Trends in Primary Angioplasty in Portugal From 2002 to 2013 According to the Portuguese National Registry of Interventional Cardiology

INTRODUCTION AND OBJECTIVES: The aim of the present paper was to report trends in coronary angioplasty for the treatment of ST-elevation myocardial infarction (STEMI) in Portugal. METHODS: Prospective multicenter data from the Portuguese National Registry of Interventional Cardiology (RNCI) and official data from the Directorate-General for Health (DGS) were studied to analyze percutaneous coronary intervention (PCI) procedures for STEMI from 2002 to 2013. RESULTS: In 2013, 3524 primary percutaneous coronary intervention (p-PCI) procedures were performed (25% of all procedures), an increase of 315% in comparison to 2002 (16% of all interventions). Between 2002 and 2013 the rate increased from 106 to 338 p-PCIs per million population per year. Rescue angioplasty decreased from 70.7% in 2002 to 2% in 2013. During this period, the use of drug-eluting stents grew from 9.9% to 69.5%. After 2008, the use of aspiration thrombectomy increased, reaching 46.7% in 2013. Glycoprotein IIb-IIIa inhibitor use decreased from 73.2% in 2002 to 23.6% in the last year of the study. Use of a radial approach increased steadily from 8.3% in 2008 to 54.6% in 2013. CONCLUSION: During the reporting period there was a three-fold increase in primary angioplasty rates per million population. Rescue angioplasty has been overtaken by p-PCI as the predominant procedure since 2006. New trends in the treatment of STEMI were observed, notably the use of drug-eluting stents and radial access as the predominant approach.

Global, regional, and national levels of maternal mortality,1990–2015 : a systematic analysis for the Global Burden of Disease Study 2015

Aplicación de la escala National Institutes of Health Stroke Scale (NIHSS) en pacientes ingresados en el Hospital Vicente Corral Moscoso con diagnóstico de enfermedad cerebrovascular isquémica, enero-diciembre de 2004, Cuenca-Ecuador

Estudio descriptivo de pacientes con ictus isquémico ingresados en el Hospital Vicente Corral dentro de las 24 horas de inicio de síntomas, desde enero a diciembre de 2004. El daño neurológico inicial fue cuantificado usando la NIHSS. El desenlace neurológico fue valorado a los 7 días y 3 meses utilizando el Indice de Barthel. Resultados: De 75 pacientes ingresados en el período de estudio, 24 cumplieron los criterios de inclusión y 23 completaron el seguimiento. A los 3 meses 66.7de pacientes, con puntaje inicial NIHSS menor que 6 evolucionaron a un resultado excelente. Los pacientes con un puntaje NIHSS igual o mayor que 16 tuvieron un mal desenlace. El 50de pacientes con un puntaje de 16 a 20 y los pacientes con puntaje mayor que 20 fallecieron. En el análisis estadístico, un puntaje mayor a 13 tuvo un Odds Ratio de 49.5 (IC 954.5 - 480.5) para un desenlace fatal a los 3 meses. La asociación fue significativa lo que otorga al punto de corte de 13 puntos una gran validez para pronosticar un buen o mal desenlace. Conclusión. Aplicando el NIHSS a los pacientes con ictus isquémico observamos que un puntaje igual o mayor a 16 predice una alta probabilidad de muerte o severa incapacidad, mientras que un puntaje igual o menor a 6 pronostica una buena recuperación. Descriptores DeCS. Ictus isquémico, NIHSS, Índice de Barthel

Primary prevention of neural tube defects: data from the portuguese national registry of congenital anomalies (RENAC)

Background: In Portugal folic acid supplementation is recommended to start at least 2-3 months before conception for primary prevention of Neural Tube Defects. The aim of this study was to evaluate, within gestations with at least one congenital anomaly, possible association between maternal socio-demographic factors and the use of folic acid. Methods: Using data from the Portuguese national registry of congenital anomalies, for the 2004-2013 period, the association between folic acid use during pregnancy and maternal characteristics was studied using the chi-square test. Results: Considering all reported cases with congenital anomaly, the use of folic acid before conception was reported by 12.7% (n = 1233) of the women; 47.8% (n = 4623) started supplementation during the 1st trimester, 7% (n = 680) did not take folic acid and 32.5% (3143) of the records had no information on folic acid use. Women with professions that require higher academic differentiation started the use of supplements before pregnancy (p <0.001); women under 19 years old and with Arab ethnicity (p <0.001) did not take folic acid. Mothers with a previous pregnancy reported less use of folic acid (11.5% versus 14.7%) than mothers without a previous pregnancy (p <0.001). Conclusions: The results suggest some degree of association between maternal characteristics and use of folic acid. To increase the consumption of folic acid before pregnancy new measures are need to promote this primary prevention, among couples and health professionals. This study highlights some maternal characteristics and subgroups of mothers for who the measures should be reinforced.

Resistance to phosphine in Sitophilus oryzae in Australia: A national analysis of trends and frequencies over time and geographical spread

In Australia, along with many other parts of the world, fumigation with phosphine is a vital component in controlling stored grain insect pests. However, resistance is a factor that may limit the continued efficacy of this fumigant. While strong resistance to phosphine has been identified and characterised, very little information is available on the causes of its development and spread. Data obtained from a unique national resistance monitoring and management program were analysed, using Bayesian hurdle modelling, to determine which factors may be responsible. Fumigation in unsealed storages, combined with a high frequency of weak resistance, were found to be the main criteria that led to the development of strong resistance in Sitophilus oryzae. Independent development, rather than gene flow via migration, appears to be primarily responsible for the geographic incidence of strong resistance to phosphine in S. oryzae. This information can now be utilised to direct resources and education into those areas at high risk and to refine phosphine resistance management strategies.

OLD NATIONAL BIBLIOGRAPHIC 1830 A 1900 BOOKS FOR THE NATIONAL LIBRARY OF COSTA RICA "Miguel Obregón Lizano"

The Final Graduation submitted to qualify for the degree of Bachelor of Library and Information Science, with the title: Old National Bibliographical Books from 1830 to 1900 for the National Library of Costa Rica "Miguel Obregon Lizano," has raised the following objectives general: Identify, create a computerized catalog and investigate policies of conservation, preservation and loan in order to facilitate access and information retrieval, and dissemination of books published between 1830 to 1900 by a CDROM.According to the above objectives are to identify, select and separate, and integrate the National Bibliographical Old Books from 1830 to 1900, under investigation, determined in accordance with this study, a pioneer in the creation of bibliographic old in the National Library of Costa Rica "Miguel Obregon Lizano," a valuable amount of documents, which are not always available to (as) students (as), for lack of disclosure or because they are not represented in catalogs, consistent with recent technology dictates.According to research, it is considered that there is a lack of old collections, and therefore, the concept, organization and creation of such funds, reason leads them to testify that this would be one of the first forays into this subject, and thus, a great contribution to the National Library and for the field of librarianship and the country at large, as it has managed to create a source of access to information for the service (as) users (as): researchers (as), historians (as), anthropologists (as), and the community at large. Therefore, the fundamental purpose of this study the unquestionable usefulness of Old National Bibliographical Books for (as) users (as) researchers (as) of the National Library.

UPDATE NEEDS OF PROFESSIONAL LIBRARY: Diagnosis of teachers and graduate degree from the School of Library, Documentation and Information (EBDI), National University of Costa Rica

This project is a diagnosis of update needs and training for professionals in bibliotecology and its results will be used for the design of a Program of Permanent training in bibliotecology, which will be implemented in Bibliotecology School, Documentation and Information of the National University.The studied population is composed by all the teachers of Bibliotecology School, Documentation and Information of the National University, in October, 2007, and all the graduated students of licentiate of the EBDI from 2000 to 2007.The results of this investigation were obtained by means of a questionnaire that was filled by each one of the members of these two populations, who corresponded to 25 teachers of the EBDI and 18 graduates of licentiate. This one also presents the information that was obtained in interviews realized to the managers of the principal institutions who are professionals contracted in bibliotecology.The results obtained of this diagnosis will allow the elaboration of the Program of Permanent training in bibliotecology, considering the formative needs of the professionals in bibliotecology of the EBDI. This project includes the following products:a) Description of the social and demographic characteristics of teachers and of graduated of licentiate of the EBDI.b) Diagnosis of needs to update and training of bibliotecology professional teachers and of graduated of licentiate of the EBDI.c) Determination of the knowledge and skills that the needs to satisfy what big employers ask for.d) Recommendations for the program. Implementation.

National evaluation of NHS genetics service investments: emerging issues from the cancer genetics pilots

In seeking to fulfil the ambition of the 2003 genetics white paper, Our Inheritance, Our Future, to ‘mainstream’ genetic knowledge and practices, the Department of Health provided start-up funding for pilot services in various clinical areas, including seven cancer genetics projects. To help to understand the challenges encountered by such an attempt at reconfiguring the organization and delivery of services in this field, a programme-level evaluation of the genetics projects was commissioned to consider the organizational issues faced. Using a qualitative approach, this research has involved comparative case-study work in 11 of the pilot sites, including four of the seven cancer genetics pilots. In this paper, the researchers present early findings from their work, focusing in particular on the cancer genetics pilots. They consider some of the factors that have influenced how the pilots have sought to address pre-existing sector, organizational and professional boundaries to these new ways of working. The article examines the relationship between these factors and the extent to which pilots have succeeded in setting up boundary-spanning services, dealing with human-resource issues and creating sustainable, ‘mainstreamed’ provision which attracts ongoing funding in a volatile NHS commissioning environment where funding priorities do not always favour preventive, risk-assessment services.

Charges against members of the House and lobby activities of the National association of manufacturers of the United States and others. Hearings before the Select Committee of the House of Representatives appointed under House resolution 198, Sixty-third Congress, first session, July 12 to [Sept. 19] 1913.

Mode of access: Internet.

Cross-resistance to elvitegravir and dolutegravir in 502 patients failing on raltegravir: a French national study of raltegravir-experienced HIV-1-infected patients

International audience

Preliminary plan for the National Botanical Garden and Arboretum, Washington, D.C. : as recommended by the National Commission of Fine Arts /

Also covers part of Anacostia Park.