Apo B/Apo A-I ratio in central and peripheral arterial diseases

BACKGROUND: The apo B/apo A-I ratio represents the balance between atherogenic particles, rich in apo B, and the antiatherogenic ones, apo A-I rich. This study investigated the association between atherosclerotic diseases in different anatomical sites and apo B/apo A-I ratio. METHODS: Lipids, lipoproteins, and apolipoproteins A-I and B were assessed in 30 subjects with coronary artery disease (CAD), 26 with ischemic stroke (IS), 30 with peripheral arterial obstructive disease (PAOD), and 38 healthy subjects (controls). RESULTS: HDLc and Apo A-I were significantly lower in PAOD and CAD groups, respectively, than in other groups. Significantly higher levels of triglycerides were observed for CAD and PAOD groups than for controls. Apo B was significantly higher in IS group than in control and PAOD groups. The apo B/apo A-I ratio showed significantly higher in CAD and IS groups when compared to control and PAOD groups (p < 0.001). CONCLUSION: The apo B/apo A-I ratio was important for identifying an increased trend for coronary and cerebral atherosclerosis. In spite of the increased trend for apo B/apo A-I ratio in IS and CAD groups, the studied variables cannot be considered in an isolated way, given as those parameters were analyzed together by a binary logistic regression, no association has been demonstrated.

INTRODUÇÃO: O índice apo B/apo A-I representa o balanço entre partículas de colesterol potencialmente aterogênicas ricas em apo B e partículas anti-aterogênicas ricas em apo A-I. O objetivo deste estudo foi investigar a associação entre doenças ateroscleróticas em diferentes sítios anatômicos e o índice apo B/apo A-I. MÉTODOS: Lípides, lipoproteínas e apolipoproteínas A-I e B foram quantificados em 30 indivíduos apresentando doença arterial coronariana (DAC), 26 com acidente vascular cerebral (AVC), 34 apresentando doença arterial obstrutiva periférica (DAOP) e 38 indivíduos hígidos (grupo controle). RESULTADOS: HDLc e apo A-I apresentaram-se significativamente mais baixos nos grupos DAOP e DAC, respectivamente, quando comparados com os demais grupos. Níveis de triglicérides foram significativamente mais elevados nos grupos DAC e PAOD quando comparados com o grupo controle. Apo B foi significativamente mais elevada no grupo AVC quando comparado com os grupos controle e DAOP. O índice apo B/apo A-I se mostrou significativamente elevado nos grupos DAC e AVC quando comparados com os demais (p < 0,001). CONCLUSÃO: O índice apo B/apo A-I foi importante para identificar uma tendência aumentada para aterosclerose coronariana e cerebral. No entanto, os parâmetros avaliados não podem ser considerados de forma isolada, considerando que nenhuma associação foi demonstrada quando os dados foram analisados pelo modelo de regressão logística binária.

Thrombophilia profile in Thai patients with arterial thrombotic disorders.

BACKGROUND: Arterial thrombosis is attributed mainly to atherosclerosis and the roles of hypercoagulability remain unclear In addition, there are ethnic variations in thrombophilia profiles. OBJECTIVE: The authors performed a survey of the thrombophilia profile in Thai patients with arterial thrombosis MATERIAL AND METHOD: The authors analyzed 103 consecutive cases of proven arterial thrombosis and requested thrombophilia profile in Chulalongkorn Hospital during 2003-2004. The mean age was 42.5 years. The proportions of stroke, peripheral arteries, and other sites were 70.9%, 22.3% and 6.8%, respectively. RESULTS: Abnormal profile was found in 35.0% with the prevalence of hyperhomocysteinemia, low protein S, antiphospholipid antibody and low protein C was 15.5%, 12.6%, 9.7%, and 5.8%, respectively. There was no difference in clinical characteristics between cases with or without detectable abnormalities. However, the authors found significant associations of low protein S with poor outcome and HIV seropositivity with antiphospholipid. CONCLUSION: The present study found that the defective protein C pathway may be the most common thrombophilia found in Thais with arterial thrombosis. Future study is required to prove the cause-effect relationship and its clinical significance.

Bandemia in sickle cell disease: a marker for differentiating osteomyelitis from vaso-occlusive crisis

Find out if bandemia [increase in the absolute band cell count] can differentiate osteomyelitis from vaso-occiusive crisis involving the bones in patients with sickle cell disease. Meaningful cut-off-points in the absolute band count [>/= 1000 and >/= 500] differentiation are also looked at. A retrospective review of records of 50 patients from each category for comparison was performed. Two cut-off-points were considered namely bandemia of >/= 1000 and >/= 500 and these were subjected to analysis. Bandemia [both >/= 1000 and >/= 500] was generally more prominent in cases of osteomyelitis as compared to VOC. There were problems with sensitivity and specificity of bandemia as a single criterion for differentiation between the two entities. Although seemingly we encounter higher counts of band white blood cells in cases of osteomyelitis occurring in patients with SCD as compared to VOC, yet because of low sensitivity in case of >/= 1000 as a cut-off-point and low sensitivity as well as non-specificity in case of >/= 500 as a cut-off-point, bandemia cannot be recommended as single diagnostic criterion

Lipid patterns in patients with chronic occlusive arterial disease affecting lower limbs.

114 consecutive patients with chronic occlusive arterial disease of lower limbs (COADL) had their serum lipid pattern compared with that of 62 controls. 53 had abnormal lipids and 36 multiple abnormalities emphasising the common prevalence of atherosclerosis among patients with COADL in Sri Lanka. 48.6% of patients under 40 years had a lipid abnormality. Smoking and lipid disorders were the main risk factors in the under 50 age group. 14 of 16 patients with aortic occlusions and five of eight patients under 45 years with iliac disease had lipid disorders. 21 of 50 patients with femoropopliteal occlusive disease also had lipid disorders. A consistent dominant lipid disorder affecting most, was not found. Total cholesterol/HDL cholesterol ratio was found to be the commonest abnormality. Serum lipid studies are advocated for those with aortoiliac and femoropopliteal disease.

Estudo dos níveis da creatino-fosfoquinase nos quadros de obstruçäo arterial aguda embólica de membros / Serum levels of creatinophosphokinase in patients with peripheral acute arterial embolism

Foram estudados 33 episódios de oclusäo arterial aguda dos membros em 32 pacientes, atendidos no Pronto Socorro do Hospital das Clínicas da Faculdade de Medicina da Universidade de Säo Paulo e no Hospital Israelita Albert Einstein, no período de 1979 a 1984. Täo logo reconhecido o episódio isquêmico, os pacientes foram submetidos a coleta de sangue para a media da atividade sérica da creatino-fosfoquinase com o objetivo de compará-la com parâmetros clínicos obtidos no pré-operatório e com o resultado do tratamento (cirúrgico em todos). Estes foram: 1) localizaçäo da isquemia, 2) tempo de evoluçäo da isquemia, 3) capacidade motora da extremidade comprometida, 4) presença de empastamento muscular, 5) recuperaçäo funcional da exttremidade, 6) preservaçäo da extremidade e 7) sobrevida. Através da aplicaçäo de testes estatísticos para se comparar os níveis séricos da creatino-fosfoquinase com os parâmetros acima, concluímos que: 1) os níveis séricos da CPK näo guardam relaçäo com a localizaçäo da isquemia, 2) näo houve diferença estatisticamente significativa entre os níveis séricos da CPK e o tempo de evoluçäo da isquemia, 3) houve elevaçäo dos níveis da CPK em pacientes com comprometimento motor, 4) os pacientes portadores de empastamento muscular apresentaram valores mais elevados da CPK, 5) houve diferença significativa nos níveis da enzima entre pacientes que recuperaram a funçäo da extremidade, 6) näo pudemos relacionar os níveis da enzima com a probabilidade de amputaçäo ou preservaçäo da extremidade e 7) os pacientes que faleceram tinham níveis de CPK mais elevados que aqueles que sobreviveram

Consideraçöes sobre lipoproteínas, risco cardiovascular e conotaçäo com o ciclo gravídico-puerperal / Lipoproteins, cardiovascular risk and connotation with the gravidic puerperal cycle

Neste estudo atualiza-se aspectos relevantes sobre a elevaçäo do colesterol total plasmático e particularmente enfatiza a sua distribuiçäo nas classes de lipoproteínas LDL (lipoproteína de baixa densidade) e HDL (lipoproteína de alta densidade), como preditores de risco para a coronariopatia, acidente vascular cerebral e/ou obstruçäo arterial periférica. O trabalho correlaciona esses aspectos com a chamada "hiperlipemia da gravidez"

Estudio de la agregación plaquetaria, la fibrinólisis y los lípidos sanguíneos en pacientes con arteriopátia diabética de los miembros inferiores / Platelet aggregation, fibrinolysis and blood lipids in patients with diabetic arterial disease of lower extremities

En la diabetes melitus se ha observado que la agregación plaquetaria se encuentra exacerbada y la fibrinólisis alterada, planteándose que esta última puede ser índice de un defecto en la defensa contra los depósitos vasculares de fibrína, que resultaria de gran importancia para la angiopatía diabética. Se propuso también una asociación entre hiperlipidemia y actividad fibrinolítica deprimida. El presente trabajo analiza el comportamiento de estos tres conjuntos o parámetros que parecen actuar de forma conjunta en la aterogénesis del diabético. Para la comparación estadística entre los grupos, se realizó un análisis de varianza de una dosificación y en los casos en que se encontraron diferencias significativas entre los grupos, se realizó una prueba de comparación múltiple. Se obtuvieron resultados que indican que tanto la agregación plaqueatria inducida por ADP, colágeno y epinefrina, como la actividad fibrinolítica media por el tiempo de lisis de euglobulinas y los PDF, sufren variaciones significativas en varios de los grupos comparados. Además de algunos parámetros lipídicos que se encuentran también significativ amente alterados. Estos resultados implican un mejor conocimiento de las características de los diferentes tipos de pacientes diabéticos que presentan complicaciones vasculares en los miembros inferiores