MYV is a projected consulting organization, which has not been able to standardize the results of its executed projects. This document has identified the current status, determining positive aspects and improving the management of projects. To implement a project management office PMO is a recently worldwide practice; generating competitive advantages. The life cycle and the management of projects and portfolio were studied. The research carried out is of mixed type, with quantitative and qualitative tools, types of study descriptive and correlational, to develop the diagnosis of the current state to propose the appropriate PMO. Data was collected to determine the management status of portfolio, organizational culture, effectiveness, practices and maturity of project management. The results obtained were statistically assessed, obtaining interesting effects and great opportunities for improvement. Likewise, it was determined that the maturity in the project management has a basic knowledge degree, with advances in own methodology and continuous improvement, which must be complemented, with a promising future in development to continue with the process followed. Based on the foregoing, the implementation of a strategic PMO proposed, whose degree of maturity is reached within a maximum period of two years, with a strategic map of the PMO and a proposal for modification of the organizational structure and PMO, as well as the implementation plan in times, metrics, risks and associated costs. It is concluded that the research work carried out answers the questions posed and projects an PMO adjusted to the organizational culture found.

MYV es una organización de consultoría proyectizada que no ha logrado estandarizar los resultados de sus proyectos ejecutados. Este estudio ha identificado el estado actual, determinando aspectos positivos y por mejorar. Implementar una Oficina de Gestión de Proyectos OGP es una práctica común a nivel mundial recientemente, generando ventajas competitivas. Se estudia el ciclo de vida y gestión de proyectos y portafolio, diferentes modelos de buenas prácticas, tipos y clasificaciones de OGP, la cultura organizacional es factor crítico de éxito. El estudio es de tipo mixto, con herramientas cuantitativas y cualitativas, tipos de estudio descriptivo y correlacional, para el diagnóstico del estado actual y plantear la propuesta de OGP adecuada. Se recolectaron datos para determinar el estado de gestión del portafolio, cultura organizacional, efectividad, prácticas y madurez de la gestión de proyectos. Los resultados fueron valorados estadísticamente obteniendo efectos interesantes y grandes oportunidades de mejora, alta correlación entre las variables; igualmente, se determinó que la madurez en la gestión tiene grado de conocimiento básico, con avances en metodología propia y mejora continua, que deben ser complementados, con futuro prometedor en desarrollo, de continuar con el proceso hasta ahora seguido. Como resultado se plantea la implementación de OGP estratégica, cuyo grado de madurez se logre en un plazo máximo de dos años, planteando mapa estratégico de OGP y propuesta de modificación de la estructura organizacional y de la OGP, así como el plan de implementación en tiempos, métricas, riesgos y costos asociados. Se responde las preguntas planteadas y proyecta una OGP ajustada a la cultura organizacional encontrada.

Abstract Background: The state of Chiapas has held the first place of extreme poverty in Mexico. The majority of Chiapas’ municipalities are inhabited by marginalized, indigenous populations, who usually present diarrhea of unknown etiology. We evaluated the nutritional status, intestinal parasites, and common bacterial pathogens, including DEC (diarrheagenic Escherichia coli) strains, in 178 children under five years of age with a high (rural) and a moderate (urban) degree of marginalization. Methods: Z-scores for anthropometric indexes from the children were obtained, whereas intestinal parasites were investigated by using a direct coproparasitoscopic analysis and a concentration method. DEC strains were detected by polymerase chain reaction (PCR). Results: The stunting prevalence in children from the rural and urban regions was 79.8 and 7.5%, respectively. Only children from rural municipalities were parasitized (72.6%), being Ascaris lumbricoides and Entamoeba histolytica/Entamoeba dispar the most prevalent parasites (57.1 and 38.1%, respectively). More than half of the children presented moderated ascariasis. Besides Giardia intestinalis, these parasites were associated with stunting. The prevalence of DEC strains was similar in both regions. Conclusions: Only children from the Chiapas Highlands (rural zone) exhibited high prevalences of stunting and intestinal parasites. A reevaluation of social development programs should be in place to address stunting and intestinal parasitoses, mainly in rural regions of Chiapas, to avoid adverse functional consequences on these children.

Resumen Introducción: El estado de Chiapas ha ostentado el primer lugar de pobreza extrema en México. La mayor parte de la población de los municipios de Chiapas es indígena, vive en condiciones de marginación y padece de diarrea de etiología desconocida. Este trabajo evaluó el estado nutricional, la presencia de parásitos intestinales y patógenos bacterianos comunes, además de cepas DEC (Escherichia coli diarreogénica) en 178 niños menores de cinco años, provenientes de una localidad con alto grado de marginación (rural) y de una con moderada marginación (urbana). Métodos: Se obtuvieron los puntajes Z de los índices antropométricos de los niños. Los parásitos intestinales se investigaron con el método coproparasitoscópico directo y un método de concentración. Las cepas DEC se detectaron mediante reacción en cadena de la polimerasa. Resultados: La prevalencia de desmedro en niños de la zona rural y urbana fue de 79.8 y 7.5%, respectivamente. Únicamente los niños de la zona rural estuvieron parasitados (72.6%), y los más prevalentes fueron Ascaris lumbricoides y Entamoeba histolytica/Entamoeba dispar (57.1 y 38.1%, respectivamente). Más de la mitad de los infantes exhibieron ascariasis moderada. Estos parásitos, además de Giardia intestinalis, se asociaron con el desmedro. En ambas regiones, la prevalencia de DEC fue similar. Conclusiones: Solo los niños de los Altos de Chiapas (zona rural) exhibieron alta prevalencia de desmedro y parásitos intestinales. Para evitar las consecuencias adversas entre los infantes, es necesario reevaluar los programas de desarrollo social para combatir el desmedro y la parasitosis intestinal, principalmente en las regiones rurales de Chiapas.

RESUMO Após validação de dois diferentes métodos de mensuração de pressão arterial sistólica (PAS) não invasivos ou indiretos (oscilométrico e Doppler vascular) com o invasivo ou direto (cateterização arterial - padrão ouro) em 12 gatos hígidos anestesiados de mesma faixa etária, os métodos não invasivos foram avaliados e comparados em 24 gatos hígidos e conscientes, divididos em quatro grupos de idade. Em cada animal, procedeu-se à mensuração da pressão pelos métodos Doppler e oscilométrico. O método oscilométrico foi o primeiro a ser realizado, e, logo em seguida, o método Doppler. Os valores considerados foram obtidos das médias de sete medidas consecutivas para cada método, com intervalo de 30 segundos entre elas. A primeira medida e as medidas discrepantes (variação ˃ 20% PAS), obtidas com sinais óbvios de estresse e/ou com movimentação do animal, foram descartadas. Os métodos de mensuração oscilométrico e Doppler, embora tenham apresentado médias estatisticamente diferentes em todos os grupos, quando comparados em cada grupo, apresentaram uma correlação significativa, alta e positiva. Ou seja, sempre que for obtido um valor elevado por um método, o mesmo fato ocorrerá com o outro método e vice-versa. Clinicamente, a diferença observada não é relevante, uma vez que a diferença média dos valores obtida pelos dois métodos, em cada grupo, foi menor que 1,1%.

ABSTRACT After two different validation systolic blood pressure measurement methods (PAS), not invasive or indirect (oscillometric and doppler vascular) with invasive or direct (arterial catheterization - Gold Standard) in 12 anesthetized healthy cats of the same age group, not invasive methods were evaluated and compared in 24 healthy conscious cats, divided into four age groups. In each animal, we proceeded to measure the pressure by Doppler and oscillometric methods. The oscillometric method was the first to be performed, and, shortly thereafter, the doppler method. The values considered were obtained from averages from seven consecutive measurements for each method with an interval of thirty seconds between them. The first measurement and disparate measurements (range ˃ 20% PAS) obtained with obvious signs of stress and / or animal movement were discarded. Methods of oscillometric and doppler measurement, although statistically different averages were shown in all groups when compared, each group showed a significant high positive correlation, meaning that when a high value is obtained by a method, the same occurs with the other method, and vice versa. Clinically, the observed difference is not relevant since the mean difference values obtained by the two methods, in each group was lower than 1.1%.

Cetengraulis edentulus is a broadely distributed engraulid in Southwest Atlantic, currently accounting for the main fish species commercially exploited at Guanabara Bay, Brazil. This study aimed to extend the knowledge on reproduction of C. edentulus at Guanabara Bay and to test whether some descriptors of reproductive activity, especially the gonadosomatic index (GSI), and the index of reproductive activity (IRA) changed among seasons. A total of 978 C. edentulus specimens were retrieved from purse seine commercial landings at Conservas Rubi S.A. company, in São Gonçalo city, RJ. Subsamples of 90-120 individuals were collected from bimonthly yields between July 2010 (winter) and June 2011 (autumn). Most fish were adults (120-170 mm TL), in response to the high selectivity of commercial fisheries. All descriptors indicated a broad spawning period (late winter to spring), peaking in November, suggesting this is the critical period to protect C. edentulus stocks from overfishing at Guanabara Bay. Fecundity averaged 12,720 oocytes and was positively related to fish size, GSI and fullness index, indicating that preserving larger individuals (TL > 160 mm) could contribute significantly to the reproductive success of C. edentulus, since they produce more oocytes. Cetengraulis edentulus é um engraulídeo amplamente distribuído no Atlântico Sudoeste, sendo um importante recurso comercialmente explorado na baía de Guanabara, Brasil. O presente estudo teve como objetivo ampliar o conhecimento sobre a reprodução de C. edentulus na baía de Guanabara e testar quais descritores da atividade reprodutiva, especialmente o índice gonadossomático (IGS) e o índice de atividade reprodutiva (IAR) se modificaram ao longo das estações do ano. Um total de 978 indivíduos de C. edentulus foram capturados pelo método de rede de cerco da frota comercial no cais da empresa Conservas Rubi S.A., na cidade de São Gonçalo, RJ. Subamostras de 90-120 indivíduos de C. edentulus foram coletados bimestralmente durante o período de julho de 2010 (inverno) e junho de 2011 (outono). A maioria dos indivíduos foram adultos (120-170 mm CT), em resposta a alta seletividade das capturas comerciais. Todos os índices indicaram um amplo período reprodutivo (final do inverno e primavera), com pico em novembro, sugerindo que este seria um período crítico para preservar os estoques de C. edentulusda sobrepesca na baía de Guanabara. A fecundidade média foi de 12720 ovócitos e foi positivamente relacionada com tamanho do peixe, IGS e índice de repleção, indicando que preservar maiores indivíduos (CT > 160 mm) poderia contribuir significativamente para o sucesso reprodutivo de C. edentulusna área, visto que esses indivíduos produzem um maior número de ovócitos.

The BIOMA research group (Biocontrol and environmental microbiology) has an industrial liquid formulation based on Purpureocillium sp. (UdeA 0109 strain), developed with the collaboration of Laverlam S.A, a Colombian (Cali) commercial house. In the present study the researchers tested the viability and the purity at different storage temperatures as well as its biological potential both in vitro and under greenhouse conditions. The results of viability showed how the infective structures were affected neither by the evaluation time nor by the storage temperatures. Studies also showed that the purity of the bioformulation in the same conditions was over 99 %, and its pathogenicity in vitro with an LC50 of 104 conidia/mL was corroborated. The greenhouse tests showed the ability to produce damages in eggs of the Meloidogyne incognita-javanica complex, and a decreasing of the J2 stages at a concentration of 108 conidia/mL in three tests performed with a different number of applications and at different times each.

El Grupo de Biocontrol y Microbiología Ambiental (BIOMA) cuenta con una formulación industrial líquida del hongo Purpureocillium sp. (cepa UdeA 0109), desarrollada de conjunto con la casa comercial Laverlam S.A. (Cali, Colombia). En la presente investigación se evaluaron la viabilidad y la pureza del producto a diferentes temperaturas de almacenamiento, así como el potencial biocontrolador in vitro y en condiciones de invernadero. Los resultados de viabilidad mostraron cómo las estructuras infectivas no se afectaron por los tiempos de evaluación ni por las temperaturas de almacenamiento. Los estudios también mostraron cómo la pureza del bioformulado bajo las mismas condiciones, se mantuvo por encima del 99 %, y además se corroboró su patogenicidad in vitro con una CL50 de 104 conidias/mL. Las evaluaciones en invernadero demostraron la propiedad de afectación de los huevos del complejo Meloidogyne incognita-javanica así como la disminución de los estadios jóvenes con una concentración de 108 conidias/mL en tres pruebas, con distintas aplicaciones y tiempos de aplicación.

Bulls in dairy production are usually slaughtered at an early age to avoid production problems and unnecessary costs. However, the animals could be a source of additional income and better quality meat. The objective of this work was to determine the characteristic and quantity of fatty acids of the Longissimus thoracis muscle of dairy bulls finished at pasture and in an intensive feeding system. Sixteen 14-mo old Holstein Friesian dairy bulls with initial live weights (LW) of 340 ± 20 kg were randomly assigned to bulls with daily pasture silage and kale (Brassica oleracea L.) supplements and 1.0% concentrate at pasture (T1) and bulls with pasture silage supplements and 2% concentrate in confinement (T2). No differences (P > 0.05) were found between treatments for dressing percentage, rib eye area, and fat cover when animals were slaughtered at 21-mo, with LW 550 kg. However, kidney fat for T1 and T2 of 4.44 and 2.61 kg an-1, respectively, were different (P < 0.05) as was pH, where T2 had a higher value (5.72) than T1 (5.46). Significant differences (P < 0.05) between treatments were found for all polyunsaturated fatty acids (PUFA), conjugated linoleic acid (CLA) c-9, t-11, C18:2 n-6 trans, C18:3 n-3, C22:5 n-3, C22:6 n-3, with higher levels for T1. Beef from the forage-fed bulls (T1) had an n-6: n-3 ratio below 4.0.

Objetivos: Determinar potenciales interacciones medicamentosas con antidepresivos y otros fármacos que pueden generar problemas relacionados con medicamentos mediante la búsqueda activa en bases de datos de pacientes afiliados al Sistema General de Seguridad Social en Salud. Métodos: Estudio descriptivo a partir de las bases de datos de dispensación de medicamentos de Audifarma S.A. a unos 4 millones de usuarios del pa ís; se hizo una revisión sistemática de potenciales interacciones de antidepresivos entre sí y con anticolinérgicos en los meses de octubre a noviembre y con tramadol durante todo el año 2010. Resultados: Se identificó un promedio mensual de 114.465 usuarios de antidepresivos. De estos, 5.776 (5,0 %) recibían dos antidepresivos simultáneamente y 178 (0,2 %), tres. La combinación más frecuente fue fluoxetina + trazodona (n = 3.235, el 56,9 % de los casos). A unos 1.127 (1,0 %) pacientes se les prescribió de manera simultánea un anticolinérgico. A 2.523 (2,1 %) usuarios se les dispensó al mismo tiempo tramadol, con lo que se elevaba el riesgo de aparición de síndrome serotoninérgico. Conclusiones: Las interacciones medicamentosas representan un riesgo potencial que muchas veces los médicos subestiman. La farmacovigilancia es una herramienta útil para optimizar recursos y prevenir resultados negativos relacionados con la medicación. Se recomienda considerar la búsqueda sistematizada para reforzar los programas de vigilancia de uso racional de medicamentos en el pa ís.

Objectives: To determine the possible drugs interactions with antidepressive agents in data bases of patients in the Health Insurance System of Colombia. Methods: From data bases of about 4 million users in Colombia, a systematic review of drugs dispensation statistics was made to identify drug interactions between antidepressive agents, cholinergic antagonists and tramadol in 2010. Results: We identified 114,465 monthly users of antidepressive agents. Of these, 5776 (5.0 %) received two, and 178 (0.2 %) received three antidepressive agents simultaneously. The most frequent combination was fluoxetine+trazodone (n =3235; 56.9 % of cases). About 1127 (1.0 %) patients were prescribed a cholinergic antagonist simultaneously; 2523 (2.1 %) users were dispensed tramadol at the same time, while raising the risk of serotonin syndrome. Conclusions: Drug interactions represent a potential risk that is often underestimated by physicians. Pharmacovigilance is a useful tool to optimize resources and prevent negative outcomes associated with medication. It is recommended that systematic search is made to enhance surveillance programs for the rational use of medicines in this country.

Background: Methadone programs have been organized in each Spanish region in a specific way. In spite of the regional interests to manage those programs in a more efficient way, so far the costs of the programs are unknown. As a previous step, it would be desirable to understand the activities related to these programs as well as their respective costs. This article aims to calculate the cost of the Methadone program in the autonomous community of La Rioja, and to understand those parameters which generate a greater cost to this programme. Methods: The study followed a similar structure as the research recently applied to the region of Murcia. The reference year for the study of the annual costs of the Methadone program was 2010. Data were obtained from different registries of several institutions involved in the regional program. Costs were classified according to different stages and dispensation centres which participated in this programme. Results: Data analysis, for a concentration of 2 mg/ml of methadone, showed an approximate annual cost of 165.759 €. Taking the total number of patients into consideration the individual cost was 412,34€. Conclusions: Dispensation is the stage which caused the largest cost to the programme, the highest per patient cost corresponded to the centre with less patients due to the fact that fixed costs are shared by a smaller group of persons; the biggest global cost of the programme came from Logroño's center but its average cost is lower.

Fundamento: Los programas de dispensación de metadona se han organizado en cada Comunidad Autónoma de una forma específica, desconociéndose sus costes derivados a pesar del interés que puede conllevar una gestión más eficiente. Nuestro estudio tiene por objetivo calcular los costes del programa de metadona en la Comunidad Autónoma de La Rioja. Métodos: El estudio se realizó en 2010. Los datos fueron recogidos a partir de los registros existentes en diferentes instituciones sanitarias, según las diferentes fases del programa. Los costes se clasificaron en función de las diferentes etapas y de los diferentes centros de dispensación. Resultados: El análisis de los datos muestra un coste total anual aproximado de 165.759 € para una concentración de 2 mg/ml de metadona, que significa un coste anual de 412,34 € por paciente. Conclusiones: La fase de dispensación de la metadona es la que mayor coste supone, el centro cuyos pacientes en términos relativos cuestan más al programa es el que cuenta con menor número de pacientes atendidos, debido a los costes fijos que han de repartirse entre menos personas, si bien el centro de Logroño tiene el mayor coste total por atender al mayor número de personas pero su coste medio por paciente es menor.

Background: Methadone programs have been organized in each Spanish region in a specific way. In spite of the regional interests to manage those programs in a more efficient way, so far the costs of the programs are unknown. As a previous step, it would be desirable to understand the activities related to these programs as well as their respective costs. This article aims to calculate the cost of the Methadone program in the autonomous community of La Rioja, and to understand those parameters which generate a greater cost to this programme. Methods: The study followed a similar structure as the research recently applied to the region of Murcia. The reference year for the study of the annual costs of the Methadone program was 2010. Data were obtained from different registries of several institutions involved in the regional program. Costs were classified according to different stages and dispensation centres which participated in this programme. Results: Data analysis, for a concentration of 2 mg/ml of methadone, showed an approximate annual cost of 165.759 €. Taking the total number of patients into consideration the individual cost was 412,34€. Conclusions: Dispensation is the stage which caused the largest cost to the programme, the highest per patient cost corresponded to the centre with less patients due to the fact that fixed costs are shared by a smaller group of persons; the biggest global cost of the programme came from Logroño's center but its average cost is lower.

Fundamento: Los programas de dispensación de metadona se han organizado en cada Comunidad Autónoma de una forma específica, desconociéndose sus costes derivados a pesar del interés que puede conllevar una gestión más eficiente. Nuestro estudio tiene por objetivo calcular los costes del programa de metadona en la Comunidad Autónoma de La Rioja. Métodos: El estudio se realizó en 2010. Los datos fueron recogidos a partir de los registros existentes en diferentes instituciones sanitarias, según las diferentes fases del programa. Los costes se clasificaron en función de las diferentes etapas y de los diferentes centros de dispensación. Resultados: El análisis de los datos muestra un coste total anual aproximado de 165.759 € para una concentración de 2 mg/ml de metadona, que significa un coste anual de 412,34 € por paciente. Conclusiones: La fase de dispensación de la metadona es la que mayor coste supone, el centro cuyos pacientes en términos relativos cuestan más al programa es el que cuenta con menor número de pacientes atendidos, debido a los costes fijos que han de repartirse entre menos personas, si bien el centro de Logroño tiene el mayor coste total por atender al mayor número de personas pero su coste medio por paciente es menor.

O cálculo de ordem fracionária (COF) lida com derivadas e integrais de ordem arbitrária (ou seja, não-inteiros) e tem as mesmas origens do clássico cálculo diferencial e integral. No entanto, até recentemente, tem sido investigado principalmente do ponto de vista matemático. Progressos nas áreas de fractais revelaram suas sutis relações com o cálculo fracionário. No entanto, o cálculo fracionário é geralmente excluído dos cursos tradicionais de Matemática, em parte porque muitos matemáticos não estão familiarizados com a sua natureza e suas aplicações. O cálculo fracionário tem se mostrado uma ferramenta útil entre os pesquisadores. Um dos objetivos deste trabalho é discutir a utilidade do cálculo fracionário nas ciências aplicadas e na engenharia. Além disso, outro propósito é incentivar o uso dessa idéia matemática como ferramenta para pesquisadores das mais diversas áreas por meio de uma apologia histórica envolvendo o desenvolvimento do cálculo fracionário.

Fractional order calculus (FOC) deals with integrals and derivatives of arbitrary (i.e., non-integer) order, and shares its origins with classical integral and differential calculus. However, until recently, it has been investigated mainly from a mathematical point of view. Advances in the field of fractals have revealed its subtle relationships with fractional calculus. Nonetheless, fractional calculus is generally excluded from standard courses in mathematics, partly because many mathematicians are unfamiliar with its nature and its applications. This area has emerged as a useful tool among researchers. One of the objectives of this paper is to discuss the usefulness of fractional calculus in applied sciences and engineering. In view of the increasing interest in the development of the new paradigm, another objective is to encourage the use of this mathematical idea in various scientific areas by means of a historical apologia for the development of fractional calculus.

Background: The use of continuous subcutaneous insulin infusion (CSII) for treating Type I diabetes mellitus (DM1) has been related to better metabolic control compared it to daily multiple insulin injections (DMI) and thus to a lowering of the related costs. However, this therapy is now being used to a lesser extent due, at least partially, to the higher initial cost of purchase. This study is aimed at estimating the clinical and economic consequences of using CSII as compared to DMI by means of a cost-utility analysis. Methods: A mathematical simulation model was adapted using nationwide clinical and economic data to simulate the long-term clinical and economic consequences for a DM1 patient. The time horizon was the patient's lifetime, including only direct healthcare costs and updating both costs and benefits at an annual 3% rate. Results: In the basecase, the patients treated using CSII gained 0.890 years (p<0.05) and 0.852 QALYs (p<0.05). CSII treatment gives rise to an incremental average cost of 25,523 € (p<0.05) per patient treated, which gave us an incremental cost- utility ratio of 29,947 €/QALY [CI 95% (29,519; 30,375)]. Conclusions: The improvement in the glucose control among those patients treated using CSII was related to an overall lower cost in the handling of DM1 patients, which was found to have a favourable cost-utility ratio in comparison to conventional MDI treatment.

Fundamento: El uso de bombas de infusión continua de insulina (BICI) para la diabetes mellitus tipo 1 (DM1) se ha relacionado con un mejor control metabólico al compararlo con las múltiples dosis de insulina (MDI). Este mejor control puede traducirse en una disminución de las complicaciones asociadas a la DM1 y por lo tanto una reducción de los costes asociados. Sin embargo el uso de esta terapia ha quedado mermado, al menos en parte, debido a su mayor coste inicial de adquisición. El objetivo del presente estudio fue estimar las consecuencias clínicas y económicas del uso de BICI frente a MDI a través de un análisis de coste-utilidad. Métodos: Se adaptó un modelo matemático de simulación que emplea datos clínicos y económicos de ámbito nacional, para simular las consecuencias clínicas y económicas a largo plazo de un paciente con DM1. El horizonte temporal fue el de toda la vida del paciente, incluyendo sólo costes directos sanitarios, y actualizando tanto costes como beneficios a una tasa del 3% anual. Resultados: En el caso base los pacientes tratados con BICI experimentaron una ganancia de vida de 0,890 años (p<0,05) y 0,852 AVACs (p<0,05). El tratamiento con BICI produce un coste medio incremental de 25.523 € (p<0,05) por paciente tratado, lo que nos condujo a un ratio coste- utilidad incremental de 29.947 €/AVAC [IC 95% (29.519, 30.375)]. Conclusiones: La mejora en el control glucémico en pacientes con BICI se asoció a una reducción del coste global del manejo de pacientes con DM1, y resultó tener una relación coste-utilidad favorable al compararla con el tratamiento convencional MDI.

Background: The use of continuous subcutaneous insulin infusion (CSII) for treating Type I diabetes mellitus (DM1) has been related to better metabolic control compared it to daily multiple insulin injections (DMI) and thus to a lowering of the related costs. However, this therapy is now being used to a lesser extent due, at least partially, to the higher initial cost of purchase. This study is aimed at estimating the clinical and economic consequences of using CSII as compared to DMI by means of a cost-utility analysis. Methods: A mathematical simulation model was adapted using nationwide clinical and economic data to simulate the long-term clinical and economic consequences for a DM1 patient. The time horizon was the patient's lifetime, including only direct healthcare costs and updating both costs and benefits at an annual 3% rate. Results: In the basecase, the patients treated using CSII gained 0.890 years (p<0.05) and 0.852 QALYs (p<0.05). CSII treatment gives rise to an incremental average cost of 25,523 € (p<0.05) per patient treated, which gave us an incremental cost- utility ratio of 29,947 €/QALY [CI 95% (29,519; 30,375)]. Conclusions: The improvement in the glucose control among those patients treated using CSII was related to an overall lower cost in the handling of DM1 patients, which was found to have a favourable cost-utility ratio in comparison to conventional MDI treatment.

Fundamento: El uso de bombas de infusión continua de insulina (BICI) para la diabetes mellitus tipo 1 (DM1) se ha relacionado con un mejor control metabólico al compararlo con las múltiples dosis de insulina (MDI). Este mejor control puede traducirse en una disminución de las complicaciones asociadas a la DM1 y por lo tanto una reducción de los costes asociados. Sin embargo el uso de esta terapia ha quedado mermado, al menos en parte, debido a su mayor coste inicial de adquisición. El objetivo del presente estudio fue estimar las consecuencias clínicas y económicas del uso de BICI frente a MDI a través de un análisis de coste-utilidad. Métodos: Se adaptó un modelo matemático de simulación que emplea datos clínicos y económicos de ámbito nacional, para simular las consecuencias clínicas y económicas a largo plazo de un paciente con DM1. El horizonte temporal fue el de toda la vida del paciente, incluyendo sólo costes directos sanitarios, y actualizando tanto costes como beneficios a una tasa del 3% anual. Resultados: En el caso base los pacientes tratados con BICI experimentaron una ganancia de vida de 0,890 años (p<0,05) y 0,852 AVACs (p<0,05). El tratamiento con BICI produce un coste medio incremental de 25.523 € (p<0,05) por paciente tratado, lo que nos condujo a un ratio coste- utilidad incremental de 29.947 €/AVAC [IC 95% (29.519, 30.375)]. Conclusiones: La mejora en el control glucémico en pacientes con BICI se asoció a una reducción del coste global del manejo de pacientes con DM1, y resultó tener una relación coste-utilidad favorable al compararla con el tratamiento convencional MDI.

The eelgrass Zostera marina L. is distributed along the Baja California Peninsula (Mexico) where it is exposed to a wide range of irradiances and temperatures that could promote changes in its biochemical composition. Consequently, the objective of this study was to characterize the variations in the levels of chlorophyll, carbohydrates, proteins, fiber, ash and calories in the shoots of Z. marina from the north (San Quintín) and south (Ojo de Liebre and San Ignacio lagoons) of the peninsula. Temperature in the southern lagoons was 5-6°C higher than in the northern lagoon; likewise, in situ irradiance was two-fold greater in the south than in the north. As a result of the lower irradiance levels, the concentration of chlorophyll in the shoots of Z. marina was twice as high (1.7 mg gWW-1) in the northern lagoon than in the southern ones (0.8 mg gWW-1). Similar to chlorophyll levels, the concentration of soluble carbohydrates in the shoots was greater in the northern lagoon than in the southern ones, suggesting that the high levels of chlorophyll are enough to compensate for the low irradiance levels and to maintain a positive carbon balance at San Quintín. On the other hand, the levels of proteins in the shoots from the north of the peninsula were slightly lower than those from the southern populations. In general, these results suggest that the different environmental conditions to which Z. marina is exposed along the peninsula impact its biochemical composition.

El pasto marino Zostera marina L. se distribuye a lo largo de la península de Baja California (México) y está expuesto a un amplio rango de irradiancias y temperaturas que podrían modificar su composición bioquímica. En consecuencia, el objetivo de este estudio fue el de caracterizar las variaciones en la concentración de clorofila, carbohidratos, proteínas, fibra, ceniza y calorías en los haces de Z. marina de poblaciones del norte (San Quintín) y el sur (Laguna Ojo de Liebre y Laguna San Ignacio) de Baja California, México. En las lagunas costeras del sur, la temperatura de la columna de agua fue aproximadamente 5-6°C más alta que en la laguna del norte de la península. Al igual que la temperatura, la irradiancia in situ fue dos veces mayor en las lagunas del sur que en la laguna del norte. Como resultado de los menores niveles de irradiancia, los niveles de clorofila en las hojas de Z. marina fueron aproximadamente dos veces mayores en las poblaciones del norte (1.7 mg gPH-1) que en las del sur (0.8 mg gPH-1) de Baja California. Al igual que la clorofila, los niveles de carbohidratos solubles en las hojas fueron mayores en las poblaciones del norte que en las del sur, lo cual sugiere que los altos niveles de clorofila son suficientes para compensar los bajos niveles de irradiancia en la laguna del norte, y mantener un balance de carbono positivo. Por el contrario, los niveles de proteínas en las hojas de Z. marina de la laguna costera del norte de la península fueron ligeramente menores que en las del sur. En general los resultados sugieren que las diferentes condiciones ambientales a las que están expuestas las poblaciones de Z. marina en Baja California impactan su composición bioquímica.