Impact of atorvastatin reload on the prevention of contrast-induced nephropathy in patients on chronic statin therapy: A prospective randomized trial.

BACKGROUND: This trial aimed to assess the efficacy of Atorvastatin reloading on the prevention of Contrast-induced nephropathy (CIN) in patients pre-treated with this statin and undergoing coronary catheterization. METHODS: This was a prospective randomized controlled study including patients on chronic atorvastatin therapy. We randomly assigned the population to the Atorvastatin Reloading group (AR group), by reloading patients with 80 mg of atorvastatin one day before and three days after the coronary procedure, and the Non-Reloading group (NR group), including patients who received their usual dose without a reloading dose. The primary endpoints were the incidence of cystatin (Cys)-based CIN and Creatinine (Scr)-based CIN. The secondary endpoints consisted of the changes in renal biomarkers (Δ biomarkers) defined as the difference between the follow-up level and the baseline level. RESULTS: Our population was assigned to the AR group (n = 56 patients) and NR group (n = 54 patients). The baseline characteristics of the 2 groups were similar. Serum creatinine (SCr)-based CIN occurred in 11.1% in the NR group, and in 8.9% in the AR group without any significant difference. Cys-based CIN occurred in 37% in the NR group and 26.8% in the AR group without any significant difference. The subgroup analysis showed that high dose reloading had significantly reduced the CYC-based CIN risk in patients with type 2 diabetes (43.5% vs 18.8%, RR = 0.43. CI 95% [0.18-0.99])). The comparison of "Δ Cystatin" and Δ eGFR between the AR and NR groups didn't show any significant difference. However, cystatin C had significantly increased between baseline and at 24 hours in the NR group (0.96 vs 1.05, p = 0.001), but not in the AR group (0.94 vs 1.03, p = 0.206). CONCLUSIONS: Our study did not find a benefit of systematic atorvastatin reloading in patients on chronic atorvastatin therapy in preventing CIN. However, it suggested that this strategy could reduce the risk of CyC-based CIN in diabetic type 2 patients.

Iron Deficiency Anemia Is Associated with Proprioceptive Deficit in Adult Women: a Cross-Sectional Case-Control Study.

Proprioception is essential to several conscious and unconscious sensations and automatic control of movement in daily life activities. Iron deficiency anemia (IDA) may alter proprioception as it could induce fatigue, and affect neural processes such as myelination, and neurotransmitters synthesis and degradation. This study aimed to explore the effect of IDA on proprioception in adult women. Thirty adult women with IDA and 30 controls participated in this study. The weight discrimination test was performed to assess proprioceptive acuity. Attentional capacity and fatigue were evaluated, too. Women with IDA had a significantly (P < 0.001) lower ability to discriminate weights compared to controls in the two difficult increments, and for the second easy weight (P < 0.01). For the heaviest weight, no significant difference was found. Attentional capacity and fatigue values were significantly (P < 0.001) higher in patients with IDA compared to controls. Moreover, moderate positive correlations between the representative proprioceptive acuity values and Hb (r = 0.68) and ferritin (r = 0.69) concentrations were found. Moderate negative correlations were found between the proprioceptive acuity values and general (r = - 0.52), physical (r = - 0.65) and mental (r = - 0.46) fatigue scores, and attentional capacity (r = - 0.52). Women with IDA had impaired proprioception compared to their healthy peers. This impairment may be related to neurological deficits due to the disruption of iron bioavailability in IDA. In addition, fatigue resulting from IDA due to the poor muscle oxygenation could also explain the proprioceptive acuity decrease in women suffering from IDA.

Beneficial effects of Salvia officinalis essential oil on vanadium-induced testicular injury, DNA damage and histological alterations in Wistar rats.

Vanadium has been shown to catalyze the generation of reactive oxygen species. Since free radical production and lipid peroxidation are potentially important mediators in testicular physiology and pathophysiology, the present study was conducted to elucidate vanadium-induced oxidative damage in rat testis and the ameliorative role of Salvia officinalis essential oil (SEO) against the adverse effects of this heavy metal. Adult male Wistar rats were treated daily during 10 days either with ammonium metavanadate (5 mg/kg bw, intraperitoneally), SEO (15 mg/kg bw, orally) or their combination. A group of rats receiving daily a saline solution served as a negative control. Vanadium treatment induced a significant decrease in body and reproductive organ weights, serum testosterone level and sperm number and motility. An increase in lipid peroxidation and protein oxidation as well as a marked inhibition in the activities of antioxidant enzymes in the testes and seminal vesicles indicated the occurrence of oxidative stress after vanadium toxicity. Histopathological changes in testis and seminal vesicles were also observed following vanadium administration. However, co-administration of SEO to vanadium-treated rats resulted in an appreciable improvement of these parameters, emphasizing the therapeutic effects of SEO. It can be suggested that SEO mitigates vanadium-induced reproductive damage due to its antioxidant capacity. Thus, we can hypothesize that SEO supplementation could protect against vanadium poisoning.

Iron deficiency anemia induces postural control disorders in young women.

BACKGROUND: Due to menstruation and restrictive dietary practices, women are at a particular risk of iron deficiency anemia (IDA). This hematologic manifestation could impair postural control as it induces fatigue, muscle weakness, cognitive and neurological functions alteration. AIM: This study aimed to investigate IDA effects on postural control in young women in comparison to healthy counterparts. MATERIAL AND METHODS: Twenty-four young women with IDA and twenty-four controls participated in this study. Center of pressure (CoP) excursions, in the bipedal and semi-tandem postures on the firm and foam surfaces in the eyes opened (EO) and closed (EC), were recorded, and Romberg index was calculated to evaluate postural control. Besides physical performance, attentional capacity, fatigue, and heart and respiratory rates were assessed. RESULTS: Young women with IDA had significantly higher CoP velocity (CoPv) values in the bipedal posture in both vision and surface conditions (EO [firm: P < 0.001 and foam: P < 0.01]; EC: P < 0.001), as well as in the semi-tandem posture (EO [firm: P < 0.01 and foam: P < 0.001]; EC: P < 0.001) compared to controls indicating that they had worse postural control than their peers. In addition, values of the respiratory rate (P < 0.001), attentional capacity (P < 0.001), physical performance (P < 0.001), fatigue (P < 0.001), and Romberg index on the foam surface in both postures (P < 0.05) were significantly higher in young women with IDA compared to controls. CONCLUSIONS: Physical performance, fatigue, tachypnea and attentional capacity resulting from IDA may explain postural control disorder in young women.

The value of sepsis biomarkers and their kinetics in the prognosis of septic shock due to bacterial infections.

INTRODUCTION: In this study, we aim to explore the value of procalcitonin (PCT), C-reactive protein (CRP), and serum cholinesterase (SChE) activity kinetics as useful predictors of mortality in patients with septic shock admitted to the intensive care unit (ICU). MATERIAL AND METHODS: We conducted a prospective single-blinded study in the ICU of a university hospital during a period of 1 year. Were included all patients 18 years of age or older, with confirmed septic shock. For all included patients, blood samples of septic biomarkers (PCT, SChE activity, and CRP) were obtained. Serum was collected at the day of ICU admission (day 0), the day of septic shock (day 1), then 3 and 5 days after the septic shock development. RESULTS: During the study period, 60 patients were included. The mean age (± SD) was 47.7 ± 19 years. There were 46 male (74%) and 14 female (26%) patients. Mean SAPSII on ICU admission was 40.7 ± 16 (median: 37), and mean SOFA score on ICU admission was 16 ± 4 (median: 7). During their ICU stay, out of the 60 included patients, 37 patients died (61%). The comparison between the 2 groups (deaths and survivors) showed that the factors associated with poor outcome were age, SOFA score on ICU admission, and the need for invasive mechanical ventilation. The day of septic shock, there was no difference in the mean concentrations in those of plasma SChE activity or in the PCT and CRP plasma between survivors and non-survivors. However, the comparison of mean plasma SChE activity, and PCT and CRP plasma concentrations (on day 3 and day 5) between survivors and non-survivors, showed a significant difference between the 2 groups. CONCLUSIONS: Our study suggests that, in a group of critically ill patients with severe septic shock, a rise or no change in procalcitonin and/or CRP level, and/or a decrease or no change in SChE activity should warn the clinician about the insufficiency and/or inadequacy of the therapy. However, a fall in procalcitonin and/or CRP levels, and/or a rise in SChE activity were associated with a favourable prognosis. Based on our study and some other data detailed above, we recommend that an estimation of SChE acti-vity, procalcitonin, and CRP on the day of septic shock, followed by estimation within the next 72-120 h, could help the prognostic assessment of critically ill patients with septic shock. Further studies are needed to define the critical values related to mortality.

Anti-oxidant and hepatoprotective effects of Salvia officinalis essential oil against vanadium-induced oxidative stress and histological changes in the rat liver.

The present study was designed to evaluate the protective effects of Salvia officinalis essential oil (SOEO) against vanadium-induced hepatotoxicity in Wistar rats. Animals were divided into three groups: the first group served as the control (C), where rats received daily 0.5 mL of saline solution (0.9%) given by intraperitoneal (i.p.) way. Rats in the second group (V) received daily by i.p. way 5 mg/kg BW of NH4VO3 (V). Rats in the third group (SV) received daily V (5 mg/kg BW) by i.p. way and SOEO (15 mg/kg BW) by gavage. Animals were sacrificed after 4 or 10 days of treatment. Administration of V increased plasma ALT, AST, ALP, and LDH activities, and cholesterol, bilirubin, triglyceride, and NO levels in rats and reduced anti-oxidant enzyme activities in the liver. Treatment with SOEO significantly attenuated these changes. Moreover, the histopathological changes and the overexpression of Hsp72/73 proteins induced by V were significantly improved by SOEO. Therefore, our results suggested that SOEO could protect against V-induced oxidative damage in rat livers. The hepatoprotective effect of SOEO might be attributed to its modulation of detoxification enzymes and/or to its anti-oxidant and free radical scavenging effects.

Effects of estrogen deficiency on liver function and uterine development: assessments of Medicago sativa's activities as estrogenic, anti-lipidemic, and antioxidant agents using an ovariectomized mouse model.

We investigated the effects of Medicago sativa supplementation on the lipid profiles and antioxidant capacities of ovariectomized mice.The study was performed on white Swiss female mice that were divided into five groups: control, treated with Medicago sativa (0.75 g/kg/day), ovariectomized, ovariectomized treated with ß-estradiol (1 µg/day) or with Medicago sativa. The mice were sacrificed after 3 and 8 weeks of treatment.Ovariectomy induced a decrease in overall growth, uterine atrophy, and hyperlipidemia demonstrated by increased cholesterol, triglycerides, and decreased HDL. We have shown the involvement of oxidative stress in this hepatic lesion proven by increased levels of TBARS, GPX, and GSH, and decreased levels of SOD and catalase.Treatment with Medicago sativa restores lipid balance, the activity of antioxidant enzymes and improves lipid peroxidation. This is probably due to the richness of this plant in polyphenols and flavonoids considered as an antioxidant and phytoestrogenic elements.

Salvia officinalis mitigates uterus and liver damages induced by an estrogen deficiency in ovariectomized rats.

The present study evaluated the antioxidant activity of Salvia officinalis (sage) and its protective effect on estrogen deficiency in ovariectomized rats. Female Wistar rats were treated during either 15 or 30 days as follows: group C: negative controls, group S: positive controls treated with sage leaves, ovariectomized rats (group OVX) and ovariectomized rats receiving either sage (OVX-S) or hormonal (Group OVX-E) treatments, respectively. After 15 and 30 days of treatments, OVX rats showed a gain in body weight and an increase of absolute and relative liver weights. Meanwhile, absolute and relative uterus weights were decreased. Moreover, ovariectomy altered plasma transaminases' activities, lipid profile, and disrupted the redox status of liver and uterine tissues. It affected also the reproductive tract by decreasing the uterus glycogen content and plasma LDH activity. Supplementation of sage via the diet reduced weight gain and oxidative stress resulting from estrogen deficiency. PRACTICAL APPLICATIONS: During menopause, sexual hormone deficiency, especially estrogen, causes several morphological and physiological disturbances in liver and uterus tissues. In fact, the body weight gain and disturbances of redox status in liver and uterus were the main health problems detected after menopause. Sage leaves, used as medicinal plant, exerted its beneficial effects in the management of menopause disorders. As an important source of antioxidants, sage leaves could prevent obesity and oxidative damage in the liver and uterus resulting from estrogen deficiency.

Effects of natural polyphenol-rich pomegranate juice supplementation on plasma ion and lipid profiles following resistance exercise: a placebo-controlled trial.

BACKGROUND: Pomegranate juice (POMj) contains abundant soluble polyphenolic antioxidant compounds and is recommended for its cardioprotective/atheroprotective properties. However, very few studies have investigated the efficacy of POMj supplementation to alter physiological responses during intensive physical exercise. This placebo-controlled study aimed to examine whether supplementation with natural polyphenol-rich-POMj could influence the ionic or lipid responses to an intensive resistance training session in elite athletes. METHODS: Nine elite weightlifters (21 ± 1 years) performed two Olympic-weightlifting sessions after ingesting placebo and POMj supplements. Venous blood samples were collected at rest and 3 min after each session for assessment of plasma sodium ([Na+]), potassium ([K+]), chloride ([Cl-]), calcium ([Ca2+]), triglyceride ([TG]) and high-density lipoprotein ([HDL-C]), low-density lipoprotein ([HDL-C]) and total ([TC]) cholesterol concentrations. RESULTS: Plasma [K+] and [TG] were lowered post-exercise compared to resting values in the PLA condition (p = 0.03 for K+ and p = 0.02 for TG) with no pre-to-post exercise differences in the other plasma ion and lipid markers (p > 0.05). Compared to rest, plasma [Na+] and [Cl-] were increased (p = 0.04, %change = 4.10% for Na+ and p = 0.02, %change = 4.44% for Cl-), but there were no differences in the other plasma ion or lipid markers post-exercise after POMj supplementation (p > 0.05). Post-exercise plasma [Na+], [Cl-], and [HDL-C] were greater following POMj supplementation compared to PLA (p = 0.01 for Cl- and HDL-C, p = 0.02 for Na+, and p = 0.04 for TC), with no between-supplement post-exercise differences in the other ion and lipid markers (p > 0.05). CONCLUSION: In conclusion, supplementation with POMj has the potential to attenuate the acute imbalance of plasma [K+] and to improve blood lipid responses (i.e., HDL-C) following resistance exercises in elite weightlifters. However, further large research in both athletic and non-athletic populations is needed to corroborate these preliminary observations and to elucidate the potential underlying mechanisms and translational potential of our novel observations. TRIAL REGISTRATION: Name of the registry:ClinicalTrials.gov PRSThe registration number:NCT02697903.Date of Registry: 03/03/2016 'Retrospectively registered'.The registration title: Pomegranate Improve Biological Recovery Kinetics in Elite Weightlifter.

The protective effects of Salvia officinalis essential oil compared to simvastatin against hyperlipidemia, liver, and kidney injuries in mice submitted to a high-fat diet.

The present study was undertaken to evaluate the effects of Salvia officinalis essential oil (SEO) and simvastatin in hyperlipidemic mice. Animals were randomly divided into four groups. The control group received a standard diet. The high-fat diet (HFD) group received HFD. The third and fourth groups received HFD associated either with simvastatin (2.5 mg/kg bw) or with SEO (4 mg/kg bw). All animals were sacrificed after 8 weeks of treatment. SEO and simvastatin reduced in HFD mice body weight gain, hyperlipidemia, disruption of liver and renal functions and reactive oxygen species production. In fact, total cholesterol, triglycerides, total lipids, and low-density lipoprotein cholesterol levels, as well as aspartate transaminase, alanine transaminase, gamma-glutamyltranspeptidase and lactate dehydrogenase activities were reduced, while fecal lipids increased compared to those of HFD mice. The lipid-lowering effect of SEO was more effective than that of simvastatin. PRACTICAL APPLICATIONS: High-fat diet provokes hyperlipidemia, atherosclerosis, and abnormal lipid metabolism leading to the development of hepatic and renal dysfunctions as well as perturbations of the antioxidant status in liver and kidney. The results of this research highlight the beneficial effects of SEO in the management of these disorders without inducing side effects; in fact, the plant essential oil decreased lipids and improved the antioxidant status more than did a synthetic drug.

Effects of pomegranate supplementation on exercise performance and post-exercise recovery in healthy adults: a systematic review.

The functional significance of pomegranate (POM) supplementation on physiological responses during and following exercise is currently unclear. This systematic review aimed (i) to evaluate the existing literature assessing the effects of POM supplementation on exercise performance and recovery; exercise-induced muscle damage, oxidative stress, inflammation; and cardiovascular function in healthy adults and (ii) to outline the experimental conditions in which POM supplementation is more or less likely to benefit exercise performance and/or recovery. Multiple electronic databases were used to search for studies examining the effects of POM intake on physiological responses during and/or following exercise in healthy adult. Articles were included in the review if they investigated the effects of an acute or chronic POM supplementation on exercise performance, recovery and/or physiological responses during or following exercise. The existing evidence suggests that POM supplementation has the potential to confer antioxidant and anti-inflammatory effects during and following exercise, to improve cardiovascular responses during exercise, and to enhance endurance and strength performance and post-exercise recovery. However, the beneficial effects of POM supplementation appeared to be less likely when (i) unilateral eccentric exercise was employed, (ii) the POM administered was not rich in polyphenols (<1·69 g/l) and (iii) insufficient time was provided between POM-ingestion and the assessment of physiological responses/performance (≤1 h). The review indicates that POM has the potential to enhance exercise performance and to expedite recovery from intensive exercise. The findings and recommendations from this review may help to optimise POM-supplementation practice in athletes and coaches to potentially improve exercise-performance and post-exercise recovery.

Effects of Pomegranate Juice Supplementation on Oxidative Stress Biomarkers Following Weightlifting Exercise.

The aim of this study was to test the hypothesis that pomegranate juice supplementation would blunt acute and delayed oxidative stress responses after a weightlifting training session. Nine elite weightlifters (21.0 ± 1 years) performed two Olympic-Weightlifting sessions after ingesting either the placebo or pomegranate juice supplements. Venous blood samples were collected at rest and 3 min and 48 h after each session. Compared to the placebo condition, pomegranate juice supplementation attenuated the increase in malondialdehyde (-12.5%; p < 0.01) and enhanced the enzymatic (+8.6% for catalase and +6.8% for glutathione peroxidase; p < 0.05) and non-enzymatic (+12.6% for uric acid and +5.7% for total bilirubin; p < 0.01) antioxidant responses shortly (3 min) after completion of the training session. Additionally, during the 48 h recovery period, pomegranate juice supplementation accelerated (p < 0.05) the recovery kinetics of the malondialdehyde (5.6%) and the enzymatic antioxidant defenses compared to the placebo condition (9 to 10%). In conclusion, supplementation with pomegranate juice has the potential to attenuate oxidative stress by enhancing antioxidant responses assessed acutely and up to 48 h following an intensive weightlifting training session. Therefore, elite weightlifters might benefit from blunted oxidative stress responses following intensive weightlifting sessions, which could have implications for recovery between training sessions.

Cystatin C: A prognostic marker after myocardial infarction in patients without chronic kidney disease.

AIMS: Cystatin C is an endogenous marker of renal function. It is a well established better marker of glomerular filtration rate than serum creatinine. There is also evidence that cystatin C is associated with atherosclerotic disease. The present prospective study evaluated the prognostic value of cystatin C after myocardial infarction in patients without chronic kidney disease. METHODS AND RESULTS: A total of 127 patients who underwent coronary angiography after an acute coronary syndrome (ACS) were included. Cystatin C was associated with the severity of coronary artery disease (CAD). Cystatin C levels were significantly higher in patients with 3-vessels disease and severe CAD according to GENSINI score (p = 0.01 and p < 0.001 respectively). Among the patients admitted for ST elevation myocardial infarction, Cystatin C concentration was correlated with the initial TIMI flow in the culprit artery (p < 0.001). Mean duration of the follow-up period was 10.76 ± 2.1 months. High Cystatin C concentrations were associated to the occurrence of unfavourable outcomes and cardiovascular mortality during follow-up (1.19 ± 0.4 vs. 1.01 ± 0.35 mg/L, p = 0.01 and 1.21 ± 0.36 vs. 0.96 ± 0.27 mg/L, p = 0.03). Among different laboratory parameters, cystatin C was the best marker to predict the occurrence of major adverse cardiovascular events during the follow-up (Area under the receiveroperating characteristic curve = 0.743). CONCLUSION: High cystatin C levels are associated with the severity of coronary artery disease in patients presenting an acute coronary syndrome and a normal renal function. Cystatin C is also associated to unfavourable cardiovascular outcomes during follow-up and appears as a strong predictor for risk of cardiovascular events and death.

Antihyperlipidemic and Antioxidant Activities of Edible Tunisian Ficus carica L. Fruits in High Fat Diet-Induced Hyperlipidemic Rats.

The phenolic constituents of the aqueous-ethanolic extract of Tunisian Ficus carica (F. carica) fruit (FE) and its antihyperlipidemic and antioxidant activities in high-fat diet-induced hyperlipidemic rats (HFD) were evaluated. The obtained results demonstrated that the FE improved the lipid profile by decreasing the total cholesterol, triglyceride, low-density lipoprotein cholesterol and increasing high-density lipoprotein cholesterol levels. It also reduced the content of thiobarbituric acid-reactive substances and increased the antioxidant enzymes in liver, heart and kidney in HFD-fed rats. These antihyperlipidemic effects and in vivo antioxidative effects correlated with the in vitro phenolic content scavenging ability. Thus, the major phenolic compounds were identified using reversed-phase ultra-high-performance liquid chromatography (RP-UHPLC) coupled with two detection systems: diode-array detection (DAD) and quadrupole time-of-flight (QTOF) mass spectrometry (MS). Therefore, in the negative ionization mode, 28 phenolic compounds, including hydroxybenzoic acids, hydroxycinnamic acids, flavanoids and hydroxycoumarins were characterized. Dihydroxybenzoic acid di-pentoside, the flavonol quercetin 3-O-rutinoside and the flavone assigned as apigenin 8-C-glucoside were the main representative compounds in 'Tounsi' fruits. This work was complemented by the detection of seven other phenolic compounds in the positive ionization mode, including anthocyanins and furanocoumarins. Overall, these results have shown that the FE has a significant hypocholesterolemic effect and antioxidant activity in HFD-fed rats. This beneficial effect may be partly due to these phenolic constituents, especially vitexin, dihydroxybenzoic acid di-pentoside as well as rutin.

Cholesterol regulatory effects and antioxidant activities of protein hydrolysates from zebra blenny (Salaria basilisca) in cholesterol-fed rats.

This study aims to explore the hypocholesterolemic effects and antioxidative activities of zebra blenny protein hydrolysates (ZBPHs) in rats fed with a hypercholesterolemic diet. The rats were fed during eight weeks a standard laboratory diet (normal rats), a high-cholesterol diet (HCD) (1%) or a HCD and orally treated with ZBPHs or undigested zebra blenny proteins (UZBPs) (400 mg per kg per day). Results showed that a hypercholesterolemic diet induced the increase of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C). Treatment with ZBPHs increased the level of high-density lipoprotein cholesterol (HDL-C) and decreased significantly the levels of TC, TG, and LDL-C. In addition, ZBPH treatment showed significant normalization of thiobarbituric acid-reactive substance (TBARS) levels as well as catalase, superoxide dismutase (SOD), and glutathione peroxidase (GPx) activities in renal and hepatic tissues. Furthermore, ZBPHs may also exert significant protective effects on liver and kidney functions, evidenced by a marked decrease in the level of serum urea, uric acid, creatinine, alkaline phosphatase (ALP), and alanine aminotransferase (ALAT). Histological studies confirmed that ZBPHs effectively protected the livers and kidneys against hypercholesterolemia-mediated oxidative damage. Therefore, the study strengthens the hypothesis that ZBPHs can be used as novel antioxidants and hypocholesterolemic compounds against hyperlipidemia induced atherosclerosis.

[Metabolic and inflammatory profiles in polycystic ovary syndrome associated to weight excess]. / Profils métabolique et inflammatoire dans le syndrome des ovaires polykystiques associé à l'excès pondéral.

Polycystic ovary syndrome (PCOS) and weight excess exhibited metabolic abnormalities and elevated cardiovascular risk. Our objective was to assess metabolic and inflammatory profiles in women with PCOS associated to weight excess; 85 women were enrolled. Four groups were then identified with and without PCOS and/or weight excess. Hyperlipidemia was significantly more observed in the two groups with weight excess. In whom insulinresistance and high sensitive C reactive protein were also elevated. Abnormalities observed when PCOS and weight excess are associated would mimic these observed in isolated weight excess with some particularities.