Interpretation of Ambulatory Blood Pressure Monitoring for Risk Stratification in Hypertensive Patients: The 'Ambulatory Does Prediction Valid (ADPV)' Approach.

Several outcome-based prospective investigations have provided solid data which support the prognostic value of 24 h ambulatory blood pressure over and beyond cardiovascular traditional risk factors. Average 24 h, daytime, and nighttime blood pressures are the principal components of the ambulatory blood pressure profile that have improved cardiovascular risk stratification beyond traditional risk factors. Furthermore, several additional ambulatory blood pressure measures have been investigated. The correct interpretation in clinical practice of ambulatory blood pressure monitoring needs a standardization of methods. Several algorithms for its clinical use have been proposed. Implementation of the results of ambulatory blood pressure monitoring in the management of individual subjects with the aim of improving risk stratification is challenging. We suggest that clinicians should focus attention on ambulatory blood pressure components which have been proven to act as the main independent predictors of outcome (average 24 h, daytime, and nighttime blood pressure, pulse pressure, dipping status, BP variability).

Uso de colgajo de pericráneo para tratamiento de fractura de seno frontal: caso clínico

Las fracturas del seno frontal se encuentran dentro de las lesiones más desafiantes en el trauma maxilofacial. Desafortunadamente, hay evidencia científica limitada acerca del tratamiento de estas fracturas. El mismo sigue siendo controvertido y, si el manejo no es el adecuado, se pueden presentar serias complicaciones. Se presenta un caso clínico de un paciente de 31 años, diagnosticado con fractura de seno frontal. El tratamiento, realizado por el Servicio de Cirugía Maxilofacial del Hospital Sirio Libanés, consistió en reducir la fractura, desfuncionalizar el seno, y obliterarlo con un colgajo de pericráneo. Se realiza una revisión de la literatura sobre diferentes tratamientos de fractura de seno frontal y los materiales existentes para realizar su obliteración, con sus ventajas y desventajas

Assessing factors that influence waste management financial sustainability.

This article examines the financial sustainability of waste management activities to understand whether and how choices oriented toward environmental protection and contextual factors influence waste management companies' revenues and costs, which, in turn, affect their financial sustainability and, thus, their ongoing viability. To achieve this purpose, a three-year empirical analysis on 880 Italian municipalities was conducted. Financial sustainability was evaluated with reference to waste management companies working in these territories, and a set of quantitative and qualitative data was considered to investigate possible influencing factors. The results show that separate waste collection may positively influence companies' financial performance, while municipalities' territorial extension negatively impacts profitability. Lastly, there is no evidence of a relationship between companies' financial sustainability and the potential presence of waste disposal plants or the geographical areas in which they operate. For the analyzed companies, thus, it seems that it would be more convenient to expand business by boosting separate waste collection activities than by enlarging the territories served. These findings can support firms' decisions regarding environmental and financial issues, both of which are crucial for long-term sustainability. It can also help policy makers detect appropriate tools to support companies in implementing European Union waste management targets.