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1.
Nutrire Rev. Soc. Bras. Aliment. Nutr ; 39(1): 130-143, abr. 2014. tab
Article in Portuguese | LILACS | ID: lil-712182

ABSTRACT

Currently, the role of healthy food is to optimize the nutrition of individuals, providing not only increased health and well-being, but also reduced risks of developing diseases caused by poor diets. Functional foods contain substances with different biological functions, called bioactive compounds, which can modulate the physiology of the body, ensuring the maintenance of health. Eggplant (Solanum melongena L.) has been cited by several authors as one of the vegetables that can be classified as functional food. The lay population has used eggplant in different ways, without criteria and evidence from studies with different objectives. Among its main uses, the treatment and/or prevention of dyslipidemia and as adjuvant in weight loss can be highlighted. This work aims to study and analyze the most recent publications in order to justify the characterization of eggplant (Solanum melongena L.) as a functional food. To this end, a literature review of articles was conducted in the Scielo, Medline, Pubmed, Bireme, and Lilacs databases, as well as in books and journals from 1992 to 2012. The selection of bibliographic reference sought to select studies that investigated the chemical composition of eggplant, elucidated its habitual use by populations, and attempted to demonstrate its functional properties. Although some studies have demonstrated the effectiveness of eggplant, more accurate investigations with standardized methodologies are needed. These further studies should address the usual forms of consumption by the population and the correlation of these forms with the objectives of the proposed use.


Actualmente, el papel de la alimentación considerada saludable es el de optimizar la nutrición de las personas, garantizándoles el aumento de la salud y del bienestar, al mismo tiempo que reduce el riesgo de desarrollar enfermedades causadas por la mala alimentación. Los alimentos funcionales presentan sustancias, denominadas compuestos bioactivos, que tienen diferentes funciones biológicas y que son capaces de modular la fisiología del organismo, garantizando el mantenimiento de la salud. La berenjena (Solanum melongena L.) ha sido citada por muchos autores como una de las hortalizas que se puede clasificar como alimento funcional. La berenjena ha sido utilizada por la población de diversas formas, aunque sin evidencias ni pruebas que lo respalden, y con diversos objetivos, entre los que podemos destacar el tratamiento y/o prevención de la dislipidemia y el auxilio en el adelgazamiento. Este trabajo tiene como objetivo estudiar y analizar las publicaciones más recientes que justifiquen la clasificación de la berenjena (Solanum melongena L.) como un alimento funcional. Para la estructuración de este estudio se realizó una revisión bibliográfica de artículos en las bases de datos Scielo, Medline, Pubmed, Bireme, Lilacs, así como en libros y revistas científicas, teniendo en cuenta el período de 1992 a 2012. La selección de la referencia bibliográfica intentó seleccionar aquellos estudios que investigaron la composición química de la berenjena, dilucidaron su uso habitual en las poblaciones y trataron de demostrar sus propiedades funcionales. Aunque algunos estudios han demostrado la eficacia de la berenjena, se necesitan investigaciones más precisas, con metodologías estandarizadas, que tengan en cuenta las formas habituales de consumo y las relacionen con los objetivos propuestos para su uso.


Atualmente o papel da alimentação considerada saudável é otimizar a nutrição dos indivíduos garantindo a estes o aumento da saúde e do bem-estar como também reduzir o risco de desenvolver doenças decorrentes da má alimentação. Os alimentos funcionais apresentam substâncias com distintas funções biológicas, denominadas compostos bioativos, que são capazes de modular a fisiologia do organismo, garantindo a manutenção da saúde. A berinjela (Solanum melongena L.) tem sido citada por diversos autores como um dos vegetais que podem ser classificados como alimento funcional. A utilização da berinjela vem sendo feita pela população leiga sob diversas formas, mesmo sem critérios e comprovações por estudos com objetivos diversos, entre eles destaca-se sua utilização para o tratamento e/ou prevenção da dislipidemia e também como coadjuvante na perda de peso. Este trabalho tem como objetivo estudar e analisar as publicações mais recentes que justifiquem a caracterização da berinjela (Solanum melongena L.) como um alimento funcional. Para a estruturação deste estudo, foi realizada uma revisão da literatura em artigos nas bases de dados Scielo, Medline, Pubmed, Bireme, Lilacs bem como em livros e revistas científicas, considerando o período de 1992 a 2012. A seleção da referência bibliográfica preocupou-se em selecionar os estudos que pesquisaram a composição química da berinjela, elucidaram seu uso habitual nas populações, bem como tentaram demonstrar suas propriedades funcionais. Apesar de alguns estudos demonstrarem a eficácia da berinjela, são necessárias investigações mais precisas, com metodologias padronizadas, realizadas com as formas habituais de consumo entre a população e relacioná-las com os objetivos propostos do seu uso.


Subject(s)
Functional Food/classification , Solanum melongena/classification , Dyslipidemias/pathology , Hypercholesterolemia/pathology
2.
Braz. j. med. biol. res ; 46(5): 454-459, maio 2013. tab
Article in English | LILACS | ID: lil-675670

ABSTRACT

A low concentration of nitric oxide associated with a high concentration of asymmetric dimethylarginine (ADMA) can explain the lack of ischemic cardioprotection observed in the presence of hypercholesterolemia. The objective of the present study was to evaluate the effect of hypercholesterolemia on ischemic pre- and postconditioning and its correlation with plasma concentrations of ADMA. Male Wistar rats (6-8 weeks old) fed a 2% cholesterol diet (n = 21) for 8 weeks were compared to controls (n = 25) and were subjected to experimental myocardial infarction and reperfusion, with ischemic pre- and postconditioning. Total cholesterol and ADMA were measured in plasma before the experimental infarct and the infarct area was quantified. Weight, total cholesterol and plasma ADMA (means ± SE; 1.20 ± 0.06, 1.27 ± 0.08 and 1.20 ± 0.08 vs 0.97 ± 0.04, 0.93 ± 0.05 and 0.97 ± 0.04 µM) were higher in animals on the hypercholesterolemic diet than in controls, respectively. Cardioprotection did not reduce infarct size in the hypercholesterolemic animals (pre: 13.55% and post: 8% compared to 7.95% observed in the group subjected only to ischemia and reperfusion), whereas infarct size was reduced in the animals on a normocholesterolemic diet (pre: 8.25% and post: 6.10% compared to 12.31%). Hypercholesterolemia elevated ADMA and eliminated the cardioprotective effects of ischemic pre- and postconditioning in rats.


Subject(s)
Animals , Male , Rats , Arginine/analogs & derivatives , Hypercholesterolemia/blood , Myocardial Infarction/etiology , Arginine/blood , Cholesterol, Dietary , Cholesterol/blood , Disease Models, Animal , Hypercholesterolemia/complications , Hypercholesterolemia/pathology , Ischemic Preconditioning, Myocardial , Myocardial Infarction/metabolism , Myocardial Infarction/pathology , Rats, Wistar
3.
Arq. bras. oftalmol ; 76(1): 1-5, jan.-fev. 2013. ilus, tab
Article in Portuguese | LILACS | ID: lil-678151

ABSTRACT

OBJETIVO: O objetivo deste trabalho é investigar a expressão do fator de crescimento vascular endotelial (VEGF) na coroide e esclera, utilizando um modelo experimental de hipercolesterolemia. MÉTODO: Coelhos New Zealand foram organizados em dois grupos: O grupo dieta normal (GN), composto por 8 coelhos (8 olhos), recebeu ração padrão para coelhos, durante 4 semanas; e o grupo hipercolesterolêmico (GH), composto por 13 coelhos (13 olhos), recebeu dieta rica em colesterol a 1% por 8 semanas. Foi realizada a dosagem sérica de colesterol total, triglicerídeos, HDL colesterol, glicemia de jejum no início do experimento e no momento da eutanásia. Ao final da 8ª semana para o GH e 4ª semana para o GN foi realizada a eutanásia dos animais e os olhos foram submetidos à análise imuno-histoquímica com os anticorpos RAM-11 e VEGFR-1. RESULTADOS: Observou-se significativo aumento do colesterol total e triglicerídeos do GH em relação ao GN (p<0,001). Houve significativo aumento da expressão da RAM-11 e VEGFR-1 na coroide e esclera dos animais do GH em relação ao GN (p<0,001). CONCLUSÃO: Este estudo demonstra que a dieta hipercolesterolêmica em coelhos induz ao aumento da concentração de macrófagos e da imunorreatividade ao VEGFR-1 na coroide e esclera, expressando similaridade com a degeneração macular relacionada à idade (DMRI) humana.


PURPOSE: The aim of this study is to investigate the expression of vascular endothelial growth factor (VEGF) in the choroid and sclera using hypercholesterolemia experimental model. METHODS: New Zealand rabbits were divided into two groups: 8 rabbits (8 eyes), in the normal diet group (NG), were fed by a standard diet for 4 weeks; and 13 rabbits (13 eyes), in the hypercholesterolemic group (HG), were fed by a 1% cholesterol-enriched diet for 8 weeks. Total serum cholesterol, triglyceride, HDL cholesterol and fasting blood glucose exams were performed at the initiation of the experiment and at the euthanasia time. After hypercholesterolemic group 8th week and NG 4th week, animals were euthanized and their eyes underwent immunohistochemical analysis with the RAM-11 and VEGFR-1). RESULTS: The diet has induced a significant increase in total cholesterol and triglyceride levels in HG when compared with NG (p<0.001). There was a significant increase in the RAM-11 and VEGFR-1 expressions in hypercholesterolemic group choroid and sclera in relation to NG (p<0,001). CONCLUSION: This study has revealed that the hypercholesterolemic diet in rabbits induces an increase in the macrophage concentration and immunoreactivity to VEGFR-1 in the choroid and sclera, resembling human age-related macular degeneration (ARMD).


Subject(s)
Animals , Humans , Male , Rabbits , Cholesterol, Dietary/adverse effects , Choroid/metabolism , Hypercholesterolemia/metabolism , Sclera/metabolism , Vascular Endothelial Growth Factor Receptor-1/metabolism , Choroid/pathology , Disease Models, Animal , Hypercholesterolemia/etiology , Hypercholesterolemia/pathology , Sclera/pathology
4.
Arch. venez. pueric. pediatr ; 75(3): 75-83, sep. 2012. tab
Article in Spanish | LILACS | ID: lil-676430

ABSTRACT

La resistencia a la insulina es muy frecuente en niños y adolescentes obesos, la cual conlleva a un significativo riesgo de desarrollar enfermedades cardiometabólicas causadas por la combinación de factores genéticos y factores asociados al estilo de vida. Evaluar la relación entre los polimorfismos del gen ApoE y el polimorfismo Pro12Ala del gen PPARγ2 en niños pre-púberes con factores de riesgo cardiometabólicos. Población y Métodos: Se evaluaron 141 niños (CANIA y Hospital “JM de los Ríos”), de los cuales 46 tienen obesidad, 33 hipercolesterolemia, 30 resistentes a la insulina (RI) y 32 controles. Se determinó colesterol total y fracciones, triglicéridos, glucosa, insulina e índice HOMA; se realizó extracción de ADN y análisis de los polimorfismos. La distribución de la frecuencia del alelo ε4 del gen de ApoE fue: 10,9% obesos, 7,6% hipercolesterolémicos, 18,3% RI y 4,6% controles. La frecuencia del polimorfismo Pro12Ala fue de 6,4% en la población estudiada. En los niños obesos e hipercolesterolémicos se observó aumento de colesterol total, LDL-c y triglicéridos asociados con la presencia del ε4; en el grupo con RI, se encontró que existen diferencias estadísticamente significativas entre el alelo ε4 con respecto al grupo control, lo que refiere que puede haber una relación clínica importante entre la presencia del alelo y el desarrollo de la enfermedad. No se encontró relación entre el polimorfismo Pro12Ala del gen PPARγ2 con factores de riesgo cardiometabólico. La presencia de varios polimorfismos en un mismo individuo podría estar asociada a factores de riesgo para enfermedad cardiometabólica


Insulin resistance (IR) is very frequent in children and adolescents obeses, which could contribute significantly in the development of cardiometabolic diseases, this could be associated to a combination of genetics factors and life’s style. Aim: To evaluate the relationship between ApoE gene polymorphisms and PPARγ2 gene Pro12Ala polymorphisms with risk factors to cardiometabolic disease in children. Population and Materials: 141 children (CANIA and Hospital “JM de los Ríos”), 46 with obesity, 33 with hypercholesterolemia, 30 with IR and 32 normal subjects. Total cholesterol and fractions, glucose, insulin and triglycerides were measured; also it was determinated the polymorphism genes on each patient. Results: The distribution of the frequency of the allele E4 of the ApoE gene were: 10, 9% obese, 7,6% hypercholesterolemia, 18,3% IR and 4,6% on normal subjects. The frequency of Pro12Ala polymorphism were up to 6,4% on the total subjects in the study. In the obese and hypercholesterolemic groups we found an increase of the total cholesterol, LDL-c and triglycerides, associated with the presence of allele ε4. In children with IR we got a significant difference of the presence of allele ε4 compared with the control group, which means that this allele could be related with the development of thedisease. It was not found a relation between the Pro12Ala of PPARγ2 gene and the development of obesity, hypercholesterolemia and insulin resistance in children. The presence of several polymorphisms in a same individual could be associated with risk factors to cardiometabolic disease


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Apolipoproteins E/genetics , Metabolic Diseases/pathology , Hypercholesterolemia/pathology , Insulin Resistance , Heart Injuries/pathology , Obesity/pathology , Polymorphism, Genetic , Pediatrics , Risk Factors
5.
Av. cardiol ; 27(3): 115-122, sept. 2007. tab
Article in Spanish | LILACS | ID: lil-607915

ABSTRACT

Determinar la equivalencia terapéutica y la seguridad de la atorvastatina amorfa y la atorvastatina cristalina, utilizadas en la fabricación de Atovarol® y Lipitor ®, a la dosis de 10 mg/día en pacientes con hipercolesterolemia. Estudio clínico multicéntrico, prospectivo, comparativo, simple-ciego, distribuido al azar, de grupos paralelos. A los pacientes que cumplieron los criterios de inclusión les fue administrada atorvastatina amorfa (Atovarol®) o atorvastatina cristalina (Lipitor®) durante un mes. Se realizó una evaluación de laboratorio previa y otra al mes de tratamiento. Se incluyeron 43 pacientes, de los cuales uno fue retirado del estudio por efectos adversos. Los 42 pacientes que completaron el tratamiento con atorvastatina (20 pacientes en el grupo atorvastatina amorfa y 22 pacientes en el grupo atorvastatina cristalina) durante un período de 4 semanas presentaron reducciones estadísticamente significativas en los valores séricos de colesterol total, colesterol LDL y triglicéridos comparados con los valores basales en cada grupo de tratamiento. No se observaron diferencias estadísticamente significativas entre los dos grupos de tratamiento, ni previo ni posterior al tratamiento. Atorvastatina amorfa fue terapéuticamente equivalente a atorvastatina cristalina en la disminución de los valores de colesterol total, colesterol LDL y triglicéridos. El porcentaje de reducción de estos valores está dentro de los rangos reportado por otros estudios clínicos realizados con atorvastatina.


To determine the therapeutic equivalence and the safety of amoãphous and crystalline atorvastatin, used in the manufacture of Atovarol® and Lipitor®, at a dose of 10 mg/day in patients with hypercholesterolemia. Multicenter, prospective, comparative, somple-blind, randomized, parallel group clínical study. Amorphous atorvastatin (Atovarol®) or crystalline atorvastatin (Lipitor®) were administered for one month to patients that met the inclusion criteria. Laboratory evaluations were performed previously and one month after treatment. 43 patients were included, of which one was withdrawn from the study due to adverse effects. The 42 patients that completed atorvastatin treatment for a period of 4 weeks (20 patients in the amorphous atorvastatin and 22 patients in the crystalline atorvastatin group), presented statistically significant reductions in serum values of total cholesterol, cholesterol-LDL and triglycerides, as compared with pretreatment values in each group. Statistically significant differences were not observed between the groups, either before or after treatment. Amorphous atorvastatin is therapeutically equivalent to crystalline atorvastatin in the reduction of total cholesterol, cholesteron-LDL and triglyceride values. The percentage of reduction of these values is withim the range reported by other atorvastatin clinical studies.


Subject(s)
Humans , Male , Female , Middle Aged , Hypercholesterolemia/pathology , Hypercholesterolemia/therapy , Simvastatin/administration & dosage , Triglycerides/blood , Cholesterol/blood , Lipoproteins, HDL/blood , Lipoproteins, LDL/blood , Venezuela
6.
EMHJ-Eastern Mediterranean Health Journal. 2007; 13 (3): 515-521
in English | IMEMR | ID: emr-157020

ABSTRACT

We investigated the correlation between hypercholesterolaemia and oxidative stress and P-selectin and interleukin-6 [IL-6] as markers for endothelial status. We studied 40 Egyptian adults with asymptomatic hypercholesterolaemia and 20 age- and sex-matched controls. Lipid peroxidation was significantly higher [P < 0.001] in the study group and positively correlated with cholesterol [P < 0.001] and low-density lipoprotein [LDL] [P < 0.002]. Glutathione peroxidase activity was also significantly higher [P < 0.001] with positive correlation with cholesterol [P < 0.001] and LDL [P < 0.001]. Markers for endothelial cell function were significantly higher in the study group [P < 0.001] with a positive correlation with cholesterol [P < 0.001] and LDL [P < 0.001]. Hypercholesterolaemia causes endothelial microinflammation, and P-selectin and IL-6 may also be risk factors for cardiovascular disease


Subject(s)
Adult , Humans , Endothelium, Vascular/pathology , Cholesterol/blood , Hypercholesterolemia/blood , Hypercholesterolemia/pathology , Vascular Diseases/blood
7.
Rev. ginecol. obstet ; 11(2): 132-6, abr.-jun. 2000. ilus, tab
Article in Portuguese | LILACS | ID: lil-268451

ABSTRACT

A obesidade e a hipercolesterolemia sao problemas de saude publica no primeiro mundo e nos paises desenvolvidos. O ginecologista e o profissional que tem contato com esta adolescente e pode orienta-la...


Subject(s)
Humans , Female , Adolescent , Feeding Behavior , Hypercholesterolemia/pathology , Obesity/pathology , Socioeconomic Factors
8.
Yonsei Medical Journal ; : 273-282, 1999.
Article in English | WPRIM | ID: wpr-150896

ABSTRACT

The external elastic lamina (EEL) serves as a barrier for cells and macromolecules between the media and adventitia in the vascular wall. We evaluated the morphological changes and quantitative assessments of the EEL architecture in the coronary circulation of pigs fed with a high cholesterol diet. Confocal microscopy analysis of the EEL from hypercholesterolemic coronary arteries revealed an altered pattern characterized by fragmentation and disorganization of the EEL associated with an increase in the thickness. Computerized digital analysis of the images obtained by confocal scanning microscopy demonstrated that compared to normal coronary arteries, the EEL of hypercholesterolemic coronary arteries decreased in the percentage of their elastin content (30.80 +/- 1.64% vs. 47.85 +/- 1.82%, p = 0.001). The percentage of elastin content was negatively correlated with the vessel wall area (r = -0.82, p = 0.001). The immunoreactivity for matrix metalloproteinase-3 (MMP-3) increased in cholesterol-fed coronary arteries, predominantly in the neointima and adventitia. This study demonstrates that experimental hypercholesterolemia induced ultrastructural changes of the EEL in coronary circulation. The EEL may also be an atherosclerosis-prone area compared with the intima. The EEL may play an important role in the development of structural changes which characterizes the early phase of coronary atherosclerosis and vascular remodeling.


Subject(s)
Female , Animals , Arteries/ultrastructure , Arteries/enzymology , Coronary Vessels/ultrastructure , Coronary Vessels/enzymology , Elastic Tissue/ultrastructure , Elastic Tissue/enzymology , Hypercholesterolemia/pathology , Hypercholesterolemia/enzymology , Matrix Metalloproteinase 3/metabolism , Swine
9.
Yonsei Medical Journal ; : 345-354, 1998.
Article in English | WPRIM | ID: wpr-229296

ABSTRACT

Atherosclerosis is the most severe problem in the high-pressure systemic circulation and similar changes also occur in the high-pressure loading valve. This study was designed to test the hypothesis that early atherosclerosis, induced by a high cholesterol diet in rabbits, is characterized by significant ultrastructural change in the elastic laminae of the aortic valve. However, it is not known whether this process is also taking place in the cardiac valve at the early stage of atherosclerosis. Animals were fed either a high cholesterol diet (n = 5) or a control diet (n = 5) for 10-12 weeks. Histologic analysis demonstrated that subendothelial thickening and foam-cell infiltration were evident in the arterialis of aortic valves. Confocal microscopy revealed an altered pattern characterized by fragmentation and disorganization of the arterialis elastic laminae of hypercholesterolemic valves. Computerized digital analysis of the images obtained by confocal scanning microscopy demonstrated that compared to normal valves, the arterialis elastic laminae of hypercholesterolemic valves decreased in percentage of their elastin content (29.03 +/- 1.10% vs. 42.94 +/- 1.35%, p = 0.023). Immunohistochemical staining for matrix metalloproteinase-3 (MMP-3) revealed MMP-3 immunoreactivity was increased in hypercholesterolemic valves, predominantly in the arterialis. This study demonstrated that early atherosclerosis, induced by a high cholesterol diet in rabbits, is characterized by significant ultrastructural change in the elastic laminae of the aortic valve. The arterialis endothelium of the aortic valve may be a more atherosclerosis-prone area compared with the ventricularis. The presence of ultrastructural defect in the elastic laminae may play a role in chronic degenerative change and a resultant valvular dysfunction.


Subject(s)
Male , Rabbits , Animals , Aortic Valve/ultrastructure , Elastic Tissue/ultrastructure , Hypercholesterolemia/pathology , Microscopy, Confocal , Matrix Metalloproteinase 3/metabolism
10.
Indian J Physiol Pharmacol ; 1995 Oct; 39(4): 407-10
Article in English | IMSEAR | ID: sea-107063

ABSTRACT

Myristica seed extr. administration to hypercholesterolemic rabbits reduced serum cholesterol and LDL Cholesterol by 69.1% and 76.3% respectively and also lowered cholesterol/phospholipid ratio by 31.2% and elevated the decreased HDL-ratio significantly. Myristica seed extr. feeding also prevented the accumulation of cholesterol, phospholipids and triglycerides in liver, heart and aorta and dissolved atheromatous plaques of aorta by 70.9-76.5%. Fecal excretion of cholesterol and phospholipid were significantly increased in seed extract fed rabbits.


Subject(s)
Animals , Anticholesteremic Agents/therapeutic use , Aorta/metabolism , Arteriosclerosis/prevention & control , Cholesterol, HDL/blood , Diet , Feces/chemistry , Hypercholesterolemia/pathology , India , Lipid Metabolism , Lipids/blood , Liver/drug effects , Male , Myocardium/metabolism , Phospholipids/blood , Plant Extracts/therapeutic use , Plants, Medicinal/chemistry , Rabbits , Seeds/chemistry
11.
Medical Journal of Cairo University [The]. 1995; 63 (2): 179-86
in English | IMEMR | ID: emr-38340

ABSTRACT

The incidence of coronary heart disease [CHD] is increasing in Egypt. There is a need for identification of some risk factors that could predict the occurrence of myocardial infarction [MI] in susceptible persons such as those with hypercholesterolemia. This case control study was done to define whether increased serum lipoprotein [a] [Lp [a]] is a risk factor for developing MI and its relation to common hypercholesterolemia. Lp [a] was estimated in a group of middle aged men [n = 17] with a past history of MI within the past two years and another age matched group of men [n = 18] with no history of CHD. Both groups were showing the criteria of having common hypercholesterolemia [low density lipoprotein [LDL] cholesterol between 135-277 mg/dl, triglycerides < 337 mg/d1 and with no family history of hypercholesterolemia and/or CHD]. The Lp [a] levels also measured in a group of healthy middle aged medical staff with no history of CHD and with normal LDL cholesterol [< 135 md/d1]. The Lp [a] serum levels were significantly higher in the group with MI [geometric mean 0.62 [95% confidence interval 0.35 to 1.14] vs 0.28 [0.2 to 0.41] g/L, p = 0.02], but there were no significant differences in other variables. Logistic regression analysis showed that Lp [a] was the only significant predictor of MI [p 0.02]. The odds ratio of MI, adjusted for age, smoking, blood presure, and apolipoprotein B, for an Lp [a] of > 0.57 g/L was 16.4, 95% confidence interval 2.2 to 125.4 [p = 0.001]. It was concluded that Lp [a] is an independent and satisfying index for risk of developing MI and could be used as a laboratory tool for identifying persons prone to suffer from the disease


Subject(s)
Humans , Risk Factors , Myocardial Infarction/etiology , Hypercholesterolemia/pathology , Coronary Disease/mortality , Hypercholesterolemia/complications
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