Argentina (AR) Body Contouring

Following independence from Spain in 1816, Argentina experienced periods of internal political conflict between conservatives and liberals. In the first decade of the 20th century, Argentina became the richest nation in Latin America, its wealth symbolized by the opulence of its capital city.

European immigrants flowed into Argentina, particularly from Italy; by 1914 nearly 6 million people had come to the country.

After World War II, a long period of Peronist rule in subsequent governments was followed by a military junta that took power in 1976.

Democracy returned in 1983 after the abortive attempt to wrest the Falkland Islands (Islas Malvinas) from United Kingdom sovereignity.

A painful economic collapse at the turn of the 21st century devalued the Argentine peso by a factor of three and ushered in a series of weak, short-lived governments along with social and economic instability. As of 2006, the country has stabilized under President Nestor Kirchner, and the economy has begun to recover.

Context  Abciximab infusion and uncoated-stent implantation is a complementary treatment strategy to reduce major adverse cardiac events in patients undergoing angioplasty for ST-segment elevation myocardial infarction (STEMI). It is uncertain whether there may be similar benefits in replacing abciximab with high-dose bolus tirofiban. Similarly, the use of drug-eluting stents in this patient population is currently discouraged because of conflicting results on efficacy reported in randomized trials and safety concerns reported by registries.

Objective  To evaluate the effect of high-dose bolus tirofiban and of sirolimus-eluting stents as compared with abciximab infusion and uncoated-stent implantation in patients with STEMI undergoing percutaneous coronary intervention.

Design, Setting, and Patients  An open-label, 2 x 2 factorial trial of 745 patients presenting with STEMI or new left bundle-branch block at 16 referral centers in Italy, Spain, and Argentina between October 2004 and April 2007.

Interventions  High-dose bolus tirofiban vs abciximab infusion and sirolimus-eluting stent vs uncoated stent implantation.

Main Outcome Measures  For drug comparison, at least 50% ST-segment elevation resolution at 90 minutes postintervention with a prespecified noninferiority margin of 9% difference (relative risk, 0.89); for stent comparison, the rate of major adverse cardiac events, defined as the composite of death from any cause, reinfarction, and clinically driven target-vessel revascularization within 8 months.

Results  ST-segment resolution occurred in 302 of 361 patients (83.6%) who had received abciximab infusion and 308 of 361 (85.3%) who had received tirofiban infusion (relative risk, 1.020; 97.5% confidence interval, 0.958-1.086; P < .001 for noninferiority). Ischemic and hemorrhagic outcomes were similar in the tirofiban and abciximab groups. At 8 months, major adverse cardiac events occurred in 54 patients (14.5%) with uncoated stents and 29 (7.8%) with sirolimus stents (P = .004), predominantly reflecting a reduction of revascularization rates (10.2% vs 3.2%). The incidence of stent thrombosis was similar in the 2 stent groups.

Conclusions  In patients with STEMI undergoing percutaneous coronary intervention, compared with abciximab, tirofiban therapy was associated with noninferior resolution of ST-segment elevation at 90 minutes following coronary intervention, whereas sirolimus-eluting stent implantation was associated with a significantly lower risk of major adverse cardiac events than uncoated stents within 8 months after intervention.

Trial Registration  clinicaltrials.gov Identifier: NCT00229515

Published online March 30, 2008 (doi:10.1001/jama.299.15.joc80026).

Who are the Ideal Candidates to Undergo Body Contouring?
The most common denominator that classify the ideal candidates in Argentina(AR) are those who are in good general health, yet are unsatisfied with their physical appearance, primarily by the presence of body fat that affects their self-concept. Their blood pressure should be normal. Their heart should be in good condition.