Prognostic value of myocardial perfusion scintigraphy in diabetic patients and without coronary lesion. / Valor pronóstico de la gammagrafía de perfusión miocárdica en pacientes diabéticos sin lesiones coronarias.

OBJECTIVE: To determine the prognostic value of myocardial perfusion scintigraphy-gated SPECT in patients with diabetes mellitus and without obstructive coronary artery disease. MATERIALS AND METHODS: This retrospective study included consecutive patients undergoing adenosine stress-rest myocardial perfusion imaging (MPI) by 99mTc-tetrofosmin between 2009 and 2011. The patients had diabetes mellitus and coronary angiography without significant coronary lesions. In total, 37 diabetic patients (female/male: 20/17; mean age: 65.2 (range: 40-78). 29 non-diabetic patients were included wich are matched with the group of diabetic patients with positive MPI. The group of non-diabetic patients had scintigraphy with myocardial ischemia and without angiographic lesions. A 36-month clinical follow-up was performed, and major cardiac events were recorded. RESULTS: In 78.3% (29/37) of diabetic patients the scintigraphic study showed myocardial ischemia, while it was negative in the 21.7%. The cardiac event rate in both groups was 6%. In diabetics with a myocardial perfusion study with myocardial ischemia, there were 3 major cardiac events. In diabetic patients with negative study had no cardiac event. In the non-diabetic control group the cardiac events rate was 3.4% (1/29). CONCLUSION: In diabetic patients without obstructive coronary disease, myocardial perfusion study can be predictor of cardiac events. A negative study can be an indicator of a better cardiovascular prognosis.

Interactions between antihypertensive drugs and food / Interacciones entre fármacos antihipertensivos y alimentos

Objective: A drug interaction is defined as any alteration, pharmacokinetics and/or pharmacodynamics, produced by different substances, other drug treatments, dietary factors and habits such as drinking and smoking. These interactions can affect the antihypertensive drugs, altering their therapeutic efficacy and causing toxic effects. The aim of this study was to conduct a review of available data about interactions between antihypertensive agents and food. Methods: The purpose of this review was to report an update of main findings with respect to the interactions between food and antihypertensive drugs by way of a search conducted in PubMed, which yielded a total of 236 articles initially. Results: After excluding different articles, which were not focusing on the specific objective, the main results refer to interactions between antihypertensive drugs and food (in general) as well as between antihypertensive agents and grapefruit juice. Discussion: Food may affect the bioavailability of antihypertensive drugs and this should be carefully considered. Advising patients to remove the grapefruit juice from their diet when treatment with these drugs seems to be the best recommendation. Given these interactions and the associated potential adverse effects the anamnesis must include detailed information about the specific eating habits of the patients (AU)

Objetivo: la interacción de medicamentos se define como cualquier alteración, farmacocinética y/o farmacodinámica, producida por diferentes sustancias, otros tratamientos, factores dietéticos y hábitos como beber y fumar. Estas interacciones pueden afectar a los fármacos antihipertensivos, alterando su eficacia terapéutica y causando efectos tóxicos. El objetivo de este estudio fue realizar una revisión de los datos disponibles acerca de las interacciones entre los fármacos antihipertensivos y los alimentos. Métodos: El objetivo de esta revisión fue proporcionar una puesta al día sobre los principales resultados con respecto a las interacciones entre alimentos y fármacos antihipertensivos mediante una búsqueda realizada en PubMed, que dio lugar inicialmente a un total de 236 artículos. Resultados: Tras la exclusión de diferentes artículos que no estaban centrados en el objetivo específico, los resultados principales se refieren a las interacciones entre los fármacos antiarrítmicos y alimentos en general y entre dichos fármacos y el zumo de pomelo. Discusión: Los alimentos pueden afectar a la biodisponibilidad de los fármacos antihipertensivos y ello debe ser considerado cuidadosamente. Advertir a los pacientes que supriman el zumo de pomelo en su dieta cuando están en tratamiento con estos fármacos parece la mejor recomendación. Dadas estas interacciones y sus potenciales efectos adversos, la anamnesis debe incluir información detallada sobre los hábitos alimentarios de los pacientes (AU)

Lipid profile and cardiovascular risk in anorexia nervosa; the effect of nutritional treatment.

OBJECTIVE: The aim of this study was to explore the lipid profile in patients with anorexia nervosa (AN), and the changes with refeeding. METHODS: The sample comprised 102 AN outpatients (mean age 22.32 ± 3.17). Blood tests, after 12-hour overnight fast, were performed before refeeding (M(0)) and after weight restoration (M(1)). Total cholesterol (TC), high-density lipoproteins (HDL), low-density lipoproteins (LDL) and triglycerides (TRG) were determined and the following cardiovascular risk markers were calculated: LDL/HDL and TC/HDL ratios. These cut-off points were considered: TC < 200 mg/dl; HDL > 40 mg/dl; LDL < 100 mg/dl and TRG < 150 mg/dl. RESULTS: The time leading to weight restoration was 8.16 ± 7.35 months. Considering patients with scores higher and lower than the corresponding cut-off points, X²-test revealed a significant difference (M(0)-M(1)) in case of TC (p < 0.05) as well as between LDL/HDL(0) and LDL/HDL(1) (p < 0.05) and between TC/HDL(0) and TC/HDL(1) (p < 0.01). Significant differences were found between HDL(0) and HDL(1) (p < 0.01) and between TRG(0) and TRG(1) (p < 0.01). Significant and negative associations between BMI(0) and TC(0) (r = -0.331; p < 0.05) and between TRG(0) and HDL(0) (r = -0.387; p < 0.05) were found. The association between TRG(1) and LDL(1) was significant and positive. DISCUSSION: Weight restoration tends to decrease the TC/HDL and LDL/HDL ratios despite a considerable percentage of patients maintain scores on the different variables of the lipid profile usually considered at risk.

Interactions between antiarrhythmic drugs and food / Interacciones entre fármacos antiarrítmicos y alimentos

Objective: A drug interaction is defined as any alteration, pharmacokinetics and/or pharmacodynamics, produced by different substances, other drug treatments, dietary factors and habits such as drinking and smoking. These interactions can affect the antiarrhythmic drugs, altering their therapeutic efficacy and adverse effects. The aim of this study was to conduct a review of available data about interactions between antiarrhythmic drugs and food. Methods: The purpose of this review was to report an update of the existing literature data on the main findings with respect to food and antiarrhythmic drugs interactions by means of a search conducted in PubMed, which yielded a total of 250 articles initially. Results: After excluding different articles which were not focusing on the specific objective, the main results refer to interactions among antiarrhythmic drugs and food in general, grapefruit juice, and others like fibre or medicinal plants. Discussion: Food may affect the bioavailability of antiarrhythmic drugs and in some specific cases (dairy products, rich-in-protein diets, grapefruit juice), this should be carefully considered. The best recommendation seems to advise patients to remove the grapefruit juice from their diet when treatment with these drugs. Fibre should be separated from taking these drugs and regarding medicinal plants and given their increased use, the anamnesis must include information about its use, the reason for that use and what types of plants are used, all in order to give the corresponding recommendations (AU)

Objetivo: La interacción de medicamentos se define como cualquier alteración, farmacocinética y/o farmacodinámica, producida por diferentes sustancias, otros tratamientos, factores dietéticos y hábitos como beber y fumar. Estas interacciones pueden afectar a los fármacos antiarrítmicos, alterando su eficacia terapéutica y sus efectos adversos. El objetivo de este estudio fue realizar una revisión de los datos disponibles acerca de las interacciones entre los fármacos antiarrítmicos y los alimentos. Métodos: El objetivo de esta revisión fue realizar una actualización de los datos de la literatura existente sobre los principales resultados con respecto a las interacciones entre alimentos y fármacos antiarrítmicos por medio de una búsqueda realizada en PubMed, que arrojó un total de 250 artículos inicialmente. Resultados: Tras la exclusión de diferentes artículos que no estaban centrados en el objetivo específico, los resultados principales se refieren a las interacciones entre los fármacos antiarrítmicos y alimentos en general, el zumo de pomelo y otros como plantas medicinales o fibra. Discusión: Los alimentos pueden afectar a la biodisponibilidad de los fármacos antiarrítmicos y en algunos casos específicos (productos lácteos, dietas ricas en proteínas, zumo de pomelo), este aspecto debe ser considerado cuidadosamente. La mejor recomendación parece ser que los pacientes supriman el zumo de pomelo en su dieta cuando están en tratamiento con estos fármacos. La fibra debería ser separada de la toma de estos medicamentos y en relación con las plantas medicinales y dado su creciente uso, la anamnesis debería incluir información sobre dicho uso y la razón del mismo, y qué tipo de plantas se utilizan, todo ello con el fin de dar las recomendaciones correspondientes (AU)

Lipid profile and cardiovascular risk in anorexia nervosa; the effect of nutritional treatment / Perfil lipídico y riesgo cardiovascular en anorexia nerviosa; efecto del tratamiento nutricional

Objective: The aim of this study was to explore the lipid profile in patients with anorexia nervosa (AN), and the changes with refeeding. Methods: The sample comprised 102 AN outpatients (mean age 22.32 ± 3.17). Blood tests, after 12-hour overnight fast, were performed before refeeding (M0) and after weight restoration (M1). Total cholesterol (TC), high-density lipoproteins (HDL), low-density lipoproteins (LDL) and triglycerides (TRG) were determined and the following cardiovascular risk markers were calculated: LDL/HDL and TC/HDL ratios. These cut-off points were considered: TC < 200 mg/dl; HDL > 40 mg/dl; LDL < 100 mg/dl and TRG < 150 mg/dl. Results: The time leading to weight restoration was 8.16 ± 7.35 months. Considering patients with scores higher and lower than the corresponding cut-off points, X2-test revealed a significant difference (M0-M1) in case of TC (p < 0.05) as well as between LDL/HDL0 and LDL/HDL1 (p < 0.05) and between TC/HDL0 and TC/HDL1 (p < 0.01). Significant differences were found between HDL0 and HDL1 (p < 0.01) and between TRG0 and TRG1 (p < 0.01). Significant and negative associations between BMI0 and TC0 (r = -0.331; p < 0.05) and between TRG0 and HDL0 (r = -0.387; p < 0.05) were found. The association between TRG1 and LDL1 was significant and positive. Discussion: Weight restoration tends to decrease the TC/HDL and LDL/HDL ratios despite a considerable percentage of patients maintain scores on the different variables of the lipid profile usually considered at risk (AU)

Objetivo: El objetivo de este estudio fue explorar el perfil lipídico en pacientes con anorexia nerviosa (AN) y los cambios con la realimentación. Métodos: Se estudiaron 102 pacientes ambulatorios con AN (edad media de 22,32 ± 3,17). Se determinaron en sangre, tras de 12 horas en ayunas, antes de la realimentación (M0) y después de la recuperación del peso (M1), colesterol total (CT), lipoproteínas de alta densidad (HDL), lipoproteínas de baja densidad (LDL) y triglicéridos (TRG) y se calcularon los siguientes marcadores de riesgo cardiovascular: LDL/HDL y CT/HDL ratios. Se consideraron los siguientes puntos de corte: CT < 200 mg/dl, HDL > 40 mg/dl, LDL <100 mg/dl y TRG < 150 mg/dl. Resultados: El tiempo para la recuperación del peso fue de 8,16 ± 7,35 meses. Teniendo en cuenta los pacientes con puntuaciones superiores e inferiores a los correspondientes puntos de corte, el test de Χ2 reveló una diferencia significativa (M0-M1) en el caso de CT (p < 0,05), así como entre LDL/HDL0 y LDL/HDL1 (p < 0,05) y entre TC/HDL0 y TC/HDL1 (p < 0,01). Se encontraron diferencias significativas entre el HDL0 y HDL1 (p < 0,01) y entre TRG0 y TRG1 (p < 0,01). Se obtuvieron asociaciones significativas y negativas entre BMI0 y CT0 (r = -0,331, p < 0,05) y entre TRG0 y HDL0 (r = -0,387, p < 0,05) se encontraron. La asociación entre TRG1 y LDL1 fue significativa y positiva. Debate: La recuperación del peso tiende a disminuir los índices TC/HDL y LDL/HDL a pesar de que un considerable porcentaje de pacientes mantiene puntuaciones en las distintas variables del perfil lipídico generalmente consideradas de riesgo (AU)

Interactions between antiarrhythmic drugs and food.

OBJECTIVE: A drug interaction is defined as any alteration, pharmacokinetics and/or pharmacodynamics, produced by different substances, other drug treatments, dietary factors and habits such as drinking and smoking. These interactions can affect the antiarrhythmic drugs, altering their therapeutic efficacy and adverse effects. The aim of this study was to conduct a review of available data about interactions between antiarrhythmic drugs and food. METHODS: The purpose of this review was to report an update of the existing literature data on the main findings with respect to food and antiarrhythmic drugs interactions by means of a search conducted in PubMed, which yielded a total of 250 articles initially. RESULTS: After excluding different articles which were not focusing on the specific objective, the main results refer to interactions among antiarrhythmic drugs and food in general, grapefruit juice, and others like fibre or medicinal plants. DISCUSSION: Food may affect the bioavailability of antiarrhythmic drugs and in some specific cases (dairy products, rich-in-protein diets, grapefruit juice), this should be carefully considered. The best recommendation seems to advise patients to remove the grapefruit juice from their diet when treatment with these drugs. Fibre should be separated from taking these drugs and regarding medicinal plants and given their increased use, the anamnesis must include information about its use, the reason for that use and what types of plants are used, all in order to give the corresponding recommendations.

Interactions between antihypertensive drugs and food.

OBJECTIVE: A drug interaction is defined as any alteration, pharmacokinetics and/or pharmacodynamics, produced by different substances, other drug treatments, dietary factors and habits such as drinking and smoking. These interactions can affect the antihypertensive drugs, altering their therapeutic efficacy and causing toxic effects. The aim of this study was to conduct a review of available data about interactions between antihypertensive agents and food. METHODS: The purpose of this review was to report an update of main findings with respect to the interactions between food and antihypertensive drugs by way of a search conducted in PubMed, which yielded a total of 236 articles initially. RESULTS: After excluding different articles, which were not focusing on the specific objective, the main results refer to interactions between antihypertensive drugs and food (in general) as well as between antihypertensive agents and grapefruit juice. DISCUSSION: Food may affect the bioavailability of antihypertensive drugs and this should be carefully considered. Advising patients to remove the grapefruit juice from their diet when treatment with these drugs seems to be the best recommendation. Given these interactions and the associated potential adverse effects the anamnesis must include detailed information about the specific eating habits of the patients.