Finanzas Conductuales: Sesgos y Métodos de mitigación.

El objetivo de este trabajo es profundizar en los fenómenos relativos a las finanzas conductuales y desarrollar un análisis empírico que permita detectar dichos sesgos. Para ello, en la parte teórica del trabajo, vamos a analizar cuáles son las principales diferencias entre las teorías clásicas y las finanzas conductuales, cuáles son las fases que componen el proceso de tomar decisiones y qué sesgos podemos encontrar en cada una de ellas. También comentaremos algunos de los métodos que existen para mitigar los efectos de los sesgos y como las emociones afectan en nuestras decisiones.A modo de ejemplificación de todos estos conceptos realizaremos un análisis experimental basado en una encuesta. En este estudio empírico, analizaremos cómo influye la aversión a las pérdidas y el descuento hiperbólico poniendo a los encuestados en diferentes situaciones. Además, analizaremos qué opinan sobre algunos conceptos financieros como por ejemplo: el stop loss y el take profit, el valor del dinero en el tiempo y si creen que las emociones influyen a la hora de tomar decisiones. Por último, analizaremos todas las respuestas obtenidas y las relacionaremos con algunos de los conceptos teóricos explicado<br /

Auditoría de estados financieros: Análisis de Calsa, S.A.

El presente trabajo tiene por objeto la presentación del proceso que se lleva a cabo durante un encargo de auditoría. Para ello, se han utilizado los conocimientos adquiridos durante el Máster de Auditoría y las prácticas realizadas.Para alcanzar tal fin, se ha realizado un análisis sobre cada una de las diferentes etapas que conforman el proceso de emisión de un informe de auditoría sobre cuentas anuales a través de una sociedad ficticia, haciendo hincapié en aquellas cuestiones que se han considerado más importantes.El contenido principal del trabajo se centra en aspectos prácticos, aunque también se recogen algunos conceptos teóricos fundamentales que ayudan a entender en qué consiste la auditoría.<br /

Usefulness of 18 F-FDG PET-CT for the management of invasive fungal infections: A retrospective cohort from a tertiary university hospital

Background: 18F-FDG PET-CT is a potentially useful technique to help manage invasive fungal infection (IFI), but information on this topic is scarce. Objectives: To describe our experience using 18F-FDG PET-CT for IFI management. Patients/Methods: Retrospective cohort of IFI episodes in a university hospital from 2018 to 2023 with a18F-FDG PET-CT performed during the episode. We analysed its impact on IFI management compared to conventional imaging. Results: Thirty-five patients diagnosed with 36 episodes of IFI (52.8% moulds, 44.4% yeasts and 2.8% Pneumocystis) underwent 55 18F-FDG PET-CT. 74.3% were immunocompromised, including 45.7% solid organ transplant recipients. Indications for 18F-FDG PET-CT were diagnostic (10.9%), staging (47.3%) and follow-up (41.8%). Altogether 18F-FDG PET-CT added value to IFI management in 50.9% episodes. In 26 patients who had both staging 18F-FDG PET-CT and conventional imaging, sites of IFI dissemination were detected in 53.8% and 19.2%, respectively. Staging 18F-FDG PET-CT unveiled occult sites in 34.6%, uncovering unknown dissemination in 19.2%. In the evaluation of endocarditis in patients with fungemia, it contributed in at least 38.5%. Follow-up 18F-FDG PET-CTs had an added value in 47.8% episodes. They were allowed to de-escalate antifungal therapy in 26.1%. There were discordant findings between 18F-FDG PET-CT and CT follow-up in 40% cases. Conclusions: Overall, 18F-FDG PET-CT added value to IFI management in more than 50% of the episodes. It increased the diagnosis of occult sites, unveiled disseminated disease missed out by conventional imaging, and contributed to diagnose or rule out endocarditis in fungemia. Follow-up 18F-FDG PET-CT helped adjust the treatment duration and deserves further stud

Recubrimiento de la Superficie Radicular Expuesta. Parte I

Gingival recession is defined as the displacement of the gingival margin apical to the Cementoenamel junction in one or more teeth. This mucogingival deformity can cause root hypersensitivity, poor esthetic appearance and cervical root caries. There are two main groups that can result in gingival recession, those derived from periodontal disease and those from traumatic origin. There are too some factors which are classified as predisposing and precipitant factors. Pathologically, gingival recessions derive from destruction of gingival connective tissue that reduces blood supply. Many procedures for surgical root coverage have been developed since introduction of laterally positioned pedicle flap, these include pedicle flaps, epithelialized free gingival grafts, connective tissue graft and guided tissue regeneration. The purpose of this article is to describe the clinical parameters and to mention the treatment options for this deformity.La recesión gingival es definida como la ubicación del margen gingival apical a la unión amelocementaria de uno o más dientes. Esta deformidad mucogingival ocasiona generalmente hipersensibilidad radicular, pobre apariencia estética y lesiones cervicales cariosas, por lo que los pacientes pueden preguntar por procedimientos de recubrimiento radicular. Existen dos grandes grupos de causas de la recesión gingival, las que se originan de una enfermedad periodontal y las de origen traumático. Además se consideran ciertos factores y se les clasifica como factores predisponen tes y precipitantes o desencadenantes. Patológicamente, las recesiones gingivales están ocasionadas por la destrucción del tejido conectivo de la gingiva lo cual ocasiona una disminución del flujo sanguíneo a nivel gingival. Desde que se introdujo el colgajo desplazado lateralmente para el tratamiento de las recesiones gingivales, se han desarrollado técnicas con el mismo fin, dentro de estas se incluyen los colgajos pediculados, el injerto gingival libre epitelializado, el injerto de tejido conectivo y la regeneración tisular guiada. Es objetivo del presente artículo describir parámetros que pueden ser evaluados clínicamente y mencionar los procedimientos empleados para su tratamiento

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

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