Distribution and Characteristics of Congenital Cardiac Surgery Centers within Bangladesh.

Congenital heart disease is a leading cause of non-communicable childhood death. This is especially true in nations with limited resources where shortages of skilled workforce, healthcare facilities, and essential equipment limit the ability to provide care. This retrospective study was designed to determine the volume and distribution of surgical care being provided to patients with congenital heart disease in Bangladesh, as well as to characterize the facilities providing such care. Pre-existing survey data of hospitals performing congenital heart surgery in the year 2022 in Bangladesh was obtained. Additional information was gathered on these facilities, including hospital location and type. The distribution of care by geographic location, type of facility, and volume of cases was reported. Overall, a total of 2333 surgeries were performed in 2022 at 28 facilities. The majority of hospitals were performing <50 cases per year, while a small number (5) provided greater than 50.0% of all surgeries. In addition, while the majority of hospitals were private in nature, the majority of surgeries occurred at not-for-profit hospitals. There was a large geographic skew of surgeries and hospitals being located within the city of Dhaka (79.0% of centers and 94.0% of surgeries). The data suggests that, though there has been great progress in increasing the number of surgeries performed in Bangladesh, the vast majority of patients still do not have access to care. In addition, nearly all care is being provided in Dhaka, which presents challenges for patients who come from across the nation seeking care. Finally, there is a great need for further research to fully understand the challenges faced and find workable solutions.

Impacto de la dislalia y disglosia en la comprensión verbal en escolares con necesidades especiales; Cuenca, Ecuador / The impact of dyslalia and dysglossia on verbal comprehension in schoolchildren with special needs; Cuenca, Equator

Este estudio analiza la relación entre los trastornos del lenguaje y la comprensión verbal en estudiantes que fueron evaluados como parte del pilotaje desarrollado por el proyecto de investigación "Efectividad del programa integral escalonado en pacientes con necesidades educativas especiales por trastornos del lenguaje y articulación", en la Unidad de Diagnóstico, Investigación Psicopedagógica y Apoyo a la Inclusión (UDIPSAI), Centro de Práctica y Relación con la Sociedad de la Universidad Católica de Cuenca. Se trata de un estudio observacional de tipo descriptivo y analítico; la técnica utilizada fue la psicometría y los instrumentos fueron pruebas para evaluar los trastornos del lenguaje y la inteligencia. Se aplicó la Prueba de Funciones Prelinguísticas y órganos fonoarticuladores, la Prueba de Articulación y la Prueba de Evaluación Clínica de los Fundamentos del Lenguaje. Para calificar la comprensión verbal se utilizó Weschler para niños -V (WISC-V) que investiga la capacidad individual dividida en escalas primarias. Para la investigación se consideró el Indice de Comprensión Verbal con las subescalas de similitudes, vocabulario, comprensión, información y acertijos. Se concluyó que la comprensión verbal es un factor importante para la presencia de trastornos del lenguaje y articulación en niños (AU)

Abundancia relativa y patrones de actividad de Didelphis marsupialis en un área periurbana de Medellín, Colombia / Relative abundance and activity patterns of Didelphis marsupialis in a peri-urban area of Medellin, Colombia

RESUMEN Objetivo. Determinar la abundancia relativa y los patrones de actividad de la zarigüeya común (Didelphis marsupialis) en una zona periurbana del municipio de Medellín, departamento de Antioquia. Materiales y métodos. El estudio se desarrolló en la sede de prácticas y clínica veterinaria Remington ubicada en el corregimiento de Santa Elena. Para el registro de datos se empleó la metodología de fototrampeo durante 3 meses (junio-agosto de 2017), invirtiendo un esfuerzo total de 166 días/trampa. Resultados. Se obtuvieron un total de 275 registros independientes de la especie y se estimó una abundancia relativa de 52.88. El patrón de actividad muestra un primer pico de actividad al comienzo de la noche (19:00) y un segundo pico en la madrugada (3:00), con una posterior disminución hacia las horas de la madrugada. Conclusiones. Los resultados muestran una abundancia relativa alta con respecto a otras localidades en Colombia, además de evidenciar una población reproductivamente activa. Al mismo tiempo se convierten en una herramienta para el fortalecimiento de estrategias de conservación y sensibilización a los pobladores locales sobre la fauna de la región.

ABSTRACT Objective. The relative abundance and activity patterns of the common opossum Didelphis marsupialis were determined in a peri-urban area of Medellín municipality, Antioquia department. Materials and methods. The study was developed in the Remington Veterinary practice at Santa Elena Corregimiento. The data recording was carried out through camera trapping methodology for three months (June-August 2017) with a total effort of 166 days-camera. Results. With a total of 275 independent records, we calculate the relative abundance index (52.88 UNITS). The activity patterns show a first activity peak beginning the night (19:00) and a second one after midnight (3:00), reducing the activity in the sunrise hours. Conclusions. These results present a high relative abundance in comparison to another Colombian localities, besides a population active reproductively. At the same time, they become a tool to support conservation strategies and sensitizing local people about the wildlife of this region.

Microbiological aspects related to the feasibility of PEF technology for food pasteurization.

Processing unit operations that seek to inactivate harmful microorganisms are of primary importance in ascertaining the safety of food. The capability of pulsed electric fields (PEF) to inactivate vegetative cells of microorganisms at temperatures below those used in thermal processing makes this technology very attractive as a nonthermal pasteurization process for the food industry. Commercial exploitation of this technology for food pasteurization requires the identification of the most PEF-resistant microorganisms that are of concern to public health. Then, the treatment conditions applicable at industrial scale that would reduce the population of these microorganisms to a level that guarantees food safety must be defined. The objective of this paper is to critically compile recent, relevant knowledge with the purpose of enhancing the feasibility of using PEF technology for food pasteurization and underlining the required research for designing PEF pasteurization processes.

Inactivation of Salmonella spp. in liquid whole egg using pulsed electric fields, heat, and additives.

This paper evaluates the lethal effectiveness on 7 different Salmonella serovars of the application, in static and continuous conditions, of pulsed electric fields (PEF) followed by heat treatments in liquid whole egg (LWE) with additives (EDTA or triethyl citrate-TC-). Compared to heat treatments, the PEF (25 kV/cm and 75-100 kJ/kg) followed by heat (52°C/3.5', 55°C/2', or 60°C/1') in LWE with 2% TC permitted the reduction of heat treatment time from 92 fold at 52°C to 3.4 fold at 60°C, and 4.8 fold at 52°C in LWE with EDTA for a 9-Log(10) reduction of the population of Salmonella Enteritidis. The new designed treatments inactivated more than 5 Log(10) cycles of Salmonella serovars Dublin, Enteritidis 4300, Enteritidis 4396, Typhimurium, Typhi, Senftenberg, and Virchow, both in static and continuous conditions. Conversely, current heat pasteurization treatments of 60°C/3.5' and 64°C/2.5' reduced 5 Log(10) cycles of various serovars of Salmonella but only 2 and 3-4 Log(10) cycles of Salmonella Senftenberg and Salmonella Enteritidis 4396, respectively. Soluble protein content (SPC) decreased 1.8%, 1.3%, and 5.0% after the successive application of PEF followed by heat at 52, 55, and 60°C in the presence of 2% TC, respectively, whereas 1.6% and 9.4% of SPC were reduced after heat pasteurization at 60 and 64°C, respectively. Results indicate that designed treatments could be an alternative to current heat pasteurization of LWE as showed higher lethal effectiveness against Salmonella serovars with a similar or even lower decrement of the soluble protein content.

Pioglitazone improves the cardiovascular profile in patients with uncomplicated systemic lupus erythematosus: a double-blind randomized clinical trial.

OBJECTIVE: We studied the effect of pioglitazone on insulin levels, inflammation markers, high-density lipoprotein (HDL) composition and subclasses distribution, in young women with uncomplicated systemic lupus erythematosus (SLE). METHODS: This double-blind trial included 30 premenopausal women (30 ±8 years old) with SLE, who were randomized to pioglitazone (30 mg/day) or placebo treatment for 3 months. Plasma and HDL lipids were determined by colorimetric enzymatic assays, insulin by radioimmunometric assay, inflammation by immunonephelometry and HDL size and subclasses distribution by a native 4-30% polyacrylamide gradient gel electrophoresis. RESULTS: Compared with placebo, pioglitazone significantly increased HDL-cholesterol plasma levels (14.2%), reduced fasting insulin plasma levels (23.6%) and the homeostasis model assessment-insulin resistance (31.7%). C-reactive protein (70.9%) and serum amyloid A (34.9%) were also significantly reduced with the pioglitazone use, whereas the HDL particle size was increased (8.80 nm vs. 8.95 nm; p = 0.044) by changes in the distribution of HDL(2b), HDL(3b), and HDL(3c) subclasses. The change in HDL size correlated with a rise in free and cholesterol-ester content in the HDL particles. CONCLUSION: Pioglitazone significantly enhanced insulin sensitivity, reduced inflammation, and modified HDL characteristics, suggesting a potential beneficial effect of this drug in patients with SLE with a risk to develop cardiovascular disease. TRIAL REGISTRATION: This trial is registered at ClinicalTrials.gov Protocol Registration System, with the number NCT01322308.

Concordancia entre histología pre, intra y postoperatoria en cáncer de endometrio / Concordance between pre and intraoperatory biopsy in endometrial cancer

Antecedentes: En pacientes con cáncer de endometrio se discute la concordancia entre biopsia pre e intraoperatoria versus la definitiva, en grado de diferenciación, tipo histológico y profundidad de mioinvasión. Método: Se determinó sensibilidad (S), especificidad (E), valor predictivo positivo (VPP) y valor predictivo negativo (VPN) de: grado de diferenciación bien diferenciado y tipo histológico sólo endometrioide en biopsia preoperatoria; y grado de diferenciación bien diferenciado, tipo histológico sólo endometrioide y profundidad de mioinvasión menor o igual a la mitad interna del miometrio, en biopsia intraoperatoria, para resultados similares en biopsia definitiva en serie clínica de pacientes con cáncer de endometrio clínicamente limitado al útero sometidas a tratamiento quirúrgico primario. Resultados: Biopsia preoperatoria: grado de diferenciación bien diferenciado S: 100 por ciento, E: 77,8 por ciento, VPP: 78,9 por ciento y VPN: 100 por ciento. Tipo histológico sólo endometrioide S: 86,4 por ciento, E: 33,3 por ciento, VPP: 86,4 por ciento y VPN: 33,3 por ciento, para resultado similar en biopsia definitiva. Biopsia intrao-peratoria: grado de diferenciación bien diferenciado S: 91,7 por ciento, E: 94,4 por ciento, VPP: 91,7 por ciento y VPN: 100 por ciento. Tipo histológico sólo endometrioide S: 95,7 por ciento, E: 77,8 por ciento, VPP: 95,7 por ciento y VPN: 70 por ciento. Profundidad de mioinvasión menor o igual a mitad interna del miometrio S: 95,2 por ciento, E: 30 por ciento, VPP: 74,1 por ciento y VPN: 75 por ciento, para resultado similar en la biopsia definitiva. Conclusión: No hubo concordancia absoluta de grado de diferenciación bien diferenciado entre biopsia preoperatoria y biopsia definitiva, ni de grado de diferenciación bien diferenciado ni tipo histológico sólo endometrioide entre biopsia intraoperatoria y biopsia definitiva, por lo que se recomienda etapificación quirúgica independiente de los resultados de las biopsias pre e...

Background: Among patients with endometrial cancer there is discussion about concordance between pre and intraoperatory biopsy and the definitive one, for diferentiation grade, histologyc type and depth of myoinvasion. Method: To determinate sensibility (S), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of: good diferenciated diferentiation grade and only endometrioid histologyc type on preoperatory biopsy, and good diferenciated diferentiation grade, only endometrioid histologyc type and inner half of the miometryum or less myoinvasion depth on intraoperatory biopsy, for similar result on definitive biopsy in a clinical cohort of patients with endometrial cancer clinically limited to uterus treated with primary surgery. Results: Preoperatory biopsy: good diferentiated diferentiation grade S: 100 percent, Sp: 77.8 percent, PPV: 78.9 percent and NPV: 100 percent. Only endometrioid histologyc type S: 86.4 percent, Sp: 33.3 percent, PPV 86.4 percent and NPV 33.3 percent, for similar result on definitive biopsy. Intraoperatory biopsy: Good diferentiated diferentiation grade S: 91.7 percent, Sp: 94.4 percent, PPV: 91.7 percent and NPV 100 percent. Only endometrioid histologyc type S: 95.7 percent, Sp 77.8 percent, PPV 95.7 percent and NPV 70 percent. Inner half of the myometrium or less myoinvasion depth S: 95.2 percent, Sp 30 percent, PPV 74.1 percent and NPV 75 percent, for similar result on definitive biopsy. Conclusion: There wasn't absolute concordance of good diferentiated diferentiation grade between preoperatory and definitive biopsy. Also there weren't absolute concordance of neither good diferentiated diferentiation grade, nor only endometrioid histologyc type, between intraoperatory and definitive biopsy, for that it is recommended surgical staging, independent of results of pre and intraoperatory biopsies.

Defining treatment conditions for pulsed electric field pasteurization of apple juice.

The influence of temperature and the presence of N(α)-lauroyl ethylester (ethyl lauroyl arginate, LAE) on the inactivation caused by continuous pulsed electric field treatments (PEF) in Escherichia coli O157:H7 suspended in apple juice have been investigated to define treatment conditions applicable at industrial scale that promote an equivalent safety level when compared with thermal processing. In the range of experimental conditions investigated (outlet temperature: 20-40 °C, electric field strength: 20-30 kV, treatment time: 5-125 µs) at outlet temperatures equal or lower than 55±1 °C, the inactivation of E. coli O157:H7 treated in apple juice ranged from 0.4 to 3.6 Log10 cycles reduction and treated in apple juice supplemented with LAE (50 ppm) ranged from 0.9 to 6.7 Log10 cycles reduction. An empirical mathematical model was developed to estimate the treatment time and total specific energy input to obtain 5 Log10 cycles reduction in the population of E. coli O157:H7 suspended in apple juice supplemented with 50 ppm of LAE at different electric field strengths and inlet temperatures. Treatment conditions established for E. coli O157:H7 were validated with other PEF resistant Gram-positive (Listeria monocytogenes, and Staphylococcus aureus) and Gram-negative (Salmonella enterica serovar Typhimurium) strains. When the treatment was applied to the apple juice, a treatment of 25 kV/cm for 63 µs corresponding with an outlet temperature of 65 °C and input energy of 125 kJ/kg was required to achieve more than 5 Log10 cycles in the four strains investigated. The addition of LAE reduced the treatment time required to obtain an equivalent inactivation (>5 Log10 cycles) in the four microorganisms to 38.4 µs, the outlet temperature to 55 °C, and the input energy to 83.2 kJ/kg.

Inactivation kinetics of pulsed electric field-resistant strains of Listeria monocytogenes and Staphylococcus aureus in media of different pH.

A study of the effect of pulsed electric fields (PEF) on the inactivation of Listeria monocytogenes STCC 5672 and Staphylococcus aureus STCC 4459 in McIlvaine buffer covering a range from pH 3.5 to 7.0 was conducted. Mathematical models based on the Weibull distribution were developed to describe the influence of the electric field strength, treatment time and pH of the treatment medium on the lethality of both Gram positive pathogenic bacteria after PEF treatments. Both microorganisms were more sensitive to PEF in media of low pH, although the influence of the pH on the PEF resistance was more significant in S. aureus. In the best cases scenario, the highest inactivation levels achieved were 3.3 and 6.1 log(10) cycles for L. monocytogenes and S. aureus respectively in pH 3.5 after 500 micros of 35 kV/cm. Based on these results and those observed in literature, L. monocytogenes STCC 5672 at any pH investigated has been shown as one of the most PEF resistant microorganism. Therefore, this microorganism should be considered as a possible target microorganism to define process criterion for PEF pasteurization.

Apo(a) phenotyping and long-term prognosis for coronary artery disease.

OBJECTIVES: Identify whether the plasma concentration of Lp(a), apo(a) size or a greater affinity for fibrin predict the likelihood of cardiac death, non-fatal myocardial infarction, unstable angina, the need for additional revascularization, and stroke (MACCE). DESIGN AND METHODS: We analyzed the clinical prognosis of 68 patients with coronary artery disease included in a case-controlled study which evaluated Lp(a) concentration, apo(a) size, and Lp(a) fibrin-binding. Cohort was conducted over a median of 8 years. We used Kaplan-Meier survival tables to evaluate cardiovascular and cerebrovascular events in the follow-up period. RESULTS: Apo(a) isoforms of small size are predictors of MACCE. We find an association between Lp(a) concentration and apo(a) fibrin-binding with major adverse cardiovascular and cerebrovascular events, although without statistically significant results. CONCLUSIONS: Small-sized apo(a) isoforms are an independent risk factor for MACCE in patients with coronary artery disease in follow-up. Lp(a) plasma concentration and apo(a) fibrin-binding were associated, although not significant.

Effect of pulsed electric field processing of red grapes on wine chromatic and phenolic characteristics during aging in oak barrels.

The influence of a pulsed electric field (PEF) treatment of grape berries at pilot-plant scale on the evolution of the chromatic and phenolic characteristics of Cabernet Sauvignon red wines during aging in American oak barrels and subsequent storage in bottle has been studied. Results obtained in this investigation confirm that the better chromatic characteristics and higher phenolic content obtained due to the PEF treatment after the fermentation process remain or even increase during aging in oxidative conditions in American oak barrels and their subsequent storage in bottle. No sensory differences in color and bouquet were detected after 8 months of aging in bottle by triangle tests. According to the results, PEF is a promising enological technology to obtain wines with the high phenolic content necessary for the production of high quality oak aged red wines.

A comparison of the effect of macerating enzymes and pulsed electric fields technology on phenolic content and color of red wine.

The effect of the addition of 2 enzymatic preparations and the application of a pulsed electric fields treatment (PEF) on the phenolic content and color of Cabernet Sauvignon wine has been compared. The evolution of color intensity (CI), anthocyanic content (AC), and total polyphenol index (TPI) from crushing to 3 mo of aging in bottle was studied. The results demonstrated that both treatments promoted greater extraction of phenolic compounds, compared to the untreated wine. However, PEF technology was more effective. After 3 mo of storage, CI, AC, and TPI were 28%, 26%, and 11%, respectively, higher in PEF-wine than in control wine. By contrast, while both enzymatic preparations increased the CI of the wine around 5%, only one of them increased the AC and TPI by 11% and 3%, respectively, in comparison with the control. After 3 mo of aging in bottle, the phenolic composition was also analyzed by high-performance liquid chromatography (HPLC). The content of nonanthocyanic families was higher in PEF-wine than in the rest of the wines. In wines treated by enzymes, only an increase in phenolic acids and flavonols with respect to the control was detected. Practical Application: Pulsed electric fields is a novel food processing technology that poses a very promising future to the enological field, due to its capacity to improve the mass transfer phenomenon. The continuous development of this technology allows nowadays the application of treatments at the semi-industrial scale. In this article, it has been demonstrated that the application of a PEF treatment to the grape pomace before maceration/fermentation is more effective, in terms of color intensity and phenolic content, than the addition of macerating enzymes.

High-density lipoproteins are abnormal in young women with uncomplicated systemic lupus erythematosus.

Little is known about qualitative abnormalities of high-density lipoproteins (HDL) in systemic lupus erythematosus (SLE). We studied distribution and composition of HDL subclasses in 30 premenopausal women with uncomplicated SLE, and 18 controls matched for age and sex. Plasma and HDL lipids were determined by colorimetric enzymatic assays, HDL size distribution by native gradient polyacrylamide gel electrophoresis (PAGE) and apolipoproteins in HDL by sodium dodecyl sulphate denaturing PAGE. Compared with controls, SLE patients had significantly lower proportions of HDL(2b) (-14.7%) and higher proportions of HDL(3b) (+8.8%) and HDL(3c) (+23.3%). Cholesteryl ester (-18%) and apolipoprotein AI (-9%) were lower, whereas triglycerides (+32%) and apolipoprotein E (+27%) were higher in SLE HDL (P < 0.05; for all). In the whole population, stepwise regression analysis showed that only insulin concentrations (R(2) = 0.327) and plasma total apo AI (R(2) = 0.114) accounted independently to the variance in HDL size. This study shows that HDL distribution and composition are abnormal in non-complicated SLE patients. These HDL abnormalities have been reported to be associated to impaired atheroprotective properties of HDL and prevalence of coronary heart disease. Therefore, they may contribute to the premature atherosclerosis observed in young women with SLE.

C-reactive protein levels and their relationship with metabolic syndrome and insulin resistance in Mexican adolescents.

OBJECTIVE: To investigate the relationship of high sensitive C-reactive protein (hs-CRP) with metabolic syndrome components and insulin resistance in Mexican adolescents. METHODS: 325 adolescents, 182 girls and 143 boys, aged 12-16 years were studied. Standardized clinical measurements and plasma lipids, glucose, insulin and hs-CRP were determined. For metabolic syndrome (MS), the NCEP-ATP III definition was used. RESULTS: MS prevalence was 13%. The most frequent MS components were low HDL-C (50%), high triglycerides (35%), and high waist circumference (28%). hs-CRP median and 75th percentile values for all children were 0.42 and 0.97 mg/dl, respectively. The highest values of hs-CRP were found in children who had MS, p <0.007. hs-CRP was positively correlated with waist circumference, triglycerides, and negatively with HDL-C, p <0.01, and positively with insulin, p <0.001. In stepwise multiple regression analysis, body mass index and HOMA-IR accounted for 10.4% and 12.7% of hs-CRP levels, respectively. CONCLUSIONS: Body mass index and insulin resistance have an independent effect on high hs-CRP levels, and explain a large part of hs-CRP concentrations in adolescents. Central adipose tissue might induce an inflammatory state that could be identified from adolescence.

Ethnicity and lipoprotein(a) polymorphism in Native Mexican populations.

BACKGROUND: Lp(a) is a lipoparticle of unknown function mainly present in primates and humans. It consists of a low-density lipoprotein and apo(a), a polymorphic glycoprotein. Apo(a) shares sequence homology and fibrin binding with plasminogen, inhibiting its fibrinolytic properties. Lp(a) is considered a link between atherosclerosis and thrombosis. Marked inter-ethnic differences in Lp(a) concentration related to the genetic polymorphism of apo(a) have been reported in several populations. AIM: The study examined the structural and functional features of Lp(a) in three Native Mexican populations (Mayos, Mazahuas and Mayas) and in Mestizo subjects. METHODS: We determined the plasma concentration of Lp(a) by immunonephelometry, apo(a) isoforms by Western blot, Lp(a) fibrin binding by immuno-enzymatic assay and short tandem repeat (STR) polymorphic marker genetic analysis by capillary electrophoresis. RESULTS: Mestizos presented the less skewed distribution and the highest median Lp(a) concentration (13.25 mg dL(-1)) relative to Mazahuas (8.2 mg dL(-1)), Mayas (8.25 mg dL(-1)) and Mayos (6.5 mg dL(-1)). Phenotype distribution was different in Mayas and Mazahuas as compared with the Mestizo group. The higher Lp(a) fibrin-binding capacity was found in the Maya population. There was an inverse relationship between the size of apo(a) polymorphs and both Lp(a) levels and Lp(a) fibrin binding. CONCLUSION: There is evidence of significative differences in Lp(a) plasma concentration and phenotype distribution in the Native Mexican and the Mestizo group.

Functional approach to investigate Lp(a) in ischaemic heart and cerebral diseases.

BACKGROUND: Lp(a), a major cardiovascular risk factor, contains a specific apolipoprotein, apo(a), which by virtue of structural homology with plasminogen inhibits the formation of plasmin, the fibrinolytic enzyme. A number of clinical reports support the role of Lp(a) as a cardiovascular or cerebral risk factor, and experimental data suggest that it may contribute to atherothrombosis by inhibiting fibrinolysis. DESIGN: A well-characterized model of a fibrin surface and an apo(a)-specific monoclonal antibody were used to develop a functional approach to detect pathogenic Lp(a). The assay is based on the competitive binding of Lp(a) and plasminogen for fibrin, and quantifies fibrin-bound Lp(a). High Lp(a) binding to fibrin is correlated with decreased plasmin formation. In a transversal case-control study we studied 248 individuals: 105 had a history of ischaemic cardiopathy (IC), 52 had cerebro-vascular disease (CVD) of thrombotic origin, and 91 were controls. RESULTS: The remarkably high apo(a) fibrin-binding in CVD (0.268 +/- 0.15 nmol L-1) compared with IC (0.155 +/- 0.12 nmol L-1) suggests the existence of peculiar and poorly understood differences in pro- or anti-thrombotic mechanisms in either cerebral and/or coronary arteries. CONCLUSIONS: Our results demonstrated that Lp(a) fibrin-binding and small Apo(a) isoforms are associated with athero-thrombotic disease.

Association of visceral fat with coronary risk factors in a population-based sample of postmenopausal women.

OBJECTIVE: To investigate in a population-based random sample of postmenopausal women the adjusted association of visceral adipose tissue (VAT) with coronary risk factors. DESIGN: Cross-sectional population-based random sample study. SUBJECTS: Ninety-eight postmenopausal women (age 50-65 y). MEASUREMENTS: Visceral and subcutaneous fat areas by computer axial tomography, anthropometry, lipid profile, fasting glucose and insulin, diet, physical activity, smoking status and alcohol intake. RESULTS: Compared to women with low VAT, women with high VAT (>117.8 cm(2)) had a less favorable metabolic profile with significantly higher fasting glucose (120+/-50 vs 98+/-39), insulin (7.9+/-10 vs 5+/-8), triglycerides (172+/-69 vs 127+/-72), apolipoprotein B (119+/-24 vs 98+/-32) and significantly lower HDL-C (38+/-10 vs 46+/-14) values in the whole sample (n=98). A similar profile was found in women without diabetes and hypertension (n=39). In multiple regression models, VAT explained a portion of the variance of TG (6.2%) in the entire sample and of total cholesterol (12.4%), LDL-C (15.8%), triglycerides (16.3%), apolipoprotein B (11.6%), and fasting glucose (28.4%) in the group of non-diabetic or hypertensive women. Our VAT cut-off point of 117.8 cm(2) corresponded to a waist circumference of 84 cm. CONCLUSION: Our results in a random population-based sample of postmenopausal women confirm the association of VAT with most coronary risk factors. These associations persisted after adjusting for diet, physical activity, smoking status and alcohol intake.

Quantification of the ultraviolet radiation (UVR) field in the human eye in vivo using novel instrumentation and the potential benefits of UVR blocking hydrogel contact lens.

BACKGROUND/AIMS: Certain degenerative eye conditions occur predominantly nasally, at the limbal region, and are associated with solar ultraviolet radiation (UVR) induced damage. The relative contribution to the in vivo ocular flux of (a) the reflection of UVR incident on the skin of the nose onto the nasal limbus, and (b) the focusing of UVR incident on the temporal side of the cornea onto the nasal limbus were examined. METHODS: A novel photodiode sensor array was used to measure the UVR field across the eye. In addition, a novel spectrometer set-up was used to measure the spectrum of radiation refracted across the cornea. The efficacy of UVR blocking hydrogel contact lenses in filtering incident UVR was assessed in vivo. RESULTS: Qualitative and quantitative data indicated an increase nasally of UVR. Photodiode readings showed a net UVR increase from the temporal to the nasal side. Transmission curves showed that most UVR incident on the limbal region is either absorbed by, or transmitted through, the ocular tissues. This radiation is filtered by UVR blocking soft contact lens. CONCLUSIONS: An increased UVR flux on the nasal side of the eye, due to reflection off the nasal skin, was identified in vivo. Any UVR passing through the cornea is either absorbed by the conjunctiva and/or transmitted through it onto the sclera where it is absorbed. UVR blocking hydrogel contact lenses can eliminate these sources of UVR.

Differential effects of obesity with and without hyperinsulinemia on plasma lipoprotein(a) concentrations in men.

To determine the association of in vivo concentrations of insulin, obesity, and gender with lipoprotein(a) [Lp(a)] levels, we used a cross-sectional population-based survey of a multistage random sample of the Mexico City adult population. We studied 423 normoglycemic, normotensive subjects from an original sample of 825, comprised of 239 men and 189 women with a mean age of 38.6 years (range, 17 to 90). All subjects were divided into 8 groups according to body mass index, fasting insulin, and gender. Lp(a) concentrations (mg/dL) were similar in obese women with and without high insulin levels (19.9 v 18.6), but hyperinsulinemic obese men had significantly lower Lp(a) levels than normoinsulinemic obese men (7.9 v 29.4). In addition, the proportion of obese men with Lp(a) concentrations of > or = 30 mg/dL was significantly higher in the normoinsulinemic than in the hyperinsulinemic (29.2% v 0.0%). The frequency distribution of Lp(a) levels was shifted to a lower range in hyperinsulinemic men compared with normoinsulinemic men. Our results show that in men, hyperinsulinemic obesity is associated with low Lp(a) levels, while obesity with normoinsulinemia is related to increased Lp(a) concentration. These observations were not found in women. These findings may explain the conflicting results reported by several studies.