Recensiones [Revista de Historia Económica Año XIV Invierno 1996 n. 1 pp. 241-297]

Editada en la Fundación Empresa PúblicaJordi Nadal y Jordi Catalán (eds.). La cara oculta de la industrialización española. La modernización de los sectores no líderes {siglos XIX y XX) (Por Miguel Martorell Linares).-- Blanca Sánchez Alonso. Las causas de la emigración española, 1880-1910 (Por Alan M. Taylor).-- Pedro Tedde de Lorca y Carlos Marichal (coords.). La formación de los bancos centrales en España y América Latina (Por Antonio Cubel).-- Josef M. Benaul, Jordi Calvei y Esteve Deu; Indústria i ciutat. Sabadell 1800-1980 (Por José Antonio Miranda Encarnación).-- Carlos Arenas Posadas (ed.). Industria y clases trabajadoras en la Sevilla del siglo XX (Por Ricardo M. Martín de la Guardia).-- Pegerto Saavedra. La vida cotidiana en la Galicia del Antiguo Régimen (Por Amparo Bejarano Rubio).-- Mauro Hernández Benítez. A la sombra de la Corona. Poder local y oligarquía urbana (Por Miguel Ángel Melón Jiménez).-- Carmen Sarasúa. Criados, nodrizas y amos. El servicio doméstico en la formación del mercado de trabajo madrileño, 1758-1868 (Por Esmeralda Ballesteros Doncel).-- Hilario Rodríguez de Gracia. Vivir y morir en Montilla. Actitudes económicas y sociales en el siglo XVII (Por Carlos Larrinaga Rodríguez).-- Enrioque Diez Sanz. La Tierra de Soria. Un universo campesino en la Castilla oriental del siglo xvi (Por Alfonso Rodríguez Grajera).-- Josep Bernabeu Mestre. Enfermedad y población. Introducción a los problemas y métodos de la epidemiología histórica (Por Abel F. Losada Alvarez).-- Herbert Klein. The American Finances of the Spanish Empire: Royal Income and Expenditures in México, Perú and Charcas, 1680-1809 (Por Carlos Marichal).-- Marcello Carmagnani. Estado y Mercado. La economía pública del liberalismo mexicano, 1850-1911 (Por Juan Carlos Sola Corbacho).-- Walther L. Bernecker. De agiotistas y empresarios. Entorno de la temprana industrialización mexicana (siglo XIX) (Por Juan Carlos Sola Corbacho).-- P. Scholliers y Vera Zamagni (eds.). Labour's Reward. Real Wages and Economic Change in 19th-and 29th-century Europe (Por Guillermo A. Pérez Sánchez).-- Pier Angelo Toninelli. Nascita de una nazione. Lo sviluppo económico degli Stati Uniti (1780-1914) (Por Gabriel Tortella Casares)Publicad

Criterios de ordenación temporal de las intervenciones quirúrgicas en patología cardiovascular y endovascular adquirida. Versión 2022

Waiting list management of cardiac surgical procedures is a main concern for all the Spanish autonomic health systems and for our scientific Society. The first statement for optimal timing of patients waiting for cardiac surgery was published in 2000. Since then, after significant changes in the management of some pathologies, new normative frameworks and the current healthcare situation, a review of the timing criteria to offer an adequate and updated standard of care is needed. In this document we aim to review the available literature in the field and stablish a consensus within a working group of the Spanish Society of Cardiovascular and Endovascular Surgery to optimize the priority recommendations in cardiac surgical waiting lists in our country. (c) 2022 Sociedad Espanola de Cirugia Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ riccuses/by-nc-nri/4.0/)

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

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

Spread of a SARS-CoV-2 variant through Europe in the summer of 2020

[EN] Following its emergence in late 2019, the spread of SARS-CoV-21,2 has been tracked by phylogenetic analysis of viral genome sequences in unprecedented detail3,4,5. Although the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced. However, travel within Europe resumed in the summer of 2020. Here we report on a SARS-CoV-2 variant, 20E (EU1), that was identified in Spain in early summer 2020 and subsequently spread across Europe. We find no evidence that this variant has increased transmissibility, but instead demonstrate how rising incidence in Spain, resumption of travel, and lack of effective screening and containment may explain the variant’s success. Despite travel restrictions, we estimate that 20E (EU1) was introduced hundreds of times to European countries by summertime travellers, which is likely to have undermined local efforts to minimize infection with SARS-CoV-2. Our results illustrate how a variant can rapidly become dominant even in the absence of a substantial transmission advantage in favourable epidemiological settings. Genomic surveillance is critical for understanding how travel can affect transmission of SARS-CoV-2, and thus for informing future containment strategies as travel resumes.S

Trabajadores/as sociales en las instituciones del defensor del pueblo (ombudsman)

La profesión de Trabajo Social se rige por los principios de los derechos humanos la justicia social, con el objetivo de conseguir un aumento en el bienestar social de la ciudadanía. Para lograr este objetivo, los profesionales del Trabajo Social, tradicionalmente vienen desarrollando sus funciones en la Administración pública, tanto en la estatal, autonómica, como local. De todos es conocida la figura del Trabajador/a social en los Servicios Sociales Comunitarios, en Salud, y en otros ámbitos donde desarrolla su labor profesional. La incorporación profesional no se ha realizado en todas las áreas de igual forma, ni con las mismas garantías, o la misma eficacia, aceptación por el resto de profesionales, etc., e incluso ha habido momentos en los que se ha tenido que reclamar por posible intrusismo profesional, o incluso no se ha visualizado la importancia de la labor realizada por el Trabajo Social. La figura del Defensor del Pueblo (Ombudsman) surge en los países con sistemas de gobierno democrático y, de forma muy resumida, están definidos como los altos comisionados para salvaguardar los derechos de la ciudadanía. Desde la creación por Ley Orgánica 3/1981, de 6 de abril, de Defensor del Pueblo, se han regulado leyes autonómicas para la creación de estas figuras en sus diferentes Parlamentos Autonómicos, así como creación de sus homónimos a nivel local. Tanto los Defensores, como el Trabajo Social y por ende los profesionales que van a llevar a cabo las funciones para cumplir estos objetivos, tiene los mismos fines, que es la defensa de los derechos de la ciudadanía, evidentemente, cada uno desde la esfera que le está encomendada

Role of Single-Nucleotide Polymorphisms in Genes Implicated in Capecitabine Pharmacodynamics on the Effectiveness of Adjuvant Therapy in Colorectal Cancer

Colorectal cancer (CRC) is a highly prevalent form of neoplasm worldwide. Capecitabine, an oral antimetabolite, is widely used for CRC treatment; however, there exists substantial variation in individual therapy response. This may be due to genetic variations in genes involved in capecitabine pharmacodynamics (PD). In this study, we investigated the role of single-nucleotide polymorphisms (SNPs) related to capecitabine’s PD on disease-free survival (DFS) in CRC patients under adjuvant treatment. Thirteen SNPs in the TYMS, ENOSF1, MTHFR, ERCC1/2, and XRCC1/3 genes were genotyped in 142 CRC patients using real-time PCR with predesigned TaqMan® probes. A significant association was found between favorable DFS and the ENOSF1 rs2612091-T allele (p = 0.010; HR = 0.34; 95% CI = 0.14–0.83), as well as with the TYMS/ENOSF1 region ACT haplotype (p = 0.012; HR = 0.37; 95% CI = 0.17–0.80). Other factors such as low histological grade (p = 0.009; HR = 0.34; 95% CI = 0.14–0.79) and a family history of cancer (p = 0.040; HR = 0.48; 95% CI = 0.23–0.99) were also linked to improved DFS. Therefore, the SNP ENOSF1 rs2612091 could be considered as a predictive genetic biomarker for survival in CRC patients receiving capecitabine-based adjuvant regimens.Grants co-funded by ERDF funds (EU) from the Instituto de Salud Carlos III (PT13/0010/0039