Obispo, financista y político: el doctor don Feliciano de Vega y Padilla (1580-1641)

Don Feliciano de Vega y Padilla (1580-1641) was one of the most distinguished members of the Peruvian colonial episcopate in the first half of the seventeenth century, and the only one who, after an outstanding ecclesiastical career, was appointed archbishop of Mexico. His passionate life, professional profile and intellectual production make Don Feliciano an interesting case study in order to understand the complex and tense dynamics of power linking Royal Patronage and the most important religious and political institutions in the city of Lima during the early colonial period. The study of Dr. Vega’s life and work also shedslight on the first generation of colonial intellectuals who debated the rights of Creole subjects. The works written by Bishop Vega constitute some of the first written expressions of the defense of prelacies and offices within the colonial Church, and the debate over the doctrine of Distributive Justice which was used to justify these claims. This article analyzes the relationship between Bishop Vega and the principal viceregal institutions: the university, the archbishopric, the cathedral chapter and the Royal Audience. Finally, it will analyze how Lima’s elite citizens, of which Vega was one, manipulated these institutions.Don Feliciano de Vega y Padilla (1580-1641) fue acaso la personalidad más destacada y emblemática del episcopado virreinal peruano de la primera mitad del siglo XVII. Luego de una brillante carrera en la universidad y el cabildo catedralicio de la ciudad de Lima, llegó a presidir tres diócesis hispanoamericanas, siendo la última de ellas el arzobispado de México. Su perfil profesional yproducción intelectual lo convierten en una de las figuras más influyentes de la elite social limeña y de la burocracia religiosa imperial de su tiempo. Su vida y su obra también ayudan a entender la trama de poder y la compleja dinámica de las relaciones entre la Corona y el virreinato peruano. Su poco conocida obra constituye una de las piedras angulares de la tradición memorialista peruana, interesada en la defensa de los derechos de prelación y el debate sobre la doctrina de la justicia distributiva. Este artículo analiza la conexión entre el doctor Vega y las principales instituciones virreinales: la universidad, el arzobispado, el cabildo catedralicio y la Real Audiencia. Asimismo, se estudia la manipulación de dichas instituciones por parte del grupo de los beneméritos, al que Vega perteneció

«El mejor arbitrio, el sermón». Discurso religioso y representación política en el Perú del siglo XVII

The article studies the historical significance of four projects (arbitrios) written by religious scholars from the Franciscan, Dominican and Jesuit orders in Peru, between 1630 and 1659. In particular, it studies the impact of these projects in the negotiation for political representation with the Crown. The article also addresses the importance of these projects as expression of the theoretical modernity of Peru’s creole church in the era of Confessionalization.El artículo analiza el significado histórico de los arbitrios escritos por intelectuales de las órdenes franciscana, dominica y jesuita en el Perú entre 1630 y 1659. En particular, se estudia su impacto para negociar una cuota de representación política para las órdenes y las elites del virreinato peruano en este período. Adicionalmente, estos memoriales son vistos como expresión de la modernidad teórica de la iglesia criolla en la era de la confesionalización

Las mujeres del virreinato del Perú: agentes de su economía, política y cultura

El continente americano, durante la era moderna, fue una mujer. Letrados de los siglos XVI y XVII lo imaginaron como una indómita amazona circundada de una fauna salvaje. Y, sobre todo, antropófaga. Era la antítesis de la ciudad cristiana, donde reinaba la idolatría. Fue entonces que los virreinatos instauraron una nueva humanidad, donde la mujer fue más que la acompañante del soldado. Los vientres de las mujeres americanas gestaron la vida de los linajes que, desde el siglo XVII, han renovado el pacto con que América se vincula con el resto del mundo. El presente volumen repasa las categorías simbólicas con que se pensó el cuerpo femenino y, sobre todo, aporta dos estudios que desde la biografía trazan las coordenadas del ámbito de acción de mujeres que, desde un aparente anonimato, ejercieron su influencia en la cultura letrada y en el ámbito político

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

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

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

La censura al interior de la Compañía de Jesús: notas sobre un manuscrito desconocido del P. Giovanni Anello Oliva S.J. (1639)

No presenta resumen

En la frontera del Reino: apuntes sobre sociedad y economía de un curato en la sierra de Piura (1780-1800)

1. Introducción: la visita de un prelado y sus fuentes Al alba del 11 de febrero de 1783, cuando aún no se habían esfumado las brumas en la parte alta de la quebrada, acompañado de su cortejo compuesto de siete "familiares" y siete esclavos, llegaba en visita pastoral al pueblo de San Pedro de Huancabamba, en la serranía piurana, el muy famoso obispo ilustrado de la diócesis de Trujillo, Don Baltasar Jaime Martínez de Compañón y Bujanda. Salió a recibirlo, como sucediera en estaciones anterio..