Ethnic variation of the C677T and A1298C polymorphisms in the methylenetetrahydrofolate-reductase (MTHFR) gene in southwestern Mexico.

In this study, we examined the distribution of genotype and allele frequencies of the C677T and A1298C polymorphisms in the methylenetetrahydrofolate-reductase gene (MTHFR) in two ethnic groups in the State of Guerrero, Mexico, which were compared with those of the Mestizo population of the region. A comparative study was conducted on 455 women from two ethnic groups and a group of Mestizo women of the State of Guerrero, Mexico: 135 Nahuas, 124 Mixtecas, and 196 Mestizas. Genotyping of both polymorphisms were performed by using polymerase chain reaction-restriction fragment length polymorphism methods. We found that the 677TT genotype was more frequent in Nahua and Mixteca women compared to Mestiza women (P = 0.008), and the most prevalent genotype in both ethnic groups was the 1298AA genotype (P < 0.001). We also compared the 677T allele frequency obtained from the groups studied with the frequencies reported in other ethnic groups of Mexico (Huichol, Tarahumara, and Purepecha). There were significant differences between the three ethnic groups compared to Nahuas (Huicholes, P = 0.004; Tarahumaras, P < 0.001; Purepechas, P = 0.042). Our results indicated significant differences in the frequencies of the C677T and A1298C polymorphisms between the two ethnic groups and the Mestizo population of the State of Guerrero. In addition, we found strong differences with other ethnic groups in Mexico. These results could be useful for future studies investigating diseases related to folate metabolism, and could help the government to design specific nutrition programs for different ethnic groups.

The integration of HR-HPV increases the expression of cyclins A and E in cytologies with and without low-grade lesions.

BACKGROUND: Cyclin-A and cyclin-E are regulators of G1-S phase of normal cell cycle. Integration of human papilloma virus high-risk (HR-HPV) could alter this mechanism, and its overexpression has been associated with poor prognosis in cervical cancer. AIM: To determine the expression of cyclin-A and cyclin-E, types of HR-HPV and physical state of DNA in cytologies with the diagnosis of low-grade squamous intraepithelial lesion (LSIL). MATERIALS AND METHODS: 115 cytological specimens in liquid base (liquid-PREP(™)) were analyzed. 25 specimens were with no signs of SIL (NSIL) and without HPV; 30 with NSIL with low-risk HPV (LR-HPV); 30 with NSIL with HR-HPV; and 30 with both LSIL and HR-HPV. The expression of cyclins was evaluated by immunocytochemistry; and the detection of viral DNA was done by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLPs) for genotyping or sequencing of HPV. The physical state of HPV was evaluated by in situ hybridization with amplification with tyramide. RESULTS: In the cytologies NSIL with LR-HPV, the expression of cyclin-A and cyclin-E was found respectively in 23.3% and 33.3% of the specimens. Among the specimens of NSIL with HR-HPV, 33.3% expressed cyclin-A and 40% cyclin-E, while 100% of the LSILs expressed the 2 cyclins. On the other hand, 100% of the samples NSIL with LR-HPV presented an episomal pattern. Of the specimens of NSIL with HR-HPV, 56.6% exhibited an episomal pattern, 23.3% integrated and 20%, mixed. Among the LSILs, 90% were mixed and 10% integrated. CONCLUSIONS: The cyclins A and E are present in the LSILs that occur predominantly in mixed state in the presence of HR-HPV.

Temporary morphological changes in plus disease induced during contact digital imaging.

OBJECTIVE: To compare and quantify the retinal vascular changes induced by non-intentional pressure contact by digital handheld camera during retinopathy of prematurity (ROP) imaging by means of a computer-based image analysis system, Retinal Image multiScale Analysis. METHODS: A set of 10 wide-angle retinal pairs of photographs per patient, who underwent routine ROP examinations, was measured. Vascular trees were matched between 'compression artifact' (absence of the vascular column at the optic nerve) and 'not compression artifact' conditions. Parameters were analyzed using a two-level linear model for each individual parameter for arterioles and venules separately: integrated curvature (IC), diameter (d), and tortuosity index (TI). RESULTS: Images affected with compression artifact showed significant vascular d (P<0.01) changes in both arteries and veins, as well as in artery IC (P<0.05). Vascular TI remained unchanged in both groups. CONCLUSIONS: Non-adverted corneal pressure with the RetCam lens could compress and decrease intra-arterial diameter or even collapse retinal vessels. Careful attention to technique is essential to avoid absence of the arterial blood column at the optic nerve head that is indicative of increased pressure during imaging.

Retinopathy of prematurity as a major cause of severe visual impairment and blindness in children in schools for the blind in Guadalajara city, Mexico.

AIM: To determine the causes of blindness in students attending schools for the blind in Guadalajara city, Mexico and to assess the availability of screening for retinopathy of prematurity (ROP) in local neonatal intensive care units. METHODS: Information on causes of blindness was obtained by interview with parents and teachers, review of records and examination. Causes of visual loss in children with a distance visual acuity of <6/60 (ie, severely visually impaired or blind) were determined and classified according to the WHO's classification system for children. RESULTS: Of 153 children in the two participating schools, 144 were severely visual impaired or blind. Their ages ranged from 4 months to 15 years and 58% were female. ROP was the most common cause of visual loss (34.7%), followed by optic nerve lesions (17.4%) and glaucoma (14.6%). 25/59 (42.3%) children aged 0-4 years were blind from ROP compared with 6/32 (18.8%) children aged 10-15 years. 78% of children blind from ROP had psychomotor delay and less than half (46%) had not received treatment for ROP. All five privately funded neonatal intensive care units in the city regularly screen for ROP compared with only four of the 12 units in the public sector. CONCLUSIONS: ROP is the leading cause of blindness in children in Mexico despite national guidelines being in place. Health policies promoting primary prevention through improved neonatal care need to be implemented. Advocacy is required so that the time ophthalmologists spend screening and treating ROP is included in their job description and hence salaried.

[Activities of the Brazilian Senate in the area of public health, 1995 and 1996]. / Atividades do Senado Federal brasileiro na área de saúde pública, 1995 e 1996.

The objective of this study was to identify and describe the actions of Brazilian senators in the field of public health in 1995 and 1996. We also sought to determine if profession, regional background, or political party influenced the senators' actions. The actions were divided into three types: legislative (proposal and review of bills and petitions); supervisory (information requests to the executive branch and the establishment of inquiry committees and other special committees); and parliamentary (speeches). The data were collected from two databases maintained by the Senate, namely MATE and DISC. Of the 89 senators who were in office during the study period, 76 were involved with public health issues. Of the total of 667 actions studied, there was a predominance of speeches (43% of all actions), most of them responding to news reported by regional or national media. Supervisory activities were limited (5% of all actions were information requests). The subjects dealt with most frequently were health policies (30%), drugs (9%), regulation of health professions (8%), disease control (7%), and worker health (6%). Concerning the professions of the senators, the most frequent categories were physicians, teachers, and journalists. The senators representing the North and Northeast regions performed 62% of the actions and were involved with almost all the health subjects. Although 43% of the actions were carried out by liberal and right-wing senators, the senators from socialist and labor parties had a stronger proportional participation (both in terms of senators involved and actions performed). It is interesting to note that socialist and labor senators showed minimal involvement in the issue of worker health. The predominance of speeches as a prevalent type of action, the limited and disjointed scope of legislative actions, and, especially, the poor monitoring and control show the need for deep changes in the work process of the Senate's technical committees and, therefore, of the Senate's technical support unit.

Large epidemics of hemorrhagic fevers in Mexico 1545-1815.

In 1545, twenty-four years after the Spanish conquest of the Aztec empire, an epidemic of a malignant form of a hemorrhagic fever appeared in the highlands of Mexico. The illness was characterized by high fever, headache, and bleeding from the nose, ears, and mouth, accompanied by jaundice, severe abdominal and thoracic pain as well as acute neurological manifestations. The disease was highly lethal and lasted three to four days. It attacked primarily the native population, leaving the Spaniards almost unaffected. The hemorrhagic fevers remained in the area for three centuries and the etiologic agent is still unknown. In this report we describe, and now that more information is available, analyze four epidemics that occurred in Mexico during the colonial period with a focus on the epidemic of 1576 which killed 45% of the entire population of Mexico. It is important to retrieve such diseases and the epidemics they caused from their purely historical context and consider the reality that if they were to reemerge, they are potentially dangerous.

[Long-term prognosis in acute myocardial infarction]. / El pronóstico a largo plazo en el infarto agudo del miocardio.

The purpose of this communication is to identify the variables contributing to long-term morbidity and mortality in survivors of an acute myocardial infarction (AMI). The study comprises 5 years of follow up in 364 patients who were admitted to the coronary care unit during the acute episode. At the end of the study, 34.5% of the patients had some degree of incapacity due to angina, cardiac failure or both. There was a precise correlation between these and the degree of myocardial dysfunction or the size of the cardiac silhouette during the AMI. Sixty-seven patients suffered a cardiac death. The 5 year cumulative survival rate by life table analysis was 78.6% at the end of the study. The death rate was clearly greater during the initial six months (7%) and reached 10.5% at the end of the first year. In subsequent years the average annual death rate was 2.2%. Two-fifths of the patients died during a recurrent AMI, one-fifth in chronic cardiac failure and the remaining two-fifths experienced a sudden death. Age, a previous infarction, ventricular dysfunction during the acute episode and a recurrent AMI resulted in a reduced possibility of post-hospital survival. Sex of the patients and ECG location of the AMI had no influence in mortality. The analysis of late deaths due to AMI suggests that mechanical dysfunction, residual ischemia and electrical instability are important factors in its determination. The data indicate that there may be considerable potential to reduce the cardiac death rate in the post-hospital phase of AMI.

Área valvar mitral e capacidade física determinada pelo teste cicloergométrico em pacientes portadores de estenose mitral / Mitral valve area and physical capacity determined by cycloergometric test in patients with mitral stenosis

Os autores estudaram 18 pacientes portadores de estenose mitral, relacionando a capacidade fisica determinada pelo teste cicloergometrico com a area valvar medida durante a cirurgia e com parametros hemodinamicos obtidos pelo cateterismo cardiaco realizado em 8 pacientes. Todos valvopatas apresentaram baixos valores para a capacidade fisica independente da area valvar mitral, da atividade profissional e do uso terapeutico de digoxina. Sugere-se, como conclusao, que o teste cicloergometrico, para os pacientes com estenose mitral estudados, nao trouxe contribuicao para a indicacao da correcao cirurgica da estenose valvar, uma vez que nao foram obtidas relacoes entre a area util valvar mitral, a capacidade funcional, e, entre esta e os dados hemodinamicos obtidos pelo cateterismo cardiaco venoso

Prevalência de bloqueios de ramos e fasciculares esquerdos do feixe de His na cardiopatia chagásica / Prevalence of bundle-branch and left fascicular blocks in the bunde of His in Chagas' cardiomyopathy

Trezentos eletrocardiogramas de portadores de cardiopatia chagasica, registrados no Hospital das Clinicas da Faculdade de Medicina de Riberao Preto da USP foram examinados. Em 174 foi observado disturbio intraventricular da conducao do estimulo. Destes, 72 apresentavam bloqueio isolado de ramo direito do feixe de His. A associacao de bloqueio de ramo direito e divisional, foi visto em 19 casos. O bloqueio divisional postero-inferior esquerdo foi encontrado em 3 casos e o completo do ramo esquerdo, isoladamente, em 11 pacientes.Usando-se a classificacao funcional das cardiopatias e o indice cardiotoracico, foi possivel verificar que os disturbios da conducao predominam em situacoes mais graves e em coracoes de maiores dimensoes. Ha forte sugestao de que o bloqueio divisional anterosuperior e a forma mais grave destas alteracoes, representando prognostico mais serico