Effect of Tumor Regression Grade on Survival and Disease-Free Interval in Patients Operated on for Locally Advanced Rectal Cancer.

INTRODUCTION: Colorectal cancer is the fourth leading cause of cancer-related death in both men and women in our population. In this regard, rectal cancer accounts for more than half of colorectal cancer deaths, and its incidence is expected to increase in the coming years. There have been significant changes in neoadjuvant therapy regimens, with promising results, as demonstrated by the recent RAPIDO and PRODIGE23 studies. Around 40% of patients diagnosed with locally advanced rectal cancer show some degree of response to neoadjuvant treatment, with complete tumor regression observed in up to one in five patients. MATERIALS AND METHODS: Retrospective observational study. A total of 181 patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy followed by surgery were analyzed. Clinical and pathological data were collected from the patients, including assessment of tumor regression through histopathological studies after surgery. The Mandard tumor regression grading system was used to categorize tumor response into different grades. RESULTS: The results showed a significant association between the degree of tumor regression and several important clinical outcomes. Specifically, patients with higher tumor regression had significantly better disease-free survival than those with less regression (p = 0.004). In addition, tumor regression was also correlated with the incidence of local recurrence (p = 0.018) and distant metastasis (p = 0.032). These associations suggest that tumor responsiveness to neoadjuvant therapy may influence the long-term progression of the disease. Regarding tumor deposits and the presence of lymphadenopathy, these factors were also found to be significantly associated with clinical outcomes. Patients with tumor deposits had a higher incidence of local recurrence (p = 0.025) and distant metastases (p = 0.041), while the presence of lymphadenopathy increased the risk of local recurrence (p = 0.013). These findings highlight the importance of evaluating not only tumor regression but also other pathological markers to predict prognosis and guide clinical management. CONCLUSIONS: The degree of tumor regression was not an independent predictor of survival compared to other variables such as nodal stage and presence of tumor deposits. This indicates that while tumor regression is an important factor, other elements also play a crucial role in determining the prognosis of patients with locally advanced rectal cancer. This study provides additional evidence for the importance of tumor regression, tumor deposits, and lymphadenopathy as predictors of clinical outcomes in patients with rectal cancer treated with neoadjuvant chemoradiotherapy.

Recurrent Ureterosciatic Herniation Causing Right Obstructive Uropathy.

Sciatic hernias are unusual, challenging to diagnose, and can present some treatment dilemmas. Sciatic hernias containing the ureter are even less common. Symptoms are variable from renal fossa pain, mild or severe pelvic pain, neuropathic pain, or dysesthesias. Although stenting alone can be a treatment option for this condition, in cases where symptoms or ureteral obstruction relapse after initial treatment, sciatic hernioplasty must be considered as the definitive treatment. This article presents the case of a female patient who presented with a history of nonspecific abdominal pain and was diagnosed with a right-sided ureterosciatic hernia. This was managed with a ureteral stent for reduction of herniated ureteral content, but after recurrence, laparoscopic sciatic hernioplasty was performed. The patient was pain-free and without obstructive uropathy at the one-year follow-up.

Thyroid abscess, an uncommon diagnosis: A case report and mini­review of the literature.

Thyroid abscess is a rare entity, commonly experienced by immunocompromised patients, or those who have anatomical abnormalities or a pre-existing thyroid disease. An early diagnosis continued by treatment with antibiotics and drainage of the abscess is the recommended therapeutic strategy for such cases. The present study describes a clinical case of this rare event, and also provides a brief literature review. The present study describes the case of a 48-year-old healthy male with no medical antecedents, apart from acute prostatitis treated with antibiotics for 6 days prior, who visited the Emergency Department of the authors' hospital with neck pain and progressive swelling of the mass. Diagnostic imaging confirmed the authors' suspicion of an abscess and revealed the lesion displacing the airway to the contralateral side. This restricted the mobility of the neck of the patient. As an emergency measure, the patient was then taken to the operating room for a neck examination. A hemithyroidectomy was finally performed. Following a prolonged hospital duration, he was discharged from the hospital and his recovery was uneventful without any voice alterations, hypocalcemia or recurrence.

Single metachronous bone metastasis following rectal adenocarcinoma: A case report.

Colorectal cancer (CRC) ranks as the third leading cause of cancer-related mortality in developed countries. While its incidence in early stages has increased due to screening programs, a significant number of patients experience the development of metastases either at the time of diagnosis or during follow-ups. Unlike certain other types of cancer, such as breast, prostate, or lung cancer, where bone tissue is a common site for secondary dissemination, CRC primarily spreads to the lymph nodes, liver and lungs. The occurrence of bone metastases from CRC is rare and usually coincides with tumor involvement in other locations. Risk factors for bone metastases include the location of the primary tumor, the age of the patients, KRAS mutations and the degree of tumor differentiation. Unlike metastases to the liver and lungs, bone metastases tend to be symptomatic, affecting the patient's quality of life and resulting in a poorer prognosis with shorter survival rates. The approach to patient management needs to be personalized. The present study describes the of a patient who underwent surgery for stage IV rectal adenocarcinoma and later developed a metastasis in the costal wall 79 months post-intervention, with no evidence of recurrence at other sites.

Spontaneous cervical hematoma caused by giant parathyroid adenoma in an elderly patient: A case report.

Spontaneous cervical hematoma usually occurs as a consequence of extracapsular bleeding from a parathyroid gland, generally due to the presence of an adenoma (giant adenoma), glandular hyperplasia, cystic component, or, less frequently, due to the existence of a carcinoma. The hematoma can be confined to the cervical compartment or extend to the mediastinum, potentially causing airway compression. Despite this, the recommended management in hemodynamically stable patients consists of surveillance and hospital monitoring with delayed surgery after a few weeks. On the other hand, in those patients with airway compromise and instability, emergency surgery, consisting of cervicotomy and drainage, is mandatory. The present study describes the case of a 78-year-old patient with a medical history of high blood pressure, non-insulin-dependent diabetes mellitus, dyslipidemia, moderate aortic stenosis, chronic kidney disease and sarcoidosis under pharmacological treatment who attended the emergency department due to symptoms of neck pain, an increase in soft tissue, and dyspnea on moderate exertion with an evolution leading to respiratory failure. This was secondary to a diagnosis of spontaneous cervical hematoma that required urgent surgical intervention. The results of histopathological analysis revealed that a giant parathyroid adenoma was responsible for the bleeding. The patient had a complicated post-operative period with a prolonged admission to the intensive care unit.

Limas rotatorias de uso en Odontopediatría: revisión de la literatura / Rotary files for use in pediatric dentistry: Literature review

Introducción: Los dientes primarios juegan un importante papel en el crecimiento y desarrollo general de los niños, por lo que es necesario conservarlos hasta el momento de su recambio fisiológico. Cuando existe una afectación pulpar que compromete la vitalidad del diente, la pulpectomía se convierte en un reto para el odontopediatra debido a la compleja anatomía radicular de los dientes primarios. En esta revisión bibliográfica se darán a conocer diferentes sistemas de limas usados en odontopediatría, y así brindar una mirada actualizada de la instrumentación rotatoria al realizar pulpectomías en los molares primarios. Material y Método: se realizó una búsqueda bibliográfica en Pubmed y Web of Science de acuerdo con criterios de inclusión y exclusión previamente establecidos. Resultados: tras aplicar los criterios de inclusión y exclusión fueron seleccionados un total de 30 referencias bibliográficas de los últimos 15 años. Conclusión: las limas rotatorias pediátricas pueden considerarse alternativas seguras y más eficientes en la realización de pulpectomías en molares primarios, ya que se reduce el tiempo de tratamiento, se produce desbridamiento completo de los conductos y se mantiene la función del diente hasta su exfoliación. (AU)

Introduction: Primary teeth play an important role in the growth and development of children, so it is necessary to keep them until the moment of their physiological replacement. When there is a pulp involvement that compromises the vitality of the tooth, pulpectomy treatment becomes a challenge for the pediatric dentist due to the complex root anatomy of primary teeth. This review of the literature will present different file systems used in primary teeth and provide an updated look at rotary instrumentation when performing pulpectomies on primary molars. Material and Method: a bibliographic search was carried out in Pubmed and Web of Science according to previously established inclusion and exclusion criteria. Results: after applying the inclusion and exclusion criteria, a total of 30 bibliographic references from the last 15 years were selected. Conclusion: pediatric rotary files can be considered safe and more efficient alternatives in performing pulpectomies on primary molars, due to treatment time is reduced, complete debridement of the root canals is produced, and tooth function is maintained until exfoliation. (AU)

Metagenómica salival aplicada en Odontología: revisión bibliográfica / Salivary metagenomics applied in dentistry: Literature review

Introducción: la metagenómica es un campo nuevo en el que se persigue obtener secuencias del genoma de los diferentes microorganismos que componen una comunidad, extrayendo y analizando su ADN de forma global. La posibilidad de secuenciar directamente los genomas de microorganismos sin necesidad de cultivarlos abre nuevas opciones que suponen un cambio de rumbo en la microbiología, sobre todo, teniendo en cuenta que en la cavidad oral sólo el 35% han sido identificadas. La microbiota oral humana es la comunidad de microorganismos comensales, simbióticos y patógenos que se encuentran en la cavidad oral. La saliva juega un papel importante en la determinación de su composición y actividad, siendo bien reconocida como un conjunto de marcadores biológicos, que se puede recolectar fácilmente, de forma no invasiva, indolora y no traumática, por lo que podría ser un sustituto de la sangre en el pronóstico y diagnóstico de enfermedades. Material y método: se realizó una búsqueda bibliográfica en Pubmed de acuerdo con unos criterios de inclusión y exclusión previamente establecidos. Resultados: fueron seleccionadas un total de 37 referencias bibliográficas entre 2010-2023. Conclusión: el análisis microbiológico de la saliva es una alternativa fácil y no invasiva. La microbiota salival refleja las alteraciones bacterianas locales que se producen en la microbiota subgingival y supragingival. Por ello resulta interesante poder ampliar el conocimiento en el mundo microbiano oral, y poder ayudar a definir con más exactitud la etiología de la caries y periodontitis y así poder avanzar hacia tratamientos preventivos y curativos mucho más eficaces. (AU)

Introduction: Metagenomics is a new field in which the aim is to obtain genome sequences of the different microorganisms that make up a community, extracting and analyzing their DNA globally. The possibility of directly sequencing the genomes of micoorganism, without the need to cultive them, opens up new options that represent a change of direction in microbiology, especially considering that only 35% have been identified in the oral cavity. The human oral microbiota is the community of commensal, symbiotic and pathogenic microorganisms found in the oral cavity. Saliva plays an important role in determining its composition and activity, being well recognized as a set of biological markers, wich can be easily collected and non-invasive, painless and non-traumatic way, so it could be a substitute for blood in the prognosis and diagnosis of diseases. Method: A literature search was carried out in Pubmed according to previously established inclusion and exclusion criteria. Results: A total of 37 bibliographic references were selected between 20102023. Conclusion: Microbiological analysis of saliva is an easy and non-invasive alternative. The salivary microbiota reflects the local bacterial alterations that occur in the subgingival and supragingival microbiota. It is therefore interesting to be able to expand knowledge in the oral microbial world, and to be able to help define more accurately the etiology of caries and periodontitis and thus be able to move towards much more effective preventive and curative treatments. (AU)

Limas rotatorias de uso en Odontopediatría: revisión de la literatura / Rotary files for use in pediatric dentistry: Literature review

Introducción: Los dientes primarios juegan un importante papel en el crecimiento y desarrollo general de los niños, por lo que es necesario conservarlos hasta el momento de su recambio fisiológico. Cuando existe una afectación pulpar que compromete la vitalidad del diente, la pulpectomía se convierte en un reto para el odontopediatra debido a la compleja anatomía radicular de los dientes primarios. En esta revisión bibliográfica se darán a conocer diferentes sistemas de limas usados en odontopediatría, y así brindar una mirada actualizada de la instrumentación rotatoria al realizar pulpectomías en los molares primarios. Material y Método: se realizó una búsqueda bibliográfica en Pubmed y Web of Science de acuerdo con criterios de inclusión y exclusión previamente establecidos. Resultados: tras aplicar los criterios de inclusión y exclusión fueron seleccionados un total de 30 referencias bibliográficas de los últimos 15 años. Conclusión: las limas rotatorias pediátricas pueden considerarse alternativas seguras y más eficientes en la realización de pulpectomías en molares primarios, ya que se reduce el tiempo de tratamiento, se produce desbridamiento completo de los conductos y se mantiene la función del diente hasta su exfoliación. (AU)

Introduction: Primary teeth play an important role in the growth and development of children, so it is necessary to keep them until the moment of their physiological replacement. When there is a pulp involvement that compromises the vitality of the tooth, pulpectomy treatment becomes a challenge for the pediatric dentist due to the complex root anatomy of primary teeth. This review of the literature will present different file systems used in primary teeth and provide an updated look at rotary instrumentation when performing pulpectomies on primary molars. Material and Method: a bibliographic search was carried out in Pubmed and Web of Science according to previously established inclusion and exclusion criteria. Results: after applying the inclusion and exclusion criteria, a total of 30 bibliographic references from the last 15 years were selected. Conclusion: pediatric rotary files can be considered safe and more efficient alternatives in performing pulpectomies on primary molars, due to treatment time is reduced, complete debridement of the root canals is produced, and tooth function is maintained until exfoliation. (AU)

Metagenómica salival aplicada en Odontología: revisión bibliográfica / Salivary metagenomics applied in dentistry: Literature review

Introducción: la metagenómica es un campo nuevo en el que se persigue obtener secuencias del genoma de los diferentes microorganismos que componen una comunidad, extrayendo y analizando su ADN de forma global. La posibilidad de secuenciar directamente los genomas de microorganismos sin necesidad de cultivarlos abre nuevas opciones que suponen un cambio de rumbo en la microbiología, sobre todo, teniendo en cuenta que en la cavidad oral sólo el 35% han sido identificadas. La microbiota oral humana es la comunidad de microorganismos comensales, simbióticos y patógenos que se encuentran en la cavidad oral. La saliva juega un papel importante en la determinación de su composición y actividad, siendo bien reconocida como un conjunto de marcadores biológicos, que se puede recolectar fácilmente, de forma no invasiva, indolora y no traumática, por lo que podría ser un sustituto de la sangre en el pronóstico y diagnóstico de enfermedades. Material y método: se realizó una búsqueda bibliográfica en Pubmed de acuerdo con unos criterios de inclusión y exclusión previamente establecidos. Resultados: fueron seleccionadas un total de 37 referencias bibliográficas entre 2010-2023. Conclusión: el análisis microbiológico de la saliva es una alternativa fácil y no invasiva. La microbiota salival refleja las alteraciones bacterianas locales que se producen en la microbiota subgingival y supragingival. Por ello resulta interesante poder ampliar el conocimiento en el mundo microbiano oral, y poder ayudar a definir con más exactitud la etiología de la caries y periodontitis y así poder avanzar hacia tratamientos preventivos y curativos mucho más eficaces. (AU)

Introduction: Metagenomics is a new field in which the aim is to obtain genome sequences of the different microorganisms that make up a community, extracting and analyzing their DNA globally. The possibility of directly sequencing the genomes of micoorganism, without the need to cultive them, opens up new options that represent a change of direction in microbiology, especially considering that only 35% have been identified in the oral cavity. The human oral microbiota is the community of commensal, symbiotic and pathogenic microorganisms found in the oral cavity. Saliva plays an important role in determining its composition and activity, being well recognized as a set of biological markers, wich can be easily collected and non-invasive, painless and non-traumatic way, so it could be a substitute for blood in the prognosis and diagnosis of diseases. Method: A literature search was carried out in Pubmed according to previously established inclusion and exclusion criteria. Results: A total of 37 bibliographic references were selected between 20102023. Conclusion: Microbiological analysis of saliva is an easy and non-invasive alternative. The salivary microbiota reflects the local bacterial alterations that occur in the subgingival and supragingival microbiota. It is therefore interesting to be able to expand knowledge in the oral microbial world, and to be able to help define more accurately the etiology of caries and periodontitis and thus be able to move towards much more effective preventive and curative treatments. (AU)

[Translation and transcultural adaptation of the Person-Centred Practice Inventory Staff (PCPI-S) for health professionals in Spain].

BACKGROUND: Person-centred practices - following national and international developments in health-care policies - have become a key approach in healthcare. The Person-Centred Practice Inventory - Staff is an instrument based on the theoretical framework Person-Centred Practice that focuses on the staff's perspective and how they experience person-centred practices. Here, the aim of this study is to obtain the first Spanish version of the PCPI-S translated and adapted into the Spanish context. METHODS: The translation and adaptation of the instrument followed the Translation and Cultural Adaptation of Patient Reported Outcomes Measures - Principles of Good Practice, which included a consulting session with experts. Content validation measures on clarity and relevance were assessed for every item (I-CVI) and the survey as a whole (S-CVI/Ave). RESULTS: No major difficulties were registered to reach an agreement on the 12 items that needed to be clarified. Regarding clarity and relevance. The validity index per item (I-CVI) obtained excellent scores for clarity in 53 items and for relevance in 59; the S-CVI/Ave showed excellent results (=90). CONCLUSIONS: This first version of the Person-Centred Practice Inventory - Staff instrument adapted to the Spanish context is conceptually and semantically equivalent to the original one. This valuable tool will be of great help to identify the perception of healthcare professionals on person-centred practices.

Traducción y adaptación transcultural al contexto español del Person-Centred Practice Inventory-Staff (PCPI-S) para profesionales de la salud / Translation and transcultural adaptation of the Person-Centred Practice Inventory Staff (PCPI-S) for health professionals in Spain

Fundamento: El Cuidado Centrado en la Persona (CCP) se haconvertido en un tema central dentro del ámbito sanitario acorde con las políticas de salud nacionales e internacionales. ElPerson Centred Practice Inventory Staff (PCPI-S) es un instrumentobasado en el modelo teórico Person-Centred Practice Frameworkque evalúa la percepción que tienen los profesionales de la salud sobre una práctica centrada en la persona. El objetivo delestudio es obtener la primera versión española del PCPI-S traducido y adaptado a nuestro contexto español.Método: Se llevó a cabo una traducción y adaptación culturaldel instrumento utilizando la guía Translation and Cultural Adaptation of Patient Reported Outcomes Measures – Principles of GoodPractice (PGP) que incluyó una sesión con expertos. También serealizó una validación de contenido de la claridad y relevanciade cada ítem (I-CVI), así como del cuestionario total (S-CVI/Ave).Resultados: No se encontraron dificultades para llegar a unconsenso en los doce ítems que necesitaron ser clarificados. Elíndice de validez de contenido por ítem (I-CVI) obtuvo una puntuación excelente para claridad en 53 ítems, y para relevanciaen 59; el índice de validez de contenido del cuestionario (S-CVI/Ave) mostró resultados excelentes (≥90).Conclusiones: Se ha obtenido la primera versión del PCPI-Sadaptada al español, conceptual y semánticamente equivalenteal cuestionario original. Este instrumento permitirá identificarla percepción que tienen los profesionales de la salud sobre unapráctica centrada en la persona.(AU)

Background: Person-centred practices – following nationaland international developments in health-care policies – havebecome a key approach in healthcare. The Person-CentredPractice Inventory – Staff is an instrument based on the theo -retical framework Person-Centred Practice that focuses onthe staff’s perspective and how they experience person-centred practices. Here, the aim of this study is to obtain the firstSpanish version of the PCPI-S translated and adapted into theSpanish context. Methods: The translation and adaptation of the instrumentfollowed the Translation and Cultural Adaptation of PatientReported Outcomes Measures – Principles of Good Practice,which included a consulting session with experts. Content validation measures on clarity and relevance were assessed forevery item (I-CVI) and the survey as a whole (S-CVI/Ave).Results: No major difficulties were registered to reach an agreement on the 12 items that needed to be clarified. Regarding clarity and relevance. The validity index per item (I-CVI) obtainedexcellent scores for clarity in 53 items and for relevance in 59;the S-CVI/Ave showed excellent results (≥90).Conclusions: This first version of the Person-Centred PracticeInventory – Staff instrument adapted to the Spanish context isconceptually and semantically equivalent to the original one.This valuable tool will be of great help to identify the perceptionof healthcare professionals on person-centred practices.(AU)

Malignant adipocytic tumours: A 20­year single­centre retrospective study.

Adipocytic tumours are the most common soft tissue neoplasms. Among them, liposarcoma is the most frequent malignant neoplasm. However, to the best of our knowledge, no previously published study has assessed the evolution and oncological prognosis of the different subtypes of liposarcoma at the retroperitoneal level compared with at other locations. The present study is a retrospective observational study in which all patients were operated on between October 2000 and January 2020 with a histological diagnosis of liposarcoma. Variables, such as age, sex, location, histological type, recurrence, type of treatment and mortality, among others, were analysed. The patients were divided into two groups: Group A (retroperitoneal location) and group B (non-retroperitoneal location). A total of 52 patients with a diagnosis of liposarcoma (17 women and 35 men) and a mean age of 57.2±15.9 years were assessed. A total of 16 patients were classified into group A and 36 into group B. The OR of recurrence was 1.5 (P=0.02) for R1 vs. R0 resection in group A. The OR of recurrence in group B for R1 vs. R0 resection was 1.8 (P=0.77), whereas for R2 vs. R0 resection, the OR was 69 (P=0.011). In conclusion, 52 cases of malignant adipocytic tumours collected during 2000-2020 were analysed with the new World Health Organization classification (updated 2020). Although its recurrence potential and capacity for distant metastasis depended on each histological type, surgical treatment with unaffected margins was the main prognostic factor for survival. The present study identified differences in relation to the survival of each histological subtype and its location, finding greater survival in dedifferentiated liposarcoma, myxoid liposarcoma and pleomorphic liposarcoma located at the extraperitoneal level than in the retroperitoneal location. Resectability was not influenced by liposarcoma location.

Acaricide residues in beeswax. Implications in honey, brood and honeybee.

For beekeeping to be sustainable, the management of colonies for the production of bee products must be economically viable without endangering the lives of bees, and must include acceptable practices such as the treatment of hives with appropriate products. Occasionally, the use of acaricides to treat the hives against varroosis is uncontrolled and can accumulate in the hives, putting the colonies at risk. In this work, a screening of seven acaricides was carried out in different apiaries in Andalusia (Spain). Their distribution in beeswax, brood, honey, and bees from colonies in different surroundings was evaluated at different times. It was found that beeswax was highly contaminated but honey, brood and bees had acceptable levels, below their respective MRL or LD50, after a certain period following varrocide treatments. Acaricides banned for their use against Varroa, such as chlorfenvinphos, cypermethrin and especially acrinathrin, were found in the hives analysed.

[Translation and transcultural adaptation of the theoretical Person-Centred Practice Framework to the Spanish context].

BACKGROUND: Person-centered care has become a key global approach that seeks to provide answers to all factors of the complex health care-related processes. This has led to the development of theoretical frameworks that represent the components of person-centered care. The internationally recognized Person-Centred Practice Framework (PCPF) (McCormack and McCance) allows multidisciplinary teams to understand and operationalize the dimensions for the development of person-centered care. The aim of this study was to obtain the first Spanish version of the PCPF translated and adapted to the Spanish context. METHODS: We translated the PCPF following the Translation and cultural adaptation process for Patient-Reported Outcomes (PRO) Measures guidelines. A consulting session with experts was part of the process and content validation on clarity and relevance for each domain was performed. RESULTS: We encountered no significant difficulties to reach agreements on most of the terms except for Having a sympathetic presence. Not only was a complex term to translate but also to trans-culturally adapt. Regarding relevance and clarity, the content index by construct (I-CVI) and the global framework (S-CVI/Ave) were consistent with their original counterparts (>0.90). CONCLUSIONS: The adapted Spanish version is clear, significant, and conceptually equivalent to the original PCPF. It will allow a better comprehension of the person-centered practice framework in the Spanish context and facilitate the implementation of this approach in clinical practices.

The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis?

BACKGROUND: The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not. METHODS: Data were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not. RESULTS: A total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were negative. Concomitant preexisting diseases including cardiovascular diseases (p < 0.0001), diabetes (p < 0.0001), and severe chronic obstructive airway disease (p = 0.005) were significantly more frequent in the COVID-19 group. Markers of sepsis severity including ARDS (p < 0.0001), PIPAS score (p < 0.0001), WSES sepsis score (p < 0.0001), qSOFA (p < 0.0001), and Tokyo classification of severity of acute cholecystitis (p < 0.0001) were significantly higher in the COVID-19 group. The COVID-19 group had significantly higher postoperative complications (32.2% compared with 11.7%, p < 0.0001), longer mean hospital stay (13.21 compared with 6.51 days, p < 0.0001), and mortality rate (13.4% compared with 1.7%, p < 0.0001). The incidence of gangrenous cholecystitis was doubled in the COVID-19 group (40.7% compared with 22.3%). The mean wall thickness of the gallbladder was significantly higher in the COVID-19 group [6.32 (SD: 2.44) mm compared with 5.4 (SD: 3.45) mm; p < 0.0001]. CONCLUSIONS: The incidence of gangrenous cholecystitis is higher in COVID patients compared with non-COVID patients admitted to the emergency department with acute cholecystitis. Gangrenous cholecystitis in COVID patients is associated with high-grade Clavien-Dindo postoperative complications, longer hospital stay and higher mortality rate. The open cholecystectomy rate is higher in COVID compared with non -COVID patients. It is recommended to delay the surgical treatment in COVID patients, when it is possible, to decrease morbidity and mortality rates. COVID-19 infection and gangrenous cholecystistis are not absolute contraindications to perform laparoscopic cholecystectomy, in a case by case evaluation, in expert hands.

Traducción y adaptación transcultural al contexto español del marco teórico Person-Centred Practice Framework / Translation and transcultural adaptation of the theoretical Person-Centred Practice Framework to the Spanish context

Fundamento: El cuidado centrado en la persona se ha convertido en un enfoque esencial a nivel global que pretende dar respuesta a todas las dimensiones que afectan a los complejos procesos de la atención sanitaria. El Person-Centred Practice Framework (PCPF), desarrollado por McCormack y McCance facilita que los equipos multidisciplinares puedan entender y operativizar todas las dimensiones que participan en el desarrollo de una atención centrada en la persona. El objetivo del estudio fue obtener la primera versión española del marco PCPF traducida y adaptada a nuestro contexto español. Método: La traducción y adaptación transcultural del PCPF se acometió utilizando la guía Translation and cultural adaptation process for Patient-Reported Outcomes (PRO) Measures, que incluye una sesión con expertos. Además, se realizó una validación de contenido de la claridad y la relevancia de cada dominio. Resultados: No se encontraron dificultades relevantes para llegar a un acuerdo en la mayoría de los términos que necesitaron ser clarificados, a excepción del término Estar presente con pleno reconocimiento del otro, que fue el más complejo de traducir y adaptar culturalmente. Respecto a la relevancia y claridad, el índice de validez de contenido por constructo (I-CVI) y del marco global (S-CVI/Ave) mostraron excelentes resultados (≥0,90). Conclusiones: Se ha obtenido una versión adaptada al español clara, relevante y conceptualmente equivalente al marco PCPF original. La disponibilidad de este marco en español facilitará una mejor comprensión de la práctica centrada en la persona y favorecerá la implementación de este enfoque en la práctica clínica.(AU)

Background: Person-centered care has become a key global approach that seeks to provide answers to all factors of the complex health care-related processes. This has led to the development of theoretical frameworks that represent the components of person-centered care. The internationally recognized Person-Centred Practice Framework (PCPF) (McCormack and McCance) allows multidisciplinary teams to understand and operationalize the dimensions for the development of person-centered care. The aim of this study was to obtain the first Spanish version of the PCPF translated and adapted to the Spanish context. Methods: We translated the PCPF following the Translation and cultural adaptation process for Patient-Reported Outcomes (PRO) Measures guidelines. A consulting session with experts was part of the process and content validation on clarity and relevance for each domain was performed. Results: We encountered no significant difficulties to reach agreements on most of the terms except for Having a sympathetic presence .Not only was a complex term to translate but also to trans-culturally adapt. Regarding relevance and clarity, the content index by construct (I-CVI) and the global framework (S-CVI/Ave) were consistent with their original counterparts (≥0.90). Conclusions: The adapted Spanish version is clear, significant, and conceptually equivalent to the original PCPF. It will allow a better comprehension of the person-centered practice framework in the Spanish context and facilitate the implementation of this approach in clinical practices.(AU)

Prognostic Factors of Survival in Patients with Peritoneal Metastasis from Colorectal Cancer.

Objectives: The aim of this study was to analyze the prognostic factors of survival in patients with peritoneal metastasis (PM) from colorectal cancer (CRC). The type of relationship between survival and the PM time of detection was used to determine whether it was synchronous with the primary tumor or metachronous. Patients and Methods: Retrospective observational study. It included patients treated for colorectal adenocarcinoma diagnosed between January 2005 and December 2019 who presented PM at the time of diagnosis or during follow-up. Variables, such as sex, age, differentiation grade, positive adenopathy (pN+), tumor size (pT), tumor location, mucinous component, peritoneal carcinomatosis index (PCI), and KRAS mutational status, were analyzed. Results: During the study period, 1882 patients were surgically treated for CRC in our hospital. Of these, 240 patients (12.8%) were included in the study after evidence of PM. The mean age was 67 ± 12 years (range: 32−92 years), and 114 patients were female (47.5%). The mean follow-up was 20 ± 13 months (median 12 months). The Kaplan−Meier survival at 36 months was higher in patients with metachronous PM (24% vs. 8%; p = 0.002), WT-KRAS tumors (31% vs. 15%; p < 0.001), N0 stage (30% vs. 19%; p < 0.001), T3 stage tumors (18% vs. 19% in T4A and 3% in T4B; p > 0.001), and tumors with classic adenocarcinoma histology (18% vs. 8%; p = 0.011). Patients with a PCI of 1−10 showed a likelihood of survival at 36 months of 56%, which was longer than that found in patients with a PCI of 11−20 (8%) or a PCI of >20 (0%) (p < 0.001). In the multiple regression analysis, the factors with an independent prognostic value were: poor grade of differentiation (HR 1.995; 95% CI: 1.294−3.077), KRAS mutation (HR 1.751; 95% CI: 1.188−2.581), PCI 11−20 (HR: 9.935; 95% CI: 5.204−18.966) and PCI > 20 (HR: 4.011; 95% CI: 2.291−7.023). Conclusions: PCI should continue as the as the most useful prognostic indicator in order to assess prognostic estimations as well as therapeutic and surgical decisions, but tumor grade and KRAS mutational status may help in the treatment decision process by providing complementary information. The time of PM detection did not achieve statistical significance in the multiple regression analysis.

Neonicotinoid contamination in wildflowers collected from citrus orchards in a northwestern Mediterranean Region (Spain) after tree foliar treatments.

Ground-cover vegetation attracts and harbors beneficial insects to the agrosystem, playing an important role in conservation biological control. Integrated pest management (IPM) program guidelines recommend the implantation of sowed or resident wild covers in perennial crops. Given the high-quality fruit requirements, even in IPM programs, insecticides can be required in citrus crops. This study presents, over a year, the levels of neonicotinoids (thiamethoxam and imidacloprid) in not-target ground-cover wildflowers growing spontaneously in citrus orchards after foliar treatment of citrus trees. The presence and persistence of these neonicotinoids in different wildflower species were studied. Concentrations of thiamethoxam and imidacloprid in whole wildflowers ranged from < method quantification limit (MQL) to 52.9 ng g-1 and from < MQL to 98.6 ng g-1, respectively. Thiamethoxam was more frequently detected than imidacloprid. Thiamethoxam and imidacloprid were detected up to 336 and 230 days after treatment, respectively. The highest detection frequencies (100%) and highest thiamethoxam and imidacloprid mean concentrations (26.0 ± 7.3 ng g-1 and 11.0 ± 10.6 ng g-1, respectively) occurred in wildflowers collected 9 days after the treatments. Since application, a clear decrease in the concentration of both compounds and differences in the accumulation depending on wildflower species were observed. Cross contamination was detected, indicating a transport from adjacent treated plots. Maintaining a cover crop in citrus orchards may lead to detrimental effects on non-target arthropods if these neonicotinoid compounds are used for pest control since they can entail a chronic exposure during at least 230 days for imidacloprid and 336 days for thiamethoxam.

Microbial Decontamination of Bee Pollen by Direct Ozone Exposure.

The bee pollen is a complete and healthy food with important nutritional properties. Usually, bee pollen is consumed dehydrated, but it is possible to market it as fresh frozen pollen, favoring the maintenance of its properties and greatly increasing its palatability, compared to dried pollen. However, fresh frozen pollen maintains a high microbiological load that can include some pathogenic genus to human health. In this work, ozonation combined with drying is applied to reduce the microbiological load. The lowest timing exposure to ozone (30 min) was chosen together with hot-air drying during 15 min to evaluate the shelf-life of treated bee-pollen under cold storage (4 °C), and initial reductions of 3, 1.5, and 1.7 log cycles were obtained for Enterobacteriaceae, mesophilic aerobes, and molds and yeasts counting, respectively. Six weeks after treatment the microbial load was held at a lower level than initially observed in fresh bee-pollen. In addition, ozone treatment did not have a negative impact on the polyphenols evaluated. Likewise, the sensory profile of the bee pollen under different treatments was studied. For all these assays the results have been favorable, so we can say that ozonation of fresh pollen is safe for human consumption, which maintains its polyphenols composition and organoleptically is better valued than dried pollen.

Unusual Case of Gallbladder Adenocarcinoma Metastasis to the Abdominal Wall 11 Years Later: Synchronous Presentation with Two Malignant Colon Tumors, Coincidence or Not?

INTRODUCTION: Abdominal wall masses are a common finding in clinical practice. A high percentage of these masses are malignant. We present the case of a patient operated for a gallbladder adenocarcinoma, who consulted eleven years later for a malignant mass of the abdominal wall in synchrony with two adenocarcinomas of the left colon and sigmoid. Case Report. A 75-year-old male underwent a laparoscopic cholecystectomy with an incidental diagnosis of adenocarcinoma in situ (TisN0M0 according to AJCC 8th edition). The operative report mentioned that the removal of the gallbladder was difficult due to the inflammatory process, and the gallbladder was accidentally opened during the operation. It was not clear from the operative report whether an extraction bag was utilized to remove the specimen, but the histopathological study confirmed an open gallbladder. He presented 11 years later with an asymptomatic heterogeneous complex cystic mass involving the anterior rectus abdominis muscle. Colonoscopy showed synchronous tumors in the descending and sigmoid colon with pathology confirming adenocarcinoma. The patient underwent an elective laparotomy with resection of the anterior abdominal wall mass, left hemicolectomy, and sigmoidectomy. The histopathological results of the abdominal mass (CK7, CK20, EMA, CEA positive) were described as metastasis of adenocarcinoma of biliary origin. Discussion. Port site recurrences are rare complications following laparoscopic surgery when malignancy is unsuspected. Possible factors related to local implantation include direct seeding of spilled bile or tumor cells into the wound or shedding of tumor cells due to pneumoperitoneum-induced loss of the peritoneal barrier at the trocar site. In the absence of distant metastasis, treatment should include wide port site excision with malignancy-free surgical margins. CONCLUSION: Abdominal wall metastasis from gallbladder carcinoma is rare, and its synchronous presentation with a malignant neoplasm of the colon is exceptional. This is the first report of a patient with abdominal wall metastasis from a gallbladder adenocarcinoma operated eleven years ago that debuted synchronously with two adenocarcinomas of the left colon and sigma.