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Family history for CAD (coronary artery disease) is an established cardiovascular (CV) risk factor and it is progressively acquiring importance in patients' CV risk stratification. Numerous studies have demonstrated that individuals with a first-degree relative affected by CAD have a significantly higher risk of developing the condition themselves; in particular, when CAD occurs at an early age in relatives. Indeed, recently published CCS (chronic coronary syndrome) ESC (European Society of Cardiology) guidelines include family history (FH) as a risk factor to consider when calculating pre-test risk for CAD. ESC guidelines on preventive cardiology (2021) only suggested CV risk assessment in the presence of a positive FH for CV disease, not considering it in the actual risk scores. Evidence suggests that positive anamnesis for relatives affected by CAD correlates with ACS (acute coronary syndrome) and CAD, with slight differences in relative risk as far as the degree of kinship is concerned. Genetic factors contribute to this correlation by influencing key processes that affect heart health, such as cholesterol metabolism, blood pressure regulation, and inflammatory responses. New technologies in the genetics field are increasing the availability of genome sequencing, and new polymorphism panels are being tested as predictive for CAD, objectifying familiarity. Advances in imaging techniques allow the assessment of coronary atherosclerosis and its composition, and these are acquiring strength in evidence and recommendations in ESC guidelines as a way to define coronary disease in low and low-to-intermediate risk patients and to guide medical therapy and interventional procedures. Use of these emerging tools to guide screening is likely to be extended, beyond high CV risk patients, to individuals with FH for early CAD and/or specific genetic profiles, as recent evidence in the literature is suggesting. [ABSTRACT FROM AUTHOR]

Ischemic heart disease is currently the most common cause of mortality and morbidity worldwide. Although myocardial ischemia is classically determined by epicardial coronary atherosclerosis, up to 40% of patients referred for coronary angiography have no obstructive coronary artery disease (CAD). Ischemia with non-obstructive coronary artery disease (INOCA) has typically been underestimated in the past because, until recently, its prognostic significance was not completely clear. This review aims to highlight differences and patterns in myocardial ischemia caused by epicardial obstructive CAD, coronary microvascular dysfunction (CMD) or vasomotor abnormalities and to elucidate the state of the art in correctly diagnosing these different patterns. [ABSTRACT FROM AUTHOR]

Mitral valve regurgitation (MR) is a multifaceted valvular heart disease. Echocardiography plays a central role in etiology assessment, severity quantification, treatment candidacy, outcome evaluation, and patient follow-up. In this review, we describe the comprehensive echocardiographic assessment of MR, including transthoracic (TTE) and transesophageal (TEE) approaches, 2D and 3D modalities, strain imaging, stress echocardiography, and artificial intelligence (AI) applications. Transcatheter edge-to-edge mitral valve repair (TEER) has been established as a key therapy for patients with severe, symptomatic MR and high surgical risk. TEER is performed under TEE guidance. We outline a practical overview of echocardiographic guidance on TEER. [ABSTRACT FROM AUTHOR]

Sacubitril/valsartan reduces heart failure (HF)-related hospitalizations and cardiovascular mortality in PARADIGM-HF and has become a foundational treatment for HF with reduced ejection fraction (HFrEF). However, data of its routine real-world use are limited, and evidence from Italian settings is lacking. The REAL.IT study aimed to characterize the demographics, pharmacotherapy, clinical characteristics and outcomes of sacubitril/valsartan-treated Italian patients with HFrEF. Electronic medical records of patients initiating sacubitril/valsartan from October 2016 to June 2019 at nine specialized hospital outpatient HF centers across Italy were reviewed. Overall, 924 adults (mean age 64.5 years, 84.6% male) were included. At baseline, 38.7% had an ischemic HF etiology, 45.9% hypertension, 23.2% atrial fibrillation, 25.4% diabetes mellitus, 26.1% an implantable cardioverter-defibrillator and 31.9% coronary artery bypass grafting. There were no clear patterns of patient selection over time. During follow-up, NYHA class improved in 37.5% of patients after a mean of 5.3 ± 3.8 months; 36.1% and 16.7% of patients were in NYHA class III during characterization and after one year of follow-up, respectively. Left ventricular ejection fraction (LVEF) improved ≥5% in 56.3% of patients at one year; 39.7% had ≥30% reduction of N-terminal pro-B-type natriuretic peptide; 2.2% had hyperkalemia during characterization and 2.6% during follow-up; and 3.8% had hypotension during characterization and 12% during follow-up. A total of 50 (5.8%) of patients had device implantation (ICD/CRT) during follow-up. HF-related hospitalization was recorded in 19.6% of patients during follow-up; 3.8% of patients died, approximately 1.3% from cardiovascular causes. Our real-world data confirm the favorable effectiveness and tolerability of sacubitril/valsartan observed in pivotal randomized controlled trials. [ABSTRACT FROM AUTHOR]

Background: Primary Synovial Chondromatosis (PSC) is a rare benign tumor of the synovial membrane in which cartilage metaplasia produces calcific loose bodies within the articular space. Only a few cases are reported in the pediatric population and its etiology remains unknown. This condition typically affects large weight-bearing joints with pain, swelling and decrease range of motion. Due to its slow progressions, delayed diagnosis is frequent and differential diagnosis should consider other chronic arthritis and malignancies. While arthroscopic removal of loose bodies is the current treatment up to now, the association of partial or complete synovectomy is debated. Case presentation: We report about a 14-year-old girl with a long-lasting right shoulder pain, especially during movements or exercise, localized tenderness and hypotonia of the glenohumeral joint. No previous trauma was mentioned. Blood exams, Mantoux test and plain radiography of the right shoulder were unremarkable. Ultrasound imaging revealed echogenic and calcified bodies stretching the glenohumeral joint and dislocating the long head of biceps tendon. Magnetic resonance showed a "rice-grain" pattern of the right shoulder. From an arthroscopic surgery, multiple loose white bodies were removed within the synovial membrane, and synovial chondromatosis was confirmed by histological analysis. At one month follow up visit, the patient completely recovered without pain. Conclusion: Synovial chondromatosis is a very uncommon cause of mono articular pain in children, especially when it affects shoulder. Pediatricians should keep in mind this condition to avoid delayed diagnosis and treatment, even in consideration of the low risk of malignant transformation. Through this case, we would highlight common diagnostic pitfalls and treatment of synovial chondromatosis. [ABSTRACT FROM AUTHOR]

This study aims to provide real-world data about starting-dose of NOACs and dose-adjustment in patients with atrial fibrillation (AF). In fact, even if new oral anticoagulation agents (NOACs) have a predictable effect without need for regular monitoring, dose-adjustments should be performed according to the summary of product information and international guidelines. We employed the Italian Medicines Agency monitoring registries comprising data on a nationwide cohort of patients with AF treated with NOACs from 2013 to 2018. Logistic regression analysis was used to evaluate the determinants of dosage choice. During the reference period, treatment was commenced for 866,539 patients. Forty-five percent of the first prescriptions were dispensed at a reduced dose (dabigatran 60.3%, edoxaban 45.2%, apixaban 40.9%, rivaroxaban 37.4%). The prescription of reduced dose was associated with older age, renal disease, bleeding risk and the concomitant use of drugs predisposing to bleeding, but not with CHA2DS2-VASc and HAS-BLED. A relative reduction of the proportion of patients treated with low dosages was evident overtime for dabigatran and rivaroxaban; whereas prescription of low dose apixaban and edoxaban increased progressively among elderly patients. Evidence based on real-world data shows a high frequency of low dose prescriptions of NOACs in AF patients. Except for older age, renal disease, bleeding risk and the concomitant use of drugs predisposing to bleeding, other factors that may determine the choice of reduced dose could not be ascertained. There may be potential under-treatment of AF patients, but further evaluation is warranted. [ABSTRACT FROM AUTHOR]

. Patients with concomitant atrial fibrillation (AF) and acute coronary syndromes (ACS) do not seem to receive proper antithrombotic therapies and present high rates of adverse clinical events.. We analyzed the follow-up data of the prospective, nationwide MATADOR-PCI registry. We assessed the use of antithrombotic strategies and the incidence of major adverse cardiovascular events (MACE) and net adverse clinical events (NACE) at 6 months, in patients with new-onset or pre-existing AF admitted for ACS and treated with percutaneous coronary intervention (PCI).. Out of the 588 patients enrolled in the registry and discharged alive (287 with pre-existing and 301 with new-onset AF), data at 6 months were obtained for 579 (98.5%) patients. Compared to hospital discharge, the rate of triple antithrombotic therapy was significantly reduced (from 76.4% to 23.6% and from 53.8% to 23.6%; both p <0.0001) while dual antithrombotic therapy (DAT) increased (from 11.8% to 56.3% and from 5.8% to 30.9%; both p <0.0001) at follow-up, in patients with pre-existing and new-onset AF, respectively. Among patients with a class IA indication to receive oral anticoagulation therapy (OAT), it was prescribed in 91% and 88% of patients with pre-existing and 64% and 62% of new-onset AF, at discharge and follow-up, respectively. At 6 months from discharge the overall rate of MACE was 8.4% and 7.6% (p =0.75), while NACE occurred in 10.8% vs 10.0% (p =0.74) of patients with pre-existing or new-onset AF, respectively.. At follow-up, DAT was the most used antithrombotic strategy for both patients with pre-existing and new-onset AF with concomitant ACS. These two groups of patients presented comparable rates of MACE and NACE at 6 months. [ABSTRACT FROM AUTHOR]

Introduction: Three Italian scientific associations of different specialties (AMD, Associazione Medici Diabetologi—for diabetologists; ANMCO,Associazione Nazionale Medici Cardiologi Ospedalieri—for cardiologists; SIMG, Società Italiana di Medicina Generale—for General Practitioners) designed this study to assess whether an integrated care organization comprising three different specialists can improve adherence and can achieve the guidelines targets in a population of individuals with type 2 diabetes, without established cardiovascular disease but at high risk (≥ 20% at 10 years according to the CUORE.ISS risk cards) compared with the current standards of care provided by the Italian National Health Service. Methods: Thirty primary care centers (general practitioners, GPs), 30 cardiology centers and 30 diabetes centers have been selected by the scientific associations, disseminated in the national territory, on the basis of proven previous cooperation in other studies. Each primary care center will enroll 100 type 2 diabetic subjects, > 45 years old, with no established cardiovascular disease, but with a high risk due to the presence of at least one other risk factor besides diabetes over the cutoff [hypertension > 135/80 mmHg, LDL cholesterol > 70 mg/dl, tobacco smoke, first-degree familiarity for CHD (coronary heart disease), central obesity according the WHO criteria]. Fifteen of 30 selected primary care centers, chosen randomly, will continue the treatment of the 100 identified patients according to their "usual care," driven by Good Clinical Practice and by current guidelines (control group or "UC"—usual care), collecting all available clinical and instrumental data and transferring them to the electronic CRF. The remaining 15, after informed consent, will submit their 100 patients each in a specific integrated pathway, which entails the mandatory operational integration and exchange of information with the diabetes specialists and cardiologists pertaining to the same previously identified area. The integrated care path for the patients in the proband group (IC, integrated care) is based on application of the recommendations of the Italian Guidelines aimed at achieving the proposed targets for the main risk factors [LDL < 70 mg/dl; SBP < 130 mmHg; HbA1c (glycated hemoglobin) ≤ 7% (52 mmol/mol]. All the clinical data will be recorded on a shared electronic CRF. The trial will last 3 years: 6 months for the enrollment and randomization of the centers, 6 months for the enrollment of the probands and control subjects, and 2 years of follow-up. The study will be conducted according the Helsinki Declaration on human experimentation ethics. Planned Outcomes: The primary planned outcome is represented by the increase in the percentage of people that achieve the target values of at least two out of three of the considered risk factors [HbA1c, SBP (systolic blood pressure), LDL cholesterol] compared with the percentage actually achieved in the control group. The secondary outcomes are: (1) a MACE (major adverse cardiac event) composite: non-fatal myocardial infarction, non-fatal stroke, mortality from any cause and hospitalization for cardiovascular disease; (2) the number of early diagnoses of new onset complications; (3) evaluation of adverse events and safety of the probands and control patients; (4) comparative cost analysis and cost-effectiveness analysis. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this clinical observational study was to assess the efficacy of L-PRF as a hemostatic agent in patients under treatment with vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs). Materials and methods: Patients under oral anticoagulant therapy (VKA or DOACs) who needed a single simple tooth extraction were enrolled. L-PRF plug was positioned inside the alveolus and secured with non-absorbable sutures. Surgical time, pain-VAS, paracetamol intake, intra-operative, post-operative biological complications, and bleeding events have been registered. Results: A total of 112 patients (59 patients for DOAC and 53 for VKA group) were enrolled. Post-operative bleeding was recorded in nine patients (17%) for VKA group and nine patients (15.3%) for DOACs group. None of the patients needed a medical support for managing of bleeding. Seven days after surgery, no cases of post-extractive complications occurred. Conclusions: The use of L-PRF resulted in limited mild late post-operative bleedings without the need of medical intervention. Clinical relevance: The use of L-PRF can be adopted for an uneventful post-operative curse in anticoagulated patients without chasing their therapy for single tooth extraction. [ABSTRACT FROM AUTHOR]

Background: To evaluate the role of nonsustained ventricular tachycardias (NSVT) for the prediction of major ventricular arrhythmias (MVA) in patients with idiopathic dilated cardiomyopathy (DCM) after optimization of medical treatment. Methods and Results: Three hundred nineteen consecutive DCM patients were evaluated after adequate stabilization on optimal angiotensin-converting enzyme (ACE) inhibitor (88%) and β-blocker (82%) therapy. Frequency, length, and rate of NSVT at 24-hour Holter monitoring were analyzed to assess their values in predicting MVA (unexpected sudden death, SVT, ventricular fibrillation, and appropriate implantable cardioverter defibrillator interventions). During follow-up (median 96 months, 1st–3rd interquartile range 52–130), MVA incidence was low, and not statistically different between patients with and without NSVT (3 and 2 per 100 patient-years, respectively, P = nonsignificant [NS] at log-rank analysis). At multivariable analysis, the number of NSVT was predictive of MVA only if left ventricular ejection fraction (LVEF) was >0.35 (two NSVT/day vs no NSVT/day: hazard ratio [HR] 5.3, 95% confidence interval [CI] 1.59–17.85 in LVEF >0.35 vs HR 0.93, 95% CI 0.3–2.81 in LVEF ≤0.35). Consequently, in patients with LVEF ≤0.35, MVA incidence rates were similar regardless of NSVT (3.6 and 4.1 patient-years, respectively, in those with and without NSVT, P = NS), while in patients with LVEF >0.35, MVA incidence (3.1 per 100 patient-years vs 0.9 per 100 patient-years, P = 0.003) was significantly higher when NSVT were present. Conclusions: After medical stabilization, NSVT did not increase the risk of MVA in patients with DCM and LVEF ≤0.35. Conversely, the number and length of NSVT runs were significantly related to the occurrence of MVA in the patients with LVEF >0.35. [ABSTRACT FROM AUTHOR]

Aim To compare ex vivo the penetration of three brands of gutta-percha cones, compacted under a constant force and heated to different temperatures, into artificial lateral canals. Methodology Resin blocks with simulated main canals, each having two lateral canals (C at 6.5 and A at 13 mm from the surface of the resin block), were selected. A gutta-percha cone, either Mynol MF, Hygenic MF or GT Tulsa 0.04 was compacted into each main canal for 5 s using a wire rod with a diameter of 0.7 mm soldered to the bottom of a metal cylinder, with a force of 2.7 kg at controlled temperatures of 37, 42, 47, 52, 60 °C. The penetration of each brand of gutta-percha into 60 lateral canals (10 at each temperature) was measured using a stereomicroscope. Statistical analysis was performed using theanova, the Scheffè test and the t-test. Results None of the three brands of cones entered up to 0.1 mm within either lateral canal until a temperature of 47 °C was reached; at that temperature only Mynol cones ( P ≤ 0.05) penetrated in four of 10 A-level canals (mean 0.13 ± 0.19 mm) and in all 10 C-level canals (mean 0.43 ± 0.12 mm). The A-level lateral canals were penetrated at 52 °C by Mynol cones (mean 0.76 ± 0.34 mm) to a significantly greater distance ( P ≤ 0.05) than Tulsa cones (mean 0.31 ± 0.12 mm) and Hygenic cones (mean 0.11 ± 0.08 mm). At 60 °C the Mynol cones (mean 1.93 ± 0.34 mm) penetrated significantly more ( P ≤ 0.05) than the Tulsa cones (mean 0.86 ± 0.22 mm) and Hygenic cones (mean 0.67 ± 0.19 mm). The C-level lateral canals were penetrated at 52 °C by Mynol cones (mean 0.91 ± 0.29 mm) to a significantly greater distance ( P ≤ 0.05) than Tulsa cones (mean 0.47 ± 0.16 mm) and Hygenic cones (mean 0.46 ± 0.15 mm), whilst no significant difference was found at 60 °C. Conclusions When heated and compacted, the three gutta-percha cones penetrated the lateral canals to different degrees. They penetrated more than 0.43 mm into the lateral canals only at temperatures higher than 47 °C. [ABSTRACT FROM AUTHOR]

Abstract: Background: The Carvedilol or Metoprolol European Trial (COMET) reported a significant survival benefit for carvedilol, a β1-, β2- and α1-blocker, vs. metoprolol tartrate, a β1-selective blocker, in patients with mild-to-severe chronic heart failure (CHF). Patients on treatment with metoprolol might benefit from switching to carvedilol. Aim: To investigate the safety and tolerability of switching β-blockers in CHF. Methods: At the end of COMET, the Steering Committee recommended that study medication was stopped without unblinding, and patients were commenced on open-label β-blockade at a dose equivalent to half the dose of blinded therapy, with subsequent titration to target or maximum tolerated dose. Patients were followed for 30 days. Results: 1321 out of 1440 patients were transitioned to open-label treatment (76.8% to carvedilol). Serious adverse and CHF-related events were respectively 9.4% and 4.7% in those switching from carvedilol to metoprolol and 3.1% and 1.5% in patients switching from metoprolol to carvedilol. Patients who switched from carvedilol to metoprolol showed the highest mortality or hospitalisation rate (12.3%) in comparison with those who switched from metoprolol to carvedilol (3.1%, p&#60;0.001) or who stayed on the same drug (carvedilol: 2.5%, p&#60;0.001; metoprolol: 4.2%, p=0.04). Reducing the initial dose of the second β-blocker maximised the safety of this strategy. Event rate was higher in patients with more severe heart failure and in those withdrawing from β-blockade. Conclusion: Our data show that switching β-blockers is a practical, safe and well-tolerated strategy to optimise treatment of CHF. Patients who switched to carvedilol showed the lowest rate of adverse events. A closer clinical monitoring is recommended during transition in high-risk patients. [Copyright &y& Elsevier]

Di Lenarda R, Cadenaro M, Sbaizero O. Effectiveness of 1 mol L- 1 citric acid and 15% EDTA irrigation on smear layer removal. International Endodontic Journal, 33, 46–52, 2000. Aim The aim of this study was to evaluate in vitro the cleansing and smear layer removal capability of alternate canal irrigation with citric acid and NaOCl. Methodology Eighty-one teeth were divided into three groups on the basis of the type of instrumentation, namely, manual stainless steel, Ni-Ti mechanized ProFile .04 taper or MACXim. The groups were further divided on the basis of irrigation protocol: 5% NaOCl alone, NaOCl alternated with 1 mol L-1 citric acid solution or a combination of 15% EDTA and Cetrimide solution. After longitudinal sectioning, dentinal walls were microphotographed with scanning electron microscopy at ×300 and ×1000 magnifications. Qualitative and quantitative cleansing level evaluations were performed using computerized image analysis software. Data were statistically evaluated using Kruskal–Wallis analysis and t-test. Results Qualitative evaluation at ×300 and ×1000 showed no statistically significant differences in cleansing ability between citric acid, EDTA and NaOCl groups. Quantitative evaluation of smear layer removal, measured as open tubules/total dentinal surface ratio, showed that 1 mol L-1 citric acid solution was comparable to EDTA (11.97% vs. 10.36%) (NS); in samples treated with ProFile .04 taper instruments citric acid was most effective (16.17%), whilst in the group treated with manual instrumentation EDTA and Cetrimide were the most effective (11.94%). Specimens irrigated with 5% NaOCl demonstrated significantly more cleansing than those obtained in the other two groups (P <0.001). Conclusions 1 mol L-1 citric acid solution was as effective in removing smear layer as EDTA, but was superior in specimens treated with ProFile .04 taper instruments. [ABSTRACT FROM AUTHOR]

Objectives: This study investigates the psychological impact of COVID‐19 on burning mouth syndrome (BMS) patients. It focuses on comparing post‐traumatic stress symptoms (PTSS), post‐traumatic growth (PTG), and resilience between BMS patients and Controls. Methods: A total of 100 BMS patients and 100 Controls from five Italian centers participated in this observational cross‐sectional study. They completed several assessments, including the General Health Questionnaire, Depression Anxiety and Stress Scale, Insomnia Severity Index, National Stressful Events Survey Short Scale, Impact of Event Scale‐Revised, Post Traumatic Growth Inventory Short Form, and Connor‐Davidson Resilience Scale. Results: BMS patients had significantly higher stress, anxiety, and depression (DASS‐21 score) and post‐traumatic stress symptoms (IES‐R‐6 score), particularly in terms of intrusive thoughts. They showed lower post‐traumatic growth (PTGI‐SF score) compared to Controls. The resilience scale (CDRS‐10) was a key predictor of PTG in both groups, explaining a significant variance in PTGI‐SF scores. Conclusions: BMS patients experienced heightened post‐traumatic stress, stress, anxiety, and depression during the COVID‐19 pandemic, with reduced post‐traumatic growth. This highlights the need to prioritize their psychological well‐being, focusing on stress management and fostering post‐traumatic growth in challenging times. [ABSTRACT FROM AUTHOR]

Objectives: Persistent idiopathic dentoalveolar pain (PIDP) is a challenging clinical entity associated with both physical and emotional consequences. Currently, the management is symptom-based and includes both topical and/or systemic treatments. More recently, botulinum neurotoxin-A (BONT-A) has been suggested as a treatment option. Materials and methods: We present a case series of 9 patients (5 female) with mean age 56 ± 15 diagnosed with PIDP. All patients reported prior experience with systemic drugs without a sufficient pain-relieving effect. BONT-A (BOTOX, Allergan) 100 U diluted with saline solution was used and the dose ranged from 20U to 50U distributed in 3 sites (intraoral and/or extraoral) per session. Patients underwent further injections (50U) monthly if pain severity measured using a Numerical Rating Scale (NRS 0–10) was still > 3 for 3 months. Pain severity and characteristics were recorded at baseline (T0), after 1 month (T1), 2 months (T2) and 3 months (T3). Results: Mean pain intensity at baseline was NRS 6 (4–10). Latency before analgesic effect was at least 5–10 days after injection. Minor adverse effects were sickness and muscular hypotonia. Pain significantly reduced to NRS 4 (0–8) at T1, to NRS 2 (0–8) at T2 and to NRS 2 (NRS 0–8) at T3. Patients’ functional variables (discomfort while chewing, talking, swallowing) were also recorded. Conclusions: BONT-A is widely used and although the exact mechanism of action remains unclear, it can be used effectively in reducing pain for a variety of conditions including PIDP. Clinical relevance: Our results suggest that BONT-A seems to be an alternative therapeutic approach for patients with PIDP. [ABSTRACT FROM AUTHOR]

Low-Density Lipoprotein (LDL) cholesterol is one of the main target for cardiovascular (CV) prevention and therapy. In the last years, Proprotein Convertase Subtilisin–Kexin type 9 inhibitors (PCSK9-i) has emerged as a key therapeutic target to lower LDL and were introduced for prevention of CV events. Recently (June 2022) the Italian Medicines Agency (AIFA) modified the eligibility criteria for the use of PCSK9-i. We designed an observational study to estimate the prevalence of eligible subjects and evaluate the effectiveness of PCSK9-i applying a Target Trial Emulation (TTE) approach based on Electronic Health Records (EHR). Subjects meeting the eligibility criteria were identified from July 2017 (when PCSK9-i became available) to December 2020. Outcomes were all-cause death and the first hospitalization. Among eligible subjects, we identified those treated at date of the first prescription. Inverse Probability of Treatment Weights (IPTW) were estimated including demographic and clinical covariates, history of treatment with statins and the month/year eligibility date. Competing risk models on weighted cohorts were used to derive the Average Treatment Effect (ATE) and the Conditional Average Treatment Effect (CATE) in subgroups of interest. Out of 1976 eligible subjects, 161 (8%) received treatment with PCSK9-i. Treated individuals were slightly younger, predominantly male, had more severe CV conditions, and were more often treated with statin compared to the untreated subjects. The latter exhibited a higher prevalence of non-CV comorbidities. A significant absolute and relative risk reduction of death and a lower relative risk for the first hospitalization was observed. The risk reduction for death was confirmed in CATE analysis. PCSk9-i were prescribed to a minority of eligible subjects. Within the TTE framework, the analysis confirmed the association between PCSK9-i and lower risk of events, aligning with findings from randomized clinical trials (RCTs). In our study, PCSK9-i provided protection specifically against all-cause death, expanding upon the evidence from RCTs that had primarily focused on composite CV outcomes. [ABSTRACT FROM AUTHOR]

This study aims to show the application of flexible statistical methods in real-world cost-effectiveness analyses applied in the cardiovascular field, focusing specifically on the use of proprotein convertase subtilisin-kexin type 9 inhibitors for hyperlipidemia. The proposed method allowed us to use an electronic health database to emulate a target trial for cost-effectiveness analysis using multistate modeling and microsimulation. We formally established the study design and provided precise definitions of the causal measures of interest while also outlining the assumptions necessary for accurately estimating these measures using the available data. Additionally, we thoroughly considered goodness-of-fit assessments and sensitivity analyses of the decision model, which are crucial to capture the complexity of individuals' healthcare pathway and to enhance the validity of this type of health economic models. In the disease model, the Markov assumption was found to be inadequate, and a "time-reset" timescale was implemented together with the use of a time-dependent variable to incorporate past hospitalization history. Furthermore, the microsimulation decision model demonstrated a satisfying goodness of fit, as evidenced by the consistent results obtained in the short-term horizon compared with a nonmodel-based approach. Notably, proprotein convertase subtilisin-kexin type 9 inhibitors revealed their favorable cost-effectiveness only in the long-term follow-up, with a minimum willingness to pay of 39 000 Euro/life years gained. The approach demonstrated its significant utility in several ways. Unlike nonmodel-based or alternative model-based methods, it enabled to (1) investigate long-term cost-effectiveness comprehensively, (2) use an appropriate disease model that aligns with the specific problem under study, and (3) conduct subgroup-specific cost-effectiveness analyses to gain more targeted insights. • Cost-effectiveness analysis utilizing electronic health records databases can offer valuable real-world evidence for drugs recently approved. However, the statistical aspects of economic-health evaluations in chronic illnesses using decision models are often overlooked. • We proposed the application of a flexible multistate decision model based on microsimulation to replicate a target trial using observational data, enabling the study of proprotein convertase subtilisin-kexin type 9 inhibitors cost-effectiveness. Notably, these methods overcome the limitations of standard Markov decision models by considering the dependence of individuals' healthcare paths on their past. • This study provides novel insights into the real-world cost-effectiveness of proprotein convertase subtilisin-kexin type 9 inhibitors in hyperlipidemia. Furthermore, the statistical approach used here could also be useful for other diseases, treatments, or healthcare systems. [ABSTRACT FROM AUTHOR]

Objectives Subjects and Methods Results Conclusions Few studies used thermal quantitative sensory testing to assess the effects of repeated capsaicin gel administration in the oral cavity. This study aimed to investigate thermal sensory and pain thresholds before and after repeated capsaicin gel administration.Ten healthy females (22 ± 2 years) applied a capsaicin gel on the gingival mucosa twice daily for 14 days, and heat pain threshold, warm detection threshold, cold pain threshold, and cold detection threshold were assessed on the oral mucosa. Measurements were performed before and after the 14 days and were compared to a control sample (n = 10, all females, 23 ± 3 years).Capsaicin increased heat pain threshold in the anterior maxilla by 2.9°C (95% CI: 1.6–4.2) (p < 0.001) and in the anterior mandible by 2.2°C (95% CI: 1.0–3.4) (p = 0.001), similar to warm detection threshold that increased by Δ1.1°C (95% CI: 0.3–1.9) (p = 0.009). No significant changes were found in the controls.These findings encourage the use of thermal quantitative sensory testing in the oral cavity to assess thermal sensation, which might be useful for assessing the effects of therapies aimed at reducing pain. [ABSTRACT FROM AUTHOR]

Purpose: There is increasing evidence that photobiomodulation (PBM) therapy is both an effective and safe approach in hematopoietic stem cell transplantation (HSCT) for both prevention and management of oral mucositis (OM), but its use in clinical practice is still limited and the timing of application is under discussion. The aim of this retrospective study was to evaluate possible differences between patients treated either with preventive or curative PBM therapy. Methods: The retrospective case series included 24 patients suffering from multiple myeloma who underwent the same conditioning and transplantation protocol. Patients were treated either with preventive PBM starting from the first day of conditioning up to two days post-HSCT or with curative PBM (starting at OM onset for four consecutive days). OM score, pain, and functional parameters were recorded. Results: All patients developed OM. Preventive PBM was significantly more effective in reducing OM severity (p < 0.0001) and pain (p < 0.0001) post-HSCT than curative PBM. Furthermore, we found a lower number of patients reporting discomfort in all subjective parameters (pain during swallowing, chewing, and speaking) in the preventive PBM group. No adverse events related to PBM therapy were recorded in both groups. Conclusion: The timing for PBM therapy in patients undergoing HSCT is crucial: when started on the first day of conditioning, it significantly reduces both pain and OM severity, providing an important benefit also in subjective oral functions such as speaking, swallowing, and chewing, thus increasing the overall adherence to the oncological therapies. [ABSTRACT FROM AUTHOR]

The precise identification and differentiation of peri-implant diseases, without the need for intrusive procedures, is crucial for the successful clinical treatment and overall durability of dental implants. This work introduces a novel approach that combines surface-enhanced Raman scattering (SERS) spectroscopy with advanced chemometrics to analyse peri-implant crevicular fluid (PICF) samples. The primary purpose is to offer an unbiased evaluation of implant health. A detailed investigation was performed on PICF samples obtained from a cohort of patients exhibiting different levels of peri-implant health, including those with healthy implants, implants impacted by peri-implantitis, and implants with peri-implant mucositis. The obtained SERS spectra were analysed using canonical-powered partial least squares (CPPLS) to identify unique chemical characteristics associated with each inflammatory state. Significantly, our research findings unveil the presence of a common inflammatory SERS spectral pattern in cases of peri-implantitis and peri-implant mucositis. Furthermore, the SERS-based scores obtained from CPPLS were combined with established clinical scores and subjected to a linear discriminant analysis (LDA) classifier. Repeated double cross-validation was used to validate the method's capacity to discriminate different implant conditions. The integrated approach showcased high sensitivity and specificity and an overall balanced accuracy of 92%, demonstrating its potential to serve as a non-invasive diagnostic tool for real-time implant monitoring and early detection of inflammatory conditions. [ABSTRACT FROM AUTHOR]

Simple Summary: Several oral problems occurring during cancer treatment can lead to the discontinuation or interruption of the scheduled treatment, with a negative impact on patient's overall survival. Very few studies focused on patients' self-reported oral problems during chemotherapy treatment for solid tumors. Through the administration of a dedicated questionnaire, we aim at correlating the presence of oral complications to demographic and medical information. Metastatic disease represented a risk factor for the onset of oral mucositis and salivary gland hypofunction, while specific chemotherapy regimens increased the risk to develop a subjective reduction in the salivary flow and difficulty in swallowing. Most of the participants were informed by the oncologist about the possibility of oral problems arising during oncological therapies. It is of paramount importance to collect observational data on oral problems from the patients' perspective in order to plan information and prevention campaigns to inform patients about their possible occurrence by providing useful tools for prevention and management. PURPOSE: Oral problems in a group of oncological patients undergoing chemotherapy (CT) for solid tumors have been examined. Incidence and severity of patients' self-reported oral problems have been evaluated along their interaction with age, gender, tumor diagnosis and stage, presence of mestastasis, CT agent type, and number of CT cycle. We also analyzed the presence of paraesthesia and anaesthesia and their predisposing factors associated with clinical and treatment-related variables. METHODS: Patients were asked to fill in a questionnaire to evaluate the onset and the intensity of oral and perioral pain, oral mucositis, salivary gland hypofunction, dysgeusia, dysphagia, dysphonia, and sensitivity neuropathy (paraesthesia or dysaesthesia) since the last CT infusion. We also investigated which types of medications have possibly been used and who recommended it, as well as patients' degree of awareness about the possibility of oral problems arising during CT. RESULTS: We recruited 194 patients and obtained 491 questionnaires. We found that a metastatic disease was a risk factor for OM (OR 2.02, p = 0.026) and salivary gland hypofunction (OR 1.66, p = 0.042) and that platinum agents, compared to mitotic inhibitors, increased the risk of developing salivary gland hypofunction (OR 2.16, p = 0.013), dysphagia (OR 3.26, p = 0.001), and anaesthesia (OR 5.16, p = 0.041). Young age was a slight protective factor for most symptoms. The 80% of enrolled patients were informed by the oncologist about possible oral problems arising during CT. CONCLUSIONS: Our study highlighted the importance of collecting observational data from the patients' perspective on oral problems arising during the routine oncology practice, across a range of solid tumors and CT regimens. The relevance of these findings focused on the key role of the multidisciplinary team in advising the patients on the possible occurrence of oral problems, also by recommending their management. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this prospective comparative clinical study was to evaluate the effect of oral anticoagulants on peri- and post-operative bleeding during simple single tooth extractions, comparing patients in treatment with vitamin K antagonists (VKAs) and patients assuming direct oral anticoagulants (DOACs). Materials and methods: Patients under oral anticoagulant therapy needing dental extraction were eligible for entering the study; patients were enrolled following inclusion and exclusion criteria and divided into VKAs and DOAC group according to the anticoagulation therapy. Included patients underwent a simple single dental extraction with elevators and forceps with a maximum surgical time of 15 minutes, without anticoagulation therapy discontinuation. All participants were assessed pre-operatively, during surgery, 30 min minutes and 7 days after surgery. Biological complications were registered and post-extraction bleeding was clinically defined according to Iwabuchi classification. Parametric and non-parametric tests were used to evaluate the variables between the groups. Results: Sixty-five patients per group were enrolled and 130 teeth were extracted. The two groups were comparable for pre-, peri-, and post-operative variables. Only 1 patient of DOAC group and 2 patients for VKA group needed medical evaluation for post-extractive bleeding. No statistically significant difference resulted in post-operative bleeding events between the groups (p = 0.425). Conclusions: DOAC and VKA patients showed the same incidence of bleeding complications after simple single tooth extraction. Bleeding events were not statistically significant and not clinically relevant. Clinical relevance: Patients assuming DOACs can be treated similarly to patients in VKAs therapy with INR index between 2 and 3. Non-ceasing of DOAC therapy seems to be appropriate for simple single dental extractions. [ABSTRACT FROM AUTHOR]

An abstract of the study "Prognostic Role of Haemodynamic Evaluation at Rest and During Exercise in Patients With Idiopathic Dilated Cardiomyopathy," by A. Di Lenarda and colleagues is presented.

An abstract of the study "Prognostic Role of Circulatory Power in Patients With Idiopathic Dilated Cardiomiopathy," by A. Di Lenarda and colleagues is presented.

An abstract of the study "Age-Related Trend in Hospital Readmissions for Heart Failure: An Analysis From Regional Administrative Databases," by G. Pulignano and colleagues is presented.

An abstract of the study "Predictive role for total and sudden death of non sustained ventricular tachycardia in dilated cardiomyopathy," by T. Kawada et al, is presented.

Epidemiologic, genetic, and clinical intervention studies have indisputably shown that low-density lipoprotein cholesterol (LDL-C) is causal in the development of atherosclerotic cardiovascular disease (ASCVD). However, LDL-C variability could be related to increased ASCVD risk in patients already treated with statins. The aim of the present retrospective real-life study was to assess the prognostic impact of LDL-C variability on all-cause mortality and cardiovascular hospitalizations in patients with stable cardiovascular artery disease. A total of 3398 patients were enrolled and followed up for a median of 56 months. Considering LDL-C < 70 mg/dL as the therapeutical target, during follow-up, the percentage of patients who achieved this goal raised from 20.7% to 31.9%. In total, 1988 events were recorded, of which 428 were all-cause deaths and 1560 were cardiovascular hospitalizations. At the last medical examination, each increase in LDL-C levels of 20 mg/dL corresponded to a 6% raise in the risk of any event (HR 1.06; 95%CI, 1.03 to 1.09). In conclusion, our real-world study supports the hypothesis that a continuous and progressive downward trend in LDL-C levels is needed to achieve and maintain a cardiovascular benefit, at least in secondary prevention. [ABSTRACT FROM AUTHOR]

Chronic care for cardiovascular disease (CVD) poses an ever increasing challenge for the future of economic and social sustainability. Caring for patients with heart failure (HF) requires a shift from fragmentation to harmonization and integration of services along the hospital to territory inpatient- outpatient pathways. Methods and Results: Since 2009, the Province of Trieste (population app. 250,000) has been developing integrated Hospital-to-Territory pathways. Clinical and instrumental data were retrieved from the Cardionet® electronic registry of Trieste Cardiovascular Center. From November 2009 to October 2013, 2,217 patients with HF were registered in the Cardiovascular Registry of the Province of Trieste (10.4% of total patients; aged 75.5, males 56%, NYHA 3-4 25%, hypertensive heart disease 49%, ischemic 47% and valvular 45%). 93% of the patients were evaluated through echocardiogram upon enrolment. LVEF was 40% (27% of patients), 41-49% (14% of patients), 50% (59% of patients). The age and Charlson index >5 within the three groups was 73, 74 and 76 years respectively (p<0.001) and 38%, 33% and 26% (p<0.001). The 3 groups of patients underwent the treatment with ACE/inhibitors/sartans and betablockers in 78%, 73% and 72%, and in 54%, 62% and 48%, respectively. Nursing interventions for the continuity of healthcare services were activated for 24% and 36% of patients in NYHA 1-2 and 3-4, respectively. Domiciliary or intermediate residential care cardiologic services (as per shared GP-cardiologist healthcare intervention plan) did not show substantial changes throughout the years amounting to 8-10% of the total care interventions. Hospitalizations due to HF within the Province of Trieste continued to decrease from 1225 in 2010 to 1095 in 2013 (-10.6%), as against an overall increase of hospital admissions in the Cardiovascular Department (from 12.9% to 18.8% of the total admissions). All of the patients discharged from the Cardiovascular Department were enrolled within three months by the Community Cardiovascular Center. The implementation of Hospital-to- Community Pathways has resulted in a gradual increase of patient referrals from other departments (from 65 and 17% to 14% and 29% respectively, within 30 or 90 days from the discharge). Until 2012 all of the patients were enrolled by the Chronic Patient Heart Clinic. Since January 2013, 173 patients (7.8%; 479 visits, 2.8/pt) with advanced HF, frailty and/or multiple comorbidities (68% males; mean age 76±9; 68% NYHA 3-4; 59% LVEF<40%; 53% in atrial fibrillation; 92% undergoing therapy with at least 5 drugs; 45% with Charlson Index >5; 36% with at least one missing BADL, 77% with at least one IADL) were enrolled in the Advanced HF Clinic, an inter-disciplinary, supportive and palliative care team which works in close collaboration with the Social Care / Health Care Districts. 39.3% of the patients were seen at home or within an intermediate residential facility. 69.3% received at least one nursing intervention, 27% at least a psycho-social assessment carried out by a psychologist. Conclusions: An integrated Hospital-to-Community network for HF allowing for Integrated Pathways between hospital, Intermediate Facilities, Social/Healthcare Districts, outpatient cardiology clinics for chronic patients and for patients with advanced HF requiring supportive and palliative care, can actually reduce hospital admissions and allow for effectively care for a fairly large amount of elderly/frail patients discharged from the internal medicine/geriatric departments with advanced HF, multiple comorbidities and specific polytherapy needs. [ABSTRACT FROM AUTHOR]

Purpose: Chronic kidney disease with renal dysfunction (RD) is associated with an increased risk of thromboembolic and hemorrhagic events in non-valvular atrial fibrillation (NVAF). Although the current European Guidelines on NVAF suggest that an accurate evaluation of the renal function is useful in hemorrhagic risk stratification, it has not been yet considered in thromboembolic risk score CHA2DS2VASc. The aim of our study was to evaluate the prognostic role of RD in a wide "real world" population of NVAF outpatients. Methods: From November 1, 2009 and October 31, 2013, we enrolled 3,398 consecutive NVAF patients. Clinical data were derived from the E-data chart for outpatient clinic (Cardionet®) of Cardiovascular Center of Trieste, Italy, and collected in a regional Data Warehouse. In 1,509 patients, glomerular filtration rate (GFR) was available at the first visit. Renal dysfunction (RD) was defined as GFR <60ml/min estimated using MDRD equation. The events recorded during the follow-up were death, cardiovascular hospitalization (CVH), major bleeding (including fatal bleeding or leading to transfusion, a decrease in hemoglobin level of 20 ≥g/L or hospital admission) and thromboembolism. Results: The median patient age was 75 (range 68-81), 39.7% were male, 38% had paroxysmal, 31.9% persistent and 30.1% permanent NVAF; 1,217 (80.1%) had hypertension, 466 (30.8%) diabetes mellitus, 295 (19.5%) heart failure, 491 (32%) coronary artery disease, 196 (13%) prior stroke or transient ischemic attack, 23 (1.5%) previous bleeding episode, 31.9% and 13.2% had Charlson Comorbid Index from 3 up to 5 and >5, respectively. 1,014 patients (67.2%) were treated with more than 5 drugs. Median HAS- BLED score was 3 (range 2-4) and ≥3 in 70% of patients; median CHA2DS2VASc score was 4 (range 3-5) and ≥2 points in 91.1% of patients. During a median follow-up of 27 months, 531 (35%) deaths or CVH, 113 (7.5%) thromboembolic events and 24 (1.6%) major bleedings were recorded. The presence of RD identified a group of older patients with more cardiovascular (CV) risk factors, more severe heart disease, higher Charlson Index, more concomitant medical therapies. During the follow-up, we recorded 48% vs 30% of deaths or CVH (p<0.001), 10% vs 7% of thromboembolic events (p=0.02) and 2.5% vs 1% of hemorrhagic events in those with and without RD (p=0.09). Patients with RD showed a global worse prognosis for CVH/death-free survival independently from the prescription of anticoagulant (p<0.001). Instead, considering thromboembolism/major bleeding free survival, patients with RD had a worse prognosis only if taking anticoagulants (p=0.038). We can hypothesize that it could be probably related to a relatively higher number of thromboembolic events in the past medical history in the anticoagulant group versus antiplatelets or not therapy (11,4% vs 9,5% vs 5,1%, respectively, p<0.001). Conclusions: In a "real world" of NVAF outpatients, RD identified a subgroup of older patients, with more complex CV and non CV disease at higher risk of CV, thromboembolic and hemorrhagic events. RD was associated with a higher rate of thromboembolism/major bleeding in patients on anticoagulants. [ABSTRACT FROM AUTHOR]

Purpose: Renal dysfunction (RD) is associated with an increased risk of thromboembolic (TE) and hemorrhagic events (HE) in non-valvular atrial fibrillation (NVAF). Which method of RD evaluation can better stratify the risk of cardiovascular (CV) events in NVAF is still unknown. We evaluated the additive prognostic role of RD in a wide "real world" population of NVAF outpatients. Methods: From November 2009 and October 2013, we enrolled 3,398 consecutive NVAF patients (pts). Clinical data were derived from the E-data chart for outpatient clinic (Cardionet®) of Cardiovascular Center of Trieste, Italy. In 1,509 pts the glomerular filtration rate (GFR) was estimated at first clinic evaluation with Cochkroft-Gault (CG), Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology collaboration (CkD-EPI) equations. RD was defined as Gfr <60 ml/min. We recalculated CHA2DS2- VASc score, adding 1 point for RD, using all the three equations. The median follow-up was 27 months (Interquartile Range-IR- 15 to 40). We evaluated incidence of death, CV hospitalization (CVH), HE (fatal bleeding or leading to transfusion, a decrease in hemoglobin level of 20 g/L or hospitalization) and thromboembolism. Results: The median age was 75 years (IR 68-81), 39.7% were male; 38% of pts had paroxysmal, 31.9% persistent and 30.1% permanent NVAF. 1,217 (80.1%) pts had hypertension, 466 (30.8%) diabetes mellitus, 295 (19.5%) heart failure, 196 (13%) prior stroke or transient ischemic attack and 23 (1.5%) previous bleedings. Median GFR was 61.8 mL/min (IR 47-77) with CG, 72.4 (IR 59-87) with MDRD and 69.1 (IR 55-84) with CKD-EPI. Median HAS-BLED score was 3 (IR 2-4) and 3 in 70% of the pts; median CHA2DS2- VASc score was 4 (IR 3-5) and 2 points in 91.1% pts. 623 (41%) pts were on anticoagulant therapy (OAT). During the follow-up, we recorded 531 (35%) deaths or CVH, 113 (7.5%) TE and 24 (1.6%) HE. Adding 1 point for RD to CHA2DS2VASc score pts were reclassified in a worse-class of risk in 47% with CG, 34% with CKD-EPI and 27% with MDRD (p<0.001). Pts with combined TE/HE during the follow-up were reclassified by the presence of RD in a worst class of risk in 62% with CG, 46% with CKD-EPI and 35% with MDRD (p=0.009). Stratifying these pts by antithrombotic therapy, the presence of RD, estimated by CG and CKD EPI, were associated to a significant higher risk of TE/HE during the follow-up (p=0.006) only in pts not treated with OAT; conversely using MDRD there was a significant higher risk only in anticoagulated pts (p=0.04). These results could be related to an higher rate of TE in the past medical history in the OAT group versus antiplatelets or not therapy (11,4% v 9,5% vs 5,1%, respectively, p<0.001). Adding RD (1 point) to CHA2DS2VASc score, considering the pts that experienced death/CVH, 58.5%, 44.7% and 36.4% of pts with RD were reclassified in a worst class of risk with CG, CKD-EPI and MDRD respectively (p<0.001), independently from OAT. Conclusions: In NVAF pts the risk reclassification by CHA2DS2VASc and moderate RD seems to have an additive prognostic impact, considering death and CVH, TE and HE. CG was the best formula for global performance to reclassify pts for risk of events during the follow-up. [ABSTRACT FROM AUTHOR]

Background: Machine learning (ML) methods to build prediction models starting from electrocardiogram (ECG) signals are an emerging research field. The aim of the present study is to investigate the performances of two ML approaches based on ECGs for the prediction of new-onset atrial fibrillation (AF), in terms of discrimination, calibration and sample size dependence. Methods: We trained two models to predict new-onset AF: a convolutional neural network (CNN), that takes as input the raw ECG signals, and an eXtreme Gradient Boosting model (XGB), that uses the signal's extracted features. A penalized logistic regression model (LR) was used as a benchmark. Discrimination was evaluated with the area under the ROC curve, while calibration with the integrated calibration index. We investigated the dependence of models' performances on the sample size and on class imbalance corrections introduced with random under-sampling. Results: CNN's discrimination was the most affected by the sample size, outperforming XGB and LR only around n = 10.000 observations. Calibration showed only a small dependence on the sample size for all the models considered. Balancing the training set with random undersampling did not improve discrimination in any of the models. Instead, the main effect of imbalance corrections was to worsen the models' calibration (for CNN, integrated calibration index from 0.014 [0.01, 0.018] to 0.17 [0.16, 0.19]). The sample size emerged as a fundamental point for developing the CNN model, especially in terms of discrimination (AUC = 0.75 [0.73, 0.77] when n = 10.000, AUC = 0.80 [0.79, 0.81] when n = 150.000). The effect of the sample size on the other two models was weaker. Imbalance corrections led to poorly calibrated models, for all the approaches considered, reducing the clinical utility of the models. Conclusions: Our results suggest that the choice of approach in the analysis of ECG should be based on the amount of data available, preferring more standard models for small datasets. Moreover, imbalance correction methods should be avoided when developing clinical prediction models, where calibration is crucial. [ABSTRACT FROM AUTHOR]

Objectives: The aetiology of Oral Lichen Planus (OLP), a chronic inflammatory disease of oral mucosa, is not yet well understood. Since innate immunity may be hypothesized as involved in the susceptibility to OLP, we studied human beta defensin 1 (hBD-1) an antimicrobial peptide constitutively expressed in the saliva, looking at functional genetic variants possibly able to diminish hBD-1 production an consequently conferring major susceptibility to OLP. Design: We analysed three DEFB1 polymorphisms at 5' UTR, -52G > A (rs1799946), -44C > G (rs1800972), -20G > A (rs11362) and two DEFB1 polymorphisms at 3'UTR, c*5G > A (rs1047031), c*87A > G (rs1800971), with the aim of correlating these genetic variants and hBD-1 salivary level in a group of OLP patients and in healthy subjects. We also evaluated hBD-1 salivary concentrations, using ELISA, in OLP and healthy controls. Results: We compared hBD-1 concentrations in OLP and healthy subjects: hBD-1 concentration was significantly higher in OLP patients respect to control. When considering the correlation between DEFB1 polymorphisms genotypes and hBD-1 expression levels, significant results were obtained for SNPs -52G > A (p = 0.03 both in OLP patients and healthy individuals) and -44C > G (p = 0.02 in OLP patients). Conclusions: hBD-1 production was different between OLP and healthy subjects (not age-matched with OLP). DEFB1 gene polymorphisms, -52G > A and -44C > G, correlated with hBD-1 salivary concentrations. [ABSTRACT FROM AUTHOR]

An abstract of the article "Changing mortality in dilated cardiomyopathy in the last 30 years: the experience oh the heart muscle disease registry of trieste," by A. Di Lenarda and colleagues is presented.

An abstract of the article "Is the long term outcome of familial dilated cardiomyopathy different with respect to sporadic forms," by A. Di Lenarda and colleagues is presented.

An abstract of the article "Long term outcome of dilated cardiomyopathy: a large cohort of patients from the Heart Muscle Disease Registry of Trieste," by A. Di Lenarda and colleagues is presented.

An abstract of the study "Atrial Fibrillation and Hospitalisation Rate in Patients With Idiopathic Dilated Cardiomyopathy," by A. Di Lenarda and colleagues is presented.

The article presents an abstract of the study "Prognostic Role of Cardiopulmonary Exercise Indexes in Patients with Heart Failure Receiving Beta-Blockers," by A. Di Lenarda and colleagues.

The article presents an abstract of the study "Patients Affected by Heart Failure with Peak Oxygen Consumption Between 10-18 ml/kg/min: Cardiopulmonary Test Offers Additional Parameters for a Better Prognostic Stratification?," by A. Di Lenarda and colleagues.

An abstract of the study "Which Is the Best Time to Perform ICD Implantation in Patients With Idiopathic Dilated Cardiomyopathy?," by M. Zecchin and colleagues is presented.