Experience on how to implement a preanalytical and POCT unit in Madrid's IFEMA field hospital during this unprecedented COVID-19 emergency.

To fight the virus SARS-CoV-2 spread to Europe from China and to give support to the collapsed public health system, the Spanish Health Authorities developed a field hospital located in the facilities of Madrid exhibition centre (IFEMA) to admit and treat patients diagnosed with SARS-CoV-2 infectious disease (COVID-19). The Department of Laboratory Medicine of La Paz University Hospital in Madrid (LMD-HULP) was designated to provide laboratory services. Due to the emergency, the IFEMA field hospital had to be prepared for patient admission in less than 1 week and the laboratory professionals had to collaborate in a multidisciplinary group to assure that resources were available to start on time. The LMD-HULP participated together with the managers in the design of the tests portfolio and the integration of the healthcare information systems (IS) (hospital IS, laboratory IS and POCT management system). Laboratorians developed a strategy to quickly train clinicians and nurses on test requests, sample collection procedures and management/handling of the POCT blood gas analyser both by written materials and training videos. The IFEMA´s preanalytical unit managed 3782 requests, and more than 11,000 samples from March 27th to April 30th. Furthermore, 1151 samples were measured by blood gas analysers. In conclusion, laboratory professionals must be resilient and have to respond timely in emergencies as this pandemic. The lab's personnel selection, design and monitoring indicators to maintain and further improve the quality and value of laboratory services is crucial to support medical decision making and provide better patient care.

Management of obstructive sleep apnoea in a primary care vs sleep unit setting: a randomised controlled trial.

OBJECTIVE: To assess the effectiveness and cost-effectiveness of primary care (PC) and sleep unit (SU) models for the management of subjects with suspected obstructive sleep apnoea (OSA). METHODS: Multicentre, open-label, two-arm, parallel-group, non-inferiority randomised controlled trial. A total of 302 subjects with suspected OSA and/or resistant hypertension were consecutively enrolled, 149 were treated at 11 PC units and 153 patients at a SU. The primary outcomes were a 6-month change in the Epworth Sleepiness Scale (ESS) score and Health Utilities Index (HUI). The non-inferiority margin for the ESS score was -2.0. RESULTS: A total of 80.2% and 70.6% of the PC and SU patients were diagnosed with OSA, respectively, and 59.3% and 60.4% of those were treated with CPAP in PC and SU units, respectively. The Apnoea-Hypopnoea Index was similar between the groups (PC vs SU (median (IQR); 23.1 (26.8) events/h vs 21.8 (35.2) events/h), and the baseline ESS score was higher in the PC than in the SU group (10.3 (6.6) vs 9 (7.2)). After 6 months, the ESS score of the PC group decreased from a mean of 10.1 to 7.6 (-2.49; 95% CI -3.3 to -1.69), and that of the SU group decreased from 8.85 to 5.73 (-3.11; 95% CI -3.94 to 2.28). The adjusted difference between groups for the mean change in the ESS score was -1.25 (one-sided 95% CI -1.88; p=0.025), supporting the non-inferiority of PC management. We did not observe differences in the HUI between groups. The cost analysis showed a median savings of €558.14/patient for the PC setting compared with the SU setting. CONCLUSIONS: Among patients with suspected OSA, the PC model did not result in a worse ESS score or HUI than the specialist model and generated savings in terms of management cost. Therefore, the PC model was more cost-efficient than the SU model. TRIAL REGISTRATION: Results; >>NCT02234765, Clinical Trials.gov.

Assessment of body composition, through anthropometric and non-anthropometric methods, of university students from valencia (Spain).

INTRODUCTION AND OBJECTIVE: The valuation of anthropometric and nutritional status of the university population is important to detect risk groups and so make nutritional recommendations. The aim of the study was to analyze the body composition and the fat component in a group of university students and to evaluate their basal metabolism to see if there was a correlation with the body composition. The study was carried out through different methods, to determine if the results obtained are comparable. SUBJECTS AND METHOD: The sample were 16 students (4 males and 12 females) from the University of Valencia, 20-33 years old. To all of them was carried out the study of body composition, and to 6 of them was carried out also a metabolic study. RESULTS: It was found that 75% of the studied subjects are normal weight, 12,5% are underweight and 12,5% are overweight. The percentage of subjects with body fat higher than the normal values are: 68,75% according to BFMNU, 25% through ISAK method and 7,69% with BIA. CONCLUSIONS: Our study reflected that the data obtained through the different methods are not directly comparable because they are based on different principles and assumptions. It was noticed the importance of considering not only fat mass, but the whole body composition to have a complete picture of the subject. Furthermore, we it was found that Indirect Calorimetry and the predictive equations are not able to estimate it correctly. In contrast BFMNU method is the one that gives more information and allows to thoroughly investigate the metabolism.

Introducción y objetivo: La valoración del estado antropométrico y nutricional de la población universitaria es importante para detectar grupos de riesgo y realizar recomendaciones nutricionales. El objetivo fue analizar la composición corporal y el porcentaje de grasa en un grupo de estudiantes universitarios y evaluar su metabolismo basal para ver si había una correlación con la composición corporal. El estudio se llevó a cabo a través de diferentes métodos, para determinar si los resultados obtenidos son comparables. Sujetos y método: La muestra fueron 16 alumnos (4 hombres y 12 mujeres) de la Universidad de Valencia, 20- 33 años de edad. A todos se hizo el estudio de la composición corporal y a 6 de ellos se hizo también un estudio metabólico. Resultados: Se encontró que el 75% de los sujetos estudiados tienen un peso normal, el 12,5% tienen bajo peso y 12,5% tiene sobrepeso. El porcentaje de sujetos con grasa corporal superior a los valores normales son: 68,75% según BFMNU, el 25% a través del método ISAK y 7,69% según BIA. Conclusiones: Nuestro estudio mostró que los datos obtenidos a través de los diferentes métodos no son directamente comparables, ya que se basan en diferentes principios y supuestos. También se ha observado la importancia de considerar no sólo la masa grasa, si no toda la composición corporal para tener una visión completa del sujeto. Además, se ha podido notar que la calorimetría indirecta y las ecuaciones de predicción del metabolismo basal no son capaces de estimarlo correctamente. En cambio el método BFMNU es el que da más información y permite investigar a fondo el metabolismo.