Dexmedetomidine supplementation for surgical field enhancement in endonasal surgery: a systematic review and meta-analysis.

BACKGROUND: Dexmedetomidine has been shown to effectively control intraoperative bleeding and improve surgical field visualization. However, its value in endonasal surgeries remains a matter of debate. METHODOLOGY: We searched PubMed, Embase, and Cochrane Central Register of Controlled Trials for studies comparing dexmedetomidine with placebo in endonasal surgeries. Outcomes included bleeding, operative time (OT), surgeon’s satisfaction, postoperative pain (POP), and nausea/vomiting (PONV). For statistical analysis, we used RevMan 5.4.1, and assessed heterogeneity with I2 statistics. RESULTS: We included a total of 1386 patients from 22 studies. In the placebo group, there was higher bleeding volume, whereas the dexmedetomidine group showed lower scores on the Fromme-Boezaart scale. Additionally, the surgeon satisfaction risk ratio (RR) increased, and OT was reduced in the dexmedetomidine group. The dexmedetomidine group had lower incidences of POP and PONV. CONCLUSIONS: In endonasal surgeries, dexmedetomidine was associated with improvements in surgical field visualization as evidenced by reduced intraoperative bleeding and postoperative morbidities.

Siete años de experiencia en pacientes intervenidos por patología proctológica bajo modalidad cirugía mayor ambulatoria y estudio del grado de satisfacción usuaria

Objetivo: Exponer los resultados de 7 años de cirugía proctológica por cirugía mayor ambulatoria (CMA) y determinar el grado de satisfacción usuaria. Material y Método: Se realizó un estudio observacional descriptivo de pacientes sometidos a cirugía proctológica bajo modalidad CMA en el Hospital Regional de Concepción entre los años 2012 y 2019. Se realizó la encuesta telefónica de satisfacción SUCMA-14. Resultados: Se evaluaron a 632 pacientes en el período de estudio. Con diferencias estadísticamente significativas entre patologías para edad, género e IMC. Se aplicó la encuesta a 270 pacientes que contestaron y respondieron. Los resultados mostraron que en general la percepción de los pacientes es positiva salvo puntuales excepciones, como el dolor postoperatorio para condilomas y hemorroides, y las complicaciones postoperatorias para la enfermedad pilonidal. Cuando se realiza el análisis multivariado a los datos correspondientes a la encuesta, no se logran diferencias significativas entre los diagnósticos, pero al aplicarlo a las variables clínico-quirúrgicas se evidencia, claramente, que existe una distinción entre éstas, en especial para la enfermedad pilonidal. Discusión: Las diferencias en términos de tiempos quirúrgicos, complicaciones y re-hospitalizaciones, no necesariamente afectan la percepción que los pacientes tienen de la CMA, ya que ésta depende de otros factores y no solo de los resultados quirúrgicos. Conclusión: Se obtuvieron resultados acorde a la literatura internacional, con peores resultados para enfermedad pilonidal. La satisfacción usuaria fue positiva en general, sin una clara distinción por patologías. Creemos que la CMA es recomendable en patología proctológica tanto por sus resultados, como por la satisfacción que genera en los pacientes.

Objective: To present the results of 7 years of colorectal surgery on mayor ambulatory surgery (MAS) and to determine patient satisfaction. Methods: A descriptive observational study of patients undergoing proctological surgery under the MAS modality was carried out at Regional Hospital of Concepción between 2012 and 2019. The SUCMA-14 satisfaction survey was applied. Results: 632 patients were evaluated in the study period. With statistically significant differences between pathologies for age, gender and BMI. The survey was applied to 270 patients who answered and responded. The results showed that, in general, the perception of the patients is positive, with exceptions, such as postoperative pain for warts and hemorrhoids, and postoperative complications for pilonidal disease. When the multivariate analysis corresponding to the survey is performed, it does not allow distinguishing between the diagnoses, but when applied to the surgical variables, it clearly shows that there is a distinction between them, with a disadvantage for pilonidal disease. Discussion: The differences in terms of surgical times, complications and re-hospitalizations do not necessarily affect the perception that patients have of the MAS, since it depends on other factors and not only on the surgical results. Conclusion: Results were concordant to what is described in the international literature, with worse results for pilonidal disease. Patient satisfaction was positive in general, without a clear distinction by pathology. We believe that MAS is recommended in proctological pathology both for its results and for the satisfaction it generates in patients.

Oxidative stress in the ovaries of mice chronically exposed to a low lead concentration: A generational approach.

Lead (Pb) is a heavy metal that alters the oxidation-reduction balance, affecting reproductive health and transfer during pregnancy and lactation. However, the multigenerational impact of exposure to low concentrations of Pb on mammalian ovaries has not been assessed. This study evaluated general parameters, histology, redox state (RS), protein carbonylation (PC), lipid peroxidation (LP), and hormone concentrations in the ovaries of mice (CD1® ICR) of three successive generations with both unigenerational (E1) and multigenerational (E2) exposure to 0.2 ppm lead acetate through the drinking water and a control group. Body weight, food consumption, the number of born pups, and their weight after weaning were not significantly affected by Pb exposure in E1 and E2. However, the ovaries of three successive generations of the E1 group, in which only the F0 was exposed, showed alterations in the ovarian histoarchitecture, increase in follicular atresia, decrease in the number of available follicles, and a significant RS and PC elevation that were surprisingly similar to those observed in the E2 group. LP increased in the second generation of E1 and E2, while hormone concentration was not altered. This is the first demonstration that exposure to low concentration of Pb induces multigenerational histological alterations and oxidative stress in mouse ovaries, that the termination of this exposure does not ensure the safety of later generations and that the lack of modifications in general parameters may facilitate the silent development of pathologies that affect ovarian health.

Profilaxis farmacológica para la prevención de la enfermedad tromboembólica en paciente con enfermedad cerebrovascular / Pharmacological prophylaxis for the prevention of thromboembolic disease in patients with cerebrovascular disease

INTRODUCCIÓN: La enfermedad cerebrovascular es un conjunto de alteraciones atribuidas a lesiones agudas y focales en el sistema nervioso central, en su mayoría secundaria a aterosclerosis DESARROLLO: En la prevención de la enfermedad cerebrovascular, existen dos grandes grupos farmacológicos, los antitromboticos y los anti plaquetarios, los cuales impactan en la calidad de vida de estos pacientes mejorando el pronóstico de los mismos. CONCLUSIONES: La enfermedad cerebrovascular comparte factores de riesgo de enfermedad tromboembólica, por lo que se recomienda iniciar profilaxis.

INTRODUCTION: Cerebrovascular disease is a group of alterations attributed to acute and focal lesions in the central nervous system, mostly secondary to atherosclerosis. DEVELOPMENT: In the prevention of cerebrovascular disease, there are two major pharmacological groups, antithrombotics and antiplatelet drugs. , which impact the quality of life of these patients, improving their prognosis. CONCLUSIONS: Cerebrovascular disease shares risk factors for thromboembolic disease, so it is recommended to start prophylaxis.

Deliberating Performance Targets: Follow-on workshop discussing PM10, NO2, CO, and SO2 air sensor targets.

The use of air sensor technology is increasing worldwide for a variety of applications, however, with significant variability in data quality. The United States Environmental Protection Agency held a workshop in July 2019 to deliberate possible performance targets for air sensors measuring particles with aerodynamic diameters of 10 µm or less (PM10), nitrogen dioxide (NO2), carbon monoxide (CO), and sulfur dioxide (SO2). These performance targets were discussed from the perspective of non-regulatory applications and with the sensors operating primarily in a stationary mode in outdoor environments. Attendees included representatives from multiple levels of government organizations, sensor developers, environmental nonprofits, international organizations, and academia. The workshop addressed the current lack of sensor technology requirements, discussed fit-for-purpose data quality needs, and debated transparency issues. This paper highlights the purpose and key outcomes of the workshop. While more information on performance and applications of sensors is available than in past years, the performance metrics, or parameters used to describe data quality, vary among the studies reports and there is a need for more clear and consistent approaches for evaluating sensor performance. Organizations worldwide are increasingly considering, or are in the process of developing, sensor performance targets and testing protocols. Workshop participants suggested that these new guidelines are highly desirable, would help improve data quality, and would give users more confidence in their data. Given the wide variety of uses for sensors and user backgrounds, as well as varied sensor design features (e.g., communication approaches, data tools, processing/adjustment algorithms and calibration procedures), the need for transparency was a key workshop theme. Suggestions for increasing transparency included documenting and sharing testing and performance data, detailing best practices, and sharing data processing and correction approaches.

Photocatalytic performance of nitrogen doped ZnO structures supported on graphene oxide for MB degradation.

In the present work, the photocatalytic efficiency of a novel system based on ZnO doped with nitrogen (ZT) and supported on graphene oxide (GO) is investigated. ZnO synthesis and their N doping were carried out in a microwave reactor using thiourea as nitrogen source, while the GO was prepared through a variation of the Hummers' method. Structural, morphological and photochemical characterization of the developed material was performed by X-ray diffraction (XRD), UV-Vis spectroscopy, energy dispersive spectroscopy (EDS), scanning electron microscopy (SEM), analysis by X-ray photoelectron spectroscopy (XPS) and Raman spectroscopy. The compounds were used to photodegrade the methylene blue molecule, which confirms the efficiency of nitrogen doped supported system compared to pristine ZnO. The degradation percentage of MB under UV energy using nitrogen-doped ZnO/GO, in a time of 35 min, reached 98% degradation; while using visible light 93% of degradation was reached.

Drosophila melanogaster Models of Friedreich's Ataxia.

Friedreich's ataxia (FRDA) is a rare inherited recessive disorder affecting the central and peripheral nervous systems and other extraneural organs such as the heart and pancreas. This incapacitating condition usually manifests in childhood or adolescence, exhibits an irreversible progression that confines the patient to a wheelchair, and leads to early death. FRDA is caused by a reduced level of the nuclear-encoded mitochondrial protein frataxin due to an abnormal GAA triplet repeat expansion in the first intron of the human FXN gene. FXN is evolutionarily conserved, with orthologs in essentially all eukaryotes and some prokaryotes, leading to the development of experimental models of this disease in different organisms. These FRDA models have contributed substantially to our current knowledge of frataxin function and the pathogenesis of the disease, as well as to explorations of suitable treatments. Drosophila melanogaster, an organism that is easy to manipulate genetically, has also become important in FRDA research. This review describes the substantial contribution of Drosophila to FRDA research since the characterization of the fly frataxin ortholog more than 15 years ago. Fly models have provided a comprehensive characterization of the defects associated with frataxin deficiency and have revealed genetic modifiers of disease phenotypes. In addition, these models are now being used in the search for potential therapeutic compounds for the treatment of this severe and still incurable disease.

Efecto de la higiene diaria con clorhexidina sobre la incidencia de contaminaciones de hemocultivos en el paciente crítico / Effect of daily cleaning with chlorhexidine on the incidence of contamination of blood cultures in the critical patient

Objetivo: Evaluar la eficacia de la higiene diaria con esponjas impregnadas con clorhexidina al 4% para disminuir la contaminación de hemocultivos en pacientes ingresados en UCI. Material y método: Estudio prospectivo, cuasi experimental, longitudinal, unicéntrico. Durante 24 meses (de abril de 2013 a marzo de 2015) fueron analizados 237 pacientes que cumplieron los criterios de inclusión, y fueron divididos en 2 grupos: uno recibió higiene corporal diaria con jabón común (grupo control, n= 118) y el otro con clorhexidina (grupo intervención, n= 119). Fueron incluidas variables demográficas, tipo de enfermedad, nivel de gravedad, estancia y mortalidad en UCI y hospitalaria, y tiempo trascurrido (minutos) desde el baño hasta la extracción de los hemocultivos. Resultados: El análisis estadístico mostró una mayor proporción de contaminación de los hemocultivos durante el período control con respecto al de intervención (15,5 vs. 6,3%); con una diferencia significativa: 9,23% (IC 95%: 1,34-16,7%), odds ratio de 2,73 (IC 95%: 1,13-6,63). El análisis de supervivencia mostró una menor probabilidad de contaminación de los hemocultivos hasta las 18 h desde el baño. El baño sin clorhexidina aumentó el riesgo de contaminación de los hemocultivos (HR: 3,05; IC 95%: 1,14-8,12). Conclusiones: El empleo de jabón con clorhexidina al 4% en la higiene diaria de los pacientes críticos disminuyó la incidencia de contaminaciones de hemocultivos y su efecto perduró al menos 18 h (AU)

Objective: To evaluate the efficacy of daily cleaning with 4% chlorhexidine-impregnated sponges in decreasing contamination of blood cultures in critically-ill patients. Material and methods: Prospective, quasi-experimental, longitudinal, single-centre trial. During 24 months (April 2013 to March 2015), we analysed 237 patients who fulfilled the inclusion criteria, divided into 2 groups: one underwent daily cleaning with common soap (control group, n= 108), and the other with chlorhexidine (intervention group, n= 109). Demographic variables, pathology group, severity scores, ICU and hospital length of stay and mortality, and time passed since cleaning to blood culture extraction were included. Results: Statistical analysis showed a higher proportion of contaminated blood cultures during the control group period in contrast with the intervention group period (15 vs. 6.3%), with a significant difference: 9.23% (CI95%: 1,34-16,7%), with an odds ratio of 2,73 (CI95%: 1,13-6,63). Surveillance analysis showed lower probability of blood culture contamination within the 18 hours following daily cleaning. Cleaning without chlorhexidine increased contamination of blood cultures (HR: 3,05; CI95%: 1,14-8,12). Conclusions: The use of 4% chlorhexidine-impregnated sponges for daily cleaning of critically-ill patients decreases blood culture contamination incidence and its protection lasts for almost 18h (AU)

Synthesis, Photocatalytic, and Antifungal Properties of MgO, ZnO and Zn/Mg Oxide Nanoparticles for the Protection of Calcareous Stone Heritage.

More recently, the biological colonization of stone heritage and consequently its biodeterioration has become the focus of numerous studies. Among all microorganisms, fungi are considered to be one of the most important colonizers and biodegraders on stone materials. This is why the development of new antifungal materials requires immediate action. ZnMgO nanoparticles (NPs) have several exciting applications in different areas, highlighting as an efficient antimicrobial agent for medical application. In this research, the application of Zn-doped MgO (Mg1-xZnxO, x = 0.096) NPs obtained by sol-gel method as antifungal coatings on dolomitic and calcitic stones has been explored as a means to develop effective protective coatings for stone heritage. Moreover, the photocatalytic and antifungal activity of Mg1-xZnxO NPs were comparatively studied with single ZnO and MgO NPs. Thus, compared to the MgO and ZnO nanomaterials, the Mg1-xZnxO NPs exhibited an enhanced photocatalytic activity. After UV irradiation for 60 min, 87% methylene blue was degraded over Zn-doped MgO NPs, whereas only 58% and 38% of MB was degraded over ZnO and MgO NPs, respectively. These nanoparticles also displayed a better antifungal activity than that of single pure MgO or ZnO NPs, inhibiting the growth of fungi Aspergillus niger, Penicillium oxalicum, Paraconiothyrium sp., and Pestalotiopsis maculans, which are especially active in the bioweathering of stone. The improved photocatalytic and antifungal properties detected in the Mg1-xZnxO NPs was attributed to the formation of crystal defects by the incorporation of Zn into MgO. The application of the MgO- and Zn-doped MgO NPs as protective coatings on calcareous stones showed important antifungal properties, inhibiting successfully the epilithic and endolithic colonization of A. niger and P. oxalicum in both lithotypes, and indicating a greater antifungal effectiveness on Zn-doped MgO NPs. The use of Zn-doped MgO NPs may thus represent a highly efficient antifungal protection for calcareous stone heritage.

Effect of daily cleaning with chlorhexidine on the incidence of contamination of blood cultures in the critical patient. / Efecto de la higiene diaria con clorhexidina sobre la incidencia de contaminaciones de hemocultivos en el paciente crítico.

OBJECTIVE: To evaluate the efficacy of daily cleaning with 4% chlorhexidine-impregnated sponges in decreasing contamination of blood cultures in critically-ill patients. MATERIAL AND METHODS: Prospective, quasi-experimental, longitudinal, single-centre trial. During 24 months (April 2013 to March 2015), we analysed 237 patients who fulfilled the inclusion criteria, divided into 2groups: one underwent daily cleaning with common soap (control group, n= 108), and the other with chlorhexidine (intervention group, n= 109). Demographic variables, pathology group, severity scores, ICU and hospital length of stay and mortality, and time passed since cleaning to blood culture extraction were included. RESULTS: Statistical analysis showed a higher proportion of contaminated blood cultures during the control group period in contrast with the intervention group period (15 vs. 6.3%), with a significant difference: 9.23% (CI95%: 1,34-16,7%), with an odds ratio of 2,73 (CI95%: 1,13-6,63). Surveillance analysis showed lower probability of blood culture contamination within the 18hours following daily cleaning. Cleaning without chlorhexidine increased contamination of blood cultures (HR: 3,05; CI95%: 1,14-8,12). CONCLUSIONS: The use of 4% chlorhexidine-impregnated sponges for daily cleaning of critically-ill patients decreases blood culture contamination incidence and its protection lasts for almost 18h.

Controlled Phase Changes of Titania Using Nitrogen Plasma.

In this work, the development of a new crystallization technique is reported, using nitrogen plasma (AC) to obtain nanostructured anatase and rutile from amorphous titanium oxide (TiO2). This methodology increases throughput and minimizes thermal effects. Nanostructured amorphous TiO2 was obtained by the sol-gel method and subsequently subjected to AC treatment, at a controlled pressure, applying different powers and treatment times in order to obtain phase changes. The obtained samples were characterized using X-ray diffraction (XRD), thermogravimetric analysis (TGA), and X-ray photoelectron spectroscopy (XPS). The results show the crystallization in parallel with anatase and rutile phases with a proportion that is directly related to the applied power in the plasma and the treatment time. This technique allows us to obtain smaller crystals in comparison with those of classic thermal methodologies. It is also demonstrated that the application of plasma represents a novel and innovative method to obtain phase polymorphic changes in titanium oxide without needing to apply prolonged heat treatments at high temperatures and can therefore be taken into consideration as a technique with low energy costs, in comparison with conventional heat treatments.

Grado de adherencia a la recomendación de actividad física, sedentarismo y riesgo cardiovascular en adolescentes de enseñanza media de Punta Arenas, Chile / Degree of adherence to physical activity recommendation, sedentary lifestyle and cardiovascular risk in teenagers from Punta Arenas, Chile

Objective: The aim of this study was to identify the degree of compliance to the global recommendations on physical activity and its association with cardiovascular risk, anthropometric and socio-demographic variables in teenagers from the district of Punta Arenas, Chile. Subjects and Methods: A random, stratified and proportional sample was obtained of322 students from private, private-subsidized and public local schools. Global physical activity questionnaire (GPAQv2), and anthropometric measurements of weight, height, waist circumference, and classification of nutritional status were applied according to the standards of the Chilean Ministry of Health. Results: 50.31% of the sample showed a normal nutritional status, 48.14% presented overweight status. We also found 666.8 min/day of average sedentary lifestyle between the means by gender. The female gender presents an OR: 1.9; 95% IC: 1.16 to 3.11 according to WHO recommendations. Discussion: It was found that most of the students resulted in the category "sufficiently active" as WHO recommended. An 82.30% showed no high cardiovascular risk. Conclusion: The level of physical activity would not be influenced by nutritional status, showing that the majority of students perform moderate physical activity on their free time.

Objetivo: El objetivo de este estudio fue identificar el grado de adherencia a las recomendaciones mundiales sobre actividad física, así como su asociación con riesgo cardiovascular, variables antropométricas y socio-demográficas en adolescentes de la comuna de Punta Arenas. Sujetos y métodos: Se obtuvo una muestra aleatoria, estratificada y proporcional de 322 estudiantes de establecimientos particular-pagados, particular-subvencionados y municipalizados. Se aplicó el cuestionario mundial sobre actividad física (GPAQv2), y mediciones antropométricas de peso, talla, perímetro de cintura, y clasificación del estado nutricional según normas MINSAL. Resultados: El 50,31% del total de la muestra tenía un estado nutricional normal y 48,14% presentó malnutrición por exceso. También, 666,8 min/día de sedentarismo promedio entre las medias por sexo. El sexo femenino presenta un OR: 1,9; 95%IC: 1,16-3,11 según recomendaciones de la OMS. Discusión: Se encontró a la mayoría de los estudiantes evaluados en la categoría "suficientemente activos" según las recomendaciones de la OMS. Se observó un alto porcentaje sin riesgo cardiovascular (82,30%). Conclusión: El nivel de actividad física no estaría condicionado por el estado nutricional, evidenciándose en la mayoría de los alumnos la realización de actividad física moderada en su tiempo libre.

Significados sobre la experiencia de hospitalización en pacientes adolescentes diagnosticados con anorexia nerviosa / Meanings about the experience of hospitalization in adolescent patients diagnosed with anorexia nervosa

Introduction: The psychiatric hospitalization of children and adolescents suffering from anorexia nervosa (AN) has important implications in their developmental stage, but its impact has been scarcely reported, particularly from the subjective individual experience. Objective: To describe the experiencing meanings constructed by anorectic children and adolescents about their hospitalization process. Method: A qualitative descriptive study based on the Grounded Theory was conducted. The sample was intentionally composed by6 patients (5 females and 1 male) with and without previous hospitalization background. A semi-structured in-depth interview was applied. The data were transcribed and analysed by using open coding and triangulation of specialists. Results: Four categories are described: (A) Impressions on mental health professionals and psychiatric hospitalization units before inpatient treatment: reported experiences were negative, influencing future interventions; (B) Impressions and experiences at admission: anguish, sadness and fear (symptomatology impairment, abuse and weight gain); (C) Therapeutic effects of hospitalization: emphasis in therapeutic alliance and symptoms remission and (D) Critical assessment concerning psychiatric hospitalizations during the adolescence: reinforcement of individual capabilities for the disorder management, benefits of the isolation from family issues, development illness awareness. Conclusion: Hospitalization in AN is a positive therapeutic resource in certain cases. Improvement process was facilitated by constructive dialogues throw the acknowledgement of the patient particular affective needs and the institutional plasticity in offering appropriate tools for their experiencing, emphasising the relevance of therapeutic alliance.

Introducción: La hospitalización psiquiátrica en anorexia nerviosa (AN) infanto-juvenil posee importantes implicancias en el vivenciar de su etapa del desarrollo, pero su impacto ha sido escasamente reportado, particularmente desde la experiencia individual subjetiva. Objetivo: Describir los significados experienciales construidos por niños y adolescentes anorécticos en torno a su proceso de hospitalización. Método: Estudio cualitativo descriptivo basado en la Grounded Theory. La muestra se constituyó intencionadamente por un total de 6 pacientes (5 mujeres y 1 hombre) con y sin antecedentes de hospitalización psiquiátrica. Se utilizó la entrevista en profundidad semi-estructurada, analizando los datos mediante triangulación de especialistas y codificación abierta. Resultados: Se describen cuatro categorías: (A) Impresiones sobre los profesionales de la salud mental y las unidades de hospitalización psiquiátrica previas a la internación: las vivencias informadas fueron negativas, influyendo en futuras intervenciones; (B) Impresiones y experiencias al momento del ingreso: angustia, tristeza y temor (empeoramiento sintomático, maltrato y aumento ponderal); (C) Efectos terapéuticos de la hospitalización: énfasis en la alianza terapéutica y en la remisión sintomática y (D) Apreciación crítica sobre las hospitalizaciones psiquiátricas durante la adolescencia: fortalecimiento de habilidades individuales para el manejo del trastorno, beneficio del distanciamiento de las problemáticas familiares, desarrollo de consciencia de enfermedad. Conclusión: La hospitalización en AN es un recurso terapéutico positivo en determinados casos. El proceso de mejoría se facilitó estableciendo diálogos constructivos mediante el reconocimiento de las necesidades afectivas particulares del paciente y la plasticidad de la institución para ofrecerle herramientas atingentes a su vivenciar, enfatizando la relevancia de la alianza terapéutica.

Indicadores de calidad asistencial en cirugía mayor ambulatoria (2010-2012) / Indicators of healthcare quality in day surgery (2010-2012)

Introducción: La monitorización de indicadores de calidad en las unidades de Cirugía Mayor Ambulatoria es una herramienta fundamental para identificar los problemas, corregirlos y prevenirlos. Dado su gran número, es indispensable la selección de los más válidos. Objetivos: Mejora continuada de la calidad asistencial de la cirugía ambulatoria en nuestro centro mediante el seguimiento de parámetros de calidad selectivos, la información periódica de los resultados y la toma de medidas correctivas. Conseguir un porcentaje de pernoctas no planificadas y cancelaciones dentro de los estándares de calidad. Material y método: Estudio prospectivo, observacional y descriptivo de la cirugía ambulatoria realizada desde enero de 2010 a diciembre de 2012. Se seleccionaron y monitorizaron los ingresos imprevistos y las anulaciones el mismo día de la operación, y sus motivos. Los ingresos se clasificaron en selección inadecuada, complicaciones médico-quirúrgicas y otros. Los resultados se evaluaron anualmente y se analizaron estadísticamente con la prueba de χ2. Resultados: Durante estos 3 años, 8.300 pacientes fueron intervenidos en régimen de cirugía mayor ambulatoria. La cirugía ambulatoria y el índice de ambulatorización se incrementaron un 5,4 y 6,4%, respectivamente (p < 0,01). Los ingresos no previstos disminuyeron progresivamente, a expensas de un menor número de complicaciones (p < 0,01). Descendieron los debidos a tiempo prolongado en la recuperación de la anestesia locorregional (p < 0,01). Las náuseas y vómitos y el dolor mal controlado fueron mejor prevenidos. La proporción de ingresos de tarde se redujo significativamente (p < 0,01). Las anulaciones se incrementaron en el año 2011 (p < 0,01). Conclusiones: La monitorización de parámetros de calidad en cirugía mayor ambulatoria ha sido una herramienta útil en nuestra gestión clínica y de la calidad. Globalmente, los ingresos imprevistos y las anulaciones han estado dentro de los estándares de calidad y han mejorado muchos indicadores analizados (AU)

Introduction: Monitoring quality indicators in Ambulatory Surgery centers is fundamental in order to identify problems, correct them and prevent them. Given their large number, it is essential to select the most valid ones. Objectives: The objectives of the study are the continuous improvement in the quality of healthcare of day-case surgery in our center, by monitoring selective quality parameters, having periodic information on the results and taking corrective measures, as well as achieving a percentage of unplanned transfer and cancellations within quality standards. Material and method: Prospective, observational and descriptive study of the day-case surgery carried out from January 2010 to December 2012. Unplanned hospital admissions and cancellations on the same day of the operation were selected and monitored, along with their reasons. Hospital admissions were classified as: inappropriate selection, medical-surgical complications, and others. The results were evaluated each year and statistically analysed using 2 tests. Results: A total of 8,300 patients underwent day surgery during the 3 years studied. The daycase surgery and outpatient index increased by 5.4 and 6.4%, respectively (P < .01). Unexpected hospital admissions gradually decreased due to the lower number of complications (P < .01). Hospital admissions, due to an extended period of time in locoregional anaesthesia recovery, also decreased (P < .01). There was improved prevention of nausea and vomiting, and of poorly controlled pain. The proportion of afternoon admissions was significantly reduced (P < .01). The cancellations increased in 2011 (P < .01). Conclusions: The monitoring of quality parameters in day-case surgery has been a useful tool in our clinical and quality management. Globally, the unplanned transfer and cancellations have been within the quality standards and many of the indicators analysed have improved

[Indicators of healthcare quality in day surgery (2010-2012)]. / Indicadores de calidad asistencial en cirugía mayor ambulatoria (2010-2012).

INTRODUCTION: Monitoring quality indicators in Ambulatory Surgery centers is fundamental in order to identify problems, correct them and prevent them. Given their large number, it is essential to select the most valid ones. OBJECTIVES: The objectives of the study are the continuous improvement in the quality of healthcare of day-case surgery in our center, by monitoring selective quality parameters, having periodic information on the results and taking corrective measures, as well as achieving a percentage of unplanned transfer and cancellations within quality standards. MATERIAL AND METHOD: Prospective, observational and descriptive study of the day-case surgery carried out from January 2010 to December 2012. Unplanned hospital admissions and cancellations on the same day of the operation were selected and monitored, along with their reasons. Hospital admissions were classified as: inappropriate selection, medical-surgical complications, and others. The results were evaluated each year and statistically analysed using χ(2) tests. RESULTS: A total of 8,300 patients underwent day surgery during the 3 years studied. The day-case surgery and outpatient index increased by 5.4 and 6.4%, respectively (P<.01). Unexpected hospital admissions gradually decreased due to the lower number of complications (P<.01). Hospital admissions, due to an extended period of time in locoregional anaesthesia recovery, also decreased (P<.01). There was improved prevention of nausea and vomiting, and of poorly controlled pain. The proportion of afternoon admissions was significantly reduced (P<.01). The cancellations increased in 2011 (P<.01). CONCLUSIONS: The monitoring of quality parameters in day-case surgery has been a useful tool in our clinical and quality management. Globally, the unplanned transfer and cancellations have been within the quality standards and many of the indicators analysed have improved.

[A protocol for the treatment of retinopathy of prematurity in Spain]. / Protocolo de tratamiento de la retinopatía del prematuro en España.

OBJECTIVE: To prepare a protocol for the treatment of retinopathy of prematurity (ROP) agreed by the majority of Spanish ophthalmologists dedicated to this topic. MATERIAL AND METHOD: A draft of the protocol was produced taking into account the experience of the participants and up to date publications. This draft was corrected by all the ophthalmologists participating in the project, and the final document was agreed by all of them. RESULTS: We present general guidelines as an aid for the treatment of ROP, including treatment criteria, treatment methods, a calendar of action, and follow-up. CONCLUSIONS: It is important to have a common working protocol for the treatment of ROP to improve care and to avoid mistakes. Although individual Hospitals may adapt the protocol to their daily activity, it is recommended that there is a minimal working protocol agreed by most of professionals dedicated to pediatric ophthalmology in Spain.

Protocolo de tratamiento de la retinopatía del prematuro en España / A protocol for the treatment of retinopathy of prematurity in Spain

Objetivo: Realizar un protocolo de tratamiento de la retinopatía del prematuro (ROP) consensuado por la mayor parte de oftalmólogos españoles dedicados al tema. Material y método: Se realizó un borrador del protocolo según la experiencia de los participantes y las publicaciones actualizadas. Este borrador fue corregido por los participantes en el protocolo y se llegó al documento final consensuado por todos los participantes. Resultados: Se presentan las directrices generales para realizar el tratamiento de la ROP, incluyendo criterios de tratamiento, metodología de actuación, calendario de actuación y seguimiento. Conclusiones: Es importante disponer de un protocolo de actuación común en el tratamiento de la ROP para mejorar la actuación y evitar errores. Aunque cada centro hospitalario deba adaptar el protocolo a su actividad clínica, es recomendable que existan un mínimo de procedimientos consensuados por todos los oftalmólogos dedicados a la ROP (AU)

Objective: To prepare a protocol for the treatment of retinopathy of prematurity (ROP) agreed by the majority of Spanish ophthalmologists dedicated to this topic. Material and method: A draft of the protocol was produced taking into account the experience of the participants and up to date publications. This draft was corrected by all the ophthalmologists participating in the project, and the final document was agreed by all of them. Results: We present general guidelines as an aid for the treatment of ROP, including treatment criteria, treatment methods, a calendar of action, and follow-up. Conclusions: It is important to have a common working protocol for the treatment of ROP to improve care and to avoid mistakes. Although individual Hospitals may adapt the protocol to their daily activity, it is recommended that there is a minimal working protocol agreed by most of professionals dedicated to pediatric ophthalmology in Spain (AU)

Programa de cribado para la retinopatía del prematuro en España / Screening program for retinopathy of prematurity in Spain

Objetivo: Realizar un protocolo de cribado de la retinopatía del prematuro (ROP), consensuado por la mayor parte de oftalmólogos españoles dedicados al tema. Material y método: Se realizó un borrador del protocolo según la experiencia de los participantes y las publicaciones actualizadas. Este borrador fue corregido por los participantes en el protocolo y se llegó al documento final consensuado por todos los participantes. Resultados: Se presentan las directrices generales para realizar el cribado de la ROP, incluyendo criterios de inclusión y exclusión, metodología de exploración y calendario de actuación. Conclusiones: Es importante disponer de un protocolo de actuación común en el cribado de la ROP para mejorar la actuación y evitar errores. Aunque cada centro hospitalario deba adaptar el protocolo a su actividad clínica es recomendable que existan un mínimo de procedimientos consensuados por todos los oftalmólogos dedicados a la ROP (AU)

Objective: To prepare a retinopathy of prematurity (ROP) screening program as agreed by most of Spanish ophthalmologists dedicated to this topic. Material and method: A draft of the protocol was produced taking into account the experience of the participants and current publications. This draft was corrected by all the ophthalmologists participating in the project and the final document produced was agreed by all of them. Results: We present general guidelines to help in the screening of ROP, including treatment criteria, treatment methods, and a calendar of action. Conclusions: It is important to have a common working protocol in the screening of ROP to improve the action and to avoid mistakes. Although individual Hospitals may adapt the protocol to their daily activity, it is recommended that there is a minimal working protocol agreed by most of professionals dedicated to pediatric ophthalmology in Spain (AU)

Screening program for retinopathy of prematurity in Spain.

OBJECTIVE: To prepare a retinopathy of prematurity (ROP) screening program as agreed by most of Spanish ophthalmologists dedicated to this topic. MATERIALS AND METHODS: A draft of the protocol was produced taking into account the experience of the participants and current publications. This draft was corrected by all the ophthalmologists participating in the project and the final document produced was agreed by all of them. RESULTS: We present general guidelines to help in the screening of ROP, including treatment criteria, treatment methods, and a calendar of action. CONCLUSIONS: It is important to have a common working protocol in the screening of ROP to improve the action and to avoid mistakes. Although individual Hospitals may adapt the protocol to their daily activity, it is recommended that there is a minimal working protocol agreed by most of professionals dedicated to pediatric ophthalmology in Spain.

Stability of hepatoprotecting agent IFC-305 encapsulated into sol-gel titania nanoparticles and drug release evaluation: water and drug concentration effect.

IFC-305 was encapsulated into nanostructured titania and functionalized with OH groups by the sol-gel process using titanium n-butoxide, to be used in a drug delivery system for the treatment of liver cancer. Synthesis was carried out at different molar hydrolysis ratios: 4, 8, 16 and 24 mol of water; and drug concentration of 10, 20 and 30%. Characterization of IFC-titania reservoirs was carried out by Fourier transformed infrared spectroscopy (FTIR), X-ray diffraction (XRD), thermal analysis (DTA-TGA), scanning electron microscopy (SEM), and N2 adsorption-desorption isotherms (BET), confirms that IFC-305 is entrapped and stabilized in the TiO2-OH matrix. Drug liberation in vitro was determined by UV spectrometry over a period of 1000 h. This study demonstrated that the higher water content and the higher amount of loaded IFC, favored hydrogen bonding between titania-OH surface and IFC-NH groups, increasing the rate of drug release.