Perspectivas actuales de las fuentes del Derecho

Presentación / Rafael de Asís Roig. - Fuentes del Derecho y comunidad civil / Dionisio Llamazares Fernández. - Las fuentes del derecho y su problemática actual / Antonio Enrique Pérez Luño. - Fuentes del Derecho y sociedad civil : la participación de ésta en la creación normativa, desde la perspectiva del ordenamiento jurídico internacional / Montserrat Abad Castelos. - La tutela de la libertad religiosa en la Unión Europea y su incidencia en el ordenamiento interno español / Adoración Castro Jover. - Sistema normativo de la Unión Europea (naturaleza de las fuentes) / Carlos Moreiro González. - La incidencia de la Unión Europea en el sistema interno de fuentes de los Estados miembros / Ana Garriga Domínguez. - Las fuentes del Derecho Islámico / Mario Losano. - Multiculturalidad, Derecho islámico y ordenamiento secular; los supuestos de la poligamia y el repudio / Agustín Motilla de la Calle. - Interculturalidad y fuentes del Derecho : algunas reflexiones desde el Derecho Internacional / Carlos Fernández Liesa . - La definitiva secularización de la legislación sobre la interrupción del embarazo en España / Daniel Capodiferro Cubero. - Interculturalidade e Fontes do Direito. - A ética da racionalidade do outro como princípio e critério objetivo na análise da interculturalidade e sua relação quanto à legitimação das fontes do direito / Artur César de Souza. - El papel de los nuevos movimientos sociales en la regulación jurídica de la globalización / Jose Antonio García Saez. - Relaciones entre ordenamientos jurídicos en el ámbito de la Unión Europea / Cristina Hermida del LLano. - La incidencia «interesada» de la Directiva 2003/86/CE en la última reforma de la Ley de extranjería española / Encarnación La Spina. - La lex mercatoria : una excepción a la legitimidad del orden jurídico-político moderno / Francisco López Ruiz. - Un paralelismo entre las teorías de los principios y la jurisprudencia de conceptos: la ruptura del puente entre las fuentes del Derecho y la sociedad civil / Luis Lloredo Alix. - La configuración de un derecho cultural sobre lo religioso como una propuesta para la plena integración de las personas de origen musulman residentes en Europa / Andrés Murcia González. - Sobre algunas concepciones de la jurisprudencia en la cultura jurídica norteamericana / Oscar Pérez de la Fuent

Prevalence and characteristics of patients with resistant hypertension and chronic kidney disease

Resistant hypertension (RH) is a common problem in patients with chronic kidney disease (CKD). A decline in the glomerular filtration rate (GFR) and increased albuminuria are associated with RH; however, there are few published studies about the prevalence of this entity in patients with CKD. Objective: To estimate the prevalence of RH in patients with different degrees of kidney disease and analyse the characteristics of this group of patients. Methods: A total of 618 patients with hypertension and CKD stages I–IV were enrolled, of which 82 (13.3%) met the criteria for RH. Results: RH prevalence increased significantly with age, the degree of CKD and albuminuria. The prevalence of RH was 3.2% in patients under 50 years, 13.8% between 50 and 79 years and peaked at 17.8% in patients older than 80 years. Renal function prevalence was 4%, 15.8% and 18.1% in patients with an estimated glomerular filtration rate (GFR) of >60, 30–59 and 300 mg/g respectively. In a logistic regression model, the characteristics associated with resistant hypertension were age, history of cardiovascular disease, GFR, albuminuria and diabetes mellitus. A total of 47.5% of patients with resistant hypertension had controlled BP (<140/90 mmHg) with 4 or more antihypertensive drugs. These patients were younger, with better renal function, less albuminuria and received more aldosterone antagonists. Conclusion: RH prevalence increases with age, the degree of CKD and albuminuria. Strategies such as treatment with aldosterone receptor antagonists are associated with better blood pressure control in this group of patients, leading to reduced prevalence

Effectiveness of direct-acting antivirals in Hepatitis C virus infection in haemodialysis patients

Hepatitis C virus (HCV) infection is highly prevalent among patients on haemodialysis and leads to a poorer prognosis compared to patients who do not have said infection. Treatment with interferon and ribavirin is poorly tolerated and there are limited data on the experience with new direct-acting antivirals (DAAs). The aim of this study is to retrospectively analyse the current prevalence of HCV infection and efficacy and safety results with different DAA regimens in the haemodialysis population of 2 hospital areas. This is a multicentre, retrospective and observational study in which HCV antibodies were analysed in 465 patients, with positive antibody findings in 54 of them (11.6%). Among these, 29 cases (53.7%) with genotypes 1 and 4 were treated with different DAA regimens, including combinations of paritaprevir/ritonavir, ombitasvir, dasabuvir, sofosbuvir, simeprevir, daclatasvir and ledipasvir, with/without ribavirin. Mean age was 53.3 ± 7.9 years, 72.4% of patients were male and the most important aetiology of chronic kidney disease involved glomerular abnormalities. In 100% of cases, a sustained viral response was achieved after 24 weeks, regardless of DAA regimen received. Adverse effects were not relevant and no case required stopping treatment. In 15 cases, ribavirin was combined with the DAA. In these cases, the most significant adverse effect was anaemic tendency, which was reflected in the increase of the dose of erythropoietin stimulating agents, although none required transfusions. In summary, we conclude that new DAAs for the treatment of HCV in haemodialysis patients are highly effective with minimal adverse effects; it is a very important advance in HCV management. These patients are therefore expected to have a much better prognosis than they have had until very recently