El poblamiento en el tercer milenio.

Si contrastamos las estrategias interpretativas utilizadas desde Andalucía occidental para la investigación del III milenio podemos observar que han transcurrido por los mismos parámetros teóricos y metodológicos que cualquier otro centro manipulador de información histórica. Ahora bien, esta región se caracteriza por utilizarlos generalmente de manera des- temporizada y dogmática debido a circunstancias académicas y/o sociopolíticas, y si esto en determinados momentos favoreció la producción historiográfica, en otros lo ha desmerecido especialmente.Este trabajo pretende alcanzar una conciencia crítica de la génesis y transcurso de la investigación prehistórica en el occidente de Andalucía y plasmar la opinión razonada de los autores de tal trayectoriaWhen contrasting the interpretative strategies used in Western Andalusia to research the III Millennium, we observe that they have developped through the same theoretical and methodological parameters that those used in any other centre that manipulates historical information. However, this region is distinguished by its anachronistic and dogmatic way of using these parameters, due to academic and/or sociopolitical circumstances, and, if this feature favoured the historiographical production at sorne stage, it has deteriorated it in other moments. This paper aims to gain a critical awareness of the genesis and development of the prehistoric research in Western Andalusia and to expound the reasoned opinion of the authors of this developmen

Efectos renales adversos por inhibidores del check-point (ICP) en pacientes con cáncer. Recomendaciones del grupo de Onconefrología de la Sociedad Española de Nefrología (SEN)

Insuficiència renal aguda; ImmunoteràpiaAcute kidney injury; ImmunotherapyInsuficiencia renal aguda; InmunoterapiaThe most widely used approach in the immunotherapy treatment of cancer is the administration of monoclonal antibodies directed against regulatory molecules of immune control that inhibit the activation of T cells, the so-called check point inhibitors (ICI). ICI nephrotoxicity epidemiology and pathology; its diagnosis with or without kidney biopsy; the type and duration of treatment; the possibility of rechallenging after kidney damage; and its indication in patients with cancer and renal transplantation are certainly controversial. In the absence of definitive studies, this document is intended to specify some recommendations agreed by the group of Onconephrology experts of the Spanish Society of Nephrology in those areas related to ICI nephrotoxicity, in order to help decision-making in daily clinical practice in Onconephrology consultations.El enfoque más utilizado en el tratamiento inmunoterápico del cáncer es la administración de anticuerpos monoclonales dirigidos contra moléculas reguladoras del control inmunitario que inhiben la activación de las células T, los llamados inhibidores del Check-Point (ICP). La epidemiología y patología de la nefrotoxicidad por los ICP; su diagnóstico con o sin biopsia renal; el tipo y la duración del tratamiento; la posibilidad de retratar después del daño renal; y su indicación en pacientes con cáncer y trasplante renal son ciertamente controvertidas. En ausencia de estudios definitivos, este documento está destinado a concretar unas recomendaciones consensuadas por el grupo de expertos de Onconefrología de la S.E.N en aquellas áreas relacionadas con la nefrotoxicidad por los ICP, con la finalidad de ayudar en la toma de decisiones en la práctica clínica diaria de las consultas de Onconefrología

Thrombotic microangiopathy in patients with malignant hypertension

10 p.-4 fig.-4 tab.Background: Thrombotic microangiopathy (TMA) is a complication of malignant hypertension (mHTN) attributed to high blood pressure (BP). However, no studies have investigated in patients with mHTN of different aetiologies whether the presence of TMA is associated with specific causes of mHTN.Methods: We investigated the presence of TMA (microangiopathic haemolytic anaemia and thrombocytopenia) in a large and well-characterized cohort of 199 patients with mHTN of different aetiologies [primary HTN 44%, glomerular diseases 16.6%, primary atypical haemolytic uraemic syndrome (aHUS) 13.1%, renovascular HTN 9.5%, drug-related HTN 7%, systemic diseases 5.5%, endocrine diseases 4.5%]. Outcomes of the study were kidney recovery and kidney failure.Results: Patients with TMA [40 cases (20.1%)] were younger, were more likely female and had lower BP levels and worse kidney function at presentation. Their underlying diseases were primary aHUS (60%), drug-related mHTN (15%), glomerular diseases [all of them immunoglobulin A nephropathy (IgAN); 10%], systemic diseases (10%) and primary HTN (5%). The presence of TMA was 92.3% in primary aHUS, 42.9% in drug-related HTN, 36.4% in systemic diseases, 12.1% in glomerular diseases and 2.3% in primary HTN. No patient with renovascular HTN or mHTN caused by endocrine diseases developed TMA, despite BP levels as high as patients with TMA. A higher proportion of TMA patients developed kidney failure as compared with patients without TMA (56.4% versus 38.9%, respectively).Conclusions: The presence of TMA in patients with mHTN should guide the diagnosis towards primary aHUS, drug-related mHTN, some systemic diseases and IgAN, while it is exceptional in other causes of mHTN.Work in this study was supported by the Instituto de Salud Carlos III/Fondo Europeo de Desarrollo Regional [ISCIII/FEDER;grants PI13/02502 and PICI14/00350 (to M.P.) and PI16/01685 and PI19/01624 (to M.P. and T.C.)]; the Spanish Ministerio de Economía y Competitividad/FEDER [SAF2015-66287-R and PID2019-104912RB-I00 (to S.R.d.C.)]; the Spanish ‘Ministerio de Ciencia Innovación y Universidades’ [RTI2018-095955-B-100 (to E.G.J.)]; the Autonomous Region of Madrid [S2017/BMD-3673 (to E.G.J., S.R.d.C. and M.P.)] and Red de Investigación Renal [RD12/0021/0029 (to M.P.)].Peer reviewe

Mortalidad por cáncer en España, 1980-1985

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Medicina. Fecha de lectura: 25 de Marzo de 199

Argumentos y fundamentos de la investigación prehistórica en Andalucía occidental: El poblamiento en el tercer milenio

Si contrastamos las estrategias interpretativas utilizadas desde Andalucía Occidental para la investigación del III milenio podemos observar que han transcurrido por los mismos parámetros teóricos y metodológicos que cualquier otro centro manipulador de información histórica. Ahora bien, esta región se caracteriza por utilizarlos generalmente de manera destemporizada y dogmática debido a circunstancias académicas y/o sociopolíticas, y si esto en determinados momentos favoreció la producción historiográfica, en otros lo ha desmerecido especialmente. Este trabajo pretende alcanzar una conciencia crítica de la génesis y transcurso de la investigación prehistórica en el Occidente de Andalucía y plasmar la opinión razonada de los autores de tal trayectoria

Registros de la expresión poblacional durante el III milenio en Andalucía occidental

En el III milenio se asiste a la más antigua eclosión demográfica de este sector regional, humanizándose toda una amplia gama de paisajes, incluso algunos de ellos por primera vez. Tal circunstancia necesita ser explicada y no sólo en base a esa cuantitativa expansión cultural, sino que habrá que intentar reconocer qué opciones la generaron y cómo un milenio después se llega a resultados diferentes. En este trabajo partimos de una recopilación y valoración de la documentación existente, hasta hoy desconectada por las diversas razones que la han determinado, con la intención de patentizar dónde y en qué sentido ha de reforzarse la investigación

Students' tax morale in spanish universities: Does gender matter?

In the last years, debate on tax morale has intensified in Spain. The deep economic and financial crisis suffered during the last years make citizens be more sensitive to tax measures and dispositions carried out by the Government. Students are not excluded from this trend, as they collaborate from an early age in maintenance of public expenditure in different situations, such as when they purchase goods or services because they pay the Value Added Tax. In addition, when they finish their studies and integrate to the world of work, their tax obligations will increase. Because of these reasons it is important to analyze tax morale or tax conscience, as a determinant factor in the degree of tax compliance. It influences in a direct way the predisposition to fulfil tax rules. In this research, from a sample of 218 undergraduate students of a Spanish university, tax morale is investigated. The study aims to analyze factors that have an influence on it and if there are significant differences among students depending on their gender, that is to say, if the fact of being a woman increases or diminishes tax morale as different studies support (in one sense or another) or not. Education and fair implementation of tax regulation are revealed as key factors to improve the degree of tax morale. As a result of this we conclude that education system must include tax considerations and show greater interest in introducing this subject in their curricula.Sarasa Pérez, CP.; Sarasa-Pérez, J.; Moya-Auñón, BA. (2015). Students' tax morale in spanish universities: Does gender matter?. ICERI2015 Proceedings. 4516-4521. http://hdl.handle.net/10251/70663S4516452

Late rectal and bladder toxicity following radiation therapy for prostate cancer: Predictive factors and treatment results

AimThis study aimed at investigating factors associated to late rectal and bladder toxicity following radiation therapy and the effectiveness of Hyperbaric Oxygen Therapy (HBOT) when toxicity is grade ≥2.BackgroundRadiation is frequently used for prostate cancer, but a 5–20% incidence of late radiation proctitis and cystitis exists. Some clinical and dosimetric factors have been defined without a full agreement. For patients diagnosed of late chronic proctitis and/or cystitis grade ≥2 treatment is not well defined. Hyperbaric Oxygen Therapy (HBOT) has been used, but its effectiveness is not well known.Materials and methods257 patients were treated with radiation therapy for prostate cancer. Clinical, pharmacological and dosimetric parameters were collected. Patients having a grade ≥2 toxicity were treated with HBOT. Results of the intervention were measured by monitoring toxicity by Common Toxicity Criteria v3 (CTCv3).ResultsLate rectal toxicity was related to the volume irradiated, i.e. V50[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]53.64 (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.013); V60[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]38.59% (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.005); V65[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]31.09% (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.002) and V70[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]22.81% (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.012). We could not correlate the volume for bladder. A total of 24 (9.3%) patients experienced a grade ≥2. Only the use of dicumarinic treatment was significant for late rectal toxicity (p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.014). A total of 14 patients needed HBOT. Final percentage of patients with a persistent toxicity grade ≥2 was 4.5%.ConclusionRectal volume irradiated and dicumarinic treatment were associated to late rectal/bladder toxicity. When toxicity grade ≥2 is diagnosed, HBOT significantly ameliorate symptoms

Monographic consultation of onconephrology. Rationale and implementation

The increase in demand for medical care for renal complications associated with neoplastic diseases is a reality in most nephrology departments. In response to this overall situation, the creation of healthcare models such as monographic consultations and develop training programs in Onconephrology could improve the care of these patients.Through an exploratory and descriptive study, we identified current situation of kidney involvement in cancer patients. The objective of the present study is to establish the criteria for specific assistance in the field of Onconephrology. For this, we have reviewed key aspects and analyzed the current situation in our country, through a survey addressed to all nephrologists through the Spanish Society of Nephrology., together with the experience of two Spanish centers. From this information, we have established some requirements and recommendations for the start-up of these consultations. Resumen: El incremento de la demanda asistencial de patología renal asociada a enfermedades neoplásicas es una realidad en la mayoría de servicios de nefrología. Para dar respuesta a esta situación, debe considerarse la creación de modelos asistenciales como consultas monográficas y desarrollar programas de formación en Onconefrologia que permitan optimizar la atención de estos pacientes.A través de un estudio exploratorio y descriptivo, identificamos cual es la situación actual de la afectación renal en pacientes con cáncer. El objetivo del presente estudio es establecer los criterios para la asistencia específica en el ámbito de la Onconefrologia. Para ello hemos revisado aspectos clave y analizado la situación actual en nuestro entorno, mediante una encuesta dirigida a todos nefrólogos a través de la S.E.N., junto a la experiencia de dos centros españoles. A partir de esta información hemos establecido una serie de requisitos y recomendaciones para la puesta en marcha de estas consultas