Effectiveness of clinical, surgical and percutaneous treatment to prevent cardiovascular events in patients referred for elective coronary angiography: an observational study

Purpose: To ascertain the most appropriate treatment for chronic, stable, coronary artery disease (CAD) in patients submitted to elective coronary angiography. Patients and Methods: A total of 814 patients included in the prospective cohort study were referred for elective coronary angiography and were followed up on average for 6±1.9 years. Main outcomes were all-cause death, cardiovascular death, non-fatal myocardial infarction (MI) and stroke and late revascularization and their combinations as major adverse cardiac and cerebral events (MACCE): MACCE-1 included cardiovascular death, nonfatal MI, and stroke; MACCE-2 was MACCE-1 plus late revascularization. Survival curves and adjusted Cox proportional hazard models were used to explore the association between the type of treatment and outcomes. Results: All-cause death was lower in participants submitted to percutaneous coronary intervention (PCI) (0.41, 0.16–1.03, P=0.057) compared to medical treatment (MT). Coronary-artery bypass grafting (CABG) had an overall trend for poorer outcomes: cardiovascular death 2.53 (0.42–15.10), combined cardiovascular death, nonfatal MI, and stroke 2.15 (0.73–6.31) and these events plus late revascularization (2.17, 0.86–5.49). The corresponding numbers for PCI were 0.27 (0.05–1.43) for cardiovascular death, 0.77 (0.32–1.84) for combined cardiovascular death, nonfatal MI, and stroke and 2.35 (1.16–4.77) with the addition of late revascularization. These trends were not influenced by baseline blood pressure, left ventricular ejection fraction and previous MI. Patients with diabetes mellitus had a significantly higher risk of recurrent revascularization when submitted to PCI than CABG. Conclusion: Patients with confirmed CAD in elective coronary angiography do not have a better prognosis when submitted to CABG comparatively to medical treatment. Patients treated with PCI had a trend for the lower incidence of combined cardiovascular events, at the expense of additional revascularization procedures. Patients without significant CAD had a similar prognosis than CAD patients treated with medical therapy

Quality of life in patients with stable coronary artery disease submitted to percutaneous, surgical, and medical therapies : a cohort study

Background: Clinical, surgical, and percutaneous strategies similarly prevent major cardiovascular events in patients with stable coronary artery disease (CAD). The possibility that these strategies have differential effects on healthrelated quality of life (HRQoL) has been debated, particularly in patients treated outside clinical trials. Methods: We assigned 454 patients diagnosed with CAD during an elective diagnostic coronary angiography to coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), or optimal medical treatment (OMT), and followed them for an average of 5.2 ± 1.5 years. HRQoL was assessed using a validated Brazilian version of the 12-Item Short-Form Health Survey questionnaire. The association between therapeutic strategies and quality of life scores was tested using variance analysis and adjusted for confounders in a general linear model. Results: There were no differences in the mental component summary scores in the follow-up evaluation by therapeutic strategies: 51.4, 53.7, and 52.3 for OMT, PCI, and CABG, respectively. Physical component summary scores were higher in the PCI group than the CABG and OMT groups (46.4 vs. 42.9 and 43.8, respectively); however, these differences were no longer different after adjustment for confounding variables. Conclusion: In a long-term follow-up of patients with stable CAD, HRQoL did not differ in patients treated by medical, percutaneous, or surgical treatments

Metabarcoding clarifies the diet of the elusive and vulnerable Australian tjakura (Great Desert Skink, Liopholis kintorei)

Introduction: Accurately quantifying the diet of species has implications for our understanding of their ecology and conservation. Yet, determining the dietary composition of threatened and elusive species in the wild is often difficult. Methods: This study presents the first dietary assessment of tjakura (Liopholis kintorei) using non-invasive sampling of scats and high-throughput sequencing techniques. Results: The tjakura in Uluru consumed 48 invertebrates, 27 plants, and two vertebrate taxa. Fruit flies (Leucophenga spp.), beetles (Harpalus spp. and Omorgus spp.), mosquitos (Culicidae spp.), termites (Termitidae spp.), spiked mallow (Malvastrum americanum), bush tomatoes (Solanum centrale), and wild turnip (Brassica tournefortii) comprised the majority of the diet. Analysis of similarity revealed that food items did not differ significantly between tjakura age groups, seasons, or time since the last fire, however, adults, hot season, and fire scar of 2018 showed a relatively higher prey diversity. Discussion: These high similarities in diet composition between age classes and fire scars indicate potential intraspecific competition when food resources are scarce. The diet diversity and potential plasticity observed in this study reflect a dietary ecology influenced by food availability rather than preference. Our study demonstrates that scat DNA metabarcoding is an important complementary tool to conventional scat analysis or indigenous knowledge as most food items we identified were previously not recorded through those methods

Significance and potential of marine microbial natural bioactive compounds against biofilms/biofouling: necessity for green chemistry

Natural products from the unique environments of sea water and oceans represent a largely unfamiliar source for isolation of new microbes, which are potent producers of secondary bioactive metabolites. These unique life-forms from the marine ecosphere have served as an important source of drugs since ancient times and still offer a valuable resource for novel findings by providing remedial treatments. Therefore, it can be expected that many naturally bioactive marine microbial compounds with novel structures and bioactivities against those from terrestrial environments may be found among marine metabolites. Biofilms in aquatic environment possess serious problems to naval forces and oceanic industries around the globe. Current anti-biofilm or anti-biofouling technology is based on the use of toxic substances that can be harmful to their surrounding natural locales. Comprehensive research has been done to examine the bioactive potential of marine microbes. Results are remarkably varied and dynamic, but there is an urgent need for bioactive compounds with environmentally friendly or “green” chemical activities. Marine microbes have the potential as upcoming and promising source of non-toxic compounds with sustainable anti-biofouling/anti-biofilm properties as they can produce substances that can inhibit not only the chemical components required for biofilm production but also the attachment, microorganism growth, and/or cell–cell communication