Activity and stability of bifunctional perovskite/carbon-based electrodes for the removal of antipyrine by electro-Fenton process.

Bifunctional perovskite/carbon-black(CB)/polytetrafluoroethylene(PTFE) electrodes for electro-generation and catalytic decomposition of hydrogen peroxide to oxidizing hydroxyl radicals have been fabricated. These electrodes were tested for electroFenton (EF) removal of antipyrine (ANT) as a model antipyretic and analgesic drug. The influence of the binder loading (20 and 40 wt % PTFE) and type of solvent (1,3-dipropanediol and water) was studied for the preparation of CB/PTFE electrodes. The electrode prepared with 20 wt % PTFE and water exhibited a low impedance and remarkable H2O2 electro-generation (about 1 g/L after 240 min, a production rate of ca. 6.5 mg/h·cm2). The incorporation of perovskite on CB/PTFE electrodes was also studied following two different methods: i) direct deposition on the CB/PTFE electrode surface and ii) addition in the own CB/PTFE/water paste used for the fabrication. Physicochemical and electrochemical characterization techniques were used for the electrode's characterization. The dispersion of perovskite particles in the own electrode matrix (method ii) exhibited a higher EF performance than the immobilisation onto the electrode surface (method i). EF experiments at 40 mA/cm2 and pH 7 (non-acidified conditions) showed ANT and TOC removals of 30% and 17%, respectively. The increase of current intensity up to 120 mA/cm2 achieved the complete removal of ANT and 92% of TOC mineralisation in 240 min. The bifunctional electrode also proved high stability and durability after 15 h of operation.

Advanced bio-oxidation of fungal mixed cultures immobilized on rotating biological contactors for the removal of pharmaceutical micropollutants in a real hospital wastewater.

Hospital wastewater represents an important source of pharmaceutical active compounds (PhACs) as contaminants of emerging concern for urban wastewater treatment plants. This work evaluates a fungal biological treatment of a hospital effluent before discharging in the municipal sewer system. This treatment was performed in rotating biological contactors (RBCs) covered with wooden planks in order to promote the attachment of the fungal biomass. These bioreactors, initially inoculated with Trametes versicolor as white rot fungi, have created biofilms of a diversified population of fungal (wood-decaying fungi belonging to Basidiomycota and Ascomycetes) and bacterial (Beta-proteobacteria, Firmicutes, and Acidobacteria) microorganisms. The mixed fungal/bacterial community achieved a stable performance in terms of carbon, nitrogen, and phosphorous reductions for 75 days of continuous operation. Moreover, a remarkable removal of pharmaceutical micropollutants was accomplished especially for antibiotics (98.4 ± 0.7, 83 ± 8% and 76 ± 10 for azithromycin, metronidazole and sulfamethoxazole, respectively). Previous studies have proven a high efficiency of fungi for the removal of microcontaminants as a result of advanced bio-oxidation processes mediated by oxidizing hydroxyl radicals. This study evidences the development of a stable fungal-bacterial mixed culture over wooden-modified RBCs for in-situ removal of pharmaceutical compounds of hospital wastewater under non-sterile conditions and non-strict temperature control, avoiding periodical fungal inoculation due to destabilization and displacement of fungal cultures by indigenous wastewater bacteria.

A double blind randomized controlled trial investigating efficacy and safety of varenicline for smoking cessation in patients with type 2 diabetes: study protocol.

Reducing exposure to cigarette smoke is an imperative for public health and for diabetic patients. Patients with diabetes who continue to smoke face challenges at quitting and the delivery of effective smoking cessation interventions is a major unmet need. The high-affinity α4ß2 nicotinic acetylcholine receptor partial agonist varenicline in combination with counseling is effective for smoking cessation, but evidence in patients with diabetes is limited. A clinical trial of varenicline targeted specifically at smokers with T2DM is warranted. This randomized, double blind, placebo-controlled trial will be the first study to test efficacy and safety of varenicline in smokers with type 2 diabetes mellitus (T2DM) over the course of 52 weeks. We hypothesize that varenicline treatment (1 mg BID, administered for 12 weeks) would increase quit rates, maintain smoking abstinence up to 1 year after treatment, and be well-tolerated in T2DM smokers intending to quit. Efficacy end points will include carbon monoxide-confirmed continuous abstinence rate (CAR) and 7-day point prevalence of abstinence. The results of this RCT will help inform medical/health authorities and physicians worldwide whether an optimally varenicline-treated cohort of T2DM patients who smoke will experience significant success rates, without significant side effects.Trial registration NCT01387425 ( https://clinicaltrials.gov/ct2/show/NCT01387425 ).

Trametes versicolor immobilized on rotating biological contactors as alternative biological treatment for the removal of emerging concern micropollutants.

White rot fungi have been studied for the removal of micropollutants of emerging concern from wastewater during the last decade. However, several issues need to be overcome for its plausible implementation at full-scale installations such as the addition of supplementary substrates, the partial re-inoculation of fresh fungi or the use of extended hydraulic retention times. This work proposes the immobilization of Trametes versicolor on rotating biological contactors at bench scale (flowrates of 10 L/d and reactor capacity of 10 L) for the treatment of different urban wastewater. This type of bioreactor achieved remarkable reductions of the total organic carbon loading of the wastewater (70-75%) in a wide range of C:N and C:P ratios with limited addition of supplementary substrates, non-refreshment of the fungal biomass and only 1-day of hydraulic retention. The addition of gallic acid as quinone-like mediator and quelated iron and manganese complexes increased the removal of pharmaceutical micropollutants mediated by the so-called advanced bio-oxidation process. The immobilization of Trametes versicolor on rotating biological contactors also showed a remarkable stabilization of the fungi during the continuous treatment of different urban wastewater under non-sterile conditions. Thus, this system is a sound alternative for biological urban wastewater treatment with pharmaceutical removal because overcome all the problems usually associated with the water treatment technologies based on white rot fungi that makes difficult the scaling-up of the process and its implementation in full scale wastewater treatment plants.

Smoking and diabetes: dangerous liaisons and confusing relationships.

The combined harmful effects of cigarette smoking and hyperglycemia can accelerate vascular damage in patients with diabetes who smoke, as is well known. Can smoking cause diabetes? What are the effects of smoking on macro and microvascular complications? Now growing evidence indicates that regular smokers are at risk of developing incident diabetes. Since the prevalence rates of smoking in patients with diabetes are relatively similar to those of the general population, it is essential to address the main modifiable risk factor of smoking to prevent the onset of diabetes and delay the development of its complications. Quitting smoking shows clear benefits in terms of reducing or slowing the risk of cardiovascular morbidity and mortality in people with diabetes. Does quitting smoking decrease the incidence of diabetes and its progression? What are the effects of quitting smoking on complications? The current evidence does not seem to unequivocally suggest a positive role for quitting in patients with diabetes. Quitting smoking has also been shown to have a negative impact on body weight, glycemic control and subsequent increased risk of new-onset diabetes. Moreover, its role on microvascular complications of the disease is unclear. What are the current smoking cessation treatments, and which ones are better for patients with diabetes? Stopping smoking may be of value for diabetes prevention and management of the disease and its macrovascular and microvascular complications. Unfortunately, achieving long-lasting abstinence is not easy and novel approaches for managing these patients are needed. This narrative review examines the evidence on the impact of smoking and smoking cessation in patients with diabetes and particularly in type 2 diabetes mellitus and its complications. In addition, management options and potential future directions will be discussed.

Electronic cigarette: a possible substitute for cigarette dependence.

Cigarette smoking is the leading cause of premature mortality in western countries and it is important for smokers to stop as early as possible. Electronic cigarettes are a popular phenomenon of global proportion. Recent uncontrolled studies, reported that a certain number of smokers have quit using electronic cigarettes. This could hint a role for electronic cigarettes to be used for smoking cessation, and therefore merits further evaluation for this purpose. Besides vaporising nicotine to be inhaled, electronic cigarettes may also provide a coping mechanism for conditioned smoking cues by replacing some of the rituals associated with smoking gestures, and for these reasons cigarette could become a tool--if studied more extensively--in the fight against tobacco-related morbidity and mortality.

Wheat starch digestion rate affects broiler performance.

Two experiments were conducted to determine the differences in starch digestion rate (KDS) among wheats from different cultivars and origins and to verify if chickens would benefit from a certain digestion rate of starch. In the first experiment, 192 chickens (21 d) were assigned to 4 diets containing 55% of each wheat sample (3 cultivars, one of them from 2 origins). Starch and protein digestion were calculated from the remaining starch and protein in 4 segments of the small intestine and in excreta, using chromic oxide as a marker. Mean retention time was measured in each segment, which enabled calculations of digestion rates. In the second experiment, 2,600 chickens were assigned to 5 isoenergetic and isonitrogenous diets (with KDS from 1.80 to 2.56 h(-1)) and growth performance was determined (1 to 34 d). In 3 treatments, dietary starch was provided each by the wheat cultivars (same origin), whereas in the other 2 treatments, 25 and 50% of the wheat starch with the highest KDS was substituted by pea starch. Clostridium perfringens and Lactobacillus in the cecal chyme and glucose in the blood (glycemic index) were measured in broilers at d 19 and 25, respectively. Starch was gradually digested along the small intestine, mainly in the jejunum (48.5 and 80.4% at proximal and distal jejunum) where the largest differences among wheat samples were found. Starch digestion rate varied with origin (from 1.96 to 2.56 h(-1)) and cultivar (from 2.17 to 2.56 h(-1)). Crude protein digestion rate (average 2.21 h(-1)) was not affected by either cultivar or origin. Broiler growth and feed conversion ratio improved in a quadratic way with KDS. The maximum broiler performance was observed with KDS around 2.2 h(-1). Blood glucose response (glycemic index) was not affected by KDS; therefore, it cannot be used to predict broiler performance. In conclusion, the rate of starch digestion varies among wheats, depending on both genetic and environmental conditions of the grain, and affects broiler performance.

Wheat starch digestion rate in broiler chickens is affected by cultivar but not by wheat crop nitrogen fertilisation.

1. A study was set up to investigate the influence of wheat cultivar and wheat crop nitrogen (N) fertilisation on starch (ST) digestion rate in broiler chickens. A total of 288 broiler chickens were used in a 3 x 2 factorial design with diets based on three varieties of wheat (Apache, Caphorn and Charger), each grown at two N application rates (40 and 170 kg of N/ha). 2. Starch digestion rate was determined by measuring the remaining starch and the mean retention time (MRT) in 4 segments of the small intestine (proximal and distal jejunum and proximal and distal ileum) and in excreta, using chromic oxide as a marker. 3. Varietal differences in starch content (714-746 g starch/kg DM) were smaller than differences caused by crop N fertilisation (705-755 g starch/kg DM). Nitrogen application increased wheat crude protein (CP) content from 94 to 130 g/kg DM. 4. The majority of the ST in all diets was digested by the time the digesta reached the distal ileum (average 0.84 in the distal jejunum and 0.96 in the proximal ileum). 5. Starch digestion differed among wheat cultivars in the proximal jejunum (from 0.43 to 0.57, P < 0.001). Afterwards no differences due to wheat cultivar or N fertilisation were found. 6. Starch digestion rate varied among wheat cultivars (from 2.45 to 3.28 h(-1), P < 0.001), but did not vary with N fertilisation, whereas dietary CP digestion rate was not affected by wheat cultivar or N fertilisation level. The digestion rate of ST was faster than that of CP (average 2.78 vs. 1.53 h(-1)). 7. The current study suggests that wheat cultivars can be classified on their rate of ST digestion independently of the N fertilisation applied to the crop during growth.

Results of a survey about specific inflammatory bowel disease units in Andalusia.

BACKGROUND: Inflammatory bowel disease (IBD) has become one of the most prevalent pathologies in Gastroenterology Units, which added to its clinical outcome, treatment, the complexity of affected patients and the need to be continuously updated for the correct management of the disease, have made essential the presence of specific IBD units in each hospital. OBJECTIVES: The primary aims of this study were: a) to reveal the existence of these units in our area and how they work; and b) to draw conclusions regarding the necessary resources in these units and their aims. MATERIAL AND METHODS: In order to analyse the presence of these specialized units and the available resources in Andalusian hospitals, a 24-question survey was designed, being answered by 11 hospitals. The evaluated questions included the number of days patients are attended and the number of physicians attending the unit, the number of available healthcare assistants, if emergencies are attended or not, if there is an activated telephone number for patient consultation, if a day care unit is available and if new treatments are easily accessible. RESULTS: A specific IBD unit is present in all studied hospitals attending more than 11 patients each, although in the 63.4% of the cases patients are not attended more than 3 days per week. On the other hand, the 81.8% of the included hospitals attend emergencies although only the 54.5% of them had a specific telephone number for patient attendance. CONCLUSIONS: A specific IBD unit is present in many Andalusian hospitals, although some deficiencies can be observed. The general opinion of this Group is that these units are necessary in order to properly attend, monitorize and treat patients affected by IBD.

Resultados de la encuesta sobre consulta monográfica de enfermedad inflamatoria intestinal realizada en Andalucía / Results of a survey about specific inflammatory bowel disease units in Andalusia

Introducción: la enfermedad inflamatoria intestinal (EII) se está convirtiendo en una de las patologías más prevalentes en las consultas de digestivo. Esta mayor prevalencia de la enfermedad, su evolución, tratamiento y el tipo de pacientes cada vez más complejos, junto a la necesidad de conocer las últimas novedades para poder atenderlos correctamente, hace pensar en la necesidad de tener una consulta específica de esta entidad. Objetivos: a) conocer si existen este tipo de consultas en nuestro medio y cómo se desarrollan; y b) elaborar una serie de conclusiones sobre la infraestructura necesaria y los objetivos de la misma. Material y métodos: se ha realizado una encuesta de 24 preguntas en las que se analiza la existencia o no de este tipo de consulta en los hospitales andaluces, así como de los medios con los que cuentan. Han respondido a la misma 11 hospitales. Se analizan cuestiones como el número de días que se pasa la consulta y el número de médicos que las atiende, el personal auxiliar con el que se cuenta, si se atienden urgencias o existe línea telefónica de consultas, y si se dispone de Unidad de Día o acceso a las últimas líneas de tratamiento, entre otras. Resultados: en todos los hospitales encuestados existe consulta monográfica. En todos ellos se ven más de 11 enfermos en cada consulta, si bien, en el 63,6% de los casos esta consulta no se pasa más de 3 días a la semana. Por otro lado, el 81,8% de los hospitales atiende urgencias pero sólo el 54,5% de los encuestados tiene línea telefónica para atender a sus pacientes. Conclusiones: la consulta monográfica de EII está extendida en Andalucía, aunque existen algunas deficiencias en las mismas. Este grupo de trabajo cree que este tipo de consulta es necesaria para la atención, seguimiento y el tratamiento correcto de los pacientes con EII(AU)

Background: inflammatory bowel disease (IBD) has become one of the most prevalent pathologies in Gastroenterology Units, which added to its clinical outcome, treatment, the complexity of affected patients and the need to be continuously updated for the correct management of the disease, have made essential the presence of specific IBD units in each hospital. Objectives: the primary aims of this study were: a) to reveal the existence of these units in our area and how they work; and b) to draw conclusions regarding the necessary resources in these units and their aims. Material and methods: In order to analyse the presence of these specialized units and the available resources in Andalusian hospitals, a 24-question survey was designed, being answered by 11 hospitals. The evaluated questions included the number of days patients are attended and the number of physicians attending the unit, the number of available healthcare assistants, if emergencies are attended or not, if there is an activated telephone number for patient consultation, if a day care unit is available and if new treatments are easily accessible. Results: a specific IBD unit is present in all studied hospitals attending more than 11 patients each, although in the 63.4% of the cases patients are not attended more than 3 days per week. On the other hand, the 81.8% of the included hospitals attend emergencies although only the 54.5% of them had a specific telephone number for patient attendance. Conclusions: a specific IBD unit is present in many Andalusian hospitals, although some deficiencies can be observed. The general opinion of this Group is that these units are necessary in order to properly attend, monitorize and treat patients affected by IBD(AU)

Effect of wheat cultivar and enzyme addition to broiler chicken diets on nutrient digestibility, performance, and apparent metabolizable energy content.

A total of 5,000 one-day-old male broiler chickens were assigned to 8 different treatments in a 4 x 2 factorial design. Four wheat cultivars (Amiro, Guadalupe, Isengrain, and Horzal) and 2 levels (0 or 1 kg/t of feed) of an enzyme cocktail (Avizyme 1300, xylanase, 2,500 U/kg and protease, 800 U/kg) were used. Nutritionally complete mash diets contained 65 and 70% of the test wheat for the starter and grower period, respectively. Test wheats were used in diets for broilers, and growth performance and AME contents were measured. Broiler performance was measured in 4,800 broilers allocated to floor pens with 75 birds each and fed from 1 to 42 d of age. Digestibilities and AME contents of diets were measured in 200 broilers from 6 to 27 d of age individually allocated to battery cages. Chromic oxide (Cr(2)O(3)) at an inclusion rate of 0.5% in the diet was used as an indigestible marker. Apparent metabolizable energy was corrected by zero N balance to obtain AME(n). Wheat cultivar strongly influenced animal performance during the starter period (1 to 21 d of age). During the grower period (21 to 42 d of age), only BW and daily feed intake were influenced by wheat cultivar. Differences in daily feed intake were associated with differences in AME(n) intake during the starter period, but not during the grower period. Nutrient digestibility was higher with the use of enzyme. Animal performance was not affected (i.e., wheat cultivar differences were not eliminated by using enzymes). During the grower period, significant interactions were detected with regard to nutrient digestibility and AME(n). Differences in AME(n) content of wheat could not be explained by digestible starch.

Réplica. El zumo de Tahitian Noni® no es hepatotóxico: nuestros comentarios / No disponible

No disponible

[Velo-cardio-facial syndrome at the psychiatry consulting-liaison service in a general hospital]. / El síndrome velocardiofacial en la interconsulta psiquiátrica en un hospital general.

Psychotic syndromes secondary to genomic disorders have low prevalence and may easily go unnoticed in the daily clinical practice. The velo-cardio-facial syndrome or DiGeorge syndrome (VCFS/DGS) is the genomic disorder most frequently associated to an interstitial deletion of the 22q11 region, with an incidence of one per every 4,000 newborns. Clinical manifestations constitute a constellation of cardiac, facial, urogenital and psychiatric disorders, among which schizophrenia or schizophreniform disorder stand out with an incidence of about 30% over the lifetime. In the following, we present the case of a 21 year old female patient who was admitted to the hematology service of our hospital due to pancytopenia secondary to metimazole, who had non-specified psychiatric background and who received antipsychotic treatment.

El síndrome velocardiofacial en la interconsulta psiquiátrica en un hospital general / Velo-Cardio-Facial syndrome at the psychiatry consulting-liaison service in a general hospital

Los síndromes psicóticos secundarios a alteraciones genómicas tienen una baja prevalencia y pueden pasar fácilmente inadvertidos en la práctica clínica diaria. El síndrome velocardiofacial o síndrome de DiGeorge (SVCF/SDG) es el trastorno genómico más frecuentemente asociado a una deleción intersticial de la región 22q11, con una incidencia de 1 por cada 4.000 recién nacidos. Las manifestaciones clínicas constituyen una pléyade de alteraciones cardíacas, faciales, urogenitales y psiquiátricas, entre las que destaca la esquizofrenia o el trastorno esquizofreniforme con una incidencia de cerca del 30 % a lo largo de la vida. A continuación presentamos el caso de una paciente de 21 años de edad que ingresó en el servicio de hematología de nuestro hospital por una pancitopenia secundaria a metimazol y que presentaba antecedentes psiquiátricos no bien filiados y realizaba tratamiento antipsicótico

Psychotic syndromes secondary to genomic disorders have low prevalence and may easily go unnoticed in the daily clinical practice. The velo-cardio-facial syndrome or DiGeorge syndrome (VCFS/DGS) is the genomic disorder most frequently associated to an interstitial deletion of the 22q11 region, with an incidence of one per every 4,000 newborns. Clinical manifestations constitute a constellation of cardiac, facial, urogenital and psychiatric disorders, among which schizophrenia or schizophreniform disorder stand out with an incidence of about 30 % over the lifetime. In the following, we present the case of a 21 year old female patient who was admitted to the hematology service of our hospital due to pancytopenia secondary to metimazole, who had non-specified psychiatric background and who received antipsychotic treatment

[Influence of climatic factors on the incidence of upper gastrointestinal bleeding]. / Influencia de los factores climáticos en la incidencia de hemorragia digestiva alta.

OBJECTIVES: Several studies have suggested the existence of seasonal variation in the incidence of upper gastrointestinal bleeding (UGB). However, the role of climatic factors has not been elucidated. The aim of the present study was to investigate the role of these factors in the incidence of UGB secondary to esophageal varices (EV), gastric ulcer (GU), and duodenal ulcer (DU). MATERIAL AND METHODS: Based on the use of the Minimum Data Set and the International Classification of Diseases, cases of endoscopically-confirmed UGB secondary to EV, GU and DU were retrospectively included (1998-2001). The incidence of UGB was correlated with daily climatic factors (temperature, atmospheric pressure, humidity, direction and speed of wind) in Jerez de la Frontera (Spain) during the study period. RESULTS: A total of 499 patients were included (GU = 192, DU = 199, EV = 108). No significant differences were found in the monthly or seasonal incidence of UGB. Episodes of UGB were grouped according to the climatic conditions present on the day of admission. No significant relationship was found between UGB and any of the daily climatic factors studied. DISCUSSION: The results of our study do not support the existence of a seasonal pattern in the incidence of UGB secondary to GU, DU or EV and allow us to conclude that, in our geographical area, these factors are not involved in episodes of bleeding.

Influencia de los factores climáticos en la incidencia de hemorragia digestiva alta / Influence of climatic factors on the incidence of upper gastrointestinal bleeding

Objetivos: La presencia de un patrón estacional en la incidencia de hemorragia digestiva alta (HDA) ha sido sugerida en numerosos trabajos, pero la implicación de factores climáticos aún no ha podido ser aclarada. Nuestro objetivo fue investigar el papel de estos factores en la incidencia de HDA secundaria a varices esofágicas (VE), úlcera gástrica (UG) y úlcera duodenal (UD). Material y métodos: Se incluyeron de forma retrospectiva (1998-2001) los casos de hemorragia digestiva alta comprobada endoscópicamente y secundaria a VE, UG y UD, mediante el empleo del Conjunto Mínimo Básico de Datos al Alta y la Clasificación Internacional de Enfermedades. Se correlacionó su incidencia con los factores climáticos diarios (temperatura, presión atmosférica, humedad, dirección y velocidad del viento) presentes en nuestra ciudad durante el período de estudio. Resultados: Se incluyeron 499 pacientes (UG, 192; UD, 199; VE, 108). No se constataron diferencias significativas en la incidencia mensual o estacional de la HDA. Los episodios de HDA fueron agrupados según las características climáticas presentes el día del ingreso. La correlación realizada entre los episodios de HDA y cada uno de los factores climáticos diarios estudiados no puso de manifiesto una asociación estadísticamente significativa. Discusión: Nuestro trabajo no apoya la existencia de un determinado patrón estacional en la incidencia de HDA secundaria a úlceras gastroduodenales o varices esofágicas y nos permite afirmar que, en nuestra área geográfica, los factores climáticos no están implicados en modo alguno con la aparición de los episodios de sangrado

Objectives: Several studies have suggested the existence of seasonal variation in the incidence of upper gastrointestinal bleeding (UGB). However, the role of climatic factors has not been elucidated. The aim of the present study was to investigate the role of these factors in the incidence of UGB secondary to esophageal varices (EV), gastric ulcer (GU), and duodenal ulcer (DU). Material and methods: Based on the use of the Minimum Data Set and the International Classification of Diseases, cases of endoscopically-confirmed UGB secondary to EV, GU and DU were retrospectively included (1998-2001). The incidence of UGB was correlated with daily climatic factors (temperature, atmospheric pressure, humidity, direction and speed of wind) in Jerez de la Frontera (Spain) during the study period. Results: A total of 499 patients were included (GU = 192, DU = 199, EV = 108). No significant differences were found in the monthly or seasonal incidence of UGB. Episodes of UGB were grouped according to the climatic conditions present on the day of admission. No significant relationship was found between UGB and any of the daily climatic factors studied. Discussion: The results of our study do not support the existence of a seasonal pattern in the incidence of UGB secondary to GU, DU or EV and allow us to conclude that, in our geographical area, these factors are not involved in episodes of bleeding

Anxiety during the performance of colonoscopies: modification using music therapy.

BACKGROUND AND STUDY AIMS: Colonoscopies are usually performed using pharmacological sedation. This process entails certain risks. In the search for alternative methods, some studies have analysed the effect music can have on patients during the procedure when used as a complement to sedation. We present a prospective, randomized study in which we assess the anxiolytic action music has when it is administered during a single colonoscopy. PATIENTS AND METHODS: We included 118 patients who were scheduled for ambulatory colonoscopies. They were randomly assigned to the control group (n = 55) and the experimental group (n = 63). We determined their levels of anxiety using the State-Trait Anxiety Inventory Test (STAI) form, which they filled in before and after the examination. Patients listened to music through personal headphones. RESULTS: The score on the STAI form before the examination was 25.25 +/- 10.49 and 28.16 +/- 11.43 in the control and experimental groups, respectively (P > 0.05). The decrease of the score on the STAI scale after the colonoscopy in the control and experimental groups was 6.27 (95% confidence interval, 3.26-9.28) and 11.35 (95% confidence interval, 8.64-14.05), respectively (P < 0.01). CONCLUSIONS: Listening to music during ambulatory colonoscopies decreases the level of anxiety that is inherent to the process without other anxiolytic methods.

Seis años de estudio: 537 hernioplastias inguinales libres de tensión / Six years of study: 537 tension-free inguinal hernioplasties

Se presentan los resultados con la técnica Lichtenstein para reparación de hernias inguinales, realizadas en 502 pacientes del hospital Dipreca. La serie está constituida por 454 hombres y 48 mujeres, con una edad promedio de 54,3 años (14 a 89 años). La ubicación fue derecha en 263 pacientes (52,4 por ciento), izquierda en 240 (47,8 por ciento). Del total de hernias, 475 hernias fueron primarias (88,5 por ciento) y 62 (11,5 por ciento) fueron recidivadas. El tamaño del defecto herniario se protocolizó, en tres grupos: ôAõ, hasta 2 cm, (35,6 por ciento); ôBõ, de 2 a 4 cm, (42,3 por ciento) y ôCõ, mayor de 4 cm, (22,1 por ciento). Los resultados fueron: complicaciones postoperatorias (8,6 por ciento). Hubo 6 recidivas, con una tasa global de 1,1 por ciento 0,4 por ciento para las primarias y 6,5 por ciento para las recidivadas. En un 9,6 por ciento se asocio una segunda cirugía. No hubo mortalidad.