Effect of sodium restriction on blood pressure of unstable or uncontrolled hypertensive patients in primary care

BACKGROUND/OBJECTIVES: The aims of the present study are: 1) to quantify sodium consumption of patients with unstable or uncontrolled hypertension, 2) to investigate if reduced sodium intake can lower BP in these patients, and 3), to assess the acceptability and feasibility of this approach. SUBJECTS/METHODS: This study included 25 adults (age: 50+ years) with frequently elevated BP or patients with uncontrolled, uncomplicated hypertension despite drug treatment in a general practice setting. BP and salt intake (24h urinary excretion and food records) were measured at baseline and after a sodium reduced diet. RESULTS: Mean (+/- SD) systolic (SBP) over diastolic (DBP) blood pressure (mmHg) at baseline was 150.7 (+/- 9.5)/84.149 (+/- 5.6). Mean urinary sodium excretion was 146 mmo1/24h. A reduction of 28 mmol sodium excretion decreased SBP/DBP to 135.5 (+/- 13.0)/82.5 (+/- 12.8) (P < 0.001). After one month of no dietary advice, only in 48%, SBP was still <= 140 mmHg. CONCLUSION: Assessment of sodium intake using food records, 24h urine collections and probing questions to identify use of sodium containing supplements or drugs are essential for tailored advice targeted at sodium intake reduction. The results of the present study indicate that reduced sodium intake can lower BP after 4 weeks in unstable or uncontrolled hypertensive patients

Ja, goed te deunen onze machtige (Psalm 147,1): De zoektocht naar een toonzetting van de Psalmen

This article describes the quest for a composition of the psalms. Vatican II proclaimed a wish in the constitution about liturgy. The hours of prayer had to be renewed, so that not only clergy and monastics, but also laymen would be able to join. Psalms formed the heart of these hours of prayer. After Vatican II, there was no liturgic translation in Dutch, nor any music, in order to sing it. In 1970, Kees aaijman began putting together prayer celebrations. After roughly 50 years of experimenting, a form of prayer arose in which one psalm is central: the Psalm celebration. By now, the series of 150 Psalm celebrations is nearly completed. For the past ten years, Kees Waaijman and the author have sought a composition of the psalms that does justice to both the individuality of the psalm and the praying people of God. Although initially the psalmic stanza arrangement seemed to be a guidance, this gradually appeared not to work. The music drew too much attention at the expense of praying. It is all about facilitating the saying of the psalm verse, consisting of two half verses that are separated and connected by a meditative caesura. Each half verse numbers an amount of pulse moments, mostly three. The composition must do these pulse moments justice, in order to provide the saying the optimal opportunity, causing the salm to be efficient in the prayer’s head and heart. After a search spanning 50 years, a space opened in which God and man are able to meet

Extracranial applications of diffusion-weighted magnetic resonance imaging

Diffusion-weighted MRI has become more and more popular in the last couple of years. It is already an accepted diagnostic tool for patients with acute stroke, but is more difficult to use for extracranial applications due to technical challenges mostly related to motion sensitivity and susceptibility variations (e.g., respiration and air-tissue boundaries). However, thanks to the newer technical developments, applications of body DW-MRI are starting to emerge. In this review, we aim to provide an overview of the current status of the published data on DW-MRI in extracranial applications. A short introduction to the physical background of this promising technique is provided, followed by the current status, subdivided into three main topics, the functional evaluation, tissue characterization and therapy monitorin

Food photographs in nutritional surveillance: errors in portion size estimation using drawings of bread and photographs of margarine and beverages consumption

Food photographs are widely used as instruments to estimate portion sizes of consumed foods. Several food atlases are available, all developed to be used in a specific context and for a given study population. Frequently, food photographs are adopted for use in other studies with a different context or another study population. In the present study, errors in portion size estimation of bread, margarine on bread and beverages by two-dimensional models used in the context of a Belgian food consumption survey are investigated. A sample of 111 men and women (age 45–65 years) were invited for breakfast; two test groups were created. One group was asked to estimate portion sizes of consumed foods using photographs 1–2 d after consumption, and a second group was asked the same after 4 d. Also, real-time assessment of portion sizes using photographs was performed. At the group level, large overestimation of margarine, acceptable underestimation of bread and only small estimation errors for beverages were found. Women tended to have smaller estimation errors for bread and margarine compared with men, while the opposite was found for beverages. Surprisingly, no major difference in estimation error was found after 4 d compared with 1–2 d. Individual estimation errors were large for all foods. The results from the present study suggest that the use of food photographs for portion size estimation of bread and beverages is acceptable for use in nutrition surveys. For photographs of margarine on bread, further validation using smaller amounts corresponding to actual consumption is recommended

Mycotoxin exposure assessments in a multi-center European validation study by 24-hour dietary recall and biological fluid sampling

The European Food Consumption Validation (EFCOVAL) project includes 600 men and women from Belgium, the Czech Republic, France, the Netherlands, and Norway, who had given serum and 24-hour urine samples, and completed 24-hour dietary recall (24-HDR) interviews. Consumption, according to 24-HDR, was matched against the European Food Safety Authority (EFSA) databases of mycotoxin contaminations, via the FoodEx1 standard classifications, producing an indirect external estimate of dietary mycotoxin exposure. Direct, internal measurements of dietary mycotoxin exposure were made in serum and urine by ultra-performance liquid chromatography coupled to tandem mass spectrometry. For the first time, mycotoxin exposures were thoroughly compared between two 24-HDRs, and two 24-hour urine samples collected during the same days covered by the 24-HDRs. These measurements were compared to a single-time point serum measurement to investigate evidence of chronic mycotoxin exposure. According to 24-HDR data, all 600 individuals were exposed to between 4 and 34 mycotoxins, whereof 10 found to exceed the tolerable daily intake. Correlations were observed between two time points, and significant correlations were observed between concentrations in serum and urine. However, only acetyldeoxynivalenol, ochratoxin A, and sterigmatocystin were found to have significant positive correlations between 24-HDR exposures and serum, while aflatoxin G1 and G2, HT-2 toxin, and deoxynivalenol were associated between concurrent 24-HDR and 24-hour urine. Substantial agreements on quantitative levels between serum and urine were observed for the groups Type B Trichothecenes and Zearalenone. Further research is required to bridge the interpretation of external and internal exposure estimates of the individual on a time scale of hours. Additionally, metabolomic profiling of dietary mycotoxin exposures could help with a comprehensive assessment of single time-point exposures, but also with the identification of chronic exposure biomarkers. Such detailed characterization informs population exposure assessments, and aids in the interpretation of epidemiological health outcomes related to multi-mycotoxin exposure