Persistent Drop Research Articles

Does Sustainability Engagement Affect Stock Return Volatility? Evidence from the Chinese Financial Market

This paper examines the impact of firms’ sustainability engagement on their stock returns and volatility by employing the EGARCH and FIGARCH models using data from the major financial firms listed in the Chinese stock market. We find evidence of a positive association between sustainability engagement and stock returns, suggesting firms’ sustainability news release in favour of the market. Although volatility persistence can largely be explained by news flows, the results show that sustainability news release has the significant and largest drop in volatility persistence, followed by popularity in Google search engine and the general news. Sustainability news release is found to affect positively stock return volatility. We also find evidence that market expectation can be driven by the dominant social paradigm when sustainability is included. These findings have important implications for market efficiency and effective portfolio management decisions.

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OBJECTIVES/SPECIFIC AIMS: Aim 1: To compare microbiome diversity among patients who develop BSI post hematopoietic stem cell transplantation (HSCT) and patients without BSI. Aim 2: To compare microbiome diversity among patients who develop moderate to severe acute GVHD post HSCT and patients without GVHD. Aim 3: To describe alterations in specific bacterial orders (Enterobacteriaceae, Clostridia, and Lactobacillales) in pediatric patients undergoing HSCT. METHODS/STUDY POPULATION: Next-generation sequencing of the hypervariable V3 region of the 16s rRNA gene isolated from stool specimens collected at baseline (start of preparative regimen to transplant day), early (day 7–14 post HSCT), and late (day 21–28 post HSCT) from 46 children was performed. Microbiome diversity was assessed by the Shannon index as well as UniFrac analysis, and compared among patients with and without GVHD/BSI. Baseline bacterial diversity was compared among patients by primary diagnosis, race, timing of antibiotic introduction and method of supplemental nutrition. RESULTS/ANTICIPATED RESULTS: Median age was 9 years (range 0.5–19.2 years). There were 36 patients with hematologic malignancies. Patients with nonmalignant disease had a characteristic pattern of microbiome diversity (and microbiota order distribution) at baseline that persisted throughout the first month of transplant (p=0.004). Over all patients, there was an early and persistent drop in microbiome diversity throughout the transplant course. Early introduction of broad spectrum antibiotics (prior to transplant day) negatively impacted microbiome diversity (p=0.02). There was no difference in microbiome diversity among patients who developed BSI, when compared with patients without BSI. Similarly, we did not find an association between microbiome diversity and the development of moderate to severe acute GVHD. Ongoing analysis is examining the individual variations in microbiome at the species level, and their relation to transplant characteristics and clinical outcomes. DISCUSSION/SIGNIFICANCE OF IMPACT: In our analysis, microbiome diversity decreased during HSCT, but in contrast to published data, mainly in adult HSCT populations, we found no association between gut microbiome diversity and GVHD or BSI. There are ongoing clinical trials in children and adults using probiotics in HSCT with the aim of decreasing GVHD. Further analysis of our data at the species level may further inform the relationship between gut microbiome alterations and HSCT complications in children and guide clinical interventions.

Glutamine metabolism regulates autophagy-dependent mTORC1 reactivation during amino acid starvation

Activation of autophagy and elevation of glutamine synthesis represent key adaptations to maintain amino acid balance during starvation. In this study, we investigate the role of autophagy and glutamine on the regulation of mTORC1, a critical kinase that regulates cell growth and proliferation. We report that supplementation of glutamine alone is sufficient to restore mTORC1 activity during prolonged amino acid starvation. Inhibition of autophagy abolishes the restorative effect of glutamine, suggesting that reactivation of mTORC1 is autophagy-dependent. Inhibition of glutaminolysis or transamination impairs glutamine-mediated mTORC1 reactivation, suggesting glutamine reactivates mTORC1 specifically through its conversion to glutamate and restoration of non-essential amino acid pool. Despite a persistent drop in essential amino acid pool during amino acid starvation, crosstalk between glutamine and autophagy is sufficient to restore insulin sensitivity of mTORC1. Thus, glutamine metabolism and autophagy constitute a specific metabolic program which restores mTORC1 activity during amino acid starvation.

Moderate sedation in cardiac electrophysiology laboratory: a retrospective safety analysis

ObjectiveCardiac electrophysiology (EP) procedures can be performed under moderate sedation without the direct involvement of an anaesthetist. However, concerns have been raised over the safety of this approach. This study...

Sovereign Risk and Bank Risk-Taking

I propose a dynamic general equilibrium model in which strategic interactions between banks and depositors may lead to endogenous bank fragility and slow recovery from crises. When banks' investment decisions are not contractible, depositors form expectations about bank risk-taking and demand a return on deposits according to their risk. This creates strategic complementarities and possibly multiple equilibria: in response to an increase in funding costs, banks may optimally choose to pursue risky portfolios that undermine their solvency prospects. In a bad equilibrium, high funding costs hinder the accumulation of bank net worth, leading to a persistent drop in investment and output. I bring the model to bear on the European sovereign debt crisis, in the course of which under-capitalized banks in defaultrisky countries experienced an increase in funding costs and raised their holdings of domestic government debt. The model is quantified using Portuguese data and accounts for macroeconomic dynamics in Portugal in 2010-2016. Policy interventions face a trade-off between alleviating banks' funding conditions and strengthening risk-taking incentives. Liquidity provision to banks may eliminate the good equilibrium when not targeted. Targeted interventions have the capacity to eliminate adverse equilibria.

Structural changes in inflation dynamics: multiple breaks at different dates for different parameters

AbstractI consider complicated patterns of structural breaks in postwar quarterly US inflation rates based on the CPI and the GDP deflator over the period from 1953:Q1 to 2013:Q4. Bayesian model selection procedures suggest that the two inflation measures had distinct structural changes in different parameters as well as at different dates. CPI inflation experienced a dramatic drop in persistence around the early 1980s, but GDP deflator inflation remains persistent throughout the postwar sample period. The residual variance for both inflation measures switched from a low volatility regime to a high volatility regime in the early 1970s, but returned to another low volatility regime at different dates: the early 1980s for GDP deflator inflation and the early 1990s for CPI inflation. The residual variance for CPI inflation has increased again since the early 2000s, while GDP deflator inflation has remained less volatile. I do not find evidence of a structural shift in the unconditional mean of either measure of inflation. When reviewing the recent literature, considerable controversy exists over the structural break in inflation persistence around the early 1980s but this appears to be dependent on the measures of inflation, as highlighted by the empirical findings in this paper.

Traumatic rupture of renal angiomyolipoma managed with angioembolization followed by elective surgery: a report of two cases.

Renal angiomyolipoma (AML) is a rare benign neoplasm of kidney origin. It is mainly comprised of varying amounts of adipose tissue, smooth muscle, and blood vessels. Most patients with small tumors have no clinical symptoms and the tumors are frequently detected by ultrasound or computed tomography (CT). The tumor size is always related to clinical symptoms. Steiner et al. reported that patients with tumor sizes greater than 4 cm were more frequently symptomatic (46%) and required surgery (54%). Spontaneous rupture of renal AML is the most severe complication. Koh and George speculated that large intratumoral pseudoaneurysm on contrast-enhanced CT was an important predictor or potential life-threatening tumor hemorrhaging. Yamakado et al. demonstrated that groups with spontaneous tumor ruptures have significantly larger sizes of tumors and aneurysm than groups with unruptured ones. Tumor size of 4 cm or larger and aneurysm size of 5 mm or larger were used as predictors of rupture. In the acute setting of a hemorrhage, transarterial embolization has been used as the treatment of choice for hemostasis in cases of stable hemodynamics. This could provide immediate access to locate the precise site of bleeding and to block the bleeder at the same time. On the other hand, angioembolization may occlude the aneurysm, destroy solid mass, and eventually, may reduce the size of parts of the tumors. When the patient’s clinical condition was stable after embolization, elective surgery or CT follow-up was recommended. Regarding the traumatic rupture of renal AML, there have been no reports related to its management. Here, we report two cases of renal AML with traumatic rupture, and suggest the management guidelines for this kind of tumor rupture. CASE REPORTS Case 1 A 31-year-old female was struck by a car while she was riding a motorcycle. Two weeks before the accident, she had palpated a mass on her right abdomen and was scheduled to receive radiologic investigation in a hospital. She was initially sent to a local hospital. No specific examinations or treatments were performed there, and she was discharged 6 hours after admission. The next morning she complained of severe pain over her right abdomen and flank. She was immediately brought to our emergency department (ED). On arrival, initial homodynamic status was stable, but physical examination revealed a huge tender mass palpated on the right side of her abdomen and flank. Gross hematuria was also noted. Abdominal CT showed a huge mass, which measured 10 15 cm and contained adipose tissue, was ruptured with perirenal hematoma and contrast extravasation on the right kidney (Fig. 1). Hypovolemic shock (blood pressure was 73/28 mm Hg) developed 4 hours after her arrival. Resuscitation, crystalloid (1,000 cc) and blood transfusion (red blood cells, 2 units) made her hemodynamics return to normal. Renal angiography was performed immediately. It revealed a space-occupying lesion from the low pole of the right kidney and abnormal hyper tropic arteries with multiple tiny aneurysms (1–2 mm) and contrast extravasation (Fig. 2). Transcatheter arterial embolization with micro-coil and gel form powder was performed. Two days after the accident, respiratory distress developed and end tracheal intubation was performed; diffusion haziness of the right lung field was found on chest x-ray film. A chest tube was inserted on the right and 800 cc of blood initially flowed out. Right flank pain was complained of and persistent drop of hemoglobin was noted. Due to suggested ongoing tumor hemorrhaging, repeated angiography (Figure 3) was performed and it demonstrated a small pseudoaneurysm (2 mm) with contrast extravasation of the inferior branch of right renal artery. Microcoil embolization was performed. Her condition became stable after two of arterial embolizations. Due to huge and fragile ruptured tumor with indistinct anatomy, elective nephrectomy including the mass was performed 1 month after admission. The pathology demonSubmitted for publication May 16, 2003. Accepted for publication January 20, 2004. Copyright © 2005 by Lippincott Williams & Wilkins, Inc. From the Department of Trauma and Emergency Surgery, Surgical Department, Chang Gung Memorial Hospital, Taoyuan, Taiwan. Address for reprints: Yu-Pao Hsu MD, Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5 Fushing Street, Taoyuan, Taiwan; email: yupao@cgmh.org.tw.

Structural Changes in Inflation Dynamics: A Bayesian Analysis Allowing for Multiple Breaks at Different Dates for Different Parameters

I make inferences about complicated patterns of structural breaks in inflation dynamics. I extend Chib's (1998) approach by allowing multiple parameters such as the unconditional mean, a group of persistence parameters, and/or the residual variance to undergo mutually independent structural breaks at different dates with the different number of breaks. Structural breaks are modeled as abrupt changes to identify potential regime shifts in economic structure such as a long-run inflation target, monetary policy, and price-setting behavior. I consider postwar quarterly U.S. inflation rates based on the CPI and the GDP deflator over the period from 1953:Q1 to 2013:Q4. I find that two inflation measures had distinct structural changes in different parameters as well as at different dates using Bayesian model selection procedures. CPI inflation experienced a dramatic drop in persistence around the early 1980s, but GDP deflator inflation is still persistent. In addition, the residual variance for both inflation measures switched from a low volatility regime to a high volatility regime in the early 1970s, but it returned to another low volatility regime at different dates: the early 1980s for GDP deflator inflation and the early 1990s for CPI inflation. The residual variance for CPI inflation has increased again since the early 2000s, while GDP deflator inflation has remained less volatile. These volatility shifts are confirmed by the empirical results based on the unobserved components model with stochastic volatility. However, I do not find evidence of a structural shift in the unconditional mean. When reviewing the recent literature, considerable controversy exists over the structural break in inflation persistence around the early 1980s but this appears to be dependent on the measures of inflation, as highlighted by the empirical findings in this paper.

NALYSIS OF THE ECLIPSING BINARY SDSS J1021+1744: A WDMS SYSTEM WITH UNUSUAL DIPS

We present our recent observations of SDSS J102102.25+174439.9, a new eclipsing white dwarf – main sequence WDMS binary with an orbital period of 0.14 days. This system belongs to the post commonenvelope binary group as shown by the spectrum from the Sloan Digital Sky Survey. We obtained our data using the ULTRASPEC instrument installed on the 2.4-m telescope at the Thai National Observatory (TNO). Our multi-band observations reveal an unusual and persistent drop in brightness after the primary eclipse. These dips, which appear to show variations in amplitude, also have a complex shape that changes within days. Dips in WDMS systems have been observed on only one other occasion, in the light curve of QS Vir prior to the eclipse of the white dwarf. The dips in SDSS J1021+1744 are unique because they are present at different wavelengths and they occur approximately at similar phases. Hosting a DA white dwarf and an M4 companion star, this system is known to be the only WDMS to show these kind of dips in its light curve. It is possible that these dips are caused by ejected materials from an active companion star, such as in QS Vir. The light curve in the g′ filter exhibits deep and narrow features, implying that the material which passes in front of the white dwarf in SDSS J1021 must be dense and small in size. Furthermore, we try to constrain the stellar and orbital parameters of SDSS J1021+1744 using the Binary Maker 3 software. We use g′ and r′ data for our light curve analysis to have a better approximation for the red dwarf star.

Long-term Land Use and Land Cover Changes Affected by the Conservation Reserve Program in the Minnesota River Valley

The Conservation Reserve Program (CRP) is a cost-share and rental payment program signed into law byPresident Reagan in 1985 and administered by the Farm Service Agency (FSA) under the United StateDepartment of Agriculture (USDA). CRP aims to counteract erosion and protect the environment by encouragingagricultural landowners to convert highly erodible cropland and other environmentally sensitive lands to nativeor alternative permanent vegetative cover through the implementation of 10-year contracts paying annual rents.CRP has been actively implemented since the enactment of the Food Security Act of 1985. Re-authorized byCongress in 1996 with major modifications, the CRP has been renewed with minor alterations several times. In1998, the joint state/federal Conservation Reserve Enhancement Program (CREP) targeted the long-termretirement of an additional 40,469 ha (100,000 acres) of agricultural land in the Minnesota River basin toenhance water quality and wildlife habitat through permanent conservation easements.This research examines land use change from 1985 to 2013 in the Minnesota River Valley beginning with an eraof no long-term set-asides to the current era with two active long-term set-aside conservation reserve programs.Multi-temporal remote sensing images from 1985, 1995, 2005 and 2013 were analyzed to map the land usechanges in response to the CRP policy alterations. The results revealed more than 36,000 ha (89,000 acres)cropland have been converted to grassland or forest during this 28-year span. A persistent drop in croplandoccurred in spite of rising corn and soybean prices since 2002 associated with Minnesota’s biofuel industry andincreased foreign demand for these commodities, which indicates that the long-term nature of the CRP andCREP contracts are critical for maintaining the conversions of cropland to grassland or forest cover whileproviding stable farm income.

Consumption Response to Credit Tightening Policy: Evidence from Turkey

We study the impact of credit tightening policy implemented by the Turkish Banking Regulation and Supervision Agency on consumer spending in the period between January 2010 and August 2013. We find that consumers with high amounts of debt were severely affected compared to consumers with low debt. Following the implementation of the policy, relative spending of highly indebted consumers dropped by more than 70%, a significant and persistent drop for many months subsequent to the policy date. The policy effect was strongest for consumers that are young, single and have a low credit card limit.

Development Aid, Agricultural Value Chains And Farmers’ Benefits: The Case of Vanilla Growers in Kasese, Uganda

This article assesses farmers’ benefits from a donor-funded programme that promoted non-traditional agricultural export crops, specifically vanilla and hot pepper. Data was obtained from a survey of 125 famers from eight farmers’ associations working with a Dutch NGO and trading company, four focus group discussions and key informant interviews. Kasese Smallholder Income and Investment Programme used a value chain approach helping farmers at various stages. Farmers benefited from input loans, agricultural skills, extension services and a market for their produce. Vanilla producers were affected by the persistent drop in the crop prices, which affected the sustainability of associations beyond the Kasese Smallholder Income and Investment Programme. Stronger famers’ associations will give more benefits; the government should therefore promote a nationwide cooperative movement and crop regulatory authorities so as to be able to help farmers sustainably.

Plasma gelsolin as a novel biomarker for cardiac surgery associated acute kidney injury in infants and young children (HUM1P.311)

Abstract Objective Cardiac surgery associated acute kidney injury (CS-AKI) strongly correlated with postoperative morbidity and mortality, especially in pediatric population. The purpose of this study was to investigate the role of plasma gelsolin (pGSN) in patients ≤3 years old, and determine whether pGSN was associated with the occurrence and severity of CS-AKI. Methods 77 patients ≤3 years of age performed on cardiac surgery were enrolled. Plasma gelsolin, creatinine, cystatin C and total protein were measured at 7 perioperative time points. Results Normalized pGSN (pGSNN) of AKI group dropped immediately after CPB (p=0.029), and still remained at lower level at 48 hours after CPB (p=0.036); PGSNN of AKI group at 2 hours after CPB was significantly lower than that of non-AKI group (p=0.002). The earliest increase of normalized pCys C (pCys CN) in AKI patients was 24 hours after CPB (p=0.008); PCys CN of AKI group at 24 hours after CPB was much higher than that of non-AKI group (p=0.002). PGSNN at 2 hours CPB was the only independent predictor of CS-AKI (p=0.032), and negatively correlated with the severity of CS-AKI (r=-0.488, p=0.002). Conclusions This study suggested that CS-AKI patients underwent a rapid and persistent drop of pGSNN after surgery; Compared with pCys CN, pGSNN appeared to be a more sensitive predictor of CS-AKI in infant and young children; PGSNN at 2 hours CPB was the only independent predictor of CS-AKI, and negatively correlated with the severity of CS-AKI.

Rectal Ischemia due to Enemas

Introduction: Rectal ischemia following the administration of a hot water enema is not a common injury. This can lead to rectal perforation and may require emergent colectomy. We present a case of severe rectal ischemia with profuse rectal bleeding secondary to a self-administered hot water enema.FigureCase: A 52-year-old female with a medical history of AIDS presented with abdominal pain and rectal bleeding for one day. Her only complaint was constipation for a week, for which she used hot water enemas for relief. On exam, she was febrile and diffusely tender in the lower abdomen. Rectal exam revealed external hemorrhoids and BRBPR. Labs revealed leukocytosis and microcytic anemia. Intravenous antibiotics for suspected colitis was started with no improvement, and there was a persistent drop in hematocrit. Colonoscopy with biopsy was performed, which revealed extensive rectal ulceration, inflammation, and friability. Biopsies showed colonic mucosa, showing focal small crypts with lamina propria edema, hemorrhage, and acute inflammation. The abdominal pain resolved with conservative management, and she was discharged on stool softeners. Discussion: Very few cases of rectal ischemia have been reported secondary to self-administered hot water enema use. Bowel ischemia is commonly seen in the elderly and those with risk factors for ischemia. In this case, there were no predisposing factors, a hot water enema was self-administered causing ischemia of the rectum. This is not a common cause of rectal ischemia, and can lead to perforation with the possible need for colectomy. To prevent this, patients and the medical staff should be educated regarding the administration of enemas and complications.

Congestive heart failure (CHF) in acute myeloid leukemia patients during induction.

7105 Background: Leukemia induction treatment is associated with significant morbidity and mortality. Myocardial stunning may be a result of chemotherapy as well as cytokines released from lysis of tumor cells leading to drop in ejection fraction (EF). When CHF is associated with sepsis, it may result in increased mortality. We report the incidence of CHF in leukemia patients undergoing induction. Methods: We performed a retrospective chart review on patients diagnosed with AML including acute promyelocytic leukemia (APL), who received chemotherapy between December 1, 2004 and December 31, 2012 at Georgia Regents University. Baseline and follow up EFs were recorded by echocardiogram or nuclear medicine scan. We evaluated patients who had a drop in EF after the first or subsequent inductions. We excluded patients who had a delayed drop in EF. Results: 217 consecutive patients with AML with normal ejection fraction at diagnosis were evaluated. 18 patients (8.2%) demonstrated a decrease in EF. This included 14 patients with AML and 4 with APL. 15 patients received one cycle of induction, 2 received re-induction and 1 was treated for relapsed disease. 2 patients did not receive anthracyclines(ACs). Median age of patients with CHF was 57 years (range 29-75). The median drop in EF was 23% (10-45%). Median days from the start of treatment to the observed drop were 25 (5-109). 6 patients are alive with median survival of 175 days. Overall, 5 out of 18 patients recovered their cardiac function with a median survival in these patients of 1,173 days. In 13 patients without recovery in EF survival was only 71 days. Conclusions: Chemotherapy by itself and cytokines released from treatment may result in reversible drop in EF in some patients and a persistent drop in the others. Re-induction is essential in a significant proportion of patients and ACs are commonly used that puts them at an increased risk for CHF. We propose that repeat cardiac evaluation, especially in patients getting re-induced, is necessary for identifying patients with cardiac abnormalities to prevent further cardiac injury and increased mortality.

The effect of bismuth oxide polymorph forms on degradation processes in ZnO varistors

Abstract The behavior of a ZnO–Bi 2 O 3 binary system and ZnO-based varistors under a biasing electric field and temperature was investigated. Both types of samples were exposed to aging with 50 μA DC at 115 °C for 22 h. The degradation effect of DC biasing was manifested by a drop of varistor voltage as well as the presence of peaks in the thermally stimulated discharge current (TSDC) spectra. It was found that the TSDC generation is related to a particular form of the Bi 2 O 3 in ceramics. Activation energies of the thermally stimulated responses ranged from 0.01 eV to 0.17 eV. In the high temperature range, the peaks attributable to degradation were found in the TSDC current when the Bi-rich inter-granular phase formed agglomerates and the Bi 2 O 3 was in its β- or defective γ- variety. When Bi 2 O 3 was in an α-form, well-crystallized γ-form, or an amorphous form, none of the high temperature TSDC maximums were identified. Under a DC bias, the varistor voltage returned to its starting value when the samples were cooled to room temperature. However, passing the current in the opposite direction by reversing the bias from positive to negative exhibited a persistent drop of the varistor voltage.

Effect of deferiprone, an oral iron chelator, in diabetic and non-diabetic glomerular disease

Compelling experimental evidence exists for the role of oxidants and iron in glomerular disease. In preliminary studies, we confirmed increased urinary catalytic iron in patients with glomerulonephritis and diabetic nephropathy. We conducted two separate single-center, prospective, single-armed, open-labeled, proof-of-concept studies to evaluate the safety and efficacy of an oral iron chelator in patients with glomerulonephritis and diabetic nephropathy. Study 1 comprised 15 patients with biopsy-proven glomerulonephritis who had persistent proteinuria despite treatment with steroids and/or cyclophosphamides. Study 2 comprised 38 adult patients with diabetic nephropathy. Patients in Study 1 were treated with deferiprone (50 mg/kg/day) in three divided doses for 6 months and Study 2 patients were treated for 9 months. In Study 1, two patients had severe gastrointestinal intolerance and withdrew from the study after one dose and are not included in the results. There was a significant reduction (47 ± 9% mean) in 24-h urinary protein (4.01 ± 1.61 to 2.21 ± 1.62 [p = 0.009]), with no significant changes in serum creatinine. In Study 2, treatment with deferiprone resulted in a marked, persistent drop in the mean albumin/creatinine ratio (187 ± 47 at baseline to 25 ± 7 mg/g, [p = 0.01]) and stable renal function over a 9-month period. No clinically significant adverse events were observed in either study. Although these are small, open-labeled, and non-randomized studies, our results suggest that future randomized, double-blind trials examining the utility of deferiprone to treat glomerular diseases appear warranted.

Has Inflation Persistence Changed under EMU?

AbstractThis paper analyzes the persistence of inflation in the euro area and, in particular, whether the persistence properties have changed since the start of European Monetary Union(EMU). For that purpose, we compare pre- and post-EMU inflation persistence, use rolling-window estimates of persistence, and apply tests specifically designed to detect break dates near the end of the sample period. In contrast to previous research, we find that inflation persistence has fallen significantly since the start of EMU. Persistence of consumer price inflation, which is central to the European Central Bank’s policy mandate, has fallen more than the persistence of deflator inflation. The drop in inflation persistence is consistent with the results from a simulated small New Keynesian model with a shift toward a more aggressive monetary policy stance.

A37 Treatment of Patients with Central Hyperthermia in Neurosurgical Intensive Care

Background and Goal of the Study: It is known that the major cause of central hyperthermia is a development of the dis-balance between neuro-mediators and neuro-hormons participating in the thermo-regulation. In case of the dopamine deficit a persistent central hyperthermia develops. In this study we tried to asses the effect of dopaminergic drugs on the central hyperthermia. Methods and Materials: We utilized dopamine receptors agonists with 44 patients having central hyperthermia above 38,9C, without symptoms of system inflammation response or centers of infection. 13 patient were receiving only bromocriptine (1st group) 7,5 mg/day, 13 others (2nd group) were receiving PK-Merz 200–400 mg/day. 13 patients of the 3rd group were receiving Pirrocsan (Proroxan) and Pipolphen (Promethazine) to suppress the hyperthermia. 8 patients of the 4th group were receiving craniocerebral hypothermia. The compositions of all 4 groups were comparable in terms of age and sex. To indirectly assess the level of the dopamine deficit we measured the level of blood prolactin on day 1 and 7 of the therapy. Results: With 8 patients from 1st and 10 from 2nd groups the temperature dropped to the subfebrile level within 2 to 3 days. Patients from the 3rd group demonstrated the temperature increases up to 3–4 times a day. Persistent drop of temperature occurred with 6 patients on 5th day. In the 4th group temperature was lowering only during hypothermia treatment. Original increase of the prolactin level was registered with 6 patients (1st group), 8 (2nd), 6(3rd) and 2 (4th). On day 7 we found the normalization of prolactin level for 1st and 2nd group. No changes we detected with the patients from 3rd and 4th groups. Conclusion: Application of dopamine receptors agonists such as bromocriptine in conjunction with Amantadine is proven to be a pathogenic therapy for central hyperthermia. Craniocerebral hypothermia is an effective method of physical cooling, but doesn’t produce the necessary pathogenetic effect. References Kondratyev A.N. Neurotrauma for Anesthesiologist-Reanimatologist on duty. St-Petersburg, Synthes Book 2008. p. 192

Prescription Prevalence and Continuing Medication Use for Secondary Prevention After Myocardial Infarction

Current guidelines recommend using aspirin, clopidogrel, beta-blockers, statins, and angiotensin converting enzyme (ACE) inhibitors after acute myocardial infarction (AMI). Although there is evidence that patients often stop taking these medications prematurely, long-term data reflecting the actual reality of care are lacking. We studied prescription prevalence and treatment persistence of secondary prevention in patients who had an AMI by analyzing relevant claims data from a German sickness fund, the Techniker Krankenkasse (these data are not necessarily representative of the entire German population). Insurees who were discharged from the hospital between 2001 and 2006 with AMI as their main discharge diagnosis were classified as users or non-users of each of the types of drug listed above on the basis of the prescriptions that they obtained in the first 90 days after they left the hospital. Treatment persistence was statistically assessed with survival analysis. Switches from one drug class to another were not examined. Of 30,028 AMI patients, 82% were initially prescribed a beta-blocker, 73% a statin, 69% an ACE inhibitor, 66% aspirin (without self-medication), and 61% clopidogrel. Five years after discharge, 10% of the patients for whom aspirin was initially prescribed were still taking it; the corresponding figures for the other drug classes were 17% for statins, 31% for ACE inhibitors, and 36% for beta-blockers. The greatest drop in treatment persistence occurred approximately one year after the AMI. Treatment persistence with recommended medication after AMI is still in need of improvement. Patient education should start as soon as possible after infarction, because the greatest drops in medication use appear to occur within one year after AMI.