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1.
Gac. méd. Méx ; 156(1): 60-66, ene.-feb. 2020. tab, graf
Article in English, Spanish | LILACS | ID: biblio-1249871

ABSTRACT

Resumen El síndrome X frágil es la condición monogenética que produce más casos de autismo y de discapacidad intelectual. La repetición de tripletes CGG (> 200) y su metilación conllevan el silenciamiento del gen FMR1. La proteína FMRP (producto del gen FMR1) interacciona con los ribosomas, controlando la traducción de mensajeros específicos y su pérdida produce alteraciones de la conectividad sináptica. El tamizaje de síndrome X frágil se realiza por reacción en cadena de la polimerasa. La recomendación actual de la Academia Americana de Pediatría es realizar pruebas a quienes presenten discapacidad intelectual, retraso global del desarrollo o antecedentes familiares de afección por la mutación o premutación. Países hispanos como Colombia, Chile y España reportan altas prevalencias de síndrome X frágil y han creado asociaciones o corporaciones nacionales de X frágil que buscan acercar a los pacientes a redes disponibles de diagnóstico y tratamiento.


Abstract Fragile X syndrome is the monogenetic condition that produces more cases of autism and intellectual disability. The repetition of CGG triplets (> 200) and their methylation entail the silencing of the FMR1 gene. The FMRP protein (product of the FMR1 gene) interacts with ribosomes by controlling the translation of specific messengers, and its loss causes alterations in synaptic connectivity. Screening for fragile X syndrome is performed by polymerase chain reaction. Current recommendation of the American Academy of Pediatrics is to test individuals with intellectual disability, global developmental retardation or with a family history of presence of the mutation or premutation. Hispanic countries such as Colombia, Chile and Spain report high prevalence of fragile X syndrome and have created fragile X national associations or corporations that seek to bring patients closer to available diagnostic and treatment networks.


Subject(s)
Humans , Male , Child, Preschool , Autistic Disorder/genetics , Fragile X Mental Retardation Protein/genetics , Fragile X Syndrome/genetics , Intellectual Disability/genetics , Pedigree , Phenotype , Ribosomes/metabolism , Attention Deficit Disorder with Hyperactivity/genetics , Sex Factors , Genetic Testing , Synaptic Transmission , Gene Silencing , Fragile X Mental Retardation Protein/metabolism , Checklist , Fragile X Syndrome/complications , Fragile X Syndrome/diagnosis , Fragile X Syndrome/therapy , Mutation
2.
Salud pública Méx ; 59(4): 423-428, Jul.-Aug. 2017. tab, graf
Article in English | LILACS | ID: biblio-903779

ABSTRACT

Abstract: Objective: Inborn errors of metabolism (IEM) are genetic conditions that are sometimes associated with intellectual developmental disorders (IDD). The aim of this study is to contribute to the metabolic characterization of IDD of unknown etiology in Mexico. Materials and methods: Metabolic screening using tandem mass spectrometry and fluorometry will be performed to rule out IEM. In addition, target metabolomic analysis will be done to characterize the metabolomic profile of patients with IDD. Conclusion: Identification of new metabolomic profiles associated with IDD of unknown etiology and comorbidities will contribute to the development of novel diagnostic and therapeutic schemes for the prevention and treatment of IDD in Mexico.


Resumen: Objetivo: Los errores innatos del metabolismo (EIM) son condiciones genéticas que pueden asociarse con trastornos del desarrollo intelectual (TDI). El objetivo de este estudio es contribuir a la caracterización metabólica de los pacientes con TDI de etiología desconocida. Material y métodos: Se realizará un tamiz metabólico mediante espectrometría de masas-tándem y fluorometría para descartar EIM; además, se analizará el perfil metabolómico de los pacientes con TDI. Conclusión: La identificación de perfiles metabolómicos asociados con los TDI de etiología desconocida contribuirá al desarrollo de nuevos esquemas diagnósticos y terapéuticos para la prevención y tratamiento de los TDI en México.


Subject(s)
Humans , Male , Female , Child , Adolescent , Young Adult , Metabolomics/methods , Intellectual Disability/etiology , Intellectual Disability/epidemiology , Metabolism, Inborn Errors/diagnosis , Mass Screening , Health Surveys , Tandem Mass Spectrometry , Fragile X Syndrome/diagnosis , Fragile X Syndrome/epidemiology , Mexico/epidemiology
3.
Braz. dent. j ; 25(6): 519-523, Nov-Dec/2014. tab, graf
Article in English | LILACS | ID: lil-732263

ABSTRACT

Surface treatment of dentin before the bleaching procedure may affect its permeability and influence the bond strength of restorative materials. This study evaluated the influence of surface treatment before the bleaching on shear bond strength (SBT) of restorative materials to intracoronal dentin. Dentin slabs were subjected to surface treatment: no bleaching (control - CON), no surface treatment + bleaching (HP), 37% phosphoric acid + bleaching (PA) and Er:YAG laser + bleaching (L). After the bleaching procedure, specimens (n=10) were restored with: microhybrid composite resin (MH), flowable composite resin (F), and resin-modified glass-ionomer cement (RMGIC). The shear test was carried out. ANOVA and Tukey's test (α=0.05) showed significant difference for surface treatment and restorative materials (p<0.05). CON presented higher STB and was statistically different from HP (p<0.05). PA and L showed intermediate values and were statistically similar to CON and HP (p>0.05). STB for MH and F were higher than RMGIC (p<0.05), and did not differ from each other (p>0.05). The surface treatments with phosphoric acid and Er:YAG laser before the bleaching procedure provided shear bond strength at the same level of unbleached dentin and the composite resins presented superior bond strength to the intracoronal dentin.


O tratamento superficial da dentina previamente ao clareamento pode afetar a sua permeabilidade e influenciar a resistência de união de materiais restaurados. Este estudo avaliou a influência do tratamento superficial antes do clareamento na resistência ao cisalhamento (RC) de materiais restauradores à dentina intracoronária. Fragmentos de dentina foram submetidos ao tratamento de superfície: não clareadas (controle - CON), sem tratamento de superfície + clareamento (HP), ácido fosfórico 37% + clareamento (AF), e laser Er:YAG + clareamento (L). Após o procedimento clareador, os espécimes foram restaurados com (n=10): resina composta micro-híbrida (MH), resina composta fluida (F), e cimento de ionômero de vidro modificado por resina (CIVMR). O teste de cisalhamento foi realizado. ANOVA e teste de Tukey (α=0,05) mostraram diferença significante para tratamento superficial e material restaurador (p<0,05). O grupo controle apresentou maior resistência de união e foi estatisticamente diferente de HP (p<0,05). AF e L mostraram valores intermediários e foram similares ao CON e HP (p>0,05). A resistência de união para MH e F foi maior que CIVMR (p<0,05), e não diferiram entre si (p>0,05). O tratamento da superfície dentinária com ácido fosfórico e laser Er:YAG previamente ao clareamento promoveu resistência de união ao nível da dentina não clareada e a adesão à dentina intracoronária foi superior com as resinas compostas.


Subject(s)
Female , Humans , Male , Fragile X Syndrome/diagnosis , Sex Chromosome Aberrations/diagnosis , Chromosome Aberrations , Chromosome Banding , Developmental Disabilities/etiology , Developmental Disabilities/genetics , Fragile X Syndrome/genetics
4.
J. pediatr. (Rio J.) ; 90(2): 155-160, Mar-Apr/2014. tab
Article in English | LILACS | ID: lil-709809

ABSTRACT

OBJECTIVE: this study aimed to investigate the cognitive and behavioral profiles, as well as the psychiatric symptoms and disorders in children with three different genetic syndromes with similar sociocultural and socioeconomic backgrounds. METHODS: thirty-four children aged 6 to 16 years, with Williams-Beuren syndrome (n = 10), Prader-Willi syndrome (n = 11), and Fragile X syndrome (n = 13) from the outpatient clinics of Child Psychiatry and Medical Genetics Department were cognitively assessed through the Wechsler Intelligence Scale for Children (WISC-III). Afterwards, a full-scale intelligence quotient (IQ), verbal IQ, performance IQ, standard subtest scores, as well as frequency of psychiatric symptoms and disorders were compared among the three syndromes. RESULTS: significant differences were found among the syndromes concerning verbal IQ and verbal and performance subtests. Post-hoc analysis demonstrated that vocabulary and comprehension subtest scores were significantly higher in Williams-Beuren syndrome in comparison with Prader-Willi and Fragile X syndromes, and block design and object assembly scores were significantly higher in Prader-Willi syndrome compared with Williams-Beuren and Fragile X syndromes. Additionally, there were significant differences between the syndromes concerning behavioral features and psychiatric symptoms. The Prader-Willi syndrome group presented a higher frequency of hyperphagia and self-injurious behaviors. The Fragile X syndrome group showed a higher frequency of social interaction deficits; such difference nearly reached statistical significance. CONCLUSION: the three genetic syndromes exhibited distinctive cognitive, behavioral, and psychiatric patterns. .


OBJETIVO: investigar o perfil cognitivo e comportamental, sintomas e transtornos psiquiátricos em crianças com três diferentes síndromes genéticas, com antecedentes socioculturais e socioeconômicos semelhantes. MÉTODOS: trinta e quatro crianças, entre 6 e 16 anos, com as síndromes de Williams-Beuren (n = 10), de Prader-Willi (n = 11) e do X-Frágil (n = 13), dos ambulatórios de Psiquiatria Infantil e Genética Médica, foram avaliadas cognitivamente pela Escala Wechsler de Inteligência para Crianças (WISC-III). Posteriormente, o QI total, o QI Verbal, o QI de Execução, os escores ponderados dos subtestes e a frequência de sintomas e transtornos psiquiátricos foram comparados entre as síndromes. RESULTADOS: diferenças significativas foram encontradas entre as síndromes quanto ao QI Verbal e os subtestes verbais e de execução. A análise Post-hoc demonstrou que os escores dos subtestes vocabulário e compreensão foram significativamente superiores na síndrome de Williams-Beuren em relação às síndromes de Prader-Willi e do X-Frágil, e os escores dos subtestes cubos e armar objetos foram significativamente superiores na síndrome de Prader-Willi em relação às síndromes de Williams-Beuren e do X-Frágil. Além disso, houve diferença significativa entre as síndromes quanto às características comportamentais e os sintomas psiquiátricos. O grupo com síndrome de Prader-Willi apresentou maior frequência de hiperfagia e comportamentos autolesivos. Já o grupo com síndrome do X-Frágil apresentou maior frequência do déficit da interação social. Esta diferença quase alcançou a significância estatística. CONCLUSÃO: as três síndromes genéticas ...


Subject(s)
Adolescent , Child , Female , Humans , Male , Cognition Disorders/psychology , Fragile X Syndrome/psychology , Intellectual Disability/psychology , Mental Disorders/psychology , Prader-Willi Syndrome/psychology , Williams Syndrome/psychology , Cognition , Cross-Sectional Studies , Cognition Disorders/genetics , Educational Status , Fragile X Syndrome/diagnosis , Income , Intellectual Disability/genetics , Mental Disorders/genetics , Prader-Willi Syndrome/diagnosis , Wechsler Scales , Williams Syndrome/diagnosis
6.
Rio de Janeiro; s.n; 2013. 89 p. ilus, tab.
Thesis in Portuguese | LILACS | ID: lil-711961

ABSTRACT

O retardo mental (RM) representa um problema de saúde pública mundial ainda negligenciado no Brasil e, em especial nas regiões mais pobres como o Nordeste. A síndrome do X frágil (SXF) é uma das formas mais estudadas de RM hereditário em seres humanos. Esta doença monogênica, de herança ligada ao X dominante, é decorrente de uma mutação no exon 1 do gene FMR1, localizado na região Xq27.3. A mutação no FMR1 se caracteriza pelo aumento de repetições de trinucleotídios CGG em tandem na região 5’ UTR desse gene, sendo a expansão dessas trincas o principal evento mutacional responsável pela SXF. De maneira geral, os fenótipos cognitivos de indivíduos do sexo masculino com a síndrome incluem deficiência intelectual de moderada à grave. No presente trabalho, realizamos um estudo transversal da SXF em indivíduos portadores de retardo mental de causa desconhecida, engajados em Programas de Educação Especial e em instituições psiquiátricas de São Luís-MA, rastreando amplificações de sequências trinucleotídicas no gene FMR1. A amostra foi composta por 238 indivíduos do sexo masculino, não aparentados, na faixa etária de 4 a 60 anos (média = 21 ± 9 anos). O DNA dos participantes foi obtido a partir de 5 mL de sangue coletados em tubos com anti-coagulante EDTA e a análise molecular da região gênica de interesse foi realizada através da reação em cadeia da polimerase, utilizando-se três primers. Dentre os indivíduos triados quanto à presença de mutações no gene FMR1, apenas um apresentou um resultado inconclusivo e 2 (0,84%) foram positivos para a SXF, sendo que um deles (3503) apresentou mais de 200 repetições CGG no locus FRAXA e o outro indivíduo (3660) apresentou uma deleção de ~197 pb envolvendo parte das repetições CGG e uma região proximal às repetições CGG. Ambos possuíam história familiar de RM ligado ao X. No indivíduo 3503 observamos as seguintes características clínicas: temperamento dócil, orelhas grandes, mandíbula proeminente e flacidez ligamentar ...


Mental retardation (MR) is considered a global public health problem in Brazil and it is still ignored mainly in poor regions like Northeast Brazil. The fragile X syndrome (FXS) is one of the most common heritable disease in humans. it is a monogenic disease with X-linked dominant inheritance due to a mutation in exon 1 of the FMR1 gene, located at Xq27.3 region. The mutation in FMR1 is characterized by the increase in number of CGG repeats in the 5 'UTR of the gene. This expansion of CGG triplets in the first exon of the FMR1 gene is the main mutational event responsible for FXS. In general, the cognitive phenotypes of males with this syndrome include intellectual disabilities from moderate to severe. In this work, we conducted a cross-sectional study of FXS in individuals with MR of unknown cause, in Especial Education Programs and Psyquiatric Instituitions in São Luís-MA, by screening for amplifications of trinucleotide sequences within the FMR1 gene. The sample consisted of 238 unrelated males, which ages were from 4 to 60 years (mean = 21 ± 9 years). The DNA of all individuals was obtained from 5 mL of peripheral blood which was colected in EDTA-anticoagulated tubes. The molecular analysis of the genetic region of interest was performed by polimerase chain reaction using three primers. Of the individuals screened for the presence of the mutation in the FMR1 gene, only one was inconclusive and two (0.84%) were positive for FXS. One (3503) presented more than 200 CGG repeats in FRAXA locus, and the other (3660) presented with a ~ 197 bp deletion involving part of CGG repeats and a proximal region to the CGG repeats. Both of these individuals have family history of X-linked Mental Retardation. The individual 3503 has the following clinical features: docile temperament, large ears, prominent jaw and ligamentous laxity. The individual 3660 presents hyperactivity, poor contact with eyes, large ears, prominent jaw, pectus excavatum, macroorchidism and little ...


Subject(s)
Humans , Male , Intellectual Disability/diagnosis , Intellectual Disability/genetics , Fragile X Syndrome/diagnosis , Fragile X Syndrome/genetics , Diagnosis, Differential , Exons/genetics , Mutation/genetics , Fragile X Mental Retardation Protein/genetics , Polymerase Chain Reaction/methods , Sequence Analysis, DNA , Trinucleotide Repeat Expansion
7.
Rev. méd. Minas Gerais ; 22(4)dez. 2012.
Article in Portuguese | LILACS | ID: lil-698421

ABSTRACT

Introdução: a síndrome do X frágil é a principal causa de retardo mental de natureza familiar. Suas características clínicas pouco marcantes fazem com que um diagnóstico de certeza a partir de testes moleculares seja imprescindível. Objetivo: descrever e avaliar as vantagens e desvantagens de uma estratégia combinada de PCR triplo metilação-específica e eletroforese capilar para o diagnóstico molecular da síndrome do X frágil, visando baixo custo, exequibilidade, reprodutibilidade e sensibilidade. Métodos: foram coletadas 43 amostras de sanguede pacientes com déficit cognitivo e de suas mães, quando indicado. Tais indivíduos possuíam exame citogenético positivo, fenótipo e/ou história familiar sugestivas de síndrome do X frágil. Após extração de DNA, foi realizada eletroforese capilar com marcadores fluorescentes,tratamento com bissulfito de sódio e três reações de PCR metilação-específicas em cada amostra. Resultados: foi possível determinar o genótipo em 29 pacientes: 23 (14 homens e nove mulheres) apresentavam alelos com tamanho normal e seis (todos do sexo masculino) possuíam alelos na faixa de mutação completa. Em outras seis amostras, todas do sexo feminino, foi possível determinar um alelo na faixa normal e outro alelo alterado, entretanto, sem diferenciação entre faixa de pré-mutação ou de mutação completa. Nas demais oito amostras(cinco homens e três mulheres), não se pôde determinar o genótipo. Conclusões: a técnica proposta faz uma triagem de pacientes, mas apresenta desvantagens, como não terem sido obtidos resultados satisfatórios com as reações para alelos metilados e a análise dos rastrosdas PCRs com três primers ter se mostrado difícil e dependente de observador.


Introduction: The fragile X syndrome is the main cause of inherited mental retardation. Its very small remarkable clinical characteristics make that a surely diagnosis from molecular tests be indispensable. Objective: To describe and assess the advantages and disadvantages of a combined strategy of methylation-specific triple polymerase chain reaction (PCR)and capillary electrophoresis for the molecular diagnosis of the fragile X syndrome, seeking low cost, feasibility, reproducibility, and sensibility. Methods: 43 blood samples were collected from patients with cognitive deficit and their mothers, when indicated. Such subjects presented a positive cytogenetic exam, phenotype and/or familiar history suggestive of the fragile X syndrome. After DNA extraction, capillary electrophoresis with fluorescent markers, treatment with sodium bisulfite, and three methylation-specific PCR reactions were performed in each sample. Results: It was possible to determine the genotype in 29 patients: 23 (14 men and 9 women) presented alleles with normal size and six (all male) had them in the complete mutation range. In other six female samples, it was possible to determine an allele in the normal range and another altered; nevertheless, without differentiation between the pre-mutation or complete mutation ranges. In the other eight samples (five men and threewomen), it was not possible to establish the genotype. Conclusions: The suggested technique does a patient?s screening, but it has some disadvantages such as non-satisfying results been seen with the reactions for methylated alleles and analysis of the PCRs tracks with three primers being difficult and dependent on the observer.


Subject(s)
Humans , Electrophoresis, Capillary , Pathology, Molecular , Fragile X Syndrome/diagnosis , Fragile X Syndrome/drug therapy
8.
Rev. Soc. Psiquiatr. Neurol. Infanc. Adolesc ; 23(2): 93-103, ago. 2012. ilus, tab
Article in Spanish | LILACS | ID: lil-677246

ABSTRACT

Resumen. El Síndrome X Frágil (SXF) constituye la causa más frecuente de retraso mental hereditario y autismo. Los individuos con mutación completa (MC) presentan alteraciones clínicas que incluyen: déficit cognitivo y atencional, hiperactividad, autismo y problemas emocionales. Los portadores de premutación (PM) pueden afectarse del síndrome de temblor y ataxia asociado a X frágil (FXTAS); el 30 por ciento de las mujeres con PM presentan insuficiencia ovárica prematura(FXPOI). Cuando un individuo presenta una MC es frecuente encontrar otros familiares afectados. El fenotipo al nacer no es evidente, se sugiere que debe hacerse el diagnóstico entre los35-37 meses, sin embargo, la edad de diagnóstico en Chile es en promedio de 8 +/- 5.8 años. El centro de diagnóstico, tratamiento y seguimiento de pacientes con síndrome X frágil (CDTSXF)es un centro multidisciplinario, que incluye diagnósticos moleculares, genetistas médicos, asesoramiento genético, neurólogos, terapeutas ocupacionales, fonoaudiólogo, evaluaciones nutricionales y psicológicas para las familias afectadas. Desde el año 2010 hemos asistido a 28familias y detectado un número significativo de afectados debido a la detección en cascada. Se ha diagnosticado a 63 probandos, 57 MC y ocho mosaicos de MC/PM. Entre las madres portadoras 37 son PM y dos presentaron una MC. En 9/28 familias había un adulto mayor con FXTAS, diez familias presentaron mujeres con FXPOI. 41/63 probandos han participado denle el protocolo multidisciplinario del CDTSXF. Los resultados de este enfoque multidisciplinario nos motiva a seguir trabajando en mejorar el comportamiento y desarrollo cognitivo de los pacientes y atender las principales necesidades de las familias afectadas.


Fragile X Syndrome (FXS) is the most common inherited form of mental retardation and a leading known cause of autism. Individuals with a full mutation (FM) present disabilities including: cognitive and attention deficit, hyperactivity, autism, and other emotional problems. Carriers of a premutation (PM) may be affected by fragile X associated tremor/ataxia syndrome (FXTAS) and primary ovarian insufficiency (FXPOI) in 30 percent of PM women. Therefore, multigenerational family involvement is commonly found when a proband is diagnosed with a FXS mutation. FXS has no obvious phenotype at birth, it is suggested that the diagnosis should be made at 35-37 months; the age of diagnosis in Chile is on average 8+/-5.8 yo. The center for diagnosis, treatment and monitoring of patients with fragile X syndrome (CDTTRABAJOMFXS), is a multidisciplinary center that includes molecular testing, medical geneticists, genetic counseling, neurologists, occupational therapists, physical therapists, and nutritional and psychological interventions to families with an FM proband. Since 2010, we have assisted 28 families with a total of 63 diagnosed probands using specific PCR and Southern blot tests. Among them, 57 had a FM and eight had a mosaic FM/PM. Among the mothers 37 are PM carriers and two presented a FM. An older adult with FXTAS was present in 9/28 families; ten families presented women with FXPOI. A significant number of affected family members have been detected through cascade screening. Among the probands 41 of 63 have received some of the multidisciplinary diagnostic and interventions. The results of this multidisciplinary work allow us to put forward more effort towards improving behavior and cognitive development of patients as well as trying to solve families’ main needs.


Subject(s)
Humans , Male , Female , Child , Patient Care Team , Fragile X Syndrome/diagnosis , Fragile X Syndrome/therapy , Clinical Protocols , Cognition Disorders , Early Intervention, Educational , Fragile X Mental Retardation Protein , Language Disorders , Mutation , Nutritional Status , Occupational Therapy , Speech, Language and Hearing Sciences , Fragile X Syndrome/genetics
10.
Arq. neuropsiquiatr ; 68(5): 791-798, Oct. 2010. ilus, tab
Article in English | LILACS | ID: lil-562811

ABSTRACT

FXTAS (Fragile X-associated tremor and ataxia syndrome) is a late- onset neurodegenerative disorder affecting mainly men, over 50 years of age, who are carriers of the FMR1 gene premutation. The full mutation of this gene causes the fragile X syndrome (FXS), the most common cause of inherited mental retardation. Individuals affected by FXTAS generally present intention tremor and gait ataxia that might be associated to specific radiological and/or neuropathological signs. Other features commonly observed are parkinsonism, cognitive decline, peripheral neuropathy and autonomic dysfunction. Nearly a decade after its clinical characterization, FXTAS is poorly recognized in Brazil. Here we present a review of the current knowledge on the clinical, genetic and diagnostic aspects of the disease.


A FXTAS (síndrome de tremor e ataxia associada ao X frágil) é uma doença neurodegenerativa de início tardio que afeta principalmente homens acima dos 50 anos de idade, portadores de pré-mutação do gene FMR1. A mutação completa desse gene é responsável pela síndrome do cromossomo X frágil (SXF), a causa mais comum de deficiência mental herdada. Indivíduos afetados pela FXTAS geralmente apresentam tremor de intenção e ataxia de marcha que podem estar associados a sinais radiológicos ou neuropatológicos específicos. Outras características comumente observadas são parkinsonismo, declínio cognitivo, neuropatia periférica e disfunções autonômicas. Quase uma década após sua caracterização clínica, a FXTAS é mal conhecida por médicos no Brasil. Esta revisão apresenta o conhecimento atual sobre os aspectos clínicos, genéticos e diagnósticos da síndrome.


Subject(s)
Animals , Humans , Male , Middle Aged , Ataxia , Fragile X Syndrome , Fragile X Mental Retardation Protein/genetics , Tremor , Ataxia/diagnosis , Ataxia/drug therapy , Ataxia/genetics , Fragile X Syndrome/diagnosis , Fragile X Syndrome/drug therapy , Fragile X Syndrome/genetics , Magnetic Resonance Imaging , Tremor/diagnosis , Tremor/drug therapy , Tremor/genetics
11.
Asunciòn; IPS/UCA; 00002009. 46 p. (Prevalencia del Sìndrome de fragilidad en adultos mayores del consultorio externo del hospital Buongermini en noviembre 2009).
Monography in Spanish | LILACS, BDNPAR | ID: biblio-1018675

ABSTRACT

El estado de fragilidad es un sìndrome clìnico,biològico y psicosocial;y se puede dar definiciòn poniendo ènfasis en cualquiera de los antes mencionados puntos o en todos y se encuentran mas o menos estandarizados.


Subject(s)
Fragile X Syndrome/complications , Fragile X Syndrome/diagnosis , Fragile X Syndrome/genetics , Fragile X Syndrome/prevention & control , Paraguay
12.
Rev. méd. Chile ; 136(12): 1542-1551, dic. 2008. ilus, tab, graf
Article in Spanish | LILACS | ID: lil-508907

ABSTRACT

Background: Mental retardation or intellectual disability affects 2 percent ofthe general population, but in 60 percent to 70 percent of cases the real cause ofthis retardation is not known. An early etiologic diagnosis of intellectual disability can lead to opportunities for improved educational interventions, reinforcing weak aáreas and providing a genetic counseling to the family Aim: To search genetic diseases underíying intellectual disabilities of children attending a special education school. Material and methods: A clinical geneticist performed the history and physical examination in one hundred and three students aged between 5 and 24 years (51 males). A blood sample was obtained in 92 of them for a genetic screening that included a standard karyotype, fragile X molecular genetic testing and search for inborn errors of metabolism by tándem mass spectrometry. Results: This approach yielded an etiological diagnosis in as much as 29 patients. Three percent of them had a fragile X syndrome. Inborn errors of metabolism were not detected. Conclusions: This type of screening should be done always in children with intellectual disability to establish an etiological diagnosis.


Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Young Adult , Cytogenetic Analysis/methods , Genetic Testing/methods , Intellectual Disability/genetics , Mutation/genetics , Education, Special , Fragile X Syndrome/diagnosis , Fragile X Syndrome/genetics , Karyotyping , Severity of Illness Index , Young Adult
13.
Article in English | WPRIM | ID: wpr-69841

ABSTRACT

The purposes of this study were to present DNA analysis findings of our case series of fragile X syndrome (FXS) based on methylation-specific polymerase chain reaction (MS-PCR), PCR, and Southern blotting alongside developmental characteristics including psychological profiles and to review the literature on FXS in Korea. The reports of 65 children (male:female, 52:13; age, 6.12+/-4.00 yrs) referred for the diagnosis of FXS over a 26-months period were retrospectively reviewed for the identification of full mutation or premutation of fragile X mental retardation 1 (FMR1). Among the 65 children, there were 4 boys with full mutation, and one boy showed premutation of FMR1, yielding a 6.15% positive rate of FXS. All 4 children with full mutation showed significant developmental delay, cognitive dysfunction, and varying degrees of autistic behaviors. The boys with premutation showed also moderate mental retardation, severe drooling, and behavioral problems as severe as the boys with full mutation. Thirteen articles on FXS in Korea have been published since 1993, and they were reviewed. The positive rate of FXS was in the range of 0.77-8.51%, depending on the study groups and the method of diagnosis. Finally, the population-based prevalence study on FXS in Korea is required in the near future.


Subject(s)
Child , Child, Preschool , Female , Fragile X Mental Retardation Protein/genetics , Fragile X Syndrome/diagnosis , Humans , Infant , Korea/epidemiology , Male , Mutation , Prevalence
14.
Rev. Méd. Clín. Condes ; 18(4): 318-323, oct. 2007. tab
Article in Spanish | LILACS | ID: lil-475844

ABSTRACT

La enfermedad psiquiátrica es un serio problema de salud con costos importantes para los individuos, sus familias y la sociedad. El por qué se produce aún no se entiende a cabalidad; a pesar de la enorme cantidad de esfuerzos de investigación, se reconoce que un subconjunto de individuos presenta problemas psiquiátricos secundarios a síndromes genéticos. La investigación de estos desórdenes entrega información en relación con las bases moleculares y bioquímicos para una mejor comprensión del origen y también para desarrollar tratamientos específicos. Estos avances en la investigación, pueden tener importantes aplicaciones para la comunidad psiquiátrica en general. Ello queda bien ejemplificado con el síndrome de X Frágil, para el cual la teoría de la mGluR ofrece prometedoras vías de tratamiento para el autismo, la ansiedad y la hiperactividad. Sin embargo, la identificación de dichos individuos no siempre es fácil. Un enfoque sistemático puede aumentar de manera significativa los resultados diagnósticos y constituir un hito en el tratamiento de las psicopatologías.


Subject(s)
Humans , Psychopathology , Fragile X Syndrome/diagnosis , Mental Disorders/genetics , Diagnosis, Differential , Genetic Predisposition to Disease , Risk Factors
15.
Rev. chil. tecnol. méd ; 27(1): 1339-1346, jul. 2007. ilus, graf
Article in Spanish | LILACS | ID: lil-474858

ABSTRACT

El síndrome Xq frágil (SXF) es una causa frecuente de retraso mental (RM); se estima que uno de cada 4.000 varones y una década 6.000 mujeres lo presentan. Clínicamente los individuos afectados se caracterizan por presentar déficit intelectual y cognitivo, déficit de lenguaje, macroorquidismo, fascie alargada y orejas prominentes, entre otras dismorfias faciales. A nivel molecular es posible distinguir fundamentalmente dos tipos de alelos mutados: premutacion y mutación completa, las cuales corresponden a amplificación del trinucleótido CGG localizado en el primer exón del gen FMR1; las premutaciones presentan entre 52 y 200 repetidos y las mutaciones completas sobre 200 CGG, con hipermetilación de la región promotora del gen FMR1 e inhibición de la expresión de la proteína FMRP, causante del RM y dismorfias características de este síndrome. Desde que se identifico la mutación en 1991, la pesquisa de pacientes afectados se inicia por el examen clínico y luego el análisis citogenetico clásico y el test de screening basado en PCR para individuos varones y análisis molecular directo del gen FMR 1 por Southern Blot con la sonda Stb 12.3 para pacientes mujeres; los varones que presentan un PCR alterado deben ser confirmados por Southern Blot. El PCR debe ser usado como método de screening solo en varones con RM, sin historia familiar; es un sensible, rápido, de bajo costo y permite determinar el numero de repetidos CGG. Proponemos el uso conjunto de estos métodos para optimizar el estudio molecular directo del gen FMR1 y establecer un protocolo mas eficiente en la pesquisa de afectados, el estudio de familiares a riesgo y el consejo genético adecuado.


Subject(s)
Male , Female , Humans , Cytogenetic Analysis/methods , RNA-Binding Proteins , Fragile X Syndrome/diagnosis , Fragile X Syndrome/genetics , Blotting, Southern , Folic Acid Deficiency/complications , Gene Amplification , Mutation , Polymerase Chain Reaction , Trinucleotide Repeats/genetics , Intellectual Disability/genetics
16.
Rev. cuba. invest. bioméd ; 26(1)ene.-mar. 2007.
Article in Spanish | LILACS | ID: lil-478645

ABSTRACT

Se efectuó una revisión sobre el síndrome frágil X, del cual en Cuba no existían reportes desde el punto de vista poblacional, hasta la realización del estudio psicopedagógico, social y clínico genético de las personas con retraso mental; mediante el cual pudo detectarse un total de 75 personas con defectos del gen FMR-1, que es el gen relacionado con esta enfermedad. Es un síndrome causado en la gran mayoría de los casos por la amplificación o mutación dinámica de las repeticiones del trinucleótido citosina-guanina-guanina (CGG) en la región promotora del gen FMR-1. La traducción de este gen da lugar a una proteína denominada FMRP. Se plantea que la ausencia o deficiencia de esta proteína ocasiona modificaciones de la actividad neuronal. Hoy día no hay cura para el síndrome frágil X, aunque se están desarrollando experimentos basados tanto en la terapia como la ingeniería genética, consistentes en reproducir la carencia de la proteína causante de la enfermedad. El tratamiento médico se limitará a reducir y palear todos los síntomas que pueden observarse en este síndrome. La temprana identificación del síndrome frágil X, resulta muy beneficiosa para los padres y la familia del paciente; pues reduce el impacto psicológico inicial y propicia que se apliquen programas de intervención precoz; proporcionando una mejor comprensión de la historia natural de la enfermedad y el estudio genético entre otros aspectos.


Subject(s)
Fragile X Syndrome/diagnosis
17.
Bahrain Medical Bulletin. 2007; 29 (2): 71-73
in English | IMEMR | ID: emr-81962

ABSTRACT

The relationship between primary and secondary care is not dichotomous. It's an extended spectrum relation, with no start and accordingly it never ends. Both settings contribute uniquely to the integrated delivery of health care. The type of interface, therefore, should not be colliding and the conflict seen in some health care settings are really arbitrary and artificial. Nevertheless, different health systems around the world through history have experienced an everlasting conflicts and controversies. Ways to recover and repair the gap have been going ever since. The vital role of primary care cannot be ignored or overlooked; it has become an integral part of all medical disciplines. Thus it is crucial to develop an understanding between primary and secondary care. This paper outlines the causes of conflicts between the two disciplines and the probable ways for resolution


Subject(s)
Humans , Male , Fragile X Syndrome/diagnosis , Comorbidity
18.
Rev. chil. pediatr ; 77(1): 34-42, feb. 2006. ilus, tab, graf
Article in Spanish | LILACS | ID: lil-469642

ABSTRACT

Introducción: El síndrome de X frágil (SXF) es una causa frecuente de retraso mental (RM), se presenta en 1 de 4 000 hombres y en 1 de 8 000 mujeres. A nivel molecular existen principalmente tres tipos de alteraciones: premutación, mutación completa y mosaicos, todas las cuales corresponden a amplificación del trinucleótido CGG localizado en el primer exón del gen FMR1: las premutaciones presentan entre 52 y 200 repetidos; las mutaciones completas, sobre 200 CGG, presentan hipermetilación de la región promotora del gen FMR1 e inhibición de la expresión de la proteína FMRP, causante del RM y dismorfias características de este síndrome. Los mosaicos presentan mutación completa y premutación o metilación parcial del gen FMR1. Los pacientes con SXF son diagnosticados clínicamente según un protocolo de tamizaje que considera 15 características clínicas que entrega un puntaje máximo de 30 puntos en individuos afectados. Objetivo: Definir criterios clínicos específicos para población chilena que ayuden a identificar a los individuos que deban ser sometidos a estudios moleculares confirmatorios de SXF. Pacientes y Método: Se consideraron 99 pacientes varones referidos al INTA por presentar retraso mental y características clínicas sugerentes del SXF; a todos se les realizó evaluación clínica utilizando el protocolo descrito por Buttler y estudio molecular con análisis directo del gen FMR1 por Southern blot. Resultados: 23 de los 99 pacientes estudiados presentaron una mutación en FMR1 y puntaje clínico entre 16 y 27 puntos; los 76 casos restantes con puntajes clínicos entre 10 y 26 puntos, no presentaron mutación en el gen FMR1. Se evaluaron las características clínicas en ambos grupos y se observó que 4 de ellas se asocian significativamente a la mutación, siendo tres de ellas independientes de la edad de los pacientes. Conclusiones: Con estos resultados y a fin de optimizar el estudio molecular directo del gen FMR1, proponemos que el criterio de selección de pacientes sea a través del examen clínico y que todo individuo con puntaje ³ 15 puntos debe ser sometido al estudio molecular.


Subject(s)
Humans , Male , Infant , Child, Preschool , Child , Adolescent , Adult , Genetic Testing , Intellectual Disability/genetics , Fragile X Syndrome/diagnosis , Fragile X Syndrome/genetics , Blotting, Southern , Chile , Trinucleotide Repeat Expansion/genetics , Genetic Markers , Methylation , Molecular Diagnostic Techniques , Mutation/genetics , Sex Factors
19.
Genet. mol. res. (Online) ; 5(3): 448-453, 2006. tab, graf
Article in English | LILACS | ID: lil-441039

ABSTRACT

Fragile X syndrome is one of the most frequent causes of mental retardation. Since the phenotype in this syndrome is quite variable, clinical diagnosis is not easy and molecular laboratory diagnosis is necessary. Usually DNA from blood cells is used in molecular tests to detect the fragile X mutation which is characterized by an unstable expansion of a CGG repeat in the fragile X mental retardation gene (FMR1). In the present study, blood and buccal cells of 53 mentally retarded patients were molecularly analyzed for FMR1 mutation by PCR. Our data revealed that DNA extraction from buccal cells is a useful noninvasive alternative in the screening of the FMR1 mutation among mentally retarded males.


Subject(s)
Humans , Male , Child, Preschool , Child , Adolescent , Adult , DNA , Fragile X Mental Retardation Protein/genetics , Fragile X Syndrome/diagnosis , Genetic Testing , Mouth Mucosa/chemistry , Mutation/genetics , Feasibility Studies , Fragile X Syndrome/genetics , Polymerase Chain Reaction
20.
Botucatu; s.n; 2006. 132 p. tab, ilus.
Thesis in Portuguese | LILACS | ID: lil-468608

ABSTRACT

A Síndrome do cromossomo X frágil (SXF) é a segunda maior causa de deficiência mental conhecida, afetando cerca de 1 em 4000 nascidos vivos, afetando a todas as populações e todos os grupos étnicos. A SXF apresenta um variado espectro de envolvimento, variando de problemas emocionais ou de aprendizado leves, até todos os níveis de deficiência mental. Os achados clínicos são consistentes mas não exclusivos, fato este que muitas vezes torna difícil seu reconhecimento através do exame físico. A SXF é, em hipótese, devida à ausência do produto gênico de FMR1. O mecanismo da mutação que dá origem à sindrome em praticamente a totalidade dos casos é a variação do número de cópias de uma repetição instável de trinucleotídeos CGG na extremidade 5 não traduzida do gene FMR1, e que tende a aumentar a cada geração, principalmente através das meioses femininas. O que ocorre é a metilação das repetições expandidas correlacionadas com a regulação da transcrição de FMR1. O presente trabalho teve por objetivo analisar a segregação do gene FMR1 em uma grande genealogia com 325 indivíduos, comparar os achados clínicos, psicológicos, fonoaudiológicos e moleculares entre os indivíduos afetados e não afetados pela lololoo na genealogia. Foram realizados exames físicos em 98 indivíduos, testes psicológicos em 65, fonoaudiológicos em 82 e moleculares em 86. Foram confirmados 8 casos de mutação completa (FM) e 7 casos de pré-mutação (PM) no gene FMR1 em 6 dos 63 núcleos familiares. A análise estatística nesta genealogia revelou uma associação entre a presença de PM no gene FMR1 e o comprometimento fonoaudiológico, e associação entre a FM no gene FMR1 e presença de palato alto, deficiência mental e comprometimento fonoaudiológico


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Genetics, Medical , Fragile X Syndrome/diagnosis , Fragile X Syndrome/etiology , Fragile X Syndrome/genetics , Fragile X Syndrome/psychology , Chromosome Disorders/genetics
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