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Causas, síntomas y tratamiento.", "creators": [], "abstractNote": "", "websiteTitle": "", "websiteType": "", "date": "", "publisher": "", "place": "", "DOI": "", "citationKey": "", "url": "http://www.cun.es/enfermedades-tratamientos/enfermedades/infarto-miocardio", "accessDate": "2014-09-16T14:51:14Z", "shortTitle": "", "language": "", "rights": "", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2014-09-16T14:51:14Z", "dateModified": "2014-09-16T14:51:14Z" } }, { "key": "IZ4XMINN", "version": 4, "library": { "type": "group", "id": 286362, "name": "INFORMED 24S", "links": { "alternate": { "href": "https://www.zotero.org/groups/informed_24s", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/286362/items/IZ4XMINN", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/informed_24s/items/IZ4XMINN", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2057471, "username": "danielr96", 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"2014-09-16T14:49:14Z" } }, { "key": "WQJFJ8J9", "version": 2, "library": { "type": "group", "id": 286362, "name": "INFORMED 24S", "links": { "alternate": { "href": "https://www.zotero.org/groups/informed_24s", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/286362/items/WQJFJ8J9", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/informed_24s/items/WQJFJ8J9", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/286362/items/H92P8GPG", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2057471, "username": "danielr96", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/danielr96", "type": "text/html" } } } }, "data": { "key": "WQJFJ8J9", "version": 2, "parentItem": "H92P8GPG", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2014-09-09T14:39:35Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/24920915", "note": "", 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"key": "4DFACISK", "version": 2, "parentItem": "C7P587G9", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2014-09-09T14:39:35Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/24966684", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2014-09-09T14:39:35Z", "dateModified": "2014-09-09T14:39:35Z" } }, { "key": "H92P8GPG", "version": 2, "library": { "type": "group", "id": 286362, "name": "INFORMED 24S", "links": { "alternate": { "href": "https://www.zotero.org/groups/informed_24s", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/286362/items/H92P8GPG", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/informed_24s/items/H92P8GPG", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2057471, "username": "danielr96", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/danielr96", "type": "text/html" } } }, "creatorSummary": "Hassanein et al.", "parsedDate": "2014", "numChildren": 1 }, "data": { "key": "H92P8GPG", "version": 2, "itemType": "journalArticle", "title": "A double-blind, randomized trial, including frequent patient-physician contacts and Ramadan-focused advice, assessing vildagliptin and gliclazide in patients with type 2 diabetes fasting during Ramadan: the STEADFAST study", "creators": [ { "creatorType": "author", "firstName": "Mohamed", "lastName": "Hassanein" }, { "creatorType": "author", "firstName": "Khalifa", "lastName": "Abdallah" }, { "creatorType": "author", "firstName": "Anja", "lastName": "Schweizer" } ], "abstractNote": "BACKGROUND: Several observational studies were conducted with vildagliptin in patients with type 2 diabetes mellitus (T2DM) fasting during Ramadan, showing significantly lower incidences of hypoglycemia with vildagliptin versus sulfonylureas, including gliclazide. It was of interest to complement the existing real-life evidence with data from a randomized, double-blind, clinical trial.\nCLINICAL TRIALS IDENTIFIER: NCT01758380.\nMETHODS: This multiregional, double-blind study randomized 557 patients with T2DM (mean glycated hemoglobin [HbA1c], 6.9%), previously treated with metformin and any sulfonylurea to receive either vildagliptin (50 mg twice daily) or gliclazide plus metformin. The study included four office visits (three pre-Ramadan) and multiple telephone contacts, as well as Ramadan-focused advice. Hypoglycemic events were assessed during Ramadan; HbA(1c) and weight were analyzed before and after Ramadan.\nRESULTS: The proportion of patients reporting confirmed (<3.9 mmol/L and/or severe) hypoglycemic events during Ramadan was 3.0% with vildagliptin and 7.0% with gliclazide (P=0.039; one-sided test), and this was 6.0% and 8.7%, respectively, for any hypoglycemic events (P=0.173). The adjusted mean change pre- to post-Ramadan in HbA(1c) was 0.05%±0.04% with vildagliptin and -0.03%±0.04% with gliclazide, from baselines of 6.84% and 6.79%, respectively (P=0.165). In both groups, the adjusted mean decrease in weight was -1.1±0.2 kg (P=0.987). Overall safety was similar between the treatments.\nCONCLUSION: In line with the results from previous observational studies, vildagliptin was shown in this interventional study to be an effective, safe, and well-tolerated treatment in patients with T2DM fasting during Ramadan, with a consistently low incidence of hypoglycemia across studies, accompanied by good glycemic and weight control. In contrast, gliclazide showed a lower incidence of hypoglycemia in the present interventional than the previous observational studies. This is suggested to be linked to the specific circumstances of this study, including frequent patient-physician contacts, Ramadan-focused advice, a recent switch in treatment, and very well-controlled patients, which is different from what is often seen in real life.", "publicationTitle": "Vascular Health and Risk Management", "publisher": "", "place": "", "date": "2014", "volume": "10", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "319-326", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Vasc Health Risk Manag", "DOI": "10.2147/VHRM.S64038", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1178-2048", "archive": "", "archiveLocation": "", "shortTitle": "A double-blind, randomized trial, including frequent patient-physician contacts and Ramadan-focused advice, assessing vildagliptin and gliclazide in patients with type 2 diabetes fasting during Ramadan", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 24920915 \nPMCID: PMC4045264", "tags": [ { "tag": "Adamantane", "type": 1 }, { "tag": "Asia", "type": 1 }, { "tag": "Biological Markers", "type": 1 }, { "tag": "Blood Glucose", "type": 1 }, { "tag": "Body Weight", "type": 1 }, { "tag": "Counseling", "type": 1 }, { "tag": "Diabetes Mellitus, Type 2", "type": 1 }, { "tag": "Dipeptidyl-Peptidase IV Inhibitors", "type": 1 }, { "tag": "Double-Blind Method", "type": 1 }, { "tag": "Europe", "type": 1 }, { "tag": "Fasting", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Gliclazide", "type": 1 }, { "tag": "Hemoglobin A, Glycosylated", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Hypoglycemia", "type": 1 }, { "tag": "Hypoglycemic Agents", "type": 1 }, { "tag": "Islam", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Medication Adherence", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Middle East", "type": 1 }, { "tag": "Nitriles", "type": 1 }, { "tag": "Office Visits", "type": 1 }, { "tag": "Pyrrolidines", "type": 1 }, { "tag": "Religion and Medicine", "type": 1 }, { "tag": "Telephone", "type": 1 }, { "tag": "Time Factors", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2014-09-09T14:39:35Z", "dateModified": "2014-09-09T14:39:35Z" } }, { "key": "T8QISZ6J", "version": 2, "library": { "type": "group", "id": 286362, "name": "INFORMED 24S", "links": { "alternate": { "href": "https://www.zotero.org/groups/informed_24s", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/286362/items/T8QISZ6J", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/informed_24s/items/T8QISZ6J", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2057471, "username": "danielr96", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/danielr96", "type": "text/html" } } }, "creatorSummary": "Lamas et al.", "parsedDate": "2014-07", "numChildren": 1 }, "data": { "key": "T8QISZ6J", "version": 2, "itemType": "journalArticle", "title": "EDTA chelation therapy alone and in combination with oral high-dose multivitamins and minerals for coronary disease: The factorial group results of the Trial to Assess Chelation Therapy", "creators": [ { "creatorType": "author", "firstName": "Gervasio A.", "lastName": "Lamas" }, { "creatorType": "author", "firstName": "Robin", "lastName": "Boineau" }, { "creatorType": "author", "firstName": "Christine", "lastName": "Goertz" }, { "creatorType": "author", "firstName": "Daniel B.", "lastName": "Mark" }, { "creatorType": "author", "firstName": "Yves", "lastName": "Rosenberg" }, { "creatorType": "author", "firstName": "Mario", "lastName": "Stylianou" }, { "creatorType": "author", "firstName": "Theodore", "lastName": "Rozema" }, { "creatorType": "author", "firstName": "Richard L.", "lastName": "Nahin" }, { "creatorType": "author", "firstName": "L.", "lastName": "Terry Chappell" }, { "creatorType": "author", "firstName": "Lauren", "lastName": "Lindblad" }, { "creatorType": "author", "firstName": "Eldrin F.", "lastName": "Lewis" }, { "creatorType": "author", "firstName": "Jeanne", "lastName": "Drisko" }, { "creatorType": "author", "firstName": "Kerry L.", "lastName": "Lee" } ], "abstractNote": "BACKGROUND: Disodium ethylenediaminetetraacetic acid (EDTA) reduced adverse cardiac outcomes in a factorial trial also testing oral vitamins. This report describes the intent-to-treat comparison of the 4 factorial groups overall and in patients with diabetes.\nMETHODS: This was a double-blind, placebo-controlled, 2 × 2 factorial multicenter randomized trial of 1,708 post-myocardial infarction (MI) patients ≥50 years of age and with creatinine ≤2.0 mg/dL randomized to receive 40 EDTA chelation or placebo infusions plus 6 caplets daily of a 28-component multivitamin-multimineral mixture or placebo. The primary end point was a composite of total mortality, MI, stroke, coronary revascularization, or hospitalization for angina.\nRESULTS: Median age was 65 years, 18% were female, 94% were Caucasian, 37% were diabetic, 83% had prior coronary revascularization, and 73% were on statins. Five-year Kaplan-Meier estimates for the primary end point was 31.9% in the chelation + high-dose vitamin group, 33.7% in the chelation + placebo vitamin group, 36.6% in the placebo infusion + active vitamin group, and 40.2% in the placebo infusions + placebo vitamin group. The reduction in primary end point by double active treatment compared with double placebo was significant (hazard ratio 0.74, 95% CI 0.57-0.95, P = .016). In patients with diabetes, the primary end point reduction of double active compared with double placebo was more pronounced (hazard ratio 0.49, 95% CI 0.33-0.75, P < .001).\nCONCLUSIONS: In stable post-MI patients on evidence-based medical therapy, the combination of oral high-dose vitamins and chelation therapy compared with double placebo reduced clinically important cardiovascular events to an extent that was both statistically significant and of potential clinical relevance.", "publicationTitle": "American Heart Journal", "publisher": "", "place": "", "date": "Jul 2014", "volume": "168", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "37-44.e5", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Am. Heart J.", "DOI": "10.1016/j.ahj.2014.02.012", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1097-6744", "archive": "", "archiveLocation": "", "shortTitle": "EDTA chelation therapy alone and in combination with oral high-dose multivitamins and minerals for coronary disease", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 24952858 \nPMCID: PMC4069605", "tags": [ { "tag": "Administration, Oral", "type": 1 }, { "tag": "Aged", "type": 1 }, { "tag": "Chelating Agents", "type": 1 }, { "tag": "Chelation Therapy", "type": 1 }, { "tag": "Coronary Disease", "type": 1 }, { "tag": "Dose-Response Relationship, Drug", "type": 1 }, { "tag": "Double-Blind Method", "type": 1 }, { "tag": "Drug Therapy, Combination", "type": 1 }, { "tag": "Edetic Acid", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Infusions, Intravenous", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Minerals", "type": 1 }, { "tag": "Survival Rate", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 }, { "tag": "United States", "type": 1 }, { "tag": "Vitamins", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2014-09-09T14:39:35Z", "dateModified": "2014-09-09T14:39:35Z" } }, { "key": "C7P587G9", "version": 2, "library": { "type": "group", "id": 286362, "name": "INFORMED 24S", "links": { "alternate": { "href": "https://www.zotero.org/groups/informed_24s", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/286362/items/C7P587G9", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/informed_24s/items/C7P587G9", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2057471, "username": "danielr96", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/danielr96", "type": "text/html" } } }, "creatorSummary": "Penfornis et al.", "parsedDate": "2014", "numChildren": 1 }, "data": { "key": "C7P587G9", "version": 2, "itemType": "journalArticle", "title": "How are patients with type 2 diabetes and renal disease monitored and managed? Insights from the observational OREDIA study", "creators": [ { "creatorType": "author", "firstName": "Alfred", "lastName": "Penfornis" }, { "creatorType": "author", "firstName": "Jean Frédéric", "lastName": "Blicklé" }, { "creatorType": "author", "firstName": "Béatrice", "lastName": "Fiquet" }, { "creatorType": "author", "firstName": "Stéphane", "lastName": "Quéré" }, { "creatorType": "author", "firstName": "Sylvie", "lastName": "Dejager" } ], "abstractNote": "BACKGROUND AND AIM: Chronic kidney disease (CKD) is frequent in type 2 diabetes mellitus (T2DM), and therapeutic management of diabetes is more challenging in patients with renal impairment (RI). The place of metformin is of particular interest since most scientific societies now recommend using half the dosage in moderate RI and abstaining from use in severe RI, while the classic contraindication with RI has not been removed from the label. This study aimed to assess the therapeutic management, in particular the use of metformin, of T2DM patients with CKD in real life.\nMETHODS: This was a French cross-sectional observational study: 3,704 patients with T2DM diagnosed for over 1 year and pharmacologically treated were recruited in two cohorts (two-thirds were considered to have renal disease [CKD patients] and one-third were not [non-CKD patients]) by 968 physicians (81% general practitioners) in 2012.\nRESULTS: CKD versus non-CKD patients were significantly older with longer diabetes history, more diabetic complications, and less strict glycemic control (mean glycated hemoglobin [HbA(1c)] 7.5% versus 7.1%; 25% of CKD patients had HbA1c ≥8% versus 15% of non-CKD patients). Fifteen percent of CKD patients had severe RI, and 66% moderate RI. Therapeutic management of T2DM was clearly distinct in CKD, with less use of metformin (62% versus 86%) but at similar mean daily doses (~2 g/d). Of patients with severe RI, 33% were still treated with metformin, at similar doses. For other oral anti-diabetics, a distinct pattern of use was seen across renal function (RF): use of sulfonylureas (32%, 31%, and 20% in normal RF, moderate RI, and severe RI, respectively) and DPP4-i (dipeptidyl peptidase-4 inhibitors) (41%, 36%, and 25%, respectively) decreased with RF, while that of glinides increased (8%, 14%, and 18%, respectively). CKD patients were more frequently treated with insulin (40% versus 16% of non-CKD patients), and use of insulin increased with deterioration of RF (19%, 39%, and 61% of patients with normal RF, moderate RI, and severe RI, respectively). Treatment was modified at the end of the study-visit in 34% of CKD patients, primarily to stop or reduce metformin. However, metformin was stopped in only 40% of the severe RI patients.\nCONCLUSION: Despite a fairly good detection of CKD in patients with T2DM, RI was insufficiently taken into account for adjusting anti-diabetic treatment.", "publicationTitle": "Vascular Health and Risk Management", "publisher": "", "place": "", "date": "2014", "volume": "10", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "341-352", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Vasc Health Risk Manag", "DOI": "10.2147/VHRM.S60312", "citationKey": "", "url": "", "accessDate": "", "PMID": "", "PMCID": "", "ISSN": "1178-2048", "archive": "", "archiveLocation": "", "shortTitle": "How are patients with type 2 diabetes and renal disease monitored and managed?", "language": "eng", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 24966684 \nPMCID: PMC4063863", "tags": [ { "tag": "Aged", "type": 1 }, { "tag": "Aged, 80 and over", "type": 1 }, { "tag": "Biological Markers", "type": 1 }, { "tag": "Cross-Sectional Studies", "type": 1 }, { "tag": "Diabetes Mellitus, Type 2", "type": 1 }, { "tag": "Diabetic Nephropathies", "type": 1 }, { "tag": "Dipeptidyl-Peptidase IV Inhibitors", "type": 1 }, { "tag": "Drug Prescriptions", "type": 1 }, { "tag": "Drug Substitution", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "France", "type": 1 }, { "tag": "Glomerular Filtration Rate", "type": 1 }, { "tag": "Hemoglobin A, Glycosylated", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Hypoglycemic Agents", "type": 1 }, { "tag": "Insulin", "type": 1 }, { "tag": "Kidney", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Metformin", "type": 1 }, { "tag": "Middle Aged", "type": 1 }, { "tag": "Physician's Practice Patterns", "type": 1 }, { "tag": "Renal Insufficiency, Chronic", "type": 1 }, { "tag": "Severity of Illness Index", "type": 1 }, { "tag": "Time Factors", "type": 1 }, { "tag": "Treatment Outcome", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2014-09-09T14:39:35Z", "dateModified": "2014-09-09T14:39:35Z" } } ]