Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Efficacy of light-emitting diode (LED) photobiomodulation in pain management, facial edema, trismus, and quality of life after extraction of retained lower third molars : A randomized, double-blind, placebo-controlled clinical trial

Background: In dentistry, one of the most common surgical procedures is the removal of retained third molars. This surgery generates great morbidity to the participants for causing pain, edema, and trismus due to surgical trauma. The objective of the present study is to evaluate the efficacy of photobiomodulation with light emitting diode (LED) in the control of pain, facial edema, trismus, and quality of life resulting from the extraction of retained lower third molars. Methods:A randomized, double-blind, placebo-controlled clinical trial involving 38 adult participants, who meet the criteria of eligibility and agree to participate in the study. Before the surgeries are performed, the facial and mouth opening measures of all the participants will be taken. Immediately after the surgeries, participants will be randomized into 2 groups. In the LED group, participants will receive LED applications (intra oral with 660 nm, 12J and extraoral with 850 nm, 108J) in the immediate postoperative, first and second days after the surgical procedure. In the control group, the participants will be attended in the same way as in the LED group, however, the person in charge of the application will simulate the irradiation. Pain (EVA and NRS-101), postoperative edema, trismus, temperature, dysphagia, and hematoma will be evaluated after 1, 2, 5, and 7 days. The oral health impact profile (OHIP-14 Questionnaire) and anxiety analysis (Beck anxiety inventory -BAI) questionnaires will be applied preoperatively and 7 days after treatment. The appropriate statistical tests will be applied for each specific analysis in a significance level of 5%. Discussion: Although the use of low-power laser in the postoperative has shown good results in the control of postoperative sequelae, this is the first study on the efficacy of the use of LED in this situation. Abbreviations: BAI = Beck anxiety inventory, LED = light emitting diode, NRS-101 = numerical rating scale 101, OHIP-14 = oral health impact profile, PBM = pohotobiomodulation, VAS = visual analog scale

Effects of artepillin C on model membranes displaying liquid immiscibility

It has been hypothesized that the therapeutic effects of artepillin C, a natural compound derived from Brazilian green propolis, are likely related to its partition in the lipid bilayer component of biological membranes. To test this hypothesis, we investigated the effects of the major compound of green propolis, artepillin C, on model membranes (small and giant unilamelar vesicles) composed of ternary lipid mixtures containing cholesterol, which display liquid-ordered (lo) and liquid-disordered (ld) phase coexistence. Specifically, we explored potential changes in relevant membrane parameters upon addition of artepillin C presenting both neutral and deprotonated states by means of small angle X-ray scattering (SAXS), differential scanning calorimetry (DSC), and confocal and multiphoton excitation fluorescence microscopy. Thermotropic analysis obtained from DSC experiments indicated a loss in the lipid cooperativity of lo phase at equilibrium conditions, while at similar conditions spontaneous formation of unilamellar vesicles from SAXS experiments showed that deprotonated artepillin C preferentially located at the surface of the membrane. Time-resolved experiments using fluorescence microscopy showed that at doses above 100 µM, artepillin C in its neutral state interacted with both liquid-ordered and liquid-disordered phases, inducing curvature stress and promoting dehydration at the membrane interface