Towards A Macroprudential Policy In The EU: Main Issues

The aim of the paper is to analyze the state of the art of macroprudential policies (MAP) with a focus on the case of the European Union. To this end the institutional framework of MAP is introduced and discussed with regard to several issues: the relationships and/or the conflicts with other policies and among the different institutional bodies involved, their mandate, accountability and governance. The operative framework - intermediate and final targets and toolkit - is specifically analyzed with regard to the case of the European Union and the introduction, in 2011, of a macroprudential supervisory pillar based on the European Systemic Risk Board (ESRB). Finally the main features of the new European supervisory architecture are addressed: the organization of MAP within the Single Supervisory Mechanisms (SSM), the definition of the role of the European Central Bank (ECB) and of the ESRB as far as macroprudential policy is concerned. In the conclusions, we evaluate the new architecture which is quite complex and cumbersome, and the challenge that the SSM is facing: to achieve comprehensive, rational, effective and efficient supervision, avoiding overlapping of competences and clarifying the specific roles of different bodies while keeping away additional burdens for the institutions supervised

Monitoring systemic risk a survey of the avialiable macropridential toolkit

Understanding the nature of systemic risk and identifying the channels of diffusion of the shocks are the necessary prerequisite to anticipate and manage successfully the insurgence of financial crises. In order to prevent financial distress and manage instability, the macroprudential regulator needs to track and measure systemic risks ex-ante. The aim of the paper is twofold: on one side, it reviews the theoretical frameworks which allow to assess the different dimensions of systemic risk and, on the other, it classifies accordingly and analyzes the methodologies available to assess in advance the occurrence of systemic distress. The paper classifies the different definitions of systemic risk and discusses their significance during the 2007-08 crisis. It presents the tools available to extract real time information on market perception of risk from market prices of securities and derivatives (i.e. CDS and equity options). The analysis is extended to the methods focused on the measurement of the financial fragility due to the networks linkages within the financial system. On the basis of the available empirical research, the paper also reviews the capacity of the different methods to spot in advance the insurgence of the crisis prior to 2007-08 and draws some preliminary conclusions on the completeness and consistency of the toolkit available to policy makers

Survival rate after early treatment for acute type-A aortic dissection with ACTH-(1-24)

Haemorrhagic shock, usually as a consequence of major trauma, is the most frequent cause of death among people younger than 40 years. Reports Indicate that melanocortin peptides are effective in reversing haemorrhagic shock. We found that in patients with aortic-dissection-induced haemorrhagic shock, the addition of an early intravenous bolus Injection of the melanocortin andrenocorticotrophic hormone (ACTH)-(1.24) to standard treatment significantly improved cardiovascular function and increased survival rate. Because administration of ACTH-(1.24) is simple, and because melanocortin peptides have no acute toxicity, their use in the early critical care of patients in shock should be more extensively assessed

ACTH analogue in treatment of acute aortic dissection-Authors' reply.

Sir\u2014The fact that the mortality rate inour patients who were assigned to thestandard treatment, without ACTH-(1-24) addition, was higher than thatreported in previous studies might beexplained by their severe haemodynamiccompromise. We selectedsubjects with type A aortic dissectioncomplicated by aortic rupture andcardiac tamponade, and with clinicaland laboratory signs of haemorrhagicshock.We share Olsson\u2019s opinion thatACTH-(1-24) essentially modifies thecomplex pathophysiology of theperioperative period. Not only byimproving the cardiovascular function;indeed, several experimental datasuggest that melanocortins have also apeculiar, adrenal-independent antiinflammatoryactivity. They reduce theproduction of proinflammatorycytokines, such as interleukins 1, 1,and 6, and tumour necrosis factor(TNF) , and inhibit the activation ofthe transcription factor NF-kB, whileincreasing the production of the antiinflammatorycytokines interleukins 8and 10;1 in particular, in conditions ofhaemorrhagic shock, melanocortinsinhibit the overproduction of TNF,nitric oxide, and free radicals.2,3Moreover, melanocortins protectagainst the outcomes either of a shorttermmyocardial ischaemia followed byreperfusion or of the permanentocclusion of a coronary artery in rats.4Our patients underwent fluidreplacement en route and ventilatorysupport but no rescue surgery. Ourcardiac surgery unit is situated roughlyin the middle of a flat territory innorthern Italy, with a high populationdensity (about 1 million people), and areasonable road system. The time lapsefrom emergency call to arrival into thecasualty ward, by ambulance or byhelicopter, is 20\u201340 min.Our animal data suggest that thetime span of ACTH-(1-24) efficacy isbest if given within 5\u201315 min of shockinduction. We have fewer human data,but they suggest that treatment must bemade within 1 h of the first signs ofshock. In case of haemorrhagic shock(road or industrial accidents, &c), webelieve ACTH should be given asintravenous bolus injection at thescene, or en route in the ambulance.The effect of ACTH lasts a few hours

Use of antidepressants during pregnancy in the Netherlands: Observational study into postpartum interventions

Background: Psychiatric disorders and use of selective antidepressants during pregnancy can have negative effects on mother and infant postpartum. This study aimed to provide evidence-based recommendations on observation of antidepressant-exposed mother-infant dyads. Methods: In this observational study, mother-infant dyads were observed for possible consequences of either the maternal psychiatric disorder or fetal exposure to selective antidepressants during pregnancy. These possible complications can lead to medical interventions, including 1. adjustment of antidepressants 2. admission to the psychiatric department 3. additional investigations due to indistinctness about the origin of neonatal symptoms 4. treatment of poor neonatal adaptation and 5. consultation of an external organization for additional care. The type, number and time to medical interventions were analyzed. Results: In 61% of the 324 included mother-infant dyads one or more intrventions were performed. Adjustment of antidepressants and treatment of poor neonatal adaptation were most prevalent. In 75% of dyads the final intervention was performed within 48 h. Conclusions: The high prevalence and type of medical interventions requires professional observation of all mother-infant dyads exposed to selective antidepressants. In the absence of specialized home care, hospital admission is indicated whereby an observational period of 48 h seems sufficient for most dyads

Biocompatibility of chemically treated bovine pericardium in rats

n/

Influence of early treatment with ACTH-(1-24) on the outcome of aortic dissection

Influence of early treatment with ACTH-(1-24) on the outcome of aortic dissectio