Examinando por Materia "Preeclampsia"

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    Restringido
    Actividad física en mujeres gestantes de Bucaramanga y su área metropolitana 2017 - 2018
    (Bucaramanga : Universidad de Santander, 2018, 2018-12-17) Aguilar Cepeda, Silvia J.; Canizales Rodríguez, Jennifer M.; Jaimes Rodríguez, Andrea J.; Jácome Hortúa, Adriana; Martínez Marín, Rocío del Pilar
    La investigación sobre el efecto de la actividad física en mujeres gestantes ha tomado mayor interés de la comunidad científica, debido al incremento en la prevalencia de enfermedades como la preclamsia, diabetes mellitus y los dolores musculo esqueléticos, que afectan la calidad de vida de la madre y el feto. Objetivo: Evaluar la Actividad Física en mujeres gestantes de Bucaramanga y su área metropolitana. Metodología: Se realizó un estudio descriptivo transversal, se incluyeron 160 mujeres gestantes de Bucaramanga y su área metropolitana, en cualquier trimestre de gestación, mayores de 18 años; se excluyeron las mujeres que tuvieran orden médica de reposo absoluto y a las mujeres con algún compromiso mental y físico que impidieran diligenciar el instrumento. La información se recolecto entre los meses de marzo y agosto de 2018, a través del cuestionario “Pregnancy Physical Activity Questionnaire”. Resultados: Se evaluaron 160 gestantes con una media de edad de 25.55 DE: ± 5.49 las cuales tenían una media gestacional de 26.1 DE: ± 7.69. El mayor gasto energético realizado por las gestantes encuestadas lo realizaron en actividades en el hogar (90%) y las de menor gasto energético fueron las actividades de transporte con un 1.25%. La actividad más realizada fue la caminata, con un 35.62% de participación. Discusión: Barros et al., en su estudio realizado en Brasil cuyo objetivo era analizar el patrón de actividad física de las mujeres gestantes de bajo riesgo, concluyó que la mayoría no realizaba ningún tipo de actividad física en su tiempo libre, aproximadamente el 27.0% realizaba caminata, la actividad predominante. El tiempo promedio semanal y la intensidad de las actividades de ocio fue de 34 min con DE: 67.5 min.
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    Acceso abierto
    Appropriate 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.
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    Acceso abierto
    Obesity and Preeclampsia. Common Pathophysiological Mechanisms
    (Frontiers in Physiology, 2018-12-19) Lopez-Jaramillo, Patricio; Barajas, Juan; Rueda-Quijano, Sandra M.; Lopez-Lopez, Cristina; Felix, Camilo; Masira
    Preeclampsia is a disorder specific of the human being that appears after 20 weeks of pregnancy, characterized by new onset of hypertension and proteinuria. Abnormal placentation and reduced placental perfusion associated to impaired trophoblast invasion and alteration in the compliance of uterine spiral arteries are the early pathological findings that are present before the clinical manifestations of preeclampsia. Later on, the endothelial and vascular dysfunction responsible of the characteristic vasoconstriction of preeclampsia appear. Different nutritional risk factors such as a maternal deficit in the intake of calcium, protein, vitamins and essential fatty acids, have been shown to play a role in the genesis of preeclampsia, but also an excess of weight gain during pregnancy or a pre-pregnancy state of obesity and overweight, which are associated to hyperinsulinism, insulin resistance and maternal systemic inflammation, are proposed as one of the mechanism that conduce to endothelial dysfunction, hypertension, proteinuria, thrombotic responses, multi-organ damage, and high maternal mortality and morbidity. Moreover, it has been demonstrated that pregnant women that suffer preeclampsia will have an increased risk of future cardiovascular disease and related mortality in their later life. In this article we will discuss the results of studies performed in different populations that have shown an interrelationship between obesity and overweight with the presence of preeclampsia. Moreover, we will review some of the common mechanisms that explain this interrelationship, particularly the alterations in the L-arginine/nitric oxide pathway as a crucial mechanism that is common to obesity, preeclampsia and cardiovascular diseases.
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    Periodontal disease severity is related to high levels of C-reactive protein in pre-eclampsia
    (2007-07) Herrera, Julián A.; Parra, Beatriz; Herrera, Enrique; Botero, Javier E.; Arce, Roger M.; Contreras, Adolfo; Lopez-Jaramillo, Patricio
    Objective Recent studies have shown that pre-eclamptic women present a high prevalence of periodontitis, suggesting that active periodontal disease may play a role in the pathogenesis of pre-eclampsia. The present study analysed the effect of periodontal disease in the concentrations of serum high-sensitivity C-reactive protein (hs-CRP), and its association with pre-eclampsia. Methods A case–control study was carried out in Cali-Colombia, comprised of 398 pregnant women (145 cases and 253 controls) who were believed to have periodontal disease, between 28 and 36 weeks of gestational age. Pre-eclampsia cases were defined as blood pressure >– 140/90 mmHg and proteinuria >– 0.3 g/24 h. Controls were pregnant women with normal blood pressure, without proteinuria, matched by maternal age, gestational age and body mass index. Sociodemographic data, obstetric risk factors, periodontal state, subgingival microbial composition and hs-CRP levels were determined in both groups. Results The case and control groups were comparable for sociodemographic characteristics. In women with pre-eclampsia and confirmed periodontal disease (n U 138), hs-CRP levels increased according to the severity of the disease (gingivitis median 4.14 mg/dl; mild periodontitis median 4.70 mg/dl; moderate/severe periodontitis median 8.8 mg/dl; P U 0.01). A similar tendency was observed in controls with periodontal disease (n U 251), but it did not reach statistical significance (gingivitis median 5.10 mg/dl; mild periodontitis median 5.12 mg/dl; moderate/severe periodontitis median 6.90 mg/dl; P U 0.07). A significant difference in hs-CRP levels was observed in pre-eclamptic women with moderate/severe periodontitis compared to controls (P U 0.01). Conclusion These findings suggest that chronic periodontitis may increase hs-CRP levels in pregnant women and lead to complications such as pre-eclampsia.
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    Restringido
    Risk 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, Patricio
    Background: 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.
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    Acceso abierto
    The role of the L-arginine-nitric oxide pathway in preeclampsia
    (2008-08-01) Lopez-Jaramillo, Patricio; Arenas, William D.; García, Ronald G.; Rincón, Melvin Y.; López Casillas, Marcos
    : Preeclampsia (PE) is a major cause of maternal and perinatal mortality, especially in developing countries. Its etiology involves multiple factors, but no specific cause has been identified. Evidence suggests that clinical manifestations are caused by endothelial dysfunction. Nitric oxide (NO), which is synthesized from L-arginine in endothelial cells by the endothelial nitric oxide synthase (eNOS), provides a tonic dilator tone and regulates the adhesion of white blood cells and platelet aggregation. Alterations in the L-arginine-NO pathway have been associated with the development of PE. Various studies, reporting decreased, elevated or unchanged levels of nitrite (NO2) and nitrate (NO3), two end products of NO metabolism, have been published. Our group contributed to those contradictory reports describing cases of PE with both elevated and decreased levels of NO2 and NO3. Apparently, diminished levels of NO could be related to deficiencies in the ingestion of dietary calcium associated to low levels of plasma ionic calcium, which is crucial to the eNOS’ activity. Also, low levels of NO could be associated with the presence of eNOS polymorphisms or the presence of increased levels of ADMA, the endogenous inhibitor of NO. High levels of NO associated to low levels of cGMP suggest a decreased bioactivity of NO, which is probably related to an increased degradation of NO caused by a high production of superoxide in states of infection and inflammation. The present article analyses and reviews the reported paradoxical roles of the L-arginine-NO pathway in PE and gives a possible explanation for these results.
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    Subclinical infection as a cause of inflammation in preeclampsia
    (2008-07) Lopez-Jaramillo, Patricio; Casas Herrera, Julián Augusto; Arenas Mantilla, Mario; Jáuregui, Isabel E.; Mendoza, Mayaris A.
    Preeclampsia, a pregnancy-exclusive hypertensive disorder, is the major cause of maternal and perinatal mortality, with a greater importance in developing countries. The role of inflammation in the pathogenesis of preeclampsia has been the object of recent studies by our group. We have described elevated levels of inflammatory markers (tumor necrosis factor alpha, interleukin-6, and C-reactive protein) in preeclamptic patients and demonstrated that Latin-American women present a higher degree of inflammation than women from developed countries. We have results that suggest that chronic subclinical infections and insulin resistance are the most probable causes of the increased inflammation in preeclampsia. Moreover, we showed that early treatment of urinary and vaginal infections decreased the incidence of preeclampsia. We also have evidence that suggests that inflammation leads to endothelial dysfunction, predisposing women to develop preeclampsia. Increased levels of inflammation markers and endothelial dysfunction are found in the early stages of pregnancy in women who later on develop preeclampsia. Appropriate prenatal care programs, including screening and treatment of urinary, vaginal, and periodontal infections in early pregnancy and prevention of factors that predispose to insulin resistance, such as excessive weight gain during pregnancy, may reduce the incidence of preeclampsia in Latin-American women.