IgG4-related disease: Effectiveness evaluation through Umehara-Okazaki 2011 and ACR/EULAR 2019 diagnostic criteria.

BACKGROUND: IgG4-related disease (IgG4-RD) is a rare, systemic immune-mediated fibro-inflammatory condition with an unclear etiology and pathophysiology, potentially affecting multiple organs. It presents with common clinical, radiological, and serological characteristics. This study aims to compare the latest two IgG4-RD classification and diagnostic criteria: Umehara-Okazaki 2011 and ACR/EULAR 2019. MATERIAL AND METHODS: In a retrospective cross-sectional study conducted across two centers from January 2010 to July 2023, we included patients suspected of having IgG4-RD from various hospital departments. Patients finally diagnosed with other pathologies were excluded. The remaining suspected IgG4-RD cases were evaluated using both Umehara-Okazaki 2011 and ACR/EULAR 2019 criteria. RESULTS: Out of 34 patients with a clinical diagnosis of IgG4-RD, the Umehara-Okazaki 2011 classified 20 patients: 5 as definitive, 7 as probable, and 8 as possible cases. Applying the ACR/EULAR 2019 criteria to the same cohort resulted in the diagnosis of 9 patients. Notably, retroperitoneal fibrosis and aortitis were the most prevalent form of presentation, accounting for 25% and 22.2% of cases classified under the 2011 and 2019 criteria, respectively. DISCUSSION: The more recent and stringent ACR/EULAR 2019 criteria focus on histopathology, various forms of presentation, and analytical data, allow for a more accurate classification of patients.

Expedient Synthesis of Thermally Stable Acyclic Amino(haloaryl)carbenes: Experimental and Theoretical Evidence of "Push-Pull" Stabilized Carbenes.

A library of novel structurally related singlet carbenes, namely, acyclic amino(haloaryl)carbenes, was designed by a high-yielding two-step procedure, and their chemical stability explored both experimentally and theoretically. Thanks to a careful selection of both the amino and the aryl substitution pattern, these carbenes exhibit a wide range of stability and reactivity, spanning from rapid self-dimerization for carbenes featuring ortho-F substituents to very high chemical stability as bare carbenes, up to 60 °C for several hours for compounds carrying ortho-Br substituents. Their structure was determined through NMR and X-ray diffraction studies, and their reactivity evaluated in benchmark reactions, highlighting the ambiphilic character of this novel class of singlet carbenes. In contrast with previously reported aryl substituents incorporating o-CF3 and t-Bu groups, which were considered "spectator", the high chemical stability of some of these carbenes relates to the stabilization of the σ-orbital of the carbene center by the π-accepting haloaryl substituent through delocalization. Kinetic protection of the carbene center is also provided by the ortho-halogen atoms, as demonstrated computationally. This push-pull stabilization effect makes acyclic amino(haloaryl) carbenes among the most ambiphilic stable carbenes reported to date, holding promise for a variety of applications.

SLESIS-R: an improved score for prediction of serious infection in patients with systemic lupus erythematosus based on the RELESSER prospective cohort.

OBJECTIVE: To develop an improved score for prediction of severe infection in patients with systemic lupus erythematosus (SLE), namely, the SLE Severe Infection Score-Revised (SLESIS-R) and to validate it in a large multicentre lupus cohort. METHODS: We used data from the prospective phase of RELESSER (RELESSER-PROS), the SLE register of the Spanish Society of Rheumatology. A multivariable logistic model was constructed taking into account the variables already forming the SLESIS score, plus all other potential predictors identified in a literature review. Performance was analysed using the C-statistic and the area under the receiver operating characteristic curve (AUROC). Internal validation was carried out using a 100-sample bootstrapping procedure. ORs were transformed into score items, and the AUROC was used to determine performance. RESULTS: A total of 1459 patients who had completed 1 year of follow-up were included in the development cohort (mean age, 49±13 years; 90% women). Twenty-five (1.7%) had experienced ≥1 severe infection. According to the adjusted multivariate model, severe infection could be predicted from four variables: age (years) ≥60, previous SLE-related hospitalisation, previous serious infection and glucocorticoid dose. A score was built from the best model, taking values from 0 to 17. The AUROC was 0.861 (0.777-0.946). The cut-off chosen was ≥6, which exhibited an accuracy of 85.9% and a positive likelihood ratio of 5.48. CONCLUSIONS: SLESIS-R is an accurate and feasible instrument for predicting infections in patients with SLE. SLESIS-R could help to make informed decisions on the use of immunosuppressants and the implementation of preventive measures.

A Computer Vision-Based System to Help Health Professionals to Apply Tests for Fall Risk Assessment.

The increase in life expectancy, and the consequent growth of the elderly population, represents a major challenge to guarantee adequate health and social care. The proposed system aims to provide a tool that automates the evaluation of gait and balance, essential to prevent falls in older people. Through an RGB-D camera, it is possible to capture and digitally represent certain parameters that describe how users carry out certain human motions and poses. Such individual motions and poses are actually related to items included in many well-known gait and balance evaluation tests. According to that information, therapists, who would not need to be present during the execution of the exercises, evaluate the results of such tests and could issue a diagnosis by storing and analyzing the sequences provided by the developed system. The system was validated in a laboratory scenario, and subsequently a trial was carried out in a nursing home with six residents. Results demonstrate the usefulness of the proposed system and the ease of objectively evaluating the main items of clinical tests by using the parameters calculated from information acquired with the RGB-D sensor. In addition, it lays the future foundations for creating a Cloud-based platform for remote fall risk assessment and its integration with a mobile assistant robot, and for designing Artificial Intelligence models that can detect patterns and identify pathologies for enabling therapists to prevent falls in users under risk.

Functional Changes After Occupational Therapy Among Individuals With a Distal Radius Fracture: A Longitudinal Study.

IMPORTANCE: Identifying the outcomes of occupational therapy after a distal radius fracture (DRF) is important so that effective strategies can be developed to mitigate the consequences associated with this common fracture. OBJECTIVE: To determine whether participation in occupational therapy improved functional status. Secondary objectives were to assess its effects on body functions and to examine the association between changes in outcome measures and occupational therapy-related factors. DESIGN: Longitudinal, with consecutive sampling over a 12-mo period. SETTING: Outpatient rehabilitation service. PARTICIPANTS: Participants were 38 adults with a unilateral DRF (ages 31-75 yr.; 81.6% female). INTERVENTION: Multicomponent occupational therapy, including supplemental techniques and activity-based interventions. OUTCOMES AND MEASURES: Functional status and body functions were assessed before and after therapy. RESULTS: All standardized measures of functional status showed significant improvements, which were large in size. Several body functions improved significantly (pain, sleep, wrist and forearm movements, and grip strength fraction), and effect sizes ranged from medium to large. For several outcome variables, earlier therapy was significantly associated with better results; moreover, the likelihood of achieving better outcomes was significantly higher among participants who attended more sessions. CONCLUSIONS AND RELEVANCE: Occupational therapy services have an important role to play after a DRF in terms of returning to daily activities and reducing impairments in body functions. Earlier intervention and attending a higher number of occupational therapy sessions are likely to further improve these outcomes. What This Article Adds: Because the effects of occupational therapy among people with a DRF remain uncertain, we quantified the outcomes of this intervention in an outpatient rehabilitation service, revealing medium to large improvements in the performance of daily activities and in various body functions. Our findings identified two factors associated with better results: early initiation of therapy and a higher number of occupational therapy sessions.

Delay in the residents' choice for General and Digestive Surgery: Analysis of the period 2018-2022.

INTRODUCTION: Every year hundreds of medical residents choose their specialization in various surgical fields. However, these numbers have been poorly analyzed. The objective of this study was to evaluate the selection of General and Digestive Surgery by medical residents and compare these results with the selection of other surgical specialties. METHODS: Cross-sectional observational study. The data from the selection of the medical residents from surgical specialties and the top 10 most demanded specialties between the years 2018 and 2022 were included. An analysis of adjusted ranking numbers based on the number of available positions was also conducted. RESULTS: The number of available positions in General and Digestive Surgery increased by 17.7% during the study period. However, the selection of our specialty has been delayed, with a median ranking number of 2419 (IQR: 1621-3284) in 2018, and 3484 (IQR: 2306-4156) in 2022 (p: .000). These differences remained significant after adjusting for the number of available positions (p: .000). The choice of Urology, Thoracic Surgery, Cardiovascular Surgery, Gastroenterology, and Paediatrics also declined during this period, while Plastic Surgery, Dermatology, Ophthalmology, Anesthesiology, and Endocrinology improved their numbers. CONCLUSION: The choice of General and Digestive Surgery has been delayed according to the data from the MIR selection of 2018-2022. The increase in the number of available positions has not been associated with a proportional increase in demand.

Analysis of recurrence and risk factors in laparoscopic sandwich technique for parastomal hernia repair.

INTRODUCTION: Parastomal hernias are frequent and highly recurrent. The sandwich technique is a combination of the keyhole and Sugarbaker techniques, using a double intraperitoneal mesh. The objective of this study was to assess the outcomes of the sandwich technique, specifically focusing on recurrence rates. MATERIALS AND METHODS: Observational retrospective study conducted in two tertiary referral centers in Catalonia, Spain. All consecutive patients who underwent parastomal hernia repair using the sandwich technique between 1st January 2016 and 31st December 2021 were included. RESULTS: A total of 38 patients underwent the laparoscopic sandwich technique for parastomal hernia repair. The overall recurrence rate was 7.9% (3/38), with a median follow-up of 39 months (IQR: 12.3-56.5). According to the EHS classification for parastomal hernia, there were 47.4% (18/38) type I defects, 10.5% (4/38) type II defects, 28.9% (11/38) type III defects, and 13.2% (5/38) type IV defects. The used mesh was predominantly TiMesh® (76.3%; 29/38), followed by DynaMesh® IPOM (23.7%; 9/38). Patients with recurrence exhibited higher rates of seroma, hematoma, surgical site infection, and one case of early recurrence attributed to mesh retraction. Consequently, postoperative complications emerged as the primary risk factor for hernia recurrence. CONCLUSION: The sandwich technique demonstrated recurrence rates consistent with those reported in the existing literature.

CD73 controls Myosin II-driven invasion, metastasis, and immunosuppression in amoeboid pancreatic cancer cells.

Pancreatic ductal adenocarcinoma (PDAC) has a very poor prognosis because of its high propensity to metastasize and its immunosuppressive microenvironment. Using a panel of pancreatic cancer cell lines, three-dimensional (3D) invasion systems, microarray gene signatures, microfluidic devices, mouse models, and intravital imaging, we demonstrate that ROCK-Myosin II activity in PDAC cells supports a transcriptional program conferring amoeboid invasive and immunosuppressive traits and in vivo metastatic abilities. Moreover, we find that immune checkpoint CD73 is highly expressed in amoeboid PDAC cells and drives their invasive, metastatic, and immunomodulatory traits. Mechanistically, CD73 activates RhoA-ROCK-Myosin II downstream of PI3K. Tissue microarrays of human PDAC biopsies combined with bioinformatic analysis reveal that rounded-amoeboid invasive cells with high CD73-ROCK-Myosin II activity and their immunosuppressive microenvironment confer poor prognosis to patients. We propose targeting amoeboid PDAC cells as a therapeutic strategy.

Transcutaneous Tibial Nerve Stimulation for Primary Dysmenorrhea: A Protocol for a Randomized Controlled Trial.

Primary dysmenorrhea (PD) is a painful menstruation that can persist for the duration of a woman's fertile life. Non-steroidal anti-inflammatory drugs, hormonal therapy, physiotherapy techniques, etc., are the main treatments. The main objective of this study is to evaluate the effectiveness of transcutaneous posterior tibial nerve stimulation (TTNS) in PD patients. The study will consist of a single-blind randomized clinical trial, parallel-assigned with two arms. Women with PD (18-43 years) with regular menstrual cycles and at least 4 points in VAS will be randomly divided into experimental (TTNS) and placebo (simulated stimulation) groups during 12 treatment sessions (1 session/week) and several follow-ups: monthly during treatment and 1, 3 and 6 months after. Maximum and mean pain intensity, pain duration, pain severity, number of anti-inflammatory drugs, quality of life, sleep quality, overall improvement, treatment satisfaction and secondary effects will be measured once a month every 6 months and at 3 and 6 months. The Student's t-test for independent samples or the Mann-Whitney U test will be used. The literature shows effective physiotherapeutic techniques for PD in the short term, which do not act on causes and have limitations. The TTNS technique can be used in transcutaneous and percutaneous modalities, with similar effectiveness, but the transcutaneous causes less discomfort. TTNS modulates pain, and long-term benefits could be achieved at low cost and without patient discomfort.

Stabilization of 14-3-3 protein-protein interactions with Fusicoccin-A decreases alpha-synuclein dependent cell-autonomous death in neuronal and mouse models.

Synucleinopathies are a group of neurodegenerative diseases without effective treatment characterized by the abnormal aggregation of alpha-synuclein (aSyn) protein. Changes in levels or in the amino acid sequence of aSyn (by duplication/triplication of the aSyn gene or point mutations in the encoding region) cause familial cases of synucleinopathies. However, the specific molecular mechanisms of aSyn-dependent toxicity remain unclear. Increased aSyn protein levels or pathological mutations may favor abnormal protein-protein interactions (PPIs) that could either promote neuronal death or belong to a coping response program against neurotoxicity. Therefore, the identification and modulation of aSyn-dependent PPIs can provide new therapeutic targets for these diseases. To identify aSyn-dependent PPIs we performed a proximity biotinylation assay based on the promiscuous biotinylase BioID2. When expressed as a fusion protein, BioID2 biotinylates by proximity stable and transient interacting partners, allowing their identification by streptavidin affinity purification and mass spectrometry. The aSyn interactome was analyzed using BioID2-tagged wild-type (WT) and pathological mutant E46K aSyn versions in HEK293 cells. We found the 14-3-3 epsilon isoform as a common protein interactor for WT and E46K aSyn. 14-3-3 epsilon correlates with aSyn protein levels in brain regions of a transgenic mouse model overexpressing WT human aSyn. Using a neuronal model in which aSyn cell-autonomous toxicity is quantitatively scored by longitudinal survival analysis, we found that stabilization of 14-3-3 protein-proteins interactions with Fusicoccin-A (FC-A) decreases aSyn-dependent toxicity. Furthermore, FC-A treatment protects dopaminergic neuronal somas in the substantia nigra of a Parkinson's disease mouse model. Based on these results, we propose that the stabilization of 14-3-3 epsilon interaction with aSyn might reduce aSyn toxicity, and highlight FC-A as a potential therapeutic compound for synucleinopathies.

Parietex™ Composite Ventral Patch for primary and incisional hernia repair.

BACKGROUNDS: Ventral hernia repair with a preformed device is a frequent intervention, but few reports exist with Parietex™ Composite Ventral Patch. The aim was to evaluate the results of this mesh with the open intraperitoneal onlay mesh (open IPOM) technique. METHODS: Observational retrospective single institution study of all consecutive patients intervened for ventral or incisional hernia with a diameter inferior to 4 cm, from January 2013 to June 2020. The surgical repair was performed according to the open IPOM technique with Parietex™ Composite Ventral Patch. RESULTS: A total of 146 patients were intervened: 61.6% with umbilical hernias, 8.2% with epigastric hernias, 26.7% with trocar incisional hernias, and 3.4% with other incisional hernias. The global recurrence rate was 7.5% (11/146). Specifically, it was 7.8% in umbilical hernias, 0% in epigastric hernias, 7.7% in trocar incisional hernias and 20% (1/5) in other incisional hernias. The median time for recurrence was 14 months (IQR: 4.4-18.7). The median indirect follow-up was 36.9 months (IQR: 27.2-49.6), and the median presential follow-up was 17.4 months (IQR: 6.5-27.3). CONCLUSION: The open IPOM technique with a preformed patch offered satisfactory results for the treatment of ventral and incisional hernias.

The impact of disease activity on health-related quality of life in patients with systemic lupus erythematosus / Impacto de la actividad clínica en la calidad de vida relacionada con la salud de pacientes con lupus eritematoso sistémico

Background and objective The aim of this research was to investigate the relationship between disease activity and health-related quality of life (HRQoL) in patients with systemic lupus erythematosus (SLE) considering the increased interest in the management of this disease. Materials and methods HRQoL was measured at clinic visits during a 12-month follow-up period using questionnaires on fatigue (FACIT-FATIGUE); quality of life, EuroQol 5-dimension (EQ-5D-5L) health questionnaire with 5 levels; disability, Health Assessment Questionnaire (HAQ), and a Global Health Status (GHS) scale. Disease activity, organ damage and other clinical factors that could affect HRQoL were recorded. The association between disease activity and HRQoL was assessed using Bayesian linear regression models with monotonic effects. Results Data from 70 patients at the baseline visit and 42 patients with 1 year of follow-up were analyzed. At baseline, 28.57% of patients presented Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)>6. In the 70 baseline patients, disease activity was associated with HRQoL in all four parameters. In the 42 patients with 12 months of follow-up, the positive association of disease activity with GHS, FACIT-FATIGUE and EQ-5D-5L and the negative association with HAQ was maintained.Patients who are smokers and those receiving immunosuppressant therapy presented low GHS and FACIT-FATIGUE scores. Moreover, older age at inclusion was significantly associated to low GHS, while low leucocyte and 25-OH-vitamin D levels were associated to fatigue perception in SLE patients. Conclusion Our results showed a statistically significant association between disease activity and HRQoL parameters. (AU)

Objetivo El objetivo del estudio fue analizar la relación entre la actividad clínica y la calidad de vida relacionada con la salud (CVRS) en pacientes con lupus eritematoso sistémico (LES).Material y métodos La CVRS se evaluó en la visita basal y durante 12 meses de seguimiento mediante un cuestionario de fatiga (FACIT-FATIGUE), calidad de vida (EQ-5D-5L), discapacidad (HAQ) y una escala analógica visual de estado general de salud (EVA). La actividad clínica, el daño acumulado y otros factores clínicos que pudieran afectar a la CVRS se analizaron mediante un modelo de regresión lineal bayesiano con efectos monotónicos. Resultados Se analizaron los datos de 70 pacientes incluidos en la visita basal y los 42 con 12 meses de seguimiento seleccionados aleatoriamente. En la visita basal el 28,57% de los pacientes presentaban un índice SLEDAI>6. La actividad clínica medida mediante el índice SLEDAI se asociaba de forma estadísticamente significativa a los 4 parámetros de CVRS. En los 42 pacientes con un año de seguimiento la relación directa entre la actividad clínica y el FACIT-FATIGUE, EVA y EQ-5D-5L, así como la relación indirecta con el HAQ, se mantuvieron. Los pacientes fumadores y aquellos bajo tratamiento inmunosupresor presentaban valores disminuidos de EVA y FACIT-FATIGUE. Además, los pacientes con edades más avanzadas presentaban valores disminuidos de EVA, y aquellos con niveles bajos de vitamina D o leucopenia presentaban mayor percepción de fatiga. Conclusión La actividad clínica se asocia a diferentes dominios de la CVRS, apoyando la evaluación de la CVRS como complemento en el manejo del LES. (AU)

Robotic versus open approach in total gastrectomy for gastric cancer: a comparative single-center study of perioperative outcomes.

The robotic approach to gastric cancer has been gaining interest in recent years; however, its benefit over the open procedure in total gastrectomy with D2 lymphadenectomy is still controversial. The aims of the study were to compare postoperative morbidity and mortality, hospital stay, and anatomopathological findings between the robotic and open approaches to oncologic total gastrectomy. We analyzed a prospectively collected database, which included patients who underwent total gastrectomy with D2 lymphadenectomy in our center using a robotic or an open approach between 2014 and 2021. Comparative analysis of clinicopathological, intraoperative, postoperative and anatomopathological variables between the robot-assisted group and the open group was performed. Thirty patients underwent total gastrectomy with D2 lymphadenectomy by a robotic approach and 48 patients by an open procedure. Both groups were comparable. The robot-assisted group presented a lower rate of Clavien-Dindo complications ≥ stage II (20 vs. 48%, p = 0.048), a shorter hospital stay (7 days vs. 9 days, p = 0.003) and had a higher total number of lymph nodes resected (22 nodes vs. 15 nodes, p = 0.001) compared to the open approach. Operative time was longer in the robotic group (325 min vs. 195 min, p < 0.001) compared to the open group. The robotic approach is associated with a longer surgical time, a lower rate of Clavien-Dindo complications ≥ stage II and a shorter hospital stay, and more lymph nodes were resected compared to the open approach.

The Internet of Things for the Intelligent Management of the Heating of a Swimming Pool by Means of Smart Sensors.

By using various smart sensors integrated in a global domotic system, a proper solar thermal management is executed. The goal is to properly manage solar energy for heating swimming pool using various devices installed at home. Swimming pools are a necessity in many communities. In summer, they are a source of refreshment. However, maintaining a swimming pool at an optimal temperature can be a challenge even in the summer months. The use of the Internet of Things in homes has enabled proper management of solar thermal energy, thus significantly improving the quality of life by making homes more comfortable and safer without using additional resources. The houses built today have several smart devices that manage to optimize the energy consumption of the house. The solutions proposed in this study to improve energy efficiency in swimming pool facilities include the installation of solar collectors to heat swimming pool water more efficiently. The installation of smart actuation devices (to efficiently control energy consumption of a pool facility via different processes) together with sensors that provide valuable information on energy consumption in the different processes of a pool facility, can optimize energy consumption thus reducing overall consumption (by 90%) and economic cost (by more than 40%). Together, these solutions can help to significantly reduce energy consumption and economic costs and extrapolate it to different processes of similar characteristics in the rest of the society.

Regio- and Stereoselective Hydroelementation of SF5 -Alkynes and Further Functionalizations.

Herein is described a fully regio- and stereoselective hydroelementation reaction of SF5 -alkynes with N, O and S-nucleophiles and further functionalization of the corresponding Z-(hetero)vinyl-SF5 intermediates, a suitable platform to access α-SF5 ketones and esters, ß-SF5 amines and alcohols under mild reaction conditions. Experimental and computational comparative studies between SF5 - and CF3 -alkynes have been performed to highlight and explain the difference of reactivity and selectivity observed between these two fluorinated motifs.

Quality of Life and Side Effects Management in Cancer Treatment-A Cross Sectional Study.

Cancer disease is a world problem which is increasing in its prevalence. Oncology patients have a multitude of symptoms derived from the treatments and from the disease itself that affect their quality of life to a greater or lesser extent. The aim of this study has been to discover the physical and psychological symptoms related to chemotherapy treatment in Spanish cancer patients in order to improve their quality of life. Symptoms from the previous week were taken into account and the Memorial Symptom Assessment Scale was used to measure the frequency, severity and associated distress of 32 symptoms. A total of 246 chemotherapy patients at the University Day Hospital in Salamanca completed the scale once while receiving chemotherapy treatment. A 95% confidence interval was considered. The most prevalent symptoms were a lack of energy (76.4%), anxiety (66.7%) and a dry mouth (60.6%). Lung cancer was the most prevalent cancer in men (26%) and breast cancer was the most prevalent cancer in women (72%). There is no consensus on which is the most prevalent symptom in this population and more studies will need to be carried out to determine the best treatment protocols. Symptom's prevalence knowledge could improve the patients' care to prevent or avoid complications and to improve the cancer patients' quality of life.

Hospitalización a domicilio para pacientes quirúrgicos ante una pandemia por SARS-CoV-2: nuestra experiencia / Hospitalization at home for surgical patients in the face of a SARS-CoV-2 pandemic: our experience

Introducción: La hospitalización a domicilio para pacientes quirúrgicos (HaDQ) es una al-ternativa a la hospitalización convencional para pacientes quirúrgicos estables clínicamente, que precisen procedimientos de enfermería complejos por intensidad, frecuencia o carac-terísticas, y control por especialista quirúrgico en el domicilio.Método: Estudio transversal, descriptivo y retrospectivo de la actividad de la HADQ de nuestro hospital durante los primeros seis me-ses del 2020, para analizar la repercusión de la pandemia por SARS-CoV-2 en la unidad. Se distinguen tres periodos: prepandemia (enero-febreo), confinamiento (marzo-abril), poscon-finamiento (mayo-junio). Se diferencian dos grupos: A (HaD convencional) y B (despistaje preoperatorio COVID19). Se recogieron diver-sas variables: mes, tipo, estancia (HaD y hospi-tal), procedimientos, reingresos, domicilio, tipo visitas, COVID+. Se realizó un análisis estadís-tico descriptivo cuantitativo y cualitativo de los resultados obtenidosResultados: Ingresaron 345 pacientes, 225 en el grupo A (fase Pre (34%), fase C (40%), y fase Pos (25%)), y 120 en el B (fase C (75%), fase Pos (25%)). El confinamiento (fase C) fue el pe-ríodo más activo de la HADQ, tanto por número de ingresos (53%), como por la complejidad del grupo A que requería más procedimientos (71%) y más visitas domiciliarias (52%). Tam-bién aumentaron los pacientes de zona de no cobertura (42%), que implicaron visitas médicas y de enfermería en Hospital de Día (HD) (21%), y aumento de consultas telefónicas médicas (36%). En la fase Pos disminuyeron un 37% los ingresos del grupo A.Conclusiones: La HaDQ se reorganizó por la pandemia para atender a más pacientes quirúr-gicos, siendo un recurso asistencial esencial, especialmente durante el confinamiento. (AU)

Introduction: The HaDQ is an alternative to conventional hospitalization for clinically stable surgical patients who require complex nursing procedures due to intensity, frequency or char-acteristics, and control by a surgical specialist at home.Method: Cross-sectional, descriptive and ret-rospective study of the HADQ activity of our hospital during the first six months of 2020, to analyze the impact of the SARSCov2 pandemic in the unit. Three periods are distinguished: pre-pandemic (Jan-Feb), lockdown (Mar-Apr), post-lockdown (May-Jun). Two groups are differen-tiated: A (conventional HaD) and B (COVID19 preoperative screening). Various variables were collected: month, type, stay (HaD and hospi-tal), procedures, readmissions, address, type of visits, covid+. A quantitative and qualitative descriptive statistical analysis of the results ob-tained was carried out.Results: 345 patients were admitted, 225 in group A (phase Pre (34%), Phase C (40%), and phase Post (25%)), and 120 in group B (Phase C (75%), phase Post (25%)). %)). The confinement (phase C) was the most active period of the HADQ, both due to the number of admissions (53%), and the complexity of group A, which re-quired more procedures (71%) and more home visits (52%). There was also an increase in pa-tients from the non-coverage area (42%), which involved medical and nursing visits at the Day Hospital (HD) (21%), and an increase in medi-cal telephone consultations (36%). In the phase Post, the income of group A decreased by 37%.Conclusions: The HaDQ was reorganized due to the pandemic to care for more surgical pa-tients, being an essential care resource, espe-cially during confinement. (AU)