Unwillingness to cooperate with COVID-19 contact tracing in Japan.

OBJECTIVES: Contact tracing for COVID-19 relies heavily on the cooperation of individuals with authorities to provide information of contact persons. However, few studies have clarified willingness to cooperate and motivation to provide information for contact tracing. This study sought to describe willingness to cooperate and motivation to report contact persons for COVID-19 contact tracing among citizens in Japan, and to assess any associated sociodemographic factors. STUDY DESIGN: Cross-sectional study. METHODS: This was an online-based survey using quota sampling. Participants were asked about their willingness to cooperate in reporting contacts for COVID-19 contact tracing if they tested positive. Participants also responded to questions regarding their reasons for cooperating or not cooperating and provided sociodemographic data. Multiple logistic regression analysis was performed to clarify associations between sociodemographic factors and willingness to cooperate. RESULTS: This study included 2844 participants. The proportion of participants who were not willing to cooperate in reporting contacts was 27.6%, with their main reasons being concerns about causing trouble for the other person and being criticised for revealing their names. Willingness to cooperate was lower among men, young adults and those with an educational level less than a university degree. CONCLUSIONS: To improve the effectiveness of contact tracing, educational campaigns, such as reducing the fear and stigma associated with COVID-19, may be important. Furthermore, it is essential to understand that individuals may have contacts whom they do not wish to disclose to others and to be considerate when handling such situations.

Risk factors for thrombocytopenia and analysis of time to platelet transfusion after azacitidine treatment.

The use of azacitidine (AZA) has been known to lead to a high incidence of hematotoxic adverse events. The aims of this study were to identify the risk factors for thrombocytopenia after the administration of AZA and to analyze time to the initial platelet transfusion. Sixty-two patients with myelodysplastic syndrome (MDS), who were treated with AZA in Gifu Municipal Hospital between March 2012 and June 2020, were included in this study. The risk factors for thrombocytopenia were identified using univariate analysis of patient characteristics, disease type, and laboratory values immediately before the start of treatment. Variables with p<0.2 identified in the univariate analysis were used as independent variables in the multivariate analysis. This analysis identified "creatinine clearance (CCr) <60 mL/min" as a significant factor (odds ratio, 4.790; 95% confidence interval [CI], 1.380-16.70; p=0.014). Subsequently, time in days to the initial platelet transfusion after the initial administration of AZA was analyzed using the log-rank test. The overall median time in days to platelet transfusion was 370 days. The log-rank test was used to determine the influence of patient characteristics, disease type, and laboratory values immediately before the start of treatment. The subsequent Cox proportional hazard regression analysis using variables with p<0.2 as independent variables identified "hemoglobin (Hb) <8.0 g/dL" as a significant factor (hazard ratio, 2.143; 95% CI, 1.001-4.573; p=0.048). The results of this study led to the following clinical implications: first, patients with CCr of <60 mL/min at the start of treatment should be treated with caution due to the risk of thrombocytopenia. Second, patients with Hb of <8.0 g/dL at the start of treatment may require platelet transfusion in the early stage of treatment.

Anti-allergic effect of the Src family kinase inhibitor saracatinib.

The aim of this study was to evaluate the anti-anaphylactic and anti-allergic potentials of saracatinib, a Src family kinase inhibitor that was already shown to be safe in clinical trials when it was used as an anti-cancer drug. Using in vitro mast cell models, we found that saracatinib inhibited the degranulation response and cytokine production in RBL2H3 cells that were stimulated with IgE and antigen without affecting cell viability. Phosphorylation of Lyn, Akt, a PI3K substrate, and MAPKs including ERK, JNK, and p38, as well as the intracellular Ca2+ increase induced by this stimulation were also suppressed by saracatinib. This drug also inhibited symptoms in our established anaphylaxis mouse model, anaphylaxis-dependent spotted distribution of immune complex in skin (ASDIS). The intravenous injection of the mixture of IgE and antigen induced acute spotted distribution of immune complex in skin in hairless HR-1 mice, and its inhibition by intradermal injection of saracatinib was observed. Moreover, toluidine blue-stained skin sections indicated that the degranulation ratio of dermal mast cells was reduced in saracatinib-treated skin compared with vehicle-treated skin. Because only a few signaling inhibitors are used as anti-anaphylaxis and anti-allergic drugs, these results indicated the valuable suggestion that saracatinib and the Src family kinase inhibitors are good candidates for anti-anaphylaxis and anti-allergic drugs.

Postoperative intensive care unit admission does not affect outcomes in elective surgical patients with severe comorbidity / El ingreso postoperatorio en la unidad de cuidados intensivos no afecta a los desenlaces en pacientes con comorbilidades graves sometidos a cirugías programadas

OBJECTIVE: The impact of postoperative intensive care upon patient outcomes was evaluated by retrospectively investigating the rate of poor outcomes among miscellaneous elective surgical patients with severe comorbidities. DESIGN: A retrospective cohort study was carried out. SETTING: University hospital. PATIENTS: Surgical patients with severe comorbidities. Intervention: The outcomes of 1218 surgical patients treated in intensive care units (ICUs) and postsurgical wards (ICU group vs. non-ICU group) were reviewed for poor outcomes (i. e. , no discharge or death). A propensity score analysis was used to generate 248 matched pairs of ICU-admitted patients and controls. Variables of interest: Poor outcome rates on postoperative day 90 and mortality on postoperative days 30 and 90. RESULTS: No significant between-group differences were observed in terms of poor outcomes on postoperative day 90 [ICU vs. non-ICU: 33/248 (13%) vs.28/248 (11%), respectively; ICU odds ratio (OR): 1.19, 95% confidence interval (CI), 0.71-2.01, p = 0.596] or in between-group differences in terms of mortality on postoperative days 30 and 90 [ICU vs. non-ICU: 4/248 (1.6%) vs.2/248 (0.8%) on postoperative day 30 and 5/248 (2.0%) vs.3/248 (1.2%) on day 90, respectively; ICU OR (95% CI), 2.00 (0.37-10.9) and 1.67 (0.40-6.97) for postoperative 30- and 90-day mortality, respectively (p = 0.683 and 0.724)]. Low preoperative body weight was negatively correlated to patient outcomes [OR (95% CI): 0.82/10 kg (0.70-0.97), p = 0.019], whereas regional analgesia combined with general anesthesia was positively correlated to patient outcomes [OR (95% CI): 0.39 (0.69-0.96), p = 0.006]. Extra ICU admission was correlated to poor patient outcomes [OR (95% CI): 4.18 (2.23-7.81), p < 0.0001]. CONCLUSIONS: Postoperative ICU admission failed to demonstrate any meaningful benefits in patients with severe comorbidities undergoing miscellaneous elective surgeries

OBJETIVO: Se evaluó el impacto de los cuidados intensivos postoperatorios sobre los desenlaces de los pacientes investigando de forma retrospectiva la tasa de desenlaces desfavorables en un grupo variado de pacientes con comorbilidades graves que se sometieron a cirugías programadas. DISEÑO: Estudio retrospectivo de cohortes. Ámbito: Hospital universitario. PACIENTES: Pacientes quirúrgicos con comorbilidades graves. INTERVENCIONES: Se revisaron los desenlaces de 1.218 pacientes quirúrgicos tratados en unidades de cuidados intensivos (UCI) y plantas posquirúrgicas (grupo UCI frente a grupo no UCI) en busca de desenlaces desfavorables (esto es, ausencia de alta o muerte). Se llevó a cabo un análisis de puntuación de la propensión para generar 248 parejas de pacientes ingresados en la UCI y sus respectivos pacientes de control. Variables de interés: Tasas de desenlaces desfavorables al día 90 tras la intervención y mortalidad a los 30 y 90 días de la intervención. RESULTADOS: No se observaron diferencias significativas entre los grupos en cuanto a desenlaces desfavorables el día 90 tras la intervención (UCI frente a no UCI: 33/248 [13%] frente a 28/248 [11%], respectivamente; oportunidad relativa [OR]: 1,19; intervalo de confianza [IC] del 95%: 0,71-2,01; p = 0,596) ni diferencias entre los grupos en términos de mortalidad al cabo de 30 y 90 días tras la intervención (UCI frente a no UCI: 4/248 [1,6%] frente a 2/248 [0,8%] el día 30 tras la intervención y 5/248 [2,0%] frente a 3/248 [1,2%] el día 90, respectivamente; OR UCI [IC del 95%]: 2,00 [0,37-10,9] y 1,67 [0,40-6,97] para la mortalidad a los 30 y 90 días de la intervención, respectivamente [p = 0,683 y 0,724]). El bajo peso preoperatorio presentó una correlación negativa con los desenlaces de los pacientes (OR [IC del 95%]: 0,82/10 kg [0,70-0,97]; p = 0,019), mientras que la analgesia regional combinada con anestesia general y el ingreso fuera de la UCI presentó una correlación positiva con los desenlaces de los pacientes (OR [IC del 95%]: 0,39 [0,69-0,96]; p = 0,006). El ingreso extra en la UCI se correlacionó con malos resultados para el paciente (OR [IC del 95%]: 4,18 [2,23-7,81], p < 0,0001). CONCLUSIONES: El ingreso posoperatorio en la UCI no demostró asociarse con ningún beneficio significativo en un grupo variado de pacientes con comorbilidades graves sometidos a cirugías programadas

Breast cancer diagnosis based on lipid profiling by probe electrospray ionization mass spectrometry.

Probe electrospray ionization mass spectrometry (PESI-MS) is an ambient ionization-based mass spectrometry method that surpasses the original electrospray ionization technique in features such as the rapidity of analysis, simplicity of the equipment and procedure, and lower cost. This study found that the PESI-MS system with machine learning has the potential to establish a lipid-based diagnosis of breast cancer with higher accuracy, using a simpler approach. Rapid mass spectrometry for breast cancer.

Postoperative intensive care unit admission does not affect outcomes in elective surgical patients with severe comorbidity.

OBJECTIVE: The impact of postoperative intensive care upon patient outcomes was evaluated by retrospectively investigating the rate of poor outcomes among miscellaneous elective surgical patients with severe comorbidities. DESIGN: A retrospective cohort study was carried out. SETTING: University hospital. PATIENTS: Surgical patients with severe comorbidities. INTERVENTION: The outcomes of 1218 surgical patients treated in intensive care units (ICUs) and postsurgical wards (ICU group vs. non-ICU group) were reviewed for poor outcomes (i.e., no discharge or death). A propensity score analysis was used to generate 248 matched pairs of ICU-admitted patients and controls. VARIABLES OF INTEREST: Poor outcome rates on postoperative day 90 and mortality on postoperative days 30 and 90. RESULTS: No significant between-group differences were observed in terms of poor outcomes on postoperative day 90 [ICU vs. non-ICU: 33/248 (13%) vs. 28/248 (11%), respectively; ICU odds ratio (OR): 1.19, 95% confidence interval (CI), 0.71-2.01, p=0.596] or in between-group differences in terms of mortality on postoperative days 30 and 90 [ICU vs. non-ICU: 4/248 (1.6%) vs. 2/248 (0.8%) on postoperative day 30 and 5/248 (2.0%) vs. 3/248 (1.2%) on day 90, respectively; ICU OR (95% CI), 2.00 (0.37-10.9) and 1.67 (0.40-6.97) for postoperative 30- and 90-day mortality, respectively (p=0.683 and 0.724)]. Low preoperative body weight was negatively correlated to patient outcomes [OR (95% CI): 0.82/10kg (0.70-0.97), p=0.019], whereas regional analgesia combined with general anesthesia was positively correlated to patient outcomes [OR (95% CI): 0.39 (0.69-0.96), p=0.006]. Extra ICU admission was correlated to poor patient outcomes [OR (95% CI): 4.18 (2.23-7.81), p < 0.0001]. CONCLUSIONS: Postoperative ICU admission failed to demonstrate any meaningful benefits in patients with severe comorbidities undergoing miscellaneous elective surgeries.

Patterns of exposure to adverse childhood experiences and their associations with mental health: a survey of 1346 university students in East Asia.

INTRODUCTION: Adverse childhood experiences (ACEs) constitute a significant global mental health burden. Prior studies typically investigated the impact of ACEs on mental health using a cumulative risk approach; most ACEs studies were also conducted in Western settings. PURPOSE: This study aimed to examine ACEs using a pattern-based approach and assess their associations with mental health outcomes by early adulthood in East Asia. METHODS: The present study included measures of exposure to 13 categories of ACEs, depression, anxiety, maladjustment, and posttraumatic stress in a sample of 1346 university students from Hong Kong, China, Taiwan, and Japan. RESULTS: Latent class analysis indicated three distinct patterns of ACE exposure: Class 1: Low ACEs (76.0%); Class 2: Household Violence (20.6%); and Class 3: Household Dysfunction (3.4%). Those representing Class 3 had significantly more ACEs compared with those in Classes 1 or 2. Controlling for age and sex, those in Class 2 reported significantly higher depression and maladjustment symptoms compared with those in Class 1; both Classes 2 and 3 had significantly higher anxiety symptoms and odds for meeting diagnostic criteria for posttraumatic stress disorders compared with those in Class 1. CONCLUSIONS: Study findings suggest that young adults' mental health, at least under certain contexts, is more closely linked with the nature and pattern of ACE co-occurrence, rather than the number of ACEs.

Amiodarone does not affect brain injury in a rat model of transient forebrain ischemia / La amiodarona no afecta a las lesiones cerebrales en un modelo de isquemia transitoria del prosencéfalo en ratas

Objectives: Although amiodarone may cause neurotoxicity that can affect patient outcomes when used during cardiopulmonary resuscitation (CPR), it has been commonly prescribed during CPR. This study investigated the possible neurotoxic effects of amiodarone in a rat model of transient forebrain ischemia. Design: A prospective laboratory animal study was carried out. Setting: Animal laboratory. Materials: Male Sprague-Dawley rats. Intervention: Eight minutes of forebrain ischemia was induced in rats by bilateral carotid occlusion and hypotension (mean arterial pressure=35mmHg) under isoflurane (1.5%) anesthesia. Amiodarone (0, 50, 100 and 150mg/kg) with saline was injected intraperitoneally 10min after ischemia. Rats given 0mg/kg of amiodarone were used as saline-treated controls. Sham operated rats received no treatment. Variables of interest: Animals were evaluated neurologically on postoperative days 4-7, and histologically after a one-week recovery period. Results: The greatest improvement in water maze test performance corresponded to the sham operated group (p=0.015 vs. saline-treated controls). No differences in performance were seen in amiodarone-treated rats compared with saline-treated controls. In the control group, 45% of the CA1 hippocampal neurons survived, compared with 78% in the sham operated group (p=0.009). Neuron survival after ischemia in the amiodarone treatment groups (50, 100 and 150mg/kg) (58%, 40% and 36%, respectively) and in the control rats did not differ significantly. Conclusions: The administration of amiodarone immediately after transient forebrain ischemia did not worsen spatial cognitive function or neuronal survival in the hippocampal CA1 region in rats. The current results must be applied with caution in humans. However, they indicate that the potential neurotoxicity induced by amiodarone during resuscitation after cardiac arrest may be negligible

Objetivos: La amiodarona puede causar neurotoxicidad que afecte a los desenlaces de los pacientes si se usa durante la reanimación cardiopulmonar (RCP), si bien este fármaco se ha prescrito habitualmente a pacientes durante la RCP. Este estudio ha investigado los posibles efectos neurotóxicos de la amiodarona en un modelo de isquemia transitoria del prosencéfalo en ratas. Diseño: Estudio prospectivo con animales de laboratorio. Ámbito: Laboratorio de animales. Materiales: Ratas Sprague-Dawley macho. Intervención: Se produjo isquemia del prosencéfalo en ratas durante ocho minutos mediante oclusión bilateral de la carótida e hipotensión (mediana de la presión arterial=35 mmHg) bajo anestesia con isoflurano (1,5%). Se inyectó intraperitonealmente amiodarona (0, 50, 100, 150 mg/kg) con solución salina 10 minutos después de la isquemia. Se administraron 0 mg/kg de amiodarona a las ratas empleadas como controles tratados con solución salina. No se administró ningún producto a las ratas del grupo quirúrgico de referencia. Variables de interés: Los animales fueron evaluados neurológicamente durante los días 4-7 tras la intervención, e histológicamente tras un período de recuperación de una semana. Resultados: La mayor mejora del rendimiento en la prueba del laberinto acuático se observó en el grupo quirúrgico de referencia (p=0,015 frente a los controles tratados con solución salina). No se observaron diferencias en el rendimiento de las ratas tratadas con amiodarona respecto a los controles que recibieron solución salina. En el grupo control sobrevivió el 45% de las neuronas del hipocampo CA1, frente al 78% en el grupo quirúrgico de referencia (p=0,009). No se observaron diferencias significativas en cuanto a la supervivencia neuronal tras la isquemia entre los grupos tratados con amiodarona (50, 100 y 150 mg/kg, 58, 40 y 36% respectivamente) y las ratas del grupo control. Conclusiones: La administración de amiodarona inmediatamente después de la isquemia transitoria del prosencéfalo no empeoró la función cognitiva espacial ni la supervivencia neuronal en la región del hipocampo CA1 en ratas. Se debe tener precaución al aplicar los resultados actuales a los humanos. Sin embargo, dichos resultados señalan que la posible neurotoxicidad inducida por la amiodarona durante la reanimación tras parada cardíaca puede ser insignificante

In reply to "Animal models for neurotoxicity assessment in cardiac arrest / Respuesta a «Modelos animales para evaluar la neurotoxicidad en el paro cardíaco»

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Impact of a systematic education model for palliative care in cancer.

In clinical practice, pharmacists are continually required to improve their knowledge and expertise; however, the postgraduate education system for professional development cannot be confidently stated to be well established. The establishment of a systematic and multifaceted educational curriculum should be useful to improve home care and pharmacists' contribution; therefore, we developed a curriculum in collaboration with the university faculty of pharmaceutical sciences, department of pharmacy in hospital, and the Fukuoka Pharmaceutical Association. Class topics were extracted from the "Kanwa-Iryou-Yakugaku", edited by the Japanese Society for Pharmaceutical Palliative Care and Sciences. The items are necessary to perform palliative care as a pharmacist. A class schedule of 6 days (24 classes in total) was formulated. Questionnaires on comprehension degree before and after each class were provided to the participants. Comprehension was assessed on a scale of 1 to 10, where "I do not understand at all" was 1 and "I understand enough" was 10. The average recovery rates of questionnaires from each class were 92.6 % and 88.9 % before and after class, respectively. The average number of participants who completely answered the questionnaire before and after class was 45.6; therefore, these data were analyzed. Comprehension degree on each topic had significantly increased after attendance of all classes (p < 0.01). The comprehension degree of participants of the medical science of palliative care did greatly improve. Consequently, it is clear that the standard education model constructed was meaningful for the professional development of pharmacists in palliative care medicine.

Cost utility analysis of pharmacist counseling care for breast cancer chemotherapy outpatients.

Chemotherapy for cancer is increasingly implemented in the outpatient setting. Pharmacists contribute to cancer treatment by conducting counseling during outpatient chemotherapy visits. They provide guidance on drug treatment, side effects, and side effect countermeasures on every visit. However, there have been few economic evaluations of pharmacist involvement in outpatient chemotherapy. Therefore, we performed a cost utility analysis. We assigned usual care (control) and pharmacist counseling to two groups of 19 patients receiving outpatient chemotherapy for breast cancer at Gifu Municipal hospital. Quality of life was measured at three timepoints before and during chemotherapy treatment using the EuroQol 5 dimension instrument (EQ-5D). EQ-5D values across the timepoints were 0.831, 0.757, and 0.791 for the control group, and 0.882, 0.883, and 0.921 for the pharmacist counseling group. The additional cost in the pharmacist counseling group was 2,227 yen per counseling session. The change in quality-adjusted life years (QALY) was a maximum of -0.021±0.186 in the control group and 0.007±0.199 in the pharmacist counseling group. The maximum cost for one QALY was 1,360,558 yen (≈12,460 US dollars). Pharmacists' counseling in outpatient cancer chemotherapy for breast cancer patients had an acceptable incremental cost-effect ratio, contributing to improved patient quality of life without significant additional expenditure to healthcare.

Performance verification of a precise vibrating-wire magnet alignment technique for next-generation light sources.

The high-accuracy alignment of magnets is a key issue in the development of next-generation light-source rings. To obtain adequate dynamic apertures, the magnets must be aligned to an accuracy of 10 µm or better. Recently, a new technique that utilizes a vibrating wire has attracted attention for this purpose as it can directly determine with high resolution the magnetic centers in a series of multipole magnets on a straight section between bending magnets. In conventional vibrating-wire alignment techniques, wire sag, which causes alignment errors, is determined from the theoretical catenary curve. By contrast, in the present study, we have measured the sag profiles of various wires in the longitudinal direction to micrometer-order accuracy. We concluded that we can reduce deviations of the actual wire sag from the theoretical curve by choosing a suitable wire. By setting up a test bench of a vibrating-wire alignment system for a series of multipole magnet on a straight section, we have achieved the total error of the magnetic-center measurements of micrometer-order in the standard deviation. Moreover, two systematic error factors, the drift of the magnetic centers due to thermal deformations of the magnets after they are excited and the change in the magnetic centers due to reassembly of the magnets after installing the vacuum chamber, are included in practical magnet alignments. We have experimentally investigated these error factors using the test bench.

REDUCTION IN AMBIENT GAMMA DOSE RATE FROM RADIOCESIUM DUE TO SNOW COVER.

In the present study, variations in ambient gamma dose rate associated with snow cover were examined in a radioactive-contaminated site in Fukushima Prefecture, Japan. The ambient gamma dose rates decreased with increasing snow depth. The reduction trends were different between fresh snow (0.1-0.2 g/cm3) and granular snow (0.3-0.4 g/cm3) depending on snow density. Snow cover water content (snow water equivalent) calculated from snow depth and density was a key parameter governing the reduction in the ambient gamma dose rate. The ambient gamma dose rates reduced to 0.6 and 0.5 at 4 g/cm2 and 8 g/cm2 of snow water equivalent, respectively. Based on gamma-ray flux density distributions, the ambient gamma dose rates from the primary gamma rays decreased more compared to those from scattered gamma rays due to snow cover.

Effects of deep sedation under mechanical ventilation on cognitive outcome in patients undergoing surgery for oral and maxillofacial cancer and microvascular reconstruction / Efectos de la sedación profunda bajo ventilación mecánica sobre los resultados cognitivos en pacientes sometidos a cirugía por cáncer oral y maxilofacial con reconstrucción microvascular

Objective: Cognitive impairment after intensive care unit (ICU) admission is becoming increasingly recognized. High-dose deep sedation has been suggested to play an important role in the development of cognitive impairment. However, the impact of heavy sedation as a single cause in the development of cognitive impairment in ICU patients remains unclear. In this study we investigated whether a three-day deep sedation protocol could reduce cognitive function in mechanically ventilated non-critical patients. Design: A prospective observational study was carried out. Patients: A total of 17 surgical patients were studied. Intervention: None. Variables of interest: Cognitive function before and after ICU admission. Results: Thirty-one patients requiring three days of sedation after microvascular reconstruction were initially enrolled in the study. Sedation in the ICU was maintained with propofol and dexmedetomidine combined with fentanyl. Cognitive function was assessed using a battery of 6 neuropsychological tests two days before surgery and three weeks after surgery. Finally, a total of 17 patients were included in the analysis. Cognitive impairment (defined as a decline of >20% from the pre-admission cognitive evaluation scores in at least two of 6 tests) was observed in 5 of the 17 patients (29%). However, there were no significant differences between the pre- and post-admission cognitive evaluations in 6 tests. Conclusions: Middle-term cognitive function can be impaired in some patients subjected to deep sedation during several days following maxillary-mandibular oral surgery with microvascular reconstruction

Objetivo: Cada vez existe un mayor consenso sobre la afectación cognitiva tras el ingreso en la unidad de cuidados intensivos (UCI). Se ha sugerido que la sedación profunda con dosis elevada desempeña un papel importante en el desarrollo de la alteración cognitiva. Sin embargo, todavía existen dudas sobre el impacto de este tipo de sedación como causa única del desarrollo de alteraciones cognitivas en pacientes ingresados en la UCI. En este estudio, investigamos si la aplicación de un protocolo de sedación profunda durante 3 días disminuía la función cognitiva en pacientes no críticos bajo ventilación mecánica. Diseño: Se llevó a cabo un estudio observacional prospectivo. Pacientes: Se estudió a un total de 17 pacientes quirúrgicos. Intervenciones: Ninguna. Variables de interés: Función cognitiva antes y después del ingreso en la UCI. Resultados: En este estudio se incluyó inicialmente a 31 pacientes que requerían 3 días de sedación tras una reconstrucción microvascular. Se mantuvo la sedación en la UCI con propofol y dexmedetomidina en combinación con fentanilo. Se evaluó la función cognitiva mediante un grupo de 6 pruebas neurofisiológicas antes de la intervención y 3 días después de esta. Por último, se incluyó a un total de 17 pacientes en el análisis. Se observó alteración cognitiva (definida como una reducción>20% frente a las puntuaciones de la evaluación cognitiva previa al ingreso en al menos 2 de las 6 pruebas) en 5 de los 17 pacientes (29%). Sin embargo, no se observaron diferencias significativas entre las evaluaciones previas y posteriores al ingreso en 6 pruebas. Conclusiones: La función cognitiva a medio plazo puede verse afectada en algunos pacientes sometidos a sedación profunda durante varios días tras una cirugía oral maxilar-mandibular con reconstrucción microvascular