Study on the Association between Cesarean Section Birth and Asthma Risk in the Pediatric Population of the Health Area of Palencia between 1993 and 2020.

INTRODUCTION AND OBJECTIVES: Both asthma prevalence and the percentage of cesarean sections have increased in parallel in recent years. Research studies suggest an increased risk of developing atopic diseases and asthma after cesarean section birth compared to vaginal delivery. The main objective of this study is to analyze the risk of asthma admission after cesarean section birth compared to vaginal delivery in the pediatric population. POPULATION AND METHODS: Retrospective observational analytical case-control study from 1993 to 2020. The cases include all admitted patients to our health area hospital, for patients aged 7 to 16 diagnosed with asthma. For each case, a control without a diagnosis of asthma is selected with the same age, and that has also caused an episode of admission. RESULTS: A total of 290 admission episodes with a diagnosis of asthma were obtained, caused by 155 patients. Out of these, 145 cases with documented delivery types were selected. For cases, 155 controls were selected. The historical proportion of cesarean sections in the asthmatic group is 18.6%, compared to 14.2% in the non-asthmatic group. There is a statistically non-significant difference of 4.4% more cesarean sections in the asthmatic group compared to the control group. DISCUSSION: We have not demonstrated a statistically significant association between being born by cesarean section and an increased risk of asthma admission. Based on this finding, we cannot conclude that there is an association between being born by cesarean section and a higher risk of suffering from asthma, unlike what has been postulated in other research studies.

Subtype Distribution of Blastocystis spp. in Patients with Gastrointestinal Symptoms in Northern Spain.

Limited molecular data exist on the prevalence and subtype distribution of Blastocystis spp., the most prevalent parasite in human and animal feces worldwide. A total of 44 different subtypes (STs) of Blastocystis are currently recognized based on the sequence of the small subunit ribosomal RNA (SSU-rRNA) gene. This is a molecular study of Blastocystis spp. in hospitalized patients with gastrointestinal symptoms in northern Spain. We analyzed 173 Blastocystis-positive patients with gastrointestinal symptoms by using nested PCR for molecular detection, subtype identification, phylogenetic analyses, and genetic diversity assessment. ST2 (34.1%) and ST3 (34.7%) predominated, followed by ST1 (15.6%) and ST4 (15.6%). Mixed infections with different subtypes were observed in some patients. Sequence analysis revealed for the first time in European humans the allele 88 (a variant of ST1). In other cases, alleles commonly found in animal samples were detected (allele 9 in ST2, allele 34 in ST3, and allele 42 in ST4). Phylogenetic analysis showed high variability in ST1 and ST2, suggesting a polyphyletic origin, while both ST3 and ST4 exhibited higher genetic homogeneity, indicating a possible monophyletic origin and recent transmission to humans. These data confirm Blastocystis spp. subtype diversity and may help in understanding the evolutionary processes and potential zoonotic transmission of this parasite.

Multi-biomarker approach to evaluate the toxicity of chlorpyrifos (active ingredient and a commercial formulation) on different stages of Biomphalaria straminea.

Biomphalaria straminea is a freshwater gastropod native to South America and used in toxicological assessments. Our aim was to estimate 48 h-LC50 and sub-chronic effects after the exposure to low concentrations of chlorpyrifos as commercial formulation (CF) and active ingredient (AI) on B. straminea adult, embryos and juveniles. Concentrations between 1 and 5000 µg L-1 were chosen for acute exposures and 0.1 and 1 µg L-1 for the sub-chronic one. After 14 days biochemical parameters, viability and sub-populations of hemocytes, reproductive parameters, embryotoxicity and offspring' survival were studied. Egg masses laid between day 12 and 14 were separated to continue the exposure and the embryos were examined daily. Offspring' survival and morphological changes were registered for 14 days after hatching. 48 h-LC50, NOEC and LOEC were similar between CF and AI, however the CF caused more sub-lethal effects. CF but not the AI decreased carboxylesterases, catalase and the proportion of hyalinocytes with respect to the total hemocytes, and increased superoxide dismutase and the % of granulocytes with pseudopods. Also CF caused embryotoxicity probably due to the increase of embryos' membrane permeability. Acetylcholinesterase, superoxide dismutase, hemocytes sub-populations, the time and rate of hatching and juveniles' survival were the most sensitive biomarkers. We emphasize the importance of the assessment of a battery of biomarkers as a useful tool for toxicity studies including reproduction parameters and immunological responses. Also, we highlight the relevance of incorporating the evaluation of formulations in order to not underestimate the effects of pesticides on the environment.

Lead exerts a depression of neurotransmitter release through a blockade of voltage dependent calcium channels in chromaffin cells.

The present work, using chromaffin cells of bovine adrenal medullae (BCCs), aims to describe what type of ionic current alterations induced by lead (Pb2+) underlies its effects reported on synaptic transmission. We observed that the acute application of Pb2+ lead to a drastic depression of neurotransmitters release in a concentration-dependent manner when the cells were stimulated with both K+ or acetylcholine, with an IC50 of 119,57 µM and of 5,19 µM, respectively. This effect was fully recovered after washout. Pb2+ also blocked calcium channels of BCCs in a time- and concentration-dependent manner with an IC50 of 6,87 µM. This blockade was partially reversed upon washout. This compound inhibited the calcium current at all test potentials and shows a shift of the I-V curve to more negative values of about 8 mV. The sodium current was not blocked by acute application of high Pb2+ concentrations. Voltage-dependent potassium current was also shortly affected by high Pb2+. Nevertheless, the calcium- and voltage-dependent potassium current was drastically depressed in a dose-dependent manner, with an IC50 of 24,49 µM. This blockade was related to the prevention of Ca2+ influx through voltage-dependent calcium channels coupled to Ca2+-activated K+-channels (BK) instead a direct linking to these channels. Under current-clamp conditions, BCCs exhibit a resting potential of -52.7 mV, firing spontaneous APs (1-2 spikes/s) generated by the opening of Na+ and Ca2+-channels, and terminated by the activation of K+ channels. In spite of the effect on ionic channels exerted by Pb2+, we found that Pb2+ didn't alter cellular excitability, no modification of the membrane potential, and no effect on action potential firing. Taken together, these results point to a neurotoxic action evoked by Pb2+ that is associated with changes in neurotransmitter release by blocking the ionic currents responsible for the calcium influx.

Use of a local anaesthetic and antiseptic wound formulation for the treatment of lambs naturally infected with Orf virus.

Contagious ecthyma (CE) is a worldwide highly contagious zoonotic viral skin disease of sheep and goats. Treatment for Orf virus (ORFV) infection usually involves topical and oral antibiotics. An anaesthetic and antiseptic topical gel (Multisolfen® or Tri-Solfen®; MS®, Medical Ethics, Australia) has been documented as an efficacious therapy for lesions from mucosal and epithelial viral infections in ruminants. The present study tested a new treatment protocol of MS® for CE therapy on-farm in 150 lambs naturally infected with ORFV. Lambs were divided into three cohorts of 50 lambs each (C, D and E). Cohort C was treated with MS® 3 times with an interval of 3 days between treatments, cohort D was treated daily with hypochlorous acid, whilst cohort E served as untreated controls. The lambs were examined clinically every two days, weight measured weekly, with whole blood and sterile swabs from ORFV lesions collected for haematological analysis and specific ORFV PCR. Cohort C presented fewer lambs displaying ORFV-associated lesions than other cohorts at different times of the experiment. Further, lesions treated with MS® were milder compared with other cohorts. However, following cessation of therapy, most of the lambs again developed ORFV-associated lesions. No differences between cohorts were observed in weight, haematological and PCR results. These findings suggest that topical treatment with MS® is effective for CE in field conditions, especially in the first stages of the clinical course, although treatment with MS® may need to be extended a minimum of 4 weeks.

Molecular Diagnosis of Footrot and Contagious Ovine Digital Dermatitis in Small Ruminants in the Iberian Peninsula.

Contagious ovine digital dermatitis (CODD) and footrot (FR), a sub-acute or acute necrotic (decaying) infectious disease involving the hoof and underlying tissues, pose economic challenges to herds in Spain and worldwide. The aetiological agent for FR is Dichelobacter nodosus, while CODD is caused by pathogenic Treponema phylogroups. We detail the findings derived from the analysis by qPCR of 105 pooled samples from 100 ovine and five caprine herds in Spain and Portugal, alongside 15 samples from healthy flocks in order to identify Dichelobacter nodosus, Fusobacterium necrophorum, Treponema spp., and three pathogenic Treponema phylogroups (T. phagedenis, T. medium, and T. pedis). Treponema spp. were detected in all 120 pools, including samples from the 15 healthy flocks where only one positive result for F. necrophorum was recorded. Mixed infections by agents different from Treponema spp. were identified in 68.57% of samples. Positive results for F. necrophorum and/or D. nodosus, were obtained for 91.4% of the pools, whereas the presence of the three pathogenic Treponema phylogroups was rare: each of them appeared in isolation in a single pool, while they were found in 18 pools in combination with other agents. While F. necrophorum was the sole finding in 16.2% of samples from affected herds, D. nodosus (the footrot causative agent) was only detected in 61% of affected farms. An improved qPCR protocol was implemented to determine the serogroups of D. nodosus in the samples and found all of them (except the G serogroup), often in combined infections (35.1%). This report concludes with comprehensive proposals for diagnosing, preventing, and treating hoof ailments, remarking the interest of the information about D. nodosus serogroups in order to improve the efficiency of immunization by choosing appropriate vaccine protocols.

Perception about the Major Health Challenges in Different Swine Production Stages in Spain.

One of the main challenges for the sustainability and productivity of the Spanish swine industry is health instability, resulting in significant economic losses. Information on the main swine diseases which affect the Spanish pig industry could help in optimizing the efforts within control programs. This study determined the frequency of occurrence of the main diseases in Spain and the main control tool used, based on perceptions from veterinarians and consultants in a specific survey. Results showed that Streptococcus (S.) suis, E. coli, and coccidia are the most frequent pathogens in the gestation and lactation phase, whereas the most important were Porcine Reproductive and Respiratory Syndrome virus (PRRSV). In the nursery phase, the most frequent were S. suis, E. coli, and PRRSV, the latter being the most important for the participants. Finally, in the fattening phase, PRRSV and Actinobacillus pleuropneumoniae were the most frequent and important pathogen, respectively. Statistical differences among responses were detected with respect to the location and the gestation and lactation phases by farm size. Regarding the tools used for controlling the diseases, vaccination was the main strategy in all production phases, except in the fattening period, in which antibiotherapy was the most common response from the participants. Finally, the improvement of management practices was the most proposed tool, suggesting its importance within control programs.

Estado de salud de pacientes con trasplante hepático por enfermedad relacionada con el consumo de alcohol vs. otras etiologías: estudio de cohortes / Health status of patients with liver transplantation by alcohol-related disease vs another etiology: a cohort study

Objetivo: Estudiar el estado de salud de un grupo de pacientes con trasplante hepático (TH) por enfermedad relacionada con el consumo de alcohol vs. otras etiologías, antes y después del trasplante. Método: Estudio longitudinal de cohortes en pacientes trasplantados hepáticos desde noviembre de 2019 hasta julio de 2022. Se incluyeron pacientes atendidos para un primer TH tanto electivo como urgente en la Unidad de Trasplantes de un hospital. Se excluyeron aquellos pacientes que ya portaban un órgano trasplantado y aquellos que necesitaron un re-TH en el primer mes tras el primer trasplante. Se recogieron variables sociodemográficas y clínicas, Model for End-Stage Liver Disease (MELDNa), índice de fragilidad hepática (LFI), efectos emocionales-conductuales del trasplante, nivel de ansiedad y depresión. En el análisis estadístico se utilizaron las pruebas de X2 de Pearson, t de Student, U de Mann-Whitney y el signo de Wilcoxon. Resultados: La muestra fue n = 67 pacientes trasplantados hepáticos, con una edad promedio de 56,37 años, siendo 67,2% hombres y 39% por enfermedad hepática relacionada con el alcohol (EHRA). De todos los pacientes incluidos, 9% fueron trasplantes urgentes. El consumo de alcohol se asoció con una mayor edad, una alta tasa de fragilidad hepática y una situación laboral no activa. La etiología alcohólica se correlacionó con una mayor preocupación durante los primeros seis meses después del trasplante de hígado. Conclusión: Existen diferencias en el estado de salud de los pacientes trasplantados hepáticos por EHRA vs. otra etiología. Las enfermeras deben considerar la etiología de la enfermedad hepática para orientar los cuidados y las intervenciones durante todo el proceso de trasplante.(AU)

Aim: To study the health status of a group of patients with liver transplantation by alcohol-related disease vs another etiology before and after the transplantation. Method: Longitudinal cohort study of liver transplant patients from November 2019 to July 2022. Adult patients attended in the unit of transplantation of a hospital for a first liver transplant, both elective and urgent, were included. Patients who already had a transplanted organ and those who required liver re-transplantation in the first month after the first transplant were excluded. Sociodemographic and clinical variables, MELDNa, liver frailty index, emotional-behavioral effects of transplantation, level of anxiety and depression were collected. Pearson's chi-square, Student's t, Mann-Whitney U, and Wilcoxon sign tests were used for statistical analysis. Results: The sample was n = 67 liver transplant patients with a mean age of 56.37 years, 67.2% being men and 39% due to alcohol-related liver disease. 9% of all included patients were urgent transplants. Alcohol consumption was associated with older age, a high rate of liver frailty, and a non-active work situation. Alcoholic etiology correlated with increased concern during the first six months after liver transplantation. Conclusion: There are differences in the health status between liver transplant patients for alcohol-related liver disease vs other etiology. Nurses must consider the etiology of liver disease to guide care and interventions throughout the transplant process.(AU)

Health status of patients with liver transplantation by alcohol-related disease vs another etiology: A cohort study.

AIM: To study the health status of a group of patients with liver transplantation by alcohol-related disease vs another etiology before and after the transplantation. METHOD: Longitudinal cohort study of liver transplant patients from November 2019 to July 2022. Adult patients attended in the unit of transplantation of a hospital for a first liver transplant, both elective and urgent, were included. Patients who already had a transplanted organ and those who required liver re-transplantation in the first month after the first transplant were excluded. Sociodemographic and clinical variables, MELDNa, liver frailty index, emotional-behavioral effects of transplantation, level of anxiety and depression were collected. Pearson's chi-square, Student's t, Mann-Whitney U, and Wilcoxon sign tests were used for statistical analysis. RESULTS: The sample was n = 67 liver transplant patients with a mean age of 56.37 years, 67.2% being men and 39% due to alcohol-related liver disease. 9% of all included patients were urgent transplants. Alcohol consumption was associated with older age, a high rate of liver frailty, and a non-active work situation. Alcoholic etiology correlated with increased concern during the first six months after liver transplantation. CONCLUSION: There are differences in the health status between liver transplant patients for alcohol-related liver disease vs other etiology. Nurses must consider the etiology of liver disease to guide care and interventions throughout the transplant process.

Cross-cultural adaptation of the FRAIL scale for critically ill patients in Spain.

AIM: To translate and culturally adapt the FRAIL scale into Spanish and perform a preliminary test of diagnostic accuracy in patients admitted to intensive care units. DESIGN: Cross-sectional diagnostic study. METHODS: Five intensive care units (ICU) in Spain were participated. Stage 1: Three native Spanish-speaking bilingual translators familiar with the field of critical care translated the scale from English into Spanish. Stage 2: Three native English-speaking bilingual translators familiar with critical care medicine. Stage 3: Authors of the original scale compared the English original and back-translated versions of the scale. Stage 4: Five nurses with more than 5 years of ICU experience and five critical care physicians assessed the comprehension and relevance of each of the items of the Spanish version in 30 patients of 3 different age ranges (<50, 50-65 and >65 years). RESULTS: The FRAIL scale was translated and adapted cross-culturally for patients admitted to intensive care units in Spain. The process consisted of four stages: translation, back translation, comparison and pilot test. There was good correspondence between the original scale and the Spanish version in 100% of the items. The participating patients assessed the relevance (content validity) and comprehensibility (face validity) of each of the items of the first Spanish version. The relevance of some of the items scored low when the scale was used in patients younger than 65 years. CONCLUSIONS: We have cross-culturally adapted the FRAIL scale, originally in English, to Spanish for its use in the critical care medical setting in Spanish-speaking countries. IMPLICATIONS FOR PROFESSIONALS: Physicians and nurses can apply the new scale to all patients admitted to the intensive care units. Nursing care can be adapted according to frailty, trying to reduce the side effects of admission to these units for the most fragile patients. REPORTING METHOD: The manuscript's authors have adhered to the EQUATOR guidelines, using the COSMIN reporting guideline for studies on the measurement properties of patient-reported outcome measures. PATIENT OR PUBLIC CONTRIBUTION: In a pilot clinical study, we applied the first version of the FRAIL-Spain scale to intensive care unit (ICU) patients. Five nurses with more than 5 years of ICU experience and five critical care physicians assessed the relevance (content validity) and comprehensibility (face validity) of the five items of the first Spanish version. Relevance was assessed using a 4-point Likert scale ranging from 1 (no relevance) to 4 (high relevance), and comprehensibility was assessed as poor, acceptable or good. Each health professional applied the scale to three patients (total number of patients = 30) of three different age ranges (<50, 50-65 and >65 years) and recorded the time of application of the scale to each patient. Although the frailty scales were initially created by geriatricians to be applied to the elders, there is little experience with their application in critically ill patients of any age. Therefore, more information is needed to determine the relevance of using this scale in critical care patients. In this pilot study, we considered that nurses and critical care physicians should evaluate frailty using this adapted scale in adult patients admitted to the Intensive Care Units.

Use of a Local Anaesthetic/Antiseptic Formulation for the Treatment of Lambs Experimentally Infected with Orf Virus.

Contagious ecthyma is a highly transmissible eruptive viral disease of the skin and mucosa of sheep and goats distributed worldwide. The treatment of orf lesions is usually based on the use of antiseptics and antibiotics for the management of presumptive secondary infections, increasing risks of antimicrobial resistance. The wound dressing formulation Tri-Solfen® (TS) containing two local anaesthetics (lignocaine and bupivacaine), adrenaline and an antiseptic (cetrimide) in a gel formulation has been demonstrated to reduce suffering and enhance recovery in cattle and buffalo with oral and skin lesions due to foot-and-mouth disease virus infection and reduced the orf viral load in lambs. In the present study, experimental infection with the orf virus was conducted in 50 newborn lambs and 25 animals were treated after the presence of the first lesions with TS and repeated three days later. Daily clinical examination, haematological, serological, biomolecular and post-mortem analyses were conducted during 34 days after treatment. Results indicated that treatment had no effect on weight gain and clinical progression of the lesions. It was determined that seroconversion after experimental infection occurs 34 days after infection and suggested that the deep basal epithelial location of the orf lesions may have prevented the therapy from having altered the clinical course.

Análisis de las propiedades psicométricas de un cuestionario para medir la actitud hacia el humor en los profesionales sanitarios / Analysis of the psychometric properties of a questionnaire to measure the attitude towards humor in healthcare professionals

Objetivo principal: Analizar las propiedades psicométricas de un instrumento diseñado específicamente para evaluar la actitud ante el humor en profesionales sanitarios. Métodos: Estudio de validación, transversal. Se determinó la fiabilidad con el índice de discriminación, el coeficiente de correlación intraclase e ítem-total, el α de Cronbach y el índice de Pearson. La validez de constructo se analizó con el análisis factorial exploratorio. Resultados principales: La Escala Multidimensional del Humor en Profesionales Sanitarios (EMHUPS) consta de 35 ítems y 8 factores: humor con el paciente, en el trabajo, en los cuidados, en el entorno privado, formación en humor, en el entorno sanitario, demanda de formación en humor y humor y ocio. Presenta una varianza del 60,99% y una fiabilidad de 0,88. Conclusión principal: La escala EMHUPS presenta unas propiedades psicométricas aceptables en la medida del humor en profesionales sanitarios. (AU)

Objective: To evaluate the psychometric properties of an instrument designed specifically designed to determine attitude towards humor in health professionals. Methods: A cross-sectional and a validation study. The reliability study analysed the discrimination capacity of the items with discrimination index, the intraclass and item-total correlation coefficient, the Cronbach's α coefficient and the Pearson's correlation coefficient. In the validation study, the Exploratory Factor Analysis was carried out. Results: The Multidimensional Scale of Humor in Healthcare Professionals (EMHUPS) consists of 35 items divided into 8 factors: humor with the patient, humor at work, humor and care, humor in the private environment, training in humor, humor and the sanitary environment, demand for training in humor and humor and leisure. These factors explained a total variance of 60.99% with overall reliability of 0.88. Conclusions: EMHUPS presents acceptable psychometric properties in the measurement of humor in healthcare professionals. (AU)

Barriers and Facilitators to the Learning and Acquisition of Research Competencies among Nursing Students through Active Methodologies: A Qualitative Study Using Reflective Writing.

BACKGROUND: The development of educational research, critical thinking skills, and evidence-based practice requires proposals for educational innovation. The purpose of this study was to explore the perspectives of undergraduate nursing students on the barriers and facilitators after the implementation of a novel activity within the course of research methodology, composed of three active learning strategies: (a) project-based learning; (b) small-group learning; and (c) self-directed learning. METHODS: A qualitative exploratory study using reflective writing was conducted at the Nursing Department of the Red Cross School (Spain). Seventy-four nursing students participated in the study, enrolled in the research methodology course. Purposive sampling was used. Online reflective notes were collected from a script of open-ended questions. An inductive thematic analysis was performed. RESULTS: The new proposals facilitated learning of the subject matter and its contents. They were useful and enabled the students to put the contents into practice. In addition, they improved the students' organization, planning, and involvement. The barriers identified were a lack of time, ambiguity, inadequate tutoring or novelty of the work, and inequity in the distribution of tasks and workloads. CONCLUSIONS: Our findings shed light on the barriers and facilitators identified by nursing students when implementing an educational innovation proposal, using three active learning methodologies as learning tools for the subject of nursing research.

Characteristics and outcomes of the Spanish registry for pediatric patients with bicuspid aortic valve (REVAB).

INTRODUCTION AND OBJECTIVES: Bicuspid aortic valve (BAV) disorder is the most common congenital heart disease. The aim of this study was to describe the characteristics of 0- to 18-year olds with BAV in a population-based registry. METHODS: Data from all pediatric patients were obtained from the Spanish registry for pediatric patients with bicuspid aortic valve (REVAB) (< 18 years). For data analysis, patients with BAV were divided into 2 groups by their features: isolated BAV and BAV with associated congenital heart disease. RESULTS: We included 1681 patients from 33 hospitals. Males accounted for 69.6% (n = 1158). Valve morphology was horizontal in 63.4% (n = 1012) and pure (Sievers type 0) in 28.4% (n=469). Isolated BAV was present in 63.7% (n=1060), and concomitant left-sided obstructive lesions in 23.4% (n=390). Interventions were required in 8.6% (n=145). CONCLUSION: These data represent the first large, population-based description of the clinical presentations and outcomes of patients enrolled in the Spanish registry for pediatric patients with bicuspid aortic valve.

GnRH agonists: Updating fixed-time artificial insemination protocols in sows.

Protocols for fixed-time artificial insemination (FTAI) in swine reproduction can help increase genetic improvement and production efficiency. Different gonadotropin-releasing hormone (GnRH) agonists have been developed to gain better control of follicular development, timing, and ovulation quality; therefore, they have been extensively used in FTAI protocols. This literature review resumes the most important characteristics of the physiology of follicular development and ovulation in sows, followed by a discussion about the hormonal alternatives available to induce ovulation (human chorionic gonadotropin, hCG; porcine luteinizing hormone, LH and GnRH agonists). Also, ovulation induction failures with GnRH agonists are described. Finally, current FTAI protocols with GnRH agonists are resumed and discussed. FTAI with GnRH agonists has proven to be an efficient, successful reproductive protocol that can be implemented in pig farms due to better knowledge of an endocrine system that regulates follicular development and ovulation and increased availability of several GnRH agonists that allow more efficient reproductive swine programs.

Resilience After COVID-19: A Descriptive, Cross-Sectional Study.

The main purpose of this study was to examine the relationship between resilience and health-related quality of life in patients following COVID-19 disease among those with and without lingering symptoms. The study design is descriptive and cross-sectional. Participants (n = 97) were adults who had earlier contracted COVID-19 disease and were in post-infection status between July and October 2020. Participants completed the following instruments: Connor-Davidson Resilience Scale, Short-Form 12-item Health Survey, and Hospital Anxiety and Depression Scale. Approximately 35% post-COVID-19 patients had a low level of resilience. The impact on the health status and resilience of those who had reported symptoms after 6 months was also significant. Age and depression had a significant impact on level of resilience. This relationship can affect patient recovery and negatively impact the ability to cope with COVID-19 disease. It is necessary to implement specialized training for clinicians on the effects of long-term COVID-19 to improve patient care. Long COVID symptoms might manifest months after an acute COVID-19 illness; clinicians who can confirm patient reports of these symptoms may help patients recover and become more resilient.

Preoperative respiratory therapy in patients undergoing surgery for lung cancer: A randomized controlled trial.

BACKGROUND: A preoperative respiratory therapy treatment was performed to analyze the effectiveness, with respect to postoperative air leak and pain, in patients undergoing surgery for lung cancer. OBJECTIVES: To analyze air leakage and postoperative pain. MATERIAL AND METHODS: Seventy one patients were studied, with a mean age of 62.58 years. Descriptive variables of gender, carcinogenic pathology, type of surgical incision and lung resection, use of glue and endostapler, and presence of adhesions were analyzed. Likewise, analysis of the quantitative variables of age, body mass index and forced expiratory volume in 1 s Two homogeneous groups resulted. Differentiated, experimental group (EG) that performed preoperative respiratory therapy and control group (CG). RESULTS: There were statistically significant differences in favor of the EG with respect to postoperative air leak on days 1-2 during the performance of physiotherapy techniques, the food and during the performance of the exercises autonomously. Furthermore, differences in air leakage were observed on days 2-4 during gait. The number of patients decreased to a greater extent in the EG. Regarding pain, there were statistically significant differences in the sample on days 1-4, with greater intensity of pain in the CG and after doing physiotherapy every day except the second. CONCLUSIONS: Preoperative respiratory therapy in patients undergoing surgery for lung cancer was effective in reducing the number of patients who presented postoperative air leak and reducing pain in the EG.

Design of an instrument to measure humor in health professionals.

AIM: The objective of this study was to develop an instrument for measuring humor in health professionals. METHODS: Observational, transversal and descriptive study of mixed methodology. The instrument was designed in several phases: literature review, item generation, determination of the scale format, review by the expert panel, pilot study, reevaluation by the expert panel, and test-retest. The pertinence, relevance and comprehension of the items were analyzed. Interobserver agreement was calculated with Kappa and the intraclass correlation coefficient considering values ≥0.61. Pared sample Student's t test and Pearson's correlation coefficient were used. A level of statistical significance was established at P < 0.05. RESULTS: The Three-Dimensional Scale of Humor in Health Professionals consists of 50 items measured with a 5-point Likert scale based on the degree of agreement. Experts' panel evaluated the global scale with 3.57 (0.79) points out of 5. An interobserver reliability of 0.69 (P < 0.001) was obtained in the pilot study. A Pearson correlation coefficient of 0.71 (P = 0.002) and an intraclass correlation coefficient of 0.69 (P = 0.001) resulted in the test-retest. No statistically significant differences were observed between test-retest scores. CONCLUSION: The Three-Dimensional Scale of Humor in Health Professionals is an innovative tool for measuring humor in the health context. This scale is created specifically for health professionals. It's necessary its validation in future studies.