MONITORIZACIÓN DEL CUMPLIMIENTO DEL PROTOCOLO DE MANTENIMIENTO DE LA CATETERIZACIÓN VENOSA MEDIANTE EL MÉTODO LQAS.

Introducción: La monitorización de indicadores es una actividad conducente a valorar si estamos a unos niveles preestablecidos de calidad y para detectar la existencia de situaciones problemáticas. El muestreo de aceptación de lotes o Lot quality assurance sampling (LQAS) es un método originado en la industria que resulta de utilidad en la monitorización en servicios sanitarios si lo que queremos es comparar la situación actual a un estándar prefijado. Objetivo: Evaluar el cumplimiento del protocolo de mantenimiento de la cateterización venosa de un hospital mediante el método LQAS. Metodología: Diseño: Estudio de monitorización de la calidad mediante el método LQAS. Ámbito: Se realizó en las áreas quirúrgicas, hospitalización, UCI y urgencias del Hospital Morales Meseguer de Murcia durante el año 2002 (3 cortes). Criterios evaluados: C1: Utilización de apósito estéril transparente; C2: Fijación correcta; C3: Presencia de desconexiones innecesarias del sistema; C4: Registro de fecha de inserción. Metodología: Partiendo de un estándar de cumplimiento del 95%, asumiendo un umbral mínimo del 85%, un Error a= 5% y un Error b=20%, se calculó un tamaño muestral de 44 casos y el número mínimo de cumplimientos del protocolo de 39. Resultados: Durante el primer y segundo cortes se obtuvieron 39 casos adecuados a protocolo, siendo de 42 en el tercer corte. Los criterios en los que más incumplimientos se producían fueron C1 (Utilización de apósito estéril transparente) y C2 (Fijación correcta). Conclusiones: Los resultados muestran la inexistencia de un problema de calidad en el protocolo estudiado. La utilización del método LQAS nos proporciona una forma rápida de decidir si estamos ante una situación problemática de calidad utilizando una muestra pequeña

o 012safety and effectiveness of regorafenib in patients with metastatic colorectal cancer mcrc in routine clinical practice final analysis from the prospective observational correlate study

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real world dosing of regorafenib reg in metastatic colorectal cancer mcrc final results from the prospective observational correlate study

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Shape-resonant superconductivity in nanofilms: from weak to strong coupling

Ultrathin superconductors of different materials are becoming a powerful platform to find mechanisms for enhancement of superconductivity, exploiting shape resonances in different superconducting properties. Here we evaluate the superconducting gap and its spatial profile, the multiple gap components, and the chemical potential, of generic superconducting nanofilms, considering the pairing attraction and its energy scale as tunable parameters, from weak to strong coupling, at fixed electron density. Superconducting properties are evaluated at mean field level as a function of the thickness of the nanofilm, in order to characterize the shape resonances in the superconducting gap. We find that the most pronounced shape resonances are generated for weakly coupled superconductors, while approaching the strong coupling regime the shape resonances are rounded by a mixing of the subbands due to the large energy gaps extending over large energy scales. Finally, we find that the spatial profile, transverse to the nanofilm, of the superconducting gap acquires a flat behavior in the shape resonance region, indicating that a robust and uniform multigap superconducting state can arise at resonance.Comment: 7 pages, 4 figures. Submitted to the Proceedings of the Superstripes 2016 conferenc

Base editing repairs an SGCA mutation in human primary muscle stem cells

Skeletal muscle can regenerate from muscle stem cells and their myogenic precursor cell progeny, myoblasts. However, precise gene editing in human muscle stem cells for autologous cell replacement therapies of untreatable genetic muscle diseases has not yet been reported. Loss-of-function mutations in SGCA, encoding α-sarcoglycan, cause limb-girdle muscular dystrophy 2D/R3, an early onset, severe and rapidly progressive form of muscular dystrophy affecting equally girls and boys. Patients suffer from muscle degeneration and atrophy affecting the limbs, respiratory muscles, and the heart. We isolated human muscle stem cells from two donors with the common SGCA c.157G>A mutation affecting the last coding nucleotide of exon 2. We found that c.157G>A is an exonic splicing mutation that induces skipping of two co-regulated exons. Using adenine base editing, we corrected the mutation in the cells from both donors with >90% efficiency, thereby rescuing the splicing defect and α-sarcoglycan expression. Base edited patient cells regenerated muscle and contributed to the Pax7 positive satellite cell compartment in vivo in mouse xenografts. We hereby provide the first evidence that autologous gene repaired human muscle stem cells can be harnessed for cell replacement therapies of muscular dystrophies. ONE SENTENCE SUMMARY: Patient primary muscle stems cells gene repaired with >90% efficiency by base editing maintain their regenerative properties for autologous cell replacement therapies of muscular dystrophy

A randomised phase 2 study comparing different dose approaches of induction treatment of regorafenib in previously treated metastatic colorectal cancer patients (REARRANGE trial)

Altres ajuts: Bayer HealthCare Pharmaceuticals Inc.Purpose: The purpose of this article is to evaluate the safety of two regorafenib dose-escalation approaches in refractory metastatic colorectal cancer (mCRC) patients. Patients and methods: Patients with mCRC and progression during or within 3 months following their last standard chemotherapy regimen were randomised to receive the approved dose of regorafenib of 160 mg QD (arm A) or 120 mg QD (arm B) administered as 3 weeks of treatment followed by 1 week off, or 160 mg QD 1 week on/1 week off (arm C). The primary end-point was the percentage of patients with G3/G4 treatment-related adverse events (AEs) in each arm. Results: There were 299 patients randomly assigned to arm A (n = 101), arm B (n = 99), or arm C (n = 99); 297 initiated treatments (arm A n = 100, arm B n = 98, arm C n = 99: population for safety analyses). G3/4 treatment-related AEs occurred in 60%, 55%, and 54% of patients in arms A, B, and C, respectively. The most common G3/4 AEs were hypertension (19, 12, and 20 patients), fatigue (20, 14, and 15 patients), hypokalemia (11, 7, and 10 patients), and hand-foot skin reaction (8, 7, and 3 patients). Median overall survival was 7.4 (IQR 4.0-13.7) months in arm A, 8.6 (IQR 3.8-13.4) in arm B, and 7.1 (IQR 4.4-12.4) in arm C. Conclusions: The alternative regorafenib dosing schedules were feasible and safe in patients with mCRC who had been previously treated with standard therapy. There was a higher numerical improvement on the most clinically relevant AEs in the intermittent dosing arm, particularly during the relevant first two cycles. Clinicaltrials.gov identifier: NCT02835924

Prediction of poor outcome in clostridioides difficile infection: A multicentre external validation of the toxin B amplification cycle

Producción CientíficaClassification of patients according to their risk of poor outcomes in Clostridioides difficile infection (CDI) would enable implementation of costly new treatment options in a subset of patients at higher risk of poor outcome. In a previous study, we found that low toxin B amplification cycle thresholds (Ct) were independently associated with poor outcome CDI. Our objective was to perform a multicentre external validation of a PCR-toxin B Ct as a marker of poor outcome CDI. We carried out a multicentre study (14 hospitals) in which the characteristics and outcome of patients with CDI were evaluated. A subanalysis of the results of the amplification curve of real-time PCR gene toxin B (XpertTM C. difficile) was performed. A total of 223 patients were included. The median age was 73.0 years, 50.2% were female, and the median Charlson index was 3.0. The comparison of poor outcome and non–poor outcome CDI episodes revealed, respectively, the following results: median age (years), 77.0 vs 72.0 (p = 0.009); patients from nursing homes, 24.4% vs 10.8% (p = 0.039); median leukocytes (cells/μl), 10,740.0 vs 8795.0 (p = 0.026); and median PCR-toxin B Ct, 23.3 vs 25.4 (p = 0.004). Multivariate analysis showed that a PCR-toxin B Ct cut-off <23.5 was significantly and independently associated with poor outcome CDI (p = 0.002; OR, 3.371; 95%CI, 1.565–7.264). This variable correctly classified 68.5% of patients. The use of this microbiological marker could facilitate early selection of patients who are at higher risk of poor outcome and are more likely to benefit from newer and more costly therapeutic options

The high-energy emission from HD 93129A near periastron

We conducted an observational campaign towards one of the most massive and luminous colliding wind binaries in the Galaxy, HD~93129A, close to its periastron passage in 2018. During this time the source was predicted to be in its maximum of high-energy emission. Here we present our data analysis from the X-ray satellites \textit{Chandra} and \textit{NuSTAR} and the γ-ray satellite \textit{AGILE}. High-energy emission coincident with HD~93129A was detected in the X-ray band up to ∼18~keV, whereas in the γ-ray band only upper limits were obtained. We interpret the derived fluxes using a non-thermal radiative model for the wind-collision region. We establish a conservative upper limit for the fraction of the wind kinetic power that is converted into relativistic electron acceleration, fNT,e0.3~G. We also argue a putative interpretation of the emission from which we estimate fNT,e≈0.006 and BWCR≈0.5~G. We conclude that multi-wavelength, dedicated observing campaigns during carefully selected epochs are a powerful tool for characterising the relativistic particle content and magnetic field intensity in colliding wind binaries