Currently, the Friedewald formula (FF) is the main method for evaluating low-density lipoprotein cholesterol (LDL-c). Recently, many limitations have emerged regarding its use, including patients with triglyceride levels ≥400 mg/dL, diabetes mellitus, and kidney or hepatic chronic diseases. We analyzed the use of the FF in patients with metabolic syndrome. We selected patients with known metabolic syndrome that fulfilled the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report and excluded patients with triglyceride levels ≥400 mg/dL and chronic liver and/or kidney disease. Using direct assays, we measured total cholesterol, high-density lipoprotein cholesterol, triglycerides, and LDL-c. Then, LDL-c was estimated using the FF and compared with the LDL-c by direct assay. The sample size was 135 patients. Using the FF, the mean LDL-c value was 124.4 ± 42.1 mg/dL; it was 125.1 ± 38.5 mg/dL by direct assay. The correlation coefficient between these two methods was 0.89, with statistical significance (P value < 0.001). There were no significant differences between the patients with triglyceride levels >150 mg/dL (P = 0.618). In conclusion, FF is a good method for estimating LDL-c in patients with metabolic syndrome.
objective: It has been implied that neointimal proliferation and remodeling are the major causes of restenosis. The objective of this study is to assess the effect of orally administered L-arginine on these two factors in hypercholesterolemic rabbits that had suffered an injury to their iliac arteries caused by a catheter balloon. Methods:The study included nineteen rabbits that were divided in two groups: control (CG) and arginine (AG). There were 19 arteries studied from the control group and 17 in the arginine group. The animals were placed on a 2% hypercholesterolemic diet for 15 days and then submitted to a balloon angioplasty in order to produce a lesion in their iliac arteries. Next, the AG animals were given a 1g/kg/day oral dose of a L-arginine solution. The animals were sacrificed 15 days after the angioplasty procedure and histological artery sections were prepared, stained and fixed. The ratio between the neointimal area (in mm 2 ) and the media layer (in mm 2 ) was used to represent lesion development. In order to determine remodeling, the ratio between the total area of the medial portion of the vessel (greater balloon contact) and the total area of the reference segment of the vessel (less balloon contact) was used.results: Mean neointimal thickness (NI/M) was 0.8151±0.2201 in CG and 0.3296±0.1133 in AG. Remodeling patterns for the two groups studied were similar. conclusion: In the experimental model used, L-arginine was able to reduce intimal tissue thickness in hypercholesterolemic rabbits but did not act on artery remodeling.
The transumbilical breast augmentation procedure has proved to be highly effective and safe when performed properly, as outlined herein. In the author's opinion, the popularity of the procedure will continue to increase among both surgeons and patients. This article focuses on the steps necessary to maximize the continuing safety of the procedure. The three most critical points are that no sharp instruments are used, the surgeon's handling of the instrument prevents any long thrusts, and at no time does any instrument point toward the abdominal or thoracic cavity. These and numerous other safety tips are presented here.
RESUMOOBJETIVO. O objetivo deste trabalho é estudar o comportamento da pressão arterial através da monitorização ambulatorial da pressão arterial (MAPA) em jovens normotensos que possuam história familiar de hipertensão. MÉTODOS. Foram avaliados pela MAPA 31 universitários normotensos, com idade entre 17 e 25 anos, cujos pais (ambos ou um deles) estivessem sendo tratados por hipertensão arterial (grupo I) e 30 indivíduos, também normotensos, cujos pais não apresentavam diagnóstico de HAS -hipertensão arterial sistêmica (grupo II). Todos os participantes tiveram dados epidemiológicos coletados e os valores de pressão arterial (PA) obtidos pela MAPA foram comparados. RESULTADOS. Não houve diferença estatística entre os grupos estudados quanto à análise das médias de PA sistólica (PAS) (p=0,195) e diastólica (PAD) (p=0,958), descenso noturno da PAS (p=0,61) e da PAD (p=0,289) e variabilidade da PAS (p=0,24) e da PAD (p=0,497). Houve significância estatística na comparação da pressão de pulso (42,74 mmHg no grupo I e 45,53 mmHg no grupo II, p=0,032) e da PAS mínima na vigília (85,00 mmHg no grupo I e 90,27 mmHg no grupo II, p=0,048). Ambos os parâmetros mencionados foram maiores nos filhos de normotensos. CONCLUSÃO. Na população estudada, houve diferença estatística significativa na pressão de pulso e PAS mínima na vigília, sendo maior nos filhos de normotensos. Os demais parâmetros da MAPA não apresentaram diferença significativa entre os grupos. UNITERMOS INTRODUÇÃOAs doenças cardiovasculares ocupam lugar de importância em termos de saúde pública em nosso país, sendo a primeira causa de morte desde a década de 60. Em 1998, dos 930 mil óbitos no Brasil, cerca de 27% foram devidos às doenças cardiovasculares. A hipertensão arterial sistêmica (HAS), por sua vez, é um importante fator de risco para o desenvolvimento dessas doenças cardiovasculares e esteve relacionada a 40% das mortes por acidente vascular cerebral e 25% das mortes por doença arterial coronariana 1 . A identificação de populações com risco para o desenvolvimento futuro de hipertensão arterial é de fundamental importância, uma vez que se tem demonstrado que vários fatores e lesões atribuídos à hipertensão são, na realidade, concomitantes ou antecedentes a ela, tendo seu início de maneira precoce. Além disso, com a detecção do risco para desenvolvimento da HAS, vários fatores ambientais (tabagismo, sobrepeso, sedentarismo e outros) relacionados à agressão vascular podem ser controlados de maneira a minimizar ou retardar a constatação de níveis tensionais elevados 2 . É conhecida a herança genética da HAS. Rotimi et al 3 estudaram 510 famílias nigerianas, encontrando uma taxa de herança de 45% para a pressão arterial sistólica e 43% para a pressão arterial diastólica nesta população.O exame de monitorização ambulatorial da pressão arterial (MAPA) tem sido empregado com segurança e eficácia como método diagnóstico e para controle da HAS 4 . Considerando a hereditariedade da HAS 5,6 , a detecção precoce de parâmetros da MAPA capazes de inferir predisposiç...
RESUMO -O termo holoprosencefalia (HPC) é usado para o complexo de deformidades hemisféricas causadas por falha no desenvolvimento da vesícula prosencefálica. Este estudo tem como objetivo relatar o espectro morfológico de 12 casos de HPC, classificá-los e compará-los com a literatura pertinente. Avaliadas 5837 necrópsias realizadas entre 1960 e 1995, 12 apresentavam HPC. Dados como sexo, idade, e presenças de outras malformações associadas foram avaliados e comparados com as demais malformações e com o total de necrópsias. A maioria dos casos era de masculinos (66,66%) e neomortos (75%). A forma de HPC mais frequentemente encontrada foi a lobar (58,3%) e a alteração facial mais frequente foi a ciclopia (25%). Houve tendência estatística de que a HPC possa, dentro das malformações do sistema nervo central (SNC), acometer mais o sexo masculino e de que a neomortalidade seja maior na HPC do que nas outras malformações do SNC.PALAVRAS-CHAVE: holoprosencefalia, malformações cerebrais, necrópsia. Holoprosencephaly: morphological aspects of twelve cases of autopsyABSTRACT -The term holoprosencephaly (HPC) is used to indicate the group of hemispheric deformities caused by a failure in the development of the prosencephalic vesicle. The purpose of this study is to explain the morphologic specter of twelve cases of HPC, qualify them, and compare them to the literature. It was evaluated 5837 pediatrics necropsies, and there were 12 cases of HPC. Data like gender, age and the presence of another associated malformations were evaluated and compared to another malformations and to the total number of necropsies. The majority of the cases was male (66.66%), and stillborns (75%). The most frequently type of HPC found was the lobar type (58.3%), and the most frequently type of facial alteration was the ciclopy (25%). There is a statistic tendency to HPC affect the male sex, in comparison with other neurologic malformations. Besides, the stillborns are more frequently observed in HPC than in other neurologic malformations.KEY WORDS: holoprosencephaly, autopsy, nervous system malformations. O termo holoprosencefalia (HPC) é usado para o complexo de deformidades hemisféricas causadas por falha no desenvolvimento da vesícula prosencefálica. A vesícula prosencefálica é a parte mais cranial do tubo neural. Ela se divide sagitalmente dando origem, bilateralmente, em torno da quinta semana de gestação às vesículas telencefálicas que formarão os dois hemisférios cerebrais. Também se divide transversalmente originando o telencéfalo e diencéfalo, e horizontalmente originando os bulbos olfatórios e vesículas ópticas 1 . Conforme o grau de severidade dessas várias falhas, a HPC pode sofrer as seguintes gradações: alobar, semilobar, lobar e arrinencefalia isolada 2,3 . Agenesia dos bulbos e dos tractos olfató-rios são achados frequentemente associados à holoprosencefalia 1,4,5 , mas podem ocorrer como malformação isolada ou estar presente em outras síndro-mes 1,5 . Frequentemente encontram-se, também, anor-
objective: This study was designed to evaluate vascular morphological and morphometric changes induced by brachytherapy with samarium-153 (Sm-153) at high doses in hypercholesterolemic rabbits.Methods: Forty-three New Zealand White hypercholesterolemic rabbits were analyzed, and the total of 86 iliac arteries underwent balloon angioplasty injury. The rabbits were divided into three different groups: two irradiation groups (IG) assigned to 15 Gy (n=14) and 60 Gy (n=36) irradiation doses, respectively, and a control group (n = 36). Histomorphometric and qualitative histological analyses were performed for tissue evaluation.results: Significant reductions were found in neointimal proliferation (NIP) (p< 0.0001), media area (MA) (p<0.0001) and percent stenosis (p<0.0001) in the 15-Gy IG, compared to the other groups. The 60-Gy IG had the higher rate of NIP, increase in media and vessel areas (VA) and percent stenosis. The 60-Gy IG also showed the greatest number of xanthomatous cells (60-Gy IG: 86.11% and 15-Gy IG: 14.29%, p<0.0001) and the highest amount of hyaline amorphous tissue (60-Gy IG:58.33% and 15-Gy IG:0%, p=0.0001) and vascular proliferation (60-Gy IG:30.56% and 15-Gy IG:0%, p=0.0221). No statistically significant differences were found among groups concerning other tissue analyses. conclusion:The high-dose irradiation of 60 Gy resulted in intense cell proliferation considered vascular radiolesion, unlike the 15-Gy dose, which was associated with an excellent inhibition of neointimal proliferation.
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