Real-world adoption of left bundle branch area pacing: Insights from the Conduction-System pacing Italian Network Group (C-SING).

Background And Objective: Left bundle branch area pacing (LBBAP) is increasingly used for treating bradycardia and heart failure. However, real-world data are limited. The Conduction-System Pacing Italian Network Group (C-SING) collected prospective data on LBBAP procedures in a nationwide context.

Elucidation on the In Vivo Activity of the Bivalent Opioid Peptide MACE2 against Several Types of Chronic Pain.

Biphalin is a bivalent μ/δ opioid receptor agonist showing a promising therapeutic profile with reduced side effects, but as a peptide is limited by poor metabolic stability and blood-brain barrier penetration. To improve these features, we developed the ligand and showed initial in vivo efficacy. To further explore the druggability of this ligand, in this report, we tested metabolic stability in human plasma, receptor engagement by 3 different routes of administration using the tail-flick test, and efficacy in 2 different pathological and chronic pain models.

Valorization of grape pomace extracts against cranberry, elderberry, rose hip berry, goji berry and raisin extracts: Phytochemical profile and in vitro biological activity.

The circular economy is gaining attention around the world as a sustainable approach to tackling environmental problems, promoting more responsible management of resources. The aim of this work is the valorization of grape pomace as a waste product of agrifood chain. We prepared decoction (DC), ultrasound-assisted and microwave-assisted extracts (UAE and MAE respectively) of grape pomace, determining their phytochemical profile (using HPLC-ESI-Q-TOF-MS), antioxidant activity and enzyme inhibitory effects.

New Teixobactin Analogues with a Total Lactam Ring.

Teixobactin is a new antibiotic peptide with strong efficacy against several Gram-positive resistant bacteria, the structure of which is extremely difficult to obtain in the laboratory via multistep conventional synthesis. To face the increasing antibiotic resistant bacteria, it is fundamental to introduce new types of antibiotics with innovative mechanisms of action without resistance; thus, many scientists are studying and developing new methods to synthesize teixobactin analogues. In this work, seven Arg-teixobactin analogues with a total lactam ring have been prepared via solid phase peptide synthesis.

Assessment of Lifestyle, Eating Habits and the Effect of Nutritional Education among Undergraduate Students in Southern Italy.

Background: The years spent at university represent a critical period that can influence both the quality of lifestyle and the eating habits of subsequent adulthood, and also, in the long term, the health of the individual. The aim of this study was to investigate the lifestyle of university students living away from home.

Methods: Each subject recruited for the study was given a questionnaire to obtain general information, eating habits and physical activity levels before (T0) and after six month of training seminars (T1).

Agomelatine: A Potential Multitarget Compound for Neurodevelopmental Disorders.

Agomelatine (AGM) is one of the latest atypical antidepressants, prescribed exclusively for the treatment of depression in adults. AGM belongs to the pharmaceutical class of melatonin agonist and selective serotonin antagonist ("MASS"), as it acts both as a selective agonist of melatonin receptors MT1 and MT2, and as a selective antagonist of 5-HT2C/5-HT2B receptors. AGM is involved in the resynchronization of interrupted circadian rhythms, with beneficial effects on sleep patterns, while antagonism on serotonin receptors increases the availability of norepinephrine and dopamine in the prefrontal cortex, with an antidepressant and nootropic effect.

Food-inspired peptides from spinach Rubisco endowed with antioxidant, antinociceptive and anti-inflammatory properties.

Rubiscolin-6 (amino acid sequence: YPLDLF) is a selective δ-opioid receptor peptide isolated from spinach Rubisco. Its synthetic analogue, peptide YPMDIV is the most potent described so far for its increased opioid activity, thus in this work it was considered as for the design of twelve new analogues . Firstly all the novel compounds have been tested for their antinociceptive and anti-inflammatory capacity and in order to evaluate their ability to maintain or loss the original activity.

The PhysioVP-AF study, a randomized controlled trial to assess the clinical benefit of physiological ventricular pacing vs. managed ventricular pacing for persistent atrial fibrillation prevention in patients with prolonged atrioventricular conduction: design and rationale.

Aims: In patients with prolonged atrioventricular (AV) conduction and pacemaker (PM) indication due to sinus node disease (SND) or intermittent AV-block who do not need continuous ventricular pacing (VP), it may be difficult to determine which strategy to adopt. Currently, the standard of care is to minimize unnecessary VP by specific VP avoidance (VPA) algorithms. The superiority of this strategy over standard DDD or DDD rate-responsive (DDD/DDDR) in improving clinical outcomes is controversial, probably owing to the prolongation of the atrialventricular conduction (PR interval) caused by the algorithms.

Permanent His bundle pacing in patients with right atriomegaly: The value of different dedicated delivery sheaths.

Background: An enlarged right atrium (RA) is a challenging anatomy that can limit the successful use of His bundle pacing (HBP). It is unknown whether new implantation tools could help overcome these challenges.

Methods: Consecutive patients with RA volume index >25 mL/m in men and >21 mL/m in women underwent permanent HBP.

Design of Analgesic Trivalent Peptides with Low Withdrawal Symptoms: Probing the Antinociceptive Profile of Novel Linear and Cyclic Peptides as Opioid Pan Ligands.

The discovery of efficacious and safe analgesics with reduced side effects is the foremost challenge in the pain field. In this work, we report the and evaluation of linear and cyclic analogues of biphalin with the aim to complete the series of structural modifications previously applied in the development of opioid peptides incorporating a xylene bridge. Replacement of Tyr by Dmt (2,5-dimethyltyrosine) in the linear biphalin analogue and cyclic analogue resulted in two new compounds (namely, and ) endowed with improved KOR/MOR/DOR binding affinity.

Discovery of κ Opioid Receptor (KOR)-Selective d-Tetrapeptides with Improved Antinociceptive Effect after Peripheral Administration.

Peripherally active tetrapeptides as selective κ opioid receptor (KOR) agonists have been prepared in good overall yields and high purity following solid-phase peptide synthesis via Fmoc protection strategy. Structural modifications at the first and second position of the FF(d-Nle)R-NH () were contemplated with aromatic side chains containing d-amino acids, such as (d)-F-Phe, (d)-F-Phe, (d)-F-Phe, which led to highly selective and efficacious KOR agonists endowed with strong antinociceptive activity following intravenous (i.v.

A Comparative Study on Phytochemical Fingerprint of Two Diverse Tondino del Tavo and Cannellino Bio Extracts.

Common bean () represents one of the most famous foods with antiobesity activity showing a significant efficacy against fat accumulation, insulin resistance and dyslipidaemia. In this work, two Italian varieties of common bean, i.e.

Closed loop stimulation with His bundle lead placement.

Unlabelled: Closed-loop stimulation (CLS; BIOTRONIK SE & Co. KG, Berlin, Germany) is a rate-responsive algorithm that analyzes intracardiac impedance trends using a standard lead placed in the right ventricle. It is unknown whether CLS could perform adequately with His bundle (HB) lead placement, as contractility dynamics may be attenuated in this region compared to the right ventricle apex.

Peptide Human Neutrophil Elastase Inhibitors from Natural Sources: An Overview.

Elastases are a broad group of enzymes involved in the lysis of elastin, the main component of elastic fibres. They are produced and released in the human body, mainly by neutrophils and the pancreas. The imbalance between elastase activity and its endogenous inhibitors can cause different illnesses due to their excessive activity.

His-Purkinje system longitudinal dissociation: From bench to bedside. A case of output-dependent fascicular capture.

Introduction: Histological studies reported that the His bundle (HB) is partitioned into narrow cords by collagen running in its long axis, providing the anatomical setting necessary for its longitudinal dissociation. Further confirmations came from the demonstration that direct HB pacing normalizes the QRS axis and duration in subjects with proximal HB lesions causing bundle branch block. However, there is no evidence of the possibility of selective HB partitions pacing destined to the composition of branches and fascicles.

Electrical storm in a patient with COVID-19 treated with hydroxychloroquine: A case report.

Hydroxychloroquine (HCQ) is a widely used drug to treat patients with coronavirus disease 19 (COVID-19). Although evidence of its efficacy and safety remains limited and controversial, both cardiac and non-cardiac adverse events are known to be associated with its use. To our knowledge, electrical storm in patients with COVID-19, or in any case treated with HCQ, has not been reported.

His bundle pacing: Clinical consequences of unnecessary right ventricle backup pacing.

As a backup lead in right ventricle (RV) is often used in His-bundle pacing (HBP) implants, in sinus rhythm patients the His lead is connected to the left ventricular (LV) port of a CRT device. In current devices, the backup pacing will be delivered 100% of time due to cross-channel ventricular refractory periods. Beyond an impact on battery, unnecessary RV pacing could find excitable tissue and capture a portion of the myocardium tissue potentially reducing the benefits of physiological HBP as shown in this case report where the switch from biventricular to LV-only pacing improved acute and 2-month echocardiography parameters.

Interatrial conduction time from electrograms of cardiac resynchronization therapy devices with left ventricular sensing.

Background: The interatrial conduction time (IACT) is relevant for atrioventricular delay optimization in cardiac resynchronization therapy (CRT) devices. However, this information cannot be easily used as it requires invasive measurements. We tested whether electrical activation of left atrium (LA) could be detected in CRT devices with left ventricular (LV) sensing and used to estimate IACT.

Alternative sites of ventricular pacing: His bundle pacing.

Since its introduction right ventricular apical (RVA) pacing has been the mainstay in cardiac pacing. However, in recent years there has been an upsurge of interest in permanent His bundle pacing (HBP), given the scientific evidence of the harmful role of dyssynchronous ventricular activation, induced by RVA pacing, in promoting the onset of heart failure and atrial fibrillation. After an intermediate period in which attention was focused on algorithms aimed at minimizing ventricular pacing, with partially inadequate and harmful results, scientific attention shifted to HBP, which proved to ensure a physiological electro-mechanical activation of the ventricles.

Is dedicated implantation tool set really needed for permanent His bundle pacing?

This case describes the feasibility of permanent His bundle pacing (HBP) with a standard bipolar lead positioned through cephalic access without a dedicated delivery sheath. The use of a stylet pre-shaped on an echocardiographic reference allowed a successful procedure without specific technical difficulties. This "simplified" approach may provide some advantages with respect to the only commercially available system.