NOVICA: características y evolución en los pacientes que presentan un primer episodio de insuficiencia cardiaca (de novo) / NOVICA: Characteristics and outcomes of patients who have a first episode of heart failure (de novo)

ANTECEDENTES Y OBJETIVOS: Describir las características clínicas y el pronóstico-mortalidad intrahospitalaria, a 30 días y a 12 meses y reconsulta en urgencias a 30 días por insuficiencia cardiaca aguda- de pacientes atendidos en servicios de urgencias hospitalarios por insuficiencia cardiaca aguda de nueva aparición o de novo (ICAN) y compararlas con los que consultan por insuficiencia cardiaca crónica descompensada (ICAD). PACIENTES: NOVICA es un análisis secundario del registro Epidemiology of Acute Heart Failure in Emergency Departments. Se compararon variables demográficas, características basales, datos del episodio agudo y seguimiento a 30 días y al año de pacientes con ICAN e ICAD. RESULTADOS: Se analizaron 8647 pacientes, 3288 ICAN (38%) y 5359 ICAD (62%). Las ICAN asociaron menor comorbilidad, mejor estado basal, datos de menor gravedad del episodio agudo: menor uso de diuréticos en perfusión intravenosa y de oxigenoterapia, menor tasa de hospitalización. Las ICAN ingresaron más frecuentemente en cardiología o unidades de cuidados intensivos y las ICAD en unidades de corta estancia. La mortalidad cruda a 30 días y a 12 meses y la reconsulta a 30 días fueron inferiores en pacientes con ICAN. No obstante, en el análisis ajustado solo la reconsulta a 30 días fue inferior en las ICAN (p < 0,001). CONCLUSIONES: Los pacientes que consultan en servicios de urgencias hospitalarios por ICAN muestran un perfil clínico diferente a los pacientes con ICAD. En los análisis ajustados, no hay diferencias entre los dos grupos en relación a mortalidad intrahospitalaria, a 30 días ni a 12 meses

BACKGROUND AND OBJECTIVES: To describe the clinical characteristics and prognosis (hospital mortality at 30 days and 12 months and emergency department readmission at 30 days for acute heart failure) of patients treated in hospital emergency departments for new-onset or de novo acute heart failure (NOAHF) and to compare the patients with those who consult for chronic decompensated heart failure (CDHF). PATIENTS: NOVICA is a secondary analysis of the Epidemiology of Acute Heart Failure in Emergency Departments registry. We compared demographic variables, baseline characteristics and data from acute episodes and follow-up at 30 days and 12 months of patients with NOAHF and CDHF. RESULTS: We analysed 8647 patients, with 3288 cases of NOAHF (38%) and 5359 cases of CDHF (62%). NOAHF was associated with lower comorbidity, better baseline state, less severe acute episode data, less use of diuretics in intravenous infusion and oxygen therapy and lower hospitalization rates. The patients with NOAHF were admitted more often to cardiology and intensive care units, and the patients with CDHF were admitted more often to short-stay units. Rates of crude mortality at 30 days and 12 months and readmission at 30 days were higher for the patients with NOAHF. In the adjusted analysis, however, only the rate of readmission at 30 days was lower for NOAHF (p<.001). CONCLUSIONS: Patients admitted to hospital emergency departments for NOAHF show a different clinical profile from patients with CDHF. In the adjusted analysis, there were no differences between the 2 groups regarding hospital mortality, 30-day mortality or 12-month mortality

NOVICA: Characteristics and outcomes of patients who have a first episode of heart failure (de novo). / NOVICA: características y evolución en los pacientes que presentan un primer episodio de insuficiencia cardiaca (de novo).

BACKGROUND AND OBJECTIVES: To describe the clinical characteristics and prognosis (hospital mortality at 30 days and 12 months and emergency department readmission at 30 days for acute heart failure) of patients treated in hospital emergency departments for new-onset or de novo acute heart failure (NOAHF) and to compare the patients with those who consult for chronic decompensated heart failure (CDHF). PATIENTS: NOVICA is a secondary analysis of the Epidemiology of Acute Heart Failure in Emergency Departments registry. We compared demographic variables, baseline characteristics and data from acute episodes and follow-up at 30 days and 12 months of patients with NOAHF and CDHF. RESULTS: We analysed 8647 patients, with 3288 cases of NOAHF (38%) and 5359 cases of CDHF (62%). NOAHF was associated with lower comorbidity, better baseline state, less severe acute episode data, less use of diuretics in intravenous infusion and oxygen therapy and lower hospitalization rates. The patients with NOAHF were admitted more often to cardiology and intensive care units, and the patients with CDHF were admitted more often to short-stay units. Rates of crude mortality at 30 days and 12 months and readmission at 30 days were higher for the patients with NOAHF. In the adjusted analysis, however, only the rate of readmission at 30 days was lower for NOAHF (p<.001). CONCLUSIONS: Patients admitted to hospital emergency departments for NOAHF show a different clinical profile from patients with CDHF. In the adjusted analysis, there were no differences between the 2 groups regarding hospital mortality, 30-day mortality or 12-month mortality.

Theoretical Insights into Unexpected Molecular Core Level Shifts: Chemical and Surface Effects.

A set of density-functional theory based tools is employed to elucidate the influence of chemical and surface-induced changes on the core level shifts of X-ray photoelectron spectroscopy experiments. The capabilities of our tools are demonstrated by analyzing the origin of an unpredicted component in the N 1s core level spectra of metal phthalocyanine molecules (in particular ZnPc) adsorbed on Cu(110). We address surface induced effects, such as splitting of the lowest unoccupied molecular orbital or local electrostatic effects, demonstrating that these cannot account for the huge core level shift measured experimentally. Our calculations also show that, when adsorbed at low temperatures, these molecules might capture hydrogen atoms from the surface, giving rise to hydrogenated molecular species and, consequently, to an extra component in the molecular core level spectra. Only upon annealing, and subsequent hydrogen release, would the molecules recover their nominal structural and electronic properties.

Comentarios sobre el estudio SOPICA en España / Comments on SOPICA study in Spain

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Insuficiencia cardiaca en el anciano, una perspectiva global / Heart failure in elderly patients, a global perspective

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Transferencia de datos de investigación epidemiológica a la práctica clínica en psiquiatría geriátrica / No disponible

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Transferencia de datos de investigación epidemiológica a la practica clínica en psiquiatría psicosomática y psiquiatría de enlace / No disponible

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Transferencia de datos de investigación epidemiológica a la práctica clínica en psiquiatría geriátrica / No disponible

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Spanish perspective on enlarging a small specialty: the national research network for liaison psychiatry and psychosomatics.

The Spanish Research Network in Liaison Psychiatry and Psychosomatics (REPEP) comprises 11 centers (nodes), and was one of the successful applicants in a very competitive call for a networking program for the National Institute of Health "Carlos III" project. This article describes its general objectives and strategic plans. Both qualitative and quantitative results support our statement that this "perspective" should help to enlarge what is presently a small specialty. Synergies in the network have been potentiated; an ambitious national study on depressive comorbidity in complex medical patients has been executed; and new research and training programs have been initiated.

[Psychiatric diseases in the elderly in an urban Aragonese population (Spain) and their relation to health determinants]. / Trastornos psíquicos en ancianos de una población urbana aragonesa (España) y su relación con los determinantes de la salud.

As a part of the SAMAR 89 Project on mental health, we present the results of a psychiatric epidemiological research (in two stages) in a representative sample of the elderly urban population of Zaragoza (Spain). We study the relation between psychological disorders and sociodemographic factors, and network and social support. In the first stage we use a adaptation of the Enquête Santé Quebec and the General Health Questionnaire of 28 items of Goldberg. The Clinical Interview Schedule and the monumental state of Folstein were used for the psychiatric diagnoses in the second stage (diagnoses criteria of the DSM-III). The psychological disorders were more frequent on the women, the more aged and the ones of low socioeconomic level. Also was detected a correspondence between bad mental health and problems in the network and social support.

[Incidence of neoplasms in non-congenital refractory anemias. Ferrokinetic pattern]. / Incidencia de neoplasias en anemias refractarias no congénitas. Patrón ferrocinético.

Twenty cases of refractory anemia were studied by means of ferrokinetic analysis with Fe-59. An accelerated plasma clearing, a diminished iron uptake by red cells, and a decreased bone marrow activity were found. Half of the cases showed secondary liver and spleen hemochromatosis. The incidence of malignant tumors observed in the studied refractory anemias was 35% (7 out of 20 cases, corresponding to 4 solid tumors and 3 leukemias). The authors suggest the convenience to study erythropoiesis in anemias with an obscure origin using the ferrokinetic procedure with Fe-59.