Impact of the COVID-19 Pandemic on the Use and Outcomes of Cardiac Procedures in COPD Patients

(1) Background: The aim of this study was to assess the effects of the COVID-19 pandemic on the use and outcomes of cardiac procedures among people with chronic obstructive pulmonary disease (COPD) in Spain. (2) Methods: We used national hospital discharge data to select patients admitted to hospital with a diagnosis of COPD from 1 January 2019 to 31 December 2020. (3) Results: The number of COPD patients hospitalized in 2019 who underwent a cardiac procedure was 4483, 16.2% higher than in 2020 (n = 3757). The length of hospital stay was significantly lower in 2020 than in 2019 (9.37 vs. 10.13 days; p = 0.004), and crude in-hospital mortality (IHM) was significantly higher (5.32% vs. 4.33%; p = 0.035). Multivariable logistic regression models to assess the differences in IHM from 2019 to 2020 showed Odds Ratio (OR) values over 1, suggesting a higher risk of dying in 2020 compared to in 2019. However, the ORs were only statistically significant for “any cardiac procedure” (1.18, 95% CI 1.03–1.47). The Charlson comorbidity index increased IHM for each of the procedures analyzed. The probability of IHM was higher for women and older patients who underwent coronary artery bypass graft or open valve replacement procedures. Suffering a COVID-19 infection was associated with significantly higher mortality after cardiac procedures. (4) Conclusions: The COVID-19 pandemic limited the access to healthcare for patients with COPD.Depto. de Salud Pública y Materno - InfantilFac. de MedicinaTRUEComunidad de MadridUniversidad Complutense de Madridpu

National Trends in Prevalence of Depression in Men and Women with Chronic Obstructive Pulmonary Disease Hospitalized in Spain, 2016–2020

(1) Background: To describe trends in the prevalence of depression in men and women with COPD hospitalized in Spain (2016–2020). (2) Methods: We used a nationwide discharge database to select all patients ≥35 years with COPD. (3) Results: The prevalence of depression was 3.54-times higher in women with COPD than in men (OR 3.54; 95%CI 3.48–3.6). It decreased significantly between 2016 and 2020, although the reduction was only significant in women (12.27% in 2016 vs. 10.56% in 2020). Older age, comorbidity and the most recent years of hospital admission were associated with lower prevalence of depression in both men and women, while obesity, obstructive sleep apnea (OSA) and use of oxygen prior to admission were risk factors. In-hospital mortality (IHM) increased significantly over time. Older age, comorbidity, the use of oxygen prior to admission and having been hospitalized in 2020 increased the risk of IHM. Female sex was associated with a lower IHM in patients with depression and COPD. (4) Conclusions: The prevalence of depression has decreased over time in women with COPD while it has not changed significantly in men with this disease. IHM increased over time both in men and women with COPD and depression, with higher prevalence in the former.Depto. de Salud Pública y Materno - InfantilFac. de MedicinaTRUEComunidad de MadridUniversidad Complutense de MadridUniversidad Complutense de Madrid; Grupo de Investigación en Epidemiología de las Enfermedades Crónicas de Alta Prevalencia en España (970970)Sociedad Española de Neumología y Cirugía de Tóraxpu

Sex Differences in COVID-19 Hospitalization and Hospital Mortality among Patients with COPD in Spain: A Retrospective Cohort Study

We aimed to assess the effect of COPD in the incidence of hospital admissions for COVID-19 and on the in-hospital mortality (IHM) according to sex. (2) Methods: We used national hospital discharge data to select persons aged ≥40 years admitted to a hospital with a diagnosis of COVID-19 in 2020 in Spain. (3) Results: The study population included 218,301 patients. Age-adjusted incidence rates of COVID-19 hospitalizations for men with and without COPD were 10.66 and 9.27 per 1000 persons, respectively (IRR 1.14; 95% CI 1.08–1.20; p < 0.001). The IHM was higher in men than in women regardless of the history of COPD. The COPD was associated with higher IHM among women (OR 1.09; 95% CI 1.01–1.22) but not among men. The COPD men had a 25% higher risk of dying in the hospital with COVID-19 than women with COPD (OR 1.25, 95% CI 1.1–1.42). (4) Conclusions: Sex differences seem to exist in the effect of COPD among patients suffering COVID-19. The history of COPD increased the risk of hospitalization among men but not among women, and COPD was only identified as a risk factor for IHM among women. In any case, we observed that COPD men had a higher mortality than COPD women. Understanding the mechanisms underlying these sex differences could help predict the patient outcomes and inform clinical decision making to facilitate early treatment and disposition decisions.Fac. de Enfermería, Fisioterapia y PodologíaTRUEComunidad de MadridUniversidad Complutense de Madridpu

La integración de los stakeholders en la empresa: identificación de sus principales dimensiones

La importancia de los Stakeholders en el mundo empresarial actual hace que las empresas estén obligadas a tenerlos en cuenta, y les provoca la necesidad de realizar esfuerzos en integrar las demandas de sus grupos de interés (GI) en las políticas y prioridades de la firma para conseguir su satisfacción. Tras analizar los distintos aspectos que se han tenido en cuenta para analizar las relaciones con los Stakeholders, y utilizando tanto el enfoque descriptivo como normativo de la teoría, identificamos tres dimensiones en el proceso de integración de los GI: el conocimiento de los GI, su implicación en la empresa a través de la consulta y la participación y la modificación de políticas y objetivos para adaptarse a sus demandas. Estas dimensiones se identifican especialmente relevantes para conseguir la satisfacción de los grupos de interés.The importance of Stakeholders in the current managerial world is forcing companies to keep them continually in mind. In addition, it causes the necessity of carrying out efforts aimed at integrating stakeholders’ demands into their politics and priorities in order to achieve their satisfaction. After analyzing the different aspects considered in the study of relationships with Stakeholders, and using both a descriptive and normative theory scope, we identify three dimensions in the process of stakeholders´ integration: the knowledge about them, their implication in the company through consulting and participation, and finally, the modification of enterprises’ politics and objectives in order to adapt to their demands. These dimensions are considered to be of special importance in ensuring Stakeholders’ satisfaction

A GSK-3b modulator delays photoreceptor cell death and preserves visual function in the rd10 mouse model of retinitis pigmentosa

1 p.Retinitis pigmentosa (RP) is a heterogeneous group of inherited retinal dystrophies that lead to blindness. Photoreceptor cell death, reactive gliosis and retinal inammation are common features in animal models of the disease. The enzyme Glycogen Synthase Kinase-3 Beta (GSK-3b) is involved in inammatory processes associated to diverse neurodegenerative pathologies. The aim of our study is to test in the rd10 mouse whether the GSK-3b inhibitor VP3.15 (a small heterocyclic molecule) is a potential therapeutic treatment for RP.SAF2013-41059-RPeer reviewe

El efecto indirecto sobre el rendimiento de la integración de los stakeholders

La literatura, tanto desde el enfoque instrumental como normativo de la Teoría de los Stakeholders, ha resaltado la influencia en el resultado de las relaciones con los grupos de interés (GI), pero este efecto se ha analizado de forma directa. En el presente trabajo, desarrollamos la influencia de la integración de los GI en el rendimiento empresarial, no de forma directa sino indirecta, a través de otras capacidades. Exponemos que la integración de los GI influye de forma indirecta sobre el rendimiento a través de otras capacidades empresariales como la innovación o el aprendizaje organizativo. Además, exponemos que este efecto indirecto se produce de dos formas: bien como elemento potenciador de esas capacidades, o bien como activo complementario sobre el resultado.Existent literature, both from the instrumental as well as the normative Stakeholders’ Theory scope, has highlighted the influence of the relationships with the stakeholders on the enterprises´ performance, but this effect has been analyzed from a direct perspective. In the current paper, we develop the influence of the stakeholders’ integration on the enterprises´ performance, not from a direct way but using an indirect perspective, through other capacities such us innovation, or organizational learning. In addition, we argue that this indirect effect takes place in two ways: as a strengthen element of those capacities, or as a complementary asset on performance

Small molecules targeting glycogen synthase kinase 3 as potential drug candidates for the treatment of retinitis pigmentosa

6 p.-5 fig.Retinitis pigmentosa (RP) is an inherited retinal dystrophy that courses with progressive degeneration of retinal tissue and loss of vision. Currently, RP is an unpreventable, incurable condition. We propose glycogen synthase kinase 3 (GSK-3) inhibitors as potential leads for retinal cell neuroprotection, since the retina is also a part of the central nervous system and GSK-3 inhibitors are potent neuroprotectant agents. Using a chemical genetic approach, diverse small molecules with different potency and binding mode to GSK-3 have been used to validate and confirm GSK-3 as a pharmacological target for RP. Moreover, this medicinal chemistry approach has provided new leads for the future disease-modifying treatment of RP.This work has been partially funded by the Spanish MINECO grants (SAF2012-37979-C03-01 to AM and SAF2013-41059-R to EJdlR).Peer reviewe

Variation in assignment of the COPD patients into a GOLD group according to symptoms severity

Introduction: The Global Organization of Lung Disease (GOLD) classifies patients with chronic obstructive pulmonary disease (COPD) taking into account the symptoms. The modified Medical Research Council’s dyspnea scale (mMRC) and the COPD assessment test (CAT) are used to assess these symptoms. In this study, we analyze the concordance of GOLD classification using mMRC and CAT. Patients and Methods: This is an observational study of a cohort of 169 patients with COPD, who were classified following the GOLD 2017 recommendations, using both mMRC and CAT. A concordance analysis was applied, and a ROC curve was generated to identify the CAT score that best concorded with the mMRC scale. Results: The concordance for the GOLD groups classified by CAT and mMRC was moderate (kappa 0.492). For mMRC score of 1 and 2, a CAT score of =9 and =16 showed the maximum value of the Youden index, respectively. By reclassifying the patients with the new cut-off points obtained, the best concordance was obtained between the cut-off point for CAT of 16 and for mMRC of 2, followed by CAT of 9 and mMRC of 1. Conclusion: Because of the deficient concordance between CAT and mMRC, we propose the use of new cut-off points in future updates of the GOLD strategy

Excess hospitalizations and mortality associated with seasonal influenza in Spain, 2008-2018

Influenza may trigger complications, particularly in at-risk groups, potentially leading to hospitalization or death. However, due to lack of routine testing, influenza cases are infrequently coded with influenza-specific diagnosis. Statistical models using influenza activity as an explanatory variable can be used to estimate annual hospitalizations and deaths associated with influenza. Our study aimed to estimate the clinical and economic burden of severe influenza in Spain, considering such models. The study comprised ten epidemic seasons (2008/2009-2017/2018) and used two approaches: (i) a direct method of estimating the seasonal influenza hospitalization, based on the number of National Health Service hospitalizations with influenza-specific International Classification of Diseases (ICD) codes (ICD-9: 487-488; ICD-10: J09-J11), as primary or secondary diagnosis; (ii) an indirect method of estimating excess hospitalizations and deaths using broader groups of ICD codes in time-series models, computed for six age groups and four groups of diagnoses: pneumonia or influenza (ICD-9: 480-488, 517.1; ICD-10: J09-J18), respiratory (ICD-9: 460-519; ICD-10: J00-J99), respiratory or cardiovascular (C&R, ICD-9: 390-459, 460-519; ICD-10: I00-I99, J00-J99), and all-cause. Means, excluding the H1N1pdm09 pandemic (2009/2010), are reported in this study. The mean number of hospitalizations with a diagnosis of influenza per season was 13,063, corresponding to 28.1 cases per 100,000 people. The mean direct annual cost of these hospitalizations was €45.7 million, of which 65.7% was generated by patients with comorbidities. Mean annual influenza-associated C&R hospitalizations were estimated at 34,894 (min: 16,546; max: 52,861), corresponding to 75.0 cases per 100,000 (95% confidence interval [CI]: 63.3-86.3) for all ages and 335.3 (95% CI: 293.2-377.5) in patients aged ≥ 65 years. We estimate 3.8 influenza-associated excess C&R hospitalizations for each hospitalization coded with an influenza-specific diagnosis in patients aged ≥ 65 years. The mean direct annual cost of the estimated excess C&R hospitalizations was €142.9 million for all ages and €115.9 million for patients aged ≥ 65 years. Mean annual influenza-associated all-cause mortality per 100,000 people was estimated at 27.7 for all ages. Results suggest a relevant under-detected burden of influenza mostly in the elderly population, but not neglectable in younger people. The online version contains supplementary material available at 10.1186/s12879-023-08015-3

Trends and Outcomes in Lung Transplantation in Patients with and without Idiopathic Pulmonary Fibrosis in Spain during the Period 2016–2020.

Background: This paper aims to assess temporal trends (2016–2020) in incidence, patient’s characteristics, complications, length of hospital stay (LOHS) and in-hospital mortality (IHM) among patients with and without idiopathic pulmonary fibrosis (IPF) undergoing lung transplantation (LTx). We also analyse the effect of the COVID-19 pandemic on LTx in these populations. (2) Methods: A retrospective, population-based observational study was conducted using the Spanish National Hospital Discharge Database. Multivariable adjustment was conducted with logistic regression to analyse the IHM. (3) Results: We identified 1777 admissions for LTx during the study period, of which 573 (32.2%) were performed in patients with IPF. The number of hospital admissions for LTx rose from 2016 to 2020, both in patients with and without IPF, but a marked reduction was observed from year 2019 to year 2020. Over time, the proportion of single LTx decreased and bilateral LTx increased significantly in both groups. The incidence of LTx complications increased significantly over time along with the increase in the incidence of IPF. No significant differences in the incidence of complications or in the IHM between patients with and without IPF were found. Suffering any complication of the LTx and pulmonary hypertension were conditions positively associated with IHM in patients with and without IPF. The IHM remained stable from 2016 to 2020 in both study populations and was not affected by the COVID pandemic. (4) Conclusions: Patients with IPF account for almost a third of all lung transplants. The number of LTx increased over time in patients with and without IPF, but a marked reduction was observed from 2019 to 2020. Although the proportion of LTx complications increased significantly over time in both groups, the IHM did not change. IPF was not associated with increased complications or IHM after LTx.Partial funding for open access charge: Universidad de Málag