scholarly journals Sex differences in psychotropic and analgesic drug use before and after initiating treatment with acetylcholinesterase inhibitors

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0243804
Author(s):  
Anne Sverdrup Efjestad ◽  
Hege Ihle-Hansen ◽  
Vidar Hjellvik ◽  
Knut Engedal ◽  
Hege Salvesen Blix
Keyword(s):  
Age Groups ◽  
Acetylcholinesterase Inhibitors ◽  
Prescription Database ◽  
Prescription Pattern ◽  
Before And After ◽  
Norwegian Prescription Database ◽  
Total Prescription ◽  
A Prospective Study ◽  
The Impact

Background/aims The aim was to explore the impact of sex on prevalence, patterns and trends in the prescription of psychotropics and analgesics in users of acetylcholinesterase inhibitors (AChEIs), before and after AChEI initiation, compared to the general population. Methods A prospective study applying data from the Norwegian Prescription Database (NorPD) in the period 2004–2016. Prescription of antidepressants, antipsychotics, analgesics including opioids, benzodiazepines and z-hypnotics in persistent AChEI users was studied in a follow-up period from four years before to two years after AChEI initiation in men and women of four age groups: 37–64, 65–72, 73–80 and 81–88 years. Results Use of antidepressants, antipsychotics and weaker analgesics increased in both sexes during the follow-up period in 11.764 persistent AChEI users. Women with pre-dementia and dementia stages of AD showed a prescription pattern with more use of psychotropics and opioids than men, except for antipsychotics. Conclusion Female sex showed to have a significant influence on the prescriptions of psychotropics and analgesics in AD patients in a pre-dementia and dementia stage. The exception is for antipsychotics, that men used more than women. The prescription pattern showed a higher extent of polypharmacy of psychotropics and/or opioids in women than in men. The total prescription pattern of analgesics could indicate an undertreatment of pain in pre-dementia and dementia stages, most pronounced in men.

Grandchildren’s food workshop: Impact of an intergenerational cooking program on dietary habits, food courage, cooking skills and two-way interaction in Danish children and their grandparents

2021 ◽  
pp. 026010602199163
Author(s):  
Anne Marie Beck ◽  
Stine B. Nielsen ◽  
Kirsten S. Bjørnsbo
Keyword(s):  
Pilot Study ◽  
Dietary Habits ◽  
Age Groups ◽  
Cooking Skills ◽  
Before And After ◽  
Chi Squared ◽  
Good Nutrition ◽  
The Impact ◽  
Dietary Data

Background: Good nutrition is a key aspect of health. Cooking activities can improve dietary habits, cooking skills and food courage in terms of courage to cook and taste new foods, in individuals of all ages. However, targeting both grandchildren and grandparents at the same time through intergenerational cooking activities, is new. Aim: This paper aims to present the impact of intergenerational cooking activities on dietary habits, food courage, cooking skills and two-way interaction between young and old participants in The Grandchildren’s Food Workshop. Methods: In this observational pilot study, the Danish Heart Foundation’s experimental cooking program for grandchildren and grandparents was developed and tested. The influence of the food workshop on the participants’ dietary habits, food courage, cooking skills and two-way interaction was assessed by a before and after questionnaire. McNemar’s and chi-squared tests were used to evaluate the effects. Results: A total of 180 grandchildren (10 to 12 years) and 183 grandparents participated in The Grandchildren’s Food Workshop. A total of 82 (46%) grandchildren (71% of which were girls) and 125 (68%) grandparents (83% of which were women) responded to the baseline and follow-up questionnaires. The impact on dietary habits and food courage was limited, while there was an impact on cooking skills in the grandchildren. The already good two-way interaction was unaltered. Conclusions: The findings indicate an impact on cooking skills among grandchildren participating in The Grandchildren’s Food Workshop, while the impact on dietary habits, food courage and two-way interaction between age groups was limited. Further research, including more detailed dietary data, should explore the significance of an intergenerational approach.

scholarly journals Do Norwegian providers comply with national recommendations when prescribing combined oral contraceptives to starters? A cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e027888
Author(s):  
Julie Ekman ◽  
Finn Egil Skjeldestad
Keyword(s):  
Public Health ◽  
Cohort Study ◽  
Age Groups ◽  
Reproductive Age ◽  
Public Health Nurses ◽  
Prescription Database ◽  
Prescription Pattern ◽  
Lower Extent ◽  
Norwegian Prescription Database ◽  
Nurses And Midwives

ObjectivesTo assess whether changes in patterns of combined oral contraceptive (COC) prescriptions to starters between 2008 and 2016 were in line with changes in national recommendations for use.DesignHistorical prospective cohort study.SettingThe national Norwegian Prescription Database.ParticipantsWomen aged 10–49 years who started COCs between 1 January 2008 and 30 June 2016, in total 285 009 women.Primary outcomeThe proportion of levonorgestrel-containing COC prescriptions to starters.InterventionThe Norwegian Medical Agency recommended levonorgestrel-containing COCs to starters from 2010 onwards.ResultsThe proportion of levonorgestrel-containing COCs prescribed to starters increased from 41% in 2008 to 80% in 2016 with the greatest increase from 2011 to 2012. This prescription pattern comprised all age groups but was observed to a lower extent among older women. Public health nurses and midwifes had the highest compliance with recommendations and prescribed levonorgestrel-containing COCs to 96% of starters aged <20 years in 2016, compared with 75% and 86% among general practitioners and doctors with no specialty.ConclusionAll professions have increased the proportion of levonorgestrel-containing COC prescriptions to starters. Public health nurses and midwives had the highest compliance with the new recommendations. Future studies will examine whether this shift in prescription pattern has prevented venous thromboembolism in women of reproductive age in Norway.

scholarly journals Drug Use before and after Initiating Treatment with Acetylcholinesterase Inhibitors

2019 ◽  
Vol 9 (1) ◽  
pp. 196-206
Author(s):  
Anne Sverdrup Efjestad ◽  
Hege Ihle-Hansen ◽  
Vidar Hjellvik ◽  
Knut Engedal ◽  
Hege Salvesen Blix
Keyword(s):  
General Population ◽  
Psychological Symptoms ◽  
Acetylcholinesterase Inhibitors ◽  
Behavioral Symptoms ◽  
Prescription Database ◽  
Opioid Use ◽  
People With Dementia ◽  
Before And After ◽  
Norwegian Prescription Database ◽  
Behavioral And Psychological Symptoms

Background/Aims: The aim was to study the prevalence of use of different drugs prescribed for behavioral and psychological symptoms of dementia in persistent users of acetylcholinesterase inhibitors (AChEIs) before and after AChEI initiation, and to compare with the use in the general population. Methods: Use of antidepressants, antipsychotics, and analgesics in the 4 years before and 2 years after AChEI initiation was studied based on data from the Norwegian Prescription Database 2004–2016. Results: The prevalence of use of antidepressants and antipsychotics the year before AChEI initiation was twice the prevalence in the age-adjusted general population and continued to rise in the first 2 years after initiation of AChEIs. The prevalence of weak analgesics and antipsychotics increased strongly in the last year before AChEI initiation. The increase in the use of antidepressants started at least 4 years before initiation of AChEIs. Opioid use was generally lower than in the general population and was not influenced by AChEI initiation. Conclusion: Increased use of antidepressants and antipsychotics was observed both before and after initiation of AChEIs and may indicate that behavioral symptoms occur in a preclinical or early phase of Alzheimer’s disease. The prescription pattern of analgesics with a low use of opioids may indicate an undertreatment of pain in people with dementia.

scholarly journals Comedication and Treatment Length in Users of Acetylcholinesterase Inhibitors

2017 ◽  
Vol 7 (1) ◽  
pp. 30-40 ◽  
Author(s):  
Anne Sverdrup Efjestad ◽  
Hege Ihle-Hansen ◽  
Vidar Hjellvik ◽  
Hege Salvesen Blix
Keyword(s):  
Clinical Effect ◽  
Anticholinergic Drug ◽  
Acetylcholinesterase Inhibitors ◽  
Prescription Database ◽  
Early Discontinuation ◽  
Concurrent Use ◽  
Discontinuation Of Treatment ◽  
Norwegian Prescription Database ◽  
A Prospective Study ◽  
Anticholinergic Burden

Background/Aims: Reduced clinical effect on cognitive decline in dementia by acetylcholinesterase inhibitors (AChEIs) may be due to concurrent use of drugs with anticholinergic properties. The aim was to analyze the incidence of AChEI use and comedication with drugs with anticholinergic properties and other potential unfavorable effects. Methods: A prospective study applying drug use data from the Norwegian Prescription Database. Anticholinergic Drug Scale (ADS) scores were used as a measure of overall anticholinergic burden. Results: Patients with high ADS scores were more frequently discontinuing treatment early. Coprescribing of antipsychotics was strongly associated with early discontinuation of AChEI treatment. Conclusion: Coprescribing with potentially unfavorable medications was common. A high ADS score was associated with early discontinuation of treatment.

scholarly journals Treatment of HIV-associated facial lipoatrophy: impact on infection progression assessed by viral load and CD4 count

2013 ◽  
Vol 88 (4) ◽  
pp. 570-577 ◽  
Author(s):  
Flávia Machado Gonçalves Soares ◽  
Izelda Maria Carvalho Costa
Keyword(s):  
Viral Load ◽  
Disease Progression ◽  
Statistical Significance ◽  
Undetectable Viral Load ◽  
Fat Distribution ◽  
Cd4 Count ◽  
Before And After ◽  
Facial Lipoatrophy ◽  
A Prospective Study ◽  
The Impact

BACKGROUND: HIV/AIDS-Associated Lipodystrophy Syndrome includes changes in body fat distribution, with or without metabolic changes. The loss of fat from the face, called facial lipoatrophy, is one of the most stigmatizing signs of the syndrome.OBJECTIVES:To evaluate the effect of FL treatment using polymethylmethacrylate (PMMA) implants on disease progression, assessed by viral load and CD4 cell count.METHODS: This was a prospective study of 44 patients treated from July 2009 to December 2010. Male and female patients, aged over 18 years, with clinically detectable FL and who had never been treated were included in the study. PMMA implantation was done to fill atrophic areas. Laboratory tests were conducted to measure viral load and CD4 count before and after treatment.RESULTS: Of the 44 patients, 72.72% were male and 27.27% female, mean age of 44.38 years. Before treatment, 82% of patients had undetectable viral load, which increased to 88.6% after treatment, but without statistical significance (p = 0.67). CD4 count before treatment ranged from 209 to 1293, averaging 493.97. After treatment, the average increased to 548.61. The increase in CD4 count after treatment was statistically significant with p = 0.02.CONCLUSION: The treatment of FL with PMMA implants showed a statistically significant increase in CD4 count after treatment, revealing the impact of FL treatment on disease progression. Viral load before and after treatment did not vary significantly.

Vascular anastomoses in intrauterine growth in monochorionic twins

2020 ◽  
Vol 48 (6) ◽  
pp. 539-543
Author(s):  
Michał Lipa ◽  
Przemysław Kosinski ◽  
Paweł Stanirowski ◽  
Mirosław Wielgos ◽  
Dorota Bomba-Opon
Keyword(s):  
Injection Technique ◽  
Digital Analysis ◽  
Monochorionic Twins ◽  
Intrauterine Growth ◽  
Blood Exchange ◽  
Sharing Patterns ◽  
A Prospective Study ◽  
The Impact ◽  
Umbilical Cords

AbstractObjectivesTo evaluate the impact of placental anastomoses on the intrauterine growth of monochorionic (MC) twins.MethodsA prospective study was conducted in a group of 53 MC twins. Intrapartally umbilical cords were clamped to identify placental sides corresponding to each twin. The postnatal dye injection technique was administered to evaluate vascular anastomoses, their number and type and visualize placental territory sharing patterns. Data from digital analysis were correlated with obstetrical follow-up.ResultsVascular anastomoses were revealed in 88.7% of cases. Arteriovenous (AV) anastomoses occurred in 75.4% and arterioarterial (AA) in 71.1% while venovenous (VV) in 26.4%. In the subgroup of MC twins without placental anastomoses, significantly higher birthweight difference and discordance were revealed when compared to MC twins without anastomoses (382.0 vs. 22 g; P = 0.03 and 49.14% vs. 16.02%; P = 0.03). On the other hand, in subgroups of MC twins with at least one AA anastomosis, twins’ birthweights were similar (p = ns) despite significantly higher placental territory sharing discordance (30.44% vs. 15.81%; P = 0.31).ConclusionsVascular anastomoses have a major impact on the intrauterine growth of MC twins. In certain cases, they may cause specific complications; however, in general, they regulate intertwin blood exchange and may compensate unequal placental territory.

scholarly journals A prospective, observational clinical trial on the impact of COVID-19-related national lockdown on thyroid hormone in young males

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Giulia Brigante ◽  
Giorgia Spaggiari ◽  
Barbara Rossi ◽  
Antonio Granata ◽  
Manuela Simoni ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Serum Levels ◽  
Stressful Event ◽  
Italian Population ◽  
Reference Ranges ◽  
Endocrine Regulation ◽  
Before And After ◽  
Hpt Axis ◽  
The Impact

AbstractTrying to manage the dramatic coronavirus disease 2019 (COVID-19) infection spread, many countries imposed national lockdown, radically changing the routinely life of humans worldwide. We hypothesized that both the pandemic per se and the consequent socio-psychological sequelae could constitute stressors for Italian population, potentially affecting the endocrine system. This study was designed to describe the effect of lockdown-related stress on the hypothalamic-pituitary-thyroid (HPT) axis in a cohort of young men. A prospective, observational clinical trial was carried out, including patients attending the male infertility outpatient clinic before and after the national lockdown for COVID-19 pandemic. The study provided a baseline visit performed before and a follow-up visit after the lockdown in 2020. During the follow-up visit, hormonal measurements, lifestyle habits and work management were recorded. Thirty-one male subjects were enrolled (mean age: 31.6 ± 6.0 years). TSH significantly decreased after lockdown (p = 0.015), whereas no significant changes were observed in the testosterone, luteinising hormone, follicle-stimulating hormone, estradiol and prolactin serum levels. No patient showed TSH serum levels above or below reference ranges, neither before nor after lockdown. Interestingly, TSH variation after lockdown was dependent on the working habit change during lockdown (p = 0.042). We described for the first time a TSH reduction after a stressful event in a prospective way, evaluating the HPT axis in the same population, before and after the national lockdown. This result reinforces the possible interconnection between psychological consequences of a stressful event and the endocrine regulation.

Aortic endograft and bridging stent-graft remodeling after branched endovascular aortic repair

Vascular ◽  
2020 ◽  
pp. 170853812098369
Author(s):  
Stefano Fazzini ◽  
Giovanni Torsello ◽  
Martin Austermann ◽  
Efthymios Beropoulis ◽  
Roberta Munaò ◽  
...  
Keyword(s):  
Stent Graft ◽  
Endovascular Repair ◽  
Main Body ◽  
Thoracoabdominal Aneurysm ◽  
Before And After ◽  
Long Term Follow Up ◽  
Instability Rate ◽  
One Year ◽  
The Impact

Objectives The results of branched endovascular repair of thoracoabdominal aneurysms are mainly dependent on durability of the graft used. The purpose of this study was to evaluate postoperative aortic main body and bridging stent-graft remodeling, and their impact on bridging stent-graft instability at one year. Methods Computed tomoangiographies of 43 patients (43 aortic main body mated with 171 bridging stent-grafts) were analyzed before and after branched endovascular repair as well as after a follow-up of 12 months. Primary endpoint was aortic main body remodeling (migration >5 mm, shortening >5 mm, scoliosis >5° or lordosis >5°). Shortening was defined as a reduced length in the long axis, scoliosis as left-right curvature, and lordosis as antero-posterior curvature. Aortic main body remodeling, aneurysm sac changes, and bridging stent-graft tortuosity were evaluated to study their correlations and the impact on the bridging stent-graft instability. Results At 12 months, aortic main body remodeling was observed in 72% of the cases, migration in 39.5% (mean 5.21 mm), shortening in 41.9% (mean 5.79 mm), scoliosis in 58.1%, (mean 10.10°), lordosis in 44.2% (mean 5.78°). Migration, shortening, and scoliosis were more frequent in patients with larger aneurysms ( p = .005), while scoliosis was significantly more frequent in type II thoracoabdominal aneurysm ( p = .019). Aortic main body remodeling was significantly associated to bridging stent-graft remodeling (r: 0.3–0.48). The bridging stent-graft instability rate was 9.3%. Despite a trend toward significance ( p = .07), none of the evaluated aortic main body and bridging stent-graft changes were associated with bridging stent-graft instability at 12 months. Conclusions Aortic main body remodeling is frequent especially in large and extended thoracoabdominal aneurysm aneurysms. Aortic main body and bridging stent-graft remodeling was significantly correlated. While these geometric changes had no significant impact on bridging stent-graft instability at one year, a close long-term follow-up after branched endovascular repair could predict bridging stent-graft failures.

Feasibility of telemedicine in the management strategy of patients with lymphoma amid the COVID-19 pandemic in Spain, a prospective study (Preprint)

2021 ◽  
Author(s):  
Raul Cordoba ◽  
Alberto Lopez-Garcia ◽  
Daniel Morillo ◽  
Maria-Angeles Perez-Saenz ◽  
Elham Askari ◽  
...  
Keyword(s):  
Prospective Observational Study ◽  
Digital Health ◽  
Hematologic Malignancies ◽  
Patient Portal ◽  
Health Strategy ◽  
Potential Risk Factors ◽  
Hospital Visits ◽  
A Prospective Study ◽  
The Impact

BACKGROUND Recurrent hospital visits were potential risk factors for COVID-19 contagion. OBJECTIVE The aims of this prospective observational study was to analyze the consequences of COVID-19 pandemic in the health care of patients with lymphoma and the impact of telemedicine strategies such as the patient portal in their management. METHODS All data were obtained from the electronic medical record (EMR). Variables such as age, sex, matter of the visit, use of patient’s portal, changes in management, impact in clinical trials and suffering from COVID-19 contagion were recorded. RESULTS 290 patients were attended in the lymphoma clinic accomplishing 437 appointments. The median age was 66 years (range 18-94), and 157 (54.13%) were male. Of them, 109 out of 290 (37.58%) were aged older then 70 years. Regarding number of visits, 214 patients (73.79%) had only 1 visit to the hospital. Only 23 patients (7.93%) didn’t have access to patient’s portal. During the follow-up, only 7 patients (2.41%) suffered from COVID-19, with a median age of 66 years (51-80). CONCLUSIONS Telemedicine such as patient’s portal are feasible strategies in the management of patients with lymphoma during the COVID-19 pandemic, with a reduction of in-person visits to hospital and a very low contagion rate. This experience allowed us to continue with a new digital health strategy in the follow up of patients with hematologic malignancies. CLINICALTRIAL Not registered.

scholarly journals Using geospatial models to map zero-dose children: factors associated with zero-dose vaccination status before and after a mass measles and rubella vaccination campaign

2021 ◽  
Author(s):  
Rohan Arambepola ◽  
Yangyupei Yang ◽  
Kyle Hutchinson ◽  
Francis D Mwansa ◽  
Julie Ann Doherty ◽  
...  
Keyword(s):  
Vaccination Campaign ◽  
Fine Scale ◽  
Healthcare Facilities ◽  
Factors Associated ◽  
Catchment Areas ◽  
Before And After ◽  
Childhood Vaccines ◽  
A Prospective Study ◽  
Vaccination Campaigns ◽  
The Impact

Introduction: Despite gains in global coverage of childhood vaccines, many children remain undervaccinated. Vaccination campaigns also known as Supplemental Immunization Activity (SIA) are commonly conducted to reach those who are undervaccinated. However, reaching these children even during an SIA is challenging. We evaluated the effectiveness of an SIA in reaching zero dose children. Methods: We conducted a prospective study in 10 health center catchment areas in Southern province, Zambia in November 2020. About 2 months before the measles and rubella SIA we developed aerial satellite maps which were then used to enumerate and survey households. Zero dose children were identified during this exercise. After the SIA, households with zero dose children identified before the SIA were targeted for mop up vaccination and to assess if they were vaccinated during the SIA. A Bayesian geospatial model was used to identify factors associated with zero-dose status before the campaign and produce fine-scale prevalence maps. Models were used to identify factors associated with measles zero-dose children reached in the campaign and identify optimal locations for additional vaccination sites. Results: Before the vaccination campaign, 4% of children under 9 months were DTP zero-dose and 17% of children 9-60 months were measles zero-dose. Of the 461 measles zero-dose children identified before the vaccination campaign, 338 (73.3%) were vaccinated during the campaign, 118 (25.6%) were reached by a targeted mop-up activity. The presence of other children in the household, younger age, greater travel time to health facilities, and living between health facility catchment areas were associated with zero-dose status. Mapping zero-dose prevalence revealed substantial heterogeneity, both within and between catchment areas. Several potential locations were identified for additional vaccination sites. Conclusion: Fine-scale variation in zero-dose prevalence and the impact of accessibility to healthcare facilities on vaccination coverage were identified. Geospatial modeling can aid targeted vaccination activities.

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