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Biomedical subjects

P Arroyo

Publications and source records attributed to P Arroyo.

At least 19 recordsLinked to original sources

Polymorphisms in candidate genes for type 2 diabetes mellitus in a Mexican population with metabolic syndrome findings.

The metabolic or insulin resistance syndrome, characterized by hypertension, dyslipidemia, glucose intolerance and hyperinsulinemia, may have genetic determinants. The insulin gene (INS), insulin receptor gene (INSR) and insulin receptor substrate 1 gene (IRS1) have been proposed as candidate genes. We examined eight polymorphisms in these genes in 163 individuals from Yucatan, Mexico; this population has a high prevalence of obesity, type 2 diabetes mellitus and dyslipidemia. Subjects were evaluated for body mass index (BMI) and blood pressure. Blood samples were collected to determine glucose, insulin, triglycerides and cholesterol levels, as well as for DNA isolation. Restriction fragment length polymorphisms in INS, INSR and IRS1 were identified by polymerase chain reaction and digestion with selected restriction enzymes. Among the eight polymorphisms analyzed, the PstI polymorphism in INS was significantly associated with hypertriglyceridemia and with the presence of at least one abnormality related to the metabolic syndrome (P=0.007 and 0.004, respectively). The MaeIII polymorphism in INS was associated with fasting hyperinsulinemia (P=0.045). In multilocus analyses including both INS polymorphisms, significant associations were seen with hypertriglyceridemia (P=0.006), hypercholesterolemia (P=0.031) and with presence of at least one metabolic abnormality (P=0.009). None of the polymorphisms in INSR or IRS1 was associated with any of these traits. These findings suggest that the insulin gene may be an important determinant of metabolic syndrome, and particularly of dyslipidemia, in this population.

Adolescent↗

Anthropometric measurements in the elderly population of Santiago, Chile.

OBJECTIVE: There are few studies on anthropometry and nutritional status in large and representative samples of elderly populations in Chile and South America. We describe age and sex differences in weight, height, body mass index, knee height, waist circumference, midarm circumference, triceps skinfold thickness, arm muscle area, and calf circumference in Chilean elderly subjects. METHODS: This was a population-based, cross-sectional study. A total of 1220 elderly persons (819 women and 411 men; age range, 60-99 y) were recruited in the city of Santiago (Chile) through a probabilistic sampling procedure carried out from October to December 1999. RESULTS: Men were significantly heavier and taller than women in all age groups, whereas body mass index values were significantly higher in women than in men. All anthropometric variables showed a decrease in average values with aging in men and women. The apparent negative slopes for the decline in average values of body weight with aging was of greater magnitude in women than in men (-0.42 kg/y and -0.54 kg/y in male and female subjects, respectively). However, significant age x sex interaction was detected only for triceps skinfold thickness. In women, quadratic terms for age provided a significantly better fit than did the simple linear model for the association between age and weight, body mass index, waist circumference, triceps skinfold thickness, calf circumference, or midarm circumference. CONCLUSION: These observations indicated that body weight changes associated with aging might be more severe in Chilean women than in men, probably determining a differential pattern of lean and fat mass loss.

Age Distribution↗

Research trends in mother-child healthcare, 1966-1995.

OBJECTIVE: To explore trends in mother-child healthcare (MCHC) research over the past 30 years. METHODS: Classifications of Medline articles were made at 5-year intervals using Medical Subject Headings (MeSH) as classifiers. Papers were classified in mutually and non-mutually exclusive categories by subject (mother and four age groups of children) and type of research (clinical, basic, epidemiologic, and unclassified) and its various combinations. RESULTS: The number of MCHC papers increased from 34,110 in 1966 to 65,028 in 1995, but the proportion of all Medline articles (18-21%) was relatively stable. There were remarkable long-term temporal stabilities in the proportions of MCHC papers of mothers and the four age groups of children. Most papers dealt with child (46%) and adolescents (45%), and only 11% studied mother and children together. Regression analysis indicated that a linear increase in number of MCHC papers in Medline (1053/year) was represented largely by single-age and combinations of age children, especially adolescence. However, the slope for mother-plus-children papers (113/year) was substantially higher than for mothers alone (64/year). Clinical papers (52%) were the dominant type of MCHC research, but the proportions of basic and epidemiologic papers and their combinations with clinical papers have increased substantially in the past decade. CONCLUSIONS: There has been a dominance of clinical and child-related papers in MCHC research, which may be a reflection of restricted outlooks of specialists in the area. This may change soon if the tendency toward increasing numbers of basic and epidemiologic papers holds.

Adolescent↗

Prevalence of pre-obesity and obesity in urban adult Mexicans in comparison with other large surveys.

OBJECTIVE: 1. To estimate the prevalence of pre-obesity and obesity in a 1992 to 1993 national survey of the Mexican urban adult population. 2. To compare our findings with other national surveys and with data for Mexican Americans. RESEARCH METHODS AND PROCEDURES: The national representative sample of the Mexican urban adult population included 8462 women and 5929 men aged 20 to 69 years from 417 towns of >2500 people. Body mass index (BMI), calculated from measured weight and height, was classified using the World Health Organization categories of underweight (BMI < 18.5 kg/m2), normal weight (BMI 18.5 to 24.9 kg/m2), pre-obesity (PreOB = BMI 25 to 29.9 kg/m2) and obesity (OB = BMI 30+ kg/m2). Estimates for Mexican Americans were calculated from U.S. survey data. RESULTS: Overall, 38% of the Mexican urban adult population were classified as pre-obese and 21% as obese. Men had a higher prevalence of pre-obesity than women did at all ages, but women had higher values of obesity. Both pre-obesity and obesity increased with age up to the age range brackets of 40 to 49 or 50 to 59 years for both men and women. Both pre-obesity and obesity prevalence estimates were remarkably similar to data for Mexican Americans from 1982 through 1984. Comparison with other large surveys showed that countries differed more in the prevalence of obesity than of pre-obesity, leading to differences in the PreOB/OB ratio, and that countries also differed in the gender ratio (female/male) for both pre-obesity and obesity. DISCUSSION: Pre-obesity and obesity were high in our population and increased with age. Our approach of characterizing large surveys by PreOB/OB and gender ratios appeared promising.

Adult↗

[Relationship between leptin and insulin blood levels in obese and lean Chilean women].

BACKGROUND: Leptin, a product of ob gene and insulin blood levels, are proportional to the amount of adipose tissue. Insulin could have an independent regulatory effect on leptin secretion. AIM: To assess the relationship between serum leptin and plasma insulin levels in obese and lean Chilean women. MATERIAL AND METHODS: One hundred forty five women, aged 20 to 60 years old, were studied. Weight, height, waist and hip circumference, fasting blood glucose, insulin and leptin levels were measured. Insulin resistance was assessed using the homeostasis model assessment. The relationship between different variables was determined using multiple linear regression, variance analysis and non parametric correlation. RESULTS: Leptin serum concentrations were positively correlated with body mass index, insulin plasma levels and degree of insulin resistance. The association of leptin with insulin was independent of body mass index and persisted after adjustments by body fat distribution and age. CONCLUSIONS: Insulin and insulin resistance are associated to high blood leptin levels and this association is independent of the degree of adiposity and body fat distribution.

Adult↗

Hypertension in urban Mexico: the 1992-93 national survey of chronic diseases.

The purpose of this work is to estimate the prevalence of hypertension in the urban population of Mexico. We studied a multistage national sample representative of the urban population in 417 cities of over 2500 people. The blood pressure of 14 657 individuals (6053 men and 8604 women) aged 20-69 years was measured after a 5-min rest using a standard mercury sphygmomanometer. The survey personnel had been previously trained and standardised. The main results show a crude prevalence of hypertension, as defined by the JNC VI, of 28.1% in women and 37.5% in men (27.2% and 37.1% age-adjusted). Both genders exhibited a trend of increasing hypertension with age. In individuals under 50 years of age, women had lower rates than men, but the difference disappeared in the older groups. The awareness of hypertension (28%) as well as the success of treatment (22%) were low in our sample. Our results had more similarities than differences with respect to those observed in other national surveys. It is concluded that hypertension in Mexico is an important public health problem similar to that seen in developing and developed nations. Efforts should be aimed at strengthening measures to prevent and control hypertension in Mexico. More information is needed of the sort obtained from longitudinal studies.

Adult↗

Overweight and hypertension: data from the 1992-1993 Mexican survey.

Data of the 1992-1993 Mexican Survey of Chronic Diseases in the Urban Adult Population were analyzed to investigate the effects of age and sex on the association between overweight and hypertension. Blood pressure, body weight, and height were measured in a group of 13,945 Mexicans aged 20 to 69 years living in towns and cities larger than 15,000 people. Hypertension was defined following the recommendations of the Joint National Committee for Detection, Evaluation, and Treatment of High Blood Pressure-V. Overweight was defined following the recommendations of the National Institutes of Health Consensus on Health and Obesity. The prevalence of types of hypertension was higher in men than in women, particularly in the groups of 20 to 39 years of age. Cross-classification of subjects according to the presence of hypertension and overweight confirmed the association between both variables. The odds ratio and 95% confidence intervals indicated that overweight was associated with systolic and diastolic hypertension and with isolated diastolic hypertension in women and, to a lesser extent, in men. This association was not found in the 60- to 69-year group in both sexes. Overweight did not show significant association with isolated systolic hypertension in both sexes. Results of a multiple logistic regression analysis of overweight on hypertension, controlling for age and sex, were consistent with these findings. It is suggested that other factors, independent of overweight, explain the observed gender-specific differences in the prevalence of hypertension in younger age groups. The hormonal environment of young women is one of the mentioned factors modifying the prevalence of hypertension in this group of the Mexican urban adult population.

Adult↗

Parity and the prevalence of overweight.

OBJECTIVE: To assess the association between previous term pregnancies and the prevalence of overweight in a group of urban women, controlling for the influence of age. METHODS: One thousand twelve women, living in middle and low socioeconomic areas of Mexico City, were interviewed at home and their reproductive histories studied. Height and weight were measured in a clinical setting using controlled procedures. Overweight (BMI > 25) was the dependent variable used to calculate odds ratios and to perform a multiple logistic regression analysis. RESULTS: Age and parity were significantly associated with the prevalence of overweight. Controlling for age, two or more previous pregnancies significantly increased the magnitude of the association. CONCLUSION: During the reproductive years parity seems to increase the risk of overweight in low and middle socioeconomic level urban women.

Adolescent↗

The therapeutic approach to the control of hypertension. Its impact on health policy.

The pharmacologic approach to the control of hypertension must consider both the clinical perspective and the Public Health approach policy in which social costs have to be balanced against benefits to the entire population. Cost-effectiveness analysis are at the core of decisions taken within this frame of reference. The issue of cost-effectiveness of preventive and therapeutic measures are crucial in the case of less developed countries. An analysis of studies undertaken in Mexico leads to the conclusion that, from a Public Health perspective, a program for the control of hypertension with a strong emphasis on drug therapy is likely to require a significant proportion of the health budget. Therefore, more emphasis must be placed on primary prevention based on modifications of life style.

Antihypertensive Agents↗

Prospective study of infection, colonization and carriage of methicillin-resistant Staphylococcus aureus in an outbreak affecting 990 patients.

In the three years between November 1989 and October 1992, an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) affected 990 patients at a university hospital. The distribution of patients with carriage, colonization or infection was investigated prospectively. Nosocomial acquisition was confirmed in at least 928 patients, 525 of whom were identified from clinical specimens as being infected (n = 418) or colonized (n = 107) by MRSA. An additional 403 patients were identified from screening specimens, of whom 58 subsequently became infected and 18 colonized. Screening of the nose, throat and perineum detected 98% of all carriers. Of the 580 infections in 476 patients, surgical wound, urinary tract and skin infections accounted for 58% of the infections. Of the 476 infected patients, death was attributable to MRSA infection in 13%. Colonization with MRSA was found in 127 patients and 42% of 165 colonized sites were the skin. Auto-infection from nasal carriage or cross-infection, probably via staff hands, seemed to be the most common mode of acquisition of MRSA infections.

Adolescent↗

[Erythrocyte transketolases and Alzheimer disease].

Abnormalities of thiamin metabolism have been reported in senile dementia of Alzheimer's type (SDAT). Transketolases (TK) were studied in 21 patients with SDAT, 24 age-matched controls and 12 chronic alcoholics. Erythrocytes were assessed for their TK activity coefficient (TK-AC, normal value 8.4 +/- 12.6%) and affinity for thaimin pyrophosphate (Km TPP, normal value 17.8 +/- 8.3 mumol). Comparison between study groups and controls demonstrated increased TK-AC in SDAT (16.6 +/- 15.7%, P < 0.05) and chronic alcoholism (43.4 +/- 40.6%, P < 0.05), and increased Km TPP (38.3 +/- 25.2 mumol, P < 0.01) in SDAT only. These findings suggest structural abnormalities of TK rather than vitamin B1 deficiency in SDAT.

Aged↗

Effects of magnesium, high energy phosphates, piracetam and thiamin on erythrocyte transketolase.

Erythrocyte transketolase activity coefficient (ETK-AC) and affinity for coenzyme (Km TPP) were assessed in 50 patients with transketolase abnormalities such as fibromyalgia or senile dementia of Alzheimer's type, before and after magnesium (Mg), thiamin+pyridoxine (B1,B6), high energy phosphates (HEP) (phosphocreatinine of adenosine triphosphate), and piracetam. Compared to 12 untreated patients, ETK-AC was significantly decreased with B1,B6 (P < 0.05, n = 10); Km-TPP was significantly decreased with HEP (P < 0.05, n = 20) and piracetam (P < 0.01, n = 5). In nine other patients treated with HEP + B1,B6 + magnesium, ETK-AC and Km TPP were both significantly decreased.

Adenosine Triphosphate↗

Nd-YAG laser applications in surgical endoscopy: a single center comprehensive experience.

A retrospective review of endoscopic procedures using the Nd-YAG laser was carried out for patients treated between September 1984 and November 1986. Two hundred twenty two procedures were performed on 104 patients (58M:46W) during this 26 month period. The study encompasses a unique period of time in this center, as it includes the initial use of the endoscopic laser technique, the learning curves associated with its application, and finally, the time when its use became routine. Treatment of tumors was the indication in 47 per cent of the cases. Gastrointestinal bleeding of benign cause was the indication in nearly half of the patients; arteriovenous malformations were the most common causes of bleeding. Laser photocoagulation of hemorrhoids was performed in 11 cases. Upper endoscopy was the route in 33 per cent of procedures. Anoscopy, flexible sigmoidoscopy, and colonoscopy were the routes in the remainder. The time spent on the procedure and the energy delivered were found to be variables of the type of lesion and the endoscopic route. Nd-YAG laser endoscopy can be used safely and effectively for a variety of bleeding and obstructive gastrointestinal conditions. Appropriate certification for granting of privileges to laser endoscopists is of utmost importance.

Adult↗