| For medical practitioners and the general public - Cholesterol Journal Article Catalog. |
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| Cholesterol screening in children: a consensus statement--finally Strong, W. B. (1991), J Med Assoc Ga 80(8): 451-2. |
| Cholesterol screening in pediatric practice Goff, D. C., Jr., G. A. Donker, et al. (1991), Pediatrics 88(2): 250-8. Abstract: Four pediatricians introduced a portable cholesterol analyzer into their group practice. Their experience is described on the basis of 12 months of screening in 1665 children and adolescents. The overall 50th and 90th percentile values for a subgroup of 1406 routinely screened children were 156 and 197 mg/dL, respectively, but there was marked variation in these values among specific age and sex groups. Cholesterol levels decreased by age group during the early teenage years and increased thereafter, these changes occurring at ages approximately 2 years younger for girls than for boys. Further analysis of screening results for 398 sibling pairs demonstrated significant concordance between paired cholesterol levels when classified by the respective age- and sex-specific 90th percentile values for each member of the pair. Sibling pairs in which both members' cholesterol values exceeded their 90th percentile value were identified 2.4 times as frequently as expected (confidence interval 1.1 to 4.5, P =.029). The observations reported here indicate that office-based cholesterol screening in a pediatric practice may be both practical and useful, although further consideration of screening criteria is needed. Age- and sex-specific reference values for cholesterol levels during childhood could improve screening results. Special emphasis should be directed toward screening siblings of children in whom high cholesterol levels have been detected. |
| Cholesterol screening in the emergency department Burns, R. B., D. B. Stoy, et al. (1991), J Gen Intern Med 6(3): 210-5. Abstract: OBJECTIVE: To determine the feasibility of providing cholesterol screening in the emergency department (ED) and to determine compliance with follow-up recommendations. DESIGN: A prospective observational study. SETTING: The Ambulatory Care and Treatment Section of the George Washington University Medical Center ED. PATIENTS/PARTICIPANTS: All patients seen in the Ambulatory Care and Treatment Section of the ED who were 18 years of age or older and who were residents of the metropolitan Washington, D.C., area were eligible to participate. During the six-month study period, 660 patients were asked to participate and 539 (82%) agreed. INTERVENTIONS: Fingerstick cholesterol measurements were performed on all participants. Participants who had elevated cholesterol levels, as determined by the National Cholesterol Education Program guidelines, were scheduled for a six-week follow-up visit in the Lipid Research Clinic, where repeat fingerstick cholesterol measurements were performed. Those participants with elevated cholesterol levels were instructed to follow up with their primary care physicians. Compliance with follow-up was assessed by a telephone contact four months after the initial ED visit. MEASUREMENTS AND MAIN RESULTS: Of the 539 participants, 100 (19%) were found to have elevated cholesterol levels. Fifty-three (53%) returned for the six-week follow-up visit. Of the 53 who returned, 7 (13%) had normal and 46 (87%) had elevated cholesterol levels. Of the 46 participants with elevated cholesterol levels, 15 (33%) reported four months after their ED visit that they had received further follow-up care. CONCLUSIONS: Cholesterol screening in the ED is feasible, but compliance with follow-up is less than desirable. |
| Cholesterol screening in the members of the Hungarian parliament Czeizel, A. E., M. Rockenbauer, et al. (1995), Am J Cardiol 76(3): 180-1. Abstract: The high proportion (49%) of male parliament members with high cholesterol levels (> or = 240 mg/dl) calls attention to their high risk for cardiovascular diseases. Our hope is that knowledge of their risk will improve their understanding concerning the importance of lifestyle and health promotion in Hungary. |
| Cholesterol screening in the pediatric office Medici, F., D. Puder, et al. (1991), Ann N Y Acad Sci 623: 200-4. |
| Cholesterol screening in the workplace Broome, J. (1990), Occup Health (Lond) 42(3): 72-3. |
| Cholesterol screening in young adults Walsh, J. and T. B. Newman (1993), Jama 270(13): 1546-7. |
| Cholesterol screening management of Florida's pediatric population DeClue, T. J. and D. M. Schocken (1991), Clin Pediatr (Phila) 30(6): 340-2. Abstract: The current cholesterol screening and management of Florida's pediatric population is evaluated utilizing a questionnaire mailed to 1,534 pediatric health care providers. Twenty percent of the physicians responded. Of the respondents, 65% do not routinely screen for the presence of hypercholesterolemia. Only 28% of the respondents obtain serum total cholesterol measurements in accordance with the American Academy of Pediatrics Committee on Nutrition recommendations. The serum total cholesterol concentration prompting treatment was 240 mg/dL (6.2 mM). Dietary counseling alone, or in combination with exercise, was the initial treatment approach recommended by 98% of the responding physicians. Dietary education for the hypercholesterolemic patient was provided by both dieticians (46%) and physicians (42%). If the initial dietary intervention was unsuccessful, 48% of the physicians would begin medical therapy. The most commonly prescribed medication was a bile acid sequestrant (70%), with the majority (52%) referring their patient to a subspecialist for evaluation and care. |
| Cholesterol screening of seven-year-old children. How to identify children at risk Larsson, B. and I. Vaara (1992), Acta Paediatr 81(4): 315-8. Abstract: An inquiry was distributed to the parents of 1052 seven-year-old school beginners, concerning three issues, i.e. a known family history of myocardial infarction, angina pectoris before the age of 55 years and hyperlipidemia. A total of 147 children with a known family history were included in the study and compared with 148 classmates as control subjects. The proband children were subgrouped according to heredity factors and subjected to multivariate analysis at the 5% significance level for serum cholesterol fractions and triglycerides vs the control group. Statistically significant increased levels of total cholesterol and low density lipoprotein cholesterol, as well as an increased low density lipoprotein cholesterol and high density lipoprotein cholesterol ratio were found for all groups with hereditary for hyperlipidemia (p less than 0.001). However, no statistically significant difference was observed in the groups with heredity for myocardial infarction or angina pectoris exclusively. Also, there was no difference in any of the risk groups for high density lipoprotein cholesterol and triglycerides. The serum cholesterol levels in the present study were, to our knowledge, higher than those found elsewhere, except for Finland. |
| Cholesterol screening practices of Florida pediatricians DeClue, T. J. and D. M. Schocken (1991), Ann N Y Acad Sci 623: 435-6. |
| Cholesterol screening programs may need an educational component Beerman, K. A., A. Jewel, et al. (1991), J Am Diet Assoc 91(4): 478-9. |
| Cholesterol screening should be targeted Garber, A. M. (1997), Am J Med 102(2A): 26-30. Abstract: For primary prevention of coronary heart disease (CHD), the American College of Physicians (ACP) has recommended that initial cholesterol screening be targeted to people who have other risk factors in addition to elevated cholesterol. This would include those with symptoms of heart disease, asymptomatic men 35-65 years old and women 45-65 years old, or younger people who have > or = 2 risk factors or who might benefit from treatment for high blood cholesterol. After the age of 75, cholesterol is no longer a risk factor, so there is no rationale for testing. In primary prevention, lipoprotein fractionation should be performed in men and women who have been identified as having elevated blood cholesterol levels, not as part of initial testing. In secondary prevention, some studies indicate that cholesterol reduction may be beneficial after age 65. In asymptomatic younger people without other risk factors, the low prevalence of CHD and rapid response to cholesterol reduction once it is initiated suggest that early screening and treatment are unnecessary. Everyone should adopt the lifestyle modifications conducive to cardiovascular health, but the ACP believes that, for primary prevention, universal screening is neither cost effective nor the best use of the patient's and physician's time. |
| Cholesterol screening using the school as a worksite Weinberg, A. D., N. K. Iammarino, et al. (1992), J Sch Health 62(2): 45-9. Abstract: This article illustrates the appropriateness of the school as a worksite for health promotion programs and demonstrates how cholesterol screening is an effective tool to introduce such a program into a school system. Of 1,639 employees, 1,217 elected to have their cholesterol measured (74% response rate). Forty-five percent had elevated cholesterol according to the NIH Consensus Panel. Of these, 12% were in the "high" category (greater than or equal to 240 mg/dl) while 33% had levels that placed them in the "borderline high" risk category (200-239 mg/dl). Cholesterol screening can be incorporated easily into most school systems due to the presence of nursing staff and health educators. Systematic planning is essential for success and must include a counseling and educational intervention coupled with an active referral and follow-up program. This type of screening should be part of a multicomponent health promotion program. |
| Cholesterol screening. Once is not enough Wilson, P. W. (1995), Arch Intern Med 155(20): 2146-7. |
| Cholesterol screening. Part III. A lab-driven program for cholesterol testing Bennett, W. D. (1990), MLO Med Lab Obs 22(4): 63-6, 68. |
| Cholesterol screening. Part IV. Benefits of cooperative efforts between the lab and a hospital wellness program Anderson, P. H. (1990), MLO Med Lab Obs 22(5): 45-6, 48, 50-1. |
| Cholesterol screening. The saga continues La Rosa, J. C. (1991), Circulation 83(4): 1456-7. |
| Cholesterol screening: comparative evaluation of on-site and laboratory-based measurements Bachorik, P. S., R. Rock, et al. (1990), Clin Chem 36(2): 255-60. Abstract: We measured cholesterol in capillary blood samples from 9683 volunteers over a four-day on-site community screening program, using the "Reflotron" desk-top analyzer (Boehringer-Mannheim Diagnostics, Indianapolis, IN). We also measured cholesterol in venous blood samples from 3% of those screened (a) with the Reflotron at the screening sites, (b) in a qualified hospital clinical laboratory, and (c) in a Centers for Disease Control standardized lipoprotein research laboratory. The sensitivity (and specificity) of the Reflotron measurements, with use of the lipoprotein laboratory measurements as the point of reference, was 0.95 (0.73) in capillary blood samples and 0.88 (0.93) in venous blood samples, compared with 0.99 (0.87) in the hospital clinical laboratory. The Reflotron measurements correlated less well with the lipoprotein laboratory values in both venous blood (r = 0.91) and capillary blood (r = 0.89) samples than did the clinical laboratory values (r greater than 0.99). Furthermore, the capillary blood measurements averaged 7% higher than venous measurements when both kinds of samples were analyzed in the Reflotron. |
| Cholesterol screening: hits and misses Record, B. and S. Record (1991), Jama 266(19): 2701-2. |
| Cholesterol screening? Dennison, B. A. (1990), Pediatrics 85(6): 1125-6. |