mtDNA Haplogroup A Enhances the Effect of Obesity on the Risk of Knee OA in a Mexican Population

[Abstract] To evaluate the influence of mitochondrial DNA haplogroups on the risk of knee OA in terms of their interaction with obesity, in a population from Mexico. Samples were obtained from (n = 353) knee OA patients (KL grade ≥ I) and (n = 364) healthy controls (KL grade = 0) from Mexico city and Torreon (Mexico). Both Caucasian and Amerindian mtDNA haplogroups were assigned by single base extension assay. A set of clinical and demographic variables, including obesity status, were considered to perform appropriate statistical approaches, including chi-square contingency tables, regression models and interaction analyses. To ensure the robustness of the predictive model, a statistical cross-validation strategy of B = 1000 iterations was used. All the analyses were performed using boot, GmAMisc and epiR package from R software v4.0.2 and SPSS software v24. The frequency distribution of the mtDNA haplogroups between OA patients and healthy controls for obese and non-obese groups showed the haplogroup A as significantly over-represented in knee OA patients within the obese group (OR 2.23; 95% CI 1.22-4.05; p-value = 0.008). The subsequent logistic regression analysis, including as covariate the interaction between obesity and mtDNA haplogroup A, supported the significant association of this interaction (OR 2.57; 95% CI 1.24-5.32; p-value = 0.011). The statistical cross-validation strategy confirmed the robustness of the regression model. The data presented here indicate a link between obesity in knee OA patients and mtDNA haplogroup A.This work is supported by Grants from Fondo de Investigación Sanitaria (PI17/00210, PI16/02124, PI20/00614, RETIC-RIER-RD16/0012/0002 and PRB3-ISCIII-PT17/0019/0014) integrated in the National Plan for Scientific Program, Development and Technological Innovation 2013–2016 and funded by the ISCIII-General Subdirection of Assessment and Promotion of Research-European Regional Development Fund (FEDER) “A way of making Europe” and Grant IN607A2017/11 from Xunta de Galicia. The authors further acknowledge AE CICA-INIBIC (ED431E 2018/03) for financial support. IRP is supported by Contrato Miguel Servet-II Fondo de Investigación Sanitaria (CPII17/00026) and AD-S is supported by Grant IN606A-2018/023 from Xunta de Galicia, Spain. The Biomedical Research Networking Center (CIBER) is an initiative from Instituto de Salud Carlos III (ISCIII)Xunta de Galicia; IN607A2017/11Xunta de Galicia; ED431E 2018/03Xunta de Galicia; IN606A-2018/02

Giant Appendicular Mucinous Cystoadenoma: Case Report and Review of the Literature

Background: Appendix tumours present an incidence of 0.2 to 0.3% among all appendectomies. It is a rare condition, commonly found as an incidental diagnosis by imaging studies due to his lack of symptoms; nevertheless it is associated with many complications when undiagnosed like pseudomixoma peritonei a condition with high morbidity and mortality. This is the importance of recognize it to establish an opportune diagnose and treatment. Case: A 49-year old man with abdominal pain of 6 days of evolution. He has medical history of diabetes mellitus 2 and hypertension. He presents to the emergency department complaining of pain in right lower quadrant and reports radiation to the ipsilateral renal fossa. Ultrasonography demonstrated an oblique cystic fusiform lesion suspicious of abscess. Simple computed tomography concluded probable mesenteric cyst. An exploratory laparotomy was performed finding a 12 X 8cm tumour lesion that protruded from the appendix. Tumour was dissected and a right hemicolectomy with side-end ileocolic anastomosis was performed. The histopathology study reveals an appendiceal mucinous neoplasm of low grade. After 5 days the patient was discharged without complications.After 8 months follow up the patients is asymptomatic and without evidence of tumour activity.Conclusion: Appendix tumours are a rare pathology with an insidious presentation representing a difficult diagnosis; requiring high index of suspect and knowledge about the correct surgical management to obtain better outcomes.</p

Liver Abscess Secondary to Ascaris Lumbricoides: Case Report

Background: Ascaris lumbricoides is one of the most frequent human helminthiasis, but the complication with liver abscess is very rare and severe, being a challenge for the correct and timely diagnosis. Case: A male of 62-years-old was brought to emergency room of a rural hospital referring one week of evolution with abdominal pain in right upper quadrant and epigastrium, with fever about 39ºC the last&nbsp; three days, anorexia, asthenia, adinamia, diarrhea, and mental status deterioration the last 24 hours. At physical exam with Glasgow 11, dehydrated, with tachycardia or tachypnea, abdominal pain in right upper quadrant and epigastrium, without rebound, and with normal bowel sounds. Laboratories report leucocytes 29300 cell/mm3, neutrophils 80%, eosinophils 8%, Hemoglobin 9.5 mg/dL, Glucose 144mg/dL, Creatinine 2, total bilirubin 2.3, indirect bilirubin 1.9, ast 124 alt 112 ggt 193. A hepatic amebian abscess is suspected and empirical management with liquids, ceftriaxone and metronidazole was started. Patient continue with fever and disturbed mental status for the next two days. Ultrasound reports hepatomegaly related with liver abscess located in left lobe, with heterogeneous echogenicity secondary to hypoechoic images, rounded, well-defi ned, displacing hepatic vessels with tubular images inside. Albendazol was added to management and after two days, by the continued bad evolution CT scan was requested and report multiple liver abscesses in left lobe, segment II and III, the biggest of 68x60mm, with 16 Hounsfi eld units. An exploratory laparotomy was performed fi nding multiple encapsulated abscesses with the presence of Ascaris lumbricoides inside that were drain and after washing an open drain was placed. Patient presents signifi cant improvement with continued medical management and was discharged 7 days after surgery. Conclusion: This is a very uncommon complication of Ascaris lumbricoides infection but must be suspected and treated promptly by the severe consequences associated, with poor outcomes although correct management.</p