Salus Group (Brazil)

Introduction: Obesity, with more than 2.0 billion people worldwide, is associated with numerous comorbidities, affecting male and female sexual and reproductive function. Objective: This study explored the main clinical studies on the impacts of obesity on sexual dysfunction in men and women, as well as treatment proposals in an attempt to mitigate or resolve this condition. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from September to October 2024 in the Web of Science, Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 95 articles were found. A total of 30 articles were evaluated in full and 14 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 23 studies with high risk of bias and 25 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=72.5%>50%. It was concluded that obesity is associated with substantial and significant impairments in quality of life. Weight loss has been shown to improve sexual function in men and women with obesity. The impact of weight loss medications and the long-term effect of bariatric surgery on sexual function require further studies. Higher visceral adiposity index is independently related to the risk of erectile dysfunction and that early intervention is necessary to reduce the progression of erectile dysfunction with high levels of visceral adiposity index. It was shown that BMI, age, smoking, diabetes and hypertension were associated with higher odds of reporting decreased sexual function.

Abstract Introduction Minimally invasive surgery (MIS) has become the standard of care in our department to address mitral valve diseases (MVD). We nowadays use the mini–thoracotomy approach independently of the MVD etiology and for both complex and simple lesions (posterior leaflet prolapse). The aim of this study was to analyze the efficacy of the approach by observing also post–operative results. Methods We retrospectively analyzed 484 patients who consecutively underwent mitral valve surgery with a minimal invasive approach from January 1st 2018 to December 31st 2022. The patients included in the study were addressed to surgery for a mainly mitral valve pathology (regurgitation, stenosis, prosthesis disfunction). All of the interventions were executed by the same surgeon. We performed a minithoracotomy at the III or IV intercostal space, depending on the anatomy of the patient, always assisted by an endoscopic camera. When necessary, we used periareolar thoracotomy or axillary approach. In the latter without assistance of the camera. The patients had a 3–month follow up visit at least and the longest follow–up monitoring was at five years. Results Overall repair rate was 90% (±3%) which increased to 96% (±1%) when we analyzed the repair rate for degenerative mitral valve pathology as unique etiology. 48% of the mitral valve insufficiency was related to posterior leaflet prolapse and among them 63% had an isolated lesion of of P2 scallop. Hospital stay was 10 days that turned to 6 days when we excluded patients with transitory complications. Conclusions MIS for isolated mitral valve disease provided a good repair rate even in complex anatomy. We also observed good results for mitral valve replacement, deemed necessary in non–degenerative etiologies. A good exposure of the valve, then, permits to address the great majority of the MVD avoiding the longer hospital stay needed after median sternotomy and guarantees a faster return to work without rib fracture implying excellent pain control.

The interest of non-Saccharomyces yeasts in wine fermentation increased constantly in last years. This study reports for the first time the enological potential of two strains Starmerella lactis-condensi MN412 and Candida oleophila YS209. In an innovative way, these strains were used in winemaking to improve floral and fruity aroma of Frappato red wine, which has not been explored. The enological performances of the two non-Saccharomyces strains were compared to a wine strain of Starmerella bacillaris, namely Cz3, previously characterized in winemaking conditions. In these three cases, the non-Saccharomyces strain was sequentially inoculated with S. cerevisiae wine strain NF213, used as control. The St. lactis-condensi MN412 was isolated from Sicilian manna, a sugar-rich matrix, extracted from Fraxinus angustifolia trees (Oleaceae). The strain C. oleophila YS209 was isolated from honey by-products. Microbiological counts showed the ability of MN412 and YS209 to maintain high counts up to 6 days of alcoholic fermentation. Regarding chemical parameters, Cz3 showed the highest glycerol production. Analysis of VOCs revealed that the trials with non-Saccharomyces yeasts were characterized by a higher concentration of esters that contributed positively to the fruity aroma of the wines. The sensory analysis confirmed that the use of MN412 and YS209 impacted positively the final wines in terms of fruity and floral intensity, respectively, while did not generate sensory defects. In conclusion, non-conventional yeasts represent strategy to improve floral-fruity freshness of wine aroma and sugar-rich matrices such as manna ash and honey might represent novel ecological niches as source of potential oenological yeast.

(1) Background: The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) in China at the end of 2019 has caused a large global outbreak. Systemic ozone therapy (OT) could be potentially useful in the clinical management of several complications secondary to SARS-CoV-2. The rationale and mechanism of action has already been proven clinically in other viral infections and has been shown in research studies to be highly effective at decreasing organ damage mediated by inflammation and oxidative stress. This review summarizes the OT studies that illustrate the possible cytoprotective mechanism of action of ozone and its physiological by-products in target organs affected by SARS-CoV-2. (2) Methods: This review encompasses a total of 74 peer-reviewed original articles. It is mainly focused on ozone as a modulator of the NF-κB/Nrf2 pathways and IL-6/IL-1β expression. (3) Results: In experimental models and the few existent clinical studies, homeostasis of the free radical and antioxidant balance by OT was associated with a modulation of NF-κB/Nrf2 balance and IL-6 and IL-1β expression. These molecular mechanisms support the cytoprotective effects of OT against tissue damage present in many inflammatory diseases, including viral infections. (4) Conclusions: The potential cytoprotective role of OT in the management of organ damage induced by COVID-19 merits further research. Controlled clinical trials are needed.

Background: A global outbreak of Mycobacterium Chimaera (MC) infections following cardiac surgery and linked to contaminated heater-cooler units (HCU) is currently ongoing. In 2017, since the status of this outbreak in Italy and the mitigation strategies adopted by adult cardiac surgery unit (ACSU) were not known, SICCH launched a national survey among Italian ACSUs. Methods: In Italy there are 90 ACSU across 20 regions. From May to Nov 2017 they were surveyed collecting data on a) patients diagnosed with MC infections b) ACSU workload c) used HCU models d) control measures adopted in theatres. Results: The response rate was 87.8%. The mean number of cardiac procedures at each ACSU was 508 ± 229/year and nationally the number of procedures/year exceeded 40k. In Italy 7 patients with MC infections following cardiac were reported since 2015: all had aortic or valve surgery as first procedure; the latency between first operation and infection was 2.8 ± 1.6 years. Mortality for patients requiring redo cardiac surgery was 50%. MC infections risk was 0.4–1 patient every 1000 cardiac procedures. The most common HCU model in Italy is the 3T HCU (70.9%). The most common control measures adopted were: implementing new HCU disinfection protocols, using sterile or filtrated water in the HCU and displacing HCU fans away from the patient: HCU replacement and microbiology testing were infrequent. Conclusions: In Italy the risk of contracting MC infections and the mortality reported are in line with other European countries; a significant heterogeneity exists on the mitigation strategies to prevent further MC inoculations.

Objective s To understand the interaction of socio-demographic factors and knowledge, attitudes and practices of the general public, parents and youth in Abu Dhabi, in order to develop culturally sensitive substance use prevention programmes. Methods The data was gathered via convenience sampling using questionnaires developed for each target group during a road show on addiction prevention. Results Perceived primary cause of substance addiction is weakened/breakdown of religiosity, as rated by 34.2% of the sample, and it is influenced by socio-demographic characteristics such as nationality, gender and education. Independent of socio-demographic characteristics, addicts were perceived by over 50% of the population as ‘victims’ and less than 6% perceived drug addicts as criminals. Majority of the respondents evaluated their parenting skills as ‘good’. International Journal of Prevention and Treatment of Substance Use Disorder Vol.1(1) 2013: 76-88 Fifteen percent of youth and adolescents considered experimenting with alcohol and hashish and perception of harm level is associated with tendency to experiment alcohol or hashish. Conclusion Religiosity seems to be perceived as a protective factor for substance use. Socio-demographic factors have an impact on attitudes and perceptions towards substance use. DOI: http://dx.doi.org/10.4038/ijptsud.v1i1.4700 International Journal of Prevention and Treatment of Substance Use Disorder Vol.1(1) 2013: 76-88

The aim of this study was to assess the incidence and clinical predictors of the development of new-onset heart failure (HF) over medium-term follow-up, in patients treated with permanent pacing in daily clinical practice. We retrospectively enrolled all consecutive patients who underwent single- or dual-chamber pacemaker implantation at the study centre. Patients with a left ventricular ejection fraction (LVEF) ≤35% or a prior diagnosis of HF were excluded. Ventricular leads were routinely implanted in the right apex. Pacemakers were implanted in 490 patients with a standard pacemaker indication and LVEF >35%. Left bundle-branch block (LBBB) was reported in 30 (8%) patients, and an LVEF <50% in 64 (13%) patients. During a follow-up of 27 ± 21 months, 32 (7%) patients reached the combined endpoint of HF death or hospitalization. On multivariate analysis, LBBB (HR, 3.50; 95% CI, 1.1-11.1; P = 0.033) and LVEF <50% (HR, 5.1; 95% CI, 1.9-14.2; P = 0.002) were confirmed as independent predictors of HF death or hospitalization. Patients with LVEF <50% and/or LBBB displayed significantly higher rates of HF death or hospitalization (log-rank test, all P<0.001). The majority of patients with a standard indication for permanent pacing and normal LV function remained in a clinically stable condition after pacemaker implantation. However, ∼7% of patients developed new-onset HF over a period of follow-up of 27 months, and the presence of LBBB and LVEF <50% at the baseline predicted HF death or hospitalization.