Friday, December 01, 2006

Lipoprotein Seminar, PBL, and POD

Our seminar this morning had two parts. The first one was by a PhD, and it covered HDL production and transport. You may know that HDL is the so-called "good cholesterol" that helps prevent your arteries from being blocked up (a condition called atherosclerosis). It is not known for sure why high HDL levels can protect people and animals from getting atherosclerosis, but here is one idea that I thought was pretty compelling. When the arteries get blocked, what is happening is that there are plaques forming in there. These plaques are formed by, among other things, a type of cell called a macrophage. You can think of macrophages as being one of the garbagemen of the body. So if you have some cholesterol or other molecules in your blood that have been altered and aren't in good condition any more, the macrophages will take them up. Unfortunately, if this happens a lot, the macrophages get over-stuffed with altered cholesterol, and they turn into something called a foam cell. Foam cells are bad news for your arteries. Since they can't get rid of the altered cholesterol, they just deposit in the arteries and contribute to forming plaques. The thought is that having a high HDL level is good because HDL is responsible for bringing cholesterol from the body back to the liver for disposal, and specifically the cholesterol being brought from the foam cells could be what lowers the person's risk for atherosclerosis. I thought it was a really good and interesting seminar. I can also tell you that after this week of seeing all the bad things that a high-fat diet can do to you, my classmates and I were not too eager to eat donuts during PBL this morning!

The second half of the seminar was given by an MD, and it was kind of dry. She was mainly presenting about the Framingham risk scoring chart, which you can use to figure out what your risk of developing atherosclerosis is. I think it would have made the seminar better if we'd calculated our own risks instead of seeing slide after slide of hypothetical people's hypothetical risks. Be that as it may, I will tell you that the best thing you can do to avoid getting atherosclerosis isn't related to improving your diet, exercising more, losing weight, stopping smoking, or keeping your blood sugar and blood pressure levels controlled, although all of those things will certainly reduce your risk. No, the biggest thing you can do to keep your risk down is to not get old. Good luck with that one.

Today was our last day of PBL with our current groups, and it is also the last day of our cardiopulmonary block. We'll be starting the renal block on Monday. I thought our last session went well. Again, we did a good job with getting our presentations done on time, we had some good discussions about several of them, and we finished class on time too. It turns out that our patient from the case is doing very well, and his lipids are back to normal. Of course, he is unrealistically compliant with all of the recommendations he's been given. One thing you will find out when you start seeing patients is that most of them are not totally compliant, and a good percentage of them are not compliant at all.

Our POD talk today was by a biochemist who studies lipid metabolism. I thought his talk was pretty interesting, and he made it fairly interactive. Besides telling us about the work he is currently doing, he also told us about how he had ended up coming here to CCF and choosing his research interests. I like when the speakers do that, because it's not always straightforward to figure out how you're going to go from being a student in medical school to being a PI running a lab. One common theme that I have seen in various researchers' stories is how much timing and serendipity play a role in getting them to where they are now. It seems that the mentors I meet and work with now will play a big part in what I will wind up doing for my own career.

I have to go meet with my PA soon, and then I'm going to take off. It was supposed to snow tonight, but luckily now it looks like it's going to hold off until tomorrow night or Sunday. Tomorrow night is Doc Opera already, and it is going to be awesome.

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