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Mitochondrial DNA (mtDNA) copy number and mitochondrial DNA haplogroups have been associated with different types of cancer, including breast cancer, because they alter cellular energy metabolism. However, whether mtDNA copy number or haplogroups are predictors of oxidative stress-related risks in human breast cancer tissue in Mexican patients remains to be determined. Using quantitative real-time PCR assays and sequencing of the mtDNA hypervariable region, analysis of mtDNA copy numbers in 82 breast cancer tissues (BCT) and matched normal adjacent tissues (NAT) was performed to determine if copy number correlated with clinical features and Amerindian haplogroups (A2, B2, B4, C1 and D1) . The results showed that the mtDNA copy number was significantly decreased in BCT compared with NAT (p = 0.010); it was significantly decreased in BCT and NAT in women > 50 years of age, compared with NAT in women < 50 years of age (p = 0.032 and p = 0.037, respectively); it was significantly decreased in NAT and BCT in the postmenopausal group and in BCT in the premenopausal group compared with NAT in the premenopausal group (p = 0.011, p = 0.010 and, p = 0.018; respectively); and it was also significantly decrease in members of the BCT group classified as having invasive ductal carcinoma I-III (IDC-I, IDC-II and IDC-III) and IDC-II for NAT compared to IDC-I of NAT (p = 0.025, p = 0.022 and p = 0.031 and p = 0.020; respectively). The mtDNA copy number for BCT from patients with haplogroup B2 was decreased compared to patients with haplogroup D1 (p = 0.01); for BCT from patients with haplogroup C1 was also decreased compare with their NAT counterpart (p = 0.006) and with BCT patients belonging to haplogroups A2 and D1 (p = 0.01 and p = 0.03; respectively). In addition, the mtDNA copy number was decrease in the sequences with three deletions relative to the rCRS at nucleotide positions A249del, A290del and A291del, or C16327T polymorphism with the same p = 0.019 for all four variants. Contrary, the copy number increased in sequences containing C16111T, G16319A or T16362C polymorphisms (p = 0.021, =0.048, and = 0.001; respectively). In conclusion, a decrease in the copy number of mtDNA in BCT compared with NAT was shown by the results, which suggests an imbalance in oxidative phosphorylation (OXPHOS) that can affect the apoptosis pathway and cancer progression. It was also observed an increase of the copy number in samples with specific polymorphisms, which may be a good sign of favourable prognosis.

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BACKGROUND: Almost 10% of women in reproductive age had a chronic disease, and contraception is frequently ignored by these patients. The lack of use of contraceptives methods has a higher repercussion in these patients; if pregnant, the risk is increased in morbidity and feto-maternal mortality. OBJECTIVES: to know the contraceptive coverage in women with chronic degenerative diseases, the kind of contraceptive methods and the unsatisfied demand. MATERIAL AND METHODS: A descriptive study was made with the application of a survey from the one elaborated by the IMSS. It explores contraception socio-demographic data, causes of non-protection and also explores Medical Doctor (MD) participation. Sample size was calculated in 385 women in reproductive age with a chronic disease. RESULTS: 428 women about 30-49 years old were interviewed, 53% of them were married, they had various diseases, the contraceptive coverage was 84%. The definitive methods were the most used with 47%, followed by the condom with 20%, intrauterine device with 13% and others in minor proportion. 38.5% of patients with sexual life have risk of pregnancy for lack of use of method or for using one of low effectiveness and continuity. Of 45 (16%) patients with sexual life that did not use methods, 29% because they wish pregnancy, 18% by collateral effects and the rest for other causes. From this same patients 21 wished getting pregnant and 24 did not, this is an unsatisfied demand of 53%. The MD's informed about risks in case of pregnancy of 83.4% of the patients. CONCLUSIONS: The contraceptive coverage is low and the unsatisfied demand is higher than in the general population. It requires the effective participation of health personal in this group of high reproductive risk.

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BACKGROUND: Preeclampsia is a pregnancy-related pathological condition triggered by an abnormal placentation which produces endothelial dysfunction (ED). ED, in turn, is associated with an increase in homocysteine (hcy) and asymmetric dimethylarginine (ADMA); these molecules are also increased when some of the B-vitamins are deficient. It is unclear whether increases in hcy and ADMA during preeclampsia are the result of ED, or the consequence of a B-vitamin deficiency. OBJECTIVE: To evaluate hcy, ADMA, folic acid (FA), vitamin B6 and B2 concentrations in patients with preeclampsia. METHODS: In a cross-sectional design 19 patients with severe preeclamp- sia (preeclampsia) and 57 with normal pregnancy (no-preeclampsia), paired by gestational age and body mass index, were studied. Plasma hcy, ADMA, FA and vitamins B6 and B12 were determined. Non-parametric statistics was used for between-groups comparisons and regression analyses to evaluate interactions among molecules. RESULTS: 72% of women were vitamin B deficient, 40% were deficient of B12 and 4% of FA. Preeclamptic patients presented hcy and ADMA concentrations higher than no-preeclamptic ones. Inferential analyses demonstrated that: hcy and ADMA are increased during preeclampsia independently from vitamins blood concentration; that the risk for pre- eclampsia is associated with high hcy but not with vitamins deficiency; and that the ratio L-arginine:ADMA decreases the preeclampsia risk. CONCLUSION: In patients with preeclampsia, increases of hcy and ADMA are associated with ED, but not with deficiency of the vitamins involved in their metabolism.

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It has been reported that infertility affects approximately 20% of couples in reproductive age around the world. Although many factors involved, ovulatory dysfunction and particularly the hypothalamus pituitary dysfunction are quite common. The first line treatment for these pathologies consists on the administration of inducing ovulation agents such as recombinant gonadotropins and clomiphene citrate which it was obtained high rates of ovulation but not of pregnancy. So determine the effect of these treatments on the endometrium at morphological and molecular level is very important to understand the female reproductive physiology and optimize clinical strategies to obtain better pregnancy rates after treatments. In this paper we detailed the studies that have reported changes at the molecular and morphological level in human endometrium.

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OBJECTIVE: To assess IR in PCOS patients, using the HE-clamp as the IR gold standard. MATERIAL AND METHODS: A transversal design was done. All patients who accepted to participate provided written informed consent. PCOS was diagnosed according to the 2003 Rotterdam criteria. IR was assessed using the H-clamp, and other IR surrogates such as; fasting plasma insulin (FPI), homeostasis model assessment (HOMA) index and insulin/ glucose rate (I/G rate). Statistical analysis was performed using measures of location and spread was used according to data distribution. RESULTS: 21 patients were included. The mean age of the total group studied was 29.5 +/- 4.8 years, and the body mass index (BMI) was 27.2 +/- 3.08 kg/m2. The 85.7% of the patients met the three Rotterdam criteria for the diagnosis of PCOS. According to the HE clamp 95.2% were IR (M/I value < 6 mg/Kg/min), in contrast the prevalence of IR using sur- rogates was 47.6%, 33.3%, and 66.6% for FPI, G/I rate, and HOMA index respectively. CONCLUSIONS: Our findings show that IR is highly prevalent in patients with PCOS, and that this prevalence is even higher when insulin sensitivity is assessed using the glucose clamp technique. This evidence suggests that IR could be considered diagnostic criteria for PCOS.

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Lipoprotein lipase (LPL) plays a pivotal role in lipid metabolism, contributes to metabolic disorders related to insulin action and body weight regulation, and is influenced by inflammation. The Pro12Ala polymorphism of the peroxisome proliferator-activated receptor (PPAR)γ2 gene seems to influence LPL functioning, but its role in obesity and insulin resistance status, which usually coexist in the clinical setting, has not been explored. Our aim was to analyze the association of obesity and insulin resistance with adipose LPL activity and expression, and the influence of the PPARγ2 Pro12Ala polymorphism. A cross-sectional study was conducted in 58 reproductive-age women who underwent elective abdominal surgery. Free-fatty acids, glucose, insulin, and selected adipokines were measured in fasting blood samples. DNA was isolated and the polymorphism genotyped. Biopsies of abdominal subcutaneous adipose tissue obtained during surgery were used to determine enzymatic LPL activity and expression; and expression of selected cytokines. Overweight/obese women presented lower LPL activity (P=0.022) and higher circulating TNF-α (P=0.020) than controls. Insulin resistant women also showed borderline lower LPL activity than non-resistant (P=0.052), but adiposity and inflammatory molecules were comparable. Nevertheless, LPL activity was higher in Pro12Ala carriers than in non-carriers after adjusting for obesity, insulin resistance and inflammation. Likewise, adipose LPL expression was increased in carriers while expression of cytokines was decreased. Our data suggest that insulin resistance is associated with low adipose LPL activity independently of obesity, but the PPARγ2 Pro12Ala polymorphism seems to protect the LPL functioning of obese insulin resistant women, likely through regulating inflammation in adipose tissue.

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BACKGROUND: The role of insulin resistance (IR) of infertile patients with chronic anovulation in their therapeutic failure to clomiphene citrate (CC) is not quite clear. OBJECTIVE: Determine the sensitivity to insulin in patients with chronic anovulation and failure to the treatment with clomiphene citrate. MATERIAL AND METHODS: A cross-sectional clinical study in infertile patients with clomiphene citrate resistance and in patients with adequate response to clomiphene citrate was carried out. In all patients insulin resistance was determined by the rate of glucose/insulin, HOMA (Homestatic Model Assessment) and the insulin sensitivity test. For the inferential statistical analysis, a Student's t test for independent samples was used. RESULTS: The average total basal insulin was 19.6 +/- 8.1 microU/mL. We observed higher concentrations in the clomiphene citrate resistance group (22.1 +/- 8.9 vs. 15.8 +/- 5.1 mU/mL p = 0.07). The glucose/insulin rate was statistically minor in patients with resistance to clomiphene citrate (4.2 +/- 1.9 versus 6.9 +/- 2.1 p = 0.02), but HOMA was not significantly different in both groups (4.3 +/- 1.4 vs. 3.9 +/- 1.3 p = 0.6). The total rate of glucose disappearance (KIIT) was 4.1 +/- 1.2. However, the statistical analysis did not show significant statistical differences between the two groups. CONCLUSIONS: Our preliminary results suggest that insulin resistance can be a mechanism involved in the pharmacologic response to ovulation induction in infertile patients, but coexisting pathophysiological mechanisms such as hyperandrogenism might also account for the lack of response to clomiphene citrate.

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OBJECTIVE: To build, validate and apply an instrument to evaluate the clinical aptitude in intraepitelial cervical neoplasia (ICN) in residents. METHODS: The instrument included four clinical real cases, validated by experts and included 106 items using true, false and don't know answers. A pilot test and the 21 Kuder-Richardson formula were used to estimate consistency. It was applied to residents, in an observational, transversal, comparative and open study, including 11 second year residents, 13 third year residents and 12 fourth year residents. RESULTS: Consistency of 0.88 was obtained; 22% were located in the middle level, 39% were located in the low level and 39% in the very low level. There were no residents in the high or very high level or by chance answer level. The Kruskal-Wallis test showed significant differences among the three groups and with the U test of Mann Whitney there were no differences between groups. CONCLUSIONS: The year of residence did not show differences in the development of clinical aptitude in ICN. Most of the residents were located in the inferior level of clinical aptitude. This study makes evident the need to reframe our educative processes in a qualitative different manner.

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Breast cancer (BC) is the second leading cause of death among Mexican women over 40 years of age. This study aimed to identify and examine the effects of cancer stage and surgical treatment on the quality of life (QOL) of Mexican women with early stage breast cancer (ESBC) treated with either modified radical mastectomy (MRM) or breast conservative surgery (BCS), plus adjuvant chemotherapy. The QLQ-C30 and QLQ BR-23 questionnaires were used to assess QOL. Sociodemographic characteristics and clinical factors of 102 women with early BC were also evaluated; analysis of variance (ANOVA) was performed and a statistical significance of p < 0.05 was assumed. Most women were of reproductive age. Meaningful differences in QOL as a result of surgical treatment, in women receiving BCS compared with those receiving MRM, were limited to body image. We conclude that MRM and BCS are essentially equivalent choices in terms of QOL, with the exception of the impact on body image. In general, women who received BCS had a better perceived QOL.

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BACKGROUND: Women's reproductive potential is closely related to nutritional status. Some of the molecules that participate in ovarian regulation are produced in the adipose tissue, and therefore their production is associated with adiposity. OBJECTIVE: To determine serum leptin, adiponectin, C-reactive protein, interleukin-6, and tumor necrosis factor alpha in infertile women with or without insulin resistance; and to associate these molecules with adiposity. METHODS: Thirty-one infertile women were included. Nutritional status was evaluated through clinical and biochemical parameters. Patients were stratified according with their body mass index and the presence of insulin resistance. For statistics, parametric analyses were conducted. RESULTS: The prevalence of overweight was 67.5%; high adiposity was present in 92.3% and central distribution of fat in 96.2% of studied women. Hypercholesterolemia was found in 32.3% of patients, hypertriglyceridemia in 25.8%, and 61.3% presented hyperinsulinemia. Overweight women presented lower adiponectin, and higher TNF-alpha and C-reactive protein concentrations, than those with normal body mass index (p < 0.05). Overweight women had also a higher probability for insulin resistance (p = 0.04). These women with insulin resistance presented lower adiponectin and higher C-reactive protein concentrations than non insulin resistance women. Body mass index correlated with leptin (r= 0.41), TNF-alpha (r= 0.41), and C-reactive protein (r= 0.33) concentrations. CONCLUSION: The prevalence of overweight, high adiposity, dislipidemias, and IR was high in our population studied. We conclude that adiposity is closely associated with some of the molecules that participate in the reproductive process and that also regulate inflammatory responses.

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