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Ralph Panos and William Eschenbacher

Open access

E. Veniou, I. Sofatzis, I. Kalantzis, M. Karakosta, M. Logothetis, E. Lianos and N. Ziras

-kB transcription factor that plays an important role in the immune response and inflammation of the adipose tissue. Dead adipocytes release free fatty acids, which through the mediation of toll-like receptor-4 (TLR-4) and the activation of NF-kB lead to the formation of ROS and the production of pro-inflammatory cytokines from stimulated macrophages. These cytokines generate further lipolysis and release of free fatty acids, thus establishing a feedback mechanism of sustained inflammation. Inflammation has been associated with various cancers such as stomach, pancreas

Open access

Maha I. A. Moaty, Salwa M. El Shebini, Nihad H. Ahmed, Ahmed M. S. Hussein, Magda S. Mohamed, Salwa T. Tapozada and Laila M. Hanna

Abstract

AIM To investigate the association between the circulating vaspin concentration and both of glucose homeostasis and insulin resistance in metabolic syndrome (MetS) patients, and also to evaluate the metabolic impact of two different dietary therapies on such conditions.

MATERIALS AND METHODS Fifty eight obese female volunteers suffering from MetS, followed a specially designed dietary therapy consists of a low caloric balanced diet, accompanied by either 30% doum biscuits (group A), or whole wheat biscuits (group B) for four weeks (phase 1). During the next four weeks, they were continued on the hypocaloric diet alone (phase 2).

RESULTS The health effects of two dietary therapies were more prominent in improving the biochemical markers of the MetS than in the body weight reduction. The lower levels of serum vaspin were significantly increased at the end of the 1st phase in both groups especially group (A). Sustained negative correlations were detected between vaspin level and both of C-peptide and insulin resistance expressed as modified homeostatic model assessment (M.HOMA).

CONCLUSION The effect of the dietary supplements may play a role in alleviating the impact of the components of the MetS and may also sustain the level of the vaspin in the sensitization of the C-peptide in order to attain glucose homeostasis.

Open access

Maha I. A. Moaty, Salwa M. El Shebini, Magda S. Mohamed, Nihad H. A. El-Arabi, Salwa T. Tapozada and Laila M. Hanna

Abstract

Aim: To investigate the relation between the metabolic syndrome (MetS), and oxidized low density lipoprotein (ox-LDL) and non-high density lipoprotein cholesterol (non-HDL-C), and to evaluate a dietary therapy composed of a balanced hypocaloric regimen plus a supplement prepared from whole wheat and tigernut flour (Cyperus Esculentus).

Material and Methods: Forty two obese Egyptian female volunteers (their mean age was 47.76± 0.90) were given a low caloric balanced diet (900-1000 kcal) for 4 weeks, and then the supplement was used to replace Baladi bread during the next four weeks. The metabolic syndrome was diagnosed according to the International Diabetes Federation criteria.

Results: The prevalence rate of MetS was found to be 76.2%.The metabolic syndrome was significantly associated with higher levels of total cholesterol (T.cholesterol), LDL-C, ox-LDL and non HDL-C. Significant and sustained reduction in the levels of fasting blood glucose and HbA1c, normalization of lipid profile, and decrease in the levels of ox-LDL were observed after the end of the two periods of the dietary therapy.

Conclusion: Metabolic syndrome is associated with higher levels of circulating ox-LDL and non-HDLC. The use of the dietary therapy composed of balanced hypocaloric regimen plus a supplement rich in antioxidants and anti-inflammatory components, reduced obesity and the risky biochemical markers of the MetS.

Open access

Meri Kirijas, Slavica Hristomanova, Dejan Trajkov, Milanka Pajkovska, Berislav Kostov and Mirko Spiroski

Abstract

Aim: To investigate the relation between the metabolic syndrome (MetS), and oxidized low density lipoprotein (ox-LDL) and non-high density lipoprotein cholesterol (non-HDL-C), and to evaluate a dietary therapy composed of a balanced hypocaloric regimen plus a supplement prepared from whole wheat and tigernut flour (Cyperus Esculentus).

Material and Methods: Forty two obese Egyptian female volunteers (their mean age was 47.76± 0.90) were given a low caloric balanced diet (900-1000 kcal) for 4 weeks, and then the supplement was used to replace Baladi bread during the next four weeks. The metabolic syndrome was diagnosed according to the International Diabetes Federation criteria.

Results: The prevalence rate of MetS was found to be 76.2%.The metabolic syndrome was significantly associated with higher levels of total cholesterol (T.cholesterol), LDL-C, ox-LDL and non HDL-C. Significant and sustained reduction in the levels of fasting blood glucose and HbA1c, normalization of lipid profile, and decrease in the levels of ox-LDL were observed after the end of the two periods of the dietary therapy.

Conclusion: Metabolic syndrome is associated with higher levels of circulating ox-LDL and non-HDLC. The use of the dietary therapy composed of balanced hypocaloric regimen plus a supplement rich in antioxidants and anti-inflammatory components, reduced obesity and the risky biochemical markers of the MetS.

Open access

I. Roubou and D.K. Alexopoulou

Abstract

Background: Innovation is one of the most difficult words to define, especially when it comes to health technology. The aim of this article is to get a better understanding of the multi-dimensional facet of innovation, how this is valued by different stakeholders and the way forward in order to create innovative interventions for the sake of the patients and the society.

Methods: A literature search was performed using mainly the PubMed database and reports from various organisations (EFPIA, etc.).

Results: In the past, innovation in the pharmaceutical industry was the result of the findings of basic science translated into clinical compounds, ending up in marketed drugs. This model is not valid anymore since significant changes reshaped the drivers of innovations and the key players. Rising costs, increased competition, new scientific and technological developments, well-informed patients created a much more challenging environment where coordinated and committed collaboration seemed to be the only way to overcome these obstacles and reach innovation in order to discover, develop and deliver medicines to patients.

Conclusions: Innovation initiatives have already proved their value by providing solutions to the major challenges the industry faces. It is now clear that a healthy biomedical ecosystem is determined by all stakeholders-academia, nonprofit/for-profit research institutions, government agencies, pharma/biotech industry and patients. Innovation initiatives provide the platform needed in which all stakeholders can meet and share their knowledge in order to deliver through innovation improved outcomes for patients while shaping an efficient and sustainable healthcare system.

Open access

A.H. Khoshab, P. Dumy and B. Kolarovszkl

Abstract

A prospective multicentral observational study of minimally invasive fusion to treat degenerative lumbar disorders, and to report outcomes of one or two level minimally invasive posterior lumbar interbody fusion (MLIF) for degenerative lumbar disorders in a multi-center 1-year prospective study. We prospectively studied a group of 32 patients, mostly female 24 ( 75% female ), and 8 males ( 25%). They underwent minimally invasive transforaminal lumbar interbody fusion (mTLIF), 21 of them monosegmental and 11 bisegmental. Patients demographics, intraoperative data and complications were recorded. Time to first ambulation, time to study-defined recovery, surgical duration, blood loss, fluoroscopy time and adverse events were recorded. Visual analogue scale (VAS) of back and legs pain, Oswestry disability index (ODI) and health-related questionnaire (EQ-5D) were assessed preoperatively and at defined time points through 12 months postoperatively. Mean surgical duration, blood loss and intraoperative fluoroscopy time were 125 vs.175 minutes, 150 vs. 170 ml, and 105 vs. 145 seconds in one- and twolevel segments, respectively. Mean preoperative VAS back (6.5) and VAS leg (7.9) scores dropped significantly (p<0.0001) to 3.5 (2.6) and 2.1 (2.0) at discharge (6 weeks). At the end, this is the largest prospective multi-center observational study of MLIF to date, following routine local standard of practice and, MLIF demonstrated favourable clinical results with early and sustained improvement in patient reported outcomes and low major perioperative morbidity.

Open access

John W. Nicholson

SUMMARY

The fluoride ion has a well-established beneficial role in dentistry in protecting the teeth from assault by caries. It is known to contribute to the dynamic mineralisation process of the natural tooth mineral, and also to become incorporated with the mineral phase, forming a thin layer of fluorapatite. This is more resistant to acid attack than the native hydroxyapatite, hence protects the tooth against further decay. Other recently discovered aspects of the role and uptake of fluoride will also be discussed.

One of the widely used dental restoratives, the glass-ionomer dental cement, is able to release fluoride in a sustained manner that may continue for many years, and this is seen as clinically beneficial. The closely related resin-modified glass-ionomer cement, and also the polyacid-modified composite resin (“compomer”) are able to do the same. There are also fluoride-containing conventional composite resins able to release fluoride.

These various materials are reviewed and the way in which they release fluoride are described, as well as the effectiveness of the release at the levels involved. Studies of effectiveness of fluoride release from these various classes of material are reviewed, and shown to suggest that release from conventional and resin-modified glass-ionomers is more beneficial than from composite resins. This is attributed to 2 causes: firstly, that it is not possible to replace the lost fluoride in composites, unlike glass-ionomers, and secondly because the other ions released from glass-ionomers (calcium, phosphate) are able to contribute to local remineralisation of the tooth. The absence of these other ions in fluoridated composites means that remineralisation is able to occur to a lesser extent, if at all.

Open access

Odusoga Osonuga and Ifabunmi Osonuga

Parasitaemia Changes in the Course of Treatment of Severe Malaria Patients with Artemether and Quinine (A Preliminary Study)

Background. Severe malaria is a medical emergency with devastating multisystemic effect, if not promptly treated with sensitive and safe drugs, death is imminent. Quinine and artemether are antimalaria drugs that are used in severe malaria.

Aim. Efforts in this study were directed at comparing parasitaemia changes in the cause of treatment of severe malaria patients with artemether and quinine in Ikenne local Government area of Ogun State, Southwest Nigeria.

Materials and Methods. Thirty two patients in the study were randomly assigned to receive either artemether or quinine under medical supervision. 32 patients were allocated into two groups. Patients in the quinine group were given 10 mg/kg body weight quinine in 5% dextrosesaline infusion intravenously 8 hour intervals but changed to oral quinine (10 mg/kg body weight, 8 hr intervals) for 7 days. The patients in artemether group received 1.6 mg/kg body weight twice at day 0 and then 1.6 mg/kg bwt daily intramuscularly for the next four days. The patients were then followed up for 14 days.

Results. The parasitological density in the study group ranged from 71,500/μl to 140,024/μl with a mean of 95,122.63 ± SD 16,044.7. The quinine group had a range of 71,500 to 108,400/μl with a mean of 89,425/μl ± SD 12,481.53. The artemether group had a range of 72,500 to 140,024/μl and a mean of 100,820/μl ± SD 17,520. There was statistical significance between the two groups (p<0.05). Parasite cleared in all patients by day 3 in quinine and artemether except in one patient in artemether group in whom parasitaemia cleared by day 7.

Conclusion. Results from this study indicated that artemether relative to quinine initiated a faster and sustained recovery from high parasitaemia level in the patients' blood.

Open access

Marica Pavkovic, Slobodanka Trpkovska-Terzieva, Tatjana Sotirova, Lidija Cevreska and Aleksandar Stojanovic

: efficacy and safety of rituximab for adults with idiopathic thrombocytopenic purpura. Ann Intern Med. 2007;146: 25-33. 19. Zaja F, Baccarani M, Mazza P, et al. Dexamethason plus rituximab yields higher sustained response rates than dexamethasone monotherapy in adults with primary immune thrombocytopenia. Blood. 2010;115: 2755-2762. 20. Bhagirath VC, Kelton JG, Moore J, Arnold DM. Rituximab maintenance for relapsed refractory thrombotic thrombocytopenic purpura. Transfusion. 2012 Apr 4. doi: 10.1111/j.1537-2995.2012.03635.x