Tibial Periosteum For The Surgical Perforation

Purpose: Report a successful case of scleral perforation repair, refractive to treatment with bank-scleral graft, using pretibial periosteum graft patch. Case Report: A patient who suffered a traumatic scleral perforation was treated unsuccessfully with bank-scleral patch graft. An autologous pretibial periosteal patch graft was then obtained and sutured to the scleral rupture with the osteogenic layer facing the sclera. The periosteum patch was covered by amniotic membrane and conjunctiva. Results: Early vascularization was observed in the first seven days postoperative. The autologous periosteal patch graft and conjunctiva remained stable over a follow-up period of 6 months. Conclusion: An autologous periosteal patch graft could be a good alternative after a non-successful bank-scleral patch repair of a scleral perforatio

Los factores claves de la innovación tecnológica: claves de la competitividad empresarial

Actualmente la innovación tecnológica está impulsada por la investigación, por interacciones entre diferentes agentes y por el conocimiento científico-tecnológico, lo que pone de relieve que se trata de un proceso orientado a la resolución de problemas, que tiene su ocurrencia primaria en el mercado, que implica relaciones formales e informales entre diferentes agentes, además del intercambio de conocimiento tácito y explícito. Para abordar el análisis de esta influencia, en este trabajo se identifican los drivers o factores que caracterizan el proceso de innovación tecnológica y que pueden clasificarse en internos y externos. Actually, technological innovation is propelled by the research, the interactions between different agents and the scientific and technological knowledge. It is a process oriented towards the resolution of problems that occurs primarily in the market, implies formal and informal relations between agents and the exchange of tacit and explicit knowledge.This paper analyses the drivers that characterize the technological innovation process.They can be classifies in internal and external. Internal drivers depend of the managers capacity to consolidate the quality and productivity dimensions (short-run), and the possibility to create technologies, competences and aptitudes that generate new products or services more quickly than the competitors (long-run). External drivers are associated to the activity sector of the firm, to its institutional context and to the economic policy that affects it

Changes in frequency-doubling perimetry in patients with type i diabetes prior to retinopathy

Purpose. To evaluate the ability of frequency-doubling technology (FDT) perimetry in detecting visual field defects in young adults with type I diabetes prior to retinopathy or with minor retinovascular changes. Methods. This comparative cross-sectional study included 30 healthy subjects and 73 age-matched patients with type I diabetes mellitus. All subjects underwent a full ocular examination including an FDT with the threshold C-20-5 strategy. Only one eye per subject was randomly included in the statistical analysis. FDT results and time to perform the test were compared between the groups. Results. The mean age was 27.1 years in the control group and 26.6 years in the diabetic group ( ). The mean period from the onset of diabetes was years, while minimal retinovascular changes were observed in 18 eyes. Mean deviation of FDT did not differ between the groups. Although global indices of FDT were within normal limits, pattern standard deviation of FDT was higher in the diabetic group ( ). The area under the receiver operating characteristic curve was 0.647 for pattern standard deviation of FDT (standard error = 0.052; ). Conclusion. FDT can detect retinal dysfunctions in diabetic patients prior to the onset of significant vascular complications

Los factores clave de la innovación tecnológica: claves de la competitividad empresarial

Actualmente la innovación tecnológica está impulsada por la investigación, por interacciones entre diferentes agentes y por el conocimiento científico-tecnológico, lo que pone de relieve que se trata de un proceso orientado a la resolución de problemas, que tiene su ocurrencia primaria en el mercado, que implica relaciones formales e informales entre diferentes agentes, además del intercambio de conocimiento tácito y explícito. Para abordar el análisis de esta influencia, en este trabajo se identifican los drivers o factores que caracterizan el proceso de innovación tecnológica y que pueden clasificarse en internos y externos. Los factores internos son resultado de actuaciones de la propia empresa y dependen de la capacidad de la dirección para consolidar las dimensiones de calidad y productividad (corto plazo), así como la posibilidad de crear, a menor coste y más rápidamente que los competidores, tecnologías, competencias y aptitudes esenciales que generen productos o servicios innovadores (largo plazo). Los factores externos están asociados al sector de actividad al que pertenece la empresa, al contexto institucional que la rodea y a las características de la política económica que le afecta.</jats:p

Analysis of the Endovenous Immunoglobulins Prescriptions in a Tertiary Hospital. Review of Indications and Proposals about Improvements.

Abstract Background. The generalization of indications and the prescriptions of endovenous immunoglobulins (EVIG) has stimulated us to analyse in collaboration with the Hospital Pharmacy Department the rational prescriptions of EVIG in a general tertiary reference hospital. Patients and Methods. Observational retrospective study performed in a general hospital with 1300 beds. We have analysed all EVIG prescriptions during 01-01/31-12-2003. Data source: clinical reports, registries from Pharmacy Department, special application form for drugs and the compassionate use request made to Spanish Department of Health. Variables: age, gender, weight, diagnosis/indication, dosage regimes, immediate complications, Department prescript and number of administrations. The indications of EVIG are classified in: A, authorized by the Spanish Association of Drugs (SAD). B, non authorized by SAD but scientific endorsed in specific situations. C, no recognized by SAD, its use is doubtful. D, inadequate. Results. Total number of patients receiving EVIG for first time: 49 (M: 29; F: 20), 11 children (1 day– 16 years) and 38 adults (25–80). Total number of doses: 261. In 9 cases the therapy continued in 2004 and 8 patients died by complications of their disease. The authorized indications were 37 (75,5%), non authorized 5 (10,2%) and non recognized 7 (14,3%). 12 cases needed compassionate prescription but only one was filled up. Indications: Idiopatic Thrombocytopenia Purpura: 17 (34,7%), Guillain-Barré: 6 (12,2%), post-Bone Marrow Trasplantation: 5 (10,2%), immunodeficiency associated to Chronic Lymphoid Leukaemia-B: 3 (6,1%), Evans Syndrome 1, common variable immunodeficiency 1, Autoimmune Haemolytic Anaemia 1. Prescriptor Haematology Department 28 (55,1%), Neurology 12 (24,5%), Pediatry 9 (16,5%), y Internal Medicine 1. Adhesion to authorized indications: 92.6% Haematology, 50% Neurology and 66.6% Pediatry. The doses fit in with the recommendations (0,4 g/kg) in 44 patients (89.8%), 3 cases under-dose (6.1%) and 2 overdose (4.1%). The infusion line was not like the recommendations in 3 cases (6,1%) and in 2 (4,1%) was modified because of pressure of patients. The application form was not filled in properly in 23 cases (46.9%). 8 patients developed some type of adverse effect associate to the infusion of EVIG in the first 24 hours. Conclusions: Rate of adequacy to authorized indications was high and the procedure of the compassionate use in the rest indications was low. The dose and infusion line were fitted in with the recommendations in most of patients. Proposals to improve: a) Protocol review, elaboration and diffusion of guidelines about EVIG indications. B) To update the application form, including authorized indications, planning of different steps, dosage of EVIG and administration rules guideline C) To elaborate and provide to the patients an informative guide about EVIG characteristics, indications and adverse effects.</jats:p