Assessment of cancer therapy-related cardiac dysfunction in breast cancer women using a new speckle tracking echocardiography index: The GAVS.

BACKGROUND: Recently, peak atrial longitudinal strain (PALS) has emerged as a possible predictor of Cancer therapy-related cardiac dysfunction (CTRCD) in cancer patients (CP), in addition to left ventricular global longitudinal strain (GLS). Thus, considering the link between left atrium and left ventricle, the aim of this study was to assess the global atrio-ventricular strain (GAVS) in CP, to detect early cardiotoxicity. METHODS: A prospective study was carried out enrolling 131 breast cancer women (mean age 51.4 ± 10.4 years) receiving anti-cancer treatment. Clinical and echocardiographic evaluation was performed at baseline (T0), 3 (T1), 6 (T2) and 12 months (T3) after starting treatment. CTRCD was defined according to the 2022 ESC Cardio-Oncology guidelines. RESULTS: Forty-four patients developed CTRCD (3 moderate and 41 mild CTRCD group A) and 87 patients did not (group B). In group A, significant changes in GLS, PALS, GAVS, LASi (left atrial stiffness index) and LVEF/GLS occurred earlier than LVEF, that reduced significantly only at T3 (p-value < .05). Significant changes in LASi, PALS and GAVS occurred even in group B but reduction in GAVS (-21% vs. -5%) and PALS (-24% vs. -12%) was significantly greater in group A compared to group B (p-value = .04). CONCLUSIONS: Our study confirms high sensitivity of speckle tracking echocardiography in detecting subclinical myocardial damage in CP and the usefulness of a multiparametric echocardiographic evaluation including PALS and GLS (GAVS) for having a global evaluation of the phenomenon cardiotoxicity.

A 3-year retrospective study of fresh socket implants: CAD/CAM customized healing abutment vs cover screws.

AIM: To evaluate width loss of the alveolar ridge three years after implant placement in a fresh extraction socket following two different tissue healing methodologies: conventional healing procedure vs CAD/CAM technology for a customized healing abutment. MATERIALS AND METHODS: Post-extraction sockets underwent immediate dental implant placement without the voids being filled between the implant surface and the socket wall. Samples (one implant per patient) were retrospectively enrolled in each group according to the type of healing procedure: implants in the conventional group underwent standard closed healing with a cover screw, while in the customized group the healing abutment was immediately screwed onto the head of the implant, mimicking the look of the extracted tooth fabricated by CAD/CAM technology. The width of the alveolar ridge was measured on 3D radiographs at baseline (before surgery) and three years postsurgery. Nonparametric statistics were performed with a significance level of 0.01. RESULTS: A total of 54 dental implants were selected. An implant survival rate of 100% was reported for all implants after 36 months. Three years after implant placement, loss in bone width was registered for both the conventional and customized groups, being 2.2 (1.1) and 0.2 (0.7) mm, respectively. Changes in the customized group were significantly lower than in the conventional group. Significant differences were again found between the groups for each of the tooth sites. Loss of bone width appeared negligible (from incisor to premolar), with values ranging between 0.2 and 0.4 mm in the customized group, whereas in the conventional group all tooth sites underwent wide shrinkage (with a bone loss ranging from 1.6 to 3.0 mm). CONCLUSION: The CAD/CAM procedure might provide the following advantages: 1) Stabilization of the gingival setting and bone volume in a fresh socket implant; 2) Maintaining the same emergence profile of teeth for restorative crowns, avoiding laboratory approximation of the emergence profile of the definitive restoration; and 3) Optimal prosthetic-surgical planning and minimally invasive extraction to preserve the integrity of the supporting tissue.

NMR-based identification of the major bioactive molecules from an Italian cultivar of Lycium barbarum.

Lycium barbarum (Solanaceae), long known to the traditional Chinese medicine because of its many health-promoting effects, has of late spread widely across the Western hemisphere, mainly on account of the nutritional richness in vitamins, minerals and antioxidant metabolites of its fruits. Data on bioactive metabolites from fruits and leaves, which are commonly consumed in soups and salads, are scarce and sometimes even contradictory. By means of NMR, the present study identified the specialised products contained in an Italian cultivar of L. barbarum. Kaempeferol, caffeic acid, 3,4,5-trihydroxycinnamic acid and 5-hydroxyferulic acid were found in fresh fruits; rutin and chlorogenic acid were detected in leaves and flowers; also, a previously undescribed N,N-dicaffeoylspermidine derivative was identified in flowers, while N-feruloyltyramine derivatives, for which interesting anti-inflammatory properties have been reported, turned out to be the major bioactive molecules in stems. The plethora of the detected bioactive molecules amplifies the nutraceutical value of berries and leaves and prompts the exploitation of L. barbarum flowers and pruned stems as sources of beneficial compounds.