Excess stroke in Mexican Americans compared with non-Hispanic Whites: the Brain Attack Surveillance in Corpus Christi Project.

Mexican Americans are the largest subgroup of Hispanics, the largest minority population in the United States. Stroke is the leading cause of disability and third leading cause of death. The authors compared stroke incidence among Mexican Americans and non-Hispanic Whites in a population-based study. Stroke cases were ascertained in Nueces County, Texas, utilizing concomitant active and passive surveillance. Cases were validated on the basis of source documentation by board-certified neurologists masked to subjects' ethnicity. From January 2000 to December 2002, 2,350 cerebrovascular events occurred. Of the completed strokes, 53% were in Mexican Americans. The crude cumulative incidence was 168/10,000 in Mexican Americans and 136/10,000 in non-Hispanic Whites. Mexican Americans had a higher cumulative incidence for ischemic stroke (ages 45-59 years: risk ratio = 2.04, 95% confidence interval: 1.55, 2.69; ages 60-74 years: risk ratio = 1.58, 95% confidence interval: 1.31, 1.91; ages >or=75 years: risk ratio = 1.12, 95% confidence interval: 0.94, 1.32). Intracerebral hemorrhage was more common in Mexican Americans (age-adjusted risk ratio = 1.63, 95% confidence interval: 1.24, 2.16). The subarachnoid hemorrhage age-adjusted risk ratio was 1.57 (95% confidence interval: 0.86, 2.89). Mexican Americans experience a substantially greater ischemic stroke and intracerebral hemorrhage incidence compared with non-Hispanic Whites. As the Mexican-American population grows and ages, measures to target this population for stroke prevention are critical.

Emergency referrals for syncopes - is an ambulatory treatment safe?

Patients after syncopy arrive frequently in an emergency unit. Two scoring systems have been validated for clinical decision making, use of diagnostic methods and need for hospitalisation. Goal of the study was quality control of ambulatory treatment of syncope patients in a University Emergency Department. 200 consecutive patients with syncope were documented, 109 of whom followed by phone-call during two years. The decision for hospitalisation or ambulatory treatment was up to the treating doctor. Age-distribution was biphasic: female sex mainly below the age 25, from 55 to 75 predominantly men. Etiology of syncope remained unclear for the majority of cases, a few neurologic (n=3) or cardiac (n=5) reasons were found with treatment consequences.

Cosmic-ray exposure ages of pallasites

We analyzed cosmogenic nuclides in metal and/or silicate (primarily olivine) separated from the main-group pallasites Admire, Ahumada, Albin, Brahin, Brenham, Esquel, Finmarken, Glorieta Mountain, Huckitta, Imilac, Krasnojarsk, Marjalahti, Molong, Seymchan, South Bend, Springwater, and Thiel Mountains and from Eagle Station. The metal separates contained an olivine fraction which although small, <1 wt% in most cases, nonetheless contributes significantly to the budgets of some nuclides (e.g., up to 35% for Ne-21 and Al-26). A correction for olivine is therefore essential and was made using model calculations and/or empirical relations for the production rates of cosmogenic nuclides in iron meteoroids and/or measured elemental concentrations. Cosmic-ray exposure (CRE) ages for the metal phases of the main-group pallasites range from 7 to 180 Ma, but many of the ages cluster around a central peak near 100 Ma. These CRE ages suggest that the parent body of the main-group pallasites underwent a major break-up that produced most of the meteorites analyzed. The CRE age distribution for the pallasites overlaps only a small fraction of the distribution for the IIIAB iron meteorites. Most pallasites and IIIAB irons originated in different collisions, probably on different parent bodies; a few IIIABs and pallasites may have come out of the same collision but a firm conclusion requires further study. CRE ages calculated from noble gas and radionuclide data of the metal fraction are higher on average than the Ne-21 exposure ages obtained for the olivine samples. As the metal and olivine fractions were taken in most cases from different specimens, the depth-dependency of the production rate ratio Be-10/Ne-21 in metal, not accounted for in our calculations, may explain the difference.

Hepatitis C in HIV-infected individuals: a systematic review and meta-analysis of estimated prevalence in Africa.

INTRODUCTION Although hepatitis C virus (HCV) screening is recommended for all HIV-infected patients initiating antiretroviral therapy, data on epidemiologic characteristics of HCV infection in resource-limited settings are scarce. METHODS We searched PubMed and EMBASE for studies assessing the prevalence of HCV infection among HIV-infected individuals in Africa and extracted data on laboratory methods used. Prevalence estimates from individual studies were combined for each country using random-effects meta-analysis. The importance of study design, population and setting as well as type of test (anti-HCV antibody tests and polymerase chain reactions) was examined with meta-regression. RESULTS Three randomized controlled trials, 28 cohort studies and 121 cross-sectional analyses with 108,180 HIV-infected individuals from 35 countries were included. The majority of data came from outpatient populations (55%), followed by blood donors (15%) and pregnant women (14%). Based on estimates from 159 study populations, anti-HCV positivity prevalence ranged between 3.3% (95% confidence interval (CI) 1.8-4.7) in Southern Africa and 42.3% (95% CI 4.1-80.5) in North Africa. Study design, type of setting and age distribution did not influence this prevalence significantly. The prevalence of replicating HCV infection, estimated from data of 29 cohorts, was 2.0% (95% CI 1.5-2.6). Ten studies from nine countries reported the HCV genotype of 74 samples, 53% were genotype 1, 24% genotype 2, 14% genotype 4 and 9% genotypes 3, 5 or 6. CONCLUSIONS The prevalence of anti-HCV antibodies is high in HIV-infected patients in Africa, but replicating HCV infection is rare and varies widely across countries.

EPIDEMIOLOGIC TRENDS OF LUNG DISEASE DUE TO MYCOBACTERIA KANSASII AND AVIUM-INTRACELLULARE IN TEXAS, 1977-1983

This study compared the reported isolations of Mycobacterium kansasii (MK) and Myobacterium avium-intracellulare (MAI) with Mycobacterium tuberculosis (MTB) between 1977-1983 in Texas. A total of 15,395 mycobacterial cases were identified of which 1,352 (8.8%) were MK or MAI. The incidence of MK was higher in urban areas than nonurban areas (p < .005). The incidence of MAI has increased in the Dallas metroplex from 34 cases to 251 for the same time period. Although the number of MK cases previously reported has always exceeded those of MAI, the numbers were equal in the last year (1983) of the study.^ More than 75% of patients with MK or MAI were Caucasians compared to only 18% of patients with MTB. Male to female ratios for MK and MAI are 3:1 and 3:2, respectively. The age distribution of MK patients were an average of 5 years younger than patients with MAI, a finding which concurs with previous studies. MK and MAI pulmonary infections continue to be absent among children and relatively absent among Hispanics.^ MK appears to be associated with occupations in construction, whereas MAI is more often associated with farm work. ^

(Table 1) U and Th isotope analyses of pyrite and anhydrite of ODP Site 158-957

Hydrothermal circulation at oceanic spreading ridges causes sea water to penetrate to depths of 2 to 3 km in the oceanic crust where it is heated to ~400 °C before venting at spectacular 'black smokers'. These hydrothermal systems exert a strong influence on ocean chemistry (Edmond et al., 1979, doi:10.1016/0012-821X(79)90061-X), yet their structure, longevity and magnitude remain largely unresolved (Elderfield and Schultz., 1996, doi:10.1146/annurev.earth.24.1.191). The active Transatlantic Geotraverse (TAG) deposit, at 26° N on the Mid-Atlantic Ridge, is one of the largest, oldest and most intensively studied of the massive sulphide mounds that accumulate beneath black-smoker fields. Here we report ages of sulphides and anhydrites from the recently drilled (Humphris et al., 1995, doi:10.1038/377713a0) TAG substrate structures -determined from 234U-230Th systematics analysed by thermal ionization mass spectrometry. The new precise ages combined with existing data (Lalou et al., 1993, doi:10.1029/92JB01898; 1998, doi:10.2973/odp.proc.sr.158.214.1998) show that the oldest material (11,000 to 37,000 years old) forms a layer across the centre of the deposit with younger material (2,300-7,800 years old) both above and below. This stratigraphy confirms that much of the sulphide and anhydrite are precipitated within the mound by mixing of entrained sea water with hydrothermal fluid (James and Elderfield, 1996, doi:10.1130/0091-7613(1996)024<1147:COOFFA>2.3.CO;2). The age distribution is consistent with episodic activity of the hydrothermal system recurring at intervals of up to 2,000 years.

40Ar-39Ar plateau and isochron ages from the Ninetyeast and Broken Ridges (Table 1)

Concordant plateau and isochron ages are obtained from 40Ar-39Ar incremental heating experiments on volcanic rocks recovered by drilling at three Leg 121 sites along the Ninetyeast Ridge and two dredge locations on the southern scarp of the Broken Ridge, eastern Indian Ocean. The new data confirm a northerly increase in the age of volcanism along the Ninetyeast Ridge, from 38 to 82 Ma; this lineament links current hotspot volcanism near the Kerguelen islands with the Rajmahal flood basalt eruptions at M0 time (117 ± 1 Ma). The Broken Ridge was formed over the same hotspot at 88-89 Ma, but later experienced rift-related volcanism in Paleocene time (63 Ma). The geometry and distribution of ages along these prominent volcanic ridges and the Mascarene-Chagos-Laccadive-Maldive ridge system in the western Indian Ocean are most compatible with plate motions over fixed hotspots near Kerguelen and Reunion islands, respectively.

Glaciological characteristics and carbon dioxide record of ice cores from Antarctica

We report a decadally resolved record of atmospheric CO2 concentration for the last 1000 years, obtained from the West Antarctic Ice Sheet (WAIS) Divide shallow ice core. The most prominent feature of the pre-industrial period is a rapid ~7 ppm decrease of CO2 in a span of ~20-50 years at ~1600 A.D. This observation confirms the timing of an abrupt atmospheric CO2 decrease of ~10 ppm observed for that time period in the Law Dome ice core CO2 records, but the true magnitude of the decrease remains unclear. Atmospheric CO2 variations over the time period 1000-1800 A.D. are statistically correlated with northern hemispheric climate and tropical Indo-Pacific sea surface temperature. However, the exact relationship between CO2 and climate remains elusive due to regional climate variations and/or uneven geographical data density of paleoclimate records. We observe small differences of 0 ~2% (0 ~ 6 ppm) among the high-precision CO2 records from the Law Dome, EPICA Dronning Maud Land and WAIS Divide Antarctic ice cores. However, those records share common trends of CO2 change on centennial to multicentennial time scales, and clearly show that atmospheric CO2 has been increasing above preindustrial levels since ~1850 A.D.

Análisis de la mortalidad en la unidad de cuidados intensivos del Hospital Central de Mendoza, Argentina

Objetivo: Analizar la mortalidad en la Unidad de Cuidados Intensivos (UCI) del Hospital Central de Mendoza y evaluar el valor predictivo de la escala APACHE II (Evaluación Fisiológica Aguda y de Salud Crónica). Material y Método: Se realizó un estudio retrospectivo y observacional de los pacientes ingresados a la Unidad de Cuidados Intensivos del Hospital Central de Mendoza, desde el 01/11/06 hasta el 31/03/08. Se calculó la distribución de sexos y de edades de la muestra, la estadía promedio, principales motivos de ingreso a la UCI y la puntuación APACHE II en las primeras 24 horas de internación. Se calculó la mortalidad esperada y la mortalidad obtenida global y se analizó el coeficiente entre ambas mortalidades. Resultados: Se incluyeron 904 pacientes, 61,82% masculinos y 38,18% femeninos, con una edad media 46 años (±19,36). Estadía promedio en la UCI 8,5 días promedio. El principal motivo de internación fueron los Traumatismos Encéfalocraneanos (TEC) con un 27,7% del total (86% asociados a politraumatismo grave). La mortalidad global obtenida fue del 41,48% vs. 24,08% esperable, con un coeficiente de mortalidad de 1,72 (p<0,0001). Conclusiones: La UCI estudiada presenta por las características de la población asistida un elevado índice de mortalidad global. La mortalidad obtenida fue 72% mayor a la mortalidad esperable según la puntuación APACHE II, demostrando esta Escala un bajo valor predictivo en nuestra UCI. La diferencia entre mortalidades podría parcialmente explicarse por la alta prevalencia de entidades con mortalidades subvaloradas por este modelo pronóstico, como pacientes politraumatizados y neurocríticos. En nuestro estudio, la Escala APACHE II presentó una franca subestimación de la mortalidad en ambas patologías. Sugerimos la realización de un estudio de regresión logística local para determinar un factor de corrección y/o adicionar puntos al valor APACHE II según el diagnóstico de ingreso del paciente. Asimismo, proponemos evaluar el empleo de medidas alternativas para predecir mortalidad, como sistemas de tercera generación (por ejemplo: APACHE III, MPM II y SAPS II).

Tab. 2: U-Pb ion-microprobe ages from Taymyr peninsula

We present the initial results of a U-Th-Pb zircon ion-microprobe investigation on samples from the Central Belt of Taimyr, in order to constrain its tectono-magmatic evolution. The zircon samples are from a deformed twomica granite (Faddey Massif), deformed metamorphosed gabbroic dike entrained as pods and lenses within metamorphosed tholeiitic basalts of the Kunar-Mod volcanic suite (Klyaz'ma River region), a metamorphosed rhyolite of the same volcanic suite overlying the basic metavolcanic rocks, as well as an undeformed dolerite dike which intrudes the metamorphosed Kunar-Mod basic volcanic rocks. Preliminary results on zircons from the two-mica granite suggest a crystallization age of ~630 Ma for this rock, with inheritance from assimilated crust 840 Ma to 1.1 Ga in age. In the Klyaz'ma River region, zircons from the meta-rhyolite yield a concordant age of -630 Ma. Zircons from the entrained metagabbroic dikes have so far yielded an age of -615 Ma (1 grain), as well as Archean ages (5 grains, concordant at 2.6-2.8 Ga). It seems likely that the Archean grains represent assimilation of older crustal material. Zircons from the post-tectonic dolerite dike have a bimodal age distribution. A well-defined younger age of 281 ±9 Ma is interpreted to represent the crystallization age of the dike, while older, concordant ages of 2.6-2.9 Ga likely represent assimilation of Archean crust (Siberian craton at depth). Several important conclusions can be drawn from the data. (1) The mafic and felsic lithologies of the Kunar-Mod volcanic suite are genetically related and should be the same age. Ages of-630 Ma (meta-rhyolite) and -615 Ma (metagabbroic dikes representing the latest stage of mafic magmatism associated the Kunar-Mod suite) suggest that these lithologies may be the same age, but more data are required to confirm this hypothesis. (2) The 630 Ma two-mica granite is similar in age to the time of high-grade metamorphism, suggesting that syntectonic granite emplacement accompanied obduction of the accretionary Central Belt to the Siberian craton. (3) An Early Permian age is well defined for the undeformed dolerite dike. Dolerite dikes occur across the whole of Taimyr, but are deformed to the south. If related, this single magmatic event pre-dates Permo-Triassic Siberian trap magmatism. Furthermore, it suggests that deformation was localized to southeastern Taimyr.

Lagrangian back-tracing results for Kohnen station; output of time dependent numerical experiment with a 3D nested Antarctic ice sheet model

A nested ice flow model was developed for eastern Dronning Maud Land to assist with the dating and interpretation of the EDML deep ice core. The model consists of a high-resolution higher-order ice dynamic flow model that was nested into a comprehensive 3-D thermomechanical model of the whole Antarctic ice sheet. As the drill site is on a flank position the calculations specifically take into account the effects of horizontal advection as deeper ice in the core originated from higher inland. First the regional velocity field and ice sheet geometry is obtained from a forward experiment over the last 8 glacial cycles. The result is subsequently employed in a Lagrangian backtracing algorithm to provide particle paths back to their time and place of deposition. The procedure directly yields the depth-age distribution, surface conditions at particle origin, and a suite of relevant parameters such as initial annual layer thickness. This paper discusses the method and the main results of the experiment, including the ice core chronology, the non-climatic corrections needed to extract the climatic part of the signal, and the thinning function. The focus is on the upper 89% of the ice core (appr. 170 kyears) as the dating below that is increasingly less robust owing to the unknown value of the geothermal heat flux. It is found that the temperature biases resulting from variations of surface elevation are up to half of the magnitude of the climatic changes themselves.

(Table 1) 40Ar/39Ar plateau and isochron ages for basalts from the Réunion hotspot track

Concordant plateau and isochron ages were calculated from 40Ar/39Ar incremental heating experiments on volcanic rocks recovered by drilling at four Leg 115 sites and two industry wells along the volcanic lineament connecting Reunion Island to the Deccan flood basalts, western Indian Ocean. The new ages provide unequivocal evidence that volcanic activity migrated southward along this sequence of linear ridges. The geometry and age distribution of volcanism are most compatible with origin above a stationary hotspot centered beneath Reunion. The hotspot became active with rapid eruption of the Deccan flood basalts, western India, and subsequent volcanic products record the northward motion of the Indian and African plates over the hotspot through Tertiary time. The radiometric ages are in general accord with basal biostratigraphic age estimates, although some adjustments in current magnetobiostratigraphic time scales may be required.

Geochemistry of neritic carbonates of ODP Hole 134-831B

Drilling at Bougainville Guyot (Ocean Drilling Program Site 831), New Hebrides Island Arc during Leg 134 revealed that 727.5 m of carbonate overlies an andesite basement. The carbonate cap at Site 831 consists of 20 m of pelagic carbonate overlying 707.5 m of neritic carbonates. The neritic section consists of ~230 m of largely unaltered aragonite sediment that overlies ~497 m of totally calcitized limestone. The deeper portion of the calcitized interval has been pervasively altered by diagenesis. Prior to this study the age distribution of sediments at Bougainville Guyot was poorly known because age diagnostic fossils are sparsely and discontinuously distributed in the sequence. We have used Sr isotopes to provide temporal constraints on the deposition of carbonates at Site 831; these constraints are critical in reconstructing the vertical movement of Bougainville Guyot before its collision with the New Hebrides Island Arc. Overall, the chronostratigraphy of Bougainville Guyot can be subdivided into three intervals: (1) a Pleistocene interval (102.4 to 391.11 meters below sea floor [mbsf]); (2) a Miocene interval (410.31 to 669.53 mbsf); and (3) an Oligocene interval (678.83 to 727.50 mbsf). Strontium isotopic ages of samples increase with increasing depth in the carbonate sequence, except near the bottom of the sequence, where several samples exhibit a consistent reversed age vs. depth trend. Such age reversals are most likely the product of post-depositional rock-water interaction. Preliminary stable isotope data are consistent with diagenetic alteration in the marine and meteoric environments. Several abrupt decreases in d87Sr, and hence age, of sediments are recognized in the carbonate cap at Bougainville Guyot. These disconformities are most likely the product of subaerial exposure in response to relative sea-level fall. Indeed, Sr-isotope ages indicate that 2 to 9 m.y. of sediment deposition is missing across these d87Sr disconformities.

Quantifying the contamination by old main-sequence stars in young moving groups: the case of the Local Association

Context. The associations and moving groups of young stars are excellent laboratories for investigating stellar formation in the solar neighborhood. Previous results have confirmed that a non-negligible fraction of old main-sequence stars is present in the lists of possible members of young stellar kinematic groups. A detailed study of the properties of these samples is needed to separate the young stars from old main-sequence stars with similar space motion, and identify the origin of these structures. Aims. Our intention is to characterize members of the young moving groups, determine their age distribution, and quantify the contamination by old main-sequence stars, in particular, for the Local Association. Methods. We used stars possible members of the young (~10-650 Myr) moving groups from the literature. To determine the age of the stars, we used several suitable age indicators for young main sequence stars, i.e., X-ray fluxes from the Rosat All-sky Survey database, photometric data from the Tycho-2, Hipparcos, and 2MASS database. We also used spectroscopic data, in particular the equivalent width of the lithium line Li I λ6707.8 Å and H_α, to constrain the range of ages of the stars. Results. By combining photometric and spectroscopic data, we were able to separate the young stars (10-650 Myr) from the old (> 1 Gyr) field ones. We found, in particular, that the Local Association is contaminated by old field stars at the level of ~30%. This value must be considered as the contamination for our particular sample, and not of the entire Local Association. For other young moving groups, it is more difficult to estimate the fraction of old stars among possible members. However, the level of X-ray emission can, at least, help to separate two age populations: stars with <200 Myr and stars older than this. Conclusions. Among the candidate members of the classical moving groups, there is a non-negligible fraction of old field stars that should be taken into account when studying the stellar birthrate in the solar neighborhood. Our results are consistent with a scenario in which the moving groups contain both groups of young stars formed in a recent star-formation episode and old field stars with similar space motion. Only by combining X-ray and optical spectroscopic data is it possible to distinguish between these two age populations.

Doença inflamatória intestinal associada a colangite esclerosante primária : um fenótipo raro

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014