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Background: Reducing cardiovascular risk through lifestyle changes that include a heart-healthy diet and regular exercise is recommended in the rehabilitation of patients with coronary artery disease (CAD). We pilot-tested the effectiveness of a dietary-education and high-intensity interval resistance training (DE-HIIRT) program on healthy food choices and associated anthropometric variables in patients with established CAD., Methods: A total of 22 participants, aged 60.0 ± 7.2 years, were enrolled in the study. Over 3 months, under the guidance and supervision of a physiotherapist, participants performed the resistance exercises 2×/week in a group setting (cohort of 11). Participants additionally attended three sessions of dietary education led by a dietician. Participants demonstrated their knowledge and understanding of dietary education by picking heart-healthy foods by reading food labels. Outcomes included change in diet (measured using the tricipital skinfold thickness Mediterranean Diet Adherence questionnaire (MEDAS-14) and the Food Consumption Frequency Questionnaire (FCFQ)) and anthropometric measurements (body composition, body circumference, and tricipital skinfold thickness). A paired t-test was performed to analyze the differences between the baseline and post-intervention results., Results: Participants significantly increased their consumption of vegetables ( p = 0.04) and lowered their consumption of sweet snacks ( p = 0.007), pastries ( p = 0.02), and processed food ( p = 0.05). Significant improvements in body mass index ( p = 0.001), waist circumference ( p = 0.0001), hip circumference ( p = 0.04), and body fat ( p = 0.0001) were also achieved., Conclusion: Making lifestyle changes that include both diet and exercise is essential in the management of CAD. The HIIRT program combined with dietary changes shows promise in achieving weight-loss goals in this population and needs to be further investigated with appropriate study designs.

Background and Objective: To determine whether circulating endothelial cells (CECs), circulating microparticles (MPs) and von Willebrand factor (vWF), established markers of endothelial dysfunction/damage, are elevated in patients with antiphospholipid antibodies (aPL) and its possible correlation with inflammation and coagulation., Patients and Methods: Twelve patients with aPL and 12 healthy subjects were studied. Levels of CECs, MPs, vWF, C reactive protein (CRP), fibrinogen (Fg), sialic acid (SA), interleukin 6 (IL-6), tissue factor (TF), thrombin generation (TG) and prothrombin (F1+2) and fibrin (DD) fragments were determined., Results: In patients, markers of dysfunction/damage endothelial, CECs, MPs and vWF; inflammation, Fg and CRP and coagulation, TF and DD were significantly elevated. The bivariate analysis showed significant correlation among CECs and Fg, AS, CRP and DD, as well as between CECs and vWF and MPs., Conclusion: Patients with aPL had endothelial dysfunction associated with an inflammatory process, which, together with high levels of Fg, TF and DD, may be responsible for the hypercoagulable state., (Copyright © 2010 Elsevier España, S.L. All rights reserved.)

Rheological blood behavior in primary Sjögren's syndrome (SS) has been scarcely investigated. We evaluated the rheological profile (blood viscosity, plasma viscosity, erythrocyte deformability, erythrocyte aggregation, erythrocyte aggregation time and erythrocyte disaggregation threshold) along with fibrinogen, high-sensitive C reactive protein, plasma lipids, immunoglobulins, total proteins and erythrocyte sedimentation rate in 22 patients with primary SS (2 males, 20 females, aged 58 ± 9 years) and in 22 healthy volunteers (3 males, 19 females, aged 57 ± 5 years). Patients showed statistically higher plasma viscosity, erythrocyte sedimentation rate and G immunoglobulin (IgG) levels and lower total cholesterol than controls (p = 0.006, p = 0.023, p = 0.034, p = 0.036, respectively). Three patients with extraglandular involvement showed the highest plasma viscosity values: 1.98 cP, 1.70 cP and 1.65 cP, respectively. No differences were observed for the other rheological parameters analyzed. In a multivariate regression analysis, only fibrinogen, triglycerides and IgG were independent determinants for plasma viscosity values (beta coefficient: 0.335; p = 0.001; beta coefficient: 0.242; p = 0.019; beta coefficient: 0.660; p < 0.001, respectively). Our results indicate that patients with primary SS show increased plasma viscosity, mostly related with IgG levels without other alterations in the rheological profile. Further research with a larger sample size achieved by multicenter studies would be desirable.

Objectives: The aim of this study was to evaluate the relevance of genetic variants of TLR5 (rs5744168) and TLR7 (rs179008) gene in systemic lupus erythematosus (SLE) in a Spanish population., Material and Methods: Our study population consisted of 752 SLE patients and 1107 healthy controls. All individual were of Spanish Caucasian origin. The TLR5 and TLR7 polymorphisms were genotyped using a PCR system with pre-developed TaqMan allelic discrimination assay., Results: No statistically significant differences were observed when the allele and genotype distribution of TLR5 rs5744168 and TLR7 rs179008 polymorphisms was compared between SLE patients and healthy controls. A significant increase frequency in the CC genotype of the TLR5 rs5744168 polymorphism among SLE patients without nephritis was found (93% vs. 87% in SLE patients with nephritis, p=0.03, OR=2.11 95%CI 0.93-3.51). However, this difference did not reach statistical significance in the allele frequencies (p=0.08)., Conclusion: These results suggest that the tested variations of TLR5 and TLR7 genes do not confer a relevant role in the susceptibility or severity to SLE in the Spanish population.

Systemic lupus erythematosus (SLE) is characterised by increased venous and arterial thrombotic risk. Although antiphospholipid antibodies (APAs) have been shown to be related with thrombotic tendency in these patients, in more than 40% of them, thrombosis occurs without the presence of such antibodies. We analysed the association of venous and arterial thrombotic events with acquired (anticardiolipin antibodies (ACAs) and lupus anticoagulant (LA)) and inherited (antithrombin (AT), protein C (PC), protein S (PS) deficiencies, factor V Leiden and the prothrombin G20210A mutation), thrombophilic risk factors in 86 SLE patients and 89 healthy controls. Patients showed a higher significant percentage of ACAs titres IgG>41 GPL u/ml and LA than controls (P=0.009; P<0.001, respectively), although no differences in AT, PC, PS deficiencies, factor V Leiden and prothrombin G20210A mutation was observed (P>0.05). When patients with and without thrombosis were compared, those with thrombosis showed a statistically higher percentage of ACAs IgG>41 GPL u/ml and LA (P=0.048; P=0.001, respectively), OR 4.33; 95% CI 1.01-18.50 and OR 11.57; 95% CI 3.28-40.75, respectively. When venous and arterial thrombotic events were considered separately, the presence of LA constituted a risk factor for arterial thrombosis (P=0.010), OR 11.33; 95% CI 1.86-68.89, as well as for venous thrombosis (P=0.005), OR 10.15; 95% CI 2.12-48.64, while ACAs IgG>41 GPL u/ml on their own, were not associated with arterial or venous thrombosis (P=0.142, P=0.233, respectively). In addition inherited thrombophilic risk factors AT, PC, PS deficiencies, factor V Leiden and PT G20210A mutation do not seem to increase thrombotic risk in SLE patients.

Atherothrombotic events are significant factors of mortality and morbidity in patients with systemic lupus erythematosus (SLE). The extent that rheological factors may be involved in these events in these patients has not been established. We measured the following rheological parameters in 86 patients with SLE, of whom 16 had suffered venous and/or arterial thrombotic events, and in 86 healthy controls: fibrinogen (Fbg), plasma viscosity (PV), blood viscosity at 230 s(-1) both at native haematocrit (BVn 230 s(-1) and corrected to 45% (BVc 230 s(-1), erythrocyte aggregation at stasis (AE0) and at 3 s(-1) (AE1), aggregation time (Ta), aggregation index at 10 s (AI10), disaggregation threshold (gammaD), and erythrocyte deformability (ED). In addition glucose, total cholesterol (T-Chol), triglycerides (TG), haematocrit (Hct) and Body Mass Index (BMI) were determined. SLE Disease Activity Index (SLEDAI) was also assessed. The patients showed a significant increase in BMI (P=0.030), TG (P<0.001), PV (P=0.007), AE0 (P=0.005), AE1 (P=0.006), AI10 (P=0.024), gammaD (P=0.001), Fbg (P=0.050); and a significant decrease in Ta (P<0.001), Hct (P<0.001) and BVn 230 s(-1) (P=0.003). When patients with SLEDAI10 were compared, the latter had lower Hct (P=0.041) and lower BVn 230 s(-1) (P=0.017) than those with less SLEDAI. No significant differences were found in any of the parameters analysed on comparing patients who had suffered a thrombotic event with those who had not. Our results suggest that, although patients with SLE have moderate rheological changes, these do not seem to be responsible for the increase in the thrombotic tendency in these patients.

Behçet's disease (BD) is associated with an increased thrombotic risk, although the prothrombotic mechanisms are not clearly defined. Alterations in blood rheology, specially increased erythrocyte aggregation has been suggested to play an important role in the development of thrombotic events in patients with Behçet's disease. In order to ascertain whether any rheological parameter could be involved in the pathogenesis of thrombotic events in Behçet's disease we have determined plasmatic lipids, fibrinogen, hematocrit, erythrocyte aggregation (Myrenne aggregometer), erythrocyte deformability (Rheodyn SSD), blood viscosity (Brookfield viscosimeter), plasma viscosity (Fresenius capillary viscosimeter) and erythrocyte indexes in Behçet's patients with a non-active disease when sampling, and a well matched control group. The patient group was made up of 40 Behçet's patients (20 male, 20 female aged 43+/-12 years) and the control group comprised 70 healthy volunteers (24 male, 46 female aged 45+/-13 years). Twelve of the 40 Behçet's patients have had a previous documented history of deep vein thrombosis at least six months before entering the study, and the other 28 did not. When patients and controls were compared, patients showed a statistically higher fibrinogen level (p=0.002), plasma viscosity (p=0.003), blood viscosity (p=0.021) and erythrocyte aggregation (p=0.049), the other rheological parameters not being statistically significant. No differences were observed in the rheological parameters when patients with and without a previous thrombotic episode were compared. Our results suggest that rheological alterations do not seem to play any role in the development of thrombotic events in patients with Behçet's disease., (Copyright 2004 IOS Press)

Objective: To evaluate a wide detection of tumor markers practiced during admission for the diagnosis of cancer in patients with idiopathic deep venous thrombosis., Material and Methods: Prospective study including 48 patients with documented DVT who lacked a predisposing cause to DVT. It was determined in serum: carcinoembryonic antigen, alphafetoprotein, CA 19-9, CA 125, beta-2-microglobulin, SCC (squamous cell antigen), NSE (neuron-specific enolase), PSA (prostate-specific antigen) in the males and CA15-3 in the women. The patients were evaluated for cancer during admission and followed up at 6 and 12 months., Results: The age was 65 years. A positive tumor marker at least was detected in 23 patients (48%). A cancer was diagnosed in 8 patients (16%), 4 in the group with elevated tumor markers and 4 in the group with normal tumor markers. We don't find significant differences in cancer incidence between both groups. However, of the 4 cases of cancer diagnosed in the group with elevated markers only 1 was considered true positive since in the others three cases the elevate tumor marker was not appropriated with the cancer diagnosed. Six tumors were diagnosed during admission and two during follow-up period. According to these results was obtained a sensitivity of 12%, a specificity of 52%, a positive predictive value of 5% and a negative predictive value of 75%., Conclusions: The cancer incidence is similar to previous series. We have found a poor sensitivity, specificity and positive predictive value. However, the negative predictive value was of 75% and the patients who were normals for results of all tumor markers and was asymptomatic during admission hadn't a subsequent cancer diagnosis.

Pirifibrate, a new hypolipemic substance, was studied in a multicenter trial for three months in 151 patients diagnosed as having type IIa, IIb or IV hyperlipoproteinemia (HLP). The patients admitted into the study had not received any hypolipemic medication for four weeks immediately before the study. We observed falls of between 24.3% and 20.0% in the average levels of plasma cholesterol in types IIa and IIb HLP. The triglycerides showed a decrease in average values, which varied between 31.0% and 38.6% in types IIb and IV HLP. The alpha-lipoproteins always increased in three types of HLP studied, while the pre-beta-lipoproteins showed a fall in averages in types IIb and IV HLP. The beta-lipoprotein levels were reduced in type IIa HLP and reached statistical significance.