First measurements of an imaging heavy ion beam probe at the ASDEX Upgrade tokamak.

The imaging heavy ion beam probe (i-HIBP) diagnostic has been successfully commissioned at ASDEX Upgrade. The i-HIBP injects a primary neutral beam into the plasma, where it is ionized, leading to a fan of secondary (charged) beams. These are deflected by the magnetic field of the tokamak and collected by a scintillator detector, generating a strike-line light pattern that encodes information on the density, electrostatic potential, and magnetic field of the plasma edge. The first measurements have been made, demonstrating the proof-of-principle of this diagnostic technique. A primary beam of 85/87Rb has been used with energies ranging between 60 and 72 keV and extracted currents up to 1.5 mA. The first signals have been obtained in experiments covering a wide range of parameter spaces, with plasma currents (Ip) between 0.2 and 0.8 MA and on-axis toroidal magnetic field (Bt) between 1.9 and 2.7 T. Low densities appear to be critical for the performance of the diagnostic, as signals are typically observed only when the line integrated density is below 2.0-3.0 × 1019 m-2 in the central interferometer chord, depending on the plasma shape. The strike line moves as expected when Ip is ramped, indicating that current measurements are possible. Additionally, clear dynamics in the intensity of the strike line are often observed, which might be linked to changes in the edge profile structure. However, the signal-to-background ratio of the signals is hampered by stray light, and the image guide degradation is due to neutron irradiation. Finally, simulations have been carried out to investigate the sensitivity of the expected signals to plasma density and temperature. The results are in qualitative agreement with the experimental observations, suggesting that the diagnostic is almost insensitive to fluctuations in the temperature profile, while the signal level is highly determined by the density profile due to the beam attenuation.

MAPK11 (p38ß) is a major determinant of cellular radiosensitivity by controlling ionizing radiation-associated senescence: An in vitro study.

Background and purpose: MAPKs are among the most relevant signalling pathways involved in coordinating cell responses to different stimuli. This group includes p38MAPKs, constituted by 4 different proteins with a high sequence homology: MAPK14 (p38α), MAPK11 (p38ß), MAPK12 (p38γ) and MAPK13 (p38δ). Despite their high similarity, each member shows unique expression patterns and even exclusive functions. Thus, analysing protein-specific functions of MAPK members is necessary to unequivocally uncover the roles of this signalling pathway. Here, we investigate the possible role of MAPK11 in the cell response to ionizing radiation (IR). Materials and methods: We developed MAPK11/14 knockdown through shRNA and CRISPR interference gene perturbation approaches and analysed the downstream effects on cell responses to ionizing radiation in A549, HCT-116 and MCF-7 cancer cell lines. Specifically, we assessed IR toxicity by clonogenic assays; DNA damage response activity by immunocytochemistry; apoptosis and cell cycle by flow cytometry (Annexin V and propidium iodide, respectively); DNA repair by comet assay; and senescence induction by both X-Gal staining and gene expression of senescence-associated genes by RT-qPCR. Results: Our findings demonstrate a critical role of MAPK11 in the cellular response to IR by controlling the associated senescent phenotype, and without observable effects on DNA damage response, apoptosis, cell cycle or DNA damage repair. Conclusion: Our results highlight MAPK11 as a novel mediator of the cellular response to ionizing radiation through the control exerted onto IR-associated senescence.

Gene network downstream plant stress response modulated by peroxisomal H2O2.

Reactive oxygen species (ROS) act as secondary messengers that can be sensed by specific redox-sensitive proteins responsible for the activation of signal transduction culminating in altered gene expression. The subcellular site, in which modifications in the ROS/oxidation state occur, can also act as a specific cellular redox network signal. The chemical identity of ROS and their subcellular origin is actually a specific imprint on the transcriptome response. In recent years, a number of transcriptomic studies related to altered ROS metabolism in plant peroxisomes have been carried out. In this study, we conducted a meta-analysis of these transcriptomic findings to identify common transcriptional footprints for plant peroxisomal-dependent signaling at early and later time points. These footprints highlight the regulation of various metabolic pathways and gene families, which are also found in plant responses to several abiotic stresses. Major peroxisomal-dependent genes are associated with protein and endoplasmic reticulum (ER) protection at later stages of stress while, at earlier stages, these genes are related to hormone biosynthesis and signaling regulation. Furthermore, in silico analyses allowed us to assign human orthologs to some of the peroxisomal-dependent proteins, which are mainly associated with different cancer pathologies. Peroxisomal footprints provide a valuable resource for assessing and supporting key peroxisomal functions in cellular metabolism under control and stress conditions across species.

Analysis of outcomes of emergency general and gastrointestinal surgery during the COVID-19 pandemic.

BACKGROUND: Few surgical studies have provided adjusted comparative postoperative outcome data among contemporary patients with and without COVID-19 infection and patients treated before the pandemic. The aim of this study was to determine the impact of performing emergency surgery in patients with concomitant COVID-19 infection. METHODS: Patients who underwent emergency general and gastrointestinal surgery from March to June 2020, and from March to June 2019 in 25 Spanish hospitals were included in a retrospective study (COVID-CIR). The main outcome was 30-day mortality. Secondary outcomes included postoperative complications and failure to rescue (mortality among patients who developed complications). Propensity score-matched comparisons were performed between patients who were positive and those who were negative for COVID-19; and between COVID-19-negative cohorts before and during the pandemic. RESULTS: Some 5307 patients were included in the study (183 COVID-19-positive and 2132 COVID-19-negative during pandemic; 2992 treated before pandemic). During the pandemic, patients with COVID-19 infection had greater 30-day mortality than those without (12.6 versus 4.6 per cent), but this difference was not statistically significant after propensity score matching (odds ratio (OR) 1.58, 95 per cent c.i. 0.88 to 2.74). Those positive for COVID-19 had more complications (41.5 versus 23.9 per cent; OR 1.61, 1.11 to 2.33) and a higher likelihood of failure to rescue (30.3 versus 19.3 per cent; OR 1.10, 0.57 to 2.12). Patients who were negative for COVID-19 during the pandemic had similar rates of 30-day mortality (4.6 versus 3.2 per cent; OR 1.35, 0.98 to 1.86) and complications (23.9 versus 25.2 per cent; OR 0.89, 0.77 to 1.02), but a greater likelihood of failure to rescue (19.3 versus 12.9 per cent; OR 1.56, 95 per cent 1.10 to 2.19) than prepandemic controls. CONCLUSION: Patients with COVID-19 infection undergoing emergency general and gastrointestinal surgery had worse postoperative outcomes than contemporary patients without COVID-19. COVID-19-negative patients operated on during the COVID-19 pandemic had a likelihood of greater failure-to-rescue than prepandemic controls.

Multidrug transporter MRP4/ABCC4 as a key determinant of pancreatic cancer aggressiveness.

Recent findings show that MRP4 is critical for pancreatic ductal adenocarcinoma (PDAC) cell proliferation. Nevertheless, the significance of MRP4 protein levels and function in PDAC progression is still unclear. The aim of this study was to determine the role of MRP4 in PDAC tumor aggressiveness. Bioinformatic studies revealed that PDAC samples show higher MRP4 transcript levels compared to normal adjacent pancreatic tissue and circulating tumor cells express higher levels of MRP4 than primary tumors. Also, high levels of MRP4 are typical of high-grade PDAC cell lines and associate with an epithelial-mesenchymal phenotype. Moreover, PDAC patients with high levels of MRP4 depict dysregulation of pathways associated with migration, chemotaxis and cell adhesion. Silencing MRP4 in PANC1 cells reduced tumorigenicity and tumor growth and impaired cell migration. Transcriptomic analysis revealed that MRP4 silencing alters PANC1 gene expression, mainly dysregulating pathways related to cell-to-cell interactions and focal adhesion. Contrarily, MRP4 overexpression significantly increased BxPC-3 growth rate, produced a switch in the expression of EMT markers, and enhanced experimental metastatic incidence. Altogether, our results indicate that MRP4 is associated with a more aggressive phenotype in PDAC, boosting pancreatic tumorigenesis and metastatic capacity, which could finally determine a fast tumor progression in PDAC patients.

Fractures in patients with poliomyelitis: Past or current challenge?

Fractures in poliomyelitic limbs are a challenge to surgeons, due to polio's sequelae and morphological disorders, which make conventional osteosynthesis difficult. We present a retrospective study of 62 patients and 73 non-simultaneous fractures in their lower limbs. Average age was 61,7 years and 53,2% were females. We analyzed the preinjury functional level, etiology of the fracture, fracture pattern, treatment used (be conservative or surgical), and implant used in surgical cases. We treated 85,1% of them surgically and 37,9% of them maintained the same functional situation as before the fracture. 55,4% of them experienced the need to add some mechanical aids after the lesion and 6,8% lost the ability to walk. Most of the surgical treatments employed were similar as the ones used in non-poliomyelitic patients, although some cases required atypical implants, such as a Multiloc (® DePuy Synthes) humeral nail for a tibial shaft fracture, due to narrow bone. Mortality along the 1st year was 2.7%. We found similar functional and radiological results as those described in non-poliomyelitic limbs.

Applying Data Science methods and tools to unveil healthcare use of lung cancer patients in a teaching hospital in Spain.

PURPOSE: Our primary goal was to study the use of outpatient attendances by lung cancer patients in Hospital Universitario Puerta de Hierro Majadahonda (HUPHM), Spain, by leveraging our Electronic Patient Record (EPR) and structured clinical registry of lung cancer cases as well as assessing current Data Science methods and tools. METHODS/PATIENTS: We applied the Cross-Industry Standard Process for Data Mining (CRISP-DM) to integrate and analyze activity data extracted from the EPR (9.3 million records) and clinical data of lung cancer patients from a previous registry that was curated into a new, structured database based on REDCap. We have described and quantified factors with an influence in outpatient care use from univariate and multivariate points of view (through Poisson and negative binomial regression). RESULTS: Three cycles of CRISP-DM were performed resulting in a curated database of 522 lung cancer patients with 133 variables which generated 43,197 outpatient visits and tests, 1538 ER visits and 753 inpatient admissions. Stage and ECOG-PS at diagnosis and Charlson Comorbidity Index were major contributors to healthcare use. We also found that the patients' pattern of healthcare use (even before diagnosis), the existence of a history of cancer in first-grade relatives, smoking habits, or even age at diagnosis, could play a relevant role. CONCLUSIONS: Integrating activity data from EPR and clinical structured data from lung cancer patients and applying CRISP-DM has allowed us to describe healthcare use in connection with clinical variables that could be used to plan resources and improve quality of care.

Alcohol binge disrupts the rat intestinal barrier: the partial protective role of oleoylethanolamide.

BACKGROUND AND PURPOSE: Chronic alcohol consumption alters the gut-brain axis, but little is known about alcohol binge episodes on the functioning of the intestinal barrier. We investigated the influence of ethanol binges on bacterial translocation, gut inflammation and immunity, and tight junction (TJ) structure and the ability of the biolipid oleoylethanolamide (OEA) to prevent ethanol binge-induced intestinal barrier dysfunction. EXPERIMENTAL APPROACH: OEA was injected i.p. before repeated ethanol administration by oral gavage. Plasma, spleen, liver and mesenteric lymph nodes (MLN) were collected in sterile conditions for determination of bacterial load. Immune/inflammatory parameters, TJ proteins and apoptotic markers were determined in colonic tissue by RT-PCR and Western blotting. TJ ultrastructure was examined by transmission electron microscopy. KEY RESULTS: Ethanol binges induced bacterial translocation to the MLN (mainly) and spleen. Colonic tissues showed signs of inflammation, and activation of innate (Toll-like receptor-4) and adaptive (IgA) immune systems and TJ proteins (occludin and claudin-3) were decreased after ethanol binges. Pretreatment with OEA reduced intestinal inflammation and immune activation and partially preserved the TJ structure affected by alcohol binges but had no effect on alcohol-induced apoptosis. Ultrastructural analyses of colonic TJs revealed dilated TJs in all ethanol groups, with less electron-dense material in non-pretreated rats. The protective effects of i.p. OEA did not reduce bacterial translocation to the MLN. However, intragastric OEA administration significantly reduced plasma LPS levels and bacterial translocation to the MLN. CONCLUSION AND IMPLICATIONS: OEA-based pharmacotherapies could potentially be useful to treat disorders characterized by intestinal barrier dysfunction, including alcohol abuse.

Evolutionary modularity and morphological integration in the haptoral anchor structures of Ligophorus spp. (Monogenea: Dactylogyridae).

An important question in the study of phenotypic evolution is whether characters are independent of each other or behave and evolve as integrated modules. Morphological integration and modularity provide a powerful framework for the analysis of the evolution of morphological traits. We used geometric morphometrics and phylogenetically independent contrasts (PIC) to test four different modularity hypotheses in the haptoral anchors of 14 monogenean species of Ligophorus. Integration between the modular units identified was further evaluated with two-block partial least squares analysis. Roots and points represented two modules in the dorsal and ventral anchors, but modularity was not statistically supported when parasite phylogeny was accounted for, which may indicate convergent evolution related to host characteristics and gill morphology. In contrast, PIC revealed medial and lateral modules in ventral anchors only. Moreover, we found evidence for ventral and dorsal anchor pairs forming two modules, supporting the notion that they play different functional roles. Integration between all identified modules was strong. We conclude that there is modular structure in the anchors of Ligophorus spp., accounted by adaptive and phylogenetic factors acting at different levels, and ventral and dorsal anchors evolve as integrated modules with specific roles in attachment.

Silicon calcium phosphate ceramic as novel biomaterial to simulate the bone regenerative properties of autologous bone.

This study was conducted to develop novel ceramic bone substitute that resembles the autologous bone behavior when used as graft material. Solid-state reaction at 1100°C was performed to synthesize ß-tricalcium phosphate (ß-TCP) and biphasic calcium phosphate (BCP). The ceramics were further analyzed to characterize phase composition, microstructural properties, cytocompatability and then challenged to regenerate critical bone defects in the parietal bone of rabbits. X-ray diffraction analysis confirmed the production of ß-TCP and indicated the synthesis of novel BCP composed of ß-TCP and silicocarnotite (calcium phosphate silicate mineral). The cytocompatibility test with human osteoblast cell line revealed enhanced cell proliferation on the BCP ceramic. The novel BCP induced the filling of about 73% of the bone defect with a newly formed bone tissue and an almost complete degradation after 12 weeks of healing. This novel ceramic resembles the autologous bone properties of complete degradation and efficient enhancement of bone formation, making it promising as bone graft material.

Knowledge acquisition for medical diagnosis using collective intelligence.

The wisdom of the crowds (WOC) is the process of taking into account the collective opinion of a group of individuals rather than a single expert to answer a question. Based on this assumption, the use of processes based on WOC techniques to collect new biomedical knowledge represents a challenging and cutting-edge trend on biomedical knowledge acquisition. The work presented in this paper shows a new schema to collect diagnosis information in Diagnosis Decision Support Systems (DDSS) based on collective intelligence and consensus methods.

Nefropatía en la enfermedad de células falciformes / Nephropathy in the sickle cell disorder

Presentamos el caso de un varón de 13 años de edad, de raza negra, afectado de anemia de células falciformes, que desarrolló una encefalopatía hipertensiva en el contexto de una glomerulonefritis membrano proliferativa tipo I con síndrome nefrótico clínico. La presencia de microalbuminuria y proteinuria constituye un marcador precoz de la nefropatía en la enfermedad de células falciformes. La prevalencia de hipertensión arterial en la población negra americana varía entre un 2 y un 28%. La hipertensión en la raza negra es más frecuente que en la caucásica, y constituye un serio problema de salud en este grupo poblacional. No encontramos datos en la bibliografía sobre la encefalopatía hipertensiva asociada a esta enfermedad (AU)

We present the case of a thirteen years old black race male patient, affected by sickle cells anaemia, who developed hypertensive encephalopathy in the context of membrano proliferative glomerulonephritis type 1 with clinic nephrotic syndrome. The presence of microalbuminuria and proteinuria constitutes an early marker of the nephropathy in the sickle cell disorder. The presence of blood pressure ranges between 2 and 28% in the black American population. Blood pressure in the black population is most frequent than in Caucasians, constituting a serious health problem in this population group. We have not found any data in the available literature about hypertensive encephalopathy associated to this disease (AU)

Targeting steroid hormone receptors for ubiquitination and degradation in breast and prostate cancer.

Proteolysis targeting chimeric molecules (Protacs) target proteins for destruction by exploiting the ubiquitin-dependent proteolytic system of eukaryotic cells. We designed two Protacs that contain the peptide 'degron' from hypoxia-inducible factor-1alpha, which binds to the Von-Hippel-Lindau (VHL) E3 ubiquitin ligase complex, linked to either dihydroxytestosterone that targets the androgen receptor (AR; Protac-A), or linked to estradiol (E2) that targets the estrogen receptor-alpha (ERalpha; Protac-B). We hypothesized that these Protacs would recruit hormone receptors to the VHL E3 ligase complex, resulting in the degradation of receptors, and decreased proliferation of hormone-dependent cell lines. Treatment of estrogen-dependent breast cancer cells with Protac-B induced the degradation of ERalpha in a proteasome-dependent manner. Protac-B inhibited the proliferation of ERalpha-dependent breast cancer cells by inducing G(1) arrest, inhibition of retinoblastoma phosphorylation and decreasing expression of cyclin D1, progesterone receptors A and B. Protac-B treatment did not affect the proliferation of estrogen-independent breast cancer cells that lacked ERalpha expression. Similarly, Protac-A treatment of androgen-dependent prostate cancer cells induced G(1) arrest but did not affect cells that do not express AR. Our results suggest that Protacs specifically inhibit the proliferation of hormone-dependent breast and prostate cancer cells through degradation of the ERalpha and AR, respectively.

Upgrade of a pacemaker defibrillator to a biventricular device: the internal jugular vein approach in a case of bilateral subclavian veins occlusion.

Cardiac resynchronization improves survival and functional class of patients with advanced chronic heart failure. Placement of a stimulation electrode in the coronary sinus via the left subclavian vein is not always possible and other alternatives are required, above all when it concerns upgrading a previous device. This paper presents the case of a patient with a pacemaker/defibrillator and occlusion of both subclavian veins who had a stimulation electrode successfully placed in the coronary sinus via the right internal jugular.

Resultados del examen final de test objetivo en las asignaturas morfológicas del ciclo básico / Results of the final exam of objective test in morphological subjects of the basic cycle

Se analizaron asignaturas comprendidas dentro del ciclo básico de la carrera de medicina entre el curso académico 2002-2003 haciéndose un estudio descriptivo retrospectivo, analizándose los exámenes finales ordinarios y sus resultados expresados en índice de calidad. La mayoría de los exámenes finales analizados están estructurados con cinco preguntas oscilando los resultados entre 2,9 y 4,4 de índice de calidad, mientras que los que tenían siete preguntas los resultados estuvieron entre 3,4 y 3,6. Las preguntas que más bajo índice tuvieron fueron las de asociación y completa(AU)

A descriptive retrospective study was made to analyze subjects from the basic cycle of the medicine career in the 2002-2003 academic year, with the ordinary final exams and their results expressed in index of quality being analyzed. Most of the final exams analyzed are structured with five questions, with the results ranging between 2,9 and 4,4 of index of quality, while in those that had seven questions the results were between 3,4 and 3,6. The questions that had the lowest index were those of associating and completing(AU)

Alcalosis metabólica hipocaliémica con pérdida salina secundaria a hipertensión arterial vasculorenal en una niña afecta de síndrome nefrótico / No disponible

Presentamos el estudio de una niña afectada de estenosis unilateral de la arteria renal. Se trata de una niña de cuatro años que presenta cuadro clínico caracterizado por vómitos de doce horas de evolución, acompañado de deshidratación, poliuria con alcalosis metabólica hipokaliémica e hiponatrémica, convulsiones y coma por encefalopatía hipertensiva. Entre los antecedentes personales, la paciente está diagnosticada de síndrome nefrótico corticosensible e hipertensión arterial, precisando tratamiento farmacológico con captopril y nifedipina para el control. Once meses antes del episodio actual se realiza angioplastia transluminal percutánea por estenosis de la arteria renal izquierda con buen resultado. En el momento del cuadro recibe tratamiento con prednisona a dosis de 40 mg/m2/48h. Se realiza nueva arteriografía renal observándose reestonosis de la arteria renal izquierda, sin resultados con angioplastia transluminal percutánea. A la vista de estudios de imagen, se realiza una nefrectomía izquierda. Buena evolución tras ocho años de seguimiento. No precisa medicación para control de su tensión arterial y no ha presentado nuevas recaídas de su síndrome nefrótico (AU)

We present the study of a girl suffering from unilateral stenosis of the renal artery. This is a four year old girl who presents a clinical picture characterized by 12 hour long vomiting, accompanied by dehydration, polyuria with hypokaliemic and hyponatremic metabolic alkalosis, seizures and coma due to hypertensive encephalopathy. Among her personal background, the patient has been diagnosed of corticosensentive nephrotic syndrome and arterial hypertension, that required drug treatment with captropril and niphdipine for the control. Eleven months before the present event, a percutaneous transluminal angioplasty was performed due to stenosis of the left renal artery with good result. At the time of the picture, she was receiving treatment with prednisone, at a dose of 40mg/m2/48h. A new renal arteriography was performed, observing restenosis of the left renal artery, without results with percutaneous transluminal angioplasty. Based on the imaging studies, a left nephrectomy was performed. Good evolution after eight years of follow up. She does not require medication to control her blood pressure and has not presented new relapses of her nephrotic syndrome (AU)

QSAR-derived choline kinase inhibitors: how rational can antiproliferative drug design be?

This review presents an overview of Choline Kinase (ChoK) inhibitors with antiproliferative activity. The consideration of ChoK as a novel target for the development of new anticancer drugs is justified. The synthesis of several derivatives based on structural modifications of hemicholinium-3 (HC-3) is not accompanied by potentiation of the neurological toxicity of HC-3. The increment of both ChoK inhibitory and antiproliferative activities was successfully obtained by the two following changes: a) substitution of the oxazonium moiety of HC-3 by several aromatic heterocycles, and b) using the 1,2-ethylene(bisbenzyl) moiety instead of the 4,4'-biphenyl fragment. In an attempt to understand the ChoK inhibitory activity, a quantitative structure-activity relationship was developed. The QSAR equations have described the forces involved in quantitative terms. The electron characteristic of the substituent at position 4 of the heterocycle and the lipophilic character of the whole molecule were found to significantly affect the antitumour activity in compounds 17-95. Trispyridinium compounds 91-95 are more potent than the bispyridinium ones 87-89 as ChoK inhibitors. Nevertheless, 91-95 are less active than 87-89 as antiproliferative agents because the latter show better lipophilicities to cross the cytosolic membranes. Inhibition of the growth of human tumours in nude mice has been demonstrated: Antitumour activity of compound 64 against human HT-29 produced a decrease of up to 70% in the size of the tumour in nude mice. These results indicate that ChoK can be used as a general target for anticancer drug design against Ras-dependent tumourigenesis.

Hospitalizaciones en menores de un año en la ciudad de Madrid y su relación con el nivel social y la mortalidad infantil / Hospitalization rates in infants aged less than 1 year in madrid and their relationship with socioeconomic indicators and infant mortality

Antecedentes: La utilización de los hospitales representa una parte muy importante del total de servicios de salud que recibe la población. Trabajos previos han revelado la importante variabilidad existente en la frecuentación hospitalaria en la población infantil. Objetivo: Describir las tasas de hospitalización en menores de un año en los distritos municipales de la ciudad de Madrid y analizar su asociación con variables socioeconómicas y mortalidad infantil. Métodos: Estudio ecológico analítico. La unidad de análisis es el distrito sanitario de la ciudad de Madrid. Se incluyeron las siguientes variables: tasa de altas totales y de altas sensibles de atención extrahospitalaria (ACSC) en menores de un año, tasa de mortalidad infantil, porcentaje de universitarios, sin estudios, parados, sin teléfono y sin agua. Se han realizado análisis de correlación y de regresión lineal. Resultados: Las tasas medias de hospitalización y de ACSC son 280,10 94,09 y 52,65 29,29. Su coeficiente de variación fue 32,47 y 55,63. Las tasas de hospitalización mostraron una correlación significativa con el porcentaje de parados (0,71), porcentaje de universitarios (-0,66) y porcentaje sin estudios (0,88). Las tasas ACSC tienen correlación con porcentaje de parados (0,51), y porcentaje de universitarios (-0,48). En los modelos de regresión lineal las variables que permanecieron fueron el porcentaje de sin estudios para las tasas de altas (R2 0,78; p < 0,0000) y parados para las tasas ACSC (R2 0,26; p < 0,032). Conclusiones: Las hospitalizaciones, totales y ACSC, en menores de un año, muestran una importante variación en la ciudad de Madrid. Se observa una asociación entre estas tasas con indicadores socioeconómicos, pero no con la mortalidad infantil (AU)

[Hospitalization rates in infants aged less than 1 year in Madrid and their relationship with socioeconomic indicators and infant mortality]. / Hospitalizaciones en menores de un año en la ciudad de Madrid y su relación con el nivel social y la mortalidad infantil.

BACKGROUND: Hospital utilization represents a significant part of all the health services offered to the population. Previous studies have demonstrated considerable variability in hospital utilization among the pediatric population. OBJECTIVE: To describe hospitalization rates in infants aged less than 1 year in the municipal districts of the city of Madrid and to analyze their association with socioeconomic indicators and infant mortality. METHODS: Ecological study with the health district of the city of Madrid as the unit of analysis. The following variables were included: overall hospital discharge rates, ambulatory care sensitive condition (ACSC) discharge rates and infant mortality rates, as well as the percentages of university graduates, without primary education, unemployed, without telephone and without tap water. Correlation and multiple regression analysis were performed. RESULTS: The mean overall and ACSC discharge rates were 280.10 94.09 and 52.65 29.29. Their coefficient of variation was 32.47 and 55.63. Discharge rates showed significant correlation with the percentage of unemployed (0.71), university graduates (-0.66) and those without primary education (0.88). ACSC rates were correlated with the percentage of unemployed (0.51) and of university graduates (-0.48). The variables included in the multiple lineal regression models were the percentage without primary education for discharge rates (R2 0.78; p < 0.0000) and the percentage of unemployed for ACSC rates (R2 0.26; p < 0.032). CONCLUSIONS: Overall and ACSC discharge rates in infants showed significant variation across the health district of the city of Madrid. These rates were significantly associated with socioeconomic indicators, but not with infant mortality.