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Search Results: 1 - 10 of 366 matches for " Altman "
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Acute coronary disease Athero-Inflammation: Therapeutic approach
Raul Altman
Thrombosis Journal , 2003, DOI: 10.1186/1477-9560-1-2
Abstract: Trials including large numbers of patients in prospective double-blind randomized studies worthwhile to confirm the efficacy of NSAID, mainly, COX-2 inhibitors, together with aspirin in the prevention of coronary events in patients with acute coronary disease.Antithrombotic therapy is currently the cornerstone of the treatment of acute coronary syndromes [1]. Findings indicate the importance of inflammation in atherothrombosis and support therapeutic use of anti-inflammatory treatment [2]. Thrombosis, as consequence of activation of platelets, thrombin generation through the coagulation cascade and inhibition of the fibrinolytic system, follows inflammation and end in an acute coronary syndrome (Figure). There is now evidence that blocking inflammation could lower thrombosis and thus acute coronary events.Combining aspirin and heparin is the antithrombotic treatment of choice in patients with unstable angina, but therapy starts when the clot is already constituted and the coronary lumen totally or partially occluded. Furthermore, thrombus formation results from several different pro-aggregating platelet stimuli and through more than one mechanism of thrombin generation. Aspirin acts by irreversible acetylation of cyclooxygenase-1 (COX-1), reducing the production of pro-aggregating thromboxane A2 in platelets and formation of the platelet aggregation inhibitor prostacyclin in the vascular wall. Acetylsalicylic acid is a relatively weak antiplatelet agent and the conjoint activities of two agonists can overcome the inhibitory effect of aspirin on platelet aggregation [3]. The main question is whether, for the prevention of cardiovascular events, other effects of aspirin could be as important or more important than its inhibition of platelet aggregation.There is considerable evidence for multi-factorial effects of aspirin. In animal models, aspirin significantly decreased levels of inflammatory factors (soluble intercellular molecule-1, monocyte chemoattractant protein
Risk factors in coronary atherosclerosis athero-inflammation: the meeting point
Raul Altman
Thrombosis Journal , 2003, DOI: 10.1186/1477-9560-1-4
Abstract: Arterial endothelium changes rapidly in response to specific stimuli. Elevated and modified LDL, cigarette smoking, hypertension, diabetes mellitus, genetic alterations, increase of plasma homocysteine, and infectious microorganisms such as herpes virus or Chlamydia pneumoniae, were considered by Ross as possible causes of endothelial dysfunction [1]. In atherosclerosis and other diseases, dysfunctional vascular endothelium leads to leukocyte recruitment. The initial phase of inflammation is usually silent and the atherosclerosis preclinical window is fairly long. In altered arterial endothelium there is increased monocyte adhesion as well as impaired nitric oxide production and vascular relaxation [5]. Adherence of monocytes to the endothelial surface is facilitated by the expression of the adhesion molecules vascular cell adhesion molecule-1 (V-CAM 1) and intercellular adhesion molecule-1 (ICAM-1).Endothelial function is a balance between vascular cell protectors and risk factors. Under physiological conditions, vascular endothelium has antithrombogenic potential. Activation of endothelia cells by proinflammatory cytokines or infectious agents is associated with a loss of antithrombotic properties. Endothelial dysfunction, injury and inflammation induce cell imbalance and a normal endothelium with anticoagulant properties becomes prothrombotic. Endothelial dysfunction is associated with a decrease of nitric oxide and an increase of oxidative stress, an important promotor of the inflammatory process [6,7] Risk factors, either acute (infection, immune local reaction) or permanent (hypertension, diabetes, dyslipemia, obesity, hyperhomocysteinemia, smoking, etc) induce endothelial dysfunction, cell injury, and a proinflammatory environment resulting in a local, tissue factor mediated activation of the clotting cascade [6,8,9]. In addition, it seems that expression of tissue factor in endothelial cells and monocytes is partly regulated by the proinflammatory cytokines
Antithrombotic prevention in vascular disease: bases for a new strategy in antithrombotic therapy
Raul Altman
Thrombosis Journal , 2007, DOI: 10.1186/1477-9560-5-11
Abstract: The hemostatic system is a physiological process to prevent hemorrhage and maintain a balance between clot formation and fluidity of blood in the circulation. After endothelial injury, platelets adhere to the exposed subendothelium and are activated by locally released agonists to stimulate thrombin formation [1], contributing to hemostatic control. Under other circumstances, such as in arterial disease, clots form upon atheroma rupture, primarily in connection with plaque conditions and in situ thrombin generation. After a clot starts to form, its growth depends on platelet recruitment and aggregation, concentration of thrombin at the surface of the clot, and changes in local blood flow. Thus, clot growth can be inhibited by blocking thrombus-bound thrombin activity and/or by inhibiting platelet function.Thrombin is the strongest platelet agonist, and inhibition of thrombin can also prevent platelet activation. In fact, any intervention singly directed at thrombin activity or platelet activation may simultaneously affect the other function [2].Aspirin (acetylsalicylic acid), and clopidogrel, are the mainstay antiplatelet therapies for arterial disease. Together with heparin, they constitute the first-line treatments for acute coronary disease. Clinical trials have established the benefit of aspirin for coronary prevention, and it is considered the gold standard for arterial antithrombotic therapy – despite its limitations with regard to preventing thrombosis.Coadministration of aspirin and clopidogrel enhances platelet inhibition, because these agents act through different platelet receptors; however, the benefit of combined antiplatelet treatment over aspirin alone in preventing thrombotic outcomes is debated [3-5].Therapies that include multiple drugs affecting primary hemostasis (antiplatelet drugs) or a combination of antiplatelets and anticoagulants, as in ischemic heart disease, are more aggressive than a single therapy. Combined antithrombotic treatment conf
Review of "Thrombosis in Clinical Practice"
Raul Altman
Thrombosis Journal , 2005, DOI: 10.1186/1477-9560-3-7
Abstract: Thrombosis is a fast moving area and is not easy to give updated information of its pathophysiology and treatment in about 300 pages as it was successfully done in this book.This multiauthored text combines basic concepts of mechanisms of thrombosis formation as well as therapeutic approaches.It provides short overviews on risk factors, therapeutics and a systematic discussion of arterial and venous thrombosis management with final recommendations according to the authors experience. It successfully delivers concise information on all aspects of a given type of thrombosis for physicians and nurses who care for patients with thrombosis related diseases.The first five chapters review the mechanism of thrombus formation (although importance of inflammation was omitted in Chapter 1), the role of the hemostatic system in arterial and venous thrombosis, characteristics of what the authors call "commonly used anticoagulant and antiplatelet drugs" (which include aspirin, heparin, and warfarin starting with an interesting historical perspective of each of them).Without doubt the risk of bleeding is the most critical aspect of patients under antithrombotic treatment; "why it happens and what to do" are questions answered in Chapter 4.Factors which determine thrombophilia are discussed in Chapter 5. Practical recommendations for screening patients with potential or already developed thrombotic process are noteworthy.The following Chapters 6 to 12 deal with treatment of arterial and venous thrombosis and include management of atrial fibrillation where the known, well established therapies are discussed. In cardiac valves, Chapter 7, a comprehensive indication for the used of oral anticoagulant with or without aspirin and the management of pregnant patients was explained. Since some not so recent data have been included in the beginning of this chapter authors missed to mention that in patients with cardiac valves prostheses, the first combined therapy (oral anticoagulant plus d
PLANT BIOTECHNOLOGY IN THE 21ST CENTURY: THE CHALLENGES AHEAD
Altman,Arie;
Electronic Journal of Biotechnology , 1999,
Abstract: in a world where population growth is outstripping food supply agricultural -and especially plant-biotechnology, needs to be swiftly implemented in all walks of life. achievements today in plant biotechnology have already surpassed all previous expectations, and the future is even more promising. the full realisation of the agricultural biotechnology revolution depends on both continued successful and innovative research and development activities and on a favourable regulatory climate and public acceptance. biotechnology should be fully integrated with classical physiology and breeding: (1) as an aid to classical breeding, (2) for generation of engineered organisms, (3) for integration of microorganisms into agricultural production systems. biotechnology is nowadays changing the agricultural and plant scene in three major areas: (1) growth and development control (vegetative, generative and reproduction/propagation), (2) protecting plants against the ever-increasing threats of abiotic and biotic stress, (3) expanding the horizons by producing specialty foods, biochemicals and pharmaceuticals.
CONTINUIDADES, CAMBIOS Y DESAFíOS democráticos en Chile (2006-2009)
Altman,David;
Colombia Internacional , 2006,
Abstract: during december of 2005 and january of 2006 chileans chose their new chief executive, michelle bachelet, and renewed congress for period 2006-2009. the elections transpired without disruptions and granted the governing coalition "concertación de partidos por la democracia" (cpd) its fourth uninterrupted mandate since transition to democracy in 1990. given that the constitutional reforms of 2005 eliminated the designated senators, this administration enjoys the most comfortable majority in congress since 1990. despite it is possible to see the chilean government immersed in a context of institutional stability and booming prices of chilean products at the international arena, this scenario couldparadoxically manifest itself in a situation of social stress that might seriously complicate the agenda of president bachelet and her coalition.
A conex?o americana: Mattoso Camara e o círculo lingüístico de Nova Iorque
Altman, Cristina;
DELTA: Documenta??o de Estudos em Lingüística Teórica e Aplicada , 2004, DOI: 10.1590/S0102-44502004000300010
Abstract: when mention is made of brazil in connection with american linguistics, it usually amounts to a reference to the linguistic circle of new york, where roman jakobson (1896-1982) and claude lévi-strauss (b. 1908) - who had recently come from brazil where he stayed from 1935 until 1939 - met and exchanged ideas. this singular event has cast a shadow on other contacts between brazil and american linguistics, among which the one between jakobson and the brazilian linguist joaquim mattoso camara (1904-1970) was much more consequential, at least in what concerns the implementation of structural linguistics in brazil and in south america during the 1950s and the 1960s. the impact of jakobson and of american linguistics on the work of mattoso camara and its subsequent influence on developments of brazilian linguistics are the focus of the article.
Plebiscitos, referendos e iniciativas populares en América Latina: ?mecanismos de control político o políticamente controlados?
Altman, David;
Perfiles latinoamericanos , 2010,
Abstract: this study examines the different ways in which citizens decide directly at the polls on topics of their concern. the direct appeal to the citizenry seems to be increasingly popular in the region and many authors do not see in it more than the use of institutional resources by the authorities to advance a particular political agenda. however, direct democracy is a much more heterogeneous phenomenon than these authors usually grant. in fact, the results of popular votes are generally much tighter than one might assume. surprisingly, the evidence shows that when used by government agents in latin america, the rate acceptance does not exceed 55%, even lower than the rate of approval when they are initiated by citizens (56%). this does not mean that, on occasions, authorities use them as exercises of popular mobilization or as tools seeking popular legitimization of the desires of political elites.
Redibujando el mapa electoral chileno: incidencia de factores socioeconómicos y género en las urnas
Altman,David;
Revista de ciencia política (Santiago) , 2004, DOI: 10.4067/S0718-090X2004000200003
Abstract: this article studies the change of cleavages in the post-authoritarian chile using electoral and socioeconomic evidence that goes beyond presidential elections and public opinion polls. this research allows us to determine that the socioeconomic conditions (measured through the index of human development) have the expected effects on the percentage of votes obtained by each of the two major coalitions of the country (the governing concertación, and the opposition alianza). in general terms, the concertación obtains better results in the communes with greater values of the index of human development and the alianza in communes with lower levels of human development. nonetheless, if we considered the curvilinear effects, the alianza perform better in communes with extreme values of idh and the concertación in the communes with average values. in other words, the concertación presents a distribution with a shape similar to an inversed u (n), and the alianza otherwise (u). with respect to the vote of women we can affirm that, although they still tend to favor parties of the alianza, women simultaneously tend to vote more to the women than to the men. therefore, we can observe gender solidarity at the polls.
La institucionalización de la ciencia política en Chile y América Latina: una mirada desde el sur
Altman,David;
Revista de ciencia política (Santiago) , 2005, DOI: 10.4067/S0718-090X2005000100001
Abstract: abstract this introduction does not try to be more than a first approach on the state-of-the-art of political science in the continent. it is argued that latin american political science must build university institutions that emphasize clear rules and defined criteria that stimulate meritocracy as their leit motif. for meritocracy to exist, criteria are necessarily to account for research and teaching productivity. evidently, the establishment of these criteria is fundamental at the time of the evaluations. currently, the continent shows enormous variations in the minimally necessary conditions for the institutionalization of the discipline. in some countries not even a degree in political science at undergraduate or graduated can be obtained. in others, less than five doctors in political science are currently working at the university realm. the urgent necessity of professionalization continues being an important subject to consider.
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