Type Of Drug Therapy Research Articles

KAJIAN POTENSI INTERAKSI OBAT PADA PASIEN GERIATRI DENGAN GAGAL JANTUNG DI RSUD Dr. MOEWARDI SURAKARTA TAHUN 2023

Geriatric patients with heart failure generally receive more than 1 type of drug therapy, called polypharmacy, which typically involves at least four types of treatment: ACEI (Angiotensin Converting Enzyme Inhibitors), diuretics, beta blockers, and digoxin. This causes an increase in the occurrence of drug interactions. This study aims to determine the potential drug interactions that occur in geriatric patients with heart failure who undergo hospitalization at Dr. Moewardi Surakarta Hospital from January to December 2023. This study is a descriptive observational study with a cross-sectional design, and the data were collected retrospectively using a purposive sampling technique based on the medical records of geriatric patients at Dr. Moewardi Surakarta Hospital in 2023. The inclusion criteria were inpatients aged ≥55 years who were diagnosed with heart failure. The exclusion criteria were patients with incomplete or illegible medical record data or who died during treatment. Drug interaction research was conducted based on Drugs.com and Medscape. The results showed that out of the 100 patients, 98 experienced drug interactions. The incidence of drug interactions was 252 minor cases (21.65%), 818 moderate cases (69.50%), and 106 major cases (9.00%). The mechanism of drug interaction was pharmacodynamic in 919 cases (65.50%), pharmacokinetic in 213 cases (30.40%), and unknown in 44 cases (4.10%).

The Relationship of Drug Therapy Problems and Outcome Therapy in Tuberculosis Patients in Surabaya Health Center

Background: Tuberculosis (TB) is a highly contagious disease and is difficult to eradicate in Indonesia. Indonesia ranks second in the number of TB sufferers in the world. Generally, TB patients use more than two types of drug therapy it can affect the drug therapy problems that arise and can affect the success of treatment.Objectives: This study aims to see the effect of the number of drugs used by TB patients on the number of drug therapy problems (DTP) and therapy outcomes in tuberculosis patients.Methods: This study was a cross-sectional study with purposive sampling conducted at health centers in the Surabaya area in January- June 2024. The sample inclusion criteria included pulmonary tuberculosis patients who had undergone treatment for over one month, were not less than 17, and could communicate well using a guided interview method.Results: The results showed that the number of patients who participated in the study was 110 people. Most patients used 4 types of drugs (30.0%). Most (30.0%) had two DTPs. Spearman's relationship test between the number of drugs and the number of DTPs with a p-value = 0.000 and a correlation coefficient of 0.472. Spearman's relationship test between the number of DTP and the outcome therapy with a p-value = 0.430 and a correlation coefficient of -0.076.Conclusion: From this study, it can be concluded that there is a significant relationship between the number of drugs and the number of DTPs in TB patients and there is no relationship between RTP and therapeutic outcomes in TB patients.

ANALYSIS OF COST EFFECTIVENESS OF ANTIBIOTIC USE IN TYPHOD FEVER PATIENTS AT KARTINI RANGKASBITUNG HOSPITAL IN 2022

The high prevalence rate of typhoid fever is one of the health problems in Indonesia. Antibiotic therapy is the only therapy that can be used to treat the main cause of typhoid fever. Antibiotics are a type of drug therapy that requires a lot of budgets to procure. This study aims to find out the most cost-effective type of antibiotic for treating typhoid fever. This research was conducted at Kartini Rangkasbitung Hospital using observational research methods with a cross-sectional approach. The data used uses secondary data conducted retrospectively. This research uses medical record data and cost data. This study was divided into three groups, namely ciprofloxacin tablets, intravenous ceftriaxone, levofloxacin tablets and intravenous levofloxacin. Based on the calculation results, the ACER value of ceftriaxone is IDR 2,955,250, the ACER value of IV levofloxacin is IDR 2,727,306, and the ACER value of levofloxacin tablets is IDR 3,047,337. The ICER value from the comparison between levofloxacin tablets and ceftriaxone is IDR 43,250. The most cost-effective antibiotic is the antibiotic levofloxacin in intravenous form.

OUTPATIENT FOLLOW-UP OF PATIENTS WITH ATHEROSCLEROSIS OF LOWER EXTREMITIES: PROMISING WAYS TO IMPROVE RESULTS

HighlightsThe article shows the positive impact of 3-year cardiology follow-up in patients with atherosclerosis of lower extremities. Aim. To study the impact of outpatient cardiology follow-up in patients with peripheral artery disease on the prognosis and the frequency and outcomes of surgical interventions.Methods. The study included 585 patients with peripheral artery disease who underwent outpatient follow-up - by a surgeon (n = 131) and a cardiologist (n = 454). The groups were compared according to the main clinical and anamnestic data and type of drug therapy. After 3 years, the incidence of adverse outcomes (nonfatal myocardial infarction, nonfatal stroke, new amputations and deaths) and factors associated with adverse outcomes in the selected cohort were evaluated.Results. The group of patients who were followed by cardiologist received optimal drug therapy more often compared with patients followed by surgeon: β-blockers (80.4% vs. 32.8%; p < 0.001), angiotensin converting enzyme inhibitors (61.0% vs. 38.2%; p < 0.001), statins (87.0% vs. 63.4%; p < 0.001). Within three years, fatal outcome was more common in the group of patients followed by surgeon (13.0% vs. 6.8%, p = 0.023). The factors that positively affected the prognosis of patients were cardiology follow-up (OR 0.34; 95% CI 0.17–0.7; p < 0.001), taking aspirin (OR 0.12; 95% CI 0.06–0.22, p < 0.001) and statins (OR 0.11; 95% CI 0.05–0.21; p < 0.001).Conclusion. The results of this study confirm the need for more effective cardiology follow-up of patients with peripheral artery disease. This will improve the results of treatment and reduce the number of complications. Further research in this area can help determine the optimal strategies for follow-up and improve the quality of life of patients with peripheral artery disease.

ANALYSIS OF INTERCONNECTION PROBLEMS DATA INDICATORS OF THE PATIENT'S QUALITY OF LIFE WITH MANUFACTURING PRINCIPLES OF REMOVABLE DENTURES

Assessing the quality of patient's life can become a crucial criterion when evaluating the effectiveness of disease treatment, as well as when comparing the efficiency of various programs: conservative and surgical treatment, various types of drug therapy, rehabilitation regimens, etc. In recent years, increasing attention has been paid to health, particularly dental, associated with the study of the life quality indicators.
 The purpose of our study was to analyze the relationship between patient's quality of life indicators and the organization of the patient's dental rehabilitation with removable denture structures and the treatment of partial and complete adentia.
 The study included 56 patients who sought dental care for partial or complete adentia. One of the conditions for forming the selective statistical population was its homogeneity in terms of age and gender composition, as well as general somatic status. When analyzing the data on the life quality of patients with partial and complete adentia, we used the SF-36 questionnaire (The Short Form-36) as a basis, comparing the data both before and after prosthetic treatment to evaluate its effectiveness. Moreover, we took into account both objective and subjective factors that could affect the life quality of patients during prosthetic treatment.
 The results of quality of life indicators in patients with partial adentia (PA-1 group) and complete adentia (CA-2 group) considering gender and age before and after treatment with partial removable and complete removable dentures, were determined applying the SF-36 questionnaire in compared groups.
 Thus, analyzing the overall picture, it is possible to note a statistically significant (Р<0.05) decrease in quality of life indicators on all scales in patients with complete adentia (CA) compared to the group of patients with partial adentia (PA).
 The evaluation of quality of life indicators has an extremely important clinical and prognostic value when making diagnosis, selecting prosthetic treatment method, and evaluating the long-term prosthetic outcomes.
 These data should be taken into account in the practical activities of prosthetic dentists, to prevent common conflicts arising due to the inconsistency of patients' expectations with the predicted results of treatment and the results of rehabilitation measures.

Differential Diagnostic Indicators for the Appointment of Non-Steroidal Anti-Inflammatory Therapy in the Treatment of Red Eye Syndrome at the Stage of Primary Outpatient Admission. Part 1

Every practicing ophthalmologist, regardless of the scope of their clinical and scientific interests, is faced with a dilemma — what treatment to prescribe to a patient who applied for a primary outpatient appointment with signs of red eye syndrome? Prescribing an adequate amount of pathogenetically substantiated therapy will reduce the potential risk of developing complications associated with drug therapy.Purpose: to study the effectiveness of the treatment the blepharoconjunctivitis, episcleritis and keratitis, the regimen of which included the non-steroidal anti-inflammatory drug Okofenac 0.09 % (Otisipharm, Russia), the main active component of which is bromfenac, showed that the average term for stopping the inflammatory process in in all groups of patients included in the study, was 7–14 days, which indicates a high level of effectiveness of the treatment. At the same time, the maximum amount of drug therapy — more than two groups of drugs was prescribed to patients with keratitis. The quality of life according to the SPEED questionnaire, which reflects the symptoms characteristic of dry eye syndrome, was significantly lower in patients in the keratitis group, which suggested a relationship between the amount of drug therapy and the onset of dry eye syndrome in the long-term period — 1 month. This assumption was confirmed by a correlation analysis, which revealed a direct correlation between the number of prescribed drugs at the beginning of treatment and the quality of life according to the SPEED questionnaire after 1 month in all three groups of patients included in the study. Since this study was aimed at studying the effectiveness of anti-inflammatory therapy in the treatment of different, not only in terms of pathogenesis, but also the localization of the process, it only revealed certain trends in the relationship between the number of prescribed drugs at the beginning of treatment and the development of dry eye signs in the long-term period. Therefore, further research is needed to study the above trend in detail.In addition, as the analysis of literature data has shown, there are currently no indications for prescribing one or another type of drug therapy in the complex treatment of inflammatory diseases related to the “red eye syndrome”. In order to form criteria that take into account the history data — somatic status, duration of the inflammatory process, complaints of patients characterizing the inflammatory process, as well as biomicroscopic signs of inflammation, to select one or another pharmaceutical group of drugs, a survey of expert ophthalmologists was conducted. Based on the data of the survey, an algorithm for rational therapy of one of the most common pathologies included in the group of diseases red eye syndrome — conjunctivitis was formed. The above algorithm will be presented in the second part of this article.

Деякі аспекти медикаментозної терапії цукрового діабету 2-го типу у людей з надмірною масою тіла

Надано короткий огляд публікацій останніх років щодо антигіперглікемізуючих препаратів, які можуть застосовуватися при цукровому діабеті 2-го типу в осіб з надмірною масою тіла. Обговорюється вплив ліків на масу тіла та функцію бета-клітин, показання до досягнення інтенсивного глікемічного контролю і вартість лікування. Особливу увагу приділено деяким групам лікарських засобів. Агоністи рецепторів глюкагоноподібного пептиду-1 стимулюють секрецію інсуліну, знижують апетит і моторику шлунково-кишкового тракту, сприяють зменшенню маси тіла. Інгібітори натрій-глюкозного котранспортера-2 зменшують ниркову реабсорбцію глюкози, виводять глюкозу із сечею, знижують артеріальний тиск і сприяють зменшенню маси тіла. Глікемічний контроль підтримується протягом тривалого часу. Зменшення маси тіла можна очікувати також від інгібіторів кишкової альфа-глюкозидази, що гальмують перетравлювання і всмоктування вуглеводів у кишечнику. Антигіперглікемічний ефект препаратів двох останніх груп (а також метформіну) не пов’язаний зі стимуляцією інкреторної функції бета-клітин, що може виснажуватися. Ускладнення цукрового діабету обумовлені не тільки гіперглікемією, але й дисліпідемією, артеріальною гіпертензією, гіподинамією, палінням та іншими факторами, що потребує індивідуального підходу до медикаментозної терапії та модифікації способу життя.

Pharmacotherapy of inflammatory bowel diseases: efficacy performance and safety management

Treatment of inflammatory bowel diseases IBD (Crohns disease, ulcerative colitis) is aimed at achieving clinical, endoscopic and histological remission, minimizing surgical complications, and ensuring a normal quality of life. However, the use of medical treatment is potentially associated with various adverse events, among which infectious complications, malignant neoplasms, as well as myelotoxicity, hepatotoxicity, skin lesions and others. The risk of side effects depends on the type of drug therapy (5-aminosalicylates, thiopurines, biologicals, etc.), the duration of treatment, the presence of extra-intestinal manifestations, etc. The article provides an overview of data on both the effectiveness and frequency of various side effects of the main classes of drugs in IBD, presents methods of investigation which can predict the effectiveness and development of side effects, the implementation of which can be considered as a variant of personalized therapy in IBD.

New Targets for Drug Therapy in Type 2 Diabetes Mellitus

The prevalence of type 2 diabetes mellitus (T2DM) has been increasing at an alarming rate. With an increased understanding of the pathophysiology of T2DM, various new therapeutic options have been developed and evaluated to bind different key targets in T2DM. The discovery of novel therapies through many approaches such as unprecedented drug combinations, modified drug molecules, and improved delivery systems can nullify some of the undesirable side effects of traditional agents, in addition to enhancing their effectiveness. Newer drug targets such as protein kinase B (Akt/PKB), AMP-activated protein kinase (AMPK), sirtuin (SIRT), and others are novel approaches that act via different mechanisms and possibly treating T2DMof distinct variations and etiologies. Other therapies such as end barrier, gene therapy, and stem cell technology utilize advanced techniques to treat T2DM, and the potential of these therapies is still not well explored. Molecular targets in T2DM are also extensively studied as they could target the defects at the molecular level. In this regard, antibody therapies and vaccinations are also developed against T2DM; however, the ongoing clinical trials are scanty, and the developmental progress is slower. There are many therapies designed to cure T2DM, each of them has its advantages and disadvantages. The preference for the treatment plan usually depends on the health status of the patient and the treatment goal. To consider an ideal treatment option, one should worry about many factors. These include patient compliance, drug efficacy and potency, bioavailability, and other pharmacological and non-pharmacological properties among others.

EXPERIENCE OF LONG-TERM USE OF DIENOGEST FOR THE TREATMENT OF ADENOMYOSIS

Endometriosis refers to a chronic, often recurrent disease that requires the appointment of a long-term management plan and the patient with the appointment of therapy that effectively affects the clinic of this disease, at the same time having good tolerability, ensuring the patient's adherence to this method of treatment. This dictates the need for careful selection of a drug that meets such requirements. Moreover, studies of drug therapy for endometriosis should also be prolonged. In this case, they allow you to qualitatively assess the effectiveness of a particular type of treatment in the context of routine clinical practice. The main clinical manifestations of endometriosis of the uterine body-adenomyosis are pain syndrome, manifested by various types of pain (dysmenorrhea, dyspareunia, dyschesia, chronic pelvic pain) and the presence of abundant uterine bleeding. The presented clinical case demonstrates the effectiveness of long-term (for 36 months) use of dienogest at a dosage of 2 mg per day (the drug Vizanna) in a continuous mode in the treatment of a patient with adenomyosis. By the 4th month of therapy, the pain syndrome, manifested by dysmenorrhea and dyspareunia, which is the leading clinical manifestation of this pathology in the patient, was completely stopped. The proposed type of therapy has also demonstrated its effectiveness in relation to another clinical manifestation of the disease - heavy uterine bleeding. By the 6th month of therapy, the patient had developed persistent amenorrhea. Good tolerability and the absence of side effects, along with a pronounced clinical effect, led to a high adherence of the patient to this type of drug therapy and allowed her to continue it in the future with dynamic monitoring.

A new approach to the treatment of patients with fungal dysbiosis

Objective — to elaborate efficient complex treatment of intestinal dysbiosis with the increased Candida spp. proliferation with the use of physiotherapeutic methods. Materials and methods. The study involved 228 patients with intestinal dysbiosis with the increased Candida spp. proliferation. The diagnosis was verified on the basis of general clinical, bacteriological and immunological investigations. Depending on the physiotherapeutic treatment, patients were divided into three groups, receiving the same type of drug therapy (polyene antibiotics orally in a dose of 1 million IU 4 times a day, according to indications they were administered systemic antimycotic drugs, diet therapy, biological products containing live bacteria, adsorbents, multivitamin complexes per os) in combination with electrophoresis with zinc and sulfur according to the 3‑electrode technique on the projection of the liver and pancreas, microwave therapy of the centimeter range in two fields simultaneously per procedure: the projection of the gallbladder and the umbilical region. The control group included 62 patients who received drug therapy only. Results. The positive result was achieved after all types of treatment in three groups, however its intensity varied. In the group of patients treated with complex therapy with inclusion of microelements’ electrophoresis according to the 3‑electrode technique on the projection of the liver and pancreas, the pronounced positive dynamics was revealed, in particular, quick relief of all complaints: flatulence disappeared in 68 % of patients, stomach ache in 81 %, and stool normalization was observed in 61 % of subjects. The significant improvement of the general condition was established in the rest of patients, confirmed by the considerable attenuation of the above listed symptoms. In case of the drug therapy only, flatulence disappeared in 5 % of patients, stomach ache in 38 %, and stool normalized in 15 % of subjects. Flatulence sustained in 36 % of patients, stomach ache in 48 %, unstable stool in 37 % of subjects. After complex therapy using microelements electrophoresis according to the 3‑electrode technique, almost complete sanitation of feces from Candida spp. (growth decrease almost in 40 times), increase in the growth of lactobacilli and bifidobacteria in the intestine has been established. These changes significantly differed from the results, obtained in the control group (decreased growth of Candida spp. was in 20 times less than in the main group, the increase in the growth of lactobacilli and bifidobacteria was in 10 times less). According to the results of laboratory tests, the significant improvement in digestion processes and in general condition was observed in the main vs. control group. Conclusions. The analysis of obtained results convincingly proves higher therapeutic efficacy of therapeutic measures in patients with intestinal dysbiosis with increased proliferation of Candida fungi when using microelements’ electrophoresis on the projection of the liver and pancreas or microwave therapy in the centimeter range on the projection of the gallbladder and the umbilical region (two fields simultaneously) in comparison with the drug therapy only.

Integrative Medicine (Herbal Medicine Combined with Drug Therapy) for Behcet's Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

This review aimed to investigate the efficacy of integrative medicine (herbal medicine combined with drug therapy) in the treatment of Behcet’s disease (BD). Eleven databases were searched from their inception to 7 December 2020, for randomized control trials (RCTs) that reported the effects of integrative medicine in treating BD. The risk of bias was assessed using seven domain criteria from the Cochrane Collaboration tool. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to assess the quality of evidence. The direction of the effect is also shown in the form of an albatross plot. Sixteen trials met the inclusion criteria and were analyzed. The overall risk of bias was determined to be uncertain. The meta-analysis showed a superior response rate with herbal medicine plus drug therapy (relative risk (RR) 1.19, 95% confidence interval (CI) 1.13 to 1.25, n = 1034, p < 0.00001, I2 = 0%, low certainty of evidence (CoE)) compared to drug therapy. Integrative medicine also lowered the recurrence rate after 2 months of follow-up (RR 0.27, 95% CI 0.09 to 0.76, n = 120, p = 0.01, I2 = 0%, low CoE). The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, and skin lesions were also significantly improved using integrative medicine, but equivalent effects were seen for oral ulcers, genital ulcers, and eye inflammation. Minor adverse events were reported in both groups. Our findings suggest that herbal medicine combined with drug therapy is more effective for the treatment of BD than drug therapy alone. Although the type of drug therapy used varied across the studies, integrative medicine was shown to improve the total response rate, skin lesions, the ESR, and the CRP level. However, the overall risk of bias of the studies was concerning, and the CoE was low. Information on adverse events (AEs) was also insufficient. In addition, the number of studies included for data synthesis for most outcomes was small. Future studies with rigorous RCTs may help establish the efficacy of integrative medicine in the treatment of BD.

Hospitalization for hypoglycaemia in people with diabetes in Denmark, 1997-2017: Time trends in incidence and HbA1c and glucose-lowering drug use before and after hypoglycaemia.

ObjectiveTo assess incidence trends of first hospitalization for hypoglycaemia in Denmark and to examine HbA1c levels and glucose‐lowering drug use before and after hospitalization among individuals with type 1 or type 2 diabetes.Research Design and MethodsWe performed a population‐based study linking diagnosis, prescription and laboratory data. Standardized incidence of first hospitalization for hypoglycaemia in Denmark was assessed for each calendar year 1997–2017. HbA1c and glucose‐lowering drug use was compared with age‐ and sex‐matched diabetes comparisons without hospitalization for hypoglycaemia.ResultsThe annual age‐ and sex‐standardized incidence rate of first hospitalization for hypoglycaemia per 100,000 person‐years increased during 1997–2003 (from 17.7 to 30.3 per 100,000 person‐years), remained stable until 2010 (30.4) and gradually declined until 2017 (22.0). During this period, we identified 3,479 people with type 1 diabetes and 15,329 people with type 2 diabetes experiencing first hospitalization for hypoglycaemia. Both diabetes groups experienced a mean HbA1c decrease of ~12%–15% in the months preceding first hospitalization, followed by a gradually increasing HbA1c afterwards. People with type 1 diabetes and hospitalization used similar insulin therapies as those without hospitalization. People with type 2 diabetes and hospitalization more often received insulin (55%) than comparisons (45%), and 45% discontinued insulin or stopped all glucose‐lowering therapy after first hospitalization.ConclusionsIncidence of hospitalizations for hypoglycaemia has declined by one fourth the last decade in the Danish population. A HbA1c decrease precedes first hospitalization for hypoglycaemia in individuals with diabetes, and profound changes in glucose‐lowering drug therapy for type 2 diabetes occur after hospitalization.

Protocolo de tratamiento y seguimiento del paciente diabético adulto. Objetivos terapéuticos y de prevención

The follow-up of patients with diabetes mellitus (DM) has to be focused on treatment adherence and healthy life-styles, in addition to control of both vascular risk factors and micro- and macrovascular complications. Drug therapy of type 2 DM is based on metformin, although other drugs and, even, insulin therapy may be used in metformin-intolerant patients or with poor glycemic control. Glycemic control is carried out by the control of glycosylate hemoglobin (HbA1c) levels, related with cardiovascular events (the lower the HbA1c, the fewer events). Risk factor control is essential in order to prevent cardiovascular events.

Hospital stay frequency of patients with cancer diseases in Rhodes Island, Greece

Abstract Background Cancer is the second leading cause of death globally and a major public health problem that poses a threat to human development. The aim of this study was to investigate the number of hospital stays of cancer patients in Rhodes island in Greece. Methods A retrospective study was conducted to examine the parameters of frequency (case numbers) of inpatient hospital stays for a 4-year period of 2015-2018 at the General Hospital of Rhodes (GHR). Results In total, 1838 cancer cases were hospitalized during the study period, with an average age of 66.5 years and a male-to-female ratio of 1.9:1. (1199 vs 639). The most frequent diagnosis was urological cancer (incl. prostate cancer, 32.2%), followed by skin cancer (15.6%), gastrointestinal cancer (incl. colorectal cancer, 14.4%), hematological cancer (10.7%), breast cancer (8.9%), gynecologic cancer (5.3%), thyroid cancer (5%), lung cancer (4.1%), ear-nose-throat cancer (2.1%) and connective and soft tissue cancer (2, 0.1%). Surgery was the most common treatment (57.5%), whereas 250 patients (13.6%) received no treatment at the GHR. Most of the patients (66.6%) received one type of drug therapy, whereas the rest received a combination of drug therapies. Due to the lack of an Oncology Department, the therapy was given by other health personnel (e.g. hematologists) according the guidelines/recommendations of oncology-health-care-professionals in tertiary-care-hospitals at the mainland. Conclusions Our results do not follow the percentages of hospitalized cancer cases as seen in other developed countries. The island of Rhodes does not have the specialized staff and the means to treat all kinds of cancer, thus the patients with other types of cancer (e.g. lung and breast cancer) were referred to receive tertiary care cancer treatment in mainland Greece. Our results yield information to guide future actions in order to improve health and quality of life in people in remote/island areas Key messages An oncology department should be created in the GHR in order patients with common cancers, like lung and breast cancer to be treated in the island of Rhodes.

Sitagliptin in Achieving Better Glycemic Control as added Drug Therapy in Type 2 Diabetes Mellitus

Sitagliptin in Achieving Better Glycemic Control as added Drug Therapy in Type 2 Diabetes Mellitus

CYTOLOGICAL METHOD OF RESEARCH IN THE DIAGNOSIS AND TREATMENT OF LICHEN PLANUS OF THE ORAL MUCOSA

One of the common inflammatory and destructive diseases in gerontostomatology is lichen planus. The course of this pathology is long, persistent and chronic. Early methods of diagnosing the disease, timely pharmacotherapy are the key to success in the treatment of lichen planus. Cytological method of research refers to the methods by which you can quickly get the results and adjust the scheme of drug symptomatic treatment of erosive and ulcerative lesions in the oral cavity. It is based on the study of the structural features of cellular elements. In this work, we examined and treated 60 patients with erosive-ulcerative form. In 30 people, in addition to traditional treatment, Titol's applications with a 0,1 % betamethasone solution are included in the scheme of complex therapy; in the second half of the patients, applications of betamethasone, fixed using a mucoadhesive polymer film, are used. In the resulting scrapings under magnification of x400 and x1000, the evaluation of the stage of destruction of epithelial cells with the corresponding morphological characteristic was made. In both cases, a positive trend was noted, however, the cytological picture was different depending on the type of drug therapy.

Evaluating associations between the benefits and risks of drug therapy in type 2 diabetes: a joint modeling approach.

ObjectivePrecision medicine drug therapy seeks to maximize efficacy and minimize harm for individual patients. This will be difficult if drug response and side effects are positively associated, meaning that patients likely to respond best are at increased risk of side effects. We applied joint longitudinal–survival models to evaluate associations between drug response (longitudinal outcome) and the risk of side effects (survival outcome) for patients initiating type 2 diabetes therapy.Study design and settingParticipants were randomized to metformin (MFN), sulfonylurea (SU), or thiazolidinedione (TZD) therapy in the A Diabetes Outcome Progression Trial (ADOPT) drug efficacy trial (n=4,351). Joint models were parameterized for 1) current HbA1c response (change from baseline in HbA1c) and 2) cumulative HbA1c response (total HbA1c change).ResultsWith MFN, greater HbA1c response did not increase the risk of gastrointestinal events (HR per 1% absolute greater current response 0.82 [95% CI 0.67, 1.01]; HR per 1% higher cumulative response 0.90 [95% CI 0.81, 1.00]). With SU, greater current response was associated with an increased risk of hypoglycemia (HR 1.41 [95% CI 1.04, 1.91]). With TZD, greater response was associated with an increased risk of edema (current HR 1.45 [95% CI 1.05, 2.01]; cumulative 1.22 [95% CI 1.07, 1.38]) but not fracture.ConclusionJoint modeling provides a useful framework to evaluate the association between response to a drug and the risk of developing side effects. There may be great potential for widespread application of joint modeling to evaluate the risks and benefits of both new and established medications.

Nephrolithiasis against type 2 diabetes mellitus: on the effect of hypoglycemic therapy on lithogenesis

Aim. To study the effects of oral hypoglycemic agents that can affect the probability of recurrence of nephrolithiasis. Materials and methods. The article is based on the results of examination and treatment of 315 patients suffering from recurrent nephrolithiasis and medically compensated type 2 diabetes mellitus treated at the N.A. Lopatkin Institute of Urology and Interventional Radiology - the branch of the SMRC of Radiology, Ministry of Health of Russia and D.D. Pletnev City Hospital Moscow Healthcare Department in 2012-2017. The patients were divided into three groups according to the applied tool antidiabetic: metformin, glibenclamide, canagliflozin. The control group consisted of patients receiving insulin therapy. Results and discussion. The propensity of Metformin to reduce the pH of urine, which has a negative impact in the conditions of urate nephrolithiasis, which is most common in the population of patients with type 2 diabetes mellitus. Glibenclamide, on the contrary, somewhat latches urine. But changes in the reaction of urine under the influence of the drug do not go beyond normal values and are not clinically significant. Canagliflozin increases diuresis due to medication induced glycosuria and stimulates renal excretion of uric acid and its salts. However canagliflozin does not cause significant shifts in the pH of urine that may somewhat negates the increased risk of recurrence of urate stone formation in the background of the uricosuric effect of the drug. Conclusion. Drug therapy of type 2 diabetes mellitus significantly affects the properties of urine from patients with nephrolithiasis.

Use of prescription drugs among women diagnosed with epithelial ovarian cancer in Denmark.

Epithelial ovarian cancer patients often suffer from chronic diseases requiring drug treatment. We assessed temporal patterns of drug use among women with ovarian cancer. We identified all postmenopausal women with epithelial ovarian cancer in Denmark 2005-2012 and a comparison cohort of age-matched women without cancer. We calculated rates of new drug treatment and total drug use and examined use of new and prevalent drugs before and after diagnosis. Analyses were stratified by histological type and stage of epithelial ovarian cancer. We identified 2742 patients. The rate of new drug treatment increased from 3 to 5months before diagnosis and peaked in the first month after diagnosis at 99 new types of drug therapy per 100 individuals (mainly antiemetics, proton-pump inhibitors, hypnotics, and opioids). Although declining, the rate of new drug use remained substantially higher among epithelial ovarian cancer patients than among controls throughout the 3-year postdiagnosis follow-up period. The number of prevalent drugs increased slightly from a median of 4 drugs (interquartile range 2-7) before diagnosis to 5 drugs (interquartile range 2-8) shortly after the diagnosis. The use of preventive drugs decreased only slightly after diagnosis. In stratified analyses, we found limited variation according to histological type, whereas patterns were slightly more pronounced among women with nonlocalized disease compared with localized disease. Drug use among postmenopausal women with epithelial ovarian cancer was substantial and varied considerably in relation to the time of cancer diagnosis, although only limited changes were seen in the use of preventive medicines.