ABSTRACT
Objetivo. Determinar la efectividad de un programa de tratamiento con quimioterapia precoz para pacientes con cáncer vesical no músculo infiltrante antes y después de un plan de formación y comunicación dirigido a los profesionales que intervienen en el mismo. Método. Estudio longitudinal prospectivo, no experimental, de una cohorte de 349 pacientes con diagnóstico endoscópico de tumor vesical no músculo infiltrante en el AGS norte de Cádiz, entre 2010 y 2013, subsidiarios de tratamiento con mitomicina C posoperatoria. Resultados. La tasa media de pacientes incluidos en el programa fue del 53,9%. Esta tasa aumentó un 79,3% a los 3 años. La reducción absoluta del riesgo de recidiva para los pacientes que recibieron QTp fue del 18,1% (IC 95%: 8,8-27,4, p < 0,001), y el número de pacientes necesario a tratar de 5,5 (IC 95%: 3,6-11,3, p < 0,001). Conclusiones. Un programa de quimioterapia precoz postoperatoria que contemple un plan de evaluación y difusión de resultados ha conseguido un adecuado nivel de adherencia entre los profesionales, obteniendo el impacto esperado en la disminución de la recidiva precoz del cáncer de vejiga no músculo infiltrante (AU)
Objective. To determine the effectiveness of early intravesical chemotherapy intervention for patients with non-muscle invasive bladder cancer, before and after a training and inter-professional communication plan. Method. Non-experimental prospective longitudinal study of a cohort of 349 patients with endoscopic diagnosis of a non-muscle invasive bladder tumour in Northern Area Health Management of Cadiz between 2010 and 2013 and amenable to postoperative treatment with mitomycin C. Results. The mean rate of patients included in the program was 53.9%. The inclusion rate rose by 79.3% at 3 years. The absolute risk reduction of recurrence for patients receiving treatment is 18.1% (95% CI; 8.81% - 27.48%, p<.001), and the number of patients needed to treat was 5.5 (95% CI; 3.6 - 11.3, p<.001). Conclusions. A program of early postoperative chemotherapy that includes a plan for evaluation and dissemination of results has achieved a good level of adherence among professionals, obtaining the expected impact on the reduction of early recurrence of non-muscle invasive bladder cancer (AU)
Subject(s)
Humans , Male , Female , Urinary Bladder Neoplasms/drug therapy , Administration, Intravesical , Instillation, Drug , Medication Adherence , Evaluation of the Efficacy-Effectiveness of Interventions , Carcinoma, Intraductal, Noninfiltrating/complications , Carcinoma, Intraductal, Noninfiltrating/drug therapy , Longitudinal Studies , Prospective Studies , Cohort StudiesABSTRACT
OBJECTIVE: To determine the effectiveness of early intravesical chemotherapy intervention for patients with non-muscle invasive bladder cancer, before and after a training and inter-professional communication plan. METHOD: Non-experimental prospective longitudinal study of a cohort of 349 patients with endoscopic diagnosis of a non-muscle invasive bladder tumour in Northern Area Health Management of Cadiz between 2010 and 2013 and amenable to postoperative treatment with mitomycin C. RESULTS: The mean rate of patients included in the program was 53.9%. The inclusion rate rose by 79.3% at 3 years. The absolute risk reduction of recurrence for patients receiving treatment is 18.1% (95% CI; 8.81% - 27.48%, p<.001), and the number of patients needed to treat was 5.5 (95% CI; 3.6 - 11.3, p<.001). CONCLUSIONS: A program of early postoperative chemotherapy that includes a plan for evaluation and dissemination of results has achieved a good level of adherence among professionals, obtaining the expected impact on the reduction of early recurrence of non-muscle invasive bladder cancer.
Subject(s)
Neoplasm Recurrence, Local/prevention & control , Urinary Bladder Neoplasms/drug therapy , Administration, Intravesical , Antibiotics, Antineoplastic , Humans , Longitudinal Studies , Prospective StudiesABSTRACT
OBJECTIVE: To know the magnitude the HBV infection on the staff of the hospital and primary care centres in Jerez (Spain) and its area. This work was carried out from a study on the seroprevalence of virus markers. DESIGN: Cross-sectional study. SETTING: Jerez and its sanitary area. PARTICIPANTS: The workers of the hospital and primary care centres in Jerez and its area who agreed to participate, who had not been vaccinated previously and had no known hepatic pathology were studied. INTERVENTIONS: Determinations of anti-HBs, anti-HBc and HbsAg were made, and the statuses of carrier (AgHBs and anti-HBC positives), immune (anti-HBs and anti-HBc positives), isolated marker (anti-HBs or anti-HBc positive), and impregnated group (all the previous situations) were taken into consideration. The global prevalence +/- CI 95% for each serological state was calculated, and associated factors such as age, sex and professional category were studied by means of the prevalence ratio (PR) +/- CI 95%. RESULTS: 1189 hospital staffers and 341 primary-care workers with majority of women, were studied. The hospital group was younger than that of the primary care centres. The most frequent professional category was that of nurse in both settings. The global prevalence of autoimmmunes was higher in primary care centres (11.1 vs 9.2), but the number of impregnated subjects was a bit bigger in the hospital. The total number of carriers, nevertheless was similar in both settings. The PR were higher in men in both settings, and an increase in age was observed in almost all serological statuses. Physicians and health workers without probable risk where those who presented the highest PR in both settings. We included the cleaning employees in the second group. CONCLUSIONS: Although there were not great differences in the serological statuses of the staff in both settings, an important percentage of immune and impregnated subjects was observed. This indicates a previous contact with HBV and the necessity in both sittings of vaccination and other available preventive measures.
