Analysis Of Drug Treatment Research Articles

The impact of hypertension on mortality and the risk of developing geriatric syndromes

Background. Hypertension (HTN) is a major risk factor for the development of cardiovascular disease in young and middle age, however, data on its effect on cardiovascular risk in older adults are contradictory. Objective. To evaluate the impact of high blood pressure on mortality and the course of major geriatric syndromes in the population aged 65 years and older. Design and methods. The prospective cohort Crystal study (2 examinations, 9 years of follow-up), the cross-sectional cohort Eucalyptus study. Sample: a random sample of community-dwelling older adults aged 65 and older (n = 1007). Main parameters: blood pressure, analysis of drug treatment, medical history, laboratory tests, comprehensive geriatric assessment. Results. HTN has been identified as a risk factor for myocardial infarction, cognitive decline, slow gait speed and low muscle strength. However, in people with frailty and slow gait speed, the presence of HTN was associated with a lower risk of all-cause mortality. The lowest risk of all — cause mortality in participants with a slow gait speed was found with systolic blood pressure 140-159 mm Hg [risk ratio (95 % confidence interval) 0,049 (0,009-0,283)], with frailty — with systolic blood pressure 160-180 mm Hg [risk ratio (95 % confidence interval) = 0,109 (0,016-0,758)]. Conclusions. HTN retains its negative predictive value in older adults and is associated with an increased risk of cardiovascular complications, decreased cognitive and physical functions, but a lower risk of mortality in people with frailty and a low level of physical function. An individual approach and an obligatory assessment of the level of physical function in older patients are required when prescribing antihypertensive therapy.

Analysis of drug treatment and pharmaceutical care for 4 cases of neonatal chylothorax

Analysis of drug treatment and pharmaceutical care for 4 cases of neonatal chylothorax

Practice and analysis of drug treatment for a patient with epilepsy secondary to brain metastasis from lung cancer

Practice and analysis of drug treatment for a patient with epilepsy secondary to brain metastasis from lung cancer

An Observational Study of Cardiovascular Risks Associated with Rheumatoid Arthritis Therapies: A Comparison of Two Analytical Approaches.

Comparative safety studies typically use hierarchical treatment categories that lump monotherapy and combination therapy. The consequence of this approach on study results is not clear. For example, studies of tumor necrosis factor inhibitors usually lump users regardless of whether they are using the drug alone or in combination with other agents. This study explored the importance of lumping vs splitting users of monotherapy and combination therapy. We also explored whether the timing of disenrollment from Health Plan membership was informative as an outcome variable when interpreting unmeasured, time-varying confounding. This observational cohort study included Kaiser Permanente Northern California 2003 to 2013 members with rheumatoid arthritis who started methotrexate. The study end point was a major cardiovascular event. In Cox proportional hazards analysis, we compared treatment classifications using five lumped categories with treatment classification using nine split categories. We also studied disenrollment as an outcome. Among 5885 patients, 238 experienced serious cardiovascular events during an average follow-up of 4.25 years. Analysis of drug treatments using 5 lumped categories was difficult to interpret because treatment effects and drug users were mixed. In contrast, analysis of 9 drug categories that split monotherapies from combination therapy was easier to interpret, although confidence intervals were wider. Analysis of drug treatment in relation to disenrollment provided useful information with which to assess study validity, although the power of the analysis was limited. In comparative safety studies, we recommend greater transparency in classifying treatment and evaluating disenrollment.

Cost-utility and budget impact analysis of drug treatments in pulmonary arterial hypertension associated with congenital heart diseases in Thailand

ABSTRACTObjective: This study aims to compare the lifetime costs and health outcomes of both first-line and sequential combination treatments with standard treatment for pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD) (PAH-CHD) patients. Methods: A cost-utility analysis was performed using a Markov model based on a societal perspective. One-way and probabilistic sensitivity analyses were performed to investigate the effect of parameter uncertainty. Results: As first-line treatments, both beraprost (incremental cost-effectiveness ratio (ICER) = 192,752 and 201,308 Thai baht (THB) per quality-adjusted life year (QALY) gained) and sildenafil (ICER = 249,770 and 226,802 THB per QALY gained) seemed cost-effective for PAH-CHD patients aged ≤30 years in functional classes II and III, respectively, while no treatment was cost-effective for the sequential combination therapy. Conclusions: Sildenafil should be included in the National Drug List of Essential Medicines as the first-line treatment for PAH-CHD, and its price per dose should be negotiated to be reduced by 43–57%.

Analysis of drug treatment of 28 patients with pulmonary infections after renal transplantation

Objective:To analyze the anti-infective and immunosuppressive treatment of pulmonary infections after renal transplantation.Methods:Clinical data of 28patients with pulmonary infections after renal transplantation were collected.Results of etiological examinations and drug susceptibility tests,therapeutic regimens and prognosis of pulmonary diseases were retrospectively analyzed.Results:Nine patients(32.1%)occurred pulmonary infections within 3months after renal transplantation,4patients(14.3%)in 3-6months after renal transplantation,and 15patients(53.6%)in more than 1year after renal transplantation.There were 6cases(21.4%)of mixed infection,11cases(39.3%)of bacterial infection,3cases(10.7%)of fungal infection,4cases(14.3%)of virus infection and 4cases(14.3%)of unknown infection.Doctors made appropriate antimicrobial regimens according to severity of the infections and adjusted the immunosuppressive regimens.Hospitalization time of the 28patients was(19.4±16.3)d.Two patients had no response to the therapy and then discharged voluntarily,2patients died,while remaining patients recovered after therapy.Conclusion:Patients are susceptible to pulmonary infections after renal transplantation.Anti-infective regimens should be applied according to the results of etiological examinations and drug susceptibility tests.

An analysis of drug treatments in a neonatal intensive care unit and neonatal pathology: Focus on the off-label use in the first month of life

UENPS.11 An analysis of drug treatments in a neonatal intensive care unit and neonatal pathology: Focus on the off-label use in the first month of life Angelica Dessi⁎, Claudia Salemi, Laura Cuzzolin, Vassilios Fanos NICU, University of Cagliari, Italy Department of Medicine & Public Health-Section of Pharmacology, University of Verona, Italy

Theoretical Analysis of Drug Treatment in Haematological Disease Using Lanchester (Osipov) Linear Law

The Lanchester linear law {\rm dx\over dt}=-Dxy /{\rm dy\over dt}=-Axy was used theoretically to analyse the interaction between drugs and cancer cells. The simulations were conducted with respect to different killing rates, different initial amounts of drug, different initial numbers of cancer cells, different half-lives of drugs in vivo, different production rates of survived cancer cells and different dose regimens. The results do not support the division of a dose of drug either homogeneously or heterogeneously.

Drug-induced proarrhythmic effects: assessment of changes in QT interval.

During the past decade interest in the potential for drugs to have proarrhythmic effects has increased substantially. The evidence which has lead to this comes from a number of sources. For example, in a study that identified over 24 000 medicolegal postmortems between 1985 and 1988 in Finland, 49 cases were detected in patients receiving psychotropic drugs, in whom the cause of death could not be determined. Analysis of drug treatment in these subjects revealed that a substantially greater proportion had been receiving the drug thioridazine than could be accounted for by consumption of this drug in the general population [1]. While this evidence does not establish causality of a proarrhythmic effect of thioridazine, it identified the need for investigation of such an effect. In a further study based on a database of over 33 000 ECGs recorded between 1975 and 1983, 183 recordings with QTc prolongation based on an arbitrary threshold of 470 ms were identified. These were compared with 187 recordings from matched subjects in which QTc values were normal. Comparison of diagnoses and drug treatment revealed hypertension to be significantly more common in those with QTc prolongation [2]. This is consistent with the QT prolongation reported in left ventricular hypertrophy [3]. In addition the drug sotalol (known to prolong action potential duration) was used more frequently in patients with QT prolongation. Mortality rates were significantly higher in patients with QT prolongation, although, this could not be explained by the increased use sotalol or other drugs. These data suggest that QT prolongation is a risk marker for increased cardiac mortality due to the prevalence of coexisting disease, although they do not define a precise risk threshold for QTc intervals. Interest in drug effects on the QT interval was further increased following reports that terfenadine, a widely used histamine 1 receptor antagonist may cause Torsade de Pointes and QT prolongation [4]. In addition interaction studies showed that the use of terfenadine with drugs known to inhibit hepatic cytochrome P 450 caused accumulation of terfenadine and greater QT prolongation [5]. The relationship between proarrhythmic effects and QT prolongation is complicated since other drugs that prolong the QT interval show no evidence of proarrhythmic activity and may in fact possess potent antiarrhythmic properties. Thus amiodarone causes significant prolongation of QT and QTc intervals and is perhaps the most effective antiarrhythmic agent available [6, 7]. There is a need for greater clarity of the electrophysiological basis for proarrhythmic drug action and more detailed studies of the cardiac effects of new therapeutic substances are required.

Retrospective analysis of drug treatment in epileptic patients.

An epidemiological analysis was performed of the adult, out-patient epilepsy clinic population of a university hospital during the period from 1 January 1981 through 30 June 1985. The number of patients that could be traced amounted to 590. An at random sample of 207 were retrospectively analysed. Gender distribution was male:female = 1.46. The mean age was 37.4 years. The diagnoses were classified according to the classification of the International League Against Epilepsy (ILAE). A preponderance of partial seizures was present, reflecting the selection in a university out-patient clinic of more difficult to treat forms of epilepsy. Antiepileptic drugs used in the treatment varied; monotherapy was obtained in 46% of the cases and carbamazepine was the most frequently prescribed drug (49%). Changes in seizure severity and factors associated with epilepsy are described. A discrepancy was found between the suspected drug levels, based upon the physician's judgement, and the plasma level measured in those patients in whom drug levels were monitored; factors interfering with clinical judgement are discussed.