Correlation between HIV viral load and aminotransferases as liver damage markers in HIV infected naive patients: a concordance cross-sectional study.

Abnormalities in liver function tests could be produced exclusively by direct inflammation in hepatocytes, caused by the human immunodeficiency virus (HIV). Mechanisms by which HIV causes hepatic damage are still unknown. Our aim was to determine the correlation between HIV viral load, and serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) as markers of hepatic damage in HIV naive infected patients. We performed a concordance cross-sectional study. Patients with antiviral treatment experience, hepatotoxic drugs use or co-infection were excluded. We used a Pearson's correlation coefficient to calculate the correlation between aminotransferases serum levels with HIV viral load. We enrolled 59 patients, 50 men and 9 women seen from 2006 to 2008. The mean (+/- SD) age of our subjects was 34.24 +/- 9.5, AST 37.73 +/- 29.94 IU/mL, ALT 43.34 +/- 42.41 IU/mL, HIV viral load 199,243 +/- 292,905 copies/mL, and CD4+ cells count 361 +/- 289 cells/mm(3). There was a moderately strong, positive correlation between AST serum levels and HIV viral load (r = 0.439, P < 0.001); and a weak correlation between ALT serum levels and HIV viral load (r = 0.276, P = 0.034); after adjusting the confounders in lineal regression model the correlation remained significant. Our results suggest that there is an association between HIV viral load and aminotransferases as markers of hepatic damage; we should improved recognition, diagnosis and potential therapy of hepatic damage in HIV infected patients.

Diets with customary levels of fat from plant origin may reverse coronary artery disease.

The primary cause of death worldwide is heart disease and the most common type of heart disease is coronary artery disease. While coronary artery disease is treated with medications, it responds to lifestyle interventions. A low-fat plant-based diet was designed for reversing coronary artery disease and it is effective in reversing the disease. It has not been tested, however, as far as we know, whether diets with customary levels of fat can also reverse coronary artery disease. Nevertheless, evidence is accumulating to show that atherosclerosis and coronary artery disease are reversed with diets containing customary levels of fat. It has been known that fats of plant origin decrease the risk factors of cardiovascular disease. It is also known that vegans who consume diets with customary levels of fat have the lowest risk of cardiovascular disease. But recent and more specific data show that atherosclerosis was decreased when nuts that are rich in fat were added to a Mediterranean diet while atherosclerosis was increased in the controls. Also, two clinical cases show that coronary artery disease was reversed by low-fat plant-based diets that were supplemented with fat-rich foods of plant origin. These data, then, provide evidence that coronary artery disease may be reversed with a diet containing customary levels of fat from plant sources. We hypothesize that coronary artery disease may be reversed by diets with customary levels of fat of plant origin that are low in saturated fat content. This hypothesis needs to be tested by comparing a traditional low-fat plant-based diet with a plant-based diet containing customary levels of fat of plant origin in their effectiveness to reverse coronary artery disease.

Prevalence of lifetime abortion and methods of contraception among female sex workers in Bogota, Colombia.

BACKGROUND: The primary objective was to estimate the lifetime prevalence of abortion and the secondary objective was to describe the use of contraceptive methods among female sex workers (FSW) in Bogota, Colombia. STUDY DESIGN: A cross-sectional survey was conducted among FSW. Information on sociodemographic characteristics, contraceptive methods, number of abortions, reasons for abortions and sexual practices was collected. RESULTS: A total of 514 FSW were enrolled. Of these, 264 (53%) had a lifetime abortion. Age, years in sex work and a previous sexually transmitted infection were associated with abortion. A total of 89 FSW(17%) reported no contraception method. Oral contraceptives, use of condoms, female sterilization and intrauterine device insertion were the most common methods of contraception. Women who were poorer, who initiated sex work at a younger age and who reported use of illegal drugs were associated with inconsistent contraception. CONCLUSION: A high lifetime prevalence of abortion and inconsistent contraception was found among FSW in Bogota. There is a need for effective and practical contraceptive methods of family health planning among FSW in Colombia.

Climate change mitigation and health effects of varied dietary patterns in real-life settings throughout North America.

BACKGROUND: Greenhouse gas emissions (GHGEs) are a major consequence of our dietary choices. Assessments of plant-based compared with meat-based diets are emerging at the intersection of public health, environment, and nutrition. OBJECTIVES: The objective was to compare the GHGEs associated with dietary patterns consumed in a large population across North America and to independently assess mortality according to dietary patterns in the same population. DESIGN: Data from the Adventist Health Study 2 (AHS-2) were used to characterize the differential environmental and health impacts of the following 3 dietary patterns, which varied in the quantity of animal and plant foods: vegetarian, semivegetarian, and nonvegetarian. The GHGE intensities of 210 foods were calculated through life-cycle assessments and by using published data. The all-cause mortality rates and all-cause mortality HRs for the AHS-2 subjects were adjusted for a range of lifestyle and sociodemographic factors and estimated according to dietary pattern. RESULTS: With the use of the nonvegetarian diet as a reference, the mean reductions in GHGEs for semivegetarian and vegetarian diets were 22% and 29%, respectively. The mortality rates for nonvegetarians, semivegetarians, and vegetarians were 6.66, 5.53, and 5.56 deaths per 1000 person-years, respectively. The differences were significant. Compared with nonvegetarians, mortality HRs were lower for semivegetarians (0.86) and vegetarians (0.91). CONCLUSIONS: Moderate differences in the caloric intake of meat products provided nontrivial reductions in GHGEs and improved health outcomes, as shown through the mortality analyses. However, this does not mean that diets lower in GHGEs are healthy.

Place of residence modifies the association between acculturation and dietary tools knowledge among Latina WIC participants: a multi-state study.

This cross-sectional study assessed: (a) awareness and knowledge of federal dietary tools (MyPyramid, Food Guide Pyramid (FGP), and food labels (FL)), and (b) the influence of acculturation and state of residence on FGP knowledge (FGPK) indicators among low-income Latina WIC participants (N = 479) living in Connecticut, Ohio, Texas, and California. Participants were familiar with FGP but only 37% recognized MyPyramid. FGPK was highest for fruits (71%) and lowest for the 'breads and cereals' group (12%). Less than half (47%) used FL's when grocery shopping. Living in OH, was associated with the lowest FGPK. Multivariate analyses showed that more acculturated individuals living in CT/CA had better FGPK than participants living in TX and their less acculturated counterparts in CT/CA. The forthcoming revised federal dietary tools need to be adequately disseminated among Latinos, with special emphasis on those with lower acculturation levels, living in rapid emerging Latino communities or in the US-Mexico border.

Walnuts and fatty fish influence different serum lipid fractions in normal to mildly hyperlipidemic individuals: a randomized controlled study.

BACKGROUND: Increased consumption of n-3 (omega-3) fatty acids decreases the incidence of coronary heart disease (CHD). OBJECTIVE: The objective was to determine whether walnuts (plant n-3 fatty acid) and fatty fish (marine n-3 fatty acid) have similar effects on serum lipid markers at intakes recommended for primary prevention of CHD. DESIGN: In a randomized crossover feeding trial, 25 normal to mildly hyperlipidemic adults consumed 3 isoenergetic diets ( approximately 30% total fat and <10% saturated fat) for 4 wk each: a control diet (no nuts or fish), a walnut diet (42.5 g walnuts/10.1 mJ), or a fish diet (113 g salmon, twice/wk). Fasting blood was drawn at baseline and at the end of each diet period and analyzed for serum lipids. RESULTS: Serum total cholesterol and LDL cholesterol concentrations in adults who followed the walnut diet (4.87 +/- 0.18 and 2.77 +/- 0.15 mmol/L, respectively) were lower than in those who followed the control diet (5.14 +/- 0.18 and 3.06 +/- 0.15 mmol/L, respectively) and those who followed the fish diet (5.33 +/- 0.18 and 3.2 +/- 0.15 mmol/L, respectively; P < 0.0001). The fish diet resulted in decreased serum triglyceride and increased HDL-cholesterol concentrations (1.0 +/- 0.11 and 1.23 +/- 0.05 mmol/L, respectively) compared with the control diet (1.12 +/- 0.11 and 1.19 +/- 0.05 mmol/L, respectively) and the walnut diet (1.11 +/- 0.11 mmol/L, P < 0.05, and 1.18 +/- 0.05 mmol/L, P < 0.001, respectively). The ratios of total cholesterol:HDL cholesterol, LDL cholesterol:HDL cholesterol, and apolipoprotein B:apolipoprotein A-I were lower (P < 0.05) in those who followed the walnut diet compared with those who followed the control and fish diets. CONCLUSION: Including walnuts and fatty fish in a healthy diet lowered serum cholesterol and triglyceride concentrations, respectively, which affects CHD risk favorably.

Syphilis infection among female sex workers in Colombia.

OBJECTIVE: To study the epidemiology of Treponema pallidum (syphilis) among female sex workers (FSW) in Santa Fe de Bogotá, Colombia. DESIGN: A cross-sectional study was conducted. Participants were interviewed using a standardized questionnaire, which collected socio-demographic characteristics and risk behavior information. Blood samples were screened for syphilis using the VDRL test and the MHATP assay. RESULTS: The prevalence of syphilis was 10.3% (53/514). Adjusted risk factors significantly associated with syphilis were: age (linear increase), education (primary or no education), monthly income (or=4 years), number of clients per week (>or=22), main workplace (street), inconsistent (never) condom use in sex work, previous STI history, and use of illegal drugs. CONCLUSIONS: Effective health education programs for improving the level of knowledge of STI and the promotion of consistent condom use activities along with other appropriate harm reduction activities are urgently required among FSW in Colombia.

Verificación biológica de los ciclos de esterilización / Biologic verification of the sterilization cycles

En 55 meses se realizaron 2,920 pruebas con IB en 91 consultorios dentales de la República Mexicana. El 71.4 por ciento (n=2,084) de los ciclos de esterilización fue en vapor de agua a presión, el 9.4 por ciento (n=274) vapor químico a presión, y el 19.2 por ciento (n=562) en calor seco. El 67.6 por ciento (n=1974) de las pruebas se realizó en forma semanal, el 16.9 por ciento (n=493) quincenal y el 15.5 por ciento (n=453) mensual. Se detectaron fallas en 7.6 por ciento (n=223) de todos los ciclos de esterilización. El 7.5 por ciento (n=156) en vapor de agua a presión, el 7.7 por ciento (n=21) en vapor químico a presión y el 8.2 por ciento (n=46) de los ciclos de calor seco. Todos los métodos de esterilización empleados fallaron con frecuencias similares (X = 0.307, P mayor 0.8)

Umbral de sensibilidad vibratoria en diabetes mellitus no dependiente de insulina / Threshold to vibratory sensitivity in non insulin dependent diabetes mellitus

Con objeto de valorar la utilidad diagnóstica del umbral de sensibilidad vibratoria (USV) en la neutropatía diabética periférica se determinó el USV con un biotesiómetro sobre acromion, olécranon, apófisis estiloides del radio, rótula y maléolo tibial, en 90 pacientes con diabetes mellitus no dependiente de insulina y en 80 individuos sanos. Además, se investigó la reproducibilidad del USV y su variación entre ambos lados del cuerpo en otros 20 sujetos. Se encontró una buena correlación entre las dos mediciones repetidas (r=0.865) y también entre ambos lados del cuerpo (r=0.943). En los diabéticos con neuropatía clínica (n=55) el USV fue significativamente más alto (p<0.001) que en los testigos sanos y que en los diabéticos sin síntomas de neuropatía (n=35). En estos últimos el USV también fue superior al de los individuos sanos (p<0.05 acromion, estiloides, maléolo), lo que sugiere la presencia de neuropatía subclínica. Se observó una relación directa entre la magnitud del USV y la duración de la diabetes (r=0.50). La evaluación del USV (X+2DE) tuvo sensibilidad diagnóstica de neutopatía de 87 por ciento y especificidad de 87 por ciento. La especificidad disminuyó en mayores de 50 años de edad. El USV es una determinación objetiva, reproducible, de fácil realización y es útil para la valoración de la neuropatía diabética sensitivomotora

Prevalencia de neuropatía en diabetes mellitus tipo II en México / Prevalence of neurophaty in type II diabetes mellitus in Mexico

Con objeto de conocer la prevalencia de nuropatía en pacientes con diabetes mellitus tipo II (DMNDI) en México, se estudiaron 90 pacientes adultos con DMNDI y 80 testigos sanos de zonas urbanas y rurales. Se investigaron datos clínicos de neuropatía sensitivomotora y autonómica, se midió el umbral de sensibilidad vibratoria (USV) en varias localizaciones y se practicaron pruebas autonómicas cardiacas (variación de R-R con la respiración, con ortostatismo y con inmersión facial). Se consideró neuropatía sesitivomotora si había datos clínicos y USV anormal, neuropatía cardiaca si había cuando menos dos pruebas normales. En el grupo testigo ninguno registró criterio de neuropatía sensitivomotora, 6.6 por ciento tuvo neuropatía cardiaca. Se encontró impotencia en 15/39 pacientes del sexo masculino (38 por ciento). Las frecuencias de neuropatías sentivomotora, de neuropatía cardiaca y de impotencia tuvieron relación directa con la duración de la DMNDI. La neuropatía es una complicación frecuente en DMNDI que se observa casi en todos los pacientes con más de 15 años de duración de la diabetes

Cáncer de cuello uterino y embarazo en el Hospital Universitario "Dr. Angel Larralde" en el quinquenio 1982-1986 / Carcinoma of the cervix and pregnancy at the Hospital Universitario \"Dr. Angel Larralde\" years 1982-1986

La prevalencia de lesiones neoplásicas intraepiteliales en embarazadas estudiadas en el Hospital Universitario "Angel Larralde entre 1982 y 1986 fue de 0.58%, encontrándose dentro del rango reportado por diferentes autores en estudios similares. La mayor prevalencia de la patología estudiada se encuentra dentro del grupo de pacientes; comprendidas entre 35 y 39 años. Un 75% de las lesiones diagnósticadas se presentaron en un grupo de embarazadas que refieren entre tres y siete gestaciones. Las lesiones intraepiteliales, incluído el cáncer in situ deben ser tratadas conservadoramente durante el embarazo, reservando los procedimientos convencionales (crioterapia, láser, etc...) para el postparto