RESUMO
Based on the two main frameworks for evaluating scientific evidence (SEC and GRADE) European cardiovascular prevention guidelines recommend interventions across all life stages using a combination of population-based and high-risk strategies with diet as the cornerstone of prevention. The evaluation of cardiovascular risk (CVR) incorporates HDL levels and psychosocial factors, a very high risk category, and the concept of age-risk. They also recommend cognitive-behavioural methods (e.g., motivational interviewing, psychological interventions) led by health professionals and with the participation of the patient's family, to counterbalance psychosocial stress and reduce CVR through the institution of positive habits such as a healthy diet, physical activity, smoking cessation, and adherence to treatment. Additionally, public health interventions - such as smoking ban in public areas or the elimination of trans fatty acids from the food chain - are also essential. Other innovations include abandoning antiplatelet therapy in primary prevention and the recommendation of maintaining blood pressure within the 130-139/80-85 mmHg range in diabetic patients and individuals with high CVR. Finally, due to the significant impact on patient progress and medical costs, special emphasis is given to the low therapeutic adherence levels observed. In sum, improving cardiovascular prevention requires a true partnership among the political class, public administrations, scientific and professional associations, health foundations, consumer associations, patients and their families. Such partnership would promote population-based and individual strategies by taking advantage of the broad spectrum of scientific evidence available, from clinical trials to observational studies and mathematical models to evaluate population-based interventions, including cost-effectiveness analyses.
Assuntos
Doenças Cardiovasculares/prevenção & controle , Envelhecimento , Promoção da Saúde , Humanos , Medicina Preventiva , Prevenção Primária , Medição de Risco , Gestão de Riscos , EspanhaRESUMO
Our group previously reported the synthesis of four polythiophene derivatives (P1-P4) used for solar cells. The cells were prepared under room conditions by spin coating, leading to low efficiencies. However, after the addition of 6-nitro-3-(E)-3-(4-dimethylaminophenyl)allylidene)-2,3-dihydrobenzo[d]-[1,3,2] oxazaborole (M1) to their active layers, the efficiencies of the cells showed approximately a two-fold improvement. In this paper, we study this enhancement mechanism by performing ultrafast transient absorption (TA) experiments on the active layer of the different cells. Our samples consisted of thin films of a mixture of PC61BM with the polythiophenes derivatives P1-P4. We prepared two versions of each sample, one including the molecule M1 and another without it. The TA data suggests that the efficiency improvement after addition of M1 is due not only to an extended absorption spectrum towards the infrared region causing a larger population of excitons but also to the possible creation of additional channels for transport of excitons and/or electrons to the PC61BM interface.
Assuntos
Aneurisma da Aorta Abdominal/epidemiologia , Aneurisma da Aorta Abdominal/cirurgia , Bases de Dados como Assunto/estatística & dados numéricos , Cooperação Internacional , Sistema de Registros/estatística & dados numéricos , Procedimentos Cirúrgicos Vasculares/estatística & dados numéricos , Viés , Interpretação Estatística de Dados , Europa (Continente)/epidemiologia , Humanos , Seleção de Pacientes , Avaliação de Programas e Projetos de Saúde , Reprodutibilidade dos Testes , Resultado do TratamentoRESUMO
Despite all the advances in nonlinear microscopy, all existing instruments are constrained to obtain images of one focal plane at a time. In this Letter we demonstrate a two-photon absorption fluorescence scanning microscope capable of imaging two focal planes simultaneously. This is accomplished by temporally demultiplexing the signal coming from two focal volumes at different sample depths. The scheme can be extended to three or more focal planes.
Assuntos
Microscopia Eletrônica de Varredura/instrumentação , Microscopia de Fluorescência/métodos , Óptica e Fotônica , Desenho de Equipamento , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Isoquinolinas/química , Isoquinolinas/farmacologia , Microscopia Eletrônica de Varredura/métodos , Microesferas , Fótons , Espectrofotometria , Fatores de TempoRESUMO
PURPOSE: To assess the usefulness of a program for the early detection of hemodialysis graft dysfunction and the impact on graft survival of percutaneous transluminal angioplasty (PTA) and stent implantation to correct venous stenosis. METHODS: A program for the early detection of hemodialysis access graft dysfunction was carried out in 110 patients over a period of 80 months. Detection was based on physical examination, flow rate measurements, venous pressure, and analytical determinations performed at dialysis. The stenoses detected were treated by PTA or PTA plus stent deployment. Survival curves compared primary and assisted patency rates for the different graft types. RESULTS: The most important indicators of dysfunction were increased venous pressure and difficulty in cannulation of the graft. Significant stenoses were revealed by 227 (92.2%) of the 246 fistulography procedures performed. PTA results were satisfactory in 100% of the Thomas grafts, 74% of the Brescia-Cimino (BC) grafts, and 53% of the polytetrafluoroethylene (PTFE) grafts. Technical success rates for stent deployment were 92% for BC grafts and 100% for PTFE grafts, while functional success rates were 96% and 97%, respectively. The difference in the primary patency (P1) and assisted patency (AP) values was statistically significant for all three graft types. There was no significant difference in the patency rates for grafts treated by PTA alone or by PTA and stent deployment. CONCLUSION: A surveillance program helped prevent graft thrombosis, and intervention as required achieved excellent primary and assisted patency rates. Stent deployment salvaged a considerable number of accesses but did not significantly extend access survival time.