Tolerancia al ejercicio y nivel de actividad física antes y después de la cirugía de corrección del pectus excavatum

El pectus excavatum (PE) es una deformidad de la pared torácica caracterizada por una depresión esternal. Aunque hay evidencias en la literatura de alteraciones principalmente en relación con el esfuerzo, los efectos fisiológicos del PE y su posterior resolución tras la corrección en relación con la intolerancia al ejercicio son objeto de controversia, a tras la intervención, aunque no se ha relacionado con la severidad del PE. Se pretendió valorar la influencia en la tolerancia al esfuerzo antes y después de la cirugía de corrección mediante la realización de pruebas de esfuerzo cardiopulmonar máximas y submáximas, y su correlación con el nivel de AF mediante cuestionarios específicos y el uso de holter de AF; así como el impacto de la cirugía en la calidad de vida de los pacientes. Se incluyó una población de 19 PE intervenidos mayoritariamente mediante la técnica de Nuss, quienes presentaron alteraciones cardiopulmonares leves principalmente evidenciadas durante el esfuerzo; con una mejora tras la cirugía de corrección en la tolerancia al ejercicio medida mediante pruebas de esfuerzo cardiopulmonar máxima y, fundamentalmente, submáxima, independientemente de los hábitos de AF que realizaban los pacientes. Así, como una mejora en la calidad de vida de los pacientes con PE tras la intervención, con un mayor impacto en la esfera psicosocial

200 años de guerra ypaz en Colombia: números y rasgos estilizados

The This paper presents the findings of a quanti-tative and longitudinal study both about theColombian civil wars, from the moment the country formed as a stable political unit, and about the ways in which pea-ce was achieved after each of them. It also provides a quantitative comparison with the other Latin American countries. The paper concludes that there are critical differences between the wars of the xix century and those of the xx, in terms of duration and harshness, as well as in the forms of peace (victories and amnesties or negotia-ted agreements), with the exception of the Thousand Days’ WarEste artículo presenta las conclusiones de un estu-dio cuantitativo y longitudinal sobre las guerrasciviles colombianas, desde el momento de la constitución del país como unidad política estable, y de las formas como se accedió a la paz después de cada una de ellas. Incluye, además, una comparación cuantitativa con los demás países de Hispanoamérica. Se concluye que hay diferencias críticas entre las guerras del siglo xix y las del xx, en cuanto a duración y severidad, así como en cuanto a las formas de la paz (victorias y amnistías o acuerdos negociados), con excepción de la Guerra de Los Mil Día

Anxiety, depression and tobacco abstinence

There is evidence of the relationship between mental illness and smoking and increased risk of depressive episodes after quitting smoking, even with specific treatments for abstinence. Objective: To assess the influence of a cessation program on the emotional state of patients by measuring levels of anxiety / depression and differences depending on the presence of psychiatric history. Method: A prospective observational study of patients taking part in a combined program (pharmacological and cognitive-behavioral) for giving up smoking. Anxiety (A) and depression (D) were measured using the HADS questionnaire at baseline, first and third month of abstinence. Results: Anxiety and depression showed significant and progressive improvement during treatment (A: baseline 9.2 ± 4.5, 5.9 ± 3.6 1 month, 3 months 4.5 ± 3.1, p <0 05 / D: baseline 5.5 ± 4.1; 1 month 3 ± 3; 3 months 2.3 ± 2.1, p <0.05), in psychiatry population (A: baseline 11.3 ± 4 , 5; 1 month 7.1 ± 3.7, 5.3 ± 3.5 3 months, p <0.05 / D: baseline 7.4 ± 4.8, 4.2 ± 3.6 one month; 3 months 3 ± 2.9, p <0.05), regardless of treatment. Abstinence rate: 58.5%, unaffected by baseline levels of anxiety and depression. No significant neuropsychiatric side effects were detected. Conclusions: Anxiety and depression levels evolved favourably during the program, achieving good results regardless of the presence of psychiatric pathology.This research project was financed by Fundación Neumosur 7/2008.YesExiste evidencia de la relación entre patología mental y tabaquismo y del mayor riesgo de sufrir un episodio depresivo al dejar de fumar, incluso con tratamientos específicos para la abstinencia. Objetivo: valorar la influencia de un programa de abandono del tabaco en el estado emocional de los pacientes mediante la medición de los niveles de ansiedad/depresión y las posibles diferencias en función de la presencia de antecedentes psiquiátricos. Método: estudio de cohortes observacional y prospectivo de pacientes que acudieron a dejar de fumar mediante programa combinado (farmacológico y cognitivoconductual). Se midió ansiedad (A) y depresión (D) utilizando el cuestionario HADS al inicio, primer y tercer mes de abstinencia. Resultados: la ansiedad y la depresión presentaron mejoría significativa y progresiva a lo largo del tratamiento (A: basal 9,2±4,6; 1 mes 5,9±3,6; 3 meses 4,5±3,1; p<0,05 / D: basal 5,5±4,1; 1 mes 3±3; 3 meses 2,3±2,1; p<0,05), en la población psiquiátrica (A: basal 11,3±4,5; 1 mes 7,1±3,7; 3 meses 5,3±3,5; p<0,05 / D: basal 7,4±4,8; 1 mes 4,2±3,6; 3 meses 3±2,9; p<0,05), e independientemente del tratamiento. Tasa de abstinencia: 58,5%, no se vio afectada por los niveles basales de ansiedad y depresión. No se detectaron efectos secundarios neuropsiquiátricos relevantes. Conclusiones: los niveles de ansiedad y depresión evolucionan favorablemente durante el programa, alcanzándose buenos resultados, independientemente de la presencia de patología psiquiátric

Preference for Easyhaler® Over Previous Dry Powder Inhalers in Asthma Patients: Results of the DPI PREFER Observational Study.

To study patient preference for and satisfaction with the Easyhaler® device and to assess ease of training and use of the inhaler in patients previously treated with a variety of dry powder inhalers (DPIs). We designed a non-interventional, cross-sectional, single-visit observational study of adult patients with persistent asthma referred to specialized care who had previously been treated with DPI inhalers for at least 3 months. Once clinical baseline data had been checked, patients filled in questionnaires on asthma control (GINA 2019), Feeling of Satisfaction with the Inhaler (FSI-10), and adherence (TAI and Morisky-Green questionnaires). Thereafter, all patients were trained in the use of Easyhaler. We assessed ease of use and satisfaction (FSI-10) with Easyhaler, as well as inhaler device preferences. We recruited 502 patients (mean age, 50.2 ± 16.2 y; 63.1% female), of whom 485 were evaluable. In response to the main objective of the study, we compared the values of the self-completed adapted FSI-10, to measure satisfaction with the inhaler. A significantly higher score in each item of the questionnaire was recorded for Easyhaler. Overall, 38% of patients showed exclusive preference for Easyhaler (compared with 15% for the previous device) or were evenly matched in 46% of cases. In the present study, Easyhaler achieved better patient ratings in terms of preference and satisfaction than previously used DPI devices. In order to improve asthma adherence strategies, patient preferences and device choice should be taken into account

Effectiveness of Switching to Benralizumab in Severe Refractory Eosinophilic Asthma.

Benralizumab is a monoclonal antibody that targets the α subunit of the IL-5 receptor. Clinical trials have demonstrated the efficacy of this agent with respect to lung function and symptom control in patients with refractory eosinophilic asthma. However, few studies have evaluated the efficacy of benralizumab after switching previous treatment with other monoclonal antibodies. We performed a multicenter retrospective study under conditions of daily clinical practice. The study population comprised consecutively included patients with severe refractory eosinophilic asthma whose initial treatment with omalizumab or mepolizumab was switched to benralizumab. Patients were evaluated at 4 and 12 months after starting treatment with benralizumab. We analyzed asthma control, number of severe exacerbations, corticosteroid cycles, visits to the emergency department, and hospital admissions, as well as lung function. Similarly, we evaluated the response to treatment according to previously established criteria. We evaluated 40 patients who switched from omalizumab (n=16) or mepolizumab (n=24) to benralizumab. The reasons for switching were lack of response in 30 cases, adverse effects in 9, and patient request in 1. Switching was followed by a significant decrease in the number of exacerbations, visits to the emergency department, and corticosteroid cycles, as well as improved ACT both at 4 and 12 months. However, no significant improvement in lung function was observed. Asthma control (including complete response and control) was achieved in 55% of patients (n=22) at 12 months. Specifically, a complete response was achieved in 30% of patients at 12 months (66.7% switching from omalizumab and 33.3% from mepolizumab). Patients diagnosed with severe refractory eosinophilic asthma who experience a partial response with omalizumab or mepolizumab could benefit from switching to benralizumab. This approach can reduce the number of exacerbations, visits to the emergency department, and corticosteroid cycles and improve control of asthma

Onset of effect and impact on health-related quality of life, exacerbation rate, lung function, and nasal polyposis symptoms for patients with severe eosinophilic asthma treated with benralizumab (ANDHI): a randomised, controlled, phase 3b trial

International audienc