RESUMO
The Mediterranean diet (MD), rich in minimally processed plant foods and in monounsaturated fats but low in saturated fats, meat, and dairy products, represents one of the most studied diets for cardiovascular health. It has been shown, from both observational and randomized controlled trials, that MD reduces body weight, improves cardiovascular disease surrogates such as waist-to-hip ratios, lipids, and inflammation markers, and even prevents the development of fatal and nonfatal cardiovascular disease, diabetes, obesity, and other diseases. However, it is unclear whether it offers cardiovascular benefits from its individual components or as a whole. Furthermore, limitations in the methodology of studies and meta-analyses have raised some concerns over its potential cardiovascular benefits. MD is also associated with characteristic changes in the intestinal microbiota, mediated through its constituents. These include increased growth of species producing short-chain fatty acids, such as Clostridium leptum and Eubacterium rectale, increased growth of Bifidobacteria, Bacteroides, and Faecalibacterium prausnitzii species, and reduced growth of Firmicutes and Blautia species. Such changes are known to be favorably associated with inflammation, oxidative status, and overall metabolic health. This review will focus on the effects of MD on cardiovascular health through its action on gut microbiota.
Assuntos
Doenças Cardiovasculares , Dieta Mediterrânea , Microbioma Gastrointestinal , Humanos , Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/microbiologia , Doenças Cardiovasculares/etiologiaRESUMO
BACKGROUND: Cauliflower (Brassica oleracea L.) and globe artichoke (Cynara scolymus L.) are vegetables with a high waste index mainly related to stems and leaves. In this study, enzymatic hydrolysates obtained from these wastes were proposed to be used as plant biostimulants. Life cycle assessment methodology was also applied to evaluate environmental performances related to cauliflower and artichoke byproducts. RESULTS: Hydrolysates (HYs) were chemically and biologically characterized. Amino acids, organic acids, amines, polyols, mineral elements, phenols, tannins, flavonoids and sulfur compounds were identified and quantified by means of NMR, inductively coupled plasma mass spectrometry and UV-visible analyses. Cauliflower leaf and flower HYs showed the highest concentration of free amino acids, whereas stems showed the highest concentration of Ca. Regarding artichoke, asparagine, glutamine and aspartic acid were exclusively detected in stems, whereas artichoke leaves showed the highest Mg and Mn levels together with the highest antioxidant activity. The HYs diluted in water were tested as biostimulants. The impacts of five concentrations of HYs (0.00, 0.28, 0.84, 2.52 and 7.56 g L-1) on seed germination and early seedling growth of crimson clover, alfalfa, durum wheat and corn were investigated. CONCLUSIONS: The application of artichoke biostimulant (0.28 g L-1) positively influenced the coefficient of velocity of germination in alfalfa, crimson clover and durum wheat, whereas cauliflower biostimulant significantly improved corn germination speed. © 2024 The Author(s). Journal of the Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
RESUMO
BACKGROUND: Optimal timing for catheter ablation of ventricular tachycardia is an important unresolved issue. There are no randomized trials evaluating the benefit of ablation after the first implantable cardioverter defibrillator (ICD) shock. METHODS: We conducted a 2-phase, prospective, multicenter, randomized clinical trial. Patients with ischemic or nonischemic dilated cardiomyopathy and primary or secondary prevention indication for ICD were enrolled in an initial observational phase until first appropriate shock (phase A). After reconsenting, patients were randomly assigned 1:1 in phase B to immediate ablation (within 2 months from shock delivery) or continuation of standard therapy. The primary end point was a composite of death from any cause or hospitalization for worsening heart failure. Amiodarone intake was not allowed except for documented atrial tachyarrhythmias. On July 23, 2021, phase B of the trial was interrupted as a result of the first interim analysis on the basis of the Bayesian adaptive design. RESULTS: Of the 517 patients enrolled in phase A, 154 (30%) had ventricular tachycardia, 56 (11%) received an appropriate shock over a median follow-up of 2.4 years (interquartile range, 1.4-4.4), and 47 of 56 (84%) agreed to participate in phase B. After 24.2 (8.5-24.4) months, the primary end point occurred in 1 of 23 (4%) patients in the ablation group and 10 of 24 (42%) patients in the control group (hazard ratio, 0.11 [95% CI, 0.01-0.85]; P=0.034). The results met the prespecified termination criterion of >99% Bayesian posterior probability of superiority of treatment over standard therapy. No deaths were observed in the ablation group versus 8 deaths (33%) in the control group (P=0.004); there was 1 worsening heart failure hospitalization in the ablation group (4%) versus 4 in the control group (17%; P=0.159). ICD shocks were less frequent in the ablation group (9%) than in the control group (42%; P=0.039). CONCLUSIONS: Ventricular tachycardia ablation after first appropriate shock was associated with a reduced risk of the combined death or worsening heart failure hospitalization end point, lower mortality, and fewer ICD shocks. These findings provide support for considering ventricular tachycardia ablation after the first ICD shock. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT01547208.
Assuntos
Ablação por Cateter , Desfibriladores Implantáveis , Insuficiência Cardíaca , Taquicardia Ventricular , Teorema de Bayes , Ablação por Cateter/efeitos adversos , Ablação por Cateter/métodos , Insuficiência Cardíaca/terapia , Humanos , Prognóstico , Estudos Prospectivos , Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/cirurgia , Resultado do TratamentoRESUMO
A fast HPLC method with fluorescence detector (FD) was developed for the determination of three tocopherols (TOCs) in milk samples from Modicana cattle breed. The ultrasound-assisted procedure was optimized for the extraction of TOCs prior to HPLC/FD analysis, reducing sample preparation time and allowing a fast quantification of α-tocopherol, δ-tocopherol and γ tocopherol. The optimized ultrasonic extraction combines an efficient and simple saponification at room temperature and a rapid HPLC quantification of TOCs in milk. The precision of the full analytical procedure was satisfactory and the recoveries at three spiked levels were between 95.3% and 87.8%. The linear correlations were evaluated (R2 > 0.99) and the relative standard deviation (RSD) values for intra-day and inter-day tests at three spiked levels were below 1% for the retention time and below 5.20% for the area at low level spiking. The proposed procedure, reducing the experimental complexity, allowed accurate extraction and detection of three TOCs in milk samples from Modicana cattle breed.
Assuntos
Cromatografia Líquida de Alta Pressão/normas , Extração Líquido-Líquido/métodos , Leite/química , Tocoferóis/isolamento & purificação , alfa-Tocoferol/isolamento & purificação , gama-Tocoferol/isolamento & purificação , Animais , Bovinos , Limite de Detecção , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Saponinas/química , Sonicação , Fatores de TempoRESUMO
BACKGROUND: An antioxidant formula based on peanut skins and hulls was developed and characterized for total and single polyphenols, as well as antioxidant power, considering the contribution provided by each peanut by-product. Subsequently, it was evaluated for its effect on the sensory properties and aroma stability of peanut bars over a 100-day period. To this purpose, snacks fortified, or not, with the natural additive were experimentally produced. RESULTS: Peanut hulls contributed to a greater extent than skins with respect to boosting the content of bioactives and the antioxidnt activity of the antioxidant formula, which was marked by a phenol content of (approximately 807 mg gallic acid equivalents g-1 ) and a 2,2-diphenyl-1-picrylhydrazyl activity similar to that of butylated hydroxytoluene (85.96% and 89.30%, respectively). From a sensory perspective, the incorporation of the formulation in snacks caused only a slightly stronger perception of astringent and bitter notes. Pyrazines, phenol, furan and pyrrole derivatives defined the aroma of snacks, being more abundant in fortified than in conventional samples. Such volatiles faded over storage, with different trends in the examined products. For example, the sum of 2,5-dimethylpyrazine, 2-ethylpyrazine and 2,3-dimethylpyrazine was 9.49 and 8.87 ppm at day 15; 5.57 and 7.16 ppm at day 45; and 5.03 and 4.65 ppm at day 100, respectively, in fortified and conventional snacks. Hydroxymethylfurfural decreased constantly over storage in conventional samples and only after day 45 in fortified bars. CONCLUSION: Overall, the antioxidant formulation did not compromise the sensory desirability of peanut snacks and induced a preservative effect on their aroma, especially during the first 15 days of storage. © 2020 Society of Chemical Industry.
Assuntos
Arachis/química , Alimentos Fortificados/análise , Odorantes/análise , Resíduos/análise , Arachis/metabolismo , Armazenamento de Alimentos , Humanos , Fenóis/química , Fenóis/metabolismo , Sementes/química , Sementes/metabolismo , Lanches , PaladarRESUMO
This study focused on the inorganic environmental contaminants in specific food products which form part of the food chain of the population residing in the area of Southern Italy (Gela) where there is a high mortality rate linked to tumor diseases and congenital malformations. Determination of toxic metals was performed by Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). The toxicological data for every toxic element has been applied to evaluate the risk for the consumer by calculating the amount of potentially toxic element that would ingest an average of 60kg weight individual adult. The analysis of the investigated samples shows a high level of metal contamination which can be linked both to the polluted water and air. The obtained results give us an idea about the agricultural products contamination and possible exposure of local people through the food chain.
Assuntos
Monitoramento Ambiental/métodos , Poluentes Ambientais , Contaminação de Alimentos/análise , Metais Pesados , Verduras/química , Irrigação Agrícola , Poluentes Ambientais/análise , Poluentes Ambientais/toxicidade , Itália , Metais Pesados/análise , Metais Pesados/toxicidade , Medição de RiscoAssuntos
COVID-19 , Coronavirus , China , Humanos , Pandemias/prevenção & controle , Cidade de Roma/epidemiologia , SARS-CoV-2RESUMO
AIMS: Transcatheter aortic valve implantation (TAVI) is a therapeutic treatment for patients with severe aortic stenosis (AS) at high surgical risk. Although the procedure is associated with a reduction in total mortality, there are no data regarding changing in the incidence of premature ventricular contractions (PVCs) and ventricular arrhythmias (VAs) after TAVI. The aim of this study was to assess the incidence of VAs before and after TAVI. METHODS AND RESULTS: We enrolled 237 patients who underwent TAVI at our centre. Ninety-one patients were excluded for the following reasons: presence of prior permanent pacemaker (PPM) (n = 20), new PPM implant after TAVI (n = 48), death during the follow-up period (n = 16), and lost at follow-up (n = 7). Finally, 146 patients were included in our analysis. The presence of VAs was evaluated in all patients recording a 24 h Holter monitoring before the procedure and after 1 and 12 months. Ventricular arrhythmias were classified according to a modified Lown grading system. Before the procedure, isolates PVCs (grade 1-2 of Lown grading system) were present in 34.9% of patients (n = 51). Complex PVCs (grade 3-4a-4b of Lown grading system) were present in 48.6% of the population (multifocal PVCs in 32 patients, 21.9%; pairs in 25 patients, 17.1%; ventricular tachycardia in 14 patients, 9.6%). One month after the procedure, we observed statistically significant incidence decrease of arrhythmias of grade 3 (from 21.9 to 17.1%) and grade 4 (pairs from 17.1 to 12.3%; ventricular tachycardia from 9.6 to 4.8%). After 12 months, there was a further significant reduction in the frequency and severity of PVCs. In particular, 45.8% of patients had isolates PVCs (<30 in all given hours of monitoring in 45 patients, 30.8%; higher than 30 in any hour of monitoring in 22 patients, 15%) while the frequency of complex arrhythmias was reduced to 16.4% (multifocal PVCs in 13 patients, 9%; couplets 8 patients, 5.5% and ventricular tachycardia in 3 patients, 2.0%). The difference was statistically significant (P < 0.01). CONCLUSION: This study indicates that VAs are common in patients with AS. We observed a significant decrease in the incidence and severity of PVCs since the first month after TAVI. Furthermore, after 1 year follow-up there was a further and significant reduction in the frequency of complex PVCs. This may be related to the benefits determined by valve replacement on left ventricular function.
Assuntos
Estenose da Valva Aórtica/mortalidade , Estenose da Valva Aórtica/cirurgia , Complicações Pós-Operatórias/mortalidade , Taquicardia Ventricular/mortalidade , Substituição da Valva Aórtica Transcateter/mortalidade , Complexos Ventriculares Prematuros/mortalidade , Idoso de 80 Anos ou mais , Causalidade , Comorbidade , Feminino , Humanos , Incidência , Itália/epidemiologia , Masculino , Fatores de Risco , Taxa de Sobrevida , Resultado do TratamentoRESUMO
This article describes the oncology programs developed in Italy for adolescents and young adults with cancer, with a specific focus on the local projects created in pediatric oncology centers. A common feature of such projects is the emphasis on creative and artistic activities and laboratories (involving music, photography, novel writing, fashion design, and so on) designed to give young patients innovative means of expression.This article highlights the amazing powers of adolescents involved in these projects: the power to produce beautiful things in a place that is not normally associated with the idea of beauty; the power to make their doctors smile and grasp the profound sense of life; the power to make hospitals become places for producing culture.
Assuntos
Neoplasias , Humanos , Adolescente , Itália , Neoplasias/terapia , Neoplasias/psicologia , Arte , Oncologia/métodos , Adulto Jovem , Feminino , Institutos de Câncer/organização & administração , MasculinoRESUMO
The meat of snails can be considered a high-quality food for the human diet and demand is already increasing across Europe. Due to the bioaccumulation of trace elements in their tissues, land snails can be a significant tool also for environmental pollution evaluation. In this study, 28 mineral elements (Ag, Al, As, B, Ba, Be, Bi, Cd, Co, Cr, Cu, Fe, Hg, K, Li, Na, Mg, Mn, Mo, Ni, Pb, Sb, Se, Sr, Ti, Tl, V, Zn) in both the edible part and the shell of edible land snails commercially available in Southern Italy belonging to Cernuella virgata, Helix aperta, Theba pisana species were investigated by ICP-MS and direct mercury analyser. The concentration of trace elements was variable among the samples. The variability demonstrates the close connection among the type of snail, the geographical origin, and the habitat in which the species grows. The edible part of the snails analysed in this study was found to be a good source of macro-nutrients. Toxic elements were detected in some samples, especially in shells; nevertheless, the values fell within the safety limits. Further investigations and monitoring of mineral contents in edible land snails are suggested both for human health and environmental pollution evaluation.
RESUMO
This is the first study in which the impact of a new bio-packaging on histamine formation in mackerel was investigated. To monitor the preservation of fresh fish samples a treatment with innovative polymeric film and a soaking procedure in liquid new biomaterial was adopted. Ultra HPLC diode array detection (UHPLC-DAD) analyses for histamine monitoring were performed on fresh, packaged, and soaked mackerel samples at different time. The histamine content threshold value was up to 7 days, and after this period the results showed that histamine levels were affected by application of biomaterial. Significant increase was detected in sample that was not treated with biofilm. The new biofilm extended the shelf-life and reveals a promising packaging system to prevent histamine biosynthesis.
RESUMO
Table salts with their specialty flake size, textures, flavors, and colors can be considered a gastronomy niche food already increasing in demand worldwide. Being unrefined, they can contain trace elements potentially both healthy and toxic. In this study, 12 mineral elements (Al, Ca, Co, Cr, Cu, Fe, Hg, Mn, Ni, Pb, Se, and Zn) in 10 different salts commercially available in southern Italy namely, Atlantic grey, Baule volante, Guerande, Hawaiian pink, Hawaiian black, Himalayan pink, Maldon, Mozia, Persian blue, and smoked salts were analyzed by inductively coupled plasma mass spectrometry (ICP-MS) and thermal decomposition amalgamation-atomic absorption spectrophotometry (TDA-AAS). The concentration of mineral elements was variable according to the type of salt and its geographical origin. Co, Cr, Cu, Hg, Pb, and Se levels were tolerable and Al, Ca, Fe, Mn, Ni, and Zn ranged significantly among the samples. Persian Blue and Atlantic Grey salts showed elevated levels of Fe and Zn; their intake can be helpful in some specific conditions. Nevertheless, Ni levels were high in Persian Blue and Smoked salts. Pb exceeded the maximum level in all samples. Additional monitoring analyses of mineral contents in table salts are recommended for human health.
RESUMO
BACKGROUNDSevere forms of idiopathic nephrotic syndrome (INS) require prolonged immunosuppressive therapies and repeated courses of high-dose glucocorticoids. Mesenchymal stromal cells (MSCs) have promising immunomodulatory properties that may be employed therapeutically to reduce patient exposure to medications and their side effects.METHODSWe performed a phase I open-label trial assessing safety and feasibility of autologous bone marrow-derived MSCs (BM-MSCs) in children and young adults with severe forms of steroid-dependent nephrotic syndrome. Following autologous BM-MSC preparation and infusion, oral immunosuppression was tapered. Safety, efficacy, and immunomodulatory effects in vivo were monitored for 12 months.RESULTSSixteen patients (10 children, 6 adults) were treated. Adverse events were limited and not related to BM-MSC infusions. All patients relapsed during follow-up, but in the 10 treated children, time to first relapse was delayed (P = 0.02) and number of relapses was reduced (P = 0.002) after BM-MSC infusion, compared with the previous 12 months. Cumulative prednisone dose was also reduced at 12 months compared with baseline (P < 0.05). No treatment benefit was observed in adults.In children, despite tapering of immunosuppression, clinical benefit was mirrored by a significant reduction in total CD19+, mature, and memory B cells and an increase in regulatory T cells in vivo up to 3-6 months following BM-MSC infusionCONCLUSIONTreatment with autologous BM-MSCs is feasible and safely reduces relapses and immunosuppression at 12 months in children with severe steroid-dependent INS. Immunomodulatory studies suggest that repeating MSC infusions at 3-6 months may sustain benefit.TRIAL REGISTRATIONEudraCT 2016-004804-77.FUNDINGAIFA Ricerca Indipendente 2016-02364623.
Assuntos
Células-Tronco Mesenquimais , Síndrome Nefrótica , Criança , Adulto Jovem , Humanos , Síndrome Nefrótica/terapia , Glucocorticoides/uso terapêutico , Terapia de Imunossupressão , RecidivaRESUMO
Background: Germ cell tumors (GCT) account for a minority of central nervous system (CNS) malignancies, highly prevalent in adolescents and young adults. Despite their aggressive biological behavior, prognosis is excellent in most cases with risk stratified treatment, consisting in a combination of chemotherapy and radiotherapy. Whole ventricular irradiation (WVI) and craniospinal irradiation, the treatment of choice for localized and metastatic disease, pose significant risk of collateral effects, therefore proton beam radiation (PBT) has been recently proposed for its steep dose fallout. Materials and methods: We report our experience in a consecutive series of 17 patients treated for CNS GCT at our Institution from 2015 to 2021. Results: Most frequent lesion location were sellar/suprasellar (35%) and bifocal germinoma (35%), followed by pineal (18%) and thalamic (12%). Two patients (12%), had evidence of disseminated disease at the time of diagnosis. At the latest follow-up all but one patient showed complete response to treatment. The only relapse was successfully rescued by additional chemotherapy and PBT. PBT was well tolerated in all cases. No visual, neurological or endocrinological worsening was documented during and after treatment. Neuropsychological evaluation demonstrated preservation of cognitive performance after PBT treatment. Conclusions: Our data, albeit preliminary, strongly support the favourable therapeutic profile of PBT for the treatment of CNS germ cell tumors.
RESUMO
BACKGROUND: Cancer is very disruptive in adolescence and hospitalizations interfere with this development stage in becoming independent, developing social relationships, and making plans for the future. A major challenge in the care of adolescents with cancer is being able to enhance their quality of life. The aim of this project is to increase our understanding of how adventure therapy influenced quality of life for adolescents with cancer. METHODS: Bambino Gesù Children's Hospital, in collaboration with the Tender to Nave Italia Foundation (TTNI), has been conducting a unique project, located on a beautiful brigantine of the Italian Navy. Adventure therapy is a form of experiential therapy that consists of various types of adventure, in particular outdoor and sailing activities. Ninety teenagers have been the protagonists of this project to date and filled out two questionnaires about quality of life and self-esteem, before and after the sailing experience. RESULTS: The adventure provides the opportunity for the participants to build interpersonal relationships and develop life skills that they can benefit from in the future experiences. All participants report a significant improvement in their quality of life and self-esteem at the end of this experience. CONCLUSION: This collaborative adventure project is a great way to learn and practice new behaviors, improve interpersonal skills, heal painful emotions, overcome personal obstacles and challenges, and help the teenagers to resume their developmental path after an onco-hematological diagnosis.
Assuntos
Neoplasias , Esportes , Criança , Adolescente , Humanos , Qualidade de Vida , Relações Interpessoais , Habilidades SociaisRESUMO
Inflammasomes are key intracellular multimeric proteins able to initiate the cellular inflammatory signaling pathway. NLRP3 inflammasome represents one of the main protein complexes involved in the development of inflammatory events, and its activity has been largely demonstrated to be connected with inflammatory or autoinflammatory disorders, including diabetes, gouty arthritis, liver fibrosis, Alzheimer's disease, respiratory syndromes, atherosclerosis, and cancer initiation. In recent years, it has been demonstrated how dietary intake and nutritional status represent important environmental elements that can modulate metabolic inflammation, since food matrices are an important source of several bioactive compounds. In this review, an updated status of knowledge regarding food bioactive compounds as NLRP3 inflammasome modulators is discussed. Several chemical classes, namely polyphenols, organosulfurs, terpenes, fatty acids, proteins, amino acids, saponins, sterols, polysaccharides, carotenoids, vitamins, and probiotics, have been shown to possess NLRP3 inflammasome-modulating activity through in vitro and in vivo assays, mainly demonstrating an anti-NLRP3 inflammasome activity. Plant foods are particularly rich in important bioactive compounds, each of them can have different effects on the pathway of inflammatory response, confirming the importance of the nutritional pattern (food model) as a whole rather than any single nutrient or functional compound.
Assuntos
Aterosclerose , Inflamassomos , Animais , Suplementos Nutricionais , Humanos , Inflamassomos/metabolismo , Inflamação/metabolismo , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismoRESUMO
The aim of this study is to prompt the recovery of industrial by-products through the production of new functional foods; it takes advantage from new throughput technologies with low environmental impact and high economic sustainability. In the field of fish processing, in order to recover the worthy protein-rich fish waste, residues from the production of Anchovies (Engraulis encrasicolus) have been converted into hydrolysate through enzymatic treatment. The obtained hydrolysate product showed a promising biological and nutritional content made by differently sized peptides and free amino acids endowed with assessed benefic effects. The study showed the possibility to produce a dry powder with an activity water (aw) of 0.3-0.5 and an essential amino acids (EAA) fraction of 42.0% over the total amino acids (TAAs). These results pave the way to the smart recovery of commercial products featured by high nutritional value, either as stand-alone items or as components of functional foods.
Assuntos
Proteínas de Peixes/química , Hidrolisados de Proteína/química , Hidrolisados de Proteína/isolamento & purificação , Resíduos , Aminoácidos Essenciais/análise , Aminoácidos Essenciais/química , Animais , Cromatografia Líquida de Alta Pressão , Peixes , Indústria de Processamento de Alimentos , Espectroscopia de Ressonância Magnética , Espectrometria de Massas/métodos , Valor Nutritivo , Peptídeos/química , PósRESUMO
A multidisciplinary protocol is proposed to monitor the preservation of fresh pumpkin samples (FP) using three commercial polymeric films: A made of biodegradable cellophane from regenerated cellulose pulp; B from corn starch, cassava and eucalyptus, C made of polylactic acid from corn starch, and a polyethylene film used as reference (REF). Chemical, mechanical and microbiological analyses were applied on packaging and fresh and packaged samples at different times. After an 11-day period, NMR spectroscopy results showed a sucrose increase and a malic acid decrease in all the biofilms with respect to FP; fructose, glucose, galactose levels remained quite constant in biofilms B and C; the most abundant amino acids remained quite constant in biofilm A and decreased significantly in biofilm B. From microbiological analyses total microbial count was below the threshold value up to 7 days for samples in all the films, and 11 days for biofilm C. The lactic acid bacteria, and yeasts and molds counts were below the acceptability limit during the 11 days for all packages. In the case of biofilm C, the most promising packaging for microbiological point of view, aroma analysis was also carried out. In this paper, you can find all the analysis performed and all the values found.
RESUMO
AIMS: There are conflicting data on the benefit of cardiac resynchronization therapy (CRT) in heart failure (HF) patients with permanent atrial fibrillation (AF). We aimed to compare patient outcomes according to the presence or absence of permanent AF at device implantation. METHODS AND RESULTS: We retrospectively analysed remote monitoring data from 1141 CRT defibrillators. Propensity score with inverse-probability weighting method was used to balance AF and sinus rhythm (SR) groups. Analysis endpoints included total mortality, appropriate defibrillation shocks, and CRT percentage. There were 229 patients (20.1%) in the AF group and 912 patients (79.9%) in the SR group. Compared with SR patients, AF patients were older (median age, 77 vs. 72 years, P < 0.001), more frequently male (82.5% vs. 75.5%, P = 0.02), and had higher heart rate (75.7 vs. 71.0 b.p.m., P < 0.001). Of the 229 AF patients, 162 (70.7%) received suboptimal CRT (<98%) and 67 (29.3%) had adequate CRT (≥98%). During a median follow-up of 24 months, total mortality did not differ between AF and SR groups (propensity-score-weighted hazard ratio, HR 1.32 [95% confidence interval, 0.82-2.15], P = 0.25). The risk of appropriate shocks was significantly higher in the AF group with <98% CRT than in the SR group (weighted-HR, 1.99 [1.21-3.26], P = 0.006) and was similar in the AF group with ≥98% CRT versus the SR group (1.29 [0.66-2.53], P = 0.45). During follow-up, sinus rhythm was recovered in 23 patients in the AF group (10%) after a median time of 106 (42-256) days. The rate of sinus rhythm recovery in the AF group was 4.5 (95% CI, 2.8-6.7) per 100 patient-years; the rate of permanent AF occurrence in the SR group was 2.5 (95% CI, 1.9-3.3) per 100 patient-years. CONCLUSIONS: Although mortality was similar across patient groups, patients with permanent AF and suboptimal CRT had twofold higher risk of appropriate shocks than SR patients or AF patients with CRT ≥ 98%.
Assuntos
Fibrilação Atrial , Terapia de Ressincronização Cardíaca , Idoso , Fibrilação Atrial/epidemiologia , Fibrilação Atrial/terapia , Terapia de Ressincronização Cardíaca/métodos , Desfibriladores , Humanos , Masculino , Estudos Retrospectivos , Resultado do TratamentoRESUMO
(1) Background: Extra-virgin olive oil (EVOO) is a precious and universally studied food matrix. Recently, the quantitative chemical composition was investigated by an innovative processing method for the nuclear magnetic resonance (NMR) experiments called Multi-Assignment Recovered Analysis (MARA)-NMR. (2) Methods: Any EVOO 13-carbon NMR (13C-NMR) profile displayed inconsistent signals. This mismatch was resolved by comparing NMR data to the official gas-chromatographic flame ionization detection (GC-FID) experiments: the analyses concerned many EVOOs but also the "exotic" Capparis spinosa oil (CSO). (3) Results: NMR and GC-FID evidenced the overwhelming presence of cis-vaccenic esters in the CSO and, more importantly, cis-vaccenic 13C-NMR resonances unequivocally matched the misunderstood 13C-NMR signals of EVOOs. The updated assignment revealed the unexpected relevant presence of cis-vaccenic ester (around 3%) in EVOOs; it was neglected, so far, because routine and official GC-FID profiles did not resolve oleic and cis-vaccenic signals leading to the total quantification of both monounsaturated fatty esters. (4) Conclusions: The rebuilt MARA-NMR and GC-FID interpretations consistently show a meaningful presence of cis-vaccenic esters in EVOOs, whose content could be a discrimination factor featuring specific cultivar or geographical origin. The study paves the way toward new quantification panels and scientific research concerning vegetable oils.