scholarly journals Drug Interactions with Antidementia Drugs: Clinical Consequences

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
C.A. de Mendonça Lima
Keyword(s):  
Adverse Effects ◽  
Drug Interactions ◽  
Cognitive Disorders ◽  
Public Health Problem ◽  
Cardiac Conduction ◽  
Major Public Health Problem ◽  
List Type ◽  
Spontaneous Reports ◽  
Increased Risk ◽  
Antidementia Drugs

Alzheimer" disease (AD) is a major public health problem, and it is at the origin of a significant burden: 15% of direct costs in dementia are attributed to pharmacological treatment. Persons with dementia often have comorbidities and receive multiple medications. Both factors increase the risk of drug-drug interactions (DDIs) which can result in adverse drug reactions (ADRs). In a study, a total of 1058 spontaneous reports were identified that involved cholinesterase inhibitors (ChEIs) in the French Pharmacovigilance Database; 35.5% contained at least one DDI; 118 of them (31.4%) were the cause of ADRs. Pharmacodynamic interactions play a far greater role than pharmacokinetic interactions in the significance of DDIs. Some known interactions with ChEIs are:1.atropinic drugs aggravate cognitive disorders;2.combinations of ChEIs and antipsychotics are associated with an increased risk of extrapyramidal adverse effects;3.combining ChEIs with drugs that reduce the heart rate, depress cardiac conduction, or induce torsades de pointes increases the risk of arrhythmias and cardiac conduction disorders.Recent studies suggest that the therapeutic response in Alzheimer"s disease is genotype specific, depending on genes associated with AD pathogenesis and/or genes responsible for drug metabolism. APOEe4/e4 genotype carriers are the poorest responders to treatments. Some ChEIs are metabolized via CYP-related enzymes and can interact with other drugs that are substrates, inhibitors or inducers of the CYP system. Health professionals should be aware of the potential adverse effects of ChEIs, including the possible DDIs and antagonist effects with other drugs.

scholarly journals Internet Addiction Among Male Adolescents in Indonesia: A Qualitative Study

2021 ◽  
Vol 15 (3) ◽  
pp. 155798832110294
Author(s):  
Windy Rakhmawati ◽  
Cecep Eli Kosasih ◽  
Restuning Widiasih ◽  
Suryani Suryani ◽  
Hidayat Arifin
Keyword(s):  
Qualitative Study ◽  
Internet Addiction ◽  
Public Health Problem ◽  
Phenomenological Approach ◽  
Self Control ◽  
Easy Access ◽  
Major Public Health Problem ◽  
Psychosocial Effects ◽  
Male Adolescents ◽  
Increased Risk

Internet has become an important part of the daily life of adolescents. Easy access to internet and its social appeal among adolescent males render them at an increased risk of internet addiction and the associated adverse physical and psychosocial effects. We conducted a qualitative study using a phenomenological approach. A purposive sample of nine male adolescents was recruited in West Java, Indonesia. Semistructured interviews were conducted until data saturation was achieved. Data were subjected to thematic analysis. We identified four main themes from the experiences of adolescents with internet addition: reasons for internet addiction, unmet social need without the internet, effects of internet addiction, and self-control over internet usage. Internet addiction among male adolescents is a major public health problem that should be addressed. The findings of this study may be useful for health professionals and families to help male adolescents manage their internet addiction.

scholarly journals Role of Oxidative Stress as a Marker of Cardiovascular Risk in Children on Regular Hemodialysis

2021 ◽  
pp. 416-421
Author(s):  
Muhammad Abrar ◽  
Mazhar Nadeem ◽  
Sunila Fatima
Keyword(s):  
Oxidative Stress ◽  
Cardiovascular Risk ◽  
Prognostic Significance ◽  
Public Health Problem ◽  
Dialysis Session ◽  
Major Public Health Problem ◽  
Arterial Blood ◽  
Increased Risk ◽  
The Mean ◽  
Regular Hemodialysis

Introduction: Chronic kidney disease (CKD) is a major public health problem worldwide, and its main consequences include loss of renal function leading to end-stage renal disease (ESRD), increased risk of cardiovascular disease (CVD), significant increase in morbidity and mortality, and a decrease in health-related quality of life. Aims and Objectives: The basic aim of the study is to analyze the oxidative stress and total antioxidant capacity as a biomarker of cardiovascular risk in those children who are on regular hemodialysis. Materials and Methods: This cross sectional study was conducted at DHQ hospital, Faisalabad during July 2020 to January 2021. The data were collected from the age of less than 18 years children of both sexes. There were 50 children who was selected for this study. At the time of the study, all the patients were on regular three HD sessions per week. In HD patients, venous blood samples were drawn immediately before and after hemodialysis session. Baseline laboratory investigations were carried out for all patients and controls including complete blood count, serum urea and creatinine, arterial pH, arterial blood gases and infection screening, which included blood and urinary cultures by standard methods.  Results: The data were collected from 50 dialysis patients. The mean age of this study is 15years. We collected all the demographic data of patients. The mean value of Urea is 64.34±2.44 mg/dl). At before-dialysis session, duration of disease positively correlated with TPX (r = 0.969, P <0.001), but, negatively correlated with TAC (r = −0.469, P <0.002). At after-dialysis session, HIF-1α negatively correlated with each of TPX (r = −0.529, P <0.001) and OSI (r = −0.459, P <0.003); while, OSI positively correlated with TPX (r = 0.944, P <0.001). Conclusion: It is concluded that HD patients, the clinical and prognostic significance of oxidative status associated with cardiovascular risk factors is very different from the general population. Although a direct causality cannot be inferred from such kind of correlative investigations.

scholarly journals Sero-epidemiology and risk factors of syphilis in Makassar, Indonesia

2019 ◽  
Vol 11 (2) ◽  
pp. 43-49
Author(s):  
Maryam Kusumawaty ◽  
Khairuddin Djawad ◽  
Muh Nasrum Massi ◽  
Andi Muhammad Adam ◽  
Siswanto Wahab ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hiv Transmission ◽  
Treponema Pallidum ◽  
Public Health Problem ◽  
Sexual Relationships ◽  
Capital City ◽  
Major Public Health Problem ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Increased Risk

Abstract Introduction. Syphilis is an infectious disease caused by Treponema pallidum spirochete and is mainly transmitted by sexual contact. Syphilis has the potential to cause serious complications and is closely related to human immunodeficiency virus (HIV) infection thus making syphilis still a major public health problem. In Indonesia, surveys of high-risk populations in 2007 and 2011 reported an increase in the prevalence of syphilis, especially in men who have sexual relationships with other men (MSM). Moreover, studies have described risk factors for HIV transmission including MSM, heterosexual contacts, Intravenous (IV) drug use, and infected partners. Objectives. To assess the epidemiological aspects and risk factors for syphilis in Makassar, as well as the correlation with a coinfection of other sexually transmitted infections. Material and Methods. This study is a multi-centre cross-sectional descriptive study with consecutive sampling. We evaluated cases for eligibility by confirming the diagnosis based on the serological result using rapid plasma reagin assay (RPR), Treponema pallidum haemagglutination (TPHA), and HIV screening kit. The cases were analyzed based on epidemiological features, risk factors and clinical findings, co-infection with other sexually transmitted infection (ST), and stadium of the disease. Results. A total of 79 serologically confirmed syphilis cases were collected between January 2017 and December 2018 in Makassar, the capital city of South Sulawesi province in Indonesia. Of the 63 male subjects (79.7%), 38 (48.1%) were homosexual/MSM, and in 41 cases of HIV-infected subjects, 25 (60.9%) of them were also MSM. Conclusion. Our study showed there was a significant correlation between syphilis and an increased risk of HIV transmission in MSM groups. The higher number of cases of syphilis and HIV co-infection among MSM can increase transmission of both infections and should be considered a major risk factor for syphilis in Makassar.

scholarly journals Update on the drug-food interactions

2014 ◽  
Vol 1 (2) ◽  
pp. 100-106
Author(s):  
Hafid Bahri ◽  
◽  
Abdelkader Douaoui ◽  
Moufida Gharbi ◽  
Djamila Amroun
Keyword(s):  
Drug Interactions ◽  
Renal Clearance ◽  
Enzyme Inhibitor ◽  
Plasma Concentrations ◽  
Public Health Problem ◽  
Therapeutic Index ◽  
Major Public Health Problem ◽  
Urine Ph ◽  
Pharmacodynamic Interaction ◽  
The Impact

Drug interactions are a major public health problem, which partly attributed to some 10,000 deaths/year in Canada. Besides the interactions between two drugs, drug interactions are also due to the effect of other substances such as foods or nutrients. The drug-food interaction will be pharmacokinetic (affecting the absorption, distribution, metabolism, and elimination) or pharmacodynamic interaction. It is in the intestine that food may have the greatest impact with mainly a change in the amount of drugs absorbed that may be clinically significant for some drugs with narrow therapeutic index (cyclosporine, phenytoin, theophylline, etc.). The absorption of the drug in the presence of food will be determined by the particular physicochemical properties of the drug but also by the impact of food on one of the parameters determining the absorption such as: modified gastric acidity and emptying, the fat content of the food, the use of common transport between the drug and nutrients, chemical reactions between elements and drugs. Fasting situations or malnutrition can affect the distribution of drugs by increasing the free drug fraction, involving sometimes the risk of overdose. Diet affects drug metabolism by changing the activity of cytochrome P450. Most often is described the increase by grapefruit juice (enzyme inhibitor) of plasma concentrations of some drugs (cyclosporine, some statins, and calcium antagonists). Other foods (garlic, smoked meats and fish, caffeine) may increase metabolism. Diet can influence two stages of renal clearance (glomerular filtration - tubular reabsorption) by modifying urine pH or renal clearance. Pharmacodynamic interactions are also monitored, especially foods rich in vitamin k or tyramine with antivitamins K or MAOIs. Finally, health professionals must mobilize against these interactions, including through patient information.

scholarly journals The evolution of antibiotic resistance in a structured host population

2018 ◽  
Vol 15 (143) ◽  
pp. 20180040 ◽  
Author(s):  
François Blanquart ◽  
Sonja Lehtinen ◽  
Marc Lipsitch ◽  
Christophe Fraser
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Population ◽  
Public Health Problem ◽  
Host Population ◽  
Major Public Health Problem ◽  
Duration Of Treatment ◽  
Transmission Rates ◽  
Risk Of Death ◽  
Increased Risk ◽  
Resistant Strains

The evolution of antibiotic resistance in opportunistic pathogens such as Streptococcus pneumoniae , Escherichia coli or Staphylococcus aureus is a major public health problem, as infection with resistant strains leads to prolonged hospital stay and increased risk of death. Here, we develop a new model of the evolution of antibiotic resistance in a commensal bacterial population adapting to a heterogeneous host population composed of untreated and treated hosts, and structured in different host classes with different antibiotic use. Examples of host classes include age groups and geographic locations. Explicitly modelling the antibiotic treatment reveals that the emergence of a resistant strain is favoured by more frequent but shorter antibiotic courses, and by higher transmission rates. In addition, in a structured host population, localized transmission in host classes promotes both local adaptation of the bacterial population and the global maintenance of coexistence between sensitive and resistant strains. When transmission rates are heterogeneous across host classes, resistant strains evolve more readily in core groups of transmission. These findings have implications for the better management of antibiotic resistance: reducing the rate at which individuals receive antibiotics is more effective to reduce resistance than reducing the duration of treatment. Reducing the rate of treatment in a targeted class of the host population allows greater reduction in resistance, but determining which class to target is difficult in practice.

scholarly journals Prevalence and Determinants of Falls among Older Adults in Ecuador: An Analysis of the SABE I Survey

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Carlos H. Orces
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Coastal Region ◽  
Public Health Problem ◽  
Linear Increase ◽  
Andes Mountains ◽  
Major Public Health Problem ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Nationally Representative

The present study based on a nationally representative sample of older adults living in the Andes mountains and coastal region of the country indicates that 34.7% of older adults had fallen in the previous year in Ecuador. Among fallers, 30.6% reported a fall-related injury. The prevalence of falls was higher in women and among older adults residing in the rural Andes mountains. In the multivariate model, women, subjects with cognitive impairment, those reporting urinary incontinence, and those being physically active during the previous year were variables found independently associated with increased risk of falling among older adults in Ecuador. Moreover, a gradual and linear increase in the prevalence of falls was seen as the number of risk factors increased. Falls represent a major public health problem among older adults in Ecuador. The present findings may assist public health authorities to implement programs of awareness and fall prevention among older adults at higher risk of falls.

scholarly journals A survey to assess awareness about fixed dose combinations (FDCs) among pharmacists in two Central Kashmir Districts, Srinagar and Budgam, Kashmir, India

2017 ◽  
Vol 6 (5) ◽  
pp. 1133
Author(s):  
Shakeel Ahmad Mir
Keyword(s):  
Adverse Drug Events ◽  
Technical Information ◽  
Public Health Problem ◽  
Fixed Dose ◽  
Healthcare Team ◽  
Major Public Health Problem ◽  
Increased Risk ◽  
Basic Facts ◽  
The Cost ◽  
Improve Patient

Background: FDCs are highly popular in Indian pharmaceutical market. The FDCs have both advantages as well as disadvantages. To be advantageous WHO guidelines for the manufacture and use of FDCs must be strictly followed. Irrational use of FDCs is a major public health problem and leads to increased risk of adverse drug events, higher treatment costs and antimicrobial resistance. FDCs as well as other single component drugs cannot be used rationally unless everyone involved directly or indirectly in the health care profession is involved. Pharmacist is a coordinator between different members of healthcare team and the patients. Hence, his role in safe use of medicines is important. The present study was undertaken to assess the knowledge of pharmacists about FDCs.Methods: A descriptive questionnaire survey was conducted in various government and private pharmacies of two Central Kashmir Districts, Srinagar and Budgam, aiming to assess the knowledge of pharmacists about FDCs. The questionnaires were distributed randomly among 79 pharmacists, out of which 60 returned the completed questionnaire.Results: 55.00% of the respondents knew the basic facts about FDCs. 96.66% knew that FDCs reduced the cost of therapy and 93.33% were aware that FDCs improve patient compliance. 60% answered incorrectly when asked about effect of FDCs on cumulative toxicity. Almost equal percentage (63.33%) answered incorrectly when asked about rationality and ADR profile of FDCs. 83.33% knew that it is difficult to know the offending agent in case ADRs occur after FDC use.78.33% respondents thought that all FDCs are approved by drug regulatory authorities.Conclusions: The study showed that pharmacists had not the enough knowledge about FDCs. Pharmacy students in their formative years of learning should be taught to promote rational use of FDCs as they are the future custodians of technical information on the products available on their domestic market.

scholarly journals Safety of intradermal rabies vaccine as pre-exposure prophylaxis among veterinary students

2017 ◽  
Vol 4 (2) ◽  
pp. 396
Author(s):  
Ravish H. S. ◽  
Aravind M. ◽  
Ashwath Narayana D. H. ◽  
Yannick P. ◽  
Phaneendra M. S.
Keyword(s):  
Chick Embryo ◽  
Adverse Reactions ◽  
Public Health Problem ◽  
Risk Groups ◽  
Embryo Cell ◽  
Rabies Vaccine ◽  
Major Public Health Problem ◽  
Veterinary Students ◽  
Chick Embryo Cell ◽  
Increased Risk

Background: Animal bites are a major public health problem in our country. Pre-exposure vaccination using cell culture vaccines is a safe and effective method of preventing rabies and is recommended for anyone who will be at continual, frequent or increased risk of exposure to the rabies virus, as a result of their occupation, such as veterinarians, animal handlers and laboratory workers dealing with any lyssaviruses. The present study was done to assess the safety of purified chick embryo cell rabies vaccine administered as pre-exposure regimen.Methods:The present study assessed the safety of purified chick embryo cell rabies vaccine administered as a 3 dose intradermal pre-exposure vaccination in healthy volunteered veterinary students of Government Veterinary College, Bangalore.  Results: 122 apparently healthy adults of both sex, between 18 and 30 years of age were enrolled in the study and 105 (86%) completed all three doses. A total of 342 doses of intradermal vaccine were administered, among which 38 adverse reactions were reported from 19 veterinary students. The adverse reactions were pain at the injection site 7 (2.1%), redness 13 (3.8%), itching at the site of injection 11 (3.2%), induration 6 (1.8%) and headache 1 (0.3%). All reactions subsided without any complication and none of them dropped out from the study because of any adverse drug reactions.  Conclusions:Pre-exposure vaccination is a useful tool for protecting high risk groups and purified chick embryo cell rabies vaccine has proved to be safe and well tolerated by intradermal route.

scholarly journals Triage and flow management in sepsis

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Hudson Henrique Gomes Pires ◽  
Fábio Fernandes Neves ◽  
Antonio Pazin-Filho
Keyword(s):  
Intensive Care ◽  
Demographic Data ◽  
Waiting Times ◽  
Public Health Problem ◽  
Interquartile Range ◽  
Critical Conditions ◽  
Major Public Health Problem ◽  
Surgical Interventions ◽  
Increased Risk ◽  
Incidence And Mortality

Abstract Background Sepsis is a major public health problem, with a growing incidence and mortality rates still close to 30% in severe cases. The speed and adequacy of the treatment administered in the first hours of sepsis, particularly access to intensive care, are important to reduce mortality. This study compared the triage strategies and intensive care rationing between septic patients and patients with other indications of intensive care. This study included all patients with signs for intensive care, enrolled in the intensive care management system of a Brazilian tertiary public emergency hospital, from January 1, 2010, to December 31, 2016. The intensivist periodically evaluated the requests, prioritizing them according to a semi-quantitative scale. Demographic data, Charlson Comorbidity Index (CCI), Sequential Organ Failure Assessment (SOFA), and quick SOFA (qSOFA), as well as surgical interventions, were used as possible confounding factors in the construction of incremental logistic regression models for prioritization and admission to intensive care outcomes. Results The study analyzed 9195 ICU requests; septic patients accounted for 1076 cases (11.7%), 293 (27.2%) of which were regarded as priority 1. Priority 1 septic patients were more frequently hospitalized in the ICU than nonseptic patients (52.2% vs. 34.9%, p <  0.01). Septic patients waited longer for the vacancy, with a median delay time of 43.9 h (interquartile range 18.2–108.0), whereas nonseptic patients waited 32.5 h (interquartile range 11.5–75.8)—p <  0.01. Overall mortality was significantly higher in the septic group than in the group of patients with other indications for intensive care (72.3% vs. 39.8%, p <  0.01). This trend became more evident after the multivariate analysis, and the mortality odds ratio was almost three times higher in septic patients (2.7, 2.3–3.1). Conclusion Septic patients had a lower priority for ICU admission and longer waiting times for an ICU vacancy than patients with other critical conditions. Overall, this implied a 2.7-fold increased risk of mortality in septic patients.

scholarly journals Adherence to Immunization: Rebuttal of Vaccine Hesitancy

2020 ◽  
pp. 1-5
Author(s):  
Tamar Etzioni-Friedman ◽  
Amos Etzioni
Keyword(s):  
Adverse Effects ◽  
Public Health Problem ◽  
World Health ◽  
Vaccine Hesitancy ◽  
Major Public Health Problem ◽  
Immunodeficiency Virus ◽  
The World ◽  
Health Organization ◽  
Near Future ◽  
New Vaccines

Immunizations have been saving the lives of millions of people since they were first used by Edward Jenner in 1796, and new vaccines are being developed all the time. Hopefully, a new vaccine for coronavirus disease 2019 (COVID-19) will be developed in the near future, and perhaps even one for human immunodeficiency virus. Although the effectiveness of vaccinations has been proven over the years and adverse effects to currently available vaccinations are extremely rare, many people continue to defer immunizations for themselves and their families. According to the World Health Organization (WHO), this phenomenon, known as “vaccine hesitancy,” is a major public health problem globally. This review summarizes the unproven adverse effects of various vaccines and stresses the importance of enforcing vaccination policies to minimize vaccine hesitancy. Every effort should be made to improve existing vaccines and to produce new ones, according to carefully designed scientific preclinical and clinical trials. This is particularly important in today’s era, in light of the global transparency regarding vaccination development, and the potential for future pandemics such as COVID-19.

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