Factores psicológicos en mujeres que padecen pelvialgia crónica grave operadas por laparoscopia o laparotomía / Psychological factors in women with severe chronic pelvic pain undergoing open or laparoscopic surgery

Propósito del trabajo Analizar la importancia del factor psicológico, entendido como niveles de ansiedad y depresión, en mujeres que padecen dolor pélvico crónico y discutir la posible relación que existe entre estos factores psicológicos y la permanencia del dolor posquirúrgico. Material y métodos Se estudió a un grupo de 41 mujeres que padecían dolor pélvico crónico durante más de 6 meses y a las cuales se les realizó como método diagnóstico-terapéutico laparoscopia o laparotomía. Los resultados fueron comparados con el grupo control constituido por 86 mujeres que acudían a consulta para ligadura tubárica bilateral quirúrgica. Estas pacientes fueron entrevistadas previamente a la cirugía para evaluar sus niveles de depresión mediante el test de Beck y de ansiedad mediante la escala de STAI. Tras la cirugía, se evaluó la permanencia del dolor mediante una encuesta telefónica. Resultados Las pacientes del grupo algia pélvica mostraron unos mayores niveles de depresión y de ansiedad estado respecto al grupo control sin diferencias significativas en cuanto a la ansiedad rasgo. Un alto porcentaje de pacientes del grupo algia pélvica permanece con dolor poscirugía en comparación con el grupo control cuando se las entrevista a los 3 meses de la intervención. Conclusión Las mujeres con dolor pélvico de más de 6 meses de duración ven afectada su calidad de vida por un aumento en los niveles de depresión y ansiedad estado, lo que podría influir en la permanencia del dolor tras la eliminación de la causa ginecológica que supuestamente lo provoca, hasta 3 meses pasada la cirugía

Purpose To analyze the importance of psychological factors, understood as levels of anxiety and depression, among women with chronic pelvic pain and to evaluate the possibility of a relationship between these psychological factors and the persistence of pain after surgery. Material and methods We studied 41 women with chronic pelvic pain for more than 6 months who had undergone laparoscopy or laparotomy as a diagnostic-therapeutic method. The results in these women were compared with those in a control group of 86 women attending the clinic for bilateral tubal ligation. These patients were interviewed before surgery to evaluate their depression and anxiety levels using the Beck test and the STAI scale. The persistence of pain after surgery was assessed through a telephone survey. Results Levels of depression and anxiety were higher in the chronic pelvic pain group than in the control group but no differences were found in the trait anxiety variable. When interviews were carried out 3 months after surgery, the percentage of patients who continued to have postoperative pain was significantly higher in the chronic pelvic pain group than in the control group. Conclusion Quality of life is impaired in women experiencing pelvic pain for more than 6 months, due to increased levels of depression and state anxiety. Persistence of pain 3 months after surgery, despite elimination of its apparent gynecological cause, could be influenced by anxiety and depression

[Osmolarity and arginine-vasopressin in children born after acute fetal-neonatal distress]. / Control osmolar y arginina vasopresina en niños nacidos después de un sufrimiento fetoneonatal agudo.

A study of urinary osmolarities and plasmatic level of arginine-vasopressin (AVP) 48 hours after birth in a group of 70 newborns (30 of which are normal and 40 of which have acute perinatal hypoxia), selected according to previously established criteria is carried out. An evolutionary study of urinary osmolarities of newborns with acute perinatal hypoxia, osmolar index and its relation to plasmatic levels of AVP during the first week of life is also considered. AVP 48 hours after birth was blatantly more elevated among those newborns who had shown acidosis at birth (p less than 0.001) which correlated significantly with urinary osmolarity, although it showed low figures (p less than 0.05). This same correlation (p less than 0.001 and p less than 0.05) appears with osmolar index and urinary osmolarity on successive days, but it is important to point out that vasopressin decreased to base values at the end of the first week of life while osmolarities in urine increased. Conclusions are: 1) AVP is higher after 48 hours of life among those newborns with acute perinatal hypoxia and decreases progressively during the first week of life, being comparable to values obtained from normally born children 48 hours after birth at the eight day of life. 2) Renal response to this hormone is slight during the first days of life.