Ética, hermenéutica y política. Filosofía en el fondo

Esta obra colectiva de ensayos académicos dictaminados, inspirados en el ciclo de conferencias Filosofía en el Fondo, ofrece una rica y entretejida lectura que, en cuatro secciones (La ética ante el problema del mal, Diferencia y alteridad, Hermenéutica de la modernidad, e Intersticios políticos), profundiza los problemas humanos que resisten el paso del tiempo desde enfoques hermenéuticos, genealógicos y críticos.ITESO, A.C

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Preneoplastic somatic mutations including MYD88(L265P) in lymphoplasmacytic lymphoma

Normal cell counterparts of solid and myeloid tumors accumulate mutations years before disease onset; whether this occurs in B lymphocytes before lymphoma remains uncertain. We sequenced multiple stages of the B lineage in elderly individuals and patients with lymphoplasmacytic lymphoma, a singular disease for studying lymphomagenesis because of the high prevalence of mutated MYD88. We observed similar accumulation of random mutations in B lineages from both cohorts and unexpectedly found MYD88(L265P) in normal precursor and mature B lymphocytes from patients with lymphoma. We uncovered genetic and transcriptional pathways driving malignant transformation and leveraged these to model lymphoplasmacytic lymphoma in mice, based on mutated MYD88 in B cell precursors and BCL2 overexpression. Thus, MYD88(L265P) is a preneoplastic event, which challenges the current understanding of lymphomagenesis and may have implications for early detection of B cell lymphomas

La fenomenología desde la perspectiva hermenéutica de Heidegger: una propuesta metodológica para la salud pública/ Phenomenology as seen from the hermeneutics perspective of Heidegger: a methodological proposal for public health

Resumen La investigación cualitativa es una estrategia metodológica de gran uso por las profesiones de la salud. La salud pública no es ajena a la aplicación de estos diseños. Objetivo: describir el método fenomenológico y sus técnicas desde la perspectiva hermenéutica de Heidegger. Metodología: se presenta un análisis de la fenomenología interpretativa de Martin Heidegger y la propuesta de diferentes técnicas de investigación cualitativa para la aplicación de este diseño metodológico cómo alternativa para Salud Pública. Resultados: se describe la epojé, intencionalidad, reducción, constitución, el proceso de análisis y la forma de presentación de resultados del diseño metodológico fenomenológico. Conclusión: la propuesta fenomenológica de este trabajo sugiere tomar una postura epistemológica a la luz de la hermenéutica de Heidegger./ Abstract Qualitative research is a very useful methodological strategy for health-related professions, and public health is no stranger to the implementations of these designs. Objective: to describe the phenomenological method and its techniques from the hermeneutic perspective of Heidegger. Methodology: this paper presents an analysis of Martin Heidegger's interpretive phenomenology and proposes various qualitative research techniques for applying this methodological design as an alternative for public health. Results: we describe the epoché, intentionality, reduction, constitution, the analysis process and the manner in which results are presented in a phenomenological study design. Conclusion: this paper's phenomenological proposal suggests taking an epistemological position in the light of Heidegger's hermeneutics

La fenomenología desde la perspectiva hermenéutica de Heidegger: una propuesta metodológica para la salud pública

Qualitative research is a very useful methodological strategyfor health-related professions, and public health is no strangerto the implementations of these designs. Objective: to describethe phenomenological method and its techniques from thehermeneutic perspective of Heidegger. Methodology: thispaper presents an analysis of Martin Heidegger's interpretivephenomenology and proposes various qualitative researchtechniques for applying this methodological design asan alternative for public health. Results: we describe theepoché, intentionality, reduction, constitution, the analysisprocess and the manner in which results are presented in aphenomenological study design. Conclusion: this paper'sphenomenological proposal suggests taking an epistemologicalposition in the light of Heidegger's hermeneutics. La investigación cualitativa es una estrategia metodológica de gran uso por las profesiones de la salud. La salud pública no es ajena a la aplicación de estos diseños. Objetivo: describir el método fenomenológico y sus técnicas desde la perspectiva hermenéutica de Heidegger. Metodología: se presenta un análisis de la fenomenología interpretativa de Martin Heidegger y la propuesta de diferentes técnicas de investigación cualitativa para la aplicación de este diseño metodológico cómo alternativa para Salud Pública. Resultados: se describe la epojé, intencionalidad, reducción, constitución, el proceso de análisis y la forma de presentación de resultados del diseño metodológico fenomenológico. Conclusión: la propuesta fenomenológica de este trabajo sugiere tomar una postura epistemológica a la luz de la hermenéutica de Heidegger. 

Pressure Retarded Osmosis Power Units Modelling for Power Flow Analysis of Electric Distribution Networks

Pressure retarded osmosis (PRO) power units, which produce electrical energy from salinity gradient sources located at coastlines, are a technology still in the process of maturation; however, there is an expectation that this technology will need to be integrated into electrical distribution networks. Such integration will drive changes in the electric response of the distribution systems which may lead to harmful operating conditions. Power flow analysis is a tool used to reveal the steady-state operating condition of distribution systems and which could be extended to study and address the integration of PRO power units. To the best of the authors’ knowledge, such extension of power flow analysis has not yet been addressed in the literature. Accordingly, this paper comprehensively provides a model to evaluate the electric current and complex power produced by PRO power units. This model is directly embedded in the forward-backward sweep (FBS) method, extending the power flow analysis of electric distribution systems in this way so as to consider the integration of PRO power units. The resulting approach permits revealing of the steady-state operating response of distribution systems and the effects that may be driven by the integration of PRO power units, as corroborated through numerical results on a 14-node test distribution system

Preneoplastic somatic mutations including MYD88(L265P) in lymphoplasmacytic lymphoma

Normal cell counterparts of solid and myeloid tumors accumulate mutations years before disease onset; whether this occurs in B lymphocytes before lymphoma remains uncertain. We sequenced multiple stages of the B lineage in elderly individuals and patients with lymphoplasmacytic lymphoma, a singular disease for studying lymphomagenesis because of the high prevalence of mutated MYD88. We observed similar accumulation of random mutations in B lineages from both cohorts and unexpectedly found MYD88(L265P) in normal precursor and mature B lymphocytes from patients with lymphoma. We uncovered genetic and transcriptional pathways driving malignant transformation and leveraged these to model lymphoplasmacytic lymphoma in mice, based on mutated MYD88 in B cell precursors and BCL2 overexpression. Thus, MYD88(L265P) is a preneoplastic event, which challenges the current understanding of lymphomagenesis and may have implications for early detection of B cell lymphomas

Prosthetic Valve Candida spp. Endocarditis: New Insights Into Long-term Prognosis—The ESCAPE Study

International audienceBackground: Prosthetic valve endocarditis caused by Candida spp. (PVE-C) is rare and devastating, with international guidelines based on expert recommendations supporting the combination of surgery and subsequent azole treatment.Methods: We retrospectively analyzed PVE-C cases collected in Spain and France between 2001 and 2015, with a focus on management and outcome.Results: Forty-six cases were followed up for a median of 9 months. Twenty-two patients (48%) had a history of endocarditis, 30 cases (65%) were nosocomial or healthcare related, and 9 (20%) patients were intravenous drug users. "Induction" therapy consisted mainly of liposomal amphotericin B (L-amB)-based (n = 21) or echinocandin-based therapy (n = 13). Overall, 19 patients (41%) were operated on. Patients <66 years old and without cardiac failure were more likely to undergo cardiac surgery (adjusted odds ratios [aORs], 6.80 [95% confidence interval [CI], 1.59-29.13] and 10.92 [1.15-104.06], respectively). Surgery was not associated with better survival rates at 6 months. Patients who received L-amB alone had a better 6-month survival rate than those who received an echinocandin alone (aOR, 13.52; 95% CI, 1.03-838.10). "Maintenance" fluconazole therapy, prescribed in 21 patients for a median duration of 13 months (range, 2-84 months), led to minor adverse effects.Conclusion: L-amB induction treatment improves survival in patients with PVE-C. Medical treatment followed by long-term maintenance fluconazole may be the best treatment option for frail patients