ABSTRACT
INTRODUCTION: Madrid has been the epicenter of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in Spain. We analyzed our experience with SARS-CoV-2 infected and cancer patients. PATIENTS AND METHODS: We included patients from March 1 to April 30 2020 at Hospital Universitario Puerta de Hierro, Majadahonda, Madrid (Spain). The inclusion criteria were diagnosis of SARS-CoV-2 infection made by reverse transcription polymerase chain reaction (RT-PCR) of nasopharyngeal specimens in cancer patients who were admitted to the hospital due to the need for respiratory support. The exclusion criteria were suspected cases not confirmed. The primary objective was to analyze the mortality rates of patients with cancer, especially those with lung cancer and COVID-19. RESULTS: Overall in-hospital mortality of cancer patients with coronavirus disease 2019 (COVID-19) was 15.2% similar to 12.7% of the global COVID-19 hospitalized population (p=0.615) and greater than that of patients admitted without SARS-CoV-2 infection during the same period 4.3% (p<0.001). Among 653 patients receiving active cancer therapy during the study period, 24 (3.7%) developed COVID-19 and required admission, 4.2% of those receiving chemotherapy, 9.5% immunotherapy and 2.1% targeted therapies. Lung and breast cancer were the most frequent cancer types (26.1%), followed by colorectal cancer (19.6%). Mortality in patients with lung cancer was 25%. The univariate analysis comparing patients who developed a serious event to those who did not showed that the higher Brescia index, CURB-65 scale, lactate dehydrogenase (LDH) or C-reactive protein (CRP) were the risk factors of developing severe complications. CONCLUSION: Patients with cancer, especially lung cancer, and SARS-CoV-2 infection have a worse overall prognosis than the general population.
ABSTRACT
BACKGROUND: To analyse the effectiveness of Paediatric Basic Life Support (PBLS) and Paediatric Immediate Life Support (PILS) courses to train medical students in paediatric cardiopulmonary resuscitation (CPR). METHODS: Eighteen courses (13 in PBLS and 5 in PILS) were delivered to 1214 medical students. Two theory tests and one practical test were performed. Students filled in an anonymous questionnaire after each course. RESULTS: The mean scores (out of 20) in the theory tests of the PBLS course were 11.4 before the course, and 19.2 upon completion (P < 0.0001). Infant BLS skills were achieved by 98.4% of students, and children BLS skills by 97% of them. The mean scores (out of 30) in the PILS courses were 17.3 before the course, and 29.1 at the end of the course (P < 0.0001). PBLS skills were achieved by 99% of students and PILS skills by 98.3% of them. The scores (out of 5) in the anonymous questionnaire were: theory classes, 4.5; teaching methods, 4.5; practice sessions, 4.7; instructor teaching skills, 4.8; and coordination of theory and practice and between instructors, 4.7. There were no significant differences between basic and intermediate CPR courses. CONCLUSIONS: PBLS and PILS courses are useful methods for delivering theory and practice training to medical students, and should be mandatory in the paediatric curriculum of medical studies
OBJETIVOS: Analizar la utilidad de cursos de reanimación cardiopulmonar básica (RCPB) e intermedia (RCPI) para la formación de los estudiantes del grado de medicina. MÉTODOS: Se impartieron 18 cursos (13 de RCPB y 5 de RCPI) a 1.214 estudiantes de medicina. Se realizaron 2 exámenes teóricos uno inicial y otro final, y una evaluación práctica. Después del curso los estudiantes realizaron una encuesta anónima. RESULTADOS: En el curso de RCPB la puntuación en el examen inicial fue de 11,4 sobre 20 y 19,2 en el examen final (p < 0,0001). Un 98,4% de los estudiantes del curso de RCPB adquirieron suficiente práctica en la RCP del lactante y 97 en la RCP del niño. En el curso de RCPI la puntuación en el examen inicial fue de 17,3 sobre 30 y 29,1 en el examen final (p < 0,0001). Un 99% de los estudiantes del curso de RCPB adquirieron suficiente práctica en la RCP básica y un 98,3% en la RCP intermedia. Las valoraciones en la encuesta anónima (sobre 5) fueron: clases teóricas 4,5; métodos de enseñanza 4,5; prácticas 4,7; capacidad docente de los profesores 4,8, y coordinación teórico-práctica y entre instructores 4,7. No existieron diferencias entre los cursos de RCP básica e intermedia. CONCLUSIONES: Los cursos de RCP pediátrica básica e intermedia son métodos útiles para la formación teórica y práctica de los estudiantes de medicina y deberían incluirse como obligatorios en el currículum del grado de medicina
