Psiconeuroinmunología del estrés en la prevención de complicaciones perinatales

Se buscó evaluar el impacto preventivo de un Modelo Biopsicosocial en la incidencia de la hipertensión arterial inducida por el embarazo (HTA) y la pre-eclampsia, y evaluar los posibles mecanismos endocrino-inmunológicos asociados con factores de estrés psicosocial. El diseño fue un ensayo clínico controlado aleatorizado. Se realizó en doce centros de Salud del Valle del Cauca y Cauca. Se incluyeron 91 pacientes primigrávidas normotensas, con alto riesgo biopsicosocial. Fueron asignadas de manera ciega y al azar a tres grupos: Grupo A: 43 (47.2%) al grupo de intervención nutricional manejado con calcio y ácido linoléico, reposo lateral), Grupo B: 24 (26.3%) con intervención psicológica individual y grupal, placebo y reposo lateral; Grupo C: 24 (26.3%) con doble placebo y reposo lateral. A todas las pacientes se les realizo seguimiento en sus aspectos obstétricos, nutricionales, inmunológicos y bioquímicos (prepost intervención), con evaluación. Prospectiva del resultado perinatal. Veinte (21.9%) pacientes desarrollaron complicaciones. En el Grupo A, se presentaron 2 (4.6%) casos de HTA y 2 (4.6%) casos de pre-eclampsia [RR=0.22 (i.c. 95% 0.08 - 0.64), p. = 0.001], sin mortalidad perinatal. En el Grupo B, 4 (16.7%) pacientes desarrollaron pre-eclampsia [RR=0.38, (i.c.95% 0.04-0.95), p=0.03], sin muerte perinatal. En el Grupo C, control, apareció pre-eclampsia en 12 (50%) casos, con 1 (4.1%) muerte perinatal y no se presentó HTA. El grupo A presentó hipertensión arterial inducida por el embarazo (HTA) y pre-eclampsia, en contraste con los otros grupos. Los riesgos relativos hacia el desarrollo de la enfermedad mostraron un efecto protector en el grupo A (nutricional) y en el grupo B (psicosocial), con una RR de 0.22 y de 0.38 respectivamente. El calcio elemental y el ácido linoléico, unidos y en dosis bajas, tomados durante el tercer trimestre del embarazo reducen significativamente la incidencia de pre-eclampsia en pacientes con alto riesgo, posiblemente a través de un incremento en los niveles de prostaglandina E2. Las intervenciones nutricional y psicosocial mejoraron el balance de las prostaglandinas vaso activas (P=0.001), lo que explicaría el efecto protector observado después de las intervenciones. Con la intervención psicosocial se presentó una disminución significativa (p=0.01) de la relación TBXB2/Pg 12, con aumento de prostaciclina 12, lo que podría explicar que la intervención psicosocial tuvo un efecto protector adicional.This research sought to evaluate the preventive impact of a Biopsychosocial Model on the incidence of pregnancy-induced hytpertension and pre-eclampsia, and in the same way to evaluate the endocrine-immunological mechanism associated with psychosocial stress factors. The research turned out to be a prospective, randomized, double-blind, clinicaly controlled study. It was carried out in 12 health centers in Valle and Cauca Department, Colombia. It included 91 normotensive, first-time mothers with a high biopsychosocial risk (score ≥3 pts). They were randomly assigned to three groups: 43 (47.2%) to the nutritional intervention Group A: (calcium and linoleic acid, lateral rest), Group B: 24 (26.3 %), with psychosocial support both individual and in groups, placebo and lateral rest, and Group C 24 (26.3 %) with double placebo and lateral rest. A close follow up in their obstetric, nutritional, inmunological and bio-chemical aspects was made on these patients, including a prospective evaluation of the perinatal outcome (pre-post intervention). In Group A (nutritional), 2 (4.6%) patients developed pregnancy induced  hytpertension and 2(4.6%) developed pre-eclampsia (RR= 0,22, i.c. 95% 0.08-0.64, p.= 0.001). In Group B, 4 (16.7%) patients developed pre-eclampsia (RR=0.38, i.c. 95% 0.04-0.95, p=0.03). In the Group C (control), 12 (50%) patients developed pre-eclampsia. Patients in Group A presented hypertension caused by pregnancy state, in contrast to the other two groups where pre-eclampsia was the only complication. The risk relatived (RR), with the development of the disease showed a protective effect in Groups A (nutritional) and Group B (psychosocial), with a RR of 0.22 and 0.38 respectively. The elemental Calcium and Linoleic Acid mixed, and in low dosages, taken during the third semester of the pregnancy period, reduced the incidence of pre-clampsia in patients with high risk, possibly through an increase in the Prostaglandin E2 levels. The nutritional and psicosocial interventions improved the balance of the vasoactive prostaglandin (P=0.001), which explains the protective effect observed once the intervention had been done. On the other hand, the psychosocial intervention showed a significant increase (P=0.01) of the relation TBXB2/Pg. 12, with the raise of prostacycline 12, which could explain that the psychosocial intervention had an additional protective effect

Association of gene BoLA DRB3.2 with production traits in a dairy herd of Antioquia, Colombia

ABSTRACT Objective. To determine the associations of BoLA DRB3.2 alleles present in Holstein and BON x Holstein cattle to production and milk quality traits in a dairy herd of Antioquia, Colombia. Materials and methods. Ninety-one cows, 66 Holstein and 25 BxH, were genotyped for the BoLA DRB3.2 gene, through PCR-RFLP technique. Furthermore, the association of the alleles of the gene BoLA DRB3.2 with milk yield (PL305), fat yield (PG305), protein yield (PP305) fat percentage (PGRA) and protein percentage (PPRO) were determined, using a general linear model. Results. Twenty-seven BoLA DRB3.2 alleles were identified; the most frequent alleles in Holstein were: BoLA DRB3.2*23, 22, and 24 with frequencies of: 0.159, 0.129, and 0.106, respectively and the most frequent alleles in BxH were: BoLA DRB3.2*23, 24 and 20 with frequencies of: 0.20, 0.140, and 0.120, respectively. Associations of BoLA DRB3.2 alleles with production and milk quality traits were also determined. In Holstein cows the BoLA DRB3.2*36 allele was associated with low PL305 (p≤0.01), high PGRA in multiparous cows (p≤0.05) and high PG305 in primiparous cows (p≤0.01). The BoLA DRB3.2*33 allele was associated with increased in the PPRO in multiparous cows (p≤0.01). In BXH cows only the BoLA DRB3*19 allele was associated with high PGRA (p≤0.05). Conclusions. The gene BoLA DRB3.2 shows high polymorphism in both groups; Holstein and BxH and some of its allelic variants were associated with production and milk quality trait

Effect of periodontal therapy on the subgingival microbiota in preeclamptic patients

INTRODUCTION: Few studies have described subgingival microbiota in pregnant women with mild preeclampsia. OBJECTIVE: Clinical periodontal and subgingival microbiota changes were identified in pregnant women with mild preeclampsia after periodontal treatment. MATERIALS AND METHODS: In a secondary analysis of a randomized clinical trial, 57 preeclamptic women were studied at Hospital Universitario del Valle in Cali, Colombia. Thirty one women were randomized to the periodontal intervention group (subgingival scaling and planing ultrasonic and manual) during pregnancy and 26 to the control group (supragingival prophylaxis). Periodontal clinical parameters and subgingival microbiota were characterized at the time of acceptance into the study and again at postpartum. Eight periodontopathic bacteria and 2 herpesviruses were assessed by polymerase chain reaction. Chi-square, McNemar or Student's t tests were used, with a significance level of p≤0.05. RESULTS: Both groups were comparable in the clinical and microbiological variables at baseline. Periodontal treatment reduced the average pocket depth in the intervention group from 2.4±0.3 to 2.3±0.2 mm (p<0.001) and in control group 2.6±0.4 to 2.44±0.4 mm, (p<0.001) and bleeding index 16.4±1.5% to 7.9±0.7% in the intervention group(p<0.001) and 17.1±1.8% to 10±0.9% in the control group (p=0.002). The frequency of detection of microorganisms did not differ significantly between groups. CONCLUSION: Scaling/root planning and supragingival prophylaxis significantly reduced the probing depth and gingival bleeding index. Periodontal treatment was not more effective than prophylaxis in reducing periodontopathic organisms or herpesvirus

Efecto del tratamiento periodontal sobre la microbiota subgingival en pacientes con preeclampsia

Introduction. Few studies have described subgingival microbiota in pregnant women with mild preeclampsia.Objective. Clinical periodontal and subgingival microbiota changes were identified in pregnant women with mild preeclampsia after periodontal treatment.Materials and methods. In a secondary analysis of a randomized clinical trial, 57 preeclamptic women were studied at Hospital Universitario del Valle in Cali, Colombia. Thirty one women were randomized to the periodontal intervention group (subgingival scaling and planing ultrasonic and manual) during pregnancy and 26 to the control group (supragingival prophylaxis). Periodontal clinical parameters and subgingival microbiota were characterized at the time of acceptance into the study and again atpostpartum. Eight periodontopathic bacteria and 2 herpesviruses were assessed by polymerase chain reaction. Chi-square, McNemar or Student’s t tests were used, with a significance level of p≤0.05.Results. Both groups were comparable in the clinical and microbiological variables at baseline. Periodontal treatment reduced the average pocket depth in the intervention group from 2.4±0.3 to  2.3±0.2 mm (p&lt;0.001) and in control group 2.6±0.4 to 2.44±0.4 mm, (p&lt;0.001) and bleeding index 16.4±1.5% to 7.9±0.7% in the intervention group(p&lt;0.001) and 17.1±1.8% to 10±0.9% in the control group (p=0.002). The frequency of detection of microorganisms did not differ significantly between groups.Conclusion. Scaling/root planning and supragingival prophylaxis significantly reduced the probing depth and gingival bleeding index. Periodontal treatment was not more effective than prophylaxis in reducing periodontopathic organisms or herpesvirus.Introducción. Pocos estudios han descrito la microbiota subgingival en mujeres embarazadas con preeclampsia leve.Objetivo. Identificar cambios periodontales y de la microbiota subgingival en mujeres embarazadas con preeclampsia, después del tratamiento periodontal.Materiales y métodos. En un análisis secundario de un ensayo clínico de asignación aleatoria, se estudiaron 57 pacientes con preeclampsia en el Hospital Universitario del Valle de Cali. Se asignaron al azar 31 al grupo de intervención periodontal (detartraje y alisado subgingival ultrasónico y manual) durante su embarazo y otras 26 al grupo control (profilaxis supragingival). Se determinaron los parámetros clínicos periodontales y la microbiota subgingival a la inclusión al estudio y en el posparto. Se evaluaron 8 bacterias periodontopáticas y 2 virus herpes por reacción en cadena de la polimerasa. Se usaron las pruebas de ji al cuadrado, test de McNemar o t de Student, con un nivel de significancia de p≤0,05.Resultados. Los grupos fueron comparables en las variables clínicas y microbiológicas al inicio del estudio. El tratamiento periodontal redujo el promedio de la profundidad de bolsa en el grupo de intervención de 2,44±0,31 a 2,31±0,24 mm (p=0,000) y en el grupo control de 2,58±0,37 a 2,44±0,39 mm (p=0,000),y el índice de sangrado, de 16,4±1,5 a 7,9±0,7 % en el primero (p=0,000), y de 17,1±1,8 a 10±0,9 %, en el segundo (p=0,002). La frecuencia de detección de microorganismos no varió de manera significativa entre los grupos.Conclusión. El raspaje y alisado radicular, así como la profilaxis supragingival, redujeron de manera significativa la profundidad a la sonda y el índice de sangrado gingival. El tratamiento periodontal no fue más efectivo que la profilaxis para reducir los organismos periodontopáticos o los virus herpes. doi: http://dx.doi.org/10.7705/biomedica.v32i2.661

Eficacia de la intervencion periodontal en el producto del embarazo en mujeres con pre-eclampsia

Objective: To determine the efficacy of periodontal intervention on pregnancy outcome in mild preeclamptic women. Methods: A sample of 60 pregnant women with mild preeclampsia (blood pressure levels <160/110 mm and proteinuria >300 mg/l in 24 hours urine) from the Hospital Universitario del Valle (Cali, Colombia) was included to the study. Preeclamptic women were randomized in two groups, one with periodontal intervention (PIG, N=28) and another in which the periodontal intervention was practiced after childbirth (NPIG, N=32). Maternal socio-demographic, medical and periodontal data were obtained. PIG included patients in which supragingival and subgingival cleaning within ultrasonic and manual devices were performed after study inclusion. The progression from mild to severe preeclampsia, eclampsia or HELLP syndrome, the number of days of clinical stability and the percentile of birth-weight adjusted for gestational age were evaluated in both groups. Results: Most of the patients (60%) were multigravids. Gestational age at inclusion was 31.8±1.6 weeks. Chronic periodontitis was a frequent finding (61.7%). Social, demographic, medical and periodontal conditions were similar between both groups. Disease progression to severe preeclampsia, eclampsia or HELLP syndrome was also similar (89.2% PIG versus 84.4%, p=0.65) (OR=1.06 IC 95% 0.87-1.29, p=0.65). Days of clinical stability were similar between the groups (median 10 days , range 1-46, PIG versus 12 days, range 1-59, p=0.57) and the percentile of birth weight adjusted with gestational age had no differences between the groups (median percentil 50 range 5-90 PIG versus percentil 55 range 5-95, p=0.73). Conclusion: Periodontal intervention does not seem to harm the health, the severity or alter the frequency on maternal complications in mild preeclampsia subjects. Objetivo: Determinar la eficacia y seguridad de la intervención periodontal sobre el producto del embarazo en gestantes hospitalizadas con diagnóstico de pre-eclampsia sin complicaciones. Métodos: En un ensayo clínico controlado se evaluaron 60 mujeres embarazadas con diagnóstico de pre-eclampsia leve (presión arterial 300mg/ l en orina de 24 horas), que se trataron en la unidad de alto riesgo obstétrico del Hospital Universitario del Valle (Cali, Colombia). Se evaluaron las características socio-demográficas, así como los aspectos médicos y periodontales. De este conjunto 28 (46.7%) gestantes se incluyeron al azar en el grupo con intervención periodontal anteparto (GIP) y 32 (53.3%) en el grupo sin intervención periodontal (GNIP). El análisis se hizo de acuerdo con la intención de tratamiento. La variable dependiente fue la proporción de mujeres que agravaron su condición pre-eclámptica hacia pre-eclampsia severa, eclampsia o síndrome de HELLP, el número de días de estabilidad clínica y el percentil de peso del recién nacido ajustado para la edad de la gestación. Resultados: De las pacientes 60% eran multíparas. La edad gestacional promedio de ingreso al estudio fue 31.8 semanas. El diagnóstico periodontal más frecuente fue periodontitis crónica (61.7%). Las características socio-demográficas, obstétricas y periodontales fueron afines en ambos grupos. La pre-eclampsia se agravó de manera comparable en los dos grupos (GIP 89.2% versus GNIP 84.4%, p=0.65) (OR=1.06 IC 95% 0.87-1.29, p=0.65). La estabilidad clínica en días, fue parecida en ambos grupos (GIP mediana 10 días, rango 1-46 versus GNIP 12 días, rango 1-59, p=0.57). La mediana del peso del recién nacido ajustado por la edad gestacional fue semejante en los dos grupos (GIP percentil 50, rango 5-90 versus GNIP percentil 53 rango 5-95, p=0.73). Conclusiones: El tratamiento periodontal en mujeres con pre-eclampsia no complicada no incrementa la severidad o frecuencia de las complicaciones maternas

Razlike u razinama anti-Müllerovog hormona u krvnoj plazmi i reproduktivnih parametara između dvije vrste goveda Bos indicus i Bubalus bubalis

The aim of this study was to evaluate the possible relationships between reproductive parameters and Anti Mullerian Hormone (AMH) levels in two closely related bovine species. AMH levels and the reproductive parameters of 50 water buffaloes (Bubalus bubalis) and 50 Zebu cattle (Bos indicus) of the same age and raised in similar conditions were evaluated. Clinical data were obtained from the farm in specialized designed format, and AMH was measured by ELISA. The results show that Zebu cattle had higher AMH levels than water buffaloes (P<0.0001), while water buffaloes exhibited better reproductive parameters: days open to pregnancy (P<0.0001), parity (P<0.0005), age at first calving (P<0.0001), and intercalving period (P<0.0001). Although both species have different reproductive parameters, no correlations were found between AMH and the reproductive parameters evaluated in either species. Finally, pregnant Zebu cattle and water buffalo showed a tendency to have lower AMH levels than non-pregnant counterparts. The results are paradoxical as the species with lower AMH levels exhibited better reproductive parameters, suggesting that the reproductive parameters within the herd do not depend solely on the ovarian reserve of females.Cilj je ovog rada bio procijeniti je li moguće ustanoviti povezanost između reproduktivnih parametara i razina anti-Müllerovog hormona (AMH) u dvije blisko srodne vrste goveda. Analizirane su razine AMH i reproduktivni parametri 50 bivola (Bubalus bubalis) i 50 zebu goveda (Bos indicus) iste dobi uzgojenih u sličnim uvjetima. Klinički podatci dobiveni su s farme u posebno osmišljenom pokusu. AMH je određivan pomoću ELISA metode. Rezultati pokazuju da su razine AMH više u goveda nego u bivola (P<0,0001). Bivoli su pokazali bolje reproduktivne parametre: servisno razdoblje (P<0,0001), paritet (P<0,0005), dob kod prvog teljenja (P<0,0001) i međutelidbeno razdoblje (P<0,0001). Premda obje vrste imaju različite reproduktivne parametre, nije ustanovljena povezanost između AMH i analiziranih reproduktivnih parametara niti u jedne od istraživanih vrsta. Zaključno, steone ženke goveda i bivola pokazuju tendenciju manjih razina AMH u usporedbi s nesteonim. Rezultati dobiveni u ovoj studiji su paradoksalni, jer vrste s nižim AMH razinama pokazuju bolje reproduktivne parametre. Ovi rezultati ukazuju na to da reproduktivni parametri unutar krda ne ovise samo o rezervi jajnih stanica u ženki

Analysis of the Modified Smith Predictor

En el presente trabajo se presenta un análisis del predictor de Smith modificado, el cual es un esquema utilizado en el control de sistemas estables, inestables e integrativos. Se desarrolla y analiza la ecuación en lazo cerrado. Adicionalmente se realizan una serie de pruebas para verificar el desempeño de este esquema de control ante diferentes condiciones del modelo de la planta. Específicamente se realizan tres pruebas. En primer lugar, se verifica cómo se comporta el esquema ante una incertidumbre en el modelo del retardo, paso seguido se muestra el comportamiento del esquema ante variaciones de los parámetros de la planta.  In this paper an analysis about the modified Smith predictor, is presented. The modified Smith predictor is a scheme used to control stable, unstable and integrative systems. The closed loop equation is developed and analyzed. Additionally, various test are made to verify the behavior of the control scheme. Specify, three test are made. First, it is verify the behavior of the scheme to deal with an uncertainty in the delay model. Second, it is verify the behavior in the face of uncertainties in the parameter of the rational model.

Síntesis de materiales compuestos tio2-tpa/biochar vía ultrasonido y sol-gel para la degradación de ibuprofeno y diclofenaco

En este trabajo, se sintetizó material residual de biomasa (cáscaras de semillas de girasol -CSG) mediante activación química y térmica para obtener carbón activado (AC) y se utilizó como soporte de TiO2 modificado con 30% de ácido tungstofosfórico (TPA) para formar fotocatalizadores compuestos para potenciar la adsorción y fotodescomposición de productos farmacéuticos y productos de cuidado personal (PPCPc)

Asociación entre consumo de calcio, niveles de parathormona y presión arterial en el embarazo

Purpose: To evaluate the association between calcium intake from diet, calciotropic hormones (PTH, PTH-rp), vasoactive regulators (endothelin, nitric oxide) and blood pressure levels during pregnancy, birth and puerperium. Method: In a prospective study 149 healthy normotensive primigravidas were followed-up from 15 weeks of gestation to puerperium. Daily calcium intake, calciuria, PTH, PTH-rp, endothelin, nitrite-nitrate, and Holter Test were assessed. Linear regression models were performed to evaluate the association between calcium intake, blood pressure levels and the laboratory tests. Multivariate regression models were performed to control potential confounders. Results: A significant increase of calcium intake during pregnancy was observed (931±301 mg/day to 1,195±467 mg/day, p<0.001). Plasma PTH-rp, endothelin, and nitrite-nitrate levels did not change during pregnancy. Among the women 38 (25.4%) had low calcium intake (<800 mg/day) with a larger increase of systolic and diastolic blood pressure during pregnancy (p=0.04) birth (p=0.006) and puerperium (p=0.01). After adjusting for other factors the multivariate analyses showed statistical association between low calcium intake, high parathormone levels and high systolic blood pressure levels during pregnancy (p=0.002). Conclusion: Low calcium intake during pregnancy is associated with a larger increase of systolic blood pressure and high parathormone levels. Objetivo: Evaluar la asociación entre la ingesta de calcio en el embarazo, los niveles de presión arterial, las hormonas calciotrópicas (PTH, PTH-rp) y sustancias vasorreguladoras (endotelina, óxido nítrico). Métodos: Se realizó un estudio prospectivo con 149 primigrávidas normotensas que fueron incluidas en la semana 15 de gestación con seguimiento y evaluación hasta el puerperio. Se evaluó la ingesta diaria de calcio, la monitoría Holter de 24 horas, la calciuria, PTH, PTH-rp, la endotelina, nitritos y nitratos. Se siguieron modelos de regresión lineal para evaluar la asociación entre la ingesta de calcio, la presión arterial, las hormonas calciotrópicas y los vasorreguladores. Para controlar las variables de confusión se hicieron modelos de regresión múltiple. Resultados: Durante el embarazo la ingesta de calcio aumentó significativamente (931±301 mg/día a 1,195±467 mg/ día, p<0.001). Entre las embarazadas 38 (25.4%) tuvieron una baja ingesta de calcio (<800 mg/día) asociada con mayores niveles de presión arterial sistólica y diastólica durante el embarazo (p=0.04), en el parto (p=0.006) y en el puerperio (p=0.01). Los mayores niveles de presión arterial sistólica durante el embarazo se asociaron con mayores niveles de paratormona y con menores niveles de ingesta de calcio (p=0.002). Los niveles plasmáticos de PTH-rp, endotelina, nitritos y nitratos no mostraron cambios durante el embarazo. Conclusión: La baja ingesta de calcio en el embarazo se asoció con mayores niveles de paratormona y de presión arterial sistólica durante el embarazo

Converter DC/AC Multilevel of Three Cells: Modeling and Simulation

El presente documento presenta un convertidor DC/AC de tres celdas. Las topologías multinivel están atrayendo gran atención en la industria, ya que logran tener un rizado en las variables de estado más pequeño. Además reducen el estrés de conmutación en los dispositivos sólidos. La topología usada en este trabajo es conocida como ondulador multinivel de condensador flotante, en la cual se impone el reto de balancear la tensión entre las celdas de conmutación con ayuda de los condensadores flotantes, además de obtener una señal sinusoidal regulada. En el trabajo se expone el modelo promediado del ondulador, y los resultados obtenido mediante simulación.  This paper presents a three-cell converter DC / AC. Multilevel topologies are attracting attention in the industry, obtained as a ripple on the state variables much smaller, and reduces stress on the switching devices. The topology used in this work is known in the technical literature as floating capacitor multilevel inverter, which imposes the challenge of balancing the voltage across each cell switching using floating capacitors, besides obtaining a sinusoidal signal regulated. The paper presents the averaged model of the inverter, and results obtained through simulation