Judit Boda

Effect of Gemfibrozil on HDL-Associated Serum Paraoxonase Activity and Lipoprotein Profile in Patients with Hyperlipidaemia

AbstractObjective: Earlier studies pointed out that the high density lipoprotein (HDL)-associated paraoxonase (PON) activity was decreased in patients with hyperlipidaemia compared with healthy age-matched controls. PON can inhibit low density lipoprotein (LDL) oxidation and has an antiatherogenic effect. The aim of the present study was to evaluate the effect of gemfibrozil on serum PON and lipoprotein levels in patients with hyperlipidaemia. Patients and Methods: 57 patients with hypertriglyceridaemia were enrolled in the study (26 males, 31 females). The mean (± SD) body mass index was 26.17 ±6.17 kg/m2. The effects of twice daily gemfibrozil 600mg on serum cholesterol, lipoproteins, triglyceride, apolipoproteins and fibrinogen levels as well as on liver and kidney function were measured. Serum PON activity was determined spectrophotometrically using paraoxon as substrate. Results: Following treatment with gemfibrozil for 3 months, serum triglyceride and cholesterol levels were significantly decreased (from 4.01 ± 1.95 to 2.69 ± 1.61 mmol/L; p < 0.003 and from 7.44 ± 2.45 to 6.22 ± 0.96 mmol/L; p < 0.05, respectively), while the protective HDL level was not significantly increased. Furthermore, the low density lipoprotein (LDL) level was not significantly decreased while the apolipoprotein B-100 level was significantly reduced (from 1.36 ± 0.29 to 1.28 ± 0.22 g/L; p < 0.05), and apolipoprotein A1 remained unchanged. The serum PON activity was significantly increased (from 220 ± 98 to 253 ± 100 U/L; p < 0.001). Standardised values for HDL (PON/HDL) were also significantly increased (from 190 ± 85 to 235 ± 104; p < 0.01). Conclusions: Gemfibrozil has a lipid-lowering effect in hypertriglyceridaemic patients and may improve the antioxidant status by increasing serum PON activity.

Rapid response to and long-term effectiveness of anti-CD20 antibody in conventional therapy resistant Graves’ orbitopathy: A five-year follow-up study

Abstract The aim of this investigations was to study the effectiveness of anti-CD20 antibody therapy in Graves’ orbitopathy (GO) resistant to glucocorticoids. Five patients were entered in the study. The protocol required no improvement of orbital status after a recent course of glucocorticoids. Activity of GO was confirmed by three independent techniques: clinical activity score (CAS), 99mTc-labeled diethylene triamine pentaacetic acid (99mTc DTPA) single photon emission computed tomography and magnetic resonance imaging. Rituximab (RTX) was given as weekly infusions of 375 mg/m2 body surface area for four weeks. The mean follow-up period was 67 (range 58–81) months. Improvement of GO has been observed in all patients: CAS before therapy was 6.5 ± 1.7 and decreased to 3.4 ± 1.6 by one month (p < 0.05) and remained unchanged (3.2 ± 1.7) at 12 months. No further CAS change, in either direction, was detected during the yearly follow-up visits. The mean DTPA uptake before therapy was 16.52 ± 4.51 MBq/cm3 and decreased to 11.97 ± 2.36 MBq/cm3 at one year (p < 0.002). The mean of T2 relaxation times before and one year after therapy were 96.91 ± 17.61 ms and 84.29 ± 9.41 ms, respectively (p < 0.001). The mean serum TSH receptor antibody (TRAb) levels before therapy, at the one month and one year control visits were 7.4 ± 3.4 U/L, 5.6 ± 4.5 U/L and 1.7 ± 1.5 U/L, respectively (p < 0.004). No correlation between changes of TRAb and activity parameters has been found. Anti-CD20 treatment seems to influence positively the clinical course of GO, and this effect seems to be stable for five years. To our knowledge, this is the longest published follow-up of RTX treatment in GO.

The importance of early diagnosis of acromegaly

The authors review the historical and epidemiological aspects, clinical features and complications of acromegaly while emphasizing the importance of the early diagnosis and treatment. Acromegaly is a rare and mostly sporadic disorder due to excessive production of growth hormone. It is characterized by progressive somatic disfigurement (mainly involving the face and extremities) and systemic manifestations. The prevalence is estimated between 40 and 125 cases/million. Generally, it is diagnosed in middle-aged adults (mean age 40 years, men and women equally affected). Due to its insidious onset and slow progression, acromegaly is often diagnosed 7 to more than 10 years after its onset. The disease has cardiovascular, rheumatological, respiratory and metabolic consequences which highly determine its prognosis. Acromegaly is associated with a number of complications resulting in a two- or four-fold increase of mortality and a decrease of life expectancy by about 10 years. The major causes of death include cardiovascular and cerebrovascular events, respiratory diseases and malignancies. The duration of the disease before the introduction of effective therapy may be a major predictor of increased mortality mainly due to complications . The early diagnosis is important for timely commencement of treatment and for prevention of serious complications of the disease.

The importance of early diagnosis in acromegaly

The authors review the historical and epidemiological aspects, clinical features and complications of acromegaly while emphasizing the importance of the early diagnosis and treatment. Acromegaly is a rare and mostly sporadic disorder due to excessive production of growth hormone. It is characterized by progressive somatic disfigurement (mainly involving the face and extremities) and systemic manifestations. The prevalence is estimated between 40 and 125 cases/million. Generally, it is diagnosed in middle-aged adults (mean age 40 years, men and women equally affected). Due to its insidious onset and slow progression, acromegaly is often diagnosed 7 to more than 10 years after its onset. The disease has cardiovascular, rheumatological, respiratory and metabolic consequences which highly determine its prognosis. Acromegaly is associated with a number of complications resulting in a two- or four-fold increase of mortality and a decrease of life expectancy by about 10 years. The major causes of death include cardiovascular and cerebrovascular events, respiratory diseases and malignancies. The duration of the disease before the introduction of effective therapy may be a major predictor of increased mortality mainly due to complications . The early diagnosis is important for timely commencement of treatment and for prevention of serious complications of the disease.

Az acromegalia korai felismerésének jelentosége

The authors review the historical and epidemiological aspects, clinical features and complications of acromegaly while emphasizing the importance of the early diagnosis and treatment. Acromegaly is a rare and mostly sporadic disorder due to excessive production of growth hormone. It is characterized by progressive somatic disfigurement (mainly involving the face and extremities) and systemic manifestations. The prevalence is estimated between 40 and 125 cases/million. Generally, it is diagnosed in middle-aged adults (mean age 40 years, men and women equally affected). Due to its insidious onset and slow progression, acromegaly is often diagnosed 7 to more than 10 years after its onset. The disease has cardiovascular, rheumatological, respiratory and metabolic consequences which highly determine its prognosis. Acromegaly is associated with a number of complications resulting in a two- or four-fold increase of mortality and a decrease of life expectancy by about 10 years. The major causes of death include cardiovascular and cerebrovascular events, respiratory diseases and malignancies. The duration of the disease before the introduction of effective therapy may be a major predictor of increased mortality mainly due to complications . The early diagnosis is important for timely commencement of treatment and for prevention of serious complications of the disease.