Fully home-based methyl aminolevulinate daylight photodynamic therapy for actinic keratosis of the face or scalp: A real life open study

Methyl aminolevulinate daylight photodynamic therapy (MAL DL-PDT) is highly effi-cacious for the treatment of nonhyperkeratotic actinic keratosis (AK), even when par-tially performed at home. To evaluate the long-term effectiveness, safety, andpatient-reported outcomes of MAL DL-PDT performed completely by the patient inreal life conditions. An open prospective study was conducted in Spain amongpatients diagnosed with at least five AK lesions on the face or the scalp. Patientsreceived instruction and information in infographic format to perform MAL DL-PDTat home. All had been treated with 30% urea daily for 7 days before the day of MALDL-PDT. Meteorological conditions on the day of the treatment and adverse effectswere recorded. Patients underwent follow-up, and a second session of home-basedMAL DL-PDT if deemed necessary, 3, 6, and 12 months after the initial treatmentsession. The study population consisted of 22 patients (19 men and three women,mean [standard deviation, SD] age, 72.05 [6.96] years). A complete response wasobserved in 47.7% of AK lesions at 3 months (p< 0.001) and 65.9% (n=199) at12 months (p< 0.001). Olsen grade II lesions showed the highest rate of response(76.07% at 12 months). The mean (SD) actinic keratosis area and severity index scoredecreased significantly from 4.99 (2.43) at baseline to 2.33 (1.01) at 12 months(p=0.0234). Adverse effects were mild and expected. A majority of patients were“satisfied”or“very satisfied”with the treatment instruction provided (90.9%) andthe treatment outcome (72.7%). MAL DL-PDT can be applied at home like any othertopical treatment for AK. Our results indicate good long-term effectiveness, a highlevel of patient satisfaction, and no significant side effect

When Virtual Assistants Meet Teledermatology: Validation of a Virtual Assistant to Improve the Quality of Life of Psoriatic Patients

Teledermatology has given dermatologists a tool to track patients’ responses to therapy using images. Virtual assistants, the programs that interact with users through text or voice messages, could be used in teledermatology to enhance the interaction of the tool with the patients and healthcare professionals and the overall impact of the medication and quality of life of patients. As such, this work aimed to investigate the effectiveness of using a virtual assistant for teledermatology and its impact on the quality of life. We conducted surveys with the participants and measured the usability of the system with the System Usability Scale (SUS). A total of 34 participants (30 patients diagnosed with moderate-severe psoriasis and 4 healthcare professionals) were included in the study. The measurement of the improvement of quality of life was done by analyzing Psoriasis Quality of Life (PSOLIFE) and Dermatology Life Quality Index (DLQI) questionnaires. The results showed that, on average, the quality of life improved (from 63.8 to 64.8 for PSOLIFE (with a p-value of 0.66 and an effect size of 0.06) and 4.4 to 2.8 for DLQI (with a p-value of 0.04 and an effect size of 0.31)). Patients also used the virtual assistant to do 52 medical consultations. Moreover, the usability is above average, with a SUS score of 70.1. As supported by MMAS-8 results, adherence also improved slightly. Our work demonstrates the improvement of the quality of life with the use of a virtual assistant in teledermatology, which could be attributed to the sense of security or peace of mind the patients get as they can contact their dermatologists directly within the virtual assistant-integrated system

Simultaneous Determination of Aflatoxins B1, B2, G1 and G2 IN Commercial Rices Using Immunoaffinity Column Clean-UP and HPLC-MS/MS

Rice is frequently contaminated with aflatoxins, that are highly toxic fungal substances and strongly involved on hepatic cancer. In this work, different extraction and clean-up methods were evaluated for the simultaneous extraction and clean-up of aflatoxins B1, B2, G1 and G2 from rice. Favourable results were obtained by using methanol – water (80:20, v/v) extraction followed by immunoaffinity columns for clean-up, with recoveries of 86–92%, standard deviations between 5 and 11%, LOD ranged between 0.09 and 0.32 µg/kg, and LOQ between 0.31 and 1.06 µg/kg. Method validation and sample analysis were performed by using HPLC-MS/MS. Nine rice samples from different origin, varieties and specific characteristics, acquired in Spanish supermarkets were analysed. In two basmati samples from the same batch aflatoxin B1 was detected at (1.62 ± 0.08) µg/kg and (0.77 ± 0.03) µg/kg, both lower than the levels established by European Regulation for aflatoxin B1 in cereals

Impact Of PET/CT On Treatment In Patients With Head And Neck Squamous Cell Carcinoma

Introduction: Although PET/CT is effective for staging HNSCC, its impact on patient management is somewhat controversial. For this reason, we considered it necessary to carry out a study in order to verify whether PET/CT helps to improve the prognosis and treatment in patients. This study was designed to address the impact of PET-FDG imaging when used alongside CT in the staging and therapeutic management of patients with HNSCC. Material and methods: Data was collected from 169 patients diagnosed with HNSCC with both CT and PET/CT (performed within a maximum of 30 days of each other). It was evaluated whether discrepancies in the diagnosis of the two imaging tests had impacted the treatment. Results: The combined use of CT and PET/CT led to a change in the treatment of 67 patients, who represented 39.7% of the sample. In 27.2% of cases, it entailed a change in the type of treatment which the patient received. In 3.0% of the cases, using both diagnostic tests led to modifications of the therapeutic intention of our patients. Conclusions: Using PET/CT in addition to the conventional imaging method in staging resulted in more successful staging and more appropriate therapeutic decision-making

Analysis of Patient Safety Incidents in Primary Care Reported in an Electronic Registry Application

Incident notification; Patient safety; Risk managementNotificació d'incident; Seguretat dels pacients; Gestió de riscNotificación de incidentes: Seguridad del paciente; Gestión de riesgoObjectives: (1) To describe the epidemiology of patient safety (PS) incidents registered in an electronic notification system in primary care (PC) health centres; (2) to define a risk map; and (3) to identify the critical areas where intervention is needed. Design: Descriptive analytical study of incidents reported from 1 January to 31 December 2018, on the TPSC Cloud™ platform (The Patient Safety Company) accessible from the corporate website (Intranet) of the regional public health service. Setting: 24 Catalan Institute of Health PC health centres of the Tarragona region (Spain). Participants: Professionals from the PC health centres and a Patient Safety Functional Unit. Measurements: Data obtained from records voluntarily submitted to an electronic, standardised and anonymised form. Data recorded: healthcare unit, notifier, type of incident, risk matrix, causal and contributing factors, preventability, level of resolution and improvement actions. Results: A total of 1544 reports were reviewed and 1129 PS incidents were analysed: 25.0% of incidents did not reach the patient; 66.5% reached the patient without causing harm, and 8.5% caused adverse events. Nurses provided half of the reports (48.5%), while doctors reported more adverse events (70.8%; p < 0.01). Of the 96 adverse events, 46.9% only required observation, 34.4% caused temporary damage that required treatment, 13.5% required (or prolonged) hospitalization, and 5.2% caused severe permanent damage and/or a situation close to death. Notably, 99.2% were considered preventable. The main critical areas were: communication (27.8%), clinical-administrative management (25.1%), care delivery (23.5%) and medicines (18.4%); few incidents were related to diagnosis (3.6%). Conclusions: PS incident notification applications are adequate for reporting incidents and adverse events associated with healthcare. Approximately 75% and 10% of incidents reach the patient and cause some damage, respectively, and most cases are considered preventable. Adequate and strengthened risk management of critical areas is required to improve PS

Hypertriglyceridemia Influences the Degree of Postprandial Lipemic Response in Patients with Metabolic Syndrome and Coronary Artery Disease: From the Cordioprev Study

Objective To determine whether metabolic syndrome traits influence the postprandial lipemia response of coronary patients, and whether this influence depends on the number of MetS criteria. Materials and Methods 1002 coronary artery disease patients from the CORDIOPREV study were submitted to an oral fat load test meal with 0.7 g fat/kg body weight (12% saturated fatty acids, 10% polyunsaturated fatty acids, 43% monounsaturated fatty acids), 10% protein and 25% carbohydrates. Serial blood test analyzing lipid fractions were drawn at 0, 1, 2, 3 and 4 hours during the postprandial state. Total and incremental area under the curves of the different postprandial parameters were calculated following the trapezoid rule to assess the magnitude of change during the postprandial state Results Postprandial lipemia response was directly related to the presence of metabolic syndrome. We found a positive association between the number of metabolic syndrome criteria and the response of postprandial plasma triglycerides (p<0.001), area under the curve of triglycerides (p<0.001) and incremental area under the curve of triglycerides (p<0.001). However, the influence of them on postprandial triglycerides remained statistically significant only in those patients without basal hypertriglyceridemia. Interestingly, in stepwise multiple linear regression analysis with the AUC of triglycerides as the dependent variable, only fasting triglycerides, fasting glucose and waist circumference appeared as significant independent (P<0.05) contributors. The multiple lineal regression (R) was 0.77, and fasting triglycerides showed the greatest effect on AUC of triglycerides with a standardized coefficient of 0.75. Conclusions Fasting triglycerides are the major contributors to the postprandial triglycerides levels. MetS influences the postprandial response of lipids in patients with coronary heart disease, particularly in non-hypertriglyceridemic patients

Working Group for the Bay of Biscay and the Iberian Waters Ecoregion (ICES WGBIE) (2-9 May 2109)

The ICES Working Group for the Bay of Biscay and the Iberian Waters Ecoregion (WGBIE) assesses the status of 23 stocks distributed from ICES Divisions 3.a–4.a though to Subarea 9, mostly distributed in Subareas 7, 8 and 9. The group was tasked with conducting assessments of stock status for 23 stocks using analytical, forecast methods or trends indicators to provide catch forecasts and a first draft of the ICES advice for 2019. For two of the Nephrops stocks updates were provided on catch data with the advice release delayed until October after the completion of the surveys used for the assessment. Analytical assessments using age-structured models were conducted for the northern stock of white anglerfish, the northern and southern stocks of megrim, four-spot megrim and sole in the Bay of Biscay. The two hake stocks and one southern stock of anglerfish were assessed using models that allow the use of length-structured data (no age data). A surplus-production model, without age or length structure, was used to assess the second southern stock of anglerfish and an age-length structure model was used for the European seabass in the Bay of Biscay. The state of stocks for which no analytical assessment could be performed was inferred from examination of catch, commercial LPUE or CPUE data and from survey information, where available. The northern stock of hake was benchmarked this year to incorporate discards into the model that were previously omitted. New reference points with the accepted benchmark assessment were proposed by the group and new proxy biomass reference points where proposed for black anglerfish in Division’s 7b-k, 8abd. A recurrent issue significantly constrained the group’s ability to fully address the terms of reference this year. Despite an ICES data call with a deadline of six weeks before the meeting, data for most stocks were submitted to ICES only two days before the start of the meeting and in one case 2 days after the meeting commenced. This delayed the process of having the data quality checked and the assessment completed before the start of the working group. This is an important matter of concerns for the working group members. The structure of the report is set out with section 1 presenting a summary of each stock, discussing general issues and conclusions. Section 2 provides descriptions of the relevant fishing fleets and surveys used in the assessment of the stocks. Sections 3–18 contains the single stock assessments