Two-year angiographic and intravascular ultrasound follow-up after implantation of sirolimus-eluting stents in human coronary arteries

BACKGROUND: The safety and efficacy of sirolimus-eluting stenting have been demonstrated, but the outcome of patients treated with this novel technology beyond the first year remains unknown. We sought to evaluate the angiographic, intravascular ultrasound (IVUS), and clinical outcomes of patients treated with sirolimus-eluting stents 2 years after implantation. METHODS AND RESULTS: This study included 30 patients treated with sirolimus-eluting Bx Velocity stenting (slow release [SR], n=15, and fast release [FR], n=15) in Sao Paulo, Brazil. Twenty-eight patients underwent 2-year angiographic and IVUS follow-up. No deaths occurred during the study period. In-stent late loss was slightly greater in the FR group (0.28+/-0.4 mm) than in the SR group (-0.09+/-0.23 mm, P=0.007). No patient had in-stent restenosis. At 2-year follow-up, only 1 patient (FR group) had a 52% diameter stenosis within the lesion segment, which required repeat revascularization. The target-vessel revascularization rate for the entire cohort was 10% (3/30) at 2 years. All other patients had < or =35% diameter stenosis. Angiographic lumen loss at the stent edges was also minimal (in-lesion late loss was 0.33+/-0.42 mm [FR] and 0.13+/-0.29 mm [SR]). In-stent neointimal hyperplasia volume, as detected by IVUS, remained minimal after 2 years (FR= 9.90+/-9 mm3 and SR=10.35+/-9.3 mm3). CONCLUSIONS: This study demonstrates the safety and efficacy of sirolimus-eluting Bx Velocity stents 2 years after implantation in humans. In-stent lumen dimensions remained essentially unchanged at 2-year follow-up in the 2 groups, although angiographic lumen loss was slightly higher in the FR group. Restenosis "catch-up" was not found in our patient population

Sirolimus-eluting stent for the treatment of in-stent restenosis: a quantitative coronary angiography and three-dimensional intravascular ultrasound study

BACKGROUND: We have previously reported the safety and effectiveness of sirolimus-eluting stents for the treatment of de novo coronary lesions. The present investigation explored the potential of this technology to treat in-stent restenosis. METHODS AND RESULTS: Twenty-five patients with in-stent restenosis were successfully treated with the implantation of 1 or 2 sirolimus-eluting Bx VELOCITY stents in Sao Paulo, Brazil. Nine patients received 2 stents (1.4 stents per lesion). Angiographic and volumetric intravascular ultrasound (IVUS) images were obtained after the procedure and at 4 and 12 months. All vessels were patent at the time of 12-month angiography. Angiographic late loss averaged 0.07+/-0.2 mm in-stent and -0.05+/-0.3 mm in-lesion at 4 months, and 0.36+/-0.46 mm in-stent and 0.16+/-0.42 mm in-lesion after 12 months. No patient had in-stent or stent margin restenosis at 4 months, and only one patient developed in-stent restenosis at 1-year follow-up. Intimal hyperplasia by 3-dimensional IVUS was 0.92+/-1.9 mm(3) at 4 months and 2.55+/-4.9 mm(3) after 1 year. Percent volume obstruction was 0.81+/-1.7% and 1.76+/-3.4% at the 4- and 12-month follow-up, respectively. There was no evidence of stent malapposition either acutely or in the follow-up IVUS images, and there were no deaths, stent thromboses, or repeat revascularizations. CONCLUSION: This study demonstrates the safety and the potential utility of sirolimus-eluting Bx VELOCITY stents for the treatment of in-stent restenosis

Lack of Neointimal Proliferation After Implantation of Sirolimus-Coated Stents in Human Coronary Arteries: A Quantitative Coronary Angiography and Three-Dimensional Intravascular Ultrasound Study

BACKGROUND: Restenosis remains an important limitation of interventional cardiology. Therefore, we aimed to determine the safety and efficacy of sirolimus (a cell-cycle inhibitor)-coated BX Velocity stents. METHODS AND RESULTS: Thirty patients with angina pectoris were electively treated with 2 different formulations of sirolimus-coated stents (slow release [SR], n=15, and fast release [FR], n=15). All stents were successfully delivered, and patients were discharged without clinical complications. Independent core laboratories analyzed angiographic and 3D volumetric intravascular ultrasound data (immediately after procedure and at 4-month follow-up). Eight-month clinical follow-up was obtained for all patients. There was minimal neointimal hyperplasia in both groups (11.0+/-3.0% in the SR group and 10.4+/-3.0% in the FR group, P:=NS) by ultrasound and quantitative coronary angiography (in-stent late loss, 0.09+/-0.3 mm [SR] and -0.02+/-0.3 mm [FR]; in-lesion late loss, 0.16+/-0.3 mm [SR] and -0.1+/-0.3 mm [FR]). No in-stent or edge restenosis (diameter stenosis >or=50%) was observed. No major clinical events (stent thrombosis, repeat revascularization, myocardial infarction, or death) had occurred by 8 months. CONCLUSIONS: The implantation of sirolimus-coated BX Velocity stents is feasible and safe and elicits minimal neointimal proliferation. Additional placebo-controlled trials are required to confirm these promising results

Crescimento de espécies do gênero Brachiaria sob alagamento em casa de vegetação Effect of flooding on the growth of Brachiaria species in greenhouse

Objetivou-se avaliar a tolerância ao alagameto de quatro espécies de Brachiaria (B. decumbens,B. brizantha, B. humidicola e B. mutica), a partir de suas características morfogênicas, fisiológicas e produtivas. Os tratamentos foram arranjados segundo esquema fatorial 4 x 3 quatro espécies de Brachiaria e três níveis de disponibilidade de água no solo (capacidade de campo, lâmina d'água de 1 e 10 cm acima do solo). O delineamento experimental foi de blocos completos ao acaso, com três repetições. O experimento foi instalado em casa de vegetação, utilizando-se colunas de PVC com 60 cm de altura x 30 cm de diâmetro. Os níveis de alagamento foram impostos a partir do 22º dia de rebrota após corte de uniformização. O acréscimo de água aos vasos, necessário para satisfazer a lâmina d'água a 1 e 10 cm do nível do solo nos respectivos vasos, foi controlado com o auxílio de furos presentes nas paredes dos vasos a 1 e 10 cm acima do nível do solo, respectivamente. O alagamento comprometeu a taxa de alongamento e acentuou a taxa de senescência das lâminas foliares, independentemente da espécie. Observou-se controle estomático das trocas gasosas em folhas de todas as espécies. O alagamento reduziu a fotossíntese líquida das espécies de Brachiaria, exceto de B. mutica, que superou as demais espécies sob a lâmina d'água de 10 cm acima do solo. Também diminuiu significativamente a área e o peso das lâminas foliares verdes, exceto em B. mutica, que apresentou apenas ligeira tendência de queda. A B. muticaapresentou numerosas raízes adventícias, que, possivelmente, lhe conferiram superior tolerância ao alagamento.<br>This study aimed to evaluate the tolerance of four Brachiaria species (B. decumbens,B. brizantha, B. humidicola and B. mutica) to flooding with regard to their morphogenetical, physiological and production characteristics. The experimental treatments resulted from a 4 x 3 factorial arrangement of four Brachiaria species and three flooding conditions (water field capacity, 1 and 10 cm water lamina above the soil surface) distributed in a completely randomized block design, with three replications. The experiment was carried out in greenhouse, in PVC column pot 60 cm high and 30 cm in diameter. The flooding was imposed during 18 days from the 22nd days of regrowth, after uniformization clipping. Small holes made 1 and 10 cm above soil level allowed to control the desired water lamina level in the pots. Flooding hindered leaf blade elongation rate and increased leaf blade senescence rate, regardless of species. Stomatal control of gas exchanges was observed in all species. Flooding reduced the photosynthesis rate in all species, except B. mutica, which out-yielded the others species under the 10 cm water level. Flooding significantly reduced the area and weight of green leaf blade, except in B. mutica which showed only a slight decrease tendency. The numerous adventitious roots of B. mutica would have played an important role in its tolerance to flooding

Exigências nutricionais da grápia ao fósforo e enxofre em Argissolo Vermelho distrófico arênico: efeito da adubação no crescimento Nutritional demand of grápia to phophorus and sulfur in paleaudalf soil: fertilization effects on growth

A grápia (Apuleia leiocarpa Vog. Macbride) é uma espécie de grande interesse madeireiro, encontrando-se, atualmente, bastante dizimada devido à exploração extrativista, sem haver reposição através de reflorestamento. O objetivo deste trabalho foi determinar os níveis ótimos de adubação de fósforo e enxofre no crescimento de plantas jovens de grápia. As plantas foram cultivadas em vasos contendo 3,5kg de solo Argissolo Vermelho distrófico arênico, sob condições de casa de vegetação não climatizada. O delineamento experimental foi o inteiramente casualizado com seis repetições. Foram avaliados 16 tratamentos em esquema bifatorial completo (4x4), representados pela combinação de quatro doses de P (0, 60, 120 e 180mg kg-1) e quatro de enxofre (0, 10, 20 e 30mg kg-1). A análise do crescimento das plantas foi realizada mensalmente através da altura da planta, diâmetro do caule e número de folhas remanescentes. Aos 130 dias após a emergência das plantas, avaliaram-se ainda o número de folhas caídas, matéria seca das folhas, caule, raízes e total da planta e a relação entre a matéria seca das raízes e da parte aérea. A produção de matéria seca total das plantas jovens de grápia respondeu positivamente à adubação conjunta de P e S, com dose de máxima eficiência técnica estimada de, respectivamente, 204 e 16mg kg-1 de solo. A adubação fosfatada na dose igual ou acima de 120mg kg-1 de solo induziu o aparecimento de clorose foliar típica da deficiência de Fe. A alta disponibilidade de P no solo favoreceu o crescimento da parte aérea em detrimento das raízes.<br>Grápia (Apuleia leiocarpa Vog. Macbride) is an important native forest species that has been in extinction process. The aim of this study was to determine the optimum levels of phosphorus and sulfur fertilization on the initial growth of grápia. Grápia plants were cultivated in pots containing 3.5kg of a Paleudalf soil, under unclimatized glasshouse conditions. Sixteen fertilization treatments were used in a complete bifactorial scheme (4x4), represented by the combination of four levels of P (0, 60, 120, and 180mg kg-1) and four levels of S (0, 10, 20, and 30mg kg-1). The plant growth in height, stem diameter, and number of leaves was analyzed monthly. After 130 days of cultivation other growth parameters were analyzed, as follow: number of fallen leaves, dry weight of roots, stem, leaves, and of the whole plant, and root/shoot dry weight ratio. The dry weight of the whole plant positively responded to the combination of phosphorus and sulfur fertilization, with the maximum technical efficiency level of 204 and 16mg kg-1 of soil, respectively. The phosphorus fertilization above 120mg kg-1 of soil gave rise a chlorosis in leaves similar to that of Fe deficiency. High availability of P in the soil was accounted for best growth of shoots in detriment of roots

Contribuições da Sociologia na América Latina à imaginação sociológica: análise, crítica e compromisso social Sociology's contribution in Latin America to sociological imagination: analysis, critique, and social commitment

O artigo aborda o papel desempenhado pela Sociologia na análise dos processos de transformação das sociedades latino-americanas, no acompanhamento do processo de construção do Estado e da Nação, na problematização das questões sociais na América Latina. São analisados seis períodos na Sociologia na América Latina e no Caribe: I) a herança intelectual da Sociologia ; II) a sociologia da cátedra; III) O período da "Sociologia Científica" e a configuração da "Sociologia Crítica"; IV) a crise institucional, a consolidação da "Sociologia Crítica" e a diversificação da sociologia; V) a sociologia do autoritarismo, da democracia e da exclusão; VI) a consolidação institucional e a mundialização da sociologia da América Latina (desde o ano de 2000), podendo-se afirmar que os traços distintivos do saber sociológico no continente foram: o internacionalismo, o hibridismo, a abordagem crítica dos processos e conflitos das sociedades latino-americanas e o compromisso social do sociólogo.<br>The article focuses on the role played by Sociology in the analysis of processes of change in Latin American societies, in the process of construction of Nation and State, in the debate of social issues in Latin America and the Caribbean. Six periods in Sociology in Latin America and the Caribbean are examined: I) sociology's intellectual legacy; II) sociology as a cathedra; III) the period of "Scientific Sociology"; IV) the institutional crisis, the consolidation of "Critical Sociology", and the diversifying of sociology; V) sociology of authoritarianism, democracy and exclusion; VI) institutional consolidation and globalization of Latin American sociology (since 2000). It may be said that the distinctive features of sociological knowledge in the continent were: internationalism, hybridism, the critical approach to processes and conflicts of Latin American societies, and the sociologist social commitment

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora