Examinando por Autor "Reyes, Laura M."
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- 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 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 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.
- PublicaciónRestringidoRisk factors for preeclampsia in women from Colombia : A case-control study(2012-07-23) Reyes, Laura M.; García, Ronald G.; Ruiz, Silvia L.; Camacho López, Paul Anthony; Ospina, Maria B.; Aroca, Gustavo; Accini, Jose Luis; Lopez-Jaramillo, PatricioBackground: Preeclampsia (PE) is a multi-causal disease characterized by the development of hypertension and proteinuria in the second half of pregnancy. Multiple risk factors have been associated with the development of PE. Moreover, it is known that these risk factors vary between populations from developed and developing countries. The aim of this study is to identify which risk factors are associated with the development of preeclampsia (PE) among Colombian women. Methods: A multi-centre case-control study was conducted between September 2006 and July 2009 in six Colombian cities. Cases included women with PE (n = 201); controls were aged-matched pregnant women (n = 201) without cardiovascular or endocrine diseases for a case-control ratio of 1:1. A complete medical chart, physical examination and biochemical analysis were completed before delivery. Multivariable logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) of potential risk factors associated with PE. Results: The presence of factors present in the metabolic syndrome cluster such as body mass index .31 Kg/m2 (OR = 2.18; 1.14–4.14 95% CI), high-density lipoprotein ,1.24 mmol/L (OR = 2.42; 1.53–3.84 95% CI), triglycerides .3.24 mmol/L (OR = 1.60; 1.04–2.48 95% CI) and glycemia .4.9 mmol/L (OR = 2.66; 1.47–4.81 95%CI) as well as being primigravidae (OR = 1.71; 1.07–2.73 95% CI) were associated with the development of PE, after adjusting for other variables. Conclusion: Factors present in the cluster of metabolic syndrome and primigravidity were associated with a greater risk of PE among Colombian women. Understanding the role of this cluster of risk factors in the development of PE is of crucial importance to prevent PE and remains to be determined.