Validación del manual de estándares de acreditación de unidades de cirugía mayor ambulatoria con acreditaciones piloto en 7 hospitales / Accreditation handbook for ambulatory health care centres. standards of validation in seven hospitals

OBJETIVO: el objetivo principal de este trabajo, fue la validación de un método de control y calidad a través del documento escrito "Manual de estándares y Guía de Acreditación de unidades de Cirugía Mayor Ambulatoria:". Los objetivos específicos fueron: a) la comprobar la validez de los estándares, b) proporcionar una herramienta de autoevaluación y c) proporcionara los acreditadores una guía para su trabajo. Los sujetos a estudio fueron 7 centros/unida desde diversas Comunidades Autónomas. MÉTODO: a) valoración de disponibilidad del centro, establecimiento de los evaluadores internos y externos y calendario, b) autoevaluación interna, c) visita de acreditación, d) elaboración de los resultados, e) reunión de los evaluadores para modificar estándares inadecuados. Las determinaciones efectuadas afectaron a las áreas de: Órganos de gobierno y dirección, recursos humanos y asistencia al paciente. RESULTADOS: los estándares fueron validados tras modificaciones no esenciales y todos los centros superaron la acreditación con mayor o menor grado de cumplimiento (AU)

OBJECTIVE: The main objective of this study was to find a method to measure and control quality through a written document: "Handbook for Accrediting Ambulatory Health Care Centres". Specific objectives were: a) to validate standards b) to provide a tool for self-evaluation for Ambulatory Surgical Units, and c) to provide an accrediting handbook. Subjects studied were7 selected Ambulatory Units, located in various Autonomous Communities and with different care and management policies. DESIGN: We evaluated; a) the availibility of the centre, the appointement of inside and outside controllers and a time-limit to obtain accreditation ,b) self- evaluation procedures, c) an accrediting survey by experts, d) survey report, e)modification of inadequate standards observed by the Experts' Committee, and f) finally a handbook. Standards measured included directing and management skills, human resources, ethics, patient care, continuity of patient care, safe practice and environment. RESULTS: Standards were validated with slight non-essential modifications and all the Centres reached accreditation (AU)

[Intraparotid lymphoepithelial cysts and the human immunodeficiency virus]. / Quistes linfoepiteliales intraparotídeos y virus de la inmunodeficiencia humana.

Lymphoepithelial lesions in the parotid gland are an uncommon benign entity, with an increasing incidence since 1980 due to the involvement of HIV infected patients. We report here three cases recorded at the ORL service in Viladecans Hospital, with cytologic investigation with echo-guided fine needle aspiration. A discussion follows on the theory that these cysts are part, together with persistent polyadenopathies, of the immune response to HIV infection. The course towards malignancy is exceptional and conservative management is most accepted.

[Abrikossoff's tumor]. / Tumor de abrikossoff.

Two cases of granular cell tumour in the tongue are presented One of them sitting in the free edge, the other one in the middle line. We consider clinic, histogenic characteristics and treatment as well Comments on the unusual presence of this tumor in the middle line of the tongue in a child.

[Solitary chondroma of the nasal septum]. / Condroma solitario de septum nasal.

A case of chondrome arising from the nasal septum, in a 42-year-old woman, is described. In spite of its benignity the prognostic is doubtful owing to its possible transformation in chondrosarcoma. The fundamentals of this onerous change are both clinical and anatomopathological, and are briefly discussed in the paper. Having in mind the spare figures of cases reported the AA. make a bibliographic survey mentioning 19 previous cases.

[Ambulatory surgery unit. One year's experience of the otorhinolaryngology service]. / Unidad de cirugía sin ingreso. Un año de experiencia del servicio de ORL.

Surgery practice is no longer defined by the number of days of stay but for its results without regard to whether it has been performed under in-patients or outpatient basis. Due to this fact and others suck as the increase in population and shortage of surgical resources, the improve in technics, and new concepts in anesthetics, we developed and out patient surgery unit in our hospital. We describe our experience in the design development and follow-up of this unit. The sticss in set on ensuring patient's safety and comfort in order to make this procedure more attractive than in patient's ones. Finally we explored the significance of data available, its pros and cons.

Effects of sodium hyaluronate on tympanic membrane perforations.

The effects of topically applied 1% sodium hyaluronate as an alternative treatment to surgery for tympanic membrane perforations was studied. In an open study, the inclusion criteria were increased by accepting patients previously treated by surgery or with placebo and, compared with a previous study, the frequency at which sodium hyaluronate was applied was reduced. Reduction in the size of the perforation was detected in 12/16 (75.0%) patients, six (37.5%) of whom showed complete tympanic healing, and in the remaining four (25.0%) there was no healing. The average percentage reduction in the perforation area was 80.5%. The two factors altered in this trial, i.e. inclusion criteria and frequency of administration of treatment, had little influence on the degree of membrane healing.

An alternative treatment for the reduction of tympanic membrane perforations: sodium hyaluronate. A double blind study.

Topical treatment with 1% sterile sodium hyaluronate solution applied on the tympanic perforation membrane has been suggested as an alternative to surgical treatment in one study only. To further investigate the effects of such a treatment, we designed a double blind study comparing topical administration of 1% sodium hyaluronate with that of 2% methylcellulose solution (placebo). After treatment the degree of perforation healing was evaluated and expressed in percentage of reduction area. The reduced area turned out to be significantly different in the group treated with sodium hyaluronate solution as compared to the placebo group. We believe that sodium hyaluronate is an alternative to myringoplasty for selected tympanic membrane perforations.

[Radiological contributions in perennial rhinitis]. / Aportaciones radiológicas en la rinitis perenne.

We considered over 500 cases of Perennial Rhinitis (PR). A radiologic study has been performed to determine mucosa alterations. The percentage of allergic PR is found to be of forty-eight percent. Radiologic alteration are found in 43% of non allergic PR. We considered also addition factors such as sex, age, occurrence of asthma and levels of IgE.

[Malignant otitis externa and HIV antibodies. A case report]. / Otitis externa maligna y anticuerpos HIV. A propósito de un caso.

The AA. inform about the case of a young man, 23, with immunodeficiency (positive HIV antibodies) and malignant otitis externa associated. They recall the etiopathogenesis, the diagnosis, the evolution and the treatment of the disease, pointing out that this case is the first one (published in the ENT bibliography) of malignant otitis-external otitis and HIV linked together.