Examinando por Autor "García, Ronald G."
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- PublicaciónRestringidoAged garlic extract improves adiponectin levels in subjects with metabolic syndrome : A double-blind, placebo-controlled, randomized, crossover study(2013-01) Gómez Arbeláez, Diego; Lahera, Vicente; Oubiña, Maria del Pilar; Valero Muñoz, Maria; De las Heras, Natalia; Rodríguez, Yudy; García, Ronald G.; Camacho López, Paul Anthony; Lopez-Jaramillo, PatricioBackground. Garlic (Allium sativum) has been shown to have important benefits in individuals at high cardiovascular risk. The aim of the present study was to evaluate the effects of the administration of aged garlic extract (AGE) on the risk factors that constitute the cluster of metabolic syndrome (MS). Methods and Design. Double-blind, crossover, randomized, placebo-controlled clinical trial to assess the effect of 1.2 g/day of AGE (Kyolic), for 24 weeks of treatment (12 weeks of AGE and 12 weeks of placebo), on subjects with MS. Results. The administration of AGE increased the plasma levels of adiponectin (𝑃 = 0.027). No serious side effects associated with the intervention were reported. Conclusion. The present results have shown for the first time that the administration of AGE for 12 weeks increased plasma adiponectin levels in patients with MS. This suggests that AGE might be a useful, novel, nonpharmacological therapeutic intervention to increase adiponectin and to prevent cardiovascular (CV) complications in individuals with MS.
- PublicaciónAcceso abiertoAppropriate prenatal care system : The best way to prevent preeclampsia in Andean countries(2009-04) Lopez-Jaramillo, Patricio; García, Ronald G.; Reyes, Laura M.; Ruiz, Silvia L.The main cause of maternal mortality in Colombia is preeclampsia; even though it is a major public health problem its etiology and physiopathology remain unknown. However it is believed that endothelial dysfunction plays a central role in the development of this disease. Many clinical trials have been carried out to demonstrate the effect of certain interventions to prevent preeclampsia and improve pregnancy outcomes. Our hypothesis is that the reduction of preeclampsia risk could be achieved through an appropriate health system that would provide an opportune and effective prenatal care to pregnant women allowing early diagnosis and treatment of frequent nutritional and health related problems.
- PublicaciónAcceso abiertoAsociación entre niveles de proteína C-reactiva y oxido nítrico con el pronostico de pacientes con enfermedad cerebro vascular isquémica(2015-04) García, Ronald G.; Rosso, Pedro; García, Zaira M.; Álvarez Camacho, Julie; Suárez, Uriel; Gómez Arbeláez, Diego; Lopez-Jaramillo, Patricio; Silva Sieger, Federico ArturoIntroduction: Inflammation and alterations in the bioavailability of nitric oxide (NO) have been involved in the pathophysiology of cerebrovascular disease. Objective: The aim of the study was to determine the prognostic value of measuring NO metabolites and inflammatory markers in patients with acute ischemic stroke. Materials and methods: A total of 158 patients with acute ischemic stroke were included in an observational cohort study. Between 48 and 72 hours post admission, a fasting blood sample was taken to determine the biochemical profile, inflammatory markers (CRP, IL1-β, IL6, TNF-α) and nitrites/nitrates plasma levels. The cohort’s follow-up was conducted for two years to determine the occurrence of a new event (stroke, myocardial infarction, heart failure) or death of vascular origin. Comparisons between groups were made using the log-rank test. A Cox multivariate regression analysis permitted to determine factors independently associated with the outcome. Results: The mean age was 70.5 ± 12.8 years. 39.2% of the subjects presented the outcome during the first 24 months of follow-up. CRP levels > 12 mg/L (HR 2.22, 95% CI 1.07-4.59) and a score > 13 on the NIHSS scale at admission (HR 2.81 95% CI 1.46-5.41) were significantly associated with an increased risk of a new event. The combination of CRP levels < 12 mg/L and nitrites/nitrates levels < 35.5 mmol/L was identified as a protective factor (HR 0.21, 95% CI 0.06-0.71). Conclusion: This study demonstrates that the determination of CRP and NOx levels could be beneficial in clinical practice to stratify the risk of future events or death of vascular origin in acute ischemic stroke patients.
- PublicaciónAcceso abiertoBrain Circuitry Supporting Multi-Organ Autonomic Outflow in Response to Nausea(2016-02) García, Ronald G.; Kim, Jieun; Sheehan, James D.; Beissner, Florian; Bianchi, Anna M.; Cerutti, Sergio; Kuo, Braden; Barbieri, Riccardo; Napadow, Vitaly; Sclocco, RobertaWhile autonomic outflow is an important co-factor of nausea physiology, central control of this outflow is poorly understood. We evaluated sympathetic (skin conductance level) and cardiovagal (high-frequency heart rate variability) modulation, collected synchronously with functional MRI (fMRI) data during nauseogenic visual stimulation aimed to induce vection in susceptible individuals. Autonomic data guided analysis of neuroimaging data, using a stimulus-based (analysis windows set by visual stimulation protocol) and percept-based (windows set by subjects’ ratings) approach. Increased sympathetic and decreased parasympathetic modulation was associated with robust and anti-correlated brain activity in response to nausea. Specifically, greater autonomic response was associated with reduced fMRI signal in brain regions such as the insula, suggesting an inhibitory relationship with premotor brainstem nuclei. Interestingly, some sympathetic/parasympathetic specificity was noted. Activity in default mode network and visual motion areas was anti-correlated with parasympathetic outflow at peak nausea. In contrast, lateral prefrontal cortical activity was anticorrelated with sympathetic outflow during recovery, soon after cessation of nauseogenic stimulation. These results suggest divergent central autonomic control for sympathetic and parasympathetic response to nausea. Autonomic outflow and the central autonomic network underlying ANS response to nausea may be an important determinant of overall nausea intensity and, ultimately, a potential therapeutic target.
- PublicaciónRestringidoCardiovascular prevention in high-risk patients with type 2 diabetes mellitus : When to start it?(2008-08-29) García, Ronald G.; Lopez-Jaramillo, Patricio
- PublicaciónAcceso abiertoComplexity Variability Assessment of Nonlinear Time-Varying Cardiovascular Control(2017-02-20) García, Ronald G.; Citi, Luca; NoggleTaylor, Jessica; Toschi, Nicola; Barbieri, Riccardo; Valenza, GaetanoThe application of complex systems theory to physiology and medicine has provided meaningful information about the nonlinear aspects underlying the dynamics of a wide range of biological processes and their disease-related aberrations. However, no studies have investigated whether meaningful information can be extracted by quantifying second-order moments of time-varying cardiovascular complexity. To this extent, we introduce a novel mathematical framework termed complexity variability, in which the variance of instantaneous Lyapunov spectra estimated over time serves as a reference quantifier. We apply the proposed methodology to four exemplary studies involving disorders which stem from cardiology, neurology and psychiatry: Congestive Heart Failure (CHF), Major Depression Disorder (MDD), Parkinson’s Disease (PD), and Post-Traumatic Stress Disorder (PTSD) patients with insomnia under a yoga training regime. We show that complexity assessments derived from simple time-averaging are not able to discern pathology-related changes in autonomic control, and we demonstrate that between-group differences in measures of complexity variability are consistent across pathologies. Pathological states such as CHF, MDD, and PD are associated with an increased complexity variability when compared to healthy controls, whereas wellbeing derived from yoga in PTSD is associated with lower time-variance of complexity.
- PublicaciónAcceso abiertoCyclic Vomiting Syndrome is characterized by altered functional brain connectivity of the insular cortex : A cross-comparison with migraine and healthy adults(2018-06) Ellingsen, Dan-Mikael; García, Ronald G.; Lee, Jeungchan; Lin, Richard L.; Kim, Jieun; Thurler, Andrea H; Castel, Shahar; Dimisko, Laurie; Rosen, Bruce R.; Hadjikhani, Nouchine; Kuo, Braden; Napadow, VitalyCyclic Vomiting Syndrome (CVS) has been linked to episodic migraine, yet little is known about the precise brain-based mechanisms underpinning CVS, and whether these associated conditions share similar pathophysiology. We investigated the functional integrity of salience (SLN) and sensorimotor (SMN) intrinsic connectivity networks in CVS, migraine and healthy controls using brain functional Magnetic Resonance Imaging. CVS, relative to both migraine and controls, showed increased SLN connectivity to middle/posterior insula, a key brain region for nausea and viscerosensory processing. In contrast, this same region showed diminished SMN connectivity in both CVS and migraine. These results highlight both unique and potentially shared pathophysiology between these conditions, and suggest a potential target for therapeutics in future studies.
- PublicaciónAcceso abiertoFibromyalgia is characterized by altered frontal and cerebellar structural covariance brain networks(2015-03-04) Kim, Hyungjun; Kim, Jieun; Loggia, Marco L.; Cahalan, Christine M.; García, Ronald G.; Vangel, Mark G.; Wasan, Ajay D.; Edwards, Robert R.; Napadow, VitalyAltered brain morphometry has been widely acknowledged in chronic pain, and recent studies have implicated altered network dynamics, as opposed to properties of individual brain regions, in supporting persistent pain. Structural covariance analysis determines the inter-regional association in morphological metrics, such as gray matter volume, and such structural associations may be altered in chronic pain. In this study, voxel-based morphometry structural covariance networks were compared between fibromyalgia patients (N=42) and age- and sex-matched pain-free adults (N=63).We investigated network topology using spectral partitioning,which can delineate local network submodules with consistent structural covariance. We also explored white matter connectivity between regions comprising these submodules and evaluated the association between probabilistic white matter tractography and pain-relevant clinical metrics. Our structural covariance network analysis noted more connections within the cerebellum for fibromyalgia patients, and more connections in the frontal lobe for healthy controls. For fibromyalgia patients, spectral partitioning identified a distinct submodule with cerebellar connections to medial prefrontal and temporal and right inferior parietal lobes, whose gray matter volume was associated with the severity of depression in these patients. Volume for a submodule encompassing lateral orbitofrontal, inferior frontal, postcentral, lateral temporal, and insular cortices was correlated with evoked pain sensitivity. Additionally, the number ofwhitematter fibers between specific submodule regionswas also associated with measures of evoked pain sensitivity and clinical pain interference. Hence, altered gray and white matter morphometry in cerebellar and frontal cortical regions may contribute to, or result from, pain-relevant dysfunction in chronic pain patients.
- PublicaciónAcceso abiertoFisiopatología y tratamiento del dolor de miembro fantasma(2013-12-12) Malavera Angarita, Mayra Alejandra; Carrillo Villa, Sandra; Gomezese Ribero, Omar Fernando; García, Ronald G.; Silva Sieger, Federico ArturoIntroduction: Phantom limb pain may be present in up to 80% of patients subjected to amputation because oftrauma or peripheral vascular disease. Severalfactors have been associated with its occurrence, including pre-amputation pain, the etiology, and the amputation level. Objective: To review the current status of the pathophysiological mechanisms, treatment options and their efficacy for the management of phantom limb pain. Method: Non-systematic review ofthe literature in PubMed and Cochrane, of articles describing the pathophysiology and treatment of phantom limb pain. Results and conclusions: The proposed pathophysiological mechanisms are still in research and include peripheral, central and psychologicalfactors. Treatment options are still limited, and less than 10% of patients report long-term improvement.
- PublicaciónAcceso abiertoFundamentos y aplicaciones clínicas de la estimulación magnética transcraneal en neuropsiquiatría(2014) Malavera Angarita, Mayra Alejandra; Silva Sieger, Federico Arturo; García, Ronald G.; Rueda, Ligia C.; Carrillo Villa, SandraTranscranial Magnetic Stimulation (TMS) is a non-invasive method for stimulation of brain that is based on the ability of a generated magnetic field to penetrate skull and brain meninges, inducing an electric current in the brain tissues that produces neuronal depolarization. TMS can be applied as single pulse of stimulation, pairs of stimuli separated by variable intervals to the same or different brain areas, or as trains of repetitive stimuli at various frequencies. Its mechanism of action is currently unknown. Repetitive TMS can modify the excitability of the cerebral cortex, and has been postulated as a diagnostic and therapeutic tool in the area of neuropsychiatry. The aim of this article is to review the knowledge of the TMS as regards its basic principles, pathophysiological mechanism, and its usefulness in clinical practice.
- PublicaciónAcceso abiertoHyperglycaemia is associated with worse outcomes in Latin-American individuals with acute myocardial infarction(2016) Gómez Arbeláez, Diego; Sánchez Vallejo, Gregorio; Pérez, Maritza; García, Ronald G.; Arguello, Jhon Freddy; Peñaherrera, Ernesto; Duarte, Yan Carlos; Casanova, Maria Eugenia; Accini, Jose Luis; Sotomayor Rubio, Aristides; Camacho López, Paul Anthony; Lopez-Jaramillo, PatricioIntroducción Las alteraciones en el metabolismo de la glucosa son un factor de riesgo y de peor pronóstico para infarto agudo de miocardio (IAM), pero esta información en población latinoamericana es limitada. Por tanto, evaluamos la asociación del estado glucémico con desenlaces a corto y largo plazo en pacientes con un primer IAM. Métodos Estudio observacional de cohorte, multicéntrico, prospectivo, conducido en 8 hospitales de Colombia y Ecuador. Resultados Se incluyeron en total 439 pacientes con diagnóstico confirmado de IAM, de los cuales 305 (69,5%) presentaron prediabetes o diabetes mellitus tipo 2 (DM2). En comparación con el grupo de normoglucemia, los pacientes con DM2 conocida presentaron mayor riesgo de estancia hospitalaria prolongada (HR: 2,60, IC 95%: 1,38-4,92, p = 0,003), de Killip clase iii/iv (HR: 9,46, IC 95%: 2,20-40,62, p = 0,002) y de insuficiencia cardiaca intrahospitalaria (HR: 10,76, IC 95%: 3,37-34,31, p < 0,001). Los pacientes con prediabetes, DM2 conocida y DM2 nueva tuvieron tasas más altas de episodios adversos cardiovasculares mayores en el seguimiento a 3 años. Conclusión Alteraciones en el metabolismo de la glucosa tienen una importante significación pronóstica a corto y a largo plazo en pacientes latinoamericanos sobrevivientes a un primer IAM.
- PublicaciónAcceso abiertoHyperinsulinemia is a predictor of new cardiovascular events in colombian patients with a first myocardial infarction(2011-04-01) García, Ronald G.; Rincón, Melvin Y.; Arenas, William D.; Silva, Sandra Y.; Reyes, Laura M.; Ruiz, Silvia L.; Ramírez, Fabián; Camacho López, Paul Anthony; Luengas, Carlos; Saaibi, José F.; Balestrini, Sebastián; Morillo, Carlos; Lopez-Jaramillo, PatricioBackground: Acute Myocardial Infarction (AMI) is one of the main causes of mortality and disability in Colombia. The factors associated to a new event in surviving subjects to a first AMI in our population have not yet been fully identified. Methods: Two hundred and ninety five surviving subjects to a first AMI (58.8±12.6 years) were included in a prospective cohort study between 2000 and 2006. Lipid profile, glycemia and plasma insulin levels were measured. Deaths of cardiovascular origin, a new AMI, unstable angina, heart failure, stroke, new myocardial revascularization or angioplasty were considered new cardiovascular events. Results: The study included 61 (20.6%) women and 234 (79.4%) men. The mean follow up time was 50± 30 months with a 38.9% incidence of new events. Fifty five patients (18.6%) were diabetic. Bi-varied analysis identified as risk factors for a new cardiovascular event the presence of: hypertension, anterior descending coronary artery stenosis, intrahospital cardiac failure, age over 55, low income, lack of education, Killip III–IV, heart rate over 76 bpm, pulse pressure over 80 mm Hg, total cholesterol over 200 mg/dl and insulin over 10 IU/ml. After logistic regression analysis, the log values of insulin remained as the only significant predictor for new cardiovascular events. Conclusions: Hyperinsulinism was the most important factor associated to the occurrence of new cardiovascular events in Colombian patients with AMI, which emphasizes the pivotal role of insulin resistance in the physiopathologic mechanisms of atherosclerosis, especially in undeveloped countries.
- PublicaciónAcceso abiertoInfluencia de la rehabilitación cardíaca sobre la tasa de re-hospitalización en pacientes con infarto agudo de miocardio, Santander, Colombia(2012-07) Naranjo Estupiñan, Néstor F.; Díaz Quijano, Fredi Alexander; García, Ronald G.The influence of cardiac rehabilitation on acute myocardial infarction patients’ readmission rates in Santander, Colombia Objective Estimating the effect of post-infarction cardiac rehabilitation (CR) on readmission/re-hospitalization rates according to intervention level. Method This was a prospective cohort study of patients diagnosed as suffering acute myocardial infarction (AMI). Data concerning infarction severity, previous illness, medical history, hospital course, Killip classification, length of hospital stay and condition on discharge. Medical records and telephone contact were used to confirm whether a patient had received CR and ascertain pertinent components. Follow-up was extended to one year. Results 96 AMI patients of both genders were included; information about CR was available for 72 of them,5 of whom had received CR based only on physical activity. 49 patients received complete CR based on education, physical activity, psychological and nutritional assessment. 18 patients had not received CR. One death and 10 new admissions/hospitalizations were recorded during follow-up. A Poisson regression model showed that patients who had received CR based only on physical activity presented significantly higher re-hospitalization rates than patients who had received a complete CR scheme (rate ratio 5.89:1.14-30.4995 % CI; p=0.04). Conclusions A multidisciplinary approach must bead opted to CR involving physical activity, education and psychological and nutritional assessment.
- PublicaciónRestringidoInter-relationships between body mass index, C-reactive protein and blood pressure in a hispanic pediatric population(2009-05) Lopez-Jaramillo, Patricio; Herrera Anaya, Elizabeth; García, Ronald G.; Camacho López, Paul Anthony; Castillo, Victor R.The link between inflammation, obesity, and cardiovascular disease (CVD) has been described in adult populations but few data are available with respect to children. The aim of this study was to describe the inter-relationships between adiposity, C-reactive protein (CRP) plasma concentrations, and blood pressure levels in a Hispanic pediatric population. Methods We included 325 schoolchildren (mean age, 10.0 years) selected from the school population of Bucaramanga, Colombia. Blood pressure, lipid profile, glucose, and CRP plasma concentration were measured using standard procedures. Body mass index (BMI) was used for evaluating the children’s nutritional condition. Correlation coefficients were calculated for all the variables using Spearman’s test. Results As expected, a positive correlation was found between BMI and systolic blood pressure (SBP) in both genders, and between CRP and SBP levels in boys. After a multivariate regression analysis, the association between adiposity and blood pressure remained significant, whereas the CRP concentrations were no longer associated with SBP. Conclusions The results obtained in our study of Hispanic school-age children show that adiposity is correlated with CRP concentrations and SBP values as has been earlier described in Caucasian populations. However, we failed to find a significant relationship between low-grade inflammation and SBP levels. Further studies are needed in order to explore alternative pathophysiological mechanisms linking obesity and high blood pressure in children and to define the impact of these associations on the cardiovascular risk of our pediatric population.
- PublicaciónAcceso abiertoNeuroimaging brainstem circuitry supporting cardiovagal response to pain : A combined heart rate variability/ultrahigh-field (7 T) functional magnetic resonance imaging study(2016-01) García, Ronald G.; Sclocco, Roberta; Beissner, Florian; Desbordes, Gaelle; Polimeni, Jonathan R.; Wald, Lawrence L.; Kettner, Norman W.; Kim, Jieun; Renvall, Ville; Bianchi, Anna M.; Cerutti, Sergio; Napadow, Vitaly; Barbieri, RiccardoCentral autonomic control nuclei in the brainstem have been difficult to evaluate non-invasively in humans. We applied ultrahigh-field (7 T) functional magnetic resonance imaging (fMRI), and the improved spatial resolution it affords (1.2 mm isotropic), to evaluate putative brainstem nuclei that control and/or sense pain-evoked cardiovagal modulation (high-frequency heart rate variability (HF-HRV) instantaneously estimated through a point-process approach). The time-variant HF-HRV signal was used to guide the general linear model analysis of neuroimaging data. Sustained (6 min) pain stimulation reduced cardiovagal modulation, with the most prominent reduction evident in the first 2 min. Brainstem nuclei associated with pain-evoked HF-HRV reduction were previously implicated in both autonomic regulation and pain processing. Specifically, clusters consistent with the rostral ventromedial medulla, ventral nucleus reticularis (Rt)/nucleus ambiguus (NAmb) and pontine nuclei (Pn) were found when contrasting sustained pain versus rest. Analysis of the initial 2-min period identified Rt/NAmb and Pn, in addition to clusters consistent with the dorsal motor nucleus of the vagus/nucleus of the solitary tract and locus coeruleus. Combining high spatial resolution fMRI and high temporal resolution HF-HRV allowed for a non-invasive characterization of brainstem nuclei, suggesting that nociceptive afference induces pain-processing brainstem nuclei to function in concert with known premotor autonomic nuclei in order to affect the cardiovagal response to pain.
- PublicaciónAcceso abiertoNonalcoholic fatty liver disease is associated with insulin resistance in a young Hispanic population(2011-02) Pérez, M.; Gonzáles, L.; Olarte, R.; Rodríguez, N.I.; Tabares, M.; Salazar, J.P.; Jaimes, S.; García, Ronald G.; Lopez-Jaramillo, PatricioObjective To investigate whether nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance (IR) in a young Hispanic population. Methods A cross-sectional study was performed in Bogotá, Colombia, during 2006 in 263 males from the Colombian Air Force (age range 29–54 years). Anthropometric measurements and biochemical determinations (glycemia, lipid profile, insulin, and HOMA-IR) were obtained in order to determine the presence of metabolic syndrome (MS) criteria and insulin resistance in this population. In addition, ultrasound studies were performed to evaluate the presence of NAFLD. Results NAFLD was detected in 26.6% (n = 70) of the subjects. Thirty four individuals had complete MS criteria (48.5%). The presence of NAFLD was associated with higher insulin levels (11.0 ± 5.1 vs. 6.6 ± 3.6, p = 0.001), and its prevalence increased from 11% (n = 8), to 24% (n = 17) to 64% (n = 45) from the lowest to the highest HOMA-IR tertile. Body mass index, triglycerides and subcutaneous and visceral fat were found to be independent predictors of NAFLD. Conclusions These results suggest that NAFLD is associated with insulin resistance and extrahepatic adiposity in nondiabetic young Hispanic population.
- PublicaciónAcceso abiertoNonlinear digital signal processing in mental health : Characterization of major depression using instantaneous entropy measures of heartbeat dynamics(2015-03-13) Valenza, Gaetano; García, Ronald G.; Citi, Luca; Scilingo, Enzo P.; Tomaz, Carlos A.; Barbieri, RiccardoNonlinear digital signal processing methods that address system complexity have provided useful computational tools for helping in the diagnosis and treatment of a wide range of pathologies. More specifically, nonlinear measures have been successful this study, we propose the use of instantaneous measures of entropy, namely the inhomogeneous point-process approximate entropy (ipApEn) and the inhomogeneous point-process sample entropy (ipSampEn), to describe a novel characterization of MD patients undergoing affective elicitation. Because these measures are built within a nonlinear point-process model, they allow for the assessment of complexity in cardiovascular dynamics at each moment in time. Heartbeat dynamics were characterized from 48 healthy controls and 48 patients with MD while emotionally elicited through either neutral or arousing audiovisual stimuli. Experimental results coming from the arousing tasks show that ipApEn measures are able to instantaneously track heartbeat complexity as well as discern between healthy subjects and MD patients. Conversely, standard heart rate variability (HRV) analysis performed in both time and frequency domains did not show any statistical significance. We conclude that measures of entropy based on non linear point-process models might contribute to devising useful computational tools for care in mental health
- PublicaciónAcceso abiertoNutritional status among women with pre-eclampsia and healthy pregnant and non-pregnant women in a Latin American country(2012-02-22) Reyes, Laura M.; García, Ronald G.; Ruiz, Silvia L.; Dehghan, Mahshid; Lopez-Jaramillo, PatricioAims: Pre‐eclampsia (PE) is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. It has been proposed that, among other risk factors, the nutritional status of women can lead to the endothelial dysfunction that characterizes this entity. The aim of the present study was to compare the nutritional status of women with PE with healthy pregnant and non‐pregnant women. Material and Methods: A multicenter case–control study was carried out. Between September 2006 and July 2009, 201 women with PE were compared with 201 pregnant, and 201 non‐pregnant aged‐matched women without cardiovascular or endocrine diseases. A clinical history and physical examination was performed. Fasting blood samples were drawn to measure serum glucose and lipid profile. The nutritional status of participants was assessed using a food frequency questionnaire. Results: The average age of women was 26.6 ± 7.2 years. Compared to healthy pregnant controls, women with PE had a higher body mass index, higher fasting blood glucose levels, higher triglycerides, and lower high‐density lipoprotein cholesterol levels. Women with PE had a higher intake of carbohydrates, energy intake and cereal compared to healthy pregnant and non‐pregnant controls. A conditional logistic regression demonstrated that carbohydrate and sodium intake are associated with PE development. Conclusions: Diets of women with PE were characterized by higher energy and carbohydrate intake compared to normal pregnant and non‐pregnant women. This suggests that higher carbohydrate and sodium intake increases the risk of PE among women in Colombia.
- PublicaciónAcceso abiertoPlasma nitrate levels and flow-mediated vasodilation in untreated(2011-05) García, Ronald G.; Zarruk, Juan G.; Barrera, Carlos; Pinzón, Alexander; Trillos, Elizabeth; Arenas, William D.; Luengas, Carlos; Tomaz, Carlos A.; Lopez-Jaramillo, PatricioObjective: Findings from several studies have revealed that major depression is associated with an increased cardiovascular risk. The physiopathologic mechanisms of this association remain unclear, although recently, it has been hypothesized that a decreased production of nitric oxide could be a potential contributor to vascular dysfunction in depressive patients. The objective of this study was to evaluate nitric oxide production and vascular endothelial function in treatment-naive young healthy adults with a first episode of major depression. Methods: A case-control study in 50 treatment-naive young adults with a first episode of major depression and 50 healthy control subjects was conducted. Plasma levels of nitric oxide metabolites (nitrates/nitrites) were determined using a colorimetric assay based on Griess reaction. Endothelial function was assessed by flow-mediated vasodilation measurements after reactive hyperemia. Results: The mean age of the depressed patients was 22.6 (standard deviation [SD], 4.6) years, whereas the controls were 23.4 (SD, 4.8) years. Sixteen men (32%) and 34 women (68%) were included in each group. The plasma nitrite/nitrate concentrations were significantly lower in depressive subjects compared with healthy controls (17.5 [SD, 4.9] Kmol/L versus 21.6 [SD, 7.0] Kmol/L, p G .001); however, flow-mediated vasodilation values were similar in both groups (13.1% [SD, 4.3%] versus 12.1% [SD, 5.0%], p = .10). Conclusions: Decreased plasma concentrations of nitric oxide metabolites are not associated with vascular endothelial dysfunction in young subjects with a first episode of major depression. Reduced nitrate/nitrite levels could reflect a decreased nitric oxide production in the central nervous system of depressed subjects. Further studies are needed to confirm this hypothesis.
- PublicaciónAcceso abiertoRelationship between cardiac vagal activity and mood congruent memory bias in major depression(2016-01) García, Ronald G.; Valenza, Gaetano; Tomaz, Carlos A.; Barbieri, RiccardoBackground Previous studies suggest that autonomic reactivity during encoding of emotional information could modulate the neural processes mediating mood-congruent memory. In this study, we use a point-process model to determine dynamic autonomic tone in response to negative emotions and its influence on long-term memory of major depressed subjects. Methods Forty-eight patients with major depression and 48 healthy controls were randomly assigned to either neutral or emotionally arousing audiovisual stimuli. An adaptive point-process algorithm was applied to compute instantaneous estimates of the spectral components of heart rate variability [Low frequency (LF), 0.04–0.15 Hz; High frequency (HF), 0.15–0.4 Hz]. Three days later subjects were submitted to a recall test. Results A significant increase in HF power was observed in depressed subjects in response to the emotionally arousing stimulus (p=0.03). The results of a multivariate analysis revealed that the HF power during the emotional segment of the stimulus was independently associated with the score of the recall test in depressed subjects, after adjusting for age, gender and educational level (Coef. 0.003, 95%CI, 0.0009–0.005, p=0.008). Limitations These results could only be interpreted as responses to elicitation of specific negative emotions, the relationship between HF changes and encoding/recall of positive stimuli should be further examined. Conclusions Alterations on parasympathetic response to emotion are involved in the mood-congruent cognitive bias observed in major depression. These findings are clinically relevant because it could constitute the mechanism by which depressed patients maintain maladaptive patterns of negative information processing that trigger and sustain depressed mood.