Reversible Cerebral Vasoconstriction Syndrome Associated with Levonorgestrel-Releasing Intrauterine System

Reversible cerebral vasoconstriction syndromes (RCVS) is a rare disease that is characterized by reversible multifocal stenosis of the cerebral arteries with various clinical manifestations. Though the pathomechanism of RCVS was unclear, we reported RCVS related to the levonorgestrel-releasing intrauterine system (IUS). A previous healthy 36-year-old woman had thunderclap headache after implanting the levonorgestrel-releasing IUS a year ago. In the serial angiography, we initially found left vertebra artery (VA), and then additionally new stenosis of both anterior cerebral arteries and middle cerebral arteries (MCA). Bilateral MCA stenosis improved but developed stenosis of right VA after a week. The mean flow velocities of both MCA increased in the first transcranial doppler (TCD), but normalized in the follow up TCD. Levonorgestrel might act as the vasoconstrictitve factor that increased the level of endothelin-1, diminished the release of NO and raised oxidative low-density lipoprotein (LDL). Although the exact pathological mechanisms for RCVS were not yet elucidated, this case might help clinicians understand the mechanisms of RCVS.

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Safety and Efficacy of the C-117 Formula for Vulnerable Carotid Artery Plaques (Spchim): A Randomized Double-Blind Controlled Pilot Study

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/9746492 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10

Author(s):

Baoying Gong ◽

Xiuyan Chen ◽

Rongming Lin ◽

Feng Zhang ◽

Jingxin Zhong ◽

...

Keyword(s):

Clinical Trials ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Low Density ◽

Double Blind ◽

Safety And Efficacy ◽

Plaque Area ◽

Formula Group ◽

The Mean

Objective. To investigate the safety and efficacy of the Herbal Medicine C-117 (C-117) formula in the treatment of carotid atherosclerotic vulnerable plaques. Methods. This was a prospective, single-centre, randomized, double-blind study. A total of 120 eligible patients were randomly divided into two groups to receive the C-117 formula or placebo. As the basic treatment, both groups were treated according to the Guidelines for Secondary Prevention of Ischemic Stroke/Transient Ischemic Stroke in China using statins to regulate blood lipids, blood pressure lowering drugs, drugs for controlling blood sugar, and antiplatelet drugs according to the indications. The primary outcomes were the change in stability, the mean change of the plaque Crouse score, and the area and number of bilateral carotid artery plaques before and after 6 months of treatment. The secondary outcomes were the total number of cardiocerebrovascular events during the treatment and follow-up and the mean changes of lipid levels. Result. After 180 days of treatment, the plaque Crouse score(95% CI, 0.39 (0.01-0.77), P=0.046) and plaque area (95% CI, 2.14 (-10.10-14.39), P=0.727) were lower in the C-117 formula group than that before treatment. The plaque Crouse score of the control group (95% CI, 0.17 (-0.24-0.57), P=0.417) was lower than that before treatment, while the plaque area (95% CI, -0.35 (-9.35-8.65), P=0.938) increased, but without statistical significance. There was no significant difference in the reduction of the intima-media thickness (IMT), plaque Crouse score, or plaque area between the two groups after treatment (P>0.05). Subgroup analysis of patients whose Lipitor medication time ≥ 20% of the 6-month treatment showed that the levels of total cholesterol, triglycerides, and low-density lipoprotein were lower in the two groups after treatment than before, and the low-density lipoprotein levels in the C-117 formula group significantly decreased (95% CI, 2.99 (-0.08-0.39), P=0.005), but there was no statistical difference between the two groups after treatment (P>0.05). No serious adverse events occurred in the two groups after 180 days of treatment. Conclusion. The C-117 formula may be antiatherosclerotic by strengthening statins to reduce the low-density lipoprotein levels and reducing the carotid plaque Crouse scores. Clinical trials with large sample sizes, long-term interventions, and follow-up are needed to investigate the efficacy of the C-117 formula. Clinical Trials Registration. This trial is registered with clinicaltrials.gov identifier: NCT03072225 (registered retrospectively on 1st March 2017).

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A multicenter prospective hospital-based cohort study on the efficacy and safety of pitavastatin.

Current Diabetes Reviews ◽

10.2174/1573399817666201228164243 ◽

2020 ◽

Vol 17 ◽

Author(s):

Abdullah Shehab ◽

Asim Ahmed Elnour ◽

Akshaya Srikanth Bhagavathula ◽

Joseph Pulavelil Kurian ◽

Gazi Hassan ◽

...

Keyword(s):

Cohort Study ◽

Adverse Events ◽

United Arab Emirates ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Low Density ◽

Efficacy And Safety ◽

Onset Diabetes ◽

The Mean ◽

New Onset

Aims: We aim to investigate the efficacy and safety of pitavastatin 4 mg in a population of people living in the United Arab Emirates (UAE). Background: Pitavastatin is a member of the HMG-CoA reductase inhibitors family which was approved for use in adult subjects with primary hyperlipidemia or mixed dyslipidemia. To date, no published studies have assessed the efficacy and safety of pitavastatin in the United Arab Emirates. Objective: The main objective of the current study was to investigate the efficacy and safety of pitavastatin in subjects with dyslipidemia for primary prevention of cardiovascular diseases based on total cardiovascular risk. Methods: This was a multicentre (four private hospitals) prospective cohort study to analyze data on the use of pitavastatin for dyslipidemia in adult outpatients in Abu Dhabi and Dubai emirates, United Arab Emirates. We have followed-up the clinical profiles of subjects in four hospitals for six-weeks during the period from June 2015 to June 2017. Efficacy was based on the evaluation of the mean (± standard deviation) change in low-density lipoprotein cholesterol between baseline and week six after the initiation of pitavastatin therapy. Safety was reported as the incidence of adverse events occurred with the use of pitavastatin and the development of new-onset diabetes. Results: A total of 400 subjects who were receiving pitavastatin 4 mg were included. The mean age of subjects was 50.7 ±10.8 years, of these 79.0% were males. At the baseline, the mean level of total cholesterol was 185.4 ±41.5 mg/dL, low density lipoprotein was 154.9 ±48.55 mg/dL, high-density lipoprotein cholesterol was 40.5 ±11.23 mg/dL and fasting blood glucose was 115.0 (±16.63) mg/dl. At the end of six weeks, low density lipoprotein levels significantly decreased to 112.09 ±41.90 mg/dl (standard mean difference [SMD] (-42.8%), 95% CI: -42.88 [-49.17 to -36.58] mg/dl, P <0.001), while high density lipoprotein levels improved (SMD, 95% CI: 1.77% [0.25 to 3.28] mg/dl, P <0.022). There were 55 subjects (13.7%) reported various adverse events such as myalgia (7.5%), sleep disorders (2.5%), and myopathy (2.2%). Furthermore, 4 (1.0%) have had developed new-onset diabetes post six-weeks of initiation of pitavastatin therapy. Conclusion: Pitavastatin 4 mg had howed robust efficacy in reducing LDL-C levels and improving HDL-C levels in subjects with dyslipidemias. The use of pitavastatin was associated with a low discontinuation rate, fewer adverse events, and very limited cases of new-onset diabetes.

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Low-density lipoprotein cholesterol goal attainment and treatment patterns in a cohort of >143,000 patients with atherosclerotic cardiovascular disease in Ontario, Canada

European Heart Journal ◽

10.1093/ehjci/ehaa946.1410 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Fairbairn ◽

P Oh ◽

R Goeree ◽

R.M Rogoza ◽

M Packalen ◽

...

Keyword(s):

Cardiovascular Disease ◽

Goal Attainment ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Data Repository ◽

Funding Source ◽

Atherosclerotic Cardiovascular Disease ◽

Low Density ◽

Low Density Lipoprotein Cholesterol

Abstract Background/Introduction Limited real-world data are available on attainment of low-density lipoprotein cholesterol (LDL-C) treatment goals in patients with atherosclerotic cardiovascular disease (ASCVD) in Canada. Purpose A retrospective observational study was conducted to describe types of ASCVD events/procedures, time between events and use of lipid lowering treatment (LLT) in patients who did not achieve LDL-C goal. Methods Patients in Ontario ≥65 years with a primary ASCVD event/procedure between 1 Apr 2005 and 31 Mar 2016, treated with an LLT and with index and follow up LDL-C values were identified from claims data at the Institute for Clinical Evaluative Sciences data repository. Patients were assessed over a 1-year follow up period for LDL-C goal attainment (<2.0 mmol/L or 50% reduction from index LDL-C) and analysed by LLT and by index event type. Results Overall, 28% of 143,302 patients ≥65 years on LLT failed to attain LDL-C goal at follow up (Figure). The proportion of patients failing to achieve LDL-C goal decreased from 35% to 22% over the 11-year study period. Mean time between index and follow up LDL-C (based on lowest score >2 weeks and up to 1 year after index LDL-C) was 203±97 days. When analysed by low-, moderate- or high-intensity statin, 57%, 30%, and 22% of patients failed to achieve LDL-C goal at follow up, respectively. Conclusions In this study, more than 1 in 4 patients with ASCVD in Ontario failed to achieve guideline recommended LDL-C goal despite treatment. In particular, ∼1 in 3 patients with cerebral and peripheral arterial disease were not at goal. An opportunity exists to better manage these high risk ASCVD patients with further statin intensification and additional LLTs This study made use of de-identified data from the ICES Data Repository, which is managed by the Institute for Clinical Evaluative Sciences with support from its funders and partners: Canada's Strategy for Patient-Oriented Research (SPOR), the Ontario SPOR Support Unit, the Canadian Institutes of Health Research and the Government of Ontario. The opinions, results and conclusions reported are those of the authors. No endorsement by ICES or any of its funders or partners is intended or should be inferred. Parts of this material are based on data and/or information compiled and provided by CIHI. However, the analyses, conclusions, opinions and statements expressed in the material are those of the author(s), and not necessarily those of CIHI Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Amgen Canada Inc.

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Subclinical Hypothyroidism and Indices for Metabolic Syndrome in Japanese Women: One-Year Follow-Up Study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2013-1353 ◽

2013 ◽

Vol 98 (8) ◽

pp. 3280-3287 ◽

Cited By ~ 18

Author(s):

Yasuyo Nakajima ◽

Masanobu Yamada ◽

Masako Akuzawa ◽

Sumiyasu Ishii ◽

Yasuhiro Masamura ◽

...

Keyword(s):

Metabolic Syndrome ◽

Odds Ratio ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Serum Triglyceride ◽

Low Density ◽

Low Density Lipoprotein Cholesterol ◽

Free T4 ◽

The Relationship

Context: Subclinical hypothyroidism (SCH) and metabolic syndrome (MetS) increase with age; however, their relationship remains unclear. Objective: Our objective was to investigate the relationship between SCH and indices of metabolic syndrome and follow up subjects for 1 year. Design: Cross-sectional and longitudinal follow-up studies of cases were collected from Takasaki Hidaka Hospital between 2003 and 2007. Participants: Overall, 11 498 participants of health checkups were analyzed. The mean age was 48 ± 9 years. Main Outcome Measures: The relationship between SCH and indices of MetS were examined. Results: Serum free T4 levels were lower in women than men in most of the age groups, and the prevalence of SCH, 6.3% in women vs 3.4% in men, increased with age, reaching 14.6% in 70-year-old women. Multivariate logistic-regression analyses revealed that waist circumference and the serum triglyceride and low-density lipoprotein-cholesterol levels were significantly higher in subjects with SCH than without among women. Reflecting these findings, the adjusted odds ratio of MetS in patients with SCH was higher than in the euthyroid subjects in women with an odds ratio of 2.7 (95% confidence interval 1.1–5.6; P = .017) but not in men. Furthermore, progression from euthyroid into SCH resulted in a significant increase in the serum triglyceride levels but not low-density lipoprotein-cholesterol in women. Conclusion: Japanese women exhibited a high prevalence of SCH associated with low free T4 levels. There was a strong association between SCH and several indices of metabolic syndrome in women. SCH may affect serum triglyceride levels and be a risk factor for metabolic syndrome.

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Effect of Whole Quail (Coturnix japonica) Egg Consumption on some Reproductive Parameters and Lipid Profile of Male Albino Rat (Rattus norvegicus)

Notulae Scientia Biologicae ◽

10.15835/nsb9310093 ◽

2017 ◽

Vol 9 (3) ◽

pp. 315-320 ◽

Cited By ~ 1

Author(s):

Chidozie N. OKOYE ◽

Samuel O. EKERE ◽

Onyinyechukwu A. AGINA ◽

Ikechukwu J. UDEANI ◽

Chukwunonso K. EZEASOR

Keyword(s):

Lipid Profile ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Control Group ◽

Low Density ◽

Epididymal Sperm ◽

Treatment Groups ◽

Egg Consumption ◽

Group A ◽

The Mean

The present study evaluated the effect of whole egg consumption on the liver, testes, cauda epididymal sperm reserve and lipid profile of male rats. These evaluations were carried out on adult twenty (20) male albino rats, which were randomly selected into four groups of 5 rats each, designated groups A, B, C and D. Group A was the control group and received only equivalent volume of distilled water, while groups B, C and D received 0.25mg/kg, 0.5mg/kg; and 1.0mg/kg body weight of the quail egg respectively. Standard procedures were carried out in the tissue processing, cauda epididymal sperm reserve and in lipid profile determinations. On days 35 and 49, the mean serum total cholesterol value of group D was significantly lower than that of the control group. On day 35, the mean serum low density lipoprotein and high density lipoprotein (LDL and HDL cholesterol) values of all the treatment groups were significantly lower and higher than that of the control group, respectively. However, on days 49 and 63, the mean serum very low density lipoprotein (VLDL cholesterol) and triglyceride values of all the treatment groups were significantly higher than that of the control group. A significant increase in cadual epididymal sperm count (CESR) was recorded on day 63 at the mid and high doses. No obvious pathological lesions were observed in the histomorphology of the testes and liver when compared to the control. Therefore, whole quail egg consumption caused an increase in serum triglyceride and very low density lipoprotein concentration, and also improved fertility. In other words, prolonged consumption of quail egg should be done with caution as it may predispose one to cardiovascular disease.

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Dilative Arteriopathy and Leucencephalopathy as Manifestations of a Neurometabolic Disease

The Open Neurology Journal ◽

10.2174/1874205x01509010028 ◽

2015 ◽

Vol 9 (1) ◽

pp. 28-31 ◽

Cited By ~ 4

Author(s):

Josef Finsterer ◽

Adam Bastovansky

Keyword(s):

Ischemic Stroke ◽

Recurrent Stroke ◽

Low Density Lipoprotein ◽

Cerebral Arteries ◽

Mitochondrial Disorder ◽

Density Lipoprotein ◽

Internal Capsule ◽

Low Density ◽

Megadolichobasilar Artery ◽

Caucasian Female

Background: Dilative arteriopathy plus leucencephalopathy as a manifestation of a mitochondrial disorder (MID) is rare. Case report: In a 70yo Caucasian female, height 160cm, weight 62kg, with mild right-sided hemiparesis due to subacute ischemic stroke in the posterior leg of the left internal capsule, a megadolichobasilar artery and marked leucencephalopathy and gliosis of the pons were detected. In addition, microbleeds in a peripheral distribution at the cortical/subcortical border were noted. After the exclusion of various differentials, which could have explained her abnormalities, a MID was suspected. Conclusions: Dilative arteriopathy of the intra-cerebral arteries, in association with recurrent stroke and supra- and infratentorial leucencephalopathy, but the absence of neurofibromatosis or increased low-density lipoprotein values, is most likely attributable to a non-syndromic MID.

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Low density lipoprotein cholesterol and all-cause mortality rate: findings from a study on Japanese community-dwelling persons

Lipids in Health and Disease ◽

10.1186/s12944-021-01533-6 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Ryuichi Kawamoto ◽

Asuka Kikuchi ◽

Taichi Akase ◽

Daisuke Ninomiya ◽

Teru Kumagi

Keyword(s):

Low Density Lipoprotein ◽

Critical Role ◽

Density Lipoprotein ◽

Community Dwelling ◽

Lipoprotein Cholesterol ◽

Low Density ◽

Adjusted Relative Risk ◽

Low Density Lipoprotein Cholesterol ◽

All Cause Mortality

Abstract Background Low-density lipoprotein cholesterol (LDL-C) independently impacts aging-related health outcomes and plays a critical role in cardiovascular diseases (CVDs). However, there are limited predictive data on all-cause mortality, especially for the Japanese community population. In this study, it was examined whether LDL-C is related to survival prognosis based on 7 or 10 years of follow-up. Methods Participants included 1610 men (63 ± 14 years old) and 2074 women (65 ± 12 years old) who participated in the Nomura cohort study conducted in 2002 (first cohort) and 2014 (second cohort) and who continued throughout the follow-up periods (follow-up rates: 94.8 and 98.0%). Adjusted relative risk estimates were obtained for all-cause mortality using a basic resident register. The data were analyzed by a Cox regression with the time variable defined as the length between the age at the time of recruitment and that at the end of the study (the age of death or censoring), and risk factors including gender, age, body mass index (BMI), presence of diabetes, lipid levels, renal function, serum uric acid levels, blood pressure, and history of smoking, drinking, and CVD. Results Of the 3684 participants, 326 (8.8%) were confirmed to be deceased. Of these, 180 were men (11.2% of all men) and 146 were women (7.0% of all women). Lower LDL-C levels, gender (male), older age, BMI under 18.5 kg/m2, and the presence of diabetes were significant predictors for all-cause mortality. Compared with individuals with LDL-C levels of 144 mg/dL or higher, the multivariable-adjusted Hazard ratio (and 95% confidence interval) for all-cause mortality was 2.54 (1.58–4.07) for those with LDL-C levels below 70 mg/dL, 1.71 (1.15–2.54) for those with LDL-C levels between 70 mg/dL and 92 mg/dL, and 1.21 (0.87–1.68) for those with LDL-C levels between 93 mg/dL and 143 mg/dL. This association was particularly significant among participants who were male (P for interaction = 0.039) and had CKD (P for interaction = 0.015). Conclusions There is an inverse relationship between LDL-C levels and the risk of all-cause mortality, and this association is statistically significant.

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Hypertriglyceridemia is associated with the incidence of preeclampsia

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v6i4.844 ◽

2018 ◽

pp. 218-221

Author(s):

Intje S Dahlan ◽

Mardiah Tahir ◽

Efendi Lukas ◽

St. Maisuri T Chalid

Keyword(s):

High Density Lipoprotein ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Mean Value ◽

High Density ◽

University Teaching ◽

Low Density ◽

Hospital Department ◽

Exact Test ◽

The Mean

Abstract Objective: to find out the correlation between lipid profille at trimester II of pregnancy and the incidence.of preeclampsia Method : The research was conducted in the Polyclinic of Hasanuddin University Teaching Hospital, Department of Obstetrics and Gynecology of the Faculty of Medicine, and it network in Makassar city from March, 2015 through March, 2016. The research used was the prospective cohort design. Results : The examination of the lipid levels of 115 pregnant mothers, aged 24-28 weeks. The mothers were then observed whether they experienced preeclampsia up to the time they gave birth or not. In the end, 8 subjects (6.9%) experienced preeclampsia and 107 subjects (93.1%) have no preeclampsia. The statistical analyses used Fisherâ€™s Exact test and Mann Whitney test. The research results indicated that the mean value of the total cholesterol and Low Density Lipoprotein (LDL) was higher in the preeclampsia group compared to the non-preeclampsia group: 267.37 Â± 64.12 : 238 Â± 37.98; 177.38 Â± 55.38 : 157.24 Â± 35.08 (p>0.05). The mean value of High Density Lipoprotein (HDL) was lower in the preeclampsia group compared to the non-preeclampsia group: 64.75 Â± 14.64 : 67.86 Â± 16.72 (p>0,05). The mean value of trigliserida in preeclampsia group was significantly higher (19,5%) compared thanin the non-preeclampsia group: 260.12 Â± 58.86 vs 209.14 Â± 65.10 (p=0,027). Conclusion : The hypertrigliseridemia was correlated with the preeclampsia incidence. Keywords:preeclampsia, lipid profile, trimester II of pregnancy Abstrak Tujuan: mengetahui hubungan antara profil lipid kehamilan trimester II dengan kejadian preeklamsia. Metode : Penelitian dilaksanakan di Poliklinik RS jejaring pendidikan Departemen Obstetri dan Ginekologi Fakulltas Kedokteran Universitas Hasanuddin dan Poliklinik Kesehatan Ibu dan Anak di beberapa Puskesmas Kota Makassar selama Maret 2015 sampai dengan Maret 2016. Rancangan penelitian yang digunakan adalah prospektif kohort. Hasil: dari 115 ibu hamil dilakukan pemeriksaan kadar lipid, 115 ibu hamil pada usia kehamilan 24 â€“ 28 minggu, kemudian diamati apakah subyek mengalami preeklamsia hingga proses persalinan. Terdapat delapan subyek (6,9%) berkembang menjadi preeklampsia dan 107 subyek tidak preeklamsia. Data dianalisis secara statistik dengan menggunakan uji Fisherâ€™s Exact dan uji Mann Whitney. Hasil penelitian menunjukkan bahwa nilai mean kolesterol total dan Low Density Lipoprotein (LDL) lebih tinggi pada kelompok preeklampsia dibandingkan kelompok tidak preeklamsia, yaitu 267,37 Â± 64,12 : 238,01 Â± 37,98; 177,38 Â± 55,38 : 157,24 Â± 35,08 (p>0,05). Nilai mean High Density Lipoprotein (HDL) lebih rendah pada kelompok preeklamsia dibandingkan tidak preeklamsia yaitu 64,75 Â± 14,64 : 67,86 Â± 16,72 (p>0,05). Nilai mean trigli seri daripada kelompok preeklamsia secara signifikan lebih tinggi 19,5 % dibandingkan kelompok tidak preeklamsia, yaitu 260,12 Â± 58,86 : 209,14 Â± 65,10 (p=0,027). Kesimpulan : Hiper trigli seridemia berhubungan dengan kejadian preeklamsia. Kata kunci : preeklamsia, profil lipid, kehamilan trimester II

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