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Biomedical subjects

Arnon Blum

Publications and source records attributed to Arnon Blum.

At least 19 recordsLinked to original sources
PubMed2006

Effects of tomatoes on the lipid profile.

PURPOSE: The Mediterranean diet has been reported to reduce cardiovascular mortality and morbidity considerably. Tomatoes and lycopene are considered potent antioxidants. Our purpose was to study the effects of a tomatoe-rich diet on the lipid profile following 300g daily of tomatoes for one month. METHODS: Plasma concentrations of triglyceride, total cholesterol, HDL-cholesterol, LDL-cholesterol and VLDL-cholesterol were determined in 98 apparently healthy volunteers (mean age 45.5+/-14.1 yr) before and after one month of follow-up. Fifty volunteers (34 women and 16 men) ate tomatoes 300g daily and 48 volunteers (32 women and 16 men) continued their regular diet without eating tomatoes for a month. RESULTS: In the regular diet group, there were no changes in the lipid profile: triglyceride level (169.6+/-156.8 vs. 147.6+/-93.4mg/dl; P=0.33), total cholesterol level (198.3+/-41.2mg/dl vs. 204.2+/-70.9mg/dl; P=0.23), HDL-cholesterol level (50.6+/-12.2mg/dl vs. 47.6+/-10.8mg/dl; P=0.79), and LDL-cholesterol level (122.7+/-39.4mg/dl vs. 120.2+/-32.2mg/dl; P=0.24) before and after the 1 month offollow-up. In the tomato-rich diet group: triglyceride level 170.8+/-85.4mg/dl to 167.4+/-99.4mg/ dl (P=0.98), total cholesterol level 207.5+/-44.3mg/ dl to 204.1+/-45.1mg/dl (P=0.68), HDL-cholesterol level 46.1+/-10.6mg/dl to 53.4+/-13.3mg/dl (P=0.03), and LDL-cholesterol level 127.7+/-41.8mg/dl to 119.1+/-41.7mg/dl (P=0.57). CONCLUSION: We found that tomatoes'-rich diet (300g daily for one month) increased HDL-cholesterol level significantly by 15.2%.

Adult↗
PubMed2005

Viral load of the human immunodeficiency virus could be an independent risk factor for endothelial dysfunction.

BACKGROUND: Recent reports of myocardial infarction in young persons infected with human immunodeficiency virus (HIV) who are receiving protease inhibitor therapy have raised concerns about premature coronary artery disease in this population. However, endothelial dysfunction, hypercoagulability, hypertriglyceridemia, and abnormal coronary artery pathology have been observed in association with HIV infection prior to the availability of protease inhibitor therapy. HYPOTHESIS: The study was undertaken to determine the association between endothelial function, viral load, CD4+ count, and other well-established risk factors for atherosclerosis. METHODS: This prospective, case-controlled study compared viral (HIV) load and the CD4+ T-lymphocyte count and endothelial function in 24 HIV-positive carriers. Brachial artery diameter, HIV viral load, and CD4 count were measured. RESULTS: We found that viral load correlated inversely with endothelial function; the higher the viral load, the worse the endothelial dysfunction (p < 0.005). CONCLUSION: High viral load appears to be associated with endothelial dysfunction in patients with HIV. This preliminary observation supports the infectious theory that viruses may play an important role in the pathogenesis of atherosclerosis.

Adult↗
PubMed2005

Endothelial function in patients with sickle cell anemia during and after sickle cell crises.

BACKGROUND: Prior studies have demonstrated increased adherence of sickle cell erythrocytes to vascular endothelial cells. While decreased production of nitric oxide and increased production of adhesion molecules have been implicated in this pathophysiology, the relative contribution of these mechanisms during acute sickle cell crises as compared to steady state conditions have not been elucidated. METHODS AND RESULTS: We studied 10 consecutive young adult patients presenting with a sickle cell crisis. Endothelial function was evaluated by a non-invasive brachial artery shear stress method. Serum levels of adhesion molecules were obtained during the crisis. Both brachial artery responsiveness and serum levels of adhesion molecules were then repeated at steady state. Ten age and gender matched volunteers served as a control group. Impaired endothelial function and impaired endothelium-independent vasodilatation were observed in all sickle cell patients during both steady state and during crisis. Flow mediated dilation (FMD)% was 3.25+/- 2.76% during crisis, 4.57+/- 4.11 at steady state, compared with the control group FMD of 11.64+/- 7.69% (p< 0.001). Flow independent dilation was 10.35+/- 11.3% during crisis, 10.03+/- 6.52% at steady state, compared with control group FID of 24.17+/- 11.87% (p< 0.001). Levels of cell adhesion molecules and markers of inflammation were increased in sickle cell crisis patients compared with the control group: sCD40 ligand levels during the acute crisis were over twice the level of normal matched volunteers (p=0.02), and similarly significant increases were seen for E-selectin (p=0.008), ICAM-1 (p=0.037) and VCAM-1 levels (p=0.01). The levels of each of these biomarkers was not significantly increased during acute crises as compared to patients' recovery state. CONCLUSIONS: Sickle cell anemia patients have severe systemic endothelial dysfunction as demonstrated by both brachial artery assessment and increased serum levels of adhesion molecules. These abnormalities characterize not only the sickle cell crisis but also the steady state pathophysiology of sickle cell anemia.

Adolescent↗
PubMed2005

Coumadin-induced hepatitis.

The diagnosis of "coumadin-induced hepatitis" is compatible with the time relationship between the start of the drug and the onset of hepatopathy, the rapid improvement following discontinuation of the drug, recurrence of liver dysfunction after re-exposure to the drug and liver histology. Although liver damage induced by coumadin derivatives is rare, it is important to be aware of the hepatotoxic potential of these drugs, which, in most cases, mimic the clinical presentation of viral hepatitis.

Journal Article↗
PubMed2005

Varicella zoster infection and pulmonary complications.

A 34-year-old immunocompetent man with varicella zoster (VZ) infection developed deep vein thrombosis and pulmonary embolism after suffering severe pneumonitis. He recovered after treatment with acyclovir, high-dose steroids, and ventilatory support. The endothelial damage could be a direct link between VZ pneumonitis and pulmonary emboli.

Journal Article↗
PubMed2005

The beneficial effects of tomatoes.

Dietary intake of tomatoes and tomato products containing lycopene has been shown to be associated with a decreased risk of chronic diseases such as cancer and cardiovascular disease in several recent studies. Serum and tissue lycopene levels have also been inversely related to the risk of chronic disease. While the antioxidant properties of lycopene are thought to be primarily responsible for its beneficial effects, evidence is accumulating to suggest that other mechanisms, such as modulation of intercellular gap junction communication, hormonal and immune systems, and metabolic pathways, may also be involved. Lycopene inhibited the activity of an essential enzyme involved in cholesterol synthesis in an in vitro study and a small clinical study, suggesting a hypocholesterolemic effect.

Journal Article↗
PubMed2004

Endothelial dysfunction and inflammation after percutaneous coronary intervention.

We studied 30 consecutive patients who underwent coronary stenting with respect to postprocedure endothelial dysfunction and levels of pre- and postprocedure cytokines. Patients with severe impairment of flow-mediated dependent dilation, but not flow- mediated independent dilation, had higher concentrations of C-reactive protein before percutaneous coronary intervention (12.9 +/- 20.2 vs 5.6 +/- 13.0 microg/ml, p = 0.04) and 24 hours after stenting (18.8 +/- 20.8 vs 11.8 +/- 20.0 microg/ml, p = 0.05) than patients without severe abnormities of systemic endothelial function. Thus, endothelium-dependent dilation abnormalities were related to the systemic inflammatory state, whereas endothelium-independent dilation abnormalities were not related to the inflammatory status of the patient.

Aged↗
PubMed2004

Transesophageal echocardiography (TEE) vs. transthoracic echocardiography (TTE) in assessing cardio-vascular sources of emboli in patients with acute ischemic stroke.

BACKGROUND: Transesophageal echocardiography (TEE) is a valuable tool in the evaluation of ischemic stroke patients. However, the real clinical impact of additional TEE data remains to be defined. Our purpose was to evaluate the impact of TEE on the management of patients at low risk for cardiogenic embolism. MATERIAL/METHODS: We studied 68 patients (57+/-10 years old) with ischemic stroke at low-risk for cardiogenic embolism. Each patient underwent bilateral carotid ultrasound Doppler study, trans-thoracic echocardiography (TTE) and TEE in order to find out left atrial spontaneous echo contrast or intracavitary thrombi, communication or aneurysm of the inter-atrial septum, ventricular septal defect, patent foramen ovale, and the presence of intra-aortic atherosclerotic plaques or thrombi. RESULTS: In 28 out of 68 patients TEE found an abnormal lesion that has not been detected by TTE: there were 23 diffuse (>5mm) atherosclerotic atheromas in the aortic arch, 5 patent foramen ovale (PFO) lesions, 3 left atrial thrombi, 1 ventricular septal defect (VSD), and 1 atrial septal defect (ASD). 6 patients had more than 1 finding. These findings changed the management, and all 28 patients started to be treated with Coumadine instead of Aspirin. Patients with PFO were sent to close the shunt with a patch. CONCLUSIONS: In half of the patients TEE (but not TTE) found a significant lesion that changed our policy of management. None of these lesions were detected by TTE. It seems that TEE is mandatory in the evaluation of patients with acute ischemic stroke.

Aged↗
PubMed2004

The predictive value of white blood cell count on the success of primary percutaneous intervention of the left anterior descending artery in patients admitted with acute anterior wall myocardial infarction.

Background: Epidemiological studies have shown correlations between the white blood cell (WBC) count and the risk of acute myocardial infarction (AMI) and stroke. The risk of AMI is four times as great in patients with WBC counts in the high-normal range (>9000/microl) as it is in those in the low-normal range (<6000/microl). A high WBC count also predicts a greater risk of re-infarction and in-hospital death. Data are still missing about the role of WBC count in the success rate of primary angioplasty. Methods: A total of 125 consecutive patients aged 40-65 years (mean age 54+/-8 years) had a primary percutaneous coronary intervention (PCI) as their first-line therapy for AMI. We evaluated interrelationships between WBC count, hemoglobin (Hg), platelets (PLT), heart rate (HR), left ventricular systolic (LVS) pressure, left ventricular diastolic (LVD) pressure, and the success rate of primary angioplasty to the occluded left anterior descending artery (LAD) in patients with AMI. Results: Of the 125 patients (30 females and 95 males), 72 underwent primary PCI to the LAD and 31 patients were referred for an emergency coronary artery bypass graft surgery (CABG). One patient died. Twenty-one patients had non-occluded arteries, most of them with a fresh thrombus and after spontaneous reperfusion. Multiple logistic dregression analysis demonstrated that low ejection fraction (p=0.01) and high WBC counts (p=0.04) were correlated with failure of angioplasty and referral for an emergency CABG. WBC counts were positively correlated with heart rate (p=0.005), platelet count (p=0.0006), and Hg level (p=0.001). Conclusions: These data suggest that measuring WBC count on admission to the catheterization laboratory for primary angioplasty provides clinically important prognostic information.

Journal Article↗
PubMed2004

Leukocytes and coronary heart disease.

Inflammation has been demonstrated to be an important risk factor for the development of cardiovascular events. Patients with elevated white blood cell counts have been shown to be in a higher risk of developing acute myocardial infarction and acute coronary and vascular events. We review the clinical data of high white blood cell counts and the prognosis, and demonstrate several possible mechanisms. It is possible that measuring white blood cell count and subpopulations could be used for a better way of risk stratification of patients admitted with acute vascular events.

C-Reactive Protein↗
PubMed2004

Soluble CD40 ligand is an early initiator of inflammation after coronary intervention.

BACKGROUND: This prospective study evaluated the early increase in markers of inflammation after coronary stenting, and the predictors of early rise. Elevation of markers of inflammation after percutaneous coronary intervention correlates with an increased risk of adverse events. The role of soluble CD40 ligand (sCD40L) as a potential initiator of inflammation after stenting has not been described. METHODS: Seventy-five patients were treated with heparin alone (n=25), or randomized to adjuvant treatment with eptifibatide (n=26) or abciximab (n=24) during stenting. Systemic blood was obtained before coronary stenting and at 10 min after stenting. C-reactive protein (CRP), interleukin (IL)-6, IL-1 receptor antagonist and sCD40L were determined by enzyme liberated immunosorbent assay. RESULTS: sCD40L exhibited the greatest relative rise (35%, P=0.01 compared to concentrations before intervention) in the first 10 min after stenting. In a logistic regression model, an early increase in the concentration of sCD40L was predicted by baseline laboratory values (white blood count and sCD40L level before stenting) and procedural characteristics (number of stents and glycoprotein IIb-IIIa inhibitor assignment). CONCLUSIONS: In conclusion, a systemic inflammatory response is detectable 10 min after coronary stent placement. The early increase in sCD40L suggests a possible role for this marker in the initiation of inflammation after coronary stenting.

Abciximab↗