Face-to-face teaching: the opinion and the commitment of the students of Physiology and Pathophysiogy III in the Pharmacy Degree of the University of Barcelona

Although university teachers and students made a significant effort to adapt to a virtual scenario during the pandemic, face-to-face teaching is considered the priority system at the University of Barcelona. However, after the pandemic period, the presence of the students in the classroom has been clearly reduced. The teachers of the subject of Physiology and Pathophysiology III of the Pharmacy Degree of the University of Barcelona have designed a survey to capture the degree of satisfaction of the students about the development of face-to-face teaching tuition and to investigate their commitment to attend the classes in the classroom. The students answered this survey on the day of the final exam. The number of students in the course 2022-2023 is 313 and 95 % of them (296 students) answered the survey, which was voluntary and anonymous. In the analysis of the results obtained, we have differentiated between the students who coursed the subject for the first time (242 students) and those who failed in previous academic years and enrolled for the second or the third time (46 students). Results indicated that the students valued positively face-to-face teaching, as 94% of all the students who answered the poll rated "quiet" or "a lot" this tuition. If we consider only the students who matriculated the subject for the first time, the degree of satisfaction increased to 95% while it decreased to 90% when the students that already coursed the subject before were assessed. When they were asked about their commitment to assist the lessons at the classroom, with the question "How often have you attended the face-to-face classes?", 77% of the students answered "quite" or "a lot". Again, if we consider the students who coursed the subject for the first time, this value increased to 81% and decreased to 61% for those who were matriculated in the subject after failing it the previous year. The main reasons that they argued for not assisting to the classes were mainly 1) lack of time due to other continuous assessment exams and activities and 2) working hours. Only 1.7% of the students adduced their absence from the classroom to reasons related to the teaching quality. In conclusion, the students are in line with our university's face-to-face teaching methods, as they continue to positively value classroom teaching, despite having lived through the pandemics, when they took online classes. Their responses to the survey show us that students of the Pharmacy Degree may feel overwhelmed with the activities and exams scheduled during each term, the lack of time the reason for not attending regular face-to-face classes every day

Relapsing-Remitting Multiple Sclerosis Is Characterized by a T Follicular Cell Pro-Inflammatory Shift, Reverted by Dimethyl Fumarate Treatment

[eng] Multiple sclerosis (MS) is considered a T cell-mediated autoimmune disease, although several evidences also demonstrate a B cell involvement in its etiology. Follicular T helper (Tfh) cells, a CXCR5-expressing CD4+ T cell subpopulation, are essential in the regulation of B cell differentiation and maintenance of humoral immunity. Alterations in circulating (c)Tfh distribution and/or function have been associated with autoimmune diseases including MS. Dimethyl fumarate (DMF) is a recently approved first-line treatment for relapsing-remitting MS (RRMS) patients whose mechanism of action is not completely understood. The aim of our study was to compare cTfh subpopulations between RRMS patients and healthy subjects and evaluate the impact of DMF treatment on these subpopulations, relating them to changes in B cells and humoral response. We analyzed, by flow cytometry, the distribution of cTfh1 (CXCR3+CCR6-), cTfh2 (CXCR3-CCR6-), cTfh17 (CXCR3-CCR6+), and the recently described cTfh17.1 (CXCR3+CCR6+) subpopulations of CD4+ Tfh (CD45RA-CXCR5+) cells in a cohort of 29 untreated RRMS compared to healthy subjects. CD4+ non-follicular T helper (Th) cells (CD45RA-CXCR5-) were also studied. We also evaluated the effect of DMF treatment on these subpopulations after 6 and 12 months treatment. Untreated RRMS patients presented higher percentages of cTfh17.1 cells and lower percentages of cTfh2 cells consistent with a pro-inflammatory bias compared to healthy subjects. DMF treatment induced a progressive increase in cTfh2 cells, accompanied by a decrease in cTfh1 and the pathogenic cTfh17.1 cells. A similar decrease of non-follicular Th1 and Th17.1 cells in addition to an increase in the anti-inflammatory Th2 subpopulation were also detected upon DMF treatment, accompanied by an increase in naïve B cells and a decrease in switched memory B cells and serum levels of IgA, IgG2, and IgG3. Interestingly, this effect was not observed in three patients in whom DMF had to be discontinued due to an absence of clinical response. Our results demonstrate a possibly pathogenic cTfh pro-inflammatory profile in RRMS patients, defined by high cTfh17.1 and low cTfh2 subpopulations that is reverted by DMF treatment. Monitoring cTfh subsets during treatment may become a biological marker of DMF effectiveness

Cardiogenic shock prognosis according to the type of infarction: STEMI vs non-STEMI. Acute-phase and 5-year mortality

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Hospital Germans Trias i Pujol Background Cardiogenic shock (CS) is a severe complication of myocardial infarction (MI) and carries a high mortality. Clinical profile and prognosis of these patients could differ depending on the electrocardiographic pattern at admission. The objective of this study is to demonstrate these differences. Methods Prospective register of patients with MI complicated with CS admitted to the acute cardiac care unit of a tertiary hospital between 2010 and 2019. Clinical characteristics and mortality at 30-day and 5-year were compared according to the presence (STEMI) or absence (NSTEMI) of ST-segment elevation. Results This study included 239 patients, 79.5% had STEMI and 20.5% had NSTEMI. There were no differences in age (69 vs. 71 years, p=0.330), gender distribution (22.4% vs. 27.4% women, p=0.486) and ejection fraction (33% vs. 30%, p=0.231). However, patients with STEMI had more extensive MI (CK-MB peak 279 vs. 85 ng/ml, p&amp;lt;0.001) and mechanical complications (17.9% vs. 0% p&amp;lt;0.001). Nevertheless, patients with NSTEMI had greater prevalence of hypertension (81.6% vs. 62.6%, p=0.012), diabetes (53.1 vs. 36.3%, p=0.033), peripheral arteriopathy (34.7% vs. 13.7%, p=0.001), previous heart failure (14.3% vs. 3.7%, p=0.005), previous MI (44.9% vs. 10.0%, p&amp;lt;0.001), percutaneous coronary angioplasty (20.4% vs. 10.0%, p=0.047) and coronary artery bypass grafting (10.2% vs. 2.1%, p=0.020). This last group had more prevalence of three-vessel disease (80.4% vs. 34.9%, p&amp;lt;0.001) and main left artery (58.7% vs. 20.6%, p&amp;lt;0.001). STEMI patients had higher 30-day mortality (59.5% vs 36.7%; p=0.004), but this difference progressively diminished. As a result, 5-year survival had no significant differences. After adjusting for main clinical predictors, STEMI was independently associated with 30-day mortality (HR 1.99), but this association disappeared when the follow-up was extended to 5 years. Conclusions Patients with CS and STEMI had more extensive infarcts and with more mechanical complications than NSTEMI. Patients with NSTEMI and CS had more cardiovascular risk factors, previous coronary artery disease, and multi-vessel involvement. 30-day mortality of STEMI with CS was higher than in NSTEMI, although 5-year mortality did not offer significant differences. </jats:sec

Reperfusion therapies and in-hospital outcomes for ST-elevation myocardial infarction in Europe: The ACVC-EAPCI EORP STEMI Registry of the European Society of Cardiology

Aims: The aim of this study was to determine the contemporary use of reperfusion therapy in the European Society of Cardiology (ESC) member and affiliated countries and adherence to ESC clinical practice guidelines in patients with ST-elevation myocardial infarction (STEMI). Methods and results: Prospective cohort (EURObservational Research Programme STEMI Registry) of hospitalized STEMI patients with symptom onset <24 h in 196 centres across 29 countries. A total of 11 462 patients were enrolled, for whom primary percutaneous coronary intervention (PCI) (total cohort frequency: 72.2%, country frequency range 0-100%), fibrinolysis (18.8%; 0-100%), and no reperfusion therapy (9.0%; 0-75%) were performed. Corresponding in-hospital mortality rates from any cause were 3.1%, 4.4%, and 14.1% and overall mortality was 4.4% (country range 2.5-5.9%). Achievement of quality indicators for reperfusion was reported for 92.7% (region range 84.8-97.5%) for the performance of reperfusion therapy of all patients with STEMI <12 h and 54.4% (region range 37.1-70.1%) for timely reperfusion. Conclusions: The use of reperfusion therapy for STEMI in the ESC member and affiliated countries was high. Primary PCI was the most frequently used treatment and associated total in-hospital mortality was below 5%. However, there was geographic variation in the use of primary PCI, which was associated with differences in in-hospital mortality