Abstract

Dipyridamole-induced stress myocardial perfusion scans (MPS) has been widely used for management of coronary artery disease. The adverse effects of dipyridamole and other stress agents have been evaluated. The aim of this research is to confirm the dynamic data on dipyridamole side effects during MPS. We collected data of 183 patients who underwent dipyridamole-induced stress MPS by retrospectively reviewing their clinical records, which included the severity of dipyridamole side effects in 3 min, 10 min, and 20 min after infusion. The incidence and severity at all three points, including the effect of age and gender, were obtained. Adverse effects occurred in 96 patients (69.6%). The most frequent symptoms were dizziness (42.8%), chest tightness (24.6%), abdominal pain (18.1%), and headache (15.2%). Most symptoms were Grade 1 to 2, according to the grading system for common terminology criteria. The median duration of symptom persistence was 36 min, not significantly different among age and gender. This study demonstrates that the adverse effects of dipyridamole were generally minimal and its duration was acceptable for clinical usage.

Abstract

The use of mycophenolate mofetil (MMF) for a variety of immune-mediated diseases in veterinary medicine has been described. However, there is only a small number of cases documenting its use in dogs with meningoencephalomyelitis of unknown aetiology (MUE). We hypothesized that the use of MMF and corticosteroids in dogs with MUE results in comparable survival data to other published treatment protocols and is associated with limited adverse effects. A retrospective study of medical case records of dogs clinically diagnosed with MUE recorded signalment, neuroanatomic localization, magnetic resonance imaging findings, cerebrospinal fluid analysis results, medications administered, follow-up neurologic examinations, survival and adverse events. Variables were compared between dogs which were treated with MMF within 30 days of diagnosis (immediate group) vs. dogs in which MMF therapy was started >30 days after diagnosis (delayed group). Twenty-five cases of MUE were identified. The overall median survival time from diagnosis was 731 days (range 43–1672 days). After 1 month of MMF treatment, 92% of dogs showed improvement on a neurological examination. There was no significant effect of any recorded parameter on survival, including delayed vs. immediate initiation of MMF treatment. Dogs with delayed treatment had significantly lower clinical remission rates than dogs with immediate treatment at 6 months after starting MMF. Adverse events were identified in two cases (8%) and were characterized by mild gastrointestinal signs (vomiting and decreased appetite). Administration of MMF appears safe in dogs with MUE. The use of MMF results in comparable survival times to alternate immunosuppressive protocols.

Abstract

The devastating civil war in Syria is arguably one of the major civil conflicts in recent times. The conflict started with protests in March 2011 and soon after escalated to a violent internal war with no end in sight to this date. The conflict has by the end of 2014 caused well in excess of 150,000 fatalities, and 6 million internally displaced people (UN), and led 3 million refugees to move out of the country (UNHCR). Beyond the human tragedy, the conflict has disrupted the functioning of the economy in many ways. It has destroyed infrastructure, prevented children from going to school, closed factories and deterred investments and trade. The economic effects of the war extend beyond the country’s borders affecting also the neighboring countries. In particular trade is one of the main channels through which the effects of the crisis are transmitted to neighboring countries. For example, the demand for goods and services in Syria is likely to have fallen thus affecting the many exporters to Syria in neighboring countries. Moreover, to the extent that Syria has become harder to cross, the war may have made trade through Syria more difficult. At the same time producers in neighboring countries may have replaced Syrian producers in Syria and in other markets as their productive assets in Syria were destroyed. This report examines the effects of the Syrian war on the Lebanese economy via one of the most important channels through which the economic impact of the war occurs, i.e. the trade channel. In doing so, it partly updates and extends the previous economic assessment of World Bank (2013b) carried out last year. Focusing specifically on trade allows us to examine in more depth the trade effects than that report was able to do. Indeed, we go beyond the effects on aggregate and sectoral imports and exports to also examine the effects on exports at firms’ level, comparing the effects in Lebanon with those in other neighboring countries, including Jordan, Turkey and Iraq.

Abstract

The objective of this study is to assess the impact of the East-West Highway improvement program on Georgia’s ability to access international markets. As highlighted extensively in the literature, improving transport infrastructure and the efficiency of the logistics sector can help countries gain competitiveness in international export markets, which can translate into faster economic growth and higher income. This study hypothesizes that investments in the EWH have reduced the cost of shipping Georgian goods to the rest of the world, and such reductions should be more significant for goods transported by road. To estimate the effect of cost reductions generated by improvements in the EWH, a gravity-type model in first-differences has been estimated. The results show that: (i) a 10 percent increase in the length of upgraded road network predicts a 1.1 percent increase in exports transported by road while no significant effect is estimated for exports on other transport modes (rail, sea, and air); (ii) the resulting increase in exports by road was reflected by a decrease in exports transported by sea; (iii) the effect is statistically and economically significant only for customs offices located along the EWH; (iv) only exports of time-sensitive products responded positively and significantly to improvements in the EWH during the 2006-2015 period; (v) upgrading the entire EWH is estimated to generate additional export revenues between USD 776 million and USD 1,466 million. It is important to note that the overall trade generating effect of the investment is expected to be somewhat lower as the results suggest some substitution between road and sea transport, but the overall impact is a significant boost to exports.

Abstract

In this context, this note summarizes the findings of a recent World Bank, SACU Secretariat assessment of regional trade facilitation based on the Trade and Transport Facilitation Assessment (TTFA) methodology. The assessment looks at regional trade facilitation through the lens of value chains, with the objective to understand how the region’s trade and transport environment could be improved to facilitate more extensive and deeply integrated regional trade, linked to competitive participation in global value chains. The remainder of this note is structured as follows: section two provides a brief overview of regional trade and freight flows. This is followed in section three by a brief review of the trade and transport environment (including infrastructure and policy) across each SACU member state. Section four summarizes the findings of the detailed analysis, from a trade facilitation perspective, of the regional value chains in four key industry sectors: agro-processing; agro-processing; automotive; beef; and textiles/apparel. Section five then focuses on identifying potential solutions to three key trade and transport facilitation challenges identified through the value chain assessments. Finally, section six concludes.

Abstract

This Cameroon economic update, the World Bank is launching a program of short, crisp and more frequent country economic reports. These economic updates will analyze the trends and constraints in Cameroon's economic development. Each issue, produced bi-annually, will provide an update of recent economic developments as well as a special focus on a selected topical issue. The economic updates aim to share knowledge and stimulate debate among those interested in improving the economic management of Cameroon and unleashing its enormous potential. The notes thereby offer another voice on economic issues in Cameroon, and an additional platform for engagement, learning and change. The report's special focus on the telecommunication sector. Cameroon has been hit by the global economic and financial crisis over the past two years, as reflected in steep declines in the price and demand for its export commodities including oil, timber, rubber, cotton and aluminum. However, the upturn in the global economy and measures taken by the authorities to stimulate domestic production, preliminary indications suggest that economic activity is recovering. Gross domestic product (GDP) growth in 2010 is estimated to have reached 3 percent on the back of stronger non-oil activities, which expanded by about 4 percent (particularly food crops, forestry, construction, transport, and telecoms). Data on private credit growth corroborate this assessment. Cameroon is a relatively small and mature oil producer, where oil production is declining. Depleting reserves, aging equipment, and more recently postponements of some development projects and investments because of the financial crisis explain this profile. The contribution of this sector to GDP growth has been mostly negative in recent years: oil production is estimated to have contracted by a further 16 percent in 2010 (to 23.2 million barrels).