scholarly journals Parnaparin: confronto con le altre eparine a basso peso molecolare

2004 ◽  
Vol 5 (1) ◽  
pp. 33-45
Author(s):  
Lorenzo Pradelli ◽  
Mario Eandi
Keyword(s):  
Drug Class ◽  
Drug Acquisition ◽  
Drug Acquisition Cost ◽  
Health Resources ◽  
Low Molecular Weight ◽  
Home Based ◽  
Dosing Regimens ◽  
Home Based Therapy ◽  
Deep Vein

Sodium parnaparin is a low molecular weight heparin (LMWH). The introduction of this drug class has represented a medical advancement in the prevention and therapy of thromboembolic pathologies, as they maintain the same efficacy of unfractionated heparin, but with simplified dosing regimens and reduced side effects. Parnaparin has demonstrated its thromboprophylactic efficacy on both high- and moderate risk surgical patients, besides resulting effective in treating established deep vein thromboses and thrombosis-associated phlebopathies. Alongside these clinical advantages, parnaparin and other LMWHs allow outpatient or home-based therapy of a large number of subjects that should otherwise be treated in hospital, with important savings of health resources and enhanced quality of life for the patients. In Italy, parnaparin drug acquisition cost is the lowest among all LMWHs for the majority of their applications, permitting marginal savings in health costs at the same efficacy level. In summary, the use of parnaparin in thrombotic pathologies has very good efficacy and safety profiles, and has positive clinical and economical outcomes for patients, health system and society as a whole.

Parnaparin: confronto con le altre eparine a basso peso molecolare

2005 ◽  
Vol 6 (3) ◽  
pp. 227-241
Author(s):  
Lorenzo Pradelli
Keyword(s):  
Drug Class ◽  
Drug Acquisition ◽  
Drug Acquisition Cost ◽  
Health Resources ◽  
Low Molecular Weight ◽  
Home Based ◽  
Dosing Regimens ◽  
Home Based Therapy ◽  
Deep Vein

Sodium parnaparin is a low molecular weight heparin (LMWH). The introduction of this drug class has represented a medical advancement in the prevention and therapy of thromboembolic pathologies, as they maintain the same efficacy of unfractionated heparin, but with simplified dosing regimens and reduced side effects. Parnaparin has demonstrated its thromboprophylactic efficacy on both high- and moderate risk surgical patients, besides resulting effective in treating established deep vein thromboses and thrombosis-associated phlebopathies. Alongside these clinical advantages, parnaparin and other LMWHs allow outpatient or home-based therapy of a large number of subjects that should otherwise be treated in hospital, with important savings of health resources and enhanced quality of life for the patients. In Italy, parnaparin drug acquisition cost is among the lowest in its class for many applications, permitting marginal savings in health costs at the same efficacy level. In summary, the use of parnaparin in thrombotic pathologies has very good efficacy and safety profiles, and has positive clinical and economical outcomes for patients, health system and society as a whole.

Parnaparin: review of the literature

2008 ◽  
Vol 9 (1) ◽  
pp. 27-40
Author(s):  
Lorenzo Pradelli
Keyword(s):  
Drug Acquisition ◽  
Drug Acquisition Cost ◽  
Health Resources ◽  
Antithrombotic Activity ◽  
Home Based ◽  
Dosing Regimens ◽  
Inflammatory Processes ◽  
Home Based Therapy ◽  
Deep Vein

Sodium parnaparin is a low molecular weight heparin (LMWH). The introduction of this drug class has represented a medical advancement in the prevention and therapy of thromboembolic pathologies, as they maintain the same efficacy of unfractionated heparin, but with simplified dosing regimens and reduced side effects. Parnaparin has demonstrated its thromboprophylactic efficacy on both high- and moderate risk surgical patients, besides resulting effective in treating established deep vein thromboses and thrombosis-associated phlebopathies. Besides and independently from its antithrombotic activity, parnaparin possesses modulating effects on cells involved in inflammatory processes, which may explain its reported utility in phlebopathies other than DVT; among LMWHs available in Italy, parnaparin is the only approved for these indications. Alongside these clinical advantages, parnaparin and other LMWHs allow outpatient or home-based therapy of a large number of subjects that should otherwise be treated in hospital, with important savings of health resources and enhanced quality of life for the patients. In Italy, parnaparin drug acquisition cost is among the lowest in its class, permitting marginal savings in health costs at the same efficacy level. In summary, the use of parnaparin in thrombotic pathologies has very good efficacy and safety profiles, and has positive clinical and economical outcomes for patients, health system and society as a whole.

An integrated approach to evaluate different tetracycline derivatives for formulary decisions

2021 ◽  
Author(s):  
Andrei Zidaru ◽  
Kady Phe ◽  
Todd M Lasco ◽  
Vincent H Tam
Keyword(s):  
Minimum Inhibitory Concentration ◽  
Acquisition Cost ◽  
Inhibitory Concentration ◽  
Treatment Options ◽  
Wholesale Price ◽  
Drug Acquisition ◽  
Drug Acquisition Cost ◽  
Integrated Approach ◽  
Base Case ◽  
Dosing Regimens

Abstract Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Stenotrophomonas maltophilia has emerged as a critical opportunistic pathogen associated with significant morbidity and mortality. Tetracycline derivatives have been recognized as alternative treatment options, but they have varied pharmacokinetic properties. An integrated approach to different tetracycline derivatives for formulary decisions is reported. Methods The minimum inhibitory concentration (MIC) data from clonally diverse bloodstream S. maltophilia isolates were examined, along with the pharmacokinetic profiles of 4 tetracycline derivatives, to predict achievable pharmacodynamic exposures with standard intravenous dosing regimens. Antimicrobial therapy was assessed using the ratio of daily drug acquisition cost relative to the ratio of the free-drug area under the time-concentration curve (fAUC) to the 90th percentile for minimum inhibitory concentration (MIC) values for isolates (fAUC/MIC90). Results In our analysis, minocycline had the greatest fAUC/MIC90. Doxycycline was the most financially preferred agent, as calculated using 2020 average wholesale price for base-case estimates of drug acquisition cost. Conclusion An integrated evaluation for antimicrobial formulary decision-making addressed local susceptibility data, pharmacokinetics, pharmacodynamics, dosing regimens, and drug acquisition costs. This comprehensive method is more objective than the conventional approach and warrants validation.

scholarly journals Deep vein thrombosis and our treatment applications: 12-year results

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Borulu F ◽  
◽  
Erkut B ◽  
Keyword(s):  
Quality Of Life ◽  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Mechanical Thrombectomy ◽  
Heparin Therapy ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Deep Vein

Introduction: Deep vein thrombosis is an important health problem that is frequently encountered in the general population and especially in surgical clinics and has a negative impact on quality of life. In this study, treatment options and results of patients with deep vein thrombosis who have been hospitalized for 12 years in Atatürk University and Erzurum Regional Hospital were examined and discussed. Methods: In our clinic, 412 cases of deep vein thrombosis (211 female, 201 male) were hospitalized between 2009 and 2021. The mean age of the patients was 49 ± 19 years. While medical treatment with heparin was given to all 412 patients; thrombolytic therapy, surgical embolectomy (vascular and pulmoner), and pharmaco-mechanical thrombectomy were applied to some of these patients. Results: Deep vein thrombosis was more common in the lower extremity (n=322, 78.2%). All patients had at least one of the complaints of pain, swelling and redness. All cases were diagnosed by color Doppler ultrasonography. Medically, standard and low molecular weight heparin therapy was given to all patients after hospitalization. Thrombolytic therapy was applied to 66 (16,1%) of the cases, pulmonary embolectomy to 8 (1,9%), surgical thrombectomy to 10 (2,4%) and pharmacomechanical thrombectomy to 44 (10,7%) patients. In addition to these 120 patients (29.1%), a vena cava filter was placed for prophylactic purposes. Conclusions: In patients diagnosed with deep vein thrombosis and hospitalized, the diagnosis should be supported by Doppler ultrasound in addition to clinical diagnosis after an etiology investigation. Early diagnosis, rapid and effective treatment methods are important for the subsequent quality of life of patients. In addition to low molecular weight heparins being the first choice agents, standard heparin administration still needs to be applied in some clinical pictures. In addition, we believe that pharmacomechanical thrombectomy can be applied in appropriate acute cases. Keywords: Deep vein thrombosis; anticoagulant treatment; heparin therapy; low-molecular-weight heparin; mechanical thrombectomy.

La tromboprofilassi post-chirurgica e la terapia del tromboembolismo venoso con eparine a basso peso molecolare: ruolo della bemiparina in una strategia di minimizzazione dei costi

2004 ◽  
Vol 5 (4) ◽  
pp. 219-226
Author(s):  
Lorenzo Pradelli ◽  
Mario Eandi
Keyword(s):  
Deep Vein Thrombosis ◽  
Drug Acquisition ◽  
Thrombotic Risk ◽  
Vein Thrombosis ◽  
A Value ◽  
National Market ◽  
Tromboembolismo Venoso ◽  
Dosing Regimens ◽  
Acquisition Costs ◽  
Deep Vein

The introduction of low molecular weight heparins (LMWHs) has opened new possibilities for the costeffective management of the thrombotic risk associated with surgical procedures, allowing prophylaxis – and sometimes even treatment of established deep vein thrombosis – on a out-patient basis. This article gives a brief overview of the pharmacological and clinical features of LMWHs, focusing on the differences with unfractionated heparin (UFH), which allow great simplification of dosing regimens and settings without disadvantages in terms of efficacy or safety. In fact, some data indicate that LMWH might be better tolerated than UFH. The overcoming of the need for hospitalization for pre- and post-surgical thromboprophylaxis has important economical implications and is leading to a different formation of health care costs in these patients. The clinical and economical consequences of the pharmacological differences between LMWHs and UFH are analyzed with a “value matrix”, a pharmacoeconomical technique for preliminary evaluations. The last section examines Italian drug acquisition costs and compares the economical values of the recommended dosing regimens of LMWHs available on the national market for the prevention and the treatment of deep vein thrombosis. Bemiparin is the most convenient LMWH for all approved indications. In the management of surgery-associated thrombotic risk, no clinically relevant differences among LMWHs have been demonstrated. Thus, bemiparin appears to be the most logical choice in a costminimization strategy.

scholarly journals Terapi Psikososial Pada Osteoartritis Di Komunitas

2021 ◽  
Vol 5 (3) ◽  
pp. 367
Author(s):  
Arum Pratiwi ◽  
Abi Muhlisin ◽  
Umi Budi Rahayu
Keyword(s):  
Uric Acid ◽  
Blood Sugar ◽  
Blood Sugar Level ◽  
Community Empowerment ◽  
Average Score ◽  
Relaxation Techniques ◽  
Home Based ◽  
Level Of Knowledge ◽  
Home Based Therapy

Program kemitraan komunitas ini dilakukan dengan tujuan membimbing, dan melatih para mitra yaitu kelompok penderita osteoartritis (OA) dan masyarakat yang berisiko untuk meningkatkan kualitas hidup. Metode yang digunakan adalah bersama dengan mitra yaitu kader kesehatan dan masyarakat, mengidentifikasi kelompok sasaran dan menciptakan home based untuk pusat terapi. Tim kemitraan ini melatih para penderita OA dengan teknik relaksasi, senam osteoarthritis, dan pendidikan kesehatan mengenai diet dan kontrol emosional. Sebelum kegiatan dilakukan, tim kemitraan melakukan pemerikasaan laboratorium asam urat dan gula darah sewaktu. Alat pemeriksaan yang digunakan adalah easy touch dan stik, media komunikasi yang digunakan adalah modul, leaflet, audiovisual, dan poster. Jumlah peserta pengabdian ini adalah 100 orang ysng kemudian teridentifikasi OA menjadi 52 orang. Hasil kegiatan ini terdiri dari gambaran hasil asam urat, gula darah, gambaran nyeri, tingkat pengetahuan yang meningkat pada mitra yaitu rata-rata nilai pre-test 55,27 menjadi 72,10; Peningkatan ketrampilan mitra yaitu mampu memperagakan senam OA dan teknik relaksasi secara mandiri.Kata Kunci: Pemberdayaan masyarakat, pelatihan, pendampinganPsychosocial Therapy for Osteoarthritis in the CommunityABSTRACTThe purpose of the community partnership program was guiding of partner to train them who are groups of osteoarthritis (OA ) sufferers and communities that risk to improve quality of life . The method of this activity including built home based therapy centers and then trained OA sufferers used relaxation techniques, osteoarthritis exercises, and health education on diet and emotional control. Before the activity was carried out, the partnership team conducted a laboratory test of uric acid detection and blood sugar level. The examination was used easy touch tools and sticks . the medium of display was used modules, leaflets, audiovisual, and posters. The number of participants of this activity was initially 100 people, next, was identified 52 participant with OA. The results of this activity consisted of a description of the results of uric acid level, blood sugar level, a description of pain, an increased level of knowledge at partners that the average score of 55.27 to 72.10; Enhancing partner skills is able to demonstrate OA exercises and relaxation techniques independently.Keywords: Community empowerment, training program, coaching, mentoring.

Low Molecular Weight Heparin Therapy: Is Monitoring Needed?

1994 ◽  
Vol 72 (03) ◽  
pp. 330-334 ◽  
Author(s):  
B Boneu
Keyword(s):  
Molecular Weight ◽  
Clinical Trials ◽  
Plasma Proteins ◽  
Bleeding Risk ◽  
Heparin Therapy ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Meta Analyses ◽  
Deep Vein ◽  
Initial Check

SummaryRecent meta-analyses indicate that low molecular weight heparins (LMWH) are more effective than unfractionated heparin (UH) in preventing and treating deep vein thrombosis. This article presents the arguments for and against the need for laboratory monitoring. At the present time, the only tests currently available for monitoring LMWH therapy are those which measure the anti Xa activity in the plasma. Due to lower binding to plasma proteins and to cell surfaces,the plasma anti Xa activity generated by a given dose of LMWH is more predictable than for UH.Some clinical trials suggest that LMWH delivered at the recommended dose expose the patient to less bleeding risk than UH. Several . meta-analyses indicate comparable risk while any overdose unaccept-ably increases the haemorrhagic risk. The lowest dose of LMWH still effective in treating established DVT is presently unknown; some reports indicate that inadequate doses of LMWH are associated with a lack of efficacy for prevention. An overview of the published clinical trials indicates that the LMWH dose has never been monitored for prevention of DVT. In the treatment of established DVT, several trials have been performed without any monitoring, while in others the dose was adapted to target a given anti Xa activity. These considerations suggest that in prevention of DVT, monitoring the dose is not required. In the treatment of established DVT, considering the haemorrhagic risk of LMWH, the risk of undertreating the patient and the absence of large clinical trials comparing the advantages of monitoring the dose or not, it might be useful to check anti Xa activity at least once at the beginning of the treatment but the need for this initial check remains to be established. Because a large proportion of patients will be in the desired range, dose adjustments will be far less frequent than for UH.

scholarly journals “Randomized trial of physical activity on quality of life and lung cancer biomarkers in patients with advanced stage lung cancer: a pilot study”

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Brett C. Bade ◽  
Geliang Gan ◽  
Fangyong Li ◽  
Lingeng Lu ◽  
Lynn Tanoue ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Lung Cancer ◽  
Randomized Trial ◽  
Cancer Biomarkers ◽  
Advanced Stage ◽  
Home Based ◽  
Advanced Stage Lung Cancer ◽  
Stage Lung Cancer

Abstract Background Lung cancer survivors need more options to improve quality of life (QoL). It is unclear to what extent patients with advanced stage disease are willing to participate in home-based physical activity (PA) and if these interventions improve QoL. The goal of our study was to determine interest in participating in our 3-month home-based walking regimen in patients with advanced stage lung cancer. We used a randomized design to evaluate for potential benefit in PA and patient-reported outcomes. Methods We performed an open-label, 1:1 randomized trial in 40 patients with stage III/IV non-small cell lung cancer (NSCLC) evaluating enrollment rate, PA, QoL, dyspnea, depression, and biomarkers. Compared to usual care (UC), the intervention group (IG) received an accelerometer, in-person teaching session, and gain-framed text messages for 12 weeks. Results We enrolled 56% (40/71) of eligible patients. Participants were on average 65 years and enrolled 1.9 years from diagnosis. Most patients were women (75%), and receiving treatment (85%) for stage IV (73%) adenocarcinoma (83%). A minority of patients were employed part-time or full time (38%). Both groups reported low baseline PA (IG mean 37 (Standard deviation (SD) 46) vs UC 59 (SD 56) minutes/week; p = 0.25). The IG increased PA more than UC (mean change IG + 123 (SD 212) vs UC + 35 (SD 103) minutes/week; p = 0.051)). Step count in the IG was not statistically different between baseline (4707 step/day), week 6 (5605; p = 0.16), and week 12 (4606 steps/day; p = 0.87). The intervention improved EORTC role functioning domain (17 points; p = 0.022) with borderline improvement in dyspnea (− 13 points; p = 0.051) compared to UC. In patients with two blood samples (25%), we observed a significant increase in soluble PD-1 (219.8 (SD 54.5) pg/mL; p < 0.001). Conclusions Our pilot trial using a 3-month, home-based, mobile health intervention enrolled over half of eligible patients with stage III and IV NSCLC. The intervention increased PA, and may improve several aspects of QoL. We also identified potential biomarker changes relevant to lung cancer biology. Future research should use a larger sample to examine the effect of exercise on cancer biomarkers, which may mediate the association between PA and QoL. Clinical trial registration Clinicaltrials.gov (NCT03352245).

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