cuidArt: Art Project of the Health Department of Dénia

Con esta iniciativa pionera en España, desarrollada por parte de la empresa DKV Seguros, se busca que la presencia del arte llene el Hospital de Dénia y forme un entorno mas humanizado. Así, junto a la Colección DKV: Arte y Salud, se muestra un importante proyecto escultórico, así como la intervención pictórica mural llevada a cabo en el área de Pediatría y desarrollada por un reconocido colectivo de Urban Art. Además, el proyecto cuenta con una Sala de Exposiciones dentro del propio hospital, que bajo el leivmotiv de Arte y Salud, programará exposiciones anuales, de producción propia y también en colaboración con distintas entidades públicas y privadas. Todo este proyecto se completa con un programa de actividades para pacientes de las distintas áreas del hospital: hemodiálisis, quimioterapia, psiquiatría y pediatría. Durante la semana se desarrollan talleres de teatro, musicoterapia y arteterapia, así como diversas intervenciones murales efímeras mientras los pacientes están recibiendo sus tratamientos. Un programa de arte al servicio de la salud, donde la humanización del entorno, el dialogo entre las diferentes disciplinas del arte y la medicina, serán la base de desarrollo del proyecto.With this initiative, pioneer in Spain, developed by DKV Seguros, the hospital is imbued with art in order to make a more humanized environment. This way, with DKV Collection: Art and Health, an important sculpture project is held as well as the wall paintings in the pediatric area, developed by an important Urban Art group. Besides, the project has an Exhibition Room, which, under the slogan of Art and Health, will hold annual exhibitions of self production as well as exhibitions in collaboration with different public and private institutions. This whole project is completed with a program of activities for patients of different areas: hemodialysis, chemotherapy, psychiatry and pediatrics. During the week drama workshops, music therapy and art therapy activities are developed at the hospital, as well as ephemeral wall paintings while patients are receiving their treatments. It is an art program at the service of health, where the humanization of the environment, the dialogue between different art disciplines and medicine will be the foundation upon which this project will be developed

Cuidart: proyecto de arte del departamento de salud de Dénia

Con esta iniciativa pionera en España, desarrollada por parte de la empresa DKV Seguros, se busca que la presencia del arte llene el Hospital de Dénia y forme un entorno mas humanizado. Así, junto a la Colección DKV: Arte y Salud, se muestra un importante proyecto escultórico, así como la intervención pictórica mural llevada a cabo en el área de Pediatría y desarrollada por un reconocido colectivo de Urban Art. Además, el proyecto cuenta con una Sala de Exposiciones dentro del propio hospital, que bajo el leivmotiv de Arte y Salud, programará exposiciones anuales, de producción propia y también en colaboración con distintas entidades públicas y privadas. Todo este proyecto se completa con un programa de actividades para pacientes de las distintas áreas del hospital: hemodiálisis, quimioterapia, psiquiatría y pediatría. Durante la semana se desarrollan talleres de teatro, musicoterapia y arteterapia, así como diversas intervenciones murales efímeras mientras los pacientes están recibiendo sus tratamientos. Un programa de arte al servicio de la salud, donde la humanización del entorno, el dialogo entre las diferentes disciplinas del arte y la medicina, serán la base de desarrollo del proyecto

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception

Predictors of complications and mortality following left colectomy with primary stapled anastomosis for cancer: results of a multicentric study with 1111 patients

Aim: Reports detailing the morbidity–mortality after left colectomy are sparse and do not allow definitive conclusions to be drawn. We aimed to identify risk factors for anastomotic leakage, perioperative mortality and complications following left colectomy for colonic malignancies. Method: We undertook a STROBE-compliant analysis of left colectomies included in a national prospective online database. Forty-two variables were analysed as potential independent risk factors for anastomotic leakage, postoperative morbidity and mortality. Variables were selected using the ‘least absolute shrinkage and selection operator’ (LASSO) method. Results: We analysed 1111 patients. Eight per cent of patients had a leakage and in 80% of them reoperation or surgical drainage was needed. A quarter of patients (24.9%) experienced at least one minor complication. Perioperative mortality was 2%, leakage being responsible for 47.6% of deaths. Obesity (OR 2.8, 95% CI 1.00–7.05, P = 0.04) and total parenteral nutrition (TPN) (OR 3.7, 95% CI 1.58–8.51, P = 0.002) were associated with increased risk of leakage, whereas female patients had a lower risk (OR 0.36, 95% CI 0.18–0.67, P = 0.002). Corticosteroids (P = 0.03) and oral anticoagulants (P = 0.01) doubled the risk of complications, which was lower with hyperlipidaemia (OR 0.3, P = 0.02). Patients on TPN had more complications (OR 4.02, 95% CI 2.03–8.07, P = 0.04) and higher mortality (OR 8.7, 95% CI 1.8–40.9, P = 0.006). Liver disease and advanced age impaired survival, corticosteroids being the strongest predictor of mortality (OR 21.5, P = 0.001). Conclusion: Requirement for TPN was associated with more leaks, complications and mortality. Leakage was presumably responsible for almost half of deaths. Hyperlipidaemia and female gender were associated with lower rates of complications. These findings warrant a better understanding of metabolic status on perioperative outcome after left colectomy