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

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

Sixto Cámara y los fundamentos del cálculo de probabilidades

El matemático riojano Sixto Cámara fue pionero en la introducción de la enseñanza de la estadística matemática en la universidad española. En este articulo realizamos un estudio histórico del discurso "El azar y los fundamentos del cálculo de probabilidades', que Cámara pronunció en la apertura del curso académico de 1933 1934 en la Universidad de Valencia. En él, Cámara hace un análisis de la evolución histórica de los fundamentos matemáticos y filosóficos del cálculo de probabilidades. Se trata de una exposición hico documentada, con numerosas citas bibliográficas y un enfoque que, exceptuando algunos matices subjetivos, resalta aquellos aspectos que hoy se consideran más relevantes

El imaginarismo según Rey y Heredia

The philosopher José María Rey y Heredia (1818-1861) wrote in 1865 the book Teoría Transcendental de las Cantidades Imaginarias, which is considered the first significant theory published in Spain about the way to consider complex numbers. Its author developed a metaphysical model of algebra to merge and harmonize philosophy and mathematics by means of imaginary quantities understanding, and taking as reference the Kant's table of categories. En este artículo se exponen los fundamentos filosófico-matemáticos y los resultados matemáticos que recoge la obra de Rey y se analizan en su contexto histórico. The contents of Rey's book are described in this article, from the philosophical and mathematical fundamentals to the mathematical results, analyzing them by taking into account their historical contextLa Teoría trascendental de las cantidades imaginarias (1865), del filósofo José María Rey y Heredia (1818-1861) se considera la primera referencia significativa publicada en España sobre la interpretación de los números complejos. Su autor pretende desarrollar una metafísica del álgebra que aúne y armonice la filosofía con las matemáticas a través de la interpretación de las cantidades imaginarias, basándose en la tabla de las categorías elaborada por Kant

Suma

Resumen de la publicaciónSe analiza un problema clásico como es la división de un segmento en media y extrema razón. El estudio se centra en ilustrar los sucesivos pasos a la hora de interpretar una magnitud. En primer lugar como una longitud, un área o un volumen, a continuación como un segmento y finalmente como un número. Esta evolución refleja el proceso de creación de la geometría analítica. Además estos tres pasos coinciden con las tres fases por las que pasa una disciplina matemática: ingenua, formal y crítica.AragónUniversitat de Barcelona. Biblioteca de Ciències de l'Educació; Passeig de la Vall D'Hebron, 171; 08035 Barcelona; +34934021035; +34934021034;ES

Sixto Cámara y los fundamentos del cálculo de probabilidades

El matemático riojano Sixto Cámara fue pionero en la introducción de la enseñanza de la estadística matemática en la universidad española. En este articulo realizamos un estudio histórico del discurso "El azar y los fundamentos del cálculo de probabilidades', que Cámara pronunció en la apertura del curso académico de 1933 1934 en la Universidad de Valencia. En él, Cámara hace un análisis de la evolución histórica de los fundamentos matemáticos y filosóficos del cálculo de probabilidades. Se trata de una exposición hico documentada, con numerosas citas bibliográficas y un enfoque que, exceptuando algunos matices subjetivos, resalta aquellos aspectos que hoy se consideran más relevantes