Nodular goiter with thyroid antibodies in chronic idiopathic urticaria.

We report a case of chronic idiopathic urticaria associated with nodular goiter and Graves disease. The urticaria resolved with normalization of the thyroid function.

Method of LDL cholesterol measurement influences classification of LDL cholesterol treatment goals: clinical research study.

Background: Low-density lipoprotein cholesterol (LDL-C) has been clearly associated with the risk of developing coronary heart disease. The best and most convenient method for determining LDL-C has come under increased scrutiny in recent years. We present comparisons of the Friedewald calculated LDL-C (C-LDL-C) and direct LDL-C (D-LDL-C) using 3 different homogenous assays.

Hypertriglyceridemia and hypercholesterolemia: effects of drug treatment on fatty acid composition of plasma lipids and membranes.

The effect of atorvastatin, simvastatin and gemfibrozil on fatty acid composition of plasma phospholipids (PL), cholesterol esters (CE), triglycerides (TG) and red cell membrane ghosts (G) has been determined in appropriate sample populations of individuals with hypertriglyceridemia (HTG) or hypercholesterolemia (HCHL). Treatments were appropriate for the condition, gemfibrozil for HTG and a statin for HCHL. Modifications depend on the drug and lipid fraction examined.

Unusual clinical course of Graves' thyrotoxicosis and concomitant sarcoidosis: case report and review of literature.

Objective: To report a case of Graves' disease with concomitant sarcoidosis involving the thyroid gland.

Methods: We present the clinical, laboratory, imaging, and pathologic findings and describe the clinical course of a patient with Graves' disease and sarcoidosis, who was unresponsive to propylthiouracil and radioiodine treatment.

Results: A 23-year-old woman presented with thyrotoxicosis and a large goiter.

Pravastatin and clopidogrel combined inhibit intimal hyperplasia in a rat carotid endarterectomy model.

Intimal hyperplasia, resulting from a complex cascade of events involving platelets, leukocytes, and smooth muscle cells, may be inhibited by the HMG-CoA reductase inhibitor pravastatin, which demonstrates inhibition of platelet activity and leukocyte adhesion and may be associated with inhibition of vascular smooth muscle cell proliferation and migration. Clopidogrel, an adenosine diphosphate (ADP) receptor inhibitor, was shown to decrease platelet activity and aggregation but not intimal hyperplasia (IH). We postulated that the combination of both pravastatin and clopidogrel would significantly decrease IH in a rat carotid endarterectomy model.

Insulin resistance and cardiovascular events with low HDL cholesterol: the Veterans Affairs HDL Intervention Trial (VA-HIT).

Objective: To assess the effect of insulin resistance and the benefit of the fibrate, gemfibrozil, on the incidence of major cardiovascular events in subjects with low HDL cholesterol and a broad range of triglyceride values who participated in the Veterans Affairs High Density Lipoprotein Intervention Trial (VA-HIT).

Research Design And Methods: This intention-to-treat analysis, specified as a secondary objective in VA-HIT, determined using Cox proportional hazards models the 5-year combined incidence of nonfatal myocardial infarction, coronary heart disease (CHD) death, or stroke in relation to the presence or absence of insulin resistance (defined by the highest tertile of the homeostasis model assessment of insulin resistance, HOMA-IR) in conjunction with lower and higher levels of HDL cholesterol and triglycerides. The study population consisted of 2,283 men with known coronary heart disease (CHD), treated with either placebo or gemfibrozil, who could be subdivided into groups with diabetes with or without insulin resistance, with no diabetes but insulin resistance, and with neither diabetes nor insulin resistance.

How should low-density lipoprotein cholesterol concentration be determined?

The National Cholesterol Education Program Adult Treatment Panel III Report (NCEP-ATP III) has identified low-density lipoprotein cholesterol (LDLC) as the primary target of therapy and has recommended using the Friedewald calculated LDL-C (CLDL- C). The present study compared a direct LDLC (D-LDL-C) method with the C-LDL-C and determined the possible impact on treatment decisions. C-LDL-C and D-LDL-C were compared in 464 consecutive patients.

Diabetes, plasma insulin, and cardiovascular disease: subgroup analysis from the Department of Veterans Affairs high-density lipoprotein intervention trial (VA-HIT).

Background: Diabetes mellitus, impaired fasting glucose level, or insulin resistance are associated with increased risk of cardiovascular disease.

Objectives: To determine the efficacy of gemfibrozil in subjects with varying levels of glucose tolerance or hyperinsulinemia and to examine the association between diabetes status and glucose and insulin levels and risk of cardiovascular outcomes.

Methods: Subgroup analyses from the Department of Veterans Affairs High-Density Lipoprotein Intervention Trial, a randomized controlled trial that enrolled 2531 men with coronary heart disease (CHD), a high-density lipoprotein cholesterol level of 40 mg/dL or less ( View Article and Find Full Text PDF

Gemfibrozil lowers plasma lipids and increases polyunsaturated fatty acid content and oxidative susceptibility of lipoproteins in hypertriglyceridemia.

Background: Gemfibrozil is an effective drug in the treatment of hypertriglyceridemia and its effects on morbidity and mortality seem out of proportion to its lipid lowering actions. There is considerable interest in its potential effects on lipoprotein fatty acid composition and consequent effect on oxidative susceptibility. Experimental results are not conclusive regarding whether gemfibrozil alters lipid composition or oxidative susceptibility of lipoproteins in humans.

Simple and rapid assessment of lipoprotein susceptibility to oxidation in the macromolecule fraction of plasma.

Background: Susceptibility of lipoprotein to oxidation is usually studied using purified lipoproteins. However, for large clinical studies or routine clinical assessment, a rapid, less time-consuming method that minimizes hydroperoxide accumulation in lipoprotein during preparation is desirable. Methods using whole plasma are complicated by the presence of an anticoagulant that may affect oxidation and the presence of antioxidants in the plasma aqueous phase.

Lipoprotein susceptibility to oxidation in the macromolecular fraction of plasma: relation to plasma lipids and oleate/linoleate ratio in comparison with whole plasma in hypertriglyceridemia.

Background: Susceptibility of lipoprotein to oxidation is usually studied using purified lipoproteins. However, for large clinical studies or routine clinical assessment, a rapid less time-consuming method is desirable. Therefore, we studied copper-mediated oxidation of the macromolecule fraction of plasma in comparison with oxidation directly in whole unfractionated plasma in a group of hyperlipidemic individuals.