Challenges and opportunities on lipid metabolism disorders diagnosis and therapy: Novel insights and future perspective

Dyslipidemia has been globally recognized, for almost seven decades, as one of the most important risk factors for the development and complications of atherosclerotic cardiovascular disease (ASCVD) [...]

Active Mg Estimation Using Thermal Analysis: A Rapid Method to Control Nodularity in Ductile Cast Iron Production

Appropriate nodularity in ductile iron castings is strongly associated with the presence of high enough not combined Mg dissolved in the melt to cast. However, the residual Mg which is commonly measured for production control accounts for both dissolved Mg and Mg combined as oxides and sulfides. To account for the uncertainties associated with such a control, it is quite usual to over treat the melt with the risk of porosity appearance. A new methodology based on thermal analysis has been developed in the present work so as to estimate the amount of free Mg dissolved in the melt ready for pouring. A combination of Te mixture and a new “reactive mixture” composed of sulfur plus a commercial inoculant has been prepared for this purpose. This reactive mixture is able to transform the magnesium remaining dissolved in the melt to combined forms of this element. Experiments performed both during start of production (when Mg overtreatment is usual) and during normal mass production indicate that important variations of free Mg occur without relevant changes in residual Mg content as determined by spectrometry. The method developed in the present work has shown to be highly effective to detect those melt batches where active Mg content is not high enough for guaranteeing a correct nodularity of castings. Selection of proper active Mg thresholds and a correct inoculation process are critical to avoid “false”-negative results when using this new method

ESC core curriculum for the general cardiologist (2013)

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Crispr gene editing in lipid disorders and atherosclerosis: Mechanisms and opportunities

Elevated circulating concentrations of low-density lipoprotein cholesterol (LDL-C) have been conclusively demonstrated in epidemiological and intervention studies to be causally associated with the development of atherosclerotic cardiovascular disease. Enormous advances in LDL-C reduction have been achieved through the use of statins, and in recent years, through drugs targeting proprotein convertase subtilisin/kexin type 9 (PCSK9), a key regulator of the hepatic LDL-receptor. Existing approaches to PCSK9 targeting have used monoclonal antibodies or RNA interference. Although these approaches do not require daily dosing, as statins do, repeated subcutaneous injections are nevertheless necessary to maintain effectiveness over time. Recent experimental studies suggest that clustered regularly interspaced short palindromic repeats (CRISPR) gene-editing targeted at PCSK9 may represent a promising tool to achieve the elusive goal of a ‘fire and forget’ lifelong approach to LDL-C reduction. This paper will provide an overview of CRISPR technology, with a particular focus on recent studies with relevance to its potential use in atherosclerotic cardiovascular disease

Patients with coronary artery disease and diabetes need improved management: a report from the EUROASPIRE IV survey: a registry from the EuroObservational Research Programme of the European Society of Cardiology

Background: In order to influence every day clinical practice professional organisations issue management guidelines. Cross-sectional surveys are used to evaluate the implementation of such guidelines. The present survey investigated screening for glucose perturbations in people with coronary artery disease and compared patients with known and newly detected type 2 diabetes with those without diabetes in terms of their life-style and pharmacological risk factor management in relation to contemporary European guidelines. Methods: A total of 6187 patients (18–80 years) with coronary artery disease and known glycaemic status based on a self reported history of diabetes (previously known diabetes) or the results of an oral glucose tolerance test and HbA1c (no diabetes or newly diagnosed diabetes) were investigated in EUROASPIRE IV including patients in 24 European countries 2012–2013. The patients were interviewed and investigated in order to enable a comparison between their actual risk factor control with that recommended in current European management guidelines and the outcome in previously conducted surveys. Results: A total of 2846 (46%) patients had no diabetes, 1158 (19%) newly diagnosed diabetes and 2183 (35 %) previously known diabetes. The combined use of all four cardioprotective drugs in these groups was 53, 55 and 60%, respectively. A blood pressure target of 9.0% (>75 mmol/mol). Of the patients with diabetes 69% reported on low physical activity. The proportion of patients participating in cardiac rehabilitation programmes was low (≈40%) and only 27% of those with diabetes had attended diabetes schools. Compared with data from previous surveys the use of cardioprotective drugs had increased and more patients were achieving the risk factor treatment targets. Conclusions: Despite advances in patient management there is further potential to improve both the detection and management of patients with diabetes and coronary artery disease

Physical Activity Status in Patients With Coronary Heart Disease: Results From the Cross-Sectional EUROASPIRE Surveys.

BACKGROUND: The study aim was to assess the physical activity levels as well as the intention to become physically active in patients with stable coronary heart disease (CHD) with a special focus on the association with their risk profile. METHODS: Analyses are based on the cross-sectional EUROASPIRE IV surveys. Information was available on 8966 patients in EUROASPIRE III and on 7998 patients in EUROASPIRE IV. Physical activity level according to patients risk profile and their medical management was assessed, the intention to become physically active was investigated and a time trend analysis was performed. RESULTS: A better cardiovascular risk profile as well as receiving physical activity advice or weight loss advice was associated with better physical activity levels. The physical activity status improved significantly over time, the proportion of patients reporting vigorous physical activity for at least 20 minutes ≥ 3 times/week increased from 14.1% to 20.2% (P < .001). Similarly, a significantly greater proportion of patients are in the maintenance stage (36.6% vs. 27.4%) and a smaller proportion in the precontemplation stage (43.2% vs. 52.3%). CONCLUSION: Although an increase was seen in the proportion of patients being adequately physical active, physical activity levels remain suboptimal in many CHD patients

Approaches in biotechnological applications of natural polymers

Natural polymers, such as gums and mucilage, are biocompatible, cheap, easily available and non-toxic materials of native origin. These polymers are increasingly preferred over synthetic materials for industrial applications due to their intrinsic properties, as well as they are considered alternative sources of raw materials since they present characteristics of sustainability, biodegradability and biosafety. As definition, gums and mucilages are polysaccharides or complex carbohydrates consisting of one or more monosaccharides or their derivatives linked in bewildering variety of linkages and structures. Natural gums are considered polysaccharides naturally occurring in varieties of plant seeds and exudates, tree or shrub exudates, seaweed extracts, fungi, bacteria, and animal sources. Water-soluble gums, also known as hydrocolloids, are considered exudates and are pathological products; therefore, they do not form a part of cell wall. On the other hand, mucilages are part of cell and physiological products. It is important to highlight that gums represent the largest amounts of polymer materials derived from plants. Gums have enormously large and broad applications in both food and non-food industries, being commonly used as thickening, binding, emulsifying, suspending, stabilizing agents and matrices for drug release in pharmaceutical and cosmetic industries. In the food industry, their gelling properties and the ability to mold edible films and coatings are extensively studied. The use of gums depends on the intrinsic properties that they provide, often at costs below those of synthetic polymers. For upgrading the value of gums, they are being processed into various forms, including the most recent nanomaterials, for various biotechnological applications. Thus, the main natural polymers including galactomannans, cellulose, chitin, agar, carrageenan, alginate, cashew gum, pectin and starch, in addition to the current researches about them are reviewed in this article.. }To the Conselho Nacional de Desenvolvimento Cientfíico e Tecnológico (CNPq) for fellowships (LCBBC and MGCC) and the Coordenação de Aperfeiçoamento de Pessoal de Nvíel Superior (CAPES) (PBSA). This study was supported by the Portuguese Foundation for Science and Technology (FCT) under the scope of the strategic funding of UID/BIO/04469/2013 unit, the Project RECI/BBB-EBI/0179/2012 (FCOMP-01-0124-FEDER-027462) and COMPETE 2020 (POCI-01-0145-FEDER-006684) (JAT)

Slovenia’s Food-Based Dietary Guidelines 2024: Eating for Health and the Planet

The dietary guidelines of Slovenia, ‘12 Steps to Healthy Eating’, were first published in 2000 and revised in 2011. The ‘Food Guide Pyramid’ was initially published in 2000 and subsequently revised in 2015. ‘The Healthy Plate’ was first introduced in 2007. In February 2023, the Slovenian Strategic Council for Nutrition proposed new Food-Based Dietary Guidelines (FBDGs) that integrate both health and environmental considerations. In September 2023, the creation of new FBDGs was included in the Action Plan for implementing the Resolution on the National Program on Nutrition and Physical Activity for Health 2015–2025. In October 2023, the Ministry of Health of Slovenia appointed the core working group of 10 multidisciplinary experts from fields such as nutrition, food science medicine, public health, environment, pharmacy, and agriculture led by Prof. Dr. Nataša Fidler Mis, who drafted the guidelines. In February 2024, the World Health Organization Regional Office for Europe organized a virtual international workshop to assist Slovenia in developing food-based dietary guidelines. In May 2024, an international expert meeting was organized by the Ministry of Health of Slovenia, the Ministry of the Environment, Climate, and Energy, and the National Institute of Public Health of Slovenia to present the first scientific draft of the SLO FBDG for external international peer review. The meeting included lectures from world-leading experts to present healthy diets from sustainable food systems, integrate climate and sustainability aspects into the new SLO FBDG, discuss the findings with the Slovenian core working group, extended working group of the SLO FBDG, and invited experts. The final version of SLO FBDG is expected to be released by the end of 2024

Personalised Management of Dyslipidaemias in patients with diabetes - It is time for a new approach.

Dyslipidemia in patients with type 2 diabetes (DMT2) is one of the worst controlled worldwide, with only about 1/4 of patients being on the low-density lipoprotein cholesterol (LDL-C) target. There are many reasons of this, including physicians’ inertia, including diabetologists and cardiologists, therapy nonadherence, but also underusage and underdosing of lipid lowering drugs due to unsuitable cardiovascular (CV) risk stratification. In the last several years there is a big debate on the risk stratification of DMT2 patients, with the strong indications that all patients with diabetes should be at least at high cardiovascular disease (CVD) risk. Moreover, we have finally lipid lowering drugs, that not only allow for the effective reduction of LDL-C and do not increase the risk of new onset diabetes (NOD), and/or glucose impairment; in the opposite, some of them might effectively improve glucose control. One of the most interesting is pitavastatin, which is now available in Europe, with the best metabolic profile within statins (no risk of NOD, improvement of fasting blood glucose, HOMA-IR, HbA1c), bempedoic acid (with the potential for the reduction of NOD risk), innovative therapies - PCSK9 inhibitors and inclisiran with no DMT2 risk increase, and new forthcoming therapies, including apabetalone and obicetrapib – for the latter one with the possibility of even decreasing the number of patients diagnosed with prediabetes and DMT2. Altogether, nowadays we have possibility to individualize lipid lowering therapy in DMT2 patients and increase the number of patients on LDL-C goal without any risk of new onset diabetes and/or diabetes control worsening, and in consequence to reduce the risk of CVD complications due to progression of atherosclerosis in this patients’ group

Readiness for smoking cessation in coronary heart disease patients across Europe: results from the EUROASPIRE III survey

Background: Readiness for smoking cessation is an important predictor of quit attempts and cessation success. We aimed to investigate the prevalence and correlates of readiness for smoking cessation in coronary heart disease (CHD) patients. Design: The EUROpean Action on Secondary and Primary Prevention by Intervention to Reduce Events III (EUROASPIRE III) survey is a cross-sectional study conducted in 2006–2007 among CHD patients <80 years of age from 22 European regions. Methods: Patients were interviewed on average 15 months after hospital admission for an acute coronary event or procedure. Readiness for smoking cessation was assessed using the smoking stages of change (SSC) short form questionnaire. Breath carbon monoxide was measured to validate self-reported non-smoking. Results: Among 2585 patients who were smoking prior to hospital admission, 25.6%, 16.8%, 8.1%, 5.6% and 44.0% were in the precontemplation (no intention to quit), contemplation (thinking of quitting), preparation (planning to quit), action (having quit within six months) and maintenance (having quit more than six months ago) stages, respectively. Significant multivariable correlates of advancement in SSC showed positive associations of older age and attended cardiac rehabilitation and negative associations of severe depressive symptoms, longer smoking duration and environmental tobacco smoke (ETS) exposure. Conclusions: One-quarter of CHD patients across Europe who were smoking prior to hospitalisation have no intention to quit, and an additional quarter is thinking of quitting or planning to quit. Patients who are younger, do not attend cardiac rehabilitation, have severe depressive symptoms, have been smoking for longer periods of time and are exposed to ETS may need to be specifically targeted in cessation interventions