1,359,051 research outputs found
Predictive values of D-dimer assay, GRACE scores and TIMI scores for adverse outcome in patients with non-ST-segment elevation myocardial infarction
No full textMuhammet Hulusi Satilmisoglu,1 Sinem Ozbay Ozyilmaz,1 Mehmet Gul,1 Hayriye Ak Yildirim,2 Osman Kayapinar,3 Kadir Gokturk,4 Huseyin Aksu,1 Korhan Erkanli,5 Abdurrahman Eksik1 1Department of Cardiology, 2Department of Biochemistry, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, 3Department of Cardiology, Duzce University Faculty of Medicine, Duzce, 4Department of Infectious Diseases, 5Department of Thoracic and Cardiovascular Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey Purpose: To determine the predictive values of D-dimer assay, Global Registry of Acute Coronary Events (GRACE) and Thrombolysis in Myocardial Infarction (TIMI) risk scores for adverse outcome in patients with non-ST-segment elevation myocardial infarction (NSTEMI).Patients and methods: A total of 234 patients (mean age: 57.2±11.7 years, 75.2% were males) hospitalized with NSTEMI were included. Data on D-dimer assay, GRACE and TIMI risk scores were recorded. Logistic regression analysis was conducted to determine the risk factors predicting increased mortality.Results: Median D-dimer levels were 349.5 (48.0–7,210.0) ng/mL, the average TIMI score was 3.2±1.2 and the GRACE score was 90.4±27.6 with high GRACE scores (>118) in 17.5% of patients. The GRACE score was correlated positively with both the D-dimer assay (r=0.215, P=0.01) and TIMI scores (r=0.504, P=0.000). Multivariate logistic regression analysis revealed that higher creatinine levels (odds ratio =18.465, 95% confidence interval: 1.059–322.084, P=0.046) constituted the only significant predictor of increased mortality risk with no predictive values for age, D-dimer assay, ejection fraction, glucose, hemoglobin A1c, sodium, albumin or total cholesterol levels for mortality.Conclusion: Serum creatinine levels constituted the sole independent determinant of mortality risk, with no significant values for D-dimer assay, GRACE or TIMI scores for predicting the risk of mortality in NSTEMI patients. Keywords: acute coronary syndrome, non-ST-segment elevation myocardial infarction, GRACE score, D-dimer assay, TIMI scor
Heterosentis martini Lanfranchi & Timi 2011
No full textHeterosentis martini Lanfranchi & Timi, 2011 Actinopterygii Pinguipes brasilianus Cuvier (Perciformes, Pinguipedidae). SI: rectum. SD: adult. L: Buenos Aires Province: Villa Gesell (37º15’S, 57º23’W). R: Timi et al. (2009, 2010), Lanfranchi and Timi (2011) (see note below). Pseudopercis semifasciata (Cuvier) (Perciformes, Pinguipedidae) (type host). SI: rectum. SD: adult. L: Buenos Aires Province: Miramar and Necochea (38º03’– 38º44’S, 57º30’– 58º44’W); Chubut Province: Valdés Peninsula (42º00’– 42º45’S). R: Timi and Lanfranchi (2009b), Lanfranchi and Timi (2011), Lunaschi et al. (2012). C: holotype (MLP-He 6255), allotype (MLP-He 6256) and paratypes (MLP-He 62571; NMNH- USNM 1398457; USNPC 103473). Note. This species was reported as Heterosentis sp. by Timi and Lanfranchi (2009b) and Timi et al. (2009, 2010). Genus HypoechinorhynchusPublished as part of Hernández-Orts, Jesús S., Kuchta, Roman, Semenas, Liliana, Crespo, Enrique A., González, Raúl A. & Aznar, Francisco J., 2019, An annotated list of the Acanthocephala from Argentina, pp. 1-64 in Zootaxa 4663 (1) on page 15, DOI: 10.11646/zootaxa.4663.1.1, http://zenodo.org/record/377237
Validity of TIMI Risk Score and HEART Score for Risk Assessment of Patients with Unstable Angina/Non-ST Elevation Myocardial Infarction Presented to an Emergency Department in Jordan
No full textMuhannad J Ababneh,1 Mahmoud Mustafa Smadi,2 Abdullah Al-Kasasbeh,1 Qutaiba Ali Jawarneh,3 Mohammad Nofal,3 Mohanad El-Bashir,4 Mohamad Ismail Jarrah,1 Liqaa A Raffee5 1Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Mathematics and Statistics, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 4Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan; 5Department of Accident and Emergency Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, JordanCorrespondence: Muhannad J Ababneh, Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan, Tel +962799964654, Fax +962 2 7095010, Email [email protected]: To examine the validity and predictability of thrombolysis in myocardial infarction (TIMI) risk and HEART scores in patients presenting to the emergency department (ED) with chest pain in Jordan (representative of the Middle East and North Africa Region, MENA).Patients and Methods: Risk scores were calculated for 237 patients presenting to the ED with chest pain. Patients were followed-up prospectively for the need for percutaneous coronary intervention, major adverse cardiovascular events, and all-cause mortality, looking for correlation and accuracy between the predicted cardiovascular risk from TIMI risk score and HEART score and the clinical outcome.Results: Of the 237 patients, approximately 77% were diagnosed with unstable angina and 23% diagnosed with non-ST elevation myocardial infarction (NSTEMI). about two thirds of the study population were smokers and known to have hypertension and dyslipidaemia. In 50 patients, the primary outcome (need for percutaneous coronary intervention (PCI) and/or major adverse cardiovascular events (MACE) at days 14 and 40, all-cause mortality) was observed. Regarding the predictability of the TIMI score, a larger number of events were observed in the study population than predicted. Patients with TIMI scores of 3 to 5 have about a 5– 8% higher event rate than predicted.Conclusion: Both TIMI and HEART risk scores were able to predict an elevated risk of major cardiovascular adverse events (MACE). The overall impression was that the TIMI risk score tended to underestimate risk in the study population.Keywords: acute coronary syndrome, risk stratification, cardiovascular diseases, emergency departmen
An Econometric model for the evolution of the Romanian Interbank Bid Rate (ROBID) in the context of the international financial crisis
No full textThe paper presents the econometric modeling of overnight inter-banking interest rates (ROBID) in our country, the analyzed period is between 1999-2010. The international financial crises had a great impact on the level of inter-banking interest rates after 2007 and it reflects the new level of risk for the Romanian system banking. The econometric model used in modeling the interest rates is an autoregressive moving average (ARMA) model, the ARMA model is typically applied to time series data; the paper propose several ARMA models, applies econometric tests and based on them the analyzed series (the inter-banking interest rates) forecast will be made.ROBID, ARIMA model, financial crisis, forecast.
A prospective investigation of the prognostic value of "TIMI" and "Front Door TIMI" in Chinese patients presenting to the emergency department with undifferentiated chest pain [Abstract]
No full textStudy Objective: Chest pain is a common complaint among emergency department (ED) patients. The Thrombolysis in Myocardial Infarction risk score (TIMI-RS) and front door Thrombolysis in Myocardial Infarction risk score (FDTIMI-RS) have been proven to be useful to risk stratify chest pain patients in many Western countries, but it has not been validated in Asian countries. We hypothesised that the TIMI-RS would be a valid tool in the Hong Kong Chinese population. The aim of this study was to establish the relationship between TIMI-RS and FDTIMI-RS and the 30-day rate of major adverse cardiac outcomes (MACE) of patients with chest pain. Methods Design: Single center prospective observational cohort study. Participants: Consecutive ED patients presenting with chest pain were enrolled from July 2009 until March 2010. Data collection: patient characteristics, TIMI-RS items and past medical and medication history. Primary outcome: MACE within 30 days of ED presentation. MACE is defined as a composite outcome which is fulfilled if any of the following occurs: death (all causes), readmission with myocardial infarction (MI), acute coronary syndrome not diagnosed at initial ED presentation, and percutaneous coronary intervention. Results: 1000 patients were recruited and 30-day follow-up was completed on all patients. Patients had a mean age of 66.7±14 years and 54% were male. 169 (17%) patients had a MACE within 30 days of ED presentation. The incidence of MACE in each TIMI-RS group is as follows: TIMI-RS 0, 1/145, (0.7%); TIMI-RS 1, 21/249 (8.4%); TIMI-RS 2, 44/239, (18.4%); TIMI-RS 3, 40/179, (22.3%); TIMI-RS 4, 42/122, (34.4%), TIMI-RS 5, 14/52, (26.9%), TIMI-RS 6/7, 7/14, (50%). There was an excellent correlation between TIMI-RS and MACE (ρ=0.964, p <0.001). Increasing FDTIMI-RS was also associated with increased risk of MACE within 30 days (ρ= 1, p=0.01). Conclusion: The TIMI-RS and FDTIMI-RS may be useful tools for risk stratification of ED patients with undifferentiated chest pain. However, patients in the low risk group still had a risk of having MACE (0.7% for TIMI-RS=0 and 1.3% for FDTIMI-RS=0). Therefore, while the scores can guide patient disposition from the ED, they cannot fully replace clinical judgement
Steps in the development of the Romanian financial system and the corellation with the level of economical growth
No full textAlong the history it has been asserted that among the determinant agents of the economical growth can be also cited the conservation and the endowment with physical, technological and human capital. This thing involves the realization of certain investigations in the infrastructure, development, and innovation, as well as in the education and the formation, that can raise the existent level of these resources in every country and to lead to a growth in the productivity, and in the competition of that country materialized through a higher GDP of a capital. But there is an extremely important factor like the way of financing, the degree of development of the financial system of the economy that leads to economical growth. On a microeconomic level, in what concerns the economical agents, financing is the most important for the development. All in all, no matter how good the product or how efficient the commercialization channels or the correlation level between technology and the human factor may be, if the business does not have an efficient financing politics, regarding the liquidity as well as the solvency and the profitableness, it will crash minimizing the other successfully realized aspects. Except the fact that it offers an efficient allocation and a reduced cost of the financial services, a well developed financial compartment identifies the potential investors, monitors and gives information regarding the behavior of the beneficiaries of the chartered capital. The financial system unifies the capital demand and the offer through banks, capital markets, and other financial mediates like mutual funds or pension funds. An efficient financial system mobilizes the collected saving by the unities that, after they satisfy their own objectives of investment and consumption, have a financing capacity for channeling it towards those units that, for realizing their investing objectives, need financing, offer an efficient payment and clearing system, in this way facilitating the financial transactions. An efficient system is the one that realizes an optimum getting in and allocation of the resources, that it has realized in a satisfying manner the remuneration conditions, assurance, and liquidity of the equivalent deposits or the instruments of collecting the resources, and on the other hand, the cost conditions and financing term for the allocated resources. Until short time ago, it was believed that the financial system develops after the contracting sector, channeling towards investments, at the request of the undertaker, the over pluses obtained as a consequence of the economies of the population. Following what Schumpeter first expressed in 1912, recent theories showed that an efficient financial system is a stimulus for the technological innovation identifying and financing the undertakers capable to successfully innovate the product and the production process. One of those who have opted for this kind of thought is Ross Levine who assures the fact that “a theoretical as well as an empirical constant work volume tends to make even the most skeptical to believe that the development of the financial system is a determinant of the economical growth, and not only a passive answer to this growth.” Levine and the others that share his opinion believe that there are inherent relations between financial intermediate and productivity and , as the amelioration of the productivity level produces on a long term benefic effects on the level of economic development, it can be said that also the financial intermediate generates economical growth. Moreover, Levine suggests that the development of the financial system has an important positive effect over the economical growth saying that “it can be eliminated a third of the already existent inequality between the countries with an important growth and those with a slow growth through the development of the financial intermediation for the latter ones until they reach a developing level comparable with the one of the countries with a quick development”. The positive association between the degree of development of the financial system and economical growth was at large analyzed also by Demirguc-Kunt (2006), Levine and King (1993), and Levine and Beck (2004). They get to the conclusion that this correlation stays significant even when other factors of influence are taken into consideration. Moreover, they prove that regarding a country with a developing financial system, the degree of financial development is correlated not only with the current growth, but also with the future economical growth. In order to do a thorough analysis of the way in which the Romanian financial system evolved, being correlated with the economical growth of the financing structure of the Romanian economy between 1990 and 2006, we leveled this analysis depending on the mutations that took place during the time in the Romanian economical and financial landscape. We have taken one by one the mutations that took place during this period regarding the Romanian banking system and capital market, as main financial agents, then the macro economical politics and their impact on the development of the financial system, and, least but not last, recent evolutions experienced by the Romanian financial system and regional level (Central and Eastern Europe) and European Union comparisons.Romanian financial system, capital market, development
Preprocedural TIMI flow and infarct size in STEMI undergoing primary angioplasty.
No full textDespite optimal epicardial recanalization, primary angioplasty for STEMI is still associated with suboptimal reperfusion in a relatively large proportion of patients. The aim the current study was to evaluate the impact of preprocedural TIMI flow on myocardial scintigraphic infarct size among STEMI undergoing primary angioplasty. Our population is represented by 793 STEMI patients undergoing primary PCI. Infarct size was evaluated at 30 days by technetium-99m-sestamibi. Poor preprocedural TIMI flow (TIMI 0-1) was observed in 645 patients (81.3%). Poor preprocedural TIMI flow was associated with more hypercholesterolemia (p = 0.012), and a trend in lower prevalence of diabetes (p = 0.081). Preprocedural TIMI flow significantly affected scintigraphic and enzymatic infarct size. Similar findings were observed in the analysis restricted to patients with postprocedural TIMI 3 flow. The impact of preprocedural TIMI flow on scintigraphic infarct size was confirmed when the analysis was performed according to the percentage of patients above the median (p < 0.001) and after adjustment for baseline confounding factors (Hypercholesterolemia and diabetes) [adjusted OR (95% CI) for pre preprocedural TIMI 3 flow = 0.59 (0.46-0.75), p < 0.001]. This study shows that among patients with STEMI undergoing primary angioplasty, poor preprocedural TIMI flow is independently associated with larger infarct size
The ratio of circulating endothelin-1 to endothelin-3 associated with TIMI risk and dynamic TIMI risk score in ST elevation acute myocardial infarction
No full textIn ST segment elevation acute myocardial infarction (STEMI), the endothelin (ET) system imbalance, reflected by the circulating ET-1:ET-3 ratio has not been investigated. This study’s primary objective was to measure the circulating ET-1:ET-3 ratio and correlate it with the risk stratification for 1 year mortality of STEMI based on TIMI score. On admission, the TIMI risk score and at discharge, the dynamic TIMI risk score were calculated in 68 consecutive subjects with STEMI. Subjects with high TIMI risk score were associated with higher mean ET-1 level and ET-1:ET-3 ratio. The ET-1:ET-3 ratio more accurately predicted the high on admission TIMI risk score than the ET-1 level. Subjects with high dynamic TIMI risk score were associated with higher mean ET-1 level and ET-1:ET-3 ratio. The ET-1:ET-3 ratio more accurately predicted the high at discharge dynamic TIMI risk score than ET-1 level. From multivariable analysis, the ET-1:ET-3 ratio was not independently associated with high on admission TIMI risk score but independently predicted high at discharge dynamic TIMI risk score (odds ratio = 9.186, p = 0.018). In conclusion, combining the ET-1 and ET-3 levels into the ET-1:ET-3 ratio provided a prognostic value by independently predicting the increased risk to 1 year mortality as indicated by at discharge dynamic TIMI risk score in patients with STEMI.The presentation of the authors' names and (or) special characters in the title of the pdf file of the accepted manuscript may differ slightly from what is displayed on the item page. The information in the pdf file of the accepted manuscript reflects the original submission by the author
IMPACT OF FINANCIAL CRISIS UPON THE ROMANIAN CAPITAL MARKET AND PROPOSED MEASURES FOR ITS RELAUNCHING
No full textHaving in consideration that the entire world has changed itself in a globalized economy, characterized by a more and more integrated and connected financial system, it becomes pretty difficult that a financial crisis from a certain economy not to be sprecapital market, financial crisis, financing alternatives
Histogram of TIMI and ChatGPT-4 scores.
No full textBoth the TIMI and ChatGPT-4 scores demonstrated a normal distribution. However, the distribution of ChatGPT-4 scores was broader than that of the TIMI scores.</p
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