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Uromodulin is a kidney-specific glycoprotein which is exclusively produced by the epithelial cells lining the thick ascending limb and early distal convoluted tubule. It is currently recognized as a multifaceted player in kidney physiology and disease, with discrete roles for intracellular, urinary, interstitial and serum uromodulin. Among these, uromodulin modulates renal sodium handling through the regulation of tubular sodium transporters that reabsorb sodium and are targeted by diuretics, such as the loop diuretic–sensitive Na+-K+-2Cl− cotransporter type 2 (NKCC2) and the thiazide-sensitive Na+/Cl− cotransporter (NCC). Given these roles, the contribution of uromodulin to sodium-sensitive hypertension has been proposed. However, recent studies in humans suggest a more complex interaction between dietary sodium intake, uromodulin and blood pressure. This review presents an updated overview of the uromodulin's biology and its various roles, and focuses on the interaction between uromodulin and sodium-sensitive hypertension. [ABSTRACT FROM AUTHOR]

The change in heating and cooling needs of Greece in the near future due to the climate change is assessed in the present study. Global and regional climate models and two different representative concentration pathways (RCPs) are used to simulate the expected change in temperature. A widely used methodology of computation of heating degree days (HDDs) and cooling degree days (CDDs) is employed with a base temperature of 18 °C. In agreement with the expected temperature rise in the near future, an HDD decrease and CDD increase under both RCPs is also expected. The changes under RCP8.5 are stronger compared to those under RCP4.5. Differences related to topography are noted. The HDD decrease is stronger than CDD increase but the relative increase in CDDs is higher than the relative increase in HDDs. The highest absolute decreases in HDDs are expected for February and March while the highest absolute increases in CDDs are expected during the three summer months. [ABSTRACT FROM AUTHOR]

We report new nanocomposites with poly(benzoxazine-co-epoxy) matrix reinforced with 1 wt% graphene. Curabox 24-111, a benzoxazine resin was copolymerised with Epilok 60-566, a mixture of epoxy resins. Copolymerisation was also carried out in the presence of different graphene powders, namely, Nanene-001 and Nanene-002, used as single fillers and as mixture (relative weight ratio 70:30 or 30:70). DSC results showed the addition of either single filler caused a delay in polymerisation and an increase in the exothermic peak temperature of the curing reaction with a related reduction in ΔH Total. compared to the neat copolymer. Copolymerisation showed a 38% reduction and 24% increase in tensile modulus (E) compared to the neat polybenzoxazine and epoxy polymer, with a respective 18% and 30% reduction in tensile strength (TS). Nanocomposites with 0.7wt% Nanene-002 + 0.3 wt% Nanene-001 showed the highest increase of 35% in TS, a 1.6% reduction in E and 36% increase in elongation at break (EB) compared to the neat copolymer matrix. Samples with 1 wt% Nanene-001 showed the largest reduction of 21% in E, a 27% increase in TS and a 45% increase in EB. Additionally, TGA thermographs showed a 22°C increase in the onset of degradation (300°C–322°C) improving the materials thermal stability. [ABSTRACT FROM AUTHOR]

Background: This systematic review explores the effects of landiolol administration in individuals presenting with supraventricular tachyarrhythmia (SVT) and concurrent left ventricular dysfunction, without being septic or in a peri-operative period. Methods: We systematically searched PubMed, Cochrane, Web of Science, and Scopus databases, retrieving a total of 15 eligible studies according to prespecified eligibility criteria. Results: Patients treated with landiolol experienced a substantial reduction in heart rate (HR) (mean HR reduction: 42 bpm, 95% confidence intervals (CIs): 37–47, I2 = 82%) and were more likely to achieve the target HR compared to those receiving alternative antiarrhythmic therapy (pooled odds ratio (OR): 5.37, 95% CIs: 2.87–10.05, I2 = 0%). Adverse events, primarily hypotension, occurred in 14.7% of patients receiving landiolol, but no significant difference was observed between the landiolol and alternative antiarrhythmic receiving groups (pooled OR: 1.02, 95% CI: 0.57–1.83, I2 = 0%). No significant difference was observed between the two groups concerning sinus rhythm restoration (pooled OR: 0.97, 95% CI: 0.25–3.78, I2 = 0%) and drug discontinuation due to adverse events (pooled OR: 5.09, 95% CI: 0.6–43.38, I2 = 0%). Conclusion: While further research is warranted, this systematic review highlights the potential benefits of landiolol administration in the management of SVTs in the context of left ventricular dysfunction. [ABSTRACT FROM AUTHOR]

Heart failure (HF) remains a major cause of morbidity and mortality worldwide. Recently, significant advances have been made in its treatment; however, diuretics remain the cornerstone in managing congestion in HF. Although diuretic resistance poses a significant challenge in the management of HF and is associated with poor outcomes, only limited alternative pharmaceutical options are available in clinical practice. The objective of this narrative review is to provide a comprehensive analysis of the current evidence on the effects of sodium-glucose co-transporter-2 (SGLT-2) inhibitors on diuretic resistance in HF patients. The primary emphasis is placed on clinical data that assess the impact of SGLT-2 inhibitors on fluid balance, symptom improvement, and clinical outcomes and secondarily on safety profile and potential adverse effects associated with SGLT-2 inhibitor use in acute decompensated HF. The current evidence on the efficacy of SGLT-2 on diuretic resistance remains controversial. Findings from observational and randomized studies are quite heterogenous; however, they converge on the notion that although SGLT-2 inhibitors show promise for mitigating diuretic resistance in HF, their diuretic effect may not be potent enough to be widely used to relieve objective signs of congestion in patients with HF. Importantly, the introduction of SGLT-2 inhibitors in HF treatment appears to be generally well tolerated, with manageable adverse effects. Further research is needed to investigate the underlying mechanisms and the possible beneficial impact of SGLT-2 inhibitors on diuretic resistance in HF. [ABSTRACT FROM AUTHOR]

Adults with congenital heart disease (ACHD) and atrial arrhythmias (AA) face an increased risk of thromboembolic events. Limited data exist on the use of non-vitamin K oral anticoagulants for thromboprophylaxis in ACHD. We aimed to assess the effectiveness and safety of apixaban in ACHD patients with AA. PROTECT-AR (NCT03854149) was a prospective, multicenter, observational study conducted from 2019 to 2023. ACHD patients with atrial fibrillation, atrial flutter, or intra-atrial re-entrant tachycardia on routine apixaban treatment were included. The historical control group consisted of patients previously on vitamin K antagonist (VKA), who were analyzed prior to their transition to apixaban. The primary effectiveness endpoint was the composite of stroke or thromboembolism. The primary safety endpoint was major bleeding. The study enrolled 218 ACHD patients with AA on apixaban, of which 73 were previous VKA users. The analysis covered 527 patient-years of prospective exposure to apixaban and 169 patient-years of retrospective exposure to VKA. The annualized rate of stroke or thromboembolism was 0.6% in the apixaban group and 1.8% in the VKA group (absolute difference − 1.2%; upper limit of one-sided 95% confidence interval [CI] 0.9%, lower than the predefined non-inferiority margin of +1.8%, P non-inferiority < 0.001). The annualized rate of major bleeding was 1.5% in the apixaban group and 2.4% in the VKA group (hazard ratio 0.64; 95% CI 0.19–2.10, P = 0.48). In ACHD patients with AA, routine apixaban use exhibited a non-inferior rate of stroke or thromboembolism compared to historical VKA use, alongside a similar rate of major bleeding. • Apixaban was associated with low rates of thromboembolism and major bleeding. • Long-term safety and effectiveness of apixaban were comparable to VKA. • Apixaban was linked to reduced non-major bleeding and improved QoL compared to VKA. ACHD, adults with congenital heart disease; CI, confidence interval, VKA, vitamin K antagonist. [Display omitted] [ABSTRACT FROM AUTHOR]