In sorrow to bring forth children: fertility amidst the plague of HIV

The HIV epidemic is lowering fertility in sub-Saharan Africa. This decline in fertility appears to reflect a fall in the demand for children, and not any adverse physiological consequences of the disease, as it is matched by changes in the expressed preference for children and the use of contraception, and is not significantly correlated with biological markers of sub-fecundity. A fall in fertility lowers dependency ratios and, for a given savings rate, increases future capital per person. These two effects more than offset the loss of prime working age adults and reduced human capital of orphaned children brought by the epidemic, allowing 27 of the nations of sub-Saharan Africa to cumulatively spend US$650 billion, or$650 billionor 5100 per dying adult AIDS victim, on patient care without harming the welfare of future generations. In sum, the behavioral response to the HIV epidemic creates the material resources to fight it

Lipid-Reduction Variability and Antidrug-Antibody Formation with Bococizumab

Cardiolog

The influence of abdominal pressure on lower extremity venous pressure and hemodynamics: a human in-vivo model simulating the effect of abdominal obesity

OBJECTIVE: To demonstrate that abdominal pressure impacts venous flow and pressure characteristics. METHODS: Venous pressure at the femoral vein was measured in 6 non-obese subjects (mean BMI 22 ± 2 kg/m(2)) that were exposed to a circumferential cuff placed around the abdominal trunk and inflated to 20 and 40 mmHg. In a second step non-obese subjects (n = 10, BMI 21.8 ± 1.8 kg/m(2)) exposed to this cuff compression were studied for duplexsonographic parameters at the femoral vein. Duplexsonographic results were compared to subjects with abdominal obesity (n = 22, BMI 36.2 ± 5.9 kg/m(2)) in whom duplexsonographic parameters at the femoral vein were studied without cuff compression. RESULTS: Intravenous pressure increased with pressure application in all participants (p = 0.0025). Duplex examination of 10 non-obese subjects revealed increasing venous diameter (p < 0.0001) and decreasing venous peak and mean velocity (all p < 0.0001) when cuff pressure was applied. Duplex parameters with cuff pressure application of 20 and 40 mmHg respectively, were similar to those in obese subjects that were studied without pressure application. CONCLUSIONS: External abdominal pressure application creates venous stasis in lower limbs. Results of this study indicate that abdominal obesity might induce resistance to venous backflow from the lower limbs. Copyright © 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved

Sedentary behavior and blood pressure control among osteoarthritis initiative participants

SummaryObjectiveTo examine the association between sedentary behavior and blood pressure (BP) among Osteoarthritis Initiative (OAI) participants.DesignWe conducted a cross-sectional analysis of the OAI 48-month visit participants whose physical activity was measured using accelerometers. Participants were classified into four quartiles according to the percentage of wear time that was sedentary (<100 activity counts per min). Users of antihypertensive medications or non-steroidal anti-inflammatory drugs (NSAIDs) were excluded. Our main outcomes were systolic and diastolic blood pressures (SBP and DBP) and “elevated BP” defined as BP ≥ 130/85 mm Hg.ResultsFor this study cohort (N = 707), mean BP was 121.4 ± 15.6/74.7 ± 9.5 mm Hg and 33% had elevated BP. SBP had a graded association with increased sedentary time (P for trend = 0.02). The most sedentary quartile had 4.26 mm Hg higher SBP (95% confidence interval (CI), 0.69–7.82; P = 0.02) than the least sedentary quartile, adjusting for age, moderate-to-vigorous (MV) physical activity, and other demographic and health factors. The probability of having elevated BP significantly increased in higher sedentary quartiles (P for trend = 0.046). There were no significant findings for DBP.ConclusionA strong graded association was demonstrated between sedentary behavior and increased SBP and elevated BP, independent of time spent in MV physical activity. Reducing daily sedentary time may lead to improvement in BP and reduction in cardiovascular risk