ABSTRACT
Osteoarthritis (OA) is a pathology of great impact worldwide. Its physiopathology is not completely known, and it is usually diagnosed by imaging techniques performed at advanced stages of the disease. The aim of this study was to evaluate early serum metabolome changes and identify the main metabolites involved in an inflammatory OA animal model. This study was performed on thirty rats. OA was induced in all animals by intra-articular injection of monoiodoacetate into the knee joint. Blood samples were taken from all animals and analyzed by mass spectrometry before OA induction and 28, 56, and 84 days following induction. Histological evaluation confirmed OA in all samples. The results of this study allow the identification of several changes in 18 metabolites over time, including organic acids, benzenoids, heterocyclic compounds, and lipids after 28 days, organic acids after 56 days, and lipid classes after 84 days. We conclude that OA induces serological changes in the serum metabolome, which could serve as potential biomarkers. However, it was not possible to establish a relationship between the identified metabolites and the time at which the samples were taken. Therefore, these findings should be confirmed in future OA studies.
Subject(s)
Metabolomics , Osteoarthritis , Rats , Animals , Metabolomics/methods , Osteoarthritis/metabolism , Metabolome , Mass Spectrometry , Knee Joint/pathologySubject(s)
Anesthesiology/organization & administration , COVID-19/epidemiology , Health Care Surveys/statistics & numerical data , Pandemics , SARS-CoV-2 , Anesthesiologists/organization & administration , Anesthesiology/statistics & numerical data , Bed Conversion/statistics & numerical data , COVID-19/therapy , Cost-Benefit Analysis , Critical Care/statistics & numerical data , Hospital Bed Capacity/statistics & numerical data , Humans , Intensive Care Units , Personnel Staffing and Scheduling , Spain/epidemiologyABSTRACT
No disponible
Subject(s)
Humans , Health Care Surveys , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Pandemics , Health Services Needs and Demand , Health Services Needs and Demand/statistics & numerical data , Critical Care/statistics & numerical data , Anesthesia Department, Hospital/supply & distribution , SpainSubject(s)
HIV Infections/prevention & control , Pre-Exposure Prophylaxis/methods , Delayed Diagnosis/statistics & numerical data , Disease Notification/statistics & numerical data , Female , HIV Infections/diagnosis , HIV Infections/epidemiology , Humans , Male , Primary Health Care , Sex Work , Sexual Partners , Sexually Transmitted Diseases/diagnosis , Spain/epidemiology , Transgender PersonsABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Preventive Health Services , Primary Health Care , HIV Infections/prevention & control , Pre-Exposure Prophylaxis/methodsABSTRACT
Background. The programmed death (PD-1) inhibitor pembrolizumab has been recently approved for the treatment of advanced melanoma. We evaluated the clinical activity of pembrolizumab in melanoma patients treated under the Spanish Expanded Access Program. Methods. Advanced melanoma patients who failed to previous treatment lines were treated with pembrolizumab 2 mg/kg every three weeks. Patients with brain metastases were not excluded if they were asymptomatic. Data were retrospectively collected from 21 centers in the Spanish Melanoma Group. Results. Sixty-seven advanced melanoma patients were analyzed. Most patients were stage M1c (73.1%), had high LDH levels (55.2%) and had ECOG PS 1 or higher (59.7%). For cutaneous melanoma patients, median overall survival was 14.0 months; the 18-month overall survival rate was 47.1%. Overall response rate was 27%, including three patients with complete responses (6.5%). Median response duration was not reached, with 83.3% of responses ongoing (3.5 m+ to 20.4 m+). From ten patients included with brain metastases, four (40%) had an objective response, two (20%) of them achieved a complete response. Significant prognostic factors for overall survival were LDH level, ECOG PS and objective response. There were no serious adverse events. Conclusion. Although this was a heavily pretreated cohort, pembrolizumab activity at the approved dose and schedule was confirmed in the clinical setting with long-term responders, also including patients with brain metastases (AU)
No disponible
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Melanoma/drug therapy , Neoplasm Metastasis/drug therapy , Health Promotion/standards , Neoplasm Staging/methods , Retrospective Studies , Prognosis , Surveys and Questionnaires , Multivariate Analysis , Melanoma/classification , Skin Neoplasms/drug therapy , Uveal Neoplasms/drug therapyABSTRACT
No disponible
Subject(s)
Humans , HIV Infections/epidemiology , HIV Infections/prevention & control , HIV/immunology , HIV Seropositivity/epidemiology , Early Diagnosis , Primary Prevention/trends , Health Education/methods , Discrimination, Psychological , Vulnerability Analysis/prevention & control , Health VulnerabilityABSTRACT
BACKGROUND: The programmed death (PD-1) inhibitor pembrolizumab has been recently approved for the treatment of advanced melanoma. We evaluated the clinical activity of pembrolizumab in melanoma patients treated under the Spanish Expanded Access Program. METHODS: Advanced melanoma patients who failed to previous treatment lines were treated with pembrolizumab 2 mg/kg every three weeks. Patients with brain metastases were not excluded if they were asymptomatic. Data were retrospectively collected from 21 centers in the Spanish Melanoma Group. RESULTS: Sixty-seven advanced melanoma patients were analyzed. Most patients were stage M1c (73.1%), had high LDH levels (55.2%) and had ECOG PS 1 or higher (59.7%). For cutaneous melanoma patients, median overall survival was 14.0 months; the 18-month overall survival rate was 47.1%. Overall response rate was 27%, including three patients with complete responses (6.5%). Median response duration was not reached, with 83.3% of responses ongoing (3.5 m+ to 20.4 m+). From ten patients included with brain metastases, four (40%) had an objective response, two (20%) of them achieved a complete response. Significant prognostic factors for overall survival were LDH level, ECOG PS and objective response. There were no serious adverse events. CONCLUSION: Although this was a heavily pretreated cohort, pembrolizumab activity at the approved dose and schedule was confirmed in the clinical setting with long-term responders, also including patients with brain metastases.
Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , Antineoplastic Agents/therapeutic use , Melanoma/drug therapy , Adult , Aged , Aged, 80 and over , Disease-Free Survival , Female , Humans , Kaplan-Meier Estimate , Male , Melanoma/mortality , Middle Aged , Proportional Hazards Models , Retrospective Studies , Salvage Therapy/methods , Spain , Treatment OutcomeABSTRACT
Los problemas de salud mental en niños y adolescentes son motivos de consulta frecuentes en Atención Primaria (AP). En la mayor parte de los casos, un tratamiento ambulatorio desde AP o desde su Centro de Salud Mental (CSM) es suficiente para una mejora significativa. Sin embargo, en ocasiones la sintomatología puede ser la manifestación de una estructuración psíquica seriamente dañada. En esos casos, donde existe un trastorno mental grave (TMG), es posible que dichos tratamientos ambulatorios no sean suficientes. En el presente artículo se presenta el Hospital de Día-Centro Educativo Terapéutico (HD-CET) Pradera de San Isidro. Un dispositivo de hospitalización parcial que forma parte de la red de Salud Mental de la Comunidad de Madrid, en el que se atiende a menores con TMG mediante un tratamiento ambulatorio intensivo. EL HD-CET consta de dos unidades: la de infantil (de 6 a 11 años) y la de adolescentes (de 12 a 17 años). Ambas cuentan con un equipo multidisciplinar de profesionales de Salud Mental, así como con un equipo docente encargado del aspecto académico de los pacientes. Se trabaja desde el modelo de comunidad terapéutica, procurando proporcionar al paciente experiencias emocionales correctoras que logren una mejora significativa y profunda del TMG (AU)
Child and adolescence mental health conditions are common in Primary Care (PC). In most cases, Mental Health Services (MHS) will achieve a good response in an outpatient basis. However, certain symptoms may indicate seriously damaged psychic structures, as found in Severe Mental Disorders (SMD), whose ambulatory care in PC and MHS may not be sufficient. Pradera de San Isidro Mental Health Day Care Hospital-Educational Therapeutic Centre (DCH-ETC) is part of Madrid Regional Mental Health Care Services, attending children and adolescents with SMD in a outpatient intensive program. DCH-ETC comprises a Children Unit attending patients of 6 to 11 years and an Adolescents Unit for patients from 12 to 17 years. A team of teachers is responsible for the continuing academic education of patients. With a Therapeutic Community model, the program aims to provide corrective emotional experiences leading to a deep and significant improvement in SMD (AU)
Subject(s)
Humans , Male , Female , Child , Adolescent , Day Care, Medical , Mental Disorders/epidemiology , Psychopharmacology/methods , Psychopharmacology/trends , Relaxation Therapy/methods , Relaxation Therapy/organization & administration , Relaxation Therapy/trends , Early Diagnosis , Mental Health/statistics & numerical data , Mental Health/standards , Community Health Services , Community Psychiatry/organization & administration , Psychopharmacology/organization & administration , Psychopharmacology/standards , Social Isolation/psychology , Confusion/therapyABSTRACT
OBJECTIVES: The objectives of this study were to investigate the acceptability of rapid HIV testing among general practitioners in Spain and to identify perceived barriers and needs in order to implement rapid testing in primary care settings. METHODS: An anonymous questionnaire was distributed online to all members of the two largest Spanish scientific medical societies for family and community medicine. The study took place between 15th June and 31st October 2010. RESULTS: Completed questionnaires were returned by 1308 participants. The majority (90.8%) of respondents were General Practitioners (GP). Among all respondents, 70.4% were aware of the existence of rapid tests for the diagnosis of HIV but they did not know how to use them. Nearly 80% of participants would be willing to offer rapid HIV testing in their practices and 74.7% would be confident of the results obtained by these tests. The barriers most commonly identified by respondents were a lack of time and a need for training, both in the use of rapid tests (44.3% and 56.4%, respectively) and required pre- and post-test counselling (59.2% and 34.5%, respectively). CONCLUSIONS: This study reveals a high level of acceptance and willingness on the part of GPs to offer rapid HIV testing in their practices. Nevertheless, the implementation of rapid HIV testing in primary care will not be possible without moving from comprehensive pre-test counselling towards brief pre-test information and improving training in the use of rapid tests.
Subject(s)
Attitude of Health Personnel , General Practice/methods , General Practitioners/psychology , HIV Infections/diagnosis , Adult , Counseling/education , Early Diagnosis , Female , General Practitioners/education , Health Knowledge, Attitudes, Practice , Humans , Knowledge , Male , Primary Health Care , Spain/epidemiology , Surveys and QuestionnairesABSTRACT
This study investigated the acceptability of rapid HIV testing among general practitioners (GP) and aimed to identify perceived barriers and needs in order to implement rapid testing in primary care settings. An anonymous questionnaire was distributed online to all members of the two largest Spanish scientific medical societies for family and community medicine. The study took place between 15 June 2012 and 31 October 2010. Completed questionnaires were returned by 1308 participants. The majority (90.8%) of respondents were GP. Among all respondents, 70.4% were aware of the existence of rapid tests for the diagnosis of HIV but they did not know how to use them. Nearly 80% of participants would be willing to offer rapid HIV testing in their practices and 74.7% would be confident of the result obtained by these tests. The barriers most commonly identified by respondents were a lack of time and a need for training, both in the use of rapid tests (44.3% and 56.4%, respectively) and required pre- and post-test counselling (59.2% and 34.5%, respectively). This study reveals a high level of acceptance and willingness on the part of GPs to offer rapid HIV testing in their practices. Nevertheless, the implementation of rapid HIV testing in primary care will not be possible without moving from comprehensive pre-test counselling towards brief pre-test information and improving training in the use of rapid tests.
Subject(s)
General Practice/methods , General Practitioners/psychology , HIV Infections/diagnosis , Diagnostic Tests, Routine , Early Diagnosis , HIV Seropositivity , Health Knowledge, Attitudes, Practice , Humans , Primary Health Care , Spain , Surveys and QuestionnairesABSTRACT
Introducción. El objetivo del trabajo es mostrar y analizar los resultados de errores preanalíticos en las muestras de laboratorio remitidas desde atención primaria a 7 laboratorios de la Comunidad Valenciana que atienden a 7 departamentos de salud. Material y métodos. Se realizó un estudio transversal mediante la evaluación y el análisis de los errores preanalíticos de 7 laboratorios. El error preanalítico se definió como muestra que no puede ser analizada por no cumplir los criterios de aceptabilidad o que no se recibe en el laboratorio. Se diseñaron indicadores de proporción que cuantifican cada incidencia respecto al total de cada muestra (hematología, coagulación, bioquímica y orina). Los errores preanalíticos y las muestras se recogieron automáticamente del Sistema de Información del Laboratorio, y también se calcularon los indicadores a tiempo real mediante un software basado en data warehouse y cubos OLAP. Resultados. La variabilidad de los resultados entre los diferentes centros fue elevada, evidenciándose que el mayor porcentaje de incidencias se debió a la falta de disponibilidad de las muestras, en especial de coagulación y de orina. Conclusiones. Existe una gran variabilidad de errores preanalíticos dependiendo del Departamento de Salud. Existe una necesidad de homogeneizar la práctica de la extracción de muestras(AU)
Purpose. To show the number of preanalytical sample errors in seven laboratories attending seven health departments of Valencian Community (Spain). Methods. Cross-sectional study of the number of preanlytical errors in samples obtained in primary care centers. An error is defined as a rejected specimen: any blood or urine sample, which cannot be successfully tested as it does not meet the acceptability criteria of the laboratory or if the sample is not received. We collected preanalytical errors from the tests requested for hematology, coagulation, chemistry, and urine samples. Registers were collected and indicators calculated automatically through a data warehouse and OLAP cubes software. Results. Larges differences in the results of preanalytical errors were observed between health departments. The highest percentage of errors occurred in coagulation samples, followed by urine, hematology and biochemistry. With regard to the type of error, the largest proportion of errors was due to failures of process. Conclusions. The high incidence of preanalytical errors and variability between health departments suggests that there is a need to standardize the drawing practice(AU)
Subject(s)
Humans , Male , Female , Multicenter Studies as Topic/methods , Quality Indicators, Health Care/statistics & numerical data , Quality Indicators, Health Care/trends , Specimen Handling/methods , Specimen Handling/statistics & numerical data , Clinical Laboratory Techniques/trends , Clinical Laboratory Techniques , Clinical Laboratory Techniques/methods , Clinical Laboratory Techniques/standards , Clinical Laboratory Techniques , Quality Indicators, Health Care/organization & administration , Quality Indicators, Health Care/standards , Quality Indicators, Health Care , Cross-Sectional Studies/methods , Cross-Sectional Studies , Primary Health Care/methodsABSTRACT
PURPOSE: To show the number of preanalytical sample errors in seven laboratories attending seven health departments of Valencian Community (Spain). METHODS: Cross-sectional study of the number of preanlytical errors in samples obtained in primary care centers. An error is defined as a rejected specimen: any blood or urine sample, which cannot be successfully tested as it does not meet the acceptability criteria of the laboratory or if the sample is not received. We collected preanalytical errors from the tests requested for hematology, coagulation, chemistry, and urine samples. Registers were collected and indicators calculated automatically through a data warehouse and OLAP cubes software. RESULTS: Large differences in the results of preanalytical errors were observed between health departments. The highest percentage of errors occurred in coagulation samples, followed by urine, hematology and biochemistry. With regard to the type of error, the largest proportion of errors was due to failures of process. CONCLUSIONS: The high incidence of preanalytical errors and variability between health departments suggests that there is a need to standardize the drawing practice.
Subject(s)
Clinical Laboratory Techniques/standards , Cross-Sectional Studies , Humans , Quality Assurance, Health Care , Quality ControlABSTRACT
El objetivo del trabajo es proponer un sistema de indicadores de gestión a partir de los datos normalizados del Sistema de Información conómico ( SIE) de la Agencia Valenciana de Salud que aplica a los laboratorios públicos de la Comunidad Valenciana. Como resultados se obtienen indicadores de costes, de complejidad, de rendimiento de personal y de rendimiento de material y se establece una comparación con los datos del SIE 2008 de los 9 laboratorios participantes. En conclusión, la obtención de los indicadores de gestión a partir del Sistema de Información Económico, no supone ningún trabajo adicional para el laboratorio; la información es homogénea y la comparación interlaboratorios proporciona una información de gran utilidad para la gestión de los laboratorios (AU)
No disponible
Subject(s)
Humans , Laboratories, Hospital/economics , Clinical Laboratory Techniques/economics , Clinical Laboratory Information Systems/organization & administration , Pilot ProjectsABSTRACT
Objetivo. Presentar los resultados del tiempo de respuesta relacionado con el tipo de cliente en ocho laboratorios clínicos de la Comunidad Valenciana que atienden a ocho departamentos de salud (2.014.475 habitantes). Material y métodos. Se utilizaron registros internos (fecha/hora de registro y validación de la prueba) y registros diarios (tipo de paciente) del Sistema Informático del Laboratorio para construir los indicadores. Estos indicadores muestran el porcentaje de pruebas clave (hemograma y glucosa y tirotropina séricas) solicitadas que son validadas en el mismo día de la extracción de muestra (pacientes ingresados o de atención primaria) y/o antes de las 12.00 a.m. (pacientes ingresados). El tiempo de respuesta de pruebas urgentes se refirió a pruebas clave (troponina y potasio séricos) y se expresó en minutos. La recogida de registros y el cálculo de indicadores se realizó de forma automática mediante una aplicación informática basada en data warehouse y cubos OLAP. Resultados. Se observaron grandes diferencias en los porcentajes de validación antes de las 12.00 a.m. para pacientes ingresados y en el día de la extracción para pacientes de atención primaria. La variabilidad observada en los tiempos de respuesta de pruebas urgentes se relacionó con el tamaño del hospital, actividad y validación por el facultativo del laboratorio. Conclusiones. El estudio de benchmarking ha servido para mostrar la gran disparidad de tiempos de respuesta en ocho departamentos de salud de la Comunidad Valenciana. La atención en el laboratorio a distintos tipos de clientes crea la necesidad de la continua adaptación de los procesos para conseguir su satisfacción(AU)
Purpose. To show turnaround time to client source in eight laboratories covering eight Health Areas (2,014,475 inhabitants) of the Valencian Community (Spain). Material and methods. Internal Laboratory Information System (LIS) registers (test register and verification date and time), and daily LIS registers were used to design the indicators, These indicators showed the percentage of key tests requested (full blood count and serum glucose and thyrotropin) that were validated on the same day the blood was taken (inpatients and Primary Care and/or at 12 a.m. (inpatients). Urgent (stat) tests were also registered as key tests (serum troponin and potassium) and were recorded in minutes. Registers were collected and indicators calculated automatically through a Data Warehouse application and OLAP cube software. Results. Long turnaround time differences were observed at 12 a.m. in inpatients, and in the day of sample extraction in primary care patients. The variability in turnaround of stat tests is related to hospital size, activity and validation by the laboratory physician. Conclusions. The study results show the large turnaround time disparity in eight Health Care Areas of Valencian Community. The various requesting sources covered by the laboratories create the need for continuous mapping processes redesign and benchmarking studies to achieve customer satisfaction(AU)
Subject(s)
Humans , Male , Female , Pilot Projects , Quality Indicators, Health Care/statistics & numerical data , Quality Indicators, Health Care , Efficiency, Organizational/standards , Laboratories/organization & administration , Laboratories , Clinical Laboratory Techniques/methods , Clinical Laboratory Techniques/standards , Primary Health Care/methods , Benchmarking/organization & administration , Quality Indicators, Health Care/trends , Biomedical Technology/organization & administration , Biomedical Technology/standards , BenchmarkingABSTRACT
PURPOSE: To show turnaround time to client source in eight laboratories covering eight Health Areas (2,014,475 inhabitants) of the Valencian Community (Spain). MATERIAL AND METHODS: Internal Laboratory Information System (LIS) registers (test register and verification date and time), and daily LIS registers were used to design the indicators, These indicators showed the percentage of key tests requested (full blood count and serum glucose and thyrotropin) that were validated on the same day the blood was taken (inpatients and Primary Care and/or at 12 a.m. (inpatients). Urgent (stat) tests were also registered as key tests (serum troponin and potassium) and were recorded in minutes. Registers were collected and indicators calculated automatically through a Data Warehouse application and OLAP cube software. RESULTS: Long turnaround time differences were observed at 12 a.m. in inpatients, and in the day of sample extraction in primary care patients. The variability in turnaround of stat tests is related to hospital size, activity and validation by the laboratory physician. CONCLUSIONS: The study results show the large turnaround time disparity in eight Health Care Areas of Valencian Community. The various requesting sources covered by the laboratories create the need for continuous mapping processes redesign and benchmarking studies to achieve customer satisfaction.
