Hina 18.7.1943

Kirje

Impact and cost of a 2-week community-based screening and awareness program for diabetes and cardiovascular risk factors in a Swiss canton.

BACKGROUND: Community-based diabetes screening programs can help sensitize the population and identify new cases. However, the impact of such programs is rarely assessed in high-income countries, where concurrent health information and screening opportunities are common place. INTERVENTION AND METHODS: A 2-week screening and awareness campaign was organized as part of a new diabetes program in the canton of Vaud (population of 697,000) in Switzerland. Screening was performed without appointment in 190 out of 244 pharmacies in the canton at the subsidized cost of 10 Swiss Francs per participant. Screening included questions on risk behaviors, measurement of body mass index, blood pressure, blood cholesterol, random blood glucose (RBG), and A1c if RBG was >/=7.0 mmol/L. A mass media campaign promoting physical activity and a healthy diet was channeled through several media, eg, 165 spots on radio, billboards in 250 public places, flyers in 360 public transport vehicles, and a dozen articles in several newspapers. A telephone survey in a representative sample of the population of the canton was performed after the campaign to evaluate the program. RESULTS: A total of 4222 participants (0.76% of all persons aged >/=18 years) underwent the screening program (median age: 53 years, 63% females). Among participants not treated for diabetes, 3.7% had RBG >/= 7.8 mmol/L and 1.8% had both RBG >/= 7.0 mmol/L and A1c >/= 6.5. Untreated blood pressure >/=140/90 mmHg and/or untreated cholesterol >/=5.2 mmol/L were found in 50.5% of participants. One or several treated or untreated modifiable risk factors were found in 78% of participants. The telephone survey showed that 53% of all adults in the canton were sensitized by the campaign. Excluding fees paid by the participants, the program incurred a cost of CHF 330,600. CONCLUSION: A community-based screening program had low efficiency for detecting new cases of diabetes, but it identified large numbers of persons with elevated other cardiovascular risk factors. Our findings suggest the convenience of A1c for mass screening of diabetes, the usefulness of extending diabetes screening to other cardiovascular risk factors, and the importance of a robust background communication campaign.

Hki 17/7 1943

Kirje 17.7.1943

Optimal bail out policy, conditionality and constructive ambiguity

This paper addresses the issue of the optimal behaviour of the Lender of Last Resort (LOLR) in its microeconomic role regarding individual financial institutions in distress. It has been argued that the LOLR should not intervene at the microeconomic level and let any defaulting institution face the market discipline, as it will be confronted with the consequences of the risks it has taken. By considering a simple costbenefit analysis we show that this position may lack a sufficient foundation. We establish that, instead, uder reasonable assumptions, the optimal policy has to be conditional on the amount of uninsured debt issued by the defaulting bank. Yet in equilibrium, because the rescue policy is costly, the LOLR will not rescue all the banks that fulfill the uninsured debt requirement condition, but will follow a mixed strategy. This we interpret as the confirmation of the "creative ambiguity" principle, perfectly in line with the central bankers claim that it is efficient for them to have discretion in lending to individual institutions. Alternatively, in other cases, when the social cost of a bank's bankruptcy is too high, it is optimal for the LOLR to bail out the insititution, and this gives support to the "too big to fail" policy.

Diversidad de diatomeas y dinoflagelados marinos del Perú

Se presenta una relación de las diatomeas y dinoflagelados registrados en el mar peruano, desde 1950 hasta la fecha. El área estudiada se extiende de los 3°30'S a l8°30'S hasta una distancia aproximada de 300 millas náuticas de la costa. En esta área pdrticipan cuatro masas de agua de características diferentes que propician una alta diversidad específica. Se identificaron 169 especies de diatomeas y 208 de dinoflagelados que corresponden respectivamente, al12% y 14% del total de especies registradas a nivel mundial. Dos géneros de diatomeas y dos de dinoflagelados contienen casi la totalidad de especies.

Invertebrados Macro-Bentónicos de área de Pisco, Perú

Entre 1978 y 1987 se realizaron muestreos de la macrofauna bentónica en 10 localidades del litoral y 14 estaciones del sublitoral, en el área de Pisco, Perú. Se diferenciaron ocho biotopos, en los que se hallaron un total de 330 taxones (excluyendo Nematoda), de los cuales 305 fueron determinados por los menos hasta el nivel genérico. El total de taxa está agrupado en 145 familias, 43 órdenes y 15 phyla, e incluye 112 Mollusca, 104 Annelida, 75 Crustacea y 39 taxa pertenecientes a otros grupos taxonómicos. Exclusivamente en fondos y orillas rocasas se encontraron 158 taxa. Considerando solamente los moluscos, poliquetos y crustáceos, con el presente estudio se incrementa de 103 a 289 el número de taxa registradas para el área investigada.

Treatment of mediastinal fibrosis with mycophenolate mofetil.

We present the case of a 67-year-old male patient with mediastinal and retroperitoneal fibrosis. In Europe, this is a rare disease. Treatment was established to prevent complications due to strictures or compressions. Because of his diabetes, a therapy of low-dose prednisone combined with mycophenolate mofetil, known as steroid sparing agent, was applied. As a result, the radiological follow-up showed a marked decrease in the mediastinal and retroperitoneal masses.

The major genetic determinants of HIV-1 control affect HLA class I peptide presentation.

Infectious and inflammatory diseases have repeatedly shown strong genetic associations within the major histocompatibility complex (MHC); however, the basis for these associations remains elusive. To define host genetic effects on the outcome of a chronic viral infection, we performed genome-wide association analysis in a multiethnic cohort of HIV-1 controllers and progressors, and we analyzed the effects of individual amino acids within the classical human leukocyte antigen (HLA) proteins. We identified >300 genome-wide significant single-nucleotide polymorphisms (SNPs) within the MHC and none elsewhere. Specific amino acids in the HLA-B peptide binding groove, as well as an independent HLA-C effect, explain the SNP associations and reconcile both protective and risk HLA alleles. These results implicate the nature of the HLA-viral peptide interaction as the major factor modulating durable control of HIV infection.

Estado reproductivo de la Merluza Merluccius gayi peruanus durante el crucero de evaluación BIC Humboldt 9705-06

Se da a conocer la actividad reproductiva de la merluza, Merluccius gayi peruanus, a través del análisis histológico de los ovarios durante el crucero de evaluación BIC Humboldt 9705-06 entre el 15 de mayo y el 08 de junio de 1997. Se identificaron cinco estadios de madurez sexual y se efectuó un análisis de la variación de estos estadios de acuerdo a un muestreo aleatorio estratificado por talla en cuatro áreas de muestreo: 3°30 '-4°59 'S; 5°-6°59 'S; 7°-8°59 'S; 9°-11°59 'S. Se determinaron dos grupos disímiles, uno en el que predominó el reposo sexual (3°30 ' - 6°59 ' S) y el otro en el que la mayoría se encontraba maduro (7°-11°59 ' S). En este último grupo el porcentaje de hembras maduras fue la más frecuente en aquellas iguales o mayores a 31 cm de longitud total. No se observaron diferencias del estado reproductivo a diferentes profundidades