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

The plasma concentration of beta-thromboglobulin (BTG), a platelet-specific protein released during platelet aggregation, is considered a sensitive marker of in vivo platelet activity. The mean plasma level in 133 asymptomatic individuals was 32.3 +/- 1.1 ng/ml, and there was no difference between those with no risk factors (32.2 +/- 1.2 ng/ml, n = 56), those who smoked (31.8 +/- 1.8 ng/ml, n = 45), those with hyperlipidemia (32.8 +/- 1.7 ng/ml, n = 15), and those exposed to both of these risk factors (34.1 +/- 2.7 ng/ml, n = 17). The mean plasma BTG level in 104 patients with symptomatic ischemic heart disease was significantly elevated (40.9 +/- 1.4 ng/ml, p less than 0.01), but there was considerable overlap with normal levels. Although no difference was found between patients with no risk factors (38.1 +/- 4.0 ng/ml, n = 13) and those with only 1 risk factor (37.0 +/- 1.8 ng/ml, n = 44), patients with 2 or more risk factors ahd a significantly elevated plasma BTG level (45.2 +/- 2.2 ng/nl, n = 47, p less than 0.01). It is concluded that risk factors themselves do not increase platelet activity, but that patients with vascular disease have activated platelets that may contribute to the progression of the disease. Plasma BTG was also measured serially for 10 days in 29 patients after hospitalization with acute ischemic cardiac pain. Although the median plasma level was elevated above normal there were no acute changes in plasma BTG after either acute infarction (n = 22) or acute ischemia (n = 7), except in 2 patients in whom pericardial friction rubs developed. Thus, measurement of systemic plasma BTG did not detect platelet involvement in acute coronary occlusion or acute ischemia.
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PMID:Plasma beta-thromboglobulin as a measure of platelet activity. Effect of risk factors and findings in ischemic heart disease and after acute myocardial infarction. 618 69

Enquiry among 85 patients who had suffered myocardial infarction revealed prodromal symptoms in 69%, which consisted of a gradually developing angina in 28% and sudden severe thoracic pains in 31%. The localization of the pain in the prodrome coincided with that of the infarction in 82%. Prodromes occurred most frequently in patients with infarction of the anterior wall. Prodromal patients showed hyperlipidemia more frequently as a risk factor. Cardiac arrhythmias, cardiogenic shock, indications of incipient aneurysm of the heart wall and signs of heart failure were no less frequent in patients with and without prodromal symptoms. 42% of the patients sought medical attention because of the prodromal complaints. The therapeutic possibilities arising from this are discussed.
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PMID:[Prodromal symptoms of acute myocardial infarction (author's transl)]. 676 30

A Bearded Collie was presented with clinical signs of intermittent weakness, intermittent pain in the back legs and a bilateral absence of the femoral pulse. Further diagnostic investigations revealed proteinuria, hypoproteinaemia, hyperlipidaemia and azotaemia. A quantitative estimation of the proteinuria using a protein/creatinine ratio indicated a loss of 483 mg kg-1 of protein per day. A large caudal aortic thrombosis was demonstrated by means of non-selective angiography and ultrasonographic examination. Autopsy confirmed an extensive aortic thrombus extending from the level of the fourth lumbar vertebra to include both iliac and femoral arteries at the level of the stifle joints. A large thrombus, 4 cm in length, was also found in the pulmonary artery. Histopathological examination of the kidneys revealed a subacute to chronic membranoproliferative glomerulonephritis.
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PMID:Aortic thrombosis in a dog with glomerulonephritis. 760 76

Between 1977 and 1990, 64 premenopausal women, under 50 years of age (42 +/- 5.6 years), were admitted for typical acute myocardial infarction with pathological Q waves. Twenty one patients had attempted myocardial revascularisation either by intravenous thrombolysis or primary angioplasty (n = 3). All patients underwent coronary angiography with selective left ventriculography during their hospital admission. This group of 64 women was characterised by the association of coronary risk factors (2.8 per patient): smoking (89%), hyperlipidaemia (67%), diabetes (45%) and oral contraception (35%). Coronary angiography showed single vessel occlusion in 86% of patients receiving oral contraception, multiple vessel disease in 36.5% and single or double vessel disease in 31.7% of the other patients. There were 3 deaths during the hospital period (4.6%), 12 cases of left ventricular failure, 2 ventricular aneurysms, 2 operated ischaemic mitral regurgitations and 9 recurrences of pain treated by angioplasty. During follow-up (36.5 +/- 4 months), 22 patients were readmitted to hospital and there were 3 further deaths, 12 cases of persistent cardiac failure, 10 cases of latent ventricular dysfunction and 9 ischaemic reoccurrences treated by angioplasty or surgery. The results in this group of patients suffering from myocardial infarction at an unusually early age for women showed that although the mortality was similar to that observed in men of the same age (9%) there was a very high morbidity and a high risk of cardiac failure. The prognosis of myocardial infarction in women, though better than 10 years ago, should improve with immediate revascularisation, the correction of cardiovascular risk factors and the rapid application of all techniques of modern cardiology.
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PMID:[Myocardial infarction in non-menopausal women. Coronary lesions and prognosis]. 764 94

We describe six patients with painful polyneuropathy associated with hyperlipidemia. Each had mild, slowly progressive neuropathy characterized by pain in feet, without proximal extension or involvement of hands. Weakness and autonomic symptoms and signs were absent. Three patients had normal tendon reflexes; three others had decreased ankle reflexes. Serum cholesterol levels were moderately increased; serum triglyceride levels were exceedingly high. In one patient, symptoms resolved with correction of hypertriglyceridemia. No other cause of peripheral neuropathy was found. Marked increases in serum triglycerides may cause painful small-fiber neuropathy.
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PMID:Neuropathy associated with hyperlipidemia. 750 Nov 85

Eighty eight patients with hyperlipidaemia (81 white patients from South Africa and seven patients of mixed race from the West Cape area) were studied. Forty eight had adult familial hypercholesterolaemia, 16 had juvenile familial hypercholesterolaemia, and 24 had mixed hyperlipidaemia (increased cholesterol and triglycerides). They were interviewed and examined and their musculoskeletal manifestations compared with 88 controls with normal lipid profiles, and matched for age, sex, and race for each group of patients. The following manifestations were significantly increased in the patients: (a) tendon xanthomas particularly of the tendo Achillis in patients with adult familial hypercholesterolaemia and mixed hyperlipidaemia; (b) tendo Achillis tendinitis in patients with adult familial hypercholesterolaemia and mixed hyperlipidaemia; and (c) oligoarthritis in patients with mixed hyperlipidaemia but not in those with adult familial hypercholesterolaemia. Migratory polyarthritis and transient tendo Achillis pain were rare. Thirty eight per cent of patients with juvenile familial hypercholesterolaemia had musculoskeletal system manifestations none of which was significantly increased compared with controls. There was a significant association between tendon xanthomas and tendo Achillis tendinitis. There was a significant difference in pretreatment cholesterol levels in the patients with adult familial hypercholesterolaemia and musculoskeletal system manifestations compared with those without and in all three groups combined. The study confirms an association between hyperlipidaemia and tendon xanthomas, tendo Achillis tendinitis, and to a lesser extent oligoarthritis but not migratory polyarthritis or transient tendo Achillis pain as reported in other studies. It also shows that musculoskeletal system manifestations antedated the diagnosis of hyperlipidaemia in 24/39 (62%) patients and that the manifestations improved or resolved completely in 19/30 (63%) patients after receiving lipid lowering treatment. It is therefore important to recognise the association between musculoskeletal system manifestations and hyperlipidaemia for diagnostic and therapeutic reasons.
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PMID:Musculoskeletal manifestations in hyperlipidaemia: a controlled study. 842 13

We conducted a retrospective study of patients younger than 20 years of age who had a diagnosis of chronic pancreatitis and underwent assessment at the Mayo Clinic between 1960 and 1990. Those with a known etiologic factor for the pancreatitis (such as a virus, trauma, alcohol, or hyperlipidemia) were excluded from the study. We compared the clinical course of the 42 patients who had hereditary pancreatitis (HP)--defined as at least two family members affected by the condition--with that of the 28 patients who had idiopathic pancreatitis (IP). The mean age at initial assessment was 7 years for those with HP and 12 years for those with IP. All patients in both groups had abdominal pain. Vomiting was more frequent in patients with HP than in those with IP; otherwise the initial symptoms were similar in both groups. Patients with HP, however, had more complications, including pseudocysts (seven patients), steatorrhea (four), ascites (three), portal hypertension (two), and diabetes (one), than did patients with IP (one each had diabetes, steatorrhea, and a pseudocyst). Complications or pain necessitated surgical intervention in 23 of 42 patients with HP versus 4 of 28 patients with IP. Overall in comparison with IP, HP seems to be a more severe variant of chronic pancreatitis, inasmuch as it is associated with more frequent complications and need for surgical intervention.
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PMID:Long-term follow-up of young patients with chronic hereditary or idiopathic pancreatitis. 847 8

The authors present a case report of a 59-year-old female suffering from hyperlipidemia who developed chronic vitamin A intoxication syndrome after ingestion of 30,000 IU retinol/daily over a period of six years. The patient's main complaints included severe headaches, morning nausea, myalgias and disability around the hip, knee, and ankle joints. Radiologically, hyperostosis of the acetabular circumference and the spine was demonstrated. Because of rapidly increasing pain, total hip replacement was performed. Histology of cross sections from the femoral head revealed destructive osteoarthritis. Since no other causative reason was found, retinol may not only be responsible for hyperostotic bone and soft tissue formations but may perhaps also account for rapid progressing of degenerative joint disease. Despite the cessation of vitamin A intake the clinical symptoms persisted due to hyperlipidemia. The enlarged number of chylomicrons and the higher fraction of very low density lipoproteins may represent a second retinyl ester pool in case of overloaded fat storing Ito-cells in the liver. Therefore, rheumatological treatment reducing risk factors such as hyperlipidemia is mandatory.
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PMID:Hyperostotic and destructive osteoarthritis in a patient with vitamin A intoxication syndrome: a case report. 891 26

The non-healing leg ulcer is examined by discussing three disease processes: peripheral vascular occlusive disease (PVOD), chronic venous insufficiency (CVI), and vasculitis. For PVOD, management decisions are based on risk factors and disease history. Comprehensive management includes the discontinuation of smoking, exercise conditioning and regulation of diabetes, hyperlipidemia, hypertension, and the appropriate application of anticoagulant/antiplatelet drugs. Methods of surgical management include bypass with autogenous or synthetic material in addition to reconstructive surgery with patch angioplasty or extra-anatomic bypass, amputation, percutaneous transluminal angioplasty/stents, thrombolytic infusion, atherectomy, intraluminal ultrasound, and angioscopy. The optimal healing environment for all ulcers prevents contamination, pain, and fluid loss. In CVI, higher venous pressure in the veins of the lower limb during exercise results in ambulatory venous hypertension and ulceration. Various theories are associated with the disease and ulceration process; the classic treatment of elevation, ambulation, and compression for venous disease remains unchallenged. Diagnosis is based on history, physical examination, invasive venography, and/or non-invasive studies. Two groups of vasculitic disorders that share varying degrees of vascular inflammation and necrosis are arteritis (lupus, erythematosus, periarteritis nodosa, dermatomyositis) and blood dyscrasias (sickle cell disease, thalassemia). Leg ulcers associated with vasculitis are due to inadequate tissue oxygenation at the local level, are typically chronic, slow to heal, and commonly recur.
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PMID:The non-healing leg ulcer: peripheral vascular disease, chronic venous insufficiency, and ischemic vasculitis. 939 80

The peripheral artery occlusive disease is a widely spread disease and its diagnosis, treatment options and consequences are frequently underestimated. Especially for the old patient, preservation of an extremity may mean mobility and quality of life. The increasing life expectancy and behaviour of prosperity including a lack of mobility are causing a rise in the frequence of atherosclerotic diseases. The prevalence of occlusive vascular diseases in patients between 55 to 64 years of age is currently 11% and is, therefore, a wide-spread disease. However, the socio-economic relevance of the occlusive vascular diseases is frequently underestimated. It causes both very high direct costs (treatment procedures, prostheses etc) as well as high indirect costs (permanent disability). Therefore, early diagnosis and treatment plays an important role in the avoidance of a progression of the disease. For an early diagnosis of the stage I of occlusive vascular diseases it makes sense to examine the vessels of patients at risk (i.e. diabetes mellitus, hypertension, hyperlipidemia, nicotine abuse, and overweight). Dopplerultra-sound and oscillometry are highly sensitive and specific diagnostic measures. The eradication of risk factor and the treatment of the secondary diseases plays the most important role in this disease stage without symptoms. A specific vessel training is indicated during stage II to encourage the development of collateral blood flow. Additionally, an interventional diagnostic and therapy should be considered in this stage with limitations in the daily activities. The administration of vasoactive drugs is controversly discussed. The acetylsalicylic acid (ASA) is remaining the most investigated substance for reducing the progress of the arteriosclerotic process. The administration of ticlopidine is justified in cases of ASA-allergies. The stages III and IV are characterized by pain at rest and necrosis. Firstly, the indication for a transcutaneous transluminal angioplasty, thrombolysis or bypass-surgery should be proofed. If procedures of revascularization are not possible, prostaglandines may improve the pain at rest and wound healing. Beside the stage of the occlusive vascular disease, the presence of risk factors, the physical status of the patient, and the location of the occlusion are of great importance for the decision about the treatment procedure.
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PMID:[Overview of the most frequent clinical manifestations of peripheral arterial occlusive disease in the elderly, its diagnosis and stage-related therapy]. 944 Oct 27


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