Analysis of experiences about Covid-19 in the Latin American context through grounded theory

This work aims to describe and analyze, through Grounded Theory, the experiences of the management of covid-19 in people in Latin America who suffered from the disease or were in the process of mourning because of it. The analysis units were open and semi-structured interviews via Zoom with ten people from seven Latin American countries who had experienced covid-19. For the analysis of the interviews, the Atlas.ti software was used. The results show the emergence of a substantive theory on the management of covid in four aspects: knowledge of the disease;accompaniment in illness and grief;exercise of spirituality;and coping strategies. It is concluded that the management of covid-19 involves both psychospiritual and social and economic aspects.

Evolution of pancreatic ductal adenocarcinoma diagnosis during the last decade

Background: Pancreatic Ductal Adenocarcinoma (PDAC) has historically been an important diagnostic and therapeutic challenge. The multidisciplinary approach and new diagnostic techniques' implementation have modified this process. Method(s): We conducted a retrospective analysis based on clinical data of patients with PDAC between the years 2010 to 2021, analyzing the diagnosis and initial treatment evolution. Result(s): 673 patients between 2010-2021 with a suspected diagnosis of pancreatic adenocarcinoma were reviewed. Most of them were metastatic (n=362;53.8%), followed by locally advanced unresectable (n=166;24.7%) and resectable or borderline resectable (n=145;21.5%). Regarding the pathological diagnosis, it was not possible in 62 patients (9.2%), varying over time from 21.2%in 2010-2012 to 1% in 2019-2021 (p<0,0001). Moreover, the number of biopsies has decreased with a mean number of biopsies to obtain a pathological diagnosis of 1.55 (2010-2012) vs 1.31 (2019-2021). During this last period, most of the diagnoses were made by cytological analysis (61.4%;n=121). Specifically in the 2019-2021 patients subgroup, we found that 18 NGS (9,1%) were performed in this period (solid tumor), with 4 patients having actionable mutations (22.2%;3 KRAS G12C). Germline (g) mutational panels were carried out in 89 patients, finding only 9 positive cases (10.1%), being 3 of them gBRCA1/2 mutated (3,4%). In our study, a decrease in palliative management was evidenced over time. In 2010-2012, 28,8% of patients received exclusively palliative care against 9,6% in 2019-21 (p, 0.0001). An increase in PDAC diagnosis was observed since 2010, 44 patients/year in 2010-12 vs. 66 patients/year in 2019-21 (including COVID-19 pandemic period). All previous results are summarized. Conclusion(s): The diagnosis of PDAC has changed throughout the last decade, increasing the percentage of patients with a pathological diagnosis without increasing the number of invasive procedures. The number of patients suitable for anti-cancer therapy has also increased among time. In our cohort, the implementation of molecular testing would change the therapeutic approach in more than 20% of patients.

Effectiveness of the BNT162b2 mRNA Covid-19 Vaccine in Spanish Healthcare Workers.

INTRODUCTION: Frontline health care workers (HCW) have higher risk than the general population to become infected by SARS.CoV.2, so they were a priority group for Covid-19 vaccine administration. We compared the incidence and prevalence of HCW infected pre-and post- vaccination with the BNT162b2 mRNA COVID-19 vaccine. MATERIAL AND METHODS: Prospective observational study carried out between 01/12/20 and 07/03/21 in La Paz University Hospital, Madrid (Spain). SARS.CoV.2 positive cases in HCW after vaccination were collected and compared to those hospitalized COVID-19 patients at the same hospital. RESULTS: Two weeks after finishing the first round of vaccinations daily new cases of HCW infections (symptomatic and asymptomatic) decreased substantially and cumulative cases of infected HCW and hospitalized COVID-19 patients started to diverge. No new positive cases of HCW infection were registered seven days after the second dose of BNT162b2 mRNA COVID-19 vaccine. CONCLUSIONS: BNT162b2 mRNA COVID-19 vaccine is highly effective in Spanish HCW.

Deceased Donor Transplantation During Covid Times: Success Story From State in India

In India, live donor transplantation is more common than deceased donor transplantations. The enactment of The Transplantation of Human Organ and tissue Act in India in the year 1994 legalized organ donation after brainstem death. In-hospital donor coordinators have been defined as one of the leading practices for deceased organ donation worldwide. The Transplant Procurement Manager is a healthcare specialist dedicated to deceased donation. Aim and objectives: The role of TPM in organ donation. To improve the deceased organ donation process. Materials and methods: KIMS Hospital, Kerala initiated an educational and international cooperation approach based on the implementation of a specialized program for healthcare professionals in 2019. It includes on-site training, international internship, hospital visits, and international experts visiting KIMS hospital to ensure best practices. KIMS appointed an in-hospital transplant procurement manager (TPM) to coordinate potential donors at intensive care units. The TPM became actively involved in the deceased organ donation (DDP) process. The cornerstone of the success was early and proactive identification of potential donors. Results: After 3 years of collaboration and following the initiation of TPM at KIMS, deceased organ donation activity increase markedly in the hospital. When compared 2020 vs 2019, a 60% increase was observed from 30 to 50 organs transplanted in the same period of time even against COVID pandemic effects worldwide. The conversion rate increased from 0% in 2018 to 21.4% in 2019. Conclusion: The hospital-based organ procurement units headed by transplant procurement managers (TPM), the role of hospitals, and the collaboration between a local and international organization in improving the deceased donor transplantation played a key role in good outcomes of donation and transplant programs. When the COVID-19 pandemic resulted in the suspension of the transplant programs across the country, the deceased donation and transplantation activity in Kerala were going unabated.