Asunto(s)
Policitemia Vera/complicaciones , Policitemia/etiología , Anciano de 80 o más Años , Comorbilidad , Resistencia a Medicamentos , Eritropoyesis/efectos de los fármacos , Eritropoyetina/sangre , Humanos , Hidroxiurea/farmacología , Hidroxiurea/uso terapéutico , Janus Quinasa 2/genética , Masculino , Mutación Missense , Flebotomía , Mutación Puntual , Riñón Poliquístico Autosómico Dominante/complicaciones , Riñón Poliquístico Autosómico Dominante/diagnóstico por imagen , Policitemia Vera/tratamiento farmacológico , Policitemia Vera/genética , UltrasonografíaRESUMEN
Patients with essential thrombocythemia often complain of various subjective neurological symptoms. This prospective study aims to assess their incidence and response to therapy. Among 37 consecutive patients with essential thrombocythemia, 11 presented with neurological symptoms. Among them 4 had thrombotic events, 7 complained of transient or fluctuating subjective symptoms, and one had both. Brain magnetic resonance imagery failed to detect any substratum in patients with subjective symptoms. JAK2V617F mutation was found in 9 of 11 patients with neurological symptoms versus 14 of 26 patients without symptoms. Ten patients received low-dose aspirin for these symptoms: complete resolution was observed in 3, improvement with persisting episodes in 2, and resistance to aspirin in 2 patients, in whom addition of cytoreductive therapy became necessary to resolve those disabling symptoms. In this prospective cohort, 30% of patients with essential thrombocythemia presented neurological symptoms. Aspirin was fully efficient in only 30% of cases. JAK2V617F mutation could be a risk factor for such symptoms.
Asunto(s)
Enfermedades del Sistema Nervioso/epidemiología , Trombocitemia Esencial/epidemiología , Sustitución de Aminoácidos , Antiinflamatorios no Esteroideos/administración & dosificación , Aspirina/administración & dosificación , Estudios de Cohortes , Femenino , Humanos , Janus Quinasa 2/genética , Janus Quinasa 2/metabolismo , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Mutación Missense , Enfermedades del Sistema Nervioso/diagnóstico por imagen , Enfermedades del Sistema Nervioso/tratamiento farmacológico , Enfermedades del Sistema Nervioso/enzimología , Enfermedades del Sistema Nervioso/etiología , Enfermedades del Sistema Nervioso/genética , Radiografía , Factores de Riesgo , Trombocitemia Esencial/complicaciones , Trombocitemia Esencial/diagnóstico por imagen , Trombocitemia Esencial/tratamiento farmacológico , Trombocitemia Esencial/enzimología , Trombocitemia Esencial/genéticaRESUMEN
Exogenous advanced glycation endproducts (AGEs, known atherogenic molecules) abundant in everyday precooked, rich in fat, overheated meals can possibly contribute to the increased risk for diabetes and cardiovascular disease in women with polycystic ovary syndrome (PCOS). The aim of the present study was to investigate the effect of a lipase inhibitor on absorbed food glycotoxins in healthy women and those with PCOS. A 2-day protocol was followed. In the first day, a meal rich in AGE was provided, which on the second day was followed by two 120-mg capsules of lipase inhibitor, orlistat. Serum AGE levels were evaluated at baseline (0 hours), and at 3 and 5 hours postmeal during the study. Thirty-six women were studied, 15 controls (mean age, 28.80 +/- 5.47 years; body mass index, 25.85 +/- 6.73 kg/m(2)) and 21 with PCOS (mean age, 25.29 +/- 5.06 years; body mass index, 30.40 +/- 7.51 kg/m(2)) (University Hospital, Athens, Greece, institutional practice). Serum AGE levels, on day 1, were significantly increased both in the control group and in the PCOS group as compared with basal values (control group, 14.1%; PCOS group, 6.0%; P < .001). The corresponding rise was significantly lower on day 2 when the same meal was combined with orlistat (control group, 4.1%; PCOS group, 2.0%; P < .01). A limitation of the study is that it is a nonplacebo, nonrandomized therapeutic trial where each subject is considered as its own control. In conclusion, this study demonstrated the beneficial effect of orlistat on the absorption of food glycotoxins.