Sedation with propofol/remifentanil versus dexmedetomidine / remifentanil for patients undergoing transcatheter aortic valve implant: A retrospective study between 2012 and 2019.

BACKGROUND AND OBJECTIVES: Percutaneous implantation of an aortic valve prosthesis is a therapeutic alternative for patients with severe aortic stenosis. The procedure is traditionally performed under general anaesthesia; however, sedation is now gaining in popularity because it reduces the need for vasoactive drugs and shortens the patient's stay in the critical care unit and on the ward. The aim of this study is to evaluate the clinical efficacy, safety and potential benefits of sedation with dexmedetomidine in patients undergoing percutaneous implantation of an aortic valve prosthesis in terms of haemodynamic and respiratory complications. MATERIALS AND METHODS: We performed a retrospective study of 222 patients that had undergone percutaneous implantation of an aortic valve prosthesis between 2012 and 2019 under sedation with either dexmedetomidine plus remifentanil (DEX-RMF) or propofol plus remifentanil (PROPO-RMF). We collected data on complications, mainly haemodynamic and respiratory, during and after the procedure. RESULTS: No significant differences were found between sedation with dexmedetomidine and propofol (in combination with remifentanil) in terms of haemodynamic stability and intraprocedural cerebral blood oxygen. In the DEX-RMF group, however, mean blood pressure, midazolam dose, and duration of anaesthesia were lower compared with the PROPO-RMF group, but the incidence of haemodynamic and respiratory complications did not differ significantly between groups. CONCLUSIONS: Our results show that sedation, particularly with adjuvant dexmedetomidine, is a valid anaesthetic techniques in percutaneous aortic valve prosthesis implantation.

Virtual reality exposure with vibrotactile stimulation for the treatment of fear of flying: A pilot study.

BACKGROUND AND OBJECTIVES: Virtual reality (VR) interventions are becoming more prevalent in treating fear of flying (FoF). Since multisensory stimulation can enhance the sense of presence in a virtual environment, the present study compared virtual reality exposure with and without vibrotactile cues to determine its contribution to the realism of the virtual experience. METHODS: A repeated measures design was used. Thirty-one participants were exposed to two experimental conditions with a minimum of a one-week interval between them: one in which participants were exposed to the virtual environment with vibrotactile cues (smart chair, SC), and another in which participants were exposed to the virtual environment without vibrotactile cues (ordinary chair, OC). The administration order of both conditions was counterbalanced to avoid possible order effects. RESULTS: Participants felt higher levels of sense of presence when using the SC than the OC. However, the addition of vibrotactile stimulation partially influenced experienced anxiety. Some personality traits were also associated with participants' sense of presence and anxiety responses during the exposure. LIMITATIONS: The sample size was smaller than required. Moreover, only self-reported measures were used. Finally, a roller coaster instead of an airplane scenario was used for the exposure, which might not have been suitable enough for provoking anxiety in participants with FoF. CONCLUSIONS: Vibrotactile cues enhanced the sense of presence. However, the addition of vibrotactile stimulation did not have a consistent effect on anxiety experienced during exposure. Therefore, the benefits of incorporating vibrotactile cues in virtual reality environments for exposure therapy are not clear.

Prevalencia de caries dental en escolares de educación infantil de una zona de salud con nivel socioeconómico bajo / Prevalence of dental caries in children enrolled in preschool education from a low socioeconomic status area

Introducción: la caries dental es una enfermedad crónica, con elevada prevalencia en preescolares españoles. La falta de higiene, la alimentación inadecuada y las algias dentarias son problemas de salud frecuentes en nuestra zona básica de salud según los resultados del análisis de situación de salud. El objetivo de este trabajo es estudiar la prevalencia de caries dental en niños de tres a cinco años en nuestra zona básica de salud mediante un estudio descriptivo transversal. Material y métodos: se realiza la inspección bucodental por dentista y la recogida de datos por higienista dental en escolares de primer, segundo y tercer curso de Educación Infantil. La variable principal estudiada es la presencia de caries. Los datos son registrados en fichas individuales y volcados en una base de datos elaborada en el programa SPSS, donde se realiza el análisis descriptivo de los mismos. Resultados: de 150 niños escolarizados en educación infantil en la zona, se revisan 121 que acuden a clase el día que se realiza la revisión (80,7%). En primer curso un 46% de los niños presentan caries, en segundo un 40,5% y en tercero encontramos un 77,3% de niños con caries en dientes temporales y un 20,8% en definitivos. Conclusiones: las cifras de caries en nuestra zona básica de salud son altas, muy superiores a los datos nacionales. Es necesario aumentar las actividades preventivas en la primera infancia, en especial en las zonas de menor nivel social como la nuestra

Introduction: dental caries is a chronic disease with a high prevalence in Spanish young children. A poor oral hygiene, inadequate dietary habits and toothaches are frequent problems in our health district based on a previous situation analysis of health. Our objective was to perform a cross-sectional descriptive study to assess the prevalence of dental caries in children aged 3 to 5 years in our health district. Materials and methods: a dentist performed an oral and dental evaluation while a dental hygienist collected data in children enrolled in years 1, 2 and 3 of preschool. The primary outcome was the presence of caries. The data were collected in individual forms and subsequently entered in a database created with the software SPSS, which we also used to perform the descriptive analysis of the data. Results: of the 150 children enrolled in preschool in our health district, we assessed 121 that attended school on the day that we carried out the checkups (80.7%). We found caries in deciduous teeth in 46% of children enrolled in year 1, 40.5% of children in year 2 and 77.3% of children in year 3, and in permanent teeth in 20.8% of children in year 3. Conclusions: the prevalence of caries was much higher in our health district compared to the previously reported nationwide prevalence. We need to increase the preventive interventions targeted to early childhood, especially in disadvantaged areas like our health district

Emotional eating and food intake after sadness and joy.

Do people with a high score on a scale for eating in response to negative emotions also show high food intake in response to positive emotions? We studied these effects in 60 female students that were preselected on the basis of extreme high or low scores on an emotional eating questionnaire. Using a between subject design we experimentally tested the difference in food intake following a mood induction designed to induce joy or sadness (the joy vs. sad mood condition). The high and low emotional eaters did not differ in their food intake, but emotional eating significantly moderated the relationship between mood condition and food intake. Whereas low emotional eaters ate similar amounts after the sad and after the joy mood condition, high emotional eaters ate significantly more after the sad mood condition than after the joy mood condition. A further finding was that a similar moderator effect for emotional eating was found for intake of sweet food but not for intake of salty food. These findings would suggest that eating in response to negative and to positive emotions refer to two different constructs.

Calidad de vida en pacientes con esquizofrenia de ascendencia étnica aymara en el norte de Chile / Quality of life of schizophrenia patients of aymaran ethnic background in the north of Chile

Objetivo:Se describe la calidad de vida en pacientes con esquizofrenia con ascendencia aymara, analizando la presencia de diferencias con pacientes de ascendencia no originaria. Método:Participaron 45 pacientes atendidos por los Servicios de Salud Mental de Arica, Chile. Se utilizó la Escala de Síntomas Positivos y Negativos (PANNSS), y el Cuestionario Sevilla de Calidad de Vida (CSVV). Resultados:Los pacientes del estudio mostraron niveles moderados de calidad de vida, con una fuerte relación con el síndrome negativo y la psicopatología general del trastorno, no hallando diferencias significativas en las dimensiones de la calidad de vida en función de la ascendencia étnica. Los resultados encontrados evidencian que la integración de los pacientes a los servicios de salud comunitarios se asocia positivamente a la valoración que hacen respecto a su calidad de vida, siendo fundamental considerar la integración de los cuidadores en los tratamientos administrados(AU)

Objective:To describe the quality of life of patients of Aymaran descent with schizophrenia and analyse the differences with patients of non-Aymaran descent. Method:The study included 45 patients who attended the Mental Health Services in Arica, Chile. The Positive and Negative Syndrome Scale (PANSS) and the Seville Quality of Life Questionnaire (SQoLQ) were used. Results:The patients of the study showed moderate quality of life levels, with a strong association with the negative syndrome and the general psychopathology of the disorder. No significant differences were found in the quality of life dimensions as regards ethnic background. Conclusions:The results found demonstrate that the integration of patients in the Community Health Services is positively associated as regards their quality of life. The integration of the caregivers is considered essential in the treatments administered(AU)