Institutions, Credit rationing and housing development

One of the basic principles that allow a smooth operation of the markets is the equilibrium between supply and demand. According to this principle, when demand exceeds supply, the price mechanism will try to bring the system back into equilibrium. When this thinking is applied to the housing market, it leads to the conclusion that any inequality in housing supply or demand is transitory. Nonetheless, the fact that a considerable share of the population live in precarious homes for generations seems to speak against the virtues of market mechanisms in the resolution of housing disequilibria. Stiglitz and Weiss (1981) argue that in the face of asymmetric information, under some conditions the equilibrium of the credit market can be marked by rationing. Asymmetric information – working through the effects of adverse selection and of incentive – has impacts on the return function of bank loans, which leads to interest rates used in housing loans to be different from those that balance supply and demand for credit, causing credit rationing. Literature of the New Institutional Economics (NIE) in turn points out the fact that institutions can reduce the degree of uncertainty by lessening the effects of asymmetric information. Regarding the housing market, the degree of property rights, as well as the mortgage institution which acts as a contract enforcement tool, provide the credit market with information on the quality of the borrower and thus broaden the social scope of this market. The purpose of this article is to understand how the equilibrium in the housing market is influenced by credit rationing and to what extend institutional development affects this scarcity and the interest rates of housing loans. The model developed in this article, which combines the tradition of dynamic models of housing investment with the premises of the New Institutional Economics and the considerations of Stiglitz and Weiss (1981) and (1992) on rationing in the credit market, allows us to identify the role of institutions on housing development.Asymmetric information, Rationed credit market, Property rights, Mortgage foreclosure costs, Housing development

Síncope cardíaca reflexa por "nevralgia" do glossofaríngeo: rara apresentação dessa doença Cardiac syncope induced by glossopharyngeal "neuralgia": a rare presentation

A primeira descrição de dor severa no trajeto do nervo glossofaríngeo foi realizada por Weisenberg, em 1910¹, em um paciente com tumor do ângulo ponto cerebelar. Entretanto, coube a Harris, em 1926², nomear como nevralgia do nervo glossofaríngeo esse raro quadro clínico, caracterizado por paroxismos de dor intensa, unilaterais, na região posterior da língua, no palato mole, na garganta e na região lateral e posterior da faringe, irradiando para o ouvido. A dor pode ser desencadeada por deglutição, tosse, bocejo ou mastigação e normalmente dura de segundos a minutos. A associaç��o de nevralgia do glossofaríngeo e síncope é muito rara e se deve a breves períodos de bradicardia, assistolia ou hipotensão, sendo a primeira descrição dessa associação, com essa fisiopatologia, realizada por Riley e cols., em 1942³.<br>The first description of severe pain in the distribution of the glossopharyngeal nerve is credited to Weisenberg, in 1910¹, in a patient with cerebellopontine angle tumor. However, it was Harris, in 1926², who coined the term glossopharyngeal neuralgia to describe this rare condition characterized by paroxysms of excruciating pain located laterally at the back of the tongue, soft palate, throat, and lateral and posterior pharynx, radiating to the ear. Swallowing, coughing, yawning or chewing may trigger pain, which usually lasts from seconds to minutes. The association between glossopharyngeal neuralgia and syncope is very rare, being identified by brief episodes of bradycardia, asystole, and hypotension. Such an association, with this same pathophysiology, was first described by Riley et al³ in 1942

Impact of systemic treatment associated to radiotherapy on quality of life in locally advanced head and neck cancer patients in Brazil: prospective real-world data study

Sem informação3715Annual Meeting of the American Society of Clinical Oncolog

Health-related quality of life outcomes in head and neck cancer : results from a prospective, real-world data study with Brazilian patients treated with intensity modulated radiation therapy, conformal and conventional radiation techniques

Purpose: To compare global health-related quality of life (HRQoL) and overall survival (OS) in patients with head and neck cancer treated with intensity modulated radiation therapy (IMRT), conformal radiation therapy (3DCRT) or conventional ra- diation therapy (2DRT). Methods and Materials: In this real-world, multi-institutional and prospective study, HRQoL outcomes were assessed using the European Organisation for Research and Treatment of Cancer Quality-of-life Questionnaire Core 30 (EORTC QLQ-C30) and European Organisation for Research and Treatment of Cancer Quality-of-life Questionnaire Head and Neck 43 (H&N43) questionnaires. Item response theory was used to generate a global HRQoL score, based on the 71 questions from both forms. The effect of treatment modality on HRQoL was studied using multivariate regression analyses. Survival was estimated using the Kaplan-Meyer method, and groups were compared by the log-rank test. Results: Five hundred and seventy patients from 13 institutions were included. Median follow-up was 12.2 months. Concern- ing the radiation technique, 29.5% of the patients were treated with 2DRT, 43.7% received 3DCRT, and 26.8% were treated with IMRT. A higher proportion of patients receiving 2DRT had a treatment interruption of more than 5 days (69% vs 50.2% for 3DCRT and 42.5% for IMRT). IMRT had a statistically significant positive effect on HRQoL compared with 3DCRT (bZ 2.627, standard error Z 0.804, P Z .001) and 2DRT had a statistically significant negative effect compared with 3DCRT (bZ 5.075, standard error Z 0.926, P < .001). Patients receiving 2DRT presented a worse OS (P Z .01). There were no differences in OS when IMRT was compared with 3DCRT. Conclusions: IMRT provided better HRQoL than 3DCRT, which provided better HRQoL than 2DRT. Patients receiving 2DRT presented a worse OS, which might be related to more frequent treatment interruptions. Ó 2020 Elsevier Inc. All rights reserved