RESUMO
PURPOSE: Post-transplant metabolic syndrome (PTMS) is associated with important causes of morbidity and mortality in solid organ transplant recipients. Our aim was to investigate predictors of PTMS in liver transplant (LT) recipients. METHODS: We randomly selected 343 adults (>18 years of age) from a large cohort of 1,262 ethnically diverse patients who received LTs during 2000-2010. RESULTS: Of 343 patients included, 68.2 % were male, with a mean age of 54 ± 10 years, 87 % White, and 31 % Hispanic. Prior to LTs, 6.2 % were on lipid-lowering agents and 24.5 % had BMI ≥ 30 (mean 26.9 ± 5 kg/m(2)). More Hispanics had diabetes before LTs compared to non-Hispanics (p = 0.037). Among those with follow-up of >6 months (n = 304) after LTs, the proportion of patients with diabetes and hypertension increased from 21.9 to 27 % (p < 0.0001), and from 11.5 to 51.6 % (p < 0.0001), respectively. Cholesterol levels increased from 150 ± 115 to 167 ± 70 (p < 0.0001). BMI remained unchanged. PTMS developed in 41 (13.5 %) and cardiovascular events in 31 (10.2 %) patients. Hispanics had higher risk of developing PTMS compared to non-Hispanics (OR 2.30, 95 % CI 1.18-4.49). Survival was not affected by PTMS (p = 0.3), ethnicity (p = 0.52), or nonalcoholic steatohepatitis as the etiology of liver disease (p = 0.50). CONCLUSIONS: More Hispanics had diabetes before LTs (29 to 18 %, p < 0.05) and were more prone to developing PTMS after LTs compared to non-Hispanics.
RESUMO
Background. Haitian immigrant women residing in Little Haiti, a large ethnic enclave in Miami-Dade County, experience the highest cervical cancer incidence rates in South Florida. While this disparity primarily reflects lack of access to screening with cervical cytology, the burden of human papillomavirus (HPV) which causes virtually all cases of cervical cancer worldwide, varies by population and may contribute to excess rate of disease. Our study examined the prevalence of oncogenic and nononcogenic HPV types and risk factors for HPV infection in Little Haiti. Methods. As part of an ongoing community-based participatory research initiative, community health workers recruited study participants between 2007 and 2008, instructed women on self-collecting cervicovaginal specimens, and collected sociodemographic and healthcare access data. Results. Of the 242 women who contributed adequate specimens, the overall prevalence of HPV was 20.7%, with oncogenic HPV infections (13.2% of women) outnumbering nononcogenic infections (7.4%). Age-specific prevalence of oncogenic HPV was highest in women 18-30 years (38.9%) although the prevalence of oncogenic HPV does not appear to be elevated relative to the general U.S. population. The high prevalence of oncogenic types in women over 60 years may indicate a substantial number of persistent infections at high risk of progression to precancer.