Post-Marketing Health Technology Monitoring. The Analysis of an Experience from a Clinical Perspective

Introduction: A system for monitoring the use of aphaeresis in the treatment of ulcerative colitis (UC), named system for monitoring aphaeresis in ulcerative colitis (SiMAC), was designed in 2006 in the Basque Country. In the present study, the opinion of the clinicians who participated in SiMAC was evaluated, in order to identify the barriers and gather suggestions that could improve implementation of this kind of system. Methods: A mixed questionnaire was designed, in order to gather clinicians’ assessments of the SiMAC monitoring system. Results: The response rate was 73.9% (17/23). The data from 40.96% (159/388) of patients with UC treated with aphaeresis was recorded. The main reasons for not including the data from all treated patients were a lack of required data or not meeting the study inclusion criteria. Positive aspects of the SiMAC were identified, as the simplicity of data collection and its systematic, multi-center approach. The negative aspects mentioned were the use of a local computer application and the lack of time for health professionals to enter data. Discussion: The use of monitoring systems helps to formalize the introduction of technologies of little-known effectiveness; involve clinicians and medical societies in coming to agreement and obtaining information about the safety, effectiveness or efficiency of new technologies; and provide relevant information to healthcare administrations for making decisions about the introduction of new technologies into healthcare practice. In order for a monitoring system to work, the process must be straightforward. A minimum set of key variables that are easy to collect must be selected, and an effort made to involve a range of stakeholders, especially institutions and scientific societies, to support the work group

Análisis del rendimiento académico en los estudios de informática de la Universidad Politécnica de Valencia aplicando técnicas de minería de datos

En este trabajo presentamos un análisis del rendimiento académico de los alumnos de nuevo ingreso en la titulación de Ingeniería Técnica en Informática de Sistemas de la Universidad Politécnica de Valencia (UPV) a lo largo de tres cursos, aunque también se ha trabajado con las titulaciones de Ingeniería Técnica en Informática de Gestión y de Ingeniería Informática. Este análisis relaciona el rendimiento con las características socioeconómicas y académicas de los alumnos, que se obtienen en el momento de su matrícula, y que se recogen en la base de datos de la universidad. Hemos definido un indicador del rendimiento para cada alumno, teniendo en cuenta las calificaciones obtenidas y las convocatorias utilizadas. Para el estudio utilizamos técnicas de minería de datos, que pretenden determinar qué nivel de condicionamiento existe entre dicho rendimiento y características como el nivel de conocimientos de entrada del alumno, su contexto geográfico y sociocultural, etc… Esto proporciona una herramienta importante para la acción tutorial, que puede apoyarse en las predicciones de los modelos que se obtienen para encauzar sus recomendaciones y encuadrar las expectativas y el esfuerzo necesario para cada alumno, lógicamente dentro de la cautela habitual a la hora de tratar modelos inferidos a partir de datos.Universidad Politécnica de Valencia, a través del programa PACE

Risk Factors for COVID-19 in Inflammatory Bowel Disease: A National, ENEIDA-Based Case–Control Study (COVID-19-EII)

(1) Scant information is available concerning the characteristics that may favour the acquisition of COVID-19 in patients with inflammatory bowel disease (IBD). Therefore, the aim of this study was to assess these differences between infected and noninfected patients with IBD. (2) This nationwide case-control study evaluated patients with inflammatory bowel disease with COVID-19 (cases) and without COVID-19 (controls) during the period March-July 2020 included in the ENEIDA of GETECCU. (3) A total of 496 cases and 964 controls from 73 Spanish centres were included. No differences were found in the basal characteristics between cases and controls. Cases had higher comorbidity Charlson scores (24% vs. 19%; p = 0.02) and occupational risk (28% vs. 10.5%; p < 0.0001) more frequently than did controls. Lockdown was the only protective measure against COVID-19 (50% vs. 70%; p < 0.0001). No differences were found in the use of systemic steroids, immunosuppressants or biologics between cases and controls. Cases were more often treated with 5-aminosalicylates (42% vs. 34%; p = 0.003). Having a moderate Charlson score (OR: 2.7; 95%CI: 1.3-5.9), occupational risk (OR: 2.9; 95%CI: 1.8-4.4) and the use of 5-aminosalicylates (OR: 1.7; 95%CI: 1.2-2.5) were factors for COVID-19. The strict lockdown was the only protective factor (OR: 0.1; 95%CI: 0.09-0.2). (4) Comorbidities and occupational exposure are the most relevant factors for COVID-19 in patients with IBD. The risk of COVID-19 seems not to be increased by immunosuppressants or biologics, with a potential effect of 5-aminosalicylates, which should be investigated further and interpreted with caution

Correction : Chaparro et al. Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain: Large-Scale Epidemiological Study. J. Clin. Med. 2021, 10, 2885

The authors wish to make the following corrections to this paper [...]

Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain : Large-Scale Epidemiological Study

(1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD-Crohn's disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)-during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100,000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31-56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p < 0.01). (4) Conclusion: The incidence of IBD in Spain is rather high and similar to that reported in Northern Europe. IBD patients require substantial therapeutic resources, which are greater in CD and in hospitals with high resources, and much higher than previously reported. One third of patients are hospitalized in the first year after diagnosis and a relevant proportion undergo surgery

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

Relación entre el cáncer colorrectal y la enfermedad inflamatoria intestinal

La enfermedad inflamatoria intestinal se asocia a un riesgo aumentado de cáncer colorrectal, que se relaciona principalmente con la inflamación crónica de larga evolución. Los factores de riesgo reconocidos son la duración y la extensión de la enfermedad, la presencia de signos de inflamación grave endoscópicos o histológicos, la colangitis esclerosante primaria, los antecedentes familiares de cáncer colorrectal y, en algunos estudios, el diagnóstico en edad juvenil. Estudios recientes han mostrado que el riesgo es menor al descrito inicialmente, o incluso similar al de la población general, y esto podría estar justificado por aspectos metodológicos o por una disminución real del riesgo debido a un mejor control de la enfermedad, el uso de fármacos con efectos quimioprotectores y la extensión de la vigilancia endoscópica en los pacientes de alto riesgo. En el presente artículo se revisan la magnitud del riesgo de cáncer colorrectal, los factores de riesgo asociados a su desarrollo, la historia natural de la displasia y las recomendaciones de vigilancia endoscópica en la enfermedad inflamatoria intestina

Procedimiento y sistema inalámbrico de medida del grado de fraguado y endurecimiento de materiales cementicios para la predicción de resistencias mecánicas

El sistema inalámbrico de medida del grado de fraguado y endurecimiento de materiales cementicios comprende un sensor ultrasónico, un sensor de temperatura, un sensor de humedad relativa, una red de comunicación inalámbrica compuesta por al menos dos nodos para la adquisición y procesamiento de señales electrónicas provenientes de sensores y un sistema informático, tal que el sistema informático calcula la resistencia mecánica del material cementicio. Por otro lado, el método comprende los siguientes pasos: capturar unos datos de temperatura T y humedad H, capturar una señal ultrasónica para la medida de velocidad de propagación V, capturar una señal ultrasónica para la medida del coeficiente de reflexión CR, enviar todos los registros anteriores de las señales sensoriales al nodo principal, procesar las señales para obtener los parámetros velocidad V y coeficiente de reflexión CR, enviar los datos obtenidos al sistema informático y calcular la resistencia mecánica mínima RC(V,CR,T,H) del material cementicio.Peer reviewedConsejo Superior de Investigaciones Científicas (España), Universidad Politécnica de Madrid, Asociación de Investigación de Industrias de la Construcción -AIDICO- Instituto Tecnológico de la ConstrucciónA1 Solicitud de patente con informe sobre el estado de la técnic

Newsletter No. 5: Feminist Spatialities

En este nuevo número, la Boletina se centra en la inescapable dimensión espacial de los procesos sociales. Si queremos construir realidades menos injustas y desiguales, esto pasa necesariamente por la construcción de espacios menos violentos y discriminatorios hacia las mujeres, otros sujetos feminizados y aquellos que no caben en el orden heteropatriarcal. Con el título de Espacialidades Feministas, el número se enfoca en la relación bidireccional entre espacio y género: los espacios que construimos día a día son el resultado, a la vez que resultan, en roles, expectativas y experiencias de género desiguales.In this new issue, Boletina focuses on the inescapable spatial dimension of social processes. If we want to build less unjust and unequal realities, this necessarily involves the construction of spaces that are less violent and discriminatory towards women, other feminized subjects and those who do not fit into the heteropatriarchal order. Entitled Feminist Spaces, the issue focuses on the bidirectional relationship between space and gender: the spaces we build every day are the result, as well as the outcome, of unequal gender roles, expectations and experiences.Otr