Browsing by Author "Vera, Claudio"

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    Is ursodeoxycholic acid effective for intrahepatic cholestasis of pregnancy?
    (MEDWAVE ESTUDIOS LTD, 2016) Marin, Sebastian Sepulveda; Maragano, Valeria Contreras; Vera, Claudio
    Intrahepatic cholestasis of pregnancy is a condition associated with fetal morbidity and mortality. Ursodeoxycholic acid has been proposed as a treatment alternative, but its use remains controversial. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified three systematic reviews including eight randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded ursodeoxycholic acid reduces prematurity risk and need for admission in neonatal intensive care units. It might also reduce maternal pruritus. La colestasia intrahepática del embarazo es una condición propia de la gestación y se asocia a mayor morbilidad y mortalidad perinatal. Dentro de las alternativas terapéuticas se ha propuesto el uso del ácido ursodeoxicólico, sin embargo su beneficio sigue siendo controvertido. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos tres revisiones sistemáticas que en conjunto incluyen ocho estudios aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que el uso de ácido ursodeoxicólico en la colestasia intrahepática del embarazo podría reducir el riesgo de prematurez y de necesidad de hospitalización del recién nacido en unidad de cuidado intensivo. También podría disminuir el prurito materno.
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    Potential impact on estimated treatment effects of information lost to follow-up in randomised controlled trials (LOST-IT): systematic review
    (BMJ PUBLISHING GROUP, 2012) Akl, Elie A.; Briel, Matthias; You, John J.; Sun, Xin; Johnston, Bradley C.; Busse, Jason W.; Mulla, Sohail; Lamontagne, Francois; Bassler, Dirk; Vera, Claudio; Alshurafa, Mohamad; Katsios, Christina M.; Zhou, Qi; Cukierman Yaffe, Tali; Gangji, Azim; Mills, Edward J.; Walter, Stephen D.; Cook, Deborah J.; Schuenemann, Holger J.; Altman, Douglas G.; Guyatt, Gordon H.
    Objective To assess the reporting, extent, and handling of loss to follow-up and its potential impact on the estimates of the effect of treatment in randomised controlled trials.
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    Prevalence and Predictors of Exclusive Breastfeeding at Hospital Discharge
    (LIPPINCOTT WILLIAMS & WILKINS, 2012) McDonald, Sarah D.; Pullenayegum, Eleanor; Chapman, Barbara; Vera, Claudio; Giglia, Lucia; Fusch, Christoph; Foster, Gary
    OBJECTIVE: To estimate the population-based prevalence and predictors of exclusive breastfeeding at hospital discharge in singleton and twin term newborns.
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    Rising infant mortality in down syndrome in Chile from 1997 to 2013
    (SOC MEDICA SANTIAGO, 2016) Donoso, Enrique; Vera, Claudio
    Background: Down syndrome (DS) is associated with higher child mortality especially due to cardiac malformations. Aim: To describe the trend in Chilean infant mortality in DS in the period 1997-2013 as compared to the general population without DS. Material and Methods: Raw data on infant deaths were extracted from the yearbooks of vital statistics of the National Institute of Statistics. The mortality risk associated to DS, relative to population without DS was estimated. Results: There were 456 deaths in infants with DS during the study period (59 early neonatal deaths, 70 late neonatal deaths and 327 post-neonatal deaths). The trend in infant mortality rate in DS was ascending (r: 0.53, p = 0.03), with an average annual percentage change of 4.6% (95% confidence interval (CI) 0.4-9.0%; p < 0.01). Compared to the population without DS, the risk of early neonatal death was lower in DS (Odds ratio (OR) 0.14, 95% CI 0.11-0.19; p < 0.01) whereas the risk of post-neonatal death was higher (OR 4.74, 95% CI 3.85-5.85; p < 0.01). Conclusions: Infant mortality in Down syndrome has an increasing trend. We postulate that these children are not accessing timely cardiac surgery, the main therapeutic tool to reduce the death risk in the first year of life.
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    Specific instructions for estimating unclearly reported blinding status in randomized trials were reliable and valid
    (ELSEVIER SCIENCE INC, 2012) Akl, Elie A.; Sun, Xin; Busse, Jason W.; Johnston, Bradley C.; Briel, Matthias; Mulla, Sohail; You, John J.; Bassler, Dirk; Lamontagne, Francois; Vera, Claudio; Alshurafa, Mohamad; Katsios, Christina M.; Heels Ansdell, Diane; Zhou, Qi; Mills, Ed; Guyatt, Gordon H.
    Objective: To test the reliability and validity of specific instructions to classify blinding, when unclearly reported in randomized trials, as "probably done" or "probably not done."