Left Atrial Remodeling and Function in Various Left Ventricular Hypertrophic Phenotypes.

Aims: How the underlying etiology and pathophysiology of left ventricular (LV) hypertrophy affects LA remodeling and function remains unexplored. The present study aims to investigate the influence of various hypertrophic phenotypes on LA remodeling and function.

Methods And Results: Patients with LV hypertrophy who underwent cardiac magnetic resonance (CMR) were compared to a control group.

Validity and Reliability of Patient Activation Measure (PAM13-I) Italian Version Among Patient Undergoing Elective Surgery.

The patient activation measure (PAM), a recognized measure of how active patients are in their care, is one of the most extensively used, widely translated, and tested instruments worldwide in measuring patient activation. This study aimed to assess the psychometric properties and construct validity of the Italian version of the 13-item Patient Activation Measure (PAM13-I) among patients undergoing elective laparoscopic cholecystectomy. A multicenter study was conducted across 111 surgical units in Italy.

Net Benefit of Early Anticoagulation for Stroke With Atrial Fibrillation: Post Hoc Analysis of the ELAN Randomized Clinical Trial.

Importance: The net clinical effect of early vs later direct oral anticoagulant (DOAC) initiation after atrial fibrillation-associated ischemic stroke is unclear.

Objective: To investigate whether early DOAC treatment is associated with a net clinical benefit (NCB).

Design, Setting, And Participants: This was a post hoc analysis of the Early Versus Late Initiation of Direct Oral Anticoagulants in Post-Ischaemic Stroke Patients With Atrial Fibrillation (ELAN) open-label randomized clinical trial conducted across 103 sites in 15 countries in Europe, the Middle East, and Asia between November 6, 2017, and September 12, 2022, with a 90-day follow-up.

Glycocalyx disruption, endothelial dysfunction and vascular remodeling as underlying mechanisms and treatment targets of chronic venous disease.

The glycocalyx is an essential structural and functional component of endothelial cells. Extensive hemodynamic changes cause endothelial glycocalyx disruption and vascular dysfunction, leading to multiple arterial and venous disorders. Chronic venous disease (CVD) is a common disorder of the lower extremities with major health and socio-economic implications, but complex pathophysiology.

Occluding mucous airway plugs in patients with obstructive lung diseases: a new treatable trait?

https://bit.ly/4gyJHFW.

Financial Toxicity and Kidney Disease in Children and Adults: A Scoping Review.

Purpose: Social determinants of health have been related with kidney diseases and their outcomes. Financial toxicity (FT) refers to the negative impact of health care costs on clinical conditions. This scoping review aimed to evaluate the literature linking FT with renal diseases.

Shaping the future rural healthcare landscape: perspectives of young healthcare professionals.

Introduction: Rural communities continue to struggle to access quality healthcare services. Even in countries where the majority of the population live in rural and remote areas, resources are concentrated in big cities, and this is continuing. As a result, countries with the highest proportion of rural residents correlate with the poorest access, which has negative implications for the health and wellbeing of people.

Informed Consent and Shared Decision-Making in Modern Medicine. Case-based Approach, Current Gaps and Practical Proposal.

Advances in personalized medicine and Systems Biology have introduced probabilistic models and error discovery to cardiovascular care, aiding disease prevention and procedural planning. However, clinical application faces cultural, technical, and methodological hurdles. Patient autonomy remains essential, with shared decision-making (SDM) gaining importance in managing complex cardiovascular treatment options.

Boosting Light-Driven CO2 Conversion into CO by a Polypyridine Iron(II) Catalyst Using an Organic Sensitizer.

Direct photochemical conversion of CO2 into a single carbon-based product currently represents one of the major issues in the catalysis of the CO2 reduction reaction (CO2RR). In this work, we demonstrate that the combination of an organic photosensitizer with a heptacoordinated iron(II) complex allows to attain a noble-metal-free photochemical system capable of efficient and selective conversion of CO2 into CO upon light irradiation in the presence of N,N-diisopropylethylamine (DIPEA) and 2,2,2-trifluoroethanol (TFE) as the electron and proton donor, respectively, with unprecedented performances (ΦCO up to 36%, TONCO > 1000, selectivity > 99%). As shown by transient absorption spectroscopy studies, this can be achieved thanks to the fast rates associated with the electron transfer from the photogenerated reduced dye to the catalyst, which protect the dye from parallel degradation pathways ensuring its stability along the photochemical reaction.

A New Design for Aortic Arch Surgery: Ex Vivo Implantation and Computerized Flow Evaluation of the ISLAND Graft.

Objective: Both the en bloc island technique and the branched graft technique (BGT) present advantages but also limitations in aortic arch surgery. Here is the first presentation of an innovative prosthesis for aortic arch replacement, conceived to overcome the disadvantages of both techniques.

Methods: The novel ISLAND graft is a tubular Dacron or hybrid prosthesis with an additional extended Dacron graft ("bubble") on the superior aspect, for en bloc island graft anastomosis.

A luminous and young galaxy at = 12.33 revealed by a JWST/MIRI detection of Hα and [O iii].

The James Webb Space Telescope has discovered a surprising population of bright galaxies in the very early Universe (≲500 Myr after the Big Bang) that is hard to explain with conventional galaxy-formation models and whose physical properties are not fully understood. Insight into their internal physics is best captured through nebular lines, but at these early epochs, the brightest of these spectral features are redshifted into the mid-infrared and remain elusive. Using the mid-infrared instrument onboard the James Webb Space Telescope, here we present a detection of Hα and doubly ionized oxygen ([O iii] 4959,5007 Å) from the bright, ultra-high-redshift galaxy candidate GHZ2/GLASS-z12.

Economic Evaluations of Health Service Interventions Targeting Patients with Multimorbidities: A Scoping Literature Review.

Introduction: Multimorbid patients have been growing, leading to an exponential increase in healthcare costs and patterns of resource utilization. Despite the heightened interest toward integrated care programs as a response to the complex need of multimorbid patients, economic evaluations of these programs remain scarce. This work investigated the economic evaluations of service interventions targeting multimorbid patients, to identify the characteristics of these programs and the methods applied to their evaluation.

Non-Celiac Gluten/Wheat Sensitivity-State of the Art: A Five-Year Narrative Review.

Non-celiac gluten/wheat sensitivity (NCGWS) is a syndrome for which pathogenesis and management remain debated. It is described as a condition characterized by gastrointestinal and extra-intestinal symptoms rapidly occurring after gluten ingestion in subjects who have had celiac disease or wheat allergy excluded. To date, the diagnosis of NCGWS is challenging as no universally recognized biomarkers have been yet identified, nor has a predisposing genetic profile been described.

Prioritizing Patient Selection in Clinical Trials: A Machine Learning Algorithm for Dynamic Prediction of In-Hospital Mortality for ICU Admitted Patients Using Repeated Measurement Data.

A machine learning prognostic mortality scoring system was developed to address challenges in patient selection for clinical trials within the Intensive Care Unit (ICU) environment. The algorithm incorporates Red blood cell Distribution Width (RDW) data and other demographic characteristics to predict ICU mortality alongside existing ICU mortality scoring systems like Simplified Acute Physiology Score (SAPS). The developed algorithm, defined as a Mixed-effects logistic Random Forest for binary data (MixRFb), integrates a Random Forest (RF) classification with a mixed-effects model for binary outcomes, accounting for repeated measurement data.

Predictors and Impact of Cardiogenic Shock in Oldest-Old ST-Elevation Myocardial Infarction Patients.

: Cardiogenic shock (CS) is the most frequent cause of in-hospital mortality after ST-elevation myocardial infarction (STEMI). Data about CS in very elderly (age ≥ 85 years) STEMI patients are scarce. We sought to assess the prognostic factors and the short- and mid-term impact of CS in this population.

Unexpected Clinically Relevant Findings Detected via Computed Tomography in Patients with Severe Aortic Stenosis Who Are Candidates for Transcatheter Aortic Valve Replacement.

The detection of unexpected findings (UF) during CT scans of patients undergoing TAVR is frequent; however, it is unclear whether such findings have a clinical impact on the TAVR pathway. We conducted a retrospective, single-center observational study enrolling patients who were candidates for TAVR. All enrolled patients underwent a CT scan before valve implantation.

"Add More Arrows to Your Quiver": The Role of Adding Another Chemotherapy Drug to Fluoropyrimidine and Long Term Radiotherapy in Locally Advanced Rectal Cancer: A Systematic Review and Meta-Analysis.

Despite optimal local control obtained with neoadjuvant chemoradiotherapy (CRT), data on overall survival (OS) and disease-free survival (DFS) of local advanced rectal cancer patients are still equivocal. This meta-analysis aimed to estimate the pathological complete response (pCR), regression rate, DFS, and OS probabilities of rectal cancer patients treated with a second chemotherapy drug added to fluoropyrimidine and long-term radiotherapy. Computerized bibliographic searches of MEDLINE, PUBMED, Web of Science and the Cochrane Central Register of Controlled Trials databases (1970-2023) were supplemented with hand searches of reference lists.

Airway Analysis and Morphometric Assessment of Dental Arches in Obstructive Sleep Apnea Patients.

: Obstructive sleep apnea is a sleep-related breathing disorder associated with craniofacial morphology and dental arches. The aim of this study was to evaluate the correlation between obstructive sleep apnea and the morphometry of dental arches and upper airways. : Forty patients were enrolled in the study, and the polysomnographic parameters evaluated were the apnea hypopnea index (AHI) and the oxygen desaturation index (ODI).

Organocatalytic Packed-Bed Reactors for the Enantioselective Flow Synthesis of Quaternary Isotetronic Acids by Direct Aldol Reactions of Pyruvates.

The utilization of the homogeneous ()-2-pyrrolidine-tetrazole organocatalyst (Ley catalyst) in the self-condensation of ethyl pyruvate and cross-aldol reactions of ethyl pyruvate donor with non-enolizable pyruvate acceptors, namely the sterically hindered ethyl 3-methyl-2-oxobutyrate or the highly electrophilic methyl 3,3,3-trifluoropyruvate, is described as the key enantioselective step toward the synthesis of the corresponding biologically relevant isotetronic acids featuring a quaternary carbon functionalized with ester and alkyl groups. The transition from homogeneous to heterogeneous flow conditions is also investigated, detailing the fabrication and operation of packed-bed reactors filled with a silica-supported version of the pyrrolidine-tetrazole catalyst (SBA-15 as the matrix).

Health Risk Factors, Prevention, and Inequalities.

The powerful quote from Martin Luther King Jr [...

Relevance of Next-Generation Sequencing in the Diagnosis of Thalassemia and Hemoglobinopathies: The Experience of Four Italian Diagnostic Hubs.

Unlabelled: Thalassemias and hemoglobinopathies are among the most common genetic diseases worldwide and have a significant impact on public health. The decreasing cost of next-generation sequencing (NGS) has quickly enabled the development of new assays that allow for the simultaneous analysis of small nucleotide variants (SNVs) and copy number variants (CNVs) as deletions/duplications of α- and β-globin genes.

Background/objectives: This study highlighted the efficacy and rapid identification of all types of mutations in the α- and β-globin genes, including silent variants, using the Devyser Thalassemia NGS kit.

Atypical Metastases from Prostate Cancer: Alpha-Methylacyl-Coenzyme A Racemase (AMACR) as a Potential Molecular Target in Prostate-Specific Membrane Antigen-Negative Prostate Adenocarcinoma.

Prostate cancer (PCa) is a high-prevalence disease usually characterized by metastatic spread to the pelvic lymph nodes and bones and the development of visceral metastases only in the late stages of disease. Positron Emission Tomography (PET) plays a key role in the detection of PCa metastases. Several PET radiotracers are used in PCa patients according to the stage and pathological features of the disease, in particular Ga/F-prostate-specific membrane antigen (PSMA) ligands.

Expert Judgment Supporting a Bayesian Network to Model the Survival of Pancreatic Cancer Patients.

: Pancreatic cancer is known for its poor prognosis. The most effective treatment combines surgery with peri-operative chemotherapy. Current prognostic tools are designed to predict patient outcomes and inform treatment decisions based on collected data.

Management of Patients with Vulvar Cancers: A Systematic Comparison of International Guidelines (NCCN-ASCO-ESGO-BGCS-IGCS-FIGO-French Guidelines-RCOG).

Background: Vulvar carcinoma is an uncommon gynecological tumor primarily affecting older women. Its treatment significantly impacts the quality of life and, not least, aesthetics because of the mutilating surgery it requires.

Objectives: The management requires a multidisciplinary team of specialists who know how to care for the patient in her entirety, not neglecting psychological aspects and reconstructive surgery.

How Antiretroviral Drug Concentrations Could Be Affected by Oxidative Stress, Physical Capacities and Genetics: A Focus on Dolutegravir Treated Male PLWH.

High levels of reactive oxygen species (ROS) are present in people living with HIV (PLWH), produced by intense physical activity; in response, our body produces antioxidant molecules. ROS influence the expression of gene-encoding enzymes and transporters involved in drug biotransformation. In addition, pharmacogenetics can influence transporter activity, and thus drug exposure.