scholarly journals Analysis of Serum Cholesterol, Statins and Atherosclerotic Plaque in Ruptured and Unruptured Intracranial Aneurysm

2022 ◽  
Author(s):  
Leonardo Zumerkorn Pipek ◽  
Nícollas Nunes Rabelo ◽  
Henrique Zumerkorn Pipek ◽  
Joao Paulo Mota Telles ◽  
Natalia Camargo Barbat ◽  
...  
Keyword(s):  
Intracranial Aneurysm ◽  
Atherosclerotic Plaque ◽  
Serum Cholesterol ◽  
Linear Regression Models ◽  
High Cholesterol ◽  
Cholesterol Levels ◽  
Reduce Serum Cholesterol ◽  
Radiological Images ◽  
The Impact

Abstract Introduction Intracranial aneurysm (IA) is a major healthcare concern. The use of statin to reduce serum cholesterol has shown evidence to reduce cardiovascular risk in various diseases, but the impact on IA has not been described. This study aims to determine whether statin use, and serum cholesterol levels interfere with outcomes after IA event. Methods A cohort of patients with IA was analyzed. Patients social and demographics data were collected. Modified Rankin scale (mRS) score after 6 months of follow-up was the endpoint. The data regarding statins use, presence or not of atherosclerotic plaque in radiological images and serum cholesterol of 35 patients were included in our study. Linear regression models were used to determine the influence of those 6 variables in the clinical outcome. Results The prevalence of atherosclerotic plaque, high cholesterol and use of statins was 34.3%, 48.5%, and 14.2%, respectively. Statins and serum cholesterol did not impact the overall outcome, measured by mRS after 6 months (p > 0.05), but did show different tendencies when separated by IA rupture status. Serum cholesterol shows an important association with rupture of aneurysm (p = 0.0382). High cholesterol and use of statins show a tendency for worse outcome with ruptured aneurysm, and the opposite is true for unruptured aneurysm. The presence of atherosclerotic plaques was not related with worse outcomes. Conclusions Multiple and opposite mechanisms might be involved in the pathophysiology of IA. Ruptured aneurysms are associated with higher levels of serum cholesterol. Serum cholesterol and statins use were not correlated with worse outcomes, but further studies are important to clarify these relationships.

Estrogen deficiency worsens steatohepatitis in mice fed high-fat and high-cholesterol diet

2011 ◽  
Vol 301 (6) ◽  
pp. G1031-G1043 ◽  
Author(s):  
Yoshihiro Kamada ◽  
Shinichi Kiso ◽  
Yuichi Yoshida ◽  
Norihiro Chatani ◽  
Takashi Kizu ◽  
...  
Keyword(s):  
Risk Factor ◽  
Liver Injury ◽  
Postmenopausal Women ◽  
Serum Cholesterol ◽  
Estrogen Deficiency ◽  
Macrophage Infiltration ◽  
High Cholesterol ◽  
High Fat ◽  
Gene Expressions ◽  
Cholesterol Levels

Recent studies indicate an accelerated progression of nonalcoholic steatohepatitis (NASH) in postmenopausal women. Hypercholesterolemia, an important risk factor for NASH progression, is often observed after menopause. This study examined the effects of estrogen on NASH in ovariectomized (OVX) mice fed a high-fat and high-cholesterol (HFHC) diet. To investigate the effects of estrogen deficiency, OVX mice and sham-operated (SO) mice were fed normal chow or HFHC diet for 6 wk. Next, to investigate the effects of exogenous estrogen replenishment, OVX mice fed with HFHC diet were treated with implanted hormone release pellets (containing 17β-estradiol or placebo vehicle) for 6 wk. OVX mice on the HFHC diet showed enhanced liver injury with increased liver macrophage infiltration and elevated serum cholesterol levels compared with SO-HFHC mice. Hepatocyte monocyte chemoattractant protein-1 (MCP1) protein expression in OVX-HFHC mice was also enhanced compared with SO-HFHC mice. In addition, hepatic inflammatory gene expressions, including monocytes chemokine (C-C motif) receptor 2 (CCR2), were significantly elevated in OVX-HFHC mice. Estrogen treatment improved serum cholesterol levels, liver injury, macrophage infiltration, and inflammatory gene expressions in OVX-HFHC mice. Moreover, the elevated expression of liver CCR2 and MCP1 were decreased by estrogen treatment in OVX-HFHC mice, whereas low-density lipoprotein dose dependently enhanced CCR2 expression in THP1 monocytes. Our study demonstrated that estrogen deficiency accelerated NASH progression in OVX mice fed HFHC diet and that this effect was improved by estrogen therapy. Hypercholesterolemia in postmenopausal women would be a potential risk factor for NASH progression.

Association of Serum Cholesterol and Triglyceride Levels with Agitation and Cognitive Function in a Geropsychiatry Unit

1996 ◽  
Vol 9 (2) ◽  
pp. 53-56 ◽  
Author(s):  
Claudia A. Orengo ◽  
Mark E. Kunik ◽  
Victor A. Molinari ◽  
Thomas A. Teasdale ◽  
Richard H. Workman ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Serum Cholesterol ◽  
Serum Triglyceride ◽  
Correlation Coefficients ◽  
Significant Negative Correlation ◽  
High Cholesterol ◽  
Cholesterol Levels ◽  
Elderly Inpatients ◽  
Comprehensive Evaluations ◽  
Relationship Of

Several studies have reported an association between aggression and cholesterol levels. The purpose of this study was to investigate the relationship of serum cholesterol and triglyceride levels with aggression and cognitive function in elderly inpatients. One hundred ten patients consecutively admitted to the Geriatric Psychiatry inpatient unit at Houston's Veterans Affairs Hospital received comprehensive evaluations by a multidisciplinary team. Fasting serum cholesterol and triglyceride levels were obtained within 3 days of admission. In addition, two geriatric psychiatrists administered the Mini-Mental State Examination (MMSE) and the Cohen-Mansfield Agitation Inventory (CMAI). Correlation coefficients were calculated between lipid levels, CMAI total and subscale scores, and MMSE scores. Multiple linear-regression analyses were done to further investigate the relation between lipid concentrations and various confounders. We found no significant correlation between serum triglyceride levels and MMSE, CMAI total, and CMAI factor scores. In addition, we found a significant positive correlation between serum cholesterol levels and physical nonaggressive behavior, and a significant negative correlation between serum cholesterol levels and MMSE scores. We found no relationship between aggressive behavior and serum cholesterol or triglyceride levels. However, an association between high cholesterol levels and agitation exists, which may be mediated by the association between high cholesterol levels and impaired cognition.

scholarly journals PP029 Hospitalizations And Costs In Bipolar Disorder Patients Initiating Long-acting Injectable Antipsychotics

2017 ◽  
Vol 33 (S1) ◽  
pp. 83-83
Author(s):  
Mallik Greene ◽  
Tingjian Yan ◽  
Eunice Chang ◽  
Ann Hartry ◽  
Michael Broder
Keyword(s):  
Bipolar Disorder ◽  
Reference Group ◽  
Cohort Analysis ◽  
Linear Regression Models ◽  
Inpatient Hospitalization ◽  
Inpatient Hospitalizations ◽  
Long Acting ◽  
Bipolar Patients ◽  
The Impact

INTRODUCTION:Existing studies have not investigated the effectiveness of one long-acting injectable antipsychotic (LAI) versus another in preventing hospitalizations among patients with bipolar disorder (BD). This study was conducted to compare all-cause inpatient healthcare utilization and associated costs among BD patients who initiated LAIs.METHODS:This retrospective cohort analysis used the Truven Health Analytics MarketScan® Commercial and Medicaid claims database. Bipolar patients >18 years with at least one claim for one of the following LAIs were identified between 1 January 2013 and 30 June 2014 (identification period): aripiprazole, haloperidol, paliperidone, and risperidone. The first day of initiating an LAI was considered the index date. Logistic regression and generalized linear regression models were conducted to estimate risk of inpatient hospitalization and associated costs during the 1-year follow up.RESULTS:A total of 1,540 BD patients initiated an LAI: 14.5 percent aripiprazole, 16.3 percent risperidone, 21.0 percent haloperidol, and 48.1 percent paliperidone. With the aripiprazole cohort as the reference group, the odds of having any inpatient hospitalizations were significantly higher in haloperidol [Odds Ratio, OR (95 percent Confidence Interval, CI): 1.49 (1.01 - 2.19)] and risperidone [1.78 (1.19 - 2.66)] cohorts. The paliperidone cohort also had a higher risk of having a hospitalization than aripiprazole, but the difference was not statistically significant (p>.05). Among LAI initiators having any inpatient hospitalizations, the adjusted mean all-cause inpatient costs were lowest in the aripiprazole cohort (USD26,002), followed by risperidone (USD27,937), haloperidol (USD30,411), and paliperidone (USD33,240). However, the cost difference was not statistically significant.CONCLUSIONS:Our study findings highlight the value of aripiprazole in reducing all-cause inpatient hospitalizations and associated costs among patients with BD during the 1-year follow-up. It is worthwhile to note that bipolar diagnoses were identified from healthcare claims coded for reimbursement purposes, thus misclassification was possible. Future studies are warranted to understand the impact of LAI use in a longer period of time.

scholarly journals The Impact of Pre-Operative Mental Health and Depression on Outcomes after Total Ankle Arthroplasty

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0018
Author(s):  
Daniel J. Cunningham ◽  
John Steele ◽  
Samuel B. Adams
Keyword(s):  
Mental Health ◽  
Patient Reported Outcomes ◽  
Total Ankle Arthroplasty ◽  
Linear Regression Models ◽  
Ankle Arthroplasty ◽  
Change Scores ◽  
Short Musculoskeletal Function Assessment ◽  
Patient Reported ◽  
The Impact

Category: Ankle Introduction/Purpose: Poor pre-operative mental health and depression have been shown to negatively impact patient- reported outcomes (PROMs) after a broad array of orthopaedic procedures involving the spine, hip, knee, shoulder, and hand. However, the relationship of mental health and patient-reported outcomes in foot and ankle surgery is less clear. The purpose of this study is to characterize the impact of pre-operative mental health and depression on patient-reported outcomes after total ankle arthroplasty. The study hypothesis is that depression and decreased SF36 MCS will be significantly associated with diminished improvement in PROMs after total ankle arthroplasty. Methods: All patients undergoing primary TAA between January 2007 and December 2016 who were enrolled into a prospective, observational study and who had at least 1 to 2-year minimum study follow-up were included. Patients were separated into 4 groups based on the presence or absence of SF36 MCS<35 and diagnosis of depression. Pre-operative to post- operative change scores in the SF36 physical and mental component summary scores (PCS and MCS), Short Musculoskeletal Function Assessment (SMFA) function and bother components, and visual analog scale (VAS) pain were calculated in 1 to 2-year follow-up. Multivariable, main effects linear regression models were constructed to evaluate the impact of SF36 and depression status on pre-operative to 1 to 2-year follow-up change scores with adjustment for age, sex, race, body mass index, current smoking, American Society of Anesthesiologist’s score, smoking, and Charlson-Deyo comorbidity score. Results: As in Table 1, adjusted analyses demonstrated that patients with MCS<35 and depression had significantly lower improvements in all change scores including SF36 MCS (-5.1 points) and PCS (-7.6 points), SMFA bother (6 points) and function scores (5.7 points), and VAS pain (7.5 points) compared with patients that had SF36>=35 and no depression. Patients with MCS<35 and no depression had significantly greater improvement in SF36 MCS (5.3 points) compared with patients that had MCS>=35 and no depression. Patients with MCS>=35 and depression had significantly lower improvement in SF36 MCS (-3.2 points) compared with patients that had MCS>=35 and no depression. Adjusted analyses of minimum 5-year outcomes demonstrated significantly increased improvement in MCS and SMFA function for patients with pre-operative MCS<35 and no depression. Conclusion: Presence of depression and decreased SF36 MCS are risk factors for diminished improvement in PROMs. Patients with depression and decreased MCS should be counseled about their risk of diminished improvement in outcomes compared to peers. As PROM’s become part of physician evaluations, it is becoming increasingly important to identify factors for diminished improvement outside of the physician’s control. [Table: see text]

scholarly journals The effect of coffee consumption on serum total cholesterol in the Sami and Norwegian populations

2010 ◽  
Vol 13 (11) ◽  
pp. 1818-1825 ◽  
Author(s):  
Tove Nystad ◽  
Marita Melhus ◽  
Magritt Brustad ◽  
Eiliv Lund
Keyword(s):  
Total Cholesterol ◽  
Serum Cholesterol ◽  
Coffee Consumption ◽  
Cross Sectional Study ◽  
Total Serum ◽  
Total Serum Cholesterol ◽  
Cross Sectional ◽  
Cholesterol Levels ◽  
The Mean ◽  
The Impact

AbstractObjectiveTo assess coffee consumption in the Sami and Norwegian populations and to investigate the impact of unfiltered boiled coffee consumption on serum cholesterol concentrations.DesignA cross-sectional study. Information was collected by self-administrated questionnaires and total serum cholesterol was analysed. Participants were divided into three ethnic groups: Sami I (Sami used as home language in the last three generations), Sami II (at least one Sami identity marker) and Norwegian.SettingIn an area with Sami, Kven/Finnish and Norwegian populations, the SAMINOR study, 2003–2004.SubjectsA total of 5647 men and 6347 women aged 36–79 years.ResultsMore than 90 % of the study populations were coffee drinkers. Only 22 % were unfiltered coffee consumers. Sami I had the highest proportion of participants who consumed nine or more cups of unfiltered coffee per day, although the number of participants was limited. Total coffee consumption was associated with increased total cholesterol for men (P < 0·01) and women (P < 0·0001). For those who drank only unfiltered coffee, a significant association was found only in Norwegian men, adjusted for physical activity in leisure time, BMI and smoking habits (P < 0·001). From the lowest (less than five cups) to the highest (nine or more cups) unfiltered coffee consumption category, the mean total cholesterol levels increased by 0·29 mmol/l in Norwegian men.ConclusionsUnfiltered coffee consumption was lower in the present study compared to previous reports. In general, total coffee consumption was positively associated with total cholesterol levels. However, for unfiltered coffee consumption, an association was found only in Norwegian men.

scholarly journals A Nonlinear Association of Serum Cholesterol Level with Incident Coronary Heart Disease in Elderly Men

Circulation ◽  
2001 ◽  
Vol 103 (suppl_1) ◽  
pp. 1362-1363
Author(s):  
Beatriz L Rodriguez ◽  
Robert D Abbott ◽  
Kamal H Masaki ◽  
Irwin J Schatz ◽  
Randi Chen ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cholesterol Level ◽  
Serum Cholesterol ◽  
Negative Relationship ◽  
Japanese American ◽  
Elderly Men ◽  
Cholesterol Levels ◽  
Non Linear

P62 Increased serum cholesterol has been found to be a direct risk factor for coronary heart disease (CHD) in middle aged individuals in epidemiologic follow-up studies. However, this relationship has not been consistently reproduced in elderly populations. From 1991-93, 2424 elderly (71-93 years old) Japanese American men from the Honolulu Heart Program cohort, who did not have prevalent CHD and who were not on cholesterol lowering drugs, were examined. The subsequent 6-year follow-up provided an opportunity to closely examine the relationship between their baseline cholesterol and their incidence of CHD as determined by surveillance and a physician panel review. The study revealed a significant non-linear association of the baseline cholesterol with the incidence of CHD (p=0.033). Among the 1524 elderly men with cholesterol values below 200mg/dl the age adjusted CHD rate decreased as the mean cholesterol level increased. In those with cholesterol levels of greater than or equal to 200mg/dl (900) the age adjusted CHD rates increased with increasing level of cholesterol. The lowest CHD rates were seen in men with cholesterol levels between 200 and 219 mg/dl. Multivariate adjustment for other know risk factors (BMI, smoking, hypertension, diabetes, and HDL), decreased the strength of this non-linear relationship but it remained significant (p=0.049). A measure of frailty (10% weight loss since an exam 20 years before) further reduced the strength of the cholesterol relationship slightly but did so by reducing the magnitude of the cholesterol/CHD relationship in both those higher cholesterol (positive relationship) and those with lower cholesterol (negative relationship). Thus it is unlikely that frailty can fully explain the reverse cholesterol/CHD relationship seen in those with lower cholesterol levels. In this study the majority of men already had cholesterol levels below the standard cutpoint of 200mg/dl and had the opposite pattern of risk as elderly men with cholesterols above that cutpoint. This would indicate that further data is needed before recommending lowering of cholesterol to levels below 200mg/dl in older individuals.

Overnight fasting serum cholesterol, HDL, LDL and triglycerides levels and bone mineral density (BMD) values during adjuvant letrozole in daily practice.

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 11040-11040
Author(s):  
C. Fontaine ◽  
M. Huizing ◽  
A. Dewaele ◽  
K. Vandenbossche ◽  
J. Vermey ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Serum Cholesterol ◽  
Hormone Receptor ◽  
Daily Practice ◽  
Fasting Serum ◽  
Mineral Density ◽  
Hormone Receptor Positive ◽  
Cholesterol Levels ◽  
Overnight Fasting

11040 Background: Background: Randomized clinical trials (RCT’s) have demonstrated a superiority of adjuvant aromatase inhibitors (AI’s) over tamoxifen (TAM) in disease free survival and overall survival, immediately postoperatively, in cross-over or extended setting in hormone receptor positive BC. In these studies AI’s were associated with increased bone demineralization and a rise in non- fasting serum cholesterol. Patients and methods: The tolerance for adjuvant letrozole was reviewed in 185 postmenopausal women with hormone receptor-positive early BC including fasting cholesterol levels and bone mineral density (BMD) values. Results: 121 patients (pts) received first-line adjuvant letrozole and 64 pts were crossed over from TAM. Median follow-up was 26 months (15–63 mths). Median age was 56 yrs (37–85y). Median time on letrozole was 23 months. Forty three of the 185 (24 %) of the pts discontinued the adjuvant therapy with letrozole (after a median duration of treatment of 5 months (1wk-30mths)), because of intolerance (83.7%)and PD in 16.3%. Median overnight fasting serum cholesterol levels did not change significantly (p=0.4) over a 2 year observation period from (203.5 mg/dl (131–342)) baseline to (205.5 mg/dl (151–330)) follow-up in 32 evaluable (14/32 pts prior TAM) pts. Median HDL levels rose from 65.5 mg/dl (38–107) to 70 mg/dl (38–103) (p=0.03) after 2 years, but LDL levels did not rise significantly. In the contrary triglycerides levels decreased from 122.5 mg/dl (48–238) to 105 mg/dl (47–285) (p=0.01). Despite the use of upfront biphosphonates in 1/3 of the pts, loss of BMD was significant for the lumbar spine after 2 years in 22 evaluable (8/22 prior TAM) pts (median T-score decreased from minus 0.3 to -0. 45, p=0.02), but not for the hip. Conclusion: Adjuvant letrozole did not significantly increase overnight fasting serum cholesterol levels in daily practice. Adjuvant letrozole was associated with a significant rise in HDL levels and a significant decrease in triglycerides levels after 2 years of therapy. Loss of BMD was observed in concordance with results from RCT’s. Adjuvant letrozole had to be discontinued prematurely because of tolerance issues in 20 % of the pts. No significant financial relationships to disclose.

Abstract 17259: Differential Changes in Plaque Behind the Stent After Bare-Metal and Drug-Eluting Stent Implantation in Humans: Implications for In-Stent Restenosis?

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ioannis Andreou ◽  
Koki Shishido ◽  
Antonios P Antoniadis ◽  
Saeko Takahashi ◽  
Masaya Tsuda ◽  
...  
Keyword(s):  
Atherosclerotic Plaque ◽  
Neointimal Hyperplasia ◽  
Drug Eluting Stent ◽  
Bare Metal ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
Relative Change ◽  
The Impact ◽  
In Stent Restenosis

Background: The natural history and the role of the atherosclerotic plaque located behind the stent (PBS) are still poorly understood. We evaluated the serial changes in PBS following bare-metal (BMS) compared with first-generation drug-eluting stent (DES) implantation and the impact of these changes on in-stent neointimal hyperplasia (NIH). Methods: 3D coronary reconstruction by angiography and intravascular ultrasound were serially performed after intervention and at 6- to 10-month follow-up in 157 Japanese patients treated with BMS (n=90) and DES (n=98; 68 sirolimus-eluting and 30 paclitaxel-eluting stents) included in the PREDICTION Study. Each reconstructed stented coronary artery was divided into consecutive 1.5-mm segments. External elastic lamina, lumen, stent, and PBS area were measured for each segment at both baseline and follow-up. At follow-up NIH area was assessed. Due to the very low rate of events in our population we used significant NIH (defined as NIH area >50% of stent area) as a binary anatomic outcome. Results: Patient, lesion, and stent characteristics were comparable between BMS and DES. There was a significant decrease in PBS area after BMS (median relative change: -7.2%, IQR -19.3 to 5.2%, p<0.001) and a significant increase after DES implantation (median relative change: 6.1%, IQR -5.7 to 20.5%, p<0.001). The decrease in PBS area significantly predicted NIH area at follow-up after controlling for baseline lumen area and baseline PBS area in both BMS (β 0.15, 95% CI 0.1 to 0.2, p<0.001) and DES (β 0.09, 95% CI 0.07 to 0.11, p<0.001). The decrease in PBS area was the most powerful predictor of significant NIH in both BMS (OR 1.13, 95% CI 1.02 to 1.26, p=0.017) and DES (OR 1.65, 95% CI 1.16 to 2.36, p=0.005). Conclusions: The PBS significantly decreased 6 to 10 months after BMS implantation, whereas after DES it increased. The decrease in PBS area was significantly associated with the development of NIH at follow-up in both stent types. These findings raise the possibility of a communication between the lesion within the stent and the underlying native atherosclerotic plaque, and may have important implications regarding the pathobiology of in-stent restenosis.

The impact of pain on the course of ADL functioning in patients with dementia

2020 ◽  
Author(s):  
Annelore H van Dalen-Kok ◽  
Marjoleine J C Pieper ◽  
Margot W M de Waal ◽  
Jenny T van der Steen ◽  
Erik J A Scherder ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Score ◽  
Nursing Home Residents ◽  
Linear Regression Models ◽  
Dutch Version ◽  
The Difference ◽  
Item Scores ◽  
The Impact ◽  
The Relationship

Abstract Background Understanding if and how pain influences activities of daily living (ADL) in dementia is essential to improving pain management and ADL functioning. This study examined the relationship between the course of pain and change in ADL functioning, both generally and regarding specific ADL functions. Methods Participants were Dutch nursing home residents (n = 229) with advanced dementia. ADL functioning was assessed with the Katz ADL scale, and pain with the Dutch version of the Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC-D). Changes of PACSLAC-D and Katz ADL scores were computed based on the difference in scores between baseline, 3-month and 6-month follow-up. Multivariate linear regression models were used to assess the relationships between change in pain score, change in total ADL score and specific ADL item scores during follow-up. Results At baseline, residents had a median ADL score of 18 (interquartile range 13–22, range 6–24) and 48% of the residents were in pain (PACSLAC-D ≥ 4). Residents with pain were more ADL dependent than residents without pain. A change in pain score within the first 3 months was a significant predictor for a decline in ADL functioning over the 6-month follow-up (B = 0.10, SE = 0.05, P = 0.045), and specifically, a decline on the items ‘transferring’ over the 6-month follow-up and ‘feeding’ during the first 3 months of follow-up. Conclusions Pain is associated with ADL functioning cross-sectionally, and a change in pain score predicts a decline in ADL functioning, independent of dementia severity. Awareness of (changes in) ADL activities is clearly important and might result in both improved recognition of pain and improved pain management.

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