RESUMO
OBJECTIVE: The aim of this study was to determine ancestry informative markers, mitochondrial DNA haplogroups, and the association between HLA-DRB1 alleles and multiple sclerosis (MS) in a group of patients from Bogotá, Colombia. METHODS: In this case-control study, genomic DNA was isolated and purified from blood samples. HLA-DRB1 allele genotyping was done using PCR. Mitochondrial hypervariable region 1 was amplified and haplogroups were determined using HaploGrep software. Genomic ancestry was estimated by genotyping a panel of ancestry informative markers. To test the association of HLA polymorphisms and MS, we ran separate multivariate logistic regression models. Bonferroni correction was used to account for multiple regression tests. RESULTS: A total of 100 patients with MS (mean age 40.4 ± 12 years; 70% females) and 200 healthy controls (mean age 37.6 ± 11 years; 83.5% females) were included in the analysis. Ancestry proportions and haplogroup frequencies did not differ between patients and controls. HLA-DRB1*15 was present in 31% of cases and 13.5% of controls, whereas HLA-DRB1*14 was present in 5% of cases and 15.5% of controls. In the multivariate model, HLA-DRB1*15 was significantly associated with MS (odds ratio [OR] = 3.05, p < 0.001), whereas HLA-DRB1*14 was confirmed as a protective factor in our population (OR = 0.16, p = 0.001). CONCLUSIONS: This study provides evidence indicating that HLA-DRB1*15 allele confers susceptibility to MS and HLA-DRB1*14 allele exerts resistance to MS in a highly admixed population. This latter finding could partially explain the low prevalence of MS in Bogotá, Colombia.
RESUMO
El código de accidente cerebrovascular es una alerta que moviliza a un equipo de respuestarápida para tratar pacientes con accidente cerebro vascular (ACV) con el fin de evaluarlos prontamente yadministrar tratamientos como la fibrinólisis.Objetivos: describir comparativamente el tratamiento dado a una población de pacientes con ACV isquémicoagudo antes del código 2007/2008 y después del código 2009/2010 considerando el tiempo para la primeraatención médica, para la atención por neurología, para realización de las neuroimágenes, la mejoría clínica por laescala NIHSS, la probabilidad de trombólisis, discapacidad, estancia hospitalaria, mortalidad intra-hospitalaria.Métodos: teniendo una base de datos con los pacientes de los dos períodos de tiempo (2007/8 -2009/10),se realizó un análisis estadístico con descripción de las variables, medidas de tendencia central, dispersión yposición, con un análisis exploratorio de las variables categóricas entre ambos períodos.Resultados: se encontró que los tiempos de la primera atención médica (24 vs 24 minutos; p =0,37), la evaluaciónneurológica (61 vs 107 minutos, p =0,06) y realización de la imagen del cerebro (45,9 vs 64,5 minutos,p =0,06) respectivamente mostraron un retraso no significativo para el segundo período de tiempo después delcódigo de ACV. El buen resultado funcional con una escala de Rankin modificada ≤ 2 (64,8 % para el primerperíodo frente a 64,6 % para el segundo período, p = 0,98) no mostró diferencias.Conclusiones: en este hospital el código de ACV no afectó el pronóstico de los pacientes con respecto atiempos de atención, frecuencia de rt-PA, discapacidad o mortalidad...
Introduction: stroke coding is an alert system that mobilizes a rapid response team to treat patients withstroke and to administer treatments like fibrinolysis.Objectives: to describe by way of comparison between two periods a population of patients with acute ischemicstroke before code 2007/2008 and after code 2009/2010 considering: time for first medical attention, neurologicalevaluation, brain imaging performing, clinical improvement by the NIHSS, thrombolysis probability,disability, length of stay in the hospital, intra-hospital mortality.Materials and methods: starting from a database of the patients for the two periods of time (2007/8 and2009/10), a statistical analysis with variable description was done, using descriptive statistics, measures of centraltendency, dispersion and position, with an exploratory analysis of the categorical variables.Results: we found that the times of first medical attention (24 vs 24 minutes; p =0.37), neurological attention(61 vs 107 minutes, p =0.06) and the time to the brain imaging (45.9 vs 64.5 minutes, p =0.06) did not showa significant delay in the second period of time after the stroke code. The good functional outcome with aRankin scale ≤ (64.8 % for the first period compared with 64.6 % in the second period, p = 0.98) did notshow any differences...
