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Patrones de presión arterial de 24 horas en pacientes con insuficiencia cardiaca estable. Prevalencia y factores asociados
No full textIntroduction and objectives
Hypertension is highly common in heart failure (HF). However, there is limited information on its prevalence, circadian variation, and relationship with the various HF phenotypes. The objective of this study was to describe the prevalence of hypertension and its patterns in HF.
Methods
This was a cross-sectional observational study of patients with optimized stable chronic HF. The patients underwent blood pressure (BP) measurement in the office and 24-hour ambulatory monitoring. We estimated the prevalence of hypertension, and its diurnal (controlled, uncontrolled, white coat, and masked) and nocturnal (dipper, nondipper, and reverse dipper) patterns. We also analyzed the factors associated with the different patterns and HF phenotypes.
Results
From 2017 to 2021, 266 patients were included in the study (mean age, 72±12 years, 67% male, 46% with reduced ejection fraction). Hypertension was present in 83%: controlled in 68%, uncontrolled in 10%, white coat in 10%, and masked in 11%. Among patients with high office BP, 51% had white coat hypertension. Among those with normal office BP, 14% had masked hypertension. The prevalence of dipper, nondipper, and reverse dipper patterns was 31%, 43%, and 26%, respectively. Systolic BP was lower in HF with reduced ejection fraction than in HF with preserved ejection fraction (P <.001).
Conclusions
Ambulatory BP monitoring in HF identified white coat hypertension in more than half of patients with high office BP and masked hypertension in a relevant percentage of patients. The distribution of daytime patterns was similar to that of the population without HF in the literature, but most of the study patients had a pathological nocturnal pattern.Introducción y objetivos
La hipertensión arterial (HTA) está muy presente en la insuficiencia cardiaca (IC). Sin embargo, su prevalencia, su variación circadiana y la relación con los fenotipos de IC es poco conocida. Nuestro objetivo es describir esta prevalencia y sus patrones en la IC.
Métodos
Estudio observacional y transversal sobre la IC crónica estable optimizada. Se obtuvo la presión arterial (PA) en consulta y monitorización ambulatoria durante 24 h. Se estimó la prevalencia de HTA, sus patrones diurnos (controlada, no controlada, de bata blanca y enmascarada) y nocturnos (dipper, nondipper y reverse dipper). Se analizaron factores asociados con patrones y fenotipos de IC.
Resultados
Entre 2017 y 2021, se incluyó a 266 pacientes con una media de edad de 72±12 años; el 67% eran varones y el 46% tenían IC con FEVI reducida. El 83% tenía HTA: el 68% controlada, el 10% no controlada, el 10% de bata blanca y el 11% enmascarada. El 51% de los pacientes con BP elevada en consulta resultaron en HT de bata blanca. El 14% de los pacientes con BP normal en consulta tenían HT enmascarada. Las prevalencias de dipper, nondipper y reverse dipper fueron del 31, el 43 y el 26% respectivamente. La BP sistólica fue menor en la IC con FEVI reducida que en la IC con FEVI conservada (p <0,001).
Conclusiones
La monitorización ambulatoria de la BP en IC identificó HT de bata blanca en más de la mitad de los pacientes con BP elevada en consulta y un porcentaje relevante de HT enmascarada. La distribución de patrones diurnos fue similar a la de la población sin IC descrita. Sin embargo, la mayoría tuvo un patrón nocturno patológico.Sin financiación5.9 Q1 JCR 20220.442 Q3 SJR 2022No data IDR 2022UE
Heart failure risk scores in advanced heart failure patients: insights from the LEVO-D registry
No full textAims: The prevalence of advanced heart failure (HF) is increasing due to the growing number of patients with HF and their better treatment and survival. There is a scarcity of data on the accuracy of HF web-based risk scores in this selected population. This study aimed to assess mortality prediction performance of the Meta-Analysis Global Group in Chronic HF (MAGGIC-HF) risk score and the model of the Barcelona Bio-HF Risk Calculator (BCN-Bio-HF) containing N terminal pro brain natriuretic peptide in HF patients receiving intermittent inotropic support with levosimendan as destination therapy.
Methods and results: Four hundred and three advanced HF patients from 23 tertiary hospitals in Spain receiving intermittent inotropic support with levosimendan as destination therapy were included. Discrimination for all-cause mortality was compared by area under the curve (AUC) and Harrell's C-statistic at 1 year. Calibration was assessed by calibration plots comparing observed versus expected events based on estimated risk by each calculator. The included patients were predominantly men, aged 71.5 [interquartile range 64-78] years, with reduced left ventricular ejection fraction (27.5 ± 9.4%); ischaemic heart disease was the most prevalent aetiology (52.5%). Death rate at 1 year was 26.8%, while the predicted 1-year mortality by BCN-Bio-HF and MAGGIC-HF was 17.0% and 22.1%, respectively. BCN-Bio-HF AUC was 0.66 (Harrell's C-statistic 0.64), and MAGGIC-HF AUC was 0.62 (Harrell's C-statistic 0.61).
Conclusions: The two evaluated risk scores showed suboptimal discrimination and calibration with an underestimation of risk in advanced HF patients receiving levosimendan as destination therapy. There is a need for specific scores for advanced HF.Orion Pharma (web-based data base)3.8 Q2 JCR 20220.899 Q1 SJR 2022No data IDR 2022UE
Aprendizaje basado en retos en el alumnado de gestión deportiva: una propuesta educativa para la mejora de la solución de problemas en la empresa
No full textLa educación superior se encuentra en constante evolución y adapta-ción, y la búsqueda de nuevas metodologías de enseñanza efectivas es una prioridad para muchos docentes involucrados en el proceso de enseñanza-aprendizaje de sus discentes. Algunas de estas metodolo-gías activas, tienen como el objetivo principal acercar a los alumnos a diferentes situaciones, similares o iguales al mundo laboral, con el finde de que éstos adquieran competencias que los ayuden a enfren-tarse, en un futuro, a distintos escenarios. Estas metodologías de inno-vación docente, están orientadas a la mejora de la formación integral de los alumnos universitarios, favoreciendo la conexión con diferentes entornos profesionales vinculados a sus estudios y facilitando que, la transición del ámbito académico al empresarial, sea más óptima y real.Sin financiaciónSPI 2022UE
A house for the Anonymous. Towards a dignified social dwelling. BBPR and Le Grazie district in Legnano
No full textEl Quartiere de Le Grazie en Legnano, fue el primer proyecto de vivienda social del estudio BBPR (Banfi, Belgiojoso, Peressutti y Rogers), construido entre 1939 y 1942. El proyecto constituyó un laboratorio de ideas donde reflexionar sobre la vivienda colectiva, con un punto crítico del racionalismo, para establecer los principios de una nueva arquitectura moderna que respondiera a un habitar social digno. El objetivo del artículo es recoger las bases enunciadas por BBPR para la proyección de vivienda social y ofrecer un instrumental que cualifique el espacio doméstico popular. La investigación se desarrolla a partir de la documentación original del proyecto básico obtenida en el archivo histórico de Legnano, así como fotografías y croquis de la autora. La estructura del texto responde a estos mecanismos del proyecto establecidos por el estudio para el diseño de sus propuestas: el orden, el espacio común, el hogar y la forma construida. Finalmente se reflexiona sobre las herramientas resultantes del desarrollo del proyecto, su aplicación y vigencia en el resto de los proyectos de vivienda social del estudio.Le Grazie district in Legnano, Italy, was the first social housing project of the BBPR studio (Banfi, Belgiojoso, Peressutti and Rogers), built between 1939 and 1942. The project constituted a laboratory of ideas in which to reflect on collective housing, with a critical view of rationalism, in order to establish the principles of a new modern architecture that would respond to a dignified social habitat. The aim of this article is to take up the bases enunciated by BBPR for the design of social housing and to offer an instrument that qualifies the popular domestic space. The research is based on the original documentation of the basic project obtained from the historical archive of Legnano, as well as photographs and sketches by the author. The structure of the text responds to these project mechanisms established by the studio for the design of its proposals: order, common space, the home, and the built form. Finally, it reflects on the tools resulting from the development of the project, their application, and their validity in the rest of the studio's social projects.Sin financiaciónNo data JCR 2022No data SJR 20220,02 C4 IDR 202
From convent to nursing home. Cloisters to maintain memory
No full textMonasterios y conventos constituyen parte fundamental del patrimonio histórico en Europa. Sin embargo, en muchos casos son islas no habitadas en áreas de densidad media o alta; estructuras de grandes dimensiones con espacios interiores y exteriores de gran valor arquitectónico, que han albergado comunidades autosuficientes en el pasado. El artículo mira a la realidad con el pasado presente; en primer lugar se introduce el desarrollo del tipo arquitectónico de claustro para la vida comunitaria; posteriormente se construye el marco teórico en el que se sustenta el paralelismo conceptual entre el deseo de retirada que buscaba el colectivo monástico, y el fenómeno de la jubilación (retirement) del estado de bienestar; finalmente se analizan varios casos de conventos históricos transformados en residencias o soluciones habitacionales para mayores en la actualidad. En todos los casos ha sido necesaria la reorganización de los espacios interiores, -adaptando estos a los modelos actuales de cuidado-, pero la estructura y el tipo arquitectónico prevalecen, rehabilitando el patrimonio histórico, y dando un nuevo uso a espacios que incorporan cuestiones en ocasiones ausentes en los programas funcionales de las residencias de nueva planta, como la relación con la naturaleza, la satisfacción estética, o el vínculo con el pasado.Medieval convents and monasteries are a fundamental part of Europe’s historical heritage. Nevertheless, many examples are uninhabited voids located in medium or high-density urban contexts. These buildings have high quality interior and exterior spaces and have hosted self-sufficient communities in the past, who lived in idiorrhythmic co-existence. In this article, reality is analysed through the lens of history. Firstly, several examples of contemporary nursing homes are presented, highlighting how they follow the cloister morphology. Then, a theoretical framework is established to present the parallelism between the desire for retirement that drove the monastic collective in the past, and the phenomenon of retirement present in modern welfare states. Finally, several examples of convents transformed into nursing homes or co-living solutions for the elderly are analysed. All case studies have undergone an internal redistribution of spaces, -adapting the buildings to contemporary standards of care-. However, the general structure and architectural typology is kept, historical heritage is rehabilitated and given a new use, incorporating often forgotten aspects in newly built care-homes, such as the relationship with nature, aesthetic satisfaction, or the relationship to history.Sin financiaciónNo data JCR 2022No data SJR 20220,02 C4 IDR 202
Los moot courts como método de aprendizaje experiencial en derecho internacional y derechos humanos
No full textSin financiaciónNo data SPI 2018UE
Adminis e brinquedos visuais: imagem - desenho/calcografia - e filme na mudança de regimes observacionais durante o século XIX
No full textEn este texto se analizarán diferentes dispositivos de imagen que influyeron tanto en la
percepción del dinamismo como en la descomposición del movimiento y que fueron
populares entre la clase ociosa del siglo XIX. En un primer bloque se introducen las
investigaciones del fisiólogo Jan Purkinje sobre las imágenes generadas a partir de la
retención de estímulos lumínicos en la retina; así como las hipótesis de Peter Roget en
torno a la ‘persistencia retiniana’ como precursoras de esta cultura de las imágenes,
prácticas de producción y reproducción de formas. Los estudios sobre la ‘persistencia
retiniana’ en la percepción tuvieron una clara influencia en la configuración de juguetes
y adminículos visuales que comenzaron a expandirse entre la sociedad moderna del siglo
XIX. En un segundo apartado se analizan algunas de estas tecnologías, ubicadas dentro
del régimen escópico de la imagen-materia, que fraccionaban el movimiento de diferentes
animales y objetos. Asimismo, se estudiará el tránsito escópico de la imagen-materia al
film y su implicación en los orígenes de la cronofotografía y las secuencias de imágenes
para introducir, en el últiEste texto analisará diferentes dispositivos de imagem que influenciaram tanto a percepção do dinamismo quanto a decomposição do movimento e que foram populares entre a classe ociosa do século XIX. A primeira seção apresenta a pesquisa do fisiologista JanPurkinje sobre imagens geradas a partir da retenção de estímulos luminosos na retina, assim como as hipóteses de Peter Roget sobre "persistência da retina" como precursores desta cultura de imagem, práticas de produção e reprodução de formas. Estudos sobre a "persistência da retina" na percepção tiveram uma clara influência na configuração dos brinquedos visuais e gadgets que começaram a se espalhar pela sociedade moderna do século XIX. Em uma segunda seção, analisaremos algumas dessas tecnologias, localizadas dentro do regime escopo da imagem-matéria, que fracionou o movimento de diferentes animais e objetos. Estudaremos também a transição escópica da imagem para o filme e sua implicação nas origens da cronofotografia e seqüências de imagem para introduzir, na última seção, sua influência na subjetividade emergente em meio à Segunda Revolução Industrial.(PID2019-106971GB-I00)No data 2022UE
Takotsubo Syndrome, Stressful Triggers, and Risk of Recurrence
No full textThe risk of recurrence in takotsubo syndrome (TTS) appears to be low, although previous studies have shown conflicting results and factors associated with recurrences are unclear. The aim of this study is to evaluate the incidence and predictors of TTS recurrences. Adult patients included in the Spanish Multicenter REgistry of TAKOtsubo syndrome (RETAKO) between January 2003 and September 2019 were identified. Patients were categorized based on recurrences during follow-up and a multivariate logistic regression model was used to identify factors associated with recurrences. A total of 1097 patients (mean age 71.0 +/- 11.9 years, 87% females) were included, repeated TTS events were documented in 44 patients (4.0%), including 13 patients with prior TTS and 31 patients with recurrent TTS during a median follow-up of 279 days. Two patients (0.02%) had two episodes of recurrence. Compared to patients who had no recurrence of TTS, those with recurrent TTS more frequently had no identifiable stressful trigger in the index admission (20 [64.5%] vs 352 [33.0%], p <0.001). Primary TTS, defined as TTS without physical trigger, was also more common in the recurrence group (93.5% vs 68.3%, p <0.001). The only factor independently associated with recurrences was the absence of an identifiable trigger (odds ratio 3.7 [95% confidence interval 1.8-7.8], p=0.001). In conclusion, our data indicate that for patients presenting with TTS, the rate of early recurrent TTS is approximately 4% per year. Among TTS patients, those who have no identifiable trigger events appear to have a higher rate of recurrence.Sin financiación2.8 Q2 JCR 20221.132 Q1 SJR 2022No data IDR 2022UE
Takotsubo syndrome in China: Serious but not so different
No full textSin financiación3.5 Q2 JCR 20221.122 Q1 SJR 2022No data IDR 2022UE
Biological sequential therapy with rituximab-belimumab in patients with recurrent lupus nephritis
No full textSin financiación1.5* JCR 20220.323 Q3 SJR 2022No data IDR 2022UE