Cumplimiento de las recomendaciones de prevención secundaria de enfermedad coronaria en pacientes sometidos a revascularización coronaria percutánea en el Hospital Universitario Fundación Santa Fe de Bogotá

Marco de referenciadiferentes ensayos clínicos han mostrado que el efecto de las revascularizaciones y los procedimientos de angioplastia en el pronóstico del paciente, tiene sólo un efecto a corto plazo, mientras que la prevención secundaria (cambio de estilo de vida y tratamiento intensivo) mejora el pronóstico a largo plazo.Objetivoevaluar el cumplimiento de las recomendaciones para prevención cardiovascular secundaria, de los pacientes sometidos a revascularización coronaria percutánea en el hospital universitario Fundación Santa Fe de Bogotá, entre los años 2008 y 2010.Materiales y métodosestudio descriptivo, ambispectivo, cuya población estuvo conformada por 332 pacientes sometidos a intervención coronaria percutánea atendidos entre enero de 2008 a diciembre de 2010 en el servicio de hemodinamia del Hospital Universitario Fundación Santa Fe de Bogotá. La recolección de la información se realizó mediante revisión de las historias clínicas de los pacientes y vía telefónica. Las metas de control se basaron en las recomendaciones de la Asociación Americana del Corazón y el Colegio Americano de Cardiología.Resultados332 pacientes fueron sometidos a revascularización coronaria percutánea y 4 fueron excluidos del estudio por falta de datos. La presentación clínica más frecuente fue la angina inestable (32,93%). Sólo se contactaron 172 (52,43%) pacientes, de los cuales 77,4% eran hombres y 22,6% mujeres. Únicamente 6 (3,5%) cumplían con el 100% de las recomendaciones para la prevención secundaria de enfermedad coronaria y 17% cumplía menos del 50% de éstas.Conclusionesla experiencia en la Fundación Santa Fe de Bogotá muestra un pobre cumplimiento de las metas de prevención secundaria de enfermedad coronaria.Contextdifferent clinical trials have shown that the effect of revascularization and angioplasty procedures in the prognosis of the patient has only a short-term effect, while secondary prevention (lifestyle change and intensive treatment) improves long-term prognosis.Objectiveto assess compliance with the recommendations for secondary prevention of cardiovascular disease in patients undergoing percutaneous coronary revascularization at the University Hospital Fundación Santa Fe de Bogotá, between 2008 and 2010.Materials and methodsa descriptive ambispective study, whose population was conformed by 332 patients undergoing percutaneous coronary intervention seen between January 2008 and December 2010 in the service of hemodynamics of the University Hospital Fundación Santa Fe de Bogotá. The data collection was conducted by reviewing the medical records of the patients and by telephone. Control targets were based on the recommendations of the American Heart Association and the American College of Cardiology.Results332 patients underwent percutaneous coronary revascularization. 4 were excluded from the study due to lack of data. The most common clinical presentation was unstable angina (32.93%). Only 172 patients (52.43%) were contacted. From these, 77.4% were male and 22.6% female. Only 6 (3.5%) met 100% of the recommendations for secondary prevention of coronary heart disease and 17% met less than 50% of these recommendations.Conclusionsthe experience in the Fundación Santa Fe de Bogotá shows a poor compliance with the goals of secondary prevention of coronary disease

Anomalous origin of coronary arteries A case report and literature review

Las alteraciones anatómicas de las arterias coronarias representan un amplio espectro de anormalidades que son diagnosticadas habitualmente como un hallazgo incidental en autopsia o durante la realización de una arteriografía coronaria. Sin embargo, algunas de éstas tienen una significancia clínica variable y pueden estar asociadas con morbilidad cardiaca significativa, incluyendo muerte súbita en la infancia, la adolescencia o la vida adulta.Q4Presentación de casos320-323Anatomic abnormalities of the coronary arteries represent a wide spectrum of abnormalities that are usually diagnosed as an incidental finding at autopsy or during the performance of coronary arteriography. However, some of these abnormalities have a variable clinical significance and may be associated with significant cardiac disease, including sudden death in childhood, adolescence or adulthood

Modelling the time-varying cell capacity in LTE networks

In wireless orthogonal frequency-division multiple access (OFDMA) based networks like Long Term Evolution (LTE) or Worldwide Interoperability for Microwave Access (WiMAX) a technique called adaptive modulation and coding (AMC) is applied. With AMC, different modulation and coding schemes (MCSs) are used to serve different users in order to maximise the throughput and range. The used MCS depends on the quality of the radio link between the base station and the user. Data is sent towards users with a good radio link with a high MCS in order to utilise the radio resources more efficiently while a low MCS is used for users with a bad radio link. Using AMC however has an impact on the cell capacity as the quality of a radio link varies when users move around; this can even lead to situations where the cell capacity drops to a point where there are too little radio resources to serve all users. AMC and the resulting varying cell capacity notably has an influence on admission control (AC). AC is the algorithm that decides whether new sessions are allowed to a cell or not and bases its decisions on, amongst others, the cell capacity. The analytical model that is developed in this paper models a cell with varying capacity caused by user mobility using a continuous -time Markov chain (CTMC). The cell is divided into multiple zones, each corresponding to the area in which data is sent towards users using a certain MCS and transitions of users between these zones are considered. The accuracy of the analytical model is verified by comparing the results obtained with it to results obtained from simulations that model the user mobility more realistically. This comparison shows that the analytical model models the varying cell capacity very accurately; only under extreme conditions differences between the results are noticed. The developed analytical and simulation models are then used to investigate the effects of a varying cell capacity on AC. Also, an optimisation algorithm that adapts the parameter of the AC algorithm which determines the amount of resources that are reserved in order to mitigate the effects of the varying cell capacity is studied using the models. Updating the parameter of the AC algorithm is done by reacting to certain triggers that indicate good or bad performance and adapt the parameters of the AC algorithm accordingly. Results show that using this optimisation algorithm improves the quality of service (QoS) that is experienced by the users.This work was partially supported by the Spanish Government through project TIN2010-21378-C02-02 and contract BES-2007-15030.Sas, B.; Bernal Mor, E.; Spaey, K.; Pla, V.; Blondia, C.; Martínez Bauset, J. (2014). Modelling the time-varying cell capacity in LTE networks. Telecommunication Systems. 55(2):299-313. https://doi.org/10.1007/s11235-013-9782-2S2993135523GPP (2010). 3GPP TR 36.213: Evolved Universal Terrestrial Radio Access (E-UTRA); Radio Resource Control (RRC); Physical layer procedures, June 2010.3GPP (2010). 3GPP TR 36.942: Evolved Universal Terrestrial Radio Access (E-UTRA); Radio Resource Control (RRC); Radio Frequency (RF) system scenarios, September 2010.Al-Rawi, M., & Jäntti, R. (2009). Call admission control with active link protection for opportunistic wireless networks. Telecommunications Systems, 41(1), 13–23.Bhatnagar, S., & Reddy, B.B.I. (2005). Optimal threshold policies for admission control in communication networks via discrete parameter stochastic approximation. Telecommunications Systems, 29(1), 9–31.Camp, T., Boleng, J., & Davies, V. (2002). A survey of mobility models for ad hoc network research. Wireless Communications and Mobile Computing, 2(5), 483–502.E3. ict-e3.eu.Elayoubi, S.-E., & Chahed, T. (2005). Admission control in the downlink of WCDMA/UMTS. In LNCS: Vol. 3427. Mobile and wireless systems (pp. 136–151).Garcia, D., Martinez, J., & Pla, V. (2005). Admission control policies in multiservice cellular networks: optimum configuration and sensitivity. In G. Kotsis, & O. Spaniol (Eds.), Lecture notes in computer science: Vol. 3427. Wireless systems and mobility in next generation Internet (pp. 121–135).Guo, J., Liu, F., & Zhu, Z. (2007). Estimate the call duration distribution parameters in GSM system based on K-L divergence method. In International conference on wireless communications, networking and mobile computing (pp. 2988–2991), Shanghai, China, September 2007.Hossain, M., Hassan, M., & Sirisena, H. R. (2004). Adaptive resource management in mobile wireless networks using feedback control theory. Telecommunications Systems, 24(3–4), 401–415.Jeong, S.S., Han, J.A., & Jeon, W.S. (2005). Adaptive connection admission control scheme for high data rate mobile networks. In IEEE 62nd Vehicular technology conference, 2005. VTC-2005-Fall (Vol. 4, pp. 2607–2611).Kim, D.K., Griffith, D., & Golmie, N. (2010). A novel ring-based performance analysis for call admission control in wireless networks. IEEE Communications Letters, 14(4), 324–326.Latouche, G., & Ramaswami, V. (1999). Introduction to matrix analytic methods in stochastic modeling. ASA-SIAM. Baltimore: Philadelphia.MONOTAS. http://www.macltd.com/monotas .Neuts, M. (1981). Matrix-geometric solutions in stochastic models: an algorithmic approach. Baltimore: The Johns Hopkins University Press.NGMN. NGMN Radio Access Performance Evaluation Methodology, January 2008.NGMN. www.ngmn.org .Prehofer, C., & Bettstetter, C. (2005). Self-organization in communication networks: principles and design paradigms. IEEE Communications Magazine, 43(7), 78–85.Ramjee, R., Nagarajan, R., & Towsley, D. (1997). On optimal call admission control in cellular networks. Wireless Networks, 3(1), 29–41.Siwko, J., & Rubin, I. (2001). Call admission control for capacity-varying networks. Telecommunications Systems, 16(1–2), 15–40.SOCRATES. www.fp7-socrates.eu .Spaey, K., Sas, B., & Blondia, C. (2010). Self-optimising call admission control for LTE downlink. In COST 2100 TD(10)10056, Joint Workshop COST 2100 SWG 3.1 & FP7-ICT-SOCRATES, Athens, Greece.Spilling, A. G., Nix, A. R., Beach, M. A., & Harrold, T. J. (2000). Self-organisation in future mobile communications. Electronics & Communication Engineering Journal, 3, 133

HIV-1 Infection in Cyprus, the Eastern Mediterranean European Frontier: A Densely Sampled Transmission Dynamics Analysis from 1986 to 2012

Since HIV-1 treatment is increasingly considered an effective preventionstrategy, it is important to study local HIV-1 epidemics to formulate tailored preventionpolicies. The prevalence of HIV-1 in Cyprus was historically low until 2005. To investigatethe shift in epidemiological trends, we studied the transmission dynamics of HIV-1 in Cyprususing a densely sampled Cypriot HIV-1 transmission cohort that included 85 percent ofHIV-1-infected individuals linked to clinical care between 1986 and 2012 based on detailedclinical, epidemiological, behavioral and HIV-1 genetic information. Subtyping andtransmission cluster reconstruction were performed using maximum likelihood and Bayesianmethods, and the transmission chain network was linked to the clinical, epidemiological andbehavioral data. The results reveal that for the main HIV-1 subtype A1 and B sub-epidemics,young and drug-naïve HIV-1-infected individuals in Cyprus are driving the dynamics of thelocal HIV-1 epidemic. The results of this study provide a better understanding of thedynamics of the HIV-1 infection in Cyprus, which may impact the development of preventionstrategies. Furthermore, this methodology for analyzing densely sampled transmissiondynamics is applicable to other geographic regions to implement effective HIV-1 preventionstrategies in local settings

Early Science with the Oscura Integration Test

Oscura is a planned light-dark matter search experiment using Skipper-CCDs with a total active mass of 10 kg. As part of the detector development, the collaboration plans to build the Oscura Integration Test (OIT), an engineering test experiment with 10% of the Oscura's total mass. Here we discuss the early science opportunities with the OIT to search for millicharged particles (mCPs) using the NuMI beam at Fermilab. mCPs would be produced at low energies through photon-mediated processes from decays of scalar, pseudoscalar, and vector mesons, or direct Drell-Yan productions. Estimates show that the OIT would be a world-leading probe for low-mass mCPs.Comment: 21 pages, 13 figure

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Origen anómalo de arterias coronarias: Reporte de un caso y revisión de la literatura Anomalous origin of coronary arteries: A case report and literature review

Las alteraciones anatómicas de las arterias coronarias representan un amplio espectro de anormalidades que son diagnosticadas habitualmente como un hallazgo incidental en autopsia o durante la realización de una arteriografía coronaria. Sin embargo, algunas de éstas tienen una significancia clínica variable y pueden estar asociadas con morbilidad cardiaca significativa, incluyendo muerte súbita en la infancia, la adolescencia o la vida adulta.Anatomic abnormalities of the coronary arteries represent a wide spectrum of abnormalities that are usually diagnosed as an incidental finding at autopsy or during the performance of coronary arteriography. However, some of these abnormalities have a variable clinical significance and may be associated with significant cardiac disease, including sudden death in childhood, adolescence or adulthood

Six years of experience in percutaneous closure of interatrial septal defects

MARCO DE REFERENCIA: los defectos del tabique interauricular son anormalidades congénitas del tabique interauricular que comprenden la comunicación interauricular y el foramen oval permeable. OBJETIVO: analizar y evaluar los resultados del cierre percutáneo con dispositivo percutáneo de pacientes con defectos del tabique interauricular en el Hospital Universitario Santa Fe de Bogotá desde la introducción de esta técnica en 2005 hasta 2011. MATERIALES Y MÉTODOS: se realizó un estudio descriptivo ambispectivo. La población estuvo conformada por pacientes adultos, independiente de edad y género, a quienes se les realizó cierre percutáneo de cualquier defecto del septo interauricular desde la introducción de esta técnica en enero 1º. de 2005 hasta junio de 2011 en el servicio de hemodinamia del Hospital Universitario Fundación Santa Fe de Bogotá. RESULTADOS: durante el periodo se hicieron 53 procedimientos de corrección de defecto del tabique interauricular por vía percutánea, en los que se usó dispositivo Amplatzer en 94,3% de los casos. El 75% (27 pacientes) se trataron de manera ambulatoria, dándose de alta luego de cuatro horas de efectuado el procedimiento. El 29,8% fueron hombres y 70,2% mujeres, con edad promedio de 52,2 ± 15,1 años. 57,8% de los pacientes tuvo foramen oval permeable y de éstos 54,5% tenía aneurisma asociado; el porcentaje restante, 42%, fue intervenido por comunicación interauricular. CONCLUSIONES: la experiencia en la Fundación Santa Fe de Bogotá muestra un excelente resultado con muy baja tasa de complicaciones, mejorías clínicas en el seguimiento a largo plazo y gran seguridad, factores que permiten que este procedimiento se lleve a cabo de manera ambulatoria.CONTEXT: atrial septal defects are congenital atrial septal abnormalities that comprise the interatrial communication (IAC) and the patent foramen ovale (PFO). OBJECTIVE: to analyze and evaluate the results of percutaneous closure with device in patients with interatrial septal defects in the University Hospital Santa Fe de Bogotá since the introduction of this technique in 2005 to 2011. MATERIALS AND METHODS: descriptive ambispective study. The population consisted of adult patients, regardless of age and gender, who underwent percutaneous closure of any atrial septal defect since the introduction of this technique in January 1st. 2005 to June 2011 in the service of hemodynamics of the University Hospital Fundación Santa Fe de Bogotá. RESULTS: during this period, 53 procedures of percutaneous correction of the atrial septal defect were performed, using the Amplatzer device in 94.3% cases. 75% (27 patients) were treated on an outpatient basis, being discharged four hours after the performance of the procedure. 29.8% were men and 70.2% women with mean age 52.2 ± 15.1 years. 57.8% of patients had patent foramen ovale and of these, 54.5% had associated aneurysm. The remainder 42%, was operated for interatrial communication. CONCLUSIONS: the experience in the Fundación Santa Fe de Bogota shows excellent results with a very low complication rate and clinical improvements in the long-term follow-up, factors that allow that this procedure can be performed on an outpatient basis

Cumplimiento de las recomendaciones de prevención secundaria de enfermedad coronaria en pacientes sometidos a revascularización coronaria percutánea en el Hospital Universitario Fundación Santa Fe de Bogotá

diferentes ensayos clínicos han mostrado que el efecto de las revascularizaciones y los procedimientos de angioplastia en el pronóstico del paciente, tiene sólo un efecto a corto plazo, mientras que la prevención secundaria (cambio de estilo de vida y tratamiento intensivo) mejora el pronóstico a largo plazo. Objetivo: evaluar el cumplimiento de las recomendaciones para prevención cardiovascular secundaria, de los pacientes sometidos a revascularización coronaria percutánea en el hospital universitario Fundación Santa Fe de Bogotá, entre los años 2008 y 2010. Materiales y métodos: estudio descriptivo, ambispectivo, cuya población estuvo conformada por 332 pacientes sometidos a intervención coronaria percutánea atendidos entre enero de 2008 a diciembre de 2010 en el servicio de hemodinamia del Hospital Universitario Fundación Santa Fe de Bogotá. La recolección de la información se realizó mediante revisión de las historias clínicas de los pacientes y vía telefónica. Las metas de control se basaron en las recomendaciones de la Asociación Americana del Corazón y el Colegio Americano de Cardiología. Resultados: 332 pacientes fueron sometidos a revascularización coronaria percutánea y 4 fueron excluidos del estudio por falta de datos. La presentación clínica más frecuente fue la angina inestable (32,93%). Sólo se contactaron 172 (52,43%) pacientes, de los cuales 77,4% eran hombres y 22,6% mujeres. Únicamente 6 (3,5%) cumplían con el 100% de las recomendaciones para la prevención secundaria de enfermedad coronaria y 17% cumplía menos del 50% de éstas. Conclusiones: la experiencia en la Fundación Santa Fe de Bogotá muestra un pobre cumplimiento de las metas de prevención secundaria de enfermedad coronaria