Wednesday, February 29, 2012
Thursday, February 16, 2012
Monday, February 13, 2012
Hypercholesterolemia
Hypercholesterolemia:
Various clinical practice guidelines have addressed the treatment of hypercholesterolemia. The American College of Physicians has addressed hypercholesterolemia in patients with diabetes.[24] Their four recommendations are:
Various clinical practice guidelines have addressed the treatment of hypercholesterolemia. The American College of Physicians has addressed hypercholesterolemia in patients with diabetes.[24] Their four recommendations are:
- Lipid-lowering therapy should be used for secondary prevention of cardiovascular mortality and morbidity for all patients (both men and women) with known coronary artery disease and type 2 diabetes.
- Statins should be used for primary prevention against macrovascular complications in patients (both men and women) with type 2 diabetes and other cardiovascular risk factors.
- Once lipid-lowering therapy is initiated, patients with type 2 diabetes mellitus should be taking at least moderate doses of a statin (the accompanying evidence report states "simvastatin, 40 mg/d; pravastatin, 40 mg/d; lovastatin, 40 mg/d; atorvastatin, 20 mg/d; or an equivalent dose of another statin").[25]
lung Noules follow up
Fleischner Society Recommended Guidelines for follow-up and management of
nodules detected incidentally during non-screening CT examinations.
(MacMahon et al, Radiology 2005: 237; 395-400.)
NODULE SIZE (mm) - LOW-RISK PATIENT
? 4 No further follow up.
>4-6 CT at 12 months, if unchanged, no further follow-up.
>6-8 CT at 6-12 months then at 18-24 months if no change.
>8 CT at around 3, 9, and 24 months; or PET or biopsy.
NODULE SIZE (mm) - HIGH-RISK PATIENT
?4 CT at 12 mo, if unchanged, no further follow-up.
>4-6 CT at 6-12 mo then at 18-24 months if no change.
>6-8 CT at 3-6 mo then at 9-12 and 24 months if no change.
>8 CT at around 3, 9, and 24 months; or PET or biopsy.
nodules detected incidentally during non-screening CT examinations.
(MacMahon et al, Radiology 2005: 237; 395-400.)
NODULE SIZE (mm) - LOW-RISK PATIENT
? 4 No further follow up.
>4-6 CT at 12 months, if unchanged, no further follow-up.
>6-8 CT at 6-12 months then at 18-24 months if no change.
>8 CT at around 3, 9, and 24 months; or PET or biopsy.
NODULE SIZE (mm) - HIGH-RISK PATIENT
?4 CT at 12 mo, if unchanged, no further follow-up.
>4-6 CT at 6-12 mo then at 18-24 months if no change.
>6-8 CT at 3-6 mo then at 9-12 and 24 months if no change.
>8 CT at around 3, 9, and 24 months; or PET or biopsy.