effect of curcumin on some of traditional and non-traditional cardiovascular risk factors: a pilot randomized, double-blind, placebo-controlled trial

Numerous interventional studies in clinical and preclinical setting stated that intake of curcumin may provide protection against cardiovascular disease. The aim of this trial was investigation of curcumin efficiency on some cardiovascular risk factors in patients with coronary artery disease [CAD]. A total of 33 patients with CAD who fulfilled inclusion and exclusion criteria were entered the study. Patients were randomly assigned to receive curcumin or placebo, 500 mg capsules, four times daily for 8 weeks. Lipid profile, blood glucose and high sensitive C-reactive protein [hs-CRP] levels were analyzed at baseline and two months after treatment. Serum levels of triglycerides [P=0.01], LDL-cholesterol [P=0.03] and VLDL-cholesterol [P=0.04] significantly decreased in the curcumin group compared to baseline, without significant changes in total cholesterol, HDL-cholesterol, blood glucose and hs-CRP levels. In all mentioned laboratory parameters, significant difference was not detected between curcumin and placebo. Although curcumin improved some of lipid profile components, it did not show appreciable effect on inflammatory markers in patients with CAD. Therefore, more detailed assessment of metabolic effects or anti-inflammatory activities of curcumin need to perform by extensive human study

Pentoxifylline decreases serum level of adhesion molecules in atherosclerosis patients

Inflammation is involved in development, progression, and complications of atherosclerotic disease. Clinical studies have indicated that the level of monocyte chemoattractant protein 1 [MCP-1], IL-18, and adhesion molecules correlates with the severity of atherosclerosis and can predict future cardiovascular events. Experimental studies have shown pentoxifylline [PTX] reduces these factors in animal models. The purpose of the present pilot study was to evaluate effect of PTX on a group of inflammatory biomarkers in patients with coronary artery disease [CAD]. Forty patients with angiographically documented CAD, who fulfilled inclusion and exclusion criteria, were entered in the double-blind, randomized, pilot clinical study. The patients were randomly given PTX [400 mg three times daily] or placebo [3 tab/day] for 2 months. Serum concentrations of MCP-1, IL-18, intercellular adhesion Molecule 1 [ICAM-1], and vascular cell adhesion molecule 1 [VCAM-1] were measured before and at the end of intervention by enzyme-linked immunosorbant assay. Our study showed that the serum levels of ICAM-1 and VCAM-1 was decreased in the study population after two-month treatment [P<0.05]. Based on the results of our pilot study, administration of PTX in CAD patients significantly decreases adhesion molecules levels

Effects of omega-3 administration on homocysteine serum concentration in renal transplant recipient

It has been shown that serum total homocysteine [HC] is a risk factor for vascular disease which characterizes endothelial damage in the general and in the End-Stage Renal Disease [ESRD] population as well. Whether n-3 polyunsaturated fatty acids decrease homocysteine [Hcy] level has been a subject of controversy. Renal transplant patients were randomized in 2 groups and received 6 months of dietary supplementation with 6 g/day of Fish oil or placebo. Homocysteine level and total cholesterol level were measured. In 40 renal transplant recipients, increase in homocysteine level was greater after Fish oil administration but not significantly, total cholesterol was decreased significantly. Based on these data omega3 fatty acids supplementation doesn't decrease serum homocysteine in renal transplant recipients but decreases total cholesterol level.

Estimating the optimal dosage of sodium valproate in idiopathic generalized epilepsy with adaptive neuro-fuzzy inference system

Epilepsy is a clinical syndrome in which seizures have a tendency to recur. Sodium valproate is the most effective drug in the treatment of all types of generalized seizures. Finding the optimal dosage [the lowest effective dose] of sodium valproate is a real challenge to all neurologists. In this study, a new approach based on Adaptive Neuro-Fuzzy Inference System [ANFIS] was presented for estimating the optimal dosage of sodium valproate in IGE [Idiopathic Generalized Epilepsy] patients. 40 patients with Idiopathic Generalized Epilepsy, who were referred to the neurology department of Mashhad University of Medical Sciences between the years 2006-2011, were included in this study. The function Adaptive Neuro- Fuzzy Inference System [ANFIS] constructs a Fuzzy Inference System [FIS] whose membership function parameters are tuned [adjusted] using either a backpropagation algorithm alone, or in combination with the least squares type of method [hybrid algorithm]. In this study, we used hybrid method for adjusting the parameters. The R-square of the proposed system was%598 and the Pearson correlation coefficient was significant [P <0.05] and equal to 0.77, but theT-test was not significant [P >0.05]. Although the accuracy of the model was not high, it wasgood enough to be applied for treating the IGE patients with sodium valproate. This paper presented a new application of ANFIS for estimating the optimal dosage of sodium valproate in IGE patients. Fuzzy set theory plays an important role in dealing with uncertainty when making decisions in medical applications. Collectively, it seems that ANFIS has a high capacity to be applied in medical sciences, especially neurology

Effects of erythropoietin on electrocardiogram changes in carbon monoxide poisoning: an experimental study in rats

The aim of this study was to define the electrocardiogram [ECG] changes following the moderate to severe CO intoxication in rats, and also evaluating the effect of erythropoietin [EPO] on observed cardiac disturbances. The growing literature on erythropoietin effect on cardiac ischemia led us to question its effect on cardiotoxicity due to the carbon monoxide poisoning. Wistar rats were exposed to three different concentrations of CO [250 PPM, 1000 PPM or 3000 PPM]. EPO was administrated [5000 IU/Kg, intraperitoneal injection] at the end of CO exposure and then the animals were re-oxygenated with ambient air. Subsequently ECG recording, heart rate and carboxyhemoglobin values were evaluated. ECG changes following the CO intoxication included ST segment elevation and depression, T wave inversion and first-degree AV block. Ischemic ECG changes reduced significantly in EPO-treated animals. In the present study, for the first time, EPO was investigated for the management of cardiac complications due to the CO poisoning. Our results showed that EPO could inhibit ischemic changes of ECG after the CO poisoning

Correlation between heat-shock protein 27 serum concentration and common carotid intima-media thickness in hemodialysis patients

Cardiovascular disease is a major factor in the deterioration of the health and the death of hemodialysis patients. Previous studies have mainly shown a decreased level of heat shock protein 27 [HSP27] in patients with cardiovascular disease. We conducted this study to investigate whether HSP27 correlates with common carotid intima-media thickness [CCIMT] and if it has a potential to be a biomarker for cardiovascular disease. In this cross-sectional study, the correlation between HSP27 serum concentration and CCIMT was investigated in 42 hemodialysis patients. An enzyme-linked immunosorbent assay method was used to measure HSP27 level in the plasma of the patients, and a high-resolution B-mode ultrasonography was applied to measure CCIMT. There was an inverse significant correlation between serum concentration of HSP27 and CCIMT only in patients that had hypertension as their only cardiovascular risk factor [r = 0.61, P = .02]. According to our results and the fact that HSP27 has been shown to be expressed in atherosclerotic plaques of both experimental animals and humans, we suggest that circulatory HSP27 concentration has a potential of being used as a marker for cardiovascular events

Therapeutic drug monitoring of valproic acid in patients with monotherapy at steady state

The role of therapeutic drug monitoring [TDM] in patient care has grown rapidly since its introduction three decades ago. The aim of present study was to evaluate the possible relationship between serum levels and the clinical response of valproic acid [VPA]. In the present study we evaluated a homogeneous group of adult patients receiving VPA monotherapy. A total of 18 epileptic patients who fulfilled inclusion and exclusion criteria were entered this prospective study. Steady state trough plasma concentration was determined by fluorescence polarization immunoassay [FPIA]. The correlation between therapeutic response and VPA serum concentration was evaluated. Mean VPA dose and mean total VPA plasma concentrations were 8.35 +/- 1.49 mg/kg/day and 50.40 +/- 4.18 micro g/ml respectively. Mean VPA clearance was 8.84 +/- 4.43 [ml/kg/h]. Plasma levels within the therapeutic range were found in 33% of epileptic patients. Plasma levels were below the therapeutic range in 67% of study population. Of patients 75% and 17% with sub-therapeutic levels achieved complete control and partial control respectively. Poor correlation was found between the plasma concentration of VPA and its therapeutic effects. Therefore, this study showed that TDM of VPA will be useful only when individuals are non-responsive to treatment or vulnerable to adverse reactions with standard doses