Low frequency of Toll-like receptors 2 and 4 gene polymorphisms in Mexican patients and their association with type 2 diabetes.

Type 2 diabetes (T2D) is characterized by a chronic low-grade inflammatory state. SNP in Toll-like receptor (TLR) genes has been associated with impaired inflammatory response. We genotyped the TLR4/D299G, TLR4/T399I and TLR2/R753Q polymorphisms. Low frequency was found with no association with T2D, nevertheless the TLR2 SNP was associated with lower levels in HDL-cholesterol values.

Candidate gene association study conditioning on individual ancestry in patients with type 2 diabetes and metabolic syndrome from Mexico City.

BACKGROUND: Type 2 diabetes (T2D) is influenced by diverse environmental and genetic risk factors. Metabolic syndrome (MS) increases the risk of cardiovascular disease and diabetes. We analysed 14 cases of polymorphisms located in 10 candidate loci, in a sample of patients with T2D and controls from Mexico City. METHODS: We analysed the association of 14 polymorphisms located within 10 genes (TCF7L2, ENPP1, ADRB3, KCNJ11, LEPR, PPARgamma, FTO, CDKAL1, SIRT1 and HHEX) with T2D and MS. The analysis included 519 subjects with T2D defined according to the ADA criteria, 389 with MS defined according to the AHA/NHLBI criteria and 547 controls. Association was tested with the program ADMIXMAP including individual ancestry, age, sex, education and in some cases body mass index (BMI), in a logistic regression model. RESULTS: The two markers located within the TCF7L2 gene showed strong associations with T2D (rs7903146, T allele, odd ratio (OR) = 1.76, p = 0.001 and rs12255372, T allele, OR = 1.78, p = 0.002), but did not show significant association with MS. The non-synonymous rs4994 polymorphism of the ADRB3 gene was associated with T2D (Trp allele, OR = 0.62, p = 0.001) and MS (Trp allele, OR = 0.74, p = 0.018). Nominally significant associations were also observed between T2D and the SIRT1 rs3758391 SNP and MS and the HHEX rs5015480 polymorphism. CONCLUSIONS: Variants located within the gene TCF7L2 are strongly associated with T2D but not with MS, providing support to previous evidence indicating that polymorphisms at the TCF7L2 gene increase T2D risk. In contrast, the non-synonymous ADRB3 rs4994 polymorphism is associated with T2D and MS.

[Usefulness of the ASA scale and thoracic radiography as indicators of perioperative cardiovascular risk]. / La utilidad de la escala de ASA y de la radiografía de tórax como indicadores de riesgo cardiovascular perioperatorio.

This paper evaluates the usefulness of ASA physical status classification and the multifactorial index of cardiac risk in the preoperative assessment, without considering arterial blood gases. With the results of this study we propose to add the ASA physical status classification, the radiologic diagnosis of chronic obstructive pulmonary disease and the multifactorial index of cardiac risk. This strategy increases the diagnostic certainty of Goldman's index of cardiac risk, is practical, not expensive and favors a better establishment of the risk of perioperative cardiovascular morbidity.

[Preoperative assessment in adults]. / La valoración preoperatoria en el adulto.

UNLABELLED: The scope of this work is to analyze the usefulness and indications of preoperative evaluation. PATIENTS AND METHODS: 791 consecutive patients candidate for surgical treatment, were studied prospectively under the next inclusion criteria: 40 years old or less than 40 years old. Blood count cell, glucose, urea, creatinine, sodium, potassium, prothrombin time, partial thromboplastin time, platelets count, liver function tests, chest x-ray and electrocardiograph made before entry. In the the post liver, lung, bleeding, infectious or metabolic complications was done, while visiting the patients every day until discharge. Relative risk (RR) was calculated for every variable, analyzing differences with X2 and Fisher's Test. Those variables with statistical significance value were analyzed with logistic regression. Only 751 patients were studied, there were 335 male (44%) and 416 female (56%), with mean age of 63.9 years. Metabolic disorders (16.9%) and postoperative infections (7.0%) were the more frequent complications. Hemorrhage during of after surgery occurred in 2.2% of the patients. There were seventeen deaths (2.2%) related directly with surgery, with systemic illness or with postoperative complications. Selection of auxiliary tests for preoperative evaluation must be agree with clinical evaluation. The major objective of clinical evaluation is to estimate risk factors for surgery.

Captopril effect on non-diabetic glomerular albuminuria.

In order to evaluate captopril effectiveness in the treatment of glomerular albuminuria in nondiabetic patients, an initial study was carried out in 16 patients with proteinuria greater than 1 gr/1, administering captopril, 50 mg/day during a 4 month follow-up period. During that time, urinary albumin levels significantly descended (p < 0.001), with a concomitant rise in serum albumin. We conclude that captopril can be effective as a part of the treatment of albuminuria associated with nephropathy of non diabetic origin.

[Captopril reduction of albuminuria in type-II diabetics with diabetic nephropathy]. / Reducción de albuminuria por captopril en diabéticos tipo II con nefropatía diabética.

This study was to search if captopril (C) reduces albuminuria in a group of type II diabetics with diabetic nephropathy (DN). Eleven type II diabetics with DN and hypertension, with albuminuria over 0.30 g/L/24th, fasten blood glucose under 250 mg/dL, serum albumin over 3 g/dL, without infection, cardiac failure or diuretic treatment, were treated with C for six months, as the only treatment for hypertension and albuminuria. Every month, albuminuria in a 24h urinary collection, medium arterial pressure (MAP), serum creatinine and fasten blood glucose were measured. Ten women and one man with 60 (50-70) years of average age (0 to 100th percentile), with 18 (8-35) years of diabetic disease, and 4 (1-7) years of clinic hypertension were studied. Before the treatment with C they had albuminuria of 6.9 (0.7 to 12.5) g/L/24h, MAP of 119.7 (93.2 to 139) mmHg, serum creatinine of 2.2 (0.7 to 7.5) mg/dL and glucose of 168 (78 to 250) mg/dL. After 6 months with C, they had albuminuria of 3.5 (0.2 to 9.6) g/L/24h (p less than 0.01), MAP of 113.4 (92.9 to 132.4) mmHg (p = 0.5), serum creatinine of 2.3 (0.5 to 6.4) mg/dL (p = 0.23) and glucose of 133 (87.5 to 239) mg/dL (p = 0.32). The MAP showed a predictive relation over albuminuria (p = less than 0.004). During the six months of study, C reduced albuminuria in type II diabetics with hypertension and diabetic nephropathy.

[A reconsideration of postoperative fever due to pulmonary atelectasis]. / Una reconsideración de la fiebre postoperatoria por atelectasia pulmonar.

Atelectasis has been reported as a common cause of fever in the first 48 hours after surgery. A group of one hundred patients programmed for elective abdominal surgery were studied with chest roentgenograms, both before and 48 hours after surgery. Thirty-one of them developed atelectasis and eighteen developed fever. Four of the patients with and fourteen without atelectasis, had fever. Five cases had unexplained fever, three of them with pulmonary atelectasis. These findings suggest that atelectasis can cause postoperative fever, but it is not the most common cause of fever in the first 48 hours after surgery.