Tuberculosis in renal transplant patients: The experience of a single center in Medellín-Colombia, 2005-2013

Introduction: Tuberculosis is a common opportunistic infection in renal transplant patients. Objective: To obtain a clinical and laboratory description of transplant patients diagnosed with tuberculosis and their response to treatment during a period ranging from 2005 to 2013 at the Pablo Tobón Uribe Hospital. Methods: Retrospective and descriptive study. Results: In 641 renal transplants, tuberculosis was confirmed in 12 cases. Of these, 25% had a history of acute rejection, and 50% had creatinine levels greater than 1.5 mg/dl prior to infection. The disease typically presented as pulmonary (50%) and disseminated (33.3%). The first phase of treatment consisted of 3 months of HZRE (isoniazid, pyrazinamide, rifampicin and ethambutol) in 75% of the cases and HZME (isoniazid, pyrazinamide, moxifloxacin and ethambutol) in 25% of the cases. During the second phase of the treatment, 75% of the cases received isoniazid and rifampicin, and 25% of the cases received isoniazid and ethambutol. The length of treatment varied between 6 and 18 months. In 41.7% of patients, hepatotoxicity was associated with the beginning of anti-tuberculosis therapy. During a year-long follow-up, renal function remained stable, and the mortality rate was 16.7%. Conclusion: Tuberculosis in the renal transplant population studied caused diverse nonspecific symptoms. Pulmonary and disseminated tuberculosis were the most frequent forms and required prolonged treatment. Antituberculosis medications had a high toxicity and mortality. This infection must be considered when patients present with a febrile syndrome of unknown origin, especially during the first year after renal transplant.

Impact of social vulnerability on the outcomes of predialysis chronic kidney disease patients in an interdisciplinary center

Introduction: Numerous studies examined the associations between socio-demographic, economic and individual factors and chronic kidney disease (CKD) outcomes and observed that the associations were complex and multifactorial. Socioeconomic factors can be evaluated by a model of social vulnerability (SV). Objective: To analyze the impact of SV on the outcomes of predialysis patients. Methods: Demographic, clinical and laboratory data were collected from a cohort of patients with predialysis stage 3 to 5 who were treated by an interdisciplinary team (January 2002 and December 2009) in Minas Gerais, Brazil. Factor, cluster and discriminant analysis were performed in sequence to identify the most important variables and develop a model of SV that allowed for classification of the patients as vulnerable or non-vulnerable. Cox regression was performed to examine the impact of SV on the outcomes of mortality and need for renal replacement therapy (RRT). Results: Of the 209 patients examined, 29.4% were classified as vulnerable. No significance difference was found between the vulnerable and non-vulnerable groups regarding either mortality (log rank: 0.23) or need for RRT (log rank: 0.17). In the Cox regression model, the hazard ratios (HRs) for the unadjusted and adjusted impact of SV on mortality were found to be 1.87 (confidence interval [CI]: 0.64-5.41) and 1.47 (CI: 0.35-6.0), respectively, and the unadjusted and adjusted impact of need for RRT to be 1.85 (CI: 0.71-4.8) and 2.19 (CI: 0.50-9.6), respectively. Conclusion: These findings indicate that SV did not influence the outcomes of patients with predialysis CKD treated in an interdisciplinary center.

Foreign exchange exposure management in a fuel procurement company operating in the commodity markets

Fluctuating commodity prices, foreign exchange rates and interest rates are causing changes in cash flows, market value and the companies’ profit. Most of the commodities are quoted in US dollar. Companies with non-dollar accounting face a double risk in the form of the commodity price risk and foreign exchange risk. The objective of this Master’s thesis is to find out how companies under commodity should manage foreign exchange exposure. The theoretical literature is based on foreign exchange risk, commodity risk and foreign exchange exposure management. The empirical research is done by using constructive modelling of a case company in the oil industry. The exposure is model with foreign exchange net cash flow and net working capital. First, the factors affecting foreign exchange exposure in case company are analyzed, then a model of foreign exchange exposure is created. Finally, the models are compared and the most suitable method is defined. According to the literature, foreign exchange exposure is the foreign exchange net cash flow. However, the results of the study show that foreign exchange risk can be managed also with net working capital. When the purchases, sales and storage are under foreign exchange risk, the best way to manage foreign exchange exposure is with combined net cash flow and net working capital method. The foreign exchange risk policy of the company defines the appropriate way to manage foreign exchange risk.

Distributed energy resources in an electricity retailer’s short-term profit optimization

Liberalization of electricity markets has resulted in a competed Nordic electricity market, in which electricity retailers play a key role as electricity suppliers, market intermediaries, and service providers. Although these roles may remain unchanged in the near future, the retailers’ operation may change fundamentally as a result of the emerging smart grid environment. Especially the increasing amount of distributed energy resources (DER), and improving opportunities for their control, are reshaping the operating environment of the retailers. This requires that the retailers’ operation models are developed to match the operating environment, in which the active use of DER plays a major role. Electricity retailers have a clientele, and they operate actively in the electricity markets, which makes them a natural market party to offer new services for end-users aiming at an efficient and market-based use of DER. From the retailer’s point of view, the active use of DER can provide means to adapt the operation to meet the challenges posed by the smart grid environment, and to pursue the ultimate objective of the retailer, which is to maximize the profit of operation. This doctoral dissertation introduces a methodology for the comprehensive use of DER in an electricity retailer’s short-term profit optimization that covers operation in a variety of marketplaces including day-ahead, intra-day, and reserve markets. The analysis results provide data of the key profit-making opportunities and the risks associated with different types of DER use. Therefore, the methodology may serve as an efficient tool for an experienced operator in the planning of the optimal market-based DER use. The key contributions of this doctoral dissertation lie in the analysis and development of the model that allows the retailer to benefit from profit-making opportunities brought by the use of DER in different marketplaces, but also to manage the major risks involved in the active use of DER. In addition, the dissertation introduces an analysis of the economic potential of DER control actions in different marketplaces including the day-ahead Elspot market, balancing power market, and the hourly market of Frequency Containment Reserve for Disturbances (FCR-D).

Internationalization of a Finnish accounting firm to Russian markets

Despite the unstable situation at the moment in Russia, the Russian market and St. Petersburg have been a very attractive from the point of view of Finnish companies. The objective of this research was to define how a Finnish accounting firm should perform its market entry to Russian markets as a part of its internationalization process. In addition, the special characteristics that support the internationalization to Russia were examined together with the implications from the behavior of potential customers at the market. The actual market entry mode was developed based on the theories of Uppsala model, transaction cost economics and the network approach. Additional emphasis was given for the service point of view. The primary data in this research was collected through semi-structured interviews with professionals from the Russian market. The results of this research show that there exists potential especially at the accounting markets in Russia. However, the current unstable situation and sanctions in Russia have led to situation where the price-sensitivity among customers is high, and costs savings are searched from multiple processes in organizations. Therefore, the accounting company should perform its market entry in small incremental steps to decrease the risks involved, and to gain specific market knowledge before committing more resources into Russian markets. A simplified process was developed to evaluate the suitable market entry mode. As a result, the level of commitment and market knowledge affect the final entry model of the firm, as well as defined goals for the particular market.

The role of management accounting systems and venture capital investors for start-up firms

The role of star-up firms in economy and the importance of venture capital investors for the growth of start-up firms have been highlighted in recent years. The growth challenges of start-up firms consist of fast changing environment, the availability of venture capital funding and the development of firm management in the growth phase. A growing number of studies have focused on management accounting systems and venture capital in start-up and growth firm context. In this thesis the role of management accounting systems and venture capital investors is considered in the growth phase of firm development. The theoretical objective of this thesis is to construct a theoretical framework in order to describe the importance of management accounting systems and venture capital investors in start-up firms. The practice orientated objective of this thesis is to study the application of management accounting systems and management accounting based information in start-up firms in high-technology industry as well as the impact of venture capital for management accounting system design. In addition, the growth challenges of start-up firms are studied in order to understand the context in which management accounting systems are used. The research approach of theoretical part is conceptual as the theoretical framework is constructed by combining literature on firm growth, management accounting and venture finance in order to analyse the phenomenon. The action-orientated research approach is appropriate for analysing and describing of the studied phenomenon through empirical evidence. The empirical evidence was collected through interviews with three experts in start-up firm accelerator centers, four representatives of start-up firms and one venture capital investor. The results indicate that the growth challenges of stat-up firms are not related to the development of management accounting systems. Managers of start-up firms expressed a positive attitude towards management accounting systems that improve efficiency of operations. In start-up firms flexible and adjustable management accounting practices, such as budgets, cash flow calculations and future-orientated analysis tools, are applied that support planning and coordination of operations. The results indicate that venture capital investors affect the provision and the quality of management accounting information during the investment process. In addition, venture capital investors enhance the use of management accounting information for internal coordination in start-up firms. By applying the theoretical framework in the analysis, it can be stated that by acting as support function management accounting systems facilitate start-up firms development.

Financialization and financial profit

This article starts from the critical review of the concept of financial capital. I consider it is necessary not to confuse this category with of financialization, which has acquired a certificate of naturalization from the rise of neoliberalism. Although financial monopoly-financial capital is the hegemonic segment of the bourgeoisie in the major capitalist countries, their dominance does not imply, a fortiori, financialization of economic activity, since it depends of the conditions of the process reproduction of capital. The emergence of joint stock companies modified the formation of the average rate of profit. The "promoter profit" becomes one of the main forms of income of monopoly-financial capital. It is postulated that financial profit is a kind of "extraordinary surplus-value" which is appropriated by monopoly-financial capital by means of the monopolistic control it exerts on the issue and circulation of fictitious capital.

Hallitustoiminnan erityispiirteet Etelä-Karjalan alueella toimivissa pk-yrityksissä

Teollisuuden rakennemuutoksen myötä pk-yrityskanta on Etelä-Karjalan alueen elinvoimaisuudelle tärkeämpi kuin koskaan. Kehittyäkseen pienistä keskikokoisiksi yritykset tarvitsevat lisää osaamista paitsi johtoon myös hallituksiinsa. Tähän selvitykseen on koottu Pk-yritysten hallitustoiminta Etelä-Karjalassa -hankkeen tuloksia. Hanketta rahoittivat Euroopan sosiaalirahasto ja Hämeen ELY-keskus ja se toteutettiin Lappeenrannan teknillisen yliopiston toimesta vuosien 2014-2015 aikana. Hankkeen keskeisenä tavoitteena oli vahvistaa Etelä-Karjalassa sijaitsevien pk-kokoluokan yritysten hallitustyötä ja hallitusten hyödyntämismahdollisuuksia sekä lisätä pk-yrityksissä toimivien hallitusjäsenten osaamista pk-yritysten hallitusjäseniltä vaadittavista taidoista ja osaamisalueista. Hankkeen toisena tavoitteena oli selvittää Suomessa toimivien venäläisomisteisten yritysten hallitustoiminnan erityispiirteitä. Hankkeen aikana toteutettiin koulutuksia ja työpajatoimintaa sekä laadittiin kaksi julkaisua. Hankkeen tiedonkeruu tapahtui haastattelemalla ja työpajatoiminnan kautta syksyn 2014 ja kevään 2015 aikana. Hankkeen tuloksina syntyi käsillä oleva selvitys hallitustoiminnan erityispiirteistä suomalaisissa ja venäläisissä Etelä-Karjalan alueella toimivissa pk-yrityksissä sekä suomalaisten pk-yritysten hallitustoiminnan erityispiirteisiin keskittyvä tiivistelmä. Hankkeeseen osallistui Etelä-Karjalan alueella toimivia pk-yrittäjiä, hallituksenjäseniä, yrityksiä tukevia toimijoita ja erilaisten sidosryhmien edustajia. Lappeenrannan teknillisen yliopiston hankepartnereina toimivat Etelä-Karjalan Hallituspartnerit ry, Etelä-Karjalan Yrittäjät ry sekä Etelä-Karjalan Kauppakamari.

Suomessa toimivien kiinteistösijoitusyritysten menestyminen 2007–2014

Tämän kandidaatintutkielman tavoitteena on tutkia Suomessa toimivien kiinteistösijoitusyritysten menestymistä aikavälillä 2007–2014. Tutkimuksen keskiössä ovat erityisesti toimialan suurimpien yritysten suoriutuminen suhteessa pienempiin yrityksiin. Yritysten menestymistä arvioidaan valittujen tunnuslukujen avulla. Tutkimus ajoittuu finanssikriisin, eurokriisin ja taantuman aikaan, jolloin taloudessa tapahtui merkittäviä muutoksia. Kiinteistömarkkinoiden voidaan ajatella olevan paikallisia, jolloin maailmantalouden muutokset eivät ole välttämättä paikallisesti näyttäytyneet yhtä suurina. Tutkielman teoriaosuus esittelee tunnuslukuanalyysimenetelmää sekä valitut neljä tunnuslukua: voittoprosentin, oman pääoman tuottoprosentin, omavaraisuusasteen ja current ration. Lisäksi teoriaosuudessa esitellään mittakaavaedun käsite ja luodaan pohjaa, mittakaavaetujen aiempien tutkimusten perusteella, tutkimuskysymyksen tarkasteluun. Tutkimuksen aineisto kerättiin Amadeus-tietokannasta, tutkimus toteutettiin kvantitatiivisena tutkimuksena SAS-ohjelmistolla käyttäen Mann-Whitney U-testi -menetelmää ja 5 prosentin merkitsevyystasoa. Valitut yritykset jaettiin liikevaihdon perusteella suuriin ja pieniin yrityksiin (rajana 10 miljoonaa euroa), joita vuosittain verrattiin tunnusluvuittain. Tutkimustulosten perusteella voidaan todeta, että toimiala ei reagoinut ajanjaksolla voimakkaasti maailmantalouden muutoksiin. Voittoprosentit sekä omavaraisuusasteet olivat vuosina 2007–2014 pienillä yrityksillä tilastollisesti parempia, sekä oman pääoman tuottoprosentit parempia vuosina 2008 ja 2009. Current ration arvoissa ei ryhmien välillä havaittu tilastollisesti eroja. Voittoprosentin tulosten perusteella voidaan todeta suurilla yrityksillä mittakaavahaittojen esiintymisen mahdollisuus heikomman tuloksentekokyvyn vuoksi. Omavaraisuusasteen ja oman pääoman tuoton tulosten perusteella voidaan päätellä mittakaavaetujen esiintymisen mahdollisuus mahdollisesti vieraan pääoman saatavuudessa, kustannuksissa ja vieraan pääoman vipuvaikutuksen myötä. Tutkimustulokset osoittavat lisäksi suurten yritysten olleen pieniä yrityksiä herkempiä talouden heilahteluille.

Études de droit pratique. De la renonciation à son hypothèque légale par la femme du vendeur au profit de l'acquéreur, par Albert Amiaud,... Études extraites de la "Revue pratique de droit français" (T. 24 et 26)...

Comprend : De la Subrogation de l'acquéreur à l'hypothèque légale de la femme de son vendeur...

Arrêt de la Cour du Parlement qui déclare le défunt Pierre Trinité duement atteint et convaincu d'etre mort relaps dans la religion prétendue réformée, pour raison de quoi il est ordonné que sa mémoire demeurera éteinte et supprimée et ses biens confisqués au profit du Roi

[Acte. 1729-07-04. Paris]