Lead(II) complexes of lateral macrobicyclic receptors that incorporate a crown moiety and a pyridine head unit

[Abstract] The coordinative properties towards lead(II) of two lateral macrobicyclic receptors that incorporate either a 1,10‐diaza‐[15]crown‐5 (L7) or a 4,13‐diaza‐[18]crown‐6 (L8) fragment are reported. Spectrophotometric titrations performed in acetonitrile solution indicate only the formation of mononuclear complexes in solution. The X‐ray crystal structures of the two receptors show that the conformation adopted by the ligand is imposed by the presence of intramolecular hydrogen‐bonding interactions that involve the secondary amine groups and the pivotal nitrogen atoms. The solid‐state structure of [Pb(L7)(NCS)](SCN)·0.5H2O shows that the metal ion is asymmetrically coordinated inside the macrobicyclic cavity. The PbII ion is coordinated to the nitrogen atom of the pyridine unit, the two secondary amine atoms, two oxygen atoms of the crown moiety, and a nitrogen atom of an isothiocyanate group. The distances between the PbII ion and the two pivotal nitrogen atoms as well as one of the oxygen atoms of the crown moiety are too long (>2.92 Å) to be considered unequivocal bonds, and should be regarded only as weak interactions. The protonation constants of L7 and L8 as well as the stability constants of their PbII complexes were investigated by using potentiometric titrations in 95 % methanol (I = 0.1 M, nBu4NClO4, 25 °C). The two receptors undergo two protonation processes in the pH range investigated (2.0 < pH < 12.0), which correspond to the protonation of the nitrogen atoms of the oxa–aza moiety. The log KPbL value obtained for L7 [9.906(1)] is approximately 1.1 log K units higher than the one determined for L8 [8.75(1)].Xunta de Galicia; PGIDIT06TAM10301PRXunta de Galicia; INCITE09E1R103013E

EN-DALBACEN 2.0 Cohort: real-life study of dalbavancin as sequential/consolidation therapy in patients with infective endocarditis due to Gram-positive cocci

Objectives: Infective endocarditis (IE) has high mortality and morbidity and requires long hospital stays to deliver the antibiotic treatment recommended in clinical practice guidelines. We aimed to analyse the health outcomes of the use of dalbavancin (DBV) in the consolidation treatment of IEs caused by Gram-positive cocci and to perform a pharmacoeconomic study. Materials and methods: This observational, retrospective, Spanish multicentre study in patients with IE who received DBV as part of antibiotic treatment in consolidation phase were followed for at least 12 months. The study was approved by the Provincial Committee of the coordinating centre. Results: The study included 124 subjects, 70.2% male, with a mean age of 67.4 years and median Charlson index of 4 (interquartile range: 2.5-6). Criteria for definite IE were met by 91.1%. Coagulase-negative staphylococci (38.8%), Staphylococcus aureus (22.6%), Enterococcus faecalis (19.4%), and Streptococcus Spp. (9.7%) were isolated more frequently, all susceptible to vancomycin. Before DVB administration, 91.2% had undergone surgery; 60.5% had received a second regimen for 24.5 d (16.6-56); and 20.2% had received a third regimen for 14.5 d (12-19.5). DBV was administered to facilitate discharge in 95.2% of cases. At 12 months, the effectiveness was of 95.9%, and there was 0.8% loss to follow-up, 0.8% IE-related death, and 3.2% relapse. Adverse events were recorded in 3.2%. The hospital stay was reduced by 14 d, and there was a mean savings of 5548.57 €/patient vs. conventional treatments. Conclusion: DBV is highly effective, safe, and cost-effective as consolidation therapy in patients with IE by Gram-positive cocci, with few adverse events

Novelistas del siglo XVII

ContieneGregorio Guadaña / por Antonio Enríquez Gómez.Los tres hermanos / por Francisco Navarrete y Ribera.Eduardo, Rey de Inglaterra / por Diego de Agreda y Vargas.Nadie crea de ligero / por Baltasar Mateo Velázquez.Los primos amantes / por Juan Pérez de Montalván [sic].La venganza á su pesar / por Andrés de Prado.El hermano indiscreto / por Diego de Agreda y Vargas.El castigo de la miseria / por María de Zayas y Sotomayor.El disfrazado / por Alonso de Castillo Solorzan

Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort

Background Acute respiratory distress syndrome (ARDS) can be classified into sub-phenotypes according to different inflammatory/clinical status. Prognostic enrichment was achieved by grouping patients into hypoinflammatory or hyperinflammatory sub-phenotypes, even though the time of analysis may change the classification according to treatment response or disease evolution. We aimed to evaluate when patients can be clustered in more than 1 group, and how they may change the clustering of patients using data of baseline or day 3, and the prognosis of patients according to their evolution by changing or not the cluster.Methods Multicenter, observational prospective, and retrospective study of patients admitted due to ARDS related to COVID-19 infection in Spain. Patients were grouped according to a clustering mixed-type data algorithm (k-prototypes) using continuous and categorical readily available variables at baseline and day 3.Results Of 6205 patients, 3743 (60%) were included in the study. According to silhouette analysis, patients were grouped in two clusters. At baseline, 1402 (37%) patients were included in cluster 1 and 2341(63%) in cluster 2. On day 3, 1557(42%) patients were included in cluster 1 and 2086 (57%) in cluster 2. The patients included in cluster 2 were older and more frequently hypertensive and had a higher prevalence of shock, organ dysfunction, inflammatory biomarkers, and worst respiratory indexes at both time points. The 90-day mortality was higher in cluster 2 at both clustering processes (43.8% [n = 1025] versus 27.3% [n = 383] at baseline, and 49% [n = 1023] versus 20.6% [n = 321] on day 3). Four hundred and fifty-eight (33%) patients clustered in the first group were clustered in the second group on day 3. In contrast, 638 (27%) patients clustered in the second group were clustered in the first group on day 3.Conclusions During the first days, patients can be clustered into two groups and the process of clustering patients may change as they continue to evolve. This means that despite a vast majority of patients remaining in the same cluster, a minority reaching 33% of patients analyzed may be re-categorized into different clusters based on their progress. Such changes can significantly impact their prognosis

Post-Franco Theatre

In the multiple realms and layers that comprise the contemporary Spanish theatrical landscape, “crisis” would seem to be the word that most often lingers in the air, as though it were a common mantra, ready to roll off the tongue of so many theatre professionals with such enormous ease, and even enthusiasm, that one is prompted to wonder whether it might indeed be a miracle that the contemporary technological revolution – coupled with perpetual quandaries concerning public and private funding for the arts – had not by now brought an end to the evolution of the oldest of live arts, or, at the very least, an end to drama as we know it

Estimación del grado de pluripatología en los pacientes atendidos en urgencias : revisión bibliográfica y aplicación clínica

En los países desarrollados, a lo largo de las últimas décadas, la población ha ido envejeciendo. Esto ha provocado un aumento de la pluripatología. Debido a dicho aumento, se han creado varias escalas para estimarla, de las cuales la más utilizada es el Índice de Charlson. Hemos creado una escala para estimar la pluripatología mediante los fármacos que el paciente toma de forma crónica, y pretendemos evaluar su utilidad. Para ello la comparamos con el Índice de Charlson y con la gravedad estimada en el triaje en 299 pacientes mayores de 65 años atentidos en el servicio de Urgencias del HUMV durante el mes de diciembre de 2015. Los resultados obtenidos nos dicen que esta escala tiene una capacidad similar al Índice de Charlson para predecir si los pacientes serán dados de alta o ingresarán en el hospital, incluso parece ser ligeramente mejor. Sin embargo, no consigue ser tan buen predictor como la gravedad estimada en el triaje. En resumen, hemos desarrollado una nueva escala sencilla y rápida de utilizar que nos permite estimar el grado de pluripatología de forma similar al Índice de Charlson.Over the last decades, population in developed countries has been getting older and older. This has caused a huge increase in pluripathology. Due to this increase, several scales have been created to measure it. Charlson Index is the most used of them. We have created a pluripathology measuring scale based on the meds patients take chronically, and we want to evaluate its usefulness. To do so we compare it to Charlson Index, and to the gravitiy estimated in triage in 299 over 65 years old patients attended in HUMV Emergency Room in December 2015. According to the results, our scale is similar to Charlson Index in predicting if patients will be discharged or hospitalized. It even seems to be slightly better. Though, it is not as good as gravity estimated in triage in doing so. To sum up, we have developed a new scale, which is easy and fast to apply, and allows us to estimate the pluripathology degree with more or less the same accuracy than Charlson Index.Grado en Medicin

Planteamiento del diseño arquitectónico del Museo Interactivo del Carnaval Negros y Blancos en el sector de la plaza del carnaval correspondiente a la estrategia urbana IV, inscrita dentro de la propuesta ciudadela del carnaval en la ciudad de San Juan de Pasto

Es claro que la región de Nariño tiene un potencial artesanal y cultural, pero lastimosamente no se encuentran equipamientos importantes que resalten este potencial como tal. A partir de este precepto surge la interrogante ¿cómo se debe proyectar un equipamiento cultural para el desarrollo, enseñanza y preservación del Carnaval de Negros y Blancos, y como mi equipamiento podrá llegar a ser parte de las “red de ciudades creativas” de la UNESCO? Es así como surge el planteamiento de un Museo Interactivo del Carnaval de Negros y Blancos en la ciudad de Pasto, el cual potencialice y venda el carnaval durante los 365 días del año. Pasto puede ser parte de una comunidad universal de cultura, arte y artesanía, de una comunidad donde el carnaval sea uno de tantos elementos para compartir y uno de los tantos pretextos para vivir, y ese es el objetivo de nuestra propuesta, a partir de un planteamiento urbano y arquitectónico, y con todo los valores culturales y simbólicos que nos definen llegar a ser parte de la “Red de Ciudades Creativas” de la UNESCO. A partir de esta iniciativa se pretende promover la cultura a nivel regional o internacional, es decir repensar nuestra ciudad a partir del potencial y, al mismo tiempo necesidad, de “exportar” tradición” e “importar conocimiento”, es repensar nuestra identidad para poder compartirla y llegar a ser parte de una realidad cultural a nivel mundial no sólo por nuestro carnaval sino pensando en todos quienes hacen que nos reconozcan como ciudad artesanal

La velocidad de denominación de letras: el mejor predictor temprano del desarrollo lector en español

This project was a longitudinal study, in 121 children, of the predictive value of naming speed and phonological awareness in learning to read and its alterations. Naming letters best predicted the execution of reading and correctly identified 63% of the children who subsequently showed difficulties in reading speed. Such difficulties have been considered the distinctive trait of dyslexia in Spanish. Some tasks of phonological awareness contributed to explaining reading efficiency and comprehension. Children with a double deficit, in naming speed and phonological awareness, had the worst performance in reading. The evaluation of naming speed at early stages can have important implications on diagnosis and intervention in children with difficulties in learning to read.En este trabajo se estudió longitudinalmente, en 121 niños, el valor predictivo de la velocidad de denominación y las habilidades fonológicas sobre el aprendizaje de la lectura y sus alteraciones. La denominación de letras predijo mejor la ejecución lectora e identificó correctamente a 63% de los niños que posteriormente presentaron dificultades en la velocidad para leer, la cual se ha considerado como el rasgo distintivo de la dislexia en español. Algunas tareas de conciencia fonológica contribuyeron a explicar la eficiencia y la comprensión lectora. Los niños con un doble déficit, en velocidad de denominación y conciencia fonológica, presentaron el peor rendimiento lector. La evaluación de la velocidad de denominación en etapas tempranas puede tener importantes implicaciones para el diagnóstico y la intervención de los niños con dificultades en el aprendizaje de la lectura