Factores asociados a mortalidad en pacientes con enfermedades autoinmunes en cuidado intensivo, Hospital de la Samaritana 2007-2013

Introducción y objetivos: Las enfermedades autoinmunes en cuidado intensivo están relacionadas con tasas de mortalidad elevadas. El propósito del presente estudio fue buscar factores asociados a mortalidad en estos pacientes. Materiales y métodos: estudio observacional de casos incidentes, retrospectivo, en base a revisión de historias clínicas de los pacientes que ingresaron a la unidad de cuidado intensivo del Hospital Universitario de la Samaritana; se recolecto un total de 68 eventos con los que se evaluó la relación de las variables estudiadas con mortalidad. Resultados: Las enfermedades autoinmunes se presentan más frecuentemente en mujeres (66%), el lupus eritematoso sistémico fue la afección reumatológica más común (36%), el promedio de edad fue de 46 años, la media de días en ventilación mecánica fue de 10 (desviación estándar 13 días), el valor del APACHE promedio fue de 19 puntos, el sistema orgánico más afectado fue el renal (58,5%) y la mortalidad global fue de 40%. Se encontró asociación estadísticamente significativa con cinco variables: presencia de shock al ingreso a UCI OR: 7,368 (IC95% 1,886-28,794); nivel de procalcitonina mayor a 10 OR: 5,231 (IC95% 1,724-15,869); complemento C3 consumido OR: 4,014 (IC95% 1,223-13,173); serositis en la radiografía de tórax OR: 3,771 (IC95% 1,238-11,492); recuento de plaquetas menor a 100.000 OR: 3,33 (IC95%: 1,037-10,714). Conclusión: Existen factores que pueden estar asociados con mortalidad en pacientes con enfermedades autoinmunes en cuidado intensivo, su detección temprana y manejo oportuno podría mejorar el pronóstico de estos pacientes.

O compromisso organizacional como o grande desafio da gestão estratégica de recursos humanos : O caso dos projectos de outsourcing da IBM Portugal

Num contexto empresarial globalizado, a gestão de recursos humanos assume importância crescente. A valorização do capital humano e a preocupação com o compromisso e produtividade das pessoas revelam-se imperativos para a gestão de recursos humanos na contemporaneidade. As políticas e práticas de recursos humanos revelam-se a forma mais eficaz de comprometer as pessoas e, consequentemente, melhorar a performance organizacional. Este trabalho final de mestrado resultou de um estágio realizado num agrupamento complementar de empresa da IBM. Além das actividades desenvolvidas em contexto organizacional, efectuou-se urna descrição de todo o processo de gestão de recursos humanos e analisou-se a relação entre as políticas e práticas de recursos humanos e o compromisso organizacional, nas suas diferentes dimensões. Os resultados deste diagnóstico revelam que os colaboradores apresentam índices elevados de compromisso organizacional para com o ACE. Este compromisso materializa-se no alinhamento dos objectivos de negócio com os objectivos dos colaboradores. A principal causa destes índices elevados de compromisso são as políticas e práticas de recursos humanos. ABSTRACT: ln a globalized business environment, HRM assumes increasing importance. The human capital and concern for the commitment and productivity of people tum out to be imperative for the contemporary human resource management. Policies and practices of human resources prove to be the most effective way to engage people and thus improve organizational performance. This scientific work resulted from one stage held in a complementary group of the IBM Company. Besides the activities in organizations, took place a description of the whole process of resource management and examined the relationship of policies and practices in human resources with organizational commitment, in its various levels. The results of this diagnosis show that employees have high levels of organizational commitment towards the ACE. This commitment is materialized in the alignment of business goals with employee objectives. The main cause of these high levels of commitment are the policies and practices of human resources.

Bioconcentration of selected personal care products in Ruditapes philippinarum (Manila clam)

The Bioconcentration Factor (BCF) is the principal source of information used to assess and regulate the potential hazard and risk for a chemical that has the potential to bioaccumulate in the marine environment, according to the Marine Strategy Framework Directive (MSFD). The main objective of this thesis was to estimate the BCFs of two different emerging contaminants in Ruditapes philippinarum (Manila clam) under controlled laboratory conditions: the UV filter 4-methylbenzylidene camphor (4-MBC) commonly used in skincare products, and the artificial sweetener Acesulfame potassium (ACE-K) used as a food additive. Ruditapes philippinarum organisms were exposed directly to 4-MBC and ACE-K nominal concentration of 1, 10 and 100 μg L-1 during 10 days. Bioconcentration factors (BCFs) were estimated according to 3 different models for both compounds. The 4-MBC estimated BCFs fall in range of 61553 - 539143 L Kg-1, showing that this compound is very bioaccumulative and could also undergo biomagnification in the marine food chain. On the contrary, estimated ACE-K BCF is consistently lower, in order of 7 L Kg-1 for the nominal exposure concentration of 100 μg L-1. The low ACE-K BCF could be explained by its high solubility in water and thus a rapid metabolization by clams during the experiments. In summary, future research focusing on the marine environment is needed on these two emerging compounds.