Medicine and Health Sciences Commons^™

Machine Learning Approach To Extract Diagnostic And Prognostic Thresholds: Application In Prognosis Of Cardiovascular Mortality, Luis J. Mena, Eber E. Orozco, Vanessa G. Felix, Rodolfo Ostos, Jesus D. Melgarejo, Gladys E. Maestre

School of Medicine Publications

Machine learning has become a powerful tool for analysing medical domains, assessing the importance of clinical parameters, and extracting medical knowledge for outcomes research. In this paper, we present a machine learning method for extracting diagnostic and prognostic thresholds, based on a symbolic classification algorithm called REMED. We evaluated the performance of our method by determining new prognostic thresholds for well-known and potential cardiovascular risk factors that are used to support medical decisions in the prognosis of fatal cardiovascular diseases. Our approach predicted 36% of cardiovascular deaths with 80% specificity and 75% general accuracy. The new method provides an innovative …

Measuring And Comparing Brain Cortical Surface Area And Other Areal Quantities, Anderson M. Winkler, Mert R. Sabuncu, B T. Yeo, Bruce Fischl, Douglas N. Greve, Peter Kochunov, Thomas E. Nichols, John Blangero, David C. Glahn

School of Medicine Publications

Structural analysis of MRI data on the cortical surface usually focuses on cortical thickness. Cortical surface area, when considered, has been measured only over gross regions or approached indirectly via comparisons with a standard brain. Here we demonstrate that direct measurement and comparison of the surface area of the cerebral cortex at a fine scale is possible using mass conservative interpolation methods. We present a framework for analyses of the cortical surface area, as well as for any other measurement distributed across the cortex that is areal by nature. The method consists of the construction of a mesh representation of …

Identification Of Common Variants Associated With Human Hippocampal And Intracranial Volumes, Jason L. Stein, Anderson M. Winkler, Laura Almasy, Joanne E. Curran, Marcio Almeida, Ravi Duggirala, Thomas D. Dyer, Harald H. H. Goring, Matthew P. Johnson, John Blangero

School of Medicine Publications

Identifying genetic variants influencing human brain structures may reveal new biological mechanisms underlying cognition and neuropsychiatric illness. The volume of the hippocampus is a biomarker of incipient Alzheimer's disease and is reduced in schizophrenia, major depression and mesial temporal lobe epilepsy. Whereas many brain imaging phenotypes are highly heritable, identifying and replicating genetic influences has been difficult, as small effects and the high costs of magnetic resonance imaging (MRI) have led to underpowered studies. Here we report genome-wide association meta-analyses and replication for mean bilateral hippocampal, total brain and intracranial volumes from a large multinational consortium. The intergenic variant rs7294919 …

Assessing Dementia In Resource-Poor Regions, Gladys E. Maestre

School of Medicine Publications

The numbers and proportions of elderly are increasing rapidly in developing countries, where prevalence of dementia is often high. Providing cost-effective services for dementia sufferers and their caregivers in these resourcepoor regions poses numerous challenges; developing resources for diagnosis must be the first step. Capacity building for diagnosis involves training and education of healthcare providers, as well as the general public, development of infrastructure, and resolution of economic and ethical issues. Recent progress in some low-to-middle-income countries (LMICs) provides evidence that partnerships between wealthy and resource-poor countries, and between developing countries, can improve diagnostic capabilities. Without the involvement of the …

High Dimensional Endophenotype Ranking In The Search For Major Depression Risk Genes, David C. Glahn, Joanne E. Curran, Anderson M. Winkler, Melanie A. Carless, Matthew P. Johnson, Harald H. H. Goring, Thomas D. Dyer, Ravi Duggirala, Laura Almasy, John Blangero

School of Medicine Publications

Background: Despite overwhelming evidence that major depression is highly heritable, recent studies have localized only a single depression-related locus reaching genome-wide significance and have yet to identify a causal gene. Focusing on family-based studies of quantitative intermediate phenotypes or endophenotypes, in tandem with studies of unrelated individuals using categorical diagnoses, should improve the likelihood of identifying major depression genes. However, there is currently no empirically derived statistically rigorous method for selecting optimal endophentypes for mental illnesses. Here, we describe the endophenotype ranking value, a new objective index of the genetic utility of endophenotypes for any heritable illness.

Methods: Applying endophenotype …

Curcumin Nanoformulations: A Future Nanomedicine For Cancer, Murali M. Yallapu, Meena Jaggi, Subhash C. Chauhan

School of Medicine Publications

Curcumin, a natural diphenolic compound derived from turmeric Curcuma longa, has proven to be a modulator of intracellular signaling pathways that control cancer cell growth, inflammation, invasion, apoptosis and cell death, revealing its anticancer potential. In this review, we focus on the design and development of nanoparticles, self-assemblies, nanogels, liposomes and complex fabrication for sustained and efficient curcumin delivery. We also discuss the anticancer applications and clinical benefits of nanocurcumin formulations. Only a few novel multifunctional and composite nanosystem strategies offer simultaneous therapy as well as imaging characteristics. We also summarize the challenges to developing curcumin delivery platforms and …

Genetic Influence On The Working Memory Circuitry: Behavior, Structure, Function And Extensions To Illness, Katherine H. Karlsgodt, Peter Bachman, Anderson M. Winkler, Carrie E. Bearden, David C. Glahn

School of Medicine Publications

Working memory is a highly heritable complex cognitive trait that is critical for a number of higher-level functions. However, the neural substrates of this behavioral phenotype are intricate and it is unknown through what precise biological mechanism variation in working memory is transmitted. In this review we explore different functional and structural components of the working memory circuitry, and the degree to which each of them is contributed to by genetic factors. Specifically, we consider dopaminergic function, glutamatergic function, white matter integrity and gray matter structure all of which provide potential mechanisms for the inheritance of working memory deficits. In …

Prevalence And Incidence Rates Of Dementia And Cognitive Impairment No Dementia In The Mexican Population: Data From The Mexican Health And Aging Study, Silvia Mejia-Arango, Luis Miguel Gutierrez

School of Medicine Publications

Objective: To estimate the prevalence and incidence of dementia and cognitive impairment without dementia (CIND) in the Mexican population.

Method: The MHAS study is a prospective panel study of health and aging in Mexico with 7,000 elders that represent eight million participants nationally. Using measurements of cognition and activities of daily living of dementia cases and CIND were identified at baseline and follow-up. Overall incidence rates and specific rates for sex, age, and education were calculated.

Results: Prevalence was 6.1% and 28.7% for dementia and CIND, respectively. Incidence rates were 27.3 per 1,000 person-years for dementia and 223 per 1,000 …

[Diabetes Mellitus As A Risk Factor For Dementia In The Mexican Elder Population] Diabetes Mellitus Como Factor De Riesgo De Demencia En La Población Adulta Mayor Mexicana, Silvia Mejia-Arango, Clemente Zúñiga-Gil

School of Medicine Publications

Introduction: Diabetes and dementia are growing problems throughout the world and especially in developing countries.

Aim: To determine the risk of developing dementia in subjects with type 2 diabetes mellitus.

Patients and methods: Diabetic elders free of dementia from the Mexican Health and Aging study, a prospective community-based cohort research were followed after two years. Socio-demographic factors, comorbid conditions and type of diabetes treatment were analyzed in subjects who become demented.

Results: At baseline, 749 participants (13.8%) had diabetes mellitus. During the follow-up period (mean: 2.02 years; range: 1-3 years), 306 of 749 persons with diabetes mellitus developed dementia, yielding …

Cross Talk Between O-Glcnacylation And Phosphorylation: Roles In Signaling, Transcription, And Chronic Disease, Gerald W. Hart, Chad Slawson, Genaro A. Ramirez-Correa, Olof Lagerlof

School of Medicine Publications

O-GlcNAcylation is the addition of β-D-N-acetylglucosamine to serine or threonine residues of nuclear and cytoplasmic proteins. O-linked N-acetylglucosamine (O-GlcNAc) was not discovered until the early 1980s and still remains difficult to detect and quantify. Nonetheless, O-GlcNAc is highly abundant and cycles on proteins with a timescale similar to protein phosphorylation. O-GlcNAc occurs in organisms ranging from some bacteria to protozoans and metazoans, including plants and nematodes up the evolutionary tree to man. O-GlcNAcylation is mostly on nuclear proteins, but it occurs in all intracellular compartments, including mitochondria. Recent glycomic analyses have shown that O-GlcNAcylation has surprisingly extensive …

Effects Of Insulin And Oral Antidiabetic Agents On Glucose Metabolism, Vascular Dysfunction And Skeletal Muscle Inflammation In Type 2 Diabetic Subjects, J. Joya-Galeana, M. Fernandez, A. Cervera, Sara M. Reyna, S. Ghosh, C. Triplitt, N. Musi, Ralph A. Defronzo, Eugenio Cersosimo

School of Medicine Publications

Background

To test potential differences between the actions of anti-diabetic medications, we examined the effects of oral hypoglycemic agents versus insulin glargine-apidra therapy in T2DM.

Methods

T2DM subjects were randomized to either OHA (pioglitazone, metformin, glipizide, n=9) or IT (n=12) for 6 months. Carotid intimal media thickness (CIMT), vascular reactivity [FMD] (% change in brachial arterial diameter [BD] post-ischemia), and sublingual nitrate [SLN] were measured with ultrasonography. Euglycemic hyperinsulinemic (80 mU/m2) clamp with [3]-3H-glucose and muscle biopsies were performed.

Results

FPG (∼257 to ∼124, OHA ∼256 to ∼142 mg/dl, IT) and HgbA1C (∼10.3 to ∼6.4%, OHA; ∼10.7 to ∼7.1%, IT), …

Blood Pressure And Cerebral White Matter Share Common Genetic Factors In Mexican Americans, Peter Kochunov, David C. Glahn, Jack Lancaster, Anderson M. Winkler, Rene L. Olvera, Joanne E. Curran, Thomas D. Dyer, Laura Almasy, Ravi Duggirala, Peter T. Fox, John Blangero

School of Medicine Publications

Elevated arterial pulse pressure and blood pressure (BP) can lead to atrophy of cerebral white matter (WM), potentially attributable to shared genetic factors. We calculated the magnitude of shared genetic variance between BP and fractional anisotropy of water diffusion, a sensitive measurement of WM integrity in a well-characterized population of Mexican Americans. The patterns of whole-brain and regional genetic overlap between BP and fractional anisotropy were interpreted in the context the pulse-wave encephalopathy theory. We also tested whether regional pattern in genetic pleiotropy is modulated by the phylogeny of WM development. BP and high-resolution (1.7 × 1.7 × 3 mm; …

Minimally Invasive Approaches For The Management Of “Difficult” Colonic Polyps, Roberto A. Cruz, Madhu Ragupathi, Rodrigo Pedraza, T. Bartley Pickron, Anne T. Le, Eric M. Haas

School of Medicine Publications

Traditionally, patients with colonic polyps not amenable to endoscopic removal require open colectomy for management. We evaluated our experience with minimally invasive approaches including endoscopic mucosal resection (EMR), laparoscopicassisted endoscopic polypectomy (LAEP), and laparoscopic-assisted colectomy (LAC). Patients referred for surgery for colonic polyps were selected for one of three minimally invasive modalities. A total of 123 patients were referred for resection of “difficult” polyps. Thirty underwent EMR, 25 underwent LAEP, and 68 underwent LAC. Of those selected to undergo EMR or LAEP, 76.4% were successfully managed without colon resection. The remaining 23.6% underwent LAC. Nine complications were encountered, including two …

Genetic Analysis Of Cortical Thickness And Fractional Anisotropy Of Water Diffusion In The Brain, Peter Kochunov, David C. Glahn, Thomas E. Nichols, Anderson M. Winkler, Elliot L. Hong, Joanne E. Curran, Rene L. Olvera, Matthew P. Johnson, Shelley A. Cole, John Blangero

School of Medicine Publications

Objectives: The thickness of the brain’s cortical gray matter (GM) and the fractional anisotropy (FA) of the cerebral white matter (WM) each follow an inverted U-shape trajectory with age. The two measures are positively correlated and may be modulated by common biological mechanisms. We employed four types of genetic analyses to localize individual genes acting pleiotropically upon these phenotypes.

Methods: Whole-brain and regional GM thickness and FA values were measured from high-resolution anatomical and diffusion tensor MR images collected from 712, Mexican American participants (438 females, age = 47.9 ± 13.2 years) recruited from 73 (9.7 ± 9.3 individuals/family) large …

Cortical Thickness Or Grey Matter Volume? The Importance Of Selecting The Phenotype For Imaging Genetics Studies, Anderson M. Winkler, Peter Kochunov, John Blangero, Laura Almasy, Karl Zilles, Peter T. Fox, Ravi Duggirala, David C. Glahn

School of Medicine Publications

Choosing the appropriate neuroimaging phenotype is critical to successfully identify genes that influence brain structure or function. While neuroimaging methods provide numerous potential phenotypes, their role for imaging genetics studies is unclear. Here we examine the relationship between brain volume, grey matter volume, cortical thickness and surface area, from a genetic standpoint. Four hundred and eighty-six individuals from randomly ascertained extended pedigrees with high-quality T1-weighted neuroanatomic MRI images participated in the study. Surface-based and voxel-based representations of brain structure were derived, using automated methods, and these measurements were analysed using a variance-components method to identify the heritability of these traits …

Transforming Grief: The Use Of Images During Bereavement In Mexico And The United States, Rebecca M. Reséndiz Rodriguez

School of Medicine Publications

According to the literature, bereavement photography was an important part of funeral rituals in many countries, including Mexicoand the United States. By the early to mid- 20^th century, the custom appeared to have fallen out of favor in both countries except in the case of neonatal bereavement photography, at least in theUnited States. By comparing participants from 2 distinct cultures - theUnited States andMexico - I hope to show that bereavement photography can still be a useful tool during grieving. Anxiety and depression related to the topic of death will be evaluated for differences or similarities between the 2 …

Whole Brain And Regional Hyperintense White Matter Volume And Blood Pressure: Overlap Of Genetic Loci Produced By Bivariate, Whole-Genome Linkage Analyses, Peter Kochunov, David Glahn, Jack Lancaster, Anderson M. Winkler, Jack W. Kent Jr., Rene L. Olvera, Shelley A. Cole, Thomas D. Dyer, Laura Almasy, Ravi Duggirala, Peter T. Fox, John Blangero

School of Medicine Publications

Background and purpose: The volume of T2-hyperintense white matter (HWM) is an important neuroimaging marker of cerebral integrity with a demonstrated high heritability. Pathophysiology studies have shown that the regional, ependymal, and subcortical HWM lesions are associated with elevated arterial pulse pressure and arterial blood pressure (BP), respectively. We performed bivariate, whole-genome linkage analyses for HWM volumes and BP measurements to identify chromosomal regions that contribute jointly to both traits in a population of healthy Mexican Americans. Our aims were to localize novel quantitative trait loci acting pleiotropically on these phenotypes and to replicate previous genetic findings on whole brain …

A Multimodal Assessment Of The Genetic Control Over Working Memory, Katherine H. Karlsgodt, Peter Kochunov, Anderson M. Winkler, Angela R. Laird, Laura Almasy, Ravi Duggirala, Rene L. Olvera, Peter T. Fox, John Blangero, David C. Glahn

School of Medicine Publications

Working memory performance is significantly influenced by genetic factors. Here, we assessed genetic contributions to both working memory performance and neuroimaging measures focused on the network of brain regions associated with working memory by using a sample of 467 human participants from extended families. Imaging measures included diffusion tensor imaging indices in major white matter tracts thought to be associated with working memory and structural magnetic resonance imaging measures of frontal and parietal gray matter density. Analyses directly addressed whether working memory performance and neural structural integrity are influenced by common genetic factors (e.g., pleiotropy). While all cognitive measures, gray …

Analysis Of Genetic Variability And Whole Genome Linkage Of Whole-Brain, Subcortical, And Ependymal Hyperintense White Matter Volume, Peter Kochunov, David Glahn, Anderson M. Winkler, Ravi Duggirala, Rene L. Olvera, Shelley A. Cole, Thomas D. Dyer, Laura Almasy, Peter T. Fox, John Blangero

School of Medicine Publications

Background and purpose: The cerebral volume of T2-hyperintense white matter (HWM) is an important neuroimaging marker of cerebral integrity. Pathophysiology studies identified that subcortical and ependymal HWM are produced by 2 different mechanisms but shared a common risk factor: high arterial pulse pressure. Recent studies have demonstrated high heritability of the whole-brain HMW volume and reported significant and suggestive evidence of genetic linkage. We performed heritability and whole-genome linkage analysis to replicate previous reported findings and to study shared genetic variance, and possible overlap for specific loci, between subcortical and ependymal HWM volumes in a population of healthy Mexican Americans. …

Impaired Regulation Of The Tnf-Alpha Converting Enzyme/Tissue Inhibitor Of Metalloproteinase 3 Proteolytic System In Skeletal Muscle Of Obese Type 2 Diabetic Patients: A New Mechanism Of Insulin Resistance In Humans, A Monroy, S Kamath, A O. Chavez, V E. Centonze, M Veerasamy, A Barrentine, J J. Wewer, D K. Coletta, C Jenkinson, Sara M. Reyna

School of Medicine Publications

Aims/hypothesis: TNF-alpha levels are increased in obesity and type 2 diabetes. The regulation of TNF-alpha converting enzyme (TACE) and its inhibitor, tissue inhibitor of metalloproteinase 3 (TIMP3), in human type 2 diabetes is unknown.

Methods: We examined TACE/TIMP3 regulation: (1) in lean and obese normal glucose tolerant (NGT) individuals and in type 2 diabetes patients; (2) following 6 h of lipid/saline infusion in NGT individuals; and (3) in cultured human myotubes from lean NGT individuals incubated with palmitate. Insulin sensitivity was assessed by a euglycaemic clamp and TACE/TIMP3 was evaluated by confocal microscopy, RT-PCR, western blotting and an in vitro …

Trastorno Bipolar En Los Niños: Hechos Actuales [Pediatric Bipolar Disorder: Actual Facts], Víctor M. Joffre-Velázquez, Gerardo García-Maldonado, Atenogenes H. Saldívar-González, Roberto A. Cruz

School of Medicine Publications

A general review of clinical reports about the pediatric bipolar disorder (PBD) published in the last 10 year was done, but we included some before that. Data was obtained in the bases PubMed, EbscoHost and OvidSP, using as key words: bipolar disorder, pediatric, children, adolescent and early onset. We select the reports clinical issues of special interest for the diagnosis and treatment and epidemiological reports related to PBD and we had particular care in select those with a good methodology. It was documented that the PBD has being diagnosed more often when good clinic and clinimetric tools are used. Imaging …

Beyond Aica Riboside: In Search Of New Specific Amp-Activated Protein Kinase Activators, Bruno Guigas, Kei Sakamoto, Nellie Taleux, Sara M. Reyna, Nicolas Musi, Benoit Viollet, Louis Hue

School of Medicine Publications

5-Aminoimidazole-4-carboxamide-1-beta-D-ribofuranoside (AICA riboside) has been extensively used in vitro and in vivo to activate the AMP-activated protein kinase (AMPK), a metabolic sensor involved in both cellular and whole body energy homeostasis. However, it has been recently highlighted that AICA riboside also exerts AMPK-independent effects, mainly on AMP-regulated enzymes and mitochondrial oxidative phosphorylation (OXPHOS), leading to the conclusion that new compounds with reduced off target effects are needed to specifically activate AMPK. Here, we review recent findings on newly discovered AMPK activators, notably on A-769662, a nonnucleoside compound from the thienopyridone family. We also report that A-769662 is able to activate …

Risk Of Dementia Associated With Elevated Plasma Homocysteine In A Latin American Population, Inara J. Chacon, Aldrín E. Molero, Gloria Pino-Ramírez, José A. Luchsinger, Joseph H. Lee, Gladys E. Maestre

School of Medicine Publications

The relationship between total homocysteine (tHcy) and dementia risk remains controversial, as the association varies among populations and dementia subtypes. We studied a Venezuelan population that has high prevalence of both elevated tHcy and dementia. We tested the hypotheses that (1) elevated tHcy is associated with increased dementia risk, (2) the risk is greater for vascular dementia (VaD) than for Alzheimer’s disease (AD), and (3) a history of stroke may partly explain this association. 2100 participants (≥55 years old) of the Maracaibo Aging Study underwent standardized neurological, neuropsychiatric, and cardiovascular assessments. Elevated tHcy was significantly associated with dementia, primarily VaD. …

Elevated Toll-Like Receptor 4 Expression And Signaling In Muscle From Insulin-Resistant Subjects, Sara M. Reyna, Sangeeta Ghosh, Puntip Tantiwong, C S. Reddy Meka, Phyllis Eagan, Christopher P. Jenkinson, Eugenio Cersosimo, Ralph A. Defronzo, Dawn K. Coletta, Apiradee Sriwijitkamol

School of Medicine Publications

OBJECTIVE— Tall-like receptor (TLR)4 has been implicated in the pathogenesis of free fatty acid (FFA)-induced insulin resistance by activating inflammatory pathways, including inhibitor of κB (IκB)/nuclear factor κB (NFκB). However, it is not known whether insulin-resistant subjects have abnormal TLR4 signaling. We examined whether insulin-resistant subjects have abnormal TLR4 expression and TLR4-driven (IκB/NFκB) signaling in skeletal muscle.

RESEARCH DESIGN AND METHODS— TLR4 gene expression and protein content were measured in muscle biopsies in 7 lean, 8 obese, and 14 type 2 diabetic subjects. A primary human myotube culture system was used to examine whether FFAs stimulate IκB/NFκB via TLR4 and …

Alzheimer's Disease And Vascular Dementia In Developing Countries: Prevalence, Management, And Risk Factors, Raj N. Kalaria, Gladys E. Maestre, Raul Arizaga, Robert P. Friedland, Doug Galasko, Kathleen Hall, José A. Luchsinger, Adesola Ogunniyi, Elaine K. Perry, Felix Potocnik

School of Medicine Publications

Despite mortality due to communicable diseases, poverty, and human conflicts, dementia incidence is destined to increase in the developing world in tandem with the ageing population. Current data from developing countries suggest that age-adjusted dementia prevalence estimates in 65 year olds are high (≥5%) in certain Asian and Latin American countries, but consistently low (1–3%) in India and sub-Saharan Africa; Alzheimer's disease accounts for 60% whereas vascular dementia accounts for ∼30% of the prevalence. Early-onset familial forms of dementia with single-gene defects occur in Latin America, Asia, and Africa. Illiteracy remains a risk factor for dementia. The APOE ε4 allele …

Clinical Indicators For Success Of Misoprostol Treatment After Early Pregnancy Failure, Candace Robledo, J. Zhang, J Troendle, K. Barnhart, M. D. Creinin, C. Westhoff, X. Huang, M. Frederick

School of Medicine Publications

Objective

To identify clinical indicators for success of misoprostol treatment after early pregnancy failure.

Methods

A total of 473 women with early pregnancy failure received 800 μg of vaginal misoprostol on treatment day 1. At the follow-up visit on day 3, a second dose was given if expulsion was incomplete. On day 8, vacuum aspiration was offered if expulsion had not occurred. Ultrasonography was used as gold standard for success. A Classification and Regression Tree analysis was undertaken to derive two decision trees for the success of misoprostol treatment on study days 3 and 8.

Results

Heavy bleeding after the …

Delayed Angiogenesis And Vegf Production In Ccr2−/− Mice During Impaired Skeletal Muscle Regeneration, Oscar Ochoa, Dongxu Sun, Sara M. Reyna, Lindsay L. Waite, Joel E. Michalek, Linda M. Mcmanus, Paula K. Shireman

School of Medicine Publications

The regulation of vascular endothelial growth factor (VEGF) levels and angiogenic events during skeletal muscle regeneration remains largely unknown. This study examined angiogenesis, VEGF levels, and muscle regeneration after cardiotoxin (CT)-induced injury in mice lacking the CC chemokine receptor 2 (CCR2). Muscle regeneration was significantly decreased in CCR2−/− mice as was the early accumulation of macrophages after injury. In both mouse strains, tissue VEGF was similar at baseline (no injections) and significantly decreased at day 3 post-CT. Tissue VEGF in wild-type (WT) mice was restored within 7 days postinjury but remained significantly reduced in CCR2−/− mice until day 21. …

[Factors Associated With Functional Dependence In Older Adults: A Secondary Analysis Of The National Study On Health And Aging, Mexico, 2001] Factores Asociados Con La Dependencia Funcional En Los Adultos Mayores: Un Análisis Secundario Del Estudio Nacional Sobre Salud Y Envejecimiento En México, 2001, Guadalupe Dorantes-Mendoza, José Alberto Avila-Funes, Silvia Mejia-Arango, Luis Miguel Gutiérrez-Robledo

School of Medicine Publications

OBJECTIVES: To identify factors associated with dependence for basic activities of daily living (BADL) and instrumental activities of daily living (IADL) in elderly adults in Mexico.

METHODS: A cross-sectional study of data from the first round of Mexico's National Study on Health and Aging, 2001, was undertaken. The sample consisted of 7 171 participants, 60 years of age or older. Multifactorial regression analysis was used to identify associations between BADL and IADL dependence and lifestyle, sociodemographics, family background, and health history, from childhood to present.

RESULTS: The mean age of the participants was 69.4 +/- 7.6 years of age, …

Effect Of Acute Exercise On Ampk Signaling In Skeletal Muscle Of Subjects With Type 2 Diabetes, Apiradee Sriwijitkamol, Dawn K. Coletta, Estela Wajcberg, Gabriela B. Balbontin, Sara M. Reyna, John Barrientes, Phyllis Eagan, Christopher P. Jenkinson, Eugenio Cersosimo, Ralph A. Defronzo, Kei Sakamoto, Nicolas Musi

School of Medicine Publications

Activation of AMP-activated protein kinase (AMPK) by exercise induces several cellular processes in muscle. Exercise activation of AMPK is unaffected in lean (BMI ~25 kg/m2) subjects with type 2 diabetes. However, most type 2 diabetic subjects are obese (BMI >30 kg/m2), and exercise stimulation of AMPK is blunted in obese rodents. We examined whether obese type 2 diabetic subjects have impaired exercise stimulation of AMPK, at different signaling levels, spanning from the upstream kinase, LKB1, to the putative AMPK targets, AS160 and peroxisome proliferator–activated receptor coactivator (PGC)-1α, involved in glucose transport regulation and mitochondrial biogenesis, respectively. Twelve type 2 diabetic, …

Deterioro Cognoscitivo Y Factores Asociados En Adultos Mayores En México [Cognitive Impairment And Associated Factors In Older Adults In Mexico], Silvia Mejia-Arango, Alejandro Miguel-Jaimes, Antonio Villa, Liliana Ruiz-Arregui, Luis Miguel Gutiérrez-Robledo

School of Medicine Publications

OBJECTIVE: To determine the prevalence of cognitive impairment in the elderly and its relation with sociodemographic and health factors in the Mexican population.

MATERIAL AND METHODS: From the first wave data of the National Aging and Health Study, collected in 2001 in Mexico, subjects 65 years or older and who had completed a cognitive assessment were selected. Subjects were classified according to two groups: with and without cognitive impairment, based on the cutoff point corresponding to the 10th percentile of the total cognitive assessment score, adjusted for age and educational level. All subjects with cognitive impairment that also had difficulty …