Treatment of Dyslipidaemia in Children

Childhood dyslipidaemia is one of the main traditional cardiovascular risk factors that initiate and exacerbate the atherosclerotic process. Healthcare providers may play a key role in the management of children with lipid abnormalities; however, they have to properly evaluate the normal lipid values and know the available treatment options in children and adolescents. Current guidelines recommend healthy behaviours as the first-line treatment for childhood dyslipidaemia. The therapeutic lifestyle changes should focus on dietary modifications, daily physical activity, reduction in body weight and tobacco smoking cessation. Parents play a key role in promoting their children’s healthy habits. In children with more severe forms of lipid abnormalities and in those who do not benefit from healthy behaviours, pharmacological therapy should be considered. Safe and effective medications are already available for children and adolescents. Statins represent the first-line pharmacological option, while ezetimibe and bile acid sequestrants are usually used as second-line drugs. Despite their limited use in children, other lipid-lowering agents (already approved for adults) are currently available or under study for certain categories of paediatric patients (e.g., familial hypercholesterolemia). Further studies are needed to evaluate the long-term efficacy, safety and tolerability of novel lipid-lowering drugs, especially in children.

Type 2 diabetes remission: How does it work?

Type 2 diabetes mellitus (Type 2 DM) is a chronic disease which rise is closely linked to the obesity epidemic and which requires long-term medical attention to limit the development of its wide-ranged complications. Many of these complications arise from the combination of resistance to insulin action, inadequate insulin secretion, and excessive or inappropriate glucagon secretion. The increasing evidence of its remission state has been discussed in the literature. Here we report on a patient with metabolic syndrome who underwent a structured therapeutic lifestyle changes (TLC) therapy which eventually led to remission of Type 2 DM.

The Effect of Moderate Intensity Fun Aerobic Gym on HDL-C and LDL- C on Overweight Women

Overweight and obesity is a major health problem in throughout the world. Hyperlipidemia and obesity are risk factor the occurrence of cardiovascular disease. Exercise is recommended as a therapeutic lifestyle changes because it leads to a variety of health benefits. Fun Aerobic gymnastics aerobics one which is quite popular in the community and a gym. Describe the gymnastics fun aerobic workout's effectiveness against related to prevention of cardiovascular disease with seeing the results before and after doing gymnastics with the result of increasing levels of HDL-c and LDL/HDL Ratios as well as lowering LDL-c levels. Using design research one group pretest and posttest design with the subject as many as 19 people and given gymnastics moderate fun aerobic intensity for 45 minutes 3 day a week for 6 weeks. Gymnastics moderate fun aerobic intensity can increase HDL-c and LDL/HDL ratio and LDL-c. The paired t test results HDL-c pre test and post test (p = 0.000), LDL-c pre test and post test (p = 0,015), HDL/LDL Ratio (p = 0.000). Mean there are meaningful difference between the before and after of gymnastics. The effect of moderate intensity fun aerobic gym on the increase of HDL-c and LDL/HDL Ratio and a decrease in LDL-c in overweight women.

Intra-coronary Imaging for the Evaluation of Plaque Modifications Induced by Drug Therapies for Secondary Prevention

Purpose of Review Patients diagnosed with coronary artery disease are at a high risk of subsequent cardiovascular events; therefore, secondary prevention in the form of therapeutic lifestyle changes, and drug therapies is vital. This article aims to review potential application of intra-coronary imaging for the evaluation of plaque modifications, induced by medications for secondary prevention for CAD. Recent Findings Intra-coronary imaging provides detailed information on the atherosclerotic plaque which is the primary pathological substrate for the recurrent ischemic cardiovascular events. These modalities can detect features associated with high risk and allow serial in vivo imaging of lesions. Therefore, intravascular imaging tools have been used in landmark studies and played a role in improving our understanding of the disease processes. Summary Changes in size and plaque composition over time can be evaluated by these tools and may help understanding the impact of a treatment. Moreover, surrogate imaging end points can be used when testing new drugs for secondary prevention.

PENGARUH THERAPEUTIC LIFESTYLE CHANGES (TLCs) TERHADAP KUALITAS HIDUP LANSIA HIPERTENSI

ABSTRAKKehadiran penyakit kronis salah satunya adalah hipertensi di kalangan lansia memberikan risiko penurunan fungsional pada populasi lansia dan dapat mempengaruhi kualitas hidup lansia. Salah satu penatalaksanaan hipertensi pada lansia adalah melakukan modifikasi perilaku atau gaya hidup lansia itu sendiri atau lebih dikenal denganTherapeutic Lifestyle Changes for hypertension (TLCs). Tujuan penelitian ini adalah pengaruh Therapeutic Lifestyle Changes (TLCs) terhadap kualitas hidup lansia dengan hipertensi.Desain penelitian yang digunakan adalah Pre Eksperimental Design (quasi experiment) dengan pretest-posttest with control group. Jumlah sampel yang digunakan adalah 64 sampel terdiri dari 32 responden pada kelompok intervensi dan kelompok kontrol. Analisis data statistic menggunakan T test independen dan Mann-Whitney test.Uji beda rata-rata menunjukan terdapat pengaruh therapeutic lifestyle changes terhadap kualitas hidup lansia dengan hipertensi pada kelompok intervensi pada domain Aktifitas pada masa lampau kini dan yang akan datang (p value 0.020), domain partisipasi sosial (p value 0.000) dan domain persahabatan dan cinta kasih (p value 0.020), sedangkan uji beda rata-rata pada kelompok intervensi dan kontrol didapatkan pengaruh kualitas lansia dengan hipertensi (p value 0.000).Kata Kunci : Therapeutic Lifestyle Changes, Kualitas hidup ABSTRACTThe presence of chronic diseases, one of which is hypertension among the elderly provides a risk of functional decline in the elderly population and can affect the quality of life of the elderly. One of the management of hypertension in the elderly is to modify the behavior or lifestyle of the elderly itself or better known as Therapeutic Lifestyle Changes for hypertension (TLCs). The purpose of this study is the effect of Therapeutic Lifestyle Changes (TLCs) on the quality of life of the elderly with hypertension.The research design used was Pre Experimental Design (quasi experiment) with pretest-posttest with control group. The number of samples used was 64 samples consisting of 32 respondents in the intervention group and the control group. Statistical data analysis using independent T test and Mann-Whitney test.The average difference test shows there is an effect of therapeutic lifestyle changes on the quality of life of the elderly with hypertension in the intervention group in the past and present domains of activity (p value 0.020), the domain of social participation (p value 0.000) and the domain of friendship and love you (p value 0.020). while the average difference test in the intervention and control group was influenced by the quality of the elderly with hypertension (p value 0.000).Keywords: Therapeutic Lifestyle Changes, Quality of life

Das polyzystische Ovarsyndrom: Aktuelle Evidenz und praktische Empfehlungen

Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women of childbearing age. Due to hyperandrogenism and chronic anovulation affected women may suffer from hirsutism, androgenetic alopecia, acne, menstrual disturbance and sub-/infertility. Furthermore underlying insulin resistance promotes hyperandrogenemia, overweight and risk for diabetes. Therefore, routine evaluation of glycemic status is recommended. Treatment strategies are based on therapeutic lifestyle changes and focus on patient-important complaints. First line pharmacologic treatment for infertility in women with PCOS is letrozole. Clomiphene and metformin can be used alternatively with lower success rates. Women seeking medical advice for hyperandrogenism can be offered oral contraceptive pills with the lowest effective estrogen dose without any preference of a certain gestagen. Risk for deep vein thrombosis should be taken into account when choosing estrogen dose and type of gestagen. Antiandrogen substances such as spironolactone should only be prescribed in combination with safe contraception due to their risk of fetal undervirilisation. Additionally, substance specific risks should be considered. Baseline treatment of overweight or metabolic issues includes behaviour modification, weight reduction and physical activity. Additional benefit can be reached by combination of lifestyle changes with metformin. Studies indicate a positive effect of inositol and antidiabetic substances like liraglutide and empagliflozin but should be regarded as experimental therapies.