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Adolescent cancer care: What has changed in Spain in the past decade?
No full textIntroduction and objective: In 2012, the Adolescents with Cancer working group published the results of a survey on care delivery for the adolescent population in Spain as a starting point for future intervention. The aim of this nationwide survey was to outline the current situation and assess whether the implemented strategies have resulted in changes in care delivery.Material and methods: Survey consisting of the same items analysed and published in 2012. The questionnaire was structured into sections devoted to epidemiology, psychosocial care, infrastructure, treatment and follow-up of adolescents with cancer. It was submitted to all hospitals in Spain with a paediatric haematology and oncology unit. We conducted a descriptive analysis of the results.Results: The percentage of patients aged up to 18 years managed in paediatric units has increa-sed from 35.9% to 77.5% in the past decade. The proportion of malignant blood tumours treated in paediatric units increased from 31% to 52%, and the proportion of solid tumours from 49% to 85%. In 2012, 30 units (out of 39) reported that new cases in adolescents amounted to up to 10% of the total. At present, only 14 (out of 40) continue to report this percentage. A decade ago, there were no specific adolescent cancer units in Spain. Now, 7 centres (out of 40) have specific multidisciplinary units. There has been little change in psychological support services for adolescents. The follow-up of survivors is carried out by paediatric specialists in 82.5% of the hospitals.Conclusions: The efforts made to centralise the care of adolescents with cancer in specific multidisciplinary adolescent units or, failing that, paediatric units, is reflected in the changes in care delivery in Spain in the past decade. Much remains to be done in key components of the management of adolescents with cancer.(c) 2022 Asociaci acute accent on Espan tilde ola de Pediatri acute accent a. Published by Elsevier Espan tilde a, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/)
Vol. 28, nº 34. Brotes de toxiinfección alimentaria por sospecha de Clostridium perfringens en un mismo establecimiento público alimentario. Temporadas 2018 y 2022
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 33/2023 y acumulado desde la semana 01/2023. Datos provisionales. Incluye además el artículo titulado “Brotes de toxiinfección alimentaria por sospecha de Clostridium perfringens en un mismo establecimiento público alimentario. Temporadas 2018 y 2022”, de “Eva Soler, Juan Pedro Castilla, Francisco Martín, Javier Pérez. Manuel Porcel, M.ª Ángeles Orts, Carlos del Moral. Diego Almagro".Ye
Vol. 28, nº 17. Enfermedad meningocócica en Andalucía. Temporada 2021-2022.
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 16/2023 y acumulado desde semana 01/2023. Datos provisionales. Incluye además el artículo titulado "Enfermedad meningocócica en Andalucía. Temporada 2021-2022", de "Virtudes Gallardo García".Ye
Modeling the potential efficiency of a blood biomarker-based tool to guide pre-hospital thrombolytic therapy in stroke patients.
No full textStroke treatment with intravenous tissue-type plasminogen activator (tPA) is effective and efficient, but as its benefits are highly time dependent, it is essential to treat the patient promptly after symptom onset. This study evaluates the cost-effectiveness of a blood biomarker test to differentiate ischemic and hemorrhagic stroke to guide pre-hospital treatment with tPA in patients with suspected stroke, compared with standard hospital management. The standard care for patients suffering stroke consists mainly in diagnosis, treatment, hospitalization and monitoring. A Markov model was built with four health states according to the modified Rankin scale, in adult patients with suspected moderate to severe stroke (NIHSS 4-22) within 4.5 hours after symptom onset. A Spanish Health System perspective was used. The time horizon was 15 years. Quality-adjusted life-years (QALYs) and life-years gained (LYGs) were used as a measure of effectiveness. Short- and long-term direct health costs were included. Costs were expressed in Euros (2022). A discount rate of 3% was used. Probabilistic sensitivity analysis and several one-way sensitivity analyses were conducted. The use of a blood-test biomarker compared with standard care was associated with more QALYs (4.87 vs. 4.77), more LYGs (7.18 vs. 7.07), and greater costs (12,807€ vs. 12,713€). The ICER was 881€/QALY. Probabilistic sensitivity analysis showed that the biomarker test was cost-effective in 82% of iterations using a threshold of 24,000€/QALY. The use of a blood biomarker test to guide pre-hospital thrombolysis is cost-effective compared with standard hospital care in patients with ischemic stroke.S
Differential efficacy with epidural blood and fibrin patches for the treatment of post-dural puncture headache
No full textBackground
Accidental dural puncture (ADP) is the most frequent major complication when performing an epidural procedure in obstetrics. Consequently, loss of pressure in the cerebrospinal fluid (CSF) leads to the development of post-dural puncture headache (PDPH), which occurs in 16%–86% of cases. To date, the efficacy of epidural fibrin patches (EFP) has not been evaluated in a controlled clinical trial, nor in comparative studies with epidural blood patches (EBP).
Methods
The objective of the present study was to compare the efficacy of EFP with respect to EBP for the treatment of refractory accidental PDPH. This prospective, randomized, open-label, parallel, comparative study included 70 puerperal women who received an EBP or EFP (35 in each group) after failure of the conventional analgesic treatment for accidental PDPH in a hospital.
Results
A higher percentage of women with EFP than EBP achieved complete PDPH relief after 2 (97.1% vs. 54.3%) and 12 h (100.0% vs. 65.7%) of the patch injection. The percentage of patients who needed rescue analgesia was significantly lower with EFP after 2 (2.9% vs. 48.6%) and 12 h (0.0% vs. 37.1%). After 24 h, PDPH was resolved in all women who received EFP. The recurrence of PDPH was reported in one woman from the EBP group (2.9%), who subsequently required a second patch. The mean length of hospital stay was significantly lower with EFP (3.9 days) than EBP (5.9 days). Regarding satisfaction, the mean value (Likert scale) was significantly higher with EFP (4.7 vs. 3.0).
Conclusions
EFP provided better outcomes than EBP for the treatment of obstetric PDPH in terms of efficacy, safety, and patient satisfaction.Ye
A Questionnaire Survey of Personal and Occupational Variables Associated With SARS-COV-2 Infection in Health Care Personnel of the Spanish Central Military Hospital
No full textSpain is the country with the highest number of health care workers affected by COVID-19 globally. This study aimed to describe the epidemiology of SARS-CoV-2 infection among health care workers (HCWs) at the Gómez Ulla Military Hospital (GUMH). A case-control study was conducted during the first COVID-19 outbreak, including all HCWs at GUMH who met the inclusion criteria. Participants included civilian and military personnel, nursing and medical students from the Spanish Military Academy, medical residents, and nursing residents of the Medical Surgical Specialty in Operations (EMQO). A 33-item questionnaire was emailed to all eligible participants to classify them as sick (cases) or healthy (controls). Out of 150 respondents, 28 (20.7%) tested positive, and 107 (79.3%) tested negative, establishing a SARS-CoV-2 infection rate of 20.7% at GUMH. Among the positive cases, 64.3% were men (P < .05), with a mean age of 47.1 years (SD 13.3), a mean BMI of 25.3 (SD 3.8), and 48.2% classified as overweight; additionally, 59.3% had blood group A and 69.2% were Rh positive. Physicians represented 50% of cases, nurses 32.1%, and auxiliary nurses 17.9% (P < .05). A lower risk of infection was observed in those with vitamin D deficiency who took supplements. Symptoms such as fever, cough, and diarrhea appeared in at least 50% of the cases, with significant differences noted.N
Mortalidad por tumores en el siglo XXI: diferencias entre Andalucía y España
No full textEn este informe se presentan las tendencias de las tasas de mortalidad por el conjunto de tumores en Andalucía y el resto de España, desde el año 2000 al 2020, mostrando las diferencias según sexo y grupos de edad para las principales causas específicas (según la lista reducida de causas de mortalidad del INE).Ye
Vol. 28, nº 41. Detección de enfermedades de declaración obligatoria a través del CMBD. 2021-2022
No full textEnfermedades de Declaración Obligatoria por provincias. Semana 40/2023 y acumulado desde la semana 01/2023. Datos provisionales. Incluye además el artículo titulado “Detección de enfermedades de declaración obligatoria a través del CMBD. 2021-2022”, de “María Cristina Rodríguez Rieiro”.Ye
Integrating Social Assistive Robots, IoT, Virtual Communities and Smart Objects to Assist at-Home Independently Living Elders: the MoveCare Project.
No full textThe integration of Ambient Assisted Living (AAL) frameworks with Socially Assistive Robots (SARs) has proven useful for monitoring and assisting older adults in their own home. However, the difficulties associated with long-term deployments in real-world complex environments are still highly under-explored. In this work, we first present the MoveCare system, an unobtrusive platform that, through the integration of a SAR into an AAL framework, aimed to monitor, assist and provide social, cognitive, and physical stimulation in the own houses of elders living alone and at risk of falling into frailty. We then focus on the evaluation and analysis of a long-term pilot campaign of more than 300 weeks of usages. We evaluated the system's acceptability and feasibility through various questionnaires and empirically assessed the impact of the presence of an assistive robot by deploying the system with and without it. Our results provide strong empirical evidence that Socially Assistive Robots integrated with monitoring and stimulation platforms can be successfully used for long-term support to older adults. We describe how the robot's presence significantly incentivised the use of the system, but slightly lowered the system's overall acceptability. Finally, we emphasise that real-world long-term deployment of SARs introduces a significant technical, organisational, and logistical overhead that should not be neglected nor underestimated in the pursuit of long-term robust systems. We hope that the findings and lessons learned from our work can bring value towards future long-term real-world and widespread use of SARs.S
La ciencia abierta en la BV-SSPA
No full textSeminario sobre Ciencia Abierta y sus implicaciones de la Biblioteca Virtual del SSPA.N