Evaluación de la fatiga en pacientes con artritis psoriásica y su asociación con otras variables de la enfermedad / Evaluation of fatigue in patients with psoriatic arthritis and association with other variables of the disease

Objetivo: Evaluar la frecuencia de fatiga en pacientes con APs y su asociación con otras variables de la enfermedad. Métodos: Pacientes ≥18 años con diagnóstico de APs según criterios CASPAR. Se evaluó fatiga, rigidez matinal, dolor, actividad de la enfermedad por el paciente y el médico por escala visual graduada (EVG). Se completaron los autocuestionarios ASQoL, PsAQoL, HAQ-A, BASFI y BASDAI. Se calcularon los índices compuestos DAS28, DAPSA y CPDAI. Resultados: Se incluyeron 112 pacientes. La mediana de fatiga fue de 3 cm (RIC 0-6). Fatiga tuvo aceptable correlación con BASDAI (r:0,63), pregunta Nº1 del BASDAI (r:0,48), DAS28 (r:0,45), DAPSA (r:0,5), HAQ-A (r:0,42), PsAQoL (r:0,49), ASQoL (r:0,48), BASFI (r:0,47), EVG de dolor (r:0,48) y de rigidez matinal (r:0,55). El 30% de nuestra cohorte presentó fatiga definida como EVG ≥6 cm. En el análisis de regresión lineal múltiple, la actividad de la enfermedad articular periférica (DAPSA coef β: 0,36, p=0,0001) y la calidad de vida (PsAQoL coef β: 0,27, p=0,009) se asociaron significativamente a fatiga. Conclusión: El 30% de nuestra cohorte de pacientes presentó EVG de fatiga ≥6 cm. La fatiga se asoció independientemente con la actividad de la enfermedad articular periférica y la calidad de vida.

Objective: To evaluate the frequency of fatigue in patients with PsA and its association with other disease variables. Methods: We included patients ≥18 years of age with PsA according to CASPAR criteria. Fatigue, morning stiffness, pain and global activity by both patients and physicians were assessed using visual analogue scales (VAS). ASQoL, PsAQoL, HAQ-A, BASFI and BASDAI were completed. DAS28, DAPSA and CPDAI were calculated. Results: We included 112 patients. Median fatigue VAS was 3 cm (IQR 0-6). Fatigue had an acceptable correlation with BASDAI (r:0.63), BASDAI question Nº1 (r:0.48), DAS28 (r:0.45), DAPSA (Rho:0.5), HAQ-A (Rho:0.42), PsAQoL (Rho:0.49), ASQoL (Rho:0.48), BASFI (Rho:0.47), pain (Rho:0.48) and morning stiffness (Rho:0.55) and a regular correlation with CPDAI (Rho:034). 30% of our cohort had fatigue, as defined by a VAS equal or greater than 6 cm. In multiple linear regression analysis, adjusting for sex, age and disease duration, peripheral disease activity (DAPSA βcoeff: 0.36, p=0.0001) and quality of life (PsAQoL βcoeff: 0.27, p=0.009) were associated with fatigue. Conclusion: Prevalence of fatigue in this cohort was 30% and it was associated with greater peripheral disease activity and worse quality of life.

A combination of the F-box motif and kelch repeats defines a large Arabidopsis family of F-box proteins.

In the sequences released by the Arabidopsis Genome Initiative (AGI), we have discovered a new large gene family (48 genes as of July 2000). A detailed computational and biochemical analysis of the predicted gene products reveals a novel family of plant F-box proteins, where the amino (N)-terminal F-box motif is followed by four kelch repeats and a characteristic carboxy-terminal domain. F-box proteins are an expanding family of eukaryotic proteins, which have been shown in some cases to be critical for the controlled degradation of cellular regulatory proteins via the ubiquitin pathway. The F-box motif of the At5g48990 gene product, a member of the family, was shown to be functionally active by its ability to mediate the in vitro interaction between At5g48990 and ASK1 proteins. F-box proteins specifically recruit the targets to be ubiquitinated, mainly through protein-protein interaction modules such as WD-40 domains or leucine-rich repeats (LRRs). The kelch repeats of the family described here form a potential protein-protein interaction domain, as molecular modelling of the kelch repeats according to the galactose oxidase crystal structure (the only solved structure containing kelch repeats) predicts a beta-propeller. The identification of this family of F-box proteins greatly expands the field of plant F-box proteins and suggests that controlled degradation of cellular proteins via the ubiquitin pathway could play a critical role in multiple plant cellular processes.

[How to reduce the number of cesarean sections?]. / Que hacer para reducir el número de cesáreas?

The cesarean section (C) frequency has increased dramatically as high as 62%. This situation has been producing a real preoccupation in all the world as well as in México. Documented bibliography about this subject, is unquestionable. We feel that at this time there is a lack of punctuals strategies in order to reduce the high frequency of C. Our communication analyzes this problem in relation to antecedents, evolution and integrated general strategies in order to reduce the C rates. Special analysis and comments involve amnioinfusion, trials for vaginal deliveries in case of previous cesarean section, prostaglandins, and external version. With these actions, at the Antiguo Hospital Civil de Guadalajara we have achieved 10.8% of C. rates, without any increase in fetomaternal morbility and/or mortality.

[Research of toxoplasmosis by intradermal reaction in suspected cases]. / Investigación de la toxoplasmosis por intradermorreacción en casos sospechosos.

Toxoplasmosis was diagnosed in 5i,2% of 5000 patients and cohabitants with suspicions of several affections who were referred to the parasitology service of the "General Calixto García" Teaching Hospital from several provinces and regions of the country. The intradermoreaction test with toxoplasmin antigen was used in all of them. Results are exposed according to affections, sex, age and origin of the patients.