Diagnóstico operativo empresarial de la clínica de Ica Dr. Julio Tataje Barriga sociedad de responsabilidad limitada

El presente trabajo de investigación ha tenido como finalidad realizar el diagnóstico operativo empresarial a la empresa La Clínica de Ica Dr. Julio Tataje Barriga, dedicada a los servicios de atenciones médicas, con el propósito de generar propuestas de mejora que generen valor y rentabilidad para la empresa en caso se decida aplicarlas. Cada capítulo de este documento cuenta con una propuesta de mejora de acuerdo al análisis realizado buscando implementar los conocimientos obtenidos y aplicarlos a la realidad empresarial con la finalidad de mejorar los procesos y generar un impacto económico a favor de la gestión de las operaciones de la Clínica de Ica. Las propuestas de mejora buscan incrementar el valor de la gestión de operaciones generando ahorros sensibles para la empresa. Finalmente, con el diagnóstico realizado se desarrollaron oportunidades de mejora, los cuales nos llevaron a implementar metodologías de mejora continua en una empresa de servicio, así como buenas prácticas de operaciones que permitieron generar un ahorro anual total de S/. 1´212,024.00 con una inversión estimada de S/. 1`194,805.00, y beneficios de S/. 1`152,469.00.The purpose of this research work was to perform the operative business diagnostic of the company La Clínica de Ica Dr. Julio Tataje Barriga, dedicated to the services of medical attention, with the purpose of generating improvement proposals that generate value and profitability for the company in case it is decided to apply them. Each chapter of this document has a proposal for improvement according to the analysis carried out seeking to implement the knowledge obtained and apply it to the business reality in order to improve the processes and generate an economic impact in favor of the management of the operations of the Clinic of Ica. The improvement proposals seek to increase the value of operations management, generating sensible savings for the company. Finally, with the diagnosis made, opportunities for improvement were developed, which led us to implement continuous improvement methodologies in a service company, as well as good operations practices that allowed us to generate a total anual saving of S/.1´212,024.00 with an estimated investment of S/.1`194,805.00, and benefits of S/.1`152,469.00.Tesi

Neoadjuvant chemotherapy versus debulking surgery in advanced tubo-ovarian cancers: pooled analysis of individual patient data from the EORTC 55971 and CHORUS trials

Background: Individual patient data from two randomised trials comparing neoadjuvant chemotherapy with upfront debulking surgery in advanced tubo-ovarian cancer were analysed to examine long-term outcomes for patients and to identify any preferable therapeutic approaches for subgroup populations. Methods: We did a per-protocol pooled analysis of individual patient data from the European Organisation for Research and Treatment of Cancer (EORTC) 55971 trial (NCT00003636) and the Medical Research Council Chemotherapy Or Upfront Surgery (CHORUS) trial (ISRCTN74802813). In the EORTC trial, eligible women had biopsy-proven International Federation of Gynecology and Obstetrics (FIGO) stage IIIC or IV invasive epithelial tubo-ovarian carcinoma. In the CHORUS trial, inclusion criteria were similar to those of the EORTC trial, and women with apparent FIGO stage IIIA and IIIB disease were also eligible. The main aim of the pooled analysis was to show non-inferiority in overall survival with neoadjuvant chemotherapy compared with upfront debulking surgery, using the reverse Kaplan-Meier method. Tests for heterogeneity were based on Cochran's Q heterogeneity statistic. Findings: Data for 1220 women were included in the pooled analysis, 670 from the EORTC trial and 550 from the CHORUS trial. 612 women were randomly allocated to receive upfront debulking surgery and 608 to receive neoadjuvant chemotherapy. Median follow-up was 7·6 years (IQR 6·0–9·6; EORTC, 9·2 years [IQR 7·3–10·4]; CHORUS, 5·9 years [IQR 4·3–7·4]). Median age was 63 years (IQR 56–71) and median size of the largest metastatic tumour at diagnosis was 8 cm (IQR 4·8–13·0). 55 (5%) women had FIGO stage II–IIIB disease, 831 (68%) had stage IIIC disease, and 230 (19%) had stage IV disease, with staging data missing for 104 (9%) women. In the entire population, no difference in median overall survival was noted between patients who underwent neoadjuvant chemotherapy and upfront debulking surgery (27·6 months [IQR 14·1–51·3] and 26·9 months [12·7–50·1], respectively; hazard ratio [HR] 0·97, 95% CI 0·86–1·09; p=0·586). Median overall survival for EORTC and CHORUS patients was significantly different at 30·2 months (IQR 15·7–53·7) and 23·6 months (10·5–46·9), respectively (HR 1·20, 95% CI 1·06–1·36; p=0·004), but was not heterogeneous (Cochran's Q, p=0·17). Women with stage IV disease had significantly better outcomes with neoadjuvant chemotherapy compared with upfront debulking surgery (median overall survival 24·3 months [IQR 14·1–47·6] and 21·2 months [10·0–36·4], respectively; HR 0·76, 95% CI 0·58–1·00; p=0·048; median progression-free survival 10·6 months [7·9–15·0] and 9·7 months [5·2–13·2], respectively; HR 0·77, 95% CI 0·59–1·00; p=0·049). Interpretation: Long-term follow-up data substantiate previous results showing that neoadjuvant chemotherapy and upfront debulking surgery result in similar overall survival in advanced tubo-ovarian cancer, with better survival in women with stage IV disease with neoadjuvant chemotherapy. This pooled analysis, with long-term follow-up, shows that neoadjuvant chemotherapy is a valuable treatment option for patients with stage IIIC–IV tubo-ovarian cancer, particularly in patients with a high tumour burden at presentation or poor performance status

Sistema de evaluación automática de usabilidad de interfaces de usuario

"La usabilidad es fundamental para el éxito de sistemas informáticos. Las pruebas y evaluaciones de usabilidad durante el desarrollo de software han ganado amplia aceptación como estrategia para mejorar la calidad del producto. La introducción temprana de las perspectivas de usabilidad en un producto es muy importante para brindar una clara visibilidad de aspectos de calidad, tanto para desarrolladores, como los analistas de pruebas. Sin embargo, en la actualidad, someter el producto a rigurosos análisis de usabilidad es una tarea engorrosa. En esta tesis se desarrolla una herramienta para reducir el estrés y tiempo invertido en la realización de pruebas de usabilidad durante el desarrollo formal de software.

Importancia de la reexpresión de cifras para una empresa dedicada a la impresión de mapas y guías

Seminario: diagnóstico financiero de la empres

Lapatinib plus trastuzumab in pretreated human epidermal growth factor receptor 2-positive metastatic breast cancer

Background: Dual human epidermal growth factor receptor 2 (HER2) blockade has been preclinically and clinically assessed in HER2-overexpressing metastatic breast cancer (mBC) with encouraging results. Patients and Methods: This is a descriptive retrospective study of trastuzumab plus lapatinib activity in patients with HER2-overexpressing mBC from two centers. The primary endpoints were to assess objective response rate (ORR) and toxicity. The secondary endpoints were to assess progression-free survival (PFS) and overall survival. Results: A total of 23 HER2-positive mBC patients previously treated with trastuzumab received a trastuzumab plus lapatinib based therapy. Chemotherapy (CT) was added to the dual HER2 blockade treatment in 13 patients (56%), whereas hormonotherapy (HT) was added in 8 patients (35%) and 2 patients (9%) received lapatinib plus trastuzumab without any other agent. ORR was 22% (5/23) and 39% (9/23) of patients had stable disease. PFS in the overall population was 4 months. PFS in patients with CT was 5 months, whereas PFS in patients with HT was 2 months. Grade ≥ 3 adverse events were diarrhea (26%) and hand-and-foot syndrome (9%). Conclusions: These findings suggest that dual HER2 blockade in combination with CT is feasible in pretreated HER2-positive mBC patients

Neoadjuvant Chemotherapy Versus Debulking Surgery in Advanced Tubo-Ovarian Cancers: Pooled Analysis of Individual Patient Data From the EORTC 55971 and CHORUS Trials

status: publishe