Predicción Cardiovascular ¿realmente útil?

En la actualidad se cuentan con muchas puntuaciones de riesgo cardiovascular.Todas estas escalas de riesgo en su mayoría están diseñadas para poblaciones con características específicas por lo que su uso fuera de estas poblaciones requiere previamente de una adaptación a la realidad epidemiológica de la población en la que se espera introducir.A pesar de las evidencias científicas disponibles, el grado en que se han implementado estas tablas e intervenciones en los países de Latinoamérica incluyendo a Cuba todavía es muy limitado. a A partir de esto surge la interrogante del presente estudioABSTRACTToday we have many cardiovascular risk scores. These  scores are mostly designed for populations with specific characteristics, so in order to use them outside these populations, requires an adaptation to the epidemiological reality of the new population. Despite scientific evidence available, the extent to which these tables and interventions have been implemented in Latin American countries including Cuba is still very limited.From this, arises the questionof this stud

COVID-19. Punto de vista del cardiólogo.

COVID-19. Punto de vista del cardiólogo

Variabilidad Interobservador del Score SYNTAX en pacientes con diagnóstico de Enfermedad Arterial Coronaria Multivaso.

Introducción: El estudio SYNTAX introdujo el score del mismo nombre con el objetivo de ayudar al Heart Team a decidir la vía óptima de revascularización en los pacientes con enfermedad arterial coronaria multivaso y del tronco de la coronaria izquierda, del mismo han sido señalados varias limitaciones dentro de ellas la reproducibilidad en la práctica clínica real. Objetivo: Determinar la variabilidad interobservador del score SYNTAX en pacientes con diagnóstico de Enfermedad Arterial coronaria multivaso o del TCI. Material y Método: Estudio observacional transversal analítico. El universo de estudio estuvo conformado por 85 pacientes diagnosticados de enfermedad arterial coronaria multivaso durante el año 2016 en el Cardiocentro CIMEQ. La muestra se seleccionó por muestreo aleatorio simple conformada por 30 pacientes. Intervinieron 3 cardiólogos intervencionistas los que reprodujeron el score Syntax de manera individual. Se usó el índice de Kappa de Fleiss para determinar la variabilidad interobservador de las siguientes variables: No. De lesiones, Calcificación severa, Longitud de lesión mayor de 20mm, Bifurcación/Trifurcación, Enfermedad difusa o de vasos pequeños, oclusiones totales y SYNTAX Score. Resultados: Se obtuvo un índice de Kappa de 0.69 para la puntuación global y de 0.82, 0.60 y 0.94 para las variables No. De lesiones, Bifurcación/Trifurcación y Oclusiones Totales respectivamente. Existió mayor variabilidad en el rango de puntuaciones intermedias.Conclusiones: El SYNTAX score presentó una buena reproductibilidad interobservador. Las variables de mayor dispersión fueron la presencia de calcificación severa, longitud de las lesiones mayor de 20 mm y la enfermedad de vasos pequeños o difusa

Diabetes Mellitus tipo 2 y puntuaciones de riesgo

La diabetes mellitus está emergiendo más rápidamente que cualquier otra enfermedad. Se ha demostrado que la prevención de la Diabetes tipo 2 es posible y requiere de acción inmediata basada en cambios del estilo de vida sostenidos en la dieta y en la actividad física, además de la identificación a nivel poblacional de los grupos con mayor riesgo de padecer la enfermedad. La presente investigación se realizó con el objetivo de caracterizar la diabetes mellitus así como las diferentes puntuaciones de riesgo existentes para la identificación de individuos con probabilidad de desarrollar diabetes mellitus tipo 2 sin alteraciones previas de la glucemia, para lo cual se consultaron un total de 46 referencias bibliográficas.ABSTRACTDiabetes mellitus is emerging more quickly than any other illness. It is not still possible to prevent the diabetes type 1 and this goal remains as an objective of the future. Has been demonstrated that the prevention of the Diabetes type 2 is possible and it requires of immediate action based on changes of the lifestyle sustained in the diet and in the physical activity, besides the identification at populational level of the groups with more risk of suffering the illness. The present investigation was carried out with the objective of characterizing the diabetes mellitus as well as the existent different punctuations of risk for the identification of individuals with probability of developing diabetes mellitus type 2 without previous alterations of the glycaemia, for that which a total of 46 bibliographical references were consulted

Impact of the Pandemic on NonInfected Cardiometabolic Patients: A Survey in Countries of Latin America—Rationale and Design of the CorCOVID LATAM Study

Background: The first case of coronavirus 2019 (COVID-19) in Latin America was detected on February 26th, 2020, in Brazil. Later, in June, the World Health Organization announced that the focus of the outbreak had shifted to Latin America, where countries already had poor control of indicators of noncommunicable diseases (NCDs). Concerns about coronavirus infection led to a reduced number of visits and hospitalizations in patients with NCDs, such as cardiovascular disease, diabetes, and cancer. There is a need to determine the impact of the COVID-19 pandemic on patients who have cardiometabolic diseases but do not have clinical evidence of COVID-19 infection. Methods: The CorCOVID LATAM is a cross-sectional survey of ambulatory cardiometabolic patients with no history or evidence of COVID-19 infection. The study will be conducted by the Interamerican Society of Cardiology. An online survey composed of 38 questions using Google Forms will be distributed to patients of 13 Latin American Spanish-speaking countries from June 15th to July 15th, 2020. Data will be analyzed by country and regions. Seven clusters of questions will be analyzed: demographics, socioeconomic and educational level, cardiometabolic profile, lifestyle and habits, body-weight perception, medical follow-up and treatments, and psychological symptoms. Results: Final results will be available upon completion of the study. Conclusions: The present study will provide answers regarding the impact of the COVID-19 pandemic on noninfected cardiometabolic patients. Data on this topic are scarce, as it is an unprecedented threat, without short-term solutions.Fil: Lopez Santi, Ricardo. Hospital Italiano de La Plata; ArgentinaFil: Piskorz, Daniel Leonardo. No especifíca;Fil: Marquez, Manlio F.. Instituto Nacional de Cardiologia Ignacio Chavez; MéxicoFil: Ramirez Ramos, Cristhian. Centro de Medicina del Ejercicio y Rehabilitación Cardíaca; ColombiaFil: Renna, Nicolas Federico. Hospital Espanol de Mendoza; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; ArgentinaFil: Ibarrola, Martin. No especifíca;Fil: Wyss, Fernando Stuardo. Servicios y Tecnología Cardiovascular de Guatemala; GuatemalaFil: Naranjo Dominguez, Adrián. Instituto de Cardiologia y Cirugia Cardiovascular; CubaFil: Perez, Gonzalo Emanuel. No especifíca;Fil: Farina, Juan María. No especifíca;Fil: Forte, Ezequiel. Centro Diagnóstico Cardiovascular; ArgentinaFil: Juarez Lloclla, Jorge Paul. Hospital de Apoyo II Santa Rosa; PerúFil: Flores de Espinal, Emma. Hospital Nacional San Juan De Dios; El SalvadorFil: Puente Barragan, Adriana. Instituto Mexicano del Seguro Social; MéxicoFil: Ruise, Mauro Gabriel. Clínica Yunes; ArgentinaFil: Delgado, Diego. University of Toronto; CanadáFil: Baranchuk, Adrian. Queens University; Canad

Differential cross section measurements for the production of a W boson in association with jets in proton–proton collisions at √s = 7 TeV

Measurements are reported of differential cross sections for the production of a W boson, which decays into a muon and a neutrino, in association with jets, as a function of several variables, including the transverse momenta (pT) and pseudorapidities of the four leading jets, the scalar sum of jet transverse momenta (HT), and the difference in azimuthal angle between the directions of each jet and the muon. The data sample of pp collisions at a centre-of-mass energy of 7 TeV was collected with the CMS detector at the LHC and corresponds to an integrated luminosity of 5.0 fb[superscript −1]. The measured cross sections are compared to predictions from Monte Carlo generators, MadGraph + pythia and sherpa, and to next-to-leading-order calculations from BlackHat + sherpa. The differential cross sections are found to be in agreement with the predictions, apart from the pT distributions of the leading jets at high pT values, the distributions of the HT at high-HT and low jet multiplicity, and the distribution of the difference in azimuthal angle between the leading jet and the muon at low values.United States. Dept. of EnergyNational Science Foundation (U.S.)Alfred P. Sloan Foundatio

Juxtaposing BTE and ATE – on the role of the European insurance industry in funding civil litigation

One of the ways in which legal services are financed, and indeed shaped, is through private insurance arrangement. Two contrasting types of legal expenses insurance contracts (LEI) seem to dominate in Europe: before the event (BTE) and after the event (ATE) legal expenses insurance. Notwithstanding institutional differences between different legal systems, BTE and ATE insurance arrangements may be instrumental if government policy is geared towards strengthening a market-oriented system of financing access to justice for individuals and business. At the same time, emphasizing the role of a private industry as a keeper of the gates to justice raises issues of accountability and transparency, not readily reconcilable with demands of competition. Moreover, multiple actors (clients, lawyers, courts, insurers) are involved, causing behavioural dynamics which are not easily predicted or influenced. Against this background, this paper looks into BTE and ATE arrangements by analysing the particularities of BTE and ATE arrangements currently available in some European jurisdictions and by painting a picture of their respective markets and legal contexts. This allows for some reflection on the performance of BTE and ATE providers as both financiers and keepers. Two issues emerge from the analysis that are worthy of some further reflection. Firstly, there is the problematic long-term sustainability of some ATE products. Secondly, the challenges faced by policymakers that would like to nudge consumers into voluntarily taking out BTE LEI

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good

Search for stop and higgsino production using diphoton Higgs boson decays

Results are presented of a search for a "natural" supersymmetry scenario with gauge mediated symmetry breaking. It is assumed that only the supersymmetric partners of the top-quark (stop) and the Higgs boson (higgsino) are accessible. Events are examined in which there are two photons forming a Higgs boson candidate, and at least two b-quark jets. In 19.7 inverse femtobarns of proton-proton collision data at sqrt(s) = 8 TeV, recorded in the CMS experiment, no evidence of a signal is found and lower limits at the 95% confidence level are set, excluding the stop mass below 360 to 410 GeV, depending on the higgsino mass