Different postprandial metabolic patterns after the consumption of fish oil and lard in healthy Chinese individuals

AimIt is well known that nutritional intervention has positive effects on the secondary prevention of coronary heart disease. Different fat compositions of meals may alter postprandial plasma lipid patterns, which can further influence lipid metabolism in vivo.MethodsIn the present study, we investigated postprandial plasma lipid parameters in twenty healthy volunteers after eating fat meals either with 80 gram lard or 80 gram fish oil. Blood samples were drawn at 0, 0.5, 1, 2, 3, 5 and 7 hours and plasma levels of total triglycerides (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were determined.ResultsIt demonstrated that postprandial plasma concentrations of TG, TC and LDL-C were significantly lower whereas HDL-C was higher after eating fish oil compared to the consumption of lard. Moreover, comparing the individuals with or without dyslipidemic family history, the healthy individuals without family history of dyslipidemia after eating fish oil had even lower postprandial plasma TG and LDL-C (P < 0.05) than the subjects with the family history. It is concluded that postprandial response following fish oil could be as a result of reduced TG, TC and LDL-C, and increased HDL-C.ConclusionsPostprandial responses following fish oil consumption may reduce TG, TC and LDL-C plasma levels, and increase HDL-C level. Individuals with dyslipidemic family history may have enhanced postprandial response than the individuals without dyslipidemic family history.     

Claustration et collectionnisme : réflexions à propos d’un cas de syndrome de Diogène avec vols kleptomaniaques et vengeurs

Social withdrawal is a pathognomonic behaviour that is consistently associated with mental illnesses. Compulsive hoarding can also be interpreted as a pathological behaviour, even when it does not involve kleptomania. Diogenes syndrome (DS) was first described in 1975, and is characterized by both behaviours - social withdrawal and compulsive hoarding. Even though it is often the manifestation of a psychiatric condition, its aetiology is diverse. The most frequent ones are however: dementia, schizophrenia and mental retardation. In this study, we describe an atypical case presenting with DS. Il consists of a young man, seen in a forensic setting, who had been diagnosed with kleptomania in the past, presents with compulsive hoarding, and whose recent thefts were fuelled by revenge. Finally, to our knowledge, the way social withdrawal is viewed is seldom taken into account. We analyse its implication on social withdrawal.     

Évolution démographique,caractéristiques et suivi clinique intrahospitalier des sujets âgés traités par angioplastie primaire pour syndrome coronarien aigu avec sus-décalage du segment ST

Background

The number of older adults treated for ST-segment elevation myocardial infarction (STEMI) is increasing. Nevertheless, their treatment might not be as optimal as younger adults. This study sought to evaluate demographic evolution, clinical characteristics and in-hospital outcomes of patients of patients aged 75 years-old or older treated by primary angioplasty for STEMI.

Underuse of cardioprotective treatment by the elderly with type 2 diabetes

AIMS: To assess whether elderly patients with type 2 diabetes use a comprehensive cardioprotective regimen (CCR) of antihypertensive, lipid-lowering and antiplatelet drugs in the year following oral antidiabetic drug initiation and, if so, to identify the determinants of such use. METHODS: Using the Quebec Diabetes Surveillance System administrative database, we carried out an inception cohort study of individuals aged 66 years and over who began oral antidiabetic therapy between 1998 and 2002. Those individuals with at least one claim in the year after starting antidiabetic treatment for an antihypertensive, a lipid-lowering and an antiplatelet drugs were deemed to be using a CCR. A multivariate logistic regression model was built to identify the characteristics associated with CCR use. RESULTS: Of the 48,505 individuals included in the study, 9912 (20.4%) used a CCR during the year following the first antidiabetic claim. Those more likely to use a CCR were men (odds ratio [OR]: 1.2; 99% confidence intervals [CI]: 1.1-1.3), those who had used an antihypertensive (1.6; 1.4-1.7), lipid-lowering (7.4; 6.8-8.0) or antiplatelet (7.3; 6.7-7.9) drug in the year before the first antidiabetic claim and those with a preexisting diagnosis of cardiovascular disease (1.9; 1.8-2.1). The odds of using a CCR increased every year. CONCLUSIONS: CCR use by the elderly with type 2 diabetes in the year following antidiabetic initiation is low, and prior use of individual cardioprotective drugs is a strong predictor of its use. These findings suggest that the treatment of important modifiable risk factors for cardiovascular disease is suboptimal.     

Bloc iliofascial et troubles cognitifs postopératoires chez la personne âgée

Objective

The aim of this study was to assess the influence of a regional analgesia technique on the incidence of postoperative cognitive dysfunction (POCD) after hip surgery, in elderly patients.

Patients and methods

Patients, aged over 65 years, were assigned in two groups according to the anaesthesia technique: group NKT (general anaesthesia with target concentration infusion of propofol and remifentanil, with a 0.1 mg/kg-bolus of morphine at the end of surgery), group KT (preoperative iliaca compartment block with catheter and then general anaesthesia without bolus of morphine). Postoperative analgesia was similar in both groups: paracetamol, tramadol, and subcutaneous morphine if verbal pain scale equal or greater than 2 (0.1 mg/kg). POCD was defined as a decrease in Mini Mental Status (MMSE) equal or greater than 2 points and was monitored during 2 days. Consumption of opioids, pain scores and side effects were recorded.

Results

Sixty-five patients were included: 34 in NKT group and 31 in KT group. MMSE scores were higher in the KT group at day1 and day2 (p = 0.01 and 0.0004, respectively). POCD was less frequent in group KT at day2 (6 % vs 41 % ; p = 0.001) and pain scores were lower during the first 48 hours (p = 0.03). Remifentanil consumption was lower in KT group (0.43 ± 0.18 mg vs 0.61 ± 0.25 mg, p = 0.002). Total amount of morphine, including the bolus in NKT group, was significantly lower in KT group (7 [5–17] mg vs 0 [0–5] mg, p < 10⁻⁶).

Conclusion

Postoperative analgesia by iliaca compartment block with catheter seems to provide a decrease in the incidence of POCD after hip surgery in elderly patients.

Study design

Prospective, observational study.