The moderating role of depressive symptoms in the association between heart rate variability and cognitive performance in cardiac patients

Introduction: Coronary heart disease (CHD) is strongly associated with cognitive impairment, which is a core feature of depression, highly prevalent in patients with CHD. Interestingly, patients with CHD and individuals with depression display reduced heart rate variability (HRV), which proxies a complex network integrating autonomic and attentional systems. This study investigated the moderating role of depressive symptoms in the relation between reduced HRV and cognitive performance in patients with CHD. Method: The sample included 274 patients with CHD (mean [standard deviation] age = 62 [9.5] years; 13 % women) admitted to cardiac rehabilitation units. Visual attention and task switching were assessed through the Trail Making Test (TMT). Depressive symptoms were assessed with the Beck Depression Inventory-II (BDI-II). Resting electrocardiographic recordings were collected to compute HRV indices. Results: Patients with more severe depressive symptoms displayed an inverse association between HRV and cognitive performance (TMT-A: b = -0.08, p = .022; TMTB: b = -0.07, p = .042), whereas patients with milder depressive symptoms showed no significant association (TMT-A: b = -0.00, p = .90; TMTB: b = -0.02, p = .44). Conclusions: Depressive symptoms may strengthen the relation between reduced HRV and poorer cognitive performance in cardiac patients. The presence of depressive symptoms may signal the dysfunction of a network subserving autonomic and cognitive function

Efficacy of Lactiplantibacillus plantarum PBS067, Bifidobacterium animalis subsp. lactis BL050, and Lacticaseibacillus rhamnosus LRH020 in the Amelioration of Vaginal Microbiota in Post-Menopausal Women: A Prospective Observational Clinical Trial

The menopausal transition marks a significant physiological shift in women. Menopause-related symptoms can significantly affect a woman's quality of life and probiotics have emerged as a promising avenue. This study aims to investigate the benefits of probiotics in improving vaginal well-being and microbiota composition in post-menopausal women. A prospective observational clinical trial was carried out enrolling 50 post-menopausal healthy women, aged between 45 and 65 years old, taking a supplement containing Lactiplantibacillus plantarum PBS067, Bifidobacterium animalis subsp. lactis BL050, and Lacticaseibacillus rhamnosus LRH020 (3B CFU/day) for 28 days. Vaginal swabs were collected to evaluate microbiota fluctuation and the inflammatory pattern was recorded. A Vaginal Health Index was provided to evaluate vaginal well-being throughout the trial. Clinical outcomes revealed a decrease in menopausal symptoms. Significant improvements were observed across various parameters: a 50% enhancement in the VHI score (p < 0.0001), alongside substantial reductions in inflammatory cytokine levels. An 87.8% decrease in IL-6, 57.6% in IL-1 beta, and 40.8% in TNF-alpha was observed (p < 0.05). Moreover, the probiotic intervention facilitated the restoration of vaginal microbiota, evidenced by an increase in lactobacilli abundance. In conclusion, the combination of these specific probiotic strains, previously clinically tested in childbearing-age women, showed to be effective also for post-menopausal women

The impact of COVID-19-related quarantine on psychological outcomes in patients after cardiac intervention: a multicenter longitudinal study

Mandatory quarantine during the COVID-19 pandemic had substantial negative consequences on psychological health in the general population. Depression, anxiety, and insomnia were reported to increase the morbidity and mortality risk in cardiac patients after cardiac interventions. Nonetheless, a gap in the evidence appeared regarding the effects of COVID-19-related quarantine on psychological outcomes in patients after cardiac interventions. The present study aimed to longitudinally investigate the effects of quarantine on depressive, anxiety, and insomnia symptoms in a group of patients who underwent cardiac intervention. Seventy-three patients admitted for cardiac rehabilitation completed a psychological assessment before and a reassessment after the quarantine and were included in the quarantine group. The control group included 76 patients who completed both evaluations before the quarantine. Depressive (Beck Depression Inventory-II; BDI-II), anxiety (Beck Anxiety Inventory-II; BAI), and insomnia (Sleep Condition Indicator; SCI) symptoms were evaluated in both groups at one (assessment) and eight (reassessment) months after cardiac intervention. The statistical analyses revealed that at reassessment, the quarantine group showed higher global depressive, anxiety, and insomnia symptoms than the control group and increased cognitive symptoms of depression. A higher presence of clinically relevant depressed patients was seen in the quarantine group. The present results showed that the COVID-19-related mandatory quarantine negatively affected psychological outcomes in patients after cardiac intervention, increasing the probability for these patients to be depressed. This, in turn, could influence patients' health in a critical period for morbidity and mortality risk. This underlines the priority of integrating and improving targeted mental health support as the pandemic continues, especially for cardiac patients

Effect of rootstock on water balance of 'Golden delicious' apple trees

The performance of three different apple rootstocks (M9, M106 and M7) was tested in Golden Delicious trees with low and high fruit load and under two water regimes. Midday leaf water potential was higher in trees on M9, lower in those on M7 and intermediate on M106. Trees on M7 showed the highest stomatal conductance in non limiting water conditions. This was equal or higher on M9 and M106 in water stress conditions, although the recovering after watering was more rapid on M7

Studies on water relations of grapevine (Vitis vinifera). Effects of sinks on leaf water potential and transpiration in non limiting conditions

The presence of sinks, both vegetative and reproductive, modifies the water relations of grapevines. The sinks enhance dehydration, induce a stable water potential at midday, and a slower rehydration. Transpiration rate is very little affected, but because of different leaf area water loss by transpiration is strongly dependent on the type and activity of sinks

Depression anticipates patients at risk of poor exercise stress test performance after percutaneous coronary angioplasty: A short-term longitudinal study

Aims: The exercise stress test is commonly used to assess physical capacity and recovery in coronary artery disease (CAD) patients after percutaneous transluminal coronary angioplasty (PTCA). Despite depressive symptoms have been consistently associated with adverse outcomes in CAD patients, they are rarely considered as risk factors of poor exercise test. The present study investigated the influence of depressive symptoms, along with anxiety, sleep problems and perceived health on exercise test in PTCA patients. Methods: One hundred and sixty-five patients who underwent PTCA completed the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory, the Sleep Condition Index and the 12-item Short-Form Health Survey and, after 20 days, underwent exercise stress test. Results: Higher BDI-II scores significantly predicted lower maximal workload measured in metabolic equivalents (METs; \u3b2 = 120.13; p = .030), shorter total exercise duration (\u3b2 = 125.23; p = .034) and the inability to reach maximum heart rate during exercise test (OR = 1.07; p = .032), even after controlling for relevant sociodemographic and biomedical risk factors. Conclusions: Depressive symptoms specifically predicted worse exercise stress test performance in patients after PTCA, controlling for common risk factors. Focusing on the assessment of depressive symptoms, in addition to sociodemographic and biomedical risk factors, is essential to anticipate patients at risk of poor physical capacity after PTCA

Images in cardiovascular medicine. Right atrial mass in a patient with T-cell chronic lymphocytic leukemia: an unusual mechanism of thrombus formation.

A 71-year-old woman with refractory T-cell (CD4) chronic lymphocytic leukemia who had been treated with chemotherapy and leukapheresis with poor control of leucocytosis was admitted because of fever, cough, and chest pain. A chest x-ray showed a right basal pneumonia, and the cytological examination of sputum showed Aspergillus fumigatus (Figure 1). The ECG at admission showed a firstdegree atrioventricular block (Figure 2A). The patient was started on broad-spectrum antibiotics and liposomal amphotericin B. Shortly before admission, because of sinus tachycardia, an ECG with Holter monitoring was performed; it showed a run of supraventricular tachycardia (Figure 2B). Therefore, while in the hospital, the patient underwent cardiac evaluation. Two-dimensional echocardiography showed a round (2016 mm) floating mass in the right atrium, close to the superior caval vein (Figure 3A, Movie). A thrombus near the distal tip of the central venous catheter was suspected, and the patient was started on nadroparin 6000 U injected subcutaneously twice daily. At the time of echocardiography, blood counts showed severe leucocytosis (white blood cell count, 396.100/L; lymphocytes, 384.940/L). After 2 weeks of therapy with low-molecular-weight heparin, the patient underwent transesophageal echocardiography, which did not show any reduction of the atrial mass and excluded any relation to the central venous catheter (Figure 3B). A cardiac computed tomography scan was performed, which showed an 8-mm defect in the right atrium with irregular shape and contrast enhancement (Figure 3C). The patient died of multiorgan failure 52 days after admission. At autopsy, a multiorgan extensive leukemic infiltration was detected. The atrial mass, located at the junction of the inferior caval vein with the atrium and attached to the crista dividens, measured 201815 mm (figure 3D). Histologically, we found an infiltration of the atrial wall by clusters of cells that reached and disrupted the endocardial atrial surface, providing a likely cause for the stratified thrombotic apposition (Figure 4A through 4D). The clustered cells were CD45-positive (Figure 4C) and CD3-positive (Figure 4D) T-lymphocytes and were confined to the peduncle