Evaluación de tesis doctoral en la escuela de post grado de la UNA - Puno

TesisLa investigación titulada "Evaluación de Tesis Doctoral en la Escuela de Post Grado de la Universidad Nacional del Altiplano de Puno" responde a la interrogante de carácter general ¿Cuál es el nivel de calidad de las tesis del Programa de Doctorado sustentadas durante los años 2009 al 2010 en la Escuela de Post Grado de la Universidad Nacional del Altiplano de Puno en relación a los aspectos académicos expresados en la aplicación de la rigurosidad epistemológica y metodológica de la investigación científica y uso de la redacción científica y de estilos? Para tal propósito de análisis de la investigación, metodológicamente se ha utilizado como tamaño de muestra 11 tesis del Programa de Doctorado de la EPG-UNA-Puno, sustentadas durante los años del 2009 al 2010; los mismos que mediante la aplicación del método de análisis documental se ha logrado llegar a los siguientes resultados: Las tesis del Programa de Doctorado en la Escuela de Post Grado de la Universidad Nacional de Puno, muestran una calidad de nivel medio (Regular), en relación al análisis de las variables aplicación y sustento de la rigurosidad epistemológica y metodológica de investigación (en las dimensiones de: planteamiento del problema; sustento y fundamentación del marco teórico; diseño y formulación del marco metodológico) y de la redacción científica (análisis de dimensiones: definición del título; resumen, introducción y formulación de conclusiones) y uso de estilos (APA); por cuanto, no necesariamente han respondido correctamente a la rigurosidad de éstas exigencias y asimismo, las respuestas han sido ambiguas y relativas Palabras clave: Tesis doctorales. Evaluación de calidad de tesis doctorales

Cholangiocarcinoma Derived from Remnant Intrapancreatic Bile Duct Arising 32 Years after Congenital Choledochal Cyst Excision: A Case Report

We report a rare case of a 46-year-old woman with cholangiocarcinoma derived from remnant intrapancreatic bile duct arising 32 years after the excision of a congenital choledochal cyst. She had undergone anastomosis of the choledochal cyst and duodenum at birth, excision of the choledochal cyst and hepaticoduodenostomy with jejunal interposition at 14 years of age as well as the excision of an infectious cyst around the anastomosis site at 21 years of age. At 29 years of age, she was diagnosed with a chronic hepatitis C virus (HCV) infection and was referred to our hospital for treatment. She did not consent to interferon-based therapy against the HCV infection. At 46 years of age, she experienced epigastric discomfort. A dynamic CT revealed multiple tumors in the liver, a tumor in the head of the pancreas as well as lymph node metastases in the mediastinum and abdominal cavity. A liver tumor biopsy revealed adenocarcinoma, and she was clinically diagnosed with cholangiocarcinoma derived from remnant intrapancreatic bile duct with multiple metastasis in the liver and lymph node metastasis. She requested palliative therapy and eventually died during the treatment course. The autopsy specimen revealed a tumor in the head of the pancreas, and on the basis of local existence and the pattern of metastasis, it was confirmed as cholangiocarcinoma derived from remnant intrapancreatic bile duct. A microscopic examination revealed a poorly differentiated adenocarcinoma. This report provides information on a case of cholangiocarcinoma derived from remnant intrapancreatic bile duct arising after the excision of congenital choledochal cyst that was assessed pathologically

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Impact of Aspiration Pneumonia on the Clinical Course of Progressive Supranuclear Palsy: A Retrospective Cohort Study

<div><p>Introduction</p><p>Although aspiration pneumonia is the most common complication of progressive supranuclear palsy (PSP), the clinical impact of aspiration pneumonia on disease course and survival has not been fully estimated. Thus, we retrospectively analyzed the prognostic factors and clinical consequences of pneumonia in PSP.</p><p>Methods</p><p>The clinical course of patients with aspiration pneumonia was surveyed. The association between baseline clinical features (2 years from disease onset) and latency to the initial development of pneumonia was investigated using survival time and Cox regression analyses.</p><p>Results</p><p>Ninety patients with a clinical diagnosis of PSP were observed for 5.1±3.8 years (mean±SD), and 22 had aspiration pneumonia. Subsequently, 20 patients (91%) had to discontinue oral feeding entirely and 13 (59%) died, whereas, of 68 patients without pneumonia, only three patients (4%) died. Time to initial development of pneumonia was strongly correlated with survival time (Spearman R = 0.92, <i>P</i><0.001), with a mean latency of 2.3 years to death. Among baseline clinical features, early fall episodes and cognitive decline were significant predictors of pneumonia (<i>P</i> = 0.001 and <i>P</i><0.001, respectively, log rank test). Cox regression analysis demonstrated that early fall episodes (adjusted hazard ratio: 3.9, 95% confidence interval: 1.2–12.5, <i>P</i> = 0.03) and cognitive decline (adjusted hazard ratio: 5.2, 95% confidence interval: 1.4–19.3, <i>P</i> = 0.02) independently predicted pneumonia. By contrast, dysphagia was not associated with pneumonia (<i>P</i> = 0.2, log rank test).</p><p>Conclusion</p><p>Initial development of pneumonia indicates an unfavorable clinical course and predicts survival time (mean survival time 2.3 years). Patients with early falls and cognitive decline were at high risk of early development of pneumonia.</p></div

Survival analyses stratified by patients’ clinical features and phenotypes during initial 2 years of disease.

<p>Latency from the start of the study to the initial development of pneumonia, stratified by with or without (A) fall episodes (log rank <i>P</i> = 0.001), (B) cognitive decline (log rank <i>P</i><0.001), (C) dysphagia (log rank <i>P</i> = 0.08), and (D) clinical phenotypes (RS and PSP-P; log rank <i>P</i> = 0.05).</p