Desfechos clínicos dos pacientes submetidos à intervenção coronária percutânea com stent bioabsorvível eluidor de everolimus

Modelo: Estudo descritivo, transversal, retrospectivo. Objetivo: Identificar desfechos clínicos e a prevalência de uso da dupla antiagregação plaquetária (DAP) 30 dias e 12 meses após implante de stent bioabsorvível eluidor de everolimus (BVS). Metodologia e casuística: Foram coletados e analisados de maneira descritiva dados referentes a antecedentes clínicos, procedimento, resultados pós-procedimento e complicações intra-hospitalares, acompanhamento e antiagregação plaquetária 30 dias e um ano após implante de BVS de pacientes submetidos a intervenção coronária percutânea (ICP) com BVS. Resultados: 169 pacientes foram submetidos a 182 a ICP com BVS para tratamento de 298 lesões, com idade média de 56,9±10,8 anos, 84% do sexo masculino. Até quatro lesões foram abordadas por ICP, 49% na artéria descendente anterior, 81,2% graves (Ellis B2 e C), 99% em TIMI 3 pós-procedimento. Após o procedimento, o infarto agudo do miocárdio (IAM) sem supradesnivelamento do segmento ST foi a principal complicação intrahospitalar (11,5%). Trinta dias após a ICP, não houve complicações relacionadas ao procedimento e 93,4% estavam em DAP. Após um ano, três pacientes foram submetidos a nova ICP não relacionada ao vaso anteriormente abordado e 80,2% mantinham DAP. Ressalta-se que não ocorreu re-estenose clinicamente significativa no período de seguimento. Conclusão: A prevalência de uso de DAP foi alta e não houve complicações precoces ou tardias relacionadas à ICP com BVS, confirmando a segurança e efetividade do procedimento na instituição.Study design: A descriptive, cross-sectional, retrospective study. Objectives: To identify clinical outcomes and the prevalence of dual antiplatelet therapy (DAPT) 30 days and 12 months after percutaneous coronary intervention (PCI) with an everolimus-eluting bioabsorbable stent (BVS). Methods and casuistry: Data regarding clinical history, procedure, post-procedure outcomes and in-hospital complications, 30-day and one-year follow-up and antiplatelet therapy were collected and analyzed of 169 patients submitted to 182 PCIs with BVS for treatment of 298 lesions. Results: The mean age was 56.9±10.8 years, 84% male. Up to four lesions were treated with PCI, 49% in the anterior descending artery, 81.2% severe (Ellis B2 and C), 99% TIMI 3 postprocedure. After the procedure, non-STEMI was the main in-hospital complication (11.5%). Thirty days after PCI, there were no procedure-related complications and 93.4% were on DAPT. After one year, three patients underwent a new PCI that was not related to the vessel previously treated and 80.2% maintained DAPT. There were no cases of clinically significant stenosis during the follow-up period. Conclusion: The prevalence of DAPT usage was high and there were no early or late complications related to PCI with BVS, confirming the safety and effectiveness of the procedure in the institution

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Segurança e eficácia dos stents farmacológicos eluidores de biolimus com polímero biodegradável: análise do registro EINSTEIN (Evaluation of Next-generation drug-eluting STEnt IN patients with coronary artery disease)

OBJETIVO: Avaliar a incidência de eventos adversos cardíacos maiores (morte cardíaca, infarto agudo do miocárdio ou necessidade de nova revascularização do vaso-alvo) em 1 ano em pacientes do "mundo real". MÉTODOS: O registro EINSTEIN é um estudo observacional prospectivo, unicêntrico, que incluiu consecutivamente 103 pacientes (152 lesões) tratados com o stent BiomatrixTM, eluidor de biolimus A9 e polímero biodegradável. RESULTADOS: A média das idades foi de 65,0±12,4 anos; o gênero masculino representou 83,5% dos pacientes; e 37,9% deles eram diabéticos. Em 1 ano, eventos adversos cardíacos maiores ocorreram em 11,7% dos pacientes, incluindo 2,9% de morte cardíaca, 4,9% de infarto agudo do miocárdio sem supradesnivelamento do segmento ST e 3,9% de revascularização do vaso-alvo. Trombose de stent esteve presente em apenas 1% (1 paciente) após o seguimento clínico de 1 ano. CONCLUSÃO: O presente registro sugere que os novos stents farmacológicos eluidores de biolimus A9 com polímero biodegradável são seguros e eficazes em pacientes da prática clínica diária, com baixas taxas de eventos adversos cardíacos maiores no longo prazo

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved