Uso problemático de las redes sociales en estudiantes universitarios

Los avances que están produciéndose en el ámbito académico con el surgimiento de herramientas de la Web 2.0 y el empleo masivo por parte de los estudiantes de la redes sociales para comunicarse entre ellos, está haciendo que el panorama educativo se encuentre ante unos desafíos a los que tiene que dar respuesta. La investigación que aquí se presenta tuvo como objetivo principal analizar el estado del empleo de la redes sociales por parte alumnado universitario, así como los posibles malos hábitos y usos problemáticos de las mismas. Se utilizó como instrumento de recogida de información un cuestionario “ad hoc” con un total de 23 ítems. Se concluye que el alumnado en general no posee malos hábitos en el empleo de las redes sociales, igualmente los resultados obtenidos ponen de manifiesto que su utilización no está plenamente integrada en las instituciones universitarias de educación superior, así como que los estudiantes no las emplean/usan como herramienta fundamental para las resolución de cuestiones académicas.

"Cómo pintar el aire". Fundamentos científicos de la perspectiva atmosférica

La perspectiva aérea o atmosférica es juzgada por los pintores como parte esencial de la pintura, una vez establecidos los presupuestos geométricos de la representación naturalista mediante la perspectiva lineal. Leonardo da Vinci fue el primer autor en definir la perspectiva aérea o atmosférica, conocidos ya a través de L. B. Alberti los fundamentos geométricos de la perspectiva lineal en el tratado De Pictura (1435). Doscientos años después, tras la influyente publicación del Optics de Newton, contextualizadas bajo el espíritu racionalista del siglo XVIII, el artículo estudia las recomendaciones que desde la ciencia y los científicos (específicamente a través de tres figuras relevantes: Brook Taylor, J. H. Lambert y Gaspard Monge) se dan a los pintores con la pretensión de arbitrar una medición exacta del color, en confrontación con el tradicional empirismo del mundo artístico. Este tema puede considerarse un capítulo de gran interés en la larga historia de la pintura y la representación de los fenómenos atmosféricos, cuyos antecedentes teóricos tienen su inicio en el Débat sur le Coloris de la Académie Française del siglo XVII y sus resultados, conducirán hacia el nacimiento de la moderna Teoría del color, en respuesta a una cuestión tan compleja sobre cómo pintar el aire.

Methods to increase response to postal and electronic questionnaires

Background: Postal and electronic questionnaires are widely used for data collection in epidemiological studies but non-response reduces the effective sample size and can introduce bias. Finding ways to increase response to postal and electronic questionnaires would improve the quality of health research. Objectives: To identify effective strategies to increase response to postal and electronic questionnaires. Search strategy: We searched 14 electronic databases to February 2008 and manually searched the reference lists of relevant trials and reviews, and all issues of two journals. We contacted the authors of all trials or reviews to ask about unpublished trials. Where necessary, we also contacted authors to confirm methods of allocation used and to clarify results presented. We assessed the eligibility of each trial using pre-defined criteria. Selection criteria: Randomised controlled trials of methods to increase response to postal or electronic questionnaires. Data collection and analysis: We extracted data on the trial participants, the intervention, the number randomised to intervention and comparison groups and allocation concealment. For each strategy, we estimated pooled odds ratios (OR) and 95% confidence intervals (CI) in a random-effects model. We assessed evidence for selection bias using Egger's weighted regression method and Begg's rank correlation test and funnel plot. We assessed heterogeneity among trial odds ratios using a Chi 2 test and the degree of inconsistency between trial results was quantified using the I 2 statistic. Main results: Postal We found 481 eligible trials.The trials evaluated 110 different ways of increasing response to postal questionnaires.We found substantial heterogeneity among trial results in half of the strategies. The odds of response were at least doubled using monetary incentives (odds ratio 1.87; 95% CI 1.73 to 2.04; heterogeneity P < 0.00001, I 2 = 84%), recorded delivery (1.76; 95% CI 1.43 to 2.18; P = 0.0001, I 2 = 71%), a teaser on the envelope - e.g. a comment suggesting to participants that they may benefit if they open it (3.08; 95% CI 1.27 to 7.44) and a more interesting questionnaire topic (2.00; 95% CI 1.32 to 3.04; P = 0.06, I 2 = 80%). The odds of response were substantially higher with pre-notification (1.45; 95% CI 1.29 to 1.63; P < 0.00001, I 2 = 89%), follow-up contact (1.35; 95% CI 1.18 to 1.55; P < 0.00001, I 2 = 76%), unconditional incentives (1.61; 1.36 to 1.89; P < 0.00001, I 2 = 88%), shorter questionnaires (1.64; 95%CI 1.43 to 1.87; P < 0.00001, I 2 = 91%), providing a second copy of the questionnaire at follow up (1.46; 95% CI 1.13 to 1.90; P < 0.00001, I 2 = 82%), mentioning an obligation to respond (1.61; 95% CI 1.16 to 2.22; P = 0.98, I 2 = 0%) and university sponsorship (1.32; 95% CI 1.13 to 1.54; P < 0.00001, I 2 = 83%). The odds of response were also increased with non-monetary incentives (1.15; 95% CI 1.08 to 1.22; P < 0.00001, I 2 = 79%), personalised questionnaires (1.14; 95% CI 1.07 to 1.22; P < 0.00001, I 2 = 63%), use of hand-written addresses (1.25; 95% CI 1.08 to 1.45; P = 0.32, I 2 = 14%), use of stamped return envelopes as opposed to franked return envelopes (1.24; 95% CI 1.14 to 1.35; P < 0.00001, I 2 = 69%), an assurance of confidentiality (1.33; 95% CI 1.24 to 1.42) and first class outward mailing (1.11; 95% CI 1.02 to 1.21; P = 0.78, I 2 = 0%). The odds of response were reduced when the questionnaire included questions of a sensitive nature (0.94; 95% CI 0.88 to 1.00; P = 0.51, I 2 = 0%). Electronic: We found 32 eligible trials. The trials evaluated 27 different ways of increasing response to electronic questionnaires. We found substantial heterogeneity among trial results in half of the strategies. The odds of response were increased by more than a half using non-monetary incentives (1.72; 95% CI 1.09 to 2.72; heterogeneity P < 0.00001, I 2 = 95%), shorter e-questionnaires (1.73; 1.40 to 2.13; P = 0.08, I 2 = 68%), including a statement that others had responded (1.52; 95% CI 1.36 to 1.70), and a more interesting topic (1.85; 95% CI 1.52 to 2.26). The odds of response increased by a third using a lottery with immediate notification of results (1.37; 95% CI 1.13 to 1.65), an offer of survey results (1.36; 95% CI 1.15 to 1.61), and using a white background (1.31; 95% CI 1.10 to 1.56). The odds of response were also increased with personalised e-questionnaires (1.24; 95% CI 1.17 to 1.32; P = 0.07, I 2 = 41%), using a simple header (1.23; 95% CI 1.03 to 1.48), using textual representation of response categories (1.19; 95% CI 1.05 to 1.36), and giving a deadline (1.18; 95% CI 1.03 to 1.34). The odds of response tripled when a picture was included in an e-mail (3.05; 95% CI 1.84 to 5.06; P = 0.27, I 2 = 19%). The odds of response were reduced when "Survey" was mentioned in the e-mail subject line (0.81; 95% CI 0.67 to 0.97; P = 0.33, I 2 = 0%), and when the e-mail included a male signature (0.55; 95% CI 0.38 to 0.80; P = 0.96, I 2 = 0%). Authors' conclusions: Health researchers using postal and electronic questionnaires can increase response using the strategies shown to be effective in this systematic review. Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.


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Effect of Turbine Inlet Temperature on Rotor Blade Tip Leakage Flow and Heat Transfer

One of the most critical gas turbine engine components, the rotor blade tip and casing, is exposed to high thermal load. It becomes a significant design challenge to protect the turbine materials from this severe situation. The purpose of this paper is to study numerically the effect of turbine inlet temperature on the tip leakage flow structure and heat transfer. In this paper, the effect of turbine inlet temperature on the tip leakage flow structure and heat transfer has been studied numerically. Uniform low (LTIT: 444 K) and high (HTIT: 800 K) turbine inlet temperature, as well as non-uniform inlet temperature have been considered. The results showed the higher turbine inlet temperature yields the higher velocity and temperature variations in the leakage flow aerodynamics and heat transfer. For a given turbine geometry and on-design operating conditions, the turbine power output can be increased by 1.33 times, when the turbine inlet temperature increases 1.80 times. Whereas the averaged heat fluxes on the casing and the blade tip become 2.71 and 2.82 times larger, respectively. Therefore, about 2.8 times larger cooling capacity is required to keep the same turbine material temperature. Furthermore, the maximum heat flux on the blade tip of high turbine inlet temperature case reaches up to 3.348 times larger than that of LTIT case. The effect of the interaction of stator and rotor on heat transfer features is also explored using unsteady simulations. The non-uniform turbine inlet temperature enhances the heat flux fluctuation on the blade tip and casing.

Effect of turbine inlet temperature on blade tip leakage flow and heat transfer

One of the most critical gas turbine engine components, rotor blade tip and casing, are exposed to high thermal load. It becomes a significant design challenge to protect the turbine materials from this severe situation. As a result of geometric complexity and experimental limitations, Computational Fluid Dynamics (CFD) tools have been used to predict blade tip leakage flow aerodynamics and heat transfer at typical engine operating conditions. In this paper, the effect of turbine inlet temperature on the tip leakage flow structure and heat transfer has been studied numerically. Uniform low (LTIT: 444 K) and high (HTIT: 800 K) turbine inlet temperature have been considered. The results showed the higher turbine inlet temperature yields the higher velocity and temperature variations in the leakage flow aerodynamics and heat transfer. For a given turbine geometry and on-design operating conditions, the turbine power output can be increased by 1.48 times, when the turbine inlet temperature increases 1.80 times. Whereas the averaged heat fluxes on the casing and the blade tip become 2.71 and 2.82 times larger, respectively. Therefore, about 2.8 times larger cooling capacity is required to keep the same turbine material temperature. Furthermore, the maximum heat flux on the blade tip of high turbine inlet temperature case reaches up to 3.348 times larger than that of LTIT case. The effect of the interaction of stator and rotor on heat transfer features is also explored using unsteady simulations.

Arteriovenous fistula outcomes in the elderly

OBJECTIVE: Over several decades, there has been an increase in the number of elderly patients requiring hemodialysis. These older patients typically have an increased incidence of comorbidities including diabetes, hypertension, and peripheral vascular disease. We undertook a systematic review of the current literature to assess outcomes of arteriovenous fistula (AVF) formation in the elderly and to compare the results of radiocephalic AVFs vs brachiocephalic AVFs in older patients.

METHODS: A literature search was performed using MEDLINE, Embase, PubMed, and the Cochrane Library. All retrieved articles published before December 31, 2014 (and in English) primarily describing the creation of hemodialysis vascular access for elderly patients were considered for inclusion. We report pooled AVF patency rates and a comparison of radiocephalic vs brachiocephalic AVF patency rates using odds ratios (ORs).

RESULTS: Of 199 relevant articles reviewed, 15 were deemed eligible for the review. The pooled 12-month primary and secondary AVF patency rates were 53.6% (95% confidence interval [CI], 47.3-59.9) and 71.6% (95% CI, 59.2-82.7), respectively. Comparison of radiocephalic vs brachiocephalic AVF patency rates demonstrated that radiocephalic AVFs have inferior primary (OR, 0.72; 95% CI, 0.55-0.93; P = .01) and secondary (OR, 0.76; 95% CI, 0.58-1.00; P = .05) patency rates.

CONCLUSIONS: This meta-analysis confirms that adequate 12-month primary and secondary AVF patency rates can be achieved in elderly patients. Brachiocephalic AVFs have both superior primary and secondary patency rates at 12 months compared with radiocephalic AVFs. These important data can inform clinicians' and patients' decision-making about suitability of attempting AVF formation in older persons.

Ligand binding and signalling pathways of PTH receptors in sea bream (Sparus auratus) enterocytes

Whole animal studies have indicated that Ca2+ uptake by the gastrointestinal tract is regulated by the action of parathyroid hormone-related peptide (PTHrP) in teleost fish. We have characterised PTH receptors (PTHR) in piscine enterocytes and established, by using aminoterminal PTHrP peptides, the amino acid residues important for receptor activation and for stabilising the ligand/receptor complex. Ligand binding of 125I-(1–35tyr) PTHrP to the membrane fraction of isolated sea bream enterocytes revealed the existence of a single saturable high-affinity receptor (KD=2.59 nM; Bmax=71 fmol/mg protein). Reverse transcription/polymerase chain reaction with specific primers for sea bream PTH1R and PTH3R confirmed the mRNA expression of only the later receptor. Fugu (1–34) PTHrP increased cAMP levels in enterocytes but had no effect on total inositol phosphate accumulation. The aminoterminal peptides (2–34)PTHrP, (3–34)PTHrP and (7–34) PTHrP bound efficiently to the receptor but were severely defective in stimulating cAMP in enterocyte cells indicating that the first six residues of piscine (1–34)PTHrP, although not important for receptor binding, are essential for activation of the adenylate cyclase/phosphokinase A (AC-PKA)-receptor-coupled intracellular signalling pathway. Therefore, PTHrP in teleosts acts on the gastrointestinal tract through PTH3R and the AC-PKA intracellular signalling pathway and might regulate Ca2+ uptake at this site. Ligand-receptor binding and activity throughout the vertebrates appears to be allocated to the same amino acid residues of the amino-terminal domain of the PTHrP molecule.

Implementação da Equipa de Emergência Médica Intra-hospitalar nos hospitais do Serviço Nacional de Saúde : análise de custo-efetividade perante a incidência da paragem cárdio-respiratória intra-hospitalar

RESUMO - Introdução: No âmbito das emergências intra-hospitalares investigou-se a hipótese da presença da Equipa Emergência Médica Intra-hospitalar (EEMI) (DGS, 2010) num Centro Hospitalar (CH), contribuir para a redução do número de mortos por Paragem Cárdiorespiratória (PCR) intra-hospitalar, quando comparado com outro CH dotado de uma equipa tradicional de resposta à PCR. Metodologia: Tratou-se de um estudo observacional, retrospetivo (2010 a 2014), com base nos dados do Grupo de Diagnóstico Homogéneo (GDH), analisado numa perspetiva de custo-efetividade no impacto sobre incidência de PCR e taxa de mortalidade. Resultados: Observou-se que o CH com EEMI apresentou uma Redução Risco Absoluto (RRA) de 9,01% de morte por PCR. A taxa de mortalidade calculada foi de 2,82 casos por 1000 episódios de internamento em que a incidência de PCR foi de 28,24 casos por cada 10 000 habitantes, duas vezes menor que CH em comparação. Quando introduzidas manobras de Ressuscitação Cárdiopulmonar (RCP), o mesmo CH teve um maior número de PCR revertidas, com uma taxa de mortalidade 2 vezes menor que o CH sem EEMI. Conclusão: Resultados demonstraram que os dois CH apresentaram riscos diferentes, em que a probabilidade do doente hospitalizado de morrer após ocorrência de PCR foi menor no grupo exposto à EEMI, com OR = 0,496 [IC 95% (0,372 a 0,662)] para dados populacionais (p = 0,0013), e OR = 0,618 [IC 95% (0,298 a 1,281)] para dados individuais, (p = 0,194). Face a melhores resultados em Saúde, considerou-se a implementação da EEMI, uma medida custo-efetiva, uma vez que o principal requisito traduz-se por reorganização das equipas tradicionais para uma vertente de prevenção da PCR.

Safety and occlusion rates of surgical treatment of unruptured intracranial aneurysms: a systematic review and meta-analysis of the literature from 1990 to 2011.

BACKGROUND AND PURPOSE: Surgical clipping of unruptured intracranial aneurysms (UIAs) has recently been challenged by the emergence of endovascular treatment. We performed an updated systematic review and meta-analysis on the surgical treatment of UIAs, in an attempt to determine the aneurysm occlusion rates and safety of surgery in the modern era. METHODS: A detailed protocol was developed prior to conducting the review according to the Cochrane Collaboration guidelines. Electronic databases spanning January 1990-April 2011 were searched, complemented by hand searching. Heterogeneity was assessed using I(2), and publication bias with funnel plots. Surgical mortality and morbidity were analysed with weighted random effect models. RESULTS: 60 studies with 9845 patients harbouring 10 845 aneurysms were included. Mortality occurred in 157 patients (1.7%; 99% CI 0.9% to 3.0%; I(2)=82%). Unfavourable outcomes, including death, occurred in 692 patients (6.7%; 99% CI 4.9% to 9.0%; I(2)=85%). Morbidity rates were significantly greater in higher quality studies, and with large or posterior circulation aneurysms. Reported morbidity rates decreased over time. Studies were generally of poor quality; funnel plots showed heterogeneous results and publication bias, and data on aneurysm occlusion rates were scant. CONCLUSIONS: In studies published between 1990 and 2011, clipping of UIAs was associated with 1.7% mortality and 6.7% overall morbidity. The reputed durability of clipping has not been rigorously documented. Due to the quality of the included studies, the available literature cannot properly guide clinical decisions.

Associations between alcohol consumption and selected cytokines in a Swiss population-based sample (CoLaus study).

To assess the associations between alcohol consumption and cytokine levels (interleukin-1beta - IL-1β; interleukin-6 - IL-6 and tumor necrosis factor-α - TNF-α) in a Caucasian population. Population sample of 2884 men and 3201 women aged 35-75. Alcohol consumption was categorized as nondrinkers, low (1-6 drinks/week), moderate (7-13/week) and high (14+/week). No difference in IL-1β levels was found between alcohol consumption categories. Low and moderate alcohol consumption led to lower IL-6 levels: median (interquartile range) 1.47 (0.70-3.51), 1.41 (0.70-3.32), 1.42 (0.66-3.19) and 1.70 (0.83-4.39) pg/ml for nondrinkers, low, moderate and high drinkers, respectively, p<0.01, but this association was no longer significant after multivariate adjustment. Compared to nondrinkers, moderate drinkers had the lowest odds (Odds ratio=0.86 (0.71-1.03)) of being in the highest quartile of IL-6, with a significant (p<0.05) quadratic trend. Low and moderate alcohol consumption led to lower TNF-α levels: 2.92 (1.79-4.63), 2.83 (1.84-4.48), 2.82 (1.76-4.34) and 3.15 (1.91-4.73) pg/ml for nondrinkers, low, moderate and high drinkers, respectively, p<0.02, and this difference remained borderline significant (p=0.06) after multivariate adjustment. Moderate drinkers had a lower odds (0.81 [0.68-0.98]) of being in the highest quartile of TNF-α. No specific alcoholic beverage (wine, beer or spirits) effect was found. Moderate alcohol consumption is associated with lower levels of IL-6 and (to a lesser degree) of TNF-α, irrespective of the type of alcohol consumed. No association was found between IL-1β levels and alcohol consumption.

Évaluation de la valeur pronostique de la lactatémie lors de dilatation à droite de la caillette ou de volvulus abomasal chez la vache laitière

Dans les élevages laitiers d’aujourd’hui, les déplacements de la caillette sont parmi les conditions chirurgicales les plus souvent rencontrées. Le pronostic pour ces pathologies est cependant très différent que l’on soit en présence d’une dilatation de la caillette à droite (DCD) ou d’un volvulus de la caillette (VC). En pratique, la distinction en période préopératoire entre ces deux conditions est difficile. Afin de limiter les pertes économiques associées aux DCD/VC, l’identification et la réforme précoce des animaux ayant le plus grand risque d’avoir une mauvaise évolution postopératoire deviennent des enjeux de premier plan. Les objectifs de cette étude étaient de déterminer la valeur pronostique de la L-lactatémie (LAC) mesurée à la ferme en préopératoire à l’aide d’un appareil portatif chez des vaches souffrant de DCD ou VC et de suggérer des seuils de LAC cliniquement significatifs. Nos résultats indiquent que la LAC est un bon indicateur pronostique lors de DCD/VC. Une LAC ≤ 2 mmol/L est un bon indicateur de succès chirurgical et s’avère très utile pour appuyer la décision d’opérer l’animal (sensibilité, spécificité, valeurs prédictives positive et négative de respectivement 76.2, 82.7, 53.3 et 93.1%). Par ailleurs, il n’y a aucun avantage économique à effectuer une chirurgie chez des vaches commerciales souffrant de DCD/VC qui ont une LAC ≥ 6 mmol/L (sensibilité, spécificité, valeurs prédictives positive et négative de respectivement 28.6, 97.5, 75 et 84%). Par conséquent, ces animaux devraient, dans la plupart des cas, être réformés en raison de la probabilité élevée qu’ils aient une mauvaise évolution postopératoire.

A Compact Electronically Reconfigurable Dual Frequency Microstrip Antenna for L-Band Applications

A novel design of a computer electronically reconfigurable dual frequency dual polarized single feed hexagonal slot loaded microstrip antenna in L-band is introduced in this chapter. pin diodes are used to switch the operating frequencies considerably without much affecting the radiation characteristics and gain. the antenna can work with a frequency ratio varying in the wide range from 1.2 to 1.4. the proposed design has an added advantage of size reduction up to 72.21% and 46.84% for the two resonating frequencies compared to standard rectangular patches. the design also gives considerable bandwidth of up to 2.82% and 2.42 % for the operating frequencies.

Resultados clínicos, radiológicos del manejo de fracturas diafisiarias de fémur con clavos elásticos endomedulares en población pediátrica

Introducción: Las fracturas de fémur en pediatría son una causa de discapacidad por requerir una inmovilización prolongada, convirtiendo su manejo en un reto para el ortopedista. El tratamiento depende de muchos factores, como la edad, el peso, el tipo de fractura y mecanismo de trauma. El estudio evaluará los desenlaces clínicos y radiológicos del paciente pediátrico con fracturas diafisiaria de fémur manejadas quirúrgicamente con clavos elásticos endomedulares. Materiales y métodos: Estudio observacional descriptivo, serie de casos, recolección de información a través de revisión de historias clínicas en pacientes sometidos quirúrgicamente con clavos elásticos. Resultados: Un total de 13 casos; promedio de edad de 8,2±2,86 años; relación hombre mujer es 3: 1. Principal mecanismo de trauma baja energía (9 casos). Con un seguimiento de 12.5±2,82 meses, el postoperatorio evidenció complicaciones menores relacionadas con irritación del punto de entrada del clavo (9 casos). Solo un caso presentó no unión de la fractura. No se documentaron otras complicaciones, existen diferencias estadísticamente significativas en la anteversión femoral del miembro fracturado y el sano (p=0,001) relacionado con problemas rotacionales, igual que la angulación en el plano sagital (p=0,030) sin repercusión para la consolidación ni la marcha. Conclusiones: El análisis de resultados clínicos y radiológicos concuerda con lo descrito en la literatura mundial, los clavos elásticos endomedulares es una técnica reproducible con resultados excelentes y satisfactorios, bajas tasas de complicaciones. Éste estudio presenta limitaciones debido al tamaño de muestra, no podemos hacer recomendaciones definitivas.

Definition of an it project portfolio management methodology for a pharmaceutical company

Con la creciente popularidad de las soluciones de IT como factor clave para aumentar la competitividad y la creación de valor para las empresas, la necesidad de invertir en proyectos de IT se incrementa considerablemente. La limitación de los recursos como un obstáculo para invertir ha obligado a las empresas a buscar metodologías para seleccionar y priorizar proyectos, asegurándose de que las decisiones que se toman son aquellas que van alineadas con las estrategias corporativas para asegurar la creación de valor y la maximización de los beneficios. Esta tesis proporciona los fundamentos para la implementación del Portafolio de dirección de Proyectos de IT (IT PPM) como una metodología eficaz para la gestión de proyectos basados en IT, y una herramienta para proporcionar criterios claros para los directores ejecutivos para la toma de decisiones. El documento proporciona la información acerca de cómo implementar el IT PPM en siete pasos, el análisis de los procesos y las funciones necesarias para su ejecución exitosa. Además, proporciona diferentes métodos y criterios para la selección y priorización de proyectos. Después de la parte teórica donde se describe el IT PPM, la tesis aporta un análisis del estudio de caso de una empresa farmacéutica. La empresa ya cuenta con un departamento de gestión de proyectos, pero se encontró la necesidad de implementar el IT PPM debido a su amplia cobertura de procesos End-to-End en Proyectos de IT, y la manera de asegurar la maximización de los beneficios. Con la investigación teórica y el análisis del estudio de caso, la tesis concluye con una definición práctica de un modelo aproximado IT PPM como una recomendación para su implementación en el Departamento de Gestión de Proyectos.

Evaluación de intervención de alertas para riesgo cardiovascular por diclofenaco en afiliados al régimen contributivo 2014 -2015

El objetivo fue evaluar la intervención de las alertas en la prescripción de diclofenaco. Estudio observacional, comparativo, post intervención, de un antes después, en pacientes con prescripción de diclofenaco. Se evaluó la intervención de las alertas restrictivas antes y después de su implementación en los pacientes prescritos con diclofenaco y que tenían asociado un diagnóstico de riesgo cardiovascular según CIE 10 o eran mayores de 65 años. Un total de 315.135 transacciones con prescripción de diclofenaco, en 49.355 pacientes promedio mes. El 94,8% (298.674) de las transacciones fueron prescritas por médicos generales.