Background
The relationship between dietary habits and multiple sclerosis (MS) risk is still controversial. Most studies have involved populations from Scandinavia, North America, and Australia. Data ...on populations from southern Europe (an area of high MS prevalence) are scarce.
Objective
To examine the association between dietary habits/nutritional status and risk of a first demyelinating event, in a southern European incident cohort.
Methods
In this incident case-control study, a detailed nutritional assessment was performed by a registered dietitian in patients with a first demyelinating event, and in age-/sex-matched controls. Body composition analysis, anthropometric evaluation, and blood tests for nutritional status were also performed.
Results
Eighty-three patients with a first demyelinating event were prospectively recruited over a 1-year period. Low intake of fibers (OR 0.846,
p
= 0.014), vitamin D (OR 0.730,
p
< 0.0001), and alpha-linolenic acid (OR 0.283,
p
= 0.014), high BMI (OR 1.132,
p
= 0.028), and ever smoker status (OR 4.472,
p
= 0.003) were all independently associated with risk of a first demyelinating event. Higher intake of rapid absorption carbohydrates, lower intake of vegetal proteins, and higher intake of animal proteins were observed in patients with a first demyelinating event.
Conclusions
Significant differences between patients and controls are observed in the dietary habits at the time of a first demyelinating event, suggesting low intake of fibers, vitamin D and alpha-linolenic acid as the main dietary risk factors. Furthermore, high cardiovascular risk dietary habits are frequent at the time of MS onset, suggesting the usefulness of nutritional intervention as part of the activities of MS centers.
Use of cardiac implantable devices and catheter ablation is steadily increasing in Western countries following the positive results of clinical trials. Despite the advances in scientific knowledge, ...tools development, and techniques improvement we still have some grey area in the field of electrical therapies for the heart. In particular, several reports highlighted differences both in medical behaviour and procedural outcomes between female and male candidates. Women are referred later for catheter ablation of supraventricular arrhythmias, especially atrial fibrillation, leading to suboptimal results. On the opposite females present greater response to cardiac resynchronization, while the benefit of implantable defibrillator in primary prevention seems to be less pronounced. Differences on aetiology, clinical profile, and development of myocardial scarring are the more plausible causes. This review will discuss all these aspects together with gender-related differences in terms of acute/late complications. We will also provide useful hints on plausible mechanisms and practical procedural aspects.
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