Factors Predictive of Success in Uncontrolled Donation After Circulatory Death in the Community of Madrid: An Analysis of Data From the Regional Registry of Donation and Transplantation (CORE Registry).

Unlabelled: Unfortunately, organ donation remains a challenge today. In Spain, uncontrolled Donation after Circulatory Death was introduced in cardiorespiratory arrests witnessed by out-of-hospital emergency services (OHES) to increase the number of donors. However, the selection of donor patients remains a challenge today.

Application of large language models in clinical record correction: a comprehensive study on various retraining methods.

Objectives: We evaluate the effectiveness of large language models (LLMs), specifically GPT-based (GPT-3.5 and GPT-4) and Llama-2 models (13B and 7B architectures), in autonomously assessing clinical records (CRs) to enhance medical education and diagnostic skills.

Materials And Methods: Various techniques, including prompt engineering, fine-tuning (FT), and low-rank adaptation (LoRA), were implemented and compared on Llama-2 7B.

Emergency crisis resource management: a simulation-based course developed by the Spanish Society of Emergency Medicine (SEMES) for health sciences students.

Objectives: Educational programs based on high-fidelity simulation training aim to promote students' acquisition of nontechnical competencies such as understanding crisis resource management (CRM). This study evaluated the efficacy of a CRM course for students in their last year of university studies in health sciences. The course was developed by the Spanish Society of Emergency Medicine (SEMES).

Influence of donor capnometry on renal graft evolution in uncontrolled donation after circulatory death.

Aim: To analyse the association between donor capnometry data and the short-term evolution of kidney grafts in cases of uncontrolled donation after circulatory death (uDCD).

Method: We used an ambispective observational study design, conducted in the Community of Madrid between January and December 2019, inclusive. Patients who suffered out-of-hospital cardiac arrest (CA) with no response to advanced cardiopulmonary resuscitation (CPR) were selected as potential donors.

Ibero-American consensus on learning outcomes for the acquisition of competencies by medical students through clinical simulation.

Objective: Our aim was to reach expert consensus on specific learning outcomes (LOs) that can be achieved through clinical simulation aimed at developing the competencies that medical students need to be able to successfully manage patients and assume general clinical responsibilities.

Materials And Methods: The six-member scientific committee peer-reviewed Spanish reference documentation (in line with the Bologna Process) on required competencies in medical undergraduate students to select an initial set of 16 competencies that could feasibly be developed through simulation and a corresponding set of 75 LOs. Snowball sampling was used to identify candidates for an international panel of simulation experts.

Family Refusal to Consent Donation: Retrospective Quantitative Analysis of Its Increasing Tendency and the Associated Factors Over the Last Decade at a Spanish Hospital.

Background: Organ and tissue recovery remains limited by several factors. This study retrospectively analyzes the factors associated with family refusal to consent to donation at a high-donor-volume Spanish hospital.

Methods: Data regarding the annual number of potential donors and family refusal rates at hospital and regional levels were retrieved from 2008 to 2017.

Alternative CPAP methods for the treatment of secondary serious respiratory failure due to pneumonia by COVID-19.

Introduction: The use of devices that provide continuous positive pressure in the airway has shown improvement in various pathologies that cause respiratory failure. In the COVID 19 pandemic episode the use of these devices has become widespread, but, due to the shortage of conventional CPAP devices, alternative devices have been manufactured. The objective of this study is to describe the use of these devices, as well as their efficacy.

Beta-blocker effect on ST-segment: a prespecified analysis of the EARLY-BAMI randomised trial.

Objective: The effect of early intravenous (IV) beta-blockers (BBs) administration in patients undergoing primary percutaneous coronary intervention (pPCI) on ST-segment deviation is unknown. We undertook a prespecified secondary analysis of the Early Beta-blocker Administration before primary PCI in patients with ST-elevation Myocardial Infarction (EARLY-BAMI) trial to investigate the effect of early IV BB on ST-segment deviation.

Methods: The EARLY-BAMI trial randomised patients with ST-elevation myocardial infarction (STEMI) to IV metoprolol (2×5 mg bolus) or matched placebo before pPCI.

Alternative CPAP methods for the treatment of secondary serious respiratory failure due to pneumonia by COVID-19.

Introduction: The use of devices that provide continuous positive pressure in the airway has shown improvement in various pathologies that cause respiratory failure. In the COVID-19 pandemic episode the use of these devices has become widespread, but, due to the shortage of conventional continuous positive airway pressure (CPAP) devices, alternative devices have been manufactured. The objective of this study is to describe the use of these devices, as well as their efficacy.

Analysis of organ procurement from non-heart-beating donors over a 10-year period in Madrid.

Objectives: The Autonomous Community of Madrid procures the largest number of organs from uncontrolled non-heart-beating donors (NHBD) after circulatory death in Spain. The aim of this study was to analyze the yield of these donations in terms of viable organs procured (category IIa) according to information extracted from the CORE registry of the Spanish National Transplant Organization (ONT) for the Madrid area.

Methods: Retrospective observational study of NHBD data registered between 2007 and 2017, including age, height, weight, body mass index (BMI), emergency care times, method of chest compressions applied (mechanical cardiopump vs manual compressions), and viable organs extracted.

Capnometry levels as an indicator of renal graft evolution in uncontrolled non-heart beating donors.

Objective: The capnometry values during resuscitation are an evolutive predictor of kidneys obtained from uncontrolled non-heart beating donors.

Design: The study comprised a retrospective onset cohort of 37 non-heart beating donors and a validation cohort of 55 trasplanted kidneys in the period 2013-2017.

Scope: The population served by the emergency service and referred to Hospital Universitario Doce de Octubre (Madrid, Spain) as potential uncontrolled non-heart beating donors.

Uncontrolled donation programs after out-of-hospital cardiac arrest. An estimation of potential donors.

Objective: To determine the number of potential deceased organ donors from out-of- hospital cardiac arrest cases (OHCA) attended by public physician-led emergency medical services in Spain, based on data recorded in the nationwide Spanish OHCA Registry (OHSCAR).

Material And Methods: We analysed OHSCAR data on deceased OHCA patients in Spain during 13 months (1/10/2013 to 31/10/2014). Variables included age, sex, estimated OHCA time, cardiopulmonary resuscitation (CPR) start time and outcome.

[Factors affecting the survival of transplants from donors after prehospital cardiac death].

Objectives: To evaluate factors that influence the survival of transplanted organs from donors after prehospital cardiac death.

Material And Methods: Retrospective observational study of data collected from hospital emergency service records. Information included prehospital cardiac deaths evaluated as donors as well as patients who received transplants.

[Validity of airway predictors in outpatient medicine].

Isolation of the airway sometimes determines the survival or death of the patient. To anticipate the presence of a difficult airway (DA) there are a number of indicators that are validated for hospitals: Mallampati, sternum and thyromental distance, interdental distance and Cormack grade. The aim of this study is to evaluate the use of these indicators in the ambulatory setting and to know the incidence of DA.