ABSTRACT
Patients with inflammatory bowel disease (IBD) treated with biologic and/or immunosuppressant drugs are at increased risk for opportunistic infections. Seroprevalence studies can confirm the diagnosis of SARS-CoV-2 infections as well as the associated risk factors. This is a descriptive study which primary endpoints were to highlight the prevalence of SARS-CoV-2 antibodies in a cohort of IBD patients in March 2021, and to analyze seroconversion in patients with known COVID-19 infection and its relationship with IBD treatments. Patients filled in a questionnaire about symptoms of COVID-19 infection and clinical information about their IBD. All included patients were tested for SARS-CoV-2 antibodies. 392 patients were included. Among patients with clinical infection, 69 patients (17,65%) were IgG-positive, 286 (73,15%) IgG-negative and 36 (9,21%) indeterminate. In relation to seroconversion among patients under biologic treatment, 13 patients of the 23 with a previous positive CRP developed antibodies (56.5%). However, when the influence of immunosuppressive treatment on the probability of developing antibodies was analyzed, no significant differences were seen between those patients with or without treatment (77.8% vs. 77.1%, p = 0.96). In our cohort of IBD patients, after one year of pandemic, there were 18.64% IgG positive patients, a higher prevalence than the general population (15.7%).
Subject(s)
Biological Products , COVID-19 , Inflammatory Bowel Diseases , Humans , COVID-19/epidemiology , Seroepidemiologic Studies , SARS-CoV-2 , Antibodies, Viral , Immunosuppressive Agents/therapeutic use , Inflammatory Bowel Diseases/drug therapy , Inflammatory Bowel Diseases/epidemiology , Immunoglobulin G , Biological Products/therapeutic useABSTRACT
OBJECTIVE: To describe the anesthetic technique used, the evaluation of airway patency, and the perioperative complications in patients with lower than average intelligence (mentally disabled) who are administered general anesthesia for dental surgery. MATERIAL AND METHODS: We carried out a prospective, descriptive, comparative study of mentally disabled ASA 2-3 patients. The patients were distributed in 2 groups: mild to moderate mental disability and severe to very severe mental disability. Induction was via intravenous or inhaled anesthesia depending on availability of venous access. Maintenance was with sevoflurane in oxygen and air at variable concentrations in order to maintain a bispectral index (BIS) between 40 and 60. Statistical comparisons were based on the chi2 test, the log-rank test and the t test. RESULTS: Forty-seven patients were enrolled. The anesthetic technique maintained hemodynamic stability in both groups. No statistically significant differences were found in Mallampati classification, Cormack-Lehane classification, or level of disability. The incidence of complications was higher in the group with more severe disability; the most common complication was difficult tracheal intubation. Bradycardia was the most common complication in the group with mild to moderate mental disability. CONCLUSIONS: The anesthetic technique used in this study proved to be safe and effective in this type of patient. A higher degree of mental disability led to less effective examination of the airway and more difficult direct laryngoscopy. BIS was as effective for monitoring in this population as it is in the general population.
Subject(s)
Anesthesia, Inhalation/methods , Anesthesia, Intravenous/methods , Intellectual Disability/complications , Oral Surgical Procedures , Tooth Diseases/surgery , Adolescent , Adult , Airway Obstruction/complications , Anesthesia, Inhalation/statistics & numerical data , Anesthesia, Intravenous/statistics & numerical data , Anesthetics, Inhalation/administration & dosage , Anesthetics, Inhalation/adverse effects , Bradycardia/chemically induced , Child , Electroencephalography , Female , Humans , Intubation, Intratracheal/methods , Male , Methyl Ethers/administration & dosage , Methyl Ethers/adverse effects , Middle Aged , Prospective Studies , Severity of Illness Index , Sevoflurane , Tooth Diseases/complicationsABSTRACT
OBJETIVO: Describir la técnica anestésica empleada,valorar la vía aérea y analizar las complicaciones perioperatoriasen pacientes con discapacidad intelectual (DI)sometidos a anestesia general para cirugía dental.MATERIAL Y MÉTODOS: Estudio prospectivo, descriptivoy comparativo de pacientes ASA II-III con DI. Se distribuyeronen dos grupos: DI leves-moderados y DI graves-muy graves. La inducción fue intravenosa oinhalatoria según la disponibilidad de acceso venoso. Elmantenimiento se realizó con oxígeno/aire, y sevofluoranoa concentración variable para mantener un BIS entre40-60. El análisis estadístico incluyó X2 de Mantel yHaensel, t de Student.RESULTADOS: Se incluyeron 47 pacientes. La técnicaanestésica mantuvo la estabilidad hemodinámica enambos grupos. No se encontraron diferencias estadísticamentesignificativas entre la clasificación Mallampati,la clasificación de Cormack-Lehane y el grado de discapacidad.La incidencia de complicaciones fue mayor enel grupo de mayor discapacidad, siendo la más frecuentela dificultad de intubación endotraqueal. La bradicardiafue la complicación más frecuente en los DI levesmoderados.CONCLUSIONES: La técnica anestésica empleada eneste tipo de pacientes se mostró segura y eficaz. Mayorgrado de DI conlleva peor exploración de la vía aérea ypeor laringoscopia directa. El BIS se mostró igualmenteeficaz que en la población sin discapacidad (AU)
OBJECTIVE: To describe the anesthetic technique used,the evaluation of airway patency, and the perioperativecomplications in patients with lower than averageintelligence (mentally disabled) who are administeredgeneral anesthesia for dental surgery.MATERIAL AND METHODS: We carried out a prospective,descriptive, comparative study of mentally disabled ASA 2-3 patients. The patients were distributed in 2 groups: mildto moderate mental disability and severe to very severemental disability. Induction was via intravenous or inhaledanesthesia depending on availability of venous access.Maintenance was with sevoflurane in oxygen and air atvariable concentrations in order to maintain a bispectralindex (BIS) between 40 and 60. Statistical comparisonswere based on the χ2 test, the log-rank test and the t test.RESULTS: Forty-seven patients were enrolled. Theanesthetic technique maintained hemodynamic stabilityin both groups. No statistically significant differenceswere found in Mallampati classification, Cormack-Lehane classification, or level of disability. The incidenceof complications was higher in the group with moresevere disability; the most common complication wasdifficult tracheal intubation. Bradycardia was the mostcommon complication in the group with mild tomoderate mental disability.CONCLUSIONS: The anesthetic technique used in thisstudy proved to be safe and effective in this type ofpatient. A higher degree of mental disability led to lesseffective examination of the airway and more difficultdirect laryngoscopy. BIS was as effective for monitoringin this population as it is in the general population (AU)
Subject(s)
Humans , Dental Care for Disabled/methods , Anesthesia, General , Anesthesia, Dental/methods , Prospective Studies , Anesthesia, Inhalation/methods , Oral Surgical Procedures/methodsABSTRACT
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