Prevalencia de demencia en adultos mayores de América Latina: revisión sistemática

Background and objectiveDementia is a growing public health problem. It involves the impairment of several cognitive functions, generating mental and physical disability, and therefore greater functional dependence. There is limited epidemiological information which reveals an approximate prevalence in older adults from Latin America. The objective of this study was to determine the prevalence of dementia in the older adult population of Latin America, and its distribution according to geographic area and gender.Materials and methodsA systematic review was carried out in databases: PubMed, Ovid, Lilacs, Cochrane, Scielo and Google Scholar, in order to identify studies that estimate the prevalence of dementia in urban and / or rural population over 65 years of age.ResultsOn February 2018, the literature search yielded 357 publications. The overall prevalence of dementia in the older adult population of Latin America was found to be 11%, prevailing more in female gender and urban people.ConclusionThe prevalence of dementia in Latin America is higher than registered previously, and even than in other continents.     

An Analysis of the Proportion of the U.S. Population that Ingests Soil or Other Non-Food Substances

Reliable quantitative data are lacking that document the prevalence of ingestion of soil and other “non-food” substances among U.S. children and adults. This article explores the proportion of the U.S. population that ingests substances such as soil, clay, starch, paint, or plaster. We compiled data from the National Health and Nutrition Examination Survey (NHANES) collected from years 1971–1975 (NHANES I) and 1976–1980 (NHANES II) because these particular surveys asked participants specific questions about non-food ingestion practices. We examined the prevalence of the behavior across multiple demographic variables, such as age, gender, education, and income level. Approximately 1% (NHANES II) to 2.5% (NHANES I) of the U.S. population ingests some type of non-food substance. The most notable variation across the demographic subgroups studied was the difference in estimated prevalence among young children (1 to <3 years) compared to older children and adults. Estimated prevalence was also higher among blacks compared to whites and within lower compared to higher socioeconomic groups. This analysis helps fill data gaps on the relative pattern of non-food ingestion practices on a national scale. This information provides perspective for risk assessors when evaluating exposure variables and for risk managers when weighing risk management alternatives.     

Moving: Characteristics of Dogs and Cats and Those Relinquishing Them to 12 U.S. Animal Shelters

The National Council on Pet Population Study and Policy Regional Shelter Survey identified moving as the most often cited of 71 reasons for relinquishing dogs and the 3rd most common reason for relinquishing cats. Most relinquished companion animals were less than 3 years old and female. Dogs were most often intact, whereas cats were most often altered. Friends had given the majority of these companion animals to the relinquishers, who had obtained them at no cost. Most had lived with the relinquishers for less than 2 years. The majority of relinquishers were White and female, and had at least a high school education. Based on the U.S. population age distribution, young adults seem to be using shelters at a significantly higher rate than would be expected. These age groups are also more mobile, according to U.S. Census data. Therefore, educational efforts that target young, potentially mobile adults could decrease the number of animals relinquished.     

Moving: characteristics of dogs and cats and those relinquishing them to 12 U.S. animal shelters

The National Council on Pet Population Study and Policy Regional Shelter Survey identified moving as the most often cited of 71 reasons for relinquishing dogs and the 3rd most common reason for relinquishing cats. Most relinquished companion animals were less than 3 years old and female. Dogs were most often intact, whereas cats were most often altered. Friends had given the majority of these companion animals to the relinquishers, who had obtained them at no cost. Most had lived with the relinquishers for less than 2 years. The majority of relinquishers were White and female, and had at least a high school education. Based on the U.S. population age distribution, young adults seem to be using shelters at a significantly higher rate than would be expected. These age groups are also more mobile, according to U.S. Census data. Therefore, educational efforts that target young, potentially mobile adults could decrease the number of animals relinquished.     

Associations among Active Transportation,Physical Activity,and Weight Status in Young Adults

Objective: To describe prevalence of active, public, and car transit by overweight status and amount of leisure‐time physical activity in a nationally representative cohort of ethnically diverse young adults. Research Methods and Procedures: Questionnaire data on patterns of transportation were collected from U.S. adolescents enrolled in Wave III (2001) of the National Longitudinal Study of Adolescent Health (N = 10, 771). Measured height and weight data were used to calculate BMI and classify adults by overweight status (BMI ≥ 25). Self‐reported physical activity data were used to classify adults into those who achieved ≥ 5 bouts of weekly moderate‐vigorous physical activity and those who did not. Results were stratified by overweight and physical activity status. Results: The vast majority of young adults used car transit (work, 90.4%; school, 74.7%). A small proportion of young adults used active means of transportation to work (8.1%) and school (26.7%), and fewer used public transportation to work or school (<10%). The proportion of individuals using active transportation was higher among the nonoverweight traveling to work (9.2%) and school (29.7%) and among the more active traveling to work (15.2%) and school (37.0%) relative to the overweight and less active young adults. Discussion: The vast majority of young adults of all racial/ethnic backgrounds, particularly blacks and Hispanics, did not use active transportation to school and/or work. Active transportation was more common among nonoverweight and more active young adults, of high socioeconomic status, particularly full‐time students. Population‐level efforts (and environmental supports) to increase non‐leisure physical activity, particularly active transportation, are sorely needed as a means of supporting and promoting overall physical activity.     

HIV and Latino migrant workers in the USA

Abstract

Migrant workers from Latin America are an essential source of economic development in the US agricultural industry. A majority of migrants are from Mexico and are undocumented and they represent a vulnerable and marginalized group in American society. There is a growing concern for HIV disease in the migrant community. The HIV prevalence rate among migrants is higher than the average rates in USA and in countries of Latin America. There are many behavioural, social, cultural, and health care risk factors and barriers that place migrants at increased risk for HIV infection. Many migrant workers contract HIV while working and living in the USA, which has contributed to rising HIV infection rates in Mexico. In order to prevent an increasing epidemic of HIV disease in Latino migrant workers, there is an urgent call for new and improved health care policies at the international, federal, state, and local levels.     

Health of Hmong in Thailand: Risk factors,morbidity and mortality in comparison with other ethnic groups

Demographic and health conditions among Hmong in Thailand were examined in comparison with other ethnic groups which closely resemble the ethnic origins of Southeast Asian refugees in the U.S. Thailand Hmong have very large extended family households, very high birth rates, low use of contraception, very young age at first marriage, and, compared with other highland minorities, relatively low infant and crude mortality rates. Hmong use of tobacco and alcohol and other stimulants is lower than other ethnic groups, and is much more frequent among men than among women. Opium was used by 15% of the men in the surveyed village, lower than among another highland group, but higher than in surveyed lowland villages. Fewer illnesses were reported by Hmong in the 7 days prior to survey than in other rural groups. Relatively low Hmong morbidity and mortality as compared with other highland ethnic groups may be associated with low use of tobacco and alcohol, and with the sharing of child care responsibilities within the large Hmong extended family households]This is the revised version of a paper presented at the Psychosocial Workshop of the Population Association of America Annual Meeting, Boston, 27 March 1985. Research was supported by National Science Foundation grant BNS 7914093, and by the East-West Center. Opinions expressed are those of the author.     

Pedagogy as View Sequence: Popular Culture, Education, and Travel

This article examines the economic and cultural construction of Latin America as an educational site, using analysis of brochures advertising educational tours, fieldwork in an educational tour organization, and interviews with educational travelers in the United States and Mexico. Representations are manipulated to define Latin America as colorful, exotic, and pristine and U.S. travelers as omniscient, sophisticated, and invisible.     

Population genetic analysis of cat populations from Mexico, Colombia, Bolivia, and the Dominican Republic: Identification of different gene pools in Latin America

In this paper we identify new genetic profiles of eight Latin American cat populations. In addition, we combine data from the present study and previously published data on 70 other American and European populations to discuss (1) the points of introduction of mutant alleles for cat coat phenotypes from Europe into Latin America, (2) the heterozygosity levels at these loci in the current Latin American cat populations, (3) the level of genetic heterogeneity among Latin American cat populations, and how this compares with levels found in North American and European cat populations, and (4) how many different cat gene pools are currently present in Latin America. We also include in our purview historical records of human migrations from Europe to and within the Americas. Our analyses clearly support the view that the current genetic profiles and structuring of cat populations in Latin America can be largely explained by the historical migration patterns of humans. This work is dedicated to the memory of Dr Roy Robinson. May he rest in peace.     

A low prevalence of cystic fibrosis in Uruguayans of mainly European descent

Cystic fibrosis is the most common hereditary disease in populations of European descent, with its prevalence depending on the populations and ethnic groups studied. In contrast to Europe and North America, there is little information about this disease in Latin America. Uruguay currently has a human population of 3,000,000, with a low rate of miscegenation and no remaining isolated Amerindian groups. In the present study, we estimated the prevalence of cystic fibrosis in this country based on the detection of DeltaF508 mutation carriers in 500 unrelated individuals and on the frequency of individuals homozygous for this mutation within the affected population. The latter was calculated from the frequency of the different mutations and genotypes observed in a sample of 52 previously described patients with confirmed cystic fibrosis. A theoretical estimate of the prevalence of cystic fibrosis based on anthropological data suggested a frequency of 25 affected individuals/100,000 inhabitants. However, our data indicated that the true prevalence in the population was considerably lower (6.9 cases/100,000 inhabitants).     

The Relationship of Antenatal and Postnatal Factors to Sudden Unexpected Death in Infancy

In the investigation of sudden unexpected death in infancy (S.U.D.) the antenatal and immediate postnatal history of the child and associated maternal circumstances have been virtually unexplored. These areas were studied using data gathered in a perinatal mortality study carried out in Ontario. By using rigid criteria, 80 cases of S.U.D. were identified and matched with live controls. Subsequent analysis showed that S.U.D. occurred slightly more often in males than females, and that the majority of deaths occurred under 4 months of age. S.U.D. was shown to be significantly related to prematurity; feeding other than at the breast; low maternal age at time of marriage, first pregnancy and the delivery of the infant under study; delayed first prenatal visits; maternal blood group and cigarette smoking. Confirmation of these findings may allow the construction of profiles of infants particularly at risk and permit the institution of preventive measures. Further prospective studies in this field are required.     

Pesticide Acute Toxicity Is a Better Correlate of U.S. Grassland Bird Declines than Agricultural Intensification

Common agricultural birds are in decline, both in Europe and in North America. Evidence from Europe suggests that agricultural intensification and, for some species, the indirect effects of pesticides mediated through a loss of insect food resource is in part responsible. On a state-by-state basis for the conterminous Unites States (U.S.), we looked at several agronomic variables to predict the number of grassland species increasing or declining according to breeding bird surveys conducted between 1980 and 2003. Best predictors of species declines were the lethal risk from insecticide use modeled from pesticide impact studies, followed by the loss of cropped pasture. Loss of permanent pasture or simple measures of agricultural intensification such as the proportion of land under crop or the proportion of farmland treated with herbicides did not explain bird declines as well. Because the proportion of farmland treated with insecticides, and more particularly the lethal risk to birds from the use of current insecticides feature so prominently in the best models, this suggests that, in the U.S. at least, pesticide toxicity to birds should be considered as an important factor in grassland bird declines.     

Prevalence of psychiatric disorders in U.S. older adults: findings from a nationally representative survey

Data on the prevalence of psychiatric disorders in late life are lacking. The present study addresses this gap in the literature by examining the prevalence of the broadest range of psychiatric disorders in late life to date; comparing prevalences across older adult age groups using the largest sample of adults aged 85+; and exploring gender differences in the prevalence of psychiatric disorders in late life. Using data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, we examined the prevalence of past-year mood, anxiety, and substance use disorders, and lifetime personality disorders in a nationally representative sample of 12,312 U.S. older adults. We stratified our analyses by gender and by older age groups: young-old (ages 55-64), middle-old (ages 65-74), old-old (ages 75-84), and oldest-old (ages 85+). The proportion of older adults who experienced any past-year anxiety disorder was 11.4%, while the prevalence of any past-year mood disorder was 6.8%. A total of 3.8% of older adults met criteria for any past-year substance use disorder, and 14.5% of older adults had one or more personality disorder. We observed a general pattern of decreasing rates of psychiatric disorders with increasing age. Women experienced higher rates of mood and anxiety disorders, while men had higher rates of substance use disorders and any personality disorder. Gender differences in rates of most psychiatric disorders decreased with increasing age. These data indicate that psychiatric disorders are prevalent among U.S. older adults, and support the importance of prevention, diagnosis, and treatment of psychiatric disorders in this population.     

Antenatal Syphilis Screening Using Point-Of-Care Testing in Low- and Middle-Income Countries in Asia and Latin America: A Cost-Effectiveness Analysis

BackgroundUntreated syphilis in pregnancy is associated with adverse clinical outcomes to the infant. In low- and middle-income countries in Asia and Latin America, 20%-30% of women are not tested for syphilis during pregnancy. We evaluated the cost-effectiveness of increasing the coverage for antenatal syphilis screening in 11 Asian and 20 Latin American countries, using a point-of-care immunochromatographic strip (ICS) test.MethodsThe decision analytical cost-effectiveness models reported incremental costs per disability-adjusted life years (DALYs) averted from the perspectives of the national health care payer. Clinical outcomes were stillbirths, neonatal deaths, and congenital syphilis. DALYs were computed using WHO disability weights. Costs included the ICS test, three injections of benzathine penicillin, and nurse wages. Country-specific inputs included the antenatal prevalence of syphilis and the proportion of women in the antenatal care setting that are screened for syphilis infection as reported in the 2014 WHO baseline report on global sexually transmitted infection surveillance. Country-specific data on the annual number of live births, proportion of women with at least one antenatal care visit, and per capita gross national income were also included in the model.ResultsThe incremental cost/DALY averted of syphilis screening is US$53 (range: US$10-US$332; Prob<1*per capita GDP=99.71%) in Asia and US$60 (range: US$5-US$225; Prob<1*per capita GDP=99.77%) in Latin America. Universal screening may reduce the annual number of stillbirths by 20,344 and 4,270, neonatal deaths by 8,201 and 1,721, cases of congenital syphilis by 10,952 and 2,298, and avert 925,039 and 197,454 DALYs in the aggregate Asian and Latin American panel, respectively.ConclusionAntenatal syphilis screening is highly cost-effective in all the 11 Asian and 20 Latin American countries assessed. Our findings support the decision to expand syphilis screening in countries with currently low screening rates or continue national syphilis screening programs in countries with high rates.     

NS1-Truncated Live Attenuated Virus Vaccine Provides Robust Protection to Aged Mice from Viral Challenge

Immunological changes associated with age contribute to the high rates of influenza virus morbidity and mortality in the elderly. Compounding this problem, aged individuals do not respond to vaccination as well as younger, healthy adults. Efforts to increase protection to this demographic group are of utmost importance, as the proportion of the population above the age of 65 is projected to increase in the coming decade. Using a live influenza virus with a truncated nonstructural protein 1 (NS1), we are able to stimulate cellular and humoral immune responses of aged mice comparable to levels seen in young mice. Impressively, a single vaccination provided protection following stringent lethal challenge in aged mice.     

Epidemiology of Candidemia in Latin America: A Laboratory-Based Survey

Background

The epidemiology of candidemia varies depending on the geographic region. Little is known about the epidemiology of candidemia in Latin America.

Methods

We conducted a 24-month laboratory-based survey of candidemia in 20 centers of seven Latin American countries. Incidence rates were calculated and the epidemiology of candidemia was characterized.

Results

Among 672 episodes of candidemia, 297 (44.2%) occurred in children (23.7% younger than 1 year), 36.2% in adults between 19 and 60 years old and 19.6% in elderly patients. The overall incidence was 1.18 cases per 1,000 admissions, and varied across countries, with the highest incidence in Colombia and the lowest in Chile. Candida albicans (37.6%), C. parapsilosis (26.5%) and C. tropicalis (17.6%) were the leading agents, with great variability in species distribution in the different countries. Most isolates were highly susceptible to fluconazole, voriconazole, amphotericin B and anidulafungin. Fluconazole was the most frequent agent used as primary treatment (65.8%), and the overall 30-day survival was 59.3%.

Conclusions

This first large epidemiologic study of candidemia in Latin America showed a high incidence of candidemia, high percentage of children, typical species distribution, with C. albicans, C. parapsilosis and C. tropicalis accounting for the majority of episodes, and low resistance rates.     

The spread of the western flower thrips Frankliniella occidentalis (Pergande)

Abstract 1 Since the late 1970s, the western flower thrips has spread from its original distribution in western North America to become a major worldwide crop pest. 2 A wide range of data sources have been used to map the original distribution in the U.S.A. and Canada, and the progress of the spread in the U.S.A., Canada, Europe, northern Africa and Australia. 3 The possible reasons for the start of the spread are discussed. The most likely reason is that intensive insecticide use in horticulture in the 1970s and 1980s selected an insecticide resistant strain or strains. These then established in glasshouses across North America and spread from there to Europe, Asia, Africa and Australia. 4 The international spread of the western flower thrips occurred predominantly by the movement of horticultural material, such as cuttings, seedlings and potted plants. Within Europe, an outward spread from the original outbreak in the Netherlands is discernible. The speed of spread was 229 ± 20 km/year. 5 The spread has not been restricted to glasshouses. The western flower thrips has established outdoors in areas with milder winters; for example, across the southern U.S.A., southern Europe and Australia. It also overwinters in some regions with colder winters. 6 Polyphagous phytophagous thrips have many factors predisposing them to become worldwide crop pests, particularly in glasshouses. Some other species that might spread in a similar way to the western flower thrips are listed.     

Immune surveillance of nasopharyngeal carcinoma (NpC)

In the U.S., nasopharyngeal carcinoma (NpC) kills >7,600 each year. Deaths are predominantly among adult men, and in most cases, early detection and treatment can save lives. Despite the annual spending of approximately 3.2 billion dollars on head and neck cancer research, NpC remains a neglected disease since its fatality rates are among the lowest nation wide. The relative survival rates from NpC have not improved in the U.S. in the last 20 years. Infection with Epstein Barr Virus (EBV) is an important co-factor in the etiology of NpC. In other regions of the word (e.g., South-East Asia, Latin America), EBV infection and NpCrelated prevalence and mortality are substantially higher and more alarming. Epidemiological data indicate high prevalence of EBV infection and increased risk for NpC among Central and South American and Asian immigrants in the U.S., and also predict a sharp increase in NpC incidence in the next decade. To face this emerging threat, it is important to develop and validate novel modes of detection and intervention for NpC. To this end, we characterized the proteomic signature of NpC, and of the tumor infiltrating lymphocytes of the CD8+, activated (CD38+, mTOR+) and regulatory immune cell (FoxP3+) phenotype. Paraffinized biopsies were processed, and tissue microarrays constructed and tested by immunohistochemistry and triimmunohistofluorescence for a battery of signaling markers, including AKT and PI3K, in conjunction with EBV status and ANKRD11, an NpC susceptibility biomarker. Microphotographs, analyzed and quantified by confocal microscopy and fractal analysis, suggest new avenues for immunotherapies of NpC.     

Absence of asymptomatic malaria in schoolchildren of Quibdó, Chocó

Asymptomatic malaria is characteristic of high intensity transmission areas in Africa but unusual in low transmission areas in Latin America. Nevertheless, asymptomatic malaria has been reported to be frequent in areas in Latin America with high and moderate intensity of transmission. Asymptomatic malaria can affect both individuals who carry parasites and are cryptic carrier reservoirs for the community. Individuals chronically infected with malaria parasites are usually unidentifiable by most malaria control programmes. In order to identify whether asymptomatic individuals harboring malaria parasites are an important reservoir of infection in Quibdó, Chocó, the prevalence of asymptomatic malaria was assessed in schoolchildren. This study was part of a major study of the epidemiology of malaria in Quibdó. A total of 255 children from 5 schools were examined, of which 223 were included in the analysis. Children reported headache (34%), cough (32%), and diarrhoea (9%). None of the children presented a positive thick smear. In addition, IFA tests in a subsample of 25 children were negative. By these criteria, the prevalence of asymptomatic malaria in Quibdó schoolchildren is 0% (95%C.I.: 0.0-1.4). Although asymptomatic malaria in adults possibly occurs, a very low prevalence is predicted.