Soluble concentrations of the terminal complement complex C5b-9 correlate with end-organ injury in preeclampsia

Q3Q1Pacientes embarazadas hipertensasObjective: We sought to determine if soluble levels of C5b-9, the terminal complement complex, correlate with end-organ injury in preeclampsia. Study Design: Project COPA (Complement and Preeclampsia in the Americas), a multi-center observational study in Colombia from 2015 to 2016, enrolled hypertensive pregnant women into four groups: chronic hypertension, gestational hypertension, preeclampsia, and preeclampsia with severe features. Trained coordinators collected clinical data, blood and urine. End-organ injury was defined by serum creatinine ≥ 1.0 mg/dl, aspartate transaminase ≥ 70U/L, platelet count < 150,000/µl, or lactate dehydrogenase ≥ 500 U/L. Data were analyzed by χ2 or Fisher’s exact test with significance at P < 0.05. Main Outcome Measure: C5b-9 concentrations in plasma and urine, using enzyme linked immunosorbent assays. Results: In total, 298 hypertensive participants were enrolled. Plasma and urine C5b-9 levels were measured in all participants and stratified by quartile (Q1-4), from lowest to highest C5b-9 concentration. Participants with low plasma C5b-9 levels (Q1) were more likely to have end-organ injury compared to those with higher levels (Q2-Q4) [platelet count < 150,000/μl (20.8% vs. 8.4%, P = 0.01); elevated serum creatinine ≥ 1.0 mg/dl (14.9% vs. 4.5%, P = 0.009)]. In contrast, participants with high urinary C5b-9 levels (Q4) were more likely to have end-organ injury compared to those with lower levels (Q1-Q3) [platelet count < 150,000/μl (19.7% vs. 7.4%, P = 0.003); elevated serum creatinine ≥ 1.0 mg/dl (12.3% vs. 4.4%, P = 0.025)]. Conclusion: We identified a pattern of increased urine and low plasma C5b-9 levels in patients with preeclampsia and end-organ injury. Soluble C5b-9 levels may be used to identify complement-mediated end-organ injury in preeclampsia.https://orcid.org/0000-0001-6822-0374Revista Internacional - IndexadaA1N

Poster2012NEW.pptx

Evidence-based interventions are considered to be the most successful interventions used in public health. They have the research to support their potential success when implemented by an organization. Evidence-based interventions are created and tested, then are implemented by a variety of organizations in various geographic locations, including non-profit organizations, public health departments, and more. These organizations have a variety of funding sources, differing amounts of employees and different staff training procedures. Also, each organization has a different client base, which can affect the success of interventions. The study overall is evaluating the impact of these differences and the reality of how Project RESPECT is implemented in actual organizations. Champions are members of an organization that motivate staff members and are integral to the sustainability of a program or organization. Champions also can be essential to the successful adoption of an intervention into an organization. This specific part of the study is exploring the impact of the presence of a champion in the organizations implementing Project RESPECT.Keywords: Champion, Public Health, Intervention, HIV, Translation, AID

The role of champions in the adoption and implementation of Project RESPECT, an evidence-based behavioral HIV/STI intervention

Evidence-based interventions are considered to be the most successful interventions used in public health. They have the research to support their potential success when implemented by an organization. Evidence-based interventions are created and tested, then are implemented by a variety of organizations in various geographic locations, including non-profit organizations, public health departments, and more. These organizations have a variety of funding sources, differing amounts of employees and different staff training procedures. Also, each organization has a different client base, which can affect the success of interventions. The study overall is evaluating the impact of these differences and the reality of how Project RESPECT is implemented in actual organizations. Champions are members of an organization that motivate staff members and are integral to the sustainability of a program or organization. Champions also can be essential to the successful adoption of an intervention into an organization. This specific part of the study is exploring the impact of the presence of a champion in the organizations implementing Project RESPECT