Percutaneous mitral valve edge-to-edge repair: in-hospital results and 1-year follow-up of 628 patients of the 2011-2012 Pilot European Sentinel Registry.

BACKGROUND The use of transcatheter mitral valve repair (TMVR) has gained widespread acceptance in Europe, but data on immediate success, safety, and long-term echocardiographic follow-up in real-world patients are still limited. OBJECTIVES The aim of this multinational registry is to present a real-world overview of TMVR use in Europe. METHODS The Transcatheter Valve Treatment Sentinel Pilot Registry is a prospective, independent, consecutive collection of individual patient data. RESULTS A total of 628 patients (mean age 74.2 ± 9.7 years, 63.1% men) underwent TMVR between January 2011 and December 2012 in 25 centers in 8 European countries. The prevalent pathogenesis was functional mitral regurgitation (FMR) (n = 452 [72.0%]). The majority of patients (85.5%) were highly symptomatic (New York Heart Association functional class III or higher), with a high logistic EuroSCORE (European System for Cardiac Operative Risk Evaluation) (20.4 ± 16.7%). Acute procedural success was high (95.4%) and similar in FMR and degenerative mitral regurgitation (p = 0.662). One clip was implanted in 61.4% of patients. In-hospital mortality was low (2.9%), without significant differences between groups. The estimated 1-year mortality was 15.3%, which was similar for FMR and degenerative mitral regurgitation. The estimated 1-year rate of rehospitalization because of heart failure was 22.8%, significantly higher in the FMR group (25.8% vs. 12.0%, p[log-rank] = 0.009). Paired echocardiographic data from the 1-year follow-up, available for 368 consecutive patients in 15 centers, showed a persistent reduction in the degree of mitral regurgitation at 1 year (6.0% of patients with severe mitral regurgitation). CONCLUSIONS This independent, contemporary registry shows that TMVR is associated with high immediate success, low complication rates, and sustained 1-year reduction of the severity of mitral regurgitation and improvement of clinical symptoms.

Usage of Urinary Antigen Test for Legionella on diagnosed community-acquired pneumonia in San Antonio hospitals

Purpose. To evaluate the use of the Legionella Urine Antigen Test as a cost effective method for diagnosing Legionnaires’ disease in five San Antonio Hospitals from January 2007 to December 2009. ^ Methods. The data reported by five San Antonio hospitals to the San Antonio Metropolitan Health District during a 3-year retrospective study (January 2007 to December 2009) were evaluated for the frequency of non-specific pneumonia infections, the number of Legionella Urine Antigen Tests performed, and the percentage of positive cases of Legionnaires’ disease diagnosed by the Legionella Urine Antigen Test.^ Results. There were a total of 7,087 cases of non-specific pneumonias reported across the five San Antonio hospitals studied from 2007 to 2009. A total of 5,371 Legionella Urine Antigen Tests were performed from January, 2007 to December, 2009 across the five San Antonio hospitals in the study. A total of 38 positive cases of Legionnaires’ disease were identified by the use of Legionella Urinary Antigen Test from 2007-2009.^ Conclusions. In spite of the limitations of this study in obtaining sufficient relevant data to evaluate the cost effectiveness of Legionella Urinary Antigen Test in diagnosing Legionnaires’ disease, the Legionella Urinary Antigen Test is simple, accurate, faster, as results can be obtained within minutes to hours; and convenient because it can be performed in emergency room department to any patient who presents with the clinical signs or symptoms of pneumonia. Over the long run, it remains to be shown if this test may decrease mortality, lower total medical costs by decreasing the number of broad-spectrum antibiotics prescribed, shorten patient wait time/hospital stay, and decrease the need for unnecessary ancillary testing, and improve overall patient outcomes.^

ROLE CONFLICT, ROLE AMBIGUITY, AND JOB DISSATISFACTION: A STUDY OF HOSPITAL EXECUTIVES

The purpose of this study was to assess the relationship of role conflict and role ambiguity to job dissatisfaction among 169 hospital executives in Houston and San Antonio, Texas. Organizational characteristics were studied as moderators.^ Role conflict and role ambiguity scores among respondents were found to be lower than in studies reported in the literature. Job dissatisfaction scores were slightly lower (indicating less dissatisfaction) than those reported elsewhere for the constructs of security, social, and esteem needs; comparable for self-fulfillment; and slightly higher for autonomy needs. Conclusions were that role ambiguity and role conflict were related to job dissatisfaction among the respondents; that the same relationships hold true when controlling for organizational characteristics; that those highest on the organizational ladder were the least dissatisfied; and that those with the greatest amount of budget responsibility had the lowest levels of job dissatisfaction. ^

Hospital district viability and Medicaid /market changes

Hospital districts (HD) that serve the uninsured and the needy face new challenges with the implementation of Medicaid managed. The potential loss of Medicaid patients and revenues may affect the ability to cost-shift and subsequently decrease the ability of the HD to meet its legal obligation of providing care for the uninsured. ^ To investigate HD viability in the current market, the aims of this study were to: (1) describe HD's environment, (2) document the HDs strategic response, (3) document changes in the HD's performance (patient volume) and financial status, and (4) determine whether relationships or trends exist between HD strategy, performance and financial status. ^ To achieve these aims, three Texas HDs (Fort Worth, Lubbock, and San Antonio) were selected to be evaluated. For each HD four types of strategic responses were documented and evaluated for change. In addition, the ability of each HD to sustain operations was evaluated by documenting performance and financial status changes (patient volume and financial ratios). A pre-post case study design method was used in which the Medicaid managed care “rollout'” date, at each site, was the central date. First, a descriptive analysis was performed which documented the environment, strategy, financial status, and patient volume of each hospital district. Second, to compare hospital districts, each hospital district was: (i) classified by a risk index, (ii) classified by its strategic response profile, and (iii) given a performance score based upon pre-post changes in patient volume and financial indicators. ^ Results indicated that all three HDs operate in a high risk environment compared to the rest of the nation. Two HDs chose the “Status Quo” response whereas one HD chose the “Competitive Proactive” response. Medicaid patient volume decreased in two of three HDs whereas indigent patient volume increased in two of the three (an indication of increasing financial risk). Total patient revenues for all HDs increased over the study period; however, the rate of increase slowed for all three after the Medicaid rollout date. All HDs experienced a decline in financial status between pre-post periods with the greatest decline observed in the HD that saw the greatest increase in indigent patient volume. ^ The pre-post case study format used and the lack of control study sites do not allow for assignment of causality. However, the results suggest possible adverse effects of Medicaid managed care and the need for a larger study, based on a stronger evaluation research design. ^

Elementos de la vanguardia surrealista en la obra de Antonio Di Benedetto

La complejidad de la literatura del escritor mendocino Antonio Di Benedetto, autor de novelas fundamentales en la literatura latinoamericana como Zama y El silenciero, es abordada, mediante el estudio comparativo, a través de los documentos producidos por el surrealismo. Del vínculo de los relatos del narrador cuyano con la vanguardia se desprende un análisis crítico de la realidad en la obra literaria, como así también de los límites de los postulados del movimiento de 1924 tomados como insumos en la obra de Di Benedetto. Por otro lado, se han estudiado las propuestas del poeta vinculado al surrealismo Antonin Artaud, para relacionarlas con los quiebres discursivos que se repiten a lo largo de la narrativa dibenedettiana.

Néspolo, Jimena. Ejercicios de pudor : sujeto y escritura en la narrativa de Antonio Di Benedetto. Buenos Aires, Adriana Hidalgo,2004, 390 p.

Fil: Niemetz, Diego. Universidad Nacional de Cuyo. Facultad de Filosofía y Letras

Kafka en la obra de Antonio di Benedetto

La influencia de Kafka en los escritores argentinos del siglo XX es bien conocida y ha sido extenspmente estudiada especialmente en los autores centrales del canon literario, como son Borges y Sábato. Sin embargo. otros autores en los que se manifiesta dicha influencia son sistemáticamente excluidos de los estudios. Entre ellos se encuentra Antonio Di Benedetto. En el presente trabajo se analiza la presencia de una serie de motivos, caracterizados por la crítica como típicamente kajkianos en la novela más reconocida del mendocino: Zama. De esta manera se apunta a completar el panorama de la recepción de Kafka en la Argentina haciendo hincapié en la experiencia regional, que por su contexto especifico de producción es mucho más afin a la de Kafka que la de los escritores canónicos. Por otra parte, la detección y análisis de esos motivos constituyen una poderosa herramienta para el estudio de la obra dibenedettiana. pues no se trata meramente de la repetición de tópicos consagrados. sino de la manifestación de una experiencia muy personal del mundo.

Annabella (El pentágono) de Antonio Di Benedetto : aproximaciones a una poética de la ficción

A partir de la idea de que las obras literarias pueden instaurar, dentro de su propia estructura, claros y profundos planteos sobre conceptos como realidad, ficción, y verdad ficcional. se indaga la poética de la ficción que de modo implícito se inscribe en la obra de Antonio Di Benedetto, más precisamente en El pentágono; novela en forma de cuentos, texto de corte experimental publicado por vez primera en 1955, en el que se presta especial atención a las relaciones entre realidad y ficción, a la posibilidad de la ficción de instituir mundos diversos y a los límites y juegos especulares entre ambos dominios. Por otra parte, se observa, en la peculiar construcción de esta novela en forma de cuentos, una estructura que en sí misma es signo del concepto de ficción que domina la obra.

Las lecciones del Profesor Alberto von Kunowsky : el eclecticismo francés y el romanticismo alemán en Mendoza

Fil: Roig, Arturo Andrés.

Los operativos de la CAM (Comando Anticomunista Mendoza)

Durante el gobierno de Löpez Rega, los primeros operativos comenzaron en el año 1974 actuando agrupados bajo en nombre de Alianza Anticomunista Argentina. En Mendoza, durante el gobierno de Cafiero, actuaba la CAM (comando anticomunista Mendoza), los cuales tenían como misión detener a los grupos que se oponían al gobierno. En muchos lugares de Mendoza se colocaron bombas, se destruyeron teatros, clubes, casas y vidas.

La literatura de Mendoza

Con el fin de conocer las últimas interpretaciones acerca de nuestro pasado regional, los videos de la serie "Mendoza, crónica de nuestra identidad", pretenden llevar adelante la tarea constante de construir y reconstruir una identidad que se mantenga abierta a los valores del pasado, pero también a la inevitable reformulación crítica de los mismos principios. La propuesta es generar un proceso de actualización y perfeccionamiento en el campo de la historia regional. En el documental LA LITERATURA DE MENDOZA, se describen las tendencias literarias en la provincia desde la época de la colonia a la actualidad. Los temas abordados son: - Los cronistas - El siglo XVIII - El Siglo XIX - El regionalismo literario - Vanguardia en Mendoza - Las últimas tendencias