Índice neutrófilo-linfocito, relación plaquetas-linfocito y distribución de la anchura del eritrocito en pacientes con preeclampsia / Neutrophil-to-lymphocyte ratio, plateletto- lymphocyte ratio, and erythrocyte width distribution. and erythrocyte width distribution in patients with preeclampsia

Resumen OBJETIVO: Comparar el índice neutrófilo-linfocito, la relación plaquetas-linfocito y la distribución de la anchura del eritrocito de mujeres con preeclampsia con o sin criterios de severidad y los de mujeres sin ésta. MATERIALES Y MÉTODOS: Estudio retrospectivo, de casos y controles, efectuado en mujeres con y sin preeclampsia atendidas entre enero y diciembre de 2019. RESULTADOS: Se estudiaron 70 mujeres con preeclampsia y 70 con embarazo sin esta complicación. El índice neutrófilo-linfocito fue significativamente mayor en las mujeres con preeclampsia (4.11 ± 2.76; IC95%: 3.47-4.75) que en las mujeres sin esta complicación (2.99 ± 1.6; IC95%: 2.62-3.36; p = 0.004), similar a la relación plaquetas-linfocitos (117.61 ± 47.53; IC95%:106.48-128.24 vs 97.64 ± 43.67; IC95%: 87.41-107.87; p = 0.006) y para la distribución de la anchura del eritrocito (14.46 ± 1.9; IC95%: 14.02-14.9 vs 13.56 ± 1.38; IC95%: 13-13.72; p = 0.0002). Ninguno de estos parámetros logró discriminar entre las pacientes con preeclampsia con o sin criterios de severidad. CONCLUSIÓN: Un índice neutrófilo-linfocito ≥ 5.1 y una relación plaquetas-linfocito ≥ 113.1 son capaces de discriminar de manera adecuada entre preeclampsia con o sin criterios de severidad.

Abstract OBJECTIVE: To compare the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and erythrocyte width distribution, of women with preeclampsia with or without severity criteria and those of women without. MATERIALS AND METHODS: Retrospective case-control study in 70 women with preeclampsia and 70 with normal pregnancy between January and December 2019. RESULTS: Seventy women with preeclampsia and 70 with pregnancy without this complication were studied. The neutrophil-lymphocyte ratio was significantly higher in women with preeclampsia (4.11 ± 2.76; 95%CI: 3.47-4.75), than in women with normal pregnancies (2.99 ± 1.6; 95%CI: 2.62-3.36; p = 0.004); which is similar for the platelet-lymphocyte ratio (117.61 ± 47.53, 95%CI: 106.48-128.24 vs 97.64 ± 43.67; 95%CI: 87.41-107.87; p = 0.006) and for the distribution of the width of the erythrocyte; (14.46 ± 1.9, CI95%: 14.02-14.9 vs 13.56 ± 1.38; CI95%: 13-13.72; p = 0.0002). None of these parameters was able to discriminate between patients with preeclampsia with or without severity criteria. A neutrophil-lymphocyte ratio ≥ 5.1 discriminates between women with a normal pregnancy and those with preeclampsia with or without severity criteria [area under the curve of 0.746, (95%CI: 0.664-0.827)], sensitivity 42%, specificity 91%, positive predictive value 82%, negative predictive value 60% and Odds Ratio 7.1 (95%CI: 2.7-18.6, p = 0.001). The platelet-lymphocyte ratio ≥ 113.4 can discriminate between women with a normal pregnancy and preeclampsia with or without severity criteria, with an area under the curve of 0.617 (95% CI 0.525-0.709). CONCLUSION: A neutrophil-lymphocyte ratio ≥ 5.1, and a platelet-lymphocyte ratio ≥ 113.1 are able to adequately discriminate between patients with normal pregnancy and those with preeclampsia with or without severity criteria.

[Association between early miscarriage and Chlamydia trachomatis infection in Aguascalientes, Mexico]. / Asociación entre aborto temprano e infección por Chlamydia trachomatis en Aguascalientes, México.

Background: Chlamydia trachomatis infection in women has been strongly associated with early membrane rupture and pre-term labor; however, the evidence linking Chlamydia trachomatis infection and early miscarriage is inconsistent. Objective: To determine if there is an association between Chlamydia trachomatis infection and early abortion in a group of women from Aguascalientes, Mexico. Material and methods: 108 early abortion product samples were analyzed using polymerase chain reaction technique, along with 42 samples that belonged to 42 patients with a normal pregnancy, in order to determine the presence of Chlamydia trachomatis. The strength of association between early abortion and Chlamydia trachomatis infection was measured with odds ratio (OR) and 95% confidence intervals (95% CI). A value of p < 0.05 was considered statistically significant. Results: Chlamydia trachomatis infection was positive in 39 of 150 patients (26%), in 37 of 108 women with early abortion (34%) and in two of 42 of women with uneventful control pregnancies (4.7%) (p = 0.002). We observed a positive association between the risk of early miscarriage and Chlamydia trachomatis infection (OR = 10.42, 95% CI, 2.39 45.54, p = 0.002). Conclusions: We found a higher frequency of Chlamydia trachomatis infection than the one previously reported in our country, and a higher risk of early abortion for Chlamydia trachomatis infection (10.42) in pregnant women, which suggests the necessity of including the molecular study of this pathogen in women in prenatal control.

Introducción: la infección por Chlamydia trachomatis es un factor de riesgo bien establecido en pacientes con ruptura prematura de membranas y parto prematuro; sin embargo, su papel en el riesgo de aborto temprano es incierto. Objetivo: determinar si existe asociación entre la presencia de infección por Chlamydia trachomatis y aborto temprano en un grupo de mujeres de Aguascalientes, México. Material y métodos: se estudiaron muestras de 108 productos de aborto temprano y 42 pacientes con embarazo normal mediante reacción en cadena de la polimerasa de punto final para determinar la presencia de Chlamydia trachomatis. Se evaluó la magnitud de la asociación entre aborto temprano e infección por este microrganismo con razón de momios (RM) e intervalos de confianza al 95% (IC 95%). Un valor de p < 0.05 se consideró significativo. Resultados: se encontró Chlamydia trachomatis en 39 de las 150 pacientes (26%), en 37 de 108 mujeres con aborto temprano (34.2%) y en dos de 42 mujeres con embarazo normal (4.7%) (p = 0.002). Se observó asociación positiva del riesgo de aborto temprano e infección por Chlamydia trachomatis con RM de 10.42, IC 95%: 2.39 45.54, p = 0.002. Conclusiones: encontramos una frecuencia de infección por Chlamydia trachomatis más elevada que la reportada previamente en nuestro país y un riesgo significativamente mayor de aborto temprano en mujeres embarazadas con esta infección (10.42), lo que sugiere la necesidad de incluir el estudio molecular de este patógeno en mujeres en control prenatal.

[The association between red cell distribution width (RDW) and short-term mortality risk in patients with acute coronary syndrome (ACS)]. / Relación entre el ancho de distribución eritrocitaria (ADE) y la mortalidad a corto plazo en pacientes con síndrome coronario agudo (SCA).

OBJECTIVE: To demonstrate the association between red cell distribution width and short-term mortality risk in patients with acute coronary syndrome. METHODS: We prospectively recruited 78 patients with acute coronary syndrome. The study population was classified according to quartiles of the red cell distribution width at hospital admission. A high red cell distribution width was defined as a value in the upper fourth quartile (>15) and a low red cell distribution width was defined as any value set in the lower three quartiles (≤15). After discharge, all patients were followed for three months. RESULTS: The short-term cardiovascular mortality was 47.2% in the high red cell distribution width group vs. 10.2% in the low red cell distribution width group (p<0.001). In the receiver operating characteristic curve analysis, a red cell distribution width value of more than 15% yielded a sensitivity of 66.7%, a specificity of 83%, and a positive predictive value of 79.7% for cardiac mortality. After multivariate analysis, high levels of red cell distribution width were independent predictors for three-month mortality (p=0.001). CONCLUSION: We demonstrated that red cell distribution width is an accessible parameter associated with short-term cardiovascular mortality in patients with acute coronary syndrome.

Unfolded protein response activation in cataracts.

PURPOSE: To analyze the expression of 78 kDa glucose-regulated protein (GRP78) and activating transcription factor 6 (ATF6), 2 factors in the unfolded protein response (UPR), in age-related and diabetes-associated cataract. SETTING: Universidad Autónoma de Aguascalientes, Aguascalientes, México. DESIGN: Experimental study. METHODS: The qualitative and quantitative expression of GRP78 and ATF6 were measured in surgical samples from 11 senile cataracts, 9 diabetic-associated cataracts, and 3 normal lenses. Both proteins were detected by immunofluorescence and immunogold-conjugated antibodies. Quantitative morphometry was used to analyze the differences in GRP78 and ATF6 between samples. The Mann-Whitney test was used for statistical analysis. RESULTS: Scanning electron microscopy showed the characteristic organization of fibers in normal lenses with regular alignment and interdigitation between them. On the other hand, lenses from eyes with senile or diabetic cataract showed the same pattern of misalignment and disorganization of the fibers. Both proteins were detected through immunofluorescence in senile and diabetic cataracts, but not in normal lenses. Immunogold-conjugated antibodies and transmission electron microscopy showed that GRP78 and ATF6 grains were 30% higher and 35% higher, respectively, in diabetic cataracts than in senile cataracts (P<.05). CONCLUSIONS: These data show for the first time in humans that GRP78 and ATF6 are present in lens fibers of senile cataracts and diabetic cataracts, establishing that the UPR may be important in the process of cataractogenesis. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Prevalencia de los genotipos fimA II y fimA IV de Porphyromonas gingivalis en un grupo de mujeres mexicanas con diabetes gestacional en la región centro de México / Prevalence of fimA II and fimA IV Porphyromonas gingivalis genotypes in a group of Mexican women with gestational diabetes in the central region of México

La diabetes gestacional (DG) es una de las complicaciones médicas que más frecuentemente afectan a las mujeres embarazadas; algunos autores reportan una prevalencia entre el 9,7 y el 13,9%. La DG puede ser causa de efectos adversos como: nacimiento pretérmino, macrosomia, nacimiento por cesárea, hiperbilirrubinemia, hipertensión gestacional, así como la predisposición de desarrollar posteriormente diabetes mellitus tipo 2 y síndrome metabólico. La literatura señala la asociación entre los microorganismos presentes en el biofilm subgingival, etiológicos de la inflamación de los tejidos de soporte dentarios y diabetes mellitus. Uno de estos microorganismos, Porphyromonas gingivalis, expresa, entre otros factores de virulencia, una proteína llamada fimbrilina, la cual presenta variaciones genotípicas relacionadas con su capacidad de inducción en la expresión de mediadores inflamatorios; los genotipos fimA II y fimA IV se consideran con mayor capacidad de virulencia y su presencia se ha asociado con la resistencia a la insulina. En este estudio analizamos la prevalencia de los genotipos fimA II y fimA IV en un grupo de mujeres mexicanas de la región central de México con DG, en mujeres con embarazo sin diabetes y mujeres sin embarazo y sin diabetes. Los resultados encontrados muestran una elevada presencia del genotipo fimA II en mujeres con DG (p < 0,05)

Gestational diabetes (GD) is one of the most common complications in pregnant women, with some authors reporting prevalence between 9.7% and 13.9%. GD can lead to the following adverse effects: preterm birth, macrosomia, cesarean birth, hyperbilirubinemia, gestational hypertension, and predisposition to later develop diabetes mellitus type 2 and metabolic syndrome. The literature shows an association between microorganisms in the subgingival biofilm, which produces inflammation of the dental support tissue, and diabetes mellitus. Porphyromonasgingivalis is one of these microorganisms, and among other virulence factors, it expresses a protein called fimbrilin which has genotypic variations related to its ability to induce expression of inflammatory mediators. Genotypes fimA II and fimA IV are considered to have a greater virulence and their presence has been associated with insulin resistance. An analysis is made on the prevalence of genotypes fimA II and fimA IV in a group of women in central region of Mexico with GD, pregnant women without diabetes, and non-pregnant women without diabetes. The results show an elevated presence of genotype fimA II in women with GD (P <.05)

Over-expression of human cystatin C in pterygium versus healthy conjunctiva.

BACKGROUND: A prospective, non-randomised, transversal and comparative study, carried out in INOVA Vision Institute and Autonomous University of Aguascalientes. Pterygium is an important illness that affects 22% people from tropic and equatorial zones. Is an inflammatory process caused by UV rays, and it has a behavior similar to a neoplasm. For this study was taken into consideration 191 samples from the INOVA Vision Institute, Aguascalientes, Mexico. Include 73 pterygia samples, which were obtained during resection under sterile conditions. 44 normal conjunctiva samples were obtained from the same patients when harvesting the conjunctival autograft, or from other patients undergoing extracapsular cataract extraction from the superior bulbar region. Tears from patients with pterygium (n = 50) and normal volunteers (n = 24) were obtained using a calibrated glass micro capillary tube. The surgical conjunctiva and pterygia samples were subjected to reverse-transcription polymerase chain reaction (RT-PCR), western blot, and immunohistochemistry. Tears were analyzed by enzyme-linked immunosorbent assays. METHODS: This was a prospective, non-randomised study involving 191 biological samples taken from patients with pterygium and normal volunteers, whom were operated under local anaesthesia by either complete resection of the lesion with primary closure, or resection with conjunctival autograft. Tissue samples were fixed in 10% formaldehyde. Sections were routinely stained with hematoxylin and eosin. HCC expression was evaluated by reverse-transcription polymerase chain reaction (RT-PCR), immunohistochemistry, and by western blotting. All tears samples were analyzed by enzyme-linked immunosorbent assays (ELISA). RESULTS: Expression levels and distribution patterns of HCC in normal conjunctiva and pterygium. Higher levels of HCC mRNAs and proteins were detected in pterygium compared with a normal conjunctiva. Immunohistochemistry revealed that HCC was localized in the apical cells of the epithelium in the normal conjunctiva. In contrast, HCC was detected in all extension of epithelial tissue, from apical to basal cells in pterygia. The concentration of HCC protein in tears was higher in patients with pterygium versus controls. CONCLUSION: HCC may play an important role in protecting normal conjunctiva, and regulating inflammatory conditions of the anterior ocular surface.