Mismanagement, ambiguity and delusion : training primary teachers in Greece

Preparing primary teachers in Greece is an area of great ambiguity and frustration for many students. This paper seeks to show the influence of social origins, characteristics and qualifications of entrants to primary teaching and its role in social mobility. The paper is based on original research with first year student teachers along with unpublished research from government sources. Outcomes of the research demonstrate a greater need for creative and strategic planning in the training of primary teachers.peer-reviewe

Radial Approach for Percutaneous Coronary Intervention: Practical Issues

In this brief article we are discussing practical issues that we have to deal with when  choosing the radial approach for coronary angiography and percutaneous coronary intervention (PCI)

Multivessel Disease in a Patient Presenting With ST-Elevation Myocardial Infarction

Patients with multivessel coronary artery disease are common among patients presenting with ST elevation myocardial infarction (STEMI). The way to treat the rest of the lesions after treating the culprit lesion is not well defined yet. In this article we present a patient with inferior STEMI, who had also an ostial left anterior descending (LAD) coronary artery stenosis

Restenosis is not associated with stent length in a pig model of coronary stent implantation

Background: The aim of this study was to determine if stent length is by itself a risk factor for intimal proliferation and restenosis. Long lesions represent an independent risk factor for restenosis after coronary stent implantation. A longer stented segment might result in a higher probability of restenosis. Methods: Twenty-two 7-month-old male farm pigs underwent implantation of two steel stents, one short (8 mm length) and one long (16 mm length), in the right coronary artery. The pigs were sacrificed 28 days after stent implantation and histomorphometric analysis of the coronary arteries was performed for neointimal area proliferation and area stenosis evaluation. Results: Seventeen short stents and 19 long stents were finally implanted. There were no differences in neointimal proliferation (1.84 ± 0.64 mm2 vs. 1.81 ± 0.94 mm2, p = 0.84), area stenosis (40 ± 9% vs. 41 ± 19%, p = 0.86) and lumen area (2.96 ± 1.30 mm2 vs. 2.51 ± ± 1.18 mm2, p = 0.21) between the short stent group and the long stent group, respectively. Conclusions: These data suggest that stent length by itself does not influence restenosis extent in the porcine model

Le crime au cœur du système

Ce livre ne décrit pas seulement la criminalité organisée : il offre un tour du monde vu par le crime organisé. Les espaces géographiques sont en effet redessinés par les activités trafiquantes : les mers et les déserts sont utilisés à leur profit, l’Amérique latine se trouve reliée à l’Europe par le désert du Sahara et la mer Rouge, pourtant sous haute surveillance, devient un lieu de transit pour les déchets européens à destination des côtes somaliennes. Le livre est également un inventaire..

Le crime au cœur du système

Ce livre ne décrit pas seulement la criminalité organisée : il offre un tour du monde vu par le crime organisé. Les espaces géographiques sont en effet redessinés par les activités trafiquantes : les mers et les déserts sont utilisés à leur profit, l’Amérique latine se trouve reliée à l’Europe par le désert du Sahara et la mer Rouge, pourtant sous haute surveillance, devient un lieu de transit pour les déchets européens à destination des côtes somaliennes. Le livre est également un inventaire..

Systemic hypertension augments, whereas insulin-dependent diabetes down-regulates, endothelin A receptor expression in the mammary artery in coronary artery disease patients

Background: Endothelin (ET) A receptor antagonism causes decreased vasodilation in hypertensive coronary arteries and decreased effects on coronary artery compliance in diabetic patients. Methods: We investigate the mRNA expression of ET-1, ETA and ETB receptors, using real time RT-PCR, in biopsies from the internal mammary artery obtained from 49 patients, 18 diabetics and 34 hypertensives, all undergoing coronary artery bypass grafting. Results: Hypertensive patients had higher ET-1 mRNA expression (16438 [8417, 23917]), than normotensive patients (2974 [2283, 18055], p=0.008). Diabetic patients had significantly lower ETA receptor levels than non-diabetic patients (455 [167, 1496] vs. 1660 [700, 3190], respectively, p = 0.003). Conclusions: Multivariate analysis demonstrated that the presence of systemic hypertension was the only independent predictor of log ETA receptor expression and log ET-1 expression, while insulin-dependent diabetes was negatively correlated with ETA receptor expression. ETB receptor expression was not correlated with any predictor. Systemic hypertension is associated with increased ET-1 and ETA receptor mRNA expression, whereas insulin-dependent diabetes down-regulates ETA receptor mRNA expression in the internal mammary artery in patients with coronary artery disease undergoing bypass grafting

Outcome of Contemporary Percutaneous Coronary Intervention in the Elderly and the Very Elderly: Insights From the Blue Cross Blue Shield of Michigan Cardiovascular Consortium

Background: There is a paucity of data on the outcome of contemporary percutaneous coronary intervention (PCI) in the elderly. Accordingly, we assessed the impact of age on outcome of a large cohort of patients undergoing PCI in a regional collaborative registry. Hypothesis: Increasing age is associated with a higher incidence of procedural‐related complications. Methods: We evaluated the outcome of 152373 patients who underwent PCI from 2003 to 2008 in the 31 hospitals participating in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium. The procedural outcomes of the cohort were compared by dividing patients into <70 years of age, 70 to 79 years, 80 to 84 years, 85 to 89 years, and ≥90 years. Results: Of the cohort, 64.64% were <70 years of age, 23.83% were 70 to 79 years, 7.85% were 80 to 84 years, 3.09% were 85 to 89 years, and 0.58% were 90 years or older. Increasing age was associated with an increase in all‐cause in‐hospital mortality, contrast‐induced nephropathy, transfusion, stroke/transient ischemic attack, and vascular complications. The overall in‐hospital mortality rate was 1.09% and increased from 0.67% in those younger than 70 years up to 5.44% in those 90 years old or greater. The mortality rate in patients over 80 years approached 12% to 15% for those with ST‐segment myocardial infarction and 39% in cardiogenic shock patients. Conclusions: The proportion of elderly patients referred for PCI is increasing. Procedural complications increase with age, and patients presenting with unstable symptoms are at the highest risk. © 2011 Wiley Periodicals, Inc. This work was supported by Blue Cross Blue Shield of Michigan. The authors have no other funding, financial relationships, or conflicts of interest to disclose.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/86865/1/20926_ftp.pd

Use of the Limited Antegrade Subintimal Tracking Technique in Chronic Total Occlusion Percutaneous Coronary Intervention

BACKGROUND There are limited data on the limited antegrade subintimal tracking (LAST) technique for chronic total occlusion (CTO) percutaneous coronary intervention (PCI).OBJECTIVES The aim of this study was to analyze the frequency of use and outcomes of the LAST technique for CTO PCI.METHODS We analyzed 2,177 CTO PCIs performed using antegrade dissection and re-entry (ADR) in the PROGRESS-CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) registry between 2012 and January 2022 at 39 centers. ADR was attempted in 1,465 cases (67.3%).RESULTS Among antegrade re-entry cases, LAST was used in 163 (11.1%) (primary LAST in 127 [8.7%] and secondary LAST [LAST after other ADR approaches failed] in 36 [2.5%]), the Stingray system (Boston Scientific) in 980 (66.9%), subintimal tracking and re-entry in 387 (26.4%), and contrast-guided subintimal tracking and re-entry in 29 (2.0%). The mean patient age was 65.2 similar to 10 years, and 85.8% were men. There was no significant difference in technical (71.8% vs 77.8%; P 1/4 0.080) and procedural (69.9% vs 75.3%; P 1/4 0.127) success and major cardiac adverse events (1.84% vs 3.53%; P 1/4 0.254) between LAST and non-LAST cases. However, on multivariable analysis, the use of LAST was associated with lower procedural success (OR: 0.61; 95% CI: 0.41-0.91). Primary LAST was associated with higher technical (76.4% vs 55.6%; P 1/4 0.014) and procedural (75.6% vs 50.0%; P 1/4 0.003) success and similar major adverse cardiac event (1.57% vs 2.78%; P 1/4 0.636) rates compared with secondary LAST.CONCLUSIONS LAST was used in 11.1% of antegrade re-entry CTO PCI cases and was associated with lower procedural success on multivariable analysis, suggesting a limited role of LAST in contemporary CTO PCI. (J Am Coll Cardiol Intv 2022;15:2284-2293) (c) 2022 by the American College of Cardiology Foundation