Clinical Characteristics and Risk Factors of Respiratory Failure in a Cohort of Young Patients Requiring Hospital Admission with SARS-CoV2 Infection in Spain: Results of the Multicenter SEMI-COVID-19 Registry.

Age is a risk factor for COVID severity. Most studies performed in hospitalized patients with SARS-CoV2 infection have shown an over-representation of older patients and consequently few have properly defined COVID-19 in younger patients who require hospital admission. The aim of the present study was to analyze the clinical characteristics and risk factors for the development of respiratory failure among young (18 to 50 years) hospitalized patients with COVID-19. This retrospective nationwide cohort study included hospitalized patients from 18 to 50 years old with confirmed COVID-19 between March 1, 2020, and July 2, 2020. All patient data were obtained from the SEMI-COVID Registry. Respiratory failure was defined as the ratio of partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2 ratio) ≤200 mmHg or the need for mechanical ventilation and/or high-flow nasal cannula or the presence of acute respiratory distress syndrome. During the recruitment period, 15,034 patients were included in the SEMI-COVID-19 Registry, of whom 2327 (15.4%) were younger than 50 years. Respiratory failure developed in 343 (14.7%), while mortality occurred in 2.3%. Patients with respiratory failure showed a higher incidence of major adverse cardiac events (44 (13%) vs 14 (0.8%), p320 U/I (OR, 1.69; 95% CI, 1.18 to 2.42; p=0.0039), AST >35 mg/dL (OR, 1.74; 95% CI, 1.2 to 2.52; p=0.003), sodium 35 mg/dL (OR, 1.74; 95% CI, 1.2 to 2.52; p=0.003), sodium 8 mg/dL (OR, 2.42; 95% CI, 1.72 to 3.41; p Young patients with COVID-19 requiring hospital admission showed a notable incidence of respiratory failure. Obesity, SAHS, alcohol abuse, and certain laboratory parameters were independently associated with the development of this complication. Patients who suffered respiratory failure had a higher mortality and a higher incidence of major cardiac events, venous thrombosis, and hospital stay

Nuevos escenarios para la innovación educativa : el Grupo CREA (Centros en Red para las Enseñanza Activas) y la renovación metodológica de los centros educativos

Convocatoria Proyectos de innovación de Extremadura 2018/2019Proyecto que agrupa a cinco centros educativos: el IES Jaranda (Jarandilla de la Vera, Cáceres), el IESO Sierra la Mesta (Santa Amalia, Badajoz), el IES Albarrega (Mérida, Badajoz), el IESO Val de Xálima (Valverde del Fresno, Badajoz), IESO Matías Ramón Martínez (Burguillos del Cerro, Badajoz) que conforman el Grupo CREA y que comparten una trayectoria común: el uso de metodologías educativas activas. A las iniciativas innovadoras llevadas a cabo colectivamente se suman las individuales de cada centro debido a la particularidad de cada uno de ellos. Los objetivos principales del proyecto son: la creación de una estructura organizativa y de coordinación entre los distintos centros participantes que permita la planificación y puesta en marcha de acciones educativas conjuntas; la introducción de cambios organizativos, funcionales, espaciales y metodológicos para llevar a cabo aprendizajes basados en proyectos, orientados al servicio a la comunidad y a los problemas sociales, centrados en el aprendizaje cooperativo, etc.; el diseño y desarrollo de programas de innovación coordinados entre los distintos centros educativos participantes; el establecimiento de mecanismos de coordinación para hacer efectiva la comunicación, el intercambio de información, el análisis y la reflexión del profesorado participante en los programas de innovación de cada uno de los centros; la formación conjunta del profesorado; el desarrollo de proyectos conjuntos para los alumnos participantes, su conexión en entornos virtuales, el intercambio de experiencias en encuentros periódicos, etc. y la generación y fomento de una nueva red creando un portal web y un espacio de comunicación e intercambio de documentaciónExtremaduraES

The clinical importance of periodic leg movements in sleep

Periodic leg movements during sleep (PLMS) are commonly found in patients with restless leg syndrome (RLS), but they may occur in other sleep disorders and several medical conditions. Their prevalence increases with age, but they can also be observed in children. During the last decades, very active research has been devoted to determine and understand the pathophysiology, associated events, and clinical significance of PLMS. This chapter tries to sum up the most relevant PLMS-related findings, focusing on the relationship between PLMS and the cardiovascular system, in order to understand the clinical implication of this complex motor phenomenon. PLMS have been associated with sympathetic overactivity, namely surges in nocturnal blood pressure and heart rate, without modification in global autonomic balance. Also, PLMS have been related to inflammatory cellular pathways, with elevated level of inflammatory markers, which are associated with cardiovascular risk. The PLMS-related modulation of the autonomic system and of inflammation may increase cardiovascular and cerebrovascular risk in subjects with frequent PLMS. Moreover, also, comorbidities associated with PLMS may play a synergic role in worsening the cardiovascular risk and the consequent mortality and morbidity. Furthermore, little is known about pathophysiological correlates in children with PLMS and their chronic implication on the cardiovascular and cerebrovascular systems. A few studies have suggested that treating PLMS with dopaminergic drugs may reduce their associated sympathetic overactivity and modify disease progression. Definitely, further research is needed to assess the clinical impact of PLMS, associated or not with RLS, and above all the long-term impact of treating PLMS on cardiovascular risk, morbidity, and mortality