The aim of this study was to evaluate the adverse drug reaction (ADR) incidence rate and new signals thereof for classic compared with new anticoagulants in real-life ambulatory settings. The authors performed an observational cross-sectional study in two cohorts of surveyed patients treated with vitamin K antagonists (VKAs; acenocoumarol or warfarin) or nonvitamin K antagonist oral anticoagulants (NOACs; apixaban, edoxaban, rivaroxaban, dabigatran etexilate). Descriptive, clinical, and ADRs data were reported and analyzed through a bivariate analysis (odds ratio [OR]) to compare the ADRs incidence rate and an adaptation of Bayesian methodology (false discovery rate [FDR] < 0.05) to detect new signals. A total of 334 patients were surveyed-average international normalized ratio (INR) of 2.6-and 45.4% taking new anticoagulants. Note that 835 ADRs were reported; 2.5 per patient (2.8 in the VKA cohort, 2.1 in the NOAC cohort). The authors obtained higher risk of epistaxis (OR, 2.18; 95% confidence interval [CI], 1.01-4.74) and hematoma (OR, 2.43; 95% CI, 1.39-4.25) with VKAs and lower risk of global bleeding symptoms with NOACs (OR, 0.45; 95% CI, 0.28-0.71). After standardizing the data, a significant risk of diarrhea with VKAs was observed (OR, 3.37; 95% CI, 1.09-10.41). They also detected an intense positive signal regarding the use of VKAs and osteoporosis (FDR < 0.001), specifically acenocoumarol (FDR < 0.002). NOACs presented lower risk of bleeding, especially dabigatran (FDR < 0.031), and of dermatological pathologies with apixaban being the safest (FDR = 0.050). The lower risk of global bleeding and a potential protective effect against osteoporosis in patients treated with NOACs postulate them as safer than VKAs.

The aim of the present study was to evaluate the risk of adverse drug reactions (ADRs) of concomitant treatments in patients treated with anticoagulants and statins. The authors performed an observational cross-sectional study in two cohorts of surveyed patients treated with vitamin K antagonists (VKAs) or non–vitamin K antagonist oral anticoagulants (NOACs). Different groups were analyzed based on the drug that each patient was taking, that is, VKAs or NOACs, as well as on the use of HMG CoA reductase inhibitors (statins) versus nonuse of these drugs; they also took into account the potential exposure to other common medications. Descriptive, clinical, and ADR data were reported and analyzed through an adaptation of Bayesian methodology (false discovery rate < 0.05) to detect new signals. Eleven different ADRs in patients on VKAs and statins and 12 in patients on VKAs without statins were found. In evaluating the concomitant therapies, the authors found that analgesics and nonsteroidal anti-inflammatory drugs were the most common therapeutic options, followed by proton pump inhibitors (PPIs). Seven ADRs were observed in patients concomitantly treated with NOACs and statins, whereas NOACs without concomitant statins were associated with a significantly lower risk of bleeding. The risk of observing an ADR among the patients who are concomitantly treated with VKAs and statins is lower than with analgesics or PPI, while the concomitant use of NOACs and statins is associated with both an increment in the number of observed ADRs and increased risk of bleeding.

Background: Suicide remains a leading cause of death and psychiatric population is often at increased risk for suicide. Therefore, there is a persistent need for well-designed clinical instruments that allows us to identify relevant risk factors. Our study aims to improve patient follow-up and identify possible suicide risk markers from a passage to self-harm among hospitalized psychiatric patients. Methods: This case-control study included the review of psychiatric, sociodemographic, drug use, and other health-related data, retrieved from 1,680 psychiatric patients’ health records. Differences between comparative groups were examined, and stepwise logistic regression analyses were performed to identify suicide risk factors within this population.Results: From the analysis of 560 suicide attempters’ clinical records, thirteen risk items were included in our final model, named as Risk Assessment Score of Suicide Attempt (RASSA). The factors that scored the highest in this model were ‘not taking antipsychotic medication’, ‘somatic comorbidity’, and ‘a family history of suicide’. Suffering from depression has a high score, and treatment with selective serotonin reuptake inhibitors (SSRIs) is also involved in the risk of a suicide attempt. Regarding medication use, opioid analgesics decreased the risk score, while taking non-opioid analgesics increased it. In terms of commonly abused substances, alcohol, cocaine, and amphetamine dependence increased the score. A higher risk was also associated with cannabis dependence, while tobacco use reduced it. As for demographics, the risk was significantly greater for women and subjects who were unmarried. Conclusions: The proposed model of risk assessment score of suicide attempt (RASSA) offers the possibility of establishing a suicide attempt risk based on data directly gathered from the health records of psychiatric patients. Therefore, it might be used as an initial screening test before patient evaluation and psychometric tests.

Objetivo. El presente proyecto ha evaluado la aplicación de la actividad de gamificación Escape Room como técnica para aumentar la dinamización y participación activa del alumnado en su formación en Fisiología dentro de un entorno de trabajo cooperativo, así como su percepción y evaluación indirecta de los conocimientos teóricos mediante su aplicación en un aprendizaje basado en resolución de problemas. Material y método. Se ha planificado y aplicado un Escape Room en estudiantes de Grados en Ciencias de la Actividad Física y del Deporte (CAFD) y Terapia ocupacional (TO) que cursan la asignatura transversal de Fisiología ambientado en un laboratorio experimental. Se planificó una estrategia no lineal y competitiva enfrentando a dos grupos de alumnos en espacios separados. Se realizó una encuesta de satisfacción al alumnado al término de la prueba. Resultados. El número total de participantes que realizó la actividad fue de 87. La implicación y el grado de satisfacción de los alumnos con la actividad fue muy elevado. En términos generales, el 60,8% del alumnado consideró esta actividad ‘muy divertida’ (5 puntos sobre 5), el 75,9% tuvo sensaciones positivas al realizarla, el 86,1% considera ‘haber aprendido algo’, el 87,3% recomendaría a sus compañeros realizar esta actividad y al 87,3% le gustaría repetir esta actividad con otras asignaturas o contenidos. Conclusiones. La técnica de gamificación Escape Room en Fisiología ha demostrado aumentar el interés y motivación por la materia, poniendo de manifiesto puntos fuertes y débiles en su conocimiento aplicado y promoviendo la formación y cooperación en grupo.    Objective. The present project has evaluated the application of the gamification activity Escape Room as a technique to increase the dynamization and active participation of students in their training in Physiology within a cooperative work environment, as well as their perception and indirect evaluation of theoretical knowledge through its application in a learning based on problem solving. Material and Method. An Escape Room has been planned and applied in students of Physical Activity and Sport Sciences (CAFD) and Occupational Therapy (OT) taking the cross-cutting subject of Physiology set in an experimental laboratory. A non-linear and competitive strategy was planned, pitting two groups of students against each other in separate spaces. A student satisfaction survey was carried out at the end of the test. Results. The total number of participants who took part in the activity was 87. The involvement and degree of satisfaction of the students with the activity was very high. In general terms, 60.8% of the students considered this activity 'very fun' (5 points out of 5), 75.9% had positive feelings when doing it, 86.1% considered 'having learned something', 87.3% would recommend this activity to their classmates and 87.3% would like to repeat this activity with other subjects or contents. Conclusions. The gamification technique Escape Room in Physiology has shown to increase interest and motivation for the subject, highlighting strengths and weaknesses in their applied knowledge and promoting group training and cooperation.

RESUMENObjetivo. El presente proyecto ha evaluado la aplicación de la actividad de gamificación Escape Room como técnica para aumentar la dinamización y participación activa del alumnado en su formación en Fisiología dentro de un entorno de trabajo cooperativo, así como su percepción y evaluación indirecta de los conocimientos teóricos mediante su aplicación en un aprendizaje basado en resolución de problemas. Material y método. Se ha planificado y aplicado un Escape Room en estudiantes de Grados en Ciencias de la Actividad Física y del Deporte (CAFD) y Terapia ocupacional (TO) que cursan la asignatura transversal de Fisiología ambientado en un laboratorio experimental. Se planificó una estrategia no lineal y competitiva enfrentando a dos grupos de alumnos en espacios separados. Se realizó una encuesta de satisfacción al alumnado al término de la prueba.Resultados. El número total de participantes que realizó la actividad fue de 87. La implicación y el grado de satisfacción de los alumnos con la actividad fue muy elevado.En términos generales, el 60,8% del alumnado consideró esta actividad 'muy divertida' (5 puntos sobre 5), el 75,9% tuvo sensaciones positivas al realizarla, el 86,1% considera 'haber aprendido algo', el 87,3% recomendaría a sus compañeros realizar esta actividad y al 87,3% le gustaría repetir esta actividad con otras asignaturas o contenidos.Conclusiones. La técnica de gamificación Escape Room en Fisiología ha demostrado aumentar el interés y motivación por la materia, poniendo de manifiesto puntos fuertes y débiles en su conocimiento aplicado y promoviendo la formación y cooperación en grupo.