Coronary artery spasm : role in acute myocardial ischaemia

Coronary artery spasm is an accepted cause of transient myocardial ischaemia in patients with variant angina. The electrocardiographic abnormality, ST segment elevation, which is a hallmark of this syndrome, resembles that seen experimentally when the animal coronary artery is ligated and clinically, when the human coronary artery is totally occluded by a balloon angioplasty catheter. Coronary artery spasm is defined as a severe localized constriction sufficiently profound to cause transient total or sub-total occlusion of an epicardial coronary artery resulting in myocardial ischaemia. Coronary artery spasm has also been suggested to play an important role in the pathophysiology of myocardial ischaemia throughout the wide clinical spectrum of coronary artery disease including effort angina, unstable angina, acute myocardial infarction and sudden death.peer-reviewe

Systematic Review on the Theme of Sustainability in Industry 4.0

On the recent process of reflection on the values ​​of a based-on consumption society, the analyst put in check the global capacity to attend the demand for capital goods and consumption combined with the simultaneous quality of life. Sustainability, in turn, as a field of disputes, seeks to extend practices in the industrial environment as a carrier of dimensions beyond the environmental, and also seeks to present new paradigms of production and consumption for the creation of new industrial value, seeking to mitigate impacts and externalities of the production process, through sustainable development. This article proposes to understand that interactions can be established between the fourth industrial revolution and the dimensions of sustainability, presenting their characteristics and their interconnections in the literature search. Through a systematic review of the literature, using the PRISMA method, the leading publications on the levels of integrated technologies of the so-called Industry 4.0 that are related to the dimensions of sustainability and its main trends in the academic field were analyzed

The long and winding road: the management of Acute Coronary Syndromes in Malta

The treatment of acute coronary syndromes in Malta has been revolutionized over the past decade by the introduction of the catheterization laboratory. With the set-up of on-call cardiac invasive teams for primary percutaneous coronary interventions in ST-elevation myocardial infarction, Malta may be counted among the elite cardiac centres. The recent completion of numerous multicentre international clinical trials has led to an upheaval in the strategy and armamentarium for the treatment of acute coronary syndromes.peer-reviewe

Empreendimentos econômicos solidários em áreas protegidas como alternativa para um desenvolvimento multiterritorial endógeno

Entre as comunidades que integram a Reserva de Desenvolvimento Sustentável do Tupé, Manaus, Amazonas, subsiste uma lógica operacional, ideológica e instrumental de produção e consumo assentada na exploração de recursos materiais, humanos e organizacionais que priorizam o lucro individual. À medida que estabelece estilos de vida diferenciados como “prêmio” para aqueles que se especializam nesta prática socioeconômica, tornando cada vez mais inviável alcançar qualquer das metas esperadas de desenvolvimento sustentável se vinculadas a áreas ambientalmente protegidas. Neste contexto e considerando que a especificidade jurídica das comunidades localizadas em áreas de preservação ambiental não deve constituir-se em obstáculo para que as metas de cidadania, preservação ambiental e qualidade de vida sejam alcançadas, sugere-se que qualquer medida de fortalecimento de sua economia seja precedida de um mapeamento das atividades locais e que justifique e direcione os recursos necessários à sua implementação. Com este entendimento, o presente texto tem como objetivo caracterizar os empreendimentos econômicos localizados na comunidade ribeirinha de Nossa Senhora do Livramento, a fim de apontar possíveis caminhos que a Economia Social e Solidária possa indicar para o desenvolvimento sustentável da comunidade examinada

Metabolic disorders in the etiology of amyotrophic lateral sclerosis : an epidemiological approach

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by a loss of motor neurons in the brain and spinal cord, leading to progressive muscle weakness in multiple regions of the body. No effective treatment is available and the disease progresses rapidly to death with an average survival time of 3-5 years after symptom onset. The etiology of ALS is unknown for the majority of the patients. Alterations in the carbohydrate and lipid metabolisms, together with hypermetabolism, are features of ALS patients that are not yet well characterized. Understanding the early metabolic symptoms of the disease might be a necessary step for the identification of an effective treatment. Paper I describes a nested case-control study on the association between diabetes and the future risk of ALS in the Swedish population. A total of 5,108 new ALS cases among the Swedish residents between 1991 and 2010 were identified from the National Patient Register. Through linkages to several nationwide Swedish registers five controls per case were selected from the entire Swedish population using incidence density sampling and diabetes diagnoses were identified for both cases and controls from hospital admission records, outpatient care records, prescription of antidiabetics, or a combination of the three. An overall inverse association between diabetes and risk of ALS was found. There was however a positive association between insulin-dependent diabetes before age 30 and ALS risk. Paper II describes the association between body mass index (BMI), BMI change and ALS risk and survival in the GENEVA study, a case-control study of United States military veterans. Self-reported BMI at age 25, 40 and at time of ALS diagnosis (interview for controls) was compared. Low BMI at age 40 was associated with increased risk of developing ALS and the association was stronger for cases with diagnostic delay shorter than one year. Stable or decreasing BMI between age 25 and 40 was also associated with higher risk of ALS compared to an increasing BMI. However, premorbid BMI and BMI change did not predict survival of ALS patients. Paper III describes the association between ALS risk and serum glucose, total cholesterol, LDL-C, HDL-C, triglycerides, apolipoprotein B (apoB), and apolipoprotein A-I (apoA-I) in a Swedish populationbased cohort study. High LDL-C, apoB and the LDL-C/HDL-C and apoB/apoA-I ratios were associated with a higher incidence of ALS. These associations seemed to be mainly due to a strong association of apoB with ALS risk. High glucose level ( 6.11 mmol/L) was associated with a lower incidence of ALS. During the 10 years before diagnosis, ALS patients had increasing levels of LDL-C, HDL-C, apoB and apoA-I, whereas gradually decreasing levels of LDL-C/HDL-C and apoB/apoA-I ratios. Paper IV describes a population-based nested case-control study of 2,475 Swedish residents diagnosed with ALS during July 2006-December 2013, and 12,375 population controls. Information on filled prescriptions of antidiabetics and statins were extracted from the Swedish Prescribed Drug Register. Antidiabetics were associated with a lower ALS risk, the association was stronger for men, for individuals above age 65, and for ALS with longer disease duration. Statins were not associated with ALS risk overall, though a positive association was noted among women. The latter association was mostly explained by increased statins use during the year before ALS diagnosis. The studies presented in this thesis have taken advantage of different study designs and populations to systematically investigate the relationship between metabolic disorders and ALS risk and, to a lesser extent, progression. Therefore, they contributed substantially to fill the knowledge gap about the association between metabolic disorders and neurodegeneration in ALS. Furthermore, Paper I and Paper IV serve as excellent examples of the unique possibilities offered by the nationwide health registers in Sweden that can, when equipped with modern analytical methods, contribute to the understanding of complex diseases

Systematic Review of the Literature on Family Farming and the Social and Solidarity Economy in Brazil and Latin America

Concerned with the increase in hunger worldwide as well as unemployment and the lack of equity in the distribution of income the United Nations began to address genuinely Latin American scientific categories in its agendas assemblies and task forces The two main categories are Family Farming with the recent establishment of the Family Farming decade 2019-2028 and the Social and Solidarity Economy as a tool for transposing the Sustainable Development Goals SDGs in the Territories Together these categories can be responsible for achieving the SDGs in 78 of the world s territory There is a need however to clarify whether the science produced in Latin America also presents trends of intersection in the search for the theoretical construction of a new paradigm of production and consumption In this sense the objective of this study was to identify trends in scientific production on the categories Family Farming and Social and Solidarity Economy An adaptation of the PRISMA method was developed as a systematic literature review to identify these trends in the scientific field in Latin America After executing the PRISMA method we arrived at 244 articles from Family Farming and 56 articles from the Social and Solidarity Economy between 2016 and 2020 categorized into Areas of Study and Knowledge Macrocategories and Microcategories There are consolidated trends in the intersection between Family Farming and the Social and Solidarity Economy in productions on Productive Inclusion Sustainable Development and Sustainability Indicators and with evident growth in the areas of productions on Food Security mainly in the Organic Foods and Agroecology microcategories and productions on Public Policies in microcategories such as the National School Feeding Program Social Transformations and Social Technologies We conclude that the relationship between Social and Solidarity Economy and Family Farming is reciprocal in terms of granting cohesion to the scientific production network extrapolating the borders of Brazil and integrating not only Latin America but also Iberoamerica as a path to the expansion of both the categorie

Contribution of Rural Non-Farm Enterprises to Buen Vivir in Protected Areas in the Amazon

Rural non-farm activities are adaptation strategies that local communities develop as socioeconomic alternatives for facing imposed restrictions in protected areas To highlight these strategies this study aimed to relate the socioeconomic variables of social agents SAs with their perceptions about the impact of rural non-farm enterprises RNFEns on the Buen Vivir of their community as residents of the Sustainable Development Reserve of Tup Manaus Amazonas In this exploratory research through semi-structured interviews and participatory observations the perceptions of the SAs about the dimensions of Buen Vivir Psychological Well-Being Time Use Community Vitality Culture Environment and others were evaluated and how these perceptions relate to the socioeconomic variables of the RNFEns In the perception of the SAs the RNFEns positively impact Buen Vivir in the dimensions with the strongest collective tendency and negatively in the dimensions with the strongest private tendency with pluriactivity being the explanatory variabl

Florestan Fernandes e os aspectos socio-históricos de uma integração híbrida no Brasil

Objetiva-se, neste texto, resgatar elementos da teoria sociológica utilizados por Florestan Fernandes para o estudo da sociedade brasileira, associando à explicação as especificidades do percurso histórico com os mecanismos ambíguos de inclusão social de seus membros. Trata-se de reconstruir interpretativamente o conceito sociológico de integração a partir da leitura imanente dos textos de Florestan Fernandes que abordam a questão da formação e desenvolvimento da sociedade brasileira. No exame das obras que tratam dos Tupinambá, dos Negros e da Revolução Burguesa, tem-se perceptível que, se no Brasil a ordem social foi mantida estável, apesar da exclusão e marginalização sistemática de grande parte de seus membros, isto se deve, segundo o autor, a um tipo especial de integração que operou e ainda opera entre os brasileiros, e que muito tem contribuído para impedir qualquer tipo de transformação ou revolução mais profunda da ordem social

Transcatheter device closure of atrial septal defect and patent foramen ovale in Malta

Significant atrial septal defects (ASD) are closed, surgically or through a transcatheter device, in order to avoid pulmonary hypertension in late life. A patent foramen ovale (PFO) may need to be closed because of transient shunt reversal resulting in transient ischaemic events or stroke. We report the Maltese experience to date in transcatheter closure of these defects. A total of 46 ASDs and 51 PFOs have been successfully closed at our unit (total 97), with very low complication rates, rates that compare very favourably with results from larger international centres.peer-reviewe