Association between angiotensin-1 converting enzyme gene polymorphism and the metabolic syndrome in a Mexican population.

Metabolic Syndrome (MS) is recognized as a cluster of cardiovascular risk factors. All components of MS have a genetic base. Genes of the renin angiotensin system are potential candidate genes for MS. We investigated whether angiotensin converting enzyme (ACE) gene polymorphism increases susceptibility to MS as an entity in a Mexican population. In a cross-sectional study, 514 individuals were studied including 245 patients with MS and 269 subjects without MS criteria. ACE gene polymorphism was detected using PCR. MS was defined according to The National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) criteria, except that the raised fasting plasma glucose

[Angiotensin-1 converting enzyme insertion/deletion gene polymorphism in a Mexican population with diabetic nephropathy]. / Polimorfismo inserción/deleción del gen de la enzima de conversión de la angiotensina en una población mexicana con nefropatía diabética.

BACKGROUND AND OBJECTIVE: Diabetic nephropathy is a polygenic and multifactorial disease. Studies of familial clustering and genetic predisposition suggest that genetic factors are involved. Among candidate genes, the coding for angiotensin-converting enzyme (ACE) polymorphism has been described. Our objective was to investigate the association ACE gene insertion/deletion (I/D) polymorphism with the development of diabetic nephropathy in a Mexican population. PATIENTS AND METHOD: In a cross-sectional study, we evaluated 204 patients with type 2 diabetes: 43 with incipient diabetic nephropathy, 45 with established diabetic nephropathy and 116 without diabetic nephropathy. Diabetic nephropathy was defined according the American Diabetes Association criteria. The ACE I/D gene polymorphism was detected by polymerase chain reaction. RESULTS: Patients with type 2 diabetes with both incipient diabetic nephropathy and established diabetic nephropathy significantly differed from controls with respect to variables that determined kidney damage (P<.0001) and serum lipids ( P<.01). The genotype DD was strongly associated with the development of incipient diabetic nephropathy (odds ratio [OR] adjusted = 2.83; 95% confidence interval, 1.74-4.59; P<.0001) and established diabetic nephropathy (OR adjusted = 2.95; 95% CI, 1.83-4.73; P<.0001). CONCLUSIONS: The ACE DD genotype is associated with the development of incipient diabetic nephropathy and established diabetic nephropathy in a Mexican population.

[Implications of the Renin-Angiotensin system in diabetic nephropathy]. / Implicaciones de sistems renina-angiotensina en la nefropatía diabética.

In the last decades, the incidence of type 2 diabetes has increased alarmingly worldwide including Mexico, and particularly among Mexican-Americans. The etiology of type 2 diabetes is multiple, in which there is a complex interaction between environmental and genetic risk factors. The kidney is a target organ that is damaged when type 2 diabetes occurs. The genetic predisposition for kidney disease in type 2 diabetes patients is the end result of the cumulative effects of multiple genetic and environmental factors. The components of the renin-angiotensin system and its genetic polymorphisms represent an area of intense research due to its association with kidney disease. Early identification of genetic risk factors for developing kidney disease could lead to timely treatment and may influence the response of the patients to drug therapy and diet recommendations.

[Consultation profile and critical points in allergic patient attention at IMSS made by a non-allergologist specialist doctor]. / Perfil de consulta y puntos críticos en la atención del paciente alérgico en el IMSS por médicos especialistas no alergólogos.

BACKGROUND: Allergic diseases represent a serious public health problem all over the world, and they use to be associated with environmental factors as well as with each patient genetic predisposition. OBJECTIVE: To characterize consult profile and critical points of allergic patients attention attended by non-allergologists specialists but referred by allergologists. MATERIAL AND METHOD: Descriptive study since October 2004 until February 2005, with a questionnaire to 255 patients attended by non-allergologists specialists in an IMSS hospital. Skin hypersensibility Prick-tests with standardized commercial extracts were practiced (1:20 p/v). RESULTS: Gender distribution was 41.96% male and 58.04% female, most of them (88.6%) from urban places (the reminder from rural ones); 55.37% with family history of allergy. In 49.02% the disease disturbs family behavior. Annual attention cost to allergic patients was 2,896.74 mexican pesos. Only 35.7% of patients get the disease control. Both work and home control of allergy exacerbation risk factors were poor. CONCLUSIONS: Critical points affecting allergic patients' treatment are attention to risk factors and to those factors exacerbating the disease (environmental and drug scheme choice). Non-allergologists specialists must consider a better control of allergic patients.

[Increased accumulated incidence of allergic rhinitis in adolescents of Morelia, Michoacán, and its relation to satisfaction of vital and affective needs]. / Incremento de la incidencia acumulada de rinitis alérgica en adolescentes de la ciudad de Morelia, Michoacán, y su relación con la satisfacción de necesidades vitales y afectivas.

OBJECTIVE: To determine the incidence (preliminary) of allergic rhinitis in a population-based sample of adolescents and its relation on how they meet basic and affective need satisfaction. MATERIAL AND METHODS: We used ISAAC survey to assess rhinitis-related symptoms in a population-based sample of adolescents from Morelia, Michoacán, Mexico. Some items were added to the survey to evaluate how they meet basic and affective needs. Random sample included 1,333 adolescents aged 11-16 years from several schools of Morelia, Michoacán. Allergic rhinitis impact on basic and affective need satisfaction was assessed. Relative risk (RR) and 95% confidence interval (CI) were estimated. RESULTS AND DISCUSSION: Until 2003, such disease was diagnosed in 12% of cases; however, the number went up after the survey: rhinitis-related symptoms were seen in 46% of those polled, of which prevalence, sensitivity and specificity rates were 27, 90, 70%, respectively. More symptoms were reported from July through December. Sixty percent of adolescents with allergic rhinitis reported sleep disturbances, with adverse effects on bed rest period (RR 2.64) [1.01-6.94]. Well-balanced diet was seen in 62% of adolescents with such disease (RR 1.56) [1.34-1.79]. Sixty-seven percent of such teenagers said that the disease does no interfere with their performance in school (RR 1.41) [0.61-3.24] and 22% felt unaccepted (RR 1.8) [0.795-16.63]. CONCLUSIONS: The estimation of incidence of allergic rhinitis found in this study is higher than in other reports. Basic and affective need satisfaction was affected; thus, implementation of psychotherapy within a multi-disciplinary approach is required.

BIG 6Ô: Un modelo para la búsqueda y organización de la información. Estudio de un caso. Las competencias docentes en las carreras de medicina / BIG 6Ô: A model for information search and organization. A case study. The teaching competences in the medical careers

Se exponen los resultados obtenidos con la aplicación del modelo Big 6Ô para la búsqueda y organización de la información disponible en el área de las competencias docentes a propósito de las necesidades existentes en esta materia entre los profesores y estudiantes de la Facultad de Ciencias Médicas y Biológicas Dr Ignacio Chávez de la Universidad Michoacana de San Nicolás de Hidalgo, México. Se identificó, seleccionó, clasificó, analizó, sintetizó y evaluó la información para obtener los datos y la información necesaria sobre el tema de las competencias docentes. Se identificaron las palabras clave y descriptores apropiados para recuperar la información y se exploraron diferentes directorios, motores de búsqueda, bases de datos, sitios de organizaciones, entre otros recursos, con el objetivo de identificar y analizar las teorías existentes sobre las competencias y la enseñanza basada en el Web, el uso y la efectividad de los materiales multimedia, las modalidades virtuales de educación, así como la enseñanza y las estrategias para incorporar las tecnologías de información y comunicación en la educación superior(AU)

BIG 6Ô: Un modelo para la búsqueda y organización de la información. Estudio de un caso. Las competencias docentes en las carreras de medicina / BIG 6Ô: A model for information search and organization. A case study. The teaching competences in the medical careers

Se exponen los resultados obtenidos con la aplicación del modelo Big 6Ô para la búsqueda y organización de la información disponible en el área de las competencias docentes a propósito de las necesidades existentes en esta materia entre los profesores y estudiantes de la Facultad de Ciencias Médicas y Biológicas Dr Ignacio Chávez de la Universidad Michoacana de San Nicolás de Hidalgo, México. Se identificó, seleccionó, clasificó, analizó, sintetizó y evaluó la información para obtener los datos y la información necesaria sobre el tema de las competencias docentes. Se identificaron las palabras clave y descriptores apropiados para recuperar la información y se exploraron diferentes directorios, motores de búsqueda, bases de datos, sitios de organizaciones, entre otros recursos, con el objetivo de identificar y analizar las teorías existentes sobre las competencias y la enseñanza basada en el Web, el uso y la efectividad de los materiales multimedia, las modalidades virtuales de educación, así como la enseñanza y las estrategias para incorporar las tecnologías de información y comunicación en la educación superior

Polimorfismo inserción/deleción del gen de la enzima de conversión de la angiotensina en una población mexicana con nefropatía diabética / Angiotensin-1 converting enzyme insertion/deletion gene polymorphism in a Mexican population with diabetic nephropathy

Fundamento y objetivo: La nefropatía diabética es una enfermedad de etiología poligénica y multifactorial. Estudios de ligamiento familiar indican que están involucrados factores genéticos. Un gen candidato es el que codifica la enzima de conversión de la angiotensina (ECA), en el que se ha identificado un polimorfismo inserción/deleción (I/D). El objetivo del presente trabajo ha sido analizar la asociación del polimorfismo I/D del gen de la ECA con la nefropatía diabética incipiente y establecida en una población mexicana. Pacientes y método: Se estudió a 204 pacientes con diabetes mellitus tipo 2, de los que 43 presentaban además nefropatía diabética incipiente y 45 nefropatía diabética establecida; los 116 restantes no tenían nefropatía diabética (controles). La nefropatía diabética se definió de acuerdo con los criterios de la American Diabetes Association. El polimorfismo I/D del gen de la ECA se detectó por reacción en cadena de la polimerasa. Resultados: Los pacientes con diabetes mellitus tipo 2 y nefropatía diabética incipiente o establecida presentaron diferencias significativas respecto a los controles en las variables que determinan el daño renal (p < 0,0001) y en los lípidos (p < 0,01). El genotipo DD se asoció estrechamente con el desarrollo de nefropatía diabética tanto incipiente (odds ratio [OR] ajustada = 2,83; intervalo de confianza [IC] del 95%, 1,74-4,59; p < 0,0001) como establecida (OR ajustada = 2,95; IC del 95%, 1,83-4,73; p < 0,0001). Conclusiones: El genotipo DD del gen de la ECA se asoció con el desarrollo de nefropatía diabética incipiente y nefropatía diabética establecida en una población mexicana

Background and objective: Diabetic nephropathy is a polygenic and multifactorial disease. Studies of familial clustering and genetic predisposition suggest that genetic factors are involved. Among candidate genes, the coding for angiotensin-converting enzyme (ACE) polymorphism has been described. Our objective was to investigate the association ACE gene insertion/deletion (I/D) polymorphism with the development of diabetic nephropathy in a Mexican population. Patients and method: In a cross-sectional study, we evaluated 204 patients with type 2 diabetes: 43 with incipient diabetic nephropathy, 45 with established diabetic nephropathy and 116 without diabetic nephropathy. Diabetic nephropathy was defined according the American Diabetes Association criteria. The ACE I/D gene polymorphism was detected by polymerase chain reaction. Results: Patients with type 2 diabetes with both incipient diabetic nephropathy and established diabetic nephropathy significantly differed from controls with respect to variables that determined kidney damage (P< .0001) and serum lipids (P<.01). The genotype DD was strongly associated with the development of incipient diabetic nephropathy (odds ratio [OR] adjusted = 2.83; 95% confidence interval, 1.74-4.59; P<.0001) and established diabetic nephropathy (OR adjusted = 2.95; 95% CI, 1.83-4.73; P<.0001). Conclusions: The ACE DD genotype is associated with the development of incipient diabetic nephropathy and established diabetic nephropathy in a Mexican population

Cinética de la D-xilosa después de su administración intraperitoneal / D-xilose kinetics after intraperitoneal administration

Este trabajo representa la primera fase de un estudio cuyo objetivo final es probar si la concentración sérica de D-xilosa, después de su administración intraperitoneal, puede utilizarse como un indicador de depuración peritoneal. Aquí exclusivamente se informan los resultados obtenidos del estudio de cinética de la D-xilosa en 10 pacientes con nefropatía diabética terminal tratados con diálisis peritoneal (DP). Se administró D-xilosa a la cavidad peritoneal a razón de 100 mg/k de peso. Después se midió en suero, orina y líquido peritoneal. La proporción del total administrado de D-xilosa que difundió del espacio intraperitoneal al compartimiento intravascular fue de 64 ñ 26 por ciento a la primera hora, 74 ñ 22 por ciento a la segunda y 80 ñ 19 por ciento a la tercera. La concentración de D-xilosa en suero a las mismas horas fue de 5 ñ 3 por ciento, 8.9 ñ 4 por ciento y 9.4 ñ 4 por ciento del total administrado (r=0.9773). Una vez conocido el modelo de distribución de la D-xilosa en esta clase de enfermos pueden efectuarse otros estudios que evalúen su utilidad como un indicador del grado de depuración peritoneal