Correlates of Achieving Statin Therapy Goals in Children and Adolescents with Dyslipidemia.

OBJECTIVE: To determine the real-world effectiveness of statins and impact of baseline factors on low-density lipoprotein cholesterol (LDL-C) reduction among children and adolescents. STUDY DESIGN: We analyzed data prospectively collected from a quality improvement initiative in the Boston Children's Hospital Preventive Cardiology Program. We included patients ≤21 years of age initiated on statins between September 2010 and March 2014. The primary outcome was first achieving goal LDL-C, defined as <130 mg/dL, or <100 mg/dL with high-level risk factors (eg, diabetes, etc). Cox proportional hazards models were used to assess the impact of baseline clinical and lifestyle factors. RESULTS: Among the 1521 pediatric patients evaluated in 3813 clinical encounters over 3.5 years, 97 patients (6.3%) were started on statin therapy and had follow-up data (median age 14 [IQR 7] years, 54% were female, and 24% obese, 62% with at least one lifestyle risk factor). The median baseline LDL-C was 215 (IQR 78) mg/dL, and median follow-up after starting statin was 1 (IQR 1.3) year. The cumulative probability of achieving LDL-C goal within 1 year was 60% (95% CI 47-69). A lower probability of achieving LDL-C goals was associated with male sex (HR 0.5 [95% CI 0.3-0.8]) and higher baseline LDL-C (HR 0.92 [95% CI 0.87-0.98] per 10 mg/dL), but not age, body mass index percentile, lifestyle factors, or family history. CONCLUSIONS: The majority of pediatric patients started on statins reached LDL-C treatment goals within 1 year. Male patients and those with greater baseline LDL-C were less likely to be successful and may require increased support.

The effects of backpack load carrying on dynamic balance as measured by limits of stability.

PURPOSE: The purpose of this research was to determine if standing dynamic balance was affected by carrying a backpack. SUBJECTS: Data was obtained from 50 healthy college students. MATERIALS AND METHODS: Limits of stability was assessed using the Smart Equitest Balance Master System(R). Reaction time, movement velocity, end point excursion, maximum excursion, and directional control were measured to evaluate movement, with and without a loaded backpack. DATA ANALYSIS: Reliability was established using an Intra-Class Correlation Coefficient (2,1). MANOVA was utilized to analyze the effect of the backpack. SUMMARY DATA: Movement velocity significantly decreased during backpack loaded trials (p=0.004). Directional control was significantly different with respect to direction (p=0.006). No significant difference in reaction time, maximum excursion, or end point excursion was observed with backpack loading (p=0.10-0.93). CONCLUSION: This study concludes that backpack load carrying has an effect on movement velocity and directional control.