Welch Company
San Francisco, CA
S U M M A R Y
DIARY: November 17, 2011 02:15 PM Thursday;
Rod Welch
VA lab cholesterol LDL fast 12 hours test Rosuvastatin effectiveness.
1...Summary/Objective
2...Total Bilirubin 1.3 Recovery Impaired Liver after Simvastatin
3...Salt Sodium Declines Near Danger Too Low
4...Glucose Declines Again Risk Diabetes Further Reduced
5...LDL 200 Huge Increase Risk CAD Goal Reduce LDL < 70 Failed
6...Lipid History....
7...LDL Cholesterol 100 Point Changes Less than 3 Months
8...Large Variations LDL Less 3 Months Indicates Unreliable Testing
9...Errors Common LDL Cholesterol Testing
10...LDL Testing Fraught with Error Test Results Variability
........Reliability of low-density lipoprotein cholesterol,
........non-high-density lipoprotein cholesterol, and apolipoprotein B
........measurement.
........Effect of a dietary portfolio of cholesterol-lowering foods
........given at 2 levels of intensity of dietary advice on serum
........lipids in hyperlipidemia: a randomized controlled trial
........Month-to-month variability of lipids, lipoproteins, and
........apolipoproteins and the impact of acute infection in
........adolescents.
........Reliability of lipid, lipoprotein, and apolipoprotein
........measurements
11...Rosuvastatin Side Effects Myopathy Muscle Pain
12...Myopathy Muscle Pain Side Effects Rosuvastatin
..............
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CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 14 0000, ref SDS 13 0000.
040502 -
040503 -
040504 -
040505 -
040507 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Visited Lab on ground floor VA in Martinez.
040902 -
040903 - On 111013, interim lab, ref SDS 14 GM65, for 6 - 8 weeks to test
040904 - results switching from Simvastatin to Rosuvastatin for managing
040905 - cholesterol, planned by Doctor Egan on 110817 1030, ref SDS 12 JQ5F,
040906 - and reported by Buena in a call earlier on 111013 1048. ref SDS 13 H291
040908 - ..
040909 - Lab today tests effectiveness reducing cholesterol LDL < 70 ordered by
040910 - Doctor Egan in a meeting at the VA in Martinez on 110817 1030,
040911 - ref SDS 12 JQ54, and reported by Ally on 111013 1404. ref SDS 14 EO7O
040913 - ..
040914 - Attendant said lab will test for...
040915 -
040916 - Lipid
040917 - Electrolyte
040918 - Myopathy
040920 - ..
040921 - Attendant said to expect results posted tomorrow.
040923 - ..
040924 - Total Bilirubin 1.3 Recovery Impaired Liver after Simvastatin
040925 - Salt Sodium Declines Near Danger Too Low
040926 - Glucose Declines Again Risk Diabetes Further Reduced
040927 -
040928 - Follow up ref SDS 14 GM65, ref SDS 11 GM65.
040930 - ..
040931 - CHEM PROFILE........... 2011 11 17 1427
040932 - PLASMA Results Units Range
040933 - GLUCOSE 108 mg/dL 74 - 118
040934 - GLUfast mg/dL Ref: <=99
040935 - NA (salt) 139 mmol/L 136 - 144
040936 - K 4.1 mmol/L 3.4 - 4.8
040937 - CL 103 mmol/L 98 - 106
040938 - CO2 30 mmol/L 23 - 33
040939 - BUN 11 mg/dL 8 - 26
040940 - CREAT 0.89 mg/dL .5 - 1.1
040941 - eGFR >60 mL/min Ref: >=60
040942 - CALCIUM 9.0 mg/dL 8.7 - 10.2
040943 - CA CORR mg/dL 8.7 - 10.2
040944 - PO4 mg/dL 2.4 - 4.5
040945 - MG mg/dL 1.8 - 2.5
040946 - ALK PHO 95 IntUnits/L 37 - 107
040947 - T. BIL 1.3 H mg/dL .3 - 1.2
040948 - D. BILI mg/dL .1 - .4
040949 - AST 25 IntUnits/L 8 - 42
040950 - ALT 24 IntUnits/L 5 - 55
040951 - ALBUMIN 4.4 g/dL 3.3 - 4.8
040952 - PROTEIN 7.4 g/dL 6.5 - 8.1
040953 - LDH IntUnits/L 90 - 208
040954 - AMYLASE Units/L 28 - 100
040955 - LIPASE Units/L 7 - 58
040956 - NH3 mcmol/L 15 - 56
040957 - URIC AC mg/dL 4.8 - 8.7
040958 - Comments: a
040960 - ..
040961 - a. TEST PERFORMED BY VA MARTINEZ, 150 MUIR ROAD, MARTINEZ CA.
040963 - ..
040964 - b. Evaluation for CREAT:
040965 -
040966 - Effective 7/2/08, new standardized method for
040967 - creatinine in place. Note reference range change.
040968 - Previous range 0.5-1.2 mg/dL.
040970 - ..
040971 - c. Evaluation for ALK PHO:
040972 -
040973 - The normal range is for an adult population less than
040974 - 50 years old. Alk Phos increases with age over 50 to
040975 - about 60% higher values by ages greater than 75 years
040976 - old.
040978 - ..
040979 - d. Evaluation for eGFR:
040980 -
040981 - eGFR Units = mL/min/1.73 square meters
040983 - ..
040984 - Glucose and salt (NA) both increase - reflect decline hiking from 40
040985 - to only 2 miles per week, past month or so, shown in case study on
040986 - 101010 0744. ref SDS 9 UT6K
040988 - ..
040989 - Total bilirubin 1.3 holding below 2.0 high in prior lab on 110727
040990 - 1238. ref SDS 11 GM65 - significant decline after ending Simvastatin,
040991 - shown by interim lab a few weeks ago on 111013 1404. ref SDS 14 557J
040992 - Hopefully indicates recovery of any impaired liver function, cited in
040993 - research on 111013 1404. ref SDS 14 LC8J
040994 -
040995 -
040996 -
040997 -
0410 -
SUBJECTS
Default Null Subject Account for Blank Record
0503 -
050401 - ..
050402 - LDL 200 Huge Increase Risk CAD Goal Reduce LDL < 70 Failed
050403 -
050404 - Follow up ref SDS 11 E19L, ref SDS 10 E19L.
050405 -
050406 - Work plan changed simvastatin 40 mg to rosuvastatin 10 mg on 110817
050407 - 1030. ref SDS 12 DG36 Lab today evaluate requirement increase dose
050408 - rosuvastatin 20 mg. 110817 1030, ref SDS 12 JQ54
050410 - ..
050411 - Assessment lab results shown below. ref SDS 0 RA5O
050412 -
050413 - LIPID PANEL............ 2011 11 17 1427
050414 - PLASMA Results Units Range
050415 - CHOL 260 H mg/dL Ref: <=200
050416 - TRIGLYC 84 mg/dL Ref: <=150
050417 - HDL 43 mg/dL Ref: >=40
050418 - LDL 200 H mg/dL Ref: <=160
050419 - LDL Dir mg/dL Ref: <=160
050420 - TRIG NF mg/dL Ref: <=150
050421 - Comments: a
050422 -
050441 - ..
050442 - Research indicates LDL is presented 2 ways: calculated, which is less
050443 - accurate, and direct, which is more expensive.
050445 - ..
050446 - Research also indicates tests for LDL cholesterol are not reliable,
050447 - shown below, ref SDS 0 N29Y, so hard to decide course of action.
050448 -
050450 - ..
050451 - Lipid History....
050453 - ..
050454 - See assessment of lab results, below. ref SDS 0 RA5O
050455 -
050456 - Collection DT Spec CHOLESTEROL Target Range
050457 - 111117 0215 PLASM 260 H mg/dL <= 200 ...... ref SDS 0 IM9N
050458 - 110727 1238 PLASM 163 ........................... ref SDS 11 E19L
050459 - 101207 0906 PLASM 151 ........................... ref SDS 10 E19L
050460 - 100721 0800 PLASM 261 H ........................... ref SDS 8 E19L
050461 - 100610 1033 PLASM 217 H ........................... ref SDS 7 QV4F
050462 - 090813 1500 PLASM 233 H ........................... ref SDS 5 8P5F
050463 - 060616 1059 PLASM 238 H ........................... 060623 0840, ref SDS 4 UO6K
050464 - 050906 1204 PLASM 257 H ........................... ref SDS 2 DG8G
050465 - 050709 1000 PLASM 277 H ........................... ref SDS 1 G69K
050467 - ..
050468 - Graph of cholesterol shown on 090813 1500. ref SDS 5 NQ86
050470 - ..
050471 - Graph of HDL and LDL are primary risk factors for CAD, see graph
050472 - below. ref SDS 0 7M42
050474 - ..
050475 - TRIGLYC
050476 - 111117 0215 PLASM 84 mg/dL <= 150 ...... ref SDS 0 IM9N
050477 - 110727 1238 PLASM 81 ........................... ref SDS 11 E19L
050478 - 101207 0906 PLASM 41 ........................... ref SDS 10 E19L
050479 - 100721 0800 PLASM 87 ........................... ref SDS 8 E19L
050480 - 100610 1033 PLASM 83 ........................... ref SDS 7 QV4F
050481 - 090813 1500 PLASM 118 ........................... ref SDS 5 8P5F
050482 - 060616 1059 PLASM 68 ........................... 060623 0840, ref SDS 4 UO6K
050484 - ..
050485 - HDL
050486 - 111117 0215 PLASM 43 mg/dL >= 40 ...... ref SDS 0 IM9N
050487 - 110727 1238 PLASM 45 ........................... ref SDS 11 E19L
050488 - 101207 0906 PLASM 47 ........................... ref SDS 10 E19L
050489 - 100721 0800 PLASM 35 L ........................... ref SDS 8 E19L
050490 - 100610 1033 PLASM 36 L ........................... ref SDS 7 QV4F
050491 - 090813 1500 PLASM 30 L ........................... ref SDS 5 8P5F
050492 - 060616 1059 PLASM 32 L ........................... 060623 0840, ref SDS 4 UO6K
050494 - ..
050495 - LDL-CHO
050496 - 111117 0215 PLASM 200 H mg/dL <= 160 ...... ref SDS 0 IM9N
050497 - 110727 1238 PLASM 102 ........................... ref SDS 11 E19L
050498 - 101207 0906 PLASM 96 ........................... ref SDS 10 E19L
050499 - 100721 0800 PLASM 209 H ........................... ref SDS 8 E19L
050500 - 100610 1033 PLASM 164 H ........................... ref SDS 7 QV4F
050501 - 090813 1500 PLASM 179 H ........................... ref SDS 5 8P5F
050502 - 060616 1059 PLASM 192 H ........................... 060623 0840, ref SDS 4 UO6K
050503 -
050504 - [On 111128 0202 letter to medical team asks about
050505 - increasing medication to rosuvastatin 20 mg or trying some
050506 - other line of care in order to reduce cholesterol LDL < 70,
050507 - ref SDS 17 EB3U, according to the VA work plan on 110817
050508 - 1030. ref SDS 12 DG36
050510 - ..
050511 - [On 111128 2038 increased medication to rosuvastatin 20 mg,
050512 - shown in case study on patient history on 101010 0744.
050513 - ref SDS 9 NV7I
050515 - ..
050516 - Previously, 2 years ago, Doctor Egan assesd coronary artery disease
050517 - (CAD) correlates with research on hyperlipidemia in the record for
050518 - 091002 0900. ref SDS 6 8X3G Aligned with prior analysis by Doctor
050519 - Sandhu on 060505 0830. ref SDS 3 OE3L
050521 - ..
050522 - Hyperlipidemia - cholesterol risk factors reviewed also on 091002.
050523 - ref SDS 6 2F8K
050525 - ..
050526 - Currently, LDL 200 rising from 102 for prior lab on 110727 1238,
050527 - ref SDS 11 E19L, does not meet objective of LDL < 70, planned in
050528 - meeting at the VA prescribing rosuvastatin 10 mg to replace
050529 - simvastatin 40 mg, reported on 110817 1030. ref SDS 12 DG36
050531 - ..
050532 - HDL has not increased, also, conflicting with objectives at that time
050533 - on 110817 1030. ref SDS 12 IO6F
050535 - ..
050536 - Significant cholesterol rise to LDL 200 may reflect artery strictures
050537 - limiting blood flow possibly aligning with recent increase in blood
050538 - pressure, roughly averaging 115 75 from October 2010, until about a
050539 - month ago, shown in case study on 101010 0744. ref SDS 3 QJ5I
050540 - Beginning OA 111030, blood pressure suddenly increased to about 135
050541 - 75, with many readings above 145. ref SDS 3 UT6K At about that same
050542 - time hiking decreased from 40 down to 2 miles per week. In recent
050543 - days, blook pressure trending down slightly with hiking increased
050544 - back to 40 miles per week.
050546 - ..
050547 - Additionally, missed a week taking rosuvastatin 10 mg because forgot
050548 - to bring pills home from assignment providing case management in
050549 - Southern California, reported on 111105, also in case study.
050550 - ref SDS 3 WWSQ
050551 -
050552 -
050554 - ..
050555 - LDL Cholesterol 100 Point Changes Less than 3 Months
050556 - Large Variations LDL Less 3 Months Indicates Unreliable Testing
050557 -
050558 - Big increases in LDL over past 3 months correlates with similar
050559 - increase over 1 month last year on 100721 0800, ref SDS 8 PTPP, and
050560 - seems incongruous, undermining reliability of lipid testing.
050562 - ..
050563 - 210 mg/dL +209 (10721 0000 (ref SDS 8 E19L)
050564 - | |
050565 - 200 | +--+ +-- 200 (111117 0215, ref SDS 0 IM9N)
050566 - 192 (060623 0840, ref SDS 4 UO6K) | |
050567 - 190 | | | |
050568 - | | | |
050569 - 180 +-----/ /----- 179 (090813 1500, ref SDS 5 8P5F)
050570 - | | | |
050571 - 170 | | | |
050572 - | | | |
050573 - 160 +---------- 164 (100610 1046, ref SDS 7 QV4F)
050574 - | |
050575 - 150 | |
050576 - | |
050577 - 140 / |
050578 - | |
050579 - 130 | |
050580 - | |
050581 - 120 | |
050582 - | |
050583 - 110 | |
050584 - | +---- 102 (110727 0000, ref1SDS 11 E19L)
050585 - 100 | |
050586 - 96 (101207 0000, ref SDS 10 E19L)
050587 - 90
050588 -
050589 - 80
050590 - ..
050591 - 70 ==================== G O A L ==========================
050592 -
050593 - 60 Simvastatin Rosuvastatin
050594 - 091104 110817 111128. ref SDS 9 NV7I
050595 - 40 20 mg 40 mg 10 mg 20 mg
050596 -
050597 - 20
050598 - ..
050599 - 10
050600 - <---2006--->/../<---2009---><---2010---><---2011---><---2012--->
050601 - 1 3 6 9 1 3 6 9 1 3 6 9 1 3 6 9 1 3 6 9
050602 -
050603 -
050604 -
0507 -
SUBJECTS
Default Null Subject Account for Blank Record
0603 -
060401 - ..
060402 - Errors Common LDL Cholesterol Testing
060403 - LDL Testing Fraught with Error Test Results Variability
060404 -
060405 - Big changes of 100 mg/DL up and down in LDL cholesterol within 1 - 3
060406 - month intervals shown in patient history, per above. ref SDS 0 5X6U
060407 -
060408 - How can body chemestry change so quickly with diet and exercise
060409 - relatively stable?
060411 - ..
060412 - Research indicates reliability of lipid cholesterol testing has been a
060413 - problem since 1988, ref SDS 0 PUPU, and continues to the present day,
060414 - as shown in following article published by the National Health
060415 - Institute this year, saying testing for LDL cholesterol is "fraught
060416 - with error." ref SDS 0 N29Y
060418 - ..
060419 - Research on the Internet shows....
060420 -
060421 - 1. Pubmed.gov
060422 - US National Library of Medicine
060423 - National Institutes of Health
060425 - ..
060426 - Journal of Clinical Lipidology
060427 -
060428 - 2011 Jul-Aug 5(4) 264-72
060429 - Epub.................................... 2011 May 27
060431 - ..
060432 - Reliability of low-density lipoprotein cholesterol,
060433 - non-high-density lipoprotein cholesterol, and apolipoprotein B
060434 - measurement.
060435 -
060436 - http://www.ncbi.nlm.nih.gov/pubmed/21784371
060438 - ..
060439 - Maine Standards Company, 765 Roosevelt Trail, Windham, ME
060440 - 04062, USA. jcontois@mainestandards.com
060442 - ..
060443 - 1. Abstract
060444 -
060445 - There is little understanding of the reliability of laboratory
060446 - measurements among clinicians. Low-density lipoprotein
060447 - cholesterol (LDL-C) measurement is the cornerstone of
060448 - cardiovascular risk assessment and prevention, but it is
060449 - fraught with error.
060451 - ..
060452 - 2. Therefore, we have reviewed issues related to accuracy and
060453 - precision for the measurement of LDL-C and the related
060454 - markers non-high-density lipoprotein cholesterol
060455 - (non-HDL-C) and apolipoprotein B. Despite the widespread
060456 - belief that LDL-C is standardized and reproducible,
060457 - available data suggest that results can vary significantly
060458 - as the result of methods from different manufacturers.
060459 - Similar problems with direct HDL-C assays raise concerns
060460 - about the reliability of non-HDL-C measurement.
060462 - ..
060463 - 3. The root cause of method-specific bias relates to the
060464 - ambiguity in the definition of both LDL and HDL, and the
060465 - heterogeneity of LDL and HDL particle size and composition.
060466 -
060467 - [On 111125 2028 CNN television broadcast analysis saying
060468 - measuring LDL cholesterol is not effective for
060469 - evaluating coronary health risks, ref SDS 16 LJ7F,
060470 - recommends measuring small particle LDL cholesterol
060471 - using coronary calcium san techology. ref SDS 16 LW75
060473 - ..
060474 - [On 111128 0202 letter to medical team cites lab today
060475 - reporting LDL 200, ref SDS 17 EA4V, and asks about
060476 - increasing medication to rosuvastatin 20 mg or trying
060477 - some other line of care in order to reduce cholesterol
060478 - LDL < 70, ref SDS 17 EB3U, according to the VA work plan
060479 - on 110817 1030. ref SDS 12 DG36
060481 - ..
060482 - [On 111128 2038 increased medication to rosuvastatin 20 mg,
060483 - shown in case study on patient history on 101010 0744.
060484 - ref SDS 9 NV7I
060486 - ..
060487 - 4. Apolipoprotein B appears to provide a more reliable
060488 - alternative, but assays for it have not been as rigorously
060489 - tested as direct LDL-C and HDL-C assays.
060491 - ..
060492 - 5. Copyright © 2011 National Lipid Association. Published by
060493 - Elsevier Inc. All rights reserved.
060495 - ..
060496 - 6. PMID: 21784371 [PubMed - indexed for MEDLINE]
060497 -
060498 -
060499 -
060501 - ..
060502 - Another article says...
060503 -
060504 - 2. Pubmed.gov
060505 - US National Library of Medicine
060506 - National Institutes of Health
060507 -
060508 - Journal American Medical Association
060510 - ..
060511 - Date.................................... 2011 Aug 24;306(8):831-9
060513 - ..
060514 - Effect of a dietary portfolio of cholesterol-lowering foods
060515 - given at 2 levels of intensity of dietary advice on serum
060516 - lipids in hyperlipidemia: a randomized controlled trial
060517 -
060518 - http://www.ncbi.nlm.nih.gov/pubmed/21862744
060520 - ..
060521 - Authors: Jenkins DJ, Jones PJ, Lamarche B, Kendall CW,
060522 - Faulkner D, Cermakova L, Gigleux I, Ramprasath V, de Souza R,
060523 - Ireland C, Patel D, Srichaikul K, Abdulnour S, Bashyam B,
060524 - Collier C, Hoshizaki S, Josse RG, Leiter LA, Connelly PW,
060525 - Frohlich J.
060527 - ..
060528 - Clinical Nutrition and Risk Factor Modification Center, St
060529 - Michael's Hospital, 61 Queen St E, Toronto, ON M5C 2T2,
060530 - Canada. cyril.kendall@utoronto.ca
060532 - ..
060533 - 1. Abstract
060534 -
060535 - CONTEXT:
060537 - ..
060538 - Combining foods with recognized cholesterol-lowering
060539 - properties (dietary portfolio) has proven highly effective
060540 - in lowering serum cholesterol under metabolically
060541 - controlled conditions.
060543 - ..
060544 - 2. OBJECTIVE:
060545 -
060546 - To assess the effect of a dietary portfolio administered at
060547 - 2 levels of intensity on percentage change in low-density
060548 - lipoprotein cholesterol (LDL-C) among participants
060549 - following self-selected diets.
060551 - ..
060552 - 3. DESIGN, SETTING, AND PARTICIPANTS:
060553 -
060554 - A parallel-design study of 351 participants with
060555 - hyperlipidemia from 4 participating academic centers
060556 - across Canada (Quebec City, Toronto, Winnipeg, and
060557 - Vancouver) randomized between June 25, 2007, and February
060558 - 19, 2009, to 1 of 3 treatments lasting 6 months.
060560 - ..
060561 - 4. INTERVENTION:
060562 -
060563 - Participants received dietary advice for 6 months on either
060564 - a low-saturated fat therapeutic diet (control) or a dietary
060565 - portfolio, for which counseling was delivered at different
060566 - frequencies, that emphasized dietary incorporation of plant
060567 - sterols, soy protein, viscous fibers, and nuts. Routine
060568 - dietary portfolio involved 2 clinic visits over 6 months
060569 - and intensive dietary portfolio involved 7 clinic visits
060570 - over 6 months.
060572 - ..
060573 - 5. MAIN OUTCOME MEASURES:
060574 -
060575 - Percentage change in serum LDL-C.
060577 - ..
060578 - 6. RESULTS:
060579 -
060580 - In the modified intention-to-treat analysis of 345
060581 - participants, the overall attrition rate was not
060582 - significantly different between treatments (18% for
060583 - intensive dietary portfolio, 23% for routine dietary
060584 - portfolio, and 26% for control; Fisher exact test, P =
060585 - .33).
060587 - ..
060588 - 7. The LDL-C reductions from an overall mean of 171 mg/dL (95%
060589 - confidence interval [CI], 168-174 mg/dL) were -13.8% (95%
060590 - CI, -17.2% to -10.3%; P < .001) or -26 mg/dL (95% CI, -31
060591 - to -21 mg/dL; P < .001) for the intensive dietary
060592 - portfolio; -13.1% (95% CI, -16.7% to -9.5%; P < .001) or
060593 - -24 mg/dL (95% CI, -30 to -19 mg/dL; P < .001) for the
060594 - routine dietary portfolio; and -3.0% (95% CI, -6.1% to
060595 - 0.1%; P = .06) or -8 mg/dL (95% CI, -13 to -3 mg/dL; P =
060596 - .002) for the control diet.
060598 - ..
060599 - 8. Percentage LDL-C reductions for each dietary portfolio were
060600 - significantly more than the control diet (P < .001,
060601 - respectively). The 2 dietary portfolio interventions did
060602 - not differ significantly (P = .66). Among participants
060603 - randomized to one of the dietary portfolio interventions,
060604 - percentage reduction in LDL-C on the dietary portfolio was
060605 - associated with dietary adherence (r = -0.34, n = 157, P <
060606 - .001).
060608 - ..
060609 - 9. CONCLUSION:
060610 -
060611 - Use of a dietary portfolio compared with the low-saturated
060612 - fat dietary advice resulted in greater LDL-C lowering
060613 - during 6 months of follow-up.
060614 -
060616 - ..
060617 - 10. TRIAL REGISTRATION:
060618 -
060619 - clinicaltrials.gov Identifier: NCT00438425
060620 -
060622 - ..
060623 - Another article says...
060624 -
060625 - 3. Pubmed.gov
060626 - US National Library of Medicine
060627 - National Institutes of Health
060628 -
060629 - Journal of Pediatrics
060631 - ..
060632 - Date.................................... 1998 Aug;133(2):242-6
060634 - ..
060635 - Month-to-month variability of lipids, lipoproteins, and
060636 - apolipoproteins and the impact of acute infection in
060637 - adolescents.
060638 -
060639 - http://www.ncbi.nlm.nih.gov/pubmed/9709713
060641 - ..
060642 - Authors: Gidding SS, Stone NJ, Bookstein LC, Laskarzewski PM,
060643 - Stein EA.
060645 - ..
060646 - Department of Pediatrics, Northwestern University Medical
060647 - School, Chicago, Illinois, USA.
060648 -
060650 - ..
060651 - 1. Abstract
060652 -
060653 - OBJECTIVE:
060655 - ..
060656 - To assess month-to-month variability of total cholesterol,
060657 - triglycerides, high-density lipoprotein-cholesterol
060658 - (HDL-C), calculated low-density lipoprotein-cholesterol
060659 - (LDL-C), apolipoprotein A1, apolipoprotein B, and
060660 - lipoprotein (a), as well as factors that could influence
060661 - variability, including recent acute infection in an
060662 - adolescent population.
060664 - ..
060665 - 2. METHODS:
060666 -
060667 - Sixty-three high school students had fasting lipids and
060668 - lipoproteins measured at 4 separate times during the school
060669 - year and another venipuncture 3 to 7 days after recovery
060670 - from an acute infection. Erythrocyte sedimentation rate
060671 - was also measured. Coefficients of variation were
060672 - calculated for each study variable. The influence of
060673 - recent infection on variability was assessed.
060675 - ..
060676 - 3. RESULTS:
060677 -
060678 - The 50th and 95th percentiles, respectively, for the
060679 - coefficient of variation for each variable were as follows:
060680 - total cholesterol, 7.3% and 13.6%; triglycerides, 22% and
060681 - 47.3%; HDL-C, 7.9% and 16.8%; LDL-C, 12.1% and 25%;
060682 - apolipoprotein A1, 6.3% and 15.2%; apolipoprotein B, 9.5%
060683 - and 17.2%; and lipoprotein (a), 19.3% and 40%. Recent
060684 - infection significantly lowered HDL-C (4 mg/dL; P < .0001)
060685 - and apolipoprotein A1 (7 mg/dL; P < .005).
060687 - ..
060688 - 4. CONCLUSIONS:
060689 -
060690 - Clinicians evaluating lipids and lipoproteins serially
060691 - should expect significant visit-to-visit variation in
060692 - triglycerides and calculated LDL-C values. Assessment of
060693 - HDL-C and apolipoprotein A1 should not be done within 2
060694 - weeks of an acute infection. Apolipoproteins B and A1 have
060695 - slightly less variability than their respective lipoprotein
060696 - cholesterol values (LDL-C and HDL-C).
060698 - ..
060699 - PMID: 9709713 [PubMed - indexed for MEDLINE]
060700 -
060702 - ..
060703 - Another article says...
060704 -
060705 - 4. Pubmed.gov
060706 - US National Library of Medicine
060707 - National Institutes of Health
060708 -
060709 - Journal of Clinical Lipidology
060711 - ..
060712 - Clin Chem............................... 1988;34(8B):B84-94.
060714 - ..
060715 - Reliability of lipid, lipoprotein, and apolipoprotein
060716 - measurements
060717 -
060718 - http://www.ncbi.nlm.nih.gov/pubmed/3042204
060720 - ..
060721 - Author: Naito, HK
060722 -
060723 - Publications...
060724 -
060725 - http://www.ncbi.nlm.nih.gov/pubmed?term=%22Naito%20HK%22[Author]
060727 - ..
060728 - Department of Biochemistry, Cleveland Clinic Foundation, OH
060729 - 44195.
060731 - ..
060732 - 1. Abstract
060733 -
060734 - The National Heart, Lung, and Blood Institute national
060735 - awareness program on cholesterol and heart disease has
060736 - placed new demands on laboratorians to utilize and perform
060737 - more reliable measurements of lipids, lipoproteins, and
060738 - apolipoproteins.
060740 - ..
060741 - 2. The general public's awareness and the clinicians' concerns
060742 - about the reliability of laboratory testing make it
060743 - paramount that the analytical problems and issues are
060744 - identified and solutions are provided to increase the
060745 - current state of reliability of the measurement of these
060746 - blood constituents. To accomplish this, the initial step
060747 - is to assess the current state of reliability of lipid,
060748 - lipoprotein, and apolipoprotein measurements in the
060749 - clinical laboratories.
060751 - ..
060752 - 3. Accuracy and precision of measurements of total
060753 - cholesterol, triglycerides, high-density lipoprotein
060754 - cholesterol, and apolipoproteins A-I and B are extensively
060755 - discussed, and general as well as some specific
060756 - recommendations are provided for some of the apparent
060757 - problems.
060759 - ..
060760 - PMID: 3042204 [PubMed - indexed for MEDLINE]
060761 -
060762 -
060763 -
060764 -
060765 -
060766 -
0608 -
SUBJECTS
Default Null Subject Account for Blank Record
0703 -
070401 - ..
070402 - Rosuvastatin Side Effects Myopathy Muscle Pain
070403 - Myopathy Muscle Pain Side Effects Rosuvastatin
070404 -
070405 - Follow up ref SDS 14 DO5O. ref SDS 10 JQ5F.
070406 -
070407 - CARDIAC ENZYMES........ 2011 11 17 1427
070408 - PLASMA Results Units Range
070409 - CK 101 IntUnits/L 36 - 340
070410 - TRPONIN ng/ml 0 - 0.07
070411 - CK-MB ng/ml 0.6 - 3.5
070412 - MYOGLOB ng/ml 20 - 82
070413 -
070415 - ..
070416 - CK dropping from 110 for test 4 weeks ago to 111013, ref SDS 14 DO5O,
070417 - down to 101 is not significant.
070419 - ..
070420 - There has been significant improvement in shoulder range of motion
070421 - without pain, reviewed on 111013 1404. ref SDS 12 RG5L This was also
070422 - reported to Doctor Sandhu a few days later on 111018 0800. ref SDS 14
070423 - NP5G
070425 - ..
070426 - Not clear in the record what baseline to use for CK diagnostic, called
070427 - out on 111013 1404. ref SDS 12 RH3K
070428 -
070429 -
070430 -
070431 -
070432 -
070433 -
070434 -
070435 -
070436 -
0705 -