529 results on '"Perales Marín A"'
Search Results
2. Perinatal and Obstetric Predictors for Autism Spectrum Disorder
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Perales-Marín, Alfredo, Peraita-Costa, Isabel, Cervera-Boada, Pablo, Tellez de Meneses, Montserrat, Llopis-González, Agustín, Marí-Bauset, Salvador, and Morales-Suárez-Varela, María
- Abstract
The objective is to identify obstetric and perinatal factors that could be significant predictors of ASD and may lead to early detection and intervention. A population-based case-control study including 128 children diagnosed with ASD and 311 controls was conducted. Information was collected through self-reported questionnaires. The factors retained as significant predictors for ASD in the final adjusted hierarchical logistic regression model were cesarean section and male gender. The study revealed a higher incidence of cesarean sections and male gender in children with ASD in comparison to unaffected children confirming the results of previous studies. Children born by cesarean section, especially males, should be more closely monitored for the presence of ASD traits for early diagnosis and intervention.
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- 2021
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3. MicroRNA-185-5p: a marker of brain-sparing in foetuses with late-onset growth restriction
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José Morales-Roselló, Gabriela Loscalzo, Eva María García-Lopez, José Santiago Ibañez Cabellos, José Luis García-Gimenez, Antonio José Cañada Martínez, and Alfredo Perales Marín
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microrna-185-5p ,foetal growth ,late-onset foetal growth restriction ,foetal doppler ,Genetics ,QH426-470 - Abstract
To compare the expression of microRNA-185-5p (miR-185-5p) in normal foetuses and in foetuses with late-onset growth restriction (FGR) and to determine the factors influencing this expression. In a prospective study, 40 foetuses (22 of them with late-onset FGR and 18 with normal growth) were scanned with Doppler ultrasound after week 35 and followed until birth. Subsequently, blood samples from umbilical cords were collected after delivery to evaluate the expression of miR-185-5p using real-time qPCR. Finally, multivariable regression analysis was applied to determine the clinical and ultrasonographic factors influencing miR-185-5p expression in both normal and late-onset FGR foetuses. In comparison with normal foetuses, late-onset FGR foetuses expressed upregulation of miR-185-5p (2.26 ± 1.30 versus 1.27 ± 1.03 2^-ddCt, P = 0.011). Multivariable regression analysis confirmed that cerebroplacental ratio (P
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- 2022
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4. Perinatal and Obstetric Predictors for Autism Spectrum Disorder
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Perales-Marín, Alfredo, Peraita-Costa, Isabel, Cervera-Boada, Pablo, Tellez de Meneses, Montserrat, Llopis-González, Agustín, Marí-Bauset, Salvador, and Morales-Suárez-Varela, María
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Pervasive developmental disorders -- Diagnosis -- Risk factors ,Prenatal diagnosis -- Analysis ,Health - Abstract
The objective is to identify obstetric and perinatal factors that could be significant predictors of ASD and may lead to early detection and intervention. A population-based case-control study including 128 children diagnosed with ASD and 311 controls was conducted. Information was collected through self-reported questionnaires. The factors retained as significant predictors for ASD in the final adjusted hierarchical logistic regression model were cesarean section and male gender. The study revealed a higher incidence of cesarean sections and male gender in children with ASD in comparison to unaffected children confirming the results of previous studies. Children born by cesarean section, especially males, should be more closely monitored for the presence of ASD traits for early diagnosis and intervention., Author(s): Alfredo Perales-Marín [sup.1] [sup.2] , Isabel Peraita-Costa [sup.3] [sup.4] , Pablo Cervera-Boada [sup.5] , Montserrat Tellez de Meneses [sup.6] , Agustín Llopis-González [sup.3] [sup.4] , Salvador Marí-Bauset [sup.3] , [...]
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- 2021
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5. Does emigration by itself improve birth weight? Study in European newborns of Indo-Pakistan origin
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José Morales-Roselló, Silvia Buongiorno, Gabriela Loscalzo, Elisa Scarinci, Tiran Dias, Paolo Rosati, Antonio Lanzone, and Alfredo Perales Marín
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Fetal growth ,Migration ,Maternal nutrition ,Birth weight ,Ethnicity ,Public aspects of medicine ,RA1-1270 ,Colonies and colonization. Emigration and immigration. International migration ,JV1-9480 - Abstract
Objective: Our aim was to evaluate the effect of emigration on fetal birth weight (BW) in a group of pregnant women coming from the Indian subcontinent. Methods: This was a retrospective study in a mixed population of pregnant women from the Indian subcontinent that either moved to Europe or stayed in their original countries. The influence of emigration along with several pregnancy characteristics: GA at delivery, fetal gender, maternal age, height, weight, body mass index (BMI) and parity on BW was evaluated by means of multivariable linear regression analysis. Results: According to European standards, babies born to Indo-Pakistan emigrants and babies born to women staying in the Indian subcontinent were similarly small (BW centile 30± 29 and 30.1 ± 28, p
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- 2023
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6. Enfermedad periodontal y diabetes mellitus gestacional: estudio caso-control
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Estévez Llorens, R., Martínez Sáez, C., Marcos Puig, B., Baquero Ruiz de la Hermosa, Mª.C., Aguado Codina, C., and Perales Marín, A.
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- 2021
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7. Effect of Adherence to the Mediterranean Diet on Maternal Iron Related Biochemical Parameters during Pregnancy and Gestational Weight Gain
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María Morales-Suárez-Varela, Isabel Peraita-Costa, Alfredo Perales-Marín, Beatriz Marcos Puig, Juan Llopis-Morales, and Yolanda Picó
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pregnancy ,Mediterranean diet ,anemia ,iron ,Science - Abstract
Gestation is a crucial life stage for both women and offspring, and outcomes are affected by many environmental factors, including diet. The Mediterranean dietary pattern (MD) is considered a healthy eating pattern that can provide the nutritional requirements of pregnancy. Meanwhile, iron deficiency anemia is one of the most frequent complications related to pregnancy. This study aimed to evaluate how the level of adherence to the MD influences maternal gestational weight gain and specific iron-related maternal biochemical parameters during the pregnancy. Accordingly, an observational, population-based study using data from pregnant women conducted over the entire course of their pregnancy was carried out. Adherence to the MD was assessed once using the MEDAS score questionnaire. Of the 506 women studied, 116 (22.9%) were classified as demonstrating a high adherence, 277 (54.7%) a medium adherence, and 113 (22.3%) a low adherence to the MD. No differences were observed in gestational weight gain among the MD adherence groups but the adequacy of weight gain did vary among the groups, with the proportions of inadequate (insufficient or excessive) weight gain presenting the most notable differences. Total anemia prevalence was 5.3%, 15.6%, and 12.3%, respectively, during the first, second, and third trimesters. For iron-related biochemical parameters, no differences are observed among the adherence groups during pregnancy. With high adherence to the MD as the reference group, the crude odds of iron deficiency diagnosis are significant in the first trimester for both the medium [OR = 2.99 (1.55–5.75)] and low [OR = 4.39 (2.15–8.96)] adherence groups, with deficient adherence to the Mediterranean dietary pattern being responsible for 66.5% (35.5–82.6) and 77.2% (53.5–88.8) of the risk of iron deficiency diagnosis for medium and low adherence, respectively. However, adjusted odds ratios were not significant, possibly due to the small sample size. Our data suggest that MD adherence could be related to gestational weight gain adequacy and that optimal adherence could reduce iron deficiency and/or anemia during pregnancy in the studied population.
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- 2023
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8. MicroRNA‐132 is overexpressed in fetuses with late‐onset fetal growth restriction
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José Morales‐Roselló, Gabriela Loscalzo, Eva María García‐Lopez, José Luis García‐Gimenez, and Alfredo Perales‐Marín
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Doppler ultrasound ,late‐onset fetal growth restriction ,microRNA ,miR‐132 ,Medicine - Abstract
Abstract Background and Aims To evaluate the expression of microRNA 132 (miR‐132) in fetuses with normal growth and in fetuses with late‐onset growth restriction (FGR). Methods In a prospective cohort study, 48 fetuses (24 with late‐onset FGR and 24 with normal growth) were scanned with Doppler ultrasound after 34 weeks to measure the umbilical artery and middle cerebral artery pulsatility indices and followed until birth. Subsequently, blood samples from the umbilical cord were collected to evaluate the expression of miR‐132 by means of Real‐time quantitative polymerase chain reaction, determining the existence of normality cut‐offs and associations with birth weight (BW) centile, cerebroplacental ratio multiples of the median (CPR MoM), and intrapartum fetal compromise (IFC). Results In comparison with normal fetuses, late‐onset FGR fetuses showed upregulation of miR‐132 (33.94 ± 45.04 vs. 2.88 ± 9.32 2−ddCt, p
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- 2022
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9. Mediterranean Dietary Pattern and Cardiovascular Risk in Pregnant Women
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María Morales Suárez-Varela, Isabel Peraita-Costa, Alfredo Perales Marín, Beatriz Marcos Puig, Agustín Llopis-Morales, and Jose M. Soriano
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nutrition ,pregnancy complications ,primary prevention ,cardiovascular disease ,risk factors ,Science - Abstract
Nutrition during pregnancy is one of the most important factors that determine the health of a mother and the proper development of her fetus. The main objective of this study was to analyze the association between adherence to a Mediterranean dietary (MedDiet) pattern and cardiovascular (CV) risk factors in pregnant women. Accordingly, we carried out an observational, population-based study using data from pregnant women present in a hospital during the entire course of their pregnancy. Adherence to the MedDiet was assessed using the MedDiet score questionnaire. Our study identified that 87.25% (95%CI: 83.48–90.27) of the women had a cardiovascular risk in relation to their dietary intake. Women with diet-related CV risk were more likely to smoke (p = 0.004), weighed more at the beginning of pregnancy, engaged in little physical activity, and had lower adherence to the MedDiet pattern than women without a diet-related CV risk. Dietary analysis showed low consumption of cereals, vegetables, and fish, which failed to satisfy the recommended portions in Spain. Adequate adherence to the MedDiet was found for 54.2% of women who were considered to be without CV risk and 45.8% of women with CV risk. Our data suggest that the MedDiet could be improved in relation to the consumption of cereals, vegetables, and fish during pregnancy in order to reduce CV risk.
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- 2023
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10. Comparison of Maternal–Fetal Outcomes among Unvaccinated and Vaccinated Pregnant Women with COVID-19
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Alicia Martínez-Varea, Elena Satorres, Sandra Florez, Josep Domenech, Julia Desco-Blay, Sagrario Monfort-Pitarch, María Hueso, Alfredo Perales-Marín, and Vicente Diago-Almela
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COVID-19 ,SARS-CoV-2 variants ,pregnancy ,vaccination ,Medicine - Abstract
Background: This study sought to elucidate whether COVID-19 vaccination, during gestation or before conception, entails a decreased incidence of severe COVID-19 disease during pregnancy. Methods: This retrospective cohort study included all pregnant women that were followed up at a tertiary University Hospital with SARS-CoV-2 infection diagnosed between 1 March 2020 and 30 July 2022. The primary outcome of the study was to compare maternal and perinatal outcomes in unvaccinated and vaccinated pregnant patients with SARS-CoV-2 infection. Results: A total of 487 pregnant women with SARS-CoV-2 infection were included. SARS-CoV-2 infection during the third trimester of pregnancy was associated with an 89% lower probability of positive cord-blood SARS-CoV-2 IgG antibodies (OR 0.112; 95% CI 0.039–0.316), compared with infection during the first or the second trimester. Vaccinated pregnant women (201 (41.27%)) with COVID-19 had an 80% lower risk for developing pneumonia and requiring hospital admission due to COVID-19 than unvaccinated patients (aOR 0.209; 95% CI 0.044–0.985). Noticeably, pregnant patients with SARS-CoV-2 infection with at least two doses of the COVID-19 vaccine did not develop severe COVID-19. Conclusion: Vaccinated women with SARS-CoV-2 infection during pregnancy are associated with decreased hospital admission due to COVID-19 as well as reduced progression to severe COVID-19.
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- 2022
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11. Outperformance of interleukin-6 over placental alpha microglobulin-1 to predict preterm delivery in symptomatic women
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Roca-Prats, Alba, primary, Diaz-Martinez, Alba, additional, Albaladejo-Belmonte, Monica, additional, Alberola-Rubio, Jose, additional, Monfort-Ortiz, Rogelio, additional, Martínez-Triguero, María L, additional, Marcos-Puig, Beatriz, additional, and Perales-Marín, Alfredo, additional
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- 2023
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12. Transitory Fetal Skin Edema in a Pregnant Patient with a Mild SARS-CoV-2 Infection
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Alicia Martínez-Varea, Julia Desco-Blay, Sagrario Monfort, María Hueso-Villanueva, Alfredo Perales-Marín, and Vicente José Diago-Almela
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Gynecology and obstetrics ,RG1-991 - Abstract
Background. Vertical transmission of the Coronavirus Disease 2019 (COVID-19) is still controversial. Additionally, the consequences of the infection during pregnancy in the offspring also are unknown. Case. A transitory fetal skin edema and polyhydramnios have been demonstrated by ultrasound in a pregnant patient with COVID-19 after a negative RT-PCR for SARS-CoV-2. The fetal findings presented a spontaneous resolution in utero, and abnormal findings were not found in the newborn. Conclusion. Women who have undergone SARS-CoV-2 infection during pregnancy should receive a subsequent appropriate follow-up in order to clarify the fetal consequences of the novel coronavirus, if any.
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- 2021
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13. Overexpression of microRNAs miR-25-3p, miR-185-5p and miR-132-3p in Late Onset Fetal Growth Restriction, Validation of Results and Study of the Biochemical Pathways Involved
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Gabriela Loscalzo, Julia Scheel, José Santiago Ibañez-Cabellos, Eva García-Lopez, Shailendra Gupta, José Luis García-Gimenez, Salvador Mena-Mollá, Alfredo Perales-Marín, and José Morales-Roselló
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late-onset fetal growth restriction ,miRNA ,network analysis ,bioinformatics ,fetal health ,cerebroplacental ratio ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
In a prospective study, 48 fetuses were evaluated with Doppler ultrasound after 34 weeks and classified, according to the cerebroplacental ratio (CPR) and estimated fetal weight (EFW), into fetuses with normal growth and fetuses with late-onset fetal growth restriction (LO-FGR). Overexpression of miRNAs from neonatal cord blood belonging to LO-FGR fetuses, was validated by real-time PCR. In addition, functional characterization of overexpressed miRNAs was performed by analyzing overrepresented pathways, gene ontologies, and prioritization of synergistically working miRNAs. Three miRNAs: miR-25-3p, miR-185-5p and miR-132-3p, were significantly overexpressed in cord blood of LO-FGR fetuses. Pathway and gene ontology analysis revealed over-representation of certain molecular pathways associated with cardiac development and neuron death. In addition, prioritization of synergistically working miRNAs highlighted the importance of miR-185-5p and miR-25-3p in cholesterol efflux and starvation responses associated with LO-FGR phenotypes. Evaluation of miR-25-3p; miR-132-3p and miR-185-5p might serve as molecular biomarkers for the diagnosis and management of LO-FGR; improving the understanding of its influence on adult disease.
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- 2021
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14. Cesarean Section as a Predictor for Autism: a Case-Control Study in Valencia (Spain)
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Perales-Marín, Alfredo, Llópis-González, Agustín, Peraita-Costa, Isabel, Cervera-Boada, Pablo, Téllez de Meneses, Montserrat, Marí-Bauset, Salvador, and Morales-Suárez-Varela, María
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- 2018
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15. Mechanical cervical ripening for prolonged pregnancies with a previous cesarean section: Double-balloon catheter vs Foley catheter
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Alicia Martínez-Varea, Andrea Santolaria-Baig, Carlos Sánchez-Ajenjo, Rogelio Monfort-Ortiz, Alfredo Perales-Marín, and Vicente Diago-Almela
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General Engineering - Abstract
Introduction: Mechanical cervical ripening methods are considered safer than prostaglandins. Many centers choose this method for pre-induction in pregnant patients with a previous cesarean section. Our objective was to compare efficacy and safety of two different mechanical ripening methods in prolonged pregnancies with a Bishop score ≤ 6 and a previous cesarean section. Methods: Non-randomized study during 6 years in which patients were divided in two cohorts: a first period of time (from November 2014 to November 2018) in which Foley catheter was used and a second period of time (from November 2018 to November 2020) in which double-balloon catheter (Cook® balloon) was the method employed. The same protocol was followed in both groups. Efficacy was defined by the achievement of active labor. Ripening success (changes in Bishop score and achievement of active labor), vaginal delivery rate and maternal and neonatal safety were recorded. Results: The double-balloon was placed in 43 patients and the Foley catheter was inserted in 129 patients. Cook catheter showed better Bishop score difference than Foley but with no statistically significance (3.09 vs 2.76, p=0.271). Active labor was achieved similarly in both groups (81.4% double-balloon vs 78.2% Foley catheter, p=0.726). Although there was a higher vaginal delivery rate in the double-balloon group (62.8%) compared with the Foley group (49.6%), the difference was not statistically significant (p=0.065). Time from catheter insertion to delivery was significantly shorter in the Foley group compared with Cook group (1704 vs 1903 minutes, p
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- 2022
16. Estatus epileptico, revision de un complejo problema neurologico y su abordaje multidisciplinario
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Dulcey, Luis Andrés, Moreno Parra, Héctor, Theran Leon, Juan Sebastian, Castillo, John, Caltagirone, Raimondo, Blanco, Edgar, Perales Marín, Rafael, Ciliberti, Maria, Dulcey, Luis Andrés, Moreno Parra, Héctor, Theran Leon, Juan Sebastian, Castillo, John, Caltagirone, Raimondo, Blanco, Edgar, Perales Marín, Rafael, and Ciliberti, Maria
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Status epilepticus (SE) is a frequent neurological emergency associated with high morbidity and mortality. According to the new ILAE 2015 definition, SE results either from the failure of the mechanisms responsible for seizure termination or initiation, leading to abnormally prolonged seizures. The definition has different time points for convulsive, focal and absence SE. Time is brain. There are changes in synaptic receptors leading to a more proconvulsant state and increased risk of brain lesion and sequelae with long duration. Management of SE must include three pillars: stop seizures, stabilize patients to avoid secondary lesions and treat underlying causes. Convulsive SE is defined after 5 minutes and is a major emergency. Benzodiazepines are the initial treatment, and should be given fast and an adequate dose. Phenytoin/fosphenytoin, levetiracetam and valproic acid are evidence choices for second line treatment. If SE persists, anesthetic drugs are probably the best option for third line treatment, despite lack of evidence. Midazolam is usually the best initial choice and barbiturates should be considered for refractory cases. Nonconvulsive status epilepticus has a similar initial approach, with benzodiazepines and second line intravenous (IV) agents, but after that, aggressiveness should be balanced considering risk of lesion due to seizures and medical complications caused by aggressive treatment. Usually, the best approach is the use of sequential IV antiepileptic drugs (oral/tube are options if IV options are not available). EEG monitoring is crucial for diagnosis of nonconvulsive SE, after initial control of convulsive SE and treatment control. Institutional protocols are advised to improve care., El estado epiléptico (EE) es una emergencia neurológica frecuente asociada con una alta morbimortalidad. De acuerdo con la nueva definición de ILAE 2017, EE resulta de la falla de los mecanismos responsables de la terminación o el inicio de las convulsiones, lo que lleva a convulsiones anormalmente prolongadas. La definición tiene diferentes puntos de tiempo para EE convulsivo, focal y de ausencia. Hay cambios en los receptores sinápticos que conducen a un estado más proconvulsivo y mayor riesgo de lesión cerebral y secuelas de larga duración. El manejo del EE debe incluir tres pilares: detener las convulsiones, estabilizar a los pacientes para evitar lesiones secundarias y tratar las causas subyacentes. El EE convulsivo se define a los 5 minutos y es una urgencia mayor. Las benzodiazepinas son el tratamiento inicial, y deben administrarse rápidamente ya una dosis adecuada. Fenitoína/fosfenitoína, levetiracetam y ácido valproico son opciones de evidencia para el tratamiento de segunda línea. Si el EE persiste, los fármacos anestésicos son probablemente la mejor opción de tratamiento de tercera línea, a pesar de la falta de evidencia. El midazolam suele ser la mejor opción inicial y se deben considerar los barbitúricos para los casos refractarios. El estado epiléptico no convulsivo tiene un enfoque inicial similar, con benzodiazepinas y agentes intravenosos (IV) de segunda línea, pero después de eso, la agresividad debe equilibrarse considerando el riesgo de lesión debido a convulsiones y complicaciones médicas causadas por un tratamiento agresivo. Por lo general, el mejor enfoque es el uso de fármacos antiepilépticos intravenosos secuenciales (la vía oral o por sonda son opciones si las opciones intravenosas no están disponibles). La monitorización EEG es crucial para el diagnóstico del SE no convulsivo, tras el control inicial del EE convulsivo y el control del tratamiento.Recibido: 13/2/2022Aceptado: 4/4/2023
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- 2023
17. Actualizacion sobre los agentes terapeuticos en enfermedad de behcet, una sistematica revision sobre una patologia compleja
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Dulcey, Luis Andrés, Caltagirone, Raimondo, Theran Leon, Juan Sebastian, Perales Marín, Rafael, Cabrera Sierra, Tatiana Valentina, Dulcey, Luis Andrés, Caltagirone, Raimondo, Theran Leon, Juan Sebastian, Perales Marín, Rafael, and Cabrera Sierra, Tatiana Valentina
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Behçet syndrome (SB) is a multisystem vasculitis with variable vessel involvement that shows significant heterogeneity among patients in terms of clinical manifestations and disease cUOrse. Treatment choice and response are both influenced by this heterogeneity. SB treatments’ main goals are to quickly suppress inflammatory exacerbations and prevent relapses in order to protect organ functions and provide good quality of life. Besides the long-term experience with steroids and traditional immunosuppressives, biologic drugs, especially TNF inhibitors, have gained increasing importance in the treatment of SB over the years. In this review, we aimed to give an overview of the studies with conventional and biological drugs with proven efficacy in the treatment of SB, as well as promising drugs and current management strategies according to clinical phenotypes., El síndrome de Behçet (SB) es una vasculitis multisistémica con afectación vascular variable que muestra una heterogeneidad significativa entre los pacientes en cuanto a las manifestaciones clínicas y el curso de la enfermedad. La elección del tratamiento y la respuesta están influenciadas por esta heterogeneidad. Los objetivos principales de los tratamientos de SB son suprimir rápidamente las exacerbaciones inflamatorias y prevenir las recaídas para proteger las funciones de los órganos y proporcionar una buena calidad de vida. Además de la experiencia a largo plazo con los esteroides y los inmunosupresores tradicionales, los fármacos biológicos, especialmente los inhibidores del TNF, han adquirido una importancia creciente en el tratamiento del SB a lo largo de los años. En esta revisión, nuestro objetivo fue dar una visión general de los estudios con fármacos convencionales y biológicos con eficacia comprobada en el tratamiento de SB.Recibido: 31/01/2023Aceptado: 14/2/2023
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- 2023
18. Effect of Adherence to the Mediterranean Diet on Maternal Iron Related Biochemical Parameters during Pregnancy and Gestational Weight Gain
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Morales Suárez-Varela, María Manuela, Peraita-Costa, Isabel, Perales-Marín, Alfredo, Marcos Puig, Beatriz, Llopis-Morales, Agustín, Picó, Yolanda, Morales Suárez-Varela, María Manuela, Peraita-Costa, Isabel, Perales-Marín, Alfredo, Marcos Puig, Beatriz, Llopis-Morales, Agustín, and Picó, Yolanda
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Gestation is a crucial life stage for both women and offspring, and outcomes are affected by many environmental factors, including diet. The Mediterranean dietary pattern (MD) is considered a healthy eating pattern that can provide the nutritional requirements of pregnancy. Meanwhile, iron deficiency anemia is one of the most frequent complications related to pregnancy. This study aimed to evaluate how the level of adherence to the MD influences maternal gestational weight gain and specific iron-related maternal biochemical parameters during the pregnancy. Accordingly, an observational, population-based study using data from pregnant women conducted over the entire course of their pregnancy was carried out. Adherence to the MD was assessed once using the MEDAS score questionnaire. Of the 506 women studied, 116 (22.9%) were classified as demonstrating a high adherence, 277 (54.7%) a medium adherence, and 113 (22.3%) a low adherence to the MD. No differences were observed in gestational weight gain among the MD adherence groups but the adequacy of weight gain did vary among the groups, with the proportions of inadequate (insufficient or excessive) weight gain presenting the most notable differences. Total anemia prevalence was 5.3%, 15.6%, and 12.3%, respectively, during the first, second, and third trimesters. For iron-related biochemical parameters, no differences are observed among the adherence groups during pregnancy. With high adherence to the MD as the reference group, the crude odds of iron deficiency diagnosis are significant in the first trimester for both the medium [OR = 2.99 (1.55–5.75)] and low [OR = 4.39 (2.15–8.96)] adherence groups, with deficient adherence to the Mediterranean dietary pattern being responsible for 66.5% (35.5–82.6) and 77.2% (53.5–88.8) of the risk of iron deficiency diagnosis for medium and low adherence, respectively. However, adjusted odds ratios were not significant, possibly due to the small sample size. Our data suggest that MD
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- 2023
19. Optimization of Imminent Labor Prediction Systems in Women with Threatened Preterm Labor Based on Electrohysterography
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Gema Prats-Boluda, Julio Pastor-Tronch, Javier Garcia-Casado, Rogelio Monfort-Ortíz, Alfredo Perales Marín, Vicente Diago, Alba Roca Prats, and Yiyao Ye-Lin
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electrohysterogram ,uterine myoelectrical activity ,tocolytic therapy ,random forest ,extreme learning machine ,K-nearest neighbors ,Chemical technology ,TP1-1185 - Abstract
Preterm birth is the leading cause of death in newborns and the survivors are prone to health complications. Threatened preterm labor (TPL) is the most common cause of hospitalization in the second half of pregnancy. The current methods used in clinical practice to diagnose preterm labor, the Bishop score or cervical length, have high negative predictive values but not positive ones. In this work we analyzed the performance of computationally efficient classification algorithms, based on electrohysterographic recordings (EHG), such as random forest (RF), extreme learning machine (ELM) and K-nearest neighbors (KNN) for imminent labor (F1_2 and ELMF1_2 provided the highest F1-score values in the validation dataset, (88.17 ± 8.34% and 90.2 ± 4.43%) with the 50th percentile of EHG and obstetric inputs. ELMF1_2 outperformed RFF1_2 in sensitivity, being similar to those of ELMSens (sensitivity optimization). The 10th–90th percentiles did not provide a significant improvement over the 50th percentile. KNN performance was highly sensitive to the input dataset, with a high generalization capability.
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- 2021
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20. Healthy mothers with normal cardiotocograms at term. Is maternal age a true determinant of perinatal outcome?
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Morales-Roselló, José, Loscalzo, Gabriela, Jakaitė, Vaidilė, Buongiorno, Silvia, and Perales Marín, Alfredo
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Cardiotocography ,Infant, Newborn ,Pregnancy Outcome ,Infant ,Obstetrics and Gynecology ,Gestational Age ,late-onset fetal growth restriction ,Doppler ultrasound ,Ultrasonography, Prenatal ,Pregnancy ,fetal smallness ,Infant, Small for Gestational Age ,Pediatrics, Perinatology and Child Health ,Humans ,cardiotocograms ,Female ,labor induction ,perinatal ,Maternal Age ,Retrospective Studies - Abstract
OBJECTIVE: to study the true determinants of adverse perinatal outcome (APO) in term healthy mothers with normal cardiotocograph (CTG), evaluating the real influence of maternal age. MATERIAL AND METHODS: In a retrospective study, we assessed a group of 529 term healthy mothers with normal CTGs that regardless of maternal age, evolved spontaneously up to 41 ± 2 weeks. The result of the conservative management was evaluated by means of univariable and multivariable logistic regression analysis, determining the association of maternal age and other clinical and ultrasonographical parameters with APO. RESULT: In contrast with low CPR MoM (OR = 0.155, p = .014), induction of labor (OR = 2.273, p = .023) and low parity (OR = 0.494, p = .026), maternal age and birth weight centile did not prove to be true determinants of perinatal outcome. The multivariable model for prediction of APO using clinical parameters presented a sensitivity of 35% and 27% for a false positive rate of 10% and 5%, AUC 0.736 (95% CI 0.655-0.818), p < .0001). CONCLUSIONS: in healthy old mothers with normal CTGs at term, APO is determined by low CPR, the existence of labor induction and low parity, while no real influence was observed for maternal age, fetal smallness, and interval examination-delivery. These results do not support the current consensus on induction at earlier weeks to prevent adverse outcomes in all cases of advanced maternal age, advocating for a more individualized, customized, and less interventional management based on fetal hemodynamics.
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- 2022
21. Safety of Nicotine Replacement Therapy during Pregnancy: A Narrative Review
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Morales-Suárez-Varela, María, primary, Puig, Beatriz Marcos, additional, Kaerlev, Linda, additional, Peraita-Costa, Isabel, additional, and Perales-Marín, Alfredo, additional
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- 2022
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22. Comparison of Maternal–Fetal Outcomes among Unvaccinated and Vaccinated Pregnant Women with COVID-19
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Martínez-Varea, Alicia, primary, Satorres, Elena, additional, Florez, Sandra, additional, Domenech, Josep, additional, Desco-Blay, Julia, additional, Monfort-Pitarch, Sagrario, additional, Hueso, María, additional, Perales-Marín, Alfredo, additional, and Diago-Almela, Vicente, additional
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- 2022
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23. MicroRNA-185-5p: a marker of brain-sparing in foetuses with late-onset growth restriction
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José Morales-Roselló, Gabriela Loscalzo, Eva María García-Lopez, José Santiago Ibañez Cabellos, José Luis García-Gimenez, Antonio José Cañada Martínez, and Alfredo Perales Marín
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MicroRNAs ,Cancer Research ,Fetal Growth Retardation ,Fetus ,Humans ,Brain ,Female ,Prospective Studies ,DNA Methylation ,Molecular Biology ,Biomarkers ,Research Paper - Abstract
To compare the expression of microRNA-185-5p (miR-185-5p) in normal foetuses and in foetuses with late-onset growth restriction (FGR) and to determine the factors influencing this expression. In a prospective study, 40 foetuses (22 of them with late-onset FGR and 18 with normal growth) were scanned with Doppler ultrasound after week 35 and followed until birth. Subsequently, blood samples from umbilical cords were collected after delivery to evaluate the expression of miR-185-5p using real-time qPCR. Finally, multivariable regression analysis was applied to determine the clinical and ultrasonographic factors influencing miR-185-5p expression in both normal and late-onset FGR foetuses. In comparison with normal foetuses, late-onset FGR foetuses expressed upregulation of miR-185-5p (2.26 ± 1.30 versus 1.27 ± 1.03 2^-ddCt, P = 0.011). Multivariable regression analysis confirmed that cerebroplacental ratio (P
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- 2021
24. Effect of Adherence to the Mediterranean Diet on Maternal Iron Related Biochemical Parameters during Pregnancy and Gestational Weight Gain.
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Morales-Suárez-Varela, María, Peraita-Costa, Isabel, Perales-Marín, Alfredo, Marcos Puig, Beatriz, Llopis-Morales, Juan, and Picó, Yolanda
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WEIGHT gain ,MEDITERRANEAN diet ,IRON deficiency anemia ,PREGNANCY complications ,PREGNANCY ,IRON deficiency - Abstract
Gestation is a crucial life stage for both women and offspring, and outcomes are affected by many environmental factors, including diet. The Mediterranean dietary pattern (MD) is considered a healthy eating pattern that can provide the nutritional requirements of pregnancy. Meanwhile, iron deficiency anemia is one of the most frequent complications related to pregnancy. This study aimed to evaluate how the level of adherence to the MD influences maternal gestational weight gain and specific iron-related maternal biochemical parameters during the pregnancy. Accordingly, an observational, population-based study using data from pregnant women conducted over the entire course of their pregnancy was carried out. Adherence to the MD was assessed once using the MEDAS score questionnaire. Of the 506 women studied, 116 (22.9%) were classified as demonstrating a high adherence, 277 (54.7%) a medium adherence, and 113 (22.3%) a low adherence to the MD. No differences were observed in gestational weight gain among the MD adherence groups but the adequacy of weight gain did vary among the groups, with the proportions of inadequate (insufficient or excessive) weight gain presenting the most notable differences. Total anemia prevalence was 5.3%, 15.6%, and 12.3%, respectively, during the first, second, and third trimesters. For iron-related biochemical parameters, no differences are observed among the adherence groups during pregnancy. With high adherence to the MD as the reference group, the crude odds of iron deficiency diagnosis are significant in the first trimester for both the medium [OR = 2.99 (1.55–5.75)] and low [OR = 4.39 (2.15–8.96)] adherence groups, with deficient adherence to the Mediterranean dietary pattern being responsible for 66.5% (35.5–82.6) and 77.2% (53.5–88.8) of the risk of iron deficiency diagnosis for medium and low adherence, respectively. However, adjusted odds ratios were not significant, possibly due to the small sample size. Our data suggest that MD adherence could be related to gestational weight gain adequacy and that optimal adherence could reduce iron deficiency and/or anemia during pregnancy in the studied population. [ABSTRACT FROM AUTHOR]
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- 2023
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25. Trombosis venosa ovárica posparto: una causa inusual de fiebre puerperal
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A. Perales Marín, A. Trelis Blanes, T. Lozoya Araque, S. Monfort Pitarch, I.R. Monfort Ortiz, and V. Diago Almela
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Gynecology ,03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,Reproductive Medicine ,business.industry ,030220 oncology & carcinogenesis ,medicine ,Obstetrics and Gynecology ,030204 cardiovascular system & hematology ,business - Abstract
Resumen La trombosis de la vena ovarica posparto es una complicacion rara e impredecible y que requiere un alto indice de sospecha clinica, cuyo diagnostico y manejo precoces son esenciales, requiriendo un abordaje multidisciplinar, para evitar cirugias innecesarias y posibles complicaciones graves. Su presentacion clinica habitual suele ser fiebre persistente y dolor abdominal, generalmente en la primera semana posparto. Revisamos 3 casos clinicos representativos, diagnosticados en nuestro centro entre 2014 y 2019, abordando los factores predisponentes, diagnostico, manejo y evolucion de estas pacientes.
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- 2021
26. GESTACOVID project: psychological and perinatal effects in Spanish pregnant women subjected to confinement due to the COVID-19 pandemic
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José Alberola-Rubio, María Ivañez-Muñoz, Alba Roca-Prats, Sara Monfort-Beltrán, Maria De Arriba-Garcia, Alfredo Perales-Marín, Alba Diaz-Martinez, and Rogelio Monfort-Ortiz
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2019-20 coronavirus outbreak ,Pediatrics ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Anxiety ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Pandemic ,medicine ,Humans ,030212 general & internal medicine ,Pandemics ,030219 obstetrics & reproductive medicine ,SARS-CoV-2 ,Depression ,business.industry ,COVID-19 ,Obstetrics and Gynecology ,Distress ,Movement restriction ,Pediatrics, Perinatology and Child Health ,Female ,Pregnant Women ,business - Abstract
COVID-19 was declared a pandemic and confinement with movement restriction measures were applied in Spain. Postnatal mental disorders are common but frequently undiagnosed, being a risk period to develop anxiety and depression symptoms. The aim of this study is to evaluate the impact of confinement as depressive and anxiety symptoms in pregnant women (PrW) and puerperal women (PuW) mental health, as well as obstetric and perinatal outcomes during this period.The self-administered survey consists of a total of 28 questions, the first 16 providing contextual information and the following ones corresponding to the GHQ-12 that has been evaluated in a binomial form. A logistic regression model has been used to assess whether the contextual variables acted as a protective or risk factor and its fitting has been represented by a receiver operating curve.Of the 754 PrW interviewed, 58.22% were screened positive. Confinement time for these was 54.93 ± 9.75 days. The risk factors that were identified after the refinement have been to have a worse general state of health, to be sadder and to be more nervous. Among the protectors have been found to have a higher Apgar 10 score and induction of labor. The area under the adjusted regression adjustment curve was 0.8056.Our results show a high prevalence of depression and anxiety symptoms with strict confinement measures. PrW and PuW must be considered a risk group to develop mental health disorders during disruption circumstances. Using a mental health screening tool could help to identify a group of patients with more risk and to carry out a careful monitoring to allow adequate management.
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- 2021
27. Mechanical cervical ripening for prolonged pregnancies with a previous cesarean section: Double-balloon catheter vs Foley catheter
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Martínez-Varea, Alicia, primary, Santolaria-Baig, Andrea, additional, Sánchez-Ajenjo, Carlos, additional, Monfort-Ortiz, Rogelio, additional, Perales-Marín, Alfredo, additional, and Diago-Almela, Vicente, additional
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- 2022
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28. Evolución obstétrica de paciente afectada de síndrome de Ehlers-Danlos
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Vila-Vives, José María, Romaguera Salort, Eugenia, Hidalgo Mora, Juan José, Molina Planta, Marta, Lozoya, Teresa, and Perales Marín, Alfredo
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- 2013
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29. The Diagnostic Ability of the Cerebroplacental Ratio for the Prediction of Adverse Perinatal Outcome and Intrapartum Fetal Compromise within One Day of Delivery
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José Morales-Roselló, Vaidilė Jakaitė, Alfredo Perales Marín, and Gabriela Loscalzo
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Middle Cerebral Artery ,medicine.medical_specialty ,medicine.medical_treatment ,Tertiary referral hospital ,Umbilical cord ,Fetal Distress ,Ultrasonography, Prenatal ,Umbilical Arteries ,Fetus ,Pregnancy ,Intensive care ,medicine ,Humans ,Retrospective Studies ,Cesarean Section ,Obstetrics ,business.industry ,Infant, Newborn ,Pregnancy Outcome ,Area under the curve ,Obstetrics and Gynecology ,medicine.anatomical_structure ,Reproductive Medicine ,Case-Control Studies ,Pulsatile Flow ,Labor induction ,Gestation ,Female ,Apgar score ,business - Abstract
Objectives: The objectives of this study were to evaluate the diagnostic abilities of the cerebroplacental ratio (CPR) for the prediction of adverse perinatal outcome (APO) and cesarean section for intrapartum fetal compromise (CS-IFC) within 1 day of delivery. Design: Retrospective observational case-control study. Methods: This was a study of 254 high-risk fetuses attending the day hospital unit of a tertiary referral hospital that underwent an ultrasound examination at 32–41 weeks and gave birth within 1 day of examination. APO was defined as a composite of abnormal intrapartum fetal heart rate or intrapartum fetal scalp pH Results: CPR in multiples of the median (MoM) was a moderate predictor of APO (area under the curve [AUC] = 0.77, p < 0.0001) and CS-IFC (AUC = 0.82, p < 0.0001). The predictive abilities of the multivariable model for APO (AUC = 0.81, p < 0.0001) and CS-IFC (AUC = 0.82, p < 0.0001) did not differ from those of CPR alone . Limitations: The small number of cases and the scarcity of information concerning labor induction. Conclusion: In high-risk pregnancies, CPR MoM is a moderate predictor of APO and CS-IFC when performed within 24 h of delivery.
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- 2021
30. Perinatal and Obstetric Predictors for Autism Spectrum Disorder
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Alfredo Perales-Marín, Salvador Marí-Bauset, María Morales-Suárez-Varela, Montserrat Tellez de Meneses, Agustín Llopis-González, Pablo Cervera-Boada, and Isabel Peraita-Costa
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Male ,Pediatrics ,medicine.medical_specialty ,genetic structures ,Autism Spectrum Disorder ,Population ,Logistic regression ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Surveys and Questionnaires ,Intervention (counseling) ,mental disorders ,Developmental and Educational Psychology ,medicine ,Humans ,0501 psychology and cognitive sciences ,Child ,education ,Male gender ,education.field_of_study ,Cesarean Section ,Incidence ,Incidence (epidemiology) ,Public health ,05 social sciences ,medicine.disease ,Autism spectrum disorder ,Case-Control Studies ,Autism ,Female ,Psychology ,030217 neurology & neurosurgery ,050104 developmental & child psychology - Abstract
The objective is to identify obstetric and perinatal factors that could be significant predictors of ASD and may lead to early detection and intervention. A population-based case-control study including 128 children diagnosed with ASD and 311 controls was conducted. Information was collected through self-reported questionnaires. The factors retained as significant predictors for ASD in the final adjusted hierarchical logistic regression model were cesarean section and male gender. The study revealed a higher incidence of cesarean sections and male gender in children with ASD in comparison to unaffected children confirming the results of previous studies. Children born by cesarean section, especially males, should be more closely monitored for the presence of ASD traits for early diagnosis and intervention.
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- 2021
31. Papel de la ortesis en el manejo del pie plano estudio intervencional
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Dulcey, Luis Andrés, Moreno Parra, Héctor, Theran Leon, Juan Sebastian, Castillo, John, Caltagirone, Raimondo, Visintini, Andrea, Perales Marín, Rafael, Aguas, Melissa, Villamizar, Diana, Araujo, Andreina, Dulcey, Luis Andrés, Moreno Parra, Héctor, Theran Leon, Juan Sebastian, Castillo, John, Caltagirone, Raimondo, Visintini, Andrea, Perales Marín, Rafael, Aguas, Melissa, Villamizar, Diana, and Araujo, Andreina
- Abstract
Flat feet favor the appearance of generalized disorders of the lower limbs due to overload.The objective of the study is to monitor the changes in the biomechanical parameters of flat feet during a complex intervention. The study included an experimental group of 20 participants (average age: 12 years, average weight: 48.18 kg) diagnosed with bilateral flat feet. The biomechanical parameters of flat foot were evaluated with the RS scan pressure plate that was used to measure the active contact area and the maximum force (Fmax) for 10 areas of the foot. The participants were evaluated at two moments (T1 and T2), at a 6-month interval. The treatment consisted of an orthotic intervention and a physiotherapy program carried out throughout this period. There are higher average values at time T1 for the right foot in the following contact areas: Midfoot - 33.6 cm2, Mid heel - 15.42 cm2, Metatarsal 2 - 10.67 cm2, Metatarsal 1 - 11, 14 cm2 ; at T2, a 2% decrease is noted for all contact areas. At time T1, the highest average values are recorded for the left foot in the following contact areas: Midfoot - 36.42 c,mT2acon median - 14.55 cm2, Metatarsal 2 - 9.15 cm2, Metatarsal 1 - 8, 62 cm2 ; at T2, a 6% decrease is noted for all contact areas. The results indicate a favorable bilateral development. There are significant differences between the two moments. The analysis of biomechanical parameters helps to monitor the changes in flat feet under the intervention of specific treatment., https://www.doi.org/10.53766/AcBio/2022.12.24.07 El pie plano favorece la aparición de trastornos generalizados de miembros inferiores por sobre-carga. El objetivo del estudio es monitorear los cambios en los parámetros biomecánicos del pie plano durante una intervención compleja. El estudio incluyó un grupo experimental de 20 partici-pantes (edad promedio: 12 años, peso promedio: 48,18 kg) diagnosticados con pie plano bilateral. Los parámetros biomecánicos del pie plano se evaluaron con la placa de presión RS scan que se utilizó para medir el área de contacto activo y la fuerza máxima (Fmax) para 10 áreas del pie. Los participantes fueron evaluados en dos momentos (T1 y T2), a los 6- intervalo de meses. El trata-miento consistió en una intervención ortésica y un programa de fisioterapia realizado durante todo este período. Hay valores promedio más altos en el momento T1 para el pie derecho en las siguien-tes áreas de contacto: Mediopié - 33,6 cm2, Talon medio - 15,42 cm2, Metatarsiano 2 - 10,67 cm2 , Metatarsiano 1 - 11,14 cm2 ; en T2, se nota una disminución del 2% para todas las áreas de contacto. En el momento T1, se registran valores promedio más altos para el pie izquierdo en las siguientes áreas de contacto: Mediopié - 36,42 c, mT2acón medio - 14,55 cm2, Metatarsiano 2 - 9,15 cm2 , Metatarsiano 1 - 8,62 cm2 ; en T2, se nota una disminución del 6% para todas las áreas de contacto. Los resultados indican un desarrollo bilateral favorable. Existen diferencias significa-tivas entre los dos momentos. El análisis de parámetros biomecánicos ayuda a monitorear los cam-bios en el pie plano bajo la intervención de tratamiento específico.Recibido:2/07/2022Aprobado:10/09/2022
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- 2022
32. Descripción de la coinfeccion Malaria Dengue a proposito de un caso clinico primera descripción en el IAHULA
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Dulcey, Luis Andrés, Caltagirone, Raimondo, Theran Leon, Juan Sebastian, Perales Marín, Rafael, Dulcey, Luis Andrés, Caltagirone, Raimondo, Theran Leon, Juan Sebastian, and Perales Marín, Rafael
- Abstract
Dengue and malaria coinfection involves different coexisting vectors and hosts maintaining contact with them or traveling to different geographical areas. The first dengue and malaria coinfection report was in 2005 in a French patient, with a history of travel to endemic areas of dengue and malaria, in whom P. falciparum and dengue serotype 2 were diagnosed. Male patient of 38 years of age and coming from the Pan-American zone, with no history, who at the beginning of February / 2018 presented generalized arthralgia’s as well as unquantified thermal increases of 3 weeks of evolution, 8 days prior to admission He presents multiple nausea, emetic episodes and abdominal pain, so he goes to our institution. In stable general conditions. TA 90 / 50 FC104 x', FR22 x'. Cardiopulmonary Without Alteration, Abdomen generalized pain. Neurological, preserved superior mental functions, preserved cranial nerves, V / V muscle strength in all 4 limbs. It required aggressive management with intravenous fluids. Thickness is confirmed confirming P. falciparum infection and serology for Dengue virus type 2 being positive with confirmatory polymerase chain reaction. It has been described that the clinical presentation of dengue and malaria coinfection tends to be more severe than in single infections and that it presents with more frequent criteria of severe malaria. On the other hand, it has been observed that the clinical presentation of coinfection is similar to dengue and is imposed on the clinical presentation of malaria., https://www.doi.org/10.53766/AcBio/2022.12.24.11 La coinfección dengue y malaria involucra diferentes vectores coexistiendo y hospederos manteniendo contacto con ellos o viajando a diferentes áreas geográficas. El primer informe de coinfección de dengue y malaria fue en el año 2005 en una paciente francesa, con antecedente de viaje a zonas endémicas de dengue y malaria, en quien se diagnosticó P. falciparum y serotipo 2 de dengue. Paciente masculino de 38 años de edad natural y procedente de la zona Panamericana, sin antecedentes, quien a principios de Febrero/2018 presenta artralgias generalizadas así como alzas térmicas no cuantificadas de 3 semanas de evolución, 8 días previo al ingreso presenta nauseas múltiples episodios eméticos y dolor abdominal por lo que acude a nuestra institución. En condiciones generales estables. TA90/50 FC104 x´, FR22 x´. Cardiopulmonar Sin Alteración, Abdomen dolor generalizado. Neurológico, funciones mentales superiores conservadas, pares craneales conservados, fuerza muscular V/V en los 4 miembros. Requirió manejo agresivo con líquidos endovenosos. Se realizan gota gruesa confirmando infección por P. falciparum y serología para Virus Dengue tipo 2 siendo positiva con Reacción de cadena de polimerasa confirmatoria. Se ha descrito que la presentación clínica de la coinfección dengue y malaria tiende a ser más severa que en las infecciones únicas y que presenta con mayor frecuencia criterios de malaria severa. Por otra parte, se ha observado que la presentación clínica de la coinfección es similar a dengue y se impone sobre la presentación clínica de malaria.Recibido:12/09/2022Aprobado:2/10/2022
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- 2022
33. MicroRNA‐132 is overexpressed in fetuses with late‐onset fetal growth restriction
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Morales‐Roselló, José, primary, Loscalzo, Gabriela, additional, García‐Lopez, Eva María, additional, García‐Gimenez, José Luis, additional, and Perales‐Marín, Alfredo, additional
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- 2022
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34. Prenatal Ultrasound Diagnosis of a Cyst of the Oral Cavity: An Unusual Case of Thyroglossal Duct Cyst Located on the Tongue Base
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E. Rodríguez Tárrega, S. Fuster Rojas, R. Gómez Portero, S. Roig Boronat, G. Pérez Martínez, J. Zamora Prado, and A. Perales Marín
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Gynecology and obstetrics ,RG1-991 - Abstract
We describe a case of a lingual thyroglossal duct cyst diagnosed prenatally by ultrasound at 26 weeks of gestation. The follow-up ultrasound scans revealed no changes in the cyst measurement. Surgical treatment was performed without any complication 72 hours after delivery with good results.
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- 2016
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35. Florid Cystic Endosalpingiosis (Müllerianosis) in Pregnancy
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José Morales-Roselló, Loida Pamplona-Bueno, Beatriz Montero-Balaguer, Domingo Desantes-Real, and Alfredo Perales-Marín
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Gynecology and obstetrics ,RG1-991 - Abstract
Cystic endosalpingiosis refers to the existence of heterotopic cystic müllerian tissue resembling structures of the fallopian tubes. We report a case of florid cystic endosalpingiosis discovered in a pregnant woman during a scheduled cesarean section and review the current knowledge of this disease. A 30-year-old woman with a twin pregnancy attended the hospital day unit at term. The first twin was in a breech presentation and a cesarean section was scheduled. During the procedure the uterine fundus and part of the body were seen completely seeded with multitude of cyst-like structures resembling hydatids of Morgagni. The immunohistochemistry analysis showed a positive expression for PAX8 (Box-8), CK7, and estrogen and progesterone receptors. The lesions did not disappear after pregnancy. Cystic endosalpingiosis should be always borne in mind, even in pregnancy, when it comes to making the differential diagnosis of a pelvic or systemic multicystic mass.
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- 2016
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36. Maternal profile according to Mediterranean diet adherence and small for gestational age and preterm newborn outcomes
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José Miguel Soriano, Vicente Diago, Agustín Llopis-González, Alfredo Perales-Marín, Isabel Peraita-Costa, María Morales-Suárez-Varela, and Agustin Llopis-Morales
- Subjects
medicine.medical_specialty ,Mediterranean diet ,Population ,Medicine (miscellaneous) ,Gestational Age ,Diet, Mediterranean ,Poor adherence ,Pregnancy ,Informed consent ,medicine ,Humans ,education ,Retrospective Studies ,education.field_of_study ,Nutrition and Dietetics ,Obstetrics ,business.industry ,Infant, Newborn ,Public Health, Environmental and Occupational Health ,Spanish version ,medicine.disease ,Cross-Sectional Studies ,Case-Control Studies ,Infant, Small for Gestational Age ,Premature Birth ,Small for gestational age ,Female ,Outcome data ,business ,Research Paper - Abstract
Objective:The objective was to evaluate maternal Mediterranean diet (MD) pattern adherence during pregnancy and its association with small for gestational age (SGA) and preterm birth. A secondary objective of the current study was to describe the sociodemographic, lifestyle and obstetric profile of the mothers studied as well as the most relevant paternal and newborn characteristics.Design:The current study is a two-phase retrospective population-based study of maternal dietary habits during pregnancy and their effect on newborn size and prematurity. The descriptive first phase examined maternal dietary habits during pregnancy along with the maternal sociodemographic, lifestyle and obstetric profile in a cross-sectional period study. In the second phase, newborn outcomes were evaluated in a nested case–control study. Adherence to MD during pregnancy was measured with the Spanish version of Kidmed index.Setting:Obstetrics ward of the La Fe Hospital in Valencia.Participants:All mother–child pairs admitted after delivery during a 12-month period starting from January 2018 were assessed for eligibility. A total of 1118 provided complete outcome data after signing informed consent.Results:14·5 % met the criteria of poor adherence (PA); 34·8 %, medium adherence (MA); and 50·7 %, optimal adherence (OA). Medium adherence to MD was associated in the adjusted scenarios with a higher risk of giving birth to a preterm newborn. No association was found between MD adherence and SGA.Conclusions:Early intervention programmes geared towards pregnant women, where women were aided in reaching OA to MD, might reduce the risk of preterm newborn.
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- 2020
37. MicroRNA-148b-3p and MicroRNA-25-3p Are Overexpressed in Fetuses with Late-Onset Fetal Growth Restriction
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Vaidile Jakaite, Silvia Buongiorno, Salvador Mena-Mollá, Ángel Maquieira Catala, José Luis García-Giménez, Antonio José Cañada Martínez, Llucia Martinez Priego, Gabriela Loscalzo, José Morales-Roselló, Daymé González-Rodríguez, and Alfredo Perales Marín
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Male ,Embryology ,Late onset ,Ultrasonography, Prenatal ,Umbilical vein ,Andrology ,Fetus ,Downregulation and upregulation ,Pregnancy ,microRNA ,Fetal growth ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Prospective cohort study ,Fetal Growth Retardation ,business.industry ,High-Throughput Nucleotide Sequencing ,Obstetrics and Gynecology ,Ultrasonography, Doppler ,General Medicine ,Fetal Blood ,Pathophysiology ,MicroRNAs ,Case-Control Studies ,Pediatrics, Perinatology and Child Health ,Female ,business - Abstract
Objective: It was the aim of this study to describe a microRNA (miRNA) profile characteristic of late-onset fetal growth restriction (FGR) and to investigate the pathways involved in their biochemical action. Methods: In this prospective study, 25 fetuses (16 normal and 9 with FGR [estimated fetal weight Results: The FGR fetuses expressed upregulation of two miRNAs: miR-25-3p and, especially, miR-148b-3p, a miRNA directly involved in Schwann cell migration, neuronal plasticity, and energy metabolism (p = 0.0072, p = 0.0013). Conclusions: FGR fetuses express a different miRNA profile, which includes overexpression of miR-25-3p and miR-148b-3p. This information might improve our understanding of the pathophysiological processes involved in late-onset FGR. Future validation and feasibility studies will be required to propose miRNAs as a valid tool in the diagnosis and management of FGR.
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- 2020
38. Diagnosis of intraamniotic inflammation by measuring vaginal interleukin-6 in patients with cervical insufficiency: could amniocentesis be avoided?
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Diana María Diago Muñoz, Alicia Martínez-Varea, Alba Roca Prats, Ricardo Alonso-Díaz, Alfredo Perales Marín, and Vicente José Diago Almela
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Inflammation ,vaginal IL-6 ,Interleukin-6 ,Infant, Newborn ,Obstetrics and Gynecology ,interleukin-6 (IL-6) ,Amniotic Fluid ,Cohort Studies ,intraamniotic inflammation ,Chorioamnionitis ,Cervical insufficiency ,Pregnancy ,Pediatrics, Perinatology and Child Health ,Vagina ,Amniocentesis ,Humans ,Female ,Uterine Cervical Incompetence ,intraamniotic IL-6 - Abstract
BACKGROUND: Cervical insufficiency is a recurrent, passive, and painless dilation of the cervix in the second trimester. The etiology is unclear, but there may be an association with subclinical intraamniotic infection. Interleukin-6 (IL-6) production in the amniotic cavity is induced by bacterial invasion, it is the major proinflammatory cytokine released in response to infection. Although the gold standard method to measure it is through an amniocentesis, the procedure constitutes an invasive technique with several associated risks. The objective of this study is to determine if there is a correlation between intraamniotic and vaginal IL-6 in patients with cervical insufficiency and bulging membranes during the second trimester of pregnancy, in order to avoid an amniocentesis before the rescue cerclage. METHODS: A cohort study was performed in which all patients with cervical insufficiency and bulging membranes admitted into our tertiary hospital between 2019 and 2020 were included, and a control group of asymptomatic women in the second trimester of gestation where studied at the same time. Patients with bulging membranes underwent an amniocentesis to quantify amniotic IL-6, and a sample of vaginal fluid for vaginal IL-6 determination was obtained from both the study and the control group. RESULTS: A total of 20 women were included in each group. Median gestational age at diagnosis was 22 weeks in patients with bulging membranes, and 21 weeks in the control group. Vaginal IL-6 in control group (10.875 pg/mL) is much lower than the study group one (1308.77 pg/ml). In patients with bulging membranes, vaginal IL-6 expression was lower in the vagina than in the amniotic cavity [average IL-6 in the amniotic cavity 26890.07 pg/mL, vs 1308.77 pg/mL in the vagina (p < .01)]. Through a Spearman coefficient correlation rank [rho = 0.709 (p < .001)], there is a positive correlation between amniotic and vaginal IL-6 values. The best value of this correlation was calculated with the ROC curve, being the area under the curve 0.929 (CI 95% 0.721-0.995), and the cutoff of point less than 61.4 pg/ml (sensitivity 83.33%; specificity 92.86%). Patients with vaginal IL-6 < 61.4 pg/ml associated a longer latency time between diagnosis and delivery, a higher neonatal weight and a lower perinatal mortality. Rescue cerclage in vaginal IL-6 < 61.4 pg/ml was the best predictor of good pregnancy outcome. CONCLUSION: There is a correlation between intraamniotic and vaginal IL-6 in patients with cervical insufficiency and bulging membranes during the second trimester of pregnancy. However, further studies are needed in order to considerate the avoidance of an amniocentesis before an emergency cerclage.
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- 2022
39. Cerebroplacental Ratio Prediction of Intrapartum Fetal Compromise according to the Interval to Delivery
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José Morales-Roselló, Asma Khalil, Gabriela Loscalzo, Silvia Buongiorno, Maia Brik, Manel Mendoza, Carolina Di Fabrizio, Elisa Scarinci, Silvia Salvi, Antonio Lanzone, and Alfredo Perales Marín
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Middle Cerebral Artery ,Embryology ,intrapartum ,Cesarean Section ,Pregnancy Outcome ,Obstetrics and Gynecology ,General Medicine ,fetal ,Ultrasonography, Prenatal ,Umbilical Arteries ,Cerebroplacental ,Predictive Value of Tests ,Pregnancy ,Pulsatile Flow ,Pediatrics, Perinatology and Child Health ,Humans ,Female ,Radiology, Nuclear Medicine and imaging ,Retrospective Studies - Abstract
Introduction: A controversy exists about the accuracy of the cerebroplacental ratio (CPR) for the prediction of cesarean section for intrapartum fetal compromise (CS-IFC). Our aim was to evaluate whether the interval to delivery modifies the accuracy of CPR either as a single marker or combined with estimated fetal weight centile (EFWc), type of labor onset (TLO), and other clinical variables. Methods: This was a multicenter retrospective study of 5,193 women with singleton pregnancies who underwent an ultrasound scan at 35+0–41+0 weeks and gave birth within 1 month of examination, at any of the participating hospitals in Spain, UK, and Italy. CS-IFC was diagnosed in case of an abnormal intrapartum fetal heart rate or intrapartum fetal scalp pH Results: The predictive ability of CPR MoM for CS-IFC worsened with the interval to delivery. In general, the best prediction was obtained prior to labor and by adding information related to EFWc and TLO (AUC 0.71 [95% CI: 0.64–0.79], 0.73 [95% CI: 0.66–0.80], and 0.75 [95% CI: 0.69–0.81]; p < 0.0001). Addition of more clinical data did not improve prediction. In addition, results did not vary when only cases with spontaneous onset of labor were studied. Conclusion: CPR MoM prediction of CS-IFC at the end of pregnancy worsens with the interval to delivery. Accordingly, it should be done in the short term and considering EFWc and TLO.
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- 2022
40. Predictors of adverse perinatal outcome up to 34 weeks, a multivariable analysis study
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Morales-Roselló J, Galindo A, Scarinci E, Herraiz I, Buongiorno S, Loscalzo G, Gómez Arriaga PI, Cañada Martínez AJ, Rosati P, Lanzone A, and Perales Marín A
- Subjects
middle cerebral artery Doppler ,umbilical artery Doppler ,uterine artery Doppler ,adverse perinatal outcome ,Cerebroplacental ratio - Abstract
The objective was to evaluate the best predictors of adverse perinatal outcome (APO) in foetuses examined up to 34 weeks and delivered by spontaneous or induced labour. This was a retrospective study of 129 pregnancies that underwent an ultrasound Doppler examination at 23-34 weeks and entered into labour within 30 days. Cerebroplacental ratio (CPR) and mean uterine artery pulsatility index (mUtA PI) were converted into multiples of the median (MoM) and estimated foetal weight (EFW) into centiles to adjust for gestational age (GA). Sonographic and clinical parameters were evaluated using logistic regression analysis.The multivariable model for the prediction of APO presented a notable accuracy: Detection rate (DR) was 39.5% for a false positive rate (FPR) of 5% and 56.8% for a FPR of 10%, AUC 0.82, p < .0001. Significant predictors were GA, EFW centile, and CPR MoM, but not mUtA PI MoM. Moreover, the type of labour onset did not exert any influence on APO. In conclusion, up to 34 weeks, prediction of APO after spontaneous or induced labour may be done measuring CPR and EFW.IMPACT STATEMENTWhat is already known on this subject? Earlier in pregnancy, foetal growth restriction is caused by placental disease causing progressive hemodynamic changes. These changes have been exhaustively described. Conversely, information about the best predictors of adverse outcome is scarce.What do the results of this study add? The findings of this study show that prior to 34 weeks and up to 1 month before labour, labour outcome might be predicted by gestational age, foetal cerebroplacental ratio (CPR) and estimated foetal weight (EFW).What are the implications of these findings for clinical practice and/or further research? If CPR behaves as a good marker of outcome not only at the end of pregnancy but also earlier in gestation, it might be interrogated along with EFW in foetuses attempting vaginal delivery to determine the risk of adverse outcome.
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- 2022
41. Overexpression of microRNAs miR-25-3p, miR-185-5p and miR-132-3p in Late Onset Fetal Growth Restriction, Validation of Results and Study of the Biochemical Pathways Involved
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Loscalzo G, Scheel J, Ibañez-Cabellos JS, García-Lopez E, Gupta S, García-Gimenez JL, Mena-Mollá S, Perales-Marín A, and Morales-Roselló J
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fetal health ,cerebroplacental ratio ,miRNA185-5p ,late-onset fetal growth restriction ,bioinformatics ,network analysis ,miRNA ,miRNA-25-3p ,miRNA132-3p - Abstract
In a prospective study, 48 fetuses were evaluated with Doppler ultrasound after 34 weeks and classified, according to the cerebroplacental ratio (CPR) and estimated fetal weight (EFW), into fetuses with normal growth and fetuses with late-onset fetal growth restriction (LO-FGR). Overexpression of miRNAs from neonatal cord blood belonging to LO-FGR fetuses, was validated by real-time PCR. In addition, functional characterization of overexpressed miRNAs was performed by analyzing overrepresented pathways, gene ontologies, and prioritization of synergistically working miRNAs. Three miRNAs: miR-25-3p, miR-185-5p and miR-132-3p, were significantly overexpressed in cord blood of LO-FGR fetuses. Pathway and gene ontology analysis revealed over-representation of certain molecular pathways associated with cardiac development and neuron death. In addition, prioritization of synergistically working miRNAs highlighted the importance of miR-185-5p and miR-25-3p in cholesterol efflux and starvation responses associated with LO-FGR phenotypes. Evaluation of miR-25-3p; miR-132-3p and miR-185-5p might serve as molecular biomarkers for the diagnosis and management of LO-FGR; improving the understanding of its influence on adult disease.
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- 2022
42. Predictors of adverse perinatal outcome up to 34 weeks, a multivariable analysis study
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José Morales-Roselló, Alberto Galindo, Elisa Scarinci, Ignacio Herraiz, Silvia Buongiorno, Gabriela Loscalzo, Paula Isabel Gómez Arriaga, Antonio José Cañada Martínez, Paolo Rosati, Antonio Lanzone, and Alfredo Perales Marín
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Middle Cerebral Artery ,Placenta ,Pregnancy Outcome ,Obstetrics and Gynecology ,Gestational Age ,Ultrasonography, Doppler ,Ultrasonography, Prenatal ,Umbilical Arteries ,perinatal outcome ,Fetal Weight ,Predictive Value of Tests ,Pregnancy ,Pulsatile Flow ,Humans ,Female ,Retrospective Studies - Abstract
The objective was to evaluate the best predictors of adverse perinatal outcome (APO) in foetuses examined up to 34 weeks and delivered by spontaneous or induced labour. This was a retrospective study of 129 pregnancies that underwent an ultrasound Doppler examination at 23-34 weeks and entered into labour within 30 days. Cerebroplacental ratio (CPR) and mean uterine artery pulsatility index (mUtA PI) were converted into multiples of the median (MoM) and estimated foetal weight (EFW) into centiles to adjust for gestational age (GA). Sonographic and clinical parameters were evaluated using logistic regression analysis.The multivariable model for the prediction of APO presented a notable accuracy: Detection rate (DR) was 39.5% for a false positive rate (FPR) of 5% and 56.8% for a FPR of 10%, AUC 0.82
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- 2022
- Full Text
- View/download PDF
43. Safety of Nicotine Replacement Therapy during Pregnancy: A Narrative Review
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María Morales-Suárez-Varela, Beatriz Marcos Puig, Linda Kaerlev, Isabel Peraita-Costa, and Alfredo Perales-Marín
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Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health - Abstract
Background: Smoking during pregnancy is a public health problem worldwide and the leading preventable cause of fetal morbidity and mortality and obstetric disease. Although the risk of tobacco-related harm can be substantially reduced if mothers stop smoking in the first trimester, the proportion of women who do so remains modest; therefore, the treatment of smoking in pregnant women will be the first therapeutic measure that health professionals should adopt when providing care to pregnant women. The recommendation of nicotine replacement therapy during pregnancy remains controversial due to the potential effects on the health of the fetus. Purpose: The aim of this review was to provide an overview of human studies about the use of nicotine replacement therapy during pregnancy, evaluating the efficacy and safety of the different formulations. Methods: The electronic databases PubMed and EMBASE were searched from May 2012 to May 2022. A total of 95 articles were identified through database searching using a combination of keywords. Out of 79 screened articles and after the removal of duplicates, 28 full-text articles were assessed for eligibility and 12 articles were finally included for review. Results: Although demonstrated to be effective in adult smokers, evidence in support of NRT in pregnant women is limited. The results of the apparent safety of the use of NRT during pregnancy contradict the FDA classification of the different NRT formulations. Faster-acting formulations seem to be the safest and even most beneficial forms for the offspring. Conclusions: NRT is not completely harmless for the fetus or for the mother; however, if an adequate assessment of the risk-benefit binomial is made, its use during pregnancy to aid in quitting smoking does seem appropriate. It is necessary to establish individual recommendations on the formulation and dose to be used during pregnancy based on individual nicotinic needs.
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- 2022
44. Diagnosis of intraamniotic inflammation by measuring vaginal interleukin-6 in patients with cervical insufficiency: could amniocentesis be avoided?
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Diago Muñoz, Diana María, primary, Martínez-Varea, Alicia, additional, Roca Prats, Alba, additional, Alonso-Díaz, Ricardo, additional, Perales Marín, Alfredo, additional, and Diago Almela, Vicente José, additional
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- 2022
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45. Risk of Gestational Diabetes Due to Maternal and Partner Smoking
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Morales-Suárez-Varela, María, primary, Peraita-Costa, Isabel, additional, Perales-Marín, Alfredo, additional, Llopis-Morales, Agustín, additional, and Llopis-González, Agustín, additional
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- 2022
- Full Text
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46. Cerebroplacental Ratio Prediction of Intrapartum Fetal Compromise according to the Interval to Delivery
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Morales-Roselló, José, primary, Khalil, Asma, additional, Loscalzo, Gabriela, additional, Buongiorno, Silvia, additional, Brik, Maia, additional, Mendoza, Manel, additional, Di Fabrizio, Carolina, additional, Scarinci, Elisa, additional, Salvi, Silvia, additional, Lanzone, Antonio, additional, and Perales Marín, Alfredo, additional
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- 2022
- Full Text
- View/download PDF
47. MicroRNA-185-5p: a marker of brain-sparing in foetuses with late-onset growth restriction
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Morales-Roselló, José, primary, Loscalzo, Gabriela, additional, García-Lopez, Eva María, additional, Ibañez Cabellos, José Santiago, additional, García-Gimenez, José Luis, additional, Cañada Martínez, Antonio José, additional, and Perales Marín, Alfredo, additional
- Published
- 2021
- Full Text
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48. Overexpression of microRNAs miR-25-3p, miR-185-5p and miR-132-3p in Late Onset Fetal Growth Restriction, Validation of Results and Study of the Biochemical Pathways Involved
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Loscalzo, Gabriela, primary, Scheel, Julia, additional, Ibañez-Cabellos, José Santiago, additional, García-Lopez, Eva, additional, Gupta, Shailendra, additional, García-Gimenez, José Luis, additional, Mena-Mollá, Salvador, additional, Perales-Marín, Alfredo, additional, and Morales-Roselló, José, additional
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- 2021
- Full Text
- View/download PDF
49. Which is the best ultrasound parameter for the prediction of adverse perinatal outcome within 1 day of delivery?
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José Morales-Roselló, Gabriela Loscalzo, Vaidilė Jakaitė, Ana Gallego, and Alfredo Perales-Marín
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medicine.medical_specialty ,Middle Cerebral Artery ,Perinatal outcome ,macromolecular substances ,Ultrasonography, Prenatal ,Umbilical Arteries ,Pregnancy ,Predictive Value of Tests ,medicine.artery ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Child ,Fetus ,business.industry ,Obstetrics ,Cesarean Section ,Ultrasound ,Infant, Newborn ,Pregnancy Outcome ,Obstetrics and Gynecology ,Fetal doppler ,Ultrasonography, Doppler ,Pulsatile Flow ,Pediatrics, Perinatology and Child Health ,Middle cerebral artery ,Female ,business - Abstract
To compare the accuracies of several sonographic parameters for the prediction of adverse perinatal outcome (APO) prior to delivery.This was a prospective study of fetuses attending the day hospital unit of a tertiary referral hospital that were scanned at 34-41 weeks and gave birth within 24 h of examination. APO was defined as a composite of abnormal intrapartum fetal heart rate or intrapartum fetal scalp pH7.20 requiring urgent cesarean section, neonatal umbilical cord pH7.10, 5' Apgar score7 and postpartum admission to neonatal or pediatric intensive care units. The accuracies of the middle cerebral, vertebral and umbilical arteries pulsatility index multiples of the median (MoM), the cerebroplacental and vertebroplacental ratios MoM and the EFW in centiles for the prediction of APO was evaluated by means of ROC curves and logistic regression analysis.A total of 2140 fetuses were prospectively scanned, however only 182 entered into spontaneous or induced labor and were delivered within 24 h of examination. In this group, MCA PI MoM was the best predictor of APO (AUC = 0.76, 95% CI 0.66-0.85,In a high-risk population of third-trimester fetuses delivering within 24 h of examination, the outcome may be moderately anticipated just with the information provided by the cerebral flow.
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- 2021
50. Author response: Disrupted PGR-B and ESR1 signaling underlies defective decidualization linked to severe preeclampsia
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Tamara Garrido-Gomez, Teresa Cordero, Irene Muñoz-Blat, Reyes Climent, Nerea Castillo-Marco, Carlos Simón, Alfredo Perales-Marín, Rogelio Monfort-Ortiz, Mónica Clemente-Ciscar, Alicia Amadoz, and Jorge Jimenez-Almazán
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Andrology ,business.industry ,Medicine ,Decidualization ,business ,Estrogen receptor alpha ,Severe preeclampsia - Published
- 2021
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