Utilidad de la consulta preanestésica para disminuir el grado de ansiedad en pacientes programados para intervención quirúrgica / Usefulness of pre-anesthetic consultation to reduce the degree of anxiety in patients scheduled for surgical intervention

ANTECEDENTES Y OBJETIVOS: La ansiedad preoperatoria puede alterar la evolución perioperatoria aumentando la necesidad de sedantes y analgésicos. La información recibida en la consulta de anestesia podría reducir el nivel de ansiedad. Nuestro objetivo fue comprobar la reducción del nivel de ansiedad tras la consulta preanestésica. MATERIALES Y MÉTODOS: Estudio observacional, unicéntrico y prospectivo. Se registraron datos sociodemográficos y clínicos. La frecuencia cardíaca, la tensión arterial y la ansiedad mediante el State-Trait Anxiety Inventory abreviado se midieron antes y después de la entrevista anestésica. Los resultados fueron analizados mediante el test de Wilcoxon y regresiones univariables. Un valor de p≤0,05 fue considerado significativo. RESULTADOS: Se incluyeron 90 pacientes, con una edad media de 62 años, 58% mujeres, 79% con estudios primarios o secundarios, 72% programados para cirugía ambulatoria, y un 72% prefería anestesia regional. La prevalencia de la ansiedad fue del 35,6% (puntuación en el State-Trait Anxiety Inventory de 5; RIC 3-9), que se redujo tras la consulta a 4 (RIC 2-6); p = 0,005. No hubo descenso significativo de los valores hemodinámicos ni relación entre el nivel de ansiedad y las variables sociodemográficas y clínicas. CONCLUSIONES: La información administrada en la entrevista anestésica logró reducir los niveles de ansiedad. Este hecho enfatiza la importancia de la consulta preanestésica en lo que a identificación y manejo de la ansiedad se refiere

BACKGROUND AND OBJECTIVES: Preoperative anxiety can alter perioperative evolution, increasing the need for sedatives and analgesics. Information received during the pre-anesthesia consultation could reduce the level of anxiety. The objective of this study was to determine whether preoperative anxiety levels decrease after the pre-anesthesia consultation. MATERIAL AND METHODS: Observational, unicentric, prospective study. Sociodemographic and clinical data were recorded. Heart rate, blood pressure and anxiety levels were measured before and after the pre-anesthesia consultation using the abbreviated State-Trait Anxiety Inventory. Results were analyzed using Wilcoxon test and univariate logistic regression. P=.05 was considered significant. RESULTS: Ninety patients were included, with a median age of 62 years; 58% were females, 79% had completed primary-secondary studies, 72% were selected for ambulatory surgery and 72% preferred regional anesthesia. The prevalence of anxiety was 35.6% (State-Trait Anxiety Inventory score 5; IQR 3-9); after the anesthesia consultation the score was reduced to 4 (IQR 2-6), P=.005. There was no significative decrease in hemodynamic values, and no significant relationship between anxiety and sociodemographic or clinical variables. CONCLUSIONS: The pre-anesthesia consultation reduces anxiety levels in surgical patients. This emphasizes the importance of the pre-anesthesia consultation in identifying and managing anxiety

Usefulness of pre-anesthetic consultation to reduce the degree of anxiety in patients scheduled for surgical intervention. / Utilidad de la consulta preanestésica para disminuir el grado de ansiedad en pacientes programados para intervención quirúrgica.

BACKGROUND AND OBJECTIVES: Preoperative anxiety can alter perioperative evolution, increasing the need for sedatives and analgesics. Information received during the pre-anesthesia consultation could reduce the level of anxiety. The objective of this study was to determine whether preoperative anxiety levels decrease after the pre-anesthesia consultation. MATERIAL AND METHODS: Observational, unicentric, prospective study. Sociodemographic and clinical data were recorded. Heart rate, blood pressure and anxiety levels were measured before and after the pre-anesthesia consultation using the abbreviated State-Trait Anxiety Inventory. Results were analyzed using Wilcoxon test and univariate logistic regression. P=.05 was considered significant. RESULTS: Ninety patients were included, with a median age of 62 years; 58% were females, 79% had completed primary-secondary studies, 72% were selected for ambulatory surgery and 72% preferred regional anesthesia. The prevalence of anxiety was 35.6% (State-Trait Anxiety Inventory score 5; IQR 3-9); after the anesthesia consultation the score was reduced to 4 (IQR 2-6), P=.005. There was no significative decrease in hemodynamic values, and no significant relationship between anxiety and sociodemographic or clinical variables. CONCLUSIONS: The pre-anesthesia consultation reduces anxiety levels in surgical patients. This emphasizes the importance of the pre-anesthesia consultation in identifying and managing anxiety.

La autopercepción del estrés psicológico se asocia con el ataque isquémico transitorio e ictus minor. Un estudio de casos y controles / Association between self-perceived psychological stress and transitory ischaemic attack and minor stroke: A case-control study

INTRODUCCIÓN: El ictus tiene una etiopatogenia compleja en la que influyen un gran número de factores de riesgo. Existe un creciente interés por el estudio de los cambios fisiopatológicos que conlleva el estrés y su posible relación con la enfermedad cerebrovascular. El propósito de este trabajo es valorar la fuerza de asociación entre la exposición al estrés y el ictus. MÉTODO: Realizamos un estudio de casos y controles (1:1), comparando la exposición al estrés en un grupo de pacientes con antecedentes de un primer ataque isquémico transitorio o ictus minor, frente a un grupo control. Se realizó una pregunta subjetiva sobre la percepción de estrés en los últimos meses y se aplicó el cuestionario estandarizado Effort-Reward Imbalance (ERI). Para el análisis utilizamos modelos de regresión logística. RESULTADOS: Incluimos 50 casos y 50 controles. No hubo diferencias significativas en las variables demográficas entre casos y controles, ni en nivel económico, situación social o laboral. El 50% de los casos refería situación de estrés moderada o grave frente al 30% de controles (OR: 2,33; IC95%: 1,02-5,30; p = 0,041). Cuestionario ERI: se observa que un mayor esfuerzo en el trabajo (OR: 1,48; IC95%: 1,19-1,83) y un mayor compromiso frente a una menor implicación laboral se asocia con el ictus (OR: 1,34; IC95%: 1,17-1,54); mientras que una mayor recompensa laboral tiene un factor protector (OR: 0,71; IC95%: 0,61-0,82). CONCLUSIONES: Existe una fuerte asociación entre la percepción del estrés y el ataque isquémico transitorio. El desequilibrio entre el esfuerzo y la recompensa laboral también se relaciona claramente con el ataque isquémico transitorio

INTRODUCTION: Stroke has a complex aetiopathogenesis influenced by numerous risk factors. There is growing interest in the study of the pathophysiological changes associated with stress and their potential relationship with cerebrovascular disease. The purpose of this paper is to assess the strength of association between exposure to stress and stroke. METHODS: We conducted a case-control study (1:1) to compare exposure to stress in a group of patients with a history of a first transient ischaemic attack (TIA) or minor stroke and in a control group. Participants were asked a subjective question about their perception of stress in the previous months and completed the standardised Effort-Reward Imbalance (ERI) questionnaire. Logistic regression models were used for data analysis. RESULTS: The study included data on 50 cases and 50 controls. There were no significant differences in demographic variables and economic, social, and employment status between cases and controls. Fifty percent of the cases reported moderate to severe stress, compared to 30% of controls (OR: 2.33; 95% CI: 1.02-5.30; P = .041). ERI questionnaire results found that greater effort at work (OR: 1.48; 95% CI: 1.19-1.83) and greater commitment is associated with stroke (OR: 1.34; 95% CI: 1.17-1.54), while higher reward constitutes a protective factor against the disease (OR: 0.71; 95% CI: 0.61-0.82). CONCLUSIONS: There is a strong association between self-perceived psychological stress and TIA. The imbalance between effort and reward at work is also clearly related to TIA

Association between self-perceived psychological stress and transitory ischaemic attack and minor stroke: A case-control study. / La autopercepción del estrés psicológico se asocia con el ataque isquémico transitorio e ictus minor. Un estudio de casos y controles.

INTRODUCTION: Stroke has a complex aetiopathogenesis influenced by numerous risk factors. There is growing interest in the study of the pathophysiological changes associated with stress and their potential relationship with cerebrovascular disease. The purpose of this paper is to assess the strength of association between exposure to stress and stroke. METHODS: We conducted a case-control study (1:1) to compare exposure to stress in a group of patients with a history of a first transient ischaemic attack (TIA) or minor stroke and in a control group. Participants were asked a subjective question about their perception of stress in the previous months and completed the standardised Effort-Reward Imbalance (ERI) questionnaire. Logistic regression models were used for data analysis. RESULTS: The study included data on 50 cases and 50 controls. There were no significant differences in demographic variables and economic, social, and employment status between cases and controls. Fifty percent of the cases reported moderate to severe stress, compared to 30% of controls (OR: 2.33; 95% CI: 1.02-5.30; P=.041). ERI questionnaire results found that greater effort at work (OR: 1.48; 95% CI: 1.19-1.83) and greater commitment is associated with stroke (OR: 1.34; 95% CI: 1.17-1.54), while higher reward constitutes a protective factor against the disease (OR: 0.71; 95% CI: 0.61-0.82). CONCLUSIONS: There is a strong association between self-perceived psychological stress and TIA. The imbalance between effort and reward at work is also clearly related to TIA.

Colloidal polymer particles as catalyst carriers and phase transfer agents in multiphasic hydroformylation reactions.

HYPOTHESIS: Colloidal particles have been used to covalently bind ligands for the heterogenization of homogeneous catalysts. The replacement of the covalent bonds by electrostatic interactions between particles and the catalyst could preserve the selectivity of a truly homogeneous catalytic process. EXPERIMENTS: Functionalized polymer particles with trimethylammonium moieties, dispersed in water, with a hydrophobic core and a hydrophilic shell have been synthesized by emulsion polymerization and have been thoroughly characterized. The ability of the particles with different monomer compositions to act as catalyst carriers has been studied. Finally, the colloidal dispersions have been applied as phase transfer agents in the multiphasic rhodium-catalyzed hydroformylation of 1-octene. FINDINGS: The hydrodynamic radius of the particles has been shown to be around 100 nm, and a core-shell structure could be observed by atomic force microscopy. The polymer particles were proven to act as carriers for the water-soluble hydroformylation catalyst, due to electrostatic interaction between the functionalized particles bearing ammonium groups and the sulfonated ligands of the catalyst. The particles were stable under the hydroformylation conditions and the aqueous catalyst phase could be recycled three times.

Causas de mortalidad por enfermedades de la piel y del tejido subcutáneo en Jerez de los caballeros (Badajoz - España) en el siglo XIX / Causes of mortality due to diseases of the skin and subcutaneous tissue in Jerez de los caballeros (Badajoz - Spain) in the 19th century

Las enfermedades de la piel y del tejido subcutáneo, en Jerez de los Caballeros durante el siglo XIX, provocaron 430 defunciones, el 2,3% del total, obtenidas mediante el análisis de los "libros de difuntos del archivo parroquial". Se agrupan siguiendo la clasificación de Bertillon: la gangrena con 325 casos y un 75,7% es la causa más abundante. Los párvulos presentan mayor mortalidad que los adultos, concretamente los <1 año: 126 óbitos. El sexo masculino tiene cifras más elevadas que las mujeres. El sector etario con mayor mortalidad en adultos, es el comprendido entre los 65 y 74 años con 48 muertes y un 11,2%. El mes con registros más elevados es julio, con 72 defunciones suponiendo un 16,8%. Los diagnósticos recogidos en las papeletas de defunción, podían sufrir errores a la hora de interpretarlos o transcribirlos a los libros de difuntos, por parte de los sacerdotes.

Diseases of the skin and subcutaneous tissue in Jerez de los Caballeros during the 19th century, caused 430 deaths, 2,3% total, obtained through the analysis of the deceased books of the parish archive. They are grouped following the Bertillon classification: with 325 cases and a 75,7% gangrene is the most abundant cause. Young children have higher mortality than adults, specifically the one year: 126 deaths. The male has figures higher than women. With higher mortality in adults age is between 65 and 74 years 48 deaths and a 11,2%. With higher registers month is July with 72 deaths assuming a 16,8%. Diagnostics collected ballots from death could suffer errors when interpreting them or transcribe them to deceased books, by the priests.

Causas de mortalidad por enfermedades de la piel y del tejido subcutáneo en Jerez de los caballeros (Badajoz - España) en el siglo XIX / Causes of mortality due to diseases of the skin and subcutaneous tissue in Jerez de los caballeros (Badajoz - Spain) in the 19th century

Las enfermedades de la piel y del tejido subcutáneo, en Jerez de los Caballeros durante el siglo XIX, provocaron 430 defunciones, el 2,3% del total, obtenidas mediante el análisis de los "libros de difuntos del archivo parroquial". Se agrupan siguiendo la clasificación de Bertillon: la gangrena con 325 casos y un 75,7% es la causa más abundante. Los párvulos presentan mayor mortalidad que los adultos, concretamente los <1 año: 126 óbitos. El sexo masculino tiene cifras más elevadas que las mujeres. El sector etario con mayor mortalidad en adultos, es el comprendido entre los 65 y 74 años con 48 muertes y un 11,2%. El mes con registros más elevados es julio, con 72 defunciones suponiendo un 16,8%. Los diagnósticos recogidos en las papeletas de defunción, podían sufrir errores a la hora de interpretarlos o transcribirlos a los libros de difuntos, por parte de los sacerdotes.(AU)

Diseases of the skin and subcutaneous tissue in Jerez de los Caballeros during the 19th century, caused 430 deaths, 2,3% total, obtained through the analysis of the deceased books of the parish archive. They are grouped following the Bertillon classification: with 325 cases and a 75,7% gangrene is the most abundant cause. Young children have higher mortality than adults, specifically the one year: 126 deaths. The male has figures higher than women. With higher mortality in adults age is between 65 and 74 years 48 deaths and a 11,2%. With higher registers month is July with 72 deaths assuming a 16,8%. Diagnostics collected ballots from death could suffer errors when interpreting them or transcribe them to deceased books, by the priests.(AU)

Nefro-urological mortality causes in Jerez de los Caballeros (Badajoz) in the nineteenth century.

The causes of mortality from nefro-urologic diseases in Jerez de los Caballeros (Badajoz) during the nineteenth century will be our object of study. We have analyzed the death registry books of the parishes in Jerez. The percentage of deaths from nefro-urologic diseases compared to other pathologies is 0.8%, being most affected males in age ranges from 25-34 and 65-75 years of age. The months with the highest mortality were July, December and January. Due to the deficient death registrations in the first decades of the century, the results should be taken with caution.

Causas de mortalidad ocular en Jerez de los Caballeros (Badajoz) en el siglo XIX / Ocular mortality reasons in Jerez de los Caballeros (Badajoz) in nineteenth century

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Punción paramedial para anestesia subaracnoidea en un paciente con gran tatuaje / Paramedian puncture for subarachnoid anaesthesia in a patient with a large tattoo

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Atractylis gummifera and Centaurea ornata in the Province of Badajoz (Extremadura, Spain)-Ethnopharmacological importance and toxicological risk.

ETHNOPHARMACOLOGICAL RELEVANCE: Atractylis gummifera L. and Centaurea ornata Willd. are locally marketed herbal remedies, even though in Spain it is forbidden to sell toxic plants like Atractylis gummifera. Intoxications in Spain are mainly due to accidental substitution of Centaurea ornata with Atractylis gummifera which may be fatal. AIM OF STUDY: The aim of this article is to analyse the current use and marketing of Atractylis gummifera and Centaurea ornata in Badajoz and analyse the ethnopharmacological relevance of two recent cases of Atractylis gummifera poisoning. BACKGROUND AND METHODS: An ethnopharmacological survey was conducted in the area where one of the poisoned patients lives and in Guadiana del Caudillo. The use, knowledge and naming of the species involved in the poisoning was assessed. This information was complemented with an exhaustive search in Spanish ethnobotanical works on the ethnopharmacological uses of both species. RESULTS: Intoxications are due to species' substitutions. The two species are similar in name and use in the area, and both are locally marketed. AG is mainly used to heal wounds and calcaneal spurs, and CO to treat gastric ulcers and wounds. CONCLUSIONS: New intoxications are likely since consumers often have limited knowledge of the plants they consume. Also, it is common to think that all medicinal plants are harmless. As the use of Atractylis gummifera seems to increase in the area, preventive measures need to be taken.

Leucoencefalopatía posterior reversible en gestante a término. Apropósito de un caso / No disponible

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[Patient with postpartum seizures: differential diagnosis]. / Paciente con convulsiones en el postparto. Diagnóstico diferencial.

Pre-eclampsia is a serious obstetric complication associated with a high rate of maternal and fetal morbidity and mortality. We report the case of a woman with a medical history of insulin-dependent diabetes mellitus and seizures possibly related to hypoglycemia who was admitted for an emergency cesarian due to severe pre-eclampsia and macrosomic fetus. In the first hour after delivery she experienced loss of consciousness and seizure, with vaginal bleeding and hypovolemic shock. Maximum vigilance is required for a patient with several concomitant diseases and a high-risk pregnancy. All prophylactic measures to lower the risk to mother and fetus should be undertaken. We analyze preanesthetic assessment, differential diagnosis, and choice of anesthesia in relation to this case.

Paciente con convulsiones en el postparto. Diagnóstico diferencial / Patient with postpartum seizures: differential diagnosis

La preeclampsia es una patología obstétrica grave con una elevada morbimortalidad materno-fetal. Presentamos el caso de una paciente, con antecedentes de diabetes mellitus insulinodependiente y convulsiones en posible relación con episodios de hipoglucemia, que ingresa para cesárea urgente por preeclampsia severa y feto macrosómico. En el postparto inmediato presenta pérdida brusca de consciencia y convulsión asociada a hemorragia vaginal y shock hipovolémico. Ante una paciente pluripatológica y con embarazo de alto riesgo es necesario extremar la vigilancia y llevar a cabo las medidas profilácticas necesarias para disminuir la morbimortalidad maternofetal. A propósito de este caso analizamos la valoración preanestésica, diagnóstico diferencial y elección de la técnica anestésica en este tipo de pacientes

Pre-eclampsia is a serious obstetric complication associated with a high rate of maternal and fetal morbidity and mortality. We report the case of a woman with a medical history of insulin-dependent diabetes mellitus and seizures possibly related to hypoglycemia who was admitted for an emergency cesarian due to severe pre-eclampsia and macrosomic fetus. In the first hour after delivery she experienced loss of consciousness and seizure, with vaginal bleeding and hypovolemic shock. Maximum vigilance is required for a patient with several concomitant diseases and a high-risk pregnancy. All prophylactic measures to lower the risk to mother and fetus should be undertaken. We analyze preanesthetic assessment, differential diagnosis, and choice of anesthesia in relation to this case