Impacto de la infraestructura de la calidad en América Latina: síntesis

Prólogo de Alicia Bárcena

Midiendo el impacto de la infraestructura de la calidad en América Latina: experiencias, alcances y limitaciones

Incluye bibliografía.

Measuring the impact of quality infrastructure in Latin America: Experiences, achievements and limitations

This document, which is partly based on by the study Impacto de la Infraestructura de la Calidad en América Latina, is a second joint effort by the Economic Commission for Latin America and the Caribbean (ECLAC) and the German National Metrology Institute (PTB) to move towards a more detailed understanding of the role played by the Quality Infrastructure in opening up possibilities for the countries in the region to innovate and compete. Through methodological analysis and the realization of case studies at the national level in certain countries in the region, the document seeks to offer a more comprehensive picture of the impact of the Quality Infrastructure and its importance for the economic and social development of countries. The document analyzes various QI related aspects, with particular emphasis on a review of conceptual elements, the role of the QI in the innovation systems of countries and a brief analysis of a set of case studies in Latin American countries. It also identifies a series of challenges and limitations for carrying out impact studies. These elements are taken up again in the final conclusions of the book, where a number of policy recommendations are outlined.

Should intentional endovascular stent-graft coverage of the left subclavian artery be preceded by prophylactic revascularisation?

Thoracic endovascular aortic repair (TEVAR) has emerged as a promising therapeutic alternative to conventional open aortic replacement but it requires suitable proximal and distal landing zones for stent-graft anchoring. Many aortic pathologies affect in the immediate proximity of the left subclavian artery (LSA) limiting the proximal landing zone site without proximal vessel coverage. In patients in whom the distance between the LSA and aortic lesion is too short, extension of the landing zone can be obtained by covering the LSA's origin with the endovascular stent graft (ESG). This manoeuvre has the potential for immediate and delayed neurological and vascular symptoms. Some authors, therefore, propose prophylactic revascularisation of the LSA by transposition or bypass, while others suggest prophylactic revascularisation only under certain conditions, and still others see no requirement for prophylactic revascularisation in anticipation of LSA ostium coverage. In this review about LSA revascularisation in TEVAR patients with coverage of the LSA, we searched the electronic databases MEDLINE and EMBASE historically until the end date of May 2010 with the search terms left subclavian artery, covering, endovascular, revascularisation and thoracic aorta. We have gathered the most complete scientific evidence available used to support the various concepts to deal with this issue. After a review of the current available literature, 23 relevant articles were found, where we have identified and analysed three basic treatment concepts for LSA revascularisation in TEVAR patients (prophylactic, conditional prophylactic and no prophylactic LSA revascularisation). The available evidence supports prophylactic revascularisation of the LSA before ESG LSA coverage when preoperative imaging reveals abnormal supra-aortic vascular anatomy or pathology. We further conclude that elective patients undergoing planned coverage of the LSA during TEVAR should receive prophylactic LSA transposition or LSA-to-left-common-carotid-artery (LCCA) bypass surgery to prevent severe neurological complications, such as paraplegia or brain stem infarction.

Ueber die physische und moralische Verfassung der heutigen Juden

Stimme eines Kosmopoliten [d.i. Karl Wilhelm Friedrich Grattenauer]

Wider die Juden : ein Wort der Warnung an alle unsere christliche Mitbürger

[Verf.: Karl Wilhelm Friedrich Grattenauer]

Erklärung an das Publikum über meine Schrift : Wider die Juden

von C. W. F. Grattenauer

Erster Nachtrag zu seiner Schrift : Wider die Juden

Karl Wilhelm Friedrich Grattenauer

Anti-Israel : eine Vorlesung in d. geheimen Akademie zum grünen Esel als Entrittsrede

geh. von Horatius Cocles [d.i. Karl Christian Ernst Graf von Benzel-Sternau]

Wider die Juden : ein Wort der Warnung an alle unsere christliche Mitbürger

[Verf.: r, d.i. Karl Wilhelm Friedrich Grattenauer]

Die Juden im Preußischen Staate : eine geschichtl. Darstellung d. politischen, bürgerl. u. privatrechtl. Verhältnisse d. Juden in Preußen, nach d. verschiedenen Landesteilen

von C. F. Koch

Symbolik des Mosaischen Cultus

Karl Christian Wilhelm Felix Baehr

Lamb Temporal Bone as a Surgical Training Model of Round Window Cochlear Implant Electrode Insertion

OBJECTIVE The preservation of residual hearing in cochlear implantation opens the door for optimal functional results. This atraumatic surgical technique requires training; however, the traditional human cadaveric temporal bones have become less available or unattainable in some institutions. This study investigates the suitability of an alternative model, using cadaveric lamb temporal bone, for surgical training of atraumatic round window electrode insertion. INTERVENTION A total of 14 lamb temporal bones were dissected for cochlear implantation by four surgeons. After mastoidectomy, visualization, and drilling of the round window niche, an atraumatic round window insertion of a Medel Flex24 electrode was performed. Electrode insertion depth and position were verified by computed tomography scans. MAIN OUTCOME MEASURE All cochleas were successfully implanted using the atraumatic round window approach; however, surgical access through the mastoid was substantially different when compared human anatomy. The mean number of intracochlear electrode contacts was 6.5 (range, 4-11) and the mean insertion depth 10.4 mm (range, 4-20 mm), which corresponds to a mean angular perimodiolar insertion depth of 229 degrees (range 67-540°). Full insertion of the electrode was not possible because of the smaller size of the lamb cochlea in comparison to that of the human. CONCLUSION The lamb temporal bone model is well suited as a training model for atraumatic cochlear implantation at the level of the round window. The minimally pneumatized mastoid as well as the smaller cochlea can help prepare a surgeon for difficult cochlear implantations. Because of substantial differences to human anatomy, it is not an adequate training model for other surgical techniques such as mastoidectomy and posterior tympanotomy as well as full electrode insertion.

December 1848 - März 1849

Boberach: Vom Standpunkt des linken Zentrums wird die Entwicklung der Parteien in der Nationalversammlung und der Verlauf der diplomatischen Verhandlungen über die Reichsverfassung vom Kremsier[er] Programm bis zum Rücktritt des Ministeriums Gagern dargestellt und die Erklärungen der Regierungen von Österreich, Preußen und Bayern kritisiert. - Wentzke: Sehr wertvolle Darstellung der Parteigestaltung in der Paulskirche nach dem Programm von Kremsier. Erörterung der diplomatischen Verhandlungen über die Reichsverfassung, soweit sie bekannt wurden. Kritik der österreichischen, bairischen [sic!] und preußischen Erklärungen vom Standpunkt der Gagern'schen Partei im engeren Sinne und ihrer Wirkung auf die Beratungen der Paulskirche. Beilage: Denkschrift über die künftigen Beziehungen zu Österreich vom Februar 1849 (von Wurm?)