RESUMEN
INTRODUCTION AND OBJECTIVE: Healthcare resources optimization is crucial to assume the growing demand of neovascular age-related macular degeneration (nAMD). This work provides guidelines and support so that each hospital can lead its change management. METHODS: The OPTIMUS project (n=10 hospitals) was based on face-to-face interviews with the key staff of the ophthalmology services, and alignment with the main responsible for each centre (nominal group) to identify potential needs for improving nAMD. The OPTIMUS nominal group was expanded to 12 centres (eVOLUTION). Through different remote work sessions, different guides and tools were defined and developed to implement proactive treatment strategies, one-step treatment administration and potential for remote visits (eConsult) in nAMD. RESULTS: The information collected from the OPTIMUS interviews and working groups (n=10 centres) defined roadmaps to promote the development of protocols and proactive treatment strategies, including healthcare workload optimization and one-stop treatment administration in nAMD. With eVOLUTION, processes and tools were developed to promote eConsult: (i) healthcare burden calculator; (ii) definition of potential patients for telematic management; (iii) definition of nAMD management archetypes; (iv) definition of processes for implementation of eConsult by archetype; and (v) key performance indicators for changing evaluation. CONCLUSIONS: Managing change is an internal task that requires an adequate diagnosis of processes and feasible implementation roadmaps. OPTIMUS and eVOLUTION provide the basic tools for an autonomous advance of hospitals in the optimization of AMD management, with the available resources.
Asunto(s)
Atención a la Salud , Degeneración Macular , Humanos , España , Hospitales , Degeneración Macular/terapia , Degeneración Macular/diagnósticoAsunto(s)
Dermatosis Facial , Anomalías Cutáneas , Masculino , Humanos , Dermatosis Facial/diagnósticoRESUMEN
El interés de esta entidad radica en su adecuado diagnóstico, ya que es a menudo confundida con otros procesos patológicos. Esto tiene como consecuencia la realización de pruebas innecesarias y tratamientos ineficaces, con las implicaciones que ello pudiera tener. Los siringomas son tumoraciones benignas que tienen su origen en las glándulas sudoríparas ecrinas a nivel dérmico. Dada su benignidad clínica e histológica no requieren tratamiento específico. Los de localización genital, por su infrecuencia, suponen un reto diagnóstico y obligan al clínico a realizar un extenso diagnóstico diferencial con otras entidades nosológicas: condiloma plano, verruga vulgar, linfangioma circunscrito y quiste epidermoide, entre otros.(AU)
The interest in this condition lies in its correct diagnosis, since it can be easily misdiagnosed. As a consequence, patients are often tested and treated in many and empiric ways, with the impact that these actions could have. Syringomas are benign tumours originating from the dermic eccrine glands. Considering its clinical and histopathological benign behaviour, they do not require any specific treatment. Genital syringomas are usually difficult to identify, as such, on a first examination, owing to their infrequency and similarity with other pathological processes such as flat condylomas, vulgar warts, circumscribed lymphangioma, or epidermoid cyst, among others.(AU)
Asunto(s)
Humanos , Femenino , Pacientes Internos , Examen Físico , Diagnóstico Diferencial , Siringoma , Vulva/lesiones , Neoplasias de Anexos y Apéndices de Piel , GinecologíaRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Embarazo , Adulto Joven , Infecciones por Poxviridae/diagnóstico , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/virología , Enfermedades Cutáneas Virales/diagnóstico , Enfermedades Cutáneas Virales/virologíaAsunto(s)
COVID-19 , Brotes de Enfermedades , Cuarentena , Escabiosis/epidemiología , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , España/epidemiología , Adulto JovenAsunto(s)
Complicaciones Neoplásicas del Embarazo , Neoplasias Cutáneas , Femenino , Humanos , EmbarazoRESUMEN
Las dermatosis purpúricas pigmentadas son un grupo de enfermedades benignas y de curso crónico. Las variantes descritas representan distintas formas clínicas de una misma entidad con unas características histopatológicas comunes para todas ellas. Exponemos a continuación un resumen de las variedades más frecuentes, sus características clínicas, dermatopatológicas y de epiluminiscencia. Al tratarse de una entidad clínica poco frecuente, benigna, y no conocerse claramente los mecanismos patogénicos de la misma, no existen tratamientos estandarizados. Se revisan los tratamientos publicados hasta el momento, la mayoría de ellos basados en casos aislados o pequeñas series de casos, sin poder establecer un nivel de evidencia suficiente como para ser recomendado ninguno de ellos como tratamiento de elección
The pigmented purpuric dermatoses are a group of benign, chronic diseases. The variants described to date represent different clinical presentations of the same entity, all having similar histopathologic characteristics. We provide an overview of the most common PPDs and describe their clinical, dermatopathologic, and epiluminescence features. PPDs are both rare and benign, and this, together with an as yet poor understanding of the pathogenic mechanisms involved, means that no standardized treatments exist. We review the treatments described to date. However, because most of the descriptions are based on isolated cases or small series, there is insufficient evidence to support the use of any of these treatments as first-line therapy
Asunto(s)
Humanos , Enfermedades de la Piel/diagnóstico , Trastornos de la Pigmentación/diagnóstico , Trastornos de la Pigmentación/terapia , Púrpura/diagnóstico , Trastornos de la Pigmentación/patología , Púrpura/terapia , Dermis/anatomía & histología , Dermis/patología , Diagnóstico Diferencial , Fototerapia , Terapia PUVARESUMEN
The pigmented purpuric dermatoses are a group of benign, chronic diseases. The variants described to date represent different clinical presentations of the same entity, all having similar histopathologic characteristics. We provide an overview of the most common PPDs and describe their clinical, dermatopathologic, and epiluminescence features. PPDs are both rare and benign, and this, together with an as yet poor understanding of the pathogenic mechanisms involved, means that no standardized treatments exist. We review the treatments described to date. However, because most of the descriptions are based on isolated cases or small series, there is insufficient evidence to support the use of any of these treatments as first-line therapy.