Francisco Imbernón Muñoz

Obstetrical outcome of pregnancy in patients with systemic Lupus Erythematosus. A study of 60 cases

OBJECTIVE To analyze the course of maternal diseases and the outcome of pregnancy in patients with systemic Lupus Erythematosus (SLE). STUDY DESIGN During a period of 11 years we prospectively followed 60 pregnancies in 46 SLE patients in a tertiary care center in Barcelona (Spain). The management protocol included: (1) planning of conception when disease was inactive; (2) frequent follow-up visits by an internist-obstetrician team; (3) use of sequential ultrasonographic, Doppler and fetal echocardiographic examinations; (4) serial evaluations of maternal immunological condition; and (5) low dose aspirin from 1 month before attempting conception and throughout pregnancy was added in women with antiphospholipid antibodies. From 1985 until 1994 prednisone prophylaxis was used in all lupus patients during the last month of pregnancy and during the first month of the puerperium; from 1995 onwards this regime was abandoned. RESULTS The mean (S.D.) age of patients was 28.6 (4.8) years (range 20 to 42) and the mean (S.D.) previous duration of SLE was 6.25 (4.8) years (range 0 to 17). SLE was diagnosed during the pregnancy in two cases (3.3%) and the disease was active at conception in four cases (6.7%); at that time nine patients (15%) were taking prednisone. Antiphospholipid antibodies were positive in 16 patients (30.4%) and there were 10 (16.7%) pregnancies in patients having lupus nephropathy. There were three first-trimester miscarriages (5%) and four (6.7%) voluntary abortions. Obstetric complications in the remaining 53 pregnancies included: preterm delivery, 11 cases (20.8%); intrauterine growth retardation, five cases (9.4%); hypertension, 10 patients (18.9%), five of them fulfilling the criteria of preeclampsia; premature rupture of membranes, four patients (7.5%); finally, 13 neonates had a birthweight lower than 2500 g. There were 15 lupus flares (28.3%), giving a flare rate of 0.044 per patient/month. There were five neonatal deaths (perinatal mortality rate, 94 per thousand): one because of complete heart block, three due to severe hyaline membrane disease resulting from extreme prematurity and one intrauterine death in a patient having the Leiden mutation. CONCLUSION Pregnancy in patients with SLE should not be regarded as an unacceptable high-risk condition for the mother or her baby provided that conception is accurately planned and patients are managed according to a careful multidisciplinary treatment schedule.

Competencias en los procesos de enseñanza-aprendizaje virtual y semipresencial

Actualmente las universidades estan inmersas en lo que se conoce como el proceso de «convergencia europea» y que llevara al Espacio Europeo de Educacion Superior (EEES). El objetivo es dotar a Europa de un sistema universitario homogeneo, compatible y flexible que permita a los estudiantes y titulados universitarios europeos una mayor movilidad, asi como ofrecer al sistema universitario europeo unos niveles de transparencia y calidad, mediante sistemas de evaluacion, que le hagan atractivo y competitivo en el ambito internacional dentro del actual proceso de globalizacion. En este articulo, interesa centrar la reflexion en dos de las modalidades de la educacion a distancia que asumiran importancia en ese cambio universitario: el e-learning y el b-learning, que consisten basicamente en la virtualizacion de los procesos de aprendizaje a traves del uso de equipos informaticos. Para ello se ha realizado una investigacion cualitativa con metodologia de estudio de casos. De entre los resultados se destaca el uso de las TIC por parte del profesorado para conseguir un mejor aprendizaje en los estudiantes, de igual forma un porcentaje importante de los profesores 78% utiliza alguna plataforma virtual como apoyo a la docencia. Como conclusion se resalta que las politicas de formacion deberian fortalecer las competencias del profesorado universitario en el uso de dispositivos telematicos, recursos e instrumentos relacionados con el aprendizaje semipresencial y virtual.Universities are currently immersed in what is known as the process of European convergence to create the European Higher Education Area (EHEA). The aim is to establish a standardized, compatible and flexible European university system that enables graduates and undergraduates to move easily from one institution to another within Europe. As a result of evaluation mechanisms, the system will be transparent and of high quality, which will make it attractive and competitive internationally in a globalized world. In this paper, we focus on two distance learning modes that will become more important as a result of this change in universities: e-learning and b-learning. These basically involve the virtualization of learning processes through the use of computer equipment. We carried out a qualitative study using the case study method. The results indicate that teaching staff use information and communication technology (ICT) to improve student learning. Similarly, a high percentage (78%) of lecturers use some form of digital platform as a support for teaching. In conclusion, training policies should strengthen university teachers’ skills in the use of ICT equipment, tools and resources related to blended and virtual learning.Universities are currently immersed in what is known as the process of European convergence to create the European Higher Education Area (EHEA). The aim is to establish a standardized, compatible and flexible European university system that enables graduates and undergraduates to move easily from one institution to another within Europe. As a result of evaluation mechanisms, the system will be transparent and of high quality, which will make it attractive and competitive internationally in a globalized world. In this paper, we focus on two distance learning modes that will become more important as a result of this change in universities: e-learning and b-learning. These basically involve the virtualization of learning processes through the use of computer equipment. We carried out a qualitative study using the case study method. The results indicate that teaching staff use information and communication technology (ICT) to improve student learning. Similarly, a high percentage (78%) of lecturers use some form of digital platform as a support for teaching. In conclusion, training policies should strengthen university teachers’ skills in the use of ICT equipment, tools and resources related to blended and virtual learning.Actualmente las universidades estan inmersas en lo que se conoce como el proceso de «convergencia europea» y que llevara al Espacio Europeo de Educacion Superior (EEES). El objetivo es dotar a Europa de un sistema universitario homogeneo, compatible y flexible que permita a los estudiantes y titulados universitarios europeos una mayor movilidad, asi como ofrecer al sistema universitario europeo unos niveles de transparencia y calidad, mediante sistemas de evaluacion, que le hagan atractivo y competitivo en el ambito internacional dentro del actual proceso de globalizacion. En este articulo, interesa centrar la reflexion en dos de las modalidades de la educacion a distancia que asumiran importancia en ese cambio universitario: el e-learning y el b-learning, que consisten basicamente en la virtualizacion de los procesos de aprendizaje a traves del uso de equipos informaticos. Para ello se ha realizado una investigacion cualitativa con metodologia de estudio de casos. De entre los resultados se destaca el uso de las TIC por parte del profesorado para conseguir un mejor aprendizaje en los estudiantes, de igual forma un porcentaje importante de los profesores 78% utiliza alguna plataforma virtual como apoyo a la docencia. Como conclusion se resalta que las politicas de formacion deberian fortalecer las competencias del profesorado universitario en el uso de dispositivos telematicos, recursos e instrumentos relacionados con el aprendizaje semipresencial y virtual.

La formación pedagógica del docente universitario

Recently, several academic events have been dealing with the issue of teacher education. Some are timid proposals and some other are more innovative such as the one dealing with introducing mandatory initial training to enter a career in higher education. This is a concern that leads us to reflecting upon that is something that seems reasonable and logical. This article assumes that the initial and ongoing education of university teachers is necessary and essential in the current and future University and we argue that, rather than demanding it, how necessary it is to ask why it is demanded, as well as to analyze the context in which such education is or could be given, and provide some clues about the content of that education so as make sure it is innovative, taking part of the alleged profession of the university teacher, so as to provide room for discussing that leads to alternatives based on participation, collegiality and collaboration among teachers.