Validation of the Portuguese version of Amsterdam Preoperative Anxiety and Information Scale (APAIS).

BACKGROUND: Preoperative anxiety is common among the oncological surgical population. Due to its psychological and physiological detrimental effects, identifying and addressing it is of uttermost importance to improve anesthetic management and patient's outcomes. The aim of this study is to validate the Portuguese version of Amsterdam Preoperative Anxiety and Information Scale (APAIS) in the oncological population. METHODS: Following forward and backward translation of the original APAIS scale, further adaptation was obtained through cognitive interviewing. The resulting instrument was tested on the day before surgery on a sample of adult cancer surgical patients from a Portuguese oncology centre. Psychometric evaluation was derived from inter-item correlation, confirmatory factor analysis, Cronbach's alpha, correlation with comparative scales, receiver operating characteristic curve and Youden index. RESULTS: 109 patients (58 males, 51 females) were included. A three-dimensional model-anxiety about anesthesia, anxiety about surgery and desire for information, showed the best fit to the data. The questionnaire revealed high internal consistency (Cronbach alpha 0.81) and good inter-item correlation. Also, Portuguese APAIS correlated well with the gold standard anxiety scale. Therefore, the psychometric properties of this scale version make it a valid and reliable instrument. The optimal cutoff to maximize both sensitivity and specificity was 12 for the APAIS global anxiety score. CONCLUSIONS: Portuguese APAIS version is an accurate tool to identify preoperative anxiety among cancer patients and might impact its management, from premedication choice to provision of information and reassurance about either anesthesia or surgery.

Características de las adolescentes embarazadas de un área de salud / Characteristics of Pregnant Adolescents in a Health Area

Introducción: El embarazo en la adolescencia se ha convertido en un fenómeno de alcance mundial, lo que ha traído aparejado el aumento de las complicaciones propias de una gestación en este período de la vida; de ahí la importancia del estudio constante del comportamiento de este suceso. Objetivo: Identificar el comportamiento de importantes variables relativas a las embarazadas adolescentes. Métodos: Se efectuó una investigación descriptiva transversal en el Policlínico Docente 30 de Noviembre de Santiago de Cuba, durante los años 2016 y 2017, a partir de las historias obstétricas de las adolescentes que se embarazaron y parieron en esos años. Se seleccionaron variables de interés como edad, edad gestacional a la captación, edad de inicio de las relaciones sexuales, escolaridad, deserción escolar, evaluación nutricional a la captación, además de la edad de la pareja sexual y el peso del niño al nacer. Resultados: Las adolescentes mostraron una media de inicio de las relaciones sexuales de 15,7 años de edad, el mayor por ciento de deserciones escolares fue en la secundaria básica, las edades de las parejas sexuales entre 20 y 39 años tuvo mayor frecuencia y las que fueron evaluadas con peso deficiente a la captación aportaron mayor cantidad de recién nacidos con bajo peso. Conclusiones: El estudio frecuente del comportamiento del embarazo en la etapa de adolescencia es determinante en el enfrentamiento a este fenómeno y constituye un arma esencial para el mejoramiento del estado de salud de la población en este grupo de edad(AU)

Introduction: Adolescent pregnancy has become a worldwide phenomenon, which has brought about the increase in complications typical of childbearing in this period of life; hence, the importance of constant study about the behavior of this event. Objective: To identify the behavior of important variables concerning pregnant adolescents. Methods: A cross-sectional and descriptive research was carried out at 30 de Noviembre Teaching Polyclinic in Santiago de Cuba, during the years 2016 and 2017, based on the obstetric histories of the adolescents who became pregnant and gave birth in those years. Variables of interest were selected, such as age, gestational age at first prenatal visit, age of onset of sexual intercourse, schooling, dropout, nutritional assessment at first prenatal visit, in addition to the age of the sexual partner and the child weight at birth. Results: The adolescents showed a mean of onset of sexual relations of 15.7 years, the highest percentage of school dropouts corresponded to the basic secondary school, the ages of their sexual partners between 20 and 39 years were more frequent, and those were evaluated with deficient weight at first prenatal visit contributed a greater number of newborns with low weight. Conclusions: The frequent study of pregnancy background in the adolescent stage is decisive in coping with this phenomenon and constitutes an essential resource for improving the health status of the population in this age group(AU)

Factores de riesgo asociados al bajo peso al nacer en un área de salud de Santiago de Cuba / Risk factors associated with low birth weight in an health area from Santiago de Cuba

Introducción: El bajo peso al nacer constituye en todo el mundo y grupos de poblaciones el índice más importante para determinar las posibilidades que tiene el recién nacido de sobrevivir y tener un crecimiento sano. Objetivo: Identificar algunos factores de riesgo sociobiológicos asociados al bajo peso al nacer en el área de salud del Policlínico Docente 30 de Noviembre de Santiago de Cuba durante el 2016. Métodos: Se realizó un estudio analítico, de casos y controles. Se escogieron como controles a las 8 puérperas que aportaron igual cantidad de recién nacidos con bajo peso y como controles a 16 de las madres cuyo producto de la concepción tuvo un peso normal en igual período. Entre las variables analizadas figuraron: edad materna, antecedentes obstétricos desfavorables, enfermedades previas asociadas y propias del embarazo, edad gestacional en el momento del parto y estado nutricional. Resultados: En la serie predominaron las enfermedades previas y propias del embarazo, fundamentalmente la anemia y la infección vaginal; mientras que el parto pretérmino tuvo alta significación estadística. Conclusiones: Los factores de riesgos biológicos con mayor fuerza de asociación fueron la malnutrición por defecto durante la captación, las enfermedades previas y asociadas al embarazo; en tanto, entre los factores con significación estadística predominaron la prematuridad y el período intergenésico corto, no así los antecedentes obstétricos desfavorables. Existió correlación entre la edad gestacional, el bajo peso al nacer, la presencia de partos pretérminos y el crecimiento intrauterino retardado.

Introduction: Low birth weight constitutes in the entire world and populational groups the most important index to determine the possibilities that the newborn has to survive and to have a healthy growth. Objective: To identify some social and biological risk factors associated with low birth weight in the health area from 30 de Noviembre Teaching Polyclinic in Santiago de Cuba during 2016. Methods: An analytic study of cases and controls was carried out. The 8 postpartum women who contributed with the same quantity of underweight newborns and as controls 16 of the mothers whose product of the conception had a normal weight in same period were chosen. Among the analyzed variables there were: maternal age, unfavorable obstetric history, associated previous diseases and diseases characterizing pregnancy, gestational age at childbirth and nutritional state. Results: Previous diseases and diseases characterizing pregnancy, fundamentally anemia and vaginal infection prevailed in the series; while preterm childbirth had a high statistical significance. Conclusions: Biological risk factors with greater association force were malnutrition defect during registration, the previous diseases and those associated with pregnancy; as long as, among the factors with statistical significance prematurity and the short intergenesis prevailed, what did not occur with the unfavorable obstetric history. Correlation existed between gestational age, low birth weight, the presence of preterm childbirths and the slowed intra-uterine growth.

Anesthetic management of carcinoid syndrome: is octreotide enough? A case report / Manejo anestésico del síndrome carcinoide: es el octreótido suficiente? Presentación de un caso

Abstract: Carcinoid tumors are rare slow-growing neuroendocrine tissue neoplasms. Their ability to secrete bioactive substances to the systemic circulation is accountable for a clinical presentation known as carcinoid syndrome. Main symptoms include bronchoconstriction, flushing, diarrhea and hemodynamic instability. Octreotide, a somatostatin analogue, is the current mainstay for carcinoid syndrome treatment and perioperative management. However, no regimen has proven to be completely effective in preventing systemic manifestations and recent literature suggests that it might be an insufficient measure. We report a case of a 51-year-old male with a functioning small bowel neuroendocrine tumor and carcinoid syndrome presenting for a primary tumor resection, discussing possible pitfalls and key points in the care of these patients.

Resumen: Los tumores carcinoides son neoplasias de tejido neuroendocrino poco comunes y de crecimiento lento. Su capacidad para secretar sustancias bioactivas a la circulación sistémica es responsable por una presentación clínica conocida como síndrome carcinoide. Los principales síntomas incluyen broncoconstricción, enrojecimiento, diarrea e inestabilidad hemodinámica. Octreótido, un análogo de la somatostatina, es el pilar actual para el tratamiento del síndrome carcinoide y su manejo perioperatorio. Sin embargo, ningún tratamiento ha demostrado ser completamente eficaz para prevenir las manifestaciones sistémicas y estudios recientes indican que puede ser una medida insuficiente. Presentamos un caso de un varón de 51 años con un tumor neuroendocrino funcionante en el intestino delgado y un síndrome carcinoide, sometido a una resección del tumor primario, discutiendo posibles dificultades y puntos clave en la atención de estos pacientes.

Electrochemical determination of 8-oxoguanine in the presence of uric acid.

The electrochemical oxidation of 8-oxoguanine (8-oxoG) in the presence of uric acid (UA) was studied by differential pulse voltammetry over a wide pH range (1-12). The results showed that both compounds follow a pH-dependent oxidation mechanism that involves two electrons and two protons corresponding to reversible charge transfer reactions. The difference between the peak potential for the oxidation of each analyte was found to be always less than 100 mV over the whole pH range, the separation being greater in the pH interval 4-7. In mixtures of both analytes, pH 6 was shown to be the best for 8-oxoG determination in the presence of uric acid, since the peak current is higher and a greater peak separation is achieved.

Development of an HPLC method with electrochemical detection of femtomoles of 8-oxo-7,8-dihydroguanine and 8-oxo-7,8-dihydro-2'-deoxyguanosine in the presence of uric acid.

A selective method based on high performance liquid chromatography with electrochemical detection (HPLC-ECD) was developed to enable simultaneous detection of 8-oxo-7,8-dihydroguanine (8-oxoGua) and 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodGuo), products of DNA oxidative damage, in the presence of uric acid (UA), a strong interferent in their electrochemical detection. The method developed consists of HPLC isocratic elution with amperometric detection on a glassy carbon electrode, enabling a detection limit for 8-oxoGua and 8-oxodGuo lower than 1nM in standard mixtures. Detection of low concentrations up to 25nM of 8-oxoGua and 8-oxodGuo in the presence of UA in a 10(4)-fold higher concentration was achieved after one-step solid phase extraction (SPE). The method was tested with urine samples and it was possible to detect and quantify the presence of 8-oxoGua, and to confirm that UA was eliminated after uricase degradation and SPE. The LOD found in urine samples was about 80nM, a value higher than in standard mixtures, due to the increase of background current in the urine matrix. The results presented here contribute to the development of a methodological approach to simultaneous determination of 8-oxoGua and 8-oxodGuo in urine samples.