This work aimed at investigating the lipid profile of zoonotic visceral leishmaniasis (VL) patients' sera and the effect of lipoproteins on the in vitro production of tumour necrosis factor-alpha (TNF-alpha), interleukin (IL)-6, IL-10 and IL-12 by Leishmania infantum-infected and uninfected macrophages. Lipids were quantified in 26 VL patients' sera and 26 healthy controls from a VL endemic area. The patients' sera had higher triglyceride and very low density lipoprotein (VLDL) levels, and much lower apolipoprotein A1, total cholesterol, low density lipoprotein (LDL) and high density lipoprotein (HDL) levels than the control sera. Lipoprotein fractions were obtained by ultracentrifugation of sera. The addition of LDL and HDL to Leishmania-infected and uninfected macrophages, in physiological concentrations, enhanced the production of IL-6 and IL-10, but not of IL-12. LDL stimulated the production of TNF-alpha only in infected macrophages, whereas HDL stimulated the production of lower amounts of TNF-alpha in both infected and uninfected macrophages. VLDL stimulated only the production of IL-10. It is proposed herein that LDL may influence the development of VL by promoting the production of TNF-alpha by infected macrophages. A decrease in plasma LDL in some VL patients (to 20 mg/mL or less); however, would tend to reduce the production of TNF-alpha and therefore to limit the development of immune-mediated pathology, not withstanding the fact that it would perhaps increase the permissiveness of macrophages to Leishmania growth.

The present work compares six biochemical methods for extraction of lipids from human serum. Although some organic solvents were good lipid extractors, they precipitated most of the total proteins and albumin. On the other hand, methodologies using Triton X-114 and silica were efficient for extraction of lipids, while sparing the protein fraction.

A339 22700 diabetic patients in Madrid was used to estimate transition probabilities in the model. Time horizon was 10 years. Prices were taken from the health care tariffs published by the Regional Health Service in Madrid and from Spanish literature. They were updated to 2013 price levels and adjusted to subsequent years by a 3% inflation rate. We used the perspective of the Regional Health Service in Madrid (public payer). Results: The model included an acute event and 3 health states. The increase in total costs in 10 years was € 1,328 per DM patient (133 € per year). In patients with hypertension the costs increased by 1,519€ in 10 years (152 € ); whereas the total increase in costs in patients with obesity was 1,535 € (153 € ). ConClusions: IS has a relevant impact on the costs of management of DM. Hypertension and obesity increase these costs even further. Prevention of DM complications and an adequate control of risk factors can lead to cost savings for the management of DM. Understanding future costs of DM might be valuable for economic evaluations.