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Background: The mainstay of cholesterol reduction therapy is the diet. But the lack of compliance and prescription problems limit its usefulness., Aim: To compare the effectiveness of a nutritional intervention given by a nutritionist with the usual recommendations given by a physician to reduce the LDL cholesterol levels in patients with coronary artery disease, treated at the Regional public hospital in Temuco., Material and Methods: One hundred and forty patients with coronary heart disease (last acute episode at least three months before), without nutritional interventions nor cholesterol-lowering drugs, who gave informed consent, were randomized to receive either instructions by their physician or to take part in a nutritional program. The nutritional intervention consisted in five educational sessions, adapted from the NCEP and from a program of the Nutrition Department of the Catholic University of Chile. Patients randomized to the medical intervention received the standard written recommendations about diet. Lipid profile was measured before the intervention and after a three and twelve months follow up., Results: After one year the group on the nutritionalprogram reduced LDL cholesterol by 11.1% (p=0.03). There were no changes in the medical group. However, only 10% patients on the nutritional intervention group and 8% of those with medical recommendations achieved LDL cholesterol levels less than 100 mg/dl. There were no changes in triglycerides, weight or body mass index during the period., Conclusions: Although this nutritional intervention proved to be more effective than usual medical instructions, most patients on secondary prevention did not achieve acceptable LDL cholesterol levels.

Pyramidal neurons in the rat CA1 hippocampal area contain intracellular receptors for the steroid hormone corticosterone, and membrane associated alpha- and beta-adrenergic receptors. We compared the effect of noradrenaline (NA) on the synaptically evoked CA1 field potential in adrenalectomized (ADX) rats, where corticosteroid receptors are not occupied, with sham-operated controls. It appeared that the increase in the amplitude of the field potential induced by 10 microM NA was more pronounced in slices from ADX rats than in sham operated controls. In vitro application of 30 nM corticosterone (20 min) to slices from ADX rats shifted the NA-evoked increases in synaptic efficacy towards the level of the sham operated rats. The incidence of a secondary population spike after application of NA was increased in slices from ADX rats compared to slices from sham controls or ADX rats treated with corticosterone. Occupation of receptors for corticosterone in the hippocampal CA1 area may therefore potentially lead to suppression of excitability.