RESUMEN
Parkinson's disease (PD) is a complex neurodegenerative condition characterized by alpha-synuclein aggregation and dysfunctional protein degradation pathways. This study investigates the differential gene expression of pivotal components (UBE2K, PSMC4, SKP1, and HSPA8) within these pathways in a Mexican-Mestizo PD population compared to healthy controls. We enrolled 87 PD patients and 87 controls, assessing their gene expression levels via RT-qPCR. Our results reveal a significant downregulation of PSMC4, SKP1, and HSPA8 in the PD group (p = 0.033, p = 0.003, and p = 0.002, respectively). Logistic regression analyses establish a strong association between PD and reduced expression of PSMC4, SKP1, and HSPA8 (OR = 0.640, 95% CI = 0.415-0.987; OR = 0.000, 95% CI = 0.000-0.075; OR = 0.550, 95% CI = 0.368-0.823, respectively). Conversely, UBE2K exhibited no significant association or expression difference between the groups. Furthermore, we develop a gene expression model based on HSPA8, PSMC4, and SKP1, demonstrating robust discrimination between healthy controls and PD patients. Notably, the model's diagnostic efficacy is particularly pronounced in early-stage PD. In conclusion, our study provides compelling evidence linking decreased gene expression of PSMC4, SKP1, and HSPA8 to PD in the Mexican-Mestizo population. Additionally, our gene expression model exhibits promise as a diagnostic tool, particularly for early-stage PD diagnosis.
RESUMEN
Resumen Los sistemas de salud están expuestos a diversos desastres que pueden impactar en la eficacia y calidad de servicio que ofrecen. Por ello, es importante contar con elementos que les permitan tener una adecuada infraestructura y organización. Este texto delinea algunos de estos elementos y acciones, cuya incorporación en los hospitales permitirá brindar una respuesta oportuna en caso de desastre. Se expone el uso del triage como un instrumento que regula el ingreso de los pacientes a los hospitales y se analiza cómo el inadecuado uso de éste durante una situación de desastre puede cobrar la vida de las personas lesionadas. Por último, se propone la preparación de un hospital ante posibles desastres y se retoma la experiencia de otro en el marco de los sismos ocurridos en México en 2017.
Abstract Health care systems are exposed to several natural disasters that could affect the effectiveness and quality of the services they offer. For this reason it is important to bring out the necessary elements that allow them a suitable organization and infrastructure. In this context some of these elements are drafted as well as a specific set of actions whose inclusion in the hospitals will allow for an optimal answer in case of natural disaster. The use of the triage is analyzed as an instrument that regulates the patient admission to the hospitals. Also, it is shown how the inadequate use of this tool during an emergency situation can follow with casualties from injured patients. For this reason, an appropriate set up for these cases is formulated. Last, the staging of a hospital before feasible contingences is proposed and the experience of the events of the 9/19 earthquake disaster retaken for this purpose.