Endocarditis infecciosa en un hospital terciario; aumento del número de casos asociados al medio hospitalario

Estudi prospectiu observacional realitzat entre gener 2003-juny 2010 amb casos diagnosticats de EI. Vam estudiar l’epidemiologia i els factors de risc de l'endocarditis infecciosa associada al medi hospitalari (EIAMH). Vam incloure 212 casos, el 34,9% eren EIAMH. Observarem un augment en la incidència en els darrers 4 anys (del 45,9% al 54,1%). La EIAMH s'ha associat a pacients grans i amb més comorbiditat. Staphylococcus aureus (21,7%) va ser el més freqüent. Aquests pacients van ser rebutjats per a la cirurgia amb major freqüència (40% vs 22%) i van presentar una major mortalitat (44,6% vs 19,6%) respecte al grup d'endocarditis comuniataria.

Hèrnia discal, una malaltia infecciosa?

Estudi prospectiu de casos-controls on s’intenta determinar el paper de P.acnes en l’etiopatogènia de la hèrnia discal. Es van analitzar a microbiologia i anatomia patològica les mostres de teixit de disc intervertebral extretes en cirurgia d’hèrnia discal en 40 pacients, i en 27 pacients intervinguts per altres patologies de columna vertebral. Els nostres resultats recolzen la hipòtesi de que la troballa de P.acnes en el disc és un contaminant, ja que no hem trobat evidència de que el procés inflamatori associat a l’hèrnia discal i la ciatàlgia tingui una etiopatogènia infecciosa.

Endocarditis infecciosa por estreptococos beta-hemolíticos. Características y curso clínico de una cohorte multinacional.

Se trata de un estudio descriptivo de una cohorte prospectiva y multinacional de pacientes adultos diagnosticados de endocarditis infecciosa, de la cual se seleccionaron los pacientes diagnosticados de endocarditis infecciosa por estreptococos beta-hemolíticos y por estreptococos orales del grupo viridans. Los objetivos del estudio fueron describir las características clínicas, ecocardiográficas y el pronóstico de los pacientes con endocarditis infecciosa causada por estreptococos beta-hemolíticos y comparar dichas características con la endocarditis causada por estreptococos del grupo viridans. Las principales conclusiones fueron que la endocarditis infecciosa por estreptococos beta-hemolíticos es una entidad poco frecuente, que presenta un curso agresivo con una alta frecuencia de complicaciones y una necesidad quirúrgica alta.

Is there a wage penalty for horizontal and vertical mismatch?

This paper studies how the horizontal and vertical mismatches in the labor market affect wage. We do so by taking into account that by choosing a job, wage and mismatches are simultaneously determined. The Seemingly Unrelated Equations model also allows us to control for any omitted variable that could cause biased estimators. We use REFLEX data for Spain. Results reveal that in most cases being horizontally matched has a wage premium and being over-educated does not affect wage. Results suggest that the modeling strategy successfully accounts for some omitted variable that affects simultaneously the probability of being horizontally matched and the wage. This could explain the existence of a wage penalty for over-educated workers when the omitted variable issue is not dealt with.

Pharmaceutical Generics, Vertical Product Differentiation, and Public Policy

This paper studies oligopolistic competition in off-patent pharmaceutical markets using a vertical product differentiation model. This model can explain the observation that countries with stronger regulations have smaller generic market shares. It can also explain the differences in observed regulatory regimes. Stronger regulation may be due to a higher proportion of production that is done by foreign firms. Finally, a closely related model can account for the observed increase in prices by patent owners after entry of generic producers.

Eficacia y seguridad del tratamiento antibiótico domiciliario endovenoso en patologia infecciosa procedente del servicio de urgencias

Este estudio de cohortes analiza la eficacia y seguridad del tratamiento antibiótico domiciliario endovenoso (TADE) en pacientes con infecciones procedentes del servicio de urgencias e ingresados en la unidad de Hospitalización a domicilio (HaD) del Hospital de Sabadell. Los pacientes procedentes de Urgencias presentaron mayor edad, mayor deterioro funcional, estancia media más corta, mayor proporción de infecciones urinarias y menor porcentaje de infecciones por P.aeruginosa. Estos pacientes no presentaron mayor riesgo de reingreso hospitalario, ni peor evolución de la infección, ni un incremento de las infecciones asociadas a cuidados sanitarios por lo que el TADE autoadministrado es seguro y eficaz.

Subcontracting and vertical integration in the Spanish cotton industry

This paper examines changes in the organization of the Spanish cotton industry from 1720 to 1860 in its core region of Catalonia. As the Spanish cotton industry adopted the most modern technology and experienced the transition to the factory system, cotton spinning and weaving mills became increasingly vertically integrated. Asset specificity more than other factors explained this tendency towards vertical integration. The probability for a firm of being vertically integrated was higher among firms located in districts with high concentration ratios and rose with size and the use of modern machinery. Simultaneously, subcontracting predominated in other phases of production and distribution where transaction costs appears to be less important.

Pharmaceutical generics, vertical product differentiation and public policy

This paper studies oligopolistic competition in off-patent pharmaceuticalmarkets using a vertical product differentiation model. This model canexplain the observation that countries with stronger regulations havesmaller generic market shares. It can also explain the differences inobserved regulatory regimes. Stronger regulation may be due to a higherproportion of production that is done by foreign firms. Finally, a closelyrelated model can account for the observed increase in prices by patentowners after entry of generic producers.

Endocarditis infecciosa y complicaciones neurológicas

Las complicaciones neurológicas (CN) son frecuentes en la endocarditis infecciosa (EI) y ensombrecen el pronóstico. Nuestro objetivo ha sido analizar los grupos con (EICN) y sin ellas (EISCN) para determinar los factores relacionados con las CN y prevenirlas. Se observó que la EICN es un grupo menos comórbido, con localización predominantemente en cavidades izquierdas y tendencia a la afectación por Staphylococcus aureus. No se observó relación con un retraso diagnóstico de EI ni con demora en el antibiótico, y la antiagregación, anticoagulación y estatinas no mostraron efecto protector. Se rechazaron más a cirugía y la mortalidad tendió a ser mayor.

Effects of convection on the removal of the multiplicity of stable states in one-dimensional vertical models

Here I develop a model of a radiative-convective atmosphere with both radiative and convective schemes highly simplified. The atmospheric absorption of radiation at selective wavelengths makes use of constant mass absorption coefficients in finite width spectral bands. The convective regime is introduced by using a prescribed lapse rate in the troposphere. The main novelty of the radiative-convective model developed here is that it is solved without using any angular approximation for the radiation field. The solution obtained in the purely radiation mode (i. e. with convection ignored) leads to multiple equilibria of stable states, being very similar to some results recently found in simple models of planetary atmospheres. However, the introduction of convective processes removes the multiple equilibria of stable states. This shows the importance of taking convective processes into account even for qualitative analyses of planetary atmosphere

States of maximum entropy production in a onedimensional vertical model with convective adjustment

We investigate the hypothesis that the atmosphere is constrained to maximize its entropy production by using a one-dimensional (1-D) vertical model. We prescribe the lapse rate in the convective layer as that of the standard troposphere. The assumption that convection sustains a critical lapse rate was absent in previous studies, which focused on the vertical distribution of climatic variables, since such a convective adjustment reduces the degrees of freedom of the system and may prevent the application of the maximum entropy production (MEP) principle. This is not the case in the radiative–convective model (RCM) developed here, since we accept a discontinuity of temperatures at the surface similar to that adopted in many RCMs. For current conditions, the MEP state gives a difference between the ground temperature and the air temperature at the surface ≈10 K. In comparison, conventional RCMs obtain a discontinuity ≈2 K only. However, the surface boundary layer velocity in the MEP state appears reasonable (≈3 m s-¹). Moreover, although the convective flux at the surface in MEP states is almost uniform in optically thick atmospheres, it reaches a maximum value for an optical thickness similar to current conditions. This additional result may support the maximum convection hypothesis suggested by Paltridge (1978)