Dirección de la Sucursal D. A. F. O.

Màster de Direcció d'Entitats Asseguradores i Financeres, Universitat de Barcelona, Facultat d'Economia i Empresa, Curs: 2006-2007, Tutor: Carlos Grau AlgueróEn la presente Tesina voy a describir en primer lugar las cinco funciones principales que debe realizar un Director de Sucursal de una entidad aseguradora, para a continuación exponer mis criterios personales a situaciones que me han sucedido durante mi ejercicio profesional como mando intermedio, sobretodo los tres últimos años como director de sucursal, con el fin de informar sobre las principales dificultades que tiene dicho cargo, y finalizaré con una breve descripción de la Dirección por Valores aplicada al Sector Asegurador puesto que creo que debe ser la forma de Dirección que tendrá lugar en un futuro breve y que determinará el posicionamiento de las entidades aseguradoras en el mercado

Analgesia postoperatoria en la cirugía del hombro mediante el bloqueo interescalénico continuo con catéteres estimulables

Descripció del recurs: el 01 setembre 2012Introducción y objetivos: La cirugía abierta del hombro es especialmente dolorosa y el bloqueo interescalénico continuo se ha mostrado eficaz para el control del dolor postoperatorio. El uso de catéteres estimulables, al ubicar la punta del catéter cerca del nervio, permitiría mejorar la analgesia obtenida y reducir los efectos secundarios. Realizamos un estudio prospectivo, randomizado y a doble ciego en 127 pacientes intervenidos de cirugía mayor de hombro. En primer lugar, practicamos un bloqueo interescalénico mediante estimulación con el abordaje de Winnie modificado por Hadzic. Con una aguja 19G de 50mm (Plexolong®), buscamos una respuesta motora en el hombro o el brazo con I 0,5 mA e insertamos un catéter estimulable un mínimo de 5 cm (Stimulong Pajunk®). A continuación, se distribuían los pacientes en tres grupos: en los grupos 0,375% y 0,2% se buscaba una respuesta motora con el catéter retirándolo lentamente y una vez obtenida con I 1 mA para obtener respuesta, eran ineficaces. Los pacientes del grupo No ST tuvieron un peor descanso nocturno durante la primera y segunda noche (p 0,05) y mayor incidencia de efectos secundarios (disnea, Sd. Claude Bernard-Horner). La disección anatómica del plexo nos ha mostrado la estrecha relación de la fascia cervical profunda con los troncos, lo que explicaría la dificultad de avanzar el catéter. Conclusiones: La verificación de la colocación de los catéteres interescalénicos mediante estimulación, aunque laboriosa, permite optimizar la analgesia reduciendo asimismo los efectos secundarios.Background and objectives: Shoulder open surgery is especially painful and continuous interscalene block has been effective for postoperative pain management. Stimulating catheters, by placing the catheter tip close to the nerve, can improve the analgesia obtained and reduce side effects. We conducted a prospective, randomized, double-blind study in 127 patients undergoing shoulder major surgery. First, we performed an interscalene block with stimulation by a modified Winnie approach by Hadzic. With a 50mm 19G needle (Plexolong®), we seeked a motor response in the shoulder or the arm with I 0.5 mA and then inserted a stimulating catheter at least 5 cm (Stimulong Pajunk®). Patients were distributed into three groups: in groups 0.375% and 0.2%, we were seeking a motor response with the catheter (I 1 mA to obtain a motor response, were ineffective. Patients in the No ST group had a worse quality of sleep during the first and second night (P 0.05) and higher incidence of side effects (dyspnea, Sd. Horner). The anatomical dissection performed has shown us the close relationship of the deep cervical fascia to the braquial trunks, which would explain the difficulty of advancing the catheters. Conclusions: The verification of the placement of interscalenic catheters by stimulation optimizes analgesia and reduces side effects

Subcutaneous phaeohyphomycosis due to Phialemoniopsis ocularis successfully treated by voriconazole

International audienceWe report a case of subcutaneous infection in a 67 year-old Cambodian man who presented with a 5-month history of swelling of the right foot. Histopathology was compatible with phaeohyphomycosis and the hyphomycete Phialemoniopsis ocularis was identified by the means of morphological and molecular techniques. The patient responded well to a 6-month oral treatment with voriconazole alone

Brentuximab vedotin in the treatment of cutaneous T-cell lymphomas: Data from the Spanish Primary Cutaneous Lymphoma Registry

[Background] Brentuximab vedotin (BV) has been approved for CD30-expressing cutaneous T-cell lymphoma (CTCL) after at least one previous systemic treatment. However, real clinical practice is still limited.[Objectives] To evaluate the response and tolerance of BV in a cohort of patients with CTCL.[Methods] We analysed CTCL patients treated with BV from the Spanish Primary Cutaneous Lymphoma Registry (RELCP).[Results] Sixty-seven patients were included. There were 26 females and the mean age at diagnosis was 59 years. Forty-eight were mycosis fungoides (MF), 7 Sézary syndrome (SS) and 12 CD30+ lymphoproliferative disorders (CD30 LPD). Mean follow-up was 18 months. Thirty patients (45%) showed at least 10% of CD30+ cells among the total lymphocytic infiltrate. The median number of BV infusions received was 7. The overall response rate (ORR) was 67% (63% in MF, 71% in SS and 84% in CD30 LPD). Ten of 14 patients with folliculotropic MF (FMF) achieved complete or partial response (ORR 71%). The median time to response was 2.8 months. During follow-up, 36 cases (54%) experienced cutaneous relapse or progression. The median progression free survival (PFS) was 10.3 months. The most frequent adverse event was peripheral neuropathy (PN) (57%), in most patients (85%), grades 1 or 2.[Conclusions] These results confirm the efficacy and safety of BV in patients with advanced-stage MF, and CD30 LPD. In addition, patients with FMF and SS also showed a favourable response. Our data suggest that BV retreatment is effective in a proportion of cases.The Spanish Primary Cutaneous Lymphoma Registry (RELCP) is promoted by the Fundación Piel Sana Academia Española de Dermatología y Venereología, which received an unrestricted grant support from Kyowa Kirin.Peer reviewe

Analgesia postoperatoria en la cirugía del hombro mediante el bloqueo interescalénico continuo con catéteres estimulables

Introducción y objetivos: La cirugía abierta del hombro es especialmente dolorosa y el bloqueo interescalénico continuo se ha mostrado eficaz para el control del dolor postoperatorio. El uso de catéteres estimulables, al ubicar la punta del catéter cerca del nervio, permitiría mejorar la analgesia obtenida y reducir los efectos secundarios. Realizamos un estudio prospectivo, randomizado y a doble ciego en 127 pacientes intervenidos de cirugía mayor de hombro. En primer lugar, practicamos un bloqueo interescalénico mediante estimulación con el abordaje de Winnie modificado por Hadzic. Con una aguja 19G de 50mm (Plexolong®), buscamos una respuesta motora en el hombro o el brazo con I1 mA para obtener respuesta, eran ineficaces. Los pacientes del grupo No ST tuvieron un peor descanso nocturno durante la primera y segunda noche (p1 mA to obtain a motor response, were ineffective. Patients in the No ST group had a worse quality of sleep during the first and second night (P <0.05) and higher incidence of side effects (dyspnea, Sd. Horner). The anatomical dissection performed has shown us the close relationship of the deep cervical fascia to the braquial trunks, which would explain the difficulty of advancing the catheters. Conclusions: The verification of the placement of interscalenic catheters by stimulation optimizes analgesia and reduces side effects

Conceptualization and prototyping of an application that collects information and statistics from the world padel tour with user testing

The padel sport has increased a lot during the last decade, introducing itself into one of the most played sports worldwide. This boost has been accompanied by a strong investment by large companies for creating new padel courts, acquiring the television rights, introducing new brands, etc. As it is a sport that still has a huge potential, there are some user needs that are not covered yet such as having apps related to the padel world. The objective of this project is to design, conceptualize and prototype a padel app for Android devices that covers the user needs of information related to the padel world. For being more accurate, the app includes all the news, videos, matches, statistics, and tournaments from the greatest competition till the date called the World Padel Tour. The aim of this project is to keep the user informed about the padel world, while we create a padel community where the users can interact with each other. For accomplishing these objectives, there are some steps that were realized during the project. After defining the objectives, the scope of the project and the roadmap to follow, the Material Design research was done. The purpose of this section is to define the requirements stablished by Android for creating an attractive user interface and experience. After that, a user’s market research conformed by interviews and a poll and, a competitor’s analysis, were carried on for defining the functionalities for the app prototype. Therefore, a function and fault tree were done thanks to these two sections. The second part of the project consisted of creating the prototype with FIGMA (a prototype designer tool) and, after that, carrying out a user test for viewing the pros and cons of the first app prototype. In the prototype section, each page or frame was explained and defined with their related icons and functions. Finally, the future actions for continuing with the project were defined and some studies were done such as the economic analysis, the environmental, the social and a gender equality analysis. The results of the prototype were notoriously positive due to the good reviews and reception by the user in the tests carried out. After all the research done in this project, there is a conclusion that can be drawn, and that is, that an app of this style has a huge potential because it is a market niche that has not yet been exploited and the user claims for having access to this information in an easy and fast wa