Background: Hypertension and obesity are major risk factors for health problems and cardiovascular diseases in developing and developed countries. There is limited evidence available on the correlation between high blood pressure and obesity despite their close association.
Methods: The current study aimed to find the correlation between anthropometric measurements, lipid profile, visfatin, apelin, and blood pressure parameters in 31 newly diagnosed hypertensive patients and 32 enalapril-treated hypertensive patients.
Results: In enalapril treated patients, a significant negative relationship between visfatin and triglyceride (TG). Conversely, there is a positive correlation between visfatin and HDL. Moreover, visfatin expressed a negative correlation with VLDL. Concerning the newly diagnosed hypertensive group, a non-significant correlation was found between serum visfatin and lipid profile parameters. Additionally, a significant negative correlation between apelin and DBP in enalapril treated patients. Moreover, significant negative correlation between apelin and SBP in enalapril treated patients. On the other hand, a non-significant correlation between apelin and blood pressure parameters in the newly diagnosed hypertensive group was found. Moreover, there was a significant positive relationship between BMI and visfatin by comparing these two variables in all studied group participants.
Conclusion: We concluded that anthropometric measurements, adipokines, and lipid profiles most closely relate to high blood pressure in hypertensive patients.
Background: Excess total body fat causes low-grade systemic inflammation that precedes cardiometabolic damage. Plycometry is a widely accepted method for measuring total body fat, but not all physicians are trained to do it. The waist-to-height ratio is simpler to assess and has been recognized as a predictor of cardiovascular risk, but not as an indicator of total body fat. This study evaluated whether plycometry can be substituted by this ratio, and thus make an early intervention on systemic inflammation without having to be trained in plycometry.
Methods: Cross-sectional study based on a clinical trial of 40 patients who underwent a 14-week weight loss intervention. As part of the evaluations, weight, height, waist circumference and total body fat were obtained, which are the variables analyzed in this study. Pearson's correlation test was performed in duplicate: before and after the intervention. In all cases a p<0.05 was considered significant.
Results: The waist-to-height ratio correlated moderately with total body fat (R=0.7) before the intervention. At the end of the intervention the correlation increased to strong (R=0.8). When stratifying by body mass index grades, a trend of higher correlation was observed in the body mass index group between 25 and 26.9 kg/m2 (0.7 before and 0.85 after the intervention, respectively).
Conclusions: The waist-to-height ratio is not a substitute for plycometry, but it can be useful in predicting a low-grade systemic inflammatory state, especially in patients with a body mass index under 27 kg/m2. Further research is needed to assess the cutoff point at which low-grade systemic inflammation begins, so that more accurate information can be provided for intervention based on waist-to-height ratio.
Background: Atherosclerotic renal artery stenosis (RAS) is a significant cause of renal failure, especially in patients with a solitary functioning kidney. Timely revascularization can potentially reverse ischemic nephropathy and prevent further complications like pulmonary edema and uncontrolled hypertension.
Case Presentation: A 71-year-old male with a solitary functioning kidney presented with worsening renal function, chronic hyponatremia, and recurrent flash pulmonary edema. The patient presented with a 95% ostial stenosis of the right renal artery. Percutaneous renal artery stenting was performed successfully, resulting in improved clinical status and renal function. Serum creatinine decreased from 3.07 mg/dL to 2.1 mg/dL post-procedure. The patient remained stable at a two-month follow-up.
Conclusion: Renal artery stenting in patients with ischemic nephropathy secondary to RAS can significantly improve renal function and overall clinical outcomes. Early intervention should be considered in similar cases to prevent irreversible renal damage.
Background: White blood count is considered one of the important inflammatory markers, and its age and gender dependent, under unusual pathological conditions, which can lead to false elevation in TWBCs and should be corrected. Rare cases associated with severe hemolytic anemia and severe leukopenia have potential limitation when corrected using conventional formula.
Case presentation: A case report of 4 years old Sudanese boy patient who was hospitalized with sickle cell disease (SCD). Complete blood count (CBC) parameters were analyzed using 3PD Automated Hematology Analyzer. Peripheral blood picture (PBP) was prepared and stained using leishmen's stain. The data calculate using alternative formula as following. Corrected TWBCs = {mean white blood cells (HPF)/ mean NRBCs (HPF)} × TWBCs. The laboratory findings revealed TWBCs: 124×103/μL, PBP show one WBCs among each 30 NRBCs in ratio of 0.033, the corrected TWBCs: 4.09×103/μL. NRBCs: 119.9×103/μL.
Conclusion: The presence of NRBCs on ratio more than 1:1 NRBCs to WBCs must be calculated using an alternative formula for calculation of NRBCs and corrected TWBCs specially in cases of severe hemolytic anemia and megaloblastic anemia.
The treatment and quality of life of individuals living with obesity represent a significant challenge to global public health. This is due to the multifactorial etiology of the condition, its high prevalence, the exponential increase in incidence, the associated costs of therapy, and, most importantly, its broad impact on the general health of affected individuals (Caballero, 2019; Sharma et al., 2024). Oral health in this population may be adversely affected, directly compromising orofacial functions such as mastication and swallowing. The lifestyles and typical dietary patterns of individuals with obesity must be taken into account (Wang et al., 2021). When present, eating and anxiety disorders may promote compulsive, periodic consumption of ultra-processed, high-calorie foods rich in sugars, sodium, and saturated fats. Under these conditions, several oral manifestations are frequently observed, including dental erosion, caries, bruxism with incisal wear, xerostomia, gingival recession, periodontal disease, dentin hypersensitivity, aphthous ulcers, and oral lichen planus (Voß et al, 2024; Arbildo-Vega et al., 2024). Drawing on clinical experience from dental evaluations of individuals with severe (Class III) obesity who are candidates for bariatric surgery at a public referral center in Northeastern Brazil, we reflect on the challenges involved in addressing oral health needs during the preoperative period for bariatric and/or metabolic surgery. The anticipation of surgical intervention and the expected changes in appearance (aesthetics), self-esteem (related to stigma), mobility, pain levels, and general health indicators often correlates with emotional distress among these patients, influenced by individual and cultural values. The waiting period prior to surgery can range from several months to years and involves a multidisciplinary approach, preoperative weight loss, and behavioral modifications, all of which are critical to achieving a successful treatment outcome. Although most literature on oral health in this context focuses on the postoperative period, optimizing masticatory function preoperatively particularly to improve chewing cycles and enhance satiety remains a major clinical challenge. Faster eating rates and insufficient mastication significantly reduce satiety, increase caloric intake, and alter enteroendocrine responses.
Oral processing including bite size and the number of chews per gram of food is influenced by food texture and complexity (Slyper, 2021). Even when patients are informed about the relevance of dental care in this context, additional barriers often arise. These include emotional responses to the proposed therapeutic approach, conflicts with other scheduled appointments, limited access to services, the need for consistent dental management and monitoring of individuals with severe obesity, the cost and time required for care, and the pursuit of satisfactory outcomes. These factors must be addressed without compromising the broader treatment goals or becoming obstacles within the multidisciplinary process. This sense of lack of control and professional ineffectiveness is frequently reported by oral health practitioners, particularly in the public healthcare system in Northeastern Brazil. The current scenario calls for the adoption of innovative approaches and strategic planning, enabling the full and effective integration of dentistry within the multidisciplinary care team.
