32 results on '"Karolinski, A"'
Search Results
2. The Tolman–Ehrenfest criterion of thermal equilibrium in scalar–tensor gravity
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Numa Karolinski and Valerio Faraoni
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Astrophysics ,QB460-466 ,Nuclear and particle physics. Atomic energy. Radioactivity ,QC770-798 - Abstract
Abstract The Tolman–Ehrenfest criterion for the thermal equilibrium of a fluid at rest in a static general-relativistic geometry is generalized to scalar–tensor gravity. Surprisingly, the gravitational scalar field, which fixes the strength of the effective gravitational coupling, does not play a role in determining thermal equilibrium. As a result, heat does not sink more in a gravitational field where gravity is stronger.
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- 2024
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3. Acceptability and continuation of use of the subdermal contraceptive implant among adolescents and young women in Argentina: a retrospective cohort study
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Daniel Maceira, Silvia Oizerovich, Gabriela Perrotta, Rodolfo Gómez Ponce de León, Ariel Karolinski, Natalia Suarez, Natalia Espinola, Sonja Caffe, and Venkatraman Chandra-Mouli
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Adolescence ,pregnancy ,public policy ,subdermal implant ,satisfaction ,adherence ,Diseases of the genitourinary system. Urology ,RC870-923 ,The family. Marriage. Woman ,HQ1-2044 - Abstract
AbstractA new public policy was instituted in Argentina for free distribution of subdermal contraceptive implants to women aged 15–24 years old in the public healthcare system. The objective of this study is to determine the extent to which this population adhered to the implant, as well as predictors of continuation. The retrospective cohort study was based on a telephone survey of a random sample of 1101 Ministry of Health-registered implant users concerning the continuation of use, satisfaction with the method and side-effects, and reasons for removal. Descriptive statistics and multivariate regression analysis were used to explore the association between adherence and having received contraceptive counselling, satisfaction, and side effects. We found high levels of adherence (87%) and satisfaction (94%). Common reported side effects were amenorrhoea or infrequent bleeding, perceived weight gain, increased menstrual bleeding and headaches. Multivariate regression analysis indicates that, among adolescents, having received contraceptive counselling increased comfort, while frequent bleeding at six months hindered trust. Participants who had a history of a prior delivery or who had themselves primarily chosen the method were less likely to request the removal of the implant. Our results support the public policy of free implant distribution in the public health sector. This is a sustainable public policy that contributes to equity and access to effective contraception. It is appropriate for adolescents and young women and will also reduce unintended pregnancies. Our results suggest that counselling patients is key prior to insertion of the implant, as it improves acceptability and continuation.
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- 2023
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4. Bases para el desarrollo e implementación de un modelo de información en salud de la mujer y perinatal orientado a la gestión en Latinoamérica
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Ariel Karolinski, Raúl Mercer, Andrés Bolzán, Pablo Salgado, Celina Ocampo, Ricardo Nieto, Maureen Birmingham, Gerardo Martínez, Luis Mainero, Suzanne Serruya, Andrés De Francisco, and Francisco Becerra-Posada
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Gestión de la información en salud ,información científica ,toma de decisiones en salud ,sistemas de información ,salud de la mujer ,perinatología ,Centro Latinoamericano de Perinatología ,Salud de la Mujer y Reproductiva ,Argentina ,Medicine ,Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
Objetivo. El Sistema Informático Perinatal (SIP) ha marcado un hito en el uso de información sistematizada en la Región de las Américas. Lo que se ha aprendido ha contribuido al desarrollo de un modelo basado en un conjunto mínimo de indicadores (CMI). El objetivo del estudio fue describir el proceso histórico y metodológico de desarrollo, implementación y escalamiento territorial de un CMI para monitorizar y evaluar políticas, programas y servicios de salud de la mujer y perinatal orientado a la gestión (SIP-GESTIÓN). Métodos. El estudio se llevó a cabo en dos etapas: 1) validación en cuatro fases de un CMI en una red de hospitales: a) construcción del modelo teórico de indicadores, b) implementación de la investigación operativa, c) selección final de indicadores, y d) definición de patrones de referencia, y 2) escalamiento territorial. Resultados. Se identificaron 17 modelos de indicadores. El modelo inicial incluyó 177 indicadores agrupados en siete dimensiones (contexto, hábitos, accesibilidad, uso de servicios, calidad de cuidados, impacto materno-fetal, e impacto materno-neonatal) que se redujeron a 21 tras tres rondas Delphi. El modelo final (SIP-GESTIÓN) incluyó 40 indicadores. Se analizaron 240 021 partos (79,1%) de un total de 303 559 atendidos en las 122 maternidades seleccionadas en 24 Jurisdicciones (100%) de Argentina. La información se presenta a nivel nacional y desagregada por región sanitaria, provincia y hospital. Conclusiones. Este modelo permitió alcanzar altos niveles de cobertura y calidad de la información y escalamiento territorial y es útil para la gestión, la investigación y la reorientación de programas y políticas.
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- 2018
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5. Influenza A/H1N1 MF59 adjuvanted vaccine in pregnant women and adverse perinatal outcomes: multicentre study
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"EVA" Study Research Group (Estudio "Embarazo y Vacuna Antigripal"), Rubinstein, F, Micone, P, Bonotti, A, Wainer, V, Schwarcz, A, Augustovski, F, Riviere, A Pichon, and Karolinski, A
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- 2013
6. Using Uniject to increase the use of prophylactic oxytocin for management of the third stage of labor in Latin America
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Althabe, Fernando, Mazzoni, Agustina, Cafferata, María L., Gibbons, Luz, Karolinski, Ariel, Armbruster, Deborah, Buekens, Pierre, and Belizán, José M.
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- 2011
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7. A comprehensive assessment of maternal deaths in Argentina: translating multicentre collaborative research into action
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Silvina Ramos, Ariel Karolinski, Mariana Romero, and Raúl Mercer
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Public aspects of medicine ,RA1-1270 - Abstract
OBJECTIVE: To perform a comprehensive assessment of maternal mortality in Argentina, the ultimate purpose being to strengthen the surveillance system and reorient reproductive health policies to prevent maternal deaths. METHODS: Our multicentre population-based study combining qualitative and quantitative methodologies included a descriptive analysis of under-registration and distribution of causes of death, a case-control study to identify risk factors in health-care delivery and verbal autopsies to analyse social determinants associated with maternal deaths. FINDINGS: A total of 121 maternal deaths occurred during 2002. The most common causes were abortion complications (27.4%), haemorrhage (22.1%), infection/sepsis (9.5%), hypertensive disorders (8.4%) and other causes (32.6%). Under-registration was 9.5% for maternal deaths (n = 95) and 15.4% for late maternal deaths (n = 26). The probability of dying was 10 times greater in the absence of essential obstetric care, active emergency care and qualified staff, and doubled with every 10-year increase in age. Other contributing factors included delays in recognizing "alarm signals"; reluctance in seeking care owing to desire to hide an induced abortion; delays in receiving timely treatment due to misdiagnosis or lack of supplies; and delays in referral/transportation in rural areas. CONCLUSION: A combination of methodologies is required to improve research on and understanding of maternal mortality via the systematic collection of health surveillance data. There is an urgent need for a comprehensive intervention to address public health and human rights issues in maternal mortality, and our results contribute to the consensus-building necessary to improve the existing surveillance system and prevention strategies.
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- 2007
8. Lost opportunities for effective management of obstetric conditions to reduce maternal mortality and severe maternal morbidity in Argentina and Uruguay
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Karolinski, Ariel, Mazzoni, Agustina, Belizán, José M., Althabe, Fernando, Bergel, Eduardo, and Buekens, Pierre
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- 2010
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9. Vaginal progesterone for maintenance tocolysis: a systematic review and metaanalysis of randomized trials
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de Tejada, Begoña Martinez and Karolinski, Ariel
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- 2015
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10. Prevention of preterm delivery with vaginal progesterone in women with preterm labour (4P): randomised double-blind placebo-controlled trial
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de Tejada, Martinez B, Karolinski, A, Ocampo, M C, Laterra, C, Hösli, I, Fernández, D, Surbek, D, Huespe, M, Drack, G, Bunader, A, Rouillier, S, de Degani, López G, Seidenstein, E, Prentl, E, Antón, J, Krähenmann, F, Nowacki, D, Poncelas, M, Nassif, J C, Papera, R, Tuma, C, Espoile, R, Tiberio, O, Breccia, G, Messina, A, Peker, B, Schinner, E, Mol, B W, Kanterewicz, L, Wainer, V, Boulvain, M, Othenin-Girard, V, Bertolino, M V, and Irion, O
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- 2015
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11. Evidence-based maternal and perinatal healthcare practices in public hospitals in Argentina
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Karolinski, Ariel, Micone, Paula, Mercer, Raúl, Gibbons, Luz, Althabe, Fernando, Belizán, José M., Messina, Analía, Lapidus, Alicia, Correa, Alberto, Taddeo, Corina, Lambruschini, Rodolfo, Bertin, Marta, Dibiase, Lucía, Montes Varela, Dolores, and Laterra, Cristina
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- 2009
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12. Pediatric hospitalizations associated with 2009 pandemic influenza A (H1N1) in Argentina
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Libster, Romina, Bugna, Jimena, Coviello, Silvina, Hijano, Diego R., Dunaiewsky, Mariana, Reynoso, Natalia, Cavalieri, Maria L., Guglielmo, Maria C., Areso, M. Soledad, Gilligan, Tomas, Santucho, Fernanda, Cabral, Graciela, Gregorio, Gabriela L., Moreno, Rina, Lutz, Maria I., Panigasi, Alicia L., Saligari, Liliana, Caballero, Mauricio T., Almeida, Rodrigo M. Egues, 0Meyer, Maria E. Gutierrez, Neder, Maria D., Davenport, Maria C., Del Valle, Maria P., Santidrian, Valeria S., Mosca, Guillermina, Dominguez, Mercedes Gracia, Alvarez, Liliana, Landa, Patricia, Pota, Ana, Bolonati, Norma, Dalamon, Ricardo, Mercol. Victoria I. Sanchez, Espinoza, Marco, Peuchot, Juan Carlos, Karolinski, Ariel, Bruno, Miriam, Borsa, Ana, Ferrero, Fernando, Bonina, Angel, Ramonet, Margarita, Albano, Lidia C., Luedicke, Nora, Alterman, Elias, Savy, Vilma, Baumeister, Elsa, Chappel, James D., Edwards, Katheryn M., Melendi, Guillermina A., and Polack, Fernando P.
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Company business management ,Market trend/market analysis ,Children's hospitals -- Management ,Polymerase chain reaction -- Usage ,Swine influenza -- Patient outcomes ,Swine influenza -- Demographic aspects ,Infants -- Patient outcomes ,Infants -- Causes of ,Infants -- Forecasts and trends - Abstract
A study was conducted to investigate the effects of the 2009 pandemic influenza A (H1N1) on children in six pediatric hospitals in Argentina. Results indicated that the H1N1 virus resulted in pediatric death rates that were ten times higher than normal seasonal influenza.
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- 2009
13. A comprehensive assessment of maternal deaths in Argentina: translating multicentre collaborative research into action/Evaluation exhaustive de la mortalite maternelle en Argentine: transposition sous forme d'interventions d'une etude menee en collaboration dans plusieurs centres/Evaluacion integral de la mortalidad materna en la Argentina: traducir la investigacion colaborativa multicentrica en accion
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Ramos, Silvina, Karolinski, Ariel, Romero, Mariana, and Mercer, Raul
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Hypertension -- Risk factors ,Hypertension -- Health aspects ,Abortion -- Health aspects ,Maternal health services -- Evaluation ,Mothers -- Patient outcomes ,Mothers -- Evaluation ,Mothers -- Risk factors - Abstract
Objective To perform a comprehensive assessment of maternal mortality in Argentina, the ultimate purpose being to strengthen the surveillance system and reorient reproductive health policies to prevent maternal deaths. Methods Our multicentre population-based study combining qualitative and quantitative methodologies included a descriptive analysis of under-registration and distribution of causes of death, a case-control study to identify risk factors in health-care delivery and verbal autopsies to analyse social determinants associated with maternal deaths. Findings A total of 121 maternal deaths occurred during 2002. The most common causes were abortion complications (27.4%), haemorrhage (22.1%), infection/sepsis (9.5%), hypertensive disorders (8.4%) and other causes (32.6%). Under-registration was 9.5% for maternal deaths (n = 95) and 15.4% for late maternal deaths (n = 26). The probability of dying was 10 times greater in the absence of essential obstetric care, active emergency care and qualified staff, and doubled with every 10-year increase in age. Other contributing factors included delays in recognizing "alarm signals"; reluctance in seeking care owing to desire to hide an induced abortion; delays in receiving timely treatment due to misdiagnosis or lack of supplies; and delays in referral/transportation in rural areas. Conclusion A combination of methodologies is required to improve research on and understanding of maternal mortality via the systematic collection of health surveillance data. There is an urgent need for a comprehensive intervention to address public health and human rights issues in maternal mortality, and our results contribute to the consensus-building necessary to improve the existing surveillance system and prevention strategies. Objectif Evaluer de maniere exhaustive la mortalite maternelle en Argentine, avec comme objectif final de renforcer le systeme de surveillance et de reorienter les politiques de sante genesique visant a prevenir les deces maternels. Methodes Notre etude multicentrique en population, associant methodes qualitatives et quantitatives, comprend une analyse descriptive du sous-enregistrement des deces maternels et de la distribution de leurs causes, une etude cas-temoins destinee a identifier les facteurs de risque dans la prestation des soins de sante, ainsi que des autopsies verbales, permettant d'analyser les determinants sociaux lies aux deces maternels. Resultats Au total, 121 deces maternels sont intervenus au cours de l'annee 2002. Ces deces etaient le plus souvent imputables a des complications d'avortement (27,4 %), a des hemorragies (22,1 %), a des infections ou a des accidents septiques (9,5 %), a des troubles hypertensifs (8,4 %) et a d'autres causes (32,6 %). Le taux de sous-enregistrement s'elevait a 9,5 % pour les deces maternels (n = 95) et a 15,4 % pour les deces maternels tardifs (n = 26). La probabilite pour la mere de mourir etait 10 fois plus elevee en l'absence de soins obstetricaux essentiels, de soins d'urgence actifs et de personnel qualifie, et multipliee par 2 pour chaque augmentation de 10 ans de l'age maternel. Parmi les autres facteurs contribuant a la mortalite maternelle, figurent la reconnaissance tardive des << signes d'alerte >> ; la reticence des femmes a solliciter des soins dans le cas d'un avortement induit qu'elles veulent cacher ; les retards dans l'administration d'un traitement (erreur diagnostique ou manque de fournitures) et, en zone rurale, les delais dans l'orientation vers un etablissement specialise ou le transport. Conclusion L'association de plusieurs types de methodes s'impose pour ameliorer la recherche et les connaissances sur la mortalite maternelle a partir de donnees de surveillance sanitaire collectees de maniere systematique. Il est urgent d'organiser une intervention de grande ampleur pour repondre aux problemes lies a la mortalite maternelle qui relevent de la sante publique et des droits de l'homme et nos resultats contribueront a l'etablissement du consensus necessaire pour ameliorer les strategies de prevention et le systeme de surveillance deja en place. Objetivo Realizar una evaluacion integral de la mortalidad materna en la Argentina, con el objetivo ultimo de fortalecer el sistema de vigilancia y reorientar las politicas de salud reproductiva para evitar las defunciones maternas. Metodos Nuestro estudio multicentrico basado en la poblacion, en el que se combinaron metodos cualitativos y cuantitativos, incluyo un analisis descriptivo del subregistro y la distribucion de las causas de defuncion, un estudio caso-control para identificar los factores de riesgo en la prestacion de atencion de salud y autopsias verbales para analizar los determinantes sociales asociados a la mortalidad materna. Resultados Durante 2002 se registraron en total 121 defunciones maternas. Las causas mas comunes fueron complicaciones de abortos (27,4%), hemorragias (22,1%), infecciones/septicemia (9,5%), trastornos hipertensivos (8,4%) y otras causas (32,6%). El subregistro fue del 9,5% para las defunciones maternas (n = 95) y del 15,4% para las defunciones maternas tardias (n = 26). La probabilidad de morir fue diez veces mayor en ausencia de atencion obstetrica esencial, guardia activa y personal calificado, y se duplicaba con cada aumento de 10 anos de la edad. Otros factores contribuyentes fueron las demoras en el reconocimiento de las << senales de alarma >>; la resistencia a buscar atencion para ocultar un aborto provocado; los retrasos del inicio del tratamiento como consecuencia de un diagnostico erroneo o de la falta de suministros; y los retrasos de la derivacion y el transporte en las zonas rurales. Conclusion Se requiere una combinacion de metodos para mejorar las investigaciones sobre la mortalidad materna y los conocimientos sobre la misma mediante la recopilacion sistematica de datos de vigilancia sanitaria. Urge implementar una intervencion integral que aborde los aspectos de la mortalidad materna relacionados con la salud publica y los derechos humanos. Nuestros resultados pueden ayudar a lograr el consenso necesario para mejorar el sistema de vigilancia y las estrategias de prevencion actuales., Introduction Maternal mortality is a human rights issue and an unequivocal expression of the economic, social and cultural disadvantages that women experience. (1,2) Maternal mortality has been identified as a [...]
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- 2007
14. Bases para el desarrollo e implementación de un modelo de información en salud de la mujer y perinatal orientado a la gestión en Latinoamérica
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Maureen Birmingham, Pablo Salgado, Celina Ocampo, Raúl Mercer, Luis Mainero, Ariel Karolinski, Andres de Francisco, Suzanne Jacob Serruya, Francisco Becerra-Posada, Gerardo Martínez, Andrés Bolzán, and Ricardo Nieto
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030219 obstetrics & reproductive medicine ,lcsh:Arctic medicine. Tropical medicine ,información científica ,lcsh:RC955-962 ,lcsh:Public aspects of medicine ,lcsh:R ,Public Health, Environmental and Occupational Health ,Argentina ,lcsh:Medicine ,Gestión de la información en salud ,lcsh:RA1-1270 ,toma de decisiones en salud ,perinatología ,sistemas de información ,03 medical and health sciences ,0302 clinical medicine ,salud de la mujer ,030212 general & internal medicine ,Salud de la Mujer y Reproductiva ,Centro Latinoamericano de Perinatología - Abstract
RESUMEN Objetivo El Sistema Informatico Perinatal (SIP) ha marcado un hito en el uso de informacion sistematizada en la Region de las Americas. Lo que se ha aprendido ha contribuido al desarrollo de un modelo basado en un conjunto minimo de indicadores (CMI). El objetivo del estudio fue describir el proceso historico y metodologico de desarrollo, implementacion y escalamiento territorial de un CMI para monitorizar y evaluar politicas, programas y servicios de salud de la mujer y perinatal orientado a la gestion (SIP-GESTION). Metodos El estudio se llevo a cabo en dos etapas: 1) validacion en cuatro fases de un CMI en una red de hospitales: a) construccion del modelo teorico de indicadores, b) implementacion de la investigacion operativa, c) seleccion final de indicadores, y d) definicion de patrones de referencia, y 2) escalamiento territorial. Resultados Se identificaron 17 modelos de indicadores. El modelo inicial incluyo 177 indicadores agrupados en siete dimensiones (contexto, habitos, accesibilidad, uso de servicios, calidad de cuidados, impacto materno-fetal, e impacto materno-neonatal) que se redujeron a 21 tras tres rondas Delphi. El modelo final (SIP-GESTION) incluyo 40 indicadores. Se analizaron 240 021 partos (79,1%) de un total de 303 559 atendidos en las 122 maternidades seleccionadas en 24 Jurisdicciones (100%) de Argentina. La informacion se presenta a nivel nacional y desagregada por region sanitaria, provincia y hospital. Conclusiones Este modelo permitio alcanzar altos niveles de cobertura y calidad de la informacion y escalamiento territorial y es util para la gestion, la investigacion y la reorientacion de programas y politicas.
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- 2018
15. The epidemiology of life-threatening complications associated with reproductive process in public hospitals in Argentina
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Karolinski, A, Mercer, R, Micone, P, Ocampo, C, Mazzoni, A, Fontana, O, Messina, A, Winograd, R, Frers, M C, Nassif, J C, Elordi, H C, Lapidus, A, Taddeo, C, Damiano, M, Lambruschini, R, Muzzio, C, Pecker, B, Natale, S, Nowacki, D, Betular, Á, Breccia, G, Di Biase, L, Montes Varela, D, Dunaiewsky, A, Minsk, E, Fernández, D, Martire, L, Huespe, M, Laterra, C, Spagnuolo, R, and Gregoris, C
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- 2013
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16. Influenza A/H1N1 MF59 adjuvanted vaccine in pregnant women and adverse perinatal outcomes: multicentre study
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Rubinstein, F, Micone, P, Bonotti, A, Wainer, V, Schwarcz, A, Augustovski, F, Riviere, Pichon A, and Karolinski, A
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- 2013
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17. Pediatric Hospitalizations Associated with 2009 Pandemic Influenza A (H1N1) in Argentina
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Libster, Romina, Bugna, Jimena, Coviello, Silvina, Hijano, Diego R., Dunaiewsky, Mariana, Reynoso, Natalia, Cavalieri, Maria L., Guglielmo, Maria C., Areso, Soledad M., Gilligan, Tomas, Santucho, Fernanda, Cabral, Graciela, Gregorio, Gabriela L., Moreno, Rina, Lutz, Maria I., Panigasi, Alicia L., Saligari, Liliana, Caballero, Mauricio T., Almeida, Rodrigo M. Egües, Meyer, Maria E. Gutierrez, Neder, Maria D., Davenport, Maria C., Del Valle, Maria P., Santidrian, Valeria S., Mosca, Guillermina, Domínguez, Mercedes Garcia, Alvarez, Liliana, Landa, Patricia, Pota, Ana, Boloñati, Norma, Dalamon, Ricardo, Mercol, Victoria I. Sanchez, Espinoza, Marco, Peuchot, Juan Carlos, Karolinski, Ariel, Bruno, Miriam, Borsa, Ana, Ferrero, Fernando, Bonina, Angel, Ramonet, Margarita, Albano, Lidia C., Luedicke, Nora, Alterman, Elias, Savy, Vilma, Baumeister, Elsa, Chappell, James D., Edwards, Kathryn M., Melendi, Guillermina A., and Polack, Fernando P.
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- 2010
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18. Population differences and the effect of vaginal progesterone on preterm birth in women with threatened preterm labor (.)
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Frederik J.R. Hermans, María Victoria Bertolino, Véronique Othenin-Girard, Cristina Laterra, Irene Hösli, Ariel Karolinski, Ewoud Schuit, Begoña Martinez de Tejada, Olivier Irion, Ben W.J. Mol, Pablo Salgado, Obstetrics and Gynaecology, and Other departments
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Pediatrics ,law.invention ,0302 clinical medicine ,Randomized controlled trial ,law ,Pregnancy ,Obstetrics and Gynaecology ,030212 general & internal medicine ,Young adult ,Progesterone ,threatened preterm labor ,education.field_of_study ,030219 obstetrics & reproductive medicine ,ddc:618 ,Obstetrics ,vaginal progesterone ,Obstetrics and Gynecology ,Gestational age ,Perinatology ,and Child Health ,Premature birth ,Randomized Controlled Trial ,Premature Birth ,Female ,Switzerland ,selection criteria ,Adult ,medicine.medical_specialty ,treatment effect ,Population ,Argentina ,Gestational Age ,Placebo ,Statistics, Nonparametric ,03 medical and health sciences ,Young Adult ,Obstetric Labor, Premature ,Double-Blind Method ,medicine ,Journal Article ,Humans ,Comparative Study ,Pediatrics, Perinatology, and Child Health ,education ,Proportional Hazards Models ,population differences ,Gynecology ,Chi-Square Distribution ,Proportional hazards model ,business.industry ,preterm birth ,Harm ,medicine.disease ,treatment interaction ,Pediatrics, Perinatology and Child Health ,Progestins ,secondary analysis ,business - Abstract
Threatened preterm labor (tPTL) is a complication of pregnancy. Identification of women and clinical definition differs between countries. This study investigated differences in tPTL and effectiveness of vaginal progesterone to prevent preterm birth (PTB) between two countries. Secondary analysis of a randomized controlled trial (RCT) from Argentina and Switzerland comparing vaginal progesterone to placebo in women with tPTL (n = 379). Cox proportional hazards analysis was performed to compare placebo groups of both countries and to compare progesterone to placebo within each country. We adjusted for baseline differences. Iatrogenic onset of labor or pregnancy beyond gestational age of interest was censored. Swiss and Argentinian women were different on baseline. Risks for delivery
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- 2016
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19. Modelo para abordar integralmente la mortalidad materna y la morbilidad materna grave
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Ariel Karolinski, Raúl Mercer, Paula Micone, Celina Ocampo, Pablo Salgado, Dalia Szulik, Lucila Swarcz, Vicente R Corte, Belén Fernández del Moral, Jorge Pianesi, and Pier Paolo Balladelli
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mortalidad materna ,lcsh:Arctic medicine. Tropical medicine ,Salud de la mujer ,lcsh:RC955-962 ,lcsh:Public aspects of medicine ,lcsh:R ,Argentina ,complicaciones del embarazo ,lcsh:Medicine ,lcsh:RA1-1270 ,investigación operativa - Abstract
La mortalidad materna es un importante problema de salud pública y de derechos humanos y refleja los efectos de los determinantes sociales sobre la salud de las mujeres. El conocimiento de la magnitud y las causas de las muertes maternas ha sido insuficiente para intervenir efectivamente en el alcance de los Objetivos de Desarrollo del Milenio. Por ello, se plantea un modelo para abordar integralmente la mortalidad materna, con siete campos: priorización y definición del problema, caracterización contextual, amplitud metodológica, gestión del conocimiento, innovación, implementación, y un sistema de monitoreo y evaluación. Este modelo permite abordar los problemas asociados con la mortalidad materna y la morbilidad materna grave mediante la integración, desde una perspectiva anticipatoria, de las complicaciones potencialmente fatales asociadas con el proceso reproductivo y su vigilancia. Se destaca la importancia de la gestión del conocimiento para la reorientación de políticas, programas y la atención sanitaria. Se debe mejorar la interacción y explotar las sinergias entre las personas, las comunidades y los actores del sistema de salud para potenciar los resultados de los programas sanitarios. Se requiere más información científica validada sobre la forma en que las intervenciones deben aplicarse en diferentes entornos. Para ello, es esencial fortalecer la articulación entre los centros de investigación, las agencias de cooperación y los organismos del Estado y su incorporación a las acciones programáticas y a la definición de una nueva agenda de salud de la mujer para la Región de las Américas.
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- 2015
20. Detecting isolated stellar-mass black holes in the absence of microlensing parallax effect.
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Karolinski, Numa and Zhu(祝伟), Wei
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BLACK holes , *PARALLAX , *MICROLENSING (Astrophysics) , *GRAVITATIONAL lenses - Abstract
Gravitational microlensing can detect isolated stellar-mass black holes (BHs), which are believed to be the dominant form of Galactic BHs according to population synthesis models. Previous searches for BH events in microlensing data focused on long time-scale events with significant microlensing parallax detections. Here we show that, although BH events preferentially have long time-scales, the microlensing parallax amplitudes are so small that in most cases the parallax signals cannot be detected statistically significantly. We then identify OGLE-2006-BLG-044 to be a candidate BH event because of its long time-scale and small microlensing parallax. Our findings have implications to future BH searches in microlensing data. [ABSTRACT FROM AUTHOR]
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- 2020
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21. Prevention of preterm delivery with vaginal progesterone in women with preterm labour (4P): randomised double-blind placebo-controlled trial
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E Schinner, Cristina Laterra, C Tuma, J.C. Nassif, M Poncelas, J Antón, R Papera, A Messina, G Breccia, V Wainer, A Bunader, O Tiberio, Michel Boulvain, M V Bertolino, D Fernández, Olivier Irion, B Peker, S Rouillier, D Nowacki, Gero Drack, M Huespe, Irene Hösli, G López de Degani, E Prentl, Ariel Karolinski, Ben W.J. Mol, R Espoile, L Kanterewicz, Véronique Othenin-Girard, F Krähenmann, M C Ocampo, B Martinez de Tejada, Daniel Surbek, E Seidenstein, and Obstetrics and Gynaecology
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Adult ,medicine.medical_specialty ,Pregnancy Trimester, Third ,Obstetric Labor, Premature/drug therapy ,Population ,Placebo-controlled study ,Receptors, Oxytocin/antagonists & inhibitors ,Tocolytic Agents/therapeutic use ,Placebo ,Intensive Care Units, Neonatal/utilization ,Young Adult ,Double-Blind Method ,Indomethacin/therapeutic use ,Pregnancy ,Infant Mortality ,medicine ,Birth Weight ,Humans ,education ,Adverse effect ,Progestins/therapeutic use ,education.field_of_study ,ddc:618 ,Obstetrics ,business.industry ,Preterm labour ,Infant, Newborn ,Infant ,Obstetrics and Gynecology ,Progesterone/therapeutic use ,Confidence interval ,Administration, Intravaginal ,Premature Birth/prevention & control ,Pregnancy Trimester, Second ,Relative risk ,Apgar Score ,Gestation ,Female ,business - Abstract
OBJECTIVE To evaluate the effectiveness of 200 mg of daily vaginal natural progesterone to prevent preterm birth in women with preterm labour. DESIGN Multicentre, randomised, double-blind, placebo-controlled trial. SETTING Twenty-nine centres in Switzerland and Argentina. POPULATION A total of 385 women with preterm labour (24(0/7) to 33(6/7) weeks of gestation) treated with acute tocolysis. METHODS Participants were randomly allocated to either 200 mg daily of self-administered vaginal progesterone or placebo within 48 hours of starting acute tocolysis. MAIN OUTCOME MEASURES Primary outcome was delivery before 37 weeks of gestation. Secondary outcomes were delivery before 32 and 34 weeks, adverse effects, duration of tocolysis, re-admissions for preterm labour, length of hospital stay, and neonatal morbidity and mortality. The study was ended prematurely based on results of the intermediate analysis. RESULTS Preterm birth occurred in 42.5% of women in the progesterone group versus 35.5% in the placebo group (relative risk [RR] 1.2; 95% confidence interval [95% CI] 0.93-1.5). Delivery at
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- 2015
22. The Magpie Trial: a randomised trial comparing magnesium sulphate with placebo for pre-eclampsia. Outcome for women at 2 years
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Duley, L, Farrell, B, Armstrong, N, Spark, P, Roberts, B, Smyth, R, Tivnan, M, Laws, A, Corfield, N, Salter, A, Thorn, L, Altman, D, Yu, L-M, Abalos, E, Carroli, B, Dellepiane, L, Duarte, M, Fernandez, H, Giordano, D, Clarke, M, Gray, A, Hey, E, Neilson, J, Simon, J, Collins, R, Karaoglou, A, Lilford, R, Moodley, J, Robson, S, Roberts, I, Rubin, P, Thornton, J, Twaddle, S, Villar, J, Walker, I, Watkins, C, Doyle, L, Bimbashi, A, Demalia, E, Gliozheni, O, Shpata, A, Karolinski, A, Lamas, M, Pesaresi, M, Wainer, V, Barbato, W, Paciocco, M, Bertin, M, Boiza, E, Castaldi, J, Partida, Y, Arias, C, Farri, M, Kerz, G, Aguirre, J, de Sagastizabal, M, Falcone, R, Morales, E, Carroli, G, Krupitzky, S, Lopez, S, Palermo, M, Varela, DM, Delprato, H, Camusso, H, Curioni, M, Ludmer, E, Brandi, R, Martin, R, Mesas, W, Taralli, R, Lezaola, M, Morosini, M, Andina, E, Bernal, L, Estiu, M, Ulens, E, de Speranza, BO, Peyrano, A, Damiano, M, Saumench, C, Horn, J, Pritchard, M, Smith-Orr, V, Wilson, M, Lawrence, A, Watson, D, Crowther, C, Paynter, J, Mannan, M, Shahidullah, M, Shamsuddin, L, Santos, CB, Freire, S, Melo, E, Cobo, E, Jaramillo, M, Cardozo, C, Fandino, N, Gaitan, H, Montano, L, Lozano, J, Rojas, M, Garcia, AB, Ramirez, AF, Miras, RG, Sampera, S, Farnot, U, Gomez, E, Rojas, G, Valdes, R, El-Kreem, HA, Al-Hussaini, T, Hammad, E, Danso, K, Kwapong, E, Ofosu-Barko, F, Jasper, MP, Peedicayil, A, Regi, A, Sharma, R, Chauhan, A, Raut, V, Udani, R, Batra, S, Muthal-Rathore, A, Ramji, S, Zutshi, V, Balakrishnan, S, Eapen, E, Koshy, G, Ambardar, B, Vadakkepat, P, Vaidya, D, Lema, V, Rijken, Y, Tadesse, E, Dada, O, Sofekun, A, Ohiaeri, C, Runsewe-Abiodun, T, Adewole, I, Adeyemo, A, Brown, B, Oladokun, R, Adewale, O, Inimgba, N, John, C, Ogu, R, Ekele, B, Isah, A, Onankpa, B, Jamelle, R, Junejo, D, Faiz, N, Gul, F, Sherin, A, Bangash, K, Mahmud, G, Masud, K, Tasneem, N, Gassama, S, Soyei, A, Agarwal, P, Rajadurai, V, Pirani, N, Delport, S, Macdonald, P, Mokhondo, R, Pattinson, R, Zondo, M, Adhikari, M, Mnguni, N, Carstens, M, Kirsten, G, Steyn, W, van Zyl, J, Helwig, A, Jacobson, S-L, Panosche, R, Hammond, E, Masanganise, L, and Colla, MTF-US
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Pediatrics ,medicine.medical_specialty ,Randomization ,pre-eclampsia ,magnesium sulphate ,Population ,Maternal Medicine ,Placebo ,law.invention ,Longterm follow-up ,Magnesium Sulfate ,Randomized controlled trial ,Interquartile range ,law ,Pregnancy ,Risk Factors ,Medicine ,Humans ,Maternal Health Services ,education ,Child ,education.field_of_study ,Eclampsia ,business.industry ,Pregnancy Outcome ,Obstetrics and Gynecology ,Patient Acceptance of Health Care ,medicine.disease ,randomised trial ,Clinical trial ,Maternal Mortality ,Relative risk ,Anticonvulsants ,Female ,business ,Follow-Up Studies - Abstract
Objective: The aim of this study was to assess long-term effects for women following the use of magnesium sulphate for pre-eclampsia. Design: Assessment at 2-3 years after delivery for women recruited to the Magpie Trial (recruitment in 1998-2001, ISRCTN 86938761), which compared magnesium sulphate with placebo for pre-eclampsia. Setting: Follow up after discharge from hospital at 125 centres in 19 countries across five continents. Population: A total of 7927 women were randomised at the follow-up centres. Of these women, 2544 were not included for logistic reasons and 601 excluded (109 at a centre where
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- 2006
23. The Magpie Trial: a randomised trial comparing magnesium sulphate with placebo for pre-eclampsia. Outcome for children at 18 months
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Duley, L, Farrell, B, Armstrong, N, Spark, P, Roberts, B, Smyth, R, Tivnan, M, Laws, A, Corfield, N, Salter, A, Thorn, L, Altman, D, Yu, L-M, Abalos, E, Carroli, B, Dellepiane, L, Duarte, M, Fernandez, H, Giordano, D, Clarke, M, Gray, A, Hey, E, Neilson, J, Simon, J, Doyle, L, Kelly, T, Squires, J, Collins, R, Karaoglou, A, Lilford, R, Moodley, J, Robson, S, Roberts, I, Rubin, P, Thornton, J, Twaddle, S, Villar, J, Walker, I, Watkins, C, Bimbashi, A, Demalia, E, Gliozheni, O, Shpata, A, Karolinski, A, Lamas, M, Pesaresi, M, Wainer, V, Barbato, W, Paciocco, M, Bertin, M, Boiza, E, Castaldi, J, Partida, Y, Farri, M, Kerz, G, Aguirre, J, de Sagastiza, M, Falcone, R, Morales, E, Carroli, G, Krupitzky, S, Lopez, S, Palermo, M, Varela, DM, Delprato, H, Camusso, H, Curioni, M, Ludmer, E, Brandi, R, Martin, R, Mesas, W, Taralli, R, Lezaola, M, Morosini, M, Andina, E, Bernal, L, Estiu, M, Ulens, E, de Speranza, BO, Peyrano, A, Damiano, M, Saumench, C, Horn, J, Pritchard, M, Smith-Orr, V, Wilson, M, Lawrence, A, Watson, D, Crowther, C, Paynter, J, Mannan, M, Shahidullah, M, Shamsuddin, L, Barros Santos, C, Freire, S, Melo, E, Cobo, E, Jaramillo, M, Cardozo, C, Fandino, N, Gaitan, H, Montano, L, Lozano, J, Rojas, M, Breto Garcia, A, Fuentes Ramirez, A, Garcia Miras, R, Sampera, S, Farnot, U, Gomez, E, Rojas, G, Valdez, R, El-Kreem, HA, Al-Hussaini, T, Hammad, E, Danso, K, Kwapong, E, Ofosu-Barko, F, Jasper, MP, Peedicayil, A, Regi, A, Sharma, R, Chauhan, A, Raut, V, Udani, R, Batra, S, Muthal-Rathore, A, Ramji, S, Zutshi, V, Balakrishnan, S, Eapen, E, Koshy, G, Ambardar, B, Vadakkepat, P, Vaidya, D, Lema, V, Rijken, Y, Tadesse, E, Dada, O, Sofekun, A, Ohiaeri, C, Runsewe-Abiodun, T, Adewole, I, Adeyemo, A, Brown, B, Oladokun, R, Adewale, O, Inimgba, N, John, C, Ogu, R, Ekele, B, Isah, A, Onankpa, B, Jamelle, R, Junejo, D, Faiz, NR, Gul, F, Sherin, A, Bangash, K, Mahmud, G, Masud, K, Tasneem, N, Gassama, S, Soyei, A, Agarwal, P, Rajadurai, V, Hani, C, Pirani, N, Delport, S, Macdonald, P, Mokhondo, R, Pattinson, R, Zondo, M, Adhikari, M, Mnguni, N, Carstens, M, Kirsten, G, Steyn, W, van Zyl, J, Helwig, A, Jacobson, S-L, Panosche, R, Hammond, E, Masanganise, L, and Collabor, MTFS
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Pediatrics ,medicine.medical_specialty ,pre-eclampsia ,magnesium sulphate ,Maternal Medicine ,Placebo ,Preeclampsia ,law.invention ,Longterm follow-up ,Disability Evaluation ,Magnesium Sulfate ,Randomized controlled trial ,law ,Pregnancy ,medicine ,Humans ,reproductive and urinary physiology ,Cause of death ,Eclampsia ,business.industry ,Pregnancy Outcome ,Obstetrics and Gynecology ,Infant ,medicine.disease ,randomised trial ,female genital diseases and pregnancy complications ,Disabled Children ,Clinical trial ,In utero ,Prenatal Exposure Delayed Effects ,Sensation Disorders ,Anticonvulsants ,Female ,Nervous System Diseases ,business - Abstract
Objective To assess the long-term effects of in utero exposure to magnesium sulphate for children whose mothers had pre-eclampsia. Design Assessment at 18 months of age for children whose mothers were recruited to the Magpie Trial (recruitment 1998–2001 ISRCTN 86938761), which compared magnesium sulphate with placebo. Setting Follow-up of children born at 125 centres in 19 countries across five continents. Population A total of 6922 children were born to women randomised before delivery at follow-up centres. Of these, 2271 were not included for logistic reasons and 168 were excluded (101 at a centre where
- Published
- 2007
24. Population differences and the effect of vaginal progesterone on preterm birth in women with threatened preterm labor (.).
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Hermans, Frederik Jan Robin, Karolinski, Ariel, Othenin-Girard, Véronique, Bertolino, María Victoria, Schuit, Ewoud, Salgado, Pablo, Hösli, Irene, Irion, Olivier, Laterra, Cristina, Mol, Ben Willem J., and Martinez de Tejada, Begoña
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- *
PREGNANCY complications , *PROGESTERONE regulation , *PREMATURE labor , *RANDOMIZED controlled trials , *GESTATIONAL age , *THERAPEUTIC use of progestational hormones , *PROGESTERONE , *PREMATURE infants , *CHI-squared test , *COMPARATIVE studies , *RESEARCH methodology , *MEDICAL cooperation , *NONPARAMETRIC statistics , *RESEARCH , *EVALUATION research , *PROPORTIONAL hazards models , *BLIND experiment , *PREVENTION , *THERAPEUTICS - Abstract
Objective: Threatened preterm labor (tPTL) is a complication of pregnancy. Identification of women and clinical definition differs between countries. This study investigated differences in tPTL and effectiveness of vaginal progesterone to prevent preterm birth (PTB) between two countries.Methods: Secondary analysis of a randomized controlled trial (RCT) from Argentina and Switzerland comparing vaginal progesterone to placebo in women with tPTL (n = 379). Cox proportional hazards analysis was performed to compare placebo groups of both countries and to compare progesterone to placebo within each country. We adjusted for baseline differences. Iatrogenic onset of labor or pregnancy beyond gestational age of interest was censored.Results: Swiss and Argentinian women were different on baseline. Risks for delivery <14 days and PTB < 34 and < 37 weeks were increased in Argentina compared to Switzerland, HR 3.3 (95% CI 0.62-18), 54 (95% CI 5.1-569) and 3.1 (95% CI 1.1-8.4). In Switzerland, progesterone increased the risk for delivery <14 days [HR 4.4 (95% CI 1.3-15.7)] and PTB <37 weeks [HR 2.5 (95% CI 1.4-4.8)], in Argentina there was no such effect.Conclusion: In women with tPTL, the effect of progesterone may vary due to population differences. Differences in populations should be considered in multicenter RCTs. [ABSTRACT FROM AUTHOR]- Published
- 2016
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25. Vaginal progesterone for maintenance tocolysis: a systematic review and metaanalysis of randomized trials
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Martinez de Tejada, Begoña and Karolinski, Ariel
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- 2015
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26. 798: Population differences influence effectiveness of progesterone in women with threatened preterm labor
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Hermans, Frederik, Karolinski, Ariel, Othenin-Girard, Véronique, Schuit, Ewoud, Laterra, Christina, Hösli, Irene, Fernández, Daniel, Irion, Olivier, Bertolino, Victoria, Mol, Ben, and de Tejada, Begoña Martinez
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- 2015
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27. Prevention of preterm delivery with vaginal progesterone in women with preterm labour (4P): randomised double-blind placebo-controlled trial.
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Martinez de Tejada, B, Karolinski, A, Ocampo, MC, Laterra, C, Hösli, I, Fernández, D, Surbek, D, Huespe, M, Drack, G, Bunader, A, Rouillier, S, López de Degani, G, Seidenstein, E, Prentl, E, Antón, J, Krähenmann, F, Nowacki, D, Poncelas, M, Nassif, JC, and Papera, R
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- *
PROGESTERONE , *PREMATURE labor prevention , *MATERNAL health services , *PLACEBOS , *NEONATAL death , *RANDOMIZED controlled trials , *THERAPEUTICS - Abstract
Objective To evaluate the effectiveness of 200 mg of daily vaginal natural progesterone to prevent preterm birth in women with preterm labour. Design Multicentre, randomised, double-blind, placebo-controlled trial. Setting Twenty-nine centres in Switzerland and Argentina. Population A total of 385 women with preterm labour (240/7 to 336/7 weeks of gestation) treated with acute tocolysis. Methods Participants were randomly allocated to either 200 mg daily of self-administered vaginal progesterone or placebo within 48 hours of starting acute tocolysis. Main outcome measures Primary outcome was delivery before 37 weeks of gestation. Secondary outcomes were delivery before 32 and 34 weeks, adverse effects, duration of tocolysis, re-admissions for preterm labour, length of hospital stay, and neonatal morbidity and mortality. The study was ended prematurely based on results of the intermediate analysis. Results Preterm birth occurred in 42.5% of women in the progesterone group versus 35.5% in the placebo group (relative risk [ RR] 1.2; 95% confidence interval [95% CI] 0.93-1.5). Delivery at <32 and <34 weeks did not differ between the two groups (12.9 versus 9.7%; [ RR 1.3; 95% CI 0.7-2.5] and 19.7 versus 12.9% [ RR 1.5; 95% CI 0.9-2.4], respectively). The duration of tocolysis, hospitalisation, and recurrence of preterm labour were comparable between groups. Neonatal morbidity occurred in 44 (22.8%) cases on progesterone versus 35 (18.8%) cases on placebo ( RR: 1.2; 95% CI 0.82-1.8), whereas there were 4 (2%) neonatal deaths in each study group. Conclusion There is no evidence that the daily administration of 200 mg vaginal progesterone decreases preterm birth or improves neonatal outcome in women with preterm labour. [ABSTRACT FROM AUTHOR]
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- 2015
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28. 770: Prevention of preterm delivery with vaginal progesterone in women with arrested preterm labor: secondary analysis of the 4P trial
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de Tejada, Begoña Martinez, Karolinski, Ariel, Othenin-Girard, Véronique, Bertolino, Victoria, Wainer, Veronica, Ocampo, Celina, Boulvain, Michel, and Olivier, Irion
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- 2014
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29. W386 LIFE-THREATENING COMPLICATIONS ASSOCIATED WITH THE REPRODUCTIVE PROCESS: MULTICENTRE COLLABORATIVE RESEARCH TO IMPROVE THE MANAGEMENT OF SEVERE MATERNAL MORBIDITY AND REDUCE MATERNAL MORTALITY
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Karolinski, A., Mercer, R., Micone, P., Ocampo, C., Mazzoni, A., Fontana, O.G., Messina, A., Winograd, R.H., and Nassif, J.C.
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- 2012
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30. O357 INFLUENZA A (H1 N1) MF59-ADJUVANTED VACCINE AND ADVERSE PERINATAL OUTCOMES. A LARGE CROSS SECTIONAL MULTICENTER STUDY
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Rubinstein, F., Micone, P., Bonotti, A., Wainer, V., Schwarcz, A., Augustovski, F., Riviere, A. Pichon, and Karolinski, A.
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- 2012
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31. Acceptability and continuation of use of the subdermal contraceptive implant among adolescents and young women in Argentina: a retrospective cohort study.
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Maceira D, Oizerovich S, Perrotta G, de León RGP, Karolinski A, Suarez N, Espinola N, Caffe S, and Chandra-Mouli V
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- Pregnancy, Humans, Female, Adolescent, Young Adult, Adult, Retrospective Studies, Argentina, Drug Implants, Levonorgestrel adverse effects, Contraceptive Agents, Female
- Abstract
A new public policy was instituted in Argentina for free distribution of subdermal contraceptive implants to women aged 15-24 years old in the public healthcare system. The objective of this study is to determine the extent to which this population adhered to the implant, as well as predictors of continuation. The retrospective cohort study was based on a telephone survey of a random sample of 1101 Ministry of Health-registered implant users concerning the continuation of use, satisfaction with the method and side-effects, and reasons for removal. Descriptive statistics and multivariate regression analysis were used to explore the association between adherence and having received contraceptive counselling, satisfaction, and side effects. We found high levels of adherence (87%) and satisfaction (94%). Common reported side effects were amenorrhoea or infrequent bleeding, perceived weight gain, increased menstrual bleeding and headaches. Multivariate regression analysis indicates that, among adolescents, having received contraceptive counselling increased comfort, while frequent bleeding at six months hindered trust. Participants who had a history of a prior delivery or who had themselves primarily chosen the method were less likely to request the removal of the implant. Our results support the public policy of free implant distribution in the public health sector. This is a sustainable public policy that contributes to equity and access to effective contraception. It is appropriate for adolescents and young women and will also reduce unintended pregnancies. Our results suggest that counselling patients is key prior to insertion of the implant, as it improves acceptability and continuation.
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- 2023
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32. The epidemiology of life-threatening complications associated with reproductive process in public hospitals in Argentina.
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Karolinski A, Mercer R, Micone P, Ocampo C, Mazzoni A, Fontana O, Messina A, Winograd R, Frers MC, Nassif JC, Elordi HC, Lapidus A, Taddeo C, Damiano M, Lambruschini R, Muzzio C, Pecker B, Natale S, Nowacki D, Betular A, Breccia G, Di Biase L, Montes Varela D, Dunaiewsky A, Minsk E, Fernández D, Martire L, Huespe M, Laterra C, Spagnuolo R, and Gregoris C
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- Abortion, Incomplete therapy, Abortion, Induced adverse effects, Abortion, Induced mortality, Adult, Antibiotic Prophylaxis, Anticonvulsants therapeutic use, Argentina, Cross-Sectional Studies, Female, Hospitals, Public, Humans, Magnesium Sulfate therapeutic use, Pregnancy, Prospective Studies, Sepsis mortality, Vacuum Curettage, Young Adult, Maternal Mortality, Pregnancy Complications epidemiology, Puerperal Disorders epidemiology
- Abstract
Objective: To analyse life-threatening obstetric complications that occurred in public hospitals in Argentina., Design: Multicentre collaborative cross-sectional study., Setting: Twenty-five hospitals included in the Perinatal Network of Buenos Aires Metropolitan Area., Population: Women giving birth in participating hospitals during a 1-year period., Methods: All cases of severe maternal morbidity (SMM) and maternal mortality (MM) during pregnancy (including miscarriage and induced abortion), labour and puerperium were included. Data were collected prospectively., Main Outcome Measures: Identification criteria, main causes and incidence of SMM; case-fatality rates, morbidity-mortality index and effective intervention's use rate., Results: A total of 552 women with life-threatening conditions were identified: 518 with SMM, 34 with MM. Identification criteria for SMM were case-management (48.9%), organ dysfunction (15.2%) and mixed criteria (35.9%). Incidence of SMM was 0.8% (95% confidence interval [95% CI] 0.73-0.87%) and hospital maternal death ratio was 52.3 per 100 000 live births (95% CI 35.5-69.1). Main causes of MM were abortion complications and puerperal sepsis; main causes of SMM were postpartum haemorrhage and hypertension. Overall case-fatality rate was 6.2% (95% CI 4.4-8.6): the highest due to sepsis (14.8%) and abortion complications (13.3%). Morbidity-mortality index was 15:1 (95% CI 7.5-30.8). Use rate of known effective interventions to prevent or treat main causes of MM and SMM was 52.3% (95% CI 46.9-57.7)., Conclusions: This study describes the importance of life-threatening obstetric complications that took place in public hospitals with comprehensive obstetric care and the low utilisation of known effective interventions that may decrease rates of SMM and MM. It also provides arguments that justify the need to develop a surveillance system for SMM., (© 2013 RCOG.)
- Published
- 2013
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