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INTRODUCTION: Alkaloids-derived drugs are a billionaire world-market and several phytochemical investigations aim the identification of new sources and/or structures. Thus, improving the way of extracting and methods to quantify them are of utmost importance. OBJECTIVE: To quantify isoquinoline-derived alkaloids in Unonopsis duckei R.E. Fr. through a new validated high-performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS) method in combination with a statistical mixture design that aimed a proper direct extraction of these compounds from leaves. METHODOLOGY: Extracts were obtained with acetone, methanol, chloroform, and n-hexane in different combinations and proportions. Chemometrics were applied in order to compare peak areas, and therefore evaluate synergism and antagonism effects between the solvents. After selection of extraction solvent, the quantification was validated and applied in the best solvent combination to quantify the main alkaloids in U. duckei. RESULTS: Chemometrics indicated a synergistic effect between chloroform and methanol solvents, thus improving alkaloid extraction and extract yield. Analytes were quantified in a 15-min method, with limits of detection (LODs) between 0.5 and 5.2 ng/mL and limits of quantification (LOQs) between 1.6 and 17.2 ng/mL. The accuracy ranged between 80 and 120%. Coefficients of variation were lower than 17.42% at all concentrations. Concentrations of the alkaloids in U. duckei varied from 6.79 to 131.10 µg/g of dried leaf and glaziovine was found to be the main compound. CONCLUSION: The integration of simplex centroid model and quantification by HPLC-MS/MS is promising. Statistical optimisation of the alkaloid extraction and application of selective, sensitive and robust HPLC-MS/MS method will contribute to quality control applications in phytotherapeutic medicines.

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OBJECTIVE: To determine the prevalence of elevated blood pressure (EBP) in Bahamian adolescents. METHODS: A cross-sectional survey employing a self-administered questionnaire, and concurrently obtaining anthropometric measurements, was conducted involving selected grades 9, 10 and 11 students of all targeted public high schools in The Bahamas. RESULTS: The mean age of the 785 participants was 14.6 (± 1.153) years, and 87.6% were Bahamian. The prevalence of elevated systolic blood pressure (SBP) was 4.7% and 6.6% for elevated diastolic blood pressure (DBP). Elevated blood pressure prevalence was 8.9%. Elevated blood pressure was more common among grade 9 students (12-14-year olds) who had the largest proportion of EBP (55.7%). Both SBP and DBP increased with age in the males. Overall, students' prevalence of overweight/obesity was 32.2% (14.4% overweight, 17.8% obese). Body mass index (BMI), number of days per week eating fast food and perception of body weight were predictive of EBP. Body mass index, age and perception of body weight were found to be predictive of SBP (ßBMI = 0.25, p < 0.001; ßAge = 0.14, p < 0.001; ßWeight = 0.08, p < 0.037) and DBP (ßDBP = 0.192, p < 0.001). Overweight/obese students were 2.7 times more likely to have EBP. Elevated blood pressure was markedly associated with BMI, family history of hypertension and parents' overweight/obese status. CONCLUSION: The estimated prevalence of EBP in adolescent school children in New Providence, Bahamas, was comparable with neighbouring nations.

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OBJECTIVE: To explore the association between obesity and the development of impaired glucose tolerance (IGT) in Bahamian adolescents. METHODS: Eight hundred and seventy-three adolescents were randomly selected from five high schools in New Providence. Each student's weight, height, and waist and hip circumferences were recorded to determine body mass index (BMI). Individuals with BMIs above the 84th and 95th percentiles were classified as overweight and obese, respectively. Venous blood samples were collected from each subject and haemoglobin Ai c (HbAi c) levels were measured using a direct immunoassay method. The criterion established by the International Expert Committee for the diagnosis of IGT (HbA i c concentration of 6.0-6.4%) was used. An analysis of covariance was performed to evaluate the relationship between obesity and IGT, and a logistic regression analysis predicted the risk of IGT based on BMI classification. RESULTS: Of the 861 adolescents who completed the study, 15.0% were classified as overweight, 15.2% as obese and 7.9% as severely obese. The overall cumulative prevalence of IGT based on HbAi c levels was 16 100 cases per 100 000 adolescents and was greater in males than in females. Higher percentages of overweight and obese students were identified as having IGT compared with their normal-weight counterparts. An analysis of covariance with post hoc analyses revealed that severely obese males and females, respectively were almost 26 (OR = 25.54, 95%CI 9.92, 65.77) or 23 (OR = 22.96, 95% CI 9.81, 53.73) times more likely to develop IGT than their normal-weight counterparts (p < 0.005). CONCLUSION: The data show a strong positive association between IGT and obesity among Bahamian adolescents.

OBJETIVO: Explorar la asociación entre la obesidad y el desarrollo de trastornos de tolerancia a la glucosa (IGT) en los adolescentes de Bahamas. MÉTODOS: Ochocientos setenta y tres adolescentes fueron seleccionados aleatoriamente de cinco escuelas secundarias en Nueva Providencia. Se registraron peso, altura, y las circunferencias de cintura y cadera de cada estudiante, para determinar el índice de masa corporal (IMC). Las personas con IMC por encima de los percentiles 84 y 95 fueron clasificados como con sobrepeso y obesos, respectivamente. Se obtuvieron muestras de sangre venosa de cada sujeto, y se midieron los niveles de hemoglobina A 1c (HbAc utilizando un método de inmunoensayo directo. Se utilizó el criterio establecido por el Comité Internacional de expertos para el diagnóstico de IGT (concentración de HbA 1c de 6.0-6.4%). Se realizó un análisis de covarianza para evaluar la relación entre la obesidad y IGT, y un análisis de regresión logística para predecir el riesgo de IGT sobre la base de la clasificación del IMC. RESULTADOS: De los 861 adolescentes que completaron el estudio, 15.0% fueron clasificados como con sobrepeso, 15.2% como obesos, y 7.9% como extremadamente obesos. La prevalencia acumulativa general de IGT basada en los niveles de HbA 1c fue 16 100 casos por 100 000 adolescentes, y fue mayor en los varones que en las mujeres. Mayores porcentajes de estudiantes con sobrepeso y obesidad fueron identificados con IGT en comparación con sus contrapartes de peso normal. Un análisis de covarianza con análisis post-hoc reveló que los varones y hembras extremadamente obesos, respectivamente, fueron casi 26 (OR = 25.54, 95%CI 9.92, 65.77) o 23 (OR = 22.96, 95% CI 9.81, 53.73) veces más propensas a desarrollar IGT que sus contrapartes de peso normal (p < 0.05). CONCLUSIÓN: Los datos muestran una fuerte asociación positiva entre IGT y obesidad entre los adolescentes de las Bahamas.

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OBJECTIVE: To explore the association between obesity and the development of impaired glucose tolerance (IGT) in Bahamian adolescents. METHODS: Eight hundred and seventy-three adolescents were randomly selected from five high schools in New Providence. Each student's weight, height, and waist and hip circumferences were recorded to determine body mass index (BMI). Individuals with BMIs above the 84th and 95th percentiles were classified as overweight and obese, respectively. Venous blood samples were collected from each subject and haemoglobin A1c (HbA1c) levels were measured using a direct immunoassay method. The criterion established by the International Expert Committee for the diagnosis of IGT (HbA1c concentration of 6.0-6.4%) was used. An analysis of covariance was performed to evaluate the relationship between obesity and IGT, and a logistic regression analysis predicted the risk of IGT based on BMI classification. RESULTS: Of the 861 adolescents who completed the study, 15.0% were classified as overweight, 15.2% as obese and 7.9% as severely obese. The overall cumulative prevalence of IGT based on HbA1c levels was 16 100 cases per 100 000 adolescents and was greater in males than in females. Higher percentages of overweight and obese students were identified as having IGT compared with their normal-weight counterparts. An analysis of covariance with post hoc analyses revealed that severely obese males and females, respectively were almost 26 (OR = 25.54, 95% CI 9.92, 65.77) or 23 (OR = 22.96,95% CI 9.81, 53.73) times more likely to develop IGT than their normal-weight counterparts (p < 0.05). CONCLUSION: The data show a strong positive association between IGT and obesity among Bahamian adolescents.

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The prevalence of chronic renal failure (CRF)/end stage renal disease and the accessibility of long term renal replacement therapy in Jamaica were evaluated. The study was conducted at six Jamaican healthcare facilities between July 1998 and December 1999 and included 605 patients with CRF. Men with CRF (57% of patients, mean age of 56.7 years) were significantly older than women (mean age 53.2 years). Hypertension was the most commonly associated medical condition (60.8% of patients) followed by diabetes mellitus (31.4% of patients). The estimated crude point prevalence of CRF in persons 20 years and over at the end of 1999 was 327 per million population. More than one-third of patients with CRF (39%) were receiving renal replacement therapy, the most common modality being haemodialysis, and only 1.8% of patients had received kidney transplantation. The prevalence of chronic renal failure was not increased in areas known to have high soil cadmium levels. Chronic renal failure is a significant public health problem in Jamaica and is placing an increasing financial burden on the healthcare sector.

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The prevalence of chronic renal failure (CRF)/end stage renal disease and the accessibility of long term renal replacement therapy in Jamaica were evaluated. The study was conducted at six Jamaican healthcare facilities between July 1998 and December 1999 and included 605 patients with CRF. Men with CRF (57 of patients, mean age of 56.7 years) were significantly older than women (mean age 53.2 years). Hypertension was the most commonly associated medical condition (60.8 of patients) followed by diabetes mellitus (31.4 of patients). The estimated crude point prevalence of CRF in persons 20 years and over at the end of 1999 was 327 per million population. More than one-third of patients with CRF (39) were receiving renal replacement therapy, the most common modality being haemodialysis, and only 1.8 of patients had received kidney transplantation. The prevalence of chronic renal failure was not increased in areas known to have high soil cadmium levels. Chronic renal failure is a significant public health problem in Jamaica and is placing an increasing financial burden on the healthcare sector

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A 19-year-old woman, who delivered a macerated stillborn at 32 weeks' gestation and had persistent postpartum vaginal bleeding, presented with a left hemiparesis three and a half months after delivery. A clinical diagnosis of persistent gestational trophoblastic disease (GTD) was made, based on quantitative serum beta-hCG of more than 200,000 IU/ml, cannon ball metastases on chest X-ray and two ring enhancing lesions, metastases, in the right parietal lobe on Computed Axial Tomography (CAT) scan of the brain. Despite combination chemotherapy, with methotrexate, cyclophosphamide and actinomycin D, her condition worsened and she died.

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A 19-year-old woman, who delivered a macerated stillborn at 32 weeks' gestation and had persistent postpartum vaginal bleeding, presented with a left hemiparesis three and a half months after delivery. A clinical diagnosis of persistent gestational trophoblastic disease (GTD) was made, based on quantitative serum beta-hCG of more than 200,000 IU/ml, cannon ball metastases on chest X-ray and two ring enhancing lesions, metastases, in the right parietal lobe on Computed Axial Tomography (CAT) scan of the brain. Despite combination chemotherapy, with methotrexate, cyclophosphamide and actinomycin D, her condition worsened and she died.

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OBJECTIVE: To determine the response to maximal treadmill exercise with the Bruce protocol in a cohort of healthy non-obese American children and adolescents. STUDY DESIGN: A retrospective review of treadmill exercise studies on 347 white American children (188 boys, 159 girls) aged 5 to 18 years was performed with metabolic criteria to verify maximal exercise effort. Data on exercise endurance time, heart rate, blood pressure, and metabolic variables were assessed and compared between age groups and sexes by unpaired t testing and analysis of variance. RESULTS: Exercise endurance time was lower in all age groups when compared with earlier published data. Girls had a lower endurance time than boys at all ages. There was no significant difference in maximum heart rate with respect to age or sex. The maximum systolic blood pressure and diastolic blood pressure increased with increasing age in both boys and girls. Boys had significantly higher maximum systolic blood pressure and diastolic blood pressure after 13 years of age. The maximum absolute oxygen consumption and indexed oxygen consumption showed similar trends for both sexes. CONCLUSION: Lower exercise endurance times are seen despite physiologic evidence of maximal effort, raising the possibility that cardiovascular conditioning is reduced in contemporary American children.

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OBJECTIVE: To investigate the sexual behaviours of students resident in the dormitories at the St. Augustine campus (SAC), Trinidad, for the 1997-98 academic year. DESIGN AND METHODS: A questionnaire was administered to randomly selected students in each dormitory at the SAC. RESULTS: 180 students were selected randomly from the dormitory population and 169 questionnaires were completed (response rate = 93.9 percent). The median age of respondents was 21 years; males comprised 50.3 percent; 66.9 percent of respondents were sexually active; 31 percent of sexually active students used condoms consistently but 18.6 percent never used condoms. The most frequent reasons for not using condoms were: unavailable at the time (31.2 percent); monogamy (18.2 percent); use of the pill (5. percent). Inconsistent condom usage was not related to socio-economic status, marital status, marital status, level of study, or described religious behaviour. Other risk practices included sexual intercourse under the influence of alcohol (35.4 percent); sexual intercourse under the influence of drugs (12.4 percent) and more than one partner in the last year (38.9 percent). Many respondents admitted to multiple risk behaviour patterns. CONCLUSIONS: A high proportion of students resident in the dormitories at the SAC are sexually active and indulge in high-risk behaviour. Students who engage in several sexual risk practices have not personalized their risk of contracting HIV. Behaviour modification is needed.(Au)

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Exploiting the biolistic process we have generated stable transgenic bean (Phaseolus vulgaris L.) plants with unlinked and linked foreign genes. Co-transformation was conducted using plasmid constructions containing a fusion of the gus and neo genes, which were co-introduced with the methionine-rich 2S albumin gene isolated from the Brazil nut and the antisense sequence of AC1, AC2, AC3 and BC1 genes from the bean golden mosaic geminivirus. The results revealed a co-transformation frequency ranging from 40% to 50% when using unlinked genes and 100% for linked genes. The introduced foreign genes were inherited in a Mendelian fashion in most of the transgenic bean lines. PCR and Southern blot hybridization confirmed the integration of the foreign genes in the plant genome.

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A qualitative and quantitative histological analysis of minor salivary glands was carried out in 60 alcoholics and 20 matched control patients. Minor salivary glands biopsies were obtained and samples were processed for conventional light microscopy. A quantitative morphometrical assessment was carried out by counting the number of acinar cells present in an area by means of a squared grid eye piece. Neither hipertrophic nor atrophic responses were found in the quantitative analysis. Histological changes such as acinar degeneration, hyperemia, mononuclear inflammatory and fat infiltration were found in both experimental and control samples. None of these findings reached statistical significance. Eleven adult alcoholics with liver damage (ASD) presented duct dilatation. On the other hand, only 3 adult alcoholics with liver damage (ACD) developed this response. This difference was statistically significant (p=0.02). Perhaps no difference was found when we compared ASD group with its respective control group (p=0.699). Whe could not differentiate if this change was due to alcoholism or another undeterminated factor. At least under the scope of this study, we may conclude that minor salivary glands are acarcely affected by alcoholism even when liver damage has been established

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Neonatal duration of hospital stay correlated with both birth weight and gestational age in positively skewed, nonlinear relationships. Within increments of birth weight, gestational age had a semi-independent influence on length of stay. Log length of stay correlated with both birth weight and gestational age in linear, normally distributed relationships. A nomogram is provided for predicting individual lengths of stay.

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El presente estudio fue realizado con el fin de verificar si las glándulas salivales menores de pacientes alcohólicos presentan cambios histopatológicos. Se seleccionó un grupo experimental conformado por 10 pacientes alcohólicos crónicos y un grupo control constituido por 10 individuos adultos no alcohólicos sin antecedentes mórbidos. Las edades de ambos grupos fluctuaban entre los 45 y 65 años. Los pacientes presentabn lesiones patológicas en la región labial inferior que justificaron la toma de la biopsia. Las muestras fueron procesadas para microscopía óptica convencional y se tiñeron con hematoxilina-eosina, tricrómico de Van Gieson-Ponceau y Sudan. Los resultados mostraron un incremento en el número de acinos por campo en el grupo experimental (p < 0,003). Esta hiperplasia de células acinares podría corresponder a una etapa temprana de sialadenosis. las muestras de los pacientes alcohólicos presentaban las células acinares hipertrofiadas, con ruptura de las membranas celulares y dilatación de los ductos. Estos hallazgos podrían explicar la hipersalivación observada en pacientes alcohólicos

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To study the relationship between anemia and breathing abnormalities in preterm infants, we measured oxygen supply and demand in two groups of anemic infants less than or equal to 32 weeks of gestational age. Six-second apnea density was less than 1% in one group and greater than or equal to 5% in the other. There were no differences in hemoglobin concentration, available oxygen, oxygen consumption, or Doppler-determined cardiac output between the two groups of infants. Furthermore, in anemic preterm infants with apnea density greater than or equal to 5%, reductions in 6-second apnea density were similar after erythrocyte transfusion (mean +/- SEM: from 8.6% +/- 1.1% to 4.7% +/- 0.7%) or after an isovolemic infusion of 5% albumin (from 9.0% +/- 1.4% to 4.7% +/- 0.7%). These results show no relationship between measures of oxygen delivery and respiratory irregularities, and indicate that volume expansion may play a role in ameliorating the pneumocardiogram abnormalities.

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Urinary D-lactate excretion, expressed as the molar D-lactate/creatinine ratio, was measured serially in nine term and premature infants with necrotizing enterocolitis, 15 healthy term infants, and eight term and premature infants sick but without NEC. The mean (+/- SD) uDL/CR of the infants with NEC was 1.63 +/- 1.09, significantly greater than the mean uDL/CR of the healthy infants (0.16 +/- 0.04) or the sick infants without NEC (0.43 +/- 0.32). The uDL/CR of infants with NEC rose coincident with the onset of disease, reached peak values at an average of 5.8 days, and subsided to baseline levels on recovery. Seven of the nine infants with NEC reached or exceeded a peak uDL/CR of 1.47; no infant without NEC reached this ratio. We conclude that uDL/CR is increased in infants with NEC and demonstrates the increased enteric bacterial activity in this disease.

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