Interplay of adipokines in the pathogenesis of essential hypertension: A comparative cross-sectional in Ghana

Background: The renin-angiotensin-system (RAS), endothelial dysfunction and sympathetic nervous system are mechanistic risk factors of hypertension. The study sought to elucidate the interplay of adipokines in the pathogenesis of essential hypertension.Methodology: This comparative cross-sectional study recruited 200 confirmed hypertensive patients from the KATH and 50 age-matched normotensives. Participants’ blood pressures, anthropometric and socio-demographic information were voluntarily obtained. Serum levels of adiponectin, leptin and resistin of the participants were quantified using the ELISA. Renal function, lipid profile and glycemic status of all subjects were also analyzed.Results: Hypertensive patients showed a significantly higher anthropometric indices of adiposity compared to normotensives, CI (p < 0.0001), BAI (p < 0.0001) and AVI (p = 0.002). Adiponectin levels (p < 0.0001) were significantly lower in the hypertensive relative to the normotensives. Furthermore, significantly higher concentrations of serum leptin (p = 0.016) and the leptin-adiponectin ratio (p = 0.001) were observed among the hypertensive compared to the normotensives. The study further observed a direct association between serum leptin and weight (r = 0.111, p = 0.022), BMI (r = 0.129, p = 0.009) and WHtR (r = 0.098, p = 0.045) but inverse relationship with height (r = -0.134, p = 0.006) among the hypertensive. Serum leptin has a significant negative correlation with HDL-C among the hypertensive (r = -0.174, p = 0.013). The fully aOR for hypertension as predicted by resistin and adiponectin were 1.12 (95% Cl, 1.02–1.25); p = 0.019) and 0.93 (95% Cl, 0.91–0.95); p = 0.0001) respectively.Conclusion: We found that elevations in serum levels of leptin and resistin, and low levels of adiponectin may play a role in the pathogenesis of essential hypertension. Therefore, adipokines may offer themselves as potential indices for early and accurate detection of high blood pressure. At the same time our presentresults also confirm the conclusions with respect to correlation of leptin and obesity. Further longitudinal studies in a larger population are warranted to investigate the physiological and pathological functions of adipokines in hypertension.Keywords: Adipokines, Hypertension, Leptin, Adiponectin, Resisti

Evaluation of individual and combined markers of urine dipstick parameters and total lymphocyte count as a substitute for CD4 count in low-resource communities in Ghana

We evaluated the individual and combined levels of urine dipstick and total lymphocyte count (TLC) as surrogate markers for CD4 count in a low-resource community in Ghana. This cross-sectional study recruited 200 HIV-infected patients from the Saint Francis Xavier Hospital, Assin Fosu, Ghana. Complete blood count, CD4 count, and urine dipstick analysis were measured for participants. The threshold values were determined as

A Canadian paediatric brain tumour consortium (CPBTC) phase II molecularly targeted study of imatinib in recurrent and refractory paediatric central nervous system tumours

PURPOSE: To evaluate the safety, efficacy and pharmacokinetics of imatinib in children with recurrent or refractory central nervous system (CNS) tumours expressing KIT and/or PDGFRA. METHODS: Nineteen patients aged 2-18 years, with recurrent or refractory CNS tumours expressing either of the target receptors KIT and/or PDGFRA (by immunohistochemistry) were eligible. Participants received imatinib orally at a dose of 440 mg/m(2)/day and toxicities and tumour responses were monitored. Serial blood and cerebrospinal fluid samples for pharmacokinetics were obtained in a subset of consenting patients. Frozen tumour samples were analysed retrospectively for KIT and PDGFRA gene amplification in a subset of patients for whom samples were available. RESULTS: Common toxicities were lymphopaenia, neutropaenia, leucopaenia, elevated serum transaminases and vomiting. No intratumoural haemorrhages were observed. Although there were no objective responses to imatinib, four patients had long-term stable disease (SD) (38-104 weeks). Our results suggest a possible relationship between KIT expression and maintenance of SD with imatinib treatment; KIT immunopositivity was seen in only 58% (11/19) of study participants overall, but in 100% of patients with SD at 38 weeks. All patient tumours showed PDGFRA expression. Pharmacokinetic data showed a high interpatient variability, but corresponded with previously reported values. CONCLUSIONS: Imatinib at 440 mg/m(2)/day is relatively safe in children with recurrent CNS tumours, but induced no objective responses. Demonstration of SD in previously progressing patients (KIT-expressing) suggests cytostatic activity of imatinib.info:eu-repo/semantics/publishedVersio

Liver iron overload assessment by T 2 magnetic resonance imaging in pediatric patients: an accuracy and reproducibility study

This is the peer reviewed version of the following article: Cheng, H. L.M., Holowka, S., Moineddin, R. and Odame, I. (2012), Liver iron overload assessment by T 2 magnetic resonance imaging in pediatric patients: An accuracy and reproducibility study. Am. J. Hematol., 87: 435-437. doi:10.1002/ajh.23114, which has been published in final form at https://doi.org/10.1002/ajh.23114. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.T2 magnetic resonance imaging (MRI) provides rapid quantification of liver iron content (LIC). The reciprocal of T2 is directly proportional to iron and has been calibrated against LIC. There has, however, been few independent validation of the T2 method in a clinical setting. In 100 MRI studies on 75 pediatric patients being investigated for liver iron overload, we assess the accuracy and reproducibility of T2-measured LIC, using regulatory approved T2-based FerriScan1 for reference measurements. Results from independent analyses by two observers demonstrated robust inter- and intra-observer agreement (intraclass correlation coefficient (ICC) 5 0.99 and 1.0, respectively). T2-measured and reference LIC were strongly correlated (r 5 0.94, P < 0.0001), with a regression slope of 0.97 over the range 0–25 mg Fe/g. The T2 technique is shown to be accurate and reproducible for rapid, non-invasive LIC quantification

Effect of dietary vegetable oil consumption on blood glucose levels, lipid profile and weight in diabetic mice: an experimental case—control study

BACKGROUND: Free fatty acids have been reported to impair insulin action; Dietary fat composition has been implicated in the development of insulin resistance as well as fasting glycaemia and type 2 diabetes mellitus. This work was designed to determine the benefits of consuming vegetable oils on the management of diabetes in diabetic mice. METHODS: Forty eight (48) maledb/db diabetic mice were randomly divided into eight groups of six. The first four groups were fed on chow (control), 10 % Red palm oil feed, 10 % groundnut oil feed, and 10 % coconut oil feed. The second four groups were fed similar to the first four groups but in addition were administered glibenclamide (2 mg/kg -wt i.p) daily at 8. AM. RESULTS: Plasma glucose in the diabetic mice was significantly reduced after consuming diets fortified with 10 % palm oil, groundnut oil and coconut oil and also in mice additionally treated with glibenclamide. In mice that were not treated glibenclamide, treatment with groundnut oil reduced total cholesterol and LDL-cholesterol and raised plasma HDL. Plasma triglycerides were unchanged. Palm oil and coconut oil had no effect on any of the plasma lipids. In mice that were treated glibenclamide, the control and palm oil treatment significantly reduced total cholesterol (p &lt; 0.05). The control, groundnut oil, palm oil and coconut oil significantly (p &lt; 0.05) reduced plasma LDL-cholesterol. HDL-cholesterol was raised in groundnut oil, and coconut oil. Plasma triglycerides were raised in only on groundnut oil. CONCLUSION: Ten percent fortified vegetable oil feeds (red palm oil, groundnut oil and coconut oil) significantly improved lipid profile and significantly reduced blood glucose in diabetic mice. Groundnut oil raised HDL and lowered LDL even in mice given glibenclamide but it did not lower total cholesterol in mice given glibenclamid

Accurate liver T2 measurement of iron overload: a simulations investigation and in vivo study

Purpose: To investigate the accuracy of T * 2 liver iron quan- tification using different curve-fitting models under varying acquisition conditions, and to compare in iron-overloaded patients the reliability of rapid T * 2 measurements against approved and slower T 2 protocols. Materials and Methods: Simulations were conducted to assess the influence of various factors on the accuracy of T * 2 measurement: curve-fitting model, signal-to-noise ratio (SNR), and echo time (TE) spacing. Fifty-four iron-over- loaded pediatric patients were assessed using a standard T 2 and two variations of T * 2 acquisitions. In both simulations and in vivo data, three analysis models were evaluated: monoexponential, constant offset, and truncated. Results: Simulations show the truncated model provides the best accuracy but is susceptible to underestimating high iron species under low SNR or high minimum TE. In contrast, the offset model tends to overestimate but main- tains the most reliable measurements across the relevant range of iron levels. Furthermore, a much lower SNR can be tolerated if the acquisition uses a low minimum TE. In vivo results confirm theoretical findings and show that T * 2 mea- surements can be as reliable as those from approved and slower T 2 protocols. Conclusion: Guidelines are provided on choosing an ap- propriate model under specific noise conditions and acqui- sition schemes to ensure accurate and rapid T * 2 liver iron quantification

Evaluation of Individual and Combined Markers of Urine Dipstick Parameters and Total Lymphocyte Count as a Substitute for CD4 Count in Low-Resource Communities in Ghana

We evaluated the individual and combined levels of urine dipstick and total lymphocyte count (TLC) as surrogate markers for CD4 count in a low-resource community in Ghana. This cross-sectional study recruited 200 HIV-infected patients from the Saint Francis Xavier Hospital, Assin Fosu, Ghana. Complete blood count, CD4 count, and urine dipstick analysis were measured for participants. The threshold values were determined as <350 cells/μl for CD4, <1200 cells/μl for TLC, and ≥+ on urine dipstick analysis. The mean age of participants was 43.09 years. Proteinuria ≥ + [aOR = 4.30 (3.0–18.5)], leukocyturia ≥ + [aOR = 2.91 (1.33–12.5)], hematuria ≥ + [aOR = 2.30 (1.08–9.64)], and TLC < 1200 cells/μl [aOR = 3.26 (3.94–15.29)] were significantly associated with increased risk of CD4 count < 350 cells/μl. Using the individual markers, the best substitute marker for predicting CD4 count < 350 cells/μl was proteinuria at a cutoff point ≥ 2++, AUC of 0.973, sensitivity of 97.6%, specificity of 100.0%, PPV of 100.0%, and NPV of 89.1%. A combination of ≤ 1200 TLC + ≥ 2++ (leukocyturia + proteinuria + hematuria) yielded an AUC of 0.980, sensitivity (72.8%), specificity (100.0%), PPV (100.0%), and NPV (97.9%). Proteinuria could serve as a noninvasive screening tool, but the combination of proteinuria, leukocyturia, hematuria, and TLC serves as a better substitute marker for CD4 count in monitoring the disease progression among HIV patients in low-resource communities