Subclinical calcified atherosclerosis in men and its association with a family history of premature coronary heart disease in first- and second-degree relatives

The authors examined the associations between coronary artery calcification and a family history of premature coronary heart disease in either first-degree (immediate family) or second-degree (grandparents, aunts, uncles) relatives in 1619 asymptomatic healthy men ages 40-50 years. The prevalence of any coronary artery calcification was 19.3% in participants (n=1102) with no family history, 26.6% in those with a first-degree family history (n=203; 12.5%), 26.5% in those with a second-degree family history (n=215, 13.3%), and 30.3% with both (n=99, 6.1%, p=0.003). After controlling for the Framingham risk score, body mass index, and ethnicity, all categories of family history were significant predictors of coronary artery calcification. The odds ratios for coronary artery calcification associated with a first- (1.49; p=0.026) and second-degree (1.41; p=0.049) family history of coronary heart disease were similar. Clinical coronary risk assessments should broadly include an assessment of premature coronary heart disease in both first- and second-degree relatives.     

The role of previously unmeasured organic acids in the pathogenesis of severe malaria

IntroductionSevere falciparum malaria is commonly complicated by metabolic acidosis. Together with lactic acid (LA), other previously unmeasured acids have been implicated in the pathogenesis of falciparum malaria.MethodsIn this prospective study, we characterised organic acids in adults with severe falciparum malaria in India and Bangladesh. Liquid chromatography-mass spectrometry was used to measure organic acids in plasma and urine. Patients were followed until recovery or death.ResultsPatients with severe malaria (n=138), uncomplicated malaria (n=102), sepsis (n=32) and febrile encephalopathy (n=35) were included. Strong ion gap (mean±SD) was elevated in severe malaria (8.2 mEq/L±4.5) and severe sepsis (8.6 mEq/L±7.7) compared with uncomplicated malaria (6.0 mEq/L±5.1) and encephalopathy (6.6 mEq/L±4.7). Compared with uncomplicated malaria, severe malaria was characterised by elevated plasma LA, hydroxyphenyllactic acid (HPLA), α-hydroxybutyric acid and β-hydroxybutyric acid (all P<0.05). In urine, concentrations of methylmalonic, ethylmalonic and α-ketoglutaric acids were also elevated. Multivariate logistic regression showed that plasma HPLA was a strong independent predictor of death (odds ratio [OR] 3.5, 95 % confidence interval [CI] 1.6–7.5, P=0.001), comparable to LA (OR 3.5, 95 % CI 1.5–7.8, P=0.003) (combined area under the receiver operating characteristic curve 0.81).ConclusionsNewly identified acids, in addition to LA, are elevated in patients with severe malaria and are highly predictive of fatal outcome. Further characterisation of their sources and metabolic pathways is now needed.

Electronic supplementary material

The online version of this article (doi:10.1186/s13054-015-1023-5) contains supplementary material, which is available to authorized users.     

Development and application of novel bio-magnetic membrane capsules for the removal of the cationic dye malachite green in wastewater treatment

Novel bio-magnetic membrane capsules (BMMCs) were prepared by a simple two-step titration-gel cross-linking method using a polyvinyl alcohol (PVA) and sodium alginate (SA) matrix to control the disintegration of phytogenic magnetic nanoparticles (PMNPs) in an aqueous environment, and their performance was investigated for adsorbing cationic malachite green (MG) dye from water. The prepared BMMCs were characterized by FTIR, powder XRD, SEM, EDX, XPS, VSM and TGA techniques. The findings revealed that the hysteresis loops had an excellent superparamagnetic nature with saturation magnetization values of 11.02 emu g⁻¹. The prepared BMMCs not only controlled the oxidation of PMNPs but also improved the adsorptive performance with respect to MG dye (500 mg g⁻¹ at 298.15 K and pH 6.5) due to the presence of a large amount of hydrophilic functional groups (hydroxyl/–OH and carboxyl/–COOH) on/in the BMMCs. The smooth encapsulation of PMNPs into the PVA–SA matrix established additional hydrogen bonding among polymer molecular chains, with improved stability, and adsorptive performance was maintained over a wide range of pH values (3–12). Importantly, the prepared BMMCs were easily regenerated just by washing with water, and they could be re-utilized for up to four (4) consecutive treatment cycles without observing any apparent dissolution of iron/Fe⁰ or damage to the morphology. According to the mass balance approach, an estimated amount of 100 mL of treated effluent can be obtained from 160 mL of MG dye solution (25 mg L⁻¹) just by employing a 0.02 g L⁻¹ adsorbent dosage. Finally, a model of BMMCs based on zero-effluent discharge was also proposed for commercial or industrial applications. The prepared BMMCs are greatly needed for improving the water/wastewater treatment process and they can be utilized as an excellent adsorbent to remove cationic pollutants for various environmental applications.

Novel bio-magnetic membrane capsules were prepared by a simple two-step titration-gel cross-linking method using a polyvinyl alcohol and sodium alginate matrix to control the disintegration of phytogenic magnetic nanoparticles in aqueous media.     

Characterization of microbial communities distributed in the groundwater pumped from deep tube wells in the Kathmandu Valley of Nepal

Although groundwater is a major water supply source in the Kathmandu Valley of Nepal, it is known that the groundwater has significant microbial contamination exceeding the drinking water quality standard recommended by the World Health Organization (WHO), and that this has been implicated in causing a variety of diseases among people living in the valley. However, little is known about the distribution of pathogenic microbes in the groundwater. Here, we analysed the microbial communities of the six water samples from deep tube wells by using the 16S rRNA gene sequences based culture-independent method. The analysis showed that the groundwater has been contaminated with various types of opportunistic microbes in addition to fecal microbes. Particularly, the clonal sequences related to the opportunistic microbes within the genus Acinetobacter were detected in all samples. As many strains of Acinetobacter are known as multi-drug resistant microbes that are currently spreading in the world, we conducted a molecular-based survey for detection of the gene encoding carbapenem-hydrolysing β-lactamase (bla(oxa-23-like) gene), which is a key enzyme responsible for multi-drug resistance, in the groundwater samples. Nested polymerase chain reaction (PCR) using two specific primer sets for amplifying bla(oxa-23-like) gene indicated that two of six groundwater samples contain multi-drug resistant Acinetobacter.     

A case of giant aneurysm following percutaneous coronary intervention

The incidence of restenosis has significantly reduced following introduction of drug-eluting stents. However. complications i.e. subacute thrombosis and aneurysm formation may be higher with these stents. We report a case of giant aneurysm formation following drug-eluting stent implantation.     

Infected common iliac artery aneurysm repaired in an infant with cadaveric vein graft

Aneurysms are rare in children. Causes include congenital, traumatic, inflammatory, and infectious etiologies. When and how to best surgically treat arterial aneurysms in a child remain unclear. We present the case of a 3-month-old child with an aneurysm of the left common iliac artery, which was first detected on abdominal ultrasound and was successfully repaired with a cadaveric vein graft.     

Assessment of Swallowing Function Impairment in Patients with Benign Goiters and Impact of Thyroidectomy: A Case Control Study

Background

Swallowing-related quality of life (QoL) in patients with benign thyroid goiters is not much studied. The aim of this study was to assess swallowing function impairment in patients with benign goiters, compare it to a control population, and also find the impact of thyroidectomy and various factors on the outcome of swallowing function.

Methods

We performed a prospective case–control study from September 2009 to September 2011 which consisted of 124 patients who were to undergo primary thyroid surgery and 100 age- and sex-matched controls. A translated and validated modified swallowing quality-of-life (SWAL-QOL) questionnaire was used to assess patients’ perception of dysphagia. Presurgery scores of patients and controls and pre- and postsurgery scores (>6 months after surgery) of patients were compared.

Results

The mean age of males and females in the control and patient groups were 37.7 vs. 39.5 years and 37.4 vs. 39.8 years, respectively. Twelve patients (9.7%) complained of dysphasia at presentation. Sixty-three patients (50.8%) underwent total thyroidectomy and 61 (49.2%) had hemithyroidectomy at the time of initial evaluation, 75, 23.4, and 1.6% of patients were euthyroid, hyperthyroid, and hypothyroid, respectively. Presurgery scores of patients in all of the 11 domains of the SWAL-QOL were lower compared to those of controls. Comparing separately with the matched controls, females had significant differences in nine domains (except for sleep and fatigue) of the SWAL-QOL questionnaire but males did not. Postoperatively, both male and female patients showed significant improvement in the scores of all the domains. Female gender, hyperthyroidism, thyroid nodularity, retrosternal extension, procedure, and weight of the resected specimen were the factors associated with significant improvement in various domains.

Conclusion

Dysphagia seems to be an underestimated problem in patients with benign goiters. Uncomplicated thyroidectomy results in significant improvement in swallowing-related QoL irrespective of patient profile and extent of thyroidectomy.