RESUMEN
Systematic work on the synthesis and characterization of two series (referred to as type A and B) of poly(amido-amine)s with tertiary amino-groups in the main chain is reported. The polymers were synthesized by polyaddition of alpha, omega-bis-(methyl-amino) alkanes with 1,4-bis-acryloylpiperazine (type A) and 1,12-bis-acryloyl-n-diaminododecane (type B). These materials, which will be employed in the preparation of block and graft copolymers for biomedical use, have been characterized by means of various techniques and the most interesting features are reported.
Asunto(s)
Materiales Biocompatibles/síntesis química , Polímeros/síntesis química , Adsorción , Heparina , Peso Molecular , Nylons/síntesis química , Poliaminas/síntesis química , TermodinámicaRESUMEN
UNLABELLED: Heterozygous familial hypercholesterolemia (FH) is the most common inherited type of primary hyperlipidemia. Patients with familial hypercholesterolemia have an increased level of LDL cholesterol since childhood, and present early associated cardiovascular disease. Ezetimibe reduces LDL by blocking sterol absorption in enterocytes. AIM: to show our experience on the use of ezetimibe in children and adolescents with familial hypercholesterolemia, with short and medium term follow-up. PATIENTS AND METHODS: Retrospective and longitudinal study. Patients who were receiving ezetimibe as monotherapy from 2003 to 2009 were included. The primary efficacy parameter was the effect of ezetimibe on the LDL after three months of treatment. Serum levels of aspartate aminotransferase, alanine aminotransferase and creatine kinase were monitored. Patients were asked if they experienced any side effect with the ezetimibe treatment. If the Patients did not achieve therapeutical goals with ezetimibe as monotherapy a statin was added. Outcome at medium term follow-up is analysed. RESULTS: The study included a total of 32 patients. The mean age at the start of ezetimibe was 9.5 years (range: 2 to 15.5). The mean total time of Ezetimibe was 2.45 years (r: 0.4 - 5.9).The decrease in mean LDL levels was -25.7% ± 12.3 or 59.5 ± 34 mg% (P<.0001; 95% CI: 47.3-71.5, t test). There were no side effects with ezetimibe monotherapy. At the end of the study, 11 patients required added statins due to failing to achieve the treatment goal. CONCLUSIONS: Ezetimibe is effective and safe for children and adolescents with FH in short and medium term follow-up.
Asunto(s)
Anticolesterolemiantes/uso terapéutico , Azetidinas/uso terapéutico , Hiperlipoproteinemia Tipo II/tratamiento farmacológico , Adolescente , Niño , Preescolar , Ezetimiba , Femenino , Humanos , Estudios Longitudinales , Masculino , Estudios RetrospectivosRESUMEN
La hipecolesterolemia familiar es el tipo de hiperlipidemia primaria hereditaria más frecuente y se asocia con una mayor prevalencia de enfermedad cardiovascular temprana. El ezetimibe reduce el LDL inhibiendo la absorción de esteroles en el enterocito. Objetivo: Mostrar nuestra experiencia en el uso de ezetimibe para el tratamiento de niños y adolescentes con hipercolesterolemia familiar heterocigota, en el corto y mediano plazo. M y M: Estudio longitudinal, retrospectivo, modelo antes-después donde cada paciente fue su propio control. Se incluyeron todos los pacientes que recibieron ezetimibe desde enero 2003 a diciembre 2009. Los pacientes cumplieron un período previo de 6 meses de dieta hipolipemiante y recomendaciones de actividad física. La eficacia se midió según la variación del LDL luego de3 meses de tratamiento. Se midieron los niveles de transaminasas y creatinfosfoquinasa antes y cada 3 meses durante el tratamiento. Se registraron los síntomas y efectos colaterales asociados con la administración de ezetimibe. Los pacientes que alcanzaron los objetivos terapéuticos continuaron con ezetimibe como monodroga, los que no, agregaron estatinas. Resultados: Se incluyeron 32 pacientes con edad media de 9,5 años (rango: 2-15,5). El tiempo total de seguimiento fue de 2,45 años (0,4-5,9 a). Luego de 3 meses de ezetimibe el LDL disminuyó un 25,7%. No se observaron efectos adversos durante el tratamiento como monoterapia. Al final del estudio, 11 pacientes habían agregado estatinas a su tratamiento por no haber alcanzado los objetivos. Conclusión: El ezetimibe resultó ser efectivo y seguro en niños y adolescentes con HF a corto y mediano plazo(AU)
Heterozygous familial hypercholesterolemia (FH) is the most common inherited type of primary hyperlipidemia. Patients with familial hypercholesterolemia have an increased level of LDL cholesterol since childhood, and present early associated cardiovascular disease. Ezetimibe reduces LDL by blocking sterol absorption in enterocytes. Aim: to show our experience on the use of ezetimibe in children and adolescents with familial hypercholesterolemia, with short and medium term follow-up. Patients and Methods: Retrospective and longitudinal study. Patients who were receiving ezetimibe as monotherapy from 2003 to 2009 were included. The primary efficacy parameter was the effect of ezetimibe on the LDL after three months of treatment. Serum levels of aspartate aminotransferase, alanine aminotransferase and creatine kinase were monitored. Patients were asked if they experienced any side effect with the ezetimibe treatment. If the Patients did not achieve therapeutical goals with ezetimibe as monotherapy a statin was added. Outcome at medium term follow-up is analysed. Results: The study included a total of 32 patients. The mean age at the start of ezetimibe was 9.5 years (range: 2 to 15.5). The mean total time of Ezetimibe was 2.45 years (r: 0.4 - 5.9).The decrease in mean LDL levels was -25.7%±12.3 or 59.5±34 mg% (P<.0001; 95% CI: 47.3-71.5, t test). There were no side effects with ezetimibe monotherapy. At the end of the study, 11patients required added statins due to failing to achieve the treatment goal. Conclusions: Ezetimibe is effective and safe for children and adolescents with FH in short and medium term follow-up(AU)