Patterns of alcohol consumption in the Seychelles Islands (Indian Ocean).

Self-reported drinking habits were examined in a random sample of 1067 persons aged 25-64 years in the Seychelles, a country in epidemiological transition where consumption of home-brewed, mostly unregistered beverages has been traditionally high. Alcohol consumption was calculated from respondents reporting at least one drink per week ('regular drinkers'). Among men, 51.1% were regular drinkers and had average intake of 112.1 ml alcohol a day. Among women, 5.9% were regular drinkers and had 49.7 ml alcohol a day. Frequency of drinking, but not amount per drinker, was slightly less in the 25-34-year than older-age categories. Home-brews (mostly palm toddy and fermented sugar cane juice) were consumed by 52% of regular drinkers and accounted for 54% of the total alcohol intake reported by all regular drinkers. Based on the reported consumption by regular drinkers only, the average annual alcohol consumption amounted respectively to 20.7 litres and 1.2 litres per man and woman aged 25-64 years, or, using extrapolation, 13.2 litres and 0.8 litres per man and woman respectively of the total population. These values may underestimate the true figures by half, since reported beer consumption accounted for 53% of beer sales. Socio-economic status was associated strongly and inversely with home-brew consumption, but slightly and positively with consumption of commercially marketed beverages. Alcohol intake was associated with smoking, high-density lipoprotein cholesterol, carbohydrate-deficient transferrin and blood pressure, but not with age and body mass index. In conclusion, these data show high alcohol consumption in the Seychelles with an important gender difference, a large proportion of alcohol derived from home-brews, and opposite tendencies for the relationships between socio-economic status and home-made or commercially marketed beverages.

Effects of fructose and glucose overfeeding on hepatic insulin sensitivity and intrahepatic lipids in healthy humans.

OBJECTIVE: To assess how intrahepatic fat and insulin resistance relate to daily fructose and energy intake during short-term overfeeding in healthy subjects. DESIGN AND METHODS: The analysis of the data collected in several studies in which fasting hepatic glucose production (HGP), hepatic insulin sensitivity index (HISI), and intrahepatocellular lipids (IHCL) had been measured after both 6-7 days on a weight-maintenance diet (control, C; n = 55) and 6-7 days of overfeeding with 1.5 (F1.5, n = 7), 3 (F3, n = 17), or 4 g fructose/kg/day (F4, n = 10), with 3 g glucose/kg/day (G3, n = 11), or with 30% excess energy as saturated fat (fat30%, n = 10). RESULTS: F3, F4, G3, and fat30% all significantly increased IHCL, respectively by 113 ± 86, 102 ± 115, 59 ± 92, and 90 ± 74% as compared to C (all P < 0.05). F4 and G3 increased HGP by 16 ± 10 and 8 ± 11% (both P < 0.05), and F3 and F4 significantly decreased HISI by 20 ± 22 and 19 ± 14% (both P < 0.01). In contrast, there was no significant effect of fat30% on HGP or HISI. CONCLUSIONS: Short-term overfeeding with fructose or glucose decreases hepatic insulin sensitivity and increases hepatic fat content. This indicates short-term regulation of hepatic glucose metabolism by simple carbohydrates.

Neoadjuvant chemotherapy and radiotherapy followed by surgery in selected patients with stage IIIB non-small-cell lung cancer: a multicentre phase II trial.

BACKGROUND: Stage IIIB non-small-cell lung cancer (NSCLC) is usually thought to be unresectable, and is managed with chemotherapy with or without radiotherapy. However, selected patients might benefit from surgical resection after neoadjuvant chemotherapy and radiotherapy. The aim of this multicentre, phase II trial was to assess the efficacy and toxicity of a neoadjuvant chemotherapy and radiotherapy followed by surgery in patients with technically operable stage IIIB NSCLC. METHODS: Between September, 2001, and May, 2006, patients with pathologically proven and technically resectable stage IIIB NSCLC were sequentially treated with three cycles of neoadjuvant chemotherapy (cisplatin with docetaxel), immediately followed by accelerated concomitant boost radiotherapy (44 Gy in 22 fractions) and definitive surgery. The primary endpoint was event-free survival at 12 months. Efficacy analyses were done by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00030810. FINDINGS: 46 patients were enrolled, with a median age of 60 years (range 28-70). 13 (28%) patients had N3 disease, 36 (78%) had T4 disease. All patients received chemotherapy; 35 (76%) patients received radiotherapy. The main toxicities during chemotherapy were neutropenia (25 patients [54%] at grade 3 or 4) and febrile neutropenia (nine [20%]); the main toxicity after radiotherapy was oesophagitis (ten patients [29%]; nine grade 2, one grade 3). 35 patients (76%) underwent surgery, with pneumonectomy in 17 patients. A complete (R0) resection was achieved in 27 patients. Peri-operative complications occurred in 14 patients, including two deaths (30-day mortality 5.7%). Seven patients required a second surgical intervention. Pathological mediastinal downstaging was seen in 11 of the 28 patients who had lymph-node involvement at enrolment, a complete pathological response was seen in six patients. Event-free survival at 12 months was 54% (95% CI 39-67). After a median follow-up of 58 months, the median overall survival was 29 months (95% CI 16.1-NA), with survival at 1, 3, and 5 years of 67% (95% CI 52-79), 47% (32-61), and 40% (24-55). INTERPRETATION: A treatment strategy of neoadjuvant chemotherapy and radiotherapy followed by surgery is feasible in selected patients. Toxicity is considerable, but manageable. Survival compares favourably with historical results of combined treatment for less advanced stage IIIA disease. FUNDING: Swiss Group for Clinical Cancer Research (SAKK) and an unrestricted educational grant by Sanofi-Aventis (Switzerland).

Subclinical hyperthyroidism and the risk of coronary heart disease and mortality

Contexte L'hyperthyroïdie infra-clinique est une perturbation de la fonction thyroïdienne, définie par une thyrotropine (TSH) basse et des taux normaux de thyroxine libre (T4L) et triiodothyronine (T3). Cette dysfonction affecte de 1% à 5% des adultes de plus de 65 ans, surtout les femmes, et pourrait être associée avec les maladies cardiovasculaires, la fibrillation auriculaire et l'insuffisance cardiaque. Toutefois, les conclusions des différentes études de cohortes sont contradictoires, avec des limites méthodologiques empêchant leur comparaison de manière formelle. L'objet du travail de thèse était d'estimer le risque de mortalité de toute cause, le risque de mortalité de cause cardiovasculaire, le risque d'événements cardiovasculaires et le risque de fibrillation auriculaire associés à l'hyperthyroïdie infra-clinique dans toutes les grandes études de cohorte prospectives disponibles à ce jour. Méthode et Résultats Les données individuelles de 52'674 participants provenant de 10 études de cohorte prospectives des Etats-Unis, d'Europe, du Brésil et d'Australie ont été analysées pour évaluer les risques à long-terme de l'hyperthyroïdie infra-clinique. L'euthyroïdie était définie par une TSH entre 0.45 et 4.49 mUI/l et l'hyperthyroïdie infra-clinique par une TSH inférieure à 0.45 mUI/l avec un taux normal de T4L, après exclusion des participants prenant des médicaments pouvant perturber la thyroïde. Sur les 52'674 participants, 2188 (4.2%) avaient une hyperthyroïdie infra-clinique. Pendant un suivi de plus de 8 ans, 8527 participants sont décédés (dont 1896 de cause cardiovasculaire), 3653 sur 22'437 ont eu un événement cardiovasculaire et 785 sur 8711 ont développé une fibrillation auriculaire. Dans des analyses ajustées pour l'âge et le sexe, l'hyperthyroïdie infra-clinique était associée à une hausse de la mortalité de toute cause (hazard ratio [HR] 1.24, intervalle de confiance à 95% [IC] 1.06-1.46), de la mortalité cardiovasculaire (HR 1.29, IC 1.02-1.62), des événements cardiovasculaires (HR 1.21, IC 0.99- 1.46) ainsi qu'une hausse de l'incidence de fibrillation auriculaire (HR 1.68, IC 1.16-2.43). Les risques ne différaient pas significativement dans les analyses stratifiées selon l'âge, le sexe ou la présence de maladies cardiovasculaires préexistantes, et étaient similaires après ajustement multiple pour les facteurs de risque cardiovasculaire. Le risque de mortalité cardiovasculaire et de fibrillation auriculaire était plus élevé avec une TSH très basse (< 0.10 Ul/I) comparé à une TSH modérément abaissée (0.10-0.44 mUI/l, valeurs ρ for trend < 0.03). Conclusions et perspectives L'hyperthyroïdie infra-clinique est associée à un risque augmenté de mortalité de toute cause, de cause cardiovasculaire et de fibrillation auriculaire, avec un risque plus élevé quand la TSH est inférieure à 0.10 mUI/l. Ces résultats sont cohérents avec les dernières recommandations internationales conseillant de considérer un traitement de l'hyperthyroïdie infra-clinique pour les adultes de plus de 65 ans ou les patients avec maladie cardiaque, en particulier si la TSH est inférieure à 0.10 mUI/l. Toutefois, des études cliniques randomisées sont encore nécessaires pour prouver l'efficacité du traitement et déterminer si l'on devrait dépister les problèmes de thyroïde dans la population générale.

Mineralização do nitrogênio em solos tratados com lodos de curtume

O objetivo deste trabalho foi avaliar, em laboratório, a mineralização líquida do N orgânico de dois lodos de curtume em solos. Um Latossolo Vermelho acriférrico e um Latossolo Vermelho-Amarelo distrófico receberam quatro doses de cada lodo (0, 595, 1.190 e 1.785 kg ha-1 de N): do efluente de caleiro (LCL), com concentração baixíssima de crômio e do decantador primário (LCR), com 17 g kg-1 de Cr. As misturas solos+lodos foram lixiviadas após incubação por períodos crescentes até 132 dias em colunas de percolação. Um modelo cinético de primeira ordem descreveu a mineralização líquida do N (R² = 0,967** a 0,998**). Aplicações de LCR, em comparação às de LCL, diminuíram a porcentagem acumulada do N mineralizado proveniente do lodo (médias de 4 e 35,5%), reduziram o valor da taxa constante de mineralização (médias de 0,0048 e 0,028 dia-1) e aumentaram substancialmente o tempo de meia-vida (T1/2) (variação de 100 a 267 e de 19 a 29 dias), o que indica inibição da mineralização do N, possivelmente em decorrência das elevadas concentrações de Cr daquele lodo. Uma análise detalhada das curvas de mineralização com a aplicação de LCR apontou a existência de três fases, que provavelmente representam adaptações sucessivas da microbiota a diferentes frações recalcitrantes do lodo.

Pesque-solte: pesca repetitiva, variáveis hematológicas e parasitismo no peixe híbrido tambacu

O objetivo deste trabalho foi avaliar a resposta hematológica e parasitológica de tambacus (Colossoma macropomum x Piaractus mesopotamicus) submetidos ao estresse de captura e a diferentes densidades de estocagem, em sistema de pesque-solte. Foram utilizados 210 peixes com peso médio inicial de 785,33±152,02 g e comprimento total médio de 34,43±2,21 cm, mantidos em viveiros escavados e divididos em três grupos: sem pesca e baixa densidade (G1), com pesca e baixa densidade (G2), e com pesca e alta densidade (G3). Não houve diferença significativa entre os valores médios da concentração de hemoglobina, do número de eritrócitos, da contagem diferencial de leucócitos e da glicose. Os peixes do grupo G3 apresentaram número maior de parasitos e trombócitos, e menor ganho de peso e hematócrito. A atividade de pesque-solte, aliada à alta densidade de estocagem, pode prejudicar o equilíbrio orgânico e o desempenho zootécnico, o que favorece a parasitose.

Estabelecimento de normas DRIS para o algodoeiro com diferentes critérios de seleção da população de referência

O objetivo deste trabalho foi avaliar o efeito de critérios de seleção de populações de referência no estabelecimento de normas DRIS na cultura do algodoeiro. Criou-se um banco de dados com a produtividade e os teores foliares de macro e micronutrientes, obtidos de talhões médios de 100 ha. Os critérios para o estabelecimento das subpopulações de alta produtividade foram talhões com: produtividade acima da média (4.380 kg ha-1); produtividade acima da média + 2/3 desvio-padrão (acima de 4.650 kg ha-1); produtividade acima da média + 1 desvio-padrão (acima de 4.785 kg ha-1); e produtividade acima da média + 4/3 desvio-padrão (acima de 4.920 kg ha-1). Os critérios de seleção da população de referência proporcionam baixa frequência de relações nutricionais concordantes, para cada norma DRIS avaliada. Independentemente do critério de seleção utilizado, os dados de produtividade média e o índice de balanço nutricional relacionam-se significativamente; e essa relação intensifica-se com o aumento no rigor do critério de inclusão de lavouras na população de referência.

Regulatory Mechanisms involved in Th2 Cell Differentiation. A Proteomics Approach.

Th2-solujen erilaistumista ohjaavat säätelyverkostot ja niiden tutkiminen proteomiikan avulla Astma ja allergiat ovat laajalle levinneitä ja vakavia sairauksia, joista kärsivät miljoonat ihmiset ympäri maailmaa. Koe-eläimillä tehdyt tutkimukset osoittavat, että interleukiini-4 (IL-4) on tärkeä allergisen astman ja allergioiden kehittymiselle ja kroonistumiselle. Se ohjaa T-auttajasolujen (Th-solujen) kehittymistä Th2-tyypin soluiksi, joilla on merkittävä rooli näiden tautien puhkeamisessa. Th2-solut tuottavat myös itse IL-4:ä, joka edesauttaa taudin seuraavien vaiheiden kehittymistä. Erityisesti STAT6-proteiini, joka aktivoituu IL-4-stimulaation seurauksena, on tarpeen Th2- vasteen syntymiselle ja kroonistumiselle antigeenin aiheuttamassa keuhkoputkien astmaattisessa tulehduksessa. Väitöskirjatyöni tarkoituksena oli käyttää kaksidimensionaaliseen elektroforeesiin (2- DE) perustuvaa proteomiikkaa ja massaspektrometriaa uusien Th2-solujen erilaistumista säätelevien proteiinien tunnistamiseksi. Erilaistumattomat Th-solut eristettiin vastasyntyneen napaverestä tai hiiren pernasta. Solut aktivoitiin Tsolureseptorin ja ns. ko-stimulatoristen reseptorien kautta ja erilaistettiin joko Th1- tai Th2-suuntaan vastaavasti erilaistavien IL-12- ja IL-4-sytokiinien avulla. Ensimmäisessä tutkimuksessa in vitro -erilaistettujen Th1- ja Th2-solujen proteomeja verrattiin keskenään proteiinien ilmenemisessä tai proteiinimodifikaatioissa olevien erojen tunnistamiseksi. Kaksi muuta päätutkimusta keskittyivät IL-4:n aiheuttamaan proteiinitason säätelyyn ensimmäisen vuorokauden aikana T-soluaktivaation jälkeen. Näistä ensimmäisessä IL-4:n aiheuttamia eroja tunnistettiin aktivoiduista ihmisen Thsoluista. IL-4:n todettiin säätelevän useita proteiineja kaspaasien välittämissä signalointiteissä sekä lisäävän T-solujen elävyyttä ja aktivoitumista. Toisessa tutkimuksessa STAT6-poistogeenisten hiirien lymfosyyttien proteomia verrattiin villityypin kontrollisoluihin T-soluaktivaation ja IL-4-stimulaation jälkeen. Näissä tutkimuksissa karakterisoitiin useita uusia IL-4:n ja STAT6:n kohdeproteiineja ja löydettiin uusia säätelyverkostoja. Tutkimustulokset ovat johtaneet uusiin Th2-erilaistumismekanismeja koskeviin hypoteeseihin.