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Papers by Héctor Fabio Espinosa Tilmans

… England Journal of …, 1994

Balloon-expandable coronary-artery stents were developed to prevent coronary restenosis after cor... more Balloon-expandable coronary-artery stents were developed to prevent coronary restenosis after coronary angioplasty. These devices hold coronary vessels open at sites that have been dilated. However, it is unknown whether stenting improves long-term angiographic and clinical outcomes as compared with standard balloon angioplasty. A total of 520 patients with stable angina and a single coronary-artery lesion were randomly assigned to either stent implantation (262 patients) or standard balloon angioplasty (258 patients). The primary clinical end points were death, the occurrence of a cerebrovascular accident, myocardial infarction, the need for coronary-artery bypass surgery, or a second percutaneous intervention involving the previously treated lesion, either at the time of the initial procedure or during the subsequent seven months. The primary angiographic end point was the minimal luminal diameter at follow-up, as determined by quantitative coronary angiography. After exclusions, 52 patients in the stent group (20 percent) and 76 patients in the angioplasty group (30 percent) reached a primary clinical end point (relative risk, 0.68; 95 percent confidence interval, 0.50 to 0.92; P = 0.02). The difference in clinical-event rates was explained mainly by a reduced need for a second coronary angioplasty in the stent group (relative risk, 0.58; 95 percent confidence interval, 0.40 to 0.85; P = 0.005). The mean (+/- SD) minimal luminal diameters immediately after the procedure were 2.48 +/- 0.39 mm in the stent group and 2.05 +/- 0.33 mm in the angioplasty group; at follow-up, the diameters were 1.82 +/- 0.64 mm in the stent group and 1.73 +/- 0.55 mm in the angioplasty group (P = 0.09), which correspond to rates of restenosis (diameter of stenosis, > or = 50 percent) of 22 and 32 percent, respectively (P = 0.02). Peripheral vascular complications necessitating surgery, blood transfusion, or both were more frequent after stenting than after balloon angioplasty (13.5 vs. 3.1 percent, P < 0.001). The mean hospital stay was significantly longer in the stent group than in the angioplasty group (8.5 vs. 3.1 days, P < 0.001). Over seven months of follow-up, the clinical and angiographic outcomes were better in patients who received a stent than in those who received standard coronary angioplasty. However, this benefit was achieved at the cost of a significantly higher risk of vascular complications at the access site and a longer hospital stay.

New England Journal of Medicine, 2006

Page 1. John Willis WITH ASSOCIATE EDITOR ВаГГу MOIIUSh WORLD v. 2005 FILM ANNUAL WITH OVER 1,000... more Page 1. John Willis WITH ASSOCIATE EDITOR ВаГГу MOIIUSh WORLD v. 2005 FILM ANNUAL WITH OVER 1,000 PHOTOGRAPHS Page 2. Page 3. Page 4. Film/Reference 49.95US49.95 US 49.95US64 95 CAN John Willis with Associate ...

La globalización o mundialización es un tema de gran actualidad en el discurso académico internac... more La globalización o mundialización es un tema de gran actualidad en el discurso académico internacional. De una preocupación inicial con entender las transformaciones de los mercados financieros y la función del Estado-nacional en dichos procesos se ha transitado hacia el estudio de las expresiones sociales, culturales y mediáticas de la globalización.

New England Journal of Medicine, 1992

Primary pulmonary hypertension is a progressive, fatal disease of unknown cause. Vasodilator drug... more Primary pulmonary hypertension is a progressive, fatal disease of unknown cause. Vasodilator drugs have been used as a treatment, but their efficacy is uncertain. We treated 64 patients with primary pulmonary hypertension with high doses of calcium-channel blockers. Patients who responded to treatment (defined as those whose pulmonary-artery pressure and pulmonary vascular resistance immediately fell by more than 20 percent after challenge) were treated for up to five years. Their survival was compared with that of the patients who did not respond and with patients enrolled in the National Institutes of Health (NIH) Registry on Primary Pulmonary Hypertension. Warfarin was given to 55 percent of the patients as concurrent therapy, on the basis of a lung scan showing nonuniformity of pulmonary blood flow (47 percent of patients who responded and 57 percent of those who did not respond). Seventeen patients (26 percent) responded to treatment, as indicated by a 39 percent fall in pulmonary-artery pressure and a 53 percent fall in the pulmonary-vascular-resistance index (P less than 0.001). Nifedipine (mean [+/- SD] daily dose, 172 +/- 41 mg) was given to 13 patients, and diltiazem (mean daily dose, 720 +/- 208 mg) was given to 4 patients. After five years, 94 percent of the patients who responded (16 of 17) were alive, as compared with 55 percent of the patients who did not respond (26 of 47, P = 0.003). The survival of the patients who responded was also significantly better than that of the NIH registry cohort (P = 0.002) and patients from the NIH registry who were treated at the University of Illinois (P = 0.001). The use of warfarin was associated with improved survival (P = 0.025), particularly in the patients who did not respond. This study suggests that high doses of calcium-channel blockers in patients with primary pulmonary hypertension who respond with reductions in pulmonary-artery pressure and pulmonary vascular resistance may improve survival over a five-year period.

American Journal of …, 2013

... Volume 9: Volume 10: Volume 11: Volume 12: Volume 13: Volume 14: Volume 15: Volume 16: Volume... more ... Volume 9: Volume 10: Volume 11: Volume 12: Volume 13: Volume 14: Volume 15: Volume 16: Volume 17: Volume 18: Volume 19: Volume 20: Volume 21: Volume 22: Volume 23: Volume 24: Volume 25: Volume 26: Volume 27: Distillation Design in Practice (LM Rose) The Art ...

Ecology, 1997

Plant species composition, species abundances, and species richness were strongly recruitment lim... more Plant species composition, species abundances, and species richness were strongly recruitment limited in a 4-yr experiment in which seeds of up to 54 species were added to patches of native grassland. Four field seasons after a one-time addition of seed, many added species ...

... Italy Paolo Traverse, Italy Workshop Chair Toby Walsh, Australia Advisory Board Wolfgang Bibe... more ... Italy Paolo Traverse, Italy Workshop Chair Toby Walsh, Australia Advisory Board Wolfgang Bibel, Germany Tony Cohn, UK Werner Horn, Austria Ramon Lopez de Mantaras, Spain Area Chairs Franz Baader, Germany Christian Bessiere, France Susanne Biundo, Germany ...

… England Journal of …, 1994

Balloon-expandable coronary-artery stents were developed to prevent coronary restenosis after cor... more Balloon-expandable coronary-artery stents were developed to prevent coronary restenosis after coronary angioplasty. These devices hold coronary vessels open at sites that have been dilated. However, it is unknown whether stenting improves long-term angiographic and clinical outcomes as compared with standard balloon angioplasty. A total of 520 patients with stable angina and a single coronary-artery lesion were randomly assigned to either stent implantation (262 patients) or standard balloon angioplasty (258 patients). The primary clinical end points were death, the occurrence of a cerebrovascular accident, myocardial infarction, the need for coronary-artery bypass surgery, or a second percutaneous intervention involving the previously treated lesion, either at the time of the initial procedure or during the subsequent seven months. The primary angiographic end point was the minimal luminal diameter at follow-up, as determined by quantitative coronary angiography. After exclusions, 52 patients in the stent group (20 percent) and 76 patients in the angioplasty group (30 percent) reached a primary clinical end point (relative risk, 0.68; 95 percent confidence interval, 0.50 to 0.92; P = 0.02). The difference in clinical-event rates was explained mainly by a reduced need for a second coronary angioplasty in the stent group (relative risk, 0.58; 95 percent confidence interval, 0.40 to 0.85; P = 0.005). The mean (+/- SD) minimal luminal diameters immediately after the procedure were 2.48 +/- 0.39 mm in the stent group and 2.05 +/- 0.33 mm in the angioplasty group; at follow-up, the diameters were 1.82 +/- 0.64 mm in the stent group and 1.73 +/- 0.55 mm in the angioplasty group (P = 0.09), which correspond to rates of restenosis (diameter of stenosis, > or = 50 percent) of 22 and 32 percent, respectively (P = 0.02). Peripheral vascular complications necessitating surgery, blood transfusion, or both were more frequent after stenting than after balloon angioplasty (13.5 vs. 3.1 percent, P < 0.001). The mean hospital stay was significantly longer in the stent group than in the angioplasty group (8.5 vs. 3.1 days, P < 0.001). Over seven months of follow-up, the clinical and angiographic outcomes were better in patients who received a stent than in those who received standard coronary angioplasty. However, this benefit was achieved at the cost of a significantly higher risk of vascular complications at the access site and a longer hospital stay.

New England Journal of Medicine, 2006

Page 1. John Willis WITH ASSOCIATE EDITOR ВаГГу MOIIUSh WORLD v. 2005 FILM ANNUAL WITH OVER 1,000... more Page 1. John Willis WITH ASSOCIATE EDITOR ВаГГу MOIIUSh WORLD v. 2005 FILM ANNUAL WITH OVER 1,000 PHOTOGRAPHS Page 2. Page 3. Page 4. Film/Reference 49.95US49.95 US 49.95US64 95 CAN John Willis with Associate ...

La globalización o mundialización es un tema de gran actualidad en el discurso académico internac... more La globalización o mundialización es un tema de gran actualidad en el discurso académico internacional. De una preocupación inicial con entender las transformaciones de los mercados financieros y la función del Estado-nacional en dichos procesos se ha transitado hacia el estudio de las expresiones sociales, culturales y mediáticas de la globalización.

New England Journal of Medicine, 1992

Primary pulmonary hypertension is a progressive, fatal disease of unknown cause. Vasodilator drug... more Primary pulmonary hypertension is a progressive, fatal disease of unknown cause. Vasodilator drugs have been used as a treatment, but their efficacy is uncertain. We treated 64 patients with primary pulmonary hypertension with high doses of calcium-channel blockers. Patients who responded to treatment (defined as those whose pulmonary-artery pressure and pulmonary vascular resistance immediately fell by more than 20 percent after challenge) were treated for up to five years. Their survival was compared with that of the patients who did not respond and with patients enrolled in the National Institutes of Health (NIH) Registry on Primary Pulmonary Hypertension. Warfarin was given to 55 percent of the patients as concurrent therapy, on the basis of a lung scan showing nonuniformity of pulmonary blood flow (47 percent of patients who responded and 57 percent of those who did not respond). Seventeen patients (26 percent) responded to treatment, as indicated by a 39 percent fall in pulmonary-artery pressure and a 53 percent fall in the pulmonary-vascular-resistance index (P less than 0.001). Nifedipine (mean [+/- SD] daily dose, 172 +/- 41 mg) was given to 13 patients, and diltiazem (mean daily dose, 720 +/- 208 mg) was given to 4 patients. After five years, 94 percent of the patients who responded (16 of 17) were alive, as compared with 55 percent of the patients who did not respond (26 of 47, P = 0.003). The survival of the patients who responded was also significantly better than that of the NIH registry cohort (P = 0.002) and patients from the NIH registry who were treated at the University of Illinois (P = 0.001). The use of warfarin was associated with improved survival (P = 0.025), particularly in the patients who did not respond. This study suggests that high doses of calcium-channel blockers in patients with primary pulmonary hypertension who respond with reductions in pulmonary-artery pressure and pulmonary vascular resistance may improve survival over a five-year period.

American Journal of …, 2013

... Volume 9: Volume 10: Volume 11: Volume 12: Volume 13: Volume 14: Volume 15: Volume 16: Volume... more ... Volume 9: Volume 10: Volume 11: Volume 12: Volume 13: Volume 14: Volume 15: Volume 16: Volume 17: Volume 18: Volume 19: Volume 20: Volume 21: Volume 22: Volume 23: Volume 24: Volume 25: Volume 26: Volume 27: Distillation Design in Practice (LM Rose) The Art ...

Ecology, 1997

Plant species composition, species abundances, and species richness were strongly recruitment lim... more Plant species composition, species abundances, and species richness were strongly recruitment limited in a 4-yr experiment in which seeds of up to 54 species were added to patches of native grassland. Four field seasons after a one-time addition of seed, many added species ...

... Italy Paolo Traverse, Italy Workshop Chair Toby Walsh, Australia Advisory Board Wolfgang Bibe... more ... Italy Paolo Traverse, Italy Workshop Chair Toby Walsh, Australia Advisory Board Wolfgang Bibel, Germany Tony Cohn, UK Werner Horn, Austria Ramon Lopez de Mantaras, Spain Area Chairs Franz Baader, Germany Christian Bessiere, France Susanne Biundo, Germany ...