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Many research groups on atherosclerosis have sought through prospective large-scale epidemiological studies to better understand which residual factors would be associated with cardiovascular risk. Thus, atherogenic dyslipidemia was defined, such as the presence in an individual of decreased HDL-C levels, increased triglyceride levels, and a relatively high proportion of small and dense LDL-C particles. On the other hand, it was found that atherogenic dyslipidemia is present in cases of insulin resistance and metabolic syndrome (low HDL-C and elevated triglycerides are part of the definition of this syndrome) and consequently in patients with type 2 diabetes mellitus. Regarding treatment, there are studies in diabetic patients with risk reduction with fenofibrate, and the guidelines recommend the association of fenofibrate with statins. Diabetes mellitus is also an important cause of hospitalizations and proportional mortality, also assuming that most deaths register only the immediate cause of this death, which is often the result of diabetes complications. Most of these complications are cardiovascular diseases, which may manifest as coronary heart disease, cerebrovascular disease or peripheral arteriopathies. These are the so-called macrovascular complications of type 2 diabetes and are present even before the onset of hyperglycemia, due to the presence of insulin resistance and associated metabolic syndrome. Metabolic syndrome is characterized by the presence in the patient of at least 3 out of 5 parameters (increased abdominal waist, high glycemia, hypertriglyceridemia, low HDL-C and arterial hypertension) and is one of the factors responsible for the macrovascular changes.

Mini reviewIn women, 46% of deaths result from cardiovascular disease (CVD) and 50% of them refer to coronary heart disease.Women, more than men, have angina pectomy as the initial manifestation of the disease (65% vs. 35%, respectively). Men, on the other hand, have acute myocardial infarction (AMI) as an initial manifestation in a higher proportion than in women (29% vs. 43%, respectively). The varied initial manifestations of ischemic diseases result in different diagnostic approaches; thus, as women report milder symptoms, despite a more severe disease, they are less submitted to diagnostic procedures, even having a positive stress test and, when they are, they are already in a more advanced state of the disease. [1][2][3][4][5][6][7][8][9][10][11]

This work is licensed under Creative Commons Attribution 4.0 License OJCR.MS.ID.000559.

AimsTo analyse the MRI abnormalities of myelin oligodendrocyte glycoprotein-antibody (MOG-Ab) associated demyelinating disease.MethodsClinical records and 165 MRIs from 56 patients with MOG-Abs were reviewed.ResultsThe median age was 29(8–71) years and 52% percent were female. Common phenotypes included isolated optic neuritis (ON)=17, or transverse myelitis (TM)=16, ON+TM =12, and combinations of above groups with cerebral and/or brainstem involvement=11. Seventeen patients (30%) fulfilled NMOSD 2015 diagnostic criteria.All patients had brain imaging and 89% (50/56) had spinal imaging. Common areas of MRI brain abnormality involved brainstem(32%), hemispheric white matter(29%), corticospinal tracts(21%), and U-fibres(20%). Dawson’s fingers were not detected in any patients.Cord imaging showed longitudinally extensive myelitis in 69% (20/29) and atrophy in 4% (2/47). Optic nerve imaging was abnormal in 69% (18/26) of patients, with bilateral lesions in 33% and long lesions (orbital and/or canalicular) in 83%. On serial MRI, radiological improvement was observed in 76% (22/29; median interval- 14 months) and importantly asymptomatic new lesions were absent in 13 untreated patients after a median of 16.5 months.ConclusionsApart from optic nerve and spinal cord changes, brainstem and hemispheric white matter abnormalities are common in MOG-antibody disease. Irrespective of treatment, asymptomatic accrual of brain and/or spinal lesions is uncommon.

Point-of-care testing (POCT) offers several advantages over traditional laboratory testing. Offering less invasive testing with a faster turnaround time is not enough if not associated with an acceptable level of accuracy. Here, we show the analytical validation behind the multi-analyte POCT immunochromatography analyser, Hilab Flow (HiF). Analyses from 4,518 clinical samples were compared to College of American Pathologists accredited laboratories for ten quantitative and thirteen qualitative exams. Compatibility between methods was evaluated in terms of association/correlation and clinical agreement. Strong correlation/ concordance was observed between quantitative (CHOL, HDL-c, TG, HbA1c, Glycemia, 25-Hydroxy Vitamin D, TSH, Uric Acid, Creatinine, Urea) and qualitative methods (COVID-19 IgG/ IgM, Beta-hCG, Syphilis, Anti-HBsAg, Zika IgG/ IgM, Influenza A/B, HIV, HCV, HBsAg, Dengue NS1, COVID-19 Ag, Dengue IgG/ IgM, PSA). Approval criteria was obtaining a kappa agreement > 0.8 or a Pearson correlation > 0.9 depending on the exam. Overall percentage agreement was greater than 95% for all exams, indicating a good clinical agreement to gold-standard laboratory-based tests. Results indicate all exams are suitable for POCT and present a reliable performance. Data support the analyser is a useful tool to aid decision-making at the clinical setting, with potential to contribute with healthcare solutions in diagnostic medicine worldwide.

The involvement of inflammation is described in all stages of atherosclerosis as well as in dyslipidemias, particularly in lipoproteins (especially oxidized LDL), coronary syndromes, hypertension, diabetes, infections, obesity, and also in the use of sexual replacement hormones. From the first steps of leukocyte recruitment in the nascent atheromatic lesion to the development of atheroma plaque, culminating in its rupture and thrombosis in the acute coronary event, we found a constant release of inflammatory mediators, soluble in plasma, from macrophages, T lymphocytes, endothelial cells and smooth muscle vessels of the vessels, hepatocytes, and adipocytes. The greatest evidence relating inflammation to the future development of cardiovascular events has been verified in large-scale population studies. High concentrations of inflammatory markers such as TNF-α, IL-6, ICAM-1, P-selectin, E-selectin, C Reactive Protein, fibrinogen, and amyloid serum A, in apparently healthy individuals, have shown predictive value for future vascular events. Considering the multifactorial etiology of coronary artery disease and its inflammatory nature, it was possible to find an association between the presence of risk factors and the increase in the concentration of biomarkers of inflammation. TNF-α is a multifunctional cytokine derived from smooth endothelial and muscle cells, as well as macrophages present in the coronary atheroma. It is involved in a number of cardiovascular processes, being increased in congestive heart failure.

Definition and functionLipids: are biomolecules, chemically heterogeneous, which are characterized by being insoluble in water. 1 The main lipids for humans are: fatty acids (FA), triglycerides (TG), phospholipids (PL) and cholesterol. 2,3 Fatty acids: the most important for man's nutrition are long-chain (C 12 -C 20 ), containing evenly numbered carbon atoms. They were defined as: saturated (not present double bond inside the molecule, e.g. steariaric C 18:0 ), monounsaturated (have a double bond, e.g. oleic C 18:1 ) and polyunsaturated (have more than a double bond, e.g. linoleic C 18:3 ). In general, saturated FA of animal origin and unsaturated ones of plant origin predominate in the diet. Longchain FA is oxidized for energy production by the process known as β oxidation, which results in sequential reduction of the chain every two carbon atoms, and the production of Acetyl-Coenzyme-A (Acetyl-Co-A) that enters the tricarboxylic acid cycle (Krebs cycle) to generate energy. The FA has an energetic function, participate in the synthesis of prostaglandins and provide Acetyl-Co-A for the synthesis of other lipids.Triglycerides: are obtained by diet or produced by the body, from the esterification of glycerol with three molecules of FA, in liver or adipose tissue. It has an essentially energetic role, for immediate or subsequent storage use. Phospholipids: have a glycerol molecule as the backbone, in which two FA are esterified. The third hydroxyl group is attached to alcohol through phosphodiester binding. Therefore, PL have both domains: one hydrophilic (phosphate group) and another hydrophobic (FA), which give it structural function in the double layer that make up cell membranes and on the surface of lipoprotein particles.Cholesterol: Is the main steroid of man, unsaturated monohydric alcohol, derived from the pentanoperhydrophenantrene cycle and is present in all cells of the body and in most fluids. It may be in free form (structural component of cell membranes and on the surface of lipoprotein), or esterified (stored inside cells or inside lipoproteins). Cholesterol esterification occurs in the blood plasma by the action of the enzyme LCAT (lecithin cholesterol acyl transferase), activated by apo A-I, which transfers an FA of lecithin to the 3-beta-hydroxide cholesterol position. Intracellular esterification occurs by the action of ACAT (acyl-CoA-cholesterol acyl transferase). Cholesterol is present in foods, with the exception of vegetables, but most of it found in the body comes from the synthesis of new from acetate (Acetyl-Co-A). The step that regulates the speed in the synthesis pathway is the conversion of 3-hydroxy-3-methylglutaryl-coenzyme A to mevalonate, catalyzed by the enzyme hydroxy-methyl-glutariICoA reductase (HMGCoA reductase). The liver is the organ responsible for most of the synthesis of new cholesterol. Cholesterol also serves as a precursor for synthesis of steroid hormones, vitamin D and bile acids.