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Biomedical subjects

Moses Elisaf

Publications and source records attributed to Moses Elisaf.

85 records · Page 5Linked to original sources
PubMed2002

Severe hypocholesterolemia with reduced serum lipoprotein(a) in a patient with visceral leishmaniasis.

We report the case of a 36-yr-old man with visceral leishmaniasis who presented with marked hypocholesterolemia, mild hypertriglyceridemia, severely decreased serum levels of HDL-cholesterol, LDL-cholesterol, apolipoproteins AI and B, and increased serum level of apolipoprotein E. Moreover, serum Lp(a) level was markedly reduced on presentation, which is the first published report on Lp(a) levels in kala-azar. Possible mechanisms for the observed alterations of the serum lipid profile are discussed.

Adult↗
PubMed2002

A tumor lysis-like syndrome during therapy of visceral leishmaniasis.

Reported herein for the first time in the literature is the case of a 41-yr-old woman who developed a tumor lysis-like syndrome, consisting of hyperkalemia, hyperphosphatemia, hyperuricemia, and acute renal insufficiency, soon after the initiation of chemotherapy for severe visceral leishmaniasis with liposomal amphotericin B. Allopurinol therapy, together with iv fluid administration and urine alkalization, resulted in full recovery of the metabolic abnormalities. Awareness of this condition can lead to prophylactic treatment as well as the early recognition and management of susceptible patients.

Adult↗
PubMedDate not supplied

Hypouricaemia as a marker of a generalized proximal tubular damage in alcoholic patients.

AIMS AND METHODS: Hypouricaemia is not frequently encountered in alcoholic patients. Described herein is the case of a 69-year-old alcoholic patient. RESULTS: The patient presented with severe hypouricaemia (serum uric acid 95.2 micro mol/l) due to renal urate wasting associated with a cluster of other metabolic abnormalities in the context of a reversible generalized dysfunction of the proximal tubules that mimicked Fanconi syndrome. CONCLUSIONS: The underlying mechanisms of this rare presentation are discussed.

Aged↗
PubMedDate not supplied

Effect of ciprofibrate on C-reactive protein and fibrinogen levels.

Statins can lower the circulating levels of C reactive protein (CRP). This effect may be relevant because CRP is a predictor of vascular risk. In contrast, the evidence that fibrates lower CRP levels is very limited. The effect of treatment with ciprofibrate (100 mg once daily) was investigated for 8 weeks in 30 patients with primary dyslipidemia. There was a significant (p < 0.01) decrease in median (range) CRP levels by 36.8% from 1.9 mg/L (1.0-6.0 mg/L) to 1.2 mg/L (1.0-5.5 mg/L). Plasma fibrinogen levels were also significantly (p = 0.05) reduced. There was no correlation between the fall in CRP levels and the changes in lipid or fibrinogen levels. These findings support the concept that fibrates, like the statins, lower serum CRP levels. However, fibrates have a different mode of action. Fibrates (with the exception of gemfibrozil) also consistently lower plasma fibrinogen levels. In contrast, the effect of statins on the circulating levels of this coagulation factor remains to be defined. These differences may help in defining the mechanisms responsible for drug-induced changes in the circulating levels of CRP and fibrinogen. A favorable effect on CRP and fibrinogen levels may increase the clinical efficacy of statins and fibrates.

C-Reactive Protein↗
PubMedDate not supplied

Statins and renal function.

Renal disease is often associated with an increased risk of vascular events. Moreover, an accelerated form of atherosclerosis commonly occurs in these patients. The reasons for these associations are not clearly defined but include the widespread presence of several established risk factors (eg, dyslipidemia, hypertension, and diabetes). Other predictors of atherosclerotic disease may also be abnormally elevated (eg, homocysteine, fibrinogen, and lipoprotein a). In addition, there is evidence that impaired renal function per se predicts vascular risk. Despite this high-risk background, the potential benefit of treatment with statins has not been widely investigated in these patients. The present review considers the evidence (experimental and clinical) that statins exert beneficial effects in patients with different types of renal disease. This includes improved renal function, decreased microalbuminuria, and a fall in blood pressure. Statins may also improve renal allograft survival. The potential mechanisms mediating these effects are considered. The interactions between statins and several risk factors that may be present in patients with impaired renal function are also considered. There is an urgent need to define the role of statins in these high-risk patients. Which is the statin of choice? This question is relevant because impaired renal function can interfere with statin pharmacokinetics. Furthermore, other drugs administered to these patients may cause serious interactions with statins.

Adult↗
PubMedDate not supplied

Influence of smoking on predictors of vascular disease.

Beyond the already well-established strong causative relationship with cancer, smoking increases the risk for vascular disease. Smoking may act directly or adversely influence risk factors contributing to the development of vascular disease. Smoking causes endothelial dysfunction, dyslipidemia (decreased high-density lipoprotein cholesterol levels, hypertriglyceridemia and increased oxidation of low-density lipoprotein cholesterol) and platelet activation leading to a prothrombotic state. Smoking increases emerging risk factors (eg, fibrinogen, homocysteine, and high-sensitivity C-reactive protein) and increases insulin resistance and the risk of developing type 2 diabetes mellitus. The beneficial effects of statins and antioxidants (eg, vitamins C and E, beta-carotene) are counteracted by smoking. Smoking-induced alterations in growth factors, adhesion molecules, and even in genes can accelerate the progression of atherosclerosis. The aim of this review is to consider the adverse consequences of smoking on the factors predisposing to vascular disease and to emphasize the beneficial effects of smoking cessation.

Arteriosclerosis↗
PubMedDate not supplied

Lack of association between carotid intima-media thickness and PAF-acetylhydrolase mass and activity in patients with primary hyperlipidemia.

Carotid intima media thickness (IMT), represents an important clinical indicator of early atherosclerosis. Human plasma platelet-activating factor acetylhydrolase (PAF-AH) is an enzyme primarily associated with low-density lipoprotein (LDL) while a small proportion of enzymatic activity is also associated with high-density lipoprotein (HDL). Plasma paraoxonase 1 (PON1) is an esterase exclusively associated with HDL. The authors investigated the possible relationship between carotid IMT and the plasma levels of PAF-AH mass and activity as well as the PON1 activity in hyperlipidemic patients. One hundred unrelated patients with primary hyperlipidemia and 67 age-and sex-matched normolipidemic apparently healthy volunteers participated in the study. The PAF-AH activity in total plasma and in HDL-rich plasma (HDL-PAF-AH activity), the plasma PAF-AH mass, and the serum PON1 activities toward paraoxon and phenyl acetate were determined. The plasma PAF-AH mass and activity were higher in hyperlipidemic patients compared to controls, whereas the HDL-PAF-AH activity, as well as the serum PON1 activities were not significantly different between the studied groups. When hyperlipidemic patients were divided into 2 subgroups according to their IMT values (IMT <0.7 mm and IMT > or =0.7 mm) patients with IMT > or =0.7 mm had significantly higher age, and serum triglyceride concentrations, whereas no difference was found in the plasma PAF-AH mass and activity as well as in the HDL-PAF-AH activity between the 2 studied subgroups. The same phenomenon was observed for serum PON1 activities. In a multivariate analysis, only the age was significantly correlated with IMT values (p<0.05). Neither the total plasma PAF-AH mass and activity nor the HDL-PAF-AH activity are associated with early carotid atherosclerosis.

1-Alkyl-2-acetylglycerophosphocholine Esterase↗
PubMedDate not supplied

Antibodies against various forms of mildly oxidized low-density lipoprotein are not associated with carotid intima-media thickness in patients with primary hyperlipidemia.

The carotid intima-media thickness (IMT) can reflect early atherosclerosis. Oxidative modification of low-density lipoprotein (LDL) leads to the formation of several immunogenic epitopes and different forms of antibodies against oxidized LDL (oxLDL). We investigated the possible relationship between autoantibody titers against various forms of mildly oxLDL and carotid IMT in patients (n=100) with primary hyperlipidemia. Three different types of mildly oxidized LDL-oxLDL(L), oxLDL(P), and oxLDL(D)-were prepared at the end of lag, propagation, and decomposition phases of oxidation, respectively. Similar types of oxLDL were also prepared from the same LDL preparations after inactivation of the LDL-associated platelet-activating factor acetylhydrolase (PAF-AH). These types were denoted as oxLDL(-)(L), oxLDL(-)(P), and oxLDL(-)(D). OxLDL types are primarily enriched in lysophosphatidylcholine (lyso-PC) due to hydrolysis of oxidized phospholipids (oxPL) by PAF-AH. OxLDL(-) types are mainly enriched in intact oxPL due to the inactivation of the LDL-associated PAF-AH before oxidation. IgG autoantibodies against all types of oxLDL were determined and IMT was evaluated ultrasonographically. IMT values were significantly associated with age, systolic blood pressure and serum triglyceride levels, whereas no correlation was found between IMT values and antibody titers against all types of either oxLDL or oxLDL(-). We suggest that autoantibodies against various types of mildly oxidized LDL enriched either in lyso-PC or in oxPL are not associated with the extent of carotid atherosclerosis. This supports the concept that extensively oxidized LDL enriched in aldehydes rather than mildly oxidized LDL may play a prominent role in the early stage of atherosclerosis.

Adult↗
PubMedDate not supplied

Effects of Cupressus sempervirens cone extract on lipid parameters in Wistar rats.

BACKGROUND: Lipid-lowering drugs have been developed to treat hyperlipidemia, but they are expensive, while serious side-effects may occasionally occur. In Albania, a hydroalcoholic extract of the cones of Cupressus sempervirens is used to treat a variety of disorders, including hyperlipidemia. The purpose of our study was to assess the effects of Cupressus sempervirens cone extract (CSE) on the lipid profile of Wistar rats. MATERIALS AND METHODS: The animals were divided into two groups. Group I (30 animals) served as a control group. Serum lipid parameters, muscle and liver enzymes, red and white blood count, platelets, and serum concentrations of uric acid and creatinine were determined at baseline and at weeks 6, 12, 18 and 24 of the study. RESULTS: The oral administration of the extract resulted in a substantial decrease of serum total cholesterol, which was significant even after 6 weeks of treatment. Moreover, these animals exhibited lower total cholesterol levels compared to the controls after the initiation of treatment (p < 0.001) during the study period. The administration of the extract led to a substantial reduction in serum triglycerides (p < 0.05) in Group I, comparing 0 week to 6-24 weeks. However no significant differences in triglyceride levels were observed between CSE animals (Group I) and controls (Group II) during the entire study period. No significant changes in HDL-cholesterol in the other parameters occurred in either group. CONCLUSION: The administration of CSE has an important lipid-lowering effect in Wistar rats.

Animals↗
PubMedDate not supplied

Awareness, treatment and control of the metabolic syndrome and its components: a multicentre Greek study.

INTRODUCTION: There are no data concerning the degree of awareness, treatment and control of the metabolic syndrome (MetS) and its components or associated vascular risk in the general population. METHODS: A cross-sectional analysis was made of a representative sample of Greek adults (n=9669, 49% men and 51% women), living in urban, semi-urban and rural areas (55%, 23% and 22%, respectively). The National Cholesterol Education Program (NCEP-ATP III) and the International Diabetes Federation (IDF) definitions for the MetS were used. RESULTS: The age-standardised prevalence of the MetS in the general population was 24.5% [95% CI 23.4-25.7%] (n=2369). This was similar in men and women and increased with age. Among subjects with the NCEP MetS the prevalence of hypertension was 71%, elevated blood glucose 55%, low high-density lipoprotein cholesterol 58%, high triglycerides 63% and abdominal obesity 82%. Only one third of subjects were aware of the MetS component conditions, less than one quarter were on treatment, and very few (< or =10%) were controlled for MetS components. Awareness of MetS individual component conditions (e.g. arterial hypertension), and consequently effective control, was lower than that reported in other cohorts, including subjects without MetS. Only 5% of subjects were aware of MetS as an entity, 2% were treated for all component conditions and only 1% were controlled. Using the IDF definition, the prevalence of MetS was higher (43.4%) and awareness, treatment and control of MetS and its components were significantly lower. CONCLUSIONS: The prevalence of MetS is high in Greece but is not recognised among the general population. Therefore, treatment and control of MetS and component conditions are extremely low. If the situation does not improve soon, MetS will cause a further increase in the vascular disease epidemic in the years to come. This calls for urgent education of the public and the medical community.

Adult↗