Radial access for cardiac catheterization and intervention in India has been growing steadily ove... more Radial access for cardiac catheterization and intervention in India has been growing steadily over the last decade with favorable clinical outcomes. However, its usage by interventional cardiologists varies greatly among Indian operators and hospitals due to large geographic disparities in health care delivery systems and practice patterns. It also remains unclear whether the advantages, as well as limitations of transradial (TR) intervention (as reported in the western literature), are applicable to developing countries like India or not. An evidence-based review involving various facets of radial procedure for cardiac catheterization, including practical, patient-related and technical issues was conducted by an expert committee that formed a part of Advancing Complex CoronariES Sciences through TransRADIAL intervention (ACCESS RADIAL TM) Advisory Board. Emerging challenges in redefining TR management based on evidence supporting practices were discussed to formulate these final recommendations through consensus.
This paper identifies and investigates conceptual and empirical links among Russia's disappointin... more This paper identifies and investigates conceptual and empirical links among Russia's disappointing growth performance of the mid-1990s, its costly and eventually unsuccessful stabilization, the macroeconomic meltdown of 1998 and the spectacular rise of non-payments. Non-payments developed into a system that flourished in an atmosphere of fundamental inconsistency between a macroeconomic policy geared at sharp disinflation and a microeconomic policy of bailing-out enterprises through soft budget constraints. It embodies a large volume of untargeted, implicit subsidies in the order of 7-10 per cent of GDP, which has stifled growth, contributed to the 1998 meltdown through its impact on public debt and made at best a questionable contribution to equity. The overwhelming priority at this point is to dismantle this system, thereby promoting enterprise restructuring and growth (by hardening budget constraints) and medium-term macroeconomic stability (by reducing the size of the subsidies).
Russia's 1998 crisis and subsequent recovery offer valuable lessons for countries simultaneou... more Russia's 1998 crisis and subsequent recovery offer valuable lessons for countries simultaneously facing unsustainable public debt dynamics and low international liquidity---a list that in recent years has included Argentina, Brazil, and Turkey. Lessons include implications for the appropriate design of rescue packages, moral hazard, and crucial factors driving post-crisis recovery. This study presents an easily replicable framework that may make
The user has requested enhancement of the downloaded file. Abstracts A151 mated. Therefore prescr... more The user has requested enhancement of the downloaded file. Abstracts A151 mated. Therefore prescriptions causing interaction coming from one office should be prevented. But prescriptions from different offices cannot be avoided by the use of this isolated solution. Only a comprehensive e-health solution summoning up medication of a patient from different sources has the potential to improve patient safety. There are pharmacologic interactions with different clinical relevance. OBJECTIVES: The aim of this study was to conduct a meta-analysis to identify the potential differences of cardiovascular risk factors between men and women in primary prevention. METHODS: A systematic review was performed identifying prospective cohorts studies in which cardiovascular risk factors were analyzed (tobacco use, hypertension, diabetes, obesity and dyslipdemia) associated to the development of acute myocardial infarction, angina pectoris or cardiovascular death, and in which results were segmented between men and women. The search was done in October 2009 in Medline, EMBASE and the Cochrane Collaboration. Two independent reviewers identified the abstracts, selected full articles and extracted the data. Relative risk(RR) with 95% confidence intervals (95%CI) were calculated. Random effects models were employed in the meta-analyses using Meta-Analyst v.2.0 software. A meta-regression was also conducted. RESULTS: From 3,712 studies, 21 cohort studies were selected. The number of participants among the trials varied between 5,000 and 600,000 per study with a follow-up from 5 to 40 years. The meta-analyses showed that premenopausal women in comparison to men had a higher risk of having cardiovascular event when they have diabetes mellitus (RR 2.79 vs. 2.03), obesity (1.62 vs. 1.41), hypercholesterolemia (1.91 vs. 1.49), increase in LDL levels (2.08 vs. 1.72) or increase in HDL levels (2.22 vs. 1.61); however, men showed higher risk of cardiovascular events when they have hypertension (RR 1.771; 95%CI 1.714-1.830 vs. RR 1.812; 95%CI 1.759-2.305
... BRIAN PINTO, FARAH ZAHIR ... The implied value for (rg) itself can be obtained through approp... more ... BRIAN PINTO, FARAH ZAHIR ... The implied value for (rg) itself can be obtained through appropriate solution from the standard debt difference equation and this ... No, for the fol-lowing reasons: - Low interest rates stem from weakness in the global economy and capital inflows, not ...
This paper takes a hard look at the experience with official intervention in sovereign debt crise... more This paper takes a hard look at the experience with official intervention in sovereign debt crises, focusing on debt crises of the 1980s, Russia in 1998, Argentina in 2001, and Greece in 2010. Based on the track record, the authors argue that in situations where countries face a solvency problem, official intervention is more likely to succeed if official money
OBJECTIVES: To estimate the relative impact of drug-eluting stents(DES) versus bare-metal stents(... more OBJECTIVES: To estimate the relative impact of drug-eluting stents(DES) versus bare-metal stents(BMS) on death, myocardial infarction(MI), target vessel revascularization(TVR), and stent thrombosis(ST) in patients with ST-elevation acute myocardial infarction(STEMI) by performing comprehensive meta-analyses of randomized controlled trials(RCTs) and observational studies METHODS: We searched Ovid-Medline, EMBASE, the Cochrane Library, and conference proceedings for articles comparing outcomes between DES and BMS among STEMI patients presented through September 2009. The quality of studies was evaluated by using the Cochrane's risk of bias for RCTs and MINORS(Methodological Index for Non-Randomized Studies) for observational studies. The relative risk(RR) using the inverse variance random-effects method for each study outcome was calculated. RCT and observational data were analyzed separately. To assess heterogeneity of RRs across trials, we used the Cochrane-Q-statistic and I 2 -statistic. Subgroup-analyses were performed by length of follow-up and meta-regression was used to evaluate predictors of outcomes by stent-type. Funnel plots, the Egger-test, and the Begg-test were used to assess publication-bias. To assess the quality of the evidence, we used GRADEpro.RESULTS: Fifteen RCTs were identified(N = 7654, kappa-statistic = 0.90). Compared with BMS, DES significantly reduced TVR(RR:0.48; 95% confidence interval[CI]:0.41-0.56) and MI(RR:0.76; 95%CI:0.60-0.96), without increasing death(RR = 0.88; 95%CI:0.70-1.11) and ST(RR:0.93; 95%CI:0.72-1.21). Among 35 observational studies(N = 44,849), DES significantly reduced death(RR:0.85; 95%CI:0.79-0.91) and TVR(RR:0.61; 95%CI:0.48-0.77). MI and ST were significantly lower in the DES group within 1-year follow-up, but there were no differences within 2-years follow-up.
Radial access for cardiac catheterization and intervention in India has been growing steadily ove... more Radial access for cardiac catheterization and intervention in India has been growing steadily over the last decade with favorable clinical outcomes. However, its usage by interventional cardiologists varies greatly among Indian operators and hospitals due to large geographic disparities in health care delivery systems and practice patterns. It also remains unclear whether the advantages, as well as limitations of transradial (TR) intervention (as reported in the western literature), are applicable to developing countries like India or not. An evidence-based review involving various facets of radial procedure for cardiac catheterization, including practical, patient-related and technical issues was conducted by an expert committee that formed a part of Advancing Complex CoronariES Sciences through TransRADIAL intervention (ACCESS RADIAL TM) Advisory Board. Emerging challenges in redefining TR management based on evidence supporting practices were discussed to formulate these final recommendations through consensus.
This paper identifies and investigates conceptual and empirical links among Russia's disappointin... more This paper identifies and investigates conceptual and empirical links among Russia's disappointing growth performance of the mid-1990s, its costly and eventually unsuccessful stabilization, the macroeconomic meltdown of 1998 and the spectacular rise of non-payments. Non-payments developed into a system that flourished in an atmosphere of fundamental inconsistency between a macroeconomic policy geared at sharp disinflation and a microeconomic policy of bailing-out enterprises through soft budget constraints. It embodies a large volume of untargeted, implicit subsidies in the order of 7-10 per cent of GDP, which has stifled growth, contributed to the 1998 meltdown through its impact on public debt and made at best a questionable contribution to equity. The overwhelming priority at this point is to dismantle this system, thereby promoting enterprise restructuring and growth (by hardening budget constraints) and medium-term macroeconomic stability (by reducing the size of the subsidies).
Russia's 1998 crisis and subsequent recovery offer valuable lessons for countries simultaneou... more Russia's 1998 crisis and subsequent recovery offer valuable lessons for countries simultaneously facing unsustainable public debt dynamics and low international liquidity---a list that in recent years has included Argentina, Brazil, and Turkey. Lessons include implications for the appropriate design of rescue packages, moral hazard, and crucial factors driving post-crisis recovery. This study presents an easily replicable framework that may make
The user has requested enhancement of the downloaded file. Abstracts A151 mated. Therefore prescr... more The user has requested enhancement of the downloaded file. Abstracts A151 mated. Therefore prescriptions causing interaction coming from one office should be prevented. But prescriptions from different offices cannot be avoided by the use of this isolated solution. Only a comprehensive e-health solution summoning up medication of a patient from different sources has the potential to improve patient safety. There are pharmacologic interactions with different clinical relevance. OBJECTIVES: The aim of this study was to conduct a meta-analysis to identify the potential differences of cardiovascular risk factors between men and women in primary prevention. METHODS: A systematic review was performed identifying prospective cohorts studies in which cardiovascular risk factors were analyzed (tobacco use, hypertension, diabetes, obesity and dyslipdemia) associated to the development of acute myocardial infarction, angina pectoris or cardiovascular death, and in which results were segmented between men and women. The search was done in October 2009 in Medline, EMBASE and the Cochrane Collaboration. Two independent reviewers identified the abstracts, selected full articles and extracted the data. Relative risk(RR) with 95% confidence intervals (95%CI) were calculated. Random effects models were employed in the meta-analyses using Meta-Analyst v.2.0 software. A meta-regression was also conducted. RESULTS: From 3,712 studies, 21 cohort studies were selected. The number of participants among the trials varied between 5,000 and 600,000 per study with a follow-up from 5 to 40 years. The meta-analyses showed that premenopausal women in comparison to men had a higher risk of having cardiovascular event when they have diabetes mellitus (RR 2.79 vs. 2.03), obesity (1.62 vs. 1.41), hypercholesterolemia (1.91 vs. 1.49), increase in LDL levels (2.08 vs. 1.72) or increase in HDL levels (2.22 vs. 1.61); however, men showed higher risk of cardiovascular events when they have hypertension (RR 1.771; 95%CI 1.714-1.830 vs. RR 1.812; 95%CI 1.759-2.305
... BRIAN PINTO, FARAH ZAHIR ... The implied value for (rg) itself can be obtained through approp... more ... BRIAN PINTO, FARAH ZAHIR ... The implied value for (rg) itself can be obtained through appropriate solution from the standard debt difference equation and this ... No, for the fol-lowing reasons: - Low interest rates stem from weakness in the global economy and capital inflows, not ...
This paper takes a hard look at the experience with official intervention in sovereign debt crise... more This paper takes a hard look at the experience with official intervention in sovereign debt crises, focusing on debt crises of the 1980s, Russia in 1998, Argentina in 2001, and Greece in 2010. Based on the track record, the authors argue that in situations where countries face a solvency problem, official intervention is more likely to succeed if official money
OBJECTIVES: To estimate the relative impact of drug-eluting stents(DES) versus bare-metal stents(... more OBJECTIVES: To estimate the relative impact of drug-eluting stents(DES) versus bare-metal stents(BMS) on death, myocardial infarction(MI), target vessel revascularization(TVR), and stent thrombosis(ST) in patients with ST-elevation acute myocardial infarction(STEMI) by performing comprehensive meta-analyses of randomized controlled trials(RCTs) and observational studies METHODS: We searched Ovid-Medline, EMBASE, the Cochrane Library, and conference proceedings for articles comparing outcomes between DES and BMS among STEMI patients presented through September 2009. The quality of studies was evaluated by using the Cochrane's risk of bias for RCTs and MINORS(Methodological Index for Non-Randomized Studies) for observational studies. The relative risk(RR) using the inverse variance random-effects method for each study outcome was calculated. RCT and observational data were analyzed separately. To assess heterogeneity of RRs across trials, we used the Cochrane-Q-statistic and I 2 -statistic. Subgroup-analyses were performed by length of follow-up and meta-regression was used to evaluate predictors of outcomes by stent-type. Funnel plots, the Egger-test, and the Begg-test were used to assess publication-bias. To assess the quality of the evidence, we used GRADEpro.RESULTS: Fifteen RCTs were identified(N = 7654, kappa-statistic = 0.90). Compared with BMS, DES significantly reduced TVR(RR:0.48; 95% confidence interval[CI]:0.41-0.56) and MI(RR:0.76; 95%CI:0.60-0.96), without increasing death(RR = 0.88; 95%CI:0.70-1.11) and ST(RR:0.93; 95%CI:0.72-1.21). Among 35 observational studies(N = 44,849), DES significantly reduced death(RR:0.85; 95%CI:0.79-0.91) and TVR(RR:0.61; 95%CI:0.48-0.77). MI and ST were significantly lower in the DES group within 1-year follow-up, but there were no differences within 2-years follow-up.
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