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1.
Enfermería Intensiva (English ed.) ; 2022.
Article in English | ScienceDirect | ID: covidwho-1819483

ABSTRACT

The COVID-19 pandemic has caused an unprecedented health crisis. Pressure on the National Health System has created unique demand particularly in certain services and care units like the critical care units. Objective To learn about the experience of nurses in caring for people with coronavirus in critical care units. Method A qualitative phenomenological study that constitutes the second phase of a mixed methodology project. We conducted interviews with 17 nurses caring for patients affected by COVID-19 in critical care units. The interviews were audio-recorded, transcribed, and analysed using thematic discourse analysis. Results This article shows the findings around the theme “the value of human resources” which is nuanced through sub-themes “it's not the beds, it's the expert staff”, “shouldering the patient's burden”, and suffering because “they have not cared well”. Discussion Expert nurses have emerged as leading professionals in the care of the critical patient during the COVID-19 pandemic. This leadership is executed from a profile framed in an inclusive philosophy where wisdom, agility and intuition are the key elements underpinning problem identification and solving in a creative way, while adapting to the needs of the patient and healthcare team as they emerge. Conclusions Expert nurses have played an advanced role in the management of care and human resources by exercising effective leadership in the clinical setting. Care has been hampered due to the crisis, which causes nurses moral distress because they have been unable to meet standards of quality and excellence in care. Resumen La pandemia por COVID-19 ha supuesto una crisis sanitaria sin precedentes. La presión asistencial sobre el Sistema Nacional de Salud ha generado escenarios insólitos de demanda especialmente llamativos en algunos servicios o unidades asistenciales como las Unidades de Cuidados Críticos. Objetivo Conocer la experiencia de los profesionales enfermeros referida a la atención de personas infectadas por coronavirus en las Unidades de Cuidados Críticos. Método Estudio cualitativo de carácter fenomenológico que constituye la segunda fase de un proyecto de metodología mixta. Se realizaron entrevistas a 17 enfermeras que prestaron cuidados en Unidades de Cuidados Críticos a pacientes afectados de COVID-19. Las entrevistas fueron audiograbadas, transcritas y analizadas mediante análisis temático del discurso. Resultados En este artículo se muestran los hallazgos en torno al tema «el valor del recurso humano» que matiza su significado a través de los subtemas «no son las camas, es el personal experto», «llevando la carga del paciente» y sufriendo por «no haber cuidado bien». Discusión Los profesionales enfermeros expertos se erigen como profesionales líderes en el cuidado del paciente crítico durante la pandemia por COVID-19. Este liderazgo se ejerce desde un perfil enmarcado en una filosofía integradora donde sabiduría, agilidad e intuición son los elementos clave que dan soporte a la identificación y resolución de problemas de forma creativa adaptándose a las necesidades emergentes de los pacientes y equipo de cuidados. Conclusiones Los profesionales enfermeros expertos han desempeñado un rol avanzado en la gestión de cuidados y de recursos humanos mediante el ejercicio de un liderazgo eficiente en el entorno clínico. Los cuidados se han visto mermados por la situación de crisis, circunstancia que les genera sufrimiento moral por no haber podido cumplir con los estándares de calidad y excelencia en el cuidado.

3.
Blood Purification ; 50(SUPPL 1):13, 2021.
Article in English | EMBASE | ID: covidwho-1816954

ABSTRACT

Introduction: Hemoperfusion (HPF) involves the passage of blood (or plasma) through an adsorption cartridge which removes solutes by binding them. Gattinoni et al. have described a new parameter: the alactic base excess (ABE). This variable is obtained by applying the following equation: ABE mmol /L = standard base excess (SBE) mmol/L + lactate mmol/L, being standard base excess mmol/L = [bicarbonate mmol/L - 24.8 mmol/L] + 16.2 mmol/L x (pH - 7.4). A negative ABE value reflects acid retention, which is associated with an increased mortality in septic patients. In the present study, we decided to evaluate if HPF could remove negative ABE value in septic patients. Material & Methods: Basal values of ABE, SBE and lactate (mean, SD) were obtained. The difference between these parameters values before and after 4 HPF (HA330) sessions (delta value) was evaluated. Student and Wilcoxon tests were applied for data analyses. Results: From 32 patients (age: 57±13, male 69%) suffering from respiratory insufficiency secondary to COVID-19 (RIC) who were treated with HPF (HA330) in the critical care unit of Clinica De la Mujer, Bogotá (Colombia), 6 presented metabolic acidosis (pH:7.37±0.1, pCO2: 36±14 mmHg, bicarbonate:20.5±3 mmol/L) with negative ABE value (-2.7±1) composed by negative SBE (- 4.7±1) and high lactate serum value (2±0.7 mmol/L). Delta ABE, SBE and lactate were: 7.7 (p:0.005), 6.1 (p:0.003) and 1.6 (p:NS), respectively. Thus, negative ABE was significantly removed by HPF, without lactate change. Conclusion: HPF significantly removed negative alactic base excess in sepsis .

4.
Blood Purification ; 50(SUPPL 1):12, 2021.
Article in English | EMBASE | ID: covidwho-1816948

ABSTRACT

Introduction: Hemoperfusion (HPF) is a depurative technique based on the passage of blood (or plasma) through an adsorption cartridge for binding diverse solutes. Among different sorts of sorbent cartridges, the HA330 one can be used for treating inflammatory overreaction since it binds cytokines. SARS-CoV2 neumonia induced cytokines storm is one of the inflammatory states which can be treated by HPF. Then, it was decided to compare the clinical evolution between critical patients suffering from respiratory insufficiency secondary to SARS-CoV2 neumonia who were treated with or without HPF based on HA330 cartridge. Material & Methods: Mortality rate, serum creatinine, and ferritin values were compared between a group of patients suffering from respiratory insufficiency due to SARS-CoV2 neumonia who received conventional treatment support (Clínica De la Costa, Barranquilla.Colombia), and another group who additionally received 4 HPF-HA330 sessions (Clínica De la Mujer, Bogotá, Colombia). Student and Wilcoxon tests were applied for data analyses. Results: From 116 patients, 57 years old (range: 47-71), male (65%) suffering from RIC, one group (n: 84) received conventional support treatment (Clínica De la Costa, Barranquilla), and the other group (n: 32) additionally received HPF-HA330 (Clínica De la Mujer, Bogotá). Both groups had similar basal serum creatinine (0.9 mg/dl), and prevalence of hypertension (49%), diabetes mellitus (26%), chronic respiratory disease (12%) and cardiopathy (9%). HPF group had higher prevalence of obesity (72% vs 44%, p: 0.013), and mechanical ventilation (90% vs 48%, p:<0.001) than the non HPF group. Mortality rate (31% vs 61%, p: 0.008), highest serum creatinine (0.5 mg/dl vs 1.4 mg/dl,p:<0.001), and post-HPF ferritin (2868 vs 1675, p:<0.001) were significantly lower in HPF group. Conclusion: Hemoperfusion reduced mortality and renal damage in patients with respiratory insufficiency secondary to SARS-CoV2 neumonia.

5.
International Conference on Marketing and Technologies, ICMarkTech 2021 ; 280:635-644, 2022.
Article in English | Scopus | ID: covidwho-1777686

ABSTRACT

Covid-19 affected the whole world in 2020, its effect brings the evolution of some markets, many experts say that it has evolved 10 years the way in which marketing is handled, focusing purely on the development of digital marketing and the transformation of Ministry of Micro, Small and Medium Enterprises (MSMEs) in Ecuador. All this because of the confinement that led people to live their lives through the screens of your cell phone, from which you could make food purchases mainly but then this gave opening for other products and then services that were giving as the restrictions were being eliminated. For this reason, it can be seen how E-commerce has emerged and for some entrepreneurs it has been easy but for others it becomes an odyssey because they do not know the fundamental aspects to develop in this world and that is why these paper aims to present concepts that will allow new MSMEs that start their activity to identify a sense of location within the wonderful world of e-commerce. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

8.
Biomedica ; 42(1), 2022.
Article in English, Spanish | Scopus | ID: covidwho-1716088

ABSTRACT

Introduction: The coronavirus disease 2019 (COVID-19) has become a significant public health problem worldwide. In this context, CT-scan automatic analysis has emerged as a COVID-19 complementary diagnosis tool allowing for radiological finding characterization, patient categorization and disease follow-up. However, this analysis is dependent on the radiologist expertise, which might result in subjective evaluations. Objective: To explore deep learning representations, trained from thoracic CT-slices, to automatically distinguish COVID-19 disease from control samples. Materials and methods: Two datasets were used: SARS-CoV-2 CT Scan (Set-1) and FOSCAL dataset (Set-2). First, the deep representations take advantage of supervised learning models, previously trained on the natural image domain, which are adjusted following a transfer learning scheme. The deep classification was carried out: (a) via end-to-end deep learning approach and (b) via Random Forest and Support Vector Machine classifiers, by feeding the deep representation embedding vectors into these classifiers. Results: The End-to-end classification achieved an average accuracy of 92.33% (89.70% precision) for Set-1 and 96.99% (96.62% precision) for Set-2. The deep feature embedding with a Support Vector Machine achieved an average accuracy of 91.40% (95.77% precision) and 96.00% (94.74% precision), for Set-1 and Set-2 respectively. Conclusion: Deep representations have achieved outstanding performance in the identification of COVID-19 cases on CT Scans, demonstrating good characterization of the COVID-19 radiological patterns. These representations 5 could potentially support the COVID-19 diagnosis on clinical settings. © 2022,Biomedica. all rights reserved

9.
Question ; 3(70):23, 2021.
Article in Spanish | Web of Science | ID: covidwho-1689593

ABSTRACT

The objective of the research was to gather several photographic accounts and findings about stories and findings in times of pandemic, with the intention of mapping experiences and views from science about living with the COVID-19 virus. Two types of methodologies were used to achieve the objectives. On the one hand, the documentary methodology was used through photographs to represent the "calm", from the point of view of family members of the researchers themselves. As for the scientific findings, we reviewed studies obtained from ScienceDirect.com from the years 2020 and 2021, which addressed the problem of infodemia (in addition to the disastrous health and economic repercussions, COVID-19 has also led to an epidemic of misinformation and rumors, an "infodemia"). Cybergraphy was also used for the study of one of the pioneering digital portals in the work of information verification in Peru, which is Ojo Publico.

10.
Int J Infect Dis ; 112: 124-129, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1654544

ABSTRACT

OBJECTIVES: The aim of this study was to evaluate the impact on 30-day mortality of early use of corticosteroids in COVID-19 patients with supplementary oxygen requirements and without invasive mechanical ventilation at the initiation of therapy. METHODS: All patients hospitalized with COVID-19 between April 15 and July 15, 2020, and requiring supplementary oxygen, were prospectively included in a database. Patients who died or required intubation within the first 48 hours were excluded. Patients who received corticosteroids within the first 5 days of hospitalization and at least 24 hours prior to intubation were allocated to the 'early corticosteroids' group. To compare both populations and adjust for non-random treatment assignment bias, a weight-adjusted propensity score model was used. RESULTS: In total, 571 patients met the inclusion criteria, 520 had sufficient information for the analysis. Of these, 233 received early corticosteroids and 287 did not. Analysis showed a reduction of 8.5% (p = 0.038) in 30-day mortality in the early corticosteroid group. The reduction in mortality was not significant when patients with corticosteroid initiation between day 5 and day 8 of hospitalization were included. CONCLUSION: Early corticosteroid use reduced mortality in patients with pneumonia due to COVID-19, who required supplementary oxygen but not initial invasive mechanical ventilation.


Subject(s)
COVID-19 , Adrenal Cortex Hormones/therapeutic use , Humans , Propensity Score , Respiration, Artificial , SARS-CoV-2 , Steroids
11.
European Urology ; 79:S173-S174, 2021.
Article in English | EMBASE | ID: covidwho-1593667

ABSTRACT

Introduction & Objectives: COVID-19 incidence and mortality among patients undergoing surgery has risen concerns about surgical safety, especially during the peaks of the SARS-CoV-2 pandemic. Our objective isto describe the outcomes at theurology department of a tertiary hospital during the second wave of the pandemic and its comparison with the first one. Materials & Methods: Observational, prospective cohort study including all patients undergoing urological surgery from 1st March to 15th November. According to the hospital organization and local epidemiological situation we delimitate the first wave from 1st March to 3rd May and the second wave from 14th August to 25th October. A set of screening and protective measures was applied from 4th May onwards. Demographic, baseline, surgical and perioperative variables, as well as postoperative outcomes, were collected. Telephone follow-up was performed at least 3 weeks after hospital discharge. Results: 624 urological surgeries were performed, 26 patients developed COVID-19 (4.17% incidence) and 6 died because of the disease (23.1% mortality). Mean time to symptom onset was 62.4 days after discharge. Prognosis was worse for those patients diagnosed during admission or up st to 14 days after discharge (statistically significant variables in Table) which happened only during the 1 wave (12% incidence, 10/83). In contrast, the 2nd wave brought 2 mild community cases (1.1% incidence, 2/186). TheFigure displays the 14-day cumulative incidence of COVID-19 cases in the population attended by our hospital and the operated urological patients, according to the date in which symptoms began or positive PCR was documented. (Table presented.) (Figure presented.) Conclusions: After implementing complete protective measures, no postoperative in-hospital COVID-19 cases were detected, even during the second wave. Most of the cases were due to community transmission and thus driven by the general epidemiological situation. While hospitals follow recommendations to avoid COVID-19 infection, urological surgery remains safe and can be maintained.

12.
Enfermeria intensiva ; 2021.
Article in Spanish | EuropePMC | ID: covidwho-1564179

ABSTRACT

La pandemia por COVID-19 ha supuesto una crisis sanitaria sin precedentes. La presión asistencial sobre el Sistema Nacional de Salud ha generado escenarios insólitos de demanda especialmente llamativos en algunos servicios o unidades asistenciales como las Unidades de Cuidados Críticos. Objetivo Conocer la experiencia de los profesionales enfermeros referida a la atención de personas infectadas por coronavirus en las Unidades de Cuidados Críticos. Método Estudio cualitativo de carácter fenomenológico que constituye la segunda fase de un proyecto de metodología mixta. Se realizaron entrevistas a 17 enfermeras que prestaron cuidados en Unidades de Cuidados Críticos a pacientes afectados de COVID-19. Las entrevistas fueron audiograbadas, transcritas y analizadas mediante análisis temático del discurso. Resultados En este artículo se muestran los hallazgos en torno al tema «el valor del recurso humano» que matiza su significado a través de los subtemas «no son las camas, es el personal experto», «llevando la carga del paciente» y sufriendo por «no haber cuidado bien». Discusión Los profesionales enfermeros expertos se erigen como profesionales líderes en el cuidado del paciente crítico durante la pandemia por COVID-19. Este liderazgo se ejerce desde un perfil enmarcado en una filosofía integradora donde sabiduría, agilidad e intuición son los elementos clave que dan soporte a la identificación y resolución de problemas de forma creativa adaptándose a las necesidades emergentes de los pacientes y equipo de cuidados. Conclusiones Los profesionales enfermeros expertos han desempeñado un rol avanzado en la gestión de cuidados y de recursos humanos mediante el ejercicio de un liderazgo eficiente en el entorno clínico. Los cuidados se han visto mermados por la situación de crisis, circunstancia que les genera sufrimiento moral por no haber podido cumplir con los estándares de calidad y excelencia en el cuidado.

13.
European Heart Journal ; 42(SUPPL 1):2122, 2021.
Article in English | EMBASE | ID: covidwho-1554760

ABSTRACT

Background: Measures taken to mitigate the spread of coronavirus disease 2019 (COVID-19) have been correlated to a decline in the number of patients seeking medical care for emergency cardiovascular illness. Here we evaluate the impact of a state-wide lockdown on ST-elevation myocardial infarction (STEMI) care. Purpose: The purpose of this study is to help understand the impact of COVID-related lockdowns on STEMI interventions. Methods: All consecutive adult patients admitted with an acute STEMI diagnosis and percutaneous intervention (PCI) performed between January 17, 2020, and July 14, 2020, at five sites across our health care network, were included in this study. Patient demographics, medical history and procedure details were collected retrospectively from electronic medical records. Data were segregated according to date into pre-lockdown, lockdown (March 17 to May 13, 2020) and post-lockdown groups. Results: A total of 225 patients formed the study cohort. Median age was 62 (IQR: 53-71) years. Patients were predominantly male (n=154, 68%), white (n=208, 92%), hypertensive (n=139, 61%) and dyslipidemic (n=135, 60%). The average weekly rate of STEMI PCIs performed pre-lockdown decreased by 40% during the lockdown from 10.9 to 6.5 PCIs per week (p<0.05). Door-to-balloon (D2B) times increased from 42 (IQR: 28-68) min pre-lockdown to 53 (IQR: 40-72) min during the lockdown (p=0.01). No significant differences were observed in in-hospital mortality or cardiac troponin measurements within 24 h of procedure between the three groups. Conclusion: Adverse effects of COVID-19-related lockdowns on acute STEMI care include a decrease in PCI volumes and prolonged D2B times. Our results provide valuable data-driven criteria to help inform patient decisions to seek care and to find ways to protect healthcare workers without compromising timely critical intervention.

14.
European Heart Journal ; 42(SUPPL 1):839, 2021.
Article in English | EMBASE | ID: covidwho-1554136

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) rapidly spread worldwide since it first emerged in December 2019, with more than 100 million cases reported to date, causing a great impact on healthcare systems. Heart failure (HF) is a major health problem. It affects about 10 million people in Europe and is the leading cause of hospitalization for patients older than 65 years. During the first wave of COVID-19 there was an important decrease in HF hospitalizations. Data regarding HF admissions during the second and third waves and inter-waves periods is scarce. Purpose: To examine the impact of COVID-19 on HF hospitalizations during the first year of the pandemic and to compare the clinical characteristics and in-hospital outcomes of patients admitted during the three pandemic waves with those admitted the previous year during the same periods. Methods: Data from a tertiary Heart Failure Unit in Southern Spain between 1 March 2020 and 28 February 2021 were compared to the corresponding time period in the previous year. The impact of the pandemic on weekly hospitalizations was assessed using a Poisson Regression model, with year, season and pandemic wave as covariates. Clinical characteristics and in-hospital outcomes of patients admitted during the three waves were compared to those admitted during the same periods one year after. Results: A significantly lower weekly number of admissions for HF was observed during the three pandemic wave periods compared to all other included periods (inter-wave periods and same periods in the previous year) (p=0.002, IRR 0.81, 0.77-0.86). Figure 1 shows monthly HF admissions between 1 March 2020 and 28 February 2021 (pandemic year) and the previous year, as well as COVID-19 hospitalized cases in our area. Clinical characteristics and in-hospital outcomes of patients admitted during the COVID-19 waves and the same periods in the previous year are shown in Figure 2. Patients admitted during the COVID-19 waves were younger, and fewer had diabetes mellitus (DM), atrial fibrillation (AF) and valvular heart disease (VHD). There were no differences in clinical outcomes (intensive care unit admission, in-hospital mortality). Conclusion: There was decline in HF hospitalization during the three waves of the pandemic year, but not during the inter-wave periods. Patients admitted during the wave periods had some clinical differences but similar in-hospital outcomes.

15.
Enferm Intensiva ; 2021 Dec 02.
Article in Spanish | MEDLINE | ID: covidwho-1549773

ABSTRACT

The COVID-19 pandemic has caused an unprecedented health crisis. Pressure on the National Health System has created unique demand particularly in certain services and care units like the critical care units. OBJECTIVE: To learn about the experience of nurses in caring for people with coronavirus in critical care units. METHOD: A qualitative phenomenological study that constitutes the second phase of a mixed methodology project. We conducted interviews with 17 nurses caring for patients affected by COVID-19 in critical care units. The interviews were audio-recorded, transcribed, and analysed using thematic discourse analysis. RESULTS: This article shows the findings around the theme "the value of human resources" which is nuanced through sub-themes "it's not the beds, it's the expert staff", "shouldering the patient's burden", and suffering because "they have not cared well". DISCUSSION: Expert nurses have emerged as leading professionals in the care of the critical patient during the COVID-19 pandemic. This leadership is executed from a profile framed in an inclusive philosophy where wisdom, agility and intuition are the key elements underpinning problem identification and solving in a creative way, while adapting to the needs of the patient and healthcare team as they emerge. CONCLUSIONS: Expert nurses have played an advanced role in the management of care and human resources by exercising effective leadership in the clinical setting. Care has been hampered due to the crisis, which causes nurses moral distress because they have been unable to meet standards of quality and excellence in care.

17.
Applied Sciences-Basel ; 11(21):18, 2021.
Article in English | Web of Science | ID: covidwho-1533756

ABSTRACT

The recent increase in user interaction with social media has completely changed the way customers communicate their opinions, questions, and concerns to brands. For this reason, many companies have established on the top of their agendas the necessity of analyzing the high amounts of user-generated content data in social networks. These analyses are helping brands to understand their customers' experiences as well as for maintaining a competitive advantage in the sector. Due to this fact, this study aims to analyze and characterize the public opinions from the messages posted by Twitter users while addressing customer services. For this purpose, this study carried out a content analysis of a customer service platform. We extracted the general users' viewpoints and sentiments of each of the discussed topics by using a wide range of techniques, such as topic modeling, document clustering, and opinion mining algorithms. For training these systems and drawing conclusions, a dataset containing tweets from the English-speaking customers addressing the @Uber_Support platform during the year 2020 has been used.

19.
American Journal of Transplantation ; 21(SUPPL 4):463, 2021.
Article in English | EMBASE | ID: covidwho-1494463

ABSTRACT

Purpose: Health systems need tools to deal with COVID-19, especially for high-risk population,such as transplant recipients. Predictive models are necessary to improve management of patients and optimize resources. Methods: A retrospective study of hospitalized transplant patients due to COVID-19 was evaluated(March 3-April 24,2020). Admission data were integrated to develop a prediction model to evaluate a composite-event defined as Intensive Care Unit admission or intensification treatment with antiinflamatory agents. Predictions were made using a Data Envelopment Analysis(DEA)-Artificial Neural Network(ANN) hybrid, whose accuracy relative to several alternative configurations has been validated through a battery of clustering techniques. Results: Of 1006 recipients with a planned or an unscheduled visit during the observation period, thirty-eight were admitted due to COVID-19. Twenty-five patients(63.2%) exhibited poor clinical course(mortality rate:13.2%), within a mean of 12 days of admission stay. Cough as a presenting symptom(P=0.000), pneumonia(P=0.011), and levels of LDH(P=0.031) were admission factors associated with poor outcomes. The prediction hybrid model working with a set of 17 input variables displays an accuracy of 96.3%, outperforming any competing model, such as logistic regression(65.5%) and Random forest(denoted by Bagged Trees,44.8%). Moreover, the prediction model allows us to categorize the evolution of patients through the values at hospital admission. Conclusions: The prediction model based in Data Envelopment Analysis-Artificial Neural Network hybrid forecasts the progression towards severe COVID-19 disease with an accuracy of 96.3%, and may help to guide COVID-19 management by identification of key predictors that permit a sustainable distribution of resources in a patient-centered model. Improving efficiency and patient parformance in the AAN with DEA, we can get high accurancy even with no-big cohorts. (Table Presented).

20.
Radiotherapy and Oncology ; 161:S303-S304, 2021.
Article in English | EMBASE | ID: covidwho-1492796

ABSTRACT

Purpose or Objective To evaluate the outcomes after high-precison RT (preferably VMAT) with increased doses (EQD2 for tumors >40 Gy) when compared to 10x3 Gy (EQD2=32.5 Gy) for metastatic spinal cord compression (MSCC) in patients with favorable survival prognoses. Materials and Methods Since 08/2019, 29 (of 65) patients (9 female, 20 male) with motor deficits due to MSCC and a favorable survival prognosis according to a validated score have been included in a phase II trial (RAMSES-01). Median age is 68 (48-90) years, and most common tumor types are prostate cancer (n=10), breast cancer (n=7) and myeloma (n=6). RT regimens include 18x2.333 Gy (EQD2=43.2 Gy, n=10), 15x2.633 Gy (41.6 Gy, n=17;fewer fractions due to Covid-19 pandemic) and 12x2.663 Gy + 3x2.333 Gy (40.5 Gy, n=2;due to concurrent immunotherapy). Primary endpoint is local progression-free survival (LPFS=no progression of motor deficits during RT and no in-field recurrence following RT). Secondary goals include effect on motor function [improvement, overall response (OR) = at least no further progression] and sensory deficits, pain relief, overall survival (OS) and toxicity. Follow-up (FU) is performed until death or for 12 months. Results Three patients are currenty under treatment, one patient died after 14 Gy. Thus, 25 patients are evaluable for LPFS and response. LPFS is 100% at the end of RT (currently n=25), and at 1 month (n=21), 3 months (n=16), 6 months (n=9), 9 months (n=5) and 12 months (n=3) following RT. Considering best response during FU, OR and improvement rates are 100% and 60%, respectively. Sensory function normalized in 5 of the 9 patients (55.6%) with pre-RT sensory dysfunction. Of 21 patients with pain (median score 8, range 4-10), 18 (86%) achieved pain relief [complete in 7 patients (33%)]. OS-rates at 6 and 12 months are 71% and 71%, respectively. Six patients died (3 sepsis, 2 pneumonia, 1 tumor progression);death was not related to RT. RT-related grade 3 toxicity occurred in 2/25 (8%) patients (1 esophagitis, 1 diarrhea). Conclusion First results of high-precision RT with increased doses for MSCC in patients with favorable survival prognoses appear very promising with high response and LPFS rates and very few grade 3 toxicities. Updated information will be presented at the meeting.

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