Phylogenetic Groups of Escherichia coli Strains from Patients with Urinary Tract Infection in Iran Based on the New Clermont Phylotyping Method

Objectives.In2013,ClermontclassifiedE.colistrainsintoeightphylogeneticgroupsusinganewquadruplexPCRmethod.Theaims ofthisstudyweretoidentifythephylogeneticgroupsofE.colibasedonthismethodandtoassesstheirantibioticresistancepatterns inBushehr,Iran.Methods.Inthiscross-sectionalstudy,140E.coliisolatesweresubjectedtophylogenetictypingbyaquadruplex PCR method. Antimicrobial susceptibility testing was performed by disk diffusion method. Results. Phylogenetic group B2 was mostpredominant(39.3%),followedbyunknown(27.1%),E(9.3%),CandcladeI(each6.4%),B1(5%),FandD(each2.9%),and A(0.7%).Themostcommonantibioticresistancewasrelatedtoamoxicillin(82.1%)andtheleasttomeropenem(0.7%).82.14%of isolatesweremultipledrugresistant(MDR).AntibioticresistancewasmainlydetectedingroupB2(50%).Conclusions.Ourfindings showedthehighprevalenceofMDRE.coliisolateswithdominanceofgroupB2.About25%ofE.coliisolatesbelongtothenewly describedphylogroupsC,E,F,andcladeI.Suchstudiesneedtobedonealsoinotherregionstoprovidegreaterunderstandingof theantibioticresistancepatternandtheprevalencesofdifferentphylogeneticgroups

Radiolabeled neurogenesis marker imaging: A revolution in the neurological diseases management?

A reduced rate of neurogenesis occurs in the adult brain of patients with neurological diseases, with the rate of new neuron proliferation not sufficient to replace neuron loss. Neurogenesis can be induced by several factors, including basic fibroblast growth factor, epidermal growth factor, and brain-derived neurotrophic factor. Neurogenesis determination is a valuable parameter for determining disease progression and monitoring various treatments. Currently, neurogenesis detection is possible by invasive methods, such as bromodeoxyuridine (BrdU) cell labeling and immunohistological analysis of immature neuron markers. However, these are not compatible with alive model examination. Neurogenesis detection by noninvasive methods, such as radiolabeling of specific antibodies and scintigraphy imaging, could shed light on immature neuronal markers. We propose that brain scintigraphy after radiolabeling of a specific antibody of an immature neuronal marker is a useful new modality for neurogenesis detection and that it would aid the management of neurological diseases

Antiepileptic Treatment Is Associated with Bone Loss: Difference in Drug Type and Region of Interest

effects of antiepileptic drugs (AEDs) on bone mineral density (BMD) are well addressed, but data on children, especially concerning new antiepileptic medications, are scarce. This study aimed to reveal the impact of these drugs on the BMD of ambulatory patients with epilepsy. Methods: BMD and detailed clinical information were obtained on 108 patients and 38 controls using dual-energy x-ray absorptiometry. The patients were categorized into 2 groups: enzyme-inducing AEDs (EIAEDs) and non-EIAEDs. Also, the patients were classified as being in either a monotherapy or a polytherapy group. All patients completed a 63-item questionnaire. In this study, the raw value of BMD, T score, and z score of the spine, neck of femur, total hip, and forearm were analyzed. Results: Patients receiving AEDs showed diminished lumbar BMD, compared with controls (P , 0.05), regardless of the type of AED (EIAEDs or non-EIAEDs). In addition, there was a significant decrease in femoral neck BMD in patients receiving EIAEDs (0.922 6 0.161, P , 0.05) but not in those treated with non-EIAEDs. Patients undergoing carbamazepine monotherapy (33 patients) showed diminished lumbar and femoral neck BMD, whereas those receiving valproate (22 patients) or undergoing polytherapy showed a BMD similar to that of controls in all studied regions of interest. There was no notable change in BMD in the Ward triangle, trochanter, or total hip in either the EIAED or the non-EIAED group. Conclusion: AED therapy, especially in patients on new-generation medication, is associated with low bone density. It is hoped that the presented data stressing several clinical and diagnostic points will stimulate a high index of suspicion to facilitate early diagnosis an

Comparison of 180° and 360° Arc Data Acquisition to Measure Scintigraphic Parameters from Gated Single Photon Emission Computed Tomography Myocardial Perfusion Imaging: Is There Any Difference?

Objective: The aim of the current study was to compare 180° and 360° data collection modes to measure end diastolic volume (EDV), end systolic volume (ESV) and ejection fraction (EF) values of the cardiac system by gated myocardial perfusion tomography. Methods: Thirty-three patients underwent gated myocardial perfusion tomography. Single photon emission computed tomography data of patients’ heart were acquired by 180°, 45° left posterior oblique to 45° right anterior oblique, and 360° to obtain EDV, ESV, EF and cardiac volume changes (V1, V2, V3, V4, V5, V6, V7 and V8) throughout each cardiac cycle. Results: Results of the current study indicated that there were no significant differences between 180° and 360° angular sampling in terms of measuring EDV, ESV and EF in myocardial perfusion imaging. Cardiac volume change patterns during a cardiac cycle were also similar in 360° and 180° scans. We also observed that there was no difference in EDV, ESV and EF values between the group with stress induced by exercise and the group with stress imposed by dipyridamole. Conclusion: As there is no difference between 180°and 360° cardiac scanning in terms of EDV, ESV and EF, half-orbit scan is recommended to study these cardiac system parameters because it offers more comfort to patients and a shorter scanning time. Keywords: 180° data collection, 360° data collection, ejection fraction, end diastolic volume, end systolic volume, gated myocardial perfusio

The effect of oxygen on the outcomes of non-ST-segment elevation acute coronary syndromes

Background This study aims to investigate the effect of oxygen in patients with non-ST-segment elevation acute coronary syndromes(NSTE-ACS) and those without hypoxia. Methods In this clinical trial, the study population includes 72 patients (41 men and 31 women) aged 18 to 84 years old who were admitted to the emergency ward, diagnosed with NSTE-ACS, and had oxygen saturation level above 90% at the time of admission. By using the random sampling methods, the patients were divided into two groups: the intervention group (36) and the control group (36). In addition to the usual treatment in the first 6 h of admission to the emergency ward, the subjects in the intervention group received oxygen with nasal cannula at a rate of 4 to 6 l per minute, whereas the control group was given the same treatment with room air. Then we compared the incidence of some outcomes in the two groups. Results The Mann–Whitney U test indicated no significant difference between the means of dysrhythmia (p = 0.141) during the first 24 h, troponin (p = 0.911), left ventricular ejection fraction (p = 0.419), frequency of angina (p = 0.214), and consumption of opioid analgesics (p = 0.297) during the second 24 h and duration of hospitalization (p = 0.887). Conclusion The use of supplemental oxygen (FiO2: 40–45%) has no significant impact on clinical outcomes in patients with NSTE-ACS without hypoxia. Therefore, it is recommended that its routine use in patients without hypoxia be limited

Assessment of the synergistic association of serum concentration of vitamin D, vitamin K and osteocalcin with coronary atherosclerosis in patients undergoing angiography

Objective: The aim of this study was to assess the association between serum concentration of vitamin D, vitamin K, and osteocalcin with coronary atherosclerosis in patients undergoing angiography. Design: In this case-control study, 138 people who referred to Bushehr Heart Center for routine examination participated. Demographic information of the participants was registered by using a standard questionnaire. Before undergoing the angiographic processes, venous blood samples were obtained via venipuncture from the antecubital vein into gel and clot activator tubes and stored at – 80 °C until the analysis. After the angiography process was over, the normal participants entered the control group and those with coronary atherosclerosis plaque placed in the case group. Finally, serum levels of vitamin K2 and Osteocalcin were measured in the samples, by using ELISA kits and the serum level of vitamin D was measured by using HPLC. Result: serum levels of vitamin D in the case group were significantly lower than in the control (p = 0.009) and, serum levels of osteocalcin in the case group were significantly higher than in the control (P = 0.019). There was no difference in K2 level between the two groups (P = 0.84). By separating the three factors like age, sex and T2DM in the two groups, a significant synergistic was found between the concentration of osteocalcin, vitamin D (just in <20 ng/ml) and coronary atherosclerosis (p = 0.025, p = 0.029 respectively). Further, an association was observed between vitamin D level and the severity of atherosclerosis (P = 0.041).). Conclusion: the results of this study suggest that the increase in the level of osteocalcin and the deficiency of vitamin D is significantly associated with coronary atherosclerosis but, not with vitamin k2. Moreover, serum vitamin D concentration is associated with severity of coronary atherosclerosis

A case of apathetic hyperthyroidism with exudative low SAAG ascites

The development of ascites in hyperthyroid patients is a rare phenomenon and usually occurs in the context of exaggeration of right-sided heart failure , so it is categorized as high SAAG ascites. In this case report, we present a 73-year-old man who was referred to us with anorexia, severe weight loss, anemia, lower limbs pitting edema, and also exudative, low SAAG ascites. Extensive work up revealed that these constellation of signs & symptoms were consequent to decompensation of his chronic right-sided heart failure resulting from apathetic hyperthyroidism

Effects of N-acetyl cysteine and melatonin on early reperfusion injury in patients undergoing coronary artery bypass grafting: A randomized, open-labeled, placebo-controlled trial

OBJECTIVES: This study assessed the efficacy of oral consumption of N-acetyl cysteine (NAC) and melatonin (ML) in reducing early reperfusion injury and acute oxidative stress in patients undergoing coronary artery bypass grafting (CABG) with respect to the measurements of cardiac troponin I, lactate, malondealdehyde (MDA), and tumor necrosis factor-α (TNF-α) levels in the blood. METHODS: This study was a randomized, open-label, placebo-controlled trial. Eighty eight patients, aged between 39 to 76 years and eligible for CABG, were recruited and randomly assigned into 3 intervention groups through a simple randomization method and underwent CABG surgery. Blood samples were withdrawn from arterial line, before the induction of anesthesia (before the start of surgery), after incision (before aortic cross-clamping), during global ischemia (during aortic cross-clamping), after aortic cross-clamping (on set of reperfusion), 15 minutes after reperfusion, and after recovery at the intense care unit. The blood samples were analyzed for troponin I, lactate, MDA and TNF-α levels. RESULTS: There was no significant difference in influencing variables among the groups at the baseline. Overall mean troponin I, lactate, and TNF- α levels were significantly different between the intervention groups (all P < .001) at the recovery phase. Post-hoc pairwise comparisons showed that the differences of mean serum levels between ML and control groups were statistically significant for MDA, TNF- α, lactate, and troponin I (P < .001, P = .001, and P = .001, respectively). The differences between NAC and control groups and between ML and NAC groups were only significant for mean lactate level (P < .001). CONCLUSION: The current study revealed that ML and NAC are potent antioxidants with similar efficacy in terms of reducing CABG related cardiac injury and oxidative stress with the dosage employed for the intervention