Castleman disease consists of several lymphoproliferative subtypes that share some histological features in the lymph nodes. On the other hand, numerous clinical findings and etiologies make the disease challenging to understand. The origin of the disease is the hyaline vascular-type unicentric Castleman disease (UCD), first reported by Benjamin Castleman et al. in 1954. Although UCD is characterized by localized lesions and lack of symptoms, multicentric Castleman disease (MCD) with multiple lesions and systemic symptoms was reported by Frizzera in 1983. MCD is further divided according to KSHV/HHV8 infection status. In KSHV/HHV8-related MCD, viral infection signals lead to excessive cytokine production, and cause clinical and pathologic abnormalities. Some cases of plasma cell-type KSHV/HHV8-negative MCD can be found in association with POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M-proteins, and skin changes), which is a paraneoplastic syndrome. The others are idiopathic MCD, which are currently considered a heterogeneous group of diseases with overlapping pathological and clinical features. In this article, we summarize the historical evolution of Castleman disease to help understand the disease concept. We also review the latest ideas and definitions of the subtypes within the MCD spectrum and summarize the histopathological findings.
{"title":"Historical and pathological overview of Castleman disease.","authors":"Midori Filiz Nishimura, Yoshito Nishimura, Asami Nishikori, Tadashi Yoshino, Yasuharu Sato","doi":"10.3960/jslrt.21036","DOIUrl":"10.3960/jslrt.21036","url":null,"abstract":"<p><p>Castleman disease consists of several lymphoproliferative subtypes that share some histological features in the lymph nodes. On the other hand, numerous clinical findings and etiologies make the disease challenging to understand. The origin of the disease is the hyaline vascular-type unicentric Castleman disease (UCD), first reported by Benjamin Castleman et al. in 1954. Although UCD is characterized by localized lesions and lack of symptoms, multicentric Castleman disease (MCD) with multiple lesions and systemic symptoms was reported by Frizzera in 1983. MCD is further divided according to KSHV/HHV8 infection status. In KSHV/HHV8-related MCD, viral infection signals lead to excessive cytokine production, and cause clinical and pathologic abnormalities. Some cases of plasma cell-type KSHV/HHV8-negative MCD can be found in association with POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M-proteins, and skin changes), which is a paraneoplastic syndrome. The others are idiopathic MCD, which are currently considered a heterogeneous group of diseases with overlapping pathological and clinical features. In this article, we summarize the historical evolution of Castleman disease to help understand the disease concept. We also review the latest ideas and definitions of the subtypes within the MCD spectrum and summarize the histopathological findings.</p>","PeriodicalId":8592,"journal":{"name":"Atherosclerosis. Supplements","volume":"5 1","pages":"60-72"},"PeriodicalIF":0.9,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9353854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78935571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-06Print Date: 2022-07-01DOI: 10.3171/2022.3.PEDS21512
David Ben-Israel, Jennifer A Mann, Michael M H Yang, Albert M Isaacs, Magalie Cadieux, Nicholas Sader, Sandeep Muram, Abdulrahman Albakr, Branavan Manoranjan, Richard W Yu, Benjamin Beland, Mark G Hamilton, Eldon Spackman, Paul E Ronksley, Jay Riva-Cambrin
<p><strong>Objective: </strong>Endoscopic third ventriculostomy and choroid plexus cauterization (ETV+CPC) is a novel procedure for infant hydrocephalus that was developed in sub-Saharan Africa to mitigate the risks associated with permanent implanted shunt hardware. This study summarizes the hydrocephalus literature surrounding the ETV+CPC intraoperative abandonment rate, perioperative mortality rate, cerebrospinal fluid infection rate, and failure rate.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed a prespecified protocol and abides by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search strategy using MEDLINE, EMBASE, PsychInfo, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus, and Web of Science was conducted from database inception to October 2019. Studies included controlled trials, cohort studies, and case-control studies of patients with hydrocephalus younger than 18 years of age treated with ETV+CPC. Pooled estimates were calculated using DerSimonian and Laird random-effects modeling, and the significance of subgroup analyses was tested using meta-regression. The quality of the pooled outcomes was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>After screening and reviewing 12,321 citations, the authors found 16 articles that met the inclusion criteria. The pooled estimate for the ETV+CPC failure rate was 0.44 (95% CI 0.37-0.51). Subgroup analysis by geographic income level showed statistical significance (p < 0.01), with lower-middle-income countries having a lower failure rate (0.32, 95% CI 0.28-0.36) than high-income countries (0.53, 95% CI 0.47-0.60). No difference in failure rate was found between hydrocephalus etiology (p = 0.09) or definition of failure (p = 0.24). The pooled estimate for perioperative mortality rate (n = 7 studies) was 0.001 (95% CI 0.00-0.004), the intraoperative abandonment rate (n = 5 studies) was 0.04 (95% CI 0.01-0.08), and the postoperative CSF infection rate (n = 5 studies) was 0.0004 (95% CI 0.00-0.003). All pooled outcomes were found to be low-quality evidence.</p><p><strong>Conclusions: </strong>This systematic review and meta-analysis provides the most comprehensive pooled estimate for the ETV+CPC failure rate to date and demonstrates, for the first time, a statistically significant difference in failure rate by geographic income level. It also provides the first reported pooled estimates for the risk of ETV+CPC perioperative mortality, intraoperative abandonment, and CSF infection. The low quality of this evidence highlights the need for further research to improve the understanding of these critical clinical outcomes and their relevant explanatory variables and thus to appreciate which patients may benefit most from an ETV+CPC. Systematic review registration no.: CRD4202016014
目的：内镜下第三脑室造口术和脉络丛烧灼术（ETV+CPC）是一种治疗婴儿脑积水的新型手术，该手术在撒哈拉以南非洲地区开展，旨在降低与永久性植入分流硬件相关的风险。本研究总结了围绕 ETV+CPC 术中放弃率、围手术期死亡率、脑脊液感染率和失败率的脑积水文献：本系统综述和荟萃分析遵循预先指定的方案，并遵守系统综述和荟萃分析首选报告项目（PRISMA）指南。从数据库建立到 2019 年 10 月，我们使用 MEDLINE、EMBASE、PsychInfo、Cochrane Central Register of Controlled Trials、Cochrane Database of Systematic Reviews、Scopus 和 Web of Science 进行了全面检索。研究内容包括采用 ETV+CPC 治疗 18 岁以下脑积水患者的对照试验、队列研究和病例对照研究。使用 DerSimonian 和 Laird 随机效应模型计算汇总估计值，并使用元回归检验亚组分析的显著性。采用建议评估、发展和评价分级（GRADE）方法对汇总结果的质量进行了评估：在筛选和审查了 12,321 篇引文后，作者发现有 16 篇文章符合纳入标准。ETV+CPC失败率的汇总估计值为0.44（95% CI 0.37-0.51）。按地域收入水平进行的分组分析显示出统计学意义（P < 0.01），中低收入国家的失败率（0.32，95% CI 0.28-0.36）低于高收入国家（0.53，95% CI 0.47-0.60）。不同脑积水病因（P = 0.09）或不同失败定义（P = 0.24）之间的失败率没有差异。围手术期死亡率（n = 7 项研究）的汇总估计值为 0.001（95% CI 0.00-0.004），术中放弃率（n = 5 项研究）为 0.04（95% CI 0.01-0.08），术后 CSF 感染率（n = 5 项研究）为 0.0004（95% CI 0.00-0.003）。所有汇总结果均为低质量证据：这项系统回顾和荟萃分析提供了迄今为止最全面的 ETV+CPC 失败率汇总估计值，并首次证明了不同地域收入水平的失败率存在显著的统计学差异。它还首次报告了 ETV+CPC 围手术期死亡率、术中放弃和 CSF 感染风险的汇总估计值。这些证据的质量不高，突出表明需要进一步研究，以加深对这些关键临床结果及其相关解释变量的理解，从而了解哪些患者可能从 ETV+CPC 中获益最多。系统综述注册编号：CRD42020160149 (https://www.crd.york.ac.uk/prospero/)。
{"title":"Clinical outcomes in pediatric hydrocephalus patients treated with endoscopic third ventriculostomy and choroid plexus cauterization: a systematic review and meta-analysis.","authors":"David Ben-Israel, Jennifer A Mann, Michael M H Yang, Albert M Isaacs, Magalie Cadieux, Nicholas Sader, Sandeep Muram, Abdulrahman Albakr, Branavan Manoranjan, Richard W Yu, Benjamin Beland, Mark G Hamilton, Eldon Spackman, Paul E Ronksley, Jay Riva-Cambrin","doi":"10.3171/2022.3.PEDS21512","DOIUrl":"10.3171/2022.3.PEDS21512","url":null,"abstract":"<p><strong>Objective: </strong>Endoscopic third ventriculostomy and choroid plexus cauterization (ETV+CPC) is a novel procedure for infant hydrocephalus that was developed in sub-Saharan Africa to mitigate the risks associated with permanent implanted shunt hardware. This study summarizes the hydrocephalus literature surrounding the ETV+CPC intraoperative abandonment rate, perioperative mortality rate, cerebrospinal fluid infection rate, and failure rate.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed a prespecified protocol and abides by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search strategy using MEDLINE, EMBASE, PsychInfo, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus, and Web of Science was conducted from database inception to October 2019. Studies included controlled trials, cohort studies, and case-control studies of patients with hydrocephalus younger than 18 years of age treated with ETV+CPC. Pooled estimates were calculated using DerSimonian and Laird random-effects modeling, and the significance of subgroup analyses was tested using meta-regression. The quality of the pooled outcomes was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>After screening and reviewing 12,321 citations, the authors found 16 articles that met the inclusion criteria. The pooled estimate for the ETV+CPC failure rate was 0.44 (95% CI 0.37-0.51). Subgroup analysis by geographic income level showed statistical significance (p < 0.01), with lower-middle-income countries having a lower failure rate (0.32, 95% CI 0.28-0.36) than high-income countries (0.53, 95% CI 0.47-0.60). No difference in failure rate was found between hydrocephalus etiology (p = 0.09) or definition of failure (p = 0.24). The pooled estimate for perioperative mortality rate (n = 7 studies) was 0.001 (95% CI 0.00-0.004), the intraoperative abandonment rate (n = 5 studies) was 0.04 (95% CI 0.01-0.08), and the postoperative CSF infection rate (n = 5 studies) was 0.0004 (95% CI 0.00-0.003). All pooled outcomes were found to be low-quality evidence.</p><p><strong>Conclusions: </strong>This systematic review and meta-analysis provides the most comprehensive pooled estimate for the ETV+CPC failure rate to date and demonstrates, for the first time, a statistically significant difference in failure rate by geographic income level. It also provides the first reported pooled estimates for the risk of ETV+CPC perioperative mortality, intraoperative abandonment, and CSF infection. The low quality of this evidence highlights the need for further research to improve the understanding of these critical clinical outcomes and their relevant explanatory variables and thus to appreciate which patients may benefit most from an ETV+CPC. Systematic review registration no.: CRD4202016014","PeriodicalId":8592,"journal":{"name":"Atherosclerosis. Supplements","volume":"6 1","pages":"18-30"},"PeriodicalIF":1.9,"publicationDate":"2022-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78946622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-28eCollection Date: 2022-01-01DOI: 10.18332/tid/144623
Fred Nalugoda, Dorean Nabukalu, Joseph Ssekasanvu, Robert Ssekubugu, Connie Hoe, Joseph Kagaayi, Nelson K Sewankambo, David M Serwadda, Maria J Wawer, Kate M Grabowski, Steven J Reynolds, Godfrey Kigozi, Ronald H Gray, Ping T Yeh, Larry W Chang
Introduction: Tobacco use is a major public health concern, particularly in low- and middle-income countries where 80% of the world's smokers reside. There is limited population-based data from rural Africa on patterns of tobacco smoking and smoker characteristics. We assessed trends in rates of smoking, characteristics of smokers, and factors associated with smoking using repeat population-based cross-sectional surveys in south-central Uganda.
Methods: Data accrued over five survey rounds (2010-2018) of the Rakai Community Cohort Study (RCCS) from consenting individuals aged 15-49 years including sociodemographic and behavioral characteristics and smoking status. Proportions of smokers per survey were compared using χ2 test for trends, and factors associated with smoking were assessed by multivariable logistic regression.
Results: The prevalence of tobacco smoking in the general population declined from 7.3% in 2010-2011 to 5.1% in 2016-2018, p<0.001. Smoking rates declined among males (13.9-9.2%) and females (2.2-1.8%) from 2010-2011 to 2016-2018. Smoking prevalence was higher among previously married (11.8-11.7%) compared to currently (8.4-5.3%) and never married persons (3.1-1.8%) from 2010-2011 to 2016-2018. Older age (≥35 years) was associated with higher odds of smoking (AOR=8.72; 95% CI: 5.68-13.39 in 2010-2011 and AOR=9.03; 95% CI: 5.42-15.06 in 2016-2018) compared to those aged <35 years (AOR=4.73; 95% CI: 3.15-7.12 in 2010-2011 and AOR=4.83; 95% CI: 2.95-7.91 in 2016-2018). Primary and secondary/higher education level was significantly associated with lower odds of smoking (AOR=0.20; 95% CI: 0.14-0.29 in 2010-2011 and AOR=0.26; 95% CI: 0.18-0.39 in 2016-2018) compared to no education (AOR=0.43; 95% CI: 0.31-0.59 in 2010-2011 and AOR=0.48; 95% CI: 0.34-0.68 in 2016-2018). Number of sexual partners and HIV status were not associated with smoking.
Conclusions: We observed declining trends in tobacco smoking in the Rakai region of rural Uganda. Smoking was more prevalent in men, older individuals, individuals who were previously married, and individuals with lower education. The decline in smoking may be due to tobacco control efforts, but there is a continued need to target sub-populations with higher smoking prevalence.
{"title":"Smoker characteristics and trends in tobacco smoking in Rakai, Uganda, 2010-2018.","authors":"Fred Nalugoda, Dorean Nabukalu, Joseph Ssekasanvu, Robert Ssekubugu, Connie Hoe, Joseph Kagaayi, Nelson K Sewankambo, David M Serwadda, Maria J Wawer, Kate M Grabowski, Steven J Reynolds, Godfrey Kigozi, Ronald H Gray, Ping T Yeh, Larry W Chang","doi":"10.18332/tid/144623","DOIUrl":"10.18332/tid/144623","url":null,"abstract":"<p><strong>Introduction: </strong>Tobacco use is a major public health concern, particularly in low- and middle-income countries where 80% of the world's smokers reside. There is limited population-based data from rural Africa on patterns of tobacco smoking and smoker characteristics. We assessed trends in rates of smoking, characteristics of smokers, and factors associated with smoking using repeat population-based cross-sectional surveys in south-central Uganda.</p><p><strong>Methods: </strong>Data accrued over five survey rounds (2010-2018) of the Rakai Community Cohort Study (RCCS) from consenting individuals aged 15-49 years including sociodemographic and behavioral characteristics and smoking status. Proportions of smokers per survey were compared using χ<sup>2</sup> test for trends, and factors associated with smoking were assessed by multivariable logistic regression.</p><p><strong>Results: </strong>The prevalence of tobacco smoking in the general population declined from 7.3% in 2010-2011 to 5.1% in 2016-2018, p<0.001. Smoking rates declined among males (13.9-9.2%) and females (2.2-1.8%) from 2010-2011 to 2016-2018. Smoking prevalence was higher among previously married (11.8-11.7%) compared to currently (8.4-5.3%) and never married persons (3.1-1.8%) from 2010-2011 to 2016-2018. Older age (≥35 years) was associated with higher odds of smoking (AOR=8.72; 95% CI: 5.68-13.39 in 2010-2011 and AOR=9.03; 95% CI: 5.42-15.06 in 2016-2018) compared to those aged <35 years (AOR=4.73; 95% CI: 3.15-7.12 in 2010-2011 and AOR=4.83; 95% CI: 2.95-7.91 in 2016-2018). Primary and secondary/higher education level was significantly associated with lower odds of smoking (AOR=0.20; 95% CI: 0.14-0.29 in 2010-2011 and AOR=0.26; 95% CI: 0.18-0.39 in 2016-2018) compared to no education (AOR=0.43; 95% CI: 0.31-0.59 in 2010-2011 and AOR=0.48; 95% CI: 0.34-0.68 in 2016-2018). Number of sexual partners and HIV status were not associated with smoking.</p><p><strong>Conclusions: </strong>We observed declining trends in tobacco smoking in the Rakai region of rural Uganda. Smoking was more prevalent in men, older individuals, individuals who were previously married, and individuals with lower education. The decline in smoking may be due to tobacco control efforts, but there is a continued need to target sub-populations with higher smoking prevalence.</p>","PeriodicalId":8592,"journal":{"name":"Atherosclerosis. Supplements","volume":"10 1","pages":"23"},"PeriodicalIF":3.7,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8883481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78491703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-01Epub Date: 2021-04-12DOI: 10.1177/1455072521996997
Ernesto Abalo
Aim: This study examines the discursive construction of medical cannabis in Swedish newspapers, with the aim of understanding how the news media recontextualise the medical potential of cannabis.
Design: The study is centred on the concept of recontextualisation, which focuses on how discourses are reinterpreted and reshaped when moving from one context to another, with a special focus on recontextualisation in relation to the media. Methodologically, the study uses critical discourse analysis to qualitatively analyse 134 articles of different subgenres, published in four Swedish newspapers between 2015 and 2020.
Results: The study shows that medical cannabis is constructed around myriad topics and contexts, ranging from news that focuses on the medical potential of cannabis to articles where medical cannabis is mentioned in passing and constructed in a more abstract form. The media have difficulties retaining a conceptual boundary between medical and recreational cannabis. Moreover, the study shows that the medical potential of cannabis is discursively constructed using three different discourses: patient discourse, strong science discourse, and weak science discourse.
Conclusions: The study suggests that there is a widening of the debate on cannabis in the Swedish public sphere, giving more recognition to the potential medical use of cannabis. The media, however, show difficulties in refining discourses on medical cannabis, which results in an altering between constructions that are strongly connected to science, and those that are not.
{"title":"Between facts and ambiguity: Discourses on medical cannabis in Swedish newspapers.","authors":"Ernesto Abalo","doi":"10.1177/1455072521996997","DOIUrl":"10.1177/1455072521996997","url":null,"abstract":"<p><strong>Aim: </strong>This study examines the discursive construction of medical cannabis in Swedish newspapers, with the aim of understanding how the news media recontextualise the medical potential of cannabis.</p><p><strong>Design: </strong>The study is centred on the concept of recontextualisation, which focuses on how discourses are reinterpreted and reshaped when moving from one context to another, with a special focus on recontextualisation in relation to the media. Methodologically, the study uses critical discourse analysis to qualitatively analyse 134 articles of different subgenres, published in four Swedish newspapers between 2015 and 2020.</p><p><strong>Results: </strong>The study shows that medical cannabis is constructed around myriad topics and contexts, ranging from news that focuses on the medical potential of cannabis to articles where medical cannabis is mentioned in passing and constructed in a more abstract form. The media have difficulties retaining a conceptual boundary between medical and recreational cannabis. Moreover, the study shows that the medical potential of cannabis is discursively constructed using three different discourses: patient discourse, strong science discourse, and weak science discourse.</p><p><strong>Conclusions: </strong>The study suggests that there is a widening of the debate on cannabis in the Swedish public sphere, giving more recognition to the potential medical use of cannabis. The media, however, show difficulties in refining discourses on medical cannabis, which results in an altering between constructions that are strongly connected to science, and those that are not.</p>","PeriodicalId":8592,"journal":{"name":"Atherosclerosis. Supplements","volume":"12 1","pages":"345-360"},"PeriodicalIF":1.9,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8899053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78504111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The 2018 American Heart Association/American College of Cardiology/Multi-Society (AHA/ACC/MS) Guideline on the Management of Blood Cholesterol and the 2019 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) Guidelines for the Management of Dyslipidemias: Lipid Modification to Reduce Cardiovascular Risk, that were recently released by the United States and Europe, provide new recommendations for the management of blood lipid levels based on the latest evidence. Despite many common points, there are several differences in the recommendations, including the definition of very-high-risk patient category, the recommendations for some categories of patients, such as those with diabetes, familial hypercholesterolemia, chronic kidney disease, and aged patients, and the use of ezetimibe and PCSK9 inhibitors. These differences suggest that multiple approaches can be used to manage lipid abnormalities in the context of cardiovascular risk reduction.
{"title":"Similarities and differences between European and American guidelines on the management of blood lipids to reduce cardiovascular risk","authors":"Lale Tokgözoğlu , Manuela Casula , Angela Pirillo , Alberico L. Catapano","doi":"10.1016/j.atherosclerosissup.2021.01.001","DOIUrl":"10.1016/j.atherosclerosissup.2021.01.001","url":null,"abstract":"<div><p>The 2018 American Heart Association/American College of Cardiology/Multi-Society (AHA/ACC/MS) Guideline on the Management of Blood Cholesterol and the 2019 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) Guidelines for the Management of Dyslipidemias: Lipid Modification to Reduce Cardiovascular Risk, that were recently released by the United States and Europe, provide new recommendations for the management of blood lipid levels based on the latest evidence. Despite many common points, there are several differences in the recommendations, including the definition of very-high-risk patient category, the recommendations for some categories of patients, such as those with diabetes, familial hypercholesterolemia, chronic kidney disease, and aged patients, and the use of ezetimibe and PCSK9 inhibitors. These differences suggest that multiple approaches can be used to manage lipid abnormalities in the context of cardiovascular risk reduction.</p></div>","PeriodicalId":8592,"journal":{"name":"Atherosclerosis. Supplements","volume":"42 ","pages":"Pages e1-e5"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.atherosclerosissup.2021.01.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25375160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01DOI: 10.1016/j.atherosclerosissup.2021.01.007
Marta Gazzotti , Manuela Casula , Elena Olmastroni , Maurizio Averna , Marcello Arca , Alberico L. Catapano
Familial hypercholesterolemia (FH) is a common genetic disorder of lipid metabolism, still underdiagnosed and undertreated in the general population. Pathology registers could play a crucial role in the creation of a comprehensive and integrated global approach to cover all aspects of this disease. Systematic data collection of patients affected by FH has increased dramatically worldwide in the past few years. Moreover, results from registers already established for the longest time showed their potentialities in the implementation of the knowledge of FH, comparing country-specific approaches and providing real-world data about identification, management and treatment of FH individuals in the clinical practice.
The potential fields of research through registers are related to the deepening of the genetic basis of disease, the study of genotype-phenotype correlation, the local adaption and implementation of diagnostic algorithms, the comparison of pharmacological approaches and treatment gaps in real-life clinical practice, the evaluation of specific subpopulations, and the identification of factors modifying cardiovascular disease risk. Registers could become also a valid resource for other rare dyslipidaemias, contributing towards the evidence-based enhancement in the worldwide care of uncommon diseases.
{"title":"How registers could enhance knowledge and characterization of genetic dyslipidaemias: The experience of the LIPIGEN in Italy and of other networks for familial hypercholesterolemia","authors":"Marta Gazzotti , Manuela Casula , Elena Olmastroni , Maurizio Averna , Marcello Arca , Alberico L. Catapano","doi":"10.1016/j.atherosclerosissup.2021.01.007","DOIUrl":"10.1016/j.atherosclerosissup.2021.01.007","url":null,"abstract":"<div><p>Familial hypercholesterolemia (FH) is a common genetic disorder of lipid metabolism, still underdiagnosed and undertreated in the general population. Pathology registers could play a crucial role in the creation of a comprehensive and integrated global approach to cover all aspects of this disease. Systematic data collection of patients affected by FH has increased dramatically worldwide in the past few years. Moreover, results from registers already established for the longest time showed their potentialities in the implementation of the knowledge of FH, comparing country-specific approaches and providing real-world data about identification, management and treatment of FH individuals in the clinical practice.</p><p>The potential fields of research through registers are related to the deepening of the genetic basis of disease, the study of genotype-phenotype correlation, the local adaption and implementation of diagnostic algorithms, the comparison of pharmacological approaches and treatment gaps in real-life clinical practice, the evaluation of specific subpopulations, and the identification of factors modifying cardiovascular disease risk. Registers could become also a valid resource for other rare dyslipidaemias, contributing towards the evidence-based enhancement in the worldwide care of uncommon diseases.</p></div>","PeriodicalId":8592,"journal":{"name":"Atherosclerosis. Supplements","volume":"42 ","pages":"Pages e35-e40"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.atherosclerosissup.2021.01.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25375165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01DOI: 10.1016/j.atherosclerosissup.2021.01.010
Marco Alings , Olivier Descamps , Benoit Guillon , Margret Leosdottir , Aldo P. Maggioni , Lluis Recasens , Walter S. Speidl , Rosario V. Tripodi , Ulf Landmesser , Alberico L. Catapano , Angela Pirillo
Post-acute coronary syndrome (ACS) patients are at very high cardiovascular risk. Despite current guidelines strongly recommend to reduce LDL-C levels and initiation of high-intensity statins as early as possible in patients admitted with an ACS, less than half of ACS patients receive a high intensity statin, and a high percentage of has LDL-C well above the goal despite therapy. There are multiple reasons for that, including physician lack of guideline adherence, patient lack of compliance with treatment, and lack of standardized procedures. Furthermore, although the prevalence of familial hypercholesterolemia is higher among patients with ACS, this condition remains poorly estimated. To fill these gaps, some European countries have launched local initiatives for the in-hospital and post-discharge ACS patient lipid management. It appears that ensuring optimal therapy during hospitalization and dedicated follow-up protocols results in a significant improvement of lipid levels in these very high risk patients, which may translate into a reduced risk of recurrent future events.
{"title":"Implementation of clinical practices and pathways optimizing ACS patients lipid management: Focus on eight European initiatives","authors":"Marco Alings , Olivier Descamps , Benoit Guillon , Margret Leosdottir , Aldo P. Maggioni , Lluis Recasens , Walter S. Speidl , Rosario V. Tripodi , Ulf Landmesser , Alberico L. Catapano , Angela Pirillo","doi":"10.1016/j.atherosclerosissup.2021.01.010","DOIUrl":"10.1016/j.atherosclerosissup.2021.01.010","url":null,"abstract":"<div><p>Post-acute coronary syndrome (ACS) patients are at very high cardiovascular risk. Despite current guidelines strongly recommend to reduce LDL-C levels and initiation of high-intensity statins as early as possible in patients admitted with an ACS, less than half of ACS patients receive a high intensity statin, and a high percentage of has LDL-C well above the goal despite therapy. There are multiple reasons for that, including physician lack of guideline adherence, patient lack of compliance with treatment, and lack of standardized procedures. Furthermore, although the prevalence of familial hypercholesterolemia is higher among patients with ACS, this condition remains poorly estimated. To fill these gaps, some European countries have launched local initiatives for the in-hospital and post-discharge ACS patient lipid management. It appears that ensuring optimal therapy during hospitalization and dedicated follow-up protocols results in a significant improvement of lipid levels in these very high risk patients, which may translate into a reduced risk of recurrent future events.</p></div>","PeriodicalId":8592,"journal":{"name":"Atherosclerosis. Supplements","volume":"42 ","pages":"Pages e59-e64"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.atherosclerosissup.2021.01.010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25370372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01DOI: 10.1016/j.atherosclerosis.2020.10.809
A. Sionis, A. Catapano, G. D. de Ferrari, D. Dudek, J. Jukema, U. Landmesser, A. Pirillo, F. Schiele, A. Zaman, J. Zamorano
{"title":"Improving lipid management in patients with acute coronary syndrome: The ACS Lipid EuroPath tool.","authors":"A. Sionis, A. Catapano, G. D. de Ferrari, D. Dudek, J. Jukema, U. Landmesser, A. Pirillo, F. Schiele, A. Zaman, J. Zamorano","doi":"10.1016/j.atherosclerosis.2020.10.809","DOIUrl":"https://doi.org/10.1016/j.atherosclerosis.2020.10.809","url":null,"abstract":"","PeriodicalId":8592,"journal":{"name":"Atherosclerosis. Supplements","volume":"22 1","pages":"e65-e71"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91185247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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