The atherogenic lipoprotein(a) [Lp(a)] is recommended to be measured at least once in each adult person's lifetime. However, the testing frequency and its impact on lipid-lowering therapy is uncertain Show more
The atherogenic lipoprotein(a) [Lp(a)] is recommended to be measured at least once in each adult person's lifetime. However, the testing frequency and its impact on lipid-lowering therapy is uncertain. This retrospective analysis included patients 40-79 years old with at least two ambulatory clinic visits to a Midwestern healthcare system between 2018-2022. Within those patients, Lp(a) testing dates to 2004. Parameters included age, sex, race, traditional ASCVD risk factors, Lp(a) levels, and lipid-lowering therapy (LLT) prevalence. Lp(a) was considered elevated if Lp(a) ≥50 mg/dL or ≥125 nmol/L, respectively. Patients ( Although testing for Lp(a) has improved, there is room for significant improvement, particularly in those with ASCVD. The higher use of LLT in all risk categories indicate that Lp(a) testing may have influenced treatment decisions. Show less
Cutaneous pyogenic granulomas (PGs) are common, benign vascular tumors of uncertain pathogenesis; however, a growing body of literature suggests that the formation of PGs may be secondary to genetic a Show more
Cutaneous pyogenic granulomas (PGs) are common, benign vascular tumors of uncertain pathogenesis; however, a growing body of literature suggests that the formation of PGs may be secondary to genetic alterations in both the Ras/Raf/MAPK and PI3K/Akt/mTOR pathways. We present three cases of spontaneous multifocal PGs that first presented in infancy, were not associated with other vascular anomalies or discernable etiology, harbored somatic genetic variants in the Ras/Raf/MAPK pathway (NRAS n = 2, FGFR1 n = 1), were refractory to treatment with beta-blockers and mTOR inhibitors, and responded best to pulsed dye laser. We propose the term "spontaneous multifocal PGs" to describe this entity. Show less