260 research outputs found

    Production, nutritional and anti-oxidative properties of currant cultivars (Ribes cv.)

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    Π ΠΈΠ±ΠΈΠ·Π»Π° (Ribes sp.) јС Π²Π΅ΠΎΠΌΠ° Π·Π½Π°Ρ‡Π°Ρ˜Π½Π° врста Ρ˜Π°Π³ΠΎΠ΄Π°ΡΡ‚ΠΈΡ… Π²ΠΎΡ›Π°ΠΊΠ°, која сС ΠΏΠΎ ΠΎΠ±ΠΈΠΌΡƒ ΠΏΡ€ΠΎΠΈΠ·Π²ΠΎΠ΄ΡšΠ΅ Ρƒ свСтским Ρ€Π°Π·ΠΌΠ΅Ρ€Π°ΠΌΠ° Π½Π°Π»Π°Π·ΠΈ Π½Π° Π΄Ρ€ΡƒΠ³ΠΎΠΌ мСсту, ΠΎΠ΄ΠΌΠ°Ρ… ΠΈΠ·Π° јагодС. Π£ Π‘Ρ€Π±ΠΈΡ˜ΠΈ јС Ρ€ΠΈΠ±ΠΈΠ·Π»Π° Π½Π΅ΠΎΠΏΡ€Π°Π²Π΄Π°Π½ΠΎ запостављСна врста, ΠΈΠ°ΠΊΠΎ ΠΏΠΎΡΡ‚ΠΎΡ˜Π΅ ΠΈΠ·ΡƒΠ·Π΅Ρ‚Π½ΠΎ ΠΏΠΎΠ³ΠΎΠ΄Π½ΠΈ агроклиматски услови Π·Π° њСно ΡƒΡΠΏΠ΅ΡˆΠ½ΠΎ гајСњС ΠΈ константна Ρ‚Ρ€Π°ΠΆΡšΠ° Π½Π° Ρ‚Ρ€ΠΆΠΈΡˆΡ‚Ρƒ Π·Π° ΠΎΠ²ΠΈΠΌ Π²ΠΎΡ›Π΅ΠΌ. Π‘ΠΏΠΎΡ€Π°Π΄ΠΈΡ‡Π½ΠΎ гајСњС Π½Π° ΠΌΠ°Π»ΠΈΠΌ ΠΏΠΎΠ²Ρ€ΡˆΠΈΠ½Π°ΠΌΠ° ΠΈΠ»ΠΈ ΠΎΠΊΡƒΡ›Π½ΠΈΡ†Π°ΠΌΠ°, ΠΏΡ€Π°Ρ›Π΅Π½ΠΎ ниским приносима ΠΈ лошијим ΠΊΠ²Π°Π»ΠΈΡ‚Π΅Ρ‚ΠΎΠΌ ΠΏΠ»ΠΎΠ΄Π°, Π½Π΅ Π·Π°Π΄ΠΎΠ²ΠΎΡ™Π°Π²Π° ΠΏΠΎΡ‚Ρ€Π΅Π±Π΅ Π΄ΠΎΠΌΠ°Ρ›Π΅Π³ Ρ‚Ρ€ΠΆΠΈΡˆΡ‚Π°. Π‘Ρ‚ΠΎΠ³Π°, Π½Π°ΠΌΠ΅Ρ›Π΅ сС ΠΏΠΎΡ‚Ρ€Π΅Π±Π° Π·Π° ΠΈΠ½Ρ‚Π΅Π½Π·ΠΈΠ²ΠΈΡ€Π°ΡšΠ΅ΠΌ ΠΏΡ€ΠΎΠΈΠ·Π²ΠΎΠ΄ΡšΠ΅ ΠΎΠ²Π΅ високорСнтабилнС врстС Π²ΠΎΡ›Π°ΠΊΠ°, Π° Ρ‚ΠΎ јС ΠΌΠΎΠ³ΡƒΡ›Π΅ остварити Π½Π΅ само подизањСм засада ΠΏΠΎ ΠΏΡ€ΠΈΠ½Ρ†ΠΈΠΏΡƒ ΠΌΠΎΠ΄Π΅Ρ€Π½Π΅ Ρ‚Π΅Ρ…Π½ΠΎΠ»ΠΎΠ³ΠΈΡ˜Π΅ гајСња, Π²Π΅Ρ› ΠΈ ΠΈΠ½Ρ‚Ρ€ΠΎΠ΄ΡƒΠΊΡ†ΠΈΡ˜ΠΎΠΌ Π½ΠΎΠ²ΠΈΡ… сорти високог ΠΊΠ²Π°Π»ΠΈΡ‚Π΅Ρ‚Π° ΠΏΠ»ΠΎΠ΄Π°. Π‘ΠΎΡ€Ρ‚Π΅ Ρ€ΠΈΠ±ΠΈΠ·Π»Π΅, Π° Π½Π°Ρ€ΠΎΡ‡ΠΈΡ‚ΠΎ прСдставници Ρ†Ρ€Π½Π΅ Ρ€ΠΈΠ±ΠΈΠ·Π»Π΅, Π·Π°Ρ…Π²Π°Ρ™ΡƒΡ˜ΡƒΡ›ΠΈ присуству Ρ„Π΅Π½ΠΎΠ»Π½ΠΈΡ… јСдињСња ΠΈ Π²ΠΈΡ‚Π°ΠΌΠΈΠ½Π° Ρƒ својим ΠΏΠ»ΠΎΠ΄ΠΎΠ²ΠΈΠΌΠ°, ΠΈΡΠΏΠΎΡ™Π°Π²Π°Ρ˜Ρƒ Π²Ρ€Π»ΠΎ високу антиоксидативну, Π°Π½Ρ‚ΠΈΠΈΠ½Ρ„Π»Π°ΠΌΠ°Ρ‚ΠΎΡ€Π½Ρƒ, Π°Π½Ρ‚ΠΈΠΌΠΈΠΊΡ€ΠΎΠ±Π½Ρƒ ΠΈ Π°Π½Ρ‚ΠΈΠΊΠ°Ρ€Ρ†ΠΈΠ½ΠΎΠ³Π΅Π½Ρƒ активност. Π£Π·ΠΈΠΌΠ°Ρ˜ΡƒΡ›ΠΈ Ρƒ ΠΎΠ±Π·ΠΈΡ€ ΠΈΠ·Ρ€Π°ΠΆΠ΅Π½Π° Π½ΡƒΡ‚Ρ€ΠΈΡ‚ΠΈΠ²Π½Π° ΠΈ Π»Π΅ΠΊΠΎΠ²ΠΈΡ‚Π° ΡΠ²ΠΎΡ˜ΡΡ‚Π²Π° ΠΏΠ»ΠΎΠ΄ΠΎΠ²Π° Ρ€ΠΈΠ±ΠΈΠ·Π»Π΅, ΠΊΠ°ΠΎ ΠΈ ΠΎΠ΄Π»ΠΈΡ‡Π½Π΅ ΠΏΡ€ΠΎΠΈΠ·Π²ΠΎΠ΄Π½Π΅ особинС ΠΎΠ²Π΅ Π²ΠΎΡ›Π½Π΅ врстС, Ρ†ΠΈΡ™ ΠΎΠ²ΠΈΡ… ΠΈΡΡ‚Ρ€Π°ΠΆΠΈΠ²Π°ΡšΠ° јС Π±ΠΈΠΎ Π΄Π° сС ΠΈΡΠΏΠΈΡ‚Π°Ρ˜Ρƒ Π½ΠΎΠ²ΠΎΠΈΠ½Ρ‚ΠΎΠ΄ΡƒΠΊΠΎΠ²Π°Π½Π΅ сортС Ρ†Ρ€Π½Π΅, Ρ†Ρ€Π²Π΅Π½Π΅ ΠΈ Π±Π΅Π»Π΅ Ρ€ΠΈΠ±ΠΈΠ·Π»Π΅ ΠΈ установи погодност ΡšΠΈΡ…ΠΎΠ²ΠΎΠ³ масовнијСг гајСња Ρƒ Π°Π³Ρ€Π΅ΠΎΠΊΠΎΠ»ΠΎΡˆΠΊΠΈΠΌ условима Π‘Ρ€Π±ΠΈΡ˜Π΅. Π”ΠΎΠ±ΠΈΡ˜Π΅Π½ΠΈ Ρ€Π΅Π·ΡƒΠ»Ρ‚Π°Ρ‚ΠΈ послуТићС Π·Π° ΠΎΠ΄Π°Π±ΠΈΡ€ сорти са Π½Π°Ρ˜Π±ΠΎΡ™ΠΈΠΌ карактСристикама, којС Ρ›Π΅ Π±ΠΈΡ‚ΠΈ ΠΏΡ€Π΅ΠΏΠΎΡ€ΡƒΡ‡Π΅Π½Π΅ Π·Π° Π΅ΡΠΏΠ»ΠΎΠ°Ρ‚Π°Ρ†ΠΈΡ˜Ρƒ Ρƒ ΠΈΠ½Ρ‚Π΅Π½Π·ΠΈΠ²Π½ΠΈΠΌ засадима Π½Π° Π·Π½Π°Ρ‚Π½ΠΎ Π²Π΅Ρ›ΠΈΠΌ ΠΏΡ€ΠΎΠΈΠ·Π²ΠΎΠ΄Π½ΠΈΠΌ ΠΏΠΎΠ²Ρ€ΡˆΠΈΠ½Π°ΠΌΠ°. ПосСбан Π°ΠΊΡ†Π΅Π½Π°Ρ‚ Ρƒ ΠΈΡΡ‚Ρ€Π°ΠΆΠΈΠ²Π°ΡšΠΈΠΌΠ° јС Π΄Π°Ρ‚ Π±ΠΈΠΎΡ…Π΅ΠΌΠΈΡ˜ΡΠΊΠΈΠΌ ΡΠ²ΠΎΡ˜ΡΡ‚Π²ΠΈΠΌΠ° ΠΏΠ»ΠΎΠ΄ΠΎΠ²Π° ΠΈ сокова сорти Ρ€ΠΈΠ±ΠΈΠ·Π»Π΅, Π° ΠΏΡ€Π΅ΠΊΠΎ ΡΠ°Π΄Ρ€ΠΆΠ°Ρ˜Π° Π΅ΡΠ΅Π½Ρ†ΠΈΡ˜Π°Π»Π½ΠΈΡ… масних кисСлина ΠΎΠ΄Ρ€Π΅Ρ’Π΅Π½ јС ΠΈ ΠΊΠ²Π°Π»ΠΈΡ‚Π΅Ρ‚ масних ΡƒΡ™Π° ΠΈΠ· сСмСна Ρ€Π°Π·Π»ΠΈΡ‡ΠΈΡ‚ΠΈΡ… сорти. Π—Π±ΠΎΠ³ ΠΏΠΎΡ‚Ρ€Π΅Π±Π΅ Π·Π° сталним ΠΊΠΎΠ½Π·ΡƒΠΌΠΎΠΌ ΠΏΠ»ΠΎΠ΄ΠΎΠ²Π° ΠΈ сокова Ρ€ΠΈΠ±ΠΈΠ·Π»Π΅, Π°Π½Π°Π»ΠΈΠ·ΠΈΡ€Π°Π½ јС ΡƒΡ‚ΠΈΡ†Π°Ρ˜ Ρ‚Π΅Ρ…Π½ΠΎΠ»ΠΎΡˆΠΊΠΈΡ… Ρ‚Ρ€Π΅Ρ‚ΠΌΠ°Π½Π° (Π·Π°ΠΌΡ€Π·Π°Π²Π°ΡšΠ° ΠΈ ΠΏΡ€Π΅Ρ€Π°Π΄Π΅) Π½Π° ΡΠ°Π΄Ρ€ΠΆΠ°Ρ˜ ΠΈ активност ΠΏΠΎΠ»ΠΈΡ„Π΅Π½ΠΎΠ»Π½ΠΈΡ… ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½Ρ‚ΠΈ Ρƒ њима. Π˜ΡΠΏΠΈΡ‚ΠΈΠ²Π°ΡšΠ° су Π²Ρ€ΡˆΠ΅Π½Π° Ρƒ ΠΊΠΎΠ»Π΅ΠΊΡ†ΠΈΠΎΠ½ΠΎΠΌ засаду Ρ€ΠΈΠ±ΠΈΠ·Π»Π΅ Π½Π° ΠΈΠΌΠ°ΡšΡƒ расадника β€žΠžΠΌΠ΅Π³Π°β€œ (сСло ΠœΠΈΡΠ»ΠΎΡ’ΠΈΠ½, ΠžΠ±Ρ€Π΅Π½ΠΎΠ²Π°Ρ‡ΠΊΠ° Посавина), Ρƒ ΠΏΠ΅Ρ€ΠΈΠΎΠ΄Ρƒ 2007-2009. Π³ΠΎΠ΄ΠΈΠ½Π°. ОглСдни засад јС ΠΏΠΎΠ΄ΠΈΠ³Π½ΡƒΡ‚ 2006. Π³ΠΎΠ΄ΠΈΠ½Π΅, ΠΏΠΎ систСму ΠΆΠΈΠ²Π΅ ΠΎΠ³Ρ€Π°Π΄Π΅ (Ρ„ΠΎΡ€ΠΌΠ° ΠΆΠ±ΡƒΠ½ΠΎΠ²Π°), са ΠΌΠ΅Ρ’ΡƒΡ€Π΅Π΄Π½ΠΈΠΌ Ρ€Π°ΡΡ‚ΠΎΡ˜Π°ΡšΠ΅ΠΌ ΠΎΠ΄ 1,8 m ΠΈ Ρ€Π°ΡΡ‚ΠΎΡ˜Π°ΡšΠ΅ΠΌ Ρƒ Ρ€Π΅Π΄Ρƒ ΠΎΠ΄ 0,8 m. Π˜ΡΡ‚Ρ€Π°ΠΆΠΈΠ²Π°ΡšΠ΅ΠΌ јС ΠΎΠ±ΡƒΡ…Π²Π°Ρ›Π΅Π½ΠΎ 29 сорти Ρ€ΠΈΠ±ΠΈΠ·Π»Π΅ (13 сорти Ρ†Ρ€Π½Π΅, 11 сорти Ρ†Ρ€Π²Π΅Π½Π΅ ΠΈ ΠΏΠ΅Ρ‚ сорти Π±Π΅Π»Π΅ Ρ€ΠΈΠ±ΠΈΠ·Π»Π΅). Π›Π°Π±ΠΎΡ€Π°Ρ‚ΠΎΡ€ΠΈΡ˜ΡΠΊΠ° ΠΈΡΠΏΠΈΡ‚ΠΈΠ²Π°ΡšΠ° су Π²Ρ€ΡˆΠ΅Π½Π° Π½Π° ΠšΠ°Ρ‚Π΅Π΄Ρ€ΠΈ Π·Π° воћарство ΠŸΠΎΡ™ΠΎΠΏΡ€ΠΈΠ²Ρ€Π΅Π΄Π½ΠΎΠ³ Ρ„Π°ΠΊΡƒΠ»Ρ‚Π΅Ρ‚Π° Π£Π½ΠΈΠ²Π΅Ρ€Π·ΠΈΡ‚Π΅Ρ‚Π° Ρƒ Π‘Π΅ΠΎΠ³Ρ€Π°Π΄Ρƒ ΠΈ Π½Π° Π˜Π½ΡΡ‚ΠΈΡ‚ΡƒΡ‚Ρƒ Π·Π° ΠΏΡ€ΠΎΡƒΡ‡Π°Π²Π°ΡšΠ΅ Π»Π΅ΠΊΠΎΠ²ΠΈΡ‚ΠΎΠ³ Π±ΠΈΡ™Π° β€žΠ”Ρ€ ΠˆΠΎΡΠΈΡ„ ΠŸΠ°Π½Ρ‡ΠΈΡ›β€œ Ρƒ Π‘Π΅ΠΎΠ³Ρ€Π°Π΄Ρƒ...Currant (Ribes sp.) is a very important berry fruit species ranking the second, after strawberry, for its commercial production on a world scale. In Serbia, currant is unjustifiably neglected fruit species because Serbia has very favorable agro-climate conditions for its successful growing and market demands for this fruit are persistent. Sporadic cultivation on small size areas or individual holdings, resulting in low yields and poor quality fruit, does not meet the demands of domestic market. Therefore, the production of this high-profitable fruit species must be intensified, which is possible to achieve not only by planting orchards based on modern technology of fruit growing principles but also by introducing new varieties of high quality fruits. Currant cultivars, especially representatives of black currant, demonstrate potent anti-oxidative, antiinflammatory, anti-microbial and anti-cancer activities due to the presence of phenolic compounds and vitamins in their fruits. Taking into account currant fruit species’ outstanding nutritional and medicinal properties as well as excellent production characteristics, the aim of investigations was to examine newly introduced cultivars of black, red and white currant and establish the suitability for their larger-scale cultivation in agro-ecological conditions of Serbia. The obtained results will be used to choose the cultivars with best properties to be recommended for exploitation in more intensive growing orchards covering larger production areas. Investigations predominantly focused on currant fruit biochemical properties and juices, and fatty oils quality from seeds of various cultivars was determined via essential fatty acids contents. Due to steady consumption needs for this fruit, analysis involved the effects of technological treatments (freezing and processing) on the contents and activities of polyphenolic components in them. Investigations were carried out in a currant collection orchard, the property of the β€œOmega” nursery (Mislodjin village, Obrenovacka Posavina), in the period 2007- 2009. The experimental orchard was planted in 2006, using the hedge system (a bush form), at 1.8 m of inter-row and 0.8 m intra-row spacing. Investigations comprised 29 currant cultivars (13 black currant cultivars, 11 red currant cultivars and 5 white currant cultivars). Laboratory analyses were performed at the Chair of Fruit Science, Faculty of Agriculture, Belgrade University, and at the Institute for Medicinal Plant Research β€œDr. Josif Pancic’, Belgrade..

    TEI INDEX MIGHT BE THE UNIQUE ECHOCARDIOGRAPHIC PARAMETER THAT DETECTS HYPERVISCOSITY SYNDROME: ACASE REPORT

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    Abstract: Hyperviscosity syndromes are disorders of infrequent prevalence in which changes of rheological characteristics cause increased resistance to blood flow, endothelial dysfunction, tissue ischemia and bleeding. Signs of hyperviscosity syndrome become clinically overt at the point of 4 centipoise units. We present a case of patient with hyperviscosity syndrome due to Waldenstrom’s macroglobulinemia with negative records on earlier cardiovascular illnesses. Laboratory diagnostic and standard echocardiography did not show any deviation towards increased cardiovascular risk, heart failure or ischemic heart disease. However, unique clinically significant change that could be indirectly related to hyperviscosity syndrome was found with the myocardium performance index (MPI). Tei-index showed median value of 0.75 corresponding to severe grades of myocardial dysfunction earlier described in the literature for other entities. Comprehensive roles of rheological changes in relation to echocardiography, pathophysiology of myocardial performance and cardiovascular continuum might be interesting point for further investigations

    Clinicopathological, radiological and bronchoscopic evaluation of suspected lung malignancy

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    Background: This study was conducted to evaluate the clinical, pathological and radiological profile of suspected lung malignancy and its correlation with bronchoscopic findings.Methods: A hospital based prospective study was conducted in the department of pulmonary medicine on 74 patients who were suspected with lung malignancy, clinically or radiologically. Following a detailed clinical examination, chest x-ray and CECT thorax, patients were included in the study and were subjected to bronchoscopy. Based on the bronchoscopic findings BAL, TBNA, forceps biopsy and TBLB were performed.Results: Out of 74 patients, most of them belonged to the age group of 51-65 years. Majority were males. Cough was the most common symptom. 51 patients had weight loss and 48 had associated reduced appetite. 50 (67.6%) were smokers. Out of them 43 (86%) were beedi smokers. In CT thorax, most common presentation was mass lesion followed by consolidation, nodules and interstial thickening. Right side was the most common side involved. Bronchoscopy revealed intraluminal growth as the most common finding and the most common pattern noted was fungating growth. Squamous cell carcinoma was the most common cell type noted in 9 (27.03%) followed by adenocarcinoma and small cell carcinoma. Squamous cell carcinoma presented more commonly as central mass with intraluminal growth and adenocarcinoma presented more commonly as peripheral lesions with extraluminal compression in bronchoscopy.Conclusions: Elderly smokers with cough and loss of appetite with weight loss can be suspicious of lung malignancy. CT and bronchoscopy are essential for the diagnosis of lung malignancy

    To Professor Petar Pfendt, In calidum, et plurium retributivus memoriae: FTIR-ATR analysis of post stamps of the Principality of Serbia issued in 1866 and 1868 and their forgeries

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    In order to further define the potential use of FTIR-ATR spectroscopy, as a non-destructive and reliable technique, for the analysis of the characteristics of post stamps, certified originals of the Principality of Serbia stamps (β€œPrince Michael issues”) issued in 1866 and 1868 as well as their forgeries were anaΒ­lyzed. Spectra enabling the comparison of the paper, dye and glue of stamps of so-called β€œVienna issues”, having denominations of 10 (orange-yellow), 20 (pink) and 40 para (blue) and β€œBelgrade issues” (1 para-green and 2 para-reddish brown), as well as 24 expert-certified forgeries, were taken. It was shown that the applied technology was, in most of the cases, a fast and suitable technique for establishing clear differences between the spectral characteristics of the paper and dye used for the original stamps, and forgeries that were most probably made decades after the printing of the genuine stamps. The differences between printΒ­ings of the same issues of the genuine stamps were also elaborated. It is proΒ­posed, for the first time in philatelic history, the possibility that β€œVienna issues” stamps may have been printed on two different papers, and, having in mind the technology of printing in the 19thΒ century, potentially, not even at the same time or in the same printing house

    ADAM8 in squamous cell carcinoma of the head and neck: a retrospective study

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    <p>Abstract</p> <p>Background</p> <p>A disintegrin and metalloproteinase (ADAMs) have been associated with multiple malignancies. ADAMs are involved in cell fusion, cell migration, membrane protein shedding and proteolysis. ADAM8 has been found to be overexpressed in squamous cell carcinomas of the lung. A new study showed that ADAM8 is significantly overexpressed in metastasis of squamous cell carcinomas of the head and neck (HNSCC).</p> <p>Methods</p> <p>We determined ADAM8 levels in the serum of 79 HNSCC patients at the time of diagnosis, in 35 patients 3 months after treatment and in 10 patients 1 year after therapy and compared the results to the sera of 31 healthy volunteers. We also constructed tissue microarrays to detect ADAM8 immunohistochemically in 100 patients. The results were correlated with the survival data of the patients to determine the diagnostic and prognostic value.</p> <p>Results</p> <p>The data demonstrated that patients with high ADAM8 expression in the tumor have worse survival rates. We found that high ADAM8 serum levels correlated with high ADAM8 expression in tumor samples. Soluble ADAM8 levels did not show any prognostic or diagnostic properties.</p> <p>Conclusion</p> <p>In summary ADAM8 expression is a prognostic factor for survival of patients with head and neck squamous cell carcinoma.</p

    Meckel-Gruber Syndrome: a population-based study on prevalence, prenatal diagnosis, clinical features, and survival in Europe

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    Meckel-Gruber Syndrome is a rare autosomal recessive lethal ciliopathy characterized by the triad of cystic renal dysplasia, occipital encephalocele and postaxial polydactyly. We present the largest population-based epidemiological study to date using data provided by the European Surveillance of Congenital Anomalies (EUROCAT) network. The study population consisted of 191 cases of MKS identified between January 1990 and December 2011 in 34 European registries. The mean prevalence was 2.6 per 100 000 births in a subset of registries with good ascertainment. The prevalence was stable over time, but regional differences were observed. There were 145 (75.9%) terminations of pregnancy after prenatal diagnosis, 13 (6.8%) fetal deaths, 33 (17.3%) live births. In addition to cystic kidneys (97.7%), encephalocele (83.8%) and polydactyly (87.3%), frequent features include other central nervous system anomalies (51.4%), fibrotic/cystic changes of the liver (65.5% of cases with post mortem examination) and orofacial clefts (31.8%). Various other anomalies were present in 64 (37%) patients. As nowadays most patients are detected very early in pregnancy when liver or kidney changes may not yet be developed or may be difficult to assess, none of the anomalies should be considered obligatory for the diagnosis. Most cases (90.2%) are diagnosed prenatally at 14.3?2.6 (range 11-36) gestational weeks and pregnancies are mainly terminated, reducing the number of LB to one-fifth of the total prevalence rate. Early diagnosis is important for timely counseling of affected couples regarding the option of pregnancy termination and prenatal genetic testing in future pregnancies

    Sex Differences in Revascularization, Treatment Goals, and Outcomes of Patients With Chronic Coronary Disease: Insights From the ISCHEMIA Trial

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    BACKGROUND: Women with chronic coronary disease are generally older than men and have more comorbidities but less atherosclerosis. We explored sex differences in revascularization, guideline-directed medical therapy, and outcomes among patients with chronic coronary disease with ischemia on stress testing, with and without invasive management. METHODS AND RESULTS: The ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial randomized patients with moderate or severe ischemia to invasive management with angiography, revascularization, and guideline-directed medical therapy, or initial conservative management with guideline-directed medical therapy alone. We evaluated the primary outcome (cardiovascular death, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest) and other end points, by sex, in 1168 (22.6%) women and 4011 (77.4%) men. Invasive group catheterization rates were similar, with less revascularization among women (73.4% of invasive-assigned women revascularized versus 81.2% of invasive-assigned men; CONCLUSIONS: Women had less extensive coronary artery disease and, therefore, lower revascularization rates in the invasive group. Despite lower risk factor goal attainment, women with chronic coronary disease experienced similar risk-adjusted outcomes to men in the ISCHEMIA trial

    Environmental enrichment intervention for Rett syndrome: An individually randomised stepped wedge trial

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    Background: Rett syndrome is caused by a pathogenic mutation in the MECP2 gene with major consequences for motor and cognitive development. One of the effects of impaired MECP2 function is reduced production of Brain Derived Neurotrophic Factor (BDNF), a protein required for normal neuronal development. When housed in an enriched environment, MECP2 null mice improved motor abilities and increased levels of BDNF in the brain. We investigated the effects of environmental enrichment on gross motor skills and blood BDNF levels in girls with Rett syndrome. Methods: A genetically variable group of 12 girls with a MECP2 mutation and younger than 6 years participated in a modified individually randomised stepped wedge design study. Assessments were conducted on five occasions, two during the baseline period and three during the intervention period. Gross motor function was assessed using the Rett Syndrome Gross Motor Scale (maximum score of 45) on five occasions, two during the baseline period and three during the intervention period. Blood levels of BDNF were measured at the two baseline assessments and at the end of the intervention period. The intervention comprised motor learning and exercise supplemented with social, cognitive and other sensory experiences over a six-month period. Results: At the first assessment, the mean (SD) age of the children was 3 years (1 year 1 month) years ranging from 1 year 6 months to 5 years 2 months. Also at baseline, mean (SD) gross motor scores and blood BDNF levels were 22.7/45 (9.6) and 165.0 (28.8) ng/ml respectively. Adjusting for covariates, the enriched environment was associated with improved gross motor skills (coefficient 8.2, 95%CI 5.1, 11.2) and a 321.4 ng/ml (95%CI 272.0, 370.8) increase in blood BDNF levels after 6 months of treatment. Growth, sleep quality and mood were unaffected. Conclusions: Behavioural interventions such as environmental enrichment can reduce the functional deficit in Rett syndrome, contributing to the evidence-base for management and further understanding of epigenetic mechanisms. Environmental enrichment will be an important adjunct in the evaluation of new drug therapies that use BDNF pathways because of implications for the strengthening of synapses and improved functioning. Trial registration: ACTRN12615001286538

    Epidemiology of maxillofacial trauma in the elderly: a European multicenter study

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    ABSTRACT Introduction: The progressive aging of European population seems to determine a change in the epidemiology, incidence and etiology of maxillofacial fractures with an increase in the frequency of old patients sustaining craniofacial trauma. The objective of the present study was to assess the demographic variables, causes, and patterns of facial fractures in elderly population (with 70 years or more). Materials and Methods: The data from all geriatric patients (70 years or more) with facial fractures between January 1, 2013, and December 31, 2017, were collected. The following data were recorded for each patient: gender, age, voluptuary habits, comorbidities, etiology, site of facial fractures, synchronous body injuries, Facial Injury Severity Score (FISS). Results: A total of 1334 patients (599 male and 735 female patients) were included in the study. Mean age was 79.3 years, and 66% of patients reported one or more comorbidities. The most frequent cause of injury was fall and zygomatic fractures were the most frequently observed injuries. Falls were associated with a low FISS value (p<.005). Concomitant injuries were observed in 27.3% of patients. Falls were associated with the absence of concomitant injuries. The ninth decade (p <.05) and a high FISS score (p <.005) were associated with concomitant body injuries too. Conclusions: This study confirms the role of falls in the epidemiology of facial trauma in the elderly, but also highlights the frequency of involvement of females, and the high frequency of zygomatic fractures.Peer reviewe
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