Lessons learned for reducing the negative impact of adverse events on patients, health professionals and healthcare organizations.

Purpose: To summarize the knowledge about the aftermath of adverse events (AEs) and develop a recommendation set to reduce their negative impact in patients, health professionals and organizations in contexts where there is no previous experiences and apology laws are not present.

Data Sources: Review studies published between 2000 and 2015, institutional websites and experts' opinions on patient safety.

Study Selection: Studies published and websites on open disclosure, and the second and third victims' phenomenon.

[In case of an adverse event don´t forget to say sorry].

Background: Disclosing information to a patient who is a victim of an adverse event (AE) presents some particularities depending on the legal framework in the country where the AE occurred. The aim of this study is to identify the limits and conditions when apologizing to a patient who has suffered an AE.

Methods: A consensus conference involving 26 professionals from different autonomous communities, institutions, and profiles (health, insurance, inspection, academic) with accredited experience in patient safety management systems and criminal law.

[Proposals for the study of the second victim phenomenon in Spanish Primary Care Centres and Hospitals].

Objective: To identify the Spanish studies conducted since 2014 on second victims. Its main objective was to identify a global response to the second victim problem, assessing the impact of adverse events (AE) on caregivers and developing of a set of tools to reduce their impact.

Method: Descriptive studies in which a sample of managers and safety coordinators from Hospitals and Primary Care were surveyed to determine the activities being carried out as regards second victims, as well as a sample of health professionals to describe their experience as a second victims.

Interventions in health organisations to reduce the impact of adverse events in second and third victims.

Background: Adverse events (AE) are also the cause of suffering in health professionals involved. This study was designed to identify and analyse organization-level strategies adopted in both primary care and hospitals in Spain to address the impact of serious AE on second and third victims.

Methods: A cross-sectional study was conducted in healthcare organizations assessing: safety culture; health organization crisis management plans for serious AE; actions planned to ensure transparency in communication with patients (and relatives) who experience an AE; support for second victims; and protective measures to safeguard the institution's reputation (the third victim).

The aftermath of adverse events in Spanish primary care and hospital health professionals.

Background: Adverse events (AEs) cause harm in patients and disturbance for the professionals involved in the event (second victims). This study assessed the impact of AEs in primary care (PC) and hospitals in Spain on second victims.

Methods: A cross-sectional study was conducted.

Association of BRCA1 germline mutations in young onset triple-negative breast cancer (TNBC).

Background: BRCA1-associated breast cancers have been associated to a triple-negative phenotype. The prevalence of BRCA1 germline mutations in young onset TNBC based on informativeness of family history has not been reported.

Patients And Methods: From January 2008 to May 2009 were collected blood and tumor samples from patients with TNBC younger than 50 years and without a family history of breast and ovarian cancer in first- and second-degree relatives.

The expansion of the universe observed with supernovae.

Over the last 20 years, supernovae have become a key tool to constrain the expansion history of the Universe through the construction of Hubble diagrams, using luminosity distances to supernovae belonging to the 'Ia' subtype. This technique was key for the discovery that the expansion of the Universe is now accelerating. We review the principle and difficulties of the measurements, the classification and diversity of supernovae, and the physics of explosion.

Prognostic role of circulating melanoma cells detected by reverse transcriptase-polymerase chain reaction for tyrosinase mRNA in patients with melanoma.

A need for factors predictive of prognosis is present in patients who are diagnosed with malignant melanoma. The detection of circulating melanoma cells by reverse transcriptase-polymerase chain reaction for tyrosinase mRNA is a possible negative prognostic factor. The aim of this study was to assess the prognostic value of reverse transcriptase-PCR for tyrosinase mRNA in peripheral blood samples.

[Benign positional vertigo, an armchair for diagnosis and for treatment: description and significance].

Objectives: The benign positional vertigo is a very frequent pathology. It requires to establish the diagnosis, to fixe the head in some positions to get various nystagmus which are observed directly or by video-nystagmoscopy or analyzed by video-nystagmography.

Purpose: To describe the diagnostic and therapeutical interests of a special armchair, now available, whose characteristics are to be able to swivel around two axes of vertical and horizontal rotations, the patient being completely interdependent of the armchair.

[Evaluation of the clinical practice of Informed Consent in clinical trials].

On the basis of existing publications it would seem legitimate to assume that in a clinical test (CT) the difficulties inherent in the process of researcher-participant communication are in practice greater than desired. Similarly, the hypothesis is adopted that difficulties exist in the formal legibility of the documents of Informed Consent. We present the results of a transversal study made of a random sample (n=160) of the CTs approved by the Ethical Committee of Clinical Research (CEIC) of Navarra during the years 1995-1999.

[Enhanced quality in a hospital microbiology laboratory: from automation to clinical advice].

Background: Quality policies focussed on the patient and applied to a hospital microbiology laboratory have led us to investigate clinicians' needs when requesting test results. The aim of this study was to analyze these requirements and to implement a plan to improve attention to the clinicians, considered as direct customers, particularly in the process of providing results.

Methods: Phase 1: To determine clinicians' needs, we studied the calls made to the Bacteriology Unit.

[Minor abnormalities of the internal ear. Radioclinical correlations].

Moderately severe cochleovestibular disorders of often late onset may arise from minor dysplasias of the internal ear. Diagnosis of these bone dysplasias is radiologic. The problem that arises is that of the indications for radiotomography of the internal ear, insofar as on the one hand no certain radioclinical equivalence exists, and on the other hand this radiologic examination is of greater diagnostic than therapeutic value.

[Bacteria seen in acute otitis media in children hospitalised for infectious diseases].

The authors draw the following conclusion on the basis of 85 cases of children hospitalised for infectious diseases : -amongst childhood infectious diseases, measles between the ages of 7 and 14 is most commonly associated with complications in the form of otitis (50 as against 19 other diseases). -Staphylococcus aureus was the dominant organism in measles otitis, but in addition to a particular affinity of this organism for measles, it is also necessary to bear in mind contamination by hospital flora, amongst which staphylococci are especially representative, in view of the late development of the otitis and the multiresistance of staphylococci isolated after the 4th day of admission. -Bacteria seen in other exanthematous fevers were more varied but if there is not rapid cure of the otitis, the generally sensitive flora is replaced by a multiresistant hospital flora, once again dominated by staphylococcus aureus and Gram negative bacilli.

[Chordoma of the base of the skull. Clinical and histological study. Therapeutic possibilities (author's transl)].

A Case of chordoma of the base of the skull is reported. It had been present with minimal symptoms for six years during which the clinical picture was limited to nasal obstruction and headache. Comparison of initial X-rays and the preoperative assessment revealed progressive destruction of the base of the skull which indicated the likelihood of considerable difficulties in excision.