Rhus coriaria L. increases serum apolipoprotein-A1 and high-density lipoprotein cholesterol levels: a double-blind placebo-controlled randomized clinical trial / 中西医结合学报

<p><b>BACKGROUND</b>Lipid-lowering effect of Rhus coriaria L. (Rhus) has been investigated in multiple animal studies with promising results. Nonetheless, its clinical efficacy has not been adequately examined.</p><p><b>OBJECTIVE</b>The aim of this study was to evaluate the lipid-lowering effects of Rhus among patients with hyperlipidemia.</p><p><b>DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS</b>The study was designed as a two-arm, double-blind placebo-controlled randomized clinical trial, using a parallel design. Eighty patients with primary hyperlipidemia were randomly assigned to receive Rhus capsules or placebo for 6 weeks.</p><p><b>MAIN OUTCOME MEASURES</b>The serum lipid levels, apolipoprotein-A1 (Apo-A1) and apolipoprotein-B (Apo-B) were measured.</p><p><b>RESULTS</b>Mean serum high-density lipoprotein cholesterol (HDL-C) and Apo-A1 levels were significantly increased in the Rhus group, compared with the placebo group, after 6 weeks of intervention (P = 0.001). The analysis of covariance test including age, gender, body mass index (BMI), and smoking as co-variables revealed that the increase in HDL-C and Apo-A1 levels remained significant, and increases in HDL-C were dependent on the increase in Apo-A1 levels. No significant difference was observed between Rhus and placebo groups in terms of mean reductions in total cholesterol, low-density lipoprotein cholesterol and triglyceride levels; however, more significant improvement was observed among obese patients (BMI ≥ 30 kg/m).</p><p><b>CONCLUSION</b>The study showed significant increases in HDL-C and Apo-A1 levels in response to Rhus supplementation in patients with hyperlipidemia.</p><p><b>TRIAL REGISTRATION</b>ClinicalTrials.gov ID: NCT02295293.</p>

Cardiac sources of embolic cerebral infarction in transesophageal echocardiography

Previous reports have suggested that 6% to 39% of ischemic strokes are caused by cardiogenic emboli [1] Thrombus formation associated with atrial fibrillation has been reported as one of the most important cardiac sources of embolism[2] Using transesophageal echocardiography [TEE], other possible sources of embolism, including atrial septal aneurysm,[3] patent foramen ovale [PFO],[4] aortic atherosclerotic plaque,[5] annular calcification of the mitral valve,[6] mitral valve prolapse [MVP],[7] prosthetic cardiac valves and endocarditis,[8] mural thrombi,[9] cardiac tumors[10], and cardiac transplants[11] have been reported as risk factors for ischemic stroke. TEE is considered more sensitive than transthoracic echocardiography [TTE] in detecting cardiac abnormalities in patients with stroke and transient ischemic attacks [12] As there is no data available in Iran regarding TEE findings after embolic cerebrovascular accident [CVA], this study was undertaken to assess the prevalence of cardiac abnormalities by the TEE technique in patients with stroke