Association Analysis Between the Functional Single Nucleotide Variants in miR-146a, miR-196a-2, miR-499a, and miR-612 With Acute Lymphoblastic Leukemia.

BACKGROUND: Acute lymphoblastic leukemia (ALL) is characterized by an abnormal proliferation of immature lymphocytes, in whose development involves both environmental and genetic factors. It is well known that single nucleotide polymorphisms (SNPs) in coding and noncoding genes contribute to the susceptibility to ALL. This study aims to determine whether SNPs in miR-146a, miR-196a-2, miR-499a, and miR-612 genes are associated with the risk to ALL in pediatric Mexican population. METHODS: A multicenter case-control study was carried out including patients with de novo diagnosis of ALL and healthy subjects as control group. The DNA samples were obtained from saliva and peripheral blood, and the genotyping of rs2910164, rs12803915, rs11614913, and rs3746444 was performed using the 5'exonuclease technique. Gene-gene interaction was evaluated by the multifactor dimensionality reduction (MDR) software. RESULTS: miR-499a rs3746444 showed significant differences among cases and controls. The rs3746444G allele was found as a risk factor to ALL (OR, 1.6 [95% CI, 1.05-2.5]; p = 0.028). The homozygous GG genotype of rs3746444 confers higher risk to ALL than the AA genotype (OR, 5.3 [95% CI, 1.23-23.4]; p = 0.01). Moreover, GG genotype highly increases the risk to ALL in male group (OR, 17.6 [95% CI, 1.04-298.9]; p = 0.00393). In addition, an association in a gender-dependent manner among SNPs located in miR-146a and miR-196a-2 genes and ALL susceptibility was found. CONCLUSION: Our findings suggest that SNP located in miR-499a, miR-146a, and miR-196a-2 genes confer risk to ALL in Mexican children. Experimental analysis to decipher the role of these SNPs in human hematopoiesis could improve our understanding of the molecular mechanism underlying the development of ALL.

Genotype-Environment Interaction Analysis of NQO1, CYP2E1, and NAT2 Polymorphisms and the Risk of Childhood Acute Lymphoblastic Leukemia: A Report From the Mexican Interinstitutional Group for the Identification of the Causes of Childhood Leukemia.

Background: Acute lymphoblastic leukemia (ALL) is the main type of cancer in children. In Mexico and other Hispanic populations, the incidence of this neoplasm is one of the highest reported worldwide. Functional polymorphisms of various enzymes involved in the metabolism of xenobiotics have been associated with an increased risk of developing ALL, and the risk is different by ethnicity. The aims of the present study were to identify whether NQO1, CYP2E1, and NAT2 polymorphisms or some genotype-environmental interactions were associated with ALL risk in Mexican children. Methods: We conducted a case-control study including 478 pediatric patients diagnosed with ALL and 284 controls (children without leukemia). Ancestry composition of a subset of cases and controls was assessed using 32 ancestry informative markers. Genetic-environmental interactions for the exposure to hydrocarbons were assessed by logistic regression analysis. Results: The polymorphisms rs1801280 (OR 1.54, 95% CI 1.21-1.93), rs1799929 (OR 1.96, 95% CI 1.55-2.49), and rs1208 (OR 1.44, 95% CI 1.14-1.81) were found to increase the risk of ALL; being the risks higher under a recessive model (OR 2.20, 95% CI 1.30-1.71, OR 3.87, 95% CI 2.20-6.80, and OR 2.26, 95% CI 1.32-3.87, respectively). Gene-environment interaction analysis showed that NAT2 rs1799929 TT genotype confers high risk to ALL under exposure to fertilizers, insecticides, hydrocarbon derivatives, and parental tobacco smoking. No associations among NQO1, CYP2E1, and ALL were observed. Conclusion: Our study provides evidence for the association between NAT2 polymorphisms/gene-environment interactions, and the risk of childhood ALL in Mexican children.

Apego de Enfermería al Curso Avanzado de Apoyo a la Lactancia Materna / Nursing attachment to the Advanced Course of Support for Breastfeeding

Introducción: el Instituto Mexicano del Seguro Social (IMSS) adopta el Curso Avanzado de Apoyo a la Lactancia Materna (CAALMA) para capacitar al personal. El apego del personal de enfermería al programa permitirá brindar a la madre información de calidad. Objetivo: identificar el nivel de apego que tiene el personal de enfermería al programa CAALMA. Metodología: estudio transversal analítico con n = 62 enfermeras, se diseñaron 2 instrumentos, con 62 ítems apegados al programa CAALMA; utilizando estadística descriptiva y pruebas no paramétricas. Resultados: se encontró apego regularmente significativo con 56.5%, la antigüedad en el hospital y la capacitación sobre lactancia materna se encontró una p < 0.001. Discusión: el apego se encontró regularmente significativo en contraste con lo reportado por Zamudio Costeño et al., quienes reportan un nivel aceptablemente significativo. Conclusión: el apego que se mostró fue regular lo que da pie a la implementación de nuevas estrategias educativas para aumentar el nivel de apego.

Introduction: The Institute Mexicano del Seguro Social (IMSS) adopts the Advanced Maternal Breastfeeding Support Course (CAALMA) to train personnel. The attachment of the nursing staff to the program will provide the mother with quality information. Objective: To identify the level of attachment that nurses have to the CAALMA program. Methodology: Analytical cross-section with n = 62 nurses, 2 instruments were designed, with 62 items attached to the CAALMA program; using descriptive statistics and non-parametric tests. Results: Regularly significant attachment was found with 56.5%, hospitality and training on breastfeeding was found p < 0.001. Discussion: Attachment was found to be regularly significant in contrast to that reported by Zamudio Costeno et al.; who report an acceptably significant level. Conclusion: The attachment that was shown was to regulate what gives rise to the implementation of new educational strategies to increase the level of attachment.

Empoderamiento del paciente con insuficiencia renal crónica en el cuidado de la diálisis peritoneal en un hospital de segundo nivel / Empowerment of patíents with chronic renal insufficiency about the care of peritoneal dialysis in a second level hospital

Introducción: el empoderamiento es un factor clave para la atención de personas con insuficiencia renal crónica (IRC) que se someten a diálisis peritoneal; su finalidad es la responsabilidad del paciente sobre su enfermedad. Objetivo: evaluar el nivel de empoderamiento que tiene el paciente con IRC sobre el cuidado de la diálisis peritoneal. Métodos: estudio analítico, transversal, en el que participaron 174 pacientes con diálisis peritoneal. Se utilizó un instrumento con 24 ítems con respuestas de opción múltiple, con el que se evaluó el nivel de empoderamiento en alto, medio y bajo. Se utilizó estadística descriptiva y la prueba de chi cuadrada. Resultados: 57.5% de los pacientes tuvo un nivel medio de empoderamiento. En relación con las dimensiones de empoderamiento, los pacientes tuvieron 85.1% en conocimiento, 88.1% en autocuidado, 83% en toma de decisiones y 81.9% en obtención de información, por lo que recayeron también en un nivel medio. La asociación de empoderamiento con edad, escolaridad y redes de apoyo tuvo una p < 0.001. Conclusiones: el nivel de empoderamiento de los pacientes en el cuidado de la diálisis peritoneal fue medio, por lo que es necesario incrementarlo, a fin de mejorar la calidad de vida.

Introduction: Empowerment is a key factor for the care of people with chronic renal insufficiency (CRI) who undergo peritoneal dialysis; its main purpose is the patients' responsibility for their disease. Objective: To assess the level of empowerment that the patient with CRI has about the care of peritoneal dialysis. Methods: Analytical, cross-sectional study, which induded 174 patients with peritoneal dialysis. It was used an instrument with 24 items, with multiple-choice questions, which assessed the level of empowerment as high, médium and low. Descriptive statistics and chi-square test were used. Results: 57.5% of patients had a médium level of empowerment. Conceming empowerment dimensions, patients presented 85.1% in knowledge, 88.1% in self-care, 83% in decision-making and 81.9% in obtaining information, which are considered médium levels as well. The association of empowerment with age, schooling and support networks produced a p valué < 0.001. Conclusions: The patients' level of empowerment about peritoneal dialysis was médium, which is why it is necessary to increase it, in order to improve the quality of life.