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.

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.

Óleo da castanha de caju: oportunidades e desafios no contexto do desenvolvimento e sustentabilidade industrial

The new millennium is marked by a growing search for renewable fuels and alternative raw materials from biomass in the petrochemicals industry. However, there are many challenges to overcome regarding technological and human resources aspects. In this scenario, cashew nut oil, which is rich in natural phenols, is considered to be very promising for the development of synthetic and functional products and as a feedstock for production of fine chemicals and a wide variety of new materials.

Otto R. Gottlieb e as conexões com o Brasil de Ernest Wenkert

Prof. Ernest Wenkert's connections with Brazil on this side of the Atlantic Ocean involved two important links: Profs. Jayr de Paiva Campello and Otto R. Gottlieb. The former, along with Prof. Giuseppe Cilento, was one of those responsible for setting up the Institute of Chemistry of UNICAMP, while Otto Gottlieb was the great pioneer of Natural Products Chemistry in Brazil. The bridge between these two professors and Wenkert paved the way for several Brazilian chemists to visit the USA, and was also important for bringing some PhDs to Brazil.

Suppea historiikki katolisen kirkon puolustajasta

Kirjallisuusarvostelu

Alguns momentos do debate sobre as teorias do 'não-si' e das 'duas verdades' na história da filosofia buddhista

O artigo reconstrói alguns momentos salientes do desenvolvimento das doutrinas do 'não-si' e das 'duas verdades' na história da filosofia buddhista, desde as formulações originárias do buddhismo de base, às conclusões alcançadas por Nāgārjuna, o fundador da escola mahāyāna do Madhyamaka. Ao longo dessa sintética reconstrução, algumas passagens das Mūlamadhyamikakārikās de Nāgārjuna, cruciais para entender a sua (controversa) concepção epistemológica, mostrar-se-ão semelhantes, no tocante à estruturação e ao desenvolvimento do discurso, à primeira parte das Milinda Pañha, um diálogo para-canônico que escolhe uma abordagem apofática para tratar o tema da 'verdade última'. Tal paralelismo formal entre as passagens dos dois textos sugere a possibilidade de uma correspondência 'substancial' entre a concepção nagarjuniana e aquela das Milinda Pañha no que se refere ao 'ultimamente verdadeiro'.

AS DUAS VERDADES DE NĀGĀRJUNA NOS COMENTÁRIOS DE BHĀVIVEKA E CANDRAKĪRTI

RESUMO Entre os vários pontos da obra de Nāgārjuna que deram origem a análises e discussões, o tema das 'duas verdades' é um dos mais controversos. Com efeito, dentro da ampla bibliografia dedicada a essa temática, são muitas, e amiúde divergentes, as tentativas de explicar o que Nāgārjuna entendesse - no verso 24.8 das suas Mūla-madhyamaka-kārikā (MMK) - com as expressões 'verdade convencional' e 'verdade suprema'. Esses pontos de vista interpretativos, entretanto, frequentemente, parecem prescindir daquele que talvez seja o critério mais confiável para dirimir as controvérsias relativas às MMK: i. e., a leitura dos comentários indianos às mesmas MMK. Em contraste com essa tendência, este escrito objetiva investigar as passagens do Prajñāpradīpa e das Prasannapadā onde encontramos explicações, respectivamente de Bhāviveka e de Candrakīrti, que dizem respeito às duas verdades. O resultado dessa pesquisa se apresentará como nitidamente favorável à interpretação da doutrina das duas verdades que, em outros escritos, chamei de 'pedagógica'.

A solo per me l'infamia

Soitinnus: sopraano, baritoni, orkesteri.

No vecchio t'inganni

Soitinnus: sopraano, baritoni, orkesteri.

Dite alla giovine

Soitinnus: sopraano, baritoni, orkesteri.

[Ennustajalintu]

Soitinnus: piano.

[Aaria oopperasta Martha]

Soitinnus: lauluääni (tenori), orkesteri.

[Duetto Parigi o cara oopperasta La Traviata]

Soitinnus: lauluäänet (sopraano, tenori), orkesteri.

[Duetto Teco io sto oopperasta Naamiohuvit]

Soitinnus: lauluäänet (sopraano, tenori), orkesteri.