Disentangling the environmental processes responsible for the world's largest farmed fish-killing harmful algal bloom: Chile, 2016.

The dictyochophyte microalga Pseudochattonella verruculosa was responsible for the largest farmed fish mortality ever recorded in the world, with losses for the Chilean salmon industry amounting to US$ 800 M in austral summer 2016. Super-scale climatic anomalies resulted in strong vertical water column stratification that stimulated development of a dynamic P. verruculosa thin layer (up to 38 µg chl a L-1) for several weeks in Reloncaví Sound. Hydrodynamic modeling (MIKE 3D) indicated that the Sound had extremely low flushing rates (between 121 and 200 days) in summer 2016. Reported algal cell densities of 7000-20,000 cells mL-1 generated respiratory distress in fish that was unlikely due to low dissolved oxygen (permanently >4 mg L-1). Histological examination of salmon showed that gills were the most affected organ with significant tissue damage and circulatory disorders. It is possible that some of this damage was due to a diatom bloom that preceded the Pseudochattonella event, thereby rendering the fish more susceptible to Pseudochattonella. No correlation between magnitude of fish mortality and algal cell abundance nor fish age was evident. Algal cultures revealed rapid growth rates and high cell densities (up to 600,000 cells mL-1), as well as highly complex life cycle stages that can be easily overlooked in monitoring programs. In cell-based bioassays, Chilean P. verruculosa was only toxic to the RTgill-W1 cell line following exposures to high cell densities of lysed cells (>100,000 cells mL-1). Fatty acid profiles of a cultured strain showed elevated concentrations of potentially ichthyotoxic, long-chain polyunsaturated fatty acids (PUFAs) (69.7% ± 1.8%)- stearidonic (SDA, 18:4ω3-28.9%), and docosahexaenoic acid (DHA, 22:6ω3-22.3%), suggesting that lipid peroxidation may help to explain the mortalities, though superoxide production by Pseudochattonella was low (< 0.21 ± 0.19 pmol O2- cell-1 h-1). It therefore remains unknown what the mechanisms of salmon mortality were during the Pseudochattonella bloom. Multiple mitigation strategies were used by salmon farmers during the event, with only delayed seeding of juvenile fish into the cages and towing of cages to sanctuary sites being effective. Airlift pumping, used effectively against other fish-killing HABs in the US and Canada was not effective, perhaps because it brought subsurface layers of Pseudochattonella to the surface, or and it also may have lysed the fragile cells, rendering them more lethal. The present study highlights knowledge gaps and inefficiency of contingency plans by the fish farming industry to overcome future fish-killing algal blooms under future climate change scenarios. The use of new technologies based on molecular methods for species detection, good farm practices by fish farms, and possible mitigation strategies are discussed.

Unaccompanied minors from the Northern Central American countries in the migrant stream: social differentials and institutional contexts.

The migration of minors unaccompanied by adults from the northern countries of Central America (El Salvador, Guatemala, and Honduras) to the United States has risen sharply in recent years, surpassing the numbers that migrated during the political conflicts in the region in the 1980s and early 1990s. While the migration of minors from the northern region of Central America may appear as a homogeneous flow, significant sociodemographic and regional differentials exist in their migration. A conceptual model of institutional conditions is presented to conceptualise how changing institutional conditions in communities of origin can produce 'push' effects for the unaccompanied migration of minors in the northern countries of Central America. The goal of the model is to conceptually advance the analysis of migration by the unaccompanied minors to the root level of structural change. US response to the migration of unaccompanied minors in the future is uncertain given that a new administration has taken charge of the Executive Branch, promising to further restrict unauthorised immigration at the southwest border.

Quantifying harmful algal bloom thresholds for farmed salmon in southern Chile.

Harmful algal blooms (HABs) have affected salmon farms in Chile since the early 1970's, causing massive losses in fish. Two large HABs occurred in 2002 and 2009, during which Alexandrium catenella blooms killed tons of salmon over an extended geographic area in southern Chile. At the beginning of 2016, high and persistent densities of Pseudochattonella cf. verruculosa and A. catenella were detected in the estuarine and marine ecosystems of southern Chile. Mortality for this latter event reached 27 million salmon and trout (i.e. 39,000 tons). Unfortunately, the threshold concentrations of algae that could be harmful to the health of farmed salmon in southern Chile have not yet been quantified. Here, to protect fish farms from HABs, critical concentration levels, i.e. thresholds at which the behavior of farmed Salmo salar is affected by harmful algae were quantified using generalized linear mixed models (GLMM). An extensive database from southern Chile covering the period from 1989 to 2016 was analyzed. The database included salmon behavior, cell abundance of microalgae and oceanographic factors. For both species analyzed, the higher the cell abundance, the greater the probability of detecting anomalous behavior. A threshold of 397 cells/mL was estimated for A. catenella, although it can increase up to ca. >975 cells/mL at a Secchi depth >6 m and up to 874 cells/mL during flood tide. A threshold value <1 cell/mL for Pseudochattonella cf. verruculosa was found to be associated with anomalous salmon behavior, which significantly increased at a water temperature of 11 °C. Evidence for a relationship between fish behavior and mortality is provided.

Improving gold nanorod delivery to the central nervous system by conjugation to the shuttle Angiopep-2.

AIM: To improve the in vivo delivery of gold nanorods (GNRs) to the central nervous system of rats, these gold nanoparticles were conjugated to Angiopep-2, a shuttle peptide that can cross the blood-brain barrier. MATERIALS & METHODS: GNRs were synthesized and modified using polyethylene glycol and Angiopep-2 (GNR-PEG-Angiopep-2). The physicochemical properties, in vitro cytotoxicity and ex vivo biodistribution of the conjugate were examined. RESULTS: GNR-PEG-Angiopep-2 was stable over the following days, and the different concentrations that were tested did not affect the viability of microvascular endothelial cells. The conjugation of Angiopep-2 to GNRs enhanced the endocytosis of these particles (in vitro) and the accumulation in brains (in vivo), when compared with GNRs modified only with PEG. CONCLUSION: This study provides evidence that Angiopep-2 improves the delivery of GNRs to the brain parenchyma. This property is highly relevant for future applications of GNRs as platforms for photothermal and theranostic purposes.

Morphologic and immunohistochemical organization of the human habenular complex.

The habenular complex (HbCpx) is a phylogenetically conserved brain structure located in the epithalamus of vertebrates. Despite its fundamental role in decision-making processes and the proposed link between habenular dysfunction and neuropsychiatric conditions, little is known about the structural and functional organization of the HbCpx in humans. The goal of this study was thus to provide a first systematic morphologic and immunohistochemical analysis of the human HbCpx to begin dissecting its nuclear and subnuclear organization. Our results confirmed that the human HbCpx is subdivided into medial (MHb) and lateral (LHb) nuclei, each showing a large degree of intranuclear morphologic heterogeneity. Analysis of serially stained sections using a combination of morphologic and immunohistochemical criteria allowed the distinction of five subnuclei in both the MHb and LHb. Overall, the observed subnuclear organization of the MHb in humans resembles the organization of subnuclei in the MHb of rats. The shape, relative size, and intranuclear organization of the LHb, however, show significant differences. The contribution of the LHb to the entire HbCpx is about five times larger in humans than in rats. Noteworthy, a dorsal domain of the LHb that contains afferent myelinated fibers from the stria medullaris and shows GABA-(B) -R(1) immunoreactive cells, appears substantially enlarged in humans when compared to rats. This feature seems to account for a large part of the relative growth in size of the LHb in humans and opens the intriguing possibility of an increased influence of limbic and striatal afferents into the LHb of humans.

Abnormal glucose metabolism in Hispanic parents of children with acanthosis nigricans.

Objective. Assess the prevalence of abnormal glucose metabolism among Hispanic parents of children with acanthosis nigricans (AN). Methods. Hispanic families (n = 258) were evaluated for metabolic and anthropometric parameters including fasting glucose levels and AN status. Results. Mothers with AN+ children had IFG (17.3%) and 4% had glucose levels ≥126 mg/dL (P = 0.028) compared to 7.1% and 1.8% of mothers with AN- children, respectively. Mothers of AN+ children also had greater odds of having impaired fasting glucose levels (OR: 3.917, 95% CI: 1.475-10.404; P < 0.004) but this was not the case for fathers (OR: 1.125, 95% CI: 0.489-2.586; P = 0.781). Mothers of AN+ children were also more likely to be AN+ (OR: 5.76, 95% CI: 2.98-11.13, P < 0.001). Screening discovered glucose levels >126 mg/dL in 9% of fathers with AN+ children. Conclusions. Hispanic mothers of AN+ children are at higher risk of carbohydrate metabolism abnormalities. AN in children can be a marker for prevention and delay programs aimed at identifying adults at risk for diabetes.

Texas needs physicians trained in public health: a new 4-year integrated MD/MPH degree program.

Traditionally, medicine and public health have not worked as synergistic disciplines because they are based on fundamentally different models. However, a number of very recent imperatives emphasize the need for dual training in these fields to address major public health problems facing society as well as the documented and forecasted workforce shortages. In response to this need, two University of Texas institutions based in San Antonio, Texas, partnered in 2007 to offer a dual 4-year Doctor of Medicine/Master of Public health (MD/MPH) degree program, one of a handful in the nation. Approximately 65 students (or 10% of three consecutive medical school classes) are currently enrolled. The dual-degree program meets the requirements of both degree programs while giving shared MPH credit for relevant courses taken in the medical curriculum and medical school credit for some courses in the public health curriculum. However, 75% of the MPH coursework originates at the School of Public Health. Initial results from focus groups conducted after the first year showed a high degree of student satisfaction, with frequent comments that the program was broadening their perspective on medicine and influencing their career and life goals. A dual MD/MPH degree is an important option for all medical students as a means of addressing pressing health issues in our society through combined training in medicine and the broader areas of prevention and population health. The four-year MD/MPH program, while posing challenges for faculty and students, attracts community- and prevention-minded medical students, reduces training costs (housing/living costs and lost time and wages before entering residency), and allows students to progress with the rest of their class.

Alterações óssea e articulares na hanseníase / Bone and joint changes in leprosy

Objetivou-se o presente trabalho de modo a contribuir para a prevenção, o diagnóstico precoce e tratamento apropriado das lesões ósseas e articulares na hanseníase, reduzindo o impacto mundial das doenças deformantes e mutilantes. Assim, foi realizada uma série de estudos retrospectivos longitudinais e de corte transversal em pacientes recém diagnosticados com Hanseníase ou que receberam poliquimioterapia (PQT) em dose fixa, com o fim de avaliar as osteoartropatias e seus mecanismos fisiopatogênicos. Foi observada uma progressão das acropatias ósseas durante e após a PQT. Em uma amostra de 93 pacientes multibacilares tratados, observou-se, clinicamente, uma prevalência de 7,5 por cento de absorção nas extremidades. Ao incluir os dados radiológicos na análise de 105 pacientes, a prevalência aumentou para 21,7 por cento. A progressão das acropatias encontrou-se associada à neuropatia periférica e suas complicações, à presença de episódios reacionais crônicos e à manutenção de níveis séricos elevados de fator de necrose tumoral alfa. A reabsorção óssea persistiu ativa em 50 por cento dos 30 pacientes avaliados após 5 anos do fim da PQT. Em pacientes com episódios reacionais prolongados ou recorrentes, avaliados com técnicas de medicina nuclear, detectaram-se freqüentes alterações ósseas e articulares principalmente de natureza inflamatória e uma elevada prevalência (27 por cento) de osteoporose lombar. Nestes pacientes, as áreas de predomínio de osso trabecular foram mais afetadas por osteopenia, enquanto nos pacientes virgens de tratamento avaliados, observou-se osteopenia predominantemente em áreas de osso compacto (80 por cento dos pacientes). Os supracitados resultados sugerem que a reação imunoinflamatória é um fator importante envolvido no acometimento ósseo e articular na hanseníase, a qual age isoladamente ou em conjunto com os mecanismos de natureza infecciosa, neurológica e vascular. Os pacientes com neuropatia periférica e episódios reacionais recorrentes devem ser acompanhados e avaliados radiologicamente após a alta terapêutica.

Acculturation in the United States is associated with lower serum carotenoid levels: Third National Health and Nutrition Examination Survey.

This study examined the association of acculturation in the United States and serum carotenoid levels. The design was a cross-sectional, nationally representative survey of 16,539 participants, 17 years of age and older, from the Third National Health and Nutrition Examination Survey (NHANES III). The main outcome measures were serum levels of alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein/zeaxanthin, lycopene, and total carotenoids. Multivariate linear regression was used to model the association of serum carotenoids and country of birth, language of interview, and years in the United States. Adjustments were made for age, sex, years of education, race/ethnicity, body mass index, alcohol use, physical activity, serum cotinine, serum cholesterol, and vitamin/mineral usage. Individuals born in the United States who speak English had the lowest levels of carotenoids, and individuals born in Mexico had the highest levels of carotenoids, with the exception of lycopene. Years of residence in the United States was associated with lower alpha-carotene (4.18 vs 1.51), beta-carotene (20.21 vs 14.87), beta-cryptoxanthin (12.51 vs 8.95), lutein/zeaxanthin (25.15 vs 18.03), and total carotenoids (88.79 vs 75.44). Years residence in the United States was positively associated with higher lycopene levels (26.69 vs 32.03). Acculturation in the United States was associated with lower fruit and vegetable intake, as measured by serum carotenoid levels.

A cholinergic gating mechanism controlled by competitive interactions in the optic tectum of the pigeon.

We describe the operation of a midbrain neural circuit in pigeons that may participate in selecting and attending to one visual stimulus from the myriad displayed in their visual environment. This mechanism is based on a topographically organized cholinergic signal reentering the optic tectum (TeO). We have shown previously that, whenever a visual stimulus activates neurons in a given tectal location, this location receives a strong bursting feedback from cholinergic neurons of the nucleus isthmi pars parvocellularis (Ipc), situated underneath the tectum. Here we show that, if a second visual stimulus is presented, even far from the first, the feedback signal to the first tectal location is diminished or suppressed, and feedback to the second tectal location is initiated. We found that this long-range suppressive interaction is mostly mediated by the nucleus isthmi pars magnocellularis, which sends a wide-field GABAergic projection to Ipc and TeO. In addition, two sets of findings indicate that the feedback from the Ipc modulates the ascending output from the TeO. First, visually evoked extracellular responses recorded in the dorsal anterior subdivision of the thalamic nucleus rotundus (RtDa), receiving the ascending tectal output, are closely synchronized to this feedback signal. Second, local inactivation of the Ipc prevents visual responses in RtDa to visual targets moving in the corresponding region of visual space. These results suggest that the ascending transmission of visual activity through the tectofugal pathway is gated by this cholinergic re-entrant signal, whose location within the tectal visual map is dynamically defined by competitive interactions.

Comparison of health behaviors among single- and multiple-member households.

OBJECTIVE: To assess the differences in health behavior between multiple-member and single-member households by gender. METHODS: Face-to-face household survey interviews were conducted. The relationship between health behaviors and living arrangement was assessed by adjusting for SES. RESULTS: Women living alone exercised more and ate less food high in fat. More highly educated men were less likely to exercise 5 or more times a week than high school or less educated men. CONCLUSIONS: By analyzing local data, a profile can be established to develop and implement appropriate public health programs aimed at these various target communities for effective intervention and healthy change in the community.

High blood pressure in school children: prevalence and risk factors.

BACKGROUND: The purpose of this study was to determine the prevalence of high blood pressure (HBP) and associated risk factors in school children 8 to 13 years of age. METHODS: Elementary school children (n = 1,066) were examined. Associations between HBP, body mass index (BMI), gender, ethnicity, and acanthosis nigricans (AN) were investigated using a school based cross-sectional study. Blood pressure was measured and the 95th percentile was used to determine HBP. Comparisons between children with and without HBP were utilized. The crude and multiple logistic regression adjusted odds ratios were used as measures of association. RESULTS: Females, Hispanics, overweight children, and children with AN had an increased likelihood of HBP. Overweight children (BMI > or = 85th percentile) and those with AN were at least twice as likely to present with HBP after controlling for confounding factors. CONCLUSION: Twenty one percent of school children had HBP, especially the prevalence was higher among the overweight and Hispanic group. The association identified here can be used as independent markers for increased likelihood of HBP in children.

Prevalence of risk for type 2 diabetes in school children.

According to the Centers for Disease Control and Prevention, 1 in 3 children born in 2000 in the United States will become diabetic. The odds are higher for African American and Hispanic children as nearly 50% of them will develop diabetes. Random screening is not effective in identifying children at risk for type 2 diabetes mellitus (T2DM); therefore, there is a need to apply screening strategies that guide the development of appropriate primary prevention efforts. To assess the prevalence of risk factors for T2DM, 1066 fifth-grade children were screened using American Diabetes Association guidelines. Overall, 22.6% were found at risk; African American and Hispanic children were almost 8 times more likely to be at risk when compared to Caucasians (odds ratio = 7.41 and 7.87). Children who reported watching TV/playing video games 2 or more hours/day were 73% more likely to be at risk. Children identified to be at risk were referred to their primary care provider and were invited to participate in a counseling session. The environmental risk factors for T2DM identified in this study are modifiable and should be targeted in preventive interventions at the school and community level to reduce overweight and consequently prevent T2DM in children, especially among minority children.

Health status and access to health care of documented and undocumented immigrant Latino women.

Immigrant Latino women represent about one fifth of the total Latino population; however, data on health status and access to care for this population is limited. Using secondary data, we used a cross-sectional study to examine sociodemographic, migration, health status, and access to health care characteristics of immigrant documented and undocumented Latino women in North Texas. Undocumented women were less likely to report having health insurance and a regular health care provider, and reported lower education and income. These results support the need for providing immigrant women with health services such as health fairs, affordable health insurance programs, community health services, and increased opportunities for participation in federal and state programs.

Hispanic physicians' tobacco intervention practices: a cross-sectional survey study.

BACKGROUND: U.S. Hispanic physicians constitute a considerable professional collective, and they may be most suited to attend to the health education needs of the growing U.S. Hispanic population. These educational needs include tobacco use prevention and smoking cessation. However, there is a lack of information on Hispanic physicians' tobacco intervention practices, their level of awareness and use of cessation protocols, and the type of programs that would best address their tobacco training needs. The purpose of this study was to assess the tobacco intervention practices and training needs of Hispanic physicians. METHODS: Data was collected through a validated survey instrument among a cross-sectional sample of self-reported Hispanic physicians. Data analyses included frequencies, descriptive statistics, and factorial analyses of variance. RESULTS: The response rate was 55.5%. The majority of respondents (73.3%) were middle-age males. Less than half of respondents routinely performed the most basic intervention: asking patients about smoking status (44.4%) and advising smoking patients to quit (42.2%). Twenty-five percent assisted smoking patients by talking to them about the health risks of smoking, providing education materials or referring them to cessation programs. Only 4.4% routinely arranged follow-up visits or phone calls for smoking patients. The majority of respondents (64.4%) indicated that they prescribe cessation treatments to less than 20% of smoking patients. A few (4.4%) routinely used behavioral change techniques or programs. A minority (15.6%) indicated that they routinely ask their patients about exposure to tobacco smoke, and 6.7% assisted patients exposed to secondhand smoke in understanding the health risks associated with environmental tobacco smoke (ETS). The most frequently encountered barriers preventing respondents from intervening with patients who smoke included: time, lack of training, lack of receptivity by patients, and lack of reimbursement by third party payers. There was no significant main effect of type of physician, nor was there an interaction effect (gender by type of physician), on tobacco-related practices. CONCLUSION: The results indicate that Hispanic physicians, similarly to U.S. physicians in general, do not meet the level of intervention recommended by health care agencies. The results presented will assist in the development of tobacco training initiatives for Hispanic physicians.

Race and ethnic disparities in cervical cancer screening in a safety-net system.

OBJECTIVES: The three objectives of this research were: 1) to examine the use of Pap smear tests among low-income women, including minority and immigrant women who were patients in a safety-net healthcare system; 2) to identify policy relevant variables that could lead to changes in use of Pap smear screening services for these women; and 3) to contribute to the literature on use of Pap smear screening, especially among minorities and immigrants. The Behavioral Model for Vulnerable Populations was used as the theoretical framework. METHODS: Pap smear screening predictors were examined using telephone interviews with a random sample of women aged 18-60, including 465 Non-Hispanic Whites, 285 African Americans, 164 Hispanic Americans, and 256 Hispanic immigrants, enrolled in a safety-net healthcare system in Texas in Fall 2000. Binary logistic regression analysis was used. RESULTS: The research revealed that Non-Hispanic Whites were most likely to have been screened ever and in the past 3 years, followed by African Americans, Hispanic immigrants, and Hispanic Americans. Among Hispanics, immigrants were most likely to have had Pap smear screening, supporting the "healthy immigrant hypothesis." Older women were most likely to have ever been screened, with younger women, most likely in the past year. Having a usual source of healthcare and a checkup for current pregnancy increased screening, while competing needs (food, clothing, housing) affected screening negatively. CONCLUSIONS: Culturally competent, community-based care for women is needed to increase Pap smear screening among minority groups, especially Hispanic immigrant and Hispanic American women.

Evaluación de la capacidad del selle del Pro-Root condensado en forma manual o ultrasónica, posterior a la retropreparación apical con ultrasonido o micro-contrángulo / Evaluation of margial seal between manual and ultrasonic condensation with the ProRoot system after apical with ultrasound or contrangle

El propósito de este estudio fue evaluar la capacidad de sellado del Pro-Root (MTA), condensado en forma manual o ultrasónica, luego de realizar la retropreparación apical con ultrasonido o microcontraángulo. Se tomaron 50 dientes extraídos de humanos los cuales se decoronaron; los conductos radiculares fueron preparados con técnica crow-down y obturados con técnica de condensación lateral y vertical. Después de la resección apical, los dientes se dividieron en 2 grupos: Grupo A: 20 dientes preparados apicalmente con ultrasonido y obturados retrógradamente con ProRoot subdividido en: A1, 10 dientes condensados con instrumento manual: A2, 10 dientes condesados con ultrasonido. El grupo B compuesto por 20 dientes preparados apicalmente con microcontraángulo y obturados retrógradamente con ProRoot se subdividió en B1:10 dientes condensados con instrumento manual; B2: dientes condensados con ultrasonidos. Los especimenes fueron sumergidos en cloruro de potasio al 1 por ciento durante 30 días para evaluar la Microfiltración con test electroquímico. La comparación entre los grupos no mostró diferencias estadísticamente significativas hasta los 20 días. A los 25 y 30 días los Grupos B1 y B2 mostraron significativamente mayor Microfiltración que los otros grupos. Se observó mayor Microfiltración en los dientes preparados apicalmente con microcontrángulo y condensados en forma manual y ultrasónicamente...

Cardiovascular risk factors in Mexican-American children at risk for type 2 diabetes mellitus (T2DM).

PURPOSE: To assess risk factors for type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) with the hypothesis that risk for T2DM in children would be associated with an increase in risk factors for CVD. METHODS: Subjects from a group of Mexican-American school children (aged 10-12 years) identified to be at risk for T2DM, and their siblings, were selected for this study. There were 68 children with acanthosis nigricans (AN+), and 71 without AN (AN-). Both AN+ and AN- children were assessed for T2DM and CVD risk factors. Probands and siblings were evaluated by physical examination, family history, and fasting serum parameters: glucose, insulin, body mass index (BMI), serum lipoproteins, and oxidized lipids. Data were analyzed by descriptive, univariate, and multivariate procedures. RESULTS: BMI, waist/hip ratio, systolic and diastolic blood pressure were all significantly higher (p <.002) in AN+, whereas Tanner stages were similar in both groups. Fasting serum glucose was in the normal range, whereas insulin was elevated in AN+ compared with AN- (30.0 +/- 1.9 microU/mL vs. 14.8 +/- 1.0 p <.0001). Insulin resistance as assessed by the homeostasis assessment model (HOMA-IR) was elevated in both groups, although higher among AN+ (p <.0001). High-density lipoprotein-cholesterol (HDL-C) was lower (6.2 mg/dL) in the AN+ group (p <.003). The lower HDL-C in AN+ was associated with elevated triglycerides and a higher serum total cholesterol TC/HDL-C ratio when contrasted with the AN- values (145.9 +/- 7.6 mg/dL vs. 97.1 +/- 0.07, p <.0001; 4.1 +/- 0.2 vs. 3.4 +/- 0.1, p <.0001, respectively). In addition to the high prevalence of overweight/obesity (BMI > 85th percentile) in this population (76.3%, 106/139), elevated insulin (59.7% >15 microU/mL), low HDL-C (27.3% <40 mg/dL), and elevated low-density lipoprotein cholesterol (LDL-C) (41.0% >100 mg/dL) were also detected. CONCLUSIONS: The altered metabolic pattern observed in this group of Mexican-American children is characteristic of metabolic syndrome, a condition associated with obesity and increased risk for both T2DM and CVD in adults. This study points to the value of BMI and acanthosis nigricans as easily accessible markers for children and nuclear families at increased risk for developing T2DM and CVD.

Vínculos tempranos y trastorno de pánico: un estudio controlado / Early attachment and panic disorder: a controlled study

El TP se define por la recurrencia de episodios abruptos de intensa angustia, asociada a una variedad de síntomas corporales desagradables y cogniciones catastróficas. Bowlby plantea que las experiencias de separación temprana se asocian con la aparición de trastornos emocionales en la adultez. Los estudios sistemáticos que han buscado una asociación entre TP y eventos biográficos de separación temprana (EBS) arrojan resultados contradictorios. En el presente estudio se compararon los reportes de EBS en 55 pacientes con TP y un grupo de 56 sujetos de comparación (GC) sin patología emocional evidente. Se aplicó una entrevista semiestructurada, en la cual se categorizaron los EBS en pérdidas reales, pérdidas simbólicas y amenaza de ruptura del vínculo. Se estudió también la frecuencia de trastornos ansiosos de la infancia. Se encontraron diferencias estadísticamente en favor del grupo con TP al comparar los eventos simbólicos de separación y la amenaza de ruptura del vínculo, pero no así en los eventos reales. También hubo diferencias significativas en todos los tipos de trastornos por ansiedad de la infancia. Los hallazgos de este estudio sugieren que habría una asociación del TP con la percepción subjetiva de vínculos tempranos inestables y con todas las formas de trastornos ansiosos de la infancia