Utilitat de la metodologia de simulació per adquirir competències en habilitats de comunicació

Podeu consultar la Vuitena trobada de professorat de Ciències de la Salut completa a: http://hdl.handle.net/2445/66524Metodología: Se describen los talleres y seminarios de simulación empleados desde el año académico 2010-11 en la Facultad de Medicina de la Universidad de Barcelona, que se ofrecen a los alumnos a partir de 2 año de grado, con el fin de ofrecer a los alumnos de forma transversal la adquisición y refuerzo continuo de competencias en habilidades de comunicación. Siguiendo las definiciones del Libro Blanco de las Facultades de Medicina y de la Guía de la Facultad de Medicina de la UB, se ofrece formación en los siguientes aspectos de la competencia de comunicación: • Escuchar con atención, obtener y sintetizar información pertinente acerca de los problemas que aquejan al enfermo, y comprender el contenido de esta información. • Comunicación de malas noticias • Obtener un consentimiento Informado • Comunicación entre profesionales Se describen el nivel de aprendizaje, el personal docente requerido, la duración de los seminarios o talleres, los objetivos docentes, el material necesario en cada actividad y el año de la formación de grado en que se aplica. Se describe la utilización de la estrategia de feed-back para la autoevaluación de la actividad práctica, empleando grabaciones de los talleres y simulaciones de los grupos de alumnos. Se describe así mismo, las encuestas empleadas para la evaluación por el docente y los compañeros de clase de las actividades de simulación y la metodología empleada de evaluación de los seminarios y su calificación dentro de la nota final de cada asignatura. Finalmente se describen las asignaturas optativas existentes en la Facultad de Medicina de la UB para reforzar las habilidades de comunicación y los planes futuros de desarrollo de actividades formativas complementarias y de refuerzo y las propuestas evaluativas de la competencia

Characteristics and outcome of adult patients with acute promyelocytic leukemia and increased body mass index treated with the PETHEMA Protocols

Objective The obesity/overweight may have an influence on APL outcomes. Methods This is the biggest multicentre analysis on 1320 APL patients treated with AIDA-induction and risk-adapted consolidation between 1996 and 2012. Patients body mass index (BMI) was classified as underweight (= 30 kg/m(2)) according to the World Health Organization (WHO) criteria. Results and conclusions Relationship between male gender, older age, and other known laboratory abnormalities in overweight/obese patients was significant. The induction mortality rate was significantly higher in APL with BMI >= 25 vs BMI = 25 had a trend to lower OS (74% vs 80%; P = .06). However, in the multivariate analysis, BMI did not retain the independent predictive value (P = .46). There was no higher incidence of differentiation syndrome with BMI >= 25, but there was a trend in obese. There was no difference in relapse rate according to the BMI. In summary, overweight/obesity does not represent an independent risk factor for APL outcomes. The influence of obesity in APL patients treated with chemotherapy-free regimens remains to be established

The expression level of BAALC -associated microRNA miR-3151 is an independent prognostic factor in younger patients with cytogenetic intermediate-risk acute myeloid leukemia

Acute myeloid leukemia (AML) is a heterogeneous disease whose prognosis is mainly related to the biological risk conferred by cytogenetics and molecular profiling. In elderly patients (⩾60 years) with normal karyotype AML miR-3151 have been identified as a prognostic factor. However, miR-3151 prognostic value has not been examined in younger AML patients. In the present work, we have studied miR-3151 alone and in combination with BAALC, its host gene, in a cohort of 181 younger intermediate-risk AML (IR-AML) patients. Patients with higher expression of miR-3151 had shorter overall survival (P =0.0025), shorter leukemia-free survival (P =0.026) and higher cumulative incidence of relapse (P =0.082). Moreover, in the multivariate analysis miR-3151 emerged as independent prognostic marker in both the overall series and within the unfavorable molecular prognostic category. Interestingly, the combined determination of both miR-3151 and BAALC improved this prognostic stratification, with patients with low levels of both parameters showing a better outcome compared with those patients harboring increased levels of one or both markers (P =0.003). In addition, we studied the microRNA expression profile associated with miR-3151 identifying a six-microRNA signature. In conclusion, the analysis of miR-3151 and BAALC expression may well contribute to an improved prognostic stratification of younger patients with IR-AML

Cis and trans regulatory mechanisms control AP2-mediated B cell receptor endocytosis via select tyrosine-based motifs.

Following antigen recognition, B cell receptor (BCR)-mediated endocytosis is the first step of antigen processing and presentation to CD4+ T cells, a crucial component of the initiation and control of the humoral immune response. Despite this, the molecular mechanism of BCR internalization is poorly understood. Recently, studies of activated B cell-like diffuse large B cell lymphoma (ABC DLBCL) have shown that mutations within the BCR subunit CD79b leads to increased BCR surface expression, suggesting that CD79b may control BCR internalization. Adaptor protein 2 (AP2) is the major mediator of receptor endocytosis via clathrin-coated pits. The BCR contains five putative AP2-binding YxxØ motifs, including four that are present within two immunoreceptor tyrosine-based activation motifs (ITAMs). Using a combination of in vitro and in situ approaches, we establish that the sole mediator of AP2-dependent BCR internalization is the membrane proximal ITAM YxxØ motif in CD79b, which is a major target of mutation in ABC DLBCL. In addition, we establish that BCR internalization can be regulated at a minimum of two different levels: regulation of YxxØ AP2 binding in cis by downstream ITAM-embedded DCSM and QTAT regulatory elements and regulation in trans by the partner cytoplasmic domain of the CD79 heterodimer. Beyond establishing the basic rules governing BCR internalization, these results illustrate an underappreciated role for ITAM residues in controlling clathrin-dependent endocytosis and highlight the complex mechanisms that control the activity of AP2 binding motifs in this receptor system

Constraints on the structure and seasonal variations of Triton's atmosphere from the 5 October 2017 stellar occultation and previous observations

CONTEXT: A stellar occultation by Neptune’s main satellite, Triton, was observed on 5 October 2017 from Europe, North Africa, and the USA. We derived 90 light curves from this event, 42 of which yielded a central flash detection. AIMS: We aimed at constraining Triton’s atmospheric structure and the seasonal variations of its atmospheric pressure since the Voyager 2 epoch (1989). We also derived the shape of the lower atmosphere from central flash analysis. METHODS: We used Abel inversions and direct ray-tracing code to provide the density, pressure, and temperature profiles in the altitude range ~8 km to ~190 km, corresponding to pressure levels from 9 µbar down to a few nanobars. RESULTS: A pressure of 1.18 ± 0.03 µbar is found at a reference radius of 1400 km (47 km altitude). (ii) A new analysis of the Voyager 2 radio science occultation shows that this is consistent with an extrapolation of pressure down to the surface pressure obtained in 1989. (iii) A survey of occultations obtained between 1989 and 2017 suggests that an enhancement in surface pressure as reported during the 1990s might be real, but debatable, due to very few high S/N light curves and data accessible for reanalysis. The volatile transport model analysed supports a moderate increase in surface pressure, with a maximum value around 2005-2015 no higher than 23 µbar. The pressures observed in 1995-1997 and 2017 appear mutually inconsistent with the volatile transport model presented here. (iv) The central flash structure does not show evidence of an atmospheric distortion. We find an upper limit of 0.0011 for the apparent oblateness of the atmosphere near the 8 km altitude