Mechanical Circulatory Support With Impella in High-Risk Patients With Chronic Total Occlusion and Complex Multivessel Disease.

Background: The therapeutic management of patients with multivessel disease and severe left ventricular dysfunction is complex and controversial.

Aims: The aim of this study was to analyze the clinical outcomes and the changes in left ventricular ejection fraction (LVEF) in patients with severe left ventricular dysfunction and at least one chronic total occlusion (CTO) undergoing percutaneous coronary intervention (PCI) with hemodynamic support provided by Impella.

Methods: Retrospective, multicenter study enrolling patients with severe left ventricular dysfunction and severe coronary artery disease with at least one CTO who required percutaneous mechanical circulatory support with Impella, from January 2019 to December 2023.

Gut bacterial communities in roadkill animals: A pioneering study of two species in the Amazon region in Ecuador.

Studying the microbial communities within the gastrointestinal tract of vertebrate species can provide insights into biodiversity, disease ecology, and conservation. Currently, we have very limited understanding of the composition of endogenous microbiota in wildlife, particularly in high biodiversity tropical areas. Knowledge is limited by the logistical and ethical challenges of obtaining samples for free-living animals.

A randomized controlled trial of the Transdiagnostic Intervention for Sleep and Circadian dysfunction implemented via facilitation and delivered by community mental health providers: Improving the "fit" of psychological treatments by adapting to context.

To determine if the use of theory, data and end-user perspectives to guide an adaptation of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) yields better outcomes and improves the "fit" of TranS-C to community mental health centers (CMHCs), relative to the standard version. Ten counties in California were cluster-randomized by county to Adapted or Standard TranS-C. Within each county, adults who exhibited sleep and circadian dysfunction and serious mental illness (SMI) were randomized to immediate TranS-C or Usual Care followed by Delayed Treatment with TranS-C (UC-DT).

[Benefits of home-based administration of palivizumab in high-risk groups].

Unlabelled: Palivizumab, a humanized monoclonal antibody against the respiratory syncytial virus (RSV), currently is indicated in groups at higher risk of developing severe RSV disease, such as extreme premature infants and patients with hemodynamically significant heart disease. In Chile, this strategy is guaranteed by Law 20850 (Ricarte Soto Law). Nevertheless, barriers to its administration included the need to transfer these labile patients and exposure to other users, with the risk of contagion in waiting rooms.