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1.
Recurso de Internet en Español | LIS - Localizador de Información en Salud, LIS-ES-CIUD, LIS-ES-PROF | ID: lis-LISBR1.1-47002

RESUMEN

Contiene: situación epidemiológica, evaluación de riesgo y medidas de salud pública en España, actuaciones y recomendaciones de salud pública de la República Popular China, la Organización Mundial de la Salud (OMS) y el Centro Europeo de Control de Enfermedades (ECDC).


Asunto(s)
Infecciones por Coronavirus , Betacoronavirus , Medición de Riesgo , Vigilancia en Salud Pública , España , China , Organización Mundial de la Salud , Neumonía Viral
4.
Waste Manag ; 102: 587-597, 2020 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-31778970

RESUMEN

Tourism contributes substantially to municipal solid waste generation, yet the waste from tourism systematically remains hidden behind residential waste flows. As a result, municipal fees are set without precise information about waste producers' contributions, causing budget imbalances and cross-subsidies between residential and economic activities. To estimate tourism's contribution to mixed waste generation in an island destination, socio-demographic, economic and disposal-related factors are modelled using municipal panel data from 2004 to 2015 for Tenerife (Spain). In contrast to previous studies, a mixed demand-supply approach is adopted to estimate the contribution of main tourism activities to mixed waste generation, thus, differentiating between tourists and residents' contributions. An auxiliary model is used to isolate employment levels in tourism activities attributable to residents' consumption and to capture tourists' and residents' mobility on the island. Estimates show that main tourism activities generate 0.40 kg of mixed waste per tourist daily, while residential and economic sectors account for 1.19 kg per resident daily. This tourism contribution is significantly lower compared to other studies, as it captures tourism's contribution to mixed waste generation, attributable only to tourists, following a mixed demand-supply approach. These results shift impacts from tourists to main tourism activities, which highlights the choices made by producers rather than the final customers and reinforces the producers extended responsibility principle. The implementation of a Pay-As-You-Throw tariff for mixed waste is discussed as a way of promoting waste prevention and recycling, as well as avoiding cross-subsidies among waste producers and, as a result, imbalances in municipal budgets.


Asunto(s)
Eliminación de Residuos , Administración de Residuos , Islas , Residuos Sólidos , España
5.
Br J Anaesth ; 124(2): 197-205, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31780140

RESUMEN

BACKGROUND: Medication-related adverse events (MRE) in anaesthesia care are frequent and require a deeper understanding if we are to prevent medication harm. METHODS: We searched for reported MRE from the Spanish Anaesthesia Incident Reporting System (SENSAR) database over a 10-yr period. SENSAR is a cross-national, multicentre system focused on perioperative and critical care. A descriptive analysis of independent variables, phase of medication process, type of MRE, and medication group involved, and their relationships with morbidity was conducted. RESULTS: A total of 1970 MRE were identified from 7072 reported incidents. Patient harm was reported in 31% of the MRE. The administration phase was more frequent (42%) and showed the highest harm rate (44%) compared with other medication process phases. The most frequent types of MRE were wrong treatment regimen and wrong medication (55% of cases). The medication groups most commonly reported were those that alter haemostasis (18%), vasoconstrictor agents (13%), and opioids (10%). Vasoconstrictor agents, benzodiazepines, and neuromuscular blocking agents were the medication groups involved in patient harm four-fold more, and opioids three-fold more, than medications that alter haemostasis. The 1970 incidents were investigated and led to implementation of 4223 local corrective patient safety and quality improvement measures. CONCLUSIONS: Patient harm in the perioperative setting from medications remains a major issue for patients, hospital leaders, and clinicians. We found patterns and specific causes that can be mitigated through proven systems solutions, and should be taken into consideration in designing sustainable solutions for safe perioperative care. CLINICAL TRIAL REGISTRATION: NCT03615898.


Asunto(s)
Anestesia/efectos adversos , Seguridad del Paciente/estadística & datos numéricos , Gestión de Riesgos/estadística & datos numéricos , Bases de Datos Factuales/estadística & datos numéricos , Humanos , Mejoramiento de la Calidad , Estudios Retrospectivos , España
6.
Rev Esp Cardiol (Engl Ed) ; 73(1): 69-77, 2020 Jan.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31761573

RESUMEN

Heart failure is a complex entity, with high morbidity and mortality. The clinical course and outcome are uncertain and difficult to predict. This document, instigated by the Heart Failure and Geriatric Cardiology Working Groups of the Spanish Society of Cardiology, addresses various aspects related to palliative care, where most cardiovascular disease will eventually converge. The document also establishes a consensus and a series of recommendations with the aim of recognizing and understanding the need to implement and progressively apply palliative care throughout the course of the disease, not only in the advanced stages, thus improving the care provided and quality of life. The purpose is to improve and adapt treatment to the needs and wishes of each patient, who must have adequate information and participate in decision-making.


Asunto(s)
Cardiología , Consenso , Insuficiencia Cardíaca/terapia , Cuidados Paliativos/normas , Sociedades Médicas , Anciano , Toma de Decisiones , Humanos , España
7.
Arch Virol ; 165(1): 157-167, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31748876

RESUMEN

Endogenous retroviruses of domestic cats (ERV-DCs) are members of the genus Gammaretrovirus that infect domestic cats (Felis silvestris catus). Uniquely, domestic cats harbor replication-competent proviruses such as ERV-DC10 (ERV-DC18) and ERV-DC14 (xenotropic and nonecotropic viruses, respectively). The purpose of this study was to assess invasion by two distinct infectious ERV-DCs, ERV-DC10 and ERV-DC14, in domestic cats. Of a total sample of 1646 cats, 568 animals (34.5%) were positive for ERV-DC10 (heterozygous: 377; homozygous: 191), 68 animals (4.1%) were positive for ERV-DC14 (heterozygous: 67; homozygous: 1), and 10 animals (0.6%) were positive for both ERV-DC10 and ERV-DC14. ERV-DC10 and ERV-DC14 were detected in domestic cats in Japan as well as in Tanzania, Sri Lanka, Vietnam, South Korea and Spain. Breeding cats, including Singapura, Norwegian Forest and Ragdoll cats, showed high frequencies of ERV-DC10 (60-100%). By contrast, ERV-DC14 was detected at low frequency in breeding cats. Our results suggest that ERV-DC10 is widely distributed while ERV-DC14 is maintained in a minor population of cats. Thus, ERV-DC10 and ERV-DC14 have invaded cat populations independently.


Asunto(s)
Gammaretrovirus/clasificación , Técnicas de Genotipaje/métodos , Infecciones por Retroviridae/epidemiología , Animales , Animales Domésticos , Asia , Cruzamiento , Gatos , Gammaretrovirus/genética , Gammaretrovirus/aislamiento & purificación , Noruega , Filogenia , Filogeografía , Infecciones por Retroviridae/virología , España , Tanzanía
8.
Waste Manag ; 102: 391-403, 2020 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-31733563

RESUMEN

The paper evaluates for the first time the embodied impact in CDW during the buildings life cycle by means of the bill of quantities of construction projects. The main objective is to be able to predict the future CDW to be generated by a project in the design stage, by means of the bill of quantities of the urbanization, construction, renovation, rehabilitation and demolition projects. The tools already in place for cost control can be used as an instrument for the introduction of sustainability considerations in construction projects. The methodology proposes a connection between the different stages of a building's life cycle, more precisely its budget. The latter is linked to other future budgets for building renovations or retrofitting projects. The result shows that urbanization and demolition generate 90% of CDW, the former is caused by earthworks and the latter is due to the elimination of all building materials. The building is removed 1.3 times, in terms of material weight, energy and water. Finally, traditional models for economic control and waste management in construction projects can be the vector which introduce environmental assessment through the building life cycle.


Asunto(s)
Industria de la Construcción , Administración de Residuos , Materiales de Construcción , Vivienda , España
9.
Plant Dis ; 104(1): 94-104, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31738690

RESUMEN

In this study, 3,426 grafted grapevines ready to be planted from 15 grapevine nursery fields in Northern Spain were inspected from 2016 to 2018 for black-foot causing pathogens. In all, 1,427 isolates of black-foot pathogens were collected from the asymptomatic inner tissues of surface sterilized secondary roots and characterized based on morphological features and DNA sequence data of the nuclear ribosomal DNA-internal transcribed spacer region, histone H3, translation elongation factor 1-alpha and ß-tubulin genes. Eleven species belonging to the genera Dactylonectria, Ilyonectria, Neonectria, and Thelonectria were identified, including Dactylonectria alcacerensis, D. macrodidyma, D. novozelandica, D. pauciseptata, D. torresensis, Ilyonectria liriodendri, I. pseudodestructans, I. robusta, Neonectria quercicola, Neonectria sp. 1, and Thelonectria olida. In addition, two species are newly described, namely D. riojana and I. vivaria. Twenty-four isolates representing 13 black-foot species were inoculated onto grapevine seedlings cultivar 'Tempranillo'. The pathogenicity tests detected diversity in virulence among fungal species and between isolates within each species. The most virulent species was D. novozelandica isolate BV-0760, followed by D. alcacerensis isolate BV-1240 and I. vivaria sp. nov. isolate BV-2305. This study improves our knowledge on the etiology and virulence of black-foot disease pathogens, and opens up new perspectives in the study of the endophytic phase of these pathogens in grapevines.


Asunto(s)
Variación Genética , Hypocreales , Enfermedades de las Plantas , Vitis , Genes Fúngicos/genética , Hypocreales/clasificación , Hypocreales/citología , Hypocreales/genética , Enfermedades de las Plantas/microbiología , Enfermedades de las Plantas/estadística & datos numéricos , España , Especificidad de la Especie , Virulencia , Vitis/microbiología
10.
Rev Esp Cardiol (Engl Ed) ; 73(1): 43-52, 2020 Jan.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31521574

RESUMEN

INTRODUCTION AND OBJECTIVES: To describe, for the first time, reference values for the cardio-ankle vascular index (CAVI), brachial-ankle pulse wave velocity (BA-PWV), carotid-femoral pulse wave velocity (CF-PWV), and the central augmentation index and to establish their association with cardiovascular risk factors in the Spanish adult population aged 35 to 75 years without cardiovascular disease. METHODS: We conducted a cross-sectional study. Through random sampling stratified by age and sex, we included 501 participants without cardiovascular disease. The mean age was 55.9 years and 50.3% were women. The measurements were taken using the SphigmoCor and Vasera VS-1500 devices. RESULTS: Values for all measures, except those for the central augmentation index, were higher in men and increased with age and blood pressure. The mean values were as follows: CAVI, 8.01±1.44; BA-PWV, 12.93±2.68m/s; CF-PWV, 6.53±2.03 m/s, and central augmentation index, 26.84±12.79. On multiple regression analysis, mean blood pressure was associated with the 4 measures, glycated hemoglobin was associated with all measures except the central augmentation index, and body mass index showed an inverse association with CAVI. The explanatory capacity of age, sex, and mean blood pressure was 62% for BA-PWV, 49% for CF-PWV 49%, 54% for the CAVI, and 38% for the central augmentation index. On logistic regression, hypertension was associated with the CAVI (OR=3.45), VOP-BT (OR=3.44), VOP-CF (OR=3.38) and with the central augmentation index (OR=3.73). CONCLUSIONS: All arterial stiffness measures increased with age. The CAVI and CF-PWV were higher in men and the central augmentation index was higher in women, with no differences in BA-PWV. This study is registered at ClinicalTrials.gov. Identifier NCT02623894.


Asunto(s)
Enfermedades Cardiovasculares/fisiopatología , Vigilancia de la Población , Rigidez Vascular/fisiología , Adulto , Anciano , Índice Tobillo Braquial , Índice de Masa Corporal , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Grosor Intima-Media Carotídeo , Estudios Transversales , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Análisis de la Onda del Pulso , Valores de Referencia , Factores de Riesgo , España/epidemiología
11.
Phytopathology ; 110(1): 94-105, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31589103

RESUMEN

Increasing evidence indicates that in wild ecosystems plant viruses are important ecological agents, and with potential to jump into crops, but only recently have the diversity and population dynamics of wild plant viruses begun to be explored. Theory proposes that biotic factors (e.g., ecosystem biodiversity, host abundance, and host density) and climatic conditions would determine the epidemiology and evolution of wild plant viruses. However, these predictions seldom have been empirically tested. For 3 years, we analyzed the prevalence and genetic diversity of Potyvirus species in preserved riparian forests of Spain. Results indicated that potyviruses were always present in riparian forests, with a novel generalist potyvirus species provisionally named Iberian hop mosaic virus (IbHMV), explaining the largest fraction of infected plants. Focusing on this potyvirus, we analyzed the biotic and climatic factors affecting virus infection risk and population genetic diversity in its native ecosystem. The main predictors of IbHMV infection risk were host relative abundance and species richness. Virus prevalence and host relative abundance were the major factors determining the genetic diversity and selection pressures in the virus population. These observations support theoretical predictions assigning these ecological factors a key role in parasite epidemiology and evolution. Finally, our phylogenetic analysis indicated that the viral population was genetically structured according to host and location of origin, as expected if speciation is largely sympatric. Thus, this work contributes to characterizing viral diversity and provides novel information on the determinants of plant virus epidemiology and evolution in wild ecosystems.


Asunto(s)
Ecosistema , Interacciones Huésped-Patógeno , Enfermedades de las Plantas , Virus de Plantas , Plantas , Potyvirus , Especificidad del Huésped , Interacciones Huésped-Patógeno/fisiología , Filogenia , Enfermedades de las Plantas/virología , Virus de Plantas/clasificación , Virus de Plantas/fisiología , Plantas/virología , Densidad de Población , Potyvirus/clasificación , Potyvirus/genética , España
12.
Angiology ; 71(2): 131-138, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31578072

RESUMEN

Patients with autoimmune disorders are at an increased risk of venous thromboembolism (VTE), but this association has not been consistently evaluated. We used the RIETE (Registro Informatizado Enfermedad Trombo Embólica) database to compare the rates of VTE recurrences, major bleeding, and death during the course of anticoagulation, according to the presence or absence of autoimmune disorders. Of 71 625 patients with VTE recruited in February 2018, 1800 (2.5%) had autoimmune disorders. Median duration of anticoagulant therapy was slightly longer in patients with autoimmune disorders (median, 190 vs 182 days; P = .001). On multivariable analysis, patients with autoimmune disorders had a similar risk of VTE recurrences (hazard ratio [HR]: 0.93; 95% confidence interval [CI]: 0.68-1.27) or major bleeding (HR: 1.07; 95% CI: 0.82-1.40) and a lower risk to die (HR: 0.66; 95% CI: 0.54-0.81) than those without autoimmune disorders. Patients with giant cell arteritis had the highest rates of major bleeding (8.6 events per 100 patient-years) and the lowest rate of recurrences (zero). In other subgroups, the rates of both events were more balanced. During anticoagulation, patients with or without autoimmune disorders had similar rates of VTE recurrences or major bleeding. However, there were some differences between subgroups of patients with autoimmune disorders.


Asunto(s)
Enfermedades Autoinmunes/complicaciones , Tromboembolia Venosa/etiología , Anciano , Anciano de 80 o más Años , Anticoagulantes/efectos adversos , Anticoagulantes/uso terapéutico , Bases de Datos Factuales , Femenino , Hemorragia/inducido químicamente , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Sistema de Registros , Medición de Riesgo , España , Tromboembolia Venosa/tratamiento farmacológico , Tromboembolia Venosa/epidemiología
13.
Phytopathology ; 110(1): 49-57, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31524081

RESUMEN

Mixed viral infections are common in plants, and the evolutionary dynamics of viral populations may differ depending on whether the infection is caused by single or multiple viral strains. However, comparative studies of single and mixed infections using viral populations in comparable agricultural and geographical locations are lacking. Here, we monitored the occurrence of pepino mosaic virus (PepMV) in tomato crops in two major tomato-producing areas in Murcia (southeastern Spain), supporting evidence showing that PepMV disease-affected plants had single infections of the Chilean 2 (CH2) strain in one area and the other area exhibited long-term (13 years) coexistence of the CH2 and European (EU) strains. We hypothesized that circulating strains of PepMV might be modulating the differentiation between them and shaping the evolutionary dynamics of PepMV populations. Our phylogenetic analysis of 106 CH2 isolates randomly selected from both areas showed a remarkable divergence between the CH2 isolates, with increased nucleotide variability in the geographical area where both strains cocirculate. Furthermore, the potential virus-virus interaction was studied further by constructing six full-length infectious CH2 clones from both areas, and assessing their viral fitness in the presence and absence of an EU-type isolate. All CH2 clones showed decreased fitness in mixed infections and although complete genome sequencing indicated a nucleotide divergence of those CH2 clones by area, the magnitude of the fitness response was irrespective of the CH2 origin. Overall, these results suggest that although agroecological cropping practices may be particularly important for explaining the evolutionary dynamics of PepMV in tomato crops, the cocirculation of both strains may have implications on the genetic variability of PepMV populations.


Asunto(s)
Variación Genética , Lycopersicon esculentum , Potexvirus , Genética de Población , Lycopersicon esculentum/virología , Filogenia , Enfermedades de las Plantas/virología , Potexvirus/genética , España/epidemiología
15.
BJOG ; 127(3): 377-387, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31631477

RESUMEN

OBJECTIVE: To assess the long-term risk factors predicting residual/recurrent cervical intraepithelial neoplasia (CIN 2-3) and time to recurrence after large loop excision of the transformation zone (LLETZ). DESIGN: Retrospective study. SETTING: Colposcopy clinic. POPULATION: 242 women with CIN 2-3 treated between 1996 and 2006 and followed up until June 2016. METHODS: Age, margins, and high-risk human papillomavirus (HR-HPV) were estimated using Cox proportional hazard and unconditional logistic regression models. The cumulative probability of treatment failure was estimated by Kaplan-Meier analysis. MAIN OUTCOME MEASURE: Histologically confirmed CIN 2-3, HR-HPV, margins, age. RESULTS: CIN 2-3 was associated with HR-HPV (HR = 30.5, 95% confidence interval [CI] = 3.80-246.20), age >35 years (HR = 5.53, 95% CI = 1.22-25.13), and margins (HR = 7.31, 95% CI = 1.60-33.44). HR-HPV showed a sensitivity of 88.8% and a specificity of 80%. Ecto+ /endocervical+ (16.7%), uncertain (19.4%) and ecto- /endocervical+ margins (9.1%) showed a higher risk of recurrence (odds ratio [OR] = 13.20, 95% CI = 1.02-170.96; OR = 15.84, 95% CI = 3.02-83.01; and OR = 6.60, 95% CI = 0.88-49.53, respectively). Women with involved margins and/or who were HR-HPV positive had more treatment failure than those who were HR-HPV negative or had clear margins (P-log-rank <0.001). CONCLUSIONS: HR-HPV and margins seem essential for stratifying post-LLETZ risk, and enable personalised management. Given that clear margins present a lower risk, a large excision may be indicated in older women to reduce the risk. TWEETABLE ABSTRACT: After LLETZ for CIN 2-3, recurrences appear more often in women with positive HR-HPV and involved margins and aged over 35.


Asunto(s)
Neoplasia Intraepitelial Cervical , Efectos Adversos a Largo Plazo , Márgenes de Escisión , Recurrencia Local de Neoplasia/diagnóstico , Neoplasia Residual/diagnóstico , Infecciones por Papillomavirus , Traquelectomía , Neoplasias del Cuello Uterino , Transformación Celular Neoplásica , Neoplasia Intraepitelial Cervical/epidemiología , Neoplasia Intraepitelial Cervical/patología , Neoplasia Intraepitelial Cervical/cirugía , Cuello del Útero/patología , Cuello del Útero/cirugía , Femenino , Humanos , Estimación de Kaplan-Meier , Efectos Adversos a Largo Plazo/diagnóstico , Efectos Adversos a Largo Plazo/epidemiología , Persona de Mediana Edad , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/epidemiología , Estudios Retrospectivos , Medición de Riesgo/métodos , España/epidemiología , Traquelectomía/efectos adversos , Traquelectomía/métodos , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/cirugía
16.
J Forensic Sci ; 65(1): 160-165, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31343744

RESUMEN

The characteristics of mental disorders, as well as deficiencies in their treatment, must be properly defined. This was a prospective, longitudinal, observational study, in which all men referred to a penitentiary psychiatric consultation of three penitentiary centers in Spain were invited to participate. Those who consented to participation (1328) were interviewed at the baseline timepoint and at intervals for up to 3 years. The presence of mental disorders was high: 68.2% had a cluster B personality disorder, 14% had an affective and/or anxiety disorders, 13% had schizophrenia, and over 80% had a dual disorder. Polypharmacy was the norm. Moreover, the health care received in prison did not match that provided in the community in terms of quantity and quality. These results should help to facilitate the design of mental healthcare provision for prisoners, focusing on both the most frequent patient profiles and equality of care.


Asunto(s)
Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Servicios de Salud Mental/organización & administración , Prisioneros/psicología , Prisiones , Adulto , Coinfección , Femenino , Infecciones por VIH/epidemiología , Hepatitis C Crónica/epidemiología , Humanos , Estudios Longitudinales , Masculino , Polifarmacia , Estudios Prospectivos , Psicotrópicos/uso terapéutico , España/epidemiología , Trastornos Relacionados con Sustancias/epidemiología
17.
Rev Esp Cardiol (Engl Ed) ; 73(1): 14-20, 2020 Jan.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31160265

RESUMEN

INTRODUCTION AND OBJECTIVES: To compare the long-term results of direct oral anticoagulants (DOAC) vs vitamin K antagonists (VKA) in real-world-patients with nonvalvular atrial fibrillation (NVAF) in a nationwide, prospective study. METHODS: The FANTASIIA registry prospectively included outpatients with AF anticoagulated with DOAC or VKA (per protocol, proportion of VKA and DOAC 4:1), consecutively recruited from June 2013 to October 2014 in Spain. The incidence of major events was analyzed and compared according to the anticoagulant treatment received. RESULTS: A total of 2178 patients were included in the study (mean age 73.8±9.4 years), and 43.8% were women. Of these, 533 (24.5%) received DOAC and 1645 (75.5%) VKA. After a median follow up of 32.4 months, patients receiving DOAC vs those receiving VKA had lower rates of stroke-0.40 (95%CI, 0.17-0.97) vs 1.07 (95%CI,0.79-1.46) patients/y, P=.032-, severe bleedings-2.13 (95%CI, 1.45-3.13) vs 3.28 (95%CI, 2.75-3.93) patients/y; P = .044-, cardiovascular death-1.20 (95%CI, 0.72-1.99) vs 2.45 (95%CI, 2.00-3.00) patients/y; P = .009-, and all-cause death-3.77 (95%CI, 2.83-5.01) vs 5.54 (95%CI, 4.83-6.34) patients/y; P = .016-. In a modified Cox regression model by the Andersen-Gill method for multiple events, hazard ratios for patients receiving DOAC were: 0.42 (0.16-1.07) for stroke; 0.47 (0.20-1.16) for total embolisms; 0.76 (0.50-1.15) for severe bleedings; 0.67 (0.39-1.18) for cardiovascular death; 0.86 (0.62-1.19) for all-cause death, and 0.82 (0.64-1.05) for the combined event consisting of stroke, embolism, severe bleeding, and all-cause death. CONCLUSIONS: Compared with VKA, DOAC is associated with a trend to a lower incidence of all major events, including death, in patients with NVAF in Spain.


Asunto(s)
Anticoagulantes/administración & dosificación , Fibrilación Atrial/tratamiento farmacológico , Accidente Cerebrovascular/prevención & control , Vitamina K/antagonistas & inhibidores , Administración Oral , Anciano , Fibrilación Atrial/complicaciones , Causas de Muerte/tendencias , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Pacientes Ambulatorios , Pronóstico , Estudios Prospectivos , España/epidemiología , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/etiología , Tasa de Supervivencia/tendencias , Factores de Tiempo
19.
Rev Esp Cardiol (Engl Ed) ; 73(1): 35-42, 2020 Jan.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31122784

RESUMEN

INTRODUCTION AND OBJECTIVES: This study sought to analyze the association of early coronary angiography with all-cause mortality and cardiovascular mortality in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS) using a large contemporary cohort of patients with NSTEACS from 2 Spanish tertiary hospitals. METHODS: This retrospective observational study included 5673 consecutive NSTEACS patients from 2 Spanish hospitals between 2005 and 2016. We performed propensity score matching to obtain a well-balanced subset of patients with the same probability of undergoing an early strategy, resulting in 3780 patients. Survival analyses were performed by Cox regression models once proportional risk test were verified. RESULTS: Among the study participants, only 2087 patients (40.9%) underwent early invasive coronary angiography. The median follow-up was 59.0 months [interquartile range, 25.0-80.0 months]. All-cause mortality was 19.0%, cardiovascular mortality was 12.8%, and 51.1% patients experienced at least 1 major cardiovascular adverse event in the follow-up. After propensity score matching, the early strategy was associated with significantly lower mortality (hazard ratio: 0.79; 95% confidence interval 0.62-0.98) in high-risk NSTEACS patients. The darly strategy showed a nonsignificant inverse tendency in patients with GRACE score <140. CONCLUSIONS: In high-risk (GRACE score≥ 140) NSTEACS patients in a contemporary real-world registry, early coronary angiography (first 24hours after hospital admission) may be associated with reduced all-cause mortality and cardiovascular mortality at long-term follow-up.


Asunto(s)
Infarto del Miocardio sin Elevación del ST/cirugía , Intervención Coronaria Percutánea/métodos , Puntaje de Propensión , Sistema de Registros , Causas de Muerte/tendencias , Angiografía Coronaria , Electrocardiografía , Estudios de Seguimiento , Humanos , Infarto del Miocardio sin Elevación del ST/diagnóstico , Infarto del Miocardio sin Elevación del ST/mortalidad , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , España/epidemiología , Tasa de Supervivencia/tendencias , Factores de Tiempo
20.
Sci Total Environ ; 701: 134755, 2020 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-31704398

RESUMEN

The objective of this study is to analyze the short-term effects of atmospheric pollutant concentrations (PM10, NO2 and O3) and heat and cold waves on the number of pre-term births and cases of low birth weight related to Saharan dust advection and biomass combustion. The dependent variables used in this analysis were the total number of births, births with low weight (>2.500 g) and pre-term births (<37 weeks), that occurred at the province level. Data provided by the NSI included: days with Saharan dust intrusion or biomass advection classified in terms of information provided by MITECO for each of the nine regions in Spain. A representative city was selected for reach region in which the registered average daily concentrations of PM10, NO2 and O3 (µg/m3) were used. These were also provided by MITECO. The daily maximum and daily minimum temperature (°C) used was those registered by the meteorological observatory station located in each province capital, provided by AEMET. Using Poisson log linear regression models, the associated relative risks (RR) were measured as well as the population attributable risk (PAR) corresponding to the variables that resulted statistically significant at p < 0.05 for days with and without intrusion of natural particulate matter. The results obtained show that the days with Saharan dust intrusion or advections due to biomass combustion- beyond the impact of PM10, primary pollutants such as NO2 (in Saharan intrusions), heat waves and O3 - are associated with the number of births, low birth weight and pre-term birth. The RR and percent PAR of the pollutants and the heat waves are greater than those obtained for PM10. The results of this study indicate that days with natural particulate matter due to biomass combustion or advection of Saharan dust put pregnant women at risk.


Asunto(s)
Contaminación del Aire/estadística & datos numéricos , Polvo/análisis , Exposición Materna/estadística & datos numéricos , Resultado del Embarazo/epidemiología , África del Norte , Monitoreo del Ambiente , Femenino , Humanos , Material Particulado/análisis , Embarazo , España
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