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18 pages, 665 KiB  
Article
Hanoi Air Quantitative Report: A Cross-Sectional Study of Knowledge, Awareness, and Sustainable Practices Related to Air Pollution Among Residents of Hanoi, Vietnam
by Laura Vanderbloemen, Pranee Liamputtong, Oanh Thi Kieu Nguyen, Khanh Vo Ngoc Hoang, Huy Xuan Huynh, Mai Phuong Hoang, Man Gia Tran, Phat Hoang Nguyen, Tran Ngoc Huyen Pham, Dev Kapil, Ahmed Elgebaly and Andrew W. Taylor-Robinson
Sustainability 2025, 17(14), 6557; https://doi.org/10.3390/su17146557 - 18 Jul 2025
Viewed by 524
Abstract
This study contributes to the broader sustainability discourse by evaluating public knowledge, awareness, and practices regarding air pollution among residents of Hanoi, Vietnam, focusing on its causes, health impacts, and mitigation strategies. A cross-sectional survey was conducted with 521 individuals in suburbs around [...] Read more.
This study contributes to the broader sustainability discourse by evaluating public knowledge, awareness, and practices regarding air pollution among residents of Hanoi, Vietnam, focusing on its causes, health impacts, and mitigation strategies. A cross-sectional survey was conducted with 521 individuals in suburbs around Hanoi. A multistage sampling technique, combining cluster and simple random sampling, was used for participant recruitment. Three central and three suburban districts of Hanoi were randomly selected as clusters. One individual from each household was invited to participate and answer a structured survey, which assessed perceptions of air pollution, its human-induced causes, recognised health impacts, and individual and community-level mitigation behaviours. Nearly all participants (98.3%) were aware of air pollution, with 65.3% attributing it to human activities and 61.2% recognising specific air pollutants as primary contributors. The majority (93.9%) acknowledged health impacts, citing respiratory infections (55.1%) and sinus issues (51.2%) as prevalent concerns. Vulnerable groups, such as children under 5 (82.3%) and adults over 65 years old (77.4%), were identified as disproportionately affected. Social media (68.9%) and television (58.3%) were the dominant sources of information. Despite a recognition of air pollution’s importance (98.5%), there was limited engagement in systemic sustainability actions, such as supporting renewable energy initiatives. Most participants (84.3%) reported personal mitigation efforts, including energy-saving practices (35.5%) and walking instead of driving a car or bike (35.3%). While awareness of air pollution and its health impacts is high among Hanoi residents, proactive engagement in systemic solutions remains limited. Policymakers should prioritise community-based programs, public–private partnerships, sustainability education, and culturally tailored policy interventions to bridge gaps between awareness and action. Tailored interventions addressing demographic and cultural factors are essential to fostering socio-environmental sustainability in rapidly urbanising contexts. Full article
(This article belongs to the Special Issue Air Pollution and Sustainability)
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24 pages, 1164 KiB  
Article
A Community-Based Assessment of Attitudes, Health Impacts and Protective Actions During the 24-Day Hangar Fire in Tustin, California
by Shahir Masri, Alana M. W. LeBrón, Annie Zhang, Lisa B. Jones, Oladele A. Ogunseitan and Jun Wu
Int. J. Environ. Res. Public Health 2025, 22(7), 1003; https://doi.org/10.3390/ijerph22071003 - 26 Jun 2025
Viewed by 1061
Abstract
Fire events can impact physical and mental health through smoke exposure, evacuation, property loss, and/or other environmental stressors. In this study, we developed community-driven, cross-sectional online surveys to assess public attitudes, health impacts, and protective actions of residents affected by the Tustin hangar [...] Read more.
Fire events can impact physical and mental health through smoke exposure, evacuation, property loss, and/or other environmental stressors. In this study, we developed community-driven, cross-sectional online surveys to assess public attitudes, health impacts, and protective actions of residents affected by the Tustin hangar fire that burned for 24 days in southern California. Results showed the most frequently reported fire-related exposure concerns (93%) to be asbestos and general air pollution and the most commonly reported mental health impacts to be anxiety (41%), physical fatigue (37%), headaches (33%), and stress (26%). Nose/sinus irritation was the most commonly reported (26.0%) respiratory symptom, while skin- and eye-related conditions were reported by 63.0% and 72.2% of the survey population, respectively. The most commonly reported health-protective actions taken by residents included staying indoors and/or closing doors and windows (67%), followed by wearing face masks (37%) and the indoor use of air purifiers (35%). A higher proportion of low-income residents had to spend money on remediation or other health-protective actions compared to high-income residents. Participants overwhelmingly reported disapproval of their city’s and/or government’s response to the fire disaster. Findings from this study underscore the potential impacts of major pollution events on neighboring communities and offer critical insights to better position government agencies to respond during future disasters while effectively communicating with the public and addressing community needs. Full article
(This article belongs to the Section Environmental Health)
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10 pages, 1200 KiB  
Article
Comparison of Frontal Sinus Dimensions with Different Skeletal Classes and Vertical Patterns: A Retrospective Study
by Alessandro Nota, Iuliia Kashtelianska, Francesco Manfredi Monticciolo, Laura Pittari, Simona Tecco and Attilio Castaldo
Healthcare 2025, 13(11), 1310; https://doi.org/10.3390/healthcare13111310 - 31 May 2025
Viewed by 370
Abstract
Background: The aim of this work is to compare the size of the frontal sinus and the different skeletal classes and divergence patterns of the subjects. Methods: This study retrospectively includes lateral radiographs performed on a total of 200 adults (78 M, 122 [...] Read more.
Background: The aim of this work is to compare the size of the frontal sinus and the different skeletal classes and divergence patterns of the subjects. Methods: This study retrospectively includes lateral radiographs performed on a total of 200 adults (78 M, 122 F; mean age 29.2 ± 8.0 years). Subject inclusion criteria were an age of 18–45 years, presence of both frontal sinuses, and good general health with no hormonal system disorders that may affect the growth and pneumatization of the frontal sinuses. Four different parameters of the frontal sinus were evaluated: length, width, perimeter, and area. In order to calculate the variables inherent to the sagittal and vertical skeletal pattern, two independent nominal variables were considered: skeletal class (ANB°) and mandibular divergence (SN^MP°). Results: The statistical analysis showed that there is a statistically significant difference between the frontal sinus dimension and the three skeletal classes. Subjects in group 3 presented significantly higher mean dimensional values. In the analysis of sinus size variables with skeletal divergence, significant results were found for the width value, which resulted in higher average values in group c. Conclusions: The present study shows a statistically significant difference in frontal sinus size among different skeletal classes and divergence patterns. This result suggests that, in future studies, it should be analyzed whether the dimensional analysis of the frontal sinus could be associated with skeletal class III malocclusion. Full article
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16 pages, 1126 KiB  
Article
Psychosocial Impact of Maxilla-For-All® Treatment Using Standard and Long Implants (Pterygoid, Trans-Sinus and Zygomatic) on Patients with Severe Maxillary Atrophies: A 1-Year Prospective Study with PIDAQ-23 and OHIP-14
by Tommaso Grandi, Paolo Toti, Cesare Paoleschi, Matteo Giorgi, Ugo Covani and Giovanni Battista Menchini-Fabris
J. Clin. Med. 2025, 14(10), 3544; https://doi.org/10.3390/jcm14103544 - 19 May 2025
Viewed by 563
Abstract
Background/Objectives: The satisfaction of patients following maxillary full-arch rehabilitation is crucial in assessing treatment effectiveness. This one-year study evaluated patients’ satisfaction, quality of life, and aesthetic perception after receiving the Maxilla-for-All®/All-On-X treatments, which combine standard, pterygoid, trans-sinus, and zygomatic implants [...] Read more.
Background/Objectives: The satisfaction of patients following maxillary full-arch rehabilitation is crucial in assessing treatment effectiveness. This one-year study evaluated patients’ satisfaction, quality of life, and aesthetic perception after receiving the Maxilla-for-All®/All-On-X treatments, which combine standard, pterygoid, trans-sinus, and zygomatic implants to support a fixed prosthesis and offer a graftless solution that reduces morbidity and treatment time. Methods: A prospective cohort study using convenience sampling of subjects treated for severe maxillary atrophies was conducted on patients receiving immediate implant-supported full-arch fixed prostheses. The Oral Health Impact Profile (OHIP-14) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ-23) were administered preoperatively and one year post-treatment. Patients were grouped based on the presence or absence of complications (surgical, technical, and mechanical) and Wilcoxon tests were used for comparison (significance level = 0.05). Results: A total of 56 patients (29 female, 27 male) participated, with no implant or prosthesis failures. Eleven patients reported unilateral sinus membrane perforation, and seven had technical or mechanical complications. Preoperatively, 69% of patients rated their oral condition as unfavorable according to the OHIP-14; this dropped significantly to 21.8% post-treatment (p-value < 0.0001). After one year, the average PIDAQ-23 score improved significantly from 44.7 ± 16.6 to 6.8 ± 5.3 (p-value < 0.0001). No significant differences were observed between patients with or without complications (p-values ranging from 0.5270 to 0.8920). Conclusions: Full-arch rehabilitation using Maxilla-for-All®/All-On-X treatments significantly improved both aesthetic perception and chewing function in patients with severe maxillary atrophies. They reported a substantial reduction in oral health-related discomfort, as shown by a significant decrease in OHIP-14 scores one year post-treatment. Clinical or technical complications did not significantly impact patients’ quality-of-life outcomes or satisfaction, supporting the reliability of this treatment protocol. Full article
(This article belongs to the Special Issue Current Trends in Implant Dentistry)
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11 pages, 800 KiB  
Article
Combined Proxies for Heart Rate Variability as a Global Tool to Assess and Monitor Autonomic Dysregulation in Fibromyalgia and Disease-Related Impairments
by Emanuella Ladisa, Chiara Abbatantuono, Elena Ammendola, Giusy Tancredi, Marianna Delussi, Giulia Paparella, Livio Clemente, Annalisa Di Dio, Antonio Federici and Marina de Tommaso
Sensors 2025, 25(8), 2618; https://doi.org/10.3390/s25082618 - 21 Apr 2025
Viewed by 674
Abstract
Background: Heart rate variability (HRV) provides both linear and nonlinear autonomic proxies that can be informative of health status in fibromyalgia (FM), where sympatho-vagal abnormalities are common. This retrospective observational study aims to: 1. detect differences in correlation dimension (D2) between FM patients [...] Read more.
Background: Heart rate variability (HRV) provides both linear and nonlinear autonomic proxies that can be informative of health status in fibromyalgia (FM), where sympatho-vagal abnormalities are common. This retrospective observational study aims to: 1. detect differences in correlation dimension (D2) between FM patients and healthy controls (HCs); 2. correlate D2 with standard HRV parameters; 3. correlate the degree of HRV changes using a global composite parameter called HRV grade, derived from three linear indices (SDNN = intervals between normal sinus beats; RMSSD = mean square of successive differences; total power), with FM clinical outcomes; 4. correlate all linear and nonlinear HRV parameters with clinical variables in patients. Methods: N = 85 patients were considered for the analysis and compared to 35 healthy subjects. According to standard diagnostic protocol, they underwent a systematic HRV protocol with a 5-min paced breathing task. Disease duration, pain intensity, mood, sleep, fatigue, and quality of life were assessed. Non-parametric tests for independent samples and pairwise correlations were performed using JMP (all p < 0.001). Results: Mann-Whitney U found a significant difference in D2 values between FM patients and HCs (p < 0.001). In patients, D2 was associated with all HRV standard indices (all p < 0.001) and FM impairment (FIQ = −0.4567; p < 0.001). HRV grade was also associated with FM impairment (FIQ = 0.5058; p < 0.001). Conclusion: Combining different HRV measurements may help understand the correlates of autonomic dysregulation in FM. Specifically, clinical protocols could benefit from the inclusion and validation of D2 and HRV parameters to target FM severity and related dysautonomia. Full article
(This article belongs to the Special Issue Intelligent Medical Sensors and Applications)
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23 pages, 4048 KiB  
Systematic Review
Insights into Sinus-Lift Bone Grafting Materials: What’s Changed?
by Anida-Maria Băbțan, Claudia N. Feurdean, Anca Ionel, Willi A. Uriciuc, Radu Chifor, Chambon Antoine Bernard Jaques, Bianca A. Boșca and Aranka Ilea
J. Funct. Biomater. 2025, 16(4), 133; https://doi.org/10.3390/jfb16040133 - 7 Apr 2025
Viewed by 2389
Abstract
Background: Sinus-lift (SL) is a pre-prosthetic procedure with the objective of increasing bone height to achieve implant insertion primary stability in implant-supported prostheses. The biomechanical properties of SL augmentation materials are influenced by their origin, manufacture, bioactive substances addition, receiver, and surgical procedure. [...] Read more.
Background: Sinus-lift (SL) is a pre-prosthetic procedure with the objective of increasing bone height to achieve implant insertion primary stability in implant-supported prostheses. The biomechanical properties of SL augmentation materials are influenced by their origin, manufacture, bioactive substances addition, receiver, and surgical procedure. This systematic review provides insights into state-of-the-art SL biomaterials, focusing on autologous bone grafting as the gold standard. Methods: The study followed the PRISMA flow diagram, searching WoS (Web of Science), Embase, Cochrane, and PubMed databases using the search terms «sinus lift» OR «sinus augmentation» OR «bone graft» OR «bovine» OR «porcine» OR «autologous» OR «allogenic» OR «xenogeneic» OR «alloplastic» OR «hydroxyapatite» OR «β-tricalcium phosphate (β-TCP)» OR «equine» OR «PRF». Results: The highest bone gain was provided by Bioglass at 42%. Articles written between 2014 and 2024 in English or French, containing human studies and with full text available, were included. Participants were required to be in good general health, without acute, chronic, or congenital diseases, or substance abuse (drugs, alcohol, or nicotine). SL surgery was performed using the lateral approach, with no Schneiderian membrane perforation or postoperative complications. The network meta-analysis was conducted using the R statistical computing environment. To assess the inconsistency between direct and indirect evidence, we used a net heat plot. To evaluate heterogeneity across studies, we used the chi-squared-based Q-test and I2 statistic. A significance level of 0.05 was applied throughout all analyses. Results: Allogeneic bovine bone and hydrox yapatite demonstrated the lowest resorption rates. Significant differences were found for residual graft and connective tissue between allogenous bovine bone (ABB) + AlB vs. β-TCP + PRF (p = 0.028); ABB + AlB vs. β-TCP (p = 0.034); ABB + AlB vs. BCP (p = 0.037). Meta-analysis showed that the overall heterogeneity was 51.8% (6.9–75%; p = 0.019), with significant heterogeneity within designs (p = 0.007) and no significant heterogeneity between designs (p = 0.39). AB had a better bone regeneration ratio compared to many of the other interventions, but only two passed the threshold of significance: A1B and B-TCP + AB. Conclusions: A grafting material’s superiority is determined by its new bone formation ratio, connective tissue integration, residual graft content, and bone resorptionratio. Although autologous bone grafting has exhibited superior bone regeneration compared to other biomaterials, it was not favored due to its unpredictable connective tissue concentration and bone resorption ratio. Additionally, autologous bone exhibited the fastest metabolic turnover among all grafting materials. Full article
(This article belongs to the Special Issue Bone Regeneration and Repair Materials, 2nd Edition)
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13 pages, 3088 KiB  
Communication
Surgical Management of Oro-Nasal Communication in Cocaine-Induced Lesions: Temporalis Muscle Flap with Le Fort I Osteotomy
by Ettore Lupi, Alessandra Ciccozzi, Roberto Becelli, Mario Mannino, Sara Bernardi and Filippo Giovannetti
J. Clin. Med. 2025, 14(6), 2033; https://doi.org/10.3390/jcm14062033 - 17 Mar 2025
Cited by 1 | Viewed by 732
Abstract
Background: Cocaine is a recreational drug known for its negative impact on health and social and economic life. One of the complications for cocaine abusers is cocaine-induced midline destructive lesion (CIMDL) syndrome, which includes the extensive destruction of the osteocartilaginous structures of the [...] Read more.
Background: Cocaine is a recreational drug known for its negative impact on health and social and economic life. One of the complications for cocaine abusers is cocaine-induced midline destructive lesion (CIMDL) syndrome, which includes the extensive destruction of the osteocartilaginous structures of the nose, the sinus, and the palate. Methods: Here, we describe three cases of the surgical management of CIMDL using a temporalis muscle flap combined with a Le Fort I osteotomy, which allows sufficient space for the muscle to settle. Results: The addition of the osteotomy allowed better handling of the pedicled flap, with no signs of relapse in the reported cases and high patient satisfaction. Conclusions: CIMDL syndrome is an impairing disease that negatively affects the functionality of the nasal and oral cavities, as well as the aesthetic. Surgical repair using a pedicled flap is a valid option in rehabilitated and sober patients with endothelial damage. Full article
(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Current Updates and Perspectives)
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11 pages, 228 KiB  
Article
Efficacy of Laser Pulpotomy vs. Conventional Vital Pulpotomy in Primary Teeth: A Comparative Clinical Analysis
by Jasna Simonoska, Roko Bjelica, Aleksandar Dimkov, Jasmina Simjanovska, Dragana Gabrić and Elizabeta Gjorgievska
Children 2025, 12(3), 341; https://doi.org/10.3390/children12030341 - 8 Mar 2025
Viewed by 1457
Abstract
Background/Objectives: Vital pulpotomy involves the partial removal of the coronal pulp tissue in cases of vital pulp exposure, aiming to maintain the health and function of the remaining radicular pulp. The first aim of this study was to compare the effects of [...] Read more.
Background/Objectives: Vital pulpotomy involves the partial removal of the coronal pulp tissue in cases of vital pulp exposure, aiming to maintain the health and function of the remaining radicular pulp. The first aim of this study was to compare the effects of two different methodological approaches towards vital pulpotomy of the primary teeth—conventional and laser pulpotomy; thereafter, the aim was to perform a comparison of the effects of the application of calcium hydroxide (Ca(OH)2) versus mineral trioxide aggregate (MTA); then, we analyzed and compared clinical and radiographic changes in pulpotomized teeth over a defined time period; finally, we determined the degree of efficiency of different methods of vital pulpotomy of the primary teeth. Methods: This study analyzed 40 primary molars, 20 teeth treated with conventional pulpotomy and 20 teeth submitted to laser pulpotomy. Additionally, two pulpotomy agents—Ca(OH)2 and MTA—were used. The following clinical parameters were examined: pain, percussion sensitivity, swelling, sinus tract presence and pathological mobility. Absence of apical radiolucency, external and internal root resorption, and periodontal ligament widening were key radiographic parameters of the success of the endodontic therapy. Results: The results showed that there was no statistically significant difference between the two pulpotomy agents—Ca(OH)2 and MTA—and therefore both can be used as alternative pulpotomy agents in the primary teeth. Conclusions: The success rate of pulpotomy with Ca(OH)2 is similar to that of pulpotomy with MTA. The combination of laser pulpotomy and the use of MTA gave the best results according to all clinical and radiographic criteria examined and in all analyzed periods. Full article
(This article belongs to the Section Pediatric Dentistry & Oral Medicine)
29 pages, 31666 KiB  
Article
Meningeal Lymphatic and Glymphatic Structures in a Pelagic Delphinid (Delphinus delphis)
by Olivia N. Jackson, Tiffany F. Keenan, Nathan P. Nelson-Maney, Sentiel A. Rommel, William A. McLellan, D. Ann Pabst, Alexander M. Costidis, Kathleen M. Caron, Dawn N. Kernagis, David S. Rotstein, Victoria G. Thayer, Craig A. Harms, Marina A. Piscitelli-Doshkov, Paul Doshkov, Lorian E. Schweikert, Kara E. Yopak, Molly Braun and Michael S. Tift
Animals 2025, 15(5), 729; https://doi.org/10.3390/ani15050729 - 4 Mar 2025
Viewed by 2910
Abstract
The glymphatic system, an analog of the peripheral lymphatic system in the brain, and the meningeal lymphatic system are critical to central nervous system health. The glymphatic system functions to distribute cerebrospinal fluid and important compounds throughout the brain and to remove metabolic [...] Read more.
The glymphatic system, an analog of the peripheral lymphatic system in the brain, and the meningeal lymphatic system are critical to central nervous system health. The glymphatic system functions to distribute cerebrospinal fluid and important compounds throughout the brain and to remove metabolic waste. The flow of cerebrospinal fluid through this system is affected by changes in cerebral blood flow, intracranial pressure, and vascular tone. Cetaceans experience profound cardiorespiratory alterations while diving that can directly affect cerebrospinal fluid and blood flow and, thus, glymphatic function. Our goal was to investigate glymphatic and lymphatic system structures, including perivascular spaces, aquaporin-4 water channels, meningeal lymphatic, and dural venous sinus vessels in the common dolphin (Delphinus delphis), using immunofluorescent labeling, histochemical staining, and postmortem computed tomography (CT) angiography. We highlight perivascular spaces and aquaporin-4 water channels surrounding blood vessels in the parenchyma and demonstrate evidence of meningeal lymphatic vessels and associated dural venous sinuses. These results demonstrate that common dolphins possess the key anatomical structures required for functional glymphatic and meningeal lymphatic systems. Future studies can build upon these anatomical discoveries to study the function and role of these systems in brain health in this species. Full article
(This article belongs to the Special Issue Recent Progress in Anatomy and Pathology of Marine Mammals)
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21 pages, 10581 KiB  
Article
Evaluation of Echocardiographic, Conventional Electrocardiographic, and Holter Variables in Jaguars (Panthera Onca) Anesthetized with Medetomidine and Ketamine: Implications for Management and Conservation
by Murillo Daparé Kirnew, Matheus Folgearini Silveira, Roberto Andres Navarrete Ampuero, Ana Paula Rodrigues Simões, Felippe Azzolini, Gediendson Ribeiro de Araújo, Pedro Nacib Jorge-Neto, Sofia Regina Polizelle, Juliane Patrícia Sipp, Cristiane Schilbach Pizzutto, Thyara Deco-Souza and Aparecido Antonio Camacho
J. Zool. Bot. Gard. 2025, 6(1), 13; https://doi.org/10.3390/jzbg6010013 - 13 Feb 2025
Viewed by 1416
Abstract
Jaguars play a crucial role in population control across multiple biomes. They are endangered and protected by in situ and ex situ conservation mechanisms to ensure their conservation. Cardiovascular diseases in wild mammals, including jaguars, often have unclear etiopathogenies, underscoring the need for [...] Read more.
Jaguars play a crucial role in population control across multiple biomes. They are endangered and protected by in situ and ex situ conservation mechanisms to ensure their conservation. Cardiovascular diseases in wild mammals, including jaguars, often have unclear etiopathogenies, underscoring the need for research into novel hemodynamic parameters. This study evaluates the cardiovascular health of fifteen clinically healthy jaguars using conventional and Holter electrocardiography, non-invasive systemic blood pressure measurement, and echocardiography. Chemical restraint was achieved with medetomidine (0.08–0.1 mg/kg) and ketamine (5 mg/kg), with anesthesia reversed using atipamezole (0.25 mg/kg). The average heart rate was 72 ± 18 bpm, with sinus rhythm in ten animals and sinus arrhythmia in five. Six animals exhibited first and second-degree atrioventricular blocks, one had supraventricular complexes, and another had premature ventricular complexes. Non-invasive systolic blood pressure remained stable at 163 ± 29 mmHg during anesthesia. Echocardiographic examination revealed mitral, tricuspid, pulmonary, and aortic valve insufficiencies via color Doppler. The transmitral flow showed a normal E/A ratio and E` < A`, suggesting a pseudonormal ventricular filling pattern. No significant anesthetic complications were observed, affirming the protocol’s safety. This study provides valuable data, validating the anesthetic protocol and establishing reference cardiovascular values for jaguars, thus paving the way for future research in other veterinary species. Full article
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16 pages, 6838 KiB  
Article
The Acute Toxicity and Cardiotoxic Effects of Levofloxacin on Zebrafish (Danio rerio)
by Yixiao Wu, Wenjing Yu, Zhenyan Song, Jiawei He, Ze Li, Qi Chen, Shiwei Wang, Ping Li and Shaowu Cheng
Toxics 2025, 13(2), 122; https://doi.org/10.3390/toxics13020122 - 5 Feb 2025
Cited by 2 | Viewed by 1732
Abstract
Emerging contaminants refer to chemical substances that have not been widely regulated but possess the potential to cause adverse effects on both the environment and human health. Antibiotics, as emerging contaminants, pose significant threats to ecosystems and human health due to their widespread [...] Read more.
Emerging contaminants refer to chemical substances that have not been widely regulated but possess the potential to cause adverse effects on both the environment and human health. Antibiotics, as emerging contaminants, pose significant threats to ecosystems and human health due to their widespread use and persistence in the environment. Levofloxacin, a broad-spectrum fluoroquinolone antibiotic, is commonly employed in the treatment of bacterial infections, and has been frequently detected in environmental matrices and freshwater systems. In this study, we assessed the effects of levofloxacin on hatchability, mortality rates, malformations, behavioral changes, and cardiac development in zebrafish embryos by exposing them to varying concentrations of levofloxacin (0, 0.5, 1, 2, 4, and 8 mM). Our results demonstrate that levofloxacin exposure significantly impaired the growth and development of zebrafish larvae, particularly at higher concentrations. Notable effects included reduced body length, abnormal yolk sac and swim bladder development, pericardial edema, prolonged distances between the sinus venosus and arteriolar bulb (SV-BA), and disruptions in heart rate. Quantitative PCR analysis further revealed that levofloxacin exposure significantly upregulated the expression of key cardiac development genes in zebrafish larvae, including nppa, myh6, cacna1ab, myl7, gata4, nkx2.5, tbx2b, and tbx5b. These findings indicate that levofloxacin exposure exerts significant toxic effects on both embryonic and larval growth as well as heart development and gene expression in zebrafish. This study provides critical insights into the potential ecological risks posed by levofloxacin along with other antibiotics while laying a foundation for further investigation into their toxicological mechanisms. Full article
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7 pages, 4795 KiB  
Case Report
Cardiac Contractility Modulation Therapy in a Transplant Candidate Patient with Advanced Heart Failure to Improve Cardiac Function and Restore Sinus Rhythm
by Giovanna Rodio, Marilisa Ludovico, Alessio Angelini, Maria Alfeo, Dennis Andrenucci, Giovanni Pugliese, Walter Luvera and Giovanni Luzzi
Hearts 2025, 6(1), 1; https://doi.org/10.3390/hearts6010001 - 10 Jan 2025
Viewed by 890
Abstract
Cardiac Contractility Modulation (CCM) is an electrical therapy based on an implantable device. This device is approved for patients with heart failure with reduced ejection fraction (HFrEF). Randomized clinical trials and thousands of described cases and studies have shown how CCM can improve [...] Read more.
Cardiac Contractility Modulation (CCM) is an electrical therapy based on an implantable device. This device is approved for patients with heart failure with reduced ejection fraction (HFrEF). Randomized clinical trials and thousands of described cases and studies have shown how CCM can improve exercise tolerance, quality of life, re-hospitalization for HF, and cardiac function by reverse left ventricular modelling. In this case report, we describe a patient candidate for a cardiac transplant based on dilated cardiomyopathy with severe LV dysfunction and narrow QRS. The patient had frequent heart failure-related hospitalizations, despite the optimal medical therapy. The strategy was to adopt the Cardiac Contractility Modulation (CCM) therapy while waiting for a cardiac transplant. During a consultation on all prospective therapy options, the patient refused the LVAD therapy, and was more confident in adopting a less invasive device therapy like CCM. This strategy had a very fast and beneficial impact on the patient’s health; the CCM improved heart failure symptoms, hemodynamics flow and cardiac functionality. Moreover, after a relatively short time, the patient went from persistent AF to Sinus Rhythm, although he started with a severe bi-atrial dilatation. These parameters were stable during an extended follow-up of 18 months. Full article
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29 pages, 847 KiB  
Review
Mechanistic Relevance of Ventricular Arrhythmias in Heart Failure with Preserved Ejection Fraction
by Pegah Bahrami, Kelly A. Aromolaran and Ademuyiwa S. Aromolaran
Int. J. Mol. Sci. 2024, 25(24), 13423; https://doi.org/10.3390/ijms252413423 - 14 Dec 2024
Viewed by 2501
Abstract
Heart failure with preserved ejection fraction (HFpEF) is increasing at an alarming rate worldwide, with limited effective therapeutic interventions in patients. Sudden cardiac death (SCD) and ventricular arrhythmias present substantial risks for the prognosis of these patients. Obesity is a risk factor for [...] Read more.
Heart failure with preserved ejection fraction (HFpEF) is increasing at an alarming rate worldwide, with limited effective therapeutic interventions in patients. Sudden cardiac death (SCD) and ventricular arrhythmias present substantial risks for the prognosis of these patients. Obesity is a risk factor for HFpEF and life-threatening arrhythmias. Obesity and its associated metabolic dysregulation, leading to metabolic syndrome, are an epidemic that poses a significant public health problem. More than one-third of the world population is overweight or obese, leading to an enhanced risk of incidence and mortality due to cardiovascular disease (CVD). Obesity predisposes patients to atrial fibrillation and ventricular and supraventricular arrhythmias—conditions that are caused by dysfunction in the electrical activity of the heart. To date, current therapeutic options for the cardiomyopathy of obesity are limited, suggesting that there is considerable room for the development of therapeutic interventions with novel mechanisms of action that will help normalize sinus rhythms in obese patients. Emerging candidates for modulation by obesity are cardiac ion channels and Ca-handling proteins. However, the underlying molecular mechanisms of the impact of obesity on these channels and Ca-handling proteins remain incompletely understood. Obesity is marked by the accumulation of adipose tissue, which is associated with a variety of adverse adaptations, including dyslipidemia (or abnormal systemic levels of free fatty acids), increased secretion of proinflammatory cytokines, fibrosis, hyperglycemia, and insulin resistance, which cause electrical remodeling and, thus, predispose patients to arrhythmias. Furthermore, adipose tissue is also associated with the accumulation of subcutaneous and visceral fat, which is marked by distinct signaling mechanisms. Thus, there may also be functional differences in the effects of the regional distribution of fat deposits on ion channel/Ca-handling protein expression. Evaluating alterations in their functional expression in obesity will lead to progress in the knowledge of the mechanisms responsible for obesity-related arrhythmias. These advances are likely to reveal new targets for pharmacological modulation. Understanding how obesity and related mechanisms lead to cardiac electrical remodeling is likely to have a significant medical and economic impact. Nevertheless, substantial knowledge gaps remain regarding HFpEF treatment, requiring further investigations to identify potential therapeutic targets. The objective of this study is to review cardiac ion channel/Ca-handling protein remodeling in the predisposition to metabolic HFpEF and arrhythmias. This review further highlights interleukin-6 (IL-6) as a potential target, cardiac bridging integrator 1 (cBIN1) as a promising gene therapy agent, and leukotriene B4 (LTB4) as an underappreciated pathway in future HFpEF management. Full article
(This article belongs to the Special Issue New Insights into Cardiac Ion Channel Regulation 3.0)
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11 pages, 1206 KiB  
Article
Estimating Coronary Sinus Oxygen Saturation from Pulmonary Artery Oxygen Saturation
by Alexander Gall, Hosamadin S. Assadi, Rui Li, Zia Mehmood, Bahman Kasmai, Gareth Matthews and Pankaj Garg
Medicina 2024, 60(11), 1882; https://doi.org/10.3390/medicina60111882 - 16 Nov 2024
Viewed by 1680
Abstract
Background and Objectives: Coronary sinus oxygen saturation is a useful indicator of health and disease states. However, it is not routinely used in clinical practice. Cardiovascular magnetic resonance imaging (CMR) oximetry can accurately estimate oxygen saturation in the pulmonary artery. This research [...] Read more.
Background and Objectives: Coronary sinus oxygen saturation is a useful indicator of health and disease states. However, it is not routinely used in clinical practice. Cardiovascular magnetic resonance imaging (CMR) oximetry can accurately estimate oxygen saturation in the pulmonary artery. This research aimed to provide a method for calculating coronary sinus oxygen saturation (ScsO2) from pulmonary artery oxygen saturation (SpaO2) that could be applied to CMR. Materials and Methods: A systematic literature review was conducted to identify prior work that included invasive measures of ScsO2 and either SpaO2 or right ventricular oxygen saturation. This revealed one study with appropriate data (ScsO2 and SpaO2 measurements, n = 18). We then carried out agreement and correlation analyses. Results: Regression analysis demonstrated a statistically significant, positive relationship between ScsO2 and SpaO2, giving a regression equation of ScsO2 = −31.198 + 1.062 × SpaO2 (r = 0.76, p < 0.001). A multivariable regression analysis of all reported variables, excluding SpaO2, independently identified superior vena cava oxygen saturation (SsvcO2) and arterial oxygen saturation (SaO2) as predictors of ScsO2 (r = 0.78, p < 0.001), deriving the equation ScsO2 = −452.8345 + 4.3579 × SaO2 + 0.8537 × SsvcO2. Conclusions: In this study, we demonstrated a correlation between coronary sinus oxygen saturation and pulmonary artery oxygen saturation, allowing the estimation of ScsO2 from SpaO2. This association enables the estimation of ScsO2 from purely CMR-derived data. We have also described a second model using arterial and superior vena cava saturation measurements, providing an alternative method. Future validation in larger, independent cohorts is needed. Full article
(This article belongs to the Section Cardiology)
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14 pages, 1191 KiB  
Review
What We Know about Nasal Polyposis: The Clinician’s Point of View
by Philippe Eloy and Gabriela Cornelia Musat
Sinusitis 2024, 8(2), 37-50; https://doi.org/10.3390/sinusitis8020006 - 26 Sep 2024
Viewed by 3856
Abstract
Nasal polyposis is defined as a Th2-driven chronic inflammation of the nose and sinus with polyps visible in the nasal fossae. It is a prevalent disease with a significant impact on health-related quality of life (HRQL). Allergies, allergic rhinitis, asthma, and aspirin intolerance [...] Read more.
Nasal polyposis is defined as a Th2-driven chronic inflammation of the nose and sinus with polyps visible in the nasal fossae. It is a prevalent disease with a significant impact on health-related quality of life (HRQL). Allergies, allergic rhinitis, asthma, and aspirin intolerance are frequently associated. The management is individual. The first line of treatment is long-term treatment with intranasal corticosteroids. Oral corticosteroids should be used with caution. When the medical treatment fails, the patient is eligible for sinus surgery, which usually consists of a complete sphenoethmoidectomy. In the case of symptomatic recurrence after both medical and surgical treatment, biologics are currently a very promising treatment effective on all respiratory tracts. Dupilumab is considered in the literature to be the molecule of choice. However, besides the international guidelines published by EPOS and Euforea, the molecule prescribed depends also on its availability in each country and the criteria edited by the health authorities to receive reimbursement. Traditional medical treatment remains necessary as a complement to biologics. At the moment, there is no consensus on when the medical treatment can be stopped. Full article
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