Worldwide comparative efficacy of nutraceuticals on lipid profile. an updated systematic review and network meta-analysis

Introduction

In case of patients without indications to statin therapy, those being close to the target and especially with statin intolerance, nutraceuticals might be an additional option of hypercholesterolemia therapy. Despite a large number of nutraceuticals, little is known on their comparative efficacy due to the paucity of head-to-head comparisons. We aimed to assess the lipid-lowering effect of various nutraceuticals by means of network meta-analysis.

Methods

PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were carefully searched to identify eligible studies to the meta-analysis. We included parallel or crossover randomized clinical trials (RCT), comparing head-to-head or to placebo/no intervention, the following nutraceuticals: a) artichoke, b) berberine, c) bergamot, d) garlic, e) green tea extract, f) plant sterols and stanols, g) policosanols, h) red yeast rice (RYR), i) silymarin, j) spirulina. We did not include soy protein, fiber, and lupin trials, as unlike other nutraceuticals they are in fact dietary interventions. Due to strikingly inconsistent results of policosanols RCTs carried out in Cuba and other countries, we excluded Cuban trials from main analysis.

Results

From the initially identified 4151 articles we finally included 131 studies. As some studies reported clinically different groups separately, they were split and finally we included 136 records, 134 with data on total cholesterol (TC), 125 with data on low-density cholesterol (LDL-C), 127 that provided information on high-density cholesterol (HDL-c) and 129 that included data regarding triglycerides (TG). Pooled studies covered data for 6755 patients randomized to nutraceutical arms and 6370 randomized to receive placebo/no intervention. For reducing TC bergamot, was identified as the most effective approach (P-score = 1.0) followed by RYR (0.90) and berberine (0.76). For increasing HDL-C, bergamot (0.98), berberine (0.85), and RYR (0.77) were the most effective. While evaluating LDL-C reduction, bergamot (1.00) and RYR (0.90) showed the highest reduction efficacy. Reducing effect of investigated nutraceuticals on TG levels was the highest for bergamot (1.00) and RYR (0.78). Majority of reports regarding Cuban policosanol trials implicated very high effectiveness of those nutraceuticals, which was in contrast to trials conducted in other countries

Conclusions

Bergamot, berberine, and RYR seemed to be most effective nutraceuticals in terms of lipid-lowering efficacy. Alleged high effectiveness of policosanols was not confirmed in our analysis. This analysis might support the physicians and patients' decisions to use only those nutraceuticals of confirmed efficacy.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): Medical University of Silesia, Katowice

Relationship of obesity to mortality in 47,399 patients from nationwide LIPIDOGRAM 2004–2015 cohort studies

Background

Evidence suggests that obesity may be associated with lower mortality rates in various cohorts of patients (obesity paradox). One possible explanation is unmeasured confounding factors induced by selection bias (collider stratification bias). Therefore, data from large cohorts with few exclusion criteria are of value as they may minimize this effect.

Purpose

To assess the association between two obesity measures body mass index (BMI; kg/m2) and waist circumference (WC; cm) with mortality in nationwide cohort of 47,399 patients.

Methods

Lipidogram studies were carried out in Poland in 2004, 2006 and 2015 in the population representative for patients in primary care setting. The median follow up was 5570 days. Patients were recruited in all 16 administrative regions in Poland and physicians were proportionally to the number of inhabitants in a given administrative region. Each patient was given a questionnaire on chronic diseases, treatment and lifestyle. Questionnaire was administered by physician. Association between BMI, WC and mortality was assessed by multivariate Cox regression and spline regression models. Weight status was classified as underweight (BMI <18.5), normal weight (BMI 18.5–24.9), overweight (BMI 25–29.9), class I obesity (BMI 30–34.9), class II obesity BMI (35–39.9), and class III obesity BMI (>40).

Results

The prevalence of hypertension, dyslipidemia, diabetes and coronary artery disease, showed a graded association with BMI, whilst smoking was most frequent in underweight patients. Correlation between BMI and WC was 0.748. As compared to normal weight patients' class III obese patients had highest mortality (HR 1.91; 95% CI: 1.650–2.202), following by class II obesity (HR 1.47, 95% CI: 1.33–1.62) and underweight patients (HR 1.47; 95% CI 1.1–1.8). Overweight patients had also slightly increased risk of dying as compared to normal weight patients (HR 1.12; 95% CI: 1.05–1.19). Similar U-shaped curve was observed for waist circumference. After adjustment for age, sex, smoking, diabetes, hypertension and LDL cholesterol highest mortality was observed for underweight patients (HR 1.88; 95% CI: 1.44–2.45), following by class III obesity (HR–1.51; 95% CI 1.31–1.75). Class I obesity and being overweight was associated with lower risk (HR 0.88; 95% CI: 0.82–0.94 and HR 0.86; 95% CI: 0.81–0.92, respectively).

Conclusions

No evidence of obesity paradox was present in unadjusted analysis. Lower mortality was observed in overweight and class I obese patients only after adjustment for risk factors and diseases typically associated with obesity. Results of multivariate analysis indicate that diseases that develop in obese patients are significantly associated with mortality more than obesity itself. Confounding may be responsible for discussed obesity paradox in literature therefore preventive measures to maintain BMI within normal range and prevent development of its complications should not be abolished.

Funding Acknowledgement

Type of funding sources: Private company. Main funding source(s): The present study was funded by an unrestricted educational grant from Valeant. As a supporter of the study, Valeant played no role in the study design, data analysis, data interpretation, or writing of the report. The present study was also supported by Silesian Analytical Laboratories (SLA, Katowice, Poland).

Serum progesterone concentrations on the day of oocyte retrieval above 9.23 ng/ml may predict ovarian hyperstimulation syndrome risk in in vitro fertilized patients

The aim of our study was to evaluate serum progesterone levels on the day of oocyte retrieval as a promising biomarker inorder to evaluate the risk of ovarian hyperstimulation syndrome in a group with controlled ovarian hyperstimulation protocols using either gonadotropin antagonists or agonists (GnRH), compare with a natural cycle control group. Patients were divided into 3 groups (148 patients in total): control group in the natural cycle, patients treated with GnRH agonist and patients treated with GnRH antagonist. When we compared both controlled ovarian hyperstimulation (COH) protocol groups with the control group, we found statistically higher levels of progesterone in patients after COH (control versus long protocol group: 1.43 ± 1.28 ng/ml versus 8.95 ± 5.95 ng/ml; P < 0.001; control versus GnRH antagonist group: 1.43 ± 1.28 ng/ml versus 7.18 ± 5.13 ng/ml; P < 0.001). According to receiver operating characteristic (ROC) analysis, the level of serum progesterone on the day of oocyte retrieval, above which the risk of ovarian hyperstimulation syndrome (OHSS) is associated with a more than fourfold higher risk (OR 4.24; 95% CI 2.6 - 6.9) was found to be 9.23 ng/ml, with AUC: 0.896, P = 0.026 (95% CI 0.845 - 0.947). Progesterone level on the day of oocyte retrieval may be used as an additional sensitivity marker in treatment of early forms as well by freezing of embryos in prevention of late forms of OHSS.

Involvement of human monogenic cardiomyopathy genes in experimental polygenic cardiac hypertrophy

Hypertrophic cardiomyopathy thickens heart muscles, reducing functionality and increasing risk of cardiac disease and morbidity. Genetic factors are involved, but their contribution is poorly understood. We used the hypertrophic heart rat (HHR), a unique normotensive polygenic model of cardiac hypertrophy and heart failure, to investigate the role of genes associated with monogenic human cardiomyopathy. We selected 42 genes involved in monogenic human cardiomyopathies to study: 1) DNA variants, by sequencing the whole genome of 13-wk-old HHR and age-matched normal heart rat (NHR), its genetic control strain; 2) mRNA expression, by targeted RNA-sequencing in left ventricles of HHR and NHR at 5 ages (2 days old and 4, 13, 33, and 50 wk old) compared with human idiopathic dilated cardiomyopathy data; and 3) microRNA expression, with rat microRNA microarrays in left ventricles of 2-day-old HHR and age-matched NHR. We also investigated experimentally validated microRNA-mRNA interactions. Whole-genome sequencing revealed unique variants mostly located in noncoding regions of HHR and NHR. We found 29 genes differentially expressed in at least 1 age. Genes encoding desmoglein 2 ( Dsg2) and transthyretin ( Ttr) were significantly differentially expressed at all ages in the HHR, but only Ttr was also differentially expressed in human idiopathic cardiomyopathy. Lastly, only two microRNAs differentially expressed in the HHR were present in our comparison of validated microRNA-mRNA interactions. These two microRNAs interact with five of the genes studied. Our study shows that genes involved in monogenic forms of human cardiomyopathies may also influence polygenic forms of the disease.

New ionic liquids based on systemic acquired resistance inducers combined with the phytotoxicity reducing cholinium cation

Systemic acquired resistance (SAR) is one of the most promising ways to support plants in the fight against viruses.

The use of oxidative stress biomarkers in live animals (in vivo) to predict meat quality deterioration postmortem (in vitro) caused by changes in muscle biochemical components

This study was conducted to determine whether circulating concentrations of blood isoprostanes can be used as an effective biomarker in lambs to predict degradation of color and/or lipid stability in meat. Lambs ( = 84) were fed diets of either lucerne pasture, annual ryegrass pasture, a commercial feedlot pellet, or a combination of annual ryegrass and feedlot pellet for 8 wk, including a 2-wk adaptation period. Blood isoprostane concentration at wk 0, 4, 6 or 8 of feeding was determined. Blood isoprostane concentration for each animal was then correlated with muscle biochemical components that impact color and/or lipid oxidative status during retail display. This included lipid oxidation levels in muscle assessed by thiobarbituric acid reactive substances and meat redness determined by a HunterLab colorimetric spectrometer. Lambs that consumed the commercial feedlot pellet had a lower muscle vitamin E level (< 0.01) and a greater level of -6 PUFA ( < 0.001) compared with lambs finished on annual ryegrass or lucerne. Lipid oxidation levels were greatest for lambs finished on the feedlot ration, lowest in lambs finished on the ryegrass diet, and intermediate for lambs finished on lucerne and ryegrass-feedlot combination ( < 0.01). After 8 wk of feeding, blood isoprostane concentration was positively correlated with lipid oxidation of meat displayed for 72 h in simulated retail conditions ( < 0.01). There was a negative linear relationship between isoprostane concentration and muscle vitamin E concentration ( = 0.07), lipid oxidation and muscle vitamin E concentration ( < 0.01) but a positive linear relationship between isoprostane concentration and muscle -6 PUFA ( < 0.001) or lipid oxidation and muscle -6 PUFA concentration ( < 0.001). Blood isoprostane concentration and lipid oxidation in meat were influenced by muscle vitamin E and -6 PUFA but not by -3 PUFA. There was no significant relationship observed between blood isoprostane concentration at 0, 4, 6 or 8 wk feeding vs. overall meat color (redness of meat) at 0 and 72 h of display, stored under simulated retail conditions. The results indicate that circulating blood isoprostane concentration can be a useful tool to predict the oxidative status of postmortem meat. Future work will examine the impact of this relationship on meat flavor/aroma deterioration post farm.

Optically Controlled Orbital Angular Momentum Generation in a Polaritonic Quantum Fluid

Applications of the orbital angular momentum (OAM) of light range from the next generation of optical communication systems to optical imaging and optical manipulation of particles. Here we propose a micron-sized semiconductor source that emits light with predefined OAM pairs. This source is based on a polaritonic quantum fluid. We show how in this system modulational instabilities can be controlled and harnessed for the spontaneous formation of OAM pairs not present in the pump laser source. Once created, the OAM states exhibit exotic flow patterns in the quantum fluid, characterized by generation-annihilation pairs. These can only occur in open systems, not in equilibrium condensates, in contrast to well-established vortex-antivortex pairs.

High levels of soluble vascular endothelial growth factor receptor 1/sFlt1 and low levels of vascular endothelial growth factor in follicular fluid on the day of oocyte retrieval correlate with ovarian hyperstimulation syndrom regardless of the stimulation protocol

The aim of the study was to assess the predictive value of vascular endothelial growth factor (VEGF), its soluble receptor - sVEGF-R1/sFlt1 and endocrine gland-derived vascular endothelial growth factor (EG-VEGF) concentrations in serum and follicular fluid (FF) for ovarian hyperstimulation syndrome (OHSS) in women undergoing controlled ovarian hyperstimulation (COH) protocols. Patients have been divided into 3 groups: control group on natural cycle, patients stimulated with GnRH agonist and patients stimulated with GnRH antagonist. The FF and serum concentrations of VEGF, EG-VEGF, sVEGF R1 and the expression of VEGF and EG-VEGF mRNA in GC in small and large follicles collected from patients were investigated. When we compared all patients in a trial, OHSS occurrence was correlated with higher level of sVEGF R1 and a lower level of VEGF in a follicular fluid from large follicles in a day of oocyte retrieval. The VEGF/sVEGF-R1 ratio for patients in COH groups, above which the risk of developing OHSS is very low (OR 0.1 (95% CI 0.01 - 0.29, P = 0.0006) was found to be 0.281 pg/ml, with AUC - 0.738, P = 0.042, (95% CI 0.656 - 0.82). High levels of sVEGF-R1 and low level of VEGF in FF on the day of oocyte retrieval correlate with OHSS regardless of the stimulation protocol.

Methylmercury-induced inhibition of paraoxonase-1 (PON1)-implications for cardiovascular risk

Methylmercury (MeHg) has been associated with increased risk for cardiovascular disease in some but not all epidemiology studies. These inconsistent results may stem from the fact that exposure typically occurs in the context of fish consumption, which is also associated with cardioprotective factors such as omega-3 fatty acids. Mechanistic information may help to understand whether MeHg represents a risk to cardiovascular health. MeHg is a pro-oxidant that inactivates protein sulfhydryls. These biochemical effects may diminish critical antioxidant defense mechanism(s) involved in protecting against atherosclerosis. One such defense mechanism is paraoxonase-1 (PON1), an enzyme present on high-density lipoproteins and that prevents the oxidation of blood lipids and their deposition in vascular endothelium. PON1 is potentially useful as a clinical biomarker of cardiovascular risk, as well as a critical enzyme in the detoxification of certain organophosphate oxons. MeHg and other metals are known to inhibit PON1 activity in vitro. MeHg is associated with lowered serum PON1 activity in a fish-eating population. The implications of lowering PON1 are evaluated by predicting the shift in PON1 population distribution induced by various doses of MeHg. An MeHg dose of 0.3 μg/kg/d is estimated to decrease the population average PON1 level by 6.1% and to increase population risk of acute cardiovascular events by 9.7%. This evaluation provides a plausible mechanism for MeHg-induced cardiovascular risk and suggests means to quantify the risk. This case study exemplifies the use of upstream disease biomarkers to evaluate the additive effect of chemical toxicity with background disease processes in assessing human risk.

The relation between the sagittal and transversal diameters in eyes with retinal detachment

Using A-mode ultrasonography, the axial length and the width (transversal or equatorial diameter) of both eyes--fellow and affected--have been measured in patients with retinal detachment. For comparison, the same measurements have been performed in healthy controls. The patients have been divided into different groups. It was found that there are some changes in the relation between the axial length and the width of the eyes in patients with retinal detachment, according to the comparison with healthy people, in most cases.

[Lipid disturbance of cell membranes in the etiopathogenesis of schizophrenia and affective disorders]

The authors present information on the key role of lipid disturbances (mainly phospholipids) of neural membranes in the etiopathogenesis of schizophrenia and affective disorders. Current theories on membrane phospholipid disturbances in the etiopathogenesis of schizophrenia and affective disorders are connected to the idea that the primary metabolic disorder in both these disorders is due to the altered activity of phospholipase AZ, which in turn brings about disturbances in other lipid elements. Especially the functional insufficiency of some necessary fatty acids, as well as disturbed prostaglandin secretion has been shown in these disorders. In the recent years evidence has been collected on the action of pharmacologic substances used in these disorders on the lipid enzyme metabolism.

Risk evaluation of ventricular tachycardia using wavelet transform irregularity of the high-resolution electrocardiogram

A new method for analysis of high-resolution ECG signals using a wavelet transform based on a modified Morlet function is presented. A polynomial filter is used to reduce low-frequency, high-amplitude noise components in the analysed signals. The method is tested on test ECG signals with simulated late potentials and finally verified on two post-infarction patient (PP) groups: 62 PPs with ventricular tachycardia and 44 PPs without arrhythmia. A new quantitative parameter, the irregularity factor, is proposed for discrimination between the study groups. The results show a significant difference in the parameter values for tachycardia patients compared with those for patients without arrhythmia. The sensitivity of the proposed method is 85%, and the specificity is 93%.

Effectiveness of high resolution ECG spectral analysis in discrimination of patients prone to ventricular tachycardia and fibrillation

INTRODUCTION

To improve the diagnostic power of high resolution electrocardiography for discriminating patients at risk of ventricular arrhythmias, new methods based on spectral analysis have been used in recent years. The purpose of this study was to evaluate the effectiveness of these methods for predicting the risk of ventricular tachycardia and ventricular fibrillation in patients after myocardial infarction.

MATERIAL AND METHODS

High resolution ECG were recorded in 129 post-infarction patients and 23 healthy volunteers. Of the post-infarction patients: 62 presented with ventricular tachycardia, 23 with ventricular fibrillation, while 44 had no clinically relevant arrhythmias. The ECG signals were recorded in three orthogonal X, Y, Z leads and averaged using cross-correlation method. Spectral analysis was performed by fast Fourier transform and the parametric modeling method with autoregressive model. Spectral analysis data were evaluated quantitatively by computing normality factor for FFT and spectral factor for AR.

RESULTS

Both methods were found to be useful for evaluating the risk of arrhythmias. The sensitivity of ventricular tachycardia risk evaluation was higher (81%--FFT, 73%--AR) than that of evaluating the risk of ventricular fibrillation (30%--FFT, 48%--AR). The specificity in post-infarction patients without arrhythmias (93%--FFT, 84%--AR) was as high as that in healthy subjects (96%--FFT, 87%--AR).

CONCLUSIONS

Spectral analysis of HRECG is an effective method for evaluating the risk of VT and VF in patients after myocardial infarction.

Impact of obesity and leptin treatment on adipocyte gene expression in Psammomys obesus

We examined the effects of leptin treatment on the expression of key genes in adipocyte metabolism in Psammomys obesus (P. obesus), a polygenic rodent model of obesity. Lean and obese P. obesus were given three daily intraperitoneal injections of either saline or leptin (total of 45 mg/kg per day) for 7 days. In lean animals, leptin treatment led to reductions in food intake, body weight and fat mass. Pair-fed animals matched for the reduction in food intake of the lean leptin-treated animals demonstrated similar reductions in body weight and fat mass. In obese P. obesus, leptin treatment failed to have any effect on body weight or body fat mass, indicating leptin resistance. Lipoprotein lipase, hormone-sensitive lipase and peroxisome proliferator activated receptor gamma 2 mRNA levels were significantly reduced in lean leptin-treated animals, whereas pair-fed animals were similar to lean controls. Uncoupling protein 2 and glycerol phosphate acyltransferase were also reduced in the lean leptin-treated animals, but not significantly so. Obese animals did not show any gene expression changes after leptin treatment. In conclusion, high circulating concentrations of leptin in lean P. obesus resulted in decreased gene expression of a number of key lipid enzymes, independent of changes in food intake, body weight and fat mass. These effects of leptin were not found in obese P. obesus.

Spectral analysis of laser-Doppler perfusion signal measured during thermal test

The method of spectral analysis of laser-Doppler perfusion signal measured during thermal test is proposed. During three 20 min phases with 40, 5, and 40 degrees C of thermal test laser-Doppler perfusion signal was recorded. For each signal phase frequency spectra were calculated using the FFT method. Quantitative parameter Spectral Factor for results evaluation was proposed. In total 94 patients were measured: 69 with Raynaud's phenomenon and 25 normal subjects. Additionally in 18 Raynaud's patients the influence of Nifedipine was studied. Results suggest that proposed parameter is able to differentiate between Raynaud's patients and normal subjects and that is useful for evaluation of Nifedipine effectiveness. However, further studies are needed to improve the method to differentiate between primary and secondary Raynaud's patients.

Leptin resistance in a polygenic, hyperleptinemic animal model of obesity and NIDDM: Psammomys obesus

OBJECTIVE

To investigate the effects of leptin administration to Psammomys obesus, a polygenic animal model of obesity and type 2 diabetes mellitus.

DESIGN

Longitudinal intervention study utilising three separate leptin treatment protocols lasting 7-14 d.

MEASUREMENTS

Body weight and food intake were measured daily, body fat and muscle content were estimated by carcass analysis on completion of the study. Blood glucose, plasma insulin, leptin, triglycerides and cholesterol were measured at baseline and twice each week during the study.

RESULTS

Relatively high doses of leptin were required to significantly reduce food intake and body fat content in lean Psammomys obesus, but had no discernible effect on their obese littermates.

CONCLUSION

As a species, Psammomys obesus appear to be relatively insensitive to the effects of leptin administration, compared with other rodents. Obese Psammomys obesus are leptin resistant relative to their lean littermates.

[Percutaneous sperm retrieval for ICSI procedures in men with obstructive azoospermia: ICSI-PESA and ICSI-TESE micromanipulation: our experience]

OBJECTIVES

The sperm retrieval for ICSI procedures is possibly using following procedures: ejaculate sperm, epididymal sperm obtained by microsurgical aspiration or percutaneous puncture and testicular sperm that are obtained by surgical excision or percutaneous biopsy. Percutaneous techniques seem to be rather simple and effective procedures.

DESIGN

The authors present their own experiences with percutaneous sperm retrieval for micromanipulation ICSI from the epididymis (ICSI-PESA) and from the testicular tissue (ICSI-TESE) in men with obstructive azoospermia and with reactive impotence. First time in Poland ICSI-PESA was done on April 11, 1996 in Private Infertility Center "Novum", Warsaw.

MATERIAL AND METHODS

From April 1996 to the end of January 1998, 10 ICSI-PESA procedures (in 9 couples) and 8 ICSI-TESE (in 6 couples) were performed. In one case ICSI-PESA was performed in man with psychological inability of masturbation during his wife's IVF protocol. All procedures were performed as the day case urology, under general anesthesia. The fine needles No 6 in PESA or biopsy needle from Hepafix Set B. Braun in TESE were used. The therapy of antibiotic and common analgesic drug was used routinely after puncture.

RESULTS

The effectiveness of obtaining sperm for micromanipulation were 100% ICSI-PESA and 75% ICSI-TESE. The pregnancy rate in PESA was 50% and 5 healthy children were born. In TESE only 1 woman (17%) was pregnant, but early spontaneous miscarriage was reported. No surgical and anesthesiological complications were noticed.

CONCLUSIONS

Obtaining sperm for micromanipulation ICSI using percutaneous epididymal puncture or testicular tissue needle biopsy seems to be effective and safe for patients with obstructive azoospermia or reactive impotence.

[Needle testicular biopsy in the diagnosis of male infertility]

OBJECTIVES

Evaluation of testicular tissue is very important diagnostic procedures in cryptozoospermia and azoospermia. It is verified the patient for treatment (stimulation spermatogenesis), for micromanipulation ICSI or for insemination donor semen procedure. Surgical biopsy is very popular between andrologist and urologist, but needle biopsy seems to be easier and safer.

DESIGN

The authors present their experience with needle testicular biopsy during the diagnosis patients with azoospermia or cryptozoospermia and the men with paraplegia after trauma and without ejaculation.

MATERIAL AND METHODS

The study group included 63 biopsies in 58 men with azoospermia and severe oligoasthenozoospermia (cryptozoospermia) and 2 with paraplegia. The specimens were taken from 125 testes under general anesthesia (i.v-Diprivan, Propofol, Zeneca and Fentanyl) using biopsy needle from Hepafix B. Braun Melsungen, Germany. All procedures were performed as a day case.

RESULTS

In 95% specimens were adequate for histopathological investigations and for planning the treatment. Only one complication (0, 8%) -small haematoma testis was observed.

CONCLUSIONS

The needle biopsy of testicular tissue is sufficiency in histopathological examination, safe for patients and easy for urologists. The total cost is much more lower than cost of surgical biopsy.

Leptin and the development of obesity and diabetes in Psammomys obesus

The recently discovered ob gene and its circulating product, leptin, may be critical factors in the control of energy balance. Recent studies in ob/ob mice, which lack circulating leptin, have shown dramatic reductions in food intake and bodyweight after leptin treatment. In addition, studies in both humans with obesity and animal models of obesity have demonstrated hyperleptinemia. Here, we report a longitudinal study examining changes in circulating leptin during the development of obesity and diabetes in Psammomys obesus. Over the 8 weeks of the study, lean animals increased their bodyweight by 154% and leptin levels remained essentially unchanged. In contrast, animals that developed obesity (223% increase in bodyweight), hyperglycemia, and hyperinsulinemia also developed hyperleptinemia between 4 weeks and 8 weeks of age. These results demonstrate that the development of hyperleptinemia is associated with the development of obesity and subsequent metabolic abnormalities.

[Angioid streaks--case report]

A case of a 46-year-old, generally healthy man, with sudden deterioration of visual acuity associated with macular haemorrhagies is presented. Angioid streaks were diagnosed basing on the ophthalmoscopical and angiographic picture of the fundus.

[Evaluation of usefulness for a new composition of gel for ultrasonographic diagnostic examination]

A new composition of gel was applied in ultrasonographic diagnostic examinations. Estimation of gel was based on the following parameter--attenuation in dB per cm at varying frequency. Considering this parameter the newly composed gel was compared with gels used so far in diagnostics.

[Studies of releasing rate of pilocarpine hydrochloride from hydrogel eye ointments]

The aim of the study was to evaluate the usefulness of hydrophilic base with pilocarpine hydrochloride. Comparisons were made between releasing rate of pilocarpine hydrochloride from hydrophilic and lipophilic bases into water and artificial tears. It was found that pilocarpine hydrochloride was released in the amount 30-40 times greater from hydrogel bases compared to lipophilic. The releasing rate of drugs from hydrogel ointments increases with the increased colloid concentration and with decreased of drug concentration in the base.

[Usefulness of a gel with a new composition for gonioscopy and laser microsurgery]

A newly composed gel was examined with a view of determining its usefulness for gonioscopy and laser microsurgery. It was found, that it did not exert any adverse effect on ocular tissue, it displayed perfect transparency and proper consistency facilitating manual operation. Experimental procedures confirmed its clinical usefulness.

[Evaluation of pupillary reaction to light flash in patients with retinitis pigmentosa]

Twenty four patients with retinal pigment dystrophy were subjected to examination of pupillary reaction. Evaluated was the amplitude of pupillary reaction on a standard light flash. The results received were compared with the field changes. It was noted that the amplitude is diminished depending on the changes in the visual field.

[Pemphigoid as a cause of marked impairment of visual acuity]

Among 11 patients aged 9-79 years with diagnosed pemphigoid 5 were men and 6 women. Three persons exhibited only some conjunctival irritation and conjunctival adhesions, the remaining 8--besides some shallowness of the fornices--showed also corneal changes. Six patients showed signs of the dry-eye syndrome and 3--symptoms of secondary glaucoma. General treatment (Avlosulfon, encorton) was applied in 8 patients.

Evaluation of a prescreening blood donor program for prevention of perinatal transfusion-acquired cytomegalovirus (CMV) infection

The purpose of this study was to evaluate the efficacy of a prescreened CMV seronegative blood donor group in preventing transfusion-acquired CMV infection in premature infants in the perinatal period. Group 0 donors with known CMV seronegative status were recruited to supply blood to the neonatal intensive care nurseries. One hundred and twenty-seven low birth weight infants born of CMV seronegative mothers remained seronegative when blood for transfusion was screened for CMV antibody. Twenty two infants shared six units of CMV seropositive blood due to technical errors or poor sensitivity of the test kit in the initial phase of the study. Fifteen of these patients were in the study group. One infant died of immaturity at four weeks of age and two of the remaining 14 showed asymptomatic CMV infection. Another infant who received granulocyte concentrates from CMV seropositive donors had symptomatic CMV infection. Throughout the 24 month study period, blood supply to the ICN was adequate and timely. The donor seroconversion rate was 0.7% per annum. Only one infant was exposed to the risk of CMV infection due to donor seroconversion. We conclude that the prescreening donor program is a sensible and efficient approach for providing CMV seronegative blood in neonatal transfusion therapy.