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------=_NextPart_01C64EA7.0CA235E0 Content-Location: file:///C:/2A09C636/Eclampsia_Villar_2006_files/pres.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C64EA7.0CA235E0 Content-Location: file:///C:/2A09C636/Eclampsia_Villar_2006_files/slide0158.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" Pre-eclampsia-Eclampsia: an unresolved problem for over 2 millennia - José Villar
3D"Text
JV Vienna Preecl / ecl 1  rev. 09 Nov 04
Pre-eclampsia-Eclampsia : an unresolved problem for ove= r 2 millennia

José Villar

Training in Reproductive Health Research
Geneva, March 2006<= /span> <= br>

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3D"Text
JV Vienna Preecl / ecl = 2  rev. 09 Nov 04
Hypertension in pregnancy

The= extent of the problem worldwide
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3D"Text
JV Vienna Preecl / ecl = 3  rev. 09 Nov 04
The 2005 WHO Global  Survey
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unresolved problem for over 2 millennia - José Villar
3D"Text
JV Vienna Preecl / ecl = 4  rev. 09 Nov 04
35 countries in America Region
11 countries randomly selected
Argentina, Brazil, Cuba, Ecuador, México,
Nicaragua, Paraguay and Perú
(24 geographic units covering the Capital city and 2 randomly selected provinces in each country)
Canada and USA
did not started
recruitment
Haiti did not
participate
410 facilities identified in 23 geographic un= its
(more than 1000 deliveries/year)
1 Province in Paraguay did not
have facilities with more than
1000 deliveries/year <= /span>
123 facilities randomly selected
3 facilities refus= ed
to participate
120 facilities collected information
4 facilities with restricted recruit= ment period
due to logistic  problems.= 3;
106546 deliveries
during study period
(independent sources)
97095 deliveries recorded
(91% coverage)
Latin America: Flow Chart
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3D"Text
JV Vienna Preecl / ecl = 5  rev. 09 Nov 04
Latin A= merica
Africa<= /span>
12.8
5.9
Any of above conditions = (%)
1.4
0.5
Chronic hypertension (%)
4.9
2.6
Hypertension (%)
(without proteinuria)
0.3
0.4
Eclampsia (%)
6.2
2.4
Preeclampsia (%)
97,095
76,971
Women surveyed (3 months period)
122
119
Number of hospitals <= span lang=3DEN-GB style=3D'font-size:67%'>randomly selected
8
7
Number of countries = randomly selected
Villar et al, 2005
Hypertensive disorders of pregnancy
 WHO Global Survey , April 2005
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JV Vienna Preecl / ecl = 6  rev. 09 Nov 04
SCREENING<= span style=3D'mso-special-format:lastCR;display:none'>
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3D"Text
JV Vienna Preecl / ecl = 7  rev. 09 Nov 04
=
•
•<= span lang=3DEN-GB style=3D'font-size:114%;display:none'>
•<= span lang=3DEN-GB style=3D'font-size:114%;display:none'>
•<= span lang=3DEN-GB style=3D'font-size:114%;display:none'>
•<= span lang=3DEN-GB style=3D'font-size:86%;text-shadow:none'>(Conde-Agudelo A,= Villar J, Lindheimer MD                  = Obstet and Gynecol 2004;104:1367-1391)
WHO systematic review of screening for  pre-eclampsia
------=_NextPart_01C64EA7.0CA235E0 Content-Location: file:///C:/2A09C636/Eclampsia_Villar_2006_files/master03_image008.png Content-Transfer-Encoding: base64 Content-Type: image/png iVBORw0KGgoAAAANSUhEUgAAAA4AAACYAQMAAADuuUrMAAAAAXNSR0ICQMB9xQAAAAZQTFRFAAAA AAAApWe5zwAAAAF0Uk5TAEDm2GYAAAAJcEhZcwAACDYAAAg0Ab6QHjwAAAAZdEVYdFNvZnR3YXJl AE1pY3Jvc29mdCBPZmZpY2V/7TVxAAAAZ0lEQVQoz8VPQQ7AIAir7mM8zaf5tLUNYVOTXddgQ5BC AX7EwDXMEz2cG41vihs5xGxQG5wYkrAeuxZxTHAAyYWOl8oDtYsxFlX9frRtW+QTi9ts8C2PK+xy WuJYeEKZrIrcRh544AbBoid2YfTKTwAAAABJRU5ErkJggk== ------=_NextPart_01C64EA7.0CA235E0 Content-Location: file:///C:/2A09C636/Eclampsia_Villar_2006_files/slide0120.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" Pre-eclampsia-Eclampsia: an unresolved problem for over 2 millennia - José Villar
3D"Text
JV Vienna Preecl / ecl = 8  rev. 09 Nov 04
•We cons= idered all cohort or cross-sectional studies= of tests to predict preeclampsia  = 3;
•
<= span class=3DBB style=3D'position:absolute;left:-4.01%'>•7,191 relevant articles → 87 studies included
------=_NextPart_01C64EA7.0CA235E0 Content-Location: file:///C:/2A09C636/Eclampsia_Villar_2006_files/master03_image009.png Content-Transfer-Encoding: base64 Content-Type: image/png iVBORw0KGgoAAAANSUhEUgAAAA4AAACYAQMAAADuuUrMAAAAAXNSR0ICQMB9xQAAAAZQTFRFAAAA AAAApWe5zwAAAAF0Uk5TAEDm2GYAAAAJcEhZcwAACDYAAAg0Ab6QHjwAAAAZdEVYdFNvZnR3YXJl AE1pY3Jvc29mdCBPZmZpY2V/7TVxAAAAZklEQVQoz8VP2w0AIQiruhijMZqjSXvGU0zu9xpsCLY8 gB/haC7uqKZcKPE6uQQbOQSUQYlAS9Qte2FXBwUweaHJXreGnBXhh2v9fsjSFO6JY9sp0C3vVsj2 CraFOjzYK7zR5oEXBsCPKLnrC1sUAAAAAElFTkSuQmCC ------=_NextPart_01C64EA7.0CA235E0 Content-Location: file:///C:/2A09C636/Eclampsia_Villar_2006_files/slide0027.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" Pre-eclampsia-Eclampsia: an unresolved problem for over 2 millennia - José Villar
3D"Text
JV Vienna Preecl / ecl = 9  rev. 09 Nov 04
Abnor= mal wave form ratio in low-risk women
Conde-Agudelo A ,Villar J, Lindheimer M, Obstet and Gynecol  2004
WHO systematic review of screening for
preeclampsia
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JV Vienna Preecl / ecl = 10<= /span>  rev. 09 Nov 04
Summary of the re= view
•There is no clinically useful screening test to predict   preeclampsia
<= span style=3D'font-size:86%;visibility:hidden'>•
<= span style=3D'font-size:86%'>• Promising :
•<= span style=3D'font-size:86%'> Combinations of tests: e.g., plasminogen activator inhibitor  [PAI-1/PAI-2] ratio = 3;
•<= span style=3D'font-size:86%'>                           + leptin = ;
•<= span style=3D'font-size:86%'>                           + placental g= rowth factor [PlGF])
•<= span style=3D'font-size:86%;display:none'>
•<= span style=3D'font-size:86%'> Reduced first trimester of PlGF and increases in its soluble inhibitor, fms-like tyrosine kinase  (sFlt-1)
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3D"Text
JV Vienna Preecl / ecl = 11<= /span>  rev. 09 Nov 04
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3D"Text
JV Vienna Preecl / ecl = 12<= /span>  rev. 09 Nov 04
<= /span>
Citat= ions excluded n =3D 154 <= /div>
Primary articles regarding sFlt-1= and pre-eclampsia n =3D 19 <= /div>
=
11 Articles excluded :
Lack of original data, reviews , letters, commentaries , sFlt-1 levels in cord blood, placental samples , samples at PE diagnosis or delivery  duplicate data .
Prima= ry articles included in systematic review: n =3D 8
sFlt-= 1:       Total citations identified :  n =3D 173
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3D"Text
JV Vienna Preecl / ecl = 13<= /span>  rev. 09 Nov 04
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JV Vienna Preecl / ecl = 14<= /span>  rev. 09 Nov 04
PREVENTION
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JV Vienna Preecl / ecl = 15<= /span>  rev. 09 Nov 04
Prevention of pre-eclampsia:  Nutrition
•Systematic reviews of R.C.T.s
• - increase protein or energy intake
• - restrict protein or energy for obese women
• - supplementing iron, folate, Mg, Zn, fish oil
• - restricting salt intake
• unlikely to be beneficial
•
•
•Promising:  Vitamin E and C (=   one trial completed ,2 <= span style=3D'position:absolute;top:72.25%;left:13.1%;width:80.89%;height:5.25%= '>ongoing )
•
•Calcium:   WHO trial completed   (N =3D 8,325 women)
Ref.  Villar J et al. J. Nutrition 2003;133:= 15-205
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JV Vienna Preecl / ecl = 16<= /span>  rev. 09 Nov 04
WHO Randomized controlled trial of calcium supplementation for = the prevention of preeclampsia = among low calcium intake women<= span lang=3DES-MODERN style=3D'color:purple;mso-special-format:lastCR;display:n= one'>
Villar J, Abdel-Aleem H, Merialdi M, Mathai M, Ali M, Zavaleta N, Purwar M, Hofmeyr GJ, Ngoc NTN, Campódonico L ,= Landoulsi S,  Carroli G and Lindheimer MD on behalf of the WHO Calcium Supplementation for t= he Prevention of Preeclampsia Trial Group ( AJOG , 2006 )
------=_NextPart_01C64EA7.0CA235E0 Content-Location: file:///C:/2A09C636/Eclampsia_Villar_2006_files/master03_image021.png Content-Transfer-Encoding: base64 Content-Type: image/png iVBORw0KGgoAAAANSUhEUgAAAA4AAACYAQMAAADuuUrMAAAAAXNSR0ICQMB9xQAAAAZQTFRFAAAA AAAApWe5zwAAAAF0Uk5TAEDm2GYAAAAJcEhZcwAACDYAAAg0Ab6QHjwAAAAZdEVYdFNvZnR3YXJl AE1pY3Jvc29mdCBPZmZpY2V/7TVxAAAAaElEQVQoz71P2w0AIQiruhijMZqjHa1ET03u8xpsCLY8 gP/haC7uqKZcKPE6uQQbOQSUQYlAS9Tt9MKuDgogeaINu4zLrjqHRvhmn78fsmMcF8a2dgp01FoP p72CbaEOA+8Kt7W89MIDiz8o/YftS0kAAAAASUVORK5CYIJ= ------=_NextPart_01C64EA7.0CA235E0 Content-Location: file:///C:/2A09C636/Eclampsia_Villar_2006_files/slide0163.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" Pre-eclampsia-Eclampsia: an unresolved problem for over 2 millennia - José Villar
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JV Vienna Preecl / ecl = 17<= /span>  rev. 09 Nov 04
=
Individual clinical screening
< 20 weeks of gestation=
Calcium <= span style=3D'position:absolute;top:31.5%;left:37.26%;width:12.73%;height:4.0%'= >1500 mg <= span style=3D'position:absolute;top:35.5%;left:37.26%;width:12.73%;height:4.0%'= >(day)
Placebo
Follow up until
hospital discharge after delivery
Pre-eclampsia
preterm delivery
Maternal and perinatal mortality secondary outcomes=
R
A
N
D
O
M
I
Z
A
T
I
O
N
Baseline = nutritional survey at = clinic level
Follow up until
hospital discharge after delivery
Pre-eclampsia
Preterm delivery
Maternal and perinatal mortality Secondary outcomes=
Study design and p= atient flow
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JV Vienna Preecl / ecl = 18<= /span>  rev. 09 Nov 04
Trial Profile
8= 325 women randomized
4= 157 Women Calcium Group
 4168 Women Placebo Grou= p
4008 available for anal= ysis of preterm delivery
4151 available for analysis of preeclampsia (at least 1 ANC visit)
143 Lost to follow up -= no delivery information (3.4%)
    1= 4362 women screened <= /span>
  = 8788 eligible women <= /span>
4 Not pregnant /2 only
trial admission form
4006 available for anal= ysis of preterm delivery
4161 available for analysis of preeclampsia (at least 1 ANC visit)
155 Lost to follow up -= no delivery information (3.7= %)
5 Not pregnant /2 only
trial admission form
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JV Vienna Preecl / ecl = 19<= /span>  rev. 09 Nov 04
Cumulative risk for women in the calcium and placebo groups for pre-eclampsia-eclampsia according to week of gestation.
At 35 weeks  (p =3D 0.04).
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charset="windows-1252" Pre-eclampsia-Eclampsia: an unresolved problem for over 2 millennia - José Villar
3D"Text
JV Vienna Preecl / ecl = 20<= /span>  rev. 09 Nov 04
Cumulative risk for women in the calcium and placebo groups for severe preeclamptic complications according to week of gestation.
(log rank test comparing both curves p =3D 0.04)
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Pre-eclampsia-Eclampsia: an unresolved problem for over 2 millennia - José Villar
3D"Text
JV Vienna Preecl / ecl = 21<= /span>  rev. 09 Nov 04
Preterm delivery according to treatment  and maternal age 
The denominators include multiple births.
All risk ratios and 95% Confidence Intervals are adjusted by centre effect.
0.68 - 1.28
0.93
77/2638
72/2638
Early preterm delivery (<32 ws)
0.83 - 1.15
0.97
256/2638
250/2638
Preterm delivery (<37 ws)
Women >20 years
0.42 - 0.98
0.64
53/1404
34/1400
Early preterm delivery (<32 ws)
0.67 - 1.01
0.82
180/1404
148/1400
Preterm delivery (<37 ws)
Women ≤20 years
0.71 - 0.93
0.82
130/4042
106/4038
Early preterm delivery (<32 ws)
0.79 - 1.05
0.91
436/4042
398/4038
Preterm delivery (<37 ws)
Total population
95% Confidence
Interval
Risk Ratio
Placebo n/N
Calcium n/N
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3D"Text
JV Vienna Preecl / ecl = 22<= /span>  rev. 09 Nov 04
Severe morbidity and mortality according to treatment group
0.57-1.21
0.83
37/4161
31/4151
= Maternal admission ≥= 2 days
      All risk ratios and 95% Confidence Intervals adjusted by centre effect.  Maternal outcomes are also adjusted by maternal body = mass index.
(*)  At least one of the following:  Admis= sion to Intensive Care or any special care unit, eclampsia, severe preeclampsia ,
     placental abruption, HELLP, renal failure or death.
0.56 - 0.88
0.70
53/3956
37/3953
Neonatal mortality
0.74 - 1.17
0.93
113/4197
105/4181
Stillbirth
0.70 - 0.91
0.80
209/4161
167/4151
= Severe maternal morbidity and mortality index = (*)
0.03 - 0.76
0.17
6/4161
1/4151
= Maternal death
0.75 - 0.95
0.85
138/4161
116/4151
= = Maternal admission to intensive care any special care unit
95% Confidence
Interval&#= 13;
Risk = Ratio <= /div>
Placebo
n/N&#= 13;
Calcium
n/N&#= 13;
&#= 13;
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3D"Text
JV Vienna Preecl / ecl = 23<= /span>  rev. 09 Nov 04
Cumulat= ive risk of neonatal mortality, by tre= atment group
Cox regression model
p =3D0.02*
Adjusted for cluste= ring on centre
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Content-Location: file:///C:/2A09C636/Eclampsia_Villar_2006_files/slide0169.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" Pre-eclampsia-Eclampsia: an unresolved problem for over 2 millennia - José Villar
3D"Text
JV Vienna Preecl / ecl = 24<= /span>  rev. 09 Nov 04
Conclusions
• Supplementation with 1= .5 gm Ca/day did not reduce = the overall incidence of pree= clampsia, however it decreased the risk for its more serious complications, including maternal and neonatal morbi= dity and mortality, as well as preterm delivery among young women.
•<= span style=3D'mso-spacerun:yes'>  
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JV Vienna Preecl / ecl = 25<= /span>  rev. 09 Nov 04
ETIOLOGY
------=_NextPart_01C64EA7.0CA235E0 Content-Location: file:///C:/2A09C636/Eclampsia_Villar_2006_files/master03_image033.png Content-Transfer-Encoding: base64 Content-Type: image/png iVBORw0KGgoAAAANSUhEUgAAAA4AAACYAQMAAADuuUrMAAAAAXNSR0ICQMB9xQAAAAZQTFRFAAAA AAAApWe5zwAAAAF0Uk5TAEDm2GYAAAAJcEhZcwAACDYAAAg0Ab6QHjwAAAAZdEVYdFNvZnR3YXJl AE1pY3Jvc29mdCBPZmZpY2V/7TVxAAAAaUlEQVQoz71PQQ7AIAgr7mM8jaf5tNHOOMVkxzXaEGwr AP8jcIW4o7lqwfJ2siU7OQWUQYVAS/a9euFHgg4weMJkz/zkppCZbOpbbPb5+iEr33FgbGMPgZZ6 x0O1NzAWSniwdrisj00P3O6eKX1cDuivAAAAAElFTkSuQmCC ------=_NextPart_01C64EA7.0CA235E0 Content-Location: file:///C:/2A09C636/Eclampsia_Villar_2006_files/slide0111.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" Pre-eclampsia-Eclampsia: an unresolved problem for over 2 millennia - José Villar
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JV Vienna Preecl / ecl = 26<= /span>  rev. 09 Nov 04
Are preeclampsia and gestational hypert= ension different entities ?       =
•Risk Factors
•
•Pregnancy outcomes =
•
•
•Vil= lar J et al AJOG 2006 (in press)
Analyses ba= sed on data from the WHO Antenatal Care trial :
 Lancet 2001 and  et al Obstet & Gynecol 2004   =
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JV Vienna Preecl / ecl = 27<= /span>  rev. 09 Nov 04
Preeclampsia
n =3D 874
Re= ference
Group
n =3D 31273
Gestational
Hypertension
n =3D 2748
IUGR
no pre-eclampsia
no Gestation= al HTA
n =3D 4720
Total Pregnant
Population&#= 13;
n =3D 41751
Analysis
Population&#= 13;
n =3D 39615
Abortions
n =3D 929
Lost to Follow Up
or Not Pregnant
n =3D 741
Congenital
malformation
n =3D 466
Preeclampsia versus Gestational Hypertension
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JV Vienna Preecl / ecl = 28<= /span>  rev. 09 Nov 04
1.4 (1.1 – 1.7)
1.0 (0.6 – 1.5)
Haemorrhage 1st / 2nd trimester
Gestational HTA
(n = =3D 2748)
Preeclampsia
 (n =3D 87= 4)
0.8 (0.6 – 0.9)
1.0 (0.7 – 1.5)
1.4 (1.1 – 1.7)
1.0 (0.7 – 1.5)
12.7 (10.0 – 16.2)
2.7 (1.2 – 6.5)
2.4 (1.5 – 3.6)
OR* (95% CI)
1.3 (1.2 – 1.5)
Reproductive Tract Infection
2.2 (1.8 – 2.6)  =
Reproductive Tract Surgery
1.3 (1.2 – 1.5)
Urinary Tract Infection
1.0 (0.8 – 1.3)
Spontaneous Abortions (> 2)
9.4 (7.8 – 11.2)
Pre-eclampsia last Pregnancy
0.9 (0.4 – 2.1)
Chronic Respiratory conditions
2.7 (2.1 – 3.5)
Diabetes / Renal / Cardiac
OR* (95% CI)
* Adjusted OR, compared with referen= ce population (n =3D 31273)
ü <= /div>
ü
ü
ü
ü
ü
ü
ü
ü <= /div>
ü
ü
ü <= /div>
Risk Factors for Preeclampsia and Gestational
Hype= rtension as compared to the Reference Population
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JV Vienna Preecl / ecl = 29<= /span>  rev. 09 Nov 04
3.0 (2.4 – 3.9)
2.8 (1.7 – 4.5)
Maternal Age (> 40 years-old)
1.2 (1.1 – 1.3)
2.2 (1.9 – 2.5)
Primiparous
1.3 (1.1 – 1.6)
1.4 (1.0 – 1.9)
Maternal Age (< 16 years-old)
Gestational HTA
 (n =3D 2748)
Preeclampsia       (n =3D 874)
 
0.9 (0.5 – 1.7)
1.3 (0.9 – 1.9)
2.7 (2.3 – 3.2)  =    
OR* (95% CI)
1.7 (1.3 – 2.2)
Previous High Weight Babies
1.4 (1.1 – 1.7)
Low BW in Last Pregnancy
2.8 (2.5 – 3.1)
Obesity (BMI > 30)
OR* (95% CI)
* Adjusted OR, compared with referen= ce population (n =3D 31273)
ü <= /div>
ü
ü
ü
ü
ü
ü
ü <= /div>
ü <= /div>
Risk Factors for Preeclampsia and Gestational
Hypertension as c= ompared to the Reference Population
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JV Vienna Preecl / ecl = 30<= /span>  rev. 09 Nov 04
Are they differen= t ?
•
•
•Preeclampsia : Primiparous ; Chronic respira= tory conditions ?
•
•Gestational Hypertension : Reproductive patholo= gy, haemorrhage and reproductive infecti= ons ? 
•<= span style=3D'mso-special-format:lastCR;display:none'>
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JV Vienna Preecl / ecl = 31<= /span>  rev. 09 Nov 04
OR (95% CI)
=
=
Neonatal Death
2.1 (1.7 – 2.4)
6.0 (5.0 – 7.3)
Crude
1.2 (1.0 – 1.5)
1.5 (1.2 – 2.0)
Adjusted *
=
=
1.8 (1.0 – 3.3)
1.4 (0.9 – 2.3)
Gestational HTA            (n =3D 2748)
4.6 (2.9 – 7.4)
Crude
Adjusted *
NICU Stay 7 or more days
Preeclampsia           (n =3D 874)
0.9 (0.5 – 1.8)
OR (95% CI)
* OR adjusted by country, treatment, birth weight and socioeconomic status <= /div>
Perinatal Outcomes for Preeclampsia and Gestational
Hypertension as c= ompared to the Reference Population
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JV Vienna Preecl / ecl = 32<= /span>  rev. 09 Nov 04
WHO systematic review of the      theories of preeclampsia:

The role of homocysteine

Mignini, L. et al, Obstet Gynecol 2005;105:411-425
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JV Vienna Preecl / ecl = 33<= /span>  rev. 09 Nov 04
Citat= ions excluded n =3D 34 <= /div>
Prima= ry articles regarding homocysteine and preec= lampsia n =3D 67 <= /span>
=
Artic= les excluded :
Lack of original data reviews, letters, comments, duplicate data
Prima= ry articles included in systematic review: n =3D 25
Total citations identified :  n =3D 101<= /b>
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JV Vienna Preecl / ecl = 34<= /span>  rev. 09 Nov 04
Strength
Consistency ?
Temporality
WMD [95= % CI]
Follow = up Studies= 3;
      
          
        
<= /div>
      
        
<= /div>
Subtotal (fixed effect model, P < .001)
0.68 [0= .40, 0.96]= 3;
= 3;
P =3D .12, I2 =3D 38= .8 %
Weighted mean difference, µmol/L
<= /div>
Homocys= teine
Lower <= /b>
Higher =
=
Review of the association between = hyperhomocysteinemia and preeclampsia
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3D"Text
JV Vienna Preecl / ecl = 35<= /span>  rev. 09 Nov 04
SMD [95= % CI]
Standard m= ean difference= 3;
    
Endothe= lial dysfunction= 3;
Lower  in
preeclampsia
Higher in
preeclampsia
Oxidati= ve stress= 3;
Concent= rations
= 3;
       
       
      
       
       
Oxidative stress and endothelial dysfunction
among women with and witho= ut preeclampsia = ;
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3D"Text
JV Vienna Preecl / ecl = 36<= /span>  rev. 09 Nov 04
HOMOC= YSTEINE
High
Levels
PREEC= LAMPSIA
High
Levels
Prote= inuria - Hypertension
High
Levels
↓ Folate
↓ Vitamin B12
MTHFR mutation
↓ Vitamin B6
CBS mutation
High
Level= s
↓ Folate
↓ Vitamin B12
MTHFR mutation
↓ Vitamin B6
CBS mutation
Endothelial
Dysfunction
Oxidative
Stress
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3D"Text
JV Vienna Preecl / ecl = 37<= /span>  rev. 09 Nov 04
Years
3D"Text
N. of citations&#= 13;
Mignini L, Villar J, Khan KS. Mapping the theories of preeclampsia: The need for systematic reviews of mechanisms of the disease= . Am J Obstet Gynecol 2005
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3D"Text
JV Vienna Preecl / ecl = 38<= /span>  rev. 09 Nov 04
Mapping the theories of pre-eclampsia:

The need for systematic reviews of mechanisms of the disease

Mignini, L. Villar, J. Khan ,K. Am. J. Obstet–Gynecol = (= 2006) =
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3D"Text
JV Vienna Preecl / ecl = 39<= /span>  rev. 09 Nov 04
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JV Vienna Preecl / ecl = 40<= /span>  rev. 09 Nov 04
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gCurSld ).mNtsHref ) } function UpdNavPane( sldIndex ){ if(gNavLoaded) PPTNav.UpdNav() } function UpdOtNavPane(){ if(gOtlNavLoaded) PPTOtlNav.UpdOtlNav() } function UpdOtlPane(){ if(gOtlLoaded) PPTOtl.UpdOtl() } function SetHasNts( fVal ) { if( gHasNts !=3D fVal ) { gHasNts=3DfVal UpdNavPane() } } function ToggleOtlText() { gOtlTxtExp=3D!gOtlTxtExp UpdOtlPane() } function ClearMedia() { // Clear any sounds playing before launching another browser window. Other= wise, // in fullscreen mode, you'll continue to hear the sound in the frames mod= e. if (PPTSld.pptSound) PPTSld.pptSound.loop =3D 0; } function FullScreen() {=20 if ( PPTSld.g_animUseRuntime ) PPTSld.document.body.pause(); ClearMedia(); var href =3D ( document.location.protocol =3D=3D 'mhtml:') ? FULLSCR_HREF = : FULLSCR_HREF+"#"+GetHrefObj(gCurSld).mSldHref; if(PPTNav.event.ctrlKey) { var w =3D (window.screen.availWidth * 1.0) / 2.0 var h =3D w * (PPTSld.g_origH * 1.0) / PPTSld.g_origW win =3D window.open( MHTMLPrefix+href,null,"toolbar=3D0,resizable=3D1,top= =3D0,left=3D0," + "width=3D"+ w + ",height=3D" + h ); if( win.document.body && PPTSld.g_animUseRuntime ) win.document.body.PPTSldFrameset=3Dwindow; } else { win =3D window.open( MHTMLPrefix+href,null,"fullscreen=3Dyes" ); if( win.document.body && PPTSld.g_animUseRuntime ) win.document.body.PPTSldFrameset=3Dwindow; } } function ToggleVNarration() { rObj=3DPPTSld.document.all("NSPlay") if( rObj && !PPTSld.g_animUseRuntime ) { if( (rObj.playState =3D=3D 1)||(rObj.playState =3D=3D 0) ) rObj.Play() else if( rObj.playState =3D=3D 2 ) rObj.Pause() else return; } else if( PPTSld.g_animUseRuntime ) { narObj =3D PPTSld.document.all("narrationID") if( narObj ) narObj.togglePause() } } function GetCurSldNum() { =20 obj=3DGetHrefObj(gCurSld) if( obj.mOrigVis =3D=3D 1 ) return obj.mSldIdx else =20 return gCurSld } function GetNumSlds() { =20 if( GetHrefObj(gCurSld).mOrigVis =3D=3D 1 ) return GetSldList().mNumVisSlds; else return GetSldList().mList.length } function GetSldNum( href ) { for(ii=3D0; ii 1 ) PopSldList(); else if( !IsFramesMode() ) { if( gLoopCont ) GoToFirst() else EndShow() } } function GoToPrevSld() { ii=3DgCurSld-1 if( ii > 0 ) { obj=3DGetHrefObj(ii) while ( obj && ( obj.mVis =3D=3D 0 ) && ( ii>0 ) ) obj=3DGetHrefObj(--ii) if( ii =3D=3D 0 ) ii=3D1 GoToSldNum(ii) } } function GoToFirst(){ GoToSld( GetHrefObj(1).mSldHref ) } function GoToLast() { ii=3DGetSldList().mList.length if( ii !=3D gCurSld ) GoToSld( GetHrefObj(ii).mSldHref ) } function GoToSldNum( num ) { if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue obj =3D GetHrefObj( num ) obj.mVis=3D1 gPrevSld=3DgCurSld gCurSld =3D num; PPTSld.location.replace(MHTMLPrefix+obj.mSldHref) if( IsFramesMode() ) { UpdNavPane(); UpdOtlPane(); UpdNtsPane() } } function GoToSld( href ) { if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue GetHrefObj( GetSldNum(href) ).mVis=3D1 PPTSld.location.replace(MHTMLPrefix+href) } function SldUpdated( id ) { if( id =3D=3D GetHrefObj(gCurSld).mSldHref ) return gPrevSld=3DgCurSld gCurSld=3DGetSldNum(id) if( IsFramesMode() ) { UpdNavPane(); UpdOtlPane(); UpdNtsPane() } } function PrevSldViewed(){ GoToSld( GetHrefObj(gPrevSld).mSldHref ) } function HasPrevSld() { return ( gIsEndShow || ( gCurSld !=3D 1 && GetHrefO= bj( gCurSld-1 ).mVis =3D=3D 1 )||( GetCurSldNum() > 1 ) ) } function HasNextSld() { return (GetCurSldNum() !=3D GetNumSlds()) } function CloseWindow() { if( HideMenu() ) return; =09 var event =3D PPTSld.event; if( !IsFramesMode() && event && (event.keyCode=3D=3D27 || event.keyCode=3D= =3D32 || event.type=3D=3D"click" ) ) window.close( self ); CatchNumKeys( self, event ); } function Unload() { gIsEndShow=3D0; } function SetupEndShow() { gIsEndShow=3D1; PPTSld.document.body.scroll=3D"no"; PPTSld.document.onkeypress=3DCloseWindow; PPTSld.document.onclick=3DCloseWindow; PPTSld.document.oncontextmenu=3D_CM; } function EndShow() { if( IsFramesMode() ) return if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue doc=3DPPTSld.document var dir =3D doc.body.dir if( dir !=3D "rtl" ) dir =3D "ltr"; doc.open() doc.writeln('


' + ENDSHOW_MESG + '

') doc.close() } function SetSldVisited(){ GetSldList().mList[gCurSld-1].mVisited=3Dtrue } function IsSldVisited(){ return GetSldList().mList[gCurSld-1].mVisited } function hrefList( sldHref, visible, advDelay, advClk ) { this.mSldHref=3D this.mNtsHref =3D sldHref this.mOrigVis=3D this.mVis =3D visible this.mVisited=3D false this.mAdvDelay=3D advDelay this.mAdvOnClk=3D advClk } function SldList(arr,curSld,fEnd) { this.mCurSld =3D curSld; this.mList =3D new Array(); var idx =3D 1; for(ii=3D0;ii 0) { PushSldList(sldList,fEnd); gCurSld =3D 1; } else if( PPTSld.event ) PPTSld.event.cancelBubble=3Dtrue } function PushSldList(arr,fEnd) { var ii =3D gSldStack.length; gSldStack[ii] =3D new SldList(arr,gCurSld,fEnd); GoToSld( gSldStack[ii].mList[0].mSldHref ); } function PopSldList() { if (gSldStack[gSldStack.length-1].fEndShow) EndShow() else { gCurSld =3D gSldStack[gSldStack.length-1].mCurSld; gSldStack[gSldStack.length-1] =3D null; gSldStack.length--; var sldList =3D gSldStack[gSldStack.length-1]; GoToSld( sldList.mList[gCurSld - 1].mSldHref ); } } var custShowList=3Dnew Array(); /********************************************* Navigation button implementation There are 2 types of buttons: ImgBtn, TxtBtn implemented as function objects. They share a similiar interface so the event handlers can call SetActive, for example, on a button=20 object without needing to know exactly=20 what type of button it is. **********************************************/ //---------------------------------- function ImgBtn( oId,bId,w,action ) //---------------------------------- { var t=3Dthis t.Perform =3D _IBP t.SetActive =3D _IBSetA t.SetInactive=3D _IBSetI t.SetPressed =3D _IBSetP t.SetDisabled=3D _IBSetD t.Enabled =3D _IBSetE t.ChangeIcon =3D null t.UserAction =3D action t.ChgState =3D _IBUI t.mObjId =3D oId t.mBorderId=3D bId t.mWidth =3D w t.mIsOn =3D t.mCurState =3D 0 } function _IBSetA() { if( this.mIsOn ) { obj=3Dthis.ChgState( gHiliteClr,gShadowClr,2 ) obj.style.posTop=3D0 } } function _IBSetI() { if( this.mIsOn ) { obj=3Dthis.ChgState( gFaceClr,gFaceClr,1 ) obj.style.posTop=3D0=20 } } function _IBSetP() { if( this.mIsOn ) { obj=3Dthis.ChgState( gShadowClr,gHiliteClr,2 ) obj.style.posLeft+=3D1; obj.style.posTop+=3D1 } } function _IBSetD() { =20 obj=3Dthis.ChgState( gFaceClr,gFaceClr,0 ) obj.style.posTop=3D0=20 } function _IBSetE( state ) { var t=3Dthis GetObj( t.mBorderId ).style.visibility=3D"visible" if( state !=3D t.mIsOn ) { t.mIsOn=3Dstate if( state ) t.SetInactive() else t.SetDisabled() } } function _IBP() { var t=3Dthis if( t.mIsOn ) { if( t.UserAction !=3D null ) t.UserAction() if( t.ChangeIcon ) { obj=3DGetObj(t.mObjId) if( t.ChangeIcon() ) obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-4)*t.mWidth else obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-0)*t.mWidth } t.SetActive() } =20 } function _IBUI( clr1,clr2,nextState ) { var t=3Dthis SetBorder( GetObj( t.mBorderId ),clr1,clr2 ) obj=3DGetObj( t.mObjId ) obj.style.posLeft=3Dobj.style.posLeft+(t.mCurState-nextState)*t.mWidth-obj= .style.posTop t.mCurState=3DnextState return obj } //----------------------------------------- function TxtBtn( oId,oeId,action,chkState ) //----------------------------------------- { var t=3Dthis t.Perform =3D _TBP t.SetActive =3D _TBSetA t.SetInactive=3D _TBSetI t.SetPressed =3D _TBSetP t.SetDisabled=3D _TBSetD t.SetEnabled =3D _TBSetE t.GetState =3D chkState t.UserAction =3D action t.ChgState =3D _TBUI t.mObjId =3D oId t.m_elementsId=3D oeId t.mIsOn =3D 1 } function _TBSetA() { var t=3Dthis if( t.mIsOn && !t.GetState() ) t.ChgState( gHiliteClr,gShadowClr,0,0 ) } function _TBSetI() { var t=3Dthis if( t.mIsOn && !t.GetState() ) t.ChgState( gFaceClr,gFaceClr,0,0 ) } function _TBSetP() { if( this.mIsOn ) this.ChgState( gShadowClr,gHiliteClr,1,1 ) } function _TBSetD() { =20 this.ChgState( gFaceClr,gFaceClr,0,0 ) this.mIsOn =3D 0 } function _TBSetE() { var t=3Dthis if( !t.GetState() ) t.ChgState( gFaceClr,gFaceClr,0,0 ) else t.ChgState( gShadowClr,gHiliteClr,1,1 ) t.mIsOn =3D 1 } function _TBP() { var t=3Dthis if( t.mIsOn ) {=20 if( t.UserAction !=3D null ) t.UserAction() if( !t.GetState ) return if( t.GetState() ) t.SetPressed() else t.SetActive() } =20 } function _TBUI( clr1,clr2,lOffset,tOffset ) { SetBorder( GetObj( this.mObjId ),clr1,clr2 ) Offset( GetObj( this.m_elementsId ),lOffset,tOffset ) } function Offset( obj, top, left ){ obj.style.top=3Dtop; obj.style.left=3Dle= ft } function SetBorder( obj, upperLeft, lowerRight ) { s=3Dobj.style; s.borderStyle =3D "solid" s.borderWidth =3D 1=20 s.borderLeftColor =3D s.borderTopColor =3D upperLeft s.borderBottomColor=3D s.borderRightColor =3D lowerRight } function GetBtnObj(){ return gBtnArr[window.event.srcElement.id] } function BtnOnOver(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetActive() } function BtnOnDown(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetPressed() } function BtnOnOut(){ b=3DGetBtnObj(); if( b !=3D null ) b.SetInactive() } function BtnOnUp() { b=3DGetBtnObj() if( b !=3D null ) b.Perform() else Upd() } function GetNtsState(){ return parent.gNtsOpen } function GetOtlState(){ return parent.gOtlOpen } function GetOtlTxtState(){ return parent.gOtlTxtExp } function NtsBtnSetFlag( fVal ) { s=3Ddocument.all.item( this.m_flagId ).style s.display=3D"none" if( fVal ) s.display=3D"" else s.display=3D"none" } function _BSetA_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etActive() } function _BSetI_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etInactive() } function _BSetP_Border(){ b =3D gBtnArr[this.mObjId]; if( b !=3D null ) b.S= etPressed() } function _BSetA_BorderImg() {=20 b =3D gBtnArr[this.mBorderId]=20 if( b !=3D null && this.mIsOn && !b.GetState() ) { obj=3Dthis.ChgState( gHiliteClr,gShadowClr,2 ) obj.style.posTop=3D0 } } function _BSetI_BorderImg() {=20 b =3D gBtnArr[this.mBorderId] if( b !=3D null && this.mIsOn && !b.GetState() ) { obj=3Dthis.ChgState( gFaceClr,gFaceClr,1 ) obj.style.posTop=3D0 } } var gHiliteClr=3D"THREEDHIGHLIGHT",gShadowClr=3D"THREEDSHADOW",gFaceClr=3D"= THREEDFACE" var gBtnArr =3D new Array() gBtnArr["nb_otl"] =3D new TxtBtn( "nb_otl","nb_otlElem",parent.ToggleOtlPan= e,GetOtlState ) gBtnArr["nb_otlElem"] =3D new TxtBtn( "nb_otl","nb_otlElem",parent.ToggleOt= lPane,GetOtlState ) gBtnArr["nb_nts"] =3D new ImgBtn( "nb_nts","nb_ntsBorder",10,parent.ToggleN= tsPane ) gBtnArr["nb_nts"].SetActive =3D _BSetA_BorderImg; gBtnArr["nb_nts"].SetInactive =3D _BSetI_BorderImg; gBtnArr["nb_ntsBorder"] =3D new TxtBtn( "nb_ntsBorder","nb_ntsElem",parent.= ToggleNtsPane,GetNtsState ) gBtnArr["nb_ntsElem"] =3D new TxtBtn( "nb_ntsBorder","nb_ntsElem",parent.To= ggleNtsPane,GetNtsState ) gBtnArr["nb_prevBorder"] =3D gBtnArr["nb_prev"]=3D new ImgBtn( "nb_prev","n= b_prevBorder",30,parent.GoToPrevSld ) gBtnArr["nb_nextBorder"] =3D gBtnArr["nb_next"]=3D new ImgBtn( "nb_next","n= b_nextBorder",30,parent.GoToNextSld ) gBtnArr["nb_sldshw"]=3D new ImgBtn( "nb_sldshw","nb_sldshwBorder",18,parent= .FullScreen ) gBtnArr["nb_sldshwBorder"] =3D new TxtBtn( "nb_sldshw","nb_sldshwBorder",pa= rent.FullScreen,null ) gBtnArr["nb_sldshwBorder"].SetActive =3D _BSetA_Border; gBtnArr["nb_sldshwBorder"].SetInactive =3D _BSetI_Border; gBtnArr["nb_sldshwText"] =3D new TxtBtn( "nb_sldshw","nb_sldshwText",parent= .FullScreen,null ) gBtnArr["nb_sldshwText"].SetActive =3D _BSetA_Border; gBtnArr["nb_sldshwText"].SetInactive =3D _BSetI_Border; gBtnArr["nb_voice"] =3D gBtnArr["nb_voiceBorder"] =3D new ImgBtn( "nb_voice= ","nb_voiceBorder",18,parent.ToggleVNarration ) gBtnArr["nb_otlTxtBorder"] =3D gBtnArr["nb_otlTxt"]=3D new ImgBtn( "nb_otlT= xt","nb_otlTxtBorder",23,parent.ToggleOtlText ) gBtnArr["nb_ntsBorder"].m_flagId=3D "nb_nts" gBtnArr["nb_ntsBorder"].SetFlag =3D NtsBtnSetFlag gBtnArr["nb_otlTxt"].ChangeIcon=3D GetOtlTxtState /********************************************* Context menu implementation _CM() is the function that's hooked up to the oncontextmenu event. Once we're asked to show the menu, we first build it by creating DIVs on-the-fly. Then we position it=20 within the screen area so it doesn't get clipped. Creating the DIVs using createElement() means we don't have to write out any extra HTML into the slide HTML files. **********************************************/ var sNext=3D"Next",sPrev=3D"Previous",sEnd=3D"End Show",sFont=3D"Arial",sAr= row=3D"Arrow",sFreeform=3D"Freeform",sRect=3D"Rectangle",sOval=3D"Oval" function ShowMenu() { BuildMenu(); var doc=3DPPTSld.document.body,x=3DPPTSld.event.clientX+doc.scrollLeft,y= =3DPPTSld.event.clientY+doc.scrollTop m =3D PPTSld.document.all.item("ctxtmenu") m.style.pixelLeft=3Dx if( (x+m.scrollWidth > doc.clientWidth)&&(x-m.scrollWidth > 0) ) m.style.pixelLeft=3Dx-m.scrollWidth m.style.pixelTop=3Dy if( (y+m.scrollHeight > doc.clientHeight)&&(y-m.scrollHeight > 0) ) m.style.pixelTop=3Dy-m.scrollHeight m.style.display=3D"" } function _CM() { if( !parent.IsFullScrMode() ) return; if(!PPTSld.event.ctrlKey) { ShowMenu() return false } else HideMenu() } function BuildMenu() { if( PPTSld.document.all.item("ctxtmenu") ) return var mObj=3DCreateItem( PPTSld.document.body ) mObj.id=3D"ctxtmenu" mObj.style.visibility=3D"hidden" var s=3DmObj.style s.position=3D"absolute" s.cursor=3D"default" s.width=3D"120px" SetCMBorder(mObj,"menu","black") var iObj=3DCreateItem( mObj ) SetCMBorder( iObj, "threedhighlight","threedshadow" ) iObj.style.padding=3D2 CreateMenuItem( iObj,sNext,M_GoNextSld,M_True ) CreateMenuItem( iObj,sPrev,M_GoPrevSld,M_HasPrevSld ) =09 CreateSeparator( iObj ) CreateMenuItem( iObj,sEnd,M_End,M_True ) mObj.style.visibility=3D"visible" } function Cancel() { window.event.cancelBubble=3Dtrue; window.event.returnVa= lue=3Dfalse } function Highlight() { ChangeClr("activecaption","threedhighlight") } function Deselect() { ChangeClr("threedface","menutext") } function Perform() { e=3DPPTSld.event.srcElement if( e.type=3D=3D"menuitem" && e.IsActive() ) e.Action() else PPTSld.event.cancelBubble=3Dtrue } function ChangeClr( bg,clr ) { e=3DPPTSld.event.srcElement if( e.type=3D=3D"menuitem" && e.IsActive() ) { e.style.backgroundColor=3Dbg e.style.color=3Dclr } } function M_HasPrevSld() { return( parent.HasPrevSld() ) } function M_GoNextSld() { if( gIsEndShow ) M_End(); else GoToNextSld() } function M_GoPrevSld() { if( gIsEndShow ) { gIsEndShow=3D0; history.back();= PPTSld.event.cancelBubble=3Dtrue; } else GoToPrevSld() } function M_True() { return true } function M_End() { window.close( self ) } function CreateMenuItem( node,text,action,eval ) { var e=3DCreateItem( node ) e.type=3D"menuitem" e.Action=3Daction e.IsActive=3Deval e.innerHTML=3Dtext if( !e.IsActive() ) e.style.color=3D"threedshadow" e.onclick=3DPerform e.onmouseover=3DHighlight e.onmouseout=3DDeselect s=3De.style; s.fontFamily=3DsFont s.fontSize=3D"9pt" s.paddingLeft=3D2 } function CreateSeparator( node ) { var sObj=3DCreateItem( node ) SetCMBorder(sObj,"menu","menu") var s=3DsObj.style s.borderTopColor=3D"threedshadow" s.borderBottomColor=3D"threedhighlight" s.height=3D1 s.fontSize=3D"0px" } function CreateItem( node ) { var elem=3DPPTSld.document.createElement("DIV") node.insertBefore( elem ) return elem } function SetCMBorder( o,ltClr,rbClr ) { var s=3Do.style s.backgroundColor=3D"menu" s.borderStyle=3D"solid" s.borderWidth=3D1 s.borderColor=3DltClr+" "+rbClr+" "+rbClr+" "+ltClr } ------=_NextPart_01C64EA7.0CA235E0 Content-Location: file:///C:/2A09C636/Eclampsia_Villar_2006_files/fullscreen.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" ------=_NextPart_01C64EA7.0CA235E0 Content-Location: file:///C:/2A09C636/Eclampsia_Villar_2006_files/buttons.gif Content-Transfer-Encoding: base64 Content-Type: image/gif R0lGODlhWAESAPf4AAAAAIAAAACAAICAAAAAgIAAgACAgICAgAQEBISEBASEBISEhAQEhMTExAQE /KTM9Pz8/ERERPz8BAT8/KSkpGRkhMTcxCRkxAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA AAAAAAAAAAAAAAAAAAAAAMDAwP8AAAD/AP//AAAA//8A/wD//////yH5BAEAAPgALAAAAABYARIA QAj/APEJHEiwoMGDCBMqXMiwocOHECNKnEixosWLGCEiQKCRo8YDIEHig2DxAD4LKD1avDDhgUuV GUOGbHBR5QGYFBG4fHAB58EKECJEwCfUYAWPFGAygLCRKQIIUKM6WAohKUGgCikcFWh1INWoYKVS 7SrQ41GbIhGYLAuVQVOoC+IyXUuUAkG1HE3KFDhAwkgJc5/qDZmxsOHDiBMrXsy4sePDGyP7lChT 5MULmDPnlDw5YmW6FTNrfgi0aNGEZPEtbfo2bNTUpYeeRph69dPWrqvCNFuBIGG1A59CYPAVQtwF cw0OxWdTIOiBCQAjaAB17fOFII8voGmRc+eOkilm/z9OvTtnjN4hYk1YoT3H2rnBOphPAB9skgq3 2lcaX/5YnJVt9BloAar12UEIRGCZdQghMABI1Tn32IQUVthYexhmqGGGMBHAgIfEhSiiiATAtOGJ GnYI4ogsEldicAYOGNJGZaml3Y0L3NTZUBz1xlB0PUoUI0jlVWRSVN89xBKSGB1YU1TMoRfVBEle hR9HQs1GEHxQ3RZZbveZthxt/LEmXHyp5XWABSCpaRJwbM13gAACPHVccgJFgF+NEhqUAEkQSCfc ddhVhh5dVTaEAEsTUNlkZUWKN9BNGDE6QU8OrSdbllzpxyVTTrU21Uj3scfhp7nNpyoDaTIEJ3P9 If8J2kbLNYegg9JRBwGhFvbq66+ZUiDssMQWK2yHxiZLrInKNotss8l+B5yBrr5p2UIJvortANoC 6+234IbLla/elRtZjeamh5CC3Sb0YLvixivvYkDFGlZqBNh7r4n6goVvv6/ZlCicN+kL71ALTnpQ dCIZp7CihkLA3UQmoWRBogyxtBPGCTnZncVR1rSTo5nuydC/Eo8kUH+lOoTyyvjoCuZu+PjYIKLD rZybtrM1d10C0QXKEVz48GrQkEeWdFJKlbb0UmEeV0SzyC6RvNB646LWIVjUNeC1zAFb+RDKXksM 9r531bwmpQW9+hQDDsx5pqwDRWBXcFES2hc+gEn/wJGdEEWdE6LoWcoxQweaTNmkhydkKaYMYY2Q p1unbLl/pPKbn3v7EZRvrKvqlja2ONvrtoIw9tn2g32/tQBlhtYkU+MNikZ7QYlPDPuMldpOmuJX nVo5VF3HjI+q89mteX5IDd/fVFClma5kiE4f2XUJhlz09gj2NbTDRifkmu7zXjR++RVJ/lPznuvr QH2iD6S+UewP9Dnon6d2NLwN8n90BB6hC68cFMCHoe+ACASP9c4DowUyEF0OPFcDI0ij/VXPaAKC UfhS95AKGoQ7IBRICI1HwhGaUIQoLGEKT6jCFrLwhSuMoQtlCMMZ2rCGOKShDm+4wxzy8Ic+DGIP B4cIRCKGMCAAOy== ------=_NextPart_01C64EA7.0CA235E0 Content-Location: file:///C:/2A09C636/Eclampsia_Villar_2006_files/frame.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" Pre-eclampsia-Eclampsia: an unresolved problem for over 2 millennia - José Villar ------=_NextPart_01C64EA7.0CA235E0 Content-Location: file:///C:/2A09C636/Eclampsia_Villar_2006_files/outline.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252"
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Outline
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