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PRIM started its business on more than just a shoestring. Tracing its roots to an orthopedic shoe store founded by Pedro Prim Fernández in 1870, PRIM now makes and markets hospital supplies in Spain and orthopedic supplies throughout Europe, Latin America, and the US. PRIM has expanded globally through several alliances: It works in the US with Camp International and it operates a joint venture with Enraf Nonius Delft in Portugal and Latin America, as well as domestically. In France PRIM works with Eurosurgical to develop items to aid surgery of the spine. With another three European prosthetic companies, PRIM owns 92% of Boston Brace Europe, an Irish company that makes aids for the treatment of scoliosis.

Progressive Medical hopes its pressure therapy will make progress in getting rid of bed sores. The company sells a variety of therapeutic air and foam mattresses and related medical products to patients with wound care needs, pulmonary complications, and immobility (i.e. paraplegics and quadriplegics). Its mattresses help to prevent and also heal patients' bedsores. The company's other products include negative pressure (vacuum) wound therapy systems and durable medical equipment (wheelchairs, walkers, and commodes), as well as products for bariatric patients. Progressive Medical also provides consulting and condition assessment services.

Pyng Medical (formerly Pyng Technologies) makes an intraosseous infusion device called FAST1 (First Access for Shock and Treatment) that hydrates victims of rapid blood loss or vein collapse -- usually the result of cardiac arrest or severe trauma. The device is used by emergency medical personnel, including those in the military (specifically, the US Department of Defense), which accounts for nearly half of Pyng Medical's total units shipped. The company sells its devices in North America, Europe, and Asia.

Q-Med seeks a smooth future, but thus far it still has a few wrinkles in its plans. The company develops and manufactures the high-tech goo Restylane dermatologists inject to fill in lines and creases in facial skin. Its Durolane product, also based on its non-animal sourced hyaluronic acids, is used as an injection to treat osteoarthritis of the knee. Its products are distributed in over 70 countries, but only Restylane has received FDA approval for use in the US. The Swedish company entered the US exchanges by buying up the shell of a public company in 2008.

Refocus Group is a medical device company that develops surgical treatments for human vision disorders. Therapeutic targets include presbyopia (commonly known as farsightedness), elevated blood pressure in the eye, and a certain form of glaucoma. Its most advanced device is the Scleral Spacing Procedure, which includes an incision handpiece, implants, and related surgical equipment, that could treat the previously mentioned vision disorders. Medcare Investment owns more than half of the firm.

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