Menstrual and reproductive factors and risk of non-fatal acute myocardial infarction in Italy

OBJECTIVE: We analyzed the relation between factors related to endogenous female hormones and the risk of acute myocardial infarction (AMI). STUDY DESIGN: We used a combined dataset from three Italian case-control studies, including 609 women with non-fatal AMI and 1106 controls hospitalized for acute conditions. RESULTS: The odds ratios (OR) of AMI were 1.36 (95% confidence intervals, CI 0.95-1.96) in women with an irregular menstrual pattern compared to a regular one, and 1.45 (95% CI 1.07-1.97) in parae compared to nulliparae, without linear trend in risk with number of children. No relation was found with menopausal status, age at menarche and menopause, abortion, and age at first and last birth. Compared to women without abortions the OR was 0.84 (95% CI 0.60-1.18) for >1 abortion; compared to women without spontaneous or induced abortion, the ORs were 0.92 (95% CI 0.62-1.38) for >1 spontaneous and 0.63 (95% CI 0.36-1.08) for >1 induced abortion. The association of parity and irregular menstrual cycles was stronger in pre-/peri-menopausal women and in current smokers. Compared to nonsmokers with regular menstrual cycle, the OR was 5.98 (95% CI 3.38-10.56) for smokers with irregular one, and compared to nonsmokers nulliparae the OR for smokers parae was 4.77 (95% CI 3.12-7.29). CONCLUSIONS: Irregular menstrual cycles and parity were related to increased AMI risk, mainly among pre-/peri-menopausal women and among smokers.     

Use and Awareness of Heated Tobacco Products in Europe

BackgroundHeated tobacco products (HTP) are new forms of tobacco consumption with limited information available on their use among the general population. Our objective was to analyze the prevalence and associations of use of HTP across 11 countries in Europe.MethodsWithin the TackSHS Project, in 2017–2018 we conducted a cross-sectional study with information on HTP use in the following countries: Bulgaria, England, France, Germany, Greece, Italy, Latvia, Poland, Portugal, Romania and Spain. In each country, face-to-face interviews were performed on a representative sample of around 1,000 subjects aged ≥15 years, for a total of 10,839 subjects.ResultsOverall, 27.8% of study participants were aware of HTPs, 1.8% were ever HTP users (ranging from 0.6% in Spain to 8.3% in Greece), and 0.1% were current users. Men were more frequently HTP ever users than women (adjusted odds ratio [aOR] 1.47; 95% confidence interval [CI], 1.11–1.95). Ever HTP use was inversely related to age (P for trend <0.001) and more frequent in ex-smokers (compared with never smokers, aOR 4.32; 95% CI, 2.69–6.95) and current smokers (aOR 8.35; 95% CI, 5.67–12.28), and in electronic cigarette past users (compared with never users, aOR 5.48; 95% CI, 3.46–8.68) and current users (aOR 5.92; 95% CI, 3.73–9.40).ConclusionsIn 2017–2018, HTP use was still limited in Europe among the general population; however, the dual use of these products, their high use among younger generations, and the interest of non-smokers in these products are worrying and indicate the need for close monitoring in terms of prevalence and the characteristics of users.Key words: heated tobacco products, heat-not-burn tobacco products, IQOS, survey, Europe     

New synthesis of a highly active δ-MgCl2 for MgCl2/TiCl4/AlEt3 catalytic systems

A good supporting material for Ziegler-Natta type catalysts was obtained by reaction between powdered metallic magnesium and 1-chloro-n-C_mH_2m+1 (m = 3–9). This reaction affords a highly disordered form of MgCl₂ which was characterized by FT-IR spectroscopy and powder X-ray diffraction (XRD) analysis. This MgCl₂ form shows a crystallographic disorder much higher than that exhibited by the products obtained following the commercial activation procedures of α-MgCl₂, either mechanical or chemical. As shown by the XRD spectra, the synthetized MgCl₂ is characterized by the typical structure of the δ-form. Therefore, this MgCl₂ form, in view of its highly disordered structure, appears as a promising material for the preparation of active supported Ziegler-Natta type catalysts. Thus, by titanation of the obtained δ-MgCl₂ we have prepared some supported catalysts which have been tested in the slurry propene polymerizations, showing high activity (136000–138000 gPP/gTi) and good stereoselectivity (82–88% I.I.).     

The Rise of Creativity: From Primary to Tertiary Process*

This discussion praises Object Relations in Psychoanalytic Theory by Jay Greenberg and Stephen Mitchell for the clarity with which it compares various psychoanalytic theories and their pedagogical usefulness. However, it emphasizes that the book views comparative psychoanalysis based on choices and assumptions with which many might differ. “Object relations” is only one of several possible lenses through which psychoanalytic theories might have been compared. By selecting object relations as the organizing perspective the authors ignore some important theorists such as Arlow and Brenner or Erik Erikson. It also notes that Greenberg and Mitchell view the choice of theoretical position as simply a matter of personal preference. This ignores the possibility of scientifically evaluating which psychoanalytic approach is most likely to achieve the best results.     

Delivering cytokines at tumor site: The immunocytokine-conjugated anti-EDB-fibronectin antibody case

Although considerable efforts have been made in the discovery of new agents for cancer treatment, several promising therapeutics cannot be applied systemically because of their severe side effects. This is the case for various recombinant pro-inflammatory cytokines that, despite their potent anti-cancer activity, can not find their way to clinical exploitation due to their devastating toxicity shown during dose escalation to therapeutically active concentrations. To circumvent these problems, an elegant and efficient way to accumulate therapeutic agents at the tumor site, thus reducing systemic side effects, is their conjugation to tumor-specific antibodies. Here, we review preclinical data about immunocytokines conjugated to a promising single-chain human antibody that selectively targets tumor-associated stroma and blood vessels by binding with high affinity and specificity to the extra domain-B (EDB) of fibronectin.     

Prevalent cardiac,renal and cardiorenal damage in patients with advanced abdominal aortic aneurysms

Chronic kidney disease (CKD), cardiac damage (CD) and the combination of the two are associated with increased morbidity and death in patients admitted to vascular surgery units. We assessed the prevalence of cardiac and renal damage and cardiorenal syndrome (CRS) in 563 patients with abdominal aortic aneurysms (AAA) who underwent cardiac screening before either an endovascular procedure (EVAR) or open surgery (OS) for aneurysm repair. CD was defined by ≥stage B as per the ACC/AHA classification of congestive heart failure (CHF), while CKD was defined by estimated GFR <60 mL/min/1.73 m² (CKD-EPI). Anemia [World Health Organization (WHO) guidelines] and iron deficiency (ID) (criteria for CHF patients) were also calculated. AAA patients were stratified into the following groups: CD, CKD, CRS or none of these conditions [no risk factors (NoRF)]. The prevalence of isolated cardiac and renal structural damage, of combined cardiorenal damage and of ID was 24.1, 15.0, 20.6 and 23.4 %, respectively. The frequency of anemia (mostly unrecognized) among the groups increased from NoRF (12.8 %)/CKD (19 %)/CD (25 %) up to CRS (38.8 %). This large-scale observational study provides clues for the increased CD/CKD risk profiles of unselected AAA patients, and underlines the need for better identification of ID/anemia and for appropriate treatment of CKD and CD before these patients undergo EVAR/OS.