Clinical and hemodynamic outcomes of trans-apical aortic valve implantation. insights from the i-ta registry

Senile degenerative calcific aortic valve stenosis (AVS) is a progressive disease characterized by a peculiar natural history. When symptoms begin (congestive heart failure and dyspnea, angina, syncope) mortality rate rapidly increase and quality of life dramatically worsen. It has been estimated that the overall survival of patients with severe symptomatic AVS is less than 50% 2 years after the onset of symptoms. The number of patients suffering from AVS worldwide will increase over time as life expectancy progressively extends. The treatment of choice for severe symptomatic AVS is aortic valve replacement (AVR) that is usually performed under general anesthesia, with median sternotomy and cardiopulmonary bypass. AVR is a well-established procedure, with excellent early and long-term results and valve prostheses have now reached optimal hemodynamic performance and duration. During the last few years, the development of sutureless aortic bioprosthesis has made easier the surgical procedure. In fact, aortic valve replacement with sutureless valves (SU-AVR) needs shorter cardiopulmonary bypass and aortic cross clamp times and can be safely performed through a minimally invasive approach. However, a recent survey showed that around 30% of patients with severe symptomatic AVS does not undergo AVR for several reasons: they are not referred for surgery by their family physician or by their cardiologist because of age, they are declined surgery for a high preoperative risk profile; they are inoperable for severe ascending aortic calcification (porcelain aorta). Trans-catheter aortic valve implantation (TAVI) is an alternative therapeutic option in high-risk or inoperable patients. TAVI can be performed through several accesses: trans-femoral (TF-TAVI), trans-apical (TA-TAVI), trans-aortic (TAo-TAVI) and trans-subclavian (TS-TAVI). This thesis will focus on TAVI and in particular on TA-TAVI in terms of, indications, technique and outcomes. We will show the results of the Italian Registry of Trans-Apical Aortic Valve Implantation (I-TA) that includes the great majority of patients who underwent TA-TAVI in Italy since this procedure became commercially available in 2008. Furthermore we will present the results of a propensity-matched study that compared all the three available surgical options for patients with severe symptomatic aortic valve stenosis: surgical aortic valve replacement (SAVR), SU-AVR and TA-TAVI. From the results of these two studies it clearly appears that TA-TAVI is an excellent therapeutic options in patients with aortic valve stenosis. The two main issues that still need to be solved are the incidence of paravalvular leak, and valve durability. Paravalvular leak has been demonstrated to have a significant impact on long term survival while the assessment of valve durability needs a longer observation of these patients in order to reach time points when structural valve deterioration is more likely to occu

PEPCE: proyecto de educación popular en contextos de encierro

El PEPCE es un proyecto de extensión y voluntariado universitario perteneciente a la FaHCE iniciado en el año 2008. Su principal objetivo es beneficiar niños, jóvenes y adultos en situación de encierro. Se trabaja con un equipo interdisciplinario, que involucra docentes y alumnos/as de las carreras de Educación Física, Ciencias de la Educación, Psicología, Bellas Artes y Derecho, en diversas instituciones de la Región: Hogar Materno infantil "Arrullos", Hospital Especializado "Ramos Mejía", Unidades Nº 18 y Nº 33 de Gorina; Hospital Neuropsiquiátrico "Alejandro Korn" de Melchor Romero; Casa de abrigo La Plata; Unidad Nº 33 de los Hornos, Unidad Nº 1 de Olmos, Instituto de niños "Rivadavia". Estas instituciones de encierro, presentan una población caracterizada por su vulnerabilidad, con un déficit estructural educativo, con consecuencias en su desempeño intelectual y social. A su vez, tienen la necesidad de ocupar el tiempo libre en actividades creativas y de socialización con la comunidad. Llevando a cabo talleres donde se realizan prácticas recreativas, deportivas y artísticas abordamos dichas problemáticas. Con estos espacios alternativos apostamos a subjetivar a personas allí donde el circuito institucional de encierro ha dejado sus marcas. El arte, el movimiento, el uso del tiempo libre permiten convertirse en puertas de entrada para el rescate de subjetividades neutralizadas por la homogeneización que provoca la institución total.Facultad de Humanidades y Ciencias de la Educació

The neurobiology of attention deficit/hyperactivity disorder.

ADHD is a brain based disorder with structural and functional abnormalities in widespread but specific areas of the brain. The most significant and consistent structural imaging findings include smaller total brain volumes, and reduced volumes in the right frontal lobe, right parietal cortex, caudate nucleus, cerebellar hemispheres, and posterior-inferior lobules of the cerebellar vermis. ADHD involves hypofunction of catecholaminergic circuits, particularly those that project to the prefrontal cortex. A minimum of 18 genes have been reported to be associated with the disorder; among them the DRD4 7-repeat allele has been found associated with a thinner prefrontal and posterior parietal cortex. Epigenetic factors acting during critical periods of prenatal and postnatal development may interact with genetic determinants. Methylphenidate, as well as the catecholaminergic nonstimulant atomoxetine, are effective in improving ADHD symptoms

PEPCE: proyecto de educación popular en contextos de encierro

El PEPCE es un proyecto de extensión y voluntariado universitario perteneciente a la FaHCE iniciado en el año 2008. Su principal objetivo es beneficiar niños, jóvenes y adultos en situación de encierro. Se trabaja con un equipo interdisciplinario, que involucra docentes y alumnos/as de las carreras de Educación Física, Ciencias de la Educación, Psicología, Bellas Artes y Derecho, en diversas instituciones de la Región: Hogar Materno infantil "Arrullos", Hospital Especializado "Ramos Mejía", Unidades Nº 18 y Nº 33 de Gorina; Hospital Neuropsiquiátrico "Alejandro Korn" de Melchor Romero; Casa de abrigo La Plata; Unidad Nº 33 de los Hornos, Unidad Nº 1 de Olmos, Instituto de niños "Rivadavia". Estas instituciones de encierro, presentan una población caracterizada por su vulnerabilidad, con un déficit estructural educativo, con consecuencias en su desempeño intelectual y social. A su vez, tienen la necesidad de ocupar el tiempo libre en actividades creativas y de socialización con la comunidad. Llevando a cabo talleres donde se realizan prácticas recreativas, deportivas y artísticas abordamos dichas problemáticas. Con estos espacios alternativos apostamos a subjetivar a personas allí donde el circuito institucional de encierro ha dejado sus marcas. El arte, el movimiento, el uso del tiempo libre permiten convertirse en puertas de entrada para el rescate de subjetividades neutralizadas por la homogeneización que provoca la institución total.Facultad de Humanidades y Ciencias de la Educació

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements