The S/S Genotype of the 5-HTTLPR (Serotonin-Transporter-Linked Promoter Region) Variant of the SLC6A4 Gene Decreases the Risk of Pre-Eclampsia.

Pre-eclampsia (PE) is a disorder characterized by hypertension in the second trimester of pregnancy that results from abnormal placentation affecting fetal development and maternal health. Previous studies have shown the role of serotonin (5-HT) that leads to poor placental perfusion, where S/S and S/L polymorphisms promote the solute carrier family 6 member 4 (SLC6A4) gene associated with the risk of developing changes in the microvasculature of the placenta. This study looked at the association between the gene variant 5-HTTLPR (serotonin-transporter-linked promoter region) of the SLC6A4 gene and the occurrence of PE. A total of 200 women were included: 100 cases (pregnant with PE) and 100 controls (pregnant without complications). Genotyping of the 5-HTTLPR variant was performed using polymerase chain reaction (PCR). Associations between the presence of the genetic variant of interest and PE and other clinical features were evaluated statistically. The frequencies of S/S, S/L, and L/L genotypes were 32%, 53%, and 15% for the cases and 55%, 25%, and 20% in the control group. Compared to the controls, the genotype frequencies S/S vs. S/L + L/L (recessive model) in the cases group were different (p = 0.002). The S/S genotype decreased the probability of PE (OR = 0.39, 95% IC: 0.22-0.69, p = 0.002) and PE with severity criteria (OR = 0.39, 95% IC: 0.17-0.91, p = 0.045). The 5-HTTLPR gene variant of the SLC6A4 gene modifies the risk of PE development among the studied population.

Security and Violence Perception of Medical Interns during Social Service Practice in Mexico.

The increase of insecurity levels in Mexico, as well as the fact that violence is a frequent experience among health personnel, motivated this study whose purpose was to evaluate the perception of security and violence that social service medical interns (SSMI) had on the institutions and localities where they carried out their social work and make visible the main types of violence to which they were exposed. This was a cross-sectional study, based on a perception survey self-administered to 157 SSMI from Zacatecas, in Mexico. A high proportion of the participants (75.8%) stated that they were victims of violence, describing 134 incidents; however, only 33.6% of SSMI made an official report. The reported incidents were related to organized crime (31.9%), verbal violence (20.6%), violence by the authorities (14.7%) and sexual harassment (11.8%). One hundred percent of the victims of sexual harassment were women (p = 0.039). According to the above, it is a priority to generate strategies to prevent and reduce the risk of exposure to the violence generated in the medical units and communities where SSMI carry out their activities as medical graduates, as well as, to efficiently process formal violence reports to promote a safe environment that favors the fulfillment of the practice of SSMIs in Mexico.

[Clinical-epidemiological profile of patients with suspicion of alimentary allergy in Mexico. Mexipreval Study]. / Perfil clínico-epidemiológico de pacientes con sospecha de alergia alimentaria en México. Estudio Mexipreval.

BACKGROUND: Adverse reaction to food has increased around the world in last years. Prevalence of food allergy raises between 2-4% in adults, and 6-8% in children. The clinical presentation is heterogeneous and varies from mild symptoms to anaphylactic reactions. Even the clinical history focused in the food is important; demonstration of allergen sensitization is mandatory. OBJECTIVE: To describe the profile of the patients with suspicion of food allergy and the regular clinical practice followed in Mexico. MATERIAL AND METHOD: An observational, descriptive, cross-sectional study was carried out from March 2013 to March 2014 using a convenience sample of allergic patients who were treated in the office, both private and public, of those physicians who seen food allergy patients. RESULTS: Clinical, epidemiological, diagnostic and therapeutic data were collected from 1,971 suspicious food allergic patients presenting for the first time in the departments of the researchers involved in the study. No difference was found in relation to gender. In relation to age, a bimodal distribution, with peaks at 2 and 35 years old, was found. A history of respiratory allergy was present in 75% of cases; 80% of patients had had any previous symptoms before seeking consultation and the most frequent clinical manifestations were cutaneous, 5% reported anaphylaxis. CONCLUSION: The foods involved in reactions change with age. The clinical presentation changes with the food, although the skin is the most frequently affected organ. Even if the suspicious were high, the confirmation with specific diagnostic tools is strongly recommended.

Antecedentes: las enfermedades alérgicas asociadas con alimentos se incrementan anualmente. Tienen una prevalencia de 2 a 4% en adultos y de 6 a 8% en niños. El cuadro clínico varía de síntomas leves hasta reacciones anafilácticas. El diagnóstico se basa en la historia clínica, pero debe demostrarse evidencia de sensibilización específica para el alergeno. Objetivo: conocer el perfil clínico-epidemiológico de los pacientes con sospecha de alergia alimentaria vistos en consultorios médicos (alergólogos y no alergólogos), así como la conducta diagnóstica y tratamiento habitual. Material y método: estudio observacional, transversal y descriptivo, efectuado en consultorios de médicos que atienden pacientes con alergia alimentaria en la República Mexicana durante un año natural de abril de 2013 a marzo de 2014, mediante un muestreo por conveniencia. Resultados: se realizaron 1,971 encuestas. No se encontró diferencia en relación con el género. En relación con la edad, se reportó una distribución bimodal, con picos a los 2 y 35 años de edad. Había antecedente de alergia respiratoria en 75% de los casos. El 80% de los pacientes tuvo algún síntoma antes de buscar atención y las manifestaciones clínicas más frecuentes afectaron la piel (57.1%). El 5% refirió haber padecido al menos un evento de anafilaxia. Conclusión: el tipo de alimento implicado cambia con la edad. La forma de manifestación clínica más frecuente fue la cutánea, pero varía con el tipo de alimento. Aun cuando la sospecha clínica sea alta, deben utilizarse métodos específicos que confirmen el diagnóstico.

Hepatitis recurrente / Relapsing hepatitis A

Introducción. La hepatitis A recurrente es una condición caracterizada por la reincidencia de los síntomas iniciales en una o más ocasiones, después de un episodio agudo de hepatitis viral, generalmente dentro de los 6 meses posteriores al inicio, presentándose en una pequeña proporción de casos, los pacientes se recuperan completamente. Caso Clínico. Se presenta el caso de un niño de 9 años de edad, con cuadro de 2 días de evolución, caracterizado por dolor abdominal, ataque al estado general y vómitos; presentando un día después ictericia, coluria y epistaxis. A la exploración física presentaba ictericia con hepatomegalia de 11 cm; la determinación de IgG e IgM anti-virus A fueron positivos. Se manejó con vitamina K y medidas generales; aparentemente, se recuperoó después de una semana, disminuyendo la hepatomegalia a 7 cm. Sin embargo, 3 semanas después se detectó nuevamente ictericia, coluria, acolia y hepatomegalia a 11 cm; estos hallazgos persisitieron por 12 semanas. Posterior al último episodio, el niño se recuperó completamente. Conclusión. Dos teorías pueden explicar la hepatitis A recurrente: infección viral continua o respuesta inmune alterada al agente. La hepatitis recurrente debe diferenciarse de una segunda infección causada por un virus diferente