Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Os Tributos Vinculados

La división tripartita de los tributos en impuestos, tasas y contribuciones, ha sido materia de controversia. Doctrinalmente hay quienes consideran que la tasa no. es un tributo independiente y es simplemente un precio; otros consideran que lo que se llaman contribuciones no son más que impuestos. El autor considera que la división tripartita de los tributos es indispensable para una apreciación integral de este tema en la hacienda pública. Para comprobar tal hipótesis discurre y analiza los distintos supuestos de configuración del impuesto, la tasa y la contribución y aporta un análisis doctrinal y jurisprudencial para soportar su acerto.A divisão tripartida dos tributos em impostos, taxas e contribuições, tem sido matéria de controvérsia. Doutrinalmente há quem consideram que a taxa não é um tributo independente e és simplesmente um preço; outros consideram que o que se chama contribuições não é mais que impostos. O autor considera que a divisão tripartida dos tributos é indispensável para uma apreciação integral deste tema na fazenda pública. Para comprovar tal hipótese discorre e analisa os diferentes supostos de configuração do imposto, a taxa e a contribuição, e aporta uma análise doutrinal e jurisprudencial para suportar seu acerto.  The tripartite division of tributes on taxes, tax rates, and contributions has been a controversial issue. There exist those who believe that tax rates are not independent tributes, but just prices. Some scholars argue that contributions are not more than taxes. The author considers this classification fundamental for obtaining an integrated vision in the field of Public Revenues. To verify his argument the author looks over and analyzes the different assumptions about the configuration of taxes, tax rates, and contributions. Likewise, the author examines legal doctrines and judicial decisions to support his argument

Os Tributos Vinculados

La división tripartita de los tributos en impuestos, tasas y contribuciones, ha sido materia de controversia. Doctrinalmente hay quienes consideran que la tasa no. es un tributo independiente y es simplemente un precio; otros consideran que lo que se llaman contribuciones no son más que impuestos. El autor considera que la división tripartita de los tributos es indispensable para una apreciación integral de este tema en la hacienda pública. Para comprobar tal hipótesis discurre y analiza los distintos supuestos de configuración del impuesto, la tasa y la contribución y aporta un análisis doctrinal y jurisprudencial para soportar su acerto.A divisão tripartida dos tributos em impostos, taxas e contribuições, tem sido matéria de controvérsia. Doutrinalmente há quem consideram que a taxa não é um tributo independente e és simplesmente um preço; outros consideram que o que se chama contribuições não é mais que impostos. O autor considera que a divisão tripartida dos tributos é indispensável para uma apreciação integral deste tema na fazenda pública. Para comprovar tal hipótese discorre e analisa os diferentes supostos de configuração do imposto, a taxa e a contribuição, e aporta uma análise doutrinal e jurisprudencial para suportar seu acerto.  The tripartite division of tributes on taxes, tax rates, and contributions has been a controversial issue. There exist those who believe that tax rates are not independent tributes, but just prices. Some scholars argue that contributions are not more than taxes. The author considers this classification fundamental for obtaining an integrated vision in the field of Public Revenues. To verify his argument the author looks over and analyzes the different assumptions about the configuration of taxes, tax rates, and contributions. Likewise, the author examines legal doctrines and judicial decisions to support his argument

La armonización tributaria de los impuestos indirectos en los países de la Comunidad Andina: Elaboración de recomendaciones y normativas sobre armonización de tributos indirectos

El presente trabajo es consecuencia del firme propósito de cada uno de los países miembros de la Comunidad Andina (CAN) de adelantar el proceso de integración, uno de cuyos objetivos finales es lograr el desarrollo armónico y equilibrado de los sistemas económicos, políticos y sociales de la región, generando un mejor nivel de vida para sus habitantes. Cada una de las medidas que se aconsejan en este estudio, solo se entenderán bajo este criterio de integración. El objetivo propuesto de alcanzar un mercado común latinoamericano solo se logra a través de un proceso gradual de armonización, político, social y comercial que elimine cualquier distorsión que se presente con motivo de las diferentes regulaciones internas de los países y que los fortalezca de cara a los mercados internacionales. Lo que explica cada una de las etapas de transición que debemos recorrer: zona de libre comercio, unión aduanera, mercado interior y comunidad económica

Los tributos vinculados

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Álvaro Pablo Ortiz - In memoriam

Tuve la grata y enriquecedora oportunidad de conocer al ilustre historiador y humanista Álvaro Pablo Ortiz Rodríguez: un hombre de profunda sensibilidad por las letras y la dialéctica de la historia en quien se personificaron siempre la vocación docente y la generosidad del maestro, en el más estricto sentido de la expresión. Sostuvimos conversaciones inolvidables acerca de la historia en general y las de Colombia y el Colegio Mayor de Nuestra Señora del Rosario en particular, recinto natural de sus cátedras peripatética y formal, en las que siempre percibí una visión aguda y rigurosa sobre los verdaderos rumbos de la biografía del espíritu colectivo

Presentación para Europa (Libro Derecho tributario internacional y supranacional)

The foreword presents the main aspects of the book on International and Supranational Tax law written by Prof. Mauricio Plazas Vega, with a critical review of last developments in the field