Multicentre, randomised, single-blind, parallel group trial to compare the effectiveness of a Holter for Parkinson's symptoms against other clinical monitoring methods: study protocol

Introduction In recent years, multiple studies have aimed to develop and validate portable technological devices capable of monitoring the motor complications of Parkinson's disease patients (Parkinson's Holter). The effectiveness of these monitoring devices for improving clinical control is not known. Methods and analysis This is a single-blind, cluster-randomised controlled clinical trial. Neurologists from Spanish health centres will be randomly assigned to one of three study arms (1:1:1): (a) therapeutic adjustment using information from a Parkinson?s Holter that will be worn by their patients for 7 days, (b) therapeutic adjustment using information from a diary of motor fluctuations that will be completed by their patients for 7 days and (c) therapeutic adjustment using clinical information collected during consultation. It is expected that 162 consecutive patients will be included over a period of 6 months. The primary outcome is the efficiency of the Parkinson?s Holter compared with traditional clinical practice in terms of Off time reduction with respect to the baseline (recorded through a diary of motor fluctuations, which will be completed by all patients). As secondary outcomes, changes in variables related to other motor complications (dyskinesia and freezing of gait), quality of life, autonomy in activities of daily living, adherence to the monitoring system and number of doctor?patient contacts will be analysed. The noninferiority of the Parkinson's Holter against the diary of motor fluctuations in terms of Off time reduction will be studied as the exploratory objective. Ethics and dissemination approval for this study has been obtained from the Hospital Universitari de Bellvitge Ethics Committee. The results of this study will inform the practical utility of the objective information provided by a Parkinson's Holter and, therefore, the convenience of adopting this technology in clinical practice and in future clinical trials. We expect public dissemination of the results in 2022.Funding This work is supported by AbbVie S.L.U, the Instituto de Salud Carlos III [DTS17/00195] and the European Fund for Regional Development, 'A way to make Europe'

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

Medias miradas. Un análisis cultural de la imagen femenina (Enrique Gil Calvo)

Enrique Gil Calvo nos ofrece un análisis de los signos visuales que se muestran en el escenario del anuncio publicitario como expresión de la identidad femenina. Para ello, a través de la observación de anuncios publicitarios impresos de distintas marcas de medias, como signo de distinción femenina (Medias Sely en 1933, Medias Eugenia de Montijo en 1960, Glory Complet en1964, Medias Balenciaga en 1966, Medias Helanca en 1980) estudia la repetición de los iconos y de los estereotipos utilizados, con una clara resonancia sexual (la mujer como objeto del deseo sexual masculino, como un transparente envoltorio de medias), dado el compulsivo fetichismo masculino y su dominio de la opinión pública

Enrique Gil Calvo Medias miradas. Un análisis cultural de la imagen femenina

Enrique Gil Calvo nos ofrece un análisis de los signos visuales que se muestran en el escenario del anuncio publicitario como expresión de la identidad femenina. Para ello, a través de la observación de anuncios publicitarios impresos de distintas marcas de medias, como signo de distinción femenina (Medias Sely en 1933, Medias Eugenia de Montijo en 1960, Glory Complet en1964, Medias Balenciaga en 1966, Medias Helanca en 1980) estudia la repetición de los iconos y de los estereotipos utilizados, con una clara resonancia sexual (la mujer como objeto del deseo sexual masculino, como un transparente envoltorio de medias), dado el compulsivo fetichismo masculino y su dominio de la opinión pública

Promoviendo la interculturalidad desde el aula: una propuesta de jóvenes con adolescentes

This article invites to reflect about certain implications to consider at the moment to propound educational projects that seek to promote interculturality in school sceneries with teens. To this end, “"Education Project for Intercultural Coexistence in Secondary Schools of Parla" (2012-2015) is presented, making an important exercise in "introspection" about its epistemological and methodological levels. In this revision the results of a collaborative work experience supported by the formation of interdisciplinary teams of university students emerge. These college students are responsible for designing, implementing and evaluating educational cycles of four sessions lasting for 1st ESO students of all secondary schools in Parla, basing the proposal on participation and dynamic dialogue as a way to show, at least, that any person has capacity of –cultural and social– agency enough to make their particular contribution to the enrichment of coexistence.El presente artículo invita a la reflexión acerca de ciertas implicaciones a considerar en el momento de plantear proyectos educativos que deseen promover la interculturalidad en escenarios escolares con adolescentes. Para ello, se presenta el “Proyecto de Educación para la Convivencia Intercultural en IES de Parla” (2012-2015), realizando un importante ejercicio de “introspección” en torno a sus niveles epistemológico y metodológico. De esta revisión surgen los resultados de una experiencia de trabajo colaborativo, sustentada en la formación de equipos interdisciplinares de jóvenes universitarios/as, quienes se encargan de diseñar, implementar y evaluar ciclos educativos de cuatro sesiones de duración para el alumnado de 1ºESO de todos los IES de Parla; basando la propuesta en la participación y en el diálogo dinámico, como forma de evidenciar, al menos, que toda persona posee capacidad de agencia –social y cultural– suficiente para realizar su aporte particular al enriquecimiento de la convivencia

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