An Unexpected Cause of Bradycardia in a Patient with Bacterial Meningitis

Sinus bradycardia which is a sinus rhythm with a resting heart rate of less than 60 bpm is caused by intrinsic cardiac disorders like sick sinus syndrome or inferior myocardial infarction, metabolic and environmental causes (such as hypothyroidism and electrolyte disorders), medications (such as beta-blockers and amiodarone), infection (such as myocarditis), increased intracranial pressure, and toxic exposure, while it can sometimes be a normal phenomenon, especially during sleep, in athletes, and during pregnancy. Symptomatic sinus bradycardia should warrant a thorough work-up in order to identify any reversible causes; otherwise, placement of a permanent pacemaker could be needed. We present the case of a patient who was admitted due to confusion and fever and was found to have pneumococcal meningitis and bacteremia, and during his hospital stay he developed symptomatic sinus bradycardia that was of intractable cause and persistent. Placement of a permanent pacemaker was chosen until the night staff of the hospital discovered by chance the neglected cause of his bradycardia

Photocatalytic and sonolytic oxidation of acid orange 7 in aqueous solution

Δημοσίευση σε επιστημονικό περιοδικόSummarization: The oxidation of 50 mg/L azodye acid orange 7 (AO7) in water was investigated by means of photocatalysis in the presence of various semiconducting catalysts and ultrasound irradiation. The UVA-induced photocatalytic degradation over TiO2 anatase suspensions was found to increase with increasing catalyst concentration, decreasing solution pH, as well as in the presence of dissolved oxygen. The presence of 1,4-benzoquinone, sodium azide or sodium chloride in the reaction mixture decreased degradation due to the scavenging of radicals and other reactive moieties. Interestingly, addition of hydrogen peroxide at various concentrations from 21 to 1050 mg/L also inhibited degradation. The sonochemical degradation of AO7 was found to increase with increasing frequency and decreasing temperature. Under similar treatment conditions, ultrasound irradiation resulted in higher conversion than photocatalysis; moreover, the sonochemically irradiated solution consistently contained low aliphatic intermediates, while the photocatalytically treated solution mainly consisted of aromatic intermediates as confirmed by GC–MS analysis. The acute toxicity to marine bacteria V. fischeri decreased following oxidation with either process. Furthermore, deep sonochemical treatment slightly improved the aerobic biodegradability as assessed by shake flask tests.Presented on: Applied Catalysis B: Environmenta

The burden and management of anemia in Greek patients with inflammatory bowel disease: a retrospective, multicenter, observational study

Background: Anemia is a common extraintestinal manifestation of Inflammatory Bowel Disease (IBD) affecting negatively the patients’ quality of life. The aim of this study was to determine the frequency and real-life management of anemia in IBD patients in Greece. Methods: This study was conducted in 17 Greek IBD referral centers. Demographic, clinical, laboratory, IBD and anemia treatment data were collected and analyzed retrospectively. Results: A total of 1394 IBD patients [560 ulcerative colitis (UC), 834 Crohn’s disease (CD)] were enrolled. Anemia at any time was reported in 687 (49.3%) patients of whom 413 (29.6%) had episodic and 274 (19.7%) had recurrent/persistent anemia. Anemia was diagnosed before IBD in 45 (6.5%), along with IBD in 269 (39.2%) and after IBD in 373 (54.3%) patients. In the multivariate analysis the presence of extraintestinal manifestations (p = 0.0008), IBD duration (p = 0.026), IBD related surgeries and hospitalizations (p = 0.026 and p = 0.004 accordingly) were risk factors of recurrent/persistent anemia. Serum ferritin was measured in 839 (60.2%) IBD patients. Among anemic patients, 535 (77.9%) received treatment. Iron supplementation was administered in 485 (90.6%) patients, oral in 142 (29.3%) and intravenous in 393 (81%). Conclusions: The frequency of anemia in IBD patients, followed at Greek referral centers, is approximately 50%. Development of recurrent/persistent anemia may be observed in 20% of cases and is independently associated with the presence of extraintestinal manifestations, IBD duration, IBD related surgeries and hospitalizations. Anemia treatment is administered in up to [Formula: see text] of anemia IBD patients with the majority of them receiving iron intravenously

Endoscopic Postoperative Recurrence In Crohn's Disease After Curative Ileocecal Resection With Early Prophylaxis By Anti-Tnf, Vedolizumab Or Ustekinumab: A Real-World Multicenter European Study

Background: Endoscopic-post-operative-recurrence [ePOR] in Crohn's disease [CD] after ileocecal resection [ICR] is a major concern. We aimed to evaluate the effectiveness of early prophylaxis with biologics and to compare anti-tumour necrosis factor [anti-TNF] therapy to vedolizumab [VDZ] and ustekinumab [UST] in a real-world setting.Methods: A retrospective multicentre study of CD-adults after curative ICR on early prophylaxis was undertaken. ePOR was defined as a Rutgeerts score [RS] >= i2 or colonic-segmental-SES-CD >= 6. Multivariable logistic regression was used to evaluate risk factors, and inverse probability treatment weighting [IPTW] was applied to compare the effectiveness between agents.Results: The study included 297 patients (53.9% males, age at diagnosis 24 years [19-32], age at ICR 34 years 126-431, 18.5% smokers, 276% biologic-naive, 65.7% anti-TNF experienced, 28.6% two or more biologics and 17.2% previous surgery). Overall, 224, 39 and 34 patients received anti-TNF, VDZ or UST, respectively. Patients treated with VDZ and UST were more biologic experienced with higher rates of previous surgery. ePOR rates within 1 year were 41.8%. ePOR rates by treatment groups were: anti-TNF 40.2%, VDZ 33% and UST 61.8%. Risk factors for ePOR at 1 year were: past-infliximab (adjusted odds ratio [adj.OR] = 1.73 [95% confidence interval, CI: 1.01-2.97]), past-adalimumab [adj.OR = 2.32 [95% CI: 1.35-4.01] and surgical aspects. After IPTW, the risk of ePOR within 1 year of VDZ vs anti-TNF or UST vs anti-TNF was comparable (OR = 0.55 [95% CI: 0.25-1.19], OR = 1.86 [95% CI: 0.79-4.381), respectively.Conclusion. Prevention of ePOR within 1 year after surgery was successful in -60% of patients. Patients treated with VDZ or UST consisted of a more refractory group. After controlling for confounders, no differences in ePOR risk were seen between anti-TNF prophylaxis and other groups