The economic crisis and the challenge of trade liberalization

El panorama económico presentado por la crisis mundial nos hace retroceder en el tiempo. Las tentaciones proteccionistas nos hacen volver la vista a un pasado en el que los países cerraron sus fronteras en un intento de proteger sus economías. Pero este viaje en el tiempo únicamente nos sirve para poner en marcha las alertas y avanzar para alejarnos de ese escenario. Este artículo analiza cómo han evolucionado los flujos comerciales desde el estallido de la crisis en el año 2007 y examina los movimientos proteccionistas de los países en el marco de la Organización Mundial del Comercio con la mirada puesta en la posibilidad de concluir la Ronda Doha.The economic outlook that the global crisis has generated makes us go back in time. Protectionist temptations make us look back to a past in which countries closed their borders in an attempt to protect their economies. But this time travel only serves to implement and advance warnings to stay away from that scenario. This article analyzes how trade flows have evolved since the outbreak of the crisis in 2007 and examines countries’ protectionist movements under the World Trade Organization with a glance toward the possibility of concluding the Doha Round

Fernando Huarte Morton (1921-2011): libro homenaje

La figura de Fernando Huarte Morton (1921-2011) tiene un gran significado para el mundo de las bibliotecas, el libro antiguo y la bibliografía española y goza de un profundo respeto, simpatía y admiración para todos aquellos que le conocieron y trataron personalmente. Desarrolló la mayor parte de su carrera profesional en la Biblioteca de la Universidad Complutense de Madrid, de la que fue director entre 1975 y 1986, contribuyendo a su modernización desde varios ámbitos: el reconocimiento institucional; la profesionalización del personal; la centralización de los fondos; la normalización de los procesos y servicios; el inicio de la mecanización del catálogo y la preocupación por el fondo antiguo y por la existencia de un edificio para albergar la gran biblioteca general. Con estas acciones, las bases de la biblioteca del siglo XXI estaban puestas. Es por este motivo, que la Biblioteca de la Universidad Complutense, institución a la que dedicó tantos años de su vida, quiera rendirle un sentido homenaje a través de la publicación de este libro en el que participan muchos de los bibliotecarios que le conocieron y que han querido dar a conocer su profesionalidad como bibliotecario, su rigor científico como estudioso e investigador y su atrayente personalidad llena de sentido del humor y de ironía

Oxigenación con membrana extracorpórea en el paciente COVID-19: resultados del Registro Español ECMO-COVID de la Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE)

Background and aim: COVID-19 patients with severe heart or respiratory failure are potential candidates for extracorporeal membrane oxygenation (ECMO). Indications and management of these patients are unclear. Our aim is to describe the results of a prospective registry of COVID-19 patients treated with ECMO. Methods: An anonymous prospective registry of COVID-19 patients treated with veno-arterial (V-A) or veno-venous (V-V) ECMO was created on march 2020. Clinical, analytical and respiratory preimplantation variables, implantation data and post-implantation course data were recorded. The primary endpoint was all cause in-hospital mortality. Secondary events were functional recovery and the combined endpoint of mortality and functional recovery in patients followed at least 3 months after discharge. Results: Three hundred and sixty-six patients from 25 hospitals were analyzed, 347 V-V ECMO and 18 V-A ECMO patients (mean age 52.7 and 49.5 years respectively). Patients with V-V ECMO were more obese, had less frequently organ damage other than respiratory failure and needed less inotropic support; Thirty three percent of V-A ECMO and 34.9% of V-A ECMO were discharged (P = NS). Hospital mortality was non-significantly different, 56.2% versus 50.9% respectively, mainly during ECMO therapy and mostly due to multiorgan failure. Other 51 patients (14%) remained admitted. Mean follow-up was 196 +/- 101.7 days (95%CI: 170.8-221.6). After logistic regression, body weight (OR 0.967, 95%CI: 0.95-0.99, P = 0.004) and ECMO implantation in the own centre (OR 0.48, 95%CI: 0.27-0.88, P = 0.018) were protective for hospital mortality. Age (OR 1.063, 95%CI: 1.005-1.12, P = 0.032), arterial hypertension (3.593, 95%CI: 1.06-12.19, P = 0.04) and global (2.44, 95%CI: 0.27-0.88, P = 0.019), digestive (OR 4,23, 95%CI: 1.27-14.07, P = 0.019) and neurological (OR 4.66, 95%CI: 1.39-15.62, P = 0.013) complications during ECMO therapy were independent predictors of primary endpoint occurrence. Only the post-discharge day at follow-up was independent predictor of both secondary endpoints occurrence. Conclusions: Hospital survival of severely ill COVID-19 patients treated with ECMO is near 50%. Age, arterial hypertension and ECMO complications are predictors of hospital mortality, and body weight and implantation in the own centre are protective. Functional recovery is only predicted by the follow-up time after discharge. A more homogeneous management of these patients is warranted for clinical results and future research optimization. (C) 2022 Sociedad Espanola de Cirugia Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U

Effectiveness, safety/tolerability of OBV/PTV/r ± DSV in patients with HCV genotype 1 or 4 with/without HIV-1 co-infection, chronic kidney disease (CKD) stage IIIb-V and dialysis in Spanish clinical practice - Vie-KinD study

Limited data are available on the effectiveness and tolerability of direct-acting antivirals (DAAs) therapies in the real world for HCV-infected patients with comorbidities. This study aimed to describe the effectiveness of OBV/PTV/r ± DSV (3D/2D regimen) with or without ribavirin (RBV) in HCV or HCV/HIV co-infected patients with GT1/GT4 and CKD (IIIb-V stages), including those under hemodialysis and peritoneal dialysis in routine clinical practice in Spain in 2015.Non-interventional, retrospective, multicenter data collection study in 31 Spanish sites. Socio-demographic, clinical variables, study treatment characteristics, effectiveness and tolerability data were collected from medical records.Data from 135 patients with a mean age (SD) of 58.3 (11.4) years were analyzed: 92.6% GT1 (81.6% GT1b and 17.6% GT1a) and 7.4% GT4, 14 (10.4%) HIV/HCV co-infected, 19.0% with fibrosis F3 and 28.1% F4 by FibroScan®, 52.6% were previously treated with pegIFN and RBV. 11.1%, 14.8% and 74.1% of patients had CKD stage IIIb, IV and V respectively. 68.9% of patients were on hemodialysis; 8.9% on peritoneal dialysis and 38.5% had history of renal transplant. A total of 125 (96.2%) of 135 patients were treated with 3D, 10 (7.4%) with 2D and 30.4% received RBV. The overall intention-to-treat (ITT) sustained virologic response at week 12 (SVR12) was 92.6% (125/135) and the overall modified-ITT (mITT) SVR12 was 99.2% (125/126). The SVR12 rates (ITT) per sub-groups were: HCV mono-infected (91.7%), HCV/HIV co-infected (100%), GT1 (92.0%), GT4 (100%), CKD stage IIIb (86.7%), stage IV (95%) and stage V (93%). Among the 10 non-SVR there was only 1 virologic failure (0.7%); 4 patients had missing data due lost to follow up (3.0%) and 5 patients discontinued 3D/2D regimen (3.7%): 4 due to severe adverse events (including 3 deaths) and 1 patient´s decision.These results have shown that 3D/2D regimens are effective and tolerable in patients with advanced CKD including those in dialysis with GT 1 or 4 chronic HCV mono-infection and HIV/HCV coinfection in a real-life cohort. The overall SVR12 rates were 92.6% (ITT) and 99.2% (mITT) without clinically relevant changes in eGFR until 12 weeks post-treatment. These results are consistent with those reported in clinical trials

All-cause mortality in the cohorts of the Spanish AIDS Research Network (RIS) compared with the general population: 1997Ł2010

Abstract Background: Combination antiretroviral therapy (cART) has produced significant changes in mortality of HIVinfected persons. Our objective was to estimate mortality rates, standardized mortality ratios and excess mortality rates of cohorts of the AIDS Research Network (RIS) (CoRIS-MD and CoRIS) compared to the general population. Methods: We analysed data of CoRIS-MD and CoRIS cohorts from 1997 to 2010. We calculated: (i) all-cause mortality rates, (ii) standardized mortality ratio (SMR) and (iii) excess mortality rates for both cohort for 100 personyears (py) of follow-up, comparing all-cause mortality with that of the general population of similar age and gender. Results: Between 1997 and 2010, 8,214 HIV positive subjects were included, 2,453 (29.9%) in CoRIS-MD and 5,761 (70.1%) in CoRIS and 294 deaths were registered. All-cause mortality rate was 1.02 (95% CI 0.91-1.15) per 100 py, SMR was 6.8 (95% CI 5.9-7.9) and excess mortality rate was 0.8 (95% CI 0.7-0.9) per 100 py. Mortality was higher in patients with AIDS, hepatitis C virus (HCV) co-infection, and those from CoRIS-MD cohort (1997. Conclusion: Mortality among HIV-positive persons remains higher than that of the general population of similar age and sex, with significant differences depending on the history of AIDS or HCV coinfection

Prevention of type 2 diabetes in prediabetic patients by using functional olive oil enriched in oleanolic acid: The PREDIABOLE study, a randomized controlled trial

26 Páginas.-- 3 Tablas.-- 2 FigurasAim To assess whether the regular intake of an oleanolic acid (OA)‐enriched olive oil is effective in the prevention of diabetes. Methods In the PREDIABOLE study, prediabetic individuals (impaired fasting glucose and impaired glucose tolerance) of both sexes (176 patients, aged 30‐80 years) were randomized to receive 55 mL/day of OA‐enriched olive oil (equivalent dose 30 mg OA/day) [intervention group (IG)] or the same oil not enriched [control group (CG)]. The main outcome was the incidence of new‐onset type 2 diabetes in both groups. Results Forty‐eight new diabetes cases occurred, 31 in the CG and 17 in the IG. The multivariate‐adjusted hazard ratio was 0.45 (95% CI, 0.24‐0.83) for the IG compared with the CG. Intervention‐related adverse effects were not reported. Conclusions The intake of OA‐enriched olive oil reduces the risk of developing diabetes in prediabetic patients. The results of the PREDIABOLE study promote the use of OA in new functional foods and drugs for the prevention of diabetes in individuals at risk of developing it.The authors especially thank the ACESUR Group (Dos Hermanas, Seville, Spain), which donated all the commercial olive oil for the trial. This collaborator had no role in the design, collection, analysis or interpretation of the data or in the decision to submit the manuscript for publication. The authors also express their gratitude to Dr. Alberto Gil‐Peralta, Neurology Service of the Virgen del Rocío University Hospital (Seville, Spain), for the critical reading of the manuscript and his helpful comments. CIBEROBN is an initiative of Instituto de Salud Carlos III (ISCIII), Madrid, Spain. The PREDIABOLE study was supported by the official funding agency for biomedical research of the Spanish Government, ISCIII, through the Fondo de Investigación para la Salud (FIS), which is co‐funded by the European Regional Development Fund, including the following projects: PI10/00913 (led by J.M.S.‐L.) and PI10/01415 (led by J.A.C.). The study was also supported by a grant of Consejería de Salud de la Junta de Andalucía (PI‐0037/2008, led by J.M.S.‐L.). None of the funding sources took part in the design, collection, analysis or interpretation of the data or in the decision to submit the manuscript for publication.Peer reviewe

Prevention of the Type 2 Diabetes by using Functional Olive Oil Enriched in Oleanolic Acid: The Prediabole Study: A Randomised Controlled Trial

Trabajo presentado en el 17th Euro Fed Lipid Congress And Expo (Oils, fats, and lipids. Driving science and technology to new horizons), celebrado en Sevilla del 20 al 23 de octubre de 2019.Diabetes, one of the most prevalent chronic diseases, represents a major public health problem worldwide. In 2017, there were 425 million diabetic people in 2017, and a significant increase in the prevalence is expected in the next years, estimating that the number of diabetics in the world will achieve 629 million in 2045. An essential topic of diabetes approach is prevention, especially in people at high risk. Oleanolic acid (OA), a natural component of olive (Olea europaea L.), has demonstrated antidiabetic action in vitro and in experimental animals. However, a similar action had not been proved in humans. The PREDIABOLE (PREvention of DIABetes with OLEanolic acid) Study is a randomised and controlled trial, entirely performed in primary care, designed to assess whether the regular intake of an OA-enriched olive oil is effective in the prevention of diabetes. Diabetes is preceded by a period of dysglycemia, known as prediabetes, in which plasma glucose is higher than normal but not meet the criteria for diabetes. Prediabetes is defined by impaired fasting glucose (IFG), and/or impaired glucose tolerance (IGT) and/or a glycated hemoglobin (HbA1C) in the range 5.7¿6.4% (39¿47 mmol/mol). Prediabetes is associated with obesity, dyslipidemia and hypertension. Compared to euglycemics, people with both IFG and IGT have 20-fold higher risk of developing type 2 diabetes at short time. Therefore, they are ideal target population to investigate new preventive strategies against diabetes. In PREDIABOLE, prediabetic individuals (IFG + IGT) of both sex (176 patients, 30-80 years old) were randomised to receive OA-enriched olive oil (equivalent-dose 30 mg OA/day) (intervention group; IG) or the same oil not enriched (control group; CG). The main outcome was the incidence of new onset type 2 diabetes in both groups. After a median 27.5 months of follow-up, 48 new diabetes cases occurred, 31 in the CG and 17 in the IG. Multivariate adjusted hazard ratio was 0.45 (95% CI, 0.24-0.83) for the IG when compared with the CG. Intervention-related adverse effects were not reported. In conclusion, the PREDIABOLE Study demonstrates that the intake of an OA-enriched olive oil results in a substantial risk reduction of developing type 2 diabetes in prediabetic patients. Furthermore, this dietary intervention is well accepted by the population and also safe and palatable, showing high potential to be long-term sustainable. The burst of diabetes prevalence demands urgent measures delaying or avoiding the appearance of the disease. In this scenario, the use of OA-enriched functional foods is an interesting strategy. Nevertheless, further research is needed to consolidate the evidence of PREDIABOLE and to extend the use of OA in the design of new foods and drugs. Clinical Trial Registration: Current Controlled Trials number ISRCTN0337266

Cuadernos sobre salud y buen trato a la infancia y adolescencia en Andalucía

Publicado en la plataforma de la Red Sabia (Red de Salud y Buen Trato a la Infancia y la Adolescencia. http://www.redsabia.org/) de la Consejería de Igualdad, Salud y Políticas SocialesContiene: Cuaderno I: Intervención Integral desde salud ante el maltrato infantil. Enfoque de derechos de la Infancia; y, Cuaderno II: ¿Qué deben saber quienes trabajan en el sistema sanitario sobre el maltrato infantil?YesEstos cuadernos de trabajo sobre salud y buen arato a la infancia en Andalucía tienen por objetivo aportar un enfoque, un método de trabajo y unos instrumentos para mejorar y reforzar la reflexión y la práctica profesional relacionada con la prevención del maltrato infantil y la promoción del buen trato en la atención sanitaria a los niños, niñas y adolescentes, así como un tratamiento integral y de calidad a las víctimas infantiles de cualquier forma de violencia ejercida sobre ellos, siempre en colaboración con aquellas otras instituciones que configuran el sistema de atención a la infancia en Andalucía