(1) Background: COVID-19-associated pulmonary aspergillosis (CAPA) has worsened the prognosis of patients with pneumonia and acute respiratory distress syndrome admitted to the intensive care unit (ICU). The lack of specific diagnosis criteria is an obstacle to the timely initiation of appropriate antifungal therapy. Tracheal aspirate (TA) has been employed under special pandemic conditions. Galactomannan (GM) antigens are released during active fungal growth. (2) Methods: We proposed the term “CAPA in progress” (CAPA-IP) for diagnosis at an earlier stage by GM testing on TA in a specific population admitted to ICU presenting with clinical deterioration. A GM threshold ≥0.5 was set as the mycological inclusion criterion. This was followed by a pre-emptive short-course antifungal. (3) Results: We prospectively enrolled 200 ICU patients with COVID-19. Of these, 164 patients (82%) initially required invasive mechanical ventilation and GM was tested in TA in 93 patients. A subset of 19 patients (11.5%) fulfilled the CAPA-IP criteria at a median of 9 days after ICU admittance. The median GM value was 3.25 ± 2.82. CAPA-IP cases showed significantly higher ICU mortality [52.6% (10/19) vs. 34.5% (50/145), p = 0.036], as well as a much longer median ICU stay than those with a normal GM index [27 (7–64) vs. 11 (9–81) days, p = 0.008]. All cases were treated with a pre-emptive systemic antifungal for a median time of 19 (3–39) days. (4) Conclusions: CAPA-IP highlights a new real-life early approach in the field of fungal stewardship in ICU programs.
ResumenSe plantea una propuesta de transposición didáctica al aula con las investigaciones realizadas sobre hu medales y el papel de los medios de comunicación como elementos clave. La metodología empleada se basa en la creación de una comunidad de aprendizaje donde se fomente la comunicación y se produzca un aprendizaje significativo en entornos naturales. Para ello se utilizan los medios de comunicación fre cuentados por los alumnos como fuente de información motivadora, especialmente las redes sociales. La importancia de utilizar los conocimientos científicos en la docencia resulta especialmente interesante en la redefinición de la figura del maestro docente investigador de las Facultades de Educación. El ob jetivo final de la propuesta es hacer más eficiente el trinomio investigaciónenseñanzaaprendizaje, edu cando a personas competentes que contribuyan a la mejora del entorno en que se desenvuelven. Palabras clave: Transposición didáctica, humedales, comunicación, educación, fuentes de información.
Didactic transposition of wetlands research
AbstractThis article is a proposal of didactic transposition into the classroom of the investigations conducted on wetlands and the role of the media as key elements. The methodology used is based on the creation of a learning community, where encouraging communication and meaningful learning occurs in natural en vironments. Frequented by students as a motivating information source, media like social networks are especially used. The importance of using scientific knowledge in teaching is especially interesting in the redefinition of the figure of new researcher teacher in faculties of education. The final objective of the proposal is to make more efficient the trinomial researchingteachinglearning, educating competent people that con tribute to the improvement of the environment in which they develop.
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