Targeting Two Sources of Cholesterol – An Advanced Treatment Approach to Lipid-lowering Management

2005 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Dr Alberico L Catapano ◽  
2014 ◽  
Vol 9 (2) ◽  
pp. 71
Author(s):  
Kazeen Abdullah ◽  
Anand Rohatgi ◽  
◽  

Statins are currently the most efficacious and widely prescribed lipid-lowering medications. The 2013 ACC/AHA cholesterol guidelines provide a dramatic shift in treatment approach with a focus on fixed-dose statins matched to individual risk scores. Statin intolerance is not uncommon and can be challenging to diagnose and manage; however, several therapeutic strategies have been successful in achieving statin tolerance. Statin use is also associated with liver enzyme elevations and increased risk of incident diabetes, but studies show these individuals benefit from statins. Several guidelines exist and statin use is expected to increase with the new cholesterol guidelines bringing along new challenges for prescribers. This review article will provide practical considerations for statin use and management of statin intolerance.


2002 ◽  
Vol 2 (1_suppl) ◽  
pp. S12-S17 ◽  
Author(s):  
François Berthezène

Dyslipidaemia is likely to play a leading role in the cardiovascular risk associated with diabetes. Diabetic dyslipidaemia is characterised by hypertriglyceridaemia, a shift from large low-density lipoprotein (LDL) to smaller denser particles, and reduced high-density lipoprotein (HDL) cholesterol. Dyslipidaemia is closely associated with insulin resistance. Patients with diabetic dyslipidaemia should receive lipid lowering therapy with statins or fibrates, as appropriate. Due to the relationship between dyslipidaemia and insulin resistance, treatment of insulin resistance should be included in multifactorial risk factor modification. Thiazolidinediones such as pioglitazone may provide a useful treatment approach.


2010 ◽  
Vol 61 (7) ◽  
pp. 1691-1698 ◽  
Author(s):  
S. Beier ◽  
S. Köster ◽  
K. Veltmann ◽  
H. Schröder ◽  
J. Pinnekamp

Considerable concern exists regarding the appearance and effects of trace and ultra trace pollutants in the aquatic environment. In this context, it is necessary to identify relevant hot spot wastewater – such as hospital wastewater – and to implement specific wastewater treatment solutions. Membrane bioreactor (MBR) technology seems to be a suitable pre-treatment approach for the subsequent advanced treatment by high pressure membrane systems such as nanofiltration (NF) and reverse osmosis (RO). This paper is based upon investigations on the first full scale MBR for separate treatment of hospital wastewater in Germany. In this study an NF as well as an RO module for further treatment of the MBR filtrate were tested. The removal efficiencies were assessed using the following target compounds: bezafibrate, bisoprolol, carbamazepine, clarithromycin, ciprofloxacin, diclofenac, ibuprofen, metronidazole, moxifloxacin, telmisartan and tramadol. In summary, the results of this study confirmed that MBR technology followed by an advanced treatment for trace pollutant removal is an adequate approach for specific treatment of hot spot wastewater such as hospital wastewater. In particular, it was shown that – comparing the tested NF and RO – only (a two stage) RO is appropriate to remove pharmaceutical residues from hospital wastewater entirely. The recommended yield of the 2-stage RO is 70% which results in a retentate sidestream of 9%. Our investigations proved that RO is a very efficient treatment approach for elimination of trace pollutants.


1997 ◽  
Vol 6 (4) ◽  
pp. 34-47 ◽  
Author(s):  
Steven H. Long ◽  
Lesley B. Olswang ◽  
Julianne Brian ◽  
Philip S. Dale

This study investigated whether young children with specific expressive language impairment (SELI) learn to combine words according to general positional rules or specific, grammatic relation rules. The language of 20 children with SELI (4 females, 16 males, mean age of 33 months, mean MLU of 1.34) was sampled weekly for 9 weeks. Sixteen of these children also received treatment for two-word combinations (agent+action or possessor+possession). Two different metrics were used to determine the productivity of combinatorial utterances. One metric assessed productivity based on positional consistency alone; another assessed productivity based on positional and semantic consistency. Data were analyzed session-by-session as well as cumulatively. The results suggest that these children learned to combine words according to grammatic relation rules. Results of the session-by-session analysis were less informative than those of the cumulative analysis. For children with SELI ready to make the transition to multiword utterances, these findings support a cumulative method of data collection and a treatment approach that targets specific grammatic relation rules rather than general word combinations.


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