Drugs Associated With Ischemic Stroke: A Review for Clinicians

Stroke ◽  
2021 ◽  
Author(s):  
João Pedro Marto ◽  
Davide Strambo ◽  
Francoise Livio ◽  
Patrik Michel
Keyword(s):  
Ischemic Stroke ◽  
World Health Organization ◽  
Anatomical Therapeutic Chemical ◽  
Drug Benefit ◽  
Phase Iii ◽  
World Health ◽  
Level Of Evidence ◽  
Potential Association ◽  
Health Organization ◽  
High Level

Certain drugs may increase the risk of ischemic stroke (IS). Our goal was to review associations between frequently used drugs and IS. We created an initial list of frequently used drugs to search Pubmed/MEDLINE from 1966 to 2020 and reviewed phase III and IV data, case series, and drug authorities’ safety warnings to assess a potential association with IS. Drugs were grouped according to the World Health Organization Anatomical Therapeutic Chemical Classification System. Predefined criteria were applied to establish a level of evidence for an association, from A (high level of evidence of association) to E (high level of evidence of absence of association). In addition, we assessed relative risks and reviewed potential mechanisms of IS facilitation. We assessed 81 drugs or drug classes from 11 World Health Organization Anatomical Therapeutic Chemical Groups. We identified a high level of association for erythropoietin, combined contraceptives, oral estrogen replacement therapy, bevacizumab, tamoxifen, and antipsychotics and a moderate level for ponatinib, nilotinib, darunavir, and gonadotropin-releasing hormone agonists. Drug dose and treatment duration may modify the risk. For a substantial number of drugs, we found no association, and for others, there were insufficient data to categorize risk. We identified a high level of association of IS with a limited number of drugs, a potential association with some, and a lack of data for others. The summarized information may help clinicians to estimate the contribution of a drug to an IS, to better assess drug benefit-risk ratios, and to support decisions about using specific drugs.

scholarly journals Immunizations in Athletes

2018 ◽  
Vol 10 (5) ◽  
pp. 427-433 ◽  
Author(s):  
Christopher D. Boston ◽  
Jennifer J. Bryan
Keyword(s):  
Disease Control ◽  
World Health Organization ◽  
Preventive Care ◽  
Vaccination Status ◽  
World Health ◽  
Team Physician ◽  
Level Of Evidence ◽  
Control And Prevention ◽  
Pubmed Search ◽  
Health Organization

Context: Immunizations are a cornerstone of preventive care and an important consideration for team physicians caring for athletes. Evidence Acquisition: A PubMed search was performed from August 2016 through May 2017 as well as a website review of the Centers for Disease Control and Prevention, World Health Organization, and Immunization Action Coalition. Study Design: Clinical review. Level of Evidence: Level 4. Results: By keeping abreast of diseases endemic to nations to which athletes may be traveling as well as the vaccination status of the athletes, team physicians can provide appropriate advice regarding immunization and prevention of disease. Conclusion: There are a host of regularly updated reliable websites to assist the team physician in these recommendations.

Cancer screening and prevention in gynaecology

2020 ◽  
pp. 755-765
Author(s):  
Lynette Denny ◽  
Rengaswamy Sankaranarayan
Keyword(s):  
Specific Antigen ◽  
Careful Consideration ◽  
World Health ◽  
Clear Understanding ◽  
Level Of Evidence ◽  
Access To Health ◽  
Screening And Prevention ◽  
Health Organization ◽  
High Level ◽  
Current Screening

In 1968, the World Health Organization published guidelines on the principles and practice of screening for disease, which are often referred to as the ‘Wilson and Jungner criteria’. These principles are still applicable today. With the onset of genetic screening, new controversies around screening emerged and in 2008, Andermann et al. synthesized and modified the Wilson criteria. Screening is a systematic attempt to select those who are at high risk of a specific disease from among apparently healthy individuals. The ultimate aim of screening is prevention of disease or to detect disease at an early, curable stage. There are many controversies about screening for cancer, such as the use of prostatic-specific antigen screening for prostate cancer, mammography screening for breast cancer, and debates around current screening for colorectal, lung, and cervical cancers. Controversies also exist with regard to the level of evidence required before screening for a disease is initiated. Even if there is a high level of evidence for efficacy and effectiveness, how the programme should be implemented needs careful consideration, particularly a clear understanding of benefits versus harms, potential or actual. In some countries, mass population screening programmes are implemented and in others, screening is dependent on access to health insurance. This chapter explores past and current screening activities among women for early detection and prevention of gynaecological cancers including cervical, ovarian, and endometrial cancers and discusses screening for vulval and vaginal cancer.

scholarly journals Analyzing Antidiabetes Drug Prescriptions With World Health Organization Anatomical Therapeutic Chemical/Defined Daily Dose Index to Assess Drug Utilization Pattern in Elderly Population of Rural Eastern India

2017 ◽  
Vol 8 ◽  
pp. 117739361770334 ◽  
Author(s):  
Sandeep Lahiry ◽  
Avijit Kundu ◽  
Ayan Mukherjee ◽  
Shouvik Choudhury ◽  
Rajasree Sinha
Keyword(s):  
World Health Organization ◽  
Drug Utilization ◽  
West Bengal ◽  
Anatomical Therapeutic Chemical ◽  
World Health ◽  
Defined Daily Dose ◽  
Prescription Data ◽  
Daily Dose ◽  
Health Organization

Objective: To analyze drug utilization (DU) pattern of antidiabetes drug (ADD) prescription in elderly type 2 diabetes mellitus (T2DM) in rural West Bengal based on 2016 World Health Organization (WHO) Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) Index. Methods: This was a prospective observational study. Prescription data of 600 elderly patients (age > 60 years) attending outpatient clinic were screened over 12 months (January 2015 to January 2016) from 5 different rural hospitals in West Bengal. Pooled data were sorted and classified in accordance with 2016 ATC/DDD WHO Index. Direct cost associated and consumption of ADD were measured as DDD/1000 patients/day. The adverse drug reactions (ADRs) related to antidiabetic medicines were monitored. Results: During the study period, mean age of patients recorded was 66.4 ± 5.0 years, with 66.6% (n = 396) having history of T2DM > 5 years. Follow-up encounters (n = 2328) revealed metformin (94.67%), sulfonylureas (SUs) (50.54%), pioglitazone (24.22%), voglibose (22.50%), insulin (9.75%), and acarbose (6.82%) to be more prevalent, constituting DU 90% (92.01%). Combination of metformin plus SU was recorded in most of the patients (56%). Insulin, however, was found to be an underutilized class ( P < .005). The DDD/1000 patients/day of metformin (2.918), glimepiride (1.577), and gliclazide (0.069) conformed to 2016 WHO ATC/DDD Index. The total ADD consumption during study period was 5.03 DDD/1000 patients/day. The average drug cost per encounter per day was Rs 11.24 ± 2.01. Nineteen ADRs were reported and their descriptions were found to be of hypoglycemia (n = 9), pedal edema (n = 2), and gastrointestinal upsets (n = 8). Target glycemic status was achieved in 40% monthly follow-up encounters. Low-store drug availability and poor compliance to treatment (>60%) were major determinants. Lack of regular aerobic exercises (>85%) and proper knowledge regarding medical nutrition therapy (MNT) (>80%) and low average consultation time (3.5 ± 0.6 minutes) were important contributing factors. Conclusions: The study exhibited increased utilization of 2 drug combinations of oral ADD and lower utilization of insulin during study period. Such inferences merit further exploration.

scholarly journals Gyógyítás és interkulturalitás

2019 ◽  
Vol 60 (4) ◽  
pp. 30-45
Author(s):  
Erika Marek ◽  
Dóra Schmél ◽  
Zoltán Katz ◽  
Nóra Faubl ◽  
Tímea Németh
Keyword(s):  
World Health Organization ◽  
Cultural Competency ◽  
Migrant Health ◽  
World Health ◽  
Health Organization ◽  
High Level

Bevezetés A 2013 óta drámai mértékben megnőtt menekülthullám váratlan kihívások elé állította az Európai Unió egészségügyi ellátórendszereit. A 2015-ös tömeges bevándorlás okozta krízis hívta életre az Egészségügyi Világszervezet (World Health Organization, WHO) által szervezett „Menekültek és migránsok egészsége” csúcstalálkozót (High-level meeting on Refugee and Migrant Health), melynek záródokumentuma rámutat az ún. „migránsérzékeny egészségügyi ellátórendszer” kialakításának és az egészségügyi dolgozók képzésének fontosságára, tekintettel a bevándorló népesség nyelvi, vallási és kulturális sokszínűségére. Kutatási céljaink között szerepel ezen ajánlások mentén vizsgálni a Pécsi Tudományegyetem Általános Orvosi Kar (PTE-ÁOK) hallgatóinak felkészültségét, jelenlegi interkulturális kompetenciaszintjét és azonosítani az esetleges hiányosságokat és fejlesztendő területeket. Módszerek Kérdőíves felmérésünket a Pécsi Tudományegyetemen (PTE) a 2016–2017-es tanév során a magyar nyelvű képzésben részt vevő 1., valamint 4. és 5. évfolyamot végző orvostanhallgatók körében végeztük el. Kutatásunk során összesen 391 kérdőívet értékeltünk, a válaszadói ráta 83,9%-os volt. Felmérésünkhöz anonim, önkitöltős kérdőívet alkalmaztunk, 94 db, többségében zárt végű kérdéssel. A felmérés eszköze a Klinikai Interkulturális Kompetencia Kérdőív (KIK-kérdőív, Clinical Cultural Competency Questionnaire) magyarra fordított és adaptált verziója volt. A felmérés kérdései 6 témakör köré csoportosultak: szociodemográfiai jellemzők; többségi populációtól eltérő kultúrájú csoportok egészségügyi ellátásával kapcsolatos háttérismeretek; attitűdök és készségek; komfortérzet kultúrközi szituációkban; a felsorolt témákkal kapcsolatos korábbi képzéseken való részvétel; illetve a jövőbeni képzéseken való részvételi szándék. Az adatok feldolgozása SPSS 21.0 programcsomaggal történt. Eredmények Az eredmények alapján megállapíthatjuk, hogy a kérdőív által vizsgált 4 fő kérdéskör esetében (ismeretek, készségek, attitűdök és komfortérzet kultúrközi szituációkban) a magasabb nyelvi kompetenciák, azaz a több idegen nyelv ismerete minden szempontból növelték az interkulturális kompetenciaszintet. A korábban elvégzett interkulturális képzési programok egyedül az ismeretek magasabb szintjével álltak összefüggésben, de nem voltak hatással a résztvevők készségeire, attitűdjeire és kultúrközi szituációkban való komfortérzetére. Számos specifikus, fejlesztendő területet azonosítottunk, mint például a kulturálisan szenzitív életvégi ellátást, valamint a munkatársak, páciensek derogáló megjegyzéseivel szembeni megküzdést. Következtetések Annak ellenére, hogy nehézséget jelenthet egy új kurzus kurrikulumba integrálása a hallgatók túlterheltsége és időhiánya miatt, a hallgatók nyitottak további ismeretek elsajátítása és készségfejlesztés iránt a migrációs kérdéskör aktualitása miatt, valamint saját ismereteik, készségeik fejlődésének érdekében. Bízunk abban, hogy eredményeinkre és hallgatóink javaslataira alapozva a közeljövőben egy sikeres, új klinikai interkulturális kompetencia kurzust indíthatunk.

scholarly journals Gambaran Penggunaan Antibiotik di Bangsal Penyakit Dalam RSUD Bangil Kabupaten Pasuruan

2020 ◽  
Vol 5 (1) ◽  
pp. 12
Author(s):  
Sinta Rachmawati ◽  
Rizki Laili Fazeri ◽  
Ika Norcahyanti
Keyword(s):  
World Health Organization ◽  
Anatomical Therapeutic Chemical ◽  
World Health ◽  
Defined Daily Dose ◽  
Daily Dose ◽  
Health Organization

<p>Penggunaan antibiotik yang tidak tepat akan berdampak terhadap terjadinya resistansi. Oleh karena itu, studi penggunaan antibiotik perlu dilakukan di fasilitas pelayanan kesehatan, termasuk rumah sakit. Penelitian ini bertujuan untuk mengetahui gambaran penggunaan antibiotik di bangsal penyakit dalam Rumah Sakit Umum Daerah (RSUD) Bangil Kabupaten Pasuruan dengan menggunakan metode<em> Anatomical Therapeutic Chemical</em> (ATC)/<em>Defined Daily Dose</em> (DDD). ATC/DDD adalah metode perhitungan penggunaan antibiotik secara kuantitatif yang direkomendasikan oleh <em>World Health Organization</em> (WHO). Pengambilan data dilakukan secara retrospektif menggunakan sumber data excel berupa rekapitulasi rekam medik. Populasi pada penelitian ini adalah seluruh pasien rawat inap dewasa di bangsal penyakit dalam sepanjang tahun 2017. Sejumlah 973 data dari keseluruhan populasi memenuhi kriteria inklusi. Analisis data dilakukan berdasarkan pada karakteristik pasien, profil antibiotik dan perhitungan kuantitatif dengan metode ATC/DDD. Hasil penelitian menunjukkan bahwa golongan antibiotik yang paling banyak digunakan adalah golongan sefalosporin sebesar 51,41%, sedangkan jenis antibiotik yang paling banyak diresepkan yaitu ceftriaxone dengan jumlah sebesar 25,86%. DDD/100 <em>patient-days</em> tertingi adalah ceftriaxone dengan nilai 27,79 DDD/100 <em>patient-days</em>. Perlu dilakukan penelitian lanjutan dengan menggunakan metode Gyssens untuk mengetahui rasionalitas penggunaan antibiotik.</p>

scholarly journals A Review on Automatic Covid-19 Lung Infection Detection from Different Imaging Techniques

2021 ◽  
Vol 9 (VII) ◽  
pp. 3850-3856
Author(s):  
Sangeeta Singh
Keyword(s):  
World Health Organization ◽  
Virus Disease ◽  
Imaging Techniques ◽  
World Health ◽  
The Novel ◽  
Corona Virus ◽  
The World ◽  
Health Organization ◽  
High Level ◽  
Precision Rate

Corona Virus Disease-2019 commonly known as COVID-19 which has been defined by the Novel Corona Virus. It is a family of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and was first detected during respiratory outbreak. It was first reported to the World Health Organization on December 31, 2019. On January 30, 2020, the World Health Organization declared the COVID-19 eruption a global health emergency. As of 27-May-2021 169,095,283 confirmed cases have been reported in the world and 2, 73, 67, 935 cases in India. It is required to identify the infection with high precision rate but there are lots of deficiency in the diagnosing system that may resulted false alarm rate. Initially it could be detected through throat saliva but now it can also be identified thought the impairment in lungs from computerized tomographical imaging technique. This paper reviewed various researches over COVID-19 diagnosis approach as well as the syndrome in respiratory organs. There are so many imaging techniques through which lungs impairments can be detected that may diagnose COVID-19 with high level of accuracy. CT scan image is the best alternative for diagnosing COVID-19.

scholarly journals Securitization on the Spread of COVID-19 in Indonesia [Sekuritasasi dalam Penyebaran Covid-19 di Indonesia]

2020 ◽  
Vol 11 (2) ◽  
pp. 127-142
Author(s):  
Cornelia Clara Tifany
Keyword(s):  
World Health Organization ◽  
Analytical Framework ◽  
Online News ◽  
World Health ◽  
Security Issue ◽  
Indonesian Government ◽  
The World ◽  
Securitization Theory ◽  
Health Organization ◽  
High Level

Based on the World Health Organization report, Coronavirus disease 2019 (COVID-19) is an infectious respiratory disease that has become an epidemic in approximately 213 countries throughout the world, including Indonesia. Prior to the first confirmed case of COVID-19 in Indonesia, the Indonesian government’s response, as represented by its high-level officials, suggested a lack of awareness. Some situations then became the turning points for the Indonesian Government, who has since focused more on dealing with the COVID-19 outbreak. Through this research, the writer aims to analyze the Indonesian Government’s treatment of COVID-19 from a health issue to a security issue. Therefore, the securitization theory focusing on the component of securitization from Buzan will be employed as an analytical framework in this research. In addition, the global health governance is also used as a reference to support the writer’s statement. In order to explain the action of the Indonesian Government, this research will use qualitative research with a focus on literacy observations through online news relating to the issues. In conclusion, the change in action of the Indonesian Government was caused by the pressure from GHG, which then showed that the spread of COVID-19 in Indonesia is a security issue.AbstrakCoronavirus disease (COVID-19) yang merupakan penyakit pernapasan menular telah mewabah kurang lebih di 213 negara di dunia berdasarkan pada laporan World Health Organization, salah satu negara yang terkena wabah adalah Indonesia. Sebelum ada konfirmasi atas kasus COVID-19 di Indonesia, terlihat sikap pihak pemerintah yang diwakili oleh pejabat tinggi menunjukkan sikap kurang perhatian. Namun beberapa situasi menjadi “turning point” bagi Pemerintah Indonesia yang kemudian memberikan fokus yang lebih dalam menghadapi wabah COVID-19 di Indonesia. Dari keadaan tersebut melalui penelitian ini, penulis menganalisis sikap Pemerintah Indonesia dalam mengubah isu kesehatan menjadi isu keamanan. Penelitian ini menggunakan teori sekuritisasi sebagai kerangka analisis dengan terfokus pada komponen sekuritisasi oleh Buzan. Di samping itu juga menggunakan tata kelola kesehatan global sebagai penopang pernyataan penulis. Agar mampu menjelaskan sikap Pemerintah Indonesia maka penelitian ini menggunakan metode penelitian kualitatif dengan fokus pada pengamatan literasi melalui berita daring yang berkaitan dengan permasalahan yang diangkat. Dalam kesimpulannya, perubahan sikap Pemerintah Indonesia disebabkan oleh adanya tekanan dari tata kelola kesehatan global yang menunjukkan bahwa penyebaran COVID-19 di Indonesia merupakan isu keamanan.

Sign in / Sign up

Export Citation Format

Share Document