Suchergebnisse

Esta obra se enmarca en el estudio de la Historia Social de la Familia a través del análisis de una élite local del sur de Castilla, concretamente en la localidad murciana de Cieza durante el s. XVII, intentando dar respuesta a su configuración y a su tipología en relación a la definición de su patrimonio material, inmaterial y relacional dentro de un contexto marcado por el fenómeno de luchas de bandos, atendiéndose a la resolución de sus objetivos, su articulación y, en definitiva, a las características de los que se han definido como bandos de linajes clientelares. Finalmente, en la búsqueda de la paz se considera el papel interpretado por la propia comunidad ciezana, los prohombres de la época cercanos al marco cortesano o comarcal, así como la necesidad de conocer cuándo y en qué grado actuaron los miembros del clero, el aparato institucional monárquico y el propio rey. Así pues, este planteamiento se centra en la institución familiar, ya que en ella se desarrollan toda una serie de estrategias matrimoniales, de transmisión patrimonial y honorífica, de sistemas de parentesco y de relaciones de amistad y dependencia tendentes a la consolidación y reproducción social, es decir, la vida en sociedad a través de las familias. Familia, élites y bandos. Estos son los tres pilares de la argumentación de la presente investigación, en la que el estudio de las banderías ciezanas, su conflicto y pacificación, se plantea en los niveles institucional, en los vínculos socio-económicos, en lo privado y ritual o de manifestación simbólica, lo que a su vez genera la unión de parientes contra adversarios, escisiones en los linajes y en el propio bando y, en última instancia, la movilización de recursos y redes de alianzas. En este planteamiento se enmarca el estudio de una élite local en construcción en el antiguo Reino de Murcia, donde la aparición del fenómeno de luchas de bandos atiende a la resolución de sus objetivos, su articulación y, en definitiva, a las características de las banderías durante el siglo barroco en una triple vertiente: la perpetuación de bandos en las áreas marginales del reino castellano, su articulación en determinados linajes que a diferencia de épocas pasadas se redefinen sobre diferentes lazos clientelares caracterizados por la nueva realidad socio-económica y política de la Castilla del s. XVII basada en la limpieza de sangre y en su sanción legal a través de la ejecutoría, el control de los oficios municipales, el control de una amplia red social clientelar y el domino de los medios económicos de la localidad. En su desarrollo temporal (1613-1705) se alcanzará un alto grado de violencia que será resuelto por las propias iniciativas de los habitantes de la villa, además de la intervención de notables personajes foráneos como el obispo de Cartagena o el marqués de los Vélez, único miembro durante el s. XVII perteneciente a la nobleza titulada murciana. Y con todo, a los poderes terrenales, incluida la propia intervención real a través del perdón del rey Carlos II, también se desarrolló una notable actividad clerical de la mano de la orden franciscana, cuyo mejor ejemplo será la edificación del convento de San Joaquín, lo que contribuirá a una paulatina nupcialidad pacifista o de unión matrimonial de las familias enfrentadas, así como el intento de sustituir los enfrentamiento linajudos y banderizos por el servicio administrativo al Rey a partir del s. XVIII, si bien pocos de los hidalgos ciezanos alcanzarán puestos de mérito por su escaso potencial político-económico y, especialmente, a su reducida red de relaciones sociales que posibilitaran el acceso a los favores de la Corte real. En definitiva, se trata del estudio de varias familias de la élite local de Cieza en un período de construcción de su poder en el marco local del s. XVII, desarrollándose los enfrentamientos de bandos como respuesta a la defensa y construcción de un poder local que les facultara un mayor control de la villa y la posibilidad de alcanzar mayores honores por parte de la Corona. SUMMARY This work belongs to the study of Family Social History through the analysis of a local elite from the south of Castile, specifically in Cieza, a town in Murcia, during the XVII century, trying to give an answer to its configuration and its typology in relation to the definition of its material, inmaterial and relational patrimony inside a context marked by the phenomenon of the factions´fights, paying attention to the resolution of its objectives, its articulation and, in short, to the characteristics of those ones who have described themselves as factions of depending lineages. Finally, in the search of peace it is taken into consideration the role played by Cieza community, the outstanding men of the age closed to the court or regional frame, as well as the necessity of knowing when and at which level the members of the clergy, the monarchical institution and the King himself. So, this proposal is centered in the familiar institution, since in it a series of matrimonial strategies are developed, of patrimonial transmission and honorary, of systems of relationship and friendship and dependency tendind towards the consolidation and social reproduction, that is to say, life in society through families. Families, elites and factions. These are the three pillars of the argument of the present investigation, in which the study of the factions in Cieza, its conflict and pacification it is proposed in the institutional levels, in the socio-economic links, in the private and ritual or of a symbolic manifestation, what generates the union of relatives against adversaries, Split in the lineage and in the faction itself, and ultimately the mobilisation of resources and alliances networks. In this proposal the study of a local elite in process in the ancient kingdom of Murcia is defined, where the appareance of the phenomenon of fights among factions attends to the resolution of it objectives, its articulation, in short, to the charcteristics of the factions during the Baroque period in a triple direction: the perpetuation of factions in the marginal áreas of the Castilian kingdom, its articulation in certain lineages which different from last ages are defined for different depending ties characterized by the new socio-economic and political reality of Castile in the XVII century base don the blood cleaning and on its approval, through the final judgement, the control of a wide social depending network and the dominion of the economic means of the locality. During its temporary development (1613-1705) a high degree of violence which will be sorted out by the inhabitans´initiatives apart from the intervention of outstanding foreign personalities like the Bishop of Cartagena or the Marquis of Velez, the only member who belonged to the Murcia aristocrazy during the XVII century. Also, to the earthly powers, including the royal intervention through the King Carlos II´s forgiveness, a remarkable clerical activity was developed by the Franciscan order, whose best example will be the construction of Saint Joaquin monastery, which will contribute to a gradual pacifist marriage statistics among the confronted families, as well as the attempt to substitute the confrontation between the highborn and the factions because of the administrative service to the King since the XVII century, few of the noblemen in Cieza will reach posts of meri for the scarce political-economical potential ans, specially, to its reducednetwork of social relationships that will make posible the access to the royal court´s favours. To sum up, it is about the study of several families of the local elite in Cieza in a period of construction of its power in the local setting of the XVII century, where the confrontation among factions as a response of defence were being developed and the constrution of a local power which authorised them with a higger control of the village and the possibility of reaching higher honours from the Cown.

IntroductionInversion of the CD4:CD8 ratio (<1) has been identified as a hallmark of immunosenescence and an independent predictor of mortality in the general population. We aimed to assess the association between the CD4:CD8 ratio and intima‐media thickness (IMT) progression in treated HIV‐infected patients as a marker of early atherosclerosis.Materials and MethodsA longitudinal study during three years was conducted in 120 HIV‐infected patients receiving antiretroviral treatment (ART). We analyzed the associations between the CD4:CD8 ratio, cardiovascular risk factor and antiretroviral (ARV) treatment and progression of subclinical atherosclerosis assessed using carotid IMT at baseline and after three years.ResultsFinally, 96 patients completed the study. Seventy‐six (79.1%) patients were male, aged 44±10 years, 39 (40.6%) were on treatment with Protease inhibitors, 49 (51.04%) with non‐nucleoside reverse transcriptase inhibitors (NNRTI), 6 (6.25%) with integrase inhibitors, 3 (3.12%) with maraviroc and 2 (2.08%) only with nucleoside reverse transcriptase inhibitors (NRTI). The mean of ARV exposition was 6.9±5.9 years. Twenty six (27 %) patients had family history of ischemic heart disease, 51 (53.12%) were smokers, 12 (12.5%) hypertensive, 4 (4.16%) type 2 diabetes, 23 (23.9%) with dyslipidemia and 31 (32.3%) were infected with C hepatitis virus. Baseline IMT was significantly associated with age (rho=0.497; p<0.001), basal glucemia (rho=0.323; p=0.001), triglycerides (rho=0.232; p=0.023), Framingham score (rho=0.324; p=0.001), CD4:CD8 ratio (rho=−0.176; p=0.05) and dyslipidemia (0.72±0.16 mm vs 0.63±0.11 mm; p=0.029). In multivariable analysis where cardiovascular risk factor and ARV were included, IMT progression was inversely associated with CD4:CD8 ratio (OR=0.283; CI 95% 0.099–0.809; p=0.019) and treatment with NNRTI (OR=0.283; CI 95% 0.099–0.809; p=0.019).ConclusionsThe inversion of CD4:CD8 ratio in treated HIV‐infected patients is independently associated with IMT progression, a marker of age‐associated disease. Therefore, it might be clinically useful as predictor of cardiovascular events. Surprisingly, there was a positive correlation between receiving NNRTI and progression of IMT.

IntroductionNucleoside reverse transcriptase inhibitor (NRTI) is associated with endothelial dysfunction and proinflammatory effects. Maraviroc (MVC) is an antagonist of CCR5 receptor. CCR5 is the receptor of RANTES (Regulated on Activation, Normal T Cell Expressed and Secreted), a mediator of chronic inflammation and endothelial function. Our aim was to evaluate the maintenance of viral suppression and improvement of endothelial function in virologically suppressed HIV‐infected patients switched to an NRTI‐sparing combined antiretroviral therapy (cART) with MVC.Materials and MethodsThis observational, non‐interventional, multicenter study was performed at the Infectious Diseases Service of Santa Lucia, Morales Meseguer, Virgen de la Arrixaca and Reina Sofía University Hospital (Murcia, Spain). The selection criteria were to be asymptomatic on a regimen with undetectable viral load (<50 HIV‐RNA copies/mL) for at least six months, no previous treatment with R5 antagonists, no evidence of previous protease inhibitor (PI) failure and available R5 tropism test. Twenty‐one HIV‐infected patients were selected after the treatment regimen was changed to Maraviroc 150 mg/once daily plus ritonavir‐boosted PI therapy. Endothelial function was prospectively evaluated through flow‐mediated dilatation (FMD) of the brachial artery at baseline and at weeks 24.ResultsWe included 21 patients on treatment with PI in combination with 2 NRTI. The mean cART exposition was 133±68.9 months. Fourteen (66.6%) were males, aged 49±9 years, 15 (71.4%) smokers, 4 (19.04%) family history of coronary heart disease, 1 (5.76%) type 2 diabetes and 3 (14.28%) hypertensive, mean total cholesterol was 185.5±35 mg/dL, c‐LDL 100.2±37 mg/dL, tryglicerides 170.42±92.03 mg/dL, cHDL 52.6±15.5 mg/dL, CD4 779,5±383.28 cells/mL, nadir CD4 187,96±96 cells/mL. After 24 weeks of follow‐up of a switch to an NRTI‐sparing regimen, 95.2% of HIV‐patients on viral suppressive cART maintained viral suppression and CD4+ T cell count. This cART switch improve endothelial function in patients with lower baseline FMD levels after 24 weeks (baseline FMD −1.19±4.84 % to 24 weeks FMD 11.32±7.27%; p=0.002).ConclusionsThe results of our study show that a switch to an NRTI‐sparing bi‐therapy with MVC improves endothelial function and maintained the immune‐virologic efficacy. This regimen emphasizes the needs for further clinical studies to associate these achievements with the incidence of non‐AIDS‐defining illnesses.