Landslides cause tsunami waves: insights from Aysén Fjord, Chile

On 21 April 2007, an Mw 6.2 earthquake produced an unforeseen chain of events in the Aysén fjord (Chilean Patagonia, 45.5°S). The earthquake triggered hundreds of subaerial landslides along the fjord flanks. Some of the landslides eventually involved a subaqueous component that, in turn, generated a series of displacement waves tsunami- like waves produced by the fast entry of a ubaerial landmass into a water body within the fjord [Naranjo et al., 2009; Sepúlveda and Serey, 2009; Hermanns et al., 2013]. These waves, with run-ups several meters high along the shoreline, caused 10 fatalities. In addition, they severely damaged salmon farms, which constitute the main economic activity in the region, setting free millions of cultivated salmon with still unknown ecological consequences.

Prehospital ticagrelor in ST-segment elevation myocardial infarction

Background:The direct-acting platelet P2Y receptor antagonist ticagrelor can reduce the incidence of major adverse cardiovascular events when administered at hospital admission to patients with ST-segment elevation myocardial infarction (STEMI). Whether prehospital administration of ticagrelor can improve coronary reperfusion and the clinical outcome is unknown. Methods: We conducted an international, multicenter, randomized, double-blind study involving 1862 patients with ongoing STEMI of less than 6 hours' duration, comparing prehospital (in the ambulance) versus in-hospital (in the catheterization laboratory) treatment with ticagrelor. The coprimary end points were the proportion of patients who did not have a 70% or greater resolution of ST-segment elevation before percutaneous coronary intervention (PCI) and the proportion of patients who did not have Thrombolysis in Myocardial Infarction flow grade 3 in the infarct-related artery at initial angiography. Secondary end points included the rates of major adverse cardiovascular events and definite stent thrombosis at 30 days. Results: The median time from randomization to angiography was 48 minutes, and the median time difference between the two treatment strategies was 31 minutes. The two coprimary end points did not differ significantly between the prehospital and in-hospital groups. The absence of ST-segment elevation resolution of 70% or greater after PCI (a secondary end point) was reported for 42.5% and 47.5% of the patients, respectively. The rates of major adverse cardiovascular events did not differ significantly between the two study groups. The rates of definite stent thrombosis were lower in the prehospital group than in the in-hospital group (0% vs. 0.8% in the first 24 hours; 0.2% vs. 1.2% at 30 days). Rates of major bleeding events were low and virtually identical in the two groups, regardless of the bleeding definition used