Lipid Lowering Therapy: An Era Beyond Statins.

Dyslipidemia, specifically elevated LDL cholesterol levels, causes atherosclerotic cardiovascular disease (ASCVD) and increases the risk of myocardial infarction and stroke. Statins, a class of drugs that exert their effects by inhibiting HMG-CoA reductase, a key enzyme in the synthesis of cholesterol, have been the mainstay of therapy for the primary prevention of cardiovascular disease and lipids reduction. Statins are associated with side effects, most commonly myopathy and myalgias, despite their proven efficacy. This review explores non-statin lipid-lowering therapies and examines recent advances and emerging research. Over the previous decades, several lipid-lowering therapies, both as monotherapy and adjuncts to statin therapy and lipid-targeting gene therapy, have emerged, thus redefining how we treat dyslipidemia. These drugs include Bile acids sequestrants, Fibrates, Nicotinic acid, Ezetimibe, Bempedoic acid, Volanesoren, Evinacumab, and the PCSK 9 Inhibitors Evolocumab and Alirocumab. Emerging gene-based therapy includes Small interfering RNAs, Antisense oligonucleotides, Adeno-associated virus vectors, CRISPR/Cas9 based therapeutics, and Non-coding RNA therapy. Of all these therapies, Bempedoic acid works most like statins by working through a similar pathway to decrease cholesterol levels. However, it is not associated with myopathy. Overall, although statins continue to be the gold standard, non-statin therapies are set to play an increasingly important role in managing dyslipidemia

Secondary infertility due to fetal bone retention: A systematic literature review

Prolonged intrauterine retention of fetal bones during an abortion procedure can lead to secondary infertility A total of 17 case reports, 7 case series, and one retrospective study were included, with a total of 75 patients. 60% had a termination in the 2nd trimester, while 20% had a pregnancy termination during the 1st trimester. Hysteroscopic resection was used to remove the intrauterine fetal bones in 69% of patients. 59 % of patients could conceivefollowing the procedure, 1% conceived despite the presence of intrauterine bones, 24% could not conceive at the time of the study, and 16% of patients had an unknown outcome. Transvaginal in 41 (55%) and pelvic ultrasound in 21(28%) were used for diagnosis. Secondary infertility is a common occurrence after a D&C procedure partially due to fetal bone retention. The gold standard for an accurate diagnosis and treatment is hysteroscopy

The re-emergence of Melioidosis in the United States amid COVID-19

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Benefit and risk evaluation of quinapril hydrochloride.

INTRODUCTION: Angiotensin-converting enzyme (ACE) inhibitors are a mainstay of antihypertensive therapy. Quinapril hydrochloride, a less commonly used, and less-studied ACE inhibitor has been approved for its primary use in hypertension. Studies also indicate its off-label use for congestive heart failure and diabetic nephropathy. The ANDI and TREND trials have been pivotal in demonstrating the effectiveness of quinapril. AREAS COVERED: The authors conducted a review of the literature analyzing the clinical efficacy and safety profile of quinapril. This review discusses the development of quinapril, provides an updated summary of the indications and contraindications, and presents a comparison with other ACE inhibitors. EXPERT OPINION: Quinapril is a safe and well-tolerated antihypertensive medication with a favorable safety profile compared to other ACE inhibitors. However, a lack of ample recent clinical trials and post-marketing data investigating the efficacy of quinapril in large cohorts has resulted in limited use in clinical practice. Quinapril may be an effective antihypertensive option for elderly populations as well as those who cannot tolerate the side effects profiles of other ACE inhibitors and as an additional treatment option for patients with heart failure with preserved ejection fraction