Low LDL-C: Is It all Good News?

Purpose Of Review: This review presents the risks and benefits of very low LDL cholesterol and the safety of using lipid-lowering therapy to achieve these levels.

Recent Findings: A growing body of literature suggests that lower LDL cholesterol levels are associated with a reduced risk of cardiovascular disease. Further, achieving these levels with pharmaceuticals is remarkably safe.

Clinical practice recommendations on lipoprotein apheresis for children with homozygous familial hypercholesterolemia: an expert consensus statement from ERKNet and ESPN.

Homozygous familial hypercholesterolaemia is a life-threatening genetic condition, which causes extremely elevated LDL-C levels and atherosclerotic cardiovascular disease very early in life. It is vital to start effective lipid-lowering treatment from diagnosis onwards. Even with dietary and current multimodal pharmaceutical lipid-lowering therapies, LDL-C treatment goals cannot be achieved in many children.

Evinacumab for Pediatric Patients With Homozygous Familial Hypercholesterolemia.

Background: Homozygous familial hypercholesterolemia (HoFH) is a rare genetic disorder characterized by severely elevated low-density lipoprotein cholesterol (LDL-C) levels due to profoundly defective LDL receptor (LDLR) function. Given that severely elevated LDL-C starts in utero, atherosclerosis often presents during childhood or adolescence, creating a largely unmet need for aggressive LDLR-independent lipid-lowering therapies in young patients with HoFH. Here we present the first evaluation of the efficacy and safety of evinacumab, a novel LDLR-independent lipid-lowering therapy, in pediatric patients with HoFH from parts A and B of a 3-part study.

Decreasing Sedentary Behaviors in Youth to Prevent and Manage Childhood Obesity: Is It Realistic?

Purpose Of Review: Decreasing sedentary behaviors has been proposed as one approach to reduce the rate of obesity in youth. This review summarizes the contemporary literature examining the efficacy of these interventions in the school and community along with an additional focus on the role of socioeconomic status in these interventions.

Recent Findings: Studies that focus on decreasing sedentary behavior have utilized a wide variety of strategies in a number of settings.

The association of objectively measured sedentary time with asthma in US youth: A glimpse into the connection between obesity and asthma.

Background: Evidence suggests that asthma and obesity may share a common pathway, possibly through an increase in inflammation. Sedentary time is thought to promote both inflammation and obesity and previous studies have found a relationship between self-reported sedentary and asthma. However, the relationship between objectively measured sedentary time and asthma is not well described.

Adherence to lipid-lowering therapy and reaching treatment goals in youth seen in a preventive cardiology clinic.

Introduction: The efficacy of lipid-lowering therapy in reducing cardiovascular disease in adults is well-established. Unfortunately, it is also well-established that adults have inadequate adherence to lipid-lowering therapy, which is associated with increased costs and mortality. However, the adherence patterns of youth prescribed lipid-lowering therapy is not well-described.

Prevalence of dental caries in children with congenital heart disease.

Background: Congenital heart defects (CHD) affect about 8 out of 1000 births worldwide. Most of the patients reach adulthood and are exposed to an increased risk of endocarditis. Since bacteria already enter the bloodstream during everyday activities, oral hygiene is given special importance in the prevention of endocarditis.

Biogeochemistry of Recently Fossilized Siliceous Hot Spring Sinters from Yellowstone, USA.

Active hot springs are dynamic geobiologically active environments. Heat- and element-enriched fluids form hot spring sinter deposits that are inhabited by microbial and macroscopic eukaryotic communities, but it is unclear how variable heat, fluid circulation, and mineralization within hot spring systems affect the preservation of organic matter in sinters. We present geological, petrographic, and organic geochemical data from fossilized hot spring sinters (<13 Ka) from three distinct hot spring fields of Yellowstone National Park.

Clinical response to lifestyle counseling for dyslipidemia and elevated blood pressure in childhood cancer survivors.

Background: Childhood cancer survivors (CCS) have increased risk of premature cardiovascular disease. Whether they respond similarly to lifestyle changes for elevated blood pressure (BP), body mass index (BMI), and dyslipidemia to those without history of childhood cancer is unknown.

Procedure: This retrospective cohort study included CCS and 3:1 age- and sex-matched controls treated at Boston Children's Hospital Preventive Cardiology (2010-2019) using lifestyle management based on National Heart, Lung, and Blood Institute (NHLBI) guidelines.

SenseHunger: Machine Learning Approach to Hunger Detection Using Wearable Sensors.

The perception of hunger and satiety is of great importance to maintaining a healthy body weight and avoiding chronic diseases such as obesity, underweight, or deficiency syndromes due to malnutrition. There are a number of disease patterns, characterized by a chronic loss of this perception. To our best knowledge, hunger and satiety cannot be classified using non-invasive measurements.

Isometric Exercise Increases the Diameter of the Ascending Aorta in Youth with Bicuspid Aortic Valves.

Central arterial pressure rises to much higher levels during heavy isometric exercise compared to other forms of exercise. For this reason, patients with bicuspid aortic valves (BAV) are often restricted from heavy isometric exercise. Although this approach may be theoretically appealing, no data exist regarding the efficacy of this activity restriction.

Surgical Repair of Congenital Atresia of the Left Coronary Ostium.

Congenital left main coronary artery atresia is an exceedingly rare condition with potentially fatal consequences if not diagnosed in a timely fashion. We present a case series in children and adolescents, including surgical repair and outcomes. We describe the presenting symptoms and subsequent management of each patient, including surgical repair and outcomes.

Improving Cardiovascular Health in a Pediatric Preventive Cardiology Practice.

Poor childhood cardiovascular health translates into poor adult cardiovascular health. We hypothesized care in a preventive cardiology clinic would improve cardiovascular health after lifestyle counseling. Over a median of 3.

Erosive Potential of Bottled Salad Dressings.

A previous clinical study showed that the prevalence of erosive toothwear in vegetarians is statistically significantly higher than in nonvegetarians, due to the consumption of vinegar and other acidic foodstuffs. To adequately inform patients, this study investigated the erosive potential of bottled salad dressings available in Switzerland and compared it with that of orange juice. Materials and Methods: One hundred enamel samples of bovine teeth were divided into ten groups.

Permeability coefficients and vapour pressure determination for fragrance materials.

Objective: This study aims to correlate new experimental data relevant to the description of the combined evaporation/permeation process of a perfume applied onto the skin.

Methods: The vapour pressure data were measured by thermogravimetric analysis (TG-DTA). The Antoine constants and the Clarke and Glew parameters were determined for the same set of fragrance molecules to describe its low vapour pressures at new temperature ranges.

Cardiorespiratory Fitness in Youth: An Important Marker of Health: A Scientific Statement From the American Heart Association.

Cardiorespiratory fitness (CRF) refers to the capacity of the circulatory and respiratory systems to supply oxygen to skeletal muscle mitochondria for energy production needed during physical activity. CRF is an important marker of physical and mental health and academic achievement in youth. However, only 40% of US youth are currently believed to have healthy CRF.

Lateral field excited quartz crystal microbalances for biosensing applications.

The most common bulk acoustic wave device used in biosensing applications is the quartz crystal microbalance (QCM), in which a resonant pure shear acoustic wave is excited via electrodes on both major faces of a thin AT-cut quartz plate. For biosensing, the QCM is used to detect the capture of a target by a target-capture film. The sensitivity of the QCM is typically based solely on the detection of mechanical property changes, as electrical property change detection is limited by the electrode on its sensing surface.

Lipoprotein Particle Predictors of Arterial Stiffness after 17 Years of Follow Up: The Malmö Diet and Cancer Study.

Background: Central arterial stiffness is a surrogate of cardiovascular risk and predicts cardiovascular mortality. Apolipoprotein B lipoproteins are also established cardiovascular risk factors. It is not known whether specific lipoprotein subclasses measured in the Malmö Diet and Cancer Study and previously shown to be associated with coronary heart disease also predict arterial stiffening after a mean period of 17 years.

The relationship between payer type and lipid outcomes in response to clinical lifestyle interventions in youth with dyslipidemia.

Background: Payer-type (government-sponsored health coverage versus private health insurance) has been shown to influence a variety of cardiovascular disease outcomes in adults. However, it is unclear if the payer-type impacts the response to a lifestyle intervention in children with dyslipidemia.

Methods: We analyzed data prospectively collected from patients under the age of 25 years who were referred to a large regional preventive cardiology clinic from 2010 to 2016 in Massachusetts.

Hypertriglyceridemia in Diabetes Mellitus: Implications for Pediatric Care.

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). It is estimated that the risk of CVD in diabetes mellitus (DM) is 2 to 10 times higher than in the general population. Much of this increased risk is thought to be related to the development of an atherogenic lipid profile, in which hypertriglyceridemia is an essential component.