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.
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.”
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