The aim of our study was to compare, in terms of aesthetic results, the use of synthetic glue to intradermal absorbable sutures in postthyroidectomy and parathyroidectomy wound closure in a single ...blinded, randomised, per protocol equivalence study. From September 2008 to May 2010, patients undergoing thyroid or parathyroid surgery (with an external approach) at the Otolaryngology Department of the University Hospital of Modena were assessed for eligibility. In total, 42 patients who had had synthetic glue application on surgical incisions (A) and 47 patients who had subcuticular sutures on their surgical incisions (B) were enrolled. The mean of the endpoint (based on the Wound Registry Scale) of group A at 10 days was 1.4, while that in group B (based on the Stony Brook Scar Evaluation Scale) was 2.9. Statistically significant (p = 0.002) and clinically significant (difference of the means = 1.5) differences in the aesthetic results were found between groups A and B at 10 days, with better results in group B. On the other hand, at 3 months, the mean of the endpoint in group A was 3.1 while that in group B was 2.8; no statistically significant (p = 0.62) or clinically significant (difference in means = 0.3) differences were found between groups A and B. In conclusion, synthetic glue differs from subcuticular suture in post-thyroidectomy or post-parathyroidectomy incision for early aesthetic results, with better outcomes for subcuticular sutures. At 3 months, there were no differences in aesthetic outcomes between groups. Moreover, sex, incision length, age, cold/hot blade and correspondence of the incision with a wrinkle in the skin did not seem to influence aesthetic outcomes with this type of incision.
Abstract
Background
Sacubitril/valsartan, the first combined angiotensin receptor-neprilysin inhibitor, has demonstrated a significant benefit compared to angiotensin inhibitor in decreasing ...ventricular arrhythmias and appropriate implantable cardioverter defibrillator (ICD) shocks in patients with heart failure with reduced ejection fraction (HFrEF). At present, there is no study which evaluates the effect of sacubitril/valsartan on the supraventricular arrhythmic burden in HFrEF patients with an ICD or cardiac resynchronisation therapy-defibrillator (CRT-D) and remote monitoring.
Purpose
To evaluate the effect of sacubitril/valsartan on the supraventricular arrhythmic burden in HFrEF patients with an ICD or CRTD and remote monitoring.
Methods
The SAVETHERHYTHM ((SAacubitril Valsartan rEal-world registry evaluating THE arRHYTHMia burden in HFrEF patients with implantable cardioverter defibrillator) is a multicentre, observational, prospective registry enrolling all patients with HFrEF, ICD or CRT-D actively followed through remote monitoring and starting treatment with sacubitril/valsartan. All patients are followed-up for at least one year after sacubitril/valsartan start. The primary endpoint is the mean number of sustained atrial tachycardia or atrial fibrillation (AT/AF) episodes per month. Secondary endpoints include the total burden of AT/AF (defined as the percentage of time in AT/AF per day), the mean number of premature ventricular contractions (PVC) per hour and the percentage of biventricular pacing per day (in patients with CRT-D). All primary and secondary endpoints are collected through remote monitoring.
Results
At the time of the first ad interim analysis, 60 patients (85.2% male, age 69±10 years) were consecutively enrolled. After treatment with sacubitril/valsartan, patients with at least one episode of AT/AF per month decreased from 32.8% to 21.3% (p=0.015). A significant decrease in number of AT/AF episodes (from 4.3 to 1.2 per year), in AT/AF burden (from 12% to 9%) and in number of PVC (from 83 to 74 per hour) were seen in patients with a previous diagnosis of paroxysmal or persistent AF (n=15; all p<0.05). Patients with permanent AF (n=7) experienced no benefits from sacubitril/valsartan therapy in terms of arrhythmic burden reduction. Patients with no previous history of AF (n=38) showed a decrease in number of AT/AF episodes (from 2.0 to 0.8 per year) and in number of PVC (from 77 to 49 per hour, all p<0.05). No new diagnosis of clinical AF was made after starting treatment with sacubitrl/valsartan, and patients with subclinical AT/AF episodes decreased from 8% to 3%.
Conclusions
Preliminary data suggest that therapy with sacubitril/valsartan could decrease arrhythmic burden in patients with non-permanent AF and reduce subclinical AT/AF episodes in patients with no history of AF. No positive effect has been noted in patients with permanent AF.
Funding Acknowledgement
Type of funding source: None
Although acid soils are common in forest ecosystems, and there is documented evidence of pH influencing transformations of organic matter in soil, there are surprisingly few studies on the influence ...of soil pH on the chemical structure of physically fractionated soil organic matter (SOM). The aim of this study was to characterize the influence of pH on the chemical and physical processes involved in SOM stabilization. Forest soils of different pH (4.4 and 7.8) sampled from two long‐term experiments at Rothamsted Research (UK) were physically fractionated. The free light fraction (FLF), the intra‐aggregate light fraction and the fine silt and clay (S + C, <25 µm) were characterized using elemental, isotopic (δ¹³C), thermogravimetric, differential thermal, diffuse reflectance infrared Fourier transform spectroscopy and high‐resolution magic angle spinning ¹H nuclear magnetic resonance analyses. The quantitative distribution of carbon (C) between SOM fractions differed between the two soils. Carbon contents in the light fractions from the acid soil were significantly greater than in those of the alkaline soil. In contrast, in S + C fractions, C content was greater in the alkaline soil. FLF from the acid soil was characterized by a greater C:N ratio, smaller δ¹³C and greater content of thermo‐labile compounds compared with FLF from the alkaline soil. In contrast, there was only a weak effect of soil pH on the chemical composition of the organic matter in S + C fractions. Irrespective of soil pH, these latter fractions contained mainly aliphatic compounds such as carbohydrates, carboxylic acid, amide and peptide derivates. This suggested that physical mechanisms, involving the interactions between SOM and mineral surfaces, are of greater importance than the presence of chemically recalcitrant species in protecting SOM associated with the finest soil fractions.
To examine the prognostic significance of the immunohistochemical expression of p63 and Ki-67 oncoproteins in patients with laryngeal squamous cell carcinoma, a retrospective evaluation was carried ...out on a cohort of 108 patients with primary laryngeal squamous cell carcinoma (LSCC) treated by primary surgery. For the immunohistochemical evaluation, tissue section obtained by formalin-fixed and paraffin-embedded tissue blocks from resection of each patient was used. Clinicopathologic data were associated with the immunostaining results. The association among the considered variables was assessed by Fisher’s exact test, Mann–Whitney test, non-parametric
χ
2
test, and Spearman’s rho rank test was used to assess the relations among them. Differences in p63 and Ki-67 immunoreactivity among the different groups were compared via Kruskal–Wallis test and post hoc tests were performed using Mann–Whitney test with Bonferroni correction. The overall survival rate was estimated via Kaplan–Meier method, and the cumulative incidence functions for different groups were compared using log-rank statistics. Cox proportional hazard model was employed in a multivariate analysis to assess the effect of prognostic factors in the overall survival rate. Furthermore, taking into account death due to other causes, we estimated LSCC-related survival and disease-free survival rates using competing risk analysis. The results of immunohistochemical examination showed a statistically significant relationship between the up-regulation of P63 and Ki-67, an increase in histological grading, and primary tumours associated with lymph node metastases. p63 and Ki-67 up-regulation was related to a shorter disease-free survival and a significant association was found between p63 and Ki-67 percentage of positive cells and patient survival. Finally, we noticed a significant relation between p63 and Ki-67 (
ρ
= 0.87). On the other hand, no statistically significant associations were found between p63 and Ki-67 down-regulation and clinicopathologic data. Our findings suggest that abnormal p63 and Ki-67 immunoreactivity may be involved in the early phases of laryngeal tumorigenesis and may become a significant prognostic predictor for both overall and disease-free survivals. These biomarkers could thus help in the selection of high-risk patients with LSCC who may benefit from more aggressive therapy or chemoprevention.
•Two sets of grapevines differing for soil mineral N were sprayed with 15N.•Nitrogen soil application increased soil mineral N.•Nitrogen soil application did not enhance N concentration in canopy ...organs.•June was more effective than July spray in increasing bud N concentration.•A positive correlation between bud N in 2014 and bud fertility in 2015 was found.
In ‘Trebbiano Romagnolo’ grapevines basal bud fertility is usually low and can be related to bud N status. The aim of the present investigation was to evaluate the effect of foliar N application on bud fertility in a mature vineyard subjected to two levels of soil N (39 and 78kgNha−1) fertility induced by application of urea. Both the vines at low and high N soil availability were sprayed once with 2.5kg15Nha−1 in pre-bloom and in post-bloom 15N-enriched-ammonium nitrate. Nitrogen soil application increased soil mineral N significantly from June to October, however, with the exception of main shoot axes, the N concentration in the canopy organs (leaves, buds, and bunches) did not respond to the increase of soil fertility. Foliar N applied in June promoted the percentage of NDFF in apical and basal bud and bunch as well, compared with the application made in July. A linear correlation between leaf and basal bud N concentration in 2014 and basal bud fertility (number of inflorescences per shoot) in 2015 was observed indicating a positive effect of sprayed N on bud fruitfulness even when soil N availability is not limiting.
Previous studies in rats have indicated that a diet enriched with Bisphenol A adversely effects metabolism and reproductive success. In rats exposed to BPA by maternal gavage, alteration in the ...developmental programming, higher obesity rates and reproductive anomalies were induced. Starting with this evidence, the aim of this study was to provide important insights on the effects induced by a BPA enriched diet, on the reproductive physiology and metabolism of juvenile fish, simulating the scenario occurring when wild fish fed on prey contaminated with environmental BPA. Seabream was chosen as model, as it is one of the primary commercial species valued by consumers and these results could provide important findings on adverse effects that could be passed on to humans by eating contaminated fish. A novel method for measuring BPA in the food and water by affinity chromatography was developed. Analysis of signals involved in reproduction uncovered altered levels of vtg and Zp, clearly indicating the estrogenic effect of BPA. Similarly, BPA up-regulated catd and era gene expression. A noteworthy outcome from this study was the full length cloning of two vtg encoding proteins, namely vtgA and vtgB, which are differently modulated by BPA. Cyp1a1 and EROD activity were significantly downregulated, confirming the ability of estrogenic compounds to inhibit the detoxification process. GST activity was unaffected by BPA contamination, while CAT activity was down regulated. These results collectively confirm the estrogenic effect of BPA and provide additional characterization of novel vtg genes in Sparus aurata.
Nitrogen (N) storage capacity of cherry (Prunus avium L.) trees grown in sand culture was preconditioned by applying contrasting N supplies for one year. During the spring of the following year, a ...constant amount of 15N was supplied and the dynamics of N remobilization and root uptake were characterized as a function of internal N status of the trees. To calculate the flux of N through xylem, both xylem sap N concentration and whole-tree transpiration rates were measured. By comparing the cumulative flux of N through the xylem with the amount of N recovered in the new above ground growth, we indirectly evaluated the recycling of N in the xylem, i.e., the amount of N derived from shoot-root translocation that was subsequently reloaded into the xylem. The contrasting N storage capacities imposed during the first year affected both N remobilization and uptake from roots in the following year. Recycling of N in the xylem apparently did not occur during the remobilization of internal reserves (i.e., during the first 6-8 weeks after bud burst). However, when remobilization declined, measurement of the cumulative flux of N through the xylem overestimated the amount of N recovered in the new biomass, allowing the extent of N recycling to be evaluated. The amount of N recycling in the xylem was greater in high-N trees, which also took up less N through their roots than trees preconditioned to have a lower internal N status. This suggests that recycling of N in the xylem is a mechanism by which plants regulate N uptake by roots.
The litter decomposition process depends on the litter chemical composition, especially the ratio between more labile compounds, cellulose, and the recalcitrant lignin and waxes. Their determination ...is crucial to predict the process, though lignin measurement presents some limitations due to drawbacks of the different methods. Thermal analysis has been successfully applied to several organic materials in order to obtain quali-quantitative information of the chemical structure of the sample. In this work TG-DTA was used in a short-term litter decomposition study of two broadleaf forest stands of contrasting ages, and the results were compared to those obtained with a chemical method (Klason’s method) commonly used to quantify cellulose and lignin. TG-DTA was applied to the litter and to the cell walls (CW) extracted from the litter, whose cellulose and lignin content was determined using the Klason’s method. When applied to litter, thermal analysis showed a weak correlation with the Klason’s method, though it allowed the detection of the dynamics of waxes, that increased during the decomposition and could influence the later stages of the process. Contrastingly, a good correlation between cellulose and lignin determined with the two methods was found when TG-DTA was applied to the CW. In this case TG-DTA, according to NMR data, also highlighted the changes in the CW chemical structure compared with that of the litters, in particular the loss of waxes and the decreased thermostability of aromatic components. Moreover, a new concept of quality of the decomposing litter, based on the balance between the energy stored in the litter and the energy needed to release it obtained by thermal analysis, was recently introduced. Samples of the old forest litter had an initial energetic balance more favorable than those collected in the young stand. At the end of the period, the decrease in litter quality was greater in the young than in the old forest samples, due to the combined effect of the higher degradation of thermolabile substances and the accumulation of more thermostable components. Thermal analysis seems to have a good potential in litter decomposition studies, as it can link structural and energetic changes during the process.
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