Influencia del modelo urbanizador "resort" en los procesos "urban sprawl" y “soil sealing” del levante español: criterios de vulnerabilidad y repercusiones en la Región de Murcia

El turismo se ha convertido en un sector económico estratégico para la generación de riqueza en todo el arco mediterráneo español. Este desarrollo turístico ha supuesto un significativo incremento del suelo residencial producido exclusivamente bajo criterios que responden a pautas definidas por los mercados inmobiliarios. Una mala praxis en materia de ordenación del territorio en combinación con un modelo de desarrollo turístico poco sostenible ha desencadenado severos impactos ambientales de carácter irreversible sobre el medio natural y sociocultural. Entre estos impactos destacan aquellos derivados de los cambios de usos de suelo tradicionales a usos vinculados a una urbanización descontrolada “urban sprawl”, proceso que a su vez origina un efecto de gran magnitud e importancia como es el sellado de suelo “soil sealling” o pérdida funcional del suelo para el desarrollo de otros usos, como el agrícola y ganadero. En este contexto global debemos definir estrategias que favorezcan una interacción sostenible entre “territorio y turismo” sobre la base de nuevos modelos de desarrollo turístico. El presente estudio tiene por objeto analizar cómo la no integración del recurso suelo en el planeamiento municipal y supramunicipal está dando origen a severos problemas económicos, ambientales y sociales que deben ser tenidos en cuenta en la planificación territorial. La finalidad de este estudio es mostrar la aplicabilidad de “soil sealing” y “urban sprawl” como indicadores de una adecuada o inadecuada planificación territorial, así como analizar la evolución de ambos procesos vinculados al modelo turístico actual en una zona geográfica concreta seleccionada en la Región de Murcia entre el año 2002 y 2012.Peer Reviewe

Trends in hospitalisation for urinary tract infection in adults aged 18-65 by sex in Spain: 2000 to 2015

Objective: To analyse trends in urinary tract infection (UTIs) hospitalisation among patients adults 18-65 aged in Spain from 2000-2015. Methods: Retrospective observational study using the Spanish Hospitalisation Minimum Data Set (CMBD), with codifications by the International Classification of Diseases (ICD-9). Variables: Type of UTIs (pyelonephritis, prostatitis, cystitis and non-specific-UTIs), sex, age (in 5 categories: 18-49 and 50-64 years in men, and 18-44, 45-55 and 56-64 years in women), comorbidity, length of stay, costs and mortality associated with admission. The incidence of hospitalisation was studied according to sex, age group and type of UTIs per 100,000. Trends were identified using Joinpoint regression. Results: From 2000-2015, we found 259,804 hospitalisations for UTIs (51.6% pyelonephritis, 7.5% prostatitis, 0.6% cystitis and 40.3% non-specific UTIs). Pyelonephritis predominated in women and non-specific UTIs in men. The hospital stay and the average cost (2,160 EUR (IQR 1,7872,540 were greater in men. Overall mortality (0.4%) was greater in non-specific UTIs. More women were admitted (rates of 79.4 to 81.7) than in men (30.2 to 41). The greatest increase was found in men aged 50-64 years (from 59.3 to 87). In the Joinpoint analysis, the incidence of pyelonephritis increased in women [AAPC 2.5(CI 95% 1.6;3.4)], and non-specific UTIs decreased [AAPC -2.2(CI 95% -3.3;-1.2)]. Pyelonephritis decreased in men [AAPC -0.5 (CI 95% -1.5;0.5)] and non-specific UTIs increased [AAPC 2.3 (CI 95% 1.9;2.6)] and prostatitis increased [AAPC 2.6 (CI 95% 1.4;3.7)]. Conclusions: The urinary infection-related hospitalisation rate in adults in Spain increased during the period 2000-2015. Pyelonephritis predominated in women and non-specific UTIs in men. The highest hospitalisation rates occurred in the women but the greatest increase was found in men aged 65-74. The lenght of stay and cost were higher in men.This study is funded by the Instituto de Salud Carlos III (ISCIII) through project PI19/01700 and RD21/0016/0027, co-funded by the European Union through funds from the European Recovery Instrument ("Next Generation EU"), in the framework of the Recovery, Transformation and Resilience Plan. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript".S

Cognitive Function with PCSK9 Inhibitors: A 24-Month Follow-Up Observational Prospective Study in the Real World—MEMOGAL Study

Introduction The cognitive safety of monoclonal antibody proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) has been established in clinical trials, but not yet in real-world observational studies. We assessed the cognitive function in patients initiating PCSK9i, and differences in cognitive function domains, to analyze subgroups by the low-density lipoprotein cholesterol (LDL-C) achieved, and differences between alirocumab and evolocumab. Methods This has a multicenter, quasi-experimental design carried out in 12 Spanish hospitals from May 2020 to February 2023. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Results Among 158 patients followed for a median of 99 weeks, 52% were taking evolocumab and 48% alirocumab; the mean change from baseline in MoCA score at follow-up was + 0.28 [95% CI (− 0.17 to 0.73; p = 0.216)]. There were no significant differences in the secondary endpoints—the visuospatial/executive domain + 0.04 (p = 0.651), naming domain − 0.01 (p = 0.671), attention/memory domain + 0.01 (p = 0.945); language domain − 0.10 (p = 0.145), abstraction domain + 0.03 (p = 0.624), and orientation domain − 0.05 (p = 0.224)—but for delayed recall memory the mean change was statistically significant (improvement) + 0.44 (p = 0.001). Neither were there any differences in the three stratified subgroups according to lowest attained LDL-C level—0–54 mg/dL, 55–69 mg/dL and ≥ 70 mg/dL; p = 0.454—or between alirocumab and evolocumab arms. Conclusion We did not find effect of monoclonal antibody PCSK9i on neurocognitive function over 24 months of treatment, either in global MoCA score or different cognitive domains. An improvement in delayed recall memory was shown. The study showed no differences in the cognitive function between the prespecified subgroups, even among patients who achieved very low levels of LDL-C. There were no differences between alirocumab and evolocumab. Registration ClinicalTtrials.gov Identifier number NCT04319081Open Access funding provided thanks to the CRUE-CSIC agreement with Springer NatureS