[Adverse socio-economic conditions associated with the presence of obesity and its metabolic comorbidities in adults in San Luis, Argentina ]. / Bajo nivel de instrucción asociado a la presencia de obesidad y sus comorbilidades metabólicas en adultos de Argentina.

The prevalence of obesity depends on biopsychosocial and environmental factors and represents a risk factor for communicable and non-communicable diseases. Objectives: To determine the association between demographic, socioeconomic and lifestyle characteristics and the presence of obesity and its metabolic comorbidities (MC) in adults in San Luis City, Argentina. Observational population-based cross-sectional study of 306 individuals aged 18-85 years from San Luis, Argentina, selected by multistage random sampling, with an overweight prevalence of 35% and a 0.05 margin of error. Socioeconomic, demographic, and lifestyle variables were assessed, and multiple logistic regression models were fitted with the presence of obesity and MC as outcomes and sociodemographic and lifestyle characteristics as covariates. Obesity was found in 17.3% of participants, diabetes in 3%, high blood pressure (HBP) in 11%, dyslipidemia in 3.3% and coronary ischemic complications (CIC) in 13%. The proportion of residents with at least one of these conditions was 26.8%. Low Educational level (EL) was positively associated with the presence of obesity (OR 3.58; IC95% 1.04-12.24; p=0,04), and its MC (OR 5.25; IC95% 1.05-26.23; p=0.04) with respect to high EL. Similarly, the possibility of presenting CIC was increased in people with medium EL (OR 5.8; IC95% 1.12-30.19; p=0.03). On the other hand, the possibility of presenting diabetes increased by 17% with increasing body mass index (BMI) (OR 1.17; IC95% 1.03-1.34; p=0.01). Finally, women were more likely to present HBP (OR 3.71; IC95% 1.01-13.72; p=0.04) and CIC (OR 3,43; IC95% 1,06-11,10; p=0,03). Conclusion: the increase in age, female sex and medium and low NI are factors and conditions of vulnerability that predispose an increase in the prevalence of MC in adults from San Luis, Argentina.

La prevalencia de obesidad depende de factores biopsicosociales y ambientales, y es un factor de riesgo para enfermedades transmisibles y no transmisibles. Objetivo: Determinar la asociación entre las características demográficas, socioeconómicas y del estilo de vida, y la presencia de obesidad y sus comorbilidades metabólicas (CM) en adultos de la ciudad de San Luis, Argentina. Estudio observacional-poblacional-transversal en 306 individuos entre 18 y 85 años de San Luis, Argentina, seleccionados mediante un muestreo aleatorio multietápico, considerando una prevalencia de sobrepeso del 35% y un error de 0,05. Se indagaron variables socioeconómicas, demográficas, del estilo de vida, y se ajustaron modelos de regresión logística múltiple incluyendo presencia de obesidad y CM como variable de respuesta, y características sociodemográficas y del estilo de vida como covariables. El 17,3% de los participantes presentó obesidad, un 3% diabetes, el 11% hipertensión arterial (HTA), el 3,3% dislipidemia y un 13% complicaciones isquémicas coronarias (CIC). La proporción de habitantes con al menos una de esas patologías fue del 26,8%. Un bajo Nivel de instrucción (NI) se asoció positivamente con la presencia de obesidad (OR 3,58; IC95% 1,04-12,24; p=0,04), y sus CM (OR 5,25; IC95% 1,05-26,23; p=0,04) respecto al NI alto. Asimismo, la posibilidad de presentar CIC se vio aumentada en personas con NI medio (OR 5,8; IC95% 1,12-30,19; p=0,03). Por otro lado, la posibilidad de presentar diabetes aumenta un 17% a medida que aumenta el índice de masa corporal (IMC) (OR 1,17; IC95% 1,03-1,34; p=0,01). Finalmente, las mujeres fueron más propensas a presentar HTA (OR 3,71; IC95% 1,01-13,72; p=0,04) y CIC (OR 3,43; IC95% 1,06-11,10; p=0,03). Conclusión: el aumento en la edad, el sexo femenino y el NI medio y bajo son factores y condiciones de vulnerabilidad que predisponen un aumento en la prevalencia de CM en adultos de San Luis, Argentina.

Non-traditional data sources in obesity research: a systematic review of their use in the study of obesogenic environments.

BACKGROUND: The complex nature of obesity increasingly requires a comprehensive approach that includes the role of environmental factors. For understanding contextual determinants, the resources provided by technological advances could become a key factor in obesogenic environment research. This study aims to identify different sources of non-traditional data and their applications, considering the domains of obesogenic environments: physical, sociocultural, political and economic. METHODS: We conducted a systematic search in PubMed, Scopus and LILACS databases by two independent groups of reviewers, from September to December 2021. We included those studies oriented to adult obesity research using non-traditional data sources, published in the last 5 years in English, Spanish or Portuguese. The overall reporting followed the PRISMA guidelines. RESULTS: The initial search yielded 1583 articles, 94 articles were kept for full-text screening, and 53 studies met the eligibility criteria and were included. We extracted information about countries of origin, study design, observation units, obesity-related outcomes, environment variables, and non-traditional data sources used. Our results revealed that most of the studies originated from high-income countries (86.54%) and used geospatial data within a GIS (76.67%), social networks (16.67%), and digital devices (11.66%) as data sources. Geospatial data were the most utilised data source and mainly contributed to the study of the physical domains of obesogenic environments, followed by social networks providing data to the analysis of the sociocultural domain. A gap in the literature exploring the political domain of environments was also evident. CONCLUSION: The disparities between countries are noticeable. Geospatial and social network data sources contributed to studying the physical and sociocultural environments, which could be a valuable complement to those traditionally used in obesity research. We propose the use of information available on the Internet, addressed by artificial intelligence-based tools, to increase the knowledge on political and economic dimensions of the obesogenic environment.

Epidemia de obesidad: evidencia actual, desafíos y direcciones futuras / Obesity epidemic: current evidence, challenges and future directions

Resumen La epidemia de obesidad es un fenómeno amplia mente estudiado en las últimas décadas, pero aun así incompletamente comprendido, cuyo control se encuen tra lejos del nivel deseable si consideramos las cifras crecientes de prevalencia observadas a nivel mundial. El presente trabajo realiza una revisión narrativa con el propósito de aportar evidencia actualizada sobre la epidemia de la obesidad en el mundo, y en particular en la región latinoamericana y Argentina, identificando además los principales desafíos y direcciones futuras para el abordaje de esta problemática de salud pública. Se describe primeramente la carga actual y tendencias crecientes de la prevalencia de obesidad, general y por grupos poblacionales, y su posible relación con aspec tos genéticos y epigenéticos. Se resumen también las consecuencias socioeconómicas directas e indirectas de esta epidemia, y las estrategias e iniciativas recientes orientadas a la prevención de la obesidad, con especial atención en aquellas reportadas como las más eficientes en el contexto latinoamericano. En función de la revisión realizada, se identifican como desafíos pendientes en esa región, el abordaje integrado de la doble carga de malnutrición así como el creciente sobrepeso infantil; se apuntan también algunos enfoques emergentes, como el sindémico, potencialmente útiles para comprender y abordar esta compleja problemática en el contex to actual. Concluyendo, se destaca la importancia de implementar estrategias renovadas, más eficientes y basadas en evidencia, para controlar la creciente pre valencia de obesidad, lo cual impactaría también en la carga de las enfermedades crónicas relacionadas, y con ello, en la economía y bienestar de las sociedades latinoamericanas.

Abstract The obesity epidemic is a phenomenon that has been widely studied in recent decades but is still incompletely understood, and its control is far from the desirable level in view of the increasing prevalence figures observed worldwide. This paper conducts a narrative review with the aim of providing updated evidence on the global obesity epidemic, and particularly on the situation in Latin America and Argentina, identifying the main chal lenges and future directions for addressing this public health problem. It first describes the current burden and increasing trends in the prevalence of obesity, in the overall population and by population groups, and its pos sible association with genetic and epigenetic aspects. It also summarizes the direct and indirect socioeconomic consequences of this epidemic, as well as recent strate gies and initiatives focused on obesity prevention, with special attention to those reported as the most efficient in the Latin American context. This review identified some pending challenges in the region, the integrated approach to the double burden of malnutrition and the growing childhood overweight; and it points out some emerging approaches, such as the syndemic approach, as potentially useful to understand and address this complex problem in the current context. In conclusion, it highlights the importance of implementing renewed, more efficient and evidence-based strategies to control the growing prevalence of obesity, which would also impact on the burden of related chronic diseases, and thus on the economy and well-being of Latin American societies.

[Obesity epidemic: current evidence, challenges and future directions]. / Epidemia de obesidad: evidencia actual, desafíos y direcciones futuras.

The obesity epidemic is a phenomenon that has been widely studied in recent decades but is still incompletely understood, and its control is far from the desirable level in view of the increasing prevalence figures observed worldwide. This paper conducts a narrative review with the aim of providing updated evidence on the global obesity epidemic, and particularly on the situation in Latin America and Argentina, identifying the main challenges and future directions for addressing this public health problem. It first describes the current burden and increasing trends in the prevalence of obesity, in the overall population and by population groups, and its possible association with genetic and epigenetic aspects. It also summarizes the direct and indirect socioeconomic consequences of this epidemic, as well as recent strategies and initiatives focused on obesity prevention, with special attention to those reported as the most efficient in the Latin American context. This review identified some pending challenges in the region, the integrated approach to the double burden of malnutrition and the growing childhood overweight; and it points out some emerging approaches, such as the syndemic approach, as potentially useful to understand and address this complex problem in the current context. In conclusion, it highlights the importance of implementing renewed, more efficient and evidence-based strategies to control the growing prevalence of obesity, which would also impact on the burden of related chronic diseases, and thus on the economy and well-being of Latin American societies.

La epidemia de obesidad es un fenómeno ampliamente estudiado en las últimas décadas, pero aun así incompletamente comprendido, cuyo control se encuentra lejos del nivel deseable si consideramos las cifras crecientes de prevalencia observadas a nivel mundial. El presente trabajo realiza una revisión narrativa con el propósito de aportar evidencia actualizada sobre la epidemia de la obesidad en el mundo, y en particular en la región latinoamericana y Argentina, identificando además los principales desafíos y direcciones futuras para el abordaje de esta problemática de salud pública. Se describe primeramente la carga actual y tendencias crecientes de la prevalencia de obesidad, general y por grupos poblacionales, y su posible relación con aspectos genéticos y epigenéticos. Se resumen también las consecuencias socioeconómicas directas e indirectas de esta epidemia, y las estrategias e iniciativas recientes orientadas a la prevención de la obesidad, con especial atención en aquellas reportadas como las más eficientes en el contexto latinoamericano. En función de la revisión realizada, se identifican como desafíos pendientes en esa región, el abordaje integrado de la doble carga de malnutrición así como el creciente sobrepeso infantil; se apuntan también algunos enfoques emergentes, como el sindémico, potencialmente útiles para comprender y abordar esta compleja problemática en el contexto actual. Concluyendo, se destaca la importancia de implementar estrategias renovadas, más eficientes y basadas en evidencia, para controlar la creciente prevalencia de obesidad, lo cual impactaría también en la carga de las enfermedades crónicas relacionadas, y con ello, en la economía y bienestar de las sociedades latinoamericanas.

[Environmental sociodemographic conditions associated with health-nutrition profiles among elderly people, Córdoba-Argentina]. / Condiciones sociodemográficas ambientales asociadas a perfiles de salud-alimentación entre personas adultas mayores, Córdoba-Argentina.

INTRODUCTION: Demographic trends indicate that population aging is not exclusive to developed countries. Argentina reaches 15.5% of the elderly population. The Covid-19 pandemic has brought to the forefront the public health situation of this population, challenging health systems, with disproportionate impacts on this group, which has suffered more than 80% of the deaths in the country, mainly in those with comorbidities. OBJECTIVE: To analyze the sociodemographic and environmental conditions involved in the process of development of health and nutrition profiles of the elderly people of Córdoba, Argentina 2020. METHODOLOGY: Epidemiological, cross-sectional, population-based study that included 221 elderly people (≥60 years old), through random sampling. Data on sociodemographic and environmental conditions, health and dietary profiles were collected through structured interviews. RESULTS: The average age of the participants was 68 years. Eighty-five percent recognized neighborhood contamination, 38% of them being garbage dumps close to their homes. Eighty-nine percent reported at least one non-communicable disease (NCD) or associated risk factor and 66% were overweight (BMI≥25kg/m2). The presence of obesity (BMI≥30kg/m2) was associated (OR=2.05; CI 1.007-3.922) with the development of NCDs. Only 4% of the population complied with the daily fruit and vegetable consumption recommendation. CONCLUSION: The predominant characteristics of the health and dietary profiles associated with NCDs identified suggest the need to study in depth the social determinants that condition the aging process.

Condiciones sociodemográficas ambientales asociadas a perfiles de salud-alimentación entre personas adultas mayores, Córdoba-Argentina / Environmental sociodemographic conditions associated with health-nutrition profiles among elderly people, Córdoba-Argentina

Introducción: Las tendencias demográficas indican que el envejecimiento poblacional no es exclusivo de los países desarrollados. Argentina alcanza el 15,5% de la población adulta mayor. La pandemia por COVID-19 puso en escena la situación de salud pública de esta población, desafiando los sistemas de salud, con impactos desproporcionados en este grupo que sufrió más del 80% de los decesos ocurridos en el país, principalmente en quienes presentaban comorbilidades. Objetivo: Analizar las condiciones sociodemográficas y ambientales que intervienen en el proceso de desarrollo de perfiles de salud y alimentación de la población adulta mayor de Córdoba, Argentina 2020. Metodología: Estudio epidemiológico de corte transversal, de base poblacional, que incluyó 221 personas adultas mayores (≥60 años) mediante muestreo aleatorizado. A través de entrevista estructurada se indagaron datos sobre condiciones sociodemográficas, ambientales, perfiles de salud y alimentación. Resultados: La edad promedio de los participantes fue de 68 años. Un 85% reconoció contaminación barrial, siendo el 38% basurales cercanos al domicilio. El 89% manifestaron al menos una enfermedad no transmisible (ENT) o factor de riesgo asociado y el 66% presentó exceso de peso (IMC≥25kg/m2). La presencia de obesidad (IMC≥30kg/m2) se asoció (OR: 2,05; IC: 1,007-3,922) con el desarrollo de ENT. Solo el 4% de la población cumplió con la recomendación de consumo diario de frutas y verduras. Conclusión: Las características predominantes de perfiles de salud y alimentación asociadas a ENT identificadas, plantean la necesidad de profundizar sobre los determinantes sociales que condicionan el proceso de envejecimiento. (AU)

Introduction: Demographic trends indicate that population aging is not exclusive to developed countries. Argentina reaches 15.5% of the elderly population. The Covid-19 pandemic has brought to the forefront the public health situation of this population, challenging health systems, with disproportionate impacts on this group, which has suffered more than 80% of the deaths in the country, mainly in those with comorbidities. Objective: To analyze the sociodemographic and environmental conditions involved in the process of development of health and nutrition profiles of the elderly people of Córdoba, Argentina 2020. Methodology: Epidemiological, cross-sectional, population-based study that included 221 elderly people (≥60 years old), through random sampling. Data on sociodemographic and environmental conditions, health and dietary profiles were collected through structured interviews. Results: The average age of the participants was 68 years. Eighty-five percent recognized neighborhood contamination, 38% of them being garbage dumps close to their homes. Eighty-nine percent reported at least one non-communicable disease (NCD) or associated risk factor and 66% were overweight (BMI≥25kg/m2). The presence of obesity (BMI≥30kg/m2) was associated (OR=2.05; CI 1.007–3.922) with the development of NCDs. Only 4% of the population complied with the daily fruit and vegetable consumption recommendation. Conclusion: The predominant characteristics of the health and dietary profiles associated with NCDs identified suggest the need to study in depth the social determinants that condition the aging process. (AU)

The "diet model" and metabolic syndrome components: Results from the Cordoba Health and Dietary Habits Investigation.

OBJECTIVES: Diet, one of the main risk factors for both metabolic syndrome (MetS) and non-communicable diseases (NCDs), is a multidimensional feature whose complexity relies on the individual and contextual characteristics of foods. The aim of this study was to build a "diet model" and estimate its relationship with MetS components in two Argentinian populations. METHODS: This was a population-based cross-sectional study that assessed bio-socio-anthropometrical variables and dietary habits using food frequency questionnaires. Dietary patterns (DPs) were drawn out using exploratory factor analysis (EFA). A structural equation model (SEM) was used to explore and confirm theoretical and empirical relationships between DPs and the diet model. The association between individuals' adherence to DPs and MetS were assessed using a multiple logistic regression analysis. We selected two cities in central Argentina according to socio-eco-environmental characteristics. Participants included 493 men and women (1:1 ratio) from 35 to 65 y of age. RESULTS: We identified four DPs: traditional Argentine (TA; processed meats, meats and eggs, fats, starchy vegetables), prudent (Pr; vegetables, fruits, milk, and yogurt), alcohol and snacks (AS), and sweets (S; candies and sodas). TA and AS DPs were associated with increased waist circumference. The S DP showed a strong effect on hypertension. Moderate adherence to the TA DP was positively associated with dyslipidemia but negatively with hypertension whenever individuals did not adhere to the AS DP. TA was positively correlated to AS and S, but inversely with Pr. CONCLUSION: This diet model integrated those food groups in an associative structure describing per se a synthesis of the Argentine dietary habits and their association with three of the five components of MetS.

Higher dietary glycemic index, intake of high-glycemic index foods, and insulin load are associated with the risk of breast cancer, with differences according to body mass index in women from Córdoba, Argentina.

Dietary patterns based on rich-carbohydrate foods were associated with breast cancer (BC) in Córdoba (Argentina). Nevertheless, the effect of dietary indicators of postprandial blood glucose or insulinemia on this cancer has not been studied. Thus, we hypothesize that higher dietary glycemic and insulinemic indices increase the risk of BC occurrence, with differential effects according to the presence/absence of overweight. A case-control study was conducted for BC (346/596 cases/controls) in Córdoba, Argentina, from 2008 to 2016. Multiple logistic regression models were used to assess the effect of glycemic index (GI), glycemic load, insulin index, and insulin load (IL) and the intake of high-GI foods (HGIF) on BC occurrence, adjusted by specific confounders and stratified by body mass index (BMI, <25 or ≥25 kg/m2). The odds ratio (OR) for BC occurrence comparing the highest versus the lowest tertile of dietary GI was 1.77 (95% confidence interval [CI], 1.19-2.64). Additionally, a positive association between the weekly intake of HGIF and the dietary IL was found (OR, 1.71; 95% CI, 1.14-2.55 and OR, 1.50; 95% CI, 1.03-2.19, respectively). In normal-weight women, dietary GI and IL were associated with cancer occurrence, whereas in overweight women, only weekly intake of HGIF was associated. Our findings suggest that the BC risk related to hyperglycemic and hyperinsulinemic diet changed according to BMI. Furthermore, frequent exposure to HGIF has a relevant role in BC occurrence and its promoting effect is even higher in the presence of overweight.

[A population-based study on seroprevalence and factors associated with SARS-CoV-2 infection in Córdoba, Argentina]. / Estudio de base poblacional de seroprevalencia y factores asociados a la infección por SARS-CoV-2 en Córdoba, Argentina.

Seroepidemiological studies help identify the indirect distribution of diseases, detecting serological markers of immunity and demonstrating undiagnosed infections in the general population. The objectives were to estimate the seroprevalence of SARS-CoV-2 antibodies in Córdoba, Argentina, from December 2020 to January 2021 and to identify factors associated with the virus' contagiousness. A population-based cross-sectional observational study was performed in 3,225 individuals over two years of age living in Córdoba city, selected by multiple-stage random sampling proportional to distribution by gender, age group, and socioeconomic status in the city's population. Clinical characteristics, anthropometry, and comorbidities were collected by interview. Qualitative serological testing was performed for detection of SARS-CoV-2 nucleocapsid IgG antibodies (ARCHITECT, Abbott). SARS-CoV-2 seroprevalence was estimated for the total population and by age group, sex, socioeconomic status, and presence of target diseases. Prevalence ratios (PR) were estimated using a log-binomial regression model. SARS-CoV-2 seropositivity was 16.68% (95%CI: 15.41-18.01). Age 2 to 18 years, living in neighborhoods with low socioeconomic status, and obesity increased the odds of seropositivity (PR = 1.50; 95%CI: 1.10-2.04, PR = 1.91; 95%CI: 1.34-2.67 and PR = 1.39; 95%CI: 1.04-1.85). The results indicate that the city of Córdoba displays differential attributes that increase the likelihood of a positive SARS-CoV-2 antibody test. This allows targeting epidemiological surveillance strategies to reduce the spread of the virus.

Los estudios seroepidemiológicos permiten conocer la distribución indirecta de las enfermedades, detectando marcadores séricos de inmunidad y demostrando infecciones no diagnosticadas en la población general. El objetivo fue estimar la seroprevalencia de anticuerpos contra el SARS-CoV-2, en Córdoba, Argentina, entre diciembre de 2020 y enero de 2021, e identificar factores asociados a la contagiosidad del virus. Se realizó un estudio observacional transversal, de base poblacional, con 3.225 individuos mayores de 2 años, residentes en Córdoba Capital, que fueron seleccionados mediante un diseño de muestreo aleatorio en múltiples etapas, proporcional a la distribución por género, franja etaria y nivel socioeconómico de la población de Córdoba. Las características clínicas, antropometría y comorbilidades se recogieron mediante entrevistas. Se realizó un test serológico cualitativo para la detección de anticuerpos IgG antinucleocápside para SARS-CoV-2 (ARCHITECT, Abbott). La seroprevalencia del SARS-CoV-2 se estimó en la población y por franja de edad, sexo, nivel socioeconómico y presencia de las patologías estudiadas. Las razones de prevalencia (RP) se estimaron usando un modelo de regresión log-binomial. La seropositividad para SARS-CoV-2 fue de 16,68% (IC95%: 15,41-18,01). Tener entre 2 y 18 años, residir en barrios con nivel socioeconómico bajo y la presencia de obesidad, aumentaron la oportunidad de seropositividad (RP = 1,50; IC95%: 1,10-2,04, RP = 1,91; IC95%: 1,34-2,67 y RP = 1,39; IC95%: 1,04-1,85). Los resultados indican que en Córdoba Capital existen atributos diferenciales que aumentan la posibilidad de ser seropositivo para SARS-CoV-2. Esto permite dirigir estrategias de vigilancia epidemiológica para reducir la propagación del virus.

Os estudos soroepidemiológicos permitem conhecer a distribuição indireta das doenças, detectando marcadores séricos de imunidade e demonstrando infecções não diagnosticadas na população geral. O objetivo foi estimar a soroprevalência de anticorpos contra o SARS-CoV-2, em Córdoba, Argentina, entre dezembro de 2020 e janeiro de 2021, e identificar fatores associados à contagiosidade do vírus. Um estudo observacional transversal foi realizado, de base populacional, com 3.225 indivíduos maiores de 2 anos, residentes em Córdoba Capital, que foram selecionados por meio de um delineamento de amostragem aleatória em múltiplos estágios, proporcional à distribuição de gênero, a faixa etária e o nível socioeconômico da população de Córdoba. As características clínicas, antropometria e comorbidades foram coletadas por meio de entrevistas. Um teste sorológico qualitativo foi realizado para a detecção de anticorpos IgG anti-nucleocapsídeo para SARS-CoV-2 (ARCHITECT, Abbott). A soroprevalência do SARS-CoV-2 foi estimada na população e por faixa etária, sexo, nível socioeconômico e presença das patologias estudadas. Razões de prevalência (RP) foram estimadas usando um modelo de regressão log-binomial. A soropositividade para SARS-CoV-2 foi de 16,68% (IC95%: 15,41-18,01). Ter entre 2 e 18 años, residir em bairros com nível socioeconômico baixo e a presença de obesidade aumentaram a chance de soropositividade (RP = 1,50; IC95%: 1,10-2,04, RP = 1,91; IC95%: 1,34-2,67 e RP = 1,39; IC95%: 1,04-1,85). Os resultados indicam que em Córdoba Capital existem atributos diferenciais que aumentam a possibilidade de ser soropositivo para SARS-CoV-2. Isso permite direcionar estratégias de vigilância epidemiológica para reduzir a propagação do vírus.

[Vaccination against SARS-CoV-2 and its relationship with illness and death from COVID-19 in ArgentinaVacinação contra SARS-CoV-2 e sua relação com doença e morte por COVID-19 na Argentina]. / Vacunación contra SARS-CoV-2 y su relación con enfermedad y muerte por COVID-19 en Argentina.

Objective: To determine the effectiveness of vaccination against SARS-CoV-2 in preventing illness and death from COVID-19 in Córdoba, Argentina, during the period from January through June 2021. Methods: A retrospective cohort study was conducted among 1,139,458 residents of the province of Córdoba. Multiple logistic regression models were developed to describe the relationship between vaccination and the presence of SARS-CoV-2 or death from COVID-19, while taking account of comorbidities and chronic disease risk factors and adjusting for sex and age. Results: Among the general population, having received one or two doses of vaccine reduced the risk of illness by 98.8% and 99.3%, respectively, and the risk of dying by 83% and 96.5%, respectively. Among those who developed COVID-19, the probability of dying was reduced by 57% and 80%, respectively. Regarding probability of death, risk increased with age, with being male, and with obesity, arterial hypertension, and diabetes mellitus. Conclusion: Vaccination is effective and protects against the risk of getting COVID-19, developing severe disease, or dying. Having obesity, arterial hypertension, or diabetes mellitus, in descending order, increases the risk of death.

Objetivo: Conhecer a eficácia da vacinação contra SARS-CoV-2 para prevenir o desenvolvimento de doença e morte por COVID-19 em Córdoba, Argentina, no período de janeiro a junho de 2021. Métodos: Foi realizado um estudo de coorte retrospectivo em 1.139.458 residentes da província de Córdoba. Foram construídos modelos de regressão logística múltipla que relacionaram a vacinação à presença de SARS-CoV-2 ou morte por COVID-19, considerando comorbidades e fatores de risco para doenças crônicas e ajustando por sexo e idade. Resultados: Ter recebido uma ou duas doses da vacina na população geral reduziu o risco de adoecimento em 98,8% e 99,3%, respectivamente; e de morrer, em 83% e 96,5%, respectivamente. Naqueles que contraíram COVID-19, a probabilidade de morrer foi reduzida em 57% e 80%, respectivamente. Em relação à probabilidade de morte, o risco aumentou com o aumento da idade e para o sexo masculino, ou com a presença de obesidade, hipertensão arterial ou diabetes mellitus. Conclusão: A vacinação é efetiva e protege contra a possibilidade de contrair COVID-19, desenvolver doença grave ou morrer. A presença de obesidade, hipertensão arterial ou diabetes mellitus, em ordem decrescente, aumenta o risco de morte.

Vacunación contra SARS-CoV-2 y su relación con enfermedad y muerte por COVID-19 en Argentina

[RESUMEN]. Objetivo. Conocer la efectividad de la vacunación contra SARS-CoV-2 para prevenir el desarrollo de enfermedad y muerte por COVID-19 en Córdoba, Argentina, en el periodo enero-junio de 2021. Métodos. Se llevó a cabo un estudio de cohorte retrospectivo en 1 139 458 residentes en la provincia de Córdoba. Se construyeron modelos de regresión logística múltiple que relacionaron la vacunación con la infección por SARS-CoV-2 o la muerte por COVID-19, considerando comorbilidades y factores de riesgo de enfermedades crónicas y ajustando por sexo y edad. Resultados. El haber recibido una o dos dosis de vacuna en la población general redujo el riesgo de enfermar un 98,8% y 99,3%, respectivamente; y de morir un 83% y 96,5%, respectivamente. En quienes contrajeron COVID-19, la probabilidad de morir se redujo en 57% y 80%, respectivamente. En cuanto a la probabilidad de muerte, el riesgo aumentó a medida que aumentaba la edad y con la pertenencia al sexo masculino o la presencia de obesidad, hipertensión arterial o diabetes mellitus. Conclusión. La vacunación es efectiva y protege contra la posibilidad de contraer COVID-19, desarrollar enfermedad grave o morir. Presentar obesidad, hipertensión arterial o diabetes mellitus, en orden decreciente, aumentan el riesgo de morir.

[ABSTRACT]. Objective. To determine the effectiveness of vaccination against SARS-CoV-2 in preventing illness and death from COVID-19 in Córdoba, Argentina, during the period from January through June 2021. Methods. A retrospective cohort study was conducted among 1,139,458 residents of the province of Córdoba. Multiple logistic regression models were developed to describe the relationship between vaccination and the presence of SARS-CoV-2 or death from COVID-19, while taking account of comorbidities and chronic disease risk factors and adjusting for sex and age. Results. Among the general population, having received one or two doses of vaccine reduced the risk of illness by 98.8% and 99.3%, respectively, and the risk of dying by 83% and 96.5%, respectively. Among those who developed COVID-19, the probability of dying was reduced by 57% and 80%, respectively. Regarding probability of death, risk increased with age, with being male, and with obesity, arterial hypertension, and diabetes mellitus. Conclusion. Vaccination is effective and protects against the risk of getting COVID-19, developing severe disease, or dying. Having obesity, arterial hypertension, or diabetes mellitus, in descending order, increases the risk of death.

[RESUMO]. Objetivo. Conhecer a eficácia da vacinação contra SARS-CoV-2 para prevenir o desenvolvimento de doença e morte por COVID-19 em Córdoba, Argentina, no período de janeiro a junho de 2021. Métodos. Foi realizado um estudo de coorte retrospectivo em 1.139.458 residentes da província de Córdoba. Foram construídos modelos de regressão logística múltipla que relacionaram a vacinação à presença de SARS-CoV-2 ou morte por COVID-19, considerando comorbidades e fatores de risco para doenças crônicas e ajustando por sexo e idade. Resultados. Ter recebido uma ou duas doses da vacina na população geral reduziu o risco de adoecimento em 98,8% e 99,3%, respectivamente; e de morrer, em 83% e 96,5%, respectivamente. Naqueles que contraíram COVID-19, a probabilidade de morrer foi reduzida em 57% e 80%, respectivamente. Em relação à probabilidade de morte, o risco aumentou com o aumento da idade e para o sexo masculino, ou com a presença de obesidade, hipertensão arterial ou diabetes mellitus. Conclusão. A vacinação é efetiva e protege contra a possibilidade de contrair COVID-19, desenvolver doença grave ou morrer. A presença de obesidade, hipertensão arterial ou diabetes mellitus, em ordem decrescente, aumenta o risco de morte.

Vacunación contra SARS-CoV-2 y su relación con enfermedad y muerte por COVID-19 en Argentina / Vaccination against SARS-CoV-2 and its relationship with illness and death from COVID-19 in Argentina / Vacinação contra SARS-CoV-2 e sua relação com doença e morte por COVID-19 na Argentina

RESUMEN Objetivo. Conocer la efectividad de la vacunación contra SARS-CoV-2 para prevenir el desarrollo de enfermedad y muerte por COVID-19 en Córdoba, Argentina, en el periodo enero-junio de 2021. Métodos. Se llevó a cabo un estudio de cohorte retrospectivo en 1 139 458 residentes en la provincia de Córdoba. Se construyeron modelos de regresión logística múltiple que relacionaron la vacunación con la infección por SARS-CoV-2 o la muerte por COVID-19, considerando comorbilidades y factores de riesgo de enfermedades crónicas y ajustando por sexo y edad. Resultados. El haber recibido una o dos dosis de vacuna en la población general redujo el riesgo de enfermar un 98,8% y 99,3%, respectivamente; y de morir un 83% y 96,5%, respectivamente. En quienes contrajeron COVID-19, la probabilidad de morir se redujo en 57% y 80%, respectivamente. En cuanto a la probabilidad de muerte, el riesgo aumentó a medida que aumentaba la edad y con la pertenencia al sexo masculino o la presencia de obesidad, hipertensión arterial o diabetes mellitus. Conclusión. La vacunación es efectiva y protege contra la posibilidad de contraer COVID-19, desarrollar enfermedad grave o morir. Presentar obesidad, hipertensión arterial o diabetes mellitus, en orden decreciente, aumentan el riesgo de morir.

ABSTRACT Objective. To determine the effectiveness of vaccination against SARS-CoV-2 in preventing illness and death from COVID-19 in Córdoba, Argentina, during the period from January through June 2021. Methods. A retrospective cohort study was conducted among 1,139,458 residents of the province of Córdoba. Multiple logistic regression models were developed to describe the relationship between vaccination and the presence of SARS-CoV-2 or death from COVID-19, while taking account of comorbidities and chronic disease risk factors and adjusting for sex and age. Results. Among the general population, having received one or two doses of vaccine reduced the risk of illness by 98.8% and 99.3%, respectively, and the risk of dying by 83% and 96.5%, respectively. Among those who developed COVID-19, the probability of dying was reduced by 57% and 80%, respectively. Regarding probability of death, risk increased with age, with being male, and with obesity, arterial hypertension, and diabetes mellitus. Conclusion. Vaccination is effective and protects against the risk of getting COVID-19, developing severe disease, or dying. Having obesity, arterial hypertension, or diabetes mellitus, in descending order, increases the risk of death.

RESUMO Objetivo. Conhecer a eficácia da vacinação contra SARS-CoV-2 para prevenir o desenvolvimento de doença e morte por COVID-19 em Córdoba, Argentina, no período de janeiro a junho de 2021. Métodos. Foi realizado um estudo de coorte retrospectivo em 1.139.458 residentes da província de Córdoba. Foram construídos modelos de regressão logística múltipla que relacionaram a vacinação à presença de SARS-CoV-2 ou morte por COVID-19, considerando comorbidades e fatores de risco para doenças crônicas e ajustando por sexo e idade. Resultados. Ter recebido uma ou duas doses da vacina na população geral reduziu o risco de adoecimento em 98,8% e 99,3%, respectivamente; e de morrer, em 83% e 96,5%, respectivamente. Naqueles que contraíram COVID-19, a probabilidade de morrer foi reduzida em 57% e 80%, respectivamente. Em relação à probabilidade de morte, o risco aumentou com o aumento da idade e para o sexo masculino, ou com a presença de obesidade, hipertensão arterial ou diabetes mellitus. Conclusão. A vacinação é efetiva e protege contra a possibilidade de contrair COVID-19, desenvolver doença grave ou morrer. A presença de obesidade, hipertensão arterial ou diabetes mellitus, em ordem decrescente, aumenta o risco de morte.

Estudio de base poblacional de seroprevalencia y factores asociados a la infección por SARS-CoV-2 en Córdoba, Argentina / A population-based study on seroprevalence and factors associated with SARS-CoV-2 infection in Córdoba, Argentina / Estudo populacional de soroprevalência e fatores associados à infecção por SARS-CoV-2 em Córdoba, Argentina

Los estudios seroepidemiológicos permiten conocer la distribución indirecta de las enfermedades, detectando marcadores séricos de inmunidad y demostrando infecciones no diagnosticadas en la población general. El objetivo fue estimar la seroprevalencia de anticuerpos contra el SARS-CoV-2, en Córdoba, Argentina, entre diciembre de 2020 y enero de 2021, e identificar factores asociados a la contagiosidad del virus. Se realizó un estudio observacional transversal, de base poblacional, con 3.225 individuos mayores de 2 años, residentes en Córdoba Capital, que fueron seleccionados mediante un diseño de muestreo aleatorio en múltiples etapas, proporcional a la distribución por género, franja etaria y nivel socioeconómico de la población de Córdoba. Las características clínicas, antropometría y comorbilidades se recogieron mediante entrevistas. Se realizó un test serológico cualitativo para la detección de anticuerpos IgG antinucleocápside para SARS-CoV-2 (ARCHITECT, Abbott). La seroprevalencia del SARS-CoV-2 se estimó en la población y por franja de edad, sexo, nivel socioeconómico y presencia de las patologías estudiadas. Las razones de prevalencia (RP) se estimaron usando un modelo de regresión log-binomial. La seropositividad para SARS-CoV-2 fue de 16,68% (IC95%: 15,41-18,01). Tener entre 2 y 18 años, residir en barrios con nivel socioeconómico bajo y la presencia de obesidad, aumentaron la oportunidad de seropositividad (RP = 1,50; IC95%: 1,10-2,04, RP = 1,91; IC95%: 1,34-2,67 y RP = 1,39; IC95%: 1,04-1,85). Los resultados indican que en Córdoba Capital existen atributos diferenciales que aumentan la posibilidad de ser seropositivo para SARS-CoV-2. Esto permite dirigir estrategias de vigilancia epidemiológica para reducir la propagación del virus.

Seroepidemiological studies help identify the indirect distribution of diseases, detecting serological markers of immunity and demonstrating undiagnosed infections in the general population. The objectives were to estimate the seroprevalence of SARS-CoV-2 antibodies in Córdoba, Argentina, from December 2020 to January 2021 and to identify factors associated with the virus' contagiousness. A population-based cross-sectional observational study was performed in 3,225 individuals over two years of age living in Córdoba city, selected by multiple-stage random sampling proportional to distribution by gender, age group, and socioeconomic status in the city's population. Clinical characteristics, anthropometry, and comorbidities were collected by interview. Qualitative serological testing was performed for detection of SARS-CoV-2 nucleocapsid IgG antibodies (ARCHITECT, Abbott). SARS-CoV-2 seroprevalence was estimated for the total population and by age group, sex, socioeconomic status, and presence of target diseases. Prevalence ratios (PR) were estimated using a log-binomial regression model. SARS-CoV-2 seropositivity was 16.68% (95%CI: 15.41-18.01). Age 2 to 18 years, living in neighborhoods with low socioeconomic status, and obesity increased the odds of seropositivity (PR = 1.50; 95%CI: 1.10-2.04, PR = 1.91; 95%CI: 1.34-2.67 and PR = 1.39; 95%CI: 1.04-1.85). The results indicate that the city of Córdoba displays differential attributes that increase the likelihood of a positive SARS-CoV-2 antibody test. This allows targeting epidemiological surveillance strategies to reduce the spread of the virus.

Os estudos soroepidemiológicos permitem conhecer a distribuição indireta das doenças, detectando marcadores séricos de imunidade e demonstrando infecções não diagnosticadas na população geral. O objetivo foi estimar a soroprevalência de anticorpos contra o SARS-CoV-2, em Córdoba, Argentina, entre dezembro de 2020 e janeiro de 2021, e identificar fatores associados à contagiosidade do vírus. Um estudo observacional transversal foi realizado, de base populacional, com 3.225 indivíduos maiores de 2 anos, residentes em Córdoba Capital, que foram selecionados por meio de um delineamento de amostragem aleatória em múltiplos estágios, proporcional à distribuição de gênero, a faixa etária e o nível socioeconômico da população de Córdoba. As características clínicas, antropometria e comorbidades foram coletadas por meio de entrevistas. Um teste sorológico qualitativo foi realizado para a detecção de anticorpos IgG anti-nucleocapsídeo para SARS-CoV-2 (ARCHITECT, Abbott). A soroprevalência do SARS-CoV-2 foi estimada na população e por faixa etária, sexo, nível socioeconômico e presença das patologias estudadas. Razões de prevalência (RP) foram estimadas usando um modelo de regressão log-binomial. A soropositividade para SARS-CoV-2 foi de 16,68% (IC95%: 15,41-18,01). Ter entre 2 e 18 años, residir em bairros com nível socioeconômico baixo e a presença de obesidade aumentaram a chance de soropositividade (RP = 1,50; IC95%: 1,10-2,04, RP = 1,91; IC95%: 1,34-2,67 e RP = 1,39; IC95%: 1,04-1,85). Os resultados indicam que em Córdoba Capital existem atributos diferenciais que aumentam a possibilidade de ser soropositivo para SARS-CoV-2. Isso permite direcionar estratégias de vigilância epidemiológica para reduzir a propagação do vírus.

Sociodemographic disparities and contextual factors in obesity: updated evidence from a National Survey of Risk Factors for Chronic Diseases.

OBJECTIVE: To assess the association of sociodemographic and environmental factors with the obesity occurrence in Argentina from a sex- and age-comparative perspective and a multilevel approach. DESIGN: Cross-sectional study based on secondary data from the National Survey of Chronic Diseases Risk Factors (CDRF) 2018, Argentina. Two-level logistic regression models stratified by sex and age were used. SETTING: The nationwide probabilistic sample of the CDRF survey and twenty-four geographical units. PARTICIPANTS: 16 410 adult people, living in Argentine towns of at least 5000 people, nested into 24 geographical units. Sex and age groups were defined as young (aged 18-44 years), middle-aged (45-64 years) and older (65 years and older) men and women. RESULTS: Single men (all age groups) and divorced/widowed men (aged 45 years or older) had a lower obesity risk compared to married ones. In the middle-aged group, men with higher education showed a lower risk than men with incomplete primary education. In young women, a marked social gradient by educational level was observed. A low-income level coupled with highly urbanised contexts represents an unfavourable scenario for young and middle-aged women. Having a multi-person household was a risk factor for obesity (OR = 1·26, P = 0·038) in middle-aged women. Contextual factors linked to the availability of socially constructed recreational resources and green spaces were associated with obesity among young adults. CONCLUSIONS: Socio-environmental determinants of obesity seem to operate differently according to sex and age in Argentina. This entails the need to address the obesity epidemic considering gender inequalities and the socio-environmental context at each stage of life.

Modified WCRF/AICR Score and All-Cause, Digestive System, Cardiovascular, Cancer and Other-Cause-Related Mortality: A Competing Risk Analysis of Two Cohort Studies Conducted in Southern Italy.

BACKGROUND: In real life, nutrition goes beyond purely biological domains. Primary prevention is the most efficient approach for reducing the risk of mortality. We aimed to study the association of lifestyle, as measured by a modified World Cancer Research Fund/American Institute for Cancer Research (mWCRF/AICR) scoring system with all-cause, digestive system disease-related (DSD-related), cardiovascular disease-related (CVD-related), cancer-related and other cause-related mortality using data from two population-based cohort studies conducted in Southern Italy. METHODS: A random sample of 5271 subjects aged 18 years or older was enrolled in 2005-2006 and followed up until 2020. Usual food intakes were estimated using a validated dietary questionnaire. Competing risks survival models were applied. RESULTS: High adherence to the mWCRF/AICR score was found to be statistically significant and negatively associated with all-cause mortality (HR 0.56, 95%CI 0.39; 0.82), DSD-related mortality (SHR 0.38, 95%CI 0.15; 0.97) and cancer-related mortality (SHR 0.43, 95%CI 0.19; 0.97) in the male sub-cohort and other-cause mortality (SHR 0.43, 95%CI 0.21; 0.88) only in the female group. CONCLUSIONS: This mWCRF/AICR score can be seen as a simple, easy tool for use in clinical practice to evaluate both qualitative and quantitative aspects of the diet.

Development and validation of a neural network for NAFLD diagnosis.

Non-Alcoholic Fatty Liver Disease (NAFLD) affects about 20-30% of the adult population in developed countries and is an increasingly important cause of hepatocellular carcinoma. Liver ultrasound (US) is widely used as a noninvasive method to diagnose NAFLD. However, the intensive use of US is not cost-effective and increases the burden on the healthcare system. Electronic medical records facilitate large-scale epidemiological studies and, existing NAFLD scores often require clinical and anthropometric parameters that may not be captured in those databases. Our goal was to develop and validate a simple Neural Network (NN)-based web app that could be used to predict NAFLD particularly its absence. The study included 2970 subjects; training and testing of the neural network using a train-test-split approach was done on 2869 of them. From another population consisting of 2301 subjects, a further 100 subjects were randomly extracted to test the web app. A search was made to find the best parameters for the NN and then this NN was exported for incorporation into a local web app. The percentage of accuracy, area under the ROC curve, confusion matrix, Positive (PPV) and Negative Predicted Value (NPV) values, precision, recall and f1-score were verified. After that, Explainability (XAI) was analyzed to understand the diagnostic reasoning of the NN. Finally, in the local web app, the specificity and sensitivity values were checked. The NN achieved a percentage of accuracy during testing of 77.0%, with an area under the ROC curve value of 0.82. Thus, in the web app the NN evidenced to achieve good results, with a specificity of 1.00 and sensitivity of 0.73. The described approach can be used to support NAFLD diagnosis, reducing healthcare costs. The NN-based web app is easy to apply and the required parameters are easily found in healthcare databases.

An intensive follow-up in subjects with cardiometabolic high-risk.

BACKGROUND AND AIM: Addressing chronic problems requires a model of care that promotes self-management of the disease and facilitates adherence to treatment. This project was designed to enhance patient's clinical and functional outcomes through a Comprehensive Model to be implemented in our health system and to evaluate the results. METHODS AND RESULTS: Different population stratification tools were tested and designed to classify subjects according to different variables. We have developed a program to detect and screen cardiometabolic risk by integrating most of the Chronic Care Model recommendations through in-house developed management software (MoviHealth®). From the results, 1317 subjects were evaluated (27% of the whole population) during the first year of follow-up which significantly improved for all variables along the follow-up period. The blood pressure of the hypertensive population in 2010 and 2015 showed the importance of enrollment of subjects and the optimization of the blood pressure control. The result of HbA1c observed in 2010 decreased progressively to 7.1 ± 1.4% in 2015, and dyslipidemia levels improved gradually. The number of cardiovascular events requiring hospitalization decreased significantly (48%), from 1.9 events per 100 subjects in 2011 to 0.98 in 2015. CONCLUSION: Our program has combined strategies for the prevention and control of non-communicable diseases, incorporating interventions to control risk factors and to reduce morbidity and mortality. It also had improvements in life quality, accessibility to health-care services, and the promotion of self-care.

[Food patterns in Argentinian women related to socioeconomic and health factors during puerperium]. / Patrones alimentarios de mujeres argentinas durante el puerperio en relación con factores socioeconómicos y sanitarios.

Introduction: Food choices and nutritional requirements of women, which vary throughout their life cycle, are unknown for Argentinian women. Objective: To identify Argentinian women's dietary patterns and their relation to socioeconomic and health characteristics, during puerperium. Method: The food intake of 249 puerperal women was assessed for a cross-sectional study. Dietary patterns were determined by factor analysis, whose adherence was associated with different variables through Spearman's correlation and multivariate analyses. Results: Three patterns were revealed: macronutritional (MP), phytochemical (PP) and energetic (EP). Physical activity and family history of cardiometabolic diseases were positively associated to MP adherence (odds ratio [OR] = 2.69 and 2.68, respectively). Women without formal employment adhered less to PP (OR = 0.49). Low educational level increased adherence to EP (OR = 2.20). Body mass index correlated inversely to PP (rho = −0.16). Correspondence analysis revealed that high adherence to MP and PP were associated with formal employment, high educational level, adequate physical activity, normal body mass index and a diverse diet. Conclusion: Food choices were conditioned by family disease, physical activity, employment, and educational level. We identified three dietary patterns in postpartum women, which constitute an original contribution to future nutritional approaches.

Introducción: Las elecciones alimentarias afectan la salud de las mujeres, cuyos requerimientos nutricionales varían durante el ciclo vital. No obstante, en Argentina se desconocen los alimentos elegidos por las mujeres durante el puerperio. Objetivo: Identificar los patrones alimentarios de mujeres argentinas durante el puerperio y su relación con las características socioeconómicas y sanitarias. Método: Se realizó un estudio transversal con 249 participantes, quienes respondieron sobre su frecuencia alimentaria. Se determinaron patrones por análisis factorial, cuya adherencia fue asociada a diferentes variables mediante correlación de Spearman y análisis multivariados. Resultados: El análisis reveló tres patrones: macronutricional (PM), fitoquímico (PF) y energético (PE). Tener antecedentes familiares de enfermedades cardiometabólicas y realizar actividad física se asociaron con mayor adherencia al PM (razón de momios [RM] = 2.69 y 2.68, respectivamente). Las mujeres sin empleo formal tuvieron menor adherencia al PF (RM = 0.49). Un bajo nivel educacional incrementó la adherencia al PE (RM = 2.20). El índice de masa corporal (IMC) se asoció inversamente al PF (rho = −0.16). El análisis de correspondencia reveló que la alta adherencia al PM y al PF, junto con una baja adherencia al PE, se asociaron con empleo formal, mayor nivel educativo, adecuada actividad física, lMC normal y una dieta diversa. Conclusiones: Las elecciones alimentarias estuvieron condicionadas por los antecedentes familiares patológicos, la actividad física, el empleo y el nivel educacional, identificándose tres patrones alimentarios propios de las mujeres, lo que constituye una contribución original para futuros abordajes nutricionales.

The effect of the Mediterranean Diet on lifespan: a treatment-effect survival analysis of a population-based prospective cohort study in Southern Italy.

BACKGROUND: The Mediterranean diet (MedDiet) is associated with good health. We aimed to estimate the effect of levels of adherence to the MedDiet on lifespan by performing treatment effects survival analysis. METHODS: A sample of 5250 subjects aged ≥18 years were randomly selected from the electoral list of Castellana Grotte and Putignano (Apulian Region, Italy). Cohorts were enrolled in 2005-06 and followed-up until December 2018. The adherence to the MedDiet was measured by the relative Mediterranean score (rMED) and categorized as high, medium and low. Time-to-death (all-causes) as estimated by average treatment effect on the treated (ATET), potential outcome mean (POM) and relative efficiency of exposure were the outcomes. RESULTS: A total of 4896 subjects were included. The median follow-up time was 12.82 (inter quartile range (IQR) 12.22-13.05), 12.91 (IQR 12.21-13.27) and 12.84 (IQR 12.19-13.03) years for high, medium and low rMED subjects respectively. By December 2018, 453 (9.25%) had died. There was a strong effect of medium and low rMED {ATET, -5.10 [95% confidence interval (CI) -9.39, -0.80] and -8.91 (95%CI -13.37, -4.45), respectively}. High rMED has an important effect on mean age at death [POM 90.16 (95% CI 86.06, 94.25)]. The relative effect size for medium and low rMED subjects was a lower lifespan of 5.62% (95% CI 1.01, 10.3) and 9.90% (95% CI 5.30, 5.30), respectively. CONCLUSIONS: We observed an important benefit in additional years of survival from adherence to MedDiet in this southern Italian cohort. Further investigation corroborating our findings in other population groups in other geographic regions will be an important contribution to promoting health and longevity.

Association of PTP4A3 expression and tumour size in functioning pituitary adenoma: a descriptive study.

BACKGROUND: PTP4A3 is a subclass of a protein tyrosine phosphatase super family and is expressed in a range of epithelial neoplasms. We evaluated PTP4A3 expression and its association with clinicopathological parameters in different types of functioning pituitary adenomas. METHODS: A total of 34 functioning pituitary adenomas samples were evaluated in this observational study. PTP4A3 expression was examined by immunohistochemical staining, and, possible correlations between PTP4A3 and some clinicopathological variables were investigated. RESULTS: PTP4A3 was expressed in 19 out of 34 tumours (55%), at the cytoplasmic level of tumorous cells. Moreover, there was significant association (p=0.042) between PTP4A3 expression and tumorous size. CONCLUSIONS: PTP4A3 was expressed in more than half of the tumours analysed, with there being a significant association with the tumorous size of functioning adenomas. This allows to speculate that PTP4A3 may regulate tumour growth, although further investigations are necessary to determine if this phosphatase can serve as a biomarker or used as a therapeutic target in pituitary macroadenomas.