22 research outputs found
Implantación del EEES en la asignatura comervio electrónico: el caso de una asignatura de nueva creación
Memoria ID12-0227. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2012-2013
Incremento de peso en pacientes con fibrosis quística: ¿es siempre beneficioso?
Introduction: The primary objective of this study was to find out the prevalence of overweight and obese status, as well as their association to pulmonary function, total cholesterol and vitamin D in patients with cystic fibrosis (CF). Materials and methods: This is a multicenter descriptive and cross-sectional study. Twelve Spanish hospitals participated. 451 patients with CF were included. Adults were classified according to body mass index (BMI) and children were classified according to BMI percentiles (WHO tables). Pearson’s correlation, Anova, Student’s t-test and multiple linear regression were conducted. Results: Mean age was 12.3 (range 4-57) years old, 51% were male and 18% had pancreatic sufficiency. Participants were classified in five nutritional status categories: 12% were malnourished; 57%, at nutritional risk; 24%, normally nourished; 6%, overweight; and 1%, obese. Pulmonary function in overweight or obese patients (91 ± 19%) was better than in malnourished patients (77 ± 24%) (p = 0.017). However, no difference was observed between those at nutritional risk (86 ± 19%) or normally nourished (90 ± 22%) groups. Overweight and obese patients had higher levels of total cholesterol (p = 0.0049), a greater proportion of hypercholesterolemia (p = 0.001), as well as lower levels of 25 OH vitamin D (p = 0.058). Conclusions: Prevalence of overweight and obese was 6 and 1%. Excess weight status does not offer any benefit in pulmonary function in comparison to normally nourished patientsIntroducción y objetivos: conocer la prevalencia de sobrepeso y obesidad, así como su asociación con la función pulmonar, el colesterol total
y la vitamina D en pacientes con fi brosis quística (FQ).
Material y métodos: estudio multicéntrico descriptivo y transversal. Participaron 12 hospitales españoles. Fueron incluidos 451 pacientes con
FQ, clasifi cados según el índice de masa corporal (IMC) en adultos y el IMC percentilado (tablas OMS) en niños. Análisis estadístico: C.Pearson,
Anova, t de Student y regresión lineal múltiple.
Resultados: la mediana de edad fue 12,3 (rango 4-57) años. Un 51% eran varones y el 18%, sufi cientes pancreáticos (SP). El 12% estaba
desnutrido; el 57%, en riesgo nutricional; el 24%, normonutrido; el 6% presentaba sobrepeso; y un 1%, obesidad. La función pulmonar en los
pacientes con sobrepeso (91 ± 19%) era mejor que en los desnutridos (77 ± 24%) (p = 0,017), sin embargo, no se observaron diferencias con
respecto a los que estaban en riesgo nutricional (86 ± 19%) o normonutridos (90 ± 22%). Los pacientes con sobrepeso tenían más elevado el
colesterol total (p = 0,0049), mayor proporción de hipercolesterolemia (p = 0,001), así como niveles más bajos de 25 OH vitamina D (p = 0,058).
Conclusiones: la prevalencia de sobrepeso y obesidad fue del 6 y el 1%. El sobrepeso y la obesidad no ofrecen benefi cio sobre la función
pulmonar en comparación con los normonutrido
Genomic mutation profile in progressive chronic lymphocytic leukemia patients prior to first-line chemoimmunotherapy with FCR and rituximab maintenance (REM)
Chronic Lymphocytic Leukemia (CLL) is the most prevalent leukemia in Western countries and is notable for its variable clinical course. This variability is partly reflected by the mutational status of IGHV genes. Many CLL samples have been studied in recent years by next-generation sequencing. These studies have identified recurrent somatic mutations in NOTCH1, SF3B1, ATM, TP53, BIRC3 and others genes that play roles in cell cycle, DNA repair, RNA metabolism and splicing. In this study, we have taken a deep-targeted massive sequencing approach to analyze the impact of mutations in the most frequently mutated genes in patients with CLL enrolled in the REM (rituximab en mantenimiento) clinical trial. The mutational status of our patients with CLL, except for the TP53 gene, does not seem to affect the good results obtained with maintenance therapy with rituximab after front-line FCR treatment
Vitamin d and chronic lung colonization in pediatric and young adults cystic fibrosis patients
Introducción y objetivos: conocer la situación en la que
se encuentran los pacientes con fibrosis quística en relación con sus niveles de vitamina D y su asociación con las
colonizaciones pulmonares crónicas.
Material y métodos: estudio multicéntrico transversal.
Participaron 12 hospitales nacionales. De noviembre a
abril del 2012 al 2014 se incluyeron 377 pacientes con fibrosis quística. Se consideraron insuficientes niveles de
vitamina D < 30 ng/ml. Presentar al menos dos cultivos
positivos en el último año fue considerado un criterio de
colonización crónica.
Resultados: los pacientes tenían una mediana de edad
de 8,9 años (2 meses—20 años). Un 65% presentaban
niveles insuficientes de vitamina D. Se observó una correlación inversa entre edad y niveles de vitamina D
(r = -0,20 p < 0,001). Los diagnosticados por cribado eran
más jóvenes y tenían niveles de vitamina D más altos.
Los niveles de vitamina D presentaron una correlación
inversa con el número de colonizaciones pulmonares
(r = -0,16 p = 0,0015). Ajustando por edad, función pancreática y diagnóstico mediante cribado, la colonización
por S. Aureus en menores de seis años y por Pseudomonas
sp. en los mayores de esa edad, incrementaban el riesgo
de presentar niveles insuficientes de vitamina D: OR 3,17
(IC95% 1,32-7,61) (p=0,010) y OR 3,77 (IC95% 1,37-
10,37)(p = 0,010), respectivamente. Conclusiones: a pesar de una suplementación adecuada, más de la mitad de nuestros pacientes no alcanzan
niveles óptimos de vitamina D. La colonización crónica
por Pseudomonas sp. en escolares y adolescentes y por
S. Aureus en lactantes y preescolares se asocia de forma
independiente con la deficiencia de vitamina D.Introduction and objectives: evaluate vitamin D status
and its association with chronic lung colonisation in Cystic Fibrosis patients.
Material and methods: descriptive cross-sectional multicenter study. From November 2012 to April 2014, at 12
national hospitals, 377 patients with Cystic Fibrosis were
included. Vitamin D levels < 30 ng/ml were classified as
insufficient. Chronic colonisation was considered if they
had at least two positive cultures in the past year.
Results: the median age was 8.9 years (2 months to 20
years). 65% had insufficient levels of vitamin D. There
was an inverse correlation between age and vitamin D
levels (r = -0.20 p < 0.001). Those diagnosed by screening,
were younger and had higher levels of vitamin D. There
was an inverse correlation between the number of colonisations and vitamin D levels (r = -0.16 p = 0.0015). Adjusting for age, pancreatic status and diagnosis by screening,
colonization by S. aureus in <6 years and Pseudomonas sp.
in > 6 years, increased the risk of insufficient levels of vitamin D: OR 3.17 (95% CI 1.32 to 7.61) (p = 0.010) and
OR 3.77 (95% CI 1.37 to 10 , 37) (p = 0.010), respectively. Conclusions: despite adequate supplementation, more
than half of our patients did not achieve optimal levels of
vitamin D. Regardless of age, diagnosis by screening or
pancreatic status, chronic colonization by Pseudomonas
sp. in children and adolescents and S. Aureus in infants
and preschoolars increases the risk of developing vitamin D deficiency in these patients.S
Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world
Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic.
Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality.
Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States.
Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis.
Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection
El expediente de prensa como herramienta de aprendizaje
Memoria ID12-0197. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2012-2013
Transición de la asignatura Estrategia Comercial al EEES: implantación de nuevas metodologías docentes
Memoria ID11-198. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2011-2012
Cuadernos metodológicos: Estándares de calidad para pruebas estandarizadas de alto impacto en el contexto académico y profesional costarricense
El uso de pruebas estandarizadas de alto impacto implica un proceso de construcción
y validación guiado científicamente, utilizando los más altos estándares de calidad para
garantizar la confiabilidad y validez de las inferencias que se realicen a partir de sus
puntuaciones. Debido a que se trata de exámenes de grandes consecuencias para la vida
y el desarrollo de las personas, las pruebas deben ser construidas, adaptadas y aplicadas
utilizando la tradición científica en psicometría y medición educativa, que brinda un cuerpo
de teorías y métodos para construir y validar este tipo de instrumentos y permite recolectar
información empírica y evidencia sólida acerca de la confiabilidad y validez de los mismos.
En este contexto de la evaluación de alto impacto, el presente documento tiene como
propósito orientar la labor y los planes de mejoramiento de las instituciones y organizaciones
comprometidas con la validez, equidad y ética en la aplicación de pruebas de estandarizadas
de alto impacto en contextos académicos y profesionales. El logro de los estándares propuestos se debe asumir como un proceso formativo, por lo tanto, es posible que en una primera valoración no se cumplan a cabalidad los estándares que aquí se presentan. Se espera que los programas responsables ejecuten acciones concretas para cumplir, en un plazo determinado, con aquellos estándares para los cuales no hay, en la actualidad, suficiente evidencia de su cumplimiento.Universidad de Costa Rica/[]/UCR/Costa RicaUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Sociales::Instituto de Investigaciones Psicológicas (IIP
Vitamin D Status in Pediatric and Young Adult Cystic Fibrosis Patients. Are the New Recommendations Effective?
Introduction: In recent years, guidelines for vitamin D supplementation have been updated and prophylactic recommended doses have been increased in patients with cystic fibrosis (CF). Objective: To evaluate safety and efficacy of these new recommendations. Results: Two cohorts of pancreatic insufficient CF patients were compared before (cohort 1: 179 patients) and after (cohort 2: 71 patients) American CF Foundation and European CF Society recommendations were published. Cohort 2 patients received higher Vitamin D doses: 1509 (1306–1711 95% CI) vs 1084 (983–1184 95% CI) IU/Day (p < 0.001), had higher 25 OH vitamin D levels: 30.6 (27.9–33.26 95% CI) vs. 27.4 (25.9–28.8 95% CI) ng/mL (p = 0.028), and had a lower prevalence of insufficient vitamin D levels (<30 ng/mL): 48% vs 65% (p = 0.011). Adjusted by confounding factors, patients in cohort 1 had a higher risk of vitamin D insufficiency: OR 2.23 (1.09–4.57 95% CI) (p = 0.028). Conclusion: After the implementation of new guidelines, CF patients received higher doses of vitamin D and a risk of vitamin D insufficiency decreased. Despite this, almost a third of CF patients still do not reach sufficient serum calcidiol levels