Clinical Validation of a 3-Dimensional Ultrafast Cardiac Magnetic Resonance Protocol Including Single Breath-Hold 3-Dimensional Sequences

Objectives: This study sought to clinically validate a novel 3-dimensional (3D) ultrafast cardiac magnetic resonance (CMR) protocol including cine (anatomy and function) and late gadolinium enhancement (LGE), each in a single breath-hold. Background: CMR is the reference tool for cardiac imaging but is time-consuming. Methods: A protocol comprising isotropic 3D cine (Enhanced sensitivity encoding [SENSE] by Static Outer volume Subtraction [ESSOS]) and isotropic 3D LGE sequences was compared with a standard cine+LGE protocol in a prospective study of 107 patients (age 58 ± 11 years; 24% female). Left ventricular (LV) mass, volumes, and LV and right ventricular (RV) ejection fraction (LVEF, RVEF) were assessed by 3D ESSOS and 2D cine CMR. LGE (% LV) was assessed using 3D and 2D sequences. Results: Three-dimensional and LGE acquisitions lasted 24 and 22 s, respectively. Three-dimensional and LGE images were of good quality and allowed quantification in all cases. Mean LVEF by 3D and 2D CMR were 51 ± 12% and 52 ± 12%, respectively, with excellent intermethod agreement (intraclass correlation coefficient [ICC]: 0.96; 95% confidence interval [CI]: 0.94 to 0.97) and insignificant bias. Mean RVEF 3D and 2D CMR were 60.4 ± 5.4% and 59.7 ± 5.2%, respectively, with acceptable intermethod agreement (ICC: 0.73; 95% CI: 0.63 to 0.81) and insignificant bias. Both 2D and 3D LGE showed excellent agreement, and intraobserver and interobserver agreement were excellent for 3D LGE. Conclusions: ESSOS single breath-hold 3D CMR allows accurate assessment of heart anatomy and function. Combining ESSOS with 3D LGE allows complete cardiac examination in less than 1 min of acquisition time. This protocol expands the indication for CMR, reduces costs, and increases patient comfort. (J Am Coll Cardiol Img 2021;14:1742–1754)Funding included Instituto de Salud Carlos III (ISCIII) and the European Regional Development Fund (ERDF) Grants DTS17/00136 to Dr. Ibáñez and PI19/01704 to Dr. Fernandez-Jimenez; Spanish Society of Cardiology Translational Research Grant 2016 to Dr. Ibáñez; European Research Council ERC-CoG 819775-MATRIX to Dr. Ibáñez; Comunidad de Madrid S2017/BMD-3867-RENIM-CM to Drs. Desco and Ibáñez; and Ministerio de Ciencia e Innovación (MICINN) RETOS2019-107332RB-I00 to Dr. Ibáñez. Dr. Fernandez-Jimenez received funding from the European Union Horizon 2020 research and innovation programme under Marie Sklodowska-Curie Hrant Agreement No. 707642. The CNIC is supported by the ISCIII, the MICINN, and the Pro CNIC Foundation. Drs. Fernandez-Jimenez, Nothnagel, Fuster, Ibáñez, and Javier Sánchez-González are inventors of a joint patent (Philips/CNIC) for the new cine imaging method here described and validated/protected under the IP #2014P00960EP. Drs. Nothnagel, Kouwenhoven, Clemence, and Javier Sánchez-González are Philips employees. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose

A case-control of patients with COVID-19 to explore the association of previous hospitalisation use of medication on the mortality of COVID-19 disease: a propensity score matching analysis

Data from several cohorts of coronavirus disease 2019 (COVID-19) suggest that the most common comorbidities for severe COVID-19 disease are the elderly, high blood pressure, and diabetes; however, it is not currently known whether the previous use of certain drugs help or hinder recovery. This study aims to explore the association of previous hospitalisation use of medication on the mortality of COVID-19 disease. A retrospective case-control from two hospitals in Madrid, Spain, included all patients aged 18 years or above hospitalised with a diagnosis of COVID-19. A Propensity Score matching (PSM) analysis was performed. Confounding variables were considered to be age, sex, and the number of comorbidities. Finally, 3712 patients were included. Of these, 687 (18.5%) patients died (cases). The 22,446 medicine trademarks used previous to admission were classified according to the ATC, obtaining 689 final drugs; all of them were included in PSM analysis. Eleven drugs displayed a reduction in mortality: azithromycin, bemiparine, budesonide-formoterol fumarate, cefuroxime, colchicine, enoxaparin, ipratropium bromide, loratadine, mepyramine theophylline acetate, oral rehydration salts, and salbutamol sulphate. Eight final drugs displayed an increase in mortality: acetylsalicylic acid, digoxin, folic acid, mirtazapine, linagliptin, enalapril, atorvastatin, and allopurinol. Medication associated with survival (anticoagulants, antihistamines, azithromycin, bronchodilators, cefuroxime, colchicine, and inhaled corticosteroids) may be candidates for future clinical trials. Drugs associated with mortality show an interaction with the underlying condition

Red Argentina de Parcelas Permanentes de Bosques Nativos para promover colaboraciones científicas en estudios de largo plazo

Las parcelas forestales permanentes son áreas de muestreo donde se registran periódicamente la identidad, abundancia y tamaño de los árboles, para estudiar cómo cambian los bosques en relación con el clima, los disturbios naturales y los usos y manejos. Hasta hoy, los patrones de cambio observados con parcelas permanentes en la Argentina tuvieron alcance local o regional. Para potenciar los vínculos entre los diferentes grupos de trabajo que promuevan colaboraciones a escalas intra- e inter-regionales creamos la Red Argentina de Parcelas Permanentes de Bosques Nativos (RAPP), abarcando las regiones forestales de los Bosques Andino-Patagónicos, Chaco Seco, Chaco Húmedo, Monte de Sierras y Bolsones, Monte de Llanuras y Mesetas, Selva Paranaense y Yungas. Aquí sintetizamos y caracterizamos la información de 317 parcelas permanentes (328.9 ha) incluidas en la RAPP, describiendo su distribución geográfica, objetivos, principales aspectos metodológicos y características de los bosques donde están establecidas (e.g., disturbios, tenencia de la tierra, estructura, riqueza de especies). Asimismo, se discute la complementariedad entre la RAPP y los inventarios nacionales de bosques nativos. Las parcelas se distribuyen entre 22.02° y 54.89° S y entre 19 y 2304 m s. n. m., aunque están concentradas principalmente en el Subtrópico (Chaco Seco, Chaco Húmedo, Selva Paranaense y Yungas) y en los Bosques Andino-Patagónicos. En todas las parcelas se identifica la taxonomía de los árboles y se miden diferentes variables dasométricas, fundamentales para responder preguntas ecológicas a una mayor escala mediante colaboraciones. Esperamos continuar incorporando grupos de trabajo a la RAPP e incentivar el establecimiento de nuevas parcelas permanentes en regiones poco representadas (e.g., Monte, Espinal y Delta e Islas del Paraná). La meta es que la RAPP permita avanzar en el estudio a largo plazo de todos los bosques nativos de la Argentina, aumentando la cobertura nacional y las interacciones entre los grupos de trabajo.Permanent forest plots are sampling areas where tree identity, abundance and size are recorded periodically, in order to study how forests change with climate, natural disturbances, uses and management. So far, patterns of change observed with permanent plots in Argentina have been local or regional. To promote scientific collaborations between different research groups within and among regions of Argentina, we created the Network of Permanent Plots of Native Argentinian Forests (RAPP), which includes the regions of Bosques Andino-Patagónicos, Chaco Seco, Chaco Húmedo, Monte de Sierras y Bolsones, Monte de Llanuras y Mesetas, Selva Paranaense and Yungas. Here we synthesize and characterize the information of 317 permanent plots (328.9 ha) included in the RAPP, describing their geographic distribution, objectives, main methodological aspects, and characteristics of the forests where they are established (e.g., disturbance, land tenure, structure, species richness), and after that, discuss the complementarity between the RAPP and the national inventories of native forests. Permanent plots are established over a wide range of latitude (22.02-54.89° S) and elevation (19 a 2304 m a. s. l.), but they are mainly concentrated in Subtropics (Chaco Seco, Chaco Húmedo, Selva Paranaense, and Yungas) and in Bosques Andino-Patagónicos. In all plots, trees are taxonomically identified and different dasometric variables are remeasured, which are the basis for potential collaborations to answer ecological questions at a larger scale. We hope to continue incorporating working groups in the RAPP and encouraging the establishment of plots, mainly in regions with a low number of permanent plots such as Monte, Espinal, and Delta e Islas del Paraná. The goal is that the RAPP advances in the long-term study of all native forests in Argentina, achieving a greater national cover and more interactions among research teams.Estación Experimental Agropecuaria BarilocheFil: Ceballos, Sergio Javier. Universidad Nacional de Tucuman. Instituto de Ecologia Regional; ArgentinaFil: Blundo, Cecilia. Universidad Nacional de Tucuman. Instituto de Ecologia Regional; ArgentinaFil: Malizia, Agustina. Universidad Nacional de Tucuman. Instituto de Ecologia Regional; ArgentinaFil: Osinaga Acosta, Oriana. Universidad Nacional de Tucuman. Instituto de Ecologia Regional; ArgentinaFil: Carilla, Julieta. Universidad Nacional de Tucuman. Instituto de Ecologia Regional; ArgentinaFil: Grau, Hector Ricardo. Universidad Nacional de Tucuman. Instituto de Ecologia Regional; ArgentinaFil: Cuchietti, Anibal. Ministerio de Ambiente y Desarrollo Sostenible de la Nación. Dirección Nacional de Bosques; ArgentinaFil: Campanello, Paula Inés. Universidad Nacional de la Patagonia San Juan Bosco. Facultad de Ingeniería; ArgentinaFil: Gasparri, Ignacio. Universidad Nacional de Tucuman. Instituto de Ecologia Regional; ArgentinaFil: Gatti, Genoveva. Universidad Nacional de Misiones. Instituto de Biología Subtropical; ArgentinaFil: Loto, Dante. Universidad Nacional de Santiago del Estero. Instituto de Biología Subtropical; ArgentinaFil: Martinez Pastur, Guillermo. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Austral de Investigaciones Cientificas. Laboratorio de recursos agroforestales; ArgentinaFil: Saucedo Miranda, Jimena. Ministerio de Ambiente y Desarrollo Sostenible de la Nación. Dirección Nacional de Bosques; ArgentinaFil: Amoroso, Mariano. Universidad Nacional de Río Negro. Instituto de Investigaciones en Recursos Naturales, Agroecología y Desarrollo Rural; ArgentinaFil: Andino, Natalia. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro de Investigaciones de la Geosfera y Biosfera; ArgentinaFil: Arpigiani, Daniela. Universidad Nacional de Río Negro. Instituto de Investigaciones en Recursos Naturales, Agroecología y Desarrollo Rural; ArgentinaFil: Aschero, Valeria. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Instituto Argentino de Nivologia, Glaciologia y Ciencias Ambientales; ArgentinaFil: Barberis, Ignacio Martin. Universidad Nacional de Rosario. Facultad de Ciencias Agrarias. Instituto de Investigaciones en Ciencias Agrarias de Rosario; ArgentinaFil: Bedrij, Natalia Alejandra. Universidad Nacional de Misiones. Instituto de Biología Subtropical; ArgentinaFil: Nicora Chequin, Renata. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botanica del Nordeste; ArgentinaFil: Chillo, María Verónica. Instituto Nacional de Tecnologia Agropecuaria (INTA). Estacion Experimental Agropecuaria Bariloche. Agencia de Extension Rural El Bolson; ArgentinaFil: Chillo, María Verónica. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Instituto de Investigaciones Forestales y Agropecuarias Bariloche; ArgentinaFil: Eibl, Beatriz. Universidad Nacional de Misiones. Facultad de Ciencias Forestales; ArgentinaFil: Eliano, Pablo. Asociación Forestal Industrial de Jujuy; ArgentinaFil: Fernandez, Romina Daiana. Universidad Nacional de Tucuman. Instituto de Ecologia Regional; ArgentinaFil: Garibaldi, Lucas Alejandro. Universidad Nacional de Río Negro. Instituto de Investigaciones en Recursos Naturales, Agroecología y Desarrollo Rural; ArgentinaFil: Giannoni, Stella. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro de Investigaciones de la Geosfera y Biosfera; ArgentinaFil: Goldenberg, Matias Guillermo. Universidad Nacional de Río Negro. Instituto de Investigaciones en Recursos Naturales, Agroecología y Desarrollo Rural; ArgentinaFil: Gonzalez Peñalba, Marcelo. Administracion Nacional de Parques Nacionales. Parque Nacional Lanin; ArgentinaFil: Jimenez, Yohana Gisell. Universidad Nacional de Tucuman. Instituto de Ecologia Regional; ArgentinaFil: Kees, Sebastian. Instituto Nacional de Tecnologia Agropecuaria (INTA). Estacion Experimental Agropecuaria Saenz Peña. Campo Anexo Estacion Forestal Plaza; ArgentinaFil: Klekailo, Graciela Noemi. Universidad Nacional de Rosario. Facultad de Ciencias Agrarias; ArgentinaFil: Lara, Martin. Administracion Nacional de Parques Nacionales. Parque Nacional Lanin; ArgentinaFil: Mac Donagh, Patricio. Universidad Nacional de Misiones. Facultad de Ciencias Forestales; ArgentinaFil: Malizia, Lucio Ricardo. Universidad Nacional de Jujuy. Centro de Estudios Territoriales Ambientales y Sociales; ArgentinaFil: Mazzini, Flavia. Universidad Nacional de Jujuy. Centro de Estudios Territoriales Ambientales y Sociales; ArgentinaFil: Medina, Walter Adrian. Universidad Nacional de Rosario. Facultad de Ciencias Agrarias. Instituto de Investigaciones en Ciencias Agrarias de Rosario; ArgentinaFil: Oddi, Facundo Jose.Universidad Nacional de Río Negro. Instituto de Investigaciones en Recursos Naturales, Agroecología y Desarrollo Rural; ArgentinaFil: Paredes, Dardo. Ministerio de Agricultura, Ganadería y Pesca de Tierra del Fuego. Dirección General de Desarrollo Forestal; ArgentinaFil: Peri, Pablo Luis. Instituto Nacional de Tecnologia Agropecuaria (INTA). Estacion Experimental Agropecuaria Santa Cruz; ArgentinaFil: Peri, Pablo Luis. Universidad Nacional de la Patagonia Austral; ArgentinaFil: Peri, Pablo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Persini, Carlos. Fundación Huellas para un Futuro, Reserva, Refugio y Estación Biológica Aponapó. ArgentinaFil: Prado, Darien Eros. Universidad Nacional de Rosario. Facultad de Ciencias Agrarias. Instituto de Investigaciones en Ciencias Agrarias de Rosario; ArgentinaFil: Salas, Roberto Manuel. Universidad Nacional del Nordeste. Facultad de Ciencias Agrarias. Instituto de Botanica del Nordeste; ArgentinaFil: Srur, Ana. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Instituto Argentino de Nivologia, Glaciologia y Ciencias Ambientales; ArgentinaFil: Villagra, Mariana. Universidad Nacional de Misiones. Instituto de Biología Subtropical; ArgentinaFil: Zelaya, Patricia. Universidad Nacional de Santiago del Estero. Facultad de Humanidades, Ciencias Sociales y de la Salud. Instituto de Estudios para el Desarrollo Social; ArgentinaFil: Villagra, Pablo Eugenio. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; Argentin

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

The PANDEMYC Score. An Easily Applicable and Interpretable Model for Predicting Mortality Associated With COVID-19.

This study aimed to build an easily applicable prognostic model based on routine clinical, radiological, and laboratory data available at admission, to predict mortality in coronavirus 19 disease (COVID-19) hospitalized patients. We retrospectively collected clinical information from 1968 patients admitted to a hospital. We built a predictive score based on a logistic regression model in which explicative variables were discretized using classification trees that facilitated the identification of the optimal sections in order to predict inpatient mortality in patients admitted with COVID-19. These sections were translated into a score indicating the probability of a patient's death, thus making the results easy to interpret. Median age was 67 years, 1104 patients (56.4%) were male, and 325 (16.5%) died during hospitalization. Our final model identified nine key features: age, oxygen saturation, smoking, serum creatinine, lymphocytes, hemoglobin, platelets, C-reactive protein, and sodium at admission. The discrimination of the model was excellent in the training, validation, and test samples (AUC: 0.865, 0.808, and 0.883, respectively). We constructed a prognostic scale to determine the probability of death associated with each score. We designed an easily applicable predictive model for early identification of patients at high risk of death due to COVID-19 during hospitalization.S

Conciliación de la medicación al ingreso en paciente crónico pediátrico: estudio multicéntrico

Resumen: Introducción: La conciliación de la medicación (CM) es una de las principales estrategias para disminuir los errores de medicación en las transiciones asistenciales. En España existen publicadas diferentes guías con recomendaciones para la implantación y el desarrollo de la CM orientadas a la población adulta, sin estar los pacientes pediátricos incluidos. En el año 2018 se llevó a cabo un estudio que permitió la posterior publicación de un documento con criterios de selección de pacientes pediátricos en los que priorizar la CM. Objetivos: Describir las características de los pacientes pediátricos con mayor probabilidad de sufrir errores de conciliación (EC), para confirmar si los resultados de un estudio previo son extrapolables. Metodología: Estudio prospectivo y multicéntrico con pacientes pediátricos ingresados. Se analizaron los EC detectados durante la realización de la CM al ingreso. La mejor historia farmacoterapéutica posible del paciente fue obtenida utilizando diferentes fuentes de información y confirmándose con una entrevista con el paciente/cuidador. Resultados: Se detectaron 1.043 discrepancias, determinándose como EC 544, afectando a 317 pacientes (43%). La omisión de algún medicamento fue el error más común (51%). La mayoría de los EC se asociaron con los medicamentos de los grupos A (31%), N (23%) y R (11%) de la clasificación ATC. La polimedicación y la enfermedad de base onco-hematológica fueron los factores de riesgo asociados a la presencia de EC con significación estadística. Conclusiones: Los hallazgos de este estudio permiten priorizar la CM en un grupo concreto de pacientes pediátricos, favoreciendo la eficiencia del proceso. Los pacientes onco-hematológicos y la polimedicación se confirman como los principales factores de riesgo para la aparición de EC en la población pediátrica. Abstract: Introduction: Medication reconciliation (MR) is one of the main strategies used to reduce medication errors in care transitions. In Spain, several guidelines have been published with recommendations for the implementation and development of MR processes aimed at the adult population, and not applicable to paediatric patients. In 2018, a study was carried out that allowed the subsequent publication of a document establishing criteria for the selection of paediatric patients in whom CM should be prioritised. Objectives: To describe the characteristics of the paediatric patients most likely to be subject to reconciliation errors (REs) to confirm whether the results of a previous study could be extrapolated. Methodology: Prospective, multicentre study in paediatric inpatients. We analysed the REs detected in the MR at the time of admission. We obtained the best possible medication history of the patient using different sources of information, subsequently confirmed through an interview with the patient/caregiver. Results: 1043 discrepancies were detected, of which 544 were categorised as REs, affecting 317 patients (43%). Omission of a drug was the most common error (51%). Most REs involved drugs in groups A (31%), N (23%) and R (11%) of the ATC classification. Polypharmacy and oncological/haematological disease were the risk factors that exhibited a statistically significant association with the occurrence of REs. Conclusions: The findings of this study allow the prioritisation of MR in a specific group of paediatric patients, contributing to improve the efficiency of the process. Oncological/haematological disease and polypharmacy were confirmed as the main risk factors for the occurrence of REs in the paediatric population

Modulation of the endocannabinoids N-arachidonoylethanolamine (AEA) and 2-arachidonoylglycerol (2-AG) on executive functions in humans

Animal studies point to an implication of the endocannabinoid system on executive functions. In humans, several studies have suggested an association between acute or chronic use of exogenous cannabinoids (Δ9-tetrahydrocannabinol) and executive impairments. However, to date, no published reports establish the relationship between endocannabinoids, as biomarkers of the cannabinoid neurotransmission system, and executive functioning in humans. The aim of the present study was to explore the association between circulating levels of plasma endocannabinoids N-arachidonoylethanolamine (AEA) and 2-Arachidonoylglycerol (2-AG) and executive functions (decision making, response inhibition and cognitive flexibility) in healthy subjects. One hundred and fifty seven subjects were included and assessed with the Wisconsin Card Sorting Test; Stroop Color and Word Test; and Iowa Gambling Task. All participants were female, aged between 18 and 60 years and spoke Spanish as their first language. Results showed a negative correlation between 2-AG and cognitive flexibility performance (r = -.37; p<.05). A positive correlation was found between AEA concentrations and both cognitive flexibility (r = .59; p<.05) and decision making performance (r = .23; P<.05). There was no significant correlation between either 2-AG (r = -.17) or AEA (r = -.08) concentrations and inhibition response. These results show, in humans, a relevant modulation of the endocannabinoid system on prefrontal-dependent cognitive functioning. The present study might have significant implications for the underlying executive alterations described in some psychiatric disorders currently associated with endocannabinoids deregulation (namely drug abuse/dependence, depression, obesity and eating disorders). Understanding the neurobiology of their dysexecutive profile might certainly contribute to the development of new treatments and pharmacological approaches