Correlation between the serum lumican level and the severity of coronary artery disease.

OBJECTIVE: Several studies have previously shown that some small leucine-rich proteoglycans (SLRPs) are associated with atherosclerotic plaque. We aim to investigate the relationship between circulating lumican levels and the severity of coronary artery disease (CAD). PATIENTS AND METHODS: This study included 255 consecutive patients who underwent coronary angiography for stable angina pectoris. All demographic and clinical data were collected prospectively. The severity of CAD was assessed based on the Gensini score and a value >40 was defined as advanced CAD. RESULTS: Eighty-eight patients were in the advanced CAD group; these are older and the frequency of diabetes mellitus, cerebrovascular accidents, reduced ejection fraction (EF), left atrium diameter was higher. Serum lumican levels were found as higher in advanced CAD group (0.4 ng/ml vs. 0.6 ng/ml, respectively, p<0.001). When the Gensini score increased, a statistically significant increase was observed in lumican levels with a good correlation (r=0.556 and p<0.001). In multivariate analysis, diabetes mellitus, EF and lumican were predictive for advanced CAD. Lumican level predicts CAD seriousness with a sensitivity rate of 64%, specificity rate of 65%. CONCLUSIONS: In this study, we reveal a relationship between serum lumican levels and CAD severity. More research is warranted to determine the mechanism and prognostic values of lumican in the atherosclerosis.

Rumen bacteria at work: bioaugmentation strategies to enhance biogas production from cow manure.

AIMS: To investigate the effects of different bioaugmentation strategies for enhancing the biogas production from cow manure and evaluate microbial community patterns. METHODS AND RESULTS: Co-inoculation with cow rumen fluid and cow rumen-derived enriched microbial consortia was evaluated in anaerobic batch tests at 36°C and 41°C. Singular addition of both rumen fluid and enriched bioaugmentation culture had a promising enhancement on methane yields; however, the highest methane yield (311 ml CH4 per gram VS at 41°C) was achieved when the anaerobic seed sludge was co-inoculated together with rumen fluid and enriched bioaugmentation culture. Bacterial community profiles were investigated by Ion PGM Platform, and specific lignocellulolytic bacteria dynamics in batch tests were assessed by qPCR. The temperature had minor effects on the abundance of bacterial community; in which Bacteroidetes and Firmicutes were the most abundant phyla in all digesters. Furthermore, Rikenellaceae, Clostridiaceae, Porphyromonadaceae, Bacteroidaceae and Ruminococcaceae played a crucial role during the anaerobic degradation of cow manure. There was an important impact of Firmicutes flavefaciens and Ruminococcus albus at 41°C, which in turn positively affected the methane production. CONCLUSION: The degree of enhancement in biogas production can be upgraded by the co-inoculation of rumen-derived bioaugmentation culture with anaerobic seed sludge with high methanogenic activity. SIGNIFICANCE AND IMPACT OF THE STUDY: A close look at the biotic interactions and their associations with abiotic factors might be valuable for evaluating rumen-related bioaugmentation applications.

Parental perception and child's nutritional status.

Childhood obesity is a health hazard increasing worldwide. Preschool period which is under supervision of parents is a critical period to detect overweight and take precautions. We studied the factors affecting parental estimation of their preschool child's weight. Three hundred sixty seven mothers completed questionnaires consisting of child's and parents' anthropometric measurements, parents' assessment of their child's and their own weight status, and general information about their lifestyle. Mothers also chose their wish for current and future body image of their child from child drawings representing percentiles. Child body mass index-for-age z score (BAZ) was related to birth weight and child's appetite. BAZ was not related to child's gender, presence of chronic disease, family pattern, parental age, education or income. 43.1 % of mothers correctly assessed child's BAZ verbally. Maternal verbal estimation was correlated with maternal visual estimation, paternal verbal estimation and child's BAZ. Mothers' wish for future figure of the child was not related to child's BAZ, but showed correlation with mothers' wish for current figure of the child. Mother's correct perception of her child's weight was found to be high, consistent with her spouse and related to child's BAZ.

Anaerobic sulfamethoxazole degradation is driven by homoacetogenesis coupled with hydrogenotrophic methanogenesis.

In this study, microbial community dynamics were assessed in two lab-scale anaerobic sequencing batch reactors (ASBRs). One of the reactors was fed by synthetic pharmaceutical industry wastewater with sulfamethoxazole (SMX) as the test reactor and the other without sulfamethoxazole as the control reactor. DNA based DGGE results indicated that Clostiridum sp. became dominant in the SMX reactor while the inoculum was dominated with Firmicutes (61%) and Methanomicrobiales (28%). However their abundances in active community decreased through the last phase. Also the abundance of hydrogenotrophs was high in each phase, while acetoclastic methanogens disappeared in the last phase. Q-PCR analysis revealed that there is a significant reduction in the bacterial community approximately 84%, while methanogens increased to 97% through the operation. Additionally an increase in the expression level of bacterial and methanogenic 16S rRNA (60% and 20%, respectively) was detected. Significant correlation between microbial community and the reactor operation data was found. The study demonstrated that the microbial community maintains the system stability under high antibiotic concentration and long-term operation by homoacetogenesis coupled with hydrogenotrophic methanogenesis.

Monitoring the abundance and the activity of ammonia-oxidizing bacteria in a full-scale nitrifying activated sludge reactor.

Cell-specific ammonia oxidation rate (AOR) has been suggested to be an indicator of the performance of nitrification reactors and to be used as an operational parameter previously. However, published AOR values change by orders of magnitude and studies investigating full-scale nitrification reactors are limited. Therefore, this study aimed at quantifying ammonia-oxidizing bacteria (AOB) and estimating their in situ cell-specific AOR in a full-scale activated sludge reactor treating combined domestic and industrial wastewaters. Results showed that cell-specific AOR changed between 5.30 and 9.89 fmol cell(-1) h(-1), although no significant variation in AOB cell numbers were obtained (1.54E + 08 ± 0.22 cell/ml). However, ammonia-removal efficiency varied largely (52-79 %) and was proportional to the cell-specific AOR in the reactor. This suggested that the cell-specific AOR might be the factor affecting the biological ammonia-removal efficiency of nitrification reactors independent of the AOB number. Further investigation is needed to establish an empirical relationship to use cell-specific AOR as a parameter to operate full-scale nitrification systems more effectively.

Acute effect of erythromycin on metabolic transformations of volatile fatty acid mixture under anaerobic conditions.

The study explored the acute inhibitory impact of erythromycin on the methanogenic activity of acclimated biomass fed with a volatile fatty acid mixture and acetate alone. Parallel batch reactors were operated for six days, with increasing erythromycin dosing in the range of 1-1000 mg L(-1). Substrate removal was monitored by means of soluble COD and volatile fatty acid (VFA) measurements together with parallel observations on biogas and methane generation. The inhibitory impact was variable with the initial erythromycin dose: At lower doses, the VFA mixture was completely removed but partially utilized, leading to reduced biogas and methane generation, suggesting the analogy of uncompetitive inhibition. At higher doses, propionate utilization was totally impaired and butyrate removal was reduced, but acetate was still fully removed. Remaining VFAs were partly converted to new VFA compound through isomerization and polymerization reactions. High erythromycin doses induced total inactivation of microbial metabolism with negligible methane generation.

Effect of Ramadan fasting on metabolic markers, dietary intake and abdominal fat distribution in pregnancy.

BACKGROUND: The aim of this study is to evaluate the effect of Ramadan intermittent fasting on metabolic markers, dietary intake, anthropometric measurements, and abdominal visceral fat thickness (VFT) in pregnancy. METHODS: Seventy-eight healthy pregnant subjects who had fasted for at least 15 days during the month of Ramadan in 2012 and 2013 and 78 controls were included in this study. Metabolic markers, dietary intake, anthropometric measurements, and ultrasonographic VFT were calculated for each subject before and after Ramadan fasting. RESULTS: When before and after Ramadan values in the fasting group were compared, we found that daily protein intake was increased (p <0.001), but fat and carbohydrate intake remained unchanged. A significant reduction was observed in liquid consumption while the frequency of asymptomatic bacteriuria was increased. High-density lipoprotein significantly increased, and glycated hemoglobin, insulin, and homeostasis model index significantly decreased (p =0.005, p =0.01, p <0.001, and p =0.03, respectively). A significant increase in ferritin was found (p =0.02). No change was observed in subcutaneous fat thickness, while VFT significantly decreased (p =0.08, p =0.005). However, in the control group, only ferritin level increased. CONCLUSION: A combined change in the number and timing of meals and the portioning of the entire daily intake into only two meals per day may have beneficial metabolic effects and reduction in VFT during pregnancy. Hippokratia 2015; 19 (4): 298-303.

Performance of anaerobic sequencing batch reactor in the treatment of pharmaceutical wastewater containing erythromycin and sulfamethoxazole mixture.

This study evaluates the joint effects of erythromycin-sulfamethoxazole (ES) combinations on anaerobic treatment efficiency and the potential for antibiotic degradation during anaerobic sequencing batch reactor operation. The experiments involved two identical anaerobic sequencing batch reactors. One reactor, as control unit, was fed with synthetic wastewater while the other reactor (ES) was fed with a synthetic substrate mixture including ES antibiotic combinations. The influence of ES antibiotic mixtures on chemical oxygen demand (COD) removal, volatile fatty acid production, antibiotic degradation, biogas production, and composition were investigated. The influent antibiotic concentration was gradually increased over 10 stages, until the metabolic collapse of the reactors, which occurred at 360 days for the ES reactor. The results suggest that substrate/COD utilization and biogas/methane generation affect performance of the anaerobic reactors at higher concentration. In addition, an average of 40% erythromycin and 37% sulfamethoxazole reduction was achieved in the ES reactor. These results indicated that these antibiotics were partly biodegradable in the anaerobic reactor system.

Risk stratification in submassive pulmonary embolism via alveolar-arterial oxygen gradient.

AIM: This study investigated the utility of the alveolar-arterial (AaDO2) gradient in predicting the short-term prognosis of submassive pulmonary embolism (PE). MATERIAL AND METHODS: This study retrospectively enrolled 124 patients with acute submassive PE. During the first 24 h of admission, all patients had initial artery blood gas collected under room air. Cardiac troponin T (cTn-T) was measured and on spiral computed tomography pulmonary angiography (CTPA) and echocardiography both right ventricle diameter and left ventricle diameter was calculated (RV/LV ratio). Patients who did not have objectively confirmed submassive PE and who had curative anticoagulant treatment for more than 24 hours and had a life expectancy less than 3 months were excluded from the study. RESULTS: The best cut-off value for AaDO2 was 42.38 mmHg and using this, fourteen of 15 patients who died had AaO2 ≥ 42.38 and 71 of 109 patients who survived had a AaO2 lower than 42.38 with a sensitivity, specificity and negative predictive value (NPV) for overall deaths were 93.3%, 65.1% and 98.6% respectively. In addition, AaDO2 < 42.38 showed significant survival benefit for overall mortality rates. In this study, having high cTn-T and PaO2/ PaCO2 < 1.83 and pulmonary artery pressure > 47.5 were also an indicator of poor prognosis for patients with submasssive PE. CONCLUSION: The AaDO2 measurement is a highly useful and simple measurement for predicting short-term prognosis in patients with submassive PE. It may be used in risk stratification of patients with submassive PE. Aggressive thrombolytic treatment strategies may be considered for patients who have AaO2 < 42.38. Hippokratia 2014; 18 (4): 333-339.

Evaluation of antioxidant properties, elemental and phenolic contents composition of wild nettle (Urtica dioica L.) from Tunceli in Turkey.

Wild nettle (Urtica dioica L.) types were sampled from different geographical regions in Tunceli (Turkey) to determine their mineral, vitamin, phenolic contents and their antioxidant properties. The total phenol varied from 37.419 ± 0.380 to 19.182 ± 1.00 mg of GAEs g(-1) of dry nettle. The highest radical scavenging effect was observed in Mazgirt parting of the ways 7.5 km with 33.70 ± 0.849 mg mL(-1). The highest reducing power was observed in the nettles from Mazgirt parting of the ways 7.5 km. Among the various macronutrients estimated in the plant samples, potassium was present in the highest quantity followed by calcium and phosphate. Kaempferol and resveratrol were not determined in some nettle samples but rutin levels were determined in all samples. Vitamin A concentrations were ranged between 13.64 ± 1.90 and 5.74 ± 1.00 (mg kg(-1) dry weight). These results show that Urtica dioica L. collected from Tunceli in Turkey could be considered as a natural alternative source for food, pharmacology and medicine sectors.

Chronic impact of tetracycline on the biodegradation of an organic substrate mixture under anaerobic conditions.

The study evaluates the chronic impact of the antibiotic tetracycline on the biodegradation of organic substrate under anaerobic conditions. The experiments involved an anaerobic sequencing batch reactor fed with a synthetic substrate mixture including glucose, starch and volatile fatty acids, and operated in a sequence of different phases with gradually increasing tetracycline doses of 1.65-8.5 mg/L, for more than five months. Tetracycline exerted a terminal/lethal effect at 8.5 mg/L on the microbial community under anaerobic conditions, which caused the inhibition of substrate/COD utilization and biogas generation and leading to a total collapse of the reactor. The microbial activity could not be recovered and re-started within a period of more than 10 days, even after stopping tetracycline dosing. At lower doses, substrate utilization was not affected but a reduction of 10-20% was observed in the biogas/methane generation, suggesting that substrate utilization of tetracycline to the biomass was limiting their bioavailability. During the experiments, tetracycline was partially removed either through biodegradation or conversion into its by-products. The adverse long-term impact was quite variable for fermenting heterotrophic and methanogenic fractions of the microbial community based on changes inflicted on the composition of remaining/residual organic substrate.

Effect of seed sludge microbial community and activity on the performance of anaerobic reactors during the start-up period.

In this study, two laboratory-scale anaerobic batch reactors started up with different inoculum sludges and fed with the same synthetic wastewater were monitored in terms of performance and microbial community shift by denaturant gradient gel electrophoresis fingerprinting and subsequent cloning, sequencing analysis in order to reveal importance of initial quality of inoculum sludge for operation of anaerobic reactors. For this purpose, two different seed sludge were evaluated. In Reactor1 seeded with a sludge having less diverse microbial community (19 operational taxonomic unit (OTU's) for Bacterial and 8 OTU's for Archaeal community, respectively) and a methanogenic activity of 150 ml CH(4) g TVS(-1) day(-1), a chemical oxygen demand (COD) removal efficiency of 78.8 ± 4.17% was obtained at a substrate to microorganism (S/X) ratio of 0.38. On the other hand, Reactor2, seeded with a sludge having a much more diverse microbial community (24 OTU's for Bacterial and 9 OTU's for Archaeal communities, respectively) and a methanogenic activity, 450 ml CH(4) g TVS(-1) day(-1), operated in the same conditions showed a better start-up performance; a COD removal efficiency of over 98% at a S/X ratio of 0.53. Sequence analysis of Seed2 revealed the presence of diverse fermentative and syntrophic bacteria, whereas excised bands of Seed1 related to fermentative and sulfate/metal-reducing bacteria. This study revealed that a higher degree of bacterial diversity, especially the presence of syntrophic bacteria besides the abundance of key species such as methanogenic Archaea may play an important role in the performance of anaerobic reactors during the start-up period.

Spatial and temporal changes in microbial diversity of the Marmara Sea sediments.

Spatial (10 different locations) and temporal (2 years) changes in characteristics of the Marmara Sea Sediments were monitored to determine interactions between the chemical and microbial diversity. The sediments were rich in terms of hydrocarbon, nitrate, Ni and microbial cell content. Denitrifying, sulfate reducing, fermentative and methanogenic organisms were co-abundant in 15 cm below the sea floor. The local variations in the sediments' characteristics were more distinctive than the temporal ones. The sulfate and nitrate contents were the main drivers of the changes in the microbial community compositions. N and P were limited for microbial growth in the sediments, and their levels determined the total cell abundance and activity. Seasonal shifts in temperatures of the shallow sediments were also reflected in the active cell abundances. It was concluded that the Marmara Sea is a promising ecosystem for the further investigation of the ecologically important microbial processes.

Methanogenic community change in a full-scale UASB reactor operated at a low F/M ratio.

A full-scale upflow anaerobic sludge blanket (UASB) reactor was investigated in terms of archaeal composition, acetoclastic methanogenic capacity and performance over a 2-year period. Performance of the reactor in terms of COD removal efficiency varied between 60% and 80% at organic loading rates (OLRs) in the range of 2.5-12 kg COD m-3 d-1. The reactor had been operated under a F/M (food to microorganisms) ratio of 0.02-0.03 gCOD gTVS-1 d-1, which is much lower than the typical values reported for similar reactors. According to specific methanogenic activity (SMA) tests the anaerobic sludge was operating at only 12-34% of its potential acetoclastic methanogenic capacity. These results demonstrated that the UASB reactor was under loaded compared to its maximum loading capacity. All other operational parameters had been maintained within their desired ranges. The SMA test and Fluorescence in situ hybridization (FISH) results revealed that a decrease in the acetoclastic methanogenic activity of the UASB sludge from 344 mL CH4 gTVS-1 d-1 to 109 mL CH4 gTVS-1 d-1 coincided with a decrease in the relative abundance of acetoclastic Methanosaeta from 90%+/-1.2 to 79%+/-1.4 of the archaeal population, and an increase in the relative abundance of hydrogenotrophic Methanobacteriales from non-detectable levels to 24%+/-0.7% of the archaeal population during the 2-year operation of the reactor. The relative abundance of archaeal cells within the UASB sludge was in the range of 15-17%.

Methanogenic and sulphate reducing bacterial population levels in a full-scale anaerobic reactor treating pulp and paper industry wastewater using fluorescence in situ hybridisation.

In this study, specific methanogenic activity (SMA) test and fluorescence in situ hybridisation (FISH) were respectively used to determine acetoclastic methanogenic capacity, and composition and number of methanogenic and sulphate reducing bacterial (SRB) populations within a full scale anaerobic contact reactor treating a pulp and paper industry effluent. The sludge samples were collected from three different heights along the anaerobic reactor having a difficulty of completely stirring. Performance of the anaerobic reactor in terms of COD removal efficiency varied between 47 and 55% at organic loading rates in a range of 1.6-1.8 kg COD m(-3) d(-1) and methane yield varied between 0.18 and 0.20 m3CH4kg CODrem(-1). The anaerobic reactor was not operated for 2 weeks during the monitoring period. According to SMA test results, potential methane production rate was 276 mLCH4 gVSS(-1) d(-1) before the off period of the reactor, however it decreased to 159 mL CH4 gVSS(-1) d(-1) after this period. SMA test and FISH results along the reactor height showed that the acetoclastic methanogenic activity of the sludge samples, the relative abundance of acetoclastic methanogens, hydrogenotrophic methanogens and acetate oxidising SRB decreased as the reactor height increased, however the relative abundance of non-acetate oxidising SRB increased.

Beneficial effects of recombinant platelet-activating factor acetylhydrolase and BN 52021 on bacterial translocation in cerulein-induced pancreatitis.

BACKGROUND: Bacterial translocation (BT) has been suggested to be responsible for the high incidence of infections occurring after acute pancreatitis (AP). The aim of this study was to investigate the effects of the platelet-activating factor (PAF) inactivator, recombinant PAF-acetylhydrolase (rPAF-AH), and the PAF receptor antagonist, BN 52021, in AP. METHODS: Forty-eight male Wistar rats were divided into 4 groups: the sham group received saline intraperitoneally every hour for 6 h; the control group received cerulein 50 g/kg i.p. every hour for 6 h; the rPAF-AH group received AP plus rPAF-AH (5 mg/kg i.v. bolus), and the BN52021 group received AP plus BN 52021 (5 mg/kg i.v. bolus). The animals were sacrificed 12 h after the first cerulein injection. RESULTS: Supramaximal cerulein stimulation induced an increase in serum pancreatic enzymes, interleukin (IL)-6, pancreatic edema, and produced histologic evidence of AP. Compared with the control group, the addition of PAF receptor antagonists had a significant effect on serum pancreatic enzymes, pancreatic edema, and the histologic score of the pancreatitis. AP caused significant increases in BT in mesenteric lymph nodes (MLNs), pancreas, liver, spleen and blood. Compared with the control group, both rPAF-AH and BN 52021 decreased BT in the pancreas and blood. In addition, rPAF-AH decreased BT in the MLNs. We also found that PAF receptor antagonists suppressed the elevation in IL-6 levels. CONCLUSION: PAF antagonists attenuated the severity of experimental AP and reduced pancreatitis-induced BT to distant sites.

[Traumatic splenic injuries]. / Travmatik dalak yaralanmalari.

Splenectomy is the frequently used surgical method for the treatment of traumatic splenic injuries. In this study, the patients who had traumatic splenic injuries were investigated and the results of surgical treatments were evaluated. There were 225 patients with traumatic splenic injuries, which contains 55 (24%) female and 170 (76%) male. The mean age was 29 (range 16-71) years. Severity of splenic injury was classified according to Moore organ injury scaling and there were 23 (10%) patients in grade 1, 96 (43%) in grade II, 75 (33%) in grade III, 24 (11%) in grade IV and 7 (3%) in grade V. Splenectomy was performed in 203 (90%) patients, splenoraphy in 18 (8%) and partial splenectomy in 4 (2%) patients. The overall mortality was 12%. A positive correlation was estimated between the combined trauma and the mortality (Fisher's Chi-Square test; chi 2 = 9,538, p < 0.002). In conclusion, non-operative treatment methods may prevent unnecessary splenectomies, especially in grade I and II blunt or penetrating splenic injuries. Combined injuries are the major factor increasing the mortality.