ABSTRACT
Worldwide, cardiovascular disease is the main cause of death, which accordingly increased by hyperlipidemia. Hyperlipidemia therapy can include lifestyle changes and medications to control cholesterol levels. Statins are the medications of the first choice for dealing with lipid abnormalities. Rosuvastatin founds to control high lipid levels by hindering liver production of cholesterol and to achieve the targeted levels of low-density lipoprotein cholesterol, another lipid lowering agents named ezetimibe may be used as an added therapy. Both rosuvastatin and ezetimibe have low bioavailability which will stand as barrier to decrease cholesterol levels, because of such depictions, formulations of this combined therapy in nanotechnology will be of a great assistance. Our study demonstrated preparations of nanoparticles of this combined therapy, showing their physical characterizations, and examined their behavior in laboratory conditions and vivo habitation. The mean particle size was uniform, polydispersity index and zeta potential of formulations were found to be in the ranges of (0.181-0.72) and (-13.4 to -6.24), respectively. Acceptable limits of entrapment efficiency were affirmed with appearance of spherical and uniform nanoparticles. In vitro testing showed a sustained release of drug exceeded 90% over 24 h. In vivo study revealed an enhanced dissolution and bioavailability from loaded nanoparticles, which was evidenced by calculated pharmacokinetic parameters using triton for hyperlipidemia induction. Stability studies were performed and assured that the formulations are kept the same up to one month. Therefore, nano formulations is a suitable transporter for combined therapy of rosuvastatin and ezetimibe with improvement in their dissolution and bioavailability.
ABSTRACT
Endothelial dysfunction is reported in erectile dysfunction (ED) and cardiovascular disease (CVD). Endocan is a serum marker in some endothelial-related disorders. Thirty patients with erectile dysfunction (Group A) and 15 controls (Group B) were enrolled in the study. Group A is subdivided into Group AI including 15 diabetic patients with ED and group AII including 15 nondiabetic patients with ED. The erectile function was assessed in all subjects using International Index of Erectile Function (IIEF-5) score. Fasting blood sugar (FBS), cholesterol and triglycerides (TG), serum endocan and carotid intima-media thickness (cIMT) were assessed in all subjects. Penile Doppler ultrasound was carried out for Group A. IIEF-5 score, serum endocan level and cIMT were significantly different between the groups. Serum endocan was positively correlated with cIMT (r = 0.342, p = 0.22) and negatively correlated with peak systolic velocity (r = -0.588, p = 0.001) and IIEF (r = -0.532, p < 0.001) although lack of correlation was detected with end-diastolic velocity, TG and cholesterol. ROC curve assessment yielded a serum endocan cut-off point of >2,392.7 ng/ml to predict the cIMT in ED patients with 83.33% sensitivity and 66.67% specificity (AUC 0.741, 95% CI 0.558-0.867). Serum endocan can correlate with ED severity and cIMT. In addition, it has a predictive value for cardiovascular risk in ED patients.
Subject(s)
Cardiovascular Diseases/diagnosis , Carotid Intima-Media Thickness , Endothelium, Vascular/physiopathology , Erectile Dysfunction/diagnosis , Neoplasm Proteins/blood , Proteoglycans/blood , Adult , Biomarkers/blood , Cardiovascular Diseases/blood , Cardiovascular Diseases/physiopathology , Case-Control Studies , Endothelium, Vascular/diagnostic imaging , Endothelium, Vascular/metabolism , Erectile Dysfunction/blood , Erectile Dysfunction/physiopathology , Humans , Male , Neoplasm Proteins/metabolism , Predictive Value of Tests , Proteoglycans/metabolism , Risk Assessment/methods , Risk Factors , Sensitivity and Specificity , Severity of Illness Index , Ultrasonography, DopplerABSTRACT
BACKGROUND: Carotid endarterectomy (CEA) is the standard treatment for atherosclerotic lesions involving the carotid bifurcation. However, CEA can be challenging under some conditions. We describe the technique and outcome of prosthetic carotid bypass grafting (PCB) with polytetrafluoroethylene (PTFE) grafts as an elective alternative to CEA. PATIENTS AND METHODS: This retrospective analysis of prospectively collected data came from a series of 110 consecutive PCBs, that is, 9.6% of 1140 carotid revascularization procedures performed in our department between September 1986 and July 2002. Primary indications for PCB were extensive atherosclerotic lesions (n = 45, 40.9%), carotid stenosis associated with kinking (n = 29, 26.4%), recurrent stenosis (n = 18, 16.4%), and stenosis after radiation therapy (n = 7, 6.4%). RESULTS: The combined stroke and death rate at 30 days was 0.9%. Mean duration of follow-up was 647 +/- 71 days. Four carotid bypass grafts (3.6%) became occluded, and stenosis recurred in 1 (0.9%). At 3 years, overall actuarial survival was 81.4 +/- 11.5 and actuarial stroke-free rate was 97.7 +/- 2.3. There were no fatal strokes. CONCLUSION: PCB is a viable technique for treatment of extensive atherosclerotic carotid lesions, recurrent carotid stenosis, and carotid stenosis after radiation therapy. Postoperative stroke, occlusion, and recurrent stenosis rates are comparable to those associated with CEA performed under optimal conditions.
