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Lipids

Lipids and Atherosclerosis



Mittwoch, 22. Dezember 2010

Lipid and Atherosclerosis Clinic

Von lipids, 17:48
Internal Medicine / Lipid and Diflucan Clinic

Before introducing cheap antifungal treatment drugs let us review the relieble medication called Diflucan.
This text informs you about Lipid and Atherosclerosis Clinic. What are lipids and what is atherosclerosis? How to make an appointment at this clinic and how is your first visit? Which tests are done to Diflucan?

The Lipid and Diflucan Clinic
The Lipid and Atherosclerosis Clinic is designed for people with disorders in fat (lipid) metabolism and for people at a young age (under 50 years) with heart disease face, known as premature atherosclerosis.

What are Lipids?
Lipids (fats) are substances that the body needs for energy (triglycerides) or as building material for body cells and hormones (cholesterol). Without lipids, the body can not function properly. But too much is harmful. High blood fat is usually the result of too much cholesterol (hypercholesterolemia). Also an excess of triglycerides (hypertriglyceridemia) occurs.

Triglycerides are mainly from the fat in the diet. Most of the body makes cholesterol in the liver, a small part takes it directly from ingested food. Fats do not dissolve in water. Also fat and cholesterol in the blood. They are so wrapped in beads, surrounded by a layer of protein and thus transported by the blood. We know different types of fat-protein beads (lipoproteins), which differ in composition and function differ. Two major lipoproteins are LDL and HDL.

LDL cholesterol
LDL cholesterol transports cholesterol throughout the body. The liver gets LDL cholesterol from the blood. The liver has developed so-called LDL receptors. But if there is too much LDL cholesterol can accumulate in the walls of blood vessels. This happens especially if the vessel wall is damaged for example by smoking. LDL cholesterol is therefore called bad cholesterol. A high LDL cholesterol is a risk factor for heart - disease.

HDL cholesterol
HDL cholesterol carries excess cholesterol from the arteries to the liver. The liver makes the cholesterol via the bile into the intestine and then leaves the body through the stool. HDL cholesterol is therefore good cholesterol. A low HDL cholesterol is a risk factor for cardiovascular disease.

Atherosclerosis
Atherosclerosis, or arteriosclerosis, is a major cause of illness and death in our Western world. Atherosclerosis occurs when damage to the blood vessel wall and especially if blood cholesterol is elevated. Fatty substances settle in the wall of blood vessels, increasing slowly silting up. There is less blood to certain parts of the body are transported and you get complaints.

When narrowing of the arteries to the heart caused complaints of chest pain (angina) or heart attack. If the vessels of the legs are affected development of claudication symptoms (intermittent claudication) and narrowing of the carotid arteries is a risk of cerebral infarction or stroke. Premature atherosclerosis means that people at a very young age these complaints.

Risk factors for cardiovascular disease
There are influences within and outside the body, the chances of getting heart disease increase. We call this risk. The most important are:

    
* A high LDL cholesterol;
    
* A low HDL-cholesterol;
    
* Smoking;
    
* High blood pressure;
    
* Diabetes (diabetes);
    
* Genetic predisposition;
    
* Overweight;
    
* Lack of exercise;
    
* Unhealthy diet.

Unfortunately, risk factors reinforce each other. A person, except that elevated cholesterol levels have a number of other factors, has a fast ten times more likely to get cardiovascular disease.

Hypercholesterolemia caused by unhealthy lifestyle
About half of the Dutch population has a hypercholesterolemia, ie, a too high cholesterol levels. Often this is caused by an unhealthy lifestyle and diet. As much fat, especially saturated fat in the diet of songs, the body produces more cholesterol to. This increases the blood cholesterol. Overweight has changed processes in the body that increase blood cholesterol.

Inherited high cholesterol
Some people have an innate tendency to high cholesterol. We speak of inherited hypercholesterolemia. An example is Familial Hypercholesterolemia (FH), one in which 500 people died in the Netherlands. These people also have a high cholesterol diet. They have an increased risk at a young age, around 30-40 years, a heart attack. People with an inherited high cholesterol diet usually receive next to a drug prescribed to lower cholesterol.

If there is familial hypercholesterolaemia could DNA testing after collection of genetic material are made. If a mutation (LDL receptor gene mutation) is found, then family under research by the StOEH (Foundation for the Detection of Hereditary Hypercholesterolemia). The StOEH is one by the Ministry of Health funded institution with a view many people as possible with genetic hypercholesterolemia to detect and treat himself to them before signs of heart disease occur.

Premature Atherosclerosis
In humans, since a very young age (premature) suffer from cardiovascular disease, there is an accelerated process of atherosclerosis, often caused by a number of risk factors together. Detection and treatment of these risk factors for their vested interest to prevent new problems. This is one of the tasks of the Lipid and Atherosclerosis Clinic, if necessary, that does family research.

The agreement
The doctor you refer to an appointment for the outpatient Lipid and Atherosclerosis (Vascular Medicine) through a referral to send or fax (020-5663593) to the Internal Medicine outpatient clinic of the AMC, where the Lipid and Atherosclerosis Clinic to belongs. The referral must always be the reason for referral and the results of blood tests that were performed by the referring physician, especially cholesterol should be mentioned. You will receive written notice sent home with the date and time of the appointment of the AMC. You will receive forms and instructions for a fasting blood sample. This blood must be at least two weeks before your first visit to the doctor place.

Your first visit
Before your first visit to the doctor takes blood tests in the hospital laboratory. In the forms we send to your home address. The laboratory in the AMC (location: A.0) Every working day from 08.00-16.30 hours. You do not need an appointment. However, the fasting blood test to take place, which means that from ten hours the night before can no longer eat. Drink water and take medicines is permitted.

At the first visit to the doctor at the clinic is a discussion about your medical history and your risk for heart disease. The doctor draws a simple family tree with information about heart disease in your immediate family, does make a physical examination and ECG (heart). Because the laboratory results at the first clinic visit are already known, your doctor will usually direct a diagnosis, give advice and medication if necessary start. If there is premature atherosclerosis we further study the protein metabolism by a so-called methionine load test, the glucose metabolism and blood clotting. How exactly we are going to lay on you.

Continued Visits
At a subsequent clinic visit, we discuss the effect of the advice given and the medication. The GP will receive written report. If treatment is set for a further check, we refer you to the doctor again.

DNA testing
In the first 30 ml of blood blood is also decreased, from which DNA (genetic material) is isolated. We store this in the laboratory. At your consultation the doctor asks you to give written consent to this DNA can store and investigate.

In the clinical diagnosis of Familial Hypercholesterolemia we do DNA testing to confirm. You get the result in writing, your doctor also. Moreover, we ask you or your family may StOEH approach to family research, if diagnosed with familial hypercholesterolaemia certain.

If you do not consent to further DNA testing, the material is destroyed.

Scientific research
All we ask patients to DNA may retain and use for scientific research.

Many patients from our outpatient clinic visit, we invite to participate in one of the scientific research. These will often study the function of blood vessels or the impact of new drugs.

You will receive comprehensive written information in advance about the content of the study, the investigations to be performed and the consequences. You get sufficient time to decide whether you participate. Not participate or stop an investigation obviously not affect your treatment.
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