Alvaro Monterrosa-Castro | Universidad de Cartagena (original) (raw)

Papers by Alvaro Monterrosa-Castro

Research paper thumbnail of Ansiedad y depresión identificadas con la Escala de Golberg en estudiantes universitarios del área de la salud

Edición 23(3) Depresión; Infecciones Urinarias; Agotamiento Profesional , 2020

Introducción. Los programas universitarios del área de la salud son exigentes y la rutina es exte... more Introducción. Los programas universitarios del área de la salud son exigentes y la rutina es extenuante, por lo tanto, generan estrés y un potencial impacto psicológico negativo en los estudiantes. El objetivo de este estudio fue determinar la prevalencia y los factores asociados a la ansiedad y a la depresión en estudiantes del área de la salud. Metodología. Estudio de tipo transversal aplicado a estudiantes de Medicina, Enfermería y Química Farmacéutica de una universidad colombiana que diligenciaron anónima y voluntariamente un formulario con datos sociodemográficos y, a su vez, la Escala de Ansiedad y Depresión de Goldberg. Se realizó regresión logística: ansiedad o depresión (variable dependiente) y las características sociodemográficas (independientes); p<0.05, estadísticamente significativo. Resultados. Los participantes corresponden a 697 jóvenes, cuyas edades oscilan entre 20.3±1.7. El 43.6% estudiaba Medicina, el 26.2% Química Farmacéutica y el 30.1% Enfermería. Se identificó ansiedad en el 49.8% (intervalo de confianza 95%:46.0-53.4) y depresión en el 80.3% (intervalo de confianza 95%:77.2-83.1). Estudiar Medicina, Enfermería, ser de sexo femenino, padecer de sobrepeso e infrapeso, haber tenido consulta previa psicológica o psiquiátrica, tener medicación permanente y sufrir de alguna enfermedad crónica, se asocia a mayor presencia de ansiedad. Proceder de zonas rurales se asoció a mayor depresión. Discusión. Los hallazgos muestran alta prevalencia de síntomas de ansiedad y depresión en el grupo de jóvenes universitarios del área de la salud. Si bien la escala utilizada no hace diagnóstico, sí sugiere la existencia de manifestaciones patológicas. Factores psicosociales, sobre todo del entorno juvenil, estuvieron asociados. Situaciones similares han sido señaladas por diferentes autores. Conclusiones. Se identificó ansiedad en la mitad de los estudiantes y depresión en ocho de cada diez. Factores inherentes a la vida universitaria, costumbres, hábitos y actividades recreativas se asociaron significativamente. Cómo citar. Monterrosa-Castro A, Ordosgoitia-Parra E, Beltrán-Barrios T, Et al. Ansiedad y depresión identificadas con la Escala de Golberg en estudiantes universitarios del área de la salud. MedUNAB. 2020;23(3):372-388. Doi: doi.org/10.29375/01237047.3881

Introduction. University programs in the health-care field are challenging and their routines are exhausting. Therefore, they create stress and a potential negative psychological impacts on students. This study’s objective was to determine the prevalence and factors associated with anxiety and depression in students in the health-care field. Methodology: A cross-sectional study applied to Medical, Nursing and Pharmaceutical Chemistry students from a Colombian university, who anonymously and voluntarily completed a form with sociodemographic data and the Goldberg Anxiety and Depression Scale. Logistic regression was performed: anxiety or depression (dependent variables) and sociodemographic characteristics (independent variables); p < 0.05, statistically significant. Results Six hundred and ninety-seven young adults participated, whose ages ranged between 20.3±1.7. Forty-three point six percent studied Medicine, 26.2% Pharmaceutical Chemistry and 30.1% Nursing. Anxiety was identified in 49.8% (95% confidence interval:46.0-53.4) and depression in 80.3% (95% confidence interval:77.2-83.1). Studying Medicine, Nursing, being female, overweight and underweight, having previously had a psychological or psychiatric consultation, taking permanent medication and suffering from a chronic disease are all associated with a higher presence of anxiety. Being from a rural area was associated with greater depression. Discussion. The findings show a high prevalence of symptoms of anxiety and depression in the group of university students in the health-care field. Even though the scale that was used does not perform diagnoses, it does suggest the existence of pathological manifestations. Psychosocial factors were associated, especially in juvenile environments. Similar situations have been indicated by various authors. Conclusion. Anxiety was identified in half of the students and depression was identified in eight of every ten. Factors inherent to university life, customs, habits and recreational activities were significantly associated. Cómo citar. Monterrosa-Castro A, Ordosgoitia-Parra E, Beltrán-Barrios T, Et al. Ansiedad y depresión identificadas con la Escala de Golberg en estudiantes universitarios del área de la salud. MedUNAB. 2020;23(3):389-404. Doi: doi.org/10.29375/01237047.3881

Introdução. Os programas universitários da área da saúde são exigentes e a rotina é extenuante, gerando estresse e um potencial impacto psicológico negativo nos estudantes. O objetivo deste estudo foi determinar a prevalência e os fatores associados à ansiedade e à depressão em estudantes da área de saúde. Metodologia. Trata-se de um estudo transversal aplicado a estudantes de Medicina, Enfermagem e Química Farmacêutica de uma universidade colombiana que preencheram, de forma anônima e voluntária, um formulário com dados sociodemográficos, assim como a Escala Goldberg de Ansiedade e Depressão. Foi realizada regressão logística: ansiedade ou depressão (variável dependente) e características sociodemográficas (independentes); p<0.05, estatisticamente significativo. Resultados. Os participantes foram 697 jovens, cujas idades variam entre os 20.3±1.7 anos. 43.6% estavam cursando Medicina, 26.2% Química Farmacêutica e 30.1% Enfermagem. Foi identificada ansiedade em 49.8% (IC 95%:46.0-53.4) e a depressão em 80.3% (IC 95%: 77.2-83.1). Estudar Medicina, Enfermagem, ser do sexo feminino, estar com sobrepeso e abaixo do peso, ter feito consulta psicológica ou psiquiátrica anterior, ter medicação permanente e sofrer de alguma doença crônica, são fatores que estão associados a uma maior presença de ansiedade. Vir de áreas rurais foi associado a uma maior depressão. Discussão. Os resultados mostram uma alta prevalência de sintomas de ansiedade e depressão no grupo de jovens universitários da área da saúde. Embora a escala utilizada não faça um diagnóstico, sugere a existência de manifestações patológicas. Fatores psicossociais, especialmente no ambiente juvenil, foram associados. Situações semelhantes têm sido apontadas por diferentes autores. Conclusão. A ansiedade foi identificada em metade dos estudantes e a depressão em oito de cada dez. Fatores inerentes à vida universitária, costumes, hábitos e atividades recreativas foram significativamente associadas. Cómo citar. Monterrosa-Castro A, Ordosgoitia-Parra E, Beltrán-Barrios T, Et al. Ansiedad y depresión identificadas con la Escala de Golberg en estudiantes universitarios del área de la salud. MedUNAB. 2020;23(3):372-388. Doi: doi.org/10.29375/01237047.3881

Research paper thumbnail of Estrés laboral, ansiedad y miedo al COVID-19 en médicos generales colombianos

Edición 23(2) Cirugía general, Coronavirus, Hemorroides, 2020

Introducción. Las epidemias pueden generar angustia en la población general y en los profesionale... more Introducción. Las epidemias pueden generar angustia en la población general y en los profesionales de la salud, y la pandemia causada por el virus del COVID-19 no es a excepción. El objetivo del presente estudio es determinar la presencia de síntomas de estrés laboral, ansiedad y miedo al COVID-19 en médicos generales, además de estimar la asociación según el ente territorial donde trabajaban. Metodología. Este es un estudio transversal que exploró síntomas y percepciones durante la pandemia del COVID-19 en médicos generales colombianos sometidos a cuarentena obligatoria que ejercieron su profesión en marzo del 2020. Previo consentimiento informado, anónima y voluntariamente, los participantes diligenciaron un formulario virtual con preguntas generales sobre COVID-19. El cuestionario buscaba encontrar problemas psicosomáticos sirviéndose de la Escala para el Trastorno de Ansiedad Generalizada (GAD-7, por sus siglas en inglés) y el FCV-19S (Fear of COVID-19). Los participantes se clasificaron en Municipio no capital o Municipio capital, según el ente territorial en donde laboraban. Regresión logística entre el ente territorial (que acá es tomada como variable independiente) con los síntomas de ansiedad, estrés laboral y miedo al COVID-19 (que en este caso es tomado como variable dependiente). Resultados: Participaron 531 médicos generales con edad promedio de 30 años. El 73.3% laboraban en Municipio capital. Un tercio de los encuestados presentó estrés laboral leve, mientras que el 6% presentó estrés laboral alto o severo, esto sin diferencias entre los grupos (p<0.05). Se identificaron síntomas de ansiedad en el 72.9%, más frecuente entre quienes laboraban en las capitales (p=0.044). El 37.1% presentó síntomas de miedo al COVID-19 (FCV-19S). No se observó asociación en la regresión logística realizada. Discusión: Factores psicosociales y psicosomáticos asociados al miedo son el común denominador de los síntomas de ansiedad y estrés laboral en las pandemias. Conclusión: Siete de cada diez participantes presentó síntomas de ansiedad o estrés laboral, mientras que cuatro presentaron síntomas de FCV-19S. No se observó asociación con la clasificación del municipio donde laboraban. Cómo citar. Monterrosa-Castro A, Dávila-Ruiz R, Mejía-Mantilla A, Contreras-Saldarriaga J, Mercado-Lara M, Flores-Monterrosa C. Estrés laboral, ansiedad y miedo al COVID-19 en médicos generales colombianos. MedUNAB. 2020;23(2): 195-213. doi: 10.29375/01237047.3890
Introduction: Epidemics can cause anxiety in the general population and health professionals. The pandemic caused by the COVID-19 virus is no exception. This study’s objective is to identify symptoms of work-related stress, anxiety and fear of COVID-19 in physicians, as well as to discover their relation with the territorial body in which they work. Methodology: This is a cross-cutting study that explored the symptoms and perceptions of Colombian physicians forced to quarantine, who exercised their profession in March, 2020 during the COVID-19 pandemic. Having provided informed consent anonymously and voluntarily, participants completed a virtual form with general questions on COVID-19. The survey was aimed at finding psychosomatic problems using the Generalized Anxiety Disorder (GAD-7) scale and Fear of COVID-19 (FCV-19S) scale. Participants were classified as working in non-capital or capital municipalities according to the territorial body in which they practiced. Logistic regression between the territorial body (which was taken as an independent variable here) and symptoms of anxiety, work-related stress and fear of COVID-19 (which, in this case, were taken as dependent variables) was performed. Results: Five hundred and thirty-one general physicians participated, with an average age of 30. Seventy-three point three percent practiced in a capital municipality. One third of the surveyed physicians presented mild work-related stress, while 6% presented high or severe work-related stress, without differences between groups (p < 0.05). Symptoms of anxiety were found in 72.9% of the surveyed physicians, more frequently among those who practiced in capitals (p = 0.044). Thirty-seven point one percent presented symptoms of fear of COVID-19 (FCV-19S). No relation was observed in the logistic regression. Discussion: Psychosocial and psychosomatic factors associated with fear are the common denominators of symptoms of anxiety and work-related stress during pandemics. Conclusion: Seven of every ten participants presented symptoms of anxiety or work-related stress, while four presented symptoms of FCV-19S. No relation was observed with the municipalities in which they worked. Cómo citar. Monterrosa-Castro A, Dávila-Ruiz R, Mejía-Mantilla A, Contreras-Saldarriaga J, Mercado-Lara M, Flores-Monterrosa C. Estrés laboral, ansiedad y miedo al COVID-19 en médicos generales colombianos. MedUNAB. 2020;23(2): 195-213. doi: 10.29375/01237047.3890
Introdução. As epidemias podem causar angústia na população em geral e nos profissionais de saúde, e a pandemia causada pelo vírus COVID-19 não é exceção. O objetivo deste estudo é determinar a presença de sintomas de estresse ocupacional, ansiedade e medo da COVID-19 em clínicos gerais, além de estimar a associação de acordo com a entidade territorial em que trabalhavam. Metodología. Este é um estudo transversal que explorou sintomas e percepções durante a pandemia da COVID-19 em clínicos gerais colombianos submetidos à quarentena obrigatória que exerceram sua profissão em março de 2020. Após consentimento informado, anonimamente e voluntariamente, os participantes preencheram um formulário virtual com perguntas gerais sobre a COVID-19. O questionário procurou encontrar problemas psicossomáticos utilizando a Escala de Desordem de Ansiedade Generalizada (GAD-7, sigla em inglês) e o FCV-19S (Fear of COVID-19). Os participantes foram classificados em município não-capital ou município capital de acordo com a entidade territorial onde trabalhavam. Regressão logística entre a entidade territorial (que aqui é tomada como variável independente) com os sintomas de ansiedade, estresse ocupacional e medo da COVID-19 (que aqui é tomada como variável dependente). Resultados. Participaram 531 médicos de clínica geral com idade média de 30 anos. Do total, 73.3% trabalhavam no município da capital. Um terço dos entrevistados apresentou leve estresse ocupacional, enquanto 6% apresentou estresse ocupacional alto ou severo, isto sem diferenças entre os grupos (p<0,05). Os sintomas de ansiedade foram identificados em 72.9%, mais frequentes entre os que trabalham nas capitais (p=0,044). Ademais, 37.1% tinham sintomas de medo da COVID-19 (FCV-19S). Nenhuma associação foi observada na regressão logística realizada. Discussão. Fatores psicossociais e psicossomáticos associados ao medo são o denominador comum dos sintomas de ansiedade e estresse ocupacional em pandemias. Conclusão. Sete em cada dez participantes apresentavam sintomas de ansiedade ou estresse no trabalho, enquanto quatro apresentavam sintomas do FCV-19S. Nenhuma associação foi observada com a classificação do município onde trabalhavam. Cómo citar. Monterrosa-Castro A, Dávila-Ruiz R, Mejía-Mantilla A, Contreras-Saldarriaga J, Mercado-Lara M, Flores-Monterrosa C. Estrés laboral, ansiedad y miedo al COVID-19 en médicos generales colombianos. MedUNAB. 2020;23(2): 195-213. doi: 10.29375/01237047.3890

Research paper thumbnail of Association of pre-eclampsia risk with maternal levels of folate, homocysteine and vitamin B12 in Colombia: A case-control study

PLoS One, 2018

Background: Maternal serum concentrations of folate, homocysteine, and vitamin B12 have been asso... more Background: Maternal serum concentrations of folate, homocysteine, and vitamin B12 have been associated with pre-eclampsia. Nevertheless, reported studies involve limited number of cases to
reliably assess the nature of these associations. Our aim was to examine the relation of these three biomarkers with pre-eclampsia risk in a large Colombian population.
Materials and methods
Design: A case-control study.
Setting: Cases of pre-eclampsia and healthy pregnant controls were recruited at the time of delivery from eight different Colombian cities between 2000 and 2012.
Population or Sample: 2978 cases and 4096 controls were studied. Maternal serum concentrations of folate, homocysteine, and vitamin B12 were determined in 1148 (43.6%) cases and 1300 (31.7%) controls. Also, self-reported folic acid supplementation was recorded for 2563 (84%) cases and 3155 (84%) controls.
Analysis: Adjusted odds ratios (OR) for pre-eclampsia were estimated for one standard deviation (1SD) increase in log-transformed biomarkers. Furthermore, we conducted analyses to compare women that reported taking folic acid supplementation for different periods
during pregnancy.
Main Outcomes Measures: Odds ratio for pre-eclampsia.
Results: After adjusting for potential confounders in logistic regression models, the OR for preeclampsia was 0.80 (95% CI: 0.72, 0.90) for 1SD increase in log-folate, 1.16 (95%CI: 1.05, 1.27) for 1SD increase in log-homocysteine, and 1.10 (95%CI: 0.99, 1.22) for 1SD increase in log-vitamin B12. No interactions among the biomarkers were identified. Women who selfreported consumption of folic acid (1 mg/day) throughout their pregnancy had an adjusted OR for pre-eclampsia of 0.86 (95%CI: 0.67, 1.09) compared to women that reported no consumption of folic acid at any point during pregnancy.
Conclusions: Maternal serum concentrations of folate were associated as a protective factor for preeclampsia while concentrations of homocysteine were associated as a risk factor. No association between maternal vitamin B12 concentrations and preeclampsia was found.

Research paper thumbnail of Insomnia and sexual dysfunction associated with severe worsening of the quality of life in sexually active hysterectomized women

Introduction: Hysterectomy is a common gynecologic surgery carried out to remove the pathologic u... more Introduction: Hysterectomy is a common gynecologic surgery carried out to remove the pathologic uterus. Objective: To establish if sleep disorders and sexual function are associated with deterioration of the quality of life (QoL) in hysterectomized and sexually active women. Methods: A cross-sectional study was carried out with inhabitants from two cities of the Colombian Caribbean. The pollsters invited women aged between 40-59 years to participate; in their communities they applied surveys with demographic characteristics: Female Sexual Function Index, Atenas Insomnia Scale and Menopause Rating Scale. Sexually active women were selected; then the association was established with logistic regression. Results: 522 women were studied with an average age of 50 years: 30% oophorectomized, 59.8% Hispanic, 40.2% afro-descendants and 22.2% hormonal therapy users. 80% of them had somato/vegetative, psychological or urogenital deterioration; 29.1% with severe deterioration of QoL and 47.5% with insomnia. Out of 390 (74.7%) with sexual activity, 59.7% suffered from sexual dysfunction. Insomnia: OR:3.05 [95%CI:1.86-4.99], sexual dysfunction OR:3.52 [95%CI:2.01-6.17], dissatisfaction about sexuality OR:4.77 [95%CI:2.08-10.93], low or non-existent sexual desire OR:2.94 [95%CI:1.65-5.25], daytime drowsiness OR:3.15 [95%CI:1.59-6.24] and decrease in daytime well-being OR:3.18 [95%CI :1.79-5.64]. These were factors associated with severe worsening of QoL, while the presence of genital lubrication was protective, OR: 0.44 [95%CI:0.21-0.93], p=0.0332. Conclusion: It was observed that insomnia and sexual dysfunction behaved as factors associated with three times more severe deterioration of the QoL in climacteric and sexually active women previously hysterectomized.

Research paper thumbnail of Insomnia and sexual dysfunction associated with severe worsening of the quality of life in sexually active hysterectomized women

Introduction: Hysterectomy is a common gynecologic surgery carried out to remove the patho-logic ... more Introduction: Hysterectomy is a common gynecologic surgery carried out to remove the patho-logic uterus. Objective: To establish if sleep disorders and sexual function are associated with deterioration of the quality of life (QoL) in hysterectomized and sexually active women. Methods: A cross-sectional study was carried out with inhabitants from two cities of the Colombian Caribbean. The pollsters invited women aged between 40-59 years to participate; in their communities they applied surveys with demographic characteristics: Female Sexual Function Index, Atenas Insomnia Scale and Menopause Rating Scale. Sexually active women were selected; then the association was established with logistic regression. Results: 522 women were studied with an average age of 50 years: 30% oophorectomized, 59.8% Hispanic, 40.2% afro-descendants and 22.2% hormonal therapy users. 80% of them had somato/vegetative, psychological or urogenital deterioration; 29.1% with severe deterioration of QoL and 47.5% with insomnia. Out of 390 (74.7%) with sexual activity, 59.7% suffered from sexual dysfunction. Insomnia: OR:3.05 [95%CI:1.86-4.99], sexual dysfunction OR:3.52 [95%CI:2.01-6.17], dissatisfaction about sexuality OR:4.77 [95%CI:2.08-10.93], low or non-existent sexual desire OR:2.94 [95%CI:1.65-5.25], daytime drowsiness OR:3.15 [95%CI:1.59-6.24] and decrease in daytime well-being OR:3.18 [95%CI:1.79-5.64]. These were factors associated with severe worsening of QoL, while the presence of genital lubrication was protective, OR: 0.44 [95%CI:0.21-0.93], p=0.0332. Conclusion: It was observed that insomnia and sexual dysfunction behaved as factors associated with three times more severe deterioration of the QoL in climacteric and sexually active women previously hysterectomized.

Research paper thumbnail of Type II diabetes mellitus and menopause: a multinational study

Climacteric, 2013

Background Type II diabetes mellitus causes metabolic changes that may lead to early menopause an... more Background Type II diabetes mellitus causes metabolic changes that may lead to early menopause and worsen climacteric symptoms.

Research paper thumbnail of Institucionalización de la enseñanza de la medicina en Cartagena desde la mirada de Horacio Zabaleta Jaspe*

Revista Ciencias …, 2012

Fue en octubre de 1976, año del cierre definitivo del casi centenario Hospital Universitario de S... more Fue en octubre de 1976, año del cierre definitivo del casi centenario Hospital Universitario de Santa Clara, cuando el médico y profesor de la Facultad de Medicina de la Universidad de Cartagena, Colombia, Horacio Zabaleta Jaspe dio a la luz un libro, que se ha convertido en clásico y obligado documento para develar la historia de la medicina, de los médicos y de la enseñanza médica local. Tomando como núcleo dicho hospital y apelando a la memoria, al sentimiento, al recuerdo, al testimonio y al documento, tejió un texto con estilo sencillo y narrativo. Bordado a la orilla de los eventos, presenta al detalle la historia de la enseñanza de la medicina en Cartagena, haciendo un relato pormenorizado de sus antecedentes, orígenes y desarrollo. El libro denominado con nostalgia, Réquiem por un viejo hospital, presenta los inicios y los devenires de la enseñanza de la medicina en Cartagena, desde los albores hasta la década de los setenta del siglo XX. Se extraen de sus páginas y se comentan entre líneas, el proceso de la institucionalización de la formación médica y el surgimiento del profesional médico, desde el protomédico a la figura formal del catedrático. Rev.

Research paper thumbnail of Benefits of maternal vaccination to prevent pertussis in infants

Pertussis, also called whooping cough, is an infectious and preventable pathology that generates ... more Pertussis, also called whooping cough, is an infectious and preventable pathology that generates important child
morbidity and mortality worldwide. There are different biological preparations for its use in infants, while for
adolescents and adults is Tdap, (acellular vaccine of purified extracts of Bordetella pertussis (BP), combined with
tetanus and diphtheria toxoid) that has been proposed as maternal vaccination (MV). The objective was to identify the
benefits of MV in the prevention of childhood pertussis, a review was made in PubMed, Science Direct, EBSCOhosT,
OvidSP and Embase databases (years 2008-2016) and an electronic alert system (January-April 2017). 1083 titles
were identified and 44 articles were selected. After the MV (administered between 27 and 36 weeks of gestation) the
passage of IgG-BP to the fetus is sufficient to generate adequate infant protection, generating two benefits: reducing
infant morbidity (number of cases and hospital admissions) and decreasing mortality by pertussis. The MV offers
93% of effectiveness [95%CI: 81-97] and OR: 0.09 [95%CI: 0,03-0,25]. The MV is more favorable in each
pregnancy than cocoon strategy, vaccination before pregnancy, before 26 weeks of gestation or in the postpartum. The
use of MV is a safe and cost-effectiveness tool to prevent childhood pertussis.

Research paper thumbnail of Manifestaciones menopaúsicas y calidad de vida en afrocolombianas. Valoración con escala Cervantes

Introducción: las manifestaciones menopaúsicas se deben estudiar realizando consideraciones étnic... more Introducción: las manifestaciones menopaúsicas se deben estudiar realizando consideraciones étnicas. Objetivo: identificar las manifestaciones menopaúsicas más prevalentes y evaluar calidad de vida (CV) según estados menstruales. Metodología: estudio que hace parte de CAVIMEC [Calidad de Vida en la Menopausia y Etnias Colombianas], realizado con Escala Cervantes que evalúa CV en la menopausia, en 646 afrocolombianas, entre 40-59 años, residentes en poblaciones del caribe y el pacífico. Resultados: edad promedio 48,7±5,7 años, 69,1% con obesidad/sobrepeso, 22,7% con estudios tecnológicos/universitarios y 40,5% posmenopáusicas. Las manifestaciones más prevalentes: oleadas de calor 76,4%; sofocaciones 73,1%; dolor músculo/articular 71,3%; no conseguían dormir 61,8%; sudoración sin esfuerzos 55,8%; sequedad de piel 50,4% y cefalea que aumentaba durante el día 44,2%. La tercera parte no podían por los nervios, las cosas le aburrían, perdieron la capacidad de relajarse o notaban que todo le daba vueltas. El 24,4% tenían menos interés en el sexo y 14,4% tenían sexualidad nada importante. Las posmenopáusicas tuvieron peor puntuación en la mayoría de las manifestaciones y en los dominios salud, psíquico, sexualidad, relación de pareja, vasomotores, salud, envejecimiento y global. Conclusión: oleadas de calor, sofocaciones y dolor musculo/articular fueron las manifestaciones más prevalentes, en siete de cada diez. Las posmenopáusicas tuvieron peor CV.
Menopausal manifestations and quality of life in
afro-colombians. Valuation whit Cervantes scale
Introduction: the menopausal manifestations should
be studied by ethnic considerations. Objective: to identify the most prevalent menopausal manifestations and to evaluate quality of life according to menstrual states. Methods: this study is a part of CAVIMEC [Quality of Life in Menopause and Colombian Ethnic Groups],
performed with Cervantes Scale, which evaluates CV in
menopause, in 646 Afro-Colombians, aged 40-59 years,
living in populations of the Caribbean and Pacific. Results: mean age 48.7±5.7 years, 69.1% with obesity/overweight, 22.7% with university/technological studies and 40.5% postmenopausal. The most prevalent manifestations: hot flashes 76.4%; suffocation 73.1%;
Muscle/joint pain 71.3%; they couldn’t sleep 61.8%; easy sweating episode 55.8%; dry skin 50.4% and headache that increased during the day 44.2%. The third part could not be good by the nerves, things like boring, lost the ability to relax or noticed that everyone was spinning 24.4% had less interest in sex and 14.4% had not significant sexuality. Postmenopausal women had worse scores in most of the manifestations and in the domains of health, psychic, sexuality, relationship, vasomotor, health, aging and global. Conclusion: hot flashes, suffocations and muscle/joint pain were the manifestations most prevalent, in seven out of ten. Postmenopausal women had worse
quality of life.

Research paper thumbnail of Instruments to study sleep disorders in climacteric women

To identify the scales to assess sleep disorders applied to women with climacteric stage. Bibliog... more To identify the scales to assess sleep disorders applied to women with climacteric stage. Bibliographical research
without intervention, the available information in scientific databases. Performed in PubMed, ScienceDirect,
Scopus, Ebscohos OvidSP and Health Library. The words used in this article: insomnia, adjustment sleep
disorder, questionnaires, studies and menopause. Publications of all types were included. Seven scales were
identified: Insomnia Severity Index, Athens Insomnia Scale, Pittsburgh Quality of sleep Index, Epworth
Sleepiness Scale, Jenkins Sleep Scale, Basic Nordic Sleep Questionnaire and The St Mary's Hospital Sleep
Questionnaire. There are validated scales in multiple languages and considered appropriate for studying sleep
disorders.

Research paper thumbnail of Artículo de Investigación CORRELACIÓN ENTRE SÍNTOMAS MENOPÁUSICOS Y PERCEPCIÓN DE ESTRÉS EN MUJERES DEL CARIBE COLOMBIANO

RESUMEN Introducción: Estrés es el conjunto de procesos y respuestas ante situaciones que requier... more RESUMEN Introducción: Estrés es el conjunto de procesos y respuestas ante situaciones que requieren mayor adaptación que lo habitual. En estrés psicológico, el individuo cree no controlar las exi-gencias del entorno. El objetivo fue estimar correlación entre síntomas menopáusicos y estrés psicológico percibido. Metodología: Estudio transversal del proyecto CAVIMEC (Calidad de Vida en la Menopausia y Etnias Colombianas), realizado en mujeres de dos ciudades del caribe Colombiano, edad 40-59 años, que participaron voluntariamente en sus comunidades. Se aplicó formulario de características sociodemográfi cas y las escalas: Perceived Stress Scale (PSS-10) y Menopause Rating Scale (MRS). A mayor puntuación de PSS-10, mayor estrés psicológico. A mayor valor MRS, mayor severidad de síntomas, deterioro de dominios y peor calidad de vida. El análisis estadístico se realizó con Epi–info 7. Resultados: 471 mujeres con 48,0(45,0-52,5) años. Premenopausia: 23,9%, perimenopausia: 11,7% y posmenopausia: 64,3%. El 61,9% en sobrepeso u obesidad, 7,2% diabéticas, 15,2% hipertensas, 15,7% ooforectomía bilateral y 50,3% histerectomizadas. 69,4% manifestó que las cosas le iban bien a menudo y 57,5 % que estaban seguras sobre su capacidad para manejar problemas personales. MRS 13,0(9,0-17,0) puntos, cansancio físico/mental 84,5%, oleadas de calor 84,5% y dolores musculo/articulares 84,3%. Se encontró correlación positiva entre oleadas de calor, molestias cardiacas, trastornos del sueño, molestias musculo/articulares, estado de ánimo depresivo, irritabilidad, ansiedad, cansancio físico/mental, problemas sexuales, problemas de vejiga, sequedad vaginal y calidad de vida, con PSS-10 (p<0,005). Calidad de vida: rho=0,41(IC95%:0,33-0,48)p<0,0001. Uroge-nital: rho=0,39(IC95%:0,31-0,46)p<0,0001. Somático: rho=0,31(IC95%:0,23-0,39)p<0,0001. Psicológico: rho=0,38(IC95%:0,31-046)p<0,0001. Conclusión: a mayor presencia de síntomas menopáusicos, mayor estrés psicológico percibido.

Research paper thumbnail of ABSTRACTS: MENOPAUSE , Vol. 21, No. 12, 2014Correlation betweenmenopausal symptoms and the perception of psychological stress in women from the Colombian CaribbeanCorrelation betweenmenopausal symptoms and the perception of psychological stress in women from the Colombian Caribbean

Correlation betweenmenopausal symptoms and the perception of psychological stress in women from t... more Correlation betweenmenopausal symptoms and the perception of psychological
stress in women from the Colombian Caribbean
Liezel Ulloque-Caamaño, Marlon Salguedo-Madrid, Alvaro Monterrosa-Castro,
Joulen Moulen-Carrascal, Enrique Ramos-Classon. Universidad de Cartagena, Cartagena,
Colombia.
Objective: to estimate the correlation between menopausal symptoms and the score in the
scale of perceived stress.
Design: Cross-sectional study that is part of the CAVIMEC (Calidad de Vida en la
Menopausia y Etnias Colombianas) research program carried out in resident women in
the cities of Cartagena and Montería in the Colombian Caribbean, with ages between
40 and 59 years. They voluntarily completed the questionnaire in 2012, which was applied
by pollsters who visited them in their own communities; the pollsters were professionals of
the health area previously trained who, in door-to-door visits, applied a questionnaire of
socio-demographic data and the scales: Perceived Stress Scale (PSS), which contains
10 items andMenopause Rating Scale (MRS), both in Spanish version. To higher score
of the MRS, higher the severity of the symptoms, the deterioration of the domains and
worse quality of life. The statistical analysis to estimate Pearson’s Correlation Coefficient
was carried out with the statistical programs Epi–info 7 and MedCalc. Study without
ethic impact in the participants.
Results: 471 women were studied. Average age: 48.3±5.1. They were distributed
according the menopausal status, premenopause: 23.9%, perimenopause: 11.7% and
postmenopause: 64.3%. 61.9% of the women were in overweight or obesity, 7.2% were
diabetic women, 15.2% had arterial hypertension, 15.7% had bilateral oophorectomy and
50.3% had been hysterectomized. 69.4% of the women manifested to have felt fairly often
or very often that things were going her way and the 57.5 % expressed to have felt herself
confident about her ability to handle her personal problems. The average score of the
MRS was 13.4±6.4, being the physical and mental exhaustion (84.5%), the hot flushes
and sweating (84.5%) and the joint and muscular discomfort (84.3%), the most frequent
symptoms. Aweak positive correlation was found between hot flushes, heart discomfort,
sleep problems, joint and muscular discomfort, depressive mood, irritability, anxiety,
physical and mental exhaustion, sexual problems, bladder problems, dryness of vagina
and the total score of the domains and of the quality of life with the total addition of the
PSS-10 (p<0.005). Quality of life: r= 0.41 [CI95%: 0.33-0.48], p<0.0001. Urogenital
domain: r= 0.39 [CI95%: 0.31-0.46], p<0.0001. Somatic domain: r= 0.31 [CI95%:
0.23-0.39], p<0.0001. Psychological domain: r= 0.38 [CI95%: 0.31-046], p<0.0001.
Conclusion: Significant and positive correlation was found between the score of the
PSS-10 and the menopausal symptoms in women from the Colombian Caribbean.

Research paper thumbnail of RAFAEL ALVEAR TERÁN: EL ÚLTIMO EXPONENTE DEL MÉTODO ANATOMOCLÍNICO EN LA UNIVERSIDAD DE CARTAGENA-COLOMBIA

RESUMEN La anatomía humana fue el epicentro del saber, quehacer y la educación médica durante fin... more RESUMEN La anatomía humana fue el epicentro del saber, quehacer y la educación médica durante finales del siglo XVIII y comienzos del siglo XIX. A este movimiento proveniente de escuelas médicas de París se le denominó el método anatomoclínico y promulgaba la articulación de los signos y síntomas de una patología con los hallazgos o lesiones anatómicas. Lo anterior permitió el auge de los anatomistas y el desarrollo de didácticas en el aprendizaje de la medicina con la disección de cadáveres humanos en los anfiteatros. Investigación, educación y asistencia clínica se realizó por décadas bajo el amparo conceptual de la medicina anatomoclínica. Con el pasar de los años surgió la medicina de laboratorio y otras corrientes como la etiopatológica y la fisiopatológica, las cuales trajeron como consecuencia que el papel de la anatomía dentro de la enseñanza y la práctica clínica fuese modificado. La Facultad de Medicina de la Universidad de Cartagena-Colombia recibió influencia de la medicina anatomoclínica por parte de docentes que realizaron sus estudios médicos en escuelas francesas y por la lectura de libros en francés. Una saga de profesores anatomistas se pueden identificar, siendo el doctor Rafael Alvear Terán, el último docente de esa facultad médica, representante de la también llamada mentalidad anatomoclínica. Rev.cienc.biomed. 2015;6(2): 394-405

SUMMARY Human anatomy was the focus of knowledge, pursuit and medical education in the late eighteenth century and early nineteenth century. This movement came from medical schools in Paris and was called the anatomo-clinical method; this method spread the articulation of the signs and symptoms in pathology findings or anatomical lesions. Also, this allowed the growth of anatomist and development of teaching learning in medicine with dissection of human cadavers in dissecting room. Investigation, education and clinical assistance were carried out for decades under the anatomo-clinical method.

Research paper thumbnail of Personal and professional use of menopausal hormone therapy among gynecologists: A multinational study (REDLINC VII)

Maturitas, 2016

Previously, the REDLINC VI study showed that the main reason for the low use of menopausal hormon... more Previously, the REDLINC VI study showed that the main reason for the low use of menopausal hormone therapy (MHT) was its low rate of prescription by doctors. To determine the use of MHT and perceived related risks among gynecologists. A self-administered and anonymous questionnaire was delivered to certified gynecologists in 11 Latin American countries. A total of 2154 gynecologists were contacted, of whom 85.3% responded to the survey (n=1837). Mean age was 48.1±11.4years; 55.5% were male, 20.3% were faculty members and 85% had a partner. Overall, 85.4% of gynecologists responded that they would use MHT if they had menopausal symptoms (81.8% in the case of female gynecologists) or prescribe it to their partner (88.2% in the case of male gynecologists; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Perceived risk related to MHT use (on a scale from 0 to 10) was higher among female than among male gynecologists (4.06±2.09 vs. 3.83±2.11, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.02). The top two perceived reported risks were thromboembolism (women 33.6% vs. men 41.4%, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.009) and breast cancer (women 38.5% vs. men 33.9%, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.03). Overall, gynecologists reported prescribing MHT to 48.9% of their symptomatic patients (women 47.3% vs. men 50.2%, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.03) and 86.8% currently prescribed non-hormonal remedies and 83.8% alternative therapies for the management of the menopause. Gynecologists who were older and academic professionals prescribed MHT more often. Although this Latin American survey showed that gynecologists are mostly supporters of MHT use (for themselves or their partners), this is not necessarily reflected in their clinical practice.

Research paper thumbnail of CORRELACIÓN ENTRE SÍNTOMAS MENOPÁUSICOS Y PERCEPCIÓN DE ESTRÉS EN MUJERES DEL CARIBE COLOMBIANO

RESUMEN Introducción: Estrés es el conjunto de procesos y respuestas ante situaciones que requier... more RESUMEN Introducción: Estrés es el conjunto de procesos y respuestas ante situaciones que requieren mayor adaptación que lo habitual. En estrés psicológico, el individuo cree no controlar las exi-gencias del entorno. El objetivo fue estimar correlación entre síntomas menopáusicos y estrés psicológico percibido. Metodología: Estudio transversal del proyecto CAVIMEC (Calidad de Vida en la Menopausia y Etnias Colombianas), realizado en mujeres de dos ciudades del caribe Colombiano, edad 40-59 años, que participaron voluntariamente en sus comunidades. Se aplicó formulario de características sociodemográfi cas y las escalas: Perceived Stress Scale (PSS-10) y Menopause Rating Scale (MRS). A mayor puntuación de PSS-10, mayor estrés psicológico. A mayor valor MRS, mayor severidad de síntomas, deterioro de dominios y peor calidad de vida. El análisis estadístico se realizó con Epi–info 7. Resultados: 471 mujeres con 48,0(45,0-52,5) años. Premenopausia: 23,9%, perimenopausia: 11,7% y posmenopausia: 64,3%. El 61,9% en sobrepeso u obesidad, 7,2% diabéticas, 15,2% hipertensas, 15,7% ooforectomía bilateral y 50,3% histerectomizadas. 69,4% manifestó que las cosas le iban bien a menudo y 57,5 % que estaban seguras sobre su capacidad para manejar problemas personales. MRS 13,0(9,0-17,0) puntos, cansancio físico/mental 84,5%, oleadas de calor 84,5% y dolores musculo/articulares 84,3%. Se encontró correlación positiva entre oleadas de calor, molestias cardiacas, trastornos del sueño, molestias musculo/articulares, estado de ánimo depresivo, irritabilidad, ansiedad, cansancio físico/mental, problemas sexuales, problemas de vejiga, sequedad vaginal y calidad de vida, con PSS-10 (p<0,005). Calidad de vida: rho=0,41(IC95%:0,33-0,48)p<0,0001. Uroge-nital: rho=0,39(IC95%:0,31-0,46)p<0,0001. Somático: rho=0,31(IC95%:0,23-0,39)p<0,0001. Psicológico: rho=0,38(IC95%:0,31-046)p<0,0001. Conclusión: a mayor presencia de síntomas menopáusicos, mayor estrés psicológico percibido.

Research paper thumbnail of P26 Homocysteine, folic acid and vitamin B12 serum levels and preeclampsia: A large-scale study from GenPE Study

Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health, 2010

We have previously demonstrated that melatonin protects against ischemia/reperfusion (I/R)-induce... more We have previously demonstrated that melatonin protects against ischemia/reperfusion (I/R)-induced oxidative damage to mitochondria in the fetal rat brain. At the same time, Takagi et al (Virchows Archiv 2004) said that FGR associated with preeclampsia may be due to decompensation of placental function against oxidative stress. The purpose of the present study was to evaluate the effects of maternally-administered melatonin on I/R-induced oxidative placental damage and FGR in rats. The utero-ovarian arteries were occluded bilaterally for 30 min in rats on day 16 of pregnancy to induce fetal ischemia. Reperfusion was achieved by releasing the occlusion and restoring circulation. Melatonin solution (20μg/ml) or the vehicle alone was administered orally during pregnancy. A sham operation was performed in control rats which were treated with vehicle alone. Laparotomy was performed on day 20 of pregnancy and the number and weight of fetal rats and placentas were measured. Placental mitochondrial respiratory control index (RCI), a marker of mitochondrial respiratory activity, was also calculated for each group. Using immunohistochemistry, we investigated the degree of immunostaining of 8-hydroxy-2-deoxyguanosine (8-OHdG), a marker of oxidative DNA damage, and redox factor-1 (ref-1), which repairs DNA damage and acts as a redox-modifying factor in rat placenta. Predictably, the I/R operation significantly decreased the weight of fetal rats and placentas and the RCI. Melatonin prevented I/R-induced changes in RCI (1.55±0.05 to 1.83±0.09, P < 0.05) and fetal growth (3.04±0.17 to 3.90±0.1, P < 0.0001). Immunohistochemistry revealed significant positive staining for 8-OHdG and ref-1 following I/R; these effects were also reduced by melatonin treatment. Results indicated that I/R-induced oxidative placental DNA and mitochondrial damage and FGR can be prevented by maternally-administered melatonin.

Research paper thumbnail of P22 Elevated levels of pentraxin 3 in HELLP syndrome and preeclampsia: GenPE study

Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health, 2010

infection with C. pneumoniae and CMV and immune response in normal and preeclampsia complicated p... more infection with C. pneumoniae and CMV and immune response in normal and preeclampsia complicated pregnancies. The first noteworthy finding of this work has shown that preeclampsia was associated with increased C. pneumonia genomic DNA loads compared with normal pregnancy controls and had higher anti-CMV IgG seropositivity than in women with normotensive interuterine growth restriction and normal pregnancy controls. Additionally, data synthesis revealed that IgG seropositivity of C. pneumonia and CMV was more prevalent among women with preeclampsia than normal pregnancy controls. The second finding of this work observed that early onset preeclampsia had increased Toll like receptor (TLR)-2 and -4 mRNA and protein expressions, elevated mRNA expressions of cryopyrin, NF-κB subunits and IL-1β, as well as increased TNF-α: IL-10 and IL-6: IL-10 ratios compared with normal pregnancy controls. Third, through a comprehensive review of published literatures and in combination of our study results, data suggested that TLR2 (Arg753Gln) and TLR4 co-segregating (Asp299Gly and Thr399Ile) gene polymorphisms seems in susceptibility to development of early onset preeclampsia. Our research findings indicated that TLR-microbial with C. pneumonia and CMV interactions play an important role in maternal inflammatory syndroms in preeclampsia. This work may contribute for identification of novel anti-inflammatory targets for preeclampsia treatment, eventually leading to improved health care for both mom and fetus.

Research paper thumbnail of Obesity and its relation to depressive symptoms and sedentary lifestyle in middle-aged women

Maturitas, 2015

The prevalence of obesity increases during female mid-life and although many factors have been id... more The prevalence of obesity increases during female mid-life and although many factors have been identified, data from Latin America is lacking. To assess factors related to obesity among middle-aged women and determine the association with depressive symptoms, sedentary lifestyle and other factors. A total of 6079 women aged 40-59 years of 11 Latin American countries were asked to fill out the Goldberg Anxiety and Depression Scale, the Menopause Rating Scale, the Athens Insomnia Scale, the Pittsburgh Sleep Quality Index and a general questionnaire containing personal socio-demographic data, anthropometric measures and lifestyle information. Obesity was defined as a body mass index (BMI) ≥30kg/m(2). Obesity was observed in 18.5% and sedentary lifestyle in 63.9%. A 55.5% presented vasomotor symptoms, 12.2% had severe menopausal symptoms and 13.2% used hormone therapy for the menopause. Prevalence of depressive symptoms was 46.5% and anxiety 59.7%. Our logistic regression model found that significant factors associated to obesity included: arterial hypertension (OR: 1.87), depressive symptoms (OR: 1.57), sedentary lifestyle (OR: 1.50) diabetes mellitus (OR: 1.34), higher number of individuals living at home (OR: 1.31), sleep problems (OR:1.22), anxiety (OR: 1.21), having a stable partner (OR: 1.20), parity (OR: 1.16) and vasomotor symptoms (OR:1.14). A lower risk for obesity was found among women using hormonal contraceptives (OR: 0.69). Obesity in middle-aged women is the consequence of the interaction of multiple factors. It was associated to hypertension, depressive symptoms, sedentary lifestyle, climacteric symptoms and other factors.

Research paper thumbnail of Age at menopause in Latin America

Menopause, 2006

To assess the age at menopause (AM) in Latin America urban areas. A total of 17,150 healthy women... more To assess the age at menopause (AM) in Latin America urban areas. A total of 17,150 healthy women, aged 40 to 59 years, accompanying patients to healthcare centers in 47 cities of 15 Latin American countries, were surveyed regarding their age, educational level, healthcare coverage, history of gynecological surgery, smoking habit, presence of menses, and the use of contraception or hormone therapy at menopause. The AM was calculated using logit analysis. The mean age of the entire sample was 49.4 +/- 5.5 years. Mean educational level was 9.9 +/- 4.5 years, and the use of hormone therapy and oral contraception was 22.1% and 7.9%, respectively. The median AM of women in all centers was 48.6 years, ranging from 43.8 years in Asuncion (Paraguay) to 53 years in Cartagena de Indias (Colombia). Logistic regression analysis determined that women aged 49 living in cities at 2,000 meters or more above sea level (OR = 2.0, 95% CI: 1.4-2.9, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and those with lower educational level (OR = 1.9, 95% CI: 1.3-2.8, P…

Research paper thumbnail of Sexual dysfunction in middle-aged women

Menopause, 2009

Objective: The purpose of this study was to assess the prevalence of sexual dysfunction (SD) and ... more Objective: The purpose of this study was to assess the prevalence of sexual dysfunction (SD) and associated risk factors among middle-aged Latin American women using one validated instrument.

Research paper thumbnail of Ansiedad y depresión identificadas con la Escala de Golberg en estudiantes universitarios del área de la salud

Edición 23(3) Depresión; Infecciones Urinarias; Agotamiento Profesional , 2020

Introducción. Los programas universitarios del área de la salud son exigentes y la rutina es exte... more Introducción. Los programas universitarios del área de la salud son exigentes y la rutina es extenuante, por lo tanto, generan estrés y un potencial impacto psicológico negativo en los estudiantes. El objetivo de este estudio fue determinar la prevalencia y los factores asociados a la ansiedad y a la depresión en estudiantes del área de la salud. Metodología. Estudio de tipo transversal aplicado a estudiantes de Medicina, Enfermería y Química Farmacéutica de una universidad colombiana que diligenciaron anónima y voluntariamente un formulario con datos sociodemográficos y, a su vez, la Escala de Ansiedad y Depresión de Goldberg. Se realizó regresión logística: ansiedad o depresión (variable dependiente) y las características sociodemográficas (independientes); p<0.05, estadísticamente significativo. Resultados. Los participantes corresponden a 697 jóvenes, cuyas edades oscilan entre 20.3±1.7. El 43.6% estudiaba Medicina, el 26.2% Química Farmacéutica y el 30.1% Enfermería. Se identificó ansiedad en el 49.8% (intervalo de confianza 95%:46.0-53.4) y depresión en el 80.3% (intervalo de confianza 95%:77.2-83.1). Estudiar Medicina, Enfermería, ser de sexo femenino, padecer de sobrepeso e infrapeso, haber tenido consulta previa psicológica o psiquiátrica, tener medicación permanente y sufrir de alguna enfermedad crónica, se asocia a mayor presencia de ansiedad. Proceder de zonas rurales se asoció a mayor depresión. Discusión. Los hallazgos muestran alta prevalencia de síntomas de ansiedad y depresión en el grupo de jóvenes universitarios del área de la salud. Si bien la escala utilizada no hace diagnóstico, sí sugiere la existencia de manifestaciones patológicas. Factores psicosociales, sobre todo del entorno juvenil, estuvieron asociados. Situaciones similares han sido señaladas por diferentes autores. Conclusiones. Se identificó ansiedad en la mitad de los estudiantes y depresión en ocho de cada diez. Factores inherentes a la vida universitaria, costumbres, hábitos y actividades recreativas se asociaron significativamente. Cómo citar. Monterrosa-Castro A, Ordosgoitia-Parra E, Beltrán-Barrios T, Et al. Ansiedad y depresión identificadas con la Escala de Golberg en estudiantes universitarios del área de la salud. MedUNAB. 2020;23(3):372-388. Doi: doi.org/10.29375/01237047.3881

Introduction. University programs in the health-care field are challenging and their routines are exhausting. Therefore, they create stress and a potential negative psychological impacts on students. This study’s objective was to determine the prevalence and factors associated with anxiety and depression in students in the health-care field. Methodology: A cross-sectional study applied to Medical, Nursing and Pharmaceutical Chemistry students from a Colombian university, who anonymously and voluntarily completed a form with sociodemographic data and the Goldberg Anxiety and Depression Scale. Logistic regression was performed: anxiety or depression (dependent variables) and sociodemographic characteristics (independent variables); p < 0.05, statistically significant. Results Six hundred and ninety-seven young adults participated, whose ages ranged between 20.3±1.7. Forty-three point six percent studied Medicine, 26.2% Pharmaceutical Chemistry and 30.1% Nursing. Anxiety was identified in 49.8% (95% confidence interval:46.0-53.4) and depression in 80.3% (95% confidence interval:77.2-83.1). Studying Medicine, Nursing, being female, overweight and underweight, having previously had a psychological or psychiatric consultation, taking permanent medication and suffering from a chronic disease are all associated with a higher presence of anxiety. Being from a rural area was associated with greater depression. Discussion. The findings show a high prevalence of symptoms of anxiety and depression in the group of university students in the health-care field. Even though the scale that was used does not perform diagnoses, it does suggest the existence of pathological manifestations. Psychosocial factors were associated, especially in juvenile environments. Similar situations have been indicated by various authors. Conclusion. Anxiety was identified in half of the students and depression was identified in eight of every ten. Factors inherent to university life, customs, habits and recreational activities were significantly associated. Cómo citar. Monterrosa-Castro A, Ordosgoitia-Parra E, Beltrán-Barrios T, Et al. Ansiedad y depresión identificadas con la Escala de Golberg en estudiantes universitarios del área de la salud. MedUNAB. 2020;23(3):389-404. Doi: doi.org/10.29375/01237047.3881

Introdução. Os programas universitários da área da saúde são exigentes e a rotina é extenuante, gerando estresse e um potencial impacto psicológico negativo nos estudantes. O objetivo deste estudo foi determinar a prevalência e os fatores associados à ansiedade e à depressão em estudantes da área de saúde. Metodologia. Trata-se de um estudo transversal aplicado a estudantes de Medicina, Enfermagem e Química Farmacêutica de uma universidade colombiana que preencheram, de forma anônima e voluntária, um formulário com dados sociodemográficos, assim como a Escala Goldberg de Ansiedade e Depressão. Foi realizada regressão logística: ansiedade ou depressão (variável dependente) e características sociodemográficas (independentes); p<0.05, estatisticamente significativo. Resultados. Os participantes foram 697 jovens, cujas idades variam entre os 20.3±1.7 anos. 43.6% estavam cursando Medicina, 26.2% Química Farmacêutica e 30.1% Enfermagem. Foi identificada ansiedade em 49.8% (IC 95%:46.0-53.4) e a depressão em 80.3% (IC 95%: 77.2-83.1). Estudar Medicina, Enfermagem, ser do sexo feminino, estar com sobrepeso e abaixo do peso, ter feito consulta psicológica ou psiquiátrica anterior, ter medicação permanente e sofrer de alguma doença crônica, são fatores que estão associados a uma maior presença de ansiedade. Vir de áreas rurais foi associado a uma maior depressão. Discussão. Os resultados mostram uma alta prevalência de sintomas de ansiedade e depressão no grupo de jovens universitários da área da saúde. Embora a escala utilizada não faça um diagnóstico, sugere a existência de manifestações patológicas. Fatores psicossociais, especialmente no ambiente juvenil, foram associados. Situações semelhantes têm sido apontadas por diferentes autores. Conclusão. A ansiedade foi identificada em metade dos estudantes e a depressão em oito de cada dez. Fatores inerentes à vida universitária, costumes, hábitos e atividades recreativas foram significativamente associadas. Cómo citar. Monterrosa-Castro A, Ordosgoitia-Parra E, Beltrán-Barrios T, Et al. Ansiedad y depresión identificadas con la Escala de Golberg en estudiantes universitarios del área de la salud. MedUNAB. 2020;23(3):372-388. Doi: doi.org/10.29375/01237047.3881

Research paper thumbnail of Estrés laboral, ansiedad y miedo al COVID-19 en médicos generales colombianos

Edición 23(2) Cirugía general, Coronavirus, Hemorroides, 2020

Introducción. Las epidemias pueden generar angustia en la población general y en los profesionale... more Introducción. Las epidemias pueden generar angustia en la población general y en los profesionales de la salud, y la pandemia causada por el virus del COVID-19 no es a excepción. El objetivo del presente estudio es determinar la presencia de síntomas de estrés laboral, ansiedad y miedo al COVID-19 en médicos generales, además de estimar la asociación según el ente territorial donde trabajaban. Metodología. Este es un estudio transversal que exploró síntomas y percepciones durante la pandemia del COVID-19 en médicos generales colombianos sometidos a cuarentena obligatoria que ejercieron su profesión en marzo del 2020. Previo consentimiento informado, anónima y voluntariamente, los participantes diligenciaron un formulario virtual con preguntas generales sobre COVID-19. El cuestionario buscaba encontrar problemas psicosomáticos sirviéndose de la Escala para el Trastorno de Ansiedad Generalizada (GAD-7, por sus siglas en inglés) y el FCV-19S (Fear of COVID-19). Los participantes se clasificaron en Municipio no capital o Municipio capital, según el ente territorial en donde laboraban. Regresión logística entre el ente territorial (que acá es tomada como variable independiente) con los síntomas de ansiedad, estrés laboral y miedo al COVID-19 (que en este caso es tomado como variable dependiente). Resultados: Participaron 531 médicos generales con edad promedio de 30 años. El 73.3% laboraban en Municipio capital. Un tercio de los encuestados presentó estrés laboral leve, mientras que el 6% presentó estrés laboral alto o severo, esto sin diferencias entre los grupos (p<0.05). Se identificaron síntomas de ansiedad en el 72.9%, más frecuente entre quienes laboraban en las capitales (p=0.044). El 37.1% presentó síntomas de miedo al COVID-19 (FCV-19S). No se observó asociación en la regresión logística realizada. Discusión: Factores psicosociales y psicosomáticos asociados al miedo son el común denominador de los síntomas de ansiedad y estrés laboral en las pandemias. Conclusión: Siete de cada diez participantes presentó síntomas de ansiedad o estrés laboral, mientras que cuatro presentaron síntomas de FCV-19S. No se observó asociación con la clasificación del municipio donde laboraban. Cómo citar. Monterrosa-Castro A, Dávila-Ruiz R, Mejía-Mantilla A, Contreras-Saldarriaga J, Mercado-Lara M, Flores-Monterrosa C. Estrés laboral, ansiedad y miedo al COVID-19 en médicos generales colombianos. MedUNAB. 2020;23(2): 195-213. doi: 10.29375/01237047.3890
Introduction: Epidemics can cause anxiety in the general population and health professionals. The pandemic caused by the COVID-19 virus is no exception. This study’s objective is to identify symptoms of work-related stress, anxiety and fear of COVID-19 in physicians, as well as to discover their relation with the territorial body in which they work. Methodology: This is a cross-cutting study that explored the symptoms and perceptions of Colombian physicians forced to quarantine, who exercised their profession in March, 2020 during the COVID-19 pandemic. Having provided informed consent anonymously and voluntarily, participants completed a virtual form with general questions on COVID-19. The survey was aimed at finding psychosomatic problems using the Generalized Anxiety Disorder (GAD-7) scale and Fear of COVID-19 (FCV-19S) scale. Participants were classified as working in non-capital or capital municipalities according to the territorial body in which they practiced. Logistic regression between the territorial body (which was taken as an independent variable here) and symptoms of anxiety, work-related stress and fear of COVID-19 (which, in this case, were taken as dependent variables) was performed. Results: Five hundred and thirty-one general physicians participated, with an average age of 30. Seventy-three point three percent practiced in a capital municipality. One third of the surveyed physicians presented mild work-related stress, while 6% presented high or severe work-related stress, without differences between groups (p < 0.05). Symptoms of anxiety were found in 72.9% of the surveyed physicians, more frequently among those who practiced in capitals (p = 0.044). Thirty-seven point one percent presented symptoms of fear of COVID-19 (FCV-19S). No relation was observed in the logistic regression. Discussion: Psychosocial and psychosomatic factors associated with fear are the common denominators of symptoms of anxiety and work-related stress during pandemics. Conclusion: Seven of every ten participants presented symptoms of anxiety or work-related stress, while four presented symptoms of FCV-19S. No relation was observed with the municipalities in which they worked. Cómo citar. Monterrosa-Castro A, Dávila-Ruiz R, Mejía-Mantilla A, Contreras-Saldarriaga J, Mercado-Lara M, Flores-Monterrosa C. Estrés laboral, ansiedad y miedo al COVID-19 en médicos generales colombianos. MedUNAB. 2020;23(2): 195-213. doi: 10.29375/01237047.3890
Introdução. As epidemias podem causar angústia na população em geral e nos profissionais de saúde, e a pandemia causada pelo vírus COVID-19 não é exceção. O objetivo deste estudo é determinar a presença de sintomas de estresse ocupacional, ansiedade e medo da COVID-19 em clínicos gerais, além de estimar a associação de acordo com a entidade territorial em que trabalhavam. Metodología. Este é um estudo transversal que explorou sintomas e percepções durante a pandemia da COVID-19 em clínicos gerais colombianos submetidos à quarentena obrigatória que exerceram sua profissão em março de 2020. Após consentimento informado, anonimamente e voluntariamente, os participantes preencheram um formulário virtual com perguntas gerais sobre a COVID-19. O questionário procurou encontrar problemas psicossomáticos utilizando a Escala de Desordem de Ansiedade Generalizada (GAD-7, sigla em inglês) e o FCV-19S (Fear of COVID-19). Os participantes foram classificados em município não-capital ou município capital de acordo com a entidade territorial onde trabalhavam. Regressão logística entre a entidade territorial (que aqui é tomada como variável independente) com os sintomas de ansiedade, estresse ocupacional e medo da COVID-19 (que aqui é tomada como variável dependente). Resultados. Participaram 531 médicos de clínica geral com idade média de 30 anos. Do total, 73.3% trabalhavam no município da capital. Um terço dos entrevistados apresentou leve estresse ocupacional, enquanto 6% apresentou estresse ocupacional alto ou severo, isto sem diferenças entre os grupos (p<0,05). Os sintomas de ansiedade foram identificados em 72.9%, mais frequentes entre os que trabalham nas capitais (p=0,044). Ademais, 37.1% tinham sintomas de medo da COVID-19 (FCV-19S). Nenhuma associação foi observada na regressão logística realizada. Discussão. Fatores psicossociais e psicossomáticos associados ao medo são o denominador comum dos sintomas de ansiedade e estresse ocupacional em pandemias. Conclusão. Sete em cada dez participantes apresentavam sintomas de ansiedade ou estresse no trabalho, enquanto quatro apresentavam sintomas do FCV-19S. Nenhuma associação foi observada com a classificação do município onde trabalhavam. Cómo citar. Monterrosa-Castro A, Dávila-Ruiz R, Mejía-Mantilla A, Contreras-Saldarriaga J, Mercado-Lara M, Flores-Monterrosa C. Estrés laboral, ansiedad y miedo al COVID-19 en médicos generales colombianos. MedUNAB. 2020;23(2): 195-213. doi: 10.29375/01237047.3890

Research paper thumbnail of Association of pre-eclampsia risk with maternal levels of folate, homocysteine and vitamin B12 in Colombia: A case-control study

PLoS One, 2018

Background: Maternal serum concentrations of folate, homocysteine, and vitamin B12 have been asso... more Background: Maternal serum concentrations of folate, homocysteine, and vitamin B12 have been associated with pre-eclampsia. Nevertheless, reported studies involve limited number of cases to
reliably assess the nature of these associations. Our aim was to examine the relation of these three biomarkers with pre-eclampsia risk in a large Colombian population.
Materials and methods
Design: A case-control study.
Setting: Cases of pre-eclampsia and healthy pregnant controls were recruited at the time of delivery from eight different Colombian cities between 2000 and 2012.
Population or Sample: 2978 cases and 4096 controls were studied. Maternal serum concentrations of folate, homocysteine, and vitamin B12 were determined in 1148 (43.6%) cases and 1300 (31.7%) controls. Also, self-reported folic acid supplementation was recorded for 2563 (84%) cases and 3155 (84%) controls.
Analysis: Adjusted odds ratios (OR) for pre-eclampsia were estimated for one standard deviation (1SD) increase in log-transformed biomarkers. Furthermore, we conducted analyses to compare women that reported taking folic acid supplementation for different periods
during pregnancy.
Main Outcomes Measures: Odds ratio for pre-eclampsia.
Results: After adjusting for potential confounders in logistic regression models, the OR for preeclampsia was 0.80 (95% CI: 0.72, 0.90) for 1SD increase in log-folate, 1.16 (95%CI: 1.05, 1.27) for 1SD increase in log-homocysteine, and 1.10 (95%CI: 0.99, 1.22) for 1SD increase in log-vitamin B12. No interactions among the biomarkers were identified. Women who selfreported consumption of folic acid (1 mg/day) throughout their pregnancy had an adjusted OR for pre-eclampsia of 0.86 (95%CI: 0.67, 1.09) compared to women that reported no consumption of folic acid at any point during pregnancy.
Conclusions: Maternal serum concentrations of folate were associated as a protective factor for preeclampsia while concentrations of homocysteine were associated as a risk factor. No association between maternal vitamin B12 concentrations and preeclampsia was found.

Research paper thumbnail of Insomnia and sexual dysfunction associated with severe worsening of the quality of life in sexually active hysterectomized women

Introduction: Hysterectomy is a common gynecologic surgery carried out to remove the pathologic u... more Introduction: Hysterectomy is a common gynecologic surgery carried out to remove the pathologic uterus. Objective: To establish if sleep disorders and sexual function are associated with deterioration of the quality of life (QoL) in hysterectomized and sexually active women. Methods: A cross-sectional study was carried out with inhabitants from two cities of the Colombian Caribbean. The pollsters invited women aged between 40-59 years to participate; in their communities they applied surveys with demographic characteristics: Female Sexual Function Index, Atenas Insomnia Scale and Menopause Rating Scale. Sexually active women were selected; then the association was established with logistic regression. Results: 522 women were studied with an average age of 50 years: 30% oophorectomized, 59.8% Hispanic, 40.2% afro-descendants and 22.2% hormonal therapy users. 80% of them had somato/vegetative, psychological or urogenital deterioration; 29.1% with severe deterioration of QoL and 47.5% with insomnia. Out of 390 (74.7%) with sexual activity, 59.7% suffered from sexual dysfunction. Insomnia: OR:3.05 [95%CI:1.86-4.99], sexual dysfunction OR:3.52 [95%CI:2.01-6.17], dissatisfaction about sexuality OR:4.77 [95%CI:2.08-10.93], low or non-existent sexual desire OR:2.94 [95%CI:1.65-5.25], daytime drowsiness OR:3.15 [95%CI:1.59-6.24] and decrease in daytime well-being OR:3.18 [95%CI :1.79-5.64]. These were factors associated with severe worsening of QoL, while the presence of genital lubrication was protective, OR: 0.44 [95%CI:0.21-0.93], p=0.0332. Conclusion: It was observed that insomnia and sexual dysfunction behaved as factors associated with three times more severe deterioration of the QoL in climacteric and sexually active women previously hysterectomized.

Research paper thumbnail of Insomnia and sexual dysfunction associated with severe worsening of the quality of life in sexually active hysterectomized women

Introduction: Hysterectomy is a common gynecologic surgery carried out to remove the patho-logic ... more Introduction: Hysterectomy is a common gynecologic surgery carried out to remove the patho-logic uterus. Objective: To establish if sleep disorders and sexual function are associated with deterioration of the quality of life (QoL) in hysterectomized and sexually active women. Methods: A cross-sectional study was carried out with inhabitants from two cities of the Colombian Caribbean. The pollsters invited women aged between 40-59 years to participate; in their communities they applied surveys with demographic characteristics: Female Sexual Function Index, Atenas Insomnia Scale and Menopause Rating Scale. Sexually active women were selected; then the association was established with logistic regression. Results: 522 women were studied with an average age of 50 years: 30% oophorectomized, 59.8% Hispanic, 40.2% afro-descendants and 22.2% hormonal therapy users. 80% of them had somato/vegetative, psychological or urogenital deterioration; 29.1% with severe deterioration of QoL and 47.5% with insomnia. Out of 390 (74.7%) with sexual activity, 59.7% suffered from sexual dysfunction. Insomnia: OR:3.05 [95%CI:1.86-4.99], sexual dysfunction OR:3.52 [95%CI:2.01-6.17], dissatisfaction about sexuality OR:4.77 [95%CI:2.08-10.93], low or non-existent sexual desire OR:2.94 [95%CI:1.65-5.25], daytime drowsiness OR:3.15 [95%CI:1.59-6.24] and decrease in daytime well-being OR:3.18 [95%CI:1.79-5.64]. These were factors associated with severe worsening of QoL, while the presence of genital lubrication was protective, OR: 0.44 [95%CI:0.21-0.93], p=0.0332. Conclusion: It was observed that insomnia and sexual dysfunction behaved as factors associated with three times more severe deterioration of the QoL in climacteric and sexually active women previously hysterectomized.

Research paper thumbnail of Type II diabetes mellitus and menopause: a multinational study

Climacteric, 2013

Background Type II diabetes mellitus causes metabolic changes that may lead to early menopause an... more Background Type II diabetes mellitus causes metabolic changes that may lead to early menopause and worsen climacteric symptoms.

Research paper thumbnail of Institucionalización de la enseñanza de la medicina en Cartagena desde la mirada de Horacio Zabaleta Jaspe*

Revista Ciencias …, 2012

Fue en octubre de 1976, año del cierre definitivo del casi centenario Hospital Universitario de S... more Fue en octubre de 1976, año del cierre definitivo del casi centenario Hospital Universitario de Santa Clara, cuando el médico y profesor de la Facultad de Medicina de la Universidad de Cartagena, Colombia, Horacio Zabaleta Jaspe dio a la luz un libro, que se ha convertido en clásico y obligado documento para develar la historia de la medicina, de los médicos y de la enseñanza médica local. Tomando como núcleo dicho hospital y apelando a la memoria, al sentimiento, al recuerdo, al testimonio y al documento, tejió un texto con estilo sencillo y narrativo. Bordado a la orilla de los eventos, presenta al detalle la historia de la enseñanza de la medicina en Cartagena, haciendo un relato pormenorizado de sus antecedentes, orígenes y desarrollo. El libro denominado con nostalgia, Réquiem por un viejo hospital, presenta los inicios y los devenires de la enseñanza de la medicina en Cartagena, desde los albores hasta la década de los setenta del siglo XX. Se extraen de sus páginas y se comentan entre líneas, el proceso de la institucionalización de la formación médica y el surgimiento del profesional médico, desde el protomédico a la figura formal del catedrático. Rev.

Research paper thumbnail of Benefits of maternal vaccination to prevent pertussis in infants

Pertussis, also called whooping cough, is an infectious and preventable pathology that generates ... more Pertussis, also called whooping cough, is an infectious and preventable pathology that generates important child
morbidity and mortality worldwide. There are different biological preparations for its use in infants, while for
adolescents and adults is Tdap, (acellular vaccine of purified extracts of Bordetella pertussis (BP), combined with
tetanus and diphtheria toxoid) that has been proposed as maternal vaccination (MV). The objective was to identify the
benefits of MV in the prevention of childhood pertussis, a review was made in PubMed, Science Direct, EBSCOhosT,
OvidSP and Embase databases (years 2008-2016) and an electronic alert system (January-April 2017). 1083 titles
were identified and 44 articles were selected. After the MV (administered between 27 and 36 weeks of gestation) the
passage of IgG-BP to the fetus is sufficient to generate adequate infant protection, generating two benefits: reducing
infant morbidity (number of cases and hospital admissions) and decreasing mortality by pertussis. The MV offers
93% of effectiveness [95%CI: 81-97] and OR: 0.09 [95%CI: 0,03-0,25]. The MV is more favorable in each
pregnancy than cocoon strategy, vaccination before pregnancy, before 26 weeks of gestation or in the postpartum. The
use of MV is a safe and cost-effectiveness tool to prevent childhood pertussis.

Research paper thumbnail of Manifestaciones menopaúsicas y calidad de vida en afrocolombianas. Valoración con escala Cervantes

Introducción: las manifestaciones menopaúsicas se deben estudiar realizando consideraciones étnic... more Introducción: las manifestaciones menopaúsicas se deben estudiar realizando consideraciones étnicas. Objetivo: identificar las manifestaciones menopaúsicas más prevalentes y evaluar calidad de vida (CV) según estados menstruales. Metodología: estudio que hace parte de CAVIMEC [Calidad de Vida en la Menopausia y Etnias Colombianas], realizado con Escala Cervantes que evalúa CV en la menopausia, en 646 afrocolombianas, entre 40-59 años, residentes en poblaciones del caribe y el pacífico. Resultados: edad promedio 48,7±5,7 años, 69,1% con obesidad/sobrepeso, 22,7% con estudios tecnológicos/universitarios y 40,5% posmenopáusicas. Las manifestaciones más prevalentes: oleadas de calor 76,4%; sofocaciones 73,1%; dolor músculo/articular 71,3%; no conseguían dormir 61,8%; sudoración sin esfuerzos 55,8%; sequedad de piel 50,4% y cefalea que aumentaba durante el día 44,2%. La tercera parte no podían por los nervios, las cosas le aburrían, perdieron la capacidad de relajarse o notaban que todo le daba vueltas. El 24,4% tenían menos interés en el sexo y 14,4% tenían sexualidad nada importante. Las posmenopáusicas tuvieron peor puntuación en la mayoría de las manifestaciones y en los dominios salud, psíquico, sexualidad, relación de pareja, vasomotores, salud, envejecimiento y global. Conclusión: oleadas de calor, sofocaciones y dolor musculo/articular fueron las manifestaciones más prevalentes, en siete de cada diez. Las posmenopáusicas tuvieron peor CV.
Menopausal manifestations and quality of life in
afro-colombians. Valuation whit Cervantes scale
Introduction: the menopausal manifestations should
be studied by ethnic considerations. Objective: to identify the most prevalent menopausal manifestations and to evaluate quality of life according to menstrual states. Methods: this study is a part of CAVIMEC [Quality of Life in Menopause and Colombian Ethnic Groups],
performed with Cervantes Scale, which evaluates CV in
menopause, in 646 Afro-Colombians, aged 40-59 years,
living in populations of the Caribbean and Pacific. Results: mean age 48.7±5.7 years, 69.1% with obesity/overweight, 22.7% with university/technological studies and 40.5% postmenopausal. The most prevalent manifestations: hot flashes 76.4%; suffocation 73.1%;
Muscle/joint pain 71.3%; they couldn’t sleep 61.8%; easy sweating episode 55.8%; dry skin 50.4% and headache that increased during the day 44.2%. The third part could not be good by the nerves, things like boring, lost the ability to relax or noticed that everyone was spinning 24.4% had less interest in sex and 14.4% had not significant sexuality. Postmenopausal women had worse scores in most of the manifestations and in the domains of health, psychic, sexuality, relationship, vasomotor, health, aging and global. Conclusion: hot flashes, suffocations and muscle/joint pain were the manifestations most prevalent, in seven out of ten. Postmenopausal women had worse
quality of life.

Research paper thumbnail of Instruments to study sleep disorders in climacteric women

To identify the scales to assess sleep disorders applied to women with climacteric stage. Bibliog... more To identify the scales to assess sleep disorders applied to women with climacteric stage. Bibliographical research
without intervention, the available information in scientific databases. Performed in PubMed, ScienceDirect,
Scopus, Ebscohos OvidSP and Health Library. The words used in this article: insomnia, adjustment sleep
disorder, questionnaires, studies and menopause. Publications of all types were included. Seven scales were
identified: Insomnia Severity Index, Athens Insomnia Scale, Pittsburgh Quality of sleep Index, Epworth
Sleepiness Scale, Jenkins Sleep Scale, Basic Nordic Sleep Questionnaire and The St Mary's Hospital Sleep
Questionnaire. There are validated scales in multiple languages and considered appropriate for studying sleep
disorders.

Research paper thumbnail of Artículo de Investigación CORRELACIÓN ENTRE SÍNTOMAS MENOPÁUSICOS Y PERCEPCIÓN DE ESTRÉS EN MUJERES DEL CARIBE COLOMBIANO

RESUMEN Introducción: Estrés es el conjunto de procesos y respuestas ante situaciones que requier... more RESUMEN Introducción: Estrés es el conjunto de procesos y respuestas ante situaciones que requieren mayor adaptación que lo habitual. En estrés psicológico, el individuo cree no controlar las exi-gencias del entorno. El objetivo fue estimar correlación entre síntomas menopáusicos y estrés psicológico percibido. Metodología: Estudio transversal del proyecto CAVIMEC (Calidad de Vida en la Menopausia y Etnias Colombianas), realizado en mujeres de dos ciudades del caribe Colombiano, edad 40-59 años, que participaron voluntariamente en sus comunidades. Se aplicó formulario de características sociodemográfi cas y las escalas: Perceived Stress Scale (PSS-10) y Menopause Rating Scale (MRS). A mayor puntuación de PSS-10, mayor estrés psicológico. A mayor valor MRS, mayor severidad de síntomas, deterioro de dominios y peor calidad de vida. El análisis estadístico se realizó con Epi–info 7. Resultados: 471 mujeres con 48,0(45,0-52,5) años. Premenopausia: 23,9%, perimenopausia: 11,7% y posmenopausia: 64,3%. El 61,9% en sobrepeso u obesidad, 7,2% diabéticas, 15,2% hipertensas, 15,7% ooforectomía bilateral y 50,3% histerectomizadas. 69,4% manifestó que las cosas le iban bien a menudo y 57,5 % que estaban seguras sobre su capacidad para manejar problemas personales. MRS 13,0(9,0-17,0) puntos, cansancio físico/mental 84,5%, oleadas de calor 84,5% y dolores musculo/articulares 84,3%. Se encontró correlación positiva entre oleadas de calor, molestias cardiacas, trastornos del sueño, molestias musculo/articulares, estado de ánimo depresivo, irritabilidad, ansiedad, cansancio físico/mental, problemas sexuales, problemas de vejiga, sequedad vaginal y calidad de vida, con PSS-10 (p<0,005). Calidad de vida: rho=0,41(IC95%:0,33-0,48)p<0,0001. Uroge-nital: rho=0,39(IC95%:0,31-0,46)p<0,0001. Somático: rho=0,31(IC95%:0,23-0,39)p<0,0001. Psicológico: rho=0,38(IC95%:0,31-046)p<0,0001. Conclusión: a mayor presencia de síntomas menopáusicos, mayor estrés psicológico percibido.

Research paper thumbnail of ABSTRACTS: MENOPAUSE , Vol. 21, No. 12, 2014Correlation betweenmenopausal symptoms and the perception of psychological stress in women from the Colombian CaribbeanCorrelation betweenmenopausal symptoms and the perception of psychological stress in women from the Colombian Caribbean

Correlation betweenmenopausal symptoms and the perception of psychological stress in women from t... more Correlation betweenmenopausal symptoms and the perception of psychological
stress in women from the Colombian Caribbean
Liezel Ulloque-Caamaño, Marlon Salguedo-Madrid, Alvaro Monterrosa-Castro,
Joulen Moulen-Carrascal, Enrique Ramos-Classon. Universidad de Cartagena, Cartagena,
Colombia.
Objective: to estimate the correlation between menopausal symptoms and the score in the
scale of perceived stress.
Design: Cross-sectional study that is part of the CAVIMEC (Calidad de Vida en la
Menopausia y Etnias Colombianas) research program carried out in resident women in
the cities of Cartagena and Montería in the Colombian Caribbean, with ages between
40 and 59 years. They voluntarily completed the questionnaire in 2012, which was applied
by pollsters who visited them in their own communities; the pollsters were professionals of
the health area previously trained who, in door-to-door visits, applied a questionnaire of
socio-demographic data and the scales: Perceived Stress Scale (PSS), which contains
10 items andMenopause Rating Scale (MRS), both in Spanish version. To higher score
of the MRS, higher the severity of the symptoms, the deterioration of the domains and
worse quality of life. The statistical analysis to estimate Pearson’s Correlation Coefficient
was carried out with the statistical programs Epi–info 7 and MedCalc. Study without
ethic impact in the participants.
Results: 471 women were studied. Average age: 48.3±5.1. They were distributed
according the menopausal status, premenopause: 23.9%, perimenopause: 11.7% and
postmenopause: 64.3%. 61.9% of the women were in overweight or obesity, 7.2% were
diabetic women, 15.2% had arterial hypertension, 15.7% had bilateral oophorectomy and
50.3% had been hysterectomized. 69.4% of the women manifested to have felt fairly often
or very often that things were going her way and the 57.5 % expressed to have felt herself
confident about her ability to handle her personal problems. The average score of the
MRS was 13.4±6.4, being the physical and mental exhaustion (84.5%), the hot flushes
and sweating (84.5%) and the joint and muscular discomfort (84.3%), the most frequent
symptoms. Aweak positive correlation was found between hot flushes, heart discomfort,
sleep problems, joint and muscular discomfort, depressive mood, irritability, anxiety,
physical and mental exhaustion, sexual problems, bladder problems, dryness of vagina
and the total score of the domains and of the quality of life with the total addition of the
PSS-10 (p<0.005). Quality of life: r= 0.41 [CI95%: 0.33-0.48], p<0.0001. Urogenital
domain: r= 0.39 [CI95%: 0.31-0.46], p<0.0001. Somatic domain: r= 0.31 [CI95%:
0.23-0.39], p<0.0001. Psychological domain: r= 0.38 [CI95%: 0.31-046], p<0.0001.
Conclusion: Significant and positive correlation was found between the score of the
PSS-10 and the menopausal symptoms in women from the Colombian Caribbean.

Research paper thumbnail of RAFAEL ALVEAR TERÁN: EL ÚLTIMO EXPONENTE DEL MÉTODO ANATOMOCLÍNICO EN LA UNIVERSIDAD DE CARTAGENA-COLOMBIA

RESUMEN La anatomía humana fue el epicentro del saber, quehacer y la educación médica durante fin... more RESUMEN La anatomía humana fue el epicentro del saber, quehacer y la educación médica durante finales del siglo XVIII y comienzos del siglo XIX. A este movimiento proveniente de escuelas médicas de París se le denominó el método anatomoclínico y promulgaba la articulación de los signos y síntomas de una patología con los hallazgos o lesiones anatómicas. Lo anterior permitió el auge de los anatomistas y el desarrollo de didácticas en el aprendizaje de la medicina con la disección de cadáveres humanos en los anfiteatros. Investigación, educación y asistencia clínica se realizó por décadas bajo el amparo conceptual de la medicina anatomoclínica. Con el pasar de los años surgió la medicina de laboratorio y otras corrientes como la etiopatológica y la fisiopatológica, las cuales trajeron como consecuencia que el papel de la anatomía dentro de la enseñanza y la práctica clínica fuese modificado. La Facultad de Medicina de la Universidad de Cartagena-Colombia recibió influencia de la medicina anatomoclínica por parte de docentes que realizaron sus estudios médicos en escuelas francesas y por la lectura de libros en francés. Una saga de profesores anatomistas se pueden identificar, siendo el doctor Rafael Alvear Terán, el último docente de esa facultad médica, representante de la también llamada mentalidad anatomoclínica. Rev.cienc.biomed. 2015;6(2): 394-405

SUMMARY Human anatomy was the focus of knowledge, pursuit and medical education in the late eighteenth century and early nineteenth century. This movement came from medical schools in Paris and was called the anatomo-clinical method; this method spread the articulation of the signs and symptoms in pathology findings or anatomical lesions. Also, this allowed the growth of anatomist and development of teaching learning in medicine with dissection of human cadavers in dissecting room. Investigation, education and clinical assistance were carried out for decades under the anatomo-clinical method.

Research paper thumbnail of Personal and professional use of menopausal hormone therapy among gynecologists: A multinational study (REDLINC VII)

Maturitas, 2016

Previously, the REDLINC VI study showed that the main reason for the low use of menopausal hormon... more Previously, the REDLINC VI study showed that the main reason for the low use of menopausal hormone therapy (MHT) was its low rate of prescription by doctors. To determine the use of MHT and perceived related risks among gynecologists. A self-administered and anonymous questionnaire was delivered to certified gynecologists in 11 Latin American countries. A total of 2154 gynecologists were contacted, of whom 85.3% responded to the survey (n=1837). Mean age was 48.1±11.4years; 55.5% were male, 20.3% were faculty members and 85% had a partner. Overall, 85.4% of gynecologists responded that they would use MHT if they had menopausal symptoms (81.8% in the case of female gynecologists) or prescribe it to their partner (88.2% in the case of male gynecologists; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Perceived risk related to MHT use (on a scale from 0 to 10) was higher among female than among male gynecologists (4.06±2.09 vs. 3.83±2.11, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.02). The top two perceived reported risks were thromboembolism (women 33.6% vs. men 41.4%, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.009) and breast cancer (women 38.5% vs. men 33.9%, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.03). Overall, gynecologists reported prescribing MHT to 48.9% of their symptomatic patients (women 47.3% vs. men 50.2%, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.03) and 86.8% currently prescribed non-hormonal remedies and 83.8% alternative therapies for the management of the menopause. Gynecologists who were older and academic professionals prescribed MHT more often. Although this Latin American survey showed that gynecologists are mostly supporters of MHT use (for themselves or their partners), this is not necessarily reflected in their clinical practice.

Research paper thumbnail of CORRELACIÓN ENTRE SÍNTOMAS MENOPÁUSICOS Y PERCEPCIÓN DE ESTRÉS EN MUJERES DEL CARIBE COLOMBIANO

RESUMEN Introducción: Estrés es el conjunto de procesos y respuestas ante situaciones que requier... more RESUMEN Introducción: Estrés es el conjunto de procesos y respuestas ante situaciones que requieren mayor adaptación que lo habitual. En estrés psicológico, el individuo cree no controlar las exi-gencias del entorno. El objetivo fue estimar correlación entre síntomas menopáusicos y estrés psicológico percibido. Metodología: Estudio transversal del proyecto CAVIMEC (Calidad de Vida en la Menopausia y Etnias Colombianas), realizado en mujeres de dos ciudades del caribe Colombiano, edad 40-59 años, que participaron voluntariamente en sus comunidades. Se aplicó formulario de características sociodemográfi cas y las escalas: Perceived Stress Scale (PSS-10) y Menopause Rating Scale (MRS). A mayor puntuación de PSS-10, mayor estrés psicológico. A mayor valor MRS, mayor severidad de síntomas, deterioro de dominios y peor calidad de vida. El análisis estadístico se realizó con Epi–info 7. Resultados: 471 mujeres con 48,0(45,0-52,5) años. Premenopausia: 23,9%, perimenopausia: 11,7% y posmenopausia: 64,3%. El 61,9% en sobrepeso u obesidad, 7,2% diabéticas, 15,2% hipertensas, 15,7% ooforectomía bilateral y 50,3% histerectomizadas. 69,4% manifestó que las cosas le iban bien a menudo y 57,5 % que estaban seguras sobre su capacidad para manejar problemas personales. MRS 13,0(9,0-17,0) puntos, cansancio físico/mental 84,5%, oleadas de calor 84,5% y dolores musculo/articulares 84,3%. Se encontró correlación positiva entre oleadas de calor, molestias cardiacas, trastornos del sueño, molestias musculo/articulares, estado de ánimo depresivo, irritabilidad, ansiedad, cansancio físico/mental, problemas sexuales, problemas de vejiga, sequedad vaginal y calidad de vida, con PSS-10 (p<0,005). Calidad de vida: rho=0,41(IC95%:0,33-0,48)p<0,0001. Uroge-nital: rho=0,39(IC95%:0,31-0,46)p<0,0001. Somático: rho=0,31(IC95%:0,23-0,39)p<0,0001. Psicológico: rho=0,38(IC95%:0,31-046)p<0,0001. Conclusión: a mayor presencia de síntomas menopáusicos, mayor estrés psicológico percibido.

Research paper thumbnail of P26 Homocysteine, folic acid and vitamin B12 serum levels and preeclampsia: A large-scale study from GenPE Study

Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health, 2010

We have previously demonstrated that melatonin protects against ischemia/reperfusion (I/R)-induce... more We have previously demonstrated that melatonin protects against ischemia/reperfusion (I/R)-induced oxidative damage to mitochondria in the fetal rat brain. At the same time, Takagi et al (Virchows Archiv 2004) said that FGR associated with preeclampsia may be due to decompensation of placental function against oxidative stress. The purpose of the present study was to evaluate the effects of maternally-administered melatonin on I/R-induced oxidative placental damage and FGR in rats. The utero-ovarian arteries were occluded bilaterally for 30 min in rats on day 16 of pregnancy to induce fetal ischemia. Reperfusion was achieved by releasing the occlusion and restoring circulation. Melatonin solution (20μg/ml) or the vehicle alone was administered orally during pregnancy. A sham operation was performed in control rats which were treated with vehicle alone. Laparotomy was performed on day 20 of pregnancy and the number and weight of fetal rats and placentas were measured. Placental mitochondrial respiratory control index (RCI), a marker of mitochondrial respiratory activity, was also calculated for each group. Using immunohistochemistry, we investigated the degree of immunostaining of 8-hydroxy-2-deoxyguanosine (8-OHdG), a marker of oxidative DNA damage, and redox factor-1 (ref-1), which repairs DNA damage and acts as a redox-modifying factor in rat placenta. Predictably, the I/R operation significantly decreased the weight of fetal rats and placentas and the RCI. Melatonin prevented I/R-induced changes in RCI (1.55±0.05 to 1.83±0.09, P < 0.05) and fetal growth (3.04±0.17 to 3.90±0.1, P < 0.0001). Immunohistochemistry revealed significant positive staining for 8-OHdG and ref-1 following I/R; these effects were also reduced by melatonin treatment. Results indicated that I/R-induced oxidative placental DNA and mitochondrial damage and FGR can be prevented by maternally-administered melatonin.

Research paper thumbnail of P22 Elevated levels of pentraxin 3 in HELLP syndrome and preeclampsia: GenPE study

Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health, 2010

infection with C. pneumoniae and CMV and immune response in normal and preeclampsia complicated p... more infection with C. pneumoniae and CMV and immune response in normal and preeclampsia complicated pregnancies. The first noteworthy finding of this work has shown that preeclampsia was associated with increased C. pneumonia genomic DNA loads compared with normal pregnancy controls and had higher anti-CMV IgG seropositivity than in women with normotensive interuterine growth restriction and normal pregnancy controls. Additionally, data synthesis revealed that IgG seropositivity of C. pneumonia and CMV was more prevalent among women with preeclampsia than normal pregnancy controls. The second finding of this work observed that early onset preeclampsia had increased Toll like receptor (TLR)-2 and -4 mRNA and protein expressions, elevated mRNA expressions of cryopyrin, NF-κB subunits and IL-1β, as well as increased TNF-α: IL-10 and IL-6: IL-10 ratios compared with normal pregnancy controls. Third, through a comprehensive review of published literatures and in combination of our study results, data suggested that TLR2 (Arg753Gln) and TLR4 co-segregating (Asp299Gly and Thr399Ile) gene polymorphisms seems in susceptibility to development of early onset preeclampsia. Our research findings indicated that TLR-microbial with C. pneumonia and CMV interactions play an important role in maternal inflammatory syndroms in preeclampsia. This work may contribute for identification of novel anti-inflammatory targets for preeclampsia treatment, eventually leading to improved health care for both mom and fetus.

Research paper thumbnail of Obesity and its relation to depressive symptoms and sedentary lifestyle in middle-aged women

Maturitas, 2015

The prevalence of obesity increases during female mid-life and although many factors have been id... more The prevalence of obesity increases during female mid-life and although many factors have been identified, data from Latin America is lacking. To assess factors related to obesity among middle-aged women and determine the association with depressive symptoms, sedentary lifestyle and other factors. A total of 6079 women aged 40-59 years of 11 Latin American countries were asked to fill out the Goldberg Anxiety and Depression Scale, the Menopause Rating Scale, the Athens Insomnia Scale, the Pittsburgh Sleep Quality Index and a general questionnaire containing personal socio-demographic data, anthropometric measures and lifestyle information. Obesity was defined as a body mass index (BMI) ≥30kg/m(2). Obesity was observed in 18.5% and sedentary lifestyle in 63.9%. A 55.5% presented vasomotor symptoms, 12.2% had severe menopausal symptoms and 13.2% used hormone therapy for the menopause. Prevalence of depressive symptoms was 46.5% and anxiety 59.7%. Our logistic regression model found that significant factors associated to obesity included: arterial hypertension (OR: 1.87), depressive symptoms (OR: 1.57), sedentary lifestyle (OR: 1.50) diabetes mellitus (OR: 1.34), higher number of individuals living at home (OR: 1.31), sleep problems (OR:1.22), anxiety (OR: 1.21), having a stable partner (OR: 1.20), parity (OR: 1.16) and vasomotor symptoms (OR:1.14). A lower risk for obesity was found among women using hormonal contraceptives (OR: 0.69). Obesity in middle-aged women is the consequence of the interaction of multiple factors. It was associated to hypertension, depressive symptoms, sedentary lifestyle, climacteric symptoms and other factors.

Research paper thumbnail of Age at menopause in Latin America

Menopause, 2006

To assess the age at menopause (AM) in Latin America urban areas. A total of 17,150 healthy women... more To assess the age at menopause (AM) in Latin America urban areas. A total of 17,150 healthy women, aged 40 to 59 years, accompanying patients to healthcare centers in 47 cities of 15 Latin American countries, were surveyed regarding their age, educational level, healthcare coverage, history of gynecological surgery, smoking habit, presence of menses, and the use of contraception or hormone therapy at menopause. The AM was calculated using logit analysis. The mean age of the entire sample was 49.4 +/- 5.5 years. Mean educational level was 9.9 +/- 4.5 years, and the use of hormone therapy and oral contraception was 22.1% and 7.9%, respectively. The median AM of women in all centers was 48.6 years, ranging from 43.8 years in Asuncion (Paraguay) to 53 years in Cartagena de Indias (Colombia). Logistic regression analysis determined that women aged 49 living in cities at 2,000 meters or more above sea level (OR = 2.0, 95% CI: 1.4-2.9, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and those with lower educational level (OR = 1.9, 95% CI: 1.3-2.8, P…

Research paper thumbnail of Sexual dysfunction in middle-aged women

Menopause, 2009

Objective: The purpose of this study was to assess the prevalence of sexual dysfunction (SD) and ... more Objective: The purpose of this study was to assess the prevalence of sexual dysfunction (SD) and associated risk factors among middle-aged Latin American women using one validated instrument.

Research paper thumbnail of Artículo de Investigación CORRELACIÓN ENTRE SÍNTOMAS MENOPÁUSICOS Y PERCEPCIÓN DE ESTRÉS EN MUJERES DEL CARIBE COLOMBIANO

RESUMEN Introducción: Estrés es el conjunto de procesos y respuestas ante situaciones que requier... more RESUMEN Introducción: Estrés es el conjunto de procesos y respuestas ante situaciones que requieren mayor adaptación que lo habitual. En estrés psicológico, el individuo cree no controlar las exi-gencias del entorno. El objetivo fue estimar correlación entre síntomas menopáusicos y estrés psicológico percibido. Metodología: Estudio transversal del proyecto CAVIMEC (Calidad de Vida en la Menopausia y Etnias Colombianas), realizado en mujeres de dos ciudades del caribe Colombiano, edad 40-59 años, que participaron voluntariamente en sus comunidades. Se aplicó formulario de características sociodemográfi cas y las escalas: Perceived Stress Scale (PSS-10) y Menopause Rating Scale (MRS). A mayor puntuación de PSS-10, mayor estrés psicológico. A mayor valor MRS, mayor severidad de síntomas, deterioro de dominios y peor calidad de vida. El análisis estadístico se realizó con Epi–info 7. Resultados: 471 mujeres con 48,0(45,0-52,5) años. Premenopausia: 23,9%, perimenopausia: 11,7% y posmenopausia: 64,3%. El 61,9% en sobrepeso u obesidad, 7,2% diabéticas, 15,2% hipertensas, 15,7% ooforectomía bilateral y 50,3% histerectomizadas. 69,4% manifestó que las cosas le iban bien a menudo y 57,5 % que estaban seguras sobre su capacidad para manejar problemas personales. MRS 13,0(9,0-17,0) puntos, cansancio físico/mental 84,5%, oleadas de calor 84,5% y dolores musculo/articulares 84,3%. Se encontró correlación positiva entre oleadas de calor, molestias cardiacas, trastornos del sueño, molestias musculo/articulares, estado de ánimo depresivo, irritabilidad, ansiedad, cansancio físico/mental, problemas sexuales, problemas de vejiga, sequedad vaginal y calidad de vida, con PSS-10 (p<0,005). Calidad de vida: rho=0,41(IC95%:0,33-0,48)p<0,0001. Uroge-nital: rho=0,39(IC95%:0,31-0,46)p<0,0001. Somático: rho=0,31(IC95%:0,23-0,39)p<0,0001. Psicológico: rho=0,38(IC95%:0,31-046)p<0,0001. Conclusión: a mayor presencia de síntomas menopáusicos, mayor estrés psicológico percibido.