scholarly journals Prevalence and Clinical Significance of Drug–Drug and Drug–Dietary Supplement Interactions among Patients Admitted for Cardiothoracic Surgery in Greece

Pharmaceutics ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 239
Author(s):  
Marios Spanakis ◽  
Maria Melissourgaki ◽  
George Lazopoulos ◽  
Athina E. Patelarou ◽  
Evridiki Patelarou

Background: Drug interactions represent a major issue in clinical settings, especially for critically ill patients such as those with cardiovascular disease (CVD) who require cardiothoracic surgery (CTS) and receive a high number of different medications. Methods: A cross-sectional study aimed at evaluating the exposure and clinical significance of drug–drug (DDIs) and drug–dietary supplement interactions (DDSIs) in patients admitted for CTS in the University Hospital of Crete Greece. DDIs were evaluated regarding underlying pharmacological mechanisms upon admission, preoperation, postoperation, and discharge from CTS clinic. Additionally, upon admission, the use of dietary supplements (DSs) and if patients had informed their treating physician that they were using these were recorded with subsequent analysis of potential DDSIs with prescribed medications. Results: The study employed 76 patients who were admitted for CTS and accepted to participate. Overall, 166 unique DDIs were identified, with 32% of them being related to pharmacokinetic (PK) processes and the rest (68%) were related to possible alterations of pharmacodynamic (PD) action. CVD medications and drugs for central nervous system disorders were the most frequently interacting medications. In total, 12% of the identified DDIs were of serious clinical significance. The frequency of PK-DDIs was higher during admission and discharge, whereas PD-DDIs were mainly recorded during pre- and postoperation periods. Regarding DS usage, 60% of patients were using DSs and perceived them as safe, and the majority had not informed their treating physician of this or sought out medical advice. Analysis of medical records showed 30 potential combinations with prescribed medications that could lead in DDSIs due to modulation of PK or PD processes, and grapefruit juice consumption was involved in 38% of them. Conclusions: An increased burden of DDIs and DDSIs was identified mostly upon admission for patients in CTS clinics in Greece. Healthcare providers, especially prescribing physicians in Greece, should always take into consideration the possibility of DDIs and the likely use of DS products by patients to promote their well-being; this should only be undertaken after receiving medical advice and an evidenced-based evaluation.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Feras H. Abuzeyad ◽  
Moonis Farooq ◽  
Salah Farhat Alam ◽  
Mudhaffar Ismael Ibrahim ◽  
Luma Bashmi ◽  
...  

Abstract Background Patients discharged against medical advice (DAMA) act as a high-risk population for the Emergency Department (ED), regardless of their presentations, and can pose a serious burden for the hospital. This study examines the prevalence, demographic and clinical characteristics, reasons, and clinical outcomes of a small sample of DAMA patients in a teaching university hospital, including readmission, morbidity, and mortality. Methods A prospective, descriptive cross-sectional study was conducted in the ED of King Hamad University Hospital (KHUH) with 98,992 patient visits during a 1-year period from June 2018 to June 2019. Consenting DAMA patients were asked to complete a data collection form. Results Patients (n = 413) had a mean age of 44.1 years with a female majority (57.1%). The majority were categorized as triage level-3 (87.7%). The main reasons for DAMA included refusal of the procedure/operation (23.2%), long ED waiting time (22.2%), subjective improvement with treatment (17.7%), and children at home (14.8%), whereas the least selected reason was dissatisfaction with medical care (1.2%). Follow-up of DAMA patients revealed that 86 cases (20.8%) were readmitted to the ED within 72 h of which 41 (47.7%) cases were morbidity and 2 (2.3%) were mortality. Marital status was a predictor of DAMA patients who revisit the ED within 72 h. Conclusion The results act as a pilot study to examine a small sample of DAMA patients’ characteristics, diagnosis, and ED revisits. Hospitals should investigate further the DAMA population on a larger scale, reasons for refusing procedures, and utilize this knowledge to improve the healthcare process.


2017 ◽  
Vol 15 (6) ◽  
pp. 693-703 ◽  
Author(s):  
Kristin Litzelman ◽  
Danielle Blanch-Hartigan ◽  
Chun Cheih Lin ◽  
Xuesong Han

ABSTRACTObjective:Experiencing a life-threatening illness such as cancer can elicit both negative (e.g., distress) and positive (e.g., growth) psychological responses. The present study sought to determine the correlates of four positive psychological byproducts in cancer survivors: becoming a stronger person, coping better with life's challenges, making positive changes in life, and adopting healthier habits.Method:Data for this cross-sectional study were taken from the Medical Expenditures Panel Survey (MEPS) Experiences with Cancer Survivorship Supplement (Yabroff et al., 2012). Cancer survivors (N = 785) reported their sociodemographic and cancer-related characteristics. Descriptive statistics were utilized to summarize cancer survivor characteristics, including demographic factors, cancer factors, and stressors and resources related to cancer. Multivariable logistic regressions were employed to assess the independent association of the stressors and resources with each psychological response, controlling for covariates. All analyses were weighted to account for the complex sampling design of the MEPS.Results:In multivariable analyses, those with a family caregiver were 50% more likely to report better coping with challenges, and around 70% were more likely to report making positive changes in life or adopting healthier habits because of their cancer. Receiving informational support from healthcare providers was also consistently associated with positive byproducts (odds ratios ranging from 1.6 to 2.0). Few of the stressors were associated with positive byproducts: having insurance problems due to cancer was positively associated with becoming a stronger person, and work limitations were associated with making positive changes in life; those who reported high perceived chances of recurrence were less likely to report becoming a stronger person.Significance of Results:Having a family caregiver and receiving detailed informational support from healthcare providers were associated with reporting positive experiences with cancer. The hypotheses and future research stimulated by these findings may improve our understanding of the process by which positive byproducts develop and may ultimately help improve psychological well-being among cancer survivors.


2020 ◽  
Vol 20 (5) ◽  
pp. 743-747
Author(s):  
Seedreza J. Moghadam ◽  
SeyedAhmad SeyedAlinaghi ◽  
Omid Dadras ◽  
Zoha Ali ◽  
Seyed Y. Mojtahedi ◽  
...  

Background: Needle Stick Injuries (NSIs) are the most common occupational injuries among HCWs. The aim of this study was to explore the prevalence and distribution of determinants for such injuries in a university hospital in Tehran, Iran, in 2016. Methods: We conducted a descriptive cross-sectional study in Ziaeian Hospital, a teaching hospital of Tehran University. The medical records of 55 Health Care Workers (HCWs) who experienced NSIs in 2016, were extracted from the hospital registry and analyzed using SPSS version 22. Results: Available data of 55 HCWs with a history of NSIs were extracted from the hospital registry. The highest number of NSIs belonged to registered nurses (34.6%), licensed practical nurses (14.5%) and medical doctors (12.7%), respectively. The majority of the NSIs occurred in the morning shift (50.9%) followed by night shift (36.4%) and evening shift (12.7%). Most of the NSIs occurred in the emergency department (38.1%) and operating room (18.2%). The healthcare workers reported fatigue as the most common reason for being injured by needles (67.4%). All the HCWs were trained and familiarized with the safety and risk control measures after needle stick exposures in the hospital. Conclusion: The present study described the determinants of NSIs among HCWs in a university hospital. The fatigue and working overload were the main reasons for NSIs. The results of this study could be used to address the shortcoming in the guidelines and protocols to ensure the sustainable safety measures that could reduce the occurrence of the NSIs in hospitals in Iran.


PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247295
Author(s):  
Md. Ashraful Islam ◽  
Aseel Fuad Al-karasneh ◽  
Mehwish Rizvi ◽  
Zeb-Un Nisa ◽  
Ahmed Majed Albakheet ◽  
...  

Purpose The aim of this study was to gather data from female students studying in both health and non-health colleges at Imam Abdulrahman Bin Faisal University and report the prevalence, reasons, and determinants of dietary supplements use. Methods A month-long cross-sectional study was conducted in health and non-health colleges affiliated to Imam Abdulrahman Bin Faisal University in Dammam, Saudi Arabia. Convenient sampling was employed, and the data was gathered through an online survey using the English and Arabic versions of the Dietary Supplement Questionnaire (DSQ). The data was analyzed using SPSS version 23 and Medcalc. The study was approved by an ethics committee. Results Data from 545 participants was collected. The overall prevalence of dietary supplement use was 32.7% (95% CI: 29.06%– 36.51%). The prevalence was 29.77% (95% CI: 25.29%– 34.56%) among students at all health colleges combined and, it was 37.50% (95% CI: 31.36%– 43.96%) among students at all non-health colleges. Most students used a brand product, spent a monthly cost of SAR 286 (USD 76.3) on supplements and agreed that supplements were good for health (N = 392, 71.9%). Students from non-health- colleges agreed that dietary supplements are good for health in greater numbers as compared to non-health college students (p < 0.001). Students aged ≥ 20 years, studying in a non-health college and up to 3rd year of study, were more 2 times more likely to agree that dietary supplements are good for health. Conclusion Supplements were commonly used among female students at this university however, it was quite low as compared to students from other local and regional universities. Prevalence was higher in non-health colleges as compared to health colleges and the most commonly used supplements were brand products and, multivitamins, used for general health and well-being. This highlights the inclination of students towards supplement use.


Healthcare ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 142
Author(s):  
Ian Roberts-Martínez Aguirre ◽  
Paula Rodríguez-Fernández ◽  
Josefa González-Santos ◽  
Nerea Aguirre-Juaristi ◽  
Nuria Alonso-Santander ◽  
...  

(1) Background: Visual impairment of people with diabetic retinopathy (DR) and its high impact on different dimensions of their lives can cause a significant deterioration in the quality of life. The aim of this study was to examine the association and relationship between quality of life related to vision and the relevant clinical and sociodemographic variables in a group of patients with DR in Spain. (2) Methods: A descriptive cross-sectional study was conducted in all patients with DR over 18 years under follow-up in the Retina Service of the University Hospital of Burgos (HUBU), recruited during the months of January and February 2020. The main study variable was quality of life related to health and vision, obtained using the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25). (3) Results: In total 87 participants made up the sample, and significant differences were found in the NEI-VFQ-25 according to gender, type of diabetes, episodes of decompensated diabetes and high blood pressure (HBP) (p < 0.05). Best-corrected visual acuity (BCVA) was also correlated with the NEI-VFQ-25 (p < 0.05). (4) Conclusions: These data could facilitate the design of action protocols focused on the well-being of the patient, in addition to considering the clinical characteristics. Further studies are needed to help understand the causal relationship between variables and that includes a wider variety of factors.


2021 ◽  
Vol 5 (1) ◽  
pp. 33-38
Author(s):  
H.K. Shrestha ◽  
R. Tamrakar ◽  
A. Shrestha ◽  
M. Uprety ◽  
B. Shrestha

Background: The therapeutic goal in hypothyroidism is to achieve patients’ well-being and restore serum thyrotropin (TSH) to levels within the reference range. However, inadequate or over replacement is common in patients receiving levothyroxine. The Objective is to assess the treatment outcome of hypothyroid patients visiting outpatient clinic of medicine department of Kathmandu University Hospital, Dhulikhel, Nepal. Method: This is a cross sectional study on diagnosed Primary Hypothyroid patients who were taking levothyroxine replacement for at least six months. Patients were defined as euthyoid if their TSH was in the normal range (0.3-3.6 mmol/L) according to the hospital laboratory. Similarly patients were defined as over treated if TSH is <0.3 mmol/L and undertreated if TSH is >3.6 mmol/L. Results: A total number of 126 patients were enrolled for this study where mean age of participants was 40.88 ± 11.47 years and only 15 (11.1%) were male. Mean duration of hypothyroidism was 3.45 ± 2.57 years and mean Levothyroxine dose was 58.93 ± 26.89 mcg. In this study, nearly 70% of participants have normal TSH level. Similarly, 21% of participants have higher level of TSH and 9% have low TSH level. Multivariate logistic regression analysis did not show any significant co relation between treatment outcome and various variables. Conclusion: Treatment of hypothyroidism with levothyroxine being most effective, easily available, simple regimen and not costly, still one third of patients are not meeting the treatment outcome. However, being the pioneer study from Nepal, this study suggests improved treatment outcomes compared to similar studies from other countries.


GeroPsych ◽  
2017 ◽  
Vol 30 (2) ◽  
pp. 61-70 ◽  
Author(s):  
Lia Oberhauser ◽  
Andreas B. Neubauer ◽  
Eva-Marie Kessler

Abstract. Conflict avoidance increases across the adult lifespan. This cross-sectional study looks at conflict avoidance as part of a mechanism to regulate belongingness needs ( Sheldon, 2011 ). We assumed that older adults perceive more threats to their belongingness when they contemplate their future, and that they preventively react with avoidance coping. We set up a model predicting conflict avoidance that included perceptions of future nonbelonging, termed anticipated loneliness, and other predictors including sociodemographics, indicators of subjective well-being and perceived social support (N = 331, aged 40–87). Anticipated loneliness predicted conflict avoidance above all other predictors and partially mediated the age-association of conflict avoidance. Results suggest that belongingness regulation accounts may deepen our understanding of conflict avoidance in the second half of life.


2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Mory Sanoh

Introduction : A chronic condition like diabetes interferes with an individual's well-being, and if some of their needs are not met because of the disease, their quality of life is reduced. In this context, therapeutic education constitutes a basic element in the management of diabetes.Materials and Methods : A cross-sectional study by self-administered questionnaire and interviews which were carried out with all type 1 and type 2 diabetics, consultants at the level of the Tit Mélil Primary Health Care establishment, in 2019 and who benefited from or not therapeutic education, with or without complications.Result : The study included 50 diabetic patients, surveys show us that type 1 diabetic patients were 13 (26%). And type 2.37 (74%). Regarding the organization of care, 74% of patients say they are under treatment with oral antidiabetics, 10% oral antidiabetics and insulins, 6% insulin therapy and others under diet. Speaking of Food, 76.5% of diabetics know the importance and know what foods to avoid.Conclusion : TVE is possible, it will result in a change in the structure of programs and new educational training for caregivers.


2017 ◽  
Vol 8 (1) ◽  
pp. 10
Author(s):  
Narendra Kumar Singh ◽  
Nishant Goyal

Background: Schizophrenia is associated with a high familial, social and economic burden. Schizophrenia is also associated with a high level of disability which may create impediments on the social and economic areas of the patients as well as on their respective family networks. Families with schizophrenia may encounter problems such as impairment of health and well being of other family members, restriction of social activities of the family members and shrinking of support from the social network. Aims: The present study examined the difference in perceived social support and burden of care between the male and female caregivers of patients with schizophrenia. Methods: This was a cross-sectional study examining the difference in perceived social support and burden of care between the male and female caregivers of patients with schizophrenia. The sample consisted of 60 (30 male and 30 female) caregivers of the patients with the diagnosis of schizophrenia as per ICD-10-DCR. Results and Conclusion: This study revealed that male caregivers perceived more social support and less burden of care as compared to female caregivers. Key words: Gender, social support, burden


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