bluuebunny/crossref_metadata_2025_split huggingface dataset:
P839 Analysis of mucosa-associated microbiota and serum cytokines levels in Crohn’s disease
Authors: Fukushima S , Shiotani A , Matsumoto H , Inoue R , Naito Y 
Published: January 2020

Abstract

Background
Most studies investigated the intestinal microbiota using stool instead of mucosa-associated microbiota (MAM). We previously analysed MAM using brushing samples during colonoscopy and reported that Actinobacteria was more abundant and Bacteroidetes was less in the brush samples than those in the faecal samples (J Clin Biochem Nutr. 2019;65:132–137). There are few clinical studies investigating correlations between MAM and serum cytokines.
To investigate the diversity and characteristics of MAM in Crohn’s disease (CD) and correlations between MAM and serum levels of inflammatory cytokines.

Methods
CD patients and non-IBD controls who were planning to undergo routine colonoscopy were recruited. 2L polyethylene glycol (PEG) was used as bowel preparation for colonoscopy. Mucosal brushing samples were taken from the ileum and sigmoid colon. 16S rRNA sequencing using the MiSeq system (Illumina, San Diego, CA, USA) was performed. The V3–V4 regions of the gene encoding 16S rDNA (460 bp) were tailed PCR amplified. Processing of sequence data was analysed using QIIME version 1.8.0. Functional changes in the microbiota were evaluated using PICRUSt. Serum cytokine levels were measured using Milliplex MAP Human Cytokine/Chemokine Magnetic Bead Panel Immunoassay.

Results
The participants were 15 CD patients (average age 43 years, 10 men), and 13 non-IBD controls (average age 58 years, 7 men). The CD group showed a decrease in alpha diversity compared with the non-IBD group, and a significant difference was observed between the two groups in the unweighted PCoA analysis. Bifidobacterium (p = 0.04) and Ruminococcus (p = 0.02) were significantly increased, and Roseburia (p = 0.03) and Oscillospira (p = 0.02) were significantly decreased in the CD group. The component of Bifidobacterium positively correlated with serum IL-15 levels.

Conclusion
MAM in CD group were different from those in non-IBD group, suggesting that certain bacteria may control mucosal immunity.
P846 Comparative study of faecal microbiota in Crohn’s disease patients in remission with and without surgical resection
Authors: Amoedo Cibeira J , Ramió-Pujol S , Serra-Pagès M , Oliver L , Bahí A , Miquel-Cusachs J O , Busquets D , Garcia-Gil J , Aldeguer X 
Published: January 2020

Abstract

Background
Inflammatory bowel disease (IBD) is defined as a group of autoimmune diseases that affects the digestive tract by causing chronic inflammatory processes. Crohn’s disease (CD) is one of the major types of IBD. Although there are several efficient drugs for its treatment, almost 80% of patients will require an intestinal resection throughout their lives. Some bacterial species found in faecal samples can be used as indicators to diagnose and monitor activity in CD patients. However, this methodology has not yet been tested in patients that underwent an intestinal resection. The aim of this study was to investigate the changes in the abundance of these species associated with total or partial intestinal resection.

Methods
In this study, we used 30 faecal samples from patients diagnosed with CD in remission withdrawn from the Biobank of the Hospital Universitari Dr. Josep Trueta of Girona. Fifteen samples corresponded to patients who underwent an intestinal resection. The following markers were quantified by qPCR: Faecalibacterium prausnitzii (Fpra), F. prausnitzii phylogroup I (PHG-I), F. prausnitzii phylogrup II (PHG-II), Escherichia coli (Eco), Akkermansia muciniphila (Akk), Ruminococcus sp. (Rum), Bacteroidetes (Bac) and Methanobrevibacter smithii (Msm).

Results
The abundances of Fpra, PHG-I, PHG-II, Rum, and Msm were significantly lower (p &lt; 0.05) in resected CD patients, whereas Eco was significantly more abundant in those patients. No significant differences were observed in the abundances of Akk and Bac.

Conclusion
In resected CD patients, beneficial butyrate-producing bacteria are underrepresented, whereas pro-inflammatory species are overpopulated. Any quantitative relationship of these indicators with the relapse probability would help to stratify these patients for a better orientation of therapeutic strategies.
P847 A pilot trial on the effect of a fibre-enriched nutritional supplement on the gut microbiota of stricturing Crohn’s disease patients
Authors: Herrera De Guise C M , Varela E , Ibarz A , Burgos R , Cardenas G , Luis Fernando M , Robles V , Borruel N , Guarner Aguilar F , Casellas F 
Published: January 2020

Abstract

Background
Diet is a potential factor that could influence the pathogenesis and activity of Inflammatory Bowel Disease(IBD). Soluble fibre is the best way to generate short-chain fatty acids such as butyrate, which has anti-inflammatory effects. Around 1/3 of Crohn’s disease (CD) patients will present with stricturing disease, most frequently in the terminal ileum. These patients often follow a very low-residue diet. CD patients present significant changes in the structure of their microbiota with a decreased prevalence of butyrate-producing bacteria such as Clostridiales species, particularly Faecalibacterium prausnitzii. Depletion of F. prausnitzii might be further enhanced in patients with a very low-residue diet. The aim of this study was to evaluate the effect of a nutritional supplement enriched with soluble fibre on the abundance of F. prausnitzii in stricturing CD.

Methods
We performed a single arm, pilot trial in CD patients with ileal stricturing disease who followed a very low-residue diet as assessed by a dietician. The fibre-enriched nutritional supplement (reg#26.06141/BA-72556) consisted of a 200ml vanilla-flavoured shake that included 3.4 gr of soluble fibre, omega-3 and oleic fatty acids. Patients received 2 supplements per day for 6 weeks, and were followed for 6 months. We obtained frozen faecal samples at time-points 0, 3, 6, 12 and 24 weeks. Total bacteria and F. prausnitzii counts were assessed by qPCR. Weight, BMI, CD activity index (CDAI), CRP, fatty acids, urine F2-isoprostanes and faecal calprotectin were also determined. Tolerance, palatability and acceptability of the supplement were assessed with validated questionnaires at weeks 3 and 6.

Results
Ten patients were included in the study with a median age of 38 [36–50] years, 60% were male, median BMI 25.2 [24.3–28.4] and 40% were current smokers. Six patients completed the 6 weeks of the supplement. Two patients did not receive the supplement because they underwent ileocecal resection, 1 patient was lost to follow-up and 1 patient dropped-out early because of poor palatability of the supplement. At baseline, all patients had F. prausnitzii levels below 109 CFU/g (median 2.02 × 106). Supplement intake did not significantly increase F. prausnitzii levels (p = 0.73) and had no effect on CDAI, CRP, urine F2-isoprostanes or faecal calprotectin. Most usual complaints associated with the supplement were abdominal bloating and flatulence.

Conclusion
CD patients with structuring disease and who follow a very low-residue diet have a markedly reduced abundance of F. prausnitzii. Intake of a 6.8 g/day fibre-enriched nutritional supplement was unable to significantly increase F. prausnitzii abundance in these patients. Fibre supplement was not associated with adverse events.
P848 A novel grape-derived prebiotic selectively enhances abundance and metabolic activity of butyrate producing bacteria in faecal samples of inflammatory bowel disease
Authors: Oliver L , Ramió-Pujol S , Amoedo J , Malagón M , Serrano M , Bahí A , Lluansí A , Busquets D , Leyanira T , Serra-Pagès M , Aldeguer X , Jesús G G 
Published: January 2020

Abstract

Background
Inflammatory Bowel Disease (IBD) is a clinical condition of the gastrointestinal tract of unknown aetiology. The two main forms of IBD are Crohn’s disease (CD) and Ulcerative colitis (UC). Recently, it has been reported that the bacterial communities present in the colon of patients with IBD are structurally different compared with those in healthy individuals. This particular dysbiosis consists of a decrease of butyrate producing bacteria and an increase of the pro-inflammatory species. The goal of this work was to test a new prebiotic of selected dietary fibre made from grape for its capacity to balance the dysbiosis typically found in patients with intestinal disorders.

Methods
Faecal samples from 16 healthy subjects and 11 IBD patients (5 CD and 6 UC) were collected by the Hospital Universitari Dr. Josep Trueta. Fresh stool samples were incubated with 200 mg, 600 mg of prebiotic, and 200 mg of apple pectin. A negative control without substrate addition was also performed. The tubes were incubated under continuous stirring for 72 hours at 37 ºC in semi-anaerobic atmosphere. Total DNA was extracted and the abundances of butyrate-producing bacterial markers (Faecalibacterium prausnitzii, and its phylogroups I and II, Roseburia hominis and Subdolinogranulum variabile) were analysed by qPCR. Concentrations of both butyrate and acetate were determined by gas chromatography as an indication of the bacterial metabolic activity.

Results
A significant increase of butyrate producing species, such as S. variabile, R. hominis and F. prausnitzii was observed in CD and UC samples when incubated with 200 mg of prebiotic compared with the negative control. F. prausnitzii phylogroup II, which is underrepresented in UC patients, also increased. No differences were found when samples were incubated with 600 mg. Regarding apple pectin, the increase on the abundance of butyrate producing bacteria was higher than the prebiotic in UC samples. In samples from healthy subjects, an increase in the butyrate producing species abundances was observed in both concentrations of prebiotic when compared with the negative control. In those samples no differences were observed when comparing apple pectin with the prebiotic. Concerning butyrate and acetate production, these substances increased in all prebiotic-supplemented samples when compared with the negative control.

Conclusion
The studied prebiotic causes an increase of the abundance and activity of butyrate-producing bacteria in both IBD patients and healthy subjects. These results points to this new dietary fibre as a promising prebiotic to maintain eubiosis and to promote the microbiota restoration of the intestinal mucosa.
38 Prognostic validation of partition values obtained with conventional two-dimensional and doppler echocardiography to grade tricuspid regurgitation severity
Authors: Previtero M , Guta A C , Ochoa-Jimenez R C , Figliozzi S , Palermo C , Baritussio A , Cecchetto A , Aruta P , Iliceto S , Badano L P , Muraru D 
Published: January 2020

Abstract

Background
Morbidity and mortality associated with severe tricuspid regurgitation (TR) have prompted interest in new corrective transcatheter procedures. However, to properly select patients for interventional procedures, and to assess their effectiveness, a reliable and reproducible grading system of TR severity is mandatory. However, the cut-off values used by current guidelines to differentiate among mild, moderate and severe TR lack clinical validation.

Purpose
We aimed to obtain the threshold values of the currently recommended quantitative echocardiographic parameters used to grade TR severity using pts’ outcome as a reference.

Methods
296 pts, with at least mild TR and complete 2D, 3D and Doppler echocardiographic study, were enrolled and assessed for potential confounders: age, NYHA class, left ventricular ejection fraction, coexistent valvular heart disease and right ventricular (RV) systolic pressure. Average diameter of the vena contracta (VCavg), effective regurgitant orifice area (EROA), regurgitant volume (RVol) and regurgitant fraction (RF) were obtained to grade TR severity. Median follow-up was 47 (17-80) months. The primary composite endpoint was the occurrence of death of any cause or hospitalization for right heart failure (RHF). Survival curves for the composite endpoint were divided in quartiles at median follow-up. Cut-off values for the echo parameters were derived to grade mild (below the 1st quartile), moderate (between 1st and 3rd quartiles), and severe (above the 3r quartile) TR.

Results
33 deaths and 72 hospitalizations for RHF occurred. Event-free rate from death or RHF at the end of follow-up was 14%, 46% and 93% in pts with severe, moderate, and mild TR, respectively. Differences reached statistical significance early (at 1 month), and lasted during the whole follow-up period (Figure). The new threshold values for mild, moderate and severe TR are summarized in Table.

Conclusions
Partition values of quantitative echo-Doppler parameters used to grade mild, moderate and severe TR according to pts’ clinical outcome are significantly lower than those currently reported in guidelines. Further studies are needed to test if these new threshold values for severe TR will translate in earlier referral of pts to valve repair and improved prognosis.
Mild Moderate Severe VCavg &lt;3 mm 3-6 mm &gt;6 mm EROA &lt;0.15 cm&sup2; 0.15-0.30 cm&sup2; &gt;0.30 cm&sup2; R Vol &lt;15 ml 15-30 ml &gt;30 ml RF &lt;25% 25-45% &gt;45%
Abstract 38 Figure.
103 Normal values and gender differences of left atrial volumes
Authors: Selmer Roenningen P , Berge T , Solberg M G , Enger S , Nygaard S , Pervez O , Orstad E B , Kvisvik B A , Aagaard E N , Lyngbakken M N , Rosjo H , Tveit A , Steine K 
Published: January 2020

Abstract

Funding Acknowledgements
Vestre Viken Hospital Trust

Background
Left atrial (LA) enlargement is associated with cardiovascular morbidity and mortality. Echocardiographic guidelines recommend body surface area (BSA) indexed LA end-systolic volume (LAVimax) in the assessment of LA size with an upper normal limit of 34 ml/m² for both genders and all age groups. LA end-diastolic volume (LAVimin) and LA emptying fraction (LAEF) may add valuable information in risk assessment, but there are limited data on normal values.

Purpose
To add knowledge and explore gender differences of LA volumetric measures.

Methods
In The Akershus Cardiac Examination 1950 Study, all inhabitants of Akershus County, Norway, born in 1950 were invited. In 3,489 individuals LAVmax and LAVmin were measured with echocardiography according to the summation of discs method and indexed to BSA. LAEF was calculated. A healthy group was defined by excluding those with heart failure, atrial fibrillation, coronary artery disease, stroke, hypertension, diabetes, chronic obstructive pulmonary disease, body mass index &gt; 30kg/m², eGFR &lt; 60 ml/min/1.73 m², left ventricular ejection fraction &lt; 50%, E/e’&gt;14 and E/A &gt; 2.0. Data are presented as mean ± standard deviation (SD) and a normal range of mean ± 2SD. T-tests were used for comparisons.

Results
In 840 healthy individuals, aged 63.8 ± 0.6 years, mean LAVimax was 25.6 ± 6.3 ml/m² and the normal range was 13.0-38.2 ml/m². Men had significantly larger volumes than women.

Conclusion
We present LA volumes and LAEF in a large cohort from the general population at age 64. The upper normal limit of LAVimax in 840 healthy individuals was 38 ml/m². Men had larger LA volumes than women, contrary to most previous studies. Thus, 13% of the healthy men in our cohort would be defined with an enlarged atrium with the current cut-off value at 34 ml/m².
Table. Left atrial (LA) volumes and LAEF Total (mean ± SD) Total (2SD range) Male (mean ± SD) Female (mean ± SD) P-value (male vs. female) All participants (n = 3489) LAVimax (ml/m&sup2;) 26.8 ± 7.6 11.6-42.0 27.9 ± 8.1 25.6 ± 6.8 &lt;0.001 LAVimin (ml/m&sup2;) 14.7 ± 5.8 3.1-26.3 15.5 ± 6.5 13.9 ± 4.9 &lt;0.001 LAEF (%) 45.6 ± 9.7 26.2-65.0 45.3 ± 10.2 45.9 ± 9.2 0.07 Healthy group (n = 840) LAVimax (ml/m&sup2;) 25.6 ± 6.3 13.0-38.2 26.6 ± 6.7 24.9 ± 5.8 &lt;0.001 LAVimin (ml/m&sup2;) 13.7 ± 4.3 5.1-22.3 14.1 ± 4.6 13.3 ± 3.9 0.008 LAEF (%) 46.8 ± 8.8 29.2-64.4 47.0 ± 9.1 46.5 ± 8.4 0.37 LAVimax, LA end-systolic volume, body surface area (BSA)-indexed; LAVimin, LA end-diastolic volume, BSA-indexed; LAEF, LA emptying fraction; SD, standard deviation
P178 Dissecting ventricular septal hematoma; a rare complication of acute myocardial infarction
Authors: Etman I , Abdelgawad H 
Published: January 2020

Abstract

Ischemic heart disease is the single most common cause of mortality worldwide despite the widespread use of reperfusion. The in-hospital mortality rates of unselected patients with STEMI in national European registries vary between 4–12%.Although the incidence of mechanical complications has declined, these adverse events are still inevitable and constitute one of the major causes of death in the early phase after myocardial infarction. Dissecting interventricular hematoma is a rare life threatening mechanical complication following myocardial infarction. The resultant bleeding dissects along a plane beneath the endocardium.

Case presentation
A 57 year old male patient presented to the emergency room complaining of acute stabbing retrosternal chest pain radiating to both shoulders associated with nausea and vomiting that started 2 hours before presentation. He was known to be smoker and diabetic and had uncontrolled hypertension.
Vital signs were stable and physical examination was unremarkable . Electrocardiography (ECG) revealed normal sinus rhythm at 80 bpm, 5 mm ST elevation in leads I, aVL, V1-V6, reciprocal ST depression in leads II, III,aVF. The patient received thrombolytic therapy within 15 minutes of presentation and it was uneventful. Follow up electrocardiography was done showing failed thrombolytic therapy. The patient was managed conservatively using dual antiplatelets, high dose atorvastatin, beta blockers, ACE inhibitors. The patient remained hemodynamically stable for 5 days after which he developed respiratory distress , heart rate was 110 bpm, blood pressure was 100/60 mmHg. Physical examination revealed clear chest ,S3 gallop. 2D/ 3D transthoracic echocardiography revealed akinesis of the apical segments and mid segment of the anterior septum. There was a dissecting hematoma seen starting at mid anterior septum and extending to the apical segment.Severe mitral valve regurgitation was seen.

Conclusion
Dissecting interventricular hematoma(DIH) is a rare yet underrecognized mechanical complication following STEMI. Transthoracic echocardiography is considered to be an important imaging modality for the bedside diagnosis.
Treatment depends upon the rate of expansion of hematoma. Accordingly, stable patients with hematoma regressing gradually does not require any intervention .However, cases with rapidly expanding hematoma with hemodynamic instability will require urgent surgical intervention.
Abstract P178 Figure. Dissecting interventricular hematoma
P207 Adjunctive application of handgrip exercise associated with rapid pacing stress echocardiography in patients with implanted pacemakers
Authors: Gosciniak P , Puzik T , Leciej M , Plonska E 
Published: January 2020

Abstract

The aim
Assessment of safety, diagnostic, and prognostic value of a stress echocardiography protocol based on rapid pacing in patients with implanted permanent pacemakers and concomitant handgrip dynamometer method. There are no data in the literature on this type of modification of the stress test.

Methods
Rapid pacing stress echo tests with further handgrip were performed in 54 patients (33 females, aged 49-88, mean 72 +/- 8 years), using previously implanted permanent pacemakers. Left ventricular segmental contractility was assessed at rest, during 3 minutes pacing at the rate of 100/minutes, over 5 minutes at 85% of maximal age-predicted heart rate and then further at peak stage per 1 minute with the addition of a handgrip (compression of the dynamometer with a force equal to half the maximum strength of the patient measured before the test). The test was performed using only VVI pacing mode in 16 patients in whom atrial pacing was not possible. In the remaining 38 patients AAI/DDD pacing mode was initially used.

Results
No severe adverse effects were observed. Significant increase in heart rate comparing to baseline was achieved [74/minutes vs. 127/minutes (P &lt; 00001)]. Wall motion score index increased significantly (from 1.07 vs. 1.15, p &lt; 00001). During the handgrip stage, both systolic (p &lt; 0.0005) and diastolic (p &lt; 0.0001) blood pressure significantly increased. Among all surveys, 18 (33%) were considered positive, 36 (67%) negative. All the examinations were diagnostic. In 35 patients coronary angiography was performed (15 pts with test positive and 20 pts with test negative). Sensitivity, specificity, accuracy, positive, and negative predictive values for significant coronary stenosis were respectively: 61.6%, 68.2%, 65.3%, 53.3%, and 75%. For patients with DM2 the above values were: 83.3%, 85.7%, 84.6%, 83.3%, 85.7%. No statistical differences were observed depending on the type of the device or the use of beta blockers In patients with LMA stenosis test sensitivity was - 100%, with LAD – 62.5%, with CX - 75% and with RCA was 71.5%. Revasculization was required in 8 patiens with test positive and 3 with test negative (p = 0.01). During 6-moth follow-up there was no cardiac death, myocardial infarction or stroke .

Conclusions
The sensitivity and specificity of the stress test using the pacemaker and the handgrip method for all patients proved to be lower than the values obtained in other stress tests. However, the use of the handgrip method during stimulation caused an increase in mean systolic and diastolic blood pressure. Such an extension makes the pacing stress echo test more physiological. Moreover the stress test using pacemaker and handgrip method proved to be safe and well-tolerated by patients. The prognostic value of the negative result of the study research using stimulation from the patient"s pacemaker and the handgrip method was high in the 6 month follow-up