Intra-aortic balloon pump inserted through the subclavian artery: A minimally invasive approach to mechanical support in the ambulatory end-stage heart failure patient

ObjectiveIntra-aortic balloon pumps are traditionally inserted through the femoral artery, limiting the patient's mobility. We used alternate approaches of intra-aortic balloon pump insertion to provide temporary and minimally invasive support for patients with decompensating, end-stage heart failure. The present study describes the outcomes with closed-chest, transthoracic intra-aortic balloon pumps by way of the subclavian artery.MethodsDuring a 3-year period, 20 patients underwent subclavian artery–intra-aortic balloon pump in the setting of end-stage heart failure. The balloon was inserted through a polytetrafluoroethylene graft sutured to the right subclavian artery in 19 patients (95%) and to the left subclavian artery in 1 patient (5%). The goal of support was to bridge to transplantation in 17 patients (85%) and bridge to recovery in 3 patients (15%). The primary outcome measure was death during subclavian artery–intra-aortic balloon pump support. The secondary outcomes included survival to the intended endpoint of bridge to transplantation/bridge to recovery, complications during subclavian artery–intra-aortic balloon pump support (eg, stroke, limb ischemia, brachial plexus injury, dissection, bleeding requiring reoperation, and device-related infection), emergent surgery for worsening heart failure, and ambulation during intra-aortic balloon pump support.ResultsThe duration of balloon support ranged from 3 to 48 days (mean, 17.3 ± 13.1 days). No patients died during subclavian artery–intra-aortic balloon pump support. Of the 20 patients, 14 (70%) were successfully bridged to transplant or left ventricular-assist device. Two patients (10%) required emergent left ventricular-assist device for worsening heart failure.ConclusionsAn intra-aortic balloon pump inserted through the subclavian artery is a simple, minimally invasive approach to mechanical support and is associated with limited morbidity and facilitates ambulation in patients with end-stage heart failure

Discutindo a educação ambiental no cotidiano escolar: desenvolvimento de projetos na escola formação inicial e continuada de professores

A presente pesquisa buscou discutir como a Educação Ambiental (EA) vem sendo trabalhada, no Ensino Fundamental e como os docentes desta escola compreendem e vem inserindo a EA no cotidiano escolar., em uma escola estadual do município de Tangará da Serra/MT, Brasil. Para tanto, realizou-se entrevistas com os professores que fazem parte de um projeto interdisciplinar de EA na escola pesquisada. Verificou-se que o projeto da escola não vem conseguindo alcançar os objetivos propostos por: desconhecimento do mesmo, pelos professores; formação deficiente dos professores, não entendimento da EA como processo de ensino-aprendizagem, falta de recursos didáticos, planejamento inadequado das atividades. A partir dessa constatação, procurou-se debater a impossibilidade de tratar do tema fora do trabalho interdisciplinar, bem como, e principalmente, a importância de um estudo mais aprofundado de EA, vinculando teoria e prática, tanto na formação docente, como em projetos escolares, a fim de fugir do tradicional vínculo “EA e ecologia, lixo e horta”.Facultad de Humanidades y Ciencias de la Educació

Transapical Approach for Mitral Valve Repair during Insertion of a Left Ventricular Assist Device

Background. Severe mitral regurgitation (MR) is common in patients who are undergoing insertion of a left ventricular assist device (LVAD). This study analyzes the outcomes of a transapical approach for edge-to-edge repair of the mitral valve during insertion of a left ventricular assist device in 19 patients with MR. Methods. This retrospective study includes 19 patients who were implanted between March 21, 2011, and August 31, 2011, at the University of Chicago. Clinical data include preoperative ejection fraction, post- and preoperative pulmonary arterial pressures, cardiopulmonary bypass time, post- and preoperative mitral regurgitation severity, endotracheal CO2, and LVAD pulse index. Results. All of the 19 patients had a reduction in mitral regurgitation. Fourteen of the 19 patients had at least a three-point reduction in MR severity. The average postoperative pulmonary arterial pressure (PAP) decreased after the surgical procedure from 44/22 ± 14/5 mmHg to 57/28 ± 9/5 mmHg. Average CPB time was 128 ± 27 minutes. Average length-of-stay (LOS) was 21 ± 10 days. Conclusions. Concomitant MV repair using a transapical approach is advantageous for this small cohort of patients. The surgical procedure is less complex and has a shorter CPB time and LOS, and all of the patients demonstrated significant improvement in postoperative MR and moderate improvement in PAP

Measurement of the Drell-Yan Cross Section in pp Collisions at s\sqrt{s} = 7 TeV

The Drell-Yan differential cross section is measured in pp collisions at sqrt(s) = 7 TeV, from a data sample collected with the CMS detector at the LHC, corresponding to an integrated luminosity of 36 inverse picobarns. The cross section measurement, normalized to the measured cross section in the Z region, is reported for both the dimuon and dielectron channels in the dilepton invariant mass range 15-600 GeV. The normalized cross section values are quoted both in the full phase space and within the detector acceptance. The effect of final state radiation is also identified. The results are found to agree with theoretical predictions.The Drell-Yan differential cross section is measured in pp collisions at sqrt(s) = 7 TeV, from a data sample collected with the CMS detector at the LHC, corresponding to an integrated luminosity of 36 inverse picobarns. The cross section measurement, normalized to the measured cross section in the Z region, is reported for both the dimuon and dielectron channels in the dilepton invariant mass range 15-600 GeV. The normalized cross section values are quoted both in the full phase space and within the detector acceptance. The effect of final state radiation is also identified. The results are found to agree with theoretical predictions

Search for supersymmetry in pp collisions at sqrt(s)=7 TeV in events with a single lepton, jets, and missing transverse momentum

Results are reported from a search for physics beyond the standard model in proton-proton collisions at a center-of-mass energy of 7 TeV, focusing on the signature with a single, isolated, high-transverse-momentum lepton (electron or muon), energetic jets, and large missing transverse momentum. The data sample comprises an integrated luminosity of 36 inverse picobarns, recorded by the CMS experiment at the LHC. The search is motivated by models of new physics, including supersymmetry. The observed event yields are consistent with standard model backgrounds predicted using control samples obtained from the data. The characteristics of the event sample are consistent with those expected for the production of t t-bar and W +jets events. The results are interpreted in terms of limits on the parameter space for the constrained minimal supersymmetric extension of the standard model.Results are reported from a search for physics beyond the standard model in proton-proton collisions at a center-of-mass energy of 7 TeV, focusing on the signature with a single, isolated, high-transverse-momentum lepton (electron or muon), energetic jets, and large missing transverse momentum. The data sample comprises an integrated luminosity of 36 inverse picobarns, recorded by the CMS experiment at the LHC. The search is motivated by models of new physics, including supersymmetry. The observed event yields are consistent with standard model backgrounds predicted using control samples obtained from the data. The characteristics of the event sample are consistent with those expected for the production of t t-bar and W +jets events. The results are interpreted in terms of limits on the parameter space for the constrained minimal supersymmetric extension of the standard model.Results are reported from a search for physics beyond the standard model in proton-proton collisions at a center-of-mass energy of 7 TeV, focusing on the signature with a single, isolated, high-transverse-momentum lepton (electron or muon), energetic jets, and large missing transverse momentum. The data sample comprises an integrated luminosity of 36 inverse picobarns, recorded by the CMS experiment at the LHC. The search is motivated by models of new physics, including supersymmetry. The observed event yields are consistent with standard model backgrounds predicted using control samples obtained from the data. The characteristics of the event sample are consistent with those expected for the production of t t-bar and W +jets events. The results are interpreted in terms of limits on the parameter space for the constrained minimal supersymmetric extension of the standard model

Measurement of the lepton charge asymmetry in inclusive WW production in pp collisions at s=7\sqrt{s} = 7 TeV

A measurement of the lepton charge asymmetry in inclusive pp to WX production at sqrt(s)= 7 TeV is presented based on data recorded by the CMS detector at the LHC and corresponding to an integrated luminosity of 36 inverse picobarns. This high precision measurement of the lepton charge asymmetry, performed in both the W to e nu and W to mu nu channels, provides new insights into parton distribution functions.A measurement of the lepton charge asymmetry in inclusive pp to WX production at sqrt(s)= 7 TeV is presented based on data recorded by the CMS detector at the LHC and corresponding to an integrated luminosity of 36 inverse picobarns. This high precision measurement of the lepton charge asymmetry, performed in both the W to e nu and W to mu nu channels, provides new insights into parton distribution functions.A measurement of the lepton charge asymmetry in inclusive pp to WX production at sqrt(s)= 7 TeV is presented based on data recorded by the CMS detector at the LHC and corresponding to an integrated luminosity of 36 inverse picobarns. This high precision measurement of the lepton charge asymmetry, performed in both the W to e nu and W to mu nu channels, provides new insights into parton distribution functions

Search for supersymmetry in events with b jets and missing transverse momentum at the LHC

A search for supersymmetry is presented using a sample of events with b jets and missing transverse momentum. The search uses a data sample of proton-proton collisions at a centre-of-mass energy of 7 TeV, corresponding to an integrated luminosity of 35 inverse picobarns, collected with the CMS detector. A total of 0.33 +0.43 -0.33 (stat.) +/- 0.13 (syst.) events is predicted, using control samples in the data, to arise from standard model processes, and one event is observed in the data. Upper limits are set at the 95% confidence level on the cross sections of benchmark supersymmetric models