A comparative analysis of primary stenting and optimal balloon coronary angioplasty in acute myocardial infarction. Six month results from the STENT PAMI trial

OBJECTIVE: To compare the outcome of balloon PTCA with final coronary stenosis diameter (SD) <=30%, with elective coronary stenting. METHODS: We performed a comparative analysis of the 6 month outcomes in patients treated with primary stenting and those who obtained an optimal balloon PTCA result treated during the first 12 hours of AMI onset included in the STENT PAMI randomized trial. RESULTS: The results were analysed into 3 groups: primary stenting (441 patients, SD=22±6%), optimal PTCA (245 patients), and nonoptimal PTCA (182 patients, SD= 37±5%). At the end of the 6 months primary stent group presented with the lowest restenosis(23 vs. 31 vs. 45%, p=0.001, respectively). Ischemia-driven target vessel revascularization rate (TVR) (7 vs. 15.5 vs. 19%, p=0.001, respectively). CONCLUSION: At the 6 month follow-up, primary stenting offered the lowest restenosis and ischemia-driven TVR rates. Compared to optimal balloon PTCA. Nonoptimal primary balloon PTCA pts (SD=31-50%), had the worst late angiographic outcomes and should be treated more actively with coronary stent implantation.

Sensitive label-free electron chemical capacitive transducer signal for D-dimer electroanalyses

Supplementary data associated with this article can be found, in the online version, at: http://dx.doi.org/10.1016/j.electacta.2015.09.169.

Avaliação da performance clínica de lentes de contacto descartáveis diárias: um estudo piloto

Dissertação de mestrado em Optometria Avançada

One-year follow-up after primary coronary intervention for acute myocardial infarction in diabetic patients: a substudy of the STENT PAMI trial

OBJECTIVE - This analysis was undertaken to determine the composite incidence of cumulative adverse events (death, reinfarction, disabling stroke, and target vessel revascularization) at the end of the first year after acute myocardial infarction, in diabetic patients who underwent coronary stenting or primary coronary balloon angioplasty. METHODS - From the STENT PAMI trial, we analyzed the 6-month angiographic and 1-year clinical outcomes of 135 diabetic (112, noninsulin dependent) patients who underwent the randomization process of the trial and compared them with 758 nondiabetic patients. RESULTS - Coronary stenting did not significantly reduce the primary composite clinical end point when compared with PTCA (20 vs. 30%, p=0.2). A significant benefit from stenting was observed in patients with noninsulin dependent diabetes, with a trend toward a lesser need for new revascularization procedures (10 vs. 21%, p<.001), with a significant reduction in the primary composite clinical end point at 1 year (12 vs. 28%, p=. 04). At 6 months, the restenosis rate were significantly reduced only in nondiabetic patients (18 vs. 33%, p<. 001). Diabetic patients had the same restenosis rate (38%) either with stenting or balloon PTCA. CONCLUSIONS - Coronary Stenting in diabetics noninsulin dependent offered a significant reduction in the composite incidence of major clinical adverse events compared with balloon PTCA.

Pre-clinical trials for Machado-Joseph Disease: Hypothesis-based and hypothesis-free therapeutic approaches

Tese de Doutoramento em Ciências da Saúde

Evaluación del uso “extra-label” de fluorquinolonas en llamas desde un enfoque plural: bienestar animal versus salud pública y ecotoxicología

La explotación comercial de la llama facilita la aparición de patologías bacterianas y parasitarias que producen importantes pérdidas económicas. Su prevención y el tratamiento exigen establecer regímenes terapéuticos eficaces y seguros que eviten la aparición de resistencias. La ausencia de especialidades farmacéuticas propias para esta especie y la falta de información científica sobre el comportamiento de los fármacos de uso habitual en llamas, obligan al veterinario a establecer pautas terapéuticas “fuera de prospecto”, a partir de su experiencia en otras especies. Esto conlleva el riesgo de alcanzar o bien niveles tóxicos o bien sub-terapéuticos, estos últimos facilitan la aparición de resistencias bacterianas transmisibles a otras poblaciones. Pretendemos describir el comportamiento cinético de dos antimicrobianos de amplio espectro y uso exclusivo en veterinaria (enrofloxacina y marbofloxacina). Los datos obtenidos nos permitirán evaluar la seguridad y eficacia de diferentes regímenes terapéuticos que puedan dar respuesta a las necesidades clínicas en esta especie. El proyecto que abordamos se encuentra en una línea de aprovechamiento de los recursos naturales dentro de un espíritu de compromiso social, desarrollo sostenible, bienestar animal y salud pública.

Ciclos económicos en economías abiertas y menos desarrolladas: el papel de los "shocks" en los términos de intercambio.The business cycle in open and less developed economies: the rol of terms-of-trade shocks.

Nuestra preocupación reside en estudiar empíricamente el mecanismo de transmisión internacional de ciclos económicos a economías pequeñas y menos desarrolladas (LDC), evaluando el impacto de los shocks en los términos de intercambio en países dónde existen imperfecciones en el mercado crediticio que imponen severas restricciones en el financiamiento de la inversión doméstica y al crecimiento económico. Primero, analizamos si la cuenta corriente responde de manera asimétrica a movimientos de largo plazo en los términos de intercambio. La hipótesis es que “en los buenos tiempos” cuando se produce una mejora permanente en términos de intercambio (y con ello el nivel de ingreso) los individuos no elevan su consumo en un monto acorde con la mejora de su ingreso (permanente) sino que ahorran una fracción del aumento en su dotación para hacer frente a una reversión en la mejora en los términos de intercambios (aunque ésta sea transitoria) en el futuro. En consecuencia, la cuenta corriente (diferencia entre ingreso y absorción) responde de manera positiva a un shock permanente en los términos de intercambio, ya que el individuo ahorra de manera cautelosa –debido a que sabe que no le prestarán para suavizar consumo - aún suponiendo que en el futuro tendrá una reversión transitoria de su ingreso. Segundo, estudiamos la relación dinámica entre los términos de intercambio y la tasa de interés en la economía pequeña abierta y con imperfecciones en el mercado crediticio (información asimétrica). La hipótesis es que la economía doméstica tiene que soportar una prima de riesgo que eleva el costo de la inversión y retarda el crecimiento (Gertler y Rogoff; 1990). Esta prima de riesgo depende, además, en forma negativa del nivel del colateral que tenga la economía. El colateral es la dotación de recursos naturales, por ejemplo, que la economía posee a los fines garantizar el cumplimiento de las obligaciones contraídas (en el modelo presentado las actividades dónde se invierten son independientes del colateral). La hipótesis establecida indica que los cambios en los términos de intercambio generan un aumento del colateral de la economía y una reducción del riesgo país: aumentos en los términos de intercambio reducen la prima de riesgo de la economía que opera en mercados de capitales con asimetrías de información, y como consecuencia aumentarían los ingresos de capitales. De esta forma, se estaría encontrando una explicación a la denominada “Paradoja de Lucas”. Finalmente, el proyecto estudia la conexión entre dos variables “clave” en la economía de los países emergentes: la relación entre los términos de intercambio y el tipo de cambio real. Argumentamos que los efectos de las mejoras de los términos de intercambio sobre los flujos de capitales externos tienden a ser sobreestimadas si no se consideran los efectos “secundarios” de éstas sobre el tipo de cambio real de la economía pequeña menos desarrollada. En este proyecto se controlan estadísticamente esta relación. La estrategia empírica elegida resulta en aplicar a un panel (constituido por dieciocho países de Latinoamérica) el método generalizado de momentos (GMM) a dos modelos de regresión estadística a los fines de abordar de manera eficiente el problema de la endogeneidad de la variable dependiente que actúa como regresor rezagado. La estrategia de estimación elegida enfatiza el análisis de la relación dinámica de las variables económicas incluidas en el análisis. The paper analyzes the general problem related to the transmission of economic cycles to Small Open Economies. The analysis focuses on terms-of-trade shocks, which are considered one of the major sources of income volatility in developing economies. Specifically, we tackle the problem related to the impact of terms-of-trade shocks in Less Developed SOEs. ‘Less Developed SOEs’ are understood as those countries who have borrowing constraints. First, we put to a test the hypothesis of asymmetric response of current account to terms-of-trade shocks (the impact of the shock on current account differs depending whether it is positive or negative), which originates from considering binding restrictions in international capital markets (Agénor and Aizenman; 2004). Second, we investigate about the main determinants of External Capital Flows (ECF) directed to Developing Countries. We put to a test the Gertler and Rogoff (1990) hypothesis that a “risky rate” arises in that markets because the economy has not sufficient amount of wealth to “collateralize” the capital she needs to borrow to take advantage of the investment opportunities she has and additionally because the lender does not have the chance of observing what the borrowed does with the funds (that is information asymmetry arises because the lender can check the realized output of investment but he can not observe if he really invest in the project or secretly lend abroad). Finally, Following Prasad, E. S., Rajan and R. Subramanian, A (2007) we measure the relationship between external capital flows and domestic currency overvaluation. We run a panel GMM estimation for a set of 18 Latin American Countries during the period 1973-2008.

Improving Post-Discharge Medication Adherence in Patients with CVD: A Pilot Randomized Trial

Background:Effective interventions to improve medication adherence are usually complex and expensive.Objective:To assess the impact of a low-cost intervention designed to improve medication adherence and clinical outcomes in post-discharge patients with CVD.Method:A pilot RCT was conducted at a teaching hospital. Intervention was based on the four-item Morisky Medication Adherence Scale (MMAS-4). The primary outcome measure was medication adherence assessed using the eight-item MMAS at baseline, at 1 month post hospital discharge and re-assessed 1 year after hospital discharge. Other outcomes included readmission and mortality rates.Results:61 patients were randomized to intervention (n = 30) and control (n = 31) groups. The mean age of the patients was 61 years (SD 12.73), 52.5% were males, and 57.4% were married or living with a partner. Mean number of prescribed medications per patient was 4.5 (SD 3.3). Medication adherence was correlated to intervention (p = 0.04) and after 1 month, 48.4% of patients in the control group and 83.3% in the intervention group were considered adherent. However, this difference decreased after 1 year, when adherence was 34.8% and 60.9%, respectively. Readmission and mortality rates were related to low adherence in both groups.Conclusion:The intervention based on a validated patient self-report instrument for assessing adherence is a potentially effective method to improve adherent behavior and can be successfully used as a tool to guide adherence counseling in the clinical visit. However, a larger study is required to assess the real impact of intervention on these outcomes.

Spatio-temporal dynamics of glycolysis in an open spatial reactor

Magdeburg, Univ., Fak. für Verfahrens- und Systemtechnik, Diss., 2008

Label monitoring on document streams

Magdeburg, Univ., Fak. für Informatik, Diss., 2012

Eine Schule für alle - Inklusive Bildung als Vision, als Label oder als Korrektur

[s.c.]

Storing Data in the Trial of Complex Technical Products

The article considers the ways of organization of databases for the storage of the results obtained during testing. A new variant of the organization of the data to ensure the ability to write to the database different sets of parameters in the form of chronological series. The required set of parameters depends on the modification of the tested technical installation.

Seasonal dynamics of a drosophilid (Diptera) assemblage and its potencial as bioindicator in open environments

Drosophila Fallen, 1823 (Diptera, Drosophilidae) is for long a well-established model organism for genetics and evolutionary research. The ecology of these flies, however, has only recently been better studied. Recent papers show that Drosophila assemblies can be used as bioindicators of forested environment degradation. In this work the bioindicator potential of drosophilids was evaluated in a naturally opened environment, a coastal strand-forest (restinga). Data from nine consecutive seasonal collections revealed strong temporal fluctuation pattern of the majority of Drosophila species groups. Drosophila willistoni group was more abundant at autumns, whereas D. cardini and D. tripunctata groups were, respectively, expressive at winters and springs, and D. repleta group at both seasons. The exotic species D. simulans Sturtevant, 1919 (from D. melanogaster group) and Zaprionus indianus Gupta, 1970 were most abundant at summers. Overall, the assemblage structure did not show the same characteristics of forested or urban environments, but was similar to the forests at winters and to cities at summers. This raises the question that this locality may already been under urbanization impact. Also, this can be interpreted as an easily invaded site for exotic species, what might lead to biotic homogenization and therefore can put in check the usage of drosophilid assemblages as bioindicators at open environments.