Metabolic syndrome: do clinical criteria identify similar individuals among overweight premenopausal women?

The purpose of this analysis was to determine to what extent the clinical criteria for metabolic syndrome (MetSyn) proposed by the World Health Organization (WHO), the European Group for Study of Insulin Resistance (EGIR), the National Cholesterol Education Program Adult Treatment Panel III (ATP III), and the International Diabetes Foundation (IDF); triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) ratio >/=3.0; and enlarged waist circumference (>/=88 cm) and elevated TG (>/=129 mg/dL) (EWET) identified similar or different overweight women and, secondarily, to examine the effect of 7% weight reduction on MetSyn status. Metabolic syndrome was determined among 256 premenopausal women (age = 41 +/- 6 years, body mass index [BMI] = 32 +/- 4 kg/m(2)) participating in a dietary weight loss clinical trial based on the clinical criteria proposed by WHO, EGIR, ATP III, and IDF. The prevalence of TG/HDL-C ratio >/=3.0 and EWET was determined and compared with MetSyn status. Based on the clinical criteria, 16.1% (EGIR), 20.7% (WHO), 31.0% (ATP III), and 31.8% (IDF) of participants met the criteria for MetSyn; 30.3% and 31.8% had TG/HDL-C >/=3.0 and EWET, respectively. Between 77% and 99% of participants were similarly classified across the clinical criteria. The highest and lowest agreements were between ATP III and IDF (kappa = 0.98; 95% confidence interval, 0.96-1.0) and WHO and IDF (kappa = 0.39; 95% confidence interval, 0.26-0.51), respectively. The TG/HDL-C ratio >/=3.0 and EWET moderately agreed with all 4 clinical criteria for MetSyn (kappa range, 0.36-0.59). Among those diagnosed with MetSyn at baseline, 64.0% to 75.0% of the participants who lost >/=7% and 25.8% to 55.6% of participants who lost <7% of their baseline body weight in 6 months no longer met the various clinical criteria for MetSyn, TG/HDL-C >/=3.0, or EWET. Our findings indicate that MetSyn varies substantially between clinical criteria, which raise questions about the clinical utility of these criteria. Regardless of MetSyn clinical criteria, >/=7% reduction in body weight has a beneficial impact on variables used to define MetSyn.     

Clinical and cost effectiveness of nebulizer therapy in emergency care for acute bronchial asthma

AIM: To evaluate clinical and cost efficacy of urgent therapeutic measures for patients with acute bronchial asthma (BA) in a large industrial city. MATERIAL AND METHOD: 380 patients with moderate and severe BA in emergency state were observed. 222 of them got berodual solution provided by pneumatic nebuliser, moistened oxygen and corticosteroids. 158 patients received standard emergency care. Bronchopulmonary and cardiovascular systems were studied. RESULTS: The proposed therapy proved 1.6 and 2.6 times more effective in moderate and severe BA, respectively, than standard therapy. It made possible to reduce the treatment cost by 30%. An algorithm for emergency care for acute BA is designed. CONCLUSION: Differential emergency care is recommended for patients with acute bronchial asthma.     

The immune status of homosexuals ill with different forms of syphilis

Status of the cell-mediated, humoral immunity, and nonspecific defense factors were examined before and after specific therapy in 40 homosexuals suffering from secondary relapsing and latent early syphilis. The findings evidence that changes in the cell-mediated immunity of homosexual syphilitics essentially differ from those in heterosexuals with syphilis: decreased count of T-helpers and elevated one of T-suppressors evidence impaired ratio of T-lymphocyte subpopulations and immunoregulatory cell imbalance. A significantly increased level of C4 complement component was observed, evidencing a deficiency of the complement system. These data call for the development of a scheme of immunocorrective therapy for homosexuals suffering from syphilis.     

Elective simultaneous operations in elderly and senile urological patients

Surgeons of Samara Regional Veterans' Hospital made elective-simultaneous operations in 229 presenile and senile patients. Surgery was performed in the urological department in 1995-2010. It is shown that over 12% patients of urological geriatric departments need elective situltaneous operations, of them 8.7% are mild, 78.6%--moderate and 12.7%--severe. The results of simultaneous operations in 133 patients and staged operations in 60 control patients (adenomectomy and Vinkelman) differed insignificantly (p > 0.05). Such achievement was realized due to advanced prophessional education of all medical personnel of the department, introduction of new techniques in examination and treatment: accurate definition of absolute and relative contraindications for simultaneous surgery, effective preoperative preparation, low-invasive operations, different variants of non-endotracheal anesthesia. In addition to a positive clinical effect, new technology of simultaneous operations reduces 2.3-fold economic costs vs staged surgery, improves significantly quality of life of the above patients.     

Blood lipid responses to plant stanol ester supplementation and aerobic exercise training

The purpose of this study was to determine the independent and combined effects of plant stanol ester (PSE) margarine and aerobic exercise on blood lipid concentrations and related intravascular enzymes in 26 healthy sedentary, middle-aged men and postmenopausal women (age, 53 +/- 8 years; body mass index, 27 +/- 1.0, % fat, 28.5 +/- 2). In a stratified double-blind manner, participants were randomly assigned to either a PSE (n = 17) or a placebo (CON, n = 9) margarine group. Participants supplemented their daily diets with 42 g of margarine spread (PSE = 3 g; CON, PSE = 0 g, of approximately equal energy content) for 9 weeks. During the last 4 weeks of margarine supplementation (MS), participants expended 400 kcal on a treadmill 5 d/wk at 65% of VO(2) reserve (2000 kcal/wk). Fasting blood samples were obtained before initiating and after 4 weeks of MS and after exercise training. All blood samples were analyzed for total cholesterol, low-density lipoprotein cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), hepatic lipase, lipoprotein lipase, and cholesterol ester transfer protein activities. Total cholesterol (-10%), low-density lipoprotein cholesterol (-13%), and triglyceride (-18%) concentrations decreased after 4 weeks of MS in the PSE group, but not in the CON group (P < .05 for all). Four weeks of aerobic exercise increased HDL-C by 21% in the CON group (P < .05) and by 4% in the PSE group (P > .05). Total cholesterol-HDL-C ratio decreased significantly (P < .05) in the PSE group, but not in the CON group. No other significant alterations were observed with either PSE or exercise. Our findings suggest that PSE is effective in reducing blood cholesterol concentrations and that exercise can increase HDL-C in middle-aged men and postmenopausal women. Our findings also suggest that PSE supplementation may attenuate the exercise-induced increase in HDL-C.