Current clinical laboratory practice: investigation of plasma lipids--which tests and when?

Clinical interest in the lipoproteins stems mainly from the association between serum cholesterol concentrations and coronary heart disease. Investigations of lipoproteins should be performed in patients with premature coronary heart disease, with a strong family history of coronary heart disease, or with certain cutaneous stigmata of hyperlipoproteinaemia and when fasting serum samples are seen to be lipaemic. Family studies should be performed in appropriate cases to identify relatives at increased risk of developing coronary heart disease. Patients with conditions known to cause secondary hyperlipoproteinaemia should be investigated if they fall into one of these categories but only after treatment of the underlying condition. Non-specialist laboratories should be able to measure total cholesterol and triglyceride concentrations and high density lipoprotein cholesterol concentrations. Lipoprotein electrophoresis has a limited role in such laboratories and is not necessary as a routine procedure. Specialist laboratories should in addition be able to measure individual lipoproteins and identify apolipoprotein E phenotypes.     

Sickness and Healing: An Anthropological Perspective

Sickness and Healing: An Anthropological Perspective. Robert A. Hahn. New Haven, CT: Yale University Press, 1995 (cloth and paper), viii. 327 pp.     

Hurricane Risk Variability along the Gulf of Mexico Coastline

Hurricane risk characteristics are examined across the U. S. Gulf of Mexico coastline using a hexagonal tessellation. Using an extreme value model, parameters are collected representing the rate or λ (frequency), the scale or σ (range), and the shape or ξ (intensity) of the extreme wind distribution. These latent parameters and the 30-year return level are visualized across the grid. The greatest 30-year return levels are located toward the center of the Gulf of Mexico, and for inland locations, along the borders of Louisiana, Mississippi, and Alabama. Using a geographically weighted regression model, the relationship of these parameters to sea surface temperature (SST) is found to assess sensitivity to change. It is shown that as SSTs increase near the coast, the frequency of hurricanes in these grids decrease significantly. This reinforces the importance of SST in areas of likely tropical cyclogenesis in determining the number of hurricanes near the coast, along with SSTs along the lifespan of the storm, rather than simply local SST. The range of hurricane wind speeds experienced near Florida is shown to increase with increasing SSTs (insignificant), suggesting that increased temperatures may allow hurricanes to maintain their strength as they pass over the Florida peninsula. The modifiable areal unit problem is assessed using multiple grid sizes. Moran’s I and the local statistic G are calculated to examine spatial autocorrelation in the parameters. This research opens up future questions regarding rapid intensification and decay close to the coast and the relationship to changing SSTs.