Implantación de un programa internacional de seguro por una compañía española sin sucursales o filiales propias en el extranjero. Caso práctico: seguro de daños materiales y RC

Màster de Direcció d'Entitats Asseguradores i Financeres, Universitat de Barcelona, Facultat d'Economia i Empresa, Curs: 2013-2014, Tutor: Casimiro Rey ViñuelaHoy en día, la situación económica y financiera ha incitado a las empresas a cruzar fronteras y a expandirse a nivel mundial. Actualmente no solo las grandes multinacionales exportan sus productos y abren filiales en el extranjero para estar presentes en otros mercados, sino que la gran mayoría de pequeñas y medianas empresas buscan refugio fuera del territorio nacional. La globalización de las empresas ha provocado la necesidad de dar una respuesta aseguradora a los clientes que se encuentran en esta situación. Sin embargo, son pocos los aseguradores que pueden ofrecer servicio de forma global. Es por todo ello, que las entidades aseguradoras que no tienen presencia en el extranjero se están intentando adaptar a los nuevos cambios y necesidades del cliente. Con esta tesis se pretende mostrar el camino que puede seguir una entidad aseguradora a la falta de estructura en el exterior para intentar no perder a sus clientes y acompañarlos en esta nueva etapa de expansión. Con la ayuda de un caso práctico, se mostrarán los mecanismos que permitirán a una compañía aseguradora expandirse a nivel internacional, sin la necesidad de establecer sucursales/filiales en el extranjero y siempre bajo el cumplimiento del marco legal establecido en cada paí

Efecto del desenfoque en la medida de la estereopsis en visión lejana en pacientes présbitas

La Agudeza visual estereoscópica (AVE) es un parámetro subjetivo que se mide normalmente en la práctica clínica diaria para detectar estrabismos, ambliopías o para valorar la visión binocular después de un tratamiento tales como cirugía refractiva o adaptación de lentes de contacto monovisión. El objetivo de este trabajo es estudiar la influencia del de la monovisión (monocular) en la estereopsis medida en visión lejana en pacientes présbitas. Para ello, se han utilizado lentes positivas de diferente cuantía (¬¬¬¬+1.00 D, ¬¬¬¬+2.00 D y ¬¬¬¬+3.00 D y se han evaluado a 18 personas. Los resultados obtenidos demuestran que la AVE disminuye a medida que aumenta el desenfoque generado. El 88,88% de los sujetos del estudio con lente de +3.00D no tuvieron AVE, en cuanto a los sujetos con la lente de +2.00D el 77,78% de los sujetos no tuvieron AVE. A partir de los resultados obtenidos, se puede deducir que el mínimo desenfoque que no afecta a la AVE es un desenfoque de +1.00 D

Lung tumorspheres as a drug screening platform against cancer stem cells

Treatment resistance and metastasis are linked to cancer stem cells (CSCs). This population represents a promising target, but remains unexplored in lung cancer. The main objective of this study was to characterize lung CSCs and discover new therapeutic strategies

PRACTICUM II de Psicologia Mèdica en els Centres d'Atenció Primària sobre la comunicació no verbal en la relació metge-pacient

La Unitat de Psicologia Mèdica de la Facultat de Medicina de la UAB va posar en marxa durant el curs 2005/2006 el Practicum II de Psicologia Mèdica en els Centres d'Atenció Primària amb l'objectiu que els estudiants comencin a copsar la importància de les conductes i dels estats psicològics de les persones en els processos de salut-malaltia que es veuen en els Centres d'Atenció Primària (CAP). El Practicum està dedicat específicament als aspectes no verbals de la comunicació entre el professional de la salut i el pacient. L'experiència forma part de l'assignatura "Bases Psicològiques dels Estats de Salut i de Malaltia", impartida a segon curs de Medicina; s'inscriu en el paradigma de l'aprenentatge des de la pràctica que protagonitzen els professionals del sistema sanitari; i s'emmarca en el context d'un procés impulsat pels equips deganals de la Facultat de Medicina de la UAB des del curs 2004/2005 per tal d'apropar l'estudiant a la pràctica clínica des del primer curs de carrera i avançar cap a la consecució dels objectius que marquen les directrius europees. Cada alumne realitza dues visites programades a un CAP i participa en quatre sessions de tutoria a la Facultat en grups reduïts. En les visites al CAP, ha d'assistir a sessions de consulta amb diversos professionals de l'àmbit de la salut. Ha d'observar, identificar i enregistrar els elements no verbals que es descriuen en els objectius del Practicum i el context en què ocorren. A les sessions de tutories s'entrena els alumnes per a fer les observacions mitjançant material audiovisual i es discuteixen les observacions realitzades en els CAP. A més, també s'utilitza com a material una monografia específica sobre el tema. L'experiència es valora favorablement. tant des del punt de vista dels resultats obtinguts pels alumnes com per la seva satisfacció.The Medical Psychology Unit of the UAB School of Medicine initiated during the academic year 2005/2006 the Medical Psychology Practicum II in primary care centers with the goal that students realize the importance of human behaviors and psychological states in health-illness processes in primary care centers. The Practicum is specifically oriented to non verbal communication between the health professional and the patient. The experience is part of the subject "Psychological Bases of Health and Illness", taught in second course of Medicine; it is registered "learning from the practice" paradigm that professionals from the health system lead; and it is framed in the context of a process promoted by the UAB School of Medicine Deanship since the academic year 2004/2005 with the goal of bringing the clinical practice to the student from the first academic year and advancing towards the achievement of the goals that the European guidelines mark. Each student does two programmed visits to primary health center and participates in four tutorials of reduced groups in the Faculty. During the visits to the primary health center, he has to attend sessions of consultation with professionals from several health areas. He has to observe, to identify and to record the non verbal elements that are described in the Practicum goals and the context in which they occur. At the tutorials, students are trained to observe through audiovisual didactic material and the observations carried out at the primary health center are argued. Moreover, a specific monograph is also used as a specific material about the subject. The experience of these last two years has been satisfactory so for the professionals of the primary care centres as for the tutors and the students. The experience is valued favorably considering students' academic results and their satisfaction

Analysis of Exosomal Cargo Provides Accurate Clinical, Histologic and Mutational Information in Non-Small Cell Lung Cancer

Lung cancer is a malignant disease with high mortality and poor prognosis, frequently diagnosed at advanced stages. Nowadays, immense progress in treatment has been achieved. However, the present scenario continues to be critical, and a full comprehension of tumor progression mechanisms is required, with exosomes being potentially relevant players. Exosomes are membranous vesicles that contain biological information, which can be transported cell-to-cell and modulate relevant processes in the hallmarks of cancer. The present research aims to characterize the exosomes' cargo and study their role in NSCLC to identify biomarkers. We analyzed exosomes secreted by primary cultures and cell lines, grown in monolayer and tumorsphere formations. Exosomal DNA content showed molecular alterations, whereas RNA high-throughput analysis resulted in a pattern of differentially expressed genes depending on histology. The most significant differences were found in XAGE1B, CABYR, NKX2-1, SEPP1, CAPRIN1, and RIOK3 genes when samples from two independent cohorts of resected NSCLC patients were analyzed. We identified and validated biomarkers for adenocarcinoma and squamous cell carcinoma. Our results could represent a relevant contribution concerning exosomes in clinical practice, allowing for the identification of biomarkers that provide information regarding tumor features, prognosis and clinical behavior of the disease. Keywords: non-small cell lung cancer; liquid biopsy; exosomes; extracellular vesicles; cell cultures; adenocarcinoma; squamous cell carcinoma; biomarker; tumorsphere

Soluble galectin-3 as a microenvironment-relevant immunoregulator with prognostic and predictive value in lung adenocarcinoma

Despite the success of therapies in lung cancer, more studies of new biomarkers for patient selection are urgently needed. The present study aims to analyze the role of galectin-3 (GAL-3) in the lung tumor microenvironment (TME) using tumorspheres as a model and explore its potential role as a predictive and prognostic biomarker in non-small cell lung cancer (NSCLC) patients. For in vitro studies, lung adenocarcinoma (LUAD) and lung squamous carcinoma (LUSC) primary cultures from early-stage patients and commercial cell lines were cultured, using tumorsphere-forming assays and adherent conditions for the control counterparts. We analyzed the pattern of secretion and expression of GAL-3 using reverse transcription-quantitative real-time PCR (RTqPCR), immunoblot, immunofluorescence, flow cytometry and immunoassay analysis. Our results using three-dimensional (3D) models of lung tumor cells revealed that soluble GAL-3 (sGAL-3) is highly expressed and secreted. To more accurately mimic the TME, a co-culture of tumorspheres and fibroblasts was used, revealing that GAL-3 could be important as an immunomodulatory molecule expressed and secreted in the TME, modulating immunosuppression through regulatory T cells (TREGS). In the translational phase, we confirmed that patients with high expression levels of GAL-3 had more TREGS, which suggests that tumors may be recruiting this population through GAL-3. Next, we evaluated levels of sGAL-3 before surgery in LUAD and LUSC patients, hypothesizing that sGAL-3 could be used as an independent prognostic biomarker for overall survival and relapse-free survival in early-stage LUAD patients. Additionally, levels of sGAL-3 at pretreatment and first response assessment from plasma to predict clinical outcomes in advanced LUAD and LUSC patients treated with first-line pembrolizumab were evaluated, further supporting that sGAL-3 has a high efficiency in predicting durable clinical response to pembrolizumab with an area under curve (AUC) of 0.801 (p=0.011). Moreover, high levels might predict decreased progression-free survival and overall survival to anti-PD-1 therapy, with sGAL-3 being a prognosis-independent biomarker for advanced LUAD