Microparticles: a component of various diseases.

Microparticles (MPs) are phenotypically and functionally heterogeneous population of microvesicles. Although MP formation represents a physiological phenomenon. A multitude of pathologies, including inflammatory and autoimmune diseases, atherosclerosis, and malignancies, are associated with a considerable increase in circulating MPs. Elevated levels of platelet­, endothelial cell­, and monocyte­derived MPs have been documented in a number of clinical conditions in which vascular dysfunction and inflammation are important pathophysiological mechanisms (e.g., coronary artery disease or thrombotic microangiopathies). Knowledge of the functional properties of MPs will contribute to a better understanding of the pathological mechanisms of communication between cells and of the causes of various diseases.

Nonalcoholic fatty liver disease of two ethnic groups in Kuwait: comparison of prevalence and risk factors.

OBJECTIVES: To assess the prevalence of nonalcoholic hepatic steatosis (nonalcoholic fatty liver disease, NAFLD) and the significance of some risk factors, such as obesity and glucose metabolism impairment, for two major ethnic groups of Kuwait: Arabs and South Asians. SUBJECTS AND METHODS: 143 adults (Arab: n = 81; South Asian: n = 62) were enrolled in the study. Anthropometric measurements including body mass index (BMI), waist circumference (WC), hip circumference (HC) and waist-to-hip ratio were performed along with abdominal ultrasonography. The prevalence of liver steatosis was assessed; its relation to glucose metabolism impairment, obesity, age and gender was compared in the two ethnic groups. RESULTS: Except for waist-to-hip ratio, the anthropometric parameters were higher in Arabs than South Asians. The respective parameters in Arabs and South Asians were: BMI: 30.9 ± 6.6 versus 27.0 ± 4.5, p < 0.001; WC: 101.5 ± 16.4 versus 94.0 ± 12.2, p = 0.002; HC: 106.6 ± 12.4 versus 99.2 ± 9.9, p < 0.001. Although Arabs were more obese, they did not exhibit a higher prevalence of steatosis (33.3 vs. 29.0%, p = 0.583). According to multivariate analysis, only gender (odds ratio 3.93, p = 0.005), glucose metabolism impairment (odds ratio 4.94, p = 0.003) and WC (odds ratio 4.75, p = 0.012) remained significantly associated with steatosis. CONCLUSION: No significant difference in NAFLD prevalence was found between Arabs and South Asians. Only gender, history of impaired glucose metabolism and abdominal obesity expressed by WC had an independent predictive value for developing liver steatosis.

Comparison of obesity and its relationship to some metabolic risk factors of atherosclerosis in Arabs and South Asians in Kuwait.

OBJECTIVE: The aims of the study were to compare obesity and its association with risk factors of atherosclerosis in Arabs and South Asians in Kuwait and to define which of the anthropometric parameters is best suited for clinical purposes in general. SUBJECTS AND METHODS: Two hundred eighty adults, patients of Al-Rashid Hospital, a private general hospital in Kuwait, were enrolled in the study. Of the 280 patients, 144 were Arab and 136 were South Asian. Basic anthropometric parameters for obesity, fasting blood glucose, total cholesterol, low-density lipoprotein and high-density lipoprotein cholesterol and triglycerides (TG) were determined. The relationship between anthropometric variables and relevant metabolic variables, as well as a comparison between the different groups, was estimated using standard statistical methods. RESULTS: Arabs were not only more obese [in males, p < 0.001 for body mass index (BMI), waist circumference (WC) and hip circumference (HC) and p = 0.001 for waist-to-hip ratio (WHR); in females, p < 0.001 for BMI, p = 0.004 for WC and p = 0.041 for HC], but also developed obesity at a younger age than did South Asians, even though, in South Asians, all anthropometric parameters were positively correlated with age (p = 0.004 for BMI, p = 0.001 for HC and p < 0.001 for WC and WHR). South Asians, however, were more prone to develop adverse effects in both lipid and glucose metabolism than Arabs were. In South Asian males, ethnicity was an independent predictor of triglycerides, according to the multiple linear regression analysis. The WHR appeared to be the most suitable predictor of dyslipidemia and impaired glucose metabolism. CONCLUSION: The degree of adiposity was different between Arabs and South Asians in Kuwait. Abdominal obesity had a different impact on cardiovascular risk factors in these two ethnic groups in Kuwait.

Tailored intermittent therapy of carcinoid.

BACKGROUND/AIMS: There is no established standard care of carcinoids as all experts agree. Endogenous somatostatin diurnal rhythm is influenced by administration of lanreotid. The purpose of this study is to evaluate efficacy of lanreotid on the clinical course in a group of patients with metastatic carcinoid. METHODOLOGY: In 43 patients with carcinoid tumors somatostatin serum level, 5-HIAA (5-hydroxyindolacetic acid), NSE (neuron-specific enolase), and chromogranin A were examined. Fifteen patients received 30mg of somatulin (Lanreotid) in two-week intervals. RESULTS: Therapy with somatostatin analogue improved symptoms in 70-80% of patients with metastases and carcinoid syndrome. 5-HIAA significantly decreased after lanreotid therapy. NSE values are undulating. With progression of the disease they rise. Chromogranin is higher in patients with advanced metastatic disease. Mesor of the diurnal excretion of somatostatin is higher (32 pg/mL) in patients with metastatic disease than in patients without (20 pg/mL). After lanreotid administration mesor decreased (16 pg/mL) in the group of patients with metastases. CONCLUSIONS: Intermittent lanreotid therapy is efficient. A rise--(ascend) of endogenous SMS level could be one of the markers of increased activity of carcinoid cells and an indication for the next application of lanreotid therapy. Mean survival of patients with metastatic carcinoid in our study was 46.3 months.

Pathological somatosensory evoked potentials in patients with hypertension: a contribution to the study of the pathophysiology of juvenile essential hypertension.

BACKGROUND: The role of factors influencing the cerebral regulation of blood pressure must be considered in the etiopathogenesis of essential hypertension The aim of our work was to explore the possibilities for differentiating certain clinical, functional and electrophysiological signs in young and adult hypertensives. This could help us to determine whether centrally active antihypertensive drugs may be more suitable than others. MATERIAL/METHODS: We examined somatosensory evoked potentials (latencies of wave deflections and amplitudes) in two groups of patients with essential hypertension. The first group consisted of 25 hypertensive patients aged 20 to 30 years with onset before age 20 (n=25). The second group consisted of 40 hypertensive patients aged 40 to 60 years with onset after the age of 30. The results were compared with those obtained from age-correlated healthy controls. RESULTS: The most interesting changes were observed in the amplitudes of somatosensory evoked potentials in the group of juvenile patients with hypertension. The decrease in the amplitude of all wave deflections was very compact, consistent, and statistically significant even after repeated examinations. This finding raises the possibility of influence or damage to the peripheral afferentation of signals in juvenile patients, with hypertension as an expression of the reactions of brainstem structures. CONCLUSIONS: Our results suggest that afferent impulses and the reactivity of brainstem structures may play a role in the etiopathogenesis of hypertension.