23 research outputs found
Renal transplantation in patients with hepatitis C virus antibody. A long national experience
Background. Renal transplantation is the best therapy for patients with hepatitis C virus (HCV) infection with end-stage renal disease. Patient and graft survival are lower in the long term compared with HCV-negative patients. The current study evaluated the results of renal transplantation in Spain in a long period (1990–2002), focusing on graft failure
The effectiveness of intermediate care including transitional care interventions on function, healthcare utilisation and costs: a scoping review.
Background and aim
Intermediate care describes services, including transitional care, that support the needs of middle-aged and older adults during care transitions and between different settings. This scoping review aimed to examine the effectiveness of intermediate care including transitional care interventions for middle-aged and older adults on function, healthcare utilisation, and costs.
Design
A scoping review of the literature was conducted including studies published between 2002 and 2019 with a transitional care and/or intermediate care intervention for adults aged ≥ 50. Searches were performed in CINAHL, Cochrane Library, EMBASE, Open Grey and PubMed databases. Qualitative and quantitative approaches were employed for data synthesis.
Results
In all, 133 studies were included. Interventions were grouped under four models of care: (a) Hospital-based transitional care (n = 8), (b) Transitional care delivered at discharge and up to 30 days after discharge (n = 70), (c) Intermediate care at home (n = 41), and (d) Intermediate care delivered in a community hospital, care home or post-acute facility (n = 14). While these models were associated with a reduced hospital stay, this was not universal. Intermediate including transitional care services combined with telephone follow-up and coaching support were reported to reduce short and long-term hospital re-admissions. Evidence for improved ADL function was strongest for intermediate care delivered by an interdisciplinary team with rehabilitation at home. Study design and types of interventions were markedly heterogenous, limiting comparability.
Conclusions
Although many studies report that intermediate care including transitional care models reduce hospital utilisation, results were mixed. There is limited evidence for the effectiveness of these services on function, institutionalisation, emergency department attendances, or on cost-effectiveness.
Electronic supplementary material
The online version of this article (10.1007/s41999-020-00365-4) contains supplementary material, which is available to authorized users
Experience with Sunitinib in metastatic renal cell carcinoma (mRCC) patients: pooled analysis from 3 Spanish observational prospective studies
[Abstract] Background: A pivotal, randomized, phase III trial demonstrated a statistically significant superiority of sunitinib over interferon-α in metastatic renal cell carcinoma (mRCC) patients.
Objective: To evaluate the effectiveness and safety of sunitinib in patients with advanced or mRCC in routine clinical practice.
Methods: Retrospective pooled analysis of clinical data from three observational and prospective studies carried out between 2007 and 2011 in 33 Spanish hospitals. Tumor response, Progression-free survival (PFS) and overall survival (OS), and main sunitinib-related toxicities were registered.
Results: 224 patients were analyzed. Median PFS 10.6 months (95% CI: 9.02–12.25), median OS 21.9 months (95% CI: 17.2–26.6). Objective response rate (ORR) 43.8% (95% CI: 36.8–50.7). Median time to PR was 3.8 months (95% CI: 3.86–5.99) and to CR 8.2 months (95% CI: 4.75–9.77). The most common ≥ grade-3 AEs were asthenia/fatigue (18.7%), hand-foot syndrome (6.2%), hypertension (5.8%) and neutropenia (4.8%). Hand-foot syndrome, diarrhea and mucositis were confirmed as independent predictors for PFS and/or OS in a multivariate analysis (p < 0.05)
Conclusions: Outcomes with sunitinib in daily clinical practice resemble those obtained in clinical trials. Long-term benefit with sunitinib is possible in advanced RCC patients but the appropriate management of toxicities is mandatory to enable patients to remain on treatment
Novel potential predictive markers of sunitinib outcomes in long-term responders versus primary refractory patients with metastatic clear-cell renal cell carcinoma
Background: several potential predictive markers of efficacy of targeted agents in patients with metastatic renal cell carcinoma (mRCC) have been identified. Interindividual heterogeneity warrants further investigation. Patients and methods: multicenter, observational, retrospective study in patients with clear-cell mRCC treated with sunitinib. Patients were classified in two groups: long-term responders (LR) (progression-free survival (PFS)≥22 months and at least stable disease), and primary refractory (PR) (progressive disease within 3-months of sunitinib onset). Objectives were to compare baseline clinical factors in both populations and to correlate tumor expression of selected signaling pathways components with sunitinib PFS. Results: 123 patients were analyzed (97 LR, 26 PR). In the LR cohort, overall response rate was 79% and median duration of best response was 30 months. Median PFS and overall survival were 43.2 (95% confidence intervals[CI]:37.2-49.3) and 63.5 months (95%CI:55.1-71.9), respectively. At baseline PR patients had a significantly lower proportion of nephrectomies, higher lactate dehydrogenase and platelets levels, lower hemoglobin, shorter time to and higher presence of metastases, and increased Fuhrman grade. Higher levels of HEYL, HEY and HES1 were observed in LR, although only HEYL discriminated populations significantly (AUC[ROC]=0.704; cut-off=34.85). Increased levels of hsa-miR-27b, hsa-miR-23b and hsa-miR-628-5p were also associated with prolonged survival. No statistical significant associations between hsa-miR-23b or hsa-miR-27b and the expression of c-Met were found. Conclusions: certain mRCC patients treated with sunitinib achieve extremely long-term responses. Favorable baseline hematology values and longer time to metastasis may predict longer PFS. HEYL, hsa-miR-27b, hsa-miR-23b and hsa-miR-628-5p could be potentially used as biomarkers of sunitinib response
Novel potential predictive markers of sunitinib outcomes in long-term responders versus primary refractory patients with metastatic clear-cell renal cell carcinoma
Background: Several potential predictive markers of efficacy of targeted agents in patients with metastatic renal cell carcinoma (mRCC) have been identified. Interindividual heterogeneity warrants further investigation. Patients and methods: Multicenter, observational, retrospective study in patients with clear-cell mRCC treated with sunitinib. Patients were classified in two groups: long-term responders (LR) (progression-free survival (PFS)=22 months and at least stable disease), and primary refractory (PR) (progressive disease within 3-months of sunitinib onset). Objectives were to compare baseline clinical factors in both populations and to correlate tumor expression of selected signaling pathways components with sunitinib PFS. Results: 123 patients were analyzed (97 LR, 26 PR). In the LR cohort, overall response rate was 79% and median duration of best response was 30 months. Median PFS and overall survival were 43.2 (95% confidence intervals[CI]:37.2-49.3) and 63.5 months (95%CI:55.1-71.9), respectively. At baseline PR patients had a significantly lower proportion of nephrectomies, higher lactate dehydrogenase and platelets levels, lower hemoglobin, shorter time to and higher presence of metastases, and increased Fuhrman grade. Higher levels of HEYL, HEY and HES1 were observed in LR, although only HEYL discriminated populations significantly (AUC[ROC]=0.704; cut-off=34.85). Increased levels of hsa-miR-27b, hsa-miR-23b and hsa-miR-628-5p were also associated with prolonged survival. No statistical significant associations between hsa-miR-23b or hsa-miR-27b and the expression of c-Met were found. Conclusions: Certain mRCC patients treated with sunitinib achieve extremely long-term responses. Favorable baseline hematology values and longer time to metastasis may predict longer PFS. HEYL, hsa-miR-27b, hsa-miR-23b and hsa-miR- 628-5p could be potentially used as biomarkers of sunitinib response
Incidencia de los proyectos de Vinculación con la Sociedad de la Universidad Politécnica Salesiana. Vol 2
Con este mismo título, en diciembre de 2021, apareció el primer volumen de este trabajo. La intención fue sistematizar algunos proyectos de vinculación que habían logrado impactos sociales en términos cualitativos y de innovación educativa. En esa oportunidad se presentó una obra con diez capítulos de reflexión, sistematización, análisis y descripción de la trascendental importancia que implica, para la UPS, la vinculación con la sociedad. Ahora, al cumplir la UPS 28 años de vida institucional, presentamos este segundo volumen, que recoge en 14 capítulos el trabajo de 3 docentes, administrativos, estudiantes e investigadores invitados de distintos campos científicos. Es la continuación de la sistematización de los proyectos de vinculación emblemáticos que se han desarrollado en las sedes de Cuenca, Quito y Guayaquil de la universidad. EN cada uno de ellos se podrá encontrar el esfuerzo que la UPS ha desarrollado en estos 28 años, desde su fundación, para conseguir transformaciones sociales. Fiel a su misión y visión institucional, ha desplegado un arduo trabajo en el capo científico, tecnológico y cultural, dándose a conocer como una institución de excelencia académica, producción científica, responsabilidad social y capacidad de incidir en el desarrollo de la sociedad ecuatorian
4to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica
Este volumen acoge la memoria académica de la Cuarta edición del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2017, desarrollado entre el 29 de noviembre y el 1 de diciembre de 2017 y organizado por la Universidad Politécnica Salesiana (UPS) en su sede de Guayaquil.
El Congreso ofreció un espacio para la presentación, difusión e intercambio de importantes investigaciones nacionales e internacionales ante la comunidad universitaria que se dio cita en el encuentro. El uso de herramientas tecnológicas para la gestión de los trabajos de investigación como la plataforma Open Conference Systems y la web de presentación del Congreso http://citis.blog.ups.edu.ec/, hicieron de CITIS 2017 un verdadero referente entre los congresos que se desarrollaron en el país.
La preocupación de nuestra Universidad, de presentar espacios que ayuden a generar nuevos y mejores cambios en la dimensión humana y social de nuestro entorno, hace que se persiga en cada edición del evento la presentación de trabajos con calidad creciente en cuanto a su producción científica.
Quienes estuvimos al frente de la organización, dejamos plasmado en estas memorias académicas el intenso y prolífico trabajo de los días de realización del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad al alcance de todos y todas
Emociones y pensamientos cambiantes desde la perspectiva de la educación superior
Las emociones y pensamientos son cambiantes, intensas, fugaces, detonantes, dominantes, divergentes, cíclicas y moduladoras generan un patrón de conducta adaptativo o desadaptativo. Desde la perspectiva de la Educación Superior(ES) que involucra a la inclusión social y con ello a la diversidad de emociones/pensamientos, donde la inclusión se da a través de la adaptación. El objetivo de la investigación fue determinar las emociones y pensamientos cambiantes que experimentan los estudiantes en las instituciones de ES en determinadas situaciones del proceso de formación profesional: inicio/fin-de-carrera, inicio/fin-de-semestre, en-procesos-de evaluación y en las clases normales. La población 480 y muestra 214 estudiantes. El enfoque cuali-cuantitativo, de nivel correlacional. Los métodos inductivo-deductivo, analítico-sintético y sistémico, de diseño no-experimental-transversal, la técnica la encuesta/cuestionario con 56 ítem, el Alfa-de-Cronbach 0,966. Dos variables: (i)Emociones y pensamientos: Miedo, Ansiedad, Ira, Culpa, Lástima, Vergüenza, Tristeza; (ii)Perspectiva de la ES: conducta Adaptativa y Desadaptativa. Los resultados en las emociones y pensamientos cambiantes existen de mayor, menor intensidad o frecuencia, las que guían su accionar en el proceso de formación profesional, están en los procesos adaptativos de supervivencia que se convierten el impulso en los estudiantes para culminar su carrera en las instituciones de ES. Se concluye, las emociones y pensamientos de los estudiantes de la carrera de Mercadotecnia SI inciden en las perspectivas de la ES en conductas de adaptabilidad/desadaptabilidad