No abstract

Background: We aimed to examine whether using a high fraction of inspired oxygen (FIO 2 ) in the context of an individualised intra-and postoperative open-lung ventilation approach could decrease surgical site infection (SSI) in patients scheduled for abdominal surgery. Methods: We performed a multicentre, randomised controlled clinical trial in a network of 21 university hospitals from June 6, 2017 to July 19, 2018. Patients undergoing abdominal surgery were randomly assigned to receive a high (0.80) or conventional (0.3) FIO 2 during the intraoperative period and during the first 3 postoperative hours. All patients were mechanically ventilated with an open-lung strategy, which included recruitment manoeuvres and individualised positive end-expiratory pressure for the best respiratory-system compliance, and individualised continuous postoperative airway pressure for adequate peripheral oxyhaemoglobin saturation. The primary outcome was the prevalence of SSI within the first 7 postoperative days. The secondary outcomes were composites of systemic complications, length of intensive care and hospital stay, and 6-month mortality. Results: We enrolled 740 subjects: 371 in the high FIO 2 group and 369 in the low FIO 2 group. Data from 717 subjects were available for final analysis. The rate of SSI during the first postoperative week did not differ between high (8.9%) and low (9.4%) FIO 2 groups (relative risk [RR]: 0.94; 95% confidence interval [CI]: 0.59e1.50; P¼0.90]). Secondary outcomes, such as atelectasis (7.7% vs 9.8%; RR: 0.77; 95% CI: 0.48e1.25; P¼0.38) and myocardial ischaemia (0.6% [n¼2] vs 0% [n¼0]; P¼0.47) did not differ between groups. Conclusions: An oxygenation strategy using high FIO 2 compared with conventional FIO 2 did not reduce postoperative SSIs in abdominal surgery. No differences in secondary outcomes or adverse events were found. Clinical trial registration: NCT02776046.

ObjectiveOrphan diseases must be considered a public health concern, underlying country-specific challenges for their accurate and opportune diagnosis, classification and management. Orphan disease registries have not yet been created in South America, a continent having a population of ~ 415 million inhabitants. In Colombia ~ 3 million of patients are affected by rare diseases. The aim of the present study was to establish the first Colombian national registry for rare diseases. The registry was created after the establishment of laws promoting the development of clinical guidelines for diagnosis, management, census and registry of patients suffering rare diseases.ResultsIn total, 13,215 patients were recorded in the Colombian registry. The survey reported 653 rare diseases. The most common diseases were congenital factor VIII deficiency (hemophilia A) (8.5%), myasthenia gravis (6.4%), von Willebrand disease (5.9%), short stature due to growth hormone qualitative anomaly (4.2%), bronchopulmonary dysplasia (3.9%) and cystic fibrosis (3.2%). Although, a marked under-reporting of cases was observed, some pathologies displayed similar behavior to that reported by other initiatives and databases. The data currently available in the registry provides a baseline for improvement regarding local and regional surveys and the start for better understanding rare diseases in Colombia.Electronic supplementary materialThe online version of this article (10.1186/s13104-017-2840-1) contains supplementary material, which is available to authorized users.

IntroductionSurgical site infection (SSI) is a serious postoperative complication that increases morbidity and healthcare costs. SSIs tend to increase as the partial pressure of tissue oxygen decreases: previous trials have focused on trying to reduce them by comparing high versus conventional inspiratory oxygen fractions (FIO2) in the perioperative period but did not use a protocolised ventilatory strategy. The open-lung ventilatory approach restores functional lung volume and improves gas exchange, and therefore it may increase the partial pressure of tissue oxygen for a given FIO2. The trial presented here aims to compare the efficacy of high versus conventional FIO2 in reducing the overall incidence of SSIs in patients by implementing a protocolised and individualised global approach to perioperative open-lung ventilation.Methods and analysisThis is a comparative, prospective, multicentre, randomised and controlled two-arm trial that will include 756 patients scheduled for abdominal surgery. The patients will be randomised into two groups: (1) a high FIO2 group (80% oxygen; FIO2 of 0.80) and (2) a conventional FIO2 group (30% oxygen; FIO2 of 0.30). Each group will be assessed intra- and postoperatively. The primary outcome is the appearance of postoperative SSI complications. Secondary outcomes are the appearance of systemic and pulmonary complications.Ethics and disseminationThe iPROVE-O2 trial has been approved by the Ethics Review Board at the reference centre (the Hospital Clínico Universitario in Valencia). Informed consent will be obtained from all patients before their participation. If the approach using high FIO2 during individualised open-lung ventilation decreases SSIs, use of this method will become standard practice for patients scheduled for future abdominal surgery. Publication of the results is anticipated in early 2019.Trial registration numberNCT02776046; Pre-results.

Both distortion and dissatisfaction with body image are crucial in the development of eating disorders. This study analyzes body dissatisfaction (BD) of young adults based on sex and nutritional status, as well as their relation to the construction of the self and others. A total of 73 university students (53% women) aged 18-28 (M = 21.96, SD = 2.04) answered a BD assessment that includes Anatomical Models Sheets, and the construction of the self and the others with the Grid Technique; In addition, the body mass index (BMI) was calculated from self-reported weight and height. Men reported more body distortion vs. women (p = .04), as well as participants with normal weight vs. overweight-obesity (p = .01); conversely, BD was more common in the group with overweight-obesity (p = .03). In women, perceived BMI correlated positively with social isolation, while self-definition "as obese" was associated with BMI and with lower self-esteem; in men, self-definition only correlated with social isolation. Although men had higher body distortion, in women, BD was related to more aspects of their identity. Resumen Tanto la distorsión como la insatisfacción con la imagen corporal (IC) son cruciales en el desarrollo de los trastornos alimentarios. Este estudio analiza la IC de jóvenes adultos en función del sexo y el estatus nutricional, así como su relación con la construcción del sí mismo y de los otros. Participaron 73 estudiantes universitarios (53% mujeres) de 18-28 años de edad (M = 21.96, DE = 2.04). La IC fue evaluada con Láminas de Modelos Anatómicos, y la construcción del sí mismo y de los otros con la Técnica de la Rejilla; además, el índice de masa corporal (IMC) fue calculado a partir del peso y la talla autoreportados. La distorsión corporal (DC) estuvo más presente en hombres vs. mujeres (p = .04), así como en los participantes normopeso vs. sobrepeso-obesidad (p = .01); contrariamente, la insatisfacción corporal fue más común en estos últimos (p = .03). En las mujeres, el IMC percibido correlacionó positivamente con aislamiento social, mientras que autodefinirse “como obesas” se asoció tanto con éste como con menor autoestima; no así en los hombres, en quienes dicha autodefinición solo correlacionó con aislamiento social. Aunque los hombres presentaron mayor DC, en las mujeres la IC se relacionó con más aspectos de su identidad.