OBJECTIVE -There are national mandates to reduce blood pressure (BP) to Ͻ130/85 mmHg, LDL cholesterol to Ͻ100 mg/dl, and HbA 1c to Ͻ7% and to institute aspirin therapy in patients with diabetes. The objective of this study was to determine the proportion of patients in urban institutions with diabetes and hypertension who meet these treatment goals.RESEARCH DESIGN AND METHODS -Using American Diabetes Association (ADA) guidelines, we evaluated the control of cardiovascular disease (CVD) risk factors in 1,372 patients receiving medical care at two major urban medical centers in Brooklyn and Detroit. Information was extracted from charts of outpatient clinics.RESULTS -Of 1,372 active clinic patients with diabetes and hypertension, 1,247 (90.9%) had type 2 diabetes, and 26.7% met the target blood pressure of 130/85 mmHg. A total of 35.5% met the goal LDL cholesterol level of Ͻ100 mg/dl, 26.7% had an HbA 1c Ͻ7%, and 45.6% were on antiplatelet therapy. Only 3.2% of patients met the combined ADA goal for BP, LDL cholesterol, and HbA 1c .CONCLUSIONS -Optimal control of CVD risk factors in adults with diabetes was achieved only in a minority of patients. Results reflect the inherent difficulties in achieving these complex guidelines in our present health care systems. Diabetes Care 25:718 -723, 2002

The cardiometabolic syndrome, an interesting constellation of maladaptive cardiovascular, renal, metabolic, prothrombotic, and inflammatory abnormalities, is now recognized as a disease entity by the American Society of Endocrinology, National Cholesterol Education Program, and World Health Organization, among others. These cardiovascular and metabolic derangements individually and interdependently lead to a substantial increase in cardiovascular disease (CVD) morbidity and mortality, making the cardiometabolic syndrome an established and strong risk factor for premature and severe CVD and stroke. Established and evolving treatment strategies including moderate physical activity, weight reduction, rigorous blood pressure control, correction of dyslipidemia, and glycemic control have proven beneficial in reversing these abnormal responses and decreasing the CVD risk.

Chromosome painting (CP) with a probe of B chromosome obtained by microdissection and fluorescence in situ hybridization (FISH) with probes of As51 satellite DNA, C( o )t-1 DNA, and 18S and 5S rDNA confirmed sharing of some repetitive DNA but not rDNA between A and B chromosomes in the fish Astyanax scabripinnis. Meiotic analysis revealed a pachytene B chromosome bivalent nearly half the size of its mitotic configuration, suggesting a self-pairing of B chromosome arms. Such an isochromosome nature of somatic B chromosome was further evidenced by CP and FISH. All the findings obtained suggest (i) intraspecific origin of B chromosome, and (ii) evolutionary enrichment of repetitive DNA classes, especially those contained in the C( o )t-1 and the As51 probes, in B chromosome. However, the precise origin of B chromosome in the present species remains to be elucidated by further molecular cytogenetic analysis because of painting of some A chromosome regions with the B chromosome-derived probe.

Cardiovascular disease (CVD) is the major cause of morbidity and mortality in diabetes. To determine the proportion of patients who met the5 were hypertension, hyperglycemia, increased low-density lipoprotein (LDL) cholesterol, low levels of high-density lipoprotein (HDL) cholesterol, and smoking. While tight control of blood glucose in both type 1 and type 2

Background Eukaryote genomes frequently harbor supernumerary B chromosomes in addition to the “standard” A chromosome set. B chromosomes are thought to arise as byproducts of genome rearrangements and have mostly been considered intraspecific oddities. However, their evolutionary transcendence beyond species level has remained untested. Results Here we reveal that the large metacentric B chromosomes reported in several fish species of the genus Astyanax arose in a common ancestor at least 4 million years ago. We generated transcriptomes of A. scabripinnis and A. paranae 0B and 1B individuals and used these assemblies as a reference for mapping all gDNA and RNA libraries to quantify coverage differences between B-lacking and B-carrying genomes. We show that the B chromosomes of A. scabripinnis and A. paranae share 19 protein-coding genes, of which 14 and 11 were also present in the B chromosomes of A. bockmanni and A. fasciatus, respectively. Our search for B-specific single-nucleotide polymorphisms (SNPs) identified the presence of B-derived transcripts in B-carrying ovaries, 80% of which belonged to nobox, a gene involved in oogenesis regulation. Importantly, the B chromosome nobox paralog is expressed > 30× more than the A chromosome paralog. This indicates that the normal regulation of this gene is altered in B-carrying females, which could potentially facilitate B inheritance at higher rates than Mendelian law prediction. Conclusions Taken together, our results demonstrate the long-term survival of B chromosomes despite their lack of regular pairing and segregation during meiosis and that they can endure episodes of population divergence leading to species formation.

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Two populations of the Astyanax scabripinnis complex, isolated by a waterfall with over 100 meters depth and inhabiting different altitudes of the same river (1850 m a.s.l. and 662 m a.s.l.) were compared in reproductive data, geometric morphometry, tooth morphology, anal-fin rays counts, and karyotype, in order to test the hypothesis of speciation between the two populations. The results in the geometric morphometry analysis showed differences between the populations. Discriminant function analysis (DFA) and canonical variance analysis revealed sexual dimorphism. Secondary sexual characters, such as hooks in the anal fin rays of the males are absent in the lower altitude population. Both populations had the same macro karyotype structure, except for the absence of B chromosomes in the lower altitude population. The fluorescence in situ hybridization showed differences for both markers (18S rDNA and 5S rDNA), and reproductive data suggests pre-zygotic reproductive isolation among the two populations. The data showed the absence of gene flow, indicating that an incipient speciation process has occurred, which leads the two populations to follow independent evolutionary pathways.Duas populações do complexo Astyanax scabripinnis isoladas por uma queda d´água de mais de 100 metros de altura e localizadas em diferentes altitudes do mesmo rio (662 m e 1850 m a.s.l.) foram comparadas através de dados de reprodução, cariótipo, morfometria geométrica, morfologia dentária, e número de raios da nadadeira anal, de modo a testar a hipótese de especiação entre as duas populações. Os resultados de morfometria geométrica mostraram diferenças entre as populações. A análise da função discriminante (DFA) e a análise de variância canônica (CVA) demonstraram a presença de dimorfismo sexual. Caracteres sexuais secundários, como ganchos em raios da nadadeira anal dos machos, estão ausentes na população de menor altitude. Ambas as populações têm a mesma macro estrutura cariotípica, exceto pela ausência de cromossomos B na população de menor altitude. A hibridação in situ mostrou diferenças para ambos os marcadores (rDNA 18S e rDNA 5S), e os dados de reprodução sugerem isolamento reprodutivo pré-zigótico entre as duas populações. Os dados mostram ausência de fluxo gênico, indicando que ocorreu um processo de especiação incipiente, o que leva as duas populações seguirem vias evolutivas independentes.

Osteoporosis is a major public health problem with low bone mass affecting nearly half the women aged 50 years or older. Evidence from various studies has shown that higher body mass index (BMI) is a protective factor for bone mineral density (BMD). Most of the evidence, however, is from studies with Caucasian women and it is unclear to what extent ethnicity plays a role in modifying the effect of BMI on BMD.A cross sectional study was performed in which records of postmenopausal women who presented for screening for osteoporosis at 2 urban medical centres were reviewed. Using logistic regression, we examined the interaction of race and BMI after adjusting for age, family history of osteoporosis, maternal fracture, smoking, and sedentary lifestyle on BMD. Low BMD was defined as T-score at the lumbar spine < -1.Among 3,206 patients identified, the mean age of the study population was 58.3 ± 0.24 (Years ± SEM) and the BMI was 30.6 kg/m 2 . 2,417 (75.4%) were African Americans (AA), 441(13.6%) were Whites and 348 (10.9%) were Hispanics. The AA women had lower odds of having low BMD compared to Whites [Odds ratio (OR) = 0.079 (0.03-0.24) (95% CI), p < 0.01]. The odds ratio of low BMD was not statistically significant between White and Hispanic women. We examined the interaction between race and BMD. For White women; as the BMI increases by unity, the odds of low BMD decreases [OR = 0.9 (0.87-0.94), p < 0.01; for every unit increase in BMI]. AA women had slightly but significantly higher odds of low BMD compared to Whites [OR 1.015 (1.007-1.14), There is thus a race-dependent effect of BMI on BMD. With each unit increase in BMI, BMD increases for White women, while a slight but significant decrease in BMD occurs in African American women.