scholarly journals Repeated dispensing of codeine is associated with high consumption of benzodiazepines

2009 ◽  
Vol 18 (2) ◽  
Author(s):  
Liliana C. Bachs ◽  
Jørgen G. Bramness ◽  
Anders Engeland ◽  
Svetlana Skurtveit
Keyword(s):  
Drugs Of Abuse ◽  
Prescription Database ◽  
Age And Gender ◽  
High Consumption ◽  
Defined Daily Doses ◽  
Concurrent Use ◽  
Norwegian Population ◽  
Norwegian Prescription Database ◽  
And Gender ◽  
One Year

Aims: Our objective was to explore the use of codeine analgesics in individual patients in Norway, giving special attention to the 10% who consume the highest amounts. Methods: We retrieved data from the Norwegian Prescription Database on patients who were dispensed at least one codeine analgesic prescription during 2006. We looked at age and gender specific 1-year periodic prevalence. The 10% of codeine users who were prescribed the highest amounts of the drug that year were further characterized. Age and gender distribution and concurrent high consumption of other potential drugs of abuse were also considered. Results: In the year 2006, a total of 386,836 individuals filled at least one prescription for codeine analgesics from Norwegian pharmacies, excluding cancer patients. The crude prevalence for the use of codeine analgesics was 7.3% and 9.3% of the male and female Norwegian population, respectively. Twelve percent of women and 9% of men who filled a codeine prescription received 120 defined daily doses (DDD) or more of codeine analgesics in 2006 (moderate to high consumers). Fifty percent of those patients (21,759) were also dispensed large amounts of benzodiazepines or carisoprodol over the same period. In comparison, only ten percent of patients who received fewer than 120 DDD of codeine analgesics were dispensed large amounts of benzodiazepines or carisoprodol. Conclusions: A high percentage of the Norwegian population used codeine analgesics. One-year prevalence use of codeine increased with age and was higher for women at all ages. Our study showed that codeine use was mainly sporadic, but that a relatively large sub-group of users were dispensed repeated prescriptions of the drug in combination with other potential drugs of abuse. Key Words: Codeine analgesics, Norwegian Prescription Database, prevalence, dispensed quantity, concurrent use, high consumers, abuse.

scholarly journals Changes in the consumption of antiepileptics and psychotropic medicines after starting low dose naltrexone: A nation-wide register-based controlled before-after study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Guttorm Raknes ◽  
Lars Småbrekke
Keyword(s):  
Low Dose ◽  
Prescription Database ◽  
Cumulative Number ◽  
Beneficial Effects ◽  
Defined Daily Doses ◽  
Psychotropic Medicines ◽  
Significant Difference ◽  
Norwegian Prescription Database ◽  
One Year ◽  
Low Dose Naltrexone

Abstract In this controlled before-after study based on data from the Norwegian Prescription Database, we examine whether starting off-label use of Low Dose Naltrexone (LDN) is followed by changes in the consumption of psychotropic medicines including antiepileptics. Patients that collected LDN for the first time in 2013 (N = 11247) were included and stratified into three groups based on LDN exposure. We compared differences in means of cumulative number of defined daily doses (DDD) as well as changes in the number of users one year before and one year after starting LDN. There was a dose-response association between increasing LDN exposure and reductions in the number of users of antiepileptics, antipsychotics and antidepressants. There were significant difference-in-differences in DDDs between the groups with the lowest and highest LDN exposure of antipsychotics (1.4 DDD, 95% CI 0.4 to 2.3, p = 0.007), and in number of users of antiepileptics (3.1% points, 95% CI 1.6% to 4.6%, p < 0.001), antipsychotics (2.1% points, 95% CI 1.2% to 3%, p < 0.001), and antidepressants (2.8% points, 95% CI 1.1% to 4.4%, p = 0.001). The findings show an association between the initiation of persistent LDN use and reduced consumption of several psychotropic medicines and antiepileptics. Beneficial effects of LDN in the treatment of psychiatric diseases cannot be ruled out.

scholarly journals Reference intervals for serum lipids and prevalence of dyslipidaemia in 6–12-year-old children: The Health Oriented Pedagogical Project (HOPP)

2018 ◽  
Vol 46 (21_suppl) ◽  
pp. 21-27 ◽  
Author(s):  
Martin Frank Strand ◽  
Per Morten Fredriksen ◽  
Ole Petter Hjelle ◽  
Morten Lindberg
Keyword(s):  
Total Cholesterol ◽  
Serum Lipids ◽  
Venous Blood ◽  
Elevated Serum ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Reference Intervals ◽  
Age And Gender ◽  
Norwegian Population ◽  
And Gender

Aims: Elevated serum lipid concentrations in childhood are thought to be risk factors for the development of cardiovascular disease later in life. The present study aims to provide age- and gender-related reference intervals for total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, and non-HDL cholesterol in healthy school children. We also investigated the prevalence of dyslipidaemia using the published criteria for these biomarkers. Methods: Venous blood and anthropometric data were collected from 1340 children in the HOPP study, aged between 6 and 12 years. Age- and gender-related reference intervals (2.5th and 97.5th percentiles) were established according to the IFCC recommendations, using the software RefVal 4.10. Results: Gender differences were observed for total cholesterol and non-HDL cholesterol, but not for HDL cholesterol. Age differences were observed for total cholesterol. The reference intervals were in the range of 3.1–5.9 mmol/L for total cholesterol, 1.0–2.4 mmol/L for HDL cholesterol and 1.4–4.2 mmol/L for non-HDL cholesterol. Dyslipidaemia prevalence was as follows: increased TC 9.6%, decreased HDL 1.6%, and increased non-HDL 5.6%. Conclusions: Age- and gender-related reference intervals in a Norwegian population are similar to those reported in other countries. The prevalence of dyslipidaemia among Norwegian children is significant, emphasising the importance of appropriate reference intervals in clinical practice.

3333Contemporary mortality rates in myocardial infarction patients in Sweden: a tale of two registries

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Siverskog ◽  
M Janzon ◽  
L.-Å Levin ◽  
J Alfredsson ◽  
M Henriksson
Keyword(s):  
Myocardial Infarction ◽  
Intensive Care ◽  
Patient Characteristics ◽  
Primary Diagnosis ◽  
Age And Gender ◽  
Quality Registry ◽  
Mortality Outcome ◽  
Mortality Difference ◽  
And Gender ◽  
One Year

Abstract Background Sweden has contributed to the understanding of the long-term prognosis after myocardial infarction (MI) utilising the quality registry SWEDEHEART, including patients admitted to heart intensive care, and the National Patient Registry (PAR), based on administrative records for Swedish hospitals. As registration procedures differ between the registries, and not all MI patients are admitted to heart intensive care, MI patients identified in SWEDEHEART and PAR, respectively, will yield different cohorts of patients. This may result in different epidemiological research findings regarding prognosis after MI. Purpose To study MI populations identified in SWEDEHEART and PAR, respectively, and investigate potential differences in mortality outcome. Methods Patients hospitalised with an MI primary diagnosis (ICD-10 I21) between 2002 and 2015 were identified using SWEDEHEART and PAR. The analysis time started at the date of hospital admission and survivors were followed for 365 days. Kaplan-Meier analysis was used to estimate survival by cohort category controlling for age and gender. Results Excluding cases with invalid data (n=1,905), 225,612 and 282,118 SWEDEHEART and PAR patients, respectively, were identified. We found 213,367 patients in both SWEDEHEART and PAR, whereas 12,245 and 68,751 patients were unique to SWEDEHEART and PAR, respectively. The one-year survival probability after MI in the SWEDEHEART population was 0.841, compared to 0.788 in PAR (Figure). This discrepancy can be explained by high mortality among patients not covered by SWEDEHEART and persists after controlling for age and gender (Table). To what extent differences in registration procedures and other patient characteristics can explain the mortality difference is an area for further research. One-year survival by age and gender Age ± 1 year Male Female PAR S.H. Diff. PAR S.H. Diff. 65 0.922 0.936 0.015 0.919 0.936 0.017 70 0.893 0.909 0.016 0.889 0.908 0.019 75 0.829 0.858 0.029 0.834 0.860 0.026 80 0.743 0.783 0.040 0.768 0.800 0.033 85 0.625 0.677 0.052 0.662 0.705 0.042 One-year survival after MI Conclusion Estimated one-year survival for MI patients differs by up to 5 percentage points depending on the registry used. Although further research is needed to fully understand these differences, epidemiological findings regarding MI prognosis should be interpreted in light of registry type used and population represented. Acknowledgement/Funding Region Östergötland

Increased Documentation and Management of Pediatric Obesity Following Implementation of an EMR Upgrade and Education

2011 ◽  
Vol 51 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Jennifer Keehbauch ◽  
Gretchen San Miguel ◽  
Leslie Drapiza ◽  
Julie Pepe ◽  
Richard Bogue ◽  
...  
Keyword(s):  
Clinical Management ◽  
Rate Of Change ◽  
Physician Education ◽  
Overweight Children ◽  
Age And Gender ◽  
Training And Education ◽  
Medicine Resident ◽  
Before And After ◽  
And Gender ◽  
One Year

Background: Overweight children are often not identified or counseled. Purpose: We assessed the documentation rate and clinical management of overweight children before and after an electronic medical record (EMR) upgrade calculating body mass index (BMI) percentile for age and gender. Methods: Family Medicine resident and faculty physicians at two sites received an EMR upgrade; Site1 physicians also received BMI training and education. From two years before to one year after the upgrade, randomly selected charts were reviewed for all encounters with overweight children for documentation of obesity and clinical management. Results: After the EMR upgrade, documentation and counseling rates significantly improved at both sites but the rate of change was greater for Site 1; postintervention documentation was significantly greater for Site 1 vs. Site 2 (40% vs. 28%, P<0.01). Conclusions: We found an increase in documentation and management of overweight children following an EMR upgrade that calculates BMI percentiles for age and gender. Physician education was an important adjunct.

scholarly journals Prevalence and Public Health Importance of Hydatidosis in Sheep Slaughtered by Unlicensed Ways

2019 ◽  
Vol 12 (1) ◽  
pp. 399-402 ◽  
Author(s):  
Fadia Abd Al-Muhsin Al-Khayat
Keyword(s):  
Public Health ◽  
Microscopic Examination ◽  
Prevalence Rate ◽  
Parasitic Disease ◽  
Public Health Importance ◽  
Age And Gender ◽  
Control Programs ◽  
And Gender ◽  
One Year ◽  
The Relationship

Hydatidosis is a zoonotic, helminthes parasitic disease that cause veterinary and human problems due to economic burden. Amis of the current study was to estimate the prevalence rate of hydatidosis infecting different organs of sheep slaughtered in street. In addition, investigate the relationship between age, gender and the infected rates in some Baghdad areas during a period from may to end of July 2018.A total of 188 sheep was examined for detection of Hydatid cyst in different organs using macroscopic and microscopic examination The overall prevalence rate of 47.9% was recorded. The results indicate non significant differences according to age and gender, the highest rate 57% was observed in sheep more than one year old compared with small ages 31.3%. The females showed the highest rate 59.3% while the male recorded 30.7%. The most affected organ was the liver 64.4% followed by the lung 25.6% and finally the spleen 10%. Conclusion of this study indicates the higher prevalence rate lead to the necessity for control programs against hydatidosis includ preventing of illegal slaughtering.

SEASONAL CHANGE IN HEMATOLOGICAL AND BIOCHEMICAL BLOOD VALUES OF HEREFORD CATTLE

2020 ◽  
Author(s):  
В.И. РАИЦКАЯ
Keyword(s):  
Blood Cells ◽  
White Blood Cells ◽  
Age And Gender ◽  
Autumn Period ◽  
Hereford Cattle ◽  
The Republic ◽  
And Gender ◽  
One Year ◽  
Physiological Values ◽  
Gender Groups

Исследования проведены в Республике Хакасия. Проанализированы изменения некоторых гематологических и биохимических параметров крови у разных половозрастных групп крупного рогатого скота герефордской породы весной, летом, осенью и зимой. Анализ крови здоровых особей показал, что в различные периоды года отмечались колебания изучаемых показателей, что может являться следствием дефицита в организме углеводного, минерально-витаминного и белкового обменов. Количество лимфоцитов в крови у коров, быков-производителей и нетелей в зимний период были ниже физиологической нормы. В осенний период этот показатель так и не приблизился к установленной норме у коров и составил 1,7×109/л, что можно объяснить погрешностями в кормлении высокопродуктивных животных и более слабыми окислительно-восстановительными процессами в их организме. Пониженное число эритроцитов в крови в зимний период у коров, быков-производителей и нетелей, кроме бычков до года, может быть также обусловлено неполноценным кормлением. Морфологический состав крови у животных различных половозрастных групп в основном находился в пределах физиологических значений и свидетельствовал о том, что они были здоровы. Уменьшение в сыворотке крови общего белка, по сравнению с физиологической нормой, в весенний период происходило у коров на 32,8%, нетелей — на 30,8%, у бычков до года — на 39,7%, а у быков-производителей летом на 36,9%, что также можно объяснить недостатком протеина в кормах и рационах. В осенний период данный показатель у всех групп приблизился к физиологической норме. The research was carried out in the Republic of Khakassia. The changes of certain hematological and biochemical blood values in various age and gender groups of cattle belonging to Hereford breed were analyzed in spring, summer, autumn, and winter. The analysis of blood from healthy animals showed the presence of fluctuations in the studied values during various periods of the year, which can be a consequence of a deficiency of carbohydrate, mineral and vitamin, as well as protein metabolism in the bodies. The number of white blood cells in the blood of cows, seed bulls, and heifers was lower than the physiological norm. During the autumn period this value in cows did not get close to the set norm and amounted to 1.7x109/L which can be explained by the errors of feeding highly-productive animals, as well as weaker redox processes in their organisms. Decreased number of red blood cells in cows, seed bulls, and heifers, except for bulls younger than one year of age, can be also caused by inadequate feeding. The morphological composition of blood of animals belonging to various age and gender groups was generally within the physiological values and showed that they were healthy. The decrease of total protein in blood serum compared to the physiological norm during the spring period was seen in cows by 32.8%, heifers — by 30.8%, bulls younger than one year of age — 39.7%, and in seed bulls during the summer, by 36.9%, which can also be explained by the lack of protein in the feed and diet. During the autumn period this value was closer to the physiological norm in all groups.

AGE AND GENDER DIFFERENCES IN GROWTH OF MASS, LENGTH AND WIDTH OF CALVARIA IN ONTOGENESIS OF ROMANOV BREED SHEEP

2020 ◽  
Keyword(s):  
Statistical Processing ◽  
Postnatal Life ◽  
Morphological Parameters ◽  
Age And Gender ◽  
Age And Gender Differences ◽  
Biological Laws ◽  
And Gender ◽  
One Year ◽  
Breed Sheep ◽  
Uterine Development

This article presents the results of scientific studies of morphometric indicators of calvary in the pre-and postnatal ontogenesis of Romanov breed sheep. Changes related to the sex of experimental animals were also studied. In order to detect general patterns of growth of calvari morphological parameters, the age stages of selecting material for research were determined: from a 2-month-old fetus to 12 months of postnatal life and from adult sheep 5-6 years old. We measured the mass, length and width of the studied material. The data obtained were subjected to statistical processing. The calvary maturity at each age in percentage, was determined. As a result of our studies, we were able to establish that the growth of linear indicators of calvary subjected to general biological laws of a decrease in its intensity with age, i.e. more rapidly, it proceeds in uterine development compared with postnatal. As for the changes in sex-related animals, it was found that growth of mass, length and width of calvary occurs in both sexes simultaneously and with almost the same intensity. In their growth, two decreases are observed: the first - before birth and the second - from 3 to 6 months. Throughout the entire periods of research, the calvary mass in females approaches its final value faster, and its length, on the contrary, in males. As for its width, in uterine development it grows somewhat faster than in females, and after birth in males. By one-year-old age of sheep, none of the calvari indicators in either males or females reaches its definitive state.

scholarly journals Age and gender differences in medical adherence after myocardial infarction: Women do not receive optimal treatment – The Netherlands claims database

2017 ◽  
Vol 25 (2) ◽  
pp. 181-189 ◽  
Author(s):  
Daniëlle C Eindhoven ◽  
Alexander D Hilt ◽  
Thomas C Zwaan ◽  
Martin J Schalij ◽  
C Jan Willem Borleffs
Keyword(s):  
Myocardial Infarction ◽  
Gender Differences ◽  
Medical Adherence ◽  
Age And Gender ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Age And Gender Differences ◽  
And Gender ◽  
One Year

Background Following myocardial infarction, medication is, besides lifestyle interventions, the cornerstone treatment to improve survival and minimize the occurrence of new cardiovascular events. Still, data on nationwide medication adherence are scarce. This study assesses medical adherence during one year following myocardial infarction, stratifying per type of infarct, age and gender. Design Retrospective cohort study. Methods In The Netherlands, all inhabitants are by law obliged to have health insurance and all claims data are centrally registered. In 2012 and 2013, all national diagnosis-codings of ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) were acquired. Furthermore, information on retrieved medication was extracted from the Dutch Pharmacy Information System. Twelve months after discharge, the retrieved medication at the pharmacy of each pharmacological therapy (aspirin-species, P2Y12-inhibitor, statin, beta-blocker, angiotensin-converting enzyme-/angiotensin 2-inhibitor, vitamin-K antagonists or novel oral anticoagulant) were analysed. Results In total, 59,534 patients (67 ± 13 years, 39,545 (66%) male, 57% NSTEMI) were included, of whom 52,672 (88%) patients were analysed for one-year medical adherence. STEMI patients more often achieved optimal medical adherence than NSTEMI patients (60% vs. 40%, p ≤ 0.001). In both STEMI and NSTEMI, use of all five indicated drugs was higher in male patients compared with female (STEMI male 61% vs. female 57%, p ≤ 0.001; NSTEMI male 43% vs. female 37%, p ≤ 0.001. With increasing age, a gradual decrease was observed in the use of aspirin, P2Y12-inhibitors and statins. Conclusion Age and gender differences existed in medical adherence after myocardial infarction. Medical adherence was lower in women, young patients and elderly patients, specifically in NSTEMI patients.

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