Parc Tauli Research Articles

Study of the Interaction between Executive Function and Adaptive Behavior at School in Girls with Fragile X Syndrome.

The aim of this research is to analyze the relationship between executive functions and adaptive behavior in girls with Fragile X syndrome (FXS) in the school setting. This study is part of a larger investigation conducted at the Hospital Parc Tauli in Sabadell. The sample consists of a total of 40 girls (26 with FXS and 14 control) aged 7–16 years, who were administered different neuropsychological tests (WISC-V, NEPSY-II, WCST, TOL) and questionnaires answered by teachers (ABAS-II, BRIEF 2, ADHD Rating Scale). The results show that there is a greater interaction between some areas of executive function (cognitive flexibility, auditory attention, and visual abstraction capacity) and certain areas of adaptive behavior (conceptual, practical, social, and total domains) in the FXS group than in the control group. These results suggest that an alteration in the executive functions was affecting the daily functioning of the girls with FXS to a greater extent.

Evaluation of tava program to improve the quality of life in young adults with autism spectrum disorders (ASD)

IntroductionAutism spectrum disorders (ASD), is a population that does not usually receive specific treatment.ObjectivesThe main objective of the present study is to evaluate whether specific interventions within the TAVA program (transition program to adult life for patients with ADS), produce significant improvements in the quality of life of young adults with ASD.MethodsThis is a prospective randomized clinical study of patients with ASD (according to DSM-5 criteria) seen in outpatient of the Parc Tauli University Hospital in Sabadell (Barcelona) since September 2017. We compared the quality of life, functionality, caregiver burden, and comorbidity of patients in TAVA program (beneficiaries of group therapy and specific medical and psychosocial interventions), with that of control patients (treatment as usual), after 2 years of intervention.ResultsOur sample is composed of 12 patients with ASD. The average age is 18.4 years. 83% of the sample are men (n = 10). 5 of the patients belonged to TAVA and the other 7 were controls. Overall, TAVA patients presented improvement in the ZARIT and BAI scales compared to control patients. The control patients evolved less favorably in the AAA, SRS and RAAS levels compared to TAVA.ConclusionsSpecific interventions in adults with ASD, improve the caregiver’s feeling of overload and the patients anxiety, compared to the usual interventions. The lack of regulated interventions produces an unfavorable evolution of the core symptoms of autism. More studies are needed to specify efficient interventions to improve the quality of life of adults with ASD.DisclosureNo significant relationships.

Follow-up of patients with delusional disorder in a specialized outpatient clinic over a 2-year period

IntroductionIn order to prevent relapse and increase medication adherence, primary care physicians and psychiatric inpatient units should consider referring patients with delusional disorder (DD) to specialized outpatient clinics for treatment and follow-up.ObjectivesThis poster describes a sample of DD patients referred to a specialized unit for DD and documents rates of follow-up care.MethodsOver a 2-year period, 29 individuals were consecutively referred to the Parc Tauli -Delusional Syndrome Working Group, which provides treatment and clinical care for patients with delusional disorders for a catchment area of nearly 450.000 inhabitants in Sabadell (Barcelona, Spain). Criteria for inclusion in the program are relatively flexible. Referred patients are evaluated at baseline and at 6 months following their first appointment. Treatment and case management are offered by a multidisciplinary team consisting of psychiatric, nursing, and social work personnel. Psychological interventions are also offered.ResultsOf the 29 persons initially referred, 27 attended at least one scheduled appointment. Twenty-one out of the 27 patients received a confirmed diagnosis of DD (14 women,7 men), 2 suffered from schizophrenia and 4 were diagnosed with other psychiatric disorders and referred to other programs: primary care (n=2), affective program (n=1) and addictions unit (n=1). A breakdown of DD subtypes follows: persecutory (n=10,47.6%), jealous (n=4,19%), somatic (n=5,23.81%), mixed (n=2,9.5%). Three patients with DD (14.3%) were lost to follow-up. Attendance rates of the 21 DD patients: 80.4% (Women:77.67%, Men:100%).ConclusionsFor a traditionally difficult-to-engage population, adherence to multidisciplinary clinic appointments was relatively high. Loss to follow-up was lower than would have been expected.Conflict of interestAGR has received honoraria, registration for congresses and/or travel costs from Janssen, Lundbeck-Otsuka and Angelini.

Effectiveness of a Manual Therapy Program as Adjuvant Treatment for School-Age Children With Attention-Deficit/Hyperactivity Disorder: A Randomized Pilot Study

Attention-deficit/hyperactivity disorder (ADHD) is a neurobiological disorder. Common symptoms are inattention, hyperactivity, impulsivity, and executive functions deficit, often with comorbidities. Main treatment involves pharmacological and non-pharmacological therapies (cognitive-behavioral therapy, psycho-pedagogical programs). Emerging non-pharmacological treatments include manual therapies (MTs) in mental health. Several MT techniques have shown effectiveness in ADHD. The objectives of this study are as follows: (a) to assess short-term effects and persistence of an MT program on neuropsychological (hyperactivity index through the Conners’ Global Index [CGI]) and neurophysiological (time–frequency domain parameters of heart rate variability [HRV]) variables in ADHD children, and (b) to test the feasibility of the design. This study was approved by the Parc Tauli Corporation Clinical Research Ethics Board (#2017311). Pilot, controlled, multidisciplinary study of eight children with ADHD randomly assigned to control group (CG; n = 4) and intervention group (IG; n = 4). Both followed multimodal treatment, and IG also received an MT program per week for 4 weeks. A physiotherapist and a psychologist analyzed short-term effects (1-week post-program) and persistence (36 weeks). Eight children (boys, 62.5%; girls, 37.5%) with an average age of 10.375 ± 0.74 years were included. Baseline HRV parameters showed basal sympathetic predominance. The MT program increased the parasympathetic activity, which was significantly maintained at 1 to 36 weeks; there were no changes in CG. One-week post-program IG showed significant CGI reduction (–7 points, p = .016*), CG without changes ( p = .41), with significant differences CG – IG ( p = .0097*), and very large effect size ( d = 2.235); 36 weeks post-program showed no effects (IG, p = .293; CG, p = .247), without differences CG – IG ( p = .369). The MT program reduced the hyperactivity index with a 1-week persistence and increased the parasympathetic activity with a 36-week persistence. More investigations are needed to generalize the outcomes. Additional research is planned to further explore the possibilities of MT in psychiatric disorders with autonomic imbalances.

Correlación entre el diagnóstico ecográfico prenatal y posnatal en casos de hidronefrosis fetal

Introducción. La ecografía prenatal permite detectar una anomalía significativa en 1% de los embarazos; de ellos, 20 a 30% son genitourinarias y 50% de estas son hidronefrosis fetales (HNF). Objetivo. Establecer una correlación entre el grado de hidronefrosis prenatal y posnatal, así como analizar las implicaciones pronósticas. Diseño, pacientes, intervenciones y variables principales. Estudio observacional retrospectivo realizado por la Unidad de Diagnóstico Prenatal del hospital Parc Taulí de Sabadell, que incluyó un total de 177 gestantes con diagnóstico ecográfico de HNF entre enero de 2011 y diciembre de 2016. Se realizó un análisis descriptivo de las variables ecográficas y perinatales más importantes. La principal variable de estudio fue el grado de dilatación de la HNF. Resultados. La prevalencia de HNF fue 1,17%. El 82,8% de los casos fue diagnosticado en la ecografía del 2º trimestre. En 42,9%, la afectación fue bilateral, y en 95,6% la malformación renal fue aislada. La cardiopatía fue la anomalía congénita asociada con más frecuencia (3,3%). De las 93 hidronefrosis de riesgo bajo diagnosticadas en el 2º trimestre, 53,8% se normalizaron en el 3er trimestre, 30,1% permanecieron estables y 16,1% progresaron. De los 32 casos de HNF moderadas-severas diagnosticadas en el 2º trimestre, solo 9,4% se normalizaron en el 3er trimestre. El 46,9% de los neonatos precisó exploraciones complementarias y 14,1% intervención quirúrgica. Conclusiones. Existe buena correlación de la HNF prenatal y posnatal. La HNF leve presenta buen pronóstico, mientras que la moderada-severa suele persistir posnatalmente.

Study on the Incidence of Perioperative Hypothermia at the Surgical Area of Parc Tauli Hospital Universitari, Sabadell

Study on the Incidence of Perioperative Hypothermia at the Surgical Area of Parc Tauli Hospital Universitari, Sabadell

Effect of Sedatives and Opioids on Patient-Ventilator Asynchronies in Critically Ill Patients

Background: Sedation improves comfort during invasive mechanical ventilation (MV) in critically ill patients, but its deleterious effects are increasingly being recognized. We aimed to describe the relationship between patient-ventilator, sedation levels and administered molecules (sedatives and/or opioids). Methods: Prospective multicentre observational trial of critically ill adults mechanically ventilated >24 hours. Level of sedation and sedative and opioid doses were recorded. Asynchronies were continuously classified in all patients with Better Care™ software as: ineffective inspiratory efforts during expiration (IEE), double cycling (DC), and asynchrony index (AI). The relationship between asynchronies, sedation level, sedative and opioid doses were analysed with linear mixed-effects models. Findings: Between October 2011 and January 2013, 79 enrolled patients accounted for 579 days of ventilatory support (14,166,469 breaths). Overall AI, IEE and DC were similar in sedatives-only, opioids-only, or sedatives-plus-opioids recipients. All asynchronies were higher in subjects receiving no drugs. Sedative doses were associated with sedation level and with reduced DC (p<0.001) in sedative-alone recipients. However, sedative-opioid combination recipients with higher sedative doses and deeper sedation had more AI and IEE events. Opioid dosing was inversely associated with AI, IEE, and DC (p<0.01) in opioids-only recipients; opiate recipient had similar sedation levels. Interpretation: A sedatives plus opioids combination provided no benefit in patient-ventilator interaction than sedatives-only or opioids-only regimens. Higher sedative doses were only associated with lower DC asynchronies. Incremental opioids were associated with less overall asynchronies without affecting sedation level. Funding: This work was funded by projects PI09/91074 and PI13/02204 in the National R D I Plan and the ISCIII-European Regional Development Fund, CIBER Enfermedades Respiratorias, Fundacion Mapfre, Fundacio Parc Tauli, Plan Avanza TSI-020302-2008-38, MCYIN and MITYC (Spain). Declaration of interests: Blanch and Murias are inventors of one Corporacio Sanitaria Parc Tauli owned US patent: Method and system for managed related patient parameters provided by a monitoring device, US Patent No. 12/538,940. Blanch, Montanya, Murias, and Lucangelo own stock options of BetterCare S.L., which is a research and development spinoff of Corporacio Sanitaria Parc Tauli (Spain). Kacmarek is a consultant for Medtronic and Orange Medical and has received research grants from Medtronic and Venner Medical. Other authors have no conflicts of interest. Ethical Approval Statement: The institutional review boards approved the protocol and waived informed consent because the study was non-interventional, posed no added risk to the patient, and did not interfere with usual care.

A web-based clinical decision support system for gestational diabetes: Automatic diet prescription and detection of insulin needs

BackgroundThe growth of diabetes prevalence is causing an increasing demand in health care services which affects the clinicians’ workload as medical resources do not grow at the same rate as the diabetic population. Decision support tools can help clinicians with the inspection of monitoring data, providing a preliminary analysis to ease their interpretation and reduce the evaluation time per patient. This paper presents Sinedie, a clinical decision support system designed to manage the treatment of patients with gestational diabetes. Sinedie aims to improve access to specialized healthcare assistance, to prevent patients from unnecessary displacements, to reduce the evaluation time per patient and to avoid gestational diabetes adverse outcomes. MethodsA web-based telemedicine platform was designed to remotely evaluate patients allowing them to upload their glycaemia data at home directly from their glucose meter, as well as report other monitoring variables like ketonuria and compliance to dietary treatment. Glycaemia values, not tagged by patients, are automatically labelled with their associated meal by a classifier based on the Expectation Maximization clustering algorithm and a C4.5 decision tree learning algorithm. Two finite automata are combined to determine the patient’s metabolic condition, which is analysed by a rule-based knowledge base to generate therapy adjustment recommendations. Diet recommendations are automatically prescribed and notified to the patients, whereas recommendations about insulin requirements are notified also to the physicians, who will decide if insulin needs to be prescribed. The system provides clinicians with a view where patients are prioritized according to their metabolic condition. A randomized controlled clinical trial was designed to evaluate the effectiveness and safety of Sinedie interventions versus standard care and its impact in the professionals’ workload in terms of the clinician’s time required per patient; number of face-to-face visits; frequency and duration of telematics reviews; patients’ compliance to self-monitoring; and patients’ satisfaction. ResultsSinedie was clinically evaluated at “Parc Tauli University Hospital” in Spain during 17 months with the participation of 90 patients with gestational diabetes. Sinedie detected all situations that required a therapy adjustment and all the generated recommendations were safe. The time devoted by clinicians to patients’ evaluation was reduced by 27.389% and face-to-face visits per patient were reduced by 88.556%. Patients reported to be highly satisfied with the system, considering it useful and trusting in being well controlled. There was no monitoring loss and, in average, patients measured their glycaemia 3.890 times per day and sent their monitoring data every 3.477days. ConclusionsSinedie generates safe advice about therapy adjustments, reduces the clinicians’ workload and helps physicians to identify which patients need a more urgent or more exhaustive examination and those who present good metabolic control. Additionally, Sinedie saves patients unnecessary displacements which contributes to medical centres’ waiting list reduction

P3.03-054 Review and Descriptive Analysis of 140 Patients Diagnosed with Malignant Mesothelioma at Consorci Sanitari Parc Tauli: Topic: Mesothelioma Clinical

P3.03-054 Review and Descriptive Analysis of 140 Patients Diagnosed with Malignant Mesothelioma at Consorci Sanitari Parc Tauli: Topic: Mesothelioma Clinical

Validation of the base deficit delta in trauma patients. Parc Tauli Hospital, Sabadell, Barcelona, Spain

Validation of the base deficit delta in trauma patients. Parc Tauli Hospital, Sabadell, Barcelona, Spain

Testing The Intranasal Route For Administration of Haloperidol In Emergency Room: Generation of Efficacy Data To Support Clinical Practice

TeSTiNg The iNTraNaSal rouTe For admiNiSTraTioN oF haloperidol iN emergeNCy room: geNeraTioN oF eFFiCaCy daTa To SupporT CliNiCal praCTiCe R. Vives Vilagut; R. Duno; N. Planet; G. Garcia; M. Payes; M. Marinosa; M.I. Iglesias-Lepine; and C. Pontes Hospital de Sabadell. Institut Universitari Parc TauliUniversitat Autonoma de Barcelona Background: Managing schizophrenic patients with agitation in the emergency room requires medications with a rapid onset of effect. Intravenous administration is impractical, and intramuscular dosing may be risky for both patients and health care professionals. The intranasal route may offer short Tmax with safer administration. Intranasal haloperidol has been reported to achieve similar plasma concentrations to intravenous dosing, but clinical data on the efficacy and safety of such approach is lacking. Psychiatrists contacted our Clinical Pharmacology Unit for methodological and logistic support to generate clinical information on the affectivity of haloperidol by the intranasal route. We present here the research protocol that was prepared. Methods: An exploratory randomized parallel observer-blinded clinical trial was designed to compare the administration of 5mg haloperidol by either intranasal or intramuscular route. The trial will include 40 agitated schizophrenic patients visited in the emergency room of Corporacio Parc Tauli who are candidates to receive haloperidol and provide previous informed consent (personally or through representative). Patients will be monitored up to 6 hours for agitation, cardiovascular parameters and adverse events. Treatments will be administered by unblinded nurses and agitation will be assessed in blind by an uninvolved psychiatrist. Main efficacy variable is the percentage of patients with score ≤ 9 in the 5 item PANSS-EC scale 20 minutes after dosing. Sample size is based on subject’s availability considering the exploratory nature of the trial. The study will be performed according to the Good Clinical Practice. Results: The clinical trial obtained Ethic’s and regulatory approvals during 2014. The first patient was recruited on December 2014. Recruitment is ongoing and expected to last 12 months. Conclusions: An exploratory trial has been prepared to help physicians to generate initial clinical information on the effectiveness of a simple intervention aimed to improve patient management by healthcare professionals in the emergency room.

Management of severe sepsis: advances, challenges, and current status.

The complexity of treating severe sepsis and septic shock has been elucidated in myriad studies, particularly in the past 10 years. The development of clinical guidelines, insight into the effect of bundle elements, and results of clinical trials have brought to light further opportunities and questions in the approach to pharmaceutical interventions for the global challenge to save lives and reduce healthcare costs. Therapeutic interventions including fluid resuscitation, hemodynamic monitoring, glycemic control, corticosteroids, and antimicrobial therapy and stewardship inform outcomes. Research on biomarkers, use of mesenchymal stem cells, blood purification, immunoglobulins, and antioxidative treatments apropos the immune response may soon yield viable therapies.

Naltrexone sustained-release/bupropion sustained-release for the management of obesity: review of the data to date.

Obesity is an emerging disease worldwide. Changes in living habits, especially with increased consumption of high-calorie foods and decreased levels of physical activity, lead to an energy imbalance that brings weight gain. Overweight and obesity are major risk factors for several chronic diseases (including cardiovascular diseases, diabetes, and cancer), reduce quality of life, and are associated with higher mortality. For all these reasons, it is of the utmost importance that the trend be reversed and obese people enabled to lose weight. It is known that eating a healthy diet and exercising regularly can help prevent obesity, but data show that in many cases these steps are not enough. This is the reason why, over the last few decades, several antiobesity drugs have been developed. However, the disappointing results demonstrated for the vast majority of them have not discouraged the pharmaceutical industry from continuing to look for an effective drug or combination of drugs. The systematic review presented here focuses on naltrexone sustained-release/bupropion sustained-release combination (Contrave®). We conclude from the current published reports that its effectiveness in the treatment of obesity can be estimated as a placebo-subtracted weight loss of around 4.5%. This weight reduction is moderate but similar to other antiobesity drugs. The safety profile of this combination is acceptable, despite additional data regarding cardiovascular disease being needed.

Factores de riesgo más prevalentes en las bronquiolitis por virus respiratorio sincitial en lactantes de 0 a 24 meses

Our aim is to describe the environmental aspects of children between 0 and 24 months, who arrived in the Emergency Department of the Hospital General de Cataluña and Hospital Parc Tauli (both within Barcelona province), and were diagnosed with respiratory syncytial virus bronchiolitis from November 2010 to February 2011. A cross-sectional observational study was conducted on children of both sexes, with ages from 0 to 24 months, and diagnosed with bronchiolitits respiratory syncytial virus +. Data was obtained by completing a non-validated questionnaire, with information provided by parents and the medical history. The most common features in the study were: a mean age of 3.8 months, most were males, with siblings of school age, mothers who did not smoke during pregnancy, were in a non-smoking environment in their home, and finally, less than 5 people living together in their home. The most common risk factors n order of prevalence were, having siblings of school age, male sex, and living in smoking environment. It was observed that the majority of children had risk associated factors associated, with only 8.2% of samples not presenting any risk factors.

More prominent inflammatory features in knee osteoarthritis in the presence of concomitant hand osteoarthritis

s / Osteoarthritis and Cartilage 21 (2013) S63–S312 S142 infection within 2years of their surgery, but did not differ in terms of risk for DVT/PE, early revision, infection, peri-prosthetic fracture or death following TKA. To our knowledge, this is the first study that has utilized a validated algorithm to identify TKA recipients with RA, thereby increasing the validity of our findings, and aiding patientphysician decision-making around joint replacement in patients with RA. Further research is required to elucidate potential explanations for the higher rates of infection in RA versus OA, including the use of biologic agents. 261 MORE PROMINENT INFLAMMATORY FEATURES IN KNEE OSTEOARTHRITIS IN THE PRESENCE OF CONCOMITANT HAND OSTEOARTHRITIS C. Orellana, N. Navarro, J. Calvet, M. Garcia-Manrique, J. Gratacos, M. Larrosa. CSiU Parc Tauli. Hosp. de Sabadell, Sabadell, Spain Background: In recent years it has been recognized the existence of a link between hand osteoarthritis and systemic inflammation. On the other hand, a significant proportion of patients with knee osteoarthritis show local clinically evident inflammatory features such as synovial effusion and synovial hypertrophy. Purpose: To evaluate if patients with knee osteoarthritis show more inflammatory signs as measured by ultrasound when hand osteoarthritis is concomitantly present. Methods: Patients aged 50 years or more with symptomatic osteoarthritis of the knee and joint effusion, Kellgren-Lawrence II-III. Demographics, BMI, disease duration, pain assessed by VAS (0-100 mm) and algofuncional Lequesne index were assessed. Knee ultrasound was performed evaluating and measuring the presence of effusion and synovial hypertrophy (defined as > 4 mm synovial thickening) at the suprapatellar midline. Results: In a cross-sectional study we analyzed 50 patients, F/M 39/11, age 61.8 10.1 years, disease duration 50.8 6.3 months, BMI 28 1.4 kg/cm2. Ten patients (20%) had concomitant hand osteoarthritis. There were no significant differences in age, disease duration, BMI or radiological grade between patients with knee and hand osteoarthritis compared with those with only knee osteoarthritis. On ultrasound examination patients with concomitant hand osteoarthritis showed a clear trend to have a more prominent joint effusion (7.39 3 vs. 6.7 2.8 mm) and synovial hypertrophy (3.6 2.6 vs. 2.7 1.8 mm), although not statistically differences were found. Patients with concomitant hand osteoarthritis also had a non-significant trend to experience greater knee pain (VAS 70.3 12.5 vs. 61 18.5 mm) and Lesquesne index scores (11.4 3.3 vs. 9.8 2.9). Conclusions: Although results were not statistically significant probably in relation to small size sample, in this study the presence of hand osteoarthritis appeared to be associated with greater inflammatory features in patients with symptomatic knee osteoarthritis. 262 NETWORKING TO CAPTURE PATIENT-REPORTED OUTCOMES DURING ROUTINE ORTHOPAEDIC CARE ACROSS TWO DISTINCT INSTITUTIONS R. Karia y, J. Slover y, C. Hauer z, Z. Gelber y, P. Band y, J. Graham z. yNew York Univ. Sch. of Med., NY, USA; zGeisinger Med. Systems, Danville, PA,

P044 Radiofrequency in the treatment of renal cell carcinoma: Experience in Parc Tauli Hospital

P044 Radiofrequency in the treatment of renal cell carcinoma: Experience in Parc Tauli Hospital

ON001 Nurse's perception on IBD patients' satisfaction with healthcare services

Background: The satisfaction of patients with inflammatory bowel disease (IBD) with healthcare services may be related to the assistance of health personnel, the information they receive about their illness and the treatments available, adequacy of facilities and the time you spend in the health professional’s office as well as the control of their disease. These patients have specific requirements that make the quality of the health service they receive is as important as the effectiveness of the treatments received. So far the satisfaction questionnaires have focused almost exclusively on treatment. The aim of this study was to determine the perception of nurses on IBD patients’ satisfaction with healthcare services. Methods: An observational, prospective, multicentre study. The questionnaire (it was elaborated and validated for this study) was administered to nurses (28 items) and patients (31 items), with six dimensions and 5 closed answers (from “strongly disagree” to “strongly agree”). The overall score is expressed in a 0 100 scale (a higher score indicates greater satisfaction). Results: The mean(SD) score of the overall perception of satisfaction of patients (N = 327) by nursing staff (N = 32), is 82.2(8.5) and 82.0(10.9) the mean patient satisfaction. Except for the dimension that measures satisfaction with information received by the patient [73.1(23.5)] in all dimensions were less scored by nurses than by patients. The mean(SD) satisfaction with healthcare staff attention was 80.4(23.4), with doctor attention 82.8(23.4), with centre facilities 69.5(23.5), with accessibility to the centre 73.4(23.6) and with received support 76.3(23.7). The aspects with which the patient is less satisfied, according nurses perception, are those related to information (particularly the disease information through leaflets and how to contact with patient associations). Conclusions: Although the patients seem to be more satisfied with healthcare services than nurses thought, there are still areas for improvement to provide a fully satisfactory healthcare to IBD patients. ON002 Efficacy of nurse-driven outpatient clinic for follow-up of inflammatory bowel disease patients on treatment with thiopurinic immunosuppresants M. Lopez1 *, A. Villoria1, A. Dosal1, L. Moreno1, N. Mane1, M. Pujol1, X. Calvet2. 1Parc Tauli, Digestive, Sabadell, Spain, 2CIBERehd, Instituto de Salud Carlos III, Parc Tauli Digestive, Sabadell, Spain

ON002 Efficacy of nurse-driven outpatient clinic for follow-up of inflammatory bowel disease patients on treatment with thiopurinic immunosuppresants

Background: The satisfaction of patients with inflammatory bowel disease (IBD) with healthcare services may be related to the assistance of health personnel, the information they receive about their illness and the treatments available, adequacy of facilities and the time you spend in the health professional’s office as well as the control of their disease. These patients have specific requirements that make the quality of the health service they receive is as important as the effectiveness of the treatments received. So far the satisfaction questionnaires have focused almost exclusively on treatment. The aim of this study was to determine the perception of nurses on IBD patients’ satisfaction with healthcare services. Methods: An observational, prospective, multicentre study. The questionnaire (it was elaborated and validated for this study) was administered to nurses (28 items) and patients (31 items), with six dimensions and 5 closed answers (from “strongly disagree” to “strongly agree”). The overall score is expressed in a 0 100 scale (a higher score indicates greater satisfaction). Results: The mean(SD) score of the overall perception of satisfaction of patients (N = 327) by nursing staff (N = 32), is 82.2(8.5) and 82.0(10.9) the mean patient satisfaction. Except for the dimension that measures satisfaction with information received by the patient [73.1(23.5)] in all dimensions were less scored by nurses than by patients. The mean(SD) satisfaction with healthcare staff attention was 80.4(23.4), with doctor attention 82.8(23.4), with centre facilities 69.5(23.5), with accessibility to the centre 73.4(23.6) and with received support 76.3(23.7). The aspects with which the patient is less satisfied, according nurses perception, are those related to information (particularly the disease information through leaflets and how to contact with patient associations). Conclusions: Although the patients seem to be more satisfied with healthcare services than nurses thought, there are still areas for improvement to provide a fully satisfactory healthcare to IBD patients. ON002 Efficacy of nurse-driven outpatient clinic for follow-up of inflammatory bowel disease patients on treatment with thiopurinic immunosuppresants M. Lopez1 *, A. Villoria1, A. Dosal1, L. Moreno1, N. Mane1, M. Pujol1, X. Calvet2. 1Parc Tauli, Digestive, Sabadell, Spain, 2CIBERehd, Instituto de Salud Carlos III, Parc Tauli Digestive, Sabadell, Spain

First-line treatment with sunitinib monotherapy in patients with advanced urothelial cancer ineligible for cisplatin-based chemotherapy: Pretreatment levels of IL8 and Hounsfield units as predictors of clinical benefit.

Article Tools Genitourinary Cancer Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/jco.2010.28.15_suppl.4540 Journal of Clinical Oncology - published online before print May 20, 2010 First-line treatment with sunitinib monotherapy in patients with advanced urothelial cancer ineligible for cisplatin-based chemotherapy: Pretreatment levels of IL8 and Hounsfield units as predictors of clinical benefit. J. BellmuntxJ. BellmuntSearch for articles by this author , J. L. Gonzalez-LarribaxJ. L. Gonzalez-LarribaSearch for articles by this author , J. P. MarotoxJ. P. MarotoSearch for articles by this author , J. CarlesxJ. CarlesSearch for articles by this author , D. E. CastellanoxD. E. CastellanoSearch for articles by this author , B. MelladoxB. MelladoSearch for articles by this author , E. GallardoxE. GallardoSearch for articles by this author , J. L. Perez-GraciaxJ. L. Perez-GraciaSearch for articles by this author , X. Villanueva Sr.xX. Villanueva Sr.Search for articles by this author , J. AlbanellxJ. AlbanellSearch for articles by this author Show More Hospital del Mar, IMIM, Barcelona, Spain; Hospital Universitario Clínico San Carlos, Madrid, Spain; Hospital Santa Creu, Barcelona, Spain; Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Clinic, Barcelona, Spain; Corporacio Parc Tauli, Sabadell, Spain; Clinica Universidad de Navarra, Pamplona, Spain; Hospital del Mar, Barcelona, Spain https://doi.org/10.1200/jco.2010.28.15_suppl.4540 Abstract Abstract 4540 Background: There is a need for improving therapy in "unfit" patients (pts) who are not able to receive standard cisplatinum-based chemotherapy and to look for response predictors. VEGF is expressed in transitional cell carcinoma and its overexpression is associated with an aggressive behavior; targeting angiogenesis maybe a rational approach. Methods: This is a multicenter, open-label, phase II clinical trial assessing oral sunitinib at 50 mg daily in a 4/2-week schedule as first-line in "unfit" urothelial cancer pts. Eligibility criteria to define "unfit" included creatinine clearance under 60 ml/min but over 30 ml/min and performance status ≥ 1 (ECOG). Pretreatment sequential serum samples and measurements of Hounsfield units were collected in pts undergoing treatment. 14 potential serum markers (cytoquines, soluble receptors, growth factors and methaloproteases) were studied (xMAP Technology of Luminex Corp). Results: 37 pts with median age of 75 years were enrolled between July 2006 and September 2009. Bladder was the most frequent primary tumor site. Visceral disease included lung (33.3 %), liver (12%) and bone metastases (12%). Median number of cycles was 2.4 (1-6). Twenty-seven pts are evaluable for efficacy; 3 PRs (8.1%) were obtained, one not confirmed due to brain mets progression; 14 pts (53.8%) had SD lasting > 3m; clinical benefit rate of 62% and median PFS being 5.9 m. Three pts are still on therapy. Most frequent toxicities were fatigue, neutropenia and thrombopenia, hypertension, hand-foot syndrome, stomatitis, haematuria, and epistaxis. IL8 baseline levels were significantly increased in nonresponders and significantly associated with PFS. Final correlative analysis with Hounsfield units is ongoing. Conclusions: Sunitinib first line in “unfit” bladder pts shows significant benefit in 62 % of pts with a median PFS of 5.9 m. leading to a delay on time to start chemotherapy. Baseline levels of IL8 were able to predict benefit and warrant further study as predictive marker of sunitinib activity. Supported by FISS PI061239 and Cellex Foundation. No significant financial relationships to disclose. © 2010 by American Society of Clinical Oncology

Visión del profesional de enfermería sobre el entorno como parte integrante del metaparadigma

Objective: To know the theoretical standpoint on the concept of environment of nurses belonging to the Healthcare Corporation Parc Tauli (CSPT) and evaluate the relationship with demographic variables and nurses proposed model in their day-to-day practice. Methodology: Descriptive, observational, cross-sectional study. 546 professionals interviewed using a questionnaire of our own elaboration between April - May, 2006. Results: 205 questionnaires were collected. Age 37 ± 9, 89.7 % women. Years work experience: 14±9. Training: 23.5 % in models. Henderson training model 74 %. They were mainly identified with definitions of environment based in Roy and Henderson. We found statistically significant relationships in the choice of environment concept with age, nursing school, year of completion, the qualification, type of service (direct or non-direct assistance), and years of experience. Conclusions: The professionals are identified with the concept of environment from the paradigm of integration, although they see the vision of transforming possibly due to the organizational vision of biomedical assistance.