6,913 research outputs found
Center-related determinants of VKA anticoagulation quality: A prospective, multicenter evaluation
No full textBackground: Center-specific TTR (c-TTR) is a measure reporting the mean patient TTR within an anticoagulation clinic describing the quality of anticoagulant monitoring offered by that clinic. c-TTR has a considerable between-center variation, but its determinants are poorly understood. Objectives: We aimed at evaluating which clinical, procedural or laboratory factors could be associated with c-TTR variability in a multicenter, observational cross-sectional study over a five-year period. Patients/Methods: Data from 832,204 individual patients followed for VKA therapy in 292 Centers affiliated with the Italian Federation of Anticoagulation Clinics (FCSA) were analyzed. c-TTR was computed based on the TTR of patients followed at each Center, and a mixed linear regression model was used for a predefined set of explanatory variables. Results: The Center next-visit interval ratio (the mean number of days after a visit with an INR outside the therapeutic range, divided by the days after a visit with an INR within the therapeutic range), the Center mean patient INR and the Center laboratory performance at EQA proficiency testing were the only variables that were independently associated with c-TTR (β- coefficients -17.32, 9.67, and -0.11, respectively; r2 = 0.635). Conclusions: These findings suggest that c-TTR associates with proactive strategies aimed at keeping patients very close to their target INR with a prompt re-evaluation of those patients with under- or over-therapeutic INR
[Poesia] Três poemas de Alberto Secama
No full textThree poems by Alberto Secama. About the author: Alberto Secama is an Angolan poet who has poems published on many websites and on facebook:https://www.facebook.com/Xungurra/abouthttp://www.pordentrodaafrica.com/cultura/africa-em-verso-rio-kwanza-por-alberto-secamahttp://www.pordentrodaafrica.com/cultura/africa-em-verso-zong-por-alberto-secamahttp://www.pordentrodaafrica.com/cultura/coluna-africa-em-verso-o-sol-la-fora-por-alberto-secamaTres poemas de Alberto Secama. Sobre el autor: Alberto Secama es un poeta angoleño que tiene poemas publicados en varios sitios y en el facebook:https://www.facebook.com/Xungurra/abouthttp://www.pordentrodaafrica.com/cultura/africa-em-verso-rio-kwanza-por-alberto-secamahttp://www.pordentrodaafrica.com/cultura/africa-em-verso-zong-por-alberto-secamahttp://www.pordentrodaafrica.com/cultura/coluna-africa-em-verso-o-sol-la-fora-por-alberto-secamaTrês poemas de Alberto Secama. Sobre o autor: Alberto Secama é um poeta angolano que possui poemas publicados em vários sites e no facebook:https://www.facebook.com/Xungurra/abouthttp://www.pordentrodaafrica.com/cultura/africa-em-verso-rio-kwanza-por-alberto-secamahttp://www.pordentrodaafrica.com/cultura/africa-em-verso-zong-por-alberto-secamahttp://www.pordentrodaafrica.com/cultura/coluna-africa-em-verso-o-sol-la-fora-por-alberto-secam
Orizzonti mantovani. Spunti e dinamiche paesaggistiche ne L'Illustrissimo di Alberto Cantoni
No full textIn the literary production of Alberto Cantoni, short story writer and novelist between the nineteenth and twentieth centuries, the novel L'Illustrissimo is highly important both because it is the last publication of the author, from Pomponesco, a small town a few kilometers south of Mantua, both because it summarizes in a single text the different nuances and different directions that his writing has taken over the course of his literary career, also due to a writing and processing time that embraces the entire span of years of his career itself. In the foreground, in addition to the numerous and brilliant characters, one of the protagonists is the Mantuan landscape which, not a simple background, becomes a true literary parameter which in different and significant ways affects the purposes and mechanisms of the novel
Plenary Session: Luis Alberto Urrea
No full texta) Plenary Session: Luis Alberto Urrea, Mexican American Chicago Writer
Luis Alberto Urrea is a 2005 Pulitzer Prize finalist for non-fiction and member of the Latino Literature Hall of Fame. He is a prolific and acclaimed writer who has used his dual-culture life border experiences to explore the complex and interconnected Mexican-US American reality. The critically acclaimed and best-selling Mexican-born author of 13 books, Urrea has won numerous awards for his poetry, fiction and essays.
Moderator: Dr. Héctor García, Loyola University Chicag
O duplo significado do sentir e do pensar nas obras de Alberto Caeiro e Descartes
No full textDissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Comunicação e Expressão. Programa de Pós-Graduação em LiteraturaA pretensão desta dissertação intitulada O duplo significado do sentir e do pensar nas obras de Alberto Caeiro e Descartes é investigar a relação entre o sentir e o puro pensar, usando como referência a poesia O Guardador de Rebanhos, de Alberto Caeiro, que apresenta de forma evidente o tema; e como este assunto é tratado nas Meditações Metafísicas de René Descartes, também de forma claramente visível. Podemos perceber em ambos os autores, uma diplopia, uma espécie de duplo olhar sobre a relação sentir e puro pensar. No primeiro capítulo vou falar sobre a tese do duplo olhar de Descartes, a respeito da relação sentir e puro pensar na leitura de Merleau-Ponty, salientando a visão de natureza. No segundo capítulo, parto da leitura das três primeiras Meditações Metafísicas para caracterizar a tensão que se pode verificar entre Descartes e Alberto Caeiro quando se referem ao puro pensar. O foco principal de Descartes, nas três primeiras Meditações, é o pensar puro, e neste ponto Alberto Caeiro critica o pensar puro. No terceiro capítulo, analisando as três últimas Meditações, percebe-se que há uma virada no pensamento de Descartes, no qual o autor inverte seu ponto de vista, aproximando-se da idéia de Alberto Caeiro. No quarto capítulo, mostrarei a leitura que outros autores fazem acerca do sentir e do pensar na obra de Alberto Caeiro, mostrando que assim como Descartes, este também ostenta uma diplopia, não do sentir, mas do pensar. The pretension of this work entitled O duplo significado do sentir e do pensar nas obras de Alberto Caeiro e Descartes is to investigate the relationship between the feeling and the pure thinking, using as reference the poetry O Guardador de Rebanhos, by Alberto Caeiro, that presents in an evident way this theme; and as this subject is treated in René Descartes' Metaphysical Meditations, also in a clearly visible way. It is possible to notice in both authors, the diplopy, a sort of double look about the relationship between feeling and pure thinking. The thesis about Descartes'double look regarding the relation of feeling and pure thinking, in Merleau-Ponty reading, pointing out the nature vision, will be treated in the first chapter. In the second chapter, I start from the reading of the first three Metaphysical Meditations to characterize the tension that can be verified between Descartes and Alberto Caeiro when they refer to the pure thinking. Descartes' main focus in the first three Meditations is pure thinking and, in this point, Alberto Caeiro criticizes pure thinking. In the third chapter, analyzing the last three Meditations, it is possible to notice that there is an alteration in Descartes' thought, in which the author inverts his point of view, approaching of Alberto Caeiro's idea. In the fourth chapter, I will show the reading that other authors do concerning feeling and thinking in Alberto Caeiro's work, showing that as well as Descartes, this also shows a diplopy, not of feeling, but of thinking
Lobbying for change as a new theory and practice of active citizenship: author interview with Alberto Alemanno
No full textDo you believe that lobbying is a vehicle for representing the interests of some rather than all, meaning its actors can never be a force for good? Alberto Alemanno, author of Lobbying for Change: Find Your Voice to Create a Better Society, might convince you of the contrary. This interview with Barbara Aubin, LSE Public Affairs, reflects on the importance of engaging with our political representatives, holding them accountable and lobbying for the causes we deeply care about as fundamental elements of a healthy democracy
Bleeding tendency and efficacy of anti-haemorrhagic treatments in patients with type 1 von Willebrand disease and increased von Willebrand factor clearance
No full textAccelerated clearance of von Willebrand factor (VWF) has been recently identified as a major pathophysiologic mechanism inducing low VWF in some patients with von Willebrand disease (VWD). The frequency of bleeding and the best treatment of these patients have never been evaluated prospectively in large series of patients. It was the aim of the present study to prospectively evaluate clinical events of 60 heterozygous patients with VWD Vicenza (VWD-VI) carrying R1205H VWF mutation and 23 with C1130F mutation, both characterised by markedly increased VWF clearance. During 71 months of follow-up, 65% of patients with VWD-VI and 61% with C1130F required treatment. The rate of spontaneous bleeding requiring consultation/treatment was 7.5/100 patients-year in patients with C1130F mutation vs. 1.9/100 patients-year in those with R1205H (p=0.004). This difference persisted also by multivariate analysis adjusted for sex, age and blood group (hazard ratio [HR]=3.3 for C1130F, 95% con fidence interval [CI] 1.16-9.27) and females were at greater risk of bleeding (HR=3, 95%CI 1.01-9.93) because of menorrhagia. Only 3/15 (20 %) women in fertile age with VWD-VI compared to 8/9 (89 %) with C1130F mutation required consultation/treatment for menorrhagia (iron supplementation, combined oral contraceptives, tranexamic acid). Almost all dental extractions, minor surgeries and deliveries occurring during followup were successfully managed with desmopressin. Major surgery required factor VIII/VWF concentrates, but a few cases benefited from desmopressin. In conclusion, similar to patients with type 1 VWD, also in patients with increased VWF clearance desmopressin maintains a major therapeutic role
Un-mutated IgVH in chronic lymphocytic leukemia is associated with a higher risk of immune thrombocytopenia
No full textUn-mutated IgVH in chronic lymphocytic leukemia is associated with a higher risk of immune thrombocytopenia
Il laboratorio nella terapia anticoagulante orale
No full textThe oral anticoagulant therapy is used in the prevention and treatment of venous and arterial thromboembolism in many different clinical settings. For this purpose, vitamin K antagonists (VKA), which indirectly reduce the activity of factors II, VII, IX and X preventing the vitamin K-mediated carboxylation of specific glutamic acid residues, and direct oral anticoagulants (DOAC), providing direct inhibition of thrombin (factor IIa) or factor Xa, are available. The VKA monitoring represents a daily challenge for clinical laboratories, due to the increasing number of patients, frequency of needed controls and the management complexity. Several solutions have been proposed to improve the management of patients treated by VKA, such as surveillance in dedicated clinics and use of portable monitors to allow patient self-testing and self-management. Although DOAC have been declared not requiring a standard laboratory monitoring, laboratory testing for measuring drug anticoagulant activity is however needed in many situations, such as in case of bleeding or thromboembolic complications, surgery or invasive procedures, suspected overdose and drug interactions, noncompliance or presence of renal or liver disease
Il laboratorio nella terapia anticoagulante orale
No full textThe oral anticoagulant therapy is used in the prevention and treatment of venous and arterial thromboembolism in many different clinical settings. For this purpose, vitamin K antagonists (VKA), which indirectly reduce the activity of factors II, VII, IX and X preventing the vitamin K-mediated carboxylation of specific glutamic acid residues, and direct oral anticoagulants (DOAC), providing direct inhibition of thrombin (factor IIa) or factor Xa, are available. The VKA monitoring represents a daily challenge for clinical laboratories, due to the increasing number of patients, frequency of needed controls and the management complexity. Several solutions have been proposed to improve the management of patients treated by VKA, such as surveillance in dedicated clinics and use of portable monitors to allow patient self-testing and self-management. Although DOAC have been declared not requiring a standard laboratory monitoring, laboratory testing for measuring drug anticoagulant activity is however needed in many situations, such as in case of bleeding or thromboembolic complications, surgery or invasive procedures, suspected overdose and drug interactions, noncompliance or presence of renal or liver disease
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