Merida Rodriguez-Lopez

• MD. MSc. PhD
• Professor at Icesi University

Cervical cancer remains a leading cause of mortality in its invasive stages, presenting a significant global public health challenge, particularly in low- and middle-income countries. Despite technological advancements that have improved the quality of cervical images captured during visual inspections, several challenges persist. This article pres...

Background The prevalence of teenage pregnancy in Colombia is higher than the worldwide average. The identification of socio-geographical disparities might help to prioritize public health interventions. Aim To describe variation in the probability of teenage maternity across geopolitical departments and socio-geographical intersectional strata in...

Objective Reducing maternal morbidity and mortality has been a challenge for low and middle-income countries, especially in the setting of hypertensive disorders of pregnancy. Improved strategies for treating obstetric patients with resistant hypertension are needed. We sought to explore whether hemodynamic parameters may be used to identify patien...

Aim This study aimed to assess the cardiometabolic sex similarities and differences in adults born small for gestational age. Methods This study was an ambispective cohort study from a birth registry in Barcelona, Spain, including 523 adult participants (20–40 years-old) subdivided as born small for gestational age (SGA, if birth weight <10th cent...

Background The intersection of artificial intelligence (AI) with cancer research is increasing, and many of the advances have focused on the analysis of cancer images. Objectives To describe and synthesize the literature on the diagnostic accuracy of AI in early imaging diagnosis of cervical cancer following Preferred Reporting Items for Systemati...

Preeclampsia is a hypertensive disorder that is usually diagnosed after 20 weeks’ gestation. Despite the deleterious effect of smoking on cardiovascular disease, it has been frequently reported that smoking has a protective effect on preeclampsia risk and biological explanations have been proposed. However, in this manuscript, we present multiple s...

Global cervical cancer incidence and mortality have remained a major public health problem. Depending on the quality and coverage of preventive programs, and the capacity of health care systems, different screening tests are used, with the Pap smear being the most widely implemented. Several difficulties have been reported in accessing timely detec...

Aims: Being born small for gestational age (SGA, 10% of all births) is associated with increased risk of cardiovascular mortality in adulthood together with lower exercise tolerance, but mechanistic pathways are unclear. Central obesity is known to worsen cardiovascular outcomes, but it is uncertain how it affects the heart in adults born SGA. We...

Background: Measuring multiple and higher-order interaction effects between multiple categorical variables proves challenging. Objectives: To illustrate a multilevel modelling approach to studying complex interactions. Methods: We apply a two-level random-intercept linear regression to a binary outcome for individuals (level-1) nested within s...

Background Being born small-for-gestational age (SGA, 10 percent of all births) is associated with increased risk of cardiovascular mortality (1,2) in adulthood together with lower exercise tolerance (3), but mechanistic pathways are unclear. Central obesity is known to worsen cardiovascular outcomes, but it is uncertain how it affects the heart in...

The diagnosis of cardiovascular illnesses uses multiple modalities in order to obtain a complete and as robust as possible assessment of the heart. However, when addressing distinct pathologies, not all information might be needed in order to achieve a confident-enough diagnosis.

Objectives: To determine the general contextual effect of the department in the variation of Cesarean section in Colombia in 2016, and their individual and contextual related factors. Methods: Cross-sectional study based on a birth cohort. We used the birth certificate database from January 1 to December 31, 2016. Three multilevel logistic models...

Background Healthcare Workers (HCW) are repeatedly exposed to SARS-CoV-2 infection. The aim of this study was to identify factors associated with SARS-CoV-2 infection among HCW in one of the largest cities in Colombia. Methods We conducted a case–control study, where cases had a positive reverse transcription-polymerase chain reaction and controls...

Importance: Being born small for gestational age (SGA), approximately 10% of all births, is associated with increased risk of cardiovascular mortality in adulthood, but mechanistic pathways are unclear. Cardiac remodeling and dysfunction occur in fetuses SGA and children born SGA, but it is uncertain whether and how these changes persist into adul...

Fetal growth restriction is one of the most common obstetric complications, affecting 7-10% of all pregnancies. Affected fetuses are exposed to an adverse environment in utero during a critical time of development and may face long-term health consequences such as increased cardiovascular risk in adulthood. Growth restricted fetuses develop remodel...

Background: Healthcare Workers (HCW) are repeatedly exposed to SARS-CoV-2 infection. The aim of this study was to identify factors associated with SARS-CoV-2 infection among HCW in one of the largest cities in Colombia. Methods: We conducted a case-control study, where cases had a positive reverse transcription-polymerase chain reaction and control...

Introduction Both echocardiography and CMR imaging are used to quantify longitudinal function. Inter‐method variability for mitral (MAPSE) and tricuspid (TAPSE) annular plane systolic excursion, and variability between directly measured MAPSE and TAPSE and as based on atrio‐ventricular plane displacement (AVPD) analysis by CMR, are however not know...

Background and aim The persistence of cardiovascular changes in fetal growth restriction (FGR) has been demonstrated from prenatal to preadolescent age, supporting the hypothesis of primary cardiac programming in FGR and the association between low birth weight and cardiovascular risk in adulthood. The aim was to follow-up the FGR cohort and explor...

Objective To describe a novel strategy, Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) to evaluate hospital performance, by analysing differences in 30-day mortality after a first-ever acute myocardial infarction (AMI) in Sweden. Design Cross-classified study. Setting 68 Swedish hospitals. Participants 43 24...

Objective: To construct nomograms for fetal cardiac, ventricular and atrial relative size and geometry using a low-risk population. Methods: Prospective cohort study including 602 low-risk singleton pregnancies undergoing a fetal echocardiography from 18 to 41 weeks of gestation to assess cardiac, atrial and ventricular relative size and spheric...

RESUMEN El COVID-19 ha impuesto grandes retos para los pacientes, las familias y el sistema de salud. A pesar de la pandemia, los problemas y enfermedades que afectan a la población se mantienen, y por ello los servicios preventivos para estos problemas deben adaptase a las condiciones actuales y brindarse en ambientes seguros. Uno de ellos es el p...

Aims: Endurance athletes develop cardiac remodeling to cope with increased cardiac output during exercise. This remodeling is both anatomical and functional and shows large interindividual variability. In this study, we quantify local geometric ventricular remodeling related to long-standing endurance training and assess its relationship with card...

Intrauterine growth restriction (IUGR) has been repeatedly identified as a risk factor for cardiovascular disease (CVD). A possible explanation for this association is the effect of IUGR on cardiovascular structure and function. However, the specific changes observed are not consistent among studies. In this paper, we analyze several sources of het...

Objectives: Fetal right ventricular (RV) function assessment is challenging due to the RV geometry and limitations of in utero assessment. Postnatally, 2D echocardiographic RV fractional area change (FAC) is used to assess RV global systolic function by calculating the percentage of change in RV area from systole to diastole. Reports on FAC are sc...

Objectives: Fetal right ventricular (RV) function assessment is challenging due to the RV geometry and limitations of in utero assessment. Postnatally, 2D echocardiographic RV fractional area change (FAC) is used to assess RV global systolic function by calculating the percentage of change in RV area from systole to diastole. Reports on FAC are sca...

Objective: There is a need for standardized reference values for cardiac dimensions in prenatal life. The objective of the present study was to construct nomograms for fetal cardiac dimensions using a well-defined echocardiographic methodology in a low-risk population. Methods: This is a prospective cohort study including 602 low-risk singleton...

Objective: To evaluate the transgenerational transmission of small for gestational age. Methods: Cohort study including a random sample of 2,043 offspring of deliveries occurring from 1975 to 1993. Of 623 offspring -now adults- that agreed to participate, 152 adults (72 born small-for-gestational age (SGA) and 80 with appropriate intrauterine gr...

30 Objective: to assess the postnatal persistence of fetal cardiovascular remodeling associated to 31 assisted reproductive technologies (ART), in children at 3 years of age. 32 Design: A cohort study of children conceived by ART. 33 Setting: Maternal-Fetal Medicine Unit, Hospital Clinic Barcelona, Spain. 34 Population sample: 80 singleton pregnanc...

Objective: to assess the postnatal persistence of fetal cardiovascular remodeling associated to assisted reproductive technologies (ART), in children at 3 years of age. Design: A cohort study of children conceived by ART. Setting: Maternal-Fetal Medicine Unit, Hospital Clinic Barcelona, Spain. Population sample: 80 singleton pregnancies conc...

Objective: M-mode and 2D have been proposed for evaluating fetal myocardial thickness. However, studies comparing the performance of both modalities are lacking. We aimed to compare 2D versus M-mode reproducibility for assessing myocardial wall thicknesses. Methods: A prospective study including 45 healthy fetuses from low-risk pregnancies evalu...

Aim: To compare macronutrient and fibre intake by pre-school children born with intra-uterine growth restriction (IUGR) or as appropriate for gestational age (AGA) and to compare their intake with paediatric nutritional recommendations for identification of potential areas of modification during early life. Methods: A parental 3-day dietary reco...

Background Preeclampsia (PE) is associated with a high risk of perinatal morbidity and mortality. However, there is no consensus in the definition of high-risk women. Aim To question current definition of high PE risk and propose a definition that considers individual heterogeneity to improves risk classification. Methods A stratified analysis by...

Discriminatory accuracy of specific bivariate combinations of risk factor for preeclampsia in the overall population of pregnancies without major risk factors. (DOCX)

Discriminatory accuracy of specific bivariate combinations of risk factor for preeclampsia in multiparous and primiparous pregnancies without major risk factors. (DOCX)

Characteristics of included and missing data among multiparous and primiparous women. (DOCX)

Bivariate interaction effect between parity and each risk factors in multiple logistic regression models. One interaction term was included in each model. Previous preeclampsia was considered a dummy variable with three categories: yes or no in multiparous and no applicable in primiparous. (DOCX)

Association between number of clinical risk factor and the risk of PE in both primiparous and multiparous adjusted by smoking, education and family situation. (DOCX)

Many cardiac diseases are associated with changes in ventricular shape. However, in daily practice, the heart is mostly assessed by 2D echocardiography only. While 3D techniques are available, they are rarely used. In this paper we analyze to which extent it is possible to obtain the 3D shape of a left ventricle (LV) using measurements from 2D echo...

Background: Recent data suggest that singleton fetuses conceived by assisted reproductive technologies (ART) present cardiovascular remodeling that may persist postnatally. Twin pregnancies are more frequent in the ART population, and are associated with increased adverse perinatal outcomes like hypertensive disorders, gestational diabetes and pre...

Background: Fetal growth restriction (FGR) affects 5% to 10% of newborns and is associated with increased cardiovascular mortality in adulthood. We evaluated whether prenatal cardiovascular changes previously demonstrated in FGR persist into preadolescence. Methods and results: A cohort study of 58 FGR (defined as birth weight below 10th centile...

Objectives: To compare the performance of a third trimester screening based on estimated fetal weight (EFW) versus a combined model composed by maternal baseline characteristics, mean arterial pressure (MAP), ultrasound and biochemical markers for the prediction of smallness for gestational age (SGA) and late-onset fetal growth restriction (FGR)....

Objective: To identify the presence of different cardiac phenotypes among FGR. Study design: Fetal echocardiography was performed in 126 FGR (defined as birth weight <10(th) centile) and 64 adequate for gestational age (AGA). Principal component and cluster analyses were performed to identify different cardiac phenotypes among FGR cases. Result...

Objective: To explore the potential value of third-trimester combined screening for the prediction of adverse perinatal outcome (APO) in the general population and among small-for-gestational-age (SGA) fetuses. Methods: This was a nested case-control study within a prospective cohort of 1590 singleton gestations undergoing third-trimester evalua...

Intrauterine Growth Restriction (IUGR) and premature birth are associated with higher risk of cardiovascular diseases throughout adulthood. The aim of this study was to evaluate the influence of these factors in ventricular electrical remodeling in preadolescents. Electrocardiography was performed in a cohort of 33-IUGR, 32-preterm with appropriate...

Objective: To evaluate the cardiac structure and function of the fetuses of pregnant women with Human Immunodeficiency Virus (HIV) infection on combined antiretroviral treatment (cART) and the HIV related and non-related determinants of abnormal findings. Design: A prospective cohort study including 42 non-infected fetuses from HIV pregnant wome...

Resumen Introducción y objetivos: El retraso del crecimiento intrauterino (RCIU) se asocia a un incremento de la mortalidad cardiovascular en la edad adulta. Se ha descrito que produce un remodelado específico en el corazón que persiste al menos hasta la infancia, pero los cambios que se producen sobre el sistema eléctrico cardiaco todavía se desco...

Background: Our aim was to determine the influence of breastfeeding and postnatal nutrition on cardiovascular remodeling induced by fetal growth restriction (FGR). Methods: A cohort study including 81 children with birthweight <10 centile (FGR) and 121 with adequate fetal growth (AGA). Cardiovascular end-points were left ventricular sphericity i...

Pre-adolescents who had suffered from intrauterine growth restriction (IUGR) during their mothers' pregnancy usually present more spherical hearts (smaller relation between base to apex measure and basal diameter), measured using echocardiograms, which has been associated with long-term cardiac disfunction. The present work aims to analyse these he...

Objetivo: determinar la prevalencia y los factores relacionados con la adherencia no farmacológica en pacientes con hipertensión arterial (HTA) y diabetes mellitus (DM). Metodología: estudio observacional transversal en pacientes adultos mayores de 35 años con diagnóstico de HTA o DM, atendidos en un programa de Renoprotección en cuidado primario e...

Background: Fetal growth restriction (FGR) is associated with global adverse cardiac remodeling in utero and increased cardiovascular mortality in adulthood. Prenatal myocardial deformation has not been evaluated in FGR to date. We aimed to evaluate prenatal cardiac remodeling comprehensively in FGR including myocardial deformation imaging. Metho...

La enfermedad de Paget de la mama es una manifestación cutánea infrecuente de cáncer de mama que tiene mejor pronóstico cuando se detecta de manera temprana. Se presenta el caso de una mujer de 56 años, que asistió a consulta en cuidado primario en la ciudad de Cali para la evaluación del resultado de una citología cérvico-uterina. Se le realizó ex...

Paget's disease of the breast is a rare cutaneous manifestation of breast cancer which has a better prognosis when detected early. We report the case of a 56 year-old woman who attended consultation in primary care in the city of Cali to evaluate the result of uterine cervical cytology. She underwent preventive breast exam and a descamative erythem...

Objective: a retrospective study was conducted on obese patients undergoing bariatric surgery in a health care institution in Cali, Colombia. The aim of this study was to describe two surgical procedures: sleeve and bypass, and the impacto weight loss, blood pressure, glomerular filtration rate and complications. Results: the sleeve procedure showe...

Objetivos. Se llevó a cabo un estudio retrospectivo con todos los pacientes sometidos a cirugía bariátrica en una institución de salud del régimen contributivo en la ciudad de Cali, con el objetivo de describir dos procedimientos quirúrgicos: la manga gástrica y la derivación gástrica por laparoscopia, en cuanto al control de peso, la tensión arter...

Methodology: Cross sectional. The most frequent mental disorders in hyper-frequent patients were detected through a telephone interview which included several modules of the PRIME MD instrument. Results: In general, healthcare service hyper-frequenters are working women, 38,7-year old in average. Basically, the consultation is due to cephalalgia...

Objetivo: Conocer los trastornos mentales más frecuentes y el impacto en la percepción de discapacidad e ideación suicida en una Institución prestadora de servicios de salud de baja complejidad en Cali. Metodología: Se realizó un estudio transversal con 254 pacientes a los que se les aplicó el instrumento PRIME-MD. En el análisis se utilizó estadís...

Hyper-frequentation in health services is a problem for patients, their families and the institutions. This study is aimed at deter-mining the frequency and characteristics of common mental disorders in hyper-frequent patients showing vague symptoms and signs at a primary healthcare service during the year 2007 in the city of Cali (Colombia). Metho...

OBJETIVO: conocer los trastornos mentales más frecuentes y el impacto en la percepción de discapacidad e ideación suicida en una Institución prestadora de servicios de salud de baja complejidad en Cali.METODOLOGIA: se realizó un estudio transversal con 254 pacientes a los que se les aplicó el instrumento PRIME–MD. En el análisis se utilizó estadíst...

This article is a literature review on frequent-attenders in health services. The current study objective was to analyze the problem for patients, families and health system and its potential related factors. A search in national and international journals was conducted to find a definition criteria for detection and to analyze the factors that may...