scholarly journals Severe Hypertriglyceridemia-Induced Acute Pancreatitis

2021 ◽  
pp. 218-224
Author(s):  
Gyula Molnár ◽  
V. Anna Gyarmathy ◽  
Noémi Zádori ◽  
Péter Hegyi ◽  
Péter Kanizsai
Keyword(s):  
Acute Pancreatitis ◽  
Acute Abdominal Pain ◽  
Blood Cholesterol ◽  
Individual Factors ◽  
Lipid Levels ◽  
Human Monoclonal Antibodies ◽  
Pcsk9 Inhibitors ◽  
Severe Hypertriglyceridemia ◽  
The Right

The prevalence of familial hypercholesterolemia (FH) is about 1 in 200–500 in the general population, but approximately less than 1% of those affected are actually diagnosed. One of the most promising approaches to treat FH is utilizing human monoclonal antibodies. This is a case study describing a 47-year-old male patient who presented to the Emergency Department with acute abdominal pain caused by severe hypertriglyceridemia (HTG)-induced acute pancreatitis (AP). We report the steps necessary for establishing the right diagnosis and the management of HTG-induced AP, which are inevitable for the reduction of severity and mortality. This case study shows that hypercholesterolemia is an underdiagnosed and potentially lethal disease. Once diagnosed, all measures should be considered to control blood cholesterol and lipid levels. The decision to administer PCSK9 inhibitors should not be solely based on economical calculation, but rather individual factors should also be considered to weigh the risk/benefit ratio.

Hypertriglyceridemia: An Infrequent, Difficult-to-predict, Severe Metabolic and Vascular Problem Associated with Estrogen Administration

2020 ◽  
Vol 18 (3) ◽  
pp. 254-261
Author(s):  
Thomas F. Whayne
Keyword(s):  
Acute Pancreatitis ◽  
Severe Side Effect ◽  
Recurrent Acute Pancreatitis ◽  
Postmenopausal Symptoms ◽  
Severe Hypertriglyceridemia ◽  
Short Period ◽  
Cv Disease ◽  
The Right ◽  
And Control ◽  
Transdermal Route

Supplementary estrogen plays important roles for female patients as convenient birth control, relief of postmenopausal symptoms, and in the management of other selected problems. However, as is the case for essentially all medications, there are side effects. Short of a major pulmonary embolus, the most severe side effect of estrogen would appear to be sporadic, rare, and severe hypertriglyceridemia associated with acute pancreatitis. The occurrence of this fortunately rare problem usually happens in the presence of some preexisting and usually mild increase in triglycerides (TG). A case of chronic and severe recurrent acute pancreatitis is described in the introduction and the management was complete estrogen avoidance. Started close to menopause and continued for a relatively short period, estrogens may have some cardiovascular (CV) benefit but the general recommendation is not to prescribe them for CV disease prevention. Estrogens may contribute to decreased diabetes mellitus (DM) risk and control. Administration of estrogens by the transdermal route may decrease some problems such as venous thromboembolism (VTE) and elevation of TG. Administration of estrogen in the right situation brings significant benefit to the female patient but skillful, careful, and knowledgeable use is essential.

The Calculation of Turbulent Diffusion Coefficients in Aquatic Ecosystems

2019 ◽  
Vol 70 (11) ◽  
pp. 3903-3907
Author(s):  
Galina Marusic ◽  
Valeriu Panaitescu
Keyword(s):  
Transport Equation ◽  
Turbulent Diffusion ◽  
Diffusion Coefficients ◽  
Aquatic Ecosystems ◽  
Specific Area ◽  
Left Bank ◽  
The Right ◽  
Prut River

The paper deals with the issues related to the pollution of aquatic ecosystems. The influence of turbulence on the transport and dispersion of pollutants in the mentioned systems, as well as the calculation of the turbulent diffusion coefficients are studied. A case study on the determination of turbulent diffusion coefficients for some sectors of the Prut River is presented. A new method is proposed for the determination of the turbulent diffusion coefficients in the pollutant transport equation for specific sectors of a river, according to the associated number of P�clet, calculated for each specific area: the left bank, the right bank and the middle of the river.

Traditionalism and politics: A case study of Northern Nigeria

1967 ◽  
Vol 2 (4) ◽  
pp. 509-524 ◽  
Author(s):  
B. J. O. Dudley
Keyword(s):  
Social Change ◽  
Local Government ◽  
Status Quo ◽  
Political Elite ◽  
High Time ◽  
The Political ◽  
Northern Nigeria ◽  
The North ◽  
The Right

In the debate on the Native Authority (Amendment) Law of 1955, the late Premier of the North, Sir Ahmadu Bello, Sardauna of Sokoto, replying to the demand that ‘it is high time in the development of local government systems in this Region that obsolete and undemocratic ways of appointing Emirs’ Councils should close’, commented that ‘the right traditions that we have gone away from are the cutting off of the hands of thieves, and that has caused a lot of thieving in this country. Why should we not be cutting (off) the hands of thieves in order to reduce thieving? That is logical and it is lawful in our tradition and custom here.’ This could be read as a defence against social change, a recrudescence of ‘barbarism’ after the inroads of pax Britannica, and a plea for the retention of the status quo and the entrenched privilege of the political elite.

Targeting the Cholesterol Paradigm in the Risk Reduction for Atherosclerotic Cardiovascular Disease: Does the Mechanism of Action of Pharmacotherapy Matter for Clinical Outcomes?

2021 ◽  
pp. 107424842110236
Author(s):  
Ruihai Zhou ◽  
George A. Stouffer ◽  
Sidney C. Smith
Keyword(s):  
Cardiovascular Disease ◽  
Clinical Outcomes ◽  
Mechanism Of Action ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Blood Cholesterol ◽  
Atherosclerotic Cardiovascular Disease ◽  
Pcsk9 Inhibitors ◽  
Cholesterol Lowering ◽  
Cholesterol Levels

Hypercholesterolemia is a well-established risk factor for atherosclerotic cardiovascular disease (ASCVD). Low-density lipoprotein cholesterol (LDL-C) has been labeled as “bad” cholesterol and high-density lipoprotein cholesterol (HDL-C) as “good” cholesterol. The prevailing hypothesis is that lowering blood cholesterol levels, especially LDL-C, reduces vascular deposition and retention of cholesterol or apolipoprotein B (apoB)-containing lipoproteins which are atherogenic. We review herein the clinical trial data on different pharmacological approaches to lowering blood cholesterol and propose that the mechanism of action of cholesterol lowering, as well as the amplitude of cholesterol reduction, are critically important in leading to improved clinical outcomes in ASCVD. The effects of bile acid sequestrants, fibrates, niacin, cholesteryl ester transfer protein (CETP) inhibitors, apolipoprotein A-I and HDL mimetics, apoB regulators, acyl coenzyme A: cholesterol acyltransferase (ACAT) inhibitors, cholesterol absorption inhibitors, statins, and proprotein convertase subtilisin kexin 9 (PCSK9) inhibitors, among other strategies are reviewed. Clinical evidence supports that different classes of cholesterol lowering or lipoprotein regulating approaches yielded variable effects on ASCVD outcomes, especially in cardiovascular and all-cause mortality. Statins are the most widely used cholesterol lowering agents and have the best proven cardiovascular event and survival benefits. Manipulating cholesterol levels by specific targeting of apoproteins or lipoproteins has not yielded clinical benefit. Understanding why lowering LDL-C by different approaches varies in clinical outcomes of ASCVD, especially in survival benefit, may shed further light on our evolving understanding of how cholesterol and its carrier lipoproteins are involved in ASCVD and aid in developing effective pharmacological strategies to improve the clinical outcomes of ASCVD.

scholarly journals Fieldwork on epistemic authority markers: What we can learn from different types of data

2020 ◽  
Vol 54 (2) ◽  
pp. 405-445 ◽  
Author(s):  
Karolina Grzech
Keyword(s):  
Data Collection ◽  
Discourse Markers ◽  
Epistemic Modality ◽  
Linguistic Meaning ◽  
Epistemic Authority ◽  
Data Collection And Analysis ◽  
The Right To Know ◽  
Cognitive Study ◽  
The Right

AbstractEpistemicity in language encompasses various kinds of constructions and expressions that have to do with knowledge-related aspects of linguistic meaning (cf. Grzech, Karolina, Eva Schultze-Berndt and Henrik Bergqvist. 2020c. Knowing in interaction: an introduction. Folia Linguistica [this issue]). It includes some well-established categories, such as evidentiality and epistemic modality (Boye, Kasper. 2012. Epistemic meaning: A crosslinguistic and functional-cognitive study. Berlin: De Gruyter Mouton), but also categories that have been less well described to-date. In this paper, I focus on one such category: the marking of epistemic authority, i.e. the encoding of “the right to know or claim” (Stivers, Tanya, Lorenza Mondada & Jakob Steensig. 2011b. Knowledge, morality and affiliation in social interaction. In Stivers et al. 2011a). I explore how the marking of epistemic authority can be documented and analysed in the context of linguistic fieldwork. The discussion is based on a case study of Upper Napo Kichwa, a Quechuan language spoken in the Ecuadorian Amazon that exhibits a rich paradigm of epistemic discourse markers, encoding meanings related to epistemic authority and distribution of knowledge between discourse participants. I describe and appraise the methodology for epistemic fieldwork used in the Upper Napo Kichwa documentation and description project. I give a detailed account of the different tools and methods of data collection, showing their strengths and weaknesses. I also discuss the decisions made at the different stages of the project and their implications for data collection and analysis. In discussing these issues, I extrapolate from the case study, proposing practical solutions for fieldwork-based research on epistemic markers.

Unemployment in the Affective Economy: Exploring the Affective Governing of Young Unemployed People in the Danish Welfare State

2020 ◽  
Vol 66 (3) ◽  
pp. 335-361
Author(s):  
Sabina Pultz
Keyword(s):  
Welfare State ◽  
Complex Relationship ◽  
Field Observations ◽  
Unemployed People ◽  
Political Implications ◽  
Governmentality Studies ◽  
The Right ◽  
The Unemployed ◽  
The Ideal

Abstract This case study investigates the affective governing of young unemployed people, and it concludes that getting money in the Danish welfare state comes with an “affective price”. In the quest for a job, unemployed people have been increasingly responsibilized in order to live up to the ideal of the active jobseeker. Consequently, when faced with unemployment, they are encouraged to work harder on themselves and their motivation. Based on an interview study with young unemployed people (N=39) and field observations made at employment fund agencies in Denmark (2014–15), I explore how young unemployed people are governed by and through their emotions. By supplementing governmentality studies (Foucault et al. 1988, 2010) with the concept of “affective economy” from Ahmed (2014), I discuss how young unemployed people who receive money from the Danish state are placed in a situation of debt. The paper unfolds how this debt becomes visible as the unemployed people often describe feeling under suspicion for not doing enough, for not being motivated enough. Through an abundance of (pro) activity, they have to prove the suspicion of being lazy wrong, and through managing themselves as active jobseekers, they earn the right to get money from the state. Here motivation, passion and empowerment are key currencies. I discuss the intricate interplay between monetary and affective currencies as well as political implications in the context of the Danish welfare. The article contributes by making visible the importance of taking affective matters into account when investigating the complex relationship between politics and psychology.

scholarly journals Familial Chylomicronemia Syndrome-Induced Acute Necrotizing Pancreatitis during Pregnancy

2021 ◽  
Vol 43 (03) ◽  
pp. 220-224
Author(s):  
Julia Cristina Coronado Arroyo ◽  
Marcio José Concepción Zavaleta ◽  
Eilhart Jorge García Villasante ◽  
Mikaela Kcomt Lam ◽  
Luis Alberto Concepción Urteaga ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Pancreatic Necrosis ◽  
Clinical Course ◽  
Necrotizing Pancreatitis ◽  
Rare Condition ◽  
Severe Hypertriglyceridemia ◽  
Fetal Complications ◽  
Acute Necrotizing ◽  
History Of ◽  
Important Objective

AbstractAcute pancreatitis is a rare condition in pregnancy, associated with a high mortality rate. Hypertriglyceridemia represents its second most common cause. We present the case of a 38-year-old woman in the 24th week of gestation with a history of hypertriglyceridemia and recurrent episodes of pancreatitis. She was admitted to our hospital with acute pancreatitis due to severe hypertriglyceridemia. She was stabilized and treated with fibrates. Despite her favorable clinical course, she developed a second episode of acute pancreatitis complicated by multi-organ dysfunction and pancreatic necrosis, requiring a necrosectomy. The pregnancy was ended by cesarean section, after which three plasmapheresis sessions were performed. She is currently asymptomatic with stable triglyceride levels. Acute pancreatitis due to hypertriglyceridemia represents a diagnostic and therapeutic challenge in pregnant women, associated with serious maternal and fetal complications. When primary hypertriglyceridemia is suspected, such as familial chylomicronemia syndrome, the most important objective is preventing the onset of pancreatitis.

HOUSEHOLD FORMATION IN 19TH-CENTURY CENTRAL ANATOLIA: THE CASE STUDY OF A TURKISH-SPEAKING ORTHODOX CHRISTIAN COMMUNITY

2002 ◽  
Vol 34 (3) ◽  
pp. 495-517
Author(s):  
Irini Renieri
Keyword(s):  
Central Anatolia ◽  
Household Formation ◽  
Greek Orthodox ◽  
Christian Community ◽  
Orthodox Christian ◽  
Complex Forms ◽  
The Right ◽  
Extended Households ◽  
The Village

This article explores household formation among the Greek Orthodox population of a mixed village of Cappadocia inhabited by Muslims, as well. The village, Çukur, was located on the right bank of the river Kızılırmak, 49 kilometers north–northwest of Kayseri.1 I aim to show that complex forms of household formation were the main type of social organization and were especially durable over time, with a high average household membership. I attempt to clarify whether the predominance of extended households—which, as other studies have shown, is not that common in the Asian portion of the Ottoman Empire—was related to the Christian character of this section of the Çukur population, or whether the agricultural basis of the village economy played a more important role.

scholarly journals Minilaparotomy a Good Option in Specific Cases: A Case Report of Bilateral Ovarian Germ Cell Tumor

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
D. Bolla ◽  
N. Deseö ◽  
A. Sturm ◽  
A. Schöning ◽  
C. Leimgruber
Keyword(s):  
Acute Abdominal Pain ◽  
Adnexal Mass ◽  
Past History ◽  
Ovarian Tissue ◽  
Abdominal Cavity ◽  
Operating Time ◽  
Expectant Management ◽  
Small Incision ◽  
Risk Of Rupture ◽  
The Right

Mature cystic teratomas (MCTs) of the ovary represent 44% of ovarian neoplasmas. The surgical approach is important in young women especially for the cosmetic results. Nowadays most of the ovarian surgeries can be performed laparoscopically. An alternative between laparoscopy and laparotomy is the minilaparotomy (ML) which can be an interesting option, thanks to the small incision. We report a 39-year-old woman who was referred to our hospital with acute abdominal pain. In her past history the patient had an uncomplicated delivery. During pregnancy a 6 cm bilateral MCT was diagnosed and expectant management was followed. A left-sided ovarial torsion was postulated, and laparoscopic detorsion was performed. To avoid a rupture of the left MCT, the operation was interrupted. To remove the cyst, a ML was done two weeks later. A left-sided salpingo-oophorectomy was performed due to a large cyst including the entire ovary. On the other side, the right dermoid cyst was entirely removed. The advantage of a ML is not only shorter operating time with less learning curve compared to laparoscopy but also the possibility to extract the adnexal mass from the abdominal cavity with lower risk of rupture and in addition the possibility to preserve more ovarian tissue.

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