Persistent transient myocardial ischemia despite beta-adrenergic blockade predicts a higher risk of adverse cardiac events in patients with coronary artery disease

AbstractObjectives. We evaluated the prevalence and prognostic significance of transient myocardial ischemia despite beta-adrenergic blockade in patients with coronary artery disease.Background. Persistence of transient ischemia despite therapy may correspond to a subset of high risk patients with coronary disease. The impact of beta-blocker withdrawal in these patients remains unknown.Methods. Patients (n = 313) with documented coronary artery disease and beta-blocker therapy, with (group I, n = 84) or without (group II, n = 229) transient ischemia on ambulatory electrocardiographic monitoring, were followed up during 21 ± 9 months for cardiac events (death, myocardial infarction, percutaneous transluminal coronary angioplasty, coronary artery bypass surgery and worsening angina). Occurrence of events was compared by log-rank test.Results. The number of coronary stenoses did not differ significantly between groups I and II. Beta-blocker therapy was discontinued more frequently during follow-up in group II (25% vs. 14% in group I, p = 0.04). Cumulative percentage of death or myocardial infarction, or both, tended to be higher in group I at 30 months (17% vs. 5% in group II, p = 0.09). Coronary angioplasty and bypass surgery were significantly more frequent in group I (p = 0.01 and 0.0008, respectively). Transient ischemia was associated with a higher cumulative probability of adverse events (p = 0.004). The number of coronary stenoses, presence of transient ischemia and beta-blocker withdrawal were the only significant prognostic factors of cardiac events in the Cox model. In group I patients, the relative hazard of cardiac events was increased threefold when beta-blocker therapy was interrupted.Conclusions. These data suggest that 1) the occurrence of transient ischemia despite beta-blocker therapy identifies a subset of high risk patients with coronary artery disease, and 2) the interruption of beta-blocker therapy increases the risk of adverse cardiac events

<i>On gagne ou on perd tous ensemble</i> : le jeu coopératif, un support pour développer le savoir-être et le savoir-faire en ULIS

Ce mémoire s'intéresse au sujet des jeux coopératifs, comme vecteurs d'un climat de classe serein et sécurisé, ainsi que de développement des habiletés cognitives telles que la régulation métacognitive. Il analyse l'effet des séances de jeux coopératifs comme réponse à certains besoins sociaux et cognitifs chez des élèves d'ULIS

STUDENT PRODUCED THEATRE PROJECTS: A VITAL ASPECT OF COLLEGIATE THEATRE

Theatre business professionals are a close-knit community of people. It is nearly certain that every college theatre major knows another student studying theatre at a different college or university. Most college level theatre programs have a student-run theatre company that encourages undergraduate production of full-length plays and musicals. East Carolina University, however, did not have a formal organization to foster student-run theatre productions for students to use what is taught in the classroom in an environment separate from their professors. By initiating a subcategory of the East Carolina Musical Theatre Association (ECMTA) that funds student produced theatre, I created additional acting, designing, and directing opportunities for undergraduate students. This theatre company, called 5th Street Players, provides the Greenville community with an entirely student-produced theatre organization that contributes relevant, thought-provoking theatrical productions

Mise en place d'un programme d'éducation thérapeutique dans un service d'oncolgie destiné aux patients traités par hormonothérapie

CHATENAY M.-PARIS 11-BU Pharma. (920192101) / SudocSudocFranceF

Mobile Arts for Peace (MAP) PPPF Project - Rwanda Imigongo Arts #2

Imigongo art is one of the artistic outputs of the Mobile Arts for Peace (MAP) Medium Grant project: Picturing Past, Present, and Future (PPPF) in Nepal and Rwanda. In Rwanda, PPPF collaborated with Uyisenga Ni Imanzi (UMN).Artwork description:Happy family. In the picture, they have chosen to depict a family living in harmony. The father is leaving for work to support his family, and the family is collaborative and happy.</p

Lodoiska : heroische Oper in 3 Aufzügen

Luigi Cherubini. Übers. aus dem Franz. des Fillette Loraux. Musik von C. Cherubin

STUDENT PRODUCED THEATRE PROJECTS: A VITAL ASPECT OF COLLEGIATE THEATRE

Theatre business professionals are a close-knit community of people. It is nearly certain that every college theatre major knows another student studying theatre at a different college or university. Most college level theatre programs have a student-run theatre company that encourages undergraduate production of full-length plays and musicals. East Carolina University, however, did not have a formal organization to foster student-run theatre productions for students to use what is taught in the classroom in an environment separate from their professors. By initiating a subcategory of the East Carolina Musical Theatre Association (ECMTA) that funds student produced theatre, I created additional acting, designing, and directing opportunities for undergraduate students. This theatre company, called 5th Street Players, provides the Greenville community with an entirely student-produced theatre organization that contributes relevant, thought-provoking theatrical productions

Nonlinear dynamics of a hanging string with a freely pivoting attached mass

International audienceWe show that the natural resonant frequency of a suspended flexible string is significantly modified (by one order of magnitude) by adding a freely pivoting attached mass at its lower end. This articulated system then exhibits complex nonlinear dynamics such as bending oscillations, similar to those of a swing becoming slack, thereby strongly modifying the system resonance that is found to be controlled by the length of the pivoting mass. The dynamics is experimentally studied using a remote and noninvasive magnetic parametric forcing. To do so, a permanent magnet is suspended by a flexible string above a vertically oscillating conductive plate. Harmonic and period-doubling instabilities are experimentally reported and are modeled using the Hill equation, leading to analytical solutions that accurately describe the experimentally observed tonguelike instability curve