Hans Reith and Sonya Rauchschwalbe
Pro-Atrial Natriuretic Peptide (proANP) A New Prognostic Marker in Clinical Outcome of Critically Ill Patients
The diagnosis of sepsis and the prediction of its outcome are important aims to tackle for this heterogeneous disease. There is a lack of biomarkers to aid in identification of risk groups, inclusion of patients in ongoing studies, and better differentiation of therapeutic strategies. Since the introduction of the prohormone procalcitonin (PCT), many studies have begun to focus on new prohormones.
The aim of the study was to evaluate the prognostic value of pro-atrial natriuretic peptide (proANP) as a new marker of sepsis outcome.
Material and methods. A cohort of 80 patients developing post-surgical sepsis was consecutively included into this study. Blood samples were obtained for analysis of proANP and determination the serum levels of sTNF-R1, TNF-α, IL-6, IL-8, IL-10, procalcitonin and neopterin. Cytokine levels were measured repeatedly until the patients discharge from the ICU.
Results. 54/80 (67.5%) fulfilled the criteria for severe sepsis and 36/80 (45.0%) developed septic shock. Multiple organ failure occurred within 60/80 patients (75.0%); the overall mortality was 26/80 (32.5%). Concerning the diagnosis of sepsis, severe sepsis, or septic shock, there was no statistical difference in the proANP values. However, there was a statistical difference in the prediction of outcome in that 26 nonsurvivors had 803.5 (441.5/ 1095) pmol/L levels while the survivors level was 315.5 (187/ 594.5) pmol/L. In addition, there were no statistical significant differences between proANP and other cytokines.
Conclusions. There was a significant correlation between proANP values and the outcome of critically ill patients. ProANP does not differentiate between clinical features like sepsis, severe sepsis or septic shock.
Stefan Eisold, Karl Guenther and Hans Reith
Diverticulitis of the Small Bowel
In contrast to diverticulosis of the large bowel, diverticular disease of the small bowel is rare. This small bowel disease is predominantly localized to the duodenum. Jejunal and ileal diverticula are rare and occur in the majority of patients without clinical impact. Less than 10% of patients develop serious complications, including obstruction, hemorrhage, perforation and penetration. Here, we present 4 patients with jejunal diverticulitis. Three of these patients experienced perforation.
Balázs József Nagy, Magdolna Makó, István Erdélyi, Andrea Ramirez, Jonathan Moncada, Iris Vural Gursel, Ana Ruiz-Martínez, Aurora Seco, José Ferrer, Fabian Abiusi, Hans Reith, Lambertus A.M. van den Broek, Jordan Seira, Diana Garcia-Bernet, Jean-Philippe Steyer and Miklós Gyalai-Korpos
Different species of microalgae are highly efficient in removing nutrients from wastewater streams and are able to grow using flue gas as a CO2 source. These features indicate that application of microalgae has a promising outlook in wastewater treatment. However, practical aspects and process of integration of algae cultivation into an existing wastewater treatment line have not been investigated. The Climate-KIC co-funded Microalgae Biorefinery 2.0 project developed and demonstrated this integration process through a case study. The purpose of this paper is to introduce this process by phases and protocols, as well as report on the challenges and bottlenecks identified in the case study. These standardized technical protocols detailed in the paper help to assess different aspects of integration including biological aspects such as strain selection, as well as economic and environmental impacts. This process is necessary to guide wastewater treatment plants through the integration of algae cultivation, as unfavourable parameters of the different wastewater related feedstock streams need specific attention and management. In order to obtain compelling designs, more emphasis needs to be put on the engineering aspects of integration. Well-designed integration can lead to operational cost saving and proper feedstock treatment enabling algae growth.