Relationship of calcium and magnesium intakes with the dietary approaches to stop hypertension score and blood pressure: the International Study of Macro/micronutrients and Blood Pressure.

OBJECTIVE: Research investigating calcium and magnesium intakes from the Dietary Approaches to Stop Hypertension (DASH) pattern and other sources in association with blood pressure is limited. We aimed to characterize sources/intake levels of calcium and magnesium in relation to overall diet quality (DASH-score) and determine modification effects with DASH score and blood pressure. METHODS: Cross-sectional United States data (average dietary and supplement intake from four 24 h recalls and eight blood pressure measurements) from two separate visits, 2195 men and women (40-59 years) in the International Study of Macro/Micronutrients and Blood Pressure were analysed. Food-based adherence to the DASH diet was estimated. Linear models tested associations between each 1-point DASH score with blood pressure. Participants were stratified by adherence to sex-specific recommended allowance for magnesium and calcium intakes. Effect-modification was tested across DASH-score quintiles and median of urinary sodium. RESULTS: DASH-score was inversely associated with SBP in fully adjusted models (-0.27; 95%CI: -0.38 to -0.15 mmHg). SBP was inversely associated with dietary calcium intake from DASH food groups: -1.54 (95% CI: -2.65 to -0.43) mmHg; calcium intake from other non-DASH food groups: -1.62 (95% CI: -2.94 to -0.29) mmHg. Dietary magnesium intake from DASH food groups (-1.59; 95% CI: -2.79, -0.40 mmHg) and from other non-DASH foods (-1.92; 95% CI: -3.31, -0.53 mmHg) was inversely associated with SBP. CONCLUSION: A higher DASH score showed a consistent association with lower BP suggesting a relationship between intakes of calcium and Mg with BP regardless of whether the source is part of the DASH diet or not, even when adjusted for supplement intakes.The INTERMAP is registered as NCT00005271 at www.clinicaltrials.gov .

Use of the Therapy App Prescinde for Increasing Adherence to Smoking Cessation Treatment.

Tobacco use poses major health risks and is a major contributor to causes of death worldwide. Mobile phone-based cessation apps for this substance are gaining popularity, often used as a component of traditional interventions. This study aimed to analyze adherence to an intervention using a mobile phone application (App-therapy Prescinde (v1)) as a function of sociodemographic variables (age, gender, educational level, and profession) as well as the primary activities supported by the app (reducing tobacco or cannabis use and increasing physical exercise). The participants were recruited through the web pages of the Occupational Risk Prevention Service and the Psychology Clinic of the University of Granada during the COVID-19 confinement period. The application's contents include three components (self-report, motivational phrases, and goal setting). Our findings indicate that being male, being aged between 26 and 62, having a high school education, and being unemployed increase the likelihood of adherence to the Prescinde therapy app three months after usage. Our findings highlight the importance of developing new therapeutic approaches and conducting in-depth studies on the factors associated with adherence to tobacco cessation and cannabis cessation treatments via mobile phone applications.

Safety and Efficacy of Traditional Heart Failure Therapies in Patients With Cardiac Amyloidosis and Heart Failure.

Randomized controlled trials have demonstrated mortality benefits for several medication classes in patients with heart failure (HF), especially with reduced ejection fraction (EF). However, the benefit of these traditional HF therapies in patients with HF from cardiac amyloidosis is unclear. our study aimed to evaluate the safety and efficacy of traditional HF therapies in patients with cardiac amyloidosis and HF with reduced EF or HF with mid-range EF (HFmrEF). We conducted a single-center retrospective study. Patients were included if they were diagnosed with cardiac amyloidosis and HF with reduced EF or HF with mid-range EF between January 2012 and 2022. The primary outcomes of interest were medication use patterns (for ß blockers [BB], angiotensin-converting enzyme inhibitors [ACEI], angiotensin receptor blockers [ARBs], angiotensin receptor neprilysin inhibitors [ARNI], and mineralocorticoid receptor antagonists [MRAs]); potential medication side effects (symptomatic bradycardia, fatigue, hypotension, lightheadedness, and syncope); hospitalization; and death. The associations of BB, ACEI/ARB/ARNI, and MRA use with clinical outcomes were evaluated using Kaplan-Meier and Cox proportional hazards regression. A total of 82 patients met study criteria. At time of cardiac amyloidosis diagnosis, 63.4% were on a BB, 51.2% were on an ACEI/ARB/ARNI, and 43.9% were on an MRA. At last follow-up, 51.2% were on a BB, 35.4% were on an ACEI/ARB/ARNI, and 43.9% were on an MRA. There were no statistically significant differences in rates of potential medication side effects in patients on the medication class compared with those who were not. There was no association with hospitalization or mortality for baseline or follow-up BB, ACEI/ARB/ARNI, or MRA use. In conclusion, BBs, ACEI/ARB/ARNIs, and MRAs may be safely used in this population. However, their use does not appear to improve mortality or hospitalization.

Gene Expression Profile of Stromal Factors in Cancer-Associated Fibroblasts from Prostate Cancer.

Recent investigations point at the stromal microenvironment to assess additional diagnostic information and provide new therapeutic targets in cancer. The aim of the study was to contribute to the characterization of the phenotype of cancer-associated fibroblasts (CAFs) in prostate cancer (PCa) compared with normal prostate-associated fibroblasts (NAFs) and fibroblasts from benign prostatic hyperplasia (BPH). Three patient populations were prospectively recruited: 23 patients with new localized PCa, 14 patients with advanced PCa treated with androgenic deprivation therapy (ADT), and 7 patients with BPH. Gene expression of 20 stroma-derived factors, including the androgen receptor (AR), chaperones (HSPA1A and HSF1), growth factors (FGF2, FGF7, FGF10, HGF, PDGFB, and TGFß), proteins implicated in invasion (MMP2, MMP9, and MMP11), inflammation (IL6, IL17RB, NFκB, and STAT3), and in-stroma/epithelium interaction (CDH11, CXCL12, CXCL14, and FAP), was evaluated. Localized PCa CAFs showed a significant higher expression of FGF7, IL6, MMP2, and MMP11 compared with NAFs or IL17RB compared with BPH fibroblasts, but significantly lower expression of FGF10 and IL17RB compared with NAFs or CXCL14 compared with BPH fibroblasts. In addition, CAFs from ADT-resistant PCa showed significantly higher MMP11 and NFκB but significant lower TGFß expression compared with CAFs from ADT-sensitive tumors. Our results contribute to defining the CAFs phenotypes associated to PCa progression, which may contribute to the diagnosis and design of alternative therapies in PCa.

Randomized Clinical Trial: Effects of ß-Hydroxy-ß-Methylbutyrate (HMB)-Enriched vs. HMB-Free Oral Nutritional Supplementation in Malnourished Cirrhotic Patients.

ß-Hydroxy-ß-methylbutyrate (HMB) supplementation increases muscle and strength mass in some muscle-wasting disorders. Malnutrition and sarcopenia are often present in liver cirrhosis. We aimed to investigate the effects of oral HMB supplementation on changes in body composition and liver status in patients with cirrhosis and malnutrition. In a randomized, controlled, double-blind trial, 43 individuals were randomized to receive twice a day and for 12 weeks an oral nutritional supplement (ONS) enriched with 1.5 g of calcium HMB per bottle or another supplement with similar composition devoid of HMB. Inclusion criteria were liver cirrhosis with at least one previous decompensation and clinical malnutrition. Liver function, plasma biochemistry analyses, and physical condition assessment were carried out at baseline, then after six and 12 weeks of supplementation. A total of 34 patients completed the clinical trial. An improvement in liver function and an increase in fat mass index were observed in both groups. None of the two ONS changed the fat-free mass. However, we observed an upward trend in handgrip strength and a downward trend in minimal hepatic encephalopathy in the HMB group. At the end of the trial and regardless of the supplement administered, fat mass content increased with no change in fat-free mass, while liver function scores and nutritional analytic markers also improved.

Amino Acid Profile in Malnourished Patients with Liver Cirrhosis and Its Modification with Oral Nutritional Supplements: Implications on Minimal Hepatic Encephalopathy.

Low plasma levels of branched chain amino acids (BCAA) in liver cirrhosis are associated with hepatic encephalopathy (HE). We aimed to identify a metabolic signature of minimal hepatic encephalopathy (MHE) in malnourished cirrhotic patients and evaluate its modification with oral nutritional supplements (ONS) enriched with ß-Hydroxy-ß-methylbutyrate (HMB), a derivative of the BCAA leucine. Post hoc analysis was conducted on a double-blind placebo-controlled trial of 43 individuals with cirrhosis and malnutrition, who were randomized to receive, for 12 weeks, oral supplementation twice a day with either 220 mL of Ensure® Plus Advance (HMB group, n = 22) or with 220 mL of Ensure® Plus High Protein (HP group, n = 21). MHE evaluation was by psychometric hepatic encephalopathy score (PHES). Compared to the HP group, an HMB-specific treatment effect led to a larger increase in Val, Leu, Phe, Trp and BCAA fasting plasma levels. Both treatments increased Fischer's ratio and urea without an increase in Gln or ammonia fasting plasma levels. MHE was associated with a reduced total plasma amino acid concentration, a reduced BCAA and Fischer´s ratio, and an increased Gln/Glu ratio. HMB-enriched ONS increased Fischer´s ratio without varying Gln or ammonia plasma levels in liver cirrhosis and malnutrition, a protective amino acid profile that can help prevent MHE.

FLT3 inhibitors in the treatment of acute myeloid leukemia: current status and future perspectives.

Mutations in the FMS-like tyrosine kinase 3 (FLT3) gene arise in 25-30% of all acute myeloid leukemia (AML) patients. These mutations lead to constitutive activation of the protein product and are divided in two broad types: internal tandem duplication (ITD) of the juxtamembrane domain (25% of cases) and point mutations in the tyrosine kinase domain (TKD). Patients with FLT3 ITD mutations have a high relapse risk and inferior cure rates, whereas the role of FLT3 TKD mutations still remains to be clarified. Additionally, growing research indicates that FLT3 status evolves through a disease continuum (clonal evolution), where AML cases can acquire FLT3 mutations at relapse - not present in the moment of diagnosis. Several FLT3 inhibitors have been tested in patients with FLT3-mutated AML. These drugs exhibit different kinase inhibitory profiles, pharmacokinetics and adverse events. First-generation multi-kinase inhibitors (sorafenib, midostaurin, lestaurtinib) are characterized by a broad-spectrum of drug targets, whereas second-generation inhibitors (quizartinib, crenolanib, gilteritinib) show more potent and specific FLT3 inhibition, and are thereby accompanied by less toxic effects. Notwithstanding, all FLT3 inhibitors face primary and acquired mechanisms of resistance, and therefore the combinations with other drugs (standard chemotherapy, hypomethylating agents, checkpoint inhibitors) and its application in different clinical settings (upfront therapy, maintenance, relapsed or refractory disease) are under study in a myriad of clinical trials. This review focuses on the role of FLT3 mutations in AML, pharmacological features of FLT3 inhibitors, known mechanisms of drug resistance and accumulated evidence for the use of FLT3 inhibitors in different clinical settings.

Focused ultrasound thalamotomy for multiple sclerosis-associated tremor.

Multiple sclerosis (MS)-related tremor is frequent and can often be refractory to medical treatment, which makes it a potential source of major disability. Functional neurosurgery approaches such as thalamic deep brain stimulation (DBS) or radiofrequency thalamotomy are proven to be effective, but the application of invasive techniques in MS tremor has so far been limited. Magnetic resonance (MR)-guided focused ultrasound thalamotomy, which has already been approved for treating essential and parkinsonian tremor, provides a minimally invasive approach that could be useful in the management of MS tremor. We report for the first time a patient with medically refractory MS-associated tremor successfully treated by focused ultrasound thalamotomy.

Identification and characterization of aspartyl-tRNA synthetase inhibitors against Mycobacterium tuberculosis by an integrated whole-cell target-based approach.

Mycobacterium tuberculosis, the causative agent of tuberculosis, has surpassed HIV as the leading cause of death due to an infectious disease worldwide, being responsible for more than 1.5 million deaths in low-income countries. In response to a pandemic threat by drug resistant strains, the tuberculosis research community is searching for new chemical entities with novel mechanisms of action to avoid drug resistance and shorten treatment regimens using combinatorial chemotherapy. Herein, we have identified several novel chemical scaffolds, GSK97C (spiro-oxazolidin-2-one), GSK93A (2-amino-1,3-thiazole, GSK85A and GSK92A (enamides), which target M. tuberculosis aspartyl-tRNA synthetase (Mt-AspRS), an essential component of the protein synthesis machinery of tuberculosis, using a whole-cell target-based screening strategy against a genetically modified Mycobacterium bovis BCG strain. We also provide further evidence of protein inhibition and inhibitor profiling through a classical aminoacylation reaction and a tRNA-independent assay, respectively. Altogether, our results have identified a number of hit new molecules with novel mechanism of action for further development through medicinal chemistry as hits and leads.

Do not do in COPD: consensus statement on overuse.

Background: To identify practices that do not add value, cause harm, or subject patients with chronic obstructive pulmonary disease (COPD) to a level of risk that outweighs possible benefits (overuse). Methods: A qualitative approach was applied. First, a multidisciplinary group of healthcare professionals used the Metaplan technique to draft and rank a list of overused procedures as well as self-care practices in patients with stable and exacerbated COPD. Second, in successive consensus-building rounds, description files were created for each "do not do" (DND) recommendation, consisting of a definition, description, quality of supporting evidence for the recommendation, and the indicator used to measure the degree of overuse. The consensus group comprised 6 pulmonologists, 2 general practitioners, 1 nurse, and 1 physiotherapist. Results: In total, 16 DND recommendations were made for patients with COPD: 6 for stable COPD, 6 for exacerbated COPD, and 4 concerning self-care. Conclusion: Overuse poses a risk for patients and jeopardizes care quality. These 16 DND recommendations for COPD will lower care risks and improve disease management, facilitate communication between physicians and patients, and bolster patient ability to provide self-care.

Potencial terapéutico del extracto de Ginkgo biloba (EGb) en pacientes con esquizofrenia / Potencial terapêutico do extrato de Ginkgo biloba (EGb) em pacientes com esquizofrenia / Therapeutic potential of Ginkgo biloba extract (EGb) in patients with schizophrenia

La esquizofrenia representa uno de los trastornos psiquiátricos más graves. Se trata de un trastorno mental psicótico caracterizado por alteraciones del pensamiento, del estado de ánimo y del comportamiento. Casi todos los antipsicóticos tienen efectos secundarios neurológicos o físicos, lo que frecuentemente conlleva el incumplimiento del tratamiento. Desde esta perspectiva es fácil justificar la conveniencia y relevancia social de buscar productos que ofrezcan una mejoría en la sintomatología de la enfermedad y reduzcan los efectos adversos y las interacciones en los pacientes. El extracto seco purificado de la hoja de Ginkgo biloba es capaz de mejorar los síntomas de la esquizofrenia crónica como un coadyuvante a la terapia con antipsicóticos, paliando los efectos adversos provocados por el uso prolongado de éstos (AU)

A esquizofrenia representa um dos transtornos psiquiátricos mais graves. É um transtorno mental psicótico caracterizado por alterações no pensamento, humor e comportamento. Quase todos os antipsicóticos têm efeitos secundários neurológicos ou físicos, o que muitas vezes leva ao abandono do tratamento. Nesta perspectiva, é fácil justificar a conveniência e a relevância social da procura de produtos que ofereçam uma melhoria na sintomatologia da doença e reduzam os efeitos adversos e as interações nos doentes. O extrato seco purificado da folha de Ginkgo biloba é capaz de melhorar os sintomas da esquizofrenia crónica como complemento da terapia antipsicótica, aliviando os efeitos adversos causados pela sua utilização prolongada (AU)

Schizophrenia is one of the most serious psychiatric disorders. It is a psychotic mental disorder characterized by alterations in thinking, mood and behavior. Almost all antipsychotic drugs have neurological or physical side effects, which often leads to noncompliance. From this perspective, it is justified the convenience and social relevance of searching products that offer an improvement in the symptomatology of the disease and reduce adverse effects and interactions in patients. The purified dry extract of Ginkgo biloba leaf is able to improve the symptoms of chronic schizophrenia when it is used as an adjuvant to antipsychotic therapy, alleviating the adverse effects caused by its prolonged use (AU)

Nanoencapsulation of Aloe vera in Synthetic and Naturally Occurring Polymers by Electrohydrodynamic Processing of Interest in Food Technology and Bioactive Packaging.

This work originally reports on the use of electrohydrodynamic processing (EHDP) to encapsulate Aloe vera (AV, Aloe barbadensis Miller) using both synthetic polymers, i.e., polyvinylpyrrolidone (PVP) and poly(vinyl alcohol) (PVOH), and naturally occurring polymers, i.e., barley starch (BS), whey protein concentrate (WPC), and maltodextrin. The AV leaf juice was used as the water-based solvent for EHDP, and the resultant biopolymer solution properties were evaluated to determine their effect on the process. Morphological analysis revealed that, at the optimal processing conditions, synthetic polymers mainly produced fiber-like structures, while naturally occurring polymers generated capsules. Average sizes ranged from 100 nm to above 3 µm. As a result of their different and optimal morphology and, hence, higher AV content, PVP, in the form of nanofibers, and WPC, of nanocapsules, were further selected to study the AV stability against ultraviolet (UV) light exposure. Fourier transform infrared (FTIR) spectroscopy confirmed the successful encapsulation of AV in the biopolymer matrices, presenting both encapsulants a high chemical interaction with the bioactive components. Ultraviolet-visible (UV-vis) spectroscopy showed that, while PVP nanofibers offered a poor effect on the AV degradation during UV light exposure (∼10% of stability after 5 h), WPC nanobeads delivered excellent protection (stability of >95% after 6 h). This was ascribed to positive interactions between WPC and the hydrophilic components of AV and the inherent UV-blocking and oxygen barrier properties provided by the protein. Therefore, electrospraying of food hydrocolloids interestingly appears as a novel potential nanotechnology tool toward the formulation of more stable functional foods and nutraceuticals.

Relationship of three different types of low-carbohydrate diet to cardiometabolic risk factors in a Japanese population: the INTERMAP/INTERLIPID Study.

PURPOSE: Low-carbohydrate diets (LCD) are a popular dietary strategy for weight reduction. The effects of LCD on long-term outcome vary depending on type of LCD, possibly due to the fact that effects on cardiometabolic risk factors may vary with different types of LCD. Accordingly, we studied these relations. METHODS: We assessed serum concentrations of high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc), high-sensitivity C-reactive protein (CRP), total cholesterol, glycated hemoglobin, and uric acid, and nutrient intakes by standardized methods in men and women ages 40-59 years from four population samples of Japanese in Japan (553 men and 544 women, combined). For people consuming usual, animal-based, and plant-based LCDs, we calculated LCD scores, based on relative level of fat, protein, and carbohydrate, by modifying the methods of Halton et al. Instead of calculating scores based on animal or vegetable fat, we used saturated fatty acids (SFA) or monounsaturated fatty acids (MUFA) + polyunsaturated fatty acids (PUFA). RESULTS: In multivariate regression analyses with adjustment for site, age, sex, BMI, smoking, alcohol intake, physical activity, and years of education, all three LCD scores were significantly positively related to HDLc (all P < 0.001), but not to LDLc. The plant-based LCD score was significantly inversely related to log CRP (coefficient = -0.010, P = 0.018). CONCLUSIONS: All three LCD scores were significantly positively related to HDLc. The plant-based LCD score was significantly inversely related to CRP. Carbohydrate intake below 50 % of total energy with higher intakes of vegetable protein and MUFA + PUFA, and lower intakes of SFA may be favorable for reducing cardiometabolic risk factors.

Application of High Resolution-Continuum Source Flame Atomic Absorption Spectrometry (HR-CS FAAS): determination of trace elements in tea and tisanes.

A new application of HR-CS FAAS (High Resolution-Continuum Source Flame Atomic Absorption Spectrometry) has been developed for the determination of several trace elements (Ca, Co, Cu, Fe, Mn, Ni, Na and Zn) in infusions made from tea, rooibos and tea with seaweed samples. The proposed methods are fast, inexpensive and show good performances: the mean analytical recovery was approximately 100%. The mean limit of detection was 29.4 µg/l, and the mean limit of quantification was 98.0 µg/l (both limits refer to the brewed samples). Due to the matrix effect observed, the standard addition method had to be applied. Preliminary classification (based on metal contents) using chemometric techniques such as PCA (Principal Component Analysis) and CA (Cluster Analysis), was successful for infusions made from rooibos and tea with seaweed, but inconclusive for black and green teas.

Relationship of dietary monounsaturated fatty acids to blood pressure: the International Study of Macro/Micronutrients and Blood Pressure.

OBJECTIVE: In short-term feeding trials, replacement of other macronutrients with monounsaturated fatty acid reduces blood pressure. However, observational studies have not clearly demonstrated a relationship between monounsaturated fatty acid intake and blood pressure. We report associations of monounsaturated fatty acid intake of individuals with blood pressure in a cross-sectional study. METHODS: The International Study of Macro/Micronutrients and Blood Pressure is a cross-sectional epidemiologic study of 4680 men and women ages 40-59 years from 17 population samples in China, Japan, UK and USA. Nutrient intake data were based on four in-depth multipass 24-h dietary recalls/person and two-timed 24-h urine collections/person. Blood pressure was measured eight times at four visits. RESULTS: Mean monounsaturated fatty acid intake ranged from 8.1%kcal (China) to 12.2%kcal (USA). With sequential models to control for possible confounders (dietary, other), linear regression analyses showed significant inverse relationship of total monounsaturated fatty acid intake with DBP for all participants; for 2238 'nonintervened' individuals, the relationship was stronger. Estimated DBP differences with 2-SD higher monounsaturated fatty acids (5.35%kcal) were -0.82 mmHg (P < 0.05) for all participants and -1.70 mmHg (P < 0.01) for nonintervened individuals. Inverse associations of dietary total oleic acid (main monounsaturated) with blood pressure in nonintervened individuals were not significant, but those of oleic acid from vegetable sources were stronger and significant (P < 0.05). CONCLUSION: Dietary monounsaturated fatty acid intake, especially oleic acid from vegetable sources, may contribute to prevention and control of adverse blood pressure levels in general populations.

Use of the dietary supplement 5-aminiolevulinic acid (5-ALA) and its relationship with glucose levels and hemoglobin A1C among individuals with prediabetes.

OBJECTIVE: This study examined the association between 5-aminolevulinic acid (5-ALA) and glucose tolerance. DESIGN: A double blinded, randomized prospective parallel-group comparison study. SETTING: Participants were recruited from the community in Honolulu, Hawaii, using radio and TV ads, and at community events. PARTICIPANTS: One hundred fifty-four males and females ages 40-70 years, with evidence of prediabetes: hemoglobin A1c (HbA1c) 5.8%-7.0% at the screening visit. INTERVENTION: Participants were randomized equally to one of three study groups: (1) low dose 5-ALA supplement (15 mg capsule); (2) high dose 5-ALA (50 mg capsule); and (3) control (placebo capsule of identical size and color). MAIN OUTCOME MEASURES: HbA1c and 2 hours post-oral glucose tolerance test (OGTT) glucose levels. RESULTS: Among individuals taking 5-ALA supplements for 12 weeks, 2 hours post-OGTT glucose levels declined significantly compared to those not taking the supplement (p= 0.02). The relationships were stronger among those with baseline glucose intolerance, or 2 hours post-OGTT glucose measurements greater than 140 mg/dL (p= 0.005 and p= 0.02 for the low and high dose group, respectively). Similar trends were observed for HbA1c but results were of borderline significance (p= 0.07). No untoward effects were reported. CONCLUSIONS: Further studies are indicated. The potential benefits of 5-ALA dietary supplementation are affirmed by this investigation.

Visuo-spatial interference affects the identification of emotional facial expressions in unmedicated Parkinson's patients.

There is evidence that visuo-spatial capacity can become overloaded when processing a secondary visual task (Dual Task, DT), as occurs in daily life. Hence, we investigated the influence of the visuo-spatial interference in the identification of emotional facial expressions (EFEs) in early stages of Parkinson's disease (PD). We compared the identification of 24 emotional faces that illustrate six basic emotions in, unmedicated recently diagnosed PD patients (16) and healthy adults (20), under two different conditions: a) simple EFE identification, and b) identification with a concurrent visuo-spatial task (Corsi Blocks). EFE identification by PD patients was significantly worse than that of healthy adults when combined with another visual stimulus.

Cambios psicológicos e intervenciones basadas en mindfulness para los supervivientes de un cáncer / No disponible

La población de supervivientes de cáncer va en aumento gracias a los avances de la medicina. Lograr solo años de supervivencia no es ya suficiente y el interés está en mejorar la calidad de vida en todas sus dimensiones incluidas las psicológicas y espirituales. Surgen nuevas necesidades psicosociales a atender para esta población. En general los trastornos mentales graves, tales como depresión mayor o Trastorno de Estrés Postraumático son raros entre los supervivientes siendo más frecuentes los trastornos adaptativos menos graves como los depresivos, ansiosos o mixtos. Pero junto a estos cambios negativos para la calidad de vida, también se han descrito cambios psicológicos positivos englobados en el concepto de crecimiento postraumático. Las afinidades entre las descripciones de los cambios de las personas que experimentan crecimiento postraumático y la actitud que promueve Mindfulness nos hace plantear que el entrenamiento en Mindfulness o Atención Plena podría promover crecimiento postraumático en los supervivientes de cáncer (AU)

The population of cancer survivors is increasing due to advances in medicine. Achieving an increase in survival is not enough and the focus is on improving the quality of life in all its dimensions, including psychological and spiritual. New psychosocial needs arise in this population. In general, major mental disorders such as major depression or PTSD are rare among survivors, while less severe adjustment disorders such as depression, anxiety or mixed are relatively common. But not only negative changes in quality of life have been described, there are also several positive psychological changes included in the concept of posttraumatic growth. The similarities between descriptions of change in people experiencing posttraumatic growth and the attitude that Mindfulness promotes suggest that Mindfulness training may promote posttraumatic growth in cancer survivors (AU)

Relationship of the polyunsaturated to saturated fatty acid ratio to cardiovascular risk factors and metabolic syndrome in Japanese: the INTERLIPID study.

AIM: There have been few studies on the relationships of the dietary polyunsaturated to saturated fatty acid ratio (P/S) to cardiovascular risk factors and metabolic syndrome. We hypothesized that there would be favorable relationships. METHODS: Metabolic cardiovascular risk factors from dietary nutrient intake were investigated in 1,004 men and women aged 40-59 years from 4 population samples of Japanese. Multiple linear regression analysis was used to examine the relationship of the dietary P/S ratio to the following risk factors: hemoglobin A1c, blood pressure, serum triglycerides, LDL and total cholesterol, and HDL-cholesterol. Adjusted odds ratio of having metabolic syndrome was also calculated. RESULTS: The dietary P/S ratio was significantly and inversely related to serum total and LDL cholesterol with control for possible confounding variables. We did not find any significant relationship between the P/S ratio and single metabolic risk factors or the prevalence of metabolic syndrome. CONCLUSIONS: Managing the P/S ratio is important to control serum LDL-cholesterol; however, increasing the P/S ratio may not improve metabolic risk factors. Other countermeasures, such as weight control, greater physical activity, and smoking cessation should be recommended to prevent and control metabolic syndrome.

Peritonitis bacteriana espontánea en pacientes con cirrosis mayores de 65 años / Spontaneous bacterial peritonitis in cirrhotic patients over 65 years

Fundamento y objetivo: Estudiar los episodios de peritonitis bacteriana espontánea (PBE) en pacientes cirróticos mayores de 65 años y comparar sus características y su evolución clínica dentro de una cohorte de pacientes cirróticos con PBE. Material y métodos: Se realizó un estudio observacional y retrospectivo sobre todas las altas hospitalarias con diagnóstico de PBE en el período de enero de 2003 a diciembre de 2005, con un total de 158 episodios. Se valoró el episodio de PBE desde su diagnóstico hasta la muerte o el fin de seguimiento por otras causas del paciente. Se dividió la cohorte en 2 grupos, según edad superior a 65 años (grupo 1: 73 episodios) o edad inferior o igual a 65 años (grupo 2: 86 episodios). Se realizó un estudio descriptivo y comparativo de ambos grupos y posteriormente se realizó un análisis de supervivencia mediante curvas de Kaplan-Meier (comparadas mediante el test log-rank) y valoración de los factores predictivos independientes mediante regresión de Cox en la cohorte global. Resultados: En el grupo 1 el 74% de los pacientes eran varones y la edad media (desviación estándar) fue de 72,8 (5,6) años, y la distribución según la clasificación de Child-Pugh fue del 8,2 (A), del 68,5 (B) y del 23,3% (C). La etiología de la cirrosis fue vírica en el 65,8% de los casos. Comparado con el grupo 2, se observó mayor frecuencia de insuficiencia renal al ingreso, prevalencia de hepatocarcinoma y etiología vírica, mientras que las cifras de bilirrubina eran superiores en el grupo 2. La mortalidad intrahospitalaria fue del 23,3%. Se observó una supervivencia a los 3 y a los 6 meses del 69,5 y del 54,8% y en el grupo 2 del 80,3 y del 78,4%, respectivamente (p=0,001). La edad superior a 65 años, la existencia de hepatocarcinoma y la presión arterial media superior a 75mmHg al ingreso fueron factores predictivos independientes de mortalidad (AU)

Aims: Our aim was to study the episodes of spontaneous bacterial peritonitis (SBP) in cirrhotic patients older than 65 years. Their clinical characteristics were compared with a cohort of cirrhotic patients with SBP. Methods: We conducted a retrospective study on all hospital discharged patients diagnosed with SBP in the period from January 2003 to December 2005, obtaining a total of 158 episodes. Two groups of patients were created: those over 65 (group 1: 73 episodes) and those aged }65 years (group 2: 86 episodes). A descriptive study, an analysis of survival by Kaplan Meier curves (compared with log-rank test) and a Cox regression analysis was conducted comparing the two groups. Results: In Group 1, males were 74%, the average age was 72.4 (SD 4.2) years, and the Child-Pugh distribution was 8.2% (A), 68.5% (B) and 23.3% (C).The most usual etiology of cirrhosis was viral (65.8%). In comparison with group 2, there was a superior frequency of renal impairment at admission, hepatocellular carcinoma and a viral etiology. Yet the bilirubin levels were higher in group 2. In-hospital mortality rate was 23.3%. The survival at 3 and 6 months was of 69.5% and 54.8%, while in group 2 it was 80.3% and 78.4% respectively (p=0001). An age> 65 years, the existence of hepatocellular carcinoma and a Mean Arterial Pressure <75mm Hg at admission, in the overall cohort, were independent predictors of mortality. Conclusion: An age above 65 years is an independent predictor of mortality following the development of an episode of spontaneous bacterial peritonitis in cirrhotic patients (AU)