The synthetic molecule stauprimide impairs cell growth and migration in triple-negative breast cancer.

Stauprimide, a semi-synthetic derivative of staurosporine, is known mainly for its potent differentiation-enhancing properties in embryonic stem cells. Here, we studied the effects of stauprimide in cell growth and migration of triple-negative breast cancer cells in vitro, evaluating its potential antitumoral activity in an orthotopic mouse model of breast cancer in vivo. Our results from survival curves, EdU incorporation, cell cycle analysis and annexin-V detection in MDA-MB-231 cells indicated that stauprimide inhibited cell proliferation, arresting cell cycle in G2/M without induction of apoptosis. A decrease in the migratory capability of MDA-MB-231 was also assessed in response to stauprimide. In this work we pointed to a mechanism of action of stauprimide involving the modulation of ERK1/2, Akt and p38 MAPK signalling pathways, and the downregulation of MYC in MDA-MB-231 cells. In addition, orthotopic MDA-MB-231 xenograft and 4T1 syngeneic models suggested an effect of stauprimide in vivo, increasing the necrotic core of tumors and reducing metastasis in lung and liver of mice. Together, our results point to the promising role of stauprimide as a putative therapeutic agent in triple-negative breast cancer.

Severe smallness as predictor of adverse perinatal outcome in suspected late small-for-gestational-age fetuses: systematic review and meta-analysis.

OBJECTIVE: To investigate the performance of severe smallness in the prediction of adverse perinatal outcome among fetuses with suspected late-onset small-for-gestational age (SGA). METHODS: A systematic search was performed to identify relevant studies in PubMed, Web of Science and Scopus. Late-onset SGA was defined as estimated fetal weight (EFW) or abdominal circumference (AC) < 10th percentile diagnosed at or after 32 weeks' gestation, while severe SGA was defined as EFW or AC < 3rd percentile or < 2 SD. Random-effects modeling was used to generate hierarchical summary receiver-operating-characteristics (HSROC) curves. The performance of severe SGA (as a presumptive diagnosis) in predicting adverse perinatal outcome among singleton pregnancies with suspected late-onset SGA was expressed as area under the HSROC curve (AUC), sensitivity, specificity and positive/negative likelihood ratios. The association between suspected severe SGA and adverse perinatal outcome was also assessed by random-effects modeling using the Mantel-Haenszel method and presented as odds ratio (OR). The non-exposed group was defined as non-severe SGA (EFW ≥ 3rd centile). RESULTS: Twelve cohort studies were included in this systematic review and meta-analysis. The studies included a total of 3639 fetuses with suspected late-onset SGA, of which 1246 had suspected severe SGA. Significant associations were found between suspected severe SGA and composite adverse perinatal outcome (OR, 1.97 (95% CI, 1.33-2.92)), neonatal intensive care unit admission (OR, 2.87 (95% CI, 1.84-4.47)) and perinatal death (OR, 4.26 (95% CI, 1.07-16.93)). However, summary ROC curves showed limited performance of suspected severe SGA in predicting perinatal outcomes, with AUCs of 60.9%, 66.9%, 53.6%, 57.2%, 54.6% and 64.9% for composite adverse perinatal outcome, neonatal intensive care unit admission, neonatal acidosis, Cesarean section for intrapartum fetal compromise, low Apgar score and perinatal death, respectively. CONCLUSION: Although suspected severe SGA was associated with a higher risk of perinatal complications, it performed poorly as a standalone parameter in predicting adverse perinatal outcome. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

Istmocele y fertilidad: revisión de la literatura a propósito de un caso / Isthmocele and fertility: A case report and review of the literature

Una de las complicaciones que puede derivarse de una cesárea es el istmocele. En muchos casos este será asintomático y puede pasar desapercibido, pero en ocasiones da lugar a sintomatología, como por ejemplo sangrado uterino anómalo, infertilidad secundaria, o bien problemas en un futuro embarazo, como acretismo placentario o rotura uterina. Existe a día de hoy mucha controversia sobre el diagnóstico de esta entidad y su posible tratamiento. La motivación de este estudio es presentar una breve revisión de la literatura a raíz de un caso clínico sobre una paciente con istmocele e infertilidad secundaria.(AU)

One of the complications that can result from a caesarean section is isthmocele. In many cases, it will be asymptomatic and can go unnoticed, but sometimes it leads to symptoms such as abnormal uterine bleeding, secondary infertility, or problems in a future pregnancy such as placental accreta or uterine rupture. There is currently much controversy about the diagnosis of this entity and its possible treatment. The aim of the present study is to present a brief review of the literature based on a case report of a patient with isthmocele and secondary infertility.(AU)

¿Son las alteraciones en la mucosa oral un signo de COVID-19? Estudio transversal en un Hospital de Campaña / Are Oral Mucosal Changes a Sign of COVID-19? A Cross-Sectional Study at a Field Hospital

Introducción La enfermedad por coronavirus-19 (COVID-19) se ha relacionado con múltiples síntomas: respiratorios, trombóticos, neurológicos, digestivos o cutáneos. Estos últimos se han clasificado en 5 tipos: lesiones acroisquémicas, lesiones vesiculares, erupción urticarial, exantema maculopapular o lesiones livedoides. Sin embargo, se han descrito mucho menos las alteraciones orales asociadas a la COVID-19. Pacientes y métodos Presentamos un estudio transversal realizado durante abril del 2020 en el Hospital de Campaña de IFEMA examinando la mucosa oral de 666 pacientes con COVID-19. Resultados En total, 78 pacientes (11,7%) presentaron alteraciones en la mucosa oral. La más frecuente fue papilitis lingual transitoria anterior en forma de U (11,5%) asociada o no a edema lingual (6,6%); estomatitis aftosa (6,9%), mucositis (3,9%) glositis con depapilación en parches (3,9%), boca urente (5,3%), lengua saburral (1,6%) y enantema (0,5%). La mayoría refería disgeusia asociada. Conclusión La cavidad oral se puede alterar por la enfermedad COVID-19, el edema lingual con papilitis lingual transitoria en forma de U o la glositis con depapilación en parches son los signos encontrados con mayor frecuencia, al igual que la sensación de ardor en la cavidad oral o boca urente. Otras manifestaciones orales que se pueden asociar a la COVID-19 son mucositis con o sin aftas o el enantema. Todos pueden ser signos clave para un diagnóstico de esta enfermedad (AU)

Background Coronavirus disease 19 (COVID-19) has many manifestations, including respiratory, thrombotic, neurologic, digestive, and cutaneous ones. Cutaneous manifestations have been classified into 5 clinical patterns: acro-ischemic (pseudo-chilblain), vesicular, urticarial, maculopapular, and livedoid. Oral manifestations have also been reported, but much less frequently. Patients and methods We performed a cross-sectional study in which we examined the oral mucosa of 666 patients with COVID-19 at the IFEMA field hospital in Madrid in April 2020. Results Seventy-eight patients (11.7%) had changes involving the oral mucosa. The most common were transient anterior U-shaped lingual papillitis (11.5%) accompanied or not by tongue swelling (6.6%), aphthous stomatitis (6.9%), a burning sensation in the mouth (5.3%), mucositis (3.9%), glossitis with patchy depapillation (3.9%), white tongue (1.6%), and enanthema (0.5%). Most of the patients also reported taste disturbances. Conclusion COVID-19 also manifests in the oral cavity. The most common manifestations are transient U-shaped lingual papillitis, glossitis with patchy depapillation, and burning mouth syndrome. Mucositis with or without aphthous ulcers or enanthema may also be observed. Any these findings may be key clues to a diagnosis of COVID-19 (AU)

Are Oral Mucosal Changes a Sign of COVID-19? A Cross-Sectional Study at a Field Hospital. / ¿Son las alteraciones en la mucosa oral un signo de COVID-19? Estudio transversal en un Hospital de Campaña.

BACKGROUND: Coronavirus disease 19 (COVID-19) has many manifestations, including respiratory, thrombotic, neurologic, digestive, and cutaneous ones. Cutaneous manifestations have been classified into 5 clinical patterns: acro-ischemic (pseudo-chilblain), vesicular, urticarial, maculopapular, and livedoid. Oral manifestations have also been reported, but much less frequently. PATIENTS AND METHODS: We performed a cross-sectional study in which we examined the oral mucosa of 666 patients with COVID-19 at the IFEMA field hospital in Madrid in April 2020. RESULTS: Seventy-eight patients (11.7%) had changes involving the oral mucosa. The most common were transient anterior U-shaped lingual papillitis (11.5%) accompanied or not by tongue swelling (6.6%), aphthous stomatitis (6.9%), a burning sensation in the mouth (5.3%), mucositis (3.9%), glossitis with patchy depapillation (3.9%), white tongue (1.6%), and enanthema (0.5%). Most of the patients also reported taste disturbances. CONCLUSION: COVID-19 also manifests in the oral cavity. The most common manifestations are transient U-shaped lingual papillitis, glossitis with patchy depapillation, and burning mouth syndrome. Mucositis with or without aphthous ulcers or enanthema may also be observed. Any these findings may be key clues to a diagnosis of COVID-19.

Doppler changes in umbilical artery, middle cerebral artery, cerebroplacental ratio and ductus venosus during open fetal microneurosurgery for intrauterine open spina bifida repair.

OBJECTIVE: To describe changes in fetal Doppler parameters during a novel technique for open fetal microneurosurgery for open spina bifida (OSB) repair. METHODS: This was a prospective study of 44 fetuses undergoing open fetal surgery for OSB repair using a novel microneurosurgery approach that is characterized by a mini-hysterotomy (diameter of 15 mm), minimal fetal manipulation and maintenance of a constant normal amniotic fluid volume throughout the procedure. Doppler velocimetry of the umbilical artery (UA), fetal middle cerebral artery (MCA) and ductus venosus (DV) was performed before the start of surgery and at prespecified timepoints during fetal surgery. UA pulsatility index (PI) > 95th percentile, DV-PI > 95th percentile, MCA-PI < 5th percentile and cerebroplacental ratio (CPR) < 5th percentile were considered abnormal. RESULTS: Median gestational age at fetal surgery was 25.2 weeks (range, 22.9-27.9 weeks). Doppler recordings were successfully obtained in all cases during all timepoints throughout the surgery. As compared with Doppler values before surgery, there was a significant increase in the proportion of fetuses with MCA-PI < 5th percentile (63.6% vs 13.6%; P < 0.001), CPR < 5th percentile (65.9% vs 15.9%; P < 0.001) and DV-PI > 95th percentile (22.7% vs 0%; P = 0.01) and a non-significant increase in the proportion of fetuses with UA-PI > 95th percentile (11.4% vs 0%; P = 0.12) during fetal surgery. None of the fetuses showed absent or reversed end-diastolic velocity in the UA or absent or reversed DV a-wave at any stage during OSB repair. All abnormal Doppler parameters returned to normal after surgery. CONCLUSIONS: During open fetal surgery for OSB repair, a small hysterotomy, reduced fetal manipulation and maintenance of a normal amniotic fluid volume seem to prevent severe fetal Doppler abnormalities. The mild Doppler changes observed during fetal surgery could be a manifestation of fetal adaptation to the stress of fetal surgery. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.

[The next psychoactive drugs: From imipramine to ketamine]. / Psychotropes du futur : de l'imipramine à la kétamine.

Since the 1950s, the therapeutic arsenal against depression has grown considerably. From the discovery of monoamine oxidase inhibitors (MAOI) to the antidepressant effect of ketamine, these pharmacological breakthroughs made the history of psychiatry. They also guided the research about the pathophysiology of depression, one of the most devasting diseases, which affects between 10 and 20 % of general population. In this article, we offer a short historical review of the various therapeutic options developed over the past century and the consequences of these innovations. We then review the most recent one, ketamine (and its enantiomer S, esketamine). Ketamine's effects are spectacular both in terms of their very short onset time, and because they are observed even in treatment-resistant depression. Just as MAOIs and tricyclic antidepressants allowed the "monoaminergic hypothesis of depression" to emerge, to unravel the mechanisms of ketamine's antidepressant effects should allow the understanding of the role of glutamatergic system, or that of neuro-inflammation, in the neurobiology of depression. Ketamine might also help to refine our understanding of the cognitive pathophysiology of depression, or even to deeply transform the clinical representations about what depression is.

Olfactory conditioned same-sex partner preference in female rats: Role of ovarian hormones.

The dopamine D2-type receptor agonist quinpirole (QNP) facilitates the development of conditioned same-sex partner preference in males during cohabitation, but not in ovariectomized (OVX) females, primed with estradiol benzoate (EB) and progesterone (P). Herein we tested the effects of QNP on OVX, EB-only primed females. Females received a systemic injection (every four days) of either saline (Saline-conditioned) or QNP (QNP-conditioned) and then cohabited for 24h with lemon-scented stimulus females (CS+), during three trials. In test 1 (female-female) preference was QNP-free, and females chose between the CS+ female and a novel female. In test 2 (male-female) they chose between the CS+ female and a sexually experienced male. In test 1 Saline-conditioned females displayed more hops & darts towards the novel female, but QNP-conditioned females displayed more sexual solicitations towards the CS+ female. In test 2 Saline-conditioned females displayed a clear preference for the male, whereas QNP-conditioned females displayed what we considered a bisexual preference. We discuss the effect of dopamine and ovarian hormones on the development of olfactory conditioned same-sex preference in females.

Vulnerability of mixotrophic algae to nutrient pulses and UVR in an oligotrophic Southern and Northern Hemisphere lake.

Nutrient inputs and ultraviolet radiation (UVR) are global factors affecting the structure and functioning of aquatic ecosystems, particularly clear-water ecosystems. We performed experiments in two model lakes highly exposed to UVR fluxes in order to test the effect that future increases in mineral nutrients transported by dust aerosol might exert on primary producers depending on the likelihood of atmospheric inputs. Lake La Caldera (Northern Hemisphere) has been receiving recurrent dust inputs from the Sahara Desert while lake Los Cántaros (Southern Hemisphere) has been less affected by dust aerosol. UVR × Nutrient synergistically stimulated primary production (PP), chlorophyll a (Chl a), with a smaller increase in phytoplanktonic biomass in La Caldera, but not in Los Cántaros, where nutrient addition unmasked the UVR inhibitory effect on phytoplankton. The proportional decrease of mixotrophic nanoflagellates (MNFs) after the nutrient pulse (in Los Cántaros) and the long-term decline of MNFs in La Caldera associated with the increase in aerosol-dust intrusions from the Sahara during the last 40 years suggest that a future scenario of intensified aerosol events from desert and desertified areas would not only reduce functional diversity with the decline of MNFs, but would ultimately alter the C flux towards the grazing chain in oligotrophic ecosystems.

Evidencias del uso de la musicoterapia y la memoria del adulto mayor / Evidence of the use of music theraphy and memory of the elderly

Con el avance del envejecimiento se observa undecline parcial de las funciones cognitivas, aunqueno es un hecho generalizado, un porcentajerelativamente alto de personas experimentan cambioscognitivos, principalmente problemas de memoria.En los últimos años, la musicoterapia ha ganado unmayor reconocimiento dentro de las intervencionesno farmacológicas. En el campo de la geriatría lamusicoterapia es capaz de modular factores dela cognición implicando diversas funciones cognitivas.El objetivo de la presente revisión es examinar lasevidencias del uso de la musicoterapia para elfortalecimiento de la memoria en la población adultamayor. Como resultado de la presente revisión seencontró que la musicoterapia ha sido utilizada envarias ocasiones como terapéutica complementariaen adultos mayores, sobre todo en aquellos quepresentan algún tipo de alteración cognitiva relevante,los efectos reportados sugieren mejoría en la funcióncognitiva de la memoria. Sin embargo, hace faltaevidencia de esta intervención en adultos mayoressanos cognitivamente

Bloqueo anestésico de nervios pericraneales como tratamiento preventivo de migraña: experiencia en una serie de 60 pacientes / Pericranial nerve blockade as a preventive treatment for migraine: Experience in 60 patients

Introducción: El bloqueo anestésico de nervios pericraneales es utilizado con frecuencia en el tratamiento de diferentes cefaleas. No hay evidencia acerca de su indicación en pacientes migrañosos. Pretendemos evaluar su eficacia como tratamiento preventivo de migraña con criterios determinados. Métodos: Entre enero del 2009 y mayo del 2013 se ofreció este tratamiento a migrañosos con fracaso o intolerancia de fármacos preventivos. Seleccionamos a aquellos con sensibilidad a la palpación en al menos un nervio supraorbitario u occipital mayor. A los 3 meses, consideramos la respuesta completa (sin dolor), parcial (reducción al menos de un 50% en severidad y/o frecuencia de episodios) o ausente. Resultados: Se practicó un bloqueo anestésico en 60 pacientes (52 mujeres, 8 varones, edad media ± desviación estándar: 40,6 ± 12,4 años, rango 19-76). El procedimiento más habitual fue el bloqueo de ambos nervios occipitales y supraorbitarios. Hubo respuesta completa de al menos 2 semanas en 23 (38,3%), parcial en 24 (40%) y ausente en 13 (21,7%). En el grupo con respuesta completa, la edad y el tiempo de evolución de la migraña eran significativamente inferiores. Sin efectos adversos significativos. Tiempo de respuesta entre 2 semanas y 3 meses. Conclusiones: El bloqueo anestésico de nervios pericraneales utilizando la sensibilidad a la palpación como criterio de selección es un procedimiento seguro y potencialmente eficaz como tratamiento preventivo de migraña. Las mayores respuestas en nuestra serie se observan en pacientes jóvenes con menos tiempo de evolución de la migraña

Introduction: Anaesthetic blockade of pericranial nerves is frequently used to treat headache disorders. There is no evidence on indication of this treatment for migraine. We aim to evaluate its effectiveness as a preventive treatment for migraine using specific indication criteria. Methods: Between January 2009 and May 2013 we offered pericranial nerve blockade to migraine patients with a history of preventive drug intolerance or failure. We selected patients with tenderness to palpation of at least one greater occipital nerve (GON) or supraorbital nerve (SON). Responses at 3 months were categorised as complete response (no pain), partial response (reduction of at least 50% in severity or frequency of headache episodes), or no response. Results: Anaesthetic blockade was performed in 60 patients (52 females, 8 males; mean age 40.6 ± 12.4 years, range 19-76). The most common procedure was blockade of GON and SON on both sides. Complete response lasting at least 2 weeks was recorded in 23 patients (38.3%), with partial response in 24 patients (40%), and no response in 13 (21.7%). In the group presenting complete response, age and length of history of migraine were significantly lower. No severe side effects were detected. Response time ranged from 2 weeks to 3 months. Conclusions: Pericranial nerves blockade using tenderness to palpation as an inclusion criterion is safe and potentially effective as prophylactic treatment for migraine. The best responses in our series were observed in younger patients with shorter histories of migraine

Pericranial nerve blockade as a preventive treatment for migraine: Experience in 60 patients. / Bloqueo anestésico de nervios pericraneales como tratamiento preventivo de migraña: experiencia en una serie de 60 pacientes.

INTRODUCTION: Anaesthetic blockade of pericranial nerves is frequently used to treat headache disorders. There is no evidence on indication of this treatment for migraine. We aim to evaluate its effectiveness as a preventive treatment for migraine using specific indication criteria. METHODS: Between January 2009 and May 2013 we offered pericranial nerve blockade to migraine patients with a history of preventive drug intolerance or failure. We selected patients with tenderness to palpation of at least one greater occipital nerve (GON) or supraorbital nerve (SON). Responses at 3 months were categorised as complete response (no pain), partial response (reduction of at least 50% in severity or frequency of headache episodes), or no response. RESULTS: Anaesthetic blockade was performed in 60 patients (52 females, 8 males; mean age 40.6 ± 12.4 years, range 19-76). The most common procedure was blockade of GON and SON on both sides. Complete response lasting at least 2 weeks was recorded in 23 patients (38.3%), with partial response in 24 patients (40%), and no response in 13 (21.7%). In the group presenting complete response, age and length of history of migraine were significantly lower. No severe side effects were detected. Response time ranged from 2 weeks to 3 months. CONCLUSIONS: Pericranial nerves blockade using tenderness to palpation as an inclusion criterion is safe and potentially effective as prophylactic treatment for migraine. The best responses in our series were observed in younger patients with shorter histories of migraine.

Quantitative nanoscale electrostatics of viruses.

Electrostatics is one of the fundamental driving forces of the interaction between biomolecules in solution. In particular, the recognition events between viruses and host cells are dominated by both specific and non-specific interactions and the electric charge of viral particles determines the electrostatic force component of the latter. Here we probe the charge of individual viruses in liquid milieu by measuring the electrostatic force between a viral particle and the Atomic Force Microscope tip. The force spectroscopy data of co-adsorbed ϕ29 bacteriophage proheads and mature virions, adenovirus and minute virus of mice capsids is utilized for obtaining the corresponding density of charge for each virus. The systematic differences of the density of charge between the viral particles are consistent with the theoretical predictions obtained from X-ray structural data. Our results show that the density of charge is a distinguishing characteristic of each virus, depending crucially on the nature of the viral capsid and the presence/absence of the genetic material.

Ansiedad en el postoperatorio de CMA / Postoperative anxiety in Day Surgery

La ansiedad es un estado anímico desagradable que incluye componentes fisiológicos, psíquicos y conductuales. Se ha demostrado que una buena información preoperatoria disminuye la ansiedad pre y postoperatoria. Las hipótesis que pretendemos verificar son diversas y se centran en los factores del entorno sociodemográfico del paciente, estado del mismo en el preoperatorio de CMA, aspectos relacionados con la información recibida en el preoperatorio y qué influencia tienen en la ansiedad en el postoperatorio inmediato de CMA. Los resultados indican que aunque un 25 % mostró ansiedad en el postoperatorio inmediato, estos presentan valores modales (4) y promedio bajos (5,22). Un 62,5 % de los pacientes de origen extranjero presentaron un nivel de ansiedad igual o superior a 4 mientras que solo el 20,99 % de los pacientes españoles lo presentaron. No se han observado diferencias significativas entre sexos en aquellos pacientes que presentaron ansiedad, a pesar de que globalmente las mujeres presentan un valor promedio de escala de Goldberg algo mayor. Aunque no se ha obtenido una relación significativa entre el nivel de información del paciente y el valor obtenido en la escala de Goldberg, sí que se observa una tendencia a una mayor dispersión en los valores de Escala de Goldberg en los pacientes que dicen haber recibido una menor información (AU)

Anxiety is an unpleasant mood including physiological, psychological and behavioral components. It has been shown that a good preoperative information decreases pre- and postoperative anxiety. We intend to verify the hypotheses are diverse and focus on socio-demographic factors patient environment, state of the same in the preoperative CMA aspects of information received in the preoperative and what influence they have in the immediate postoperative anxiety CMA. The results indicate that while 25 % showed anxiety in the immediate postoperative period, they present modal values (4) and lower average (5.22). 62.5 of foreign-born patients had an anxiety level equal to or higher than 4 while only 20.99 of the Spanish patients presented it. No significant differences were observed between sexes in those patients with anxiety, although women globally have an average value somewhat larger scale Goldberg. Although it has not obtained a significant relationship between the level of patient information and the value obtained in the scale of Goldberg, yes that is a trend to greater dispersion in the values of Scale Goldberg in patients who claim to have received a less information (AU)

Detección y actuación en la ansiedad preoperatoria inmediata. De la teoría a la práctica / Detecting and solving pre-operative anxiety. Theory and practice

Introducción: Cada día son más numerosos los estudios que muestran que el estado psicológico prequirúrgico, en especial la ansiedad, incide en la recuperación posquirúrgica. Del mismo modo, el control de la ansiedad preoperatoria disminuye la incidencia de eventos adversos durante la anestesia y la cirugía. El objetivo de este trabajo es evaluar si el personal sanitario considera necesario el cuidado emocional frente a la ansiedad y estudiar cómo se brinda dicha atención. Material y métodos: Se realizó un cuestionario sobre el cuidado emocional de la ansiedad al personal sanitario de la UCSI del Hospital Universitario Valle de Hebrón (Barcelona) de forma anónima que constaba de 37 preguntas valoradas en escala Likert (1 a 5). Se realizó un análisis de conglomerados para agrupar las preguntas según temática. Posteriormente se estimó la media de cada pregunta y grupo hallado con su intervalo de confianza. Resultados: Se contestaron 51 cuestionarios con un 94,1 % (n = 48) de mujeres y una experiencia profesional de 24,1 (rango, 1 a 47) años. Se hallaron 7 grupos de preguntas que hacían referencia a: planificación del cuidado emocional, uso de escalas, cuidado emocional, percepción de la ansiedad, emociones del paciente, entorno y actuaciones ante la ansiedad. El personal realiza actuaciones frente a la ansiedad (media: 3,9, intervalo de confianza del 95 % de 3,8 a 4,0) a pesar del poco uso de escalas validadas (2,4, IC 95 % de 2,2 a 2,7). Conclusiones: El personal sanitario no hace uso de escalas de ansiedad aunque se consideran necesarias. Frente a la ansiedad pre-quirúrgica se brinda cuidado emocional basándose en la experiencia profesional y en el criterio personal (AU)

Introduction: Every day, many studies show that preoperative psychological state, particularly anxiety, affects the postoperative recovery. Similarly, control preoperative anxiety decreases the incidence of adverse events during the anesthesia and surgery stages. The aim of this study is to evaluate if healthcare practitioners take into consideration the emotional care against anxiety and to study how such care is provided. Methods: A questionnaire about the emotional care against anxiety was performed to the health staff of the Ambulatory Surgery Unit of Vall d’Hebron University Hospital (Barcelona) in an anonymous way consisting of 37 Likert questions (1 to 5) was performed. A cluster analysis was performed to group questions by topic. Then, the mean of each question as well as the mean for each group with its confidence interval were estimated. Results: 51 questionnaires were answered with 94.1 % (n = 48) of women and a professional experience mean of 24.1 (range, 1-47) years. Seven groups of questions were found: emotional care planning; use of scales; emotional care; perception of anxiety; patient’s emotions; environment; and proceedings before the anxiety. The practitioners take actions against anxiety (mean: 3.9, confidence interval 95 % from 3.8 to 4.0) despite the little use of validated scales (2.4, 95 % CI 2.2 to 2.7). Conclusions: The medical staff does not use scales of anxiety but they are considered necessary. Faced with the pre-surgical anxiety, emotional care is provided based on professional experience and personal judgment (AU)

¿Por qué se anulan las intervenciones quirúrgicas en Cirugía Mayor Ambulatoria? / Why are surgical procedures cancelled in Ambulatory Surgery?

Introducción: La Cirugía Mayor Ambulatoria es utilizada por centros hospitalarios de toda España. En nuestra unidad los usuarios deben cumplir ciertos criterios para poder ser intervenidos que, en ocasiones, son explicados en la consulta de enfermería previa y verificados antes de la intervención en el área de pre-anestesia. En esta, se anotan las posibles incidencias que podrían poner en riesgo la cirugía. Los objetivos del estudio fueron: 1) describir dichas incidencias; 2) determinar cuáles de ellas se asocian con la anulación de la intervención, y 3) estudiar si la realización de la consulta de enfermería se asocia con un menor número de incidencias. Material y métodos: La muestra estaba formada por todos los usuarios del área de pre-anestesia de la unidad de cirugía sin ingreso del Hospital Vall d'Hebron durante los meses de enero y febrero de 2014. Se recogieron variables socio-demográficas, tipo de intervención, número y tipo de incidencias registradas y si se produjo la anulación de la cirugía. Resultados: De un total de 874 usuarios, se registraron 110 incidencias en 101 usuarios (11,6 %) conllevando el 1 % de anulaciones (9 casos). La incidencia más frecuente fue la ausencia de ayuno (2,5 %). Las anulaciones tuvieron relación significativa con 5 tipologías de incidencias. Se halló asociación entre la realización de la consulta de enfermería y la disminución de incidencias (odds ratio = 0,48, IC95 %: de 0,26 a 0,91). Conclusión: La realización de una consulta de enfermería y el control de criterios en el área pre-anestésica se antojan indispensables para minimizar los riesgos durante la intervención (AU)

Introduction: Ambulatory Surgery is used by hospitals all around Spain. In our unit, the users musts meet specific standards in order to be operated on, that are explained, sometimes in prior nursing consultation, and checked before the intervention in the pre-anesthesia unit. The possible incidents that might jeopardize the surgery are noted. The study objectives were: 1) describe such incidents; 2) determine which of them were associated with the cancellation of the intervention, and 3) study if the performance of the nursing consultation was associated with having fewer incidents. Methods: The sample was malle up by all the users of the pre-anesthesia area at the surgery unit of Vall d'Hebron's Hospital during the months of January and February 2014. The variables collected were socio-demographic, type of intervention, number and type of recorded incidents and if the surgery was cancelled. Results: From a total of 874 users, 110 incidents were reported in 101 patients (11.6 %) involving 9 (1 %) cancellations. The most frequent incidence was the absence of fasting (2.5 %). The cancellations were significantly related with five kinds of incidents. Association between making a nursing consultation and the decrease in the incidence rate (odds ratio = 0.48 CI95 %: from 0.26 to 0.91) was found. Conclusion: Making a nursing consultation and monitorizing the guidelines in the pre-anesthetic area are a must in order to minimize the risks during the surgery (AU)