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Lipid-Lowering Agents HMG-CoA reductase inhibitors (statins) These agents inhibit the rate-limiting step in cholesterol biosynthesis by competitively inhibiting HMG-CoA reductase. Note the following: Low-density lipoprotein (LDL) reduction of 25%-60% Examples include Atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin Contraindications include hypersensitivity, active liver disease, pregnancy, lactation, coadministration with strong CYP3A4 inhibitors (selected statins) Vitamin B3 Vitamin B3 inhibits very-low-density lipoprotein (VLDL) synthesis. Note the following: LDL reduction of 10% High-density lipoprotein (HDL) increase of 20% Example includes Niacin (nicotinic acid) Contraindications include hypersensitivity, liver disease, active peptic ulcer, severe hypotension, arterial bleeding Fibrates Fibrates enhance lipoprotein lipase, resulting in increased VLDL catabolism, fatty acid oxidation, and triglycerides elimination. They decrease hepatic extraction of free fatty acids. Note the following: LDL reduction of 15% Triglyceride reduction of 35% Examples include Gemfibrozil, fenofibrate, fenofibrate (micronized), fenofibric acid Contraindications include active liver disease, renal disease, primary biliary cirrhosis, gallbladder disease 2-Azetidiones These agents inhibit sterol transporter at brush border and, consequently, intestinal absorption of cholesterol. LDL reduction of 15% Example includes Ezetimibe Contraindications include hypersensitivity, coadministration with statins (if active liver disease) Bile acid sequestrants These agents lower cholesterol and LDL via bile duct sequestration. Note the following: LDL reduction of 15% Examples include Cholestyramine, colesevelam, colestipol Contraindications include biliary/bowel obstruction, serum triglycerides >300-500 mg/dL, history of hypertriglyceridemia-induced pancreatitis
urgical management of proximal humerus fractures may be categorized either according to fracture type (eg, Neer type, anatomic type, greater tuberosity, surgical neck, anatomic neck, articular surface, lesser tuberosity fragments) or according to method of fixation (eg, closed reduction with no fixation, percutaneous fixation, open reduction with internal fixation [ORIF], humeral head replacement associated with tuberosity fixation
Prostate Cancer spreads in 3 ways. First is spreads by local growth. Second it spreads through the lymphatic system, and lastly, it spreads through the blood stream. Dr. Patrick Swift, a radiation oncologist, discusses how prostate cancer spreads.
Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition that affects millions of children and often continues into adulthood. ADHD includes a combination of persistent problems, such as difficulty sustaining attention, hyperactivity and impulsive behavior.
Virtual Ports, Ltd. (http://www.virtual-ports.com) is a medical device company developing and marketing instruments to improve minimally invasive laparoscopic procedures.
The EndoGrab retraction system reduces the number of ports needed for surgery by eliminating the need for traditional hand held retraction. For the surgeon, this simple solution results in the need for less auxiliary personnel, a decreased overall surgery cost, and more control over the surgery. The EndoGrab also offers added benefit to the patient who will experience less post-operative discomfort and scarring.
The EndoGrab is an internally anchored, hands-free retracting device that is introduced at the start of surgery through a 5mm trocar by means of a proprietary Applier tool. The Surgeon uses the Applier to attach the EndoGrab to both the organ requiring retraction and to the internal abdominal wall, thereby removing the organ from the operative field. The Applier is then removed and the port is free for use by other instruments.
3D video animation produced by Virtual Point Multimedia (http://virtual-point.com)
Shaken baby syndrome — also known as abusive head trauma, shaken impact syndrome, inflicted head injury or whiplash shake syndrome — is a serious brain injury resulting from forcefully shaking an infant or toddler. Shaken baby syndrome destroys a child's brain cells and prevents his or her brain from getting enough oxygen. Shaken baby syndrome is a form of child abuse that can result in permanent brain damage or death. Shaken baby syndrome is preventable. Help is available for parents who are at risk of harming a child. Parents also can educate other caregivers about the dangers of shaken baby syndrome.
UW Health orthopedic surgeon Richard Illgen has pioneered robotic-assisted knee replacement and serves as a regional and national expert in these techniques. Learn more: http://www.uwhealth.org/49421