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OBJETIVO: Demonstrar a prevalência da hiperglicemia de estresse em coorte de pacientes com síndrome coronariana aguda e a correlação com óbito, insuficiência cardíaca e/ou disfunção ventricular esquerda sistólica, na fase intra-hospitalar. MÉTODOS: Estudo de coorte prospectiva inicial constituída por pacientes internados com síndrome coronariana aguda, com ou sem supradesnivelamento do segmento ST. Foram comparados os grupos para demonstrar a correlação entre hiperglicemia de estresse e eventos cardiovasculares. Na comparação entre os grupos com e sem hiperglicemia de estresse, foram usados o teste do qui-quadrado ou exato de Fisher, e o teste t de student. As variáveis com valor de pOBJECTIVE: To demonstrate the prevalence of stress hyperglycemia in a cohort of patients with acute coronary syndrome and to determine the correlation of stress hyperglycemia with death, heart failure and/or left ventricular systolic dysfunction during the intrahospital phase. METHODS: A prospective initial cohort study of hospitalized patients with acute coronary syndrome with or without ST segment elevation. The groups were compared to demonstrate the correlation between stress hyperglycemia and cardiovascular events. The chi-square test or Fisher's exact test and student's t-test were used to compare the groups with and without stress hyperglycemia. The variables with p

OBJETIVOS: O tempo de internação prolongado após cirurgia cardíaca é associado a resultados imediatos ruins e aumento dos custos. O objetivo deste estudo foi analisar o poder preditor do escore de Ambler na previsão do tempo de internação em unidade de terapia intensiva. MÉTODOS: Estudo de coorte retrospectiva com dados coletados de 110 pacientes submetidos à cirurgia de troca valvar isolada ou associada. Os valores do escore aditivo e logístico do escore de Ambler e as performances preditivas do escore de Ambler foram obtidos por meio da curva ROC. A estadia em unidade de terapia intensiva definiu-se como normal 3 dias. A área sobre as curvas dos modelos aditivo e logístico foram comparadas por meio do teste de Hanley-MacNeil. RESULTADOS: A média de permanência em unidade de terapia intensiva foi de 4,2 dias. Sessenta e três pacientes pertenciam ao sexo masculino. O modelo logístico apresentou área sob a curva ROC de 0,73 e 0,79 para internação >3 dias e 3 dias e OBJECTIVES: The length of stay after prolonged cardiac surgery has been associated with poor immediate outcomes and increased costs. This study aimed to evaluate the predictive power of the Ambler Score to anticipate the length of stay in the intensive care unit. METHODS: This was a retrospective cohort study based on data collected from 110 patients undergoing valve replacement surgery alone or in combination with other procedures. Additive and logistic Ambler Scores were obtained and their predictive performances calculated using the Receiver Operating Characteristic curve. The normal length stay in the intensive care unit was assumed to be 3 days. The areas under the receiver operating curves for both the additive and logistic models were compared using the Hanley-MacNeil test. RESULTS: The mean intensive care unit length of stay was 4.2 days. Sixty-three patients were male. The logistic model showed areas under the receiver operating characteristic curve of 0.73 and 0.79 for hospitalization > 3 days and < 3 days, respectively, showing good discriminative power. For the additive model, the areas were 0.63 and 0.59 for hospitalization > 3 days and < 3 days, respectively, a poor discriminative power. CONCLUSIONS: In our database, prolonged length of stay in the intensive care unit was positively correlated with the logistic Ambler score. The performance of the logistic Ambler Score had good discriminative power for correlation with the intensive care unit length of stay.

FUNDAMENTO: Trombólise e angioplastia transluminal coronariana (ATC) primária são técnicas bem estabelecidas, mas grande parte dos pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST (IAM com SST) não as recebem quando do atendimento hospitalar. OBJETIVO: Descrever tratamentos inicial e final e desfechos de uma coorte com IAM com SST. MÉTODOS: Analisados, da internação até a alta, 158 pacientes com IAM com SST, de uma população total de 351 pacientes internados com (SCA) nos hospitais de Campos dos Goytacazes, entre 2004 e 2006. RESULTADOS: Dos 158 pacientes com IAM com SST, 67,7% chegaram ao hospital nos primeiros 180 minutos, 81,3% em 360 minutos e 8,4% após doze horas. Realizados 148 estudos cinecoronariográficos (93,7%). Observadas lesões de mais de 70% em 266 territórios arteriais. Tratamento inicial foi ATC em 41(26%), trombolíticos em 50 (32%), com 80% de sucesso. Tratamento clínico em 67 (42%). Cerca de 35% dos pacientes deveriam ser trombolizados mas não o foram. No tratamento final foram 93 ATCs, 89 delas com sucesso angiográfico (95,7), sangramento 2 (2,2), oclusão subaguda 2 (2,2%), dissecção tronco 1 (1,1), pseudo aneurisma 1 (1,1). Nenhum óbito durante angioplastia; na evolução, houve dois óbitos (2,1%). Doze pacientes submetidos a cirurgia de revascularização miocárdica (CRM). Tratamento clínico 53 (33%), com 11 óbitos (20,7%). Letalidade global 9,5%, consideradas as três formas de tratamento. CONCLUSÃO: Pacientes atendidos em tempo adequado para reperfusão, porém 1/3 deles não recebeu o procedimento. Tratamento predominante foi ATC, com baixa morbidade. Dois óbitos na evolução. Baixa letalidade global.FUNDAMENTO: La trombólisis y la angioplastia transluminal coronaria (ATC) primaria son técnicas bien establecidas, sin embargo gran parte de los pacientes con infarto agudo de miocardio con supradesnivel del segmento ST (IAM con SST) no las reciben cuando de la atención hospitalaria. OBJETIVO: Describir los tratamientos inicial y final y los desenlaces de una cohorte con IAM con SST. MÉTODOS: Se analizaron, desde la internación hasta el alta, a 158 pacientes con IAM con SST, de una población total de 351 pacientes internados con (SCA) y los hospitales de la ciudad de Campos dos Goytacazes, entre 2004 y 2006. RESULTADOS: De los 158 pacientes con IAM con SST, un 67,7% ingresaron al hospital en los primeros 180 minutos, un 81,3% en 360 minutos y un 8,4% tras 12 horas. Se realizaron 148 estudios cinecoronariográficos (93,7%). Se observaron lesiones de más del 70% en 266 territorios arteriales. El tratamiento inicial consistió en ATC en 41(26%), trombolíticos en 50 (32%), con el 80% de éxito. Tratamiento clínico en 67 (42%). Se debería trombolizar alrededor del 35% de los pacientes pero no se lo hizo. En el tratamiento final fueron 93 ATCs, 89 de ellas con éxito angiográfico (95,7), sangrado 2 (2,2), oclusión subaguda 2 (2,2%), disección tronco 1 (1,1), pseudoaneurisma 1 (1,1). No hubo óbito durante la angioplastia; en la evolución, hubo dos óbitos (2,1%). Doce pacientes sometidos a cirugía de revascularización miocárdica (CRM). El tratamiento clínico 53 (33%), con 11 óbitos (20,7%). Letalidad global el 9,5%, consideradas las tres formas de tratamiento. CONCLUSIÓN: Se atendieron a los pacientes en tiempo adecuado para reperfusión, pero 1/3 de ellos no recibió el procedimiento. El tratamiento predominante fue ATC, con baja morbilidad. Dos fueron los óbitos en la evolución. Baja letalidad global.BACKGROUND: Although thrombolysis and primary CTA are well-established procedures, they are not administered in a large proportion of the patients with STEMI who arrive to the emergency rooms. OBJECTIVE: Describe initial and final the results in a cohort of STEMI patients METHODS: The study included, from hospital admission to the discharge, 158 patients diagnosed with STEMI, from a total of 351 patients with ACS admitted to hospitals in Campos dos Goytacazes, RJ, Brazil, between 2004 and 2006. RESULTS: Of the 158 patients with STEMI, 67.7% arrived to the hospital within 180 minutes, 81.3% within 360 minutes, and 8.4% after twelve hours from the symptoms. Cinecoronariographic studies (148) were performed (93,7%). Lesions of over 70% were observed in 266 artery territories. The initial treatment was CTA in 41 (26%), thrombolytics in 50 (32%), 80% of success. Clinical treatment in 67 (42%). Approximately 35% of the patients should have undergone thrombolysis, but they didn´t. During the final treatment, 93 CTAs were performed: 89 with angiographic success (95.7%), bleeding 2 (2.2%), subacute occlusion 2 (2.2%), trunk dissection 1 (1.1%), pseudoaneurism 1 (1.1%). No deaths during angioplasty; during evolution, there were two deaths (2.1%). Twelve patients underwent myocardial revascularization surgery (MRS), while 53 underwent clinical treatment, with 11 deaths (20.7%). Global lethality was 9.5%, considering the three types of treatment. CONCLUSIONS: Patients were suitable for reperfusion, but one third of them did not have the procedure. Two deaths during evolution. The most predominant treatment was CTA, with low morbidity. Low global lethality.

Abstract Background Point-of-care ultrasound (POCUS) is becoming more prevalent in recent years for evaluating patients presenting with musculoskeletal injuries in the emergency department (ED). This imaging modality has been utilized to diagnose soft tissue and bony injuries accurately, obtain appropriate consultation, and perform timely interventional procedures in the ED. Case presentation We present the case of a 55-year-old man who presented to the ED with significant left ankle pain following a ground-level fall. His physical examination showed swelling and tenderness around the ankle. POCUS examination aided the rapid and accurate detection of acute Achilles tendon rupture. Conclusion This case demonstrates that POCUS is a valuable diagnostic tool in evaluating patients with a suspected Achilles tendon rupture, especially in a resource-limited setting.

Opioid medications are the mainstay of pain management but present substantial side-effects such as respiratory depression which can be lethal with overdose. Most opioid drugs, such as fentanyl, act on opioid receptors such as the G-protein-coupled µ-opioid receptors (MOR). G-protein-coupled receptors activate pertussis toxin-sensitive G-proteins to inhibit neuronal activity. Binding of opioid ligands to MOR and subsequent activation G proteins βγ is modulated by regulator of G-protein signaling (RGS). The roles of G-proteins βγ and RGS in MOR-mediated inhibition of the respiratory network are not known. Using rodent models to pharmacologically modulate G-protein signaling, we aim to determine the roles of βγ G-proteins and RGS4. We showed that inhibition of βγ G-proteins using gallein perfused in the brainstem circuits regulating respiratory depression by opioid drugs results in complete reversal of respiratory depression. Blocking of RGS4 using CCG55014 did not change the respiratory depression induced by MOR activation despite co-expression of RGS4 and MORs in the brainstem. Our results suggest that neuronal inhibition by opioid drugs is mediated by G-proteins, but not by RGS4, which supports the concept that βγ G-proteins could be molecular targets to develop opioid overdose antidotes without the risks of re-narcotization often found with highly potent opioid drugs. On the other hand, RGS4 mediates opioid analgesia, but not respiratory depression, and RGS4 may be molecular targets to develop pain therapies without respiratory liability.

The present study evaluates oxidative stress markers in serum, brain and heart of albino Wistar rats after exposure to multiple transceiver mobile phone electromagnetic radiation, vibration and sound. Forty five (45) male albino Wistar rats weighing 140–180 g were randomly selected into nine groups (n = 5) viz; A serving as the control without mobile phone; groups B1, B2…E1, E2 were continuously exposed to electromagnetic field from double (1) and triple (2) transceiver mobile phone kept in various modalities with at least 10 min call per day within 9:00–21:00 h. Groups B1 and B2 were in silence mode, C1 and C2 in vibration, D1 and D2 in ring tone (sound), while E1 and E2 were in sound and vibration mode. After six weeks of exposure, the animals were sacrificed; serum, brain and heart were taken for oxidative stress assessment. Results showed that electromagnetic field radiation, vibration and sound from double and triple transceiver mobile phone cause decrease in the levels of glutathione peroxidase, superoxide dismutase, and malondialdehyde in the serum, heart and the brain. Catalase was observed to decrease only in the brain. Nitric oxide activities increased in the brain and heart of the treatment groups exposed to both phone types. Exposure to double or triple transceiver mobile phone radiation, vibration and sound causes oxidative stress to serum, brain and the heart. Keywords: Oxidative stress, Nitric oxide, Mobile phone electromagnetic radiation, Vibration and sound

Introduction: A dental visit provides the patient with an opportunity to discuss the habit of tobacco consumption and its detrimental effects on oral and general health. Cessation advice, as well as pharmacological therapy, has been used by health professionals to help patients quit tobacco use. Aim: To investigate the knowledge and practices of tobacco use cessation (TUC) interventions among final year students and interns in Chennai, India. Materials and Methods: A cross-sectional random sampling technique was used to collect information from final year students and interns, from four dental colleges in Chennai. Data regarding TUC interventions were obtained using a structured and self-administered questionnaire, comprising 30 questions. Results: A total of 53% and 47%, final year students and interns, respectively participated in the study. The response rate was 75%. Statistically significant associations were observed between the students' year of study and their views on the inclusion of TUC in clinical practice (P < 0.05) as well as the advice/interventions practiced by them (P < 0.05). Significantly higher proportions of interns, when compared to the final year students (P < 0.05) regarded periodontal disease as a symptom of tobacco consumption, agreed that tobacco use could cause implant failure, informed patients about the negative effects of smoking on oral health, discussed the ill-effects of passive smoking and admitted to helping their patients quit smoking. Conclusion: Several parameters related to TUC interventions were different among final year dental students and interns. This study reveals that significant numbers of dental students are not practicing any TUC methods in their routine dental curriculum which might help patients discontinue tobacco use.

The aim here is to define the values of French celebrity weeklies and the social identities they convey. More specifically, their alleged popularity is examined with respect to their democratic impact. Is the cult of celebrity a populist ideology per se ? Does it sanction the abuses generated by the « Society of the Spectacle » ? Or, insofar as it gives rise to new political practices, could it contribute to revitalize the public sphere ?

Through interviews with managers and senior executives of some of France’s celebrity weeklies, we first examine the structural constraints dictated to the editorial staff by both photo agencies and celebrities. Then we explore the “subjective sphere” and the “economies of worth” of gossip columnists, showing how they negotiate with their derogatory public image in order to give meaning to their professional role.

Metabolic syndrome (MetS) is a cluster of metabolic abnormalities affecting ~25% of adults and is linked to chronic diseases such as cardiovascular disease, cancer, and neurodegenerative diseases. Oxidative stress and inflammation are key drivers of MetS. Hesperidin, a citrus bioflavonoid, has demonstrated antioxidant and anti-inflammatory properties; however, its effects on MetS are not fully established. We aimed to determine the optimal dose of hesperidin required to improve oxidative stress, systemic inflammation, and glycemic control in a novel mouse model of MetS. Male 5-week-old C57BL/6 mice were fed a high-fat, high-salt, high-sugar diet (HFSS; 42% kcal fat content in food and drinking water with 0.9% saline and 10% high fructose corn syrup) for 16 weeks. After 6 weeks of HFSS, mice were randomly allocated to either the placebo group or low- (70 mg/kg/day), mid- (140 mg/kg/day), or high-dose (280 mg/kg/day) hesperidin supplementation for 12 weeks. The HFSS diet induced significant metabolic disturbances. HFSS + placebo mice gained almost twice the weight of control mice ( p < 0.0001). Fasting blood glucose (FBG) increased by 40% ( p < 0.0001), plasma insulin by 100% ( p < 0.05), and HOMA-IR by 150% ( p < 0.0004), indicating insulin resistance. Hesperidin supplementation reduced plasma insulin by 40% at 140 mg/kg/day ( p < 0.0001) and 50% at 280 mg/kg/day ( p < 0.005). HOMA-IR decreased by 45% at both doses ( p < 0.0001). Plasma hesperidin levels significantly increased in all hesperidin groups ( p < 0.0001). Oxidative stress, measured by 8-OHdG, was increased by 40% in HFSS diet mice ( p < 0.001) and reduced by 20% with all hesperidin doses ( p < 0.005). In conclusion, hesperidin supplementation reduced insulin resistance and oxidative stress in HFSS-fed mice, demonstrating its dose-dependent therapeutic potential in MetS.

Background: Citrus bioflavonoids are polyphenolic compounds that are derived from citrus fruits and vegetables. Although they are well known for their powerful antioxidant properties, their effects on glycemic control are not well understood. This review aims to highlight the potential benefits of using citrus bioflavonoids in patients with type 2 diabetes mellitus and its metabolic complications, as well as the medicinal effects of known subclasses of naturally occurring citrus bioflavonoids., Methods: In this systematic review, a survey of studies was conducted from January 2012 to February 2023 using various databases (PubMed, Medline, Google Scholar, and Scopus) to determine the effects of citrus bioflavonoid supplementation on reducing oxidative stress, improving lipid profiles, and glycemic index in patients with diabetes mellitus, as well as the proposed mechanisms of action., Results: The results of the survey indicate that citrus bioflavonoids may have a positive impact on reducing oxidative stress levels in patients with type 2 diabetes mellitus. In addition to reducing oxidative stress, citrus bioflavonoids may also have a positive impact on other markers of diabetes. For example, studies have shown that they can reduce non-enzymatic protein glycation, which is a process that occurs when glucose molecules bind to proteins in the body., Conclusion: The reduction in oxidative stress that can be achieved using citrus bioflavonoids may help to maintain antioxidant levels in the body, thereby reducing the severity of diabetes and its complications. These findings suggest that citrus bioflavonoids may be a useful complementary therapy for patients with diabetes., Competing Interests: Declaration of competing interest All authors declare no conflict of interest exist., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Acute kidney injury (AKI) is characterized by fast decline in renal function within a short period of time. Renal ischemic-reperfusion (I-R) injury is the main cause of AKI. This study aims to investigate the possible nephroprotective effect of lycopene on renal ischemic-reperfusion injury in mice model. Forty Swiss Albino adult male mice were randomly allocated onto one of the four study groups: sham group: mice had median laparotomy under anesthesia with no procedures performed, renal tissues and blood samples were collected. ischemic-reperfusion group (I-R-control): mice underwent median laparotomy under anesthesia, followed by 30 min bilateral renal ischemia. Renal tissues and blood samples were collected after 2 h from reperfusion. Vehicle-treated group: mice were pretreated with intra 1% dimethyl sulfoxide 30 min before inducing ischemia. Lycopene-treated group: mice were pretreated with 10 mg/kg intraperitoneal injection of lycopene 30 min before inducing renal ischemia. Renal tissues, and blood samples were collected after 2 h from reperfusion. Blood and tissue samples were collected to look for evidence of inflammation and necrosis. Blood urea nitrogen, serum creatinine as well as plasma NGAL levels were significantly increased in the active control group ( P  ≤ 0.05), when compared to the sham group. Similarly, renal levels of Notch2/Hes 1, TLR 2, IL-6, Bax, and F2-isoprostane were significantly increased in the active control group as compared to the sham group ( P  ≤ 0.05). Moreover, lycopene treatment was found to be significantly effective in reducing the increased levels of these markers after I-R injury ( P  ≤ 0.05)., Competing Interests: Conflict of interestThe authors declare that they have no potential conflict of interest., (© Association of Clinical Biochemists of India 2019.)

Aims: Diabetic nephropathy (DN) is a serious microvascular complication of a longstanding hyperglycemia. This study aims to evaluate whether urinary neutrophil gelatinase-associated lipocalin (NGAL) and urinary Interleukin-18 possess a better diagnostic value than albumin creatinine ratio in assessing the severity of nephropathy in patients with type 2 diabetes mellitus (T2DM)., Material & Methods: Ninety participants diagnosed with T2DM were recruited and they were divided into three study groups according to their albumin/creatinine ratio (ACR): (Normoalbuminuria group, Microalbuminuria group, and Macroalbuminuria group). A matching of Ninety healthy subjects were included as controls. Blood and urine samples were collected to measure various markers of glycemic control and kidney function., Results: IL-18 levels were not changed significantly between all study groups (P > 0.05), despite a significant positive correlation between IL-18 and urinary albumin levels. NGAL levels were significantly increased in Microalbuminuria group and Macroalbuminuria group as compared to the control and Normoalbuminuria groups. NGAL was also positively correlated with urinary albumin and ACR, but negatively correlated with the age and body mass index. Receiver Operating Characteristic curves revealed that for early detection of DN, the best cutoff values to discriminate DN and diabetic without nephropathy groups were ˃ 21.4 ng/ml for NGAL (94.67 sensitivity, 26.67% specificity), ≤0.34 pg/mL for IL-18 (72% sensitivity, 53.33% specificity), and ˃29.8 mg/g for ACR (80% sensitivity, 100% specificity)., Conclusion: We conclude that the urinary ACR is a more accurate individual biomarker of DN when compared to both NGAL and IL-18., (Copyright © 2018 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Acute kidney inschemia/reperfusion (I/R) injury is characterized by an abrupt loss of kidney function, resulting in the retention of urea and other nitrogenous waste products and in the dysregulation of extracellular volume and electrolytes. Despite the advances in therapeutic techniques, the mortality and morbidity of patients remain high and have not appreciably improved. This study aims to evaluate the potential protective effect of TAK-242 on renal ischemia/reperfusion injury using an animal model. Thirty-five adult male Sprague-dawely rats (weighing 200-300), were assigned randomly into the following experimental groups (n = 7 in each group), Control (I/R), Sham (negative control), TAK-242 (5 mg/kg body weight), TAK-242 (10 mg/kg body weight) and Vehicle (DMSO). Rats were exposed to a 30 min of ischemia then 3 h of reperfusion. At the end of reperfusion phase, rats were sacrificed then plasma, serum and tissue samples were obtained to measure markers of kidney oxidative stress and inflammation. Plasma levels of neutrophil gelatinase-associated lipocalin (NGAL), and tissue levels of interleukin-18 (IL-18) and malondialdehyde (MDA) were significantly lower in TAK-242 pretreated groups than the vehicle group and the control group (p < 0.05). Furthermore; serum levels of urea and creatinine were significantly lower in the TAK-242 pretreated groups as compared to the control group (p < 0.05). We conclude that administration of TAK-242 can be useful preventive method in attenuating the degree of acute kidney injury during ischemic reperfusion process as shown by a significant reduction of urinary inflammatory markers as well as significant reduction of urea and creatinine levels., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: This study aims to investigate the inflammatory response in Novolimus bioresorbable coronary scaffold implantation after a course treatment with trimetazidine (35mg tablet/twice daily for 4days)., Methods: This was a randomized single blind study. Forty diabetic patients with critical coronary stenosis were subjected to elective coronary scaffold implantation in Al-Najaf Center for Cardiac Surgery and Trans-Catheter Therapy, Najaf, Iraq, between January and July 2015. All patients were informed about the nature of the study and they signed the consent form before they included in the study. Patients were randomly allocated into the two study groups: Group 1 included 20 patients who did the elective coronary scaffold implementation without trimetazidine medication. Group 2 included 20 patients who did the elective coronary scaffold implementation with a course of the trimetazidine (35mg tablet/twice daily for 4days)., Results: There were significant reduction in the levels of the interleukin-6 and cardiac troponin-I in the trimetazidine-treated group (group 2) compared to the control group (group 1) (P<0.001), after 12h and 24h post-operative. This was associated with a significant rise in the levels of interleukin 10 in group 2 compared to group 1 (P<0.001). Pentraxin-3 was significantly reduced in group 2 but only 24h post-operative (P<0.006)., Conclusion: Our study concluded that trimetazidine minimizes the acute inflammatory response occurred due to systemic release of inflammatory markers into blood in diabetic patients undergoing elective Novolimus bioresorbable coronary scaffold implementation., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Aim: This study was done to illustrate the clinical and biochemical effects of ethinyl estradiol-cyproterone acetate (EE-AC) and metformin in this disease., Methods: This was a randomized control trial study, done on twenty-six female patients already diagnosed as cases of PCOS. Participants were divided into two study groups: group one (Group 1), received metformin of 500mg twice daily and the second group (Group 2), was given ethinyl estradiol-cyproterone acetate for 21 consecutive days followed by 7 days drug-free. The course of the treatment for both groups was continued for three consecutive months., Results: Group 1 showed a statistical significant increase in serum high density lipoprotein cholesterol (HDL-C) levels (P=0.006) and a decrease in the level of triglyceride (TG) (P=0.006). In addition, Group 1 had a significant reduction in the levels of very density lipoprotein cholesterol (VLDL-C) (P=0.006). Group 2 had a significant increase in serum TG levels (P=0.01), associated with a significant decrease in serum LDL-C (P=0.04). Serum testosterone was significantly reduced in group 1 (P=0.038). This was associated with an improvement in glucose tolerance test (GTT) and BMI in the same group (group 1). Group 2, had an improvement in the menstrual cycle control; hirsutism and acne., Conclusion: This study showed that metformin treatment is beneficial in improving serum lipids; glucose homeostasis and BMI, however, the ethinyl estradiol-cyproterone acetate is superior in improving the clinical manifestation of patients with PCOS, including menstrual cycle regulation, hyperandrogenic state., (Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Objectives: Studies have shown that people with type 2 diabetes mellitus (T2DM) may develop atherosclerosis due to the disturbance in oxidative control and progressive dyslipidemia. Our study aimed to highlight the benefits of simvastatin treatment in improving serum lipids and reducing oxidative damage in patients with T2DM., Methods: Our randomized control trial included 56 patients with T2DM and dyslipidemia. The participants were on glibenclamide (5mg/day) during the period of the study. The patients were divided into two study groups (groups 1 and 2). Group 1 was the control group and consisted of 31 patients. Group 2 consisted of 25 participants, who were given simvastatin 20mg tablet once daily for 12 weeks. The control group did not receive simvastatin. Both groups were followed-up for measurement of blood pressure, pulse rate, serum lipids, and parameters of oxidative stress., Results: The simvastatin treated group showed a significant improvement with reduced erythrocyte glutathione compared to the control group (p<0.001). This was also associated with a significant reduction in erythrocyte malondialdehyde in the simvastatin treated group compared to the control group (p<0.001). Serum lipids reflected a similar improvement in the levels of erythrocyte malondialdehyde., Conclusion: Our study highlights the beneficial role of simvastatin in improving the degree of oxidative stress in patients with T2DM through its effects on serum lipids and lipid peroxidation.

Background: Copper (Cu) is essential both for its role in antioxidant enzymes, like Cu/zinc (Zn) superoxide dismutase (SOD) and ceruloplasmin, as well as its role in lysyl oxidase, essential for the strength and integrity of the heart and blood vessels. With such a central role in cardiovascular health, Cu has been generally overlooked in the debate over improving our cardiovascular health. Cu deficiency has produced many of the same abnormalities present in cardiovascular disease. It seems almost certain that Cu plays a large role in the development of this killer disease, not because of its excess in the diet, but rather its deficiency., Aim: This study was undertaken to investigate the cardiovascular effects of Cu deficiency on the activity of SOD in patients with type 2 diabetes mellitus (T2DM) with and without diabetic nephropathy., Materials and Methods: Fifty-five patients with T2DM were recruited in this study which were divided into two subgroups based on the presence of microalbuminuria, the first group (microal buminuric group, n = 31) had a microalbuminuria between 30 and 299 μg/mg. The second group (normoal buminuric group, n = 29) had an albumin level less than 30 μg/mg. The two diabetic groups were compared to the control group (n = 37)., Results: The results of our study showed a significant reduction in the levels of SOD enzyme associated with an increased urinary Cu excretion in microalbuminuric group compared to the control group at P < 0.05., Conclusions: The current study illustrates that the regulation of the blood concentrations of Cu may be a potential therapeutic target for prevention and treatment of diabetic nephropathy.

Objective: To demonstrate the prevalence of stress hyperglycemia in a cohort of patients with acute coronary syndrome and to determine the correlation of stress hyperglycemia with death, heart failure and/or left ventricular systolic dysfunction during the intrahospital phase., Methods: A prospective initial cohort study of hospitalized patients with acute coronary syndrome with or without ST segment elevation. The groups were compared to demonstrate the correlation between stress hyperglycemia and cardiovascular events. The chi-square test or Fisher's exact test and student's t-test were used to compare the groups with and without stress hyperglycemia. The variables with p<0.20 in the univariate analysis were submitted to logistic regression., Results: In total, 363 patients with an average age of 12.45 ± 62.06 were studied. There was a predominance of males (64.2%). In total, 96 patients (26.4%) presented with stress hyperglycemia. There were no differences between the groups with or without stress hyperglycemia. The area under the ROC curve was 0.67 for the relationship between stress hyperglycemia and the composite outcome heart failure, left ventricular systolic dysfunction or death at the end of the hospital admission. The ROC curve proved that stress hyperglycemia was the predictor of the composite outcome (death, heart failure and/or ventricular dysfunction). The multivariate analysis did not indicate age, stress hyperglycemia or admission heart rate as risk factors., Conclusion: Stress hyperglycemia was common in the studied sample. In the univariate analysis, the presence of stress hyperglycemia was associated with such events as death, heart failure and/or intrahospital ventricular dysfunction in patients with acute coronary syndrome.

Background: Our study set out to determine the prevalence of depressive symptoms and variables that influence its presence in patients hospitalized for heart failure. Depression is associated with a substantially increased risk of developing heart failure in individuals at risk, and has been related to adverse outcomes in patients with established heart failure. It is important to determine its prevalence in different populations and assess related causes., Methods: We conducted a cross-sectional study of 103 patients with heart failure, admitted to public hospital, via a questionnaire that evaluates clinical variables, socio-demographics and we applied the Beck Depression Inventory to determine the prevalence of depressive symptoms and predictors of their presence. We used the chi2, Student test and considered significant when < 0.05 and subjected to logistic regression analysis when between 0.05 and 0.1., Results: The mean age of the patients in our study was 65.4 ± 13.6. Depressive symptoms were present in 69 (67%) patients: 35 (34%) had mild depressive symptoms, 22 (21.3%) had moderate symptoms and 12 (11.6%) patients presented severe symptoms. Marital status was significant when analyzed, and the predictors of depressive symptoms were marital status, sex, living arrangements and heart failure etiology., Conclusions: Because depressive symptoms in patients hospitalized for heart failure are very common, it is important to detect these disorders. The prevalence of these varies according to socio-demographic and clinical data, and these factors should be taken into consideration when planning future studies, as well as screening and intervention programs for co-morbid depressive disorders in hospitalized patients with heart failure.

Objectives: The length of stay after prolonged cardiac surgery has been associated with poor immediate outcomes and increased costs. This study aimed to evaluate the predictive power of the Ambler Score to anticipate the length of stay in the intensive care unit., Methods: This was a retrospective cohort study based on data collected from 110 patients undergoing valve replacement surgery alone or in combination with other procedures. Additive and logistic Ambler Scores were obtained and their predictive performances calculated using the Receiver Operating Characteristic curve. The normal length stay in the intensive care unit was assumed to be <3 days and prolonged >3 days. The areas under the receiver operating curves for both the additive and logistic models were compared using the Hanley-MacNeil test., Results: The mean intensive care unit length of stay was 4.2 days. Sixty-three patients were male. The logistic model showed areas under the receiver operating characteristic curve of 0.73 and 0.79 for hospitalization > 3 days and < 3 days, respectively, showing good discriminative power. For the additive model, the areas were 0.63 and 0.59 for hospitalization > 3 days and < 3 days, respectively, a poor discriminative power., Conclusions: In our database, prolonged length of stay in the intensive care unit was positively correlated with the logistic Ambler score. The performance of the logistic Ambler Score had good discriminative power for correlation with the intensive care unit length of stay.

Background: Although thrombolysis and primary CTA are well-established procedures, they are not administered in a large proportion of the patients with STEMI who arrive to the emergency rooms., Objective: Describe initial and final the results in a cohort of STEMI patients, Methods: The study included, from hospital admission to the discharge, 158 patients diagnosed with STEMI, from a total of 351 patients with ACS admitted to hospitals in Campos dos Goytacazes, RJ, Brazil, between 2004 and 2006., Results: Of the 158 patients with STEMI, 67.7% arrived to the hospital within 180 minutes, 81.3% within 360 minutes, and 8.4% after twelve hours from the symptoms. Cinecoronariographic studies (148) were performed (93,7%). Lesions of over 70% were observed in 266 artery territories. The initial treatment was CTA in 41 (26%), thrombolytics in 50 (32%), 80% of success. Clinical treatment in 67 (42%). Approximately 35% of the patients should have undergone thrombolysis, but they didn't. During the final treatment, 93 CTAs were performed: 89 with angiographic success (95.7%), bleeding 2 (2.2%), subacute occlusion 2 (2.2%), trunk dissection 1 (1.1%), pseudoaneurism 1 (1.1%). No deaths during angioplasty; during evolution, there were two deaths (2.1%). Twelve patients underwent myocardial revascularization surgery (MRS), while 53 underwent clinical treatment, with 11 deaths (20.7%). Global lethality was 9.5%, considering the three types of treatment., Conclusions: Patients were suitable for reperfusion, but one third of them did not have the procedure. Two deaths during evolution. The most predominant treatment was CTA, with low morbidity. Low global lethality.