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Articles by Carl E. Orringer
Total Records ( 4 ) for Carl E. Orringer
  Carl E. Orringer
  not available
  Carl E. Orringer
 

Background

Cardiac computed tomography for coronary artery calcium scoring, a diagnostic test associated with relatively low radiation exposure, provides incremental coronary risk stratification above that provided by Framingham risk scoring in asymptomatic, intermediate-risk patients. Knowledge of the appropriate use of coronary calcium scoring enables the clinician to more appropriately match the intensity of preventive cardiovascular care to the individual's absolute risk of coronary heart disease (CHD).

Methods

A Medline search was used for original articles pertinent to coronary artery calcium scoring from 2000 to 2010.

Results

Despite the presence of coronary risk factors, up to 45% of asymptomatic, presumed intermediate-risk patients referred for coronary calcium scoring have no detectable coronary calcium, a finding associated with a 1 to 2% 10-year risk of CHD death or nonfatal myocardial infarction. Such patients could logically be given a more prolonged opportunity to respond to therapeutic lifestyle change and, if necessary, generic lipid-altering medication before more expensive treatment strategies are implemented.

Conclusions

Because coronary calcium scoring is usually a self-pay test, the test should be ordered only in those circumstances in which knowledge of the results will change coronary risk management. This review addresses these issues and attempts to place the clinical utility of this important diagnostic test in perspecitive for the clinician.

  Carl E. Orringer , Jennifer G. Robinson , Ralph La Forge and Christopher R. Seymour
 

Background

In 2010 a survey of the National Lipid Association (NLA) membership was developed and launched with the objective of exploring the demographics, practice patterns, and educational needs of the health professionals in our organization involved in the practice of clinical lipidology.

Objectives

To report the results of this survey and use this information to enable the organization to better serve the needs of our membership.

Methods

A 30-question survey was administered to the NLA membership before and shortly after the Annual Scientific Sessions in May, 2010. Demographic information, test ordering patterns, educational needs and resources, and technology awareness of 640 valid respondents was assessed.

Results

The respondents represent a balanced mix of practitioners in rural and metropolitan population centers throughout the United States. Physicians represent 67%, nurse practitioners and physician assistants 16%, and pharmacists 8% of the respondents. Among physicians, 50% are internal medicine or family medicine specialists, 32% cardiologists, and 11% endocrinologists. Most working in lipid clinics reported that their clinic was financially solvent. The respondents believed that adjunctive lipoprotein testing was clinically useful in risk prediction. The greatest educational needs included statin intolerance; strategies for improving compliance; metabolic syndrome; and lipoprotein particle and apolipoprotein B concentration. The most important sources of lipid information were the Journal of Clinical Lipidology and the NLA Annual Scientific Sessions.

Conclusions

The survey provided valuable information that may be used to better serve the practice and educational needs of the membership of the NLA.

  Terry A. Jacobson , Matthew K. Ito , Kevin C. Maki , Carl E. Orringer , Harold E. Bays , Peter H. Jones , James M. McKenney , Scott M. Grundy , Edward A. Gill , Robert A. Wild , Don P. Wilson and W. Virgil Brown
  Various organizations and agencies have issued recommendations for the management of dyslipidemia. Although many commonalities exist among them, material differences are present as well. The leadership of the National Lipid Association (NLA) convened an Expert Panel to develop a consensus set of recommendations for patient-centered management of dyslipidemia in clinical medicine. The current Executive Summary highlights the major conclusions in Part 1 of the recommendations report of the NLA Expert Panel and includes: (1) background and conceptual framework for formulation of the NLA Expert Panel recommendations; (2) screening and classification of lipoprotein lipid levels in adults; (3) targets for intervention in dyslipidemia management; (4) atherosclerotic cardiovascular disease risk assessment and treatment goals based on risk category; (5) atherogenic cholesterol-non-high-density lipoprotein cholesterol and low-density lipoprotein cholesterol-as the primary targets of therapy; and (6) lifestyle and drug therapies intended to reduce morbidity and mortality associated with dyslipidemia.
 
 
 
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