The web site logo

Login My Account
 
tdayspring's blog 
Blogs - - Posts
Aug 9, 2010 0 comments Risk assessment Risk assessment
Go over to my Lipidaholics Group page and get into the case which asks does a seemingly healthy 38 year old woman with an extremely low Framingham Risk Score need advanced CV tresting?  Post you comments please!  Do you all know who was Rachel Jackson?  This case is dedicated to her.
Aug 3, 2010 1 comments Exercise and Nutrition Exercise and Nutrition

All lipidologists treating or advising women need to read this superb document regarding the use of all hormonal therapies: estrogen, progetogens, SERMS, tibilone.  

 

The entire statement can be found at http://www.endo-society.org/journals/ScientificStatements/upload/jc-2009-2509v1.pdf

KeywordsKeywords: women hormones estrogen 
Jul 25, 2010 0 comments Exercise and Nutrition Exercise and Nutrition

Friends and Lipidaholics: I have made three postings today -  Go over to Lipidaholics Group to see Case #261 and decide if your very high risk patient had an LDL-C < 40 mg/dL if you would reduce the potent statin dose. At the Lipid Geeks Group there is a cute little diissertation on fatty acids and my comments on the newest statin: pitavastatin (Livalo).

 

I'd love comments on all!

 

Happy Lipiding,  Tom D

KeywordsKeywords: fatty acids pitavastatin 
Jul 5, 2010 0 comments Endocrine Endocrine
For a thorough discussion of how critically important lipoprotein compostion is in impacting apoB and LDL-P. This is the critical pathophysiology not being taught! Did you know LDL-TG outpredicts LDL-C as a risk factor?  Why? Here is the study no one has ever read.  The Ludwigshafen Risk and Cardiovascular Health Study.  Conclusions: Alterations of LDL metabolism characterized by high LDL-TG are related to CAD, systemic low-grade inflammation, and vascular damage. High LDL-TGs are indicative of CE-depleted LDL, elevated IDL, and dense LDL. LDL-TG may better reflect the atherogenic potential of LDL than LDL-C. (Circulation. 2004;110:3068-3074.)   Go over to my Lipid Geeks group and learn why particle compositon not particle size rules! For slides accompanying slides go to my web site www.lipidcenter.com  click on professionals, click on lipid and lipoprotein study materials and then click on Lipoprotein anatomy
KeywordsKeywords: ldl-p apob. ldl-tg lipoproteins 
Jun 30, 2010 1 comments Clinical Trials Clinical Trials
ACCORD Eye Study: A subgroup of 2856 participants was evaluated for the effects of these interventions (aggressive BP control, aggressive glycemic control and aggresssive lipid control at 4 years on the progression of diabetic retinopathy by 3 or more steps on the Early Treatment Diabetic Retinopathy Study Severity Scale (as assessed from seven-field stereoscopic fundus photographs, with 17 possible steps and a higher number of steps indicating greater severity) or the development of diabetic retinopathy necessitating laser photocoagulation or vitrectomy.   This article (10.1056/NEJMoa1001288) was published on June 29, 2010, at NEJM.org.   http://content.nejm.org/cgi/content/full/NEJMoa1001288
Conclusions: Intensive glycemic control and intensive combination treatment (statin plus fenofibrate) of dyslipidemia, but not intensive blood-pressure control, reduced the rate of progression of diabetic retinopathy.
Fenofibrate, when added to statin therapy, slows the progression of diabetic retinopathy in patients with type 2 diabetes. Authors did not find a significant difference in the progression of diabetic retinopathy between patients receiving standard antihypertensive therapy and those receiving intensive antihypertensive therapy according to treatment protocols.
This is now the third study suggesting microvascular benefits with fenofibrate:  DAIS (microalbuminuria): FIELD (microalbuminuria, retinopathy and amputations of feet and toes due to neuropathic ulcerations). Editorialist in the NEJM stated the findings strongly suggest the need for further evaluation of the potential importance of fenofibrate in our armamentarium of treatments for this condition (diabetic retinopathy).    http://content.nejm.org/cgi/content/full/NEJMe1005667 
Unlike the macrovascular benefits of fenoofibrate seen in the study seen only in the patiets with high TG and low HDL-C, the eye benefit was not related to baseline lipids
TD
Apr 26, 2010 0 comments Uncategorized Uncategorized
Just released: Thiazolidinedione Drugs and Cardiovascular Risks A Science Advisory From the American Heart Association and American College of Cardiology Foundation Sanjay Kaul, MD, FAHA, FACC, Chair; Ann F. Bolger, MD, FAHA, FACC; David Herrington, MD, MHS, FAHA, FACC; Robert P. Giugliano, MD, ScM, FACC; Robert H. Eckel, MD, FAHA   Circulation. 2010;121:1868-1877. 
Keys to Patient Management

The following are keys to patient management:
• Identification and treatment of correctable risk factors
– Smoking cessation
– High-quality diet
– Weight control
– Exercise

• Use of established secondary prevention strategies
– Aspirin (or clopidogrel in patients intolerant of aspirin)
– Lipid lowering, with statins as the first-line therapy
– Blood pressure lowering

• Early and consistent attention to controlling hyperglycemia while avoiding hypoglycemia
– Metformin is generally first-line therapy, particularly in obese patients
– Thiazolidinediones should not be used with an expectation of benefit with respect to IHD events
– Insufficient data exist to support the choice of pioglitazone over rosiglitazone
– Thiazolidinediones increase the risk of heart failure and should not be initiated in patients with class III/IV CHF
KeywordsKeywords: diabetes tzds metformin 
Apr 26, 2010 0 comments Uncategorized Uncategorized

Please go over to the Lipid Geeks group under Groups URL and see my comments on a very inetersting case entitled "A case report of a diabetic woman with very low HDL-C."  You will learn something about HDL mapping but you will not miss the forest through the trees.

 

Tom D

KeywordsKeywords: hdl-c ldl-p diabetes 
Apr 23, 2010 0 comments Uncategorized Uncategorized

I got a tweet from a world famous lipidologist that I want to share:

 

"So, if particles = disease, but lipids no = particles, why the surprise that lipids no = disease?

 

Think about it! 

KeywordsKeywords:  
Apr 18, 2010 0 comments Uncategorized Uncategorized

How would you answer if asked how much do TG typically raise during pregnancy in normal women? The answer is 200-400%. How would you council a woman with serious TG elevations who wanted to be come pregnant?  Go over to the Groups page, click on the Lipidaholics Group and read case 256. I's appreciate any  comments.

 

Tom Dayspring

Apr 3, 2010 0 comments Uncategorized Uncategorized
Interesting case discussion where a rising LDL-C in a diabetic is of no concern. Go over to the Lipdaholics Groups page to see the case and add comments
KeywordsKeywords: ldl-p diabetes 
Results per page:
1 2 3 4 >>
Author Information
Thomas Dayspring
Posts: 0
Comments: 0
Job Title: Clinical Assistant Professor of Medicine; Director: North Jersey Institute of Menopausal Lipidology
Keywords
8 ldl-p (8)
4 diabetes (4)
3 acids (3)
3 hdls (3)
2 testing (2)
2 statins (2)
2 fatty (2)
2 apob (2)
2 apob. (2)
2 fibrates (2)
2 women (2)
1 estrogen (1)
1 vitamin (1)
1 risk (1)
1 advanced (1)
1 hdl (1)
1 particle (1)