Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Targeting the Intrinsic Apoptosis Pathway: A Window of Opportunity for Prostate Cancer

Despite major improvements in the management of advanced prostate cancer over the last 20 years, the disease remains invariably fatal, and new effective therapies are required. The development of novel hormonal agents and taxane chemotherapy has improved outcomes, although primary and acquired resistance remains problematic. Inducing cancer cell death via apoptosis has long been an attractive goal in the treatment of cancer. Apoptosis, a form of regulated cell death, is a highly controlled process, split into two main pathways (intrinsic and extrinsic), and is stimulated by a multitude of factors, including cellular and genotoxic stress. Numerous therapeutic strategies targeting the intrinsic apoptosis pathway are in clinical development, and BH3 mimetics have shown promising efficacy for hematological malignancies. Utilizing these agents for solid malignancies has proved more challenging, though efforts are ongoing. Molecular characterization and the development of predictive biomarkers is likely to be critical for patient selection, by identifying tumors with a vulnerability in the intrinsic apoptosis pathway. This review provides an up-to-date overview of cell death and apoptosis, specifically focusing on the intrinsic pathway. It summarizes the latest approaches for targeting the intrinsic apoptosis pathway with BH3 mimetics and discusses how these strategies may be leveraged to treat prostate cancer

Mouse models in endocrine tumors.

Endocrine and neuroendocrine tumors comprise a highly heterogeneous group of neoplasms that can arise from (neuro)endocrine cells, either from endocrine glands or from the widespread diffuse neuroendocrine system, and, consequently, are widely distributed throughout the body. Due to their diversity, heterogeneity and limited incidence, studying in detail the molecular and genetic alterations that underlie their development and progression is still a highly elusive task. This, in turn, hinders the discovery of novel therapeutic options for these tumors. To circumvent these limitations, numerous mouse models of endocrine and neuroendocrine tumors have been developed, characterized and used in pre-clinical, co-clinical (implemented in mouse models and patients simultaneously) and post-clinical studies, for they represent powerful and necessary tools in basic and translational tumor biology research. Indeed, different in vivo mouse models, including cell line-based xenografts (CDXs), patient-derived xenografts (PDXs) and genetically engineered mouse models (GEMs), have been used to delineate the development, progression and behavior of human tumors. Results gained with these in vivo models have facilitated the clinical application in patients of diverse breakthrough discoveries made in this field. Herein, we review the generation, characterization and translatability of the most prominent mouse models of endocrine and neuroendocrine tumors reported to date, as well as the most relevant clinical implications obtained for each endocrine and neuroendocrine tumor type

Aps Sustainable and Inclusive Social Volunteering: learning by doing a service stop the community (II)

El objetivo principal es consolidar el desarrollo de competencias genéricas y específicas que capacite a los y las participantes para transmitir la importancia de la Agenda 2030 en la universidad y la comunidad, desarrollando capacidades de reafirmación social para canalizar acciones encaminadas hacia los Objetivos de Desarrollo Sostenible (ODS). A través de la metodología del Aprendizaje-Servicio se busca promover un encuentro para el trabajo conjunto, mediante la conexión entre la individualidad de las personas, el trabajo grupal y comunitario. Los fundamentos del Trabajo Social nos permitirán trabajar un enfoque de derechos, valores y compromiso. Además, se promoverá el desarrollo de habilidades para la vida desde la educación popular, la educación eco-social, el diseño universal del aprendizaje, los entornos inclusivos, la lectura fácil y los huertos eco-didácticos. En el proyecto participará un grupo de veinte voluntarios/as (estudiantes de grado y máster de la Facultad de Trabajo Social y personas externas con diversidad intelectual), puntualmente estudiantes de Bellas Artes y Estudios Estadísticos. Como Aprendizaje, las actividades formativas programadas buscan formar al voluntariado tanto en los ODS como en las capacidades comentadas anteriormente. Para su desarrollo, se contará con recursos de las entidades colaboradoras, tanto propias de la UCM como externas. Como Servicio a la Comunidad, se propondrá al voluntariado el reto de ser embajadores/as de los ODS, compartiendo su mensaje en la universidad y comunidad, desde el conocimiento científico y el reconocimiento a los demás (cultura, saberes y procesos distintos a los nuestros). La gestión operativa se realizará a tres niveles: equipo técnico, para el seguimiento y evaluación del proyecto; equipo de acompañamiento, para coordinar actividades con el voluntariado y garantizar cohesión grupal; y equipo de relaciones institucionales, para coordinar con entidades colaboradoras los espacios y agenda para las actividades con el voluntariado.The main objective is to consolidate the development of generic and specific skills that train the participants to convey the importance of the 2030 Agenda in the university and the community, developing capacities for social reaffirmation to channel actions aimed at the Sustainable Development Goals ( ODS). Through the Service-Learning methodology, it seeks to promote a meeting for joint work, through the connection between the individuality of people, group and community work. The foundations of Social Work will allow us to work on a focus on rights, values ​​and commitment. In addition, the development of life skills will be promoted from popular education, eco-social education, universal learning design, inclusive environments, easy reading and eco-didactic gardens. A group of twenty volunteers will participate in the project (undergraduate and master's students from the Faculty of Social Work and external people with intellectual diversity), occasionally students of Fine Arts and Statistical Studies. As Learning, the programmed training activities seek to train volunteers both in the SDGs and in the capacities mentioned above. For its development, there will be resources from collaborating entities, both from the UCM and from outside. As Community Service, the challenge of being ambassadors of the SDGs will be proposed to volunteers, sharing their message in the university and community, based on scientific knowledge and recognition of others (culture, knowledge and processes different from ours). Operational management will be carried out at three levels: technical team, for the monitoring and evaluation of the project; support team, to coordinate activities with volunteers and guarantee group cohesion; and institutional relations team, to coordinate with collaborating entities the spaces and agenda for volunteer activities.Depto. de Trabajo Social y Servicios SocialesFac. de Trabajo SocialTRUEServicio ApS. Universidad Complutense de Madridunpu