Effects of pioglitazone on asymmetric dimethylarginine and components of the metabolic syndrome in nondiabetic patients (EPICAMP Study): A double-blind, randomized clinical trial

The present trial aimed to investigate the effects of pioglitazone on the serum level of asymmetric dimethylarginine (ADMA), a marker of endothelial function, and some indices of inflammation and glucose and lipid metabolism in nondiabetic metabolic syndrome patients. 104 eligible participants (57 female; age between 20 and 70) were enrolled in a double-blind placebo-controlled trial and were randomized to receive either pioglitazone (uptitrated to 30 mg/day) or matching placebo for 24 weeks. Participants were clinically examined and a blood sample was obtained at baseline and at the end of the trial. Pioglitazone significantly improved C-reactive protein level irrespective of changes in insulin sensitivity. Compared with the placebo group, alanine and aspartate transaminases were decreased and high-density lipoprotein cholesterol was increased after treatment with pioglitazone. A considerably greater weight gain was also recorded in the intervention group. We failed to observe any significant changes in serum ADMA in either group and between groups with and without adjustment for age, sex, and components of the metabolic syndrome. In a nutshell, pioglitazone seems to have positive effects on lipid profile, liver transaminases, and systemic inflammation. However, its previously demonstrated endothelial function-improving properties do not seem to be mediated by ADMA. © 2013 Pedram Shokouh et al

Antihypertensive and antioxidant effects of dietary black sesame meal in pre-hypertensive humans

<p>Abstract</p> <p>Background</p> <p>It has been known that hypertension is an independent risk factor for cardiovascular disease (CVD). CVD is the major cause of morbidity and mortality in developed and developing countries. Elevation of blood pressure (BP) increases the adverse effect for cardiovascular outcomes. Prevention of increased BP plays a crucial role in a reduction of those outcomes, leading to a decrease in mortality. Therefore, the purpose of this study was to investigate the effects of dietary black sesame meal on BP and oxidative stress in individuals with prehypertension.</p> <p>Methods</p> <p>Twenty-two women and eight men (aged 49.8 ± 6.6 years) with prehypertension were randomly divided into two groups, 15 subjects per group. They ingested 2.52 g black sesame meal capsules or placebo capsules each day for 4 weeks. Blood samples were obtained after overnight fasting for measurement of plasma lipid, malondialdehyde (MDA) and vitamin E levels. Anthropometry, body composition and BP were measured before and after 4-week administration of black sesame meal or a placebo.</p> <p>Results</p> <p>The results showed that 4-week administration of black sesame meal significantly decreased systolic BP (129.3 ± 6.8 vs. 121.0 ± 9.0 mmHg, <it>P </it>< 0.05) and MDA level (1.8 ± 0.6 vs. 1.2 ± 0.6 μmol/L, <it>P </it>< 0.05), and increased vitamin E level (29.4 ± 6.0 vs. 38.2 ± 7.8 μmol/L, <it>P </it>< 0.01). In the black sesame meal group, the change in SBP tended to be positively related to the change in MDA (<it>R = 0.50, P </it>= 0.05), while the change in DBP was negatively related to the change in vitamin E (<it>R = -0.55, P </it>< 0.05). There were no correlations between changes in BP and oxidative stress in the control group.</p> <p>Conclusions</p> <p>These results suggest the possible antihypertensive effects of black sesame meal on improving antioxidant status and decreasing oxidant stress. These data may imply a beneficial effect of black sesame meal on prevention of CVD.</p

Weight changes in Parkinson's disease patients after subthalamic nucleus deep brain stimulation surgery

Bachground: After Sub-Thalamic Nucleus Deep Brain Stimulation (STN-DBS), an effective treatment for Parkinson disease patients, weight gain has been observed. As this method of treatment is only in use since two years in Iran, no information regarding its side effects (including weight gain) existed thus far. Objective: We conducted this study to evaluate the weight gain 1 and 3 months after the DBS surgery. Methods: We enrolled all patients who underwent bilateral STN-DBS in Rasool Akram Hospital affiliated to Iran University of Medical Sciences in 2008-2009. Unified Parkinson Disease Rating Scale (UPDRS), neuropsychological assessment, pulmonary and cardiac evaluation before the surgery were carried out for all patients. They were weighted before, 1 and 3 months after the STN-DBS. Results: The average weight of patients was 70.7 ± 14.4, 74.1 ± 16.2 and 76.6 ± 14.4 Kg before, 1 and 3 months after the STN-DBS, respectively (P < 0.037). Conclusion: Our results confirm that rapid weight gain (as soon as 1 month after surgery) occurred in STN-DBS treated parkinsonian patients

The situation of new risk factors of cardiovascular disease in urban population of Isfahan

During recent years, many epidemiological studies on risk factors of cardiovascular disease (CVD) have been preformed among which are fibrinogen, activity of factor VII, lipoprotein (A), and hemocystein as new CVD risk factors. Through completed studies, it is found that in urban population of Isfahan more than one risk factor (Hypertension, smoking, hypercholesterolemia, diabetes and obesity) are seen in 32% of men and a descriptive cross-sectional study was performed in 1998-99 and 409 subjects (175 men, 234 women) were randomly sample. Then each subject underwent a blood test, electrocardiography, medical examination and daily physical activity assessment. Nutrient intakes were obtained through assessment of food consumption as 3-day recall. Personal information and anthropometric measurements were also recorded. Fast blood sugar and serum lipids were measured by auto analyzer Elan 2000; lipoprotein (A) by ELISA; hemocystein by HPLC; fibrinogen by turbidimetry and factor VII by calculating coagulation time compared to standard time. Statistical analyses were done by t-test. The results showed that mean fibrinogen, factor VII, lipoprotein (A), and hemocystein were 244.9±67 mg/dl, 118.3±58 percent, 13.3±13 mg/dl and 11.5±3 µmol/lit respectively in studied population. By comparing these new CVD risk factors over the world, it was determined that their levels were in the normal range in urban population of Isfahan. The level of fibrinogen and hemocystein are higher and lower in women than those in men respectively that is compatible with many other studies. Keywords: Fibrinogen, Activity of factor VII, Lipoprotein (a), Hemocystein, Thrombi

NUTRIENT INTAKES IN ISFAHANIAN ADULTS BY: IRANIAN FOOD CONSUMPTION PROGRAM (IFCP) 1998

Introduction. Survey for food consumption patterns prepares the quantitative and qualitative scales for assessing nutriotonal state among population. Healthy nutrition is one of the preventive factors for non communicable diseases as cardiovascular disease (CVD). Regarding the increasing trends in CVD mortality/morbidity and relatively high incidences of CVD risk factors in Isfahan, it is essential to determine food consumption patterns in this population.&#13; Methods. One of the most reliable procedure for social food patterns is 24 hr recall, performed mainly by pictural questionnaire. Food Consumption Program-Heart Concern Software (IFCP) was developed for this task through 24 hr recall. By this computerized program, user can work with pictures of food album for determining what kind and how much foods the patients consumed. The sensitivity of this software is very high for determining nutrient intakes corresponding to Iranian cooking and feeding culture. In this cross sectional study, 1193 people (aged 20-70 years old) were selected systematically from 40 clusters in Isfahan city through 4 seasons. For each person, two computerized questionnaires were completed for personal characteristics and daily food consumption by an instructive operator. Interview for 24 hr food consumption was design for 3 days determined randomly through a week. Therefore, distribution were maintained for food data. The obtained yearly data was analysed by the same program achieved the level of energy, carbohydrate, portein, total fat, cholesterol and fatty acids intaken form daily feeding.&#13; Results. Mean energy intake was 2380.9±1082.2 Kcal/day for total population. Thre was a significant difference between men and women in all age groups (P &lt; 0.0001). The energy obtained from fat was 29.28 percent in people aged 20-70 years old in Isfahan city. Cholesterol intake for each person was 253.5 ± 179.1 mg/day and the energy obtained from each fatty acid groups as SFA, MUFA and PUFA are 13.11, 9.40 and 5.22 percent of total energy. Also, carbohydrate intake for each person is 344.2 ± 179.4 gr/day in Isfahan population (obtained energy is equal 58.8 percent of total energy). Protein intake was 79.3 ± 30.5 gr/day.&#13; Discussion. Regarding the obtained results, it is essential to promote people especially in age groups of 20-29 and 50-59 years old to improve their nutriton pattern considering lower intakes of calory, fatty acid groups and increasing nutriton fiber

"The Iranian Food Consumption Program (IFCP), A Unique Nutritional Software in Iran"

The Iranian Food Consumption Program (IFCP), a unique program in Iran was developed to aim accurate calculation of nutrient intakes in relation to heart health investigation released in Isfahan Cardiovascular Research Center in March 1998 for the first time. The new versions came out along changes in computer technology. This interview-based program is designed to gather data through designed questionnaires in two dietary and non-dietary parts under an individual code number for each subject. The interview can be repeated to nine times for each code number. The non-dietary questionnaires are used to obtain information about personal, demographic and anthropometric characteristics, lipid profiles, personal and family history for cardiovascular disease and its risk factors, fasting blood sugar, blood pressure and heart rate records as well as physical activity data. The dietary data collection is flexibility programmed to be able to match easily with different methods of nutrition assessment especially record-assisted 24-hour recall method. A photographic food atlas makes food recalling accurate, easily and in real quantity and quality amounts. Therefore, a separate food list is made for each subject containing foods, ingredients and composed nutrients by record. Food analysis is performed to obtain daily nutrients intakes extremely accurate according to Iranian Food Table with over 1377 food items and values of 45 nutrients. The ultimate file can be exported in nearly eleven formats for statistical analysis. Consequently, the nutrient status can be easily investigated in designed studies for individuals, groups and populations especially concerning heart health. Also, the validity of the software was established by a comparative study through a trial and error. IFCP is useful for diet therapy, dietetic practice, nutrition research and epidemiological survey

"Smoking prevalence and its combination with some cardiovascular risk factors "

This study was carried out on 2200 men and women aged 20-70 years in isfahan who participatd in isfahan Cardiovacular Risk Facor survery, in order to find prevalence of cigarette smoking in this population and estimate the relation of smoking with other CAD risk factors. All information was obtained by standard questionnaires mainly concerning smoking habits of subjects and their personal characteristics, etc. Serum lipids and fasting blood glucose levels were measured from 12-14 hr fasting specimen by ELAN 2000 autoanalyzer. Blood pressure was measured according to WHO standardized method. The prevalence of cigarette smoking among Isfanhan population is 11.1% (0.92 in women, 23.3%) in men. Contrary to serum total cholesterol (T.cho) and fasting blood sugar (FBS), the mean levels of HDL cholesterol (HDL-C) systolic (SBP) and diastolic blood pressure (DBP) and body mass index (BMI) were significantly higher in non-smokers than smokers (P&lt;0.05). Hypertension and obesity were significantly more prevalent in non-smokers than smokers. When the prevalence of risk factors were studied in two BMI levels, the prevalence of hypertriglyceridemia was significantly more in smokers than non-smokers opposite to hypertension in either BMI level. Higher prevalence of low HDL-C and hypertension in either BMI level. Higher prevalence of low HDL-C and hypercholesterolemia was observed in smokdrs than non-smokers when BMI &lt;27 kg/m2 was considered. The results of the present study revaled that hypertensions is more prevalent in non-smokers than smokers. The observation that high blood pressure was less common among smokers than non-smokers may be related to the lower prevalence of obesity in smokers.We conclude that due to the low prevalence of smoking in Iranian women, it is better to present the data regarding smoking as sex-based in our society. On the other hand Cigarette smoking is not only considered as a major risk factor for CVD but also it may have a role in increasing some of other CVD risk factors in our populatio

"The effect of supervised exercise training on psychological characteristics and physical fitness after myocardial infarction "

Regarding the increasing prevalence of cardiovascular disease (CVD) especially myocardial infarction (MI), and the insufficiency of information in the field of physical rehabilitation, this study aimed to investigate the effectiveness of a course of physical rehabilitation on the psychological status and physical characteristics f cardiac patients. In this study, the effect of 8 weeks exercise training, 3 sessions of 45 minutes duration per week, on the physical and psychological function of MI patients was evaluated. Eighty patients who were referred to the rehabilitation unit of Isfahan cardiovascular Research Center were randomly divided into two groups of exercise and non-exercise. The data of pre and post exercise course were analyzed with the SPSS software using the two-sample t-test and multiple liner regression. The comparison of the mean changes of functional capacity. Weight, body mass index (BMI), heart rate, and systolic and diastolic blood pressures between exercise and non-exercise groups after 8 weeks showed significant difference for all studied factors (P&lt;0.05). Also, investigating the psychological characteristics such as depression, anxiety and hostility scores indicated a significant change after exercise training (P&lt;0.05). Personality and behavior showed no significant difference. This study suggests the functional has a significant effect on improving the function capacity and psychological behavior in post MI patients

MEAN DURATION OF EKG CHANGES IN PATIENTS WITH UNSTABLE ANGINA

Abstract&nbsp; INTRODUCTION: Chest pain in unstable angina is associated with EKG changes in T-wave and ST-segment, which may help diagnose the disease. Based on certain references EKG changes prolonged for more than 12 hours may be suggestive of non-Q myocardial infarction. This study was conducted to assess the mean duration of EKG changes in patients with unstable angina. methods: This cross-sectional study was conducted on 34 patients in 2001. The subjects were randomly selected among patients hospitalized in the critical care unit of Isfahan Nour Hospital. New ST-segment T-wave changes and ruling out of acute myocardial infarction by enzymatic tests (Total CPK, CPK-MB, LDH) constituted criteria of inclusion in the study. Subjects with Wolf-Parkinson-White syndrome (WFW), salivary diseases, those taking anti-arrhythmic, anti-angina, or digital medications, patients with left bundle branch block, and those who had recently undergone surgery (all of which may cause T-wave and ST-segment changes) were excluded from the study. The patients were followed up for three months after discharges. results: EKG changes persisted for 28.65&plusmn;7 days. Changes of ST-segment and T-wave lasted for 14.7&plusmn;24 and 30.1&plusmn;38 days, respectively. The minimum and maximum durations of EKG changes in patients were 1 day and 90 days, respectively. Eight patients underwent angiography; seven displayed abnormal findings. Statistical analysis did not show a significant relationship between the duration of EKG changes and severity of coronary involvement or incidence of future complications. Discussion: EKG changes in patients with unstable angina who have recently developed these changes may persist for an average duration of one month and may complicate diagnosis. Hence greater importance should be attached to clinical symptoms and further laboratory diagnostic methods should be used.Keywords . Myocardial infarction . ST-segment . T-wave . EKG changes</p