Relative risk for AIDS between homo/bisexual and heterosexual men

OBJETIVO: Analisar o risco relativo para Aids na população de homens que fazem sexo com homens em relação à população heterossexual masculina. MÉTODOS: Foram utilizadas estimativas sobre a proporção de homens que fazem sexo com homens no Brasil e dados de Aids do Sistema Nacionald e Agravos de Notificação. Foram calculadas estimativas para o risco relativo (RR) para Aids desta população em relação à população heterossexual masculina do Brasil; cidade e estado de São Paulo; e cidade e estado do Rio de Janeiro, para o período de 1996 a 2003. As trajetórias do RR neste período também foram analisadas. RESULTADOS: As estimativas do RR declinaram, mostrando tendência de estabilização: de 34,3 para 19,3 no País como um todo e entre 32,1 e 6,3 nos locais analisados. Para o País em 2003, o RR dos bissexuais masculinos em relação à população heterossexual masculina era 16. O RR para homossexuais exclusivos teve trajetória decrescente em todos os locais analisados, mas não para os bissexuais. CONCLUSÕES: O risco relativo para homens que fazem sexo com homens foi mais elevado em relação aos heterossexuais, em todos os locais. Esse resultado indica alta e persistente vulnerabilidade dessa população.OBJECTIVE: To assess the relative risk for AIDS between men who have sex with other men and heterosexual men. METHODS: Estimates on the proportion of men who have sex with men in Brazil and AIDS data from Brazil's Information System for Notifiable Diseases, were utilized. Estimates were calculated for the relative risk (RR) for AIDS of men who have sex with men with respect to heterosexual masculine population in Brazil; state and city of São Paulo; and state and city of Rio de Janeiro, from 1996 to 2003. The trajectory of the RR in this period was also analyzed. RESULTS: The estimates for relative risk decreased, with a tendency to stabilize: from 34.3 to 19.3 in the entire country and from 32.1 and 6.3 in the locations analyzed. In the country in 2003, the relative risk of bisexual men in relation to heterosexual men was 16.0. The RR for exclusive homosexuals had a decreasing trajectory in all of the locations studied, but not for the bisexual population. CONCLUSIONS: In all locations, the relative risk for men who have sex with other men was higher in relation to heterosexual men. This result indicates a high and persistent vulnerability among this population

Risco relativo para Aids de homens homo/bissexuais em relação aos heterossexuais

OBJECTIVE: To assess the relative risk for AIDS between men who have sex with other men and heterosexual men. METHODS: Estimates on the proportion of men who have sex with men in Brazil and AIDS data from Brazil's Information System for Notifiable Diseases, were utilized. Estimates were calculated for the relative risk (RR) for AIDS of men who have sex with men with respect to heterosexual masculine population in Brazil; state and city of São Paulo; and state and city of Rio de Janeiro, from 1996 to 2003. The trajectory of the RR in this period was also analyzed. RESULTS: The estimates for relative risk decreased, with a tendency to stabilize: from 34.3 to 19.3 in the entire country and from 32.1 and 6.3 in the locations analyzed. In the country in 2003, the relative risk of bisexual men in relation to heterosexual men was 16.0. The RR for exclusive homosexuals had a decreasing trajectory in all of the locations studied, but not for the bisexual population. CONCLUSIONS: In all locations, the relative risk for men who have sex with other men was higher in relation to heterosexual men. This result indicates a high and persistent vulnerability among this population.OBJETIVO: Analisar o risco relativo para Aids na população de homens que fazem sexo com homens em relação à população heterossexual masculina. MÉTODOS: Foram utilizadas estimativas sobre a proporção de homens que fazem sexo com homens no Brasil e dados de Aids do Sistema Nacionald e Agravos de Notificação. Foram calculadas estimativas para o risco relativo (RR) para Aids desta população em relação à população heterossexual masculina do Brasil; cidade e estado de São Paulo; e cidade e estado do Rio de Janeiro, para o período de 1996 a 2003. As trajetórias do RR neste período também foram analisadas. RESULTADOS: As estimativas do RR declinaram, mostrando tendência de estabilização: de 34,3 para 19,3 no País como um todo e entre 32,1 e 6,3 nos locais analisados. Para o País em 2003, o RR dos bissexuais masculinos em relação à população heterossexual masculina era 16. O RR para homossexuais exclusivos teve trajetória decrescente em todos os locais analisados, mas não para os bissexuais. CONCLUSÕES: O risco relativo para homens que fazem sexo com homens foi mais elevado em relação aos heterossexuais, em todos os locais. Esse resultado indica alta e persistente vulnerabilidade dessa população

Relación entre las fases precoces de la enfermedad renal y el síndrome metabólico

Advanced kidney disease is a major health problem due to its association with high cardiovascular morbidity and mortality. Early recognition of advanced kidney disease is the mainstay to avoid its progression. Since metabolic syndrome and insulin resistance are risk factors for both cardiovascular and advanced kidney disease, we investigated the relationship of early kidney disease (EKD) with metabolic syndrome and insulin resistance, and their association with surrogate markers of arteriosclerosis. METHODS: We studied 1498 subjects. Insulin resistance was defined as HOMA >/=3.7 mmol (muU)/L(2) and EKD as stages 1 and 2 of the NKF-KDOQI. Carotid intima-media thickness was used as a surrogate marker of arteriosclerosis. RESULTS: The presence of one trait of metabolic syndrome was associated with an odds ratio (OR) for EKD of 2.3 (95% confidence interval [CI], 1.18-4.48) that increased to 6.72 (95% CI, 3.56-13.69) in subjects with the syndrome. All the traits of the syndrome except low level of high-density lipoproteins showed an increased OR for EKD. Increasing HOMA was also directly correlated with higher OR for EKD, being as high as 3.89 (95% CI, 1.99-7.59) for subjects in the fourth quartile. Subjects with the syndrome plus EKD showed an increased intima-media thickness compared with those without kidney disease. CONCLUSIONS: Insulin resistance and all metabolic syndrome traits except low level of high-density lipoproteins were significantly associated with an increased OR for EKD. Both metabolic syndrome and EKD were independently and additively related to the presence of surrogate markers of arteriosclerosis

Validation of plasma fibrinogen as a marker of carotid atherosclerosis in subjects free of clinical cardiovascular disease

BACKGROUND AND OBJECTIVES: Fibrinogen has been found to be an independent risk factor for cardiovascular disease. The aim of this study was to validate the measurement of plasma fibrinogen as a marker of subclinical atherosclerosis in a series of asymptomatic subjects (n=519, median age 55.5 years, 80% men). DESIGN AND METHODS: All individuals had a complete clinical examination, lipid profile (cholesterol and its high and low density lipoprotein fractions and triglycerides), global vascular risk assessment (PROCAM), and B-mode ultrasonography of the carotid arteries to determine the intima-media thickness (IMT) and the presence of atheroma plaques. C-reactive protein (CRP), and von Willebrand factor (vWF) were also measured in all subjects as markers of inflammation/endothelial damage. RESULTS: In the univariate model, a positive relationship was found between plasma fibrinogen concentration and carotid IMT (p<0.001). Fibrinogen concentration also correlated positively with age (p<0.001), systolic blood pressure (p<0.001), smoking (p<0.05), diabetes (p<0.05), PROCAM (p<0.001), CRP and vWF (p<0.001). In the multivariate analysis, the association of fibrinogen with carotid IMT remained significant (p=0.008) after adjustment for all parameters analyzed. INTERPRETATION AND CONCLUSIONS: In a population sample of adults without clinically overt atherosclerotic disease, elevated fibrinogen levels was related to carotid IMT independently of a wide range of important confounding variables. Plasma fibrinogen may represent a systemic marker of carotid atherosclerosis

NADPH Oxidase–Dependent Superoxide Production Is Associated With Carotid Intima-Media Thickness in Subjects Free of Clinical Atherosclerotic Disease

Objective—Oxidative stress plays a critical role in the pathogenesis of atherosclerosis. The NADPH oxidase constitutes the main source of superoxide in phagocytic and vascular cells. This study aimed to investigate the levels of NADPH oxidase–mediated superoxide production in phagocytic cells and the association between phagocytic superoxide production and carotid intima-media thickness (IMT), a surrogate marker of asymptomatic atherosclerosis. Methods and Results—NADPH oxidase–mediated superoxide production was determined by a chemiluminescence assay using lucigenin and associated with IMT for 184 asymptomatic subjects free of overt clinical atherosclerotic disease. Compared with individuals in the lowest tertile of superoxide production, those in the upper tertile ( 20 counts/sec) showed significantly higher IMT (P 0.05). In correlation analysis, a positive relationship was found between superoxide production and carotid IMT. Superoxide production also correlated positively (P 0.05) with body mass index (BMI). In multivariate analysis, the association of superoxide production with carotid IMT remained significant after adjustment for age, sex, systolic blood pressure, BMI, triglycerides, glucose, and smoking. Conclusions—In a population sample of adults without clinically overt atherosclerotic disease, increased NADPH oxidase activity was associated with enhanced carotid IMT, suggesting a relationship between phagocytic NADPH oxidase– mediated oxidative stress and the development of atherosclerosis

Increased phagocytic nicotinamide adenine dinucleotide phosphate oxidase–dependent superoxide production in patients with early chronic kidney disease

Background. Oxidative stress has been implicated in the pathogenesis of atherosclerosis that develops in patients with advanced chronic kidney disease (CKD). This study was designed to investigate whether a relationship exists between phagocytic nicotinamide adenine dinucleotide phosphate (NADPH) oxidase–dependent superoxide anion (•O2 −) production and subclinical atherosclerosis in patients with early CKD. Methods. Superoxide production was assayed by chemiluminescence under baseline and stimulated conditions on mononuclear cells obtained from asymptomatic patients with stage 1 to 2 CKD (N = 22) and healthy controls (N = 21). Ultrasonographic determination of carotid intima-media thickness (IMT) was used to assess the presence of atherosclerosis. Results. Although there were no differences in baseline •O2 − production between controls and patients, the •O2 − production in phorbol myristate acetate–stimulated mononuclear cells was increased (P < 0.05) in patients compared with controls. The phorbol myristate acetate–induced •O2 − production was completely abolished by apocynin, a specific inhibitor of NADPH oxidase. A direct correlation (r = 0.441, P < 0.05) was found between plasma insulin levels and NADPH oxidase–mediated •O2 − production in patients. Carotid IMT was higher (P < 0.005) in patients than in controls. CarotidIMTvalues above the upper normal limit in controls were found in 70% and 40% of patients with increased or normal NADPH oxidase–mediated •O2 − production, respectively. Conclusion. Generation of •O2 − that is mainly dependent on NADPH oxidase is abnormally enhanced in patients with early CKD. It is suggested that this alteration could be related to the development of subclinical atherosclerosis in these patients

Hetero-Diels–Alder Cycloaddition with RAFT Polymers as Bioconjugation Platform

We introduce the bioconjugation of polymers synthesized by RAFT polymerization, bearing no specific functional end group, by means of hetero‐Diels–Alder cycloaddition through their inherent terminal thiocarbonylthio moiety with a diene‐modified model protein. Quantitative conjugation occurs over the course of a few hours, at ambient temperature and neutral pH, and in the absence of any catalyst. Our technology platform affords thermoresponsive bioconjugates, whose aggregation is solely controlled by the polymer chains

Hetero-Diels-Alder-Cycloaddition mit RAFT-Polymeren als Biokonjugationsplattform

Wir stellen die Biokonjugation von Polymeren vor, die durch RAFT‐Polymerisation mittels Hetero‐Diels‐Alder‐Cycloaddition durch ihren inhärenten terminalen Thiocarbonylthiorest mit einem dienmodifizierten Modellprotein synthetisiert wurden und keine spezifische funktionelle Endgruppe tragen. Die quantitative Konjugation erfolgt im Verlauf einiger Stunden bei Raumtemperatur und nahezu neutralem pH‐Wert und in Abwesenheit jeglichen Katalysators. Unsere Technologieplattform liefert thermoresponsive Biokonjugate, deren Aggregation allein durch die Polymerketten gesteuert wird