Patterns of sex work contact among men in the general population of Switzerland, 1987-2000

OBJECTIVES: To analyse the prevalence of lifetime recourse to prostitution (LRP) among men in the general population of Switzerland from a trend and cohort perspective. METHODS: Using nine repeated representative cross-sectional surveys from 1987 to 2000, age-specific estimates of LRP were computed. Trends and period effect were analysed as the evolution of cross-sectional population estimates within age groups and overall. Cohort analysis relied on cohorts constructed from the 1989 survey and followed in subsequent waves. Age and cohort effects were modelled using logistic regression and non-parametric monotone regression. RESULTS: Whereas prevalence for the younger groups was found to be logically lower, there was no consistent increasing or decreasing trend over the years; there was no significant period effect. For the 17-30 year age group, the mean estimate over 1987-2000 was 11.5% (range 8.3 to 12.7%); for the 31-45 year group, the mean was 21.5% (range over 1989-2000 20.3 to 23.0%). Regarding cohort analysis, the prevalence of LRP was found to increase steeply in the youngest ages before reaching a plateau near the age of 40 years. At the age of 43 years, the prevalence was estimated to be 22.6% (95% CI 21.1% to 24.1%). CONCLUSIONS: The steep increase in the cohort-wise prevalence of LRP in younger ages calls for a concentration of prevention activities in young people. If the plateauing at approximately 40 years of age is not followed by a further increase later in life, which is not known, then consumers of paid sex would be repeat buyers only, a fact that should be taken into account by prevention.

Nevirapine vs efavirenz in virologically supressed patients: Differences in lipoprotein subclasses and inflammatory biomarkers.

Background: The interaction between lipid disturbances and inflammatory markers is not well known in patients on antiretroviral therapy (ART). As nevirapine (NVP) is associated with a better lipid profile than efavirenz (EFV), we investigated the relationships between lipid profiles, lipoprotein subclasses and inflammatory biomarkers in patients with prolonged viral suppression with either NVP or EFV and no obvious clinical inflammation. Methods: 122 clinically stable HIV-infected patients with HIV-1 RNA <20 copies longer than 6 months on NNRTI therapy were studied. 72 (59%) were on EFV and 50 (41%) on NVP. Any potentially inflammatory co-morbid diseases (concurrent viral hepatitis, diabetes, hypertension, chronic liver or renal diseases), or statin treatment, were exclusion criteria. Inflammatory biomarkers included hsCRP, LpPLA2, sCD40L, IL-6, IL-8, t-PA, MCP-1, p-selectin and VCAM-1. Lipoprotein subclass measures (VLDL, LDL, IDL and HDL particle number and size) were obtained by the use of proton nuclear magnetic resonance spectroscopy. Results: 82% were male; median age 45 years. Median CD4 count 550/μL (IQR 324). Median time since HIV diagnosis 96 months (IQR 102) and accumulated time on ART 50 months (IQR 101). Patients on NVP had higher time since HIV diagnosis (126.9 [66.7] vs 91.3 [6.6] months, p=0.008) a prolonged time on ART (89.6 [54.6] vs 62.3 [52.2] months, p=0.01) and were older (47.7 vs 40.7 years, p=0.001) than those on EFV. NVP-treated patients presented increased HDL-c (55.8 [16] vs 48.8 [10.7] mg/dL, p=0.007) and apoA1 levels (153.4 [31.9] vs 141.5 [20.5] mg/dL, p=0.02), and reduced apoB/apoA1 ratio (0.68 [0.1] vs 0.61 [0.1], p=0.003) than EFV-treated patients. No differences in inflammatory markers or lipoprotein subclasses were found between NVP and EFV. In patients with extreme lipid values (less favorable: 75th percentiles of LDL, small/dense LDLp and small HDLp, or more favorable: HDL p75 and apoB/apoA1 ratio p25), no consistent differences in inflammatory biomarkers were found. Conclusions: Patients with prolonged viral suppression on NVP present significantly higher HDL and apoA1 levels and reduced apoB/apoA1 ratios than those on EFV, but no differences were found in lipoprotein particles nor inflammatory biomarkers. Relationships between lipid parameters and inflammatory biomarkers in NNRTItreated patients are complex and do not show a linear relationship in this study.

Efectividad de una estrategia de intervención preventiva, basada en entrevistas telefónicas estructuradas, en una población laboral con riesgo cardiovascular moderado/alto.

OBJECTIVE This study assesses the effectiveness of a structured telephone survey on cardiovascular prevention, in modifying lifestyle, on cardiovascular risk parameters, percentage of smoking cessation and overall cardiovascular risk (CVR). DESIGN Quasi-experimental study of preventive intervention. SETTING Ibermutuamur (Spanish Accident and Health Insurance Company). Centres established throughout Spain. PARTICIPANTS A total of 4,792 workers with moderate/high cardiovascular risk who had agreed to be contacted by phone. Subjects with a previous diagnosis of cardiovascular disease and those receiving treatment for hypertension, hypercholesterolemia or diabetes were excluded. INTERVENTION A final total of 3,085 workers were contacted and were followed up by telephone surveys on the first, fourth and eighth month after the initial check up (CU) in order to emphasise cardiovascular health advice (Group A); we failed to contact 1,707 workers, who only attended the baseline and one year CUs (Group B). PRINCIPAL OUTCOMES: CUs included medical records and physical examination, with two blood pressure measurements, Body Mass Index (BMI), and biochemical parameters. Cardiovascular risk was stratified following the European cardiovascular SCORE. Individuals with a relative risk higher than 4 were also considered as high-risk. All workers were informed about their cardiovascular risk profile (CVRF) and healthy cardiovascular lifestyle measures. They were also given a letter for their General Practitioner (GP) to inform them on the worker's cardiovascular risk level. RESULTS A total of 71.5% of the workers were over 45 years, 95.0% males, 76.6% manual workers ("Blue Collar") and 69.7% smokers. Both groups showed improvement in lipid parameters, blood pressure, smoking cessation and overall cardiovascular risk in the second CU. There were significant differences in favour of Group A as regards blood pressure, lipids (except HDL cholesterol), BMI, glycaemia, smoking cessation (A: 23.5%/B: 19.44%, P=0.001) and CVR stratum improvement (A: 46.6%/B: 37.7%, P=0.0001). The large majority (85%) of workers read preventive recommendations; 33% knew their risk level and 73% knew their CVRF. 52.9% gave the letter to the GP, which led them to start therapies on diet (47%), hypertension (19.5%), dyslipidaemia (16.7%), diabetes (4.4%) and smoking (2.9%) and no changes were made in 36.5% of cases. CONCLUSIONS The results of this study suggests that cardiovascular prevention strategy based on structured telephone surveys on high/moderate CVR subjects to promote lifestyle changes could be effective at reducing CVR. A clinical trial is required for confirmation. Sending information on CVRF following routine medial CUs and Primary Care involvement, could contribute to the positive changes observed.

Prepregnancy body mass index and resting metabolic rate during pregnancy.

AIM: The resting metabolic rate (RMR) varies among pregnant women. The factors responsible for this variability are unknown. This study aimed to assess the influence of the prepregnancy body mass index (BMI) on the RMR during late pregnancy. METHODS: RMR, height, weight, and total (TEE) and activity (AEE) energy expenditures were measured in 46 healthy women aged 31 ± 5 years (mean ± SD) with low (<19.8), normal (19.8-26.0), and high (>26.0) prepregnancy BMI at 38.2 ± 1.5 weeks of gestation (t(gest)) and 40 ± 7 weeks postpartum (t(post)) (n = 27). RESULTS: The mean t(gest) RMR for the low-, normal-, and high-BMI groups was 1,373, 1,807, and 2,191 kcal/day, respectively (p = 0.001). The overall mean t(gest) RMR was 316 ± 183 kcal/day (21%), higher than the overall mean t(post) value and this difference was correlated with gestational weight gain (r = 0.78, p < 0.001). The scaled metabolic rate by allometry (RMR/kilograms⁰·⁷³) was similar in the low-, normal-, and high-BMI groups, respectively (p = 0.45). Changes in t(gest) TEE closely paralleled changes in t(gest) RMR (r = 0.84, p < 0.001). AEE was similar among the BMI groups. CONCLUSION: The RMR is significantly increased in the third trimester of pregnancy. The absolute gestational RMR is higher in women with high prepregnancy BMI due to increased body weight. The scaled metabolic rate (RMR/kilograms⁰·⁷³) is similar among the BMI groups of pregnant women.

Risk factors for head and neck cancer in young adults: a pooled analysis in the INHANCE consortium.

BACKGROUND: Increasing incidence of head and neck cancer (HNC) in young adults has been reported. We aimed to compare the role of major risk factors and family history of cancer in HNC in young adults and older patients. METHODS: We pooled data from 25 case-control studies and conducted separate analyses for adults ≤45 years old ('young adults', 2010 cases and 4042 controls) and >45 years old ('older adults', 17 700 cases and 22 704 controls). Using logistic regression with studies treated as random effects, we estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: The young group of cases had a higher proportion of oral tongue cancer (16.0% in women; 11.0% in men) and unspecified oral cavity / oropharynx cancer (16.2%; 11.1%) and a lower proportion of larynx cancer (12.1%; 16.6%) than older adult cases. The proportions of never smokers or never drinkers among female cases were higher than among male cases in both age groups. Positive associations with HNC and duration or pack-years of smoking and drinking were similar across age groups. However, the attributable fractions (AFs) for smoking and drinking were lower in young when compared with older adults (AFs for smoking in young women, older women, young men and older men, respectively, = 19.9% (95% CI = 9.8%, 27.9%), 48.9% (46.6%, 50.8%), 46.2% (38.5%, 52.5%), 64.3% (62.2%, 66.4%); AFs for drinking = 5.3% (-11.2%, 18.0%), 20.0% (14.5%, 25.0%), 21.5% (5.0%, 34.9%) and 50.4% (46.1%, 54.3%). A family history of early-onset cancer was associated with HNC risk in the young [OR = 2.27 (95% CI = 1.26, 4.10)], but not in the older adults [OR = 1.10 (0.91, 1.31)]. The attributable fraction for family history of early-onset cancer was 23.2% (8.60% to 31.4%) in young compared with 2.20% (-2.41%, 5.80%) in older adults. CONCLUSIONS: Differences in HNC aetiology according to age group may exist. The lower AF of cigarette smoking and alcohol drinking in young adults may be due to the reduced length of exposure due to the lower age. Other characteristics, such as those that are inherited, may play a more important role in HNC in young adults compared with older adults.

Anàlisi del grau de coneixement d'aspectes relacionats amb l'activitat física i la salut que tenen les dones de 30 a 45 anys de Vallromanes

L’objectiu de l’estudi és identificar el grau de coneixement que tenen les dones de 30 a 45 anys del municipi de Vallromanes sobre aspectes relacionats amb l’activitat física i la salut, així com identificar quins coneixements són més específics perquè s’adhereixin a la pràctica regular d’activitat física. A més, de comprovar quins d’aquests possibles coneixements relacionats a la promoció de la salut pública són més eficients per fer augmentar el coneixement d’aquest grup de dones i alhora fer-les conscients de la importància de l’activitat física per la salut. Així doncs, a la mostra de l’estudi han participat 35 dones. La informació ha estat recopilada a través del qüestionari per identificar els estadis de canvi de l’activitat física (Marcus, Rossi, Selby, Niaura, i Abrams, 1992) i un qüestionari elaborat específicament per aquesta investigació. Els resultats obtinguts demostren, a trets generals, que les dones que es troben en estadis de canvi on tenen conductes actives físicament o compleixen amb les recomanacions mundials d’activitat física per la salut, tenen un major grau de coneixença i conscienciació sobre coneixements relacionats amb l’activitat física i la salut. Per tant, això porta a concloure que l’augment del coneixement i conscienciació d’aquest és un motiu perquè les dones participants en l’estudi s’adhereixin a la pràctica regular d’activitat física. No obstant, cal tenir present quines estratègies de salut pública són més específiques i eficients per fer augmentar el coneixement del grup de dones estudiat i adherir-les a la pràctica.

Leiomioma perfurado do intestino delgado

A perforated jejunal leiomyoma is a rare condition; only seven cases have been described in the literature. We report a case of a 45 years old man with a perforate acute abdomen. At laparotomy, a 12 cm multilobulated firm mass, located 20 cm distal from Treitz ligament, was removed. Histological sections disclosed a jejunal leiomyoma. The benign pattern of the lesion was confirmed with no mitosis and no atypical cellurarity. Five years later, the patient is free of the disease.

Arterial hypertension and metabolic profile in patients with polycystic ovary syndrome

PURPOSE: To evaluate parameters related with arterial pressure and metabolic profile in women with polycystic ovary syndrome (POS). METHODS: This monocentric study at the University Hospital Endocrinology Section included 60 women aged 18-45 years, 42 being diagnosed with POS and acting as 18 controls. All women were subjected to transvaginal ultrasound and monitored for arterial pressure for 24 h in the ambulatory (MAP). Venous blood samples were taken between 07.00 and 09.00, after 12 h fasting. Basal (BG) and fasting glucose concentrations, total cholesterol and its fractions, triglycerides and insulin (to calculate the homeostatic assay insulin-resistance, HOMA-IR) were measured. Collected data were the mean arterial blood pressure (24-h awake/sleep cycle), arterial pressure nocturnal descensus, glycemia and fasting glucose for HOMA-IR, and lipid profile. The Student's t test was used to compare homogeneous variables; the Mann-Whitney test was used to compare non-homogeneous variables; the Pearson's correlation coefficient was used to search for correlation between the variables. The c² test was used for comparison of the absence of nocturnal descensus. Significance was taken as p<0.05. RESULTS: The mean age of the patients with POS was 27.4±5.5 (18-45 years, n=42) and the body mass index (BMI) was 30.2±6.5 kg/m² (18.3-54.9). In the Control Group, the mean age was 31.4±6.1 (18-45 years) and the BMI was 27.1±6.2 kg/m² (18.3-54.9, n=18). No difference in the metabolic parameters and insulin resistance was observed between the two groups. Comparison between these parameters and MAP showed that the only parameter with a correlation was the BMI, independent of the POS diagnosis. This was not seen in nocturnal descensus, which was uncorrelated with POS and any of the other studied parameters. CONCLUSION: POS women do not show higher arterial blood pressure, glycemia, HDL-col, TG, HOMA-IR and BMI compared to non-POS women. However, POS patients showed correlation between arterial pressure and BMI, suggesting that obesity is a primary factor involved in arterial pressure changes in these patients.

Grados altos en la Escala de Fisher predicen el desarrollo de hidrocefalia en pacientes con hemorragia subaracnoidea espontanea

Objetive. To determine if high grades of Fisher scale are useful to predict the development of hydrocephalus in consecutive Colombian patients with spontaneous subarachnoid hemorrhage (SAH) assessed from January 2005 to April 2012 with 12 month follow-up. Methods. 251 patients were included in a restrospective manner. The association between Fisher scale and hydrocephalus was analyzed bivariate and multivariate analysis. In addition, a systematic literature review (SLR) was done. Results. In our cohort of patients, the etiology of SAH was due to aneurysms; 78,5%. The prevalence of hydrocephalus was found to be of 27,1%. Overall survival with a 12 month follow-up was of 65,7%. Average age of included patients was 55,5 ± 15 years, and most of them were women; 65,7%. Having Fisher 4 and Hunt-Hess III are significantly associated with hydrocephalus: adjusted OR: 2.93 95% CI: 1.51-5.65, P <0.001, adjusted OR: 2.83 95% CI: 1.31-6.17 P=0.008 respectively. The SRL showed an overall prevalence of hydrocephalus between 17 and 68% and mortality varied between 3.0% and 33%. 50% of the included studies significantly associated intraventricular hemorrhage ( Fisher 4) with hydrocephalus. Conclusion. Our results confirm current concepts on post-SAH hydrocephalus and the fact that is obstructive and secondary to Fisher 4 and having neurological impairment on admission (Hunt and Hess III).

Escala de Fisher como factor predictor de hidrocefalia en hemorragia subaracnoidea espontanea

Objetivo. Determinar si la cantidad de sangre y su localización es el espacio subaracnoideo, medible con la escala de Fisher en las primeras 24 horas de ocurrido el ictus hemorrágico, es un factor predictor para el desarrollo de hidrocefalia en pacientes con diagnóstico de hemorragia subaracnoidea (HSA) espontánea, vistos en el Hospital Universitario Clínica San Rafael (HUCSR) con seguimiento de 12 meses. Métodos. 251 pacientes fueron incluidos en una cohorte retrospectiva. La asociación entre la escala de Fisher y el desarrollo de hidrocefalia en pacientes con HSA espontánea fue analizada a través de un análisis bivariado y multivariado. Resultados. La edad promedio de los pacientes fue de 55,5 ± 15 años; con predominancia en el sexo femenino 65,7%. La prevalencia de hidrocefalia fue de 27,1% en la cohorte y la etiología de la HSA fue en su mayoría por ruptura de aneurismas de arterias cerebrales; 78,5%. La sobrevida a 12 meses fue de 65,7%. Tanto el grado 4 en la escala de Fisher como Hunt-Hess III se asocian con el desarrollo de hidrocefalia: ORA; 2.93 IC 95%: 1.51-5.65, P <0.001, ORA 2.83 IC 95%: 1.31-6.17 P=0.008 respectivamente. Conclusión. La presencia de sangrado Intraventricular o intraparenquimatoso ( Fisher 4) en las primeras 24 horas, asociado a un deterioro neurológico al ingreso Hunt-Hess III están asociados con el desarrollo de hidrocefalia en los 251 pacientes evaluados con diagnóstico de HSA espontánea; hallazgos consistentes con lo reportado en la literatura mundial.

Prevalencia de los trastornos de voz ocupacionales en los docentes de dos instituciones educativas de nivel superior en Colombia en el año 2013-2014

Resumen: En la población docente, el uso de la voz como principal herramienta del trabajo por su esfuerzo constante y prolongado constituye el principal factor de riesgo para padecer trastornos de la voz, concomitante con otros factores que inciden en la presentación de estas patologías. Objetivo: Determinar la prevalencia de los trastornos en la voz y sus factores asociados de la población docente de dos instituciones de educación superior (IES) en Colombia y los factores de riesgo asociados. Materiales y métodos: Se realizó un estudio descriptivo de tipo transversal, en el que participaron 149 docentes de dos IES (instituciones de educación superior) de dos ciudades de Colombia. Se aplicó un cuestionario sustentado en el Modelo de Técnicas Foniátricas para Prevenir la Disfonía en Profesores de Secundaria en Portugal y validado por la escuela de Medicina y Ciencias de la Salud, programa de fonoaudiología de la Universidad del Rosario con el trabajo denominado “La Voz como herramienta de trabajo” para Colombia; el cual indagaba los factores riesgo asociados al uso de la voz en el quehacer docente. Se realizó un análisis descriptivo de las variables cualitativas con frecuencias absolutas y porcentajes, medidas de tendencia central, promedio y mediana, de dispersión y desviación estándar. La información recolectada fue analizada con el software SPSS.PASW 18. La correlación entre las variables dependientes y las independientes, se realizaron con el coeficiente no-paramétrico de Spearman y la asociación con la prueba Ji-cuadrado de Pearson o el test exacto de Fisher (valores esperados < 5). Se evaluaron las distribuciones de las variables ordinales de las variables de problemas de la voz con el género, con la prueba no-paramétrica exacta de Mann Whitney. Las pruebas estadísticas se evaluaron a un nivel de significancia del 5% (p<0.05). Resultados: El promedio de edad fue de 36±11.7 años, con un rango que varió entre 25 y 68 años. El género más frecuente fue el masculino con 57,0% de participación. Los datos presentados se dan como resultado de las respuestas a tres preguntas indicativas de los trastornos de voz, las cuales no fueron respondidas por la totalidad de los docentes, por esta razón los datos se presentan así t= número total de personas que respondieron la pregunta y n= número de personas que respondieron afirmativamente. La prevalencia de alteración de voz fue del 63,4% (t=82; n=52), de disminución en el volumen de su voz de 57,3% (t=122; n=70) y cansancio laríngeo en el 76,8% (t=121; n=93). El cansancio laríngeo fue significativamente mayor en los hombres que en las mujeres (p=0.026, Test Mann Whitney exacto a una cola), con algunos hábitos de voz como el realizar esfuerzos en el cuello al hablar (rs = 0,461; p< 0,001) y con la dificultad para inhalar o exhalar aire al hablar (rs = 0,368; p<0.001), con el ruido de fondo (rs =0,361, p<0,001), al permanecer en ambientes contaminados con polvo y humedad (rs=0,311; p=0.001), con sufrir de estrés representado por dolor cervical en espalda y hombros (rs=0,349, p<0.001), y con los problemas familiares (rs= 0,397; p<0.001). Al analizar con la disminución del volumen de voz durante la práctica docente, las correlaciones más significativas mostradas fue estadísticamente mayor entre los hombres que en las mujeres (p=0.006, Test Mann Whitney exacto a una cola), con el esfuerzo cervical para hablar (rs =:0,596, p=<,001), y con el presentar dificultad para inhalar/exhalar aire al usar la voz (rs =0,508, p<,001), con la exposición a ruido de fondo (rs=0,204, p=0,030), ambientes contaminados con polvo y humedad (rs:=305, p<,001), con el estrés (rs =0,316, p=0,001), con los problemas familiares (rs =0,560, p<,001) y en las mujeres con la alteración de la voz en presencia de la menstruación (rs =0,751, p=0,000). Por último, se correlacionó con las alteraciones de voz durante la exposición laboral en la que se mostró mayor correlación en las mujeres que en los hombres (p=0.001, Test Mann Whitney exacto a una cola). Se mostró correlación directa con el no realizar pausas al hablar (rs=0,337, p<0,001), con toser para aclarar la voz (rs =0,349, p=0,001), y con el uso de la voz grave (rs =0,975; p=,004) ,con la presencia de ruido de fondo mientras se dicta clase (rs =0,370, p=0,001) con el permanecer en ambientes contaminados con polvo y humedad (rs =0,253,p=,023), con los síntomas cervicales asociados al estrés (rs=0,323, p=0,003), e inversa con los cambios en tono y volumen de la voz en presencia de menstruación en las mujeres (rs=-0,414,p=,017). Conclusiones: Con los hallazgos encontrados en este estudio es importante reconocer que en las características demográficas, se encontró que el género masculino refirió mayor cantidad de problemas de voz. Para las características laborales la antigüedad ocupacional es factor principal que incide en los problemas de voz; en el análisis de las características demográfico– laborales en las variables analizadas, el grupo etario que reporto cansancio laríngeo se encontraba entre los 36 a 45 años de edad, y los que referían un tiempo de exposición ocupacional mayor a 6 y menor a 15 años. En cuanto a los factores ambientales se identificó que la asociación más significativa está relacionada con estar sometido a cambios bruscos de temperatura, estar expuesto a ruido de fondo durante su labor y finalmente a permanecer en ambientes contaminados. Por ultimo al analizar las alteraciones de la voz con las características personales de los docentes, se observó que el estrés y los problemas familiares inciden de forma significativa en estas patologías. Con estos resultados se recomienda establecer un sistema de vigilancia epidemiológica en las IES, donde se capacite integralmente a los docentes en cuanto a los factores de riesgo personales y de hábitos de voz, además de supervisar y adecuar los factores ambientales que inciden en la presentación de trastornos de voz para evitar la presentación de estas patologías.

Resonancia magnética cardiaca: medidas lineales y volumétricas en adultos sanos

Introducción: La gran mayoría de las medidas de normalidad utilizadas para la interpretación de resonancia cardiaca son extrapoladas de las medidas de ecocardiografía. Los limitados registros de medidas de normalidad se encuentran ajustados en poblaciones extranjeras, no hay registros en latinoamericanos. Objetivo: Determinar las dimensiones cardiacas utilizando resonancia magnética en una población de personas sin antecedente médicos con repercusión cardiaca para lograr una muestra de valores que permitan ajustar las medidas de normalidad utilizadas por nuestro servicio. Materiales y métodos: se analizaron 45 sujetos sanos con edad comprendida entre los 21 y 45 años, las adquisiciones se realizaron utilizando un equipo de RM de 1,5 teslas, el análisis de las imágenes se realizó mediante el programa Cardiac Volume Vx. Se evaluaron múltiples parámetros morfofuncionales a través de análisis estadístico por medio del sistema SPSS versión 23. Resultados: Mediciones obtenidas de ventrículo izquierdo principales fueron volumen diastólico en mujeres de 62 ml +/- 7.1 y en hombres de 65 ml +/- 11.2 y fracción de eyección de 60 % +/- 5 en mujeres y de 62 % +/- 9 en hombres. En ventrículo derecho el volumen diastólico final se encontró 81.8 ml +/- 14.6 en mujeres y 100 ml +/- 24.8 en hombres y fracción de eyección de 53 % +/- 17 en mujeres y de 45 % +/- 12 en hombres. Volumen de fin de diástole de 50 +/- 12.7 ml en mujeres y de 49 ml +/- 19 ml en hombres y fracción de eyección de aurícula izquierda de 55 % +/- 0.08 en mujeres y de 50 % +/- 0.07 en hombres. Volumen de fin de diástole de 44.1 ml +/- 18.5 en mujeres y de 49.2 ml +/- 22.9 en hombres y fracción de eyección de aurícula derecha de 50 % +/- 11 en mujeres y de 45 % +/- 8 en hombres. Se obtuvieron otras medidas lineales y volumétricas adicionales de cavidades cardiacas y de grandes vasos supracardiacos. Conclusiones: se describen los valores de referencia de los parámetros morfofuncionales de las cavidades cardiacas y de vasos supracardiacos. El sexo fue tenido en cuenta como covariable relacionada con la modificación de los parámetros evaluados. Se sugieren variaciones en las medidas de cavidades cardiacas para la población estudiada relacionada con aclimatación crónica a la altitud de la ciudad de Bogotá.

Incorporation of cis-9,trans-11 or trans-10,cis-12 conjugated linoleic acid into plasma and cellular lipids in healthy men

This study investigated the incorporation of cis-9,trans-11 conjugated linoleic acid (c9,t11 CLA) and trans-10,cis-12-CLA (t10,c12 CLA) into plasma and peripheral blood mononuclear cell (PBMC) lipids when consumed as supplements highly enriched in these isomers. Healthy men (n = 49, age 31 +/- 8 years) consumed one, two, and four capsules containing similar to600 mg of either c9,t11 CIA or t10,c12 CLA per capsule for sequential 8 week periods followed by a 6 week washout before consuming the alternative isomer. Both isomers were incorporated in a dosedependent manner into plasma phosphatidylcholine (PC) (c9,t11 CLA r = 0.779, t10,c12 CLA r = 0.738; P < 0.0001) and cholesteryl ester (CE) (c9,t11 CLA r = 0.706, t10,c12 CLA r = 0.788; P < 0.0001). Only t10,c12 CLA was enriched in plasma nonesterified fatty acids. Both c9,t11 CIA and t10,c12 CLA were incorporated linearly into PBMC total lipids (r = 0.285 and r = 0.273, respectively; P < 0.0005). The highest concentrations of c9,t11 CLA and t10,c12 CLA in PBMC lipids were 3- to 4-fold lower than those in plasma PC and CE. These data suggest that the level of intake is a major determinant of plasma and PBMC CLA content, although PBMCs appear to incorporate both CLA isomers less readily.

Incorporation of cis-9,trans-11 or trans-10,cis-12 conjugated linoleic acid into plasma and cellular lipids in healthy men

This study investigated the incorporation of cis-9,trans-11 conjugated linoleic acid (c9,t11 CLA) and trans-10,cis-12-CLA (t10,c12 CLA) into plasma and peripheral blood mononuclear cell (PBMC) lipids when consumed as supplements highly enriched in these isomers. Healthy men (n = 49, age 31 +/- 8 years) consumed one, two, and four capsules containing similar to600 mg of either c9,t11 CIA or t10,c12 CLA per capsule for sequential 8 week periods followed by a 6 week washout before consuming the alternative isomer. Both isomers were incorporated in a dosedependent manner into plasma phosphatidylcholine (PC) (c9,t11 CLA r = 0.779, t10,c12 CLA r = 0.738; P < 0.0001) and cholesteryl ester (CE) (c9,t11 CLA r = 0.706, t10,c12 CLA r = 0.788; P < 0.0001). Only t10,c12 CLA was enriched in plasma nonesterified fatty acids. Both c9,t11 CIA and t10,c12 CLA were incorporated linearly into PBMC total lipids (r = 0.285 and r = 0.273, respectively; P < 0.0005). The highest concentrations of c9,t11 CLA and t10,c12 CLA in PBMC lipids were 3- to 4-fold lower than those in plasma PC and CE. These data suggest that the level of intake is a major determinant of plasma and PBMC CLA content, although PBMCs appear to incorporate both CLA isomers less readily.

Avaliação demográfica, clinico-laboratorial e genética de indivíduos com lupus eritematoso sistêmico e artrite reumatóide residentes em região tropical

The aetiology of autoimmunes disease is multifactorial and involves interactions among environmental, hormonal and genetic factors. Many different genes may contribute to autoimmunes disease susceptibility. The major histocompatibility complex (MHC) genes have been extensively studied, however many non-polymorphic MHC genes have also been reported to contribute to autoimmune diseases susceptibility. The aim of the present study was to evaluate the influence of SLC11A1 gene in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Ninety-six patients with SLE, 37 with RA and 202 controls enrolled in this case-control study, were evaluated with regard to demographic, genetic, laboratorial and clinical data. SLE mainly affects females in the ratio of 18 women for each man, 88,3% of the patients aged from 15 to 45 years old and it occurs with similar frequency in whites and mulattos. The rate of RA between women and men was 11:1, with 77,1% of the cases occurring from 31 to 60 years. The genetic analysis of the point mutation -236 of the SLC11A1 gene by SSCP did not show significant differences between alleles/genotypes in patients with SLE or RA when compared to controls. The most frequent clinical manifestations in patients with SLE were cutaneous (87%) and joint (84.9%). In patients with RA, the most frequent out-joint clinical manifestation were rheumatoid nodules (13,5%). Antinuclear antibodies were present in 100% of the patients with SLE. There was no significant relation between activity of disease and presence of rheumatoid factor in patients with RA, however 55,6% of patients with active disease presented positive rheumatoid factor. Significant association between alleles/genotypes of point mutation -236 and clinical manifestations was not found