Informe sobre detección de necesidades de información [Recurso en línea]: Zona formativa 5 : Alto y Bajo Guadalentín

Precede al título : Comisión territorial

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

Estudio clínico y acústico de la voz en pacientes portadores de prótesis fonatoria de Herrmann tras laringuectomía total fonatoria / Mariano Rosique Arias ; directores José Luis Ramón García, Juan Antonio Jiménez-Cervantes Nicolás.

Tesis-Universidad de Murcia.MEDICINA ESPINARDO. DEPOSITO. MU-Tesis 563.Consulte la tesis en: BCA. GENERAL. ARCHIVO UNIVERSITARIO. T.M.-1735

Eutrophication in coastal areas of the Mar Menor lagoon: The mitigation role of the salt marshes.

The Mar Menor lagoon is one of the largest coastal lagoons (135 km2 surface) of the Mediterranean basin. It receives runoff waters coming from the nearby intensive agricultural area of Campo de Cartagena, which have led this lagoon to be declared as a sensitive area for eutrophication in June 2001 under European Directive 91/271/EEC and as a vulnerable zone for nitrates contamination in December 2002 under Directive 91/676/EEC. Moreover, the existence of mining activities (nowadays discontinued) in the nearby area of Sierra de Cartagena-La Union has caused the spread of metal polluted wastes into the Mar Menor lagoon and its salt marshes. As a consequence, huge coastal areas are buried by metal enriched wastes, and although most of them have been colonized by vegetation, others remain bare and exposed to erosive agents (e.g. wind, water). At the same time, the Mar Menor and its salt marshes have been included in the Ramsar Convention on Wetlands. Also, it is a Special Protected Area of Mediterranean Interest (SPAMI), a Specially Protected Area (SPA) under the EU Wild Birds Directive and a Site of Community Importance (SCI) to be integrated in the Nature 2000 Network (EU Habitats Directive). In addition, the Campo de Cartagena- Mar Menor zone hosts important economic activities related with agriculture, fisheries and tourism (Conesa and Jiménez-Cárceles, 2007). Hence, the habitat conservation and the uses of the territory must be compatible and overcome the environmental problems of the zone. This paper summarizes several studies carried out in the Mar Menor area from year 2000 till nowadays. The methodologies followed in these works were based on international scientific and technical protocols. The research included field and lab experiments. The first ones had the goal of answering questions such as what, where, when, by means of descriptive field survey studies (Álvarez-Rogel et al., 2000, 2001, 2006b, 2007a y c, Álvarez-Rogel et al., 2006a, 2007b; Jiménez-Cárceles, 2007; Jiménez-Cárceles et al., 2006; Jiménez-Cárceles and Álvarez-Rogel, 2008; Egea et al., 2011). Afterwards, the research had the goal of explaining how the processes occurred, by means of experimental set ups not included here (greenhouse experiments, columns, lab, etc.). This chapter deals with the field survey studies in order to describe the nutrient dynamics and eutrophication risks in the coastal areas of the Mar Menor lagoo

Desarrollo del sistema pigmentario de la estría vascular del oído interno del jerbo (Meriones unguiculatus) en relación con la función auditiva : análisis bioquímico, morfológico y electrococleográfico / Dionisio Andrés Pérez Mestre ; Directores: Juan Jiménez-Cervantes Nicolás, José Carlos García-Borrón Martínez, Concepción Ferrer Cazorla.

Tesis - Universidad de Murcia.MEDICINA ESPINARDO. DEPOSITO. MU-Tesis 595.Consulte la tesis en: BCA. GENERAL. ARCHIVO UNIVERSITARIO. T.M.-1822

Informe sobre detección de necesidades de formación : zona formativa 5 : Alto y Bajo Guadalentín

Resultados del trabajo realizado por la Comisión Territorial de Formación Profesional en el que se detectan las necesidades formativas en los municipios de las comarcas del Alto y Bajo Guadalentín de la Región de Murcia; zona de influencia de esta Comisión. El objetivo de este trabajo es dar respuesta a la demanda de recursos humanos por parte del sistema productivo, proporcionando al sistema formativo las bases para redefinir y actualizar de forma constante tanto el conjunto de perfiles profesionales presentes como los que se puedan detectar en el futuro. En este informe se estudia la situación de cuatro escenarios relevantes: población, mercado laboral, sistema productivo y oferta formativa. Para ello se han analizado las siguientes fuentes de información: matriz DAFO; encuesta realizada por el Observatorio Regional de Empleo sobre necesidades formativas y ocupacionales; análisis de las principales variables socioeconómicas de la zona formativa y, por último el estudio de la oferta formativa, tanto de formación profesional reglada, como ocupacional.MurciaES

How do women living with HIV experience menopause? Menopausal symptoms, anxiety and depression according to reproductive age in a multicenter cohort

CatedresBackground: To estimate the prevalence and severity of menopausal symptoms and anxiety/depression and to assess the differences according to menopausal status among women living with HIV aged 45-60 years from the cohort of Spanish HIV/AIDS Research Network (CoRIS). Methods: Women were interviewed by phone between September 2017 and December 2018 to determine whether they had experienced menopausal symptoms and anxiety/depression. The Menopause Rating Scale was used to evaluate the prevalence and severity of symptoms related to menopause in three subscales: somatic, psychologic and urogenital; and the 4-item Patient Health Questionnaire was used for anxiety/depression. Logistic regression models were used to estimate odds ratios (ORs) of association between menopausal status, and other potential risk factors, the presence and severity of somatic, psychological and urogenital symptoms and of anxiety/depression. Results: Of 251 women included, 137 (54.6%) were post-, 70 (27.9%) peri- and 44 (17.5%) pre-menopausal, respectively. Median age of onset menopause was 48 years (IQR 45-50). The proportions of pre-, peri- and post-menopausal women who had experienced any menopausal symptoms were 45.5%, 60.0% and 66.4%, respectively. Both peri- and post-menopause were associated with a higher likelihood of having somatic symptoms (aOR 3.01; 95% CI 1.38-6.55 and 2.63; 1.44-4.81, respectively), while post-menopause increased the likelihood of having psychological (2.16; 1.13-4.14) and urogenital symptoms (2.54; 1.42-4.85). By other hand, post-menopausal women had a statistically significant five-fold increase in the likelihood of presenting severe urogenital symptoms than pre-menopausal women (4.90; 1.74-13.84). No significant differences by menopausal status were found for anxiety/depression. Joint/muscle problems, exhaustion and sleeping disorders were the most commonly reported symptoms among all women. Differences in the prevalences of vaginal dryness (p = 0.002), joint/muscle complaints (p = 0.032), and sweating/flush (p = 0.032) were found among the three groups. Conclusions: Women living with HIV experienced a wide variety of menopausal symptoms, some of them initiated before women had any menstrual irregularity. We found a higher likelihood of somatic symptoms in peri- and post-menopausal women, while a higher likelihood of psychological and urogenital symptoms was found in post-menopausal women. Most somatic symptoms were of low or moderate severity, probably due to the good clinical and immunological situation of these women

Investigación educativa en las aulas de primaria

Reúne trabajos derivados de la experiencias de diversos docentes en educación primaria en los siguientes temas: Tecnología de Información y Comunicación, educación inclusiva, enseñanza de la música, educación física, enseñanza de la historia, acoso escolar, auto-evaluación, métodos de enseñanza, inteligencia emocional, percepción del alumno, marco cognitivo en comprensión lectora y comunicación escuela-familia

Compilación de Proyectos de Investigacion de 1984-2002

Instituto Politecnico Nacional. UPIICS