Assessment of the Relationship between Clinical Variants of Psoriasis and Killer Immunoglobulin-like Receptor (KIR) Genes: A Systematic Review with Meta-analysis.

BACKGROUND: Psoriasis (Ps) is an autoimmune dermatosis. Previous studies have shown an association between KIR genes and susceptibility to some clinical variants of Ps. Therefore, we conducted an exhaustive systematic review with meta-analysis to evaluate the relationship between KIR genes and susceptibility to clinical variants of Ps in the overall population and according to ethnicity. METHODS: According to PRISMA guidelines, we performed a systematic review through PubMed and Web of Science to identify relevant available scientific publications about KIR genes and Ps. The quality of the studies was evaluated using the Newcastle-Ottawa scale. Odds ratios (OR) and 95% confidence intervals (95%CI) were estimated using random and fixed effect models for the analyzed genes. Heterogeneity was tested using Cochran's Q-Statistic and I2, and the risk of bias was tested using the Begg test and Egger linear regression. RESULTS: A total of 10 case-control studies were included, comprising a variable number of KIR typified genes and psoriasis vulgaris (PsV) as the main clinical variant studied. In the total pooled results, the KIR2DS1 gene (OR = 1.518, p = .010, 95%CI: 1.105 to 2.086) was related to higher susceptibility to PsV, while the KIR2DS4 (OR = 0.563, p = .005, 95%CI: 0.376 to 0.842) and KIR3DL1 (OR = 0.602, p = .040, 95%CI: 0.370 to 0.977) genes were related to protection against PsV. CONCLUSION: This meta-analysis demonstrates that subjects that carry the KIR2DS1 gene could have a potential risk factor for the development of PsV. Conversely, KIR2DS4 and 3DL1 genes appear to confer protection against PsV.

Causas, curso clínico y desenlace de pacientes con estancia prolongada en la unidad de cuidados intensivos de un hospital de Ginecoobstetricia de la Ciudad de México / Causes, clinical course and outcome of patients with prolonged stay in the Intensive Care Unit of a Hospital of Obstetrics and Gynecology in Mexico City

Resumen OBJETIVO: Identificar las causas, curso clínico y el desenlace de las pacientes con estancia prolongada en la unidad de cuidados intensivos de un centro de atención ginecoobstétrica de tercer nivel. MATERIALES Y MÉTODOS: Estudio retrolectivo, transversal y descriptivo de serie de casos llevado a cabo en la unidad de cuidados intensivos de la Unidad Médica de Alta Especialidad Hospital de Ginecoobstetricia 3 del Centro Médico Nacional La Raza del Instituto Mexicano del Seguro Social, Ciudad de México, en pacientes admitidas entre enero de 2016 y diciembre de 2019. Solo se consultaron los expedientes de las pacientes con estancia prolongada definida: tiempo en días, con dos desviaciones estándar por encima de la media general. Se estudiaron los motivos de ingreso, causas que condicionaron la estancia prolongada y el desenlace. RESULTADOS: Se estudiaron 34 pacientes con estancia prolongada que representaron el 2.23% del total de casos de la unidad de cuidados intensivos. Motivos de ingreso: complicaciones del embarazo 20 de 34, complicaciones de la cirugía del aparato genitourinario 7 de 34 y también 7 de 34 con complicaciones quirúrgicas de tumores malignos pelvi-abdominales. La estancia prolongada en la unidad de cuidados intensivos, en promedio, fue de 11.99 ± 4.21 días, condicionada por reintervenciones por sangrado en 9 de 34 pacientes, lesión renal aguda 7 de 34, insuficiencia multiorgánica 5 de 34, descontrol hipertensivo 4 de 34, reintervenciones por infección 3 de 34, desempaquetamiento 3 de 34, ventilación mecánica 2 de 34 y cetoacidosis diabética 1 de 34. Dos pacientes fallecieron (hemorragia intraoperatoria urogenital n = 1 y sepsis de partida abdominal n = 1). CONCLUSIONES: Los casos con estancia prolongada representaron un pequeño porcentaje, las principales causas fueron multifactoriales y la frecuencia de mortalidad fue baja.

Abstract OBJECTIVE: To identify the causes, clinical course and outcome of patients with prolonged stay in the intensive care unit of a third level gyneco-obstetric care center. MATERIALS AND METHODS: Retrolective, cross-sectional, descriptive case series study conducted in the intensive care unit of the Unidad Médica de Alta Especialidad Hospital de Gineco-Obstetricia 3 del Centro Médico Nacional La Raza del Instituto Mexicano del Seguro Social, Mexico City, in patients admitted between January 2016 and December 2019. Only the records of patients with defined prolonged stay were consulted: time in days, with two standard deviations above the overall mean. We studied the reasons for admission, causes that conditioned the prolonged stay and the outcome. RESULTS: Thirty-four patients with prolonged stay were studied, representing 2.23% of the total number of cases in the intensive care unit. Reasons for admission: pregnancy complications 20 out of 34, complications of genitourinary system surgery 7 out of 34 and also 7 out of 34 with surgical complications of pelvi-abdominal malignant tumors. Prolonged stay in the intensive care unit, on average, was 11.99 ± 4.21 days, conditioned by reinterventions for bleeding 9 of 34, acute kidney injury 7 of 34, multiorgan failure 5 of 34, hypertensive decontrol 4 of 34, reinterventions for infection 3 of 34, unpacking 3 of 34, mechanical ventilation 2 of 34 and diabetic ketoacidosis 1 of 34. Mortality occurred in 2 cases (urogenital intraoperative bleeding n = 1 and abdominal game sepsis n = 1). CONCLUSIONS: Cases with prolonged length of stay represented a small percentage, the main causes were multifactorial, and the frequency of mortality was low.

Association Study between Psoriatic Arthritis and Killer Immunoglobulin-Like Receptor (KIR) Genes: A Meta-Analysis.

Background: Psoriatic Arthritis (PsA) is a seronegative spondyloarthropathy frequently associated with psoriasis. Studies have shown different members of the KIR (Killer Immunoglobulin-like Receptor) gene family may act as potential susceptibility factors; however, data have been inconsistent or with a reduced sample size. Therefore, the objective of this investigation was to determine associations between KIR genes and PsA susceptibility a meta-analysis approach. Methods: We performed a systemic search on PubMed, Scopus, and Web of Science to identify association studies linking KIR genes with PsA susceptibility. The search cut-off was May 2019. Odds Ratio (OR), 95% Confidence Intervals (95% CI), and forest plots were obtained for each KIR gene. Publication bias was evaluated by Begg and Egger linear regression tests. Results: Five articles were included in this meta-analysis. The KIR2DL2, 2DS1, 2DS2, and 2DS3 genes were positively associated with susceptibility to PsA (OR = 1.269, p = .003; OR = 1.392, p < .001; OR = 1.279, p = .002; and OR = 1.230, p = .038, respectively). In Caucasians, positive association with susceptibility to PsA were maintained by KIR2DL2, 2DS1, and 2DS2 genes (OR = 1.257, p = .005; OR = 1.535, p = .003; and OR = 1.267, p = .004, respectively). Conclusion: These associations suggest that KIR2DL2, 2DS1, 2DS2, and 2DS3 genes are susceptibility factors for PsA.

High plasma levels of soluble P-Selectin and Factor VIII predict venous thromboembolism in non-small cell lung cancer patients: The Thrombo-Nsclc risk score.

INTRODUCTION: Venous thromboembolism (VTE) is common in non-small cell lung cancer (NSCLC) patients undergoing systemic chemotherapy. The usefulness of Khorana score (KRS) to predict risk in lung cancer patients is limited, and the identification of patients who would benefit most from thromboprophylaxis is challenging. We aimed to identify variables whose values before chemotherapy helped in predicting VTE occurrence, and build a model to assess VTE risk. MATERIALS AND METHODS: A cohort of newly diagnosed NSCLC patients to undergo outpatient chemotherapy, not under anticoagulant treatment, was recruited. Pre-chemotherapy demographic, clinical, analytical and tumor-specific variables were collected. Patients were prospectively followed-up for 12 months to record VTE events. Bivariate and multivariate analyses were performed to identify VTE-associated variables, and a prediction model was built and compared with KRS. RESULTS: 90 patients were recruited, 18 of whom had a VTE event during follow-up. High baseline levels of factor VIII (FVIII) and, especially, soluble P-selectin (sP-selectin), were independently associated with VTE risk (hazard ratio [HR] 4.15, 95% confidence interval [CI] 1.17-14.71, and 66.40 [8.70-506.69], respectively). Our so-called Thrombo-NSCLC risk score, which assigns 1 and 3 points to high FVIII and sP-selectin values, respectively, was significantly better than KRS in predicting VTE (area under the curve [AUC] 0.93 vs. 0.55, sensitivity 94.4 vs. 35.0%, specificity 93.1 vs. 60.0%). Our prediction model showed significant discriminating capacity between high risk vs. intermediate/low risk patients, while KRS did not. CONCLUSIONS: The Thrombo-NSCLC risk score may be useful to identify those NSCLC patients who would benefit most from thromboprophylaxis.

Neumonías de la comunidad en la infancia / Pneumonia of the community in childhood

Los virus son los responsables más frecuentes de neumonías en menores de 1 año. Entre las bacterias, Streptococcus pneumoniae y Haemophilus tipo bson las más frecuentemente aisladas. En el recién nacido (menor de 1 mes) se deberá tener en cuenta la posibilidad de Streptococcus grupo B, enterobacterias y Staphylococcus aureus. A partir de los 3 años de edad el Mycoplasma pneumoniae comienza a aumentar su prevalencia. A pesar de que los virus son los agentes etiológicos más frecuentes, cuando no se pueda descartar la infección bacteriana, sola o asociada, los cuadros serán tratados como presumiblemente bacterianos. Tos, taquipnea, tiraje y fiebre son los indicadores más fieles de neumonía, por lo que se debe remarcar la importancia de su presencia

HOXA9 is Underexpressed in Cervical Cancer Cells and its Restoration Decreases Proliferation, Migration and Expression of Epithelial-to-Mesenchymal Transition Genes.

HOX transcription factors are evolutionarily conserved in many different species and are involved in important cellular processes such as morphogenesis, differentiation, and proliferation. They have also recently been implicated in carcinogenesis, but their precise role in cancer, especially in cervical cancer (CC), remains unclear. In this work, using microarray assays followed by the quantitative polymerase chain reaction (qPCR), we found that the expression of 25 HOX genes was downregulated in CC derived cell lines compared with nontumorigenic keratinocytes. In particular, the expression of HOXA9 was observed as down-modulated in CCderived cell lines. The expression of HOXA9 has not been previously reported in CC, or in normal keratinocytes of the cervix. We found that normal CC from women without cervical lesions express HOXA9; in contrast, CC cell lines and samples of biopsies from women with CC showed significantly diminished HOXA9 expression. Furthermore, we found that methylation at the first exon of HOXA9 could play an important role in modulating the expression of this gene. Exogenous restoration of HOXA9 expression in CC cell lines decreased cell proliferation and migration, and induced an epithelial-like phenotype. Interestingly, the silencing of human papilloma virus (HPV) E6 and E7 oncogenes induced expression of HOXA9. In conclusion, controlling HOXA9 expression appears to be a necessary step during CC development. Further studies are needed to delineate the role of HOXA9 during malignant progression and to afford more insights into the relationship between downmodulation of HOXA9 and viral HPV oncoprotein expression during cercical cancer development.

Human papillomavirus genotyping by Linear Array and Next-Generation Sequencing in cervical samples from Western Mexico.

BACKGROUND: The Linear Array® (LA) genotyping test is one of the most used methodologies for Human papillomavirus (HPV) genotyping, in that it is able to detect 37 HPV genotypes and co-infections in the same sample. However, the assay is limited to a restricted number of HPV, and sequence variations in the detection region of the HPV probes could give false negatives results. Recently, 454 Next-Generation sequencing (NGS) technology has been efficiently used also for HPV genotyping; this methodology is based on massive sequencing of HPV fragments and is expected to be highly specific and sensitive. In this work, we studied HPV prevalence in cervixes of women in Western Mexico by LA and confirmed the genotypes found by NGS. METHODS: Two hundred thirty three cervical samples from women Without cervical lesions (WCL, n = 48), with Cervical intraepithelial neoplasia grade 1 (CIN I, n = 98), or with Cervical cancer (CC, n = 87) were recruited, DNA was extracted, and HPV positivity was determined by PCR amplification using PGMY09/11 primers. All HPV- positive samples were genotyped individually by LA. Additionally, pools of amplicons from the PGMY-PCR products were sequenced using 454 NGS technology. Results obtained by NGS were compared with those of LA for each group of samples. RESULTS: We identified 35 HPV genotypes, among which 30 were identified by both technologies; in addition, the HPV genotypes 32, 44, 74, 102 and 114 were detected by NGS. These latter genotypes, to our knowledge, have not been previously reported in Mexican population. Furthermore, we found that LA did not detect, in some diagnosis groups, certain HPV genotypes included in the test, such as 6, 11, 16, 26, 35, 51, 58, 68, 73, and 89, which indicates possible variations at the species level. CONCLUSIONS: There are HPV genotypes in Mexican population that cannot be detected by LA, which is, at present, the most complete commercial genotyping test. More studies are necessary to determine the impact of HPV-44, 74, 102 and 114 on the risk of developing CC. A greater number of samples must be analyzed by NGS for the most accurate determination of Mexican HPV variants.

Expression of WNT genes in cervical cancer-derived cells: Implication of WNT7A in cell proliferation and migration.

According to the multifactorial model of cervical cancer (CC) causation, it is now recognized that other modifications, in addition to Human papillomavirus (HPV) infection, are necessary for the development of this neoplasia. Among these, it has been proposed that a dysregulation of the WNT pathway might favor malignant progression of HPV-immortalized keratinocytes. The aim of this study was to identify components of the WNT pathway differentially expressed in CC vs. non-tumorigenic, but immortalized human keratinocytes. Interestingly, WNT7A expression was found strongly downregulated in cell lines and biopsies derived from CC. Restoration of WNT7A in CC-derived cell lines using a lentiviral gene delivery system or after adding a recombinant human protein decreases cell proliferation. Likewise, WNT7A silencing in non-tumorigenic cells markedly accelerates proliferation. Decreased WNT7A expression was due to hypermethylation at particular CpG sites. To our knowledge, this is the first study reporting reduced WNT7A levels in CC-derived cells and that ectopic WNT7A restoration negatively affects cell proliferation and migration.

Expression of transcription factor grainyhead-like 2 is diminished in cervical cancer.

The transcription factor grainyhead-like 2 (GRHL2) is evolutionarily conserved in many different species, and is involved in morphogenesis, epithelial differentiation, and the control of the epithelial-mesenchymal transition. It has also recently been implicated in carcinogenesis, but its role in this remains controversial. Expression of GRHL2 has not previously been reported in cervical cancer, so the present study aimed to characterize GRHL2 expression in cervical cancer-derived cell lines (CCCLs) and cervical tissues with different grades of lesions. Microarray analysis found that the expression of 58 genes was down-regulated in CCCLs compared to HaCaT cells (non-tumorigenic human epithelial cell line). The expression of eight of these genes was validated by quantitative real-time PCR (qPCR), and GRHL2 was found to be the most down-regulated. Western blot assays corroborated that GRHL2 protein levels were strongly down-regulated in CCCLs. Cervical cells from women without cervical lesions were shown to express GRHL2, while immunohistochemistry found that positivity to GRHL2 decreased in cervical cancer tissues. In conclusion, a loss or strong reduction in GRHL2 expression appears to be a characteristic of cervical cancer, suggesting that GRHL2 down-regulation is a necessary step during cervical carcinogenesis. However, further studies are needed to delineate the role of GRHL2 in cervical cancer and during malignant progression.

Factores asociados a la depresión en grandes urbes: el caso del distrito Federal en México / Fatores associados com depressao nas grandes urbes: o caso do Distrito Federal do México / Factors associated with depression in large cities: the case of Federal District in Mexico

El presente trabajo analiza la influencia que diversas variables tienen sobre las personas que viven en el Distrito Federal y que padecen depresión. La primera hipótesis se orienta por las estadísticas internacionales, para señalar que el sexo influye en la depresión, sobre todo cuando se es mujer. La segunda hipótesis, apoyada en diferentes teorías, muestra una estrecha relación entre ingreso, edad y condición de pobreza sobre dicho padecimiento. Los resultados mostraron que el ingreso y la edad son variables importantes, pero no los factores determinantes de aquél. La escolaridad y el género resultaron ser las variables más significativas...

This paper analyzes the influence of different variables have on people living in the Federal District and suffering from depression. The first hypothesis is oriented by international statistics to show that gender influences depression as variable, especially for females. The second hypothesis based on different theories shows a close relationship between income, age and poverty status on that condition. The results showed that income and age are important but not determinants of it, but education and gender were the most significant variables...

O artigo presente analisa a influência que diversas variáveis têm sobre as pessoas que moram no Distrito Federal e adoecem de depressão. A primeira hipótese é orientada pelas estatísticas internacionais para assinalar que o sexo influi na depressão, sobretudo quando mulher. A segunda hipótese, apoiada em diferentes teorias, mostra uma estreita relação entre rendas, idade e condição de pobreza com dita doença. Os resultados mostraram que rendas e idade são variáveis importantes, mas não fatores determinantes daquilo. A escolaridade e o gênero resultaram as variáveis más significativas...

Autotrasplantes dentales: revisiónsistemática de la literatura / Autologous dental transplants: a systematic review of literature

Antecedentes: los autotrasplantes dentales son una técnica que se ha utilizado durantemucho tiempo; sin embargo, son poco utilizados por las múltiples variables que determinansu éxito y la falta de unificación de criterios en la técnica. Objetivo: identificar, por medio deuna revisión sistemática de la literatura, las tasas de éxito de los autotrasplantes dentalesy algunos de los factores que modifican dichas tasas. Método: se realizó una búsqueda deliteratura sobre autotrasplantes dentales en revistas incluidas en las bases de datos biomédicasMedline, EMBASE, CINAHL, Scisearch y PsycLIT, así como en bases de datos electrónicascon un foco específico como Cochrane Controlled Trials Register de la Cochrane Library,Health Technology Assessment y NHS-EED. Se elaboraron medidas de resumen y evaluaciónde la calidad metodológica mediante el programa Revman 5. Resultados: se seleccionaronveintidós artículos en los que las tasas de éxito de los autotrasplantes alcanzaron un 84 %general: 83 % en dientes con ápices cerrados, 95 % cuando se utilizó sutura con férula acrílica y95,75 % en dientes a los que se les realizó terapia endodóntica un mes después del autotransplante.Conclusión: la literatura revisada sugiere que los autotrasplantes dentales pueden seruna alternativa para la restitución a corto, mediano y largo plazo de dientes perdidos, aunqueel nivel de evidencia es III, dado que los estudios analizados son solamente de tipo descriptivo...

Background: Dental autotransplantation is a technique that has been used for a long time;however, it is not frequently used due to the many variables that determine its effectivenessand the lack of unified technical criteria. Aim: Identify, through a systematic review of literature,success rates of tooth autotransplantation and some factors that modify those rates.Method: A literature search on autologous dental transplantation was carried out in journalsincluded in the Medline, EMBASE, CINAHL, SCISEARCH and PsycLIT biomedical databases,as well as in the Cochrane Controlled Trials Register (Cochrane Library), Health TechnologyAssessment and NHS-EED specialized databases. Summary measures were developed andmethodological quality was assessed through the RevMan 5 software. Results: A total of 22articles were selected. They showed 84 % general success rates of autotransplantations, 83 %in closed apex teeth, 95 % when an acrylic splint suture was used, and 95.75 % when rootcanal therapy was carried out one month after the transplantation. Conclusion: The literaturestudied suggests that dental autotransplantation may be an alternative for the restitution oftooth loss in the short-, mid-, and long-term, even though the level of evidence is III becausethe studies analyzed are only descriptive...

Plants used by native Amazonian groups from the Nanay River (Peru) for the treatment of malaria.

AIM OF THE STUDY: In order to evaluate the antimalarial potential of traditional remedies used in Peru, Indigenous and Mestizo populations from the river Nanay in Loreto were interviewed about traditional medication for the treatment of malaria. MATERIALS AND METHODS: The survey took place on six villages and led to the collection of 59 plants. 35 hydro-alcoholic extractions were performed on the 21 most cited plants. The extracts were then tested for antiplasmodial activity in vitro on Plasmodium falciparum chloroquine resistant strain (FCR-3), and ferriprotoporphyrin inhibition test was also performed in order to assume pharmacological properties. RESULTS: Extracts from 9 plants on twenty-one tested (Abuta rufescens, Ayapana lanceolata, Capsiandra angustifolia, Citrus limon, Citrus paradise, Minquartia guianensis, Potalia resinífera, Scoparia dulcis, and Physalis angulata) displayed an interesting antiplasmodial activity (IC(50)<10 µg/ml) and 16 remedies were active on the ferriprotoporphyrin inhibition test. CONCLUSIONS: The results give scientific validation to the traditional medical knowledge of the Amerindian and Mestizo populations from Loreto and exhibit a source of potentially active plants.