Rate versus rhythm control in atrial fibrillation and clinical outcomes: Updated systematic review and meta-analysis of randomized controlled trials

SummaryAtrial fibrillation is the most frequently occurring sustained cardiac arrhythmia and is associated with a significantly increased risk of thromboembolic events and death. We sought to compare the clinical efficacy of rate and rhythm control strategies in patients with non-postoperative atrial fibrillation. We searched the PubMed database and the Cochrane Central Register of Controlled Trials for randomized controlled trials comparing rate versus rhythm control in patients with atrial fibrillation. Studies were retrieved and we analysed major clinical outcomes. Risk ratios (RRs) and 95% confidence intervals were calculated assuming random effects due to the clinical heterogeneity of the study populations. Eight randomized controlled trials were identified, with a total of 7499 patients with atrial fibrillation. There were no significant differences in the effects of rate and rhythm control on any outcome: all-cause mortality (RR: 0.95; CI: 0.86–1.05), cardiovascular mortality (RR: 0.99; CI: 0.87–1.13), arrhythmic/sudden death (RR: 1.12; CI: 0.91–1.38), ischaemic stroke (RR: 0.89; CI: 0.52–1.53), systemic embolism (RR: 0.89; CI: 0.69–1.14) and major bleeding (RR: 1.10; CI: 0.89–1.36). Updated data pooled from a large population of patients with atrial fibrillation suggests that rate and rhythm control strategies have similar effects on major clinical outcomes. Other factors, including individual preferences, comorbidities, drug tolerance and cost issues, should be considered when choosing the approach for these patients

Numerical modelling of micromixing in a T-mixer flow at low Reynolds numbers

International audienceHighlights  CFD simulations are performed to study micromixing in a laminar microfluidic flow.  Segregation indices are calculated using the Villermaux-Dushman protocol.  Micromixing is modelled directly with CFD and indirectly with a lamellar model.  The two solutions are compared in terms of computational cost and analysis times

Gathering big data for teamwork evaluation with microworlds

info:eu-repo/semantics/publishedVersio

Numerical modelling of micromixing in a T-mixer flow at low Reynolds numbers

International audienceHighlights  CFD simulations are performed to study micromixing in a laminar microfluidic flow.  Segregation indices are calculated using the Villermaux-Dushman protocol.  Micromixing is modelled directly with CFD and indirectly with a lamellar model.  The two solutions are compared in terms of computational cost and analysis times

Comportamento hidro-mecânico de escavações em condições não saturadas

Tese de mestrado integrado. Engenharia Civil (Geotecnia). Universidade do Porto. Faculdade de Engenharia. 201

Teamwork Evaluation with a Microworld Platform

Trabalho apresentado em IEEE 20th International Conference on Computer Supported Cooperative Work in Design,4-6 maio 2016, Nanchang, ChinaN/

A lembrança como corpo do tempo: diálogos sobre comunicação e temporalidades a partir de João Guimarães Rosa

Aqui, abordamos a demanda comunicacional de culto à velocidade/aceleração do tempo e seu confronto com a ideia de demora/contemplação. Exemplo desse embate entre pressa e vagar, o conto A Terceira Margem do Rio, de João Guimarães Rosa, mostra-se uma metodologia de reflexão. Por ele, acionamos a lembrança (um cerne do conto) como a esteira de uma temporalidade única (ou um rio que corre infinitamente), associamos outras figuras midiáticas e travamos diálogos sobre comunicação e temporalidades

Copeptin for discriminating two-year mortality in heart failure patients with moderate to severe systolic dysfunction

© 2012 Marques JS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. This article was originally published in a special issue, Cardiac Biomarkers handled by Editor(s). Dr. Virginija Jazbutyte, Institute for Molecular and Translational Therapy Strategies, GermanyBackground: Patients with heart failure and impaired systolic function may have a highly variable clinical course that renders it difficult to assess the individual prognosis. We hypothesized that ejection fraction would incompletely characterize prognosis in systolic heart failure and that biomarkers would add significant information. This study addresses the specific question whether co-peptin may add value in the evaluation of two-year prognosis in heart failure patients with known systolic dysfunction. Methods: Prospective observational cohort study in 37 patients with symptomatic chronic heart failure (classes II to IV of the NYHA classification) and moderate to severe left ventricular systolic dysfunction. We evaluated clinical, echo-cardiographic and laboratory predictors of 24-month mortality specifically assessing the role of co-peptin. Results: Six patients (16%) died during the follow-up. Patients who died had significant higher prevalence of NYHA class IV heart failure, higher blood osmolality and higher levels of NT-proBNP and co-peptin. In unvariable analysis NYHA functional class (p=0.013), serum creatinine (p=0.034), osmolality (p=0.009), NT-proBNP (p=0.013) and copeptin (p=0.003) were predictors of mortality at 24 months. Only copeptin (p=0.004) remained an independent predictor of death in Cox regression analysis. Conclusions: Our results suggest that, in patients with heart failure and impaired left ventricular systolic function, copeptin level determination may be useful for predicting mortality at two years.The study was funded by Centro de Cardiologia da Universidade de Lisboa (CCUL), Cardiology Centre of Lisbon University.info:eu-repo/semantics/publishedVersio