Dyslipidaemia of Obesity, Metabolic Syndrome and Type 2 Diabetes Mellitus: the Case for Residual Risk Reduction After Statin Treatment

Dyslipidaemia is frequently present in obesity, metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM). The predominant features of dyslipidaemia in these disorders include increased flux of free fatty acids (FFA), raised triglyceride (TG) and low high density lipoprotein cholesterol (HDL-C) levels, a predominance of small, dense (atherogenic) low density lipoprotein cholesterol (LDL) particles and raised apolipoprotein (apo) B values Posprandial hyperlipidaemia may also be present. Insulin resistance (IR) appears to play an important role in the pathogenesis of dyslipidaemia in obesity, MetS and T2DM. The cornerstone of treatment of this IR-related dyslipidaemia is lifestyle changes and in diabetic patients, tight glycaemic control. In addition to these measures, recent clinical trials showed benefit with statin treatment. Nevertheless, a substantial percentage of patients treated with statins still experience vascular events. This residual vascular risk needs to be addressed. This review summarizes the effects of hypolipidaemic drug combinations (including statins with cholesterol ester protein inhibitors, niacin, fibrates or fish oil, as well as fibrate-ezetimibe combination) on the residual vascular risk in patients with obesity, MetS or T2DM

Dyslipidemia Induced by Drugs Used for the Prevention and Treatment of Vascular Diseases

Dyslipidemia is a major vascular risk factor. Interestingly, several agents used for the prevention and treatment of vascular diseases have an adverse effect on the lipid profile. In addition, agents belonging to the same class (e.g. beta blockers) can have significantly different actions on lipid levels. We summarize the effects of drugs used for the prevention and treatment of vascular diseases on the lipid profile. These effects should be considered when selecting a specific agent, particularly in high-risk patients

An Open Platform for Modeling Method Conceptualization: The OMiLAB Digital Ecosystem

This paper motivates, describes, demonstrates in use, and evaluates the Open Models Laboratory (OMiLAB)—an open digital ecosystem designed to help one conceptualize and operationalize conceptual modeling methods. The OMiLAB ecosystem, which a generalized understanding of “model value” motivates, targets research and education stakeholders who fulfill various roles in a modeling method\u27s lifecycle. While we have many reports on novel modeling methods and tools for various domains, we lack knowledge on conceptualizing such methods via a full-fledged dedicated open ecosystem and a methodology that facilitates entry points for novices and an open innovation space for experienced stakeholders. This gap continues due to the lack of an open process and platform for 1) conducting research in the field of modeling method design, 2) developing agile modeling tools and model-driven digital products, and 3) experimenting with and disseminating such methods and related prototypes. OMiLAB incorporates principles, practices, procedures, tools, and services required to address the issues above since it focuses on being the operational deployment for a conceptualization and operationalization process built on several pillars: 1) a granularly defined “modeling method” concept whose building blocks one can customize for the domain of choice, 2) an “agile modeling method engineering” framework that helps one quickly prototype modeling tools, 3) a model-aware “digital product design lab”, and 4) dissemination channels for reaching a global community. In this paper, we demonstrate and evaluate the OMiLAB in research with two selected application cases for domain- and case-specific requirements. Besides these exemplary cases, OMiLAB has proven to effectively satisfy requirements that almost 50 modeling methods raise and, thus, to support researchers in designing novel modeling methods, developing tools, and disseminating outcomes. We also measured OMiLAB’s educational impact

Is there an additional benefit from coronary revascularization in diabetic patients with acute coronary syndromes or stable angina who are already on optimal medical treatment?

Cardiovascular disease (CVD) is common in patients with diabetes mellitus (DM) and related clinical outcomes are worse compared with non-diabetics. The optimal treatment in diabetic patients with coronary heart disease (CHD) is currently not established. We searched MEDLINE (1975-2010) using the key terms diabetes mellitus, coronary heart disease, revascularization, coronary artery bypass, angioplasty, coronary intervention and medical treatment. Most studies comparing different revascularization procedures in patients with CHD favoured coronary artery bypass graft (CABG) surgery in patients with DM. However, most of this evidence comes from subgroup analyses. Recent evidence suggests that advanced percutaneous coronary intervention (PCI) techniques along with best medical treatment may be non-inferior and more cost-effective compared with CABG. Treatment of vascular risk factors is a key option in terms of improving CVD outcomes in diabetic patients with CHD. The choice between medical therapy and revascularization warrants further assessment