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Introduccion: En el desarrollo de los Programas de Deteccion Precoz de Cancer Colorrectal (PDPCCR), la colonoscopia es la prueba diagnostica final, asi como el principal factor l imitante, este hecho sumado a situaciones como la reciente pandemia por COVID, que puso en minimos el funcionamiento de varios servicios de endoscopia a nivel nacional, hace que nos plantearamos intentar buscar patrones predictivos que a futuro permitan la priorizacion de aquellos pacientes con mayor riesgo de endoscopia patologica dentro del programa de cribado, a fin de agilizar el desarrollo de los mismos. Metodos: Estudio retrospectivo basado en una muestra de datos clinicos y endoscopicos recopilados de las 2 primeras rondas del PDPCCR del Area de la Tramuntana-Hospital Comarcal de Inca (Mallorca). Resultados: Se encontro asociacion entre la variabilidad de la edad, el sexo y los valores cuantitativos de la sangre oculta en heces inmunoquimica (SOHi) con el riesgo de hallazgos endoscopicos, asi como la toma de antiinflamatorios no esteroideos (AINES) y acido acetilsalicilico (AAS) como factores protectores. Conclusiones: Hemos podido replicar los resultados de otros estudios, lo que fortalece nuestro programa de cribado, y nos sirve de base para obtener prospectivamente modelos de riesgo mas precisos.Copyright © 2023 Elsevier Espana, S.L.U. Todos los derechos reservados.
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Business sectors are generally evolving towards the adoption of models of sustainable practice, but is this also true in the specific audio-visual sector? This question leads us to examine whether sustainable practices are carried out in the image and sound sector, using sector business leadership as a starting point. Adopting a long-term perspective has helped companies survive difficult times, such as seemingly ever more frequent economic crises and recessions, as well as to overcome the current COVID-19 pandemic and its aftermath. Together with review of appropriate literature, the study aims to analyse the perception of managers in the audio-visual sector regarding styles of leadership in their organizations, through the Bee and Locust Sustainable Leadership framework that Avery and Bergsteiner developed in 2011. A quantitative study was carried out based on the analysis of the responses given by fifty middle and senior managers from the audio-visual sector in Spain who answered a 54-poit questionnaire. The findings yielded interesting results. Organizations within the audio-visual sector were found to display elements of both bee and locust leadership styles. The results showed that idea contribution and teamwork were valued by the managers interviewed. Furthermore, considerable importance was attached to the need to implement continuous training and the development of corresponding professional careers in companies. Overall, the results showed that there was a clear need for companies in the audio-visual sector to put greater effort into promoting and successfully achieving sustainable practices at the operational level. © 2022 Communication & Society.
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Background: Strategies for locally advanced rectal cancer LARC usually consisted of neoadjuvant concomitant chemoradiotherapy (CRT) followed by adjuvant chemotherapy, or short-course radiotherapy (SCRT). TNT is a novel approach for LARC, with several randomized clinical trials exploring its role and paving the way for implementation in clinical practice. Nevertheless, the COVID-19 pandemic represented a challenge for a timely diagnosis, implementation and follow-up of new treatment strategies in these pts. Methods: Records of all the pts diagnosed with LARC and stage IV rectal cancer evaluated in the Oncology department of Vall d’Hebron Hospital between Jan 1st, 2017 and Dec 31th 2021 were included. The period 2017-19 was considered pre-pandemic (PP) and 2020-2021 during-pandemic (DP). Patients with LARC receiving neoadjuvant and/or adjuvant treatment were analyzed, including those treated with SCRT, CRT, and TNT. Data regarding demographics, diagnosis and staging, preoperative treatment received, surgical outcomes, including treatment response, and pathological stage were collected. Results: 390 patients were included (31.28% female, 68.71% Male, median age 69). LARC pts characteristics included 123 (31.54%) either cT4 or cN2, 59 low rectal cancers, 4 with signet ring cells. Neoadjuvant treatment was done in 160 pts (CRT) and 59 pts (TNT). pCR was achieved in 20% and 22% for CRT, and TNT respectively (p0.84). 32 pts received only SCRT with 6.25% pCR. An increased ratio of stage IV pts compared to LARC was evident during the pandemic (stage IV 26.38% 2017-2019, 37.14% 2020-2021, p=0.044). The proportion of high risk LARC increased during pandemic (34.89% PP vs 39.04% DP, p=0.041). No difference was found in terms of pCR amongst the PP and DP patients (25.3% vs 27%, p=0.83) nor different strategies (TNT: 26.47% PP and 26.6% PD, p=0.98 and CRT 23.89% PP and 27.27 % PD, p=0.82). Conclusions: Efficacy of LARC neoadjuvant treatment measured by pCR was maintained in pts before and during COVID-19 pandemic despite an increasing proportion of new LARC high-risk pts. Evaluation of TNT impact in LARC outcomes was challenging because of pandemic confounding role. Real-world data in a post-pandemic setting is essential to evaluate outcome trends in LARC pts;an increase in high-risk LARC and metastatic pts should be expected. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosures: A. García Álvarez: Speaker Bureau / Expert testimony: ANGELINI PHARMA ESPAÑA;Travel / Accommodation / Expenses: Pfizer, Ipsen, Eisai Europe. All other authors have declared no conflicts of interest.
Subject(s)
COVID-19 Vaccines , COVID-19/prevention & control , Lymphadenopathy , Adult , BNT162 Vaccine , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/adverse effects , Female , Humans , Lymphadenopathy/diagnostic imaging , Lymphadenopathy/etiology , Remission, Spontaneous , SARS-CoV-2 , Ultrasonography/methodsABSTRACT
OBJECTIVES: The study aims to assess the impact of the second COVID-19 pandemic wave on migraine characteristics. METHODS: This is an observational cross-sectional study conducted on migraine patients previously interviewed during the first Italian pandemic outbreak. A second structured telephone interview was conducted between 20 November 2020 and 18 January 2021. We compared migraine characteristics among T0 (before pandemic), T1 (during the first pandemic phase), and T2 (during the second pandemic phase). RESULTS: Among the 433 patients interviewed during the first pandemic phase, 304 cases were finally considered. One hundred forty-eight patients had a control visit between March 2020 and December 2020, 120 had an in-person visit, 14 by phone, the remainder used telemedicine software provided by the hospital. Frequency of headache, number of symptomatic drugs and headache intensity worsened during T2, compared to T0 and T1, especially in episodic migraine. Headache intensity increased relating to the negative emotional impact of the pandemic. Migraine management during the pandemic did not influence the clinical outcome. CONCLUSION: The prolongation of the pandemic seems to have a negative impact on migraine evolution. The arousal and negative psychological behavior toward the COVID-19 outbreak seem to worsen migraine.
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Social responsibility (SR) is a philosophy which starts to permeate the medical schools and drives the need to revise their mission in society and how to better contribute to its development for equity, participation, collaboration and social welfare values. We speak of the fact that medical schools must become aware of their obligations to satisfy the needs of society, as expressed by the global consensus in SR. In some countries, especially in the Anglo-Saxon ones, USA, Australia and Canada SR where has already being implemented. In Europe its implementation is still limited, except for some very specific cases in France and Belgium due to the Francophone Network. For some authors we are facing a change in the medical education paradigm which may have similar impact as the Flexner report in 1910, when a radical change took place, both in the training of the doctor and in the professional practice, which led to specialization and detriment of general medicine. The aim of this article is to clarify the concept, background and implications of SR in health science schools, as well as to present the main models developed up to now, all of them oriented to Primary and Community Care, a weakness that the COVID-19 pandemic has highlighted. © 2020 Elsevier España, S.L.U.
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Rationale: COVID-19 may manifest with a wide range of symptoms and its degree of severity may be from mild to severe. Our aim was to assess the prevalence and pathophysiology of oropharyngeal dysphagia (OD), malnutrition (MN), nutritional risk, and the needs of compensatory treatments in patients admitted due to COVID-19 at the Consorci Sanitari del Marseme (CSdM), Catalonia, Spain. Methods: Prospective observational study with clinical assessment of OD (clinical symptoms, clinical observation and Volume-Viscotisy Swallowing Test) and nutritional screening with NRS2002 and GLIM criteria in consecutive COVID-19 patients admitted at the Hospital de Mataró (CSdM) during 2020 Covid-19 pandemics. Patient’s clinical characteristics and their needs of compensatory treatments for OD and MN were assessed at baseline and will be followed up at 3 and 6 months. Here we present the baseline data. Results: We included 268 hospitalized patients, 52.2% men, with a mean age of 70.2±17.0 yr, severity of disease was moderate-severe in 34%. At hospital admission prevalence of OD was 52.4% (49.4% had impaired efficacy and 44.9% impaired safety of swallow). Pathophysiology of OD includes ICU and post-extubating factors (16%), neurological factors (32%), respiratory insufficiency (42%) and interstitial pneumonia (74%). Up to 43.7% of patients needed thickeners to be safely hydrated (38.7% with 250mPa·s and 5.2% with 800mPa·s of Xanthan Gum thickeners) and 54.5% had mastication impairments needing texture-modified diets (27.7% easy mastication and 28.8% puree). 74.2% of patients presented a NRS2002>3 and were at risk of MN, 46% had MN and 73.8% of patients received ONS. Conclusion: Prevalence of OD, nutritional risk and MN in patients with COVID-19 at admission in a General Hospital is very high. Pathophysiology is multifactorial and not limited to ICU factors. Early treatment includes fluid thickening, texture modified foods and nutritional support. References: 10 Basic procedures to assess and treat oropharyngeal dysphagia in patients with COVID-19 (SARS-CoV-2) infection. Disclosure of Interest: O. Ortega: None declared, V. Arreola: None declared, W. Nascimento: None declared, A. Martín: None declared, A. Costa: None declared, M. Arús: None declared, M. Roca: None declared, P. Viñas: None declared, S. Carríon: None declared, P. Clavé Grant / Research Support from: Nutricia Danone Advanced Nutrition