Genetic biomarkers related to hemarthrosis, inflammation, and cartilage structure in pediatric patients with hemophilic arthropathy.

BACKGROUND: The pathophysiology of hemophilic arthropathy is complex and not completely understood. In this study, we aimed to identify biomarkers that can affect the hemophilic arthropathy severity. METHODS: Fifty patients were analyzed for biomarker frequencies; in 37 patients, articular symptoms were evaluated based on the physical joint examination score, and in 18, it was based on magnetic resonance imaging. Eight polymorphisms, namely FV 1691G>A, FII 20210G>A, MTHFR 677C>T and 1298A>C, TNFα-308G>A and -238G>A, ACAN VNTR, and IL1RN*2-VNTR were identified. RESULTS: Patients with the MTHFR 677TT genotype showed a higher number of affected joints (1.83 ± 0.9 vs. 0.55 ± 0.7 for CC; p = .023), whereas those with the MTHFR 1298AC genotype exhibited higher effusion according to two radiologists (0.90 ± 0.31/1.20 ± 0.63 vs. 0.38 ± 0.52/0.50 ± 0.53 for AA genotype; p = .043/0.036, respectively). In addition, patients with the TNFα-308GA genotype had more subchondral cysts (0.75 ± 0.95 vs. 0.07 ± 0.26 for GG genotype; p = .041). CONCLUSIONS: The distribution of risk genotypes for MTHFR and TNFα-308GA suggests their association with clinical parameters of hemophilic arthropathy. Cohort studies are essential to verify these associations.

Nutritional support strategies in pediatric cancer patients in Mexico / Estrategias de soporte nutricio en pacientes pediátricos con cáncer en México

Background: Meeting the nutritional needs of pediatric patients on oncology services in low budget public hospitals of Mexico is a continuous challenge, due to its financial resources. Objective: To evaluate the effectiveness of a nutritional strategy for children and adolescents with cancer in a public hospital of Mexico, based on a complacency diet. Methods: Across-sectional study included 58 children and adolescents (1-18 years old). An assessment of nutritional status was applied and a dietary diary was elaborated for 24 hours with the double weight method. Results: 43 patients (74.4%) had an adequate nutritional status. The average energy intake was 72.8% and average protein intake 168.3% of the requirements. The hospital meals accounted for 67.5% of the energy intake, 28.5% resulted from snacks and 3.9% from oral nutritional supplements or polymeric smoothies. Conclusion: The nutritional strategy based on offering a menu at the request supported by smoothies or oral nutritional supplements and the permission to introduce snacks to the hospital offers convenience and flexibility for meal times and favors the energy intake in hospitalized pediatric oncology patients.

Introducción: debido a la escasez de recursos económicos, los hospitales públicos de México tienen un reto continuo para satisfacer las necesidades nutricionales de niños en los servicios de oncología pediátrica. Objetivo: evaluar la eficacia de una estrategia nutricional en niños y adolescentes con cáncer, de un hospital público de México, basada en una dieta a complacencia. Métodos: se llevó a cabo un estudio transversal en el que se incluyeron 58 niños y adolescentes (1-18 años de edad). Se realizó una evaluación antropométrica del estado nutricio y se elaboró un diario dietético durante 24 horas con el método de doble pesada. Resultados: 43 pacientes (74.4%) tenían un estado nutricio adecuado. El consumo promedio de energía fue 72.8% y de proteínas 168.3% del requerimiento. Del total de las calorías consumidas 67.5% provenían del menú hospitalario, 28.5% de refrigerios y 3.9% de suplementos alimenticios o licuados artesanales. Conclusión: la estrategia nutricional basada en una dieta a complacencia apoyada por licuados y suplementos alimenticios más un permiso para la introducción de refrigerios al hospital, favoreció la ingestión calórica, ofreció comodidad y flexibilidad durante las horas de comida a los pacientes oncológicos pediátricos hospitalizados.

Patient-Generated Subjective Global Assessment of nutritional status in pediatric patients with recent cancer diagnosis.

BACKGROUND: The subjective global assessment (SGA) is a simple, sensitive tool used to identify nutritional risk. It is widely used in the adult population, but there is little evidence on its effectiveness in children with cancer. OBJECTIVE: This cross-sectional study was undertaken to demonstrate significant correlation between a simplified version of the Patient-Generated SGA (PG-SGA) and anthropometric assessment to identify nutritional status in children recently diagnosed with cancer. METHODS: The nutritional status of 70 pediatric cancer patients was assessed with the PG-SGA and anthropometric measurements. The relation between the assessments was tested with ANOVA, independent samples t-test, Kappa statistic, and non-parametric Spearman and Kendall correlation coefficient. The PG-SGA divided the patients into four groups: well nourished, mildly, moderately and severely malnourished. RESULTS: The prevalence of malnutrition according to the PG-SGA was 21.4%. The correlations (r ≥ 0.300, p < 0.001) and the concordance (k ≥ 0.327, p < 0.001) between the PG-SGA and anthropometric indicators were moderate and significant. CONCLUSIONS: The results indicate that the PG-SGA is a valid tool for assessing nutritional status in hospitalized children recently diagnosed with cancer. It is important to emphasize that the subjective assessment does not detect growth retardation, overweight or obesity.

Diferencias entre conductas alimentarias de preescolares que recibieron lactancia materna completa y preescolares que recibieron sucedáneos de la leche humana / Eating behaviors of preschoolers who were exclusively breastfed, and preschoolers who received human milk substitutes

El propósito fue demostrar diferencias en las conductas alimentarias entre preescolares que recibieron lactancia materna completa (LMC: exclusiva o predominante) y preescolares que recibieron sucedáneos de la leche humana (SLH), que acuden a jardín de niños de la zona metropolitana de Guadalajara. En estudio trasversal analítico por conveniencia, se seleccionaron a 177 preescolares de tres a cinco años de edad, sanos, nacidos a término, peso normal al nacer, con antecedentes de alimentación con LME o SLH que acudían a tres jardines de niños. Se aplicó un cuestionario validado de conductas alimentarias que consta de ocho escalas. Se obtuvieron variables socioeconómicas y demográficas de las familias e indicadores antropométricos de los participantes. Se aplicaron pruebas t de Student, U de Mann-Whitney, Chi cuadrado, razón de momios, coeficiente de correlación de Pearson y regresión logística. Hubo 2.8 veces mayor probabilidad de puntaje elevado en la escala comer menos por emociones en el grupo de SLH [RM=2.8 (1.0, 8.3), p=0.037]. Se observaron 15 correlaciones significativas entre las diferentes escalas del cuestionario en el grupo de LMC (62.5%) y nueve en el grupo de SLH (37.5%). Hubo siete correlaciones significativas entre las escalas en el grupo LMC que no fueron significativas en el grupo de SLH. En preescolares que recibieron LMC, a mayor lentitud para comer hubo menor irritabilidad hacia los alimentos (r=-0.325, p=0.01). Los preescolares con antecedentes de LMC tendrían menor probabilidad de alteraciones de conducta alimentaria y mostraron mayor número de correlaciones significativas entre las escalas que los preescolares que recibieron SLH(AU)

The purpose was to demonstrate differences in eating behaviors among preschool children who received full breastfeeding (FBF: exclusive or predominant) and preschool children who received human milk substitutes (HMS), who attend kindergarten in the metropolitan area of Guadalajara, Mexico. In analytical cross-sectional study by convenience, 177 preschoolers, three to five years old, healthy, term infants with normal weight at birth and feeding history of FBF or HMS attending three kindergartens were selected. A validated questionnaire of eating behaviors consisting of eight scales was applied. Socioeconomic and demographic variables of families and anthropometric indicators of participants were obtained. Student's t test, U Mann-Whitney, chi-square, odds ratio, Pearson correlation coefficient and logistic regression tests were applied. There were 2.8 times more likely to score high on the scale eat less by emotions in HMS group [OR = 2.8 (1.0, 8.3), p = 0.037]. Fifteen significant correlations between different scales of the questionnaire in the FBF group (62.5%) and nine in the HMS group (37.5%) were observed. There were seven significant correlations among the scales in FBF group, but not significant in the HMS group. In preschoolers receiving FBF, more frequency of eating slowly was related to less irritability to food (r=-0.325, p=0.01).Preschoolers with a history of FBF would be less likely to have alterations in eating behavior and showed more significant correlations between the scales that preschoolers who received HMS(AU)

Circunferencia de cintura y su asociación con factores de riesgo cardiovascular en niños y adolescentes con obesidad / Waist circumference and association with cardiovascular risk factors in obese children and adolescents

Introducción. Se ha demostrado que algunos indicadores indirectos de adiposidad, como el índice de masa corporal, se asocian con alteraciones metabólicas que incluyen los factores de riesgo cardiovascular. El objetivo de este trabajo fue evaluar la asociación de los valores del índice de masa corporal (IMC) y circunferencia de cintura (CC) con factores de riesgo cardiovascular en niños y adolescentes con obesidad. Métodos. Se llevó a cabo un estudio transversal en 115 niños y adolescentes con obesidad (IMC > + 2.0 DE). Se determinaron los valores de peso, talla y circunferencia de cintura. Se midió la presión arterial (PA) y las concentraciones séricas del perfil de lípidos, glucosa e insulina. Se calculó el índice HOMA-IR. Se identificó la correlación entre IMC y CC con parámetros bioquímicos y PA. Se realizaron modelos multivariados para evaluar la asociación de IMC y CC con factores de riesgo cardiovascular. Resultados. La edad promedio fue de 9.75 ± 3.1 años. Se identificó una correlación positiva y significativa de IMC y CC con PA, insulina y HOMA-IR. En modelos multivariados, tanto IMC como CC mostraron asociación con PA y alteraciones metabólicas. Conclusiones. En niños y adolescentes con obesidad, tanto la CC como el IMC se asocian con las alteraciones de la PA, insulina y HOMA-IR.

Background. It has been demonstrated that indirect indicators of adiposity such as body mass index are associated with metabolic disorders including cardiovascular risk factors. The objective was to evaluate the association of body mass index (BMI) and waist circumference (WC) with cardiovascular risk factors in obese children and adolescents. Methods. Cross-sectional study in 115 obese children and adolescents (BMI >+ 2.0 SD). Weight, height and waist circumference were measured. Blood pressure (BP), serum lipid profile, glucose and insulin were determined and HOMA-IR index was calculated. The correlation between BMI and WC with biochemical parameters and BP was identified; multivariate models were performed to evaluate the association of BMI and WC with cardiovascular risk factors. Results. Mean age was 9.75 ± 3.1 years. A significant positive correlation of BMI and WC with BP, insulin and HOMA-IR was identified. In multivariate models, both BMI and WC showed an association with these alterations. Conclusions. In obese children and adolescents, both the WC and BMI are associated with alterations in BP, insulin and HOMA-IR.

Association of genetic polymorphisms with histological grading of necroinflammation, staging of fibrosis, and liver function in Mexicans with chronic hepatitis C virus infection.

BACKGROUND/AIM: The aim of this work was to establish an association between the single-nucleotide polymorphisms (SNPs) of TGFB1 (rs1800471), AT (rs3789679), MMP-1 (rs17886084), MMP-3 (rs35068180), and PAI-1 (rs1799889) and the histological grading of necroinflammation, staging of hepatic fibrosis, and liver function in Mexican patients with advanced liver fibrosis due to chronic hepatitis C virus infection. METHODS: AT, MMP-1, MMP-3, and PAI-1 gene polymorphisms were analyzed by polymerase chain reaction in real time, whereas TGFB1 polymorphism was detected by polymerase chain reaction-based restriction fragment length polymorphism in 38 patients with established advanced liver fibrosis and 50 subjects from the general population. Grading of necroinflammation and staging of liver fibrosis were assessed by liver biopsy and graded according to modified histological activity index Ishak score. RESULTS: Regarding TGFB1 SNP, significant differences were found between G/G and G/C genotypes of patients with hepatic necroinflammation (P = 0.05) and hepatic fibrosis (P = 0.002). There were also significant differences among genotypes of patients with the AT SNP in hepatic necroinflammation (P = 0.01). The albumin-globulin ratio between genotypes of patients with the MMP-3 SNP gene showed significant differences (P = 0.02). CONCLUSION: Our findings demonstrate that a specific combination of genotypes associated with biochemical values and a histological high score determine more severe liver disease. The presence of the G/G genotype of TGFB1 SNP in patients was significantly associated with severity of liver necroinflammation and fibrosis. Patients with the G/G genotype of AT SNP were associated with severe necroinflammation. The albumin-globulin ratio was increased in patients with the 6A allele of MMP-3 SNP. These results might contribute to diagnosis and further establishment of liver disease treatment.

Ingestión de calcio y adiposidad en adolescentes de 12 a 16 años en Guadalajara, México / Calcium intake and adiposity in adolescents aged 12- 16 years in Guadalajara, Mexico

El objetivo del trabajo fue evaluar la asociación entre el consumo de calcio (Ca) y adiposidad en un grupo de adolescentes. Se realizó un estudio transversal en 125 adolescentes de 12 a 16 años. El consumo de Ca se evaluó por encuestas alimentarias de recordatorio de 24 horas y frecuencia de consumo de alimentos. Se midió la adiposidad por métodos antropométricos e impedancia bioeléctrica (IBE). Se identificó la relación entre el consumo de Ca y adiposidad mediante correlación simple; se realizaron modelos multivariados ajustados al consumo de energía, edad, sexo y menarquía. El promedio de edad fue de 13.5 ± 0.8 años. Se identificó correlación negativa entre el consumo de Ca y los indicadores antropométricos peso, pliegues cutáneos, índice de masa corporal, masa grasa y porcentaje de grasa (los dos últimos por IBE y solamente en mujeres). El análisis multivariado, que incluyó el consumo de energía, no demostró asociación entre el consumo de Ca y adiposidad. En conclusión, el consumo de Ca no se asocia a adiposidad en adolescentes; los modelos multivariados mostraron que el consumo total de energía y la menarquía son las variables que muestran mayor asociación con adiposidad en esta etapa de la vida.

The purpose was to evaluate the association between calcium (Ca) intake and adiposity in adolescents. A cross-sectional study of 125 adolescents 12 to 16 years. Ca intake was evaluated by 24-hour recall dietary surveys and food frequency consumption. Adiposity was measured by anthropometric methods and bioelectrical impedance (BIA). The association between Ca intake and adiposity was identified by simple correlation and multivariate models adjusted to energy consumption, age, sex and menarche. Mean age of adolescents was 13.5 ± 0.8 years. A negative correlation was identified between Ca intake and anthropometric indicators weight, skinfolds, body mass index, fat mass and percentage of fat (the latter two by BIA and only in women). Multivariate analysis, including energy consumption showed no association between Ca intake and adiposity. In conclusion, Ca consumption does not associate with adiposity in adolescents; multivariate models showed that energy intake and menarche are the variables that show a higher association with adiposity at this stage of life.

TGF-ß1 serum concentration as a complementary diagnostic biomarker of lung cancer: establishment of a cut-point value.

UNLABELLED: Lung cancer is a malignant disease with increasing mortality rates. Cytokines play a role in normal cell growth regulation and differentiation and are also implicated in malignant disease. Among these cytokines, Transforming Growth Factor ß type 1 (TGF-ß1) acts as a tumor promoter in malignant cells. Several clinical studies have found high levels of TGF-ß1 in various cancer types. The aim of this study was to establish a TGF-ß1 cut-off point as a complementary diagnostic tool in lung cancer detection. Therefore, 72 clinically well-characterized individuals were studied, 41 lung cancer patients and 31 healthy subjects. Serum TGF-ß1 concentration was measured by an enzyme-linked immunosorbent assay (ELISA). We compared statistically the serum TGF-ß1 concentration between both groups with analysis of variance, linear regression and receiver operating curve analysis. We observed that lung cancer patients produced higher TGF-ß1 levels than healthy individuals (37,225±9,436 vs. 28,416±9,324 pg/ml, P<0.001). The cut-point diagnostic value was 30,500 pg/ml with 80.5% sensitivity, 64.5% specificity and odds ratio: 7.5, 95% CI: 2.6-21.8. CONCLUSIONS: We found significantly higher TGF-ß1 levels in lung cancer patients than in healthy individuals. We propose the measurement of serum TGF-ß1 levels as a complementary diagnostic test in lung cancer detection.

Gene expression profiling identifies WNT7A as a possible candidate gene for decreased cancer risk in fragile X syndrome patients.

BACKGROUND AND AIMS: Although sporadic cases of cancer in patients with fragile X syndrome (FXS) have been reported, extensive studies carried out in Denmark and Finland concluded that cancer incidence in these patients is lower than in the general population. On the other hand, the FMR1 protein, which is involved in the translation process, is absent in FXS patients. Hence, it is reasonable to assume that these patients exhibit an abnormal expression of some proteins involved in regulating tumor suppressor genes and/or oncogenes, thus explaining its decreased cancer frequency. We undertook this study to analyze the expression of oncogenes and tumor suppressor genes in fragile X syndrome patients. METHODS: Molecular analysis of the FMR1 gene was achieved in 10 male patients and controls. Total RNA from peripheral blood was used to evaluate expression of oncogenes and tumor suppressor genes included in a 10,000 gene microarray library. Quantitative real-time PCR was utilized to confirm genes with differential expression. RESULTS: Among 27 genes showing increased expression in FXS patients, only eight genes exhibited upregulation in at least 50% of them. Among these, ARMCX2 and PPP2R5C genes are tumor suppressor related. Likewise, 23/65 genes showed decreased expression in >50% of patients. Among them, WNT7A gene is a ligand of the beta-catenin pathway, which is widely related to oncogenic processes. Decreased expression of WNT7A was confirmed by quantitative RT-PCR. Expression of c-Myc, c-Jun, cyclin-D and PPARdelta genes, as target of the beta-catenin pathway, was moderately reduced in FXS patients. CONCLUSIONS: Results suggest that this diminished expression of the WNT7A gene may be related to a supposed protection of FXS patients to develop cancer.

Consumo de refrescos y riesgo de obesidad en adolescentes de Guadalajara, México / Consumption of sweetened beverages as a risk factor for adolescent obesity in Guadalajara, Mexico

Introducción. El propósito del estudio fue demostrar que el consumo elevado de refrescos es un riesgo de obesidad en adolescentes de 12 a 16 años de edad. Métodos. En un diseño transversal se incluyeron al azar 105 varones y 105 mujeres sanos de una secundaria técnica del área metropolitana de Guadalajara, México. Se determinaron: pliegues cutáneos tricipital y subescapular, índice de masa corporal (IMC) y porcentaje de grasa corporal. Se realizó una encuesta de frecuencia de consumo de refrescos por día y una encuesta por recordatorio de 24 horas de la ocasión de consumo, ingestión de energía, macro y micro-nutrimentos. Se realizaron pruebas para datos paramétricos y no paramétricos y se estimó la razón de momios (RM) (intervalo de confianza de 95 %). Resultados. Se observó que las mujeres tuvieron más grasa corporal (P =0.001). Los varones consumieron más energía y nutrimentos (P <0.01), además de refrescos (P =0.005), y tuvieron más obesidad (P =0.001). El consumo de refrescos fue considerado dañino por 90% de los adolescentes. Entre 17-25% de los adolescentes consumieron más de 750 mL/ día de refresco. El consumo elevado de refrescos fue un factor mayor de riesgo de obesidad (RM 3.37 [1.14-7.29]) que de sobrepeso y obesidad juntos (RM 2.73 [1.27-5.86]). Conclusión. Los resultados demostraron que el consumo elevado de refrescos con alto contenido de energía representó un riesgo de obesidad en una población de adolescentes mexicanos.

Background: We undertook this study to demonstrate that high consumption of carbonated beverages is a risk factor for obesity in adolescents 12- to 16-years of age attending a technical high school of the metropolitan Guadalajara area. Methods. We included a healthy group of 105 males and 105 females in a cross-sectional and randomized study. Body mass index (BMI), tricipital and subscapular skin folds and percentage of body fat were determined. An estimation of the daily and occasional sweetened beverage consumption, energy and nutrient intake, and demographic and socioeconomic characteristics were also obtained. Parametric and nonparametric test and odd ratios (OR) (95% Cl) were estimated. Results. Females had a major percentage of body fat (P =0.001). The energy and most of the nutrient intake (P <0.01), consumption and preference for sweetened beverages (P =0.005) and frequency of obesity were higher in males (P =0.001). However, sweetened beverages were considered harmful by 90% of the adolescents. Between 17 and 25% of adolescents consumed >750 mL/day. The high consumption of sweetened beverages was a major risk factor for overweight and obesity together (OR 2.73 [1.27-5.86]) and this risk increased when obesity was analyzed alone (OR 3.37 [1.14-7.29]). Conclusions. This study demonstrated that the high consumption of sweetened beverages is a risk factor of obesity in a population of Mexican teenagers.

Procalcitonin and C-reactive protein serum levels as markers of infection in a pediatric population with febrile neutropenia and cancer.

BACKGROUND: Procalcitonin and C-reactive-protein are inflammatory markers for sepsis. The authors evaluated their sensitivity and specificity in pediatric patients with cancer and febrile neutropenia. PROCEDURE: Serum procalcitonin and C-reactive-protein were evaluated. Patients (n = 54) were divided into 2 groups, with severe infection (n = 18) or without documented infection (n = 36). RESULTS: Procalcitonin and C-reactive protein were significantly higher in the high-risk group. Procalcitonin displayed 72.2% sensitivity and 80.5% specificity. C-reactive-protein had a sensitivity of 77.7% and specificity of 77.2%. CONCLUSIONS: Procalcitonin is an accurate predictor of bacterial infection in neutropenic children, while C-reactive-protein may be a better screening test in emergency settings.

[Lung cancer histological types and diagnostic methods in a tertiary care facility]. / Tipos histológicos y métodos diagnósticos en cáncer pulmonar en un centro hospitalario de tercer nivel.

OBJECTIVE: To describe the histological frequencies, diagnostic methods, gender and age of lung cancer patients in a third level care hospital in western Mexico. METHODS: A retrospective and descriptive study (2002 to 2005) was undertaken. From all reviewed cases, 242 patients had a diagnosis compatible with lung cancer. We analyzed the histological type, gender, age group, and diagnostic method. RESULTS: The histological type frequencies of lung cancer were as follows: 63.6% adenocarcinoma, 19.0% squamous cell carcinoma, 15.2% small cell carcinoma, and 2.2% large-cell carcinoma. Among these patients, a male-female ratio of 2:1 with a mean age of 63 years was found. Regarding the diagnostic methods followed, the most common included: transthoracic needle aspiration, bronchial biopsy, and bronchial washing. CONCLUSIONS: Adenocarcinoma was the most frequent histological type in the sample studied, an association between female gender and risk of developing adenocarcinoma was detected.

Tipos histológicos y métodos diagnósticos en cáncer pulmonar en un centro hospitalario de tercer nivel / Lung cancer histological types and diagnostic methods in a tertiary care facility

Objetivo: Describir las frecuencias de tipos histológicos, métodos diagnósticos, sexo y edad de pacientes con cáncer pulmonar, en el Centro Médico Nacional de Occidente del Instituto Mexicano del Seguro Social, Guadalajara, Jalisco. Métodos: Estudio descriptivo y retrospectivo de los casos revisados entre 2002 y 2005; 242 pacientes presentaron diagnóstico de cáncer pulmonar. Se analizó el tipo histológico, sexo, edad y métodos diagnósticos. Resultados: Los tipos histológicos de cáncer pulmonar presentaron las siguientes frecuencias: adenocarcinoma 63.6%, carcinoma de células escamosas 19.0%, carcinoma de células pequeñas 15.2% y carcinoma de células grandes 2.2%. Se encontró una relación varón:mujer de 2:1, con una edad promedio de 63 años. Los métodos diagnósticos más utilizados fueron biopsia por aspiración con aguja fina, biopsia bronquial y lavado bronquial. Conclusiones: En la población analizada, el adenocarcinoma fue el tipo histológico más frecuente. Además, se encontró asociación entre el sexo femenino y el riesgo de presentar adenocarcinoma.

OBJECTIVE: To describe the histological frequencies, diagnostic methods, gender and age of lung cancer patients in a third level care hospital in western Mexico. METHODS: A retrospective and descriptive study (2002 to 2005) was undertaken. From all reviewed cases, 242 patients had a diagnosis compatible with lung cancer. We analyzed the histological type, gender, age group, and diagnostic method. RESULTS: The histological type frequencies of lung cancer were as follows: 63.6% adenocarcinoma, 19.0% squamous cell carcinoma, 15.2% small cell carcinoma, and 2.2% large-cell carcinoma. Among these patients, a male-female ratio of 2:1 with a mean age of 63 years was found. Regarding the diagnostic methods followed, the most common included: transthoracic needle aspiration, bronchial biopsy, and bronchial washing. CONCLUSIONS: Adenocarcinoma was the most frequent histological type in the sample studied, an association between female gender and risk of developing adenocarcinoma was detected.

Depression and its correlation with in patients pain in the rheumatology service of a Mexican teaching hospital.

The depressive symptoms are associated with chronic pain in this study. A cross-sectional study was performed. A visual analog scale was used to register pain intensity. Depressive symptoms were measured using the Center of Epidemiological Studies (CES-Dr) scale as modified by Eaton and reviewed for use in the Mexican population. The study included 245 patients, with a mean age of 46 years, 86.1% of whom were female. The prevalence of some degree of depression was 55.1%. Patients with fibromyalgia had the highest prevalence of symptoms of depression (78.38%) and major depression (29.73%). Stepwise multiple regressions indicated that the best model (r2 = 0.26) to predict the CES-Dr score included the global pain score (P < 0.0001) and education level (P < 0.004). The Cronbach's alpha of the CES-Dr was high (alpha = 0.888). There was moderate correlation (r = 0.442), P < 0.0001 of the CES-Dr numeric score with the intensity of global pain.

Consenso cultural sobre alimentos en adolescentes embarazadas de Guadalajara, México / Cultural consensus regarding food in pregnant adolescents from Guadalajara, México

Objetivo Caracterizar la estructura semántica y el nivel de consenso cultural que manifiestan las adolescentes embarazadas que acuden a la consulta externa del Hospital Civil de Guadalajara Dr. Juan I Menchaca. Métodos Estudio cualitativo mediante entrevistas estructuradas con la técnica de listas libres. Muestreo propositivo no aleatorizado que incluyo a 54 adolescentes embarazadas de 12 a 19 años de edad. Resultados Los alimentos del desayuno y la cena obtuvieron un mayor grado de consenso cultural, detectándose 14 alimentos para el desayuno y 8 para la cena. Conclusión Conocer el modelo de consenso cultural de los alimentos nos permite reforzar, modificar o agregar alimentos saludables a la dieta de las adolescentes embarazadas.

Objective Characterising the semantic structure and cultural consensus level of pregnant adolescents attending outpatient consultation at the "Dr. Juan I Menchaca" civil hospital in Guadalajara. Methods A qualitative study using free-list structured interviews. Non-randomised propositive sampling included 54 pregnant adolescents aged 12-19. Results There was a significant degree of cultural consensus concerning breakfast and dinner food; 14 foods were detected for breakfast and 8 for dinner. Conclusion Ascertaining the pattern of cultural consensus concerning food led us to reinforcing, modifying or adding healthy foods to pregnant adolescents' diet.

Contribution of TNF-308A and CCL2-2518A to carotid intima-media thickness in obese mexican children and adolescents.

BACKGROUND: Although commonly used in adults to detect early atherosclerosis, the value of the carotid intima-media thickness (CIMT) in children and adolescents is not clear. This marker has an inheritable component that supports the notion of a genetic influence. Among the genes studied as candidates for atherosclerosis development are those for chemokines, cytokines, and adhesion molecules because of their participation in atheroma formation through monocyte recruitment and migration. METHODS: We analyzed the relationship between CIMT and functional polymorphic variants in the genes for chemokines and proinflammatory cytokines associated with cardiovascular events in adults in lean and obese but otherwise healthy 6- to 19-year-old subjects. RESULTS: In the obese group, systolic blood pressure correlated negatively (r =-0.332; p = 0.008) and the TNF-308A allele correlated positively (r = 0.262; p = 0.040) with CIMT. The mean CIMT was higher in obese individuals with the TNF-308A allele than in those with TNF-308G allele (p = 0.041). In a multiple regression model for the total population, an increase in CIMT was explained by body mass index, systolic and diastolic blood pressure, and the TNF-308A and CCL2-2518A alleles (r(2) = 0.321; p = 0.022). CONCLUSIONS: This study contributes to the understanding of the pathophysiology of atherosclerosis and suggests that genetic markers of an increased inflammatory response and its deleterious effects are already present in obese children and adolescents.

Hábitos de alimentación y factores culturales en adolescentes embarazadas / Food habits and culture factors in pregnant adolescents

El propósito fue identificar hábitos de alimentación en adolescentes embarazadas y sus conceptos culturales con mayor influencia. Se estudiaron 54 sujetos de 12 a 19 años de edad de la ciudad de Guadalajara, se obtuvieron datos socioeconómicos, dietéticos, frecuencia de consumo de alimentos y se exploraron sus conceptos culturales en alimentación; con prueba chi cuadrado se estimó la asociación entre variables. El consumo de grasas fue bajo en adolescentes tardías vs. temprana/media 57 vs. 71g/d (p=0,05), el de hierro, calcio y zinc fue deficiente en la etapa temprana/media, mientras que el ácido fólico fue muy bajo en la etapa tardía. La tortilla de maíz fue el cereal y alimento más consumido (93-96 por ciento). Las frituras y refrescos (62 y 55 por ciento) prevalencieron en la etapa temprana/media. De las costumbres locales, los tacos, pozole y hamburguesas fueron los más referidos (74.1 por ciento). Refirieron perjudiciales a las grasas (36.7 por ciento), "comida chatarra" (30 por ciento), chile (26.7 por ciento), refrescos embotellados( 23.3 por ciento), comidas preparadas (26.7 por ciento) y sal (10 por ciento). Creían que las verduras (77 por ciento), frutas (60 por ciento), leche (21 por ciento), clados (17 por ciento) y carnes (12.5 por ciento) eran benéficos durante el embarazo. 96 por ciento consideraba que los caldos de pollo y de frijol eran nutritivos (mito) y que había alimentos prohibidos (tabúes) durante el embarazo: chile (48 por ciento), "producto" chatarra (20 por ciento) y sal (16 por ciento). El prejuicio fue más común en adolescentes tardías (60.9 por ciento) (p=0.03]. Los hábitos de alimentación erráticos y la confusión conceptual propician una ingestión baja de nutrimentos y colocan a estas adolescentes embarazadas en riesgo nutricio

Augmented serum level of major histocompatibility complex class I-related chain A (MICA) protein and reduced NKG2D expression on NK and T cells in patients with cervical cancer and precursor lesions.

BACKGROUND: Cervical cancer is the second most common cancer in women worldwide. NK and cytotoxic T cells play an important role in the elimination of virus-infected and tumor cells through NKG2D activating receptors, which can promote the lysis of target cells by binding to the major histocompatibility complex class I-related chain A (MICA) proteins. Increased serum levels of MICA have been found in patients with epithelial tumors. The aim of this study was to compare the levels of soluble MICA (sMICA) and NKG2D-expressing NK and T cells in blood samples from patients with cervical cancer or precursor lesions with those from healthy donors. METHODS: Peripheral blood with or without heparin was collected to obtain mononuclear cells or sera, respectively. Serum sMICA levels were measured by ELISA and NKG2D-expressing immune cells were analyzed by flow cytometry. Also, a correlation analysis was performed to associate sMICA levels with either NKG2D expression or with the stage of the lesion. RESULTS: Significant amounts of sMICA were detected in sera from nearly all patients. We found a decrease in the number of NKG2D-expressing NK and T cells in both cervical cancer and lesion groups when compared to healthy donors. Pearson analysis showed a negative correlation between sMICA and NKG2D-expressing T cells; however, we did not find a significant correlation when the analysis was applied to sMICA and NKG2D expression on NK cells. CONCLUSION: Our results show for the first time that high sMICA levels are found in sera from patients with both cervical cancer and precursor lesions when compared with healthy donors. We also observed a diminution in the number of NKG2D-expressing NK and T cells in the patient samples; however, a significant negative correlation between sMICA and NKG2D expression was only seen in T cells.

Protective in vivo effect of curcumin on copper genotoxicity evaluated by comet and micronucleus assays.

Curcumin is a phytochemical with antiinflammatory, antioxidant and anticarcinogenic activities. Apparently, curcumin is not genotoxic in vivo, but in vitro copper and curcumin interactions induce genetic damage. The aim of this study was to test if in vivo copper excess induces DNA damage measured by comet and micronucleus assays in the presence of curcumin. We tested 0.2% curcumin in Balb-C mice at normal (13 ppm) and high (65, 130 and 390 ppm) copper ion concentrations. The comet and micronucleus assays were performed 48 hr after chemical application. Comet tail length in animals treated with 0.2% curcumin was not significantly different from the control. Animals exposed to copper cations (up to 390 ppm) exhibited higher oxidative DNA damage. Curcumin reduced the DNA damage induced by 390 ppm copper. We observed statistically significant increase in damage in individuals exposed to 390 ppm copper versus the control or curcumin groups, which was lowered by the presence of curcumin. Qualitative data on comets evidenced that cells from individuals exposed to 390 ppm copper had longer tails (categories 3 and 4) than in 390 ppm copper + curcumin. A statistically significant increase in frequency of micronucleated erythrocytes (MNE/10000TE) was observed only in 390 ppm copper versus the control and curcumin alone. Also cytotoxicity measured as the frequency of polychromatic erythrocytes (PE/1000TE) was attributable to 390 ppm copper. The lowest cytotoxic effect observed was attributed to curcumin. In vivo exposure to 0.2% curcumin for 48 hr did not cause genomic damage, while 390 ppm copper was genotoxic, but DNA damage induced by 390 ppm copper was diminished by curcumin. Curcumin seems to exert a genoprotective effect against DNA damage induced by high concentrations of copper cations. The comet and micronucleus assays prove to be suitable tools to detect DNA damage by copper in the presence of curcumin.

DNA damage in mouse lymphocytes exposed to curcumin and copper.

Dietary polyphenolics, such as curcumin, have shown antioxidant and anti-inflammatory effects. Some antioxidants cause DNA strand breaks in excess of transition metal ions, such as copper. The aim of this study was to evaluate the in vitro effect of curcumin in the presence of increasing concentrations of copper to induce DNA damage in murine leukocytes by the comet assay. Balb-C mouse lymphocytes were exposed to 50 microM curcumin and various concentrations of copper (10 microM, 100 microM and 200 microM). Cellular DNA damage was detected by means of the alkaline comet assay. Our results show that 50 microM curcumin in the presence of 100-200 microM copper induced DNA damage in murine lymphocytes. Curcumin did not inhibit the oxidative DNA damage caused by 50 microM H2O2 in mouse lymphocytes. Moreover, 50 microM curcumin alone was capable of inducing DNA strand breaks under the tested conditions. The increased DNA damage by 50 mM curcumin was observed in the presence of various concentrations of copper, as detected by the alkaline comet assay.