The Effects of a Perindopril-Based Regimen in Relation to Statin Use on the Outcomes of Patients with Vascular Disease: a Combined Analysis of the ADVANCE, EUROPA, and PROGRESS Trials.

PURPOSE: To study the effects of a perindopril-based regimen on cardiovascular (CV) outcomes in patients with vascular disease in relation to background statin therapy. METHODS: A pooled analysis of the randomized ADVANCE, EUROPA, and PROGRESS trials was performed to evaluate CV outcomes in 29,463 patients with vascular disease treated with perindopril-based regimens versus placebo. The primary endpoint was a composite of CV mortality, nonfatal myocardial infarction, and stroke. Multivariable Cox regression analyses were performed to assess the effects of a perindopril-based regimen versus placebo in relation to statin use. RESULTS: At randomization, 39.5% of the overall combined study population used statins. After a mean follow-up of 4.0 years (SD 1.0), the cumulative event-free survival was highest in the statin/perindopril group and lowest in the no statin/placebo group (91.2% vs. 85.6%, respectively, log-rank p < 0.001). In statin users (adjusted hazard ratio [aHR] 0.87, 95% confidence interval [CI] 0.77-0.98) and non-statin users (aHR 0.80, 95% CI 0.74-0.87), a perindopril-based regimen was associated with a significantly lower risk of the primary endpoint when compared to placebo. The additional treatment effect appeared numerically greater in non-statin users, but the observed difference was statistically nonsignificant. CONCLUSION: Our data suggest that the treatment benefits of a perindopril-based regimen in patients with vascular disease are independent of statin use.

Predictors of cardiac arrhythmic events in non coronary artery disease patients.

Arrhythmic sudden cardiac death (SCD) represents a major worldwide public health problem accounting for 15-20% of deaths. Risk stratification to identify patients at risk of SCD is crucial in order to implement preventive measures in the general population. Several biomarkers have been tested exploring different pathophysiological mechanisms of cardiac conditions. Conflicting results have been described limiting so far their use in clinical practice. The use of new biomarkers such as microRNAs and sex hormones and the emerging role of genetic on risk prediction of SCD is a current research topic showing promising results.This review outlines the role of plasma biomarkers to predict ventricular arrhythmias and SCD in non coronary artery disease with a special focus on their relationship with the genetic biomarkers.

The role of Trichoderma spp. and silica gel in plant defence mechanisms and insect response in vineyard.

Several elicitors, stimulating induced resistance mechanisms, have potential in preventing or mitigating pathogen infections. Some of these compounds, triggering the production of jasmonic acid (JA), a precursor of herbivore-induced plant volatiles, could also play a central role in indirect resistance to pest species, by improving beneficial arthropod performance, and necrotrophic pathogens. In the current work, Trichoderma gamsii/T. asperellum and silica gel treatments - alone and in combination - were studied to evaluate the plant defence mechanism on grapevines (Vitis vinifera L.) by laboratory and field trials. JA production level was measured before and after Plasmopara viticola infection on potted vines. JA production induced by silica gel was higher than that caused by Trichoderma before infection. In Trichoderma-treated plants, JA production increased after P. viticola inoculation. In vineyard field trials, Mymaridae (Hymenoptera: Chalcidoidea) showed higher captures in transparent sticky traps on silica gel-treated plants, in comparison with control. On the other hand, no significant attraction was detected for Ichneumonoidea and other Chalcidoidea in silica gel and T. gamsii/T. asperellum-treated plants. The potential effects of elicitors are discussed, in the frame of attract and reward strategy.

Application of molecular tools to elucidate the microbiota of seafood.

The aim of this review is to present the methodologies currently applied to identify microbiota and pathogens transmitted to humans through seafood consumption, focusing on molecular techniques and pointing out their importance, advantages, disadvantages and applicability. Knowledge of available techniques allows researchers to identify which technique best fits their expectations. With such discernment, it will be possible to infer which disadvantages will be present and, therefore, not interfering with the final result. Two methodologies can be employed for this purpose, dependent and independent cultures. However, the dependent culture has certain limitations that can be solved through the independent cultivation techniques, such as PCR, PFGE and NGS, especially through the sequencing of the 16S rRNA region, providing a complete view of microbial diversity. These have revolutionized microbiological knowledge, mainly because they allow for the identification of uncultivable micro-organisms, which represent a substantial portion of total micro-organisms, making it possible to elucidate not yet described taxa which may display pathogenic potential, besides quantifying microbial communities, microbiota genetics, translated proteins and produced metabolites. In addition, transcriptomic and metabolomic techniques also allow for the evaluation of possible impacts that microbial communities may create in their environment, as well as the determination of potential pathogenicity to humans.

The Treatment Effect of an ACE-Inhibitor Based Regimen with Perindopril in Relation to Beta-Blocker use in 29,463 Patients with Vascular Disease: a Combined Analysis of Individual Data of ADVANCE, EUROPA and PROGRESS Trials.

INTRODUCTION: In everyday practice, angiotensin converting enzyme inhibitors and beta-blockers are cornerstone treatments in patients with (cardio-)vascular disease. Clear data that evaluate the effects of the combination of these agents on morbidity and mortality are lacking. METHODS: In this retrospective pooled analysis of three large perindopril outcome trials (ADVANCE, EUROPA, PROGRESS), clinical outcomes were evaluated in 29,463 patients with vascular disease. Multivariate Cox regression analyses were performed in patients randomized to a perindopril-based regimen or placebo (treatment effect), and data were stratified according to background beta-blocker treatment. The primary endpoint was a composite of cardiovascular mortality, non-fatal myocardial infarction, and stroke. RESULTS: The cumulative incidence of the primary endpoint over mean follow-up of 4.0 years (Sd 1.0) was significantly lower in the beta-blocker/perindopril group (9.6%; 545/5700 patients) as compared to beta-blocker/placebo (11.8%; 676/5718 patients) (p < 0.01). Adding perindopril to existing beta-blocker treatment reduced the relative risk of the primary endpoint by 20% (hazard ratio (HR) 0.80; 95% confidence interval (CI) 0.71-0.90), non-fatal myocardial infarction by 23% (HR 0.77; 95% CI 0.65-0.91), and all-cause mortality by 22% (HR 0.78; 95% CI 0.68-0.88) as compared to placebo. Significant treatment benefit was not observed for stroke (HR 0.93; 95% CI 0.75-1.15). Significance was maintained for the primary endpoint and cardiovascular endpoints when data were further stratified by baseline hypertension. However, the mortality benefit was only observed in patients with hypertension with background beta-blocker use. CONCLUSIONS: These data suggest that the beneficial cardioprotective effects of perindopril treatment are additive to the background beta-blockers use.

Novel role of the nutraceutical bioactive compound berberine in lectin-like OxLDL receptor 1-mediated endothelial dysfunction in comparison to lovastatin.

BACKGROUND AND AIMS: Oxidized LDL (oxLDL) or pro-inflammatory stimuli lead to increased oxidative stress linked to endothelial dysfunction and atherosclerosis. The oxLDL receptor-1 (LOX1) is elevated within atheromas and cholesterol-lowering statins inhibit LOX1 expression. Berberine (BBR), an alkaloid extracted from plants of gender Berberis, has lipid-lowering and anti-inflammatory activity. However, its role in regulating LOX1-mediated signaling is still unknown. The aim of this study was to investigate the effect of BBR on oxLDL- and TNFα-induced endothelial dysfunction in human umbilical vein endothelial cells (HUVECs) and to compare it with that of lovastatin (LOVA). METHODS AND RESULTS: Cytotoxicity was determined by lactate dehydrogenase assay. Antioxidant capacity was measured with chemiluminescent and fluorescent method and intracellular ROS levels through a fluorescent dye. Gene and protein expression levels were assayed by qRT-PCR and western blot, respectively. HUVECs exposure to oxLDL (30 µg/ml) or TNFα (10 ng/ml) for 24 h led to a significant increase in LOX1 expression, effect abrogated by BBR (5 µM) and LOVA (5 µM). BBR but not LOVA treatment abolished the TNFα-induced cytotoxicity and restored the activation of Akt signaling. In spite of a low direct antioxidant capacity, both compounds reduced intracellular ROS levels generated by treatment of TNFα but only BBR inhibited NOX2 expression, MAPK/Erk1/2 signaling and subsequent NF-κB target genes VCAM and ICAM expression, induced by TNFα. CONCLUSIONS: These findings demonstrated for the first time that BBR could prevent the oxLDL and TNFα - induced LOX1 expression and oxidative stress, key events that lead to NOX, MAPK/Erk1/2 and NF-κB activation linked to endothelial dysfunction. CHEMICAL COMPOUNDS STUDIED IN THIS ARTICLE: Berberine (PubChem CID: 2353); Lovastatin (PubChem CID: 53232).

Effects of photobiomodulation on experimental models of peripheral nerve injury.

Phototherapy has demonstrated positive effects in the treatment of peripheral nerve injury, but there is a need to investigate the dosimetric parameters. Thus, the aim of the present study was to conduct a literature review on the effects of photobiomodulation with the use of low-level laser therapy (LLLT) on the treatment of peripheral nerve injury in experimental models. The databases of PubMed/MEDLINE, SCOPUS, and SPIE Digital Library were searched for articles on the use of LLLT in experimental models of peripheral nerve injury published in English between January 2007 and March 2016. The laser parameter variability was wavelength (632.8 to 980 nm), power (10 to 190 mW), and total energy (0.15 to 90 J) in pulsed or continuous wave and single or multiple points. Eighteen original articles demonstrating the effects of LLLT on the acceleration of functional recovery, morphological aspects as well as the modulation of the expression inflammatory cytokines, and growth factors were selected. LLLT is a viable phototherapeutic modality for the treatment of peripheral nerve injury, demonstrating positive effects on the neuromuscular repair process using either red or infrared light. The majority of studies used a power of up to 50 mW and total energy of up to 15 J administered to multiple points. The determination of these parameters is important to the standardization of a LLLT protocol to enhance the regeneration process following a peripheral nerve injury.

Growth Factors and COX2 Expression in Canine Perivascular Wall Tumors.

Canine perivascular wall tumors (PWTs) are a group of subcutaneous soft tissue sarcomas developing from vascular mural cells. Mural cells are involved in angiogenesis through a complex crosstalk with endothelial cells mediated by several growth factors and their receptors. The evaluation of their expression may have relevance since they may represent a therapeutic target in the control of canine PWTs. The expression of vascular endothelial growth factor (VEGF) and receptors VEGFR-I/II, basic fibroblast growth factor (bFGF) and receptor Flg, platelet-derived growth factor B (PDGFB) and receptor PDGFRß, transforming growth factor ß1 (TGFß1) and receptors TGFßR-I/II, and cyclooxygenase 2 (COX2) was evaluated on frozen sections of 40 PWTs by immunohistochemistry and semiquantitatively scored to identify their potential role in PWT development. Statistical analysis was performed to analyze possible correlations between Ki67 labeling index and the expression of each molecule. Proteins of the VEGF-, PDGFB-, and bFGF-mediated pathways were highly expressed in 27 (67.5%), 30 (75%), and 19 (47.5%) of 40 PWTs, respectively. Proteins of the TGFß1- and COX2-mediated pathways were highly expressed in 4 (10%) and 14 (35%) of 40 cases. Statistical analysis identified an association between VEGF and VEGFR-I/II (P = .015 and .003, respectively), bFGF and Flg (P = .038), bFGF and PDGFRß (P = .003), and between TGFß1 and COX2 (P = .006). These findings were consistent with the mechanisms that have been reported to play a role in angiogenesis and in tumor development. No association with Ki67 labeling index was found. VEGF-, PDGFB-, and bFGF-mediated pathways seem to have a key role in PWT development and growth. Blockade of tyrosine kinase receptors after surgery could represent a promising therapy with the aim to reduce the PWT relapse rate and prolong the time to relapse.

Serum Vitamin A and Inflammatory Markers in Individuals with and without Chronic Obstructive Pulmonary Disease.

BACKGROUND: Vitamin A is essential for the preservation and integrity of the lung epithelium and exerts anti-inflammatory effects. OBJECTIVE: Evaluating vitamin A in the serum and sputum and testing its correlation with inflammatory markers in individuals with or without COPD. Methods. We evaluated dietary intake, serum and sputum vitamin A, tumor necrosis factor alpha, interleukin- (IL-) 6, IL-8, and C-reactive protein in 50 COPD patients (age = 64.0 ± 8.8 y; FEV1 (forced expiratory volume in the first second) (%) = 49.8 ± 16.8) and 50 controls (age = 48.5 ± 7.4 y; FEV1 (%) = 110.0 ± 15.7). RESULTS: COPD exhibited lower serum vitamin A (1.8 (1.2-2.1) versus 2.1 (1.8-2.4) µmol/L, P < 0.001) and lower vitamin A intake (636.9 (339.6-1349.6) versus 918.0 (592.1-1654.6) RAE, P = 0.05) when compared with controls. Sputum concentration of vitamin A was not different between groups. Sputum vitamin A and neutrophils were negatively correlated (R (2) = -0.26; P = 0.03). Smoking (0.197, P = 0.042) exhibited positive association with serum vitamin A. COPD was associated with lower serum concentrations of vitamin A without relationship with the systemic inflammation. CONCLUSIONS: Serum concentration of vitamin A is negatively associated with the presence of COPD and positively associated with smoking status. Sputum retinol is quantifiable and is negatively influenced by neutrophils. Although COPD patients exhibited increased inflammation it was not associated with serum retinol.

Value of sentinel lymph node biopsy in papillary thyroid cancer: initial results of a prospective trial.

The objectives of the study were to evaluate the performance of sentinel lymph node biopsy (SLNB) in detecting occult metastases in papillary thyroid carcinoma (PTC) and to correlate their presence to tumor and patient characteristics. Twenty-three clinically node-negative PTC patients (21 females, mean age 48.4 years) were prospectively enrolled. Patients were submitted to sentinel lymph node (SLN) lymphoscintigraphy prior to total thyroidectomy. Ultrasound-guided peritumoral injections of (99m)Tc-phytate (7.4 MBq) were performed. Cervical single-photon emission computed tomography and computed tomography (SPECT/CT) images were acquired 15 min after radiotracer injection and 2 h prior to surgery. Intra-operatively, SLNs were located with a gamma probe and removed along with non-SLNs located in the same neck compartment. Papillary thyroid carcinoma, SLNs and non-SLNs were submitted to histopathology analysis. Sentinel lymph nodes were located in levels: II in 34.7 % of patients; III in 26 %; IV in 30.4 %; V in 4.3 %; VI in 82.6 % and VII in 4.3 %. Metastases in the SLN were noted in seven patients (30.4 %), in non-SLN in three patients (13.1 %), and in the lateral compartments in 20 % of patients. There were significant associations between lymph node (LN) metastases and the presence of angio-lymphatic invasion (p = 0.04), extra-thyroid extension (p = 0.03) and tumor size (p = 0.003). No correlations were noted among LN metastases and patient age, gender, stimulated thyroglobulin levels, positive surgical margins, aggressive histology and multifocal lesions. Sentinel lymph node biopsy can detect occult metastases in PTC. The risk of a metastatic SLN was associated with extra-thyroid extension, larger tumors and angio-lymphatic invasion. This may help guide future neck dissection, patient surveillance and radioiodine therapy doses.

Bronchial microbiome of severe COPD patients colonised by Pseudomonas aeruginosa.

The bronchial microbiome in severe COPD during stability and exacerbation in patients chronically colonised by Pseudomonas aeruginosa (PA), has not been defined. Our objective was to determine the characteristics of the bronchial microbiome of severe COPD patients colonised and not colonised by P. aeruginosa and its changes during exacerbation. COPD patients with severe disease and frequent exacerbations were categorised according to chronic colonisation by P. aeruginosa. Sputum samples were obtained in stability and exacerbation, cultured, and analysed by 16S rRNA gene amplification and pyrosequencing. Sixteen patients were included, 5 of them showing chronic colonisation by P. aeruginosa. Pseudomonas genus had significantly higher relative abundance in stable colonised patients (p = 0.019), but no significant differences in biodiversity parameters were found between the two groups (Shannon, 3 (2-4) vs 3 (2-3), p = 0.699; Chao1, 124 (77-159) vs 140 (115-163), p = 0.364). In PA-colonised patients bronchial microbiome changed to a microbiome similar to non-PA-colonised patients during exacerbations. An increase in the relative abundance over 20 % during exacerbation was found for Streptococcus, Pseudomonas, Moraxella, Haemophilus, Neisseria, Achromobacter and Corynebacterium genera, which include recognised potentially pathogenic microorganisms, in 13 patients colonised and not colonised by P. aeruginosa with paired samples. These increases were not identified by culture in 5 out of 13 participants (38.5 %). Stable COPD patients with severe disease and PA-colonised showed a similar biodiversity to non-PA-colonised patients, with a higher relative abundance of Pseudomonas genus in bronchial secretions. Exacerbation in severe COPD patients showed the same microbial pattern, independently of previous colonisation by P. aeruginosa.

A biodistribution study of PEGylated PCL-based nanoparticles in C57BL/6 mice bearing B16/F10 melanoma.

One of the major drawbacks that limits the clinical application of nanoparticles is the lack of preliminary investigations related to their biocompatibility, biodegradability and biodistribution. In this work, biodegradable PEGylated polymer nanoparticles (NPs) have been synthesized by using macromonomers based on poly(ε-caprolaconte) oligomers. More in detail, NPs have been produced by adopting a surfactant-free semibatch emulsion polymerization process using PEG chains as a stabilizing agent. The NPs were also labeled with rhodamine B covalently bound to the NPs to quantitatively study their biodistribution in vivo. NPs were investigated in both in vitro and in vivo preclinical systems to study their biodistribution in mice bearing B16/F10 melanoma, as well as their biocompatibility and biodegradability. The NP concentration was evaluated in different tissues at several times after intravenous injection. The disappearance of the NPs from the plasma was biphasic, with distribution and elimination half-lives of 30 min and 15 h, respectively. NPs were retained in tumors and in filter organs for a long time, were still detectable after 7 d and maintained a steady concentration in the tumor for 120 h. 48 h after injection, 70 ± 15% of the inoculated NPs were excreted in the feces. The favorable tumor uptake, fast excretion and absence of cytotoxicity foster the further development of produced NPs as drug delivery carriers.

Canine perivascular wall tumors: high prognostic impact of site, depth, and completeness of margins.

Canine perivascular wall tumors (cPWTs) arise from vascular mural cells and are included among soft tissue sarcomas (STSs). Most prognostic studies are performed on canine STSs as a general group and regardless of their specific histotype. The aim of this study was to identify pathological parameters and profiles with prognostic impact for cutaneous/subcutaneous cPWTs. Anatomical location, type of growth, surgical margins, and size and depth of the tumor were collected in 56 cPWTs. The association between each pair of variables was evaluated by χ(2) test. Multiple correspondence analysis (MCA) was performed to describe the multivariate association of variables and was followed by cluster analysis to identify specific pathological profiles. The prognostic impact of variables and profiles was assessed by Cox regression model. Size and depth were significantly associated with increased relapse probability. Cases with complete surgical margins did not recur. Other single variables were not significantly associated with relapse. Cluster analysis on MCA considering site, depth, margins, and type of growth identified 3 pathological profiles associated with PWT relapse and having a high prognostic impact. Major prognostic factors for cPWTs were tumor size, depth of growth, and pathological profiles.

Modulating effect of low level-laser therapy on fibrosis in the repair process of the tibialis anterior muscle in rats.

The treatment of muscle injuries is a common practice at rehabilitation centers. Low-level laser therapy (LLLT) has demonstrated positive effects regarding the modulation of the inflammatory response, the enhancement of the tissue repair process and the prevention of fibrosis. The aim of the present study was to evaluate the effects of LLLT on morphological aspects of muscle tissue, collagen remodeling and activity of matrix metalloproteinase 2 (MMP-2) in rat skeletal muscle following acute injury. Wistar rats were divided into five groups: (1) control group (n = 10), (2) sham group (n = 10), (3) LLLT group (n = 30), (4) non-treated injury group (n = 30) and (5) injury + LLLT group (n = 30). Cryoinjury was performed on the belly of the tibialis anterior (TA) muscle. LLLT was performed daily with an AlGaAs laser (780 nm; beam spot of 0.04 cm(2), output power of 40 mW, power density of 1 W/cm(2), energy density of 10 J/cm(2) and 10-s exposure time). Animals were euthanized at 1, 3 and 7 days. The TA muscles were removed and weighed. Morphological aspects were evaluated using H & E staining. The amount and distribution of collagen fibers were evaluated by picrosirius staining. Characterization and activity of MMP-2 were evaluated by zymography and Western blot techniques, respectively. The results revealed that LLLT induced a reduction in inflammatory infiltrate and myonecrosis after 1 day, an increase in the number of blood vessels after 3 and 7 days as well as an increase in the number of immature muscle fibers and MMP-2 gelatinase activity after 7 days. In conclusion, LLLT has a positive effect on the inflammatory process, MMP2 activity and collagen organization and distribution in the repair process of rat skeletal muscle.

Effect of nandrolone decanoate on skeletal muscle repair.

This study analyzed the effect of nandrolone decanoate (ND) on muscle repair and the expression of myogenic regulatory factors following cryoinjury in rat skeletal muscle. Adult male Wistar rats were randomly divided into 4 groups: control group, sham group, cryoinjured group treated with ND and non-injured group treated with ND. Treatment consisted of subcutaneous injections of ND (5 mg/kg) twice a week. After sacrifice, the tibialis anterior muscle was removed for the isolation of total RNA and analysis of myogenic regulatory factors using real-time PCR as well as morphological analysis using the hematoxylin-eosin assay. There was a significant increase in MyoD mRNA after 7 days and in myogenin mRNA after 21 days in the cryoinjured ND group in comparison to other groups in the same period. The morphological analysis revealed no edema or myonecrosis after 7 days as well as no edema or inflammatory infiltrate after 14 days in the cryoinjured ND group. In conclusion the anabolic steroid nandrolone decanoate can modulate the muscle repair process in rats following cryoinjury by influencing the expression of regulatory myogenic factors and phases of muscle repair.

The role of illness perception and emotions on quality of life in fibromyalgia compared with other chronic pain conditions.

OBJECTIVE: Fibromyalgia syndrome (FMs) is a chronic widespread pain condition that can negatively impact on all aspects of patient's life. The purpose of this study was: first, to evaluate illness perception (IP), quality of life (QoL) and affective-emotive variables (EAV) of patients with FM; and second, to compare these variables to different pain conditions. METHODS: Consecutive 34 women (mean age 47.4±8.3 years) affected by FM were enrolled for the study from December 2009 to May 2011. IP was evaluated by means of the Revised Illness Perception Questionnaire, QoL through Nottigham Health Profile and EAV through the Beck Depression Inventory. Scores were compared with rheumatoid arthritis (RA) (n=20; mean age 53±12.8 years) and low back pain (LBP) (n=20; 51.3±7.8 years) groups. RESULTS: FM patients scored higher than RA and LBP groups on IP (Identity scale mean: FM=8.8±2.3, AR=5.5±3.3, LBP=4.1±2.9; Kruskal-Wallis=24.42). Moreover FM patients show higher EAV (mean FM=21±9.6, AR=8.9±5.6, LBP=14.9±6.5; Kolmogorov-Smirnov Z=2.17) and QoL (Pain scale mean: FM=74.2±24.1; AR=35.7±19.9; LBP=56.5±20.4; Kolmogorov-Smirnov Z=2.27; Energy scale mean: FM=86.2±28.5; AR=46.8±35.4; LBP=61.6 ±63.7; Kolmogorov-Smirnov Z=1.98) than RA group. CONCLUSIONS: Our study highlighted dysfunctional IP, low QoL, high EAV scores in FM patients and the significant relations between these variables. Research results provided support for relevance of a multidisciplinary approach to the management of FM, including psychological interventions, according to a biopsychosocial perspective.

Occlusal contact in children with Temporomandibular Disorders. A pilot study.

AIM: The aim of the present study was to perform a comparative analysis of occlusal contact points in children with and without signs and symptoms of Temporomandibular Disorders (TMD). STUDY DESIGN: Cross-sectional study. One hundred fifty children between 6 and 14 years of age were evaluated using the Helkimo questionnaire and a clinical exam. The occlusal contact points in each child were recorded during maximal intercuspation with the aid of carbon strips. Digital photographs were taken of the upper and lower arches before and after recording the occlusal contacts. The number of contact points between sides were compared and recorded on individual charts (occlusograms). STATISTICS: Student's t-test and Pearson's chi-square test were used for the statistical analysis, with the level of significance set at 0.05, which revealed no statistically significant differences between genders. The Student's t-test revealed a statistically significant difference in the mean number of occlusal contact points between the participants with and without TMD, with a higher number of contact points among those without TMD. There was no significant difference between sides. RESULTS The results of this study show a difference in the number of occlusal contact points in centric occlusion between children with and without TMD. CONCLUSION Regardless of the degree of severity, the number of occlusal contact points is lower among children with TMD.

Effect of different feeding systems on color of longissimus muscle from Bos cattle: A systematic review and meta-analysis.

Considering the relevance of meat discoloration for meat production chain and the conflicting results regarding the influence of feeding regimes on color of fresh beef and the lack of meta-analytic studies on this subject we investigated the effect of grain-fed and pasture-fed regimes on color of beef longissimus from Bos cattle through a systematic review with meta-analysis. A systematic search from 2001 to 2021 was performed in two databases and 126 papers were eligible for meta-analysis. Pasture-fed longissimus beef exhibited higher a* (8.21%) and C* (8.61%) values, and lower h* values (17.18%) than grain-fed counterparts, indicating a greater color for longissimus beef from pasture-fed animals. Among the pasture-fed regimes, those containing alfalfa, bermudagrass, cowpea and pearl millet were the most effective for color improvements. Our findings indicate potential feeding regimes to mitigate global economic losses from meat discoloration and suggest the necessity to develop suitable processing strategies to improve the color of beef from grain-fed Bos cattle.

Efficacy of ivabradine in combination with Beta-blocker versus uptitration of Beta-blocker in patients with stable angina.

PURPOSE: The antianginal and anti-ischemic efficacy of the selective I (f) inhibitor ivabradine is established in patients with stable angina in monotherapy and in combination with other antianginals, including beta-blocker. This pilot study compared the antianginal and anti-ischemic efficacy and hemodynamic profile of ivabradine plus 5 mg bisoprolol versus those of 10 mg bisoprolol in patients with stable angina. PATIENTS AND METHODS: Twenty-nine patients with stable angina and moderate left ventricular systolic dysfunction already on bisoprolol 5 mg od were randomized into 2 groups. Group 1 (n = 17) received ivabradine (5-7.5 mg bid) in addition to bisoprolol 5 mg od, while in group 2 (n = 12) bisoprolol was uptitrated first to 7.5 mg and then 10 mg od. Patients underwent a treadmill test, 6-minute walking test, and echocardiography at baseline and after 2 months. RESULTS: Mean resting heart rate decreased in both groups, from 76.6 ± 4.6 bpm to 59.3 ± 2.5 bpm (P < 0.001) in group 1 and from 75.9 ± 3.0 bpm to 60.5 ± 2.3 bpm (P = 0.002) in group 2. The effect on resting heart rate did not differ significantly between the two groups. However, more patients became asymptomatic in group 1 than in group 2. Addition of ivabradine also improved exercise capacity, as shown by the results of the 6-minute walking and exercise tolerance tests, whereas in group 2 neither parameter was significantly affected. Chronotropic reserve significantly improved with ivabradine, but not with bisoprolol 10 mg. CONCLUSIONS: These results suggest that combining ivabradine with low dose bisoprolol in stable angina patients produces additional antianginal and anti-ischemic benefits and improves chronotropic reserve.

Speckle Tracking Echocardiography in Non-ST-Segment Elevation Acute Coronary Syndromes.

Non-ST-segment elevation acute coronary syndromes (NSTE-ACSs) are a group of clinical conditions characterized by acute myocardial ischemia. Conventional echocardiography is generally used to evaluate cardiac function using wall motion analysis and left ventricular ejection fraction but may be insufficient to explore all the complex features of NSTE-ACSs, which may vary substantially from patient to patient in terms of severity of ischemia and extent of involved myocardium. In the last years, speckle tracking echocardiography (STE) has become a widely available technique for the non-invasive assessment of cardiac function and has been repeatedly applied in the setting of NSTE-ACSs. In this review we summarize current evidence about the use of STE in patients with NSTE-ACSs, trying to underline advantages and limitations in comparison with conventional echocardiography for: diagnosis of NSTE-ACS, differential diagnosis, identification of high-risk patients, and prediction of outcome.