Transcatheter aortic valve implantation in very elderly patients: immediate results and medium term follow-up.

OBJECTIVE To evaluate immediate transcatheter aortic valve implantation (TAVI) results and medium-term follow-up in very elderly patients with severe and symptomatic aortic stenosis (AS). METHODS This multicenter, observational and prospective study was carried out in three hospitals. We included consecutive very elderly (> 85 years) patients with severe AS treated by TAVI. The primary endpoint was to evaluate death rates from any cause at two years. RESULTS The study included 160 consecutive patients with a mean age of 87 ± 2.1 years (range from 85 to 94 years) and a mean logistic EuroSCORE of 18.8% ± 11.2% with 57 (35.6%) patients scoring ≥ 20%. Procedural success rate was 97.5%, with 25 (15.6%) patients experiencing acute complications with major bleeding (the most frequent). Global mortality rate during hospitalization was 8.8% (n = 14) and 30-day mortality rate was 10% (n = 16). Median follow up period was 252.24 ± 232.17 days. During the follow-up period, 28 (17.5%) patients died (17 of them due to cardiac causes). The estimated two year overall and cardiac survival rates using the Kaplan-Meier method were 71% and 86.4%, respectively. Cox proportional hazard regression showed that the variable EuroSCORE ≥ 20 was the unique variable associated with overall mortality. CONCLUSIONS TAVI is safe and effective in a selected population of very elderly patients. Our findings support the adoption of this new procedure in this complex group of patients.

Endocarditis caused by nonhemolytic group B streptococcus.

We report a case of bacterial endocarditis caused by nonhemolytic group B streptococcus (GBS) in a 67-year-old man with no predisposing risk factors. Nonhemolytic GBS strains rarely cause illness and are usually detected in perinatal infections. We believe this to be the first reported case of endocarditis caused by a nonhemolytic strain of GBS.

L'histoire de l'enfant prodigue par personnages : par laquelle est demonstrée la vie misérable ou parviendront ceux qui despendent leurs biens prodigalement

[Enfant prodigue (français moyen). 1616]

Metacognitive training for adolescents with psychosis: A multiple case study

Cognitive biases may be one of the explaining factor underlying psychotic symptoms like delusions and hallucinations. Metacognitive training (MCT) was demonstrated, in adults with schizophrenia, to reduce these cognitive biases. However, to the best of our knowledge, there has been no research on adolescents with psychosis. The current study aimed at assessing the feasibility, treatment adherence and its benefi cial effects on psychotic symptoms, depression, social functioning and self-esteem of a MCT. Participants were fi ve psychotic adolescents with psychosis, aged 16-18, who attended the Day Care Unit for Adolescents (DCUA). The MCT, delivered in group, corresponds to 2x8 modules, lasting between 45 and 60 minutes once a week. To measure MCT's effi ciency, the Positive And Negative Syndrome Scale (PANSS), the Social and Occupational Functioning Assessment Scale (SOFAS), the Health of Nation Outcome Scale for Children and Adolescent (HoNOSCA), the depression scale of Calgary and the self-esteem scale of Rosenberg have been used. The results of the 5 patients indicate that MCT is feasible and the treatment adherence is moderate. The schedule of the MCT needs to be adapted to the availability of the participants. At a descriptive level, the MCT allows to reduce psychotic and depressive symptoms (PANSS & Calgary) as well as to improve the social functioning (SOFAS & HoNOSCA) and self-esteem (Rosenberg). To sum up, MCT seem to be an interesting alternative and/or a good additional treatment to reduce cognitive bias, psychotic symptoms as well as improving social functioning

[Archives de la parole]. , Biaini / M. Alexis Ben Kori, chant. Première surate du Coran / M. Alexis Ben Kori, voix

Enregistrement : Paris, Université de Paris, La Sorbonne, 28-01-1914

G-1 Appeal Activity in the Public Assistance Programs, December 2001

Monthly report from the Iowa Department of Human Services

Finales de novela en las Ejemplares

Article que analitza els paràgrafs finals de les novel·les d'en Miguel de Cervantes Saavedra

ASTRAL Score Predicts 5-Year Dependence and Mortality in Acute Ischemic Stroke.

BACKGROUND AND PURPOSE: The ASTRAL score was externally validated showing remarkable consistency on 3-month outcome prognosis in patients with acute ischemic stroke. The present study aimed to evaluate ASTRAL score's prognostic accuracy to predict 5-year outcome. METHODS: All consecutive patients with acute ischemic stroke registered in the Athens Stroke Registry between January 1, 1998, and December 31, 2010, were included. Patients were excluded if admitted >24 hours after symptom onset or if any ASTRAL score component was missing. End points were 5-year unfavorable functional outcome, defined as modified Rankin Scale 3 to 6, and 5-year mortality. For each outcome, the area under the receiver operating characteristics curve was calculated; also, a multivariate Cox proportional hazards analysis was performed to investigate whether the ASTRAL score was an independent predictor of outcome. The Kaplan-Meier product limit method was used to estimate the probability of 5-year survival for each ASTRAL score quartile. RESULTS: The area under the receiver operating characteristics curve of the score to predict 5-year unfavorable functional outcome was 0.89, 95% confidence interval 0.88 to 0.91. In multivariate Cox proportional hazards analysis, the ASTRAL score was independently associated with 5-year unfavorable functional outcome (hazard ratio, 1.09; 95% confidence interval, 1.08-1.10). The area under the receiver operating characteristics curve for the ASTRAL score's discriminatory power to predict 5-year mortality was 0.81 (95% confidence interval, 0.78-0.83). In multivariate analysis, the ASTRAL score was independently associated with 5-year mortality (hazard ratio, 1.09, 95% confidence interval, 1.08-1.10). During the 5-year follow-up, the probability of survival was significantly lower with increasing ASTRAL score quartiles (log-rank test <0.001). CONCLUSIONS: The ASTRAL score reliably predicts 5-year functional outcome and mortality in patients with acute ischemic stroke.

Desempenho dos professores e coordenadores pedagógicos da Delegação do MEES do concelho da Praia. “ O caso dos pólos educativos de Ponta d’Água e Lavadouro”

A melhoria da qualidade do ensino aprendizagem constitui um desafio ao sector da educação e à sociedade Cabo-verdiana. Neste contexto, o Ministério da educação e Ensino Superior, através dos seus serviços centrais, vem atribuindo uma grande importância ao desenvolvimento profissional contínuo do corpo docente. Um processo que tem o seu inicio nas instituições de formações e continuado nas escolas. Neste sentido, acredita que para uma formação permanente sólida e efectiva, o local privilegiado é a própria escola.

Análise Comparativa da Rentabilidade de algumas Culturas de Regadio na Ilha de Santiago

A informação sobre a formação do custo de produção, a produtividade e conhecimento dos elementos que formam o custo de produção, são fundamentais para a tomada de decisão dos agricultores na adopção de técnicas para a realização das suas actividades agrícolas. Com este trabalho pretende-se analisar a produção, o custo de produção e os níveis de rentabilidade das culturas de tomate, repolho e cenoura comparativamente às duas tecnologias de rega utilizadas, nas condições do cultivo do agricultor da Ilha de Santiago. Para isso foi concebido uma ficha de inquérito, na qual foi registadas todas as informações técnicas e económicas junto dos agricultores referente às culturas mencionadas, à medida que vem se efectuando visitas as suas explorações agrícolas. Os resultados demonstram que produzir cenoura no sistema gota-gota garantam maior produtividade em relação ao sistema tradicional. O mesmo não se pode dizer em relação ao tomate e repolho. Em relação ao custo de produção comparativamente às tecnologias de rega a analise estatística não acusou diferenças significativas. Os resultados demonstram ainda que a produção das citadas culturas em ambas tecnologias é rentável e com a economia de água na ordem dos 50% quando as mesmas são praticadas no sistema gota-gota. Entretanto, concluiu-se que o rendimento do agricultor é determinado pelo nível de produção e pela época de produção, pois no período quente o preço de produtos em causa é mais elevado e consequentemente o produtor arrecada maior receita.

Impact de la consommation de sel sur la santé: les croyances de la population suisse [Impact of salt intake on health: beliefs of the Swiss population].

Excessive salt intake increases the risk of developing hypertension and cardiovascular disease. Sodium intake remains high both in developed and emerging countries. The Swiss Federal Office of Public Health has ordered a national survey on the salt intake in Switzerland, realized in different centers. This article presents the results of the awareness of the Swiss population concerning the relationship between excessive salt intake and health. This survey reveals a lack of knowledge regarding the association between high salt intake and cardiovascular disease, the sodium content of usual food, and the recommended daily value of sodium intake. Strategies to reduce salt consumption need to be reinforced by collaborations between health authorities and health care professionals.