Lipid disorders

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In the November issue of Drug Benefit Trends, a Viewpoint titled "How Can We Improve Drug Safety?" and an Editorial titled, "Is the Time Right for a BTC Drug Class?" seemed to send mixed signals about whether there should be a third category of medications stocked behind the counter (BTC) for which pharmacists would provide counseling.

A 48-year-old Hispanic man had a tender, bleeding growth within a darkly pigmented plaque on the right flank. The pigmented lesion had been present since birth; it was previously asymptomatic. The tumor arose out of the mainly flat patch 6 months earlier and had slowly enlarged. The patient worked indoors, wore sunscreen daily, and generally avoided outdoor activities. He had no family history of skin cancer.

SAN DIEGO -- Older patients with HIV infection have robust responses to highly active antiretroviral therapy (HAART), with no increased risk of metabolic disorders or other adverse effects, according to two studies.

LUEBECK, Germany -- Left main coronary artery disease appears to be highly heritable and a better predictor of a sibling's risk than a general family history of heart disease.

SYDNEY -- For patients with coronary artery disease, a maximum risk reduction required not only the lowest level of LDLs, but also the highest level of HDLs, found investigators here.

Congestive heart failure and cirrhosis are the most common causes of transudative pleural effusions, while pneumonia and malignancy are responsible for the majority of exudative effusions. Plain chest films are valuable in confirming the presence of an effusion, providing clues to the cause, and directing the method of pleural fluid sampling. Thoracentesis is safe and simple, and it is diagnostic in about 75% of cases. Pleural biopsy is indicated for unexplained exudative effusions, most of which are found to result from malignancy or tuberculosis. Medical thoracoscopy, if available, is the procedure of choice for patients with these effusions. Thoracoscopy permits visually directed pleural biopsies and allows for therapeutic intervention at the time of diagnosis, obviating the need for subsequent invasive procedures.