Is the obesity epidemic exaggerated? Clues from a developing country

Rapid response to: Patrick Basham and John Luik. Is the obesity epidemic exaggerated? Yes. BMJ 2008; 336: 244. doi: 10.1136/bmj.39458.495127.AD

Risk factors of stroke mortality in the African region: a cohort study

Background: Population-based cohort studies of risk factors of stroke are scarce in developing countries and none has been done in the African region. We conducted a longitudinal study in the Seychelles (Indian Ocean, east of Kenya), a middle-income island state where the majority of the population is of African descent. Such data in Africa are important for international comparison and for advocacy in the region. Methods: Three examination surveys of cardiovascular risk factors were performed in independent samples representative of the general population aged 25-64 in 1989, 1994 and 2004 (n=1081, 1067, and 1255, respectively). Baseline risk factors data were linked with cause-specific mortality from vital statistics up to May 2007 (all deaths are medically certified in the Seychelles and kept in an electronic database). We considered stroke (any type) as a cause of death if the diagnosis was reported in any of the 4 fields in the death certificates for underlying and concomitant causes of death. Results. Among the 2479 persons aged 35-64 at baseline, 280 died including 56 with stroke during follow up (maximum: 18.2 years; mean: 10.2 years). In this age range, age-adjusted mortality rates (/100'000/year) were 969 for all cause and 187 for stroke; age-adjusted prevalence of high blood pressure (≥140/90 mmHg) was 48%. In multivariate Cox survival time regression, stroke mortality was increased by 18% and 35% for a 10-mmHg increase in systolic, respectively diastolic BP (p<0.001). Stroke mortality was also associated with age, smoking ≥5 cigarettes vs. no smoking (HR: 2.4; 95% CI: 1.2-4.8) and diabetes (HR: 1.9; 1.02-3.6) but not with sex, LDL-cholesterol intake, alcohol intake and professional occupation. Conclusion. This first population-based cohort study in the African region demonstrates high mortality rates from stroke in middle-aged adults and confirms associations with high BP and other risk factors. This emphasizes the importance of reducing BP and other modifiable risk factors in high risk individuals and in the general population as a main strategy to reduce the burden of stroke.

Alterações nas concentrações de fósforo em solos cultivados com arroz irrigado no Rio Grande do Sul

Os solos utilizados para a cultura de arroz irrigado por alagamento no Estado do Rio Grande do Sul são oriundos de diferentes materiais de origem, os quais conferem diferentes características mineralógicas e químicas, que alteram de forma diferenciada a disponibilidade de P para a cultura. Com o objetivo de verificar essas diferenças na disponibilidade de P para o arroz em solos oriundos de diferentes materiais de origem, conduziu-se um experimento fatorial, delineado em blocos ao acaso, em que cinco solos foram submetidos à ausência ou presença de superfosfato triplo. Os solos derivados de sedimentos de arenito e granito (Planossolos) apresentaram redução mais rápida do Fe com liberação do P adsorvido, quando comparados aos solos derivados de sedimento de basalto. Os Planossolos apresentaram maior quantidade de P acumulado no arroz que o Vertissolo e Chernossolo, sem ou com a adição de superfosfato triplo. A adição de superfosfato triplo resultou em maior quantidade de P acumulado na planta para todos os solos.

The contribution of rectangularization to the secular increase of life expectancy: an empirical study.

BACKGROUND: In low-mortality countries, life expectancy is increasing steadily. This increase can be disentangled into two separate components: the delayed incidence of death (i.e. the rectangularization of the survival curve) and the shift of maximal age at death to the right (i.e. the extension of longevity). METHODS: We studied the secular increase of life expectancy at age 50 in nine European countries between 1922 and 2006. The respective contributions of rectangularization and longevity to increasing life expectancy are quantified with a specific tool. RESULTS: For men, an acceleration of rectangularization was observed in the 1980s in all nine countries, whereas a deceleration occurred among women in six countries in the 1960s. These diverging trends are likely to reflect the gender-specific trends in smoking. As for longevity, the extension was steady from 1922 in both genders in almost all countries. The gain of years due to longevity extension exceeded the gain due to rectangularization. This predominance over rectangularization was still observed during the most recent decades. CONCLUSIONS: Disentangling life expectancy into components offers new insights into the underlying mechanisms and possible determinants. Rectangularization mainly reflects the secular changes of the known determinants of early mortality, including smoking. Explaining the increase of maximal age at death is a more complex challenge. It might be related to slow and lifelong changes in the socio-economic environment and lifestyles as well as population composition. The still increasing longevity does not suggest that we are approaching any upper limit of human longevity.

La prévalence des douleurs du dos et de ses facteurs de risque chez les citoyens suisses convoqués à leur recrutement en Suisse romande en 1985

L'objet de cette étude est d'estimer la prévalence des douleurs du racis chez les jeunes hommes convoqués pour la première fois à leur recrutement en Suisse romande en 1985. On s'intéresse donc aux douleurs présentes au moment du recrutement, mais également aux douleurs déjà révolues, puisqu'on sait qu'il s'agit d'une affection qui récidive facilement. Ceci est donc considéré comme un facteur de risque. D'autres facteurs de risque tels que le sport et la profession exercée seront analysés afin d'estimer leur influence sur la prévalence des cervico-dorso-lombalgies. [Auteur, p. 7]

Relação entre óxidos de ferro e de manganês e a sorção de fósforo em solos no Rio Grande do Sul

Os solos utilizados para a cultura de arroz irrigado por alagamento no Estado do Rio Grande do Sul são oriundos de diferentes materiais de origem e estão sujeitos às variações temporais das condições de oxidação e redução. Essas condições contribuem para as variações nos teores totais e na crista-linidade de óxidos de Fe e de Mn, as quais estão relacionadas aos processos de sorção e dessorção, afetando a disponibilidade de P para a cultura de arroz irrigado. Com o objetivo de verificar a sorção de P e a sua disponibilidade para o arroz em solos oriundos de diferentes materiais de origem, foram desenvolvidos dois estudos: o primeiro para determinar os teores totais de Fe e de Mn e a capacidade máxima de adsorção de P (CMAP) pelas isotermas de Langmuir; além disso, foram associados a CMAP e os teores totais de Fe e de Mn, na razão FeOx6/Fe dit, razão MnOx6/Mn dit argila e da matéria orgânica. O segundo estudo foi para quantificar a sorção de P durante quatro períodos de alagamento do solo. Os solos oriundos de sedimento de basalto (Luvissolo, Vertissolo e Chernossolo) apresentaram maior CMAP do que os oriundos de sedimento de granito e arenito (Planossolos e Gleissolos), devido aos maiores teores totais de Fe e também às razões de Fe extraído por oxalato de amônio a pH 6 (Fe ox6)/ferro extraído por ditionito (Fe dit) e Mn extraído por oxalato de amônio a pH 6 (Mn ox6)/Mn dit. A razão Fe ox6/Fe dit apresentou a maior associação com a CMAP em todos os solos utilizados. O Planossolo teve menor sorção de P do que os solos oriundos de sedimento de basalto em todos os períodos de alagamento.

Mortinatalité et mortalité infantile dans le canton du Valais

[Table des matières] Caractéristiques des naissances, 1979-1985. Evolution séculaire des mortalités néonatale, post-néonatale et infantile par sexe, 1901-1987 (données quinquennales). Evolution de la mortinatalité par sexe, 1969-1987. Taux de mortalité, canton de Valais, 1979-1985(87).

Immunogenicity of the carcinoembryonic antigen derived peptide 694 in HLA-A2 healthy donors and colorectal carcinoma patients.

Carcinoembryonic antigen (CEACAM5) is commonly overexpressed in human colon cancer. Several antigenic peptides recognized by cytolytic CD8+ T-cells have been identified and used in colon cancer phase-I vaccination clinical trials. The HLA-A*0201-binding CEA(694-702) peptide was recently isolated from acid eluted MHC-I associated peptides from a human colon tumor cell line. However, the immunogenicity of this peptide in humans remains unknown. We found that the peptide CEA(694-702) binds weakly to HLA-A*0201 molecules and is ineffective at inducing specific CD8+ T-cell responses in healthy donors. Immunogenic-altered peptide ligands with increased affinity for HLA-A*0201 were identified. Importantly, the elicited cytolytic T lymphocyte (CTL) lines and clones cross-reacted with the wild-type CEA(694-702) peptide. Tumor cells expressing CEA were recognized in a peptide and HLA-A*0201 restricted fashion, but high-CEA expression levels appear to be required for CTL recognition. Finally, CEA-specific T-cell precursors could be readily expanded by in vitro stimulation of peripheral blood mononuclear cell (PBMC) from colon cancer patients with altered CEA peptide. However, the CEA-specific CD8+ T-cell clones derived from cancer patients revealed low-functional avidity and impaired tumor-cell recognition. Together, using T-cells to demonstrate the processing and presentation of the peptide CEA694-702, we were able to corroborate its presentation by tumor cells. However, the low avidity of the specific CTLs generated from cancer patients as well as the high-antigen expression levels required for CTL recognition pose serious concerns for the use of CEA694-702 in cancer immunotherapy.