Objectives. The aim of this study was to confirm the implication of macrophage migration inhibitory factor (MIF) gene in SSc susceptibility or clinical phenotypes in a large European population.
...Methods. A total of 3800 SSc patients and 4282 healthy controls of white Caucasian ancestry from eight different European countries were included in the study. The MIF −173 single nucleotide polymorphism (SNP) was selected as genetic marker and genotyped using Taqman 5′ allelic discrimination assay.
Results. The MIF −173 SNP showed association with SSc P = 0.04, odds ratio (OR) = 1.10, 95% CI 1.00, 1.19. Analysis of the MIF −173 polymorphism according to SSc clinical phenotype revealed that the frequency of the −173*C allele was significantly higher in the dcSSc group compared with controls (P = 5.30E-03, OR = 1.21, 95% CI 1.07, 1.38). Conversely, the frequency of the MIF −173*C allele was significantly underrepresented in the lcSSc group compared with dcSSc patients, supporting previous findings (P = 0.04, OR = 0.86, 95% CI 0.75, 0.99); meta-analysis including previous results (P = 0.005, OR = 0.83, 95% CI 0.73, 0.94).
Conclusion. Our results confirm the role of MIF −173 promoter polymorphism in SSc, and provide evidence of a strong association with the dcSSc subgroup of patients. Hence, the MIF −173 variant is confirmed as a promising clinical phenotype genetic marker.
The current knowledge of the influence of systemic sclerosis (SSc) risk loci in the clinical sub-phenotypes is still limited. The main limitation lies in the low frequency of some sub-phenotypes ...which could be solved by replication studies in independent cohorts and meta-analysis between studies. In this regard, CCR6 gene variants have been recently associated with anti-topoisomerase I positive (ATA+) production in SSc patients in a candidate gene study. This gene has been proposed to have a critical role in IL-17-driven autoimmunity in human diseases.
In order to confirm the association between CCR6 and ATA+ SSc patients, we performed an independent replication study in populations of European ancestry. We studied two CCR6 genetic variants (rs968334 and rs3093024) in a total of 901 ATA+ SSc cases, 3,258 ATA- SSc cases and 7,865 healthy controls and compared allelic frequencies for those SNPs in ATA+ SSc with healthy controls and also with ATA- SSc patients.
The comparison performed between ATA+ SSc patients and healthy controls showed significant association with SNP rs968334 (p=4.88x10(-2), OR=1.11). When we compared ATA+ SSc cases with ATA- SSc, both SNPs, rs3093024 and rs968334, showed significant associations (p=2.89x10(-2), OR=1.13; p=1.69x10(-2), OR=1.15). Finally, in order to increase even more sample size and statistical power, we meta-analysed our study with the previous reported and found a significant association between SNP rs3093024 and ATA+ SSc patients (p=1.00x10(-4), OR=1.16) comparing with healthy controls.
Our work confirms the association of CCR6 gene and ATA+ SSc patients.
Abatacept (ABA) is a recombinant human fusion protein that blocks co-stimulation signals on T lymphocytes, impeding their activation. Randomized and controlled trials examining efficacy and safety ...have been performed with ABA combined with methotrexate (MTX), vs MTX monotherapy and vs infliximab (IFB) combined with MTX in patients with rheumatoid arthritis and who are naïve to biologic therapy. ABA has shown to be more effective than MTX and at least as effective as IFB+MTX, in terms of activity and clinical remission, physical function and reduction in radiological progression. Safety data at 7 years have shown that the drug is comparable to MTX in monotherapy and safer than the IFB+MTX combination, although infections still constitute the main risk when using ABA. This review summarizes the safety and efficacy data of the AIM, ATTEST, Phase IIb IM101-100, and AGREE trials.
El abatacept (ABA) es una proteína de fusión recombinante humana que permite el bloqueo de la señal co-estimuladora del linfocito T, evitando su activación. Se han realizado estudios aleatorizados y controlados de eficacia y seguridad del ABA combinado con metotrexato (MTX), frente a MTX en monoterapia y frente a infliximab (IFB) combinado con MTX en pacientes con artritis reumatoide naive a terapia biológica. ABA ha demostrado ser más eficaz que el MTX y al menos igual que IFB+MTX, en términos de actividad y remisión clínica, funcionalidad física y disminución de la progresión radiológica. Los datos de seguridad a 7 años han demostrado que el fármaco es equiparable al MTX en monoterapia y más seguro que la combinación IFB+MTX, aunque las infecciones continúan siendo el principal riesgo del uso de ABA. En esta revisión se resumen los datos de seguridad y eficacia de los estudios AIM, ATTEST, fase IIb IM101-100 y AGREE.
The prevalence of lung obstruction increases with age and the presence of comorbidities. Although a complete spirometry is necessary to confirm the diagnosis, this may be impractical in elderly ...patients with cognitive impairment or functional dependence. Recently, the use of portable devices using the FEV
/FEV
ratio have shown to be useful for assessing the presence of lung obstruction, with greater ease of use, but its usefulness has not been established in the elderly population with multiple morbidities.
A cross-sectional study was conducted on patients hospitalised in the complex chronic patients Unit of the University Hospital Mútua de Terrassa. All of them completed a questionnaire that included -among other things- measurements of functional dependence and cognitive impairment. Three manoeuvres validated with the Piko-6 device were attempted before discharge, and considering an FEV
/FEV
<0.75 as criteria for obstruction. An analysis was performed on the characteristics of the population that was able to perform the tests, as well as the prevalence of pulmonary obstruction.
A total of 54 patients were included in the study, of which 35 (64.81%) performed the manoeuvres correctly. Patients who were unable to complete the manoeuvres of the Piko-6 had more functional dependence (Barthel 19 vs. 72, P<.0001) and cognitive impairment (Pfeiffer 1 vs. 9, P<.0001; MEC 28/35 vs. 3/35, P<.010). The prevalence of obstruction was 71.43%, with an underdiagnosis of 72%.
The FEV
/FEV
ratio was not determined in 35.18% of the patients due to cognitive impairment or functional dependence. The prevalence of obstruction and underdiagnosis exceeded 70%.
The aim of the present study was to investigate the possible role of CD40 and CD40 ligand (CD40LG) genes in the susceptibility and phenotype expression of systemic sclerosis (SSc).
In total, 2,670 ...SSc patients and 3,245 healthy individuals from four European populations (Spain, Germany, The Netherlands, and Italy) were included in the study. Five single-nucleotide polymorphisms (SNPs) of CD40 (rs1883832, rs4810485, rs1535045) and CD40LG (rs3092952, rs3092920) were genotyped by using a predesigned TaqMan allele-discrimination assay technology. Meta-analysis was assessed to determine whether an association exists between the genetic variants and SSc or its main clinical subtypes.
No evidence of association between CD40 and CD40LG genes variants and susceptibility to SSc was observed. Similarly, no significant statistical differences were observed when SSc patients were stratified by the clinical subtypes, the serologic features, and pulmonary fibrosis.
Our results do not suggest an important role of CD40 and CD40LG gene polymorphisms in the susceptibility to or clinical expression of SSc.
Introduction. Anxiety and depression in pregnant women are a public health problem. Their adequate detection requires valid and reliable instruments that are also useful for prevention and treatment. ...Objective. To identify the psychometric properties of the Hospital Anxiety and Depression Scale (HADS) in a sample of Mexican pregnant women. Method. The HADS was applied to 716 pregnant women between 13 and 46 years old (M = 26.55; SD = 6.56) attended in a public hospital in Mexico City. Results. With a sample of 358 participants, a parallel analysis indicated a bifactorial structure for HADS, identified by exploratory factor analysis (Factor 1: anxiety, Factor 2: depression). The factors explained 53% of the variance and correlated positively (r = .36). The global internal consistency (Cronbach’s α = .81; ordinal α = .93) and by factor (anxiety: Cronbach’s α = .79; ordinal α = .88; depression: Cronbach’s α = .79; ordinal α = .87) was acceptable. With data from the remaining 358 participants, a confirmatory factor analysis showed an acceptable fit for the structure detected (χ2/gl = 2.72; RMSEA = .06 IC .05, .08; GFI = .93; AGFI = .90; TLI = .90; CFI = .92). Discussion and conclusions. The Hospital Anxiety and Depression Scale has adequate psychometric properties to be used in pregnant Mexican women. Its use in routine pregnancy controls would be useful to prevent, detect, and timely treat these conditions.
Introducción. La ansiedad y la depresión en gestantes representan un problema de salud pública. Su adecuada detección requiere de instrumentos válidos y confiables que también sirvan para su prevención y tratamiento. Objetivo. Identificar las propiedades psicométricas de la Escala Hospitalaria de Ansiedad y Depresión (HADS) en una muestra de mujeres embarazadas mexicanas. Método. Se aplicó la HADS a 716 gestantes de entre 13 y 46 años (M = 26.55; DE = 6.56), atendidas en un hospital público en la Ciudad de México. Resultados. Con una muestra de 358 participantes, un análisis paralelo indicó una estructura bifactorial para la HADS, identificada mediante análisis factorial exploratorio (Factor 1: ansiedad, Factor 2: depresión). Los factores explicaron el 53% de la varianza y correlacionaron positivamente (r = .36). La consistencia interna global (α de Cronbach = .81, α ordinal = .93) y por factor (ansiedad: α de Cronbach = .79, α ordinal = .88; depresión: α de Cronbach = .79, α ordinal = .87) fue aceptable. Con los datos de las 358 participantes restantes, un análisis factorial confirmatorio mostró un ajuste aceptable para la estructura detectada (χ2/gl = 2.72; RMSEA = .06 IC .05, .08; GFI = .93; AGFI = .90; TLI = .90; CFI = .92). Discusión y conclusión. La Escala Hospitalaria de Ansiedad y Depresión posee adecuadas propiedades psicométricas para su empleo en mujeres embarazadas mexicanas. Su uso en controles rutinarios del embarazo sería útil para prevenir, detectar y atender oportunamente estos padecimientos.
Resumen OBJETIVO: Describir la prevalencia de patología endometrial diagnosticada mediante histeroscopia en pacientes infértiles atendidas en un centro de tercer nivel. MATERIALES Y MÉTODOS: Estudio ...descriptivo, retrospectivo y observacional efectuado en pacientes con diagnóstico de infertilidad atendidas en el Departamento de Biología de la Reproducción Humana del Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México. Criterios de inclusión: pacientes infértiles entre 18 y 43 años a quienes se realizó histeroscopia. Criterios de exclusión: pacientes del servicio de Reproducción Humana a quienes no se les realizó histeroscopia o ésta fue fallida. Se utilizó el paquete estadístico para las ciencias sociales (SPSS Statistics) versión 20.0. El análisis estadístico fue descriptivo, con media, desviación estándar o porcentaje. RESULTADOS: Se analizaron los expedientes físicos de 440 pacientes infértiles a quienes se efectuó histeroscopia. Las características demográficas incluyeron edad, IMC, tipo y años de infertilidad. Los hallazgos histeroscópicos fueron: cavidad uterina normal 38.4% y anormal 61.6%, pólipo o endometrio polipoide en 34.3%, malformación mülleriana 13.4%, sinequias 10.7%, leiomioma 7.3%, hiperplasia endometrial 1.4%, adenomiosis 0.9%, cuerpo extraño 0.9%. El 7.5% consiguió el embarazo espontáneo y a 21.8% se les practicaron distintas técnicas de reproducción asistida y se logró el embarazo en 34.3%. CONCLUSIONES: La evaluación de la cavidad uterina es un requisito indispensable del estudio de las pacientes infértiles; en esta búsqueda más de la mitad tuvieron hallazgos histeroscópicos anormales.
Desafíos de la investigación en el siglo XXI Guzmán Nariño, Víctor Fernando; Rivera Arrieta, Elisa Eugenia; Santos Hernández, Vanesa
Revista Dialogus,
10/2022
9
Journal Article
La investigación es un proceso que abarca muchas variables y constituye un pilar fundamental para la educación y el progreso, ya que promueve el desarrollo humano desde todas sus dimensiones, ...desarrollando numerosas competencias y habilidades. La investigación en el siglo XXI afronta muchos desafíos, pero sin duda, uno de los más relevantes es lograr que los individuos se interesen y sean actores de un proceso de investigación continuo, en donde sea posible la articulación de diferentes escenarios estrechamente relacionados con el desarrollo humano como son; la escuela, la universidad, el estado y la sociedad. Sin duda alguna, existe una amplia diferencia entre la cultura investigativa de las grandes potencias mundiales y la región de América latina y el Caribe; partiendo de esta realidad, el presente ensayo intenta hacer un análisis de algunas de las causas claramente identificadas, principalmente en Colombia, por investigadores, entidades estatales, y desde la práctica pedagógica personal de sus autores y; plantea algunas de las necesidades y oportunidades que se vislumbran desde el establecimiento de políticas públicas, la asignación de un presupuesto ajustado a las necesidades y sus garantías de cumplimiento.
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