Organization of patient transfer from conventional hospital to hospitalization at home / Organisation du transfert des patients de l'hospitalisation conventionnelle vers l'hospitalisation à domicile

INTRODUCTION: The organization of patient transfer from conventional hospital to hospitalization at home (HAH) is not well known. PURPOSE OF RESEARCH: Our study aims to describe this organization by identifying the key professionals of the pathways and the incentives and obstacles to the continuity of care. RESULTS: Patient transfer from conventional hospital to HAH is a period of strong tension between all health care professionals and the organization of discharge is not sufficiently anticipated by hospital prescribers. The description of the patient clinical state is not always shared between the conventional hospital and the HAH professionals mainly when they do not work together. An HAH physician can be of support. Finally, the HAH nurse has a main role at the interface of the hospital department, the patient, and the home care professionals with an important activity of coordination of interventions. CONCLUSIONS: Patient transfer from conventional hospital to HAH should be anticipated by hospital professionals upon entrance and common needs assessment tools would allow a better security of the pathways.

Introduction: L'organisation du transfert des patients de l'hospitalisation conventionnelle vers l'hospitalisation à domicile (HAD) est peu connue. But de l'étude: Notre étude a eu pour objectif de décrire cette organisation en identifiant les acteurs clés de ce parcours avec les incitatifs et les obstacles à la continuité des soins. Résultats: Le transfert des patients de l'hospitalisation conventionnelle vers l'HAD est une période de forte tension entre tous les professionnels de santé et l'organisation de la sortie est peu anticipée par les prescripteurs hospitaliers. La description de l'état clinique du patient n'est pas toujours partagée entre les médecins hospitaliers et les infirmières de l'HAD, surtout lorsqu'ils n'ont pas l'habitude de travailler ensemble. Le médecin coordonnateur de l'HAD contribue dans ce contexte à construire une vision commune. Enfin, l'infirmière de l'HAD joue un rôle central, à l'interface entre le service hospitalier, le patient et les professionnels du domicile, avec une forte activité de coordination des interventions. Conclusion: Le transfert des patients de l'hôpital conventionnel vers l'HAD devrait être anticipé par les professionnels hospitaliers dès l'entrée en hospitalisation et l'utilisation d'outils communs d'évaluation des besoins permettrait une meilleure sécurisation des parcours.

New 2,4-bis[(substituted-aminomethyl)phenyl]phenylquinazoline and 2,4-bis[(substituted-aminomethyl)phenyl]phenylquinoline Derivatives: Synthesis and Biological Evaluation as Novel Anticancer Agents by Targeting G-Quadruplex.

The syntheses of novel 2,4-bis[(substituted-aminomethyl)phenyl]phenylquinazolines 12 and 2,4-bis[(substituted-aminomethyl)phenyl]phenylquinolines 13 are reported here in six steps starting from various halogeno-quinazoline-2,4-(1H,3H)-diones or substituted anilines. The antiproliferative activities of the products were determined in vitro against a panel of breast (MCF-7 and MDA-MB-231), human adherent cervical (HeLa and SiHa), and ovarian (A2780) cell lines. Disubstituted 6- and 7-phenyl-bis(3-dimethylaminopropyl)aminomethylphenyl-quinazolines 12b, 12f, and 12i displayed the most interesting antiproliferative activities against six human cancer cell lines. In the series of quinoline derivatives, 6-phenyl-bis(3-dimethylaminopropyl)aminomethylphenylquinoline 13a proved to be the most active. G-quadruplexes (G4) stacked non-canonical nucleic acid structures found in specific G-rich DNA, or RNA sequences in the human genome are considered as potential targets for the development of anticancer agents. Then, as small aza-organic heterocyclic derivatives are well known to target and stabilize G4 structures, their ability to bind G4 structures have been determined through FRET melting, circular dichroism, and native mass spectrometry assays. Finally, telomerase inhibition ability has been also assessed using the MCF-7 cell line.