Monday, September 26, 2022

Reduction of LDL Cholesterol

 Studies have found that if the LDL cholesterol is reduced to less than 70 mg/dL and preferably less than 55 mg/dL, the size of the plaques can get smaller.19-Jul-2021

https://www.uptodate.com/contents/high-cholesterol-and-lipid-treatment-options-beyond-the-basics


Safety and Efficacy of Extremely Low LDL-Cholesterol Levels and Its Prospects in Hyperlipidemia Management

Dhrubajyoti Bandyopadhyay,corresponding author 1 Arshna Qureshi, 2 Sudeshna Ghosh, 3 Kumar Ashish, 4 Lyndsey R. Heise, 5 Adrija Hajra, 6 and Raktim K. Ghosh 7

J Lipids. 2018; 2018: 8598054. Published online 2018 Apr 23. doi: 10.1155/2018/8598054

PMCID: PMC5937425PMID: 29850255

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5937425/



PCSK9 Therapies


Inclisiran from Novartis


Inclisiran - It Was To Be The Cholesterol Drug For The Masses. Novartis Changed That.

John LaMattinaContributor

I cover news on drugs and R&D in the pharma industry

Jan 3, 2022,

https://www.forbes.com/sites/johnlamattina/2022/01/03/it-was-to-be-the-cholesterol-drug-for-the-masses-novartis-changed-that/ 


Two PCSK9 antibodies were approved by the FDA in 2015: Praluent (Sanofi/Regeneron) and Repatha (Amgen). Unfortunately, the list prices of these much anticipated drugs were initially set at a jaw dropping $14,000/year/patient.

in 2018 first Amgen, then Sanofi/Regeneron lowered the list prices to $5,850, hoping that higher sales would ensue. 


In India, Price on 26.9.2022

Repatha Sure Click Evolocumab 140mg Mg Solution For Injection in Prefilled Syringe
₹ 19,500/ PIECE

Usage/Application: Personal

size: 1 PREFILLED PEN DEVICE(s)

Treatment: Heart disorders

Manufacturer: DR REDDY'S LABORATORIES LTD

Strength: 140mg

Brand: EVOLOCUMAB

(Two injections per month are needed.)

Sunday, September 25, 2022

Arterial Stiffness - Mechanism of Development and Its Reduction

 Mechanisms, Pathophysiology, and Therapy of Arterial Stiffness

Susan J. Zieman, Vojtech Melenovsky and David A. Kass

Originally published24 Feb 2005https://doi.org/10.1161/01.ATV.0000160548.78317.29Arteriosclerosis, Thrombosis, and Vascular Biology. 2005;25:932–943

https://www.ahajournals.org/doi/10.1161/01.atv.0000160548.78317.29

Diurnal Blood Pressure Variation

 Diurnal blood pressure variation and related behavioral factors

Yuhei Kawano 

Hypertension Research volume 34, pages281–285 (2011)

https://www.nature.com/articles/hr2010241

Cilnidipine - Use and Benefits

 


Patent - New use of cilnidipine

https://patents.google.com/patent/CN102416013A/en




Withdrawal of Blood Pressure Medicine

 Withdrawal is possible.


Withdrawal of antihypertensive medication: a systematic review

J Hypertens. 2017 Sep; 35(9): 1742–1749. Published online 2017 May 9. doi: 10.1097/HJH.0000000000001405

PMCID: PMC5548513PMID: 28486271

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548513/



Friday, September 23, 2022

Cholesterol and Triglycerides - Information

High cholesterol in legs - Symptoms

https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/high-cholesterol-signs-of-dangerously-high-cholesterol-levels-present-in-your-legs/photostory/86712234.cms  



Reduction of LDL Cholesterol by 25% to 60% in Patients With Primary Hypercholesterolemia by Atorvastatin, a New HMG-CoA Reductase Inhibitor.

James W. Nawrocki, Stuart R. Weiss, Michael H. Davidson, Dennis L. Sprecher, Sherwyn L. Schwartz, Paul-J. Lupien, Peter H. Jones, Harry E. Haber and Donald M. Black.

Originally published1 May 1995https://doi.org/10.1161/01.ATV.15.5.678Arteriosclerosis, Thrombosis, and Vascular Biology. 1995;15:678–682

Arteriosclerosis, Thrombosis, and Vascular Biology Vol. 15, No. 5





Rosuvastatin for lowering lipids
50% reduction in LDL is reported in multiple studies.
Stephen P Adams, Sarpreet S Sekhon, and James M Wrightcorresponding author
Cochrane Database Syst Rev. 2014 Nov; 2014(11): CD010254. Published online 2014 Nov 21.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463960/


Who Needs Cholesterol-lowering Medicine

Your treatment plan for high cholesterol will depend on your current cholesterol levels and your risk of heart disease and stroke. Your risk for heart disease and stroke depends on other risk factors, including high blood pressure and high blood pressure treatment, smoking status, age, high-density lipoprotein cholesterol level, total cholesterol level, diabetes, family history, and whether you have already had a heart attack or stroke.

Your health care provider may prescribe medicine if:

You have already had a heart attack or stroke, or you have peripheral arterial disease.

Your LDL cholesterol level is 190 mg/dL or higher.

You are 40–75 years old with diabetes and an LDL cholesterol level of 70 mg/dL or higher.

You are 40–75 years old with a high risk of developing heart disease or stroke and an LDL cholesterol level of 70 mg/dL or higher.

https://www.cdc.gov/cholesterol/treating_cholesterol.htm


Efficacy of alternate day versus everyday dosing of rosuvastatin in hyperlipidemia.

Alternate day gives same effect as daily dose

Chandrashekar Panchavarthi, Ushasree Takkela Shankara, Vijayakrishna Pakanati, Shirisha Siddamshetty, Jaya Prakash Konda, Sai kumar Gowlikar

https://dx.doi.org/10.18203/2319-2003.ijbcp20163234

Published: 2017-01-10

https://www.ijbcp.com/index.php/ijbcp/article/view/635

Fat Cells


https://en.wikipedia.org/wiki/Adipocyte

https://journals.physiology.org/doi/full/10.1152/ajpregu.00257.2017



Ud. 24.9.2022

Pub 5.10.2021



Excess Salt May Make Arteries Stiff and Cause Vascular Problems



Data from both animal and human studies provide evidence that salt impairs endothelial function and increases arterial stiffness independent of blood pressure.
Vascular Effects of Dietary Salt
David G. Edwards and William B. Farquhar
Curr Opin Nephrol Hypertens. Author manuscript; available in PMC 2017 May 15.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5431073/




Heart failure and salt: The great debate
December 18, 2018


Vascular Stiffness in Aging and Disease

REVIEW article
Front. Physiol., 07 December 2021
Sec. Vascular Physiology
https://doi.org/10.3389/fphys.2021.762437
This article is part of the Research Topic
Cardiovascular Remodeling in Aging and Disease

Effects of Sodium Intake on Health and Performance in Endurance and Ultra-Endurance Sports

by Eleftherios Veniamakis 1,Georgios Kaplanis 1,Panagiotis Voulgaris 1 andPantelis T. Nikolaidis 2,*ORCID
1
Department of Nutrition and Dietetics, Hellenic Mediterranean University, 72300 Sitia, Greece
2
School of Health and Caring Sciences, University of West Attica, 12243 Athens, Greece
*
Author to whom correspondence should be addressed.
Academic Editor: Alberto Pérez-López
Int. J. Environ. Res. Public Health 2022, 19(6), 3651; https://doi.org/10.3390/ijerph19063651
Received: 26 January 2022 / Revised: 3 March 2022 / Accepted: 8 March 2022 / Published: 19 March 2022






ud. 24.9.2022, 17.9.2022
pub. 25.9.2019








Abdominal Angina

 


Abdominal Angina

Kunal Mahajan; Azeberoje Osueni; Muhammad Haseeb.


Abdominal angina is postprandial pain that occurs in mesenteric vascular occlusive disease when blood flow to the colon is unable to meet visceral demands. This is similar to intermittent claudication in peripheral vascular disease or angina pectoris in coronary artery disease. 


Atherosclerotic disease is the most common cause of abdominal angina.  In most people, it is occlusion of the superior mesenteric artery that is responsible for the abdominal symptoms.


Shortly after eating, patients with abdominal angina are unable to increase flow in the mesenteric vessels, and they develop pain.


Author Information

Last Update: May 23, 2022.

https://www.ncbi.nlm.nih.gov/books/NBK441943/


Mesenteric artery disease

https://academic.oup.com/eurheartj/article/39/9/763/4095038


https://www.bcm.edu/healthcare/specialties/cardiovascular-medicine/vascular-health/mesenteric-artery-disease


Mesenteric artery stenosis

Debabrata Mukherjee and Leslie Cho.

https://www.ncbi.nlm.nih.gov/books/NBK27423/


Chronic Mesenteric Ischemia: Diagnosis and Treatment

Eric J. Hohenwalter, M.D.1

Semin Intervent Radiol. 2009 Dec; 26(4): 345–351.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036470/


Mesenteric Artery Ischemia

Alin Gragossian; Maxim E. Shaydakov; Patrick Dacquel.


Author Information

Last Update: May 9, 2022.

https://www.ncbi.nlm.nih.gov/books/NBK513354/



Chronic Mesenteric Ischemia

Ronak Patel; Abdul Waheed; Michael Costanza.


Author Information

Last Update: July 12, 2022.


Mesenteric ischemia is a manifestation of peripheral vascular disease in which the blood supply fails to meet the metabolic demands of visceral organs.


Mesenteric artery stenosis is relatively common, occurring in up to 10% of the population over 65 years of age. However, CMI has a very low incidence, accounting for less than 1 in 1000 hospital admissions for abdominal pain. Patients are typically between the ages of 50 and 70 years of age, with a strong female predominance, and have other coexisting manifestations of atherosclerotic disease.


Indications for Surgery


Signs of peritonitis on physical exam

Massive lower GI hemorrhage

Ongoing signs of abdominal pain, fever, or  sepsis

Symptoms that have persisted for more than 14 to 21 days

Chronic malabsorption leading to protein-losing colopathy

Colonoscopic evidence of segmental colitis with frank ulceration

Presence of an ischemic stricture and abdominal symptoms

https://www.ncbi.nlm.nih.gov/books/NBK430748/





Stroke - Treatment and Prevention with Homeopathy

 Stroke - Treatment and prevention with Homeopathy and Schuessler salts (homeopathic cell salts): A homeopathic and naturopathic guide


Robert Kopf

BookRix, 14-Jul-2018 - Health & Fitness - 52 pages


A stroke occurs when the blood supply to part of the brain is interrupted or severely reduced, depriving brain tissue of oxygen and glucose. Stroke is also referred to as cerebrovascular accident. Within minutes, brain cells begin to die.

Signs and symptoms of stroke include sudden dizziness, loss of balance and coordination, trouble with speaking and understanding, difficulty with eating and swallowing, confusion, sudden and severe headache, vomiting, altered consciousness and sudden tingling, weakness, paralysis or numbness of the face, arm or leg especially on one side of the body.

In this naturopathic adviser, I will give you recommendations how to prevent a stroke and support the treatment with Homeopathy, Schuessler salts (also named cell salts, tissue salts) and herbal tinctures. I will present you the most proven homeopathic remedies and Schuessler salts, including the appropriate potency and dosage. I wish you much success, joy of life and especially your health.

https://books.google.co.in/books?id=IVXgAgAAQBAJ











Monday, September 19, 2022

Increase in Blood Viscosity - Complications

 


https://www.nature.com/articles/hr2012172


Blood Rheology: Key Parameters, Impact on Blood Flow, Role in Sickle Cell Disease and Effects of Exercise

2019

https://www.frontiersin.org/articles/10.3389/fphys.2019.01329/full


All you need to know about thick blood

https://www.medicalnewstoday.com/articles/319842 



Blood viscosity and blood pressure: role of temperature and hyperglycemia 

Yildirim Çinar, A. Mete Şenyol, Kamber Duman

American Journal of Hypertension, Volume 14, Issue 5, May 2001, Pages 433–438,

https://academic.oup.com/ajh/article/14/5/433/205476


https://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/blood-viscosity-reducing-drugs



Steep rise in cases of arterial thrombosis in post-Covid patients, say doctors

"Don't take severe leg pain or any abnormal changes in the body casually, especially during the post-Covid period," said a doctor

By: Lifestyle Desk

New Delhi | August 20, 2021 9:10:47 am

https://indianexpress.com/article/lifestyle/health/arterial-thrombosis-blood-clots-gangrene-amputation-post-covid-patients-doctors-symptoms-treatment-7460872/


POST-THROMBOTIC SYNDROME

Last updated June 29, 2022


Venous Stress Disorder

An In-Depth Guide for Patients and Health Care Providers

Compression socks

https://www.stoptheclot.org/postthrombotic-syndrome/


https://courses.lumenlearning.com/suny-ap2/chapter/blood-flow-blood-pressure-and-resistance-no-content/    Lot details


https://www.cureus.com/articles/27906-the-role-of-blood-viscosity-in-infectious-diseases


Pharmacology in Rehabilitation, Updated 5th Edition

Front Cover

Charles D. Ciccone

F.A. Davis, 24-Jan-2022 - Medical - 720 pages

Drugs - Pentoxifylline

https://books.google.co.in/books?id=vwFgEAAAQBAJ&pg=PT782#v=onepage&q&f=false



Clinical Aspects of Blood Viscosity and Cell Deformability


G. D. O. Lowe, J. C. Barbenel, C. D. Forbes

Springer Science & Business Media, 06-Dec-2012 - Medical - 262 pages


After many years of relative neglect, the importance of study of factors governing blood flow has at last achieved recognition; in this volume are documented many of the techniques, and the basic scientific and clinical observations, which have helped to open up understanding of this highly important aspect of human physiology and pathology in recent years. The text is logically divided into five sections beginning with blood cell deformability, then moving on to theoretical consideration of blood rheology, followed by accounts of the interrelationships between rheology, blood flow and vascular occlusion. The final two sections deal with blood rheology in clinical practice and therapeutic aspects of the study of blood flow. As regards blood cell deformability (Section A), the basic problem is set out by Kiesewetter and colleagues in the first paragraph of chapter 1 (p. 3), in which they point out that whereas human erythrocytes at rest have a diameter of approxi mately 7. 5 /-tm, nutritive capillaries have diameters ranging from 3-5 /-tm, and chapters in section A give an account of the ways in which the red cell can undergo deformation to permit capillary perfusion and the maintenance of the microcirculation.

Effects on Blood Flow

https://books.google.co.in/books?id=ePcqBgAAQBAJ&pg=PA243#v=onepage&q&f=false


Exercise Testing and Exercise Prescription for Special Cases: Theoretical Basis and Clinical Application


James S. Skinner

Lippincott Williams & Wilkins, 2005 - Medical - 418 pages


This text discusses how theoretical and applied aspects of exercise testing and exercise prescription must be modified due to the restrictions and/or limitations created by a specific health state. Topics covered include: general principles of exercise testing and exercise prescription; discussion of the importance of such general factors as age, gender, and environment; specific health states, general treatment, risk factors, how it may affect and be affected by exercise; how to modify exercise testing procedures; how to prescribe exercise; and the effects from exercise programs.


Exercise Issues for Claudication

https://books.google.co.in/books?id=zNr9j6g9GHAC&pg=PA319&lpg=PA319#v=onepage&q&f=false

Sunday, September 18, 2022

Mango Kernel - Benefits - Mango Seed

 


https://www.healthbenefitstimes.com/mango-seed/


https://www.dnaindia.com/ahmedabad/report-nutrient-rich-gutli-is-the-hero-in-mango-tale-researchers-2608398


https://www.linkedin.com/pulse/mango-seed-kernel-highly-nutritious-food-chemicals-should-patel/


Telugu

https://telugu.samayam.com/lifestyle/health/health-benefits-of-mango-kernels/articleshow/91180003.cms

Friday, September 16, 2022

Muscle Cramps

 


Foods That May Help With Muscle Cramps

 Medically Reviewed by Poonam Sachdev on March 06, 2022

https://www.webmd.com/pain-management/ss/slideshow-muscle-cramps-foods



Are cramps caused by lack of salt?

By Claudia Hammond

1st May 2012

This common affliction has often been ascribed to low salt levels in your diet, but what causes these painful aches is still a mystery.

https://www.bbc.com/future/article/20120430-are-cramps-due-to-lack-of-salt


Immunotherapy


Immunotherapy to Treat Cancer
Immunotherapy is a type of cancer treatment that helps your immune system fight cancer. The immune system helps your body fight infections and other diseases. It is made up of white blood cells and organs and tissues of the lymph system.

Immunotherapy is a type of biological therapy. Biological therapy is a type of treatment that uses substances made from living organisms to treat cancer.
2019
https://www.cancer.gov/about-cancer/treatment/types/immunotherapy


Chemotherapy and immunotherapy (atezolizumab).


Chemotherapy

In women with metastatic breast cancer that is hormone receptor negative, has not responded to hormone therapy, has spread to other organs or has caused symptoms, treatment may include:

Chemotherapy with one or more drugs.
Chemotherapy and immunotherapy

In women with metastatic breast cancer that is hormone receptor negative and HER2 negative, treatment may include:

Chemotherapy and immunotherapy (atezolizumab).
https://www.cancer.gov/types/breast/patient/breast-treatment-pdq#_707



https://onlinelearning.hms.harvard.edu/hmx/immunity/

https://www.allergy.org.au/patients/immunodeficiencies/covid-19-and-immunodeficiency

https://www.dw.com/en/the-immune-systems-fight-against-the-coronavirus/a-53048894

https://www.frontiersin.org/subjects/coronavirus


The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The experience of clinical immunologists from China
Wen Zhang, Yan Zhao, [...], and Shuyang Zhang
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102614/



ud. 17.9.2022
pub. 13.4.2020

Congestive Heart Failure

 

Congestive Heart Failure (CHF)

https://www.healthline.com/health/congestive-heart-failure



Congestive Heart Failure Diet: How to Reduce Fluid

https://www.healthline.com/health/congestive-heart-failure-diet



Tuesday, September 13, 2022

Stents - Different Varieties

 September 12, 2022

Optimed’s Tentos 4-F Stent System Launched in Europe

    

September 12, 2022—Optimed,  Germany, announced the launch of the Tentos 4-F self-expanding stent system for the treatment of superficial femoral and infrapopliteal arteries. It is now commercially available. According to the company, the Tentos stent is offered in diameters of 3 to 8 mm and is compatible with 0.018-inch guidewires. The delivery system features a low crossing profile and is compatible with all 4-F sheaths. The Tentos stent is designed with thinner struts and shorter stent rings and provides tighter stent wall apposition compared to conventional superficial femoral artery stents. The Tentos system also has enhanced vessel coverage, conformability, and visibility compared to Optimed’s current 4-F stent system. 

https://evtoday.com/news/optimeds-tentos-4-f-stent-system-launched-in-europe-and-other-ce-mark-countries


Saturday, September 10, 2022

PURE - Cardiovascular Diseases Studies - Publications

 

2017

https://www.thelancet.com/article/S0140-6736(17)32252-3/fulltext


2022

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01441-6/fulltext


https://www.thehindu.com/sci-tech/health/similar-strategies-required-to-handle-cardiovascular-disease-in-men-and-women-lancet-study/article65875126.ece



Pure Diet score


https://ipccs.org/2018/09/04/higher-healthy-diet-score-reduced-cv-disease-and-mortality-worldwide/




https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7435701/

WHO guidelines on foods

https://www.who.int/news-room/fact-sheets/detail/healthy-diet


Practical advice on maintaining a healthy diet

Fruit and vegetables

Eating at least 400 g, or five portions, of fruit and vegetables per day reduces the risk of NCDs (2) and helps to ensure an adequate daily intake of dietary fibre.


Fruit and vegetable intake can be improved by:


always including vegetables in meals;

eating fresh fruit and raw vegetables as snacks;

eating fresh fruit and vegetables that are in season; and

eating a variety of fruit and vegetables.

Fats

Reducing the amount of total fat intake to less than 30% of total energy intake helps to prevent unhealthy weight gain in the adult population (1, 2, 3). Also, the risk of developing NCDs is lowered by:


reducing saturated fats to less than 10% of total energy intake;

reducing trans-fats to less than 1% of total energy intake; and

replacing both saturated fats and trans-fats with unsaturated fats (2, 3) – in particular, with polyunsaturated fats.

Fat intake, especially saturated fat and industrially-produced trans-fat intake, can be reduced by:


steaming or boiling instead of frying when cooking;

replacing butter, lard and ghee with oils rich in polyunsaturated fats, such as soybean, canola (rapeseed), corn, safflower and sunflower oils;

eating reduced-fat dairy foods and lean meats, or trimming visible fat from meat; and

limiting the consumption of baked and fried foods, and pre-packaged snacks and foods (e.g. doughnuts, cakes, pies, cookies, biscuits and wafers) that contain industrially-produced trans-fats.

Salt, sodium and potassium

Most people consume too much sodium through salt (corresponding to consuming an average of 9–12 g of salt per day) and not enough potassium (less than 3.5 g). High sodium intake and insufficient potassium intake contribute to high blood pressure, which in turn increases the risk of heart disease and stroke (8, 11).


Reducing salt intake to the recommended level of less than 5 g per day could prevent 1.7 million deaths each year (12).


People are often unaware of the amount of salt they consume. In many countries, most salt  comes from processed foods (e.g. ready meals; processed meats such as bacon, ham and salami; cheese; and salty snacks) or from foods consumed frequently in large amounts (e.g. bread). Salt is also added to foods during cooking (e.g. bouillon, stock cubes, soy sauce and fish sauce) or at the point of consumption (e.g. table salt).


Salt intake can be reduced by:


limiting the amount of salt and high-sodium condiments (e.g. soy sauce, fish sauce and bouillon) when cooking and preparing foods;

not having salt or high-sodium sauces on the table;

limiting the consumption of salty snacks; and

choosing products with lower sodium content.

Some food manufacturers are reformulating recipes to reduce the sodium content of their products, and people should be encouraged to check nutrition labels to see how much sodium is in a product before purchasing or consuming it.


Potassium can mitigate the negative effects of elevated sodium consumption on blood pressure. Intake of potassium can be increased by consuming fresh fruit and vegetables.


Sugars

In both adults and children, the intake of free sugars should be reduced to less than 10% of total energy intake (2, 7).  A reduction to less than 5% of total energy intake would provide additional health benefits (7).


Consuming free sugars increases the risk of dental caries (tooth decay). Excess calories from foods and drinks high in free sugars also contribute to unhealthy weight gain, which can lead to overweight and obesity. Recent evidence also shows that free sugars influence blood pressure and serum lipids, and suggests that a reduction in free sugars intake reduces risk factors for cardiovascular diseases (13).


Sugars intake can be reduced by:


limiting the consumption of foods and drinks containing high amounts of sugars, such as sugary snacks, candies and sugar-sweetened beverages (i.e. all types of beverages containing free sugars – these include carbonated or non‐carbonated soft drinks, fruit or vegetable juices and drinks, liquid and powder concentrates, flavoured water, energy and sports drinks, ready‐to‐drink tea, ready‐to‐drink coffee and flavoured milk drinks); and

eating fresh fruit and raw vegetables as snacks instead of sugary snacks.