Effects of antihypertensive drugs on carotid intima-media thickness: Focus on angiotensin II receptor blockers. A review of randomized, controlled trials

Carotid intima-media thickness (IMT) and plaques have been shown to have a strong continuous relationship with cardiovascular (CV) morbidity and mortality; therefore, carotid atherosclerosis, as assessed by ultrasonography, can be regarded as a reliable surrogate end-point for therapeutic interventions. In this survey, we report the results of 16 double blind, randomized, controlled studies comparing: 1) antihypertensive drugs versus placebo/no treatment (five trials including 3,215 patients); 2) different active antihypertensive drug regimens (five trials including 4,662 patients); 3) angiotensin-II receptor blockers (ARBs) versus other antihypertensive agents (six trials including 841 patients). Our main findings can be summarized as follows: I) Long-term antihypertensive treatment has a blunting effect on carotid IMT progression, regardless of types of drugs. II) Calcium-channel blockers (CCBs) are more effective than other antihypertensive drugs including diuretics, beta-blockers, and angiotensin converting-enzyme (ACE)-inhibitors in this blunting effect; III) the effect of ARBs compared to other antihypertensive regimens (mostly based on atenolol) on carotid atherosclerosis progression needs to be further elucidated, as a protective effect was demonstrated by some, but not all studies examined. Thus, further studies are needed to clarify the role of ARBs in this therapeutic area

Modification of water retention and rheological properties of fresh state cement-based mortars by guar gum derivatives

International audienceThe present study examines the influence of chemical composition and structure of guar gum derivatives on water retention capacity (WR) and rheological behavior of fresh state cement-based mortars. The investigation was also completed by adsorption isotherms. For this, original guar gum, three HydroxyPropyl Guars (HPG) and two hydrophobically modified HPGs were selected. The effect of the molar substitution (MSHP) and of hydrophobic substitution (DSAC) was investigated. The results highlight that chemical composition of HPGs has a remarkable effect on fresh state properties of mortars. The original guar gum does not impact on neither WR nor rheological behavior. Increasing MSHP leads to an improvement of the WR and the stability of mortars while the hydrophobic units further enhance WR and lead to a decrease in the yield stress and an increase in the resistance to the flow of admixed mortars

Effect of Guar Gum Derivatives on Fresh State Properties of Portland Cement-Based Mortars

International audienceMortars are traditionally made from a mixture of sand, a binder and water. However, modern factory-made mortars are currently, very complex materials. Indeed, to exhibit various properties from the fresh paste to the hardened material, mortar formulations are composed of many mineral and organic admixtures. Among organic admixtures, polysaccharides are widely used in mortar formulation to improve water retention capacity of the freshly-mixed materials. The water retention capacity is an essential property of mortars to enhance cement hydration and its adhesion to a substrate. Moreover, many polysaccharide admixtures, acting as viscosity-enhancing agents, prevent segregation and improve the homogeneity and workability of cement-based system. Indeed, the viscosity of the system strongly increases using polysaccharides. Nevertheless, polysaccharides, as sugars, act on cement hydration. The main drawback is the retarding effect in hydration mechanism and setting-time of the cement.The aim of this study is to focus on the effect of guar gum derivatives on fresh state properties of Portland cement-based mortars, such as water retention, rheological behavior and the hydration delay. This work focuses on the guar gum derivatives since their manufacturing process is low pollutant and they provide very good properties to cement-based mortars. The results highlight that the chemical composition of guar gum derivatives (MS, DS, additional alkyl chain) are the key levers to improve water retention of mortars and to adapt the rheological behavior of the cementitious paste to a specific application

Metabolic syndrome and multiple organ damage in essential hypertension

Aim. We investigated the prevalence of the metabolic syndrome (MS) in hypertensive patients categorized according to the number of markers of organ damage (OD) in order to assess the value of a systematic search for cardiac and extra-cardiac OD in the MS setting. Methods. A total of 3119 untreated and treated essential hypertensives included in the Evaluation of Target Organ Damage in Hypertension (ETODH), an observational registry of hypertension-related OD, were considered for this analysis. All patients underwent extensive investigation for left ventricular hypertrophy (LVH) or LV concentric remodeling (cardiac OD), carotid plaques and/or intima-media thickening (vascular OD) and microalbuminuria (MA) and/or increased serum creatinine (renal OD). Subjects were classified as: positive for none (group 0), one (group I), two (group II) or three markers (group III) of OD. Results. MS prevalence rates progressively rose across the groups stratified according to the OD score, reaching a 2.3-fold increase in group III compared with their MS counterparts in group 0. The distribution of subjects with and without the MS across the groups was 15% vs 29% (group 0), 32% vs 38% (group I), 39% vs 26% (group II) and 14% vs 7% (group III), respectively. Thus, subjects having two or three markers of OD were 53% among those with MS and 33% (p<0.01) among those without it. Conclusion. Our findings indicate a strong association between the MS and OD by showing that a clustering of two or three markers of OD is the prevalent cardiovascular phenotype in MS hypertensives referred to a specialist center and call for a systematic evaluation of cardiac and extracardiac OD in this setting

Investigation on the Loss of Taste and Smell and Consequent Psychological Effects: A Cross-Sectional Study on Healthcare Workers Who Contracted the COVID-19 Infection

The aim of this study was to investigate the correlation between psychological distress and taste and sense of smell dysfunctions on healthcare workers (HCW) who contracted the COVID-19 infection in the midst of the disease outbreak. Reports of sudden loss of taste and smell which persist even after recovery from COVID-19 infection are increasingly recognized as critical symptoms for COVID-19 infections. Therefore, we conducted a cross-sectional study on COVID-19 HCW (N = 104) who adhered to respond to a phone semistructured interview addressing the virus symptoms and associated psychological distress. Data were collected from June to September 2020. Findings confirm the association between experienced taste/olfactory loss and emotional distress and suggest that dysfunctions of taste and smell correlate positively with anxiety and depression. Furthermore, their psychological impact tends to persist even after the recovery from the disease, suggesting the need for appropriate psychological interventions to prevent people from developing more serious or long-lasting psychological disorders and, as far as HCW, to reduce the risk of work-related distress

Natural attenuation can lead to environmental resilience in mine environment

Four streams flowing in the Iglesiente and Arburese mine districts (SW Sardinia, Italy), exploited for zinc (Zn) and lead (Pb) extraction from sulphides and secondary non-sulphide mineralization (calamine ores), have been studied combining investigations from the macroscale (hydrologic tracer techniques) to the microscale (X-ray powder diffraction, scanning electron microscopy, X-ray absorption spectroscopy). In the investigated area, concerns arise from release of metals to water during weathering of ore minerals and mine-waste. Specifically, Zn is observed at extremely high concentrations (10s of mg/L or more) in waters in some of the investigated catchments. The results from synoptic sampling campaigns showed marked differences of Zn loads, from 6.3 kg/day (Rio San Giorgio) to 2000 kg/day (Rio Irvi). Moreover, natural attenuation of metals was found to occur i) through precipitation of Fe compounds (Fe oxy/hydroxides and “green rust”), ii) by means of the authigenic formation of metal sulphides promoted by microbial sulphate reduction, iii) by metal intake in roots and stems of plants (Phragmites australis and Juncus acutus) and by immobilization in the rhizosphere, and iv) by cyanobacterial biomineralization processes that lead to formation of Zn-rich phases (hydrozincite and amorphous Zn-silicate). The biologically mediated natural processes that lead to significant abatement and/or reduction of metal loads, are the response of environmental systems to perturbations caused from mine activities, and can be considered part of the resilience of the system itself. The aim of this study is to understand the effect of these processes on the evolution of the studied systems towards more stable and, likely, resilient conditions, e.g. by limiting metal mobility and favouring the improvement of the overall quality of water. The understanding of how ecosystems adapt and respond to contamination, and which chemical and physical factors control these natural biogeochemical barriers, can help to plan effective remediation actions

Prognostic value of H-index in patients surgically treated for squamous cell carcinoma of the larynx.

OBJECTIVE: Recently, a novel host-related index, the Host-index (H-index), including both inflammatory and nutritional markers, has been described and observed to stratify prognosis in patients with squamous cell carcinoma (SCC) of the oral cavity more accurately than other host-related indexes This study aimed to investigate the prognostic performance of the H-index using pretreatment blood tests in patients receiving up-front surgery for SCC of the larynx. METHODS: This retrospective observational study included a multicenter series of consecutive patients with SCC of the larynx diagnosed between 1 January 2009 and 31 July 2018, whose pretreatment blood tests were available and included the parameters necessary for the calculation of neutrophil to lymphocyte ratio (NLR) and the H-index. Their association with disease-free survival (DFS) and overall survival (OS) was measured. RESULTS: A total of 231 patients were eligible for the present analysis (median [range] age, 68 [37-96] years; 191 [82.7%] men). The median follow-up was 73 months. In multivariable Cox proportional hazards regression models, increasing age (adjusted hazard ratio [aHR], 1.07 per year; 95% CI, 1.04-1.09), advanced pT stage (aHR = 1.71 95% CI: 1.07-2.71), and having close or positive surgical margins (aHR = 2.01; 95% CI: 1.21-3.33) were significantly associated with poor OS. Among blood parameters, a higher neutrophil count was a strong predictor of both worse DFS (aHR for recurrence/death = 2.34; 95% CI: 1.24-4.40) and OS (aHR for death = 2.67; 95% CI: 1.51-4.71). Among inflammatory blood indexes, while NLR was not significantly associated with DFS or OS, patients with H-index ≥8.37 showed a higher aHR for both recurrence/death (2.82; 95% CI: 1.65-4.79) and death (2.22; 95% CI: 1.26-3.89). CONCLUSION: In conclusion, the present study confirms the prognostic value of pretreatment H-index, an easily measurable inflammatory and nutritional index, in patients with SCC of the larynx. LEVEL OF EVIDENCE: III

Assessment of origin and fate of contaminants along mining-affected Rio Montevecchio (SW Sardinia, Italy): A hydrologic-tracer and environmental mineralogy study

Hydrologic tracer techniques were applied to Rio Montevecchio (SW Sardinia, Italy), a stream affected by mine drainage, allowing the calculation of discharge and contaminant loads. Discharge along the stream showed a constant increase throughout the 2.7 km-long study reach, up to 13.6 l/s at the last synoptic point. Calculated loads of mine-related constituents were large, reaching values of 1780 kg/day for, 340 kg/day for Zn, 47 kg/day for Fe, and 50 kg/day for Mn. The difference of the cumulative instream metal loads between the first and the last synoptic sampling points indicated gains of 421 kg/day for Zn, 2080 kg/day for, 56 kg/day for Mn, and 50 kg/day for Fe. The source areas critical for contaminants loading were almost all concentrated in the first 800 meters of the stream, with the exception of Pb, whose loading occurs evenly along the whole study reach. Precipitation of secondary minerals along the streambed was responsible for a very high attenuation of Al and Fe loads (66% and 77%) and affected also and Zn loads, though less effectively. Rio Montevecchio has the second highest metal load among the rivers investigated with tracer techniques in SW Sardinia. In comparison with Rio Irvi, which has one order of magnitude higher metal loads, natural attenuation processes limit the loads in Rio Montevecchio. Results are useful to clarify the hydrogeochemical paths involved in the release and attenuation of pollutants, improving our understanding of stream responses to contamination and aiding development of site-specific remediation actions

Gestione delle pazienti con tumore fillode della mammella: esperienza triestina nel periodo 2006-2014

La diagnosi e la gestione dei tumori fillodi della mammella \ue8 complessa a causa del basso tasso di incidenza e dell\u2019imprevedibilit\ue0 del comportamento di questo tipo di neoplasie (meno dell\u20191% tra tutti i tumori della mammella [1]). L\u2019obiettivo di questo studio \ue8 analizzare i casi di tumori filloidi diagnosticati a Trieste nel periodo 2006-2014 al fine di contestualizzare il comportamento particolarmente aggressivo di un tumore fillode maligno insorto in una paziente con pregressi fillodi benigni

How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p &lt; 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p &lt; 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p &lt; 0.0001) or urgent (20.4% vs. 38.5%; p &lt; 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p &lt; 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice