Search

Cardiovascular diseases are the most common cause of death in the world. For almost 60 years, vitamin K antagonists (VKAs) were the mainstay of anticoagulation therapy, but in recent years direct oral anticoagulants (DOACs) have become the anticoagulant treatment of choice. DOACs were initially considered drugs with no significant food interactions; however, clinical observations from daily practice have proved otherwise as interactions with food ingredients have been reported. Food, dietary supplements or herbs may contain substances that, when administered concomitantly with DOACs, can potentially affect the plasma concentration of the drugs. The aim of this paper was to evaluate the clinical significance of drug–food interactions of DOACs, such as dabigatran, rivaroxaban, apixaban, edoxaban and betrixaban. Patients treated with anticoagulants should avoid products containing St. John’s wort and take special care with other food ingredients. As the interest in dietary supplements is on the rise, healthcare providers can contribute to the development of well-designed clinical trials on interactions between DOACs and food, and distribute sufficient knowledge about the proper use of these supplements among patients.

Not required for Clinical Vignette.

Objectives: Several inconsistent studies have investigated whether the uterine environment of androgenized pregnant women is a risk factor for an in-utero developmental imprinted predisposition towards subsequent\ud polycystic ovarian syndrome (PCOS) among their female offspring. These are difficult to compare due to variable parameters and subject selection criteria. Few epidemiological studies have analyzed the incidence of PCOS\ud amongst adult daughters of PCOS affected women previously. Our study aimed to investigate risk factors relating to the development of PCOS in the female offspring of PCOS patients.\ud Methods: We used a questionnaire to collect a mother-to-daughter medical history and relevant information, in order to understand risk factors, which might relate to the presence of PCOS daughters of PCOS patients.\ud Results: Of four hundred and one responses, 131 participants were included in the final analysis. There was no statistical association with the subsequent development of PCOS amongst female offspring of women with PCOS. However, there was a significantly higher prevalence of post-term birth among PCOS mothers. Nevertheless, the major determinant of risk of subsequent incidence of PCOS amongst daughters was a higher BMI, regardless of the mothers BMI.\ud Conclusion: Socio-economic family influences, affecting BMI, may be the reason for any mother to daughter association with PCOS.