Pharyngeal Kaposi’s Sarcoma : a case report

El artículo reseña un caso clínico de un hombre de 52 años de edad, con infección por HIV, quien presenta la aparición de una masa exofítica en el paladar blando y la base de la lengua. Esta lo llevó a un cuadro de disfagia y dificultad respiratoria progresiva, manejada de urgencias con traqueostomía y gastrostomía. El servicio de patología reportó una afectación tumoral por sarcoma de Kaposi.Reporte de caso328-333This article shows a case of a man of 52-years-old with HIV infection, who presents exophytic mass appeared in the soft palate and tongue base. This ultimately led to dysphagia and progressive respiratory difficulty, which had to be managed with tracheostomy and gastrostomy emergency. Pathology reports a tumor, involvement by Kaposi’s sarcoma

Multiple Myeloma, What a Radiologist Should Know

El mieloma múltiple (MM) es la malignidad primaria del hueso más común en el adulto con variadas manifestaciones clínicas e imaginológicas. Conocer sus presentaciones y realizar un diagnóstico eficiente resulta de mucha importancia, puesto que esto determina importantes diferencias en los factores pronósticos y en las conductas asumidas por los médicos tratantes. Su impacto en la evolución de la enfermedad y en la economía subraya la necesidad del adecuado conocimiento de las presentaciones de esta enfermedad por parte de médicos clínicos y radiólogos. Afortunadamente, la tecnología actual en imágenes diagnósticas ha avanzado a tal punto que permite a los radiólogos sacar conclusiones acertadas que repercutirán en el manejo de estos pacientes de forma determinante.Artículo de revisión4441-4450Multiple myeloma (MM) is the most common primary malignancy of the bone in adults with varied clinical manifestations and imaging features. It is extremely important to know its presentations, as well as to perform an efficient diagnosis, as this could determine significant differences in prognostic factors and behaviors assumed by the treating physicians. Its impact on the evolution of the disease and the economy underscores the need for an adequate knowledge of this disease by clinicians and radiologists. Fortunately, current advances in diagnostic imaging technology allow radiologists to draw accurate conclusions that will affect the treatment of these patients in a decisive wa

COVID-19 outbreaks in a transmission control scenario: challenges posed by social and leisure activities, and for workers in vulnerable conditions, Spain, early summer 2020

Severe acute respiratory syndrome coronavirus 2 community-wide transmission declined in Spain by early May 2020, being replaced by outbreaks and sporadic cases. From mid-June to 2 August, excluding single household outbreaks, 673 outbreaks were notified nationally, 551 active (>6,200 cases) at the time. More than half of these outbreaks and cases coincided with: (i) social (family/friends’ gatherings or leisure venues) and (ii) occupational (mainly involving workers in vulnerable conditions) settings. Control measures were accordingly applied

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

Sarcoma de Kaposi faríngeo: presentación de un caso

This article shows a case of a man of 52-years-old with HIV infection, who presents exophytic mass appeared in the soft palate and tongue base. This ultimately led to dysphagia and progressive respiratory difficulty, which had to be managed with tracheostomy and gastrostomy emergency. Pathology reports a tumor, involvement by Kaposi’s sarcoma.El artículo reseña un caso clínico de un hombre de 52 años de edad, con infección por HIV, quien presenta la aparición de una masa exofítica en el paladar blando y la base de la lengua. Esta lo llevó a un cuadro de disfagia y dificultad respiratoria progresiva, manejada de urgencias con traqueostomía y gastrostomía. El servicio de patología reportó una afectación tumoral por sarcoma de Kaposi

Sarcoma de Kaposi faríngeo: presentación de un caso

El artículo reseña un caso clínico de un hombre de 52 años de edad, con infección por HIV, quien presenta la aparición de una masa exofítica en el paladar blando y la base de la lengua. Esta lo llevó a un cuadro de disfagia y dificultad respiratoria progresiva, manejada de urgencias con traqueostomía y gastrostomía. El servicio de patología reportó una afectación tumoral por sarcoma de Kapos

Sarcoma de Kaposi faríngeo: presentación de un caso

This article shows a case of a man of 52-years-old with HIV infection, who presents exophytic mass appeared in the soft palate and tongue base. This ultimately led to dysphagia and progressive respiratory difficulty, which had to be managed with tracheostomy and gastrostomy emergency. Pathology reports a tumor, involvement by Kaposi’s sarcoma.El artículo reseña un caso clínico de un hombre de 52 años de edad, con infección por HIV, quien presenta la aparición de una masa exofítica en el paladar blando y la base de la lengua. Esta lo llevó a un cuadro de disfagia y dificultad respiratoria progresiva, manejada de urgencias con traqueostomía y gastrostomía. El servicio de patología reportó una afectación tumoral por sarcoma de Kaposi

COVID-19 in hospitalized HIV-positive and HIV-negative patients : A matched study

CatedresObjectives: We compared the characteristics and clinical outcomes of hospitalized individuals with COVID-19 with [people with HIV (PWH)] and without (non-PWH) HIV co-infection in Spain during the first wave of the pandemic. Methods: This was a retrospective matched cohort study. People with HIV were identified by reviewing clinical records and laboratory registries of 10 922 patients in active-follow-up within the Spanish HIV Research Network (CoRIS) up to 30 June 2020. Each hospitalized PWH was matched with five non-PWH of the same age and sex randomly selected from COVID-19@Spain, a multicentre cohort of 4035 patients hospitalized with confirmed COVID-19. The main outcome was all-cause in-hospital mortality. Results: Forty-five PWH with PCR-confirmed COVID-19 were identified in CoRIS, 21 of whom were hospitalized. A total of 105 age/sex-matched controls were selected from the COVID-19@Spain cohort. The median age in both groups was 53 (Q1-Q3, 46-56) years, and 90.5% were men. In PWH, 19.1% were injecting drug users, 95.2% were on antiretroviral therapy, 94.4% had HIV-RNA < 50 copies/mL, and the median (Q1-Q3) CD4 count was 595 (349-798) cells/μL. No statistically significant differences were found between PWH and non-PWH in number of comorbidities, presenting signs and symptoms, laboratory parameters, radiology findings and severity scores on admission. Corticosteroids were administered to 33.3% and 27.4% of PWH and non-PWH, respectively (P = 0.580). Deaths during admission were documented in two (9.5%) PWH and 12 (11.4%) non-PWH (P = 0.800). Conclusions: Our findings suggest that well-controlled HIV infection does not modify the clinical presentation or worsen clinical outcomes of COVID-19 hospitalization

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]