Effects of different phylotypes of avian pathogenic Escherichia coli isolated from broiler chickens with colibacillosis on heterophils functional activities: an in vitro study.

Avian pathogenic Escherichia coli (APEC) is a major cause of colibacillosis and is associated with economic losses to the poultry production worldwide. Heterophils are the first line of immune defense of the avian host against invasive pathogens. In this study, APEC isolates from chickens with colibacillosis were assigned to phylogenetic groups and immunological activities of heterophils against these groups were examined. A total of 92 APEC isolates was obtained from 106 samples of diverse organs collected from chickens with colibacillosis from different farms in West Azerbaijan province, Iran. Isolates were assigned to phylogenetic groups based on the Clermont triplex PCR method, and immunological activities (including phagocytosis, respiratory burst and bacterial killing) of heterophils against these groups were examined. As results, the frequency of A, B1, B2 and D groups were 35.87, 44.57, 5.43 and 14.13%, respectively. In addition, opsonized Escherichia coli isolates belonging to B1 group significantly enhanced the level of respiratory burst (0.52 ± 0.02%) while the killing level of them was significantly lower than the other groups (29.40 ± 5.09%). There was no significant difference in phagocytic activity of heterophils against the phylogenetic groups. In conclusion, incomplete immune responses to B1 phylogenetic group maybe a principal cause of mortality by colibacillosis caused by this group. It is suggested to study heterophilic immune reaction against E. coli phylogenetic group for development of effective prevention strategy.

Percutaneous Transluminal Mitral Commissurotomy in Pregnant Women with Severe Mitral Stenosis.

Background: Mitral stenosis tends to worsen during pregnancy because of the increase in the cardiac output and the heart rate. In nonresponders to medical therapy, percutaneous transluminal mitral commissurotomy (PTMC) may be performed when there is a suitable valvular anatomy. In this study, we aimed to investigate the clinical and fetal outcomes of pregnant women with mitral stenosis who underwent PTMC. Methods: Thirty-one patients undergoing PTMC during pregnancy were enrolled in this study. The mitral valve area (MVA), the transmitral valve mean gradient (MVMG), and the severity of mitral regurgitation were assessed pre- and postprocedurally by transthoracic and transesophageal echocardiography. The radiation time was measured during the procedure. The patients were followed up during pregnancy, and the neonates were monitored for weight, height, the head circumference, the birth Apgar score, and the adverse effects of radiation for at least 12 months. Results: PTMC was successfully performed on 29 (93.5%) patients. No maternal death or pulmonary edema was reported. The mean MVA significantly increased (from 0.73±0.17 cm2 to 1.28±0.24 cm2; P<0.001), and the mean MVMG significantly decreased (from 19.62±5.91 mmHg to 8.90±4.73 mmHg; P<0.001) after the procedure. A significant decrease in the systolic pulmonary artery pressure was also detected. Mitral regurgitation did not increase in severity in 16 (51.6%) patients. There was no significant relationship between the Apgar score, weight, height, and the head circumference at birth and at the radiation time. Conclusion: In our series, PTMC during pregnancy was a safe and effective procedure. Lowering the radiation time with low frame-count techniques confers a significant decrease in radiation-related complications.

Subclinical systolic and diastolic dysfunctions in patients with metabolic syndrome and angiographically normal coronary arteries: An echocardiographic study.

BACKGROUND: The metabolic syndrome (MetS), as a combination of cardiovascular risk factors, is associated with subclinical cardiovascular diseases. We sought to evaluate the subclinical myocardial dysfunctions using echocardiography in patients with normal coronary arteries. MATERIALS AND METHODS: In this cross-sectional study, we assessed 50 consecutive patients with angiographically-proven normal coronary arteries and a left ventricular (LV) ejection fraction (EF) ≥55%. The diagnosis of MetS was based on the National Cholesterol Education Program/Adult Treatment Panel III criteria. All patients were examined using conventional and two-dimensional speckle tracking echocardiography for evaluating the myocardial functions. RESULTS: The patients' mean age was 52.3 ± 8.3 years with 32 females (64%). LV EF, mass index, and full volume were comparable between groups. The LV myocardial performance index (0.40 ± 0.13 vs. 0.32 ± 0.10; P = .027), global longitudinal strain (GLS, -15.8 ± 4.5 vs. -19.7 ± 2.1; P < .001), and global circumferential strain (-17.9 ± 6.1 vs. -21.5 ± 3.3; P = .014) were different between patients with or without MetS, respectively. The GLS discriminated patients with MetS (area under the curve = 0.837, sensitivity 80%, specificity 88%, P < .001). CONCLUSIONS: In MetS without coronary artery disease, echocardiography demonstrated subclinical systolic and diastolic dysfunction.