Association of personal, behavioral and positive psychological variables with somatization and number of diseases in Mexican general population: the influence of gender.

The objective of the study is to determine the personal, behavioral and psychological variables associated with somatization and the number of diseases in each gender from a sample of Mexican general population. They answered a questionnaire of behavioral and psychological variables including somatization and the sum of 16 different diseases and any additional one, finally the body mass index (BMI) was measured. A total of 164 participants (women = 90, men = 74) were included. We observed that women had more somatization and number of diseases than men and that more variables (mainly psychological) were associated with somatization and with the number of diseases in women than in men. Among the variables most negatively correlated in women with both variables were sleep quality (r = -0.525 and r = -0.536, p < 0.001), self-acceptance (r = -0.460 and r = -0.501, p < 0.001), positive relations with others (r = -0.447 and r = -0.441 p < 0.001), environmental mastery (r = -0.414, p < 0.001, for both variables), purpose in life and optimism; while men only showed a low negative correlation between emotion regulation and the number of diseases (r = -0.289, p < 0.05). The positive associated variables in women were anxiety, negative emotions and depression; while men showed a lower correlation between these three variables only with somatization. The somatization and age were positively related to the number of diseases in both genders and the BMI was significantly associated with the number of diseases only in men. In conclusion, women had more somatization and number of diseases than men and also had more relation between psychological variables and the two dependent variables than men, which could in part explains the higher values of somatization and the number of diseases in women, considering that they usually present higher values of psychopathological variables.

Relaxation with heat and procedural information to diminish anxiety in presurgical patients of hernia surgery.

Presurgical anxiety has been associated with postsurgical pain and complications, therefore we decided to compare two psychological interventions in order to reduce presurgical anxiety-state and pain in patients undergoing hernia surgery. Patients undergoing the presurgical consultation for hernia repair (umbilical or inguinal), were invited. The group of procedural information consisted in administering an informative brochure after the presurgical consultation, while the relaxation with heat group (RWH) consisted in giving a heat pack to the patients while asking them to think in the benefits of the surgery and instructions of relaxation were given, this was performed at the operating theater before surgery. Anxiety-state and pain levels were measured after presurgical consultation and a day after just before surgery. Ninety-five patients were included in 3 groups of study (control = 36, procedural information = 31 and RWH = 28); when we included only those individuals with moderate or high anxiety at the presurgical consultation, we found that procedural information (-4.72 ± 6.10) and RWH diminished anxiety (-9.29 ± 6.91) but only RWH group reached statistical significance when compared with control group (-9.29 ± 6.91 vs -0.56 ± 9.82, p = 0.007). In conclusion, RWH produced a significantly higher reduction of anxiety-state before hernia surgery.

Association between personal, medical and positive psychological variables with somatization in university health sciences students.

OBJECTIVE: To measure personal, medical and psychological positive and negative variables and to determine their relation with somatization in a sample of health sciences students. Subjects and methods: A total of 594 (34.43%) of the 1725 health science students of a public university answered an online survey with personal and medical information as well as the following psychological variables: phsychological well-being, five facets mindfulness questionnaire (FFMQ), life satisfaction, depression, and academic stress. Additionally, the presence of 11 somatic symptoms and 11 diseases during the last year was measured. Results: Most students were women (74.06%) who were 19.96 ± 4.28 years old. The global frequency of somatization in the previous year was 66.59%, and the presence of any measured disease 14.75%. With the multivariate analysis, self-acceptance was the most related variable (negatively) with somatization, followed by the sum of diseases, female gender, academic stress, smoking, and depression, in a model with an R-value of 0.634, self-acceptance was also the most related variable (negatively) with depression, being this last the most related variable with academic stress. Conclusions: After analyzing all variables considered in this study, self-acceptance was the most related variable with somatization and depression; this highlights the importance of strengthening the acceptance of the self in the student population in order to prevent these conditions and their consequences.

Biochemical diagnosis of mucopolysaccharidosis in a Mexican reference center.

Mucopolysaccharidoses (MPS) are a group of genetic disorders, each resulting from the deficiency of one of the lysosomal enzymes that catabolizes mucopolysaccharides. For the accurate diagnosis of the disease, the quantification of a specific enzymatic activity is needed. In the present study, we analyzed seven MPS over several periods of time ranging from 2 to 5 years in a reference center in Mexico. During this time, a total of 761 samples belonging to 505 individuals with suspected MPS were analyzed. A total of 198 (26.01%) positive results were found. Among these, MPS IVA accounted for the highest frequency of positive results (49.10%), followed by MPS III (17.69%, IIIA: 11.80% and IIIB: 5.89%). Adjusting for the number of births per year, the estimated incidence per 100,000 births for MPS analyzed were as follows: MPS I: 0.19, MPS II: 0.15, MPS IIIA: 0.26, MPS IIIB: 0.13, MPS IVA: 1.10, MPS VI: 0.17 and MPS VII: 0.23, and the combined estimated incidence of MPS was 2.23 per 100,000 births; however, this incidence seems to be highly underestimated when compared with the results of newborn screenings.

Author Correction: Association between G1733A (rs6152) polymorphism in androgen receptor gene and recurrent spontaneous abortions in Mexican population.

The original version of this article unfortunately contained two mistakes in the Abstract and the Discussion sections that the authors would like to correct.

Association between brain structural anomalies, electroencephalogram and history of seizures in Mucopolysaccharidosis type II (Hunter syndrome).

Mucopolysaccharidosis type II or Hunter syndrome (MPS II) is a genetic disease that can course with intellectual impairment and central nervous system (CNS) alterations. To date, no report has documented electroencephalogram (EEG) measures associated with CNS alterations, detected by imaging studies, and the history of seizures in patients with MPS II. Therefore, we decided to search this association. We included 9 patients with MPS II and performed imaging studies of the brain to detect the presence of cortico-subcortical atrophy, enlarged subarachnoid space and supratentorial ventricular size. Additionally, we performed EEG studies in sleep and awake conditions and a complete clinical description. Five out of the nine patients presented history of seizures and all except one patient (88.9%) presented some CNS structural alteration in the imaging studies, being the most frequent the cortico-subcortical atrophy (77.8%). The EEG results showed low amplitude in all patients and low voltage in sleep condition in eight patients with interhemispheric asymmetry in six patients during awake and sleep conditions. Although the five patients with history of seizures did not present a distinctive EEG anomaly, four of them presented some structural alteration in the imaging studies. In conclusion, most patients presented structural alterations in the CNS; likewise, all of them presented EEG anomalies mainly during sleep conditions. However, a clear association between EEG, CNS and the history of seizures was not established.

Identification of beta-Lactamases and beta-Lactam-Related Proteins in Human Pathogenic Bacteria using a Computational Search Approach.

A systematic analysis of beta-lactamases based on comparative proteomics has not been performed thus far. In this report, we searched for the presence of beta-lactam-related proteins in 591 bacterial proteomes belonging to 52 species that are pathogenic to humans. The amino acid sequences for 19 different types of beta-lactamases (ACT, CARB, CifA, CMY, CTX, FOX, GES, GOB, IMP, IND, KPC, LEN, OKP, OXA, OXY, SHV, TEM, NDM, and VIM) were obtained from the ARG-ANNOT database and were used to construct 19 HMM profiles, which were used to identify potential beta-lactamases in the completely sequenced bacterial proteomes. A total of 2877 matches that included the word "beta-lactamase" and/or "penicillin" in the functional annotation and/or in any of its regions were obtained. These enzymes were mainly described as "penicillin-binding proteins," "beta-lactamases," and "metallo-beta-lactamases" and were observed in 47 of the 52 species studied. In addition, proteins classified as "beta-lactamases" were observed in 39 of the species included. A positive correlation between the number of beta-lactam-related proteins per species and the proteome size was observed (R 0.78, P < 0.00001). This correlation partially explains the high presence of beta-lactam-related proteins in large proteomes, such as Nocardia brasiliensis, Bacillus anthracis, and Mycobacterium tuberculosis, along with their absence in small proteomes, such as Chlamydia spp. and Mycoplasma spp. We detected only five types of beta-lactamases (TEM, SHV, CTX, IMP, and OXA) and other related proteins in particular species that corresponded with those reported in the literature. We additionally detected other potential species-specific beta-lactamases that have not yet been reported. In the future, better results will be achieved due to more accurate sequence annotations and a greater number of sequenced genomes.

Association between G1733A (rs6152) polymorphism in androgen receptor gene and recurrent spontaneous abortions in Mexican population.

INTRODUCTION: Recurrent spontaneous abortion (RSA) is a multifactorial condition that occurs with a frequency of 0.2-5% in women of reproductive age. Among genetic factors, the single nucleotide polymorphism (SNP) G1733A in the androgen receptor (AR) gene has been associated with its presence in Greek and Iranian populations. Therefore, the aim of this study is to determine its possible association with RSA in this population. PATIENTS AND METHODS: A total of 156 Mexican RSA (with at least 2 consecutive abortions) unrelated patients and 152 unrelated healthy women were included, the presence of karyotype anomalies in the parents as well as uterine anomalies as well as antiphospholipid antibodies was excluded in patients; while all the controls presented at least two healthy pregnancies and no abortion. In all the included women, the presence of the SNP G1733A was determined by restriction fragment length polymorphism (RFLP) technique. RESULTS: No significant differences were observed in age between groups. The genotype GG, GA, and AA had a frequency of 0.70, 0.27, and 0.03 in patients and of 0.89, 0.10, and 0.01 in controls [corrected] (p < 0.001); while the A allele frequency was of 0.06 and 0.16 in controls and patients, respectively (p < 0.0001). The difference in allele frequency increased 10-15% when patients with primary RSA (with no live births) and with at least three abortions were included. CONCLUSIONS: The SNP G1733A of the AR gene is significantly associated with RSA in Mexican patients. These results coincide with previous reports in other populations.

Correlation of Metabolic Variables with the Number of ORFs in Human Pathogenic and Phylogenetically Related Non- or Less-Pathogenic Bacteria.

To date, a few works have performed a correlation of metabolic variables in bacteria; however specific correlations with these variables have not been reported. In this work, we included 36 human pathogenic bacteria and 18 non- or less-pathogenic-related bacteria and obtained all metabolic variables, including enzymes, metabolic pathways, enzymatic steps and specific metabolic pathways, and enzymatic steps of particular metabolic processes, from a reliable metabolic database (KEGG). Then, we correlated the number of the open reading frames (ORF) with these variables and with the proportions of these variables, and we observed a negative correlation with the proportion of enzymes (r = -0.506, p < 0.0001), metabolic pathways (r = -0.871, p < 00.0001), enzymatic reactions (r = -0.749, p < 00.0001), and with the proportions of central metabolism variables as well as a positive correlation with the proportions of multistep reactions (r = 0.650, p < 00.0001) and secondary metabolism variables. The proportion of multifunctional reactions (r: -0.114, p = 0.41) and the proportion of enzymatic steps (r: -0.205, p = 0.14) did not present a significant correlation. These correlations indicate that as the size of a genome (measured in the number of ORFs) increases, the proportion of genes that encode enzymes significantly diminishes (especially those related to central metabolism), suggesting that when essential metabolic pathways are complete, an increase in the number of ORFs does not require a similar increase in the metabolic pathways and enzymes, but only a slight increase is sufficient to cope with a large genome.

Identification of DNA Methyltransferase Genes in Human Pathogenic Bacteria by Comparative Genomics.

DNA methylation plays an important role in gene expression and virulence in some pathogenic bacteria. In this report, we describe DNA methyltransferases (MTases) present in human pathogenic bacteria and compared them with related species, which are not pathogenic or less pathogenic, based in comparative genomics. We performed a search in the KEGG database of the KEGG database orthology groups associated with adenine and cytosine DNA MTase activities (EC: 2.1.1.37, EC: 2.1.1.113 and EC: 2.1.1.72) in 37 human pathogenic species and 18 non/less pathogenic relatives and performed comparisons of the number of these MTases sequences according to their genome size, the DNA MTase type and with their non-less pathogenic relatives. We observed that Helicobacter pylori and Neisseria spp. presented the highest number of MTases while ten different species did not present a predicted DNA MTase. We also detected a significant increase of adenine MTases over cytosine MTases (2.19 vs. 1.06, respectively, p < 0.001). Adenine MTases were the only MTases associated with restriction modification systems and DNA MTases associated with type I restriction modification systems were more numerous than those associated with type III restriction modification systems (0.84 vs. 0.17, p < 0.001); additionally, there was no correlation with the genome size and the total number of DNA MTases, indicating that the number of DNA MTases is related to the particular evolution and lifestyle of specific species, regulating the expression of virulence genes in some pathogenic bacteria.

Association between Oxidative Stress with Psychological and Biochemical Variables in a Sample of Healthy Mexican People: A Cross-Sectional Study.

Oxidative stress (OS) has been linked to cell damage and chronic disease development; however, the study of psychological factors related with OS has been limited, as has its relationship with biochemical and personal variables. Therefore, the aim of this study was to evaluate the association between a wide variety of personal, psychological, and biochemical factors with OS in a sample of healthy Mexican people. A total of 134 participants, from which 70 (52%) were women, without known chronic conditions were included in the study, and the molecule 8-hydroxy-2'-deoxyguanosine (8-OHdG) was also measured as a marker of OS. We observed in the multivariate analysis of the whole sample that depressive symptoms (measured with CES-D scale) were the only psychological variable significantly associated (positively) with 8-OHdG. In addition, the following sociodemographic variables were associated with 8-OHdG: age, schooling (positively correlated), and the frequency of vitamins/antioxidant consumption (negatively correlated). The biochemical variables of erythrocytes in urine and amylase were positively correlated with 8-OHdG, while glucose was negatively correlated with it. Additional biochemical variables were associated in the multivariate analysis of each sex, including the positive correlation of LDL-cholesterol, LDH enzyme, lymphocytes, and the negative correlation of phosphorus and eosinophils in women's samples, as well as the positive correlation of potassium, uric acid, and leucocytes in urine and the negative correlation of erythrocytes and lipase in the men's samples. In conclusion, depression was the only psychological variable positively correlated with 8-OHdG after adjusting for confounders, and new associations with biochemical variables were found with some differences between sexes.

Sex Differences in the Relationship between Personal, Psychological and Biochemical Factors with Blood Pressure in a Healthy Adult Mexican Population: A Cross-Sectional Study.

Hypertension is one of the main risk factors related to cardiovascular mortality, being the levels of blood pressure (BP) related to a variety of personal, anthropometric, biochemical and psychological variables; however, the study evaluating the association of all these factors in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in a sample of relatively healthy subjects has not been performed. The aim of the study was to determine the main variables associated with SBP and DPB in a sample of relatively healthy subjects. A total of 171 participants were included, in which personal, anthropometric, positive and negative psychological variables and biochemical variables were measured. We observed that men showed higher levels of SBP and DBP than women, with more differences for SBP. Among the biochemical factors and SBP, we found that albumin and monocytes were positively correlated with it, while potassium, phosphorus and eosinophils were negatively correlated with it. Additionally, schooling was a constant variable negatively correlated with SBP in all samples (global, men and women). Among psychological variables, we observed that emotional perception was negatively correlated with SBP in men's and women's samples, while autonomy was positively correlated with SBP in the men's sample; however, their association was less when compared with the personal and biochemical variables included in the multivariate model. With regard to DBP, we observed that the biochemical variables, hemoglobin, sodium, uric acid and glucose, were positively correlated with DBP in the global sample, while chloride and BUN were negatively correlated with it. In addition, many personal and behavioral variables, including BMI, age and smoking consumption frequency, also correlated with DBP in the global sample. In conclusion, BP is affected by different factors, and these affect each sex differently.

MDR1 (ABCB1) polymorphisms: functional effects and clinical implications.

MDR1 gene encodes for P glycoprotein (P-gp), which plays an important role in bioavailability and cell-toxicity limitation of a wide range of drugs and xenobiotics. Three single nucleotide polymorphisms (SNPs) in the coding region (C3435T, C1236T and G2677T/A) are the most widely studied SNPs in MDR1 and have been related to substrate and inhibitor-dependent functional modifications in in vitro studies and reduced expression in tissues. The three SNPs exhibit the highest frequencies in Asian and Caucasians populations and the lowest in African populations. In regard to the clinical implications of MDR1 SNPs, it was found in large meta-analysis that C3435T SNP was associated with a slight increase in the susceptibility to ulcerative colitis and cancer and was related with slight modifications in tacrolimus pharmacokinetics and platinum-based chemotherapy response in lung cancer. On the other hand, C3435T SNP has shown controversial results in many other cases of disease susceptibility and drug pharmacokinetics where no meta-analyses have been performed. There is less information about C1236T and G2677T/A SNPs, which, although investigated in some diseases and drug pharmacokinetics, have a very limited number of published meta-analyses. Further studies should include analysis of the haplotype 1236T-2677T/A-3435T as well as other SNPs in MDR1, other transporters and drug metabolizers that may be related with the outcome variable.

Perceptions of Knowledge, Disease Impact and Predictive Genetic Testing in Family Members at Risk to Develop Early-Onset Alzheimer's Disease (EOAD) and Their Levels of Suicidal Ideation: A Mixed Study.

Early-onset Alzheimer's disease (EOAD) is an autosomal dominantly inherited disease, in which a founder effect has been described for A431E mutation in the PSEN1 gene, with most of the affected patients being residents of a small town in the state of Jalisco in Mexico. To date, no studies have been performed in order to know the impact of the disease on this population. Therefore, the objective of this study was to investigate the perceptions in the knowledge, the impact of the disease and the intention to take the predictive genetic testing in the population at genetic risk of Jalisco. For this objective, we performed a mixed study that included a qualitative methodology (semi-structured interviews), and, in addition, we measured suicidal ideation, stress and depression with quantitative instruments in order to compare them with a control group. Of the 28 invited individuals, 9 accepted to participate, from which, 5 (55.56%) participants did not know their genetic risk to develop the disease and 5 (55.56%) would want to take the predictive genetic testing in order to be prepared to face the disease; however, among those who did not want to know, 2 individuals (22.22%) mentioned that they would consider suicide if they were positive for the pathogenic variant. On the impact of the disease, we detected that the adaptation to the familiar's needs was the most frequent answer, including changes in their lifestyle (being responsible since very young, changes in social life and familiar dynamic), this being their main stressor, followed by changes in plans for the future and contemplating the possibility of being affected. Although no differences in stress and depression between groups were observed, we detected that suicidal ideation was significantly higher in the group of cases. These results highlight the importance to involve all the family in genetic counseling in order to clarify any doubts and also to attend to them psychologically to prevent suicidal ideation and attempts.

Sex Differences in Mental Status and Coping Strategies among Adult Mexican Population: A Cross-Sectional Study.

We performed a cross-sectional study in order to determine the association between stress coping strategies and stress, depression, and anxiety, in which the Mexican population was invited to answer these variables by an electronic questionnaire. A total of 1283 people were included, of which 64.8% were women. Women presented higher levels of stress, depression, and anxiety than men; likewise, women showed a higher frequency of some maladaptive coping strategies (behavioral disengagement and denial) and lower levels of some adaptive ones (active coping and planning); additionally, maladaptive coping strategies were positively correlated with stress and depression in both sexes: self-blame, behavioral disengagement, denial, substance use, and self-distraction. Likewise, there were negative correlations between stress and depression and the adaptive strategies: planning, active coping, acceptance, and positive reframing. For women, religion presented negative correlations with stress, depression, and anxiety, and humor showed low positive correlations with stress, anxiety, and depression. In conclusion, most adaptive and maladaptive coping strategies are common in both sexes with the exception of religion, which seems to be adaptive in women and neutral in men, and humor, which seems to be adaptive in men and maladaptive in women. In addition, emotional and instrumental support seem to be neutral in both sexes.

Sex Differences in the Atherogenic Risk Index in Healthy Mexican Population and Its Relationship with Anthropometric and Psychological Factors.

Dyslipidemia is a risk factor for cardiovascular disease and mortality; however, the association of this variable with a wide range of personal and psychological variables has not been researched. Therefore, the aim of this study was to compare lipid levels and anthropometric measures between sexes and to determine the association between personal and psychological variables with the atherogenic risk index (ARI). An adult population which auto-reported as healthy was invited to participate via social media and in person. They filled out a questionnaire with personal and psychological variables; in addition, the body mass index (BMI) and waist-to-hip ratio (WHR) were measured, and a blood sample was obtained to determine serum lipids. A total of 172 participants were included, from which 92 (53.49%) were women; both sexes were comparable in age and most sociodemographic values. Men showed significantly higher levels of total cholesterol, LDL cholesterol, triglycerides, ARI, and lower levels of HDL cholesterol. The men also showed higher values of WHR than the women. In the bivariate analysis, ARI showed the highest correlation with WHR (r = 0.664) in the men and with BMI (r = 0.619) in the women. In the multivariate analysis, the quality of food intake was negatively correlated with ARI in the global and women's samples, and the psychological variables of assertiveness and positive relations with others were negatively correlated with ARI in women, while purpose in life was negatively correlated with ARI in men. In conclusion, the higher levels of serum lipids and ARI in men can be explained by the higher values of WHR in this sex. Behavioral and psychological variables could be protective factors for high ARI.

Association between Psychological, Biochemical and Personal Factors with the Inflammatory Marker High-Sensitive C Reactive Protein (Hs-CRP) in Mexican Healthy Population.

In the last decades, it has been shown that inflammatory processes play a role in the development of mental and physical problems; although some studies have researched the relationship between inflammation and psychological variables, the inclusion of biochemical variables as possible confounders has been limited. Therefore, the aim of this study was to determine whether psychological variables are associated with the inflammatory marker, highly sensitive CRP (hs-CRP), after controlling for personal and biochemical variables in the Mexican population. The study was performed at the University of Guadalajara facilities, during the second half of 2022. Healthy subjects were invited to participate in the study, which consisted of the measurement of personal, psychological, and biochemical variables. We included 172 participants, 92 (52.9%) of which were women; the median (range) of age of the whole sample was 22 (18-69) years old. In the bivariate analysis, significant positive correlations were observed between hs-CRP and body mass index (BMI) and waist/hip ratio (WHR) in both sexes, together with leukocytes, uric acid, low-density lipoprotein (LDL), triglycerides, and the liver enzymes gamma glutamyl transferase (GGT) and alkaline phosphatase (ALP). In the multivariate regression analysis of the global and men's samples, anxiety was positively associated with hs-CRP, while depression and positive relations with others were negatively associated with hs-CRP. In conclusion, psychological variables influence inflammation mainly in men, and anxiety was the main contributor; in addition, positive relation with others is a variable that should be further explored as a psychological protector of inflammation in both sexes.

Brief COPE Short Version (Mini-COPE): A Proposal of Item and Factorial Reduction in Mexican Population.

The factorial reduction of Brief COPE has not been successfully replicated by independent studies, and few have been performed in Spanish-speaking populations; therefore, the objective of this study was to perform a factorial reduction of the instrument in a large sample of the Mexican population and perform a convergent and divergent validity of the factors obtained. We distributed a questionnaire via social networks with sociodemographic and psychological variables, including the Brief COPE and the scales of the CPSS, GAD-7, and CES-D to measure stress, anxiety, and depression. A total of 1283 persons were included, most of whom (64.8%) were women and had a bachelor's degree (55.2%). After performing the exploratory factorial analysis, we did not find a model with an adequate fit and a reduced number of factors; therefore, we decided to reduce the number of items according to the most representative ones of adaptive, maladaptive, and emotional coping strategies. The resulting model with three factors showed good fit parameters and good internal consistency of the factors. In addition, the nature and naming of the factors were confirmed by convergent and divergent validity, with significant negative correlations between factor 1 (active/adaptive) and stress, depression, and anxiety, significant positive correlations between factor 2 (avoidant/maladaptive) and these three variables, and no significant correlation between factor 3 (emotional/neutral) and stress or depression. This shortened version of the brief COPE (Mini-COPE) is a good option to evaluate adaptive and maladaptive coping strategies in Spanish-speaking populations.

Family Functioning and Suicide Attempts in Mexican Adolescents.

Suicide is considered a public health problem that affects families worldwide. Family functioning is the capability of the family system to fulfill needs during the stages of its development. In this study, we focused on evaluating family cohesion and adaptability in a group of adolescents who had attempted suicide and were hospitalized at a hospital for mental health disorders, compared to a control group. Methods: based on Olson's circumplex model, we used the FACES III scale to gain insights into the family functioning of both suicidal and control groups. Results: The case group presented lower scores in cohesion and adaptability compared to the control group, with moderate effect-size for cohesion (Cohen's d/r test = 1.217/0.52) and low effect-size for adaptability (Cohen's d/r test = 0.746/0.35) (p < 0.001 for both variables), and also presented predominantly disengaged families (72.5% in the case group vs. 27.5% in the control group) and structured families (45% in the case group vs. 23.8% in the control group). The type of family described by the adolescents with a history of suicide attempts may explain the presence of low self-esteem and little emotional support usually present in this type of patient.

CD28 proximal promoter polymorphisms in systemic lupus erythematosus susceptibility.

CD28 expression and serum levels are significantly increased in patients with SLE than in healthy controls (HC). Until now, there are no studies of proximal promoter polymorphisms of CD28 gene in SLE. Therefore, our objective was to investigate the polymorphisms present in the proximal promoter of CD28 in a group of SLE and HC and to associate the polymorphisms present with the CD28 serum levels of 40 patients and 40 controls. One hundred and seven patients as well as 108 controls matched by age range and genders were included. The 11 ACR criteria were analyzed on the clinical files, and the proximal promoter region of CD28 gene was analyzed by direct sequencing of a 489-basepair fragment. C28 serum levels (sCD28) were measured by ELISA technique in 40 patients and 40 controls. Only two of the eight reported polymorphisms were found, and they correspond to rs35593994 (-372 A/G) and rs56156157 (-145 -/C). The first had a prevalence of 41 and 36% in patients and controls respectively and the second of 1.4% in both groups. None of these polymorphisms were associated with SLE, and the polymorphism -372 A/G was not associated with the clinical features of disease. Likewise, the association with the sCD28 and the genotypes of -372 A/G polymorphism was not significant. The polymorphisms of the proximal promoter of CD28 are not associated with SLE, and the polymorphism -372 A/G is not associated with the diagnostic criteria of SLE or the sCD28.