RISQUES CARDIO-VASCULAIRES CHEZ L'ENFANT PORTEUR D'UNE CARDIOPATHIE CONGENITALE : MESURE DE L'ONDE POULS

Contexte La mesure de la vitesse de l'onde de pouls (VOP) est la méthode d'évaluation reconnue de la rigidité aortique, un facteur de risque cardio-vasculaire indépendant. Les enfants avec une cardiopathie congénitale sont plus à risque de dysfonctions vasculaires, mais il existe peu de données concernant la VOP chez ces patients dans la littérature. Objectifs La présente étude se donne pour but d'obtenir des valeurs de la VOP chez des enfants atteints d'une cardiopathie congénitale. Les valeurs mesurées seront comparées entre deux groupes de cardiopathies : un groupe contrôle dont le débit aortique est normal à diminué et un second groupe de patients avec un hyperdébit aortique. Méthode Il s'agit d'une étude rétrospective dans laquelle la VOP a été mesurée à partir d'images digitalisées enregistrées lors de cathétérisme cardiaque chez des enfants ayant une cardiopathie congénitale. Le diagnostic, l'âge, le poids, la taille et la fréquence cardiaque (FC) de ces patients ont également été récoltés. Les données ont été analysées au moyen de statistiques inférentielles univariées afin de comparer les valeurs des deux groupes. Résultats 25 patients contrôles (diverses cardiopathies) et 35 enfants avec une tétralogie de Fallot (TdF) ont été inclus. Les deux groupes sont comparables en terme d'âge, de poids, de taille et de FC. Les valeurs de VOP obtenues sont de 643.4 ± 173.7 cm/s pour le groupe Fallot contre 414.4 ± 65.9 cm/s pour les contrôle. La différence de ces valeurs est hautement significative (P<0.0001). Conclusions La VOP est significativement plus élevée chez des patients atteints de TdF, dont le débit aortique est élevé, que chez des patients contrôles avec un débit aortique normal à diminué. L'hyperdébit aortique dans la TdF est donc à l'origine d'une rigidité artérielle et ces patients ont un risque cardiovasculaire élevé

Slovenia, Country Risk, and FDI -Three Levels of Analysis Mixed Methodologies Offer Fresh Insights

The purpose of this study is to discover relationships among FDI (Foreign Direct Investment), country risk, investor expectations, and certain financial variables in Slovenia, and to do this on three levels of analysis: standard statistical analysis, chart or graphical analysis, and a qualitative field study. The quantitative work displays relationships of the variables using cointegrationand VAR analyses. The chart section imposes visually the variable of country risk on the same data source as the statistical analysis. And the field study incorporates aspects of international finance such as legal, historic, social, and political issues into the research

Drug utilization patterns in Zabljak municipality, Serbia and Montenegro

Background: Information about drug utilization among the out patients in Serbia & Montenegro is scanty, and there are no available publications on the topic. Objective: To evaluate and compare patterns of drug utilization in the Zabljak municipality. Methods: Prescriptions for outpatients (n=456) and dispensing records from local pharmacy in Zabljak were reviewed retrospectively over three-months period. Results: The leading diagnoses were infectious diseases of the respiratory system and hypertension. The average number of Defined Daily Doses per 1000 inhabitants per day was 175.05. Cardiovascular drugs (42.8 DDD/1000/day), drugs for gastrointestinal system (39 DDD/1000/day) and antibacterial drugs (19.05 DDD/1000/day) were the most frequently prescribed drugs. Conclusion: The total number of drugs utilized per 1000 inhabitants per day was within the acceptable range. However, the pattern of diagnoses did not correspond to the pattern of drug utilization. Much remains to be done to promote rational selection and use of drugs in outpatients in Serbia and Montenegro. South African Family Practice Vol. 49 (1) 2007: pp. 1

Opportunities for financing sustainable development using complementary local currencies

Financing building retrofit projects that contribute to climate change mitigation has always represented a significant barrier. With 28% of global emissions coming from existing buildings, it is of paramount importance to carry out retrofit measures that lead to significant reduction of these emissions. Whilst this is perfectly possible to achieve with current methods and current technology, there is no sufficient conventional finance to carry out zero carbon retrofit at scale required for climate change mitigation. The article introduces an alternative and sustainable business model that creates new opportunities for financing zero carbon retrofit of buildings. It demonstrates that the value of solar energy falling on roofs of buildings can become a driver for new local economic systems, and discusses the requirements for practical application.Peer reviewedFinal Published versio

Injectable interferon beta-1b for the treatment of relapsing forms of multiple sclerosis

Multiple sclerosis (MS) is chronic inflammatory and demyelinating disease with either a progressive (10%–15%) or relapsing-remitting (85%–90%) course. The pathological hallmarks of MS are lesions of both white and grey matter in the central nervous system. The onset of the disease is usually around 30 years of age. The patients experience an acute focal neurologic dysfunction which is not characteristic, followed by partial or complete recovery. Acute episodes of neurologic dysfunction with diverse signs and symptoms will then recur throughout the life of a patient, with periods of partial or complete remission and clinical stability in between. Currently, there are several therapeutic options for MS with disease-modifying properties. Immunomodulatory therapy with interferon beta-1b (IFN-β1b) or -1a, glatiramer and natalizumab shows similar efficacy; in a resistant or intolerant patient, the most recently approved therapeutic option is mitoxantrone. IFN-β1b in patients with MS binds to specific receptors on surface of immune cells, changing the expression of several genes and leading to a decrease in quantity of cell-associated adhesion molecules, inhibition of major histocompatibility complex class II expression and reduction in inflammatory cells migration into the central nervous system. After 2 years of treatment, IFN-β1b reduces the risk of development of clinically defined MS from 45% (with placebo) to 28% (with IFN-β1b). It also reduces relapses for 34% (1.31 exacerbations annually with placebo and 0.9 with higher dose of IFN-β1b) and makes 31% more patients relapse-free. In secondary-progressive disease annual rate of progression is 3% lower with IFN-β1b. In recommended doses IFN-β1b causes the following frequent adverse effects: injection site reactions (redness, discoloration, inflammation, pain, necrosis and non-specific reactions), insomnia, influenza-like syndrome, asthenia, headache, myalgia, hypoesthesia, nausea, paresthesia, myasthenia, chills and depression. Efficacy of IFN-β1b in relapsing-remitting MS is higher than that of IFN-β1a, and similar to the efficacy of glatiramer acetate. These facts promote IFN-β1b as one of the most important drugs in the spectrum of immunological therapies for this debilitating disease

The impact of childhood maltreatment on aggression, criminal risk factors, and treatment trajectories in forensic psychiatric patients

Introduction: Children’s development into healthy well-functioning adults can be negatively affected by adversity. Adverse childhood experiences (ACEs) have been shown to lead to a variety of poor life outcomes, ranging from mental health problems (e.g., anxiety or suicidality) through problematic health behaviors to serious physical diseases and even early death. ACEs can also make people more prone to aggressive behavior, criminality, and recidivism. In this study, we investigated the association between ACEs, specifically childhood maltreatment (CM), and forensically relevant factors; aggression, criminal risk factors, and treatment trajectories, as little is known about these associations in forensic psychiatric patients.Methods: The study includes data derived from two studies in The Netherlands, of which the first study enrolled 128 patients residing in a Forensic Psychiatric Center (FPC) and the second study included 468 patients who were released unconditionally from FPCs between 2009 and 2013. We expected that more CM would be correlated with higher levels of aggression, higher clinical risk factor scores, and less decrease in clinical risk factor scores over time. To investigate this, we applied correlational analyses and linear growth curve modeling on risk assessment scores and self-report as well as staff report questionnaires on CM and aggression.Results: Consistent with our first hypothesis, patients with higher CM scores also had higher aggression and risk assessment scores. The effect sizes were small to medium (0.12 to 0.34). Unexpectedly, CM did not influence the course of these treatment trajectories, however, we found that patients with histories of CM had a significantly longer length of stay in a forensic facility than patients without CM (respectively, 10.8 years and 9.3 years on average).Discussion: This study underlines the importance of carefully examining the history of ACEs and CM in forensic psychiatric patients and considering this in forensic risk assessment and risk guided treatment. More research is needed to draw conclusions about whether and how histories of ACEs should be considered and targeted during treatment trajectories

Acute coronary syndrome in diclofenac sodium-induced type I hypersensitivity reaction : Kounis syndrome

Drug-induced type I hypersensitivity reactions are frequent. Sometimes, acute coronary syndrome (ACS) can be registered in such patients, which may have a serious impact on the course and management of the allergic reaction. Because of potentially atypical ACS clinical presentations, the ECG is an obligatory diagnostic tool in any allergic reaction. Coronary artery spasm is the pathophysiological basis of ACS, triggered by the action of potent vasoactive mediators (histamine, neutral proteases, arachidonic acid products) released from the cells involved in type I hypersensitivity. Allergic angina and allergic myocardial infarction are referred to as Kounis Syndrome. We describe herein a case of ACS in a patient with registered systemic immediate hypersensitivity reaction which developed following the muscular administration of diclofenac sodium.peer-reviewe

The Financial Setting for FDI Inflows into The Czech Republic and Slovakia

This study examines the relationship between foreign direct investment in the Czech Republic and Slovakia and such potentially explanatory factors as trade flows, measures of economic and financial stability, and country risk. The authors find that as the Czech and Slovak Republics progress toward market economies, some policy points to consider include: transparency of markets, economic systems, social and political organizations; an increase in commerce and investment, which makes reversals of reforms less likely and the condition of financial factors that contribute to increased investment

The Google Car: Driving Toward A Better Future?

Google’s dramatic ascent and subsequent domination in the past fifteen years of the technology and information industries has financially enabled Google to explore seemingly unrelated projects ranging from Google Mail to the Google Car. In particular, Google has invested a significant amount of resources in the Google Car, an integrated system that allows for the driverless operation of a vehicle. While initial reports indicate that the Google Car driverless automobile will be more safe and efficient than current vehicles, the Google Car is not without its critics. In particular, the existential threat that the car presents to several large industries, including the insurance, health care and construction industries, creates an additional challenge to the success of the Google Car well beyond the standard competitive threats from other established car manufacturers in the automobile industry, which begs the question, “Can the Google Car be successful?” With so many challenges above and beyond the competitive forces typically threatening long-term profitability, will the Google Car be able to create and sustain a competitive advantage for Google in the driverless car space