21 research outputs found

    Mapa de procesos de la Formación Sanitaria Especializada de los Residentes del Hospital General Universitario Reina Sofía de Murcia. Póster

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    Los centros docentes hospitalarios deben identificar y eleborar un mapa de los procesos involucrados en la formación postgrado de especialistas en Ciencias de la Salud, así como sus interrelaciones.Para elaborar el mapa se han identificado los procesos estratégicos, clave y de soporte que intervienen la formación del residente, desde su incorporación al centro hasta su salida como especialista. Con ello se pretende dar una visión general del sistema de Formación Sanitaria Especeializada de los Residentes de nuestro centro.Campus Mare Nostrum, Universidad Politécnica de Cartagena, Universidad de Murcia, Región de Murci

    Plan de gestión de la calidad docente del Hospital General Universitario Reina Sofía de Murcia

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    [SPA]El Plan de Gestión de la Calidad Docente (PGCD) es el conjunto de documentos que describen y desarrollan tanto la organización para la docencia como las directrices y requisitos para gestionar y asegurar la calidad de la formación sanitaria especializada en nuestro centro docente hospitalario. El objetivo general del PGCD es el diseño, evaluación y control de la calidad de los distintos elementos que configuran la estructura docente del hospital, destinada a la formación sanitaria especializada (sistema de residencia). El Plan ha sido elaborado por la Jefatura de Estudios y la Unidad de Calidad y ha sido aprobado por la Comisión de Docencia y la Direción. Pretendemos medir lo que estamos haciendo, con la intención de mejorar. Hemos marcado unos estándares de cumplimiento que se aplican a indicadores de calidad relacionados con las acciones vinculadas al PGCD que tienen asignadas los órganos docentes y la Dirección. Periódicamente se analizarán los indicadores de calidad y, de no alcanzar los resultados esperados, se tomarán las medidas correctoras oportunas y se documentarán. El PGCD está sujeto a revisiones periódicas a fin de asegurar su continua adecuación a la gestión de las actividades docentes del centro. Como mínimo se revisará una vez al año. [ENG]The Teaching Quality Management Plan (TQMP) is the set of documents that describe and develop both teaching organization with guidelines and requirements for managing and ensuring the quality of postgraduate specialized medical training (residency system) in our teaching hospital. The overall objective of the TQMP is the design, evaluation and quality control of the various elements that make up the training structure of the hospital for specialist medical training. The Plan has been prepared by the Chief of Studies and the Quality Unit and has been approved by the Teaching Committee and Hospital Manager. Pretend to measure what we are doing, with the aim of improving. We have developed some standards of compliance that apply to quality indicators related to the different objectives. Periodically, we examine the quality indicators and, if not achieve the expected results, the appropriate remedial action will be taken and documented. Our TGMP is subject to periodic review to ensure its continued relevance to the management of the learning activities of the center. It will be reviewed at least once a year.Campus Mare Nostrum, Universidad Politécnica de Cartagena, Universidad de Murcia, Región de Murci

    Guillain-Barré syndrome following the 2009 pandemic monovalent and seasonal trivalent influenza vaccination campaigns in Spain from 2009 to 2011: outcomes from active surveillance by a neurologist network, and records from a country-wide hospital discharge database

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    Background: Studies have shown a slight excess risk in Guillain-Barre syndrome (GBS) incidence associated with A(H1N1) pdm09 vaccination campaign and seasonal trivalent influenza vaccine immunisations in 2009-2010. We aimed to assess the incidence of GBS as a potential adverse effect of A(H1N1) pdm09 vaccination. Methods: A neurologist-led network, active at the neurology departments of ten general hospitals serving an adult population of 4.68 million, conducted GBS surveillance in Spain in 2009-2011. The network, established in 1996, carried out a retrospective and a prospective study to estimate monthly alarm thresholds in GBS incidence and tested them in 1998-1999 in a pilot study. Such incidence thresholds additionally to observation of GBS cases with immunisation antecedent in the 42 days prior to clinical onset were taken as alarm signals for 2009-2011, since November 2009 onwards. For purpose of surveillance, in 2009 we updated both the available centres and the populations served by the network. We also did a retrospective countrywide review of hospital-discharged patients having ICD-9-CM code 357.0 (acute infective polyneuritis) as their principal diagnosis from January 2009 to December 2011. Results: Among 141 confirmed of 148 notified cases of GBS or Miller-Fisher syndrome, Brighton 1-2 criteria in 96 %, not a single patient was identified with clinical onset during the 42-day time interval following A(H1N1) pdm09 vaccination. In contrast, seven cases were seen during a similar period after seasonal campaigns. Monthly incidence figures did not, however, exceed the upper 95 % CI limit of expected incidence. A retrospective countrywide review of the registry of hospital-discharged patients having ICD-9-CM code 357.0 (acute infective polyneuritis) as their principal diagnosis did not suggest higher admission rates in critical months across the period December 2009-February 2010. Conclusions: Despite limited power and underlying reporting bias in 2010-2011, an increase in GBS incidence over background GBS, associated with A(H1N1) pdm09 monovalent or trivalent influenza immunisations, appears unlikely

    Formación especializada en España: del internado rotatorio a la troncalidad

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    La implantación en España del sistema de formación sanitaria especializada (FSE) mediante residencia ha supuesto un gran avance en el terreno de la educación médica. El Hospital General de Asturias, en 1963, y la Clínica Puerta de Hierro de Madrid, en 1964, iniciaron la formación de médicos internos y residentes (MIR), pese a que contravenía lo estipulado en la Ley de especialidades de 1955 y a que entraba en conflicto con el sistema de especialización a través de las escuelas universitarias, entonces vigente. El nuevo sistema recibió un fuerte impulso coincidiendo con la expansión de las residencias de la Seguridad Social, y los principales centros hospitalarios lo fueron implantando progresivamente. En 1968 se constituyó el denominado “seminario de hospitales con programas de posgraduados”, que elaboró en 1970 el primer manual de acreditación de hospitales. Su influjo sobre el ministerio fue muy grande, y a partir de 1971 tienen lugar las primeras convocatorias de ámbito nacional, aunque por concurso de méritos y con entrevista local de los solicitantes. Recién creado el Ministerio de Sanidad y Seguridad Social, se publica el Real Decreto (RD) 2015/1978, primera norma que reconoce que las enseñanzas de especialización podrán cursarse por el sistema de residencia, que se convertirá en obligatorio para las especialidades que requieran formación hospitalaria a partir de 1984. La reforma del sistema de FSE viene de la mano de la Ley 44/2003, de ordenación de las profesiones sanitarias, y sus disposiciones de desarrollo: el RD 1146/2006, que regula los derechos y deberes del residente; el RD 183/2008, que clasifica las especialidades y regula importantes aspectos del sistema de FSE; los decretos autonómicos de ordenación de la FSE (solo cinco hasta ahora), y, finalmente, el RD 639/2014, que regula la troncalidad, la reespecialización, las áreas de capacitación específica, las pruebas de acceso y otros aspectos. Sin embargo, toda esta extensa normativa reguladora, muy formalizada y que pretende la excelencia del sistema, contrasta con los importantes incumplimientos existentes y los numerosos desarrollos pendientes, que ponen de manifiesto la evidente falta de adecuación de la normativa a la realidad del sistema formativo asistencial en el que se sustenta, que sigue careciendo de una estructura docente mínimamente profesionalizada

    Estudio de las subfracciones de las lipoproteínas de alta densidad y su relación con dos programas de ejercicio físico en varones jóvenes / Jacinto Fernández Pardo ; director Juan Rubiés Prat.

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    Tesis-Universidad de Murcia.MEDICINA ESPINARDO. DEPOSITO. MU-Tesis 176.Consulte la tesis en: BCA. GENERAL. ARCHIVO UNIVERSITARIO. T.M.-396

    Cambios en las lipoproteínas de alta densidad, sus subfracciones y otras partículas lipoproteicas, inducidos por el ejercicio físico moderado, y su regresión tras el cese de la actividad física / Julio Antonio Carbayo Herencia ; director Jacinto Fernández Pardo.

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    Tesis-Universidad de Murcia.MEDICINA ESPINARDO. DEPOSITO. MU-Tesis 514.Consulte la tesis en: BCA. GENERAL. ARCHIVO UNIVERSITARIO. T.M.-1529

    Planimetric and histological study of the aortae in atherosclerotic chickens treated with nifedipine, verapamil and diltiazem

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    Calcium appears to be involved in many of the cellular events which are thought to be important in atherogenesis. Calcium channel blockers have been shown to reduce arterial lipid accumulation in animals without altering serum cholesterol. Avian models of atherosclerosis offer economic and technical advantages over mammalian models. In this study, we examine the effects of nifedipine, verapamil and diltiazem at clinical and higher doses, on the extent of atherosclerosis of egg-fed chickens. In order to assess the extent of atherosclerosis quantitatively, the aortic lesions of the thoracic and abdominal aorta, aortic arch and supraaortic regions were measured by planimetry. Atherosclerotic lesions were evaluated histologically. Statistically significant reductions in the lipid deposition of the aorta were found in all the treated groups. The extent and distribution of atherosclerotic lesions were decreased in a significant way by verapamil, nifedipine and diltiazem. The higher the dosage used, the higher the regression of the atherosclerotic lesions. At clinical dosage, nifedipine showed the highest decrease of the lesions. In addition, the chicken atherosclerosis model has proved itself useful and very suitable for in vivo drug intervention studies

    Guillain-Barré syndrome following the 2009 pandemic monovalent and seasonal trivalent influenza vaccination campaigns in Spain from 2009 to 2011: outcomes from active surveillance by a neurologist network, and records from a country-wide hospital discharge database

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    BACKGROUND: Studies have shown a slight excess risk in Guillain-Barré syndrome (GBS) incidence associated with A(H1N1)pdm09 vaccination campaign and seasonal trivalent influenza vaccine immunisations in 2009-2010. We aimed to assess the incidence of GBS as a potential adverse effect of A(H1N1)pdm09 vaccination. METHODS: A neurologist-led network, active at the neurology departments of ten general hospitals serving an adult population of 4.68 million, conducted GBS surveillance in Spain in 2009-2011. The network, established in 1996, carried out a retrospective and a prospective study to estimate monthly alarm thresholds in GBS incidence and tested them in 1998-1999 in a pilot study. Such incidence thresholds additionally to observation of GBS cases with immunisation antecedent in the 42 days prior to clinical onset were taken as alarm signals for 2009-2011, since November 2009 onwards. For purpose of surveillance, in 2009 we updated both the available centres and the populations served by the network. We also did a retrospective countrywide review of hospital-discharged patients having ICD-9-CM code 357.0 (acute infective polyneuritis) as their principal diagnosis from January 2009 to December 2011. RESULTS: Among 141 confirmed of 148 notified cases of GBS or Miller-Fisher syndrome, Brighton 1-2 criteria in 96 %, not a single patient was identified with clinical onset during the 42-day time interval following A(H1N1)pdm09 vaccination. In contrast, seven cases were seen during a similar period after seasonal campaigns. Monthly incidence figures did not, however, exceed the upper 95 % CI limit of expected incidence. A retrospective countrywide review of the registry of hospital-discharged patients having ICD-9-CM code 357.0 (acute infective polyneuritis) as their principal diagnosis did not suggest higher admission rates in critical months across the period December 2009-February 2010. CONCLUSIONS: Despite limited power and underlying reporting bias in 2010-2011, an increase in GBS incidence over background GBS, associated with A(H1N1)pdm09 monovalent or trivalent influenza immunisations, appears unlikelyS
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