Dietary therapy

The answer is c. (Hardman, p 15230 Administration of intravenous CaG would immediately correct the tetany that might occur in a patient in whom a thyroidectomy was recently performed. Parathyroid hormone would act more slowly but could be given for its future stabilizing effect. Long-term control of a patient after a thyroidectomy can be obtained with vitamin D and dietary therapy Calcitonin is a hypocalcemic antagonist of parathyroid hormone. Plicamycin (mithramycin) is used to treat Paget s disease and hypercalcemia. The dose employed is about one-tenth the amount used for plicamycin s cytotoxic action. 

The objectives of dietary therapy are to progressively decrease the intake of total fat, saturated fat, and cholesterol and to achieve a desirable body weight (Table 9-4). 

When used as monotherapy, statins are the most potent total and LDL cholesterol-lowering agents and among the best tolerated. Total and LDL cholesterol are reduced in a dose-related fashion by 30% or more when added to dietary therapy. 

Evaluation of dietary therapy with diet diaries and recall survey instruments allows information about diet to be collected in a systematic fashion and may improve patient adherence to dietary recommendations. 

Reducing coronary heart disease risk Consider gemfibrozil therapy in those Type Mb patients who have low HDL-cholesterol levels in addition to elevated LDL-cholesterol and triglycerides and who have not responded to weight loss, dietary therapy, exercise, and other pharmacologic agents. 

Despite the return of her earlier symptoms, she adamantly refused further HRT even when informed again of its effectiveness for osteoporosis. However, she was very interested in pursuing dietary therapy with phytoestrogens, since this is what several women in her church group are doing. 

Since the Kidney-Qi and essence are inherited from our parents and do not increase after we are born, tonifying the Kidney cannot be achieved in a short period of time. However, with this idea in mind, we can take steps to conserve our Kidney-Qi and essence throughout our lifetime. There are many ways to tonify and protect the Kidney, such as Chinese herbal therapy, Qi Gong exercise, Chinese dietary therapy and a healthy lifestyle. All of these can prevent disease, maintain health and ensure longevity. By this means, a person with a weak constitution can live a happy and healthy life, and someone with a strong constitution can live longer than average. 

Hypercholesterolemia in the patients with persistent nephrotic syndrome should be treated. Statins are similarly effective as in nonnephrotic subjects and are able to reduce total and LDL cholesterol by about 30% (M2). Reduction of proteinuria by inhibitors of angiotensin-converting enzyme is also able to reduce LDL cholesterol (M2). Dietary therapy seems to be less effective. 

The total fat intake must be reduced to achieve weight reduction by diet therapy.70 Dietary recommendations also include a reduction in saturated fatty acids. Drug therapy must be started only after confirmation of lipid levels such as cholesterol, triglycerides, LDL, and HDL. Adequate trial must be initiated with modification of dietary therapy, only failing which drug therapy must be started. 

Special dietary measures are of major, often even of decisive importance for several types of liver disease or associated complications. Here, too, the false, universal claim that there is no liver diet is invalid. In the same way that treatment of a liver condition is indeed possible, there are also dietary measures for certain forms or complications of liver disease. After an exact diagnosis has been established, there is often a necessity for dietary therapy depending on the respective hepatological situation. 

No particular therapy is effective. It is not known whether the minute quantities of phytomenadione that are present in some foods, such as parsley, kale, brussels sprouts, spinach, cucumber, soy bean oil, and green and black tea leaves, preclude effective dietary therapy. Since the mechanism of this reaction is thought to be delayed hypersensitivity, another potential therapeutic approach is topical application of tacrolimus (FK-506), a potent inhibitor of interleukin 2 and T cell activation. Tacrohmus up to now has only been shown to suppress allergic contact dermatitis to dinitrophenol. 

Singh, R., Niaz, M., and Ghosh, S. 1994. Hypolipidemic and antioxidant effects of Commiphora mukul as an adjunct to dietary therapy in patients with hypercholesterolemia. Cardiovasc. Drugs Ther. 8,... 

Patients with type III hyperlipoproteinemia exhibit increased plasma cholesterol and triacylglycerol and the presence of 6-VLDL. Dysbetalipoproteinemics are prone to premature vascular disease, eruptive xanthomas on elbows and knees, and planar xanthomas in the palmar and digital creases. These patients respond well to therapy. Dietary therapy is preferred, but drug therapy (see below) may also be necessary. 

If dietary therapy is unsuccessful, drug therapy should be employed. Five classes of drugs are available for treatment of hyperlipoproteinemias their effects are due to decreased production or enhanced removal of lipoprotein from plasma. 

The answer is b. (Murray, pp 238-249. Scriver, pp 2165-2194. Sack, pp 121—144. Wilson, pp 287—324.) In treating inborn errors of metabolism that present acutely in the newborn period, aggressive fluid and electrolyte therapy and caloric supplementation are important to correct the imbalances caused by the disorder. Calories spare tissue breakdown that can increase toxic metabolites. Since many of the metabolites that build up in inborn errors ol metabolism are toxic to the central nervous system, hemodialysis is recommended for any patient in stage II coma (poor muscle tone, few spontaneous movements, responsive to painful stimuli) or worse. Dietary therapy should minimize substances that cannot be metabolized—in this case fatty acids, since the oxidation of branched-chain fatty acids results in propionate. Antibiotics are frequently useful because meta-bolically compromised children are more susceptible to infection. 

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