Papers by Jose Nicolás Aradillas Lopez
BMC Medicine, 2015
The current epidemic of obesity and cardiometabolic diseases in developing countries is described... more The current epidemic of obesity and cardiometabolic diseases in developing countries is described as being driven by socioeconomic inequalities. These populations have a greater vulnerability to cardiometabolic diseases due to the discrepancy between the maternal undernutrition and its consequence, low-birth weight progeny, and the subsequent modern lifestyles which are associated with socioeconomic and environmental changes that modify dietary habits, discourage physical activity and encourage sedentary behaviors. Maternal undernutrition can generate epigenetic modifications, with potential long-term consequences. Throughout life, people are faced with the challenge of adapting to changes in their environment, such as excessive intake of high energy density foods and sedentary behavior. However, a mismatch between conditions experienced during fetal programming and current environmental conditions will make adaptation difficult for them, and will increase their susceptibility to obesity and cardiovascular diseases. It is important to conduct research in the Latin American context, in order to define the best strategies to prevent the epidemic of cardiometabolic diseases in the region.
Eos, Transactions American Geophysical Union, 2003
Revista Española de Cardiología (English Edition), 2008
Given that treatment for secondary prevention in patients undergoing cardiac surgery is underused... more Given that treatment for secondary prevention in patients undergoing cardiac surgery is underused, we devised a hospital intervention to increase its implementation. The intervention involved all physicians in the department of cardiac surgery agreeing to complete a report on each patient before hospital discharge. The document recorded the indications for the recommended treatments, and prompted for details of the drugs prescribed, the doses used, the reasons for not prescribing the recommended drugs, if that was the case, and the use of alternative medicines. The efficacy of the intervention was evaluated by comparing the rate of drug use in the year in which it was introduced (2003, n=341) with retrospective data on the rate in the previous year (n=369). The rates of use of aspirin, statins, angiotensinconverting enzyme inhibitors, and beta-blockers by patients who required them all showed an absolute increase, of 13.4%, 38.3%, 21.8%, and 21.5%, respectively. In conclusion, the introduction of a simple and inexpensive intervention was able to significantly increase the use of drugs for secondary prevention in patients undergoing cardiac surgery.
Medicina Oral Patología Oral y Cirugia Bucal, 2012
The possible connection between chronic oral inflammatory processes, such as apical periodontitis... more The possible connection between chronic oral inflammatory processes, such as apical periodontitis and periodontal disease (PD), and systemic health is one of the most interesting aspects faced by the medical and dental scientific community. Chronic apical periodontitis shares important characteristics with PD: 1) both are chronic infections of the oral cavity, 2) the Gram-negative anaerobic microbiota found in both diseases is comparable, and 3) in both infectious processes increased local levels of inflammatory mediators may have an impact on systemic levels. One of the systemic disorders linked to PD is diabetes mellitus (DM); is therefore plausible to assume that chronic apical periodontitis and endodontic treatment are also associated with DM. The status of knowledge regarding the relationship between DM and endodontics is reviewed. Upon review, we conclude that there are data in the literature that associate DM with a higher prevalence of periapical lesions, greater size of the osteolityc lesions, greater likelihood of asymptomatic infections and worse prognosis for root filled teeth. The results of some studies suggest that periapical disease may contribute to diabetic metabolic dyscontrol.
Current Hypertension Reviews, 2015
Hypertension affects 1 billion people worldwide and is considered the leading cause of death, str... more Hypertension affects 1 billion people worldwide and is considered the leading cause of death, stroke, myocardial infarction and congestive heart failure. Sodium intake is reported to be a modifiable determinant of hypertension and reductions in its consumption have been widely recommended. Various strategies have been proposed to address the observed epidemic of cardiovascular diseases, particularly in medium and low-income countries. Among these strategies, reducing dietary sodium intake and increasing dietary potassium intake are commonly included in guidelines for the treatment of hypertension and the prevention of cardiovascular disease. In the present article, we review the results of recent studies that have raised questions about potential adverse effects associated with low sodium intake on important health outcomes, including cardiovascular diseases and death. It is clear from these studies, that there are contradictory and irreconcilable positions in the interpretation of the evidence, a situation that indicates that there is an urgent need for international randomized controlled trials that consistently demonstrate that the low levels of sodium intake recommended in the guidelines are safe and beneficial for different populations around the world. In the interim, and in accordance with a number of experts, we agree that the current evidence argues against the reduction of dietary sodium as an isolated public health recommendation and that an alternative approach of recommending high quality, potassium rich diets, might achieve greater health benefits, including blood-pressure reduction, than aggressive sodium reduction alone.
Revista Española de Cardiología, 2008
Dada la infrautilización de los tratamientos de prevención secundaria en pacientes sometidos a ci... more Dada la infrautilización de los tratamientos de prevención secundaria en pacientes sometidos a cirugía cardiaca, se diseñó una intervención hospitalaria para mejorar su empleo consistente en el compromiso de los miembros del servicio de cirugía cardiaca de cumplimentar antes del alta hospitalaria un formulario que recordaba las indicaciones de los tratamientos recomendados, preguntaba por su prescripción, la dosis empleada, la causa de no prescribir, si era el caso, y el uso de fármacos alternativos. Su eficacia se evaluó comparando la tasa de utilización de los fármacos el año de su uso, 2003 (n = 341), con la del año previo, obtenida retrospectivamente (n = 369). El uso de ácido acetilsalicílico, estatinas, inhibidores de la convertasa angiotensínica y bloqueadores beta en candidatos ideales aumentó en total el 13,4, el 38,3, el 21,8 y el 21,5% respectivamente. En conclusión, una intervención sencilla y barata fue capaz de mejorar significativamente el empleo de fármacos de prevención secundaria en pacientes sometidos a cirugía cardiaca. Palabras clave: Prevención secundaria. Cirugía cardiaca. Mejora de calidad.
Medicina Oral Patología Oral y Cirugia Bucal, 2012
Objective: The purpose of this study was to investigate the incidence of squamous cell carcinoma ... more Objective: The purpose of this study was to investigate the incidence of squamous cell carcinoma (SCC) of the anterior two thirds of the tongue in a population living in central and southern Portugal, all treated at Instituto Português de Oncologia de Lisboa, Francisco Gentil (IPOLFG). Study Design: This study was a retrospective review of all patients who had a histopathological diagnosis of SCC of the anterior two thirds of the tongue and had been treated in the Head and Neck Surgery Unit at the IPOLFG (Lisbon, Portugal), between 1st January 2001 and 31st December 2009. The risk factors evaluated were: gender; age; alcohol consumption; tobacco use; prosthesis use and the carcinoma site. Results: Of the 424 cases analysed, 71% were men. Mean age of occurrence was in 5th decade for males and the 6th decade for females, and the border of the tongue was the most common location. Alcohol consumption and tobacco had a lower impact in women, being the most common aetiological factors in the male population. No significant association was observed between patients and the use of a prosthesis. Conclusions: In spite of the consumption of aohol and tobacco starting to decline in certain parts of the world, our findings showed both factors still have a significant impact in male population. Further research should be done to determine aetiological factors in females.
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Papers by Jose Nicolás Aradillas Lopez