Sex-related inequalities in management of patients with acute coronary syndrome-results from the EURHOBOP study

Background: Real‐world data from different levels of hospital specialisation would help to understand if differences in management between women and men with acute coronary syndrome (ACS) are still a priority target. We aimed to identify sex inequalities in management of patients with different types of ACS. Methods: We analysed 1757 patients with a non‐ST‐elevation ACS (NSTEACS) and 1184 with ST elevation myocardial infarction (STEMI) or left bundle branch block (non‐classifiable (NC) ACS (STEMI/NC ACS group), consecutively discharged from ten Portuguese hospitals with different specialisation levels, between 2008 and 2010. We estimated odds ratios (OR) and 95% confidence intervals (95% CI) for the association between sex and the performance of coronary angiography, reperfusion and revascularisation. Results: Among STEMI/NC ACS, men had higher probability of performing coronary angiography than women (adjusted OR = 1.64, 95% CI: 1.11‐2.44), while among NSTEACS patients there was no significant difference by sex (adjusted OR = 1.26, 95% CI: 0.99‐1.62). In patients who underwent coronary angiography, there was no difference in proportion of women and men submitted to revascularisation, regardless of the ACS type. Although men with STEMI/NC ACS were more likely to undergo reperfusion (crude OR = 2.17, 95% CI: 1.68‐2.81), the effect became not significant after multivariable adjustment (adjusted OR = 1.33, 95% CI: 0.96‐1.84). Conclusion: Women diagnosed with STEMI/NC, but not NSTEACS, had lower probability when compared with men to be submitted to coronary angiography. There was no difference in performance of reperfusion and revascularisation by sex.Executive Agency for Health and Consumers, Grant/Award Number: 2008 13 12 - EURHOBOP; Universidade do Porto (EPIUnit), Grant/Award Number: POCI-01-0145-FEDER-006862

The Highly Miniaturised Radiation Monitor

We present the design and preliminary calibration results of a novel highly miniaturised particle radiation monitor (HMRM) for spacecraft use. The HMRM device comprises a telescopic configuration of active pixel sensors enclosed in a titanium shield, with an estimated total mass of 52 g and volume of 15 cm$^3$. The monitor is intended to provide real-time dosimetry and identification of energetic charged particles in fluxes of up to 10$^8$ cm$^{-2}$ s$^{-1}$ (omnidirectional). Achieving this capability with such a small instrument could open new prospects for radiation detection in space.Comment: 17 pages, 15 figure

Transmission of correlated electrons through sharp domain walls in magnetic nanowires: a renormalization group approach

The transmission of correlated electrons through a domain wall in a ferromagnetic one dimensional system is studied theoretically in the limit of a domain wall width smaller or comparable to the electron Fermi wavelength. The domain wall gives rise to both potential and spin dependent scattering of the charge carriers. Using a poor man's renormalization group approach for the electron-electron interactions, we obtain the low temperature behavior of the reflection and transmission coefficients. The results show that the low-temperature conductance is governed by the electron correlations, which may suppress charge transport without suppressing spin current. The results may account for a huge magnetoresistance associated with a domain wall in ballistic nanocontacs.Comment: 13 pages, 6 figure

Stevens-Johnson syndrome/toxic epidermal necrolysis and erythema multiforme drug-related hospitalisations in a national administrative database

BACKGROUND: Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and erythema multiforme (EM) are immunologically-mediated dermatological disorders commonly triggered by drug exposure and/or other external agents. We aimed to characterise SJS/TEN- and EM-drug-related hospitalisations in a nationwide administrative database, focusing on demographic and clinical characteristics, and in the most frequently implicated drug classes. METHODS: We analysed all drug-related hospitalisations with associated diagnosis of SJS/TEN or EM in Portuguese hospitals between 2009 and 2014. We compared gender, age, comorbidities, length of stay, and in-hospital mortality and estimated the number of episodes per million packages sold of drug classes. Predictors of in-hospital mortality were investigated in both conditions by logistic regression. RESULTS: There were 132 SJS/TEN-related and 122 EM-related hospitalisations. Incidence and in-hospital mortality of SJS/TEN episodes (24.2%) were consistent with previous studies. HIV co-infection was more common among SJS/TEN hospitalisations (9 vs. 2% with EM; P = 0.009). Liver disease, advanced age, and a TEN diagnosis, were significantly associated with higher risk of mortality in patients with SJS/TEN. The highest numbers of SJS/TEN and EM episodes per million drug packages sold were observed for antivirals (8.7 and 1.5, respectively), antineoplastic/immunosuppressive drugs (5.6 and 3.9, respectively) and hypouricaemic drugs (5.0 and 2.4, respectively). CONCLUSIONS: SJS/TEN in-hospital mortality is high, and its risk factors include advanced age, liver disease, and TEN diagnosis. The drug classes most frequently associated with these conditions include antivirals, hypouricaemic drugs and antineoplastic/immunosuppressive drugs. Administrative databases seem useful in the study of SJS/TEN drug-related hospitalisations, yielding results consistent with previous studies and on a nationwide basis.info:eu-repo/semantics/publishedVersio

Comportamento dos suínos submetidos a diferentes períodos de aspersão e descanso.

Projeto/Plano de Ação: 02.06.01.001