Risk Factors Associated with COVID-19 Mortality in the State of Durango, Mexico.

The coronavirus disease 2019 (COVID-19) has caused over six million deaths worldwide since its emergence in Wuhan China, factors associated with COVID-19 mortality, such as comorbidities, age, and observed symptomatology still remain a major subject of study. In the present work, a total of 16,345 SARS-CoV-2 positive cases from Durango Mexico diagnosed from May 2020 to December 2021 were analyzed to establish an association of COVID-19 mortality with clinical and demographic variables in a case-control study. Selected variables include patient age, smoking status, sex, presence of comorbidities such as hypertension, diabetes and obesity, as well as patient symptomatology such as fever, dyspnea, abdominal pain and diarrhea. Results indicate that among analyzed data, the median age was 43 years; 54% were female, with a mortality rate of 5.66%. Multivariate regression analysis indicated that the comorbidities associated with the highest risk factor were advanced age (>60) with an odds ratio of 4.127 (IC 95%, 3.37-5.05), hypertension with 1.961 (IC 95%, 1.57-2.45), diabetes with 1.753 (IC 95%, 1.39-2.20) and obesity with 1.413 (IC 95%, 1.11-1.78) respectively. On the other hand, the symptom associated with the highest risk factor was dyspnea with an odds ratio of 18.369 (IC 95%, 14.42-23.39). Our data suggests an association between hypertension and old age with COVID-19 mortality. Other findings include the prevalence of dyspnea, polypnea and cyanosis as a major predictor for COVID-19 mortality, as well as lower mortality risks among health workers.

Epigenetic marks in suicide: a review.

Suicide is a complex phenomenon and a global public health problem that involves several biological factors that could contribute to the pathophysiology of suicide. There is evidence that epigenetic factors influence some psychiatric disorders, suggesting a predisposition to suicide or suicidal behavior. Here, we review studies of molecular mechanisms of suicide in an epigenetic perspective in the postmortem brain of suicide completers and peripheral blood cells of suicide attempters. Besides, we include studies of gene-specific DNA methylation, epigenome-wide association, histone modification, and interfering RNAs as epigenetic factors. This review provides an overview of the epigenetic mechanisms described in different biological systems related to suicide, contributing to an understanding of the genetic regulation in suicide. We conclude that epigenetic marks are potential biomarkers in suicide, and they could become attractive therapeutic targets due to their reversibility and importance in regulating gene expression.

Análisis epidemiológico de bacteriemias asociadas a catéter en una terapia intensiva médico-quirúrgica / Epidemiological analysis of catheter-related bloodstream infections in medical-surgical intensive care units

Resumen Se realizó un estudio observacional retrospectivo analítico que evaluó la epidemiología de las bacteriemias asociadas a catéter central (BAC) en 773 adultos internados en la unidad de cuidados intensivos (UCI) del Hospital Alemán de Buenos Aires entre diciembre de 2018 y junio de 2020. Durante el pe riodo de estudio, la incidencia fue 8.7 eventos cada 1000 días catéter. El desarrollo de BAC se asoció con mala evolución clínica, que fue puesta en evidencia por una duración de la internación en UCI significativamente mayor que la de los pacientes sin BAC (mediana: 21.5 días vs. 4 días, p < 0.001). La mortalidad también fue mayor, pero sin significancia estadística (24% vs. 20%, OR 1.26 [0.61-2.63]). Los microorganismos más frecuentemente aislados fueron bacterias Gram positivas (73%) y, entre ellas, Staphylococcus epidermidis fue la más frecuente (40%). De los 47 aislamientos de microorganismos relevados, 8 (17%) fueron gérmenes multirresistentes. El análisis multivariado identificó el tiempo de permanencia del catéter como factor de riesgo para desarrollar BAC (OR 1.10 [1.05 - 1.15], p < 0.001). En dicho análisis, una mayor tasa de BAC no fue influida por el sitio anatómico de inserción del catéter, el servicio donde se realizó el procedimiento (UCI o quirófano/servicio de emergencias), la experiencia previa del médico en el procedimiento, ni el uso de ultrasonido para guiar la cateterización. Con cluimos que las BAC son una complicación frecuente en nuestro servicio con consecuencias clínicas relevantes. Conocer la epidemiología y la problemática de cada servicio permite programar intervenciones dirigidas a corregir problemas concretos de salud pública.

Abstract A retrospective-observational analytical study was carried out to evaluate the epidemiology of catheter-related bloodstream infections (CRBSI) in 773 adult patients hospitalized in the inten sive care unit (ICU) of the Hospital Alemán of Buenos Aires, Argentina, between 1 December 2018 and 30 June 2020. During the study period, the incidence of CRBSI was 8.7 cases per 1000 catheter days. The occurrence of CRBSI was found associated with a poor clinical evolution, as evidenced by a stay in the ICU significantly longer than the stay of patients without CRBSI (median: 21.5 days vs. 4 days, p < 0.001). CRBSI-associated mortality was not statistically higher (24% vs. 20%, OR 1.26 [0.61-2.63]). Gram-positive bacteria were the most frequently identified microorganisms (73%), being Staphylococcus epidermidis the most frequent (40%). Of the 47 isolates of microorganisms surveyed, 8 (17%) were multi-resistant germs. The permanence time of the catheter was identified as a risk factor for developing CRBSI (OR 1.10 [1.05 - 1.15], p < 0.001) in a multivariate analysis. In this analysis, the risk of infection was not influenced by the anatomical site of insertion of the catheter, the ward where the procedure was performed (ICU vs. operating room/external ward), the skill of the medical practitioner, or the use of ultrasound to guide vascular accesses. We conclude that CRBSIs are a frequent complication in our department with relevant clinical consequences. Knowing the epidemiology and the problems of each service allows programming interventions aimed to correct specific public health problems.

[Epidemiological analysis of catheter-related bloodstream infections in medical-surgical intensive care units]. / Análisis epidemiológico de bacteriemias asociadas a catéter en una terapia intensiva médico-quirúrgica.

A retrospective-observational analytical study was carried out to evaluate the epidemiology of catheter-related bloodstream infections (CRBSI) in 773 adult patients hospitalized in the intensive care unit (ICU) of the Hospital Alemán of Buenos Aires, Argentina, between 1 December 2018 and 30 June 2020. During the study period, the incidence of CRBSI was 8.7 cases per 1000 catheter days. The occurrence of CRBSI was found associated with a poor clinical evolution, as evidenced by a stay in the ICU significantly longer than the stay of patients without CRBSI (median: 21.5 days vs. 4 days, p < 0.001). CRBSI-associated mortality was not statistically higher (24% vs. 20%, OR 1.26 [0.61-2.63]). Gram-positive bacteria were the most frequently identified microorganisms (73%), being Staphylococcus epidermidis the most frequent (40%). Of the 47 isolates of microorganisms surveyed, 8 (17%) were multi-resistant germs. The permanence time of the catheter was identified as a risk factor for developing CRBSI (OR 1.10 [1.05 - 1.15], p < 0.001) in a multivariate analysis. In this analysis, the risk of infection was not influenced by the anatomical site of insertion of the catheter, the ward where the procedure was performed (ICU vs. operating room/external ward), the skill of the medical practitioner, or the use of ultrasound to guide vascular accesses. We conclude that CRBSIs are a frequent complication in our department with relevant clinical consequences. Knowing the epidemiology and the problems of each service allows programming interventions aimed to correct specific public health problems.

Se realizó un estudio observacional retrospectivo analítico que evaluó la epidemiología de las bacteriemias asociadas a catéter central (BAC) en 773 adultos internados en la unidad de cuidados intensivos (UCI) del Hospital Alemán de Buenos Aires entre diciembre de 2018 y junio de 2020. Durante el periodo de estudio, la incidencia fue 8.7 eventos cada 1000 días catéter. El desarrollo de BAC se asoció con mala evolución clínica, que fue puesta en evidencia por una duración de la internación en UCI significativamente mayor que la de los pacientes sin BAC (mediana: 21.5 días vs. 4 días, p < 0.001). La mortalidad también fue mayor, pero sin significancia estadística (24% vs. 20%, OR 1.26 [0.61-2.63]). Los microorganismos más frecuentemente aislados fueron bacterias Gram positivas (73%) y, entre ellas, Staphylococcus epidermidis fue la más frecuente (40%). De los 47 aislamientos de microorganismos relevados, 8 (17%) fueron gérmenes multirresistentes. El análisis multivariado identificó el tiempo de permanencia del catéter como factor de riesgo para desarrollar BAC (OR 1.10 [1.05 - 1.15], p < 0.001). En dicho análisis, una mayo r tasa de BAC no fue influida por el sitio anatómico de inserción del catéter, el servicio donde se realizó el procedimiento (UCI o quirófano/servicio de emergencias), la experiencia previa del médico en el procedimiento, ni el uso de ultrasonido para guiar la cateterización. Concluimos que las BAC son una complicación frecuente en nuestro servicio con consecuencias clínicas relevantes. Conocer la epidemiología y la problemática de cada servicio permite programar intervenciones dirigidas a corregir problemas concretos de salud pública.

Maternal and umbilical cord procalcitonin, high-sensitivity C-reactive protein, and interleukin-6 levels in preeclamptic and normotensive patients: A cross-sectional study.

OBJECTIVES: To report maternal and umbilical vein levels of procalcitonin (PCT) in patients with preeclampsia (PE) compared to controls. As secondary aims, we measured high-sensitivity C-reactive protein (hs-CRP), and interleukin-6 (IL-6). Moreover, correlation analyses were performed between the inflammatory biomarkers and mean arterial pressure (MAP). STUDY DESIGN: This was a single center, cross-sectional study. MAIN OUTCOME MEASURES: After Institutional Review Board approval and written informed consent, patients with or without PE were enrolled. PCT, hs-CRP, and IL-6 levels were compared between groups using multiple linear regression models. We calculated the adjusted ratios of geometric means (aRGM) for the comparison of patients with and without PE. Correlation analysis between the inflammatory biomarkers and MAP was performed using Spearman's method. RESULTS: A total of 156 participants were enrolled, yielding 156 venous blood samples and umbilical venous blood samples. Seventy-six patients were in the PE group, and 80 patients were in the control group. Maternal plasma and serum concentrations of PCT (aRGM 3.35 (95% confidence interval [CI]: 2.26, 4.95; p < 0.001)), hs-CRP (aRGM 1.85 (95% CI: 1.30, 2.63; p = 0.003)), and IL-6 (aRGM 1.49 (95% CI: 1.08, 2.04; p = 0.045)) were higher in the PE group. In umbilical venous samples, the concentrations of PCT (aRGM 2.54 (95% CI: 1.46, 4.44; p = 0.003)) and hs-CRP (aRGM 1.45 (95% CI: 1.13, 1.87; p = 0.012)) in the PE group were higher than the controls. No difference in umbilical venous IL-6 concentrations were detected between PE vs. control groups (aRGM 1.46; 95% CI: 1.07, 1.98; p = 0.051). There was positive correlation for both PCT and hs-CRP with MAP in maternal and umbilical venous samples. However, there was no correlation between IL and 6 and MAP in maternal or umbilical venous samples. CONCLUSIONS: PCT levels were elevated in maternal and umbilical venous samples of patients with PE, and correlated with disease severity.

Full Atrioventricular Block Secondary to Acute Poisoning Mercury: A Case Report.

Background: The biological behaviour and clinical significance of mercury toxicity vary according to its chemical structure. Mercury differs in its degree of toxicity and in its effects on the nervous, digestive and immune systems as well as on organs such as the lungs, kidneys, skin, eyes and heart. Human exposure occurs mainly through inhalation of elemental mercury vapours during industrial and artisanal processes such as artisanal and small-scale gold mining. Case presentation: A 52-years-old female, housewife, with a body mass index of 25.3 kg/cm², without smoking or alcohol habits or any important clinical or chronic cardiovascular history, was admitted to the emergency room due to probable accidental poisoning by butane gas. Clinical manifestations with a headache, dizziness, cough, and dyspnoea of medium to small efforts. An initial physical exploration with Glasgow scored at 15, with arrhythmic heart sounds, pulmonary fields with bilateral subcrepitant rales and right basal predominance. Electrocardiographic findings were as follows: a cardiac frequency of 50 beats per minute and atrioventricular dissociation. Laboratory parameters were: white blood cells at 15.8 × 108/L; aspartate aminotransferase at 38 U/L; lactate dehydrogenase at 1288 U/L; creatine-kinase at 115 U/L; CK-MB fraction at 28 U/L; and other biochemical parameters were within the reference values. A radiographic evaluation showed flow cephalization, diffuse bilateral infiltrates with right basal predominance. In addition, the patient presented data of low secondary expenditure to third-degree atrioventricular (AV) block for which the placement of a transvenous pacemaker was decided, substantially improving the haemodynamic parameters. Subsequently, after a family interrogation, the diagnosis of mercury inhalation poisoning was established. An initial detection of mercury concentration (Hg(0)) was carried out, reporting 243.5 µg/L. In view of this new evidence, mercury chelation therapy with intravenous calcium disodium ethylenediamine tetraacetic acid (CaNa2·EDTA) was initiated. After 8-days of hospital stay, she presented a favourable evolution with both clinical and radiological improvements, so that the mechanical ventilation progressed to extubating. Subsequently, she was referred for cardiology because of her persistent 3rd-degree atrioventricular block, deciding to place a definitive bicameral pacemaker. The patient was discharged from the hospital 14 days after admission due to clinical improvements with mercury plasma levels at 5 µmol/L and a heart rhythm from the pacemaker. Conclusions: We show evidence that acute exposure to elemental mercury can affect the heart rhythm, including a complete atrioventricular blockage.

Apoptosis in pancreatic ß-cells is induced by arsenic and atorvastatin in Wistar rats with diabetes mellitus type 2.

INTRODUCTION: Diabetes Mellitus type 2 (T2D) is a multifactorial disease. However, it is known that there is an important effect in pancreatic ß-cells caused by apoptosis of pro-apoptotic proteins, possibly related to arsenic exposure and atorvastatin treatment. OBJECTIVE: The goal of this study was to evaluate the effects of atorvastatin treatment on apoptosis of pancreatic ß-cells in Wistar rats with induced diabetes type 2 exposed to arsenic. MATERIAL & METHODS: T2D in Wistar rats was induced by administration of Streptozotocin. The plasmatic glucose concentrations were measured using the glucose oxidase method, and the concentration of glycated hemoglobin (HbA1c) in whole blood was determined. Exposure to arsenic was measured from urine using atomic absorption with hydride generation, and pro-apoptotic proteins in pancreatic ß-cells were observed using the Western blotting technique. RESULTS: Caspase-3 was present in rats that were treated with 10 mg/kg of oral atorvastatin and exposed to 0.01 and 0.025 mg/L of arsenic, but no others proteins were present, such as pro Caspase-8, bcl-2, and Fas. The glycemic levels were 129.2 ±â€¯7.0 mg/dL in the control group and 161.8 ±â€¯14.6 mg/dL and 198.3 ±â€¯18.2 mg/dL (p < .05) in the study groups. HbA1c increased from 2.53% to 3.64% (p < .05) in the control and study groups. CONCLUSIONS: Atorvastatin treatment and arsenic exposure alone are capable of generating apoptosis in pancreatic ß-cells of Wistar rats with T2D. Together, all of these factors induce apoptosis in pancreatic cells.

Takayasu arteritis a cause of hypertensive disorder of pregnancy: a case report.

BACKGROUND: Takayasu arteritis is a rare, chronic, granulomatous systemic vasculitis of unknown etiology and a few cases have been reported in pregnancy. In pregnancies concomitant with Takayasu arteritis or after diagnosis, Takayasu arteritis negatively affects pregnancy by increasing 13-fold the odds of complications such as hypertensive disorders. The best recommendations in this scenario are still to be made. CASE PRESENTATION: We present a case of 21-year-old, gravid 1, Mexican woman of Mestizo descent with chronic hypertension diagnosed since she was 15-years old who presented severe hypertension during pregnancy (early second trimester); the diagnosis of hypertensive disorder of pregnancy was ruled out requiring first-line and second-line antihypertensive therapy without serious associated maternal or fetal morbidity. CONCLUSIONS: Takayasu arteritis and pregnancy play an important role in maternal and fetal outcomes. Efforts should be made to further investigate the Takayasu arteritis diagnosis in pregnant women with refractory hypertension.

Hypocholesterolemia is an independent risk factor for depression disorder and suicide attempt in Northern Mexican population.

BACKGROUND: Cholesterol has been associated as a risk factor for cardiovascular disease. Recently, however, there is growing evidence about crucial requirement of neuron membrane cholesterol in the organization and function of the 5-HT1A serotonin receptor. For this, low cholesterol level has been reported to be associated with depression and suicidality. However there have been inconsistent reports about this finding and the exact relationship between these factors remains controversial. Therefore, we investigated the link between serum cholesterol and its fractions with depression disorder and suicide attempt in 467 adult subjects in Mexican mestizo population. METHODS: Plasma levels of total cholesterol, triglycerides, and high-density lipoprotein cholesterol (HDL-c) and low density lipoprotein cholesterol (LDL-c) were determined in 261 MDD patients meeting the DSM-5 criteria for major depressive disorder (MDD), 59 of whom had undergone an episode of suicide attempt, and 206 healthy controls. RESULTS: A significant decrease in total cholesterol, LDL-cholesterol, VLDL-cholesterol and triglyceride serum levels was observed in the groups of MDD patients and suicide attempt compared to those without suicidal behavior (p < 0.05). After adjusting for covariates, lower cholesterol levels were significantly associated with MDD (OR 4.229 CI 95% 2.555 - 7.000, p<.001) and suicide attempt (OR 5.540 CI 95% 2.825 - 10.866, p<.001) CONCLUSIONS: These results support the hypothesis that lower levels of cholesterol are associated with mood disorders like MDD and suicidal behavior. More mechanistic studies are needed to further explain this association.

Lack of Association Between Cytomegalovirus Infection and Hypertensive Disorders in Pregnancy: A Case-Control Study in Durango, Mexico.

It is not clear whether infection with cytomegalovirus (CMV) is associated with hypertensive disorders in pregnant women. Through a case-control study design, 146 women suffering from hypertensive disorders in pregnancy (cases) and 146 age-matched normotensive pregnant women (controls) were examined for the presence of anti-CMV IgG and IgM antibodies with enzyme-linked immunoassays. IgM seropositive samples were further assayed by enzyme-linked fluorescent assay (ELFA). Anti-CMV IgG antibodies were found in 138 (94.5%) controls and in 136 (93.2%) cases (odds ratio [OR] = 0.78; 95% confidence interval [CI]: 0.30-2.05; P = 0.62). High (>18 IU/ml) levels of anti-CMV IgG antibodies were found in 37.7% of the 138 seropositive controls and in 34.6% of the 136 seropositive cases (OR = 0.87; 95% CI: 0.53-1.43; P = 0.59). Anti-CMV IgM antibodies were found in 1 (0.7%) of the controls but in none of the cases using ELFA (P = 1.0). Seropositivity to CMV was not associated with a previous preeclampsia and was similar among cases regardless their mean systolic and diastolic blood pressures, and mean arterial blood pressure. No serological evidence of an association between CMV infection and hypertensive disorders of pregnancy was found. Further research to elucidate the role of CMV in hypertensive disorders in pregnancy should be conducted.

Association between Blood Lead Levels and Delta-Aminolevulinic Acid Dehydratase in Pregnant Women.

Blood lead levels (BLLs) and delta-aminolevulinic acid dehydratase (ALAD) activity are considered biomarkers of lead exposure and lead toxicity, respectively. The present study was designed to investigate the association between BLLs and ALAD activity in pregnant women from Durango, Mexico. A total of 633 pregnant women aged 13-43 years participated in this study. Blood lead was measured by a graphite furnace atomic absorption spectrometer. ALAD activity was measured spectrophotometrically. Mean blood lead was 2.09 ± 2.34 µg/dL; and 26 women (4.1%) crossed the Centers for Disease Control (CDC) recommended level of 5 µg/dL. ALAD activity was significantly lower in women with levels of lead ≥5 µg/dL compared to those with BLLs < 5 µg/dL (p = 0.002). To reduce the influence of extreme values on the statistical analysis, BLLs were analyzed by quartiles. A significant negative correlation between blood lead and ALAD activity was observed in the fourth quartile of BLLs (r = -0.113; p < 0.01). Among women with blood lead concentrations ≥2.2 µg/dL ALAD activity was negatively correlated with BLLs (r = -0.413; p < 0.01). Multiple linear regression demonstrated that inhibition of ALAD in pregnant women may occur at levels of lead in blood above 2.2 µg/dL.

Oxidative stress equilibrium during obstetric event in normal pregnancy.

OBJECTIVE: The aim of this study was to determine malondialdehyde (MDA) concentration as an oxidative stress marker and total antioxidant capacity (TAC) in pregnancy before and after perinatal event. METHODS: This study was performed on 200 healthy full-term pregnant women admitted to pregnancy resolution in Maternal-Child Hospital of Durango, Mexico. Oxidative stress and TAC were assessed through detection of lipid peroxidation by quantitation of thiobarbituric acid-reactive substances (TBARS) and TAC through ferric reducing ability of the plasma (FRAP). RESULTS: Our results showed increased levels of MDA after vaginal delivery (VD). TAC was also increased after obstetric event, but it did not differ between VD and caesarean section. CONCLUSIONS: We demonstrated that MDA concentrations are increased two hours after obstetric event, and this increase correlates with VD. The TAC was increased as a compensatory mechanism during obstetric event. Another important finding is that women receiving analgesia administration in VD, as well as dexamethasone administration in caesarean section, experienced a protector effect that decreased MDA levels.

Arsenic exposure and risk of preeclampsia in a Mexican mestizo population.

BACKGROUND: Exposure to arsenic in drinking water has been associated with various complications of pregnancy including fetal loss, low birth weight, anemia, gestational diabetes and spontaneous abortion. However, to date, there are no studies evaluating its possible association with preeclampsia. METHODS: This case-control study involved 104 preeclamptic and 202 healthy pregnant women. The concentrations of arsenic in drinking water and urine were measured using a Microwave Plasma-Atomic Emission Spectrometer. RESULTS: We found relatively low levels of arsenic in household tap water (range of 2.48-76.02 µg/L) and in the urine of the participants (7.1 µg/L vs 6.78 µg/L in cases and controls, respectively). CONCLUSIONS: The analysis between groups showed for the first time that at these lower levels of exposure there is no association with preeclampsia.

Lack of association between Toxoplasma gondii infection and hypertensive disorders in pregnancy: a case-control study in a Northern Mexican population.

BACKGROUND: The outcome of pregnancy is often threatened by hypertension disorders, i.e. eclampsia. Rate of infection with the protozoan parasite Toxoplasma gondii can be as high as 80% in pregnant women, and infection acquired during pregnancy can lead to fetal death. Very little is known about a potential association between infections, i.e. those with Toxoplasma gondii, and hypertensive disorders during pregnancy. METHODS: Through a case-control study design, we investigated the presence of anti-Toxoplasma IgG and anti-Toxoplasma IgM antibodies in 146 pregnant women suffering from hypertensive disorders (cases) and 146 age-matched normotensive pregnant women (controls) attending a public hospital in Durango City, Mexico. Obstetric and blood pressure characteristics from cases and controls were also obtained. RESULTS: Seroprevalence of anti-Toxoplasma IgG antibodies and IgG titers did not differ significantly in controls (8/146; 5.5%) and cases (9/146; 6.2%). Anti-Toxoplasma IgM antibodies were found in 2 (1.2%) controls and none of the cases. Seroprevalence of T. gondii in controls (5.5%) was similar to seroprevalences found in patients with mild preeclampsia (4/27: 14.8%), severe preeclampsia (5/95: 5.3%), eclampsia (0/16: 0%) and HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) (0/8: 0%) (P = 0.23). CONCLUSIONS: Our results suggest that latent infection with T. gondii is not associated with hypertensive disorders in pregnant women in Northern Mexico. Further studies with larger sample sizes are needed to elucidate the association of infection with T. gondii with hypertensive disorders in pregnancy.

Polymorphisms in DNA repair genes (APEX1, XPD, XRCC1 and XRCC3) and risk of preeclampsia in a Mexican mestizo population.

Variations in genes involved in DNA repair systems have been proposed as risk factors for the development of preeclampsia (PE). We conducted a case-control study to investigate the association of Human apurinic/apyrimidinic (AP) endonuclease (APEX1) Asp148Glu (rs1130409), Xeroderma Pigmentosum group D (XPD) Lys751Gln (rs13181), X-ray repair cross-complementing group 1 (XRCC) Arg399Gln (rs25487) and X-ray repair cross-complementing group 3 (XRCC3) Thr241Met (rs861539) polymorphisms with PE in a Mexican population. Samples of 202 cases and 350 controls were genotyped using RTPCR. Association analyses based on a χ2 test and binary logistic regression were performed to determine the odds ratio (OR) and a 95% confidence interval (95% CI) for each polymorphism. The allelic frequencies of APEX1 Asp148Glu polymorphism showed statistical significant differences between preeclamptic and normal women (p = 0.036). Although neither of the polymorphisms proved to be a risk factor for the disease, the APEX1 Asp148Glu polymorphism showed a tendency of association (OR: 1.74, 95% CI = 0.96-3.14) and a significant trend (p for trend = 0.048). A subgroup analyses revealed differences in the allelic frequencies of APEX1 Asp148Glu polymorphism between women with mild preeclampsia and severe preeclampsia (p = 0.035). In conclusion, our results reveal no association between XPD Lys751Gln, XRCC Arg399Gln and XRCC3 Thr241Met polymorphisms and the risk of PE in a Mexican mestizo population; however, the results in the APEX1 Asp148Glu polymorphism suggest the need for future studies using a larger sample size.

Haplotype analysis of TGF-ß1 gene in a preeclamptic population of northern Mexico.

OBJECTIVE: To determine the frequencies of -800G/A (rs1800468), -509C/T (rs1800469) and 869T/C (rs1800470) polymorphisms and their haplotypes in the TGF-ß1 gene and their association with preeclampsia in a population of northern México. DESIGN AND METHODS: This case-control study involved 175 preeclamptic and 253 normoevolutive pregnant women. The polymorphisms were genotyped by real time PCR. RESULTS: The allele and genotype frequencies of polymorphisms showed no significant differences between cases and controls; the -800AA genotype had a very low frequency in cases (1%) and controls (0.4%). The TT genotype of the 869T/C polymorphism is a protective factor of severe preeclampsia (OR 0.56, 95% CI 0.32-0.98). The -509C/T and 869T/C polymorphisms were in linkage disequilibrium (D'=.537, p=.009). The most common haplotypes in case and control groups were -800G/-509C/869C, 34.95% and 37.24%, respectively. We found no increased risk of preeclampsia by haplotype. CONCLUSIONS: Our results suggest that -800G/A, -509C/T and 869T/C polymorphisms of TGF-ß1 gene or their haplotypes are not associated with preeclampsia and that only the TT genotype of 869T/C polymorphism is a protective factor of severe preeclampsia in a population of northern México.

Association of COMT G675A and MTHFR C677T polymorphisms with hypertensive disorders of pregnancy in Mexican mestizo population.

OBJECTIVE: To investigate the relationship between COMT G675A and MTHFR C677T polymorphisms and hypertension disorders of pregnancy (HDP) in a Mexican mestizo population. DESIGN AND METHODS: This case-control study involved 194 HDP and 194 normoevolutive pregnant women. The polymorphisms were genotyped by real time PCR. RESULTS: Our results showed that the COMT AA genotype increases the risk to HDP (OR: 2.67; 95% CI 1.33-5.35), preeclampsia (OR: 2.69; 95% CI 1.00-7.22) and gestational hypertension (OR: 3.87; 95% CI 1.25-12.0). Furthermore, the double mutant genotype (COMTAA/MTHFRTT) potency the risk to HDP more than two times (OR: 5.21; 95% CI 1.12-24.3, p=0.019). CONCLUSION: Our work provides evidence that COMT 675AA genotype is a risk factor for HDP and that this risk is increased by the presence of MTHFR 677TT genotype in a Mexican mestizo population.

SLC41A1 is the only magnesium responsive gene significantly overexpressed in placentas of preeclamptic women.

OBJECTIVE: To examine expression profile of magnesium responsive genes (MRGs) in placentas of normoevolutive and preeclamptic women. METHODS: The expression profiles of MRGs were determined in placentas of normoevolutive (N=26) and preeclamptic (N=25) women by RT-qPCR. RESULTS: Among all tested MRGs (9) only SLC41A1 (encoding for Na(+)/Mg(2+) exchanger) was significantly overexpressed in ~54.2% of preeclamptic (n=24) and in ~9.5% of normoevolutive (n=21) specimens. On average, SLC41A1 was overexpressed sixfold in the preeclamptic group. Presence of SLC41A1 in placentas was confirmed by Western blot analysis. CONCLUSION. SLC41A1 is significantly overexpressed in nearly 55% of preeclamptic placentas. This may indicate a direct contribution of changed Mg homeostasis in the development of preeclampsia.

Genetic variation in oxidative stress and DNA repair genes in a Mexican population.

BACKGROUND: Oxidative stress has been associated with several complex diseases. Effects generated as a result of oxidative stress may be modulated by various genes. Variation in these genes, particularly when located within coding or regulating regions, may be the primary cause of this modulation. The aim of this work was to determine the allelic and genotypic frequencies of CAT C-262T, SOD3 Ala58Thr, APEX1 Asp148Glu, XPD Lys751Gln and XRCC3 Thr241Met genetic markers in a northern Mexican population. SUBJECTS AND METHODS: This study analysed 250 unrelated individuals by RT-PCR. RESULTS: A high allele mutant frequency was found in SOD3 Ala58Thr and APEX1 Asp148Glu genetic markers (0.395 and 0.38, respectively). A correspondence analysis showed that northern Mexicans are close to European populations. A linkage disequilibrium test between XPD Lys751Gln and CAT C-262T and XPD Lys751Gln and SOD3 Ala58Thr genetic markers was significant (p = 0.000). CONCLUSION: The genetic markers described in this work will be a valuable resource for future functional studies in the northern Mexican population to explore comprehensively their role in the aetiology of human diseases. Furthermore, it will be necessary to replicate these studies in other regions of Mexico due to differences between Mexican sub-populations.