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any topic related to medications and new drugs, new guidelines in treatment

Carmelo Scarpignato, Luigi Gatta, Angelo Zullo, Corrado Blandizzi
BACKGROUND: The introduction of proton pump inhibitors (PPIs) into clinical practice has revolutionized the management of acid-related diseases. Studies in primary care and emergency settings suggest that PPIs are frequently prescribed for inappropriate indications or for indications where their use offers little benefit. Inappropriate PPI use is a matter of great concern, especially in the elderly, who are often affected by multiple comorbidities and are taking multiple medications, and are thus at an increased risk of long-term PPI-related adverse outcomes as well as drug-to-drug interactions...
November 9, 2016: BMC Medicine
Brian Shiner, Christine Tang, Andrew C Trapp, Renata Konrad, Isa Bar-On, Bradley V Watts
OBJECTIVE: Primary care screening programs for mental health disorders are designed to detect patients who might benefit from treatment. As such, the utility of these programs is predicated on the actions that take place in response to a positive screen. Our objective was to characterize the cascade of care delivery steps following a positive screen for a mental health disorder. METHOD: We examined the care received by primary care patients over the year following a new positive screen for depression, posttraumatic stress disorder (PTSD) or alcohol misuse...
November 2014: General Hospital Psychiatry
J González-Bueno, E Chamorro-de-Vega, E R Alfaro-Lara, M Galván-Banqueri, B Santos-Ramos
OBJECTIVE: To describe the profile of new drugs evaluated by the Pharmacy and Therapeutics committee in a tertiary hospital using a standardized tool, the Guideline for the Introduction of New Drugs in the Formulary (GINF form), as main objective. MATERIALS AND METHODS: Retrospective observational study of drugs was assessed during 2008-2011. Variables related to the drug, the request, and the result of the evaluation were collected based on information contained in the GINF form and in the assessment reports...
September 2013: Farmacia Hospitalaria
D T Eurich, S Simpson, A Senthilselvan, C V Asche, J K Sandhu-Minhas, F A McAlister
OBJECTIVE: To determine if the use of sitagliptin in newly treated patients with type 2 diabetes is associated with any changes in clinical outcomes. DESIGN: Retrospective population based cohort study. SETTING: Large national commercially insured US claims and integrated laboratory database. PARTICIPANTS: Inception cohort of new users of oral antidiabetic drugs between 2004 and 2009 followed until death, termination of medical insurance, or December 31 2010...
2013: BMJ: British Medical Journal
Edith M Heintjes, Fernie J A Penning-van Beest, Arian W Plat, Willem Jan Meerding, Kate Webb, Miriam C Sturkenboom, Ron M C Herings
STUDY OBJECTIVES: To compare the cholesterol level goal attainment rates in patients receiving simvastatin doses recommended in clinical practice guidelines and simvastatin doses most frequently prescribed in clinical practice versus other statins at various dose levels, and to assess statin adherence rates in patients receiving all statins. DESIGN: Retrospective cohort study. DATA SOURCE: PHARMO database, which contains linked prescription drug information, hospitalization records, and laboratory test results of over 1 million patients in the Netherlands...
July 2012: Pharmacotherapy
Ernest Rasyidi, Jeffery N Wilkins, Itai Danovitch
Within the United States there exists a profound discrepancy between the significant public health problem of substance abuse and the access to treatment for addicted individuals. Part of the insufficient access to treatment is a function of relatively low levels or professional experts in addiction medicine. Part of the low levels of professional addiction experts is the result of inadequate addiction medicine training of medical students and residents. This article outlines deficits in addiction medicine training among medical students and residents, yet real change in the addiction medicine training process will always be subject to the complexity of producing alterations across multiple credentialing institutions as well as the keen competition between educators for “more time” for their particular subject...
June 2012: Psychiatric Clinics of North America
Stacie B Dusetzina, Bradley N Gaynes, Morris Weinberger, Joel F Farley, Betsy Sleath, Richard A Hansen
OBJECTIVE: This study examined the extent to which children with bipolar I disorder received recommended treatment of mood-stabilizer or second-generation antipsychotic monotherapy and factors associated with its receipt. METHODS: Administrative claims data collected from January 1, 2005, to December 31, 2007, were used to construct a cohort of 412 privately insured children with bipolar I disorder. The primary outcome measure was the receipt of mood-stabilizer or second-generation antipsychotic monotherapy within 90 days of an index diagnosis of bipolar disorder...
December 2011: Psychiatric Services: a Journal of the American Psychiatric Association
Richard Kones
A recent explosion in the amount of cardiovascular risk and incipient, undetected subclinical cardiovascular pathology has swept across the globe. Nearly 70% of adult Americans are overweight or obese; the prevalence of visceral obesity stands at 53% and continues to rise. At any one time, 55% of the population is on a weight-loss diet, and almost all fail. Fewer than 15% of adults or children exercise sufficiently, and over 60% engage in no vigorous activity. Among adults, 11%-13% have diabetes, 34% have hypertension, 36% have prehypertension, 36% have prediabetes, 12% have both prediabetes and prehypertension, and 15% of the population with either diabetes, hypertension, or dyslipidemia are undiagnosed...
2011: Drug Design, Development and Therapy
Yingbing Wang, Tarik K Alkasab, Ozden Narin, Rosalynn M Nazarian, Rathachai Kaewlai, Jonathan Kay, Hani H Abujudeh
PURPOSE: To retrospectively determine the incidence of nephrogenic systemic fibrosis (NSF) in a large academic medical center after the adoption of restrictive gadolinium-based contrast agent (GBCA) administration guidelines. MATERIALS AND METHODS: For this retrospective HIPAA-compliant study, institutional review board approval was obtained and the requirement for informed consent was waived. Restrictive GBCA guidelines were adopted in May 2007. The guidelines (a) require a recent serum creatinine level measurement in any patient who is aged 60 years or older and/or at risk for renal disease, (b) limit the maximal weight-based GBCA dose administered to any patient with an estimated glomerular filtration rate (eGFR) lower than 60 mL/min/m(2) to 20 mL, and (c) prohibit the administration of any GBCA in patients who have an eGFR lower than 30 mL/min/m(2) and/or are undergoing chronic dialysis treatment (except in emergency situations)...
July 2011: Radiology
Bryan A Liang, Tim Mackey
Individual conflicts of interest are rife in healthcare, and substantial attention has been given to address them. Yet a more substantive concern-institutional conflicts of interest ("ICOIs") in academic medical centers ("AMCs") engaged in research and clinical care-have yet to garner sufficient attention, despite their higher stakes for patient safety and welfare. ICOIs are standard in AMCs, are virtually unregulated, and have led to patient deaths. Upon review of ICOIs, we find a clear absence of substantive efforts to confront these conflicts...
2010: American Journal of Law & Medicine
Cynthia M A Geppert, Michael P Bogenschutz
The coming decades will see exciting breakthroughs in the treatment of SUDs, such as further elucidation of the genetic mechanisms of addiction. Yet if the past is any guide to the future, each new discovery will bring with it new challenges to the core ethical obligations of honoring informed consent, protecting confidentiality, and respecting justice, while also protecting the public from harm and ensuring the good of the individual patient. For the emerging scientific shift to a biobehavioral model of addiction to transform cultural attitudes and enhance treatment and research will require the scientifically rigorous and ethically sound agency of ethicists and addiction professionals to influence public policy...
June 2009: Psychiatric Clinics of North America
Leslie Citrome
Guidelines on the use of second-generation antipsychotics and physical health monitoring have begun to include information on hyperprolactinemia, and generally recommend that patients should be queried about possible symptoms related to elevated prolactin: menstrual abnormalities, galactorrhea and sexual dysfunction. However, with only two exceptions, none of the guidelines suggest performing baseline plasma prolactin levels. Although several of the guidelines mention the potential for hyperprolactinemia to be associated with osteopenia and osteoporosis, there is no guidance how to monitor for this...
March 2008: Journal of Psychopharmacology
Joan M Cook, Randall Marshall, Christina Masci, James C Coyne
BACKGROUND: There is a continued high prevalence of benzodiazepine use by older community-residing adults and of their continued prescription by practitioners, despite well known adverse effects and the availability of safer, effective alternatives. OBJECTIVES: To understand factors influencing chronic use of benzodiazepines in older adults. DESIGN: Qualitative study, semistructured interviews with physicians. PARTICIPANTS: Thirty-three practicing primary care physicians around Philadelphia...
March 2007: Journal of General Internal Medicine
Paul Coulthard
SCOPE AND PURPOSE: This guidance is intended to promote good clinical practice for the provision in dentistry of conscious sedation that is both safe and effective. It is not a recipe book for sedation and therefore does not include details of drug dosages. The recommendations are applicable to all patients receiving conscious sedation, to facilitate the provision of any type of dental treatment whether it is delivered in a dental practice, a community dental service clinic or a hospital setting...
2006: Evidence-based Dentistry
(no author information available yet)
The Global Strategy for further reducing the leprosy burden and sustaining leprosy control activities (2006 - 2010) has been widely welcomed and endorsed. The overall goal is to provide access to quality leprosy services for all affected communities following the principles of equity and social justice. The purpose of these Operational Guidelines is to help managers of national health services to implement the new Global Strategy in their own countries. This will be done as they develop detailed policies applicable to their own situation, and revise their National Manual for Leprosy Control...
September 2006: Leprosy Review
Mary Jo V Pugh, Perry J Foreman, Dan R Berlowitz
The incidence of epilepsy in patients aged >60 years is higher than in any other period of life. Yet, until recently, what was known about the treatment of older patients with epilepsy has been inferred from studies in younger patients. A growing body of clinical evidence focused exclusively on the elderly suggests that, while some issues are similar for older and younger adults, older patients with epilepsy may require even more attention regarding antiepileptic drug (AED) selection than younger patients...
2006: Drugs & Aging
Trisha Suppes, Ellen B Dennehy, Robert M A Hirschfeld, Lori L Altshuler, Charles L Bowden, Joseph R Calabrese, M Lynn Crismon, Terence A Ketter, Gary S Sachs, Alan C Swann
BACKGROUND: A panel consisting of academic psychiatrists and pharmacist administrators of the Texas Department of State Health Services (formerly Texas Department of Mental Health and Mental Retardation), community mental health physicians, advocates, and consumers met in May 2004 to review new evidence in the pharmacologic treatment of bipolar I disorder (BDI). The goal of the consensus conference was to update and revise the current treatment algorithm for BDI as part of the Texas Implementation of Medication Algorithms, a statewide quality assurance program for the treatment of major psychiatric illness...
July 2005: Journal of Clinical Psychiatry
Tracy L Skaer
Patients with moderate-to-severe malignancy-related pain require opioid pharmacotherapy. Many cancer patients continue to be prescribed subtherapeutic doses of pain medications resulting in undue suffering and diminished quality of life. Pain associated with malignancy and its treatment may exacerbate other symptoms associated with cancer, including nausea, fatigue, weakness, dyspnoea, constipation and impaired cognition. The choice of analgesic pharmacotherapy should be individualised and based on the intensity of pain reported by the patient, rather than its specific aetiology...
2004: Drugs
P Sangani, G Rutherford, D Wilkinson
BACKGROUND: Sexually transmitted infections (STI) are common in developing countries. The World Health Organisation (WHO) estimates that in 1999, 340 million new cases of syphilis, gonorrhoea, chlamydial infection and trichomoniasis occurred. Human immunodeficiency virus (HIV) infection is also common in developing countries. UNAIDS estimates that over 95% of the 40 million people infected with HIV by December 1999 live in developing countries (UNAIDS 2003). The STI and HIV epidemics are interdependent...
2004: Cochrane Database of Systematic Reviews
Carl Erik Mogensen
Guidelines for medical treatment are becoming increasingly popular and many guidelines have been produced by various societies in diabetes, hypertension, and renal disease as well as general medicine. By their nature, they are outdated considering the rapid and efficient publication of many papers related to the treatment of hypertension in diabetes. Increased blood glucose causes vascular damage and abnormal vascular structure all over the body, an abnormal structure that is especially vulnerable to high blood pressure, even within the so-called normal range...
March 2003: Journal of Hypertension. Supplement: Official Journal of the International Society of Hypertension
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