Can Routine Blood Biochemistry Parameters be Predictive Prognostic Marker(s) in Operated Patients with Meningioma WHO Grade 1?

Background Today, there is a need for new and independent additional advanced markers that can predict the prognosis of meningioma patients, postoperatively. The present study aimed to find out postoperative short-term prognostic markers in patients with meningioma using their demographic data and routine blood biochemistry findings evaluated preoperatively. Methods The Glasgow Coma Scale (GCS), and Glasgow Outcome Scale (GOS) scores of the patients were recorded. Additionally, preoperatively obtained serum glucose, Creactive protein (CRP), sodium, potassium, creatinine, blood urea nitrogen, aspartate aminotransferase (AST), alanine aminotransferase, and hemoglobin level values, platelet, leukocyte, neutrophil, lymphocyte, eosinophil, basophil, andmonocyte count results, erythrocyte sedimentation rate (ESR), neutrophil-lymphocyte ratio, plateletlymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) values were evaluated. Results In the present study, 23 operated patients with meningioma World Health Organization (WHO) grade 1 (17 females, 6 males) were included. Correlation test results revealed that the GCS score, platelet count, and serum potassium level values could directly predict the short-term prognosis of these patients. Additionally, these test results suggested that the lymphocyte, monocyte, and eosinophil count values, PLR, LMR, ESR, serum glucose, CRP, and AST level values could be indirect markers in predicting the short-term prognosis. However, likelihood ratio test results revealed that only monocyte count value, LMR value, and serum CRP level value could be the markers for prediction of the short-term prognosis. Conclusion At the end of the present study, it was concluded that the monocyte count value, LMR value, and serum CRP level value could be the best markers in predicting the short-term prognosis of the operated meningioma patients.

Interval training based on ventilatory anaerobic threshold increases cardiac vagal modulation and decreases high-sensitivity c-reative protein: randomized clinical trial in coronary artery disease

Background: Autonomic dysfunction and inflammatory activity are involved in the development and progression of coronary artery disease (CAD), and exercise training has been shown to confer a cardiovascular benefit. Objective: To evaluate the effects that interval training (IT) based on ventilatory anaerobic threshold (VAT) has on heart rate variability (HRV) and high-sensitivity C-reactive protein (hs-CRP) levels, as well as the relationship between both levels, in patients with CAD and/or cardiovascular risk factors (RF). Method: Forty-two men (aged 57.88±6.20 years) were divided into two training groups, CAD-T (n= 12) and RF-T (n= 10), and two control groups, CAD-C (n= 10) and RF-C (n=10). Heart rate and RR intervals in the supine position, cardiopulmonary exercise tests, and hs-CRP levels were measured before and after IT. HRV was analyzed by spectral and symbolic analysis. The CAD-T and RF-T underwent a 16-week IT program of three weekly sessions at training intensities based on the VAT. Results: In the RF-T, cardiac sympathetic modulation index and hs-CRP decreased (p<0.02), while cardiac parasympathetic modulation index increased (p<0.02). In the CAD-T, cardiac parasympathetic modulation index increased, while hs-CRP, systolic, and diastolic blood pressures decreased (p<0.02). Both control groups showed increase in hs-CRP parameters (p<0.02). There was a strong and significant association between parasympathetic and sympathetic modulations with hs-CRP. Conclusion: The IT program based on the VAT promoted a decrease in hs-CRP associated with improvement in cardiac autonomic modulation.

Efeito de um programa regular de exercício físico sobre a proteína C-reativa de indivíduos com risco de doenças cardiovasculares / Effect of a Regular Aerobic Exercise Program on C-Reactive Protein among People at Risk for Cardiovascular Disease

Fundamentos: Estudos observacionais sugerem que exercício físico possui efeito anti-inflamatório, no entanto essa hipótese não está definitivamente confirmada por ensaios clínicos randomizados.Objetivo: Verificar o efeito da atividade física aeróbica sobre o processo inflamatório sistêmico em indivíduos com risco cardiovascular. Métodos: Ensaio clínico randomizado, em que foram incluídos indivíduos sedentários, com pelo menos dois fatores de risco para doença coronariana ou doença cardiovascular estabelecida. Os voluntários foram randomizados para três meses de treinamento aeróbico supervisionado (grupo-treino) ou apenas aconselhamento quando a hábitos de vida saudáveis (grupo-controle). Proteína C-reativa (PCR) foi mensurada por método de alta sensibilidade antes e após a intervenção. Resultados: Avaliados 68 indivíduos. Os grupos treino e controle apresentaram características basais semelhantes. Houve melhora da capacidade funcional apenas nos pacientes do grupo-treino. Observou-se aumento de PCR após três meses no grupo-controle, cuja mediana evoluiu de 2,2 mg/L (IIQ =1,0 mg/L - 4,3 mg/L)para 3,2 mg/L (IIQ =2,4 mg/L - 5,5 mg/L), p=0,006.Esse fenômeno não foi observado no grupo-treino,que apresentou mediana basal de 1,7 mg/L(IIQ =0,97 mg/ L - 4,8 mg/L), estatisticamente semelhante ao valor final de 2,5 mg/L (1,0 mg/L - 4,7 mg/L), p=0,46.Quando a variação percentual da PCR foi comparada entre os grupos, houve maior incremento no grupo controle(+58,0 %; IIQ =11,0 % - 151,0 %), comparado ao grupo-treino (+17,0 %; IIQ =-36,0 % - 79,0 %),p intergrupo=0,046.

Background: Although observational studies suggest that exercise has anti-inflammatory effects, this possibility has not been confirmed definitively through randomized clinical trials. Objective: To assess the effects of aerobic activities on systemic inflammatory processes among people at cardiovascular risk. Methods: A randomized clinical trial encompassing sedentary subjects with at least two risk factors for heart disease or established cardiovascular disease. These volunteers were assigned randomly to three months of supervised aerobic training (training group) or just counseling on healthy lifestyle habits (control group). C-reactive protein (CRP) was measured by a highly sensitive method before and after these interventions. Results: Assessing 68 subjects. The training and control groups had similar baseline characteristics. There was improvement in functional capacity among only the training group patients. After three months, an increase in the CRP was noted in the control group, whose median rose from 2.2mg/L(IQR=1.0 to 4.3mg/L) to 3.2mg/L (IQR=2.4 to5.5mg/L) - p=0.006. This phenomenon was not found in the training group, which presented a baseline median of 1.7mg/L (IQR =0.97 to 4.8mg/L),statistically similar to the final value of 2.5mg/L(1.0 to 4.7mg/L) - p=0.46. When the percentage variation in the CRP was compared for these groups, there was a greater increase in the control group (+58%, IQR=11% to 151%), compared to the training group (+17%, IQR= -36% to 79%) - intergroupp=0.046.

Indicação de revascularização miocárdica em pacientes dialíticos / Indication myocardial revascularization in dialysis patients

Fundamentos: Pacientes dialíticos apresentam alto risco aterosclerótico, sendo previsto aumento nas indicações de revascularização miocárdica (RM) nesse grupo.Objetivos: Avaliar características clínicas, laboratoriais, ecoDopplercardiográficas e cineangiocoronariográficas de pacientes dialíticos e do subgrupo com indicação de RM.Métodos: Foram analisados 94 pacientes dialíticos submetidos à cineangiocoronariografia, estratificados em dois grupos: com e sem doença coronariana (DAC). Resultados: 94 pacientes, 57,4 % homens, média de idade 53,9±10,1 anos, 95,7 % hemodialíticos, mediana do tempo diálise 60,0 meses. Ao ecoDopplercardiograma a fração de ejeção média foi 61,07±12,06 % (n=84); função diastólica normal em 16,9 %, tipo I em 63,9 %, tipo II em 12,0 % e tipo III em 7,2 %. A população estudada foi estratificada em dois grupos: com DAC (n=47) e sem DAC (n=47). No grupo com DAC, 27,7 % eram triarteriais, 12,8 % uniarteriais e 9,6 % biarteriais, sendo mais frequente: DAC prévia (17,0 % vs. 2,1 %; p=0,003), calcificação parietal à cineangiocoronariografia (76,6 % vs. 10,6 %; p<0,001) e uso prévio de betabloqueadores (55,3 % vs. 27,7 %; p=0,007). Nos pacientes não diabéticos, aqueles com disfunção diastólica tiveram quatro vezes mais chance de coronariopatia (OR 4,26 IC 1,03-23,55; p=0,048). Houve elevada indicação de RM nos coronariopatas (61,7 %), com indicação cirúrgica em 51,7 % dos revascularizáveis. Conclusões: DAC prévia, calcificação parietal na cineangiocoronariografia e uso prévio de betabloqueadores foram mais frequentes nos coronariopatas. Disfunção diastólica ao ecoDopplercardiograma foi o único preditor independente para DAC em pacientes dialíticos. Indicação de RM foi elevada nos coronariopatas.

Background: Dialysis patients are at high risk for atherosclerosis, with increased indications for myocardial revascularization (MR) in this group. Objectives: To assess clinical, laboratory, echoDoppercardiographic and coronary angiography parameters among dialysis patients and in a subgroup with MR indications. Methods: 94 dialysis patients undergoing coronary angiography were analyzed and divided into two groups: with and without coronary artery disease (CAD). Results: 94 patients; 57.4% men, mean age 53.9±10.1 years, 95.7% on hemodialysis, median dialysis time of 60.0 months. Mean ejection fraction in echocardiography: 61.07±12.06% (n=84), normal diastolic function in 16.9%, type I diastolic dysfunction in 63.9%, type II in 12.0% and type III in 7.2%. The population was divided into two groups: with CAD (n = 47) and without CAD (n = 47). In the CAD group, 27.7% had three-vessel, 12.8% one-vessel and 9.6% two-vessel disease, with prior CAD (17.0% vs. 2.1%; p=0.003), parietal calcification in coronary angiography (76.6% vs. 10.6%; p<0.001), with prior use of beta-blockers (55.3% vs. 27.7%; p=0.007) being more frequent in the CAD group. Among non-diabetic patients, those with diastolic dysfunction were four times more likely to have CAD (OR 4.26 CI 1.03–23.55; p=0.048). There was a high level (61.7%) of MR indications among CAD patients, with surgery indicated for 51.7% of those suitable for revascularization. Conclusions: Prior CAD, parietal calcification in coronary angiography and prior use of beta-blockers were more frequent in the CAD group. Diastolic dysfunction in the echoDopplercardiograms was the only independent CAD predictor among dialysis patients, with MR indications high for coronary heart disease patients.

Inflammatory markers, endothelial function and cardiovascular risk / Marcadores inflamatórios, função endotelial e riscos cardiovasculares

The need to study cardiovascular diseases (CVD) has become more and more relevant as their prevalence has increased over the years. An intact endothelial wall is essential to vascular health. Certain factors are responsible for maintaining this tissue intact, including nitric oxide (NO), which provokes dilation of blood vessels in response to shear stress. Expression of the endothelial nitric oxide synthase (eNOS) enzyme, which produces nitric oxide in response to increases in blood flow, is of fundamental importance to maintenance of the vascular system. When this enzyme is inhibited, nitric oxide production is reduced, causing endothelial dysfunction. Since C-reactive protein inhibits production of nitric oxide by the eNOS enzyme, it is one of the causes of endothelial dysfunction and cardiovascular events. The objective of the present study was to review scientific articles in the literature related to the subject 'inflammatory markers and endothelial function'. A wide-ranging review of the current literature was conducted, using systematic analysis of bibliographic references indexed in PubMed, Scielo, Medline and LILACS database, for the years 1992 to 2013. The studies reviewed show that increases in inflammation causes reductions in NO and increases in cardiovascular events. Increased inflammation is associated with higher incidence of cardiovascular diseases...

A necessidade de estudo das Doenças Cardiovasculares (DCV) vem à tona pelo aumento da sua prevalência ao longo dos anos. Uma parede endotelial íntegra é essencial para a saúde vascular. Alguns fatores são responsáveis pela integridade deste tecido, como o óxido nítrico (NO), que provoca a dilatação do vaso sanguíneo em resposta ao estresse de cisalhamento. A expressão da enzima óxido nítrico sintase endotelial (eNOS), que produz óxido nítrico em resposta ao incremento do fluxo sanguíneo, é fundamental para a manutenção do sistema vascular. Quando há inibição desta enzima, ocorre diminuição da produção de óxido nítrico, causando disfunção endotelial. A PCR inibe a produção de óxido nítrico pela enzima eNOS, sendo então uma causadora de disfunção endotelial e eventos cardiovasculares. O presente artigo tem como objetivo revisar artigos científicos na literatura relacionados ao tema 'marcadores inflamatórios e função endotelial'. Foi realizada uma ampla revisão de literatura atual, utilizando-se análise sistemática das referências bibliográficas nas bases de dados PubMed, Scielo, Medline e Lilacs, no período de 1992 a 2013. Os estudos revisados mostram que o aumento da inflamação causa uma diminuição de NO e aumento de eventos cardiovasculares. O aumento da inflamação está associado ao aumento da incidência de doenças cardiovasculares...

[Effects of twelve-week strength training on serum chemerin, TNF-alpha and CRP level in subjects with the metabolic syndrome]

Inflammation plays an essential role in the insulin resistance process, and chemokines, such as chemerin, seem to play a pivotal role in the pathogenesis of insulin resistance. In this study we examined the effects of 12 weeks strength training on serum chemerin, CRP and TNF-alpha level in association with cardiometabolic risk factors, [age: 45.251 +/- 4.3 yr, body mass index: 29.53 +/- 1.32 kg/m[2]] in subjects with the metabolic syndrome. Twenty-one subjects with the metabolic syndrome were randomly assigned to strength training [n= 11] and control [n= 10] groups. Strength training was performed 3 times weekly for 12 weeks. Body composition [computed tomography], metabolic and inflammatory parameters were measured prior to and after the intervention. After a 12 week strength training, fasting glucose, insulin resistance index [HOMA-IR], total cholesterol, LDL-cholesterol, triglycerides and abdominal fat [visceral fat] were significantly decreased [p<0.05]. Concurrently, chemerin and CRP concentrations were significantly decreased in response to strength training [p<0.05], but TNF-alpha remained unchanged [p>0.05]. This study demonstrated that 12 weeks of strength training caused an improvement in cardiometabolic risk factors in subjects with the metabolic syndrome, and this improvement was associated with decreased chemerin and CRP levels [inflammatory markers]

[ evaluation of correlation between plasma level of CRP and WBC with ischemic stroke severity and infarct volume]

Stroke is one of the important causes of death. However the prognostic factors are not clearly defined. There are many evidences which show the role of inflammatory factors during the progression of stroke but the relation of CRP and stroke is still vague. This study was designed to determine the relation between CPR Level and WBS with severity of stroke [according to CNSS score] and volume of infarct in stroke patients. This is a cross sectional study performed during the winter and spring of 2007 on 49 patients with stroke hospitalized in Vali-e-Asr hospital of Arak. Clinical examination was done by using CNSS scoring. The CRP and WBC were measured in the first 72 hour of onset of the disease. The CT scanning together with infarct volume estimation was performed at the same time. There was no correlation between the volume of infarct with CRP serum level [r=-0.14, p=0.39] and WBC [r=-0.17, p=0.92. Also there was no correlation between CNSS score with CRP level [r=-0.04, p=0.81] and WBC [r=-0.124, p=0.40] too, but there was a significant correlation between CNSS score and stroke volume in brain CT scan [r=-0.43, p=0.006]. According to data in this study there was no correlation between serum acute phase reactant, the volume and severity of infarction

Associação de marcadores inflamatórios e níveis tensionais em indivíduos hipertensos com diabetes mellitus tipo 2 / Inflammatory markers and blood pressure levels in hypertensive patients with type 2 diabetes

A hipertensão arterial e o diabetes mellitus são fatores de risco que predispõem à aterosclerose.A capacidade funcional do endotélio vascular é exercida basicamente pela células endoteliais, que são sensíveis às mudanças das forças hemodinâmicas, liberando diversas substâncias, entre elas a Interleucina 6 (IL menos 6) e a Proteína C Reativa (PCR).Essa última é sintetizada pelo fígado e liberada pela estimulação pró-inflamatória da IL menos 6.Objetivo: verificar associação entre níveis elavados de pressão arterial e marcadores inflamátórios...