RUNX3 gene polymorphisms and haplotypes in Mexican patients with colorectal cancer.

We analyzed a possible association between RUNX3 gene polymorphisms and haplotypes in Mexican patients with colorectal cancer (CRC). Genomic DNA samples were obtained from the peripheral blood of 176 Mexican patients with CRC at diagnosis and from 195 individuals that formed the control group. The polymorphisms were detected by polymerase chain reaction-restriction fragment length polymorphism. Association was estimated by odds ratio (OR). The haplotypes and linkage disequilibrium were established using the Arlequin v3.5 software. We found that the RUNX3 polymorphisms analyzed were in Hardy-Weinberg equilibrium. The RUNX3 rs2236852 AA genotype and A allele showed association with CRC (OR = 0.39, 95%CI = 0.21-0.73, P < 0.01; OR = 0.65, 95%CI = 0.49-0.87, P < 0.01, respectively), while the rs6672420, rs11249206, and rs760805 polymorphisms did not show significant association with CRC. The TA haplotype (SNPs rs760805 and rs2236852) showed an increased risk for CRC (OR = 2.52, 95%CI = 1.47-4.30, P < 0.001). In conclusion, we found that the AA genotype and A allele of rs2236852 polymorphism confer a decreased CRC risk, while the TA haplotype appears to increase the risk of CRC development in Mexican patients.

Effect of ZNF217 gene polymorphisms on colorectal cancer development in a Mexican population.

The ZNF217 gene, a potential oncogene amplified and overexpressed in several cancers including colorectal cancer (CRC), acts as a transcription factor that activates or represses target genes. The polymorphisms rs16998248 (T>A) and rs35720349 (C>T) in coronary artery disease have been associated with reduced expression of ZNF217. In this study, we analyzed the 2 polymorphisms in Mexican patients with CRC. Genotyping of rs16998248 and rs35720349 sites was performed by polymerase chain reaction-restriction fragment length polymorphism in 203 Mexican Mestizos, 101 CRC patients, and 102 healthy blood donors. Although no statistical differences regarding genotype and allele frequencies of ZNF217 polymorphisms were observed (P > 0.05), linkage disequilibrium was significant in CRC patients (r(2) = 0.39, P < 0.0001), as a result of reduced AC haplotype frequency. Thus, the AC haplotype may protect against CRC.

Association of MMP7-181A/G and MMP13-77A/G polymorphisms with colorectal cancer in a Mexican population.

Colorectal cancer (CRC) is characterized by enhanced expression and activity of several metalloproteinases (MMPs), including MMP13 and MMP7, which play an important role in tumor invasion and metastasis. The objective of this study was to analyze the association of functional MMP7-181A/G and MMP13-77A/G promoter polymorphisms with susceptibility to CRC in a Mexican population. Genomic DNA samples were obtained from peripheral blood of 102 CRC patients and 125 blood donors who were included as the control group. Identification of polymorphisms was based on polymerase chain reaction-restriction fragment length polymorphism methodology. The association was estimated by the odds ratio (OR) test. The results showed that MMP7-181A/G and MMP13-77A/G variants were associated with CRC. For MMP7-181A/G, the AA (P=0.02, OR=3.38, 95% confidence interval (CI)=1.16-9.84) and AG (P=0.01, OR=3.4, 95%CI=1.17-9.83) genotypes were associated with an increased risk of CRC. For MMP13-77A/G, the AA and AG genotypes were associated with CRC (AA genotype: P=0.04, OR=3.2, 95%CI=1.004-10.2; AG genotype: P=0.01, OR=4.08, 95%CI=1.3-13.07). In conclusion, AA and AG genotype carriers for both polymorphisms are at a higher risk of developing CRC in this Mexican population.

Limitación del esfuerzo terapéutico. Opinión de los profesionales / Limits of therapeutic effort. professional opinions

Introducción En nuestra práctica asistencial nos encontramos con la necesidad de atender a pacientes con situaciones no reversibles, debido a la avanzada edad o a enfermedades crónicas subyacentes y al cambio del tipo de patologías a las que se enfrenta en la actualidad el personal sanitario. El objetivo de esta investigación fue conocer la valoración ética de los profesionales sanitarios de nuestro centro, respecto a las medidas extraordinarias de soporte de vida. Material y Métodos Estudio descriptivo prospectivo realizado en el Hospital General Universitario de Ciudad Real durante los meses de abril a agosto del año 2010.La muestra de conveniencia estuvo formada por 189 profesionales de diferentes categorías que durante el periodo de estudio prestaban su servicio en nuestro hospital. Se incluyó un cuestionario adaptado para su utilización en el ámbito hospitalario que consta de 18 ítems con respuesta dicotómica. Se solicitó consentimiento informado y se garantizó la confidencialidad de la información. Resultados Se obtiene una muestra total de 189 profesionales, de los cuales un 21,7% fueron varones frente a un 78,3% que fueron mujeres. La media de edad se sitúo en 40,39 años DS± 10, con una moda de 31 años. Los profesionales que participaron fueron médicos, enfermeras y auxiliares de enfermería, con una media de experiencia laboral de 15,8% años DS± 10,4.El 79,9% se encuentra a favor de la eutanasia, el 93,6% en contra de la distanasia, el 92,6% a favor de la antidistanasia y un 99,5% a favor de la ortotonasia. El colectivo médico es el más contrario a la aplicación de la eutanasia p=0,0001.Se han observado diferencias entre la práctica religiosa y la actitud ética ante situaciones al final de la vida. Conclusiones La mayoría de los participantes tomaría en cuenta la decisión del paciente de limitar las medidas extraordinarias en (..) (AU)

Introduction: In our clinical practice we find the need to care for patients with irreversible conditions, due to advanced age or underlying chronic disease, and a change in the types of disease currently facing the health workforce. The objective of this research was to study the ethical assessment of health professionals in our Hospital on extraordinary life supportmeasures. Material and Methods: Prospective descriptive study conducted at the Hospital General Universitario de Ciudad Real during the months of April to August 2010.The convenience sample consisted of 189 professionals from different categories working in our hospital during the study period. It included a questionnaire adapted for use in hospitals, comprising 18 items with dichotomous responses. Informed consent was requested and the confidentiality of information ensured. Results: A sample of 189 professionals, of whom 21.7% were male and 78.3% were female. The mean age was 40.39 years SD + 10, with a mode of 31 years. The professionals involved were doctors, nurses and nursing assistants, with an average experience of 15.8% ± 10.4 SD years. A total of 79.9% were in favour of euthanasia, 93.6% against dysthanasia, 92.6% for antidysthanasia, and 99.5% for orthotonasia. The medical group was the one most against the use of euthanasia P=.0001.Differences were found between religious practice and the ethical situations at the end of life. Conclusions: Most participants took into account the patient’s decision to limit extraordinary measures in terminal disease situations. The study reveals that the effectiveness and usefulness of our clinical practice should include an ethical evaluation by professionals with the patient. It became clear that the majority of the sample of professionals is against over-aggressive treatment, and for a dignified death (AU)

MLH1 and XRCC1 polymorphisms in Mexican patients with colorectal cancer.

DNA repair proteins maintain DNA integrity; polymorphisms in genes coding for these proteins can increase susceptibility to colorectal cancer (CRC) development. We analyzed a possible association of MLH1 -93G>A and 655A>G and XRCC1 Arg194Trp and Arg399Gln polymorphisms with CRC in Mexican patients. Genomic DNA samples were obtained from peripheral blood of 108 individuals with CRC (study group) at diagnosis and 120 blood donors (control group) from Western Mexico; both groups were mestizos. The polymorphisms were detected by PCR-RFLP. Association was estimated by calculating the odds ratio (OR). We found that the MLH1 and XRCC1 polymorphisms were in Hardy- Weinberg equilibrium. The MLH1 655A>G polymorphism in the 655G allele was associated with a 2-fold increase risk for CRC (OR = 2.04 and 95% confidence interval (95%CI) = 1.12-3.69; P < 0.01), while the MLH1 -93G>A polymorphism allele was associated with a protective effect (OR = 0.60, 95%CI = 0.40-0.89; P = 0.01 in the -93A allele and OR = 0.32, 95%CI = 0.13-0.79; P = 0.01 in the AA genotype). The XRCC1 Arg194Trp and Arg399Gln polymorphisms did not show any significant associations. In conclusion, we found that MLH1 -93G>A and 655A>G polymorphisms are associated with CRC in Mexican patients.

[Limits of therapeutic effort. Professional opinions]. / Limitación del esfuerzo terapéutico. Opinión de los profesionales.

INTRODUCTION: In our clinical practice we find the need to care for patients with irreversible conditions, due to advanced age or underlying chronic disease, and a change in the types of disease currently facing the health workforce.The objective of this research was to study the ethical assessment of health professionals in our Hospital on extraordinary life support measures. MATERIAL AND METHODS: Prospective descriptive study conducted at the Hospital General Universitario de Ciudad Real during the months of April to August 2010. The convenience sample consisted of 189 professionals from different categories working in our hospital during the study period.It included a questionnaire adapted for use in hospitals, comprising 18 items with dichotomous responses.Informed consent was requested and the confidentiality of information ensured. RESULTS: A sample of 189 professionals, of whom 21.7% were male and 78.3% were female. The mean age was 40.39 years SD + 10, with a mode of 31 years.The professionals involved were doctors, nurses and nursing assistants, with an average experience of 15.8% ± 10.4 SD years.A total of 79.9% were in favour of euthanasia, 93.6% against dysthanasia, 92.6% for antidysthanasia, and 99.5% for orthotonasia. The medical group was the one most against the use of euthanasia P=.0001. Differences were found between religious practice and the ethical situations at the end of life. CONCLUSIONS: Most participants took into account the patient's decision to limit extraordinary measures in terminal disease situations.The study reveals that the effectiveness and usefulness of our clinical practice should include an ethical evaluation by professionals with the patient. It became clear that the majority of the sample of professionals is against over-aggressive treatment, and for a dignified death.