New markers predicting prognosis in patients with Crimean-Congo hemorrhagic fever: HDL cholesterol and eosinophil levels

To assess the frequency of lipid abnormalities and treatment outcomes for hyperlipidemia in HIV-positive patients receiving antiretroviral (ARV) therapy as outpatients at a Veterans Affairs HIV clinic. All patients monitored for at least 3 months were reviewed. Data collected included age, most recent CD4+ cell count and viral load, ARV history, and all fasting cholesterol, triglyceride, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) values. The ARV therapy at the time of lipid readings was classified as including protease inhibitors (PI+) or not including them (PI-). Lipid values were compared with goals per national guidelines and risk factors. Male patients (n = 101) providing 210 lipid profiles were evaluated (median 2 per patient). Median age was 51 years. Fourteen patients were diabetic, 31 were hypertensive, and 6 patients had documented coronary disease. Mean cholesterol, triglycerides, and LDL values were significantly higher in PI+ (n = 50) compared with those of PI- patients (n = 51; p < 0.05). HDL values were not different between groups. Significantly more PI+ patients had lipid concentrations above recommended goals compared with PI- patients (17 vs. 7; p = 0.04). Six patients achieved lipid goals after following a low-fat diet (4 PI+). Fifteen subjects (11 PI+) were being treated with medications. Ten patients (67%) reached lipid goals, 2 had not reached goals (13%), and 3 (20%) were undergoing medication titration. Our HIV-infected patients had significantly higher cholesterol, triglyceride, and LDL values when PI+. In contrast to other reports, the majority of patients treated for lipid abnormalities achieved treatment goals.

Fasting samples of 1329 apparently healthy vegetarian Gujarati population were tested for total cholesterol, triglycerides and three major fractions of lipoproteins, i.e. high density lipoproteins, low density lipoproteins and very low density lipoproteins. All the values showed marked increase with the age. Except for serum triglycerides, values differ in males and females in the age group of above 45 years. Compared to Northern Indian population low density lipoprotein and high density lipoprotein values were higher, but values of triglycerides and very low density lipoproteins were lower. There is no significant difference in total cholesterol values. Compared to Southern Indian population low density lipoprotein and very low density lipoprotein values were higher but values of triglycerides, total cholesterol and high density lipoprotein were lower. All serum lipid values were significantly lower than the Westem population. The range of values for both the sexes is presented for different age groups.

Dose-response relationship between physical activity and dyslipidemia in youth

Objective:Hypocholesterolemia is a metabolism disorder that may be seen in chronic diseases and malignancies. Various dyslipidemia profiles have been shown in adult and pediatric hematological malignancies. We aimed to evaluate the lipid profile properties in patients diagnosed with a hematological malignancy compared to a healthy control group.Method:Out of 1213 patients diagnosed with hematologic malignancy, the data of 98 patients whose pretreatment lipid profiles had already been studied, were reviewed. Forty healthy individuals were selected as the control group. The levels of total cholesterol, triglycerides (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were compared.Results:Triglyceride values were significantly higher (p=0.02), and the total cholesterol, LDL and HDL levels were lower in the study group compared to the control group. Triglyceride values were higher (p=0.013), and HDL levels were lower (p=0.022) in parallel with increases in uric acid levels. There was a significant correlation between the International Prognostic Index (IPI) score and TG (p=0.003) in those diagnosed with non-Hodgkin lymphoma (NHL). Whereas no significant correlation was found between TG, total cholesterol, and LDL values in the limited (early) and advanced stage NHL, while a significant negative correlation was found with HDL (p=0.027).Conclusion:Hypertriglyceridemia, as well as low LDL and HDL values may be seen in hematological malignancies. It should be kept in mind that there may be chronic diseases and malignancies in the etiology of incidental hypocholesterolemia and hypertriglyceridemia. Further studies are needed on this subject to determine the effects of dyslipidemia on the pathogenesis and prognosis of the disease in hematological malignancies.

The purpose of this study is to determine erythrocyte sedimentation rate (ESR), C - reactive protein (CRP), serum amyloid-A (SAA) and cholesterol levels in patients with Crimean-Congo Hemorrhagic Fever (CCHF) and determine the relationship of these parameters with the severity of disease. By polymerase chain reaction and enzyme-linked immunosorbent assay (ELISA) method 40 patients were diagnosed as CCHF and 39 volunteer without any systemic disease whose blood were taken and their serum separated. SAA, CRP and ESR were measured with ELISA, nephelometry and Mix-Rate x100 vital diagnostic device, respectively, in serum samples. High density lipoprotein (HDL), low density lipoprotein (LDL) and total cholesterol levels were determined by using autoanalyzer HDL, LDL and total cholesterol kit (Syncron LX20). Statistically significant difference was determined between patients and controls in terms of the levels of SAA, CRP, HDL, LDL and total cholesterol (p<0.05). However, there was no significant difference between the groups in terms of the levels of ESR. In addition, neither SAA, CRP, ESR nor HDL, LDL and total cholesterol levels varied with the severity of disease in the cases assessed (p>0.05). Using of CRP and SAA together might increase the sensitivity of diagnosis of CCHF infection. However, none of the parameters investigated in this study were found to be a proper marker of the prognosis in CCHF. Cholesterol levels were significantly decreased in patients with CCHF, which was suggested to be associated with the increased serum levels of SAA in the patient group.

Low serum levels of high-density lipoprotein (HDL) are commonly encountered in patients with coronary artery disease (CAD). An example of this type of patient is a 42-year-old white man with a history of sudden-onset angina secondary to a 90% obstructive lesion along the proximal left anterior descending coronary artery. The family history was significant for his father, who died of a myocardial infarction (MI) at age 44 years. The patient underwent percutaneous transluminal angioplasty with stenting but developed in-stent restenosis. He underwent cutting balloon angioplasty and brachytherapy and was asymptomatic for approximately 6 months. The stent then developed a high-grade occlusion with recurrence of angina, and the patient required single-vessel bypass surgery. The patient’s baseline serum lipid profile revealed low-density lipoprotein (LDL) 128 mg/dL, HDL 27 mg/dL, and triglycerides 92 mg/dL. His lipoprotein(a), C-reactive protein, and homocysteine levels were normal. He was not hypertensive, had no impairment of glycemic control, and did not smoke. With a combination of simvastatin 40 mg and niacin (Niaspan; Kos Pharmaceuticals) 1000 mg daily, the patient’s lipid profile improved, with LDL 78 mg/dL, HDL 43 mg/dL, and triglycerides 60 mg/dL. Follow-up stress testing demonstrated normal myocardial perfusion, and the patient has been asymptomatic for 2 years. With few exceptions, low HDL is an independent risk factor for CAD in case-control and prospective observational studies. In contrast, high HDL levels are associated with longevity and are protective against the development of atherosclerotic disease. In the Framingham Study, risk for CAD increases sharply as HDL levels fall progressively below 40 mg/dL.1 In the Quebec Cardiovascular Study, for every 10% reduction in HDL, risk for CAD increased 13%.2 Many clinicians believe that low HDL is associated with increased CAD risk because it is a marker for hypertriglyceridemia and elevated remnant particle concentrations. The Prospective Cardiovascular Munster …

Abdominal obesity modifies the risk of hypertriglyceridemia for all-cause and cardiovascular mortality in hemodialysis patients

Small studies have suggested that honey benefits patients with high cholesterol concentrations. The present study aimed to confirm this finding in a larger group of subjects. Sixty volunteers with high cholesterol, stratified according to gender and hydroxymethylglutaryl-coenzyme A reductase inhibitor (statin) treatment (yes/no), were randomized to receive 75 g of honey solution or a honey-comparable sugar solution once daily over a period of 14 days. Baseline measurements, including body mass index (BMI) and lipid profile, were obtained, and subjects also completed dietary questionnaires and the Inventory for the Assessment of Negative Bodily Affect-Trait form (INKA-h) questionnaire. Measurements were repeated 2 weeks later. BMI and high-density lipoprotein (HDL) cholesterol values were significantly correlated (r = -0.487; P < .001) as were BMI and a lower ratio of low-density lipoprotein (LDL) cholesterol to HDL cholesterol (r = 0.420; P < .001), meaning that subjects with a high BMI had a lower HDL cholesterol value. INKA-h scores and LDL cholesterol values were also significantly correlated (r = 0.273, P = .042). Neither solution influenced significantly cholesterol or triglyceride values in the total group; in women, however, the LDL cholesterol value increased in the sugar solution subgroup but not in the women taking honey. Although ingesting honey did not reduce LDL cholesterol values in general, women may benefit from substituting honey for sugar in their diet. Reducing the BMI lowers the LDL cholesterol value, and psychological interventions also seem important and merit further investigation.

This study aimed to investigate some liver enzymes and blood lipids in adult women after 14 weeks of swimming training. The study was voluntarily participated by 28 women students between the ages of 18-24 studying at the faculty of sports sciences. Participants were divided into two groups experimental and control groups. The experimental group received basic swimming training 2 days a week for 14 weeks. Each study session was planned for 90 minutes. The control group did not participate in any study. Blood samples were taken from the experimental and control groups before and after the start of the training program. Shapiro-Wilk test was applied to determine whether the obtained data showed normal distribution and it was determined that the data showed normal distribution. Therefore, Paired Samples T Test and Independent Samples T Tests were used. Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Gamma Glutamyl Transferase (GGT), Urea, Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL), Triglyceride (TG), and Cholesterol values of the experimental and control groups were compared according to the values obtained from the blood samples. There were significant differences between the post-test measurements of Triglyceride and Cholesterol values in the comparison between the groups. The intra-group comparison showed significant differences in HDL and triglyceride values in the experimental group. As a result, it was observed that 14 weeks of basic swimming training in adult women had positive effects on some plasma lipid levels but did not show any significant changes in liver enzymes.

Background and Aim: The CCHF (Crimean-Congo hemorrhagic fever) virus causes a severe disease in human with a case fatality rate of up to 50%. Since, there is no specific treatment or approved vaccine against CCHF viral infections, an accurate and early detection as well as a reliable surveillance and quantitative determination of viral load is necessary for patient improvement and case management. In this research, our aim was to develop a probe based one-step real-time reverse-transcription polymerase chain reaction (rRT-PCR) assay for in-house quantitative detection of CCHF virus. Methods: At first, the highly conserved S-fragment sequence of CCHF virus genome was adapted from GenBank and the specific probe and primers targeting this region were designed. Then, viral RNAs were extracted from 37 blood samples of different patients from east of Iran (Zahedan). The specificity and sensitivity of the probe and primers were also evaluated in positive blood samples, confirmed to have CCHF virus. A standard (PTG19-T vector containing S-fragment) for quantization was also constructed and the viral load was determined in some of positive samples. Results: From a total of 37 suspicious blood samples, 15 samples were confirmed to be positive for CCHF virus by this probe based one-step rRT-PCR assay and no false-positive result was detected according to sequencing data. The predicted fragment of 176 bp was also confirmed in all positive samples by gel-based electrophoresis analysis. The assay was linear between 10 to 103 copy numbers per each microliter of extracted plasmid for this technique and the viral load determined in one of patient blood samples was 55,000 viral particles per each milliliter, for example. Bioinformatics and experimental evaluations approved the specificity of this assay. The LOD of the assay was 10 (or fewer) copy numbers of viral genome per each microliter of the extracted genome. Conclusions: This research showed that the developed probe based one-step rRT-PCR assay is a specific, rapid, sensitive and the simple tool for detection and viral load determination of the CCHF virus. Keywords: CCHF Virus, Real-time RT-PCR, Quantitative, viral load, S-region.

The association of nutritional profile and prognosis of degenerative diseases associated with carbohydrate and lipid metabolism at high altitude of district Ziarat, Pakistan

Background: Diabetes mellitus comprises a group of metabolic disorders such as hyperglycemia, dislipidemia, microvasicular complications etc. The prevalence of type 1 and type 2 diabetes mellitus (DM) is rising dramatically. Diabetes is one of the most common non-communicable diseases leading to morbidity and mortality particularly in developing countries. The increased risk for developing multiple atherosclerotic risk factors among diabetic cases has been attributed to micro-vascular complications. Cardiovascular disease (CVD) is commonly associated with type 1 or type 2 DM cases. Also, CVD is the major cause of morbidity and mortality. Approximately, 80% deaths among the diabetic population were due to CVD, while 75% of the deaths among the hospitalized diabetic cases were also due to the complications of CVD. Aim: To find out the association between the intake of probiotic curd and CVD risk factors among recently diagnosed prediabetic cases. Methods: The study was a hospital based case-control study. The study cases were newly diagnosed with prediabetic condition, aged between 20-50yrs of both genders. Out of 75 cases screened, 25 cases were recruited as prediabetic cases based on their HbA1c values (DCCT-5.7 to 6.5%) and supplemented with probiotic curd while remaining 50 cases were not supplemented probiotic curd considered as control cases. The cases were drawn from the outpatient Department of Osmania General Hospital Hyderabad, India for the study purpose. To study the beneficial effects of probiotic curd on prediabetic cases, various biochemical parameters viz fasting blood glucose, HbA1c (glycated Hb) lipid profile, i.e., total cholesterol, triglycerides LDL (Low Density Lipoproteins), and HDL (High Density Lipoproteins) cholesterol were analyzed in both supplemented and control groups using commercially available kits. Results: The results indicated significant changes as per the clinical parameters at different level in the values of fasting blood glucose, total cholesterol, HDL, LDL and triglycerides in the prediabetic cases supplemented with probiotic curd for a period of 30 days as compared to the control cases. Conclusions: From this study, it was concluded that the supplementation of probiotic delays the progression of prediabetes mellitus to diabetes mellitus.

IntroductionDyslipidemia is the most important causal risk factor for atherosclerotic cardiovascular diseases (ASCVD). Atherosclerosis affects multiple vascular beds, accounting for nearly majority of Coronary heart disease and some proportion of Ischemic strokes. Baseline lipid levels have an effect on the short-term mortality due to cerebrovascular accident (CVA). But in some studies, there was no dyslipidemia in patients who presented with acute ischemic stroke. It is important to evaluate the serum lipid levels in both the types of strokes to guide lipid lowering therapy, which can reduce incidence of stroke and related mortality. This study is undertaken to analyse and evaluate the role of serum lipids in patients of stroke in our centre. The recently updated guidelines for management of dyslipidemia from the European Society of Cardiology (ESC), European Atherosclerosis society (EAS) and Lipid association of India (LAI) presents a further challenge since they recommend aggressive goals for LDL lowering based on the risk profile. Literature shows that aggressive lipid management is initiated but not maintained in patients with ischemic stroke.ObjectivesAnalyse and evaluate the lipid values in Acute ischemic stroke to initiate aggressive lipid management.Materials and methodsIt's a Prospective observational study for the period of six months, enrolled 63 patients of Acute Ischemic Stroke admitted at our center. Serum lipid profile was measured in all patients. Data was entered in Microsoft Excel and analysed by descriptive statistics. Patients between 40 – 80 years of age of either sex with clinical findings, brain CT-scan or MRI indicative of cerebral infarction were enrolled in this study. The patients with cardio-embolic stroke, hemorrhagic stroke, any underlying diseases especially liver disease, familial hypercholesterolemia, hypothyroidism and pregnancy were excluded. With Ethics committee's approval, patients parameters such as Age, Sex, Weight, Co-morbidities (hypertension, diabetes, ischemic heart disease, previous stroke, LDL value, HDL value, Total cholesterol, Triglycerides, non HDL, HbA1C, history of lipid lowering drugs, were entered on Excel sheet.ResultsIn this study conducted on 63 patients, its been found that females accounts for 25%, Incidence of Young adult stroke was significant,(16%). Patients with co-morbidities were significant in number (71.4%.) Patients on antilipid treatment were few (9.6%), amongs all ischemic stroke patients Out of 63, diabetic patients (HbA1C > 6.5%) were 31, among those 48.5% of patients had LDL > 100 mg/dL, in 9.6% patients had LDL values between 71–100 mg/dL and in 41.90% of patients had LDL < 70 mg/dl. VLDL values were deranged more commonly in diabetic group than in non-diabetic group. The TG levels, however, did not influence the risk of ischemic stroke.DiscussionsAn increase in low-density lipoprotein (LDL) cholesterol or a decrease in high-density lipoprotein (HDL) cholesterol may be additional risk factors for cerebrovascular diseases. In this study, we prospectively evaluated patients with ischemic stroke (except for cardioembolic) with lipid values such as serum cholesterol, triglycerides, LDL cholesterol, HDL cholesterol, very low-density lipoprotein cholesterol, and apoprotein A and B. In the ischemic stroke patient, age and high levels of LDL are associated with greater risk of developing ischemic stroke. The TG levels, however, did not influence the risk. Findings of the present study indicating no role for TG values in the ischemic strokes. One meta-analysis found that in clinical trials reductions in LDL-C level were associated with a significant relative risk reduction in stroke for the atherosclerotic subtype. Also found that treatment with cholesterol-lowering medications modified the effect of an elevated LDL-C level, such that those not taking medications did not have an association with ischemic stroke risk. Stroke risk reduction strategies aimed at reducing all components of the plasma lipid profile will have significant benefits.ConclusionsAlthough serum lipids are well known risk factors for atherosclerosis, the relationship between serum lipid profile and ischemic stroke is not very strong. While the increased serum cholesterol level is directly related to the risk of coronary disease. But the relationship between cholesterol level and the risk of stroke remains undetermined because dyslipidemia alone may not be causative factor for development of stroke. Targetting high LDL levels should be the primary goal to reduce these events and eventually decrease the related morbidity and mortality rates. The present study was designed to evaluate the lipid profile levels in patients of acute ischemic stroke. Its been found that the incidence of young stroke was 16%. This small study gives very strong indication for complete evaluation to define risk factors for development of ischemic stroke.

Objective: Our main aim was to investigate the serum lipid levels in a series of patients with liver cirrhosis of viral origin. Subjects and Methods: The study comprised 90 patients, 60 with viral liver cirrhosis, equally divided between hepatitis virus C (HCV) and B (HBV) etiologies, and 30 control patients with no known liver pathology. Patients were investigated during a 5-year period in the 1st Medical Clinic of the Emergency County Hospital of Craiova, Romania. The following series of serum lipid parameters were recorded: lipemia, total cholesterol and cholesteryl ester, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, very-low-density lipoprotein (VLDL) cholesterol and triglyceride (TG) values. Statistical analysis of these parameters was performed using the ANOVA test followed by Tukey multiple comparison tests to compare replicate means; p < 0.05 was considered statistically significant. Results: We observed significantly lower values for serum lipids (543.5 and 549.37 mg/dl in the HBV and HCV cirrhosis subgroups, compared with 649.9 mg/dl in controls), total cholesterol (143.6 and 147.9 vs. 198.0 mg/dl, respectively), cholesteryl esters (83.6 and 80, compared to 147.9 mg/dl, respectively), LDL cholesterol (91.6 and 88.5 vs. 132.4 mg/dl) in both cirrhosis groups when compared with controls (p < 0.001), as well as HDL cholesterol (32.1 and 36.9 vs. 47.3 mg/dl, p < 0.05). However, TG and VLDL cholesterol values of controls and cirrhosis groups were similar (p > 0.05). We did not register any differences between the two cirrhosis groups (p > 0.05). Conclusion: Our data showed that both HCV and HBV cirrhosis severely impaired liver lipid metabolism. Late stages of the disease resulted in a pseudonormalization of VLDL cholesterol and TG values.

The Fulani of northern Nigeria are indigenous semi-nomadic pastoralists whose diet consists largely of dairy products. Despite their consumption of relatively large amounts of saturated fats, an earlier study showed that their total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and serum triglyceride levels fall within the reference range of values for North Americans. Men in the cities of Jos and Abuja, two populations who also reside in northern Nigeria, differ from the Fulani with regard to diet and activity level. Males in both Jos and Abuja have diets consisting of high protein or carbohydrate and are more sedentary than the Fulani subjects. The main aims of the study were to measure the concentrations of various lipids in the blood serum of male urban dwellers in Jos and Abuja and to compare their blood lipid profiles with those of the rural Fulani (mean age 33.9 years). Blood serum samples from 118 men in Jos (mean age 37.9 years) and 77 men in Abuja (mean age 34.4 years) were analyzed for total cholesterol, triglycerides, LDL, HDL, homocysteine, folate, and vitamin B12. In addition to height and weight, systolic and diastolic blood pressures were measured. The mean total cholesterol, triglyceride, HDL and LDL values for the three groups of subjects fell within or close to the accepted range of values for North Americans. However, the Fulani males had HDL values (mean, 33.9 mg/dL) below the range of values prescribed for North Americans (>40 mg/dL). Moreover, the Fulani men and the men in Abuja had a total cholesterol/ HDL ratio of 4.2 and 4.0 respectively, which exceed the accepted value (< or =3.5) prescribed by the Columbia University. In all three populations, the incidence ofhomocysteinaemia (serum homocysteine > 12.4 micromol/L) was very high. Their mean homocysteine levels ranged from 14.7 to 16.7 pmol/L and could not be accounted for by folate or vitamin B12 status. The mean blood pressures of the Abuja (127/77 mm Hg) and the Fulani (120/74 mm Hg) men were within the normotensive range (<130/85 mm Hg). However, the mean blood pressures of the Jos males (131/85 mm Hg) indicated borderline hypertension. These data indicate that, with regard to serum lipids, urban and rural adult Nigerian males have generally favourable risk factors for cardiovascular disease when compared with healthy North Americans. All three sub-populations, however, have levels of homocysteine that are cause for concern vis-à-vis their overall health status.