La COVID-19 por SARS-CoV-2 también ha afectado a la educación médica / COVID-19 by SARS-CoV-2 has also affected medical education

El virus SARS-CoV-2, además de provocar una pandemia con centenares de miles de enfermos y con decenas de miles de fallecidos, ha tenido la capacidad ("el poder") de romper las prácticas educativas estándar. Esto ha tenido, o puede tener, un beneficio: reconsiderar lo que es realmente importante y lo que no lo es tanto. Y eso tiene un gran valor para el docente y para el discente. Y también ha servido para reconocer y encontrar formas alternativas con las que se puede transmitir el saber. En definitiva, el profesor ha tenido la oportunidad de contribuir a crear un modelo educativo capaz de impulsar el desarrollo de nuevas formas y métodos de aprendizaje. Ciertas técnicas y recursos educativos han podido ser reconocidos como presentes o ausentes de nuestro sistema educativo. Esto implica que ciertos recursos han de estar presentes o que es preciso optimizar los que ya están disponibles para enseñar, para aprender o para evaluar. La tecnología permite facilitar el contacto directo entre profesor y alumno, entre profesores, y entre alumnos. Pero sobra decir que la tecnología ha de estar disponible.

The SARS-CoV-2 virus, besides causing a pandemic, with hundreds of thousands ill, and tens of thousands dead, has caused a major shift in standard education practices. This has had, or may have, one benefit: to reconsider what is ultimately relevant or not in the classroom. And this is of great value for the teacher and for the student. And it has also served to recognise and find alternative ways to transmit the knowledge. All things considered, the teacher has had the opportunity to contribute in creating an education with the aim of developing new ways and methods of learning. Certain educational techniques and resources have been recognised as present or absent in our education system. It is necessary for certain resources used to teach, learn and evaluate to be available and those that are already present, require optimization. Technology helps to provide direct contact between teacher and student, between teachers and between students. But it goes without saying that this technology has to be available.

Residual macrovascular risk in 2013: what have we learned?

Cardiovascular disease poses a major challenge for the 21st century, exacerbated by the pandemics of obesity, metabolic syndrome and type 2 diabetes. While best standards of care, including high-dose statins, can ameliorate the risk of vascular complications, patients remain at high risk of cardiovascular events. The Residual Risk Reduction Initiative (R3i) has previously highlighted atherogenic dyslipidaemia, defined as the imbalance between proatherogenic triglyceride-rich apolipoprotein B-containing-lipoproteins and antiatherogenic apolipoprotein A-I-lipoproteins (as in high-density lipoprotein, HDL), as an important modifiable contributor to lipid-related residual cardiovascular risk, especially in insulin-resistant conditions. As part of its mission to improve awareness and clinical management of atherogenic dyslipidaemia, the R3i has identified three key priorities for action: i) to improve recognition of atherogenic dyslipidaemia in patients at high cardiometabolic risk with or without diabetes; ii) to improve implementation and adherence to guideline-based therapies; and iii) to improve therapeutic strategies for managing atherogenic dyslipidaemia. The R3i believes that monitoring of non-HDL cholesterol provides a simple, practical tool for treatment decisions regarding the management of lipid-related residual cardiovascular risk. Addition of a fibrate, niacin (North and South America), omega-3 fatty acids or ezetimibe are all options for combination with a statin to further reduce non-HDL cholesterol, although lacking in hard evidence for cardiovascular outcome benefits. Several emerging treatments may offer promise. These include the next generation peroxisome proliferator-activated receptorα agonists, cholesteryl ester transfer protein inhibitors and monoclonal antibody therapy targeting proprotein convertase subtilisin/kexin type 9. However, long-term outcomes and safety data are clearly needed. In conclusion, the R3i believes that ongoing trials with these novel treatments may help to define the optimal management of atherogenic dyslipidaemia to reduce the clinical and socioeconomic burden of residual cardiovascular risk.