Blood biomarkers for cognitive decline and clinical progression in a Mexican American cohort.

Introduction: The clinical translation of biofluid markers for dementia requires validation in diverse cohorts. The study goal was to evaluate if blood biomarkers reflecting diverse pathophysiological processes predict disease progression in Mexican American adults. Methods: Mexican American adults (n = 745), 50 years of age and older, completed annual assessments over a mean of 4 years. Serum collected at baseline was assayed for total tau, neurofilament light (NFL), ubiquitin carboxyl-terminal hydrolase LI, glial fibrillary acidic protein (GFAP), soluble cluster of differentiation 14 (sCD14), and chitinase-3-like protein 1 (YKL-40). Results: Higher GFAP and NFL were associated with global cognitive decline. Only GFAP was associated with increased incident dementia risk (hazard ratio: 1.611 (95% confidence interval: 1.204-2.155)) and inclusion of additional biomarkers did not improve model fit. Discussion: Among a panel of six blood biomarkers previously associated with neurodegenerative disease, only GFAP predicted incident dementia in our cohort. The findings suggest that blood GFAP levels may aid dementia-risk prediction among Mexican American adults.

Incident prolonged QT interval in midlife and late-life cognitive performance.

BACKGROUND: Measures of cardiac ventricular electrophysiology have been associated with cognitive performance in cross-sectional studies. We sought to evaluate the association of worsening ventricular repolarization in midlife, as measured by incident prolonged QT interval, with cognitive decline in late life. METHODS: Midlife QT interval was assessed by electrocardiography during three study visits from 1965/68 to 1971/74 in a cohort of Japanese American men aged 46-68 at Exam 1 from the Honolulu Heart Study. We defined incident prolonged QT as the QT interval in the upper quartile at Exam 2 or 3 after QT interval in lower three quartiles at Exam 1. Cognitive performance was assessed at least once using the Cognitive Abilities Screening Instrument (CASI), scored using item response theory (CASI-IRT), during four subsequent visits from 1991/93 to 1999/2000 among 2,511 of the 4,737 men in the Honolulu-Asia Aging Study otherwise eligible for inclusion in analyses. We used marginal structural modeling to determine the association of incident prolonged QT with cognitive decline, using weighting to account for confounding and attrition. RESULTS: Incident prolonged QT interval in midlife was not associated with late-life CASI-IRT at cognitive baseline (estimated difference in CASI-IRT: 0.04; 95% CI: -0.28, 0.35; p = 0.81), or change in CASI-IRT over time (estimated difference in annual change in CASI-IRT: -0.002; 95%CI: -0.013, 0.010; p = 0.79). Findings were consistent across sensitivity analyses. CONCLUSIONS: Although many midlife cardiovascular risk factors and cardiac structure and function measures are associated with late-life cognitive decline, incident prolonged QT interval in midlife was not associated with late-life cognitive performance or cognitive decline.

Incidencia de trombosis de stents coronarios en el ®mundo real¼ / Incidence of coronary stent thrombosis in the ®real world¼

ANTECEDENTES: la evidencia disponible de stents liberadores de medicamento proviene de estudios controlados con estrictos criterios de inclusión, limitando sus conclusiones y haciendo difícil la aplicación de sus resultados en el mundo real. OBJETIVO: determinar la incidencia de trombosis de stents liberadores y no liberadores de medicamento en pacientes del ®mundo real¼. METODOLOGÍA: estudio de incidencia para determinar el número de casos de trombosis de stents implantados, mediante información obtenida a partir de historias clínicas, bases de datos y seguimiento clínico, y con base en características demográficas, factores de riesgo, consumo de clopidogrel y casos de trombosis del stent con un seguimiento de cero días a un año. RESULTADOS: 640 stents implantados (69,2% no medicados, 30,8% medicados de los cuales 18,9% eran medicados con placlitaxel y 11,9% medicados con sirolimus). Se identificaron doce eventos de trombosis (siete stents medicados y cinco no medicados). La incidencia de trombosis con cualquier tipo de stent fue de 1,88% (IC 95% 0,97-3,28). La incidencia de trombosis con stent medicado fue 3,55% (IC 95% 1,43-7,32), y con stent no medicado 1,13% (IC 95% 0,37-2,64) p=0,000. El riesgo relativo de trombosis con stent medicado es de 3,14 (IC 95% 1,01-9,78) p=0,037. El riesgo relativo de presentar trombosis con stent medicado en infarto agudo del miocardio es 8,11 (IC 95% 2,32-28,31) p=0,001. CONCLUSIONES: la incidencia de trombosis del stent aumenta en el mundo real, y existe mayor riesgo de trombosis de stents medicados especialmente cuando son implantados en el contexto de un infarto agudo del miocardio. Es necesario realizar estudios futuros que involucren una población de pacientes más amplia y con seguimiento a largo plazo.

BACKGROUND: The existing evidence of drug-eluting stents comes from controlled studies done with strict inclusion criteria, limiting their conclusions and making difficult to apply their findings in the real world.Objectives: determine the incidence of thrombosis between bare metal stents versus drug-eluting stents in patients in the ®real world¼. METHODS: incidence study to determine the number of cases of thrombosis in implanted stents through information gathered from clinical records, data bases and clinical follow-up, based on demographic characteristics, risk factors, clopidogrel treatment and events of stent thrombosis with a 0 days to 1 year follow-up. RESULTS: 640 stents were implanted. 69.2% were bare metal stents and 30.8% drug-eluting stents, from which 18.9% were with placlitaxel and 11.9% with sirolimus. 12 thrombosis events were identified (7 with drug-eluting stents and 5 with bare metal stents). The incidence of thrombosis with any kind of stent was 1.88 %( CI 95% 0.97-3.28). The incidence of thrombosis with drug-eluting stents was 3.55% (CI 95%1.43-7.32), and with bare metal stents 1.13% (CI 95% 0.37-2.64) p=0.000. The relative risk of thrombosis with drug eluting stents is 3.14 (CI 95%1.01-9.78) p=0.037. The relative risk of thrombosis with drug eluting stents and acute myocardial infarction is 8.11 (CI 95%2.32-28.31) p=0,001. CONCLUSIONS: there is an increased incidence of thrombosis of coronary stents in the real world and a greater risk of thrombosis with drug eluting stents, especially when implanted in the context of an acute myocardial infarction. It is necessary to conduct further studies that may involve a higher sample of patients population and long-term follow-up.

Asociación de polimorfismos de la región promotora del gen de la interleucina 10 con la urticaria papular por picadura de pulga / Association of Interleukin 10 (IL-10) gene promoter region polymorphisms with flea bite papular urticaria

Objetivos. Establecer si los polimorfismos en la región promotora del gen de la IL-10 localizados en las posiciones -819 y -592 están asociados con la urticaria papular causada por la picadura de pulga, en pacientes pediátricos que asistieron a consulta de alergia o de dermatología a la Fundación Santa Fe de Bogotá, Colombia. Métodos. La frecuencia de estos dos polimorfismos en el ADN fue analizada en 25 niños con urticaria papular y 22 controles por medio de PCR (Polymerase Chain Reaction) y RFLP (Restriction Fragment Length Polymorphisms). Resultados. No hubo diferencias significativas entre las frecuencias alélicas y genotípicas de cada polimorfismo individual o SNP (-819 o -592) entre pacientes y controles (p=0,21, OR=1,87, IC95% 0,79-4,40) cuando fueron calculados por la prueba exacta de Fisher. Conclusiones. Aunque en este trabajo preliminar no se encontró asociación de los polimorfismos reportados en otras poblaciones con la enfermedad alérgica, hay una tendencia en nuestros experimentos a encontrar un mayor número de haplotipos AT en pacientes que en controles Los resultados publicados por nuestro grupo de investigación, en cuanto a que la secreción de IL-10 in vitro se encuentra disminuida en pacientes con urticaria papular y no en controles sanos, indicar ían que la expresión genética de esta citocina estaría alterada en pacientes y, por consiguiente, esta condición estaría exacerbando la enfermedad. Los niveles disminuidos de esta citocina reguladora permitirían el desarrollo de condiciones hiperinmunes, como la alergia y la autoinmunidad...

Objectives: In this study we aimed to establish whether IL-10 promoter region genetic polymorphisms in positions -819 and -592 were associated with papular urticaria caused by flea bite in pediatric patients from the Fundación Santa Fe de Bogotá, Colombia.Methods: The frequency of these DNA polymorphisms was analyzed in 25 infants suffering papular urticaria and 22 healthy controls, after amplification of their corresponding DNA through polymerase chain reaction (PCR) and further analysis of resulting restriction fragment length polymorphisms (RFLP). Results: We found no significant differences in allelic and genotypic frequencies of either -819 or -592 SNPs between patients and healthy controls (p=0.21, OR=1.87, 95% IC=0.79-4.40). Conclusions: Although we did not find in this preliminary study a genetic association between papular urticaria and previously reported allergyassociated SNPs such as -819 and -592, we found higher numbers of allergy-associated AT haplotypes in patients than in controls. Previously published results from our group showed in vitro a diminished IL-10 secretion in patients and not in healthy controls. This finding, together with our present results, would indicate that the genetic expression of this cytokine could be altered in patients and that this condition could determine the exacerbation of papular urticaria. Low levels of this cytokine would allow for the development of hyperimmune conditions such as allergy and autoimmunity...

Prevalence of and factors associated with current asthma symptoms in school children aged 6-7 and 13-14 yr old in Bogotá, Colombia.

This cross-sectional study of children aged 6-7 years and adolescents aged 13-14 years in Bogotá, Colombia, assessed the prevalence of asthma symptoms and their associations with dietary, health, and behavioral habits. This study is part of the International Study of Asthma and Allergies in Childhood (ISAAC)-phase III. Asthma prevalence among the children was assessed using a parental self-administered written questionnaire (WQ), and among adolescents using a WQ together with a video questionnaire (VQ). Associations were estimated with bivariate and multivariate analysis. The study found that the 6-7 year age-group were more likely to report current asthma symptoms than the 13-14 year age-group (10.4% [WQ] vs. 8.6% [WQ] and 8.0% [VQ], respectively). Factors associated with current asthma symptoms among the 6-7 year age-group included higher maternal education (OR = 1.7, [95% CI 1.2-2.6], p = 0.007), a cat in the home during the last year (OR = 1.5, [95% CI 1.0-2.3], p = 0.036), watching TV 1-2 hours/day (OR = 2.1, [95% CI 1.2-3.9], p = 0.013), and medication with acetaminophen in the first and most recent year of life (OR = 1.8, [95% CI 1.3-2.4], p < 0.001; OR = 2.2, [95% CI 1.7-2.8], p < 0.001, respectively) or antibiotics in the first year of life (OR = 1.9, [95% CI 1.4-2.5], p < 0.001). Among the 13-14 year age-group, factors associated with current asthma symptoms included medication with acetaminophen during the last year (OR = 1.8, [95% CI 1.4-2.3], p < 0.001); cereal, milk, and fruit consumption 3 or more times weekly (OR = 1.5, [95% CI 1.1-1.9], p = 0.010; OR = 0.8, [95% CI 0.6-1.0], p = 0.046; OR = 0.6, [95% CI 0.4-1.0], p = 0.031, respectively). Overall, compared with that in other Latin American centers, asthma prevalence in Bogotá is close the lower estimates. However, associations with dietary, health, and behavioral habits need further study to assess their complex relationship with asthma.

Prevalencia del síndrome metabólico en pacientes diabéticos / Prevalence of the metabolic syndrome in diabetic patients

Antecedentes: las diferentes definiciones que han surgido para síndrome metabólico (SM) en los últimos 10 años han llevado a confusiones. En octubre de 2005, la American Heart Association (AHA) realizó algunas modificaciones para optimizar el uso de los criterios del National Cholesterol Education Program’s Adult Treatment Panel III Report (ATPIII) en la práctica clínica diaria.Objetivo: determinar la prevalencia del síndrome metabólico como se define por el ATPIII comparado con la definición de la AHA 2005 en los pacientes de la clínica de diabetes de una institución de tercer nivel.Material y métodos: estudio de corte transversal. Se revisaron 249 historias clínicas entre enero de 2004 y septiembre de 2005. Se describió la población a estudio y se estimó la prevalencia del síndrome metabólico según los criterios del ATPIII y de la AHA...

Prevalence of multiple sclerosis in Bogotá, Colombia.

Among Latin American countries, Colombia is considered a low-risk area for multiple sclerosis (MS) and no studies on MS prevalence have been conducted in any of the country's large urban settings. To fill this gap and assess the prevalence of MS in Bogotá as of December 31, 2002, this study reviewed the clinical records of patients diagnosed with MS in most Bogotá hospitals. This review produced a sample of 296 patients with an MS diagnosis whose reliability was verified by a neurologist with expertise in MS. The total prevalence rate identified for December 2002 was 4.41/100,000 inhabitants (95% CI 3.9-4.9), including a rate of 5.98/100,000 (95% CI 5.2-6.8) for women and 2.71/100,000 (95% CI 2.2-3.3) for men (differences measured at p < 0.001). The prevalence estimates for Bogotá, confirm the city's status as a low-risk area for MS.