Factores asociados al éxito de una empresa seguidora dentro del mercado ecuatoriano de medicina veterinaria : estudio del caso CCLabs

La industria de medicina veterinaria en Ecuador ha crecido un 37 por ciento en los últimos 5 años, participando de la misma, laboratorios líderes y empresas seguidoras. El siguiente trabajo tiene como objetivo principal identificar los factores que inciden en el éxito de empresas seguidoras en el mercado de medicina veterinaria, a partir del estudio de caso CCLabs. Se basa en el marco teórico propuesto por Joskow, quien plantea que el abordaje de la nueva economía institucional se realiza a través de la vía del entorno institucional, la vía de la moderna organización industrial y por último la vía de las estructuras de gobernancia. La empresa CCLabs ha tenido un crecimiento superior al promedio del mercado, lo que ha sido posible dada la combinación de una serie de factores relacionados a la evolución del sector en que la empresa se desenvuelve y a la estrategia de la empresa. Con respecto al sector estos son: el crecimiento del mercado con un nivel de rivalidad moderado, así como el hecho de que las patentes de los productos de empresas líderes en I+D+i están vencidas y el creciente enforcement del marco regulatorio disminuyendo la competencia desleal. La empresa desarrolla distintas estrategias y desarrollo de canales comerciales que permiten reducir los costos de transacción

Helminth parasites in feces of Antillean manatees Trichechus manatus manatus (Sirenia:Trichechidae) in Mexico: Gulf of Mexico and Caribbean

Background. Low helminth diversity has been reported in West Indian manatees (Trichechus manatus ). Most studies were conducted on the Florida sub species T. m. latirostris in subtropical environments, therefore limited information is available for the tropical Antillean subspecies T. m. manatus. In Mexico, there are apparently two population units of T. m. manatus. Goals. The objective of this study was to survey the presence and prevalence of helminth parasite eggs in the feces of T. m. manatus from the Gulf of Mexico (GM) and Caribbean coasts (CAR) of Mexico. Methods. We used 31 fecal samples collected from GM (n = 22) and CAR (n = 9), from 2005 to 2008. Feces were fixed and preserved in 70% ethanol until analysis. Both floatation and sedimentation techniques were used. Helminth eggs were identified using specialized literature and graphic catalogs. Results. We found parasite eggs in 61.2% of feces; all samples from CAR had helminths. We documented eggs from five helminths: three digenetic (Chiorchis fabaceus, C. groschafti, and Pulmonicola cochleotrema) and two Nematoda (Heterocheilus tunicatus and Ascarididae gen. sp.). Two species were found exclusively from GM, one exclusively from CAR, and two species were common to both locales. Conclusions. Diversity was consistently low in the samples. Four of the species found are common to Florida and Caribbean islands and one is a new registry for this host. Future examination of manatee carcasses could confirm the presence of adult helminth species for new registries for this host.Background. Low helminth diversity has been reported in West Indian manatees (Trichechus manatus ). Most studies were conducted on the Florida sub species T. m. latirostris in subtropical environments, therefore limited information is available for the tropical Antillean subspecies T. m. manatus. In Mexico, there are apparently two population units of T. m. manatus. Goals. The objective of this study was to survey the presence and prevalence of helminth parasite eggs in the feces of T. m. manatus from the Gulf of Mexico (GM) and Caribbean coasts (CAR) of Mexico. Methods. We used 31 fecal samples collected from GM (n = 22) and CAR (n = 9), from 2005 to 2008. Feces were fixed and preserved in 70% ethanol until analysis. Both floatation and sedimentation techniques were used. Helminth eggs were identified using specialized literature and graphic catalogs. Results. We found parasite eggs in 61.2% of feces; all samples from CAR had helminths. We documented eggs from five helminths: three digenetic (Chiorchis fabaceus, C. groschafti, and Pulmonicola cochleotrema) and two Nematoda (Heterocheilus tunicatus and Ascarididae gen. sp.). Two species were found exclusively from GM, one exclusively from CAR, and two species were common to both locales. Conclusions. Diversity was consistently low in the samples. Four of the species found are common to Florida and Caribbean islands and one is a new registry for this host. Future examination of manatee carcasses could confirm the presence of adult helminth species for new registries for this host

Implementation of a green chemistry practice for the teaching of spectrophotometry

In the laboratory of Instrumental Analysis the topics of quantification of analytes by colorimetry are addressed, this practice was initially performed using potassium dichromate as a chemical reagent that is toxic and causes damage to the environment. Based on the objective of the practice (to facilitate the teaching of colorimetry) and to reduce the negative impact on the environment and the health of students, an alternative practice was designed that uses a red plant dye to replace the potassium dichromate; the dye is a low-cost and relatively harmless compound for both health and the environment. The practice was carried out with ten student volunteers, who worked individually, from the powder dye prepared a solution and then a series of dilutions to determine the concentration of a test sample. The experience could be carried out individually in work teams and the concentration of a problem sample provided could be determined. The implemented practice is a green alternative for teaching colorimetry in university students

Propuesta de Supply Chain Management y Logística para la empresa Cementos Argos

"Anexo A Señalización de plano de Layout propuesto (Capítulo 6), Anexo B Lista de chequeo para la cadena de abastecimiento (Capitulo 8)Por medio del desarrollo del presente trabajo se logra identificar el papel que cumple el Supply Chain Management y Logística, desde los fundamentos teóricos y objetivos se puede proponer una nueva implementación en sus procesos actuales, con el fin de mejorar en rendimiento, competitividad, calidad, y satisfacción de sus clientes; la función de sus operaciones. Se observo la conformación estructural de la empresa, identificando las diferentes áreas de trabajo, y el rol que cumple cada una en el proceso de cadena de suministro desde el momento de la adquisición de la materia prima, hasta el momento de entrega del producto final a los clientes. De igual forma se logra realizar un análisis más profundo con relación a la posición que tiene Colombia con respecto en la logística informada por el Banco Mundial, ya para finalizar se efectuó un análisis basado en el plano Layout que cuenta la empresa Cementos Argos en la actualidad, identificando sus puntos críticos y que podrían generar una mejora en el proceso de distribución.Por medio del desarrollo del presente trabajo se logra identificar el papel que cumple el Supply Chain Management y Logística, desde los fundamentos teóricos y objetivos se puede proponer una nueva implementación en sus procesos actuales, con el fin de mejorar en rendimiento, competitividad, calidad, y satisfacción de sus clientes; la función de sus operaciones. Se observo la conformación estructural de la empresa, identificando las diferentes áreas de trabajo, y el rol que cumple cada una en el proceso de cadena de suministro desde el momento de la adquisición de la materia prima, hasta el momento de entrega del producto final a los clientes. De igual forma se logra realizar un análisis más profundo con relación a la posición que tiene Colombia con respecto en la logística informada por el Banco Mundial, ya para finalizar se efectuó un análisis basado en el plano Layout que cuenta la empresa Cementos Argos en la actualidad, identificando sus puntos críticos y que podrían generar una mejora en el proceso de distribución

Effectiveness of Modified Vaccinia Ankara-Bavaria Nordic Vaccination in a Population at High Risk of Mpox: A Spanish Cohort Study

Background: With over 7,500 cases notified since April 2022, Spain has experienced the highest incidence of mpox in Europe. From July 12th onwards, the Modified Vaccinia Ankara-Bavaria Nordic (MVA-BN) smallpox vaccine was offered as pre-exposure prophylaxis for individuals at high-risk of mpox, including those receiving pre-exposure prophylaxis for HIV (HIV-PrEP). Our aim was to assess the effectiveness of one dose of MVA-BN vaccine as pre-exposure against mpox virus (MPXV) infection in persons on HIV-PrEP. Methods: We conducted a national retrospective cohort study between July 12 and December 12, 2022. Individuals ≥18 years, receiving HIV-PrEP as of July 12 and with no previous MPXV infection or vaccination were eligible. Each day, we matched individuals receiving a first dose of MVA-BN vaccine and unvaccinated controls of the same age group and region. We used a Kaplan-Meier estimator and calculate risk ratios (RR) and vaccine effectiveness (VE = 1-RR). Results: We included 5,660 matched pairs, with a median follow-up of 62 days (interquartile range 24-97). Mpox cumulative incidence was 5.6 per 1,000 (25 cases) in unvaccinated and 3.5 per 1,000 (18 cases) in vaccinated. No effect was found during days 0-6 post-vaccination (VE -38.3; 95% confidence interval (95%CI): -332.7; 46.4), but VE was 65% in ≥7 days (95%CI 22.9; 88.0) and 79% in ≥14 days (95%CI 33.3; 100.0) post-vaccination. Conclusions: One dose of MVA-BN vaccine offered protection against mpox in a most-at-risk population shortly after the vaccination. Further studies need to assess the VE of a second dose and the duration of protection over time.S

Immigrant IBD Patients in Spain Are Younger, Have More Extraintestinal Manifestations and Use More Biologics Than Native Patients

BackgroundPrevious studies comparing immigrant ethnic groups and native patients with IBD have yielded clinical and phenotypic differences. To date, no study has focused on the immigrant IBD population in Spain. MethodsProspective, observational, multicenter study comparing cohorts of IBD patients from ENEIDA-registry who were born outside Spain with a cohort of native patients. ResultsWe included 13,524 patients (1,864 immigrant and 11,660 native). The immigrants were younger (45 +/- 12 vs. 54 +/- 16 years, p < 0.001), had been diagnosed younger (31 +/- 12 vs. 36 +/- 15 years, p < 0.001), and had a shorter disease duration (14 +/- 7 vs. 18 +/- 8 years, p < 0.001) than native patients. Family history of IBD (9 vs. 14%, p < 0.001) and smoking (30 vs. 40%, p < 0.001) were more frequent among native patients. The most prevalent ethnic groups among immigrants were Caucasian (41.5%), followed by Latin American (30.8%), Arab (18.3%), and Asian (6.7%). Extraintestinal manifestations, mainly musculoskeletal affections, were more frequent in immigrants (19 vs. 11%, p < 0.001). Use of biologics, mainly anti-TNF, was greater in immigrants (36 vs. 29%, p < 0.001). The risk of having extraintestinal manifestations [OR: 2.23 (1.92-2.58, p < 0.001)] and using biologics [OR: 1.13 (1.0-1.26, p = 0.042)] was independently associated with immigrant status in the multivariate analyses. ConclusionsCompared with native-born patients, first-generation-immigrant IBD patients in Spain were younger at disease onset and showed an increased risk of having extraintestinal manifestations and using biologics. Our study suggests a featured phenotype of immigrant IBD patients in Spain, and constitutes a new landmark in the epidemiological characterization of immigrant IBD populations in Southern Europe

Multicentre, randomised, single-blind, parallel group trial to compare the effectiveness of a Holter for Parkinson's symptoms against other clinical monitoring methods: study protocol

Introduction In recent years, multiple studies have aimed to develop and validate portable technological devices capable of monitoring the motor complications of Parkinson's disease patients (Parkinson's Holter). The effectiveness of these monitoring devices for improving clinical control is not known. Methods and analysis This is a single-blind, cluster-randomised controlled clinical trial. Neurologists from Spanish health centres will be randomly assigned to one of three study arms (1:1:1): (a) therapeutic adjustment using information from a Parkinson?s Holter that will be worn by their patients for 7 days, (b) therapeutic adjustment using information from a diary of motor fluctuations that will be completed by their patients for 7 days and (c) therapeutic adjustment using clinical information collected during consultation. It is expected that 162 consecutive patients will be included over a period of 6 months. The primary outcome is the efficiency of the Parkinson?s Holter compared with traditional clinical practice in terms of Off time reduction with respect to the baseline (recorded through a diary of motor fluctuations, which will be completed by all patients). As secondary outcomes, changes in variables related to other motor complications (dyskinesia and freezing of gait), quality of life, autonomy in activities of daily living, adherence to the monitoring system and number of doctor?patient contacts will be analysed. The noninferiority of the Parkinson's Holter against the diary of motor fluctuations in terms of Off time reduction will be studied as the exploratory objective. Ethics and dissemination approval for this study has been obtained from the Hospital Universitari de Bellvitge Ethics Committee. The results of this study will inform the practical utility of the objective information provided by a Parkinson's Holter and, therefore, the convenience of adopting this technology in clinical practice and in future clinical trials. We expect public dissemination of the results in 2022.Funding This work is supported by AbbVie S.L.U, the Instituto de Salud Carlos III [DTS17/00195] and the European Fund for Regional Development, 'A way to make Europe'

Rate and duration of hospitalisation for acute pulmonary embolism in the real-world clinical practice of different countries : Analysis from the RIETE registry

publishersversionPeer reviewe

Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio