Desarrollo de un plan de gestión para la mejora de los procesos de supervisión y administración de las Redes LAN en el Tecnológico Nacional, a través de un software especializado, de Octubre de 2015 a Febrero de 2016

El objetivo principal de este proyecto es desarrollar un plan de gestión para la mejora de los procesos de supervisión y administración de las redes LAN en el Tecnológico Nacional a través de un software especializado. Como parte del plan de gestión del proyecto se elaboraron el plan de gestión del alcance, del tiempo, del costo, de comunicaciones, de riesgos, de RRHH, y de los interesados, basado en las buenas prácticas que sugiere el Instituto de Gerencia de Proyectos en la Guía de Fundamentos de Gerencia de Proyectos. De las técnicas empleadas se destaca el juicio experto, así como análisis documental a diversas fuentes sobre Gerencia de Proyectos en general y ejemplos de proyectos similares. Se utilizó la investigación descriptiva transversal, porque se basa en técnicas específicas para la recolección de datos, tales como la entrevista, observación, análisis documental y la evaluación. Adicionalmente, se utilizaron las herramientas de Gerencia de Proyectos tales como: MS Project 2010, WBS chart pro, plantillas para la elaboración de la matriz de riesgos, estimación de costos. Como resultado se pudo obtener el tiempo y costo que el proyecto requerirá, además de una descripción detallada del alcance con los criterios de aceptación. Como recomendación general se sugirió para el futuro adoptar practicas recomendadas por el PMBoK e utilizar otras metodologías en la institución para realizar un mejor planeamiento y el control de los proyectos futuros

A report of disseminated adenocarcinoma presenting as thrombotic thrombocytopenic purpura

Thrombotic microangiopathies (TMAs) represent a heterogeneous group of diseases characterized by a microangiopathic hemolytic anemia, peripheral thrombocytopenia, and organ failure of variable severity. TMAs encompass thrombotic thrombocytopenic purpura (TTP), typically characterized by fever, central nervous system manifestations and hemolytic uremic syndrome (HUS), in which renal failure is the prominent abnormality. In patients with cancer TMAs may be related to various antineoplastic drugs or to the malignant disease itself. The reported series of patients with TMAs directly related to cancer are usually heterogeneous, retrospective, and encompass patients with hematologic malignancies with solid tumors or receiving chemotherapy, each of which may have distinct presentations and pathophysiological mechanisms. Patients with disseminated malignancy who present with microangiopathic hemolytic anemia and thrombocytopenia may be misdiagnosed as thrombotic thrombocytopenic purpura (TTP) Only a few cases of TTP secondary to metastatic adenocarcinoma are known in the literature. We present a case of a 34-year-old man with TTP syndrome secondary to metastatic small-bowel adenocarcinoma. Patients with disseminated malignancy had a longer duration of symptoms, more frequent presence of respiratory symptoms, higher lactate dehydrogenase levels, and more often failed to respond to plasma exchange treatment. A search for systemic malignancy, including a bone marrow biopsy, is appropriate when patients with TTP have atypical clinical features or fail to respond to plasma exchange

A Sustainable Approach to the Metabolic Syndrome in Children and Its Economic Burden

The prevalence of obesity continues to grow, resulting in metabolic syndrome and increasing economic burden for health systems. The objectives were to measure the ability of the NIM-MetS test, previously used in the adults, for the early and sustainable detection of the Metabolic Syndrome (MetS) in children and adolescents. Moreover, to determine the economic burden of the children with MetS. Furthermore, finally, to use and implement the NIM-MetS test, via a self-created online software, as a new method to determine the risk of MetS in children. The method used was an observational study using different instruments (NIM-MetS test, International Diabetes Federation (IDF), or Cook) and measures (body mass index). Additionally, the economic burden was estimated via a research strategy in different databases, e.g., PubMed, to identify previous papers. The results (N = 265 children, age from 10–12) showed that 23.1% had obesity and 7.2% hypertension. The prevalence of MetS using the NIM-Mets was 5.7, and the cost of these children was approximate 618,253,99 euros. Finally, a model was obtained and later implemented in a web platform via simulation. The NIM-MetS obtained is a non-invasive method for the diagnosis of risk of MetS in children

Be careful what you eat and drink; Coprinic and Kounis syndrome in a patient with the Samter`s triad

Allergic reactions to chemicals, food products or even insect bites are encountered all over the world with a variety of manifestations. Symptoms range from the development of a minor rash to life threatening anaphylactic reactions. Sometimes, acute coronary syndrome (ACS) can be registered in such patients, which may have a serious impact on the course and management of the allergic reaction. Mushroom poisoning constitutes the main portion of plant toxicities in Spain. Depending on the type of mushroom, the adverse effects range from mild gastrointestinal (GI) symptoms to major cytotoxic effects resulting in organ failure and death. Coprinopsis atramentaria poisoning is rare but with serious consequences. We report a case of a 27 year old patient with a previous history of mild persistent asthma, nasal polyps and aspirin allergy that arrived to the Emergency Department with dizziness and temor after consuming beer at a party. On arrival to the hospital, the patient suddenly collapsed, with an electrocardiogram (ECG) showing ST elevation in the inferior leads and 3rd degree atrioventricular (AV) block accompanied by urticarial-like lesions. After administration of treatment, the patient and ECG abnormalities improved. A detailed medical history showed that the patient had eaten scrambled mushrooms and beer. Expert analysis demonstrated that the combined consumption of Coprinopsis atramentaria and alcoholic beverages produced a disulfiram-like reaction (Coprinic syndrome) and type I Kounis syndrome. No case like this has been previously reported

Coordinación de actividades transversales del módulo básico de los Grados en Biología y Ciencias del Mar

La coordinación de las actividades de un curso pretende mejorar la calidad de la docencia. En este sentido la calidad tiene diferentes matices y aspectos como la cohesión de los cursos, la gestión de la planificación temporal, y la coordinación de las competencias transversales, así como la solución a las incidencias que aparecen a lo largo del curso. Una vez en marcha el curso, a partir de los planes elaborados inicialmente y con la aportación del alumnado en las respectivas reuniones de coordinación, tanto del presente curso como de los anteriores, se ha creado una dinámica de mejora de la planificación coordinada que afecta a todas las competencias del ciclo básico. Se han detectado puntos críticos en la gestión de los recursos que pueden ser limitados, como laboratorios, aulas de ordenadores, la distribución de los tipos de actividades en cada semana, o incluso el propio horario que no es ilimitado. Estos aspectos introducen las principales restricciones cuando se trata de evaluar los esfuerzos de carga de créditos ECTS semanales. La gestión de todos estos aspectos ayudará en el proceso continuo de mejora de la calidad de la docencia en el segundo semestre del ciclo básico de los Grados en Biología y en Ciencias del Mar

Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

Presentaciones electrocardiográficas atípicas en pacientes con síntomas isquémicos, tiempo de cambiar la estrategia.

There are a number of atypical electrocardiographic patterns that have recently been described, and indicate and impending risk of myocardial infarction, also known as “ST elevation myocardial infarction equivalents”. These include isolated posterior myocardial infarction, Wellens syndrome, De Winter's pattern, ST segment elevation in aVR, Sgarbossa's criteria for complete left bundle branch block or pacemaker and the hyperacute T-waves. These patterns must be known and recognized by the emergency physicians, since clinical symptoms together with early detection accelerates the definitive treatment. We describe three cases that have been diagnosed in the emergency services with an early activation of the hemodynamic service after the recognition of these conditions.Existen una serie de alteraciones electrocardiográficas atípicas que se han descritos recientemente, y que tienen la importancia de indicar un riesgo elevado de presentar un infarto del miocardio o, también conocidos como "equivalentes de síndrome coronario agudo con elevación del segmento ST (SCACEST)”. Entre ellos se encuentran el infarto del miocardio aislado de cara posterior, el síndrome de Wellens, el patrón de Winter, la elevación del segmento ST en aVR, los criterios de Sgarbossa para el bloqueo completo de rama izquierda o marcapasos y las ondas T hiperagudas. Estos deben ser conocidos y reconocidos por los emergencistas, ya que la clínica junto con la detección temprana de los mismos agiliza el tratamiento definitivo del mismo. Describimos tres casos que han sido diagnosticados en los servicios de urgencias y tras el reconocimiento del mismo se agilizó la activación del servicio de hemodinámica