La anécdota en el siglo XVIII : Materiales para el estudio de la anécdota en la literatura francesa del siglo XVIII

[email protected] señala la coordinadora en la «Introducción», hemos creído conveniente recoger en esta Monografía una serie de anotaciones que Lola Jiménez había ido re-uniendo mientras preparaba su trabajo. A partir de los archivos que José Luis Canet tuvo a bien cedernos, hemos organizado estos materiales en dos secciones distintas. La primera contiene cinco textos de distintos autores, a los que hemos incorporado un pequeño comentario de Lydia Vázquez. La segunda sección está conformada por una relación de referencias bibliográficas que, sin duda, serán de gran utilidad para quien desee proseguir ahondando en esta sugerente línea de investigación

La anécdota, un género breve : Chamfort

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Phosphorus binders: preferences of patients on hemodialysis and its impact on treatment compliance and phosphorus control

Introducción: En la actualidad disponemos de un amplio abanico de captores del fósforo (CF), pero sabemos poco acerca de las preferencias de los pacientes y de su repercusión sobre el cumplimiento del tratamiento y el control de los niveles de fósforo. Objetivo: Estudiar las preferencias y creencias de los pacientes respecto a los CF, y su influencia sobre el cumplimiento del tratamiento y el control de los niveles de fósforo. Pacientes y métodos: Estudio observacional transversal. Se incluyeron 121 pacientes que respondieron un cuestionario genérico de cumplimiento del tratamiento (SMAQ) y a un cuestionario específico sobre cumplimiento del tratamiento con CF, tipo de CF preferido y razones de dicha preferencia. Todos los pacientes entrevistados habían probado dos o tres CF. Las consecuencias de la falta de cumplimiento del tratamiento con CF se estimaron indirectamente analizando los valores promedio de fósforo sérico. Resultados: El 40% de los pacientes era incumplidor según el cuestionario SMAQ; se encontró una asociación estadísticamente significativa entre la falta de cumplimiento en general y no alcanzar el objetivo de fósforo sérico promedio 5,5 mg/dl (OR = 4,7; IC 95%, 1,1-6,5; p = 0,03). Un 43,8% de los pacientes no refirió tener preferencias entre los diferentes tipos de CF; para el resto de pacientes, el CF preferido fue Royen®, seguido de Fosrenol®, Renagel® y Pepsamar®. Las razones expresadas para el desagrado con el Renagel® fueron las siguientes: incomodidad en la toma por su gran tamaño (28,8%), necesidad de tomar muchos comprimidos y gran consumo de agua (57,7%) e intolerancia gástrica (13,3%). En el caso del Fosrenol®: incómodo de tomar (72,7%) e intolerancia gástrica (27,2%); para el Pepsamar®: mal sabor (54,5%) e intolerancia gástrica (45,4%). Sólo al 9,4% no le gustaba el Royen®. Al analizar los conocimientos de los pacientes respecto a la utilidad de los CF, un 42% sabía que servían para controlar el fósforo; un 52% no lo sabía y un 6% tenía ideas equivocadas. En cuanto a su importancia: un 47% no conocía por qué son importantes; un 2% tenía ideas erróneas; un 9% creía que era beneficioso para la salud; un 11% creía que era bueno «porque lo dice el medico»; un 26% porque controla el fósforo y un 5% lo relacionaba con el hueso. Ningún paciente relacionó los CF con la enfermedad cardiovascular. Un 24,4% no se llevaba los CF cuando salía fuera de casa o estaba con los amigos; eran pacientes más jóvenes a quienes se les habían prescrito un mayor número de comprimidos de CF y que presentaban un mayor riesgo de no cumplir el objetivo de fósforo (OR = 10,5; IC 95%, —1,8 a —16,4; p 5,5 mg/dl (OR = 13.3; IC 95%, 1,1-1,5; p = 0,0001). Paradójicamente, los pacientes que no cumplían con el tratamiento demostraban un mejor conocimiento de su uso (OR = 17,3; IC 95%, 2,2-10,1; p 5.5 mg/dl (χ2: 4.7; 95% CI 1.07-6.5; p = 0.03). Paradoxically, non-adherent patients showed greater knowledge of the use (χ2: 17.3; 95% CI -2.2-10.1; p 5.5 mg/dl) (χ2: 13.3; 95% CI -1.1-1.5; p = 0.0001). Calcium acetate was the prefered PB in 47.1% of patients, lanthanum carbonate in 40%, sevelamer in 20.6% and aluminum hydroxide in 19.4%. The reasons claimed by patients for their negative ratings of PB were the type of dosage form, the taste, the number of tablets and gastric intolerance. Gastric intolerance and bad taste were more frequent in aluminum hydroxide patients (19.4% and 22.2%, respectively). Sevelamer received complaints about its dosage form because the tablets were too large and a large number of tablets were required (27.2%). 17.7% of patient who were taking lanthanum carbonate did not like the chewable tablets. Conclusion: patients who were taking binders that they did not like had worse serum P levels and were prescribed higher doses of binders. Knowing patients’ preferences about the drugs prescribed may be a key factor in achieving adequate adherence to treatment

Lead in terrestrial game birds from Spain

[EN] We analysed exposure to Pb and its relationship with lead-based ammunition in seven species of terrestrial game birds-common woodpigeon (Columba palumbus), rock dove (Columba livia), stock dove (Columba oenas), European turtle-dove (Streptopelia turtur), red-legged partridge (Alectoris rufa), Barbary partridge (Alectoris barbara) and common quail (Coturnix coturnix)-from rural and urban areas in different parts of Spain (Valencia, Castilla-La Mancha, Castilla y Leon, Madrid, Islas Canarias and Navarra). A total of 530 liver samples were analysed, and the presence of Pb pellets was studied in the crop, gizzard and intestine; the state and appearance of these organs were also analysed. The number of specimens suspected to have ingested Pb shot was 28 (5.6%), and the geometric mean concentration of hepatic Pb was 0.054 mu g g(-1) (wet weight, ww). A low percentage of samples (4.8%) were above the abnormal exposure threshold (0.65 mu g g(-1) ww), and, in these specimens, renal Pb concentrations were determined. Common woodpigeons and rock doves from Madrid were found to have high concentrations of Pb in their livers, and, so, both species can be considered to be good bioindicators of Pb contamination in rural (common woodpigeons) and urban (rock doves) environments. Partridges bred for hunting may be more prone to ingesting pellets from the environment, a fact that should be taken into account in management decisions.This study was funded by the Spanish Sectoral Federation of Weapons and Ammunition (FSA). The authors would like to thank Miguel A. Sanchez Isarria for his help in collecting samples, to Valentin Urrutia and Inma Salvat for their help in processing the samples, to Alberto Ferrer (Departamento de Estadistica e Investigacion Operativa Aplicadas y Calidad, Universidad Politecnica de Valencia) for the statistical treatment of the data, and to the Department of Animal Surgery at the Veterinary Clinical Hospital of the University of Murcia for conducting the X-ray analyses of the samples.Romero, D.; De Jose, A.; Theureau De La Peña, JM.; Ferrer Gisbert, A.; Raigón Jiménez, MD.; Torregrosa Soler, JB. (2020). Lead in terrestrial game birds from Spain. Environmental Science and Pollution Research. 27(2):1585-1597. https://doi.org/10.1007/s11356-019-06827-yS15851597272Ákoshegyi I (1997) Lead poisoning of pheasants caused by lead shots. Magy Allatorvosok Lapja 119(6):328–330Anger H (1971) Gamebird diseases. 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Ecotoxicol Environ Saf 118:71–82Best TL, Garrison TE, Schmitt CG (1992) Availability and ingestion of lead shot by mourning doves (Zenaida macroura) in southeastern New Mexico. Southwest Nat 37:287–292Beyer WN, Franson JC, Locke LN, Stroud RK, Sileo L (1998) Retrospective study of the diagnostic criteria in a lead-poisoning survey of waterfowl. Arch Environ Contam Toxicol 35:506–512Bingham RJ, Larsen RT, Bissonette JA, Hall JO (2015) Widespread ingestion of lead pellets by wild chukars in northwestern Utah. Wildl Soc Bull 39(1):94–102Butler DA (2005) Incidence of lead shot ingestion in red-legged partridges (Alectoris rufa) in Great Britain. Vet Rec 157:661–662Butler DA, Sage RB, Draycott RAH, Carroll JP, Potts D (2005) Lead exposure in ring-necked pheasants on shooting estates in Great Britain. Wildl Soc Bull 33:583–589Cai F, Calisi RM (2016) Seasons and neighborhoods of high lead toxicity in New York City: the feral pigeon as a bioindicator. 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Springer Science & Business Media, Berlin, GermanyHolladay JP, Nisanian M, Williams S, Tuckfield RC, Kerr R, Jarrett T, Tannenbaum L, Holladay SD, Sharma A, Gogal RM Jr (2012) Dosing of adult pigeons with as little as one #9 lead pellet caused severe δ-ALAD depression, suggesting potential adverse effects in wild populations. Ecotoxicology 21(8):2331–2337. https://doi.org/10.1007/s10646-012-0989-xHolland G (1882) Pheasant poisoned by swallowing shot. The Field 59:232Hutton M, Goodman GT (1980) Metal contamination of feral pigeons Columba livia from the London area. Part I: tissue accumulation of lead cadmium and zinc. Environ Pollut Ser A 22:207–217Johansen P, Pedersen HS, Asmund G, Riget F (2006) Lead shot from hunting as a source of lead in human blood. Environ Pollut 142(1):93–97Johnson CK, Kelly TR, Rideout BA (2013) Lead in ammunition: a persistent threat to health and conservation. Ecohealth 10(4):455–464Kendall RJ, Lacher TE Jr, Bunck C, Daniel B, Driver C, Grue CE, Leighton F, Stansley W, Watanbe PG, Whitworth M (1996) An ecological risk assessment of lead shot exposure in non-waterfowl avian species: upland game birds and raptors. Environ Toxicol Chem 15:4–20Kerr R, Holladay S, Jarrett T, Selcer B, Meldrum B, Williams S, Tannenbaum L, Holladay J, Williams J, Gogal R (2010) Lead pellet retention time and associated toxicity in northern bobwhite quail (Colinus virginianus). Environ Toxicol Chem 29(12):2869–2874. https://doi.org/10.1002/etc.355Keymer IF (1958) A survey and review of the causes of mortality in British birds and the significance of wild birds as disseminators of disease. Vet Rec 70:713–720Keymer IF, Stebbings RSJ (1987) Lead poisoning in a Partridge (Perdix perdix) after ingestion of gunshot. 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Corema album archaeobotanical remains in western Mediterranean basin. Assessing fruit consumption during Upper Palaeolithic in Cova de les Cendres (Alicante, Spain)

[EN] Information about plant gathering by Palaeolithic hunter-gatherers in Europe is scarce because of the problems of preservation of plant remains in archaeological sites and due to the lack of application of archaebotanical analysis in many of them. Botanical macroremains wood charcoal, seeds, fruits, leaves, etc. - provide information not only about palaeoeconomy of hunter-gatherers, but also about climate, landscape and vegetation dynamics. In Gravettian and Solutrean levels of Cova de les Cendres (Alicante, Spain), Corema album pyrenes (Empetraceae or crowberries family) have been identified. On the contrary, wood charcoal of this species has not been documented among the remains of firewood. This differential presence of plant organs, together with the nutritional value of its fruits, which is presented here, make us hypothesize the systematic gathering of C. album fruits for human consumption. They have a high content in vitamin C, as well as potassium, magnesium and copper. Corema album (camariria) is a unique species, nowadays in danger of extinction. Its main population is located on the Atlantic coast of Iberian Peninsula, but in 1996 a small population was discovered on the Mediterranean Iberian coast (Benidorm, Spain). Archaeobotanical data from Cova de les Cendres (Teulada-Moraira, Spain) presented here point to a larger population of camariria during Upper Palaeolithic on the coast of Alicante. The harsh climatic conditions of the Last Glacial Maximum during Solutrean period, with colder temperatures and aridity increase, could explain the reduction of the presence of C album remains until its absence in Magdalenian. The climatic amelioration during Upper Magdalenian did not mean the recovery of camariria population in the Moraira headland area. Probably, the rising of the sea level would affect them destroying its dune habitat. (C) 2019 Elsevier Ltd. All rights reserved.Archaeological research at Cova de les Cendres was funded by Spanish Ministerio de Ciencia e Innovacion (HAR2011-24878; CGL2012-34717; HAR2014-5267 degrees 1-P; HAR2017-85153/P) and by Generalitat Valenciana (Grant PROMETEOII/2013/016; PROMETEO/2017/060). Seed analyses were carried out as doctoral research at the Departament de Prehistoria, Arqueologia i Historia Antiga (Universitat de Valencia) with the financial support of an "Atraccio de Talent" of VLC-Campus predoctoral grant to C.M. Martinez-Varea. Thanks to the Donana Biological Reserve for having allowed us to use the Singular Technical Scientific Installation for the Corema sampling. Authors want to thank M. Macias from Universitat Politecnica de Valencia for software development to draw the charcoal diagram and Eva Arnau from Universitat de Valencia for 3D modeling.Martínez-Varea, CM.; Ferrer-Gallego, P.; Raigón Jiménez, MD.; Badal, E.; Ferrando-Pardo, I.; Laguna-Lumbreras, E.; Real, C.... (2019). 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mHealth intervention to improve quality of life in patients with chronic diseases during the COVID-19 crisis in Paraguay: A study protocol for a randomized controlled trial

Background Patients with chronic disease represent an at-risk group in the face of the COVID-19 crisis as they need to regularly monitor their lifestyle and emotional management. Coping with the illness becomes a challenge due to supply problems and lack of access to health care facilities. It is expected these limitations, along with lockdown and social distancing measures, have affected the routine disease management of these patients, being more pronounced in low- and middle-income countries with a flawed health care system. Objectives The purpose of this study is to describe a protocol for a randomized controlled trial to test the efficacy of the Adhera® MejoraCare Digital Program, an mHealth intervention aimed at improving the quality of life of patients with chronic diseases during the COVID-19 outbreak in Paraguay. Method A two-arm randomized controlled trial will be carried out, with repeated measures (baseline, 1-month, 3-month, 6-month, and 12-month) under two conditions: Adhera® MejoraCare Digital Program or waiting list. The primary outcome is a change in the quality of life on the EuroQol 5-Dimensions 3-Levels Questionnaire (EQ-5D-3L). Other secondary outcomes, as the effect on anxiety and health empowerment, will be considered. All participants must be 18 years of age or older and meet the criteria for chronic disease. A total of 96 participants will be recruited (48 per arm). Conclusions It is expected that the Adhera® MejoraCare Digital Program will show significant improvements in quality of life and emotional distress compared to the waiting list condition. Additionally, it is hypothesized that this intervention will be positively evaluated by the participants in terms of usability and satisfaction. The findings will provide new insights into the viability and efficacy of mHealth solutions for chronic disease management in developing countries and in times of pandemic

Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study

Background: Limited evidence exists on the role of glucose-lowering drugs in patients with COVID-19. Our main objective was to examine the association between in-hospital death and each routine at-home glucose-lowering drug both individually and in combination with metformin in patients with type 2 diabetes mellitus admitted for COVID-19. We also evaluated their association with the composite outcome of the need for ICU admission, invasive and non-invasive mechanical ventilation, or in-hospital death as well as on the development of in-hospital complications and a long-time hospital stay. Methods: We selected all patients with type 2 diabetes mellitus in the Spanish Society of Internal Medicine’s registry of COVID-19 patients (SEMI-COVID-19 Registry). It is an ongoing, observational, multicenter, nationwide cohort of patients admitted for COVID-19 in Spain from March 1, 2020. Each glucose-lowering drug user was matched with a user of other glucose-lowering drugs in a 1:1 manner by propensity scores. In order to assess the adequacy of propensity score matching, we used the standardized mean difference found in patient characteristics after matching. There was considered to be a significant imbalance in the group if a standardized mean difference > 10% was found. To evaluate the association between treatment and study outcomes, both conditional logit and mixed effect logistic regressions were used when the sample size was ≥ 100. Results: A total of 2666 patients were found in the SEMI-COVID-19 Registry, 1297 on glucose-lowering drugs in monotherapy and 465 in combination with metformin. After propensity matching, 249 patients on metformin, 105 on dipeptidyl peptidase-4 inhibitors, 129 on insulin, 127 on metformin/dipeptidyl peptidase-4 inhibitors, 34 on metformin/sodium-glucose cotransporter 2 inhibitor, and 67 on metformin/insulin were selected. No at-home glucose-lowering drugs showed a significant association with in-hospital death; the composite outcome of the need of intensive care unit admission, mechanical ventilation, or in-hospital death; in-hospital complications; or long-time hospital stays. Conclusions: In patients with type 2 diabetes mellitus admitted for COVID-19, at-home glucose-lowering drugs showed no significant association with mortality and adverse outcomes. Given the close relationship between diabetes and COVID-19 and the limited evidence on the role of glucose-lowering drugs, prospective studies are needed

Dendritic cell deficiencies persist seven months after SARS-CoV-2 infection

Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 infection induces an exacerbated inflammation driven by innate immunity components. Dendritic cells (DCs) play a key role in the defense against viral infections, for instance plasmacytoid DCs (pDCs), have the capacity to produce vast amounts of interferon-alpha (IFN-α). In COVID-19 there is a deficit in DC numbers and IFN-α production, which has been associated with disease severity. In this work, we described that in addition to the DC deficiency, several DC activation and homing markers were altered in acute COVID-19 patients, which were associated with multiple inflammatory markers. Remarkably, previously hospitalized and nonhospitalized patients remained with decreased numbers of CD1c+ myeloid DCs and pDCs seven months after SARS-CoV-2 infection. Moreover, the expression of DC markers such as CD86 and CD4 were only restored in previously nonhospitalized patients, while no restoration of integrin β7 and indoleamine 2,3-dyoxigenase (IDO) levels were observed. These findings contribute to a better understanding of the immunological sequelae of COVID-19

Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease : A Multicentre Study of Geteccu

Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered "exposed". The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2-2.0), urgent surgery (OR: 1.6; 95% CI: 1.2-2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1-1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3-2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97-1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03-2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections

Predictive Power of the "Trigger Tool" for the detection of adverse events in general surgery: a multicenter observational validation study

Background In spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events. This study was designed to validate the hypothesis that a new “Trigger Tool” represents a sensitive predictor of adverse events in general surgery. Methods An observational multicenter validation study was performed among 31 hospitals in Spain. The previously described “Trigger Tool” based on 40 specific triggers was applied to validate the predictive power of predicting adverse events in the perioperative care of surgical patients. A prediction model was used by means of a binary logistic regression analysis. Results The prevalence of adverse events among a total of 1,132 surgical cases included in this study was 31.53%. The “Trigger Tool” had a sensitivity and specificity of 86.27% and 79.55% respectively for predicting these adverse events. A total of 12 selected triggers of overall 40 triggers were identified for optimizing the predictive power of the “Trigger Tool”. Conclusions The “Trigger Tool” has a high predictive capacity for predicting adverse events in surgical procedures. We recommend a revision of the original 40 triggers to 12 selected triggers to optimize the predictive power of this tool, which will have to be validated in future studies