Person: Gómez Martínez, Ana María
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First Name
Ana María
Last Name
Gómez Martínez
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Medicina
Department
Cirugía
Area
Cirugía
Identifiers
17 results
Search Results
Now showing 1 - 10 of 17
Item Implementación de una app de cuidados perioperatorios en cirugía torácica electiva(Cirugía Española, 2022) Fraile Olivero, Carlos Alfredo; Jarabo Sarceda, José Ramón; Fernández Martín, Elena; Santos Capa, Passio Beatriz; Arribas Manzanal, Pedro Daniel; Gómez Martínez, Ana María; Calatayud Gastardi, Joaquín; Hernando Trancho, Florentino; Targarona, Eduard M.; Bruna, Marcos; Cerdán Santacruz, Carlos; Lopez Cano, Manuel; Ríos, Antonio; Turrado Rodriguez, VíctorIntroduccion: La inconsistencia en el diseño e implementacion de los programas de cuidados perioperatorios limita su universalizacion, y es aquı´ donde las tecnologias en salud pueden estandarizar estos procesos. El objetivo del estudio es crear una app para smartphone con un programa de cuidados perioperatorios, implementarla en un grupo de pacientes programados para un procedimiento quirurgico toracico y evaluar su utilizacinn. Metodos: Estudio prospectivo y descriptivo. Se creo´ una app (Fissios App) que contiene 40 recomendaciones perioperatorias y un programa de 10 ejercicios de fisioterapia respiratoria. A los pacientes se les recomendo utilizarla antes y despues de la cirugia; para medir su utilizacion se creo y se aplico un cuestionario. Se realizo un analisis descriptivo de las variables de los pacientes, las respuestas del cuestionario y se evaluo su asociacion. Resultados: Se incluyeron 131 pacientes, el 60,3% eran varones con una mediana de edad de 62 años (51-71), y el 26,72% habıan completado estudios secundarios. El 89,3% resaltaron la facilidad para descargar y configurar la app. Ma s del 90% de los pacientes valoraron positivamente la claridad para explicar los ejercicios respiratorios y las recomendaciones perioperatorias. Ciento cuatro (79,4%) pacientes destacaron la contribucion del uso de la app para afrontar el postoperatorio. Conclusiones: Se creo una app (Fissios App) con un programa de cuidados perioperatorios y se implemento satisfactoriamente sin importar la edad ni el nivel educativo de los pacientes. La herramienta explica claramente la informacion contenida, y su uso antes de la cirugıa les ayudo a afrontar el postoperatorio, con un nivel adecuado de exigencia fısica y de tiempo de uso.Item Implementación de un programa de cribado del malestar emocional en un servicio de cirugía torácica(Cirugía Española, 2019) Cruzado Rodríguez, Juan Antonio; Martínez García, Vanesa; Salas Gutiérrez, Verónica; Jarabo Sarceda, José Ramón; Fraile Olivero, Carlos Alfredo; Fernández Martín, Elena; Calatayud Gastardi, Joaquín; Gómez Martínez, Ana María; Hernando Trancho, Florentino; Targarona Soler, Eduardo M.; Bruna Esteban, Marcos; Cerdán Santacruz, Carlos; López Cano, Manuel; Turrado Rodríguez, Víctor; Ríos Zambudio, Antonio; Moreno Mata, NicolásIntroducción El objetivo del presente estudio es examinar la precisión diagnóstica de los test de cribado utilizados para detectar la necesidad de atención psicológica en pacientes remitidos para cirugía torácica. Métodos Se evaluó la presencia de malestar emocional en un total de 105 pacientes remitidos para cirugía torácica por medio de la entrevista clínica psicológica (variable criterio). Los métodos de cribado utilizados fueron: el juicio del médico (sí/no), la Escala Hospitalaria de Ansiedad y Depresión (HADS), la pregunta única para evaluar depresión «¿se siente usted deprimido?» (ADEP) (1-5) y la pregunta única para medir ansiedad «¿se siente ansioso?» (AANA) (1-5). Resultados De acuerdo con la entrevista entrevista clínica psicológica, el 34% de los pacientes fueron casos clínicos que requerían intervención psicológica. La puntuación total de la escala HADS (punto de corte 10) mostró una sensibilidad del 0,89, especificidad del 0,75 y un ABC de 0,883; la ADEP (punto de corte 1) mostró una sensibilidad del 0,79, especificidad del 0,74 y ABC del 0,795; la AANS (>1) obtuvo una sensibilidad del 0,78, especificidad del 0,41 y ABC de 0,69 y el juicio del médico mostró una sensibilidad del 0,47 y especificidad del 0,86. Conclusiones Un alto porcentaje de pacientes remitidos para cirugía torácica requirieron intervención psicológica. El mejor instrumento para identificar a aquellos pacientes con necesidades psicológicas, tomando la entrevista psicológica como variable criterio, fue la puntuación total del HADS. Este instrumento es simple y breve, bien aceptado por los pacientes, de fácil aplicación en un servicio de cirugía torácica y tiene buena capacidad diagnóstica.Item Combined Hepatic and Pulmonary Metastasectomies From Colorectal Carcinoma. Data From the Prospective Spanish Registry 2008–2010(Archivos de bronconeumología, 2018) Jarabo Sarceda, José Ramón; Gómez Martínez, Ana María; Calatayud Gastardi, Joaquín; Fernández, Elena; Pajuelo, Nuria; Embún, Raúl; Molins, Laureano; Rivas, Juan J.; Hernando Trancho, Florentino; Villar Álvarez, Felipe; Granda Orive, José Ignacio de; Martínez García, Miguel ÁngelIntroduction: Resection of both liver and lung metastases from colorectal carcinoma (CRC) is a standardof care in selected patients with oligometastatic disease. We present here the analysis of the subgroupof patients undergoing combined surgery from the Spanish Group of Surgery of Pulmonary Metastases(PM) from Colorectal Carcinoma (GECMP-CCR-SEPAR).Methods: We analyze characteristics, survival and prognostic factors of patients undergoing combinedresection from March-2008 to February-2010 and followed-up during at least 3 years, from the prospec-tive multicenter Spanish Registry.Results: A total of 138 patients from a whole series of 543 cases from 32 thoracic surgery units underwentboth procedures. Seventy-seven (43.8%) resected liver metastases were synchronic with colorectal tumor.Median disease specific survival (DSS) from first pulmonary metastasectomy was 48.9 months, beingthree and 5-year DSS 65.1% and 41.7%, respectively. From CRC-surgery median DSS was 97.2 months, with3 and 5-year DSS rates of 96.7% and 77%, respectively. Five-year DSS from pulmonary metastasectomywas 41.7% for patients with combined resection and 52.4% for those without hepatic involvement (P = .04).Differences disappeared when considering DSS from colorectal surgery. Carcinoembrionary antigen (CEA)before lung surgery over 10 mg/dl and bilateral PM were independent prognostic factors for survival(hazard ratio 2.4 and 2.5, respectively).Conclusions: Patients with resection of PM of CRC with history of resected hepatic metastases presentedsignificantly lower disease specific survival rates than those undergoing pulmonary metastasectomyalone. CEA before lung surgery and bilateral PM associated worse prognosis.Item Detection and evaluation of preoperative psychological care needs in cancer and noncancer patients referred to thoracic surgery(Cirugía Española, 2022) Cruzado Rodríguez, Juan Antonio; Martínez García, Vanesa; Pacheco González, Irene; Salas Gutiérrez, Verónica; Jarabo Sarceda, José Ramón; Calatayud Gastardi, Joaquín; Valle Teresa, Laura del; Fernández Martín, Elena; Gómez Martínez, Ana María; Hernando Trancho, FlorentinoObjectives: (a) to evaluate and compare the psychological treatment needs of patients with cancer and non-cancer, who are going to undergo scheduled thoracic surgery, and (b) evaluate and compare the diagnostic accuracy of the screening tests of psychological treatment needs for cancer and non-cancer patients. Method: The need for psychological treatment was evaluated in a total of 169 patients prior to thoracic surgery, through a clinical interview. The screening tests used were: the physician’s judgment (yes/no), the Hospital Anxiety and Depression Scale (HADS) and, the single-item interview to assess depression ‘‘Do you feel depressed?’’ (DEPQ). Results: The number of patients who needed psychological treatment in the total sample was 47 (27.81%), in non-cancer-patients: 22 (30.99%) and in cancer patients: 25 (25.51%). The participants with treatment needs were more often young women with primary education levels, with more fears and concerns regarding their disease. With respect to the screening tests, the HADS-T (cut-off point =13) obtained a sensitivity (SE) of 0.75 and Specificity (SP) of 0.81 in the total sample. In patients with cancer, the HADS total score (cut-off point 10) obtained an SE = 0.84 and SP = 0.80, and, in non-cancer patients, the HADS total score (cut-off point=13) showed an SE = 0.59 and SP = 0.84. The DEPQ and the physician’s judgment did not achieve adequate levels of precision. Conclusions: A high percentage of patients have psychological treatment needs before performing thoracic surgery, which are similar for cancer and non-cancer patients. Preoperative detection of patients who need psychological intervention is feasible with a simple screening test: HADS, which achieves greater precision in cancer patients.Item Implementing a distress screening program in a thoracic surgery service(Cirugía Española, 2019) Cruzado Rodríguez, Juan Antonio; Martínez García, Vanesa; Salas Gutiérrez, Veronica; Jarabo Sarceda, José Ramón; Fraile Olivero, Carlos Alfredo,; Fernández Martín, Elena; Calatayud Gastardi, Joaquín; Gómez Martínez, Ana María; Hernando Trancho, Florentino; ElsevierThe aim of the present study was to examine the diagnostic accuracy of screening tests in detecting cases requiring psychological intervention among patients referred for thoracic surgery. Methods: Emotional distress was evaluated in 105 patients referred for thoracic surgery by means of a diagnostic psychological interview (criterion variable). The screening ability of the following methods was analyzed: the physician’s opinion (Yes/No), Hospital Anxiety and Depression Scale (HADS), single-item interview: ‘‘Are you depressed?’’ (Depression Question, ADEP) (1–5) and the single-item interview: ‘‘Are you anxious?’’ (Anxiety Question, ANXQ) (1–5). Results: According to the clinical interview, 34% of the patients were clinical cases requiring psychological intervention. The total HADS (cut-off point of 10) showed a sensitivity=0.89, specificity=0.75 and AUC=0.883; the ADEP scale (>1) showed a sensitivity=0.79, pecificity=0.74 and AUC=0.795; the ANXQ scale (>1) showed a sensitivity=0.78, specificity=0.41 and AUC=0.690; and the physician’s opinion showed a sensitivity=0.47 and specificity=0.86. Conclusions: A high percentage of patients referred for thoracic surgery required psychological intervention. The best instrument to identify those patients requiring psychological care, taking a psychological interview as the criterion variable, was the total HADS score. This test is brief, simple and well accepted by patients; it is easy to implement within a thoracic surgery service and has a good diagnostic accuracy.Item Physicians' viewpoints on faculty anatomists and dissection of human bodies in the undergraduate medical studies(Annals of Anatomy, 2021) Arráez Aybar, Luis Alfonso; García Mata, Ricardo; Murillo González, Jorge Alfonso; Cuadra Blanco, Crótida De La; Gómez Martínez, Ana María; Bueno López, José Luis; Wojciech Pawlina, MDBackground: Studies abound regarding the views of faculty anatomists and medical students on the importance of anatomy and the dissection of human bodies, but very little is known about the views of practicing physicians. Methods: A survey was distributed among physicians and surgeons practicing in Spain in order to find out their views on the practice and consequences of human dissection by undergraduate students of medicine. The most relevant definition to qualify faculty anatomists of medical schools was also requested. Responses were repeatedly clustered into characteristic subgroups for analysis. Results: In total, 536 physicians and surgeons belonging to 36 different specialties in seven Spanish hospitals responded to the survey. The results highlighted two main facts. Firstly, faculty anatomists were perceived as teachers, above any other professional identity (namely: physician, biologist or scientist); nonetheless, the ascription of identities varied between specialties (p=0.009); and it also depended on whether the respondents had dissected in their undergraduate degree (p=0.03) and on the respondent's gender (p=0.03). Secondly, physicians and surgeons confirmed that dissecting human cadavers serves the undergraduate student not only for acquiring anatomical knowledge, but also essential skills and attitudes, including professionalism. Conclusions: The results strongly suggest that dissection practice should be reinforced and enriched in undergraduate medical school. As this is important in itself, the results of the study could also help with the development of strategies to alleviate the current shortage of adequately trained anatomists for medical degrees.Item Manejo perioperatorio y periprocedimiento del tratamiento antitrombótico: documento de consenso de SEC, SEDAR, SEACV, SECTCV, AEC, SECPRE, SEPD, SEGO, SEHH, SETH, SEMERGEN, SEMFYC, SEMG, SEMICYUC, SEMI, SEMES, SEPAR, SENEC, SEO, SEPA, SERVEI, SECOT y AEU(Revista Española de Cardiología, 2018) Vivas Balcones, Luis David; Leyva Rodríguez, Francisco; Gómez Martínez, Ana María; Santos Bueso, Enrique Miguel; Figuero Ruiz, ElenaEn los últimos años, el número de pacientes anticoagulados y antiagregados está aumentando significativamente. Al ser un tratamiento crónico, es de esperar que a lo largo de su vida necesiten un procedimiento quirúrgico o intervencionista que pueda requerir la interrupción del fármaco antitrombótico. La decisión de retirar o mantener dicho tratamiento estará determinada, por un lado, por el riesgo trombótico y, por otro, por el hemorrágico. De la interacción entre estos 2 factores dependerá la actitud ante la anticoagulación y la antiagregación. El objetivo de este documento de consenso, coordinado desde el Grupo de Trabajo de Trombosis Cardiovascular de la Sociedad Española de Cardiología y certificado por un amplio número de sociedades científicas que participan en el proceso asistencial del paciente durante el periodo perioperatorio o periprocedimiento, consiste en proponer una serie de recomendaciones prácticas y sencillas con el fin de homogeneizar la práctica clínica diaria.Item Perioperative and Periprocedural Management of Antithrombotic Therapy: Consensus Document of SEC, SEDAR, SEACV, SECTCV, AEC, SECPRE, SEPD, SEGO, SEHH, SETH, SEMERGEN, SEMFYC, SEMG, SEMICYUC, SEMI, SEMES, SEPAR, SENEC, SEO, SEPA, SERVEI, SECOT and AEU(Revista Española de Cardiología, 2018) Vivas Balcones, Luis David; Gómez Martínez, Ana María; Ferreiro, José LuisDada la variabilidad y heterogeneidad del manejo de los fármacos antitrombóticos pericirugía, desde la Sociedad Española de Cardiología se coordinó y lideró un documento de consenso con otras 20 sociedades para guiar mediante algoritmos sencillos y de fácil utilización el manejo de estos fármacos en la práctica clínica. During the last few years, the number of patients receiving anticoagulant and antiplatelet therapy has increased worldwide. Since this is a chronic treatment, patients receiving it can be expected to need some kind of surgery or intervention during their lifetime that may require treatment discontinuation. The decision to withdraw antithrombotic therapy depends on the patient's thrombotic risk versus hemorrhagic risk. Assessment of both factors will show the precise management of anticoagulant and antiplatelet therapy in these scenarios. The aim of this consensus document, coordinated by the Cardiovascular Thrombosis Working Group of the Spanish Society of Cardiology, and endorsed by most of the Spanish scientific societies of clinical specialities that may play a role in the patient-health care process during the perioperative or periprocedural period, is to recommend some simple and practical guidelines with a view to homogenizing daily clinical practice.Item Utilidad de la determinación sérica de marcadores tumorales en el diagnóstico del carcinoma broncogénico : cálculo de la probabilidad mediante regresión logística(2002) Gómez Martínez, Ana María; Balibrea Cantero, José Luis; Torres García, Antonio JoséEn este trabajo de tesis doctoral se defiende la utilidad de los marcadores tumorales en el diagnóstico del carcinoma broncogénico y la posibilidad de realizar un cálculo de la probabilidad de esta enfermedad a través del procedimiento estadístico de regresión logística.Item Role of Telomere Length in Survival of Patients with Idiopathic Pulmonary Fibrosis and Other Interstitial Lung Diseases(Biomedicines, 2023) Tesolato, Sofía; Vicente Valor, Juan; Jarabo Sarceda, José Ramón; Calatayud Gastardi, Joaquín; Saiz-Pardo Sanz, Melchor; Nieto Barbero, María Asunción; Linares Gómez, María; Álvaro Álvarez, Dolores; Fraile, Carlos Alfredo; Hernando Trancho, Florentino; Iniesta Serrano, María Pilar; Gómez Martínez, Ana María; Uziel, OritInterstitial lung diseases (ILDs) constitute a group of more than 200 disorders, with idiopathic pulmonary fibrosis (IPF) being one of the most frequent. Telomere length (TL) shortening causes loss of function of the lung parenchyma. However, little is known about its role as a prognostic factor in ILD patients. With the aim of investigating the role of TL and telomerase activity in the prognosis of patients affected by ILDs, we analysed lung tissue samples from 61 patients. We measured relative TL and telomerase activity by conventional procedures. Both clinical and molecular parameters were associated with overall survival by the Kaplan–Meier method. Patients with IPF had poorer prognosis than patients with other ILDs (p = 0.034). When patients were classified according to TL, those with shortened telomeres reported lower overall survival (p = 0.085); differences reached statistical significance after excluding ILD patients who developed cancer (p = 0.021). In a Cox regression analysis, TL behaved as a risk‐modifying variable for death associated with rheumatic disease (RD) co‐occurrence (p = 0.029). Also, in patients without cancer, ferritin was significantly increased in cases with RD and IPF co‐occurrence (p = 0.032). In relation to telomerase activity, no significant differences were detected. In conclusion, TL in lung tissue emerges as a prognostic factor in ILD patients. Specifically, in cases with RD and IPF co‐occurrence, TL can be considered as a risk‐modifying variable for death.