Valistuneita arvauksia : talousennusteiden osuvuus 1997-2001

Kirjoitus perustuu vuosikokousesitelmään Kansantaloudellisessa Yhdistyksessä 21.3.2002.

Outcome of patients with acute coronary syndrome in hospitals of different sizes in Switzerland

Objective: To assess the impact of patient admission in different hospital types in Switzerland on early in-hospital and 1-year outcomes in patients with acute coronary syndrome (ACS).Methods: From 1997 to 2009, 31,010 ACS patients from 76 Swiss hospitals were enrolled in the AMIS Plus registry. Large tertiary teaching institutions with 24 hour/7 day cardiac catheterization facilities were classified as type A hospitals, all others as type B. One-year outcome was studied in a subgroup of patients admitted after 2005. Multivariate logistic regression models were used to calculate the odds ratios (OR with 95%CI) for independent predictors of mortality and major adverse cardiac events (MACE).Results: There were 11 type A hospitals with admissions of 15,987 (52%) patients and 65 type B hospitals with 15,023 (48%) patients. Patients initially admitted into B hospitals were older, more frequently female, hypertensive and diabetic, had more severe comorbidities and more frequently NSTE-ACS/UA. They were less likely to receive aspirin, clopidogrel and GPIIb/IIIa antagonists. STE-ACS patients initially admitted into B hospitals received more thrombolysis than those admitted into A hospitals, but less percutaneous coronary intervention (PCI). From the patients admitted to B hospitals, 5271 (35%) were transferred for intervention. Crude in-hospital mortality and MACE were higher in patients from B hospitals. Crude 1-year mortality of 3747 ACS patients followed up was higher in patients initially admitted into B hospitals, but no differences were found for MACE. Hospital type, after adjustment for age, risk factors, type of ACS and co-morbidities, was not an independent predictor of in-hospital mortality (OR 0.94; 0.76-1.16), in-hospital MACE (0.98; 0.82-1.17), 1-year mortality or 1-year MACE (1.06; 0.85-1.33). Analysis of the time of admission indicated a crude outcome in favor of hospitalization during duty-hours but no significant effect could be documented for 1-year outcome.Conclusion: ACS patients admitted to type B hospitals were older, had more severe co-morbidities, more NSTEACS and received less intensive treatment. However, after correcting for baseline inequalities, early and mid-term outcomes were similar regardless of hospital type. Ultimate patient outcome thus does not appear to be influenced by the type of hospital where the initial admission takes place. Appropriate early referral of selected patients probably partly explains this finding.

Eficiência de diferentes volumes e concentrações de calda para quebra de dormência na macieira cultivar 'Gala'

Este trabalho teve como objetivo avaliar a eficiência dos diferentes volumes de calda --340, 450, 1.000, 1.350 L/ha -- em duas concentrações de óleo mineral (OM) + cianamida hidrogenada (CH) -- 30+3 e 50+5 L/ha, respectivamente -- em macieira da cultivar Gala. Os resultados mostraram que nos anos com, pelo menos, 800 unidades de frio, todos os volumes e concentrações foram eficientes, exceto o de 340 L/ha, na concentração de 30+3 L/ha de OM+CH. Nos anos com menos de 800 unidades de frio, os melhores resultados foram com a concentração de 50+5 L/ha de OM+CH, em todos os volumes testados.

Evolution: social selection for eccentricity.

The dress code of paper wasps, like that of humans, is related to their social habits: species with a flexible nest-founding strategy have highly variable black-and-yellow markings. This color polymorphism facilitates individual recognition and might have been selected to permit complex social interactions.

Anteeksi kuinka, mutta mistä olikaan kysymys?

Vastine Ilkka Pyysiäisen Tieteessä tapahtuu -lehdessä 2/2002 olleeseen kirjoitukseen

Valores bioquímicos sanguíneos en hembras brahman bajo condiciones de pastoreo

Con el objeto de establecer un rango de referencia para diferentes metabolitos en hembras bovinas B. indicus, se tomaron 5-10 mL de suero sanguíneo a 21 hembras bovinas Brahman registradas en el departamento de Caldas, Colombia. Se determinó la concentración de los diferentes metabolitos que forman parte de un perfil metabólico estándar, como beta-hidroxibutirato, proteína total, albúmina, globulinas, urea, aspartato aminotransferasa (AST), calcio y magnesio. Los resultados fueron analizados mediante la obtención del rango, promedio y desviación estándar (DE). El intervalo de referencia se estableció en el 95% (x±2DE). El promedio y la DE obtenidos para cada metabolito fueron: beta-hidroxibutirato 0,34±0,15 mmol/L; proteína total 81±9 g/L; albúmina 41±3 g/L; globulinas 40±10 g/L; urea 3,31±1,43 mmol/L; AST 158±34 U/L; Ca 2,50±0,21 mmol/L y Mg 1,40±0,44 mmol/L. Se observó que las alteraciones más frecuentes fueron aumento en la concentración de butiratos y globulinas y aumento en la actividad de AST. Según los resultados obtenidos, se puede señalar que los valores encontrados para la concentración de diferentes metabolitos séricos en hembras Brahman mantenidas en pastoreo, son similares a los valores descritos para bovinos B. taurus.

Tutkimuksen merkitystä ei pidä yliarvioida

Kommentti Risto Selinin (Tieteessä tapahtuu 1/2002) arvioon väitöskirjasta Pyhät bodarit - yhteisöllisyys ja onni täydellisessä ruumiissa.

High Molecular Weight Methacrylate Sealing of a Bridge Deck, HR-2031, 1988

The Iowa Department of Transportation used a high molecular weight methacrylate (HMWM) resin to seal a 3,340 ft. x 64 ft. bridge deck in October 1986. The sealing was necessary to prevent deicing salt brine from entering a substantial number of transverse cracks that coincided with the epoxy coated top steel and unprotected bottom steel. HMWM resin is a three component product composed of a monomer, a cumene hydroperoxide initiator and a cobalt naphthenate promoter. The HMWM was applied with a dual spray bar system and flat-fan nozzles. Initiated monomer delivered through one spray bar was mixed in the air with promoted monomer from the other spray bar. The application rate averaged 0.956 gallons per 100 square feet for the tined textured driving lanes. Dry sand was broadcast on the surface at an average coverage of 0.58 lbs. per square yard to maintain friction. Coring showed that the HMWM resin penetrated the cracks more than two inches deep. Testing of the treated deck yielded Friction Numbers averaging 33 with a treaded tire compared to 36 prior to treatment. An inspection soon after treatment found five leaky cracks in one of the 15 spans. One inspection during a steady rain showed no leakage, but leakage from numerous cracks occurred during a subsequent rain. A second HMWM application was made on two spans. Leakage through the double application occurred during a rain. Neither the single or double application were successful in preventing leakage through the cracks.

Visualization of aqueous shunt position and patency using anterior segment optical coherence tomography.

PURPOSE: To describe the use of anterior segment optical coherence tomography (AS-OCT) to clarify the position and patency of aqueous shunt devices in the anterior chamber of eyes where corneal edema or tube position does not permit a satisfactory view. DESIGN: Noncomparative observational case series. METHODS: Four cases are reported in which aqueous shunt malposition or obstruction was suspected but the shunt could not be seen on clinical examination. The patients underwent AS-OCT to identify the position and patency of the shunt tip. RESULTS: In each case, AS-OCT provided data regarding tube position and/or patency that could not be obtained by slit-lamp examination or by gonioscopy that influenced management. CONCLUSIONS: AS-OCT can be used to visualize anterior chamber tubes in the presence of corneal edema that precludes an adequate view or in cases where the tube is retracted into the cornea. In such cases, AS-OCT is useful in identifying shunt patency and position, which helps guide clinical decision making.