Indicator for patient safety: Readmission within 30 days for nosocomial infection.

Objetivos: Describir la frecuencia de reingresos en 30 días por infección nosocomial en el “Hospital Torrecárdenas” de Almería. Materiales y métodos: 25.653 episodios. El reingreso por infección nosocomial (IN): proporción de pacientes al alta de cada uno de los episodios hospitalarios durante el periodo de estudio que son reingresados de modo urgente en 30 días con IN, ya conste como diagnóstico principal del nuevo ingreso. Resultados: Proporción de reingresos por IN es 2,6‰ (IC95% 2,0 – 3,3), que supone un total de 67 episodios de reingreso por IN (5,0% del total). Unidad con mas reingresos por IN: UGC de urología 9,7‰ (IC95% 1,9 – 17,4)). Mayor probabilidad de reingreso se asocia al sexo masculino, a una mayor edad, a determinados diagnósticos y servicio al alta. Las unidades de hospitalización con más reingresos: salud mental, obstetricia, oncología radioterápica, oncología y reumatología, sin embargo, las unidades con mas reingresos por IN: urología, angiología y C.Vascular, oncología, neumología y cardiología. Las enfermedades que destacan como reingreso por IN: “otras alteraciones de uretra y vías urinaria” “infección postoperatoria, no clasificada en otro lugar”. Discusión y conclusiones: Se ha caracterizado el patrón de reingresos por IN en el hospital de Torrecárdenas, utilizándose para ser utilizado para implementar acciones preventivas y como un indicador de calidad asistencial.Objectives: To describe the frequency of readmission within 30 days for nosocomial infection at the “Hospital Torrecardenas” of Almeria. Material and methods: The source is from 1/1/2007 to 31/1/2008 CMBDh, analyzed 25,653 episodes. Readmissions for nosocomial infection (NI): proportion of patients at discharge for each hospital episode during the study period that are so urgently readmitted in 30 days with IN, and is credited as the primary diagnosis of new entry or as a diagnosis secondary. Descriptive analysis of variables such as age, sex, high service, month high, episode duration and primary diagnosis, using association between variables.Results: The proportion of readmissions by IN is 2.6 ‰ (IC95% 2,0–3,3), representing a total of 67 episodes of readmission for IN (5.0% of readmissions). The unit with more readmissions for IN was the hospital's urology unit (9.7 ‰ (IC95% 1,9–17,4)). A higher probability of readmission was associated with male gender, older age, certain diagnostic and service to hospital discharge. Inpatient units with more readmissions: mental health, obstetrics, radiation oncology, oncology and rheumatology, however, drives with more readmissions IN: urology, Angiology and Vascular C., oncology, pulmonology and cardiology. The diseases that stand out as readmission for IN are “other disorders of urethra and urinary tract” “postoperative infection, not elsewhere classified”. Conclusions: We have characterized the pattern of readmissions due to infections in the hospital Torrecárdenas, used to be used to implement preventive measures as an indicator of quality

The value of metabolic imaging to predict tumour response after chemoradiation in locally advanced rectal cancer

Preliminary data of this work were presented by RCM and awarded at the 2009 Annual Meeting of the Spanish Society of Coloproctology (AECP) held in Barcelona.Background: We aim to investigate the possibility of using 18F-positron emission tomography/computer tomography (PET-CT) to predict the histopathologic response in locally advanced rectal cancer (LARC) treated with preoperative chemoradiation (CRT). Methods: The study included 50 patients with LARC treated with preoperative CRT. All patients were evaluated by PET-CT before and after CRT, and results were compared to histopathologic response quantified by tumour regression grade (patients with TRG 1-2 being defined as responders and patients with grade 3-5 as non-responders). Furthermore, the predictive value of metabolic imaging for pathologic complete response (ypCR) was investigated. Results: Responders and non-responders showed statistically significant differences according to Mandard's criteria for maximum standardized uptake value (SUVmax) before and after CRT with a specificity of 76,6% and a positive predictive value of 66,7%. Furthermore, SUVmax values after CRT were able to differentiate patients with ypCR with a sensitivity of 63% and a specificity of 74,4% (positive predictive value 41,2% and negative predictive value 87,9%); This rather low sensitivity and specificity determined that PET-CT was only able to distinguish 7 cases of ypCR from a total of 11 patients. Conclusions: We conclude that 18-F PET-CT performed five to seven weeks after the end of CRT can visualise functional tumour response in LARC. In contrast, metabolic imaging with 18-F PET-CT is not able to predict patients with ypCR accuratelyFounded by the Fundación Investigación Mutua Madrileña. We are indebted to M. Expósito Ruiz for statistical support. and to J-L Marín Aznar for pathologic analysisYe

Microarray profiling of mononuclear peripheral blood cells identifies novle candidate genes related to chemoradiation response in rectal cancer

Preoperative chemoradiation significantly improves oncological outcome in locally advanced rectal cancer. However there is no effective method of predicting tumor response to chemoradiation in these patients. Peripheral blood mononuclear cells have emerged recently as pathology markers of cancer and other diseases, making possible their use as therapy predictors. Furthermore, the importance of the immune response in radiosensivity of solid organs led us to hypothesized that microarray gene expression profiling of peripheral blood mononuclear cells could identify patients with response to chemoradiation in rectal cancer. Thirty five 35 patients with locally advanced rectal cancer were recruited initially to perform the study. Peripheral blood samples were obtained before neaodjuvant treatment. RNA was extracted and purified to obtain cDNA and cRNA for hybridization of microarrays included in Human WG CodeLink bioarrays. Quantitative real time PCR was used to validate microarray experiment data. Results were correlated with pathological response, according to Mandard´s criteria and final UICC Stage (patients with tumor regression grade 1–2 and downstaging being defined as responders and patients with grade 3–5 and no downstaging as non-responders). Twenty seven out of 35 patients were finally included in the study. We performed a multiple t-test using Significance Analysis of Microarrays, to find those genes differing significantly in expression, between responders (n = 11) and non-responders (n = 16) to CRT. The differently expressed genes were: BC 035656.1, CIR, PRDM2, CAPG, FALZ, HLA-DPB2, NUPL2, and ZFP36. The measurement of FALZ (p = 0.029) gene expression level determined by qRT-PCR, showed statistically significant differences between the two groups. Gene expression profiling reveals novel genes in peripheral blood samples of mononuclear cells that could predict responders and non-responders to chemoradiation in patients with locally advanced rectal cancer. Moreover, our investigation added further evidence to the importance of mononuclear cells’ mediated response in the neoadjuvant treatment of rectal cancer.This investigation was supported by the Fundación Investigación Biomédica Mutua Madrileña. MC, CC and AB were supported by projects P08-TIC-4299 and CTS2200 of Junta de Andalucía, TIN2009-13489 of DGICT, Madrid, and GREIB PYR_2010-02 and 2010_05 of University of Granada

Expression Profiling of Rectal Tumors Defines Response to Neoadjuvant Treatment Related Genes

To date, no effective method exists that predicts the response to preoperative chemoradiation (CRT) in locally advanced rectal cancer (LARC). Nevertheless, identification of patients who have a higher likelihood of responding to preoperative CRT could be crucial in decreasing treatment morbidity and avoiding expensive and time-consuming treatments. The aim of this study was to identify signatures or molecular markers related to response to pre-operative CRT in LARC. We analyzed the gene expression profiles of 26 pre-treatment biopsies of LARC (10 responders and 16 non-responders) without metastasis using Human WG CodeLink microarray platform. Two hundred and fifty seven genes were differentially over-expressed in the responder patient subgroup. Ingenuity Pathway Analysis revealed a significant ratio of differentially expressed genes related to cancer, cellular growth and proliferation pathways, and c-Myc network. We demonstrated that high Gng4, c-Myc, Pola1, and Rrm1 mRNA expression levels was a significant prognostic factor for response to treatment in LARC patients (p<0.05). Using this gene set, we were able to establish a new model for predicting the response to CRT in rectal cancer with a sensitivity of 60% and 100% specificity. Our results reflect the value of gene expression profiling to gain insight about the molecular pathways involved in the response to treatment of LARC patients. These findings could be clinically relevant and support the use of mRNA levels when aiming to identify patients who respond to CRT therapy.C, CC and AB were supported by projects CTS2200 and PI-0710-2013 of Junta de Andalucía, TIN2013-41990-R of Programa Estatal I+D+i MINECO, and GREIB PYR_2010-02 and 2010_05 of University of Granada

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Cultivo del langostino

1 póster. Editor científico Dr. Juan Espinosa de los Monteros (OESA)Fases del cultivo del langostino japonés o tigre.Peer reviewe

Characteristic of locally advanced rectal cancer patients included in this study.

<p>Characteristic of locally advanced rectal cancer patients included in this study.</p

Representative fluorescence in situ hybridization (FISH) signal patterns using the c-Myc break-apart and CEP8 probe in locally advanced rectal cancer (LARC); a, b) c-Myc rearrangement is absent as evidenced by the presence of normal red-green fusion signals only.

<p>Multiple copies (3–4 copies or 4–6 copies) of c-Myc are present in the tumor; c, d) Two copies of chromosome 8.</p