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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Severe obesity affects the health and quality of life of 4 million Americans. The major cost of treating severe obesity and its associated comorbidities of hypertension, diabetes, cardiovascular disease, pulmonary insufficiency, cancer, and degenerative arthritis as well as the poor long-term results of medical, drug, and behavioral therapy has increased the numbers of patients being referred for surgical treatment. Gastric bypass and vertical banded gastroplasty are the two procedures recommended for severely obese patients. These operations currently have low morbidity and mortality. Surgery should be considered adjuvant therapy and must be part of a multidisciplinary approach. The significant long-term weight control resulting from the surgical therapy is associated with improvement and, often, resolution of comorbidities, including diabetes, hypertension, hyperlipidemia, and pulmonary insufficiency.
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PMID:The role of gastric surgery in the multidisciplinary management of severe obesity. 787 45

To evaluate long-term benefits and risks of CyA therapy in renal transplantation, we analyzed the 10-year experience with all 59 patients who had received a first cadaveric renal graft until August 1983 and were immunosuppressed with CyA. We compared their actual graft survival with that of all 213 patients who had received a first cadaveric graft from 1967 until August 1983, but were immunosuppressed initially with azathioprine and prednisone (AzaP). For comparison of p-creatinine, proteinuria, blood pressure, lipids, uric acid and skin malignancies we evaluated the patients staying unchanged on initial therapy for 10 years (CyA = 12, AzaP = 53). RESULTS. (1) Actual graft survival at 10 years was 34% (20/59) with CyA and 27% (58/213) in AzaP treated patients (intention to treat) (P = .09 = ns). At 1 to 5 years, graft survival was 15% superior with CyA, but after 7 years the survival curve of the CyA-group has closely joined the chronic decline seen in the AzaP group. This behaviour could neither be explained by chronic CyA-nephrotoxicity nor by chronic rejection after switching from CyA to AzaP. (2) P-creatinine at 10 years was significantly (P < .03), but mildly elevated under CyA (130 +/- 52; AzaP = 109 +/- 65). (3) Proteinuria (g/d) at 10 years was not significantly different (CyA = 0.41 +/- 0.58, versus AzaP = 0.83 +/- 1.61). (4) Systolic blood pressure was higher at 10 years under CyA (152 +/- 19) than under AzaP (136 +/-) (P < .02), but diastolic pressure was not (89 +/- 10 versus 84 +/- 12; ns). Antihypertensive drug/patient was twice as high under CyA (1.25 versus 0.64 P < .02). (5) Cholesterol, triglyceride, HDL were not different. 75% of the CyA-patients were steroid free at 10 years, none of the AzaP-patients. (6) P-uric acid was not significantly different in both groups (494 +/- 192 vs 400 +/- 124), but 42% of CyA-patients were on uric acid lowering drug (given after at least one gout attack) as compared to 9% under AzaP (P < .006). (7) Seventeen percent of patients under CyA for 10 years had at least one skin cancer, not different from 15% of AzaP-patients. CONCLUSIONS. The main benefit of CyA was the better graft survival up to 5 years and the chance to stay free of steroids. The main risks of CyA were nephrotoxicity, hypertension and symptomatic hyperuricemia. No difference was found for hyperlipidemia and skin-malignancies.
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PMID:Long-term benefits and risks of cyclosporin A (sandimmun)--an analysis at 10 years. 794 Jul 65

The first vasectomy operation was carried out 100 years ago in patients with prostate hyperplasia with symptoms. Then it became extensively used for hereditary hygiene purposes/eugenics, especially after the passing of the sterilization law in Denmark in 1935. In Nazi Germany, vasectomies and castrations were also used for forced sterilization of undesired races. Vasectomy has become a popular method of fertility control, especially in the US. In Denmark it is also popular, and since the 1973 sterilization law, approximately 100,000 procedures have been performed with a 95% rate of satisfaction. Vasectomy seems not to be as harmless as previously thought. The blockage of the transport route from the testes does not stop spermatogenesis. Spermatozoa are a certain kind of foreign matter which are first produced in puberty and act as antigens vis-a-vis other organisms. Certain immune complexes are formed that can have implication for a number of autoimmune diseases. Later in life vasectomy can be a potentiating factor in arteriosclerosis according to rhesus monkey experiments. Men with hypertension, hyperlipidemia, or heavy smokers should not undergo vasectomy. On the other hand, a 1990 epidemiological study showed no increased risk of cardiovascular diseases in vasectomized men. Yet the immune complexes could have other, more serious biological consequences. In large cohort studies the connection to testicular cancer has not been proven with certainty, but there may be an increased risk of prostate cancer among the vasectomized. The American Urological Association (AUA) has recently recommended that men over 40 who had been vasectomized should undergo examination and tests for prostate-specific antigen every year for early detection of cancer. There has been no indication of an increased mortality from prostate cancer among vasectomized men in the above epidemiological studies, but the AUA advises counseling patients about the possible connection.
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PMID:[Vasectomy]. 800 96

Coffee is the most commonly used drug in the United States. The medical literature is conflicted regarding the harmful effects of coffee and caffeine. Because the articles that have appeared are so different, a formal meta-analysis is not the ideal way to summarize the data. However, this literature review suggests that coffee does not have an appreciable effect on hyperlipidemia, hypertension, ischemic heart disease, or cancer. The effects of decaffeinated coffee are much less well-defined, and there is little rationale for recommending that patients switch to decaffeinated coffee. A less appreciated problem with caffeine is that it may increase the risk of osteoporosis and hip fracture.
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PMID:Coffee: brew or bane? 801 Mar 38

Cytokines induce a number of changes in lipid metabolism that can produce hyperlipidemia. Leukemia inhibitory factor (LIF), a recently discovered cytokine, has been suggested to play a role in the cancer cachexia syndrome through its ability to decrease lipoprotein lipase (LPL) activity. This study explores the mechanism by which LIP decreases LPL activity in cultured adipocytes and determines its effects on fatty acid synthesis and lipolysis to see if it shares the same catabolic effects on fat cells as seen with other cytokines, such as tumor necrosis factor (TNF). LIF decreased LPL activity in cultured adipocytes by 44% compared with an 85% decrease produced by TNF. Although the percent decrease in LPL activity is not as great in LIF-incubated adipocytes as in TNF-incubated adipocytes, the half-maximal doses for both cytokines are similar. LPL messenger RNA levels paralleled LPL activity in the LIF-treated adipocytes, suggesting that the effect of LIF on LPL activity is predominantly mediated through transcriptional regulation. In contrast to TNF, LIF tended to increase the de novo synthesis of fatty acids. Acetyl coenzyme-A carboxylase messenger RNA levels paralleled the changes seen in fatty acid synthesis for both cytokines. LIF caused a small increase in lipolysis, whereas TNF increased lipolysis by greater than 2-fold. These results demonstrate that the catabolic effects of LIF are weaker than those of TNF and are predominantly directed toward decreasing LPL activity, which may contribute to the hyperlipidemia associated with infection, inflammation, and cancer.
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PMID:Leukemia inhibitory factor induces changes in lipid metabolism in cultured adipocytes. 801 46

The progress of surgical techniques and the development of more potent immunosuppressive drugs have increased the success rate of renal transplantation such that the quality of life for kidney transplant patients is at the present time superior to that for dialysed patients. However, both renal and extrarenal complications may develop. Acute rejection episodes are the main factor governing long-time renal survival and its treatment with reinforced immunosuppressive therapy may lead to severe infections. Surveillance of kidney transplant patients should include the thorough search for side effects of immunosuppressive therapy and potential drug interactions. Progressive loss of graft function is observed in the majority of patients. Cardiovascular complications, related to the increased incidence of hypertension and hyperlipidemia, remains the main cause of death in kidney transplant patients. Long-term immunosuppression also increases the incidence of cancer, in particular of skin cancer and lymphoma. Despite these potential complications, major efforts must be made to improve organ donation, as both on medical and economical grounds, renal transplantation appears to be the best method available for kidney function replacement.
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PMID:[After care following kidney transplantation]. 801 6

The Muir-Torre syndrome is a rare disorder characterized by sebaceous neoplasms of the skin and multiple visceral malignancies. The syndrome appears to be a familial, autosomal dominant condition. We diagnosed this syndrome in a previously unreported patient and found a personal and family history of malignancies and hyperlipidemia. The association of Muir-Torre syndrome with a family history of hyperlipidemia, another autosomal dominant condition, has not been previously reported. The possible genetic relationship between the two disorders is discussed.
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PMID:Muir-Torre syndrome associated with a family history of hyperlipidemia. 843 39

Numerous investigations have demonstrated altered systemic lipid metabolism in cancer patients, as well as aberrant lipid utilization by tumor cells. The most common measure of altered systemic lipid metabolism in these individuals has been hyperlipidemia. Although cachexia is not generally considered to be associated with gynecologic cancers, this study demonstrates the presence of lipolysis-promoting activity, detectable in sera and ascites of ovarian cancer patients and indices of altered systemic lipid metabolism. Elevated lipolysis promoting activity was detectable in the sera of 7/9 patients and in the ascites of 5/5 patients. Since previous studies have indicated that cancer patients exhibit a 2.5-fold enhancement in hormone-sensitive lipase (HSL) versus normal controls, as a potential mechanism for elevated lipolysis, the ability of ascites-derived factors to induce HSl was examined. The addition of three of four ascites fluids increased the level of HSL in normal adipocytes. All of the patients' samples exhibited elevated lipid levels versus normal peritoneal fluid. Isolation and analysis of lipids from three ovarian cancer patients revealed four consistent altered lipid parameters compared to normal peritoneal fluid: elevated monoglycerides, diglycerides, and free fatty acids and decreased triacylglycerides. While "classical" cachexia is not a common feature of ovarian cancer, the presence of circulating lipolysis-promoting activity and altered lipid metabolism, generally observed in cachectic individuals, can be demonstrated in these ovarian cancer patients. Based on recent evidence indicating a role of lipids in carcinogenic initiation or promotion, the presence of tumor-derived lipolysis-promoting factor and lipid metabolism alterations may provide a mechanism for the epidemiologically observed association between lipids and certain cancers, including ovarian cancer.
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PMID:Aberrations in normal systemic lipid metabolism in ovarian cancer patients. 855 25

1. INTRODUCTION. In primary care, the appropriate selection of test items is needed for correct diagnosis; it is also needed from the point of view of cost effectiveness. Thus, the Japan Society of Clinical Pathology recommended screening test items in clinical medicine [1]. In this study, we developed a microcomputer-based decision support system using these screening items to guide general medical practitioners to a correct interpretation of the results of laboratory tests. 2. SYSTEM Configuration The current version of the decision support system is designed to be run on PC-9821Bp (486 NEC computer) under the Window 3.0 environment. The input parameters are 26 essential items of laboratory tests, including urinalysis, fecal occult blood, hematological, and biochemical and serological tests recommended by the Japan Society of Clinical Pathology. The support system is composed of two processes. Firstly, the system can output any of the following diagnostic categories: 1) inflammatory disease, 2) muscular or myocardial disease, 3) anemia, 4) malignant tumor, 5) reno-urinary disease, 6) hepatobiliary disease, 7) diabetes mellitus, 8) gastrointestinal disease, 9) bone disease, 10) hyperlipidemia, and 11) normal. In the next step, the system can output some recommendations as to what minimum tests or what maneuver must be done to reconfirm the final diagnosis. The diagnostic part of the program uses decision-tree logic. 3. RESULTS. The subjects were 219 patients who were admitted to the Nagoya University Hospital; the diagnostic categories had been already confirmed. In each diagnostic category, 10-20 cases of infectious disease, 34 of 74 cases of malignant disease, 2 of 6 cases of muscular disease, 14 of 14 cases of anemia, 2 of 16 cases of malignant tumor, 42 of 55 cases of reno-urinary disease, 8 of 14 cases of diabetes mellitus, 9 of 20 cases of gastrointestinal disease, 3 of 26 cases of bone disease, and 14 of 18 cases of hyperlipidemia were correctly diagnosed using the first step of this system. 4. DISCUSSION. This diagnosis supporting system was very efficient for screening anemia, reno-urinary disease, diabetes mellitus, and hyperlipidemia. If this system is combined with information from disease history and physical examination, the diagnosis will be both easy and enhanced. Since the system can suggest effective tests to pinpoint the disease, unnecessary tests will be avoided. Lower diagnostic accuracy was seen in infectious disease, malignant tumor, muscular disease, and bone disease. For these diagnostic categories, additional items are necessary. In conclusion, basic tests are very useful for screening anemia, reno-urinary disease, diabetes mellitus, and hyperlipidemia; the system can provide the minimum and correct test items for diagnosis in primary care.
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PMID:A decision support system for diagnostic consultation in laboratory tests. 859 61

A prospective case-control study was carried out to clarify associations of cerebral transient ischemic attacks (TIAs) and other stroke risk factors with progression and exacerbation of cardiovascular and cerebrovascular disorders; 243 neurologically normal controls and 123 TIA patients without prior history of stroke were followed up for a mean interval of 4.4 years of TIA patients, 26 (21%) developed other events (excluding recurrent TIAs); 10 died of vascular causes (8.1%). Of controls, 44 (18%) developed events; 13 died of vascular causes (5.4%) and 3 from cancer. TIA patients were at 2.3 times greater risk than normal controls for stroke or death from vascular causes. They were predominantly male with significantly higher associations of risk factors for stroke, including hypertension, heart disease, diabetes mellitus, smoking, hyperlipidemia, alcohol consumption, and limited education. Controls developing vascular events compared with controls who did not were older, more frequently male, and with greater incidences of heart disease. TIA patients had lower rates of cerebral perfusion compared with controls that persisted throughout the study, with similar rates of decline related to aging among both groups. Among TIA patients, stroke risk factors were more prevalent than among controls. The longer their duration, the greater the incidence and the more rapid the rate of severe, often fatal cardiovascular complications.
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PMID:Prospective study of vascular events and cerebral perfusional changes following transient ischemic attacks. 863 63


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