Assessment of the diagnostic value of diffusion tensor imaging in patients with spinal cord compression: a meta-analysis

We investigated the diagnostic value of the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) of magnetic resonance diffusion tensor imaging (DTI) in patients with spinal cord compression (SCC) using a meta-analysis framework. Multiple scientific literature databases were exhaustively searched to identify articles relevant to this study. Mean values and standardized mean differences (SMDs) were calculated for the ADC and FA in normal and diseased tissues. The STATA version 12.0 software was used for statistical analysis. Of the 41 articles initially retrieved through database searches, 11 case-control studies were eligible for the meta-analysis and contained a combined total of 645 human subjects (394 patients with SCC and 251 healthy controls). All 11 studies reported data on FA, and 9 contained data related to the ADC. The combined SMDs of the ADC and FA showed that the ADC was significantly higher and the FA was lower in patients with SCC than in healthy controls. Subgroup analysis based on the b value showed higher ADCs in patients with SCC than in healthy controls at b values of both ≤500 and >500 s/mm2. In summary, the main findings of this meta-analysis revealed an increased ADC and decreased FA in patients with SCC, indicating that DTI is an important diagnostic imaging tool to assess patients suspected to have SCC.

Contact force-guided catheter ablation for the treatment of atrial fibrillation: a meta-analysis of randomized, controlled trials

Contact force (CF) sensing technology allows real-time monitoring during catheter ablation for atrial fibrillation (AF). However, the effect of CF sensing technology on procedural parameters and clinical outcomes still needs clarification. Because of the inconsistent results thus far in this area, we performed a meta-analysis to determine whether CF sensing technology can improve procedural parameters and clinical outcomes for the treatment of AF. Studies examining the benefits of CF sensing technology were identified in English-language articles by searching the MEDLINE, Web of Science, and Cochrane Library databases (inception to May 2015). Ten randomized, controlled trials involving 1834 patients (1263 males, 571 females) were included in the meta-analysis (681 in the CF group, 1153 in the control group). Overall, the ablation time was significantly decreased by 7.34 min (95%CI=-12.21 to -2.46; P=0.003, Z test) in the CF group compared with the control group. CF sensing technology was associated with significantly improved freedom from AF after 12 months (OR=1.55, 95%CI=1.20 to 1.99; P=0.0007) and complications were significantly lower in the CF group than in the control group (OR=0.50, 95%CI=0.29 to 0.87; P=0.01). However, fluoroscopy time analysis showed no significantly decreased trend associated with CF-guided catheter ablation (weighted mean difference: -2.59; 95%CI=-9.06 to 3.88; P=0.43). The present meta-analysis shows improvement in ablation time and freedom from AF after 12 months in AF patients treated with CF-guided catheter ablation. However, CF-guided catheter ablation does not decrease fluoroscopy time.

Randomized controlled trials of serotonin-norepinephrine reuptake inhibitor in treating major depressive disorder in children and adolescents: a meta-analysis of efficacy and acceptability

New generation antidepressant therapies, including serotonin-norepinephrine reuptake inhibitor (SNRIs), were introduced in the late 1980s; however, few comprehensive studies have compared the benefits and risks of various contemporary treatments for major depressive disorder (MDD) in young patients. A comprehensive literature search of PubMed, Cochrane, Embase, Web of Science, and PsycINFO databases was conducted from 1970 to January 2015. Only clinical trials that randomly assigned one SNRI or placebo to patients aged 7 to 18 years who met the diagnostic criteria for major depressive disorder were included. Treatment success, dropout rate, and suicidal ideation/attempt outcomes were measured. Primary efficacy was determined by pooling the risk ratios (RRs) of treatment response and remission. Acceptability was determined by pooling the RRs of dropouts for all reasons and for adverse effects as well as suicide-risk outcomes. Five trials with a total of 973 patients were included. SNRIs were not significantly more effective than placebo for treatment response but were for remission. The comparison of patients taking SNRIs that dropped out for all reasons and those taking placebo did not reach statistical significance. Significantly more patients taking SNRIs dropped out for adverse effects than those taking placebo. No significant difference was found in suicide-related risk outcomes. SNRI therapy does not display a superior efficacy and is not better tolerated compared to placebo in these young patients. However, duloxetine has a potential beneficial effect for depression in young populations, showing a need for further research.

Prevalência de tuberculose em transplantados renais: revisão sistemática e meta-análise

INTRODUÇÃO: A prevalência de tuberculose entre transplantados renais (TB-TXR) é maior do que na população geral. Assim, objetivamos realizar uma revisão sistemática e meta-análise da prevalência de TB-TXR. MÉTODOS: Após buscas eletrônicas e revisão de referências, estimou-se a prevalência agrupada de TB-TXR e realizou-se meta-regressão. Como referência para comparações, utilizou-se a prevalência de TB na população geral (0,18%; 95% IC = 0,16-0,20). RESULTADOS: Foram triados 253 estudos e 41 incluídos. A prevalência agrupada de TB-TXR foi 2,51% (95% IC = 2,17-2,85). Na meta-regressão, amostra > 2501 e alta prevalência de TB na população geral (p < 0,05) permaneceram associadas com a prevalência de TB-TXR. CONCLUSÃO: A prevalência agrupada de TB-TXR encontrada foi 14 vezes maior do que a prevalência de TB na população geral e, dessa forma, destacamos a necessidade de que o planejamento de medidas de prevenção e controle da TB específicas para este grupo de indivíduos seja pauta nas discussões do setor saúde.

Polimorfismo nulo dos genes GSTM1 e GSTT1 na suscetibilidade do câncer renal: evidências baseadas em meta-análise

ResumoIntroduçãoO câncer renal é uma doença oncourológica complexa e multifatorial.Objetivo:Realizar uma meta-análise para investigar a associação do polimorfismo nulo dos genes GSTM1 e GSTT1 no contexto do câncer renal.Método:Estudos em seres humanos, do tipo caso-controle, publicados no período de 1999 a 2013, que investigavam a associação do polimorfismo nulo dos genes GSTM1 e GSTT1 no câncer renal, foram agrupados para a confecção da presente meta-análise.Resultados:Foram selecionados 10 artigos sobre o tema proposto. Não foram encontradas associações entre o polimorfismo nulo dos genes GSTM1 (OR = 1,015; IC95% = 0,897-1,147) e GSTT1 (OR = 1,081; IC95% = 0,791- 1,479) e o câncer renal.Conclusões:Conclui-se que os polimorfismos nulos de GSTM1 e GSTT1 não estão associados ao risco do desenvolvimento de câncer renal, pois apresentam papel limitado, se é que existe alguma contribuição efetiva, no desenvolvimento dos tumores renais.

Efeitos da independência do banco central e da taxa de rotatividade sobre a inflação brasileira

Nowadays, the belief is strong in the Brazilian federal government that operational central bank independence is a basic condition to assure price stability. The literature concerning this subject highlights that a high degree of independence and a low turnover of central bank governor are associated with low inflation. This paper analyzes the relation between central bank independence and inflation in Brazil during 1980-2002. The findings denote that there is no effect on inflation due to an increase in degree of independence and a fall in turnover rate.

Metas para inflação e taxa de juros no Brasil: uma análise do efeito dos preços livres e administrados

After surpassed more than half a decade since the adoption of inflation targeting in Brazil, it can be seen that maintaining a high interest rate is inherent to the strategy for the conduction of the monetary policy. The objective of this paper is to show that the present policy for defining the basic interest rate of the economy, based on the response to inflation considering both market and administered prices, is onerous for the Brazilian society. Based on findings from empirical evidence in the period 1999-2004, the adoption of a core inflation, a change in the time horizon for definition of targets, and, in common agreement between Banco Central do Brasil and National Treasury, a definition of these inflation targets, as a framework to increase efficiency of the monetary regime, creates possibilities for proposing a reduction on the Selic rate.

Inflação e deflação de ativos a partir do mercado imobiliário americano

This paper deals with the financial crisis triggered after the default of subprime mortgages in the United States which expanded to a global systemic crisis. It is divided into a brief introduction and three sections. The first section sums up the dynamics of inflation and deflation of real estate and financial assets which characterizes finance-led cycles. The second section covers major effect of financial assets deflation on the American and European banks. The third section focuses on measures implemented by central banks in order to manage this financial crisis.

Metas de inflação em perspectiva: a influência do trinômio reputação-credibilidade-transparência sobre a economia

Although inflation target regime seeks to serve as a reference for the expectation formation process of the agents, its implementation does not necessarily imply the acquisition or the best result in terms of economic growth. The present article aims the development of a model that explains, by firms' investment decisions, the product path behavior, undertaking monetary authority may present distinct situations associated with the reputation-credibility-transparency trinomial. The article also detaches different kinds of reputation and its degrees.

Metas de inflação, política monetária e investimento: um estudo para dezessete países

In this paper two hypotheses about the relationship between monetary policy and investment in the context of the inflation target system were tested. One of these hypotheses is based on the idea of neutrality of money, and the other hypothesis is based on the reject of that idea. An investment equation for seventeen economies using a piece-wise dummy variable was estimated by the Methodology of Panel Data. The results highlight that a negative correlation between current expectation of restrictive monetary policy and current investment rose after the inflation target system implementation.

Metas de inflação: lições da era Greenspan

This paper approaches the experience of monetary policy in the Greenspan period and suggests what lessons could be learnt. The adoption of inflation targeting would denote a step backward in the policymaking process in the USA, for, since the 1980s, a distinctive feature is flexibility of response to adjust to unexpected events and changing environments. The Fed was able to exercise an informed judgement in critical situations and this opens the case for the importance of not restraining policymakers' actions through the adoption of tight rules. Furthermore, that the various experiences with inflation targeting are indisputably huge successes, and that this framework represents the state of the art (therefore nothing else can alternatively be done), remains to be seen.

Endividamento público, crescimento, moeda e inflação: comentário a "Matemática agradável", de Gerson Lima

The paper aims at analyzing the article by Gerson Lima on the manner by which fiscal deficit should be covered. It presents a more general dynamic model, where the principle of effective demand is explicitly used. By doing that, it is possible to treat as endogenous variables the national income and the government entries, what brings the result that the public debt must not follow an explosive path unless the very restrictive conditions of Lima's paper prevail. It also evaluates Lima's implicit inflation theory, and argues against his approximation to Friedman's framework.

Endividamento público, crescimento, moeda e inflação: comentário a "matemática agradável", de Gerson Lima - a réplica

This paper aims at replying critical commentaries made by Leite, F. P., Aggio, G. O. e Angeli, E. (this Review, 2009) on two Author's theses. The first one states that, if public deficit is to be financed, then either interest rate applied is negative or government invests as if it where a profit-making business enterprise. Otherwise, public debt will mathematically follow an explosive trend. The second one says that if there is no debt and public deficit is paid with money issuing, then the monetary stock will tend to an equilibrium level.

Juros, câmbio e o sistema de metas de inflação no Brasil

Interest rate, exchange rate and the system of inflation target in Brazil. In the consensus view of the Brazilian system of inflation targeting, the core of inflation is due to demand shocks; the rate of interest is set to control demand; and some variation in the exchange rate happens as "collateral damage". In this note we argue that in reality core inflation comes from cost push; the interest rate affects the exchange rate; changes in the exchange rate affect costs and prices; it is the effect of interest rates on demand that is the "collateral damage" and that the long run anchor of the system is low average real wage rigidity.