The role of videopericardioscopy in evaluating indeterminate pericardial effusions

Background. The pericardial biopsy has opened a new perspective for the etiologic diagnosis of pericardial effusions, because adequate pericardial visualization via the use of a video camera can provide more accurate results. We assessed the usefulness of videopericardioscopy for the diagnosis and treatment of pericardial effusion of indeterminate origin. Methods. We conducted a retrospective study of clinical data from patients who underwent videopericardioscopy examination for pericardial effusion without an established diagnosis. The video-assisted pericardioscopy procedure was performed through a small incision in the xiphoid area. Results. From January 1998 to January 2007, 101 consecutive patients underwent videopericardioscopy evaluation for pericardial effusion. Ten patients were excluded because of lack of data. Fifty men and 41 women were included ( mean age, 50 years; range, 14-76 years). All of the patients had moderate or significant pericardial effusion as demonstrated by echocardiography or computed tomography. The following diagnoses for the pericardial effusions were established: nonspecific inflammation, 50 cases ( 54.94%); neoplastic disorders, 22 cases ( 24.17%); tuberculous, 11 cases ( 12.08%); bacterial inflammatory process, 3 cases ( 3.29%); chylopericardial, 2 cases ( 2.19%); fungal infection, 2 cases ( 2.19%); and viral infection, 1 case ( 1.09%). Pericardioscopy evaluation provided the definitive diagnosis via the pericardial biopsy in 36.26% of the cases and via the results of fluid analyses in 13.18% of the cases; the use of both methods established the definitive diagnosis in 45.05% of the cases in this group of patients. The overall morbidity rate was 4.3%, and the most common complication was arrhythmia due to intraoperative manipulation, which ceased with the removal of the instruments from the pericardial cavity. We had 1 death, by cardiac tamponade, in the perioperative period. Conclusion. Videopericardioscopy is a safe and efficient method for obtaining a better diagnosis of and satisfactory therapeutic results for pericardial effusions of indeterminate cause, and such results are obtained via an improved exploration of the pericardial cavity.

Stabilization constraints from different-average public debt levels in a Monetary Union with country-size asymmetry

In the sequence of the recent financial and economic crisis, the recent public debt accumulation is expected to hamper considerably business cycle stabilization, by enlarging the budgetary consequences of the shocks. This paper analyses how the average level of public debt in a monetary union shapes optimal discretionary fiscal and monetary stabilization policies and affects stabilization welfare. We use a two-country micro-founded New-Keynesian model, where a benevolent central bank and the fiscal authorities play discretionary policy games under different union-average debt-constrained scenarios. We find that high debt levels shift monetary policy assignment from inflation to debt stabilization, making cooperation welfare superior to noncooperation. Moreover, when average debt is too high, welfare moves directly (inversely) with debt-to-output ratios for the union and the large country (small country) under cooperation. However, under non-cooperation, higher average debt levels benefit only the large country.

Anticipation, Learning and Welfare: the Case of Distortionary Taxation

We study the impact of anticipated fiscal policy changes in a Ramsey economy where agents form long-horizon expectations using adaptive learning. We extend the existing framework by introducing distortionary taxes as well as elastic labour supply, which makes agents. decisions non-predetermined but more realistic. We detect that the dynamic responses to anticipated tax changes under learning have oscillatory behaviour that can be interpreted as self-fulfilling waves of optimism and pessimism emerging from systematic forecast errors. Moreover, we demonstrate that these waves can have important implications for the welfare consequences of .scal reforms. (JEL: E32, E62, D84)

Preinfarction angina prior to first myocardial infarction does not influence long-term prognosis: a retrospective study with subgroup analysis in elderly and diabetic patients.

BACKGROUND AND HYPOTHESIS Although prodromal angina occurring shortly before an acute myocardial infarction (MI) has protective effects against in-hospital complications, this effect has not been well documented after initial hospitalization, especially in older or diabetic patients. We examined whether angina 1 week before a first MI provides protection in these patients. METHODS A total of 290 consecutive patients, 143 elderly (>64 years of age) and 147 adults (<65 years of age), 68 of whom were diabetic (23.4%) and 222 nondiabetic (76.6%), were examined to assess the effect of preceding angina on long-term prognosis (56 months) after initial hospitalization for a first MI. RESULTS No significant differences were found in long-term complications after initial hospitalization in these adult and elderly patients according to whether or not they had prodromal angina (44.4% with angina vs 45.4% without in adults; 45.5% vs 58% in elderly, P < 0.2). Nor were differences found according to their diabetic status (61.5% with angina vs 72.7% without in diabetics; 37.3% vs 38.3% in nondiabetics; P = 0.4). CONCLUSION The occurrence of angina 1 week before a first MI does not confer long-term protection against cardiovascular complications after initial hospitalization in adult or elderly patients, whether or not they have diabetes.

Issuance of patient reminders for influenza vaccination by US-based primary care physicians during the first year of universal influenza vaccination recommendations.

To estimate the number of physician-reported influenza vaccination reminders during the 2010-2011 influenza season, the first influenza season after universal vaccination recommendations for influenza were introduced, we interviewed 493 members of the Physicians Consulting Network. Patient vaccination reminders are a highly effective means of increasing influenza vaccination; nonetheless, only one quarter of the primary care physicians interviewed issued influenza vaccination reminders during the first year of universal vaccination recommendations, highlighting the need to improve office-based promotion of influenza vaccination.

The Conservativeness of the Central Bank when Institutional Quality is Poor

We propose an extension of Alesina and Tabellini 's model (1987) to include corruption, which is understood as the presence of weak institutions collecting revenue through formal tax channels. This paper analyses how conservative should an independent central bank be when the institutional quality is poor. When there are no political distortions, we show that the central bank has to be more conservative than the government, except with complete corruption. In this particular case, the central bank should be as conservative as the government. Further, we obtain that the relationship between the optimal relative degree of conservativeness of the central bank and the degree of corruption is affected by supply shocks. Concretely, when these shocks are not important, the central bank should be less conservative if the degree of corruption increases. However, this result may not hold when the shocks are relevant. JEL classi fication: D6, D73, E52, E58, E62, E63. Keywords: Central Bank Conservativeness; Corruption; Fiscal Policy; Monetary Policy; Seigniorage.

Nutritional influences on lipogenesis and thermogenesis after a carbohydrate meal.

In vivo lipogenesis and thermogenesis were studied for 24 h after ingestion of 500 g of carbohydrate (CHO) in subjects who had consumed either a high-fat, a mixed, or a high-CHO diet during the 3-6 days preceding the test. CHO oxidation and conversion to fat was significantly less in the high-fat diet group (222 +/- 5 g) than in the mixed (300 +/- 13 g) or high-CHO diet (331 +/- 7 g) groups, resulting in a greater glycogen storage in the high-fat (278 +/- 6 g) than in the other two groups (197 +/- 11 and 170 +/- 2 g). Net lipogenesis occurred sooner and lasted longer in the high-CHO group, amounting to 0.8 +/- 0.5, 3.4 +/- 0.6, and 9 +/- 1 g of lipid synthesized in the high-fat, mixed, and high-CHO groups, respectively. The thermic effect of the CHO load was 5.2 +/- 0.5% on the high-fat, 6.5 +/- 0.4% on the mixed diet, and 8.6 +/- 0.4% on the high-CHO diet. Significant relationships were demonstrated between the postabsorptive nonprotein respiratory quotient and net lipogenesis after the CHO load (r = 0.82) and between net lipogenesis and the increase in energy expenditure (r = 0.71). It is concluded that the antecedent diet influences the amount of net lipogenesis and the magnitude of thermogenesis after a large CHO test meal. However, lipogenesis remains too limited even after such large CHO intakes to cause an increase in the body's fat content.

The Effects of Corruption and Seigniorage on Growth and Inflation

In the last two decades, cases of corruption have been unveiled in different countries, raising public awareness and reinforcing a trend in which society expects more from their leaders. Our objective in this paper is to examine the effects of corruption and seigniorage on inflation and growth rates. The model used in this article is an extension of the model used by Huang and Wei (2006). We find interesting results and one of them is that, under some conditions, corruption has a positive impact on the growth rate. JEL classification : D73, E52, E58, E62. Keywords : Corruption; Fiscal Policy; Growth; Monetary Policy; Seigniorage.

Competição relativa de espécies de plantas daninhas com dois cultivares de soja

Um experimento para avaliação da competição relativa de espécies de plantas daninhas, em relação a cultivares de soja de ciclos vegetativo precoce (Embrapa-48) e médio (Embrapa-62), foi instalado em Londrina-PR, em 1998/99. Foram comparadas quatro espécies daninhas: amendoim-bravo (Euphorbia heterophylla), capim-marmelada (Brachiaria plantaginea), corda-de-viola (Ipomoea grandifolia) e fedegoso (Senna obtusifolia), ajustadas às densidades de 0, 15 e 30 plantas m-2. O experimento foi conduzido em blocos casualizados, com parcelas subdivididas, fatorial 4x3x2 e quatro repetições. A emergência da soja e a das plantas daninhas foram quase simultâneas. Ambos os cultivares responderam de modo similar à competição. A produtividade do cv. Embrapa-48 foi de 2.819 kg ha-1, e a do cv. Embrapa-62, de 2.565 kg ha-1, na ausência de plantas daninhas. As intensidades relativas médias de competição foram: B. plantaginea (0,35) < I. grandifolia (0,59) < E. heterophylla (0,61) < S. obtusifolia (1,00). As estimativas de redução de produtividade de soja, feitas por meio de equações de regressão linear/cultivar, indicaram os seguintes coeficientes de redução (%) por unidade de planta daninha m-2: B. plantaginea (Y E48 = -1,47; Y E62 = -1,58); I. grandifolia (Y E48 = -2,51; Y E62 = -2,67), E. heterophylla (Y E48= -2,47; Y E62 = -2,83); e S. obtusifolia (Y E48 = 4,52; Y E62 = -4,21). Equações de ajuste de reduções de produção de soja às infestações de plantas daninhas são discutidas.

Early Development and Putative Primordial Germ Cells Characterization in Dogs

Contents Previously, three distinct populations of putative primordial germ cells (PGCs), namely gonocytes, intermediate cells and pre-spermatogonia, have been described in the human foetal testis. According to our knowledge, these PGCs have not been studied in any other species. The aim of our study was to identify similar PGC populations in canine embryos. First, we develop a protocol for canine embryo isolation. Following our protocol, 15 canine embryos at 21-25 days of pregnancy were isolated by ovaryhysterectomy surgery. Our data indicate that dramatic changes occur in canine embryo development and PGCs specification between 21 to 25 days of gestation. At that moment, only two PGC populations with distinct morphology can be identified by histological analyses. Cell population 1 presented round nuclei with prominent nucleolus and a high nuclear to cytoplasm ratio, showing gonocyte morphology. Cell population 2 was often localized at the periphery of the testicular cords and presented typical features of PGC. Both germ cell populations were positively immunostained with anti-human OCT-4 antibody. However, at day 25, all cells of population 1 reacted positively with OCT-4, whereas in population 2, fewer cells were positive for this marker. These two PGCs populations present morphological features similar to gonocytes and intermediate cells from human foetal testis. It is expected that a population of pre-spermatogonia would be observed at later stages of canine foetus development. We also showed that anti-human OCT-4 antibody can be useful to identify canine PGC in vivo.

Economia política do gasto social no Brasil desde 1980/85

Este Artigo Compara Dois Documentos de Pontos de Vista Ideológicos Opostos Sobre Gastos Sociais. Ambos Concordam que Existe Regressividade nos Sistemas de Seguridade Social. o Documento Lisboa Conclui que os Gastos Sociais são em Geral Regressivos, em Contraposição ao Documento Porchmann. Demonstra-Se neste Artigo Que, após a Transição para a Democracia em 1985, Enquanto o Crescimento da Renda foi de Apenas 8,5% em 20 Anos, os Gastos Sociais Per Capita Cresceram 43,4%. este Incremento Explica a Significativa Melhora dos Padrões Sociais do Período e Demonstra Que, Contrário À Visão Conservadora, os Gastos Sociais Foram Efetivos em Reduzir a Desigualdade.

The political economy of global economic disgovernance

A Desgovernança Econômica Global, Mais do que a Governança Caracteriza Hoje a Economia Mundial. Dois Fatos Substanciam Essa Afirmativa: a Crise Recorrente do Balanço de Pagamentos nos Países em Desenvolvimento, e o Enorme Déficit em Conta Corrente dos Estados Unidos. as Crises nos Mercados Emergentes são Essencialmente Resultantes da Estratégia que o Norte Propõe para o Sul: a Estratégia de Crescimento com Poupança Externa. Dado o Fato de que a Entrada de Capital Aumenta a Taxa de Cambio, e que os Paises não Reconheceram as Principais Oportunidades de Investimento nos Anos 1990, Tal Estratégia Levou não ao Aumento das Taxas de Acumulação de Capital e ao Crescimento, Mas ao Aumento do Déficit em Conta Corrente e À Crise do Balanço de Pagamento (Financeiro). por Outro Lado, o Déficit em Conta Corrente dos Estados Unidos é um Problema Sério. Aquele Já é um País Devedor, Mas os Ajustes Continuam a ser Adiados. a Probabilidade de um Soft Landing (Desfecho Satisfatório) é Pequena. as Duas Fontes de Instabilidade Estão Relacionadas Aos Déficits em Conta Corrente e À Moeda Sobrevalorizada. a Política Econômica por Trás tem um Nome: Taxa de Câmbio Populista, uma das Duas Formas de Populismo Econômico (A Outra é o Populismo Fiscal). Isto não é Surpreendente em Países em Desenvolvimento, Mas Pode ser em um País Desenvolvido, como os Estados Unidos. Ainda Assim não é Surpreendente Quando se Considera a Recessão Política e Social que a Sociedade Americana Está Vivendo Desde o Fim da Segunda Guerra

Upper Lip Prosthesis Retained to a Palatal Obturator

In cases of total or partial maxillectomies, the prosthetic rehabilitation is an effective alternative to minimize the sequelae left by surgical resection. The present study reports a clinical case of a 52-year-old patient who underwent partial maxillectomy, with upper lip involvement. The oronasal communication, resultant from surgical resection, did not allow the patient to return to her normal social life. Besides, the upper lip partial resection damaged her face's aesthetics. The proposed treatment was the confection of an upper lip prosthesis retained by a palatal obturator. The prosthesis insertion restored the patient's facial aesthetics, contributing not only to function, but also to psychosocial adaptation.

Early Development and Putative Primordial Germ Cells Characterization in Dogs

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)