Sex Differences in the Association of Age at Hypertension Diagnosis With Brain Structure

BACKGROUND

Sex differences exist in the likelihood of cognitive decline. The age at hypertension diagnosis is a unique contributor to brain structural changes associated with cerebral small vessel disease. However, whether this relationship differs between sexes remains unclear. Therefore, our objective was to evaluate sex differences in the association between the age at hypertension diagnosis and cerebral small vessel disease-related brain structural changes.

METHODS

We used data from the UK Biobank to select participants with a known age at hypertension diagnosis and brain magnetic resonance imaging (n=9430) and stratified them by sex and age at hypertension diagnosis. Control participants with magnetic resonance imaging scans but no hypertension were chosen at random matched by using propensity score matching. For morphological brain structural changes, generalized linear models were used while adjusting for other vascular risk factors. For the assessment of white matter microstructure, principal component analysis led to a reduction in the number of fractional anisotropy variables, followed by regression analysis with major principal components as outcomes.

RESULTS

Males but not females with a younger age at hypertension diagnosis exhibited lower brain gray and white matter volume compared with normotensive controls. The volume of white matter hyperintensities was greater in both males and females with hypertension than normotensive controls, significantly higher in older females with hypertension. Compared with normotensive controls, white matter microstructural integrity was lower in individuals with hypertension, which became more prominent with increasing age.

CONCLUSIONS

Our study demonstrates that the effect of hypertension on cerebral small vessel disease-related brain structure differs by sex and by age at hypertension diagnosis.

Validation of two real-time PCRs targeting the PE-PGRS 20 gene and the region of difference 4 for the characterization of Mycobacterium bovis isolates

This study aimed to develop and validate real-time PCR for the diagnosis of Mycobacterium bovis isolates. Two hundred and seventy-four M. bovis isolates and 156 M. tuberculosis isolates were tested. Both qPCRs amplified all of the 274 M. bovis samples, but none of the 156 M. tuberculosis samples. The qPCR for PE-PGRS 20 had 91% efficiency and a detection limit of 0.32 ng (sensitivity and specificity for qPCR "Mbovis.100" were 99.64 and 100%, respectively). The qPCR for RD4 had 100% efficiency, and a detection limit of 4 pg (diagnostic sensitivity and specificity were 100 and 100%. The qPCR tests were performed using 4 extraction sets, 3 qPCR kits, and with a range of equipment; yet, all combinations produced similar results in a diagnostic test, demonstrating the robustness of this method. The techniques proved to be efficient, robust, sensitive, and specific for the diagnosis of M. bovis.

Reproducibilidad de una prueba para la evaluación funcional del balance dinámico y la agilidad del adulto mayor

Introducción: la prueba 8 foot up & go evalúa el balance dinámico y la agilidad del adulto mayor. Aunque se ha evaluado su reproducibilidad en población norteamericana, se desconoce si funciona de manera similar en una población diferente como la colombiana.Objetivo: evaluar la reproducibilidad prueba-reprueba y el nivel de acuerdo de la prueba 8 foot up & go para la evaluación funcional del balance dinámico y la agilidad en una muestra de adultos mayores de Bucaramanga.Materiales y métodos: se llevó a cabo un estudio de evaluación de pruebas diagnósticas en 114 adultos mayores. Se evaluó la reproducibilidad prueba-reprueba mediante el coeficiente de correlación intraclase (CCI [2,1]) con sus respectivos intervalos de confianza del 95% (IC95%). El nivel de acuerdo se estableció mediante el método de Bland y Altman.Resultados: la reproducibilidad prueba-reprueba fue muy buena (CCI: 0,98; IC95%: 0,98-0,99); se encontró buen nivel de acuerdo para las mujeres (promedio de las diferencias [PD] = 0,04 segundos y límites de acuerdo [LA]: -1,27; 1,36 segundos) y los individuos institucionalizados (PD = 0,04 segundos [LA]: -3,18; 3,27 segundos).Conclusión: la prueba 8 foot up & go tiene muy buena reproducibilidad y buen nivel de acuerdo en población adulta mayor local colombiana.

Validez Facial del Instrumento de Medición de Hábitos de Vida (MHAVIDA) en Personas con Discapacidad de 5-13 Años

Introducción: La Clasificación Internacional del Funcionamiento (CIF) ha definido la discapacidad como un término que incluye deficiencias, limitaciones en la actividad y restricciones en la participación. Objetivo: Establecer la validez facial del instrumento de medición de hábitos de vida (MHAVIDA), que evalúa la participación social en niños y niñas de entre 5 y 13 años de edad que se encuentran en Condición de Discapacidad (CD). Materiales y métodos: Se realizó un estudio de evaluación de pruebas diagnósticas, así como la adaptación cultural de los instrumentos con 6 madres de niños y niñas sin condición de discapacidad (CD). A su vez, la validez facial fue evaluada por 19 madres de niños y niñas en CD, a quienes se les aplicó el instrumento mediante entrevista, realizada por dos estudiantes de último año de Fisioterapia. Resultados: El instrumento MHAVIDA para el rango de 5 a 13 años de edad, que evalúala participación social fue traducido oficialmente, y adaptado al lenguaje local con preguntas comprensibles, claras y fáciles de responder. Se encontraron palabras o preguntas confusas principalmente en las categorías educación y nutrición del instrumento que fueron modificadas y, finalmente, se obtuvo un instrumento con validez facial y adaptabilidad cultural pertinente al contexto. Conclusión: Se obtuvo un instrumento útil para evaluar la participación social a partir de los hábitos de vida de la población de 5 a 13 años con discapacidad, lo cual proporciona una base sólida para mejorar las intervenciones en rehabilitación.ABSTRACTIntroduction: The International Classification of Functioning (ICF) has defined disability as a term that includes impairments, activity limitations and restrictions. Objective: To establish the facial validity of the instruments Assessment of Life Habits (LIFE-H) for disabled children between 5 and13 years old. Materials and methods: a study was carried out on the assesment of diagnostic tests, as well as the cultural adaptation of the instruments using 6 mothers of children without disabilities (CD) as a reference. At the same time, the validity was assessed by 19 mothers of boys and girls in CD who were assessed through an interview done by two last year physiotherapy students. Results: The LIFE-H for age 5-13 years old, in order to assess social participation were officially translated, adapted to local language with comprehensible, clear, and easy to answer questions. We obtained an instrument with facial validity and relevant cultural adaptability to the context. We found confusing words or questions in education and nutrition categories in the LIFE-H for 5-13 years old that were modified. Conclusion: We obtained a useful tool to measure social participation from the habits of children with disabilities, which provides a sound basis for improving interventions in rehabilitation. It is suggested to continue the evaluating the reliability of this instrument.

Pseudorabies virus can be classified into five genotypes using partial sequences of UL44

Suid herpesvirus 1 (SuHV-1) is the causative agent of pseudorabies (PR), a disease of great importance due to the huge losses it causes in the swine industry. The aim of this study was to determine a method for genotyping SuHV-1 based on partial sequences of the gene coding for glycoprotein C (gC) and to elucidate the possible reasons for the variability of this region. A total of 109 gCsequences collected from GenBank were divided into five major groups after reconstruction of a phylogenetic tree by Bayesian inference. The analysis showed that a portion of gC (approximately 671 bp) is under selective pressure at various points that coincide with regions of protein disorder. It was also possible to divide SuHV-1 into five genotypes that evolved under different selective pressures. These genotypes are not specific to countries or continents, perhaps due to multiple introduction events related to the importation of swine.

Analysis of acylcarnitine profiles in umbilical cord blood and during the early neonatal period by electrospray ionization tandem mass spectrometry

Acylcarnitine profiling by electrospray ionization tandem mass spectrometry (ESI-MS/MS) is a potent tool for the diagnosis and screening of fatty acid oxidation and organic acid disorders. Few studies have analyzed free carnitine and acylcarnitines in dried blood spots (DBS) of umbilical cord blood (CB) and the postnatal changes in the concentrations of these analytes. We have investigated these metabolites in healthy exclusively breastfed neonates and examined possible effects of birth weight and gestational age. DBS of CB were collected from 162 adequate for gestational age neonates. Paired DBS of heel-prick blood were collected 4-8 days after birth from 106 of these neonates, the majority exclusively breastfed. Methanol extracts of DBS with deuterium-labeled internal standards were derivatized before analysis by ESI-MS/MS. Most of the analytes were measured using a full-scan method. The levels of the major long-chain acylcarnitines, palmitoylcarnitine, stearoylcarnitine, and oleoylcarnitine, increased by 27, 12, and 109%, respectively, in the first week of life. Free carnitine and acetylcarnitine had a modest increase: 8 and 11%, respectively. Propionylcarnitine presented a different behavior, decreasing 9% during the period. The correlations between birth weight or gestational age and the concentrations of the analytes in DBS were weak (r ≤ 0.20) or nonsignificant. Adaptation to breast milk as the sole source of nutrients can explain the increase of these metabolites along the early neonatal period. Acylcarnitine profiling in CB should have a role in the early detection of metabolic disorders in high-risk neonates.

[Congenital hypothyroidism screening: seasonal variations of TSH levels]

OBJECTIVE: To evaluate the seasonal differences in newborn TSH levels. METHOD: A restrospective study was performed using normal blood TSH measurements collected in a neonatal screening program for congenital hypothyroidism, during the extremes of temperature (summer/winter) in order to verify the seasonal influence on that exam. Blood samples were collected from baby feet on filter paper in health care public institutions in Rio de Janeiro city and TSH were analyzed by immunofluorimetric method. For this study we considered samples with TSH levels less then 20 micro U/ml. The factors age, birth weight and prematurity were all observed.RESULTS: We evaluated 388 measurements: 159 in the summer and 229 in the winter. Newborn and infants aged from 2 days to 3 months were included. The time of collection of the exam was significant in the measurement of TSH and the mean levels of TSH collected in the summer were somewhat higher than those collected in the winter (p = 0,0001), when analyzed by the t-test, even so when the age was taken into account. Using F-test (p=0,0234) we observed differences between TSH levels in age groups. TSH levels in the newborn with 2 to 7 days of age differ significantly from those of higher age. Birth weight and prematurity do not show interference with the TSH measurement.CONCLUSIONS: Newborn and infant TSH levels were significantly higher in the summer than in the winter.