Risk of type 2 diabetes according to traditional and emerging anthropometric indices in Spain, a Mediterranean country with high prevalence of obesity: results from a large-scale prospective cohort study.

Background: Obesity is a major risk factor for type 2 diabetes mellitus (T2DM). A proper anthropometric characterisation of T2DM risk is essential for disease prevention and clinical risk assessement. Methods: Longitudinal study in 37 733 participants (63% women) of the Spanish EPIC (European Prospective Investigation into Cancer and Nutrition) cohort without prevalent diabetes. Detailed questionnaire information was collected at baseline and anthropometric data gathered following standard procedures. A total of 2513 verified incident T2DM cases occurred after 12.1 years of mean follow-up. Multivariable Cox regression was used to calculate hazard ratios of T2DM by levels of anthropometric variables. Results: Overall and central obesity were independently associated with T2DM risk. BMI showed the strongest association with T2DM in men whereas waist-related indices were stronger independent predictors in women. Waist-to-height ratio revealed the largest area under the ROC curve in men and women, with optimal cut-offs at 0.60 and 0.58, respectively. The most discriminative waist circumference (WC) cut-off values were 99.4 cm in men and 90.4 cm in women. Absolute risk of T2DM was higher in men than women for any combination of age, BMI and WC categories, and remained low in normal-waist women. The population risk of T2DM attributable to obesity was 17% in men and 31% in women. Conclusions: Diabetes risk was associated with higher overall and central obesity indices even at normal BMI and WC values. The measurement of waist circumference in the clinical setting is strongly recommended for the evaluation of future T2DM risk in women.

DsRed2 transient expression in Culex quinquefasciatus mosquitoes

Culex quinquefasciatus mosquitoes have been successfully genetically modified only once, despite the efforts of several laboratories to transform and establish a stable strain. We have developed a transient gene expression method, in Culex, that delivers plasmid DNA directly to the mosquito haemolymph and additional tissues. We were able to express DsRed2 fluorescent protein in adult Cx. quinquefasciatus mosquitoes by injecting plasmids directly into their thorax. The expression of DsRed2 in adult Cx. quinquefasciatus mosquitoes is an important stepping stone to genetic transformation and the potential use of new control strategies and genetic interactions.

Parasite load and risk factors for poor outcome among children with visceral leishmaniasis. A cohort study in Belo Horizonte, Brazil, 2010-2011

Clinical and laboratory risk factors for death from visceral leishmaniasis (VL) are relatively known, but quantitative real-time polymerase chain reaction (qPCR) might assess the role of parasite load in determining clinical outcome. The aim of this study was to identify risk factors, including parasite load in peripheral blood, for VL poor outcome among children. This prospective cohort study evaluated children aged ≤ 12 years old with VL diagnosis at three times: pre-treatment (T0), during treatment (T1) and post-treatment (T2). Forty-eight patients were included and 16 (33.3%) met the criteria for poor outcome. Age ≤ 12 months [relative risk (RR) 3.51; 95% confidence interval (CI) 1.89-6.52], tachydyspnoea (RR 3.46; 95% CI 2.19-5.47), bacterial infection (RR 3.08; 95% CI 1.27-7.48), liver enlargement (RR 3.00; 95% CI 1.44-6.23) and low serum albumin (RR 7.00; 95% CI 1.80-27.24) were identified as risk factors. qPCR was positive in all patients at T0 and the parasite DNA was undetectable in 76.1% of them at T1 and in 90.7% at T2. There was no statistical association between parasite load at T0 and poor outcome.

Effect of a specific supplement enriched with n-3 polyunsaturated fatty acids on markers of inflammation, oxidative stress and metabolic status of ear, nose and throat cancer patients.

Malnutrition affects 40-50% of patients with ear, nose and throat (ENT) cancer. The aim of this study was to assess changes induced by a specific nutritional supplement enriched with n-3 polyunsaturated fatty acids, fiber and greater amounts of proteins and electrolytes, as compared with a standard nutritional supplement, on markers of inflammation, oxidative stress and metabolic status of ENT cancer patients undergoing radiotherapy (RT). Fourteen days after starting RT, 26 patients were randomly allocated to one of two groups, 13 supplemented with Prosure, an oncologic formula enriched with n-3 polyunsaturated fatty acids, fiber and greater amounts of proteins and electrolytes (specific supplement), and 13 supplemented with Standard-Isosource (standard supplement). Patients were evaluated before RT, and 14, 28 and 90 days after starting RT. The results showed that there were no significant differences between the groups, but greater changes were observed in the standard supplement group, such as a decline in body mass index (BMI), reductions in hematocrit, erythrocyte, eosinophil and albumin levels, and a rise in creatinine and urea levels. We concluded that metabolic, inflammatory and oxidative stress parameters were altered during RT, and began to normalize at the end of the study. Patients supplemented with Prosure showed an earlier normalization of these parameters, with more favorable changes in oxidative stress markers and a more balanced evolution, although the difference was not significant.

Long-term effects of varying consumption of ω3 fatty acids in ear, nose and throat cancer patients: assessment 1 year after radiotherapy.

Abstract A prospective 1-year follow-up study in ear, nose, and throat (ENT) cancer patients was carried out one year after radiotherapy to assess the effect of varying consumption of ω3 fatty acid according to whether they consumed more or less than the 50th percentile of ω3 fatty acids. Clinical, analytical, inflammatory (CRP and IL-6), and oxidative variables (TAC, GPx, GST, and SOD) were evaluated. The study comprised 31 patients (87.1% men), with a mean age of 61.3 ± 9.1 years. Hematological variables showed significant differences in the patients with a lower consumption of ω3 fatty acids. A lower mortality and longer survival were found in the group with ω3 fatty acid consumption ≥50th percentile but the differences were not significant. No significant difference was reached in toxicity, inflammation, and oxidative stress markers. The group with ω3 fatty acid consumption <50th percentile significantly experienced more hematological and immune changes.

Perifollicular erythema as a trichoscopy sign of progression in frontal fibrosing alopecia.

INTRODUCTION Frontal fibrosing alopecia (FFA) in an entity characterized by the recession of the frontotemporal hairline (FTHL) with alopecic scarring change. In recent years there are numerous articles discussing the usefulness of dermoscopy for the clinical diagnosis of different types of scarring alopecia. MATERIALS AND METHODS We value 79 patients diagnosed with FFA, evaluating some trichoscopical findings described as typical for FFA: Absence of follicular opening, follicular hyperkeratosis, follicular plugs and erythema. RESULTS In a population of 79 women, 100% showed no follicular opening, 72.1% follicular hyperkeratosis, 66.3% perifollicular erythema and 44.8% follicular plugs. Thus, 100% of patients had at least one of the dermoscopic elements described as suggestive of FFA, 53% two of them, 45% three and 27%, all those elements. Perifollicular erythema was present in 95% of cases in which the disease was active. CONCLUSIONS We consider that the presence of perifollicular erythema will be a direct marker of FFA activity.

Origins and functional evolution of Y chromosomes across mammals.

Y chromosomes underlie sex determination in mammals, but their repeat-rich nature has hampered sequencing and associated evolutionary studies. Here we trace Y evolution across 15 representative mammals on the basis of high-throughput genome and transcriptome sequencing. We uncover three independent sex chromosome originations in mammals and birds (the outgroup). The original placental and marsupial (therian) Y, containing the sex-determining gene SRY, emerged in the therian ancestor approximately 180 million years ago, in parallel with the first of five monotreme Y chromosomes, carrying the probable sex-determining gene AMH. The avian W chromosome arose approximately 140 million years ago in the bird ancestor. The small Y/W gene repertoires, enriched in regulatory functions, were rapidly defined following stratification (recombination arrest) and erosion events and have remained considerably stable. Despite expression decreases in therians, Y/W genes show notable conservation of proto-sex chromosome expression patterns, although various Y genes evolved testis-specificities through differential regulatory decay. Thus, although some genes evolved novel functions through spatial/temporal expression shifts, most Y genes probably endured, at least initially, because of dosage constraints.

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Contient : 1 Recueil de généalogies portugaises ; 2 Recueil de généalogies extraites "de hum livro de Nunalvares Pereira" ; 3 Recueil de généalogies : "Estos linages que se siguen se copiaron de un libro de Alonsso Lopez de Haro de los linages de Portugal, y, por lo que dize en el de los Pimenteles, parece se le dio Nunalbarez Pereyra." ; 4 "Desçendencia dos Teives feita por D. Belchor de Teive." ; 5 Notes sur divers membres de la famille de Mello ou Merlo ; 6 "Familia y quadrilla de Blasco Ximeno." Cette généalogie se termine par une notice sur D. Gomez d'Avila y Toledo, deuxième marquis de Velada ; 7 "Linhagem dos de Castelbranco, recopilada por Dom Manoel de Castelbranco, conde de Villanova." ; 8 Notes généalogiques sur les familles Pinheiro, Manoel et Tserclaes ; 9 "Memoria dos titulos que os reis de Portugal criarão de novo neste reyno," de João Ier à Philippe III ; 10 "Los grandes y titulos de Castilla." ; 11 "Visoreys e governadores da India." ; 12 Notes généalogiques sur les Souza et les Maldonado ; 13 "Adiantados que ouve em Portugal." ; 14 "Epitaphios que estão no mosteiro de S. Antonio da Castanheyra." ; 15-34 Documents relatifs à la prise de la ville de Salvador (Bahia, Brésil) par les hollandais (1624) et à la reprise par l'armée hispano-portugaise (1625) ; 15 "Lista dos navios, capitaes d'elles e soldados, fidalgos e nobres que se embarcarão e partirão ao soccorro da Bahia, a 21 de novembro de 1624, sendo capitão geral d'esta armada don Manoel de Meneses." ; 16 "Relaçaõ do dinheiro e cousas reduzidas a elle com que este reyno servio a Sua Magd na ocasiaõ do apresto da armada para o socorro da Bahia no Brasil, que vae ao todo noventa e tres contos coatrocentos e hum mil." 1624 ; 17 "Relaçaõ da armada que partio de Lisbóa em socorro da Bahia e do susseço que teve." ; 18 "Carta para hum fidalgo recidente na corte de Madrid, em que brevemente se relata o corpo principal de toda a armada, que d'este porto de Lixboa salio para a empreza da Bahya, aos 23 de novembro de 1624." Lisbonne, 12 décembre 1624 ; 19 "Relaçaõ das armadas de Sua Magde do dia em que chegaraõ a Bahia e do que se tem feito na expugnaçaõ do enemigo, desde 29 de março que foi vespera de Pascoa, em que deraõ fundo na dita Baia as armadas, ate 22 abril, em que se mandou a Pernambuco o papel de que se tirou esta rellaçaõ, a qual mandaraõ os governadores de Portugal a Sua Magde." 1625 ; 20 "Relaçion de Lorenço Perez Carballo de lo que pasa en la Baya, de quinçe de abril de 1625." ; 21 "Copia da carta que dom Manoel de Menezes, capitaõ mor da armada da esquadra de Portugal, escreveo a S. Mgde, da Bahia, dando conta do que succedeo nella, desde 29 de março te 12 de mayo de 1625." ; 22 "Relaçaõ de que o capitaõ don Manoel de Meneses faz mençaõ na sua carta atraz." 1625 ; 23 "Discurso breve del suçeso que han tenido las armas de su Magd en la jornada del Brasil, desde que salieron de España asta la rrestauraçion de la çiudad de San Salvador, que tomaron los Olandeses en diez de mayo del año pasado de mill y seisçientos y veinte y quatro... Fecha en diez de mayo de mill y seisçientos y veinte y cinco." ; 24 "Copia de las cartas y respuestas que ubo de parte de los Olandeses y Don Fadrique de Toledo Ossorio, desde 28 de abril [1625] hasta 30 que se rindio la plaza" de San Salvador ; 25 "Capitulos conspirados por el sor Coronel y los del Conssejo en la Baya para ofreçer a su Exa Don Fadrique de Toledo, general por su Mgd d'España." 29 et 30 avril 1625 ; 26" Relacion del viaje y sucesso de la Armada que por mandado de su Magestad partio al Brasil, a echar de alli los enemigos que lo ocupavam. Francisco de Avendaño y Vilela. En Sevilla por Francisco de Lyra, año de 1625." ; 27 "Relaçion de la jornada que ba haziendo la armada real a las partes del Brasil, que salio de la baya de Cadiz, martes á catorze de henero de seiscientos y veinte y cinco." ; 28 État-major des tercios de D. Juan de Orellana et D. Pedro Osorio et du tercio de Naples du marquis de Torrecusso, embarqués à Cadix pour le Brésil, le 14 janvier 1625 ; 29 "Brevis, succinta ac vera narratio expeditionis illius, quam quidam mercatores sub auspiciis et autoritate illustrium D. D. ordinum Holandiae, Zelandiae, etc. suseperunt in Brasilium, anno 1623." ; 30 Relation de combats entre Portugais et Hollandais sur les côtes du Brésil ; 31 Notes généalogiques sur les familles Costa, Correa de Moura et Moreno, communiquées au compilateur du recueil par D. Luis Lobo et D. Antonio Correa Barem ; 32 "Relaçaõ do que o capitaõ Francisco de Padilha fes en quanto andou nos asaltos ate a vinda da armada." 1624 ; 33 Relation de l'attaque de Sam Bento au Brésil, en 1625 ; 34 Relation de l'expédition des flottes espagnole et portugaise au Brésil et de la prise de San Salvador. 1625

ClubADSL: When your neighbors are your friends

ADSL is becoming the standard form of residential and small-business broadband Internet access due to, primarily, its low deployment cost. These ADSL residential lines are often deployed with 802.11 Access Points (AP) that providewireless connectivity. Given the density of ADSL deployment, it is often possible for a residential wireless client to be in range of several other APs, belonging to neighbors, with ADSL connectivity. While the ADSL technology has showed evident limits in terms of capacity (with speeds ranging 1-10 Mbps), the short-range wireless communication can guarantee a muchhigher capacity (up to 20 Mbps). Furthermore, the ADSL links in the neighborhood are generally under-utilized, since ADSL subscribers do not connect 100% of the time. Therefore, it is possible for a wireless client to simultaneously connect to several APs in range and effectively aggregate their available ADSL bandwidth.In this paper, we introduce ClubADSL, a wireless client that can simultaneously connect to several APs in range on different frequencies and aggregate both their downlink and uplink capacity. ClubADSL is a software that runs locally on the client-side, and it requires neither modification to the existing Internet infrastructure, nor any hardware/protocol upgradesto the 802.11 local area network. We show the feasibility of ClubADSL in seamlessly transmitting TCP traffic, and validate its implementation both in controlled scenarios and with current applications over real ADSL lines. In particular we show that a ClubADSL client can greatly benefit from the aggregated download bandwidth in the case of server-client applications such as video streaming, but can also take advantage of the increased upload bandwidth greatly reducing download times with incentive-based P2P applications such as BitTorrent.

O monitoramento de processos físicos de esterilização em hospitais do interior do estado de Goiás

Estudo descritivo com o objetivo de identificar a realização de controles físicos, químicos e biológicos dos processos de esterilização pelo vapor saturado sob pressão e em estufas de Pasteur em Centros de Material e Esterilização - CME. Os dados foram obtidos por meio de entrevista ao responsável pelo CME do maior hospital de todas as cidades do interior do Estado de Goiás, com número de habitantes igual ou superior a 20.000, no período de agosto de 2005 a junho de 2006. Participaram 44 municípios. Foi utilizado o programa SPSS, para análise. Em 31 (94,0%) hospitais não havia enfermeiros exclusivos no CME, os responsáveis eram técnicos e auxiliares de enfermagem. A maioria não realizava os controles físicos, químicos e biológicos dos processos de esterilização e, em apenas um, esses eram realizados simultaneamente. O descumprimento da monitorização dos ciclos de esterilização, impedindo a garantia da qualidade dos processos, representa risco à população assistida.

Aconselhamento sobre modos saudáveis de vida na Atenção Primária e práticas alimentares dos usuários

Trata-se de estudo seccional para verificar a realização de aconselhamento sobre modos saudáveis de vida por profissionais de saúde e sua associação com a adoção de práticas alimentares saudáveis em serviço de Atenção Primária à Saúde. Participaram 417 usuários, a maioria mulheres (78,9%), com mediana de idade de 39 anos, elevada prevalência de excesso de peso (59,1%) e inadequações alimentares importantes, contrastando com a baixa frequência de aconselhamento (40,8%). Mas, ainda assim, os usuários aconselhados apresentaram maior adequação no consumo de balas/goma de mascar (p=0,031), refrigerante comum (p=0,036), salgados (p=0,037), temperos industrializados (p=0,005) e ovos (p=0,010). A adoção de práticas alimentares saudáveis foi mais frequente entre os mais velhos e as mulheres (p<0,05). Apesar da importância de aconselhamento frente ao perfil alimentar e de saúde identificado, este foi pouco frequente, sugerindo a necessidade de maior atuação dos profissionais de saúde, visando à prevenção, ao controle de agravos e à promoção da saúde.

Conocimiento y utilidad del código deontológico del educador/a social en el colegio profesional de educadores/as sociales del País Vasco

En el Congreso de Toledo en 2007 se aprobó el Código Deontológico del Educador/a Social. Han pasado, pues, cinco años y se hace necesario indagar si el Código realmente orienta en la intervención del educador/a o es un documento más, que no resulta significativo para el trabajo educativo. Este trabajo se justifica, por tanto, en el intento de indagar la utilidad de esta “Guía Ética” y, también, desde la mirada dinámica del propio Código, valorar su modificación para adaptarlo a la realidad de la intervención socio-educativa, a los conflictos éticos de hoy en día. Por otro lado, se quiere abordar, desde la ética de la complejidad, cómo se pone o no en marcha en los equipos de trabajo, la reflexión ética propia de cada ámbito de intervención, si son conocidos y debatidos los valores que se pretenden transmitir. La primera parte del trabajo abordará una breve interpretación histórica del Educador/a Social en el País Vasco desde los años 70 del siglo pasado, hasta nuestros días. Para pasar a continuación a describir el proceso de creación de lo que fue denominado “Primer Esbozo del Código Deontológico del Educador/a Social” redactado en la Universidad de Deusto en 1996. Por su importancia manifiesta en la creación del Código, se explica el origen del mismo a partir del III Congreso del Educador/a Social que se celebró en Barcelona, conjuntamente con el XV Congreso Mundial de la AIEJI. A raíz de este Congreso, ASEDES (Asociación Estatal de Educación Social) encargó la creación de una comisión para la redacción del Código Deontológico del Educador/a Social. Se explica la construcción del Código a partir de la DECLARACIÓN DE BARCELONA (2001) y, también, se le describe, más adelante en el mismo capítulo. Para finalizar esta primera parte, se hace una breve revisión bibliográfica donde se recogen una serie de textos que, desde mi punto de vista, realizan aportaciones en referencia a la reflexión ética y deontológica y que se relacionan con la situación social actual. En la segunda parte de trabajo se explican los objetivos, hipótesis y diseño de la investigación, para, posteriormente, pasar a describir los resultados de los diferentes items del cuestionario. Finalmente, se realizan una serie de conclusiones-recomendaciones para mejorar el conocimiento y utilidad del Código Deontológico del Educador/a So

Lower thigh subcutaneous and higher visceral abdominal adipose tissue content both contribute to insulin resistance.

It is well known that visceral adipose tissue (VAT) is associated with insulin resistance (IR). Considerable debate remains concerning the potential positive effect of thigh subcutaneous adipose tissue (TSAT). Our objective was to observe whether VAT and TSAT are opposite, synergistic or additive for both peripheral and hepatic IR. Fifty-two volunteers (21 male/31 female) between 30 and 75 years old were recruited from the general population. All subjects were sedentary overweight or obese (mean BMI 33.0 ± 3.4 kg/m(2)). Insulin sensitivity was determined by a 4-h hyperinsulinemic-euglycemic clamp with stable isotope tracer dilution. Total body fat and lean body mass were determined by dual X-ray absorptiometry. Abdominal and mid-thigh adiposity was determined by computed tomography. VAT was negatively associated with peripheral insulin sensitivity, while TSAT, in contrast, was positively associated with peripheral insulin sensitivity. Subjects with a combination of low VAT and high TSAT had the highest insulin sensitivity, subjects with a combination of high VAT and low TSAT were the most insulin resistant. These associations remained significant after adjusting for age and gender. These data confirm that visceral excess abdominal adiposity is associated with IR across a range of middle-age to older men and women, and further suggest that higher thigh subcutaneous fat is favorably associated with better insulin sensitivity. This strongly suggests that these two distinct fat distribution phenotypes should both be considered in IR as important determinants of cardiometabolic risk.