Pregestational diabetes is described when a woman with diabetes before the onset of pregnancy becomes pregnant and consequently she is vulnerable to higher risk for adverse outcomes in the embryo/foetus. Strict glycaemic control, with minimal glucose variability, starting from before conception and maintained throughout pregnancy decreases significantly adverse foetal and maternal outcomes; maternal hypoglycaemic episodes are the major barrier in achieving this goal. Insulin degludec is an ultralong-acting analogue, which has half-life of over 25 h and full duration of effect of more than 42 h, reaching a steady-state serum concentration after 2–3 days of its administration. It promotes flat, steady, peakless and predictable insulin concentrations, with minor intra-individual and inter-individual variability. It also exerts a low mitogenic/metabolic potency ratio. This review examines thoroughly all current evidence of the administration of insulin degludec in pregestational diabetes as well as its future role in this population.
{"title":"Insulin degludec in pregestational diabetes: evidence and perspectives","authors":"G. Papaetis, Konstantinos C. Mikellidis","doi":"10.5114/amsad/188092","DOIUrl":"https://doi.org/10.5114/amsad/188092","url":null,"abstract":"Pregestational diabetes is described when a woman with diabetes before the onset of pregnancy becomes pregnant and consequently she is vulnerable to higher risk for adverse outcomes in the embryo/foetus. Strict glycaemic control, with minimal glucose variability, starting from before conception and maintained throughout pregnancy decreases significantly adverse foetal and maternal outcomes; maternal hypoglycaemic episodes are the major barrier in achieving this goal. Insulin degludec is an ultralong-acting analogue, which has half-life of over 25 h and full duration of effect of more than 42 h, reaching a steady-state serum concentration after 2–3 days of its administration. It promotes flat, steady, peakless and predictable insulin concentrations, with minor intra-individual and inter-individual variability. It also exerts a low mitogenic/metabolic potency ratio. This review examines thoroughly all current evidence of the administration of insulin degludec in pregestational diabetes as well as its future role in this population.","PeriodicalId":356804,"journal":{"name":"Archives of Medical Science – Atherosclerotic Diseases","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140990739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mushood Ahmed, Rubab Zahra, Areeba Ahsan, Zain Ali Nadeem, Priyansha Singh, Sehar Fatima, Farhan Shahid, Raheel Ahmed
The unprotected left main coronary artery (ULMCA) disease is regarded as the highest-risk lesion subset of coronary artery disease (CAD). It is linked to significantly higher risks of cardiovascular morbidity and mortality when compared to other obstructive CAD. It has a mortality rate of up to 50% on a 3-year follow-up if left untreated [1]. For individuals with unprotected LMCA disease, the conventional revascularization method
{"title":"Intravascular ultrasound-guided versus angiography-guided percutaneous coronary intervention in patients with unprotected left main coronary artery disease: a systematic review and meta-analysis of randomized controlled trials and propensity score-matched studies","authors":"Mushood Ahmed, Rubab Zahra, Areeba Ahsan, Zain Ali Nadeem, Priyansha Singh, Sehar Fatima, Farhan Shahid, Raheel Ahmed","doi":"10.5114/amsad/188269","DOIUrl":"https://doi.org/10.5114/amsad/188269","url":null,"abstract":"The unprotected left main coronary artery (ULMCA) disease is regarded as the highest-risk lesion subset of coronary artery disease (CAD). It is linked to significantly higher risks of cardiovascular morbidity and mortality when compared to other obstructive CAD. It has a mortality rate of up to 50% on a 3-year follow-up if left untreated [1]. For individuals with unprotected LMCA disease, the conventional revascularization method","PeriodicalId":356804,"journal":{"name":"Archives of Medical Science – Atherosclerotic Diseases","volume":" 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140995394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Common therapies for cardiovascular diseases (CVDs) are associated with wide side effects. Thus, herbal medicines have been regarded due to fewer side effects, availability, cultural beliefs, and being cheap. For thousand years, herbal medicine has been used for bacterial infections, colds, coughs, and CVDs. Cinnamon bark contains phenolic compounds such as cinnamaldehyde and cinnamic acid with protective properties which can reduce the risk of cardiovascular diseases, cardiac ischemia and hypertrophy, and myocardial infarction. Furthermore, cinnamon has antioxidant and anti-inflammatory properties and exhibits beneficial effects on the complications of diabetes, obesity, hypercholesterolemia, and hypertension which cause CVDs. Although the protective effects of cinnamon on the heart have been reported in many studies, it needs more clinical studies to prove the pharmaceutical and therapeutic efficacy of cinnamon on risk factors of CVDs.
{"title":"Cinnamon: a nutraceutical supplement for the cardiovascular system","authors":"Taherah Mohammadabadi, Rajesh Jain","doi":"10.5114/amsad/184245","DOIUrl":"https://doi.org/10.5114/amsad/184245","url":null,"abstract":"Common therapies for cardiovascular diseases (CVDs) are associated with wide side effects. Thus, herbal medicines have been regarded due to fewer side effects, availability, cultural beliefs, and being cheap. For thousand years, herbal medicine has been used for bacterial infections, colds, coughs, and CVDs. Cinnamon bark contains phenolic compounds such as cinnamaldehyde and cinnamic acid with protective properties which can reduce the risk of cardiovascular diseases, cardiac ischemia and hypertrophy, and myocardial infarction. Furthermore, cinnamon has antioxidant and anti-inflammatory properties and exhibits beneficial effects on the complications of diabetes, obesity, hypercholesterolemia, and hypertension which cause CVDs. Although the protective effects of cinnamon on the heart have been reported in many studies, it needs more clinical studies to prove the pharmaceutical and therapeutic efficacy of cinnamon on risk factors of CVDs.","PeriodicalId":356804,"journal":{"name":"Archives of Medical Science – Atherosclerotic Diseases","volume":"13 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140712692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Mulita, Vasileios Leivaditis, G. Verras, Christos Pitros, Platon Dimopoulos, P. Katsakiori, Danai Dafnomili, L. Tchabashvili, Konstantinos Tasios, Dimitrios Kehagias, Andreas Antzoulas, S. Papadoulas, E. Koletsis
Aortoenteric fistula (AEF) is defined as the abnormal communication between the aorta and the gastrointestinal tract. AEFs are divided into primary and secondary usually after abdominal aortic aneurysm (AAA) recovery and are a rare but quite dangerous cause of gastrointestinal bleeding that the general surgeon may face during his/her career. Secondary AEF was first described in 1953 to a 44-year-old woman 3 months after an AAA operation. This review presents the role of the surgeon in the management of secondary aortoenteric fistulas. AEFs are a rare but fatal gastrointestinal bleeding cause that the general surgeon may be asked to manage. Diagnosis requires the combination of strong clinical suspicion and the presence of a history of AAA surgery. Although a vascular surgery case, general surgeons play a role in choosing the technique of restoring the intestinal tract, which seems to be significantly related to subsequent morbidity and mortality.
{"title":"Secondary aortoenteric fistula: a narrative review of the view of the surgeon","authors":"F. Mulita, Vasileios Leivaditis, G. Verras, Christos Pitros, Platon Dimopoulos, P. Katsakiori, Danai Dafnomili, L. Tchabashvili, Konstantinos Tasios, Dimitrios Kehagias, Andreas Antzoulas, S. Papadoulas, E. Koletsis","doi":"10.5114/amsad/186358","DOIUrl":"https://doi.org/10.5114/amsad/186358","url":null,"abstract":"Aortoenteric fistula (AEF) is defined as the abnormal communication between the aorta and the gastrointestinal tract. AEFs are divided into primary and secondary usually after abdominal aortic aneurysm (AAA) recovery and are a rare but quite dangerous cause of gastrointestinal bleeding that the general surgeon may face during his/her career. Secondary AEF was first described in 1953 to a 44-year-old woman 3 months after an AAA operation. This review presents the role of the surgeon in the management of secondary aortoenteric fistulas. AEFs are a rare but fatal gastrointestinal bleeding cause that the general surgeon may be asked to manage. Diagnosis requires the combination of strong clinical suspicion and the presence of a history of AAA surgery. Although a vascular surgery case, general surgeons play a role in choosing the technique of restoring the intestinal tract, which seems to be significantly related to subsequent morbidity and mortality.","PeriodicalId":356804,"journal":{"name":"Archives of Medical Science – Atherosclerotic Diseases","volume":"211 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140723246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kamleshun Ramphul, J. Dhaliwal, S. Sombans, Jatin Kumar Passi, S. Aggarwal, Nomesh Kumar, Hemamalini Sakthivel, Raheel Ahmed, R. Verma
Coronavirus disease 2019 (COVID-19) can lead to cardiovascular complications. We aimed to understand the trends in admission for COVID-19 and the incidence of various cardiovascular events.The 2020 and 2021 National Inpatient Sample (NIS) was studied for cases of COVID-19 between April 2020 and December 2021 in the United States. Linear-by-linear association helped us understand the trends of various events.The number of cases of COVID-19 was highest in January 2021 (261,469 patients). The incidence of acute pulmonary embolism rose from 2.08% in April 2020 to 4.82% in November 2021, while deep vein thrombosis cases rose from 1.74% in April 2020 to 2.63% in December 2021. The incidence of cardiac arrest varied, with a maximum of 3.00% in August 2021. Similarly, acute ischemic stroke cases experienced their highest incidence in January 2021 (0.91%). The incidence of myocarditis was highest in April and May 2020 (0.42% each). Peak takotsubo cases were seen between October and December 2021. The highest overall all-cause mortality among COVID-19 cases was seen in April 2020 (16.74%).Throughout the 21 months of our analysis, various trends in COVID-19 cases and incidence of cardiac events were noticed. This could relate to the different variants of COVID-19, their direct and indirect impact on coagulation pathways and the myocardial tissues, and the protective roles of the vaccines.
{"title":"Trends in admissions for COVID-19 in the United States between April 2020 and December 2021 and cardiovascular events","authors":"Kamleshun Ramphul, J. Dhaliwal, S. Sombans, Jatin Kumar Passi, S. Aggarwal, Nomesh Kumar, Hemamalini Sakthivel, Raheel Ahmed, R. Verma","doi":"10.5114/amsad/185410","DOIUrl":"https://doi.org/10.5114/amsad/185410","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) can lead to cardiovascular complications. We aimed to understand the trends in admission for COVID-19 and the incidence of various cardiovascular events.The 2020 and 2021 National Inpatient Sample (NIS) was studied for cases of COVID-19 between April 2020 and December 2021 in the United States. Linear-by-linear association helped us understand the trends of various events.The number of cases of COVID-19 was highest in January 2021 (261,469 patients). The incidence of acute pulmonary embolism rose from 2.08% in April 2020 to 4.82% in November 2021, while deep vein thrombosis cases rose from 1.74% in April 2020 to 2.63% in December 2021. The incidence of cardiac arrest varied, with a maximum of 3.00% in August 2021. Similarly, acute ischemic stroke cases experienced their highest incidence in January 2021 (0.91%). The incidence of myocarditis was highest in April and May 2020 (0.42% each). Peak takotsubo cases were seen between October and December 2021. The highest overall all-cause mortality among COVID-19 cases was seen in April 2020 (16.74%).Throughout the 21 months of our analysis, various trends in COVID-19 cases and incidence of cardiac events were noticed. This could relate to the different variants of COVID-19, their direct and indirect impact on coagulation pathways and the myocardial tissues, and the protective roles of the vaccines.","PeriodicalId":356804,"journal":{"name":"Archives of Medical Science – Atherosclerotic Diseases","volume":"93 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140747373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad Muneeb Arshad, Kamleshun Ramphul, R. Dachepally, M. Almasri, R. Memon, Hemamalini Sakthivel, Azfar Zaman, Raheel Ahmed, Farhan Shahid
Cardiovascular disease (CVD) is the leading cause of death and disability in the United States (US) and worldwide. The Global Burden of Disease (GBD) study in 2019 showed that total incidence of cardiovascular disease doubled from 271 million in 1990 to 523 million in 2019
{"title":"Five-year trends in risk factors for cardiovascular disease among adolescents in the United States","authors":"Muhammad Muneeb Arshad, Kamleshun Ramphul, R. Dachepally, M. Almasri, R. Memon, Hemamalini Sakthivel, Azfar Zaman, Raheel Ahmed, Farhan Shahid","doi":"10.5114/amsad/185775","DOIUrl":"https://doi.org/10.5114/amsad/185775","url":null,"abstract":"Cardiovascular disease (CVD) is the leading cause of death and disability in the United States (US) and worldwide. The Global Burden of Disease (GBD) study in 2019 showed that total incidence of cardiovascular disease doubled from 271 million in 1990 to 523 million in 2019","PeriodicalId":356804,"journal":{"name":"Archives of Medical Science – Atherosclerotic Diseases","volume":"258 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140751135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Raheel Ahmed, Noem Najam, Kamleshun Ramphul, Sebastian Mactaggart, Mansimran Singh Dullay, Joseph Okafor, A. Azzu, Maham Bilal, Rahat A Memon, Hemamalini Sakthivel, R. Khattar, A. Wells, J. Baksi, K. Wechalekar, V. Kouranos, Anwar Chahal, Rakesh Sharma
Sarcoidosis is a systemic inflammatory disorder characterised by non-caseating granulomas. Cardiac sarcoidosis (CS) normally causes conduction abnormalities, ventricular arrhythmias, and heart failure. Little is known about the characteristics and impact of sarcoidosis in patients admitted with ST-elevation myocardial infarction (STEMI). This study aims to fill this void.Utilising the National Inpatient Sample (NIS) database (2016–2020), individuals with STEMI were identified and categorised based on sarcoidosis presence whilst adjusting for confounders via logistic regression models.Among 851,290 STEMI patients, 1215 had sarcoidosis. Before propensity matching, sarcoidosis patients were notably different in demographics and comorbidities compared to non-sarcoidosis patients. After propensity score matching (PSM), sarcoidosis patients were found to have a higher incidence of supraventricular tachycardia (SVT) (2.5% vs. 1.3%, p = 0.024) and acute kidney injury (AKI) (23.3% vs. 20.8%, aOR = 1.269, 95% CI: 1.02–1.58, p = 0.033) but a lower incidence of undergoing coronary artery bypass graft (CABG) (5.5% vs. 8.5%, aOR = 0.663; 95% CI: 0.472–0.931, p = 0.018), while no significant disparities were noted in PCI, cardiogenic shock, mortality, or mean length of stay (LOS).Using propensity-matched large real-world data of STEMI patients, sarcoidosis was associated with fewer cases of CABG and a greater incidence of AKI and SVT compared to non-sarcoidosis patients.
肉样瘤病是一种以非酪化性肉芽肿为特征的全身性炎症性疾病。心脏肉样瘤病通常会导致传导异常、室性心律失常和心力衰竭。人们对ST段抬高型心肌梗死（STEMI）患者肉样瘤病的特征和影响知之甚少。本研究旨在填补这一空白。利用全国住院患者样本（NIS）数据库（2016-2020年），根据肉样瘤病的存在情况对STEMI患者进行识别和分类，同时通过逻辑回归模型对混杂因素进行调整。在851290名STEMI患者中，有1215人患有肉样瘤病。在倾向匹配之前，肉样瘤病患者与非肉样瘤病患者在人口统计学和合并症方面存在明显差异。倾向评分匹配（PSM）后发现，肉样瘤病患者室上性心动过速（SVT）（2.5% 对 1.3%，P = 0.024）和急性肾损伤（AKI）（23.3% vs. 20.8%，aOR = 1.269，95% CI：1.02-1.58，p = 0.033），但接受冠状动脉旁路移植术（CABG）的发生率较低（5.5% vs. 8.5%，aOR = 0.使用倾向匹配的 STEMI 患者大型真实世界数据，肉样瘤病与较少的 CABG 病例以及较高的 AKI 和 SVT 发生率相关。
{"title":"Characteristics and clinical outcomes of patients with Sarcoidosis admitted for ST-elevation myocardial infarction in the United States: A propensity matched analysis from the National Inpatient Sample","authors":"Raheel Ahmed, Noem Najam, Kamleshun Ramphul, Sebastian Mactaggart, Mansimran Singh Dullay, Joseph Okafor, A. Azzu, Maham Bilal, Rahat A Memon, Hemamalini Sakthivel, R. Khattar, A. Wells, J. Baksi, K. Wechalekar, V. Kouranos, Anwar Chahal, Rakesh Sharma","doi":"10.5114/amsad/184701","DOIUrl":"https://doi.org/10.5114/amsad/184701","url":null,"abstract":"Sarcoidosis is a systemic inflammatory disorder characterised by non-caseating granulomas. Cardiac sarcoidosis (CS) normally causes conduction abnormalities, ventricular arrhythmias, and heart failure. Little is known about the characteristics and impact of sarcoidosis in patients admitted with ST-elevation myocardial infarction (STEMI). This study aims to fill this void.Utilising the National Inpatient Sample (NIS) database (2016–2020), individuals with STEMI were identified and categorised based on sarcoidosis presence whilst adjusting for confounders via logistic regression models.Among 851,290 STEMI patients, 1215 had sarcoidosis. Before propensity matching, sarcoidosis patients were notably different in demographics and comorbidities compared to non-sarcoidosis patients. After propensity score matching (PSM), sarcoidosis patients were found to have a higher incidence of supraventricular tachycardia (SVT) (2.5% vs. 1.3%, p = 0.024) and acute kidney injury (AKI) (23.3% vs. 20.8%, aOR = 1.269, 95% CI: 1.02–1.58, p = 0.033) but a lower incidence of undergoing coronary artery bypass graft (CABG) (5.5% vs. 8.5%, aOR = 0.663; 95% CI: 0.472–0.931, p = 0.018), while no significant disparities were noted in PCI, cardiogenic shock, mortality, or mean length of stay (LOS).Using propensity-matched large real-world data of STEMI patients, sarcoidosis was associated with fewer cases of CABG and a greater incidence of AKI and SVT compared to non-sarcoidosis patients.","PeriodicalId":356804,"journal":{"name":"Archives of Medical Science – Atherosclerotic Diseases","volume":"49 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140257139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vasileios Leivaditis, B. Ehle, Athanasios Papatriantafyllou, F. Mulita, E. Koletsis, G. Verras, Konstantinos Tasios, Andreas Antzoulas, Nikolaos Charokopos, Manfred Dahm, P. Katsakiori, K. Grapatsas
Doege-Potter syndrome (DPS), a rare paraneoplastic phenomenon characterised by non-islet cell tumour hypoglycaemia (NICTH), presents clinicians with intricate diagnostic and therapeutic challenges. This comprehensive review consolidates current understanding, clinical presentations, diagnostic modalities, therapeutic interventions, and emerging trends in managing DPS. The pathophysiology of DPS revolves around dysregulated insulin-like growth factors (IGF), particularly IGF-2, produced by mesenchymal tumours, notably solitary fibrous tumours (SFT). Clinical manifestations encompass recurrent hypoglycaemic episodes, often distinct from typical hypoglycaemia, with implications for insulin and counterregulatory hormone levels. Diagnosis necessitates a multidisciplinary approach integrating biochemical assays, imaging studies, and histopathological confirmation of the underlying neoplasm. Surgical resection remains the cornerstone of treatment, complemented by adjunctive therapies to manage persistent hypoglycaemia. Prognosis is influenced by successful tumour resection and long-term surveillance for recurrence. A patient-centred approach, incorporating supportive services and multidisciplinary care, is essential for optimal outcomes in individuals affected by DPS.
{"title":"Addressing recurrent hypoglycaemia through thoracic surgical intervention: understanding Doege-Potter syndrome, a rarity in syndromes","authors":"Vasileios Leivaditis, B. Ehle, Athanasios Papatriantafyllou, F. Mulita, E. Koletsis, G. Verras, Konstantinos Tasios, Andreas Antzoulas, Nikolaos Charokopos, Manfred Dahm, P. Katsakiori, K. Grapatsas","doi":"10.5114/amsad/183433","DOIUrl":"https://doi.org/10.5114/amsad/183433","url":null,"abstract":"Doege-Potter syndrome (DPS), a rare paraneoplastic phenomenon characterised by non-islet cell tumour hypoglycaemia (NICTH), presents clinicians with intricate diagnostic and therapeutic challenges. This comprehensive review consolidates current understanding, clinical presentations, diagnostic modalities, therapeutic interventions, and emerging trends in managing DPS. The pathophysiology of DPS revolves around dysregulated insulin-like growth factors (IGF), particularly IGF-2, produced by mesenchymal tumours, notably solitary fibrous tumours (SFT). Clinical manifestations encompass recurrent hypoglycaemic episodes, often distinct from typical hypoglycaemia, with implications for insulin and counterregulatory hormone levels. Diagnosis necessitates a multidisciplinary approach integrating biochemical assays, imaging studies, and histopathological confirmation of the underlying neoplasm. Surgical resection remains the cornerstone of treatment, complemented by adjunctive therapies to manage persistent hypoglycaemia. Prognosis is influenced by successful tumour resection and long-term surveillance for recurrence. A patient-centred approach, incorporating supportive services and multidisciplinary care, is essential for optimal outcomes in individuals affected by DPS.","PeriodicalId":356804,"journal":{"name":"Archives of Medical Science – Atherosclerotic Diseases","volume":"27 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140419901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Agouridis, T. Filippatos, M. Kostapanos, C. Kostara, V. Tsimihodimos
Lipoprotein(a) [Lp(a)] is a strong, genetically determined, pathogenetic factor of atherosclerotic cardiovascular disease (ASCVD). The aim of this post-hoc analysis was to compare the effect of hypolipidemic treatment on Lp(a) levels of patients with mixed hyperlipidemia.We previously randomized patients with mixed hyperlipidemia (low-density lipoprotein [LDL-C] > 160 mg/dl and triglycerides > 200 mg/dl) to rosuvastatin monotherapy 40 mg/day (R group, n = 30) or rosuvastatin 10 mg/day combined with fenofibrate 200 mg/day (RF group, n = 30) or omega-3 fatty acids 2 g/day (RΩ group, n = 30). In the present post-hoc analysis, we included only the patients whose Lp(a) levels were assessed (16, 16 and 15 in the R, RF and RΩ groups, respectively). Lipid profile and Lp(a) were measured at baseline and after 3 months of treatment.Significant reductions in total cholesterol, LDL-C, non-high-density lipoprotein-cholesterol (non-HDL-C) and triglyceride levels were observed in all groups. A significant increase in Lp(a) levels was noted in the R (p = 0.017) and RF (p = 0.029) groups, while no significant difference was seen in the RΩ group (p = NS). Regarding Lp(a) elevations, no differences were found between groups. In the R group, a strong negative correlation between the changes in Lp(a) and LDL-C (r = –0.500, p = 0.049) was observed, while a significant negative correlation between the changes in Lp(a) and triglycerides (r = –0.531, p = 0.034) was noted in the RF group.Rosuvastatin and/or fenofibrate treatment increases Lp(a) levels in patients with mixed hyperlipidemia. Novel therapies should target Lp(a) level reduction to decrease the residual ASCVD risk in patients with mixed hyperlipidemia.
{"title":"The effect of rosuvastatin alone or in combination with fenofibrate or omega-3 fatty acids on lipoprotein(a) levels in patients with mixed hyperlipidemia","authors":"A. Agouridis, T. Filippatos, M. Kostapanos, C. Kostara, V. Tsimihodimos","doi":"10.5114/amsad/178441","DOIUrl":"https://doi.org/10.5114/amsad/178441","url":null,"abstract":"Lipoprotein(a) [Lp(a)] is a strong, genetically determined, pathogenetic factor of atherosclerotic cardiovascular disease (ASCVD). The aim of this post-hoc analysis was to compare the effect of hypolipidemic treatment on Lp(a) levels of patients with mixed hyperlipidemia.We previously randomized patients with mixed hyperlipidemia (low-density lipoprotein [LDL-C] > 160 mg/dl and triglycerides > 200 mg/dl) to rosuvastatin monotherapy 40 mg/day (R group, n = 30) or rosuvastatin 10 mg/day combined with fenofibrate 200 mg/day (RF group, n = 30) or omega-3 fatty acids 2 g/day (RΩ group, n = 30). In the present post-hoc analysis, we included only the patients whose Lp(a) levels were assessed (16, 16 and 15 in the R, RF and RΩ groups, respectively). Lipid profile and Lp(a) were measured at baseline and after 3 months of treatment.Significant reductions in total cholesterol, LDL-C, non-high-density lipoprotein-cholesterol (non-HDL-C) and triglyceride levels were observed in all groups. A significant increase in Lp(a) levels was noted in the R (p = 0.017) and RF (p = 0.029) groups, while no significant difference was seen in the RΩ group (p = NS). Regarding Lp(a) elevations, no differences were found between groups. In the R group, a strong negative correlation between the changes in Lp(a) and LDL-C (r = –0.500, p = 0.049) was observed, while a significant negative correlation between the changes in Lp(a) and triglycerides (r = –0.531, p = 0.034) was noted in the RF group.Rosuvastatin and/or fenofibrate treatment increases Lp(a) levels in patients with mixed hyperlipidemia. Novel therapies should target Lp(a) level reduction to decrease the residual ASCVD risk in patients with mixed hyperlipidemia.","PeriodicalId":356804,"journal":{"name":"Archives of Medical Science – Atherosclerotic Diseases","volume":"15 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139960967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heng Yang, Xiaofeng Cheng, Yujun Chen, Zhenhao Zeng, Gongxian Wang
The aim of the study was to study the role of nanobacteria in the formation of renal calculi and the underlying mechanism.A total of 90 clean Wistar male rats were randomly divided into a negative control group, an experimental group, and an interference group. From the end of the first week of modelling, 10 consecutive times once a week, 3 rats in each group were randomly selected to measure the biochemical blood markers and urine metabolism. After sacrifice, the formation of kidney stones was assessed by observing the ultrastructure of the kidney by electron microscopy and pathohistology. Finally, the expression of calcium-sensitive receptor (CaSR) and claudin-14 protein in the kidney tissue was examined by western blotting.Compared with the control group, the gross structure of the kidney was changed in the model group. At the fourth week of modelling, the rats in the nanobacteria group had significantly enlarged kidneys and increased kidney-to-body ratio, and the difference had statistical significance (p < 0.05). The colour of the kidney profile was dark, the structure of the skin pulp was less clear, and the accumulation of yellowish particles was observed at the junction of the cortical pulp. The creatinine, uric acid, urea nitrogen, and urinary calcium of the rats in the nanobacteria group began to increase at the third week, and the difference between the third and eighth week had statistical significance (p < 0.05). However, the difference between the 3 groups had no statistical significance after the eighth week. At the fourth week, we observed the formation of calculi, which were mainly distributed in the renal tubules and surrounding tissues. The kidney stone formation rate was 52.4% in the nanobacteria group and 27.8% in the interference group, and the difference had statistical significance (p < 0.05). Ultrastructure observations revealed that from the fourth week, the renal tissues in the nanobacteria group showed expanded renal tubules, swollen renal tubular epithelium, granular degeneration, shedding and lymphocyte infiltration of renal tubular epithelial cells, and a small amount of calcium salt crystals in renal tubules. At the third week, the expression of CaSR and Claudin-14 protein in the nanobacteria group increased, and the difference had statistical significance (p < 0.05). The expression of CaSR and Claudin-14 was positively correlated with urinary calcium (p < 0.05).The formation of renal calculi began in the fourth week after the model was established, and the crystals were mostly located in the renal tubules. During the formation of renal calculi, the renal tubular epithelial cells were damaged, showing granular degeneration and small amounts of calcium salt crystals, accompanied by a few renal tubules beginning to expand and epithelial swelling, granular degeneration, necrosis and shedding of renal tubular epithelial cells, lymphocyte infiltration in the renal interstitium, and small amounts of calcium salt crystals
{"title":"Preliminary study of the role of nanobacteria in the formation of renal stones in experimental rats and its mechanism","authors":"Heng Yang, Xiaofeng Cheng, Yujun Chen, Zhenhao Zeng, Gongxian Wang","doi":"10.5114/amsad/177534","DOIUrl":"https://doi.org/10.5114/amsad/177534","url":null,"abstract":"The aim of the study was to study the role of nanobacteria in the formation of renal calculi and the underlying mechanism.A total of 90 clean Wistar male rats were randomly divided into a negative control group, an experimental group, and an interference group. From the end of the first week of modelling, 10 consecutive times once a week, 3 rats in each group were randomly selected to measure the biochemical blood markers and urine metabolism. After sacrifice, the formation of kidney stones was assessed by observing the ultrastructure of the kidney by electron microscopy and pathohistology. Finally, the expression of calcium-sensitive receptor (CaSR) and claudin-14 protein in the kidney tissue was examined by western blotting.Compared with the control group, the gross structure of the kidney was changed in the model group. At the fourth week of modelling, the rats in the nanobacteria group had significantly enlarged kidneys and increased kidney-to-body ratio, and the difference had statistical significance (p < 0.05). The colour of the kidney profile was dark, the structure of the skin pulp was less clear, and the accumulation of yellowish particles was observed at the junction of the cortical pulp. The creatinine, uric acid, urea nitrogen, and urinary calcium of the rats in the nanobacteria group began to increase at the third week, and the difference between the third and eighth week had statistical significance (p < 0.05). However, the difference between the 3 groups had no statistical significance after the eighth week. At the fourth week, we observed the formation of calculi, which were mainly distributed in the renal tubules and surrounding tissues. The kidney stone formation rate was 52.4% in the nanobacteria group and 27.8% in the interference group, and the difference had statistical significance (p < 0.05). Ultrastructure observations revealed that from the fourth week, the renal tissues in the nanobacteria group showed expanded renal tubules, swollen renal tubular epithelium, granular degeneration, shedding and lymphocyte infiltration of renal tubular epithelial cells, and a small amount of calcium salt crystals in renal tubules. At the third week, the expression of CaSR and Claudin-14 protein in the nanobacteria group increased, and the difference had statistical significance (p < 0.05). The expression of CaSR and Claudin-14 was positively correlated with urinary calcium (p < 0.05).The formation of renal calculi began in the fourth week after the model was established, and the crystals were mostly located in the renal tubules. During the formation of renal calculi, the renal tubular epithelial cells were damaged, showing granular degeneration and small amounts of calcium salt crystals, accompanied by a few renal tubules beginning to expand and epithelial swelling, granular degeneration, necrosis and shedding of renal tubular epithelial cells, lymphocyte infiltration in the renal interstitium, and small amounts of calcium salt crystals","PeriodicalId":356804,"journal":{"name":"Archives of Medical Science – Atherosclerotic Diseases","volume":"1 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139777788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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