Newly developed post-operative atrial fibrillation is associated with an increased risk of late recurrence of atrial fibrillation in patients who underwent open heart surgery: Long-term follow up

Background: Herein is sought to determine whether the occurrence of post-operative atrial fibrillation (POAF) increases the risk of late recurrence of atrial fibrillation (AF) in patients undergoing open heart surgery (OHS). Methods: This study included 938 patients (56.7 ± 13.1 years old, 550 males) with no history of AF who underwent OHS. All patients were monitored continuously for development of POAF after surgery until the time of hospital discharge and received clinical follow up with serial evaluation of rhythm status. Results: Among the total population, POAF occurred in 207 (22.1%) patients and late AF in 88 (9.4%) patients during the mean follow up period of 78.1 ± 39.1 months. Development of late AF oc¬curred more frequently in patients with POAF than in those without [29.0% (60/207) vs. 3.8% (28/731), p < 0.01]. Higher septal E/e’ ratio (HR 1.04, 95% CI 1.00–1.08, p = 0.04) was an independent predic¬tor of late occurrence of AF and an episode of POAF (HR 27.12, 95% CI 8.46–86.96, p < 0.01) was the most powerful predictor. Conclusions: POAF is significantly associated with an increased risk of late AF recurrence during long-term follow up. Careful concern regarding late recurrence of AF with serial evaluation of rhythm status is required in patients with POAF

Retropharyngeal abscess coinfected with and after rhinoviral infection in a 1-month-old infant

A retropharyngeal abscess is a rare disease entity in young infants but can develop after nasopharyngeal viral infection. Group B Streptococcus and Staphylococcus aureus are the most common pathogens in young infants, however, Mycobacterium tuberculosis is very rare. We report the case of retropharyngeal abscess and coinfection with S. aureus and M. tuberculosis in a very young infant presenting with respiratory symptoms due to upper airway obstruction. Usually tuberculous retropharyngeal abscesses are caused by the direct invasion of the bacteria from the spine via anterior longitudinal ligament of the spine. However, in this case, no associated spinal disease was observed

Effect of lactarius piperatus fruiting body maturity stage on antioxidant activity measured by several biochemical assays

The effects of fruiting body maturity on antioxidant activity and antioxidants production of the wild mushroom, Lactarius piperatus, were evaluated. Several biochemical assays were used to screen the antioxidant properties: reducing power, 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging capacity, inhibition of erythrocytes hemolysis mediated by peroxyl radicals and inhibition of lipid peroxidation using the b-carotene linoleate model system. The amounts of phenols, flavonoids, ascorbic acid, b-carotene and lycopene present in the immature, mature and degraded fruiting bodies were also determined. The highest antioxidant contents and the lowest EC50 values for antioxidant activity were obtained in the mature stage with immature spores

Chemical composition, and antioxidant and antimicrobial activities of three hazelnut (Corylus avellana L.) cultivars.

Hazelnut (Corylus avellana L.) is a very popular dry fruit in the world being consumed in different form and presentations. In the present work, three hazelnut cultivars (cv. Daviana, Fertille de Coutard and M. Bollwiller) produced in Portugal, were characterized in respect to their chemical composition, antioxidant potential and antimicrobial activity. The samples were analysed for proximate constituents (moisture, fat, crude protein, ash), nutritional value and fatty acids profile by GC/FID. Antioxidant potential was accessed by the reducing power assay, the scavenging effect on DPPH (2,2-diphenyl-1-picrylhydrazyl) radicals and b-carotene linoleate model system. Their antimicrobial capacity was also checked against Gram positive (Bacillus cereus, B. subtilis, Staphylococcus aureus) and Gram negative bacteria (Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae) and fungi (Candida albicans, Cryptococcus neoformans). Results showed that the main constituent of fruits was fat ranging from 56% to 61%, being the nutritional value around 650 kcal per 100 g of fruits. Oleic was the major fatty acid varying between 80.67% in cv. F. Coutard and 82.63% in cv. Daviana, followed by linoleic, palmitic, and stearic acids. Aqueous hazelnut extract presented antioxidant activity in a concentration-dependent way, in general with similar behaviour for all cultivars. Hazelnut extracts revealed a high antimicrobial activity against Gram positive bacteria (MIC 0.1 mg/ mL) showing a good bioactivity of these fruits

Validation of Biomarker-Based ABCD Score in Atrial Fibrillation Patients with a Non-Gender CHA2DS2-VASc Score 0-1:A Korean Multi-Center Cohort

PURPOSE: Atrial fibrillation (AF) patients with low to intermediate risk, defined as non-gender CHA(2)DS(2)-VASc score of 0–1, are still at risk of stroke. This study verified the usefulness of ABCD score [age (≥60 years), B-type natriuretic peptide (BNP) or N-terminal pro-BNP (≥300 pg/mL), creatinine clearance (<50 mL/min/1.73 m(2)), and dimension of the left atrium (≥45 mm)] for stroke risk stratification in non-gender CHA(2)DS(2)-VASc score 0–1. MATERIALS AND METHODS: This multi-center cohort study retrospectively analyzed AF patients with non-gender CHA(2)DS(2)-VASc score 0–1. The primary endpoint was the incidence of stroke with or without antithrombotic therapy (ATT). An ABCD score was validated. RESULTS: Overall, 2694 patients [56.3±9.5 years; female, 726 (26.9%)] were followed-up for 4.0±2.8 years. The overall stroke rate was 0.84/100 person-years (P-Y), stratified as follows: 0.46/100 P-Y for an ABCD score of 0; 1.02/100 P-Y for an ABCD score ≥1. The ABCD score was superior to non-gender CHA(2)DS(2)-VASc score in the stroke risk stratification (C-index=0.618, p=0.015; net reclassification improvement=0.576, p=0.040; integrated differential improvement=0.033, p=0.066). ATT was prescribed in 2353 patients (86.5%), and the stroke rate was significantly lower in patients receiving non-vitamin K antagonist oral anticoagulant (NOAC) therapy and an ABCD score ≥1 than in those without ATT (0.44/100 P–Y vs. 1.55/100 P-Y; hazard ratio=0.26, 95% confidence interval 0.11–0.63, p=0.003). CONCLUSION: The biomarker-based ABCD score demonstrated improved stroke risk stratification in AF patients with non-gender CHA(2)DS(2)-VASc score 0–1. Furthermore, NOAC with an ABCD score ≥1 was associated with significantly lower stroke rate in AF patients with non-gender CHA(2)DS(2)-VASc score 0–1

Bioactive properties and chemical composition of six walnut (Juglans regia L.) cultivars

The chemical composition, antioxidant potential and antimicrobial activity were studied in six walnuts (Juglans regia L.) cultivars (cv. Franquette, Lara, Marbot, Mayette, Mellanaise and Parisienne) produced in Portugal. Concerning their chemical composition the main constituent of fruits was fat ranging from 78.83% to 82.14%, being the nutritional value around 720 kcal per 100 g of fruits. Linoleic acid was the major fatty acid reaching the maximum value of 60.30% (cv. Lara) followed by oleic, linolenic and palmitic acids. The aqueous extracts of walnut cultivars were investigated by the reducing power assay, the scavenging effect on DPPH (2,2-diphenyl-1-picrylhydrazyl) radicals and b-carotene linoleate model system. All the walnut extracts exhibited antioxidant capacity in a concentration- dependent manner being the lowest EC50 values obtained with extracts of cv. Parisienne. Their antimicrobial capacity was also checked against gram positive (Bacillus cereus, Bacillus subtilis, Staphylococcus aureus) and gram negative bacteria (Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae) and fungi (Candida albicans, Cryptococcus neoformans), revealing activity against the different tested microorganisms

A comparative study of chemical composition, antioxidant and antimicrobial properties of Morchella esculenta (L.) Pers. from Portugal and Serbia

A comparative study on chemical composition (nutritional value, primary and secondary metabolites), antioxidant properties (scavenging activity, reducing power and inhibition of lipid peroxidation), and antimicrobial activity (antibacterial and demelanizing properties) of two samples of Morchella esculenta (morel) from different countries (Portugal and Serbia) was performed. This species was chosen for being one of the most highly prized edible mushrooms in the world. Both samples are rich in carbohydrates (including free sugars) and proteins, and contain several bioactive compounds such as organic acids, phenolic compounds and tocopherols. Polyunsaturated fatty acids were the most abundant compounds followed by mono or saturated fatty acids. Sample from Portugal (SP) gave higher radical scavenging activity and reducing power, while sample from Serbia (SS) showed higher lipid peroxidation inhibition. Both samples gave antibacterial activity against five bacteria (in some cases even better than standard antibiotics) and demelanizing activity against four micromycetes, showing SS higher activities. As far as we know, this is the first study reporting chemical compounds and bioactivity of morel samples from Portugal and Serbia. Furthermore, a novel method for evaluation of demelanizing activity was presented.The authors are grateful to Fundacao para a Ciencia e a Tecnologia (FCT, Portugal) and COMPETE/QREN/EU (research project PTDC/AGR-ALI/110062/2009; bilateral cooperation action Portugal/Serbia 2011; strategic projects PEst-OE/AGR/UI0690/2011 and PEst-C/QUI/UI0686/2011), and to Serbian Ministry of Education and Science (grant number 173032) for financial support. S.A. Heleno (BD/70304/2010) and L. Barros (BPD/4609/2008) also thank FCT, POPH-QREN and FSE

A contact investigation after exposure to a child with disseminated tuberculosis mimicking inflammatory bowel disease

Purpose Tuberculosis (TB) is one of the most important diseases that cause significant mortality and morbidity in young children. Data on TB transmission from an infected child are limited. Herein, we report a case of disseminated TB in a child and conducted a contact investigation among exposed individuals. Methods A 4-year-old child without Bacille Calmette-Guérin vaccination was diagnosed as having culture-proven disseminated TB. The child initially presented with symptoms of inflammatory bowel disease, and nosocomial and kindergarten exposures were reported. The exposed individuals to the index case were divided into 3 groups, namely household, nosocomial, or kindergarten contacts. Evaluation was performed following the Korean guidelines for TB. Kindergarten contacts were further divided into close or casual contacts. Chest radiography and tuberculin skin test or interferon-gamma-releasing assay were performed for the contacts. Results We examined 327 individuals (3 household, 10 nosocomial, and 314 kindergarten contacts), of whom 18 (5.5%), the brother of the index patient, and 17 kindergarten children were diagnosed as having latent TB infection (LTBI). LTBI diagnosis was more frequent in the children who had close kindergarten contact with the index case (17.1% vs. 4.4%, P=0.007). None of the cases had active TB. Conclusion This is the first reported case of TB transmission among young children from a pediatric patient with disseminated TB in Korea. TB should be emphasized as a possible cause of chronic diarrhea and failure to thrive in children. A national TB control policy has been actively applied to identify Korean children with LTBI

Korean Society of Nephrology 2022 Recommendations on controversial issues in diagnosis and management of hyponatremia

The Korean Society for Electrolyte and Blood Pressure Research, in collaboration with the Korean Society of Nephrology, has published a clinical practice guideline (CPG) document for hyponatremia treatment. The document is based on an extensive evidence-based review of the diagnosis, evaluation, and treatment of hyponatremia with the multidisciplinary participation of representative experts in hyponatremia with methodologist support for guideline development. This CPG consists of 12 recommendations (two for diagnosis, eight for treatment, and two for special situations) based on eight detailed topics and nine key questions. Each recommendation begins with statements graded by the strength of the recommendations and the quality of the evidence. Each statement is followed by rationale supporting the recommendations. The committee issued conditional recommendations in favor of rapid intermittent bolus administration of hypertonic saline in severe hyponatremia, the use of vasopressin receptor antagonists in heart failure with hypervolemic hyponatremia, and syndrome of inappropriate antidiuresis with moderate to severe hyponatremia, the individualization of desmopressin use, and strong recommendation on the administration of isotonic fluids as maintenance fluid therapy in hospitalized pediatric patients. We hope that this CPG will provide useful recommendations in practice, with the aim of providing clinical support for shared decision-making to improve patient outcomes