Oxidative status alteration during aerobic-dominant mixed and anaerobic-dominant mixed effort in judokas.

This study aimed to depict the oxidative status variation in judokas during aerobic-dominant mixed effort (AeDME) and anaerobic-dominant mixed effort (AnDME). It is to be expected that the sporting commitment of Judo is a stimulus of oxidative stress leading to the recruitment of antioxidant responses. Blood samples were collected from 17 athletes at rest, immediately after a training session (AeDME) and after a 5-min bout (AnDME). AeDME and AnDME caused significant increases in malondialdehyde (MDA) (p < 0.01 and p < 0.001 respectively) and glutathione (GSH) (p = 0.018 and p < 0.001 respectively). Blood thiol concentrations decreased following AeDME and AnDME (p < 0.001) whilst catalase decreased significantly after AnDME (p = 0.026) only. Uric acid increased significantly after AnDME than after AeDME (p = 0.047) while, conversely, total bilirubin was higher after AnDME than after AeDME (p = 0.02). We may ultimately summarize that AeDME and AnDME caused oxidative stress, higher in AnDME, and some antioxidant response slightly higher in AnDME compared to AeDME. In sports, monitoring of oxidative stress status is recommended as part of the training regimen.

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.

Case report: Management challenges of late diagnosed 17-alpha hydroxylase deficiency.

Herein we report the intriguing case of a 42-year-old woman presenting with grade three hypertension, severe hypokalemia and primary amenorrhea, which revealed to be the complete form of 17 alphahydroxylase deficiency. We also discuss the challenging therapeutic approach as well as the outcomes and the follow-up of this patient.

Prognostic Value of Serum Cholinesterase Activity in Severe SARS-CoV-2-Infected Patients Requiring Intensive Care Unit Admission.

We evaluated the prognostic value of serum cholinesterase (SChE) levels in SARS-CoV-2-infected patients requiring intensive care unit (ICU) admission. This is a retrospective study of severe, critically ill, adult COVID-19 patients, all of whom had a confirmed SARS-CoV-2 infection and were admitted into the ICU of a university hospital. We included all patients admitted to our ICU and whose SChE levels were explored on ICU admission and during ICU stay. One hundred and thirty-seven patients were included. There were 100 male and 37 female patients. The mean of SChE activity on ICU admission was 5,656 ± 1,818 UI/L (range: 1926-11,192 IU/L). The SChE activity on ICU admission was significantly lower in nonsurvivors (P < 0.001). A significant association between the SChE activity on ICU admission and the need for invasive mechanical ventilation was found. We also found a significant correlation between the SChE activity and other biomarkers of sepsis (C-reactive protein, procalcitonin, and leukocytes) on ICU admission and during the ICU stay. A significant correlation among SChE nadir value activity recorded during ICU stay, the occurrence of nosocomial infection, and the outcome of studied patients was found. Our study shows that the low SChE activity value is associated with a severe outcome. It might be used as a biomarker to aid in prognostic risk stratification in SARS-CoV-2-infected patients. Further studies for external validation of our findings are needed on this subject.

Effect of Artichoke (cynara scolymus) on cardiac markers, lipid profile and antioxidants levels in tissue of HFD-induced obesity.

Obesity plays a pivotal role in the insulin resistance disease, which is related to hypertension, hyperlipidemia, type 2 diabetes mellitus, and an increased risk of cardiovascular disease. The purpose of the present study was done to evaluate the effect of artichoke leaves extract (ALE) in the high-fat diet (HFD)-induced cellular obesity and cardiac damage in Wistar rats. Body and organ weights, serum lipid profile, cardiac markers, and antioxidants enzymes were measured. Oral administration of ALE at two doses 200 and 400 mg/kg for a period of 60 days showed a significant decrease in body and organ weights, serum total cholesterol, triglycerides, LDH, ALT accompanied by decreasing in oxidative stress biomarker (MDA, and AOPP) and increasing antioxidant enzymes (SOD, CAT, and GPx) levels as compared to HFD groups. The histological findings showed a cardioprotective effect of ALE. These findings suggest that ALE exert anti-oxidant cardiac effects in HFD- induced obese rats.

Preventive effect of Artichoke (Cynara scolymus L.) in kidney dysfunction against high fat-diet induced obesity in rats.

A high-fat diet (HFD) promotes oxidative stress, which contributes to the development of kidney dysfunction. We examined the protective effects of an ethanol extract of artichoke leaves (EEA) compared to Atorvastatin (ATOR) in the kidney of Wistar rats fed a high-fat diet. The experimental animals were divided into five groups: control (Cont), HFD, HFD treated with EEA (200 mg/kg), HFD treated with EEA (400 mg/kg), and HFD treated with ATOR. Organ weights, lipid profile, renal markers, and antioxidants enzymes were measured. Oral administration of EEA (200 and 400 mg/kg) for 60 days showed a significant decrease in organ weights and kidney markers levels accompanied by decreasing in oxidative stress biomarkers as compared to HFD groups. The histological findings showed a renoprotective effect of artichoke extract. These findings suggest that EEA exerts anti-oxidant kidney effects in HFD- induced obese rats.

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.

Testosterone and cortisol variation due to training and fight in judokas.

BACKGROUND: The aim of this study was to evaluate the effectiveness of judo workout by determining the testosterone (T) and cortisol (C) responses and their associations with the results of a judo fight. METHODS: A prospective study involved 17 judokas. Three blood samples were taken from each athlete: at rest, immediately after a 90 min training session and 72 hours later immediately after a 5 min fight, to evaluate T, C and lactic acid. RESULTS: Results showed no significant difference for T (P=0.17), C (P=0.51) or testosterone/cortisol (T/C) ratio (t = 0.901 (16), p =0.38) after training. A significant difference was found for the C (p =0.002) and the T/C ratio (p =0.04) after the fight. In contrast with the losers, the winner judokas reported a significant increase in the C (P=0.002) and T (P=0.013) concentrations at rest and after the fight. No significant difference was found for C (P=0.77) or T (P=0.43) at rest and after training. CONCLUSIONS: The "fight" effort induced more biological stress than the "training" effort. In addition, the cortisol response and the T/C ratio revealed an association with a subsequent victorious judo fight. Thus, the hormonal response, particularly the C concentration, to a training could allow the assessment of the readiness of judokas for a future competition. This new strategy can allow to better manage the capacity of judoka at the training for the sake of an improvement of performance during competitions.

Homozygous pArg610del Mutation Unusually Associated With Severe Delay of Growth in 2 Acid Sphingomyelinase Deficiency-affected Sibs.

BACKGROUND: Typically, patients with Acid Sphingomyelinase Deficiency (ASMD) because of p.Arg610del mutation, have mild phenotype with normal linear growth. OBSERVATION: We reported the case of 2 Tunisian brothers who have been referred for splenomegaly, polyadenopathies, pubertal, and growth delay. Molecular testing of SMPD1 gene revealed the presence of a homozygous p.Arg610del mutation. Lysosphingomyelin and its isoform-509 were both increased confirming ASMD for both cases. Growth hormone deficiency was highly suspected but growth hormone response after stimulating tests was acceptable for both patients. CONCLUSIONS: There is no correlation between phenotype-genotype in case of p.Arg610del mutation that could be associated to a severe delay of growth.

LC-MS/MS Analysis and Hepatoprotective Activity of Artichoke (Cynara scolymus L.) Leaves Extract against High Fat Diet-Induced Obesity in Rats.

Cynara scolymus L. (Artichoke) has been used for the treatment of metabolic disorders. The purpose of the present study was to investigate the hepatoprotective effect of Cynara scolymus leaves extract against a high fat diet (HFD) induced rats. This study investigated the most abundant phenolic compounds rich Cynara scolymus leaves extract and it is antihypercholesterolemic and antioxidative effects in vivo. The hypercaloric high fat diet (HFD) was treated with 200 mg/kg and 400 mg/kg of ethanol extract (EEA) from leaves of Cynara and atorvastatin (ATOR) (10 mg/kg/day) during an 8-week period. Lipid profile was measured and oxidative stress systematic in hepatic tissue was determined. Our data revealed that HFD-induced hepatic dysfunction manifested by significant abnormal levels of AST, ALT, ALP, LDH, and OCT was accompanied by increasing levels of oxidative stress biomarker (ROS, MDA, and AOPP) while decreasing in antioxidant status. Coadministration of EEA significantly reduced serum lipid profile and hepatic disorders which was confirmed to be histological by reducing the fatty liver deposition in hepatic lobule. These findings suggest that Cynara leaves exert antiobesity and antioxidant liver effects in HFD-induced obese rats.

Plasma Saturated and Monounsaturated Fatty Acids in Behçet's Disease.

BACKGROUND: Fatty Acid (FA) composition of serum has been associated with many markers of inflammation. In this study, we tried to examine plasma Saturated Fatty Acid (SFA) and Monounsaturated Fatty Acid (MUFA) composition in Behçet's Disease (BD) patients. The associations between the circulating FA levels and some markers of inflammation have also been investigated. METHODS: This study is a cross-sectional one. In fact, a total of 101 BD patients and healthy controls group of 99 subjects are enrolled. Gas Chromatograph equipped with a Capillary Split/Splitless Injector and flame ionization detector was used to analyze the plasma SFA and MUFA compositions. The high sensitivity C-Reactive Protein (hsCRP) and fibrinogen levels were measured using standard techniques. RESULTS: BD patients had significantly higher proportions of Mystiric Acid (MA), Palmitic Acid (PAM), Palmitoleic Acid (POA) and Stearoyl-CoA Desaturase (SCD)-16, compared to controls.The results revealed that patients with severe involvements had high levels of POA and total MUFA associated with higher SCD-16 activity compared to those with minor ones. The receiver operator characteristic curve analysis revealed that POA could well discriminate BD patients with severe clinical manifestations. In the bivariate analysis, hsCRP was found to be positively correlated with total SAFA and POA elongase activity index but negatively correlated with SCD-18 activity index. The STA, POA, elongase and SCD-16 activity index are correlated with fibrinogen. On the other hand, the multivariate analysis showed that POA remained associated with higher levels of hsCRP. CONCLUSION: Unfavourable plasma SFA and MUFA profile were reported in BD patients. POA, which is associated with higher plasma hsCRP level, may play a role in the pathogenesis of BD.

Association of hyperhomocysteinemia with genetic variants in key enzymes of homocysteine metabolism and methotrexate toxicity in rheumatoid arthritis patients.

OBJECTIVES: The study investigated the association between plasma homocysteine, folate and vitamin B12 with 5,10 methylenetetrahydrofolate reductase (MTHFR C677T and A1298C), thymidylate synthase (TYMS 2R â†’ 3R) and methionine synthase (MTR A2756G) polymorphisms and methotrexate (MTX) treatment and toxicity in Tunisian Rheumatoid arthritis (RA) patients. METHODS: A total of 185 patients with RA were included. Homocysteine (Hcy) was assessed by fluorescence polarization immunoassay, and folate and vitamin B12 were measured by chemiluminescence immunoassays. The genetic polymorphisms were analyzed by PCR or PCR-RFLP. Hyperhomocysteinemia (HHC) was considered for Hcy > 15 µmol/L. RESULTS: MTHFR C677T polymorphism was associated with HHC in RA patients (multi-adjusted OR, 95% CI 2.18, [1.07-4.57]; p = 0.031). No association was detected with the remaining polymorphisms. Plasma Hcy, folate, and vitamin B12 did not differ according to each polymorphism, or with MTX treatment or toxicity. However, HHC was more prevalent in patients with than those without MTX toxicity (32.7 vs. 16.7%; p = 0.035). CONCLUSIONS: The MTHFR 677TT genotype is an independent risk factor for HHC in Tunisians RA patients. HHC could be a useful marker of MTX toxicity in RA patients.

Acute and delayed responses of steroidal hormones, blood lactate and biomarkers of muscle damage after a resistance training session: time-of-day effects.

BACKGROUND: The present study aimed to investigate the effect of time-of-days (TOD) on some biochemical and hormonal responses after resistance training sessions. METHODS: Ten trained subjects (22±2 years) performed, in randomized order, three resistance-training-sessions at 7 a.m., 1 p.m. and 5 p.m. Each training-session included six upper and lower body resistance exercises with 3×10 repetitions. Blood lactate (Lac), creatine kinase (CK), lactate dehydrogenase (LDH), cortisol (C) and testosterone (T) were collected at rest, 3 min and 48 h after each-session. RESULTS: At rest, steroidal hormones were higher in the morning compared to the evening (P<0.01), whereas, no significant TOD effect on Lac, CK or LDH was observed. 3min after training, whatever the TOD, Lac, CK and T increased significantly (P<0.001). However, a significant decrease in C and a significant increase of T/C ratio were registered only after morning training. 3 min and even 48 h after training, the diurnal variations (i.e., morning to evening) of CK and C have been altered with higher early evening values of CK and lower one of C; whereas, T, Lac and LDH conserved their resting diurnal variation. Additionally, 48 h after the morning session, CK and T/C ratio remained elevated compared to the baseline levels. CONCLUSIONS: In conclusion, resistance exercises soliciting both lower and upper limbs seems to alter the diurnal variation of CK and C, to enhance the morning anabolism/catabolism status and to produce more favorable environment for muscular adaptation up to 48 h post-training.

Chemoprotective role of ethanol extract of Urtica urens L. against the toxicity of imidacloprid on endocrine disruption and ovarian morphometric in female rats, GC/MS analysis.

Imidacloprid (IMI) is a widely used in Tunisia and abroad, and high doses of IMI have been known to cause endocrine disruption. Some reports claim that Urtica urens L. (UU) can reduce toxicity thanks to it anti-inflammatory and antioxidant activities, but there is no scientific evidence justifying its use, which lets us think to its direct effect on the metabolism of the ovarian tissue. The present study was undertaken to evaluate the protective effect of UU against the toxicity of Confidor®, whose active substance is imidacloprid (IMI), in female rat, as well as the chemical compositions of UU ethanol (EtOH) extract by GC-MS. Female rats were divided into control group, 3 groups treated with IMI at 50, 200 or 300mg/kg/day and three groups co-treated with IMI (50, 200 or 300mg/kg/day)+100mg/kg/day of UU, for 60days. Blood samples were collected for the dosage of 17ß-estradiol levels. Ovaries were removed for tissular dosage of malondialdehyde (MDA), advanced oxidation protein products (AOPP), glutathione (GSH), vitamin E, catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx). Histological and histomorphometric examinations were performed as well. IMI caused an acute ovary injury, increased the ovary tissue levels of MDA and AOPP, and decreased the levels of GSH, vitamin E, and antioxidant enzyme activities. The number and the diameter of follicles were markedly diminished together with a reduction of the relative weight of ovaries. Compared with controls, the treated rats exhibited a significant reduction in serum 17b-estradiol levels. These results suggest an endocrine disruption by IMI which may interfere with ovarian follicles development in rat. The injection of UU EtOH extract improved the histological and all biochemical parameters cited above. In conclusion, IMI induced an acute ovary injury accompanied with disturbance of oxidant status and causes follicular atresia. Significant antioxidant activities were also observed in UU EtOH and a total of 31 compounds were identified. The injection of UU EtOH provided a significant protection which might be due to its antioxidant activities.

Value of Serum Cholinesterase Activity in the Diagnosis of Septic Shock Due to Bacterial Infections.

BACKGROUND: We aimed to investigate whether serum cholinesterase (SChE) activity can be helpful for the diagnosis of septic shock and to evaluate its usefulness in comparison with procalcitonin (PCT) and C-reactive protein (CRP). METHODS: A prospective single-blinded study conducted in an intensive care unit of university hospital. Patients were classified as having cardiogenic shock, septic shock, or hemorrhagic shock. We also included a control group without neither hemodynamic instability nor sepsis. For all included patients, SChE, PCT, and CRP were simultaneously sampled. RESULTS: The comparison of sepsis markers between all groups showed that the mean values of PCT and CRP were significantly higher in patients with septic shock. However, SChE activity was significantly lower in this group. The SChE activity was found to be more accurate than PCT and CRP for the diagnosis of septic shock. In fact, an SChE activity ≤ 4000 UI/L predicted the diagnosis of septic shock with a sensitivity of 78%, a specificity of 89%, a predictive negative value of 97%, and a predictive positive value of 65%. However, the prognostic value of SChE activity was poor in multivariate analysis. CONCLUSION: The SChE activity level was significantly decreased in patients with septic shock. However, its prognostic value is poor. Our results suggest that SChE activity is useful for the diagnosis of septic shock. Further studies are warranted to confirm our findings.

Effects of mental training on muscular force, hormonal and physiological changes in kickboxers.

BACKGROUND: The aim of the present study was to examine the effects of mental training on muscular force generation, hormonal alterations, and physiological adaptations in male trained kickboxers. METHODS: Fifty-three male trained kickboxers (24.2±4.4 years, 1.75±0.08 m and 70.4±10.2 kg) were randomly assigned to a physical-training group (PG; N.=20), physical and mental training group (PMG: N.=18, mental-training package [MTP] plus physical training] or control group (CG: N.=15). Physical fitness tests: countermovement jump (CMJ), medicine ball throw (MBT), bench press, and half-squat tests; hormones: resting cortisol (C) blood sample, plasma testosterone (T) concentration, and T/C ratio; and physiological variables: resting heart rate (HR), and blood pressure (BP) were assessed before training commenced (baseline) and at week 6 and 12 of training. RESULTS: PMG and PG improved performance in CMJ height (16.2%, 8.4%), MBT (27.9%, 14.2%), bench press (26.5%, 15.7%), half-squat (27.2%, 16.3%), T concentration (35.2%, 22.4%), and T/C ratio (60%, 0%, for PMG only), respectively. In contrast, the C concentration decreased for the PMG (16.3%) and increased for the PG (22%) after 12 weeks. The PMG and PG had significant decrease from pre- to post-training for the resting HR (9.1%, 3%, respectively) and BP (8.5%, 5.3%, respectively). Furthermore, there was a significant increase in MBT (9.3%) after 6 weeks in PMG. Outlined improvements (PMG and PG) were favorable compared to CG (P<0.05) in all instances. CONCLUSIONS: The greater muscular force generation in PMG than PG seem to be explained by the reduction of hormonal and physiological stress after 12 weeks.

Antioxidative/oxidative effects and retarding osteoconductivity of ciprofloxacin-loaded porous polyvinyl alcohol/bioactive glass hybrid.

This study investigated the effect of bioglass (melting)-polyvinyl alcohol (BG (M)-PVA) and bioglass (melting)-polyvinyl alcohol-20 %ciprofloxacin (BG(M)-PVA-20Cip) in improving antioxidant activity and regenerating bone capacity. These composites were implanted in femoral condyles of ovariectomized Wistar rats and compared to that of controls groups. After the different period of implantation (15, 30, 60 and 90 days), the treatment of ovariectomized rats with BG(M)-PVA-20Cip showed a significantly higher malondialdehyde concentration when compared to that of BG(M)-PVA group. The superoxide dismutase, glutathione peroxidase and catalase in BG(M)-PVA-20Cip group showed significantly lower activities when compared to those in BG(M)-PVA group. So, BG(M)-PVA is more tolerated by organism than BG(M)-PVA-20Cip. Moreover, the alkaline phosphatase and acid phosphatase activities showed an excellent osteoinductive property of BG (M)-PVA. This property decreased with the presence of ciprofloxacin which is confirmed by histopathological analysis. Several physicochemical techniques showed a rapid reduction in Si and Na in one hand and an accelerator rise in Ca and P ions concentrations in other hand in BG(M)-PVA than in the BG(M)-PVA-20Cip. Therefore, the incorporation of ciprofloxacin in BG(M)-PVA is characterized by a prooxidant effect in oxidant-antioxidant balance at the beginning of treatment and a retard effect of formation of apatitic phase.

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.