Treatment of hypercholesterolemia in NIDDM with policosanol

OBJECTIVE

To determine whether elevated levels of cholesterol and low-density lipoprotein (LDL) cholesterol in non-insulin-dependent diabetes mellitus (NIDDM) patients could be decreased by policosanol, a new cholesterol-lowering drug. NIDDM predisposes patients to coronary artery disease (CAD) through the direct action of hyperglycemia on the arteries as well as the dyslipidemia induced by NIDDM.

RESEARCH DESIGN AND METHODS

This double-blind placebo-controlled trial was performed in 29 patients with NIDDM and hypercholesterolemia. After stable glycemic control was achieved by diet and/or oral hypoglycemic drugs, patients were instructed to follow a cholesterol-lowering diet for 6 weeks. Patients who met entry criteria received, under double-blind conditions, policosanol (5 mg) or placebo tablets twice a day for 12 weeks.

RESULTS

Policosanol (10 mg/day) significantly reduced total cholesterol by 17.5% and LDL cholesterol by 21.8% compared with baseline and placebo. Furthermore, high-density lipoprotein (HDL) cholesterol was raised by 11.3% (not significant), and triglycerides showed a statistically nonsignificant decrease of 6.6%. These changes in lipid profile were similar to those induced by policosanol in nondiabetic patients with type II hyperlipoproteinemia.

CONCLUSIONS

Glycemic control was unaffected by treatment. No clinically or biochemically adverse effects attributable to treatment were observed. Only one patient (placebo) withdrew from the trial because of an adverse experience (erythema). We concluded that policosanol is effective and safe in patients with NIDDM and hypercholesterolemia.

Protection against Campylobacter diarrhea: role of milk IgA antibodies against bacterial surface antigens

In developing countries, Campylobacter jejuni causes diarrhea and dysentery, especially in children less than one year of age. Breast feeding protects against infectious diarrhea, with milk IgA antibody playing a determining role. Therefore, it has been proposed to increase the protective effect of human milk by vaccinating women of child-bearing age. To identify antigens which may induce protective breast-milk IgA, we analyzed 60 strains of C. jejuni isolated from asymptomatically- and symptomatically-infected breast-fed children less than 12 months of age. Surface antigens of C. jejuni, separated by polyacrylamide gel electrophoresis, were probed with breast milk collected concurrently with the fecal sample from which C. jejuni was isolated, and specific IgA was developed by immunoblotting. Our results indicate that milk antibodies against three high molecular weight bacterial surface antigens of 95, 110 and 185 kDa are involved in protection of infants infected with C. jejuni (p = 0.00964 for one-tailed Fisher's exact test).

Estimation of the daily intake of cadmium which may be consumed by students 12-17 years old in secondary schools in the city of Havana

In the present article we offer information regarding the estimated amounts of cadmium which may be consumed by 12,000 students 12 to 17 years old, who attend boarding secondary schools. The method of analysis used to determine cadmium is that reported by the Association of Official Analytical Chemists using atomic absorption spectrometry with air-acetylene flame. The estimated quantities of cadmium which these students may consume according to the offered foods are smaller than those recommended as provisional tolerable weekly intake by the Joint FAO/WHO Expert Committee on Food Additives.

Estimation of the daily intake of nitrates and nitrites which may be consumed by students 12-17 years old in secondary schools in the city of Havana

In the present article we offer informations regarding the estimated amounts of nitrates and nitrites which may be consumed by 12,000 students 12 to 17 years old, who attend boarding schools. The method of analysis used to determine nitrates and nitrites is that reported by the Joint FAO/WHO Expert Committee using a cadmium reducing column. The estimated quantities of nitrates and nitrites which these students may consume according to their food intake are smaller than those recommended as admissible daily intake by the Joint FAO/WHO Expert Committee on Food Additives.

Alpha 1-antitrypsin deficiency and liver cirrhosis in adults

Although cirrhosis of the liver caused by alpha 1-antitrypsin deficiency is not uncommon in children, only a few cases have been described in adults. We have seen three such patients--one man and two women, ranging in age from 57 to 66 years. These cases show the wide spectrum of this genetically influenced disease.

Gastric lipomas--an update of clinical presentation, diagnosis, and treatment

Although gastric lipomas, an extremely rare tumor, were once found mostly during autopsy studies and laparotomy for upper intestinal hemorrhages and obstruction, we are now able to diagnose these masses with CT scanners and gastrointestinal endoscopy. Surgery is now necessary only under certain circumstances. We present two cases of gastric lipomas with different clinical presentations, both diagnosed preoperatively.