PICKING THE BEST NOVEL ORAL ANTICOAGULANT FOR ATRIAL FIBRILLATION: EVIDENCE FROM A WARFARIN-CONTROLLED NETWORK META-ANALYSIS

Warfarin is a mainstay atrial ibrillation (AF) treatment, yet it has a narrow therapeutic window. Novel agents have been successfully tested against warfarin, yet no direct comparison among them is available. We thus performed a pair-wise and warfarin-adjusted network metaanalyses of novel oral anticoagulants for AF

Silicon Avalanche Pixel Sensor for High Precision Tracking

The development of an innovative position sensitive pixelated sensor to detect and measure with high precision the coordinates of the ionizing particles is proposed. The silicon avalanche pixel sensors (APiX) is based on the vertical integration of avalanche pixels connected in pairs and operated in coincidence in fully digital mode and with the processing electronics embedded on the chip. The APiX sensor addresses the need to minimize the material budget and related multiple scattering effects in tracking systems requiring a high spatial resolution in the presence of a large occupancy. The expected operation of the new sensor features: low noise, low power consumption and suitable radiation tolerance. The APiX device provides on-chip digital information on the position of the coordinate of the impinging charged particle and can be seen as the building block of a modular system of pixelated arrays, implementing a sparsified readout. The technological challenges are the 3D integration of the device under CMOS processes and integration of processing electronics.Comment: 13th Topical Seminar on Innovative Particle and Radiation Detectors IPRD1

Incidence, etiology and predictors of adverse outcomes in 43,315 patients presenting to the Emergency Department with syncope: An international meta-analysis.

BACKGROUND: Syncope remains challenging for Emergency Department (ED) physicians due to difficulties in assessing the risk of future adverse outcomes. The aim of this meta-analysis is to establish the incidence and etiology of adverse outcomes as well as the predictors, in patients presenting with syncope to the ED. METHODS: A systematic electronic literature review was performed looking for eligible studies published between 1990 and 2010. Studies reporting multivariate predictors of adverse outcomes in patients presenting with syncope to the ED were included and pooled, when appropriate, using a random-effect method. Adverse events were defined as 'incidence of death, or of hospitalization and interventional procedures because of arrhythmias, ischemic heart disease or valvular heart disease'. RESULTS: 11 studies were included. Pooled analysis showed 42% (CI 95%; 32-52) of patients were admitted to hospital. Risk of death was 4.4% (CI 95%; 3.1-5.1) and 1.1% (CI 95%; 0.7-1.5) had a cardiovascular etiology. One third of patients were discharged without a diagnosis, while the most frequent diagnosis was 'situational, orthostatic or vasavagal syncope' in 29% (CI 95%; 12-47). 10.4% (CI 95%; 7.8-16) was diagnosed with heart disease, the most frequent type being bradyarrhythmia, 4.8% (CI 95%; 2.2-6.4) and tachyarrhythmia 2.6% (CI 95%; 1.1-3.1). Palpitations preceding syncope, exertional syncope, a history consistent of heart failure or ischemic heart disease, and evidence of bleeding were the most powerful predictors of an adverse outcome. CONCLUSION: Syncope carries a high risk of death, mainly related to cardiovascular disease. This large study which has established the most powerful predictors of adverse outcomes, may enable care and resources to be better focused at high risk patients. Copyright \ua9 2011 Elsevier Ireland Ltd. All rights reserved