scholarly journals The effect of therapy on subclinical atherosclerosis of the carotid arteries in patients with calcium pyrophosphate crystal deposition disease and osteoarthritis (pilot study)

2021 ◽  
Vol 59 (6) ◽  
pp. 708-714
Author(s):  
M. S. Eliseev ◽  
O. V. Zhelyabina ◽  
M. N. Chikina ◽  
E. I. Markelova ◽  
I. G. Kirillova ◽  
...  

Endothelial dysfunction associated with chronic microcrystalline inflammation plays a role in the progression of atherosclerosis in calcium pyrophosphate crystal deposition diseases (CPPD).The aim of the study was to assess the dynamics of the development of atherosclerosis based on changes in the thickness of the intima-media complex (ICIM) of the carotid arteries (CA) in patients with CPPD receiving long-term anti-inflammatory therapy (colchicine, methotrexate, hydroxychloroquine).Materials and methods. 26 patients with CPPD and 26 patients with osteoarthritis aged over 18 years old were included. Exclusion criteria: age >65 years; presence of cardiovascular diseases. The blood lipid spectrum, hs-CRP level, anthropometric parameters were determined for all, and Doppler ultrasound ultrasonography of the carotid arteries (CA) was performed. Patients were followed up for not <6 months, assessed ICIM CA at 1 visit, then patients with CPPD, at the discretion of the attending physician, were prescribed methotrexate at a dose of 15 mg per week, hydroxychloroquine 200 mg 1 time per day or colchicine 0.5 mg 2 times a day. Patients could take NSAIDs if they were in pain. The SCORE index has been calculated for everyone.Results. Initially, ICIM values did not differ in patients with CPPD and OA. Initially, ICIM>0.9 mm were detected in 11 of 22 (50%) patients with CPPD and in OA in 8 of 19 (42%) (p=0.39). In dynamics, patients with CPPD revealed a decrease in the number of patients with ICIM>0.9 mm from 42 to 18%. At the same time, in 8 patients with CPPD, ICIM>0.9 mm was combined with a CRP level >0.2 mg/l. Out of 22 patients with CPPD, 14 (64%) patients showed a decrease in the mean values of ICIM, in 2 (9%) patients - an increase, in 5 patients the mean values of ICIM did not change. After 6 months of therapy, out of 11 patients with CPPD with ICIM >0.9 mm, after 6 months of therapy, in 7 cases there was a decrease in the indicator less than the specified value, in 5 of them a decrease in serum CRP level <2 mg/l was recorded. In patients with CPPD, the serum CRP level significantly decreased; in patients with OA, it did not change. Out of 19 patients with OA, 9 (47%) patients showed an increase in the mean ICIM over time, while the rest did not change. In those treated with hydroxychloroquine, a decrease in the mean ICIM parameters was observed in 5 out of 6 (83%) patients, colchicine - in 6 out of 9 (67%) patients, methotrexate - in 4 out of 7 (57%) patients.With CPPD, the result of therapy with colchicine, methotrexate and hydroxychloroquine in relation to the development of the initial signs of atherosclerosis according to Doppler ultrasound ultrasonography of CA can be realized based on the presence of chronic inflammation.

2021 ◽  
Vol 15 (5) ◽  
pp. 33-38
Author(s):  
M. S. Eliseev ◽  
O. V. Zhelyabina ◽  
A. M. Novikova ◽  
M. N. Chikina ◽  
E. I. Markelova ◽  
...  

To this date there have been no studies of subclinical atherosclerosis in the patients with calcium pyrophosphate crystal deposition disease (CPPD); in osteoarthritis (OA) such works are rare.Objective: to assess the prevalence of subclinical atherosclerosis of carotid arteries (CA) in patients with CPPD and OA.Patients and methods. The case-control study included 26 patients with CPPD and OA. The diagnosis of CPPD was based on the criteria of D.J. McCarty, diagnosis of OA was based on national clinical practice guidelines. We recorded data on smoking, blood pressure level. Assessed blood lipid spectrum, serum levels of glucose, creatinine, uric acid, CRP. Obesity was diagnosed in accordance with the WHO recommendations. All patients underwent CA Doppler ultrasonography (DUS). An increase in intima-media thickness (IMT) >0.9 mm was considered a manifestation of subclinical atherosclerosis. The SCORE index was calculated for all patients.Results and discussion. The median serum CRP level was comparable in CPPD and OA. The CRP level >5 mg/L was detected in 8 patients with CPPD and in 3 patients with OA (p=0.09). Initial signs of atherosclerosis were present in 11 (42%) patients with CPPD and in 8 (31%) patients with OA (p=0.39). In CPPD, an increase in IMT was associated with a CRP level of ≥5 mg/L in 19% of cases, and in OA – in 12.5% (p=0.08). An increase in IMT >1.3 mm was not found in patients of both groups.Conclusion. In patients with CPPD and OA, subclinical atherosclerosis is often present according to the CA ultrasound. Early detection of uncomplicated subclinical atherosclerosis in CPPD and OA is necessary for timely initiation of treatment aimed to prevent the progression of atherosclerosis and the development of cardiovascular diseases.


Author(s):  
V. V. Kucheryavchenko

In recent years, the concept of "metabolic syndrome" has become more spreading, and in parallel with disorders of carbohydrate and lipid metabolism, endothelial dysfunction is no less significant. The aim of our work was to analyze changes in homocysteine (HC) as a marker of metabolic syndrome in patients with an increased body mass index (IBMI) in polytrauma. The study involved 224 patients with polytrauma, who had different initial values of body mass index (BMI) and were treated at the polytrauma department and the intensive care unit for patients with combined injuries for a period from 1 day to 1 year since the moment of injury. All the patients were subjected to identifying the level of serum HC. The patients had the same severity according to the APACHE II scale, 14 ± 5.8, at the admission to the hospital, and were divided into 3 stratified clinical groups depending on the initial values of anthropometric parameters and BMI. The study was conducted on the 1, 3, 7, 14, 30 and 360 days from the date of polytrauma. Assessment of blood serum HC was performed by ELISA. It was found that the overweight patients with BMI ≤ 29.9 demonstrated an increase in the mean values of blood HC on the 7th and 14th days of the treatment, with a further decrease on the 15th day since the date of injury. For the patients with BMI within the range of 30.0 - 39.9, the persistence of the HC index during the first month of the treatment at baseline with an increase on the 360th day was found out. The patients with BMI ˃ 40.0 showed an increase in the level of blood HC through the year since the date of polytrauma. It was revealed that the level of HС directly affects the course of traumatic disease in patients with increased BMI, its severity in terms of uniformity of injuries received and the same range of severity according to the APACHE II scale depends on BMI at the admission to the hospital.


Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 5166-5166
Author(s):  
William Breuer ◽  
Hussam Ghoti ◽  
Hesham Jeadi ◽  
Ada Goldfarb ◽  
Eliezer A. Rachmilewitz ◽  
...  

Abstract Abstract 5166 Background. Systemic iron overload (SIO) is characterized by persistently high levels of plasma iron that often surpass transferrin's (Tf) binding capacity and generate chemical forms identified as non-Tf bound iron (NTBI). These forms have been perceived as: a. clinically important indicators of SIO per se and of impending organ damage, because cells chronically exposed to iron overloaded plasma attain iron levels and ensuing ROS formation that override their antioxidant capacities and b. as pharmacological targets for chelation and thereby of prevention of tissue iron overload. However, NTBI determination in the clinical setting has been confounded by the chemical heterogeneity of iron forms found in fluids like plasma/sera of SIO patients, the presence of residual amounts of undefined chelates or chelators and the need to dislodge NTBI from native ligands with agents that facilitate its detection. We have assayed the overt forms of NTBI that represent the native pool of labile (= redox-active, chelatable and membrane permeant) iron in plasma/serum. We defined it as ‘labile plasma iron' or LPI and analyzed it by the Aferrix FeROS™ test (1) and used it to asses chelation regimens in their ability to maintain patients' plasma at relatively low (basal) LPI levels (<0.4 μ M, ref. 2). Detection of NTBI forms with both low redox activity and poor chelator accessibility (defined as cryptic LPI) can also be done with the FeROS™ test by supplementing samples with an agent (nitrilotriacetate= NTA < 0.5 mM) that in plasma “extracts” iron from native NTBI. Thus whereas LPI measures overtly labile NTBI in native plasma (i.e. LPI), LPIplus detects both overt + cryptic forms, as in classical NTBI assays that involve either mobilization + filtration (3) or in the DCI (directly chelatable iron) assay that measures deferrioxamine chelatable NTBI (4). Aim. To compare SIO parameters in polytransfused thalassemia major patients, chelated and non-chelated, as revealed by measurements of overt and cryptic LPI. Methods. The studies involved: 1. The Hadassah Medical Center (HMC) in Jerusalem, where 15–20 (randomly selected, age 14–35) patients were under regular transfusion/chelation treatment and 2. The European Medical Center in Gaza (EMC), where regularly transfused patients (age 10–22) were only sporadically chelated. NTBI assays were performed on sera prepared from blood, (where applicable taken after >10 hrs drug washout, as described for LPI (1,2) and DCI (4); for LPIplus, the LPI test was conducted in the presence of 0.5 mM NTA. Results. As shown previously (2,4), LPI was detected only in patients with >70% Tf-saturation. In HMC, the mean LPI of n=18 patients rose from 0.51±0.41 μ M to 1.00 ±0.46 μ M in the presence of NTA, matching the DCI level of 0.91±0.7 μ M. The LPI rise was detected in 12/15 (= 80%) of samples with LPI>0.4 μ M (≂p 66% of the entire cohort). Thus, despite chelation, a substantial number of patients had relatively low but significant levels of both overt and cryptic NTBI. Among the 3 patients with no significant LPI or DCI (0.2-0.4 μ M), 2/3 became LPI positive (0.6-0.8 μ M) when tested with NTA. Unexpectedly, in EMC-Gaza, among 20 transfused unchelated patients with serum ferritins > 5000 ng/ml and Tf saturation >100%, 8/20 of them (≂p 40%) had undetectable levels of overt LPI but substantial cryptic NTBI. In the remaining 12/20, the mean overt LPI of 0.69±0.65 μ M rose significantly (p<0.01) to 2.05 ±1.56 μ M when the cryptic component (NTA-extractable) was added. Discussion. Overt and cryptic NTBI components were detected by two modalities of the LPI assay in both regularly chelated and unchelated thalassemia patients, although to different extents and proportions. Compared to chelated patients, those unchelated had significantly higher mean values of both overt and cryptic NTBI components, despite the higher proportion of patients with only cryptic NTBI. On an individual basis, the persistent appearance of either/both LPI component(s) of NTBI could provide a measure of SIO and/or the success of individual chelation regimens. However, remaining to be established is the pathophysiological role of each component of NTBI to SIO, disease progression and treatment success. Supported by ISF and the Canadian Friends of HUJI. 1. Esposito et al. Blood 102:2670-7 (2003); 2. Zanninelli et al. Br. J. Hematol. 147: 744–51(2009); 3. Hider R. Eur J Clin Invest 32:S50–4 (2002); 4. Pootrakul et al. Blood 104: 1504–10 (2004). Disclosures: Cabantchik: Aferrix Ltd: Consultancy, Membership on an entity's Board of Directors or advisory committees.


2021 ◽  
Vol 66 (2) ◽  
pp. 69-74
Author(s):  
S. Yu. Vorotnikova ◽  
L. K. Dzeranova ◽  
N. S. Fedorova ◽  
E. A. Pigarova ◽  
M. G. Vershinina ◽  
...  

Prolactin exists in various forms including the monomeric biologically active form (23kDa) and a higher molecular weight form, bound most commonly to IgG, known as macroprolactin (>100kDa). Macroprolactin lacks biological activity and is one of the causes of false-positive results. In Russian Federation the most common method for macroprolactin determination is PEG precipitation test. We had conducted a retrospective analysis of 37 samples of patients with hyperprolactinemia (3 of them were males). The mean age was 30 [25;35] years. Prolactin level was measured by the immunoenzyme method with manual PEG precipitation and TRACE. The mean values found by the immunoenzyme method with manual PEG precipitation were 461,6 [375,0;821,2] mU/l, by TRACE - 449,9 [357,2;749,2] mU/l. The number of patients with normal prolactin levels was 30% (11) confirmed by two methods, high prolactin level at 46% (17). The prevalence of clinical symptoms of hyperprolactinemia was not differ depend the groups. The phenomenon of macroprolactinemia was registered in 32% (12) of patients. In 8 persons of this group normal prolactin level was revealed and in 4 patients hyperprolactinemia was found by TRACE. Measurements of prolactin levels by the TRACE method is useful for correct diagnosis in patients with equivocal results received by traditional method with PEG precipitation.


2021 ◽  
Vol 13 (2) ◽  
Author(s):  
Anita Lamošová ◽  
Oľga Kyselovičová ◽  
Petra Tomková

The purpose of this study was to investigate the effect of one-year specific aerobic gymnastics training on selected anthropometric and motor parameters in 6-11-year-old girls. 23 girls (average age in the beginning of the study was 8.04 ± 1.22 years) were involved in the study representing 2 different aerobic gymnastics sports clubs in Slovakia. The selected group completed their regular trainings and competitions for a period of one year. Measurements were taken in January 2019 and January 2020, in the middle of the preparatory period. Normality of distribution of the traits was examined using the Shapiro-Wilk test. Data were analyzed using Wilcoxon signed-rank test. Considering anthropometric parameters, there were significant changes (p≤0.01) in body height, body weight and BMI. Considering motor parameters, the mean values of straddle support hold and back extension endurance test increased significantly to the level of p≤0.05. The mean values of 4x10m shuttle run, standing long jump, modified push-ups, sit-ups in 60s increased significantly to the level of p≤0.01. No significant changes were observed in bent arm hang test or hanging knee tucks. On the other hand, the values of 1 leg stand with eyes closed and 2-min endurance shuttle run decreased insignificantly.


2004 ◽  
Vol 4 (2) ◽  
pp. 45-50
Author(s):  
Jasminka Hadžihalilović ◽  
Amira Redžić ◽  
Rifat Terzić ◽  
Fatima Jusupović ◽  
Amir Hadžihalilović ◽  
...  

Birth order and its effect on growth and development of children and youths have rarely been studied so far. The objective of this research was an analysis of the birth order effects on some anthropometric properties of the boys 11-16 years old. The sample consisted of 748 boysfrom the Tuzla region. As the sample included very few boys born as the third, forth, or fifth child, we decided to consider only the differences in the mean values for some anthropometric parameters between the groups of the first- and the second-born. Measurements were taken according to IBP and the following parameters were investigated: body height, body mass, chest circumference, upper arm circumference, upper leg circumference, sitting height, arm length, leg length, pelvis width, shoulders width, length and width of head. We established that in most generations the firstborn boys have larger mean values for most anthropometric variables in comparison to the second-born.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Gavazzoni ◽  
M Z Zuber ◽  
M M Miura ◽  
A P Pozzoli ◽  
M T Taramasso ◽  
...  

Abstract Introduction Intraprocedural guidance and monitoring with transesophageal echocardiography (TEE) and invasive hemodynamic assessment are currently the best available options for evaluating procedural success of percutaneous mitral valve (MV) repair with Mitraclip System (Abbott Vascular, Santa Clara, CA, USA). However, despite its crucial importance, echocardiography has some limitations in immediate evaluation of residual jets after clip implantation, so that, in absence of validated method for double orifice effective regurgitant orifice (ERO) assessment, the most reliable parameter that is currently used is the mean trans-valvular gradient. Purpose This prospective study aimed to assess the role of a new echocardiographic parameter obtained from 3D-Color-Full volume imaging of MR for evaluation of outcomes of mitraclip procedures, comparing it with invasive LAP measurements. Material and methods We prospectively performed the computation of a new parameter in patients with symptomatic moderate-severe to severe primary or secondary mitral regurgitation (MR) underwent MitraClip procedure. This parameter is easy and fast to be obtained out of 3D dataset and represents the 2D area of the proximal isovelocity surface zone visualized from the ventricular view, without any imaging processing (“3D dual volume PISA area”) (figure). It was obtained as following: i) acquisition of 3D-zoomed-color image of MR jet with adequate frame rates; ii)displaying of the volume sampling in “dual volume layout” so one can see the “ventricular aspect” of the jet area corresponding to proximal isovelocity surface “zone”; iii) awareness of correct alignment to the direction of the flow in proximal zone; iiii) freezing and direct measurement of this area (summarize if more than 1 orifice) (1 attached). We compared the variation of this parameter from the beginning to end of procedure with the variation of LAP measurements, that is currently the most important parameter for assessing outcome of procedures. Results The study includes dataset of 11 patients. The baseline value of 3D dual volume PISA area was 1,191±0,40 cm2 and the mean change we obtained was 0,65±0,30 cm2 (mean of 77% of reduction until the end of procedure). Mean values of LAP were slightly decreased in all cases: basal m-LAP was 12±3,3 mmHg and decreased by 15%. Despite the small number of patients, we observed a significant correlation between the changes of LAP and the change of 3D dual volume PISA area (R: 0.6, p: 0,048). Conclusions This is the first demonstration of the usefulness of echocardiographic parameter obtained by 3Ddual volume layout imaging for rapid intraprocedural guidance in Mitraclip procedure. This parameter is related to hemodynamic variations that it currently considerable surrogate of outcomes. These data need to be confirmed by a larger study.


Author(s):  
Adesola Olubunmi Adekoya ◽  
Musili Bolanle Fetuga ◽  
Olumide Olatokunbo Jarrett ◽  
Tinuade Adetutu Ogunlesi ◽  
Jean-Pierre Chanoine ◽  
...  

Abstract Background Previous studies suggest significant ethnic and racial differences in clitoral sizes and anogenital distances in the newborn. This study aimed to document normative data on clitoral sizes and anogenital distances of apparently normal term female infants in Sagamu. Methods The study was a multi-center, cross-sectional descriptive research carried out among 317 female term infants within the first 72 h of life. Interviewer-based questionnaire was applied to obtain sociodemographic data, pregnancy and birth history. A sliding digital caliper was used for measurement. Data analysis was with SPSS version 20.0. Results The mean clitoral length was 6.7 ± 1.6 mm while the mean clitoral width was 5.6 ± 0.8 mm. The mean fourchette-clitoris distance, anus-clitoris distance and anus-fourchette distance were 21.9 ± 2.1 mm, 35.5 ± 2.5 mm and 17.0 ± 2.6 mm respectively. The anus-clitoris and anus-fourchette distances significantly correlated with the anthropometric parameters while the clitoral measurements did not. Conclusion The mean values recorded in this study were higher than observed in most previous studies. This simple, affordable and non-invasive evaluation could aid early diagnosis and treatment of female infants with potentially harmful conditions such as congenital adrenal hyperplasia.


2016 ◽  
Vol 17 (4) ◽  
pp. 321-326
Author(s):  
Aleksandra Cvetkovic ◽  
Suncica Sreckovic ◽  
Marko Petrovic

Abstract This study sought to compare the biometric values and intraocular lens (IOL) power obtained by standard ultrasound and optical biometry. We examined 29 eyes in preparation for cataract surgery. None of the patients had refractive surgery or corneal anomaly. In all patients, the horizontal and vertical refractive power of the cornea was determined using a keratometer (Bausch&Lomb). The axial length of the eye was determined via A-scan ultrasound (BVI-compact-V-plus) using Hollady’s formula. The IOL power and complete biometric measurements were obtained via an IOL Master-500-Zeiss using the Hollady-2 formula. All obtained values were compared and analysed using the statistical program SPSS 20. The average age of treated patients was 71.21±1.68 years. In 16 patients with dense cataracts (55.17%), it was not possible to determine the IOL power by optical biometry. Optical biometry obtained significantly increased axial length values of 24.04±0.29 mm compared with those obtained with ultrasound biometry (23.89±0.28 mm, p=0.003). The mean refractive cornea power values of the horizontal meridian measured using a keratometer (42.50±0.47 D) and an IOL Master (42.69±0.49 D) were not statistically different (p=0.187). The mean values of the refractive cornea power of the vertical meridian obtained using a keratometer (42.62±0.48D) and an IOL Master (43.36±0.51 D) exhibited a statistically significant difference (p=0.000). The keratometer obtained statistically significant lower mean values of corneal refractive power (42.73±0.32 D) compared with those obtained with optical biometry (43.22±0.35 D, p=0.000). Ultrasound biometry obtained significantly increased the mean values of IOL power (20.19±0.48D) compared with those obtained with optical biometry (19.71±0.48 D, p=0.018). The large number of patients who receive an operation for dense cataracts indicate the need for representation of both biometric methods in our clinical practice.


2019 ◽  
Vol 57 (216) ◽  
Author(s):  
Ritee Shrestha ◽  
Bipana Manandhar ◽  
Hari Prasad Upadhyay ◽  
Nirjala Laxmi Madhikarmi

Introduction: Human nose is one of the important anthropometric parameters for identification of ethnicity and sex of an individual of an unknown identity. The nasal index holds a great value in anthropological studies, because it is one of the anthropometric indices acknowledged in nasal surgery as well as management. The study aims to find the mean nasal index and the nose type of dental students of Kantipur Dental College of Nepal. Methods: This descriptive cross-sectional study was conducted among 140 dental students of age groups 17-25 years, in the Department of Anatomy, Kantipur Dental College Teaching Hospital and Research Center, Basundhara, Kathmandu. The studied population belongs to dental students of Kantipur Dental College and Research Centre. The nasal parameters including the nasal height, nasal width was measured using Digital Vernier Caliper and the nose was classified in three different types based on the value of nasal index. Results: The mean nasal index of total population was 81.34±14.88 mm with confidence interval range of 78.85 and 83.83 mm. Mesorrhine type of nose was found to be most common among the total population. Mean nasal index in male is 84.49±12.46 mm and in female is 80.66±15.32 mm. Conclusions: This study concludes that the mean values of nasal index of all the students falls under mesorrhine (medium) type of nose.


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