Short-term impact of noise, other air pollutants and meteorological factors on emergency hospital mental health admissions in the Madrid region

A number of environmental factors, such as air pollution, noise in urbanised settings and meteorological-type variables, may give rise to important effects on human health. In recent years, many studies have confirmed the relation between various mental disorders and these factors, with a possible impact on the increase in emergency hospital admissions due to these causes. The aim of this study was to analyse the impact of a range of environmental factors on daily emergency hospital admissions due to mental disorders in the Madrid Autonomous Region (MAR), across the period 2013–2018

Industrias audiovisuales: tendencias de producción y consumo

La digitalización de la creación cultural y su difusión online ha supuesto la entrada en los mercados de poderosos y novedosos agentes que se han convertido en los líderes no sólo de la industria tecnológica, sino de toda la producción cultural y de la economía. Dicha digitalización de los medios, además de la convergencia de las pantallas y la ruptura de la linealidad vertical y unidireccional de los medios convencionales ha conllevado un profundo cambio de paradigmas que atañe directamente a la creación audiovisual. Este volumen de la serie iniciada en el año 2012 a partir de las investigaciones de los estudiantes de la asignatura Estructura del mercado audiovisual del grado de Comunicación Audiovisual en la Universidad de Málaga nos lleva al análisis de la recepción y del consumo de diversas industrias del audiovisual, pero también al análisis de la producción condicionada por el contexto económico y por la demanda, así como a diversas cuestiones relacionadas con el marketing y los modelos de negocio de aquellas industrias. En una disciplina en la que no abundan los trabajos académicos actualizados, los autores y autoras de este volumen ofrecen con sus aportaciones estudios de casos significativos y paradigmáticos del estado de los diversos sectores de las industrias audiovisuales. Presentados aquí a modo de capítulos, estos textos suponen la iniciación en la investigación de estudiantes que combinan su formación académica e investigadora con su formación como profesionales en el área de la Comunicación Audiovisual. Ofrecemos aquí una selección de aquellas investigaciones que destacan por su interés, su capacidad analítica y crítica, su actualidad, su pertinencia y su disciplinada adecuación a una metodología de investigación apropiada para unos estudios que forman parte de las Ciencias Sociales. https://www.eumed.net/libros/1851/index.htm

Antileishmanial activity of sp2-iminosugar derivatives

A series of sp2-iminosugar-type glycomimetics bearing S-linked pseudoglycoside substituents (sulfide, sulfoxide and sulfone derivatives) has been synthesized and evaluated as new potential drugs against the protozoan parasite Leishmania, responsible of leishmaniasis, the second most relevant parasitic disease after malaria. All the prepared compounds share a bicyclic 5N,6O-oxomethylidenenojirimycin glyconelike moiety bearing a substitution pattern of configurational complementarity with the natural a-glucosides and incorporate either an n-octyl or n-dodecyl aglycone-like substituent. Not surprisingly, they behaved as potent to moderate competitive inhibitors of a-glucosidase (inhibition constants, Ki, in the range 1.3 to 447 mM). Evaluation of the antileishmanial activity indicated that the dodecyl pseudoglycosides present a significant antiparasitic activity in intracellular amastigotes of Leishmania donovani, the clinically relevant form of the parasite. The antileishmanial effect seems to be associated with the anticancer and proapoptotic activity of the glycomimetics, but not with the a-glucosidase inhibitory efficiency. The (SS)-configured dodecylsulfoxide derivative 4, exhibiting the most favourable activity/toxicity profile, was further assayed in combination treatment with miltefosine, the first oral antileishmanial drug, using the fixed ratio isobologram method. The interaction between derivative 4 and 0.1, 0.2 and 0.3 mM miltefosine was classified as synergistic, showing combination indices of 0.78, 0.76 and 0.80, respectively. Additionally, a miltefosine resistant Leishmania line and the wild-type strain showed similar susceptibility to derivative 4. The results illustrate the potential of sp2-iminosugar pseudoglycosides as promising prototypes for the development of new therapeutic strategies for leishmaniasisPeer reviewe

The Error of Estimated GFR in Type 2 Diabetes Mellitus

Type 2 diabetes mellitus represents 30–50% of the cases of end stage renal disease worldwide. Thus, a correct evaluation of renal function in patients with diabetes is crucial to prevent or ameliorate diabetes-associated kidney disease. The reliability of formulas to estimate renal function is still unclear, in particular, those new equations based on cystatin-C or the combination of creatinine and cystatin-C. We aimed to assess the error of the available formulas to estimate glomerular filtration rate in diabetic patients. We evaluated the error of creatinine and/or cystatin-C based formulas in reflecting real renal function over a wide range of glomerular filtration rate (from advanced chronic kidney disease to hyperfiltration). The error of estimated glomerular filtration rate by any equation was common and wide averaging 30% of real renal function, and larger in patients with measured glomerular filtration rate below 60 mL/min. This led to chronic kidney disease stages misclassification in about 30% of the individuals and failed to detect 25% of the cases with hyperfiltration. Cystatin-C based formulas did not outperform creatinine based equations, and the reliability of more modern algorithms proved to be as poor as older equations. Formulas failed in reflecting renal function in type 2 diabetes mellitus. Caution is needed with the use of these formulas in patients with diabetes, a population at high risk for kidney disease. Whenever possible, the use of a gold standard method to measure renal function is recommended

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease