O professor de biologia e a possibilidade de uso de diferentes abordagens de ensino com materiais midiáticos a fim de desenvolver a criticidade do aluno do ensino médio

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Do primeiro impacto à prática profissional

A partir da experiência pessoal da autora - seja como professora universitária de teatro de animação ou como diretora e encenadora - este artigo apresenta um panorama atual da formação profi ssional nessa área. Cinco aspectos foram considerados: vivências iniciais; ofi cinas, palestras e leituras; pesquisas acadêmicas e pesquisas compartilhadas em processo de montagem

A professora-poeta

A evocação da experiência da poeta Lupe Cotrim como professora de Estética nos três primeiros anos da ECA-USP ressalta a sua liderança na criação de um diálogo entre alunos e professores de diferentes setores da Escola; a memória desta experiência luminosa, vivida pelo autor como aluno, dá ensejo a observações sobre o isolamento atual dos vários segmentos das artes e da comunicação na pesquisa e na formação dos alunos, tema que requer uma reflexão mais efetiva.

Representations of workplace psychological harassment in print news media

OBJECTIVE: To analyze discourses on workplace psychological harassment in print media. METHODOLOGICAL PROCEDURES: Documental study on workplace psychological harassment that analyzed news stories published in three major newspapers of the State of Sao Paulo (southeastern Brazil) between 1990 and 2008. Discourse analysis was performed to identify discursive practices that reflect the phenomenon of psychological harassment in today's society, explanations for its occurrence and impact on workers' health. RESULT ANALYSIS: This theme emerged in the media through the dissemination of books, academic research production and laws. It was initially published in general news then in jobs and/or business sections. Discourses on compensation and precautionary business practices and coping strategies are widespread. Health-related aspects are foregone under the prevailing money-based rationale. Corporate cultures are permissive regarding psychological harassment and conflicts are escalated while working to achieve goals and results. Indifference, embarrassment, ridicule and demean were common in the news stories analyzed. CONCLUSIONS: The causal explanations of workplace harassment tend to have a psychological interpretation with emphasis on individual and behavioral characteristics, and minimizing a collective approach. The discourses analyzed trivialized harassment by creating caricatures of the actors involved. People apprehend its psychological content and stigmatization which contributes to making workplace harassment an accepted practice and trivializing work-related violence.

Avaliação do stent coronário eluidor de everolimus XIENCE TM V na cpopulação feminina latino-americana do estudo de braço único SPIRIT Women: acompanhamento clínico de um ano

INTRODUÇÃO: Os estudos com stents farmacológicos têm avaliado predominantemente populações masculinas de descendência europeia. O estudo de braço único SPIRIT Women avalia o stent eluidor de everolimus XIENCE TM V em lesões de novo complexas em uma população feminina do mundo real, incluindo pacientes latino-americanas. Esta análise permite compreender como essa população responde ao implante de stent, comparativamente a pacientes não-latino-americanas. MÉTODOS: Das 1.572 pacientes matriculadas em 73 locais fora dos Estados Unidos, 138 (9%) foram recrutadas na Argentina, no Brasil e na Venezuela. RESULTADOS: As lesões-alvo tinham diâmetro de referência do vaso entre 2,25 mm e 4 mm e extensão da lesão ≤ 28 mm. As características basais foram semelhantes entre os grupos, com exceção de maior prevalência de hipertensão arterial, infarto do miocárdio (IM) de parede anterior e história familiar de doença arterial coronária na coorte latino-americana. As lesões tendiam a ser mais complexas em mulheres latino-americanas, com menor diâmetro de referência do vaso-alvo, maior extensão da lesão, maior excentricidade e angulação e mais lesões tipo B2/C. Os eventos foram adjudicados de acordo com as definições do Academic Research Consortium. Em um ano, o desfecho combinado de morte por todas as causas, IM e revascularização do vaso-alvo (RVA) foi de 12,1% na população não-latino-americana e de 10,1% na população latino-americana (P = 0,58). CONCLUSÕES: Em um ano, os baixos índices de eventos cardíacos adversos, incluindo trombose do stent, falha da lesão-alvo, morte cardíaca, IM e RVA nas mulheres latino-americanas foram comparáveis aos das mulheres não-latino-americanas, apesar da maior complexidade das lesões. Esses resultados demonstram a segurança e a eficácia do stent XIENCE TM V nessa pequena coorte de pacientes latino-americanas, à semelhança do que é observado com populações maiores e mais variadas.

Diversity and local democracy. The case of Republic of Macedonia - implications of ethnic diversity on municipal decision making and organizational performance

This research seeks to review the level of knowledge achieved in interpreting the relationship between the ethnic diversity at the workplace in the public sector and the organizational performance; as well as seeks to contribute in understanding the implications of this relationship. The study commenced with investigating the academic research in the relevant area addressing the following research questions: (a) How are diversity management and organizational performance conceptualized? (b) What are the existing findings of research concerning diversity at the workplace in the public organizations and organizational performance? (c) What factors intervene the relationship between the diversity and organizational performance? Based on the findings from the review of the academic research, this study seeks to contribute in understanding the ethnic diversity – performance relationship and its mplications at the local level in the Macedonian context. The reform process in Macedonia as a multicultural society, where for many years, inter-ethnic relations have been one of the most sensitive political issues, affecting both the stability of the country and the progress, focused mainly on the implementation of the decentralization and inclusion of ethnic minorities in the decision making process. With the implementation of the Ohrid Framework Agreement workforce at the units of local self-government in Republic of Macedonia is becoming more balanced with respect to ethnic minorities, with more workforce participation than ever by Albanians, Turks, Roma and other minorities. As public organizations at local level become more diverse along ethnic lines, it makes sense to pay more attention to how different ethnic groups interact with one another at work. Thus it gives additional importance on the research question addressed in the study and gives significance of the research in a broader scope.

The Effect of Support Measures on Involvement in Technology Transfer

The present PhD dissertation is dedicated to the general topic of knowledge transfer from academia to industry and the role of various measures at both institutional and university levels in support of commercialization of university research. The overall contribution of the present dissertation work refers to presenting an in-depth and comprehensive analysis of the main critical issues that currently exist with regard to commercial exploitation of academic research, while providing evidence on the role of previously underexplored areas (e.g. strategic use of academic patents; female academic patenting) in a general debate on the ways to successful knowledge transfer from academia to industry. The first paper, included in the present PhD dissertation, aims to address this gap by developing a taxonomy of literature, based on a comprehensive review of the existing body of research on government measures in support of knowledge transfer from academia to industry. The results of the review reveal that there is a considerable gap in the analysis of the impact and relative effectiveness of the public policy measures, especially in what regards the measures aimed at building knowledge and expertise among academic faculty and technology transfer agents. The second paper, presented as a part of the dissertation, focuses on the role of interorganizational collaborations and their effect on the likelihood of an academic patent to remain unused, and points to the strategic management of patents by universities. In the third paper I turn to the issue of female participation in patenting and commercialization; in particular, I find evidence on the positive role of university and its internal support structures in closing the gender gap in female academic patenting. The results of the research, carried out for the present dissertation, provide important implications for policy makers in crafting measures to increase the efficient use of university knowledge stock.

Media activism on and off line by Italian adolescents and young adults

From several researchers it appears that Italian adolescents and young people are grown up with commercial television which is accused to contain too much violence, sex, reality shows, advertising, cartoons which are watched from 1 to 4 hours daily. Adolescents are also great users of mobile phones and spend a lot of time to use it. Their academic results are below the average of Ocse States. However the widespread use of communication technology and social networks display also another side of adolescents who engage in media activism and political movement such as Ammazzateci tutti!, Indymedia, Movimento 5 Stelle, Movimento No Tav. In which way does the world economic crisis -with the specific problems of Italy as the cutting founds for school, academic research and welfare, the corruption of political class, mafia and camorra organisation induce a reaction in our adolescents and young people? Several researches inform us about their use of internet in terms of spending time but, more important, how internet, and the web 2.0, could be an instrument for their reaction? What do they do online? How they do it? Which is the meaning of their presence online? And, has their online activity a continuity offline? The research aims are: 1. Trough a participant observation of Social Network profiles opened by 10 young active citizens, I would seek to understand which kind of social or political activities they engage in online as individuals and which is the meaning of their presence online. 2. To observe and understand if adolescents and young people have a continuity of their socio-political engagement online in offline activities and which kind of experiences it is. 3. Try to comprehend which was (or which were) the significant, learning experiences that convinced them about the potential of the web as tool for their activism.

Intercultural Performance and Dialogue. From Richard Schechner Performance Studies Onwards

Attraverso un excursus storico, teorico e metodologico, questa tesi di dottorato analizza la nascita, gli sviluppi e l’attuale dimensione costitutivo-identitaria dei Performance Studies, un ambito di ricerca accademica che, nato negli Stati Uniti alla fine degli anni Settanta, ha sempre palesato una natura restia nei confronti di qualunque tentativo definitorio. Se i Performance Studies concepiscono la performance sia come oggetto d’analisi sia come lente metodologica, e se, come evidenziato da Richard Schechner, praticamente tutto può essere “elevato a performance” e quindi indagato secondo le categorie analitiche di questa disciplina, ecco allora che, con uno slittamento transitivo e “meta-metodologico”, questa ricerca dottorale ha scelto come proprio oggetto di studio i Performance Studies stessi, osservandoli “as performance” e avvalendosi degli strumenti metodologici suggeriti dal suo stesso oggetto d’analisi. Questo lavoro indaga come l’oggetto di studio dei Performance Studies sia, seguendo la teoria schechneriana, il “behaved behavior”, e dunque come di conseguenza, il repertorio, prima ancora che l’archivio, possa essere considerato il fedele custode delle “pratiche incorporate”. Soffermandosi su esempi di “reenactment” performativo come quelli messi in atto da Marina Abramović e Clifford Owens, così come sui tentativi condotti dalla sezione dell’Intangible Cultural Heritage dell’UNESCO, suggerisce validi esempi di “archiviazione” della performance. L’elaborato prende poi in esame casi che esemplificano la proficua identificazione tra “studiare performance” e “fare performance”, sottolinea il ruolo cruciale e imprenscindibile determinato dal lavoro di ricerca sul campo inteso come “osservazione partecipante”, ed evidenzia il costante coinvolgimento sociale e politico assunto dai Performance Studies. Questa dissertazione affronta e supporta l’efficacia dei Performance Studies nel proporsi come uno strumento innovativo in grado di analizzare un mondo sempre più performativo nelle sue dinamiche. La loro natura tanto interdisciplinare quanto interculturale sembra farne una lente adeguata attraverso cui promuovere livelli diversi di performance dialogica tra culture localmente distinte ma globalmente assimilabili.

Methods and strategies to identify the mode of action of phytoactive compounds

Small molecules affecting biological processes in plants are widely used in agricultural practice as herbicides or plant growth regulators and in basic plant sciences as probes to study the physiology of plants. Most of the compounds were identified in large screens by the agrochemical industry, as phytoactive natural products and more recently, novel phytoactive compounds originated from academic research by chemical screens performed to induce specific phenotypes of interest. The aim of the present PhD thesis is to evaluate different approaches used for the identification of the primary mode of action (MoA) of a phytoactive compound. Based on the methodologies used for MoA identification, three approaches are discerned: a phenotyping approach, an approach based on a genetic screen and a biochemical screening approach.rnFour scientific publications resulting from my work are presented as examples of how a phenotyping approach can successfully be applied to describe the plant MoA of different compounds in detail.rnI. A subgroup of cyanoacrylates has been discovered as plant growth inhibitors. A set of bioassays indicated a specific effect on cell division. Cytological investigations of the cell division process in plant cell cultures, studies of microtubule assembly with green fluorescent protein marker lines in vivo and cross resistant studies with Eleusine indica plants harbouring a mutation in alpha-tubulin, led to the description of alpha-tubulin as a target site of cyanoacrylates (Tresch et al., 2005).rnII. The MoA of the herbicide flamprop-m-methyl was not known so far. The studies described in Tresch et al. (2008) indicate a primary effect on cell division. Detailed studies unravelled a specific effect on mitotic microtubule figures, causing a block in cell division. In contrast to other inhibitors of microtubule rearrangement such as dinitroanilines, flamprop-m-methyl did not influence microtubule assembly in vitro. An influence of flamprop-m-methyl on a target within the cytoskeleton signalling network could be proposed (Tresch et al., 2008).rnIII. The herbicide endothall is a protein phosphatase inhibitor structurally related to the natural product cantharidin. Bioassay studies indicated a dominant effect on dark-growing cells that was unrelated to effects observed in the light. Cytological characterisation of the microtubule cytoskeleton in corn tissue and heterotrophic tobacco cells showed a specific effect of endothall on mitotic spindle formation and ultrastructure of the nucleus in combination with a decrease of the proliferation index. The observed effects are similar to those of other protein phosphatase inhibitors such as cantharidin and the structurally different okadaic acid. Additionally, the observed effects show similarities to knock-out lines of the TON1 pathway, a protein phosphatase-regulated signalling pathway. The data presented in Tresch et al. (2011) associate endothall’s known in vitro inhibition of protein phosphatases with in vivo-effects and suggest an interaction between endothall and the TON1 pathway.rnIV. Mefluidide as a plant growth regulator induces growth retardation and a specific phenotype indicating an inhibition of fatty acid biosynthesis. A test of the cuticle functionality suggested a defect in the biosynthesis of very-long-chain fatty acids (VLCFA) or waxes. Metabolic profiling studies showed similarities with different groups of VLCFA synthesis inhibitors. Detailed analyses of VLCFA composition in tissues of duckweed (Lemna paucicostata) indicated a specific inhibition of the known herbicide target 3 ketoacyl-CoA synthase (KCS). Inhibitor studies using a yeast expression system established for plant KCS proteins verified the potency of mefluidide as an inhibitor of plant KCS enzymes. It could be shown that the strength of inhibition varied for different KCS homologues. The Arabidopsis Cer6 protein, which induces a plant growth phenotype similar to mefluidide when knocked out, was one of the most sensitive KCS enzymes (Tresch et al., 2012).rnThe findings of my own work were combined with other publications reporting a successful identification of the MoA and primary target proteins of different compounds or compound classes.rnA revised three-tier approach for the MoA identification of phytoactive compounds is proposed. The approach consists of a 1st level aiming to address compound stability, uniformity of effects in different species, general cytotoxicity and the effect on common processes like transcription and translation. Based on these findings advanced studies can be defined to start the 2nd level of MoA characterisation, either with further phenotypic characterisation, starting a genetic screen or establishing a biochemical screen. At the 3rd level, enzyme assays or protein affinity studies should show the activity of the compound on the hypothesized target and should associate the in vitro effects with the in vivo profile of the compound.

La revisione della traduzione editoriale dall'inglese all'italiano tra ricerca accademica, professione e formazione: stato dell'arte e prospettive future

Quando si parla di traduzione, si pensa spesso solo al risultato di un processo, valutato e analizzato come tale. Sembra ci si dimentichi del fatto che, prima di arrivare a quel risultato finale, il traduttore applica più o meno consapevolmente tutta quella serie di strumenti di analisi, critica, correzione, rilettura, riformulazione e modifica che rientrano nell’attività di revisione. A questa prima fase, di cui ogni traduttore fa esperienza nel lavorare alla propria traduzione, segue di norma una fase successiva in cui la traduzione è rivista da un’altra figura professionale della filiera editoriale (di solito, e auspicabilmente, un altro traduttore) e infine altre fasi ancora del processo di lavorazione e pubblicazione del testo tradotto. Oltre a essere un’attività cruciale di ogni attività di traduzione e processo editoriale, la revisione riveste anche un fondamentale ruolo didattico nella formazione dei traduttori. L’idea alla base di questo progetto di ricerca nasce dal bisogno di triangolare riflessioni e dati concreti sulla revisione provenienti dalla ricerca accademica, dalla pratica professionale e dall’esperienza didattico-formativa, in un triplice approccio che informa l’intero progetto, di cui si illustrano i principali obiettivi: • formulare una nuova e chiara definizione sommativa del termine “revisione” da potersi utilizzare nell’ambito della ricerca, della didattica e della prassi professionale; • fornire una panoramica tematica, critica e aggiornata sulla ricerca accademica e non-accademica in materia di revisione; • condurre un’indagine conoscitiva (tramite compilazione di questionari diversificati) sulla pratica professionale della revisione editoriale in Italia, allo scopo di raccogliere dati da traduttori e revisori, fornirne una lettura critica e quindi individuare peculiarità e criticità di questa fase del processo di lavorazione del libro tradotto; • presentare ipotesi di lavoro e suggerimenti su metodi e strumenti da applicare all’insegnamento della revisione in contesti didattici e formativi.

Das deutsche Kriegsgefangenenwesen 1939 - 1945

Zusammenfassung: Die vorliegende Untersuchung zum deutschen Kriegsgefangenenwesen (KGW) im Zweiten Weltkrieg schließt eine wichtige Lücke innerhalb der geschichtswissenschaftlichen Forschungen zum Themenkreis der Kriegsgefangenschaft in deutschem Gewahrsam. Bisherige Studien (bis einschließlich 1997) behandeln vor allem sozial- und kulturgeschichtliche Aspekte der Kriegsgefangenen (Kgf.), der Lagergesellschaft und dem Alltag von Soldaten in Kriegsgefangenschaft. Der Verfasser indes legt mit seiner Magisterarbeit erstmals eine Organisations- und Strukturgeschichte des deutschen Kriegsgefangenenwesens von 1939 bis 1945 vor, welche fundamentale Grundlagen der deutschen militärischen Lagerorganisation und Verwaltung dokumentiert. So wird die Entwicklung von den Vorkriegsplanungen bis zum Kriegsende anhand der zentralen Dienststellen herausgearbeitet und im Kontext des Genfer Kriegsgefangenenabkommens von 1929 und völkerrechtlicher Implikationen gewichtet. Hiermit untrennbar verbundene Einflußnahmen nichtmilitärischer Stellen in die Entscheidungsgewalt der Streitkräfte im Heimatkriegsgebiet und in den Wehrmachtbefehlshaberbereichen werden nicht zuletzt auch anhand mehrerer Organigramme veranschaulicht. Zudem dokumentiert und analysiert die Untersuchung die im Kriegsverlauf stetig verschärften Maßnahmen zur Fluchtprävention und der konzertierten Fahndung nach geflohenen Kriegsgefangenen: Die Machterosion des Oberkommandos der Wehrmacht (OKW) zugunsten des Reichsführers-SS, des Reichssicherheitshauptamts und nicht zuletzt der Parteikanzlei der NSDAP wird so augenfällig. Trotz eminenter Schriftgutverluste kann der Verfasser vor allem anhand einer nahezu vollständig erhaltenen Schlüsselquelle die Stellenbesetzung und Organisationsstruktur der mit Kriegsgefangenenfragen befassten Stellen im OKW rekonstruieren. Die Auswertung dieser Sammelmitteilungen / Befehlssammlung für das Kriegsgefangenenwesen sowie an anderer Stelle überlieferter Organisationsbefehle ermöglicht wichtige Änderungen am derzeitigen Forschungsstand. Darüber hinaus beschäftigt sich die vorliegende Untersuchung mit dem Arbeitseinsatz Kriegsgefangener in der deutschen Wirtschaft als in der zweiten Kriegshälfte zentralem Element der Kriegsgefangenschaft. Außerdem wird beleuchtet, welche politischen, (rassen)ideologischen oder reziprok konnotierten Faktoren den Stellenwert gefangener Soldaten unterschiedlicher Nationalität innerhalb der Gefangenenhierarchie im deutschen Kriegsgefangenenwesen bestimmten. Inhalt: 1. Einführung; 2. Die Entwicklung des Kriegsvölkerrechts und das Genfer Kriegsgefangenenabkommen von 1929; 3. Einleitende Bemerkungen zum deutschen Kriegsgefangenenwesen: Quellenlage, Grundlagen; 4. Organisationsstruktur und Aufgaben des KGW: Zuständigkeiten für Kgf. in OKW und OKH, Abt. Wehrmachtverluste und Kriegsgefangene, der General z.b.V. für das KGW 1939 bis Ende 1941, Allgemeine und Organisationsabteilung seit Januar 1942, Generalinspekteur und Inspekteur des KGW von Juli 1943 bis Oktober 1944, das Kriegsgefangenenwesen unter Himmler seit Oktober 1944; 5. Die Kriegsgefangenenlager: Lagertypen, Anzahl und Verwendung, die Gesamtzahl Kgf. und Belegstärken ausgewählter Lager; 6. Richtlinien für KGL: Die Sammelmitteilungen / Befehlssammlung für das KGW, Lagerorganisation und Behandlung Kriegsgefangener; 7. Die Post der Kriegsgefangenen: Tätigkeit von Auslandsbriefprüfstelle, Abwehr III Referat Kgf. und Abwehrstellen der Wehrkreise, Vorgaben für Postüberwachung und Stimmungsberichte der Asten, Befehle zur Kgf-Post und Kooperation mit Hilfsorganisationen und Schutzmächten; 8. Fluchtprävention: Bestimmungen und Maßnahmen zur Fluchtvereitelung, der Fluchterlass vom 22.09.1942, der Sonderfahndungsplan der Sicherheitspolizei und des SD vom 28.09.1942, Erlass zur Kriegsfahndung vom 5.12.1942, der Fluchterlaß vom 02.07.1943, der Erlaß zur Mitarbeit NSDAP bei Groß- und Kriegsfahndungen vom 10.07.1943, Schulung zur Fluchtprävention auf Wehrkreisebene 1944, Preisausschreiben "Wie verhindere ich Fluchten?" vom 09.04.1945, Anwerbung von V-Leuten durch die Abwehr; 9. Arbeitseinsatz Kriegsgefangener in der deutschen Wirtschaft und beteiligte Stellen; 10. Der Status Kriegsgefangener unterschiedlicher Nationalitäten im Vergleich; 11. Schluss

Revision of a Liquid Fuel Airblast Atomizer and Installation of a Laser Extinction System for Measurement of Soot Produced During Liquid Fuel Combustion

Studying liquid fuel combustion is necessary to better design combustion systems. Through more efficient combustors and alternative fuels, it is possible to reduce greenhouse gases and harmful emissions. In particular, coal-derived and Fischer-Tropsch liquid fuels are of interest because, in addition to producing fewer emissions, they have the potential to drastically reduce the United States' dependence on foreign oil. Major academic research institutions like the Pennsylvania State University perform cutting-edge research in many areas of combustion. The Combustion Research Laboratory (CRL) at Bucknell University is striving to develop the necessary equipment to be capable of both independent and collaborative research efforts with Penn State and in the process, advance the CRL to the forefront of combustion studies. The focus of this thesis is to advance the capabilities of the Combustion Research Lab at Bucknell. Specifically, this was accomplished through a revision to a previously designed liquid fuel injector, and through the design and installation of a laser extinction system for the measurement of soot produced during combustion. The previous liquid fuel injector with a 0.005" hole did not behave as expected. Through spray testing the 0.005" injector with water, it was determined that experimental errors were made in the original pressure testing of the injector. Using data from the spray testing experiment, new theoretical hole sizes of the injector were calculated. New injectors with 0.007" and 0.0085" orifices were fabricated and subsequently tested to qualitatively validate their behavior. The injectors were installed in the combustion rig in the CRL and hot-fire tested with liquid heptane. The 0.0085" injector yielded a manageable fuel pressure and produced a broad flame. A laser extinction system was designed and installed in the CRL. This involved the fabrication of a number of custom-designed parts and the specification of laser extinction equipment for purchase. A standard operating procedure for the laser extinction system was developed to provide a consistent, safe method for measuring soot formation during combustion.

Clinical end points in coronary stent trials: a case for standardized definitions

BACKGROUND: Although most clinical trials of coronary stents have measured nominally identical safety and effectiveness end points, differences in definitions and timing of assessment have created confusion in interpretation. METHODS AND RESULTS: The Academic Research Consortium is an informal collaboration between academic research organizations in the United States and Europe. Two meetings, in Washington, DC, in January 2006 and in Dublin, Ireland, in June 2006, sponsored by the Academic Research Consortium and including representatives of the US Food and Drug Administration and all device manufacturers who were working with the Food and Drug Administration on drug-eluting stent clinical trial programs, were focused on consensus end point definitions for drug-eluting stent evaluations. The effort was pursued with the objective to establish consistency among end point definitions and provide consensus recommendations. On the basis of considerations from historical legacy to key pathophysiological mechanisms and relevance to clinical interpretability, criteria for assessment of death, myocardial infarction, repeat revascularization, and stent thrombosis were developed. The broadly based consensus end point definitions in this document may be usefully applied or recognized for regulatory and clinical trial purposes. CONCLUSION: Although consensus criteria will inevitably include certain arbitrary features, consensus criteria for clinical end points provide consistency across studies that can facilitate the evaluation of safety and effectiveness of these devices.

Longest available clinical outcomes after drug-eluting stent implantation for unprotected left main coronary artery disease: the DELFT (Drug Eluting stent for LeFT main) Registry

OBJECTIVES: The purpose of this study was to investigate the long-term safety and efficacy of percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation for unprotected left main coronary artery (ULMCA) disease. BACKGROUND: Long-term clinical outcomes after DES implantation for ULMCA disease have not yet been ascertained. METHODS: From April 2002 to April 2004, 358 consecutive patients who underwent PCI with DES implantation for de novo lesions on ULMCA were retrospectively selected and analyzed in 7 European and U.S. tertiary care centers. No patients were excluded from the analysis, and all patients had a minimum follow-up of 3 years. RESULTS: Technical success rate was 100%. Procedural success rate was 89.6%. After 3 years, major adverse cardiovascular events (MACE)-free survival in the whole population was 73.5%. According to the Academic Research Consortium definitions, cardiac death occurred in 9.2% of patients, and reinfarction, target lesion revascularization (TLR), and target vessel revascularization (TVR) occurred in 8.6%, 5.8%, and 14.2% of patients, respectively. Definite stent thrombosis occurred in 2 patients (specifically at 0 and 439 days). In elective patients, the 3-year MACE-free survival was 74.2%, with mortality, reinfarction, TLR, and TVR rates of 6.2%, 8.3%, 6.6%, and 16%, respectively. In the emergent group the 3-year MACE-free survival was 68.2%, with mortality, reinfarction, TLR, and TVR rates of 21.4%, 10%, 2.8%, and 7.1%, respectively. CONCLUSIONS: Routine DES implantation in ULMCA disease seems encouraging, with favorable long-term clinical results.