Gender differences in cardiovascular risks of obese adolescents in the Bronx

Objective: The associations between the degree of obesity and cardiovascular disease (CVD) risks and the impact of gender differences with regard to these risk factors are not well understood. The aim of our study was to examine the gender−specific differences in CVD risk factors in inner−city minority youths.Methods: A total of 269 adolescents (109 males and 160 females) were included in this retrospective study. Data on multiple metabolic variables were collected. Evaluation of abnormalities in these parameters was based on standard criteria. Pearson correlations were calculated to examine the relationship between body mass index (BMI) z−score and obesity−related parameters. Chi−square and Fisher’s tests were used to compare the frequencies of single or multiple cardiovascular risks in the two gender groups.Results: In the male group, BMI z−scores showed significant positive correlations with insulin resistance and diastolic blood pressure. In the female group, BMI z−scores showed significant positive correlations with insulin resistance and systolic blood pressure. In both genders, the prevalence of CVD risks was high, but a similar risk pattern was established in both sexes, with dyslipidemia being the highest, hypertension the second, and impaired glucose tolerance (IGT) being the least outstanding. The most important finding in this study was that the male group had a significantly higher prevalence of systolic hypertension.Conclusion: Male inner−city minority adolescents show a high prevalence of CVD risks associated with obesity. Appropriate risk stratification is critical to developing and implementing both therapeutic and preventive interventions.Conflict of interest:None declared.     

Bivalent Ligands Targeting Multiple Pathological Factors Involved in Alzheimer's Disease

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Doppler echocardiography in normally functioning replacement aortic valves: a review of 129 studies

Echocardiography is the technique of choice for the assessment of replacement aortic valves. Hemodynamic function depends on the design and size of the valve. This review summarizes the published information available to the end of 2005. The most obstructive valve was the caged-ball, followed by the stented porcine and single tilting-disc valves. The stented bovine pericardial valves were slightly less obstructive than these, and similar to the intra-annular bileaflet mechanical valves. Stentless valves appeared slightly less obstructive still, and similar to reduced-cuff mechanical bileaflet valves. Homografts were the least obstructive. Approximate guide thresholds suggesting obstruction were derived.     

In vitro antioxidant and antihyperlipidemic activities of Bauhinia variegata Linn

Objectives:

To evaluate the ethanolic and aqueous extracts of Bauhinia variegata Linn. for in vitro antioxidant and antihyperlipidemic activity.

Materials and Methods:

Ethanolic and aqueous extracts of the stem bark and root of B. variegata Linn. were prepared and assessed for in vitro antioxidant activity by various methods namely total reducing power, scavenging of various free radicals such as 1,2-diphenyl-2-picrylhydrazyl (DPPH), super oxide, nitric oxide, and hydrogen peroxide. The percentage scavenging of various free radicals were compared with standard antioxidants such as ascorbic acid and butylated hydroxyl anisole (BHA). The extracts were also evaluated for antihyperlipidemic activity in Triton WR-1339 (iso-octyl polyoxyethylene phenol)-induced hyperlipidemic albino rats by estimating serum triglyceride, very low density lipids (VLDL), cholesterol, low-density lipids (LDL), and high-density lipid (HDL) levels.

Result:

Significant antioxidant activity was observed in all the methods, (P < 0.01) for reducing power and (P < 0.001) for scavenging DPPH, super oxide, nitric oxide, and hydrogen peroxide radicals. The extracts showed significant reduction (P < 0.01) in cholesterol at 6 and 24 h and (P < 0.05) at 48 h. There was significant reduction (P < 0.01) in triglyceride level at 6, 24, and 48 h. The VLDL level was also significantly (P < 0.05) reduced from 24 h and maximum reduction (P < 0.01) was seen at 48 h. There was significant increase (P < 0.01) in HDL at 6, 24, and 48 h.

Conclusion:

From the results, it is evident that alcoholic and aqueous extracts of B. variegata Linn. can effectively decrease plasma cholesterol, triglyceride, LDL, and VLDL and increase plasma HDL levels. In addition, the alcoholic and aqueous extracts have shown significant antioxidant activity. By the virtue of its antioxidant activity, B. variegata Linn. may show antihyperlipidemic activity.     

A high-fat diet and regulatory T cells influence susceptibility to endotoxin-induced liver injury

In nonalcoholic fatty liver disease, the pathogenesis of progression from simple steatosis to steatohepatitis has not been fully clarified. Many factors, including oxidative stress and hepatic immune regulation, contribute to the inflammation in steatosis. Because regulatory T cells (Tregs) are important components of immune regulation, we have now investigated their role in the pathogenesis of nonalcoholic steatohepatitis. Wild-type C57BL/6 mice were fed a high-fat (HF) diet to induce steatosis, and the hepatic lymphocyte population was analyzed by flow cytometry. HF-induced steatosis was associated with the depletion of hepatic Tregs and led to up-regulation of the inflammatory tumor necrosis factor-alpha signaling pathway. When challenged by exogenous lipopolysaccharide, the HF-fed mice developed liver inflammation. In contrast, the adoptive transfer of Tregs decreased inflammation in HF-fed mice. In comparison with effector T cells, Tregs had a lower expression of Bcl-2 and, therefore, increased susceptibility to oxidative stress-induced apoptosis. The treatment of mice with the antioxidant Mn(III)tetrakis(4-benzoic acid)porphyrin chloride reduced Treg apoptosis, increased the number of hepatic Tregs, and decreased hepatic inflammation in HF-fed mice. CONCLUSION: Our results indicate that increased oxidative stress in a fatty liver causes the apoptosis of Tregs, reduces the number of hepatic Tregs, and leads to a lowered suppression of inflammatory responses. This scenario is likely one of the pathogenetic mechanisms that facilitate the transformation of simple steatosis into steatohepatitis when a fatty liver is exposed to second or third hits.     

Peroxisome proliferator-activated receptor-gamma regulates expression of PDX-1 and NKX6.1 in INS-1 cells

In the 60% pancreatectomy (Px) rat model of beta-cell adaptation, normoglycemia is maintained by an initial week of beta-cell hyperplasia that ceases and is followed by enhanced beta-cell function. It is unknown how this complex series of events is regulated. We studied isolated islets and pancreas sections from 14-day post-Px versus sham-operated rats and observed a doubling of beta-cell nuclear peroxisome proliferator-activated receptor (PPAR)-gamma protein, along with a 2-fold increase in nuclear pancreatic duodenal homeobox (Pdx)-1 protein and a 1.4-fold increase in beta-cell nuclear Nkx6.1 immunostaining. As PPAR-gamma activation is known to both lower proliferation and have prodifferentiation effects in many tissues, we studied PPAR-gamma actions in INS-1 cells. A 3-day incubation with the PPAR-gamma agonist troglitazone reduced proliferation and increased Pdx-1 and Nkx6.1 immunostaining, along with glucokinase and GLUT2. Also, a 75% knockdown of PPAR-gamma using RNA interference lowered the mRNA levels of Pdx-1, glucokinase, GLUT2, and proinsulin II by more than half. Our results show a dual effect of PPAR-gamma in INS-1 cells: to curtail proliferation and promote maturation, the latter via enhanced expression of Pdx-1 and Nkx6.1. Additional studies are needed to determine whether there is a regulatory role for PPAR-gamma signaling in the beta-cell adaptation following a 60% Px in rats.     

Simultaneous or sequential combined living donor-intestine transplantation in children

BACKGROUND: Since the report of the first successful living donor combined liver-intestine transplant in pediatric patients, three other cases have been performed. In this article, we describe surgical technique, outcome, and propose a broader application of this procedure using deceased donors. PATIENTS: Four children of mean age 15.5 months (11-24 months) and weight 9.5 kg (8-10.9 kg) affected by end-stage liver and intestinal failure underwent living donor combined liver-intestine transplant with a left lateral liver and a distal segment of jejunum. In one case, the organs were transplanted simultaneously and in three in staged procedures. In all cases the liver transplant was performed first. The intestine was always transplanted with systemic venous drainage. The biliary anastomosis was a duct-to-duct, a biliodigestive, or a combined one according to the biliary anatomy of the liver graft. The abdomen was routinely closed with a Vicryl mesh followed by a skin graft. A loop graft ileostomy was fashioned for protocol biopsies and taken down within 3 months. RESULTS: One intestine was lost to generalized ischemia. The child was promptly retransplanted with another living donor graft. All children are alive and well at an average follow-up of 30 months (18-54 months). CONCLUSIONS: Living donor combined liver-intestine transplant can be performed successfully with excellent early outcome. The in situ splitting technique here described can be applied to obtain grafts for small children from appropriate adult deceased donors.     

HPTLC method for the estimation of alkaloids of Cinchona officinalis stem bark and its marketed formulations

We report a sensitive method for the estimation of quinine (Qn), cinchonine (Cn), and cinchonidine (Cnd) and a new method based on fluorescence enhancement and detection and quantification of quinidine (Qnd) from Cinchona stem bark and its formulations, using HPTLC. Standard solutions of Qn, Qnd, Cn, and Cnd were applied on precoated HPTLC plates and developed with chloroform/diethylamine (9.6:1.4 v/v). The plates were scanned and quantified at 226 nm for Qn, Cn, Cnd and for Qnd at 366 nm in fluorescence and reflectance mode ([symbol: see text] K400 filter). The method was validated for precision, accuracy and repeatability. Further, the stem bark of Cinchona officinalis and some herbal and homeopathic formulations were evaluated for their individual alkaloid content applying the developed method.     

A biostatistical approach to ayurveda: quantifying the tridosha

OBJECTIVE: To compute quantitative estimates of the tridosha--the qualitative characterization that constitutes the core of diagnosis and treatment in Ayurveda--to provide a basis for biostatistical analysis of this ancient Indian science, which is a promising field of alternative medicine. SUBJECTS: The data sources were 280 persons from among the residents and visitors/training students at the Brahmvarchas Research Centre and Shantikuj, Hardwar, India. DESIGN/METHODOLOGY: A quantitative measure of the tridosha level (for vata, pitta, and kapha) is obtained by applying an algorithmic heuristic approach to the exhaustive list of qualitative features/factors that are commonly used by Ayurvedic doctors. A knowledge-based concept of worth coefficients and fuzzy multiattribute decision functions are used here for regression modeling. VALIDATION AND APPLICATIONS: Statistical validation on a large sample shows the accuracy of this study's estimates with statistical confidence level above 90%. The estimates are also suited for diagnostic and prognostic applications and systematic drug-response analysis of Ayurvedic (herbal and rasayanam) medicines. An application with regard to the former is elucidated, extensions of which might also be of use in investigating the role of nadis in Ayurvedic healing vis-a-vis acupuncture and acupressure techniques. The importance and scope of this novel approach are discussed. CONCLUSIONS: This pioneering study shows that the concept of tridosha has a sound empirical basis that could be used for the scientific establishment of Ayurveda in a new light.