Clinical-epidemiological profile of the patient attended in a fracture liaison service (FLS) of a regional hospital in north-west of Spain. / [Artículo traducido] Perfil clínico-epidemiológico del paciente atendido en una unidad multidisciplinar de fractura de cadera de un hospital de primer nivel en el noroeste de España.

INTRODUCTION: Hip fractures constitute a capital public health issue associated with aging and frailty because of its impact on both quality of life and morbidity and mortality in older people. Fracture liaison services (FLS) have been proposed as tools to minimize this emergent problem. MATERIAL AND METHODS: A prospective observational study was conducted with 101 patients treated for hip fracture by the FLS of a regional hospital between October 2019 and June 2021 (20 months). Epidemiological, clinical, surgical, and management variables were collected during admission and up to 30 days after discharge. RESULTS: Mean age of patients was 87.6 ± 6.1 years and 77.2% were female. Some degree of cognitive impairment was detected at admission in 71.3% of patients using the Pfeiffer questionnaire, and 13.9% were nursing home residents, and 76.24% could walk independently before the fracture. Fractures were more commonly pertrochanteric (45.5%). Patients were receiving antiosteoporotic therapy in 10.9% of cases. The median surgical delay from admission was 26 h (RIC 15-46 h), the median length of stay was 6 days (RIC 3-9 days) and in-hospital mortality was 10.9%, and 19.8% at 30 days, with a readmission rate of 5%. DISCUSSION: Patients treated in our FLS at the beginning of its activity were similar to the general picture in our country in terms of age, sex, type of fracture, and proportion of patients treated surgically. A high mortality rate was observed, and low rates of pharmacological secondary prevention were followed at discharge. Clinical results of FLS implementation in regional hospitals should be assessed prospectively in order to decide their suitability.

COVID 19 and the new challenges in health management: The pilot experience of the Internal Medicine Department of a Regional hospital / COVID 19 y los nuevos retos en gestión sanitaria: la experiencia piloto del Servicio de Medicina Interna de un hospital de primer nivel

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COVID-19 y Argumentum ad ignorantiam o "no todo vale" / COVID 19 and "Argumentum ad ignorantiam" or "not everything goes"

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Réplica: Ivermectina en COVID-19. ¿Argumentum ad ignorantiam? / Reply to: Ivermectin in COVID-19. Argumentum ad ignorantiam?

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Covid-19 and thrombosis: beyond a casual association

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Assessment of engineered surfaces roughness by high-resolution 3D SEM photogrammetry.

We describe a methodology to obtain three-dimensional models of engineered surfaces using scanning electron microscopy and multi-view photogrammetry (3DSEM). For the reconstruction of the 3D models of the surfaces we used freeware available in the cloud. The method was applied to study the surface roughness of metallic samples patterned with parallel grooves by means of laser. The results are compared with measurements obtained using stylus profilometry (PR) and SEM stereo-photogrammetry (SP). The application of 3DSEM is more time demanding than PR or SP, but it provides a more accurate representation of the surfaces. The results obtained with the three techniques are compared by investigating the influence of sampling step on roughness parameters.

La calidad de vida desde la perspectiva de las adicciones / Quality of life from the perspective of addiction

Introducción. La calidad de vida (CV) es un concepto que incorpora la percepción del individuo sobre el estado de salud, estilo y satisfacción con la vida, estado mental o bienestar y ayuda a identificar déficits en áreas de funcionamiento, facilitando la identificación de grupos de riesgo y la planificación de medidas preventivas. El objetivo del estudio es evaluar la calidad de vida relacionada con la salud (CVRS) en pacientes en tratamiento por consumo de sustancias adictivas en la Unidad Asistencial de Drogodependencias de Monforte de Lemos (Lugo). Métodos. En la muestra de 100 usuarios se estudiaron variables sociodemográficas, de salud y de consumo, así como otras relacionadas con la CV medida a través del cuestionario SF-36. Los datos se analizaron con el paquete estadístico SPSS 15. Resultados. Existieron diferencias de medias en la mayor parte de las 8 dimensiones analizadas, con puntuaciones más altas en general por parte de los varones, aunque dichas diferencias no alcanzaron significación estadística salvo en el rol físico (p = 0,03). Se recogieron datos significativos el análisis en función de la situación sociolaboral, la droga principal, las enfermedades infecciosas y las somáticas. Conclusiones. En general la CVRS es más baja en nuestros usuarios que en la población general, y en los hombres es mayor que en las mujeres; el área más comprometida es la vitalidad. En las circunstancias actuales encontrarse en situación laboral activa repercute en una mejor CVRS (AU)

Introduction. Quality of life (QoL) is a concept that incorporates an individual's perception of health status, style and life satisfaction, mental state or well-being, and helps identify gaps in areas of functioning, facilitating the identification of risk groups and planning of preventive measures. The aim of the study is to assess the quality of life related to health (HRQOL) in patients treated for substance use in the Drug Dependency Care Unit of Monforte de Lemos (Lugo). Methods. Sociodemographic variables, health, consumer and other related QoL measured by the SF-36 questionnaire were studied in a sample of 100 users. Data were analysed with SPSS 15. Results. There were differences in the means in most of the eight dimensions analysed, with higher scores generally by men, although these differences did not reach statistical significance except for physical role (P = .03). A meaningful data analysis is presented based on the work situation, primary drug, and infectious and somatic diseases. Conclusions. Overall HRQOL is lower in our users than in the general population, and it is higher in men than in women, with the most compromised area being vitality. In the present circumstances, being in active employment leads to a better HRQOL (AU)

[Quality of life from the perspective of addiction]. / La calidad de vida desde la perspectiva de las adicciones.

INTRODUCTION: Quality of life (QoL) is a concept that incorporates an individual's perception of health status, style and life satisfaction, mental state or well-being, and helps identify gaps in areas of functioning, facilitating the identification of risk groups and planning of preventive measures. The aim of the study is to assess the quality of life related to health (HRQOL) in patients treated for substance use in the Drug Dependency Care Unit of Monforte de Lemos (Lugo). METHODS: Sociodemographic variables, health, consumer and other related QoL measured by the SF-36 questionnaire were studied in a sample of 100 users. Data were analysed with SPSS 15. RESULTS: There were differences in the means in most of the eight dimensions analysed, with higher scores generally by men, although these differences did not reach statistical significance except for physical role (P=.03). A meaningful data analysis is presented based on the work situation, primary drug, and infectious and somatic diseases. CONCLUSIONS: Overall HRQOL is lower in our users than in the general population, and it is higher in men than in women, with the most compromised area being vitality. In the present circumstances, being in active employment leads to a better HRQOL.

Otro gran imitador..., con desenlace fatal / Another great wannabe..., with fatal outcome

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Análisis de la calidad de vida en pacientes con insuficiencia cardíaca mediante el cuestionario genérico SF-36 / Analysis of quality of life using the generic SF-36 questionnaire in patients with heart failure

Objetivo. La insuficiencia cardíaca es una de las principales enfermedades crónicas que afectan a la calidad de vida relacionada con la salud. El objetivo del presente estudio ha sido evaluar la calidad de vida en pacientes con clase funcional i - iii de la New York Heart Association mediante el cuestionario SF-36 usando una cohorte de supervivientes del Grupo de Estudio EPICOUR y compararlo con la calidad de vida de la población general española para el mismo sexo y grupo de edad. Material y métodos. Se diseñó un estudio de cohorte, observacional y prospectivo con los supervivientes del Grupo de Estudio EPICOUR a los que se les realizó control clínico-evolutivo y cuestionario SF-36. Resultados. Se estudió la calidad de vida en 50 pacientes (60% hombres). La edad media de los hombres fue de 64,8 años y de las mujeres de 68,3. Al analizar el SF-36 se observó que los resultados fueron más bajos en la esfera física que en la esfera mental. La calidad de vida empeoraba a medida que aumentaba la clase funcional. Al comparar los pacientes con la población general para el mismo sexo y edad, los pacientes con insuficiencia cardíaca mostraron puntuación inferior en todas las escalas (diferencias significativas en función física, dolor corporal, vitalidad y función social para los hombres y función física y rol emocional para las mujeres). Conclusiones. La insuficiencia cardíaca provoca un impacto negativo en la calidad de vida, tanto en la función física como en la función psicosocial, agravándose el deterioro con el incremento de la clase funcional(AU)

Objective: Heart failure is one of the major chronic diseases that affect health related quality of life. The objective of this study was to evaluate the quality of life in patients with New York Heart Association functional class i-iii using the SF-36 on a cohort of survivors of the EPICOUR Study Group and compare the quality of life with the general Spanish population of the same sex and age group. Material and methods: A cohort study, observational, and prospective study was conducted on survivors of the EPICOUR Study Group, on whom a clinical-progression-outcome review was performed along with the SF-36. Results: The quality of life was studied in 50 patients (60% male). The average age of men was 64.8 years and women 68.3. When analyzing the SF-36, it was observed that the results were lower in the physical dimensions than in the mental dimensions. The quality of life worsened with increasing functional class (statistically significant differences for scales of physical functioning, social functioning and borderline significance in mental health scale). When comparing patients with the general population of the same age and sex, patients with heart failure showed lower scores on all scales (significant differences in physical functioning, body pain, vitality, and social role for men, and physical function and emotional role for women). Conclusions: Heart failure causes a negative impact on quality of life, physical functioning, as well as psychosocial function, with the impairment becoming worse with increased functional class (AU)

[Analysis of quality of life using the generic SF-36 questionnaire in patients with heart failure]. / Análisis de la calidad de vida en pacientes con insuficiencia cardíaca mediante el cuestionario genérico SF-36.

OBJECTIVE: Heart failure is one of the major chronic diseases that affect health related quality of life. The objective of this study was to evaluate the quality of life in patients with New York Heart Association functional class I-III using the SF-36 on a cohort of survivors of the EPICOUR Study Group and compare the quality of life with the general Spanish population of the same sex and age group. MATERIAL AND METHODS: A cohort study, observational, and prospective study was conducted on survivors of the EPICOUR Study Group, on whom a clinical-progression-outcome review was performed along with the SF-36. RESULTS: The quality of life was studied in 50 patients (60% male). The average age of men was 64.8 years and women 68.3. When analyzing the SF-36, it was observed that the results were lower in the physical dimensions than in the mental dimensions. The quality of life worsened with increasing functional class (statistically significant differences for scales of physical functioning, social functioning and borderline significance in mental health scale). When comparing patients with the general population of the same age and sex, patients with heart failure showed lower scores on all scales (significant differences in physical functioning, body pain, vitality, and social role for men, and physical function and emotional role for women). CONCLUSIONS: Heart failure causes a negative impact on quality of life, physical functioning, as well as psychosocial function, with the impairment becoming worse with increased functional class.

A new approach to the ferritin iron core growth: influence of the H/L ratio on the core shape.

An electron microscopy study, in combination with modeling and image simulation, of four different reconstituted ferritin samples: recombinant human H and L homopolymers, and H and L heteropolymers of native L-subunit-rich horse spleen and H-subunit-rich human heart ferritins, points out the existence of a correlation between iron core shape and protein shell.

Factores pronósticos de mortalidad de la insuficiencia cardíaca en una cohorte del noroeste de España. Estudio EPICOUR / Mortality prognosis factors in heart failure in a cohort of North-West Spain. EPICOUR study

Objetivos. La insuficiencia cardíaca (IC) supone un importante problema de salud pública, tanto por su elevada morbimortalidad como por el alto coste sanitario que provoca. Se realiza este estudio para estudiar la supervivencia de pacientes con IC en relación con la función ventricular y otros posibles factores de riesgo (FR) asociados con el pronóstico de la IC. Material y métodos. Estudio de cohortes, prospectivo, considerando como potenciales participantes a cualquier paciente hospitalizado por IC entre el 1 de enero de 1999 y el 31 de diciembre de 2002 (5.318 pacientes), a quien se le hubiese realizado ecocardiografía que mostrase disfunción sistólica ó diastólica (2.387 pacientes). Se eligió por muestreo aleatorio simple una muestra de 384 pacientes, transcurridos al menos 24 meses tras el episodio índice de hospitalización. La medición principal residió en la supervivencia y en las diferencias observadas en función de la fracción de eyección del ventrículo izquierdo, de la clase funcional (CF) de IC y de otras características clínicas y epidemiológicas. Se utilizaron las pruebas de Kaplan-Meier, del log-rank y de Cox. Resultados. La edad media fue de 74,84 años (rango: 36–95). 53,4% varones y 56,5% primer ingreso. El antecedente personal más frecuente fue hipertensión arterial (HTA) (59,9%), seguido de valvulopatía (41,9%) y enfermedad coronaria (EC) (26,8%). El 44,3% presentaban fibrilación-flutter auricular (FA). La supervivencia global observada a los 5 años fue de 47,9% y la específica por IC de 74,8%. No hubo diferencias significativas en supervivencia entre pacientes con insuficiencia cardíaca y función sistólica preservada (IC-FSP) y aquellos con disfunción sistólica (p=0,248). Son factores pronósticos de mortalidad por IC la CF basal previa al ingreso avanzada (Hazard ratio (HR) 5,37), el deterioro de filtrado glomerular (FG) (HR 0,98), la hipoalbuminemia (HR 0,59), la hiponatremia (HR 0,93), y la hiperpotasemia (HR 1,79). El índice de Castelli superior a 4,5 se halla en el límite de la significación estadística. Conclusiones. La supervivencia global observada a los 5 años es similar a la de otras series publicadas, siendo la específica por IC algo inferior, no habiendo diferencias en la supervivencia respecto a la fracción de eyección del ventrículo izquierdo (FEVI). Destacan como factores pronósticos de mortalidad por IC la hipoalbuminemia, la hiperpotasemia y el índice de Castelli elevado(AU)

Aims. Heart failure (HF) is a serious health problem in Spain because it has a high mortality rate and causes considerable costs to the health-care system. This paper presents a study made in the Spanish province of Ourense to study the survival of patients with HF related to the ventricular function or other possible risk factors (RF) associated with the HF prognosis. Material and methods. A prospective cohort study was performed, considering any patient hospitalized due to HF from 1 January 1999 to 31 December 2002 (5318 patients) who had undergone an echocardiography that showed systolic or diastolic dysfunction as potential participants (2387 patients). After at least 24 months of the index episode of hospitalization, a sample of 2384 patients was chosen by random sampling. The principal measurement was based on survival and the differences observed in the performance of the left ventricular ejection fraction, of functional class (FC) of HF and of other clinical and epidemiological characteristics. The Kaplan-Meier, log-rank and Cox tests were used. Results. Mean age of the patients 74.84 (range 36–95); 53.4% males and 56.5% first admission. The most common antecedent was arterial hypertension (HTA) (59.9%), followed by valvulopathy (41.9%) and heart disease (HD) (26.8%). A total of 44.3% of the patients had atrial fibrillation-flutter (AF). Global survival at 5 years was 47.9% and specific survival rate for HF was 74.8%. There were no significant differences in survival between patients with heart failure and preserved systolic function (HF-PSF) and those who suffered systolic dysfunction (p=0.248). Prognostic factors of mortality in patients with HF are: advanced functional class (class III–IV) prior to admission (Hazard ratio [HR] 5.37), deterioration of the glomerular filtration rate (GFR) (HR 0.98), hypoalbuminemia (HR 0.59), hyponatremia (HR 0.93) and hyperkalemia (HR 1.79). The Castelli index higher than 4.5 is in the limit of statistical significance. Conclusions. Global survival rate observed at 5 years of research is similar to the results found in already-published papers. Specific survival rate for HF is lower and there are no differences in the survival rate with regard to the left ventricle ejection fraction (Ef). However, we show that hypoalbuminemia, hyperkalemia and high Castelli index are important prognostic factors of mortality in patients with HF(AU)

[Mortality prognosis factors in heart failure in a cohort of North-West Spain. EPICOUR study]. / Factores pronósticos de mortalidad de la insuficiencia cardíaca en una cohorte del noroeste de España. Estudio EPICOUR.

AIMS: Heart failure (HF) is a serious health problem in Spain because it has a high mortality rate and causes considerable costs to the health-care system. This paper presents a study made in the Spanish province of Ourense to study the survival of patients with HF related to the ventricular function or other possible risk factors (RF) associated with the HF prognosis. MATERIAL AND METHODS: A prospective cohort study was performed, considering any patient hospitalized due to HF from 1 January 1999 to 31 December 2002 (5318 patients) who had undergone an echocardiography that showed systolic or diastolic dysfunction as potential participants (2387 patients). After at least 24 months of the index episode of hospitalization, a sample of 2384 patients was chosen by random sampling. The principal measurement was based on survival and the differences observed in the performance of the left ventricular ejection fraction, of functional class (FC) of HF and of other clinical and epidemiological characteristics. The Kaplan-Meier, log-rank and Cox tests were used. RESULTS: Mean age of the patients 74.84 (range 36-95); 53.4% males and 56.5% first admission. The most common antecedent was arterial hypertension (HTA) (59.9%), followed by valvulopathy (41.9%) and heart disease (HD) (26.8%). A total of 44.3% of the patients had atrial fibrillation-flutter (AF). Global survival at 5 years was 47.9% and specific survival rate for HF was 74.8%. There were no significant differences in survival between patients with heart failure and preserved systolic function (HF-PSF) and those who suffered systolic dysfunction (p=0.248). Prognostic factors of mortality in patients with HF are: advanced functional class (class III-IV) prior to admission (Hazard ratio [HR] 5.37), deterioration of the glomerular filtration rate (GFR) (HR 0.98), hypoalbuminemia (HR 0.59), hyponatremia (HR 0.93) and hyperkalemia (HR 1.79). The Castelli index higher than 4.5 is in the limit of statistical significance. CONCLUSIONS: Global survival rate observed at 5 years of research is similar to the results found in already-published papers. Specific survival rate for HF is lower and there are no differences in the survival rate with regard to the left ventricle ejection fraction (E(f)). However, we show that hypoalbuminemia, hyperkalemia and high Castelli index are important prognostic factors of mortality in patients with HF.