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

Case reports of 2 patients who developed pancreatitis and hyperlipidemia while using oral contraceptives are presented. The 1st patient had been taking Ovulen for 2 years when severe abdominal pain suddenly developed. Initially cholecystitis was diagnosed. Symptoms subsided within 1 week but recurred 2 months later, when the white blood count was increased to 16,400/cubic mm. Serum was grossly lipemic with a triglyceride level of 3500 mg% and serum cholesterol 560 mg%. 3 days later triglycerides had fallen to 400 mg% and cholesterol to 270 mg%. Cholecystography was normal. The pain had subsided. Symptoms have not recurred since stopping use of Ovulen. The 2nd patient was admitted with severe abdominal pain of 48 hours duration. Similar attacks of pain had occurred previously but had been of short duration. She had been taking Ovulen for 3 years. White blood count was increased to 18,000. Serum was grossly lipemic. Serum glyceride concentration was 7000 mg% and cholesterol 1200 mg%. Afer 3 days triglycerides were 500 mg% and cholesterol 475 mg%. Pancreatitis was diagnosed. Therapy was Ryles tube suction, atropine, intravenous saline, and a broad spectrum antibiotic. Symptoms subsided in 10 days. The hyperlipidemia is thought to have been a primary condition causing the pancreatitis. [Patients known to have such a condition should avoid use of oral contraceptives.
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PMID:Hyperlipidaemia and pancreatitis associated with oral contraceptive therapy. 118 40

Cholesterolosis and adenomyomatosis, two diseases of the gallbladder that are unrelated to cholelithiasis or cholecystitis, are detected on oral cholecystograms with considerable frequency. These disorders are of uncertain etiology, and it is also unclear if they cause clinical symptoms. Cholesterolosis is the result of the accumulation of triglycerides and esterified sterols in macrophages in the lamina propria. The abnormality is unassociated with cholesterol gallstones, supersaturation of bile with cholesterol, hyperlipidemia, obesity, or atherosclerosis. Adenomyomatosis involves hyperplasia of the tissues of the gallbladder wall with outpouches of the mucosa similar to diverticula of the colon. In this report, the pathology, etiology, clinical and radiologic features, and treatment of these two entities are reviewed.
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PMID:The hyperplastic cholecystoses: cholesterolosis and adenomyomatosis. 640 1

We reported a rare case of marked dilatation of the bilateral common carotid artery (CCA) associated with stenosis of the left middle cerebral artery (MCA). A 64-year-old female was admitted with right hemiparesis and dysarthria. She was hospitalized 2 years ago for cholecystitis. For 5 years, she has been under medical treatment for hypertension, diabetes mellitus, hyperlipidemia, cardiac failure associated with hypertrophic cardiomyopathy, and atrial fibrillation. Brain CT scan showed infarction of the left corona radiata. Angiography revealed marked dilatation of the bilateral CCA and the internal carotid artery (ICA), moderate dilatation of the innominate artery and the right subclavian artery, kinking of the right CCA, diverticular outpouching of the left ICA, and stenosis of the right external carotid artery and the left MCA. Breast CT scan revealed moderate dilatation and marked calcification of the ascending aorta and the aortic arch. Laboratory examination did not show any sign of inflammation, rheumatoid factor (RA), antistreptolysis-O (ASLO) and antinucleotic antibody. Based on the clinical course, radiological findings and laboratory data, possible diagnosis of the dilatation of the bilateral CCA was discussed with particular emphasis on arteriosclerotic aneurysm and aortitis syndrome.
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PMID:[Marked dilatation of the bilateral common carotid artery: a case report]. 773 79

Aetiologic factors (gallstones, hyperlipidemia I-IV, hypertriglyceridaemia) make their occurrence, mainly, in the third trimester of gestation. Two cases of acute pancreatitis in pregnancy are described; in both cases patients referred healthy diet, no habit to smoke and no previous episode of pancreatitis. An obstructive pathology of biliary tract was the aetiologic factor. Vomiting, upper abdominal pain are aspecific symptoms that impose a differential diagnosis with acute appendicitis, cholecystitis and obstructive intestinal pathology. Laboratory data (elevated serum amylase and lipase levels) and ultrasonography carry out an accurate diagnosis. The management of acute pancreatitis is based on the use of symptomatic drugs, a low fat diet alternated to the parenteral nutrition when triglycerides levels are more than 28 mmol/L. Surgical therapy, used only in case of obstructive pathology of biliary tract, is optimally collected in the third trimester or immediately after postpartum. Our patients, treated only medically, delivered respectively at 38th and 40th week of gestation. Tempestivity of diagnosis and appropriate therapy permit to improve prognosis of a pathology that, although really associated with pregnancy, presents high maternal mortality (37%) cause of complications (shock, coagulopathy, acute respiratory insufficiency) and fetal (37.9%) by occurrence of preterm delivery.
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PMID:[Acute pancreatitis and pregnancy]. 813 93

The development of acute acalculous cholecystitis (AAC) after cardiovascular surgery is an infrequent but devastating complication, the etiology and management of which remains controversial. To evaluate the etiology, treatment, and outcome of patients with AAC, the cases of six patients encountered within an 8-year period who developed AAC after cardiovascular surgery requiring cardiopulmonary bypass (CPB) were reviewed. Atherosclerotic risk factors including diabetes, hyperlipidemia, and smoking were evident in five patients, three of whom had a history of stroke or arteriosclerosis obliterans, while low cardiac output was recognized in three. Percutaneous transhepatic cholecystostomy was performed in five patients, and another required cholecystectomy for peritonitis due to gangrene of the gallbladder. Two patients died of respiratory failure and sepsis after 15 and 82 days of percutaneous drainage, respectively; however, the four survivors had an excellent outcome without any biliary tract disease during a mean follow-up period of 5.3 years. In conclusion, AAC after cardiovascular surgery may result from hypoperfusion of the gallbladder due to various factors including CPB, visceral atherosclerosis, and low cardiac output. We advocate early percutaneous cholecystostomy for patients without peritonitis, while early cholecystectomy is indicated for those with peritonitis.
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PMID:Acute acalculous cholecystitis after cardiovascular surgery. 1087 May 75

Over the last few years, weight loss has been recognised as a key factor in the control and prevention of coronary heart disease, hypertension, type 2 diabetes, hyperlipidaemia, cardiorespiratory failure and other chronic degenerative diseases. It has been shown that even a modest loss of 5% of initial body weight can reduce, eliminate or prevent these disorders in a large proportion of overweight patients. The early benefits of weight loss can be explained by the direct effects of a low calorie diet, but the long-term effects can only partially be attributed to diet, physical exercise or behavioural modifications. Long-term studies have shown that a sustained moderate weight loss of 10% improves glycemic control as a result of reduced insulin resistance, the better control or prevention of hypertension, increased HDL-and decreased LDL-cholesterol and VLDL triglycerides, improved diastolic function and the propagation of a cardiac stimulus that reduces the risk of ventricular arrhythmias. The health benefits of modest weight loss are particularly evident and useful when excess body fat is a major health hazard, as in the case of class III obesity (BMI > 40 kg/m2), which is often characterised by prevalent visceral fat accumulation. Baseline serum glucose, cholesterol, triglyceride, uric acid and blood pressure levels are usually higher in the upper body than is the case in peripheral obesity, and tend to decrease more in response to moderate weight loss. A therapeutic programme aimed at obtaining a gradual and moderate weight loss avoids the complications due to the rapid weight loss associated with inappropriate, unbalanced diets or even more harmful treatments. These complications include cholelithiasis and the subsequent risk of cholecystitis, lean body mass loss and a stable decrease in energy expenditure with a high probability of regaining weight (weight cycling syndrome). In conclusion, a large number of obese patients may be sensitive to a modest weight loss even without the achievement of ideal body weight. Sustained moderate weight loss by itself is definitely beneficial in obesity (especially "malignant" and "morbid" obesity), but also in diabetes, hypertension, hyperlipidaemia, cardiorespiratory diseases and other chronic degenerative diseases associated with any degree of excess body fat.
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PMID:Benefits of sustained moderate weight loss in obesity. 1205 5

Changes in serum protein levels are produced by oral contraceptives. They reflect hepatic synthesis of proteins. Changes range from a 40% decrease in orosomucoid to an 180% increase in ceruloplasmin. Alterations in the concentration of some globulin proteins lead to altered serum levels of some hormones and trace metals. Plasma levels of cortisol and thyroxine are most affected. An estrogen-induced increase in thyroxine-binding globulin causes a transient reduction in free thyroxine (T4). This results in a compensatory increase in thyroid-stimulating hormone. The net effect is an unchanged concentration of T4 and the patient may be reported as euthyr id. Increases in renin substrate with rise in renin activity, angiotensin 2, and aldosterone, may be related to the development of hypertension in some women. Oral contraceptives may cause significant increases in some lipids. Elevations in cholesterol and nonesterified fatty acids are less changed. The drug-induced changes can complicate a definite diagnosis of hyperlipidemia. The glucose tolerance curve in users of oral contraceptives may simulate the diabetic type. Hepatic function tests may suggest hepatic damage. There is a higher incidence of cholecystitis and gallstones in women using oral contraceptives. Blood coagulation tests may be modified. Drug interference from oral contraceptive use must be considered in interpreting laboratory reports.
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PMID:Drug interference with laboratory tests: oral contraceptives. 1226 Jan 55

The obesity epidemic has contributed to an increased prevalence of gallstones and a higher percentage of chronic acalculous cholecystitis. Obesity is associated with Type II diabetes and hyperlipidemia in murine models. In addition, we have previously demonstrated that serum glucose, insulin, cholesterol, and triglycerides correlated with gallbladder contractility in murine models. However, the relative role of insulin resistance and gallbladder fat infiltration in this phenomenon remain unclear. Therefore, we tested the hypothesis that gallbladder wall lipids are related to obesity and diet and are inversely correlated with gallbladder contractility. One hundred lean control (C7BL/6J) and 36 obese leptin-deficient (Lep(ob)) 8-week-old female mice were fed either a chow diet or a 1.0% cholesterol, 15% butterfat (high-lipid) diet for four weeks. Pooled gallbladders were then analyzed for free fatty acids (FFA), phospholipids (PL), total cholesterol (TC), and triglycerides (TG). Cholesterol/phospholipid ratios were then calculated. The Lep(ob) mice fed a chow diet had significantly higher (P < 0.01) gallbladder lipids than the three other groups. The lean mice that were fed a high-lipid diet had increased (P < 0.05) gallbladder TC compared to the lean mice on a chow diet. In addition, the cholesterol/phospholipid ratio was significantly increased (P < 0.01) in the lean mice fed a high-lipid diet compared to the other three groups. Finally, the high-lipid diet decreased gallbladder FFA (P < 0.01), PL (P = 0.08), and TC (P < 0.05) in Lep(ob) mice. These data suggest that (1) obese mice have increased gallbladder lipids; (2) a high-cholesterol, high-fat diet increases gallbladder lipids and the cholesterol/phospholipid ratio in lean mice; but (3) decreases gallbladder fatty acids, phospholipids, and cholesterol in obese mice. Prior studies have documented similarly decreased gallbladder response to neurotransmitters in obese mice on a chow diet, as well as lean and obese mice on a high-lipid diet. Therefore, we conclude that leptin-deficient obesity and/or a high-fat diet causes nonalcoholic fatty gallbladder disease, which is manifested by diminished gallbladder contractility.
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PMID:Nonalcoholic Fatty gallbladder disease: the influence of diet in lean and obese mice. 1645 50

Obesity, diabetes, and hyperlipidemia are known risk factors for the development of gallstones. A growing body of animal and human data has correlated insulin resistance with organ dysfunction. The relationship among obesity, diabetes, hyperlipidemia, and abnormal gallbladder motility remains unclear. Therefore, we designed a study to investigate the association among obesity, insulin resistance, hyperlipidemia, and gallbladder dysmotility. One hundred ninety-two healthy adult nondiabetic volunteers were studied. Gallbladder ultrasounds were performed before and after a standardized fatty meal. A gallbladder ejection fraction (EF) was calculated, and an EF of < 25% was considered abnormal. Serum was analyzed for cholesterol, triglycerides, cholecystokinin, leptin, glucose, and insulin. The homeostasis assessment model (HOMA) was used to determine insulin resistance. The volunteers had a mean age of 38 years (range, 18-77), and 55% were female. Thirty subjects (15%) had gallstones and were excluded from the study. Thirty subjects (19%) had abnormal gallbladder motility (EF < 25%). In lean subjects (n = 96) fasting glucose was significantly increased in the 16 subjects with gallbladder EF < 25% versus the 80 subjects with gallbladder EF > 25% (109 +/- 20 mg/dl versus 78 +/- 2 mg/dl, P < 0.05). Similarly, the HOMA index was significantly greater in subjects with gallbladder EF < 25% versus gallbladder EF >25% (3.3 +/- 1.2 versus 2.0 +/- 0.2, P < 0.05). In obese subjects (n = 66), fasting glucose, insulin, and insulin resistance were not associated with a gallbladder EF < 25%. These data suggest that in lean, nondiabetic volunteers without gallstones, gallbladder dysmotility is associated with an elevated fasting glucose as well as a high index of insulin resistance. We conclude that insulin resistance alone may be responsible for gallbladder dysmotility that may result in acalculous cholecystitis or gallstone formation.
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PMID:Insulin resistance causes human gallbladder dysmotility. 1684 64

The study was undertaken to determine the serum lipid profile in patients with obstructive jaundice (OJ) of various genesis versus those with chronic viral hepatitis B (CVHB). The serum lipid profile was studied in 50 patients with OJ whose cause was cancer diseases and calculous cholecystitis in 20 and 30 patients, respectively. Thirty patients with CVHB were examined as a control group. In patients with OJ, the relative serum content of phospholipids was found to be twice less than that in patients with CVHB. In patients with OJ, hyperlipemia was mainly caused by free cholesterol or cholesterol esters. As compared with the patients with calculous cholecystitis and CVHB, the patients with cancer diseases had low sphingomyelin levels; this fact may be used as an additional measure in detecting OJ of cancer genesis.
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PMID:[Serum lipid spectrum in patients with obstructive jaundice]. 1822 56


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