Análisis de asociación de los polimorfismos -725C>G (rs1233334), -201G>A (rs1233333) y 14 bp deleción/inserción (14-pb del/ins) (rs66554220) del gen HLA-G en mujeres mexicanas con pérdida gestacional recurrente / Analysis of association of polymorphisms -725C >G ( rs1233334 ), -201G >A ( rs1233333 ) and 14 bp deletion / insert (14 - bp / ins ) ( rs66554220 ) of HLA -G gene mexican women with recurrent pregnancy loss

Antecedentes: El antígeno leucocitario humano (HLA)-G es una molécula inmunomoduladora que contribuye a la aceptación del feto semialogénico. Algunos polimorfismos de un solo nucleótido (SNP) en las regiones no codificantes del gen HLA-G inducen a la disminución de moléculas HLA-G, lo cual contribuye a complicaciones en el embarazo, tales como la preeclampsia o pérdida gestacional recurrente. Objetivo: Analizar la asociación de los polimorfismos -725C>G (rs1233334), -201G>A (rs1233333) y 14 bp deleción/inserción (14-pb del/ins) (rs66554220) del gen HLA-G en mujeres mexicanas con PGR. Métodos: Los polimorfismos -725C>G (rs1233334), -201G>A (rs1233333) y 14-pb del/ins (rs66554220) se identificaron por medio de PCR-SSOP (Polymerase Chain Reaction-sequence-specific oligonucleotide probe) y PCR (Polymerase Chain Reaction), respectivamente, en 58 mujeres con pérdida gestacional recurrente (> 2 abortos), sin factores de riesgo identificables y 56 mujeres fértiles no relacionadas (> 2 nacidos vivos). Resultados: El polimorfismo -725C>G (rs1233334) presentó diferencias significativas entre los grupos de estudio pero no se asoció con PGR (p=0,02601; OR=11,484; IC95 por ciento =0,617-213,659). Los polimorfismos -201G>A (rs1233333) y 14-pb del/ins (rs66554220) no se distribuyeron de manera diferente entre los grupos de estudio ni se asociaron con pérdida gestacional recurrente. Los polimorfismos analizados se encontraron en equilibrio de ligamiento (D'>0,3563; r²<0,1140). Conclusión. Este estudio sugiere que los polimorfismos -725C>G (rs1233334), -201G>A (rs1233333) y 14-pb del/ins (rs66554220) del gen HLA-G están en equilibrio de ligamiento y no influyen en el riesgo de pérdida gestacional recurrente en mujeres mexicanas.

Background: The human leukocyte antigen (HLA)-G is an important immunomodulatory molecule that contributes to the acceptance of the semi-allogeneic fetus. Some single nucleotide polymorphisms (SNP) in the noncoding regions of the HLA-G gene may influence the cellular levels of HLA-G, contributing to pregnancy complications such as preeclampsia or recurrent pregnancy loss. Objective: To analyze the association of -725C>G (rs1233334),-201G>A (rs1233333) and 14 bp deletion/insertion (14-bp del/ins) (rs66554220) polymorphisms in the HLA-G gene in Mexican women with RPL. Methods: -725C>G (rs1233334), -201G>A (rs1233333) and 14-bp del/ins (rs66554220) polymorphisms in the HLA-G gene were identified by PCR-SSOP (polymerase chain reaction-sequence-specific oligonucleotide probe) and PCR (polymerase chain reaction), respectively, in 58 women with recurrent pregnancy loss (> 2 miscarriages) without identifiable risk factors and 56 unrelated fertile women (> 2 live births). Results: -725C>G (rs1233334) polymorphism showed significant differences between the study groups but it was not associated with recurrent pregnancy loss (p=0.02601, OR=11.484; 95 percent CI=0.617-213.659). -201G>A (rs1233333) and 14-bp del/ins (rs66554220) polymorphisms were not distributed differently in study groups and not associated with RPL. Analyzed polymorphisms were in linkage disequilibrium (D' > 0.3563, r² < 0.1140). Conclusion: This study suggests that -725C>G (rs1233334), -201G>A (rs1233333) and 14-pb del/ins (rs66554220) in the HLA-G gene are in linkage equilibrium and do not influence the risk of recurrent pregnancy loss in Mexican women.

Necesidades de salud desde la perpectiva de los usuarios / Health needs from a clientïs perspective

Background: The perception of the population about their needs must be considered in health care planning. Aim: To describe health care needs from the perspective of potential clients of public health services. Material and methods: An enquiry to a representative sample of 202 dwellings, ascribed to a Family Health Service, was done. Subjects were asked about the health problems in their family and neighborhood. Twelve families from this sample were randomly chosen and interviewed about their health conception, needs and demands. Results: The mean age of subjects, per dwelling, was 31 years. Fifty percent were nuclear families and 6 percent were mono parental. Perceived problems were economical in 60 percent and health related in 12 percent. Eighty percent of health problems were related to addictions and violence. Interviewed subjects associated health with lack of services, with their experience with illness and pain and with a risk of social isolation and incommunication. Health care demands were referred to a better medical care. People declared needs in environmental hygiene, physical and mental health self care, food and jobs. Conclusions: Using this information, simple strategies could be implemented to cope with health care demands of the population