Utilización de dibujos, imágenes y otros elementos multimedia en el diseño de recursos para la docencia virtual

Se presentan una serie de recursos hipermedia, que el grupo de autores han desarrollado con el ánimo de facilitar el aprendizaje de los alumnos en disciplinas de alto contenido descriptivo. En este caso concreto se refieren a la anatomía microscópica animal y vegetal, aunque las aplicaciones informáticas y procedimientos empleados son aplicables también a otras disciplinas, siempre con dicho carácter descriptivo en común. Fundamentalmente se trata de módulos interactivos de autoaprendizaje en formato SCORM, que incorporan como principal elemento dibujos descriptivos sobre las estructuras histológicas estudiadas. Tales dibujos se presentan al usuario como archivos tipo flash, con visualización interactiva y secuencial, para facilitar su comprensión. A la vez, incorporan enlaces con otra aplicación, diseñada previamente por los autores, bajo el aspecto de atlas histológico, en el que se recogen ejemplos de la realidad en forma de microfotografías, algunas de ellas navegables (microscopía virtual). Incluyen igualmente pruebas de autoevaluación y la posibilidad, dado su formato compatible, de que el profesor pueda realizar un completo seguimiento de su utilización a través de diferentes Plataformas de Docencia Virtual (LMSs). Por otro lado se han desarrollado otros recursos hipermedia en formato AVI de contenidos relacionados con el manejo de dispositivos y técnicas de uso habitual en histología. Incluyen, además de las grabaciones en video, imágenes fijas, texto, títulos de crédito y comentarios hablados ilustrando los contenidos expuestos. El acceso a este material se hace a través de una página web índice, con hipervínculos a cada archivo. Todos los recursos presentados se encuentran actualmente disponibles a través del servidor y la LMS de la Universidad de Jaén, pudiéndose acceder a los mismos desde la URL: http://virtual.ujaen.es/atlas/.This work is addressed to introduce a number of hypermedia resources aimed to facilitate the learning of students in descriptive disciplines. We have focused on animal and vegetal microscopic anatomy, although the applications and procedures described can be also applicable to other descriptive disciplines. In this way, self-study interactive modules in SCORM format were designed, incorporating descriptive drawings of the histological structures. These drawings are presented as flash-type files to the users, which can observe them in an interactive and sequential way to facilitate understanding. At the same time, they incorporate links to an interactive histological atlas, previously designed by the authors, in which are collected real photomicrographs, some of them available as “virtual microscopy” (a section that allows examining images as real observations using the microscope). The drawings also include self-evaluation tests, as well as the possibility that the teacher can conduct an exhaustive monitoring of the use of this teaching tool through different Learning Management Systems (LMSs). On the other hand, other hypermedia resources in AVI format have been developed. Such tools are related to the management of devices and techniques commonly used in Histology. They also include video recordings, images, text, credit, and spoken comments illustrating the contents. The access to this material can be achieved through an index web page with hyperlinks to each file. These tools are currently available through the server and LMS of the University of Jaén (Spain) in http://virtual.ujaen.es/atlas/

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Philadelphia-negative chronic myeloproliferative neoplasm follow-up: when the phone rings. Changes during the COVID-19 pandemic and patient satisfaction. Experience in 30 health centers in Spain.

The SARS-CoV-2 pandemic has favored the expansion of telemedicine. Philadelphia-negative chronic myeloproliferative neoplasms (Ph-MPN) might be good candidates for virtual follow-up. In this study, we aimed to analyze the follow-up of patients with Ph-MPN in Spain during COVID-19, its effectiveness, and acceptance among patients. We present a multicenter retrospective study from 30 centers. Five hundred forty-one patients were included with a median age of 67 years (yr). With a median follow-up of 19 months, 4410 appointments were recorded. The median of visits per patient was 7 and median periodicity was 2.7 months; significantly more visits and a higher frequency of them were registered in myelofibrosis (MF) patients. 60.1% of visits were in-person, 39.5% were by telephone, and 0.3% were videocall visits, with a predominance of telephone visits for essential thrombocythemia (ET) and polycythemia vera (PV) patients over MF, as well as for younger patients

Coeducación : una escuela hacia la igualdad

Mención honorífica de la convocatoria de premios 'Irene: la paz empieza en casa 2008'. Incluye resumen con las actividades realizadas en el proyectoPresenta un proyecto de coeducación para la igualdad de sexos realizado en el IES 'Reyes de España' en Linares (Jaén), entre los cursos 2006 y 2008. A través del proyecto se han introducido cambios que incluyen una perspectiva de género en la práctica docente buscando favorecer prácticas correctoras de estereotipos sexistas; planifica objetivos y actuaciones para corregir desigualdades y discriminaciones sexistas, promueve la autoformación y el trabajo en equipo; fomenta un uso no sexista del lenguaje; utiliza una metodología activa, participativa, significativa y lúdica; utiliza las nuevas tecnologías como edición de video, carteles, página web, presentaciones didácticas en PowerPoint e Impress, revistas digitales, ejercicios informáticos en software libre realizados con Flash, Graffitis, campañas publicitarias, periódico escolar, etc.; incorpora procedimientos de evaluación para valorar el grado de consecución de los objetivos establecidos; establece mecanismos de difusión escrita, informática y audiovisual a través de una página web; y utiliza materiales y recursos en español, francés e inglés.AndalucíaBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 Planta; 28014 Madrid; Tel. +34917748000; Fax +34917748026; [email protected]

Switching TNF antagonists in patients with chronic arthritis: An observational study of 488 patients over a four-year period

The objective of this work is to analyze the survival of infliximab, etanercept and adalimumab in patients who have switched among tumor necrosis factor (TNF) antagonists for the treatment of chronic arthritis. BIOBADASER is a national registry of patients with different forms of chronic arthritis who are treated with biologics. Using this registry, we have analyzed patient switching of TNF antagonists. The cumulative discontinuation rate was calculated using the actuarial method. The log-rank test was used to compare survival curves, and Cox regression models were used to assess independent factors associated with discontinuing medication. Between February 2000 and September 2004, 4,706 patients were registered in BIOBADASER, of whom 68% had rheumatoid arthritis, 11% ankylosing spondylitis, 10% psoriatic arthritis, and 11% other forms of chronic arthritis. One- and two-year drug survival rates of the TNF antagonist were 0.83 and 0.75, respectively. There were 488 patients treated with more than one TNF antagonist. In this situation, survival of the second TNF antagonist decreased to 0.68 and 0.60 at 1 and 2 years, respectively. Survival was better in patients replacing the first TNF antagonist because of adverse events (hazard ratio (HR) for discontinuation 0.55 (95% confidence interval (CI), 0.34-0.84)), and worse in patients older than 60 years (HR 1.10 (95% CI 0.97-2.49)) or who were treated with infliximab (HR 3.22 (95% CI 2.13-4.87)). In summary, in patients who require continuous therapy and have failed to respond to a TNF antagonist, replacement with a different TNF antagonist may be of use under certain situations. This issue will deserve continuous reassessment with the arrival of new medications. © 2006 Gomez-Reino and Loreto Carmona; licensee BioMed Central Ltd

Prosthetic Valve Candida spp. Endocarditis: New Insights Into Long-term Prognosis—The ESCAPE Study

International audienceBackground: Prosthetic valve endocarditis caused by Candida spp. (PVE-C) is rare and devastating, with international guidelines based on expert recommendations supporting the combination of surgery and subsequent azole treatment.Methods: We retrospectively analyzed PVE-C cases collected in Spain and France between 2001 and 2015, with a focus on management and outcome.Results: Forty-six cases were followed up for a median of 9 months. Twenty-two patients (48%) had a history of endocarditis, 30 cases (65%) were nosocomial or healthcare related, and 9 (20%) patients were intravenous drug users. "Induction" therapy consisted mainly of liposomal amphotericin B (L-amB)-based (n = 21) or echinocandin-based therapy (n = 13). Overall, 19 patients (41%) were operated on. Patients <66 years old and without cardiac failure were more likely to undergo cardiac surgery (adjusted odds ratios [aORs], 6.80 [95% confidence interval [CI], 1.59-29.13] and 10.92 [1.15-104.06], respectively). Surgery was not associated with better survival rates at 6 months. Patients who received L-amB alone had a better 6-month survival rate than those who received an echinocandin alone (aOR, 13.52; 95% CI, 1.03-838.10). "Maintenance" fluconazole therapy, prescribed in 21 patients for a median duration of 13 months (range, 2-84 months), led to minor adverse effects.Conclusion: L-amB induction treatment improves survival in patients with PVE-C. Medical treatment followed by long-term maintenance fluconazole may be the best treatment option for frail patients

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective