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Drug burden index

Hermann Blessberger, Juergen Kammler, Hans Domanovits, Oliver Schlager, Brigitte Wildner, Danyel Azar, Martin Schillinger, Franz Wiesbauer, Clemens Steinwender
BACKGROUND: Randomized controlled trials have yielded conflicting results regarding the ability of beta-blockers to influence perioperative cardiovascular morbidity and mortality. Thus routine prescription of these drugs in unselected patients remains a controversial issue. OBJECTIVES: The objective of this review was to systematically analyse the effects of perioperatively administered beta-blockers for prevention of surgery-related mortality and morbidity in patients undergoing any type of surgery while under general anaesthesia...
March 13, 2018: Cochrane Database of Systematic Reviews
Núria López-Matons, Dolors Conill Badell, Gloria Obrero Cusidó, Domènec Gil Saladié, Jaume Padrós Selma, Adela Martin-López
OBJECTIVE: Describe the prevalence of the anticholinergic drugs (AD) used in patients who consult in regard to loss of memory. Assess the cognitive and functional repercussion of these drugs. PATIENTS AND METHODS: Retrospective review of the clinic history of the patients who consulted the clinic in 2015 and 2016. We used the Anticholinergic Cognitive Burden Scale. We explored cognition with the Mini Mental State Examination (MMSE) and function with the Barthel Index and the Lawton and Brody Scale...
March 7, 2018: Medicina Clínica
Christopher R Ensor, Carlo J Iasella, Kate M Harrigan, Matthew R Morrell, Cody A Moore, Norihisa Shigemura, Adriana Zeevi, John F McDyer, Raman Venkataramanan
Calcineurin inhibitors (CNIs) are the backbone of traditional immunosuppressive regimens for lung transplant recipients (LTR). The CNIs are both narrow therapeutic index drugs with significant interpatient and intrapatient variability that require therapeutic drug monitoring to ensure safety and effectiveness. We hypothesized that tacrolimus time-in-therapeutic range (TTR) affects acute and chronic rejection rates in LTRs. This was a single-center, observational, cross-sectional study of 292 adult LTRs. Subjects who received tacrolimus post-transplant for the first year were included...
March 7, 2018: American Journal of Transplantation
Flora N Balieva, Andrew Y Finlay, Jörg Kupfer, Lucía Tomas Aragones, Lars Lien, Uwe Gieler, Françoise Poot, Gregor B E Jemec, Laurent Misery, Lajos Kemeny, Francesca Sampogna, Henriët van Middendorp, Jon Anders Halvorsen, Thomas Ternowitz, Jacek C Szepietowski, Nikolay Potekaev, Servando E Marron, Ilknur K Altunay, Sam S Salek, Florence J Dalgard
Skin disease and its therapy affect health-related quality of life (HRQoL). The aim of this study was to measure the burden caused by dermatological therapy in 3,846 patients from 13 European countries. Adult outpatients completed questionnaires, including the Dermatology Life Quality Index (DLQI), which has a therapy impact question. Therapy issues were reported by a majority of patients with atopic dermatitis (63.4%), psoriasis (60.7%), prurigo (54.4%), hidradenitis suppurativa (54.3%) and blistering conditions (53%)...
March 2, 2018: Acta Dermato-venereologica
Jean-Eric Tarride, Robert B Hopkins, Natasha Burke, Jason R Guertin, Daria O'Reilly, Charlene D Fell, Genevieve Dion, Martin Kolb
Background: Idiopathic pulmonary fibrosis (IPF), although rare, is a severe and costly disease. Objective: To estimate the clinical and economic burden of IPF over multiple years before and after diagnosis using comprehensive administrative databases for the province of Quebec, Canada. Methods: Several administrative databases from Quebec, providing information on hospital care, community care, and pharmaceuticals, were linked over a 5-year period ending March 31, 2011, which was before approval of antifibrotic drugs in Canada...
2018: ClinicoEconomics and Outcomes Research: CEOR
Charlotte Rouzaud-Laborde, Pierre Lafitte, Laurent Balardy, Zofia Czosnyka, Eric A Schmidt
OBJECTIVES:  Arterial hypertension is among the leading risks for mortality. This burden requires in hypertensive patients the use of single, double or more antihypertensive drugs. The relationship between intracranial pressure (ICP) and arterial blood pressure is complex and still under debate. The impact of antihypertensive drugs on ICP is unknown. We wanted to understand whether the use of antihypertensive drugs has a significant influence on ICP and cerebrospinal fluid (CSF)/brain related parameters...
2018: Acta Neurochirurgica. Supplement
James Wilton, Syed W Noor, Alexandre Schnubb, James Lawless, Trevor A Hart, Troy Grennan, Shawn Fowler, John Maxwell, Darrell H S Tan
BACKGROUND: To maximize public health impact and cost-effectiveness, HIV pre-exposure prophylaxis (PrEP) must reach individuals at high HIV risk. Referrals for PrEP can be self- or provider-initiated, but there are several challenges to both. We assessed whether HIV risk differed by referral source among gay, bisexual and other men who have sex (gbMSM) screening for an HIV PrEP demonstration project. METHODS: PREPARATORY-5 was an open-label PrEP demonstration project enrolling gbMSM at high risk of HIV acquisition in Toronto, Canada...
February 27, 2018: BMC Public Health
Sandhya Mehta, Sabyasachi Ghosh, Stephen Sander, Effie Kuti, William K Mountford
BACKGROUND: Multiple studies have reported that type 2 diabetes mellitus (T2DM) is a major risk factor for cardiovascular diseases (CVD), and presence of T2DM and CVD increases risk of death. There is growing interest in examining the effects of antidiabetic treatments on the reduction of cardiovascular events in T2DM adults with a history of CVD and thus at higher risk of cardiovascular events. OBJECTIVE: To estimate the incremental all-cause health care utilization and costs among adults with T2DM and a history of CVD compared with adults without a history of CVD, using a national linked electronic medical records (EMR) and claims database...
March 2018: Journal of Managed Care & Specialty Pharmacy
Byomesh Tripathi, Shilpkumar Arora, Varun Kumar, Mohamed Abdelrahman, Sopan Lahewala, Mihir Dave, Mahek Shah, Bryan Tan, Sejal Savani, Apurva Badheka, Radha Gopalan, Ghanshyam Palamaner Subash Shantha, Juan Viles Gonzales, Abhishek Deshmukh
BACKGROUND: Catheter ablation is widely accepted intervention for atrial fibrillation (AF) refractory to antiarrhythmic drugs (AAD), but limited data is available regarding contemporary trends in major complications and in hospital mortality due to the procedure. This study was aimed at exploring the temporal trends of in-hospital mortality, major complications and impact of hospital volume on frequency of AF ablation related outcomes. METHOD: Nationwide inpatient sample (NIS) database was utilized to identify the AF patients treated with catheter ablation...
February 25, 2018: Journal of Cardiovascular Electrophysiology
Om Dawani, Raja Samir Khan, Mujtaba Jamal Syed, Abdul Moid Shehzad, Ahmed Alratoot, Muhammad Faizan Ahmed
For many years, tuberculosis (TB) has been endemic in Pakistan; many rare and unusual presentations have been reported. There is a myriad of non-specific symptoms which always requires a high index of clinical suspicion for TB. World Health Organization data suggest that Pakistan ranks as the fifth highest country burdened with TB and has the fourth highest prevalence of multi-drug resistant TB globally. With an annual incidence of 277 cases per 100,000, the importance of early diagnosis and treatment is self-evident...
January 1, 2018: Tropical Doctor
Joanna M Zakrzewska, Ning Wu, John Y K Lee, Brian Werneburg, Deborah Hoffman, Ying Liu
BACKGROUND AND AIM: Trigeminal neuralgia (TN) is a rare orofacial disorder characterized by severe unilateral paroxysmal pain in the region of the fifth cranial nerve. Clinical guidelines recommend carbamazepine (only US Food and Drug Administration-approved drug for TN) and oxcarbazepine as first-line therapies. We utilized the US Truven Health MarketScan database to examine treatment patterns among patients with TN. METHODS: Included patients were aged ≥18 years, newly diagnosed with TN (≥2 TN diagnoses ≥14 days apart; no diagnosis in the prior year), continuously enrolled 1 year pre-index, with ≥3 years' follow-up post-index...
February 19, 2018: Clinical Journal of Pain
Charles D Burger, A Burak Ozbay, Howard M Lazarus, Ellen Riehle, Leslie B Montejano, Gregory Lenhart, R James White
BACKGROUND: Despite multiple treatment options, the prognosis of pulmonary arterial hypertension (PAH) remains poor. PAH patients experience a high economic burden due to comorbidities, hospitalizations, and medication costs. Although combination therapy has been shown to reduce hospitalizations, the relationship between treatment, health care utilization, and costs remains unclear. OBJECTIVE: To provide a characterization of health care utilization and costs in real-world settings by comparing periods before and after initiating PAH-specific treatment...
February 13, 2018: Journal of Managed Care & Specialty Pharmacy
Mathias Tiedemann Svendsen, Flemming Andersen, Kirsten Hammond Andersen, Klaus Ejner Andersen
BACKGROUND: Topical corticosteroid or corticosteroid/calcipotriol preparations are recommended first-line topical treatments of psoriasis, but a main cause for the lack of efficacy of topical treatments is considered low rates of adherence to topical drugs. Patient support by the use of applications (apps) for smartphones is suggested to improve medical adherence. METHODS/DESIGN: Design: An investigator-initiated, single-center, single-blind, parallel-group, phase-4 clinical superiority randomized controlled trial (RCT)...
February 7, 2018: BMC Dermatology
Bernardo Sousa-Pinto, António Cardoso-Fernandes, Luís Araújo, João Almeida Fonseca, Alberto Freitas, Luís Delgado
BACKGROUND: Penicillin allergy is commonly reported, but only a minority of claimants has a confirmed diagnosis. Nevertheless, patients labeled as having penicillin allergy are treated with second-line antibiotics, which are more expensive and less effective, possibly increasing the risk of drug-resistant infections. OBJECTIVE: To compare hospitalizations with and without registration of penicillin allergy concerning their morbidity and hospital resource use. METHODS: We analyzed a national administrative database containing a registration of all Portuguese hospitalizations from 2000 to 2014...
February 2018: Annals of Allergy, Asthma & Immunology
Xavier Serra-Picamal, Ramon Roman, Joan Escarrabill, Anna García-Altés, Josep Maria Argimón, Nestor Soler, Rosa Faner, Elisenda Martinez Carbonell, Antoni Trilla, Alvar Agusti
BACKGROUND: Patients with Chronic Obstructive Pulmonary Disease (COPD) may suffer episodes of exacerbation (ECOPD) that require hospitalization and worsen their health status, and prognosis. We hypothesized that a detailed interrogation of health-care "big data" databases can provide valuable information to better understand the risk factors and outcomes of these episodes. MATERIAL AND METHODS: We interrogated four databases of the Catalan health-care system (>8,000,000 registries) to identify patients hospitalized because of ECOPD for the first time (index event) between 2010 and 2012...
January 16, 2018: Respiratory Medicine
Shuichi Watanabe, Takahide Fukatsu, Kosuke Kanemoto
BACKGROUND: With the ageing of the general population, demand has grown for measures to prevent hospitalization for dementia, which can exacerbate problems associated with activities of daily living in elderly individuals. Anticholinergic medication has been shown to cause falls, delirium, and cognitive impairment in aged patients. However, the risk of hospitalization associated with the administration of anticholinergics is unclear. METHODS: We analyzed the records of 61 outpatients (26 men, 35 women; mean age: 78 ± 7 years; mean follow-up period: 420 days) diagnosed with dementia (Alzheimer's disease: n = 45; dementia with Lewy bodies: n = 3; undifferentiated n = 13) and prescribed anti-dementia drugs between May 2013 and December 2014...
January 2018: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
Yi Zhun Zhu, Weijun Wu, Qing Zhu, Xinhua Liu
Despite several advances in percutaneous coronary intervention and the discovery of new drugs, the incidence of myocardial infarction and deaths due to cardiovascular diseases (CVD) has not decreased markedly in China. The quality of life is affected seriously, which further results in great social and family burden. Many drugs, from the century-old aspirin to the newly FDA-approved Byvalson, have been proven to be effective in the treatment and prevention of CVD. As clinically reported, those life-saving drugs still have their side effects in regards to the narrow therapeutic indexes influenced by individual genetic variations...
January 19, 2018: Pharmacology & Therapeutics
Pimsiri Srivarangkul, Wanchalerm Yuttithamnon, Aphinya Suroengrit, Saran Pankaew, Kowit Hengprasartporn, Thanyada Rungrotmongkol, Preecha Phuwaphriasirisarn, Kiat Ruxrungtham, Siwaporn Boonyasuppayakorn
Dengue infection is a global burden affecting millions of world population. Previous studies indicated that flavanones were potential dengue virus inhibitors. We discovered that a novel flavanone derivative, 5-hydroxy-7-methoxy-6-methylflavanone (FN5Y), inhibited DENV2 pH-dependent fusion in cell-based system with strong binding efficiency to DENV envelope protein at K (P83, L107, K128, L198), K' (T48, E49, A50, L198, Q200, L277), X' (Y138, V354, I357), and Y' (V97, R99, N103, K246) by molecular dynamic simulation...
January 19, 2018: Antiviral Research
Kjell Larsson, Björn Ställberg, Karin Lisspers, Gunilla Telg, Gunnar Johansson, Marcus Thuresson, Christer Janson
BACKGROUND: Severe and uncontrolled asthma is associated with increased risk of exacerbations and death. A substantial proportion of asthma patients have poor asthma control, and a concurrent COPD diagnosis often increases disease burden. The objective of the study was to describe the prevalence and managemant of severe asthma in a Swedish asthma popuöation. METHODS: In this observational cohort study, primary care medical records data (2006-2013) from 36 primary health care centers were linked to data from national mandatory Swedish health registries...
January 18, 2018: Respiratory Research
Emna Harigua-Souiai, Yosser Zina Abdelkrim, Imen Bassoumi-Jamoussi, Ons Zakraoui, Guillaume Bouvier, Khadija Essafi-Benkhadir, Josette Banroques, Nathan Desdouits, Hélène Munier-Lehmann, Mourad Barhoumi, N Kyle Tanner, Michael Nilges, Arnaud Blondel, Ikram Guizani
Leishmaniases are neglected parasitic diseases in spite of the major burden they inflict on public health. The identification of novel drugs and targets constitutes a research priority. For that purpose we used Leishmania infantum initiation factor 4A (LieIF), an essential translation initiation factor that belongs to the DEAD-box proteins family, as a potential drug target. We modeled its structure and identified two potential binding sites. A virtual screening of a diverse chemical library was performed for both sites...
January 18, 2018: PLoS Neglected Tropical Diseases
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