RESUMO
OBJECTIVE: The clinical course of alcoholism has been described as a series of distinct, alcohol-related life events that occur in an orderly sequence. However, whether that sequence differs, depending on ethnicity and country of origin, is less clear. The purposes of this study were to investigate the sequence and progression of alcohol-related life events in individuals of East Indian (Indo) and African (Afro) heritage on the islands of Trinidad and Tobago, and compare those results with data reported previously by the Collaborative study for the Genetics of Alcoholism (COGA). METHOD: Participants who were alcohol dependent (based on Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, criteria) and of Afro-Trinidadian and Tobagonian ancestry or Indo-Trinidadian ancestry were recruited from inpatient treatment facilities. A total of 148 alcohol-dependent men and women completed the Semi-Structured Assessment of the Genetics of Alcoholism, which assessed the physical, psychological, and social manifestations of alcohol dependence and other psychiatric disorders. RESULTS: A high degree of similarity in the sequence of alcohol-related life events was found between Indo-Trinidadian, Afro-Trinidadian and Tobagonian, and COGA participants. However, Trinidadian and Tobagonian alcoholics were more likely to endorse severe alcohol drinking in the form of binges (2 or more days of intoxication), blackouts, withdrawal, and medical consequences; however, they were less likely to endorse aggressive acts associated with drinking. Progression to alcohol dependence was significantly slower in Trinidadian and Tobagonian alcoholics than in the U.S. population of alcoholics, but severe alcohol symptoms were more commonly endorsed in Trinidadian and Tobagonians.
Assuntos
Humanos , Research Support, Non-U.S. Gov't , Alcoolismo , Trinidad e TobagoRESUMO
Population dynamics predict a drastic growth in the number of older minority women, and resultant increases in the number of fractures. Low bone mineral density (BMD) is an important risk factor for fracture. Many studies have identified the lifestyle and health-related factors that correlate with BMD in Whites. Few studies have focused on non-Whites. The objective of the current analyses is to examine the lifestyle, anthropometric and health-related factors that are correlated with BMD in a population based cohort of Caribbean women of West African ancestry. We enrolled 340 postmenopausal women residing on the Caribbean Island of Tobago. Participants completed a questionnaire and had anthropometric measures taken. Hip BMD was measured by DXA. We estimated volumetric BMD by calculating bone mineral apparent density (BMAD). BMD was >10% and >25% higher across all age groups in Tobagonian women compared to US non-Hispanic Black and White women, respectively. In multiple linear regression models, 35-36% of the variability in femoral neck and total hip BMD respectively was predicted. Each 16-kg (one standard deviation (SD)) increase in weight was associated with 5% higher BMD; and weight explained over 10% of the variability of BMD. Each 8-year (1 SD) increase in age was associated with 5% lower BMD. Current use of both thiazide diuretics and oral hypoglycemic medication were associated with 4-5% higher BMD. For femoral neck BMAD, 26% of the variability was explained by a multiple linear regression model. Current statin use was associated with 5% higher BMAD and a history of breast feeding or coronary heart disease was associated with 1-1.5% of higher BMAD. In conclusion, African Caribbean women have the highest BMD on a population level reported to date for women. This may reflect low European admixture. Correlates of BMD among Caribbean women of West African ancestry were similar to those reported for U.S. Black and White women.
Assuntos
Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Humanos , Feminino , Research Support, Non-U.S. Gov't , Densidade Óssea , Inquéritos Epidemiológicos , Estilo de Vida , Pós-Menopausa , Inquéritos e Questionários , Trinidad e Tobago/epidemiologia , Saúde da Mulher , População Negra , Osteoporose Pós-MenopausaRESUMO
BACKGROUND: Low white blood cell counts (WBC) or absolute neutrophil counts (ANC) may delay or prevent the completion of appropriate chemotherapy, especially among women receiving adjuvant therapy for breast and colon cancer, and affect cancer survival. Because race/ethnicity is also associated with survival, the authors compared WBC and ANC in healthy American-born women of African descent and European descent, and women from Barbados/Trinidad-Tobago, the Dominican Republic, Haiti, and Jamaica. METHODS: Blood samples from 261 healthy women ages 20 to 70 years were tested for WBC with differential, cytokine and growth factor levels, and ancestry informative and neutrophil elastase polymorphisms. The authors analyzed the association between neutropenia and serum WBC growth factor levels, cytokine levels, and neutrophil elastase c199a polymorphism. RESULTS: The median WBC and ANC differed among the 6 groups (P < .01 for WBC and P < .0001 for ANC). Dominicans were found to have higher median WBC and ANC than all other groups (P < .03). Neutropenia (ANC < 1500 cu/mm) was observed among 2.7% to 12.5% of the groups of predominantly African descent; no other groups were found to have neutropenia (P < .05). Granulocyte-colony-stimulating factor was found to be lower in white women, but tumor necrosis factor-alpha and C-reactive protein were not found to be correlated with ethnicity. Women of African origin were more likely to have polymorphisms of African ancestry (P < .001) and c199a alleles (P < .0001), which were also associated with low ANC levels. CONCLUSIONS: In the current study, the authors observed a strong association between neutropenia and African descent among asymptomatic women from the U.S. and the Caribbean. Among women of African descent who develop a malignancy, this association may contribute to racial disparities in treatment and outcomes.
Assuntos
Adulto , Pessoa de Meia-Idade , Idoso , Humanos , Feminino , Estudo Comparativo , Research Support, Non-U.S. Gov't , Contagem de Células Sanguíneas , Negro ou Afro-Americano , Hispânico ou Latino , Contagem de Leucócitos , Neutropenia/etnologia , Neutropenia/epidemiologia , Neutrófilos , Estados Unidos/epidemiologia , Estados Unidos/etnologia , Índias Ocidentais/epidemiologia , Região do Caribe , Trinidad e TobagoRESUMO
BACKGROUND: Grey matter and other structural brain abnormalities are consistently reported in first-onset schizophrenia, but less is known about the extent of neuroanatomical changes in first-onset affective psychosis. AIMS: To determine which brain abnormalities are specific to (a) schizophrenia and (b) affective psychosis. METHOD: We obtained dual-echo (proton density/T2-weighted) magnetic resonance images and carried out voxel-based analysis on the images of 73 patients with first-episode psychosis (schizophrenia n=44, affective psychosis n=29) and 58 healthy controls. RESULTS: Both patients with schizophrenia and patients with affective psychosis had enlarged lateral and third ventricle volumes. Regional cortical grey matter reductions (including bilateral anterior cingulate gyrus, left insula and left fusiform gyrus) were evident in affective psychosis but not in schizophrenia, although patients with schizophrenia displayed decreased hippocampal grey matter and increased striatal grey matter at a more liberal statistical threshold. CONCLUSIONS: Both schizophrenia and affective psychosis are associated with volumetric abnormalities at the onset of frank psychosis, with some of these evident in common brain areas.
Assuntos
Humanos , Research Support, Non-U.S. Gov't , Esquizofrenia , Anormalidades Congênitas , Transtornos Psicóticos , Trinidad e TobagoRESUMO
The aim of this study was to estimate the heritability of and environmental contributions to skeletal muscle phenotypes (appendicular lean mass and calf muscle cross-sectional area) in subjects of African descent and to determine whether heritability estimates are impacted by sex or age. Body composition was measured by dual-energy X-ray absorptiometry and computed tomography in 444 men and women aged 18 yr and older (mean: 43 yr) from eight large, multigenerational Afro-Caribbean families (family size range: 21-112). Using quantitative genetic methods, we estimated heritability and the association of anthropometric, lifestyle, and medical variables with skeletal muscle phenotypes. In the overall group, we estimated the heritability of lean mass and calf muscle cross-sectional area (h(2) = 0.18-0.23, P < 0.01) and contribution of environmental factors to these phenotypes (r(2) = 0.27-0.55, P < 0.05). In our age-specific analysis, the heritability of leg lean mass was lower in older vs. younger individuals (h(2) = 0.05 vs. 0.23, respectively, P = 0.1). Sex was a significant covariate in our models (P < 0.001), although sex-specific differences in heritability varied depending on the lean mass phenotype analyzed. High genetic correlations (rho(G) = 0.69-0.81; P < 0.01) between different lean mass measures suggest these traits share a large proportion of genetic components. Our results demonstrate the heritability of skeletal muscle traits in individuals of African heritage and that heritability may differ as a function of sex and age. As the loss of skeletal muscle mass is related to metabolic abnormalities, disability, and mortality in older individuals, further research is warranted to identify specific genetic loci that contribute to these traits in general and in a sex- and age-specific manner.
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Feminino , Research Support, Non-U.S. Gov't , População Negra , Fatores Etários , Composição Corporal/genética , Peso Corporal , Meio Ambiente , Família/etnologia , Herança Multifatorial , Músculo Esquelético/fisiologia , Fenótipo , Característica Quantitativa Herdável , Caracteres Sexuais , Trinidad e Tobago/etnologiaRESUMO
The objective of the study was to examine pregnancy outcomes in women with systemic lupus erythematosus (SLE) and population controls in Trinidad. We performed a cross-sectional analysis of adverse outcomes in pregnancies of Afro-Caribbean women with SLE and without SLE. One hundred and twenty-two female adult cases of SLE and 203 neighbourhood age-matched women without SLE were interviewed concerning details of their reproductive history, and the anticardiolipin antibody (ACL) status was established for women with SLE. A total of 1,029 pregnancies were reported (356 by women with SLE, 673 by women without SLE). In women with > or = 1 pregnancy the total number of pregnancies was similar in women with a diagnosis of SLE and women without; however, a lower proportion of women with SLE had ever been pregnant compared with women without SLE (80% versus 91%, P = 0.002). In multivariate logistic regression analyses adjusted for maternal age, district of residence, pregnancy order and smoking, SLE pregnancies were more than twice as likely to end in foetal death than non-SLE pregnancies (odds ratio (OR), 2.4; 95% confidence interval (CI), 1.2-4.7). This effect was driven by a large increase in the odds of stillbirth (OR, 8.5; 95% CI, 2.5-28.8). The odds of early miscarriage (OR, 1.4; 95% CI, 0.6-3.1) and of mid-trimester miscarriage (OR, 1.9; 95% CI, 0.4-9.5) were higher, but were not statistically significantly different, in SLE pregnancies than in non-SLE pregnancies. The odds of ectopic pregnancy (OR, 7.5; 95% CI, 0.9-62.5) and of preterm birth (OR, 3.4; 95% CI, 1.2-10.0) were higher in SLE pregnancies conceived after diagnosis than in non-SLE pregnancies. There was no evidence of raised levels of IgG or IgM ACL among the majority (93/97 women, 96%) of SLE cases who reported sporadic mid-trimester miscarriage or stillbirth, although there was evidence of high levels of IgM and IgG ACL among women reporting three or more miscarriages and three consecutive miscarriages, and of raised IgG ACL among those experiencing ectopic pregnancy. In conclusion, we found evidence for a large increase in risk of stillbirth in the pregnancies of Afro-Caribbean Trinidadian women with SLE (not accounted for by high ACL status). There was some evidence of an increased risk of preterm delivery and ectopic pregnancy in pregnancies conceived after a diagnosis of maternal SLE.
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Gravidez , Recém-Nascido , Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Feminino , Research Support, Non-U.S. Gov't , Aborto Espontâneo/epidemiologia , África/etnologia , Anticorpos Anticardiolipina/sangue , Estudos de Casos e Controles , Estudos Transversais , Morte Fetal/epidemiologia , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/imunologia , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/imunologia , Resultado da Gravidez , Inquéritos e Questionários , Fatores de Risco , Trinidad e Tobago/epidemiologiaRESUMO
The 3' noncoding region (3' NCR) of flaviviruses contains secondary and tertiary structures essential for virus replication. Previous studies of yellow fever virus (YFV) and dengue virus have found that modifications to the 3' NCR are sometimes associated with attenuation in vertebrate and/or mosquito hosts. The 3' NCRs of 117 isolates of South American YFV have been examined, and major deletions and/or duplications of conserved RNA structures have been identified in several wild-type isolates. Nineteen isolates (designated YF-XL isolates) from Brazil, Trinidad, and Venezuela, dating from 1973 to 2001, exhibited a 216-nucleotide (nt) duplication, yielding a tandem repeat of conserved hairpin, stem-loop, dumbbell, and pseudoknot structures. YF-XL isolates were found exclusively within one subclade of South American genotype I YFV. One Brazilian isolate exhibited, in addition to the 216-nt duplication, a deletion of a 40-nt repeated hairpin (RYF) motif (YF-XL-DeltaRYF). To investigate the biological significance of these 3' NCR rearrangements, YF-XL-DeltaRYF and YF-XL isolates, as well as other South American YFV isolates, were evaluated for three phenotypes: growth kinetics in cell culture, neuroinvasiveness in suckling mice, and ability to replicate and produce disseminated infections in Aedes aegypti mosquitoes. YF-XL-DeltaRYF and YF-XL isolates showed growth kinetics and neuroinvasive characteristics comparable to those of typical South American YFV isolates, and mosquito infectivity trials demonstrated that both types of 3' NCR variants were capable of replication and dissemination in a laboratory-adapted colony of A. aegypti.
Assuntos
Camundongos , Animais , Humanos , Research Support, Non-U.S. Gov't , Research Support, U.S. Gov't, P.H.S. , Aedes/virologia , Sequência de Bases , Células Cultivadas , Variação Genética , Dados de Sequência Molecular , Conformação de Ácido Nucleico , Filogenia , RNA não Traduzido/química , RNA não Traduzido/genética , RNA não Traduzido/fisiologia , RNA Viral/química , RNA Viral/genética , RNA Viral/fisiologia , Vírus da Febre Amarela/classificação , Vírus da Febre Amarela/crescimento & desenvolvimento , Vírus da Febre Amarela/genética , Vírus da Febre Amarela/isolamento & purificação , Vírus da Febre Amarela/patogenicidade , Trinidad e Tobago , Brasil , VenezuelaRESUMO
Social network theory is used to elicit details of the social structure of a population of free-ranging guppies, Poecilia reticulata. They were found to have a complex and highly structured social network, which exhibited characteristics consistent with the 'small world' phenomenon. Stable partner associations between individuals were observed, a finding that fulfils the basic prerequisite for the evolution of reciprocal altruism. The findings are discussed in relation to the ecology and evolution of the wild population, highlighting the potential application of network theory to social associations in animals.
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Animais , Masculino , Feminino , Estudo Comparativo , Research Support, Non-U.S. Gov't , Modelos Biológicos , Poecilia/fisiologia , Dinâmica Populacional , Comportamento Social , Meio Social , Trinidad e TobagoRESUMO
Because not all females are equally attractive, and because mating reduces the chances of getting further copulations, males should prefer better-quality mates. In this paper, we use the Trinidadian guppy (Poecilia reticulata) to explore the effects of two non-correlated measures of female quality--size and reproductive status--on male mating decisions. All male guppies employ two alternative mating tactics. We found that large females, particularly those from a high predation site, were the target of most sneaky mating attempts. The response persisted in fish raised under standard conditions over several generations in the laboratory. In addition, non-pregnant females received more courtship displays. We conclude that males can discriminate among females and that they uncouple their mating tactics to track different axes of quality.
Assuntos
Animais , Masculino , Feminino , Estudo Comparativo , Research Support, Non-U.S. Gov't , Análise de Variância , Tamanho Corporal , Observação , Poecilia/fisiologia , Reprodução/fisiologia , Rios , Fatores Sexuais , Trinidad e TobagoRESUMO
BACKGROUND: Antibiotic overuse and misuse for upper respiratory tract infections in children is widespread and fuelled by public attitudes and expectations. This study assessed knowledge, beliefs, and practices regarding antibiotic use for these paediatric infections among children's caregivers' in Trinidad and Tobago in the English speaking Caribbean. METHODS: In a cross-sectional observational study, by random survey children's adult caregivers gave a telephone interview from November 1998 to January 1999. On a pilot-tested evaluation instrument, respondents provided information about their knowledge and beliefs of antibiotics, and their use of these agents to treat recent episodes (< previous 30 days) of upper respiratory tract infections in children under their care. Caregivers were scored on an antibiotic knowledge test and divided based on their score. Differences between those with high and low scores were compared using the chi-square test. RESULTS: Of the 417 caregivers, 70% were female and between 18-40 years, 77% were educated to high school and beyond and 43% lived in urban areas. Two hundred and forty nine (60%) respondents scored high (>or12) on antibiotic knowledge and 149 (34%) had used antibiotics in the preceding year. More caregivers with a high knowledge score had private health insurance (33%), (p < 0.02), high school education (57%) (p < 0.002), and had used antibiotics in the preceding year (p < 0.008) and within the last 30 days (p < 0.05). Caregivers with high scores were less likely to demand antibiotics (p < 0.05) or keep them at home (p < 0.001), but more likely to self-treat with antibiotics (p < 0.001). Caregivers administered antibiotics in 241/288 (84%) self-assessed severe episodes of infection (p < 0.001) and in 59/126 (43%) cough and cold episodes without visiting a health clinic or private physician (p < 0.05). CONCLUSIONS: In Trinidad and Tobago, caregivers scoring low on antibiotic knowledge have erroneous beliefs and use antibiotics inappropriately. Children in their care receive antibiotics for upper respiratory tract infections without visiting a health clinic or a physician. Educational interventions in the community on the consequences of inappropriate antibiotic use in children are recommended. Our findings emphasise the need to address information, training, legislation and education at all levels of the drug delivery system towards discouraging self-medication with antibiotics in children.