Recibido el 31 de enero de 2014; aceptado el 8 de octubre de 2014 Disponible en Internet el 27 de junio de 2015
ResumenEl objetivo del presente trabajo de investigación es doble: estudiar qué información explica el riesgo de las acciones y analizar si la implantación de las Normas Internacionales de Información Financiera (NIIF), realizada en el mercado español en 2005, influye en dicha información. Conocer qué información contable y/o macroeconómica explica el riesgo de una acción es una información útil para el empresario y para el profesional de la gestión, pues nos indica qué variables observar para estimar la evolución del riesgo y, en consecuencia, la evolución del coste de capital o tasa de actualización. La tasa de actualización es una variable muy importante en muchas decisiones financieras, y su valor, que depende entre otras variables del riesgo, tiene una gran influencia en la decisión. Por este motivo es importante que dicha tasa se determine de forma objetiva, algo especialmente difícil en las pequeñas y medianas empresas (PYMES). Una gestión eficiente implica poder anticiparse a los efectos futuros, actuar para capturar los efectos positivos y minimizar los efectos negativos. Si sabemos qué variables explican el riesgo, conoceremos qué indicadores observar para analizar su comportamiento y prever lo que vaya a suceder en el futuro sobre la tasa de actualización.
Objectives: To describe a case of a patient with a placenta previa accreta with a history of preterm delivery and a short cervix. Methods: Placenta accreta is an obstetric entity that has been increasing.The coexistence of this finding, adding to the short cervix and a localisation of the placenta previa in a patient with a history of preterm delivery, confronts us with various debates, regarding what is the ideal moment of termination of pregnancy and the alternatives management. Results: This is a 23-year-old patient with a history of 2 previous Caesarean sections. Those who enter the emergency department with profuse, non-painful vaginal bleeding undergo emergency obstetric ultrasound, evidencing a previous, total, occlusive placenta with ultrasound signs suggestive of placental accretions and a length of the cervix of 19mm. The patient is hospitalised and treatment with hydroxyprogesterone caproate, due to the history of 2 preterm labour, with clinical improvement, progressive bleeding reduction and hemodynamic stability. A Medical Board is held and it is considered to continue management with weekly progesterone caproate, with the goal of bringing the pregnancy to week 34 to reduce the impact of prematurity. Conclusions: Placental accretion represents a challenge for obstetric management and the coexistence of a history of preterm delivery and short cervix implies the integration of preventive management of preterm delivery and the organisation of a multidisciplinary equipment. 105 cases, compared with migration in cases with cord attachment directed downwards (5 out of 31 cases only migrated). Conclusions: Evaluation of direction of umbilical cord insertion into the placenta at 11-14 weeks of gestation might be a useful predictor of upwards placental migration with advance of pregnancy. Further studies are needed to confirm this finding.
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