Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry

Aims: This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results: Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P\ua0 64 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P\ua0=\ua00.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P\ua075 years. Conclusions: There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF 6445%

Unraveling the transcriptional regulatory networks associated to mycobacterial cell wall defective form induction by glycine and lysozyme treatment

It is known that a combined glycine/lysozyme treatment is able to induce in vitro the mycobacterial conversion from the bacillary to the cell wall defective forms. These forms also naturally occur in vivo as a response to various antimicrobial factors such as lysozyme released by phagocytic cells. Although they have been successfully isolated from patients with several chronic diseases, their role in pathogenesis is still unknown, mainly due to the difficulties in handling the in vivo isolated variants. Moreover, nothing is known about the transcriptional peculiarities that may exist in comparison to the vegetative phase. Hence, in this study, we simulated in vitro the induction of the mycobacterial cell wall defective state by using a glycine and lysozyme-based treatment in order to identify the gene expression profiles of both pathogenic and non-pathogenic mycobacteria. DNA-microarray results showed that in contrast to the non-pathogenic Mycobacterium smegmatis species, glycine and lysozyme treated forms of Mycobacterium tuberculosis and Mycobacterium avium subspecies paratuberculosis regulated a repertoire of genes usually expressed in vivo during adaptation and persistence within host environments. Results suggest that the cell wall defective state may represent an important stage in the life-cycle of pathogenic mycobacteria that potentially coordinates persistence

Expression profiling of Mycobacterium tuberculosis H37Rv and Mycobacterium smegmatis in acid-nitrosative multi-stress displays defined regulatory networks

Several studies regarding the transcriptome of Mycobacterium tuberculosis following the exposure to various in vitro simulated phagosomal stressors, have already tried to elucidate the bacterium behavior during the intracellular infection. An in vitro acid-nitrosative multi-stress was carried out for M. tuberculosis H37Rv and Mycobacterium smegmatis MC2155 in order to analyze by DNA-microarray the gene expression changes associated respectively to pathogenic and non-pathogenic mycobacterial species. During acid-nitrosative multi-stress both mycobacteria shift their transcriptome to allow the anaerobic respiratory state and energy pathways characteristic of starvation. M. tuberculosis counteracts the combined acid-nitrosative stress more efficiently than M. smegmatis as also shown by the up-regulation of glbN and hmp genes, that are specifically directed to NO detoxification. Moreover, the down-regulation of some virulence factors involved in phthiocerol dimycocerosates synthesis strengthens the hypothesis that these major virulence determinants may be attenuated by M. tuberculosis in the presence of reactive nitrogen species. In fact, it down-regulates other genes implicated in the synthesis of membrane structural lipids but in contrast to M. smegmatis, M. tuberculosis up-regulates many genes annotated for the synthesis of peptidoglycan. Results suggest a gene regulation of M. tuberculosis which reveals a distinctive expression pattern under stressful environment

Photolysis of alpha-tocopherol in olive oils and model systems

The photolysis of a-tocopherol (I) in olive oil (O) acid in some model systems (n-hexane = H; anhydrous n-hexane = KA, and triolein = T) was studied under sunlight and under artificial light (lambda > 290 nm) by HPLC and GC/MS. In O and T, I disappeared linearly to 50% of the starting concentration, reached a constant value, and finally disappeared rapidly from the medium. In the model system, photolysis followed a pseudo-first-order kinetics. Although no peaks attributable to photoproducts were found in O, a main product identified by H-1 and C-13 NMR and GC/MS as 5-formyltocopherol (II) was found in the model systems. Irradiation of compound II led to species undetectable by HPLC in agreement with a slower consecutive kinetic process than that of I. In the HA and T systems, the formation of II occurred at lower levels than in H. The possible behavior of photodegradation is discussed

Photolysis of Alpha-Tocopherol in Olive Oils and Model Systems.

The photolysis of a-tocopherol (I) in olive oil (O) and in some model systems [n-hexane=H; anhydrous n-hexane=HA, and triolein=T] was studied under sunlight and under artificial light (lambda>290 nm) by HPLC and GC-MS. In O and T, I disappeared linearly until the 50% of the starting concentration, reached a constant value, and finally disappeared rapidly from the medium. In the model system, photolysis followed a pseudo first order kinetics. While no peaks attributable to photoproducts were found in O, a main product identified by 1H, 13C NMR and GC-MS as 5-formyl tocopherol (II) was found in the model system. Irradiation of compound (II) led to species undetectable by HPLC in agreement with a slower consecutive kinetic process than that of I. In the HA and T systems, the formation of (II) occurred at lower levels than in H. The possible behaviour of photodegradation is discussed.JRC.(EI)-Environment Institut

Evaluation of a single strain starter culture, a selected inoculum enrichment, and natural microflora in the processing of Tonda di Cagliari natural table olives: Impact on chemical, microbiological, sensory and texture quality

The processing of natural table olives is still empirical and far to be controlled. Taking natural fermentation (NF) as control, the performances of a single strain LAB starter culture (SSL) and a selected inoculum enrichment (SIE) were compared. The results showed that the SIE was more efficient in controlling spoiling microflora (Enterobacteriaceae spp.) compared to SSL and NF. Indeed, Enterobacteriaceae in SIE samples were not detectable starting from 10 days, while in SSL and NF samples starting from 30 days. Both starters rapidly acidified the brine, lowering the pH to safety levels (<4.0) after 12 days, while NF samples reached pH 4.3 after 45 days, and these values were kept constant up to 150 days. Moreover, both starters showed debittering activity, as stated through sensory analyses and HPLC analysis of phenols. Compared to NF samples, SIE and SSL extracts retained more hydroxytyrosol at the end of the process, and this could partially account for their higher scavenging activity. Texture profile analysis (TPA) showed that olives processed with SIE inoculum were firmer and more elastic, compared to SSL inoculated olives, thus resulting more similar to NF samples