1,721,054 research outputs found
La terapia dell'ipertensione arteriosa nel controllo del rischio cardiovascolare globale
No full textSevere Hypertriglyceridemia-Related Acute Pancreatitis
No full textAcute pancreatitis is a potentially life-threatening complication of severe hypertriglyceridemia. In some cases, inborn errors of metabolism such as lipoprotein lipase deficiency, apoprotein C-II deficiency, and familial hypertriglyceridemia have been reported as causes of severe hypertriglyceridemia. More often, severe hypertriglyceridemia describes various clinical conditions characterized by high plasma levels of triglycerides (>1000mg/dL), chylomicron remnants, or intermediate density lipoprotein like particles, and/or chylomicrons. International guidelines on the management of acute pancreatitis are currently available. Standard therapeutic measures are based on the use of lipid-lowering agents (fenofibrate, gemfibrozil, niacin, -3 fatty acids), low molecular weight heparin, and insulin in diabetic patients. However, when standard medical therapies have failed, non-pharmacological approaches based upon the removal of triglycerides with therapeutic plasma exchange can also provide benefit to patients with severe hypertriglyceridemia and acute pancreatitis. Plasma exchange could be very helpful in reducing triglycerides levels during the acute phase of hyperlipidemic pancreatitis, and in the prevention of recurrence. The current evidence on management of acute pancreatitis and severe hypertriglyceridemia, focusing on symptoms, treatment and potential complications is reviewed herein
Severe hypertriglyceridemia-related acute pancreatitis: Myth or reality?
No full text[No abstract available
Hypertriglyceridaemia, Postprandial Lipaemia And Non-Hdl Cholesterol.
No full textMaintaining total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels within healthy limits decreases the risk of atherosclerotic vascular disease (AVD) and cardiovascular (CV) events. The predictive value of elevated TG levels for coronary artery disease (CAD) seen in univariate analysis tends to disappear on multivariate analyses, especially when correction is made for HDL-C. The relationship between TG and HDL-C is complex and not fully understood. Hydrolysis of TG by lipoprotein lipase convertsHDL subclass 3 to a larger lipoprotein enriched in both phospholipid and TG. This process occurs in postprandial lipaemia (PPL). An additional factor for the complex relationship between TGs and CV risk is that the lipoproteins which transport plasma TG (chylomicrons, very low density lipoproteins and their remnants) are heterogeneous particles. Therefore, they may differ in their level of atherogenicity. PPL is a physiological process during which plasma lipoproteins and their subclasses undergo variations in concentration and composition following consumption of food, particularly fatty food. "Postprandial hyperlipidaemia" is the quantitative/qualitative alteration of this normal process. These lipoprotein alterations could play a role in the development of CV disease (CVD). However, lipid levels used to evaluate CV risk are usually measured in the fasting state. This review focuses on TG, PPL, postprandial hyperlipidaemia and non-HDL-C, their relationships and potential predictive role in atherogenesis and CVD
COMPARSA DI REPLICAZIONE VIRALE DURANTE IL TRATTAMENTO CON CYA IN PAZIENTECON ARTRITE REUMATOIDE E POSITIVITÀ PER ANTICORPI ANTI-HCV.
No full textTiming clinical events in the treatment of pancreatitis and hypertriglyceridemia with therapeutic plasmapheresis
No full textBackground: Hyperlipidemic pancreatitis (HP) is caused by severe hypertriglyceridemia (SHTG). Evidence of SHTG refractoriness to standard medical treatment but not to therapeutic apheresis has increased in the last years. Methods: Described is the timing of clinical events and the sequence of therapeutic plasma-exchange (TPE) procedures to treat pancreatitis due to SHTG in a male patient, Caucasian, aged 49. years, referred to emergency for severe epigastric pain. There was no history of alcohol consumption, a pre-existing mild hyperlipidemia was treated with diet alone, and biliary imaging was normal. Physical examination revealed epigastric tenderness. Laboratory investigation revealed marked hypertriglyceridemia (11,355. mg/dL; range: 30-150), and hypercholesterolemia (941. mg/dL; range: 80-200). Serum amylase (Amy) and lipase (Lip) were increased: 160. UI/L (range: 20-100) and 175. UI/L (range: 13-60), respectively. A computerized tomography (CT) scan of the abdomen revealed a picture compatible with acute pancreatic phlogosis. It was diagnosed as " acute secondary pancreatitis (AP) and SHTG" Results: The patient was successfully submitted to three sessions of TPE in emergency. He was released from hospital after 13. days of hospitalization. The levels of lipids and lipoproteins in his plasma were as follows: triglycerides (TG) 185. mg/dL; total cholesterol (TC) 179. mg/dL; HDL-cholesterol (HDLC) 22. mg/dL; LDL-cholesterol (LDLC) 120. mg/dL. Conclusions: The decision to submit the patient with clinical evidence of HP caused by SHTG to apheresis was correct. The improvement in the clinical picture was fast and the recovery was complete. © 2011 Elsevier Ltd
Tollerabilità ed effetti collaterali dell'interferone alfa nel trattamento delle epatiti croniche virali
No full textIt is reported a review on side effects and toxicity of alfa interferon in treatment of chronic viral hepatitis. The clinical experience in 44 patients affected by chronic hepatitis and treated with 3MU of alfa interferon is analysed
Soluble P-selectin as a marker of platelet hyperactivity in patients with chronic obstructive pulmonary disease
No full textA comparative analysis between soluble (s) P-selectin and von Willebrand Factor (vWF) was performed in 40 patients with chronic obstructive pulmonary disease (COPD) and 20 healthy subjects, with the aim of investigating whether the occurrence of elevated levels of sP-selectin may reflect activation of platelets, endothelial cells, or both. Plasma sP-selectin levels were significantly higher in patients compared to controls (P<0.01), Similarly vWF levels were elevated in patients compared to healthy subjects, although the difference did not reach statistical significance. Lipoprotein (a) [Lp(a)] levels were Lower in COPD patients than controls (P<0.0001). The analysis of the correlation among all the variables demonstrated that plasma sP-selectin did not correlate with vWF. Conversely, plasma sP-selectin levels significantly correlated with either oxygen (rho=-0.41, P<0.05) or carbon dioxide (rho=0.47, P<0.05) tension. An inverse correlation between serum Lp(a) and plasma sl-selectin levels (rho=-0.35, P<0.05) was also observed. Moreover, increasing levels of sP-selectin in COPD patients significantly correlated with the impairment of blood gas tensions. In conclusion, the results obtained indicate the prominent platelet origin of circulating sl-selectin, suggesting that sP-selectin might be considered a marker of in vivo platelet activation in patients with COPD
Ormoni sodiomodulanti cardiaci e renali nell'ipertensione arteriosa giovanile. Considerazioni fisiopatologiche e terapeutiche derivate da una esperienza condotta nel Policlinico Militare Celio di Roma
No full textSodium balance plays a primary role in blood pressure regulation. Atrial natriuretic peptide, a recently discovered natriuretic substance, seems to participate in renal sodium handling, but its behavior in essential hypertension has not been fully defined. In our study, to avoid the "contamination" of factors other than hypertension, we evaluated the plasma levels of atrial natriuretic peptide in young men at military draft age. Our main results showed that plasma atrial natriuretic peptide levels are higher in young hypertensives with low plasma renin activity and low urinary excretion of active kallikrein. The influence of a positive genetic background for essential hypertension on plasma atrial natriuretic peptide levels was also investigated. Our data showed slightly elevated levels of the atrial hormone in young normotensives with a family history of hypertension
Peripheral neuropathy without cryoglobulinemia in patients with hepatitis C virus infection
No full textBACKGROUND: An association between essential mixed cryoglobulinemia and hepatitis C virus infection has been documented by many reports. Some clinical manifestations such as purpura, arthralgia, vascular lesions and peripheral neuropathies are also connected with the presence of detectable cryoglobulins. The association between HCV infection, the presence of mixed cryoglobulinemia and peripheral neuropathy is well documented. The aim of this study was to define the possible presence of peripheral neuropathy in HCV patients without detectable cryoglobulins and the possible association with the different genotypes. METHODS: Twenty patients (11 females, 9 males) with chronic HCV hepatitis and without detectable cryoglobulins were submitted to neurological and electrophysiological studies to detect a possible peripheral neurological involvement. In all patients the HCV infection was assumed by the presence of antibodies to HCV with ELISA assay and then confirmed with recombinant immunoblot assay. HCV genotyping was obtained by INNO LIPA in 15 out of 20 patients. In 4 patients a sural nerve biopsy was possible. RESULTS: Genotype 1b was present in 80% of patients, while 1a in 13.3% and 4 in 6.6%. Thirteen patients had positive neurological anamnesis (65%), while neurological examination was positive in 40% of the cases. Electromyographic study was positive in 50% of subjects. The sural nerve biopsies agreed with axonal degeneration in amyelinated fibres. CONCLUSIONS: Our results suggest a possible peripheral neurological system involvement in patients with HCV infection without cryoglobulin
- …
