salud y Protección Social, “Observatorio Nacional de Cáncer guia metodológica,” ONC Colomb., p. 18, 2018.
Ministerio De Salud y Protección Social and Instituto Nacional de Cancerología, “Plan nacional para el control del cáncer en Colombia 2012-2020,” Minist. Salud Y Protección Soc., pp. 1–85, 2012, [Online]. Available: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/IA/INCA/plan-nacional-control-cancer-2012-2020.pdf.
C. Pardo and R. Cendales, “Cancer incidence estimates and mortality for the top five cancer in Colombia, 2007-2011,” Colomb. Med., vol. 49, no. 1, pp. 16–22, 2018, doi: 10.25100/cm.v49i1.3596.
A. M. Alvarado García and Á. M. Salazar Maya, “Análisis del concepto de envejecimiento,” Gerokomos, vol. 25, no. 2, pp. 57–62, 2014, doi: 10.1080/00039896.1964.10663695.
D. Hanahan and R. A. Weinberg, “Hallmarks of cancer: The next generation,” Cell, vol. 144, no. 5, pp. 646–674, 2011, doi: 10.1016/j.cell.2011.02.013.
I. Carreca, L. Balducci, and M. Extermann, “Cancer in the older person,” Cancer Treat. Rev., vol. 31, no. 5, pp. 380–402, 2005, doi: 10.1016/j.ctrv.2005.04.012.
S. Hoffe and L. Balducci, “Cancer and Age: General Considerations,” Clin. Geriatr. Med., vol. 28, no. 1, pp. 1–18, 2012, doi: 10.1016/j.cger.2011.09.001.
C. López-Otín, M. A. Blasco, L. Partridge, M. Serrano, and G. Kroemer, “The Hallmarks of Aging Europe PMC Funders Group,” Cell, vol. 153, no. 6, pp. 1194–1217, 2013, doi: 10.1016/j.cell.2013.05.039.
E. Laconi, F. Marongiu, and J. DeGregori, “Cancer as a disease of old age: changing mutational and microenvironmental landscapes,” Br. J. Cancer, vol. 122, no. 7, pp. 943–952, 2020, doi: 10.1038/s41416-019-0721-1.
J. W. Shay, “Role of Telomeres and Telomerase in Aging and Cancer,” Cancer Discov., vol. 176, no. 3, pp. 139–148, 2017, doi: 10.1158/2159-8290.CD-16-0062.Role.
M. I. Zvereva, D. M. Shcherbakova, and O. A. Dontsova, “Telomerase: Structure, functions, and activity regulation,” Biochem., vol. 75, no. 13, pp. 1563–1583, 2010, doi: 10.1134/S0006297910130055.
Y.-S. Cong, W. E. Wright, and J. W. Shay, “Human Telomerase and Its Regulation,” Microbiol. Mol. Biol. Rev., vol. 66, no. 3, pp. 407–425, 2002, doi: 10.1128/mmbr.66.3.407-425.2002
J. D. Hayes, A. T. Dinkova-Kostova, and K. D. Tew, “Oxidative Stress in Cancer,” Cancer Cell, vol. 38, no. 2, pp. 167–197, Aug. 2020, doi: 10.1016/j.ccell.2020.06.001.
M. Esteller, “Cancer epigenomics: DNA methylomes and histone-modification maps,” Nat. Rev. Genet., vol. 8, no. 4, pp. 286–298, 2007, doi: 10.1038/nrg2005.
W. J. Locke et al., “DNA Methylation Cancer Biomarkers: Translation to the Clinic,” Front. Genet., vol. 10, no. November, pp. 1–22, 2019, doi: 10.3389/fgene.2019.01150.
J. K. Pedersen, G. Engholm, A. Skytthe, and K. Christensen, “Cancer and aging: Epidemiology and methodological challenges,” Acta Oncol. (Madr)., vol. 55, no. Suppl 1, pp. 7–12, 2016, doi: 10.3109/0284186X.2015.1114670.
L. Balducci, “Epidemiology of cancer and aging.,” J. Oncol. Manag., vol. 14, no. 2, pp. 47–50, 2005, [Online]. Available: http://www.ncbi.nlm.nih.gov/pubmed/16018199.
A. Magnuson et al., “Geriatric assessment with management intervention in older adults with cancer: a randomized pilot study,” Support. Care Cancer, vol. 26, no. 2, pp. 605–613, Feb. 2018, doi: 10.1007/s00520-017-3874-6.
Officer Alana and Manandhar Mary, “Década del Envejecimiento Saludable 2020-2030,” Organ. Mund. la Salud, pp. 1–7, 2020, [Online]. Available: https://www.who.int/ageing/sdgs/en/.
H. Sung et al., “Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries,” CA. Cancer J. Clin., vol. 71, no. 3, pp. 209–249, 2021, doi: 10.3322/caac.21660.
Fondo Colombiano de Enfermedades de Alto Costo Cuenta de Alto Costo [CAC]., “Situación del Cáncer en la población adulta atendida en el SGSSS de Colombia 2016,” 2017.
S. Pilleron et al., “Global cancer incidence in older adults, 2012 and 2035: A population-based study,” Int. J. Cancer, vol. 144, no. 1, pp. 49–58, 2019, doi: 10.1002/ijc.31664.
S. Hoffe and L. Balducci, “Cancer and Age: General Considerations,” Clin. Geriatr. Med., vol. 28, no. 1, pp. 1–18, 2012, doi: 10.1016/j.cger.2011.09.001.
N. C. I. Surveillance Research Program, “SEER*Explorer: An interactive website for SEER cancer statistics,” SEER cancer statistics, 2020. https://seer.cancer.gov/explorer.
Cancer Research UK, “Cancer mortality statistics,” Cancer Research UK, 2018.
M. Roser and H. Ritchie, “Cancer,” OurWorldInData.org., 2015
C. E. DeSantis et al., “Cancer statistics for adults aged 85 years and older, 2019,” CA. Cancer J. Clin., vol. 69, no. 6, pp. 452–467, 2019, doi: 10.3322/caac.21577.
Ministerio de Salud Colombia, “SABE COLOMBIA 2015: ESTUDIO NACIONAL DE SALUD, BIENESTAR Y ENVEJECIMIENTO. RESUMEN EJECUTIVO Introducción,” 2015. Accessed: Sep. 06, 2018. [Online]. Available: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/GCFI/Resumen-Ejecutivo-Encuesta-SABE.pdf.
DANE, “Censo Nacional de Población y Vivienda,” DANE, Publ. para todos, 2018, [Online]. Available: https://www.dane.gov.co/index.php/estadisticas-por-tema/demografia-y-poblacion/censo-nacional-de-poblacion-y-vivenda-2018/cuantos-somos.
Ministerio de Salud y Protección Social, “Documento Metodológico Encuesta Nacional de Salud, Bienestar y Envejecimiento SABE Colombia,” p. 27, 2018, [Online]. Available: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/GCFI/doc-metodologia-sabe.pdf.
Ministerio de Salud y Protección Social Oficina de Promoción Social, “Sala situacional de la Población Adulta Mayor,” Minist. Salud y Protección Soc., pp. 3–4, 2018, [Online]. Available: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/PS/sala-situacion-envejecimiento-2018.pdf.
Instituto Nacional de Cancerología - ESE, “Anuario 2020,” Bogotá, D. C., 2021.
E. Soto-Perez-de-Celis et al., “Cancer and aging in Ibero-America,” Clin. Transl. Oncol., vol. 20, no. 9, pp. 1117–1126, 2018, doi: 10.1007/s12094-018-1844-1.
G. R. Williams et al., “Comorbidity in older adults with cancer,” J. Geriatr. Oncol., vol. 7, no. 4, pp. 249–257, 2016, doi: 10.1016/j.jgo.2015.12.002.
T. L. Jørgensen, J. Hallas, S. Friis, and J. Herrstedt, “Comorbidity in elderly cancer patients in relation to overall and cancer-specific mortality,” Br. J. Cancer, vol. 106, no. 7, pp. 1353–1360, 2012, doi: 10.1038/bjc.2012.46.
L. Adès, R. Itzykson, and P. Fenaux, “Myelodysplastic syndromes,” Lancet, vol. 383, no. 9936, pp. 2239–2252, 2014, doi: 10.1016/S0140-6736(13)61901-7.
S. Burgstaller, P. Wiesinger, and R. Stauder, “Myelodysplastic Syndromes in the Elderly: Treatment Options and Personalized Management,” Drugs and Aging, vol. 32, no. 11, pp. 891–905, 2015, doi: 10.1007/s40266-015-0312-7.
N. Burdett, A. D. Vincent, M. O’Callaghan, and G. Kichenadasse, “Competing risks in older patients with cancer: A systematic review of geriatric oncology trials,” J. Natl. Cancer Inst., vol. 110, no. 8, pp. 825–830, 2018, doi: 10.1093/jnci/djy111.
B. Kanapuru, “Clinical trials : US Food and Drug Enrollment of Older Adults in Cancer Clinical Trials- A Continuing Conversation.”
R. C. Chen, T. J. Royce, M. Extermann, and B. B. Reeve, “Impact of Age and Comorbidity on Treatment and Outcomes in Elderly Cancer Patients,” Semin. Radiat. Oncol., vol. 22, no. 4, pp. 265–271, 2012, doi: 10.1016/j.semradonc.2012.05.002.
C. Terret, G. B. Zulian, A. Naiem, and G. Albrand, “Multidisciplinary approach to the geriatric oncology patient,” J. Clin. Oncol., vol. 25, no. 14, pp. 1876–1881, 2007, doi: 10.1200/JCO.2006.10.3291.
C. Handforth et al., “The prevalence and outcomes of frailty in older cancer patients: A systematic review,” Ann. Oncol., vol. 26, no. 6, pp. 1091–1101, 2015, doi: 10.1093/annonc/mdu540
M. A. Schonberg, H. Medical, B. Israel, and D. Medical, “Decision making around mammography screening for older women,” J Am Geriatr Soc., vol. 64, no. 12, pp. 2413–2418, 2016, doi: 10.1111/jgs.14503.Decision.
T. Kalsi et al., “The impact of comprehensive geriatric assessment interventions on tolerance to chemotherapy in older people,” Br. J. Cancer, vol. 112, no. 9, pp. 1435–1444, 2015, doi: 10.1038/bjc.2015.120.
M. J. Molina Garrido, “Peculiaridades en la atención y manejo del anciano oncológico,” in Tratado de medicina geriátrica, 2020, pp. 1205–1211.
D. H. Solomon, “Geriatric assessment: methods for clinical decision making.,” JAMA, vol. 259, no. 16, pp. 2450–2, 1988, [Online]. Available: http://www.ncbi.nlm.nih.gov/pubmed/3280847.
M. T. E. Puts et al., “An update on a systematic review of the use of geriatric assessment for older adults in oncology,” Ann. Oncol., vol. 25, no. 2, pp. 307–315, 2014, doi: 10.1093/annonc/mdt386.
A. Magnuson, S. Sattar, G. Nightingale, R. Saracino, E. Skonecki, and K. M. Trevino, “A Practical Guide to Geriatric Syndromes in Older Adults With Cancer: A Focus on Falls, Cognition, Polypharmacy, and Depression,” Am. Soc. Clin. Oncol. Educ. B., no. 39, pp. e96–e109, 2019, doi: 10.1200/edbk_237641.
P. Limpawattana, K. Phimson, A. Sookprasert, W. Sirithanaphol, and J. Chindaprasirt, “Prevalence of Geriatric Syndromes in Elderly Cancer Patients Receiving Chemotherapy,” Curr. Gerontol. Geriatr. Res., vol. 2020, pp. 1–5, Feb. 2020, doi: 10.1155/2020/9347804.
L. Kirkhus et al., “Geriatric assessment is superior to oncologists’ clinical judgement in identifying frailty,” Br. J. Cancer, vol. 117, no. 4, pp. 470–477, 2017, doi: 10.1038/bjc.2017.202.
S. K. Inouye, S. Studenski, M. Tinetti, and G. Kuchel, “Geriatric Syndromes: Clinical, Research and Policy Implications of a Core Geriatric Concept in older adults related to primary and secondary prevention,” J. Am. Geriatr. Soc., vol. 55, no. 5, pp. 780–91, 2007.
C. Handforth et al., “Comprehensive geriatric assessment and decision-making in older men with incurable but manageable (chronic) cancer,” Support. Care Cancer, vol. 27, no. 5, pp. 1755–1763, 2019, doi: 10.1007/s00520-018-4410-z.
C. Hernandez Torres and T. Hsu, “Comprehensive Geriatric Assessment in the Older Adult with Cancer: A Review,” Eur. Urol. Focus, vol. 3, no. 4–5, pp. 330–339, 2017, doi: 10.1016/j.euf.2017.10.010.
D. Li et al., “Geriatric Assessment–Driven Intervention (GAIN) on Chemotherapy-Related Toxic Effects in Older Adults With Cancer,” JAMA Oncol., vol. 7, no. 11, p. e214158, Nov. 2021, doi: 10.1001/jamaoncol.2021.4158.
S. G. Mohile et al., “Evaluation of geriatric assessment and management on the toxic effects of cancer treatment (GAP70+): a cluster-randomised study,” Lancet, vol. 398, no. 10314, pp. 1894–1904, Nov. 2021, doi: 10.1016/S0140-6736(21)01789-X.
M. Extermann, “Cancer in the Elderly: Moving the Needle Toward Evidence-Based Personalized Oncology,” Int. J. Radiat. Oncol. Biol. Phys., vol. 98, no. 4, pp. 718–720, 2017, doi: 10.1016/j.ijrobp.2016.11.005.
S. G. Mohile et al., “Practical assessment and management of vulnerabilities in older patients receiving chemotherapy: Asco guideline for geriatric oncology,” J. Clin. Oncol., vol. 36, no. 22, pp. 2326–2347, 2018, doi: 10.1200/JCO.2018.78.8687.
E. Dotan et al., “Older adult oncology, version 1.2021: Featured updates to the NCCN guidelines,” JNCCN J. Natl. Compr. Cancer Netw., vol. 19, no. 9, pp. 1006–1019, 2021, doi: 10.6004/jnccn.2021.0043.
F. Javier, M. Peromingo, O. Carlos, and M. E. Baeza, “Revista Española de Geriatría y Gerontología Propuesta de desarrollo de una unidad de oncogeriatría . Tiempos de cambio : nuestra realidad,” vol. 53, no. 3, pp. 149–154, 2020.
S. G. Mohile et al., “Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Chemotherapy: ASCO Guideline for Geriatric Oncology,” J. Clin. Oncol., vol. 36, no. 22, pp. 2326–2347, Aug. 2018, doi: 10.1200/JCO.2018.78.8687.
D. Saliba et al., “The Vulnerable Elders Survey: A Tool for Identifying Vulnerable Older People in the Community,” J. Am. Geriatr. Soc., vol. 49, no. 12, pp. 1691–1699, Dec. 2001, doi: 10.1046/j.1532-5415.2001.49281.x.
D. Li, E. Soto-Perez-De-Celis, and A. Hurria, “Geriatric assessment and tools for predicting treatment toxicity in older adults with cancer,” Cancer J. (United States), vol. 23, no. 4, pp. 206–210, 2017, doi: 10.1097/PPO.0000000000000269.
L. Repetto et al., “Comprehensive Geriatric Assessment Adds Information to Eastern Cooperative Oncology Group Performance Status in Elderly Cancer Patients: An Italian Group for Geriatric Oncology Study,” J. Clin. Oncol., vol. 20, no. 2, pp. 494–502, Jan. 2002, doi: 10.1200/JCO.2002.20.2.494.
G. Nightingale et al., “Perspectives on functional status in older adults with cancer: An interprofessional report from the International Society of Geriatric Oncology (SIOG) nursing and allied health interest group and young SIOG,” J. Geriatr. Oncol., vol. 12, no. 4, pp. 658–665, May 2021, doi: 10.1016/j.jgo.2020.10.018.
E. Morros-gonzález, I. Márquez, J. Pablo, and D. Patino-hernandez, “Life-space assessment and associated clinical factors : SABE Colombia Avaliação do espaço de vida e fatores clínicos associados : SABE Colômbia,” pp. 1–6, 2021.
A. Hurria, M. S. Lachs, H. J. Cohen, H. B. Muss, and A. B. Kornblith, “Geriatric assessment for oncologists: Rationale and future directions,” Crit. Rev. Oncol. Hematol., vol. 59, no. 3, pp. 211–217, 2006, doi: 10.1016/j.critrevonc.2006.03.007.
M. I. Bennett, S. Kaasa, A. Barke, B. Korwisi, W. Rief, and R. D. Treede, “The IASP classification of chronic pain for ICD-11: Chronic cancer-related pain,” Pain, vol. 160, no. 1, pp. 38–44, 2019, doi: 10.1097/j.pain.0000000000001363.
R. Voumard, E. Rubli Truchard, L. Benaroyo, G. D. Borasio, C. Büla, and R. J. Jox, “Geriatric palliative care: a view of its concept, challenges and strategies,” BMC Geriatr., vol. 18, no. 1, p. 220, Dec. 2018, doi: 10.1186/s12877-018-0914-0.
J. M. Wooten, “Pharmacotherapy considerations in elderly adults,” South. Med. J., vol. 105, no. 8, pp. 437–445, 2012, doi: 10.1097/SMJ.0b013e31825fed90.
T. Borza et al., “The course of depressive symptoms and mortality in older patients with cancer,” Aging Ment. Heal., vol. 0, no. 0, pp. 1–8, 2021, doi: 10.1080/13607863.2021.1932739.
J. A. Yesavage et al., “Development and validation of a geriatric depression screening scale: A preliminary report,” J. Psychiatr. Res., vol. 17, no. 1, pp. 37–49, 1982, doi: 10.1016/0022-3956(82)90033-4.
J. Lacau St Guily et al., “NutriCancer: A French observational multicentre cross-sectional study of malnutrition in elderly patients with cancer,” J. Geriatr. Oncol., vol. 9, no. 1, pp. 74–80, 2018, doi: 10.1016/j.jgo.2017.08.003.
G. Torbahn, T. Strauss, C. C. Sieber, E. Kiesswetter, and D. Volkert, “Nutritional status according to the mini nutritional assessment (MNA)® as potential prognostic factor for health and treatment outcomes in patients with cancer - a systematic review,” BMC Cancer, vol. 20, no. 1, p. 594, 2020, doi: 10.1186/s12885-020-07052-4.
J. R. Huedo Rodenas, Isabel; Romero Macías, “El anciano con neoplasias hematológicas,” in Tratado de medicina geriátrica, 2021, pp. 1228–1244.
A. P. Navarrete-reyes et al., “Principios geriátricos para pacientes con cáncer,” Geriatr Gerontol Aging, vol. 15, p. e0210010, 2021, doi: 10.5327/Z2447-212320212100009.
S. Rohrmann, “Epidemiology of Frailty in Older People,” vol. Adv Exp Me, no. 1216, pp. 21–27, 2020, doi: 10.1007/978-3-030-33330-0_3.
J. U. Ramírez Ramírez, M. O. Cadena Sanabria, and M. E. Ochoa, “Aplicación de la Escala de fragilidad de Edmonton en población colombiana. Comparación con los criterios de Fried,” Rev. Esp. Geriatr. Gerontol., vol. 52, no. 6, pp. 322–325, Nov. 2017, doi: 10.1016/j.regg.2017.04.001.
J. F. Gómez Montes, C. Curcio Borrero, and G. M. Henao, “Fragilidad en ancianos Colombianos,” Rev.Medica.Sanitas, vol. 15, no. 4, pp. 8–16, 2012, [Online]. Available: http://www.unisanitas.edu.co/Revista/45/08 ANCIANOS DFN.pdf.
J. M. Ocampo-Chaparro, C. A. Reyes-Ortiz, X. Castro-Flórez, and Gómez Fernando, “Fragilidad en personas adultas mayores y su asociación con determinantes sociales de la Salud. Estudio SABE Colombia,” Colomb. Med., vol. 50 (2), pp. 89–101, 2019.
J. W. Faller, D. do N. Pereira, S. de Souza, F. K. Nampo, F. de S. Orlandi, and S. Matumoto, “Instruments for the detection of frailty syndrome in older adults: A systematic review,” PLoS One, vol. 14, no. 4, p. e0216166, Apr. 2019, doi: 10.1371/journal.pone.0216166.
A. J. Cruz-Jentoft et al., “Sarcopenia: revised European consensus on definition and diagnosis,” Age Ageing, vol. 48, no. 1, pp. 16–31, Jan. 2019, doi: 10.1093/ageing/afy169.
G. R. Williams, R. F. Dunne, S. Giri, S. S. Shachar, and B. J. Caan, “Sarcopenia in the Older Adult With Cancer,” J. Clin. Oncol., vol. 39, no. 19, pp. 2068–2078, Jul. 2021, doi: 10.1200/JCO.21.00102.
T. K. Malmstrom, D. K. Miller, E. M. Simonsick, L. Ferrucci, and J. E. Morley, “SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes,” J. Cachexia. Sarcopenia Muscle, vol. 7, no. 1, pp. 28–36, Mar. 2016, doi: 10.1002/jcsm.12048
M. E. Charlson, P. Pompei, K. L. Ales, and C. R. MacKenzie, “A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation,” J. Chronic Dis., vol. 40, no. 5, pp. 373–383, Jan. 1987, doi: 10.1016/0021-9681(87)90171-8.
T. L. Jørgensen, J. Hallas, S. Friis, and J. Herrstedt, “Comorbidity in elderly cancer patients in relation to overall and cancer-specific mortality,” Br. J. Cancer, vol. 106, no. 7, pp. 1353–1360, Mar. 2012, doi: 10.1038/bjc.2012.46
J. Tomaka, S. Thompson, and R. Palacios, “The relation of social isolation, loneliness, and social support to disease outcomes among the elderly,” J. Aging Health, vol. 18, no. 3, pp. 359–384, 2006, doi: 10.1177/0898264305280993.
NCI, “Common Toxicity Criteria Manual Version 2.0,” Natl. Cancer Inst. Cancer Ther. Eval. Progr., no. 301, pp. 1–31, 1999
P. Caillet et al., “Optimal management of elderly cancer patients: Usefulness of the comprehensive geriatric assessment,” Clin. Interv. Aging, vol. 9, pp. 1645–1660, 2014, doi: 10.2147/CIA.S57849.
A. Hurria et al., “Predicting chemotherapy toxicity in older adults with cancer: A prospective multicenter study,” J. Clin. Oncol., vol. 29, no. 25, pp. 3457–3465, 2011, doi: 10.1200/JCO.2011.34.7625.
M. Extermann et al., “Predicting the risk of chemotherapy toxicity in older patients: The chemotherapy risk assessment scale for high-age patients (CRASH) score,” Cancer, vol. 118, no. 13, pp. 3377–3386, 2012, doi: 10.1002/cncr.26646.
I. Ortland et al., “Comparing the performance of the CARG and the CRASH score for predicting toxicity in older patients with cancer,” J. Geriatr. Oncol., vol. 11, no. 6, pp. 997–1005, 2020, doi: 10.1016/j.jgo.2019.12.016.
A. Naseer et al., “International efforts in geriatric radiation oncology,” J. Geriatr. Oncol., Nov. 2021, doi: 10.1016/j.jgo.2021.11.002.
A. Hurria et al., “Identifying vulnerable older adults with cancer: Integrating geriatric assessment into oncology practice,” J. Am. Geriatr. Soc., vol. 55, no. 10, pp. 1604–1608, 2007, doi: 10.1111/j.1532-5415.2007.01367.x.
E. Murcia and J. Aguilera, “Boletín Servicios Oncológicos en Colombia, 2017,” p. 22, 2017, [Online]. Available: http://www.cancer.gov.co/files/libros/archivos/SO.COLOMBIA.pdf.
S. De Investigaciones and V. Epidemiológica, “Boletín de servicios oncológicos Boletín de servicios oncológicos,” pp. 1–33, 2019.
W. arbey Gutiérrez, “Situación actual del médico geriatra en Colombia Title: Geriatricians in Colombia,” vol. 56, no. 2, pp. 163–177, 2015.
F. J. Martínez Peromingo, C. Oñoro Algar, M. E. Baeza Monedero, C. González de Villaumbrosia, D. Real de Asua Cruzat, and R. Barba Martín, “Propuesta de desarrollo de una unidad de oncogeriatría. Tiempos de cambio: nuestra realidad,” Rev. Esp. Geriatr. Gerontol., vol. 53, no. 3, pp. 149–154, May 2018, doi: 10.1016/j.regg.2017.10.007.
C. Terret, G. B. Zulian, A. Naiem, and G. Albrand, “Multidisciplinary approach to the geriatric oncology patient,” J. Clin. Oncol., vol. 25, no. 14, pp. 1876–1881, 2007, doi: 10.1200/JCO.2006.10.3291.
G. R. Williams et al., “Comorbidity in older adults with cancer,” J. Geriatr. Oncol., vol. 7, no. 4, pp. 249–257, 2016, doi: 10.1016/j.jgo.2015.12.002.
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spelling Atribución-NoComercial-SinDerivadas 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Torres Espinosa, Catalina91a38a2edbfc5099c0fcc5b0c5c4f774Moreno Ladino, Ingrid Juliana87d1359f981443909a625b968ecc0fd92022-02-14T16:00:05Z2022-02-14T16:00:05Z2022-02-09https://repositorio.unal.edu.co/handle/unal/80972Universidad Nacional de ColombiaRepositorio Institucional Universidad Nacional de Colombiahttps://repositorio.unal.edu.co/ilustraciones, gráficas, tablasIntroducción: La población mundial envejece de forma acelerada. El cáncer es una de las principales causas de muerte en el mundo y por diferentes mecanismos genéticos, ambientales y fisiológicos, los ancianos son más susceptibles a sufrir de esta enfermedad, lo que explica que en todo el mundo entre el 50-60% de los diagnósticos con cáncer se hagan en ancianos. La caracterización multidimensional del anciano con cáncer es una herramienta útil para la mejor toma de decisiones en estos pacientes. Objetivo: Caracterizar la población mayor de 60 años hospitalizados por Oncología de un Hospital Universitario de tercer nivel e identificar los principales diagnósticos, comorbilidades, mortalidad, identificar cuáles de ellos fueron evaluados por el servicio de geriatría y cuales fueron sus principales síndromes geriátricos. Pacientes y métodos: Estudio descriptivo con recolección de información de forma retrospectiva. Se tomaron los pacientes mayores de 60 años hospitalizados por el servicio de Oncología del Hospital Universitario Nacional con neoplasia confirmada durante el período febrero 2019 - febrero 2020. Se realizó un análisis estadístico con las principales características demográficas y clínicas de la población seleccionada. Se revisaron las historias de los pacientes valorados por el servicio de geriatría para caracterizar los síndromes geriátricos en esta población. Resultados: El presente estudio caracterizó a la población mayor de 60 años hospitalizada por el servicio de Oncología del Hospital Universitario Nacional. La prevalencia pacientes ancianos con cáncer hospitalizados fue del 44.49%, la mayoría de los pacientes fueron del sexo femenino (55.67%). Los cánceres más frecuentes fueron del sistema hematopoyético y linfoide, seguido por el gastrointestinal. La mayoría de los pacientes se encontraban en estado avanzado de la enfermedad y la intención era paliativa. La mortalidad fue del 18.55%. De todos los pacientes ancianos con cáncer, el 11.34% fue valorado por el servicio de geriatría, evidenciando como principales síndromes geriátricos la fragilidad, desnutrición y comorbilidad severa. La VGI permitió en 18.18% la modificación del esquema de quimioterapia. Conclusiones: Este es el primer estudio que caracteriza la población geriátrica con cáncer del Hospital Universitario Nacional. Se resalta la importancia y utilidad de la valoración geriátrica integral en todos los ancianos puesto que brinda herramientas para la mejor toma de decisiones en estos pacientes. El tipo de cáncer más frecuente es el del sistema hematopoyético y linfoide lo que sirve de insumo para estudios futuros. (Texto tomado de la fuente).Introduction: The world population is aging rapidly. Cancer is one of the main causes of death in the world and due to different genetic, environmental, and physiological mechanisms, the elderly are more susceptible to suffering from this disease, which explains that worldwide between 50-60% of cancer diagnoses are made in the elderly. The multidimensional characterization of the elderly with cancer is a useful tool for better decision-making in these patients. Objective: To characterize the population older than 60 years hospitalized by the Oncology Service at the National University Hospital and to identify the main diagnoses, comorbidities, mortality, identify which were evaluated by the geriatric service and which were their main geriatric syndromes. Patients and methods: An observational, descriptive, cross-sectional study. Patients over 60 years of age hospitalized by the Oncology Service of the National University Hospital with confirmed neoplasia during the period February 2019 - February 2020 were selected. Statistical analysis was performed to describe the main demographic and clinical characteristics of the selected population. The records of the patients assessed by the Geriatric Department were reviewed to characterize geriatric syndromes in this population. Results: The present study characterized the population older than 60 years hospitalized by the Oncology Service of the National University Hospital. The prevalence of hospitalized elderly patients with cancer was 44.49%, most of the patients were female (55.67%), most of the patients were female (55.67%). The most frequent cancers were hematopoietic and lymphoid system, followed by gastrointestinal origin. Most of the patients were in an advanced stage of the disease and the intention was palliative. Mortality was 18.55%. Of all the elderly patients with cancer, 11.34% were assessed by the Geriatric Service, showing frailty, malnutrition, and severe comorbidity as the main geriatric syndromes. The VGI allowed in 18.18% of patients, the modification of the chemotherapy scheme. Conclusions: This is the first study that characterizes the geriatric population with cancer of the National University Hospital. The importance and usefulness of comprehensive geriatric assessment in all the elderly is highlighted, since it provides tools for better decision-making in these patients. The most frequent type of cancer is hematopoietic and lymphoid system, which serves as input for future studies.Especialidades MédicasEspecialista en Geriatría4. Metodología 4.1. Diseño del estudio Se trata de un estudio descriptivo con recolección de información de forma retrospectiva. 4.2. Población Pacientes mayores de 60 años hospitalizados por el servicio de Oncología del Hospital Universitario Nacional con neoplasia confirmada por biopsia durante el período febrero 2019 - febrero 2020. 4.3. Tamaño de muestra Se tomó la cantidad de pacientes que cumplieran los criterios de inclusión y exclusión mencionados a continuación. 4.4. Criterios de inclusión • Pacientes mayores de 60 años hospitalizados por el servicio de Oncología en el Hospital Universitario Nacional durante el período febrero 2019 - febrero 2020. • Diagnóstico de la neoplasia confirmado por biopsia. 4.5. Criterios de exclusión Pacientes que al momento de la revisión de la historia clínica no cuenten con la información suficiente para llevar a cabo el estudio o tiempo de hospitalización <48 horas. 4.6. Procedimientos y recolección de la información Las bases de datos usadas para este estudio fueron proporcionadas por el Hospital Universitario Nacional de Colombia en el periodo de estudio mencionado anteriormente. Los datos demográficos, diagnósticos clínicos, estancia y mortalidad de pacientes, así como otros datos de tipo derivado y personal fueron ajustados en la base de datos para garantizar la anonimidad de los pacientes. De conformidad con este principio de protección de datos personales se implementaron las herramientas digitales necesarias para garantizar estándares necesarios de anonimidad y recopilación de bases de datos en línea a través de la plataforma REDCap®. Asimismo, la información recopilada durante el estudio tuvo custodia únicamente en el equipo del investigador y bajo ningún motivo fue consultada por fuentes externas a menos que hubiése una autorización manifiesta por parte del Hospital Universitario Nacional.v, 83 páginas sin numerarapplication/pdfspaUniversidad Nacional de ColombiaBogotá - Medicina - Especialidad en GeriatríaDepartamento de Medicina InternaFacultad de MedicinaBogotá, ColombiaUniversidad Nacional de Colombia - Sede Bogotá610 - Medicina y salud::616 - EnfermedadesDemographyDemografíaCancer--Patients--Hospital careAged--Hospital careCancerosos-atención hospitalariaAncianos-Atención hospitalariaAncianoCáncerOncologíaValoración geriátrica integralOncogeriatríaAdulto mayorElderlyCancerOncologyGeriatricsComprehensive geriatric assessmentOncogeriatricsCaracterización clínica y demográfica de la población geriátrica en el servicio de oncología de un hospital universitario de Bogotá en un período de 12 mesesClinical and demographic characterization of the geriatric population in the oncology service of a university hospital of Bogota in a period of 12 monthTrabajo de grado - Especialidad Médicainfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/acceptedVersionTexthttp://purl.org/redcol/resource_type/TMBogotáBiremeR. Suzman and J. Beard, “WHO,Global Health and Aging,Technical Report,” Natl. Insititute Aging,National Institutes Heal., vol. 1, no. 4, pp. 273–277, 2011, doi: 11-7737.WHO/FWC/ALC, “Informe mundIal sobre el envejecimiento y la salud,” Organ. Mund. la Salud, p. 31, 2015.N. Denewet, S. De Breucker, S. Luce, B. Kennes, S. Higuet, and T. Pepersack, “Comprehensive geriatric assessment and comorbidities predict survival in geriatric oncology,” Acta Clin. Belgica Int. J. Clin. Lab. Med., vol. 71, no. 4, pp. 206–213, 2016, doi: 10.1080/17843286.2016.1153816.de R. S. Hamaker ME, Buurman BM, van Munster BC, Kuper IM, Smorenburg CH, “The Value of a Comprehensive Geriatric Assessment for Patient Care in Acutely Hospitalized Older Patients with Cancer,” Oncologist, vol. 16, no. 10, pp. 1403–1412, 2011, doi: 10.1634/theoncologist.2011-0227.M. C. White, D. M. Holman, J. E. Boehm, L. A. Peipins, M. Grossman, and S. Jane Henley, “Age and cancer risk: A potentially modifiable relationship,” Am. J. Prev. Med., vol. 46, no. 3 SUPPL. 1, pp. 1–16, 2014, doi: 10.1016/j.amepre.2013.10.029.H. Wildiers et al., “International society of geriatric oncology consensus on geriatric assessment in older patients with cancer,” J. Clin. Oncol., vol. 32, no. 24, pp. 2595–2603, 2014, doi: 10.1200/JCO.2013.54.8347.D. Swaminathan and V. Swaminathan, “Geriatric oncology: problems with under-treatment within this population,” Cancer Biol. Med., vol. 12, no. 4, pp. 275–283, 2015, doi: 10.7497/j.issn.2095-3941.2015.0081.I. H. Rodenas and L. Balducci, “Cáncer y envejecimiento,” in Tratado de medicina geriátrica, 2020, pp. 1196–1204.L. Decoster et al., “Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients: An update on SIOG recommendations,” Ann. Oncol., vol. 26, no. 2, pp. 288–300, 2015, doi: 10.1093/annonc/mdu210.J. Overcash, N. Ford, E. Kress, C. Ubbing, and N. Williams, “Comprehensive geriatric assessment as a versatile tool to enhance the care of the older person diagnosed with cancer,” Geriatr., vol. 4, no. 2, pp. 1–13, 2019, doi: 10.3390/geriatrics4020039.P. Caillet et al., “Optimal management of elderly cancer patients: Usefulness of the comprehensive geriatric assessment,” Clin. Interv. Aging, vol. 9, pp. 1645–1660, 2014, doi: 10.2147/CIA.S57849.M. O. Cadena Sanabria, “Evaluación del instrumento VES-13, escala TITAN y dominios de la Valoracin Geriátrica Integral como predictores de complicaciones durante el tratamiento de ancianos con cáncer,” p. 55, 2012, [Online]. Available: http://www.bdigital.unal.edu.co/7696/.K. Palmer and G. Onder, “Comprehensive geriatric assessment: Benefits and limitations,” Eur. J. Intern. Med., vol. 54, no. February, pp. e8–e9, 2018, doi: 10.1016/j.ejim.2018.02.016.R. L. Siegel, K. D. Miller, H. E. Fuchs, and A. Jemal, “Cancer Statistics, 2021,” CA. Cancer J. Clin., vol. 71, no. 1, pp. 7–33, 2021, doi: 10.3322/caac.21654Minisiterio de Salud y Protección Social, “Observatorio Nacional de Cáncer guia metodológica,” ONC Colomb., p. 18, 2018.Ministerio De Salud y Protección Social and Instituto Nacional de Cancerología, “Plan nacional para el control del cáncer en Colombia 2012-2020,” Minist. Salud Y Protección Soc., pp. 1–85, 2012, [Online]. Available: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/IA/INCA/plan-nacional-control-cancer-2012-2020.pdf.C. Pardo and R. Cendales, “Cancer incidence estimates and mortality for the top five cancer in Colombia, 2007-2011,” Colomb. Med., vol. 49, no. 1, pp. 16–22, 2018, doi: 10.25100/cm.v49i1.3596.A. M. Alvarado García and Á. M. Salazar Maya, “Análisis del concepto de envejecimiento,” Gerokomos, vol. 25, no. 2, pp. 57–62, 2014, doi: 10.1080/00039896.1964.10663695.D. Hanahan and R. A. Weinberg, “Hallmarks of cancer: The next generation,” Cell, vol. 144, no. 5, pp. 646–674, 2011, doi: 10.1016/j.cell.2011.02.013.I. Carreca, L. Balducci, and M. Extermann, “Cancer in the older person,” Cancer Treat. Rev., vol. 31, no. 5, pp. 380–402, 2005, doi: 10.1016/j.ctrv.2005.04.012.S. Hoffe and L. Balducci, “Cancer and Age: General Considerations,” Clin. Geriatr. Med., vol. 28, no. 1, pp. 1–18, 2012, doi: 10.1016/j.cger.2011.09.001.C. López-Otín, M. A. Blasco, L. Partridge, M. Serrano, and G. Kroemer, “The Hallmarks of Aging Europe PMC Funders Group,” Cell, vol. 153, no. 6, pp. 1194–1217, 2013, doi: 10.1016/j.cell.2013.05.039.E. Laconi, F. Marongiu, and J. DeGregori, “Cancer as a disease of old age: changing mutational and microenvironmental landscapes,” Br. J. Cancer, vol. 122, no. 7, pp. 943–952, 2020, doi: 10.1038/s41416-019-0721-1.J. W. Shay, “Role of Telomeres and Telomerase in Aging and Cancer,” Cancer Discov., vol. 176, no. 3, pp. 139–148, 2017, doi: 10.1158/2159-8290.CD-16-0062.Role.M. I. Zvereva, D. M. Shcherbakova, and O. A. Dontsova, “Telomerase: Structure, functions, and activity regulation,” Biochem., vol. 75, no. 13, pp. 1563–1583, 2010, doi: 10.1134/S0006297910130055.Y.-S. Cong, W. E. Wright, and J. W. Shay, “Human Telomerase and Its Regulation,” Microbiol. Mol. Biol. Rev., vol. 66, no. 3, pp. 407–425, 2002, doi: 10.1128/mmbr.66.3.407-425.2002J. D. Hayes, A. T. Dinkova-Kostova, and K. D. Tew, “Oxidative Stress in Cancer,” Cancer Cell, vol. 38, no. 2, pp. 167–197, Aug. 2020, doi: 10.1016/j.ccell.2020.06.001.M. Esteller, “Cancer epigenomics: DNA methylomes and histone-modification maps,” Nat. Rev. Genet., vol. 8, no. 4, pp. 286–298, 2007, doi: 10.1038/nrg2005.W. J. Locke et al., “DNA Methylation Cancer Biomarkers: Translation to the Clinic,” Front. Genet., vol. 10, no. November, pp. 1–22, 2019, doi: 10.3389/fgene.2019.01150.J. K. Pedersen, G. Engholm, A. Skytthe, and K. Christensen, “Cancer and aging: Epidemiology and methodological challenges,” Acta Oncol. (Madr)., vol. 55, no. Suppl 1, pp. 7–12, 2016, doi: 10.3109/0284186X.2015.1114670.L. Balducci, “Epidemiology of cancer and aging.,” J. Oncol. Manag., vol. 14, no. 2, pp. 47–50, 2005, [Online]. Available: http://www.ncbi.nlm.nih.gov/pubmed/16018199.A. Magnuson et al., “Geriatric assessment with management intervention in older adults with cancer: a randomized pilot study,” Support. Care Cancer, vol. 26, no. 2, pp. 605–613, Feb. 2018, doi: 10.1007/s00520-017-3874-6.Officer Alana and Manandhar Mary, “Década del Envejecimiento Saludable 2020-2030,” Organ. Mund. la Salud, pp. 1–7, 2020, [Online]. Available: https://www.who.int/ageing/sdgs/en/.H. Sung et al., “Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries,” CA. Cancer J. Clin., vol. 71, no. 3, pp. 209–249, 2021, doi: 10.3322/caac.21660.Fondo Colombiano de Enfermedades de Alto Costo Cuenta de Alto Costo [CAC]., “Situación del Cáncer en la población adulta atendida en el SGSSS de Colombia 2016,” 2017.S. Pilleron et al., “Global cancer incidence in older adults, 2012 and 2035: A population-based study,” Int. J. Cancer, vol. 144, no. 1, pp. 49–58, 2019, doi: 10.1002/ijc.31664.S. Hoffe and L. Balducci, “Cancer and Age: General Considerations,” Clin. Geriatr. Med., vol. 28, no. 1, pp. 1–18, 2012, doi: 10.1016/j.cger.2011.09.001.N. C. I. Surveillance Research Program, “SEER*Explorer: An interactive website for SEER cancer statistics,” SEER cancer statistics, 2020. https://seer.cancer.gov/explorer.Cancer Research UK, “Cancer mortality statistics,” Cancer Research UK, 2018.M. Roser and H. Ritchie, “Cancer,” OurWorldInData.org., 2015C. E. DeSantis et al., “Cancer statistics for adults aged 85 years and older, 2019,” CA. Cancer J. Clin., vol. 69, no. 6, pp. 452–467, 2019, doi: 10.3322/caac.21577.Ministerio de Salud Colombia, “SABE COLOMBIA 2015: ESTUDIO NACIONAL DE SALUD, BIENESTAR Y ENVEJECIMIENTO. RESUMEN EJECUTIVO Introducción,” 2015. Accessed: Sep. 06, 2018. [Online]. Available: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/GCFI/Resumen-Ejecutivo-Encuesta-SABE.pdf.DANE, “Censo Nacional de Población y Vivienda,” DANE, Publ. para todos, 2018, [Online]. Available: https://www.dane.gov.co/index.php/estadisticas-por-tema/demografia-y-poblacion/censo-nacional-de-poblacion-y-vivenda-2018/cuantos-somos.Ministerio de Salud y Protección Social, “Documento Metodológico Encuesta Nacional de Salud, Bienestar y Envejecimiento SABE Colombia,” p. 27, 2018, [Online]. Available: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/GCFI/doc-metodologia-sabe.pdf.Ministerio de Salud y Protección Social Oficina de Promoción Social, “Sala situacional de la Población Adulta Mayor,” Minist. Salud y Protección Soc., pp. 3–4, 2018, [Online]. Available: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/PS/sala-situacion-envejecimiento-2018.pdf.Instituto Nacional de Cancerología - ESE, “Anuario 2020,” Bogotá, D. C., 2021.E. Soto-Perez-de-Celis et al., “Cancer and aging in Ibero-America,” Clin. Transl. Oncol., vol. 20, no. 9, pp. 1117–1126, 2018, doi: 10.1007/s12094-018-1844-1.G. R. Williams et al., “Comorbidity in older adults with cancer,” J. Geriatr. Oncol., vol. 7, no. 4, pp. 249–257, 2016, doi: 10.1016/j.jgo.2015.12.002.T. L. Jørgensen, J. Hallas, S. Friis, and J. Herrstedt, “Comorbidity in elderly cancer patients in relation to overall and cancer-specific mortality,” Br. J. Cancer, vol. 106, no. 7, pp. 1353–1360, 2012, doi: 10.1038/bjc.2012.46.L. Adès, R. Itzykson, and P. Fenaux, “Myelodysplastic syndromes,” Lancet, vol. 383, no. 9936, pp. 2239–2252, 2014, doi: 10.1016/S0140-6736(13)61901-7.S. Burgstaller, P. Wiesinger, and R. Stauder, “Myelodysplastic Syndromes in the Elderly: Treatment Options and Personalized Management,” Drugs and Aging, vol. 32, no. 11, pp. 891–905, 2015, doi: 10.1007/s40266-015-0312-7.N. Burdett, A. D. Vincent, M. O’Callaghan, and G. Kichenadasse, “Competing risks in older patients with cancer: A systematic review of geriatric oncology trials,” J. Natl. Cancer Inst., vol. 110, no. 8, pp. 825–830, 2018, doi: 10.1093/jnci/djy111.B. Kanapuru, “Clinical trials : US Food and Drug Enrollment of Older Adults in Cancer Clinical Trials- A Continuing Conversation.”R. C. Chen, T. J. Royce, M. Extermann, and B. B. Reeve, “Impact of Age and Comorbidity on Treatment and Outcomes in Elderly Cancer Patients,” Semin. Radiat. Oncol., vol. 22, no. 4, pp. 265–271, 2012, doi: 10.1016/j.semradonc.2012.05.002.C. Terret, G. B. Zulian, A. Naiem, and G. Albrand, “Multidisciplinary approach to the geriatric oncology patient,” J. Clin. Oncol., vol. 25, no. 14, pp. 1876–1881, 2007, doi: 10.1200/JCO.2006.10.3291.C. Handforth et al., “The prevalence and outcomes of frailty in older cancer patients: A systematic review,” Ann. Oncol., vol. 26, no. 6, pp. 1091–1101, 2015, doi: 10.1093/annonc/mdu540M. A. Schonberg, H. Medical, B. Israel, and D. Medical, “Decision making around mammography screening for older women,” J Am Geriatr Soc., vol. 64, no. 12, pp. 2413–2418, 2016, doi: 10.1111/jgs.14503.Decision.T. Kalsi et al., “The impact of comprehensive geriatric assessment interventions on tolerance to chemotherapy in older people,” Br. J. Cancer, vol. 112, no. 9, pp. 1435–1444, 2015, doi: 10.1038/bjc.2015.120.M. J. Molina Garrido, “Peculiaridades en la atención y manejo del anciano oncológico,” in Tratado de medicina geriátrica, 2020, pp. 1205–1211.D. H. Solomon, “Geriatric assessment: methods for clinical decision making.,” JAMA, vol. 259, no. 16, pp. 2450–2, 1988, [Online]. Available: http://www.ncbi.nlm.nih.gov/pubmed/3280847.M. T. E. Puts et al., “An update on a systematic review of the use of geriatric assessment for older adults in oncology,” Ann. Oncol., vol. 25, no. 2, pp. 307–315, 2014, doi: 10.1093/annonc/mdt386.A. Magnuson, S. Sattar, G. Nightingale, R. Saracino, E. Skonecki, and K. M. Trevino, “A Practical Guide to Geriatric Syndromes in Older Adults With Cancer: A Focus on Falls, Cognition, Polypharmacy, and Depression,” Am. Soc. Clin. Oncol. Educ. B., no. 39, pp. e96–e109, 2019, doi: 10.1200/edbk_237641.P. Limpawattana, K. Phimson, A. Sookprasert, W. Sirithanaphol, and J. Chindaprasirt, “Prevalence of Geriatric Syndromes in Elderly Cancer Patients Receiving Chemotherapy,” Curr. Gerontol. Geriatr. Res., vol. 2020, pp. 1–5, Feb. 2020, doi: 10.1155/2020/9347804.L. Kirkhus et al., “Geriatric assessment is superior to oncologists’ clinical judgement in identifying frailty,” Br. J. Cancer, vol. 117, no. 4, pp. 470–477, 2017, doi: 10.1038/bjc.2017.202.S. K. Inouye, S. Studenski, M. Tinetti, and G. Kuchel, “Geriatric Syndromes: Clinical, Research and Policy Implications of a Core Geriatric Concept in older adults related to primary and secondary prevention,” J. Am. Geriatr. Soc., vol. 55, no. 5, pp. 780–91, 2007.C. Handforth et al., “Comprehensive geriatric assessment and decision-making in older men with incurable but manageable (chronic) cancer,” Support. Care Cancer, vol. 27, no. 5, pp. 1755–1763, 2019, doi: 10.1007/s00520-018-4410-z.C. Hernandez Torres and T. Hsu, “Comprehensive Geriatric Assessment in the Older Adult with Cancer: A Review,” Eur. Urol. Focus, vol. 3, no. 4–5, pp. 330–339, 2017, doi: 10.1016/j.euf.2017.10.010.D. Li et al., “Geriatric Assessment–Driven Intervention (GAIN) on Chemotherapy-Related Toxic Effects in Older Adults With Cancer,” JAMA Oncol., vol. 7, no. 11, p. e214158, Nov. 2021, doi: 10.1001/jamaoncol.2021.4158.S. G. Mohile et al., “Evaluation of geriatric assessment and management on the toxic effects of cancer treatment (GAP70+): a cluster-randomised study,” Lancet, vol. 398, no. 10314, pp. 1894–1904, Nov. 2021, doi: 10.1016/S0140-6736(21)01789-X.M. Extermann, “Cancer in the Elderly: Moving the Needle Toward Evidence-Based Personalized Oncology,” Int. J. Radiat. Oncol. Biol. Phys., vol. 98, no. 4, pp. 718–720, 2017, doi: 10.1016/j.ijrobp.2016.11.005.S. G. Mohile et al., “Practical assessment and management of vulnerabilities in older patients receiving chemotherapy: Asco guideline for geriatric oncology,” J. Clin. Oncol., vol. 36, no. 22, pp. 2326–2347, 2018, doi: 10.1200/JCO.2018.78.8687.E. Dotan et al., “Older adult oncology, version 1.2021: Featured updates to the NCCN guidelines,” JNCCN J. Natl. Compr. Cancer Netw., vol. 19, no. 9, pp. 1006–1019, 2021, doi: 10.6004/jnccn.2021.0043.F. Javier, M. Peromingo, O. Carlos, and M. E. Baeza, “Revista Española de Geriatría y Gerontología Propuesta de desarrollo de una unidad de oncogeriatría . Tiempos de cambio : nuestra realidad,” vol. 53, no. 3, pp. 149–154, 2020.S. G. Mohile et al., “Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Chemotherapy: ASCO Guideline for Geriatric Oncology,” J. Clin. Oncol., vol. 36, no. 22, pp. 2326–2347, Aug. 2018, doi: 10.1200/JCO.2018.78.8687.D. Saliba et al., “The Vulnerable Elders Survey: A Tool for Identifying Vulnerable Older People in the Community,” J. Am. Geriatr. Soc., vol. 49, no. 12, pp. 1691–1699, Dec. 2001, doi: 10.1046/j.1532-5415.2001.49281.x.D. Li, E. Soto-Perez-De-Celis, and A. Hurria, “Geriatric assessment and tools for predicting treatment toxicity in older adults with cancer,” Cancer J. (United States), vol. 23, no. 4, pp. 206–210, 2017, doi: 10.1097/PPO.0000000000000269.L. Repetto et al., “Comprehensive Geriatric Assessment Adds Information to Eastern Cooperative Oncology Group Performance Status in Elderly Cancer Patients: An Italian Group for Geriatric Oncology Study,” J. Clin. Oncol., vol. 20, no. 2, pp. 494–502, Jan. 2002, doi: 10.1200/JCO.2002.20.2.494.G. Nightingale et al., “Perspectives on functional status in older adults with cancer: An interprofessional report from the International Society of Geriatric Oncology (SIOG) nursing and allied health interest group and young SIOG,” J. Geriatr. Oncol., vol. 12, no. 4, pp. 658–665, May 2021, doi: 10.1016/j.jgo.2020.10.018.E. Morros-gonzález, I. Márquez, J. Pablo, and D. Patino-hernandez, “Life-space assessment and associated clinical factors : SABE Colombia Avaliação do espaço de vida e fatores clínicos associados : SABE Colômbia,” pp. 1–6, 2021.A. Hurria, M. S. Lachs, H. J. Cohen, H. B. Muss, and A. B. Kornblith, “Geriatric assessment for oncologists: Rationale and future directions,” Crit. Rev. Oncol. Hematol., vol. 59, no. 3, pp. 211–217, 2006, doi: 10.1016/j.critrevonc.2006.03.007.M. I. Bennett, S. Kaasa, A. Barke, B. Korwisi, W. Rief, and R. D. Treede, “The IASP classification of chronic pain for ICD-11: Chronic cancer-related pain,” Pain, vol. 160, no. 1, pp. 38–44, 2019, doi: 10.1097/j.pain.0000000000001363.R. Voumard, E. Rubli Truchard, L. Benaroyo, G. D. Borasio, C. Büla, and R. J. Jox, “Geriatric palliative care: a view of its concept, challenges and strategies,” BMC Geriatr., vol. 18, no. 1, p. 220, Dec. 2018, doi: 10.1186/s12877-018-0914-0.J. M. Wooten, “Pharmacotherapy considerations in elderly adults,” South. Med. J., vol. 105, no. 8, pp. 437–445, 2012, doi: 10.1097/SMJ.0b013e31825fed90.T. Borza et al., “The course of depressive symptoms and mortality in older patients with cancer,” Aging Ment. Heal., vol. 0, no. 0, pp. 1–8, 2021, doi: 10.1080/13607863.2021.1932739.J. A. Yesavage et al., “Development and validation of a geriatric depression screening scale: A preliminary report,” J. Psychiatr. Res., vol. 17, no. 1, pp. 37–49, 1982, doi: 10.1016/0022-3956(82)90033-4.J. Lacau St Guily et al., “NutriCancer: A French observational multicentre cross-sectional study of malnutrition in elderly patients with cancer,” J. Geriatr. Oncol., vol. 9, no. 1, pp. 74–80, 2018, doi: 10.1016/j.jgo.2017.08.003.G. Torbahn, T. Strauss, C. C. Sieber, E. Kiesswetter, and D. Volkert, “Nutritional status according to the mini nutritional assessment (MNA)® as potential prognostic factor for health and treatment outcomes in patients with cancer - a systematic review,” BMC Cancer, vol. 20, no. 1, p. 594, 2020, doi: 10.1186/s12885-020-07052-4.J. R. Huedo Rodenas, Isabel; Romero Macías, “El anciano con neoplasias hematológicas,” in Tratado de medicina geriátrica, 2021, pp. 1228–1244.A. P. Navarrete-reyes et al., “Principios geriátricos para pacientes con cáncer,” Geriatr Gerontol Aging, vol. 15, p. e0210010, 2021, doi: 10.5327/Z2447-212320212100009.S. Rohrmann, “Epidemiology of Frailty in Older People,” vol. Adv Exp Me, no. 1216, pp. 21–27, 2020, doi: 10.1007/978-3-030-33330-0_3.J. U. Ramírez Ramírez, M. O. Cadena Sanabria, and M. E. Ochoa, “Aplicación de la Escala de fragilidad de Edmonton en población colombiana. Comparación con los criterios de Fried,” Rev. Esp. Geriatr. Gerontol., vol. 52, no. 6, pp. 322–325, Nov. 2017, doi: 10.1016/j.regg.2017.04.001.J. F. Gómez Montes, C. Curcio Borrero, and G. M. Henao, “Fragilidad en ancianos Colombianos,” Rev.Medica.Sanitas, vol. 15, no. 4, pp. 8–16, 2012, [Online]. Available: http://www.unisanitas.edu.co/Revista/45/08 ANCIANOS DFN.pdf.J. M. Ocampo-Chaparro, C. A. Reyes-Ortiz, X. Castro-Flórez, and Gómez Fernando, “Fragilidad en personas adultas mayores y su asociación con determinantes sociales de la Salud. Estudio SABE Colombia,” Colomb. Med., vol. 50 (2), pp. 89–101, 2019.J. W. Faller, D. do N. Pereira, S. de Souza, F. K. Nampo, F. de S. Orlandi, and S. Matumoto, “Instruments for the detection of frailty syndrome in older adults: A systematic review,” PLoS One, vol. 14, no. 4, p. e0216166, Apr. 2019, doi: 10.1371/journal.pone.0216166.A. J. Cruz-Jentoft et al., “Sarcopenia: revised European consensus on definition and diagnosis,” Age Ageing, vol. 48, no. 1, pp. 16–31, Jan. 2019, doi: 10.1093/ageing/afy169.G. R. Williams, R. F. Dunne, S. Giri, S. S. Shachar, and B. J. Caan, “Sarcopenia in the Older Adult With Cancer,” J. Clin. Oncol., vol. 39, no. 19, pp. 2068–2078, Jul. 2021, doi: 10.1200/JCO.21.00102.T. K. Malmstrom, D. K. Miller, E. M. Simonsick, L. Ferrucci, and J. E. Morley, “SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes,” J. Cachexia. Sarcopenia Muscle, vol. 7, no. 1, pp. 28–36, Mar. 2016, doi: 10.1002/jcsm.12048M. E. Charlson, P. Pompei, K. L. Ales, and C. R. MacKenzie, “A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation,” J. Chronic Dis., vol. 40, no. 5, pp. 373–383, Jan. 1987, doi: 10.1016/0021-9681(87)90171-8.T. L. Jørgensen, J. Hallas, S. Friis, and J. Herrstedt, “Comorbidity in elderly cancer patients in relation to overall and cancer-specific mortality,” Br. J. Cancer, vol. 106, no. 7, pp. 1353–1360, Mar. 2012, doi: 10.1038/bjc.2012.46J. Tomaka, S. Thompson, and R. Palacios, “The relation of social isolation, loneliness, and social support to disease outcomes among the elderly,” J. Aging Health, vol. 18, no. 3, pp. 359–384, 2006, doi: 10.1177/0898264305280993.NCI, “Common Toxicity Criteria Manual Version 2.0,” Natl. Cancer Inst. Cancer Ther. Eval. Progr., no. 301, pp. 1–31, 1999P. Caillet et al., “Optimal management of elderly cancer patients: Usefulness of the comprehensive geriatric assessment,” Clin. Interv. Aging, vol. 9, pp. 1645–1660, 2014, doi: 10.2147/CIA.S57849.A. Hurria et al., “Predicting chemotherapy toxicity in older adults with cancer: A prospective multicenter study,” J. Clin. Oncol., vol. 29, no. 25, pp. 3457–3465, 2011, doi: 10.1200/JCO.2011.34.7625.M. Extermann et al., “Predicting the risk of chemotherapy toxicity in older patients: The chemotherapy risk assessment scale for high-age patients (CRASH) score,” Cancer, vol. 118, no. 13, pp. 3377–3386, 2012, doi: 10.1002/cncr.26646.I. Ortland et al., “Comparing the performance of the CARG and the CRASH score for predicting toxicity in older patients with cancer,” J. Geriatr. Oncol., vol. 11, no. 6, pp. 997–1005, 2020, doi: 10.1016/j.jgo.2019.12.016.A. Naseer et al., “International efforts in geriatric radiation oncology,” J. Geriatr. Oncol., Nov. 2021, doi: 10.1016/j.jgo.2021.11.002.A. Hurria et al., “Identifying vulnerable older adults with cancer: Integrating geriatric assessment into oncology practice,” J. Am. Geriatr. Soc., vol. 55, no. 10, pp. 1604–1608, 2007, doi: 10.1111/j.1532-5415.2007.01367.x.E. Murcia and J. Aguilera, “Boletín Servicios Oncológicos en Colombia, 2017,” p. 22, 2017, [Online]. Available: http://www.cancer.gov.co/files/libros/archivos/SO.COLOMBIA.pdf.S. De Investigaciones and V. Epidemiológica, “Boletín de servicios oncológicos Boletín de servicios oncológicos,” pp. 1–33, 2019.W. arbey Gutiérrez, “Situación actual del médico geriatra en Colombia Title: Geriatricians in Colombia,” vol. 56, no. 2, pp. 163–177, 2015.F. J. Martínez Peromingo, C. Oñoro Algar, M. E. Baeza Monedero, C. González de Villaumbrosia, D. Real de Asua Cruzat, and R. Barba Martín, “Propuesta de desarrollo de una unidad de oncogeriatría. Tiempos de cambio: nuestra realidad,” Rev. Esp. Geriatr. Gerontol., vol. 53, no. 3, pp. 149–154, May 2018, doi: 10.1016/j.regg.2017.10.007.C. Terret, G. B. Zulian, A. Naiem, and G. Albrand, “Multidisciplinary approach to the geriatric oncology patient,” J. Clin. Oncol., vol. 25, no. 14, pp. 1876–1881, 2007, doi: 10.1200/JCO.2006.10.3291.G. R. Williams et al., “Comorbidity in older adults with cancer,” J. Geriatr. Oncol., vol. 7, no. 4, pp. 249–257, 2016, doi: 10.1016/j.jgo.2015.12.002.Público generalORIGINAL1032450381.2022.pdf1032450381.2022.pdfTesis de Especialidad en Geriatríaapplication/pdf1515107https://repositorio.unal.edu.co/bitstream/unal/80972/3/1032450381.2022.pdf497f363510213db316a60be1df60a172MD53LICENSElicense.txtlicense.txttext/plain; charset=utf-84074https://repositorio.unal.edu.co/bitstream/unal/80972/4/license.txt8153f7789df02f0a4c9e079953658ab2MD54THUMBNAIL1032450381.2022.pdf.jpg1032450381.2022.pdf.jpgGenerated Thumbnailimage/jpeg5674https://repositorio.unal.edu.co/bitstream/unal/80972/5/1032450381.2022.pdf.jpg1353d4378ba9f9b0a8ad8cafd55801fdMD55unal/80972oai:repositorio.unal.edu.co:unal/809722024-08-02 23:11:16.144Repositorio Institucional Universidad Nacional de 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EVESURBIFBPUiBMQSBTRUNSRVRBUsONQSBHRU5FUkFMLiAqTEEgVEVTSVMgQSBQVUJMSUNBUiBERUJFIFNFUiBMQSBWRVJTScOTTiBGSU5BTCBBUFJPQkFEQS4gCgpBbCBoYWNlciBjbGljIGVuIGVsIHNpZ3VpZW50ZSBib3TDs24sIHVzdGVkIGluZGljYSBxdWUgZXN0w6EgZGUgYWN1ZXJkbyBjb24gZXN0b3MgdMOpcm1pbm9zLiBTaSB0aWVuZSBhbGd1bmEgZHVkYSBzb2JyZSBsYSBsaWNlbmNpYSwgcG9yIGZhdm9yLCBjb250YWN0ZSBjb24gZWwgYWRtaW5pc3RyYWRvciBkZWwgc2lzdGVtYS4KClVOSVZFUlNJREFEIE5BQ0lPTkFMIERFIENPTE9NQklBIC0gw5psdGltYSBtb2RpZmljYWNpw7NuIDE5LzEwLzIwMjEK

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