Aphasia improvement without logotherapy during motor neurorehabilitation of post-stroke hemiparesis using virtual reality or modified constraint-induced movement therapy: A retrospective cohort.

BACKGROUND: Some research suggests that post-stroke aphasia can recover "on its own", however, there is evidence of a common neural substrate for motor and language systems. We hypothesize, that motor neurorehabilitation of hemiparesis could be related to simultaneous improvement in aphasia. OBJECTIVE: To measure changes in post-stroke aphasia and its relation with hemiparesis treated with different therapies. METHODS: Database information (n = 32) on post-stroke hemiparesis (Fugl-Meyer Scale evaluated) managed with virtual reality (VR) versus modified constraint-induced movement therapy (mCIMT) or regular therapy (rPT/OT) was analyzed. None received logotherapy (LT) by appointment at four months. INCLUSION CRITERIA: < 3 months after the stroke, aphasia severe (Boston Aphasia Intensity Scale), and all three evaluations. RESULTS: Twenty-one patient records met inclusion criteria (71,4% women and mean age 66,67±3,13 years) who received VR, mCIMT, or rPT/OT (n = 6, 8, and 7, respectively). There was continuous intra-groups improvement in aphasia (p < 0.05), but inter-groups the greater aphasia recovery (p = 0.05) and hemiparesis (p = 0.02) were in VR, with a high correlation in evolution between them (r = 0.73; p = 0.047). CONCLUSION: High clinical correlation between aphasia, without LT, and hemiparesis evolution during motor neurorehabilitation would support common neural connections stimulation. We will conduct a clinical trial, with a larger sample size to contrast our hypothesis.

[Functionality/isokinetic work of quadriceps in patients with gonarthrosis managed with prolotherapy]. / Funcionalidad/trabajo isocinético de cuádriceps de pacientes con gonartrosis manejados con proloterapia.

Background: Prolotherapy may be a good option in the complementary treatment of knee osteoarthritis (OA) patients, specifically for the increase of functionality. Objective: To determine the effectiveness of prolotherapy in OA grade II - III in the functionality and muscular work of knee flexors and extensors. Material and methods: a double-blind randomized controlled clinical trial was conducted. It included patients diagnosed with OA grades II-III. The experimental group was infiltrated in both knees with 6 ml of 25% glucose solution and 0.05% lidocaine; control group with 0.45% saline solution and 0.05% lidocaine. All patients received a comprehensive rehabilitation program. The isokinetic work of the knee flexor and extensor muscles, pain and functionality were measured, prior to infiltration and at 3-month follow-up. To compare the difference in means, the Student's T test was applied, considering P<0.05 as significant. The project was approved by the local ethics and research committee. Results: 37 patients were recruited, 17 in the prolotherapy group. There were no intergroup differences in functionality, isokinetic knee flexor/extensor work, and pain at baseline, or during follow-up up to 12 weeks. Conclusions: In the present study we identify that both prolotherapy and saline infiltration increased functionality, strength, and decreased pain; however, no statistically significant difference was found between the two group.

Introducción: la proloterapia puede ser buena opción en el tratamiento complementario de pacientes con osteoartrosis de rodilla (OA), específicamente para el incremento de la funcionalidad. Objetivo: determinar la efectividad de la proloterapia en OA grado II-III en la funcionalidad y en el trabajo muscular de flexores y extensores de rodilla. Material y métodos: se realizó un ensayo clínico controlado aleatorizado a doble ciego. Incluyó a pacientes con el diagnostico de OA grados II-III. Al grupo experimental se les infiltraron 6 mL de solución glucosada al 25% y lidocaína al 0.05% en ambas rodillas; al grupo control con solución salina al 0.45% y lidocaína al 0.05%. Todos los pacientes recibieron un programa integral de rehabilitación. Se midió el trabajo isocinético de los músculos flexores y extensores de rodilla, dolor y funcionalidad, previa infiltración y a los tres meses de seguimiento. Para comparar la diferencia de medias, se aplicó la prueba de t de Student, considerando p < 0.05 como significativo. El proyecto se aprobó en el comité local de ética e investigación. Resultados: se reclutaron 37 pacientes, 17 en el grupo de proloterapia. No hubo diferencias intergrupo en la funcionalidad, trabajo isocinético de flexores/extensores de rodilla y dolor iniciales, ni durante el seguimiento hasta las 12 semanas. Conclusiones: en el presente estudio identificó que tanto la proloterapia como la infiltración con solución salina incrementaron la funcionalidad, fuerza y disminuyeron el dolor; sin embargo, no se encontró diferencia estadísticamente significativa entre los dos grupos.

[Tele-rehabilitation program in patients with distal radius fracture: a controlled clinical trial]. / Programa de telerrehabilitación en pacientes con fractura de radio distal: ensayo clínico controlado.

Background: Distal radius fractures are very frequent fractures in the world, so it is necessary to establish new rehabilitation strategies. Objective: To determine the effectiveness of tele rehabilitation versus supervised treatment in the functional recovery of patients with distal radius fracture. Method: A randomized clinical trial was conducted that included 91 patients with distal radius fractures grades AO23 A and AO23B, which were randomly assigned to a treatment group, the supervised rehabilitation group received for two weeks a program of 10 treatment sessions and the tele rehabilitation group received through the Moodle platform instructions to carry out the rehabilitation program. Outcome measures (functionality, active range of motion, hand grip strength, quality of life and pain) were measured at the time of admission to rehabilitation and at 1, 3 and 6 months. Results: In both treatment groups at 6 months, statistically significant intragroup differences in functionality were demonstrated, with no intergroup differences. Conclusions: At 6 months, both rehabilitation programs increase functionality, range of motion, quality of life and decrease pain, without statistically significant differences intergroup.

Antecedentes: Las fracturas de radio distal son fracturas muy frecuentes en el mundo, por lo que es necesario establecer nuevas estrategias de rehabilitación. Objetivo: Determinar la efectividad de la telerrehabilitación en comparación con el tratamiento supervisado en la recuperación funcional de los pacientes con fractura de radio distal. Método: Se realizó un ensayo clínico aleatorizado que incluyó 91 pacientes con fracturas de radio distal de grados AO23A y AO23B, los cuales se asignaron aleatoriamente a un grupo de rehabilitación supervisado que recibió durante 2 semanas un programa de 10 sesiones de tratamiento o un grupo de telerrehabilitación que mediante la plataforma de Moodle recibió instrucciones para realizar el programa de rehabilitación. Las medidas de resultado (funcionalidad, rango de movimiento activo, fuerza de prensión de la mano, calidad de vida y dolor) se midieron en el momento del ingreso a rehabilitación y a los 1, 3 y 6 meses. Resultados: A los 6 meses, ambos grupos de tratamiento demostraron diferencias estadísticamente significativas intragrupo en la funcionalidad, sin diferencias intergrupo. Conclusiones: A los 6 meses, ambos programas de rehabilitación aumentan la funcionalidad, el rango de movimiento y la calidad de vida, y disminuyen el dolor, sin diferencias estadísticamente significativas intergrupo.

[Factors associated with functionality in patients with closed ankle fracture]. / Factores asociados a funcionalidad en pacientes con fractura cerrada de tobillo.

Background: Ankle fractures are among the most frequent fractures in the lower limb, predominantly affecting young people and representing approximately 9% of all fractures. Objective: To identify the factors associated with functionality in patients with closed ankle fracture. Material and methods: Observational and retrospective study. Records of people with a diagnosis of ankle fractures admitted to rehabilitation between January to December 2020 in a Physical Medicine and Rehabilitation Unit of a third level hospital were included. Age, sex, body mass index (BMI), days of disability, mechanism of injury, type of treatment, length of stay in rehabilitation, type of fracture and functionality were captured. Chi-squared and Student's t test were used to determine the association. Subsequently a multivariate analysis with binary logistic regression was performed. Results: The average age of the subjects was 44.8 years, the female sex was presented in 54.7%, the average BMI was 28.8%, 66% carried out a paid work activity, 65% received surgical treatment, the average time of disability was 140 days, the factors associated with functionality independently were age, pain, dorsiflexion and plantar flexion upon admission to rehabilitation. Conclusions: Ankle fractures occur in a young population and the factors associated with functionality were age, dorsiflexion, plantar flexion, and pain upon admission to rehabilitation.

Introducción: las fracturas de tobillo son las fracturas más frecuentes en el miembro inferior. Afectan predominantemente a personas jóvenes y representan aproximadamente el 9% de todas las fracturas. Objetivo: identificar los factores asociados a funcionalidad en pacientes con fractura cerrada de tobillo. Material y métodos: estudio observacional y retrospectivo. Se incluyeron expedientes de personas con diagnóstico de fractura cerrada de tobillo ingresados a rehabilitación entre enero y diciembre del 2020 en la Unidad de Medicina Física y Rehabilitación de tercer nivel. Se registró edad, sexo, índice de masa corporal (IMC), días de incapacidad, mecanismo de lesión, tipo de tratamiento, tiempo de estancia en rehabilitación, tipo de fractura y funcionalidad. Para determinar la asociación de las variables con la funcionalidad se utilizó la prueba de chi cuadrada y t de Student, y posteriormente se hizo un análisis multivariado con regresión logística bivariada. Resultados: la edad promedio de los sujetos fue de 44.8 años, el sexo femenino se presentó en el 54.7%, el IMC promedio fue de 28.8%, 66% realizaba una actividad laboral remunerada, el 65% recibió tratamiento quirúrgico, el tiempo de incapacidad promedio fue de 140 días, los factores asociados a funcionalidad de manera independiente fueron la edad, el dolor, la dorsiflexión y la flexión plantar al ingreso de rehabilitación. Conclusiones: las fracturas de tobillo se presentan en población joven y los factores asociados a funcionalidad fueron la edad, dorsiflexión, flexión plantar y dolor al ingreso de rehabilitación.

Functional improvement in individuals with chronic spinal cord injury treated with 4-aminopyridine: A systematic review.

Study design: Systematic review. Objective: To provide current evidence on the efficacy of 4-aminopyridine (4-AP) to bring about functional improvement in individuals with chronic traumatic spinal cord injury (SCI). Methods: The Medline (PubMed), Web of Science and SCOPUS databases were systematically searched for relevant articles on the efficacy of 4-AP to treat SCI, from the dates such articles were first published until May 2022. Full-text versions of all the articles selected were examined independently by two reviewers. Methodological quality was rated using the Modified Jadad Scale, and risk of bias was assessed with the RoB-2 test. Data extracted included human models/types, PRISMA assessment protocols, and the results of each study. Descriptive syntheses are provided. Results: In total, 28 articles were initially identified, 10 of which were included after screening. Most of the studies reviewed reported some degree of patient improvement in one or more of the following parameters: motor, sensitivity and sexual function, sphincter control, spasticity, ability to function independently, quality of life, central motor conduction, pain, and pulmonary function. Conclusions: This review confirms the efficacy of 4-AP in improving several conditions resulting from SCI but further research on this topic is warranted. Additional randomized clinical trials with 4-AP involving larger sample sizes are needed, as are consistent outcome measures in order to obtain adequate data for analysis with a view to enhance treatment benefits. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=334835, PROSPERO CRD42022334835.

Prevalent coinfection and associated factors for Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus in patients submitted to renal replacement therapy: A cross-sectional study of 21 dialysis units in the State of Mexico.

BACKGROUND: Chronic kidney disease (CKD) predispose to viral coinfections in patients submitted to renal replacement therapy (RRT); nevertheless, few reports have been performed to elucidate the current epidemiology within this population in Mexico. AIM: To estimate the prevalence of HBV, HCV, and HIV coinfection and to explore factors associated with prevalent coinfection in patients living with renal failure undergoing to RRT. METHODS: A multicenter cross-sectional recruitment across 21 units at the Mexican Institute of Social Security (IMSS) at the State of Mexico was performed during 2019. A standardized clinical questionnaire was performed to elucidate individual and relatives-related conditions. A treatment facility questionnaire was applied to the chief responsible of each unit to explore treatment facility variables. Serological testing, clinical, biochemical, and anthropometrical parameters were extracted from clinical records. RESULT: In 1,304 patients (57.5% male, mean age 45.5 (SD: 15.6) years, and 95.8% in hemodialysis), the prevalence of any viral coinfection was 3.14% (95% CI: 2.32%-4.23%). The highest viral coinfection prevalence were for HCV, HBV, and HIV, in which men and subjects diagnosed after 2010's had the highest rates. We identify that being submitted to peritoneal dialysis, being treated in a surrogated dialysis center and living with a close relative with prior hepatitis coinfection were associated factors for any viral coinfection. CONCLUSION: In patients submitted to RRT, the prevalence of viral coinfection remains high compared with general population. Screening strategies, medical awareness and targeted public healthcare policies should prioritize better care practices within patients submitted to RRT in Mexico.

Cost analysis of drug treatment in hypertensive patients at social security health care family medicine units.

OBJECTIVE: To estimate the increase of drug treatment costs associated with predictive factors of hypertensive patients in family medicine units. MATERIALS AND METHODS: A generalized linear model was employed to estimate costs with data from a microcosting costing study for a 1-year time horizon. Sources of dada were medical electronic files, phar-macy records and unitary prices updated to 2019. RESULTS: From a total of 864 patients older than 65 years were 67% and women 65%. Factors with most influence on mean drug treatment costs were diabetes, age and complications associ-ated with hypertension. Mean annual cost of antihypertensive treatment was 61 dollars (CI95% 55,67) and median were 32 dollars (IQR 30,35) per patient. Incremental costs for diabetes were 23 dollars (CI95% 13,33) and 25 dollars (CI95% 5,45) in the group of ≥ 65 years. CONCLUSION: Diabetes, age and complications were the factors with largest influence on hypertension pharmacological costs.

Cost analysis of drug treatment in hypertensive patients at social security health care family medicine units / Análisis de costo de tratamientos farmacológicos en pacientes hipertensos en unidades de medicina familiar de seguridad social en salud

Abstract: Objective: To estimate the increase of drug treatment costs associated with predictive factors of hypertensive patients in family medicine units. Materials and methods: A generalized linear model was employed to estimate costs with data from a microcosting costing study for a 1-year time horizon. Sources of dada were medical electronic files, pharmacy records and unitary prices updated to 2019. Results: From a total of 864 patients older than 65 years were 67% and women 65%. Factors with most influence on mean drug treatment costs were diabetes, age and complications associated with hypertension. Mean annual cost of antihypertensive treatment was 61 dollars (CI95% 55,67) and median were 32 dollars (IQR 30,35) per patient. Incremental costs for diabetes were 23 dollars (CI95% 13,33) and 25 dollars (CI95% 5, 45) in the group of ≥ 65 years. Conclusion: Diabetes, age and complications were the factors with largest influence on hypertension pharmacological costs.

Resumen: Objetivo: Estimar el aumento de costos de tratamiento farmacológico de hipertensión asociado con factores predictivos en pacientes de unidades de medicina familiar. Material y métodos: El análisis utilizó un modelo lineal generalizado alimentado con información de un estudio de microcosteo en 2016. Las fuentes de información fueron los registros médicos del expediente electrónico y de farmacia y los precios unitarios del cuadro básico de medicamentos transformados a dólares americanos correspondientes a 2019. Resultados: Las variables significativas con mayor influencia fueron diabetes, edad y complicaciones asociadas con hipertensión. El costo promedio anual de tratamiento antihipertensivo por paciente fue de 61 dólares (IC95% 55,67) Los resultados sugieren un costo incremental de 23 dólares (IC95% 13,33) cuando se tiene diabetes y de 25 dólares (IC95% 5, 45) en el grupo ≥ 65 años. Conclusiones: Diabetes, edad y complicaciones son los factores encontrados que más influyen en los costos farmacológicos de tratamiento de la hipertensión.

[Bibliometric analysis of scientific publications on COVID-19 elaborated by staff of the Instituto Mexicano del Seguro Social]. / Análisis bibliométrico de las publicaciones científicas sobre COVID-19 realizadas por personal IMSS.

Background: Since the beginning of the pandemic, new knowledge about COVID-19 obtained by research has been disseminated in medical and scientific journals, but the large number of publications that have been generated in such a short time has been impressive. Objective: To perform a bibliometric analysis of the published articles in medical-scientific journals carried-out by the Mexican Social Security Institute (IMSS) personnel on COVID-19. Material and methods: Systematic review of the literature, identifying the publications included in the PubMed and EMBASE databases, up to September 2022. Articles on COVID-19 were included, in which at least one author had IMSS affiliation; there was no restriction on the type of publication, so original articles, review articles, clinical case reports, etc. were included. The analysis was descriptive. Results: 588 abstracts were obtained, of which 533 full length articles met the selection criteria. Most were research articles (48%), followed by review articles. Mainly clinical or epidemiological aspects were addressed. They were published in 232 different journals, with a predominance of foreign journals (91.8%). Around half of the publications were carried out by IMSS personnel together with authors from other institutions, national or foreign. Conclusions: The scientific contributions prepared by IMSS personnel have contributed to understanding clinical, epidemiological and basic aspects of COVID-19, which has had an impact on improving the quality of care for its beneficiaries.

Introducción: desde el inicio de la pandemia los nuevos conocimientos sobre COVID-19 han sido difundidos en revistas médico-científicas, y ha sido impresionante la gran cantidad de publicaciones que se ha generado en tan poco tiempo. Objetivo: realizar un análisis bibliométrico de los artículos publicados en revistas médico-científicas elaborados por personal del Instituto Mexicano del Seguro Social (IMSS) sobre COVID-19. Material y métodos: revisión sistemática de la literatura, identificando las publicaciones incluidas en las bases de datos PubMed y EMBASE, hasta septiembre de 2022. Se incluyeron los artículos sobre COVID-19 en los que al menos un autor tuviera adscripción IMSS, sin restricción del tipo de publicación, por lo que se incluyeron artículos originales, de revisión, reportes de casos clínicos, etc. El análisis fue de tipo descriptivo. Resultados: se obtuvieron 588 resúmenes, de los cuales 533 artículos cumplieron con los criterios de selección. La mayoría correspondió a artículos de investigación y revisión. Principalmente se abordaron aspectos clínicos o epidemiológicos. Se publicaron en 232 revistas diferentes, predominando revistas extranjeras (91.8%). Alrededor de la mitad de las publicaciones fueron realizadas por personal del IMSS en conjunto con autores de otras instituciones, nacionales o extranjeras. Conclusiones: las aportaciones científicas elaboradas por personal del IMSS han contribuido a conocer aspectos clínicos, epidemiológicos y básicos sobre COVID-19, lo cual ha impactado en la mejora de la calidad de atención de sus derechohabientes.

Epidemiological profile of mandibular fractures in an emergency department.

OBJECTIVE: To identify the epidemiological profile of mandibular fractures in the emergency department. METHOD: Observational, retrospective study included records of persons with a diagnosis of mandibular fracture treated between January 1, 2015 and June 30, 2019, from the emergency department of the Hospital de Traumatología Dr. Victorio de la Fuente Narváez. The age, sex, occupation, comorbidities, prevalence of mandibular fractures according to the number of fractures and anatomical area, were obtained from the clinical records. RESULTS: 319 subjects with mandibular fractures were included in the study, which were young people (32.5 years) of the male sex (89.7%), the majority developed some trade (64.2%), 14.4% had some comorbidity, 76% had alcoholism when time of injury. The most affected anatomical site was the mandibular angle followed by the parasymphysis, the most frequent cause of injury was due to physical aggression. CONCLUSIONS: Mandibular fractures in our emergency department are usually simple, mainly affecting the angle of the jaw, occurring mainly in men in their third decade of life, assaults are the most frequent injury mechanism and are generally associated with substance use toxic.

OBJETIVO: Identificar el perfil epidemiológico de las fracturas mandibulares en el servicio de urgencias. MÉTODO: Estudio ­observacional, retrospectivo, en el que se incluyeron expedientes de derechohabientes con diagnóstico de fractura mandibular tratados entre el 1 de enero de 2015 y el 30 de junio de 2019 en el servicio de urgencias del Hospital de Traumatología Dr. Victorio de la Fuente Narváez. De los expedientes se obtuvieron la edad, el sexo, la ocupación, la comorbilidad, el antecedente de toxicomanías y la prevalencia de las fracturas mandibulares de acuerdo con el número de fracturas y la zona anatómica. RESULTADOS: Se incluyeron 319 sujetos con fracturas mandibulares, jóvenes (32.5 años), con predominio del sexo masculino (89.7%), la mayoría desarrollaba algún oficio (64.2%), el 14.4% con alguna comorbilidad y el 76% presentaba alcoholismo al momento de la lesión. El sitio anatómico más afectado fue el ángulo mandibular, seguido de la parasínfisis. La causa más frecuente de lesión fue por agresión física. CONCLUSIONES: Las fracturas mandibulares en nuestro servicio de urgencias suelen ser simples y afectar el ángulo de la mandíbula, presentándose principalmente en hombres en la tercera década de la vida. Las agresiones son el mecanismo de lesión mas frecuente y por lo general se asocian al consumo de sustancias tóxicas.

Association of depression and functional outcomes in patients treated surgically for cervical spondylotic myelopathy through an anterior approach.

OBJECTIVE: To determine the association of Depression with clinical outcomes in patients treated surgically for cervical spondylotic myelopathy (CSM) using an anterior approach. METHOD: An observational study was conducted in patients with ECM. The Beck scale, modified scale of the Japanese Orthopedic Association (mJOA), neck disability index (NDI) and the Visual Analogue Scale (VAS) were used preoperatively, one month and 3 months after surgery. RESULTS: Initial VAS showed more severe degrees in patients with depression. At one month and third month after surgery, there was a significant decrease in pain in the group without depression (p = 0.03). The mJOA at one month and three months was observed that the degree of severity decreased in both groups, being more noticeable in the group without depression (p = 0.02). Presurgical NDI was higher in the group with depression. At three months in both groups the improvement was noticeable with respect to the degree of preoperative disability. CONCLUSIONS: There is a favorable relationship in patients with ECM undergoing surgical treatment in the absence of depression prior to surgery and clinical evolution, with the possibility of promoting multidisciplinary management prior to surgery in patients with depression.

OBJETIVO: Determinar la asociación de depresión con los resultados clínicos en pacientes tratados quirúrgicamente por mielopatía espondilótica cervical (MEC) mediante abordaje anterior. MÉTODO: Se realizó un estudio observacional en pacientes con MEC. Se utilizaron la escala de Beck, la escala modificada de la Japanese Orthopaedic Association (mJOA), el índice de discapacidad del cuello (NDI) y la escala visual análoga (EVA) de forma prequirúrgica, al mes y 3 meses posterior a la cirugía. RESULTADOS: La EVA inicial mostró mayor gravedad en los pacientes con depresión. Al mes y al tercer mes posteriores a la cirugía hay una disminución significativa del dolor en el grupo sin depresión (p = 0.03). En la mJOA al mes y a los 3 meses se observó que la gravedad disminuyó en ambos grupos, siendo más notorio en el grupo sin depresión (p = 0.02). El NDI prequirúrgico fue mayor en el grupo con depresión. A los 3 meses, en ambos grupos la mejoría fue notoria con respecto al grado de incapacidad preoperatorio. CONCLUSIONES: Existe una relación favorable en los pacientes con MEC sometidos a tratamiento quirúrgico entre la ausencia de depresión previa a cirugía y la evolución clínica, con la posibilidad de promover un manejo multidisciplinario previo a la cirugía en los pacientes con depresión.

Bone mineral density and fractures in postmenopausal women of Maya-Mestizo ethnic origin with different body mass indexes.

BACKGROUND: Obesity protects against bone loss, but it increases the risk of fragility fractures. AIM: To determine if bone mineral density (BMD) and the prevalence of fractures are different in postmenopausal Maya-Mestizo women grouped according to their body mass index (BMI). SUBJECTS AND METHODS: We studied 600 postmenopausal Maya-Mestizo women. A structured questionnaire for risk factors was applied. Body mass index was determined. BMD was assessed at the lumbar spine and total hip by dual-energy X-ray absorptiometry. History of low trauma fracture was determined from medical records. ANOVA was used to compare mean BMD between women with different BMI. To compare the frequency of fractures according to BMI group, we used χ2 test. RESULTS: According to WHO classification of BMI, 16.3% of women had normal BMI, 35.3% were overweight, and 48.4% had obesity. We found that women with obesity had a higher BMD versus women with normal BMI or overweight in all the anatomical sites analysed. The prevalence of history of fractures was 18.2%. We did not find differences between the women of different BMI; the wrist was the most frequent skeletal site of the fracture. CONCLUSION: Obesity in postmenopausal Maya-Mestizo women is not a risk factor for developing fragility fractures.

Complete sequence of the ANKK1 gene in Mexican-Mestizo individuals with obesity, with or without binge eating disorder.

BACKGROUND: The aim of this study was to investigate if Mexican-Mestizo individuals with obesity, with or without binge eating disorder (BED), exhibited mutations or other type of genetic variants in the sequence of ANKK1. SUBJECTS AND METHODS: Fifty unrelated individuals (21-53 years of age) with obesity, of Mexican-Mestizo ethnic origin were included; 25 of them had BED and 25 presented obesity without BED. The diagnosis of BED was based on criteria proposed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Besides, we also analyzed 100 individuals with normal body mass index. DNA from blood leukocytes was amplified by the polymerase chain reaction and all exons of ANKK1 were sequenced. RESULTS: After ANKK1 sequencing we did not find any mutations; however, we observed various polymorphisms. One polymorphism, rs4938013 in exon 2 showed an association with obesity, whilst rs1800497 (also known as Taq1A) in exon 8, showed an association with BED (P = 0.020). Remarkable, for this study, the number of individuals for both polymorphisms for and additive model was sufficient to derive strong statistical power (80%, with a P < 0.05). CONCLUSIONS: To our knowledge, this constitutes the first report where the complete sequences of ANKK1 has been analyzed in individuals with obesity, with or without BED. No mutations were found; however, one polymorphism was associated with obesity, with or without BED, and another one was associated with BED.

Higher prepregnancy body mass index is a risk factor for developing preeclampsia in Maya-Mestizo women: a cohort study.

AIM: Preeclampsia and obesity are two closely related syndromes. The high maternal prepregnancy body mass index (BMI) is a risk factor for present preeclampsia, independently of the ethnic background of the studied population. The aim of this study was to analyse in a prospective cohort study the relation between prepregnancy BMI and development of preeclampsia in Maya-Mestizo women. DESIGN: This is a prospective cohort study of 642 pregnant women that were included in the first trimester of the pregnancy (gestational age ≤12 weeks at the first antenatal visit) and all of them were of Maya-Mestizo ethnic origin from the state of Yucatán, México. We assessed the potential risk factors for preeclampsia and documented the prepregnancy BMI (kg/m2) that was based on measured height and maternal self-report of prepregnancy weight at the initial visit. Besides, in the antenatal visit we documented if the pregnant women developed preeclampsia. RESULTS: Of the 642 pregnant Maya-Mestizo women, 49 developed preeclampsia, with an incidence of 7.6% (44.9% had severe and 55% mild). The prepregnancy BMI was higher in women with developed preeclampsia than in those with normal pregnancies. Women with overweight or obesity in comparison with normal weight presented a RR = 2.82 (95% CI: 1.32-6.03; P = 0.008) and RR= 4.22 (95% CI: 2.07-8.61; P = 0.001), respectively. CONCLUSIONS: Our findings expand the previous studies to show that the higher prepregnancy BMI is a strong, independent risk factor for preeclampsia.

PPARGC1A and ADIPOQ polymorphisms are associated with aggressive prostate cancer in Mexican-Mestizo men with overweight or obesity.

BACKGROUND: Obesity constitutes a risk factor for the development of aggressive forms of prostate cancer. It has been proposed, that prostate cancer has a genetic predisposition and that PPARGC1A and ADIPOQ polymorphisms play a role in the development of this condition. OBJECTIVE: To analyse the association of two PPARGC1A and ADIPOQ polymorphisms as well as their haplotypes, with the development of aggressive prostate cancer in Mexican-Mestizo men with overweight or obesity. SUBJECTS AND METHODS: Two hundred fifty seven men with prostate cancer of Mexican-Mestizo origin were included. Body mass index (BMI) was determined and the degree of prostate cancer aggressiveness by the D'Amico classification. DNA was obtained. Rs7665116 and rs2970870 of PPARGC1A, and rs266729 and rs1501299 of ADIPOQ were studied by real-time PCR allelic discrimination. Pairwise linkage disequilibrium, between single nucleotide polymorphisms was calculated and haplotype analysis was performed. RESULTS: A higher-risk (D'Amico classification) was observed in 21.8% of patients. An association of cancer aggressiveness with rs2970870 of PPARGC1A, and rs501299 of ADIPOQ, as well as with one haplotype of ADIPOQ was documented. CONCLUSIONS: This is the first study regarding the relationship of PPARGC1A and ADIPOQ polymorphisms, and the aggressiveness of prostate cancer in men with overweight or obesity.

Association of CYP1A1 and CYP1B1 polymorphisms with bone mineral density variations in postmenopausal Mexican-Mestizo women.

Herein, we investigated potential associations between polymorphisms of genes related to estrogen metabolism and bone mineral density (BMD) in postmenopausal women. This was a cross-sectional study, in which two hundred and ninety postmenopausal Mexican-Mestizo women were studied. The BMD of the lumbar spine (LS), total hip (TH), and femoral neck (FN) was measured. The distribution of the genetic polymorphisms, including rs1799814 and rs1048943 at CYP1A1 as well as rs1056836 at CYP1B1, were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), single-stranded conformational polymorphism (SSCP), and DNA sequencing. Deviations from Hardy-Weinberg equilibrium (HWE) were tested, and linkage disequilibrium (LD) was calculated by direct correlation (r2). Moreover, haplotype analysis was performed. All polymorphisms were in HWE. The genotype and allele distributions of the three single nucleotide polymorphisms (SNPs) studied showed no significant differences. However, statistical significance was reached when constructing haplotypes. The CG haplotype in CYP1A1 was associated with variations in LS and FN BMD after adjustment for covariates (p = 0.021 and 0.045, respectively), but the association with TH BMD was not significant. These results suggested that the CG haplotype in CYP1A1 may play an important role in the mechanism of osteoporosis and may be useful as a genetic marker.

Association of a TFAM haplotype with aggressive prostate cancer in overweight or obese Mexican Mestizo men.

BACKGROUND: Mitochondrial dysfunction has been associated with the development of cancer and obesity, being prostate cancer more aggressive in obese men. It has been suggested that the mitochondrial transcription factor A (TFAM) plays a central role in these events. OBJECTIVE: The aim of this study was to analyze the possible association of 3 TFAM polymorphisms, as well as their haplotypes, with the development of aggressive prostate cancer in overweight or obese Mexican Mestizo men. SUBJECTS AND METHODS: A total of 257 unrelated men with histologically confirmed prostate cancer, of Mexican Mestizo ethnic origin, were included. Body mass index was determined and the degree of prostate cancer aggressiveness was demarcated by the D'Amico classification. DNA was obtained from blood leukocytes. The rs1937, rs1049432, and rs11006132, as well as their haplotypes, were studied by real-time polymerase chain reaction allelic discrimination. Deviations from Hardy-Weinberg equilibrium were tested. Pairwise linkage disequilibrium between single nucleotide polymorphisms was calculated; haplotype analysis was performed. RESULTS: A higher risk (D'Amico classification) was documented in 56 patients (21.8%). We did not find a significant association among those polymorphisms analyzed; however, one haplotype was significantly associated with cancer aggressiveness. CONCLUSIONS: To our knowledge, this constitutes the first study regarding the relationship of 3 TFAM polymorphisms, as well as their haplotypes, and the aggressiveness of prostate cancer in overweight or obese men; the most frequent haplotype was associated with cancer aggressiveness.

Polymorphisms of APLN-APLNR system are associated with essential hypertension in Mexican-Mestizo individuals.

The aim of this study was to evaluate if polymorphisms of APLN and APLNR genes may play a role as susceptibility markers for hypertension in a group of Mexican-Mestizo patients. A case-control study was carried out including normotensive and hypertensive individuals. For these, two polymorphisms of APLN (rs3761581 and rs56204867) and two of APLNR () genes were genotyped by 5' exonuclease TaqMan assay in 400 normotensive individuals and 383 patients. The results showed that, under an additive model adjusted by BMI, HDL, triglycerides, glucose and family history of essential hypertension, the rs7119375 and rs10501367 polymorphisms of APLNR gene were associated significantly with a decreased risk of essential hypertension (P=0.039 and P=0.029, respectively). Besides, the haplotypes analysis of these polymorphisms showed that H1 haplotype was associated with an increased risk of essential hypertension (P=0.026), while the H2 haplotype was associated with a decreased risk (P=0.032). Contrary, the rs3761581 and rs56204867 polymorphisms of APLN gene were not associated with essential hypertension (P=0.1707 and P=0.0769, respectively). The data suggest that APLNR rs7119375 and rs10501367 are associated with a decreased risk of essential hypertension in our Mexican-Mestizo studied group, but further studies are warranted.

Genetic variants in ATP6 and ND3 mitochondrial genes are not associated with aggressive prostate cancer in Mexican-Mestizo men with overweight or obesity.

Mitochondrial defects have been related to obesity and prostate cancer. We investigated if Mexican-Mestizo men presenting this type of cancer, exhibited somatic mutations of ATP6 and/or ND3.Body mass index (BMI) was determined; the degree of prostate cancer aggressiveness was demarcated by the Gleason score. DNA from tumor tissue and from blood leukocytes was amplified by the polymerase chain reaction and ATP6 and ND3 were sequenced. We included 77 men: 20 had normal BMI, 38 were overweight and 19 had obesity; ages ranged from 52 to 83. After sequencing ATP6 and ND3, from DNA obtained from leukocytes and tumor tissue, we did not find any somatic mutations. All changes observed, in both genes, were polymorphisms. In ATP6 we identified, in six patients, two non-synonymous nucleotide changes and in ND3 we observed that twelve patients presented non-synonymous polymorphisms. To our knowledge, this constitutes the first report where the complete sequences of the ATP6 and ND3 have been analyzed in Mexican-Mestizo men with prostate cancer and diverse BMI. Our results differ with those reported in Caucasian populations, possibly due to ethnic differences.