External validation of BIA equations to estimate appendicular skeletal muscle mass in older adults: Importance of the bias analysis and derivation of correction factors to achieve agreement.

There are several equations based on bioelectrical impedance analysis (BIA) to estimate with high precision appendicular skeletal muscle mass (ASM). However, most of the external validation studies have reported that these equations are inaccurate or biased when applied to different populations. Furthermore, none of the published studies has derived correction factors (CFs) in samples of community-dwelling older adults, and none of the published studies have assessed the influence of the dual-energy X-ray absorptiometry (DXA) model on the validation process. This study assessed the agreement between six BIA equations and DXA to estimate ASM in non-Caucasian older adults considering the DXA model and proposed a CF for three of them. This analysis included 547 non-institutionalized subjects over 60 years old from the northwest of Mexico who were physically independent and without cognitive impairment: 192 subjects were measured using DXA Hologic, while 355 were measured by DXA Lunar. The agreement between each of the equations and DXA was tested considering the DXA model used as a reference method for the design of each equation, using the Bland and Altman procedure, a paired t test, and simple linear regression as objective tests. This process was supported by the differences reported in the literature and confirmed in a subsample of 70 subjects measured with both models. Only six published BIA equations were included. The results showed that four equations overestimated ASMDXA, and two underestimated it (p < 0.001, 95% CI for Kim's equation:-5.86--5.45, Toselli's:-0.51--0.15, Kyle's: 1.43-1.84, Rangel-Peniche's: 0.32-0.74, Sergi's: 0.83-1.23, and Yoshida's: 4.16-4.63 kg). However, Toselli's, Kyle's and Rangel-Peniche's equations were the only ones that complied with having a homogeneous bias. This finding allowed the derivation of CFs, which consisted of subtracting or adding the mean of the differences from the original equation. After estimating ASM applying the respective CF, the new ASM estimations showed no significant bias and its distribution remained homogeneously distributed. Therefore, agreement with DXA in the sample of non-Caucasian was achieved. Adding valid CFs to some BIA equations allowed to reduce the bias of some equations, making them valid to estimate the mean values of ASM at group level.

Disparities in prostate cancer incidence and mortality rates: Solvable or not?

Prostate cancer (PCa) is recognized as a disease possessing not only great variation in its geographic and racial distribution but also tremendous variation in its potential to cause morbidity and death and it, therefore, ought not to be considered a homogenous disease entity. Morbidity and death from PCa are disproportionately higher in men of African ancestry (MAA) who are generally observed to have more aggressive disease and worse outcomes following treatment compared to men of European ancestry (MEA). The higher rates of PCa among MAA relative to MEA appear to be multifactorial and related to inherent differences in biological aggressiveness; a continued lack of awareness of the disease and methods of prevention; a lower prevalence of screen-detected PCa; comparatively lower access to quality healthcare as well as systemic and institutionalized disparities in the administration of optimal care to MAA in developed countries such as the United States of America where high-quality care is available. Even when access to quality healthcare is assured in equal access settings, it appears that MAA still have worse outcomes after PCa treatment stage-for-stage and grade-for-grade compared to MEA, suggesting that, inherent racial, ethnic and biological differences are paramount in predicting poor outcomes. This review has explored the different contributing factors to the current disparities in PCa incidence and mortality rates with emphasis on the incongruence in how research has been conducted in understanding the disease towards developing therapies.

Evaluación del Índice de Korkhaus en adultos chilenos con oclusión normal / Evaluation of Korkhaus Index in Chilean adult individuals with normal occlusion

El examen de modelos es una de las múltiples herramientas diagnósticas que posee la ortodoncia y ortopedia dentomáxilofacial. Los valores con que se construyó su norma estadística están basados en poblaciones específicas y no reflejan las diferencias morfológicas existentes en el complejo cráneofacial entre las distintas etnias. El propósito de esta investigación fue identificar las longitudes transversales y sagitales de los maxilares de la población adulta mestiza chilena con oclusión normal y compararlas con el índice de Korkhaus basado en una población adulta caucásica alemana. Se reclutaron 20 estudiantes de pregrado de la Facultad de Odontología de la Universidad de Valparaíso con oclusión normal. Se registraron ambas arcadas dentarias con yeso y se aplicó el índice de Korkhaus: se midió la longitud interpremolar, la longitud intermolar, la longitud anterior superior y la longitud anterior inferior. La comparación entre los valores de la muestra y los valores referenciales del índice de Korkhaus fue hecha con la prueba de rangos de Wilcoxon mediante el software estadístico STATA 15.0 y se consideraron significativos valores de p<0,05. Se encontró una diferencia estadísticamente significativa en el valor de la longitud anterior superior (p-0,013); para la longitud interpremolar (p-0,9552) la longitud intermolar (p-0,8223) y la longitud anterior inferior (p-0,0452) no se hallaron diferencias. La mayor magnitud de la longitud anterior superior de la arcada dentaria respecto a la población adulta caucásica alemana se debe al rasgo de protrusión dentaria presente en la población mestiza chilena, lo cual no altera las características de una oclusión normal.

The model exam is one of many diagnostic tools in orthodontics and dentomaxillofacial orthopedics. The values on which the statistical norm were constructed, are based on specific populations and they do not reflect the morphological differences in the craniofacial complex between the different ethnic groups. The purpose of this study was to identify the transverse and sagittal maxillary and mandibular lengths of the Chilean mestizo adult population with normal occlusion, and compare them with the Korkhaus index based on a German Caucasian adult population. For this study 20 undergraduate students with normal occlusion were recruited from the Faculty of Dentistry of the University of Valparaíso. Both upper and lower dental casts were obtained from each student, and Korkhaus index was applied: the interpremolar length, intermolar length, upper anterior length and lower anterior length were measured. Comparison between the values of the sample and the reference values of the Korkhaus index was made with the Wilcoxon range test using the STATA 15.0 statistical software and significant values of p <0.05 were considered. A statistically significant difference was found in the value of the upper anterior length (p-0.013); for the interpremolar length (p-0.9552) the intermolar length (p-0.8223) and the lower anterior length (p-0.0452) no differences were found. The greater magnitude of the dental arch upper anterior length compared to the German Caucasian adult population is due to dental protrusion present in the Chilean mestizo population, which does not affect the normal occlusion characteristics.

Frequencies and significance of HLA genes in Amerindians from Chile Cañete Mapuche.

Mapuche Amerindians live now widespread in Central South Chile and Argentina and speak "Mapudungun", an unclassified language. A group of Chilean Mapuche was studied for HLA genes using standard techniques. Typical Amerindian HLA genes and haplotypes are found in the population, like HLA-DRB1*14:02, -08:02 and class II haplotype DRB1*08:02-DQB1*04:02. However, these and other genes are also common in Pacific Islanders. Thus, relatedness of First America Inhabitants with some Pacific Islanders is stressed. Evidences of Pacific and Atlantic cultural and genetic exchange, probably in both directions, and California Man settlements found since 130,000 years ago makes it necessary a revision of Americas peopling. This study may be also useful for medical Mapuche use in Transplantation and HLA and disease Epidemiology.

Race-associated expression of MHC class I polypeptide-related sequence A (MICA) in prostate cancer.

Despite the lack of a complete understanding of the disparities involved, prostate cancer (PCa) has both higher incidence and death rates in African American Men (AAM) relative to those of Caucasian American Men (CAM). MHC class I polypeptide related sequence A (MICA) is an innate immunity protein involved in tumor immunoevasion. Due to a lack of reports of race-specific expression of MICA in PCa, we evaluated MICA expression in patients' tumors and in cell lines from a racially diverse origin. Immunohistochemistry was done on a tissue microarray (TMA) with antibodies against MICA. Tumor MICA mRNA was assessed by data mining using Oncomine and PROGeneV2. Surface MICA and release rate of soluble (s) MICA was evaluated in PCa cell lines originally derived from African American (MDA-PCa-2b) or Caucasian (LNCaP and DU-145) PCa patients. Prostate tumor tissue had a 1.7-fold higher MICA expression relative to normal tissue (p < .0001). MICA immunoreactivity in PCa tissue from AAM was 24% lower (p = .002) compared to CAM. Survival analysis revealed a marginal association of low MICA with poor overall survival (OS) (p = .058). By data mining analysis, a 2.9-fold higher level of MICA mRNA was evidenced in tumor compared to normal tissue (p < .0001). Tumors from AAM had 24% lower levels of MICA mRNA compared to tumors from CAM (p = .038), and poor prognosis was found for patients with lower MICA mRNA (p = .028). By flow cytometry analysis, cell fraction positive for surface MICA was of 3% in MDA-PCa-2b cells, 54% in DU-145 cells, and 67% in LNCaP cells (p < .0001). sMICA was detected in DU-145 and LNCaP cells, but was not detected in MDA-PCa-2b cells. Both LNCaP and DU-145 cells were sensitive to cytolysis mediated by Natural killer (NK) cells. MDA-PCa-2b cells, however were between 1.3-fold at 10:1 Effector:Target (E:T) ratio (p < .0001) and 2-fold at 50:1 E:T ratio (p < .0001) more resistant to NK-mediated cytolysis relative to cells from Caucasian origin. These results suggest that MICA expression may be related to the aggressive nature of PCa. Our findings also demonstrate for the first time that there are variations in MICA expression in the context of racial differences. This study establishes a rationale for further investigation of MICA as a potential race-specific prognostic marker in PCa.

Amelanotic iris melanoma in a 7 year-old hispanic boy with subclinical globe perforation. / Melanoma amelanótico del iris en un niño hispano de 7 años con perforación del globo subclínica.

We report an unusual case of an amelanotic melanoma in a 7 year old hispanic child with subclinical globe perforation. Uveal melanoma rarely occurs in children. Young affected patients are mostly light-colored eye Caucasian adolescents. Since they are not common, these tumors are usually not recognized and misdiagnosed. Differential diagnoses and therapeutic options are outlined.

Morphological criteria of feminine upper eyelashes, quantified by a new semi-automatized image analysis: Application to the objective assessment of mascaras.

BACKGROUND: The wide diversity of feminine eyelashes in shape, length, and curvature makes it a complex domain that remains to be quantified in vivo, together with their changes brought by application of mascaras that are visually assessed by women themselves or make-up experts. METHODS: A dedicated software was developed to semi-automatically extract and quantify, from digital images (frontal and lateral pictures), the major parameters of feminine eyelashes of Mexican and Caucasian women and to record the changes brought by the applications of various mascaras and their brushes, being self or professionally applied. RESULTS: The diversity of feminine eyelashes appears as a major influencing factor in the application of mascaras and their related results. Eight marketed mascaras and their respective brushes were tested and their quantitative profiles, in terms of coverage, morphology, or curvature were assessed. Standard applications by trained aestheticians led to higher and more homogeneous deposits of mascara, as compared to those resulting from self-applications. CONCLUSION: The developed software appears a precious tool for both quantifying the major characteristics of eyelashes and assessing the making-up results brought by mascaras and their associated brushes.

Validation of the GLI-2012 spirometry reference equations in Argentinian children.

AIM: The Global Lung Function Initiative (GLI) has produced spirometry reference equations for use in different ethnic groups. Previous reports have shown that the GLI equations do not adequately describe lung function in all populations and that adopting the new equations into clinical practice can increase the number of patients considered to have abnormal lung function. Therefore, before adopting these equations into local practice it is necessary to establish how well the equations represent the local population. The present study was conducted to determine how well the GLI spirometry reference equations represented the young children in Argentina, a population not included in the GLI dataset. METHODS: Spirometry was measured in 2072 healthy children (50.9% males) aged 3.0-12.4 years (mean 6.64 ± SD 1.39), with a height range of 93.0-158.5 cm and weight range from 13.1 to 54.7 kg. We used the GLI "Caucasian" and "other/mixed" race equations to create Z-scores. RESULTS: The Z-scores predicted by the Caucasian GLI equations did not differ from zero and fitted the data well. Z-scores calculated using "other/mixed race" fit less well. Using the GLI definition of low lung function (Z-score <1.65) 6.8% of our healthy population had abnormal FVC, 4.9% had abnormal FEV1, 5.9 % had abnormal FEV0.75, and 3.9% had abnormal FEF25-75 when using the "Caucasian" GLI equation. This compares well with the expected 5% below the lower limit of normal. CONCLUSION: We recommend the use of the GLI-2012 Caucasian equations for spirometry undertaken in Argentinian children.

Higher insulin and glucagon-like peptide-1 (GLP-1) levels in healthy, young South Asians as compared to Caucasians during an oral glucose tolerance test.

OBJECTIVE: Higher insulin levels during an oral glucose test (OGTT) have been shown in South Asians. We aimed to investigate if this increased insulin response causes reactive hypoglycemia later on, and if an increased glucagon-like-peptide-1 (GLP-1) response, which could contribute to the hyperinsulinemia, is present in this ethnic group. METHODS: A prolonged, 6-h, 75-g OGTT was performed in healthy, young Caucasian (n=10) and South Asian (n=8) men. The glucose, insulin and GLP-1 response was measured and indices of insulin sensitivity and beta-cell activity were calculated. RESULTS: Age (Caucasians (CAU) 21.5±0.7 years vs South Asians (SA) 21.4±0.7 years (mean±SEM)) and body mass index (CAU 22.7±0.7 kg/m(2) vs SA 22.1±0.8 kg/m(2)) were comparable between the two groups. South Asian men were more insulin resistant, as indicated by a comparable glucose but significantly higher insulin response, and a significantly lower Matsuda index (CAU 8.7(8.6) vs SA 3.2(19.2), median(IQR)). South Asians showed a higher GLP-1 response, as reflected by a higher area under the curve for GLP-1 (CAU 851±99.8 mmol/l vs SA 1235±155.0 mmol/L). During the whole 6-h period, no reactive hypoglycemia was observed. CONCLUSION: Healthy, young South Asian men have higher insulin levels during an OGTT as compared to Caucasians. This does not, however, lead to reactive hypoglycemia. The hyperinsulinemia is accompanied by increased levels of GLP-1. Whether this is an adaptive response to facilitate hyperinsulinemia to overcome insulin resistance or reflects a GLP-1 resistant state has yet to be elucidated.

Head and neck cancer. An aetiopathogenetic study of non-endemic lymphoepithelioma.

An aetiopathogenetic analysis of non-endemic nasopharyngeal carcinoma (NPC) in European and Southern American patient groups was performed. Specifically, the study sought to determine the proportion of Epstein-Barr Virus (EBV)-positive tumour cells in NPC patients in two very different populations (Europe and South America) in areas not associated with a high incidence of NPC. Clinical data (age, sex and onset of clinical disease) were also analyzed. A total of 50 NPC samples, 24 from a European hospital (EH) and 26 from two South American hospitals (SAH), were included. Nuclear staining for Epstein-Barr virus-encoded small RNA (EBER) was performed by in situ hybridization (ISH). Latent membrane protein 1 (LMP1) expression was measured by immunohistochemical (IHC) analysis. A higher incidence of NPC was observed in patients > 40 years of age in EH; in SAH, by contrast, the incidence was higher in patients aged ≤ 40 years. Cervical lymph node metastasis was detected in 31 patients (of whom 84.6% were from SAH). A total of 72% of samples were EBERpositive; the incidence of EBER positivity was greater in type 3 NPCs. EBV was detected in a large proportion of epithelial cells in samples from both EH and SAH (75% vs. 69.2%, respectively). An association was found between EBER detection in lymphocytes and patient origin (p = 0.0001). LMP1 expression was detected in 64% of patients. ISH for the detection of EBER is the most sensitive technique for demonstrating EBV in tumour tissue. The incidence of EBV was not significantly greater in either of the study populations, but was significantly higher in patients with type 3 NPC. Definitive histological diagnosis of NPC was reached earlier in EH than in SAH, where metastases were more frequently diagnosed, suggesting that the disease had reached a more advanced stage by the time treatment was started.

Multiple arterial variations in the right upper limb of a caucasian male cadaver / Múltiples variaciones arteriales en el miembro superior derecho de un cadáver caucásico masculino

Anatomical variations of the arterial patterns in the upper limb have been describe in many anatomical studies, but the occurrence of four variations in a ipsilateral upper limb is rare. These arterial variations were observed in the right upper limb of a 65 -year old Caucasian male cadaver during routine dissection in the anatomy department, College of Medicine at the King Saud University, Riyadh. These arterial variations include: 1) a large common trunk of the axillary artery giving origin to subscapular artery, profunda brachii artery, common circumflex humoral artery and superior ulnar collateral artery, 2) superficial brachial artery; 3) superficial brachioulnar artery, and 4) the radialis indicis branch from superficial palmar arch. Appreciation of variations in the upper limb vessels is important due to increasing number of procedures both diagnostic and therapeutic as in breast cancer surgery, flap harvesting and arteriogaphy.

En numerosos estudios se han descrito las variaciones anatómicas de los patrones arteriales en el miembro superior, sin embargo, la aparición de cuatro variantes ipsilaterales en un miembro superior es poco frecuente. Estas variaciones arteriales fueron observadas en el miembro superior derecho de un cadáver caucásico masculino de 65 años de edad, durante la disección de rutina en el Departamento de Anatomía de la Facultad de Medicina de la Universidad de King Saud, en Riad. Estas variaciones arteriales incluyen: 1) un gran tronco común de la arteria axilar dando origen a las arterias subescapular, braquial profunda, braquial común y colateral ulnar superior; 2) la arteria braquial superficial; 3) la arteria braquioulnar superficial y 4) la rama radial del índice desde el arco palmar superficial. La observación de variaciones en los vasos del miembro superior es importante debido al número cada vez mayor de procedimientos diagnósticos y terapéuticos, como en la cirugía del cáncer de mama, la recolección de colgajos y arteriografías.

Do Caucasian and Asian clocks tick differently?

The Period 3 and Clock genes are important components of the mammalian molecular circadian system. Studies have shown association between polymorphisms in these clock genes and circadian phenotypes in different populations. Nevertheless, differences in the pattern of allele frequency and genotyping distribution are systematically observed in studies with different ethnic groups. To investigate and compare the pattern of distribution in a sample of Asian and Caucasian populations living in Brazil, we evaluated two well-studied polymorphisms in the clock genes: a variable number of tandem repeats (VNTR) in PER3 and a single nucleotide polymorphism (SNP) in CLOCK. The aim of this investigation was to search for clues about human evolutionary processes related to circadian rhythms. We selected 109 Asian and 135 Caucasian descendants. The frequencies of the shorter allele (4 repeats) in the PER3 gene and the T allele in the CLOCK gene among Asians (0.86 and 0.84, respectively) were significantly higher than among Caucasians (0.69 and 0.71, respectively). Our results directly confirmed the different distribution of these polymorphisms between the Asian and Caucasian ethnic groups. Given the genetic differences found between groups, two points became evident: first, ethnic variations may have implications for the interpretation of results in circadian rhythm association studies, and second, the question may be raised about which evolutionary conditions shaped these genetic clock variations.

Comparação entre a forma e dimensão do arco dentário inferior de brasileiros e norte americanos / Comparison of dental arch form and dimension between brazilian and north american

A largura e a forma do arco dentário são importantes fatores para se determinar os objetivos e a estabilidade do tratamento ortodôntico. Este estudo visa determinar as diferenças morfológicas entre o arco dentário inferior de indivíduos Caucasianos Norte-Americanos (AM) e Caucasianos Brasileiros (BR), de acordo com a Classe de Angle e o gênero. A amostra foi constituída por 331 modelos de gesso pré-tratamento ortodôntico da arcada inferior, tendo sido obtida a partir de dois grupos: 160 Caucasianos Norte-Americanos (60 Classe I, 50 Classe II e 50 Classe III) e 171 Caucasianos Brasileiros (61 Classe I, 60 Classe II e 50 Classe III). As superfícies oclusais dos modelos de gesso foram fotocopiadas; a partir das imagens obtidas, foi identificado o ponto clínico do braquete para cada dente de acordo com a espessura do dente inferior referentes aos dados de Andrews. Baseado nestes pontos, foram realizadas medidas de dimensões do arco dentário com o uso de um paquímetro e verificada a forma do arco com templates ortodônticos. Os dados referentes às dimensões do arco foram avaliados estatisticamente através da análise de Kruskal-Wallis e para se avaliar a diferença na distribuição de freqüência de forma de arco foi utilizado o teste Qui-quadrado. Os resultados mostraram que existem diferenças significativas nas dimensões do arco dentário entre AM e BR. O grupo AM apresentou uma menor largura intercaninos que o grupo BR (p<0,05), exceto para o subgrupo feminino Classe I. A largura intermolares também foi menor no grupo AM (p<0,05), mas não foram encontradas diferenças significativas nos subgrupos de Classe III. Os valores médios de profundidade de arco na região de caninos e de molares foram menores para o grupo BR, porém apenas significativas para o subgrupo feminino Classe I (p<0,05)...

The purpose of this study was to evaluate the morphologic differences between North American Caucasian (AM) and Brazilian Caucasian (BR) mandibular dental arches. The sample consisted of 331 pretreatment mandibular orthodontic plaster models divided in two groups; 160 of North American Caucasians (60 Class I, 50 Class II and 50 Class III) and 171 of Brazilians (61 Class I, 60 Class II and 50 Class III). The occlusal surfaces of the mandibular models were photocopied and the clinical bracket point for each tooth was identified. Templates were overlaid to select the arch form; additionally 4 linear and 2 proportional measurements were taken. The results showed significantly differences in arch dimension between the two ethnic groups. The AM group showed significantly smaller intercanine width (p<0,05), excepting for the Class I aches in the female group. In addition, the AM group also showed a significantly smaller intermolar width (p<0,05); no differences were found in the Class III malocclusion group though. The BR group showed smaller canine and molar depths, but the differences were significantly smaller only in the Class I female group (p<0,05)...

Familial history of type 2 diabetes in patients from Southern Brazil and its influence on the clinical characteristics of this disease / História familiar de diabetes tipo 2 em pacientes do sul do Brasil e sua influência nas características dessa doença

OBJECTIVE: To investigate the presence of maternal and paternal history of type 2 diabetes mellitus (DM) in relatives of 644 type 2 diabetic patients from Southern Brazil, and also to evaluate its influence on the clinical characteristics of this disease. PATIENTS AND METHODS: Familial history of type 2 DM was investigated by a questionnaire. The maternal and paternal history was investigated over two generations. Complete data sets on familial history were obtained from 396 patients. RESULTS: In general, 76.6 percent of the patients reported at least one first-degree affected relative. Besides, 31.6 percent of the patients reported a maternal history of type 2 DM and 12.6 percent reported a paternal history. Patients with maternal and/or paternal history presented a lower age at type 2 DM diagnosis when compared to patients without familial history. In addition, patients with only paternal history presented a higher frequency of hypertension than patients with no familial history. CONCLUSIONS: This study suggests that there is a significant maternal effect in the transmission of type 2 DM in Southern Brazil, and that most of the clinical characteristics of this disease do not differ between patients with or without familial history of type 2 DM.

OBJETIVOS: Investigar a presença de história materna e paterna de diabetes mellitus tipo 2 (DM) entre familiares de 644 pacientes diabéticos tipo 2 provenientes do sul do Brasil, bem como avaliar sua influência nas características clínicas dessa doença. MATERIAIS E MÉTODOS: A história familiar de DM tipo 2 foi investigada através de um questionário, sendo que a presença de história materna e paterna foi investigada em duas gerações. Dados completos sobre história familiar foram obtidos para 396 pacientes. RESULTADOS: Em geral, 76,6 por cento dos pacientes reportaram ao menos um familiar em primeiro grau afetado por DM tipo 2. Além disso, 31,6 por cento dos pacientes relataram uma história materna de DM tipo 2 e 12,6 por cento relataram uma história paterna. Pacientes com história materna e/ou paterna apresentaram uma idade de diagnóstico de DM tipo 2 mais baixa quando comparado a pacientes sem história familiar. Adicionalmente, pacientes que relataram apenas história paterna de DM tipo 2 apresentaram uma maior freqüência de hipertensão do que pacientes sem história familiar. CONCLUSÕES: Nosso estudo sugere que há um efeito materno significativo na transmissão do DM tipo 2 no Sul do Brasil, e que a maioria das características clínicas dessa doença não difere entre pacientes com e sem história familiar de DM tipo 2.