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Elliot Dinetz,1 Claudia Zeballos-Palacios,2 Claudia A Martinez3 1Department of Integrative and Family Medicine, University of Miami Miller School of Medicine Miami, Miami, FL, USA; 2Department of Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA; 3Department of Medicine, Cardiovascular Division, University of Miami Miller School of Medicine, Miami, FL, USACorrespondence: Elliot Dinetz, Tel +786.490.5915, Email dr@elliotdinetz.comAbstract: The aim of this manuscript is to provide a review of available options to enhance cardiovascular health and prevent cardiovascular disease (CVD) in the aging population using a systems-biology approach. These include the role of the gut microbiome, the early identification and removal of environmental toxins, and finally age related sex hormones and supplement replacement which all influence aging. Implementing such a comprehensive approach has the potential to facilitate earlier risk assessment, disease prevention, and even improve mortality. Further study in these areas will continue to advance our understanding and refine therapeutic interventions for a healthier cardiovascular aging process.Keywords: vascular aging, cardiovascular aging, inflammaging, systems biology medicine, microbiome, toxic metals, bioidentical hormone replacement

Introducción: La homofobia es un importante problema social, en particular para los adolescentes. La discriminación y el desprecio a que son sometidos aquellos adolescentes homosexuales o los que tienen dudas en torno a su identidad sexual, tiene consecuencias adversas en todo su desarrollo ulterior. Detectar y enfrentar conductas homofóbicas en los colegios, resulta clave si pretendemos una sociedad justa y sana, donde la convivencia con la diversidad se respete. La UNESCO invita a todas las sociedades a enfrentar estas conductas desde la ética individual y las políticas públicas en ambientes escolares. Objetivos: Conocer la prevalencia de homofobia en los adolescentes escolarizados de un colegio de la localidad de suba en la ciudad de Bogotá e identificar los métodos preventivos. Metodología: Se aplicó una encuesta presencial auto diligenciada y dicotómica a estudiantes de sexto a once grados, indagando por variables sociodemográficas y utilizando un test cuantitativo, en donde el total de su sumatoria indica si es o no homofóbico. Resultados: Se encuestaron 843 estudiantes. El 24,9% de la población encuestada no son homofóbicos, el 49,1% aún tienen algunos prejuicios y el 26% son homofóbicos. Se compararon los homofóbicos versus los no homofóbicos entre sexo femenino y masculino obteniendo como relaciones significativas un OR de 0.25, IC 95% Li 0.16 y Ls 0.37, también se comparó la homofobia versus la no homofobia entre edades de 13-15 años con 10-12 años obteniendo OR de 0.43, Li 0,27 y Ls 0,70, entre edades de 16-19 años con 10-12 años obteniendo OR de 0.3, Li 0.17 y Ls 0.51 y finalmente entre edades de 16-19 años con 13-15 años obteniendo OR 0.68, Li 0.42 y Ls 1.09. Conclusión: La homofobia es un rechazo que se puede generar de manera involuntaria a través del desprecio y la discriminación, ya que no se tiene en común la misma orientación social, pensamientos o ideologías. Se encontró que el 26% de los adolescentes escolarizados son homofóbicos. Se evidenció mayores actitudes homofóbicas en el sexo masculino que el femenino y se observó que entre menos edad entre los adolescentes, hay más actitudes homofóbicas.

María A Trak-Fellermeier,1,* Maribel Campos,1,* Marytere Meléndez,1,* Jeremy Pomeroy,2 Cristina Palacios,3 Juana Rivera-Viñas,4 Keimari Méndez,4 Irma Febo,5 Walter Willett,6 Mathew W Gillman,7 Paul W Franks,6,8 Kaumudi Joshipura1,9 1Center for Clinical Research and Health Promotion, School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA; 2Clinical Research Center, Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI, USA; 3Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA; 4Department of Obstetrics and Gynecology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA; 5Department of Pediatrics, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, USA; 6Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA; 7Division of Chronic Disease Research Across the Life Course, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA; 8Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Skåne University Hospital, Malmö, Sweden; 9Department of Epidemiology, Harvard T.H. Chan Public Health School, Harvard University, Boston, MA, USA *These authors contributed equally to this work Background: Inappropriate gestational weight gain (GWG) has been associated with adverse perinatal events. High rates of GWG have been reported among Hispanic women. Observational studies indicate that dietary and physical activity interventions during the prenatal period may improve maternal and infant health, but very few randomized trials have been conducted among high-risk overweight/obese Hispanic women. Accordingly, we conducted a lifestyle intervention among high-risk pregnant women and evaluated its impact on achieving appropriate GWG and on improving birthweight.Methods: Eligible overweight/obese women presenting at the University Hospital in Puerto Rico with a singleton pregnancy before 16 gestational weeks were recruited and randomized to lifestyle intervention (n=15) or control group (n=16). The lifestyle intervention focused on improving physical activity and diet quality and optimizing caloric intake. We evaluated the impact of the lifestyle intervention on achieving appropriate GWG and on infant birthweight. Poisson and linear regression analyses were performed. Results: The primary intent to treat analysis showed no significant effect on achievement of appropriate GWG/week through 36 weeks in the intervention group (4/15 women) when compared with the control group (3/16 women) (adjusted incidence rate ratio =1.14; 95% CI: 0.20, 6.67). Although not statistically significant, women in the intervention group (6/15) were 1.7 times more likely to achieve appropriate weekly GWG until delivery when compared with controls (4/16 women) (adjusted incidence rate ratio = 1.67; 95% CI: 0.40, 6.94). We observed lower adjusted birthweight-for-length z-scores in the intervention compared with the control group among male newborns with z-score difference −1.74 (−3.04, −0.43), but not among females −0.83 (−3.85, 2.19). These analyses were adjusted for age and baseline body mass index.Conclusion: Although larger studies are required to determine whether women with obesity may benefit from prenatal lifestyle interventions targeting GWG, our results are suggestive of the intervention improving adherence to established Institute of Medicine guidelines. Keywords: gestational weight gain, lifestyle modification, pregnancy, birthweight, neonatal, randomized controlled trial, overweight, obese, intervention

Trak-Fellermeier MA, Campos M, Meléndez M, et al. Diabetes Metab Syndr Obes. 2019;12:225–238. On page 225, Abstract, Results subheading, “Although not statistically significant, women in the intervention group (6/15) were 1.7 times more likely to achieve appropriate weekly GWG until delivery when compared with controls (4/16 women) (adjusted incidence rate ratio = 1.67; 95% CI: 0.40, 6.94).” should read “Although not statistically significant, women in theintervention group (6/15) were 1.7 times more likely to achieve appropriate total GWG until delivery when compared with controls (4/16 women) (adjusted incidence rate ratio = 1.67; 95% CI: 0.40, 6.94).” Appropriate GWG (baseline to delivery) section, 2nd to 4th line on page 230, “Forty percent (6/15) of women in the interventionachieved appropriate GWG/week compared with 25%(4/16) in the control group.” should read “Forty percent (6/15) ofwomen in the intervention achieved appropriate total GWG compared with 25% (4/16) in the control group.” The authors apologize for not noticing the inconsistencies between the text and Table 3 earlier. Read the original article

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