scholarly journals Dynamics of the number of myocardial revascularization operations in some countries in comparison with the Russian Federation in 2000–2018

2021 ◽  
Vol 10 (4) ◽  
pp. 68-78
Author(s):  
V. Yu. Semenov ◽  
I. V. Samorodskaya

Aim. To study the dynamics of the number of coronary artery bypass grafting (CABG) and percutaneous coronary interventions (PCI) in some countries and Russia in the 2000–2018..Methods. The data of the official statistics of the Organization for Economic Cooperation and Development on the number of CABG and PCI were used. The countries that have provided data for most of the analyzed years and have more than 30 CABG per 100,000 population (22 countries) were selected. Data on the number of interventions in Russia were obtained from the CNIIOiIZ and Bakulev NMICSSH. The US data are obtained from the literature.Results. In most countries, the number of CABG decreased by 2018.The United States, Denmark, Finland, Israel, and Luxembourg were the most variable in the average indicator. The most expressed decrease occurred in Finland (2.9 times). The number of PCI has increased significantly (in 9 countries by more than 2 times). The exception was the United States, where the number of PCI decreased by 2 times from 2003 to 2016. In Russia, there was an increase in CABG and PCI (by 10.2 and 50.5 times, respectively). The number of CABG and PCI per 100,000 population was 23 and 34 times less, respectively, in Russia than the international average in 2000, and 1.4 and 1.55 times less in 2018. The decrease in CABG is due to the improvement of PCI technologies, as well as the improvement of pharmaceutical treatment of coronary vessels. The number of proceedings, including court ones, on the validity of stent implantation is growing. The crosscountry variability of the use of cardiac surgical methods is influenced by the organizational and financial characteristics of the healthcare system, demographic and clinical characteristics of patients, the knowledge of doctors, etc. The experience of Russia fully confirms this.Conclusion. There is no optimal method for accurately assessing the population's need for certain treatment methods. Each country chooses its own tactics, taking into account its resource capabilities, approaches to decision-making, its values and preferences, but the general trend is a decrease in the number of CABG operations while increasing the PCI. In Russia, there is a multiple increase in the number of CABG and PCI, but it is less than the indicators of most countries. 

Author(s):  
David W Schopfer ◽  
Nirupama Krishnamurthi ◽  
Hui Shen ◽  
Mary A Whooley

Objective: Referral to cardiac rehabilitation (CR) is one of nine performance measures for patients with ischemic heart disease (IHD), but fewer than 20% of eligible patients participate in the United States. Home-based CR programs (available in the United Kingdom, Australia, and Canada) have similar effects on morbidity and mortality as traditional (facility-based) CR, but they are not currently available or reimbursed in the US. We sought to determine whether implementing home-based programs could increase CR participation among patients with IHD. Methods: Using electronic health records from 134 VA medical centers, we identified 106,277 veterans hospitalized for acute myocardial infarction, percutaneous coronary intervention or coronary artery bypass grafting between 2010 and 2015. We compared the proportion of eligible patients who participated in CR at 13 VA hospitals that offered referral to either home-based CR or facility-based CR vs. 121 VA hospitals that offered referral to only facility-based CR (usual care). Results: The number of VA medical centers offering home-based CR increased from 2 in 2010 to 13 in 2015. Among the 20,949 eligible patients hospitalized at VA medical centers that implemented home-based CR between 2010 and 2015, CR participation increased from 11% to 26% (Figure). Among the 85,328 eligible patients hospitalized at VA medical centers that did not offer home-based CR, CR participation increased from only 8% to 11%. Conclusion: Among eligible patients with IHD, participation in CR more than doubled at VA medical centers that implemented home-based CR programs between 2010 and 2015, whereas participation increased by only 3% at VA medical centers that did not implement home-based CR programs. Home-based CR is an effective way of engaging patients who may otherwise decline to participate in CR.


Author(s):  
Justin M Bachmann ◽  
Loren Lipworth ◽  
Thomas J Wang ◽  
Michael T Mumma ◽  
Mary A Whooley ◽  
...  

Background: Cardiac rehabilitation (CR) is underutilized in the United States, with less than 20% of eligible patients participating in CR programs. Individual socioeconomic status is associated with CR utilization, but the effect of neighborhood socioeconomic context on CR use has not been described. We investigated the association of CR participation with neighborhood socioeconomic context in the Southern Community Cohort Study (SCCS). Methods: The SCCS is a prospective cohort study of 84,569 largely poor adults in the southeastern United States, of which 52,117 participants have Medicare or Medicaid claims. Using these claims data, we identified SCCS participants with hospitalizations for myocardial infarction, percutaneous coronary intervention, coronary artery bypass surgery or cardiac valve surgery and ascertained their CR utilization. Neighborhood socioeconomic context was assessed using a previously validated neighborhood deprivation index. This index was derived using 11 census-tract level variables including median household value and percentage of households with public assistance income. We used multivariable-adjusted logistic and Cox regression to evaluate the association of CR participation with neighborhood socioeconomic context and mortality. Results: A total of 4456 SCCS participants (56% female, 59% Black) were eligible for CR at a mean age of 60.5 + 9.1 years and an average of 4.0 + 2.5 years after study enrollment. CR utilization was low as expected, with 308 subjects (6.9%) participating in CR programs. CR participation is inversely associated with all-cause mortality (hazard ratio [HR] 0.52, 95% confidence interval [CI] 0.39-0.70, p=<0.0001) and cardiovascular disease (CVD) mortality (HR 0.38, 95% CI 0.22-0.65, p=<0.001) after multivariable adjustment. Neighborhood socioeconomic context is strongly associated with CR participation after adjustment for individual socioeconomic status (educational level and household income) as well as rural status (Table). Conclusions: Neighborhood socioeconomic context predicts CR participation in addition to individual socioeconomic status. These data invite research on interventions to increase CR access in deprived communities.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Efehi Igbinomwanhia ◽  
Alejandro Sanchez Nadales ◽  
Richard A Grimm ◽  
Brian P Griffin ◽  
Samir R Kapadia ◽  
...  

Introduction: Improvements in primary prevention, medical therapies and interventions have coincided with a rapidly aging population across the globe. The contemporary characteristics and in-hospital outcomes of non-ST-elevation myocardial infarction (NSTEMI) among patients ≥ 80 years old in the United States (US) are not well studied. Methods: Adults (≥ 18) with a primary discharge diagnosis of NSTEMI were identified from the 2016 National Inpatient Sample. The exposure of interest was age ≥80 years, with a comparison group of those aged between 18 and 79 years. Results: Of 93,875 patients who had NSTEMI, 22,210 (23.65%) were ≥ 80 years. Among patients ≥ 80 years, 52.5% were female, 73.6% were Caucasians, with a significant proportion being managed by conservative therapy (73.4%). Patients ≥ 80 years were less likely to receive percutaneous coronary intervention (PCI) (adjusted odds ratio [aOR]: 0.49; 95% confidence intervals [CI]: 0.47-0.51) or coronary artery bypass graft surgery (CABG) (aOR: 0.28; 95% CI: 0.25-0.30) when compared to the younger group. Regardless of management strategy, patients ≥ 80 years old had higher inpatient mortality compared to younger patients. Patients ≥ 80 years undergoing PCI experienced more complete heart block, but not other complications, such as cardiogenic shock, cardiac arrest, and stroke, compared to the younger group (Table). NSTEMI patients ≥ 80 years who were managed conservatively or by CABG had a higher Elixhauser comorbidity index than patients undergoing PCI. Conclusions: A significant number of NSTEMI patients in the US were aged ≥ 80 years. Despite overall similar in-hospital complications profiles across management strategies, NSTEMI in patients ≥ 80 years was most often managed conservatively.


Author(s):  
Steven Hurst

The United States, Iran and the Bomb provides the first comprehensive analysis of the US-Iranian nuclear relationship from its origins through to the signing of the Joint Comprehensive Plan of Action (JCPOA) in 2015. Starting with the Nixon administration in the 1970s, it analyses the policies of successive US administrations toward the Iranian nuclear programme. Emphasizing the centrality of domestic politics to decision-making on both sides, it offers both an explanation of the evolution of the relationship and a critique of successive US administrations' efforts to halt the Iranian nuclear programme, with neither coercive measures nor inducements effectively applied. The book further argues that factional politics inside Iran played a crucial role in Iranian nuclear decision-making and that American policy tended to reinforce the position of Iranian hardliners and undermine that of those who were prepared to compromise on the nuclear issue. In the final chapter it demonstrates how President Obama's alterations to American strategy, accompanied by shifts in Iranian domestic politics, finally brought about the signing of the JCPOA in 2015.


2014 ◽  
Vol 23 (3) ◽  
pp. 381-388 ◽  
Author(s):  
Euan Hague ◽  
Alan Mackie

The United States media have given rather little attention to the question of the Scottish referendum despite important economic, political and military links between the US and the UK/Scotland. For some in the US a ‘no’ vote would be greeted with relief given these ties: for others, a ‘yes’ vote would be acclaimed as an underdog escaping England's imperium, a narrative clearly echoing America's own founding story. This article explores commentary in the US press and media as well as reporting evidence from on-going interviews with the Scottish diaspora in the US. It concludes that there is as complex a picture of the 2014 referendum in the United States as there is in Scotland.


2018 ◽  
Vol 47 (3) ◽  
pp. 130-134

This section, updated regularly on the blog Palestine Square, covers popular conversations related to the Palestinians and the Arab-Israeli conflict during the quarter 16 November 2017 to 15 February 2018: #JerusalemIstheCapitalofPalestine went viral after U.S. president Donald Trump recognized Jerusalem as the capital of Israel and announced his intention to move the U.S. embassy there from Tel Aviv. The arrest of Palestinian teenager Ahed Tamimi for slapping an Israeli soldier also prompted a viral campaign under the hashtag #FreeAhed. A smaller campaign protested the exclusion of Palestinian human rights from the agenda of the annual Creating Change conference organized by the US-based National LGBTQ Task Force in Washington. And, UNRWA publicized its emergency funding appeal, following the decision of the United States to slash funding to the organization, with the hashtag #DignityIsPriceless.


2019 ◽  
Vol 35 (2) ◽  
pp. 143-170
Author(s):  
Gerardo Gurza-Lavalle

This work analyses the diplomatic conflicts that slavery and the problem of runaway slaves provoked in relations between Mexico and the United States from 1821 to 1857. Slavery became a source of conflict after the colonization of Texas. Later, after the US-Mexico War, slaves ran away into Mexican territory, and therefore slaveholders and politicians in Texas wanted a treaty of extradition that included a stipulation for the return of fugitives. This article contests recent historiography that considers the South (as a region) and southern politicians as strongly influential in the design of foreign policy, putting into question the actual power not only of the South but also of the United States as a whole. The problem of slavery divided the United States and rendered the pursuit of a proslavery foreign policy increasingly difficult. In addition, the South never acted as a unified bloc; there were considerable differences between the upper South and the lower South. These differences are noticeable in the fact that southerners in Congress never sought with enough energy a treaty of extradition with Mexico. The article also argues that Mexico found the necessary leeway to defend its own interests, even with the stark differential of wealth and resources existing between the two countries. El presente trabajo analiza los conflictos diplomáticos entre México y Estados Unidos que fueron provocados por la esclavitud y el problema de los esclavos fugitivos entre 1821 y 1857. La esclavitud se convirtió en fuente de conflicto tras la colonización de Texas. Más tarde, después de la guerra Mexico-Estados Unidos, algunos esclavos se fugaron al territorio mexicano y por lo tanto dueños y políticos solicitaron un tratado de extradición que incluyera una estipulación para el retorno de los fugitivos. Este artículo disputa la idea de la historiografía reciente que considera al Sur (en cuanto región), así como a los políticos sureños, como grandes influencias en el diseño de la política exterior, y pone en tela de juicio el verdadero poder no sólo del Sur sino de Estados Unidos en su conjunto. El problema de la esclavitud dividió a Estados Unidos y dificultó cada vez más el impulso de una política exterior que favoreciera la esclavitud. Además, el Sur jamás operó como unidad: había diferencias marcadas entre el Alto Sur y el Bajo Sur. Estas diferencias se observan en el hecho de que los sureños en el Congreso jamás se esforzaron en buscar con suficiente energía un tratado de extradición con México. El artículo también sostiene que México halló el margen de maniobra necesario para defender sus propios intereses, pese a los fuertes contrastes de riqueza y recursos entre los dos países.


Author(s):  
Ana Elizabeth Rosas

In the 1940s, curbing undocumented Mexican immigrant entry into the United States became a US government priority because of an alleged immigration surge, which was blamed for the unemployment of an estimated 252,000 US domestic agricultural laborers. Publicly committed to asserting its control of undocumented Mexican immigrant entry, the US government used Operation Wetback, a binational INS border-enforcement operation, to strike a delicate balance between satisfying US growers’ unending demands for surplus Mexican immigrant labor and responding to the jobs lost by US domestic agricultural laborers. Yet Operation Wetback would also unintentionally and unexpectedly fuel a distinctly transnational pathway to legalization, marriage, and extended family formation for some Mexican immigrants.On July 12, 1951, US president Harry S. Truman’s signing of Public Law 78 initiated such a pathway for an estimated 125,000 undocumented Mexican immigrant laborers throughout the United States. This law was an extension the Bracero Program, a labor agreement between the Mexican and US governments that authorized the temporary contracting of braceros (male Mexican contract laborers) for labor in agricultural production and railroad maintenance. It was formative to undocumented Mexican immigrant laborers’ transnational pursuit of decisively personal goals in both Mexico and the United States.Section 501 of this law, which allowed employers to sponsor certain undocumented laborers, became a transnational pathway toward formalizing extended family relationships between braceros and Mexican American women. This article seeks to begin a discussion on how Operation Wetback unwittingly inspired a distinctly transnational approach to personal extended family relationships in Mexico and the United States among individuals of Mexican descent and varying legal statuses, a social matrix that remains relatively unexplored.


2019 ◽  
Author(s):  
Gremil Alessandro Naz

<p>This paper examines the changes in Filipino immigrants’ perceptions about themselves and of Americans before and after coming to the United States. Filipinos have a general perception of themselves as an ethnic group. They also have perceptions about Americans whose media products regularly reach the Philippines. Eleven Filipinos who have permanently migrated to the US were interviewed about their perceptions of Filipinos and Americans. Before coming to the US, they saw themselves as hardworking, family-oriented, poor, shy, corrupt, proud, adaptable, fatalistic, humble, adventurous, persevering, gossipmonger, and happy. They described Americans as rich, arrogant, educated, workaholic, proud, powerful, spoiled, helpful, boastful, materialistic, individualistic, talented, domineering, friendly, accommodating, helpful, clean, and kind. Most of the respondents changed their perceptions of Filipinos and of Americans after coming to the US. They now view Filipinos as having acquired American values or “Americanized.” On the other hand, they stopped perceiving Americans as a homogenous group possessing the same values after they got into direct contact with them. The findings validate social perception and appraisal theory, and symbolic interaction theory.</p>


2009 ◽  
Vol 1 (1) ◽  
pp. 93-116 ◽  
Author(s):  
Mauricio Tenorio-Trillo

By identifying two general issues in recent history textbook controversies worldwide (oblivion and inclusion), this article examines understandings of the United States in Mexico's history textbooks (especially those of 1992) as a means to test the limits of historical imagining between U. S. and Mexican historiographies. Drawing lessons from recent European and Indian historiographical debates, the article argues that many of the historical clashes between the nationalist historiographies of Mexico and the United States could be taught as series of unsolved enigmas, ironies, and contradictions in the midst of a central enigma: the persistence of two nationalist historiographies incapable of contemplating their common ground. The article maintains that lo mexicano has been a constant part of the past and present of the US, and lo gringo an intrinsic component of Mexico's history. The di erences in their historical tracks have been made into monumental ontological oppositions, which are in fact two tracks—often overlapping—of the same and shared con ictual and complex experience.


Sign in / Sign up

Export Citation Format

Share Document