17 research outputs found
Predictive Power of the "Trigger Tool" for the detection of adverse events in general surgery: a multicenter observational validation study
Background
In spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events. This study was designed to validate the hypothesis that a new “Trigger Tool” represents a sensitive predictor of adverse events in general surgery.
Methods
An observational multicenter validation study was performed among 31 hospitals in Spain. The previously described “Trigger Tool” based on 40 specific triggers was applied to validate the predictive power of predicting adverse events in the perioperative care of surgical patients. A prediction model was used by means of a binary logistic regression analysis.
Results
The prevalence of adverse events among a total of 1,132 surgical cases included in this study was 31.53%. The “Trigger Tool” had a sensitivity and specificity of 86.27% and 79.55% respectively for predicting these adverse events. A total of 12 selected triggers of overall 40 triggers were identified for optimizing the predictive power of the “Trigger Tool”.
Conclusions
The “Trigger Tool” has a high predictive capacity for predicting adverse events in surgical procedures. We recommend a revision of the original 40 triggers to 12 selected triggers to optimize the predictive power of this tool, which will have to be validated in future studies
Application of a molecular diagnostic algorithm for haemophilia A and B using next-generation sequencing of entire F8, F9 and VWF genes
Efficacy and safety of daclatasvir-based antiviral therapy in hepatitis C virus recurrence after liver transplantation. Role of cirrhosis and genotype 3. A multicenter cohort study.
Direct-acting antiviral agents (DAA) combining daclatasvir (DCV) have reported good outcomes in the recurrence of hepatitis C virus (HCV) infection after liver transplant (LT). However, its effect on the severe recurrence and the risk of death remains controversial. We evaluated the efficacy, predictors of survival, and safety of DAC-based regimens in a large real-world cohort. A total of 331 patients received DCV-based therapy. Duration of therapy and ribavirin use were at the investigator's discretion. The primary end point was sustained virological response (SVR) at week 12. A multivariate analysis of predictive factors of mortality was performed. Intention-to-treat (ITT) and per-protocol SVR were 93.05% and 96.9%. ITT-SVR was lower in cirrhosis (n = 163) (96.4% vs. 89.6% P = 0.017); the SVR in genotype 3 (n = 91) was similar, even in advanced fibrosis (96.7% vs. 88%, P = 0.2). Ten patients (3%) experienced virological failure. Therapy was stopped in 18 patients (5.44%), and ten died during treatment. A total of 22 patients (6.6%) died. Albumin (HR = 0.376; 95% CI 0.155-0.910) and baseline MELD (HR = 1.137; 95% CI: 1.061-1.218) were predictors of death. DCV-based DAA treatment is efficacious and safe in patients with HCV infection after LT. Baseline MELD score and serum albumin are predictors of survival irrespective of viral response
Discriminación y su relación con las conductas de riesgo y la salud percibida en estudiantes universitarios españoles: Un estudio transversal
Background: Discrimination during vital
moments, such as the university period, can generate a
high impact on people’s behavior and health. The aim
of this study was to analyze the possible association of
discrimination with perceived health and with different
risk behaviors, as well as to describe gender differences
in Spanish university students. Discrimination during
vital moments, such as college, can have a high impact
on people’s behavior and health.
Methods: A cross-sectional study was carried
out with data from first-year university students from
11 Spanish universities (n=9,862). Discrimination,
perceived health, alcohol consumption, smoking,
consumption of illegal substances, leisure time
connected to the Internet, risky sexual relations,
family function, risk of mental health problems and
risk of eating disorders were assessed. Prevalences
with their 95% confidence intervals were obtained
and for quantitative variables the mean and standard
deviation were calculated. Odds ratios with 95%
confidence intervals were calculated to determine
the relationship between discrimination and the other
variables.
Results: An association was found between
discrimination and fair or poor perceived health (OR:
1.7; p=0.0001), consumption of illegal substances
(OR: 1.3; p=0.002), problematic internet use (OR: 1.3;
p=0.004), family dysfunction (OR: 1.8; p=0.0001),
risk of mental health problems (OR: 1.9; p=0.0001)
and eating disorders (OR: 1.5; p=0.0001). Regarding
gender differences, higher prevalence of discrimination
was observed in men with health status perceived as fair
or worse (OR: 2.2; p=0.0001), family dysfunction (OR:
1.8; p=0.0001), risk of mental health problems (OR:
2.2; p=0.0001) and eating disorders (OR: 1.9; p=0.002).
Women, apart from the previous variables, presented
association of discrimination with consumption of
illegal substances (OR: 1.3; p=0.005) and problematic
internet use (OR: 1.4; p=0.002).
Conclusions: The study findings underline that
there is an association between discrimination and
risk behaviors among Spanish university students.
In turn, discrimination was associated with poor or
fair perceived health, this relationship being similar
in both men and women.Fundamentos: La discriminación durante los
momentos vitales, como el periodo universitario,
puede generar un alto impacto en la conducta y
en el estado de salud de las personas. El estudio
tuvo como objetivo analizar la posible asociación
de la discriminación con la salud percibida y con
distintas conductas de riesgo, así como describir las
diferencias de género en estudiantes universitarios
españoles.
Métodos: Se realizó un estudio transversal
con datos de estudiantes universitarios de primera
matrícula de primer curso de 11 universidades
españolas (n=9.862). Se valoró la discriminación,
la salud percibida, el consumo de alcohol, el hábito
tabáquico, el consumo de sustancias ilegales, el
tiempo de ocio conectado a internet, la práctica de
relaciones sexuales de riesgo, la función familiar, el
riesgo de problemas de salud mental y el riesgo de
trastornos de la conducta alimentaria. Se obtuvieron
las prevalencias con sus intervalos de confianza al
95% y para las variables cuantitativas la media y
desviación estándar. Se calcularon las Odds Ratio con
los intervalos de confianza al 95% para conocer la
relación entre la discriminación y las otras variables.
Resultados: Se encontró asociación entre la
discriminación y una regular o mala salud percibida
(OR: 1,7; p=0,0001), el consumo de sustancias
ilegales (OR: 1,3; p=0,002), el uso problemático de
internet (OR: 1,3; p=0,004), la disfunción familiar
(OR: 1,8; p=0,0001), el riesgo de problemas de
salud mental (OR: 1,9; p=0,0001) y de trastornos
de la conducta alimentaria (OR: 1,5; p=0,0001). En
cuanto a las diferencias de género, se apreciaron
mayores prevalencias de discriminación en hombres
con estado de salud percibida como regular o peor
(OR: 2,2; p=0,0001), disfunción familiar (OR: 1,8;
p=0,0001), riesgo de problemas de salud mental
(OR: 2,2; p=0,0001) y de trastornos de la conducta
alimentaria (OR: 1,9; p=0,002). Las mujeres, además
de las variables anteriores, mostraron asociación de la
discriminación con el consumo de sustancias ilegales
(OR: 1,3; p=0,005) y el uso problemático de internet
(OR: 1,4; p=0,002).
Conclusiones: Los hallazgos del estudio subrayan
que existe asociación entre la discriminación y las
conductas de riesgo de los estudiantes universitarios
españoles. A su vez, la discriminación se asoció
con una mala o regular salud percibida, siendo esta
relación similar tanto en hombres como en mujeres
Primary Chemoradiotherapy Treatment (PCRT) for HER2+ and Triple Negative Breast Cancer Patients: A Feasible Combination
Primary systemic treatment (PST) downsizes the tumor and improves pathological response. The aim of this study is to analyze the feasibility and tolerance of primary concurrent radio–chemotherapy (PCRT) in breast cancer patients. Patients with localized TN/HER2+ tumors were enrolled in this prospective study. Radiation was delivered concomitantly during the first 3 weeks of chemotherapy, and it was based on a 15 fractions scheme, 40.5 Gy/2.7 Gy per fraction to whole breast and nodal levels I-IV. Chemotherapy (CT) was based on Pertuzumab–Trastuzumab–Paclitaxel followed by anthracyclines in HER2+ and CBDCA-Paclitaxel followed by anthracyclines in TN breast cancers patients. A total of 58 patients were enrolled; 25 patients (43%) were TN and 33 patients HER2+ (57%). With a median follow-up of 24.2 months, 56 patients completed PCRT and surgery. A total of 35 patients (87.5%) achieved >90% loss of invasive carcinoma cells in the surgical specimen. The 70.8% and the 53.1% of patients with TN and HER-2+ subtype, respectively, achieved complete pathological response (pCR). This is the first study of concurrent neoadjuvant treatment in breast cancer in which three strategies were applied simultaneously: fractionation of RT (radiotherapy) in 15 sessions, adjustment of CT to tumor phenotype and local planning by PET. The pCR rates are encouraging
The Impact of University Collaborative Learning on Student Academic Performance: A Wiki and Blog for Political Science and Administration wiki and a blog for Political Science and Administration
Este proyecto se inició en 2015 y por ello, se trata de continuar elaborado una wiki sobre este área de conocimiento, este año junto a un blog, donde los alumnos a aprenden a trabajar colaborativa y autónomamente, además de medir su rendimiento.This project started in 2015 and therefore, the aim is to continue to develop a wiki on this area of knowledge, this year together with a blog, where students learn to work collaboratively and collaboratively, as well as to
autonomously, as well as measuring their performance.Depto. de Ciencia Política y de la AdministraciónFac. de Ciencias Políticas y SociologíaFALSEUniversidad Complutense de Madridsubmitte
The impact of collaborative university learning on student academic performance: A wiki for political and administrative science
Este proyecto es la continuación de otro financiado desde la convocatoria de 2015. Se trata de seguir elaborando una Wiki donde los alumnos tiene que aprender a trabajar colaborativa y autónomamente, además de medir su rendimiento.This project is the continuation of another project funded since the 2015 call. It is intended to follow developing a Wiki where students have to learn to work collaboratively and autonomously, in addition to measuring their performance.Fac. de Trabajo SocialFALSEUCMsubmitte