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Carballo-Nunez E.,Hospitalario Universitario Of Orense | Gonzalez-Rodriguez L.,Hospitalario Universitario Of Orense | Gonzalez-Boubeta R.,Hospitalario Universitario Of Vigo | Alves-Perez M.T.,Hospitalario Universitario Of Orense
Ginecologia y Obstetricia de Mexico | Year: 2015

Background: Obstetric cholestasis has been associated with an increased risk of preterm delivery, intrapartum meconium, foetal distress and intrauterine foetal death. There is no consensus about the frequency of each of these complications or about the prognostic value of serum bile acids and transaminase levels. Bile acids levels above 40μml/L have been associated with adverse perinatal outcomes. Objectives: To determine the frequency of adverse perinatal outcomes in single pregnancies with cholestasis of pregnancy and assess the association between levels of bile acids and transaminases in maternal serum, together with perinatal outcomes. Material and method: Retrospective descriptive study of 71 women diagnosed of intrahepatic cholestasis in the years 2006-2011 in the University of Vigo Clinical Hospital Complex (Spain). Results: The mean gestational age at the diagnostic was 35 weeks 6 days, being 10% of babies premature. There was one intrauterine foetal death (1.4%). We found 18.3% intrapartum meconium. Caesarean sections were performed in 5.6% of the deliveries due to foetal distress. No neonate presented Apgar < 7, or PH in the umbilical artery < 7. The 75,5% of infants did not present respiratory distress, while 5 (6.75%) presented serious distress. We found no statistically significant association between adverse perinatal outcomes and the level of bile acids. High levels of transaminases were related to prematurity (p = 0.009; p = 0.010) and severe distress (p = 0.027; p = 0.008). Conclusion: The low frequency of adverse outcomes observed in our series could be in relation to the low rate of prematurity. Neither the biochemical nor clinical features are suitable for predicting foetal complications. © 2015, Asociacion Mexicana de Ginecologia y Obstetricia. All rights reserved.

Peuskens J.,Universitair Psychiatrisch Centrum | Olivares J.M.,Hospitalario Universitario Of Vigo | Pecenak J.,University Hospital | Tuma I.,FNSP Hradec Kralove | And 5 more authors.
Current Medical Research and Opinion | Year: 2010

To assess treatment retention on risperidone long-acting injection (RLAI) and outcomes in schizophrenia patients for whom 24 months of follow-up data in the electronic Schizophrenia Treatment Adherence Registry (e-STAR) were available. e-STAR is an ongoing, international, multicenter, prospective, observational registry assessing use of antipsychotics in patients with schizophrenia or schizoaffective disorder in a normal clinical practice setting. Parameters were assessed prior to and post-initiation of RLAI. Data presented are from six European countries that enrolled patients in e-STAR after they initiated treatment with RLAI. Clinical and demographic information were collected at baseline and treatment-related data, including RLAI discontinuation, psychiatric hospitalization and medication utilization, were collected prospectively every 3 months. Data collection continued for 24 months, even for patients who discontinued RLAI therapy. Hospitalization and medication utilization were also collected retrospectively by chart review for the 12-month period prior to RLAI initiation. A total of 1659 patients (mean age, 39.2; 18.3 inpatients) completed the study. Twenty-four months after initiating therapy (initial RLAI doseCombining double low line33.6mg) 85 of patients (nCombining double low line1410) remained on RLAI (completers) while 15 discontinued therapy. The main reasons for discontinuation were insufficient response (28.5), patient/family choice (26.1), adverse events (9.6) and unacceptable tolerability (6.0). At baseline, compared to completers, discontinuers were younger (37.4 vs. 39.6 years, pCombining double low line0.01), had schizophrenia for a shorter time (10.2 vs. 11.9 years, pCombining double low line0.02), had lower Global Assessment of Functioning (GAF) scores (43.5 vs. 48.0, pCombining double low line0.0001), higher utilization of benzodiazepines (56.5 vs. 43.3) and more initiated therapy as inpatients (30 vs. 16). With RLAI therapy GAF scores improved significantly (p<0.001) for both groups but the 24-month value for discontinuers was lower than that of completers (55.4 vs. 67.2). Compared to the pre-RLAI initiation period, at 12 months post-initiation completers had greater reductions than discontinuers in the percent of patients hospitalized (66.2 reduction vs. 29.2) and in the length (68 reduction vs. 0) and number (80.0 vs. 14.3) of hospital stays, differences that remained at 24 months. The most common adverse events while patients were taking RLAI were nervous system disorders (6.8), psychiatric disorders (5.6), weight increase (3.2), reproductive system and breast disorders (2.5) and gastrointestinal disorders (2.1). These observational data confirm that RLAI is an effective treatment in schizophrenia and high levels of adherence to therapy offers an opportunity for effective long-term disease management and significant sustained decreases in hospitalization. © 2010 Informa UK Ltd.

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