scholarly journals Factors Affecting The Drugs Availability on Program Rujuk Balik (PRB) at PRB Drugs Facility in Ex Karesidenan Kediri (Study of Hipertension Drugs)

2018 ◽  
Vol 16 (1) ◽  
pp. 30
Author(s):  
Sri Dias Tuti ◽  
Umi Athiyah ◽  
Wahyu Utami
Keyword(s):  
Term Treatment ◽  
Drug Selection ◽  
Management Support ◽  
Drug Management ◽  
Early Step ◽  
Cross Sectional ◽  
Drug Availability ◽  
Factors Affecting ◽  
Pharmaceutical Management ◽  
Long Term Treatment

PRB drugs service was given to chronically patients who still need long term treatment therefore there was need to guarantee the availability of medicines for their therapeutic needs. The objectives of this research were to know about PRB drug management, to know drug management support, policy, the availability of PRB drugs, and to analize the effects of drug management, drug management support, and policy on drug availability in PRB drug facility in Ex Karesidenan Kediri. Study on the availability of drugs hypertension due to prevalence of hypertension  disease tends to increase from 7.6% in 2007 to 9.5% in 2013. This research used cross sectional approach by giving questionnaires to 18 respondents of PRB drug managers who had fulfilled the inclusion criteria. Those respondents were measured on the capability in PRB drug managements and assessment of PRB drug management support and policy. The questionnaires were valid and reliable. The management, management support, and policy score were tested for effect on PRB drug availability for Hypertension by using multiple linear regression. From this research, it was known that PRB Drug Management, PRB Drug Management Supporting Assessment, and PRB Policy by PRB drug managers in drug service facilities in Ex Karesidenan Kediri were mostly categorized as good enough.  The availability of PRB drugs at PRB drugs facility with stock calculations indicated the ability to provide PRB medication to serve PRB prescription of hypertension was 28.71%. While the facilitieas that were able to serve an average of 72.67, thus providing substitution drugs beyond the average of PRB stock of 43.95%. The efforts were done for examples, borrowed similar drugs from regular supplies, medicines administered when they were available, or established the similar drugs at prices closed to e-catalogue. The results of the analysis showed that simultaneously PRB Drug Management factors, PRB Drug Management Supports, and PRB Policy have significant effects on PRB Drug Availability (p<0.10). PRB drug management had the greatest effects on the availability (p<0.10), especially in the case of Drug Selection (p<0.10). Selection of drugs was the first step to be done from a cycle of drug management, where the early step was the step that most determine the next steps. The pharmaceutical management framework affected the availability of PRB drugs, particularly the Drug Management factor, especially in the drug selection step. Drug selection was an early step of the drug management cycle that determined the next step.

scholarly journals What Differs between Patients under Methadone and under Buprenorphine for Opioid Use Disorder (OUD) in Daily Clinical Practice in France? A Short Report

2021 ◽  
Vol 18 (4) ◽  
pp. 1425
Author(s):  
Morgane Guillou-Landreat ◽  
Antoine Dany ◽  
Gaëlle Challet-Bouju ◽  
Edouard Laforgue ◽  
Juliette Leboucher ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Opioid Use Disorder ◽  
Term Treatment ◽  
Pharmacological Therapy ◽  
Daily Clinical Practice ◽  
Short Report ◽  
Opioid Use ◽  
Cross Sectional ◽  
Long Term Treatment ◽  
Social Profiles

(1) Background: Opioid use disorder (OUD) is a complex condition that can require long-term treatment. Pharmacological therapy for OUD involves treatment with opioid agonists (OMT) tailored to individual profiles. The aim of our study in daily clinical practice was to compare the profiles of patients treated with methadone (MTD) and those using buprenorphine (BHD or BHD-naloxone-NX). (2) Methods: A cross-sectional multicentre study explored the psychological, somatic and social profiles of patients with Opioid Use Disorder (OUD) following Opioid Maintenance Treatment (BHD, BHD/NX, or MTD). Descriptive and comparative analyses were performed (3) Results: 257 patients were included, a majority were men using heroin. 68% (178) were on MTD, 32% (79) were on BHD. Patients with MTD were significantly more likely to report socio-affective damage, and more likely to be younger and not to report oral or sublingual use as the main route for heroin or non-medical opioids (4) Conclusions: In daily clinical practice, regarding OUD damage, only socio-affective damage was significantly more prevalent among patients on MTD than among those on BHD in the multivariate model. Age and route of administration also differed, and our results could raise the issue of the type of OMT prescribed in case of non-medical use of prescribed opioids. These hypothesis should be confirmed in larger studies.

scholarly journals Hypomagnesemia Induced by Long-Term Treatment with Proton-Pump Inhibitors

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Simone Janett ◽  
Pietro Camozzi ◽  
Gabriëlla G. A. M. Peeters ◽  
Sebastiano A. G. Lava ◽  
Giacomo D. Simonetti ◽  
...  
Keyword(s):  
Receptor Antagonist ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Term Treatment ◽  
Cross Sectional ◽  
Magnesium Metabolism ◽  
Poor Renal Function ◽  
Long Term Treatment

In 2006, hypomagnesemia was first described as a complication of proton-pump inhibitors. To address this issue, we systematically reviewed the literature. Hypomagnesemia, mostly associated with hypocalcemic hypoparathyroidism and hypokalemia, was reported in 64 individuals on long-term proton-pump inhibitors. Hypomagnesemia recurred following replacement of one proton-pump inhibitor with another but not with a histamine type-2 receptor antagonist. The association between proton-pump inhibitors and magnesium metabolism was addressed in 14 case-control, cross-sectional studies. An association was found in 11 of them: 6 reports found that the use of proton-pump inhibitors is associated per se with a tendency towards hypomagnesemia, 2 found that this tendency is more pronounced in patients concurrently treated with diuretics, carboplatin, or cisplatin, and 2 found a relevant tendency to hypomagnesemia in patients with poor renal function. Finally, findings likely reflecting decreased intestinal magnesium uptake were observed on treatment with proton-pump inhibitors. Three studies did not disclose any relationship between magnesium metabolism and treatment with histamine type-2 receptor antagonists. In conclusion, proton-pump inhibitors may cause hypomagnesemia. In these cases, switching to a histamine type-2 receptor antagonist is advised.

CLINICALAND MYCOLOGICAL PROFILE OF ONYCHOMYCOSIS IN A HILLY STATE OF NORTH - EAST INDIA .

2021 ◽  
pp. 41-43
Author(s):  
Subrata kumar Das ◽  
Saptadipa Das
Keyword(s):  
Epidemiological Data ◽  
Common Species ◽  
Term Treatment ◽  
Predisposing Factor ◽  
Cross Sectional ◽  
Diagnostic Strategies ◽  
North East India ◽  
North East ◽  
Number Of Patients ◽  
Long Term Treatment

Background: Onychomycosis is a chronic fungal infection of nger nails and toe nails. It is a non life threatening condition and requires long-term treatment. Mostly patients seek medical care for cosmetic purpose unless it gets secondarily infected and produce pain. Aims: The aim of this study was to determine the prevalence of various causative agents of onychomycosis and to study the clinical and mycological patterns of onychomycosis . Material and Methods: This was a cross sectional observational study which was carried over a period of one year , from December 2019 to November 2020 . A total of 47 patients were included in the study , who visited Dermatology OPD of SMIMS , Sikkim, India. After clinical evaluation , nail samples were subjected for KOH mount and culture. Results:This study included 47 patients of clinically diagnosed onychomycosis , 30 males and 17 males . In the present study maximum number of patients belonged to the age group 30-40 years with 28 patients . Most of the study subjects , 22 were agricultural worker . We found that trauma to the nails was the commonest predisposing factor 17. Out of 47 patients 33 patients were KOH positive and 21 patients were culture positive. Most common type of onychomycosis was Distal lateral subungual onychomycosis with 2 cases . Most common species identied in our study was T.rubram with 5 patients , followed by T. mentagrophytes with 3 patients. Conclusion: Along dermatophytes , NDM and yeasts were also common aetiological agents of onychomycosis. Since onychomycosis can cause physical , psychological and occupational problems, the clinico-epidemiological data can be helpful in development of preventive and diagnostic strategies.

scholarly journals Evaluation of Drug Management Achievement in Pharmacy Installation of Langsa General Hospital

2020 ◽  
Vol 8 (1) ◽  
pp. 5-10
Author(s):  
Mauliana M ◽  
Wiryanto W ◽  
Urip Harahap
Keyword(s):  
General Hospital ◽  
Outcome Measures ◽  
Hospital Pharmacy ◽  
Management System ◽  
Qualitative Data ◽  
Drug Selection ◽  
National Formulary ◽  
Drug Management ◽  
Prospective Data ◽  
Drug Availability

Objective: to evaluate the achievements of drug management in Pharmacy Installation of Langsa General Hospital Design: The study used descriptive designs for 2018 data which were retrospective and prospective. Data was collected in the form of quantitative and qualitative data from document observations and interviews with relevant Pharmacy Installation officers. Interventions: the intervened  variable were drug selection, planning and procurement, and distribution. Main outcome measures: the main measurement in this study were suitability of drug items available with the National Formulary, frequency of procurement of each drug item per year,  accuracy of  data on the number of drugs on the stock card, percentage and value of expired and / or damaged drugs, percentage of dead stock and level of drug availability. Results:  drug management system that conformed  to the following standards were the suitability of the available drug items with the National Formulary (88.37%); the accuracy of data on the number of drugs on the stock card (100%) and  drug availability (13 months 14 days).  Drug mangement which were not accordance with standard: the frequency of procurement of each drug item per year; percentage of expired and / damaged drug values (2.64%) and percentage of dead stock (3.24%). Conclusion: it could  be concluded that the management of drugs in Langsa General Hospital Pharmacy Installation had not been fully effective and efficient in accordance with established standards.    

Abstract 419: Human ApoB100/CETP Transgenic Mouse is a Useful Animal Model for Evaluation of HDL-C Elevation and Suppression of Atherosclerosis by Peroxisome Proliferator-Activated Receptor Delta Agonist

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Noriyuki Naya ◽  
Keita Fukao ◽  
Akemi Nakamura ◽  
Kohji Nomura ◽  
Seijiro Hara ◽  
...  
Keyword(s):  
Term Treatment ◽  
Serum Lipoprotein ◽  
Peroxisome Proliferator ◽  
Cross Sectional ◽  
Peroxisome Proliferator Activated Receptor ◽  
New Class ◽  
Promising Target ◽  
Long Term Treatment ◽  
Apoe Ko Mice ◽  
Lipoprotein Profiles

PPARδ is one of the transcription factors that regulate lipid metabolism. Recently, PPARδ agonists have been reported to induce the elevation of plasma HDL-C levels in obese mice, rhesus monkeys as well as humans, indicating their potentials as a new class of HDL-C raising agent. In addition, anti-atherosclerotic effects of PPARδ agonists were reported in LDLR-KO and ApoE-KO mice. In these mice, however, the lipoprotein profiles are greatly different from those in humans in terms of the deficiency in CETP and ApoB100, and thus the anti-inflammatory effects were regarded as a main anti-atherosclerotic mechanism of PPARδ agonists. It has been reported that human ApoB100/CETP transgenic (hApoB100/CETP-Tg) mice have similar lipoprotein profiles with humans. In this study, we used hApoB100/CETP-Tg mice placed under a western diet for evaluation of GW501516, one of the most potent and selective PPARδ agonists, in order to investigate the linkage between HDL-C elevation and anti-atherosclerotic potency. For evaluation of plasma HDL-C levels, the hApoB100/CETP-Tg mice were orally treated with GW501516 for 1 week and its potency was compared with fenofibrate, a PPARα agonist used in the clinic. For evaluation of the anti-atherosclerotic effect, the mice were orally treated with GW501516 for 18 weeks and atherosclerosis at the aortic valves was determined by cross-sectional lesion analysis. Serum lipoprotein parameters were periodically monitored and lipoprotein profiles were analyzed by FPLC method. Treatment with GW501516 resulted in significant elevation of plasma HDL-C levels with more potency compared to fenofibrate (24% and 15% elevation at 10mg/kg, respectively). Serum apoA-I was also increased by the similar ratio as HDL-C, and the particle size of HDL was not changed, suggesting that the numbers of HDL particle are increased by GW501516. Long term treatment of GW501516 (3 and 10 mg/kg) resulted in dose-dependent suppression of atherosclerosis (42 and 57% inhibition, respectively) with a strong correlation with HDL-C elevation (p<0.001). By using hApoB100/CETP-Tg mice, PPARδ was confirmed as a promising target of anti-atherosclerotic therapy as a new class of HDL-C raising agent.

Effectiveness of Long-Term Treatment of Multiple Myeloma in Regular Care: Comparison of a Longitudinal and a Cross-Sectional Analysis Approach

2021 ◽  
pp. 1-8
Author(s):  
Tilman Steinmetz ◽  
Angela Ernst ◽  
Martin Hellmich ◽  
Melanie Heinz ◽  
Uwe Totzke
Keyword(s):  
Multiple Myeloma ◽  
Treatment Guidelines ◽  
Term Treatment ◽  
Subsequent Treatment ◽  
New Drugs ◽  
Event Analysis ◽  
Cross Sectional ◽  
Regular Care ◽  
Long Term Treatment ◽  
Cross Sectional Studies

<b><i>Introduction:</i></b> New drugs for multiple myeloma have considerably increased the options for consecutive treatment lines in regular care. Official treatment guidelines still discuss several regimens per line, and therefore, current practice is of topical interest. Large cross-sectional studies revealed a greater than linear loss of patients reaching consecutive treatment lines of ever decreasing effectiveness. <b><i>Methods:</i></b> In a longitudinal approach, we analyzed data of all 145 multiple myeloma patients treated in our outpatient clinic in Germany between January 1, 2012, and December 31, 2019, using a time-to-event analysis with death as competitive risk. <b><i>Results:</i></b> The estimated incidences of reaching the 2nd, 3rd, 4th, and 5th lines of therapy were 88, 66, 44, and 30%, respectively. Median times to subsequent treatment lines were 34, 18, 14, 13, and 15 months, respectively. <b><i>Discussion:</i></b> Percentages of patients reaching later therapy lines were considerably greater than predicted by cross-sectional studies and median times after the 1st line did not suggest a further decrease in effectiveness, while use of new drug regimens was similar to that reported in cross-sectional studies. <b><i>Conclusion:</i></b> Effectiveness of later therapy lines appears to be underestimated by cross-sectional analyses, and the conveyed focus on 1st-line treatment for multiple myeloma needs to be scrutinized.

The role of cross-sectional echocardiography in Kawasaki disease

1991 ◽  
Vol 1 (3) ◽  
pp. 221-224 ◽  
Author(s):  
José A. Ettedgui ◽  
William H. Neches ◽  
Elfriede Pahl
Keyword(s):  
Kawasaki Disease ◽  
Coronary Arteriography ◽  
Term Treatment ◽  
Left Ventricular ◽  
Arterial Stenosis ◽  
Cross Sectional ◽  
Coronary Aneurysms ◽  
Long Term Treatment ◽  
Clear Delineation

SummaryCross-sectional echocardiography is an essential tool in the evaluation ofchildren with Kawasaki disease, both in the acute and chronic stages. In the acute phase of the illness, it is valuable for diagnosis and management of pancarditis and for the long-term monitoring of pericardial effusions, left ventricular function, and the rare cases of chronic valvar dysfunction. When coronary arterial abnormalities are detected, echocardiography can serially evaluate long-term treatment with drugs which prevent the aggregation of platelets and monitor the resolution of coronary aneurysms. The value of cross-sectional echocardiography, nonetheless, is very limited in the detection of coronary arterial stenosis. Coronary arteriography is still important for the diagnosis of obstructive lesions in the coronary arteries and should be used in conjunction with cross-sectional echocardiography for the appropriate long- term management of children with Kawasaki disease at high risk of developing coronary arterial stenosis. Perhaps, in the future, high resolution transesophageal echocardiography will allow clear delineation of coronary arterial anatomy and specifically stenosis, but its role in the evaluation and management of children with Kawasaki disease remains to be explored.

scholarly journals A joint effort over a period of time: factors affecting use of urate-lowering therapy for long-term treatment of gout

2016 ◽  
Vol 17 (1) ◽  
Author(s):  
Jane C. Richardson ◽  
Jennifer Liddle ◽  
Christian D. Mallen ◽  
Edward Roddy ◽  
Samantha Hider ◽  
...  
Keyword(s):  
Time Factors ◽  
Term Treatment ◽  
Joint Effort ◽  
Factors Affecting ◽  
Lowering Therapy ◽  
Long Term Treatment

scholarly journals Long-term re-evaluation of primary aldosteronism after medical treatment reveals high proportion of normal mineralocorticoid secretion

2013 ◽  
Vol 168 (4) ◽  
pp. 525-532 ◽  
Author(s):  
Barbara Lucatello ◽  
Andrea Benso ◽  
Isabella Tabaro ◽  
Elena Capello ◽  
Mirko Parasiliti Caprino ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Primary Aldosteronism ◽  
Cross Sectional Study ◽  
Term Treatment ◽  
Duration Of Treatment ◽  
Cross Sectional ◽  
Long Term Treatment ◽  
Suppression Test ◽  
Mineralocorticoid Antagonists

ObjectiveIn most cases of primary aldosteronism (PA), an adrenal aldosterone-secreting tumor cannot be reasonably proven, so these patients undergo medical treatment. Controversial data exist about the evolution of PA after medical therapy: long-term treatment with mineralocorticoid antagonists has been reported to normalize aldosterone levels but other authors failed to find remission of mineralocorticoid hypersecretion. Thus, we planned to retest aldosterone secretion in patients with medically treated PA diagnosed at least 3 years before.DesignRetrospective, cross-sectional study.MethodsThe same workup for PA as at diagnosis (basal aldosterone to renin activity ratio (ARR) and aldosterone suppression test) was performed after stopping interfering drugs and low-salt diet, in 34 subjects with PA diagnosed between 3 and 15 years earlier, by case finding from subgroups of hypertensive patients at high risk for PA. Criteria for persistence of PA were the same as at diagnosis (ARR (pg/ml per ng per ml per h) >400, aldosterone >150 pg/ml basally, and >100 pg/ml after saline infusion) or less restrictive.ResultsPA was not confirmed in 26 (76%) of the patients and also not in 20 (59%) using the least restrictive criteria suggested by international guidelines. Unconfirmed PA was positively associated with female sex, higher potassium levels, longer duration of hypertension, and follow-up, but not with adrenal mass, aldosterone levels at diagnosis, and treatment with mineralocorticoid antagonists.ConclusionsThis study suggests that mineralocorticoid hyperfunction in patients with PA after medical treatment may decline spontaneously. Higher potassium concentration and duration of treatment seem to increase the probability of this event.

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