Q: I know a cholesterol level less than 200 is desirable in adults, but how about teen-agers? My son has a cholesterol level of 185. Is that OK for a 16-year-old?
A: A panel examining blood cholesterol levels in children and adolescents, has proposed a cholesterol less than 170 is desirable, a cholesterol of 200 or greater is high, and those in between are borderline. Because your son's cholesterol is borderline, the panel would recommend he have a second cholesterol test. If that value is also borderline or high, he should have further tests for triglycerides and HDL cholesterol after an overnight fast to determine whether the "bad" LDL cholesterol is elevated.
You might be interested to know the panel did not recommend measuring cholesterol levels in all children and adolescents. Instead, it recommended screening for those children and adolescents who had a parent with high cholesterol or parents
or grandparents with evidence of atherosclerotic disease involving the arteries to the heart, legs or brain at 55 years of age or younger.
Q: My brother was recently told he has Hodgkin's disease. I would appreciate more information on this disease and how it is treated.
A: Hodgkin's disease is a type of lymphoma, malignant tumors of the lymphatic system which includes lymph nodes and the spleen. Hodgkin's disease accounts for about one in 100 cancers in this country, and most commonly occurs in people between the ages of 15 and 35, or older than 50. Painless, progressive enlargement of lymph nodes in the neck is often the first manifestation of the disease. Lymph nodes under the arms, in the groin, and within the abdomen or chest may also be involved. Large tumors may cause coughing by compressing the trachea (windpipe) or difficulty in swallowing from pressure on .. the esophagus. Many patients with Hodgkin's disease complain of weakness, tiredness, fever, night sweats, loss of ap
petite, weight loss and itching. The diagnosis is made by examination of tissue, usually from a lymph node, removed by a minor surgical procedure (biopsy). Following diagnosis, a number of specialized tests can determine the extent of involvement of lymphatic tissues elsewhere in the body. This step -- staging -- is essential to appropriate therapy.
Hodgkin's disease in younger individuals usually begins in one group of lymph nodes and spreads gradually to nearby lymphatic tissues. As a result, the disease is potentially curable if radiation treatment to a localized area is begun before the tumor has spread. When the disease is more widespread, it is treated with one or more drugs (chemotherapy) or by a combination of chemotherapy and radiation. These two forms of treatment have led to a cure in about 75 percent of patients whose Hodgkin's disease has not spread widely throughout the body.
Dr. Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine and associate dean for faculty affairs at the school.