Snacking on raisins may offer a heart-healthy way to lower blood pressure

If you have slightly higher than normal blood pressure -- known as prehypertension -- consider eating a handful of raisins. New data suggest that, among individuals with mild increases in blood pressure, the routine consumption of raisins (three times a day) may significantly lower blood pressure, especially when compared to eating other common snacks, according to research presented today at the American College of Cardiology's 61st Annual Scientific Session. The Scientific Session, the premier cardiovascular medical meeting, brings cardiovascular professionals together to further advances in the field. Even though raisins are popularly cited to lower blood pressure on various websites and are known to have intrinsic properties that could benefit heart and vascular health, researchers believe this is the first controlled study to scientifically support raisins' blood pressure-lowering effects compared to alternative snacks.
"It is often stated as a known fact that raisins lower blood pressure. But we could not find much objective evidence in the medical literature to support such a claim," said Harold Bays, MD, medical director and president of Louisville Metabolic and Atherosclerosis Research Center (L-MARC) and the study's lead investigator. "However, our study suggests if you have a choice between eating raisins or other snacks like crackers and chocolate chip cookies, you may be better off snacking on raisins at least with respect to blood pressure."
In this investigation, Dr. Bays and his team conducted a randomized controlled clinical trial to compare the blood pressure effect of eating raisins versus other snacks in 46 men and women with prehypertension. Participants were randomly assigned to snack on raisins or prepackaged commercial snacks that did not contain raisins, other fruits or vegetables but had the same number of calories per serving three times a day for 12 weeks. The study controlled for individual differences in nutrition and physical activity.
Data analyses found that compared to other snacks, raisins significantly reduced systolic blood pressure at weeks 4, 8, and 12, ranging from -4.8 to -7.2% or -6.0 to -10.2 mmHg (p values <0.05). Within group analysis demonstrated that raisins significantly reduced mean diastolic blood pressure at all study visits, with changes ranging from -2.4 to -- 5.2 mmHg (p values < 0.05). Pre-packaged snacks (including crackers and cookies) did not significantly reduce systolic or diastolic blood pressure at any study visit.
"Overall, these findings support what many people intrinsically believe: that natural foods often have greater health benefits than processed foods," Dr. Bays said.
The study did not identify how raisins lower blood pressure. However, raisins are high in potassium, and have fiber, polyphenols, phenolic acid, tannins and antioxidants.
"Raisins are packed with potassium, which is known to lower blood pressure," Dr. Bays said. "They are also a good source of antioxidant dietary fiber that may favorably alter the biochemistry of blood vessels, causing them to be less stiff, which in turn, may reduce blood pressure."
Although this study was not designed or powered to evaluate for outcomes benefits, other studies support that in patients with prehypertension, mild lowering of blood pressure with medications may have clinical benefits in reducing cardiovascular events.
According to the Centers for Disease Control and Prevention, nearly one in three (28 percent) American adults have prehypertension -- defined as a systolic pressure from 120 to 139 millimeters of mercury (mm Hg) or a diastolic pressure from 80 to 89 mm Hg. This study's findings help validate some current nutritional recommendations. For example, 60 raisins -- about a handful -- contain 1 gram of fiber and 212 milligrams of potassium, which are both recommended in the Dietary Approaches to Stop Hypertension (DASH) diet.
Dr. Bays cautions that this was a single site study; larger trials are needed to confirm the blood pressure-regulating effect of raisins. Nonetheless, he says work in this area is particularly exciting because applying similar scientific methods to natural products, as required for drug development, provides consumers with objective data about which foods may or may not benefit heart health.
This study was funded by the California Raisin Marketing Board through a grant to L-MARC Research Center.

**Source: American College of Cardiology

En un estudio asocian el tabaco con la esquizofrenia

Fumar afecta negativamente a nuestra salud; provoca cáncer, enfermedades cardiovasculares, respiratorias, etc. Ahora, un estudio que se publica en The Proceedings of the National Academy of Sciences (PNAS), sugiere que, en personas sanas que poseen determinantes variantes genéticas que aumentan el riesgo de la esquizofrenia, los fumadores tienen un marcador neurobiológico de la esquizofrenia más elevado que los no fumadores.

Los científicos han pensado durante mucho tiempo que la esquizofrenia era hereditaria. Sin embargo, como un crisol de trastornos con diferentes causas genéticas se oculta tras las manifestaciones de esquizofrenia, los investigadores aún no han sido capaces de identificar el principal gen responsable. Ahora, el equipo de Boris Quednow, del Hospital Universitario de Zurich (Suiza), ha analizado la relación entre las variaciones genéticas en TCF4, que se sabe que aumentan el riesgo de esquizofrenia, y un déficit en el procesamiento de la información asociada con el trastorno.

Los autores analizaron 1821 voluntarios sanos, seleccionados al azar, con 21 variaciones en el gen TCF4, y evaluaron sus hábitos de fumar. Las personas con esquizofrenia tienen un alto índice de consumo de tabaco.

A través de un electroencefalograma, los investigadores vieron que los portadores de cuatro variantes distintas del gen TCF4 tenían alterado el procesamiento de la información auditiva. Cuando los autores ajustaron los resultados de acuerdo al hábito de fumar, encontraron que, entre los portadores de las variantes del gen TCF4, los fumadores muestran mayores déficits en el procesamiento de la información que los no fumadores.

Los autores concluyen que fumar puede interactuar con las mutaciones en TCF4 y jugar un papel importante en el desarrollo del déficit en el procesamiento de la información asociada con la esquizofrenia. A pesar de que aún queda por determinar si el hecho de fumar modula el riesgo de esquizofrenia en sí, los resultados puede facilitar nuevas pistas sobre factores de riesgo genético para la esquizofrenia.

**Publicado en "ABC SALUD"

Researchers identify drugs with fewest side-effects for treating irritable bowel syndrome

• 
  

Cedars-Sinai researchers have determined that two prevalent drug therapies -- rifaximin and lubiprostone -- offer some of the best options for treating irritable bowel syndrome, a widespread disorder that affects up to one in five Americans. The findings, based on an analysis of more than two dozen large-scale clinical trials, are contained in a peer-reviewed study published online by The American Journal of Medicine and set to appear in the publication's April print edition. Patients with irritable bowel syndrome often experience abdominal pain or cramps, excess gas or bloating and visible abdominal distension. Many drug therapies cause troubling side effects of their own, including nausea, insomnia, palpitations and decreased appetite.
"For the millions of patients who suffer from IBS, effective treatment options have been very scarce," said Dr. Mark Pimentel, a lead author of the study and director of Cedars-Sinai's Gastrointestinal Motility Program.
Pimentel and the other researchers analyzed common treatments for IBS.
For diarrhea forms of the condition, they evaluated tricyclic antidepressants; alosetron, a drug that slows movement of stool in the gut; and rifaximin, an antibiotic that stays in the gut and is currently FDA-approved to treat traveler's diarrhea and hepatic encephalopathy.
For constipation forms of IBS, the researchers examined antidepressants known as serotonin reuptake inhibitors and lubiprostone, a drug that promotes gut secretion.
The research found striking differences:
• For every 2.3 patients who benefited from tricyclic antidepressants, one suffered harmful side effects and had to stop taking the medication.
• For every 2.6 patients helped by alosetron, one had to halt the drug.
• By contrast, for every 846 patients aided by rifaximin, one had to discontinue the medication.
• Lubiprostone and serotonin reuptake inhibitors demonstrated a complete lack of "harm" to IBS patients with constipation, as defined by the study.
"We found that rifaximin and lubiprostone have the lowest level of harmful side effects of all the well-studied drug therapies for IBS," Pimentel said.
"This underscores the need for us to continue to monitor new therapies for this disease," Pimentel added. "While it is important to see benefit with drugs, harm is something we do not often assess well."
Besides Cedars-Sinai, other centers participating in the research included the School of Medicine at Texas Tech University's Health Sciences Center; the UCLA Department of Medicine; Beth Israel Deaconess Medical Center; and Harvard Medical School.
Funding for the study was provided by the Beatrice and Samuel A. Seaver Foundation.
Pimentel discovered the use of rifaximin for IBS. Cedars-Sinai holds patent rights to the discovery and has a licensing agreement with Salix Pharmaceuticals Inc., which markets the drug. Pimentel is a consultant to Salix and serves on its scientific advisory board. None of the authors is affiliated with lubiprostone maker Takeda Pharmaceuticals or other drugs that were evaluated.

**Source: Cedars-Sinai Medical Center

Incontinence 20 years after child birth 3 times more common after vaginal delivery

• 
  

Women are nearly three times more likely to experience urinary incontinence for more than 10 years following a vaginal delivery rather than a caesarean section, finds new research at the Sahlgrenska Academy at the University of Gothenburg, Sweden. Urinary incontinence (UI) is a common condition affecting adult women of all ages and can have a negative influence on quality of life.
This new study from the University of Gothenburg in Sweden looked at the prevalence and risk factors for UI 20 years after vaginal delivery (VD) or caesarean section (CS). The study included women who had only one child and assessed their prevalence of UI for less than five years, between 5-10 years and for more than 10 years.
Over six thousand women involved
The SWEPOP (Swedish pregnancy, obesity and pelvic floor) study was conducted in 2008 and data were obtained from the Medical Birth Register (MBR) for deliveries between 1985 and 1988. A questionnaire was sent to women and 6, 148 completed it answering questions on height, weight, urinary or anal incontinence, genital prolapse, menstrual status, hysterectomy, the menopause and hormone treatment.
Prevalence of incontinence tripled
Overall, the prevalence of UI was considerably higher after a vaginal delivery (40.3%) compared to women who delivered by caesarean section (28.8%).
The study also found that the prevalence of UI for more than 10 years almost tripled after VD (10.1%) compared to women who had a CS (3.9%).
Overweight also a risk factor
In addition, the paper looks at the impact of BMI on UI. The risk increase of UI in obese women more than doubled in comparison to women with a normal BMI after VD and more than tripled after CS.
Many risk factors
Maria Gyhagen, Department of Obstetrics and Gynaecology, Sahlgrenska Academy, University of Gothenburg, Sweden and co-author of the paper said:
"In conclusion, the risk of developing urinary incontinence was higher 20 years after a vaginal delivery compared to a caesarean section.
"There are many factors affecting urinary incontinence but obesity and aging as well as obstetric trauma during childbirth are known to be three of the most important risk factors."
Affects daily life
BJOG Deputy Editor-in-Chief, Pierre Martin-Hirsch, added: "Urinary incontinence affects many women and can have a big impact on day to day life.
"However, women need to look at all the information when deciding on mode of delivery as despite vaginal delivery and BMI being linked to urinary incontinence, caesarean section involves its own risks."

**Source: University of Gothenburg

Los beneficios metabólicos de la ingestión de chocolate parecen anular su efecto en el peso

abc

La siempre delgada Katherine Hepburn lo decía: «Lo que ves ante ti es el resultado de toda una vida comiendo chocolate». Y puede que tenga razón, al menos según las últimas pesquisas científicas. Sabíamos que su consumo protegía el corazón, que podría ser el mejor antidepresivo comestible e incluso que tenía propiedades antienvejecimiento. A cambio, había que asumir que ese placer tan saludable engordaba. Pero, quizá, ni eso. Un estudio de la Universidad de California afirma que los adultos que toman chocolate de forma habitual están, de hecho, más delgados que aquellos que no lo hacen.

Este nuevo dato se publica en la revista «Archives of Internal Medicine» y los resultados se basan en un estudio con 1.018 hombres y mujeres con una media de edad de 57 años. Ninguno de ellos tenía problemas cardiovasculares, diabetes o colesterol «malo». A estos voluntarios se les preguntó cuántas veces comían a la semana chocolate y se les calculó el índice de masa corporal, la fórmula matemática que tiene en cuenta la altura y el peso para determinar si hay sobrepeso. De media, todos los participantes lo tomaban dos veces a la semana y hacían ejercicio casi cuatro a la semana

La hipótesis de partida de estos investigadores era que el consumo de chocolate de forma moderada y regular podía tener un efecto neutro en el peso. Y el resultado fue sorprendente, mejor del esperado. Los adultos que consumían chocolate con mayor frecuencia tenían un índice de masa corporal más bajo que el resto.

Calorías para no contar

Para el equipo de Beatrice Golomb que realizó el trabajo, estos resultados no fueron casuales. Los que comían más chocolate no tomaban menos calorías de otros alimentos (de hecho comían más), ni tampoco hacían más ejercicio para estar más delgados. En su opinión, no hay diferencias en el comportamiento que puedan explicar que su hallazgo es el resultado de una simple ecuación entre calorías ingeridas y calorías quemadas. «Nuestro estudio muestra que la composición de las calorías, más que el número de ellas, importa más para determinar su impacto en el peso», asegura Golomb.

«En el caso del chocolate, es una buena noticia tanto para los que ya tienen la costumbre de tomarlo como para los que desean empezarlo», dice.

**Publicado en "ABC"

Litiasis Renal. Ecografia y urgencias

Litiasis conocida controlada durante una consulta por hematuria. Exepto los calculos gordos como en este paciente, el Vscan no suele verlos en los riñones.

**Dr Philippe Girard

Médicos Sin Fronteras utiliza la música para sensibilizar sobre los tratamientos contra el SIDA a los enfermos de Zimbabue

Positive Generation es una iniciativa puesta en marcha por Médicos Sin Fronteras que pretende a través de la música y las voces de grandes artistas nacionales e internacionales, y de enfermos de sida de aquel país, combatir el sida y poder dar tratamiento a muchos enfermos en el país africano de Zimbabue. En Zimbabue, donde hay una alta prevalencia de VIH/sida. Médicos Sin Fronteras (MSF), que ofrece tratamiento a más de 34.000 personas en el país, muchas de ellas, niños y adolescentes y utiliza la música como medio de sensibilización para explicar a los afectados y sus familias que no están solos, que hay tratamiento para estabilizar la enfermedad y que hay que combatir el estigma. Los coros de estos grupos de apoyo, formados en su mayoría por zimbabuenses que tienen la enfermedad y están en tratamiento, representan un ejemplo a seguir porque transmiten una actitud abierta y positiva ante el VIH/sida. Así, las canciones, melodías y ritmos de estos coros explican que la unión hace la fuerza y que, con tratamiento, hay un futuro y una vida por delante. Con Positive Generation, un grupo de artistas nacionales e internacionales, de la mano de Alejandro Sanz y el productor y compositor Javier Limón, han usado como base la música y los coros de estos grupos zimbabuenses. Una extraordinaria labor de fusión musical, en la que talentos y ritmos de aquí y de allá forman una innovadora serie de piezas únicas que nos siguen hablando de la voluntad de acompañar, vivir y luchar, sobre la determinación de seguir adelante y, juntos, conseguir tratamiento para todo aquel que lo necesite. Artistas de la talla de Alejandro Sanz, Estrella Morente, Carlos Vives, Juan Luis Guerra, Andrés Calamaro o Antonio Carmona son algunos de los participantes de esta iniciativa en la que graban con diferentes coros formados por enfermos de sida que siguen con vida gracias al tratamiento. Este disco está a la venta a través de diferentes puntos de venta descritos en la página web de Medicos Sin Fronteras, donde también se pueden escuchar algunas canciones y descargar on line. Médicos Sin Fronteras recuerda que en Zuimbabue uno de cada siete adultos y 150.000 niños, tienen sida. En este link se recoge brevemente en imágenes la iniciativa Positive Generation http://www.youtube.com/watch?v=jluGdAcz_xs&feature=player_embedded#!.  Y en este enlace un extenso documental sobre este proyecto y el sida en Zimbabue, realizado por David Trueba www.rtve.es/noticias/positive-generation