La protección del consumidor en los contratos vinculados

El presente estudio analiza la protección del consumidor que celebra contratos vinculados, resaltando las carencias que existen en la normativa para la adecuada protección del mismo. Se examinan los requisitos necesarios para que un contrato pueda ser considerado vinculado y se da solución a las consecuencias que provocan los casos de incumplimiento del proveedor, determinando quién ha de soportar el riesgo en dichas situaciones. Se fijan los derechos que tiene el consumidor ante la ineficacia del contrato de consumo y sus efectos en el contrato de crédito, y se determina si el consumidor queda debidamente protegido. Se estudia la liquidación de las relaciones contractuales de los contratos vinculados, los supuestos de cesión de créditos de los mismos, y la protección del consumidor de contratos vinculados que emplea efectos cambiarios. Realizo un especial análisis de los principales motivos alegados por los prestamistas para evitar que la LCCC despliegue sus efectos, atendiendo a lo largo de todo el trabajo al examen de las resoluciones del Tribunal Supremo sobre la materia, así como a la jurisprudencia menor

Asistencia virtual para apoyo de profesores en nuestra página web

El desarrollo de la inteligencia artificial ofrece metodologías innovadoras. El asistente virtual puede resultar de gran utilidad para un contacto y formación permanente, y es una realidad en creciente expansión en el ámbito empresarial. Este proyecto de innovación se apoya en cuestiones de desarrollo tecnológico de nuestra realidad social, cada vez más inmersa en un mundo de ciencia, tecnología e ingeniería, que se va extendiendo rápidamente al resto de disciplinas científicas. El principal objetivo del proyecto es incorporar de forma beneficiosa la tecnología y utilizarla al servicio del aprendizaje. En un entorno de aprendizaje que requiere capacidad de juicio y de pensamiento crítico para la de toma de decisiones, es importante hacer partícipes a los profesores en la búsqueda de sus necesidades no resueltas y la adopción de posibles soluciones, utilizando la tecnología más moderna. Además, también en una sociedad que avanza a una velocidad imparable en el ámbito digital, facilitar el acceso a información de forma global, beneficia no sólo a los alumnos, sino también a los profesores, y aporta valor añadido a la Universidad Complutense de Madrid. Tras la experiencia del confinamiento en la etapa Covid19 y el teletrabajo la asistencia virtual es una necesidad. La originalidad del Proyecto estriba precisamente en el planteamiento de la incorporación de la asistencia virtual e inteligencia artificial para la asistencia y apoyo a los profesores. En el ámbito europeo es cada vez mayor la preocupación por el uso y aplicaciones de la tecnología. Por ello, en primer lugar, es importante detectar las necesidades reales de los profesores, las lagunas de información y las dificultades para encontrarla, habilitando encuestas y grupos de trabajo, y profundizar sobre las cuestiones de interés a juicio de todos los implicados

Comparative serology techniques for the diagnosis of Trypanosoma cruzi infection in a rural population from the state of Querétaro, Mexico

Immunological diagnostic methods for Trypanosoma cruzi depend specifically on the presence of antibodies and parasitological methods lack sensitivity during the chronic and “indeterminate” stages of the disease. This study performed a serological survey of 1,033 subjects from 52 rural communities in 12 of the 18 municipalities in the state of Querétaro, Mexico. We detected anti-T. cruzi antibodies using the following tests: indirect haemagglutination assay (IHA), indirect immunofluorescence assay (IFA), ELISA and recombinant ELISA (rELISA). We also performed Western blot (WB) analysis using iron superoxide dismutase (FeSOD), a detoxifying enzyme excreted by the parasite, as the antigen. Positive test results were distributed as follows: ELISA 8%, rELISA 6.2%, IFA and IHA 5.4% in both cases and FeSOD 8%. A comparative study of the five tests was undertaken. Sensitivity levels, specificity, positive and negative predictive values, concordance percentage and kappa index were considered. Living with animals, trips to other communities, gender, age, type of housing and symptomatology at the time of the survey were statistically analysed using SPSS software v.11.5. Detection of the FeSOD enzyme that was secreted by the parasite and used as an antigenic fraction in WBs showed a 100% correlation with traditional ELISA tests

¿Necesitamos un asistente virtual para apoyo y formación permanente de profesores, alumnos y egresados en nuestra página web?

Se trata de identificar las necesidades no resueltas y otras cuestiones de interés, y proponer la utilización del asistente virtual como herramienta de apoyo en el acceso, la formación presente y futura, con carácter permanente, al alumno y al profesor; ello supone su utilidad en el momento presente y en el futuro, como herramienta de formación y acceso permanente. La originalidad del Proyecto estriba precisamente en el planteamiento de la incorporación de la asistencia virtual e inteligencia artificial para la asistencia y apoyo a los alumnos y profesores. El uso de la tecnología es cada vez más mayor, y puede revertir en beneficio al alumno desde una perspectiva más amplia de la que un profesor individualmente puede ofrecerle; se lograría así el acceso a la información con una intervención humana mínima, en cualquier momento y en cuestiones generales de amplio espectro, al que cada profesor en su especialidad no llega a abarcar, y los programas voluntarios de mentorías tampoco

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

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