Intervención asistida con animales (IAA): Análisis de la situación en España

This article describes the current state of animal-assisted intervention (AAI) in Spain, which is an emerging sector that is currently undergoing rapid expansion. The study covered the activities of 275 professionals working in 55 institutions with 213 trained animals. These professionals are systematically and continuously developing programs for animal-assisted therapy (AAT), animal-assisted activities (AAA), and animal-assisted education (AAE) in Spain. The institutions have a multi-professional character in that they mainly bring together the disciplines of animal training, psychology, and education. Their main activity is AAT, which mainly centres on the areas of disability/neurorehabilitation, education, psychology/psychiatry, social integration, and gerontology. Future studies will verify if this upward trend continues to grow or becomes stable.En este estudio se describe la actividad profesional de las principales entidades (instituciones, empresas, fundaciones, asociaciones, etc.) que en España se dedican de manera sistemática y continuada a la Intervención asistida con animales (IAA), incluidas la Terapia (TAA), las Actividades (AAA) y la Educación asistidas con animales (EAA). La Intervención asistida con animales en España está experimentando en la actualidad un gran auge y expansión. El estudio recoge la actividad de 275 profesionales que, junto a 213 animales, pertenecen a 55 entidades distribuidas por toda España. Todas ellas se dedican a desarrollar programas de Intervención asistida con animales de manera sistemática y continuada. Estas entidades se definen por su carácter multiprofesional aglutinando trabajadores de disciplinas diversas, tales como el adiestramiento animal, la psicología y la educación, fundamentalmente. Su actividad principal es la terapia asistida con animales, siendo sus ámbitos de actuación prioritarios la neurorehabilitación, la educación, la psicología/psiquiatría, la integración social y la gerontología. En el futuro, estudios similares comprobarán si esta tendencia expansiva sigue creciendo o se estabiliza

Severe vaccine-acquired rotavirus infection in an infant with primary intestinal lymphangiectasia

Clinical letterTo date, severe cases of vaccine-related rotavirus infection have only been reported in infants with severe combined immunodeficiency after immunization. We describe the first case of vaccine-related rotavirus gastroenteritis in an infant with intestinal lymphangiectasia.S

Effectiveness of Fosfomycin for the Treatment of Multidrug-Resistant Escherichia coli Bacteremic Urinary Tract Infections

IMPORTANCE The consumption of broad-spectrum drugs has increased as a consequence of the spread of multidrug-resistant (MDR) Escherichia coli. Finding alternatives for these infections is critical, for which some neglected drugs may be an option. OBJECTIVE To determine whether fosfomycin is noninferior to ceftriaxone or meropenem in the targeted treatment of bacteremic urinary tract infections (bUTIs) due to MDR E coli. DESIGN, SETTING, AND PARTICIPANTS This multicenter, randomized, pragmatic, open clinical trial was conducted at 22 Spanish hospitals from June 2014 to December 2018. Eligible participants were adult patients with bacteremic urinary tract infections due to MDR E coli; 161 of 1578 screened patients were randomized and followed up for 60 days. Data were analyzed in May 2021. INTERVENTIONS Patients were randomized 1 to 1 to receive intravenous fosfomycin disodium at 4 g every 6 hours (70 participants) or a comparator (ceftriaxone or meropenem if resistant; 73 participants) with the option to switch to oral fosfomycin trometamol for the fosfomycin group or an active oral drug or pa renteral ertapenem for the comparator group after 4 days. MAIN OUTCOMES AND MEASURES The primary outcome was clinical and microbiological cure (CMC) 5 to 7 days after finalization of treatment; a noninferiority margin of 7% was considered. RESULTS Among 143 patients in the modified intention-to-treat population (median [IQR] age, 72 [62-81] years; 73 [51.0%] women), 48 of 70 patients (68.6%) treated with fosfomycin and 57 of 73 patients (78.1%) treated with comparators reached CMC (risk difference, -9.4 percentage points; 1-sided 95% CI, -21.5 to infinity percentage points; P = .10). While clinical or microbiological failure occurred among 10 patients (14.3%) treated with fosfomycin and 14 patients (19.7%) treated with comparators (risk difference, -5.4 percentage points; 1-sided 95% CI. -infinity to 4.9; percentage points; P = .19), an increased rate of adverse event-related discontinuations occurred with fosfomycin vs comparators (6 discontinuations [8.5%] vs 0 discontinuations; P = .006). In an exploratory analysis among a subset of 38 patients who underwent rectal colonization studies, patients treated with fosfomycin acquired a new ceftriaxone-resistant or meropenem-resistant gram-negative bacteria at a decreased rate compared with patients treated with comparators (0 of 21 patients vs 4 of 17 patients [23.5%]; 1-sided P = .01). CONCLUSIONS AND RELEVANCE This study found that fosfomycin did not demonstrate noninferiority to comparators as targeted treatment of bUTI from MDR E coli; this was due to an increased rate of adverse event-related discontinuations. This finding suggests that fosfomycin may be considered for selected patients with these infections

Adelante / Endavant

Séptimo desafío por la erradicación de la violencia contra las mujeres del Institut Universitari d’Estudis Feministes i de Gènere "Purificación Escribano" de la Universitat Jaume

Intervención asistida con animales (IAA): análisis de la situación en España

This article describes the current state of animal-assisted intervention (AAI) in Spain, which is an emerging sector that is currently undergoing rapid expansion. The study covered the activities of 275 professionals working in 55 institutions with 213 trained animals. These professionals are systematically and continuously developing programs for animal-assisted therapy (AAT), animal-assisted activities (AAA), and animal-assisted education (AAE) in Spain. The institutions have a multi-professional character in that they mainly bring together the disciplines of animal training, psychology, and education. Their main activity is AAT, which mainly centres on the areas of disability/neurorehabilitation, education, psychology/psychiatry, social integration, and gerontology. Future studies will verify if this upward trend continues to grow or becomes stable.En este estudio se describe la actividad profesional de las principales entidades (instituciones, empresas, fundaciones, asociaciones, etc.) que en España se dedican de manera sistemática y continuada a la Intervención asistida con animales (IAA), incluidas la Terapia (TAA), las Actividades (AAA) y la Educación asistidas con animales (EAA). La Intervención asistida con animales en España está experimentando en la actualidad un gran auge y expansión. El estudio recoge la actividad de 275 profesionales que, junto a 213 animales, pertenecen a 55 entidades distribuidas por toda España. Todas ellas se dedican a desarrollar programas de Intervención asistida con animales de manera sistemática y continuada. Estas entidades se definen por su carácter multiprofesional aglutinando trabajadores de disciplinas diversas, tales como el adiestramiento animal, la psicología y la educación, fundamentalmente. Su actividad principal es la terapia asistida con animales, siendo sus ámbitos de actuación prioritarios la neurorehabilitación, la educación, la psicología/psiquiatría, la integración social y la gerontología. En el futuro, estudios similares comprobarán si esta tendencia expansiva sigue creciendo o se estabiliza

Prevalence of reduced lung diffusing capacity and CT scan findings in smokers without airflow limitation: a population-based study

Background Population distribution of reduced diffusing capacity of the lungs for carbon monoxide (DLCO) in smokers and main consequences are not properly recognised. The objectives of this study were to describe the prevalence of reduced DLCO in a population-based sample of current and former smoker subjects without airflow limitation and to describe its morphological, functional and clinical implications.Methods A sample of 405 subjects aged 40 years or older with postbronchodilator forced expiratory volume in 1 s/forced vital capacity (FVC) >0.70 was obtained from a random population-based sample of 9092 subjects evaluated in the EPISCAN II study. Baseline evaluation included clinical questionnaires, exhaled carbon monoxide (CO) measurement, spirometry, DLCO determination, 6 min walk test, routine blood analysis and low-dose CT scan with evaluation of lung density and airway wall thickness.Results In never, former and current smokers, prevalence of reduced DLCO was 6.7%, 14.4% and 26.7%, respectively. Current and former smokers with reduced DLCO without airflow limitation were younger than the subjects with normal DLCO, and they had greater levels of dyspnoea and exhaled CO, greater pulmonary artery diameter and lower spirometric parameters, 6 min walk distance, daily physical activity and plasma albumin levels (all p<0.05), with no significant differences in other chronic respiratory symptoms or CT findings. FVC and exhaled CO were identified as independent risk factors for low DLCO.Conclusion Reduced DLCO is a frequent disorder among smokers without airflow limitation, associated with decreased exercise capacity and with CT findings suggesting that it may be a marker of smoking-induced early vascular damage.Trial registration number NCT03028207

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

Experiencias de innovación educativa en la Universidad de Murcia (2008)

Resumen tomado de la publicaciónSe recogen diversos proyectos de innovación realizados por el profesorado de la Universidad de Murcia. Son experiencias de adaptación, en las que se han diseñado, aplicado y evaluado diversas acciones de enseñanza, como : el aprendizaje basado en problemas, portafolios, aprendizaje cooperativo, planes de acción tutorial o curso cero de acogida de estudiantes, entre otros. Se trata de dar respuesta al cambio que requiere el proceso de de Convergencia Europea.MurciaBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín 5 -3 Planta; 28014 Madrid; Tel. +34917748000; [email protected]