Abstract Introduction: Antiplatelet therapy after coronary artery bypass graft (CABG) has been used. Little is known about the predictors and efficacy of clopidogrel in this scenario. Objective: Identify predictors of clopidogrel following CABG. Methods: We evaluated 5404 patients who underwent CABG between 2000 and 2009 at Duke University Medical Center. We excluded patients undergoing concomitant valve surgery, those who had postoperative bleeding or death before discharge. Postoperative clopidogrel was left to the discretion of the attending physician. Adjusted risk for 1-year mortality was compared between patients receiving and not receiving clopidogrel during hospitalization after undergoing CABG. Results: At hospital discharge, 931 (17.2%) patients were receiving clopidogrel. Comparing patients not receiving clopidogrel at discharge, users had more comorbidities, including hyperlipidemia, hypertension, heart failure, peripheral arterial disease and cerebrovascular disease. Patients who received aspirin during hospitalization were less likely to receive clopidogrel at discharge (P≤0.0001). Clopidogrel was associated with similar 1-year mortality compared with those who did not use clopidogrel (4.4% vs. 4.5%, P=0.72). There was, however, an interaction between the use of cardiopulmonary bypass and clopidogrel, with lower 1-year mortality in patients undergoing off-pump CABG who received clopidogrel, but not those undergoing conventional CABG (2.6% vs 5.6%, P Interaction = 0.032). Conclusion: Clopidogrel was used in nearly one-fifth of patients after CABG. Its use was not associated with lower mortality after 1 year in general, but lower mortality rate in those undergoing off-pump CABG. Randomized clinical trials are needed to determine the benefit of routine use of clopidogrel in CABG.

El bullying es definido como un abuso sistemático de poder. El desarrollo del programa de investigación sobre bullying escolar está delineado en cuatro fases. La naturaleza distinta del cyberbullying, y también de la identidad basada en el bullying, son subrayados. Se discuten los métodos de medición y los tipos de tasas de prevalencia obtenidos. Se encuentran resumidos un conjunto de factores de riesgo para la transformación como un agresor, o víctima. Una serie de intervenciones centradas en la escuela son descritas, conjuntamente con la discusión de un meta-análisis de sus resultados. En resumen, la investigación y la práctica van de la mano en la pesquisa analizada, y tuvieron algún éxito por lo menos en reducir lo que es un problema significativo en la vida de muchos niños.

O bullying é definido como um abuso sistemático de poder. O desenvolvimento do programa de pesquisa sobre bullying escolar é delineado em quatro fases. É sublinhada a natureza distinta do cyberbullying, e também da identidade baseada no bullying. Discute-se os métodos de medição e os tipos de taxas de prevalência obtidos. Enuncia-se um conjunto de fatores de risco para o envolvimento como agressor/vítima. Descreve-se uma série de intervenções centradas na escola juntamente com a discussão de uma meta-análise dos seus resultados. Em resumo, a investigação e a prática têm andado a par na pesquisa analisada, e tiveram algum sucesso pelo menos em reduzir o que é um problema significativo na vida de muitas crianças.

Le harcèlement est défini comme un abus systématique de pouvoir. Le développement du programme de recherche sur le harcèlement à l’école se décline en quatre phases. La nature distincte du cyber-harcèlement, ainsi que de l’identifié fondée sur le harcèlement, est soulignée. Les méthodes de mesure sont discutées et les types de taux de prévalence obtenus. Un ensemble de facteurs de risque pour devenir un harceleur ou une victime sont énoncés. Une série d’interventions centrées sur l’école sont décrites, avec la discussion d’une méta-analyse des résultats. En résumé, la recherche et la pratique se côtoient dans la recherche analysée, et elles ont du moins contribué à réduire un problème important dans la vie de beaucoup d’enfants.

Bullying is defined as a systematic abuse of power; the development of the research program on school bullying is outlined over four phases. The distinctive nature of cyberbullying, and also of identity-based bullying, is outlined. Measurement methods are discussed, and the kinds of prevalence rates obtained. A range of risk factors for involvement as a bully, or victim, are summarized. A range of school-based interventions are described, together with discussion of a meta-analysis of their outcomes. In summary, research and practice have gone hand-in-hand in the research reviewed, and have had some success in at least reducing what is a significant problem in the lives of many children.