La implementación de las TIC en el aula de Inglés en Andalucía

Los numerosos avances tecnológicos con los que contamos en el siglo XXI posibilitan una mejora de la calidad de la enseñanza. La Consejería de Educación de la Junta de Andalucía ha tomado medidas para promover el uso de las nuevas tecnologías en el aula y ha ofrecido distintos recursos e instalaciones para profesores y estudiantes. Se pretende actualizar la docencia y potenciar el desarrollo de las competencias básicas por parte del alumnado para satisfacer las exigencias de la sociedad del conocimiento. Los objetivos de esta investigación son corroborar si las iniciativas oficiales coinciden con la práctica real en las escuelas de secundaria, estudiar los libros de texto usados y el nivel de implementación del programa Escuela TIC 2.0 . Además de las conclusiones del trabajo, se establecen recomendaciones para la mejora del programa mencionado.The 21st century has brought with it many new technological developments which enable an improvement of the quality of education. The Regional Ministry of Education in Andalucía has taken measures to promote the use of new technologies in the classroom and has provided teachers and students with different resources and facilities. The aim is to update the teaching practice and to strengthen the development of basic competences by students to meet the demands of the knowledge society. The objectives of this study research are to corroborate if the official initiatives meet the real practice in secondary schools, to study the textbooks used and the level of implementation of the project Escuela TIC 2.0. In addition to the conclusions, a number of recommendations will be also produced in order to improve the above-mentioned project

Papilopatía diabética: a propósito de dos casos

Unidad Docente de Inmunología, Oftalmología y ORLFac. de Óptica y OptometríaTRUEpu

Skin lesions with perimenstrual exacerbation: a diagnosis challenge

La dermatitis herpetiforme (DH) es una dermatosis ampollosa autoinmune subepidérmica de curso crónico, considerada como la expresión cutánea de la intolerancia al gluten. Forma parte de un abanico de patologías que tienen en común la sensibilidad a este componente, aunque solo un bajo porcentaje de pacientes desarrollará un cuadro de enteropatía sensible al gluten con malabsorción clínica. Se manifiesta mediante una erupción papulovesicular pruriginosa de predominio en superficies de extensión y nalgas. El estudio inmunológico puede en algunos casos no ser específico, pero se considera patognomónico los depósitos granulares de IgA en la unión dermoepidérmica. El tratamiento se basa en la dieta estricta libre de gluten (DSG) y el uso adicional de dapsona para las manifestaciones cutáneas. Presentamos dos casos de pacientes con brotes de dermatitis polimorfa e inespecífica de años de evolución y predominio perimenstrual, que precisaron múltiples tratamientos y pruebas complementarias hasta la positividad y confirmación del diagnóstico de DH.Dermatitis herpetiformis (DH) is an autoinmune subepidermal bullous dermatosis of chronic course, considered the cutaneous expression of gluten intolerance. It´s part of a range of pathologies that have in common the sensitivity to this component, but only a small percentage of patients develop gluten sensitive enteropathy with clinical malabsorption. The clinic is manifested by a predominantly papulovesicular rash pruritic, in extension surfaces and buttocks. Immuno-pathological study may not be specific in some cases, but it´s considered pathognomonic the presence of IgA granular deposits in the dermoepidermal junction. Treatment is based on strict gluten free diet (GFD) and the additional use of dapsone for cutaneous manifestations. We present two patients with polymorphous and unspecific dermatitis for years and perimenstrual outbreaks, which required multiple treatments and laboratory tests to confirm the diagnosis of DH

No evidence that wild red deer (Cervus elaphus) on the Iberian Peninsula are a reservoir of Mycobacterium avium subspecies paratuberculosis infection

The potential role of red deer (Cervus elaphus) as a reservoir of Mycobacterium avium subspecies paratuberculosis (MAP) infection is largely unknown. A total of 332 wild red deer were investigated using post-mortem examination, bacteriology and serology. Only three animals (1.12%) were found to have lesions on histopathological examination and no MAP bacteria were recovered on culture. The results suggest it is unlikely that wild red deer make a significant contribution to the maintenance of MAP infection in the region. The cross-reactivity of the ELISAs used indicates this diagnostic modality is ineffective in the detection of MAP infection in this species. The implications of these results for the control of this important pathogen in both livestock and wildlife are discussed.This research was supported by MCINN Grants AGL2008-03875/FEDER and FP7EU/TB-STEP-212414.Peer Reviewe

Effectiveness of a strategy that uses educational games to implement clinical practice guidelines among Spanish residents of family and community medicine (e-EDUCAGUIA project):A clinical trial by clusters

This study was funded by the Fondo de Investigaciones Sanitarias FIS Grant Number PI11/0477 ISCIII.-REDISSEC Proyecto RD12/0001/0012 AND FEDER Funding.Background: Clinical practice guidelines (CPGs) have been developed with the aim of helping health professionals, patients, and caregivers make decisions about their health care, using the best available evidence. In many cases, incorporation of these recommendations into clinical practice also implies a need for changes in routine clinical practice. Using educational games as a strategy for implementing recommendations among health professionals has been demonstrated to be effective in some studies; however, evidence is still scarce. The primary objective of this study is to assess the effectiveness of a teaching strategy for the implementation of CPGs using educational games (e-learning EDUCAGUIA) to improve knowledge and skills related to clinical decision-making by residents in family medicine. The primary objective will be evaluated at 1 and 6months after the intervention. The secondary objectives are to identify barriers and facilitators for the use of guidelines by residents of family medicine and to describe the educational strategies used by Spanish teaching units of family and community medicine to encourage implementation of CPGs. Methods/design: We propose a multicenter clinical trial with randomized allocation by clusters of family and community medicine teaching units in Spain. The sample size will be 394 residents (197 in each group), with the teaching units as the randomization unit and the residents comprising the analysis unit. For the intervention, both groups will receive an initial 1-h session on clinical practice guideline use and the usual dissemination strategy by e-mail. The intervention group (e-learning EDUCAGUIA) strategy will consist of educational games with hypothetical clinical scenarios in a virtual environment. The primary outcome will be the score obtained by the residents on evaluation questionnaires for each clinical practice guideline. Other included variables will be the sociodemographic and training variables of the residents and the teaching unit characteristics. The statistical analysis will consist of a descriptive analysis of variables and a baseline comparison of both groups. For the primary outcome analysis, an average score comparison of hypothetical scenario questionnaires between the EDUCAGUIA intervention group and the control group will be performed at 1 and 6months post-intervention, using 95% confidence intervals. A linear multilevel regression will be used to adjust the model. Discussion: The identification of effective teaching strategies will facilitate the incorporation of available knowledge into clinical practice that could eventually improve patient outcomes. The inclusion of information technologies as teaching tools permits greater learning autonomy and allows deeper instructor participation in the monitoring and supervision of residents. The long-term impact of this strategy is unknown; however, because it is aimed at professionals undergoing training and it addresses prevalent health problems, a small effect can be of great relevance. Trial registration: ClinicalTrials.gov: NCT02210442.Publisher PDFPeer reviewe

Laboratorio escénico de técnicas performativas

Actividades realizadas en el desarrollo del Proyecto de Innovación docente Laboratorio De Técnicas Performativas realizado en el curso 2019-2

Stratification of radiosensitive brain metastases based on an actionable S100A9/RAGE resistance mechanism

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.Whole-brain radiotherapy (WBRT) is the treatment backbone for many patients with brain metastasis; however, its efficacy in preventing disease progression and the associated toxicity have questioned the clinical impact of this approach and emphasized the need for alternative treatments. Given the limited therapeutic options available for these patients and the poor understanding of the molecular mechanisms underlying the resistance of metastatic lesions to WBRT, we sought to uncover actionable targets and biomarkers that could help to refine patient selection. Through an unbiased analysis of experimental in vivo models of brain metastasis resistant to WBRT, we identified activation of the S100A9-RAGE-NF-κB-JunB pathway in brain metastases as a potential mediator of resistance in this organ. Targeting this pathway genetically or pharmacologically was sufficient to revert the WBRT resistance and increase therapeutic benefits in vivo at lower doses of radiation. In patients with primary melanoma, lung or breast adenocarcinoma developing brain metastasis, endogenous S100A9 levels in brain lesions correlated with clinical response to WBRT and underscored the potential of S100A9 levels in the blood as a noninvasive biomarker. Collectively, we provide a molecular framework to personalize WBRT and improve its efficacy through combination with a radiosensitizer that balances therapeutic benefit and toxicity.info:eu-repo/semantics/publishedVersio

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Cine en compañía para prevenir enfermedades

El proyecto “Cine en compañía para prevenir enfermedades” es continuación del proyecto iniciado en 2017 (INNOVA-Docencia 18/2018, ApS-UCM 18/2019) y se encuadra en el campo de Salud Pública, higiene y prevención de enfermedad, dirigido a personas desfavorecidas o en riesgo de exclusión social. En esta edición se ha ampliado el área de conocimiento y profesores participantes, incluyendo no solo enfermedades infecciosas, como en ediciones anteriores, sino otras del ámbito de la Bioquímica y Biología Molecular. El proyecto es multidisciplinar e interfacultativo (21 tutores: profesores, colaboradores postdoctorales, doctorandos, estudiantes participantes en ediciones anteriores y técnico de laboratorio, de las Facultades de Farmacia, Biología y Medicina y del Hospital 12 de Octubre) y en él han participado 41 estudiantes de distintos Grados (Biología, Bioquímica, Ciencia y Tecnología de los Alimentos, Derecho, Farmacia, Ingeniería Electrónica) y Postgrados (Máster en Biología Sanitaria, y en Microbiología y Parasitología: Investigación y Desarrollo; Doctorado en Bioquímica y Biología Molecular) y participantes en la asignatura Transversal “Ciencia para la Sociedad”. La necesidad social detectada y atendida es la situación de algunos colectivos, por ejemplo, personas sin hogar, mujeres en exclusión, adictos a drogas, presidiarios o familias residentes en áreas no salubres, de una mayor exposición a determinadas enfermedades debido a sus condiciones de vida (enfermedades infecciosas, mentales, metabólicas derivadas de adicciones o alcoholismo), además de que encuentran escasas posibilidades de conocer cómo prevenirlas y la forma adecuada de recibir tratamiento. Adicionalmente, y no menos importante, acusan una carencia severa de compañía, atención y escucha de sus necesidades. Los estudiantes de universidad que cursan estudios en el campo de Ciencias y Ciencias de la Salud estudian estas enfermedades, por lo que pueden ayudar a estos colectivos en la mejora de prácticas higiénico-sanitarias, así como al acceso a la información para su prevención y tratamiento. Las actividades desarrolladas en el proyecto han consistido en el acompañamiento y desarrollo de una actividad lúdica mediante la proyección de películas comerciales que traten una enfermedad de interés en el colectivo a atender, seguida de coloquio para ayudar a conocer las formas adecuadas de prevención y tratamiento. Los equipos de 4-5 estudiantes (de distintas titulaciones y cursos) y dos tutores (senior y junior) han realizado varias visitas a centros sociales atendidos por Fundaciones con las que existe convenio de la UCM (centros de día para personas sin hogar, mujeres en exclusión, discapacitados o presidiarios, gestionados por Cáritas, Hogar-Sí, Diaconía, Medinacelli). Han investigado en profundidad las enfermedades que afectan y de interés del grupo atendido, seleccionado y analizado críticamente películas adecuadas, preparado materiales divulgativos (carteles, juegos) y diseñado y analizado encuestas para evaluar su actividad por parte de las personas atendidas y los coordinadores de los centros. Los resultados de las encuestas a todos los participantes (tutores, estudiantes, centros) y la recogida de opiniones y memorias de los estudiantes muestran una alta consecución de los objetivos de aprendizaje previstos, refuerzo de contenidos específicos de los estudios y, sobre todo, trabajo y adquisición de competencias transversales como trabajo en equipo, coordinación y asunción de responsabilidades, análisis crítico o expresión científica divulgativa. En cuanto a los objetivos de servicio, destaca la utilidad del proyecto en atención e información a los colectivos, la aplicación de los estudios a situaciones reales en atención a personas desfavorecidas y el valor social del proyecto

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio