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The new La2MnIrO6 ferromagnetic oxide is detected by solid-state chemical analysis and phenomenological super exchange theory. The spin-polarized configuration of the oxide is identified by self-consistent electronic structure computations. Theoretical and experimental magnetic properties of the oxide are consistent.

Obesity-induced insulin resistance (IR) is a common problem in humans as well as domestic dogs. It is well-known that this syndrome is associated with many modifications but it is still unclear if the changes are alterations or adaptations. The purpose of this study was to develop obesity-induced IR in dogs, through a long-term overfeeding period, and to explore hormonal and metabolic disturbances associated with the development of this syndrome. Dogs were overfed for 7 months. Body weight increased by 43 ± 5%, and insulin sensitivity decreased by 44 ± 5%. Plasma insulin-like growth factor 1 (IGF1), tumour necrosis factor alpha (TNF α), and non-esterified fatty acids (NEFA) concentrations progressively increased during the overfeeding period (IGF1: 111 ± 13 to 266 ± 32 ng/ml, p < 0.001; TNF α: 5 ± 5 to 134 ± 41 pg/ml; NEFA: 0.974 ± 0.094 to 1.590 ± 0.127 mmol/l, p < 0.05). These metabolic and hormonal impairments are associated with IR, in obese dogs, and could explain, at least in part, the outbreak of this syndrome. [ABSTRACT FROM AUTHOR]

From the nutrition point of view, lipids are primarily considered as energy suppliers, their dietary intake having to be limited. In fact, lipids are sources of various fatty acids, and dietary recommendations include the required daily intakes in different fatty acids (fatty acid profile). Beyond these quantitative aspects, fatty acids are part of larger molecules, mainly triacylglycerols (TAG), that are organized in supramolecular structures as for example fat crystals and lipid droplets. Recent advances in nutrition research have demonstrated that these structures, and lipid organization in food matrices, influence digestibility and metabolism of fatty acids. Therefore, the members of the technological network Listral propose a synthesis of the knowledge about the influence of molecular and supramolecular structures of lipids on digestion and metabolic fate of dietary fatty acids originating from for the main food industry sectors. Fatty acids are mainly provided in the diet in the form of TAG, or phospholipids (PL) where they are esterified in external (sn-1, sn-3) or internal (sn-2) position of the glycerol backbone. They can also be found as ethyl esters (EE) in specific formulations. These molecular characteristics of the lipid molecules affect their hydrolysis and their absorption rate but also their metabolism in indifferent organs, as assessed in studies often using inter esterified fat sources. The results depend on the types of fatty acids (saturated or polyunsaturated fatty acids) but also on the model used for the studies: in vitro or in vivo studies; animal model, human newborn or adult, either healthy or exhibiting some diseases. Among others, it was found that the crystal form and fat melting point as affected by the fatty acid profiles and the lipid molecular structures directly impact fatty acid absorption kinetics through modifications of lipolytic enzyme activities. However, in these studies, the relative effect of the thermal properties of lipids and the proportion of saturated fatty acids chains in sn-2 position were hardly distinguished. Supramolecular structures, namely type and size of the fat droplets and their interfacial composition, of lipids, either in their native forms or obtained after food processes, also affect the digestibility and absorption of lipids. This aspect is reviewed with specific focus on dairy, marine, meat, oil plant and egg products. The impact of other nutritional components present in these food matrices on the absorption of lipids is also discussed.

Objetivo. Establecer si ciertas características de los jóvenes influyen en la elección de las personas con quienes hablan sobre el SIDA. Material y métodos. A partir de una encuesta realizada por el Consejo Nacional para la Prevención y Control del SIDA (CONASIDA) en 1997 se hizo una regresión logística multinomial. El estudio abarca a 4 886 jóvenes de uno u otro sexo, de 15 a 19 años, en 13 entidades federativas de México. Resultados. El modelo, que incluye las variables sexo, actividad sexual, condición de actividad laboral y escolaridad del padre resultó significativo y altamente predictor de las personas con quienes los jóvenes hablan del SIDA, siempre en comparación con los jóvenes que no hablan con nadie. Los hombres jóvenes hablan del SIDA con su padre más que las mujeres, y las mujeres más con su madre. Los sexualmente activos hablan más con los amigos, y algo menos con los maestros, que los sexualmente inactivos. A mayor escolaridad del padre, los jóvenes tienen más interlocutores y hablan más sobre el SIDA en el ámbito familiar, comparados con los que tienen padre sin escolaridad. Conclusiones. Se sugiere diseñar estrategias diferenciadas de educación en salud sexual de acuerdo con las características de las subpoblaciones.

Exome sequencing (ES) has become the method of choice for diagnosing rare diseases, while the availability of short-read genome sequencing (SR-GS) in a medical setting is increasing. In addition, new sequencing technologies, such as long-read genome sequencing (LR-GS) and transcriptome sequencing, are being increasingly used. However, the contribution of these techniques compared to widely used ES is not well established, particularly in regards to the analysis of non-coding regions. In a pilot study of five probands affected by an undiagnosed neurodevelopmental disorder, we performed trio-based short-read GS and long-read GS as well as case-only peripheral blood transcriptome sequencing. We identified three new genetic diagnoses, none of which affected the coding regions. More specifically, LR-GS identified a balanced inversion in NSD1, highlighting a rare mechanism of Sotos syndrome. SR-GS identified a homozygous deep intronic variant of KLHL7 resulting in a neoexon inclusion, and a de novo mosaic intronic 22-bp deletion in KMT2D, leading to the diagnosis of Perching and Kabuki syndromes, respectively. All three variants had a significant effect on the transcriptome, which showed decreased gene expression, mono-allelic expression and splicing defects, respectively, further validating the effect of these variants. Overall, in undiagnosed patients, the combination of short and long read GS allowed the detection of cryptic variations not or barely detectable by ES, making it a highly sensitive method at the cost of more complex bioinformatics approaches. Transcriptome sequencing is a valuable complement for the functional validation of variations, particularly in the non-coding genome., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: SMG9 deficiency is an extremely rare autosomal recessive condition originally described in three patients from two families harboring homozygous truncating SMG9 variants in a context of severe syndromic developmental disorder. To our knowledge, no additional patient has been described since this first report., Methods: We performed exome sequencing in a patient exhibiting a syndromic developmental delay and in her unaffected parents and report the phenotypic features., Results: Our patient presented with a syndromic association of severe global developmental delay and diverse malformations, including cleft lip and palate, facial dysmorphic features, brain abnormalities, heart defect, growth retardation, and severe infections. She carried a novel SMG9 homozygous variant NM&#95;019108.3:c.1177C>T, p.(Gln393*), while her unaffected parents were both heterozygous., Conclusions: We confirm that bi-allelic truncating SMG9 variants cause a severe developmental syndrome including brain and heart malformations associated with facial dysmorphic features, severe growth and developmental delay with or without ophthalmological abnormalities, severe feeding difficulties, and life-threatening infections., (© 2019 Wiley Periodicals, Inc.)

Background: Worldwide, the importance of contraception to control fertility has been recognized. A useful indicator of the gap between reproductive preferences and the provision of contraception is "unmet need for contraception". The aims of this paper are to estimate the levels of unmet need for contraception among married and single women, and to explore factors associated with unmet need for contraception for spacing and limiting births in Mexico., Methods: We used the Mexican National Survey of Demographic Dynamics 2014, using a sub-sample of 56,797 sexually active women aged 15-49 years who were either currently in union or who had never been in union to estimate the prevalence of unmet need for spacing and limiting births. We applied multivariable binary logistic regressions to examine the relationship between unmet need for spacing and limiting considering associated factors., Results: Unmet need for contraception was estimated at 11.5% among women in union (6.4% limiting; 5.1% spacing), and 28.9% for women never in union (8% limiting; 20.9% spacing). In the logistic regression for unmet need for spacing, the likelihood was statistically significant associated with younger women (OR = 6.8; CI = 2.95-15.48); women never in union (OR = 1.6; CI = 1.40-1.79); low levels of education (OR = 1.4; CI = 1.26-1.56); and residing in poor regions (OR = 1.9; CI = 1.52-2.49). Those with full access to public services were significantly less likely to have unmet need for spacing (OR = 0.8; CI = 0.66-0.88). In the logistic regression for unmet need for limiting, being younger (OR = 6.3; CI = 4.73-8.27), never in union and sexually active (OR = 3.0; CI = 2.47-3.54); with less schooling (OR 1.13; CI: 1.02-1.26); rural residence (OR = 1.2; CI = 1.07-1.32); and residing in poor regions (OR = 1.5; CI = 1.23-1.93) were factors positively associated with this unmet need. Women with private health services were the least likely to have unmet need for limiting (OR = 0.5; CI = 0.37-0.77)., Conclusions: Younger women currently in union and never in union had the highest unmet needs of contraception for spacing and limiting. The results from this study suggest that in Mexico family planning services must prioritize the contraception needs of all young women, both in union and not in union, with appropriate and suitable services to cover their needs.

Objective: To estimate calendar of sexual debut in Mexico and its trends using national representative household surveys., Materials and Methods: Analysis of five birth cohorts extracted from four national population based household surveys in Mexico (National Health Survey 2000, National Survey on Demographic Dynamics 2009, National Youth Survey 2010, and National Health & Nutrition Survey 2012), using as outcome the proportion of individuals that reported sexual debut before the age of 16 and before the age of 20., Results: Overall, the four analyzed surveys produce consistent results, although some differences were found. While a larger proportion among younger cohorts reported sexual debut before the age of 20, that was not the case for sexual debut before 16 years., Conclusions: While data seems to reflect a relative stable age of sexual debut in Mexico, there is a recent trend to prepone sexual initiation that highlights the need to strengthen comprehensive sexual education and the supply of sexual & reproductive health services that are accessible and friendly to adolescents thus responding to the growing demand from this age group.

Background: Sleeve gastrectomy (SG) is a recent increasingly realized isolated procedure performed in the surgical treatment of obesity., Aim: The goal of this study was to evaluate the long term postoperative results among a multicentric cohort., Methods: Retrospective multicenter study including patients operated from 2006 to 2010 within the Brest's Bariatric Surgery Network., Results: The immediate postoperative course was uneventful in 90%. The minor complication rate was 6.9%. The major complication rate was 3%. Postoperative mortality was nil. Late complication rate was 5%. The excess weight loss mean was 42 ± 20 % at 4 years. Success rate was 55%, and the result was judged moderate in 31%. The improvement of co-morbidities has focused on type 2 diabetes to cure 49%, dyslipidemia was corrected in 60% of cases. Improved hypertension in 47% of cases, the disappearance of sleep apnea paired in 62% of cases., Conclusion: This study confirms in a multicenter feasibility of the SG and its effectiveness Long-term weight loss and resolution of comorbidities in addition it emphasizes the need for monitoring post operative extended to detect any vitamin deficiencies.

Although short-term incubation of hepatocytes with oleic acid (OA) stimulates secretion of apolipoprotein B100 (apoB100), exposure to higher doses of OA for longer periods inhibits secretion in association with induction of endoplasmic reticulum (ER) stress. Palmitic acid (PA) induces ER stress, but its effects on apoB100 secretion are unclear. Docosahexaenoic acid (DHA) inhibits apoB100 secretion, but its effects on ER stress have not been studied. We compared the effects of each of these fatty acids on ER stress and apoB100 secretion in McArdle RH7777 (McA) cells: OA and PA induced ER stress and inhibited apoB100 secretion at higher doses; PA was more potent because it also increased the synthesis of ceramide. DHA did not induce ER stress but was the most potent inhibitor of apoB100 secretion, acting via stimulation of autophagy. These unique effects of each fatty acid were confirmed when they were infused into C57BL6J mice. Our results suggest that when both increased hepatic secretion of VLDL apoB100 and hepatic steatosis coexist, reducing ER stress might alleviate hepatic steatosis but at the expense of increased VLDL secretion. In contrast, increasing autophagy might reduce VLDL secretion without causing steatosis.

Objective: Obesity induces a program of systemic inflammation that is implicated in the development of many of its clinical sequelae. Hepatic inflammation is a feature of obesity-induced liver disease, and our previous studies demonstrated reduced hepatic steatosis in obese mice deficient in the C-C chemokine receptor 2 (CCR2) that regulates myeloid cell recruitment. This suggests that a myeloid cell population is recruited to the liver in obesity and contributes to nonalcoholic fatty liver disease., Research Design and Methods: We used fluorescence-activated cell sorting to measure hepatic leukocyte populations in genetic and diet forms of murine obesity. We characterized in vivo models that increase and decrease an obesity-regulated CCR2-expressing population of hepatic leukocytes. Finally, using an in vitro co-culture system, we measured the ability of these cells to modulate a hepatocyte program of lipid metabolism., Results: We demonstrate that obesity activates hepatocyte expression of C-C chemokine ligand 2 (CCL2/MCP-1) leading to hepatic recruitment of CCR2(+) myeloid cells that promote hepatosteatosis. The quantity of these cells correlates with body mass and in obese mice represents the second largest immune cell population in the liver. Hepatic expression of CCL2 increases their recruitment and in the presence of dietary fat induces hepatosteatosis. These cells activate hepatic transcription of genes responsible for fatty acid esterification and steatosis., Conclusions: Obesity induces hepatic recruitment of a myeloid cell population that promotes hepatocyte lipid storage. These findings demonstrate that recruitment of myeloid cells to metabolic tissues is a common feature of obesity, not limited to adipose tissue.

The HIV/AIDS epidemics in Mexico has remained stable in terms of its slow growth during the last decade. Since the beginning of this century, efforts have been made to improve the epidemiological registration system. An important number of probability studies involving multiple geographic locations in Mexico and larger numbers of high-risk vulnerable populations have also been carried out, while continuing surveillance of volunteers for HIV testing. The analysis of recently obtained information and its comparison with that of the past century have unveiled the traces left by the new epidemics in its wake. The joint analysis of available information indicates that there are changes in transmission patterns of HIV/ AIDS that have modified the prevalence figures of previous decades. While transmission of blood-borne HIV infections have ceased, the number of HIV-seropositive drug users has increased, particularly in the northern of Mexico. In the population of men having sex with men (MSM) a decline in HIV prevalence has been noticed, excepting in the male sex working (MSW) group in whom a significant increase has been observed. The population with heterosexual practice clearly shows a steady growth of AIDS in women, particularly in young women from rural areas and in native women.

Objective: Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a central player in the regulation of cholesterol homeostasis, increasing the low-density lipoprotein (LDL) receptor degradation. Our study aimed at exploring the pathogenic consequences in vivo and in vitro of a PCSK9 prodomain mutation found in a family with hypobetalipoproteinemia (FHBL)., Methods and Results: A white 49-year-old diabetic man had profound FBHL (LDLC: 16 mg/dL) whereas his daughter and sister displayed a milder phenotype (LDLC 44 mg/dL and 57 mg/dL, respectively), all otherwise healthy with a normal liver function. A monoallelic PCSK9 double-mutant R104C/V114A cosegregated with FBHL, with no mutation found at other FHBL-causing loci. A dose-effect was also found in FBHL relatives for plasma APOB and PCSK9 (very-low to undetectable in proband, approximately 50% decreased in sister and daughter) and LDL catabolic rate (256% and 88% increased in proband and daughter). Transient transfection in hepatocytes showed severely impaired processing and secretion of the double mutant which acted as a dominant negative over secretion of wild-type PCSK9., Conclusions: These results show that heterozygous PCSK9 missense mutations may associate with profound hypobetalipoproteinemia and constitute the first direct evidence in human that decrease of plasma LDLC concentrations associated to PCSK9 LOF mutations are attributable to an increased clearance rate of LDL.

This article explores trends in sexual behavior in Latin America, envisaged from a life-course perspective, taking into account social differences. It is focused on three main issues: the timing of early sexual and reproductive events, sexual activity during adulthood, and measurement of homosexuality-bisexuality. It draws on general population data from nonspecific surveys, as surveys dealing specifically with sexual behavior are scarce in Latin American countries. A traditional feature in these societies is the huge amount of social inequality, which translates directly into social differences in sexual experience, especially among women. Despite the decline in fertility, an early start of unions and of reproductive experience remains typical of groups with lower education. Another aspect is the diversity of national patterns and gender systems, very far from the image of cultural homogeneity generally associated with this region. Data show a low prevalence of homosexuality/bisexuality, which can be a result of underreporting. The paper eventually stresses the necessity of carrying out more sexual behavior surveys of the general population in the region.

ER stress can cause hepatic insulin resistance and steatosis. Increased VLDL secretion could protect the liver from ER stress-induced steatosis, but the effect of lipid-induced ER stress on the secretion of VLDL is unknown. To determine the effect of lipids on hepatic ER stress and VLDL secretion, we treated McA-RH7777 liver cells with free fatty acids. Prolonged exposure increased cell triglycerides, induced steatosis, and increased ER stress. Effects on apoB100 secretion, which is required for VLDL assembly, were parabolic, with moderate free fatty acid exposure increasing apoB100 secretion, while greater lipid loading inhibited apoB100 secretion. This decreased secretion at higher lipid levels was due to increased protein degradation through both proteasomal and nonproteasomal pathways and was dependent on the induction of ER stress. These findings were supported in vivo, where intravenous infusion of oleic acid (OA) in mice increased ER stress in a duration-dependent manner. apoB secretion was again parabolic, stimulated by moderate, but not prolonged, OA infusion. Inhibition of ER stress was able to restore OA-stimulated apoB secretion after prolonged OA infusion. These results suggest that excessive ER stress in response to increased hepatic lipids may decrease the ability of the liver to secrete triglycerides by limiting apoB secretion, potentially worsening steatosis.

Tijuana, Mexico, just south of San Diego, California, is located by the busiest land border crossing in the world. Although UNAIDS considers Mexico to be a country of "low prevalence, high risk," recent surveillance data among sentinel populations in Tijuana suggests HIV prevalence is increasing. The aim of this study was to estimate the number of men and women aged 15 to 49 years infected with HIV in Tijuana. Gender and age-specific estimates of the Tijuana population were obtained from the 2000 Mexican census. Population and HIV prevalence estimates for at-risk groups were obtained from published reports, community based studies, and data from the Centro Nacional para la Prevención y Control del VIH/SIDA (CENSIDA). Age-specific fertility rates for Mexico were used to derive the number of low and high-risk pregnant women. Numbers of HIV-positive men and women were estimated for each at-risk group and then aggregated. A high growth scenario based on current HIV prevalence and a conservative, low growth estimate were determined. A total of 686,600 men and women in Tijuana were aged 15 to 49 years at the time of the 2000 census. Considering both scenarios, the number of infected persons ranged from 1,803 to 5,472 (HIV prevalence: 0.26 to 0.80%). The majority of these persons were men (>70%). The largest number of infected persons were MSM (N = 1,146 to 3,300) and IDUs (N = 147 to 650). Our data suggest that up to one in every 125 persons aged 15-49 years in Tijuana is HIV-infected. Interventions to reduce ongoing spread of HIV are urgently needed.

Background: Given the relevance of HSV-2 infection in youth, the aim of this study was to determine the seroprevalence of HSV-2 in college students in Cuernavaca, Mexico, as well as the sociodemographic and sexual behavioral characteristics associated with this infection., Methods: A cross-sectional study was carried out using convenience sampling with consenting students of both genders. Students answered a questionnaire and provided a blood sample to detect antibodies to HSV-2 by Western blot. To establish the magnitude of the association between the prevalence of HSV-2 infection and the selected risk factors, we estimated prevalence odds ratios by performing logistic analyses of these results, Results: Overall seroprevalence of HSV-2 was 5.9% (20/340; CI(95%) 3.7-8.9), 7.0% (14/200; CI(95%) 3.9-11.5) for women and 4.3% (6/140; CI(95%) 1.6-9.1) for men. HSV-2 infection was independently associated with female sex (POR=5.3, CI(95%) 1.4-19.7), age (26 years and over, POR=4.7, CI(95%) 1.0-22.2), number of sexual partners over the last year (two or more partners POR=4.1, CI(95%) 1.2-14.2), a history of genital ulcers (POR=6.1, CI(95%) 1.9-19.8), and having been paid for sex (POR=21.4, CI(95%) 1.0-447.5)., Conclusions: The frequency of HSV-2 infection among these students was lower than in other Mexican populations who have high-risk sexual behavior. However, there was a subgroup of participants identified as having high-risk sexual behavior. These individuals could, therefore, be prone to acquiring and transmitting HSV-2 infection and represent the target group for whom preventive interventions against HSV-2 and other STIs might be developed.

Injection drug use is a growing but understudied problem in Tijuana, a city situated on the northwestern Mexico-U.S border. The authors studied factors associated with receptive needle sharing in an effort to inform prevention activities. In 2003, street-recruited injection drug users (IDUs) in Tijuana underwent interviews on injection risk behaviors and rapid HIV antibody tests. Logistic regression was used to identify correlates of receptive needle sharing at the last injection episode. Of 402 IDUs, 87.6% were male; the median age was 34. HIV prevalence was 4.01% (95% CI: 2.29-6.51). One third reported receptive needle sharing at last injection. Factors independently associated with receptive needle sharing were years living in Tijuana (Adjusted Odds Ratio [AdjOR]= 0.97 per year, 95% CI: 0.96-0.99), being bisexual/homosexual (AdjOR=2.12; 95% CI: 1.30 - 3.44), unemployed (AdjOR=2.5; 95% CI: 1.52-4.10), never having an HIV test (AOR: 4.02; 95% CI: 2.44-6.60), having friends who placed importance on avoiding HIV (AdjOR: 0.36; 95% CI: 0.19-0.68) and last injecting in a shooting gallery (AdjOR=1.98; 95% CI: 1.21-3.24). These results underscore the need to increase access to voluntary HIV testing and counseling to IDUs and migrants in Tijuana, as well as expand access to sterile syringes in an effort to avert widespread HIV transmission.

Objectives: Provide an overview of the relation between migration to the United States and AIDS cases in Mexico. Characterize the sexual behaviors of Mexican migrants. Describe HIV/AIDS prevention and clinical attention actions developed., Methods: The following were analyzed: AIDS cases databases, various prevalence studies, the migrants survey, and information of the Ministries of the Interior and of Health. A documental analysis was undertaken of works published between 1992 and 2000 on migration and AIDS., Results: In terms of their sexual practices, migrants in the past year had more sexual partners, tended to use a condom in their most recent relation in greater proportion, and had greater use of injected medicines and drugs. Two bi-national programs undertake epidemiological surveillance activities, while several initiatives have used innovative formats to provide prevention information to migrants. Imminent universal coverage leaves the challenge to assure quality of attention for migrants., Conclusions: Studies to evaluate the impact of international migration on distribution of infected persons will be indispensable to establish priorities in prevention and attention among migrants. More information is needed on bi-national health projects to understand the impact they may have in prevention, while continuity of the prevention initiatives must be guaranteed. Attention to migrants in bi-national contexts requires information exchange agreements on migrants living with the HIV/AIDS.

Chiral P,N-ligands with pseudo-C2 and pseudo-Cs symmetry based on chiral pyrrolidine and phospholane rings or on dinaphthatodihydroazepino and dinaphthatodihydrophosphepino moieties were prepared and assessed in the palladium-catalyzed allylic substitutions of allylic acetates. Higher selectivity was achieved with pseudo-C2-symmetric ligands based on the binaphthyl skeleton than with the analogous C2-symmetric P,P- and N,N-analogues. Pseudo-C2-type ligands had properties superior to those of pseudo-meso-type ligands when 1,3-diphenyl-2-propenyl acetate was used as a substrate, whereas the reverse situation was found for 3-cyclohexenyl acetate. Chirally flexible ligands, prepared by substitution of one of the rigid binaphthyl skeletons for a flexible biphenyl system, were found to induce chirality to the same extent as a 1:1 mixture of the rigid ligands.

Objective: To investigate the current sexual behavior and condom use during the first sexual intercourse among adolescents, as well as variations and factors influencing condom use at first sexual intercourse., Material and Methods: The data source for this study was Mexico's National Health Survey 2000. Study subjects were male and female adolescents aged 12 to 19 years (n = 16,258). Statistical analysis consisted of descriptive statistics and multivariate logistic regression, to assess the association of four types of factors (demographic, socioeconomic, cultural, and cognitive) with condom use during the first sexual intercourse., Results: Males and residents of urban areas reported greater sexual activity and condom use. Typically, adolescents who used condoms during the first sexual intercourse were male, older, resided in urban areas, non-speakers of an indigenous language, and with higher schooling., Conclusions: New policies should be framed to prevent sexually transmitted infections to span the gap between knowledge and practice, targeting adolescents starting sexual activity earlier, those who speak an indigenous language, living in rural areas, with less schooling, and females. The English version of this paper is available too at:http://www.insp.mx/salud/index.html.

Objective: To establish whether certain characteristics of the young influence their choice of people with whom to discuss AIDS., Material and Methods: A national survey was conducted in 1997 by the Consejo Nacional para la Prevención y Control del SIDA (CONASIDA, Mexican Council for AIDS Prevention and Control). Study subjects were 4886 male and female 15-19 year-old teenagers. Multinomial logistic regression was used to analyze data., Results: A model including the variables sex, sexual activity, work conditions, and father's schooling level, turned out to be significant and highly predictive of people with whom teenagers discuss AIDS, as compared to teenagers speaking with no one. Male teenagers discuss AIDS with their fathers more than female teenagers, and female teenagers discuss AIDS more with their mothers. Sexually active teenagers discuss AIDS more with their friends and less with their teachers than sexually inactive teenagers. The greater schooling level the father has, the more people teenagers have with whom to discuss AIDS and the more they discuss AIDS at home, compared to teenagers with fathers without schooling., Conclusions: Differentiated sexual education training strategies should be designed in accordance with subpopulations' characteristics. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

Objective: The blood pressure (BP) response to the doctor's visit, generally referred as the white coat (WC) response, is usually estimated by the difference between office BP (OBP) and ambulatory BP (ABP). The purpose of this study was to determine the validity of this estimation. To that end, we compared the real WC effect and the estimated WC effect (OBP-ABP) in terms of magnitude and consequences on target organs., Design: The study comprised 88 patients referred for hypertension. The real WC effect was measured using a Finapres device and expressed as the maximal WC effect (Max WC) or the average WC effect (Aver WC). For the estimation of target organ damages, the whole hypertensive group was separated into two groups according to the medians of the Aver WC, the Max WC, and the estimated WC effects, successively. Left ventricular mass index, E to A mitral wave ratio and pulse wave velocity were compared between groups as were serum creatinine, cholesterol and glucose levels., Results: The estimated WC effect proved to be a bad index of the real response to the doctor's visit as assessed by their difference of magnitude between the two (20 +/- 17, 12 +/- 12 and 30 +/- 14 mmHg as estimated WC, Aver WC and Max WC effects, respectively), their loose correlations (r=0.31, P=0.004 between estimated WC and Aver WC effects; r=0.27, P=0.01 between estimated WC and Max WC effects), and finally by the fact that they were in agreement in less than two-thirds of the patients for the categorization of the WC response. Concerning target organ damages, no difference in terms of cardiac mass, diastolic function, arterial distensibility, renal function and cardiovascular risk profile could be discerned between the groups with a high and a low WC effect, either real or estimated, when age and ABP were taken into account., Conclusion: The present work supports the view that the true WC effect and its estimation are not equivalent. However, the way in which the WC response is defined does not alter its effect on target organs or cardiovascular risk profile.

Unlabelled: The aims of the study were to analyze the clinical features, the penetrance and the mode of inheritance of 13 French families with dilated cardiomyopathy using diagnostic criteria recently established by a European collaboration., Methods: Screening consisted of physical examination, ECG and Echo of all the probands first degree relatives (n = 118). Using major Echo criteria [ejection fraction (EF) < 45% or FS < 25% and left ventricular diameter (LVD) > 117% of the predictive value], or combined minor Echo/ECG criteria, relatives were classified as affected, unknown or healthy., Results: (1) Adult affected relatives (n = 31) were identified with major Echo criteria in 74% of cases, and with combined minor Echo/ECG criteria in 26% of cases. (2) In the unknown relatives (n = 21), the most common abnormality was an isolated left ventricular dilation (67%). (3) Mode of inheritance was autosomal dominant (AD) in 11 families and possibly autosomal recessive in two. (4) In AD families, the penetrance was incomplete in adults (72%), age-related (O.R.: 1.3 per 10 years; 95% CI 1.03-1.56) and sex-related [greater in men (87%) than in women (61%), actuarial survival curve: P<0.002]. (5) Mortality related to end stage heart failure was 2.2 times as high as mortality related to sudden death (11% vs. 5%)., Conclusions: (1) In the absence of a specific phenotype of FDC, the characterization of relatives appears more accurate when minor criteria were added. (2) Since high mortality (16%) and incomplete penetrance frequently give rise to small nuclei of clinically affected and alive relatives per family, the accurate model of penetrance that we proposed might be helpful in the future to enhance the statistical power of linkage analysis in this disease.

A 70-year-old man presented with a posteroinferolateral acute myocardial infarction complicated by rupture of the left ventricular inferior wall and partial rupture of the posteromedial papillary muscle. Transthoracic echocardiography documented both of these complications and led to prompt and successful surgical repair.