Burden, Severity and Characteristic Pattern of Coronary Artery Disease using 160-Slice Computed Tomographic Angiography: Earliest Report from Northern Nigeria.

BACKGROUND: Coronary computed tomography angiography (CCTA) allows for non-invasive visualization of the coronary arteries which is promising in diagnosing coronary artery disease. OBJECTIVES: To determine the prevalence, morphology, anatomic distribution pattern and correlates of CAD in our environment. METHODS: This cross-sectional study was conducted on the first cohort of patients referred for CCTA in our hospital. The patients were examined with 160-slice Toshiba® CT scanner. Their demographic data, relevant clinical information as well as the findings on CCTA were extracted and documented. The data were analysed using the R programming software version 4.0.4. RESULTS: Out of a total of 153 patients who presented for CCTA within the study period, 133 (84.7%) were eligible for analysis. Their age ranged from 22-78 years with a mean ± SD of 55.8 ± 11.7 years. A total of 33 (24.8%) had normal CCTA, while 100 (75.2%) had either stenosis or total occlusion. There was a significantly higher (p-value of 0.00001) calcium score among those with stenosis compared to those with normal CCTA. The severity of the stenotic lesion was associated with the calcium score. The logistic regression analyses showed a statistically significant (P = 0.0415, OR = 1.0569, 97.5% CI =1.078152-1.123240) association between age and the presence of coronary stenosis. In addition, most of the stenotic lesions were in the left anterior descending artery (LAD). CONCLUSION: Majority of the patients had coronary artery disease of variable severity and the LAD was the most involved artery. There was no significant association between sex and severity of the disease; however, old age and higher number of lesions were associated with severe disease.

CONTEXTE: L'angiographie coronaire par tomodensitométrie (ATCC) permet une visualisation non invasive des artères coronaires, ce qui est prometteur pour le diagnostic de la maladie coronarienne. OBJECTIFS: Déterminer la prévalence, la morphologie, le modèle de distribution anatomique et les corrélats de la maladie coronarienne dans notre environnement. MÉTHODES: Cette étude transversale a été menée sur la première cohorte de patients envoyés pour un CCTA dans notre hôpital. Les patients ont été examinés à l'aide d'un tomodensitomètre Toshiba® à 160 coupes. Leurs données démographiques, les informations cliniques pertinentes ainsi que les résultats de l'ACTC ont été extraits et documentés. Les données ont été analysées à l'aide du logiciel de programmation R version 4.0.4. RÉSULTATS: Sur un total de 153 patients qui se sont présentés pour une ACTC pendant la période de l'étude, 133 (84,7 %) étaientéligibles pour l'analyse. Leur âge était compris entre 22 et 78 ans,avec une moyenne + écart-type de 55,8 + 11,7 ans. Au total, 33 (24,8%) avaient une CCTA normale, tandis que 100 (75,2 %) présentaient une sténose ou une occlusion totale. Le score calcique était significativement plus élevé (valeur p de 0,00001) chez les patients présentant une sténose que chez ceux dont l'ACTC était normale. La gravité de la lésion sténosée était associée au score calcique. Les analyses de régression logistique ont montré une association significative (P=0,0415, OR= 1,0569, 97,5% CI=1,078152-1,123240) entre l'âge et la présence d'une sténose coronaire. En outre, la plupart des lésions sténosées se trouvaient dans l'artère descendante antérieure gauche (LAD). CONCLUSION: La majorité des patients présentaient une maladie coronarienne de gravité variable et l'artère LAD était l'artère la plus touchée. Il n'y avait pas d'association significative entre le sexe et la sévérité de la maladie ; cependant, l'âge avancé et le nombre plus élevé de lésions étaient associés à la sévérité de la maladie. Mots-clés: Angiographie, Tomodensitométrie, Artères Coronaires, Stenose.

Duplication 17p11.2 (Potocki-Lupski Syndrome) in a child with developmental delay.

Potocki-Lupski syndrome (PTLS), also known as duplication 17p11.2 syndrome, trisomy 17p11.2 or dup(17)(p11.2p11.2) syndrome, is a developmental disorder and a rare contiguous gene syndrome affecting 1 in 20,000 live births. Among the key features of such patients are autism spectrum disorder, learning disabilities, developmental delay, attention-deficit disorder, infantile hypotonia and cardiovascular abnormalities. Previous studies using microarray identified variations in the size and extent of the duplicated region of chromosome 17p11.2. However, there are a few genes which are considered as candidates for PTLS which include RAI1, SREBF1, DRG2, LLGL1, SHMT1 and ZFP179. In this report, we investigated a case of a 3-year-old girl who has developmental delay. Her chromosome analysis showed a normal karyotype (46,XX). Analysis using array CGH (4X44 K, Agilent USA) identified an ~4.2 Mb de novo duplication in chromosome 17p11.2. The result was confirmed by fluorescence in situ hybridization (FISH) using probes in the critical PTLS region. This report demonstrates the importance of microarray and FISH in the diagnosis of PTLS.

Dysregulation of RBFOX2 Is an Early Event in Cardiac Pathogenesis of Diabetes.

Alternative splicing (AS) defects that adversely affect gene expression and function have been identified in diabetic hearts; however, the mechanisms responsible are largely unknown. Here, we show that the RNA-binding protein RBFOX2 contributes to transcriptome changes under diabetic conditions. RBFOX2 controls AS of genes with important roles in heart function relevant to diabetic cardiomyopathy. RBFOX2 protein levels are elevated in diabetic hearts despite low RBFOX2 AS activity. A dominant-negative (DN) isoform of RBFOX2 that blocks RBFOX2-mediated AS is generated in diabetic hearts. DN RBFOX2 interacts with wild-type (WT) RBFOX2, and ectopic expression of DN RBFOX2 inhibits AS of RBFOX2 targets. Notably, DN RBFOX2 expression is specific to diabetes and occurs at early stages before cardiomyopathy symptoms appear. Importantly, DN RBFOX2 expression impairs intracellular calcium release in cardiomyocytes. Our results demonstrate that RBFOX2 dysregulation by DN RBFOX2 is an early pathogenic event in diabetic hearts.

The effect of oleic acid stabilizer on the surface properties of bimetallic PtNi catalysts.

A detailed study on the surface properties of oleic acid-stabilized PtNi nanoparticles supported on silica is reported. The oleic acid-stabilized PtNi nanoparticles were synthesized using NaBH4 as the reducing agent at various temperatures and oleic acid concentrations, prior to incorporation onto the silica support. X-ray diffraction studies of the unsupported oleic acid-stabilized PtNi particles revealed that the PtNi existed as alloys. Upon incorporation onto silica support, surface properties of the catalysts were investigated using H2-temperature reduction (H2-TPR), H2-temperature desorption (H2-TPD) and H2-chemisorption techniques. It was found that for the bimetallic catalysts, no oxides or very little oxidation occurred. Furthermore, these catalysts exhibited both Pt and Ni active sites on its surface though the availability of Ni active sites was dominant. A comparison of the surface properties of these materials with those prepared without oleic acid in our previous work [N. H. H. Abu Bakar et al., J. Catal. 265, 63 (2009)] and how they affect the hydrogenation of benzene is also discussed.

Sporadic Legionnaires' disease: the role of domestic electric hot-water tanks.

Sporadic community-acquired legionellosis (SCAL) can be acquired through contaminated aerosols from residential potable water. Electricity-dependent hot-water tanks are widely used in the province of Quebec (Canada) and have been shown to be frequently contaminated with Legionella spp. We prospectively investigated the homes of culture-proven SCAL patients from Quebec in order to establish the proportion of patients whose domestic potable hot-water system was contaminated with the same Legionella isolate that caused their pneumonia. Water samples were collected in each patient's home. Environmental and clinical isolates were compared using pulsed-field gel electrophoresis. Thirty-six patients were enrolled into the study. Legionella was recovered in 12/36 (33%) homes. The residential and clinical isolates were found to be microbiologically related in 5/36 (14%) patients. Contaminated electricity-heated domestic hot-water systems contribute to the acquisition of SCAL. The proportion is similar to previous reports, but may be underestimated.

Composition of macrobenthos in the Bakkhali channel system, Cox's Bazar with notes on soil parameter.

Macrobenthos in coastal environment that play a significant role in the food web. It could also use as a good indicator of aquatic ecosystem health. The abundance and composition of macrobenthos in Bakkhali channel system, Cox's Bazar were conducted in relation to the soil parameters. Samples were collected using Ekman Berge bottom grab from five different stations of Bakkhali channel. Macrobenthos were comprised of five major groups namely Polychaeta (9.96-30.31%), Oligochaeta (3.68-59.707%), Crustacea (0.02-58.40%), Bivalvia (1.40-82.09%) and Gastropoda (0.08-4.25%). Total number of macrobenthos was higher at station I (9000 individuals m(-2)) and station II (8517 individuals m(-2)) compared to other stations. Shannon diversity index among the stations ranged from 0.65-1.04. Soil pH and soil moisture ranged from 6.1-6.4 and 23.44-31.29%, respectively. The highest organic carbon concentration was observed at station I (2.11%) and lowest at station III (1.40%). Maximum fraction of sand by weight was found at stations II (81.88%) and III (87.88) while the highest fraction of clay (21.52%) and silt (8.0%) were recorded in station I. It was observed that benthic bivalves were positively correlated (r = 0.891, p > 0.05) with silt fraction of the sediments.

Structural and thermal characterizations of silica nanoparticles grafted with pendant maleimide and epoxide groups.

Grafting of free maleimide and epoxide pendant groups onto the surface of approximately 7-nm silica nanoparticles was investigated. Glycidyloxypropyl groups (3-glycidyloxypropyltrimethoxysilane and 3-aminopropyltrimethoxysilane) that carried epoxide groups and aminopropyl groups were grafted to the silica surface with the help of condensation reactions. Maleimide groups [1,1(')-(methylenedi-4,1-phenelene) bismaleimide] were introduced to the silica surface via nucleophilic addition reaction with the aminopropyl groups pre-grafted onto the surface. The grafted silica samples were characterized using CHN, FTIR, DSC, TGA-FTIR, and 13C and 29Si CP/MAS NMR spectroscopy. NMR analyses revealed that all the functional groups were covalently bonded to the silica surface and most of the maleimide and epoxide rings remained intact on surface. DSC analysis showed that the epoxide groups were more reactive than the maleimide groups.

A novel Shigella dysenteriae serovar isolated in Canada.

The etiological agent most commonly associated with bacillary dysentery is Shigella. As part of its mandate, the Bacteriology and Enteric Disease Program of Health Canada identifies and serotypes unusual isolates of Shigella received from provincial laboratories of public health. In this report, six unusual isolates from three provinces were analyzed biochemically and serologically using slide and tube agglutinations and molecularly using standard pulsed-filed gel electrophoresis (PFGE), PCR, and PCR-restriction fragment length polymorphism (RFLP) techniques. All six isolates were identical. PFGE analysis grouped these strains; biochemically, they were mannitol negative and consistent with the profile of Shigella. Serologically, these strains produced weak reactions in Shigella dysenteriae serovars 4 and 16 and Escherichia coli O159 and O173 antisera. Molecular serotyping by PCR-RFLP of the rfb gene produced an S. dysenteriae serovar 2/E. coli O112ac pattern. They were positive by PCR for ipaH and ial enteroinvasive genes but negative for all other genes tested. Antiserum was prepared from one of the isolates and tested against Shigella and E. coli reference strains as well as the other isolates. The antiserum reacted with the five remaining isolates and showed cross-reactivity with S. dysenteriae serovars 1, 4, and 16; Shigella flexneri type 3; and E. coli O118, O159, O168, O172, and O173 antigens. Absorbing the sera with E. coli O159 and S. dysenteriae serovar 4 antigen removed all cross-reactions and only slightly reduced the homologous titer. Based on biochemical, molecular, and complete serological analysis, we propose that these six isolates represent a new provisional serovar of S. dysenteriae, type strain BEDP 02-5104.

Risk factors for non-fatal myocardial infarction in young South Asian adults.

OBJECTIVE: To determine the risk factors for premature myocardial infarction among young South Asians. DESIGN AND SETTING: Case-control study in a hospital admitting unselected patients with non-fatal acute myocardial infarction. METHODS AND SUBJECTS: Risk factor assessment was done in 193 subjects aged 15-45 years with a first acute myocardial infarct, and in 193 age, sex, and neighbourhood matched population based controls. RESULTS: The mean (SD) age of the subjects was 39 (4.9) years and 326 (84.5%) were male. Current smoking (odds ratio (OR) 3.82, 95% confidence interval (CI) 1.47 to 9.94), use of ghee (hydrogenated vegetable oil) in cooking (OR 3.91, 95% CI 1.52 to 10.03), raised fasting blood glucose (OR 3.32, 95% CI 1.21 to 8.62), raised serum cholesterol (OR 1.67, 95% CI 1.14 to 2.45 for each 1.0 mmol/l increase), low income (OR 5.05, 95% CI 1.71 to 14.96), paternal history of cardiovascular disease (OR 4.84, 95% CI 1.42 to 16.53), and parental consanguinity (OR 3.80, 95% CI 1.13 to 1.75) were all independent risk factors for acute myocardial infarction in young adults. Formal education versus no education had an independently protective effect on acute myocardial infarction (OR 0.04, 95% CI 0.01 to 0.35). CONCLUSIONS: Tobacco use, ghee intake, raised fasting glucose, high cholesterol, paternal history of cardiovascular disease, low income, and low level of education are associated with premature acute myocardial infarction in South Asians. The association of parental consanguinity with acute myocardial infarction is reported for the first time and deserves further study.

Development of a Canadian standardized protocol for subtyping methicillin-resistant Staphylococcus aureus using pulsed-field gel electrophoresis.

A panel of 24 methicillin-resistant Staphylococcus aureus strains was distributed to 15 laboratories in Canada to evaluate their in-house pulsed-field gel electrophoresis (PFGE) protocols and interpretation criteria. Attempts to compare fingerprint images using computer-aided analysis were not successful due to variability in individual laboratory PFGE protocols. In addition, individual site interpretation of the fingerprint patterns was inadequate, as 7 of 13 sites (54%) made at least one error in interpreting the fingerprints from the panel. A 2-day standardized PFGE protocol (culture to gel image) was developed and distributed to all of the sites. Each site was requested to use the standardized protocol on five strains from the original panel. Thirteen sites submitted gel images for comparisons. The protocol demonstrated excellent reproducibility and allowed interlaboratory comparisons with Molecular Analyst DST software (Bio-Rad) and 1.5% band tolerance.

The role of K+ATP channels in the control of pre- and post-ischemic left ventricular developed pressure in septic rat hearts.

Myocardial function is impaired 24 h after the induction of sepsis, however, recovery of left ventricular (LV) function after 35 min of global ischemia is complete. The mechanisms by which this protection occurs are unknown. Ischemic preconditioning, another form of myocardial protection from ischemia/reperfusion (I/R) injury, has been shown to be modulated by ATP-sensitive potassium (K+ATP) channels. To investigate the role of K+ATP channels in the regulation of coronary flow (CF) and protection from I/R injury in septic rat hearts, we assessed the effects of the K+ATP channel antagonist glibenclamide (GLIB) and the agonist cromakalim (CROM) on pre- and post-ischemic CF and left ventricular developed pressure (LVDP). Although GLIB decreased pre-ischemic CF in both control and septic rat hearts, LVDP was unaffected. After I/R, CF was decreased in GLIB-treated control and septic rat hearts and LVDP was more severely depressed in control rat hearts than in septic rat hearts. CROM increased pre-ischemic CF in the septic group although LVDP was unaltered in both groups. After I/R, control rat heart CF was depressed but LVDP completely recovered. Post-ischemic CF in septic rat hearts was elevated compared with vehicle-treated septic rat hearts, but the recovery of LVDP was not improved. These results suggest that K+ATP channels modulate CF in septic rat hearts, but do not mediate cardioprotection as observed in control rat hearts.

Immediate loading of dental implants in the edentulous mandible: a preliminary case report from an international prospective multicenter study.

The ability to predictably achieve long-term osseointegration in patients with compromised anatomical resources has been demonstrated numerous times in modern oral implantology. Recently, clinical attention has focused on new methods of reducing treatment time. One-stage surgical procedures and immediate loading of implants at the time of placement are two techniques that have demonstrated promising clinical results. A prospective clinical study of immediately splinting and loading a new, one-stage implant is currently in progress in the United States and France. An overview of the implant design and presentation of one case study from the University of Pittsburgh demonstrates how this promising technique is performed.

A cluster of bloodstream infections and pyrogenic reactions among hemodialysis patients traced to dialysis machine waste-handling option units.

From June 17 through November 15, 1995, ten episodes of Enterobacter cloacae bloodstream infection and three pyrogenic reactions occurred in patients at a hospital-based hemodialysis center. In a case-control study limited to events occurring during October 1-31, 1995, seven dialysis sessions resulting in E. cloacae bacteremia or pyrogenic reaction without bacteremia were compared with 241 randomly selected control sessions. Dialysis machines were examined, dialysis fluid and equipment were cultured, and E. cloacae isolates were genotyped by pulsed-field gel electrophoresis. Each dialysis machine had a waste-handling option (WHO) through which dialyzer-priming fluid was discarded before each dialysis session; in 7 of 11 machines, one-way check valves designed to prevent backflow from the WHO into patient bloodlines were dysfunctional. In the case-control study, case sessions were more frequent when machines with >/=1 dysfunctional check valves were used. E. cloacae with identical pulsed-field gel electrophoresis patterns were isolated from case patients, dialysis fluid, station drains, and WHO units. Our investigation shows that bloodstream infections and pyrogenic reactions were caused by backflow from contaminated dialysis machine WHO units into patient bloodlines. The outbreak was terminated when WHO use was discontinued, check valves were replaced, and dialysis machine disinfection was enhanced.

The role of coronary flow and adenosine in postischemic recovery of septic rat hearts.

Sepsis depresses myocardial function but prevents subsequent ischemia-reperfusion injury. Elevated coronary flow (CF) and endogenous adenosine may be important factors in the complete recovery of postischemic myocardial function observed in septic rat hearts. The purpose of this study was to determine the effects of manipulating CF and of antagonizing adenosine receptors on the postischemic recovery of left ventricular developed pressure (LVDP) in septic and control rat hearts. The relationship between CF and LVDP in septic rat hearts before ischemia was depressed compared with control. However, this relationship was unaltered by ischemia in septic hearts, whereas in control hearts it was severely depressed. Preventing the elevation of CF during reperfusion did not significantly affect the recovery of LVDP in septic rat hearts. Adenosine antagonism by 8-phenyltheophylline (0.1 and 1 nM) prevented the elevated CF during reperfusion, and the higher dose significantly depressed postischemic function. We conclude that elevated CF did not contribute to the recovery of postischemic LVDP in septic rat hearts but that endogenous adenosine may provide protection from ischemia.

A prolonged outbreak of Shigella sonnei infections in traditionally observant Jewish communities in North America caused by a molecularly distinct bacterial subtype.

During 1994-1996, Shigella sonnei outbreaks occurred in 8 North American traditionally observant Jewish communities. These communities remain relatively separate from neighboring populations while maintaining close contact by travel with coreligionists in other cities. Epidemiologic investigations suggested community-to-community transmission via travel. Outbreak-related and control isolates of S. sonnei from each city were subtyped by pulsed-field gel electrophoresis (PFGE) to confirm an epidemiologic linkage between outbreaks. Forty-three (94%) of 46 outbreak-related isolates had closely related PFGE patterns, constituting a single subtype; 33 (94%) of 35 control isolates demonstrated unrelated PFGE patterns. Several patterns differing by < or = 3 bands were identified within the outbreak subtype; one of these accounted for 65% of outbreak isolates. Hence, a single subtype of S. sonnei caused an international outbreak involving 8 traditionally observant Jewish communities, but not neighboring populations, over a 2-year period, suggesting sustained propagation of the epidemic strain between communities.