Caracterización de las empresas “gacelas” aragonesas para el periodo 1998-2000

Durante los últimos años se han realizado estudios sobre un tipo de empresas caracterizadas por su competitividad y dinamismo, “las empresas gacela”. En este trabajo se analiza: primero, la importancia de este tipo de empresas en la comunidad autónoma de Aragón (España) durante el periodo 1998-2000. Después, se observan las diferencias en tamaño y recursos entre las gacelas y las compañías no gacela. Por último, se estudian las diferencias en productividad, eficiencia y rentabilidad. El análisis empírico ha sido realizado tomando datos de la cuenta de resultados y del balance de situación, los cuales están disponibles para cada empresa y cada año, obtenidos a partir de la base de datos SABI. Se comprueba cómo las empresas gacelas crecen en mayor proporción, son más jóvenes, más pequeñas, más eficientes en producción y más rentables que las compañías no gacelas.Of late years, there have been several studies concerning about a specific type of firms which are distinguished by their competitiveness and dynamism “The Gazelle Companies”. In this paper we analyse: First, the importance of this type of firms in the Spanish Autonomous Community of Aragón during the period 1998-2000. After that, we look at differences in size and resources between gazelle and non-gazelle companies. And at last, we look at differences in productive efficiency and profitability. The empirical analysis has been done using data taken from the income statement and balance sheet which are available for each firm and for each year from the Date’s Base SABI. We find that gazelle firms growth at a higher rate, are younger, smaller, more efficient in production and more profitable than non-gazelle firms

Luxación del núcleo de polietileno acetabular en prótesis total de cadera

El desmontaje del núcleo de polietileno en prótesis modulares de cadera es una complicación rara, generalmente atribuible a malposición de los implantes o accidentes sobre la cadera proteizada. Se presenta un caso en el que se produjo este accidente sobre implantes bien orientados, atribuible a un intento excesivo de recuperar movilidad sobre una cadera previamente rígida y con retracción residual de partes blandas.Disassembly of polythylene cup in modula hip prostheses is an uncommon complication usually due to malposition of the implants, or accidents on the prosthetic hip. We report a case showing this complication, having the implants in correct position. The cause of dislocation was thrught to be a stressing passive mobilization on a hip with residual retrated soft tissues

Osteotomía valguizante de tibia con placa atornillada de angulación variable (VCO)

Se presenta un análisis retrospectivo de 28 pacientes afectos de genu varo, en quienes se realizó osteotomía valguizante de tibia y fijación con placa atornillada de angulación variable. Este material proporciona la corrección deseada y un montaje estable y sólido capaz de permitir la movilidad precoz de la rodilla. El seguimiento medio fue de 15 meses, valorándose los plazos de recuperación funcional de los pacientes, movilidad conseguida y las necesidades de rehabilitación. Los resultados clínicos y radiológicos a corto plazo son semejantes a otras series que emplean criterios de selección de pacientes candidatos a esta técnica. Las necesidades de tratamiento rehabilitador fueron sensiblemente menores.We report a retrospective analysis of 28 patients presenting varus deformity treated by proximal tibial opening-wedge osteotomy and using a screwed plate of variable angle. This device provides the desired correction, a steady and secure assembly allowing early knee movement. The average follow-up was 15 months. At that time, the period of functional recovery, mobility and need of functional rehabilitation were assessed. Short-term clinical and radiographic findings were similar to other series using selection criteria for suitable patients. The need of functional rehabilitation was markedly lower

pretreatment with the monoacylglycerol lipase inhibitor urb602 protects from the long term consequences of neonatal hypoxic ischemic brain injury in rats

Pretreatment with the monoacylglycerol lipase inhibitor URB602 protects from the long-term consequences of neonatal hypoxic–ischemic brain injury in rat

First -decay spectroscopy of and new -decay branches of

19 pags., 14 figs., 3 tabs.The  decay of the neutron-rich and was investigated experimentally in order to provide new insights into the nuclear structure of the tin isotopes with magic proton number above the shell. The -delayed -ray spectroscopy measurement was performed at the ISOLDE facility at CERN, where indium isotopes were selectively laser-ionized and on-line mass separated. Three -decay branches of were established, two of which were observed for the first time. Population of neutron-unbound states decaying via rays was identified in the two daughter nuclei of and , at excitation energies exceeding the neutron separation energy by 1 MeV. The -delayed one- and two-neutron emission branching ratios of were determined and compared with theoretical calculations. The -delayed one-neutron decay was observed to be dominant -decay branch of even though the Gamow-Teller resonance is located substantially above the two-neutron separation energy of . Transitions following the  decay of are reported for the first time, including rays tentatively attributed to . In total, six new levels were identified in on the basis of the coincidences observed in the and decays. A transition that might be a candidate for deexciting the missing neutron single-particle state in was observed in both  decays and its assignment is discussed. Experimental level schemes of and are compared with shell-model predictions. Using the fast timing technique, half-lives of the , and levels in were determined. From the lifetime of the state measured for the first time, an unexpectedly large transition strength was deduced, which is not reproduced by the shell-model calculations.M.P.-S. acknowledges the funding support from the Polish National Science Center under Grants No. 2019/33/N/ST2/03023 and No. 2020/36/T/ST2/00547 (Doctoral scholarship ETIUDA). J.B. acknowledges support from the Universidad Complutense de Madrid under the Predoctoral Grant No. CT27/16- CT28/16. This work was partially funded by the Polish National Science Center under Grants No. 2020/39/B/ST2/02346, No. 2015/18/E/ST2/00217, and No. 2015/18/M/ST2/00523, by the Spanish government via Projects No. FPA2017-87568-P, No. RTI2018-098868-B-I00, No. PID2019-104390GB-I00, and No. PID2019-104714GB-C21, by the U.K. Science and Technology Facilities Council (STFC), the German BMBF under Contract No. 05P18PKCIA, by the Portuguese FCT under the Projects No. CERN/FIS-PAR/0005/2017, and No. CERN/FIS-TEC/0003/2019, and by the Romanian IFA Grant CERN/ISOLDE. The research leading to these results has received funding from the European Union’s Horizon 2020 research and innovation programme under Grant Agreement No. 654002. M.Str. acknowledges the funding from the European Union’s Horizon 2020 research and innovation program under Grant Agreement No. 771036 (ERC CoG MAIDEN). J.P. acknowledges support from the Academy of Finland (Finland) with Grant No. 307685. Work at the University of York was supported under STFC Grants No. ST/L005727/1 and No. ST/P003885/1

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Metástasis cardíacas de melanoma maligno manifestadas en forma de enfermedad del nodo sinusal

Describimos el caso de un paciente con metástasis diseminadas por melanoma maligno manifestadas en forma de taquiarritmias y bradiarritmias sintomáticas similares a las halladas en la enfermedad del nodo sinusal. El estudio necrópsico mostró una extensa invasión nodular de la aurícula derech