Comparison of Different Automated Office Blood Pressure Measurement Devices: Evidence of Nonequivalence and Clinical Implications.

Background: Automated office blood pressure (AOBP) measuring devices are increasingly recommended as preferred blood pressure (BP) diagnostic tools, but it is unclear how they compare and how clinical environments impact their performance.

Methods: This prospective randomized factorial parallel 4-group study compared BP estimates by BpTRU (VSM MedTech, Vancouver, BC, Canada) and Omron HEM 907 (Omron Healthcare, Kyoto, Japan) devices in closed vs open areas. Patients diagnosed with hypertension were recruited during office visits.

The Gap Between Manual and Automated Office Blood Pressure Measurements Results at a Hypertension Clinic.

Background: Blood pressure (BP) readings taken in clinics are often higher than BP readings taken in a research setting. Recent guidelines and clinical trials have highlighted the necessity of using automated office blood pressure (AOBP) devices and standardizing measurement procedures. The goal of the present study was to compare AOBP vs manual BP measurement in both research and clinical environments in which operators and devices were the same and measurement procedures were standardized and optimal.

Myotoxicity of statins: Mechanism of action.

Statins are effective drugs to reduce cardiovascular events secondary to dyslipidemia; however, they cause frequent undesirable side effects. The incidence of statin-induced myotoxicity (SIM) is presented by 7 to 29% of patients, depending upon the report. SIM may develop in presence of abnormally high concentrations of statins in the myocyte and/or in presence of muscular conditions that may predispose to SIM.

Mid term results of distal femoral fractures treated with a polyaxial locking plate: a multi-center study.

Objective: Locking plates have become a standard implant in the treatment of distal femoral fractures. Newer designs allow polyaxial screw placement as well as the ability to lock the lag screws.

Methods: The consecutive multi-centre study cohort consists of all distal femoral fractures treated with the NCB® Distal Femur plate (Zimmer, Warsaw, USA) and a minimum follow-up of twelve months.

Effectiveness and tolerability of oral administration of low-dose salmon oil to HIV patients with HAART-associated dyslipidemia.

Purpose: To assess the effectiveness of low-dose salmon oil for the treatment of highly active antiretroviral therapy (HAART)-induced dyslipidemia in HIV-infected patients.

Method: Randomized, open-label, parallel and crossover, multicenter study. Patients received 1 g salmon oil tid for 24 weeks (SO-24) or no additional treatment for 12 weeks and salmon oil for weeks 12 to 24 (CT-SO).

Minimally invasive treatment of pilon fractures with a low profile plate: preliminary results in 17 cases.

Objective: To determine the results of "biologic fixation" with a minimally invasive plating technique using a newly designed low profile "Scallop" plate in the treatment of pilon fractures.

Design: Retrospective case series.

Setting: A tertiary referral center.

Glycerol kinase deficiency: evidence for complexity in a single gene disorder.

Glycerol kinase deficiency (GKD) occurs as part of an Xp21 contiguous gene syndrome or as isolated GKD. The isolated form can be either symptomatic with episodic metabolic and central nervous system (CNS) decompensation or asymptomatic with hyperglycerolemia and glyceroluria only. To better understand the pathogenesis of isolated GKD, we sought individuals with point mutations in the GK coding region and measured their GK enzyme activities.

Coexisting dysbetalipoproteinemia and familial hypercholesterolemia. Clinical and laboratory observations.

Type III dysbetalipoproteinemia and familial hypercholesterolemia (FH) are two metabolic disorders giving rise to severe disturbances of lipid homeostasis and premature atherosclerosis. Both metabolic abnormalities have a genetic basis and co-occurrence in the same patient has seldom been described. Because of the unique structure of the French Canadian population, there was an opportunity to observe patients with both dysbetalipoproteinemia (E2/2 homozygotes) and FH (N=14) and to compare their clinical data with that of patients with type III (N=75), patients with FH (N0.

Contribution of acute-phase proteins and cardiovascular risk factors to erythrocyte aggregation in normolipidemic and hyperlipidemic individuals.

Background: Numerous studies have demonstrated that elevated concentrations of acute-phase proteins affect red blood cell (RBC) aggregation. Plasma lipids and lipoproteins were also shown to be correlated with RBC aggregation in hypercholesterolemia. However, whether acute-phase proteins promote RBC hyperaggregation in hyperlipidemic patients is unknown.

Sonography of Achilles tendon xanthomas in patients with heterozygous familial hypercholesterolemia.

Objective: Xanthomas are an essential diagnostic criteria of familial hypercholesterolemia. The objective of this study was to determine if xanthomas of the Achilles tendon can be revealed on sonography when the condition is clinically unsuspected in patients with heterozygous familial hypercholesterolemia.

Subjects And Methods: Ninety-four patients (52 females, 42 males; 12-73 years old; mean age, 44 years) with a proven diagnosis of heterozygous familial hypercholesterolemia were studied.

Lipoprotein lipase gene mutations in coronary artery disease.

Background: Genetic lipoprotein disorders are frequently associated with premature coronary artery disease (CAD). Functional mutations of the lipoprotein lipase (LPL) gene are associated with altered plasma lipoprotein profiles and are relatively common in French Canadians.

Objective: To investigate the prevalence of LPL gene mutations in a group of patients with premature CAD and in a healthy control group.

Differences in the erythrocyte aggregation level between veins and arteries of normolipidemic and hyperlipidemic individuals.

The objectives of this study were to detect differences in the Doppler power backscattered by blood in vivo, and to identify factors affecting the backscattered power. The main hypothesis was that variations in the erythrocyte aggregation level between veins and arteries of normolipidemic and hyperlipidemic individuals can be detected with power Doppler ultrasound. Doppler measurements were performed at 5 MHz, with an Acuson 128 XP/10 system, over the carotid artery and jugular vein, external iliac artery and vein, common femoral artery and vein and popliteal artery and vein.

Influence of acute-phase proteins on erythrocyte aggregation.

With the exception of fibrinogen, immunoglobulins, and albumin, little information is available on the effect of acute-phase proteins on erythrocyte aggregation. The objective of this study was to investigate the effects of haptoglobin (Hp), C-reactive protein (CRP), ceruloplasmin (Cp), alpha 1-acid glycoprotein (alpha 1-AGP), and alpha 1-antitrypsin (alpha 1-AT) on the aggregation kinetics and shear resistance of erythrocyte aggregates. The plasma concentration of these proteins was measured in 20 healthy individuals and kept unchanged while the concentration of the protein tested was increased.

G-->A substitution at position -75 of the apolipoprotein A-I gene promoter. Evidence against a direct effect on HDL cholesterol levels.

The present study sought to resolve the contradictory evidence as to whether the G-->A substitution at position -75 of the apoA-I gene promoter raises HDL cholesterol (HDL-C) levels by examining the effect of this polymorphism in French Canadians, a relatively genetically homogeneous population. Among 308 women, carriers of the A allele displayed 12% and 10% higher mean plasma HDL-C and apoA-I concentrations, respectively, than did noncarriers. Among 345 men, no effect of the A allele was noted.

Predominance of large LDL and reduced HDL2 cholesterol in normolipidemic men with coronary artery disease.

Previous studies have indicated that a predominance of small, dense LDL particles is associated with coronary artery disease (CAD) risk. In the present study we examined the LDL peak particle diameter (determined by lipid-stained 2% to 16% gradient gel electrophoresis) in 92 normolipidemic men with CAD (total cholesterol < 200 mg/dL and triglyceride < 250 mg/dL) and 92 matched healthy controls. Plasma triglyceride, LDL cholesterol, and apo B levels were similar in subjects with CAD and in control subjects, whereas subjects with CAD had decreased HDL2 cholesterol levels (mean +/- SEM, 10 +/- 0.

MR imaging of Achilles tendon in patients with familial hyperlipidemia: comparison with plain films, physical examination, and patients with traumatic tendon lesions.

Objective: The purpose of this study was to evaluate the MR imaging characteristics of Achilles tendons in patients at risk for tendon xanthomas because of familial hyperlipidemia and to compare these findings with those seen on plain radiographs and physical examination. We also wished to determine if MR imaging could be used to differentiate xanthomas from traumatic tendinopathy in a second group of patients who had no history of hyperlipidemia but who had a history of trauma to the Achilles tendon.

Subjects And Methods: We evaluated the MR imaging studies of 26 Achilles tendons in 13 patients with heterozygous familial hypercholesterolemia (n = 11) and type III dysbetalipoproteinemia (n = 2).

Response to HMG CoA reductase inhibitors in heterozygous familial hypercholesterolemia due to the 10-kb deletion ("French Canadian mutation") of the LDL receptor gene.

The 10-kb deletion ("French Canadian mutation") of the low-density lipoprotein (LDL) receptor gene is the most common mutation causing familial hypercholesterolemia among subjects of French Canadian descent. In affected subjects, it results in a null allele of the LDL receptor gene and provides a unique opportunity to examine single-allele regulation of this gene in humans. We sought to ascertain the response of inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase in subjects with the French Canadian mutation of the LDL receptor gene and to correlate this response with biochemical variables and the haplotype of the nondeletion LDL receptor allele.

Limitations of ultrasonic duplex scanning for diagnosing lower limb arterial stenoses in the presence of adjacent segment disease.

Purpose: The purpose of this study was to provide a quantitative evaluation of the effect of adjacent segment lesions on disease classification in lower limb arteries by ultrasonic duplex scanning.

Methods: Lower limb arterial duplex scanning from the distal aorta to the popliteal artery was performed in 55 patients. Arterial lesions evaluated by visual interpretation of Doppler spectra were compared blindly with those measured by angiography.

Comparative efficacy and safety of pravastatin, nicotinic acid and the two combined in patients with hypercholesterolemia.

In a comparative study, 158 patients with type IIa or IIb primary hypercholesterolemia received either placebo, nicotinic acid extended-release capsules (0.5 to 1.0 g twice daily), pravastatin (40 mg at bedtime), or the combination for a short-term, 8-week period.

Influence of probucol on enhanced LDL oxidation after fish oil treatment of hypertriglyceridemic patients.

The susceptibility of low-density lipoprotein (LDL) to oxidation was studied in hypertriglyceridemic men (5 with type III and 5 with type IV) at baseline on a low-saturated-fat, low-cholesterol diet, after 6 weeks of dietary supplementation with fish oil (Promega, 12 g/d), and after 6 weeks of fish oil combined with probucol (500 mg BID). The relative content of n-3 polyunsaturated fatty acids in plasma and LDL was increased during the two treatment periods, and a low alpha-tocopherol to n-3 polyunsaturated fatty acids ratio was observed. Plasma thiobarbituric acid-reactive substances (TBARS) levels were unchanged after 6 weeks of fish oil, but the ratio of lipid peroxides to the reduced triglyceride (TG) levels (MDA:TG) was significantly higher (P < .

The response to lovastatin treatment in patients with heterozygous familial hypercholesterolemia is modulated by apolipoprotein E polymorphism.

In a retrospective study, we examined the influence of apolipoprotein (apo) E polymorphism and gender on the response to treatment with 80 mg/d lovastatin in a homogeneous population of patients with familial hypercholesterolemia (FH), most of whom were carriers of the 10-kb deletion of the low-density lipoprotein (LDL) receptor gene. Apo E phenotype distribution among the 189 FH patients was not different from that of a normal population sample. The total and LDL cholesterol (LDL-C) response to lovastatin in the overall group (men and women) was significantly lower in the E4 subset compared with E2 and E3 subsets.

Genealogy and regional distribution of lipoprotein lipase deficiency in French-Canadians of Quebec.

Lipoprotein lipase (LPL) deficiency, an autosomal recessive disorder causing chylomicronemia, has a high prevalence in the French-Canadian population of Quebec. The molecular basis of LPL deficiency has been defined, and two major mutations have been shown to have an uneven geographic distribution. Two mutations, one at residue 188 (M-188) and the other at residue 207 (M-207), are described here; they account for 95% of the mutant alleles.

A missense mutation (Asp250----Asn) in exon 6 of the human lipoprotein lipase gene causes chylomicronemia in patients of different ancestries.

We have previously reported two common lipoprotein lipase (LPL) gene mutations underlying LPL deficiency in the majority of 37 French Canadians (Monsalve et al., 1990. J.

Effect of ensemble averaging on amplitude and feature variabilities of Doppler spectrograms recorded in the lower limb arteries.

The objective of the present study was to analyse the effect of averaging Doppler blood flow signals in lower limb arteries on amplitude and feature variabilities. Doppler signals recorded in 41 iliac and 35 superficial femoral arteries having different categories of stenosis were averaged over 1-15 cardiac cycles. Based on the relative decreasing rate of an index of variability, results indicated that amplitude variability of the spectrograms was exponentially reduced to 30, 6 and 1 per cent when averaging five, ten and 15 cardiac cycles, respectively.