Previous studies in dementia epidemiology have reported higher Alzheimer's disease rates in African-Americans when compared with White Americans. To determine whether genetically determined African ancestry is associated with neuropathological changes commonly associated with dementia, we analyzed a population-based brain bank in the highly admixed city of São Paulo, Brazil. African ancestry was estimated through the use of previously described ancestry-informative markers. Risk of presence of neuritic plaques, neurofibrillary tangles, small vessel disease, brain infarcts and Lewy bodies in subjects with significant African ancestry versus those without was determined. Results were adjusted for multiple environmental risk factors, demographic variables and apolipoprotein E genotype. African ancestry was inversely correlated with neuritic plaques (P=0.03). Subjects with significant African ancestry (n=112, 55.4%) showed lower prevalence of neuritic plaques in the univariate analysis (odds ratio (OR) 0.72, 95% confidence interval (CI) 0.55–0.95, P=0.01) and when adjusted for age, sex, APOE genotype and environmental risk factors (OR 0.43, 95% CI 0.21–0.89, P=0.02). There were no significant differences for the presence of other neuropathological alterations. We show for the first time, using genetically determined ancestry, that African ancestry may be highly protective of Alzheimer's disease neuropathology, functioning through either genetic variants or unknown environmental factors. Epidemiological studies correlating African-American race/ethnicity with increased Alzheimer's disease rates should not be interpreted as surrogates of genetic ancestry or considered to represent African-derived populations from the developing nations such as Brazil.

No abstract

RESUMENObjetivo Determinar la prevalencia de depresión y comparar indicadores sociodemográficos, metabólicos y clínicos, en personas con diabetes tipo 2 deprimidas y no deprimidas. Material y métodos Se realizó un estudio transversal comparativo en una muestra de 450 personas con diabetes tipo 2, mayores de 30 años, con más de un año de diagnóstico y sin determinación de psicopatología. Aplicamos escala de Zung modificada y encuesta sociodemográfica, evaluamos Hemoglobina glucosilada, índice de masa corporal (IMC), tensión arterial y glucemia de ayuno; registramos antigüedad diagnóstica y estadio clínico de diabetes. Resultados La prevalencia de depresión fue de 63 %, en una proporción de 3 a 1, mayor en mujeres que en hombres con razón de momios 3,17(IC 95 % 2,08-4,82) p=0,0000. Existen diferencias en escolaridad, estado civil y ocupación entre deprimidos y no deprimidos (p<0.05), la edad no presenta diferencias, al igual que las variables metabólicas, excepto IMC, antigüedad diagnóstica y estadio clínico 3 y 4. En las variables socio-demográficas y clínico-metabólicas por sexo, no encontramos asociación en las primeras (p>0.05), no obstante, antigüedad diagnostica y estadio clínico si se asocian con sexo, la primera de estas se asoció solo en hombres y la segunda en ambos sexos. Conclusiones La prevalencia de depresión es alta en las personas con diabetes y las mujeres tienen mayor riesgo. La edad no muestra asociación entre personas con diabetes que están deprimidas, a diferencia de escolaridad, estado civil, y ocupación; la depresión se presentó más en personas con más antigüedad diagnóstica de diabetes y mayor IMC.Palabras Clave: Depresión, diabetes, estudio comparativo (fuente: DeCS, BIREME).Rev. salud pública. 10 (1): [137][138][139][140][141][142][143][144][145][146][147][148][149] 2008

Susto is a Latin American folk illness attributed to having a fright-ening experience, often including “soul loss” as part of the etiology. This article focuses on contemporary descriptions of susto among mestizos in Mexico and Mexican Americans in south Texas and explores the link between susto and soul loss in detail. Interviews conducted in Guadalajara, Mexico (n = 50), and in the Rio Grande Valley of Texas (n = 951) indicate that only a minority of informants aware of susto have also heard of soul loss and that even among those who have had susto, soul loss is not necessarily a part of susto. Soul loss, in fact, is more often equated with death. Our data, as well as a careful review of earlier reports of susto and soul loss, suggest that what was thought to have left the body may not be the “soul” but rather a “vital force.”

No abstract

No abstract

International research enrolling human subjects has raised an ethical concern regarding the just distribution of benefits between the countries that design the research and the host communities. Although several universal declarations have expressed this concern, a gap between theory and practice continues to exist, as well as a significant divergence between the design of the research protocol and the social context where it will be implemented. Although institutional review boards have made a valuable effort to evaluate international research, their sensitivity to the just sharing of research benefits as well as their attention to the social context must be evaluated. This article analyzes the distribution of benefits in a review of international research in Mexico and produces an ethical reflection based on the results.

Surfactant rescue therapy can be utilized effectively early in the course of respiratory distress syndrome (RDS) in infants weighing > 1,000 g and treated exclusively with continuous positive airway pressure (CPAP) therapy. Thirteen infants (BW, 1,774 +/- 580 g; GA, 31 +/- 3 weeks) comprising the CPAP/SURFACTANT group were compared with 12 infants (BW, 1,753 +/- 556 g; GA, 31 +/- 2 weeks) who comprised the intermittent mandatory ventilation (IMV)/surfactant group, and with 14 infants (BW, 1,776 +/- 332 g; GA, 32 +/- 2 weeks) treated with CPAP before surfactant was clinically available. A 5 mL/kg dose of Exosurf Neonatal (Burroughs-Wellcome) was administered to infants intratracheally when the FiO2 requirement reached 0.40 to maintain the PO2 above 50 torr. Infants in the CPAP/surfactant group were intubated solely for surfactant administration and extubated within 18 +/- 6 min of treatment. The CPAP/surfactant group was treated at a mean age of 12.3 +/- 9.3 h, and the IMV/surfactant group at 10.2 +/- 9.8 h. Alveolar-arterial oxygen gradient (AaDO2), oxygenation index (OI), and mean airway pressure (MAP) were determined immediately before and after surfactant therapy, and at comparable times for the CPAP-only group. A significant difference was found in pre-treatment AaDO2, OI and MAP between the CPAP/surfactant group and IMV/surfactant group, but not between the CPAP/surfactant group and the CPAP-only group. Similarly, a significant difference in AaDO2, OI and MAP continued post-treatment was noted. However, a significant difference was also found at this time between the CPAP/surfactant group and the CPAP-only group. In addition, a significant difference was noted in AaDO2 and OI pre- and post-treatment within each surfactant-treated group. Furthermore, in the CPAP-only group AaDO2 and OI actually worsened (212 +/- 70 vs. 239 +/- 68; 4.0 +/- 1 vs. 4.5 +/- 2, respectively). There was a significant reduction in the duration of oxygen therapy (3 +/- 2 vs. 5 +/- 2 vs. 4.5 +/- 2 days, respectively) as well as in the total days of hospitalization (30 +/- 10 vs. 42 +/- 15 vs. 43 +/- 12 days, respectively). We conclude that in this small group of infants surfactant administration was effective and safe. It appeared to improve the course of RDS and shorten the duration of oxygen exposure and days of hospitalization.