PDF Diez intentos y dos clasificaciones aleccionadoras en una opinión (Spanish Edition)

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Long-term effects of spinal cord stimulation on angina symptoms and quality of life in patients with refractory angina pectoris--results from the European Angina Registry Link Study EARL. Severe angina pectoris in asthma attack: a case report. Asthma is a chronic inflammatory disorder of the airways related to the obstruction of reversible airflow. Asthma presents as recurrent attacks of cough and dyspnea. Poor control causes recurrent admissions to the ICU, and mortality is related to poor drug compliance and follow-up.

Angina pectoris is a syndrome of recurrent chest discomfort related to myocardial ischemia. The presence of these two disorders rarely has been reported. We reported a year-old boy who was referred with exacerbation of asthma and developed angina pectoris during hospitalization.

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He had labored breathing and diffuse wheezing. During treatment of the asthma, the patient developed severe chest pain due to shunt formation and coronary hypoxia, caused by the sole administration of ventolin, since oxygen had been disconnected. After receiving appropriate therapy, both his asthma and angina recovered, and, to date, he has not experienced angina pectoris again. Invaliderende angina pectoris behandlet med elektrisk rygmarvsstimulation ERS. Thirty patients who had severe incapacitating angina pectoris which had not reacted to the conventional therapeutic measures and which required massive daily opioid consumption were treated with electrical spinal cord stimulation SCS by means of a completely implantable stimulation system OBJECTIVE: To determine the prevalence of angina and possible angina and its distribution by main demographic and socioeconomic characteristics among adults 40 years of age or older.

Selection of medical treatment in stable angina pectoris. However, little information is available on how this first evaluation may be used to select Modern diagnostic capabilities for vasospastic angina diagnostics intracoronary provocative testing. Full Text Available This review is devoted to a topical problem of modern cardiology — techniques of diagnosing vasospastic angina. The results of retrospective and prospective studies on the efficacy and safety of vasospastic angina diagnostics are reviewed.

The literature on the prevalence, progression and treatment of this pathology is discussed. Received 13 January Accepted 6 February Financing: The study did not have sponsorship. Conflict of interest: The authors declare no conflict of interest. METHODS - We prospectively studied 46 patients 24 females with unstable angina and 46 control patients 19 males, paired by sex and age, blinded to the laboratory data.

Details of diets, smoking habits, medication used, body mass index, and the presence of hypertension and diabetes were recorded, as were plasma lipid and glucose levels, C-reactive protein, and lipoperoxidation in all participants. Patients with renal disease were excluded. Plasma homocysteine was estimated using high-pressure liquid chromatography. Among females, however, a statistically significant difference was observed between the 2 groups: Diagnostic possibilities of radionuclide investigation in patterns with stable and unstable angina pectoris.

Myocardial radiocardiography and scintigraphy with 99m Tc-pyrophosphate was performed in 58 patients with stable angina and 60 patients with unstable angina. In patients with stable angina , positive scintigrams were mostly recorded after anginal attacks. Their central hemodynamic parameters deteriorated progressively as angina increased in severity. Patients with unstable angina typically showed myocardial accumulation of the label that was unrelated to anginal attacks and recordable by direct-projection scintigraphy.

The assessment of myocardial radiocardiographic and scintigraphic data allows one to differentiate between stable and unstable angina. Detection of angina -related coronary artery in patients with unstable angina pectoris by using I-BMIPP myocardial scintigraphy. To evaluate the diagnostic accuracy of detection of angina -related coronary arteries in patients with unstable angina pectoris. The decrease in myocardial uptake of I-BMIPP agreed with the decrease in regional wall motion by using ultrasonic echocardiography. Long-term effects of electrical neurostimulation in patients with unstable angina : Refractory to conventional therapies.

Patients with unstable angina pectoris may become refractory to conventional therapies. Jan 15, The treatment of angina pectoris in patients with arterial hyper An alternative mechanism whereby labetalol may reduce angina pectoris is Significance of Tcm pyrophosphate accumulation in unstable angina. Tcm pyrophosphate PYP and Tl simultaneous dual energy single photon emission computed tomography SPECT were performed in 33 patients with clinically unstable angina.

Clinical features, types of unstable angina , ECG changes, and serial creatine kinase CK data were compared in the two groups. Although metallic coronary stents significantly reduce angina pectoris compared with optimal medical therapy, angina after percutaneous coronary intervention PCI remains frequent. We, therefore, sought to compare the incidence of any angina during the 1 year after PCI among the spectrum of commercially available metallic stents. The primary end point was patient-reported angina within 1 year of PCI. Multivariable logistic regression was performed to assess the independent association of stent type with any angina at 1 year.

Overall, 8, patients were queried in regard to angina symptoms; Major adverse cardiovascular events, a composite of all-cause mortality, target vessel revascularization, and Q-wave myocardial infarction, increased with angina severity: 6. Baseline Canadian Cardiovascular Society class 3 or 4 angina , history of coronary artery bypass grafting, and history of PCI were associated with a higher likelihood of angina at 1 year; increasing age, male gender, presentation with acute coronary syndrome, and higher stented length were associated with less angina.

In conclusion, metallic stent type is not associated with the occurrence of angina at up to 1 year after PCI. Technetiumm-pyrophosphate myocardial imaging in unstable angina. The authors have found that approximately one third of patients with the syndrome of unstable angina pectoris have abnormal 99mTc-pyrophosphate myocardial scintigrams even in the absence of abnormal enzymes and electrocardiographic confirmation of the presence of acute myocardial necrosis.

Thus, 99mTc-pyrophosphate myocardial imaging technique appears to represent a sensitive means to detect acute multicellular injury associated with the clinical syndrome of unstable angina pectoris even when cardiac enzymes are normal and the electrocardiogram does not definitively document the presence of acute myocardial necrosis. Ginkgo Biloba extract for angina pectoris: a systematic review. To evaluate the efficacy and safety of Ginkgo Biloba extract for patients with angina pectoris according to the available evidence. Electronic databases were searched for all of the randomized controlled trials RCTs of angina pectoris treatments with Ginkgo Biloba extract, either alone or combined with routine Western medicine RWM , and controlled by untreated, placebo, Chinese patent medicine, or RWM treatment.

No language restriction was applied. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards. RevMan 5. A total of 23 RCTs involving 2, patients were included and the methodological quality was evaluated as generally low. Reported adverse events included epigastric discomfort, nausea, gastrointestinal reaction, and bitter taste.

Ginkgo Biloba extract may have beneficial effects on patients with angina pectoris, although the low quality of existing trials makes it difficult to draw a satisfactory conclusion. More rigorous, high quality clinical trials are needed to provide conclusive evidence. Full Text Available Aim. To evaluate antianginal and antiischemic efficiency of nebivolol in patients with stable angina pectoris. Material and methods. After days of control period 50 randomly selected patients began to take nebivolol in initial dose of 5mg once daily and 50 patients started to take metoprolol in initial dose of 50 mg twice daily.

Duration of treatment was 8 weeks. Efficiency of treatment was assessed according to the results of control treadmill assessment and control daily ECG monitoring. The sensitivity of the symptom angina pectoris as a marker of transient myocardial ischaemia in chronic stable angina pectoris. Therapeutic decisions in patients with angina pectoris are traditionally based on the history reported by the patient, since objective evidence of myocardial ischaemia during daily life is often not available. In this study, ambulatory ST segment monitoring was performed in 60 patients with a his In this study, ambulatory ST segment monitoring was performed in 60 patients The patients were grouped according to the results of exercise testing and coronary arteriography, and one group Pain and ST segment changes were best correlated in patients with a positive exercise test, positive angiography and who were not receiving Cada factor y elemento expuesto es categorizado.

High probability of disease in angina pectoris patients. Sex-related differences were statistically significant.

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Addition of at-rest ECG data results in some improvement, particularly A unique case of 'variant' angina pectoris has been observed in a patient with normal coronary arteries and typical chest pain appearing spontaneously at rest, and repeatedly provoked by ergonovine maleate 0. While saline solution could not provoke chest pain and treatment with a beta-blocking agent increased the frequency of ischemic attacks, a calcium antangonist therapy reduced and eventually eliminated the attacks. Thus, this case provides evidence for yet another aspect of a 'variant' form of angina pectoris: small vessel coronary artery spasm.

Update on ranolazine in the management of angina. Chronic stable angina CSA remains prevalent, and the goal of treatment is control of symptoms and reduction in cardiovascular events. Ranolazine is a selective inhibitor of the late sodium current in myocytes with anti-ischemic and metabolic properties. Multiple, randomized, placebo-controlled trials have shown that ranolazine improves functional capacity and decreases anginal episodes in CSA patients, despite a lack of a significant hemodynamic effect.

More recently, ranolazine has been shown to have beneficial and potent antiarrhythmic effects, both on supraventricular and ventricular tachyarrhythmias, largely due to its inhibition of the late sodium current. Randomized controlled trials testing these effects are underway. Lastly, ranolazine appears to be cost-effective due to its ability to decrease angina -related hospitalizations and improve quality of life. Keywords: ranolazine, chronic stable angina , coronary artery disease. Chronic stable angina CSA remains prevalent, and the goal of treatment is control of sym Mortality rates attributable to coronary heart disease have declined in recent years, possibly related to changes in clinical presentation patterns and use of proven secondary prevention strategies.

Sexual function in patients with chronic angina pectoris. Drugs for erectile dysfunction ED may be contraindicated with nitrates commonly used to treat patients with angina pectoris, and certain antianginal therapies may worsen ED. The American Heart Association and the Princeton Consensus Conference panel of experts recommend that patients with coronary artery disease and ED who experience angina pectoris undergo full medical evaluations to assess the cardiovascular risks associated with resuming sexual activity before being prescribed therapy for ED.

Short- and long-acting nitrates remain a contraindication with phosphodiesterase-5 inhibitors commonly used to treat patients with ED, and the benefits of the other antianginal therapies must be weighed against their effects on cardiovascular health and erectile function. In conclusion, patients with coronary artery disease and ED who wish to initiate phosphodiesterase-5 inhibitor therapy and need to discontinue nitrate therapy need treatment options that manage their angina pectoris effectively, maintain their cardiovascular health, and provide the freedom to maintain their sexual function.

Inmunodeficiencia y autoinmunidad constituyen 2 polos de la respuesta inmunitaria que pueden interrelacionarse con cierta frecuencia. Randomized double-blind comparison of metoprolol, nifedipine, and their combination in chronic stable angina. In a randomized double-blind study, treatment with either metoprolol, nifedipine, or their combination was compared for effects on ischemic variables and heart rate obtained during ambulatory monitoring in 42 patients with chronic stable angina. All patients had severe chronic stable angina It is concluded that metoprolol monotherapy, as well as its combination with nifedipine, effectively reduces total ischemic activity compared with placebo and nifedipine monotherapy.

Control of ischemic activity in chronic stable angina may have We evaluated the clinical significance of myocardial imaging using I p-iodophenyl methyl pentadecanoic acid BMIPP scintigraphy in patients with stable effort angina pectoris SAP and unstable angina pectoris UAP. We compared those BMIPP findings with myocardial perfusion images obtained with Tl and the regional wall motion determined by left ventriculography.

These results suggest that myocardial ischemic regions decreased BMIPP uptake show the disturbance of fatty acid metabolism and lead to abnormal wall motions. Such ischemic regions may be clinically severe state in patients with angina pectoris. To evaluate antianginal efficacy and safety of nicorandil for angina attack prevention and relief in patients with ischemic heart disease IHD and symptoms of stable angina class All patients received amlodipine 10 mg QD within 2 weeks.

For angina attack relief patients used nicorandil mg and in case of its inefficacy — nitroglycerin. In 2 weeks a Coronary spasm is involved in many clinical scenarios, such as stable angina , acute coronary syndrome, sudden cardiac death, non-ischemic cardiomyopathy, arrhythmia and syncope. In recent years, imaging tools such as computerized tomographic angiography, intravascular ultrasound or optical Patients with vasospastic angina represent a heterogeneous cohort of patients with regard to the extent of concomitant coronary atherosclerosis.

They share the common pathophysiological phenomenon Diabetes mellitus tipo 2 y osteoartritis primaria de rodilla. Effectiveness of acupuncture for angina pectoris: a systematic review of randomized controlled trials. The purpose of this systematic review is to assess the effectiveness of acupuncture for angina pectoris. Eleven electronic databases were searched until January The study included randomized controlled trials that the effectiveness of acupuncture alone was compared to anti- angina medicines in addition to conventional treatment and the effectiveness of a combination of acupuncture plus anti- angina medicines was compared to anti- angina medicines alone.

The trial selection, data extraction, quality assessment and data analytic procedures outlined in the Cochrane Handbook were involved. The study included 25 randomized controlled trials involving 2, patients that met our inclusion criteria. The pooled results showed that the number of patients with ineffectiveness of angina relief was less in the combined acupuncture-anti- angina treatment group than in the anti- angina medicines alone group RR 0.

Only four trials mentioned adverse effects. One trial found no significant difference between acupuncture and Chinese medicine, and three reported no adverse events. The quality of the trials was found to be low. The findings showed very low evidence to support the use of acupuncture for improving angina symptoms and ECG of angina patients.

However, the quality of the trials included in this study was low. Large and rigorously designed trials are needed to confirm the potential benefit and adverse events of acupuncture. The clinical problem in patients. The techniques and observations in these patients with coronary artery disease all suggest that acute transient regional myocardial ischemia is caused by a variety of mechanisms. Global variability in angina pectoris and its association with body mass index and poverty. In the absence of a previous global comparison, we examined the variability in the prevalence of angina across 52 countries and its association with body weight and the poverty index using data from the World Health Organization-World Health Survey.

The body mass index BMI was determined as the weight in kilograms divided by the square of the height in meters. The poverty index a standard score of socioeconomic status for a given country was extracted from the United Nations' statistics. The associations of angina with the BMI and poverty index were analyzed cross-sectionally using univariate and multivariate analyses. The prevalence of angina ranged from 2. Those participants with a BMI of poverty status was considered.

In conclusion, significant variations were found in the anginal rates across 52 countries worldwide. An increased BMI was significantly associated with the odds of having angina. Published by Elsevier Inc. Improving diagnosis and treatment of women with angina pectoris and microvascular disease. Farmakologi, hypertension, IHD, skeletal muscle fibre composition, muscle coenzyme Q10, ischaemic heart disease, effort angina , muscle fibre lesion, muscle ubiquinone Incidence and follow-up of Braunwald subgroups in unstable angina pectoris.

This study was performed to establish the prognosis of patients with unstable angina within the subgroups of the Braunwald classification. Among many classifications of unstable angina , the Braunwald classification is frequently used. However, the incidence and risk for each. Management of Ludwig's angina in pregnancy: a review of 10 cases Background: Ludwig's angina is a rapidly spreading cellulitis that may produce upper airway obstruction often leading to death. Aim: The present paper reviews the management of Ludwig's angina in the third trimester of pregnancy. The inherent dangers to the mother and her unborn child are highlighted.

Materials and To assess validity of adjuvant use of pumpan, a homeopathic compound, in patients with unstable angina pectoris and angina of effort functional class III-IV receiving conventional treatment. A direct open controlled trial for 15 months performed initially in hospital, then outpatiently, covered 49 patients with severe angina. Examination of the patients included evaluation of clinical condition and the disease course, lipid metabolism, hemostasis, blood plasma electrolytes, aminotransferases, echo-CG, bicycle exercise, rheoencephalography, ultrasonic dopplerography of head and neck vessels.

Pumpan produced a positive effect total nonspecific systemic resistance improved, number of hospitalizations reduced, intracardiac hemodynamics improved in some cases with severe angina. Homeopathic compound pumpan can be recommended in the treatment of severe angina to reinforce antianginal effect, improve the disease clinical course, to obtain a hypocoagulative and hypocholesterolemic effect, to normalize intracardiac hemodynamics, to raise myocardial performance and intracoronary reserve as well as nonspecific resistance of the body. Efficacy of anipamil, a phenylalkylamine calcium antagonist, in treatment of angina pectoris.

To evaluate the efficacy of anipamil, a phenylalkylamine calcium antagonist, in treatment of stable angina pectoris, we performed a randomized, double blind placebo-controlled, cross-over study. Inclusion criteria were a stable angina pectoris for at least 2 months, b an exercise test Nineteen patients were randomized to enter the study. In 3-week periods, they received either anipamil 80 mg once daily o. At the end of each period, an exercise test was performed. The number of angina pectoris attacks was significantly reduced during treatment with anipamil 80 mg p.

Patients with unstable chest discomfort and cardiac troponin I values below the decision limit of myocardial infarction were diagnosed as having unstable angina pectoris. The definition of acute coronary At median follow-up of 3. Age-adjusted log-rank statistics revealed Ventricular repolarization alterations in women with angina pectoris and suspected coronary microvascular dysfunction.

We compared T-wave morphology and QTc interval in women with angina pectoris with a control group as well as the associations with CMD. CMD might be an explanation Angina in patients with coronary artery disease is associated with worse quality of life; however, the relationship between angina frequency and resource utilization is unknown. Using data from the MERLIN-TIMI 36 trial, we assessed the association between the extent of angina after an acute coronary syndrome ACS and subsequent cardiovascular resource utilization among stable outpatients who completed the Seattle Angina Questionnaire at 4 months after an ACS and who were then followed for an additional 8 months.

Angina frequency was categorized as none score, ; patients , monthly score, 61 to 99; patients , weekly score, 31 to 60; patients , and daily score, 0 to 30; patients. Multivariable regression models evaluated the association between angina frequency and overall costs attributable to cardiovascular hospitalizations, outpatient visits and procedures, and medications. Angina monocitica con sovrainfezione da Prevotella denticola: caso clinico. Full Text Available Monocytic angina with superinfection of Prevotella denticola: clinical case Monocytic angina is a clinical sindrome caused by Epstein-Barr virus characterized by fever, pharyngitis, exudative tonsillitis, swollen lymphoglands, splenomegaly and hepatomegaly.

The inflamed pharynx and necrotic tonsils of infectious mononucleosis are subject to bacterial superinfection initially or during the course of the illness; the reduced PO2 tension and low oxidation-reduction potential that prevail in a vascular and necrotic tissues favour the growth of anaerobes. In this article we reported the clinical case of a ten years old children, who presented fever and tonsillopharyngitis; he was treated with cefotaxime and piperacillin, he did not improve in health. He was admitted to hospital Department of Otorhinolaryngology. The patient was treated with aminoglycoside tobramycin, piperacillin and cortisone; the clinical situation deteriorated.

Pus sample was collected from the tonsils and cultured. Children was treated with piperacillin-tazobactam, with rapid symptomatic relief. Consideraciones actuales. Exercise-based cardiac rehabilitation for adults with stable angina. A previous Cochrane review has shown that exercise-based cardiac rehabilitation CR can benefit myocardial infarction and post-revascularisation patients. However, the impact on stable angina remains unclear and guidance is inconsistent. To assess the effects of exercise-based CR compared to usual care for adults with stable angina.

We searched two trials registers, and performed reference checking and forward-citation searching of all primary studies and review articles, to identify additional studies. We included randomised controlled trials RCTs with a follow-up period of at least six months, which compared structured exercise-based CR with usual care for people with stable angina. Two review authors independently assessed the risk of bias and extracted data according to the Cochrane Handbook for Systematic Reviews of Interventions.

Two review authors also independently assessed the quality of the evidence using GRADE principles and we presented this information in a 'Summary of findings' table. Seven studies participants met our inclusion criteria. Trials had an intervention length of 6 weeks to 12 months and follow-up length of 6 to 12 months. The comparison group in all trials was usual care without any form of structured exercise training or advice or a no-exercise comparator.

The mean age of participants within the trials ranged from 50 to 66 years, the. Previous studies suggest that among patients with stable coronary artery disease, patients with diabetes mellitus DM have less angina and more silent ischemia when compared with those without DM. However, the burden of angina in diabetic versus nondiabetic patients after elective percutaneous coronary intervention PCI has not been recently examined.

We also examined the rates of antianginal medication prescriptions at discharge. A multivariable, repeated-measures Poisson model was used to examine the independent association of DM with angina over the year after treatment. Among elective PCI patients mean age, 65 years; At baseline and at each follow-up, patients with DM had similar angina prevalence and severity as those without DM. Patients with DM were more commonly prescribed calcium channel blockers and long-acting nitrates at discharge DM versus not: In the multivariable, repeated-measures model, the risk of angina was similar over the year after PCI in patients with versus without DM relative risk, 1.

Patients with stable coronary artery disease and DM exhibit a burden of angina that is at least as high as those without DM despite more antianginal prescriptions at discharge. These findings contradict the conventional teachings that patients with DM experience less angina because of silent ischemia. Ethnicity and smoking are well-known risk factors for the pathogenesis of coronary vasospasm. Oxidative stress induced by smoking plays a crucial role in coronary vasospasm, but is not enough to account for the pathogenesis of coronary vasospasm, indicating that genetic factors are strongly involved.

The study group comprised vasospastic angina patients VSAs , 61 microvascular angina patients MVAs and 61 non-responders NRs diagnosed by acetylcholine provocation test. This association was strongly influenced by gender in the MVA only. There were no significant associations between the other polymorphisms and coronary vasospasm.

Proyecto de creatividad literaria en el aula de Primaria. Role of ivabradine in management of stable angina in patients with different clinical profiles. In chronic stable angina , elevated heart rate contributes to the development of symptoms and signs of myocardial ischaemia by increasing myocardial oxygen demand and reducing diastolic perfusion time. Accordingly, heart rate reduction is a well-known strategy for improving both symptoms of myocardial ischaemia and quality of life QOL.

The heart rate-reducing agent ivabradine, a direct and selective inhibitor of the I f current, decreases myocardial oxygen consumption while increasing diastolic time, without affecting myocardial contractility or coronary vasomotor tone. Ivabradine is indicated for treatment of stable angina and chronic heart failure HF.

This review examines available evidence regarding the efficacy and safety of ivabradine in stable angina , when used as monotherapy or in combination with beta-blockers, in particular angina subgroups and in patients with stable angina with left ventricular systolic dysfunction LVSD or HF. Trials involving more than 45 patients receiving treatment with ivabradine have shown that this agent has antianginal and anti-ischaemic effects, regardless of age, sex, severity of angina , revascularisation status or comorbidities.

Evaluation of coronary hemodynamics and exercise Tl-myocardial scintigraphy in patients with vasospastic angina. To clarify the coronary hemodynamics and myocardial perfusion in patients with vasospastic angina , we performed exercise Tl-myocardial scintigraphy planar and SPECT in 72 patients and left coronary digital subtraction angiography DSA in 37 patients without significant organic coronary artery stenosis.

Coronary artery spasm was documented by coronary angiography in all patients. The left coronary circulation time CCT was prolonged in patients with vasospastic angina. The mechanism of prolonged CCT is still unknown, but we suspected that prolonged CCT was induced by increased peripheral coronary vascular resistance in patients with vasospastic angina. It was concluded that the peripheral coronary circulation was disturbed in patients with vasospastic angina , but its abnormal coronary circulation had no relation to location of spasm-induced vessels.

We concluded that impaired coronary microcirculation was taken a part of pathophysiology in vasospastic angina. Meta-analysis of acupuncture therapy for the treatment of stable angina pectoris. Angina pectoris is a common symptom imperiling patients' life quality. The aim of this study is to evaluate the efficacy and safety of acupuncture for stable angina pectoris. Clinical randomized-controlled trials RCTs comparing the efficacy of acupuncture to conventional drugs in patients with stable angina pectoris were searched using the following database of PubMed, Medline, Wanfang and CNKI.

Total 8 RCTs, including angina pectoris cases with patients received acupuncture therapy and patients received conventional drugs, were included. Acupuncture may be an effective therapy for stable angina pectoris. More clinical trials are needed to systematically assess the role of acupuncture in angina pectoris. Magnetic resonance imaging in patients with unstable angina : comparison with acute myocardial infarction and normals. The role of magnetic resonance imaging in characterizing normal, ischemic and infarcted segments of myocardium was examined in 8 patients with unstable angina , 11 patients with acute myocardial infarction, and 7 patients with stable angina.

Eleven normal volunteers were imaged for comparison. Myocardial segments in short axis magnetic resonance images were classified as normal or abnormal on the basis of perfusion changes observed in thallium images in 22 patients and according to the electrocariographic localization of infarction in 4 patients. T2 relaxation time was measured in 57 myocardial segments with abnormal perfusion 24 with reversible and 33 with irreversible perfusion changes and in 25 normally perfused segments.

T2 in abnormal myocardial segments of patients with stable angina also was not significantly different from normal. The data indicate that T2 prolongation is not specific for acute myocardial infarction and may be observed in abnormally perfused segments of patients with unstable angina. Effects of acupuncture in moderate, stable angina pectoris. In order to evaluate the effects of acupuncture in moderate, stable angina pectoris, 49 patients were randomized to either genuine or sham acupuncture. In sham acupuncture needles were inserted into points within the same spinal segment as in genuine acupuncture, but outside the Chinese meridian The effect was evaluated from exercise tests, anginal attack rate and nitroglycerin consumption.

There were no significant differences between the effects of genuine and sham acupuncture either on exercise test variables or on subjective variables. In patients receiving genuine acupuncture No significant changes were observed in patients receiving sham acupuncture. Nine of the patients could reduce opioid consumption and 14 out of 27 could cease their otherwise daily opioid consumption. In four In the first 22 patients in whom a unipolar electrode was introduced, displacement of the electrode and subsequent reoperation was a frequent problem. This problem disappeared after change to multipolar electrodes as slight changes in placing Salvianolate injection in the treatment of unstable angina pectoris.

Abstract Background: To systematically evaluate the clinical efficacy and safety of Salvianolate injection in the treatment of unstable angina pectoris UAP. Methods: Using literature databases, we conducted a thorough and systematic retrieval of randomized controlled trials RCTs that using Salvianolate injection for treating UAP. Results: A total of 22 RCTs with participants were included. An unusual case of typical angina which occurred on a long haul flight is presented.

This case is notable as this was the index presentation, with no previous symptoms prior to this. Physiological changes at altitude can be marked, and include hypoxia, tachycardia and an increase in cardiac output. These changes were enough to expose underlying angina in our patient. This was his index presentation, and there were no similar symptoms in the past. Background history included hypercholesterolaemia and benign prostatic hypertrophy only.

He led a rather sedentary lifestyle. A CT coronary angiogram showed significant disease in the proximal left anterior descending artery and proximal right coronary artery. He went on to have a coronary angiogram with invasive physiological measurements, which determined both lesions were physiologically significant. This is consistent with the IS policy of sealing its members off from political competition. It was likely that I would have left the IS at some point, but it should have been on my own terms. This is generally correct, but it leaves out a lot.

Globally the capitalists have been on the offensive for the past decade. The existence of the Soviet Union as a counterweight to the NATO imperialists strengthened the hand of various nationalists in their conflicts with imperialism and played a key role in the defeats of imperialism in China, Cuba and Vietnam. The ultimate collapse of the Soviet bloc led directly to a series of major concessions and retreats by leftist forces globally, e. Of course history did not come to an end when the Stalinist regimes did — the working class has continued to struggle.

But we must recognize that the recent significant struggles Ontario, France, South Korea have had a defensive character and that generally the level of political consciousness is far behind the level of struggle. The consciousness of the proletariat has been lowered, not raised, by the destruction of the Soviet Union which, while it was not genuinely socialist, was correctly seen by many workers as having an economy that, since , had operated outside the dictates of global capitalism.

The capitalists have also concluded that socialism is dead — which is one reason they are being so aggressive about take backs. Yes there are, but so what!? Bitterness does not equal class consciousness. Lenin said that class struggle does not automatically produce revolutionary consciousness. The working class, through its own struggles for existence, can only achieve trade-union consciousness — a form of bourgeois ideology. This is because working class struggle tends to be sectional and national.

The role of the vanguard party is to bring political class consciousness an understanding of history, of the various social classes and oppressed groupings in society and of the common interest shared by workers internationally to the most advanced workers from outside the framework of their own immediate experience:. It would have to be brought to them from without. The history of all countries shows that the working class, exclusively by its own effort, is able to develop only trade union consciousness, i.

The initial members of a communist movement will naturally come to revolutionary politics as intellectuals Marx, Engels, Lenin, and Trotsky all came from such backgrounds. Life on the shop floor may give workers a gut-level hatred of their boss, but it does not automatically give them an understanding of the operation of the capitalist system as a whole. This does not mean that workers cannot become Marxist revolutionaries, but to do so requires investigation independently of their work experience.

An unbalanced view of the state of the class struggle leads the IS to overestimate the possibilities for the left in general and itself in particular. There is an amazing contradiction between this definition of membership and the IS claim to be building a Leninist vanguard. This statement was edited out of further editions of the book, but it shows that the party question is not a question of principle for the IS, but one that changes according to the historical juncture.

Lenin argued for a high commitment to politics and activity as a criterion for membership? Now take a look at your branch membership list. The party question is the central one for revolutionaries. A real revolutionary group must be made up of serious people, committed to the revolutionary program. This defines the membership of a Leninist group.

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But in the IS you can be a lot of things — a feminist, a social democrat or an anarchist. These are all forms of bourgeois consciousness. It is the task of Marxists to argue with people like this, to win them away from such illusions — not to recruit them as they are and thereby dilute the organization. Only those who reject feminism, socialdemocracy or anarchism, and embrace Marxism, can be recruited. If you started a rock-climbing club, would you let people join who thought you should go scuba-diving instead?

The IS has too many people going in too many different directions. As a whole, they have no direction. This is what Lenin had to say about those who put artificial unity over political principle:. We are surrounded on all sides by enemies, and we have to advance almost constantly under their fire. We have combined, by a freely adopted decision, for the purpose of fighting the enemy, and not of retreating into the neighbouring marsh, the inhabitants of which, from the very outset, have reproached us with having separated ourselves into an exclusive group and with having chosen the path of struggle instead of the path of conciliation.

And now some among us begin to cry out: Let us go into the marsh! And when we begin to shame them, they retort: What backward people you are! Are you not ashamed to deny us the liberty to invite you to take a better road! Oh, yes, gentlemen! You are free not only to invite us, but to go yourselves wherever you will, even into the marsh.

In fact, we think that the marsh is your proper place, and we are prepared to render you every assistance to get there. This is not possible without general participation in party activities. This requires clarity with organizational decisiveness. An organization built in this way is doomed either to be bypassed by great events or to betray. This ensured that at critical moments they could not offer decisive revolutionary leadership to the working class. The IS leadership knows this history, but is incapable of drawing the operational conclusions.

The priority of revolutionaries must be to forge a politically principled vanguard of the working class. Such groups can never lead a working-class revolution. Being a revolutionary is not easy. You have to raise a revolutionary program to be able to win people to revolutionary politics. By , when the brutalized, impoverished, war-weary Russian proletariat understood that the Bolsheviks had told them the truth there was a mass radicalization that turned the Bolsheviks into a mass party and led directly to the October Revolution.

In the Gulf War, the IS abandoned the Leninist position of military defence of Iraq so that they could enter anti-war coalitions with their liberal-left milieu. Because of their lack of political principles, they would not distinguish between an imperialist power US and an imperialist victim Iraq.

The IS, in this case, bowed to the pressure of bourgeois ideology. But in the early s, when Lenin advanced this tactic, there was a wide layer of militant workers following the recently created Labour Party. How different the situation is today! The NDP and New Labour retain a connection to the union bureaucracy, but they do not even pretend to run on a working-class programme.

They are very clear that capitalism has nothing to fear with them in power — as they have proven time and again. The task of revolutionaries is to break illusions. But for supposed Marxists to call for voting for the social democrats when they run on an overtly pro-capitalist programme and point to their record of union-bashing and attacks on the poor and oppressed can only create illusions.

The document goes on:. In the middle of the Bob Rae years of despair, when thousands were leaving the party, we argued against the stream to still vote for the NDP. Our vote has nothing to do with its record. It is the only party that is based on the union movement and not the corporations. This is an astounding statement, when you think of it. But secondly because it so brazenly admits that its electoral support to the NDP has nothing to do with the existence of illusions of the workers, but merely the fact that it is connected to the labour bureaucrats.

The Steering Committee document continues:. But not the IS leadership! The NDP in power had hung itself — the best elements in its base were melting away were. Yet still the IS supported the social democrats. This is exactly the opposite of what Lenin advocated. Instead of seeking to rally some of the thousands of workers who were deserting the NDP in disgust at its betrayals, and direct them to the left into supporting independent labour candidates against NDPers who backed the hated Social Contract, Socialist Worker used its credentials to try to corral left-wing voters for Rae.

But we do not support the NDP. But when there is no such layer because the social democracy is so nakedly pro-capitalist, then there is no reason for revolutionaries to call for militant workers to vote for it. In fact, by doing so, Marxists can actually help create illusions among leftist workers that there is some reason to still vote NDP. Despite all the fine talk about working class independence, the IS bottom line is always determined by popularity. Their new position is nothing but commentary.

So they water things down. Democratic Centralism or Bureaucratic Centralism? And the IS leadership is very resistant to any kind of fundamental political discussion. Any opposition to the leadership is taken care of very quickly, and in a way designed to prevent serious political discussion. In Vancouver, the Steering Committee recently split the branch to isolate a democratically elected branch leadership. In my own case, it took only slightly more than a month to expel me after it became known that I was developing differences.

The lack of democracy is particularly clear in the way the international group runs. The IS internationally is a bureaucratic centralist organization. The individual members at the national level have no say in determining the international line of the group. Periodic delegated international conventions and an elected international leadership as in the Fourth International under Trotsky could provide the possibility of democratically evaluating and correcting the line of the group.

Trotsky stood for a democratic centralist international:. The means used to short-circuit serious political debate internally are also extended in an attempt to shelter ISers from political discussion with people outside the group as well. Organizations such as the Trotskyist League and the Bolshevik Tendency are excluded from all IS public meetings purely on the basis of their politics — to avoid any uncomfortable questions they might raise.

I admit that I once agreed with, and participated in, the IS exclusion policy. I regret this and now reject this policy percent. I also regret and repudiate anything I may have said in ignorance about these groups in the past. The IS policy is not even limited to the groups standing furthest to its left.

They are poison, and we have to turn our back hard on them. It is a distraction for us to be spending time analyzing their politics, discussing their paper, etc. It sucks us into the otherworldly milieu of the small sects. For similar reasons the IS generally avoids or at least tries to minimize situations where its members end up working closely with members of other groups even when they share a common objective like to defend Mumia Abu Jamal.

If the politics of all the other groups were indeed so irrelevant to the issues facing the working class there would not be much need for discussion. But the fact is that they often discuss the same issues that the IS does, even if they sometimes draw different conclusions or propose different tactics. Whether they are right or wrong on a particular question, a policy of simply refusing to read, discuss or debate with them is not aimed at helping develop a rounded Marxist consciousness — it can only tend to prevent IS members from seriously thinking about politics.

IS members should ask themselves why the writings of all the great revolutionaries Marx, Lenin and Trotsky are full of polemics and political criticisms of other leftists. Marxism is a science. A science can only develop if all shades of opinion are able to be heard. I believe that the revolutionary left would be in much better shape if differences were debated thoroughly and openly. Political exclusions and attempts to prevent your members from reading or discussion other points of view on the left only make sense if you have something to hide.

It is very important to know the history of the Marxist movement and particularly of your own organization. Most members pick up this information informally in bits and pieces. In fact they were not capitalist — which is why the US was so hostile to it. One thing that Tony Cliff and the IS leadership have never been able to explain is why, if is was incorrect to call for a victory of the North Korean Stalinists against the US and its South Korean puppets in the s, was it okay to support the North Vietnamese Stalinists against the US and its South Vietnamese puppets 15 years later?

The forces involved in the two conflicts were virtually identical. The only thing that was different — and for the IS this is decisive — was the degree of popularity. In the early s the Cold War was at its height and there was a massive wave of anticommunist hysteria. This was clearly a direct result of the enormous ideological pressures of McCarthyism bearing down on the left.

But by the late s, with the New Left, the Vietnamese were popular with the radicalizing students the IS sought to recruit. So Cliff switched the IS line to defending the popular Stalinists against imperialism. Trotsky said that opportunists always know which way the wind is blowing. I would like to make it clear that I have no personal animosity toward comrades in the IS.

I know there are plenty of dedicated people in the group who really want to be communists and to fight to change the world. Unfortunately, they are in the wrong organization. They are like chickens with their heads cut off — running around a lot, but not really getting anywhere. The raw, relatively politically inexperienced people who are constantly being recruited to regenerate the group have the advantage of making it very easy for the regime to get what it wants internally. In the last few months, I have done some reading about other groups which took a similar approach in the past.

Some of them grew to thousands of people, but ultimately fell apart because what holds a group together is the set of ideas, the program, shared by the members. Groups like the IS which place a higher value on short-run success than winning influence for their ideas, end up spitting out a lot of good people, many of who drift away from the left.

The only way to build a serious group is on the basis of a serious, consistently revolutionary program and consistently politically principled activity. Being small is no virtue, but it is better to have a revolutionary group of whatever size than a bigger revisionist one. Because a small revolutionary group has the possibility of one day leading to victory, whereas an opportunist one like the IS never can, no matter how big it gets. There are a lot of individuals in the IS who can have a large impact on the direction of the revolutionary left in this country.

But the road to revolution is a precipitous path and there are not shortcuts. It is sometimes difficult, but it is always necessary, to tell the working class the truth. A revolutionary group must have the courage to openly side with Iraq against Canadian imperialism in a military conflict in the Persian Gulf or to vote for leftist opponents of the capitalist ANC in South Africa. I declare for the International Bolshevik Tendency. The only possibility for the future of humanity on this planet is communism.

This can only come about through a proletarian revolution led by vanguard party. I look forward to future discussions with IS members about how such a party can be created. Estaba ansioso por que el fraccionalismo pasara y por volver al trabajo constructivo. Ese es un modo seguro de deshacer todo el trabajo constructivo de los militantes sindicales y otros activistas en un lapso de tiempo relativamente corto. Esas cosas han sucedido anteriormente. Si alguna vez ha habido un hombre de buena voluntad, ese fue Debs; era alguien que se entregaba, un trabajador constructivo, un constructor.

Debs no soportaba las disputas. Pensaba que su influencia en el movimiento de masas, su popularidad entre los miembros del partido, el entusiasmo revolucionario que generaba cada vez que hablaba, eran suficientes para darle forma al curso del partido. Pero estaba equivocado. Y fue por eso que al final su gloria fue ensombrecida por la tragedia. Su trabajo de masas tiene poca utilidad y poco sentido sin el partido. El mundo conoce a Marx como el autor de El capital. La lucha por el socialismo es impensable sin una lucha por hacer revolucionarios a los sindicatos.

Eso es lo que le da una importancia tan trascendente al trabajo partidista en los sindicatos. Pero en el fondo no es una disputa personal, y no hay manera de evitarla. Lo permea todo en la sociedad presente. Pero lo era, y lo recordamos bien. No se la puede evitar por las siguientes razones:. En el lenguaje leninista, tal procedimiento siempre se ha considerado como una ofensa criminal contra el partido.

En nuestro movimiento tales combinaciones siempre se han considerado antileninistas. Esto no es accidental. Buenos Aires, Ed. Cartago, , p. El apoyo de Marx a Bismarck1 en la guerra franco-prusiana estaba dictado por consideraciones similares. Ambas combatieron unidas [en la batalla para vencer] la resistencia de la vanguardia del proletariado.

Akira Iriye con The Human Rights Revolution: An International History Gratis Libros

Una vez conseguido esto, cerraron una contra otra en feroz acometida. Quien disponga del producto sobrante cuenta con el poder del Estado. Buenos Aires, Editorial El Yunque, , p. Y este desarrollo no parece tener fin. Pero siempre se conservan algunas de tales conquistas.

Creemos que esto demuestra suficientemente que Cliff ha tomado una cita del Stalin de Trotsky y la ha sacado fuera de contexto. Cuando estudiamos la historia de Francia, vemos la variedad de formas, gobiernos y superestructuras que se desarrollaron en el transcurso de la lucha de clases. El Viejo era muy claro. Continuemos donde se detuvo Cliff:. El subrayado es nuestro. Encuentra la base de la ley del valor, no en la sociedad rusa, sino en el entorno capitalista mundial. Y esto se aplica para todas las formas de sociedad.

Simplemente plantea lo que debe ser demostrado. Por otro lado dice:. El subrayado en el original. La diferencia es que mientras en la sociedad capitalista se manifiesta a ciegas por las leyes del mercado, en Rusia la actividad consciente juega un papel importante. Cliff dijo antes que la ley del valor no funcionaba en Rusia. A estas preguntas Cliff da dos respuestas contradictorias. Algunas de las leyes del capitalismo se aplican y otras son anuladas. Por ejemplo, Trotsky argumenta:. La ley del valor no es eliminada, sino que es modificada.

Uno es un esclavo basado en el trabajo esclavo, el otro es un esclavo asalariado. Presenta material interesante demostrando las tremendas cargas que el impuesto sobre el volumen de negocios impone a las masas. Cliff muestra como el impuesto sobre el volumen de negocios se aplica en Rusia. Ese debe ser el punto de partida. A este respecto, Cliff no es del todo coherente.

Dice que la ley del valor no funciona y, por tanto, tampoco lo hacen todas las leyes que emanan de ella. Desde luego. Cliff escribe:. Cuando alcanza una cierta etapa tenemos relaciones capitalistas con una superestructura feudal. Para librarse de estas restricciones, las fuerzas productivas tienen que organizarse sobre una base diferente y toda la historia humana y su movimiento, consiste en el desarrollo de este antagonismo en sus diversas etapas en diferentes sociedades.

Obras Completas, Volumen 27, p. Abstraer una parte conduce al error. Los obreros siguen siendo asalariados, proletarios. Sin embargo, esto no se puede hacer de golpe. La forma transitoria hacia esto es la propiedad estatal. Los elementos de la nueva sociedad que estaban creciendo dentro de la vieja, ahora se hacen dominantes. Lo que causa el conflicto dentro del capitalismo es que las leyes se manifiestan ciegamente. Antes de que pueda ser introducido el socialismo, debe necesariamente haber un tremendo desarrollo de las fuerzas productivas, muy superior al logrado bajo el capitalismo.

Y particularmente este era el caso en la Rusia atrasada. La ley del valor se aplica y debe aplicarse hasta que los productores tengan acceso directo al producto. En resumen. El dinero se difumina, la ley del valor se desvanece, el Estado se diluye. Y por muy buenas razones. Cliff responde a esto:. Pero examinemos el propio proceso de pensamiento de Cliff sobre esta materia.

Tanto la clase capitalista como el proletariado de Rusia han utilizado precisamente la misma maquina del Estado. Al hacer esto, cae en concepciones formalistas y abstractas sobre el Estado obrero anterior a En lugar de dedicarse a la tarea de demostrar su tesis, hace afirmaciones ciegas y las presenta como ya demostradas. Pero veamos sus conclusiones:. No hay forma de destituir tal casta excepto por la violencia revolucionaria. Cliff escribe lo siguiente:. Vemos como Cliff basa su caso en si la clase obrera tiene o no el control sobre la maquinaria estatal. Tomemos el ejemplo de Rusia.

No obstante, hay que tener cuidado al utilizar generalizaciones marxistas, que indudablemente son correctas, en un sentido absoluto. La verdad es siempre concreta, pero si no analizamos las ramificaciones particulares y las circunstancias concretas, inevitablemente llegaremos a errores y abstracciones. En todo el material de Cliff, olvida el hecho de que el Estado en determinadas condiciones puede jugar y juega un papel relativamente independiente en la lucha entre las clases. De nuevo contrastamos esto con lo que dice Engels:.

Por las mismas razones mencionadas arriba, en determinadas condiciones, el Estado consigue una cierta independencia de la base que originalmente representaba. Los formalistas normalmente se pierden en uno u otro lado del problema. Por ejemplo Cliff escribe:. Se necesita una alta dosis de acrobacia mental para responder a esto. Debido a esto, los maestros marxistas explicaron que a la larga la superestructura debe estar en correspondencia con ella.

Tomemos un caso extremadamente rico en ejemplos, la historia de Francia. En los jacobinos6 acapararon todo el poder. Estas revoluciones tuvieron consecuencias sociales importantes. Conllevaron cambios significativos incluso en el propio personal del Estado. Se pueden dar muchos ejemplos en la historia de la manera en que un sector de la clase dominante ataca a otro sector de la misma.

No puede representar a la clase capitalista porque ha sido expropiada. La respuesta de Cliff es que la burocracia constituye la nueva clase dominante, la clase capitalista de Rusia. Los hombres se dividen en gobernados y en especialistas en gobernar, que se colocan por encima de la sociedad y son llamados gobernantes, representantes del Estado.

Esto claramente es un sin sentido. En el mejor de los casos ellos tiene derecho a salarios de superintendencia. Pero no eran una clase. Esto no les convierte en una clase dominante. Porque estaban defendiendo la propiedad privada. Cliff afirma que la burocracia dirige y planifica la industria. En la sociedad capitalista, los directores planifican y dirigen la industria en las empresas y trust individuales. Pero esto no les convierte en propietarios de esas empresas. La burocracia dirige toda la industria.

Tomemos dos ejemplos: Bulgaria y Checoslovaquia. El poder real estaba en manos de la clase obrera. Seleccionaron el personal clave y dirigente. El proceso era tan claro como el agua en el caso de Checoslovaquia. Pero el poder decisivo, por ejemplo, los cuerpos armados de hombres, estaban organizados por ellos y bajo su control. Los estalinistas armaron a los trabajadores, organizaron una milicia obrera. Los partidos estalinistas tienen todas las ventajas sobre la Cuarta Internacional —un aparato estatal, organizaciones de masas, dinero, etc.

Cliff ha hecho las preguntas a las personas equivocadas. Ellos simplemente prepararon el terreno para el dominio del nuevo Estado de la clase capitalista. Esa era una variante posible. Contrasta el amplio punto de vista de Lenin con el mecanicista de Cliff. Entonces, la dictadura del absolutismo se debilita.

Extracto de Workers Vanguard No. El mes pasado cuando Decenas de miles han muerto en la lucha. Las figuras principales en el derrocamiento de Somoza han sacado, cada una a su manera, algunas lecciones de esta historia en sus intentos de evitar una nueva Cuba. Entre ellas, un factor decisivo fue la beligerancia de los EE. Al mismo tiempo, los dirigentes norteamericanos no se disponen a entregar un cheque en blanco a los sandinistas.

Managua ha pedido que los EE. Parece que los guerrilleros sandinistas han entregado a los representantes burgueses la mayor parte del poder gubernamental. Pero el verdadero poder no se ubica en estos ministerios. Nicaragua se va a convertir en una nueva Nicaragua, que es una cosa muy distinta. Un ascenso de lucha social combativa desde abajo p. Una de las primeras medidas de la junta revolucionaria fue de mandar que todos los civiles entregaran los fusiles, muchos de ellos adquiridos cuando los guardias abandonaron en masa sus armas.

Dado el caos revolucionario, es poco probable que este decreto se haya cumplido. Las expropiaciones no deben ser limitadas solamente a la propiedad de Somoza. Informe del PDC — agosto de Mientras utilizamos todos los procedimientos legales disponibles, no tenemos confianza en la justicia de las cortes, sino que al contrario confiamos en la fuerza de la protesta de las masas. Agradecemos el apoyo de todos en esta lucha. As we can see from the editorial, the CP of Palestine has not escaped the nationalist hysteria in both camps, and has split into two national parties.

Only the Palestinian Trotskyists have maintained the Socialist position by calling upon Jewish and Arab workers to break away from the class enemies within their ranks and conduct their independent struggle against imperialism. Politicians and diplomats are still trying to find a formula for the disastrous situation into which Palestine has been plunged by the UNO deciding upon partition. As far as we are concerned there is no point in this distinction.

We are daily witnessing the killing or maiming of men and women, old and young, Jew or Arab. As always, the working masses and the poor suffer most. Not so very long ago the Arab and Jewish workers were united in strikes against a foreign oppressor. This common struggle has been put to an end. Today the workers are being incited to kill each other. The inciters have succeeded. As if this communal strife were not the very instrument by which partition is brought about! It was easy for the imperialists to foresee that and well may they be satisfied with the course of events.

Britain was a loser in the last world war. She has lost the bulk of her foreign assets. Her industry is lagging behind. Building up her productive apparatus requires dollars and manpower. Partition will release her from her financial obligations, enable her to employ her soldiers in the productive process while her source of income will remain intact. By partition a wedge is driven between the Arab and Jewish worker. The price Britain has to pay for the advantages gained by partition is to renounce her ruling monopoly in this country. On the other hand, Wall Street has to come out into the open and contribute its share toward the foul business of safeguarding imperialist positions.

Partition, therefore, is a compromise between the imperialist robbers arising from a changed power constellation. However, they dodged — the problem was passed on to the UNO. And the Soviet Union? Why did not her representative call the UNO game the swindle it really is? Yet it is the same unsavory dish that has been set for India, Greece and Indo-China. The Zionists were overcome with a sense of triumph when offered the bone by the UNO cooks. Now they saw their chance. Of course, not for nothing.