13 research outputs found

    The role of the new oral anticoagulants in the treatment of coronary disease

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    International conference on the healthy effect of virgin olive oil

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    Ageing represents a great concern in developed countries because the number of people involved and the pathologies related with it, like atherosclerosis, morbus Parkinson, Alzheime's disease, vascular dementia, cognitive decline, diabetes and cancer. Epidemiological studies suggest that a Mediterranean diet (which is rich in virgin olive oil) decreases the risk of cardiovascular disease. The Mediterranean diet, rich in virgin olive oil, improves the major risk factors for cardiovascular disease, such as the lipoprotein profile, blood pressure, glucose metabolism and antithrombotic profile. Endothelial function, inflammation and oxidative stress are also positively modulated. Some of these effects are attributed to minor components of virgin olive oil. Therefore, the definition of the Mediterranean diet should include virgin olive oil. Different observational studies conducted in humans have shown that the intake of monounsaturated fat may be protective against age-related cognitive decline and Alzheimer's disease. Microconstituents from virgin olive oil are bioavailable in humans and have shown antioxidant properties and capacity to improve endothelial function. Furthermore they are also able to modify the haemostasis, showing antithrombotic properties. In countries where the populations fulfilled a typical Mediterranean diet, such as Spain, Greece and Italy, where virgin olive oil is the principal source of fat, cancer incidence rates are lower than in northern European countries. The protective effect of virgin olive oil can be most important in the first decades of life, which suggests that the dietetic benefit of virgin olive oil intake should be initiated before puberty, and maintained through life. The more recent studies consistently support that the Mediterranean diet, based in virgin olive oil, is compatible with a healthier ageing and increased longevity. However, despite the significant advances of the recent years, the final proof about the specific mechanisms and contributing role of the different components of virgin olive oil to its beneficial effects requires further investigations. © 2005 Blackwell Publishing Ltd

    Fe de errores de «Papel de los nuevos anticoagulantes orales en el tratamiento de la enfermedad coronaria»

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    En el artículo publicado anteriormente, se ha detectado un error en la filiación de uno de los autores. En lugar de Juan J. Badimónb,c debe ser: Juan J. Badimónc © 2017In the previously published article, an error has been detected in the affiliation of one of the authors. Instead of Juan J. Badimónb, c should be: Juan J. Badimónc © 201

    The role of the new oral anticoagulants in the treatment of coronary disease

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    Los nuevos anticoagulantes orales llegaron para quedarse en la prevención de ataques cerebrovasculares isquémicos en pacientes con fibrilación auricular no valvular. Varios estudios clínicos han establecido su eficacia y seguridad1---3. Sin embargo, el papel que pueden tener en otras patologías, como la enfermedad coronaria, no está bien estudiado y todavía existen varias e importantes preguntas sin responder. Una de estas es su papel en la prevención secundaria de la enfermedad coronaria, dado que a pesar de un tratamiento médico óptimo y la doble terapia antiplaquetaria, el riesgo de reinfarto ha disminuido tan solo un 30%, fenómeno posiblemente explicado por otros factores relacionados, como el metabolismo lipídico, el estado inflamatorio y el estado protrombótico en el que el factor X activado (Xa), tiene un rol fundamental al generar la conversión de protrombina inactiva a trombina, la cual es el agonista más potente para la agregación plaquetaria4,5. El segundo interrogante está relacionado con los pacientes que tienen fibrilación auricular no valvular y enfermedad coronaria que requieren implante de un stent, en quienes los nuevos anticoagulantes orales podrían llegar a ser una alternativa en combinación con antiagregantes plaquetarios. Actualmente, en Colombia se cuenta con dos tipos de nuevos anticoagulantes orales, los inhibidores directos del factor X activado (rivaroxabán y apixabán) y los inhibidores directos de la trombina (dabigatrán), que pueden ser una nueva herramienta terapéutica para responder a estos interrogantes. Los inhibidores del factor Xa suprimen la síntesis de trombina de una manera indirecta al inhibir este factor, mientras que los antitrombínicos directos inhiben la actividad de la trombina

    Relación entre el efecto antiagregante de la aspirina y el recuento plaquetario: posibles implicaciones en la dosificación

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    Introduccion El 30% de los pacientes presentan antiagregacion plaquetaria inadecuada con 100 mg/dia de aspirina (AAS) luego de la cirugia de revascularizacion miocardica (CRM), que podria deberse a una accion inhibitoria menor de esta dosificacion de AAS a la mayor activacion plaquetaria y al aumento del recambio plaquetario que ocurren en el posoperatorio. Objetivos Evaluar la relacion entre el recuento plaquetario y el menor efecto antiagregante y determinar si dosis fragmentadas de AAS mejoran la antiagregacion. Material y metodos Luego de la CRM con bypass cardiopulmonar (2,95 puentes en promedio), se aleatorizaron prospectivamente 50 pacientes a tres grupos: 18 pacientes (G100) a 100 mg/dia, 14 (G300) a 300 mg/dia y 18 (G100�~3) a 100 mg 3 veces por dia de AAS. En el preoperatorio todos recibieron 100 mg/dia. La reactividad plaquetaria se midio mediante agregacion en sangre entera con acido araquidonico antes de la cirugia (T0), al primero (T1), tercero (T2) y septimo dias (T3) y al mes (T4) pos-CRM. Resultados En el preoperatorio todos los pacientes tenian valores optimos de antiagregacion (0 W). En el posoperatorio, los pacientes del G100�~3 tuvieron mejores niveles de antiagregacion (p < 0,05). Ningun paciente del G100�~3 tuvo valores . 6 W, correspondientes a los de personas sanas sin AAS, a diferencia de 5 pacientes (28%) del G100 y 4 pacientes (29%) del G300. Se observo una asociacion estadisticamente significativa entre la antiagregacion plaquetaria y el recambio del numero de plaquetas (R2 = 0,57; p = 0,001). Un recambio diario > 20% se relaciono con valores de agregacion plaquetaria . 6 W con un OR = 2,1 (IC 1,8-4,21; p = 0,0028). Conclusiones En los pacientes sometidos a CRM, la menor respuesta antiagregante a la AAS se correlaciono con el recambio aumentado de plaquetas. El tratamiento podria fragmentarse con dosis bajas de AAS para obtener mejor antiagregacion

    Olive oil and health: Summary of the II international conference on olive oil and health consensus report, Jaén and Córdoba (Spain) 2008

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    Olive oil (OO) is the most representative food of the traditional Mediterranean Diet (MedDiet). Increasing evidence suggests that monounsaturated fatty acids (MUFA) as a nutrient, OO as a food, and the MedDiet as a food pattern are associated with a decreased risk of cardiovascular disease, obesity, metabolic syndrome, type 2 diabetes and hypertension. A MedDiet rich in OO and OO per se has been shown to improve cardiovascular risk factors, such as lipid profiles, blood pressure, postprandial hyperlipidemia, endothelial dysfunction, oxidative stress, and antithrombotic profiles. Some of these beneficial effects can be attributed to the OO minor components. Therefore, the definition of the MedDiet should include OO. Phenolic compounds in OO have shown antioxidant and anti-inflammatory properties, prevent lipoperoxidation, induce favorable changes of lipid profile, improve endothelial function, and disclose antithrombotic properties. Observational studies from Mediterranean cohorts have suggested that dietary MUFA may be protective against age-related cognitive decline and Alzheimer's disease. Recent studies consistently support the concept that the OO-rich MedDiet is compatible with healthier aging and increased longevity. In countries where the population adheres to the MedDiet, such as Spain, Greece and Italy, and OO is the principal source of fat, rates of cancer incidence are lower than in northern European countries. Experimental and human cellular studies have provided new evidence on the potential protective effect of OO on cancer. Furthermore, results of case-control and cohort studies suggest that MUFA intake including OO is associated with a reduction in cancer risk (mainly breast, colorectal and prostate cancers).CIBEROBN is an initiative of ISCIII and CEAS Foundation, Spain.Peer reviewe
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