Statin intolerance in a referral lipid clinic.

Background: Statins effectively prevent atherosclerotic cardiovascular disease, but rates of statin discontinuation after adverse events are high.

Objective: Describe the range and relative frequencies of adverse events potentially attributable to statins in lipid referral practice and assess statin rechallenge outcomes.

Methods: Retrospective cohort study of 642 patients with statin-associated adverse events evaluated in a referral lipid clinic between January 1, 2004 and January 27, 2011.

Recent Clinical Trials in Osteoporosis: A Firm Foundation or Falling Short?

The global burden of osteoporotic fractures is associated with significant morbidity, mortality, and healthcare costs. We examined the ClinicalTrials.gov database to determine whether recently registered clinical trials addressed prevention and treatment in those at high risk for fracture.

Statin intolerance: more questions than answers.

The dramatic effectiveness of statins in improving the course of atherosclerotic cardiovascular disease tends to overshadow questions of statin intolerance. Thus after more than 25 years of clinical statin use, intolerance remains a poorly understood, frustrating issue for patients and providers. It has been extraordinarily difficult to define statin intolerance and its implications for clinical practice.

Are current clinical trials in diabetes addressing important issues in diabetes care?

Aims/hypothesis: Clinical trials assessing interventions for treating and preventing diabetes mellitus and its complications are needed to inform evidence-based practice. To examine whether current studies adequately address these needs, we conducted a descriptive analysis of diabetes-related trials registered with ClinicalTrials.gov from 2007 to 2010.

Adverse reactions of Achilles tendon xanthomas in three hypercholesterolemic patients after treatment intensification with niacin and bile acid sequestrants.

Multiple cholesterol-reducing therapies have been shown to induce the regression of tendon xanthoma in patients with familial hypercholesterolemia. We present 3 cases of adverse reactions in Achilles tendon xanthomas after the addition of niacin and bile acid sequestrants to ongoing statin therapy. Reduction in tendon dimensions and marked softening of xanthomas were interpreted as cholesterol removal from heavily infiltrated tissue sites.

Short communication: from wasting to obesity: initial antiretroviral therapy and weight gain in HIV-infected persons.

Data on weight gain and the progression to overweight/obesity in HIV-infected persons during initial combination antiretroviral therapy (cART) are limited, and comparisons to the general population are inconclusive. Weight and body mass index (BMI) changes were studied in HIV-infected adults who remained on initial cART for 12 consecutive months and in an HIV-uninfected cohort receiving care at Duke University Medical Center between 1998 and 2008. Overweight/obesity was defined as BMI ≥25 kg/m(2).

Partnership in employee health. A workplace health program for British Columbia Public Service Agency (Canada).

Objective: To evaluate the My Health Matters! (MHM) program, a multifaceted workplace intervention relying on education and awareness, early detection and disease management with a focus on risk factors for metabolic syndrome.

Participants: The MHM program was offered to 2,000 public servants working in more than 30 worksites in British Columbia, Canada.

Methods: The MHM program included a health risk assessment combined with an opportunity to attend an on-site screening and face-to-face call back visits and related on-site educational programs.

Osteoporosis in lung transplant candidates compared to matched healthy controls.

Purpose: Advanced lung disease increases the risk for diminished bone mineral density (BMD). The prevalence and severity of osteoporosis in lung transplant candidates is unclear.

Methods: We retrospectively evaluated BMD of subjects screened for lung transplant at our institution.

Lipid changes associated with antiretroviral therapy: results differ by reporting approach.

In order to evaluate consistency and comparability of lipid reporting in antiretroviral treatment (ART) studies, 25 ART trials cited in the Department of Health and Human Services Guidelines were analyzed. Changes in lipids from a separate clinical cohort initiating ART were presented using different approaches to illustrate impact of various methods. Most trials presented lipids as the proportion of graded laboratory toxicities (n=20).

Carcinoid tumor of the renal pelvis: report of a case with positive urine cytology.

A case of histologically and ultrastructurally confirmed carcinoid tumor of the renal pelvis is reported. The patient's urine sediment showed a few groups and sheets of polygonal malignant cells with scant cytoplasm and oval nuclei displaying chromatin clumping and micronucleoli.

Heterotopic adrenocortical oncocytoma. A case report with light and electron microscopic studies.

Background: The case of a benign oncocytoma arising in a patient from retroperitoneal heterotopic adrenocortical tissue is reported; this tumor was found in a 44-year-old man.

Methods: The tumor consisted of polygonal cells with granular eosinophilic cytoplasm packed with swollen mitochondria.

Results: Scattered tumor cells showed abundant smooth endoplasmic reticulum suggesting that the tumor was of adrenocortical origin.

An alternative approach for statistical analysis of kidney transplant data: multivariate analysis of single-center experience.

To avoid the center effect and the possible hidden interactions of multicenter studies, the validity of the Cox Proportional Hazards Model for the analysis of a single-center kidney transplant program was tested, considering 287 renal transplants performed in a 10-year period. The inclusion of type of donor and main immunosuppressive drug as covariates in the model did not violate the proportionality assumption of the Cox model. According to this method, the following covariates were significant in predicting graft survival: cyclosporine, type of donor, good human leukocyte antigen (HLA)-A and HLA-B match (DR data were not considered), highest percentage of reactive antibodies against panel cells, and nephroangiosclerosis as a primary renal disease.

Neodymium:YAG laser therapy for infiltrating bladder cancer.

There were 32 high risk patients with stages T2 to T4 bladder cancer treated with neodymium:YAG laser irradiation to the tumor base after cautery resection between July 1981 and October 1986. All 12 patients with stage T2 disease followed for 6 to 78 months had no recurrence locally although 4 had stage T1 recurrences elsewhere in the bladder. Of 14 stage T3 cancer patients 8 demonstrated tumor persistence locally but 3 were well 4 to 24 months later without local recurrence (all stage T3a) and 3 were alive 14 to 24 months later with stage T1 recurrences.

Treatment of Dunning R3327-AT rat prostate tumors with photodynamic therapy in combination with misonidazole.

Fischer X Copenhagen rats bearing Dunning R3327-AT tumors were treated with hematoporphyrin derivative and red light (630 nm from an argon-driven dye laser) alone or in combination with the hypoxic cell radiosensitizer, misonidazole (MISO). In vitro studies had suggested that hypoxia might significantly decrease the cytotoxicity of photodynamic therapy (PDT) and labeling with [14C]MISO had revealed a significant fraction of viable hypoxic cells in this tumor. PDT alone resulted in a growth delay of 8.

Applicability of nuclear androgen receptor quantification to human prostatic adenocarcinoma.

It has been proposed that concentrations of nuclear androgen receptor may be predictive of tumor hormone dependence in cases of advanced human prostatic cancer. We have investigated the ability of this receptor population to reflect patient prognosis during endocrine therapy in 12 cases of stage D disease. KCl-extractable, nuclear matrix-bound and total nuclear androgen receptor concentrations showed a significant positive correlation with duration of patient survival (p less than 0.

The radiation sensitivities of R3327-H and R3327-AT rat prostate adenocarcinomas.

Dunning R3327-H and R3327-AT tumors growing subcutaneously in the flanks of Fischer X Copenhagen rats were irradiated with 137Cs gamma-rays at volumes of approximately 300 mm. The effects of various doses of radiation were estimated by measurements of subsequent tumor growth as well as by histological evaluation. The well-differentiated, hormonally-responsive R3327-H tumor was more radiosensitive than the anaplastic R3327-AT tumor.

Relationship between concentrations of extractable and matrix-bound nuclear androgen receptor and clinical response to endocrine therapy for prostatic adenocarcinoma.

The relationship between androgen receptor concentrations and clinical response to endocrine therapy for prostatic adenocarcinoma was investigated for 13 stage D patients. Both cytoplasmic and nuclear-androgen receptors were quantified. For nuclear androgen receptor, nuclei were isolated and treated with high ionic strength buffer (0.

Androgen binding sites on nuclear matrix of normal and hyperplastic human prostate.

To further characterize human prostatic androgen receptor, nuclei were isolated from normal prostate (no. = 3) and benign prostatic hyperplasia specimens (no. = 10).

Interstitial applications of laser irradiation in hematoporphyrin derivative-photosensitized Dunning R3327 prostate cancers.

Two prostate tumour models (Dunning R3327H and AT) were tested in rats to see if they were sensitive to hematoporphyrin-photoradiation therapy (HPD-PRT). The R3327H tumours were irradiated by implantation of a single fiber optic and the R3327 AT tumours were treated with implantation of four fiber optics simultaneously. Thermal measurements made at the tip of the fiber and up to 1 cm from the tip indicated temperature rises from 1.

Estrogen receptor in human benign prostatic hyperplasia.

Estrogens have been proposed as a major etiological factor in the pathogenesis of benign prostatic hyperplasia in man. The presence of estrogen receptor in benign prostatic hyperplasia would support this concept. Using the receptor stabilizer, sodium molybdate, and a hydroxylapatite assay we assayed human benign prostatic hyperplasia for the presence of cytosolic estrogen receptor.

Segmental irradiation of the bladder with neodymium YAG laser irradiation.

The Neodymium YAG laser energy source can be readily adapted for cystoscopic use by some simple modifications of existing urologic equipment. Both the fiberoptic resectoscope and a deflecting cystourethroscope have been adapted for this purpose. Fixation of the fiber tip 1 cm.

Response of the Dunning R3327H prostatic adenocarcinoma to radiation and various chemotherapeutic drugs.

Dunning R3327H prostatic adenocarcinoma was bilaterally transplanted in the flanks of animals at the Papanicolaou Institute in Miami, and the animals were received at the Cross Cancer Institute (Edmonton, Alberta, Canada) each month. The animal flanks were palpated weekly, and when tumor volumes reached a size of approximately 300 mm3 the animals were randomized into treatment groups for the assessment of various therapies. Tumor volumes were determined each week before and after various treatments, and tumor growth was compared to that in untreated controls.

Management of nonseminomatous testicular cancer--a total community experience.

Reports have been made in important advances in the therapy of nonseminomatous germ cell tumors from specialized cancer therapy centers that treat a selected referred patient population. We herein examine the impact of these improvements on the total community of a large geographic area. Using the facilities of a comprehensive cancer registry and standardizing the treatment of nonseminomatous germ cell tumors from 1976 to the present, we have shown that there has been a marked improvement in the over-all survival of patients with these tumors in northern Alberta.