BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: BACKGROUND:Systematic repetition postures adopted during trainings could generate alterations in the sagittal spinal curvatures. OBJECTIVE:The purposes were: 1) to analyse the sagittal spinal curvatures and pelvic tilt in Latin American style dancers; 2) to compare the spinal sagittal mobility and hamstring muscle extensibility between Latin American style dancers and non-dancers; and 3) to evaluate the influence of wearing dance shoes upon the sagittal spine posture in standing. METHODS:A total of 20 Latin American style professional dancers and 20 non-dancers (control group) were evaluated during standing, relaxed sitting, maximal trunk flexion with knees flexed and extended, lying prone, and maximal trunk extension. Additionally, dancers were analysed while standing barefoot, and wearing heeled-shoes, during forward walking and the paso-doble posture. The hamstring muscle extensibility was evaluated by the active knee extension test. RESULTS:The spinal morphology in Latin American style professional dancers is characterised by lower thoracic kyphosis, lumbar lordosis and anterior pelvic tilt in the standing posture as well as a flexible spine, especially in flexion postures, in addition to suitable hamstring muscle extensibility. CONCLUSIONS:The spinal morphology of Latin American style professional dancers is characterised by lower thoracic kyphosis and lumbar lordosis and anterior pelvic tilt in the standing posture as well as a flexible spine, especially in flexion postures, and suitable hamstring muscle extensibility.

背景与目标： 背景：在训练过程中采用的系统性重复姿势可能会导致矢状脊柱弯曲的改变。
目的：目的是：1）分析拉丁美洲风格舞蹈演员的矢状脊柱弯曲度和骨盆倾斜度； 2）比较拉丁美洲舞者和非舞者的脊柱矢状活动度和绳肌的伸展性； 3）评估穿着舞蹈鞋对站立时矢状脊柱姿势的影响。
方法：在站立，放松坐姿，最大屈膝屈膝，屈膝伸直，俯卧，最大伸直躯干的过程中，对总共20名拉丁美洲风格的专业舞蹈演员和20名非舞蹈演员（对照组）进行了评估。此外，还对舞者进行了分析，他们在赤脚站立的过程中赤脚站立，穿着高跟鞋。 the绳肌的可伸展性通过主动膝关节伸展试验进行评估。
结果：拉丁美洲风格的专业舞者的脊柱形态的特征是站立姿势下胸椎后凸，腰椎前凸和前骨盆倾斜，以及灵活的脊柱，尤其是屈曲姿势，此外还具有适当的绳肌可伸展性。
结论：拉丁美洲风格的专业舞者的脊柱形态特征是下胸驼背和腰椎前凸和站立姿势的前骨盆倾斜以及灵活的脊柱，特别是在屈曲姿势中，并且适当的绳肌可伸展性。

BACKGROUND & AIMS: BACKGROUND:One main practice gap in allergology that has been detected in several regions of the world is the application of specific immunotherapy (SIT). The prescription and practice of SIT should characterize allergologic specialists, but there are regional discrepancies in such practice. A detailed knowledge of the regulatory and legislation aspects and drawbacks would help improve and harmonize SIT practice. OBJECTIVE:To describe in Latin America the level of allergy training and the characteristics of the use of SIT, including the medical and legal aspects. METHODS:Three sources were used: a 24-item questionnaire sent to 22 allergologic leaders in 11 Latin American countries, 2 face-to-face meetings, and information from health authorities involved in the approval of medical substances. RESULTS:In 56% of countries, the specialty of allergology is a third-level care specialty and/or a subspecialty. Two countries have a special training program for pediatric allergists. Passing a board examination is mandatory in 3 countries, and recertification every 2 to 5 years occurs without examination. Sublingual and subcutaneous SITs are available in all Latin American countries. No legislation restricts SIT prescription and it can be performed by nonspecialists in 7 of 11 countries. In 90% of countries, allergists use allergen extracts from the United States (subcutaneous immunotherapy) and Europe (sublingual and subcutaneous immunotherapies), and 50% also manufacture extracts locally. Only 1 country has legal requirements for the quality of raw materials. CONCLUSION:The present analysis helps to identify gaps in the field of allergologic training and SIT in Latin America, many of them amendable.

背景与目标： 背景：在世界上几个地区发现的过敏学方面的一个主要实践空白是特异性免疫疗法（SIT）的应用。 SIT的处方和做法应以过敏科专家为特征，但这种做法存在地区差异。对法规和立法方面以及弊端的详细了解将有助于改善和统一SIT实践。
目的：描述拉丁美洲的过敏训练水平和使用SIT的特征，包括医学和法律方面。
方法：使用了三种来源：向拉丁美洲11个国家的22名过敏学领导者发送的24项问卷，两次面对面的会议以及来自参与批准医疗物质的卫生当局的信息。
结果：在56％的国家中，过敏科专业为三级护理专业和/或亚专业。有两个国家为小儿过敏症患者提供了特殊的培训计划。必须在3个国家/地区通过董事会考试，并且每2至5年进行一次重新认证，而无需进行考试。所有拉丁美洲国家都提供舌下和皮下SIT。没有法律限制SIT处方，并且11个国家中有7个国家的非专业人员可以执行该处方。在90％的国家中，过敏症患者使用来自美国（皮下免疫疗法）和欧洲（舌下和皮下免疫疗法）的过敏原提取物，还有50％的过敏原也在当地生产。只有一个国家/地区对原材料的质量有法律要求。
结论：本分析有助于查明拉丁美洲的变态反应训练和SIT领域的差距，其中许多差距是可以修正的。

BACKGROUND & AIMS: OBJECTIVE:The objective of this guideline is to provide recommendations for treating patients with the more common forms of histoplasmosis. PARTICIPANTS AND CONSENSUS PROCESS: A working group of 8 experts in this field was convened to develop this guideline. The working group developed and refined the guideline through a series of conference calls. OUTCOMES:The goal of treatment is to eradicate the infection when possible, although chronic suppression may be adequate for patients with AIDS and other serious immunosuppressive disorders. Other important outcomes are resolution of clinical abnormalities and prevention of relapse. EVIDENCE:The published literature on the management of histoplasmosis was reviewed. Controlled trials have been conducted that address the treatment of chronic pulmonary and disseminated histoplasmosis, but clinical experience and descriptive studies provide the basis for recommendations for other forms of histoplasmosis. VALUE: Value was assigned on the basis of the strength of the evidence supporting treatment recommendations, with the highest value assigned to controlled trials, according to conventions established for developing practice guidelines. BENEFITS AND COSTS: Certain forms of histoplasmosis cause life-threatening illnesses and result in considerable morbidity, whereas other manifestations cause no symptoms or minor self-limited illnesses. The nonprogressive forms of histoplasmosis, however, may reduce functional capacity, affecting work capacity and quality of life for several months. Treatment is clearly beneficial and cost-effective for patients with progressive forms of histoplasmosis, such as chronic pulmonary or disseminated infection. It remains unknown whether treatment improves the outcome for patients with the self-limited manifestations, since this patient population has not been studied. Other chronic progressive forms of histoplasmosis are not responsive to pharmacologic treatment. TREATMENT OPTIONS:Options for therapy for histoplasmosis include ketoconazole, itraconazole, fluconazole, amphotericin B (Fungizone; Bristol-Meyer Squibb, Princeton, NJ), liposomal amphotericin B (AmBisome; Fujisawa, Deerfield, IL), amphotericin B colloidal suspension (ABCD, or Amphotec; Seques, Menlo Park, CA), and amphotericin B lipid complex (ABLC, or Abelcet; Liposome, Princeton, NJ).

背景与目标： 目的：本指南的目的是为治疗更常见的组织胞浆菌病患者提供建议。参与者和共识过程：召集了一个由该领域的8位专家组成的工作组来制定此指南。工作组通过一系列电话会议制定并完善了指南。
结果：治疗的目标是在可能的情况下根除感染，尽管对艾滋病和其他严重免疫抑制疾病的患者进行慢性抑制可能就足够了。其他重要结果是临床异常的解决和预防复发。
证据：回顾了有关组织胞浆菌病处理的公开文献。已经进行了针对慢性肺和弥漫性组织胞浆菌病的治疗的对照试验，但是临床经验和描述性研究为其他形式的组织胞浆菌病的推荐提供了基础。价值：根据为制定治疗指南制定的惯例，根据支持治疗建议的证据的强度来分配价值，将最高价值分配给对照试验。收益和成本：某些形式的组织胞浆菌病会危及生命，并导致相当大的发病率，而其他表现形式则不会引起任何症状或轻微的自我限制疾病。然而，非渐进性的组织胞浆菌病可能会降低功能能力，从而影响工作能力和数月的生活质量。对于患有渐进形式的组织胞浆菌病（例如慢性肺部或弥漫性感染）的患者，治疗显然是有益且具有成本效益的。由于该患者人群尚未得到研究，因此治疗是否能改善具有自限性表现的患者的结局仍是未知的。其他慢性进行性组织胞浆菌病对药物治疗无反应。
治疗方案：组织胞浆菌病的治疗方案包括酮康唑，伊曲康唑，氟康唑，两性霉素B（Fungizone; Bristol-Meyer Squibb，Princeton，NJ），脂质体两性霉素B（AmBisome; Fujisawa，Deerfield，IL），两性霉素B胶体（CDCD）或Amphotec； Seques，Menlo Park，CA）和两性霉素B脂质复合物（ABLC或Abelcet；脂质体，普林斯顿，新泽西州）。

BACKGROUND & AIMS: UNLABELLED:In the first population-based study of vertebral fractures in Latin America, we found a 11.18 (95% CI 9.23-13.4) prevalence of radiographically ascertained vertebral fractures in a random sample of 1,922 women from cities within five different countries. These figures are similar to findings from studies in Beijing, China, some regions of Europe, and slightly lower than those found in the USA using the same standardized methodology. INTRODUCTION:We report the first study of radiographic vertebral fractures in Latin America. METHODS:An age-stratified random sample of 1,922 women aged 50 years and older from Argentina, Brazil, Colombia, Mexico, and Puerto Rico were included. In all cases a standardized questionnaire and lateral X-rays of the lumbar and thoracic spine were obtained after informed consent. RESULTS:A standardized prevalence of 11.18 (95% CI 9.23-13.4) was found. The prevalence was similar in all five countries, increasing from 6.9% (95% CI 4.6-9.1) in women aged 50-59 years to 27.8% (95% CI 23.1-32.4) in those 80 years and older (p for trend < 0.001). Among different risk factors, self-reported height loss OR = 1.63 (95% CI: 1.18-2.25), and previous history of fracture OR = 1.52 (95% CI: 1.14-2.03) were significantly (p < 0.003 and p < 0.04 respectably) associated with the presence of radiographic vertebral fractures in the multivariate analysis. In the bivariate analyses HRT was associated with a 35% lower risk OR = 0.65 (95% CI: 0.46-0.93) and physical activity with a 27% lower risk of having a vertebral fracture OR = 0.73 (95% CI: 0.55-0.98), but were not statistically significant in multivariate analyses CONCLUSION:We conclude that radiographically ascertained vertebral fractures are common in Latin America. Health authorities in the region should be aware and consider implementing measures to prevent vertebral fractures.

背景与目标： 在拉丁美洲进行的第一项基于人群的脊椎骨折研究中，我们从五个国家/地区的1,922名妇女中随机抽取了X线照片确定的脊椎骨折患病率，分别为11.18（95％CI 9.23-13.4）。这些数字与在中国北京，欧洲某些地区的研究结果相似，但略低于在美国使用相同标准化方法得出的结果。
简介：我们报告了拉丁美洲的首例放射学性脊椎骨折研究。
方法：采用年龄分层的随机抽样方法，对来自阿根廷，巴西，哥伦比亚，墨西哥和波多黎各的1,922名年龄在50岁以上的女性进行了抽样。在所有情况下，经过知情同意后，可获得一份标准化的问卷以及腰椎和胸椎的X线片。
结果：标准化患病率为11.18（95％CI 9.23-13.4）。这五个国家的患病率相似，从50-59岁女性的6.9％（95％CI 4.6-9.1）上升到80岁以上女性的27.8％（95％CI 23.1-32.4）（趋势

结论：我们得出结论，放射照相确定的椎体骨折在拉丁美洲很常见。该地区的卫生部门应了解并考虑采取预防椎骨骨折的措施。

BACKGROUND & AIMS: OBJECTIVE:In this paper we review progress as well as challenges encountered in Canada, the United States and England with regard to ensuring safety of health information technology. METHOD:A review of major programs and initiatives for ensuring safety of health information technology in the three countries was conducted. Published literature and Web resources from national programs were reviewed for relevant information. RESULTS:It was found that in all three countries the issue of technology-induced error has been recognized as being of critical importance. The three countries have developed approaches for dealing with the issue that have some commonalities; however, they are at varying different stages of maturity, with England having the longest standing and most well developed safety programs, while Canada and the United States are at earlier stages. The types of approaches employed have included work on developing standards related to usability and interface design, certifications, directives from regulatory bodies, educational initiatives in health information technology (HIT) safety as well as research into safer HIT design and implementation methods. CONCLUSIONS:HIT promises to lead to improved patient safety. However, it has become recognized that if not designed and deployed appropriately, such systems can lead to new types of errors. Based on this recognition, a variety of initiatives are being undertaken in Canada, the United States and England to promote the safe design, procurement and deployment of HIT. It is concluded that improved approaches to system design, testing, regulation, error reporting, safety education and cross-country collaboration will be needed to further promote safer HIT.

背景与目标： 目的：在本文中，我们回顾了在确保健康信息技术安全方面在加拿大，美国和英国所取得的进步以及所面临的挑战。
方法：对确保这三个国家健康信息技术安全的主要计划和举措进行了审查。审查了来自国家计划的已出版文献和网络资源，以获取相关信息。
结果：发现在所有三个国家中，技术引起的错误问题已被认为是至关重要的。这三个国家已经制定了处理这一问题的方法，这些方法具有一些共同点。但是，它们处于不同的成熟阶段，英格兰的历史最悠久，安全计划也最完善，而加拿大和美国则处于较早的阶段。所采用的方法类型包括：开发与可用性和界面设计有关的标准，认证，监管机构的指令，健康信息技术（HIT）安全方面的教育计划以及对更安全的HIT设计和实施方法的研究。
结论：HIT有望改善患者的安全性。但是，人们已经认识到，如果设计和部署不当，此类系统可能会导致新型错误。基于这种认识，加拿大，美国和英国正在采取各种举措来促进HIT的安全设计，采购和部署。结论是，将需要改进的系统设计，测试，法规，错误报告，安全教育和跨国合作的方法，以进一步促进更安全的HIT。

BACKGROUND & AIMS: OBJECTIVE:To assesses the safety and rationale of antibacterial fixed-dose combinations in the private sector in Latin America and determine the extent of their use. METHODS:Analysis of FDCs was based on retail sales data for eight Latin American countries (Argentina, Brazil, Chile, Colombia, Mexico, Peru, Uruguay and Venezuela) between 1999 and 2009. FDCs were classified according to the pre-defined criteria. Use was expressed as daily defined doses per 1000 inhabitants per day (DDD/TID). RESULTS:A total of 175 antibacterial FDCs contained a mean of 1.3 antibacterial substances and 3.2 other active substances. Thirty-seven (21%) FDCs were classified as unsafe, 124 (70%) as lacking sufficient evidence for efficacy and only 14 (9%) of all FDCs were considered rational, for example amoxicillin and clavulanic acid. Consumption of unsafe FDCs decreased by 0.011 DDD/TID (95% CI: -0.012 to -0.009) annually, from 0.173 DDD/TID in 1999 to 0.070 DDD/TID in 2009 (overall decrease, 59.7%). Consumption of FDCs lacking sufficient evidence decreased by 30.3% (-0.018 DDD/TID [95% CI: -0.028 to -0.008] annually), while use of rational FDCs increased by 17.1% (from 1.283 DDD/TID to 1.497 DDD/TID annually). CONCLUSION:The majority of antibacterial FDCs in the private sector lack therapeutic benefit. Despite the decrease in the consumption of unsafe antibacterials and those lacking sufficient evidence, their use remains high and their marketing does not fit into strategies of prudent use of antibiotics to contain antibacterial resistance.

背景与目标： 目的：评估拉丁美洲固定部门中抗菌固定剂量组合的安全性和基本原理，并确定其使用范围。
方法：FDC的分析基于1999年至2009年之间八个拉丁美洲国家（阿根廷，巴西，智利，哥伦比亚，墨西哥，秘鲁，乌拉圭和委内瑞拉）的零售数据。FDC根据预先定义的标准进行分类。使用量表示为每天每1000居民定义的剂量（DDD / TID）。
结果：总共175个抗菌FDC含有平均1.3种抗菌物质和3.2种其他活性物质。三十七（21％）个FDC被归类为不安全，124个（70％）被认为缺乏足够的疗效证据，所有FDC中只有14个（9％）被认为是合理的，例如阿莫西林和克拉维酸。每年，不安全FDC的消费量下降了0.011 DDD / TID（95％CI：-0.012降至-0.009），从1999年的0.173 DDD / TID下降到2009年的0.070 DDD / TID（总体下降了59.7％）。缺乏足够证据的FDC的消费量下降了30.3％（-0.018 DDD / TID [95％CI：-0.028至-0.008]每年），而合理FDC的使用量则增长了17.1％（从1.283 DDD / TID到1.497 DDD / TID每年）。
结论：私营部门中的大多数抗菌FDC缺乏治疗益处。尽管不安全的抗菌药物的消费有所减少，并且缺乏足够的证据，但它们的使用仍然很高，并且其行销也不适合谨慎使用含有抗菌素耐药性的抗生素的策略。

BACKGROUND & AIMS: BACKGROUND AND OBJECTIVES:Ranolazine was approved by the US Food and Drug Administration in January 2006 for the treatment of chronic angina pectoris, and is the first approved agent from a new class of anti-anginal drugs in almost 25 years. The primary objective of this study was to determine the concentration of ranolazine in human plasma using the liquid chromatography/tandem mass spectrometry (LC-MS/MS) method and to compare the pharmacokinetic properties of ranolazine after administration of single and multiple doses of ranolazine in healthy Chinese adult volunteers. METHODS:A randomized, open-label, single- and multiple-dose study design was used in the study. Subjects were randomized to receive a single dose of 500, 1,000, or 1,500 mg of ranolazine. Those who received the single dose continued on to the multiple-dose phase and received 500 mg twice daily for 7 days. In the single-dose phase, blood samples were collected from 0 to 48 h after drug administration. In the multiple-dose phase, samples were obtained before drug administration at 8:00 am and 8:00 pm on days 6 and 7 to determine the minimum steady-state plasma concentration (C(min,ss)) of ranolazine; on day 8, samples were collected from 0 to 48 h after drug administration. All values were expressed as means (standard deviations [SDs]). Adverse events (AEs) were monitored throughout the study via subject interview, vital signs, and blood sampling. RESULTS:The LC-MS/MS method was developed and validated. Twelve Chinese subjects (six men, six women) were enrolled in the single-dose phase of the pharmacokinetic study. The mean (SD) age of the subjects was 24.7 (1.6) years; their mean (SD) weight was 61.3 (6.4) kg, their mean (SD) height was 165.7 (4.5) cm, and their mean (SD) body mass index was 21.6 (6.6) kg/m(2). The main pharmacokinetic parameters [mean (SD)] for ranolazine after administration of a single oral dose of 500, 1,000, and 1,500 mg were as follows: maximum plasma concentration (C(max)) 741.5 (253.0), 1,355.0 (502.0), and 2,328.7 (890.5) ng/mL, respectively; area under the concentration-time curve from time zero to 48 h (AUC(48)) 9,071.9 (3,400.0), 16,573.5 (6,806.2), and 29,324.5 (10,857.2) ng·h/mL; AUC from time zero extrapolated to infinity (AUC(∞)) 9,826.7 (3,152.0), 16,882.4 (6,790.8), and 29,923.5 (10,706.3) ng·h/mL; time to reach C(max) (t(max)) 5.3 (1.4), 4.2 (1.2), and 5.9 (2.8) h; elimination half-life (t(½)) 6.4 (3.3), 6.4 (3.5), and 6.7 (4.3) h. Mean (SD) values for the main pharmacokinetic parameters for ranolazine after administration of multiple doses were as follows: steady-state C(max) (C(max,ss)) 1,732.9 (547.3) ng/mL; C(min,ss) 838.1 (429.8) ng/mL; steady-state AUC at time t (AUC(ss,(t))) 14,655.5 (5,624.2) ng·h/mL; average steady-state plasma drug concentration during multiple-dose administration (C(av,ss)) 1,221.3 (468.7) ng/mL; t(max) 3.46 (1.48) h; t(½) 6.28 (2.48) h. CONCLUSION:In this group of healthy Chinese subjects, AUC and C(max) increased proportionally with the dose, whereas t(½) was independent of the dose. The pharmacokinetic properties of ranolazine were linear after administration of single oral doses of 500 to 1,500 mg. Compared with the pharmacokinetic parameters of the subjects who received a single dose, those who received multiple doses (twice daily) of ranolazine had a larger AUC from time zero to the time of the last measurable concentration (AUC(last)), AUC(∞), C(max), and apparent total body clearance of drug from plasma after oral administration (CL/F), and shorter t(max) (all p < 0.05). Furthermore, some of the main pharmacokinetic parameters of ranolazine may reflect ethnic differences. This dosage was generally well tolerated by all the subjects.

背景与目标： 背景与目的：雷诺嗪于2006年1月获得美国食品和药物管理局的批准，用于治疗慢性心绞痛，并且是近25年以来来自新型抗心绞痛药物的首个批准药物。这项研究的主要目的是使用液相色谱/串联质谱法（LC-MS / MS）确定人血浆中雷诺嗪的浓度，并比较雷诺嗪单次和多次给药后雷诺嗪的药代动力学特性。健康的中国成人志愿者。
方法：本研究采用随机，开放标签，单剂量和多剂量研究设计。受试者被随机分配接受单剂量的雷诺嗪500、1,000或1,500毫克。那些接受单剂量的患者继续进入多剂量阶段，并每天两次服用500毫克，共7天。在单剂量阶段，在给药后0到48小时内收集血液样本。在多剂量阶段，在第6天和第7天的上午8:00和晚上8:00给药之前获取样品，以确定雷诺嗪的最小稳态血浆浓度（C（min，ss））；在给药第8天，在给药后0至48小时收集样品。所有值均表示为平均值（标准偏差[SDs]）。在整个研究过程中，通过受试者访谈，生命体征和血液采样监测不良事件（AE）。
结果：LC-MS / MS方法得到了开发和验证。药代动力学研究的单剂量阶段招募了十二名中国受试者（六名男性，六名女性）。受试者的平均（SD）年龄为24.7（1.6）岁；它们的平均（SD）重量为61.3（6.4）千克，平均（SD）高度为165.7（4.5）厘米，其平均（SD）体重指数为21.6（6.6）kg / m（2）。雷诺嗪单次口服500、1,000和1,500 mg的主要药代动力学参数[平均值（SD）]如下：最大血浆浓度（C（max））741.5（253.0），1,355.0（502.0），和2,328.7（890.5）ng / mL；从时间零到48小时的浓度-时间曲线下的面积（AUC（48））9,071.9（3,400.0），16,573.5（6,806.2）和29,324.5（10,857.2）ng·h / mL；从零时的AUC外推至无穷（AUC（∞））9,826.7（3,152.0），16,882.4（6,790.8）和29,923.5（10,706.3）ng·h / mL；达到C（max）（t（max））5.3（1.4），4.2（1.2）和5.9（2.8）h的时间;消除半衰期（t（1/2））6.4（3.3），6.4（3.5）和6.7（4.3）h。雷诺嗪多次给药后主要药代动力学参数的平均值（SD）如下：稳态C（max）（C（max，ss））1,732.9（547.3）ng / mL; C（min，ss）838.1（429.8）ng / mL;在时间t的稳态AUC（AUC（ss，（t）））14,655.5（5,624.2）ng·h / mL;多剂量给药期间的平均稳态血浆药物浓度（C（av，ss））1,221.3（468.7）ng / mL; t（最大值）3.46（1.48）h; t（1/2）6.28（2.48）小时
结论：在这组健康的中国受试者中，AUC和C（max）与剂量成比例增加，而t（1/2）与剂量无关。雷诺嗪的药代动力学特性在单次口服剂量为500至1,500 mg后呈线性。与接受单剂量受试者的药代动力学参数相比，接受雷诺嗪多次给药（每天两次）的受试者从零时间到最后可测量浓度（AUC（last）），AUC（∞）的AUC较大），C（max）和口服给药后药物从血浆中的表观总体清除率（CL / F），以及t（max）较短（所有p <0.05）。此外，雷诺嗪的一些主要药代动力学参数可能反映出种族差异。所有受试者通常都很好地耐受该剂量。

BACKGROUND & AIMS: BACKGROUND:North American indigenous populations experience higher rates of obesity and chronic disease compared with nonindigenous populations. Improvements in musculoskeletal fitness can mitigate negative health outcomes, but is not well understood among indigenous populations. This review examines musculoskeletal fitness measures among North American indigenous populations. METHODS:A total of 1632 citations were evaluated and 18 studies were included. RESULTS:Comparisons of musculoskeletal fitness measures between North American indigenous men and boys and women and girls were generally not reported. The greatest left and right combined maximal grip strength and maximal leg strength among Inuit boys and men and girls and women were observed among 20-29 years age group. Maximal combined right and left grip strength declined from 1970 to 1990, by an average of 15% among adults and 10% among youth. Maximal leg extension among Inuit has declined even further, averaging 38% among adults and 27% among youth from 1970 to 1990. Inuit men demonstrate greater grip strength and lower leg strength than Russian indigenous men, whereas Inuit women demonstrate greater leg strength. CONCLUSIONS:Further research is needed to better understand physical fitness among indigenous peoples and the potential for improving health and reducing chronic disease risk for indigenous peoples through physical fitness.

背景与目标： 背景：与非土著居民相比，北美土著居民的肥胖和慢性病发病率更高。肌肉骨骼适应性的改善可以减轻负面的健康后果，但在土著居民中尚未得到很好的理解。这项审查审查了北美土著人口中的肌肉骨骼适应措施。
方法：总共对1632篇文献进行了评估，包括18项研究。
结果：一般没有报道北美土著男子和男孩与妇女和女孩之间的肌肉骨骼健身措施的比较。在20至29岁年龄段的人群中，因纽特人男女中最大的左右最大握力和最大腿部力量相结合。从1970年到1990年，左右手的最大组合力量下降了，成年人平均下降15％，青年平均下降10％。因纽特人的最大伸腿幅度甚至进一步下降，从1970年到1990年，成年人平均平均伸腿38％，青年平均27％。因纽特人男性比俄罗斯土著男子表现出更大的握力和更低的腿部力量，而因纽特人女性则表现出更大的腿部力量。
结论：需要进行进一步的研究，以更好地了解土著人民的身体适应性，以及通过身体适应性改善土著人民健康和减少慢性病风险的潜力。

BACKGROUND & AIMS: :In this article, one of the novel mutations, c.208_209+ 8del10, was incorrectly given as c.69_70+8del10. It corresponds to patient 64 in Table 4.

背景与目标： ：在本文中，一种新颖的突变c.208_209 8del10被错误地命名为c.69_70 8del10。它对应于表4中的患者64。

BACKGROUND & AIMS: :We previously described a divergent clinical and molecular presentation of hepatocellular carcinoma (HCC) in Peru. The present study aimed to further characterize the tissue features associated with this singular nosological form of HCC in order to gain insight into the natural history of the disease. We performed an exploratory analysis of the histology of both tumor and non-tumor liver (NTL) tissues from 50 Peruvian HCC patients, and compared with that of 75 individuals with non-HCC liver tumor or benign liver lesions as a baseline for NTL features. We complemented this approach with a transcriptome analysis in a subset of NTL tissue samples and also performed an ultra-sensitive hepatitis B virus (HBV) detection in liver tissues of the patients. Overall, results highlighted the low rate of liver parenchymal alterations in a young patient cohort (median age: 40 years old), despite a strong prevalence of underlying HBV infection (c. 67%). Withal, liver clear cell foci of cellular alteration were genuinely associated with HCC and appended to some changes in immune and G protein-coupled receptor gene expression ontologies. Our findings confirm the occurrence of a particular setting of HCC in South America, a region where the pathophysiology of liver cancer remains largely unexplored.

背景与目标： ：我们之前在秘鲁描述了肝细胞癌（HCC）的不同临床表现和分子表现。本研究旨在进一步表征与这种单一的肝癌病原学形式相关的组织特征，以便深入了解该疾病的自然病史。我们对50例秘鲁HCC患者的肿瘤和非肿瘤肝（NTL）组织的组织学进行了探索性分析，并将其与75例非HCC肝肿瘤或良性肝病患者的NTL特征基线进行了比较。我们在一部分NTL组织样本中通过转录组分析对这种方法进行了补充，并且还在患者的肝组织中进行了超灵敏的乙型肝炎病毒（HBV）检测。总体而言，结果表明，尽管潜在的HBV感染率很高（约67％），但在年轻患者队列（中位年龄：40岁）中，肝实质改变的发生率较低。肝透明细胞病变的细胞真正与肝癌相关，并伴随着免疫和G蛋白偶联受体基因表达本体的某些变化。我们的研究结果证实了南美肝癌的特殊背景，肝癌的病理生理学在很大程度上尚待探索。

BACKGROUND & AIMS: :Background Reports on sex differences in stroke outcome and risk factors are scarce in Latin America. Our objective was to analyze clinical and prognostic differences according to sex among participants in the LASE (Latin American Stroke Registry). Methods and Results Nineteen centers across Central and South America compiled data on demographics, vascular risk factors, clinical stroke description, ancillary tests, and functional outcomes at short-term follow-up of patients included from January 2012 to January 2017. For the present study, all these variables were analyzed according to sex at hospital discharge. We included 4788 patients with a median in-hospital stay of 8 days (interquartile range, 5-8); 2677 were male (median age, 66 years) and 2111 female (median age, 60 years). Ischemic stroke occurred in 4293: 3686 as cerebral infarction (77%) and 607 as transient ischemic attack cases (12.7%); 495 patients (10.3%) corresponded to intracerebral hemorrhage. Poor functional outcome (modified Rankin scale, 3-6) was present in 1662 (34.7%) patients and 38.2% of women (P<0.001). Mortality was present in 6.8% of the registry, with 7.8% in women compared with 6.0% in men (P=0.01). Death and poor functional outcome for all-type stroke showed a higher risk in female patients (hazard ratio, 1.3, P=0.03; and hazard ratio, 1.1, P=0.001, respectively). Conclusions A worse functional outcome and higher mortality rates occurred in women compared with men in the LASE, confirming sex differences issues at short-term follow-up.

背景与目标： ：在拉丁美洲，关于中风结局和危险因素的性别差异的报道很少。我们的目标是根据LASE（拉丁美洲中风注册中心）参与者的性别分析临床和预后差异。方法和结果从2012年1月至2017年1月，在短期随访中，中美洲和南美洲的19个中心收集了有关人口统计学，血管危险因素，临床中风描述，辅助检查和功能结局的数据。 ，所有这些变量都根据出院时的性别进行了分析。我们纳入了4788名患者的中位住院天数为8天（四分位间距为5-8）；男性2677岁（中位年龄66岁），女性2111岁（中位年龄60岁）。缺血性中风发生在4293：3686例为脑梗死（77％）和607例为短暂性脑缺血发作病例（12.7％）； 495例（10.3％）对应于脑出血。 1662名患者（34.7％）和女性的38.2％的患者存在功能不良的结果（改良的Rankin评分，3-6）。死亡率为6.8％，女性为7.8％，男性为6.0％（P = 0.01）。所有类型中风的死亡和较差的功能预后均显示女性患者较高的风险（危险比为1.3，P = 0.03；危险比为1.1，P = 0.001）。结论在LASE中，与男性相比，女性的功能结局更差，死亡率更高，这证实了短期随访中的性别差异问题。

BACKGROUND & AIMS: :Phylogenetic analysis of ITS sequences of members of the Craterellus cornucopioides complex (Black Trumpet mushrooms) supports the taxonomic separation of Craterellus fallax apart from C. cornucopioides, with which it has been synonymized in the past. Examination of Pinus virginiana ectomycorrhizal (ECM) root tips and sequence comparison with other insufficiently identified environmental sequences from roots of Tsuga, Quercus, and possibly Castanea supports a broad host range in North America for the ECM symbiont C. fallax. This is the first molecular confirmation of an ECM symbiont with P. virginiana, which associates with a wide diversity of ECM fungi, and the first report of a Cantharellaceae symbiont with this tree, an eastern North American two-needled pine. Three unique species in the C. cornucopioides complex are recovered based on phylogenetic analysis: C. fallax, C. cornucopioides, and an unidentified Craterellus species similar to C. fallax but smaller in stature with smaller spores.

背景与目标： ：对Cratellerus cornucopioides复合体（黑喇叭菇）成员的ITS序列进行系统进化分析，可支持Craterellus fallax的分类学分离（除C. cornucopioides以外），在过去已将其作为同义词。北美松树根外生根（ECM）的根尖检查以及与来自Tsuga，Quercus以及Castanea根的其他未充分鉴定的环境序列的序列比较支持北美在ECM共生菌C.fallax的广泛宿主范围。这是首次证实了弗吉尼亚州疟原虫与多种ECM真菌相关的ECM共生体的分子生物学特征，也是该树（北美东部两针松）与该树共生的Cantharellaceae共生体的首次报道。根据系统发育分析，可回收到角果梭菌复合体中的三个独特物种：角果梭菌，角果梭菌和一种身份不明的Craterellus菌种，类似于角质梭菌，但身材较小，孢子较小。

BACKGROUND & AIMS: PREMISE OF THE STUDY:Early plant taxonomists formed hypotheses about relationships among taxa based on characters such as morphology, anatomy, phytochemistry, ecology, and geography. Modern molecular systematic methods, based on DNA sequence variation, augment early methods and provide an additional line of evidence by which to evaluate taxonomic hypotheses. In North America north of Mexico, wild onions (Allium, Amaryllidaceae) are represented by 84 native species, 81 of which belong to subgenus Amerallium. On the basis of morphology, these species have been divided into eight informal taxonomic "alliances" hypothesized to represent shared evolutionary history among species. The main aim of this research was to test the monophyly of the alliances with molecular phylogenetic methods. METHODS:We sampled 74 Amerallium species north of Mexico and two Mexican endemics and constructed a molecular phylogeny of subgenus Amerallium in North America based on predominantly noncoding sequences from two nuclear ribosomal RNA regions (ITS and ETS) and two plastid regions (trnL-F and rpL32-trnL). KEY RESULTS:Most clades are well supported in analyses of nuclear data and when nuclear and plastid data are combined. However, the plastid data alone did not produce a well-resolved or well-supported tree. Morphological alliances were sometimes congruent with groups recovered in the molecular phylogeny, but strict monophyly was observed in only three of eight alliances. CONCLUSIONS:We propose an infrageneric classification that recognizes two sections in New World Amerallium. Because there is substantial incongruence between morphological and molecular groups, we advocate retaining informal alliances rather than adopting formal subsections until further morphological and molecular analyses can be carried out.

背景与目标： 研究的前提：早期的植物分类学家根据形态，解剖学，植物化学，生态学和地理学等特征对分类单元之间的关系提出了假设。基于DNA序列变异的现代分子系统方法扩充了早期方法，并提供了另一条证据来评估分类学假设。在墨西哥北部的北美，野生洋葱（葱属，金莲花科）以84种本地物种为代表，其中81种属于Amerallium亚属。根据形态，这些物种已被划分为八个非正式的分类学“联盟”，其假设是代表物种之间共享的进化历史。这项研究的主要目的是用分子系统发育方法来检验同盟的单一性。
方法：我们从墨西哥北部的74种Amerallium物种和两种墨西哥特有种中取样，并基于两个核糖体RNA区域（ITS和ETS）和两个质体区域（trnL-F和rpL32-trnL）。
关键结果：大多数进化枝在核数据分析以及核和质体数据结合时得到很好的支持。但是，仅质体数据不能产生解析度高或支撑良好的树。形态联盟有时与在分子系统发育中恢复的基团一致，但在八个联盟中只有三个发现严格的单一性。
结论：我们提出了一种亚基分类法，该分类法可以识别《新世界》中的两个章节。由于形态和分子组之间存在很大的不一致，因此我们主张保留非正式的联盟，而不是采用正式的分部，直到可以进行进一步的形态和分子分析为止。

BACKGROUND & AIMS: CONTEXT:Adherence to antiretroviral therapy is a powerful predictor of survival for individuals living with human immunodeficiency virus (HIV) and AIDS. Concerns about incomplete adherence among patients living in poverty have been an important consideration in expanding the access to antiretroviral therapy in sub-Saharan Africa. OBJECTIVE:To evaluate estimates of antiretroviral therapy adherence in sub-Saharan Africa and North America. DATA SOURCES:Eleven electronic databases were searched along with major conference abstract databases (inclusion dates: inception of database up until April 18, 2006) for all English-language articles and abstracts; and researchers and treatment advocacy groups were contacted. Study Selection and Data Abstraction To best reflect the general population, studies of mixed populations in both North America and Africa were selected. Studies evaluating specific populations such as men only, homeless individuals, or drug users, were excluded. The data were abstracted in duplicate on study adherence outcomes, thresholds used to determine adherence, and characteristics of the populations. A random-effects meta-analysis was performed in which heterogeneity was examined using multivariable random-effects logistic regression. A sensitivity analysis was performed using Bayesian methods. DATA SYNTHESIS:Thirty-one studies from North America (28 full-text articles and 3 abstracts) and 27 studies (9 full-text articles and 18 abstracts) from sub-Saharan Africa were included. African studies represented 12 sub-Saharan countries. Of the North American studies, 71% used patient self-report to assess adherence; this was true of 66% of the African assessments. Studies reported similar thresholds for adherence monitoring (eg, 100%, >95%, >90%, >80%). A pooled analysis of the North American studies (17,573 patients total) indicated a pooled estimate of 55% (95% confidence interval, 49%-62%; I2, 98.6%) of the populations achieving adequate levels of adherence. Our pooled analysis of African studies (12,116 patients total) indicated a pooled estimate of 77% (95% confidence interval, 68%-85%; I2, 98.4%). Study continent, adherence thresholds, and study quality were significant predictors of heterogeneity. Bayesian analysis was used as an alternative statistical method for combining adherence rates and provided similar findings. CONCLUSION:Our findings indicate that favorable levels of adherence, much of which was assessed via patient self-report, can be achieved in sub-Saharan African settings and that adherence remains a concern in North America.

背景与目标： 背景：坚持抗逆转录病毒疗法是感染人类免疫缺陷病毒（HIV）和AIDS的个体生存的有力预测指标。对生活在贫困中的患者不完全依从的担忧已成为在撒哈拉以南非洲地区扩大获得抗逆转录病毒疗法的机会的重要考虑因素。
目的：评估撒哈拉以南非洲和北美地区抗逆转录病毒疗法依从性的估计。
数据来源：检索了11个电子数据库以及主要会议摘要数据库（包括日期：该数据库的建立至2006年4月18日），以查找所有英语文章和摘要。并与研究人员和治疗倡导团体进行了联系。研究选择和数据抽象为了更好地反映总人口，我们选择了北美和非洲的混合人群研究。评估仅针对男性，无家可归者或吸毒者等特定人群的研究被排除在外。重复提取有关研究依从性结果，用于确定依从性的阈值和人群特征的数据。进行了一项随机效应荟萃分析，其中使用多变量随机效应逻辑回归分析了异质性。使用贝叶斯方法进行敏感性分析。
数据综合：包括来自北美的31项研究（28篇全文和3篇摘要）和27项研究（9篇全文和18篇摘要）来自撒哈拉以南非洲。非洲研究代表了12个撒哈拉以南国家。在北美的研究中，有71％的患者使用患者自我报告来评估依从性；非洲评估中有66％是这样。研究报告了相似的依从性监测阈值（例如100％，> 95％，> 90％，> 80％）。一项对北美研究的汇总分析（总共17573名患者）表明，汇总评估的55％（95％置信区间，49％-62％； I2，98.6％）的人群达到了足够的依从性。我们对非洲研究的汇总分析（共12116例患者）表明，汇总估计值为77％（95％置信区间，68％-85％； I2，98.4％）。研究大陆，依从性阈值和研究质量是异质性的重要预测指标。贝叶斯分析被用作结合率的替代统计方法，并提供了相似的发现。
结论：我们的研究结果表明，在撒哈拉以南非洲地区，可以实现良好的依从性水平，其中大部分是通过患者的自我报告评估的，而依从性仍然是北美关注的问题。