ABSTRACT
Objetivo: Evaluar el impacto sobre la incidencia y recurrencia de eventos cardiovasculares y cerebrovasculares (prevención primaria y secundaria), los niveles de las fracciones lipídicas y la incidencia de efectos secundarios en personas con hipercolesterolemia intolerantes al tratamiento con las estatinas. Métodos: Se elaboró una guía de práctica clínica siguiendo los lineamientos de la guía metodológica del Ministerio de Salud y Protección Social para recolectar de forma sistemática la evidencia científica y formular las recomendaciones utilizando la metodología GRADE. Población Población adulta, con diagnóstico de dislipidemia, o en riesgo de desarrollarla, intolerantes al manejo con las estatinas. Recomendaciones: Se formulan recomendaciones a favor del uso de diferentes medicamentos (los fibratos, la niacina, los ácidos omega 3, las resinas secuestradoras de ácidos biliares, el ezetimibe), según su efectividad hipolipemiante y reducción de eventos cardiovasculares, como propuesta adaptada al contexto social colombiano.
Objective To evaluate the impact on the incidence and recurrence of cardiovascular and cerebrovascular events (primary and secondary prevention), the levels of lipid fractions and the incidence of side effects in people with hypercholesterolemia intolerant to statin therapy. Methods: A clinical practice guideline was developed following the guidelines of the methodological guidance of the Ministry of Health and Social Protection to systematically collect the evidence and make recommendations using the GRADE methodology. Population: Adult population, diagnosed with dyslipidemia or at risk of developing, intolerant to management with statin drugs. Recommendations: Recommendations for the use of different medications (fibrates, niacin, omega 3 acids, bile acid binding resins, ezetimibe) are formulated according to their lipid-lowering effectiveness and reduction of cardiovascular events, a proposal adapted to the Colombian social context.
Subject(s)
Cardiovascular Diseases , Hypercholesterolemia , Therapeutics , Hydroxymethylglutaryl-CoA Reductase Inhibitors , LipidsABSTRACT
A palladium-catalyzed synthesis of the carbazole framework is described, including the preparation of 2-, 5-, and 7-oxygenated natural and unnatural carbazole alkaloids. A series of N-arylcyclohexane enaminones, generated by condensation of cyclohexane-1,3-dione with diverse anilines, were aromatized by a Pd(0)-catalyzed thermal treatment to afford the corresponding diarylamines. The latter were submitted to a Pd(II)-catalyzed cyclization and methylation processes to provide the desired carbazoles, including clausine V. Following an inverse strategy, a new and short total synthesis of glycoborine is also reported.
