Usefulness of pre-anesthetic consultation to reduce the degree of anxiety in patients scheduled for surgical intervention. / Utilidad de la consulta preanestésica para disminuir el grado de ansiedad en pacientes programados para intervención quirúrgica.

BACKGROUND AND OBJECTIVES: Preoperative anxiety can alter perioperative evolution, increasing the need for sedatives and analgesics. Information received during the pre-anesthesia consultation could reduce the level of anxiety. The objective of this study was to determine whether preoperative anxiety levels decrease after the pre-anesthesia consultation. MATERIAL AND METHODS: Observational, unicentric, prospective study. Sociodemographic and clinical data were recorded. Heart rate, blood pressure and anxiety levels were measured before and after the pre-anesthesia consultation using the abbreviated State-Trait Anxiety Inventory. Results were analyzed using Wilcoxon test and univariate logistic regression. P=.05 was considered significant. RESULTS: Ninety patients were included, with a median age of 62 years; 58% were females, 79% had completed primary-secondary studies, 72% were selected for ambulatory surgery and 72% preferred regional anesthesia. The prevalence of anxiety was 35.6% (State-Trait Anxiety Inventory score 5; IQR 3-9); after the anesthesia consultation the score was reduced to 4 (IQR 2-6), P=.005. There was no significative decrease in hemodynamic values, and no significant relationship between anxiety and sociodemographic or clinical variables. CONCLUSIONS: The pre-anesthesia consultation reduces anxiety levels in surgical patients. This emphasizes the importance of the pre-anesthesia consultation in identifying and managing anxiety.

Association between self-perceived psychological stress and transitory ischaemic attack and minor stroke: A case-control study. / La autopercepción del estrés psicológico se asocia con el ataque isquémico transitorio e ictus minor. Un estudio de casos y controles.

INTRODUCTION: Stroke has a complex aetiopathogenesis influenced by numerous risk factors. There is growing interest in the study of the pathophysiological changes associated with stress and their potential relationship with cerebrovascular disease. The purpose of this paper is to assess the strength of association between exposure to stress and stroke. METHODS: We conducted a case-control study (1:1) to compare exposure to stress in a group of patients with a history of a first transient ischaemic attack (TIA) or minor stroke and in a control group. Participants were asked a subjective question about their perception of stress in the previous months and completed the standardised Effort-Reward Imbalance (ERI) questionnaire. Logistic regression models were used for data analysis. RESULTS: The study included data on 50 cases and 50 controls. There were no significant differences in demographic variables and economic, social, and employment status between cases and controls. Fifty percent of the cases reported moderate to severe stress, compared to 30% of controls (OR: 2.33; 95% CI: 1.02-5.30; P=.041). ERI questionnaire results found that greater effort at work (OR: 1.48; 95% CI: 1.19-1.83) and greater commitment is associated with stroke (OR: 1.34; 95% CI: 1.17-1.54), while higher reward constitutes a protective factor against the disease (OR: 0.71; 95% CI: 0.61-0.82). CONCLUSIONS: There is a strong association between self-perceived psychological stress and TIA. The imbalance between effort and reward at work is also clearly related to TIA.

Colloidal polymer particles as catalyst carriers and phase transfer agents in multiphasic hydroformylation reactions.

HYPOTHESIS: Colloidal particles have been used to covalently bind ligands for the heterogenization of homogeneous catalysts. The replacement of the covalent bonds by electrostatic interactions between particles and the catalyst could preserve the selectivity of a truly homogeneous catalytic process. EXPERIMENTS: Functionalized polymer particles with trimethylammonium moieties, dispersed in water, with a hydrophobic core and a hydrophilic shell have been synthesized by emulsion polymerization and have been thoroughly characterized. The ability of the particles with different monomer compositions to act as catalyst carriers has been studied. Finally, the colloidal dispersions have been applied as phase transfer agents in the multiphasic rhodium-catalyzed hydroformylation of 1-octene. FINDINGS: The hydrodynamic radius of the particles has been shown to be around 100 nm, and a core-shell structure could be observed by atomic force microscopy. The polymer particles were proven to act as carriers for the water-soluble hydroformylation catalyst, due to electrostatic interaction between the functionalized particles bearing ammonium groups and the sulfonated ligands of the catalyst. The particles were stable under the hydroformylation conditions and the aqueous catalyst phase could be recycled three times.

Causas de mortalidad por enfermedades de la piel y del tejido subcutáneo en Jerez de los caballeros (Badajoz - España) en el siglo XIX / Causes of mortality due to diseases of the skin and subcutaneous tissue in Jerez de los caballeros (Badajoz - Spain) in the 19th century

Las enfermedades de la piel y del tejido subcutáneo, en Jerez de los Caballeros durante el siglo XIX, provocaron 430 defunciones, el 2,3% del total, obtenidas mediante el análisis de los "libros de difuntos del archivo parroquial". Se agrupan siguiendo la clasificación de Bertillon: la gangrena con 325 casos y un 75,7% es la causa más abundante. Los párvulos presentan mayor mortalidad que los adultos, concretamente los <1 año: 126 óbitos. El sexo masculino tiene cifras más elevadas que las mujeres. El sector etario con mayor mortalidad en adultos, es el comprendido entre los 65 y 74 años con 48 muertes y un 11,2%. El mes con registros más elevados es julio, con 72 defunciones suponiendo un 16,8%. Los diagnósticos recogidos en las papeletas de defunción, podían sufrir errores a la hora de interpretarlos o transcribirlos a los libros de difuntos, por parte de los sacerdotes.

Diseases of the skin and subcutaneous tissue in Jerez de los Caballeros during the 19th century, caused 430 deaths, 2,3% total, obtained through the analysis of the deceased books of the parish archive. They are grouped following the Bertillon classification: with 325 cases and a 75,7% gangrene is the most abundant cause. Young children have higher mortality than adults, specifically the one year: 126 deaths. The male has figures higher than women. With higher mortality in adults age is between 65 and 74 years 48 deaths and a 11,2%. With higher registers month is July with 72 deaths assuming a 16,8%. Diagnostics collected ballots from death could suffer errors when interpreting them or transcribe them to deceased books, by the priests.

Nefro-urological mortality causes in Jerez de los Caballeros (Badajoz) in the nineteenth century.

The causes of mortality from nefro-urologic diseases in Jerez de los Caballeros (Badajoz) during the nineteenth century will be our object of study. We have analyzed the death registry books of the parishes in Jerez. The percentage of deaths from nefro-urologic diseases compared to other pathologies is 0.8%, being most affected males in age ranges from 25-34 and 65-75 years of age. The months with the highest mortality were July, December and January. Due to the deficient death registrations in the first decades of the century, the results should be taken with caution.

Atractylis gummifera and Centaurea ornata in the Province of Badajoz (Extremadura, Spain)-Ethnopharmacological importance and toxicological risk.

ETHNOPHARMACOLOGICAL RELEVANCE: Atractylis gummifera L. and Centaurea ornata Willd. are locally marketed herbal remedies, even though in Spain it is forbidden to sell toxic plants like Atractylis gummifera. Intoxications in Spain are mainly due to accidental substitution of Centaurea ornata with Atractylis gummifera which may be fatal. AIM OF STUDY: The aim of this article is to analyse the current use and marketing of Atractylis gummifera and Centaurea ornata in Badajoz and analyse the ethnopharmacological relevance of two recent cases of Atractylis gummifera poisoning. BACKGROUND AND METHODS: An ethnopharmacological survey was conducted in the area where one of the poisoned patients lives and in Guadiana del Caudillo. The use, knowledge and naming of the species involved in the poisoning was assessed. This information was complemented with an exhaustive search in Spanish ethnobotanical works on the ethnopharmacological uses of both species. RESULTS: Intoxications are due to species' substitutions. The two species are similar in name and use in the area, and both are locally marketed. AG is mainly used to heal wounds and calcaneal spurs, and CO to treat gastric ulcers and wounds. CONCLUSIONS: New intoxications are likely since consumers often have limited knowledge of the plants they consume. Also, it is common to think that all medicinal plants are harmless. As the use of Atractylis gummifera seems to increase in the area, preventive measures need to be taken.

[Patient with postpartum seizures: differential diagnosis]. / Paciente con convulsiones en el postparto. Diagnóstico diferencial.

Pre-eclampsia is a serious obstetric complication associated with a high rate of maternal and fetal morbidity and mortality. We report the case of a woman with a medical history of insulin-dependent diabetes mellitus and seizures possibly related to hypoglycemia who was admitted for an emergency cesarian due to severe pre-eclampsia and macrosomic fetus. In the first hour after delivery she experienced loss of consciousness and seizure, with vaginal bleeding and hypovolemic shock. Maximum vigilance is required for a patient with several concomitant diseases and a high-risk pregnancy. All prophylactic measures to lower the risk to mother and fetus should be undertaken. We analyze preanesthetic assessment, differential diagnosis, and choice of anesthesia in relation to this case.

Beetles as possible vectors of infections caused by Mycobacterium avium species.

Mycobacteria were not isolated from any of 229 beetle imagoes of 29 species originating from 14 distinct localities in the Czech and Slovak Republics: 186 imagoes (34 samples) and 43 imagoes (12 samples) from the wild and herds with paratuberculosis infected ruminants, respectively. From 75 environmental samples taken from barns with infected ruminants, Mycobacterium avium subsp. paratuberculosis was isolated from five scrapings of the floors in barns and a feed processing room. From bran and peat taken from pig farms, M. a. hominissuis was diagnosed in 13% of 72 samples and in 69% of 70 samples, respectively. M. a. avium was isolated from 2 (2.9%) and atypical mycobacteria from 12 (17.1%) peat samples. In the respective experiments, larvae of Tenebrio molitor Linnaeus and Zophobas atratus Fabricius were infected in vitro with isolates of M. a. paratuberculosis of IS900 RFLP type B-C1 and M. a. avium of IS901 RFLP type F-C3. T. molitor larvae were also infected with M. a. hominissuis by naturally contaminated bran and peat. M. a. paratuberculosis and M. a. avium were diagnosed in larvae of both species on days 1 to 3 post infection (p.i.). M. a. hominissuis was isolated from T. molitor larvae fed by bran on days 4 to 9 p.i. and from imagoes on day 35 p.i. and from larvae fed by peat on days 4 to 14 p.i. RFLP types of all the isolates identified before infection and after isolation from larvae were identical. Thus, beetles could mechanically transmit mycobacteria, this hazard should be considered for both the implementation of control measures and feeding captive animals with larvae.

Body mass index and some psychopathological symptoms in open community nuns.

This article examines the connections between body weight and psychopathological symptoms in a religious community. The Symptom Checklist 90-Revised was administered to 34 nuns, whose body mass index (BMI) values significantly correlated with hostility (r=0.46, p<0.01). These findings support the idea that people living in open religious communities share social values regarding weight and body size, and reveal high levels of psychological discomfort when body weight increases.

[The concept of health in the General Health Law (1986)]. / El concepto de salud en la Ley General de Sanidad (1986).

The 1986 "Le General de Sanidad" (Sanitary General Regulations) has been studied using the method of the "Topología del Discurso" in order to elucidate what are the thoughts of the lawmakers. The law protects not only the population of catastrophes as it happened with the choleric epidemic of the XIX century, but considers a new concept a sanitary wealth should be provided to the individuals. Together with this new concept there are new ones such as equality and universalization of the sanitary assistence that would be keys of the aim of the lawmakers: to coordinate all the State resources in the reform of the spanish sanity. This includes the integration of the Universities. This can help in the understanding of the dificulties in the development and aplication of the Law present reality.