Design and Rationale for a Real-World Prospective, Multicenter Registry of Myocardial Revascularization Failure and Secondary Revascularization: The REVASEC Study.

AIM: To investigate key aspects of the problem of myocardial revascularization failure (MRF) and repeat or secondary myocardial revascularization (SR) in contemporary practice. METHODS: The registry of secondary revascularization (REVASEC) is an investigator-initiated, multicenter, prospective registry enhanced with data monitoring and independent event adjudication (ClinicalTrials.govNCT03349385). It includes patients with prior revascularization referred to coronary angiography for suspected MRF with broad inclusion criteria. The main objectives are to describe the characteristics of patients with prior revascularization referred for repeat angiography, to describe and the rate and mechanisms of MRF (stent or graft failure, coronary artery disease progression or residual coronary artery disease); to evaluate the management including medical treatment and SR of these patients; and to assess the prognosis according to the outlined causative mechanisms. The registry has one year follow up for the primary endpoint (Patient-oriented composite endpoint including all-cause death, any myocardial infarction or any new unplanned revascularization according to subsets of MRF), but extended follow-up will be carried out up to 5 years. CONCLUSION: The REVASEC Registry will provide updated data on the characteristics, patterns of treatment, and 1-year outcomes of patients with MRF and SR in contemporary clinical practice.

Análisis histórico de la Reforma Psiquiátrica andaluza: los inicios y el proyecto / Historical analysis of the psychiatric reform in Andalucia: the beginning and the proposed

Se expone en las páginas siguientes el proceso de transformación de los recursos psiquiátricos habido en la región de Andalucía, España. En este artículo se describe en primer lugar, las transformaciones realizadas en los últimos años de la etapa franquista, y cuya iniciativa se debió casi exclusivamente a las actividades organizadas por los profesionales frente a las Administraciones de las que dependían. En segundo lugar, el período posterior a la instauración de la democracia y que permitió y favoreció el desarrollo de políticas sanitarias que diseñaron e implantaron nuevos modelos de atención sanitaria general y de salud mental en particular.

The following paper talks about the transformation process of psychiatrics resources in Andalousia, Spain. This article firstly describes the transformations happened in the last years of the Franco disctatorship and whose initiatives were set, almost exclusively, by the professionals, instead of the authorities which they were depending on. Secondly, the following period to the establishment of the democracy allowed and helped the development of sanitary politics that draw and introduced new methods of sanitary general attention and particularly of mental health.

Análisis histórico de la reforma psiquiátrica andaluza: la salud mental reformada sin manicomios / Historical analysis of the psychiatric reform in Andalucia: mental health reform without asylums

Se expone en las páginas siguientes el proceso de transformación de los recursos psiquiátricos habido en la región de Andalucía, España. En esta segunda parte se analiza el desarrollo acaecido después de la desaparición del organismo creado para llevar a cabo la reforma. Así, se ofrece una visión crítica de la integración de los recursos de salud mental en el sistema sanitario general, del desmantelamiento completo de los hospitales psiquiátricos, de la creación de servicios sociales específicos para personas con trastornos mentales graves y de la situación actual de la salud mental "reformada", dando cuenta de los logros y de las dificultades de cada etapa de este extenso periodo de veinte años:1991-2011.

The following paper talks about the transformation process of psychiatrics resources in Andalucia, Spain. This second part analyzes the development that took place after the disappearance of the organism created to carry out the reform. It offers a critical approach to the incorporation of the mental health resources into the general sanitary system, to the complete extinction of the psychiatric hospitals, to the creation of specific social services for people suffering from serious mental disorder and to the present situation of the "reformed" mental health, informing about the goals and difficulties of each phase of these long twenty years: 1991-2011.