European Journal of Cardiovascular Medicine

Background: To assess antimicrobial sensitivity profile of ESBL producing E. coli isolates from various clinical samples. Methodology: Seventy- Eight E. coli isolates recovered from samples including pus, urine, blood, cerebrospinal fluid (CSF), stool, sputum, and different body fluids from inpatient and outpatient department received in the bacteriology laboratory in the department of microbiology were selected. ESBL screening and confirmation along with antimicrobial susceptibility test was done by Kirby–Bauer disk diffusion method according to the Clinical Laboratory Standards Institute (CLSI) guidelines. Results: Out of 48 inpatients samples of E. coli, 11 were found in pus, 20 in urine, 10 in blood, 4 in stool and 3 in sputum. Out of 30 outpatient samples, 7 were found in pus, 13 in urine, 5 in blood, 3 in stool and 2 in sputum. The difference was significant (P< 0.05). Antimicrobial susceptibility pattern of E. coli in pus, urine and blood against Ampicillin was 34%, 27% and 35%. Against Piperacillin was 43%, 42% and 60%. Against Piperacillin/Tazobactam was 91%, 85% and 82.4%. Against Amoxicillin/Clavulanic acid was 82%, 70% and 72%. Against Cefoperazone/Sulbactam was 80%, 78% and 84%. Against Cefoperazone was 32%, 27% and 54%. Against Cefoxitin was 27%, 35% and 32%. Against Ceftriaxone was 26%, 25% and 31%. Against Aztreonam was 37% , 23% and 20%. Against Imipenem was 100%, 100% and 100%. Against Gentamicin was 76%, 49% and 66%. Against Amikacin was 81%, 62% and 45%. Against Ciprofloxacin was 55%, 52% and 48%. Against Ofloxacin was 52%, 56% and 53% respectively. There was 62% ESBL producer in inpatients and 47% outpatient samples. There was 38% non-ESBL producers in inpatient and 53% outpatient samples. A significant difference was observed (P< 0.05). There was significant difference in antimicrobial susceptibility pattern of ESBL producing E. coli in urine and blood against various antibiotics (P< 0.05). Conclusion: There was high prevalence of ESBL against inpatient and outpatient samples obtained from blood, pus and urine

A 82-year-old man with hypercholesterolemia, hypertension and glucidic intolerance, presented with angina pectoris upon exertion. The vital signs were normal. Echocardiography showed normal left ventricular (LV) ejection fraction, non-critical aortic valvular stenosis and LV diastolic dysfunction. Rest and stress myocardial echocardiography showed a reversible abnormal septal-wall motion. Therefore, an initial diagnosis of possible coronary artery disease was made. Coronary arteriography showed no atherosclerotic lesions in the 3 major coronary arteries; however, in the anterior descending artery a communication with the right ventricle (RV) cavity through five small, diffuse fistulae was detected (Figure 1 and 2), resulting in complete RV contrast opacification. The patient was stabilised on medical therapy because he refused any further invasive therapy.

Background: Apolipoprotein E (ApoE) is necessary for normal lipid metabolism. Deficiency of this protein hinders plasma clearance of both triglycerides and cholesterol. Lipids are, shunted through alternate metabolic pathways, thus resulting in abnormal mitochondrial function. Given the oxygen consumption required for normal heart function, the mitochondria are of particular importance and the preservation of their optimal function is critical. Methods: Using high-resolution respirometry (HRR) and immunoblotting to quantify mitochondrial oxidative phosphorylation (OXPHOS) capacity in permeabilised cardiomyocytes, the goal of this study was to investigate the effects of ApoE deficiency on energy metabolism in the hearts of young mice. Results: Our results demonstrate a reduced basal respiration (ADP restricted) in the ApoE-/- mice. This is furthermore translated to an increased efficiency of the mitochondria, as expressed by a higher respiratory control ratio in ApoE-/- mice. Conclusions: This indicates that early stages of ApoE deficiency positively affects oxidation and phosphorylation coupling within cardiac mitochondria. Our findings provide important information regarding the early phases of preferential lipid metabolism in cardiomyocytes and can help explain the benefits of short term high fat intake for prevention of development and progression of heart failure.

Background: The Calcium Score (CS) is a pre clinical index of atherosclerosis and the prediction of cardiovascular risk is more accurate if CS is included. Current guidelines recommend the use of CS scoring for cardiovascular risk with intermediate-risk patients but there is not established the role of CS in patient with low risk factors.Objective: To define the prognostic significance of CS in smokers (SMO) or not smokers (NSMO)without symptoms. Diabetic patients were excluded in the first analysis.Methods: we’ve studied, in primary prevention, 32 not diabetic patients, 16 females and 16 males, range 60 ± 15 years old, with a metabolic syndrome based on the Third Adult Treatment Panel ATP III criteria of the National Cholesterol Education Program. Patients underwent to a heart coronary CT angiography (HCCT), a not invasive procedure. We have classified the patients into two groups: SMO (a pack of cigarettes for 10 years minimum) and NSMO (In NSMO category are included adults patients that have never smoked or have smoked not more than 100 cigarettes during their entire life). The SMO displayed have higher CS (94 (3;301.5) vs 0 (0;10.2); p<0.001), in comparison with NSMO. Accordingly, the associations between CS and cigarette smoking was still maintained after adjustment for age (rs 0.317; p<0.05). Finally, multiple regression analysis showed that smoke was the variable that best predicted the CST variance (R2 0.131; ®-standardised coefficient 0.362; p<0.05) . Results: CS gravity and extension have been elevated in smokers and the statistical correlation has been highly significant. CS is related to age, epicardial fat and smoke. Stepwise analysis demonstrated that smoke parameter is independent to age and epicardial fat. Conclusions: CS score offers a direct measurement of subclinical coronary pathology. Our study demonstrates that smokers have an elevated CS and the CS, in our opinion, is absolutely useful for the screening of coronary disease in asymptomatic smokers.