Rachel score: a nomogram model for predicting the prognosis of lung neuroendocrine tumors.

BACKGROUND: Lung NET, classified in typical carcinoids (TC) and atypical carcinoids (AC), are highly heterogeneous in their biology and prognosis. The histological subtype and TNM stage are well-established prognostic factors for lung NET. In a previous work by our group, we demonstrated a significant impact of laterality on lung NET survival outcomes. MATERIALS AND METHODS: We developed a nomogram that integrates relevant prognostic factors to predict lung NET outcomes. By adding the scores for each of the variables included in the model, it was possible to obtain a prognostic score (Rachel score). Wilcoxon non-parametric statistical test was applied among parameters and Harrell's concordance index was used to measure the models' predictive power. To test the discriminatory power and the predictive accuracy of the model, we calculated Gonen and Heller concordance index. Time-dependent ROC curves and their area under the curve (AUC) were used to evaluate the models' predictive performance. RESULTS: By applying Rachel score, we were able to identify three prognostic groups (specifically, high, medium and low risk). These three groups were associate to well-defined ranges of points according to the obtained nomogram (I: 0-90, II: 91-130; III: > 130 points), providing a useful tool for prognostic stratification. The overall survival (OS) and progression free survival (PFS) Kaplan-Meier curves confirmed significant differences (p < 0.0001) among the three groups identified by Rachel score. CONCLUSIONS: A prognostic nomogram was developed, incorporating variables with significant impact on lung NET survival. The nomogram showed a satisfactory and stable ability to predict OS and PFS in this population, confirming the heterogeneity beyond the histopathological diagnosis of TC vs AC.

Role of thyroid stimulating hormone in the maintenance and functioning of the human corpus luteum.

PURPOSE: To evaluate the impact of high thyroid stimulating hormone (TSH) levels on human granulosa-luteal (hGL) cells. METHODS: hGL cells were isolated from follicular aspirates derived from patients undergoing IVF treatment without any thyroid disorder (serum TSH 0.5-2 mU/L). Cells were cultured at 37 °C in DMEM, supplemented with 5% FBS. The cells were treated with 1 nM LH and increasing concentrations of TSH. At the end of culture, conditioned medium and cells were collected to analyze progesterone production, cell viability, and mRNA levels of genes involved in the steroidogenesis process. Human ovarian tissues were analyzed for TSH receptor (TSHR) expression by IHC. RESULTS: The expression of TSHR was detected in human corpus luteum by IHC and in hGL by RT-PCR. In hGL cells, TSH treatment did not modulate progesterone production nor the expression of steroidogenic genes, such as p450scc and HSD3b 1/2. However, TSH induced a dose-dependent increase in cell death. Finally, TSH did not affect LH-induced p450scc and HSD3b1/2 expression while LH partially reverted TSH negative effect on cell death in hGL. CONCLUSIONS: Elevated TSH levels in hypothyroid women may be associated with impaired CL functioning and maintenance. These findings open a new line of research for the importance of the treatment of women with thyroid dysfunction that could contribute to the onset of infertility.

Gender-related differences in patients with carcinoid syndrome: new insights from an Italian multicenter cohort study.

BACKGROUND: The incidence of neuroendocrine neoplasm (NEN) and related carcinoid syndrome (CaS) has increased markedly in recent decades, and women appear to be more at risk than men. As per other tumors, gender may be relevant in influencing the clinical and prognostic characteristics of NEN-associated CS. However, specific data on carcinoid syndrome (CaS) are still lacking. PURPOSE: To evaluate gender differences in clinical presentation and outcome of CaS. METHODS: Retrospective analysis of 144 CaS patients from 20 Italian high-volume centers was conducted. Clinical presentation, tumor characteristics, therapies, and outcomes (progression-free survival, PFS, overall survival, OS) were correlated to gender. RESULTS: Ninety (62.5%) CaS patients were male. There was no gender difference in the site of primary tumor, tumor grade and clinical stage, as well as in treatments. Men were more frequently smokers (37.2%) and alcohol drinkers (17.8%) than women (9.5%, p = 0.002, and 3.7%, p = 0.004, respectively). Concerning clinical presentation, women showed higher median number of symptoms (p = 0.0007), more frequent abdominal pain, tachycardia, and psychiatric disorders than men (53.3% vs 70.4%, p = 0.044; 6.7% vs 31.5%, p = 0.001; 50.9% vs. 26.7%, p = 0.003, respectively). Lymph node metastases at diagnosis were more frequent in men than in women (80% vs 64.8%; p = 0.04), but no differences in terms of PFS (p = 0.51) and OS (p = 0.64) were found between gender. CONCLUSIONS: In this Italian cohort, CaS was slightly more frequent in males than females. Gender-related differences emerged in the clinical presentation of CaS, as well as gender-specific risk factors for CaS development. A gender-driven clinical management of these patients should be advisable.

Diabetes management in cancer patients. An Italian Association of Medical Oncology, Italian Association of Medical Diabetologists, Italian Society of Diabetology, Italian Society of Endocrinology and Italian Society of Pharmacology multidisciplinary consensus position paper.

Cancer management has significantly evolved in recent years, focusing on a multidisciplinary team approach to provide the best possible patient care and address the various comorbidities, toxicities, and complications that may arise during the patient's treatment journey. The co-occurrence of diabetes and cancer presents a significant challenge for health care professionals worldwide. Management of these conditions requires a holistic approach to improve patients' overall health, treatment outcomes, and quality of life, preventing diabetes complications and cancer treatment side-effects. In this article, a multidisciplinary panel of experts from different Italian scientific societies provide a critical overview of the co-management of cancer and diabetes, with an increasing focus on identifying a novel specialty field, 'diabeto-oncology', and suggest new co-management models of cancer patients with diabetes to improve their care. To better support cancer patients with diabetes and ensure high levels of coordinated care between oncologists and diabetologists, 'diabeto-oncology' could represent a new specialized field that combines specific expertise, skills, and training.

Diabetes technology and sexual health: which role?

PURPOSE: The aim of this review is to evaluate the effects of new technology used in the management of diabetes mellitus (DM), including the use of continuous glucose monitoring (CGM) and the administration of insulin through continuous subcutaneous insulin infusion (CSII), on male and female sexual function. METHODS: This narrative review was performed for all available prospective, retrospective and review articles, published up to June 2023 in PubMed. Data were extracted from the text and from the tables of the manuscript. RESULTS: Sexual dysfunctions are an underestimated comorbidity of DM in both male and female. Although erectile dysfunction (ED) is recognized by the guidelines as a complication of DM, female sexual dysfunction (FSD) is poorly investigated in clinical setting. In addition to the complications of DM, the different types of therapies can also influence male and female sexual response. Furthermore, insulin therapy can be administered through multiple-daily injections (MDI) or a CSII. The new technologies in the field of DM allow better glycemic control which results in a reduction in the occurrence or aggravation of complications of DM. Despite this evidence, few data are available on the impact of new technologies on sexual dysfunctions. CONCLUSIONS: The use of DM technology might affect sexual function due to the risk of a worse body image, as well as discomfort related to CSII disconnection during sexual activity. However, the use is related to an improved metabolic control, which, in the long-term associates to a reduction in all diabetes complications, including sexual function.

MiRNA dysregulation underlying common pathways in type 2 diabetes and cancer development: an Italian Association of Medical Oncology (AIOM)/Italian Association of Medical Diabetologists (AMD)/Italian Society of Diabetology (SID)/Italian Society of Endocrinology (SIE)/Italian Society of Pharmacology (SIF) multidisciplinary critical view.

Increasing evidence suggests that patients with diabetes, particularly type 2 diabetes (T2D), are characterized by an increased risk of developing different types of cancer, so cancer could be proposed as a new T2D-related complication. On the other hand, cancer may also increase the risk of developing new-onset diabetes, mainly caused by anticancer therapies. Hyperinsulinemia, hyperglycemia, and chronic inflammation typical of T2D could represent possible mechanisms involved in cancer development in diabetic patients. MicroRNAs (miRNAs) are a subset of non-coding RNAs, ⁓22 nucleotides in length, which control the post-transcriptional regulation of gene expression through both translational repression and messenger RNA degradation. Of note, miRNAs have multiple target genes and alteration of their expression has been reported in multiple diseases, including T2D and cancer. Accordingly, specific miRNA-regulated pathways are involved in the pathogenesis of both conditions. In this review, a panel of experts from the Italian Association of Medical Oncology (AIOM), Italian Association of Medical Diabetologists (AMD), Italian Society of Diabetology (SID), Italian Society of Endocrinology (SIE), and Italian Society of Pharmacology (SIF) provide a critical view of the evidence about the involvement of miRNAs in the pathophysiology of both T2D and cancer, trying to identify the shared miRNA signature and pathways able to explain the strong correlation between the two conditions, as well as to envision new common pharmacological approaches.

The effects of non-andrological medications on erectile dysfunction: a large single-center retrospective study.

PURPOSE: To evaluate the association among andrological diseases at the first outpatient visit and the medications taken by patients for other comorbidities, as well as the differential impact between specific medication and relative comorbidities. METHODS: This is a single-center retrospective study based on subjects who referred to the Andrology Unit with a well-defined andrological diagnosis. RESULTS: A total of 3752 subjects were studied (mean age ± DS 46.2 ± 16.5 years). A total of 19 categories of andrological diseases and 110 type of medications for other comorbidities were identified. ED was the most frequent andrological pathology at the first andrological examination (28.7%), followed by infertility (12.4%). The couple of variables that were statistically significant in the univariate association analysis (p < 0.001) were: ED and (a) antihypertensives; (b) antihyperglycemics; (c) lipids-lowering; (d) psychotropics. The univariate and multivariate regression analyses confirmed the association. All the related comorbidities were also significantly associated with the univariate analysis, and all remained significantly associated with multivariate analysis. A multivariate analysis was also conducted to analyze the association between ED and the following pairs of variables "DM-antihyperglycemics", "dyslipidemia-lipids-lowering", and "hypertension-antihypertensives". In all cases, the pathology, but not the specific treatment, was significantly associated with ED. CONCLUSION: ED is significantly associated with antihypertensive, antihyperglycemic, lipid-lowering, psychotropic drugs' intake. Anyway, ED appears to be more related to the diseases than to the specific therapies. The definitive cause/effect relationship should be established based on future prospective studies.

Male factor infertility and assisted reproductive technologies: indications, minimum access criteria and outcomes.

BACKGROUND: Infertility, which is defined as the inability to conceive after at least 12 months of regular unprotected sexual intercourses, affects about 15-20% of couples worldwide and a male factor is involved in about half of the cases. The development of assisted reproductive technology (ART) made it possible to conceive also to individuals affected from severe oligospermia or azoospermia. However, the impact of the male factor on embryo development, implantation, prevalence of chromosomal abnormalities, genetic and epigenetic alterations, and clinical and obstetric outcomes is still controversial. PURPOSE: This narrative review examines the indications, minimum access criteria, and outcomes by individual ART technique in relation to the male factor.

The role of thyroid function in female and male infertility: a narrative review.

PURPOSE: We herein aimed to review the new insights into the impact of impaired thyroid function on male and female fertility, spacing from spontaneous pregnancy to ART, with the objective of providing an updated narrative revision of the literature. METHODS: This narrative review was performed for all available prospective, retrospective and review articles, published up to 2021 in PubMed. Data were extracted from the text and from the tables of the manuscript. RESULTS: Thyroid dysfunction is frequently associated with female infertility, whereas its link with male infertility is debated. Female wise, impaired function is detrimental to obstetric and fetal outcomes both in spontaneous pregnancies and in those achieved thanks to assisted reproduction technologies (ART). Furthermore, the reference range of TSH in natural pregnancy and ART procedures has recently become a matter of debate following recent reports in this field. On the other hand, the impact of thyroid function on the male reproductive system is less clear, although a possible role is suggested via modulation of Sertoli and Leydig cells function and spermatogenesis. CONCLUSION: Thyroid function should be carefully monitored in both male and female, in couples seeking spontaneous pregnancy as well as ART, as treatment is generally immediate and likely to improve chances of success.

Erectile dysfunction as a marker of endocrine and glycemic disorders.

PURPOSE: The aim of this study was to evaluate in a population of patients with erectile dysfunction (ED): (a) the prevalence of a previously unknown endocrine/glycemic disorders; (b) the correlation between ED severity and endocrine/glycemic disorders. METHODS: 1332 patients referred for ED from 2013 to 2020 were included. The ED diagnosis was made using the International-Erectile-Function-Index-5 questionnaire. ED severity was considered according to presence/absence of spontaneous erections, maintenance/achievement deficiency. All patients were subjected to search for sociodemographic and clinical characteristics: age, ethnicity, marital status, previous use of PDE5i, previous prostatectomy, diabetes mellitus (DM), prediabetes, endocrine dysfunctions. RESULTS: The mean ± SD age was 54.3 ± 13.7 years. The 19.1% (255/1332) of patients were already in treatment for prediabetes/diabetes or endocrine dysfunctions. Among the remaining 1077, the prevalence of previously unknown endocrine and glycemic disorders was 30% (323/1077). Among them, 190/323 subjects (58.8%) were affected by hypogonadism, with high estradiol level observed in 8/190 (4.2%). The prevalence of new glycemic alterations was 17.3% (56/323) [specifically, 32/56 (57.1%) DM, and 24/56 (42.9%) prediabetes]. A thyroid dysfunction was observed in 40/323 subjects (12.3%) and hyperprolactinemia in 37/323 (11.5%). Patients with new diagnosis of DM showed more severe form of ED compared to the total group {difficulty in the achievement of erection: 46/56 [82.2%, vs 265/1332 (19.9%), p < 0.05]; absence of spontaneous erection 23/56 [41.1%, vs 321/1332 (24.1%), p < 0.05]}. CONCLUSION: ED is an early marker of endocrine/glycemic disorder, and a previously unknown dysfunction was found in more than a quarter of patients. A newly diagnosed DM is associated with ED severity, especially in elderly man and in presence of hypertension.

The role of ejaculatory dysfunction on male infertility.

BACKGROUND: The aim of this study was to evaluate: 1) the prevalence of male infertility due to ejaculatory dysfunction (premature ejaculation-PE, intravaginal ejaculatory dysfunction-IVEjD, anejaculation-AE, and retrograde ejaculation-RE); and 2) the hormonal profile and semen characteristics of such subjects. METHODS: N.3280 subjects who were referred to our andrology unit for infertility were studied. Exclusion criteria: the presence of known causes of male infertility and erectile dysfunction. In all subjects were performed: medical history and andrological physical examination; hormonal profile; semen analysis or centrifugation/resuspension of post-orgasmic urine; IIEF-5 questionnaire for the diagnosis of ED; PEDT questionnaire for the diagnosis of EP. RESULTS: the prevalence of ejaculatory dysfunctions in infertile males was 1.8% (59/3280). The causes were: a) absence of ejaculation in 37/3280 subjects (1.1%); among them, 23/3280 (0.7%) subjects showed a condition of RE and 14/3280 (0.4%) of AE; b) PE in 16/3280 subjects (0.5%); and c) IVEjD in 6/3280 subjects (0.2%). Hormonal values and seminal parameters (when semen analysis was possible) were within the normal ranges in all the cases. In subjects with RE, sperm recovery was possible in 69.9% (16/23) subjects after centrifugation and resuspension of post-orgasmic urine. CONCLUSIONS: The prevalence of male infertility due to ejaculatory dysfunctions is overall just under 2%. The main cause is retrograde ejaculation; psychogenic origins could also have an important role. It is important to identify the cause of ejaculatory dysfunction in order to decide upon correct management (PE treatment, centrifugation and resuspension of post-orgasmic urine, penile vibratory stimulation, and psychological counselling).

The CATCH checklist to investigate adult-onset hypogonadism.

Adult-onset hypogonadism is a syndrome often underdiagnosed, undertreated, or incompletely explored. There are various reasons for this: firstly, undefined age range of men in whom testosterone levels should be investigated and then no definitive serum cutoff point for the diagnosis of hypogonadism; and finally, variable and non-specific signs and symptoms; men and physicians do not pay adequate attention to sexual health. All these factors make the diagnostic criteria for hypogonadism controversial. The evaluation of the clinical features and causes of this syndrome, its link with age, the role of testosterone and other hormone levels, and the presence of any comorbidities are all useful factors in the investigation of this population. The purpose of this manuscript, after an accurate analysis of current literature, is to facilitate the diagnosis of hypogonadism in men through the use of the CATCH acronym and a checklist to offer a practical diagnostic tool for daily clinical practice. A narrative review of the relevant literature regarding the diagnosis of late-onset hypogonadism or adult-onset hypogonadism was performed. PubMed database was used to retrieve articles published on this topic. A useful new acronym CATCH (Clinical features [symptoms] and Causes, Age, Testosterone level, Comorbidities, and Hormones) and a practical checklist to facilitate the evaluation of hypogonadism in aging men were used. The evaluation of the clinical features and causes of hypogonadism, the link with age, the role of Testosterone and other hormones, and the evaluation of comorbidities are important in investigating adult-onset hypogonadism. The CATCH checklist could be helpful for clinicians for an early diagnosis of both hypogonadism and associated comorbidities. We suggest the use of this acronym to advocate the investigation of declining testosterone in aging men.

Prevalence of Diabetes Mellitus (DM) in a population of men affected by Erectile Dysfunction (ED).

AIMS: A) to evaluate the prevalence of patients affected by Diabetes Mellitus (DM) in a population of men with Erectile Dysfunction (ED); B) to define the epidemiological, biochemical and therapeutic aspects. MATERIALS AND METHODS: N.934 subjects referred at our Andrology Unit for ED were studied. The diagnosis of ED was evaluated using the IIEF-5 questionnaire (Total score ≤21). RESULTS: The prevalence of subjects affected by DM in a population of men with ED was 19.5% (182/934). The age ranges were: ≥55 years (108/182; 59.3%); ≥40<55 years (70/182; 38.5%); <40 years (4/182; 2.2%). HbA1c mean value was 7.9% ± 0.8%. No significant differences were found in DM onset timing or in anti-diabetic treatment. In n.125/182 cases (68.7%) the ED onset followed the diagnosis of DM; in n.34/182 cases (18.7%) it appeared at the same time; and in n.23/182 cases (12.6%) appeared before DM diagnosis. ED TREATMENT: in n.18/182 subjects (9.9%) there was a concomitant hypotestosteronemia; these patients were treated only with testosterone replacement; this treatment was efficacious (IIEF-5 total score ≥22) in 8/18 subjects (44.4%). In n.146/182 subjects (80.2%) a treatment with PDE5-i was given. Of these 146 subjects, the therapy was given "on demand" to 108 subjects (efficacy in 50.9%; 55/108) and "once a day" to the remaining 38 subjects (efficacy 63.1%, 24/38) (p=0.428, n.s.). N.15/182 subjects (8.2%) were treated with intracavernous injections of Alprostadil (efficacy in 8/15, 53.3%). In n.3/182 subjects (1.6%) a penile prosthesis was implanted. CONCLUSIONS: DM is one of the most frequent organic causes of ED; there were many strategies to treat this symptom without interfering with the antidiabetic treatment. Finally, ED can be predictive of DM.

[Protein hydrolysate as a dietetic resource] / Hidrolisado protéico como recurso dietético.

OBJECTIVE: The central goal of this paper was to study the application of beef meat and poultry (turkey and chicken) hydrolysates to the preparations used in our Brazilian current feeding practices. METHODS: The various kinds of meat were hydrolyzed with fresh pineapple under similar conditions to those daily used at home. The selection of three types of preparation was dependent on whether their contents included starch or gelatin and liquid, like soup, mousse and fruit-shake. Hydrolysate were added to the preparations as part of the liquid content of their recipes. The acceptability of the preparations was checked out by employing the hedonic-scale affective test with untrained tasters. Variance analysis and the Tukeýs test were performed with a 5% level of significance for the results.RESULTS: The selected recipes were the following: bitterroot soup, fruit and vegetable-shakes and grape mousse, all of them containing starch or gelatin as an element to camouflage the bitter taste of the aminoacids. The preparations were well accepted: approximately 76% of the tasters reported having liked the soup at least somewhat; as to the shakes, more than 50% gave positive answers, and as to the mousse, approximately 88% reported having liked it. There were no statistically significant differences (p< 0.05) concerning the application of the three hydrolysates in all the preparations tested. CONCLUSIONS: The use of hydrolysed meat to replace liquid content of recipes is highly practicable, requiring only an adequate selection of recipes and their ingredients, that should include starch and gelatin in order to get fully satisfactory products. These preparations might serve as a basis for other ones, adapted to each diet.

[Regular diet and cardiovascular disease risk factors]. / Dieta habitual e fatores de risco para doenças cardiovasculares.

INTRODUCTION: A survey by sampling in a county of the State of S. Paulo in 1990 sought, by means of home interviews, to analyse the habitual diet and risk factors for cardiovascular disease of people over 20 years of age. METHODOLOGY: Of the sub-specimen of a comprehensive study population, 557 individuals, aged between 20 and 88, were interviewed. The habitual diet, characterized by the dietary history, was compared with the recommendations on energy and nutrients of the WHO and the risk factors (obesity, lipemic disorders and diabetes mellitus) diagnosed by the Body Mass Index and biochemical measurements. RESULTS AND CONCLUSIONS: It was observed that 60% of the population consume a diet with total energy below the estimated need and that the caloric contribution of carbohydrates was of 56%, of the lipids 29% and of the proteins 15%. However, by percentile analysis, the caloric contribution of lipids and of proteins was far above the recommended levels to the detriment of the carbohydrates. Energy, caloric distribution and quantity of cholesterol were satisfactory in only 5% of diets. Among the risk factors for the cardiovascular disease studied, obesity was found to be present in 38% of individuals, lipemic disorders in 26% and diabetes mellitus in 5%. Preponderantly light physical activity together with unsatisfactory diet, both in qualitative as in quantitative terms, aggravated this scenario still further.

[Atherosclerotic cardiovascular disease, lipemic disorders, hypertension, obesity and diabetes mellitus in the population of a metropolitan area of southeastern Brazil. II--Lipemic disorders]. / Doenças cardiovasculares ateroscleróticas, dislipidemias, hipertensão, obesidade e diabetes melito em população da área metropolitana da região Sudeste Do Brasil: II--dislipidemias.

This study has sought to characterize the prevalence of lipemic disorders and other risk factors of atheroschlerotic cardiovascular disease in population groups of Cotia county in Greater S. Paulo, Brazil. The population groups were defined on the basis of socio-economic characteristics and geographical location within the county such as provided elements for the delimitation of the "study areas". A sample representative of each of these areas was taken, constituting in all 1,041 individuals. The data related to eating habits were collected from a sub-sample of 568 people. The lipemic disorders diagnosed were as follows: high risk hypercholesterolemias with values approximately 240 mg/dl for total cholesterol and approximately 160 mg/dl for LDL-cholesterol; borderline risk hypercholesterolemias with values > 200 mg/dl and > 130 mg/dl for total cholesterol and LDL-cholesterol respectively; hypertriglyceridemia, with values approximately 250 mg/dl. The following risk factors were included: atherogenic eating habits (consumption of proteins of animal origin, saturated fats and cholesterol), smoking, drinking, sedentary life style, obesity (IMC > 25 kg/m2), hypertension (140/90 mmHg) and diabetes mellitus (glycemia > 120 mg/dl). The results found were the following: 1--the average number of risk factors was significant by greater among men than among women, for the age groups below 50 years of age (p < 0.01): between 50 and 55 years of age they were equal for the two groups, reaching their greatest value at 60 years of age with a sharp reduction after this latter age as regard the men but presenting a constant gradual increase for the women; 2--the average number of risk factors increased with age for both sexes (p < 0.01); 3--the prevalences of high risk hypercholesterolemias together with hypertriglyceridemia (> = 250 mg/dl) were significantly greater in the classes of higher socio-economic level; 4--the lipemic profile associated with lipemic disorders show that these latter rarely occur with just one constituent in isolation; 5--when the high-risk hypercolesterolemias are added to the borderline cases accompanied by two or more risk factors and hypertriglyceridemia they give a total of 39.2% of men and 32.8% of women, that is to say, 35.4% of the sample need immediate clinical-educational intervention.

[Atherogenic food habits of population groups in a metropolitan area of southeastern Brazil]. / Hábitos alimentares aterogênicos de grupos populacionais em área metropolitana da região sudeste do Brasil.

This present study is one part of the project "Atherosclerotic cardiovascular diseases, lipemic disorders, hypertension, obesity and diabetes mellitus in a population of the metropolitan area of S. Paulo, Brazil" undertaken in Cotia county. An alimentary inquiry based on the alimentary history of the individual was carried out among a subsample of the population (568 individuals). The objectives of the inquiry are the following: a) the identification of the atherogenic potential of the diets of different human groups, stratified according to social class and b) the analysis of consumption differentials of some nutrients, which confer atherogenicity to the diet, as between social classes. The consumption differentials were analyzed as between men and women, by social class and taking the 50th percentile (P50) of the sample as the standard of reference, with regard to the following dietary constituents: energy, total proteins, proteins of animal origin, percentages of protein calories (P%), fatty acids, fats (F%) and carbohydrates (CH%). Also, according to this criterion, some diet profiles were analyzed in the light of the recommendations of the National Cholesterol Education Program (NEP) as regards the calorie supplied by fats (F%), saturated fatty acids (SFA%), carbohydrates (CH%) and cholesterol (> 300 mg/day). The following were the findings obtained: the consumption differentials were more pronounced among the men. The social class which presented the largest percentages above the P50 of the sample, with regard to energy, total proteins, fats and carbohydrates, were the non-specialized workers, i.e. the manual laborers who have a high expenditure of energy, an that of small property owners and shop-keepers who lead a sedentary life. The class of the greatest acquisitive power and highest educational level presented a moderate consumption of these constituents. On the other hand, the consumption of the proteins of animal origin, above the P50, among men and women, maintained a direct relationship with socioeconomic level. The proportion of calories coming from fats (F%) and protein (P%) was directly proportional to the acquisitive power of the class, while that of carbohydrates (CH%) presented an inverse relationship. On the other hand, the consumption of cholesterol in excess of 300 mg/day was found to between 37 and 50% and 20 and 32% for men and women, respectively. The percentage of diets with more than 30% of calories coming from fats (F%) varied from 25 to 40% for men and 45 to 50% for women. The participation of the saturated fatty acids (SFA%) in proportions greater or equal to 10 was relatively low for both sexes: being of 5 to 17% for the men and of less than 10% for the women. The percentages of cases in the relationship saturated to unsaturated fatty acids (SFA/UFA) maintaining values less than 1% was also low for the population in general, being of 7 and 22% for the men and less than 10% for the women. It is concluded that diet probably is an important risk factor in cardiovascular diseases, lipemic disorders, obesity and hypertension, for a large part of the population, mainly for the small property owners and shop-keepers, is viable.

[Atherosclerotic cardiovascular diseases, dyslipidemia, hypertension, obesity, and diabetes mellitus in a population of the metropolitan area of southeastern Brazil. I--Research methodology]. / Doenças cardiovasculares ateroscleróticas, dislipidemias, hipertensão, obesidade e diabetes melito em população da área metropolitana da região sudeste do Brasil. I--Metodologia da pesquisa.

An epidemiological study was carried out into the risk factors for the following atherosclerotic cardiovascular diseases: lipemic disorders, obesity, hypertension, diabetes mellitus as related to some factors which characterize life-style (sedentary, drinking, smoking and eating habits). The population studied belongs to the metropolitan area of S. Paulo. The research project had the following objectives: a) the development of an epidemiological baseline for the study of the risk factors for the atherosclerotics cardiovascular diseases represented by the lipimic disorders, obesity, hypertension and diabetes mellitus and their relationship with personal, family and social characteristics; b) the for clinical-educative treatment of patients or people at risk. In view of the objectives above it was decided that the project should in an integrated way with the local health centers and community associations in the field work phase. For this purpose, the methodology adopted was that of establishing small geographical areas, denominated "study areas", in accordance with socioeconomic criterion. Clinico-biochemical and eating surveys were carried out and interviews held with a view to obtaining data on socioeconomic and demographic and life-style characteristics. The clinical survey collected data on anthropometric measurements, arterial pressure, electrocardiogram and symptoms of heart disease. The biochemical survey consisted of the measurement of the following constituents of the blood: total cholesterol, HDL cholesterol, triglyceride, magnesium, glucose, sodium, potassium and phosphorous. The eating survey covered data of historic food consumption. By means of indicators such as income, schooling, occupation, position held in the occupation, ownership of property and respective size of property and employment of labour, the social classes were established. The clinico-educative intervention was carried out in the following way: a) the team made contact with the community associations and the health centers, that begin to participate in the project, permitting the use of their physical space for the carrying out of surveys and clinical exams and taking part in the work of publishing and explaining the project; b) those individuals with positive diagnosis or who are found at risk were referred to the health centers which then include assistance for the diseases in question in their permanent activities. After the end the project the team gave to the community a report on the prevalence of the morbidities researched in their population.

[Dyslipidemia and some risk factors in the population outside of the metropolitan region of São Paulo, SP-Brazil. A pilot study]. / Dislipidemias e alguns fatores de risco associados em uma população periférica da Região Metropolitana de São Paulo, SP-Brasil. Um estudo piloto.

A survey of the prevalence of lipemic disorders and some risk factors associated with them (obesity, hypertension and alcoholism), in a representative sample of the population of 20 years of age and over in a locality typical of the peripheral zone of the Greater S. Paulo Region, Brazil, both in terms of the poverty of the population and with regard to the lack of public sources such as sewage, transport and housing, is undertaken. The following results were obtained: a) the prevalence of one risk factor was about 55%, and of two or more associated risk factors was of approximately 9% in the age group from 20 to 39. There was found to be a prevalence of about 51% and 57%, respectively of two or more associated risk factors for the age groups from 40 to 59 and 60 years of age and over; b) the prevalence of lipemic disorders proper was of about 49%, 58% and 57% respectively, for the age groups of 20 to 39, 40 to 59 and 60 years of age and over. In these cases the most prevalent risk factors among men were alcoholism and hypertension, either isolatedly or associated with obesity, and among women the most prevalent was obesity, alone or associated with hypertension; c) the most prevalent lipemic disorder was due to HDL-cholesterol, mainly among the younger people. The prevalence lower-than-normal HDL-cholesterol, was of about 28% and of "other lipemic disorders" was of 22% in the age group between 20 and 39 years of age.(ABSTRACT TRUNCATED AT 250 WORDS)