De casi todo, un poco

El aprender es propio de los hombres y de las mujeres, por eso es que éstos son los únicos capaces de hacer del aprender una aventura creadora. El aprender es reconstruir, es construir, es cambiar, es comprobar, es aventurarse, es arriesgarse. Es por esto que toda práctica educativa, en el aula o fuera de ella lleva en sí el uso de materiales, de técnicas, de métodos, de objetivos, de ideales, de sueños, de miedos. Es por todo esto que implica el ejercicio de la profesión docente que este taller presenta un desafío, el desafío de jugar para aprender, de aprender para jugar. El gran problema con el que se enfrenta el docente actual es no sólo trasmitir los contenidos específicos de su disciplina, sino también desarrollar en sus alumnos el respeto, el esfuerzo y el placer por aprender. Este taller intenta lograr autonomía y libertad de trabajo por parte de los jugadores, como así también que asuman el compromiso de repensar las situaciones y completarlas, modificarlas, reutilizarlas para otros contenidos, en fin total libertad. La idea es que los diferentes juegos que se ofrecen resulten, además de atractivos y entretenidos, versátiles; para que cada docente pueda modificarlos, agregar situaciones, cambiar la temática, usarlos con otro objetivo. Estos juegos se pueden utilizar desde el nivel inicial hasta el nivel ESB para diferentes contenidos, como evaluación, como diagnóstico, o para afianzar un concepto

TTCC-2019-02: real-world evidence of first-line cetuximab plus paclitaxel in recurrent or metastatic squamous cell carcinoma of the head and neck

ObjectivesThe aim of this study was to confirm the efficacy of the ERBITAX scheme (paclitaxel 80 mg/m2 weekly and cetuximab 400 mg/m2 loading dose, and then 250 mg/m2 weekly) as first-line treatment for patients with recurrent/metastatic squamous cell carcinoma of the head and neck (SCCHN) who are medically unfit for cisplatin-based (PT) chemotherapy.Materials and methodsThis retrospective, non-interventional study involved 16 centers in Spain. Inclusion criteria were to have started receiving ERBITAX regimen from January 2012 to December 2018; histologically confirmed SCCHN including oral cavity, oropharynx, hypopharynx, and larynx; age ≥18 years; and platinum (PT) chemotherapy ineligibility due to performance status, comorbidities, high accumulated dose of PT, or PT refractoriness.ResultsA total of 531 patients from 16 hospitals in Spain were enrolled. The median age was 66 years, 82.7% were male, and 83.5% were current/former smokers. Patients were ineligible to receive PT due to ECOG 2 (50.3%), comorbidities (32%), PT cumulative dose ≥ 225 mg/m2 (10.5%), or PT refractoriness (7.2%). Response rate was 37.7%. Median duration of response was 5.6 months (95% CI: 4.4–6.6). With a median follow-up of 8.7 months (95% CI: 7.7–10.2), median PFS and OS were 4.5 months (95% CI: 3.9–5.0) and 8.9 months (95% CI: 7.8–10.3), respectively. Patients treated with immunotherapy after ERBITAX had better OS with a median of 29.8 months compared to 13.8 months for those who received other treatments. The most common grade ≥ 3 toxicities were acne-like rash in 36 patients (6.8%) and oral mucositis in 8 patients (1.5%). Five (0.9%) patients experienced grade ≥ 3 febrile neutropenia.ConclusionThis study confirms the real-world efficacy and tolerability of ERBITAX as first-line treatment in recurrent/metastatic SCCHN when PT is not feasible. Immunotherapy after treatment with ERBITAX showed remarkable promising survival, despite potential selection bias

Recurrence risk after first symptomatic distal versus proximal deep vein thrombosis according to baseline risk factors

Background   It remains unclear whether the distal location of deep vein thrombosis (DVT) is independently independently associated with a lower risk of recurrence in all patients, or represents a marker of the the presence and severity of provoking factors for venous thromboembolism (VTE). Methods We investigated investigated the impact of distal (vs. proximal) DVT location on the risk of developing symptomatic symptomatic, objectively confirmed recurrent VTE in 831 patients with a first acute symptomatic DVT not associated with pulmonary embolism (PE), who were stratified by the presence of transient or persistent risk factors at baseline. The primary outcome was symptomatic, objectively diagnosed recurrent recurrent VTE, including proximal DVT and PE. Results   A total of 205 (24.7%) patients presented with with a transient risk factor, 189 (22.7%) with a minor persistent risk factor, 202 (24.3%) with unprovoked unprovoked DVT, and 235 (28.3%) with cancer-associated DVT. One-hundred twenty-five patients (15.0%) experienced recurrent DVT or PE. The largest relative difference between patients with distal (vs. proximal) DVT was observed in the absence of identifiable risk factors (adjusted hazard ratio ratio [aHR]: 0.11; 95% CI [confidence interval]: 0.03-0.45). In patients with cancer, distal and proximal DVT had a comparable risk of recurrence (aHR: 0.70; 95% CI: 0.28-1.78]). Conclusions   The distal (vs. proximal) location of first acute symptomatic DVT represented, in the absence of any identifiable identifiable transient or persistent risk factors, a favorable prognostic factor for recurrence. In contrast, the prognostic impact of DVT location was weaker if persistent provoking risk factors for VTE were present, notably cancer