The Puerto Rico Young Adults' Stress, Contextual, Behavioral & Cardiometabolic Risk (PR-OUTLOOK) Study: Design and Methods.

The Puerto Rico (PR) Young Adults' Stress, Contextual, Behavioral & Cardiometabolic Risk Study (PR-OUTLOOK) is investigating overall and component-specific cardiovascular health (CVH) and cardiovascular disease (CVD) risk factors in a sample of young (age 18-29) Puerto Rican adults in PR (target n=3,000) and examining relationships between individual-, family/social- and neighborhood-level stress and resilience factors and CVH and CVD risk factors. The study is conducting standardized measurements of CVH and CVD risk factors and demographic, behavioral, psychosocial, neighborhood, and contextual variables and establishing a biorepository of blood, saliva, urine, stool, and hair samples. The assessment methods are aligned with other National Heart, Lung, and Blood Institute funded studies: the Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT) of adults 30-75 years, the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), the Boston Puerto Rican Health Study (BPRHS), and the Coronary Artery Risk Development in Young Adults (CARDIA). PR-OUTLOOK data and its biorepository will facilitate future longitudinal studies of the temporality of associations between stress and resilient factors and CVH and CVD risk factors among young Puerto Ricans, with remarkable potential for advancing the scientific understanding of these conditions in a high-risk but understudied young population.

Ruta Chalepensis Full Extract and Organic Phases Exhibit Nematocidal Activity Against Haemonchus Contortus Eggs and Infective Larvae (L3).

The ovicidal and larvicidal effect of a full aqueous extract (FE) and two phases: an aqueous (Aq-Ph) and an ethyl acetate (EtOAc-Ph) from Ruta chalepensis (Rc) stems and leaves against Haemonchus contortus (Hc) were assessed. The egg hatching inhibition (EHI) assay and larval mortality (LM) test were performed by triplicate in 96-well micro-titration plates (n=4 wells). The FE against Hc eggs and larvae was assessed at 1.25, 2.5, 5, 10 and 20 mg/mL; and 30, 60, 90, 120,150 and 200 mg/ mL, respectively. The ovicidal effect of Aq-F and EtOAc-F was assessed at 1.25, 2.5, 5, 10 and 20 mg/mL. Plates were incubated at 28 °C for 48 (ovicidal assay) and 72 h (larvicidal assay). The EHI results were considered based on the mean number of eggs hatching failure after 48 h exposure. The LM was recorded after 72 h exposure to the Rc phases and expressed as mortality percentage. The Rc FE caused 96 and 100% EHI at 10 and 20 mg/mL, respectively; meanwhile, 74% LM was recorded at 200 mg/mL (p<0.05). The Aq-Ph showed 78.5% EHI at 2.5 mg/mL. Likewise, the EtOAc-Ph caused 100% EHI in almost all concentrations. Eighteen compounds including alkaloids, cumarins, triterpens, flavonoids, tannins, saponins and sterols were identified by GC-MS analysis. The results indicate that the aqueous extract from Rc possesses bioactive compounds with in vitro nematocidal activity against Hc; mainly in the EtOAc-Ph. Further studies should be performed to elucidate those compounds searching for alternative methods of control of the sheep haemonchosis.

Utility of point-of-care vs reference laboratory testing for the evaluation of glucose levels.

AIMS: To assess the level of agreement between point-of-care and laboratory reference glucose values in defining glycaemic status. METHODS: We analysed 1292 overweight/obese, non-institutionalized participants, aged 40-65 years, in the San Juan Overweight Adults Longitudinal Study. Fasting venous blood glucose was determined using a point-of-care Bayer Contour Blood Glucose Meter and by Vitros System 250 instrument (laboratory). American Diabetes Association thresholds were used to classify participants into normoglycaemia (< 5.6 mmol/l), prediabetes (5.6 to 6.9 mmol/l), or diabetes groups (≥ 7 mmol/l). RESULTS: Bland-Altman plot analysis showed a slope of 0.04 (P=0.002) for the regression between the mean difference and the average of the two methods. The slopes were significantly different from zero among people with normoglycaemia (ß=-0.57, P<0.001), and prediabetes (ß=-0.75, P<0.001) but not among people with diabetes (ß=-0.02, P=0.68). When the prediabetes and diabetes groups were merged into one group, the slope was 0.01, and the glucose values remained similar using the two methods (P=0.76). CONCLUSION: Point-of-care blood glucose measurement may be useful to screen people with diabetes, and to assess glucose among individuals with diabetes where blood can be drawn, but laboratory tests are unavailable or untimely.

Prognostic models for identifying adults with intellectual disabilities and mealtime support needs who are at greatest risk of respiratory infection and emergency hospitalisation.

BACKGROUND: Among adults with intellectual disabilities (ID), problems with eating, drinking and swallowing (EDS), and an associated need for mealtime support, are common, with an estimated 15% of adults known to specialist ID services requiring mealtime support. We set out to identify which adults with ID who receive mealtime support are at an increased risk of respiratory infections and emergency hospitalisation related to EDS problems. METHOD: An exploratory, prospective cohort study was undertaken in the East of England. At baseline, structured interviews with the caregivers of 142 adults with ID and any type of mealtime support needs were used to gather information on health and support needs over the previous 12 months. These interviews were repeated at follow-up, 12 months later. The resulting dataset, covering a 24-month period, was analysed with logistic regression, using model averaging to perform sensitivity analysis, and backwards step-wise variable selection to identify the most important predictors. RESULTS: Individuals with a history of respiratory infections (in the first year of study), those who had epilepsy and those with caregiver-reported difficulty swallowing were most likely to have respiratory infections in the second year. Adults with increasing mealtime support needs, epilepsy and/or full mealtime support needs (fed mainly or entirely by a caregiver or enterally) were at increased risk of emergency hospitalisation for EDS-related problems. CONCLUSIONS: Our findings highlight the importance of carefully monitoring health issues experienced by adults with ID and EDS problems, as well as their eating, drinking and swallowing skills. However, the models developed in this exploratory research require validation through future studies addressing the EDS problems commonly experienced by adults with ID and their implications for health outcomes and quality of life. Further research into the relationship between epilepsy and EDS problems would provide much-needed insight into the complex relationship between the two areas.

Consumption of nutritional pellets with Duddingtonia flagrans fungal chlamydospores reduces infective nematode larvae of Haemonchus contortus in faeces of Saint Croix lambs.

Two groups of six Haemonchus contortus infected Saint Croix lambs each received different diets for 11 weeks: control group, commercial food, molasses and lucerne hay; and treated group, nutritional pellets (NPs) containing Duddingtonia flagrans at 2 × 106 chlamydospores/kg body weight (BW), sorghum and lucerne hay. Mean BW gain (BWG), body condition score (BCS) and packed cell volume (PCV) and also eggs/g of faeces (EPG) and recovered L3 were compared using a repeated measures across time model. Groups had similar BWG (control 139.7 ± 0.035 g/day and treated 167.7 ± 0.041 g/day), BCS (control 3.6 ± 0.39 and treated 3.4 ± 0.46) and PCV (control 32.5 ± 1.68% and treated 30.0 ± 1.68%). The mean EPG of the control group was 1215 ± 1040 and in the treated group it was 2097.91 ± 2050. No reduction in larval population was observed during weeks 2 and 3. The greatest larval population reduction in the faeces of treated lambs was observed during the first week (70.5%) and from weeks 6 to 11, with a mean value close to 70% (P < 0.05). In general, both experimental groups showed a similar feed conversion. It was concluded that both diets resulted in similar lamb growth, PCV, BCS and H. contortus EPG. However, NP consumption significantly reduced the H. contortus L3 population in lamb faeces.

Potamodromous migrations in the Magdalena River basin: bimodal reproductive patterns in neotropical rivers.

Magdalena River basin potamodromous fishes have two annual reproductive seasons: the subienda in the first half of the year and the mitaca in the second. Both upstream migrations are c. 30-45 days long; after that, with the onset of the rainy season, fishes spawn and remain in the river (resident individuals) or start a downstream movement (the bajanza) to return to the Magdalena floodplain lakes (nursery, shelter and feeding grounds). Due to their particular gonad development the bocachico Prochilodus magdalenae and probably the comelón Leporinus muyscorum are physiologically able to undertake two annual basin migrations. In the presence of dams or hydropower structures, fishes are able to find alternative migration routes. Some species should be re-classified in their migratory behaviour.

The incidence of healthcare use, ill health and mortality in adults with intellectual disabilities and mealtime support needs.

BACKGROUND: Adults with intellectual disabilities (ID) experience a wide range of eating, drinking and/or swallowing (EDS) problems, for which they receive diverse mealtime support interventions. Previous research has estimated that dysphagia (difficulty swallowing) affects 8% of all adults with ID and that 15% require some form of mealtime support. People with ID (whether they require mealtime support or not) also experience a greater burden of ill health and die younger than their peers in the general population with no ID. METHODS: Using an exploratory, population-based cohort study design, we set out to examine health-related outcomes in adults with ID who receive mealtime support for any eating, drinking or swallowing problem, by establishing the annual incidence of healthcare use, EDS-related ill health, and all-cause mortality. This study was conducted in two counties in the East of England. RESULTS: In 2009, 142 adults with mild to profound ID and a need for any type of mealtime support were recruited for a baseline survey. At follow-up 1 year later, 127 individuals were alive, eight had died and seven could not be contacted. Almost all participants had one or more consultations with a general practitioner (GP) each year (85-95%) and, in the first year, 20% reportedly had one or more emergency hospitalizations. Although their annual number of GP visits was broadly comparable with that of the general population, one-fifth of this population's primary healthcare use was directly attributable to EDS-related ill health. Respiratory infections were the most common cause of morbidity, and the immediate cause of all eight deaths, while concerns about nutrition and dehydration were surprisingly minor. Our participants had a high annual incidence of death (5%) and, with a standardized mortality ratio of 267, their observed mortality was more than twice that expected in the general population of adults with ID (not selected because of mealtime support for EDS problems). CONCLUSIONS: All Annual Health Checks now offered to adults with ID should include questions about respiratory infections and EDS functioning, in order to focus attention on EDS problems in this population. This has the potential to reduce life-threatening illness.

HIV-related symptoms and patient clusters among Chileans living with HIV.

Identifying both Human immunodeficiency virus (HIV)-related and co-morbid symptoms experienced by people living with HIV (PLWH) who are receiving antiretroviral therapy (ART) treatment is a major challenge for healthcare providers globally. Yet, little research to date has examined the symptoms of illness experienced by PLWH including patients living in Central and South American. To address this gap, this study was designed to identify symptoms of HIV by socio-demographic and/or clinical characteristics among Chilean patients living with the virus. A convenience sample of 209 Chilean PLWH was recruited from an outpatient clinic in Santiago, Chile. A structured interview was used to elicit socio-demographic information and HIV symptoms status. Additional clinical information was obtained through a review of the participants' medical records. Results show that patients' most commonly reported HIV-related symptoms were fear/worries (66%), anxiety (52%), gas/bloating (50%), and thirst (50%). Multivariate analysis revealed a positive association between the number of reported HIV-related symptoms and number of years living with HIV. Having completed college was negatively associated with number of symptoms. Latent class analysis indicated that PLWH in the sample who had completed college were two times more likely to experience a mild intensity of HIV-related symptoms than their lesser educated counterparts. Similarly, logistic regression revealed that college-educated PLWH were twice as likely to be classified in the subgroup reporting mild intensity of symptoms than those who lacked a college degree. Overall, the study's results reveal that many Chilean PLWH, even those with high CD4 counts and low or undetectable viral loads, are not symptom free. The findings point to the need for clinicians to tailor a plan of care for individuals living with HIV that is based on their symptomatology.

Effects of dietary oregano essential oil and vitamin E on the lipid oxidation stability of cooked chicken breast meat.

The antioxidant effect of oregano essential oil and vitamin E was evaluated in cooked chicken breast meat. In total, 480 broilers were randomly assigned to 6 treatments and 4 replications. Broilers were raised with a corn-soybean meal diet including either crude soybean oil or acidulated soybean oil soapstock, each supplemented with vitamin E at 10 or 100 mg or oregano essential oil at 100 mg/kg of feed. At 42 d, broilers were slaughtered and their breast meat was prepared into strips (1.5 × 10 cm) or patties (150 g). Fatty acid composition of the muscle was determined. For lipid oxidation stability, both meat strips and patties were cooked to an internal temperature of 74°C and malonaldehyde contents were assessed during 0, 3, 6, and 9 d of storage at 4°C. Each storage day had 4 replications per treatment. The meat lipid oxidative stability was estimated by content of malonaldehyde values. Results showed that feed consumption, weight gain, and feed conversion were not affected by the dietary oils or antioxidants, except for the mortality in acidulated soybean oil soapstock with the 10-mg vitamin E treatment. The fatty acid composition of the meat was similar between the 2 diets given the same antioxidant supplement. The oxidation stability of meat lipids in both types of meats showed a significant (P < 0.05) interaction between oils, antioxidants, and storage time. In the crude soybean oil oil diet, the malonaldehyde value in the 10-mg vitamin E treatment was the highest, followed by oregano essential oil, and then the 100-mg vitamin E treatment at 9 d of storage, whereas the value of oregano essential oil in the acidulated soybean oil soapstock diet was the highest, followed by the 10-mg vitamin E, and then the 100-mg vitamin E treatment during the 9 d of storage. In conclusion, the dietary oils and antioxidants used can be included in broiler diets without negative effects on their productivity. The antioxidant effect of vitamin E was higher with a higher supplementation level, regardless of the oil treatment, whereas the antioxidant effect of oregano essential oil was better in crude soybean oil than in the acidulated soybean oil soapstock diet.

Effect of soluble corn fiber supplementation for 1 year on bone metabolism in children, the MetA-bone trial: Rationale and design.

Calcium intake is critical for adequate bone mineralization in adolescence, but it is usually inadequate in US adolescents. A strategy to maximize bone mineralization is to increase calcium absorption, which could be achieved by soluble corn fiber (SCF). There are no studies determining the long-term effects of SCF on bone mass in children. OBJECTIVES: To determine the effect of one-year SCF supplementation compared to placebo on bone mass and bone biomarkers in children with low habitual calcium intake. We hypothesize that SCF supplementation will result in a higher bone mineral content and higher levels of bone formation and lower bone resorption biomarkers. METHODS: 240 healthy children (10-13 years), with usual low calcium intake, will be randomized to four experimental groups for 1 year: (1) SCF (12 g/d); (2) SCF (12 g/d) + 600 mg/d of calcium; (3) Placebo (maltodextrin); and (4) Placebo +600 mg/d of calcium. The supplements have been pre-mixed with a flavored powder beverage and participants will only need to dilute it in water and drink this twice per day. Bone will be measured using dual energy x-ray absorptiometry (DXA) at baseline, 6 and 12 months. Serum bone biomarkers will be measured at baseline and at 12 months. CONCLUSIONS: If supplementing diets with SCF lead to higher bone mass during adolescence, this could help achieve the genetic potential for PBM and to start adult life with stronger bones. If successful, SCF can be incorporated into diets for promoting bone health in adolescents.

Interethnic differences in the accuracy of anthropometric indicators of obesity in screening for high risk of coronary heart disease.

BACKGROUND: Cut points for defining obesity have been derived from mortality data among Whites from Europe and the United States and their accuracy to screen for high risk of coronary heart disease (CHD) in other ethnic groups has been questioned. OBJECTIVE: To compare the accuracy and to define ethnic and gender-specific optimal cut points for body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) when they are used in screening for high risk of CHD in the Latin-American and the US populations. METHODS: We estimated the accuracy and optimal cut points for BMI, WC and WHR to screen for CHD risk in Latin Americans (n=18 976), non-Hispanic Whites (Whites; n=8956), non-Hispanic Blacks (Blacks; n=5205) and Hispanics (n=5803). High risk of CHD was defined as a 10-year risk > or =20% (Framingham equation). The area under the receiver operator characteristic curve (AUC) and the misclassification-cost term were used to assess accuracy and to identify optimal cut points. RESULTS: WHR had the highest AUC in all ethnic groups (from 0.75 to 0.82) and BMI had the lowest (from 0.50 to 0.59). Optimal cut point for BMI was similar across ethnic/gender groups (27 kg/m(2)). In women, cut points for WC (94 cm) and WHR (0.91) were consistent by ethnicity. In men, cut points for WC and WHR varied significantly with ethnicity: from 91 cm in Latin Americans to 102 cm in Whites, and from 0.94 in Latin Americans to 0.99 in Hispanics, respectively. CONCLUSION: WHR is the most accurate anthropometric indicator to screen for high risk of CHD, whereas BMI is almost uninformative. The same BMI cut point should be used in all men and women. Unique cut points for WC and WHR should be used in all women, but ethnic-specific cut points seem warranted among men.

The prevalence of radiographic vertebral fractures in Latin American countries: the Latin American Vertebral Osteoporosis Study (LAVOS).

UNLABELLED: In the first population-based study of vertebral fractures in Latin America, we found a 11.18 (95% CI 9.23-13.4) prevalence of radiographically ascertained vertebral fractures in a random sample of 1,922 women from cities within five different countries. These figures are similar to findings from studies in Beijing, China, some regions of Europe, and slightly lower than those found in the USA using the same standardized methodology. INTRODUCTION: We report the first study of radiographic vertebral fractures in Latin America. METHODS: An age-stratified random sample of 1,922 women aged 50 years and older from Argentina, Brazil, Colombia, Mexico, and Puerto Rico were included. In all cases a standardized questionnaire and lateral X-rays of the lumbar and thoracic spine were obtained after informed consent. RESULTS: A standardized prevalence of 11.18 (95% CI 9.23-13.4) was found. The prevalence was similar in all five countries, increasing from 6.9% (95% CI 4.6-9.1) in women aged 50-59 years to 27.8% (95% CI 23.1-32.4) in those 80 years and older (p for trend < 0.001). Among different risk factors, self-reported height loss OR = 1.63 (95% CI: 1.18-2.25), and previous history of fracture OR = 1.52 (95% CI: 1.14-2.03) were significantly (p < 0.003 and p < 0.04 respectably) associated with the presence of radiographic vertebral fractures in the multivariate analysis. In the bivariate analyses HRT was associated with a 35% lower risk OR = 0.65 (95% CI: 0.46-0.93) and physical activity with a 27% lower risk of having a vertebral fracture OR = 0.73 (95% CI: 0.55-0.98), but were not statistically significant in multivariate analyses CONCLUSION: We conclude that radiographically ascertained vertebral fractures are common in Latin America. Health authorities in the region should be aware and consider implementing measures to prevent vertebral fractures.

Inferring genetic parameters of lactation in Tropical Milking Criollo cattle with random regression test-day models.

This study inferred genetic and permanent environmental variation of milk yield in Tropical Milking Criollo cattle and compared 5 random regression test-day models using Wilmink's function and Legendre polynomials. Data consisted of 15,377 test-day records from 467 Tropical Milking Criollo cows that calved between 1974 and 2006 in the tropical lowlands of the Gulf Coast of Mexico and in southern Nicaragua. Estimated heritabilities of test-day milk yields ranged from 0.18 to 0.45, and repeatabilities ranged from 0.35 to 0.68 for the period spanning from 6 to 400 d in milk. Genetic correlation between days in milk 10 and 400 was around 0.50 but greater than 0.90 for most pairs of test days. The model that used first-order Legendre polynomials for additive genetic effects and second-order Legendre polynomials for permanent environmental effects gave the smallest residual variance and was also favored by the Akaike information criterion and likelihood ratio tests.

Seroprevalence of HPV 6, 11, 16 and 18 and correlates of exposure in unvaccinated women aged 16-64 years in Puerto Rico.

BACKGROUND: To understand risk factors for HPV exposure in Puerto Rican women, we evaluated HPV 6, 11, 16, and 18 serology in women aged living in the San Juan metropolitan area. METHODS: As part of a cross-sectional study, a population-based sample of 524 HPV unvaccinated Hispanic women ages 16-64 years completed face-to-face and computer assisted interviews and provided blood and self-collected anal and cervical specimens. Serology used multiplex virus-like particle based-IgG ELISA and HPV DNA was detected with L1-consensus PCR. RESULTS: 32% and 47% were seropositive to HPV types included in the bivalent (16/18) and quadrivalent (6/11/16/18) vaccines, respectively. Type-specific seroprevalence was HPV6 - 29%, HPV11 - 18%, HPV16 - 23%, and HPV18 - 17%; seroprevalence was high in the youngest age-group (16-19: 26-37%). HPV seropositivity was associated with having ≥ 3 lifetime sexual partners (OR=2.5, 95% CI=1.7-3.9) and detection of anogenital HPV DNA (OR=1.8, 95% CI=1.2-2.6). CONCLUSIONS: The high cumulative exposure of HPV vaccine types 6/11/16/18 in this Hispanic population was influenced by factors related to HPV exposure through sexual behavior. High seroprevalence in the youngest age-group indicates early age of exposure to HPV in Puerto Rico, highlighting the need for HPV vaccination starting prior to age 16.

Spinosad, a naturally derived insecticide, for control of Aedes aegypti (Diptera: Culicidae): efficacy, persistence, and elicited oviposition response.

The naturally derived insecticide spinosad is a reduced-risk material that is neurotoxic to Diptera. The 24-h 50% lethal concentration by laboratory bioassay in third instars of Aedes aegypti (L.) (Diptera: Culicidae) (Rockefeller strain) was estimated at 0.026 ppm. Two identical field trials were performed in an urban cemetery in southern Mexico during the dry and wet seasons. Water containers treated with 1 or 5 ppm spinosad suspension concentrate (Tracer, Dow Agrosciences) were as effective in preventing the development of Aedes spp. (mostly Ae. aegypti) as temephos granules during both trials, whereas the bacterial insecticide VectoBac 12AS performed poorly. The half-life of aqueous solutions of spinosad (10 ppm) placed in a warm sunny location was 2.1 d, compared with 24.5 d for solutions in a shaded location. Spinosad, temephos, and VectoBac were not repellent to gravid Ae. aegypti at the concentrations tested, and no ovicidal properties were observed. The 24-h survival of neonate larvae but was reduced by 94-100% in the presence of residues carried over from the spinosad treatments, but it was not affected by residues of temephos or VectoBac. The toxicological properties of spinosad, combined with its favorable environmental profile, should encourage the detailed evaluation of spinosad as a mosquito larvicide in domestic and urban environments.

[Factors related with post-surgical complications in elderly patients with glioblastoma multiforme]. / Factores relacionados con complicaciones posquirurgicas en pacientes de edad avanzada con glioblastoma multiforme.

INTRODUCTION: Glioblastoma multiforme is the most frequent malignant tumour of the central nervous system, and its incidence reaches 80% in those over 50 years of age. Life expectancy has increased in the population in recent times and an analysis of the post-surgical complications affecting elderly patients is of great importance for a correct surgical indication. AIMS: To analyse the factors related with post-surgical complications in elderly patients. PATIENTS AND METHODS: A sample of 88 patients diagnosed with glioblastoma multiforme between 31 and 78 years of age was analysed retrospectively. The variables taken into consideration in the study were: personal medical history, age, functional status, pre-anaesthetic status, tumour characteristics, type of surgery and post-surgical complications. RESULTS: Age was observed to have an influence on local (p = 0.006) and systemic surgical complications (p = 0.034), and on the Clavien-Dindo scale (p = 0.001). Persons with a poorer functional status and cardiovascular risk presented more systemic complications (p = 0.006 and 0.044) and a lower score on the Clavien-Dindo scale (p = 0.024 and 0.025) respectively. Likewise, more local complications are found in the case of excisional procedures than in biopsies (p = 0.027). The pre-anaesthetic status and anti-haemostatic treatments were not related with such events. CONCLUSIONS: Patients over 65 years of age present a higher incidence of pathological antecedents and a poorer pre-surgical functional status. Age, cardiovascular risk, functional status and the type of surgical procedure have significantly increased the occurrence of post-surgical complications.

TITLE: Factores relacionados con complicaciones posquirurgicas en pacientes de edad avanzada con glioblastoma multiforme.Introduccion. El glioblastoma multiforme es el tumor maligno mas frecuente del sistema nervioso central, y su incidencia es del 80% en los mayores de 50 años. En los ultimos tiempos se ha producido un aumento en la esperanza de vida de la poblacion, y el analisis de las complicaciones posquirurgicas en pacientes de edad avanzada resulta de gran relevancia para una correcta indicacion quirurgica. Objetivo. Analizar factores relacionados con las complicaciones posquirurgicas en pacientes de edad avanzada. Pacientes y metodos. Se analizan retrospectivamente 88 pacientes diagnosticados de glioblastoma multiforme entre 31 y 78 años. Las variables estudiadas son: antecedentes personales, edad, estado funcional, estado preanestesico, caracteristicas tumorales, tipo de cirugia y complicaciones posquirurgicas. Resultados. Se observa una influencia de la edad en las complicaciones quirurgicas locales (p = 0,006) y sistemicas (p = 0,034) y en la escala de Clavien-Dindo (p = 0,001). Las personas con peor estado funcional y riesgo cardiovascular presentaron mas complicaciones sistemicas (p = 0,006 y 0,044) y peor graduacion en dicha escala (p = 0,024 y 0,025). Asimismo, hallamos mas complicaciones locales en las cirugias de exeresis que en las biopsias (p = 0,027). El estado preanestesico y los tratamientos antihemostaticos no se relacionaron con dichos eventos. Conclusiones. Los pacientes mayores de 65 años presentan una mayor incidencia de antecedentes patologicos y peor estado funcional prequirurgico. La edad, el riesgo cardiovascular, el estado funcional y el tipo de cirugia han aumentado de manera significativa las complicaciones posquirurgicas.

Factors Associated with HPV Vaccine Awareness in a Population-Based Sample of Hispanic Women in Puerto Rico.

OBJECTIVES: The objective of this study was to investigate the factors associated with HPV awareness among women aged 16 to 64 years, among underserved minority Hispanic women living in Puerto Rico. METHODS: A population-based, cross-sectional sample of 566 women, ages 16 to 64 years, living in the San Juan metropolitan area were surveyed regarding sexual behavior, HPV knowledge, and HPV vaccine uptake. Data was analyzed using descriptive statistics and multivariate logistic regression. RESULTS: Overall, 64.8 % of the women in the sample had heard about the HPV vaccine. Among those in the recommended catch-up vaccination age range (16-26 years, n = 86), 4.7 % had received at least one dose of the HPV vaccine. Of those aware of the availability of the HPV vaccine, most had learned about it through the media, whereas, only 39.6 % had learned about it from a physician. Multivariate logistic regression analysis showed that HPV awareness (OR 8.6; 95 % CI 5.0-14.8) and having had an abnormal Pap smear (OR 2.0; 95 % CI 1.2-3.4) were associated with HPV vaccine awareness (p < 0.05). CONCLUSION: HPV vaccine awareness among Hispanic women in the San Juan metropolitan area of Puerto Rico continues to be low. Strong recommendations from physicians and participation in HPV vaccine educational efforts are essential if the rate of HPV vaccination is to increase in the targeted population. Compared to the USA, and to their US Hispanic counterparts, a health disparity with regard to HPV vaccine awareness and coverage is evident in Puerto Rico; targeted action to deal with this disparity is urgently needed.

Prevalence, genotyping, and correlates of anogenital HPV infection in a population-based sample of women in Puerto Rico.

BACKGROUND: Oncogenic HPV infection is associated to anogenital cancer. We estimate the prevalence and correlates of anogenital HPV infection among a population-based sample of women aged 16-64 years living in the metropolitan area of Puerto Rico. METHODS: 564 women completed face-to-face and computer assisted interviews and self-collected anal and cervical specimens. HPV DNA testing used MY09/MY11 consensus HPV L1 primers and beta-globin as an internal control for sample amplification. Positive specimens were typed by dot-blot hybridization. RESULTS: Weighted prevalence of cervical, anal, and cervical/anal co-infection was 29.4%, 38.6%, and 17.1%, respectively. The commonest oncogenic HPV types detected in the cervix and anus were: 68 (8% vs. 7%) and 16 (5.5% vs. 5.1%), correspondingly. Having ≥3 lifetime sexual partners (OR: 2.3; 95% CI: 1.5-3.5) and last year anal intercourse (OR: 1.6; 95% CI: 1.1-2.5) increased the odds of anogenital HPV infection. Cervical infection was independently associated to anal infection (OR: 3.0; 95% CI: 2.0-4.6). CONCLUSIONS: Similar to others, our results confirm the burden of anogenital HPV infection in women and its relationship with sexual behavior. As vaccination increases, future studies should monitor changing trends in HPV infection in this population, and the relationship between anal and cervical HPV-related disease.

Rice varieties with similar amylose content differ in starch digestibility and glycemic response in humans.

Three high-amylose rice varieties, IR42, IR36, and IR62, with similar chemical composition including amylose content (26.7-27.0%), were cooked under the same conditions and tested for in vitro digestibility as well as blood glucose and insulin responses in healthy human volunteers. The starch-digestion rate and the glycemic and insulin responses were the highest in IR42, followed by IR36 and, then IR62. The differences were not due to unabsorbed carbohydrate but were related to their physicochemical properties, such as gelatinization temperature, minimum cooking time, amylograph consistency, and volume expansion upon cooking. When the three varieties were cooked for their minimum cooking time, they had the same degree of gelatinization and their starch-digestion rates and glycemic responses were similar. We conclude that amylose content alone is not a good predictor of starch-digestion rate or glycemic response. Rice varieties with similar high-amylose contents can differ in physicochemical (gelatinization) properties and this, in turn, can influence starch digestibility and blood glucose response.

Characterization of V3 loop of HIV type 1 spreading rapidly among injection drug users of Manipur, India: a molecular epidemiological perspective.

PIP: Blood samples were obtained from six HIV-infected IV drug users attending the Indian Council for Medical Research Clinic at Imphal, the capital of Manipur state, as part of a study to analyze the sequences of the third variable region (V3) of the HIV envelope in that population. 18 sequences were obtained from the study participants, men aged 24-29 years. A fragment of the envelope gene encompassing the entire V3 loop and partial sequences from the third conserved region was sequenced, while amplifications were performed on DNA extracted directly from patient peripheral blood mononuclear cells to avoid the introduction of artifacts during cell culture. One set of viruses seems to be most closely related to a prototypical virus recovered from IV drug users in Thailand (Thai B), while the other sequences clustered more closely with a North American clade B virus (HXB). Sequences recovered from one person are rather diverse.^ieng