Sirolimus Can Increase the Disappearance Rate of Cardiac Rhabdomyomas Associated with Tuberous Sclerosis: A Prospective Cohort and Self-Controlled Case Series Study.

OBJECTIVES: To investigate the efficacy and safety of sirolimus in the treatment of cardiac rhabdomyomas associated with tuberous sclerosis complex and the specific benefits in different subgroups. STUDY DESIGN: The study was a prospective cohort and self-controlled case series study. Based on the prevalence of cardiac rhabdomyoma at different ages, we estimated the natural tumor disappearance rate. The subgroup analysis was done by Cox regression. Self-controlled case series method was used to assess the magnitude and duration of the drug effect. Adverse events were described. RESULTS: A total of 217 patients were included in the cohort study. Tumor disappearance rate was higher in younger age groups (hazard ratio = 0.99, P = .027) and female patients (hazard ratio = 2.08, P = .015). The age-adjusted incidence ratio showed that the disappearance of rhabdomyomas between 3 and 6 months was more related to sirolimus. Adverse events were observed 60 times in 42 of 217 children, mainly stomatitis. CONCLUSIONS: Sirolimus can increase the disappearance rate of cardiac rhabdomyoma in the tuberous sclerosis complex population. Efficacy varies by sex and age: female and younger patients have higher tumor disappearance rate. Sirolimus is well-tolerated.

Chlorella pyrenoidosa supplementation increased the concentration of unsaturated fatty acids in the rumen fluid of cattle fed a low-quality tropical forage

The objective of this study was to evaluate the effects of algae and cottonseed meal (CSM) supplementation on the fatty acid (FA) profile in the rumen fluid (RF) of steers fed a low-quality forage. Five Bos indicus crossbred steers, 187±7.5 kg liveweight (LW; mean±SD), were fed a low crude protein speargrass (Heteropogon contortus) hay as the basal diet alone or supplemented with either Spirulina platensis, Chlorella pyrenoidosa , Dunaliella salina , or CSM in Latin square design. The proportion of individual FA in the RF of steers varied in response to supplement, and these were most likely due to differences in the FA profile in supplements. Steers supplemented with Chlorella pyrenoidosa and CSM had a higher concentration of linoleic acid (C18:2n-6) in RF than unsupplemented steers or steers offered the other supplements, but there was no difference in the concentration in RF in steers supplemented with Chlorella pyrenoidosa and CSM. The concentration of linolenic acid (C18:3n-3) was higher in the RF of unsupplemented steers compared with supplemented steers. Steers receiving Chlorella pyrenoidosa supplementation showed an increase in total unsaturated FA in the RF compared with other supplemented and unsupplemented steers, which if transferred to meat, could have health related benefits to consumers. None of the supplements led to the formation of isomers known to inhibit fat synthesis.(AU)