Pandemia desde la academia: experiencias transdisciplinarias de la universidad cuencana en tiempos de COVID-19

Pandemia es una palabra con origen profundo que en el tiempo se ha cargado con la historia de pueblos y naciones, alcanzando su plena expresión en nuestra sociedad globalizada. No solamente por las estadísticas que atraen la atención de todo el mundo y nos obligan a razonar de manera lógico-numérica, cuantitativa, olvidando que muchas veces los números son personas, y no rinden la justa cuenta de todos aquellos seres humanos que representan estas cifras. Una pandemia logra su máxima expresión al alcanzar el mayor número de personas, esto refleja en su etimología proveniente del griego pan (todo) y demos (pueblo) y desde sus orígenes ha significado principalmente una cosa, la “reunión del pueblo”. Dicha noción invita a reflexionar sobre el porqué de las medidas sanitarias, del aislamiento y confinamiento, y, más aún, nos recuerda la importancia de la unión como decisión ancestral al origen de nuestras sociedades, columna portante de la familia, fortaleza de cualquier sistema en desequilibrio. Reconociendo esto, se evidencia la capacidad de transformar juntos las debilidades en fortalezas, de saber demostrar nuestro mejor impulso a la solidaridad y colaboración cuando sentimos que nos necesitan, que permite terminar con alegría un capítulo con la seguridad de que el próximo será mucho mejor. Este espíritu es responsable de la iniciativa de quienes enfrentamos los desafíos del contexto desde la unión, con la aspiración de formar seres humanos en un espacio compartido de generación de conocimiento y conformación de valores humanos y sociales que llamamos Universidad

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

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Mirando a África

Este proyecto pretende acercar a la comunidad educativa del centro una realidad tan próxima, compleja y dramática como la del continente africano, desde casi todas las materias. Y pretende hacerlo en coherencia con valores que identifican al centro. Los objetivos son fomentar la colaboración y participación de los alumnos intercambiando sus propias experiencias; potenciar una conciencia social y ecológica; formar integralmente a los alumnos para el mejor desarrollo de la sociedad; valorar la utilidad de la enseñanza activa y el aprendizaje cooperativo; diseñar actividades que permitan desarrollar una enseñanza interdisciplinar; posibilitar que los alumnos desarrollen estrategias globalizadoras de organización del conocimiento mediante el tratamiento de la información; favorecer el aprendizaje significativo; animar al profesorado a buscar estrategias que favorezcan la actividad didáctica; fomentar la lectura y el uso correcto de la expresión oral y escrita, además de mejorar la ortografía; extender el conocimiento y la utilización de las nuevas tecnologías de la información y la comunicación; estrechar las relaciones entre los diferentes sectores de la comunidad educativa; fomentar la participación activa en la vida social; mejorar la convivencia en el centro; desarrollar hábitos de vida saludables; provocar en los alumnos una visión positiva del centro como lugar de ocio y de enriquecimiento cultural; desarrollar y favorecer las inquietudes culturales de los alumnos; desarrollar las actitudes positivas hacia otras culturas; extender el conocimiento de lenguas extranjeras y mantener relaciones estables de colaboración con instituciones culturales y sociales. Las actividades desarrolladas se organizan en tres modalidades que son actividades globales que implican a toda la comunidad educativa como un concurso de lectura llamado África desde la biblioteca, el día del Libro, viaje de fin de curso a Túnez, apadrinar una escuela en Marruecos, una jornada cultural antes de las vacaciones de Semana Santa, talleres a cargo de la Fundación Yehudi Menuhin y Hora 31 con ciclos de charlas y conferencias; actividades durante el horario lectivo en los distintos departamentos didácticos como proyecciones de películas, composición de textos, debates y trabajos en equipo; y las actividades realizadas fuera del horario lectivo como son talleres, cineclub, coloquios, exposiciones, actividades de cooperación y asistir a diversos espectáculos. La metodología es diversa, en relación con la pluralidad de actividades que se llevan a cabo. Como indicadores del proceso de evaluación se toman para las actividades del currículo, la propia evaluación de profesores. Aunque es un indicador cuantitativo para el análisis final y junto a otros parámetros, se trabaja también la evaluación cualitativa, para que las conclusiones tengan un carácter más global de los resultados del proyecto. Por el contrario, las actividades que se realizan fuera del horario lectivo se miden con el grado de participación. Además como herramienta de evaluación individual se elaboran encuestas para alumnos y profesores para que reflejen sus opiniones personales sobre el proyecto. Se adjunta como anexo dos CD-ROM y cuestionarios..Madrid (Comunidad Autónoma). Consejería de Educación. Dirección General de Mejora de la Calidad de la EnseñanzaMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES

Demographic, clinical, and functional determinants of antithrombotic treatment in patients with nonvalvular atrial fibrillation

Altres ajuts: Alliance Bristol-Myers Squibb/Pfizer.Background: This study assessed the sociodemographic, functional, and clinical determinants of antithrombotic treatment in patients with nonvalvular atrial fibrillation (NVAF) attended in the internal medicine setting. Methods: A multicenter, cross-sectional study was conducted in NVAF patients who attended internal medicine departments for either a routine visit (outpatients) or hospitalization (inpatients). Results: A total of 961 patients were evaluated. Their antithrombotic management included: no treatment (4.7%), vitamin K antagonists (VKAs) (59.6%), direct oral anticoagulants (DOACs) (21.6%), antiplatelets (6.6%), and antiplatelets plus anticoagulants (7.5%). Permanent NVAF and congestive heart failure were associated with preferential use of oral anticoagulation over antiplatelets, while intermediate-to high-mortality risk according to the PROFUND index was associated with a higher likelihood of using antiplatelet therapy instead of oral anticoagulation. Longer disease duration and institutionalization were identified as determinants of VKA use over DOACs. Female gender, higher education, and having suffered a stroke determined a preferential use of DOACs. Conclusions: This real-world study showed that most elderly NVAF patients received oral anticoagulation, mainly VKAs, while DOACs remained underused. Antiplatelets were still offered to a proportion of patients. Longer duration of NVAF and institutionalization were identified as determinants of VKA use over DOACs. A poor prognosis according to the PROFUND index was identified as a factor preventing the use of oral anticoagulation

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

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

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. 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: A total of 3120 patients with IE (1327  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 th