Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Estrogen replacement in menopause should be used for specific symptoms such as ovarian failure, hot flushes, vaginal atrophy, atrophy of the vulva, and atrophic urethritis. The dose should be as low as possible to be effective and perscribed for as short as time as possible, since there are possible risks of uterine cancer, breast cancer, increased blood pressure, gallstones, deep vein thrombosis, and thromboembolism. Estrogens should be administered to provide the maximum benefit with the minimum risk involved. Estrogens should not be given to patients with known contraindications such as: suspected breast or uterine cancer; undiagnosed genital bleeding; Dubin-Johnson syndrome; acute hepatic disease; previous or present thromboembolism; or severe thrombophlebitis. Careful evaluation should be made before administering estrogen to women with uterine myomata, hyperlipidemia, hypercholesterolemia, sevare varicose veins, chronic hepatic dysfunction, diabetes mellitus, porphyria, or severe hypertension.
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PMID:Estrogen replacement in the menopause. 39 Apr 56

Factors contributing to deep vein thrombosis (DVT) were studied in 51 patients (62 knees) who had a cementless total knee arthroplasty (TKA) and in 51 patients (69 knees) who had a cemented TKA. All patients were treated with a primary TKA using a porous-coated anatomic prosthesis with a porous-coated central tibial stem. Deep vein thrombosis was diagnosed by roentgenographic venography, and pulmonary embolism was diagnosed by perfusion lung scanning. Incidence of DVT was 32%, and there was no pulmonary embolism. The factors that do not seem to have much relevancy to DVT were advanced age, orthopedic disease, one- or two-staged bilateral TKA, venous anatomic variations, number of venous valves, coagulation assay data, hypertension, tourniquet time, choice of cementless or cemented TKA, severity or duration of operation, amount of blood loss, and amount of blood transfused. Conversely, more immediate relevant factors were obesity, postoperative prolonged immobilization, earlier venous disease, and hyperlipidemia.
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PMID:Factors leading to low incidence of deep vein thrombosis after cementless and cemented total knee arthroplasty. 195 58

The incidence of deep vein thrombosis in 244 patients who had total knee replacement has been studied. In 120 the prosthesis was cemented and in 124 it was cementless. In all cases the replacement was primary and a porous-coated prosthesis with a porous-coated central tibial stem was used. Deep vein thrombosis was diagnosed by venography, and pulmonary embolism by perfusion scanning. The incidence of deep vein thrombosis in the cementless knees (23.8%) and in the cemented (25%) was approximately the same. The only significant predisposing factors for deep vein thrombosis in both groups were obesity, prolonged postoperative immobilisation, previous venous disease and hyperlipidaemia.
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PMID:The incidence of deep vein thrombosis after cementless and cemented knee replacement. 221 55

The overall risk of oral contraceptive (OC) use is minimal when women over 35 years of age, smokers, and those with multiple risk factors (thromboembolic disorders, cerebrovascular or coronary artery disease, liver tumors, breast cancer, estrogen-dependent neoplasms, undiagnosed abnormal genital bleeding, and congenital hyperlipidemia) are excluded. OC use increases the risk of hypertension by 1-5%, depending on age, parity, and duration of use, but even this small risk is decreased when multiphasic OCs are prescribed. Deep venous thrombosis in the leg is 4 times more prevalent in OC users than nonusers and the risk of superficial thrombosis is doubled. Again, fewer thromboembolic complications occur when the estrogen dosage is low. The risk of myocardial infarction is not believed to increase with OC use as long as other risk factors--smoking, obesity, hypertension, age over 35 years, hypercholesterolemia--are not present. Studies involving the original high-dose OCs revealed a 3-fold increase in the risk of thrombotic stroke and a 2-fold increase in the risk of hemorrhagic stroke, but low-dose OCs appear to have no effect on the potential for stroke. The impact of OC use on breast cancer cannot yet be determined given the very long latency period of this cancer. In terms of benign breast disease, OC users have been shown to be at substantially reduced risk of lesions, fibroadenomas, and fibrocystic changes. OCs also protect women from endometrial and ovarian cancer, although the pill seems to accelerate the progression of cervical dysplasia. Other beneficial effects of OC use include reductions in the incidence of pelvic inflammatory disease, endometriosis, ectopic pregnancy, and ovarian cysts.
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PMID:Oral contraceptive pills. Part II: Potential complications and health benefits. 228 19

In about 50% of the cases of spontaneous deep vein thrombosis a congenital deficiency of an inhibitor of coagulation or an insufficient fibrinolytic mechanism can be detected. In arterial thromboembolism a connection with hyperactive platelets or with a diminished availability of tissue plasminogen activator can be found in about 70%. However, in these cases the defect which provokes thrombosis is mostly acquired and is connected with hyperlipidemia and/or with atherosclerotic alterations of the vessel wall. A study on patients with thromboembolic tendency and detectable risk factors was carried out. A total of 470 patients could be observed for 2 years under an adequate antithrombotic prophylaxis. The occurrence of thromboembolic episodes 2 years prior to prophylaxis and 2 years under prophylaxis was compared. In venous cases thrombosis could be controlled almost completely by coumarins when the underlying cause was a deficient plasmatic inhibitor. In patients with diminished fibrinolysis there was only a partial effect of oral anticoagulants. A better result could be obtained when pentosan polysulfate was administered. In arterial thromboembolism the results of prophylaxis were less convincing. The efficacy of ASA in patients with an increased platelet function was only moderate. In addition, ASA hat to be discontinued in about 20% of the patients because of gastrointestinal problems. Pentosan polysulfate in patients with a diminished fibrinolytic capacity had a fairly good effect and resulted in a 60% reduction of thromboembolic manifestations. It is shown that an exact diagnosis of the underlying deficiency which is likely to cause thrombosis can also improve the efficacy and the specificity of prophylaxis.
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PMID:Antithrombotic therapy in patients with known risk factors for thromboembolism. 248 12

Vascular risk, mainly thromboembolitic risk, attributed to oral contraceptives (OCs) since 1962, has been primarily linked to ethinyl estradiol (EE). OCs which combine estrogen and have been associated with cerebral vascular accidents. A 1977 study showed a 40% increase of mortality due to cardiovascular complications in women taking OCs. There were of both an arterial and a venous character. The risk of myocardial infarction was 3 times more frequent among OC users. Deep venous thrombosis and pulmonary embolism were more numerous. Some other risk factors include smoking, hypertension, diabetes, and age 35. The risk of heart attack vanishes a few years after stopping OC use. The reduction of EE (and similarly progesterone) dosage from 100-50 mcg also lower the risk of hypertension, cerebral vascular accidents, and venous thrombosis. Prolonged use of OCs causes disorders of hemostasis affecting the walls of blood vessels, modifying the viscosity of blood flow (increase of hematocrits, reduction of venous tonus), modifying plasmatic coagulation (increase of platelets, increase of factors VII and X and plasma fibrinogen, and decrease of antithrombin III activity), and increased fibrinolysis. These anomalies are exclusively associated with high doses of estrogens. 5% of women using OCs develop moderate hypertension of 5-10 mm Hg of systolic pressure 5 years later, but after cessation it is reversed. OCs stimulate the renin-angiotensin-aldosterone system causing accelerated production of angiotensin II with the resultant forceful vasotension. 3 months after quitting OC use, high blood pressure returns to normal. EE can provoke diabetes; it increases very low density lipoprotein (VLDL) and high density lipoprotein (HDL) production, but total cholesterol is hardly affected. The androgenic property of progestogens reduces HDL. Combined OCs are contraindicated for women with hypertension, hyperlipidemia, diabetes, and a family history of vascular accidents.
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PMID:[Oral contraception and the vascular risk]. 251 20

The possible association of hyperlipidemia and deep vein thrombosis (DVT) was investigated in 59 consecutive patients. The incidence of hyperlipidemia, judged by the value of serum total cholesterol and triglyceride, was unexpectedly high (overall 59%, high total cholesterol alone 25%, high triglyceride alone 9%, combined 25%), as compared with 29% of the control (p < 0.001). The idiopathic DVT patients (without known etiologic factors) had a higher incidence of hypercholesterolemia (63%) than the normal subjects (20%, p = 0.0002). The idiopathic DVT patients showed higher total cholesterol level of 255 +/- 72 mg/dl than that of 194 +/- 36 in the control subjects (p < 0.0001). And 67% of the idiopathic DVT patients were hyperlipidemic. Thereby, hyperlipidemia may be an important etiologic factor in DVT, which has not been recognized previously. The low incidence of DVT in Asians may, thus, be attributable to their lower cholesterol level.
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PMID:Hyperlipidemia: a novel etiologic factor in deep vein thrombosis. 1052 14

This study was conducted to identify patients at high risk of the development of Pulmonary Embolism (PE) after open heart surgery, to evaluate pertinent diagnostic methods, and to assess the mortality associated with this complication. We evaluated the records of 2,551 consecutive patients who underwent open heart surgery over a 10-year period to identify those patients in whom PE developed. All surgical reports, ventilation/perfusion scans, pulmonary angiograms, and autopsies from the same period were also reviewed. Preoperative and postoperative risk factors for pulmonary embolism were also analyzed, as well as the outcome of this complication in each type of surgical procedure. Pulmonary embolism was identified in 69 (2.7%) patients after open heart surgery, in 43 (62.3%) of whom the diagnosis was established within the first week of surgery. Factors associated with high incidence for PE were hyperlipidemia, congestive heart failure and heparin-induced thrombocytopenia (P < 0.001); obesity and prolonged mechanical ventilation (P < 0.005); and prior right heart catheterization by the femoral approach and prior PE and/or deep vein thrombosis (P < 0.05). The diagnosis of PE was established by a high-probability ventilation/perfusion scan in 25 patients, by pulmonary angiography in 42 (29 of whom had prior V/Q scan read as intermediate or low probability for PE) and by autopsy in two patients. The mortality rate in patients who had PE was 7.2%, while in those without this complication it was 3.2%. These findings suggest that aggressive approach for the diagnosis of PE by pulmonary angiography whenever the V/Q scan is not read as high probability is crucial in patients with recent open heart surgery; such approach may identify patients with PE at an early stage and may have an impact in reducing mortality incurred by this complication. This diagnostic assessment should be emphasized in the perioperative period, especially in patients with multiple significant and identifiable risk factors for PE.
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PMID:Critical role of pulmonary angiography in the diagnosis of pulmonary emboli following cardiac surgery. 882 30

Our retrospective study has shown that hyperlipidemia is a novel etiologic factor in deep-vein thrombosis (DVT) and that most of the idiopathic DVT patients were hyperlipidemic (Thrombosis Research 79, 147-151, 1995). The aim of our current study is to analyze the interrelationship between hyperlipidemia and DVT by means of a case-control study. A series of lipid parameters were analyzed using serum from 109 patients with deep vein thrombosis (DVT). One hundred nine age- and sex-matched subjects served as controls. Diagnosis of hyperlipidemia was made if the serum cholesterol level was above 220 mg/dL or if the triglyceride level was above 150 mg/dL. Among several types of hyperlipidemia examined, the risk factor associated with the highest estimated odds ratio was carriage of hypercholesterolemia associated with hypertriglyceridemia (odds ratio 5.1) followed in order by hypercholesterolemia without hypertriglyceridemia (odds ratio 2.6) and hypertriglyceridemia without hypercholesterolemia (odds ratio 0.9). These findings support the hypothesis that hypercholesterolemia plays an important role in the pathogenesis of DVT.
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PMID:Hypercholesterolemia as a risk factor for deep-vein thrombosis. 1052 14

A 29-year old man was admitted to an emergency psychiatric ward because of exacerbation of a chronic paranoid schizophrenia. He was restrained after arrival, and seven days later a deep venous thrombosis and a pulmonary embolism were diagnosed. No haematological predisposing factors (coagulation inhibitor deficiency, activated protein C resistance, or antiphospholipid antibodies) were identified, except for a questionable borderline increase of the fibrinolysis inhibitor PAI-1, and combined type II hyperlipidaemia. During the last 15-20 years, there has been a considerable reduction in the use of restraint and seclusion in Norway. The use of seclusion and restraint may be effective in preventing injury and reducing agitation, but these procedures may also have harmful physical, and in particular psychological side-effects. To our knowledge, this is the first report to demonstrate an association between venous thromboembolism and physical restraint. Immobilisation is a well-known risk factor for thrombophlebitis, and special attention should be paid to this problem on psychiatric wards. However, until more is known about thrombosis in relation to restraint, it is not advisable to recommend prophylactic treatment of thrombosis.
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PMID:[Venous thromboembolism in connection with physical restraint]. 965 10


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