Plasma proteomic analysis makes it possible to develop a map of the protein isoforms that are expressed in plasma during an ACS.

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BACKGROUND The COVID-19 pandemic has renewed the interest in telepsychiatry as a way to help psychiatrists care for their patients, but mental health providers’ unfamiliarity and concerns may impede implementation of such services. This study aimed to determine the effect of an online educational intervention on awareness, knowledge, attitude and skills of telepsychiatry among psychiatrists. OBJECTIVE This study aimed to determine the effect of an online educational intervention on awareness, knowledge, attitude and skills of telepsychiatry among psychiatrists. METHODS The study used a pre-post test design to compare awareness, knowledge, attitude and skills of telepsychiatry among psychiatrists participating in an online course of practical telepsychiatry. The Telemedicine AKAS Questionnaire adapted to Telepsychiatry was applied before and after the educational intervention, during the months of October to December 2020. RESULTS Responses from 213 participants were analyzed before the educational intervention and from 152 after it. The knowledge showed by Spanish psychiatrists before the educational intervention was good in 61% of participants, fair in 37% and inadequate in 2%. Concerning attitudes towards telepsychiatry, 62% self-reported a high attitude, 33% moderate, and 5% low. With regard self-reported skills, 57% of the participating psychiatrists were highly skilled or experts, 22% moderately skilled, and 9% unskilled in handling telepsychiatry equipment. Despite the high baseline values, the educational intervention improved significantly psychiatrists’ awareness, knowledge and attitudes toward telepsychiatry although not their skills. CONCLUSIONS Online course of practical telepsychiatry was effective although future editions need to improve its focus on skills. This educational intervention represents an effort to promote the implementation of telepsychiatry as a healthcare alternative.

e18674 Background: In 2019, we used the American Society of Clinical Oncology (ASCO) Quality Training Program (QTP) as an instrument to improve the inclusion rate in clinical trials (CTs) for bladder cancer patients from 24% in 2018 to 43,75% in 2019. CTs play an important role in developing new treatments, expanding or refining treatments that are already available, and/or identifying behavioral changes that can prolong or improve the lives of subjects. Therefore, we believe it is important for patients and for society to maintain the inclusion rate in clinical trials despite COVID-19 pandemic. Methods: We collected the number of bladder cancer patients evaluated for the first time in the Oncology department, the number of patients who were offered a clinical trial, the screen failures and the number of patients enrolled in CTs. Results: In 2019, we were able to increase the enrollment rate in CTs for bladder cancer patients to from 24% to 43,75% thanks to the ASCO-QTP. With this program we created a list of measures and identified the ones that would have a greater impact. The one that seems to have had the highest impact is the diffusion of CTs in the Investigation Unit and the Genitourinary (GU) board. In 2020, thanks to this measure and despite the COVID-19 pandemic, we were able to maintain a 40,81% enrollment rate. When analyzing the patients evaluated for the first time in the Oncology department, 48 in 2019 and 49 in 2020, there were some interesting differences. In 2020, 42,86% had stage IV disease with respect to 39,6% in 2019, and only 22,44% had non-muscle invasive disease (NMIBC) versus 33,33% in 2019. However, thanks to the diffusion of CTs in the Investigation Unit and in the GU-board, which translates in an early derivation of patients to Medical Oncology and an increase in the number of available CTs, we were able to offer a CT to 73,5% of patients in 2020 against 60,4% in 2019. Although there was an increase of screen failures in 2020 (32,65% vs. 16,66%), 50% of them were due to the absence of a biomarker in a biomarker driven CT, with respect to 25% in 2019. Conclusions: Using ASCO-QTP as an instrument, we identified the importance of the diffusion of CTs and the close collaboration between departments. Maintaining these measures, we were able to uphold the inclusion rate in CTs for bladder cancer patients in 40,81% despite the later diagnosis of patients due to COVID-19 pandemic.

Results: ECGs of LPF-VT (n=183) were compared with 61 ECGs showing RBBB and LAHB. Univariate analysis demonstrated differences in QRS axis, limb (I, aVR) and precordial (V1, V2, V6) ECG leads. On multivariate logistic regression analysis, LPF-VT was more often associated with atypical RBBB-like V1 morphology (OR=5.1, 95% CI=1.7-15.6, p=0.004), positive QRS in aVR (OR=19.2, 95% CI=4.3-86.5, p<0.001), V6 R/S ratio ≤1 (OR=6.7, 95% CI=1.6-28.5, p=0.01) and QRS ≤140ms (OR=7.7, 95% CI=2.9-20.3, p<0.001). Using these 4 variables a prediction model was developed. Patients with 3 out 4 positive variables had high probability of having LPF-VT, whereas patients with <1 positive variable always had RBBB plus LAHB. Conclusions:The morphological ECG characteristics of LPF-VT were defined and a high accurate tool for correctly differentiating LPF-VT from RBBB and LAHB aberrancy was developed. Background: For restoration of sinus rhythm, electrical cardioversion (ECV) is the most effective therapy. The delay in performing ECV could lead to increased left atrial electric remodeling and increased atrial fibrillation (AF) recurrences. The aim of our study was to compare two ECV strategies with different delay times and value their influence in AF recurrence. Methods: A total of 401 consecutive patients with paroxismal AF (duration less than 7 days), that went under ECV between October 2012 and March 2016, were included. They were divided into two different therapeutical strategy groups: a) transesophageal echocardiography and early ECV before 10 days since AF diagnosis was made (n=178) and b) 3 week oral anticoagulation treatment and late ECV. (n=221). ECV effectiveness and AF recurrences were analysed in weeks 4 and 8 after ECV was performed. Results: Demographic characteristics were similar in both groups. Mean time from AF diagnosis to ECV was shorter in early ECV group. (3,01 vs. 26,82 days; p<0,001). There were no significant differences in the use of betabloquers (18,8% vs 22,9%; p=0,154), nor in the left atrial dilatation degree (47,1% vs 52,9%; p=0,277) between both groups. A greater number of patients under antiarrythmic drugs was found in the late ECV strategy group. (32,7% vs 21,9%; p 0,02). No difference in inmediate ECV effectiveness was observed between the two groups. (early: 89,5% vs.late: 88,2%; p=NS), A higher AF recurrence rate was documented in late ECV group; 4 weeks after ECV (38% vs. 26,2%; p=0,017), and 8 weeks after ECV (41,6% vs 26,3%, p=0,002). P6377 | BEDSIDE