Tackling the challenge of peer learning in hybrid and online universities.

Peer learning is not fully developed or researched in online and hybrid higher education. This research analyses a peer learning experience in the asynchronous part of hybrid teaching, in one of the largest blended universities in Europe, promoting students to act as teachers of their peers, by preparing digital content (videos) for the course. This article studies whether there are behaviour patterns and different perceptions associated between students who act as teachers, and those who only act as students. The results indicate, among other findings, that students demand this type of activities, and value them very positively. Specifically, the "teachers" consider that this activity increases their motivation for the subject and their performance; they also consider that it significantly improves their creativity and communication skills, and they would definitely participate in the project again. The assessment of the students who merely view the materials is also very positive, and they prefer a learning method through classmate videos than the traditional learning method with printed materials. The research is also a boost to finding ways to promote learning among equals in non-classroom teaching in digital environments.

Avulsión de bronquio fuente derecho debido a traumatismo torácico cerrado / Right main bronchus avulsion due to thoracic blunt trauma

La incidencia de roturas traqueobronquiales secundarias a un traumatismo torácico cerrado es baja, y la mayoría de estos pacientes no llegan con vida a los centros de atención hospitalaria. La presentación clínica es variable dependiendo de la localización de las lesiones, los daños asociados y si las estructuras peribronquiales permanecen íntegras. Para su diagnóstico temprano se debe tener un alto índice de sospecha clínica y una correcta interpretación de los hallazgos semiológicos y radiológicos, lo que permite su rápida y correcta resolución. La demora en el tratamiento aumenta tanto la mortalidad como las complicaciones tempranas y tardías.

The incidence of tracheobronchial ruptures secondary to blunt thoracic trauma is low and most affected patients do not arrive alive to hospitals. Clinical presentation varies with the location of lesions, associated injuries and whether the peribronchial structures remain intact. Early diagnosis requires a high index of clinical suspicion and a correct interpretation of semiologic and radiologic findings, which allows for a rapid and correct resolution. Delay in treatment increases the mortality as well as early and late complications.

Venobronchial fistula: an unusual complication of long-term central venous access.

A venobronchial fistula developed between the azygous vein and the upper aspect of the right main bronchus 12 months after completion of the treatment of a stage IIIB non-small-cell lung cancer in a 54-year-old man. The fistula contained the tip of the catheter placed for chemotherapy perfusion. The reported case presented risk factors previously identified for such a complication. In addition, some clinical particularities were present, suggesting new potent risk factors and some preventive means for safe long-term central venous catheterization.

Does the extent of lymph node dissection influence outcome in patients with stage I non-small-cell lung cancer?

OBJECTIVE: To assess the therapeutic effect of the extent of lymph node dissection performed in patients with a stage pI non-small-cell lung cancer (NSCLC). METHODS: We analysed data on 465 patients with stage I NSCLC who were treated with surgical resection and some form of lymph node sampling. The median number of lymph node sampled was 10 and the median number of ipsilateral mediastinal lymph node stations sampled was two. We chose to define a procedure that harvested 10 or more lymph nodes and sampled two or more ipsilateral mediastinal stations as a lymphadenectomy, by contrast with sampling when one or both criteria were not satisfied. The effect of the surgical techniques: lymph node sampling (LS; n=207) vs. lymphadenectomy (LA; n=258) on 30-day mortality and overall survival were investigated. RESULTS: A total of 6244 lymph nodes was examined, including 4306 mediastinal lymph nodes. The mean (+/-SD) numbers of removed lymph nodes were 7+/-6.1 per patient following LS vs.18.6+/-9.3 following LA (P=0.001). An average mean of 1+/-0.90 mediastinal lymph node station per patient was sampled following LS vs. 2.7+/-0.8 following LA (P<10(-6)). Overall 30-day mortality rates were 2.4 and 3.1%, respectively. LA was disclosed as a favourable prognosticator at multivariate analysis (Hazard Risk: 1.43; 95% Confidence Interval: 1.00-2.04; P=0.048), together with younger patient age, absence of blood vessels invasion, and smaller tumour size. CONCLUSIONS: Importance of lymph node dissection affects patients outcome, while it does not enhance the operative mortality. A minimum of 10 lymph nodes assessed, and two mediastinal stations sampled are suggested as possible pragmatic markers of the quality of lymphadenectomy.