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INTRODUCTION: There are few longitudinal studies of dementia in developing countries. We used longitudinal data from the Maracaibo Aging Study to accurately determine the age- and sex-specific incidence of dementia in elderly Latin Americans. METHODS: The Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) was used to diagnose dementia, which was classified as Alzheimer's disease, vascular dementia, or other. Age- and sex-specific incidence was estimated as the number of new cases of dementia divided by person-years (p-y) of follow-up. RESULTS: The incidence of all dementia diagnoses was 9.10 per 1000 p-y (95% confidence interval [CI] 7.13-11.44; 8026 total p-y), 5.18 for Alzheimer's disease (95% CI 3.72-7.03; 7916 total p-y), and 3.35 for vascular dementia (95% CI 2.19-4.91; 7757 total p-y). DISCUSSION: Among Maracaibo Aging Study participants younger than 65 years, the incidence of dementia was higher than that of US Whites. Among individuals older than 65 years, the incidence was comparable to the mean of previous incidence estimates for other populations worldwide.
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Envejecimiento , Demencia/epidemiología , Evaluación Geriátrica , Factores de Edad , Anciano , Anciano de 80 o más Años , Apolipoproteína E4/genética , Planificación en Salud Comunitaria , Demencia/diagnóstico , Demencia/genética , Femenino , Humanos , Incidencia , América Latina/epidemiología , Modelos Logísticos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Pruebas NeuropsicológicasRESUMEN
The aim of the study was to identify chromosomal regions that may harbor putative genetic variants influencing age at onset in familial late-onset Alzheimer's disease (LOAD). Data from a genome-wide scan that included genotyping of APOE were analyzed in 1,161 individuals from 209 families of Caribbean Hispanic ancestry with a mean age at onset of 73.3 years multiply affected by LOAD. Two-point and multipoint analyses were conducted using variance component methods using 376 microsatellite markers with an average intermarker distance of 9.3 cM. Family-based test of association was also conducted for the same set of markers. Age at onset of symptoms among affected individuals was used as the quantitative trait. Our results showed that the presence of APOE-epsilon4 lowered the age at onset by 3 years. Several candidate loci were identified. Using linkage analysis strategy, the highest logarithm of odds (LOD) scores were obtained using a conservative definition of LOAD at 5q15 (LOD = 3.1), 17q25.1 (LOD = 2.94), 14q32.12 (LOD = 2.36), and 7q36.3 (LOD = 2.29) in a model that adjusted for APOE-epsilon4 and other covariates. Both linkage and family-based association identified 17p13 as a candidate region. Family-based association analysis showed markers at 12q13 (p = 0.00002), 13q33 (p = 0.00043), and 14q23 (p = 0.00046) to be significantly associated with age at onset. The current study supports the hypothesis that there are additional genetic loci that could influence age at onset of late onset Alzheimer's disease. The novel loci at 5q15, 17q25.1, 13q33, and 17p13 and the previously reported loci at 7q36.3, 12q13, 14q23, and 14q32 need further investigation.
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Enfermedad de Alzheimer/genética , Ligamiento Genético , Hispánicos o Latinos/genética , Adulto , Edad de Inicio , Anciano , Anciano de 80 o más Años , Apolipoproteína E4/genética , Región del Caribe , Femenino , Humanos , Escala de Lod , Masculino , Repeticiones de Microsatélite , Persona de Mediana Edad , Presenilina-1/genéticaRESUMEN
The relationship between total homocysteine (tHcy) and dementia risk remains controversial, as the association varies among populations and dementia subtypes. We studied a Venezuelan population that has high prevalence of both elevated tHcy and dementia. We tested the hypotheses that (1) elevated tHcy is associated with increased dementia risk, (2) the risk is greater for vascular dementia (VaD) than for Alzheimer's disease (AD), and (3) a history of stroke may partly explain this association. 2100 participants (>/=55 years old) of the Maracaibo Aging Study underwent standardized neurological, neuropsychiatric, and cardiovascular assessments. Elevated tHcy was significantly associated with dementia, primarily VaD. When history of stroke and other confounding factors were taken into account, elevated tHcy remained a significant risk factor in older (>66 years), but not in younger (55-66 years) subjects. Ongoing studies of this population may provide insight into the mechanism by which tHcy increases risk for dementia.
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La tuberculosis es una enfermedad infectocontagiosa cuya prevalencia en nuestra población es muy alta, y sigue aumentando debido a las condiciones socioeconómicas reinantes en nuestra región. Tuberculosis y embarazo es una asociación que muchas veces no es diagnosticada. Se reporta el caso de una paciente con gestación de 28 semanas con diagnóstico de Tuberculosis Pulmonar Activa. Se discutió la metodología diagnóstica de tuberculosis durante el embarazo, así como también el tratamiento y sus efectos colaterales en estas pacientes. El nacimiento ocurrió a las 37 semanas de gestación por cesárea segmentaria. En este caso el diagnóstico de tuberculosis neonatal fue negativo. Por último se realizó una revisión de la literatura reciente publicada acerca del tema
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Humanos , Femenino , Embarazo , Cesárea , Embarazo , Tuberculosis Pulmonar , VenezuelaRESUMEN
Este trabajo tiene como objetivo investigar la existencia de un posible control genético de la no disyunción del cromosoma 21 en 501 familias con Síndrome de Down por trisomía libre (TLI) que asistieron a la Unidad de Genética Médica de LUZ entre 1971 y 1988. Como población control (CON) se tomaron 418 familias de individuos sin patología genética aparente y con edades aproximadas a la de los pacientes. Se deteminó la frecuencia de uniones consanguíneas entre los padres de pacientes y controles (UCPM), entre abuelos maternos (UCAM) y entre los abuelos paternos (UCAP). De acuerdo con los resultados UCPM fue significativamente mayor en TLI que en CON. Asimismo, el coeficiente de consanguinidad de los progenitores de TLI fue 3 veces mayor al de los progenitores de los CON. Los resultados de este trabajo sugieren que la consanguinidad debe ser considerada como otro factor de riesgo para la no disyunción del cromosoma 21 e independiente al de la edad materna y apoyan como hipótesis más probable la de la existencia de un gen recesivo autosómico, que al alcanzar la homocigosis en el cigoto lo predispone a sufrir no disyunción del cromosoma 21 en su primera división