Personality Goes a Long Way

This article reviews books which test the personalization of politics, looking at different dimensions of the growing importance of leaders over time, namely for political parties, in electoral behaviour and in the media. Only recently have wide-ranging comparative longitudinal studies on leaders been carried out. The personalization thesis is not equally demonstrated across all dimensions. Indeed, we find something of a puzzle: There is no strong trend towards personalization of party organizations, whereas in electoral behaviour the evidence points to the increasing use by voters of leaders as heuristics. This attests to the decline of the importance of parties. The personalization of media may be the mechanism which explains the change in voting behaviour, and the third and final section of the review looks into that arena. We conclude with some suggestions on further research on the personalization of politics.info:eu-repo/semantics/publishedVersio

Echokardiographische Quantifizierung der linksventrikulären Kontraktilität und der transvalvulären Flussprofile der Herzklappen während halbliegender Fahrradergometrie in einer gesunden pädiatrischen Population:Erstellung von Referenzwerten

Die Stress-Echokardiographie ermöglicht die Detektion myokardialer und valvulärer Dysfunktionen, die unter Ruhebedingungen maskiert sind. Wir quantifizierten bei 153 gesunden Kindern (82 weiblich, 13.1±2.25 Jahre) die Ejektions- (EF%) und Verkürzungsfraktion (FS%), die Faserverkürzungsgeschwindigkeit (Vcf) und den meridionale Wandstress (ESWSm), sowie die maximale (PFV) und mittlere Flussgeschwindigkeit (MFV), die Ejektions- (ET), Akzelerations- (AT) und Dezelerationszeit (DT) an der Aorten- (AK), Mitral- (MK) und Pulmonalklappe (PK) unter fahrrad-ergometrischer Belastung (ExT). Dabei nahm die Kontraktilität (EF, FS, Vcf) proportional zur ExT zu (p0.05). PFV war in Ruhe: AK>MK>PK, und stieg unter maximaler ExT an allen Herzklappen gleichermaßen um ca. 60% vs. Ruhewert an. Die vorliegenden Daten eignen sich als Referenzwerte zur Diagnostik und Verlaufskontrolle myokardialer und valvulärer Dysfunktion bei Kindern

Endovascular Recanalization and Angioplasty of a Lengthy, 25 Years Old Superficial Femoral Artery Occlusion

Introduction: Often physicians and patients believe that occluded vessels could not be recanalized because an occlusive lesion is too long or exists over a very long period. We report a successful recanalization of a lengthy, quarter-century old superficial femoral artery occlusion through a percutaneous transluminal angioplasty.Report: We present the recanalization and angioplasty of the superficial femoral artery in a patient with a 37 cm long and 25 years old superficial femoral artery occlusion with limb ischemia, and who was considered as a high surgical risk. Through a subintimal dissection plane and with subsequent Pacific-balloon dilatation, two stent grafts were deployed to maintain patency. The post-intervention angiography and ankle-brachial index (ABI) showed a satisfactory primary outcome.Discussion: The recent guidelines recommend the endovascular therapy as the preferred strategy in patients with long and complex femoropopliteal lesions, an adequate recommendation as our case demonstrates. This case demonstrates that neither lesion length nor duration of an occlusion should be a cause to withhold an endovascular treatment.</p

Large mobile thrombus in non-atherosclerotic thoracic aorta as the source of peripheral arterial embolism

Abstract The presence of thrombi in the atherosclerotic and/or aneurysmatic aorta with peripheral arterial embolism is a common scenario. Thrombus formation in a morphologically normal aorta, however, is a rare event. A 50 years old woman was admitted to the mergency department for pain, coldness, and anesthesia in the the left foot. She had a 25 years history of cigarette smoking, a history of postmenopausal hormone replacement therapy (HRT), hypercholesterolemia and hyperfibrinogenemia. An extensive serologic survey for hypercoagulability, including antiphospholipid antibodies, and vasculitis disorders was negative. Transesophageal echocardiography revealed a large, pedunculated and hypermobile thrombus attached to the aortic wall 5 cm distal of the left subclavian artery. The patient was admitted to the surgery department, where a 15 cm long fresh, parietal thrombus could be removed from the aorta showing no macroscopic wall lesions or any other morphologic abnormalities. This case report demonstrates the possibility of evolving a large, pedunculated thrombus in a morphologically intact aorta in a postmenopausal woman with thrombogenic conditions such as hyperfibrinogenemia, hypercholesterolemia, smoking and HRT. For these patients, profiling the individual risk and weighing the benefits against the potential risks is warranted before prescribing HRT.</p

Clinical Characteristics and Current Practice of Endovascular Revascularization in Aorto-Iliac, Femoropopliteal and Infra-Popliteal Lower Extremity Artery Disease—Insights from the RECCORD Registry

Background: Endovascular revascularization (EVR) is a pillar of therapeutic management in patients with symptomatic lower extremity artery disease (LEAD). Due to lack of scientific evidence, the approach of EVR type and the devices used at the different anatomic vascular segments of the lower limbs vary substantially between operators and centers. We analyzed data from the RECcording COurses of vasculaR Diseases (RECCORD) registry to assess the current real-world EVR treatment patterns in relation to anatomic vascular segments in symptomatic LEAD patients in Germany. Patients and Methods: RECCORD is an ongoing, prospective, multicenter, all-comers and entirely web-based registry platform. Baseline demographic and periprocedural data of patients undergoing EVR for symptomatic LEAD were assessed and performed EVRs were grouped according to the intervened anatomic vascular segment. We analyzed four EVR groups comprising either the aorto-iliac, femoropopliteal, or infrapopliteal segments (all these EVRs with or without a further intervention in another anatomic segment) or the infrapopliteal segment alone. Results: A total of 2210 EVR segments (in 1639 patients) were analyzed. Of those 616 (27.9%) were aorto-iliacal, 1346 (60.9%) femoropopliteal, 248 (11.2%) infrapopliteal and 104 (4.7%) only infrapopliteal segments. Aorto-iliac EVR was associated with younger age, smoking, claudication and simple lesions, while the distal infrapopliteal EVRs were related to advanced age, diabetes, multiple comorbidities, limb threatening ischemia and complex lesions. The use of different EVR devices at the aorto-iliac, femoropopliteal, infrapopliteal and only infrapopliteal segments were: only ballon-angioplasty: 8.3%, 12.9%, 58.1% and 63.5%; stenting: 82.3%, 45.3%, 16.9% and 12.5%; drug-coated balloon: 11.2%, 55.0%, 19.4% and 19.2%. Conclusion: The RECCORD registry data demonstrate that in LEAD clinical and lesion characteristics are related to anatomic vascular segments. Despite the clear relationship between vascular segments and the current use of device types, prospective, segment-specific clinical studies are warranted to establish a consistent, evidence-based path for EVR in LEAD