Heart failure with improved ejection fraction (HFimpEF) has emerged in recent years as a distinct clinical phenotype within the spectrum of heart failure subtypes. Current evidence supports the hypothesis that HFimpEF represents a state of functional remission rather than a definitive cure, with important clinical implications, particularly for the continuation of guideline-directed medical therapy (GDMT) and for decision-making regarding device therapies. Withdrawal or de-escalation of treatment is associated with high rates of recurrent systolic function deterioration, justifying the indefinite continuation of disease-modifying therapy. A descriptive narrative review of the available literature was performed to summarise current evidence on the definition, epidemiology, pathophysiological mechanisms, left ventricular ejection fraction (LVEF) trajectories, advanced diagnostic tools, and therapeutic considerations in HFimpEF, and to discuss the main knowledge gaps and future research directions. A better understanding of this phenotype will enable more effective risk stratification and progress towards more individualised management of patients with heart failure, with potential benefits for long-term patient outcomes and care.
Background. Brugada syndrome (BrS) is associated with an elevated risk of sudden cardiac death (SCD). This study investigated health-related quality of life (HRQoL) among patients with BrS and examined whether clinical features and indicators of arrhythmic risk are related to patient-reported well-being.Methods. The study included 70 patients who were divided into three groups: spontaneous or sodium channel blocker test (SCBT) induced type 1 BrS electrocardiogram pattern (T1BrP), patients with negative SCBT, and control group. All patients completed the Short Form Health Survey version 2 (SF-36v2) questionnaire and underwent detailed SCD risk stratification.Results. The HRQoL of patients with T1BrP (median Modified Shanghai score was 4 [3.5–4.5], median Sieira score = 1 [0–2] points) did not differ compared with those with negative SCBT. In patients with T1BrP the Sieira score correlated with a poorer self-assessment of health (p = 0.014, R = 0.50), increased limitations in lifting or carrying groceries (p = 0.004, R = -0.57) and a stronger disagreement with the statement that they are as healthy as anybody they know (p = 0.019, R = 0.48). Moreover, Sieira score correlated negatively with Physical Functioning scale score (p = 0.025, R = -0.47). Among patients with T1BrP, those who experienced syncope, showed lower scores on the General Health scale compared to the remainder (51 [27–57] vs. 67 [57–82] points, p = 0.032). Conclusions. The diagnosis of BrS, especially among patients at low risk of SCD, does not significantly affect HRQoL. However, patients with T1BrP and higher clinical risk tend to feel less healthy and more limited in their daily lives.
Aim. Hop leaves represent an underutilised by-product of hop cultivation and a potential source of bioactive compounds. This study aimed to compare the chemical composition, antioxidant activity, metal-chelating capacity, and enzyme inhibitory potential of leaves and cones from four hop cultivars (Blisk, Nugget, Bačka, and Saphir).Material and methods. Hop leaf and cone extracts were chemically characterised, and their antioxidant, metal-chelating, and enzyme-inhibitory activities were evaluated using in vitro assays. Total phenolic content (TPC) was determined spectrophotometrically, while xanthohumol and lupulone were quantified by HPLC. Chemical profiles were characterised using GC–MS. Antioxidant activity was evaluated using DPPH, ABTS, FRAP, and CUPRAC assays. Metal-chelating activity and the inhibition of acetylcholinesterase, butyrylcholinesterase, and tyrosinase were also assessed.Results. Cones exhibited higher TPC and greater concentrations of xanthohumol and lupulone than leaves. The highest TPC was recorded for Blisk cones (22.01 mg GAE/g), whereas leaves contained 6.54–12.70 mg GAE/g. Blisk cones contained the highest xanthohumol concentration (2.55 mg/g) and showed the strongest cholinesterase inhibition, with IC50 values of 15.9 mg/mL and 17.98 mg/mL against acetylcholinesterase and butyrylcholinesterase, respectively. Among the leaves, the Blisk cultivar exhibited the highest antioxidant activity and enzyme-inhibitory potential, with acetylcholinesterase inhibition (IC50 = 20.4 mg/mL) comparable to that of selected cone samples. In contrast, metal-chelating activity was stronger in leaves (IC50 = 3.17–3.64 mg/mL) than in cones (5.93–10.91 mg/mL). Principal component analysis indicated associations between phenolic content, antioxidant activity, and cholinesterase inhibition.Conclusions. These findings demonstrate that hop leaves are a valuable source of compounds with antioxidant, metal-chelating, and enzyme-inhibitory activities that may be relevant to neuroprotection. In particular, leaves of the Blisk cultivar exhibited biological activity comparable to that of selected cone samples, supporting their further investigation for food, nutraceutical, and pharmaceutical applications.
Torsio testis adalah kedaruratan urologi yang menyebabkan kerusakan jaringan akibat cedera iskemia-reperfusi, seringkali berujung pada infertilitas. Belum ada agen terapeutik standar untuk kondisi ini. Platelet Rich Plasma (PRP), sebagai agen autolog kaya faktor pertumbuhan, memiliki potensi mengurangi stres oksidatif dan memperbaiki sel. Penelitian ini bertujuan menganalisis pengaruh PRP terhadap perbaikan histopatologi testis dan kualitas spermatozoa tikus pasca torsio. Penelitian eksperimental ini menggunakan 15 tikus putih jantan (Rattus norvegicus) yang dibagi 3 kelompok, Kelompok I (Torsio + PRP 10 µl intratestikular), Kelompok II (Torsio tanpa PRP), dan Kelompok III (Kontrol normal). Torsio 720° diinduksi selama 4 jam, diikuti detorsi. Evaluasi histopatologi dan kualitas spermatozoa (konsentrasi, motilitas, viabilitas, morfologi) dilakukan setelah 14 hari. Secara histopatologi, Kelompok I (PRP) menunjukkan perbaikan jaringan tubulus seminiferus yang lebih baik dibanding Kelompok II (Torsio). Analisis spermatozoa menunjukkan Kelompok I memiliki rerata konsentrasi, motilitas, dan morfologi normal yang secara signifikan lebih tinggi dibanding Kelompok II (p<0,05). Namun, tidak ada perbedaan signifikan pada viabilitas. Pemberian PRP berpengaruh positif terhadap perbaikan histopatologi tubulus seminiferus dan secara signifikan meningkatkan kualitas spermatozoa (konsentrasi, mortilitas, dan morfologi) pada tikus pasca torsio testis.
Hepatocellular Carsinoma (HCC) merupakan kanker hati primer yang paling sering ditemukan dan menjadi penyebab utama kematian akibat kanker di dunia. Alpha-fetoprotein (AFP) digunakan secara luas sebagai penanda tumor dalam diagnosis dan pemantauan HCC, di mana peningkatan kadar AFP diduga berkorelasi dengan derajat keparahan penyakit berdasarkan sistem klasifikasi Barcelona Clinic Liver Cancer (BCLC). Penelitian ini bertujuan untuk mengetahui hubungan antara kadar AFP dengan derajat keparahan HCC berdasarkan klasifikasi BCLC di RSUD dr. Zainoel Abidin Banda Aceh tahun 2024. Penelitian ini menggunakan desain observasional analitik dengan pendekatan cross-sectional, dengan data diperoleh dari rekam medis pasien HCC yang memenuhi kriteria inklusi. Sebanyak 40 pasien dijadikan sampel dan dibagi berdasarkan stadium BCLC (A–D), kemudian dianalisis menggunakan uji Kruskall Wallis karena data tidak berdistribusi normal. Hasil penelitian menunjukkan bahwa distribusi pasien terbanyak terdapat pada stadium BCLC B (37,5%) dengan mayoritas berjenis kelamin laki-laki dan rentang usia 14–74 tahun. Kadar AFP menunjukkan rentang luas (1,41–1000 ng/mL) dengan nilai yang meningkat seiring bertambahnya derajat BCLC dimana kadar AFP pada stadium A dan B yaitu 1,41-1000 ng/mL dan stadium C dan D yaitu 68,86-1000 ng/mL, serta terdapat perbedaan signifikan antara kadar AFP pada stadium A, B,C,dan D dengan p = 0,01. Penelitian ini menunjuukan terdapat hubungan bermakna antara kadar AFP dengan derajat keparahan HCC, di mana peningkatan kadar AFP pada stadium lanjut mencerminkan aktivitas tumor yang lebih agresif serta gangguan fungsi hati yang lebih berat. Pemeriksaan AFP dapat dijadikan indikator tambahan dalam menilai progresivitas HCC meskipun perlu dikombinasikan dengan penilaian klinis dan radiologis lainnya.
