Dynamics of pneumococcal nasopharyngeal carriage in healthy children attending a day care center in northern Spain. Influence of detection techniques on the results

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Implantar un Sistema de Gestion Integral en Software libre

El proyecto de fin de carrera “Implantar un Sistema de Gestión Integral en Software libre” se ha desarrollado en la empresa Avanzosc con sede en Azkoitia. Una peculiaridad del proyecto es que a su vez se ha utilizado como cliente otra empresa, q2K, Soluciones Informáticas en Gestión Estratégica. El objetivo del proyecto es implantar en q2K un sistema de planificación de recursos empresariales (ERP, Enterprise Resource Planning), esto le permite reunir en una única aplicación todos los procesos de negocio de la empresa. La implantación de un ERP requiere de una importante inversión ya que el coste de la licencia de un sistema ERP propietario es elevado. Una interesante alternativa para evitar este desembolso es optar por un de ERP de software libre con todas las ventajas de configuración y personalización. En nuestro caso se ha adoptado OpenERP que es un software integral, modular y adaptable, adecuado para pequeñas y medianas empresas. El desarrollo del proyecto ha estado supervisado por el equipo de trabajo de Avanzosc, empresa líder en España en implantación de OpenErp, siguiendo la metodología de trabajo propia de esta empresa.

Gestión integral de la ampliación de una infraestructura de sistemas y servicios

Este proyecto se sitúa en el ámbito de las empresas que ofertan servicios informáticos a terceros. Estas empresas se dedican a cubrir las necesidades de gestión de la infraestructura de sistemas y servicios de los clientes. En concreto, los proyectos de ampliación de esas infraestructuras suelen ser bastante problemáticos. Este proyecto desarrolla un conjunto de procedimientos que permiten gestionar la ampliación de una infraestructura de sistemas y servicios de acuerdo a una librería de buenas prácticas denominada ITIL.

Una aproximación integral desde la metodología del descubrimiento del conocimiento al problema de la predicción de supervivencia en el desastre del Titanic

El objetivo de este trabajo es estudiar el Desastre del Titanic, utilizando la metodología del Descubrimiento del Conocimiento (KDD). La tesis propone diferentes variantes de cómo aplicar técnicas de Minería de Datos y herramientas del Aprendizaje Automático para predecir de forma eficiente la sobrevivencia de los pasajeros. Con este fin se han adaptado diferentes algoritmos de pre-procesamiento de datos, selección de variables y clasificación, a las características particulares del problema tratado. Algunos de estos algoritmos han sido implementados o sus implementaciones han sido modificadas para el caso específico del problema del Titanic.

Asymptotic Hyperstability of a Class of Linear Systems under Impulsive Controls Subject to an Integral Popovian Constraint

This paper is focused on the study of the important property of the asymptotic hyperstability of a class of continuous-time dynamic systems. The presence of a parallel connection of a strictly stable subsystem to an asymptotically hyperstable one in the feed-forward loop is allowed while it has also admitted the generation of a finite or infinite number of impulsive control actions which can be combined with a general form of nonimpulsive controls. The asymptotic hyperstability property is guaranteed under a set of sufficiency-type conditions for the impulsive controls.

Clinical factors associated with a Candida albicans Germ Tube Antibody positive test in Intensive Care Unit patients

Background: Poor outcomes of invasive candidiasis (IC) are associated with the difficulty in establishing the microbiological diagnosis at an early stage. New scores and laboratory tests have been developed in order to make an early therapeutic intervention in an attempt to reduce the high mortality associated with invasive fungal infections. Candida albicans IFA IgG has been recently commercialized for germ tube antibody detection (CAGTA). This test provides a rapid and simple diagnosis of IC (84.4% sensitivity and 94.7% specificity). The aim of this study is to identify the patients who could be benefited by the use of CAGTA test in critical care setting. Methods: A prospective, cohort, observational multicentre study was carried out in six medical/surgical Intensive care units (ICU) of tertiary-care Spanish hospitals. Candida albicans Germ Tube Antibody test was performed twice a week if predetermined risk factors were present, and serologically demonstrated candidiasis was considered if the testing serum dilution was >= 1: 160 in at least one sample and no other microbiological evidence of invasive candidiasis was found. Results: Fifty-three critically ill non-neutropenic patients (37.7% post surgery) were included. Twenty-two patients (41.5%) had CAGTA-positive results, none of them with positive blood culture for Candida. Neither corrected colonization index nor antifungal treatment had influence on CAGTA results. This finding could corroborate that the CAGTA may be an important biomarker to distinguish between colonization and infection in these patients. The presence of acute renal failure at the beginning of the study was more frequent in CAGTA-negative patients. Previous surgery was statistically more frequent in CAGTA-positive patients. Conclusions: This study identified previous surgery as the principal clinical factor associated with CAGTA-positive results and emphasises the utility of this promising technique, which was not influenced by high Candida colonization or antifungal treatment. Our results suggest that detection of CAGTA may be important for the diagnosis of invasive candidiasis in surgical patients admitted in ICU.

Somatisation in primary care: experiences of primary care physicians involved in a training program and in a randomised controlled trial

Background: A new intervention aimed at managing patients with medically unexplained symptoms (MUS) based on a specific set of communication techniques was developed, and tested in a cluster randomised clinical trial. Due to the modest results obtained and in order to improve our intervention we need to know the GPs' attitudes towards patients with MUS, their experience, expectations and the utility of the communication techniques we proposed and the feasibility of implementing them. Physicians who took part in 2 different training programs and in a randomised controlled trial (RCT) for patients with MUS were questioned to ascertain the reasons for the doctors' participation in the trial and the attitudes, experiences and expectations of GPs about the intervention. Methods: A qualitative study based on four focus groups with GPs who took part in a RCT. A content analysis was carried out. Results: Following the RCT patients are perceived as true suffering persons, and the relationship with them has improved in GPs of both groups. GPs mostly valued the fact that it is highly structured, that it made possible a more comfortable relationship and that it could be applied to a broad spectrum of patients with psychosocial problems. Nevertheless, all participants consider that change in patients is necessary; GPs in the intervention group remarked that that is extremely difficult to achieve. Conclusion: GPs positively evaluate the communication techniques and the interventions that help in understanding patient suffering, and express the enormous difficulties in handling change in patients. These findings provide information on the direction in which efforts for improving intervention should be directed.

Efficacy and safety of autologous platelet rich plasma for the treatment of vascular ulcers in primary care: Phase III study

Background: Vascular ulcers are commonly seen in daily practice at all levels of care and have great impact at personal, professional and social levels with a high cost in terms of human and material resources. Given that the application of autologous platelet rich plasma has been shown to decrease healing times in various different studies in the hospital setting, we considered that it would be interesting to assess the efficacy and feasibility of this treatment in primary care. The objectives of this study are to assess the potential efficacy and safety of autologous platelet rich plasma for the treatment of venous ulcers compared to the conventional treatment (moist wound care) in primary care patients with chronic venous insufficiency (C, clinical class, E, aetiology, A, anatomy and P, pathophysiology classification C6). Design: We will conduct a phase III, open-label, parallel-group, multicentre, randomized study. The subjects will be 150 patients aged between 40 and 100 years of age with an at least 2-month history of a vascular venous ulcer assigned to ten primary care centres. For the treatment with autologous platelet rich plasma, all the following tasks will be performed in the primary care setting: blood collection, centrifugation, separation of platelet rich plasma, activation of coagulation adding calcium chloride and application of the PRP topically after gelification. The control group will receive standard moist wound care. The outcome variables to be measured at baseline, and at weeks 5 and 9 later include: reduction in the ulcer area, Chronic Venous Insufficiency Quality of Life Questionnaire score, and percentage of patients who require wound care only once a week. Discussion: The results of this study will be useful to improve the protocol for using platelet rich plasma in chronic vascular ulcers and to favour wider use of this treatment in primary care.