In Vivo Validation of a Nanostructured Electrospun Polycaprolactone Membrane Loaded with Gentamicin and Nano-Hydroxyapatite for the Treatment of Periodontitis.

The aim of this research was to validate the use of a gentamicin (GEN) and nano-hydroxiapatite (nHAP)-loaded polycaprolactone nanostructured membrane (NM) as an innovative, highly efficient, low-cost treatment for periodontitis. We conducted an in vivo study on Wistar rats, in which we induced periodontitis by placing silk ligatures around the first right and left upper molars. The subjects were divided into three groups; the first group received no periodontal treatment, the second group received open flap debridement, and the third group received open flap debridement, together with the positioning of the GEN and nHAP-loaded nanostructured membrane as a treatment. The extent of periodontal regeneration was assessed by the periodontal pocket depth, bleeding on probing, tooth mobility, dental plaque, microbiological analysis, concentration of MMP-8 in saliva, plasma levels of CRP, and histological analysis. The results showed that using open flap debridement with the NM is more efficient, and it significantly reduces the probing depth, extent of bleeding on probing, dental mobility, bacterial plaque, and pathogenic flora. The concentrations of MMP-8 and CRP decrease. The histological analysis demonstrated that NM leads to bone regeneration. Our study indicates that gentamicin and nano-hydroxyapatite embedded in the fiber of the biodegradable membranes might be a promising therapeutic option for periodontitis treatment.

Development of a Novel Approach for Detection of Equine Lameness Based on Inertial Sensors: A Preliminary Study.

Both as an aid for less experienced clinicians and to enhance objectivity and sharp clinical skills in professionals, quantitative technologies currently bring the equine lameness diagnostic closer to evidence-based veterinary medicine. The present paper describes an original, inertial sensor-based wireless device system, the Lameness Detector 0.1, used in ten horses with different lameness degrees in one fore- or hind-leg. By recording the impulses on three axes of the incorporated accelerometer in each leg of the assessed horse, and then processing the data using custom-designed software, the device proved its usefulness in lameness identification and severity scoring. Mean impulse values on the horizontal axis calculated for five consecutive steps above 85, regardless of the leg, indicated the slightest subjectively recognizable lameness, increasing to 130 in severe gait impairment. The range recorded on the same axis (between 61.2 and 67.4) in the sound legs allowed a safe cut-off value of 80 impulses for diagnosing a painful limb. The significance of various comparisons and several correlations highlighted the potential of this simple, affordable, and easy-to-use lameness detector device for further standardization as an aid for veterinarians in diagnosing lameness in horses.

Left atrial dysfunction as a determinant of pulmonary hypertension in patients with severe aortic stenosis and preserved left ventricular ejection fraction.

In patients with severe aortic stenosis (AS), the presence of pulmonary hypertension (PH) has been linked to a poor prognosis. We aimed to assess the main determinants of PH in patients with severe AS and preserved left ventricular ejection fraction (LVEF). We prospectively enrolled 108 consecutive patients with isolated severe AS (indexed aortic valve area <0.6 cm2/m2) and LVEF >50%, in sinus rhythm. Left atrial (LA) function was assessed using longitudinal deformation parameters (by speckle tracking echocardiography). PH (defined as systolic pulmonary artery pressure >40 mmHg) was present in 20 patients. Patients with severe AS and PH were older (p = 0.05), had higher BNP values (p = 0.05) and a greater degree of LV diastolic dysfunction: higher E/e' and E/A ratios and lower EDT values (p < 0.03 for all) compared to patients without PH. There were no differences between groups regarding AS severity and LV systolic function parameters. Patients with PH had a more impaired LA function: lower septal and lateral late diastolic peak velocity a' (p < 0.001 and p = 0.04 respectively) and lower LA peak longitudinal strain and strain rate parameters (p ≤ 0.005 for all). In multivariable analysis, LA late diastolic longitudinal strain rate was the only independent correlate of PH in our patients (p = 0.04). Patients with isolated severe AS, preserved LVEF and PH had larger LA volumes, a more impaired LA function, and higher LV filling pressures compared to those without PH. LA booster pump function, reflected by late diastolic longitudinal strain rate, emerged as an independent correlate of PH in these patients.

Utility of QRS width and echocardiography parameters in an integrative algorithm for selecting heart failure patients with cardiac dyssynchrony.

BACKGROUND: Cardiac resynchronization therapy (CRT) is an effective treatment in dilated cardiomyopathy (DCM). However, it has been demonstrated that mechanical dyssynchrony is not related to electrical dyssynchrony. We hypothesized that a new QRS width cutoff could be easier to use as a first step in the selection of patients with inter- and intraventricular dyssynchrony. METHODS: We included 58 patients with DCM. Electrocardiographic (PR interval and QRS width) and echocardiographic (left ventricular dimensions, systolic and diastolic function, dyssynchrony parameters) data were evaluated in all patients. RESULTS: According to QRS width, we divided the study population in two groups: Group 1, 25 patients having a narrow QRS (120 ms). Patients in Group 2 had larger left ventricles, with similar systolic function and more severe diastolic dysfunction than patients with narrow QRS. Interventricular dyssynchrony was more frequent in group 2 (54.5% vs 20%, p=0.01), while intraventricular dyssynchrony was highly prevalent in both groups (82.1% vs 72%, p=0.48). A QRS>140 ms best predicted the presence of interventricular dyssynchrony (sensitivity 78.2% and specificity 63.6%), while a QRS>150 ms best predicts intraventricular dyssynchrony (sensitivity 48.6% and specificity 80%). CONCLUSIONS: Intraventricular dyssynchrony has a high prevalence in patients with DCM, irrespective of the QRS width. Using a higher QRS width cutoff (150 ms) might help in patient selection for CRT. Electrocardiography and echocardiography can be combined into a selection algorithm for patients receiving resynchronization therapy.

Spontaneous echo contrast of unexpected etiology.

Cor triatriatum sinister is a rare congenital anomaly characterized by the presence of a fibromuscular membrane dividing the left atrium into two chambers: one entering the four pulmonary veins, the other connecting to the mitral valve. The extent of the communication between the two chambers and the presence of associated lesions determine the severity of symptoms and the complications. We report the case of a 20-year-old man firstly diagnosed with obstructive cor triatriatum sinister and severe pulmonary hypertension.