Effects of cobalt-chromium everolimus eluting stents or bare metal stent on fatal and non-fatal cardiovascular events: patient level meta-analysis

Objectives: To examine the safety and effectiveness of cobalt-chromium everolimus eluting stents compared with bare metal stents. Design: Individual patient data meta-analysis of randomised controlled trials. Cox proportional regression models stratified by trial, containing random effects, were used to assess the impact of stent type on outcomes. Hazard ratios with 95% confidence interval for outcomes were reported. Data sources and study selection: Medline, Embase, the Cochrane Central Register of Controlled Trials. Randomised controlled trials that compared cobalt-chromium everolimus eluting stents with bare metal stents were selected. The principal investigators whose trials met the inclusion criteria provided data for individual patients. Primary outcomes: The primary outcome was cardiac mortality. Secondary endpoints were myocardial infarction, definite stent thrombosis, definite or probable stent thrombosis, target vessel revascularisation, and all cause death. Results: The search yielded five randomised controlled trials, comprising 4896 participants. Compared with patients receiving bare metal stents, participants receiving cobalt-chromium everolimus eluting stents had a significant reduction of cardiac mortality (hazard ratio 0.67, 95% confidence interval 0.49 to 0.91; P=0.01), myocardial infarction (0.71, 0.55 to 0.92; P=0.01), definite stent thrombosis (0.41, 0.22 to 0.76; P=0.005), definite or probable stent thrombosis (0.48, 0.31 to 0.73; P<0.001), and target vessel revascularisation (0.29, 0.20 to 0.41; P<0.001) at a median follow-up of 720 days. There was no significant difference in all cause death between groups (0.83, 0.65 to 1.06; P=0.14). Findings remained unchanged at multivariable regression after adjustment for the acuity of clinical syndrome (for instance, acute coronary syndrome v stable coronary artery disease), diabetes mellitus, female sex, use of glycoprotein IIb/IIIa inhibitors, and up to one year v longer duration treatment with dual antiplatelets. Conclusions: This meta-analysis offers evidence that compared with bare metal stents the use of cobalt-chromium everolimus eluting stents improves global cardiovascular outcomes including cardiac survival, myocardial infarction, and overall stent thrombosis.

La reforma fiscal 2014 y la opinión de los asesores fiscales

La reforma fiscal en España ha sido una demanda recurrente en los últimos tiempos, posiblemente reforzada por la crisis económica. Esta fue aprobada a finales de 2014, entrando en vigor en 2015 y 2016. No se trata de una reforma global, habiéndose centrado en el IRPF y en el impuesto sobre sociedades. Este artículo repasa sus, a nuestro entender, aspectos más relevantes y, de manera novedosa, para identificar sus disfunciones, los contrasta con la opinión de los asesores fiscales, actores clave en nuestro sistema fiscal, dado el alcance mayoritario del mecanismo de autoliquidación. En general, se puede concluir que los trade-offs resueltos en esta reforma van en la dirección de elimi­nar, cuanto menos parcialmente, disfunciones previas, aunque, como se ha sugerido, hay aspectos todavía sin tratar (IVA o imposición sobre la riqueza).

Chromosomal evolution and comparative gene mapping in the Drosophila repleta species group

A review of our recent work on the cromosomal evolution of the Drosophila repleta species group is presented. Most studies have focused on the buzzatii species complex, a monophyletic set of 12 species which inhabit the deserts of South America and the West Indies. A statistical analysis of the length and breakpoint distribution of the 86 paracentric inversions observed in this complex has shown that inversion length is a selected trait. Rare inversions are usually small while evolutionary successful inversions, fixed and polymorphic, are predominantly of medium size. There is also a negative correlation between length and number of inversions per species. Finally, the distribution of inversion breakpoints along chromosome 2 is non-random, with chromosomal regions which accumulate up to 8 breakpoints (putative "hot spots"). Comparative gene mapping has also been used to investigate the molecular organization and evolution of chromosomes. Using in situ hybridization, 26 genes have been precisely located on the salivary gland chromosomes of D. repleta and D. buzzatii; another nine have been tentatively identified. The results are fully consistent with the currently accepted chromosomal homologies between D. repleta and D. melanogaster, and no evidence for reciprocal translocations or pericentric inversions has been found. The comparison of the gene map of D. repleta chromosome 2 with that of the homologous chromosome 3R of D. melanogaster shows an extensive reorganization via paracentric inversions and allows to estimate an evolution rate of ~1 inversion fixed per million years for this chromosome

Making home rules for mother tongues : the legal implications of linguistic diversity in the design of autonomy regimes

Principen om nationalismen där det politiska och det nationella är samspelt kan vara av markant betydelse för uppbyggande av autonomiska regimer. Likaså tillåter decentralicering och delegering av befogenheter för språk och utbildning (officiellt erkännande av språk, standardisering av språk, undervisningsspråk och relaterade läroplaner) formning av identiteter inom dessa autonomiska regimer. Resultatet är en ofullkomlig cirkulär relation där språk, samfund och politiska institutioner ömsesidigt och kontinuerligt formar varandra: lingvistiskt mångfald prägar och formger autonomiska ordningar och vice-versa. De juridiska implikationerna av territoriella och icke-territoriella former av autonomi är dock av en annan art. Emedan territoriell autonomi bygger på idéen om ett eventuellt inkluderande hemland för lingvistiska grupper, vars vistelseort är avgörande, förstärker den icke-territoriella autonomin idéen om ett exclusivt samfund bestående av själv-identifierade medlemmar som är kapabla till självstyre oavsett territoriella gränser. Denna avhandling utgör an analys av sådana juridiska implikationer genom komparativa och institutionella analyser. Avhandlingen föreslår som resultat en serie av normativa och pragmatiska rekommendationer inriktade på att främja demokratiseringsprocesser i linje med principer om multikulturalism.

La educación no formal de adultos en Costa Rica : un panorama de instituciones y sus programas

Tesis (Maestría en Educación de Adultos) (UANL)

Epistemología de lo social

Tesis (Maestría en Metodología de las ciencias) UANL

Distribución y taxonomía del género neotoma (Mammalia: rodentia)en el estado de Nuevo León, México

Tesis (Maestría en Ciencias con Especialidad en Manejo de Vida Silvestre) UANL

Determinación del número de variantes y frecuencias génicas de microsatélites de ADN en las razas bovinas Holstein Friesian y simmentalen el noreste de México

Tesis (Maestría en Ciencias Veterinarias con Énfasis en Producción Animal) UANL

Tratamiento de la mastitis crónica recurrente

Tesis (Esp. Ginecología y Obstetricia) U.A.N.L.

Análisis jurídico del Sistema Estatal de Planeación de Desarrollo Urbano del Estado de Nuevo León

Tesis (Maestría en Derecho Público) U.A.N.L.

Sinopsis pedagógica del Colegio Civil 1933-1993 : (2a. parte)

UANL

Sinopsis pedagógica del Colegio Civil : primera parte \f 1857-1932

UANL

Monterrey y sus 400 años en la educación

UANL

El porfiriato y la malograda revolución mexicana

UANL