Characteristics of Liver Transplantation in Argentina: A Multicenter Study.

INTRODUCTION: There is a lack of information regarding outcomes after liver transplant in Latin America. OBJECTIVES: This study sought to describe outcomes after liver transplant in adult patients from Argentina. METHODS: We performed an ambispective cohort study of adult patients transplanted between June 2010 and October 2012 in 6 centers from Argentina. Only patients who survived after the first 48 hours postransplantation were included. Pretransplantation and posttransplantation data were collected. RESULTS: A total of 200 patients were included in the study. Median age at time of transplant was 50 (interquartile range [IQR] 26 to 54) years. In total, 173 (86%) patients had cirrhosis, and the most frequent etiology in these patients was hepatitis C (32%). A total of 35 (17%) patients were transplanted with hepatocellular carcinoma. In patients with cirrhosis, the median Model for End-Stage Liver Disease (MELD) score at time of liver transplant was 25 (IQR 19 to 30). Median time on the waiting list for elective patients was 101 (IQR 27 to 295) days, and 3 (IQR 2 to 4) days for urgent patients. Almost 40% of the patients were readmitted during the first 6 months after liver transplant. Acute rejection occurred in 27% of the patients. Biliary and vascular complications were reported in 39 (19%) and 19 (9%) patients, respectively. Renal failure, diabetes, and dyslipidemia were present in 40 (26%), 87 (57%), and 77 (50%) at 2 years, respectively. CONCLUSIONS: We believe the information contained in this article might be of value for reviewing current practices and developing local policies.

Epidemiología del parkinsonismo en el Área de Salud de Guadalajara / Epidemiology of parkinsonism in the Guadalajara Health Area

Objetivos. 1) Hallar la prevalencia de los síndromes parkinsonianos en el Área de Salud de Guadalajara y en sus Zonas Básicas de Salud, así como la tipología de la enfermedad de Parkinson; 2) determinar la distribución del consumo de medicación antiparkinsoniana en el total del Área, y 3) evaluar el coste por persona y año de este consumo según criterios de sexo y edad. Material y método. Estudio descriptivo transversal. Se estudiaron 1.352 personas afectas de parkinsonismo en el Área de Guadalajara, de ambos sexos y todas las edades. Se midieron las variables edad, sexo, medio, diagnóstico, tipología de la enfermedad de Parkinson mediante el índice de Hoehn y Yahr, tratamiento, coste total y coste medio del tratamiento por persona y año. Se calcularon las prevalencias y se utilizaron los métodos propios de la estadística descriptiva. Resultados. La prevalencia de parkinsonismo era de 585/105 habitantes, siendo superior en el medio rural (p < 0,05), en mujeres (p < 0,01) y en mayores de 90 años (p < 0,01). La mayoría padecía enfermedad de Parkinson (p < 0,001), de los cuales el 43,4% tenía una sintomatología concordante con el grado ii de Yahr (p < 0,001). El principio activo más consumido era la levodopa/carbidopa (51,3%) (p < 0,001), y el coste medio de los fármacos por persona era de 514,37 Euros. Conclusiones. La prevalencia de parkinsonismo es similar a la existente en el resto del país, aunque en nuestro estudio es predominante en el sexo femenino y el medio rural. La levodopa es el fármaco más utilizado, y el coste medio terapéutico por persona se asemeja al de las demás zonas de España (AU)

Objectives. 1) To determine the prevalence of Parkinson syndromes in the Guadalajara Health Area and its Basic Health Zones, as well as the typology of the Parkinson's disease; 2) to determine the distribution of antiparkinsonian medication use in the whole Area, and 3) to evaluate the cost per person and per year of this use according to the criteria of sex and age. Material and method. A descriptive cross-sectional study including 1,352 subjects affected by parkinsonism in the Guadalajara Area of both sexes and all ages. The variables measured were age, sex, environment, diagnosis, typology of the Parkinson's disease using the Hoehn and Yahr index, treatment, total cost and mean cost of the treatment per person per year. Prevalences were calculated, and the appropriate descriptive statistics were used. Results. The prevalence of parkinsonism was 585/105 inhabitants, being higher in a rural environment (P < .05), in females (P < .01) and in subjects over 90 years (P < .01). The majority suffered from Parkinson's disease (P < .001), of whom 43.4% had symptoms equivalent to Yahr grade ii (P < .001). The active ingredient most used was levodopa/carbidopa (51.3%) (P < .001) and the mean drug cost per person was 514.37 Euros. Conclusions. The prevalence of parkinsonism is similar to that in the rest of the country, although in our study there is a predominance of females and it is in a rural environment. Levodopa is the drug most used, and the mean therapeutic cost per person is similar to the rest of Spain (AU)

[Epidemiology of parkinsonism in the Guadalajara Health Area]. / Epidemiología del parkinsonismo en el Área de Salud de Guadalajara.

OBJECTIVES: 1) To determine the prevalence of Parkinson syndromes in the Guadalajara Health Area and its Basic Health Zones, as well as the typology of the Parkinson's disease; 2) to determine the distribution of antiparkinsonian medication use in the whole Area, and 3) to evaluate the cost per person and per year of this use according to the criteria of sex and age. MATERIAL AND METHOD: A descriptive cross-sectional study including 1,352 subjects affected by parkinsonism in the Guadalajara Area of both sexes and all ages. The variables measured were age, sex, environment, diagnosis, typology of the Parkinson's disease using the Hoehn and Yahr index, treatment, total cost and mean cost of the treatment per person per year. Prevalences were calculated, and the appropriate descriptive statistics were used. RESULTS: The prevalence of parkinsonism was 585/10(5) inhabitants, being higher in a rural environment (P<.05), in females (P<.01) and in subjects over 90 years (P<.01). The majority suffered from Parkinson's disease (P<.001), of whom 43.4% had symptoms equivalent to Yahr grade II (P<.001). The active ingredient most used was levodopa/carbidopa (51.3%) (P<.001) and the mean drug cost per person was 514.37€. CONCLUSIONS: The prevalence of parkinsonism is similar to that in the rest of the country, although in our study there is a predominance of females and it is in a rural environment. Levodopa is the drug most used, and the mean therapeutic cost per person is similar to the rest of Spain.