Criterios hemodinámicos y funcionales de indicación de una asistencia en la insuficiencia cardíaca aguda (shock cardiogénico)

Los dispositivos de soporte circulatorio son requeridos con frecuencia en el shock poscardiotomía, shock postinfarto agudo de miocardio y shock debido a miocarditis. La implantación de un dispositivo de asistencia ventricular conserva la vida de los pacientes con shock cardiogénico y conduce a la recuperación del fracaso secundario de órganos vitales. La selección de pacientes para terapia mediante dispositivos de soporte mecánico es el proceso más importante para la obtención de un resultado exitoso. Numerosos factores de riesgo con impacto sobre los resultados pueden ser identificados y tratados antes de la implantación del dispositivo. Evaluar el riesgo de este tratamiento requiere evaluar el grado de disfunción de sus órganos vitales y otros factores técnicos. A los pacientes les debe ser ofrecida la opción de asistencia ventricular si cumplen los criterios de necesidad, poseen el potencial de recuperación de sus órganos, y presentan un riesgo adecuado.Circulatory support devices are frequently required in postcardiotomy shock, post-myocardial infarction shock and acute myocarditis. The implantation of a ventricular assist device preserves the lives of patients with life-threatening cardiogenic shock and leads to recovery from secondary organ failure. Patient selection for mechanical assist devices therapy is the most important step in obtaining a successful outcome. Numerous risk factors impact on the outcome, many of which can be identified and treated before device surgery. Assessing the risk of this therapy requires evaluating the degree of organ dysfunction and technical factors. Patients should be offered the option of ventricular assist therapy if they meet criteria for requirement, potential for organ recovery, and present an appropriate operative risk

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Government deficit sustainability, and monetary versus fiscal dominance: The case of Spain, 1850-2000

In this paper, we provide a test of the sustainability of the Spanish government deficit over the period 1850-2000, and examine the role played by monetary and fiscal dominance in order to get fiscal solvency. The longer than usual span of the data would allow us to obtain some more robust results on the fulfilling of the intertemporal budget constraint than in most of previous analyses. First, we analyze the relationship between primary surplus and debt, following the recent critique of Bohn (2007), and investigate the possibility of structural changes occurring along the period by means of the new approach of Kejriwal and Perron (2008). The analysis is complemented in two directions: (i) performing Granger-causality tests in order to distinguish properly between a fiscal dominant and a monetary dominant regime; and (ii) presenting the impulse-response functions of debt to innovations in the primary surplus, through the approach of Canzoneri, Cumby and Diba (2001).Fiscal policy, Sustainability, Fiscal Theory of the Price Level, Monetary dominance, Fiscal dominance.

Is the Fisher Effect Nonlinear? Some Evidence for Spain, 1963-2002

In this paper we examine the role of nonlinearities in the relationship between nominal interest rates and inflation, in order to shed some additional light on the mostly unfavorable evidence on the presence of a full Fisher effect. The analysis is applied to the case of Spain for the period 1963-2002, which allows us to re-examine and extend previous results on the subject. The empirical methodology makes use of recent developments on threshold cointegration, so that cointegration between a pair of variables should be expected once a certain threshold was reached.Interest rate, Fisher effect, Threshold cointegration, nonlinearity.

Cointegrated TFP processes and international business cycles

A puzzle in international macroeconomics is that observed real exchange rates are highly volatile. Standard international real business cycle (IRBC) models cannot reproduce this fact. We show that total factor productivity processes for the United States and the rest of the world are characterized by a vector error correction model (VECM) and that adding cointegrated technology shocks to the standard IRBC model helps explaining the observed high real exchange rate volatility. Also, we show that the observed increase of the real exchange rate volatility with respect to output in the past twenty years can be explained by changes in the parameter of the VECM.

Is the Budget Deficit Sustainable when Fiscal Policy is nonlinear? The Case of Spain, 1961-2001

In this paper we re-examine the long-run sustainability of budget deficits, when fiscal policy is conducted as a nonlinear process. Our empirical methodology makes use of recent developments on threshold cointegration that consider the possibility of a nonlinear relationship between government revenues and expenditures. The analysis is applied to the case of Spain, a country that has recently accomplished an important fiscal consolidation. Overall, our results suggest the presence of significant nonlinear effects in Spanish fiscal policy, so that fiscal authorities would cut deficits only if they are “large”, and assuring their long-run sustainability.Fiscal policy, Sustainability, Threshold cointegration.

On the sustainability of government deficits: some long-term evidence for Spain, 1850-2000

We provide a test of the sustainability of the Spanish government deficit over the period 1850-2000, from the estimation of a cointegration relationship between government expenditures and revenues derived from the intertemporal budget constraint. The longer than usual span of the data allows us to obtain more robust results on the fulfilment of the intertemporal budget constraint than most of the previous analyses. Two additional robustness checks are provided. First, we investigate the possibility of structural changes occurring along the period analyzed, using the new approach of Kejriwal and Perron (2008, 2010) to testing for multiple structural changes in cointegrated regression models. Second, we investigate whether the behaviour of fiscal authorities has been non-linear, by means of the procedure of Hansen and Seo (2002) based on a threshold cointegration model. Our results show that (i) the government deficit has been strongly sustainable in the long run, (ii) no evidence is found on any significant structural break throughout the whole period, and (iii) fiscal sustainability has been attained due to the non-linear behaviour of fiscal authorities, which have only acted on the budget deficit when it has exceeded around 4.5% of GDP.fiscal policy, sustainability, structural change, threshold cointegration, nonlinearity