Successful hyperlipemic pregnancy

Article Abstract:

People with hypertriglyceridemia, or high blood levels of triglycerides (fatty acids and glycerol), have a tendency to suffer from abdominal pain and pancreatitis (inflammation of the pancreas). The combination of severe hypertriglyceridemia, high levels of other lipids (fats), abdominal pain, pancreatitis, and sometimes confusion and difficulty breathing is called chylomicronemia syndrome, formerly known as hyperlipidemic abdominal crisis. The cause of this syndrome is a genetic disorder of triglyceride (TG) metabolism, but it is usually triggered by the co-existence of genetic defects and conditions such as pregnancy and the use of estrogens. Gestational pancreatitis, or pancreatitis during pregnancy, carries a mortality of about one in five for both the mother and the fetus. Most women develop increased TG levels during pregnancy, but patients with inherited defects in very-low-density lipoprotein (VLDL) metabolism have a high risk of hypertriglyceridemia and pancreatitis. A 33-year-old woman with triglyceridemia and a history of both spontaneously aborted pregnancies (miscarriages) and gestational pancreatitis was recognized as being at high risk for life-threatening complications during the second trimester of her fifth pregnancy. The treatment for hypertriglyceridemia consists of discontinuing oral feeding, suctioning gastric secretions, and providing fluids intravenously. Low-fat (high-carbohydrate) diets increase triglyceride levels when eaten normally, but not when given intravenously. While having her TG level measured weekly, the patient followed dietary restrictions; she received intermittent intravenous feeding whenever the TG level exceeded a defined limit, regardless of her symptoms. The patient's pregnancy continued to term without further complications. Hypertriglyceridemia should be identified before a crisis occurs by monitoring TG levels. Gestational pancreatitis can be prevented by dietary management and intravenous therapy; treatment should be based on laboratory values, not on symptomatology. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Care and treatment, Causes of, Complications and side effects, Pregnancy, Pancreatitis, Hyperlipoproteinemia

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Effect of a media blitz and a threatened lawsuit on stimulant treatment

Article Abstract:

The number of Ritalin prescriptions for hyperactive/inattentive students dropped greatly after 1987 due to well publicized lawsuits over its use. The medication rate for elementary and secondary students doubled every four to seven years from 1971 through 1987. After 20 lawsuits filed throughout the United States and discussion on major national television shows and in print media, medication use dropped 39% for all students and 48% for elementary students. School nurses reported that parents rejected medication for their children because they were concerned about side effects, reluctant to give medication for hyperactivity, and had concerns based on televised information or newspaper articles. School staff apprehension about potential litigation and adverse publicity plus physician concern contributed to the decline. Of those children who were taken off medication, 47% developed mild to moderate adjustment problems and 36% developed a major degree of school maladjustment. Pediatricians have switched to prescribing tricyclic antidepressants, drugs associated with greater medical risk.

Cases, Influence, Product liability, Products liability, Mass media, Attention-deficit hyperactivity disorder, Attention deficit hyperactivity disorder, Methylphenidate, Methylphenidate hydrochloride

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