National Heart Institute

Abstract Background Atherosclerosis poses a significant global health burden, urging the need to discover new therapeutic targets. Emerging evidence suggests associations between gut microbiota and direct vascular bacterial infection in atherosclerosis. However, antibiotics failed to treat atherosclerosis, underscoring the complexity of the microbial community that promotes atherogenesis1. The involvement of fungi in plaque development remains largely understudied, with limited research using low-throughput methods. Purpose In this study, we aimed to investigate the potential of fungi as contributors to coronary artery infection–mediated atherogenesis by applying whole-metagenome analysis of aspirated thrombi from patients with atherosclerosis. Methods This study recruited nine patients with ST-segment–elevation myocardial infarction (STEMI) and one patient with non-STEMI. DNA was extracted from five non-host-depleted samples with prior mechanical lysis in liquid nitrogen and four host-depleted samples with prior collagenase treatment, followed by whole-genome amplification. In addition, one sample was extracted using both methods. Eight libraries passed QC and were sequenced using the Illumina NovaSeq platform. Sequencing reads underwent quality trimming and stringent host read removal. Fungal hits were identified via Bowtie2 mapping to the fungal RefSeq database, validated by BLAST and Kraken2. Species-level identification was performed by reference genome alignment. Results A total of twenty-one fungal genera were identified in six samples, whereas two samples showed no detectable fungi. Alternaria was the most prevalent genus detected in five samples (62.5%) and exhibited the highest relative abundance in two of them. The second most prevalent genus was Aspergillus, detected in four samples (50%). It displayed high relative abundance in two of these samples and co-occurred with Candida. Additionally, Malassezia was detected in three samples (37.5%). Conclusions These genera, except for Candida, were first identified in atherosclerotic thrombi in our study. Furthermore, compositional alterations of these genera, along with Exophiala, have been previously documented in the gut of patients with atherosclerosis, indicating a possible link between gut dysbiosis and direct vessel infection in atherosclerosis. Reinforcing this connection, Candida has been shown to evade monocytes, disseminate to distant organs through the “Trojan horse” mechanism, which is also associated with gut dysbiosis, and induce foam cell formation in vitro. An additional potential pathway involves fungal translocation as a sequela of long COVID syndrome. Our findings suggest a possible fungal gut–vessel axis in infection-driven atherosclerosis, involving fungus-laden monocytes and post-COVID-19 fungal translocation. This pathway could represent a novel therapeutic target, warranting further investigation.

The aim of the study was to comprehensively characterize the population of hypertrophic cardiomyopathy (HCM) patients in Poland in 2016-2021, including the analysis of annual incidence, prevalence, comorbidities, and therapeutic paths. A population-based cross-sectional study was conducted using data from the Polish National Health Fund database. The analysis included a registered annual incidence and prevalence rates, mortality, prognosis, and data on patients pathways in the healthcare system. In 2016, the registered annual incidence of HCM diagnosis in Poland was 1,494 cases (3.89/100,000), decreasing to 808 cases (2.11/100,000) in 2021. Despite the decline in new diagnoses, the registered prevalence of HCM increased from 13,271 cases (34.53/100,000) in 2016 to 13,880 cases (36.23/100,000) in 2021, indicating improved patient survival. Annual mortality rose from 824 deaths (2.14/100,000) in 2016 to 1,022 deaths (2.67/100,000) in 2021, with the highest mortality observed in older adults (60+ years). The study highlights significant underdiagnosis of HCM in Poland. Mortality in HCM population remains high, underscoring the need for improvement in earlier detection and comprehensive care strategies in Polish healthcare system.

This study aims to evaluate the impact of varied oven drying temperatures on the chemical quality, or proximate composition, of salted eggs, specifically focusing on the ash, fat, and carbohydrate content. Furthermore, the research identified the optimal treatment temperature to yield the best quality salted eggs. The research employed an experimental method utilizing a Completely Randomized Design (CRD) with four treatment groups: P0 (control, no oven drying), P1 (70°C for 6 hours), P2 (80°C for 6 hours), and P3 (90°C for 6 hours). Each treatment was replicated five times (n=5), using 10 duck eggs per replicate. The data obtained (percentage of ash, fat, and carbohydrate content) were analyzed using Analysis of Variance (ANOVA) followed by Duncan's Multiple Range Test (DMRT) when a significant treatment effect was observed. The results indicated that the oven drying temperature significantly affected (P < 0.05) the ash, fat, and carbohydrate content of the salted eggs. Oven drying at 90°C was proven to yield salted eggs with the best chemical composition, as evidenced by optimal ash, fat, and carbohydrate levels

Pengelantangan dalam industri tekstil bertujuan untuk menghilangkan kotoran alami, pigmen dan zat pengotor lainnya dari serat tekstil serta meningkatkan daya serap kain dan menghasilkan warna yang lebih cerah dan merata ketika proses pencelupan, pencapan dan penyempurnaan akhir. Percobaan ini bertujuan untuk mempelajari Primusan Ocean sebagai zat pemasakan 3 in 1 yang digunakan sebagai bahan pembantu dalam proses pengelantangan serat kapas maupun serat campuran. Primusan Ocean mengandung tiga komponen, yaitu zat pembasah, stabilisator dan katalis, yang memungkinkan proses pemasakan dilakukan lebih efisien. Metode pengamatan yang dilakukan adalah variasi pemakaian NaOH, variasi suhu dan variasi penetralan dan tanpa penetralan setelah proses pengelantangan. Variasi konsentrasi NaOH adalah 0.6 gram/liter, 0.8 gram/liter, 1.0 gram/liter dan 1.2 g/l dibandingkan dengan cara konvensional dengan pemakaian NaOH 2 g/l, variasi suhu 98°C x 60 menit dan 115°C x 20 menit. Variasi tersebut ada yang dilakukan penetralan dan tanpa penetralan. Proses akhir dari semua hasil pengelantangan dilakukan pencelupan dengan zat warna reaktif Synozol Blue KBR 0.5 % pada suhu 60° C x 60 menit. Pengujian hasil pengelantangan dan pencelupan dilakukan untuk menilai beberapa parameter, yaitu derajat putih, daya serap, ketuaan warna dan kerataan warna. Penggunaan Primusan Ocean menunjukkan hasil lebih baik dibandingkan metode konvensional, terutama ketika digunakan konsentrasi NaOH sebesar 1,0 gram/liter dan 1,2 gram/liter, pada suhu 115°C selama 20 menit, disertai proses penetralan setelahnya. Adapun nilai yang didapatkan yaitu derajat putih 62.4, daya serap cara tetes 0.11 detik. Sedangkan nilai ketuaan warna dengan Primusan Ocean mendapatkan ΔE 0.11 dengan ketuaan warna 99.87% dibandingkan dengan metode konvensional.

Flexor tendon injuries in zones II–V are challenging because of the risk of adhesions and rupture. Although early passive mobilization limits rupture, it often compromises the functional recovery. Recent approaches favor early active mobilization with strong, multi-stranded core sutures to enhance outcomes. This study evaluated early active mobilization after eight-strand core repair in a tertiary care setting. In this prospective study, 143 tendons from 30 patients who underwent surgery were followed up. The injured tendons were repaired using an eight-strand cross-locked cruciate technique with a double-stranded 4-0 suture, providing the tensile strength of eight strands with the same number of suture passes as in traditional four-core repairs, thereby reducing operative time without increasing bulk. Early active mobilization was initiated on postoperative day 2. The patients underwent digitally supervised physiotherapy and were monitored using a dedicated WhatsApp group, which enabled real-time guidance and compliance monitoring. The outcomes were measured in terms of total active motion, grip strength, pinch strength, time to return to work, postoperative pain, and complications. Of the 30 patients, 28 (93.3%) had fair-to-excellent outcomes, whereas only 2 (6.7%) had poor outcomes. Most patients (93.3%) returned to work within 12 weeks postoperatively. Four (13.3%) patients had complications, such as wound infection and skin necrosis. The patients showed significant changes in grip strength (45.2%) and pinch strength (70.7%) between weeks 8 and 12. No tendon ruptures were observed. The eight-core suturing technique used for flexor tendon repair withstood the forces of early active mobilization, which began on the second day after surgery, resulting in fair-to-excellent outcomes. It supports digitally supervised physiotherapy through app-based monitoring, enhancing patient compliance, and reducing reliance on in-person therapy sessions. This combination led to excellent functional recovery with minimal complications.

Background: According to the global burden of cardiovascular diseases (CVD), Egypt experiences one of the highest CVD-related mortalities. Albuminuria is recognized as a risk marker for CVD and is associated with smoking. However, the association between smoking and albuminuria is understudied in countries with very high CVD burden, such as Egypt. Hypothesis: Self-reported smoking is associated with albuminuria regardless of the presence of prior CVD. Methods: This cross-sectional study involves 1,870 patients who were either admitted to or followed up at the National Heart Institute, the largest cardiac center in Egypt. The patients were asked about their diagnosed CVD and associated risk factors. CVD was defined as a history of acute coronary syndrome, heart failure, or cardiac surgery. Urine samples were collected from patients in both inpatient units and outpatient clinics. The urinary albumin-to-creatinine ratio (UACR) was analyzed quantitatively and categorized on the 30 and 300 mg/dl cut-off. Smoking status was determined through self-reporting. The UACR categories were compared between smokers and nonsmokers among participants with and without CVD using the Chi-squared test. A multivariable linear regression model adjusted for age, sex, hypertension, and diabetes was used to test the association between smoking and log-transformed UACR values stratified by history of CVD. Results: The prevalence of CVD was 37%, with a similar mean age (52 ± 13) among participants with and without CVD. Among the entire study population, 11% reported smoking, with the majority being men. The prevalence of males and smokers was 38% and 9% in participants with no CVD, respectively, in comparison to 49% and 15% in participants with CVD. The median [25th-75th percentile] of UACR was 40 [11-130] mg/dl. The prevalence of UACR >300 mg/dl tends to be higher among smokers in participants with and without CVD condition ( Figure 1A ), with a p-value of 0.003 and 0.008, respectively. Smoking was independently associated with higher values of UACR, regardless of the CVD condition ( Figure 1B ) Conclusion: A consistent association exists between smoking and elevated UACR in a sample of the Egyptian population, who are known to have a substantial burden of CVD.

Abstract Background Breast asymmetry is a frequent finding on mammography, which could be the result of summing artifacts or normal variation in the breast parenchymal pattern, or it could be a sign of underlying actual pathology. When mammography and breast sonography are unclear or produce inconsistent results, magnetic resonance imaging (MRI) may be utilized to accurately diagnose breast diseases. Objectives To figure out the diagnostic value of both unenhanced and dynamic contrast-enhanced MRI (UEMRI and DCEMRI) in the assessment of cases with mammographically detected breast asymmetries. Methods Fifty-one women with breast asymmetries identified through diagnostic or screening mammography participated in this prospective trial. All patients had UEMRI and DCEMRI, and the reported results were compared either by using the histopathology from suspicious lesions with a score of BIRADS 4 or 5 or by ultrasonography follow-up in benign instances with a score of BIRADS 3. Results The results of UEMRI in correlation to pathology/follow-up data revealed a sensitivity of 100.00%, a specificity of 90.62%, a positive predictive value of 87.5%, a negative predictive value of 100.00%, and an accuracy of 94.3%. DCEMRI showed a sensitivity of 100.00%, a specificity of 81.2%, a positive predictive value of 77.78%, a negative predictive value of 100.00%, and an accuracy of 88.68%. Conclusions The diagnostic performance of the DCEMRI and UEMRI in breast asymmetries showed no significant difference, and hence for assessing breast asymmetry, UEMRI may be regarded as a valid substitute for DCEMRI and a trustworthy diagnostic method, especially in cases where contrast administration can’t be done.