Electrocardiogram as prognostic and diagnostic parameter in follow up of patients with heart failure

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Albumin to creatinine ratio as a predictor to the severity of coronary artery disease

Introduction: Microalbuminuria (MA) is a well-known risk factor for coronary artery disease (CAD). It is associated with higher cardiovascular mortality, especially in diabetics. However, there are few data linking angiographic severity of CAD to MA.Aim: The aim of the present study was to assess the albumin to creatinine ratio as a new predictor for CAD and to correlate with its severity apart from other traditional CAD risk factors.Methods: Our study included 100 patients with documented CAD by coronary angiography in Alexandria main university hospital. The severity of CAD was scored on the basis of the number and the extent of lesions within the coronary arteries by using Syntax score. Urine albumin excretion was measured for all patients in morning spot urine samples by immune precipitation technique. We correlate between MA and severity of CAD.Results: In a total of 100 patients (74 males and 26 females), (mean age 55.71± 8.99 y) MA was present in 34 patients only. Patients were divided into two groups; group I included those without MA and group II with MA. CAD occurred more frequently in males than in females and in smokers than in non-smokers. There were no significant differences in the prevalence of hypertension and hypercholesterolemia between the two groups. A direct relationship between MA and extension of atherosclerotic coronary lesions was noticed (P = 0.009).Conclusion: Patients with MA having more severe angiographic CAD were compared to those without MA. This relation is independent of other risk factors. MA could be utilized as an independent risk factor for CAD.Keywords: Coronary artery disease (CAD); Microalbuminuria (MA); Albumin–creatinine rati

Influence of Pyrolysis Temperature and Production Conditions on Switchgrass Biochar for Use as a Soil Amendment

Biochars form recalcitrant carbon and increase water and nutrient retention in soils; however, the magnitude is contingent upon production conditions and thermo-chemical conversion processes. Herein we aim at (i) characterizing switchgrass (Panicum virgatum L.)-biochar morphology, (ii) estimating water-holding capacity under increasing ratios of char: soil; and, (iii) determining nutrient profile variation as a function of pyrolysis conversion methodologies (i.e. continuous, auger pyrolysis system versus batch pyrolysis systems) for terminal use as a soil amendment. Auger system chars produced at 600 °C had the greatest lignin portion by weight among the biochars produced from the continuous system. On the other hand, a batch pyrolysis system (400 °C – 3h) yielded biochar with 73.10% lignin (12 fold increases), indicating higher recalcitrance, whereas lower production temperatures (400 °C) yielded greater hemicellulose (i.e. greater mineralization promoting substrate). Under both pyrolysis methods, increasing biochar soil application rates resulted in linear decreases in bulk density (g cm-3). Increases in auger-char (400 °C) applications increased soil water-holding capacities; however, application rates of \u3e2 Mt ha-1 are required. Pyrolysis batch chars did not influence water-holding abilities (P\u3e0.05). Biochar macro and micronutrients increased, as the pyrolysis temperature increased in the auger system from 400 to 600 °C, and the residence time increased in the batch pyrolysis system from 1 to 3 h. Conversely, nitrogen levels tended to decrease under the two previously mentioned conditions. Consequently, not all chars are inherently equal, in that varying operation systems, residence times, and production conditions greatly affect uses as a soil amendment and overall rate of efficacy

Molecular and serological techniques for the diagnosis of culture negative infective endocarditis in Alexandria Main University Hospital

AbstractBackground and aimCulture-negative infective endocarditis (CNIE) is a diagnostic dilemma. The study was carried out to estimate the prevalence of CNIE among definite IE cases, to describe the epidemiologic and clinical characteristics of CNIE patients and to diagnose the microbial etiology of CNIE using molecular and serological techniques.Subjects and methodsSixty-five definite IE cases were enrolled in a prospective observational study between January and December 2010. CNIE cases were tested by 16SrRNA and seminested PCR for 35 blood samples, serological tests and the study of ten valve tissue specimens.ResultsCNIE constituted 39 (60%) cases. The mean age of CNIE patients was 31years. Male to female ratio was 2.9:1. Healthcare associated IE accounted for 15.4%, native valve IE for 66.7% and intravenous drug abuse for 20.5% of cases. The mitral valve was the most frequently involved (56.4%). Out of 39 CNIE cases, seminested blood PCR detected 12 cases (ten Staphylococci, two Streptococci). Five cases were reactive by serology (three Bartonella, one Coxiella, and one Brucella). Six cases were positive by analysis of valve tissue (three Staphylococci, three Streptococci). The combined results of all diagnostic tools decreased the percentage of non-identified causes of CNIE from 60% to 24.6%.ConclusionsOur data underlined the role of collecting blood culture before starting antibiotics and the role of seminested PCR in the diagnosis of conventional causes of CNIE. The importance of serology to identify non conventional causes was also highlighted

Genes Contributing to Staphylococcus aureus Fitness in Abscess- and Infection-Related Ecologies

ABSTRACT Staphylococcus aureus is a leading cause of both community- and hospital-acquired infections that are increasingly antibiotic resistant. The emergence of S. aureus resistance to even last-line antibiotics heightens the need for the development of new drugs with novel targets. We generated a highly saturated transposon insertion mutant library in the genome of S. aureus and used Tn-seq analysis to probe the entire genome, with unprecedented resolution and sensitivity, for genes of importance in infection. We further identified genes contributing to fitness in various infected compartments (blood and ocular fluids) and compared them to genes required for growth in rich medium. This resulted in the identification of 426 genes that were important for S. aureus fitness during growth in infection models, including 71 genes that could be considered essential for survival specifically during infection. These findings highlight novel as well as previously known genes encoding virulence traits and metabolic pathways important for S. aureus proliferation at sites of infection, which may represent new therapeutic targets