La influencia de los factores contextuales e individuales en la aparici?n de mypes innovadoras en pa?ses emergentes: el caso de dos mypes peruanas

En el Per?, como en otros pa?ses emergentes, existe una gran cantidad de micro y peque?as empresas, las cuales emplean a una gran porci?n de la PEA, teniendo un rol importante en la econom?a. Estas mypes surgen inicialmente como emprendimientos, que en muchas ocasiones fracasan sin llegar a sus objetivos. La innovaci?n en las mypes nace como medio para crecer, sobrevivir y competir con otras empresas. Por tanto, es de inter?s nacional lograr la aparici?n de m?s mypes innovadoras, y para ello es necesario conocer qu? factores, contextuales e individuales, facilitan la creaci?n y aparici?n de mypes innovadoras. Para esto, se estudian dos casos de mypes peruanas

Detection of lymph node metastasis in lung cancer patients using a one-step nucleic acid amplification assay: a single-centre prospective study

BACKGROUND: The use of one-step nucleic acid amplification (OSNA) allows for lymph node (LN) metastasis to be detected rapidly and accurately. We conducted a prospective single-centre clinical trial to evaluate OSNA assay in detecting LN metastasis of lung cancer. PATIENTS AND METHODS: A total of 705 LNs from 160 patients with clinical stage IA to IVA lung cancer were included in this study. The LNs were divided and submitted to routine histological diagnosis and OSNA assay and the results were compared. We also examined keratin 19 expression of different histological types lung primary tumours. RESULTS: When the cut-off value was set to 250 copies/microl, the concordance rate between the two methods was 96.17% and the sensitivity 97.14%. Discordant results were observed in 27 LNs of 21 patients. Most of these discordant results were molecular micrometastasis expressing a very low number of copies with negative histology. Most thoracic tumours were positive for keratin 19. CONCLUSIONS: Our data show that the OSNA assay might be a useful and sensitive method to diagnose LN metastasis in lung cancer and could be applied to intraoperative decision-making in personalised lung cancer surgery based on LN status and a more accurate staging of patients

Avalia??o da integra??o de enxerto de gordura no dorso da m?o

Made available in DSpace on 2015-04-14T13:35:01Z (GMT). No. of bitstreams: 1 426504.pdf: 4328362 bytes, checksum: 74a78cee96d1cf6cc80c54d02c210b62 (MD5) Previous issue date: 2010-09-30Introduction: Autologous fat transplantation is a well-established method often used for soft-tissue augmentation, both in cosmetic and reconstructive procedures. Its most important disadvantages are the unpredictable rate of fat absorption and the difficulty to evaluate results objectively. This study describes quantitative methods to measure the rate of fat absorption. Methods: Nine patients seen in the Hand Surgery Service of Hospital S?o Lucas of Pontif?cia Universidade Cat?lica do Rio Grande do Sul (PUCRS) from March 2008 to October 2009 underwent autologous fat grafting prepared using centrifugation or not in areas of hand atrophy due to ulnar nerve lesions. To evaluate graft integration, digital photos of the hands and diagnostic radiographs were obtained before and after the procedures. Results: The cases were analyzed quantitatively according to patients individual sequelae. Overall, the results of digital photos showed no significant changes in measures. The radiographic technique, although not adequate to measure depth and volume, was more efficient. This type of image provides information about the area of the whole hand or of a region of interest, and demonstrates the augmentation in graft recipient areas. Radiographic analyses may be used to evaluate grafting results. In the qualitative analysis, no observer found deterioration in the cases under study. Most observers did not see any change in the claw condition, but the other evaluations were positive. The statistic difference between methods was not significant, although the procedures that were prepared with centrifugation were rated improved by the observers at a greater percentage. Conclusion: a) The qualitative method described in the literature did not reveal any statistically significant difference between the two grafting methods under study. b) Two quantitative methods to evaluate the integration of fat graft were developed and tested. The comparison between evaluation methods revealed that radiographic images were more efficient than digital photos. c) Results suggest that, based on the radiographic images, computed tomography may be an alternative to measure volume and follow up fat absorptionINTRODU??O: O transplante de gordura aut?loga se transformou em um m?todo bem estabelecido e frequentemente aplicado para o aumento de tecido adiposo, tanto em indica??es cosm?ticas como reconstrutivas. A desvantagem mais significativa sobre o enxerto de gordura aut?loga est? no seu ritmo de absor??o altamente imprevis?vel e nas formas de avaliar, de maneira objetiva, os resultados. Este trabalho define metodologias quantitativas que podem ser utilizadas para medir o grau de reabsor??o do enxerto. M?TODO: Avalia??o realizada em 9 pacientes atendidos no Servi?o de Cirurgia da M?o do Hospital S?o Lucas da Pontif?cia Universidade Cat?lica do Rio Grande do Sul (PUCRS), no per?odo de mar?o de 2008 a outubro 2009. Realizou-se o procedimento de enxerto de gordura aut?loga, com ou sem centrifuga??o, em ?reas de atrofia da m?o devido a les?es do nervo ulnar. Para avaliar a integra??o do enxerto, foram utilizadas imagens digitais de fotografias com escala e de radiologia diagn?stica pr? e p?s-procedimento. RESULTADOS: Os casos foram analisados de forma quantitativa, respeitando a individualidade das sequelas observadas. O resultado referente ?s fotografias digitais, de forma global, mostra que n?o houve altera??es significativas nas dimens?es medidas. Cabe ressaltar que a t?cnica de imagenologia por raios X, mesmo apresentando as limita??es de estudo em profundidade de volumetria, mostrou-se mais eficiente. Esse tipo de imagem possibilita o estudo da ?rea total da m?o ou regi?o de interesse, evidenciando um aumento nas ?reas enxertadas. Ficou demonstrado que o uso de an?lises radiol?gicas quantitativas ? um m?todo que pode ser utilizado na avalia??o dos resultados. De forma geral, na avalia??o qualitativa, nenhum avaliador verificou piora para os casos estudados. A maior parte dos avaliadores n?o percebeu altera??o na condi??o de garra, sendo as demais avalia??es positivas. Na compara??o entre os m?todos, apesar do maior percentual para a resposta Melhorou nos procedimentos realizados com centrifuga??o da gordura enxertada, essa diferen?a n?o pode ser considerada estatisticamente significativa. CONCLUS?O: a) O m?todo qualitativo sugerido pela bibliografia n?o conseguiu definir diferen?a significativa entre os dois m?todos de enxerto comparados. b) Foram definidos e avaliados dois m?todos quantitativos para a avalia??o da integra??o da gordura do enxerto. A compara??o entre os m?todos de avalia??o utilizados mostrou que as imagens diagn?sticas geradas com raios X s?o ferramentas mais eficientes do que as fotografias digitais. c) Sugere-se, com base nos resultados obtidos com as imagens da radiologia diagn?stica, que imagens de tomografia computadorizada possam ser utilizadas para realiza??o de estudos volum?tricos e acompanhamento de autoabsor??o de gordura enxertada

Una mirada cr?tica y reflexiva frente a las pr?cticas pedag?gicas de los docentes en correspondencia con el modelo pedag?gico del Instituto Educativo Moriah de la ciudad de Ibagu?

83 p.El presente estudio tiene como prop?sito realizar una mirada reflexiva y cr?tica frente al modelo pedag?gico establecido en el PEI del Instituto Educativo Moriah, buscando con ello mejorar las pr?cticas pedag?gicas de algunos docentes las cuales no est?n en relaci?n con el modelo propuesto y los resultados poco significativos en las pruebas saber. Durante el desarrollo del presente estudio se tuvo en cuenta referentes te?ricos, conceptuales y legales que permitieron caracterizar el modelo pedag?gico constructivista y a la vez permiti? identificar la realidad de la instituci?n en cuanto a las pr?cticas pedag?gicas y su pertinencia con el modelo pedag?gico planteado en el PEI. Por lo anterior, se hizo uso de la encuesta a 13 docentes y 41 estudiantes de los grados d?cimo y und?cimo, y una observaci?n de clase al 23% de la planta docente que corresponde a las ?reas de ciencias sociales, ciencias naturales e ingl?s a trav?s de una lista de chequeo mediante la cual se pretende identificar caracter?sticas del modelo pedag?gico utilizada en las pr?cticas de aula. Al aplicar estos instrumentos y realizar el an?lisis a los resultados de las pruebas Saber 11 se pudo obtener informaci?n significativa que llevaron al an?lisis contextual y permiti? identificar que la gran mayor?a de docentes utilizan diversas estrategias metodol?gicas en sus pr?cticas, por lo que no tienen claro el modelo pedag?gico de la instituci?n. Esto puede influir de manera negativa en los resultados de las pruebas Saber 11, ya que al no haber coherencia en la metodolog?a de los docentes y al no conocer los lineamientos que reglamentan y norma tizan el proceso educativo del I. E. Moriah afecta directamente en el proceso de ense?anza y aprendizaje de los estudiantes, ya que ellos tambi?n evidencian una variaci?n en sus aprendizajes. Si los docentes manejaran el modelo pedag?gico de la instituci?n y aplicaran todas las estrategias y metodolog?as del constructivismo se podr?a evidenciar un cambio significativo en los resultados de las pruebas Saber 11.The purpose of this study is to make a reflexive and critical view of the pedagogical model established in the PEI of the Moriah Educational Institute, seeking to improve the pedagogical practices of some teachers, which are not related to the proposed model and the insignificant results. In the tests know. During the development of this study, theoretical, conceptual and legal references were taken into account that allowed characterizing the constructivist pedagogical model and at the same time allowed identifying the reality of the institution in terms of pedagogical practices and its relevance to the pedagogical model proposed in the PEI. Therefore, 13 teachers and 41 students of the tenth and eleventh grades were used in the survey, and a 23% class observation of the teaching staff corresponding to the areas of social sciences, natural sciences and English through of a checklist through which it is intended to identify characteristics of the pedagogical model used in classroom practices. By applying these instruments and performing the analysis to the results of the Saber 11 tests, significant information could be obtained that led to the contextual analysis and allowed us to identify that the vast majority of teachers use various methodological strategies in their practices, so they are not clear about the pedagogical model of the institution. This can negatively influence the results of the Saber 11 tests, since there is no coherence in the methodology of the teachers and not knowing the guidelines that regulate and standardize the educational process of the IE Moriah directly affects the process of teaching and learning of students, since they also show a variation in their learning. If teachers managed the pedagogical model of the institution and applied all the strategies and methodologies of constructivism, a significant change in the results of the Saber 11 tests could be evidenced

Gu?a r?pidas de consultor?a telef?nica m?dica y de enfermer?a

Gu?a de consulta para o persoal m?dico e de enfermar?a que desenvolve o seu traballo en centros de coordinaci?n telef?nica para a atenci?n ?s urxencias e ?s emerxencias sanitarias. Est? estruturada en 12 cap?tulos nos que describen os principais protocolos de actuaci?n para a asistencia ?s patolox?as m?is com?ns atendidas no ?mbito de urxencias extra hospitalarias.Gu?a de consulta para el personal m?dico y de enfermer?a que desarrolla su trabajo en centros de coordinaci?n telef?nica para la atenci?n a las urgencias y a las emergencias sanitarias. Est? estructurada en 12 cap?tulos en los que describen los principales protocolos de actuaci?n para la asistencia a las patolog?as m?s comunes atendidas en el ?mbito de urgencias extra hospitalarias