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Tessa van Middelaar, Sophie D Ivens, Petra G van Peet, Rosalinde K E Poortvliet, Edo Richard, A Jeannette Pols, Eric P Moll van Charante
OBJECTIVES: To explore general practitioners' (GPs) routines and considerations on (de)prescribing antihypertensive medication (AHM) in older patients, their judgement on usability of the current guideline and needs for future support. DESIGN: Semistructured interviews. SETTING: Dutch general practice. PARTICIPANTS: Fifteen GPs were purposively sampled based on level of experience and practice characteristics until saturation was reached...
April 20, 2018: BMJ Open
Bernadette Flood
The population with intellectual disabilities is one of the most vulnerable groups in society. Medication use is the main therapeutic intervention in this population and psychotropic medications can be prescribed for mental health conditions and for challenging behaviors. Clinical experience of prescribers and pharmacists working with people with intellectual disabilities suggests that reducing or stopping psychotropic medication is not always straightforward. What is required is rational, rather than rationed, prescribing of psychotropic medications...
March 30, 2018: Pharmacy (Basel, Switzerland)
Noll L Campbell, Kathleen A Lane, Sujuan Gao, Malaz A Boustani, Fred Unverzagt
STUDY OBJECTIVE: To determine the influence of anticholinergic medications on transitions in cognitive diagnosis of older adults in primary care. DESIGN: This observational cohort study was conducted over a mean follow-up of 3.2 years. Anticholinergic exposure was defined by pharmacy dispensing and claims records. Cognitive diagnosis was performed by an expert panel at baseline and annually up to four years. DATA SOURCE: Medication exposure and other clinical data were extracted from the Indiana Network for Patient Care (INPC), while the cognitive diagnosis was derived from a cognitive screening and diagnosis study...
March 30, 2018: Pharmacotherapy
Doron Garfinkel, Nataly Ilin, Alexander Waller, Ashley Torkan-Zilberstein, Netanel Zilberstein, Itai Gueta
BACKGROUND: Elderly patients are exposed to increased number of medications, often with no proof of a positive benefit/risk ratio. Unfortunately, this trend does not spare those with limited life expectancy, including end-stage cancer patients who require only palliative treatment. For many medications in this subpopulation, the risk of adverse drug events outweighs the possible benefits and yet, many are still poly-medicated during their last year of life. AIM: To describe the extent of polypharmacy among end-stage cancer patients, at the time of admission to homecare hospice...
January 23, 2018: International Journal of Clinical Practice
Doron Garfinkel
Background: The aim of this study was to evaluate efficacy and safety of poly-de-prescribing (PDP) based on the Garfinkel method in older people with polypharmacy. Methods: A longitudinal, prospective, nonrandomized study in Israel was carried out between 2009 and 2016. Comprehensive geriatric assessments were performed at home in people age ⩾66 years consuming ⩾6 prescription drugs. Exclusion criteria were life expectancy <6 months and a seeming unwillingness to cooperate (poor compliance)...
January 2018: Therapeutic Advances in Drug Safety
Mark Jones, Susan Tett, Geeske M E E Peeters, Gita D Mishra, Annette Dobson
INTRODUCTION: Extensive clinical research has consistently shown statins lower the risk of cardiovascular events and mortality. Some studies also suggest statins increase the risk of new-onset diabetes. Research to date has rarely included elderly women, hence little is known about the risk of diabetes after statin exposure in this population. OBJECTIVES: Our objectives were to evaluate and estimate the risk of new-onset diabetes associated with statin exposure in a cohort of elderly Australian women...
March 2017: Drugs & Aging
Idoia Arrizabalaga Aldalur, Beatriz García Martinez, Shahrazad Benabdellah Abouhammadi, María Del Carmen García Tirado, Alfredo Pardo Cabello, Pilar Parra Rosado
No abstract text is available yet for this article.
March 2017: Revista Española de Geriatría y Gerontología
Arjun Poudel, Nancye M Peel, Lisa M Nissen, Charles A Mitchell, Leonard C Gray, Ruth E Hubbard
OBJECTIVE: To explore the relationship between polypharmacy and adverse outcomes among older hospital inpatients stratified according to their frailty status. DESIGN AND SETTING: A prospective study of 1418 patients, aged 70 and older, admitted to 11 hospitals across Australia. MEASUREMENTS: The interRAI Acute Care (AC) assessment tool was used for all data collection, including the derivation of a frailty index calculated using the deficit accumulation method...
August 1, 2016: Journal of the American Medical Directors Association
Jason A Gregg, Ronald L Tyson, Donna Cook
In the elderly, Potentially Inappropriate Prescriptions (PIPs) are quite common and connected with adverse drug events (ADEs), hospital stays, increased medical acuities, and inefficacious healthcare. Benzodiazepines as a class have been identified as an independent risk factor for ADE's and shown to be associated with sedation and impairments in cognition, memory, and balance, lending to an increased risk for falls. Clinically inappropriate medications continue to be prescribed and preferred by many clinicians over non-pharmacological strategies despite continued evidence demonstrating poor outcomes in older adults...
September 2016: Rehabilitation Nursing: the Official Journal of the Association of Rehabilitation Nurses
Jennifer Zelmer
No abstract text is available yet for this article.
February 2016: Healthcare Policy, Politiques de Santé
Emily Reeve, Danijela Gnjidic, Janet Long, Sarah Hilmer
AIMS: The aim of this study was to identify what definitions have been published for the term 'deprescribing', and determine whether a unifying definition could be reached. A secondary aim was to uncover patterns between the published definitions which could explain any variation. METHODS: Systematic literature searches were performed (earliest records to February 2014) in MEDLINE, Embase, CINAHL, Informit, Scopus and Google Scholar. The terms deprescrib* or de-prescrib* were employed as a keyword search in all fields...
December 2015: British Journal of Clinical Pharmacology
Amit S Mutha, Vijay R Kulkarni, Sagar B Bhagat, Amit S Beldar, Sadiq B Patel
INTRODUCTION: Erectile dysfunction (ED) is a common occurrence and its incidence is expected to increase significantly along with the increase in various lifestyle diseases. The drug utilization for ED is very low. Also, studies describing the prescription pattern in ED are lacking. MATERIALS AND METHODS: We conducted a retrospective cross-sectional observational study, including a drug utilization analysis, of 606 prescriptions as per the standard guidelines (WHO and STROBE)...
July 2015: Journal of Clinical and Diagnostic Research: JCDR
José Fernando de Macedo, Gustavo Capinzaiki de Macedo, Luciana Aparecida Campos, Ovidiu Constantin Baltatu
Patients with systemic lupus erythematosus have a poor prognosis of pregnancy, since it is associated with significant maternal and fetal morbidity, including spontaneous miscarriage, pre-eclampsia, intrauterine growth restriction, fetal death and pre-term delivery. We report a case with successful pregnancy in a patient with systemic lupus erythematosus and hypertension. A 39-year-old nulliparous woman presented with systemic lupus erythematosus with antinuclear and antiphospholipid antibodies, hypertension and recurrent pregnancy loss presented for assisted reproduction...
September 2015: Medicine (Baltimore)
Juliana Garcia, Vera M Costa, Alexandra Carvalho, Paula Baptista, Paula Guedes de Pinho, Maria de Lourdes Bastos, Félix Carvalho
Amanita phalloides, also known as 'death cap', is one of the most poisonous mushrooms, being involved in the majority of human fatal cases of mushroom poisoning worldwide. This species contains three main groups of toxins: amatoxins, phallotoxins, and virotoxins. From these, amatoxins, especially α-amanitin, are the main responsible for the toxic effects in humans. It is recognized that α-amanitin inhibits RNA polymerase II, causing protein deficit and ultimately cell death, although other mechanisms are thought to be involved...
December 2015: Food and Chemical Toxicology
Jenny Fairthorne, Geoff Hammond, Jenny Bourke, Nick de Klerk, Helen Leonard
Psychiatric disorders are more common in the mothers of children with autism spectrum disorder (ASD) or intellectual disability (ID) after the birth of their child. We aimed to assess the relationship between women's psychiatric contacts and subsequent offspring with ASD/ID. We linked three Western Australian registers to investigate pre-existing maternal outpatient psychiatric contacts and the odds of ASD/ID in a subsequent child. Women with a previous outpatient psychiatric contact were more than twice as likely to have a child with ASD [OR 2...
February 2016: Journal of Autism and Developmental Disorders
S Terraneo, M Ferrer, I Martín-Loeches, M Esperatti, M Di Pasquale, V Giunta, M Rinaudo, F de Rosa, G Li Bassi, S Centanni, A Torres
In immunocompetent patients with nosocomial pneumonia, the relationship between Candida spp. isolation in respiratory samples and outcomes or association with other pathogens is controversial. We therefore compared the characteristics and outcomes of patients with intensive care unit-acquired pneumonia (ICUAP), with or without Candida spp. isolation in the respiratory tract. In this prospective non-interventional study, we assessed 385 consecutive immunocompetent patients with ICUAP, according to the presence or absence of Candida spp...
January 2016: Clinical Microbiology and Infection
Marine Delobeau, Ahlam Abdou, Eve Puzenat, Elise Deveza, Caroline Biver-Dalle, Alison van de Laak, Blandine Roche-Kubler, Lucine Vuitton, Stéphane Koch, Daniel Wendling, François Aubin
INTRODUCTION: Although the efficacy of TNF blockers has been demonstrated in hidradenitis suppurativa (HS), many paradoxical effects have also been described with TNF antagonists. We wished to describe patients with adalimumab (ADA)-induced paradoxical HS. METHODS: This is a retrospective descriptive case series of four patients with ADA-induced paradoxical HS. RESULTS: All the patients had a good response to TNFa antagonist therapy at the time of HS occurrence...
2016: Journal of Dermatological Treatment
D Barberena, G Gatti, F De Zela
We present a simple device that works as a secondary source of light with prescribed polarization properties. The device has great versatility, allowing complete control over both the degree of polarization and the Stokes vector that belongs to the fully polarized component of partially polarized light beams. We report experimental results that illustrate the device's versatility, by showing how polarized states can be moved within the Poincaré ball along spiraling paths.
April 1, 2015: Journal of the Optical Society of America. A, Optics, Image Science, and Vision
Roi Piñeiro Pérez, Begoña Santiago García, Cecilia M Fernández Llamazares, Fernando Baquero Artigao, Antoni Noguera Julian, María José Mellado Peña
INTRODUCTION: There are no paediatric formulations of anti-tuberculous drugs in Spain, with the only exception being rifampicin. Some paediatricians often prescribe composite formulations (CF), while others prefer to give crushed tablets. Nevertheless, there is no consensus in this regard, or any pharmacokinetic studies validating these procedures. In this situation, the Spanish Network for the Study of Paediatric Tuberculosis (pTBred) has launched the Magistral Project, which has as its first phase aims to analyse the desirability of developing child-friendly pharmaceutical formulations and other aspects regarding the anti-tuberculous drug prescription in children...
July 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
Delphine Berthod, Blaise Genton, Christoph Hatz, Johannes Blum, Serge de Vallière
BACKGROUND: Fever is a frequent cause of medical consultation among returning travelers. The objectives of this study were to assess whether physicians were able to identify patients with influenza and whether the use of an influenza rapid diagnostic test (iRDT) modified the clinical management of such patients. METHODS: Randomized controlled trial conducted at 2 different Swiss hospitals between December 2008 and November 2012. Inclusion criteria were 1) age ≥ 18 years, 2) documented fever of ≥ 38 °C or anamnestic fever + cough or sore throat within the last 4 days, 3) illness occurring within 14 days after returning from a trip abroad, 4) no definitive alternative diagnosis...
September 2015: Travel Medicine and Infectious Disease
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