Subject(s)
Choline , Hyperparathyroidism, Secondary , Radiopharmaceuticals , Humans , Choline/analogs & derivatives , Hyperparathyroidism, Secondary/diagnostic imaging , Hyperparathyroidism, Secondary/blood , Fluorine Radioisotopes , Positron Emission Tomography Computed Tomography/methods , Hyperparathyroidism/diagnostic imaging , Hyperparathyroidism/bloodABSTRACT
INTRODUCTION: The implementing of the WHO Surgical Safety Checklist (SSC) has helped to improve patient safety. The aim of this study was to assess the level of compliance of the SSC, and incorporating the non-compliances as «triggers¼ in the Global Trigger Tool (GTT). SETTING: Acute Geriatric Hospital (200 beds). Retrospective study, study period: 2011-2014. The SSC formulary and the methodology of the GTT were used for the analysis of electronic medical records and the compliance with the SSC. The NCCP MERP categories were used to assess the severity of the harm. RESULTS: Out of all the electronic medical records (EMR), a total of 227 (23.6%) discharged patients (1.7% of interventions in the four year study period) were analysed. All (100%) of the EMR included the SSC, with 94.4% of the items being completed, and 28.2% of SSC had all items completed in the 3 phases of the process. Surgical adverse events decreased from 16.3% in 2011 to 9.4% in 2014 (P=.2838, not significant), and compliance with all items of SSC was increased from 18.6% to 39.1% (P=.0246, significant). CONCLUSIONS: The GTT systematises and evaluates, at low cost, the triggers and incidents/ AEs found in the EMR in order to assess the compliance with the SSC and consider non-compliance of SSC as «triggers¼ for further analysis. This strategy has never been referred to in the GTT or in the SCC formulary.
Subject(s)
Checklist , Guideline Adherence , Preoperative Care/standards , Health Services for the Aged , Hospitals, Special , Humans , Retrospective StudiesABSTRACT
Introducción. La implantación del listado de verificación quirúrgica (LVQ) por la OMS ha permitido mejorar la seguridad de los pacientes. El objetivo ha sido evaluar el grado de cumplimiento del LVQ incorporando los no cumplimientos como triggers o pistas en la herramienta Global Trigger Tool (GTT). Material y métodos. Ámbito: hospital geriátrico de agudos con 200 camas. Estudio retrospectivo. Periodo de estudio: 2011-2014. Se utilizó el formulario del LVQ y la metodología del GTT para el análisis de historias clínicas y el cumplimiento del LVQ desde el año 2011 hasta el año 2014. Para el grado del daño se usaron las categorías del National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP). Resultados. Se analizaron 227 historias de pacientes dados de alta (23,6%) de todas las historias electrónicas (1,7% de las intervenciones en los 4 años). El 100% de las historias contenían el LVQ, el 94,4% de los ítems estaban cubiertos y 28,2% de los LVQ tenían todos los ítems cumplimentados en las 3 fases del proceso. Los efectos adversos quirúrgicos disminuyeron del 16,3% en el año 2011 al 9,4% en el año 2014 (p=0,2838, no significativo) y el cumplimiento de todos los ítems del LVQ aumentó del 18,6 al 39,1% (p=0,0246, significativo). Conclusiones. La herramienta GTT permite sistematizar con un menor coste de tiempo la búsqueda de historias clínicas al azar para evaluar el cumplimiento del LVQ y considerar a los no cumplimientos del LVQ como triggers para su análisis posterior. Esta estrategia no ha sido nunca contemplada en el GTT ni en la sistemática del LVQ (AU)
Introduction. The implementing of the WHO Surgical Safety Checklist (SSC) has helped to improve patient safety. The aim of this study was to assess the level of compliance of the SSC, and incorporating the non-compliances as «triggers» in the Global Trigger Tool (GTT). Material and methods. Setting: Acute Geriatric Hospital (200 beds). Retrospective study, study period: 2011-2014. The SSC formulary and the methodology of the GTT were used for the analysis of electronic medical records and the compliance with the SSC. The NCCP MERP categories were used to assess the severity of the harm. Results. Out of all the electronic medical records (EMR), a total of 227 (23.6%) discharged patients (1.7% of interventions in the four year study period) were analysed. All (100%) of the EMR included the SSC, with 94.4% of the items being completed, and 28.2% of SSC had all items completed in the 3 phases of the process. Surgical adverse events decreased from 16.3% in 2011 to 9.4% in 2014 (P=.2838, not significant), and compliance with all items of SSC was increased from 18.6% to 39.1% (P=.0246, significant). Conclusions. The GTT systematises and evaluates, at low cost, the triggers and incidents/ AEs found in the EMR in order to assess the compliance with the SSC and consider non-compliance of SSC as «triggers» for further analysis. This strategy has never been referred to in the GTT or in the SCC formulary (AU)
Subject(s)
Humans , Male , Female , Patient Safety/legislation & jurisprudence , Patient Safety/standards , Quality of Health Care/organization & administration , Quality of Health Care/standards , Forms as Topic/standards , Formulary, Hospital/standards , Quality of Health Care , Retrospective Studies , Medical Records/legislation & jurisprudence , Medical Records/standards , Forms and Records Control/standards , 28599ABSTRACT
Broccoli (Brassica oleracea var. italica) is a vegetable that requires the application of postharvest techniques to extend its marketability. Controlled atmosphere and 1-MCP treatments are most used to extend the shelf life of broccoli and reduce post-harvest deterioration. The aim of this study was to evaluate the visual, physicochemical and functional changes of broccoli head samples stored at 1-2 °C and 85-90% relative humidity (RH) in air (Control samples), under controlled atmospheres (10% O(2) and 5% CO(2)) (CA samples) and treated with 1-MCP (0.6 µL/L). After storage all samples were maintained at 20 °C for 2 and 4 days, in order to assess their shelf life. The most suitable postharvest treatment to extend broccoli quality during storage and shelf life, in terms of maintaining the visual quality and reducing loss of health-promoting compounds, was achieved by storage under controlled atmosphere conditions. The use of 1-MCP reduced the loss of green colour and chlorophyll pigments, but only during cold storage not during shelf life at 20 °C.
Subject(s)
Brassica/chemistry , Brassica/drug effects , Cyclopropanes/pharmacology , Food Preservation/methods , Atmosphere , Brassica/growth & development , Food Storage , Humidity , Plant Extracts/analysisABSTRACT
OBJECTIVE: The incidence of esophageal cancer has increased considerably over recent years, it now being the 6th most frequent cause of cancer-related death. Our study has aimed to compare the clinical value of PET/CT and CT scan in the initial staging of patients with esophageal cancer. MATERIAL AND METHODS: Fifty nine patients (6 women) diagnosed of esophageal cancer were assessed retrospectively. All patients underwent diagnostic CT scan and PET/CT for initial staging within 3 to 15 days following clinical diagnosis. RESULTS: PET/CT showed intracellular (18)F-FDG entrapment having pathological significance in all the tumors (100%), signs of locoregional lymph node infiltration (N1) in 34 and a total of 19 lesions consistent with metastasis (M1) in 14 patients (23.72%). The CT scan detected malignancy in 57 patients (96.6%), abnormal lymph node in 32 patients and 17 N1 in 12 patients (20.33%). In three cases, CT- PET detected synchronous esophageal lesion in staging studies for other neoplastic processes (lung and ear-nose-throat). CONCLUSION: PET/CT showed a higher detection rate of primary malignant lesions, abnormal lymph nodes and distant metastases. A change in stage was only observed in two patients.
Subject(s)
Adenocarcinoma/diagnostic imaging , Carcinoma, Squamous Cell/diagnostic imaging , Esophageal Neoplasms/diagnostic imaging , Fluorine Radioisotopes , Fluorodeoxyglucose F18 , Neoplasm Staging/methods , Positron-Emission Tomography , Radiopharmaceuticals , Tomography, X-Ray Computed , Adenocarcinoma/pathology , Adenocarcinoma/therapy , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/therapy , Case Management , Esophageal Neoplasms/pathology , Esophageal Neoplasms/therapy , Female , Humans , Lymphatic Metastasis , Male , Neoplasm Metastasis , Retrospective StudiesABSTRACT
Objetivos: La incidencia del carcinoma de esófago se ha incrementado considerablemente en los últimos años, siendo en la actualidad la sexta causa más frecuente de muerte por cáncer. El objetivo de nuestro estudio es comparar la utilidad de la PET/TAC con 18F-FDG y la TAC en la estadificación inicial en pacientes con carcinoma esofágico. Material y método: Se han valorado de manera retrospectiva 59 pacientes (6 mujeres) diagnosticados de una neoplasia esofágica. A todos los pacientes se les realizó una TAC y una PET/TAC de estadificación inicial entre 3 y 15 días después del diagnóstico. Resultados: La PET/TAC mostró el atrapamiento intracelular de 18F-FDG de significación patológica en todos los tumores (100%), signos de infiltración ganglionar locorregional (N1) en 34 y un total de 19 lesiones compatibles con metástasis (M1) en 14 pacientes (23,72%). La TAC mostró la lesión tumoral en 57 pacientes (96,6%), infiltración ganglionar en 32 pacientes y 17 M1 en 12 pacientes (20,33%). En tres casos la PET/ TAC detectó la lesión esofágica de manera sincrónica en estudios de estadificación de otros procesos neoplásicos (pulmón y área otorrinolaringológica). Conclusión: La PET/TAC mostró una mayor detección de lesiones tumorales primarias, así como adenopatías infiltradas y metástasis a distancia. Sólo se observó un cambio de estadificación en dos pacientes(AU)
Objective: The incidence of esophageal cancer has increased considerably over recent years, it now being the 6th most frequent cause of cancer-related death. Our study has aimed to compare the clinical value of PET/CT and CT scan in the initial staging of patients with esophageal cancer. Material and methods: Fifty nine patients (6 women) diagnosed of esophageal cancer were assessed retrospectively. All patients underwent diagnostic CT scan and PET/CT for initial staging within 3 to 15 days following clinical diagnosis. Results: PET/CT showed intracellular 18F-FDG entrapment having pathological significance in all the tumors (100%), signs of locoregional lymph node infiltration (N1) in 34 and a total of 19 lesions consistent with metastasis (M1) in 14 patients (23.72%). The CT scan detected malignancy in 57 patients (96.6%), abnormal lymph node in 32 patients and 17 N1 in 12 patients (20.33%). In three cases, CT- PET detected synchronous esophageal lesion in staging studies for other neoplastic processes (lung and ear-nose-throat). Conclusion: PET/CT showed a higher detection rate of primary malignant lesions, abnormal lymph nodes and distant metastases. A change in stage was only observed in two patients(AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Adenocarcinoma , Carcinoma, Squamous Cell , Esophageal Neoplasms , Radionuclide Imaging , Fluorine Radioisotopes , Fluorodeoxyglucose F18 , Radiopharmaceuticals , Positron-Emission Tomography , Tomography, X-Ray Computed , Neoplasm Staging/methods , Adenocarcinoma , Carcinoma, Squamous Cell/pathology , Esophageal Neoplasms/pathology , Lymphatic Metastasis , Neoplasm Metastasis , Retrospective StudiesSubject(s)
Adenoma/diagnostic imaging , Adrenal Gland Neoplasms/diagnostic imaging , Adrenal Gland Neoplasms/secondary , Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Carcinoma, Non-Small-Cell Lung/secondary , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/pathology , Humans , Male , Middle Aged , Radionuclide ImagingABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Adenoma , Adrenal Gland Neoplasms , Adrenal Gland Neoplasms/secondary , Carcinoma, Non-Small-Cell Lung , Carcinoma, Non-Small-Cell Lung/secondary , Lung Neoplasms/pathology , Lung NeoplasmsABSTRACT
Multitud de instituciones utilizan continuamente la planificación como instrumento para organizar sus actividades a largo plazo. La metodología es sencilla: análisis de la situación de partida, evaluación de los escenarios previsibles y, diseño de las acciones a realizar en el modelo inicial, siempre en un horizonte temporal definido. Dichas pautas se adaptan a cualquier tipo de entidad, pública o privada, independientemente de la amplitud de su espacio territorial de actuación y de su ámbito de aplicación
No disponible
Subject(s)
Humans , Strategic Planning , National Health Strategies , 34002 , Societies, Medical/trends , Quality Assurance, Health Care/trendsABSTRACT
OBJECTIVE: The objective of this study is to analyze the influence of tumor size and age of the patient in the detection of the SN in breast neoplasms. MATERIAL AND METHODS: A total of 190 patients affected of breast cancer with a mean age of 57 years (range from 28 to 87 years) were studied. According to age, the following were distinguished: under 40 years, 23 patients; between 40 and 60 years, 102 patients and over 60 years, 65 patients. The lesions were classified based on size (in mm) into: less than 10 in 27 patients, between 10 and 20 in 61 patients, between 20 and 30 in 64 patients, and greater than 30 in 38 patients. In all the cases, a scintigraphy was performed at 2 hr. post-injection of 3 mCi of 99mTc-nanocoloide, in the peritumoral area. After lymphoscintigraphy detection of the SN, cutaneous labeling was performed and it was detected surgically by a gamma detector probe. A complete lymphadenectomy was performed in all the patients. The histopathology was performed with hematoxylin-eosin and immunohistochemistry techniques and the state of the SN was compared with the remaining lymph nodes of the lymphadenectomy. RESULTS: The SN was located in 169 of the 190 cases (89%). In 164 cases, it was found in the axilla. The greatest percentage of those not detected was observed in tumors over 30 mm (32%) and patients older than 60 years (30%). No false negative were observed in tumors under 10 mm or in patients under 40 years, but the false negative rate increased with the patient's age and the tumor size. CONCLUSIONS: The patient's age and tumor size seem to influence SN detection rates. The FN rates seem to be superior in patients over 60 years. Patients under 40 years with tumors less than 10 mm are those who benefit most from this technique.
Subject(s)
Breast Neoplasms/pathology , Sentinel Lymph Node Biopsy , Adult , Age Factors , Aged , Aged, 80 and over , Female , Humans , Middle AgedABSTRACT
Objetivo: El objetivo de este estudio es analizar la influencia del tamaño del tumor y la edad de la paciente en la detección del GC en neoplasias de mama. Material y métodos: Se estudiaron 190 pacientes afectas de neoplasia de mama. Edad media de 57 años (rango comprendido entre 28 y 87 años). Según la edad distinguieron: menores de 40 años, 23 pacientes; entre 40 y 60 años, 102 pacientes y mayores de 60 años, 65 pacientes. Las lesiones se clasificaron en función del tamaño (en mm) en: menor de 10 en 27 pacientes, entre 10 y 20 en 61 pacientes, entre 20 y 30 en 64 pacientes, y superior a 30 en 38 pacientes. En todos los casos se practicó una gammagrafía a las 2 h post-inyección de 3 mCi de 99mTc-nanocoloide, en el área peritumoral. Tras la detección linfogammagráfica del GC se realizó un marcaje cutáneo, y mediante una sonda gammadetectora se detectó quirúrgicamente. En todas las pacientes se realizó linfadenectomia completa. La histopatología se realizó con técnicas de hematoxilina-eosina e inmunohistoquimia, y se comparó el estado del GC con el resto de ganglios de la linfadenectomía. Resultados: El GC se localizó en 169 de los 190 casos (89 por ciento). En 164 casos se localizó en axila. El mayor porcentaje de no detecciones se observó en tumores mayores de 30 mm (32 por ciento) y pacientes mayores de 60 años (30 por ciento). No se observaron falsos negativos en tumores de menos de 10 mm ni en pacientes menores de 40 años, pero la tasa de falsos negativos aumenta con la edad de la paciente y el tamaño del tumor. Conclusiones: La edad de las pacientes y el tamaño del tumor parece influir en las tasas de detección del GC. Las tasas de FN parecen ser superiores en las pacientes mayores a 60 años. Las pacientes menores de 40 años y con tumores de menos de 10 mm son las que más se benefician de esta técnica (AU)
Subject(s)
Middle Aged , Adult , Aged, 80 and over , Aged , Female , Humans , Sentinel Lymph Node Biopsy , Age Factors , Breast NeoplasmsABSTRACT
No disponible
No disponible
Subject(s)
Humans , 51706/analysis , Total Quality Management/standards , Models, Organizational , Quality Indicators, Health Care , Clinical Audit/organization & administrationSubject(s)
Blood Platelets , Hematologic Diseases/diagnostic imaging , Leukocytes , Antibodies, Monoclonal/pharmacokinetics , Cell Separation , Cellular Senescence , Granulocytes/immunology , Hematologic Diseases/blood , Humans , Indium Radioisotopes , Isotope Labeling/methods , Liver/pathology , Organometallic Compounds , Oxyquinoline/analogs & derivatives , Radionuclide Imaging , Spleen/pathology , Technetium Tc 99m ExametazimeABSTRACT
We present the incidence the esophageal squamous cell carcinoma in Asturias, based on the review of the clinical histories of eleven years (1975-85). Of 356 total cases, 92.4% were male patients and the remaining 7.6% females; the relation M:F was 12.2:1. Mean age at the time of diagnosis was 59.4 +/- 9.6 for males and 70 +/- for females. Total annual incidence was 2.8 +/- 0.8 cases/10(5) + population/year. Maximal annual incidence was registered in 1981: 1.1 cases/10(5) population/year. Asturias has eight health districts; those with highest incidence were mining areas: Mieres, Cangas de Narcea and Riaño. Compared to that of some developing countries, the incidence of esophageal cancer in Asturias is low, similar to that in European countries (except France) and white population of the USA; there is an aggregation of cases in males living in mining areas.
