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1.
In. Soeiro, Alexandre de Matos; Leal, Tatiana de Carvalho Andreucci Torres; Accorsi, Tarso Augusto Duenhas; Gualandro, Danielle Menosi; Oliveira Junior, Múcio Tavares de; Caramelli, Bruno; Kalil Filho, Roberto. Manual da residência em cardiologia / Manual residence in cardiology. Santana de Parnaíba, Manole, 2 ed; 2022. p.830-834, tab.
Monography in Portuguese | LILACS | ID: biblio-1353529
3.
J. bras. nefrol ; 41(3): 393-399, July-Sept. 2019. graf
Article in English | LILACS | ID: biblio-1040251

ABSTRACT

Abstract Lipoprotein glomerulopathy (LPG) is an uncommon cause of nephrotic syndrome and/or kidney failure. At microscopy, LPG is characterized by the presence of lipoprotein thrombi in dilated glomerular capillaries due to different ApoE mutations. ApoE gene is located on chromosome 19q13.2, and can be identified in almost all serum lipoproteins. ApoE works as a protective factor in atherosclerosis due its interaction with receptor-mediated lipoprotein clearance and cholesterol receptor. Most common polymorphisms include ApoE2/2, ApoE3/2, ApoE3/3, ApoE4/2, ApoE4/3, and ApoE4/4. All age-groups can be affected by LPG, with a discrete male predominance. Compromised patients typically reveal dyslipidemia, type III hyperlipoproteinemia, and proteinuria. LPG treatment includes fenofibrate, antilipidemic drugs, steroids, LDL aphaeresis, plasma exchange, antiplatelet drugs, anticoagulants, urokinase, and renal transplantation. Recurrence in kidney graft suggests a pathogenic component(s) of extraglomerular humoral complex resulting from abnormal lipoprotein metabolism and presumably associated to ApoE.


Resumo A glomerulopatia por lipoproteínas (GLP) é uma patologia rara que causa síndrome nefrótica e/ou insuficiência renal. Na microscopia, a GLP é caracterizada pela presença de trombos de lipoproteínas em capilares glomerulares dilatados devido a diferentes mutações no gene da ApoE. O gene da ApoE está localizado no cromossomo 19q13.2 e pode ser identificado em quase todas as lipoproteínas séricas. A ApoE age como fator de proteção na arterioesclerose por conta de sua interação com a depuração de lipoproteínas mediada por receptores e com o receptor de colesterol. Dentre os polimorfismos mais comuns destacam-se ApoE2/2, ApoE3/2, ApoE3/3, ApoE4/2, ApoE4/3 e ApoE4/4. A GLP pode acometer indivíduos de todas as faixas etárias, com discreta predominância do sexo masculino. Pacientes afetados tipicamente apresentam dislipidemia, hiperlipoproteinemia tipo III e proteinúria. O tratamento da GLP é conduzido com fenofibrato, antilipêmicos, corticosteroides, LDL-aferese, troca de plasma, antiplaquetários, anticoagulantes, uroquinase e transplante renal. Recidiva no enxerto renal indica a existência de componentes patogênicos do complexo humoral extraglomerular resultante de metabolismo lipoproteico anômalo, possivelmente associado a ApoE.


Subject(s)
Humans , Male , Female , Child, Preschool , Adult , Middle Aged , Kidney Diseases/pathology , Kidney Diseases/therapy , Apolipoproteins E/genetics , Sex Factors , Kidney Transplantation , Treatment Outcome , Kidney Diseases/complications , Kidney Diseases/genetics , Kidney Failure, Chronic/surgery , Kidney Failure, Chronic/etiology , Mutation , Hypolipidemic Agents/therapeutic use
6.
Arq. gastroenterol ; 54(2): 139-144, Apr.-June 2017. tab
Article in English | LILACS | ID: biblio-838833

ABSTRACT

ABSTRACT BACKGROUND The prevalence of obesity and metabolic syndrome is increasing worldwide and both behavior modification and drug therapy have low adherence. Gastric bypass has shown effective results in both reducing weight and improving comorbidities. OBJECTIVE To evaluate the impact of Roux-en-Y Gastric Bypass Surgery (RYGB) on both metabolic syndrome components and the use of associated drugs in obese patients. METHODS Historical cohort of patients subjected to Roux-en-Y Gastric Bypass Surgery (RYGB) between January 2007 and March 2014 in a private clinic. The sample consisted of 273 obese class II and III individuals, 86.4% of whom were female, with age ≥20 years, followed up for 2 months after surgery. Sociodemographic, anthropometric, biochemical, clinical, and drug-use data were collected from patients’ medical records. RESULTS Significant differences were found in weight, body mass index and waist circumference, after 60 postoperative days. Components for metabolic syndrome diagnosis (hypertension P=0.001; hyperglycemia P<0.001; hypertriglyceridemia P=0.006) were reduced after 60 days of postoperative, with the exception HDL-c (P=0.083). There was a significant reduction in the use of antihypertensive (P<0.001), hypoglycemic (P=0.013), lipid lowering (P<0.001), and antiobesity (P=0.010) drugs and increased use of gastroprotective drugs, vitamins, and minerals (P<0.001) after 60 postoperative days. CONCLUSION Patients subjected to Roux-en-Y Gastric Bypass Surgery exhibited both weight loss and significant improvement not only in metabolic syndrome components (except for HDL-c) but in the use of drugs associated with obesity and metabolic syndrome.


RESUMO CONTEXTO A prevalência de obesidade e síndrome metabólica é crescente no mundo e tanto a terapia de modificação de estilo de vida quanto a medicamentosa têm baixa adesão. O bypass gástrico tem apresentado resultados eficazes na redução de peso e comorbidades. OBJETIVO Avaliar o impacto do bypass gástrico em Y de Roux nos componentes da síndrome metabólica e sobre o uso de drogas associadas em pacientes obesos. MÉTODOS Coorte histórica de pacientes submetidos ao bypass gástrico em Y de Roux entre janeiro de 2007 e março de 2014, em clínica privada. A amostra foi composta por 273 indivíduos obesos classe II e III, 86,4% dos quais eram do sexo feminino, idade ≥20 anos, acompanhados por 2 meses após a cirurgia. Dados sociodemográficos, antropométricos, bioquímicos, clínicos e de uso de medicamentos foram coletados nos prontuários dos pacientes. RESULTADOS Foram encontradas diferenças significativas no peso, índice de massa corporal e circunferência da cintura, após 60 dias de pós-operatório. Os componentes para diagnóstico da síndrome metabólica (hipertensão P=0,001; hiperglicemia P<0,001; hipertrigliceridemia P=0,006) foram reduzidos no pós-operatório, com exceção do HDL-c (P=0,083). Houve uma redução significativa no uso de medicamentos anti-hipertensivos (P<0,001), hipoglicêmicos (P=0,013), hipolipemiantes (P<0,001), antiobesidade (P=0,010) e uma maior utilização de gastroprotectores, vitaminas e minerais (P<0,001) após 60 dias de pós-operatório. CONCLUSÃO Os pacientes submetidos ao bypass gástrico em Y de Roux exibiram perda de peso e uma melhora significativa, não só em componentes da síndrome metabólica (exceto para o HDL-c), mas também no uso de medicamentos associados à obesidade e à síndrome metabólica.


Subject(s)
Humans , Male , Female , Adult , Aged , Obesity, Morbid/surgery , Gastric Bypass , Metabolic Syndrome/complications , Metabolic Syndrome/drug therapy , Socioeconomic Factors , Obesity, Morbid/complications , Retrospective Studies , Cohort Studies , Anti-Obesity Agents/therapeutic use , Hypoglycemic Agents/therapeutic use , Middle Aged , Antihypertensive Agents/therapeutic use , Hypolipidemic Agents/therapeutic use
7.
Arch. endocrinol. metab. (Online) ; 61(2): 198-201, Mar.-Apr. 2017. tab
Article in English | LILACS | ID: biblio-838424

ABSTRACT

SUMMARY Severe hypertriglyceridemia accounts for up to 7% of all cases of acute pancreatitis. Heparin and insulin activate lipoprotein lipase (LPL), thereby reducing plasma triglyceride levels. However, the safety and efficacy of heparin and insulin in the treatment of hypertriglyceridemia-associated acute pancreatitis have not been well established yet. We successfully used heparin and insulin as first-line therapy in four consecutive patients with acute pancreatitis secondary to hypertriglyceridemia. In a literature search, we revised almost all reports published to date of patients managed successfully with this combination. Heparin and insulin appear to be a safe, effective, and inexpensive first-line therapy for hypertriglyceridemia-associated acute pancreatitis.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Pancreatitis/etiology , Pancreatitis/drug therapy , Heparin/therapeutic use , Hypertriglyceridemia/complications , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Anticoagulants/therapeutic use , Fenofibrate/therapeutic use , Triglycerides/blood , Hypertriglyceridemia/drug therapy , Acute Disease , Reproducibility of Results , Treatment Outcome , Drug Therapy, Combination , Lipoprotein Lipase/therapeutic use , Hypolipidemic Agents/therapeutic use
8.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 26(3): 174-179, jul.-set. 2016. tab
Article in Portuguese | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-832394

ABSTRACT

A hipercolesterolemia familiar (HF) é doença metabólica muito comum, mas não reconhecida e tratada adequadamente. Sua forma homozigótica, mais rara, leva a aumentos muito importantes do LDL-colesterol e à evolução dramática da aterosclerose e suas complicações em fases muito precoces da vida. Na sua forma mais branda, muito mais comum, a heterozigótica, o aparecimento de manifestações ateroscleróticas costuma ser mais tardio, dependendo da intensidade das alterações do perfil lipídico e dos outros fatores de risco eventualmente presentes. Os recursos terapêuticos para controle da HF vão desde as mudanças do estilo de vida até os medicamentos de uso comum como estatinas potentes em altas doses, na maioria das vezes combinadas à ezetimiba e/ou resina, niacina e fibratos. Novos produtos foram aprovados para uso em outros países, como a lomitapida e o mipomersen, mas apenas para a HF na forma homozigótica. Os inibidores da PCSK9 são importante esperança no controle desses pacientes. As pesquisas com os inibidores da CETP têm sido marcadas por decepções, mas um estudo clínico envolvendo um deles ainda está em andamento. Nosso país não dispõe da LDL-aférese, recurso que se tem mostrado fundamental para a melhora do prognóstico dos portadores das formas graves da HF


Familial hypercholesterolemia (FH) is a common metabolic disease, although not adequately recognized and treated. Its rarer, homozygous form leads to a significant increase in LDL-cholesterol and marked development of atherosclerosis and its complications in very early phases of life. In its milder, much more common, heterozygous form, the appearance of clinical manifestations usually occurs later, depending on the intensity of the changes in lipid profile and the presence of other risk factors. Therapeutic resources for FH control range from changes in lifestyle to medications commonly used as high potency statins in high dosages, in most cases combined with ezetimibe and/or resins, niacin and fibrates. New products have recently been approved for use in other countries such as lomitapide and mipomersen, but only for homozygous FH. PCSK9 inhibitors are an important hope for the control of these patients.Research with CETP inhibitors has failed to demonstrate clinical benefits to date, but a clinical study evaluating one of them is still ongoing. Our country does not have availability of LDL-apheresis, a resource that has proven fundamental for improving the prognosis of patients with more severe forms of FH


Subject(s)
Humans , Male , Female , Therapeutics/methods , Hyperlipoproteinemia Type II , Hypolipidemic Agents/therapeutic use , Primary Prevention/methods , Cardiovascular Diseases/prevention & control , Risk Factors , Drug Therapy/methods , Drug Therapy, Combination/methods , Life Style , Cholesterol, LDL/analysis , Cholesterol, LDL/blood , Metabolic Diseases/complications , Metabolic Diseases/diagnosis
9.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 26(3): 180-189, jul.-set. 2016. tab
Article in Portuguese | LILACS | ID: biblio-832403

ABSTRACT

Nas últimas duas décadas, comprovou-se que a terapia com estatinas é o instrumento isolado mais potente para atenuar o risco cardiovascular, e seu uso frequente foi enfatizado como um dos elementos mais importantes para reduzir a mortalidade cardiovascular nos países desenvolvidos. Uma incidência igualmente frequente de sintomas musculares em usuários de estatinas levanta a possibilidade de um nexo de causalidade, que leva a uma entidade patológica conhecida como sintomas musculares associados a estatinas (SMAS). Estudos e ensaios clínicos mecanicistas destinados a estudar os SMAS levaram a uma definição clara da sua história natural e incidência exata. Essa informação é essencial para evitar riscos desnecessários de formas graves de SMAS. Ao mesmo tempo, essa compreensão concreta dos SMAS evita o diagnóstico exagerado e a suspensão desnecessária de uma das mais poderosas estratégias de prevenção atuais. Nesse contexto, este artigo de revisão reuniu todas as informações disponíveis sobre o assunto, que são apresentadas em detalhe neste documento como a base da identificação e tratamento dos SMAS


In the last 2 decades, statin therapy has proved to be the most potent isolated instrument for attenuating cardiovascular risk, and its frequent use has been highlighted as one of the most important elements for reducing cardiovascular mortality in developed countries. An equally frequent incidence of muscle symptoms in statin users raises the possibility of a causal link, leading to a disease entity known as statin-associated muscle symptoms (SAMS). Mechanistic studies and clinical trials designed to the study of SAMS have led to a clear definition of its natural history and accurate incidence. This information is vital for avoiding unnecessary risk of severe forms of SAMS. At the same time, this concrete understanding of SAMS prevents over-diagnosis and unnecessary suspension of one of the most powerful prevention strategies available today. In this context, this review has gathered all the available information on the issue, which is presented in detail, in this document, as the basis for the identification and management of SAMS


Subject(s)
Humans , Signs and Symptoms , Therapeutics , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Hypolipidemic Agents/therapeutic use , Lovastatin/adverse effects , Risk Factors , Simvastatin/adverse effects , Creatine Kinase , Atorvastatin/adverse effects
11.
Ciênc. saúde coletiva ; 21(12): 3899-3906, 2016. tab
Article in Portuguese | LILACS | ID: biblio-828529

ABSTRACT

Resumo A utilização de medicamentos para tratamento das dislipidemias é relevante no controle das doenças cardiovasculares. O objetivo deste artigo é analisar a prevalência, a utilização e a participação do setor público no fornecimento de medicamentos para as pessoas a partir de 40 anos em farmacoterapia de controle das dislipidemias, residentes em um município da região Sul do Brasil. Estudo transversal de base populacional. Foram entrevistados no domicilio 1180 indivíduos a partir de 40 anos residentes em Cambé/PR, dos quais 967 realizaram exames laboratoriais. A prevalência de dislipidemias foi de 69,2%, dos quais 16,1% utilizavam medicamentos. Entre os indivíduos em tratamento para as dislipidemias, 22,2% apresentaram resultados de exames adequados. Os fármacos hipolipemiantes mais utilizados foram sinvastatina (81,5%) e bezafibrato (6,5%), obtidos principalmente por pagamento direto em farmácias e drogarias privadas (52,2%) e serviços próprios do SUS (33,6%). Em nível populacional a prevalência das dislipidemias foi elevada, o seu controle baixo, com menor participação do setor público no fornecimento dos medicamentos do que a aquisição mediante pagamento direto em farmácias e drogarias privadas, sugerindo alcance limitado das políticas públicas de controle das dislipidemias.


Abstract The use of medications for the treatment of dyslipidemia is relevant in the control of cardiovascular disease. This article aims to analyze the prevalence, the use and the participation of the public sector in the supply of medication for adults aged 40 years and above using pharmacotherapy for dyslipidemia control living in a city in the southern region of Brazil. A cross-sectional, population-based study was conducted. Household interviews were staged with 1180 individuals aged over 40 living in Cambé, State of Paraná, of which 967 took laboratory examinations. The prevalence of dyslipidemia was 69.2%, of which 16.1% were taking medication. Among individuals undergoing treatment for dyslipidemia, 22.2% had adequate test results. Lipid-lowering medication used were simvastatin (81.5%) and bezafibrate (6.5%), mainly obtained by direct payment to private pharmacies and drug stores (52.2%) and NHS services (33.6%). A high prevalence of dyslipidemias was observed in population terms, together with a low level of dyslipidemia control and low participation of the public sector regarding the supply of medication compared to acquisition through direct payment for medication in private pharmacies. These results suggest a limited range of public policy for control of dyslipidemia.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Cardiovascular Diseases/prevention & control , Dyslipidemias/drug therapy , Hypolipidemic Agents/therapeutic use , Public Sector , Bezafibrate/supply & distribution , Bezafibrate/therapeutic use , Brazil/epidemiology , Cross-Sectional Studies , Dyslipidemias/complications , Dyslipidemias/epidemiology , Hypolipidemic Agents/supply & distribution , Interviews as Topic , Prevalence , Simvastatin/supply & distribution , Simvastatin/therapeutic use
12.
Rev. Soc. Bras. Clín. Méd ; 13(1)abr. 2015. tab
Article in Portuguese | LILACS | ID: lil-749212

ABSTRACT

JUSTIFICATIVA E OBJETIVOS: Identificar o perfil lipídico dos pacientes renais crônicos e analisar a prevalência das alterações lipídicas nesses pacientes. MÉTODOS: Realizado um estudo retrospectivo em 136 pacientes portadores de doença renal crônica (DRC) não dialítica atendidos em um único ambulatório. Foram coletados os seguintes dados: sexo, idade, comorbidades, medicações em uso, exame físico e exames laboratoriais. Calculou-se a prevalência das principais dislipidemias e as variáveis foram analisadas por meio das estatísticas descritivas: média aritmética e mediana. Foram utilizados os testes t de Student, Mann-Whitney, qui-quadrado e Exato de Fisher. As variáveis foram comparadas entre os grupos com e sem dislipidemia. RESULTADOS: A prevalência de dislipidemias foi de 75,7%, sendo a média dos valores de colesterol total (CT) de 179,6±41,0mg/dl, HDL-colesterol de 46,1±12,6mg/dl,LDL-colesterol de 101,7±34,5mg/dl e de triglicerídeos de 160,0±87,2mg/dl. O grupo com dislipidemia apresentou níveis superiores de triglicerídeos e inferiores de HDL-colesterol. CONCLUSÕES: Observamos elevada prevalência de dislipidemia neste estudo.


BACKGROUND AND OBJECTIVES: Identify the lipid profile of chronic renal patients and the prevalence of lipid disorders in these patients. METHODS: A retrospective study was performed in 136 patients with chronic kidney diseases (CKD) not dialytic, treated in a unique clinic. The following data were collected: gender, age, comorbidities, medications in use, physical examination and laboratory tests. It has been estimated the prevalence of dyslipidemias and main variables were analyzed through descriptive statistics: arithmetic mean and median. The Student's t-tests, Mann-Whitney, chi-squareand Fisher exact were used. Variables were compared between groups with and without dyslipidemia. RESULTS: The prevalence of dyslipidemias was 75.7%, with an average of the total cholesterol of 179.6±41.0mg/dl, HDL-cholesterol of 46.1±12.6mg/dl, LDL cholesterol of 101.7±34.5mg/dl and triglyceride levels of 160.0±87.2mg/dl. The group with dyslipidemia showed increased levels of triglycerides and lower HDL cholesterol. CONCLUSIONS: We observed a high prevalence of dyslipidemia in this study.


Subject(s)
Humans , Male , Female , Middle Aged , Cardiovascular Diseases , Dyslipidemias , Hypolipidemic Agents/therapeutic use , Lipids/blood , Renal Insufficiency, Chronic
13.
Article in English | IMSEAR | ID: sea-157652

ABSTRACT

Altered cholesterol levels in the blood or dyslipidemia is a major modifiable risk factor for CVD and is closely associated with the pathophysiology of CVD. Asians, particularly Indians, have a unique pattern of dyslipidemia; with lower HDL cholesterol, increased triglyceride levels and higher proportion of small dense LDL cholesterol, with characteristic centripetal obesity. ‘Statins’ belong to the group of 3-hydroxy-3-methylglutaryl Coenzyme A reductase inhibitors that have been shown to reduce levels of total and LDL cholesterol. Study Objective: To evaluate the lipid lowering efficacy and safety of Rosuvastatin in Indian dyslipidemics in routine clinical practice by measuring the percent change in Total Cholesterol, LDL, TG and HDL over a period of 16 weeks. Methodology : This was a multicentric, open-labeled, post-marketing surveillance study. A committee of key opinion leaders was formed. A total of 1200 doctors were approached of whom 800 provided us with subject data. Each participating doctor was given case report forms and requested to recruit patients according to the inclusion and exclusion criteria. Lipid profile of each recruited patient was done before initiating therapy and at the end of 4 months. Rosuvastatin was given at a dose of either 5mg/ 10mg OD for 4 months. Results : A total of 11, 656 subjects were recruited into this study out of which 10, 410 complete case report forms were considered (n=10410). The study included 65% males and 35% females. Majority of the subjects were in the age group of 46-55years (35.2%) and 56-65 years (29.4%). In this study, the total cholesterol (TC), LDL-C, Triglycerides (TG) has significantly decreased by 46.13%, 53.74% and 41.93% respectively. Also the HDLC levels increased by 26.84%, thereby, indicating a significant change in the levels of all the dyslipidemic indicators. With the reported number of adverse events (n=4) related to Rosuvastatin, it is evident that the drug is safe and tolerable. There were no significant changes observed in the liver and renal function tests with Rosuvastatin reiterating their safety. Conclusion : Rosuvastatin has shown greater efficacy in lowering LDL cholesterol and non-HDL-cholesterol concentrations. It has been shown to enable more patients to reach their LDL cholesterol goals and to do so with an acceptable safety profile.


Subject(s)
Aged , Female , Cholesterol, HDL/blood , Cholesterol, HDL/drug effects , Cholesterol, LDL/blood , Cholesterol, LDL/drug effects , Dyslipidemias/drug therapy , Fluorobenzenes/administration & dosage , Humans , Hypolipidemic Agents/administration & dosage , Hypolipidemic Agents/therapeutic use , India , Male , Middle Aged , Pyrimidines/administration & dosage , Pyrimidines/analogs & derivatives , Sulfonamides/administration & dosage , Sulfonamides/analogs & derivatives
14.
Arq. bras. endocrinol. metab ; 57(8): 653-658, Nov. 2013. ilus, graf, tab
Article in Portuguese | LILACS | ID: lil-696907

ABSTRACT

Lipodistrofia congênita generalizada (CGL) com hipertrigliceridemia extrema desde o primeiro ano de vida está associada a piores riscos metabólicos. Foram utilizados dados contidos no prontuário do paciente, bem como revisão bibliográfica para composição do texto. Relatamos o caso de um lactente com fenótipo típico e hipertrigliceridemia de 1.360 mg/dL, que foi tratado com bezafibrato na dose de 30 a 60 mg/dia dos 11 meses aos 5 anos e 6 meses de idade, aferindo um nadir de triglicérides de 55 mg/dL. Evolução clínico-laboratorial antes e após bezafibrato foi feita ao longo de cinco anos e seis meses. O fenótipo apresentado foi classificado clinicamente em CGL tipo 2. Apesar do controle eficiente da hipetrigliceridemia e da ausência de desenvolvimento de diabetes melito, o uso de bezafibrato não impediu o aparecimento de esteatose hepática durante a evolução. A terapia antilipemiante com fibrato se mostrou eficaz em manter níveis normais de triglicerídeos, colesterol e suas frações e não se associou a efeitos colaterais graves durante o período descrito.


Congenital generalized lipodystrophy (CGL) with severe hypertriglyceridemia in a children less than 1 year of age is associated with worse metabolic risk. We used data from patient records, as well as extensive literature research to write the manuscript. We report the case of an infant with typical phenotype of CGL and hypertriglyceridemia of 1,360 mg/dL who was treated with bezafibrate at a dose of 30 to 60 mg/day from age 11 months to 5.5 years old, with a measurement of nadir of triglycerides of 55 mg/dL. Clinical evolution and clinical laboratory tests before and after bezafibrate were carried out over 5 years and 6 months. Phenotype was classified as CGL type 2. Despite the efficient control of hypertriglyceridemia and absence of development of diabetes mellitus, the use of bezafibrate did not prevent the onset of hepatic steatosis during evolution. Hypolipidemic therapy with bezafibrate proved effective in maintaining the levels of triglycerides, cholesterol and its fractions at normal levels, and its use was not correlated with severe side effects during the described period.


Subject(s)
Humans , Infant , Male , Bezafibrate/therapeutic use , Hypertriglyceridemia/drug therapy , Hypolipidemic Agents/therapeutic use , Lipodystrophy, Congenital Generalized/drug therapy , Growth Charts
15.
Indian J Exp Biol ; 2013 Sept; 51(9): 702-708
Article in English | IMSEAR | ID: sea-149373

ABSTRACT

The present study was undertaken to evaluate the antidiabetic and antihyperlipidemic activities of Allopolyherbal formulation (APHF) consisting of combinations of three well known medicinal plants used in traditional medicines (Trigonella foenum graceum, Momordica charantia, Aegle marmelos) and synthetic oral hypoglycaemic drug (Glipizide-GL). The optimized combination of lyophilized hydro-alcoholic extracts of drugs was 2:2:1 using OGTT model. The optimized PHF was simultaneously administered with GL and optimized using OGTT model in diabetic rats and further studied in STZ-induced diabetic rats for 21 days. The results (serum glucose level, lipid profile, hepatic enzymes and body weight) were compared with the standard drug GL (10 mg/kg body wt). The optimized APHF (500+5 mg/kg body wt) has shown significant antihyperglycemic and antihyperlipidemic activities. The results were comparable with the standard; even better than the GL (10 mg/kg body wt) alone. The proposed hypothesis has reduced the no. of drug components from eight to three and dose almost 50 % of both PHF and GL which fulfil the FDA requirements for export. Thus the developed APHF will be an ideal alternative for the existing hypoglycemic formulations in the market with an additional advantage of hypolipidemic effect and minimizing the cardiovascular risk factors associated with diabetes.


Subject(s)
Animals , Diabetes Mellitus, Experimental/complications , Diabetes Mellitus, Experimental/drug therapy , Glucose Tolerance Test , Herbal Medicine , Hyperlipidemias/complications , Hyperlipidemias/drug therapy , Hypoglycemic Agents/therapeutic use , Hypolipidemic Agents/therapeutic use , Rats , Streptozocin
16.
J. bras. med ; 101(4): 7-12, jul.-ago. 2013.
Article in Portuguese | LILACS | ID: lil-699658

ABSTRACT

Neste artigo revisaremos o tratamento antiplaquetário e antilipêmico, controle da pressão arterial e controle da frequência cardíaca e sua influência na mortalidade e novos eventos, aplicável a todo paciente portador de doença coronariana crônica.


We review the antiplatelet and hypolipidemic treatment, blood pressure and heart rate control and its influence on mortality and new events, applicable to all patients with chronic coronary disease.


Subject(s)
Humans , Male , Female , Coronary Disease/therapy , Hypolipidemic Agents/administration & dosage , Hypolipidemic Agents/therapeutic use , Platelet Aggregation Inhibitors/administration & dosage , Platelet Aggregation Inhibitors/therapeutic use , Clofibric Acid/therapeutic use , Aspirin/administration & dosage , Diet, Fat-Restricted , Drug Interactions , Heart Rate , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Life Style , Arterial Pressure
17.
Article in English | IMSEAR | ID: sea-157528

ABSTRACT

Objective: To evaluate the effects of Emblica officinalis (Amla) extract on serum lipids and atherogenesis, in albino rats fed with high fat diet. Materials and Methods: Healthy albino rats of Wistar strain (150-200 gm each) were randomized into five groups of six animals each- Group A (received normal diet), Group B (received normal diet + Emblica officinalis extract 1 gm/kg BW) Group C (received high fat diet consisting of vanaspati ghee and coconut oil at a ratio of 3:2, at a dose of 10 ml/kg/day), Group D (received high fat diet + Emblica officinalis extract 1 gm/kg BW) and Group E (received high fat diet + simvastatin 1.8 mg/ kg BW). Treatment period was 8 weeks. At the end of 8 weeks, lipid profile was evaluated by estimating total cholesterol, serum triglyceride, serum LDL, serum HDL and atherogenic index. Results: Ethanolic extract of Emblica officinalis showed significant antihyperlipidaemic activity (P< 0.01) with significant improvement in atherogenic index (p<0.01). Conclusion: Present study suggests that Emblica officinalis extract at a dose of 1 gm/kg BW exerts antihyperlipidaemic effect comparable to that of simvastatin. It also possesses hypolipidaemic activity.


Subject(s)
Animals , Atherosclerosis/drug therapy , Diet, High-Fat/adverse effects , Hyperlipidemias/blood , Hyperlipidemias/drug therapy , Hypolipidemic Agents/therapeutic use , Lipids/blood , Lipids/drug therapy , Lipids/metabolism , Phyllanthus emblica/pharmacology , Phytotherapy , Plant Extracts/pharmacology , Rats , Rats, Wistar , Simvastatin/pharmacology
18.
Rev. panam. salud pública ; 33(6): 383-390, Jun. 2013. tab
Article in English | LILACS | ID: lil-682465

ABSTRACT

OBJECTIVE: To determine the effectiveness of lipid-lowering therapy in a sample of patients affiliated with the Sistema General de Seguridad Social en Salud (the Colombian health system). METHODS: A cross-sectional study was conducted from 1 January 2010-30 June 2011. From a total of 8 316 patients in 10 cities, a random sample of 600 was stratified according to dyslipidemia. Information on sociodemographic and anthropometric characteristics, risk factors, and pharmacological and laboratory variables were obtained from medical records. RESULTS: Subjects were predominantly female (56.2%), with a mean age of 65.1 ± 11.5 years; 93.2% had hypertension; 29.0%, diabetes mellitus; and 10.2%, a history of myocardial infarction. The patients were being treated with lovastatin (84.1%) or gemfibrozil (12.3%)-both at doses below what is recommended-or atorvastatin (1.8%). In patients with high cardiovascular risk, 38.6% achieved goals for low-density lipoprotein cholesterol (LDL-C) levels (<100 mg/dL). Among those at moderate risk, 49.4% reached the target level (< 130 mg/dL). On average, there was a 4.9% reduction in LDL-C. Sex, age, history of cardiovascular disease and/or diabetes mellitus, use of hydrochlorothiazide, and poor therapy adherence were statistically associated with a lack of dyslipidemia control. CONCLUSIONS: Because a lack LDL-C control occurred in patients with two or more of the following variables: male, more than 55 years of age, diabetes and/or a history of cardiovascular disease, received lower doses of lovastatin, or non-adherent to treatment, it is recommended that medication be increased based on clearly-defined therapeutic goals and that comorbidities be assessed and effectively treated.


OBJETIVO: Determinar la eficacia del tratamiento hipolipemiante en una muestra de pacientes afiliados al Sistema General de Seguridad Social en Salud de Colombia. MÉTODOS: Se llevó a cabo un estudio transversal desde el 1 de enero del 2010 al 30 de junio del 2011. De un total de 8 316 pacientes de 10 ciudades seleccionadas, se estratificó una muestra aleatoria de 600 pacientes en función de la dislipidemia. A partir de los expedientes médicos, se obtuvo información sobre las características sociodemográficas y antropométricas, los factores de riesgo y las variables farmacológicas y de laboratorio. RESULTADOS: En la muestra predominaban las mujeres (56,2%) y la media de la edad era de 65,1 ± 11,5 años; 93,2% de los pacientes eran hipertensos; 29,0% eran diabéticos; y 10,2% tenían antecedentes de infarto de miocardio. Los pacientes recibían tratamiento con lovastatina (84,1%) o gemfibrozilo (12,3%) -ambos a dosis inferiores a las recomendadas- o atorvastatina (1,8%). El 38,6% de los pacientes con alto riesgo de enfermedad cardiovascular alcanzaron los objetivos de reducción de los niveles de colesterol unido a lipoproteínas de baja densidad (C-LDL) (< 100 mg/dL). El 49,4% de los pacientes que presentaban un riesgo moderado también alcanzaron los niveles fijados como objetivo (< 130 mg/dL). En promedio, hubo una reducción de 4,9% del C-LDL. El sexo, la edad, los antecedentes personales de enfermedad cardiovascular y diabetes, la administración de hidroclorotiazida y la deficiente adherencia al tratamiento se asociaron estadísticamente con una falta de control de la dislipidemia. CONCLUSIONES: Dado que se produjo un control deficitario del C-LDL en pacientes con dos o más de las siguientes variables: varones, mayores de 55 años, diabéticos o con antecedentes de enfermedad cardiovascular, que recibían dosis bajas de lovastatina, o mostraban falta de adherencia al tratamiento, se recomienda que se aumente la medicación con base en objetivos terapéuticos claramente definidos y que se evalúen y se traten eficazmente las comorbilidades.


Subject(s)
Aged , Female , Humans , Male , Dyslipidemias/drug therapy , Hypolipidemic Agents/therapeutic use , Colombia , Cross-Sectional Studies , Retrospective Studies , Treatment Outcome
19.
Medicina (B.Aires) ; 73(1): 26-30, feb. 2013. tab
Article in Spanish | LILACS | ID: lil-672023

ABSTRACT

Los objetivos del estudio fueron comparar la frecuencia de riesgo cardiovascular (CV) elevado y dislipemia (DLP) en pacientes con artritis reumatoide (AR) y en controles, identificar variables de la enfermedad asociadas a DLP y estimar el porcentaje de pacientes con AR medicados para DLP. Estudio de corte transversal que incluyó 409 pacientes con AR y 624 controles. El riesgo CV se determinó con las clasificaciones NCEP y SCORE modificados por European League Against Rheumatism (EULAR). Para DLP se utilizó la definición de Adult Treatment Panel III (ATP III). La frecuencia de riesgo CV elevado fue similar en pacientes con AR y controles excepto cuando fue definida por NCEP-EULAR (7% vs. 2%; p = 0.00002). La DLP fue encontrada en el 43% de los pacientes con AR y en el 47% de los controles (p = 0.15). Los pacientes con AR y DLP tuvieron más manifestaciones extra-articulares (36% vs. 24%; p = 0.01) y mayor velocidad de sedimentación globular (VSG) (21 (13-35) vs. 18 (10-30) mm; p = 0.003). El tratamiento recibido para DLP varió según la definición utilizada (11% a 32%). Se encontró mayor riesgo CV en los pacientes con AR solo cuando se definió por NCEP- EULAR. Los pacientes con AR y DLP tuvieron mayor VSG y manifestaciones extra-articulares. La mayoría de los pacientes con AR y DLP no estaban recibiendo tratamiento hipolipemiante.


The objectives of this study were to compare the frequency of dyslipidemia (DLP) and the elevated cardiovascular risk between rheumatoid arthritis (RA) patients and a control group, to identify disease-related factors associated with the presence of DLP and to estimate the frequency of RA patients receiving treatment for DLP. This is a cross sectional study that included 409 RA patients and 624 controls. Cardiovascular (CV) risk was determined using the Framingham score, National Cholesterol Education Program (NCEP) and the Systematic Coronary Risk Evaluation (SCORE) adapted versions according to the European League Against Rheumatism (EULAR) guidelines. DLP was defined according to the Adult Treatment Panel III (ATPIII). The frequency of CV risk was similar in RA patients and controls, except when NCEP-EULAR adapted version for RA was applied (7% vs. 2%; p = 0.00002). A 43% of patients and 47% of controls had DLP (p = 0.15). RA patients with DLP tended to have extra-articular manifestations more frequently (36% vs. 24%; p = 0.01) and higher erythrocyte sedimentation rate (ESR) (21 [13-35] vs. 18 [10-30] mm; p = 0.003). RA patients treated for DLP varied between 11% and 32% according to the definition used. Patients with RA showed an elevated CV risk only when the NCEP-EULAR definition was used. Among RA patients, those with higher ESR and the presence of extra-articular manifestations were more likely to show DLP. The vast majority of patients were not receiving treatment for DLP.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Arthritis, Rheumatoid/complications , Cardiovascular Diseases/etiology , Dyslipidemias/epidemiology , Argentina/epidemiology , Case-Control Studies , Cross-Sectional Studies , Dyslipidemias/drug therapy , Hypolipidemic Agents/therapeutic use , Prevalence , Risk Assessment , Risk Factors
20.
Arq. bras. cardiol ; 99(5): 997-1007, nov. 2012. tab
Article in Portuguese | LILACS | ID: lil-656637

ABSTRACT

FUNDAMENTO: A dislipidemia secundária à terapia antirretroviral potente nos pacientes com HIV está associada à significativa elevação da morbimortalidade cardiovascular por doença aterosclerótica, sendo, portanto, necessário tratamento imediato e eficaz. OBJETIVO: Demonstrar a efetividade e a segurança da rosuvastatina e do ciprofibrato no tratamento da dislipidemia associada à terapia antirretroviral potente em pacientes com HIV. MÉTODOS: Trezentos e quarenta e seis pacientes com dislipidemia foram submetidos a tratamento farmacológico: 200 pacientes com hipertrigliceridemia receberam ciprofibrato (Grupo I); 79 pacientes com hipercolesterolemia receberam rosuvastatina (Grupo II); e 67 pacientes com dislipidemia mista receberam ciprofibrato associado a rosuvastatina (Grupo III). O perfil lipídico foi avaliado antes e após o tratamento hipolipemiante, sendo feita comparação estatística pelo teste de Wilcoxon. Transaminases hepáticas e creatinofosfoquinase foram dosadas para controle de toxicidade hepática e muscular. RESULTADOS: As concentrações séricas de triglicérides e de colesterol total foram significativamente menores do que as obtidas antes do tratamento, para os três grupos experimentais (p < 0,002). Observou-se aumento significativo do HDL colesterol nos grupos experimentais I e III (p < 0,002). Nos grupos I e II, o LDL-colesterol foi significativamente menor (p < 0,001). Nenhum dos pacientes apresentou elevações de transaminases ou de creatinofosfoquinase a níveis de toxicidade significativa. CONCLUSÃO: Os resultados deste estudo demonstram que ciprofibrato, rosuvastatina ou a combinação de ambos pode ser considerada tratamento hipolipemiante efetivo, seguro e com boa tolerância nos pacientes com Aids submetidos à terapia antirretroviral potente.


BACKGROUND: Dyslipidemia secondary to highly active antiretroviral therapy in patients with HIV is associated with a significant increase in cardiovascular morbidity and mortality due to atherosclerotic disease, requiring, thus, immediate and effective treatment. OBJECTIVE: To demonstrate the effectiveness and safety of rosuvastatin and ciprofibrate in the treatment of dyslipidemia associated with highly active antiretroviral therapy in patients with HIV. METHODS: Three hundred and forty-six patients with dyslipidemia underwent pharmacological treatment as follows: 200 patients with hypertriglyceridemia received ciprofibrate (Group I); 79 patients with hypercholesterolemia received rosuvastatin (Group II); and 67 patients with mixed dyslipidemia received ciprofibrate associated with rosuvastatin (Group III). The lipid profile was assessed before and after the lipid-lowering treatment, and the Wilcoxon test was used for statistical comparison. Liver transaminases and creatine phosphokinase were measured to assess liver and muscle toxicity. RESULTS: The serum concentrations of triglycerides and total cholesterol were significantly lower than those obtained before the lipid-lowering treatment in the three experimental groups (p < 0.002). A significant increase in HDL-cholesterol was observed in Groups I and III (p < 0.002). In Groups I and II, LDL-cholesterol was significantly lower (p < 0.001). None of the patients experienced elevations in transaminases or creatine phosphokinase to significantly toxic levels. CONCLUSION: The results of this study show that ciprofibrate and rosuvastatin or a combination of both can be considered an effective, safe and well-tolerated lipid-lowering treatment for patients with AIDS on highly active antiretroviral therapy.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Antiretroviral Therapy, Highly Active/adverse effects , Dyslipidemias/drug therapy , Fibric Acids/therapeutic use , Fluorobenzenes/therapeutic use , HIV Infections/drug therapy , Hypolipidemic Agents/therapeutic use , Pyrimidines/therapeutic use , Sulfonamides/therapeutic use , Cardiovascular Diseases/chemically induced , Cholesterol/blood , Dyslipidemias/chemically induced , Risk Factors , Statistics, Nonparametric , Treatment Outcome , Triglycerides/blood
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