Recurrent myocardial infarction in a young cocaine abuser

Cocaine increases the risk of cardiovascular diseases, including myocardial infarction. We herein describe a case of a 22-year-old man with a long history of cocaine abuse. He presented at our institution because of acute coronary syndrome with ST segment elevation. Emergency coronary angiography revealed ostial occlusion of the left anterior descending artery, which required desobstruction and implantation of a bare metal stent. Angioplasty was complicated 4 months later by in-stent restenosis requiring reintervention. This case highlights myocardial infarction as a cocaineinduced effect. Appropriate treatment and cessation of cocaine abuse may prevent cardiovascular complications and recurrences

Perforation d’anévrysme de la valve mitrale postérieure: complication rare de l’endocardite infectieuse: à propos d’un cas

L'anévrysme de la valve mitrale est une anomalie rare dont la physiopathologie est mal élucidée. Il se définit par une protubérance localisée au niveau du feuillet valvulaire mitral bombant dans l'oreillette gauche. La localisation sur le feuillet postérieur est exceptionnelle. Nous rapportons le cas d'un jeune homme de 26 ans suivi depuis 4 ans pour une insuffisance aortique rhumatismale qui est hospitalisé pour un syndrome fébrile avec poussée d'insuffisance cardiaque gauche. L'échocardiographique transthoracique (ETT) et transoesophagienne (ETO) ont mis en évidence des végétations sur la valve aortique avec un large anévrysme de la petite valve mitrale associé à une fuite mitrale importante. Le patient a bénéficié d'un double remplacement valvulaire mitral et aortique avec des suites opératoires simples. Une suspicion clinique avec une imagerie adaptée préopératoire et un traitement chirurgical à temps sont nécessaires pour reconnaître et traiter cette complication rare de l'endocardite infectieuse

Medidas preventivas no antitruste:

Contexto: As medidas preventivas no antitruste podem ser instrumentos essenciais para combater os efeitos de condutas anticompetitivas quando não se pode aguardar o desfecho de uma investigação completa. Por outro lado, tais medidas suscitam preocupações, na medida em que, se erroneamente adotadas, podem provocar sérios danos às partes envolvidas e, eventualmente, deixar a dinâmica concorrencial em situação pior do que antes da sua aplicação. Objetivo: Para que se possa avançar nas discussões sobre o tema, serão discutidos seus critérios-chave de aplicação (fumus boni iuris e periculum in mora), os princípios gerais fundamentais (temporariedade, reversibilidade, adaptabilidade, imediatidade, eficácia e proporcionalidade) e alguns aspectos de política pública concorrencial associados às medidas preventivas overenforcement, underenforcment e teorias do dano), sempre ilustrados com os precedentes do CADE entre 2020 e 2022 sobre a aplicação ou não de medidas preventivas. O objetivo do artigo é analisar, portanto, os fundamentos para a aplicação das medidas preventivas e, em especial, como eles têm sido abordados nos casos recentes do CADE. Método: Método exploratório e jurisprudencial. Conclusões: Dos 8 (oito) casos do CADE entre 2020 e 2022 contabilizados para fins do presente estudo, verifica-se que em 3 (37,5%) houve o indeferimento do pedido de preventiva, em 3 (37,5%) houve o deferimento parcial do pedido e em 2 (25%) houve o deferimento integral do pedido de medida preventiva, sendo que em um destes, porém, houve a reversão da medida judicialmente. Tanto a Nota da OCDE de 2022 quanto a própria experiência da autoridade concorrencial brasileira apontam para a consolidação e – por que não dizer – para a popularização das medidas preventivas, sendo que ele adquire uma importância especial em face dos mercados digitais e dos desafios que eles impõem à análise antitruste

Management of Cardiac Involvement in NeuroMuscular Diseases: Review

Neuromuscular Diseases are a heterogeneous molecular, clinical and prognosis group. Progress has been achieved in the understanding and classification of these diseases

Can Teacher Training Programs Influence Gender Norms? Mixed-Methods Experimental Evidence from Northern Uganda

This mixed-methods cluster-randomized controlled trial examines the impact of a teacher-training program that aimed to promote positive gender socialization in the conflict-affected region of Karamoja, Uganda. The theory of change suggests that the education system and teachers can play critical roles in promoting positive gender roles and gender equality, which has important implications for peacebuilding. Our study found evidence that the program positively influenced teachers’ knowledge about the difference between gender and sex, and their attitudes toward gender roles and gender identity. We found no quantitative evidence for any short-term change in teachers’ practices as a result of the program, nor did we find quantitative evidence of effects from a complementary, randomly assigned text-message intervention meant to reinforce the information delivered during the training. Qualitative research suggested that, while teachers adopted basic practices taught in the training, they were unready or unable to adopt more complex practices. The main implication is that training can influence teachers’ knowledge and attitudes on gender equality, but traditional gender norms can be a barrier to changing behavior in the short term. A further implication is the importance of involving the community to create enabling environments in which new ideas about gender equality can be accepted and translated into practice

Evidences of continental groundwater inputs to the shelf zone in Albardão, RS, Brazil

A região sul do Brasil é uma área altamente produtiva, cujos processos oceanográficos ainda são pouco compreendidos devido ao grande número de forçantes, tais como aportes continentais do Rio da Prata, Lagoa dos Patos, diferentes massas de água oceânicas e a complexa contribuição da água subterrânea. A plataforma da região do Albardão é extremamente rica em nutrientes dissolvidos, especialmente na zona costeira. O estreito cordão arenoso que separa a região do Albardão da Lagoa Mangueira levou-nos a questionar a possibilidade do transporte de água subterrânea e se este poderia contribuir de forma expressiva na produtividade dessa região. Para testar essa hipótese, associamos dados de nutrientes das Lagoas Mirim e Mangueira a dados inéditos da plataforma da região do Albardão, todos em período de alta precipitação. Este trabalho demonstra a necessidade de incluir o transporte de água subterrânea da Lagoa Mangueira para a região costeira, como uma das principais fontes para o aumento da produtividade da região. Entretanto, para quantificar e compreender melhor este fenômeno faz-se necessário o uso de isótopos naturais como traçadores desses aportes subterrâneos.The southern coastal region of Brazil is highly productive and many of its oceanographic processes are still poorly understood due to a great number of forces, such as the continental input from the Plata River and Patos Lagoon, several distinct oceanic water masses, and a complex contribution from groundwater. The shelf near Albardão is highly rich in dissolved nutrients, particularly in the coastal zone. The narrow sandy barrier that separates the ocean from Mangueira Lagoon has led us to wonder about the possibility of groundwater, and if it might play a role in the productivity of the surrounding area. In order to test this hypothesis, nutrient data from Mirim and Mangueira Lagoons and from Albardão were collected during a rainy period. The present work shows the need to include groundwater transport from Mangueira Lagoon to the coastal zone as one of the main sources for the productivity in that region. However, for such phenomenon to be quantified and better understood, it becomes necessary to use natural isotopes as tracers of the underground input

Coronary Fistulas: A Case Series

Coronary artery fistula is an uncommon finding during angiographic exams. We report a case series of five patients with congenital coronary fistulas. The first patient was 56 years old and had a coronary fistula associated with a partial atrio ventricular defect, the second patient was 54 years old and had two fistulas originating from the right coronary artery with a severe atherosclerotic coronary disease, the third patient was 57 years old with a fistula originating from the circumflex artery associated with a rheumatic mitral stenosis, the fourth patient was 50 years old and had a fistulous communication between the right coronary artery and the right bronchial artery, and the last patient was 12 years old who had bilateral coronary fistulas draining into the right ventricle with an aneurismal dilatation of the coronary arteries. Angiographic aspects of coronary fistulas are various; management is controversial and depends on the presence of symptoms