Role of Neutrophil Gelatinase-Associated Lipocalin in the Diagnosis and Early Treatment of Acute Kidney Injury in a Case Series of Patients with Acute Decompensated Heart Failure: A Case Series

Patients with acute decompensated heart failure (ADHF) frequently develop worsening in renal function until Acute Kidney Injury (AKI). The use of kidney injury biomarkers could be useful in the early diagnosis of AKI. In the present study, the role of the neutrophil gelatinase-associated lipocalin (NGAL), compared to the standard creatinine, in ADHF patients, was analyzed to evaluate if an early treatment could affect the outcome. A case series of 24 ADHF patients was enrolled and patients randomly divided in two groups (Group A and Group B). In Group A, NGAL, creatinine, and eGFR were measured, while in Group B, creatinine and eGFR alone were measured. NGAL was measured by turbidimetric immunoassay and creatinine using an enzymatic spectrophotometric method. In presence of AKI, creatinine increase and eGFR decrease were significantly lower in Group A than in Group B, whereas in absence of AKI the difference between the two groups was not significant. Hospitalization stay was significantly lower in Group A (receiving early treatment based on NGAL) than in Group B. In ADHF patients, plasma NGAL in combination with creatinine was superior to the standard creatinine in the diagnosis and early treatment of AKI with a better outcome and a decreased hospital stay

Rheumatic Heart Disease In Eritrean Schoolchildren: Results From An International Cooperation Project

Background Rheumatic Heart Disease is one of the main non-communicable diseases in low-to-middle income countries and represents the second leading cause of cardiovascular morbidity and mortality in endemic areas. To date, no cross-sectional surveys have been conducted in Eritrea. The aim of this study is to determine the prevalence of rheumatic heart disease in eritrean schoolchildren. Methods Randomly selected schoolchildren from 4 to 19 years of age in Eritrea were screened for rheumatic heart disease according to standard echo-cardiographic criteria. Results Echocardiographic screening detected rheumatic heart disease in 390 of 8945 schoolchildren. The overall prevalence of rheumatic heart disease was 43.6 cases per 1000 (95% CI, 39.4 to 47.8). The prevalence was higher in rural areas compared to urban areas (odds ratio 2.2; 95% CI, 2.8 to 1.7; p < 0.0001) and increased with age (chi-squared for trend 12.44; p = 0.0004). The mitral valve and aortic valve were involved in the 97% and 11,3% of cases, respectively. Congenital heart disease was detected in 103 children and the prevalence was 11.5 cases per 1000 (95% CI, 13.7 to 9.3). Conclusions Echocardiographic screening revelead for the first time the prevalence of rheumatic heart disease in eritrean schoolchildren. The prevalence was one of the highest in the world. These results may have important public health implications and may represent a first step for the implementation of a national prevention program