Dysphagia in hospitalized patients: Prevalence, related factors and impact on aspiration pneumonia and mortality.

BACKGROUND: Oropharyngeal dysphagia can be highly concerning in hospitalized patients, increasing morbidity and mortality, making its early identification essential. We aimed to characterize dysphagia and its association with aspiration pneumonia and mortality in a tertiary hospital in Barcelona, Spain. METHODS: Using data from all hospital discharges during the period 2018-2021, we identified the characteristics of patients with dysphagia and their distribution among hospital departments through the minimum data set, which codifies patients' diagnoses according to the International Classification of Diseases 10th Revision (ICD-10). We used logistic regression models to assess the association between dysphagia, aspiration pneumonia and mortality. RESULTS: Dysphagia was present in 2.4% of all hospital discharges and was more frequent in older patients and in men. The diagnoses most frequently associated with dysphagia were aspiration pneumonia (48.2%) and stroke (14%). Higher prevalence of dysphagia was found in the acute geriatric unit (10.3%), neurology (7.6%) and internal medicine (7.5%) wards. Dysphagia was associated with aspiration pneumonia, aOR = 8.04 (95%CI, 6.31-10.25), and independently increased the odds of death among hospitalized patients, aOR = 1.43 (95%CI, 1.19-1.73). CONCLUSIONS: We conclude that dysphagia is a prevalent and transversal condition, increasing the risk of mortality in all patients, and efforts should be intensified to increase its early detection and correct management.

Impact of the COVID-19 pandemic on breast cancer screening indicators in a Spanish population-based program: a cohort study.

Background: To assess the effect of the COVID-19 pandemic on performance indicators in the population-based breast cancer screening program of Parc de Salut Mar (PSMAR), Barcelona, Spain. Methods: We conducted a before-and-after, study to evaluate participation, recall, false positives, the cancer detection rate, and cancer characteristics in our screening population from March 2020 to March 2021 compared with the four previous rounds (2012-2019). Using multilevel logistic regression models, we estimated the adjusted odds ratios (aORs) of each of the performance indicators for the COVID-19 period, controlling by type of screening (prevalent or incident), socioeconomic index, family history of breast cancer, and menopausal status. We analyzed 144,779 invitations from 47,571women. Results: During the COVID-19 period, the odds of participation were lower in first-time invitees (aOR = 0.90 [95% CI = 0.84-0.96]) and in those who had previously participated regularly and irregularly (aOR = 0.63 [95% CI = 0.59-0.67] and aOR = 0.95 [95% CI = 0.86-1.05], respectively). Participation showed a modest increase in women not attending any of the previous rounds (aOR = 1.10 [95% CI = 1.01-1.20]). The recall rate decreased in both prevalent and incident screening (aOR = 0.74 [95% CI = 0.56-0.99] and aOR = 0.80 [95% CI = 0.68-0.95], respectively). False positives also decreased in both groups (prevalent aOR = 0.92 [95% CI = 0.66-1.28] and incident aOR = 0.72 [95% CI = 0.59-0.88]). No significant differences were observed in compliance with recall (OR = 1.26, 95% CI = 0.76-2.23), cancer detection rate (aOR = 0.91 [95% CI = 0.69-1.18]), or cancer stages. Conclusions: The COVID-19 pandemic negatively affected screening attendance, especially in previous participants and newcomers. We found a reduction in recall and false positives and no marked differences in cancer detection, indicating the robustness of the program. There is a need for further evaluations of interval cancers and potential diagnostic delays. Funding: This study has received funding by grants PI19/00007 and PI21/00058, funded by Instituto de Salud Carlos III (ISCIII) and cofunded by the European Union and Grant RD21/0016/0020 funded by Instituto de Salud Carlos III and by the European Union NextGenerationEU, Mecanismo para la Recuperación y la Resiliencia (MRR).

Quenching the Chiral Magnetic Effect via the Gravitational Anomaly and Holography.

In the presence of a gravitational contribution to the chiral anomaly, the chiral magnetic effect induces an energy current proportional to the square of the temperature in equilibrium. In holography the thermal state corresponds to a black hole. We numerically study holographic quenches in which a planar shell of scalar matter falls into a black hole and raises its temperature. During the process the momentum density (energy current) is conserved. The energy current has two components, a nondissipative one induced by the anomaly and a dissipative flow component. The dissipative component can be measured via the drag it asserts on an additional auxiliary color charge. Our results indicate strong suppression very far from equilibrium.

Litiasis coledociana: tratamiento por vía laparoscópica / Ductal biliary stones: laparoscopic treatment

Entre el 10-IV-1991 y el 10-X-1992 fueron practicadas 250 colecistectomías por vía laparoscópica. En tres pacientes (1.2%) se efectuó además por la misma vía, luego de colangiografía transcística, coledocotomía, extracción de cálculos, exploración de las vía biliar principal y colecodrenaje, repitiendo maniobras semejantes a las realizadas en cirugía convencional. El tiempo operatorio más prolongado fue de 120 minutos. Se describe la técnica quirúrgica utilizada. No se observaron complicaciones inherentes al método. Los resultados de esta experiencia inicial señalan un promisorio futuro. Mediante un video se documenta el procedimiento

Litiasis coledociana: tratamiento por vía laparoscópica / Ductal biliary stones: laparoscopic treatment

Entre el 10-IV-1991 y el 10-X-1992 fueron practicadas 250 colecistectomías por vía laparoscópica. En tres pacientes (1.2%) se efectuó además por la misma vía, luego de colangiografía transcística, coledocotomía, extracción de cálculos, exploración de las vía biliar principal y colecodrenaje, repitiendo maniobras semejantes a las realizadas en cirugía convencional. El tiempo operatorio más prolongado fue de 120 minutos. Se describe la técnica quirúrgica utilizada. No se observaron complicaciones inherentes al método. Los resultados de esta experiencia inicial señalan un promisorio futuro. Mediante un video se documenta el procedimiento