OBJECTIVE: Leptin, the product of the human ob gene is increased in obese individuals, suggesting resistance to its effect. We examined the relationship of serum leptin levels with respect to obesity, gender and insulin levels in two populations with different ethnic compositions in Chile. METHODS: Leptin and insulin levels were determined by radioimmunoassay (RIA) and correlated with body mass index (BMI), gender and ethnic background. 79 Caucasian subjects from Santiago and 65 Mapuche natives from the Araucania region, Chile, were included in this study. RESULTS: Leptin concentrations in obese subjects were signi®cantly increased in both ethnic groups in relation to lean status: Caucasian and Mapuche obese 19.3 AE 11.6 and 10.1 AE 5.8 (P`0.001), respectively vs Caucasian and Mapuche lean 10.4 AE 5.8 and 4.7 AE 2.9 (P`0.001, respectively). When we compared Mapuche and Caucasian groups, similar leptin levels were observed among the males of the two populations in both metabolic states (lean and obese). In contrast, the leptin level distributions between women showed a marked difference, having a minor value in the Mapuche women with a comparable value with the male group in this ethnic population. CONCLUSIONS: The leptin concentrations are associated with obesity in both ethnic groups in Chile. However, the leptin levels between the Mapuche natives were signi®cantly decreased compared to the Caucasian group. The gender distribution does not seem to be important in the Mapuche natives. The ethnic composition seems to be important in the leptin distribution in the analysed populations.
ObjectiveTo estimate the incidence rate of type 1 diabetes in the urban area of Santiago, Chile, from March 21, 1997 to March 20, 1998, and to assess the spatio-temporal clustering of cases during that period. Methods All sixty-one incident cases were located temporally (day of diagnosis) and spatially (place of residence) in the area of study. Knox's method was used to assess spatiotemporal clustering of incident cases. ResultsThe overall incidence rate of type 1 diabetes was 4.11 cases per 100,000 children aged less than 15 years per year (95% confidence interval: 3.06-5.14). The incidence rate seems to have increased since the last estimate of the incidence calculated for the years 1986-1992 in the metropolitan region of Santiago. Different combinations of space-time intervals have been evaluated to assess spatio-temporal clustering. The smallest p-value was found for the combination of critical distances of 750 meters and 60 days (uncorrected p-value = 0.048). Conclusions Although these are preliminary results regarding space-time clustering in Santiago, exploratory analysis of the data method would suggest a possible aggregation of incident cases in space-time coordinates. Resumo Objetivo97 97 97 97 Rev Saúde Pública 2001;35(1):96-100 www.fsp.usp.br/rsp Incidence rate and spatio-temporal of type 1
Background: Latin Americans and Chilean Amerindians have the highest prevalence of cholesterol gallstone disease (GSD) and gallbladder cancer (GBC) in the world. A handful of loci have been associated with GSD in populations of predominantly European ancestry, however they only explain a small portion of the population-attributable risk of the disease. Methods:We performed a genome-wide association study (GWAS) for GSD in 1,095 admixed Latinos with Mapuche Native American Ancestry, followed by a replication analysis of 10 candidate single nucleotide polymorphisms (SNPs) with suggestive genomewide significance (P<1x10 -5 ) in 1,643 individuals. Disease status was assessed by cholecystectomy or abdominal ultrasonography. Logistic regression analyses were adjusted for age, sex, BMI, Type 2 Diabetes and Amerindian ancestry. Associated variants were further examined in two large GSD European populations and in a Chilean gallbladder cancer (GBC) cohort. We determined the expression levels of a novel GSD-candidate gene in normal and GSD-tissue samples. Results:We consistently replicated the ABCG8 gene (rs11887534; P=3.24x10 -8 , OR=1.74) associated with GSD in admixed Latinos and identified a novel candidate signal within the TRAF3 gene on chromosome 14 (rs12882491; P=1.11x10 -7 , OR=1.40). ABCG8 and TRAF3 variants also conferred risk to GBC. Gene expression analyses indicated that TRAF3 levels were significantly decreased in the gallbladder (P=0.015) and the duodenal mucosa (P=0.001) of affected GSD individuals compared to healthy controls. Conslusions:We confirmed ABCG8 and identified TRAF3 both associated with GSD and GBC in admixed Latinos. Decreased TRAF3 expression levels could enhance gallbladder inflammation as is observed in GSD and GSD-associated GBC.Gallstone disease (GSD) is a complex gastrointestinal disorder defined by the development of gallstones in the gallbladder, most of the time cholesterol compounds. 1 The presence of gallstones are common in the world population (~10-20% of presence in adults) and although their appearance can remain silent throughout life, more than 20% of the patients develop symptoms that include intense abdominal pain, jaundice, fever, nausea and vomiting, requiring medical attention and therefore establishing itself as a clinical condition . 2 Main complications of GSD are acute cholecystitis, acute pancreatitis and bile duct obstruction, 3 and these are generally treated by surgical removal of the gallbladder (cholecystectomy). In Chile, these procedures accounts for more than 40,000 interventions each year, 4 with a net cost of more than US $25 million for the public healthcare system. GSD is also the main risk factor for gallbladder cancer (GBC), a disease that presents a high mortality rates in Chile (38.2 deaths per 100,000 inhabitants). 5 In the vast majority of cases, GBC is an adenocarcinoma characterized by high lethality due to late diagnosis and the ineffectiveness of chemotherapy/radiotherapy. With the removal of the gallbladder and its stones, GBC risk is consid...
NEUROLEPTOANALGESIA EM MAITACA-DE-CABEÇA-AZUL (Pionus menstruus) PARA IMOBILIZAÇÃO DE FRATURA EM ULNA ESQUERDA -RELATO DE CASO ....
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