Influència de les condicions meteorològiques en la patologia condral

Introducció: En la pràctica clínica habitual, molts pacients atribueixen el dolor articular a certes condicions meteorològiques. Objectiu: Avaluar l'efecte de les condicions climàtiques en pacients amb artrosi. Mètodes: Aquest treball es va realitzar amb pacients de l'Institut Poal de Reumatologia de Barcelona i les dades van ser analitzats per Bioibérica Farma. Va consistir en un estudi prospectiu, a doble cec, que va incloure 80 pacients amb artrosi, comparats amb un grup control de 42 subjectes. L'avaluació del dolor (EAV de Huskisson) i la capacitat funcional (HAQ) es van determinar diàriament durant un mes, i les variables climàtiques estudiades van ser la temperatura, la humitat i la pressió atmosfèrica. Resultats: Les nostres dades demostren que els pacients artròsics tenen un augment del dolor articular en resposta a una disminució de la pressió, la qual cosa indica que les condicions de baixa pressió atmosfèrica exacerben el dolor en aquests pacients. Conclusió: Aquestes dades suggereixen que en el futur podria ser factible modular els tractaments farmacològics i no farmacològics per a alguns pacients artròsics en funció de la previsió meteorològica i evitar, en la mesura possible, el dolor articular i la incapacitat funcional associats a la malaltia, tot millorant la qualitat de vida d'aquests pacients

Influencia de las condiciones meteorológicas en la patología condral

Introducción: En la práctica clínica habitual, muchos pacientes atribuyen el dolor articular a ciertas condiciones meteorológicas. Objetivo: Evaluar el efecto de las condiciones climáticas en pacientes con artrosis. Métodos: El presente trabajo se realizó con pacientes del Instituto Poal de Reumatología de Barcelona y los datos fueron analizados por Bioibérica Farma. Consistió en un estudio prospectivo, a doble ciego, que incluyó 80 pacientes con artrosis, comparados con un grupo control de 42 sujetos. La evaluación del dolor (EAV de Huskisson) y la capacidad funcional (HAQ) se eterminaron diariamente durante un mes, y las variables climáticas estudiadas fueron la temperatura, la humedad y la presión atmosférica. Resultados: Nuestros datos demuestran que los pacientes artrósicos experimentan un aumento del dolor articular en respuesta a una disminución de la presión, lo que indica que las condiciones de baja presión atmosférica exacerban el dolor en estos pacientes. Conclusión: Estos datos sugieren que en el futuro podría ser factible modular los tratamientos farmacológicos y no farmacológicos para algunos pacientes artrósicos en función de la previsión meteorológica y evitar, en la medida de lo posible, el dolor articular y la incapacidad funcional asociados a la enfermedad, mejorando así la calidad de vida de estos pacientes

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population