Safety and Efficacy of Traditional Heart Failure Therapies in Patients With Cardiac Amyloidosis and Heart Failure.

Randomized controlled trials have demonstrated mortality benefits for several medication classes in patients with heart failure (HF), especially with reduced ejection fraction (EF). However, the benefit of these traditional HF therapies in patients with HF from cardiac amyloidosis is unclear. our study aimed to evaluate the safety and efficacy of traditional HF therapies in patients with cardiac amyloidosis and HF with reduced EF or HF with mid-range EF (HFmrEF). We conducted a single-center retrospective study. Patients were included if they were diagnosed with cardiac amyloidosis and HF with reduced EF or HF with mid-range EF between January 2012 and 2022. The primary outcomes of interest were medication use patterns (for ß blockers [BB], angiotensin-converting enzyme inhibitors [ACEI], angiotensin receptor blockers [ARBs], angiotensin receptor neprilysin inhibitors [ARNI], and mineralocorticoid receptor antagonists [MRAs]); potential medication side effects (symptomatic bradycardia, fatigue, hypotension, lightheadedness, and syncope); hospitalization; and death. The associations of BB, ACEI/ARB/ARNI, and MRA use with clinical outcomes were evaluated using Kaplan-Meier and Cox proportional hazards regression. A total of 82 patients met study criteria. At time of cardiac amyloidosis diagnosis, 63.4% were on a BB, 51.2% were on an ACEI/ARB/ARNI, and 43.9% were on an MRA. At last follow-up, 51.2% were on a BB, 35.4% were on an ACEI/ARB/ARNI, and 43.9% were on an MRA. There were no statistically significant differences in rates of potential medication side effects in patients on the medication class compared with those who were not. There was no association with hospitalization or mortality for baseline or follow-up BB, ACEI/ARB/ARNI, or MRA use. In conclusion, BBs, ACEI/ARB/ARNIs, and MRAs may be safely used in this population. However, their use does not appear to improve mortality or hospitalization.

Efecto cicatrizante en incisiones periodontales por extracto hidroalcohólico de Morinda citrifolia

Los tratamientos periodontales implican cortes y sangrado de la mucosa gingival; la Morinda citrifolia, específicamente sobre los fragmentos encargados de la cicatrización (plaquetas), tiene un efecto más significativo en los procesos curativos de las lesiones. Objetivo. Identificar el potencial cicatrizante de los extractos hidroalcohólicos de Morinda citrifolia (noni peruano) en los procesos regenerativos de las incisiones periodontales al 70% a diversas concentraciones (1%; 5; y 10%) y su efecto coadyuvante acelerador en la vía oral como curación de tejidos. Materiales y Métodos. Se realizó una investigación aplicada, bajo el diseño experimental. Para ello, se llevó a cabo un estudio previo para el análisis farmacognóstico, porcentaje de humedad, pruebas de solubilidad y el análisis fitoquímico cualitativo para garantizar que el análisis farmacológico y la prueba experimental se completaran adecuadamente. Se administraron dosis a cinco ratas albinas macho Holtzman divididas en cuatro grupos a los cuales se les aplicó las concentraciones en cantidades de 0,5 ml dos veces al día en la incisión, la cual se evaluó durante siete días para obtener parámetros específicos, como infección, tono de piel gingival, cierre de heridas, reducción del tamaño de la incisión y porcentaje de curación. Resultados. Indicaron que todos los grupos que se le suministró el extracto hidroalcohólico al 70% en varias concentraciones mejoró su actividad curativa al reducir el tamaño de la incisión en la encía al séptimo día, donde resultó que la mejor concentración fue del 5% en comparación con las otras concentraciones (1% y 10%). Investigación que indica la eficacia de la Morinda citrifolia peruana como acelerador del proceso de curación en la terapia periodontal.

Periodontal treatments involve cuts and bleeding of the gingival mucosa; Morinda citrifolia, specifically on the fragments in charge of healing (platelets), has a more significant effect on the healing processes of the lesions. Objective. To identify the healing potential of hydroalcoholic extracts of Morinda citrifolia (Peruvian noni) in the regenerative processes of periodontal incisions at 70% at various concentrations (1%; 5; and 10%) and its accelerating coadjuvant effect in the oral route as tissue healing. Materials and Methods. An applied research was carried out under an experimental design. For this purpose, a previous study was carried out for pharmacognostic analysis, moisture percentage, solubility tests and qualitative phytochemical analysis to ensure that the pharmacological analysis and experimental test were properly completed. Doses were administered to five male Holtzman albino rats divided into four groups to which the concentrations were applied in 0.5 ml amounts twice daily to the incision, which was evaluated for seven days for specific parameters, such as infection, gingival skin tone, wound closure, incision size reduction and percentage healing. Results. They indicated that all groups that were given the 70% hydroalcoholic extract in various concentrations improved their healing activity by reducing the size of the gingival incision on the seventh day, where it turned out that the best concentration was 5% compared to the other concentrations (1% and 10%). Conclusion. Research indicating the efficacy of Peruvian Morinda citrifolia as an accelerator of the healing process in periodontal therapy.

Os tratamentos periodontais envolvem corte e sangramento da mucosa gengival; a Morinda citrifolia, especificamente sobre os fragmentos responsáveis pela cicatrização (plaquetas), tem um efeito mais significativo nos processos de cicatrização das lesões. Objetivo. Identificar o potencial cicatrizante de extratos hidroalcoólicos de Morinda citrifolia (noni peruano) nos processos regenerativos de incisões periodontais a 70% em diversas concentrações (1%; 5; e 10%) e seu efeito coadjuvante acelerador na via oral como cicatrizante tecidual. Materiais e métodos. Foi realizada uma pesquisa aplicada sob um desenho experimental. Para esse fim, foi realizado um pré-estudo para análise farmacognóstica, porcentagem de umidade, testes de solubilidade e análise fitoquímica qualitativa para garantir que a análise farmacológica e o teste experimental fossem adequadamente concluídos. Cinco ratos albinos Holtzman machos divididos em quatro grupos foram dosados e as concentrações foram aplicadas em quantidades de 0,5 ml duas vezes ao dia na incisão, que foi avaliada por sete dias quanto a parâmetros específicos, como infecção, tônus gengivais da pele, fechamento da ferida, redução do tamanho da incisão e porcentagem de cicatrização. Resultados. Eles indicaram que todos os grupos que receberam extrato hidroalcoólico a 70% em várias concentrações melhoraram sua atividade de cicatrização ao reduzir o tamanho da incisão gengival no sétimo dia, sendo que a melhor concentração foi de 5% em comparação com as outras concentrações (1% e 10%). Conclusão. A pesquisa indica a eficácia da Morinda citrifolia peruana como um acelerador do processo de cicatrização na terapia periodontal.

A randomized controlled trial comparing the AccuVein AV300 device to standard insertion technique for intravenous cannulation of anesthetized children.

OBJECTIVES AND AIMS: To evaluate the efficacy of the AccuVein AV300 device in improving the first-time success rate of intravenous cannulation of anesthetized pediatric patients. BACKGROUND: The AccuVein AV300 device was developed to assist venepuncture and intravenous cannulation by enhancing the visibility of superficial veins. It uses infrared light to highlight hemoglobin so that blood vessels are darkly delineated against a red background. METHODS/MATERIALS: Patients were randomized to cannulation with the AccuVein AV300 device or standard insertion by experienced pediatric anesthesiologists. An observer recorded the number of skin punctures and cannulation attempts required, and the time between tourniquet application and successful cannulation or four skin punctures, whichever came first. RESULTS AND CONCLUSIONS: There were 146 patients with a median age of 4.6 years (range, 0.18-17.1 years), 46.6% were male, 80.8% were light skin colored, and 15.7% were younger than 2 years. The first-attempt success rates were 75% (95% CI, 63.8-84.2%) using AV300 and 73% (95% CI, 61.9-81.9%) using the standard method (P = 0.85). Patients with dark or medium skin color were 0.38 times less likely to have a successful first attempt than patients with light skin color. The difference between the two treatment groups in number of skin punctures and the time to insertion was not significant. Although the AV300 was easy to use and improved visualization of the veins, we found no evidence that it was superior to the standard method of intravenous cannulation in unselected pediatric patients under anesthesia.

NmDef02, a novel antimicrobial gene isolated from Nicotiana megalosiphon confers high-level pathogen resistance under greenhouse and field conditions.

Plant defensins are small cysteine-rich peptides that inhibit the growth of a broad range of microbes. In this article, we describe NmDef02, a novel cDNA encoding a putative defensin isolated from Nicotiana megalosiphon upon inoculation with the tobacco blue mould pathogen Peronospora hyoscyami f.sp. tabacina. NmDef02 was heterologously expressed in the yeast Pichia pastoris, and the purified recombinant protein was found to display antimicrobial activity in vitro against important plant pathogens. Constitutive expression of NmDef02 gene in transgenic tobacco and potato plants enhanced resistance against various plant microbial pathogens, including the oomycete Phytophthora infestans, causal agent of the economically important potato late blight disease, under greenhouse and field conditions.