Propuesta para un programa de control de calidad en radiología general

De la necesidad de indagar sobre los protocolos de control de calidad en imágenes radio diagnósticas, surge el interés de llevar a cabo un trabajo en el marco del diplomado de profundización en la Universidad Nacional Abierta y a Distancia – UNAD, en la Tecnología en Radiología e Imágenes Diagnósticas. El objetivo del trabajo fue determinar los elementos necesarios para cumplir con un programa de control de calidad en radiología convencional, en centros de imágenes diagnósticas en Colombia. Para cumplir con el objetivo, se planteó un enfoque cualitativo y la técnica de análisis documental por medio de la lectura sistemática. Durante el desarrollo del trabajo se contemplaron 5 fases con sus respectivas tareas, las cuales ayudaron a la construcción de la guía para la implementación de un programa de control de calidad que pueda ser utilizada por los centros de imágenes diagnósticas en Colombia. Las conclusiones más relevantes apuntaron a que, en general, los organismos internacionales coinciden en que los programas de control de calidad son herramientas que ayudan a la sociedad porque optimizan la radiación ionizante a favor de la humanidad. Asimismo, se logró determinar que los elementos necesarios para cumplir con un programa de control de calidad en radiología convencional son: relevamiento del servicio, relevamiento radio sanitario actual, prueba de aceptación, prueba de estado, tasa de rechazo de imagen y indicadores de dosis a los pacientes.From the need to investigate the quality control protocols in radio diagnostic imaging, It arose the interest to carry out a study within the diagnostic images. The interest arises to carry out a work in the framework of the diploma of deepening in the National Open University at the Universidad Nacional Abierta y a Distancia - UNAD, in the Technology in Radiology and Diagnostic Imaging. The objective of the work was to determine the necessary elements to comply with a quality control program in conventional radiology in diagnostic imaging centers in Colombia. In order to fulfill the objective, a qualitative approach and aqualitative approach and the technique of documentary analysis by means of systematic reading were taken into account. During the development of the work, 5 phases with their respective tasks were contemplated, which the construction of a guide for the implementation of a quality control program that can be used by the centers quality control program that can be used by diagnostic imaging centers in Colombia. The most relevant conclusions pointed out that, in general, international organizations agree that quality control programs are tools that help society because they optimize the ionizing radiation to use because they optimize ionizing radiation for the benefit of mankind. It was also possible to determine that the necessary elements to comply with a quality control program in conventional radiology are: survey of the service, current radio sanitary survey, acceptance test, status test and image rejection rate and dose indicators to patients

Prosthetic Valve Candida spp. Endocarditis: New Insights Into Long-term Prognosis—The ESCAPE Study

International audienceBackground: Prosthetic valve endocarditis caused by Candida spp. (PVE-C) is rare and devastating, with international guidelines based on expert recommendations supporting the combination of surgery and subsequent azole treatment.Methods: We retrospectively analyzed PVE-C cases collected in Spain and France between 2001 and 2015, with a focus on management and outcome.Results: Forty-six cases were followed up for a median of 9 months. Twenty-two patients (48%) had a history of endocarditis, 30 cases (65%) were nosocomial or healthcare related, and 9 (20%) patients were intravenous drug users. "Induction" therapy consisted mainly of liposomal amphotericin B (L-amB)-based (n = 21) or echinocandin-based therapy (n = 13). Overall, 19 patients (41%) were operated on. Patients <66 years old and without cardiac failure were more likely to undergo cardiac surgery (adjusted odds ratios [aORs], 6.80 [95% confidence interval [CI], 1.59-29.13] and 10.92 [1.15-104.06], respectively). Surgery was not associated with better survival rates at 6 months. Patients who received L-amB alone had a better 6-month survival rate than those who received an echinocandin alone (aOR, 13.52; 95% CI, 1.03-838.10). "Maintenance" fluconazole therapy, prescribed in 21 patients for a median duration of 13 months (range, 2-84 months), led to minor adverse effects.Conclusion: L-amB induction treatment improves survival in patients with PVE-C. Medical treatment followed by long-term maintenance fluconazole may be the best treatment option for frail patients