Familial hypercholesterolemia (FH) is an autosomal dominant-inherited genetic disorder that leads to elevated blood cholesterol levels. FH may present as severely elevated total cholesterol and low ...density lipoprotein (LDL) cholesterol levels or as premature coronary heart disease (CHD).
This review presents information on the disease and on the effects of drug treatment and lifestyle changes.
Routine lipid testing should identify most patients with FH. Once an index case is identified, testing should be offered to family members. Early diagnosis and aggressive treatment with therapeutic lifestyle changes and statins can prevent premature CHD and other atherosclerotic sequelae in patients with FH.
Emerging therapies such as LDL apheresis and novel therapeutic agents may be useful in patients with homozygous FH or treatment-resistant FH. Liver transplantation is the only effective therapy for severe cases of homozygous FH.
Hypertriglyceridemia Pejic, Rade N; Lee, Daniel T
Journal of the American Board of Family Medicine,
2006 May-Jun, Letnik:
19, Številka:
3
Journal Article
Recenzirano
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Hypertriglyceridemia is a commonly encountered lipid abnormality frequently associated with other lipid and metabolic derangements. The National Cholesterol Education Program recommends obtaining a ...fasting lipid panel in adults over the age of 20. The discovery of hypertriglyceridemia should prompt an investigation for secondary causes such as high fat diet, excessive alcohol intake, certain medications, and medical conditions (eg, diabetes mellitus, hypothyroidism). In addition, patients should be evaluated for other components of the metabolic syndrome. These include abdominal obesity, insulin resistance, low high-density lipoprotein (HDL), high triglyceride, and hypertension. Hypertriglyceridemia is classified as primary hypertriglyceridemia when there are no secondary causes identified. Primary hypertriglyceridemia is the result of various genetic defects leading to disordered triglyceride metabolism. It is important to treat hypertriglyceridemia to prevent pancreatitis by reducing triglyceride levels to <500 mg/dL. Furthermore, lowering triglycerides while treating other dyslipidemias and components of the metabolic syndrome will reduce coronary events. However, it is controversial how much isolated hypertriglyceridemia correlates directly with coronary artery disease and further studies are needed to clarify whether treatment for this condition leads to meaningful clinical outcomes. Therapeutic lifestyle changes (TLC) are the first line of treatment for hypertriglyceridemia. These changes include a low saturated fat, carbohydrate-controlled diet, combined with alcohol reduction, smoking cessation, and regular aerobic exercise. High doses of omega-3 fatty acids from fish and fish oil supplements will lower triglyceride levels significantly. When patients do not reach their goals by TLC, drug therapy should be started. In cases of isolated hypertriglyceridemia, fibrates are initially considered. When elevated low-density lipoprotein levels accompany hypertriglyceridemia, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors are preferred. In patients with low HDL levels and hypertriglyceridemia, extended release niacin can be considered. A combination of the medicines may be necessary in recalcitrant cases.
Letters to the Editor Zanetti-Yabur, Alana; Pejic, Rade N; Dy, Rajany ...
The Ochsner journal,
04/2017, Letnik:
17, Številka:
1
Journal Article
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CASE REPORT The patient is a 58-year-old male with end-stage renal disease secondary to hypertension and polycystic kidney disease on hemodialysis. VOO was suspected, and the venous anastomosis was ...taken down after reclamping the vasculature, but no obvious problem was visualized. ...when the arterial clamp was opened, no venous bleeding was seen, suggesting a problem proximally. ...the back-table surgeon must fully interrogate the lumen of the renal vein—especially true when creating an elongated venous outflow conduit for right kidney allografts—to offset the chance occurrence of VOO. 1.
Odnosi između 25 indikatora motoričkih sposobnosti i 18 sukcesivno mjerenih sekvenci na standardnom poligonu pješadijskih prepreka izmjerenih u dva navrata određeni su kvazikanoničkom analizom ...kovarijanci. Utvrđeno je da motoričke sposobnosti u visokoj mjeri i na različite načine utiču na: duotrajnu eksploataciju bazičnih motoričkih znanja, efikasno svladavanje biomehanički složenih i biiomehanički jednostavnih motoričkih zadataka.
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