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Patients with alpha-1 antitrypsin deficiency (AATD), commonly categorized as a rare disease, have been affected by the changes in healthcare management brought about by COVID-19. This study's aim was to identify the changes that have taken place in AATD patient care as a result of the COVID-19 pandemic in Spain and to propose experts' recommendations aimed at ensuring humanized and quality care for people with AATD in the post-pandemic situation.

[Background] For patients with suspected pulmonary embolism (PE), age- or clinically-adjusted D-dimer threshold level can be used to define a negative test that safely excludes PE and reduces the use of imaging. However, the utility of this approach in patients hospitalized for chronic obstructive pulmonary disease (COPD) exacerbation is undefined., [Methods] We ran an analysis of the patients hospitalized for COPD exacerbation and randomized to the intervention in the SLICE trial. Using the conventional strategy as the reference, we compared the proportion of patients with a negative D-dimer result, and the negative predictive value and sensitivity of three D-dimer threshold strategies for initial PE or subsequent diagnosis of venous thromboembolism (VTE): the age-adjusted strategy, the Wells-adjusted strategy, and the YEARS-adjusted strategy., [Results] We included 368 patients. Using a conventional threshold, 182 (49.5%) patients had negative D-dimer values, of whom 1 (0.6%) had PE (sensitivity, 94.1%). The use of an age-adjusted threshold increased the number of patients in whom PE could be excluded from 182 to 233 patients (63.3%), and the proportion of false-negative findings increased from 0.5% to 1.7% (sensitivity, 76.5%). With the use of the Wells or YEARS strategies, 64.4% and 71.5% had negative values, and the proportion of false-negative findings was 2.5% (sensitivity, 64.7%) and 2.7% (sensitivity, 58.8%), respectively., [Conclusions] In patients hospitalized for COPD exacerbation, compared with the conventional strategy, age- or clinically-adjusted strategies of D-dimer interpretation were associated with a larger proportion of patients in whom PE was ruled out with a higher failure rate., [Trial Registration] ClinicalTrials.gov number: NCT02238639.

OBJECTIVE To compare usual care plus an active strategy for diagnosing PE with usual care alone in patients hospitalized for COPD exacerbation. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial conducted across 18 hospitals in Spain. A total of 746 patients were randomized from September 2014 to July 2020 (final follow-up was November 2020). INTERVENTIONS Usual care plus an active strategy for diagnosing PE (D-dimer testing and, if positive, computed tomography pulmonary angiogram) (n = 370) vs usual care (n = 367). MAIN OUTCOMES AND MEASURES The primary outcome was a composite of nonfatal symptomatic venous thromboembolism (VTE), readmission for COPD, or death within 90 days after randomization. There were 4 secondary outcomes, including nonfatal new or recurrent VTE, readmission for COPD, and death from any cause within 90 days. Adverse events were also collected. RESULTS Among the 746 patients who were randomized, 737 (98.8%) completed the trial (mean age, 70 years; 195 [26%] women). The primary outcome occurred in 110 patients (29.7%) in the intervention group and 107 patients (29.2%) in the control group (absolute risk difference, 0.5% [95% CI, −6.2% to 7.3%]; relative risk, 1.02 [95% CI, 0.82-1.28]; P = .86). Nonfatal new or recurrent VTE was not significantly different in the 2 groups (0.5% vs 2.5%; risk difference, −2.0% [95% CI, −4.3% to 0.1%]). By day 90, a total of 94 patients (25.4%) in the intervention group and 84 (22.9%) in the control group had been readmitted for exacerbation of COPD (risk difference, 2.5% [95% CI, −3.9% to 8.9%]). Death from any cause occurred in 23 patients (6.2%) in the intervention group and 29 (7.9%) in the control group (risk difference, −1.7% [95% CI, −5.7% to 2.3%]). Major bleeding occurred in 3 patients (0.8%) in the intervention group and 3 patients (0.8%) in the control group (risk difference, 0% [95% CI, −1.9% to 1.8%]; P = .99). CONCLUSIONS AND RELEVANCE Among patients hospitalized for an exacerbation of COPD

Las sexualidades alternativas (swinger1 y bdsm2) se muestran como espacios libremente elegidos por mujeres y hombres para desarrollar una sexualidad no hegemónica en términos de total igualdad y consentimiento de las mujeres. El trabajo cuestiona estos presupuestos con la información obtenida a través de entrevistas realizadas a informantes clave, debates en foros de Internet, grupos de discusión y búsqueda y análisis básico de datos en diferentes páginas web. Se profundiza en las vivencias y experiencias de mujeres y hombres practicantes, con énfasis en la sexualidad femenina. Se analiza el mito de la mujer perversa en la dominación femenina3 como objeto de fantasía sexual masculina. La reformulación del personaje en términos de género, proponiéndola a las mujeres como posibilidad, es un elemento importante en el trabajo. Las conclusiones a las que se llega evidencian la fuerte persistencia de los estereotipos de género y la reproducción de forma masiva y sistemática de los roles de género en el juego sexual. Las vivencias de la sexualidad de las mujeres están impregnadas del sistema sexo/género y de su tradicional opresión. La subyugación femenina aparece, sin embargo, en un escenario de posibilidades y oportunidades para desarrollar una sexualidad genuinamente libre e igualitaria en aparente contradicción., Alternative sexualities (swinger y bdsm) show as freely chosen spaces by women and men to develop a non hegemonic sexuality in terms of total equality and consent of women. The work questions these pre-supposed with the information obtained from interviews of key informers, Internet debates, discussion groups and search and basic analysis of dates in different web pages. It penetrates in vivences and experiences of people who practice alternative sexualities emphatizing female sexuality. It will analyze the myth of perverse woman in female domination as a male sexual fantasy object. Its reelaboration in terms of gender is a key element in the present work, offered to women as a possibility. It shows the strong persistence of gender stereotypes and the massive and systematic reproduction of genders roles in sexual play. The way women live their sexuality is polluted by the sex/gender system and its traditional oppression. The female subjugation is combined with a scene of possibilities and opportunities to develop a genuine, free and equal sexuality in apparent contradiction.

Se cuestiona y analiza una actividad que ejerce violencia sobre las mujeres, la doble discriminación que conlleva y cómo a pesar de ello puede convertirse en un elemento de toma de conciencia y de poder partiendo de personalidades femeninas concretas.

Se analiza el diseño metodológico y las conclusiones a las que se ha llegado en tres trabajos científicos relacionados con la igualdad de género, obteniendo conclusiones secundarias que enriquecen los resultados de las investigaciones.

Se investiga y analiza la persistencia del llamado "techo de cristal" dentro del contexto universitario, más concretamente dentro de la actividad investigadora de las mujeres, y sus posibles causas, así como las implicaciones que la crisis económica puede estar teniendo en el proceso.