Is perioperative COVID-19 really associated with worse surgical outcomes among vaccinated patients?

INTRODUCTION: During the surge of the SARS-CoV-2 pandemic, studies revealed high complication and morbidity rates following surgical procedures in COVID-19 positive patients. Anesthetic and surgical societies swiftly developed strategies to mitigate these risks, including a recommended postponement of elective surgeries for a minimum of 7 weeks post-COVID infection. Nowadays, with a predominantly vaccinated population, it has become crucial to discern the influencing factors on post-COVID morbidity and mortality and a reevaluation of the existing recommendations pertaining to elective surgery. METHODS: A single-center case-control study was conducted, including patients who underwent surgery between November 2021 and March 2022 and met the inclusion criteria. Eighty COVID-19 positive patients were matched 1:1 with 80 controls, each undergoing an identical intervention within a 2-week time frame. The primary outcome was 30-day postoperative mortality and secondary outcome postoperative complications (respiratory and thromboembolic). RESULTS: At the time of surgery, 88.8% of patients in the case group and 92.5% in the control group had received at least one vaccine dose. Mortality and morbidity did not show a significant difference when comparing the case and control groups (7.5% vs 6.2%, p = 0.755; 11.3% vs 8.9%, p = 0.541 respectively). In the COVID-positive group, mortality was significantly associated with age over 70 years, ASA score over III, RCRI over 1, emergency procedures, and absence of thromboembolic prophylaxis. CONCLUSIONS: In contrast to previously reported findings, we did not observe an increased morbi-mortality in patients with perioperative COVID-19 infection. It may not be necessary to delay elective interventions, except in cases with a high-risk.

Consumo de alcohol en jóvenes españoles / No disponible

El consumo de alcohol ha aumentado de forma espectacular entre los jóvenes españolesen las últimas décadas; se ha convertido en una conducta ampliamente generalizada, especialmenteen el tiempo de ocio del fin de semana, formando parte de la llamada “culturadel botellón”, socialmente tolerada y extendida

Alcohol consumption has increased a lot among Spanish young people in the last decades;it has become a conduct widely generalized, especially in the weekend’s leisure time,taking part of the so called “culture of the large bottle”, socially tolerated and extended

Consumo de cocaína en jóvenes españoles / No disponible

El abuso de cocaína no suele acompañarse de cambios físicos espectaculares ni existe un gran fenómeno de tolerancia, pero tiene un enorme poder de adicción, incluso superior al de la heroína. Existe alta comorbilidad con otros trastornos psiquiátricos que pueden favorecer su consumo. El uso habitual y/o abusivo puede provocar importantes complicaciones orgánicas, psicológicas y sociales

Cocaine abuse usually is not accompanied by spectacular physical changes nor exists a great phenomenon of tolerance, but it has an enormous power to create addiction, even superior to the one of heroin. High comorbidity with other psychiatric disorders exists, and they can favour the consumption. The habitual and/or abusive use can cause important organic, psychological and social complications

Intervención del pediatra de Atención Primaria en la prevención del consumo de sustancias de abuso / No disponible

El aumento del consumo de sustancias de abuso, el policonsumo, la baja percepcióndel riesgo por parte de los jóvenes y la consideración de estos consumos en el contexto deuna cultura de ocio y diversión constituyen serios problemas para la salud actual y futurade nuestros adolescentes.El pediatra de Atención Primaria (AP) goza de una posición privilegiada por los frecuentescontactos con el niño en crecimiento y su familia.La prevención del consumo de sustancias de abuso debe realizarse de una forma integrale inespecífica, como prevención de conductas de riesgo, durante la infancia y adolescencia.En este trabajo se plantean distintas posibilidades de intervención en la prevención delconsumo de sustancias de abuso desde la AP

The increase of substance abuse consumption, polyconsumption, the low perception ofrisk by young people and the consideration of these consumptions in the context of a leisureculture and fun, constitute a serious problem for the present and future health of ouradolescents.Primary Care Paediatrician (AP) enjoys an exceptional position because of his/her frequentcontacts with the growing child and his/her family.Prevention of substance abuse consumption must be carried out in a comprehensiveand unspecific way, as risk behaviour’s prevention, during childhood and adolescence.In this work, different possibilities of intervention on substance abuse prevention areconsidered from Primary Care Health

Consumo de cannabis en jóvenes españoles / No disponible

El cannabis es la droga ilegal más consumida en los países del Primer Mundo; está presente en todos los grupos socioeconómicos y étnicos, tanto en áreas urbanas como rurales. Su consumo suele aparecer asociado al de otras drogas legales e ilegales. Existe una importante banalización sobre su uso: sólo la mitad de los jóvenes considera que el consumo de cannabis puede provocar muchos problemas para la salud y sólo el 70% identifica, por parte de sus padres, una actitud de prohibición absoluta de consumo

Cannabis is the illegal drug more consumed in First World’s countries; it is present in all socioeconomic and ethnic groups, as much in urban as in rural areas. Its consumption usually appears associated to other legal and illegal drugs. An important banalization exists on its use: only half of the young people consider that the cannabis consumption can cause many health problems and only 70% identify, from their parents, an attitude of absolute prohibition of consumption

Reversibility of morphine effects on phagocytosis by murine macrophages.

Proneness of addicts to infections may be partially due to opiate effects on immune cells. We find that acute morphine inhibits phagocytosis in murine peritoneal macrophages in vitro with apparent desensitization at high concentrations, whereas chronic exposure results in a state akin to tolerance/dependence where macrophages seem to require morphine to phagocytize at a control level. However, both putative desensitization and tolerance/dependence are reversible, since drug re-addition several hours after withdrawal results in inhibition, as in acute exposure. This shows that opiate effects on immune cells are variably related to the experimental context in which they are administered, which is of relevance for understanding their potential role in immunosuppression.

Bone density is compromised in amenorrheic women despite return of menses: a 2-year study.

OBJECTIVE: To determine the effects of estrogen deprivation on bone mass in young women in whom large bone mass increases are known to occur. METHODS: Over 2 years, nine amenorrheic and 21 normal women were studied, classified into exercising (dancers) and sedentary subjects. An integrated estrogen exposure score was used to determine estrogen response during the 2 years of study. Bone mineral density was measured by single and dual photon absorptiometry in the spine, wrist, and foot (metatarsus). RESULTS: Hypoestrogenism was present in all amenorrheic women in the first year, and mean estrogen exposure scores were lower in these subjects during the 2 years. Mean spine, wrist, and metatarsal bone mineral density measurements were lower in the amenorrheic women and remained below the levels in controls, despite changing clinical indices and return of menses in some of the subjects. Amenorrheic dancers showed the greatest increase in spine bone mineral density, gaining 9.65% in the first year, 4.49% in the second, and an increase of 14.43% (P < .05) over the total period. Their bone mineral density values, however, remained significantly below those of normal controls during the duration of the study. The most significant gains were seen in two subjects with weight gain and return of irregular periods (three periods in 12 months). CONCLUSION: Young amenorrheic exercising women appear to increase bone mass before the return of normal menses; however, bone mass remained below control values during 2 years of study, possibly because of long-term adolescent hypoestrogenism.