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Introduction In recent years, the introduction of new antifungals for the prevention of invasive fungal infections (IFIs) in hemato-oncological patients, particularly extended-spectrum azoles, has led to a change in the diagnostic and therapeutic strategies for established or suspected breakthrough IFI. The aim of the study was to identify the diagnostic and therapeutic strategies used in the management of IFIs in hemato-oncological patients in Spain, and to assess compliance with the recommendations of the consensus documents and clinical practice guidelines. Patients and Methods An online, anonymous, cross-sectional survey was conducted between January and September 2016 involving 137 specialists from third-level hospitals in Spain with Departments of Hematology that regularly deal with IFIs. Results Galactomannan test was available to 95.6% of specialists, and was used in 61.7% of the cases for diagnostic confirmation and early treatment. The (1 → 3) β-D-glucan test was only available to 10.2%. A total of 75.3% of the participants estimated the incidence of breakthrough IFI due to filamentous fungus as being 1-10%. In turn, 83.3% of the participants decided a change in antifungal class after failure of prophylaxis, in concordance with the recommendations of the national and international consensus documents. Conclusions The present study, the first of its kind conducted in Spain, shows that a high percentage of the medical professionals implicated in the management of hemato-oncological patients at high risk of suffering IFIs follow the recommendations of the national and international consensus documents and guidelines.

Type 2 Sodium-Glucose Cotransporter (SGLT2) Inhibitors exercise their glucose-lowering effect through the inhibition of glucose reabsorption in the kidney. However, the cardiovascular and renal effects, as well as in those of cardiac failure, seem to occur independently from the glucose–lowering effects of these drugs. The principal mechanisms of action that explain their cardiovascular benefits are the hypotensive effect and the decrease in fill pressures, as well as direct effects on the metabolism of the myocardial cell. There is also a reduction in the urine albumin, as well as non-glycaemic effects, and a decrease in adipose tissue, with an increase in haematocrit and urine uric acid. Each one of these novel mechanisms is described in this article. © 2019

La derivación intrahepática transyugular portosistémica (TIPS) es un procedimiento eficaz para lograr la descompresión portal y para manejar algunas de las complicaciones. Aunque entre las indicaciones con mayor evidencia están la hemorragia variceal esofágica y el tratamiento de la ascitis refractaria, cada vez hay mas datos que sugieren su eficacia en otras entidades como el hidrotórax hepático, el síndrome de Budd-Chiari, las varices ectópicas y el síndrome hepato renal. Esta revisión busca proporcionar un análisis de las indicaciones más comunes y menos típicas para su creación, así como conceptos sobre los materiales y técnica utilizadas

It could be argued that in recent years there has been a tendency in some media theorists – especially film theorists – that consists of making a dramatic break between images captured digitally and those that are analog, essentially in their indexical aspect. This aspect is, in Peircean semiotics,attributed to signs that maintain an existential relation with their objects, a trace of their presence in time and space. For some contemporary thinkers –the philosopher of technique Bernard Stiegler, for example –who is aligned with the theoretical tradition of photorealism led by figures such as Roland Barthes and Andre Bazin, the digital image is subjected to a discretization process in which the guarantee of the existence of what is portrayed is lost –in contrast with the analog photography– which is characterized by continuity, and which shows an absolute contiguity to its referent. Others like Tom Gunning or Arlindo Machado consider that this approach mystifies analogue photography and obliterates the complexity of its processes and its historicity. Contemporary documentaries, largely influenced by the emergence of new recording, editing and display technologies based on digital substrate, appear as a paradox in which a field of production, traditionally based on a strong indexical connection with its objects, get close to the issue of the digital revolution that establishes a crisis of beliefs based on a break between the image and its referent. We analyze this issue through 2 productions: Recollection (Kamal Aljafari, 2015), a film made possible by digital alteration tools, and Life in a Day (Kevin McDonald, 2011), a production that shows the importance of digital culture to carry out a large–scale collective documentary. Se podría afirmar que en los últimos años ha surgido una cierta tendencia por parte de algunos teóricos de los medios, y especialmente del cine, consistente en marcar una fuerte ruptura entre la imagen capturada digitalmente y la imagen analógica, esencialmente en su aspecto indicial, aquel que en la semiótica peirciana se atribuye a los signos que mantienen una relación existencial con su objeto, una huella de su presencia en un tiempo y lugar. Para algunos pensadores contemporáneos, como el filósofo de la técnica Bernard Stiegler, quien se alinea en una tradición teórica sobre el realismo fotográfico encabezada por figuras como Roland Barthes y Andre Bazin, la imagen digital se somete a un proceso de discretización en el que se pierde la garantía de la existencia de lo retratado, frente a la fotografía analógica, caracterizada por la continuidad, y que muestra una contigüidad absoluta con su referente. Otros, como Tom Gunning o Arlindo Machado, consideran que esta postura mistifica a la fotografía analógica y oblitera la complejidad de sus procesos y su trayectoria histórica. El documental contemporáneo estaría condicionado en gran medida por el surgimiento de nuevas tecnologías de registro, edición y exhibición en sustrato digital, y se manifestaría como una paradoja que acerca un campo de producción, tradicionalmente basado en una fuerte conexión indicial con sus objetos representados, a la problemática del fenómeno de lo digital que instaura una crisis de la creencia basada en una ruptura con los referentes. Analizaremos este fenómeno considerando dos producciones: Recollection (Kamal Aljafari, 2015), un filme posibilitado por las herramientas de alteración digital, y Life in a Day (Kevin McDonald, 2011), que muestra la importancia de la cultura digital para la realización de un documental colectivo de grandes proporciones.

We document the first records of Gerrhonotus parvus in the state of Coahuila, México. From March 2012 to March 2017, 6 males and 2 females were found in pine forest and submontane scrubland plant communities in the Sierra de Zapalinamé Natural Protected Area, which is located in the municipalities of Saltillo and Arteaga. These records extend the known distribution of the species 28–44 km west of the nearest occurrences in the state of Nuevo León.

En este trabajo presentamos una experiencia docente, y el recurso docente correspondiente, que hemos seguido durante el primer cuatrimestre del curso 17/18 en una asignatura de introducción a la programación. Nuestro principal objetivo era trabajar sobre la motivación de los alumnos, haciendo que el aprendizaje de los fundamentos de la programación fuese lo más atractivo e intuitivo posible. Para ello, nos hemos apoyado en tres elementos principales: el lenguaje de programación Python, el uso de un entorno de desarrollo interactivo como los notebooks de Jupyter, y la adopción de una estrategia de aprendizaje significativo entendido como el proceso en el que en todo momento se sabe “para qué sirve” el conocimiento que se está adquiriendo. Los tres elementos han contribuido a mejorar la calidad de la enseñanza con respecto a ediciones anteriores de la asignatura. Los resultados académicos obtenidos en la evaluación y los indicios que hemos podido extraer de una encuesta realizada a los alumnos son muy positivos, lo que nos anima a seguir en esta dirección. Todo el material docente utilizado en la asignatura está disponible públicamente en un repositorio GitHub. In this paper we present a teaching experience, and the corresponding teaching resource, which we have followed during the first semester of the 17-18 academic year in a subject of introduction to programming. Our main objective was to work on the motivation of the students, making the learning of the main concepts of programming as attractive and intuitive as possible. We have relied on three main elements: the Python programming language, the use of an interactive development environment such as the Jupyter notebooks, and the adoption of a meaningful learning strategy. We understand by meaningful learning the process in which at every moment the student knows “what is the use” of the knowledge that is being acquired. The three elements have contributed to improve the quality of the teaching compared to previous editions of the subject. The academic results obtained in the evaluation and several insights that we have been able to extract from a survey made to the students are very positive, which encourages us to continue in this direction. All the teaching material used during the course is publicly available in a GitHub repository.

Learning objectives Background Findings and procedure details Conclusion Personal information References, Learning objectives: To recognize which are the main parasitic diseases that present involvement of the thorax. To identify the imaginological manifestations in thorax of parasitic...