252 research outputs found
Evaluation of a postdischarge coronary artery disease management program
ObjectivesWe conducted a demonstration project to assess the value of a nurse practitioner (NP) based coronary artery disease management (CADâDM) program for patients with an acute coronary syndrome (ACS) or percutaneous coronary intervention.MethodsPatients were recruited to attend three 1âh monthly visits. The intervention included assessment of clinical symptoms and guidelineâbased treatments; education regarding CAD/ACS; review of nutrition, exercise, and appropriate referrals; and recognition of significant symptoms and emergency response.ResultsTwo hundred thirteen (84.5%) completed the program. Physician approval for patient participation was 99%. Average age was 63 ± 11 years, 70% were male, and 89% white. At baseline, 61% (n = 133) had one or more cardiopulmonary symptoms, which declined to 30% at 12 weeks, p < .001. Sixtyânine percent attended cardiac rehabilitation or an exercise consult. Compared to the initial assessment, an additional 20% were at lowâdensity lipoprotein cholesterol < 70 mg/dL (p = .04), an additional 35% met exercise goals (p < .0001), and there was an improvement in the mental (baseline 49.7 vs. 12 weeks 53, p = .0015) and physical components (44 vs. 48, p = .002) of the SFâ12 health survey.ConclusionThis NPâbased CADâDM program was well received and participants demonstrated improvement in physical and mental health, and increased compliance with recommended lifestyle changes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/112261/1/jaan12201.pd
Antioxidant supplementation reduces the susceptibility of low density lipoprotein (LDL) to oxidation in patients with coronary artery disease
Diagnosis of acquired generalized lipodystrophy in a single patient with T-cell lymphoma and no exposure to Metreleptin
Abstract
Background
Metreleptin, a recombinant methionyl -human -leptin, was approved to treat patients with generalized lipodystrophy (GL) in February 2014. However, leptin therapy has been associated with the development of lymphoma. We present a unique case of a patient with prior history of T cell lymphoma in remission, who was diagnosed with Acquired Generalized Lipodystrophy (AGL) during the following year after a clinical remission of her lymphoma without receiving leptin therapy.
Case presentation
A 33-year-old woman with a diagnosis of stage IV subcutaneous panniculitis like T-cell lymphoma in 2011, underwent chemotherapy. Shortly after completion therapy, she had a relapse and required more chemotherapy with complete response, followed by allogenic stem cell transplant on June 28, 2012. Since that time, she has been on observation with no evidence of disease recurrence. Subsequent to the treatment, she was found to have high triglycerides, loss of fat tissue from her entire body and diagnosis of diabetes. Constellation of these findings led to the diagnosis of AGL in 2013. Her leptin level was low at 3.4âng/mL (182âpmol/mL). She is currently not receiving any treatment with Metreleptin for her AGL.
Conclusions
Causal association between exogenous leptin therapy and T-cell lymphoma still remains unclear. We hereby present a case of a young woman who was diagnosed with AGL after going into remission from T-cell lymphoma and who has never been treated with Metreleptin. Steroid therapy and chemotherapy might have masked the diagnosis of AGL in this patient. We believe that patients can develop these 2 conditions independent of each other.https://deepblue.lib.umich.edu/bitstream/2027.42/148289/1/40842_2019_Article_76.pd
Carotid Artery Function Is Restored in Subjects With Elevated Cardiovascular Disease Risk After a 12-Week Physical Activity Intervention.
Sympathetic nervous system activation elicits carotid artery vasodilation in healthy subjects, yet vasoconstriction in those with cardiovascular disease (CVD). Whether carotid artery vasoconstriction can be reversed is currently unknown. Nineteen subjects with increased risk for CVD were referred to a 12-week physical activity intervention, and 12 participants with increased risk for CVD were recruited as a no treatment control group. Cardiorespiratory and vascular health measures were collected at baseline and 12 weeks. Results indicate that carotid artery vasoconstriction in response to sympathetic stimulation may be reversed in subjects at increased risk of CVD. These findings warrant further investigation
Reported obstructive sleep apnea does not diminish the cardiometabolic health benefits from a comprehensive lifestyle intervention program
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146568/1/jch13406_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146568/2/jch13406.pd
Efficacy and safety of pravastatin in the long-term treatment of elderly patients with hypercholesterolemia
Elevated cholesterol levels are a major risk factor for coronary heart disease, which remains a significant problem in patients beyond age 65 years. Because drug therapy for the control of hypercholesterolemia in elderly patients is frequently considered to be indicated, we investigated the efficacy and safety of pravastatin in the treatment of elderly subjects with primary hypercholesterolemia. In this 96-week, multicenter, double-blind, placebo-controlled study, 142 subjects (95 women, 47 men) 64 to 90 years of age with elevated cholesterol levels despite dietary intervention were randomized to receive pravastatin 20 mg at bedtime or matching placebo (2:1). Dosage could be doubled after 8 weeks, a bile acid-binding resin could be added after 16 weeks, and nicotinic acid or probucol could be added after 32 weeks, as needed, to adequately lower the low-density lipoprotein cholesterol (LDL-C) levels. Significant reductions in the levels of LDL-C (-30.9%), total cholesterol (Total-C; -21.9%), and triglycerides (TG; -16.7%) and significant increases in the levels of high-density lipoprotein cholesterol (HDL-C; 11.3%) were noted in the group receiving pravastatin treatment at 16 weeks (P In this study, pravastatin was well tolerated and effective in lowering LDL-C, Total-C, and TG and in raising HDL-C during long-term treatment of elderly patients with primary hypercholesterolemia.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31935/1/0000888.pd
Impact of a structured lifestyle programme on patients with metabolic syndrome complicated by nonâalcoholic fatty liver disease
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147867/1/apt15063.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147867/2/apt15063_am.pd
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