Fluvastatin increases insulin-like growth factor-1 gene expression in rat model of metabolic syndrome

Insulin-like growth factor- 1 [IGF-1] was found to have a role in both glucose homeostasis and cardiovascular diseases. The present study was designed to compare the effects of fluvastatin and metformin on IGF- 1 mRNA expression within the liver and on other individual components of the metabolic syndrome induced in rats by high fructose feeding. Rats fed 60% fructose in diet for 6 weeks were treated daily with fluvastatin [3.75mg/kg/day] or metformin [200mg/kg/day] during the last 2 weeks and were compared with untreated fructose fed group. Fasting levels of plasma cholesterol, triglyceride, glucose, insulin, nitric oxide products, IGF- 1 and IGF- 1 mRNA within the liver as well as systolic blood pressure and body weight were determined. Compared to control rats, the fructose fed group developed hypertension, hyperlipidemia, hyperinsulinemia, hyperglycemia and endothelial dysfunction as well as decreased levels of plasma IGF- 1 and its mRNA within the liver. Fructose fed rats treated with fluvastatin or metformin for 2 weeks showed significant decrease in plasma cholesterol, triglyceride, insulin and glucose levels compared to untreated fructose fed group. Also, both drugs increased significantly plasma levels of nitric oxide products and IGF-1 together with significant increase in IGF-1 mRNA within the liver. However, only metformin treated rats showed significant decrease in systolic blood pressure compared to fructose fed group. This study showed that in a rat model of insulin resistance, fluvastatin improves the metabolic profile and increases plasma level of IGF-1 and its gene expression as effective as metformin

Comparing three clinical screening tools in identification of geriatric depression in a rural community setting

With the demographic transition, the elderly population is growing all over the world. Depression, currently considered as the 'disease of the century' ranks among the most significant health problems in older adults causing substantial morbidity, disability, functional decline, and mortality. Depression is reported in 13% of elderly community dwelling, and 24% of older medical outpatients, but there is a consensus that geriatric depression is underestimated. This is because older people in the community may not have contact with health services and because physicians may not screen for depression using the too lengthy tools leading to compounding of the depression problem. Efforts are needed to locate and identify those at risk and to provide care relevant to their needs. The Geriatric Depression Scale [GDS] is a screening instrument for depression in the elderly. Using a shortened GDS can greatly facilitate identification and assessment of depression in clinical and community settings. Determining the toll of depression among geriatric rural population in El Minia as well as to assess the value of application of the shorter version of geriatric depression scale and two-questions from PRIME-MD for screening of depression. The 15-item GDS, 5-items GDS and two-questions from PRIME-MD completed by all participants during community visit. 165 community dwellers aged 60 years and older were chosen randomly to be participated in the study and subjected to interview questionnaire administered to them at their household in Tehna Elgabal village, El Minia Governorate. ROC curve analyses showed .good agreement between 15-GDS, five-GDS and two-items PRIME-MD screener. Using GDS 15, it was found that nearly 30% of the participated geriatric rural populations in El Minia were moderately to severely depressed, while as 37.6% of them were categorized as so using GDS 5. Two items PRIME-MD screening categorized 24.2% as moderately- to- severely depressed. GDS was found to have a good specificity [0.85] in a representative sample of community-dwelling oldest old for the presence of major depression. This scale was developed as a basic screening measure for depression in older adults. 15-GDS is correlated to 5-GDS and Two items-PRIME-MD screener [r = 0.53, P < .000, r = 0.44, P =0.000] respectively.ROC curve analyses showed good agreement between 15-GDS and the 5-GDS as well as the Two-items PRIME-MD screener. It was found that 2 items [measuring depressed mood and anhedonia over the past month] demonstrated good sensitivity [88%] but only modest specificity [60%] compared with the 15-GDS. It was found that 5-GDS demonstrated excellent sensitivity [92%] but only fair specificity [50%] compared with the 15-GDS Interview Schedule. Nearly one fourth of community geriatric participated in the this study were found to be moderately to severely depressed using the 2-item PRIME-MD depression screening questionnaire which was found to be an efficient and effective way of separating patients with milder levels of depression from those with moderate to severe impairment. It was found that the short forms were adequate substitute for the long form and tends to be more suitable to be incorporated and widely used in primary care and community setting

Serum soluble fas in patients with pre-eclampsia and the syndrome of hemolytic anemia, elevated liver enzymes and low platelet count [HELLP] syndrome

Pre-eclampsia carries statistically significant perinatal risk to both the mother and the fetus. HELLP syndrome is a complex disease process that is probably mediated by numerous factors. It appears that the immune system may play a role in its pathogenesis.Apoptosis or programmed cell death is a physiological process for normal development and reproductive function. It has been found to be involved in different inflammatory and immune disorders. The Fas-Fas ligand system is one of the best-studied death systems that can mediate apoptosis. Soluble Fas [sFas], a protein related to the tumor necrosis factor receptor family, protects cells from Fas mediated apoptosis by binding to Fas ligand preventing it from stimulating Fas receptor on the cell membranes and consequently inducing apoptosis. The objective of this work is to assess whether serum levels of soluble Fas, are altered in cases of pre-eclampsia and HELLP syndrome. Results showed that serum soluble Fas was statistically higher in patients with HELLP syndrome compared to those with mild or severe pre-eclampsia with values of 12.7 +/- 1.1 u/ml, 7.1 +/- 1.1 u/ml and 8.1 +/- 1.3 respectively. Moreover, it was higher than normal control subjects with mean serum value of 6.1 +/- 0.4 u/ml

Tumor necrosis factor alpha as a parameter used in assessing patients with acute myocardial infarction with and without acute left sided heart failure

To clarify the use of tumor necrosis factor alpha in the course and prognosis of acute myocardial infarction and its relation to development of left sided heart failure following myocardial infarction. This case-control study was conducted on 30 persons, 20 of them were newly diagnosed as acute myocardial infarction [AMI] [group A] and 10 healthy age and sex-matched served as controls [group B]. All subjects [patients and controls] were subjected to full medical history and family history of coronary heart disease, thorough clinical examination, chest X-ray post- anterior [PA] and lateral, electrocardiography [ECG], measurement of cardiac enzymes [CPK, SGOT, LDH, CBC, CRP and ESR], estimation of plasma TNF alpha for both patients and controls by ELISA. AMI patients [group A] had a highly significant increase of serum TNF alpha level on admission, especially with those with signs of heart failure, significant increase of its level at 24 hours and insignificant increase of its level at 48 hours compared to healthy control [group B]. There was a significant positive correlation between TNF alpha and CPK level on admission in AM1 patients. There was a significant negative correlation between them at 24 and 48 hours

Pain relief effect of different radiation doses of sequential half body radiotherapy for multiple osseous metastases

Thirty eight patients suffering from widespread osseous metastases and attending Kasr El-Aini centre of Radiation Oncology and Nuclear medicine [NEMROCK] from the period December 1984 to February 1987 were included in this work. The dose chosen for upper half body was 500 cGy in 6 patients or 600 cGy in another 6 patients [single midline corrected dose], while for lower half body it was 700 cGy in 11 patients or 800 cGy in 15 patients. All patients. All patients showed some degree of pain relief while complete pain relief was achieved in 13/21 patients [61.9%] who received high dose irradiation either for UHB [600 cGy] and in 6/17 patients [35%] who received low dose irradiation. The duration of pain relief proved to be longer in the group treated by high dose radiation dose [264 days] than those treated by low dose [153 days]. A marked statistically significant prolonged pain relief period was noticed in the group treated by 800 cGy to lower half body [316 days] than in the group treated by 700 cGy [165 days], such a difference has not been observed in the upper half body irradiation between 500 cGy [130 days] and 600 cGy [133 days]. The optimal dose for UHB which seems satisfactory is either 500 or 600 cGy while for LHB 800 cGy is the optimal dose. Sequential half body irradiation seems to be least expensive and the most efficient treatment for widespread osseous metastases

First line cytotoxic therapy with cyclophosphamide, mitoxantrone [Novantrone], 5-fluorouracil, in advanced inoperable breast cancer

Twenty-four patients [mean age 48.7 years] with advanced inoperable breast cancer, were treated with the combination of cyclophosphamide 500 mg/m2, 5FU 500 mg/m2 and mitoxantrone 10 mg/m2 by i.v. route. In the absence of limiting toxicity the doses of mitoxantrone and 5FU were increased, respectively, to 12 mg/m2 and 750 mg/m2. Seven patients were premenopausal and the mean rating of all patients on Karnofsky scale was 90. Six patients were newly diagnosed and 14 had a disease free interval of less than two years. The objective response rate in this study was 83.4% [CR 7/24 patients or 29.2% and PR 13/24 patients or 54.2%]. Leukopenia was the most frequent side effect [grade 3 in 25.9% of the cycles]. Grade 3 nausea-vomiting was observed that this combination is effective in inoperable breast cancer patients causing little toxicities

Immunosuppressive characteristics of radio and chemotherapy on some cellular immune responses in malignant lymphomas

Twenty-one patients with Hodgkin's disease [HD] and 40 patients with non-Hodgkin lymphoma [NHL] were subjected to either chemo or radiotherapy according, to the clinical stage and to the pathological classification. The immunosuppressive effect of either treatment modality was evaluated in respect to the pretreatment immunological status. The results demonstrated that both types of treatments exhibited the same depressive effect on the cell mediated immunity [CMI]. The five years survival of these patients showed the dependence of survival not only on the clinical stage, and the pathological type, but also on the integrity of CMI profile of the patient