Desarrollo de un sistema informático integrado de gestión clínica en un servicio de Cirugía General. Monitorización de resultados para la toma de decisiones

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Cirugía. Fecha de lectura: 7-10-201

The relationship between landscape patterns and human-caused fire occurrence in Spain

Aim of study: Human settlements and activities have completely modified landscape structure in the Mediterranean region. Vegetation patterns show the interactions between human activities and natural processes on the territory, and allow understanding historical ecological processes and socioeconomic factors. The arrangement of land uses in the rural landscape can be perceived as a proxy for human activities that often lead to the use, and escape, of fire, the most important disturbance in our forest landscapes. In this context, we tried to predict human-caused fire occurrence in a 5-year period by quantifying landscape patterns. Area of study: This study analyses the Spanish territory included in the Iberian Peninsula and Balearic Islands (497,166 km2). Material and Methods: We evaluated spatial pattern applying a set of commonly used landscape ecology metrics to landscape windows of 10x10 sq km (4751 units in the UTM grid) overlaid on the Forest Map of Spain, MFE200. Main results: The best logistic regression model obtained included Shannon’s Diversity Index, Mean Patch Edge and Mean Shape Index as explicative variables and the global percentage of correct predictions was 66.3 %. Research highlights: Our results suggested that the highest probability of fire occurrence at that time was associated with areas with a greater diversity of land uses and with more compact patches with fewer edges

Low Back Pain in Cycling. Are There Differences between Road and Mountain Biking?

Low back pain (LBP) is known to affect cyclists. This study aimed to describe perceived lumbar dysfunction and compare the pain sensation in recreational cyclists who practice road and mountain biking. Forty males were randomly assigned to carry out a 3-h road cycling (RC) and mountain biking (MTB) time trial (TT) at submaximal intensity. LBP and pain pressure threshold (PPT) were measured before and after the TT. A significant increment at the LBP was found after RC TT (p 0.01). Low back pain perception increases with cycling in recreational cyclists. Nevertheless, this increase appears to be more related to the traits of the cyclist than the modality practiced

Derivación de pacientes. Centros y Unidades de Referencia. CSUR y ERN

The increasing complexity of the cases attended, and the growing availability of diagnostic and therapeutic procedures, determines the need to develop innovative solutions to guarantee access to healthcare for all citizens.In Spain, the Centres, Services and Reference Units (CSUR), identify the healthcare providers that can provide a better-specialized care in the most complex pathologies and procedures. The Cohesion Fund Information System (SIFCO) deals with the process to facilitate access to available CSUR between autonomous communities and regions. So far, 74 pathologies and procedures have been identified to be designated as CSUR in the Spanish National Health Service.Unlike the CSUR, the European Reference Networks (ERN), are not set up to refer patients from one healthcare provider to another, but to facilitate the communication and feedback between the most specialized professionals dealing with rare and complex pathologies.The first 24 ERNs were approved in March 2017, incorporating more than 900 highly specialized centres in more than 300 hospitals in 26 member states. One of these ERN is coordinated by a Spanish hospital.La creciente complejidad de los procesos atendidos y de los procedimientos diagnósticos y terapéuticos disponibles justifica la necesidad de definir fórmulas innovadoras para garantizar el derecho a la salud de todos los ciudadanos.En España, los Centros, Servicios y Unidades de Referencia (CSUR) identifican a los dispositivos asistenciales que pueden prestar una mejor atención especializada en las patologías y procedimientos más complejos. A través del Sistema de Información del Fondo de Cohesión (SIFCO), se realizan las gestiones necesarias para la atención de los pacientes en CSUR ubicados en otra Comunidad Autónoma.Hasta el momento, se han acordado 74 patologías o procedimientos para los que es necesario designar CSUR en el Sistema Nacional de Salud.A diferencia de los CSUR, las Redes Europeas de Referencia (ERN) no se constituyen para la derivación de pacientes de unos centros a otros, sino para facilitar la comunicación entre los especialistas europeos que cuentan con la mayor experiencia en las patologías más raras o complejas. Las primeras 24 ERNs fueron aprobadas en marzo de 2017, incorporando a más de 900 centros de alta especialización en más de 300 hospitales de 26 estados miembros. Una de estas ERN está coordinada por un hospital español

Análisis del artículo 29 de la Constitución Política de los Estados Unidos Mexicanos como un mecanismo jurídico para agotar la facultad discrecional del ejecutivo federal frente eventos catastróficos

Las obligaciones están inherentes en los súbditos del Estado cuando realizan acciones u omisiones que prevea la norma jurídica en los casos en concreto, esto es, el súbdito del Estado deberá contribuir al gasto público para solventar dichas acciones que puedan prevalecer y preverse en las respectivas Leyes de Ingresos y de Egresos de una nación. La problemática radica en cuanto a la efectiva interpretación y aplicación de los Principios de Proporcionalidad y de Equidad toda vez que las leyes tributarias son de aplicación estricta, los confictos que se susciten en la interpretación y la aplicación efectiva, traen menos cabo al mismo Estado y contrae una obligación conflictual económica, administrativa, fiscal, laboral y contablemente hablando a una empresa. Para que esta situación no prevalezca y puedan resolverse a mejor puerto los conflictos hacendarios, estudiaremos los efectos inherentes de la política económica implementada desde la óptica contributiva en el reflejo de esta compleja pandemia con la finalidad de aplicarlo y ejercitarlo como política pública y su efectiva conciencia cívica-contributiva en beneficio del contribuyente y de la efectiva recaudación económica para el Estado

Incidence of suspected serious adverse drug reactions in corona virus Ddsease-19 patients detected by a pharmacovigilance program by laboratory signals in a tertiary hospital in Spain: Cautionary data

BACKGROUND: From March to April 2020, Spain was the center of the SARS-CoV-2 pandemic, particularly Madrid with approximately 30% of the cases in Spain. The aim of this study is to report the suspected serious adverse drug reactions (SADRs) in COVID-19 patients vs. non-COVID-19 patients detected by the prospective pharmacovigilance program based on automatic laboratory signals (ALSs) in the hospital (PPLSH) during that period. We also compared the results with the suspected SADRs detected during the same period for 2019. METHODS: All ALSs that reflected potential SADRs including neutropenia, pancytopenia, thrombocytopenia, anemia, eosinophilia, leukocytes in cerebrospinal fluid, hepatitis, pancreatitis, acute kidney injury, rhabdomyolysis, and hyponatremia were prospectively monitored in hospitalized patients during the study periods. We analyzed the incidence and the distribution of causative drugs for the COVID-19 patients. RESULTS: The incidence rate of SADRs detected in the COVID-19 patients was 760.63 (95% CI 707.89–816.01) per 10,000 patients, 4.75-fold higher than the SADR rate for non-COVID-19 patients (160.15 per 10,000 patients, 95% CI 137.09–186.80), and 5.84-fold higher than the SADR rate detected for the same period in 2019 (130.19 per 10,000 patients, 95% CI 109.53–154.36). The most frequently related drugs were tocilizumab (59.84%), dexketoprofen (13.93%), azithromycin (8.43%), lopinavir-ritonavir (7.35%), dexamethasone (7.62%), and chloroquine/hydroxychloroquine (6.91%). CONCLUSIONS: The incidence rate of SADRs detected by the PPSLH in patients with COVID-19 was 4.75-fold higher than that of the non-COVID-19 patients. Caution is recommended when using medications for COVID-19 patients, especially drugs that are hepatotoxic, myotoxic, and those that induce thromboembolic events

Aula blanca. Espacio abierto para la docencia interdisiciplinar en pintura

Memoria ID-0087. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2014-2015

WM-SIMA: Herramienta de simulación para el enlace descendente LTE-Advanced

In this paper, we present a novel and efficient link level simulation framework for the donwlink (DL) of Long Term Evolution Advanced (LTE-A) cellular networks. The tool, called Wireless Mobile SIMulator Advanced (WM-SIMA), is available to be downloaded so that researchers can use it to evaluate the performance for different network configurations. In this work, the main characteristics of WM-SIMA are presented. As a case of use, the Average Spectral Efficiency (ASE) is obtained for the DL of a two-tier network, composed of Macro Access Points (MAPs) and Pico APs (PAPs). Simulation results confirms that there exist an optimal Cell Range Expansion (CRE) bias in the cell association that maximizes the ASE. Interestingly, it is confirmed that this optimal bias does not depend on the number of PAPs, while increasing the number of PAPs leads to a higher ASE for the same bias.Ministerio de Economía y Competitividad (TEC2013-44442-P). Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Effectiveness of vestibular training for balance and dizziness rehabilitation in people with multiple sclerosis: A Systematic Review and Meta-Analysis

Postural instability and dizziness are commonly observed in people with multiple sclerosis (PwMS). The aim of this systematic review was to evaluate the evidence for the use of vestibular rehabilitation, in comparison with other exercise interventions or no intervention, to treat balance impairments and dizziness in PwMS. An electronic search was conducted by two independent reviewers in the following databases: MEDLINE (Pubmed), Scopus, the Physiotherapy Evidence Database (PEDro), Web of Science (WOS), Lilacs, CINHAL and the Cochrane Database of Systematic Reviews (CDSR). A quality assessment was performed using the PEDro scale and the Cochrane Risk of Bias Tool. When possible, the data were pooled in a meta-analysis (95%CI). This systematic review followed the PRISMA guideline statement and was registered in the PROSPERO database (CRD42019134230). Seven studies were included, with a total of 321 participants analysed. Compared with no intervention, vestibular rehabilitation was more effective for balance development (SMD = 2.12; 95% CI = 0.49, 3.75; p = 0.01; I2 = 89%) and dizziness symptoms improvement (SMD = −17.43; 95% CI = −29.99, −4.87; p= 0.007; I2= 66%). Compared with other exercise interventions, improvements in favour of the experimental group were observed, but statistical significance for the differences between groups was not reached

Recursos para la Enseñanza de la Alimentación en la Formación Inicial de Maestros (PIMCD, nº 103, convocatoria 2015)

Actualización y mejora de recursos sobre la enseñanza-aprendizaje de la Alimentación para la Formación Inicial de Maestros puestos en practica en el desarrollo docente