KIR gene in ethnic and Mestizo populations from Mexico

Killer cell immunoglobulin-like receptors are characterized by their great diversity of genes and alleles. Population studies have identified the presence of a broad variety of genotypes. In Mexico, there are diverse ethnic groups representing 9% of the total population and the rest is composed of Mestizos with a more varied biology. For the purpose of this study, genotyping was performed in Mestizos, in Mexico City inhabitants, and in three ethnic groups. The frequencies of genes KIR2DL2, 2DL5, 2DS1-3, 2DS5, and 3DS1 showed a greater variability in the groups studied. A total of 12 different genotypes were identified, the higher number for the Mestizos and the lower number for the Tarahumaras. Genotype 1 was found at a greater frequency in all the groups, except for the Tarahumaras, in which genotype 4 was more frequent. The frequency of genotypes 4 and 8 in Mexicans was higher than that for other populations analyzed. By subtyping of KIR3DL1, 3DL2, 2DL1, and 2DL3, two B haplotypes were identified in families; both were absent in Caucasian families. Our results indicated a greater diversity of genes in the Mestizos group than in the ethnic groups.

[Consistency and validity of the evaluation of the clinical chart]

OBJECTIVE

Assess the degree of external consistency and validity of the EXP CLIN instrument has for measuring the quality information contained in medical charts.

MATERIAL AND METHODS

In a transverse comparative study, two hundred and twelve clinical charts were randomly selected belonging to patients seen at a pediatric hospital. The charts were assessed using the EXP-CLIN for phases: 1) internal assessment: by hospital personnel of the pediatric hospital, and, II) external assessment: by personnel from other hospitals. The results were analyzed using the concordance method.

RESULTS

The concordance percentages were found to be 76% for medical charts and medical notes related with the process of diagnosis-treatment, as well as the general characteristics of the clinical chart. The concordance percentages average was 88%, supporting the idea that when the EXP-CLIN instrument is applied twice to the same chart, good concordance is obtained between the two measures.

CONCLUSIONS

Given that the application of the instrument documented a good level of external consistency, its use is justified for assessing the quality of the information contained in the charts of the patients seen at our unit.

[Lipid profile in healthy newborn infants and its correlation with maternal lipid levels]

OBJECTIVE

To determine serum levels of lipid, cholesterol, triglycerides and lipoproteins in newborns and their mothers and to know the association between them.

MATERIAL AND METHODS

Blood samples were taken from 200 newborns and from their mothers, and analyzed for lipid, cholesterol, triglyceride and lipoprotein content in an autoanalyzer. Data were analyzed with the Epi Info 6 program. Central tendency measurements, variance analysis and Pearson correlation coefficient were obtained.

RESULTS

Average lipid levels in newborn blood samples was 625.2 +/- 130, 158.8 +/- 44 mg/dl of cholesterol, 136.9 +/- 97 mg/dl of triglycerides, 70.5 +/- 23.9 mg/dl LDL, 52.7 +/- 14 mg/dl HDL and 26.5 +/- 15.5 mg/dl VLDL.

CONCLUSIONS

Newborn cholesterol levels were similar to values reported by Alpers and higher than levels published by the American Committee of Pediatric Biochemistry in USA. An association between levels in mothers and their children was found.

[Classification by levels of clinico-epidemiological research designs]

The objective was to identify the characteristics of epidemiologic designs enabling their classification. A critical review of the literature in the clinical epidemiologic area was done to establish the main differences between designs. A meeting with experts to discuss this controversial topic and obtain criteria by consensus was organized. We propose an integral classification based on levels with two fundamental shafts: intervention and explanatory reasoning.

Nutritional state alterations in children with acute lymphoblastic leukemia during induction and consolidation of chemotherapy

The objective of the study was to determine if children with high risk acute lymphoblastic leukemia (ALL) exhibit higher frequency of alterations in nutritional state during the phases of induction and consolidation of chemotherapy than children with low risk ALL, based on the arm muscle area. The design was concurrent comparative cohorts. It was performed at pediatric hematology service of the Hospital General del Centro Médico Nacional "La Raza" and hematology service of the Hospital de Pediatría del Centro Médico Nacional "Siglo XXI". One hundred-five patients were incorporated into the study: 53 with high risk (HR) ALL and 52 with low risk (LR) ALL. Basal measurements of arm circumference and tricipital skinfold were surveyed monthly (for 3 months) by standardized personnel. Altered nutritional state during follow-up was defined as the loss of 10% or more of the arm muscular area (AMA) measured at diagnosis. Statistics of proportion analysis with a significance level of 0.05 and relative risk (RR) with confidence intervals (CI) were calculated. In the first month the RR was 0.77 (CI 0.31-1.87); the LR group was the most affected. In the second month the RR was 7.31 (CI 1.41-38.03); the most affected group was the HR. In the third month the RR was 1.77 (CI 0.60-4.92); the HR group was the most affected. High-risk patients show a higher frequency of nutritional state alterations reflected in AMA during the second month after diagnosis. This may be caused by the more aggressive chemotherapy received by these patients.