Impact on clinical practice of the preoperative screening of Covid-19 infection in surgical oncological patients. Prospective cohort study.

BACKGROUND: In the oncological patient, an COVID-19-Infection, whether symptomatic or asymptomatic, a surgical procedure may carry a higher postoperative morbidity and mortality. The aim of this study was to describe the impact on clinical practice of sequential preoperative screening for COVID-19-infection in deciding whether to proceed or postpone surgery. METHODS: Prospective, cohort study, based on consecutive patients' candidates for an oncological surgical intervention. Sequential preoperative screening for COVID-19-infection: two-time medical history (telematic and face-to-face), PCR and chest CT, 48 h before of surgical intervention. COVID-19-infection was considered positive if the patient had a suggestive medical history and/or PCR-positive and/or CT of pneumonia. RESULTS: Between April 15th and May 4th, 2020, 179 patients were studied, 97 were male (54%), mean (sd) age 66.7 (13,6). Sequential preoperative screening was performed within 48 h before to surgical intervention. The prevalence of preoperative COVID-19-infection was 4.5%, 95%CI:2.3-8.6% (8 patients). Of the operated patients (171), all had a negative medical history, PCR and chest CT. The complications was 14.8% (I-II) and 2.5% (III-IV). There was no mortality. The hospital stay was 3.1 (sd 2.7) days.In the 8 patients with COVID-19-infection, the medical history was suggestive in all of them, 7 presented PCR-positive and 5 had a chest CT suggestive of pneumonia. The surgical intervention was postponed between 15 and 21 days. CONCLUSION: Preoperative screening for COVID-19-infection using medical history and PCR helped the surgeon to decide whether to go ahead or postpone surgery in oncological patients. The chest CT may be useful in unclear cases.

Age of pubertal onset affects the intensity and duration of pubertal growth peak but not final height.

This paper analyzed the intensity and duration of height growth during puberty in boys and girls in relation to rhythm of maturation. A longitudinal clinical follow-up between ages of 10 and 20 years, was carried out in a sample of 251 children grouped according to age at pubertal onset: boys (genital stage 2) at the ages of 11 (n = 28), 12 (n = 38), 13 (n = 42), and 14 (n = 27); and girls (breast stage 2) at the ages of 10 (n = 37), 11 (n = 47), 12 (n = 19), and 13 (n = 13). Height was measured annually. Testicular volume and genital development were assessed in boys, and breast development was assessed in girls. There were significant differences (P < 0.001) in height at the age of pubertal onset among maturity groups. Late maturers were taller than early maturers (r = 0.49, P < 0.001 for girls; r = 0.38, P < 0.001 for boys). However, final heights did not differ according to age of onset in either sex. In boys, later onset of puberty was associated with a smaller pubertal height gain (r = -0.60, P < 0.001) and a shorter period of pubertal growth (r = -0.61, P < 0.001). Equally in girls, earlier onset of puberty was associated with a greater pubertal height gain (r = -0.68, P < 0.001) and a longer period of pubertal growth (r = -0.59, P < 0.001). In conclusion, age of pubertal onset does not affect final height attained in both sexes, since there is an inverse compensatory phenomenon in both sexes between height at pubertal onset and the intensity and duration of pubertal growth.

Scores on the State-Trait Anxiety Inventory for children in a longitudinal study of pubertal Spanish youth.

Changes in scores on the State-Trait Anxiety Inventory for Children for a sample of 534 pubertal adolescents were longitudinally studied over a period of 4 years. Biological development and other variables were investigated. For the 310 boys, A-trait scores decreased significantly with age. The 224 girls showed significantly higher scores than boys in all years of the study. No significant relationship was found between anxiety and pubertal maturity. The year-to-year persistence in symptomatology of anxiety ranged between 55.6% and 66.1% for girls and between 48.5% and 53.1% for boys. Girls showed bi- and tri-annual persistence between 31% and 50%, and boys between 13% and 27%. Neuroticism scores formed the best predictor of A-trait scores. Symptomatology of anxiety is not transient during early adolescence, so personality may provide a risk indicator in the development of anxiety.