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BACKGROUND/AIM: Prior immune-checkpoint inhibitors, weekly paclitaxel-cetuximab was one of the few options for platinum-ineligible patients with recurrent/ metastatic squamous cell carcinoma of the head and neck (R/M-SCCHN). This real-world study analyzed the long-term outcomes of this regimen. PATIENTS AND METHODS: A multicenter, retrospective, observational, cross-sectional, chart review study was realized in nine hospitals of the Galician Group of Head and Neck Cancer. Eligible population was adult platinum-ineligible patients with R/M SCCHN (unfit to, or after progressing following EXTREME or other platinum-based regimens) that received weekly paclitaxel plus cetuximab regimen as first- or second-line (1L or 2L) between January 2009 and December 2014. The efficacy was evaluated (1L-2L) in regards to overall survival (OS) and progression-free survival (PFS), and safety was assessed as the incidence of adverse events (AEs). RESULTS: Seventy-five R/M-SCCHN patients received the scheme (1L, n=50; 2L: n=25). The mean age of the patients was 59 years (1L, 59.5 years; 2L, 59.2 years), 90% were male (1L, 96%; 2L, 79%), 55% were smokers (1L, 60.4%; 2L, 45.8%), and 61% presented ECOG performance status (PS) 1 (1L, 54%; 2L, 62.5%). Median OS [interquartile range (IQR)] was 8.85 (4.22-40.96) months. Median PFS (IQR) was 8.5 (3.93-12.55) (1L) and 8.8 (5.62-16.91) (2L) months. Disease control rate was 60% (1L) and 85% (2L). Weekly paclitaxel-cetuximab was well tolerated in 1L/2L (cutaneous-toxicity, mucositis, neuropathy; mainly Grade 1-2). No grade 4 AEs were notified in 2L. CONCLUSION: Weekly paclitaxel-cetuximab is an active and well tolerated therapeutical option in platinum-ineligible or after platinum regimens in R/M-SCCHN patients.
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Esse artigo teve como objetivo analisar as produções científicas dos últimos cinco anos, voltadas aos ambientes restauradores em universidades. Foi definida a pergunta norteadora e realizada a seleção de artigos nas bases de dados. Foram encontrados 774 artigos, destes verificou-se os que atendiam aos critérios, assim, restaram 15 artigos. Após a análise crítica realizou-se a discussão com a literatura e a elaboração do fluxograma com demonstração das etapas. Houve a primazia de estudos internacionais e a prevalência do uso da união das teorias Psicoevolucionista e Restauração da Atenção. As principais características dos ambientes foram: árvores, arbustos, vegetação, flores, sons de pássaros e ausência de pessoas. Salienta-se como benefícios a promoção do bem-estar, o aumento da atenção e a diminuição do estresse. Tal pesquisa possibilitou identificar os aspectos físicos para a implantação de ambientes restauradores nas universidades.
This article aimed to analyze the scientific productions of the last five years, focused on the restorative environments in universities. The guiding question was defined and the selection of articles in the databases was conducted. A total of 774 articles were found to verify which of those met the criteria; thus, 15 articles remained. After the critical analysis, a discussion with the literature was conducted, and a flowchart with a demonstration of the phases was elaborated. There was a primacy of international studies and a prevalence of the use of the Psychoevolutionary and Attention Restoration theories. The main characteristics of the environments were: trees, bushes, vegetation, flowers, bird sounds, and absence of people. The outstanding benefits were the promotion of well-being, increased attention, and decreased stress. This research made possible to identify the physical aspects for the implementation of restorative environments in universities.
Este artículo tiene como objetivo analizar las producciones científicas de los últimos cinco años, centradas en los ambientes restauradores en las universidades. Se definió la pregunta orientadora y se realizó la selección de artículos en las bases de datos. Fueron hallados 774 artículos, sobre los cuales se verificaron los que cumplían los critérios, quedando así 15 artículos. Después del análisis crítico, se llevó a cabo una discusión con la literatura y la preparación del flujograma con la demostración de etapas. Los estudios internacionales primaron y prevaleció el uso de la unión de las teorías Psicoevolucionistas y de Restauración de la Atención. Las principales características de los ambientes eran: árboles, arbustos, vegetación, flores, sonidos de pájaros y ausencia de personas. Se destacan como beneficios el fomento del bienestar, el aumento de la atención y la reducción del estrés. Esta investigación permitió identificar los aspectos físicos para la implementación de ambientes restauradores en las universidades.
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Humanos , Calidad de Vida/psicología , Estudiantes/psicología , Universidades , Salud Mental , Publicaciones Científicas y Técnicas , Psicología Ambiental , AmbienteRESUMEN
INTRODUCCIÓN: La metodología del benchmarking estratégico aplicado a la gestión de riesgos comenzó a utilizarse en el año 2016 en la Compañía Quirónsalud y fue el punto de partida para la implantación de los objetivos de calidad asistencial y de seguridad del paciente. OBJETIVO GENERAL: Realizar un seguimiento continuo y sistemático de las líneas estratégicas marcadas en la Estrategia de Seguridad del Paciente y evaluar su grado de cumplimiento. METODOLOGÍA: Mediante un análisis de debilidades, amenazas, fortalezas y oportunidades (DAFO), se identificaron 17 riesgos, para los que se establecieron objetivos e indicadores. Se utilizó la información disponible en el Conjunto Mínimo Básico de Datos (CMBD) y los indicadores definidos por la Agency for Healthcare Research and Quality (AHRQ), los indicadores de calidad de la hospitalización del grupo Helios (EIQI ́s) y el indicador de cirugía precoz en fractura de cadera de la Organización para la Cooperación y el Desarrollo Económico (OCDE). También se incorporaron los indicadores en el Observatorio de Resultados del Servicio Madrileño de Salud (SERMAS) y los de la Central de Resultados del Servicio Catalán de Salud (CatSalut). RESULTADOS: Entre los resultados obtenidos en 2019 cabe destacar el porcentaje de hospitales que han experimentado una mejora continuada en los indicadores. Implantación de rondas de seguridad trimestrales con participación de la dirección >90%. El % Checklists en cirugía programada >85%. El % de pacientes ingresados con registro de la 5ª constante > 79%. El % de intervenciones por fractura de cadera a las 48h tras ingreso > 78%.Los porcentajes de compromiso (abordaje del objetivo) y de cumplimiento (alcanzar la meta corporativa o superar lo pactado con la Dirección Corporativa) de los indicadores, han experimentado un crecimiento progresivo en los últimos años situándose en 2019 en un 94% y en un 85% respectivamente. CONCLUSIONES: El benchmarking estratégico mejora la eficacia en la gestión de riesgos asistenciales porque permite realizar análisis comparados, identificar y compartir buenas prácticas e introduce el elemento de competencia entre los hospitales promoviendo el compromiso con la estrategia
INTRODUCTION: The strategic benchmarking methodology applied to risk management began to be applied at Quirónsalud Company in 2016. This was the starting point for the implementation of the Company's healthcare quality objectives, including the patient safety objectives. GENERAL OBJECTIVE: To assess the degree to which Quirónsalud facilities comply with the strategy lines set forth in the group-wide patient-safety strategy program. METHODS: Through an analysis of strengths, weaknesses, opportunities and threats (SWOT), 17 threats were identified. This were used to set company-wide targets and indicators. The set of quality indicators were obtained from the information available in the minimum basic data set (MBDS), the indicators defined by the Agency for Healthcare Research and Quality (AHRQ), the hospital-quality indicators of the Helios group (EIQI ́s) and the early hip fracture surgery indicator of the Organization for Economic Co-operation and Development (OECD). In addition, some of the indicators included in the Observatorio de Resultados del Servicio Madrileño de Salud (SERMAS) and the Central de Resultados de Servicio Catalán de Salud (CatSalut) were also incorporated. RESULTS: Among the results obtained in year 2019, the percentage of hospitals that have experienced continuous improvement in the indicators should be highlighted. Implementation of quarterly executive walkarounds > 90%. The % of checklists used in elective surgery > 85%. The % of inpatients evaluated for the 'Fifth Vital Sign' > 79%. The % of hip-fracture surgeries performed within 48h of admission > 78%.There has been a progressive increase over recent years in the degree of commitment to (target approach) and fulfillment (achieve the corporate goal or exceed what was agreed with the Corporate Management) of indicators (94% and 85%, respectively).CONCLUSIONS: Strategic benchmarking improves effective management of care-related risks by allowing comparative analysis, enabling organizations to identify and share best practices, and by introducing an element of competition between hospitals, thereby driving commitment to organization-wide strategy
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Humanos , Benchmarking/métodos , Evaluación de Procesos, Atención de Salud/métodos , Seguridad del Paciente/normas , Gestión de Riesgos/métodos , 34002 , Medición de Riesgo , Factores de Riesgo , Guías de Práctica Clínica como Asunto , Factores de Tiempo , España , Indicadores de Calidad de la Atención de Salud , Lista de VerificaciónRESUMEN
Introducción: Los parechovirus humanos (HPeV) son virus de la familia Picornaviridae, recientemente descritos, a los que se atribuyen cuadros de fiebre sin foco (FSF), sepsis clínica, gastroenteritis, meningitis o encefalitis fundamentalmente en lactantes pequeños. Nuestro objetivo fue describir la epidemiología y las características clínicas de las infecciones por HPeV en nuestro medio. Pacientes y métodos: Estudio multicéntrico prospectivo, llevado a cabo en 12 hospitales a nivel nacional, entre 2013-2015, en niños < 3 años con FSF, sepsis clínica o patología neurológica. Se realizó determinación de HPeV mediante RT-PCR en el Centro Nacional de Microbiología en suero, heces o líquido cefalorraquídeo. Resultados: Se analizan 47 infecciones por HPeV de un total de 850 muestras (5,52%), siendo HPeV-3 el más frecuente (29 casos), con predominio en mayo y julio, con una distribución bienal. El 57% eran neonatos y solo 2 > 3 meses. Todos los pacientes presentaron fiebre, el 45% irritabilidad, el 18,6% exantema y el 14% diarrea. No se observa ninguna alteración específica en las pruebas bioquímicas. El diagnóstico final más frecuente fue FSF (61%) seguido de sepsis clínica (29%). Aunque un 29% de los niños precisaron ingreso en cuidados intensivos, solo un paciente presentó secuelas. Conclusiones: Los HPeV circulan en nuestro país, afectando fundamentalmente a lactantes < 2 meses y se asocian a FSF y sepsis clínica, con un predominio en primavera y verano. Sería de interés implementar las técnicas moleculares de diagnóstico en todos los hospitales para reconocer y manejar adecuadamente estas infecciones (AU)
Introduction: Human parechovirus (HPeV) is one of the recently described picornaviridae viruses that have been associated with fever of unknown origin (FUO), clinical sepsis, gastroenteritis, meningitis, or encephalitis in very young infants. The aim of this study is to describe the epidemiology and clinical features of these viruses. Patients and methods: A prospective multicentre 3-year study was conducted in 12 hospitals in Spain. Out of 850 specimens examined, 47 were positive (5.52%), with HPeV-3 being the most frequent (29 cases). Infections occurred throughout the year, but mainly in May and July, and a biennial distribution was observed. More than half (57%) were neonates, and only 2 children were older than 3 months. Fever was present in all children, with irritability in 45%, rash in 18.6%, and diarrhoea in 14%. The results of biochemical tests were all in normal range. The most common final diagnosis was FUO (61%), followed by clinical sepsis (29%). Up to 29% of infants were admitted to the intensive care unit, but only one patient had sequelae. Results: Out of 850 specimens examined, 47 were positive (5.52%) for HPeV, with HPeV-3 being the most frequent (29 cases). Infections occurred throughout the year, but mainly in May and July, and a biennial distribution was observed. More than half (57%) were neonates, and only 2 children were older than 3 months. Fever was present in all children, with irritability in 45%, rash in 18.6%, and diarrhoea in 14%. The results of biochemical tests were all in normal range. The most common final diagnosis was FUO (61%), followed by clinical sepsis (29%). Up to 29% of infants were admitted to the intensive care unit, but only one patient had sequelae. Conclusions: HPeV circulates in our country, mainly during spring and summer, and affects young infants with a FUO and clinical sepsis. Molecular diagnostic techniques in all hospitals could help in improving the management of patients with these infections (AU)
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Humanos , Lactante , Preescolar , Parechovirus/patogenicidad , Infecciones por Picornaviridae/epidemiología , Estudios Prospectivos , Sepsis/epidemiología , Meningitis Bacterianas/epidemiología , Gastroenteritis/epidemiología , Encefalitis/epidemiologíaRESUMEN
INTRODUCTION: Human parechovirus (HPeV) is one of the recently described picornaviridae viruses that have been associated with fever of unknown origin (FUO), clinical sepsis, gastroenteritis, meningitis, or encephalitis in very young infants. The aim of this study is to describe the epidemiology and clinical features of these viruses. PATIENTS AND METHODS: A prospective multicentre 3-year study was conducted in 12 hospitals in Spain. Out of 850 specimens examined, 47 were positive (5.52%), with HPeV-3 being the most frequent (29 cases). Infections occurred throughout the year, but mainly in May and July, and a biennial distribution was observed. More than half (57%) were neonates, and only 2 children were older than 3 months. Fever was present in all children, with irritability in 45%, rash in 18.6%, and diarrhoea in 14%. The results of biochemical tests were all in normal range. The most common final diagnosis was FUO (61%), followed by clinical sepsis (29%). Up to 29% of infants were admitted to the intensive care unit, but only one patient had sequelae. RESULTS: Out of 850 specimens examined, 47 were positive (5.52%) for HPeV, with HPeV-3 being the most frequent (29 cases). Infections occurred throughout the year, but mainly in May and July, and a biennial distribution was observed. More than half (57%) were neonates, and only 2 children were older than 3 months. Fever was present in all children, with irritability in 45%, rash in 18.6%, and diarrhoea in 14%. The results of biochemical tests were all in normal range. The most common final diagnosis was FUO (61%), followed by clinical sepsis (29%). Up to 29% of infants were admitted to the intensive care unit, but only one patient had sequelae CONCLUSIONS: HPeV circulates in our country, mainly during spring and summer, and affects young infants with a FUO and clinical sepsis. Molecular diagnostic techniques in all hospitals could help in improving the management of patients with these infections.