Modelo de negocio para el desarrollo de un servicio automotriz móvil

Tesis (Ingeniero Civil Industrial)Se ha desarrollado un modelo de negocio que contempla un estudio de mercado, técnico y económico-financiero para la creación de un servicio automotriz móvil enfocado en la provincia de Concepción, determinando el interés de mercado, localización, tamaño y distribución del proyecto y la comprobación de la viabilidad y rentabilidad del mismo. El taller móvil estará debidamente equipado para la prestación de servicios de mantenimiento preventivo y correctivo a vehículos livianos, del tipo: automóvil, camioneta, furgón y jeep, categorizando cada uno de ellos en las tres procedencias de fabricación: Coreana, Europea y Japonesa con mayor participación en las comunas: Concepción, San Pedro, Hualpen, Talcahuano, Chiguayante. El servicio se ejercerá a vehículos con no más de 6 años de antigüedad (hasta el año 2008) empleando maquinaria especializada, facilitando la prestación de todos los servicios automotrices satisfaciendo necesidades de calidad y comodidad, favoreciéndose de la flexibilidad del servicio. El estudio financiero arrojo indicadores como el VAN en $697.189 y la TIR en el 20recuperación en años, demostraron la factibilidad y viabilidad del presente proyecto, percibiéndose utilidades al segundo año. Con la creación del taller de servicios automotrices se procura generar empleos y sobre todo la inyección de capital en la ciudad.It was developed a business model that consider studies of market, technical and financial-economical to the creation of and movable automotive service focused in Concepción province, determining a market interesting, localization, size and distribution of the project and the checking of viability and profitability. The movable repair shop will be equipped for the execution of the services of precautionary and corrective maintenance to light vehicles of kinds: car, pickup truck, van and jeep, categorizing each of them in the three precedencies of fabrication: Korean, European and Japanese with more participation at the communes: Concepción, San Pedro, Hualpen, Talcahuano and Chiguayante. The service will be execute to vehicles with no more of 6 years of antiquity (until 2008), using specializing machinery, to ease the execute of all the automotive services, satisfying needs of quality and comfortability, favoring of the flexibility of the service. The financial study will concede indicator as NPV$697.189 and IRR 20%; additionally the economic indicators stabilized by recovery period in years, shows the profitability and viability of the project, perceive profits since the second year. With the creation of the automotive service repair shop it is expected to generate jobs and stock-in-trade at the city

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Correction: Antimicrobial management of Tropheryma whipplei endocarditis: the Spanish Collaboration on Endocarditis (GAMES) experience

Erratum.-- Spanish Collaboration on Endocarditis-Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España (GAMES).[Objectives] Tropheryma whipplei has been detected in 3.5% of the blood culture-negative cases of endocarditis in Spain. Experience in the management of T. whipplei endocarditis is limited. Here we report the long-term outcome of the treatment of previously reported patients who were diagnosed with infective endocarditis (IE) caused by T. whipplei from the Spanish Collaboration on Endocarditis-Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España (GAMES) and discuss potential options for antimicrobial therapy for IE caused by T. whipplei.[Patients and methods] Seventeen patients with T. whipplei endocarditis were recruited between 2008 and 2014 in 25 Spanish hospitals. Patients were classified according to the therapeutic regimen: ceftriaxone and trimethoprim/sulfamethoxazole, doxycycline + hydroxychloroquine and other treatment options.[Results] Follow-up data were obtained from 14 patients. The median follow-up was 46.5 months. All patients completed the antibiotic treatment prescribed, with a median duration of 13 months. Six patients were treated with ceftriaxone and trimethoprim/sulfamethoxazole (median duration 13 months), four with doxycycline + hydroxychloroquine (median duration 13.8 months) and four with other treatment options (median duration 22.3 months). The follow-up after the end of the treatments was between 5 and 84 months (median 24 months).[Conclusions] All treatment lines were effective and well tolerated. Therapeutic failures were not detected during the treatment. None of the patients died or experienced a relapse during the follow-up. Only six patients received antibiotic treatment in accordance with guidelines. These data suggest that shorter antimicrobial treatments could be effective.Peer reviewe

Antimicrobial management of Tropheryma whipplei endocarditis: the Spanish Collaboration on Endocarditis (GAMES) experience

Spanish Collaboration on Endocarditis-Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España (GAMES)[Objectives] Tropheryma whipplei has been detected in 3.5% of the blood culture-negative cases of endocarditis in Spain. Experience in the management of T. whipplei endocarditis is limited. Here we report the long-term outcome of the treatment of previously reported patients who were diagnosed with infective endocarditis (IE) caused by T. whipplei from the Spanish Collaboration on Endocarditis-Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España (GAMES) and discuss potential options for antimicrobial therapy for IE caused by T. whipplei.[Patients and methods] Seventeen patients with T. whipplei endocarditis were recruited between 2008 and 2014 in 25 Spanish hospitals. Patients were classified according to the therapeutic regimen: ceftriaxone and trimethoprim/sulfamethoxazole, doxycycline + hydroxychloroquine and other treatment options.[Results] Follow-up data were obtained from 14 patients. The median follow-up was 46.5 months. All patients completed the antibiotic treatment prescribed, with a median duration of 13 months. Six patients were treated with ceftriaxone and trimethoprim/sulfamethoxazole (median duration 13 months), four with doxycycline + hydroxychloroquine (median duration 13.8 months) and four with other treatment options (median duration 22.3 months). The follow-up after the end of the treatments was between 5 and 84 months (median 24 months).[Conclusions] All treatment lines were effective and well tolerated. Therapeutic failures were not detected during the treatment. None of the patients died or experienced a relapse during the follow-up. Only six patients received antibiotic treatment in accordance with guidelines. These data suggest that shorter antimicrobial treatments could be effective.Peer reviewe

Additional file 1 of Statistical analysis plan for the multicenter, open, randomized controlled clinical trial to assess the efficacy and safety of intravenous tirofiban vs aspirin in acute ischemic stroke due to tandem lesion, undergoing recanalization therapy by endovascular treatment (ATILA trial)

Additional file 1: Supplementary Material 1. Minor Revision. Supplementary Material 2. DSMB. Supplementary Material 3. Full protocol