Simuladores de Planificadores de Sistemas en Tiempo Real

En este artículo se presenta un simulador desarrollado que permite ejecutar diferentes planificadores de Tiempo Real, como el algoritmo de planificación cíclica, Algoritmo de la Razón Monótona (RMA) y EDF (Earliest Deadline First) para un conjunto de procesos con unos datos dados y muestra los resultados obtenidos. Mediante este simulador se facilita a los alumnos el aprendizaje de los algoritmos de planificación.This paper presents a simulator that has been developed to allow the execution of scheduling algorithms such as the Cyclic Non­preemptive Executive, Rate­monotonic scheduling (RMS) and Earliest Deadline First (EDF) for a given set of processes with different values and the simulator displays the results. With this simulator, students are able to learn about scheduling algorithms.Universidad de Granada: Departamento de Arquitectura y Tecnología de Computadores; Vicerrectorado para la Garantía de la Calidad

Adecuación del uso de las benzodiacepinas zolpidem y zopiclona en problemas atendidos en atención primaria

ObjetivoEstimar la proporción de prescripciones de las benzodiacepina zolpidem y zopiclona que cumplen criterios normativos de adecuada prescripción.Identificar las variables asociadas con una adecuada prescripción.DiseñoObservacional, transversal.ÁmbitoCentro de Salud de Monóvar del Área IV de Madrid.SujetosMuestra aleatoria de 270 prescripciones activas de benzodiacepinas en adultos del registro de prescripciones del sistema informático OMI-AP versión 5.0.MedicionesDimensiones: a) correcta indicación diagnóstica; b) ausencia de benzodiacepinas de vida media larga en ancianos; c) existencia de visitas de apoyo o seguimiento, y d) adecuación global o coexistencia de indicaciones correctas y visitas de seguimiento. Variables independientes recogidas en relación con el paciente, el prescriptor y la prescripción.ResultadosCorrecta indicación diagnóstica en el 75,6%, ausencia de benzodiacepinas de vida media larga en ancianos del 79,8%, existencia de visitas de apoyo en el 63,3% y adecuación global en el 53%. Principales diagnósticos: ansiedad pura en el 29%, ansiedad relacionada con otros procesos en el 18,6%, insomnio en el 14,8%, enfermedades circulatorias en el 14,8%, abuso de alcohol y drogas en el 4,5%, enfermedad osteomuscular en el 4,4% y esquizofrenia en el 4,4%. Sustancias más prescritas: lorazepam en el 27,8% y bromazepam en el 23,7%. Duración media de las prescripciones: 18,58 meses. Origen: el 68,5% en el centro de salud, el 10% en el cantro de salud mental y el 10% en el hospital. La variable que más se asocia con la adecuación global tras ajustar por las restantes variables es la prescripción originada en salud mental (odds ratio [OR]=6,67; intervalo de confianza [IC] del 95%, 1,92-23,18).ConclusionesLa duración media de las prescripciones contraviene todos los estándares. La adecuación global o coexistencia de indicación diagnóstica correcta con presencia de visitas de seguimiento se asocia con la prescripción en el ámbito de la salud mental.ObjetivesTo estimate the proportion of benzodiazepine prescriptions that comply with the guidelines for appropriate prescription.To identify the variables associated with appropriate prescription.DesignObservational, cross-sectional study.SettingMonóvar Health Centre in Area IV, Madrid, Spain.SubjetsRandom sample of 270 active benzodiazepine prescriptions in adult patients from the prescriptions record of the OMI-AP V. 5.0 computer system.MeasurementsThe chosen dimensions for appropriate prescription were: a) correct diagnostic indication; b) absence of benzodiazepines with long half-life in the elderly; c) existence of support or monitoring visits; d) oerall appropriateness or coexistence of correct diagnostic indications and monitoring visits. Independent variables were recorded in relation to patient, person prescribing and prescription.ResultsDiagnostic indication, 75.6%; absence of benzodiazepines with long half-life in the elderly, 79.8%; existence of support visits, 63.3%; overall appropriateness, 53%. Main diagnoses: pure anxiety, 29%; anxiety related to other illness, 18.6%; insomnia, 14.8%; cardiovascular illness, 14.8%; alcohol and drug abuse, 4.5%; osteo-muscular illness, 4.4%; schizophrenia, 4.4%. Most prescribed substances: lorazepam, 27.8%; bromazepam, 23.7%. Average life of prescriptions: 18.58 months. Origins: health centre, 68.5%; outpatient psychiatry, 10%; hospital, 10%. The variable that is most closely associated with overall appropriateness, fitted with the rest of the variables, is out-patient psychiatry prescription (OR, 6.67; 95% CI, 1.92-23.18).ConclusionsThe mean duration of the prescriptions infringes all standards. The overall appropriateness or correct coexistence of adequate diagnostic indication with followup visits is associated with out-patient Psychiatry prescription

Diagnosis delay and follow-up strategies in colorectal cancer. Prognosis implications: a study protocol

Multicenter study[Abstract] Background: Controversy exists with regard to the impact that the different components of diagnosis delay may have on the degree of invasion and prognosis in patients with colorectal cancer. The follow-up strategies after treatment also vary considerably. The aims of this study are: a) to determine if the symptoms-to-diagnosis interval and the treatment delay modify the survival of patients with colorectal cancer, and b) to determine if different follow-up strategies are associated with a higher survival rate. Methods/design: Multi-centre study with prospective follow-up in five regions in Spain (Galicia, Balearic Islands, Catalonia, Aragón and Valencia) during the period 2010-2012. Incident cases are included with anatomopathological confirmation of colorectal cancer (International Classification of Diseases 9th revision codes 153-154) that formed a part of a previous study (n = 953).At the time of diagnosis, each patient was given a structured interview. Their clinical records will be reviewed during the follow-up period in order to obtain information on the explorations and tests carried out after treatment, and the progress of these patients.Symptoms-to-diagnosis interval is defined as the time calculated from the diagnosis of cancer and the first symptoms attributed to cancer. Treatment delay is defined as the time elapsed between diagnosis and treatment. In non-metastatic patients treated with curative intention, information will be obtained during the follow-up period on consultations performed in the digestive, surgery and oncology departments, as well as the endoscopies, tumour markers and imaging procedures carried out.Local recurrence, development of metastases in the follow-up, appearance of a new tumour and mortality will be included as outcome variables.Actuarial survival analysis with Kaplan-Meier curves, Cox regression and competitive risk survival analysis will be performed. Discussion: This study will make it possible to verify if the different components of delay have an impact on survival rate in colon cancer and rectal cancer. In consequence, this multi-centre study will be able to detect the variability present in the follow-up of patients with colorectal cancer, and if this variability modifies the prognosis. Ideally, this study could determine which follow-up strategies are associated with a better prognosis in colorectal cancer

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population