Suzanna Immanuel

The role of apolipoprotein E polymorphism in improving dyslipidemia in obese adolescents following physical exercise and National Cholesterol Education Program Step II intervention.

Abstract Background: Lifestyle changes are important factors for managing dyslipidemia before considering blood lipid-lowering drugs. However, genetic factors can influence the response outcome. Objective: We aimed to determine a dyslipidemia management strategy in obese adolescents. Patients and methods: A total of 60 dyslipidemic obese adolescents received physical exercise and the NCEP step II diet for 28 days. Apolipoprotein E (apo E) genotypes and blood lipid levels were compared before and after interventions. Results: The apo E3/E3 genotype was found to be common in all subjects. Mean levels of total cholesterol, triglyceride, and low-density lipoprotein-cholesterol (LDL-C) improved in subjects with the E3 allele after the intervention, but not the E2 allele. Total cholesterol and LDL-C, but not triglyceride levels, improved in subjects with the E4 allele. Discussion: Apo E alleles might influence improvement in lipid profiles after diet and exercise interventions. These results could inform personalized dyslipidemia management in obese adolescents, to determine which subjects would benefit from blood lipid-lowering drugs.

In Vitro Antibacterial Interaction of Doripenem and Amikacin against Multidrug-Resistant Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae Isolates

Evaluation of the in vitro interaction of doripenem and amikacin against Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae was done by classifying them into four groups: doripenem and amikacin sensitive (DOR-S/AMK-S), doripenem sensitive and amikacin resistant (DOR-S/AMK-R), doripenem resistant and amikacin sensitive (DOR-R/AMK-S), and both doripenem and amikacin resistant (DOR-R/AMK-R). The MIC of each antibiotic and their combination was obtained using the Etest method. The fractional inhibitory concentration index was calculated to classify the results as synergistic, additive, indifferent, or antagonistic interaction. In the DOR-S/AMK-S class, 1 isolate of A. baumannii showed synergy and the other 5 showed additive results, 5 isolates of P. aeruginosa showed additive and 1 isolate showed indifferent result, and 2 isolates of K. pneumoniae showed additive and the other 4 showed indifferent results. In the DOR-S/AMK-R class, 3 isolates of A. baumannii showed additive and the other 3 showed indifferent results, 2 isolates of P. aeruginosa showed indifferent results, and 1 isolate of K. pneumoniae showed additive and the other 5 showed indifferent results. In the DOR-R/AMK-S class, 1 isolate of A. baumannii showed additive and the other 5 showed indifferent results, 1 isolate of P. aeruginosa showed additive and the other 5 showed indifferent results, and 4 isolates of K. pneumoniae showed additive and the other 2 showed indifferent results. In the DOR-R/AMK-R class, 6 isolates of A. baumannii showed indifferent results, 1 isolate of P. aeruginosa showed additive and the other 5 showed indifferent results, and 1 isolate of K. pneumoniae showed additive and the other 5 showed indifferent results. Synergy occurred in only 1 (1.5%) isolate. Additive interaction occurred in 24 (35.3%) isolates, and indifferent interaction occurred in 43 (63.2%) isolates. Doripenem sensitive combined with amikacin sensitive reduced MIC significantly in all bacterial isolates when compared to single MIC of each antibiotic.