Dise?o y construcci?n del edificio de vivienda multifamiliar Las Cumbres

El proyecto de tesis ?Dise?o y construcci?n del edificio de vivienda multifamiliar Las Cumbres? consta de 20 pisos, 320 departamentos y tiene una duraci?n de 22 meses, es un proyecto que se plantea ejecutar por primera vez en la ciudad de Lima. El prop?sito de la presente tesis es desarrollar la gesti?n del proyecto de acuerdo a la gu?a del PMBOK 6ta edici?n, de tal forma que podamos obtener informaci?n?n relevante de c?mo gestionar proyectos multifamiliares en Lima ,aplicarlos a proyectos reales y tener ?xito en ellos. En la actualidad para que un proyecto pueda tener ?xito tiene que haber una planificaci?n que contemple las 10 ?reas de conocimiento de la Gu?a PMBOK como son: Plan de gesti?n del alcance, de los plazos, de los costes, de calidad, de recursos, de comunicaciones, de riesgos, de interesados, de adquisiciones e integraci?n de todas la ?reas, si solo nos enfocamos en alcance, costo y tiempo, podr?amos llegar a fracasar y dejar de trabajar factores cr?ticos de ?xito. El sector de la construcci?n en el Per? es un motor de la econom?a y reacciona de manera inmediata con el crecimiento y es generador de empleo, estando en un mercado cada vez mas competitivo resulta imprescindible para las empresas implementar la gesti?n de proyectos para asegurar en mayor medida el ?xito de las estrategias. Adem?s, ?sta tesis se desarroll? contando con un equipo interdisciplinario y as? contribuy? a analizar desde puntos de vista diferentes, enriqueciendo a?n m?s el documento

Hydroxychloroquine is associated with a lower risk of polyautoimmunity: data from the RELESSER Registry

OBJECTIVES: This article estimates the frequency of polyautoimmunity and associated factors in a large retrospective cohort of patients with SLE. METHODS: RELESSER (Spanish Society of Rheumatology Lupus Registry) is a nationwide multicentre, hospital-based registry of SLE patients. This is a cross-sectional study. The main variable was polyautoimmunity, which was defined as the co-occurrence of SLE and another autoimmune disease, such as autoimmune thyroiditis, RA, scleroderma, inflammatory myopathy and MCTD. We also recorded the presence of multiple autoimmune syndrome, secondary SS, secondary APS and a family history of autoimmune disease. Multiple logistic regression analysis was performed to investigate possible risk factors for polyautoimmunity. RESULTS: Of the 3679 patients who fulfilled the criteria for SLE, 502 (13.6%) had polyautoimmunity. The most frequent types were autoimmune thyroiditis (7.9%), other systemic autoimmune diseases (6.2%), secondary SS (14.1%) and secondary APS (13.7%). Multiple autoimmune syndrome accounted for 10.2% of all cases of polyautoimmunity. A family history was recorded in 11.8%. According to the multivariate analysis, the factors associated with polyautoimmunity were female sex [odds ratio (95% CI), 1.72 (1.07, 2.72)], RP [1.63 (1.29, 2.05)], interstitial lung disease [3.35 (1.84, 6.01)], Jaccoud arthropathy [1.92 (1.40, 2.63)], anti-Ro/SSA and/or anti-La/SSB autoantibodies [2.03 (1.55, 2.67)], anti-RNP antibodies [1.48 (1.16, 1.90)], MTX [1.67 (1.26, 2.18)] and antimalarial drugs [0.50 (0.38, 0.67)]. CONCLUSION: Patients with SLE frequently present polyautoimmunity. We observed clinical and analytical characteristics associated with polyautoimmunity. Our finding that antimalarial drugs protected against polyautoimmunity should be verified in future studies