26 research outputs found
La enseñanza en el mĂĄster de abogacĂa a travĂ©s del anĂĄlisis de casos reales de carĂĄcter multidisciplinar. Aprendizaje "a partir del estudio de razonamientos parciales temĂĄticos"
Generar blog para publicaciones de alumnos del MĂĄster AbogacĂa, con "entradas" dirigidas. HabrĂa anĂĄlisis desde varias disciplinas añadiĂ©ndose estudios con enfoque basado en otras ĂĄreas de conocimiento, generando interdisciplinariedad
Differences in the clinical and hormonal presentation of patients with familial and sporadic primary aldosteronism
Purpose: To compare the clinical and hormonal characteristics of patients with familial hyperaldosteronism (FH) and sporadic primary aldosteronism (PA). Methods: A systematic review of the literature was performed for the identification of FH patients. The SPAIN-ALDO registry cohort of patients with no suspicion of FH was chosen as the comparator group (sporadic group). Results: A total of 360 FH (246 FH type I, 73 type II, 29 type III, and 12 type IV) cases and 830 sporadic PA patients were included. Patients with FH-I were younger than sporadic cases, and women were more commonly affected (P = 0.003). In addition, the plasma aldosterone concentration (PAC) was lower, plasma renin activity (PRA) higher, and hypokalemia (P < 0.001) less frequent than in sporadic cases. Except for a younger age (P < 0.001) and higher diastolic blood pressure (P = 0.006), the clinical and hormonal profiles of FH-II and sporadic cases were similar. FH-III had a distinct phenotype, with higher PAC and higher frequency of hypokalemia (P < 0.001), and presented 45 years before sporadic cases. Nevertheless, the clinical and hormonal phenotypes of FH-IV and sporadic cases were similar, with the former being younger and having lower serum potassium levels. Conclusion: In addition to being younger and having a family history of PA, FH-I and III share other typical characteristics. In this regard, FH-I is characterized by a low prevalence of hypokalemia and FH-III by a severe aldosterone excess causing hypokalemia in more than 85% of patients. The clinical and hormonal phenotype of type II and IV is similar to the sporadic case
Innovaciones y mejoras en el proyecto tutorĂa entre compañeros. Curso 2015-2016
Memoria ID-0137. Ayudas de la Universidad de Salamanca para la innovaciĂłn docente, curso 2015-2016
Autonomous cortisol secretion in patients with primary aldosteronism: prevalence and implications on cardiometabolic profile and on surgical outcomes
Purpose: The aim of this study was to evaluate the prevalence of autonomous cortisol secretion (ACS) in patients with primary aldosteronism (PA) and its implications on cardiometabolic and surgical outcomes.
Methods: This is a retrospective multicenter study of PA patients who underwent 1 mg dexamethasone-suppression test (DST) during diagnostic workup in 21 Spanish tertiary hospitals. ACS was defined as a cortisol post-DST >1.8 ÎŒg/dL (confirmed ACS if >5 ÎŒg/dL and possible ACS if 1.8â5 ÎŒg/dL) in the absence of spe cific clinical features of hypercortisolism. The cardiometabolic profile was compared with a control group with ACS without PA (ACS group) matched for age and DST levels.
Results: The prevalence of ACS in the global cohort of patients with PA (n = 176) was 29% (ACSâPA; n = 51). Ten patients had confirmed ACS and 41 possible ACS. The cardiometabolic profile of ACSâPA and PA-only patients was simil ar, except for older age and larger tumor size of the adrenal lesion in the ACSâPA group. When comparing the ACSâPA group (n = 51) and the ACS group (n = 78), the prevalence of hypertension (OR 7.7 (2.64â22.32)) and cardiovascular events (OR 5.0 (2.29â11.07)) was higher in ACSâPA patients than in ACS patients. The coexistence of ACS in patien ts with PA did not affect the surgical outcomes, the proportion of biochemical cure and clinical cure being similar between ACSâPA and PA-only groups.
Conclusion: Co-secretion of cortisol and aldosterone affects almost one-thi rd of patients with PA. Its occurrence is more frequent in patients with larger tumors and advanced age. However, the cardiometabolic and surgical outcomes of patients with ACSâPA and PA-only are similar
Innovación en las enseñanzas universitarias: experiencias presentadas en las III Jornadas de Innovación Educativa de la ULL
En este libro se recoge un conjunto de experiencias de innovaciĂłn educativa desarrolladas en la ULL en el curso 2011-12. Se abordan distintos ĂĄmbitos y ramas del conocimiento, y ocupan temĂĄticas variadas que han sido desarrolladas con rigor, y con un claro potencial para su extrapolaciĂłn a efectos de la mejora educativa en el ĂĄmbito universitario. Esta publicaciĂłn constituye una primera
ediciĂłn de una serie que irĂĄ recogiendo las experiencias de innovaciĂłn educativa de la ULL. Este es un paso relevante para su impulso en nuestra instituciĂłn, como lo es el de su vinculaciĂłn con la investigaciĂłn educativa, para potenciar
su publicaciĂłn en las revistas cientĂficas en este ĂĄmbito cada vez mĂĄs pujante y relevante para las universidades. Sobre todo representan el deseo y el compromiso del profesorado de la ULL para la mejora del proceso educativo mediante
la investigaciĂłn, la evaluaciĂłn y la reflexiĂłn compartida de nuestras prĂĄcticas y planteamientos docentes
La renovaciĂłn de la palabra en el bicentenario de la Argentina : los colores de la mirada lingĂŒĂstica
El libro reĂșne trabajos en los que se exponen resultados de investigaciones presentadas por investigadores de Argentina, Chile, Brasil, España, Italia y Alemania en el XII Congreso de la Sociedad Argentina de LingĂŒĂstica (SAL), Bicentenario: la renovaciĂłn de la palabra, realizado en Mendoza, Argentina, entre el 6 y el 9 de abril de 2010. Las temĂĄticas abordadas en los 167 capĂtulos muestran las grandes lĂneas de investigaciĂłn que se desarrollan fundamentalmente en nuestro paĂs, pero tambiĂ©n en los otros paĂses mencionados arriba, y señalan ademĂĄs las ĂĄreas que reciĂ©n se inician, con poca tradiciĂłn en nuestro paĂs y que deberĂan fomentarse. Los trabajos aquĂ publicados se enmarcan dentro de las siguientes disciplinas y/o campos de investigaciĂłn: FonologĂa, Sintaxis, SemĂĄntica y PragmĂĄtica, LingĂŒĂstica Cognitiva, AnĂĄlisis del Discurso, PsicolingĂŒĂstica, AdquisiciĂłn de la Lengua, SociolingĂŒĂstica y DialectologĂa, DidĂĄctica de la lengua, LingĂŒĂstica Aplicada, LingĂŒĂstica Computacional, Historia de la Lengua y la LingĂŒĂstica, Lenguas AborĂgenes, FilosofĂa del Lenguaje, LexicologĂa y TerminologĂa
Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study
Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008â11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003â13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 Ă 10â10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 Ă 10â8 DHFR p=8·37 Ă 10â7 MTRNR2L2 p=2·15 Ă 10â9) and to a lesser extent in REGISTRY (MSH3 p=9·36 Ă 10â4 DHFR p=8·45 Ă 10â4 MTRNR2L2 p=1·20 Ă 10â3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 Ă 10â8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16â0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06â0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and lowâmiddle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of âsingle-useâ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for lowâmiddle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both highâ and lowâmiddleâincome countries
Actas de las Jornadas Provinciales de Ciencias Experimentales y MatemĂĄticas
Se presentan las actas de las Jornadas celebradas en Ciudad Real en abril de 1990 y que recogen los trabajos de innovaciĂłn didĂĄctica en las ĂĄreas de ciencias experimentales y matemĂĄticas y los resĂșmenes de las tres conferencias: Historia de la quĂmica, Enseñanza de la matemĂĄtica a travĂ©s de la resoluciĂłn de problemas y DidĂĄctica de las ciencias experimentales en el nuevo marco curricular..Castilla La ManchaBiblioteca de EducaciĂłn del Ministerio de EducaciĂłn, Cultura y Deporte; Calle San AgustĂn 5 -3 Planta; 28014 Madrid; Tel. +34917748000; [email protected]