Diseño, validación y aplicación clínica de un cuestionario de conocimiento (ConocEAP) de los pacientes con enfermedad arterial periférica / Design, validation and clinical application of a knowledge questionnaire (ConocEAP) in patients with peripheral arterial disease

INTRODUCCIÓN: Existe mucha desinformación en la población general y en los pacientes vasculares en particular sobre la enfermedad arterial periférica (EAP). Su adecuado conocimiento puede mejorar el autocuidado y la adherencia al tratamiento en los pacientes que la padecen. OBJETIVO: Desarrollar, validar e implementar un cuestionario que evalúe el conocimiento de los pacientes con EAP sobre su enfermedad y determinar las características clínicas y sociodemográficas que influyen en dicho conocimiento. MATERIAL Y MÉTODO: Se diseñó un cuestionario autoadministrado denominado ConocEAP, con 24 ítems de respuesta dicotómica estructurado en 5 áreas: conocimientos generales (4 ítems), factores de riesgo (6), régimen terapéutico (10), farmacoterapia (2) y signos de alarma (2). Se analizó su validez racional, de contenido mediante valoración de expertos y se implementó un pretest cognitivo. Se administró a 120 pacientes hospitalizados por EAP. La fiabilidad se analizó mediante alfa de Cronbach. RESULTADOS: Edad de los encuestados 72 °æ 13 a˜nos, 79% varones. El conocimiento global de la enfermedad fue del 60,5%. El régimen terapéutico y los signos de alarma fueron las áreas de mayor desconocimiento, y los factores de riesgo y farmacoterapia las que tuvieron mayor número de aciertos. El sexo femenino y un nivel de estudios superior se asocian a mayor conocimiento. Respecto al conocimiento de los factores de riesgo, no hubo diferencias significativas entre los pacientes que los presentaban y los que no. CONCLUSIONES: El diagnóstico de EAP no va ligado a un incremento del conocimiento sobre la enfermedad. El cuestionario ConocEAP es una herramienta válida y fiable que permite identificar el nivel de conocimiento de cada paciente y ofrece la oportunidad de individualizar las intervenciones educativas

INTRODUCTION: Peripheral artery disease (PAD) is largely unrecognised, but adequate knowledge can improve self-care and compliance in PAD patients. OBJECTIVE: To develop, validate and implement a questionnaire to assess the knowledge PAD patients have about their disease and to determine the clinical and sociodemographic characteristics determining that knowledge. MATERIAL AND METHOD: A self-administered questionnaire called ConocEAP was designed. It had 24 dichotomous response items structured into 5 areas: general knowledge (4 items), risk factors (6), therapeutics (10), pharmacotherapy (2), and warning signs (2). Rational validity was analysed by expert assessment and a cognitive pre-test was also implemented. It was administered to 120 patients admitted to hospital due to PAD. Reliability was analysed using Cronbach's alpha. RESULTS: The mean age was 72 °æ 13 years, with 79% males. Overall knowledge of the disease was 60.5%. Therapeutic regimen and warning signs were the areas of less knowledge, and risk factors and pharmacotherapy those with the highest number of correct answers. Female sex and higher education levels are associated with greater knowledge. There was no significant difference between patients as regards knowledge of risk factors, whether they had them or not. CONCLUSIONS: Diagnosis of PAD is not related to a greater knowledge about the disease. ConocEAP questionnaire is a valid and reliable tool, able to identify the level of knowledge of each patient and provides the opportunity to individualise educational interventions

Dietary fiber and its interaction with drugs.

As the intake of purified dietary fibers is increasing in the society, it is necessary to know how these fibers interact with simultaneously administered drugs, in order to ensure adequate therapeutic effects, minimizing the risk for adverse effects. This paper reviews the literature on the interactions between different types of purified fibers and several drugs.

Dietary fiber and its interaction with drugs / La fibra dietética y su interacción con los fármacos

As the intake of purified dietary fibers is increasing in the society, it is necessary to know how these fibers interact with simultaneously administered drugs, in order to ensure adequate therapeutic effects, minimizing the risk for adverse effects. This paper reviews the literature on the interactions between different types of purified fibers and several drugs (AU)

El uso, cada vez más frecuente, de distintos tipos de fibra dietética en la población hace necesario conocer cómo interaccionan dichas fibras con los fármacos empleados simultáneamente, para garantizar un adecuado efecto terapéutico y minimizar la posibilidad de aparición de efectos adversos. En el presente trabajo se revisan las publicaciones relativas a las interacciones entre distintos tipos de fibras dietéticas purificadas y fármacos (AU)

[Glucomannan: properties and therapeutic applications]. / Glucomanano: propiedades y aplicaciones terapéuticas.

Glucomannan is a dietary fiber employed quite frequently in the western countries since two decades now, as its ingestion plays an important role in human health. However, eastern people have used this fiber for more than a thousand years. This dietary fiber is the main polysaccharide obtain from the tubers of the Amorphophallus konjac plant, a member of the family Araceae found in east Asia. The chemical structure of glucomannan consists, mainly, in mannose and glucose in the ratio 8:5 linked by beta (1-->4) glycosidic bonds. This soluble fiber has a extraordinarily high waterholding capacity, forming highly viscous solutions when dissolved in water. It has the highest molecular weight and viscosity of any known dietary fiber. It has been demonstrated that this product is highly effective in the treatment of obesity due to the satiety sensation that it produces; as a remedy for constipation, because it increases the faeces volume; as hypocholesterolemic agent, interfering in the transport of cholesterol and of bile acids and as hypoglycemic and hypoinsulinemic agent, probably, by delaying gastric emptying and slowering glucose delivery to the intestinal mucosa. To the beneficial properties of this fiber, several disadvantages can be added as the production of flatulence, abdominal pain, esophageal obstruction, lower gastrointestinal obstruction or even the possible modification of the bioavailability of other drugs. This paper reviews the main characteristics of glucomannan, as well as its properties, physiologic effects and therapeutic uses.

Glucomanano: propiedades y aplicaciones terapéuticas / Glucomannan: properties and therapeutic applications

La fibra dietética glucomanano se utiliza con cierta frecuencia en Occidente desde hace dos décadas, dadas sus demostradas acciones beneficiosas para la salud, si bien su uso se remonta, en las civilizaciones orientales, a más de mil años. Esta fibra es el principal polisacárido obtenido de los tubérculos de la planta originaria del este asiático Amorphophallus konjac y que pertenece a la familia Araceae. La estructura química del glucomanano incluye Dmanosa y D-glucosa (en una proporción 8:5, respectivamente), unidas por enlace (14).El glucomanano es una fibra muy soluble, que posee una excepcional capacidad de captar agua, formando soluciones muy viscosas. Posee un peso molecular y una viscosidad más elevados que cualquier fibra conocida. Se ha demostrado que es eficaz en la obesidad, por la sensación de saciedad que produce; en el estreñimiento debido a que aumenta el volumen fecal; como hipocolesterolemiante interfiriendo en el transporte de colesterol y ácidos biliares; y también disminuye los niveles de glucosa e insulina, probablemente debido a que retrasa el vaciado gástrico y, por tanto, dificulta el acceso de la glucosa a la mucosa intestinal. A estas propiedades beneficiosas, podemos añadir algunos inconvenientes como la producción de flatulencia, molestias abdominales, obstrucciones esofágicas o del tracto gastrointestinal, o incluso puede modificar la biodisponibilidad de otros fármacos que se administren al mismo tiempo que la fibra. Esta revisión recoge las principales características del glucomanano, así como sus propiedades, efectos fisiológicos y aplicaciones terapéuticas (AU)

Glucomannan is a dietary fiber employed quite frequently in the western countries since two decades now, as its ingestion plays an important role in human health. However, eastern people have used this fiber for more than a thousand years. This dietary fiber is the main polysaccharide obtain from the tubers of the Amorphophallus konjac plant, a member of the family Araceae found in east Asia. The chemical structure of glucomannan consists, mainly, in mannose and glucose in the ratio 8:5 linked by ß (1→ 4). glycosidic bonds. This soluble fiber has a extraordinarily high waterholding capacity, forming highly viscous solutions when dissolved in water. It has the highest molecular weight and viscosity of any known dietary fiber. It has been demonstrated that this product is highly effective in the treatment of obesity due to the satiety sensation that it produces; as a remedy for constipation, because it increases the faeces volume; as hypocholesterolemic agent, interfering in the transport of cholesterol and of bile acids and as hypoglycemic and hypoinsulinemic agent, probably, by delaying gastric emptying and slowering glucose delivery to the intestinal mucosa. To the beneficial properties of this fiber, several di sadvantages can be added as the production of flatulence, abdominal pain, esophageal obstruction, lower gastrointestinal obstruction or even the possible modification of the bioavailability of other drugs. This paper reviews the main characteristics of glucomannan, as well as its properties, physiologic effects and therapeutic uses (AU)

[Effect of Ispaghula husks on postprandial glycemia in healthy female volunteers]. / Influencia de las cutículas de semillas de Plantago ovata (Ispaghula husk) en la glucemia posprandial en voluntarias sanas.

OBJECTIVES: To evaluate the influence of Ispaghula husk in the postprandial glucose concentrations in serum in healthy volunteers. MATERIAL AND METHODS: This study is divided in two assays and 7 healthy women with ages ranging from 35 to 45 years participated in both assays. Assay 1. Administration of 50 g of glucose dissolved in 125 ml of water (followed by other 150 ml of water). Assay 2. It was carried out one week later in the same women and conditions as assay 1 but adding 10.5 g of Ispaghula husk to the dissolution. In both assays, blood samples were obtained at 0, 10, 20, 30, 45, 60, 75, 90 and 120 minutes after administration and glucose concentration was determined in serum. RESULTS: The value of the area under the mean glucose concentration-time curve obtained in assay 2 (in the presence of fiber) was a 13.6% lower than that obtained in assay 1 (significant difference, p < or = 0.05). Individual concentration-time curves obtained in assay 1 can be considered as normal in 4 of the 7 volunteers. Abnormalities observed in the other 3 curves were due to: her history of prediabetic in one of them (glucose concentration values over 180 mg/100 ml); diabetic patients in her family in other of them (2 values over 180 mg/100 ml) and hypoglycaemia in two of the volunteers. When we administered glucose with fiber in assay 2, in all cases, the maximum concentration reached was lower, the variations in glycaemia values were also lower along the different sampling times (peaks disappear or are less marked) and no hypoglycaemia appeared.