Ronda

Researchers are evaluating whether a comprehensive nurse-led program called BEST CARE ICTUSHC can reduce complications and improve recovery for adults aged 18 and older hospitalized with acute ischemic or hemorrhagic stroke in hospitals lacking specialized Stroke Units. The study aims to see if this program improves early detection of swallowing difficulties to prevent pneumonia and reduces attention problems like hemineglect, enhancing quality of life up to six months after discharge. This trial compares patients receiving the BEST CARE ICTUSHC program with those receiving usual hospital care in a stepped-wedge design across multiple hospitals. The BEST CARE ICTUSHC intervention includes specialized training for nursing staff, systematic use of the Modified Swallowing Assessment to detect dysphagia, and the FLECHA Project, which adapts the patients environment with visual signs, spatial reorganization, and QR code-guided care plans tailored to stroke type and side. It also involves strict monitoring protocols for temperature, blood sugar, and blood pressure, plus early removal of invasive devices. During the control phase, usual care is provided without standardized dysphagia screening. The intervention phase adds educational outreach, compensatory care strategies, and ongoing support to ensure program implementation. Participants will be monitored from admission through hospitalization, discharge, and follow-up at 30 days and six months post-discharge. Assessments include swallowing tests, evaluation of hemineglect using the Catherine Bergego Scale, and health-related quality of life measurements. Vital signs and device use are tracked daily during hospital stay. Follow-up calls collect health and quality of life data. The study uses statistical methods to account for hospital differences and time effects, aiming to understand both clinical outcomes and how the program integrates into routine care.

Primary immune thrombocytopenia PIT, formerly called idiopathic thrombocytopenic purpura, is a disease where platelets are destroyed faster than they are made, leading to low platelet counts. The causes are not fully understood, and the disease affects patients differently, making diagnosis based on ruling out other causes. There is limited data on how common PIT is in Spain, so this study aims to better understand the characteristics and treatment of patients with PIT and other immune thrombocytopenias in Spain. This research is an observational, multicenter study collecting information from hospital patient records across Spain. It includes children from 2 months old and adults who have been monitored since 2015 with a diagnosis or suspicion of PIT or similar immune-related thrombocytopenia. The study gathers data on clinical features, lab results, and treatments received, without introducing any new treatments or interventions. Participants medical histories will be reviewed to describe their disease and treatment details. Researchers will analyze clinical and laboratory data from enrollment onwards, comparing it with past published ITP data and evaluating responses to first and subsequent treatments. The study is sponsored by the Fundacin Espaola de Hematologa y Hemoterapia and will continue collecting data until 2034.