PO-61 - Patients' Experiences of LIving with CANcer associated thrOmbosis in Spain (PELICANOS).

INTRODUCTION: The Patients' Experiences of LIving with CANcer associated thrombosis (PELICAN) study has identified the experience of cancer-associated thrombosis (CAT) to be a distressing one, for which patients feel ill prepared for and receive insufficient support. However, such data was from a United Kingdom (UK) population and may not be representative of all nationalities, cultures and healthcare systems. AIM: To explore the experience of cancer associated thrombosis amongst patients living in Spain. MATERIALS AND METHODS: Twenty consecutive patients with CAT were recruited from a Spanish University Hospital. Where possible spouses were interviews in conjunction. Semi-structured qualitative interviews were undertaken, assited by a pre-agreed promt list. Interviews were audio recorded and transcribed verbatim. Preliminary data analysis was undertaken using thematic analysis. RESULTS: Several commonalities between UK and Spanish patients were identified including the traumatic nature of the experience, need for information and adaptive behaviors through ritualization. Three new major themes also emerged: Communication needs: over emphasis on heparin injection training, additional need for explanation of cause, response and prognosis The impact of CAT on the concept of self: CAT was considered defining watershed moment, confirmation of seriousness of the cancer, The impact of CAT on the family dynamic: distressing diagnosis for loved ones, exaggerated desire to help which could disempower patient independence. CONCLUSIONS: The experience of CAT is a distressing one which brings with it additional information needs through effective communication. Within the Spanish population, the role of family is of particular importance as well as the impact of CAT on the patient's feelings of worth and personal identity. Effective communication, support and access to information are essential in order to minimize distress and enhance treatment complicance.

Home management of acute medical complications in cancer patients: a prospective pilot study.

BACKGROUND: The development of reliable alternatives to conventional hospitalization in patients with cancer would have great clinical and economical value. The aim of the present study was to assess the feasibility of a home-based nursing intervention model as a safe alternative for the management of acute medical complications in cancer patients who would otherwise require conventional hospitalization. PATIENTS AND METHODS: From October 2013 to October 2014, we prospectively evaluated the outcomes of consecutive acute medical episodes treated at home under the home-based intervention program named the Bridge Project (BP). Episodes were classified as "avoided hospitalization in outpatients" (AHO) vs. "reduced hospitalization in inpatients" (RHI). The primary end-point was to assess the rate and causes of BP intervention failure (unplanned hospital readmission or death). RESULTS: Two hundred and forty-six consecutive episodes (52 % AHO and 48 % RHI) involving 203 patients (55 % male; mean age 63 years) were enrolled. The main conditions managed at home were non-neutropenic infections (40 %), febrile neutropenia (20 %), and cancer-related complications (28 %). The median duration of the BP intervention was 5 days (range 1-16 days). No deaths were reported at home. Unplanned hospital readmissions occurred in 9 % of episodes (14 % in AHO vs. 4 % in RHI; p = 0.001). Five of the 22 readmitted patients (22.7 % of the BP failures; 2.5 % of the whole series) died during hospitalization. The BP intervention burden was 1353 days, representing a potential saving of 14 % of days of hospitalization during the study period. CONCLUSIONS: The BP is a safe intervention which can potentially avoid or reduce the length of hospitalization in selected cancer patients with acute medical complications. Our findings support further development of innovative home-based clinical approaches to promote potentially avoidable hospitalization in this setting.

Synthesis of Ag@Silica Nanoparticles by Assisted Laser Ablation.

This paper reports the synthesis of silver nanoparticles coated with porous silica (Ag@Silica NPs) using an assisted laser ablation method. This method is a chemical synthesis where one of the reagents (the reducer agent) is introduced in nanometer form by laser ablation of a solid target submerged in an aqueous solution. In a first step, a silicon wafer immersed in water solution was laser ablated for several minutes. Subsequently, an AgNO3 aliquot was added to the aqueous solution. The redox reaction between the silver ions and ablation products leads to a colloidal suspension of core-shell Ag@Silica NPs. The influence of the laser pulse energy, laser wavelength, ablation time, and Ag(+) concentration on the size and optical properties of the Ag@Silica NPs was investigated. Furthermore, the colloidal suspensions were studied by UV-VIS-NIR spectroscopy, X-Ray diffraction, and high-resolution transmission electron microscopy (HRTEM).

Morbimortalidad cardiovascular asociada al índice tobillo-brazo en la población general / Cardiovascular morbidity-mortality associated to ankle-brachial index in the general population

Antecedentes y objetivos. Un índice tobillo-brazo (ITB) anormal se asocia con un elevado riesgo de enfermedad cardiovascular. El objetivo del estudio fue investigar la asociación entre un ITB bajo con el riesgo de muerte de causa cardiovascular en una población atendida en un centro de salud. Pacientes y métodos. Participaron 1.361 voluntarios de entre 60 y 79 años sin enfermedad arterial periférica conocida, reclutados en una consulta de atención primaria. Se les hizo una historia clínica, una exploración física, un análisis de sangre y se les determinó el ITB. Cuatro años después se contactó con ellos y se les interrogó sobre problemas cardiovasculares acaecidos durante ese periodo. Las causas de los ingresos o de las muertes se confirmaron en las historias clínicas del centro de salud y/o del hospital de zona. Resultados. Se consiguió información sobre la evolución clínica de 1.300 participantes (edad media 69,6 años; un 38,2% eran varones). El seguimiento medio fue de 49,8 meses. Hubo 13 muertes de causa cardiovascular y 49 eventos cardiovasculares mayores. Un ITB bajo basal (<0,9) se asoció con un significativo mayor riesgo de muerte cardiovascular (riesgo relativo ajustado 6,83; intervalo de confianza 95%: 1,36-34,30; p=0,020), así como con un mayor riesgo de eventos cardiovasculares (riesgo relativo ajustado 2,42; intervalo de confianza 95%: 0,99-5,91; p=0,051). El ITB alto (>1,4) o incompresible no se asoció con un mayor riesgo cardiovascular. Conclusiones. En población general seguida en un centro de salud, un ITB bajo se asocia con un mayor riesgo de muerte cardiovascular (AU)

Background and objectives. Abnormal ankle-brachial index (ABI) is associated with a high risk of cardiovascular disease. This study has aimed to investigate the association between low ABI and risk of cardiovascular death in a general population attended in a primary care center. Patients and methods. A total of 1,361 volunteers aged between 60 and 79 years without any evidence of peripheral artery disease who attended a primary care center participated in the study. They underwent a complete physical examination, together with standard blood tests and ABI was determined. The participants were contacted by telephone 4 years later and asked about any cardiovascular problems for that period. Causes of death and hospitalization were confirmed in the medical records in the primary care center and/or hospital. Results. Information was obtained about the clinical evolution of 1,300 participants (mean age 69.9 years, 38.2% men). Mean follow-up was 49.8 months. There were 13 cardiovascular death and 49 major cardiovascular events. Low ABI (<0.9) was associated with a significant higher risk of cardiovascular death (adjusted relative risk 6.83; 95% confidence interval 1.36-34.30, P=.020), and with a higher risk of major cardiovascular events (adjusted relative risk 2.42; 95% confidence interval 0.99-5.91, P=.051). High or uncompressible ABI was not associated with higher cardiovascular risk. Conclusions. A low ABI was associated with higher risk of cardiovascular death in the general population followed-up in a primary care center (AU)

Cardiovascular morbidity-mortality associated to ankle-brachial index in the general population.

BACKGROUND AND OBJECTIVES: Abnormal ankle-brachial index (ABI) is associated with a high risk of cardiovascular disease. This study has aimed to investigate the association between low ABI and risk of cardiovascular death in a general population attended in a primary care center. PATIENTS AND METHODS: A total of 1,361 volunteers aged between 60 and 79 years without any evidence of peripheral artery disease who attended a primary care center participated in the study. They underwent a complete physical examination, together with standard blood tests and ABI was determined. The participants were contacted by telephone 4 years later and asked about any cardiovascular problems for that period. Causes of death and hospitalization were confirmed in the medical records in the primary care center and/or hospital. RESULTS: Information was obtained about the clinical evolution of 1,300 participants (mean age 69.9 years, 38.2% men). Mean follow-up was 49.8 months. There were 13 cardiovascular death and 49 major cardiovascular events. Low ABI (<0.9) was associated with a significant higher risk of cardiovascular death (adjusted relative risk 6.83; 95% confidence interval 1.36-34.30, P=.020), and with a higher risk of major cardiovascular events (adjusted relative risk 2.42; 95% confidence interval 0.99-5.91, P=.051). High or uncompressible ABI was not associated with higher cardiovascular risk. CONCLUSIONS: A low ABI was associated with higher risk of cardiovascular death in the general population followed-up in a primary care center.