Nutrición 2015

Nutrición

Analizador de Composición Corporal Ultra Liviano de uso Profesional.

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Control Software Impresión Impresora Easy Body por voz Body Pass A4 Térmica Software

> Fácil de instalar y transportar.

> Rango de Frecuencia: 5, 50, 250 k Hz

> Capacidad de medición: Todo el cuerpo así como la medición

segmentada (brazos, piernas y tronco o torso)

> Pantalla: 7 pulgadas de ancho LCD a color

> Dimensión: 400x735x890 mm (An x Pr x, + / - 10 mm)

Comparación de resultados con el método de dilución, que es el Gold estándar para calcular el total del agua corporal. Alta precisión (coeciente de correlación R = 0,97), la tasa de reaparición (coeciente de correlación R = 0,99)

Fuente: validez de agua corporal total en la impedancia (X-SCAN)

La tecnología de análisis de composición corporal se realiza mediante IDM Y 5FACTORS

La tecnología de nuestra empresa hizo posible crear el analizador de composición corporal profesional ligero y exacto.

Opcionales: Medición de la altura por medio de tallímetro ultrasonido (heighmeter opcional).

Posible la impresión en papel de tamaño A4 para hoja de resultados.

A. Datos personales:Nombre, ID, altura, peso, edad, género, anotación de fecha y hora. B. Composición corporalSe trata de un análisis preciso de la composición corporal entre la relación correlativa del agua corpo-ral total y la composición corporal. El analizador de Jawon Medical usa el método de dilución isotópica. No sólo para los datos de medición, se indican también la evaluación y la escala apropiada en función del peso estándar.

C. Evaluación del control del pesoEs conveniente para reconocer lo que debe de hacerse, aumentar el músculo, disminuir la grasa, mantener la situación actual, esto por medio de los gráficos de barras.

D. Análisis Abdominal En cuanto a la grasa visceral el IOI simplemente presenta el nivel con el fin de evaluar la grasa abdominal. Para el nivel de grasa visceral se evalúa el VSR, que es la relación entre la grasa visceral y la grasa subcutánea (grasa visceral y grasa subcutánea), en comparación con diversos datos clínicos.

Opcional

En la zona de evaluación de la grasa visceral nos permite evaluar o identificar causas o enfermedades relacionadas con la vida.

Evaluación de la distribución de grasa corporal por W.H.R.

La obesidad superior e inferior en el cuerpo se divide para dar la distribución de la grasa corporal.

Parte superior e inferior del cuerpo grasa baja o alta de grasaGlútea / parte inferior del cuerpo / ginecoide / obesidad tipo pera. Es conocido dentro del cuerpo "La grasa corporal se acumula en la cadera o el muslo." Solo tienden a ser causadas en la mujer.

Parte inferior del cuerpo más bajo de grasa corporal o el superior mayor de grasaAbdominal superior del cuerpo / obesidad tipo manzana.

La grasa corporal se acumula alrededor del abdomen o la cintura.

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Guía de producto

Método de Medición

Rango de frecuencia

Áreas de medición

Principalesresultados

Energía

Consumo de energía

Fuente de alimentación

Pantalla

Teclado

Dispositivo de transmisión Dispositivo de impresión

Dimensión

Peso

Rango de medición

Tiempo de medición

Altura paciente

Medición del peso

Edad de paciente Ambiente de

Operación

Almacenamiento

Opcionales

BIA via método tetra-polar usando 8 electrodos BIA a través de este método de contacto.

5, 50, 250 khz.

Todo el cuerpo y medición segmentada en brazos, piernas y tronco

Peso, Peso estándar, Masa magra corporal, total de agua corporal, Agua Intra celular., Agua extra celular, BMI,(Índice de masa corporal) Porcentaje de grasa corporal, Masa de grasa corporal, WHR(Relación cintura cadera), Tasa metabólica basal, Radio de ECW/TBW, Relación de la ECW / ACT, Masa magra corporal segmentadas, impedancia.

Dentro de 280μA.

60VA

Entrada: AC 100 ~ 230V, 50/60 Hz, Salida: DC 12V, 5A adaptador

LCD a color de 7 pulgadas

Teclado, PC remoto control teclado

Puerto USB, puerto RS-232 (inalambrico)

Puerto USB, impresora térmica

400x735x890 mm(anchoi, largo, alto, ±10 mm)400x845x2250 mm(anchoi, largo, alto, ±10 mm), con el tallimetro ultrasónico opcional

Aproximadamente de 10 kilos (unidad principal)Aproximadamente de 15 kilos (unidad principal), con el tallimetro ultrasónico opcional

100～950Ω

Menor a 1 minuto.

39.4～78.7 pulga

10 a 200 kilos

De 6 ~ 90 años de edad

Temperatura de 10 ~ 40 ° C, humedad 30 ~ 75% (sin condensación)

Temperatura -20 ~ 60 ° C, humedad inferior al 95% (sin conden-sación)

Tallimetro ultrasónico, Easy Body Plus (Programa de consulta, Impresora térmica. Monitor de presión arterial, Maleta de transporte tipo A, Maleta de transporte tipo B, Scanner de código de barras.

ioi 353Modelo

* Para los propósitos de mejora, las especificaciones y el diseño están sujetos a cambios sin previo aviso.

La obesidad parte superior del cuerpo se relaciona con la enfermedad o riesgo cardio vascular que está relacionada con la vida.

E. Guía de ControlGuía de control muestra el objetivo para controlar el peso, la masa de grasa corporal y masa magra suave basada en el resultado del análisis de la composición corporal. El consumo recomendado de las calorías y la cantidad de ejercicio que se presenta acorde al objetivo de controlar, reducir la grasa corporal o aumento de la masa muscular.El consumo recomendado de calorías y la cantidad de ejercicio se basan en el control de 0,5 kg por semana que es el método de control de peso más razonable.

F. Tipo de cuerpoConsejo de tipo está dividido en 9 tipos diferentes. Es fácil de entender qué clase de cuerpo tiene la persona.

Caso 1. El aumento de la grasa corporalCaso 2. La disminución de la grasa corporalCaso 3. Disminución de la masa corporal magra o masa muscular suave

G. Evaluación segmentariaProporciona M.B.F. (Masa de grasa corporal) / S.L.M. (Masa muscular suave) y la evaluación de los brazos, las piernas y el tronco.

Evaluación de la masa grasa corporal y S.L.M. del brazo izquierdoEvaluación de la masa grasa corporal y S.L.M. del brazo derechoEvaluación de la masa grasa y bady S.L.M. del troncoEvaluación de la masa grasa corporal y S.L.M. de la pierna izquierdaEvaluación de la masa grasa corporal y S.L.M. del brazo derecho

H. Cambio en la Composición corporalCompruebe el cambio de peso, grasa corporal y el músculo para la medición anterior y el presente

Reg. n. 387- AUNI EN ISO 9001:2008

Reg. n. 387- MUNI EN ISO 13485:2003 Teléfono: 2240-3600 ext 133 - 108 • Email:[email protected]

Dirección: Tibás, 325 mts este de la Municipalidad.

The first desktop Indirect Calorimetry system with research and clinical grade accuracy

Accurate Measurement of Resting Energy Expenditure using ventilated canopy (dilution technique)

Monitor patient’s energy requirements simply and effectively

Affordable, Portable, Compact, Easy to Use with Built-in Printer

Validated vs. Gold Standard Technique

Desktop Indirect Calorimetry

The Fitmate GS is the first portable desk-top indirect calorimeter using the dilution technique for accurate measurements of Resting Energy Expenditure (REE, RMR) in a clinical setting. Provided with a com-pact blower and a canopy hood, it is the ideal companion for bed-side applica-tions and for interdisciplinary nutritional monitoring by hospital Nutrition Support Teams (NST).

The use of a ventilated hood make the test highly comfortable allowing patients to breathe freely. The ventilated hood can also be used for long periods of time with minimal discomfort and no air leaks from the system.

Fitmate GS allows reliable, accurate, easy and quick measurement without the need of consumable and complicated calibra-tion procedures with gas cylinders.

Applications

The nutritional care and management of confined-to-bed and critically-ill patients includes provision of adequate nutri-tion support in order to avoid malnutri-tion, to improve nutritional status and to prevent negative outcomes associated with overfeeding or underfeeding (im-paired immune function, impaired ventila-tory drive, prolonged ventilatory depen-dence, increased infectious morbidity and mortality...).

Inappropriate nutrition support (under-feeding or overfeeding) can have harmful consequences for the health of the patient and significant impact on costs of treat-ment, rate of complications, increased length of hospital stay and mortality1.

1 McClave SA, Snider HL. “Use of indirect calorimetry in clinical nutrition.” Nutr Clin Pract. 1992 Oct;7(5):207-21

The success of nutrition support relies, therefore, on accurately determine energy requirements and prevent the increase of negative cumulative balance so that ad-equate energy and nutrients can be pro-vided to the patient.

While prediction equations are generally considered not as accurate as required for predicting the energy expenditure in a clinical setting, Indirect Calorimetry is the “Gold Standard” for determining caloric needs in confined-to-bed patients and is indispensable for Nutrition Support Teams providing nutrition care to patients in dif-ferent departments of the hospital.

Fitmate GS is the ideal companion for de-termining proper nutrition support in dif-ferent application fields such as:

Hospital Nutrition Support Team (NST)

Critical care/ICU

Burn units

Eating disorders, Anorexia/Cachexia, Bariatric surgery

Nutrition support in home care, long-term care facilities, nursing homes

Accurate Resting Energy Expenditure

Fitmate has been validated for the mea-surement (also using a canopy hood2) of Oxygen Consumption (VO2) and Resting Metabolic Rate (RMR/REE). It measures VO2 and assumes a constant Respiratory Quotient (RQ), set at 0.85 (or user de-fined). Oxygen uptake (VO2) is measured in real time and data is shown every 30 seconds. RMR testing is simple, fast and a report printout is provided in seconds via the built-in thermal printer.

2 Vandarakis D. et al. A Comparison of Cosmed Metabolic Systems for the Determination of Resting Metabolic Rate. Research in Sports Medicine, 21:187–194, 2013

Five different flow rates can be set depending on subject’s weight.

The bubble shape and the removable blanket allow easy cleaning and disinfection of the canopy hood with a soft cloth and a non alcoholic detergent.

Fitmate GS ideally complements the use of a full VO2/VCO2 indirect calorimetry laboratory (like COSMED Quark RMR). Fitmate GS allows fast, flexible and more frequent baseline monitoring of energy requirements of all spontaneously breath-ing patients3.

3 Nieman DC, et al. “Validation of Cosmed’s FitMate in measuring oxygen consumption and estimating resting metabolic rate”. Res Sports Med. 2006 Apr-Jun;14(2):89-96

All measurements can be viewed in real time on the LCD screen. Warning alerts are prompted in case levels of ventilation or oxygen concentration are out of range.

Once assessment is completed data can be dowloaded on the PC, measurements can be reviewed i.e. selecting custom REE interval for better steady state detection. The software allows users to save all data, make trends etc.

Patient data

Printout sample of the RMR measurement provided by the integrated printer once test is completed

REE Graph Kcal/day vs. time)

Discarded interval

Measurement interval

Averaged values

Quality control Indexes

Actual results compared with predicted values

RMR measurement can also be performed optionally using silicone multi-use face masks (5 sizes: 3 adult, 2 pediatric)

Ventilated Canopy Hood

Fitmate GS comes with a large and com-fortable transparent hood connected to a blower that guarantees air flow inside the hood. The blower pumps air in at a defined flow, chosen among five different flow rates dependent on subject weight.

The patient lies in bed and comfortably breathes inside the hood, where the ex-pired gas dilutes with room air. A sam-ple of this mixture is then conveyed to the turbine and sampling line in order to get ventilation parameters and oxygen concentration.

The Fitmate GS screen prompts messages and security alerts when ventilation is not detected or when oxygen concentration is too low or too high, in this case the flow rate can be regulated by the blower in or-der to keep a steady concentration of O2 inside the hood.

For safety reasons the blower is equipped with 4 AA batteries (not rechargeable) to prevent failures due to lack of power.

Breath by Breath REE measurement

Optionally, simple breath by breath rest-ing measurements can be performed with face masks (multi-use ergonomic sili-cone masks: 5 available sizes) or with the “mouthpiece & nose clip” technique (with COSMED antibacterial filter).

Users Software printouts

Fitmate Suite

Fitmate unit

Thermal printouts

REE measurement with “mouthpiece & nose-clip” technique

© 2013/05 COSMED E & OE. Subject to alterations without prior notice. P/N.: C03979-02-93

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Distributed by:USAConcord, CA - Chicago, IL

Phone +1 (925) 676-6002Fax +1 (925) 676-6005

[email protected]

CHINAGuangzhou

Phone +86 (20) 8332-4521Fax +86 (20) 8332-0683

[email protected]

Toll Free 800 426-3763 [email protected] cosmed.com

COSMED srlHeadquarters

Via dei Piani di Monte Savello 37Albano Laziale - Rome00041 ITALYPhone +39 06 931-5492Fax +39 06 931-4580

[email protected]



[email protected]

Technical Specification

Tests w/Unit w/Software

Nutritional AssessmentResting Energy Expenditure (REE, RMR)

Energy Balance

Physical Activity Monitoring* estimated integrated w/ Lifecorder

Other MeasurementsBody Composition (skin-fold) (3 sites) (3 and 7 sites)Standard Measurements (blood pressure, WHR, resting heart rate, BMI..)

Diet Software w/ Weekly Meal Planner

Framingham Index (Risk Analysis)

REE Measurement (Oxygen Consumption)

Sensor Type GFC (Galvanic Fuel Cell)O2 Measurement range 0-25%Sampling Rate 30 sec / 60 secCalibration Automatic on room airWarm-up time 10 secondsREE Accuracy ± 2%O2 Accuracy ±0.02%O2 Sensor Lifespan 12-18 monthsMax REE/RMR Testing Time 50 min

Flowmeter

Type Bidirectional digital turbine Ø 28mmFlow range 0-16 l/sFlow resistance <0.6 cmH2O/l/s @ 14l/sAccuracy Flow/Volume ±2% or 20 ml/s

Hardware (Unit)

Dimensions & Weight 24 x 20 x 8 cm (9,4 x 7,8 x 3,1 in) / 1.5kg (3,3 lb)Display Color LCD 320 x 240 pixelPrinter High speed thermal printer 12 cm (4,7 inches)Memory Capacity 200 test (5 min per each REE measurement)

Hardware (Canopy)

Dimensions 46.8x32x22 cmCanopy Volume 18,7 lFlow rate range 12-44.4 l/minBlower internal battery 4 AA

Standard Packaging Includes

Fitmate GS unit, AC/DC Adapter, USB cable, Fitmate PC Software (CD-Rom), Body meter, Oxygen sensor, Canopy hood, Canopy blower, control board

Available languages

Firmware Italian, English, Spanish, French, German, Portuguese, Greek, Dutch, Turkish, Chinese, Korean, Japanese, Finnish, Polish, Russian, Slovenian

Software Italian, English, Spanish, French, German, Portuguese, Greek, Dutch, Chinese, Finnish, Russian, Slovenian

PC configuration required

Pentium or faster, Windows XP, VISTA (32/64 bit), Windows 7 (32/64 bit) 128 Mb RAM or more, USB, CD-Rom reader, 80 Mb on HD space available.

Safety & Quality Standards

Equipment complies with MDD (93/42 EEC); EN 60601-1 (safety) / EN 60601-1-2 (EMC) FDA 510(k) cleared.COSMED is an organization whose quality management system is certified by CERMET according to UNI EN ISO 9001:2008 and UNI EN ISO 13485:2004.

References

1. Nieman D. et al. Validation of COSMED’s Fitmate™ in measuring oxygen consumption and estimat-ing resting metabolic rate. Research in Sports Medicine, 14: 1–8, 2006

2. Lupinski L., Singer P. et al. Comparison between the Fit Mate metabolic system and the Deltatrac II metabolic monitor in the measurement of resting energy expenditure and oxygen consumption in non-ventilated patients. Clinical Nutrition Supplements (January 2010), 5 (2), pg. 65-66

3. Vandarakis D. et al. A Comparison of Cosmed Metabolic Systems for the Determination of Resting Metabolic Rate. Research in Sports Medicine, 21:187–194, 2013

With an estimated lifespan of 12-18 months, the O2 cell comes in a sealed bag and it’s easy to replace. Cell efficiency can be checked at anytime by software.

Nutritional Assessment

The Most Accurate Indirect Calorimetry for Research and Clinical Practice provided in a compact/bed-side solution

Indirect calorimetry (continuous VO2, VCO2)

Accurate measurement metabolism substrate (RQ, FAT, CHO, PRO)

Provided with flow-based-dilution Canopy Hood & Multi-Use Face Masks

Either Spontaneously Breathing subjects or Mechanically Assisted patients

Ethanol Burning Kit (option)

ICU Kit for ventilated patients (option)

The Quark RMR is the latest innovation in Indirect Calorimetry designed to accurate-ly and instantaneously measure patient’s energy requirements and response to arti-ficial nutrition during prolonged hospital-ization or admission to the intensive care unit. The assessment of nutritional needs of critically ill patients is vital as overfeed-ing and negative energy balance can be detrimental to their health and recovery.

By measuring REE and providing the cor-rect energy balance in critically ill patients, hospital may improve patient outcome, and decrease the length of hospitalization which will have a significant and immedi-ate impact on the bottom line.

Quark RMR accuracy and reliability have been validated against the Gold Standard either with healthy/obese subjects (using canopy hood)1 or with mechanically as-sisted patients (with ICU module)2.

Applications

The Quark RMR is an essential piece of equipment for:

Research in Clinical Nutrition

Critical Care & Nutrition Support in hospitals

Cancer centers, neurological and coma patients, burn patients, trans-plants patients

Bariatric Centers

Key features

Indirect calorimetry VO2, VCO2, RQ, REE and related parameters

Substrate utilization (%FAT, %CHO, %PRO)

High FiO2 kit for elevated O2 levels (option) up to 60%

Automatic quality control during test is provided by a random check on gas concentrations

Accurate Indirect Calorimetry

The Quark RMR uses latest technology in gas analyzers. It is provided with an Infrared (NDIR) CO2 sensor and a fast-response, stable, durable and non-con-sumable Paramagnetic O2 sensor. Both sensors are virtually maintenance free and reliable, even after many years of use.

High Versatility

Tests can be carried out in three different options:

1 - Canopy Hood

Quark RMR comes with a flow-dilution-based hood for spontaneous breath-ing patients. Not requiring conventional mouthpiece or mask, it allows measure-ment with improved patient comfort. No need to distinguish between inspira-tion and expiration, flow rate is directly measured with digital turbine flowmeter. Ventilatory rate is regulated by the Quark.

2 - Ventilator

Quark RMR can be optionally integrated with a ventilator for nutrition assessment in Intensive Care Unit (ICU). Gas is sam-pled breath by breath through a PVC line connected proximally to the Y-piece of the ventilator tubing, while patient minute ventilation is measured by a turbine flow-meter connected to the expiratory port of the ventilator. The software of the Quark has a function for detecting any bias flow from the ventilator and compensating for this when calculating VCO2 and VO2.

3 - Face Mask

A simpler and not expensive breath by breath analysis through Quark RMR with multi-use silicone face masks. Real time measurement of the volume of air ven-tilated by the patient (flowmeter at the mouth). Not common in clinical and re-search, but still valid alternative for weight management measurements.

PC Software

User-friendly interface, intuitive com-mands and icons are the perfect tools for fast and reliable data collection and inter-pretation in any hospital department or doctor’s office.

Users can set-up their own workspace (choosing parameters, graphs and icons to display)

Automatic steady state calculation based on user defined criteria

Calculate REE by selecting any time interval during a test

Calculate NPRQ by adding manually the individual Ureic Nitrogen level

Complete patient archive, diagnosis database and custom reports

Automatic generation of PDF files with user-defined file names

Batch printing of multiple reports

Runs in network environments com-patible with any MS protocol

Quark RMR can measure REE in mechanically assisted patients by a connection to the exhalation port of a ventilator (optional software required)

Canopy hood

Comfortable silicone multi-use face masks available in 5 sizes (3 adult, 2 pediatric)

1 A new indirect calorimeter is accurate and reliable for measuring basal energy expenditure, thermic effect of food and substrate oxidation in obese and healthy subjects. [Martin Laville, et al . e-SPEN, European e-Journal of Clinical Nutrition and Metabolism, 6 (2011) e7-e15.]2 Indirect calorimetry in mechanically ventilated patients. A systematic comparison of three instruments. [Martin Sundström, et al. Clinical Nutrition Journal 2013 Feb;32(1):118-21]

Predicted values and % of variation

User defined selection of resting interval

BMI classes

Header (user defined)

Patient information

List of main parameters

Options / Accessories

ICU Module Optional kit allowing metabolic measurements of mechanically assisted patients by connecting Quark RMR with the ventilator

Ethanol Burning kit Optional quality control test for routine calibration. It consists of the measurement of the total CO2 production by burning a known quantity of Ethanol. If system is accu-rate, the RQ measurement of Quark RMR is expected to range from 0.64 to 0.69

Gas Mixture Gas calibration cylinders of different concentrations and sizes

Silicone Face Mask Silicone multi-use facial mask with ergonomic head-cap (5 sizes available: 3 Adult, 2 Pediatric)

Medical Cart Ideal for easy transportation of Quark RMR for bed-side applications

Above: Real time display of all measured parameters in a tabular or graphical format

Below: 1 page report, Nutritional Assessment

Ethanol Burning Kit

Bias Flow Calibration

© 2013/05 COSMED E & OE. Subject to alterations without prior notice. P/N C03098-02-93

COSM

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pro

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nam

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and

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be r

egist

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.

Distributed by:USAConcord, CA - Chicago, IL

Phone +1 (925) 676-6002Fax +1 (925) 676-6005

[email protected]

CHINAGuangzhou

Phone +86 (20) 8332-4521Fax +86 (20) 8332-0683

[email protected]

Toll Free 800 426-3763 [email protected] cosmed.com



[email protected]



[email protected]

Technical Specification

Tests

Nutritional AssessmentResting Energy Expenditure (REE, RMR)

Indirect Calorimetry (VO2, VCO2,) w/ Mask

Indirect Calorimetry (VO2, VCO2,) w/ Canopy Hood

Indirect Calorimetry (VO2, VCO2,) w/ Ventilator (ICU) m

Respiratory Quotient (RQ), Non-Protein Respiratory Quotient (NPRQ)

Metabolism Substrate Utililzation (%FAT, %PRO, %CHO)

Physical mixing chamber m

Other MeasurementsHR Interface w/ external ECG (TTL)

Integrated Pulse Oximeter (SpO2) m

Cardio Pulmonary Exercise Testing (VO2, VCO2) m

Analyzers Oxygen (O2) Carbon dioxide (CO2)

Type Paramagnetic NDIRRange 0-100 %* 0-10 %Accuracy ± 0.02% ± 0.1%Response time 120ms 100 msWarm-up time 5 min 10 min* Standard Range 0-30% - ICU Range 0-60% - Elevated FiO2 Testing: User defined

Flowmeter

Type Bi-directional digital turbine (Ø 18 mm)Ventilation Range 0-50 l/minAccuracy ±2% or 100 ml/minResistance <0.7 cmH2O/l/s @ 3 l/s

Hardware

Dimensions / weight (Quark RMR unit) 17 x 30 x 45 cm/8 KgDimensions / weight (Canopy hood) 32 x 50 x 30 cm/0.6 KgConnection to ventilator By exhalation port

Standard Packaging Includes

Quark RMR unit, Canopy, Flowmeter Resting (2 pcs.), antibacterial filters, PC software RMR, calibration syringe, HR monitor (receiver and transmitter), power supply cable, USB cable, user manual

Available languages

Italian, English, French, Spanish and German

Electrical requirements

Voltage 110-240V ±10%; 50/60HzInternal emergency battery 12V; 1,2 Ah

PC configuration required

PC Pentium or higher, Windows XP, Vista (32 bit), Windows 7 (32 bit), 64 Mb RAM, USB or RS 232 , CD reader, 20 Mb space free on HD, Monitor VGA, SVGA, XGA

Safety and Quality Standards

Quark RMR is in compliance with the European Directive 93/42/CEE concerning medical devices.Equipment complies with FDA 510 (k)COSMED is an organisation whose quality management system is certified by CERMET according to UNI EN ISO 9001:2008 and UNI EN ISO 13485:2004.

Optional medical graded cart for comfortable bed-side applications

Investment Protection

COSMED has done everything to pro-tect customer’s investment by keeping operating costs as low as possible. The product was designed to eliminate or-dinary maintenance and make trouble-shooting as easy as possible. Free soft-ware upgrades for the first 12 months to keep you up to date with the latest scientific guidelines.

Canopy ventilator and plugs are easily reachable on the back of the Quark RMR

Representante exclusivo:

Contáctenos

Tel: (506) 2240-3600 ext. 133Fax: (506) 2240-3600 Ext.:117

E-mail: [email protected]ón: Tibas 350 este de la municipalidad

Apdo: 191-2150 Moravia, San José, Costa Rica

Una división de Grupo CICADEX

Nutrición 2015

Documents

Transcript of Nutrición 2015