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Search Results: 1 - 10 of 264037 matches for " Juan Carlos; Bestard Pavón "
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Deficiencias en la entrevista médica realizada por alumnos de Medicina Interna bajo observación directa y registro de audio
Canelles Pupo,Marino G.; Moreno Rodríguez,Miguel ángel; Echevarria Parlay,Juan Carlos; Bestard Pavón,Luis Alberto;
Revista Cubana de Medicina Militar , 2003,
Abstract: the medical interview is the most powerful diagnostic tool for physicians, since it is the most important source for obtaining primary data. the aim of this paper was to determine the most frequent deficiencies found in the medical interview made by students from the second semester of the 3rd year of the medical career. a descriptive study was conducted during the academic courses 1999-2000 and 2000-2001. of a total of 99 students, the medical interview was recorded to 50 of them. the collected data were compared with what was witten in the history of the present disease they were evaluated by a survey that classified the imperfections as regards the history of the present disease, types of questions and general aspects. 383 difficulties were found (17.0 % of a possible total of 2 250). 168 (43,8 %) were connected with the history of the present disease, 153 (40.0 %) with the general aspects of the development of the interview and there were 62 mistakes (16.2 %) in relation to the type of question. many deficiencies were observed in the medical interview made by students not only concerning the domain of semiological abilities but also in the interpersonal communication.
Deficiencias en la entrevista médica realizada por alumnos de Medicina Interna bajo observación directa y registro de audio
Marino G. Canelles Pupo,Miguel ángel Moreno Rodríguez,Juan Carlos Echevarria Parlay,Luis Alberto Bestard Pavón
Revista Cubana de Medicina Militar , 2003,
Abstract: La entrevista médica es la herramienta diagnóstica más poderosa con que cuenta el médico, constituye la fuente más importante de la obtención de datos primarios. El objetivo del trabajo fue determinar las deficiencias más frecuentes encontradas en la entrevista médica por alumnos del segundo semestre de tercer a o de la carrera de medicina. Se realizó un trabajo descriptivo durante los cursos académicos 1999-2000 y 2000-2001, de un total de 99 alumnos se les grabó la entrevista médica a 50. Se compararon los datos recogidos con lo transcripto en la historia de la enfermedad actual, estos fueron evaluados mediante una encuesta que clasificó las imperfecciones con respecto a la historia de la enfermedad actual, tipos de preguntas y aspectos generales. Se encontraron 383 dificultades (17,0 % de un total posible de 2 250); en relación con la historia de la enfermedad actual fueron 168 (43,8 %); en relación con los aspectos generales del desarrollo de la entrevista, 153 (40,0 %) y con el tipo de pregunta, 62 errores (16,2 %). Se presentaron numerosas deficiencias en el interrogatorio médico realizado a pacientes por los alumnos y estas fueron tanto en el dominio de las habilidades semiológicas como en las de comunicación interpersonal. The medical interview is the most powerful diagnostic tool for physicians, since it is the most important source for obtaining primary data. The aim of this paper was to determine the most frequent deficiencies found in the medical interview made by students from the second semester of the 3rd year of the medical career. A descriptive study was conducted during the academic courses 1999-2000 and 2000-2001. Of a total of 99 students, the medical interview was recorded to 50 of them. The collected data were compared with what was witten in the history of the present disease They were evaluated by a survey that classified the imperfections as regards the history of the present disease, types of questions and general aspects. 383 difficulties were found (17.0 % of a possible total of 2 250). 168 (43,8 %) were connected with the history of the present disease, 153 (40.0 %) with the general aspects of the development of the interview and there were 62 mistakes (16.2 %) in relation to the type of question. Many deficiencies were observed in the medical interview made by students not only concerning the domain of semiological abilities but also in the interpersonal communication.
INFLUENCIA DE LAS TARJETAS DE DEBITO SOBRE LA DEMANDA DE EFECTIVO
Pérez Velasco Pavón,Juan Carlos;
Cuadernos de economía , 2002, DOI: 10.4067/S0717-68212002011600003
Abstract: within by the electronic money definition, the plastics have a significant place, both the debit cards and the new option, even in the experimental stage known as the electronic purse or prepayment. the advanced technological changes, especially the incorporated microchips into plastics and the internet have facilitated the payment system. these circumstances (the facilities with plastics) have generated the acceptation on the debit card and the electronic purse by the people, and it has altered and transformed several habits deeply rooted in our customs, in particular in latin america. the goal of this work is to develop a demand model of bills and coins model, such as the baumol-tobin inventory model. it includes the option of the buyers to buy their items with cash or debit cards. the sellers cash demand is added to the model because it is a necessary condition in order to find the solution. the sellers could accept debit card only if they have a machine capable of making the necessary transactions between the bank account's client and bank account's seller. if they don't have a machine, they will only accept cash. if we incorporate the sellers cash demand, we will be able to find the proportion of debit card expenditure. this share depends on the quantity of sellers with debit card machine. the benefit of this model is that we can study the debit cards as substitution of cash
INFLUENCIA DE LAS TARJETAS DE DEBITO SOBRE LA DEMANDA DE EFECTIVO
Juan Carlos Pérez Velasco Pavón
Cuadernos de Economía , 2002,
Abstract: Dentro de lo que se conoce como dinero electrónico las tarjetas tienen un lugar destacado, ya sea que se considere a las de débito o a la nueva opción, aun en etapa experimental, conocida como monedero electrónico o prepagada. Los adelantos tecnológicos al respecto han incidido favorablemente en ese medio de pago, lo que ha generado que, día con día, su aceptación por parte del público se incremente rompiendo con algunos hábitos y costumbres muy arraigados. El propósito del presente trabajo es desarrollar un modelo de demanda de billetes y monedas del tipo inventarios (Baumol-Tobin) que contemple la opción de que las compras se realicen a través de tarjetas de débito. A su vez, se a ade la demanda de efectivo de los vendedores, los cuales podrán aceptar las tarjetas -y modificar su demanda- dependiendo de si poseen o no un aparato capaz de realizar los movimientos pertinentes. La razón de incorporar a estos últimos agentes al modelo se debe a que la proporción de transacciones con tarjetas respecto al total depende tanto de las decisiones de los consumidores como las de los propios vendedores. Con ello se podrá estudiar, paso a paso, la faceta de las tarjetas de débito como medio de pago y como sustituto cercano del efectivo Within by the electronic money definition, the plastics have a significant place, both the debit cards and the new option, even in the experimental stage known as the electronic purse or prepayment. The advanced technological changes, especially the incorporated microchips into plastics and the internet have facilitated the payment system. These circumstances (the facilities with plastics) have generated the acceptation on the debit card and the electronic purse by the people, and it has altered and transformed several habits deeply rooted in our customs, in particular in Latin America. The goal of this work is to develop a demand model of bills and coins model, such as the Baumol-Tobin inventory model. It includes the option of the buyers to buy their items with cash or debit cards. The sellers cash demand is added to the model because it is a necessary condition in order to find the solution. The sellers could accept debit card only if they have a machine capable of making the necessary transactions between the bank account's client and bank account's seller. If they don't have a machine, they will only accept cash. If we incorporate the sellers cash demand, we will be able to find the proportion of debit card expenditure. This share depends on the quantity of sellers with debit card machine. The benefit of this model is that we c
Síndrome hemolítico urémico Uremic haemolytic syndrome
Juan Carlos Jaime Fagundo,Yosniel Delgado Giniebra,Dunia Castillo González,Valia Pavón Morán
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2003,
Abstract: Se realiza una revisión de los aspectos generales del síndrome hemolítico urémico (SHU): epidemiología, patogenia, manifestaciones clínicas y tratamiento. El SHU es el resultado de la acción de numerosos factores etiológicos y patogénicos, causado principalmente por una verotoxina producida por diferentes cepas de Escherichia coli. En esta entidad se produce un da o endotelial que genera una serie de fenómenos tales como: adhesión, agregación plaquetaria y depósitos de fibrina, que llevan a la formación de trombos en la microcirculación: la microangiopatía trombótica. El SHU se caracteriza por la combinación de insuficiencia renal aguda, trombocitopenia y anemia hemolítica microangiopática. Las diarreas y las infecciones del tracto respiratorio superior son los factores precipitantes más comunes. La plasmaféresis y la diálisis son actualmente el tratamiento de elección It was made a review of the general aspects of the uremic haemolytic syndrome (UHS): epidemiology, pathogeny, clinical manifestations and treatment. UHS results from the action of numerous ethiological and pathogenic factors It is mainly caused by a verotoxin produced by different Escherichia coli strains. In this entity, it is produced an endothelial damage that generates a series of phenomena, such as adhesion, platelet aggregation and deposits of fibrin, leading to the formation of thrombi in the microcirculation: thrombotic microangiopathy. UHS is characterized by a combination of acute renal failure, thrombocytopenia and microangiopathic haemolytic anemia. Diarrheas and upper respiratory tract infections are the most common precipitating factors. Plasmaphaeresis and dialysis are nowadays the election treatment
Evaluación a largo plazo de la esplenectomía parcial en pacientes con esferocitosos hereditaria Long-term assessment of the partial splenectomy in patients with hereditary spherocytosis
Heidys Garrote Santana,Valia Pavón Morán,Juan Carlos Jaime Facundo,Haycelvi Cisneros Zerquera
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2010,
Abstract: Se evaluó la efectividad de la esplenectomía parcial (EP) en 17 pacientes con esferocitosis hereditaria atendidos en el Instituto de Hematología e Inmunología. La edad al diagnóstico fue de 6,71 ± 5,38 meses. Todos presentaron esplenomegalia. Un paciente presentó litiasis vesicular antes de la intervención. Los criterios para indicar la esplenectomía fueron: requerimientos transfusionales (82,4 %), anemia crónica y esplenomegalia (11,7 %) y esplenomegalia (5,9 %). La edad al momento de la EP fue de 7,0 ± 2,6 a os. La hemoglobina (Hb) estaba disminuida en el 94,1 % de los enfermos; los reticulocitos aumentados en el 100 % y la bilirrubina total e indirecta elevada en el 76,5 % y 88,2 %, respectivamente. El promedio de edad actual de los pacientes es de 16,24 ± 4,26 a os, con un tiempo de evolución de 9,24 ± 4,47 a os. Las variables de laboratorio posoperatorio mostraron incremento significativo de la Hb (p= 4 × 10-9) y disminución de los reticulocitos (p= 0,003). La tendencia en el tiempo de la Hb mantuvo estabilidad de los niveles alcanzados luego de la intervención, en todos los pacientes con más de 10 a os de operados, no así para los reticulocitos. Dos pacientes presentaron crecimiento del fragmento esplénico; uno se asoció con mala respuesta clínico-hematológica. No se comprobó sepsis ni complicaciones tromboembólicas con posterioridad al proceder. The effectiveness of partial splenomegalia (PS) was assessed in 17 patients with hereditary spherocytosis seen in the Hematology and Immunology Institute. Age at diagnosis was of 6.71 ± 5.38 months. All of them had splenomegalia. A patient had vesicular lithiasis before intervention. Criteria to presence of splenomegalia were: transfusion requirements (822.4 %), chronic anemia and splenomegalia (11.7 %) and splenomegalia (5.9 %). Age at moment of PS was of 7.0 ± 2.6 years. Hemoglobin (Hb) was low in the 94.1 % of patients; reticulocytes increased in the 100 % and the total and indirect bilirubin was high in the 76.5 % and the 88.2 %, respectively. Current mean age of patients is 16.24 ± 4.26 years with a course time of 9.24 ± 4.47 years. Postoperative laboratory variables showed a significant increase of Hb (p= 4 × 10-9) and a decrease of reticulocytes (p= 0.003). Trend in time of Hb remained stable in levels achieved after intervention in all patients with more than 10 years of operated on, but not for reticulocytes. Two patients showed a growing of splenic fragment; one was associated with a poor clinical-hematological response. There not sepsis or thromboembolism complications after procedure.
Trasplante no mieloablativo de células hematopoyéticas
Pavón Morán,Valia; Dorticós Balea,Elvira; Jaime Fagundo,Juan Carlos; Carnot Uría,José;
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2003,
Abstract: the transplantation of haematopoietic cells is a therapeutic option for many diseases. the conventional preparatory treatments are associated with a high morbimortality due to toxicity over organs and tissues, which limits their indications to young individuals and with a competent health status.the beneficial role of the graft versus tumor effect and the evidence of induction of a new remission with infusion of lymphocytes from the donor in patients that relapsed after an allogeneic transplant, laid the foundations for the development of less aggressive and nonmyeloablative but intensively immunosupressor preparatory treatments that would allow the taking of the graft and a state of mixed chimerism that may be modulated by a state of total chimera. the results show that the implant may be attained after a nonmyeloablative treatment. at present, the ideal schemes, as well as the posttransplant immunosupressor therapy are to be determined
Nuevas estrategias en el tratamiento de la leucemia mieloide crónica
Pavón Morán,Valia; Jaime Fagundo,Juan Carlos; Agramonte Llanes,Olga; Hernández Ramírez,Porfirio;
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2007,
Abstract: new therapeutic models have been recommended in the last years to be used in patients with chronic myeloid leukemia (cml) resistant or intolerant to imatinib. most of the models are based on interventions on specific sites of the signal transmission system that the cells used to send information to the nucleus. one of the strategies that has been incorporated is the use of farnesyl transferase inhibitors. therapeutic products that may be administered by oral route, due to the small size of their molecules, have already been identified. at present, there are 4 inhibitors in more advanced stages, mainly the r115777 (zarnestra, tipifarnib). the search for other tretament models gave rise to the appearance of new molecules that may be used to treat the cases of resistance or intolerance to imatinib, such as desatinib and dilotinib. other molecule under experimentation phase is that currently known as pkc 412 (n-benzoylstaurosporine), cgp41251 that is a powerful selective inhibitor of the protein kinase c isoforms . the development of the molecular therapeutics has advanced rapidly and its application to cml has attained very positive results that should increase with the incorporation of the new drugs under study and of those that will certainly emerge in the future
Trasplante de células progenitoras hematopoyéticas: tipos, fuentes e indicaciones
Jaime Fagundo,Juan Carlos; Dorticós Balea,Elvira; Pavón Morán,Valia; Cortina Rosales,Lázaro;
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2004,
Abstract: the hematopoietic progenitor cell transplantation is the infusion of these cells obtained from bone marrow, peripheral blood, umbilical cord or fetal liver into a patient who has been prepared for receiving the graft. this procedure has turned into a therapeutical variant to be used in a wide variety of diseases such as malignant hemopathies, aplastic anemia, immunodeficiencies and a large number of solid tumors. at present, the number of transplanted patients amounts to 30 000 yearly all over the world. the selection of the source and the type of transplantation depend on different factors. a literature review of some basic aspects of transplantation of hematopoeitic cells such as history, types, sources and indications was made
Imatinib en leucemia mieloide crónica
Pavón Morán,Valia; Hernández Ramírez,Porfirio; Jaime Fagundo,Juan Carlos; Agramonte Llanes,Olga;
Revista Cubana de Hematolog?-a, Inmunolog?-a y Hemoterapia , 2005,
Abstract: chronic myeloid leukemia (cml) was the first neoplasia in which it was possible to present a model of genotype that served as a target for a molecular action therapy. the activation of multiple ways of transduction signals in the cells with the bcr-abl gene favors the increase of the cellular proliferation, interferes the apoptosis, and perturbs the interaction with the extracellular matrix and the stroma. the introduction of imatinib in the treatment of cml has modified the evolution and prognosis of this disease. imatinib has proved to have a high level of efficiency associated with a smaller number of adverse reactions on being compared with the regimens based on interferon and hydroxyurea
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