Impacto de la implementación del aprendizaje basado en problemas en combinación con las prácticas de laboratorio clínico y virtual de Fisiopatología para el desarrollo de competencias profesionales

Sección Deptal. de Fisiología (Farmacia)Fac. de FarmaciaFALSEsubmitte

Impaired Condensin Complex and Aurora B kinase underlie mitotic and chromosomal defects in hyperdiploid B-cell ALL

B-cell acute lymphoblastic leukemia (B-ALL) is the most common pediatric cancer, and high-hyperdiploidy (HyperD) identifies the most common subtype of pediatric B-ALL. Despite HyperD is an initiating oncogenic event affiliated to childhood B-ALL, the mitotic and chromosomal defects associated to HyperD B-ALL (HyperD-ALL) remain poorly characterized. Here, we have used 54 primary pediatric B-ALL samples to characterize the cellular-molecular mechanisms underlying the mitotic/chromosome defects predicated to be early pathogenic contributors in HyperD-ALL. We report that HyperD-ALL blasts are low proliferative and show a delay in early mitosis at prometaphase, associated to chromosome alignment defects at the metaphase plate leading to robust chromosome segregation defects and non-modal karyotypes. Mechanistically, biochemical, functional and mass-spectrometry assays revealed that condensin complex is impaired in HyperD-ALL cells, leading to chromosome hypocondensation, loss of centromere stiffness and mis-localization of the chromosome passenger complex proteins Aurora B Kinase (AURKB) and Survivin in early mitosis. HyperD-ALL cells show chromatid cohesion defects and impaired spindle assembly checkpoint (SAC) thus undergoing mitotic slippage due to defective AURKB and impaired SAC activity, downstream of condensin complex defects. Chromosome structure/condensation defects and hyperdiploidy were reproduced in healthy CD34+ stem/progenitor cells upon inhibition of AURKB and/or SAC. Collectively, hyperdiploid B-ALL is associated to defective condensin complex, AURKB and SAC

Adaptación a un entorno semipresencial de una nueva herramienta mixta del aprendizaje basado en problemas en combinación con las prácticas de laboratorio clínico a la nueva asignatura Bases Anatómicas y Fisiología del Cuerpo Humano

Sección Deptal. de Fisiología (Farmacia)Fac. de FarmaciaFALSEsubmitte

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

NDUFA4 is a subunit of complex IV of the mammalian electron transport chain

Item does not contain fulltextThe oxidative phosphorylation system is one of the best-characterized metabolic pathways. In mammals, the protein components and X-ray structures are defined for all complexes except complex I. Here, we show that NDUFA4, formerly considered a constituent of NADH Dehydrogenase (CI), is instead a component of the cytochrome c oxidase (CIV). Deletion of NDUFA4 does not perturb CI. Rather, proteomic, genetic, evolutionary, and biochemical analyses reveal that NDUFA4 plays a role in CIV function and biogenesis. The change in the attribution of the NDUFA4 protein requires renaming of the gene and reconsideration of the structure of CIV. Furthermore, NDUFA4 should be considered a candidate gene for CIV rather than CI deficiencies in humans

Self-assessment, Co-assessment, and the use of ICT as an innovative approach in Physiopathology practices and their effect on the student's teaching-learning process

En las últimas décadas, la educación universitaria ha evolucionado hacia un enfoque constructivista en consonancia con las recomendaciones del Espacio Europeo de Educación Superior (EEES). En este paradigma, los estudiantes asumen un papel activo en el proceso de enseñanza-aprendizaje, mientras los profesores actúan como facilitadores. Las metodologías constructivistas fomentan el desarrollo tanto individual como grupal de competencias específicas y genéricas, al tiempo que permiten la inclusión de agentes de evaluación formativa para estimular la crítica y la autocrítica del alumno en su desempeño. En este contexto, surge la necesidad de aplicar el constructivismo a la evaluación, involucrando al estudiante en su propio proceso de evaluación. La autoevaluación y la coevaluación emergen como alternativas concretas para lograrlo. La autoevaluación implica que el estudiante analice y valore de manera sistemática su trabajo durante el proceso de aprendizaje para mejorar resultados y fomentar la autocrítica. Por otro lado, la coevaluación es una evaluación entre compañeros que permite valorar la implicación y actitud de los miembros del grupo, estimulando el aprendizaje colectivo. Las Tecnologías de la Información y Comunicación (TIC) juegan un papel importante en la educación y en la evaluación de los alumnos, diferenciándose de las prácticas tradicionales. La implementación de TIC no solo desarrolla habilidades en el proceso enseñanza-aprendizaje, sino también favorece la autoevaluación y la coevaluación. Con base en este enfoque, se presenta un proyecto de innovación docente en la asignatura de Fisiopatología para estudiantes de Farmacia. Los alumnos crearán videos sobre temas específicos de la práctica y se evaluarán a sí mismos y a sus compañeros utilizando la herramienta App Plickers. Sin embargo, aún no existe una metodología claramente definida para la implementación de estrategias constructivistas y uso de TIC en Fisiopatología, destacando la importancia y relevancia de este proyecto.Depto. de FisiologíaFac. de FarmaciaFALSEsubmitte

La evaluación : Seminario de Educación Física

No publicadoEn este volumen se recogen los trabajos finales de los asistentes al Curso 'La evaluación en Educación Física', celebrado en el CPR de León durante el cuso 1995-1996. Estos trabajos toman la forma de Unidades Didácticas, en las que se pone especial énfasis en la evaluación, sus métodos y técnicas. La apreciación de la evaluación dentro del área de Educación Física puede presentar algunas dificultades añadidas a las presentadas a la hora de hacer cualquier tipo de evaluación. Por ello, los grupos de trabajo han optado por reflexionar acerca del planteamiento de la evaluación en Primaria, realizando una ficha de observación en la que se contengan todos los bloques temáticos para poder obtener unos puntos de referencia en la observación lo más objetivos posibles y adecuados al momento de trabajo. .CEP de LeónCastilla y LeónES

Down syndrome as risk factor for respiratory syncytial virus hospitalization : A prospective multicenter epidemiological study

Respiratory syncytial virus (RSV) infection in childhood, particularly in premature infants, is associated with significant morbidity and mortality. To compare the hospitalization rates due to RSV infection and severity of disease between infants with and without Down syndrome (DS) born at term and without other associated risk factors for severe RSV infection. In a prospective multicentre epidemiological study, 93 infants were included in the DS cohort and 68 matched by sex and data of birth (±1 week) and were followed up to 1 year of age and during a complete RSV season. The hospitalization rate for all acute respiratory infection was significantly higher in the DS cohort than in the non-DS cohort (44.1% vs 7.7%, P<.0001). Hospitalizations due to RSV were significantly more frequent in the DH cohort than in the non-DS cohort (9.7% vs 1.5%, P=.03). RSV prophylaxis was recorded in 33 (35.5%) infants with DS. The rate of hospitalization according to presence or absence of RSV immunoprophylaxis was 3.0% vs 15%, respectively. Infants with DS showed a higher rate of hospitalization due to acute lower respiratory tract infection and RSV infection compared to non-DS infants. Including DS infants in recommendations for immunoprophylaxis of RSV disease should be considered