Context: Vitamin D deficiency is a global concern. There are many factors that affect the levels of vitamin D including demographics, gender, skin pigmentation, geographic location, and body mass index (BMI). In Lima, Peru, vitamin D levels may be influenced by ethnicity, socioeconomic status, overcrowded conditions, air pollution, and chronic disease status. Objective: The purpose of this cross-sectional study was to measure the prevalence of vitamin D deficiency and insufficiency in a sample of impoverished adults living in northern Lima. It was hypothesized that more than 40% of the study sample would have deficient levels of vitamin D. The Endocrine Society defines deficient levels asbeing < 20 ng/mL of 25(OH)D3, insufficient being 21–29 ng/mL of 25(OH)D3. Methods: In June 2016, a Global Health team from Ohio University Heritage College of Osteopathic Medicine provided medical clinics in impoverished communities in northern Lima. From a random sample of consenting adults, finger stick capillary blood samples were applied to Whatman protein saver cards and subsequently dried.Dried blood samples were punched, extracted, and analyzed by liquid chromatography tandem mass spectrometry. Participants had BMI measured as well. Results: 25(OH)D3 samples were obtained from 144 adults, 116 (80.6%) women, 20 (13.9%) men, 8 (5.6%) unspecified gender, age range of 18–94 with a mean of 39 years. In 66 patients (45.8%), 25(OH)D3 was deficient. In 74 patients (51.4%), 25(OH)D3 was insufficient. In 4 patients (2.8%), 25(OH)D3 was sufficient. For the women, 57 (49.1%) were deficient, 56 (48.3%) insufficient. For the men, 7 (35%) were deficient, 13 (65%) insufficient. Mean BMI was 27.3, with a range of 17.3–43.3; 40.3% were overweight and 23.6% were obese. No relationship between vitamin D levels and gender was identified (p = 0.203). There was no significant association betweenBMI levels and vitamin D levels (p = 0.418). Conclusions: In this sample, nearly one half of those tested had deficient levels of 25(OH)D3, with the vast majority (97%) having less than sufficient levels. This study population also demonstrated an average BMI of 27.3. Further study is needed to clarify the role of vitamin D as a therapeutic and its relationship with BMI.
RESUMENIntroducción: Las enfermedades relacionadas al estilo de vida son uno de los mayores retos de salud del siglo 21. Objetivos: El propósito de esta investigación fue obtener una base de datos para estudiar la prevalencia de enfermedades de las personas que viven en pobreza en Li-ma, Perú. Métodos: La investigación estuvo localizada en los distritos de Comas y Carabayllo en Lima, Perú. Contamos con un total de 829 adultos y 770 niños (0-17 años de edad) participantes. La data fue recolectada a través de clínicas comunitarias gratuitas, estas incluyeron muestras de sangre para evaluar la hemoglobina, glucosa, hemoglobina glicosilada, lípidos, vitamina D, y anticuerpos en contra de Chagas y Helicobacter pylori. Para la población pediátrica sólo se utilizó los records médicos; no se utilizaron muestras de sangre con propósitos de inves-tigación. Resultados: Los resultados más significativos fueron: 50,9% con presión arterial sanguínea elevada siendo sistólica o diastólica, 47% Con hemoglobina glicosilada eleva-da, 24% glucosa en ayuno elevada, 57,2% con un al menos un parámetro elevado del panel lípido, 32,6% hemoglobina baja, 97,2% Vitamina D baja, 59% positivo para anticuerpos de Helicobacter, y 5,6% positivo con anticuerpos de Chagas. La prevalencia de sobrepeso y obesidad fue 65,1% para adultos y 42,3% para la población pediátrica. Conclusión: Los resultados demuestran anomalías relacionadas al estilo de vida. Esta in-formación puede utilizarse para desarrollar estrategias de prevención y trata-miento de las enfermedades relacionadas al estilo de vida, con enfoque en la educación y cambios en el estilo de vida. Palabras clave: Obesidad; Diabetes; Dislipidemias; Anemia; Hipertensión; Chagas; Helicobac-ter pylori; Vitamina D. (fuente: DeCS BIREME) ABSTRACTIntroduction: Diseases linked to lifestyle are one of the major burdens of the 21st century. Objectives: The purpose of this research was to obtain baseline data to study the preva-lence of diseases in people living in poverty in Lima, Peru. Methods: The research was located in the districts of Comas and Carabayllo in Lima, Pe-ru. A total of 829 adults and 770 children (0-17 years old) participated. Data was collected through free community clinics, including blood samples to evaluate hemoglobin, glucose, hemoglobin A1c, lipids, vitamin D, and antibod-ies against Chagas and Helicobacter pylori. For the pediatric population only medical records were utilized; no blood samples were obtained for research purposes. Results: Abnormal results demonstrated were: 50,9% elevated either systolic or diastolic blood pressure, 47% elevated hemoglobin A1c, 24% elevated fasting glucose, 57,2% elevated at least one parameter of the lipid profile, 32,6% low hemoglo-bin, 97,2 % low vitamin D, 59% positive Helicobacter antibodies, and 5,6% positive Chagas antibodies. Prevalence of overweight / obesity was 65,1% for adults and 42,3% for pediatric participants. Conclusion: Results demonstrated multiple lifestyle related abnormalities. This information can be utilized to develop ...
This study reviews the operative technique of external jugular vein to the internal jugular vein (IJV) bypass and discusses its advantages of decreasing postoperative complications in bilateral neck dissection patients. A retrospective chart review was performed on 2 patients at a single institution with prior bilateral neck dissection and jugular vein bypass. The tumor resection, reconstruction, bypass, and postoperative management were led by the listed senior author (S.P.K). An 80-year-old (case 1) and a 69year-old (case 2) underwent bilateral neck dissection with the creation of a micro-venous anastomosis. This bypass allowed for improved venous drainage without adding significant time or difficulty to the procedure. Both patients recovered well in the initial postoperative period with maintained venous drainage. This study describes an additional technique that the trained microsurgeon can consider during the index procedure and reconstruction that can benefit the patient without adding significant time or technical challenges to the remaining portion of the procedure.
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