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BACKGROUND: The metabolic syndrome (MS) is described as an association of health problems that a given person may simultaneously or successively develop, and it is considered a serious condition because it is related to a significantly increased risk of suffering diabetes, coronary disease and brain damage. Nutrition, along with other factors such as physical activity and genetic inheritance, has an influence on preventing MS. OBJECTIVE: The aim of this research is to demonstrate important aspects concerning the diagnosis, the prevalence, and the prevention of metabolic syndrome among the population of the tropical coast of Granada. METHODS: 119 individuals from the tropical coast of Granada were studied to collect personal data such as their body mass index, body fat percentage, glycaemia, total cholesterol, HDL cholesterol, LDL cholesterol, and food intake (through nutritional survey). RESULTS: As a result of this research, a metabolic syndrome prevalence of 20,2% was obtained, 58,3% of which was related to women. The results obtained show significant statistical differences between individuals having metabolic syndrome and the control group. Particularly, these differences can be noted in parameters such as the BMI or the % of body fat. Nevertheless, there are no significant differences between the two groups concerning parameters related to nutrition such as % of fat, carbohydrates, proteins and kcal/day. CONCLUSION: As a conclusion from the research, we can state that the metabolic syndrome prevalence among the population of the tropical coast of Granada is similar to the figure obtained for the population in the US and in other areas of Spain. In addition, this research shows that metabolic syndrome is more frequent among individuals whose BMI and % of body fat is higher than 30.

Antecedentes: El síndrome metabólico (SM) es una asociación de problemas de salud que pueden aparecer de forma simultánea o secuencial en un mismo individuo, y es importante porque se relaciona con un incremento significativo de riesgo de diabetes, enfermedad coronaria y enfermedad cerebrovascular. La nutrición junto a otros factores como es el ejercicio físico y la genetica del individuo, influyen en la prevención del SM. Objetivo: Conocer aspectos importantes como el diagnostico, prevalencia y prevención del síndrome metabólico en población de la Costa Tropical Granadina. Métodos: Se estudiaron en 119 individuos de la Costa Granadina parámetros como el indice de masa corporal, el porcentaje de grasa corporal, análisis clínicos de glucosa, colesterol total, colesterol HDL, colesterol LDL y estudiaron valores nutricionales mediante encuesta. Resultados: En el estudio se obtuvo una prevalencia el Síndrome metabólico del 20,2%, del que el 58,3% correspondía a mujeres. Los resultados obtenidos reflejan diferencias estadísticas significativas entre los individuos con síndrome metabólico y el grupo control, observándose dichas diferencias en parámetros tales como IMC o el porcentaje de grasa corporal. Sin embargo en parámetros como porcentaje de lípidos, porcentaje de hidratos de carbono, porcentaje de proteínas y kcal/día no hay diferencias significativas entre los individuos con SM y los individuos control. Conclusión: De esta manera podemos deducir del estudio que la prevalencia de síndrome metabólico en la población de la Costa Tropical Granadina se asemeja a la obtenida en EE.UU y a la obtenida en algunas zonas estudiadas en España. Igualmente, se puede apreciar en este estudio como el síndrome metabólico es más frecuente en personas con IMC y % de grasa corporal superior a 30.

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OBJECTIVES: To determine among adult patients with type-2 diabetes mellitus the proportion diagnosed with diabetic polyneuropathy (DPN) by clinical evaluation and by the Hoffmann reflex (H-reflex). In addition, the predictive value of the H-reflex in the diagnosis of DPN was evaluated. METHODS: Studies were carried out on 150 adult patients referred for neuropathy screening. Diagnostic criteria for DPN were at least two abnormalities in clinical neurophysiological examinations and electrophysiological testing (H-reflex and nerve conduction velocity). Logistic regression analysis was performed to identify unique contributions of study characteristics to positive versus negative outcomes. RESULTS: H-reflex was absent in 39.3% (59/150) and latency was prolonged in 43.3% (65/150) of patients. Ulnar nerve motor branch nerve conduction showed prolonged latency in 9.3% (14/150) of patients. Logistic regression analysis indicated that the H-reflex was significantly associated with positive outcomes. CONCLUSION: The H-reflex could have a predictive value in DPN, providing more quantitative information regarding diagnosis than conventional nerve conduction studies.

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Maternal protein restriction (MPR) during pregnancy impaired the reproduction of male offspring. We investigated, during the first wave of spermatogenesis, whether MPR exerts deleterious effects on germ cell proliferation and differentiation, as well as androgen receptor (AR) protein expression, which was used as a marker for Sertoli cell (SC) maturation. At the beginning of pregnancy (day 0), dams were fed a control diet (C: 20% casein) or a restricted isocaloric diet (R: 10% casein). After birth, four groups were established: CC, RR, CR and RC (first letter diet during pregnancy and second during lactation). Male offspring were studied at postnatal days 14, 21 and 36. At birth, pup body weight was unchanged. Body weight and testis weight were reduced in RR and CR groups at all ages evaluated. MPR delayed the germinal epithelium development at all ages evaluated. On performing Western blot and immunohistochemistry, AR expression was found to be lower in the three restricted groups. The results suggest that MPR during pregnancy and/or lactation delays SC maturation and germ cell differentiation, and affects intratubular organization. These changes might be responsible for the lower fertility rate at older ages.

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Germline mutations in the BRCA1 and BRCA2 genes predispose to breast and ovarian cancer. A variable incidence of mutations has been reported for these genes. The contribution of BRCA1 and BRCA2 mutations to Mexican women with breast and/or ovarian cancer is not known. Because of the increasing prevalence of breast cancer in this population, it is necessary to study the presence of mutations in both genes. We screened BRCA1 and BRCA2 genes in 40 patients: 29 patients with a history of breast and/or ovarian cancer, and 11 patients with early-onset breast cancer (< 40 years), through denaturing high performance liquid chromatography analyses. We found two frameshift mutations in BRCA1 and one missense mutation in each gene. Additionally we found several intronic variants as well as synonymous mutations. We found 5% of deleterious mutations in the BRCA genes. Larger studies are needed to establish the significance and prevalence of BRCA mutations among Mexican women.

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Breast cancer is the second most frequent tumor in Mexico. Patients diagnosed with this cancer have a higher risk of developing a second malignancy. The objective of our study was to see the frequency, types of second cancers, and its impact on survival, in order to be able to deliver a proper and efficient follow up to these patients, because our patients differ from the population of breast cancer in the rest of the world. Our patients are younger and therefore at higher risk. The clinical records of breast cancer patients treated at the Instituto Nacional de Cancerologia Mexico from 1983 to 1992 were reviewed. In 1370 evaluable patients, 77 (5.6%) developed a second neoplasm, of those, 56 (72.7%) in the contralateral breast and 21 in other sites (27.3%), thyroid was the most frequent followed by ovary and endometrium. Mean age of the patients was 51.5 yr, 45.5 for the other breast and 55.5 for other malignancies (p = 0.01). Median survival for all the group was of 180 mo (3-238). Patients were significantly younger in the contralateral breast group, although all our breast cancer patients are younger. The most frequent second malignancy after the other breast, was thyroid followed by ovary and endometrium with similar survival for both groups.

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This study explored the effects of fasting on body fuel mobilization in the common vampire bat (Desmodus rotundus) fed a high-protein diet (bovine blood). An uncommon fragility during food deprivation has been reported for this species to the point of untimely deaths after only 2-3 nights of fasting. The immediate biochemical responses to fasting, however, have not been established. Thus, blood glucose, plasma FFA, glycogen, protein, and fat concentrations in the liver and muscles were determined in fed and 24-, 48- and 72 h-fasted individuals. The results indicate that D. rotundus is unable to maintain adequate levels of blood glucose during fasting, probably due to low tissue stores of energy fuels or difficulty in mobilizing them. Other factors may play an important role in this species abundance, such as the previously reported behavior of reciprocal blood regurgitation.

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Polymerase chain reaction (PCR)-restriction fragment length polymorphism analysis (PRA) which relies on the amplification of a 439-bp portion of the hsp65 gene present in all mycobacteria, followed by two distinct digestions (with BstEII and HaeIII) of the PCR product, offers a rapid and easy alternative that allows identification of the species without the need for specialized equipment. Wild leprosy in the nine-banded armadillo (Dasypus novemcinctus) is characterized by the presence of multiple bacilli in internal organs such as lymph nodes, spleen and liver, as well as in nerves and skin. We could observe this in 9 out of 132 animals captured in Corrientes, Argentina, an area endemic for leprosy in humans. Mycobacterium leprae were recognized in those naturally infected animals through different techniques. Three samples of extracted DNA of the mycobacteria present in the spleen, liver and popliteal lymph node of a naturally infected animal during the Experimental Program in Armadillo (PEA) and three samples of human lepromas were processed by PRA. The patterns of the six samples analyzed were identical and were characteristic of M. leprae. These studies, made for the first time in Argentina, corroborate the initial discoveries in South America made by our investigative group on the detection of armadillos naturally infected with the Hansen bacillus.

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This study compared food insecurity, nutritional status (as measured through anthropometry and dietary intake), and food preparation patterns of low-income Puerto Rican female out-of-treatment drug users with that of low-income Puerto Rican women who reported no drug use. A convenience sample of 41 drug users was compared with 41 age-matched non-drug-users from inner-city Hartford, Connecticut. A culturally appropriate food frequency questionnaire was administered and anthropometric measurements were taken. The findings suggest a high degree of poverty among all study participants, but in particular among drug users. Drug users were more likely than the controls to be food insecure (P < 0.05) and to be exposed to increasingly severe food sufficiency problems. The daily frequency of consumption of vegetables was lower (P = 0.03) for drug users than non-drug-users. Conversely, the frequency of consumption for sweets/desserts was significantly higher for drug users than the controls (P = 0.0001). Drug users, who were classified as food insecure were less likely to consume vegetables (P = 0.004) and fish (P = 0.03) than were controls who were food insecure. When comparing drug users with controls, the former group reported consuming fewer meals during a usual week than the latter group (P < 0.0001). Drug users were more likely to fry foods (P = 0.02) while the controls were more likely to bake (P = 0.005), boil (P = 0.02), and steam (P = 0.002) foods. All anthropometric measurements, except for height, were significantly lower for drug users. The results show that drug users generally maintain poorer nutritional status than non-drug-users. Nutrition interventions as part of drug treatment are needed.

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OBJECTIVE: To identify factors associated with the initiation of breast-feeding in a predominantly Puerto Rican population living in inner-city Hartford, Conn. DESIGN: Retrospective study of 144 Latino women (mean +/- standard deviation age = 26.3 +/- 5.7 years) with children at least 1 year old but younger than 6 years old (mean +/- standard deviation age = 3.0 +/- 1.2 years) at the time of the survey. Women were recruited from agencies sponsoring health programs for mothers and children. They were interviewed in their homes (69%) or at the Hispanic Health Council, Hartford, Conn (31%). SUBJECTS/SETTING: Low-income Latino women who had at least 1 preschooler at the time of the interview. The women lived in inner-city Hartford, and the overwhelming majority were Puerto Rican and received welfare assistance and food stamps. Seventy-eight percent of the women chose to be interviewed in Spanish; the other 22% were interviewed in English. STATISTICAL ANALYSES: Explanatory variables that related to breast-feeding initiation (P < or = .2) in bivariate chi 2 analyses were entered into a multivariate logistic regression model that was reduced using backward stepwise elimination procedures. RESULTS: Multivariate analyses indicated that breast-feeding the previous child, shorter length of maternal residence in the United States, not receiving prenatal bottle-feeding advice, more recent birth, and higher birth weight were positively associated with breast-feeding initiation. A major reason for choosing not to breast-feed was that women felt socially uncomfortable doing it. APPLICATIONS: Breast-feeding initiation was more likely in Latino women who received prenatal breast-feeding counselling and postpartum support. Mothers of low-birth-weight infants and women breast-feeding for the first time may need additional help. These findings can be used by programs like the Special Supplemental Nutrition Program for Women, Infants, and Children to increase breast-feeding initiation.

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Se presenta el esquema de estudio y diagnóstico de 202 pacientes con incontinencia de orina evaluadas en el Servicio de Ginecología, con la colaboración del Servicio de Urología de­ Hospital Clínico San Borja Arriarán. Con el esquema descrito se excluyen de­ tratamiento quirúrgico el 22,3 por ciento de ellas. Se enfatiza la necesidad de estudio y diagnóstico preoperatorio, para no efectuar indicaciones quirúrgicas injustificadas con desmedro de técnicas útiles y el consiguiente desprestigio de los cirujanos que las efectúan. Se analizan los fundamentos de los esquemas utilizados y los elementos de diagnóstico diferencial para aquellas incontinencias que son de tratamiento médico

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The 1991/92 Epidemiology and Family Health Survey (ENESF) from Honduras was examined for associations between prelacteal feeds and breast-feeding outcomes. The ENESF is a self-weighted nationally representative survey that included 2380 women with children under the age of two. Multivariate logistic regression was used to examine the association between prelacteal feeds and breast-feeding practices among 0- to 6-mo-old infants (n = 714), and to identify factors associated with milk-based prelacteal feeds. Providing milk-based prelacteal feeds was negatively associated with both exclusive (odds ratio = 0.18) and any breast-feeding (0.21). Prelacteal water was negatively associated with exclusive breast-feeding (0.19). Both water- and milk-based prelacteal feeds were associated with a delayed milk arrival and a delay in the time at which the child was offered the breast for the first time. Our findings suggest that prelacteal feeds have an adverse effect on breast-feeding outcomes.

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Se analiza el número de infecciones urinarias en dos grupos de 25 pacientes cada uno, operadas de prolapso genital. Se estudia el efecto del Solcourovac (MR) como profilaxis de infección urinaria en 25 pacientes operadas de prolapso con sonda Foley como drenaje postoperatorio. Se establece una diferencia con el grupo control estadísticamente significativa (p<0,05) en relación al número de infecciones postoperatorias, 76 porciento de urocultivos negativos en las pacientes vacunadas versus 24 porciento de urocultivos negativos en las no vacunadas

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The prevalence of bottle propping (permitting an infant to drink from a bottle unattended) and the determinants of this practice at 1 week and 4 months of life were studied in a selected sample of urban women in Hermosillo, Mexico. The sample (n = 165) consisted of mothers planning to breast-feed who gave birth to healthy infants at one of two public hospitals. Data were obtained by interviewing women shortly before they were discharged from the hospital and at about 1 week and 4 months postpartum. Among those mothers giving liquid breast milk substitutes to their infants, the percentage practicing bottle propping increased from 27% at 1 week (n = 20/74) to 67% at 4 months (n = 87/130). Women who practiced bottle propping at 1 week were significantly more likely to continue this practice at 4 months. Bottle propping was significantly more common, both at 1 week and 4 months, among women who had completely weaned their infants than among those who were still combining breast and formula feeding. Multivariate logistic regression indicated that 1-week risk factors for bottle propping were low socioeconomic status, being a multiparous single mother, and being a young mother (< or = 18 years old) with a female infant, while 4-month risk factors were complete weaning, delivery in a "nursery" (versus a "rooming-in") hospital, and lack of support by the mother's partner for breast-feeding. While the possible health risks associated with early bottle propping have not been well defined, the extent of the practice observed in this study suggests that such risks deserve further investigation.

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The prevalence of bottle propping (permitting an infant to drink from a bottle unattended) and the determinants of this practice at 1 week and 4 months of life were studied in a selected sample of urban women in Hermosillo, Mexico. The sample (n = 165) consisted of mothers planning to breast-feed who gave birth to healthy infants at one of two public hospitals. Data were obtained by interviewing women shortly before they were discharged from the hospital and at about 1 week and 4 months postpartum. Among those mothers giving liquid breast milk substitutes to their infants, the percentage practicing bottle propping increased from 27 percent at 1 week ( n = 20/74) to 67 percent at 4 months (n = 87/130). Women who practiced bottle propping at 1 week were significantly more likely to continue this practice at 4 mounts. Bottle propping was significantly more common, both at 1 week and 4 months, among women who had completely weaned their infants than among those who were still combining breast and formula feeding. Multivariate logistic regression indicated that 1-week risk factors for bottle propping were low socioeconomic status, being a multiparous single mother, and being a young mother (18 years old) with a female infant, while 4-month risk factors were complete weaning, delivery in a "nursery" (versus a "rooming-in") hospital, and lack of suppport by the mother's partner for breast-feeding. While the possible health risks associated with early bottle propping have not been well defined, the extent of the practice observed in this study suggests that such risks deserve further investigation

This article will also be published in Spanish in the BOSP. Vol. 119, 1995

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Survival analysis and logistic regression were used to identify factors associated with the onset of perceived insufficient milk among 165 healthy mothers who planned to breast-feed and gave birth by vaginal delivery, without complications, to a healthy term infant in either a nursery (n = 58) or a rooming-in-hospital where formula supplementation was not allowed (n = 107). Women were interviewed in the hospital and at 1 wk, 2 mo and 4 mo postpartum. Women from both hospitals were similar in socioeconomic, demographic, anthropometric, previous infant feeding experience and prenatal care variables. Eighty percent of the women reported perceived insufficient milk at some point during the study. The cue interpreted most often as indicating insufficient milk was the crying of the infant. Multivariate analyses indicated that lack of confidence in breast-feeding, delayed onset of milk production, maternal education, multiparity, sore nipples, early introduction of formula to the previous child and mother breast-fed as a child were significantly associated (P < 0.05) with perceived insufficient milk. Among women who reported perceived insufficient milk before 1 wk, breast-feeding confidence and maternal education interacted with the hospital in which they delivered.

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We identified determinants of breastfeeding and full breastfeeding among 165 healthy mothers from Hermosillo, Mexico who planned to breastfeed and delivered vaginally a healthy term infant. Deliveries took place in either a nursery (n = 58) or a rooming-in (n = 107) public hospital where formula supplementation was not allowed. Multivariate analyses indicated that at 1 week full breastfeeding was associated (P < or = 0.05) with early milk arrival, social support for full breastfeeding and planned breastfeeding duration. At 2 months, full breastfeeding was associated with social support for full breastfeeding and early milk arrival. Breastfeeding was positively associated with early milk arrival and inversely associated with early introduction of supplementary bottles, maternal employment, maternal body mass index and infant age. At 4 months, full breastfeeding was positively associated with social support for full breastfeeding and inversely associated with infant age. Breastfeeding was positively associated with planned breastfeeding duration and inversely associated with early introduction of a bottle and urban background. Rooming-in mothers reported that their milk came in earlier (P < or = 0.05) than did the nursery group. Milk arrival was later when a bottle was introduced in the first week; both of these variables might be important in explaining a positive effect of rooming-in on lactation performance.

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We compared the lactation performance of 165 healthy mothers who planned to breastfeed and gave birth by vaginal delivery, without complications to a healthy infant in either a nursery (NUR) (n = 58) or a rooming-in hospital where formula supplementation was not allowed. In the rooming-in hospital, women were randomly assigned to a group that received breastfeeding guidance during the hospital stay (RIBFG) (n = 53) or to a control group (RI) (n = 54). Women were interviewed in the hospital and at 8, 70 and 135 days post-partum (pp). The groups were similar in socio-economic, demographic, anthropometric, previous breastfeeding experience and prenatal care variables. Non-parametric survival analyses adjusting for potential confounding factors show that breastfeeding guidance had a positive impact (P < or = 0.05) on breastfeeding duration among primiparous women who delivered in the rooming-in hospital. Among primiparae, the RI and RIBFG groups had higher (P < or = 0.05) full breastfeeding rates than the NUR group in the short term. In the longer term, only the difference between the RIBFG and the NUR group remained statistically significant. The maternity ward system did not have a statistically significant effect on the lactation performance of multiparae.

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La célula de Langerhans (C.L.), reconocida actualmente cocmo el brazo aferente más periférico de la respuesta inmune, ubivada en el estrato suprabasal de la epidermis en el ser humano, ratas, cobayos y conejos; no conocemos datos que la hayan demostrado en el armadillo de siete y nueve bandas con técnicas histoquímicas (ATP) asa) o con marcadores monoclonales (OKT 6). En este trabajo se investigó la presencia de las cálulas de Langerhans en la epidermis de 11(once) armadillos, ocho de nueve bandas y tres de siete bandas. Entre los primeros se estudió un caso de Lepra salvaje. Los sitios de las biopsias quirúrgicas fueron la cara ventral de las raíces de los miembros. Se dividió el material en tres partes y hasta el momento sólo se procesó usna parte para láminas epidérmicas marcadas con ATPasa,, según técnica de Wolff y Winkelman modificada, para su cuantificación y estudió morfológico. Hasta la fecha en las once muestras hemos detectado la presencia de las C.L. sin diferencias entre los armadillos de siete y nueve bandas. Tampoco encontramos diferencias significativas entre la Lepra Salvaje y los animales sanos. La morfología difiere en tamaño y forma comparada con las observadas en el cobayo y en el hombre. Son más finas las dendritas más largas pero a veces casi imperceptibles por su escaso grosor. De distribución irregular lo que dificulta de sobremanera su cuantificación, por lo que nos parece prematuro aventurar una cifra para cuantificar esta población celular. En la presentación ejem

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La célula de Langerhans (C.L.), reconocida actualmente cocmo el brazo aferente más periférico de la respuesta inmune, ubivada en el estrato suprabasal de la epidermis en el ser humano, ratas, cobayos y conejos; no conocemos datos que la hayan demostrado en el armadillo de siete y nueve bandas con técnicas histoquímicas (ATP) asa) o con marcadores monoclonales (OKT 6). En este trabajo se investigó la presencia de las cálulas de Langerhans en la epidermis de 11(once) armadillos, ocho de nueve bandas y tres de siete bandas. Entre los primeros se estudió un caso de Lepra salvaje. Los sitios de las biopsias quirúrgicas fueron la cara ventral de las raíces de los miembros. Se dividió el material en tres partes y hasta el momento sólo se procesó usna parte para láminas epidérmicas marcadas con ATPasa,, según técnica de Wolff y Winkelman modificada, para su cuantificación y estudió morfológico. Hasta la fecha en las once muestras hemos detectado la presencia de las C.L. sin diferencias entre los armadillos de siete y nueve bandas. Tampoco encontramos diferencias significativas entre la Lepra Salvaje y los animales sanos. La morfología difiere en tamaño y forma comparada con las observadas en el cobayo y en el hombre. Son más finas las dendritas más largas pero a veces casi imperceptibles por su escaso grosor. De distribución irregular lo que dificulta de sobremanera su cuantificación, por lo que nos parece prematuro aventurar una cifra para cuantificar esta población celular. En la presentación ejem

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