Drug Use Research Articles

Eficacia terapéutica de los anestésicos disociativos en depresión

Depression is a prevalent mental disorder that significantly affects the quality of life despite the existence of conventional treatments, a large proportion of patients do not respond adequately to these, the use of dissociative drugs for the treatment of depression has gained attention. in recent years, especially with the use of ketamine. This anesthetic has been used clinically for decades and has demonstrated rapid and significant antidepressant properties, especially in patients with resistant depression. This is a review of the literature that analyzes the therapeutic efficacy of dissociative anesthetics, such as ketamine. Using databases such as Pubmed, Scopus and Google Scholar, the articles were filtered using inclusion and exclusion criteria. Research reveals that these medications offer a promising alternative for refractory patients, contributing to a rapid and positive response compared to traditional antidepressants. Dissociative anesthetics represent a viable option in the therapy of depression, especially in contexts where conventional treatments have failed, highlighting the need for specialized training in these drugs due to the need for follow-up and adequate monitoring in the patient due to the adverse effects of its administration, in addition to its availability in mental health clinics.

Antimalarial Susceptibility Profile of Plasmodium falciparum Isolated from Human Population in Selected Health Facilities in Keffi Metropolis, Nasarawa State, Nigeria

Aim: This study was aimed to determine the susceptibility profile of Plasmodium falciparum to antimalarial drugs to assess the efficacy of the ones in use. Study Design: This is a hospital-based descriptive study design. Place and Duration of Study: Department of Microbiology, Faculty of Natural and Applied Sciences, Nasarawa State University, Keffi, between December, 2023 and April, 2024. Methodology: A total of 385 blood samples were collected and screened for malaria parasites by microscopy. Species-specific screening was done using Rapid Diagnostic Test (RDT). Stock/working solutions of selected antimalarial drugs were prepared using standard protocols. The parasite cultivation and its susceptibility to selected antimalarial drugs was determined using the WHO protocol. Matured schizonts were quantified. The degree of antimalarial drugs inhibition of scizonts maturation was determined and the drugs 50% inhibitory concentration (IC50) required to prevent parasite schizont maturation indicating resistance was determined. Results: Malaria prevalence by microscopy was 29.9% (95% CI = 25.34 to 34.71%) and 26.7% by RDT. The RDT had a sensitivity of 89.6% (95% CI = 82.48% to 94.49%), specificity of 100.00% (95% CI = 98.64% to 100.00%), Positive Predictive Value of 100.00% (95% CI = 96.48% to 100.00%); and Negative Predictive Value of 95.8% (95% CI = 92.94% to 97.46%). The accuracy of the RDT was 96.88% (95% CI = 94.62 to 98.38%). Six out of the 35 isolates showed 17.1% resistance to Artemether + Lumafantrine. Conclusion: Malaria is present in the study population and is resistant to some of the antimalarial drugs in use. The need for periodic antimalarial drugs surveillance to determine the efficacy of drugs in use is highly recommended.

Factors Associated With FDA-Approved Quit Medication Use Among a Sample of Adult Tobacco Users in a County in Central California.

To examine associations between identified factors to accessing Food and Drug Administration-approved quit medication (FDAQM) and use among a sample of tobacco users. Cross-sectional, online survey. County in Central California. Current adult tobacco users (n = 76). Demographics self-reported likelihood of quitting in the next month, contacting a healthcare provider about quitting, time since last healthcare visit, provider asking about tobacco/nicotine use, provider advice to quit, provider FDAQM prescription and FDAQM use in the past year. Logistic regression. Those with a higher likelihood of quitting had a lower odds of FDAQM use (OR = 0.15, 95% CI = 0.03, 0.73) while those who had contacted a healthcare provider had a higher odds (OR = 15.39, 95% CI = 2.72, 87.05). While the sample was limited, this research provides evidence in an understudied tobacco cessation area. More work is needed to understand the generalizability of these results and develop interventions that address these factors.

Antipsychotic Drug Prescribing in Children Previously Treated With Stimulants for ADHD: A Population-Based Longitudinal Study: La prescription d'antipsychotiques chez les enfants précédemment traités avec des stimulants pour le TDAH : une étude longitudinale basée sur la population.

Stimulant drug treatment in preschool-age children for attention-deficit hyperactivity disorder (ADHD) as well as the concomitant use of antipsychotic drugs is largely unstudied in terms of longitudinal outcomes. We characterized longitudinal patterns of stimulant drug use in children diagnosed for ADHD and analyzed the mental health disorders leading to add-on therapy with antipsychotics. The study population comprised of children and adolescents (age: 0-19 years) in the province of British Columbia (BC), Canada, with at least one dispensing for any psychotropic drug between 1997 and 2017 (N = 144,825). BC health administrative databases were used to identify children with diagnosis for ADHD and dispensings for stimulant and antipsychotic drugs. Longitudinal patterns of drug use and diagnostic codes proximal to the add-on of antipsychotics were assessed. We found that residence in rural regions and lack of child psychiatrists are significantly associated with higher rates of stimulant drug prescription in preschool and early school-age children. Residence in rural regions was also associated with a higher rate for the concomitant use of antipsychotics over the course of stimulant treatment. When comparing children starting stimulant therapy before the age of 6 with those starting therapy after 6 years, we found an 82% increase in the likelihood of antipsychotic add-on in those starting stimulants at younger ages (HR: 1.82, 95% CI [1.63-2.04]). Moreover, children starting stimulant therapy before the age of 6 years had 3.57-fold higher rates of diagnostic codes for specific delays in development (ICD-9 315) in close proximity to the antipsychotic add-on. The question remains whether the add-on of antipsychotics is a consequence of insufficient action of the stimulant in ADHD, or required to ameliorate the adverse effects of the stimulant drug. Our result suggests that care need to be taken in the diagnosis for ADHD in children at the age when entering elementary school.

Protective and Risk Factors for Campus Dating and Sexual Violence at Non-Traditional Academic Institutions: A Scoping Literature Review.

Despite a plethora of research examining campus dating and sexual violence (DSV) risk and protective factors, little of this research has been conducted at non-traditional institutions such as minority-serving institutions (MSIs), community colleges, or non-predominantly white institutions. A review of research on statistically significant protective and risk factors for campus perpetration or victimization at non-traditional institutions resulted in 12 articles. The inclusion criteria for the study were that the article was in English, in a peer-reviewed journal, and published between 2010 and 2021. Keyword searches identified 1,160 articles on campus DSV, which were then screened to ensure the quantitative research was conducted at a non-traditional institution. Significant perpetration and victimization factors, characteristics of the samples and institutions of these studies, and the research design were extracted. Few studies included in the review investigated DSV at MSIs, commuter campuses, or community colleges. Also, studies more commonly examined victimization, risk factors, and sexual violence, as opposed to perpetration, protective factors, or dating violence. Cross-cutting factors for both dating and sexual violence included alcohol and drug use, demographics, and prior abuse. Cross-cutting factors for both victimization and perpetration included personality characteristics, alcohol and drug use, demographics, and history of abuse. Future research should investigate DSV at non-traditional institutions to increase our understanding of risk and protective factors at these rarely studied institutions.

The Legal Definition of Religion in the Context of Modern Religious Exercise with Psychedelics: Protection, Double Standards, and Potential Expansion under RFRA

In the United States, the convergence of religious freedom and the prohibition of controlled substances is legally complex, increasing, and evolving. As interest in psychedelic religious practices expands, legal protection of religious exercise pursuant to the First Amendment and the Religious Freedom Restoration Act (RFRA) enables certain religious communities to use controlled substances in rituals through exemptions from the Controlled Substances Act (CSA). RFRA was enacted in response to a Supreme Court case that failed to safeguard sacramental drug use as a legitimate religious exercise and requires application of stricter analysis of federal government activities that infringe religious freedom. Key to this protection is defining what constitutes a legitimate religious belief when it involves illegal substances. By analyzing court precedents, this essay explores how the legal definition of religion has preferred Judeo-Christian concepts and determined, with a bias, that psychedelic religious practices are not recognizable enough as religious. It argues that the evolving nature of society and religious practice necessitates a reevaluation of legal standards to ensure that the legal right to religious exercise, as applied and intended, protects the minority and remains consistent with modern expressions of faith and ritual.

Unveiling the Nexus of trafficking: Socio-economic determinants, victimization forms, and psychological impacts on women in Bangladesh

The trafficking of women and girls represents a severe infringement upon fundamental human rights and has exhibited a concerning upward trend in various regions worldwide, including Bangladesh. The study addressed the effect of social class, poverty, empowerment, education and areas of residence for women trafficking in Bangladesh and identified the physical and mental sufferings of the victims. This study employed an exploratory qualitative research design and recruited participants from the Dhaka Metropolitan Area. The sample was selected from the victims who were repatriated from January 2020 to December 2021 by the reputed human rights organization Bangladesh National Women Lawyer Association, Dhaka. To maintain proper ethical guidelines, in-depth interviews were conducted through semi-structured questionnaires. The study's results indicate that women with lower socio-economic status and marginalized positions experience higher victimization. The trafficking of women in Bangladesh is facilitated by a range of factors, including poverty, limited access to education and employment opportunities, weak familial bonds, dysfunctional family dynamics, fraudulent job offers, the use of digital platforms, the presence of organized trafficking syndicates, and a complex nexus of factors in border areas. The study also identified that victims experienced severe physical and psychological maltreatment including sexual assault, coercion, physical abuse, and intravenous drug use. Victims also suffer from psychological trauma including threat, anger, depression, insomnia, vomiting, low self-esteem, self-blaming, and skipping meals. Stigmatization and victim blaming also occurred while they were successfully repatriated to their destination. The study concludes with the policy recommendation that the legal agencies of the state should increase the security and surveillance on the border, ensure the safety and security of the survivors, and provide mental support through service providers.

Use of disease modifying anti-rheumatic drugs and risk of multiple myeloma in US Veterans with rheumatoid arthritis

BackgroundBiologic (b) and targeted synthetic (ts) disease-modifying anti-rheumatic drugs (DMARDs) used in the management of rheumatoid arthritis (RA) target inflammatory pathways implicated in the pathogenesis of multiple myeloma (MM). It is unknown whether use of b/tsDMARDs affects the incidence of MM.MethodsIn this cohort study using Veterans Health Administration (VHA) data, we identified Veterans newly diagnosed with RA from 1/1/2002 to 12/31/2018 using diagnostic codes and medication fills. DMARD exposure was categorized as follows: conventional synthetic (cs)DMARDs; bDMARDs, which included tumor necrosis factor inhibitors (TNFi), non-TNFi; and a tsDMARD, tofacitinib. A Cox proportional hazards model with time-varying exposure was used to estimate the hazard ratio for developing MM among those who received b/tsDMARD medications relative to b/tsDMARD-naïve persons.Results27,540 veterans with RA met eligibility criteria of whom 8322 (30%) took a b/tsDMARD during follow-up. There were 77 incident cases of MM over 192,000 person-years of follow-up. The age-adjusted incidence rate (IR) of MM among b/tsDMARD-naïve patients was 0.37 (95% CI 0.28–0.49) per 1000 person-years and 0.42 among current or former b/tsDMARD users (95% CI 0.25–0.65). Adjusting for age and other demographic characteristics, the hazard ratio for MM associated with use of b/tsDMARDs was 1.32 (95% CI 0.78, 2.26).ConclusionIn this study of Veterans with RA, the rate of MM did not differ between b/tsDMARD and csDMARD users. The relatively short duration of follow-up and few events limited our power to detect treatment-related differences in MM risk.

Blood pressure control with active ultrafiltration measures and without antihypertensives is essential for survival in hemodiafiltration and hemodialysis programs for patients with CKD: a prospective observational study

BackgroundHigh blood pressure is a prevalent condition in patients with chronic kidney disease on hemodialysis. Adequate control of high blood pressure is essential to reducing deaths in this group. The present study aimed to observe mortality prospectively in a group of patients in hemodialysis and hemodiafiltration programs in whom the use of antihypertensives was optimized with the point-of-care dry weight (POC-DW) technique.MethodsThe present observational, prospective study was carried out at the Pafram hemodiafiltration unit in Morona Santiago, Ecuador, and the hemodialysis unit of the Fundación Renal del Ecuador in Guayaquil, Ecuador, from August 2019 to December 2023. Patients who were receiving hemodiafiltration were included. Weight was optimized with POC-DW for eight weeks. In Group 1, patients whose use of antihypertensive drugs was not required to control systolic blood pressure with a value less than 150 mmHg predialysis, less than 130 mmHg postdialysis, and a peridialytic blood pressure (defined as post-HD minus pre-HD SBP) between 0 and − 20 mmHg were analyzed. In Group 2, patients who required antihypertensive drugs for not meeting the aims of systolic blood pressure were included. The variables included clinical, demographic, mortality, description of the treatment, and routine laboratory tests in dialysis programs. The sample was nonprobabilistic. Survival analysis was performed for the study groups. The log-rank test (Mantel-Cox) was used for survival comparisons.ResultsThe study included 106 patients. Optimal blood pressure control without antihypertensive treatment was achieved in 52 patients (49.1%) (Group 1). In 54 patients (50.9%), antihypertensive agents were required (Group 2). There was more significant mortality in the group that received antihypertensives: 11 patients in group 1 (21.2%) versus 25 patients in group 2 (46.3%) (P = 0.005). Survival was more significant in group 1, with an HR of 2.2163 (1.125–4.158) (P = 0.0243).ConclusionIn hemodiafiltration and hemodialysis programs, blood pressure control with active ultrafiltration measures and without using antihypertensives is essential for survival in patients with CKD.

Lipids, lipid-lowering drug target genes and pancreatic cancer: a Mendelian randomization study.

Pancreatic cancer (PC) is a malignant tumor with a low survival rate. Lipid modifiers show potential for PC therapy, but evidence is lacking. This Mendelian randomization (MR) study aimed to explore the relationship between lipid traits, and lipid-lowering drug target genes with PC risk. Genetic instrumental variables associated with lipid traits and lipid-lowering drug target genes were used to perform MR analyses of PC risk. MR estimation was based on genome-wide association study data from two large sample sets, and the MR results were meta-analyzed to assess their impact on PC risk. To ensure the reliability of lipid-modifying drug targets, we conducted a Summary Data-based Mendelian Randomization (SMR) analysis. Additionally, a two-step MR analysis was employed to explore potential mediating effects. In two independent datasets, HMG-CoA reductase (HMGCR) inhibition was statistically associated with a lower risk of PC (OR 0.50, [95% CI 0.25-1.00]; p = 0.0453). The results were further supported by SMR analysis, which showed a similar association (OR 0.51, [95% CI 0.28-0.96]; p = 0.0369). Mediation analysis revealed that 11.69% of the protective effect of HMGCR inhibitors on PC is mediated through lower BMI levels. No significant effect of lipid traits and the other eight lipid-lowering drug targets on PC risk was found. This study suggests that HMGCR may be a potential drug target for the treatment or prevention of PC, providing important insights into the use of lipid-targeted drugs in PC therapy.

Prerequisites and limitations of the use of oral anticoagulants in pregnant women in real-world clinical practice

Relevance. Anticoagulants are commonly used during pregnancy is a fairly common practice. Due to the widespread use of oral anticoagulants in real practice and the high frequency of unplanned pregnancy, physicians should assess the risks and plan pregnancy management strategies.Objective. The purpose of this analysis was to assess the legal background and evidence on the risks associated with the use of oral anticoagulants in pregnant women in real-world clinical practice.Materials and methods. An analysis of the official instructions for the use of oral anticoagulants registered in Russia, an analysis of the published literature on reproductive toxicity and the use of drugs during pregnancy, and a general comparative analysis of the predominance of individual oral anticoagulants in practical healthcare in Russia.Results. The results of the analysis revealed high variability in the restrictions on the use of oral anticoagulants during pregnancy. At the same time, the actual evidence of reproductive toxicity for drugs does not differ significantly and indicates the absence of signals of potential teratogenicity, at least based on the available number of observations. The maximum number of pregnancy observations exceeding the number of observations on warfarin use was reported for the use of rivaroxaban (505 cases in the largest analysis). The remaining representatives are described by several dozen observations. In Russia, the use of oral anticoagulants is also a prerequisite for the more likely use of rivaroxaban and apixaban in cases of unplanned pregnancy.Conclusions. In real-world clinical practice, exposure to oral anticoagulants is a prerequisite for pregnancy, which requires decision-making on strategies for pregnancy management. Instructions for the use of drugs do not contain reasonable information or formulations for decision-making based on accumulated knowledge about reproductive toxicity. Based on published data on the use of drugs in this group during pregnancy in real-world clinical practice, there is no sign of teratogenic potential for all representatives, with the exception of warfarin, whereas the largest number of observations concerns the most commonly used rivaroxaban.

Learning to read and interpret tattoos.

Tattooing has been a facet of many civilizations and cultures for millennia with a recent resurgence in popularity in many Western countries. The reasons for tattooing are diverse ranging from simple decorative designs to enforced tattooing of concentration camp inmates. In a forensic context tattoos are frequently observed and may play a role in some cases of identification, even after decomposition, incineration or dismemberment. More broadly however, tattoos can provide significant information on a decedent's name and age, country or region of origin, religion, names of family members and friends, pet ownership, political affiliations, sporting and recreational activities, military service, gang memberships, drug usage and medical data. Thus, careful reading of tattoos at the time of post mortem examination can sometimes be a very productive exercise delivering background material on a decedent that may not have been provided in police reports.

Depression, non-medical pain prescriptions, and suicidal behavior in cancer survivors.

A cancer diagnosis results in significant distress and adverse psychosocial sequelae, including suicide, the 10th leading cause of death in theUSA. Primary risks for death by suicide include depression and opioid abuse, which are prevalent among cancer survivors. Yet, it remains unclear whether they are also associated with other suicidal outcomes, such as ideation, planning, and suicidal attempt. We used cross-sectional data from the National Survey on Drug Use and Health (2015-2019, N = 214,271), a nationwide study in the USA that provides data on mental health and other health concerns. Outcome of interest was suicidality (suicidal ideation, planning, and attempt). Main exposures were history of depression and non-medical use of pain prescriptions. Using weighted logistic regression analyses adjusted for sociodemographic factors and substance use, we estimated odds of suicidal ideation, planning, and attempt. There were 7635 cancer survivors in our study, which was our analytic sample. We found an associations between a history of cancer and suicidal ideation (aOR = 1.32, 95% CI 1.10, 1.58). Among cancer survivors, depression and non-medical use of pain prescriptions were consistently associated with suicidal ideation (aORdepression = 7.37, 95% CI 4.52, 12.03; aORpain prescriptions = 3.36, 95% CI 1.27, 8.91, planning (aORdepression = 10.31, 95% CI 5.79, 18.34; and aORpain prescriptions = 3.77, 95% CI 1.20, 11.85), and attempt (aORdepression = 4.29, 95% CI 1.41, 13.06). Both depression and non-medical pain prescriptions areindependently associated with increased odds of suicidal behavior among cancer survivors. Routinely assessing for depression and history ofnon-medical use of pain prescriptions could beanimportant suicide prevention strategy in oncology. Given the increased risk of suicide mortality among cancer survivors, it is critical that risk factors for suicidalbehavior, such as depression and use of non-medical pain prescriptions, are routinely screened for as part of cancercare.

Effect of antiretroviral therapy on the mortality of HIV-1 infection long-term non-progressors: a cohort study

BackgroundThe study aims to investigate the demographic characteristics, the variations in their immune status, and mortality risk among HIV-1 infection long-term non-progressors (LTNP).MethodsEligible LTNP and typical progressors (TP) were recruited in Guangxi by December 2018. Participants were followed up until December 2022, monitoring ART status, CD4+ T cell counts, and survival/death outcomes. Multivariate logistic, Cox regression, and Kaplan-Meier method were employed to scrutinize associated factors and mortality risk of LTNP.ResultsA total of 212 LTNP and 390 TP were included. LTNP cohort predominantly comprised males (84.43%), those diagnosed with HIV at age ≤ 40 years (93.87%), and those infected through injection drug use (59.91%). The mortality rate of LTNP were lower than TP (12.74% vs. 27.18%). TP had a higher mortality risk compared to LTNP (adjusted hazard ratio [aHR] = 4.051, 95% CI: 2.284–7.186, P < 0.001). The mortality risk was also elevated in the ART-naïve group versus the ART-experienced ones (aHR = 3.943, 95%CI: 2.658–5.850, P < 0.001). Notably, the CD4/CD8 ratio in the LTNP group did not fully recover (< 1.0) despite ART. However, LTNP with ART-experienced had a significantly lower mortality risk compared to ART-naïve LTNP group (Log-rank: P = 0.003).ConclusionsART effectively restores and maintains normal CD4+ T cell levels among LTNP, thereby decreasing mortality risk. Nonetheless, the CD4/CD8 ratio in LTNP exhibits incompletely recovered post-ART. These findings provide a scientific foundation for promoting ART in LTNP population.

Public Xylazine Awareness and Support for Policies and Initiatives to Address the Xylazine Threat among US Adults

Objectives Xylazine, a nonopioid veterinary tranquilizer, is increasingly being added to the illicit opioid supply. When used by humans, xylazine can cause severe skin ulcers and extreme sedation. This study aimed to examine awareness of xylazine and support for policies/initiatives to address the xylazine threat among US adults. Methods An AmeriSpeak survey with US nationally representative adults aged 18 and older was administered in March 2024. Survey questions assessed awareness of xylazine and potential xylazine use, drug/opioid use history, and support for 10 policies/initiatives to address the xylazine threat (including a range of drug checking initiatives, wound care initiatives, punitive policies, harm reduction policies, and xylazine education campaigns). We conducted weighted descriptive and regression analysis of survey data from a nationally representative sample of 1215 US adults. Results Most respondents were not aware of xylazine (88%, n = 1063). Approximately 10% (n = 117) were aware of xylazine but had not used it, and around 2% (n = 23) were aware of xylazine and possibly had used it. On average, participants supported only 1.52 (SD = 2.41) of 10 listed policies/initiatives to address the xylazine threat. The number of policies/initiatives supported varied by xylazine awareness, gender, marital status, and drug use history. Conclusions Among the US public, xylazine awareness and support for policies/initiatives to address the xylazine threat are low. Public xylazine educational campaigns may be warranted to help the public understand the severity of the xylazine threat, garner support for associated policies/initiatives, and reduce xylazine-related harms.

The effectiveness of a drink-counting and a breathalyser-coupled smartphone application for reduced heavy drinking among alcohol-dependent adults in Sweden: A randomised controlled trial.

Studies using smartphone apps in treatment for alcohol dependence are lacking. This study aimed to test the consumption-reducing effects of using two app-based alcohol interventions as complement to treatment as usual (TAU). Three-armed, parallel, randomised controlled trial. Specialised outpatient clinic within the Stockholm Centre for Dependency Disorders, Stockholm, Sweden. 162 alcohol-dependent adults (46% female), with no social problems or mental disorders, who had no other drug use, were included. Mean age was 50 years, and the majority were highly educated, employed and had not previously received any alcohol treatment. Participants were randomised to (1) TAU+drink-counting app (Glasklart, n = 52), (2) TAU+app-coupled breathalyser (iBAC Pro, n = 58) or (3) TAU only (n = 52). TAU included four sessions of clinician-led psychological treatment based on motivational interviewing/cognitive behavioural therapy, combined with pharmacotherapy when requested, for 12 weeks. The primary outcome was past 4-week heavy drinking days (HDD) at 26 weeks post-randomisation, adjusted for baseline HDD, and assessed by structured interviews using Timeline Followback. Secondary outcomes included weekly consumption, consumption patterns, phosphatidylethanol and dependence at 12 and 26 weeks. Analyses compared TAU+drink-counting app and TAU+breathalyser each with TAU alone. At 26 weeks, participants with TAU+breathalyser had statistically significantly lower HDD [incidence rate ratio (IRR) = 0.67, 95% confidence interval (CI) = 0.49, 0.91] compared with those with TAU alone. There was no evidence of any effects on HDD for those with TAU+drink-counting app, compared with TAU alone (IRR = 0.94, 95% CI = 0.70, 1.25) or of any other effects. In Sweden, treatment as usual (TAU) for alcohol dependence combined with a smartphone application coupled with a breathalyser was more effective than TAU alone in reducing self-reported heavy drinking. There was no evidence that TAU combined with a smartphone application for drink-counting was more effective than TAU alone.

Head and neck injuries from personal motorised vehicles in the United States

BackgroundThe use of personal electric vehicles in the United States has increased head and neck injuries. This study analyses the types, frequencies, demographics and management of these injuries across motorised...

Use of antiepileptic drugs in mental disorders

Antiepileptic drugs (AEDs) are quite often used in psychiatric practice and are considered the drugs of choice for mental disorders, primarily recurrent and bipolar depression and mania, behavioral and anxiety disorders with signs of bipolar emotional dysregulation, mental disorders with dependence on psychoactive substances. The level of evidence for the use of AEDs varies, sometimes they are used outside the recommendations of the FDA, EMA, outside the instructions of the Pharmcenter of Ukraine. Currently, mood stabilizers such as valproate, lamotrigine, carbamazepine have the highest level of evidence. Most psychotropic drugs are recommended for use in the treatment of affective disorders (antipsychotics, antidepressants, lithium salts) and attention deficit hyperactivity disorders (psychostimulants, atomoxetine) from the age of 6, which explains the widespread use of valproate and lamotrigine in pediatric practice outside direct indications. Bipolar affective disorders have a high level of comorbidity with generalized anxiety and panic disorder, which sometimes demonstrate low sensitivity to benzodiazepine therapy, but respond well to valproic acid salt therapy. The use of gabapentin in anxiety disorders is based on the results of controlled studies. Anticonvulsants are widely used in alcohol and substance abuse, addictive disorders, emotional and behavioral disorders associated with withdrawal states. The therapeutic and side effects of AEDs are closely related to behavioral disorders in epilepsy. They can improve or worsen behavioral symptoms associated with signs of emotional bipolar dysregulation and attention deficit hyperactivity disorder. It is expected that the list of AEDs will continue to grow, and new proposals for use in psychiatric practice will appear.

Prevalence, Awareness, Treatment and Control of Hypertension in Residents’ Sample of Luanda, Angola

Hypertension (HTN) is an important risk factor for cardiovascular complications and is considered a public health problem worldwide. We aimed to evaluate the prevalence, awareness, treatment and control of HTN in a population sample in Luanda, Angola. A cross-sectional study was carried out which included 1480 individuals, between May 2018 and June 2019; we recruited participants at three different points of the city. Blood pressure (BP) was measured with semi-automatic device (Omron®, EM-7131-E). For each participant, three BP measurements were taken after 5 minutes resting and the mean of the two last measurements was used for systolic and diastolic BP. HTN was defined as BP ≥140/90 mmHg or use of antihypertensive drugs. The sample included mostly young people (39.7±11.6 years old) and male (69.3%). HTN prevalence was 34.9%; 47.4% of patients were aware of their condition; 36.8% were taking medication and of these only 35.8% had BP under control. There was a positive correlation between BP and age. The prevalence of HTN was high, almost half of the patients were unaware and, among the hypertensive patients who were under medication, most of them did not have their BP under control. HTN prevalence was high; awareness, treatment and control were low.

The Association Between Medication Adherence and Rational Drug Use Knowledge and Health Literacy in Older Adults Residing in Nursing Homes.

Medication adherence is a crucial factor in managing and treating chronic diseases in older adults. Health literacy (HL) skills and rational drug use (RDU) knowledge are important for individuals to make informed decisions about medication adherence behaviours. This study was conducted to determine the association between medication adherence and rational drug use knowledge and health literacy in older adults residing in nursing homes. The cross-sectional study was conducted with 121 older adults residing in a nursing home in Turkey. The data were collected using the Participant Information Form, the Medication Adherence Report Scale (MARS-5), the Rational Drug Use Scale (RDUS), and The Turkish version of the European Health Literacy Survey Questionnaire (HLS EUEU-Q-TR). The mean age of the older adults was 69.92 ± 6.45 years and 76.9% were male. The mean score of MARS-5 was 21.80 ± 3.55. Among older adults, 43.8% were found to have inadequate RDU knowledge, 28.9% had inadequate HL, and 46.3% had problematic-limited HL. The RDU knowledge was a statistically significant strong predictor of medication adherence (R2 = 0.495, p < 0.001). The HL was a statistically significant predictor of medication adherence (R2 = 0.037, p < 0.05). The study found that medication adherence among older adults residing in nursing homes was moderate, RDU knowledge and HL levels were low, and medication adherence increased as RDU knowledge and HL levels increased.