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Purpose: Characterize head and neck squamous cell carcinomas in solid transplant recipients and compare outcomes with non-transplanted population. Methods: We carried a retrospective cohort analysis in a tertiary care center in Madrid, Spain. The study reviews 26 cases of non-cutaneous HNSCC diagnosed in solid organ transplant recipients between 2000 and 2017. We select a cohort of 130 (1:5) non-transplanted patients among all non-transplanted patients diagnosed during the same period for comparison purposes, through hierarchical clustering analysis. Univariate, overall and specific survival analysis and multivariate Cox proportional hazards regression were used to evaluate our objectives. Results: The overall risk of non-cutaneous HNSCC in solid transplant recipients was 7.2 cases per 1000. Alcohol abuse (p = 0.021) and upfront surgery (p = 0.019) were more likely to occur in transplanted patients. Age > 60 was an independent predictor of worse outcomes both for overall (HR = 2.4, p < 0.001) and specific (HR = 2.1, p = 0.012) survival. Transplant significantly worse overall survival (HR = 2.1, p = 0.012) but no statistical significant differences were observed on specific survival (p = 0.392). Conclusions: Solid organ transplant recipients have a higher risk of suffering non-cutaneous HNSCC. The higher mortality rate of these patients does not appear to be directly related to suffering from head and neck cancer, although it seems to contribute to developing other fatal complications in these fragile patients. [ABSTRACT FROM AUTHOR]

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Introduction. The objective is to describe the problems related to outpatient psychogeriatric care in the context of the SARS-CoV-2 pandemic, as well as the proposed and implemented solutions for optimizing care for elderly people with mental disorders during the pandemic, that can also be applied in emerging similar situations in the future. Methods. Data on healthcare provision and clinical problems in psychogeriatric practice over the course of one year of the COVID-19 pandemic were collected as the basis for proposals for action by a consensus of psychiatrists expert in psychogeriatrics. Setting: Outpatient psychogeriatric care services in the Madrid region, Spain. Results. Eight topics relating to difficulties in the provision of psychogeriatric care were identified (access to services, treatment adherence, referrals and contact, continuity of care, isolation, nursing homes and laboratory tests) and agreement was reached on 14 possible solutions. In addition, 7 clinical problems of particular relevance were identified (bereavement, sleep, psychopharmacological treatments, physical, cognitive-behavioural and social deterioration, and violence) and 17 possible solutions proposed. Conclusions. The SARS-CoV-2 pandemic poses a high risk to life for the geriatric population. Measures such as lockdowns and limiting contacts, exert a direct risk to mental health and an indirect risk due to greater difficulties in accessing psychogeriatric care. It is necessary to detect these situations and implement changes in how care is provided to this highly vulnerable population. We propose a series of possible solutions to the problematic situations detected that may be helpful in a variety of psychogeriatric care contexts. [ABSTRACT FROM AUTHOR]