Hvidbergcormier5188

Background Androgen deprivation therapy (ADT) is widely used in the treatment of testosterone-dependent prostate carcinomas. ADT often increases plasma LDL and HDL cholesterol and triglycerides. The aim was to test whether ADT changes the transfer of lipids to HDL, an important aspect of this metabolism and HDL protective functions, and related parameters. Methods Sixteen volunteers with advanced prostate carcinoma submitted to pharmacological ADT or orchiectomy had plasma collected shortly before and after 6 months of ADT. In vitro transfer of lipids to HDL was performed by incubating plasma with donor emulsion containing radioactive lipids by 1 h at 37 °C. After chemical precipitation of apolipoprotein B-containing lipoprotein, the radioactivity of HDL fraction was counted. Results ADT reduced testosterone to nearly undetectable levels and markedly diminished PSA. ADT increased the body weight but glycemia, triglycerides, LDL and HDL cholesterol, HDL lipid composition and CETP concentration were unchanged. However, ADT increased the plasma unesterified cholesterol concentration (48 ± 12 vs 56 ± 12 mg/dL, p = 0.019) and LCAT concentration (7.15 ± 1.81 vs 8.01 ± 1.55μg/mL, p = 0.020). Transfer of unesterified (7.32 ± 1.09 vs 8.18 ± 1.52%, p less then 0.05) and esterified cholesterol (6.15 ± 0.69 vs 6.94 ± 1.29%, p less then 0.01) and of triglycerides (6.37 ± 0.43 vs 7.18 ± 0.91%, p less then 0.001) to HDL were increased after ADT. Phospholipid transfer was unchanged. Conclusion Increase in transfer of unesterified and esterified cholesterol protects against cardiovascular disease, as shown previously, and increased LCAT favors cholesterol esterification and facilitates the reverse cholesterol transport. Thus, our results suggest that ADT may offer anti-atherosclerosis protection by improving HDL functional properties. This could counteract, at least partially, the eventual worse effects on plasma lipids.Background Rare diseases may be life-threatening or chronically debilitating conditions. Patient care needs are often complex and challenging to coordinate and deliver effectively. Rare diseases and their clinical management may therefore substantially impact on patients' health-related quality of life (HRQOL). The use of patient-reported outcome measures (PROMs) may complement clinical assessments by elucidating patients' perspectives on their health status and care priorities. This study explored the opinions of patients and clinicians on the use of PROMs in the management of patients with rare diseases in routine clinical practice. Methods A total of 15 semi-structured one-to-one interviews were conducted with four patients with primary sclerosing cholangitis (PSC); five renal transplant recipients; and six PSC doctors from University Hospitals Birmingham (UHB) NHS Foundation Trust. A focus group session was also conducted with 10 clinical staff members (doctors, nurses and other allied health professionalo patients and encouraging patient involvement in their care. They also felt that the disease-specific CLDQ and PedsQL-TM were more relevant than the generic SF12 and EQ-5D. Conclusions Patients with rare diseases often experience impaired HRQOL. The use of an ePROM system may enhance the routine management of patients with rare diseases.Background Lifestyle behaviours are potential risk factors for disease and mortality, but less is known about the association with health in retirement age. The aim of this paper was to study the prevalence, clustering and combined effects of lifestyle behaviours and their association with health outcomes in the first decade after retirement in a Norwegian cohort. Methods Participants were 55-64-year-olds at baseline in the Nord-Trøndelag Health Survey 2 (HUNT2, 1995-97) who also participated in HUNT3 (2006-08). Logistic regression analyses were used to investigate the association of daily smoking, physical inactivity, risky alcohol consumption, disturbed sleep duration, excessive sitting time and low social participation before retirement with self-rated health (n = 4022), life satisfaction (n = 5134), anxiety (n = 4461) and depression (n = 5083) after retirement, 11 years later. 1-Azakenpaullone molecular weight Results Low social participation and physical inactivity were the most prevalent lifestyle behaviours (41.1 and 40.6%). Risky alcohol consumption and disturbed sleep were the lifestyle behaviours most strongly associated with poor self-rated health, poor life satisfaction and anxiety after retirement (OR's = 1.39-1.92). Physical inactivity was additionally associated with depression (OR = 1.44 (1.12-1.85)). Physical inactivity had the largest population attributable fractions for reducing poor self-rated health and depression (14.9 and 8.8%). An increasing number of lifestyle risk behaviours incrementally increased the risk for the adverse health outcomes. Conclusions Risky alcohol consumption and disturbed sleep duration were most strongly associated with poor health outcomes after retirement age. On a population level, increased physical activity before retirement had the largest potential for reducing adverse health outcomes after retirement age.Background Implementing evidence-based management of dyslipidaemia is a challenge worldwide. Objectives To understand physician beliefs and behaviour and identify uncertainties in dyslipidaemia management across four world regions. Methods Web-based survey of 1758 physicians in Japan, Germany, Colombia and the Philippines who were selected randomly from existing databases. Key inclusion criteria were 1) for cardiologists and diabetes/endocrinology specialists ≥50 dyslipidaemia patients examined in the last month; 2) for specialists in neurology/neurosurgery/stroke medicine ≥50 dyslipidaemia patients and ≥ 20 patients with a history of ischaemic stroke examined in the last month; and 3) for specialists in nephrology and general medicine based at centres with ≥20 beds and ≥ 50 dyslipidaemia patients examined in the last month. The self-report survey covered dyslipidaemia management, target low-density lipoprotein cholesterol (LDL-C) levels in different patient groups, and statin safety. All physicians gave voluntary consent and all data were anonymised.