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Del Brutto, O.H.; Mera, R.M.; Zambrano, M.; Del Brutto, V.J. |
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Title |
Severe edentulism is a major risk factor influencing stroke incidence in rural Ecuador (The Atahualpa Project) |
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Journal Article |
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Year |
2017 |
Publication |
International Journal of Stroke : Official Journal of the International Stroke Society |
Abbreviated Journal |
Int J Stroke |
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Volume |
12 |
Issue |
2 |
Pages |
201-204 |
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Keywords |
Adult; Comorbidity; Ecuador/epidemiology; Female; Follow-Up Studies; Humans; Hypertension/complications/epidemiology; Incidence; Male; Middle Aged; Mouth, Edentulous/complications/*epidemiology; Prospective Studies; Risk Factors; Rural Population; Severity of Illness Index; Stroke/complications/*epidemiology; Ecuador; Stroke incidence; cohort study; edentulism; stroke risk factors |
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Abstract |
Background There is no information on stroke incidence in rural areas of Latin America, where living conditions and cardiovascular risk factors are different from urban centers. Aim Using a population-based prospective cohort study design, we aimed to assess risk factors influencing stroke incidence in community-dwelling adults living in rural Ecuador. Methods First-ever strokes occurring from 1 June 2012 to 31 May 2016, in Atahualpa residents aged >/=40 years, were identified from yearly door-to-door surveys and other overlapping sources. Poisson regression models adjusted for demographics, cardiovascular risk factors, edentulism and the length of observation time per subject were used to estimate stroke incidence rate ratio as well as factors influencing such incidence. Results Of 807 stroke-free individuals prospectively enrolled in the Atahualpa Project, follow-up was achieved in 718 (89%), contributing 2,499 years of follow-up (average 3.48 +/- 0.95 years). Overall stroke incidence rate was 2.97 per 100 person-years of follow-up (95% CI: 1.73-4.2), which increased to 4.77 (95% CI: 1.61-14.1) when only persons aged >/=57 years were considered. Poisson regression models, adjusted for relevant confounders, showed that high blood pressure (IRR: 5.24; 95% CI: 2.55-7.93) and severe edentulism (IRR: 5.06; 95% CI: 2.28-7.85) were the factors independently increasing stroke incidence. Conclusions Stroke incidence in this rural setting is comparable to that reported from the developed world. Besides age and high blood pressure, severe edentulism is a major factor independently predicting incident strokes. Public awareness of the consequences of poor dental care might reduce stroke incidence in rural settings. |
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4 Department of Neurology, University of Chicago, Chicago, IL, USA |
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1747-4930 |
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PMID:27777377 |
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Call Number |
ref @ user @ |
Serial |
97655 |
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Del Campo Vega, C.; Tutte, V.; Bermudez, G.; Parra, D.C. |
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Title |
Impact on Area-Level Physical Activity Following the Implementation of a Fitness Zone in Montevideo, Uruguay |
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Journal Article |
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Year |
2017 |
Publication |
Journal of Physical Activity & Health |
Abbreviated Journal |
J Phys Act Health |
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14 |
Issue |
11 |
Pages |
883-887 |
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Keywords |
Soparc; observation; parks |
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BACKGROUND: The aim of the study was to measure the level of physical activity (PA) of the users of an urban park before and after the installation of 2 fitness zones (FZs) and to assess the impact of that intervention on the users' level of PA. METHODS: The System for Observing Play and Recreation in Communities method was applied in the urban plaza Liber Seregni in Montevideo (Uruguay): 14 different areas were mapped and then recategorized as fitness (for PAs, including sports), green, and paved zones. Observations were made in the spring (Sep-Oct) of 2011 and 2014, before and after placing 2 FZs. Participation was analyzed by gender, year, mapped areas, and zones, and significant differences were assessed using the chi2 test. RESULTS: In total, 7342 individuals (4091 men and 3251 women) were observed. A greater number of people with intense PA could be seen in the FZ, with significant differences between 2011 (45%) and 2014 (70%; P < .05). CONCLUSION: This is the first longitudinal study on the impact of an intervention to increase the level of PA in public spaces in Uruguay. Higher intensity levels of PA and fewer sedentary people were observed after the installation of the FZ. |
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1543-3080 |
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PMID:28556669 |
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98022 |
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Derose, K.P.; Payan, D.D.; Fulcar, M.A.; Terrero, S.; Acevedo, R.; Farias, H.; Palar, K. |
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Factors contributing to food insecurity among women living with HIV in the Dominican Republic: A qualitative study |
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Journal Article |
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Year |
2017 |
Publication |
PloS one |
Abbreviated Journal |
PLoS One |
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Volume |
12 |
Issue |
7 |
Pages |
e0181568 |
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Adolescent; Adult; Domestic Violence; Dominican Republic/epidemiology; Female; *Food Supply; HIV/isolation & purification; HIV Infections/*epidemiology; Humans; Middle Aged; Qualitative Research; Social Stigma; Social Support; Socioeconomic Factors; Young Adult |
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BACKGROUND: Food insecurity contributes to poor health outcomes among people living with HIV. In Latin America and the Caribbean, structural factors such as poverty, stigma, and inequality disproportionately affect women and may fuel both the HIV epidemic and food insecurity. METHODS: We examined factors contributing to food insecurity among women living with HIV (WLHIV) in the Dominican Republic (DR). Data collection included in-depth, semi-structured interviews in 2013 with 30 WLHIV with indications of food insecurity who resided in urban or peri-urban areas and were recruited from local HIV clinics. In-person interviews were conducted in Spanish. Transcripts were coded using content analysis methods and an inductive approach to identify principal and emergent themes. RESULTS: Respondents identified economic instability as the primary driver of food insecurity, precipitated by enacted stigma in the labor and social domains. Women described experiences of HIV-related labor discrimination in formal and informal sectors. Women commonly reported illegal HIV testing by employers, and subsequent dismissal if HIV-positive, especially in tourism and free trade zones. Enacted stigma in the social domain manifested as gossip and rejection by family, friends, and neighbors and physical, verbal, and sexual abuse by intimate partners, distancing women from sources of economic and food support. These experiences with discrimination and abuse contributed to internalized stigma among respondents who, as a result, were fearful and hesitant to disclose their HIV status; some participants reported leaving spouses and/or families, resulting in further isolation from economic resources, food and other support. A minority of participants described social support by friends, spouses, families and support groups, which helped to ameliorate food insecurity and emotional distress. CONCLUSIONS: Addressing food insecurity among WLHIV requires policy and programmatic interventions to enforce existing laws designed to protect the rights of people living with HIV, reduce HIV-related stigma, and improve gender equality. |
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Division of HIV, ID and Global Medicine, School of Medicine, University of California – San Francisco, San Francisco, California, United States of America |
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1932-6203 |
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PMID:28742870 |
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Call Number |
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97262 |
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Author |
Derose, K.P.; Payan, D.D.; Fulcar, M.A.; Terrero, S.; Acevedo, R.; Farias, H.; Palar, K. |
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Title |
Factors contributing to food insecurity among women living with HIV in the Dominican Republic: A qualitative study |
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Journal Article |
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Year |
2017 |
Publication |
PloS one |
Abbreviated Journal |
PLoS One |
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Volume |
12 |
Issue |
7 |
Pages |
e0181568 |
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Keywords |
Adolescent; Adult; Domestic Violence; Dominican Republic/epidemiology; Female; *Food Supply; HIV/isolation & purification; HIV Infections/*epidemiology; Humans; Middle Aged; Qualitative Research; Social Stigma; Social Support; Socioeconomic Factors; Young Adult |
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BACKGROUND: Food insecurity contributes to poor health outcomes among people living with HIV. In Latin America and the Caribbean, structural factors such as poverty, stigma, and inequality disproportionately affect women and may fuel both the HIV epidemic and food insecurity. METHODS: We examined factors contributing to food insecurity among women living with HIV (WLHIV) in the Dominican Republic (DR). Data collection included in-depth, semi-structured interviews in 2013 with 30 WLHIV with indications of food insecurity who resided in urban or peri-urban areas and were recruited from local HIV clinics. In-person interviews were conducted in Spanish. Transcripts were coded using content analysis methods and an inductive approach to identify principal and emergent themes. RESULTS: Respondents identified economic instability as the primary driver of food insecurity, precipitated by enacted stigma in the labor and social domains. Women described experiences of HIV-related labor discrimination in formal and informal sectors. Women commonly reported illegal HIV testing by employers, and subsequent dismissal if HIV-positive, especially in tourism and free trade zones. Enacted stigma in the social domain manifested as gossip and rejection by family, friends, and neighbors and physical, verbal, and sexual abuse by intimate partners, distancing women from sources of economic and food support. These experiences with discrimination and abuse contributed to internalized stigma among respondents who, as a result, were fearful and hesitant to disclose their HIV status; some participants reported leaving spouses and/or families, resulting in further isolation from economic resources, food and other support. A minority of participants described social support by friends, spouses, families and support groups, which helped to ameliorate food insecurity and emotional distress. CONCLUSIONS: Addressing food insecurity among WLHIV requires policy and programmatic interventions to enforce existing laws designed to protect the rights of people living with HIV, reduce HIV-related stigma, and improve gender equality. |
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Division of HIV, ID and Global Medicine, School of Medicine, University of California – San Francisco, San Francisco, California, United States of America |
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1932-6203 |
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PMID:28742870 |
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Call Number |
ref @ user @ |
Serial |
98011 |
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Author |
Emery, I.F.; Gopalan, A.; Wood, S.; Chow, K.-H.; Battelli, C.; George, J.; Blaszyk, H.; Florman, J.; Yun, K. |
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Expression and function of ABCG2 and XIAP in glioblastomas |
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Journal Article |
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2017 |
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Journal of Neuro-Oncology |
Abbreviated Journal |
J Neurooncol |
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133 |
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1 |
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47-57 |
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Abcg2; Glioblastoma; Glioma stem cells; Ko143; Xiap |
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Despite multimodal treatment that includes surgery, radiation and chemotherapy, virtually all glioblastomas (GBM) recur, indicating that these interventions are insufficient to eradicate all malignant cells. To identify potential new therapeutic targets in GBMs, we examined the expression and function of proteins that are associated with therapy resistance and cancer cell survival. We measured the expression of eight such proteins in 50 GBM samples by immunohistochemistry and analyzed patient survival. We report that GBM patients with high expression of ABCG2 (also called BCRP) or XIAP at the protein level had worse survival than those with low expression. The adjusted hazard ratio for ABCG2 was 2.35 and for XIAP was 2.65. Since glioma stem cells (GSCs) have been shown to be more resistant than bulk tumor cells to anti-cancer therapies and to express high levels of these proteins, we also sought to determine if ABCG2 and XIAP have functional roles in GSCs. We used small molecule inhibitors to treat patient-derived GBM tumorspheres in vitro and observed that inhibitors of ABCG2, Ko143 and fumitremorgin, significantly reduced self-renewal. These results suggest that ABCG2 and XIAP proteins may be useful indicators of patient survival and that inhibition of ABCG2 may be a promising therapeutic strategy in GBMs. |
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Peak Center for Brain and Pituitary Tumors, Houston Methodist Research Institute, 6670 Bertner Ave, Houston, TX, 77030, USA. kyun@houstonmethodist.org |
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0167-594X |
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PMID:28432589 |
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ref @ user @ |
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96591 |
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