Clinical Course of Patients With Worsening Heart Failure With Reduced Ejection Fraction

Background

Epidemiology of patients with worsening heart failure and reduced ejection fraction (HFrEF) in the real-world setting is not well described.

Satiety and memory enhancing effects of a high-protein meal depend on the source of protein

Objective: High- protein diets have become increasingly popular with various touted benefits. However, the extent to which protein quantity and source affects cognitive functioning through altering postprandial amino acid profiles has not been investigated. Further, whether all protein sources are similarly anorexigenic is uncertain. The objective of this study was to determine the influence of protein level and source on Barnes maze performance, satiety and plasma amino acid levels in male Sprague-Dawley rats.

Methods: Rats were entrained to a meal-feeding schedule consisting of a 30 minutes meal, equivalent to 20% of average daily intake, one hour into the dark phase then ad libitum access to food for 5 h. On test days, rats received one of three isocaloric diets as their first meal, hereafter referred to as Egg White (EW), Wheat Gluten (WG), or Basal, and then were measured for cognitive performance, feeding behavior, or plasma amino acid levels via jugular catheter. Percentage energy from protein was 35% for both EW and WG and 20% for Basal with equal amounts provided by EW and WG proteins.

Results: Rats provided EW performed similarly to Basal on the Barnes maze, whereas WG performed worse. EW increased satiety, whereas WG reduced satiety relative to Basal. Both EW and WG increased postprandial concentrations of large neutral and branched chain amino acids relative to Basal, but in EW, concentrations were slower to peak, and peaked to a higher level than WG.

Discussion: Results demonstrate the importance of protein source for cognition and satiety enhancing effects of a high-protein meal.     

A plastic intraoral device for the collection of human parotid saliva.

A plastic intraoral (IO) cup developed to facilitate collection of human parotid saliva was tested on two groups of patients. Samples collected in both IO and tubed cups exhibited no significant differences in lysozyme or lactoperoxidase activity, levels of total protein or secretory IgA, or in flow rates. Results suggest that the IO cup provides a simple, reliable method for collecting parotid saliva.     

Considerations for anterior implant esthetics

There are several factors to consider when restoring failing dentition in the anterior region. While a tooth can be replaced with an implant, achieving an esthetic result is challenging. The dental team must evaluate numerous criteria to define the optimal treatment plan. Among the considerations are whether to extract the tooth and perform immediate implant replacement or to perform a ridge preservation procedure. This article presents diagnostic determinants to help decide the most appropriate course of therapy to achieve functional and esthetic results.     

Psychosis and sexual abuse: An interpretative phenomenological analysis

Objectives

This study aimed to investigate the first‐person perspective of psychosis sufferers who survived childhood sexual abuse.

Methods

Interpretative phenomenological analysis was employed to explore the experiences of 7 women with a history of sexual abuse and psychosis.

Results

Analysis generated six themes: (a) degradation of self, interlinking shame, guilt, and sometimes disgust; (b) body‐self entrapment, experiencing bodily constraint and distortion; (c) a sense of being different to others, involving interpersonal problems; (d) unending struggle and depression, a pervasive sense of defeat; (e) psychotic condemnations and abuse, describing psychotic phenomena related to harm and sexual abuse; and (f) perception of links to the past, the links made from past abuse to current functioning.

Conclusion

Participants suffered extreme psychological, physical, and interpersonal difficulties past and present. Psychotic experiences reported exhibited themes of condemnation by external entities and reflected the topic of sexual abuse. Participants did not generally link psychosis to their past abusive experiences.