Cavitation corrosion and repassivation kinetics of titanium in a heavy brine LiBr solution evaluated by using electrochemical techniques and Confocal Laser Scanning Microscopy

The cavitation corrosion behaviour of commercially pure Grade 2 titanium in a 992 g/l LiBr solution has been investigated at 25 °C using an ultrasound device. Cavitation was found to have more influence on the anodic branch than on the cathodic branch, shifting the corrosion potential, Ecorr, and the OCP value towards more negative potentials, and increasing the corrosion current density, icorr, by six times. The repassivation kinetics of Grade 2 titanium have also been studied in the 992 g/l LiBr solution, at 25 °C and various applied potentials, using cavitation to damage the electrode surface. The repassivation kinetics have been analysed in terms of the current density flowing from the area damaged by cavitation, and the results were described by the equation i(t) = A·t−n. At potentials within the passive region, the passive film grew according to the high-field ion conduction model in which log i(t) is linearly proportional to 1/q(t). The damage generated during the potentiostatic tests has been quantified by means of Confocal Laser Scanning MicroscopyWe wish express our gratitude to the Ministerio de Ciencia e Innovacion (Project CTQ2009-07518), for the economical support of this research, to the Generalitat Valenciana for its help in the CLSM acquisition (MY08/ISIRYM/S/100), and to Dr. M. Asuncion Jaime for her translation assistance.Fernández Domene, RM.; Blasco Tamarit, ME.; García García, DM.; García Antón, J. (2011). Cavitation corrosion and repassivation kinetics of titanium in a heavy brine LiBr solution evaluated by using electrochemical techniques and Confocal Laser Scanning Microscopy. Electrochimica Acta. 58:264-275. https://doi.org/10.1016/j.electacta.2011.09.034S2642755

Influenza vaccine and risk of acute myocardial infarction in a population-based case-control study

Objective To assess the relationship between influenza vaccination and risk of a first acute myocardial infarction (AMI) in the general population by different epidemic periods. Methods This is a population-based case?control study carried out in BIFAP (Base de datos para la investigación farmacoepidemiológica en atención primaria), over 2001?2015, in patients aged 40?99 years. Per each incident AMI case, five controls were randomly selected, individually matched for exact age, sex and index date (AMI diagnosis). A patient was considered vaccinated when he/she had a recorded influenza vaccination at least 14 days before the index date within the same season. The association between influenza vaccination and AMI risk was assessed through a conditional logistic regression, computing adjusted ORs (AOR) and their respective 95% CIs. The analysis was performed overall and by each of the three time epidemic periods per study year (pre-epidemic, epidemic and postepidemic). Results We identified 24 155 AMI cases and 120 775 matched controls. Of them, 31.4% and 31.2%, respectively, were vaccinated, yielding an AOR of 0.85 (95% CI 0.82 to 0.88). No effect modification by sex, age and background cardiovascular risk was observed. The reduced risk of AMI was observed shortly after vaccination and persisted over time. Similar results were obtained during the pre-epidemic (AOR=0.87; 95% CI 0.79 to 0.95), epidemic (AOR=0.89; 95% CI 0.82 to 0.96) and postepidemic (AOR=0.83; 95% CI 0.79 to 0.87) periods. No association was found with pneumococcal vaccine (AOR=1.10; 95% CI 1.06 to 1.15). Conclusions Results are compatible with a moderate protective effect of influenza vaccine on AMI in the general population, mostly in primary prevention, although bias due to unmeasured confounders may partly account for the results.Instituto de Salud Carlos IIIMinisterio de Ciencia e InnovaciónHospital Universitario Príncipe de Asturia

Selective Serotonin Reuptake Inhibitors and Risk of Noncardioembolic Ischemic Stroke: A Nested Case-Control Study

BACKGROUND: Multiple studies have reported that the use of selective serotonin reuptake inhibitors (SSRIs) is associated with an increased risk of ischemic stroke; however, this finding may be the result of a confounding by indication. We examined the association using different approaches to minimize such potential bias. METHODS: A nested case-control study was carried out in a Spanish primary health-care database over the study period 2001 to 2015. Cases were patients sustaining an ischemic stroke with no sign of cardioembolic or unusual cause. For each case, up to 5 matched controls (for exact age, sex, and index date) were randomly selected. Antidepressants were divided in 6 pharmacological subgroups according to their mechanism of action. The current use of SSRIs (use within a 30-day window before index date) was compared with nonuse, past use (beyond 365 days) and current use of other antidepressants through a conditional logistic regression model to obtain adjusted odds ratios and 95% CI. Only initiators of SSRIs and other antidepressants were considered. RESULTS: A total of 8296 cases and 37 272 matched controls were included. Of them, 255 (3.07%) were current users of SSRIs among cases and 834 (2.24%) among controls, yielding an adjusted odds ratio of 1.14 (95% CI, 0.97?1.34) as compared with nonusers, 0.94 (95% CI, 0.77?1.13) as compared with past-users and 0.74 (95% CI, 0.58?0.93) as compared with current users of other antidepressants. No relevant differences were found by duration (?1, >1 year), sex, age (<70, ?70 years old) and background vascular risk. CONCLUSIONS: The use of SSRIs was not associated with an increased risk of noncardioembolic ischemic stroke. On the contrary, as compared with other antidepressants, SSRIs appeared to be protective.Instituto de Salud Carlos IIIMinisterio de Ciencia e InnovaciónFondo Europeo de Desarrollo Regiona

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Formación de los tutores de las prácticas externas como herramienta eficaz en la mejora del aprendizaje del estudiante y su inserción laboral

El objetivo del proyecto es mejorar la calidad de la tutorización de las prácticas externas y fomentar las buenas prácticas que garanticen el proceso de enseñanza-aprendizaje. Están implicados tutores académicos, externos, instituciones y estudiante

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Las tres hermanas : adaptación y guión para el alumnado de edades comprendidas entre 12 y 16 años

Adaptación del guión y elaboración de la guía Encarnación Fernández GómezDirigido a alumnos de edades comprendidas entre los 12 y 16 años, esta adaptación de la obra teatral de Antón Chéjov, tiene como objetivo sensibilizar al alumnado de Educación Secundaria en la igualdad de oportunidades, en la comprensión de los valores de la igualdad entre mujeres y hombres y de la no discriminación por razón de género y en la prevención de la violencia de género. La obra se sitúa en la Rusia imperial zarista de finales del siglo XIX donde se reflexiona acerca de las discriminaciones y desigualdades que padecían las mujeres en esa época. Se muestran las circunstancias económicas, sociales y familiares propias del fin del zarismo y previas al primer estallido social de 1905. Se analizan los valores aparecidos en la obra de no discriminación social, económica, o política hacia las mujeres en razón a su sexo. La adaptación, se acompaña de una guía didáctica de apoyo al profesorado de Educación Secundaria.MadridBiblioteca Regional de Madrid Joaquín Leguina; Calle Ramírez de Prado, 3; 28045 Madrid; +34917208850; +34917208890; [email protected]