Abstract:
:Bile acid sequestrants (BAS) continue to command a position in the treatment of dyslipidemias 25 years after their introduction. Partial diversion of the enterohepatic circulation using BAS depletes the endogenous bile acid pool by approximately 40%, thus stimulating an increase in bile acid synthesis from cholesterol, which lowers low-density lipoprotein cholesterol (LDL-C) by 15 to 26%. Three BAS are currently used for treating hypercholesterolemia in the United States: the conventional sequestrants, cholestyramine and colestipol, and the specifically engineered BAS, colesevelam hydrochloride (HCl). Compared with conventional BAS, colesevelam HCl has enhanced specificity, greater affinity, and higher capacity for binding bile acids, due to its polymer structure engineered for bile acid sequestration. BAS are not absorbed by the intestine and thus have no systemic drug-drug interactions, but may interfere with the absorption of some drugs. Although BAS monotherapy effectively lowers LDL-C, combination therapy, especially with BAS and statins, is becoming increasingly common due to complementary mechanisms of action. Low-dose statin plus BAS combinations lead to greater or similar LDL-C reductions compared with high-dose statin monotherapy and may have a better safety profile. Combinations of BAS with nonstatin lipid-lowering agents, including niacin, fibrates, and cholesterol absorption inhibitors, may be useful in those patients who require intensive lipid-lowering, but are statin intolerant. BAS treatment can significantly reduce coronary artery disease (CAD) progression and the risk of CAD-associated outcomes. It is also becoming clear that BAS and other therapies that manipulate the bile acid synthetic pathway may have clinically useful therapeutic effects on other metabolic disorders including type 2 diabetes.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Insull W Jrdoi
10.1097/01.smj.0000208120.73327.dbsubject
Has Abstractpub_date
2006-03-01 00:00:00pages
257-73issue
3eissn
0038-4348issn
1541-8243journal_volume
99pub_type
杂志文章,评审abstract:BACKGROUND:Non-insulin-dependent diabetes mellitus (NIDDM) and hyperhomocysteinemia are both associated with increased lipid peroxidation (oxidative stress). This may contribute to the accelerated vascular disease associated with these conditions. It is not known whether the coexistence of elevated homocysteine levels ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199709000-00008
更新日期:1997-09-01 00:00:00
abstract::In an attempt to prevent morbidity and mortality in carotid endarterectomy, we monitored 47 operations with intraoperative EEG to determine which patients should have a shunt during endarterectomy. The EEG was recorded for up to five minutes during test carotid cross-clamping. When EEG asymmetry between the cerebral h...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197908000-00018
更新日期:1979-08-01 00:00:00
abstract::Elevation in fasting serum gastrin levels was found in three patients being evaluated for persistent upper abdominal pain without radiographic evidence of peptic ulcer disease. Fiberoptic endoscopy of the upper gastrointestinal tract in each patient revealed characteristic changes of chronic atrophic gastritis. Gastri...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197612000-00010
更新日期:1976-12-01 00:00:00
abstract::Diagnostic peritoneal lavage (DPL) is an established procedure in evaluation of trauma victims but is less well established for use in patients suspected of having acute intra-abdominal disease. Twenty-six seriously ill patients at our institution who had DPL for acute intra-abdominal disease form the basis of this re...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199004000-00015
更新日期:1990-04-01 00:00:00
abstract::I have described two patients who had recurrent spontaneous myoclonic jerking in the alcohol withdrawal state. These movements were distinguishable clinically and electroencephalographically from partial seizures and epilepsia partialis continua. The jerking did not respond to anticonvulsants but resolved as the withd...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198308000-00028
更新日期:1983-08-01 00:00:00
abstract::Twenty-eight women were tested with a standard three-hour oral glucose tolerance test before and after three years of using a combination-type oral contraceptive containing mestranol and ethynodiol diacetate (Ovulen). At the three-year test time there was a significant elevation of the patients' weights and their 1-, ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197710000-00010
更新日期:1977-10-01 00:00:00
abstract::Atomoxetine (Strattera®, Eli Lilly and Co.) is the first non-stimulant drug in the United States (US) to be approved for the treatment of attention deficit hyperactivity disorder (ADHD). In the past, physicians have been concerned about the safety of a variety of ADHD medications. As a result, non-stimulant drugs were...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e318205e575
更新日期:2011-02-01 00:00:00
abstract::We evaluated the indices of arterial distensibility in a group (N = 40) of normotensive subjects and patients with borderline or established hypertension by measuring intra-arterial pressure, pulse wave velocity, and a mathematical modification of MOEN's formula to calculate arterial distensibility. Multiple linear re...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198401000-00015
更新日期:1984-01-01 00:00:00
abstract::The transition of care between pediatric and adult medicine is a challenging time for patients and physicians. This longitudinal process encompasses much more than the physical transfer of a patient between providers. Established transition of care processes and literature exist for many chronic disease populations, b...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.14423/SMJ.0000000000001017
更新日期:2019-09-01 00:00:00
abstract::The topical anesthetic solution TAC (tetracaine, adrenaline, cocaine) has gained widespread acceptance as the preferred local anesthetic for repairing skin lacerations in children. Despite this popularity, there are no universally accepted guidelines for its application. We report the case of a 6-month-old infant who ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198911000-00004
更新日期:1989-11-01 00:00:00
abstract::Coronary heart disease (CHD) is the leading cause of morbidity and mortality in patients more than 65 years old. Within this population, elevated cholesterol levels are prevalent and associated with increased risk of CHD. Despite increasing emphasis on lipid-lowering treatment in the elderly population, questions rema...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2002-11-01 00:00:00
abstract::Central hypothyroidism is an exceedingly rare form of hypothyroidism that results from a variety of conditions affecting the hypothalamus and the pituitary gland. The classic biochemical abnormality seen in these patients includes a low serum level of circulating thyroxine (T4) concomitant with an inappropriately low ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000051278.88218.03
更新日期:2003-02-01 00:00:00
abstract::Since 1965, 330 patients have received chronic dialysis treatment at the Nashville VA Hospital. Home hemodialysis training was established in 1968, and a unique class format has been used since 1970. Despite the national trend of fewer patients beginning home dialysis each year, more than 50 percent of our patients ha...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197712000-00016
更新日期:1977-12-01 00:00:00
abstract::Asbestos is a versatile fibrous mineral that can cause lung disease and death. Asbestosis, benign pleural disease, lung cancer, and mesothelioma can all result from inhaling asbestos. The history of disease and exposure risks are discussed. The difficult assessment of risk and the long latency period for development o...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199206000-00009
更新日期:1992-06-01 00:00:00
abstract::There are an estimated 22 million users of smokeless tobacco in the United States, 3 million of them under age 21. We surveyed physicians and patients to determine whether the health hazard of smokeless tobacco was recognized and whether preventive measures were being implemented. Although more than 80% of physicians ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract::One hundred fifty patients underwent surgery for mitral valve disease between January 1974 and May 1981. There were 98 female and 52 male patients with a mean age of 57 years (+/- 18.6). One hundred forty-six patients were in New York Heart Association functional class III or IV. Pathologic diagnoses included 67% rheu...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198306000-00005
更新日期:1983-06-01 00:00:00
abstract::Rapid loss of erythrocyte galactose-1-phosphate uridyl transferase in hemolysates from an infant 26 days after transfusion led to investigation of the possiblity of an unstable enzyme or other variant of galactosemia. However, the child was found to have the classic type of galactosemia. The seeming transferase instab...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197503000-00010
更新日期:1975-03-01 00:00:00
abstract::An elderly woman complaining of a gait disorder was found to have the GALOP syndrome (gait ataxia, late-onset polyneuropathy). She exhibited mild distal weakness and sensory loss in the legs, a positive Romberg, and an unsteady gait. Serum immunofixation disclosed a monoclonal IgM-kappa protein. There was specific IgM...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000117799.38569.B8
更新日期:2004-04-01 00:00:00
abstract::There is controversy in the medical literature regarding the significance of "sickle cell cardiomyopathy." In an attempt to clarify this, we studied 14 patients with sickle cell anemia (age range 16 to 36 years) using simultaneous echocardiography and phonocardiography. The values of systolic time intervals and echoca...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198003000-00020
更新日期:1980-03-01 00:00:00
abstract::We present a case believed to be the first reported North American presentation of Ascaris lumbricoides within the urogenital tract. A young man came to the emergency department because of painless hematuria and having observed a 6-inch worm exit his urethra while urinating. The most common site for A lumbricoides inf...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2001-04-01 00:00:00
abstract::We have described an unusual case of tuberculous sacroiliitis associated with adrenal insufficiency, with details of radiologic studies and review of the literature concerning tuberculous sacroiliitis. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198309000-00032
更新日期:1983-09-01 00:00:00
abstract::Cobalamin (vitamin B12) deficiency warrants appropriate evaluation because cobalamin is necessary in certain biochemical functions. R-binder deficiency, which causes low cobalamin levels, is a rare and benign pseudodeficiency. If not further evaluated by determining levels of methylmalonic acid and homocysteine, howev...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2002-09-01 00:00:00
abstract::We reviewed the records of 101 patients over the age of 60 who had exploration and cholecystectomy in 1982 at Norfolk General Hospital. There were 52 elective and 49 emergency cases. Women comprised 57.4% of the patients, and almost 50% of the patients were over the age of 70. Forty-nine percent of the cases were emer...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198704000-00016
更新日期:1987-04-01 00:00:00
abstract::Primary carcinoma of the trachea is not common. Of 23 cases diagnosed as "carcinoma of the trachea" at our institution since 1949, 21 actually represented secondary involvement from carcinoma of the larynx, lung, or esophagus. The two cases of primary carcinoma of the trachea are presented. Discussed are the relation ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197704000-00020
更新日期:1977-04-01 00:00:00
abstract::Bullous pemphigoid (BP) is an immunobullous disease characterized by circulating IgG antibodies directed towards cutaneous basement zone antigens. We report the case of a patient who had BP localized to a stoma site. At initial examination, a nodule was noted on the temple, which proved to be a large cell lymphoma, B-...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199912000-00019
更新日期:1999-12-01 00:00:00
abstract::We reviewed the first 100 consecutive patients treated with extracorporeal shock wave lithotripsy (ESWL) at one institution. A total of 115 treatments were delivered to 58 men and 42 women. Patients with calculi of various sizes were treated and compared for (1) length of hospitalization, (2) ancillary procedures, (3)...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198801000-00010
更新日期:1988-01-01 00:00:00
abstract::We have used the island gluteus maximus musculocutaneous flap to cover sacral pressure sores. In this report, we describe the surgical anatomy, cadaveric dissections (n = 25), and postoperative follow-up (one to 40 months) in 13 clinical cases. Our results compare favorably with those of other previously reported seri...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章
doi:
更新日期:1985-10-01 00:00:00
abstract::Thirty-three anterior staple capsulorrhaphies of the shoulder were reviewed at an average 49.7 months postoperatively (range 12 to 127 months); one postoperative dislocation occurred. The patients' quality of athletic participation improved with surgical therapy in 50%, remained the same in 38%, and was lowered in 12%...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199005000-00009
更新日期:1990-05-01 00:00:00
abstract::We have presented a case of pregnancy complicated by diabetes insipidus. Treatment with desmopressin acetate (DDAVP) appropriately managed the DI, and was not associated with a worsening of the condition as pregnancy progressed. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198706000-00026
更新日期:1987-06-01 00:00:00
abstract::The hypothenar hammer syndrome is a distinct entity of digital ischemia caused by the repetitive compression of the distal ulnar artery against the hook of the hamate. Definite diagnosis should most likely rely on selective arteriography. Primary resection with anastomosis and cervicodorsal sympathectomy have both bee...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198104000-00031
更新日期:1981-04-01 00:00:00