Use Of Route Research Articles

Hepatitis C Virus Reinfection Among Men Who Have Sex With Men With HIV in New York City.

Hepatitis C virus (HCV) reinfection rates are substantially higher than primary infection rates among men who have sex with men (MSM) with human immunodeficiency virus (HIV) in European cohorts. The behaviors mediating this high rate of transmission among MSM are poorly characterized. We performed a prospective cohort study in New York City (NYC) of MSM with HIV who cleared HCV to determine the incidence of and risk factors for HCV reinfection. We assessed the risk behaviors for primary HCV in NYC: receipt of semen in the rectum, and sexualized methamphetamine use, along with route of use. Multivariable analysis was performed with Andersen-Gill extension of the Cox proportional hazards model. From 2000 through 2018, among 304 MSM with HIV who cleared HCV, 42 reinfections occurred over 898 person-years, for an incidence rate of 4.7 per 100 person-years. Assessing 1245 postclearance visits, only receipt of semen into the rectum was associated with reinfection (hazard ratio, 9.7 [95% confidence interval: 3.3-28.3], P < .001); methamphetamine use was not. The high HCV reinfection rate over almost 2 decades demonstrates that sexual transmission of HCV is not inefficient or unusual and that direct-acting antiviral treatment is not sufficient for HCV elimination among MSM in NYC. The contrasts between both the rates of and risk factors for primary and HCV reinfection suggest that HCV prevalence is highly heterogenous among sexual networks and that sexualized methamphetamine use, rather than mediating transmission, is instead a surrogate marker for the highest HCV prevalence networks. As neither condoms nor treatment have been successful strategies for HCV prevention in NYC, novel interventions are needed to stem this sexually transmitted HCV epidemic.

Dual-Modified Hyaluronic Acid for Tunable Double Cross-Linked Hydrogel Adhesives.

Conventional techniques for the closure of wounds, such as sutures and staples, have significant drawbacks that can negatively impact wound healing. Tissue adhesives have emerged as promising alternatives, but poor adhesion, low mechanical properties, and toxicity have hindered their widespread clinical adoption. In this work, a dual modified, aldehyde and methacrylate hyaluronic acid (HA) biopolymer (HA-MA-CHO) has been synthesized through a simplified route for use as a double cross-linked network (DCN) hydrogel (HA-MA-CHO-DCN) adhesive for the effective closure and sealing of wounds. HA-MA-CHO-DCN cross-links in two stages: initial cross-linking of the aldehyde functionality (CHO) of HA-MA-CHO using a disulfide-containing cross-linker, 3,3'-dithiobis (propionic hydrazide) (DTPH), leading to the formation of a self-healing injectable gel, followed by further cross-linking via ultraviolet (UV) initiated polymerization of the methacrylate (MA) functionality. This hydrogel adhesive shows a stable swelling behavior and remarkable versatility as the storage modulus (G') has shown to be highly tunable (103-105 Pa) for application to many different wound environments. The new HA-MA-CHO-DCN hydrogel showed excellent adhesive properties by surpassing the burst pressure and lap-shear strength for the widely used bovine serum albumin-glutaraldehyde (BSAG) glue while maintaining excellent cell viability.

Environmental Impact of e-Fuels via the Solid Oxide Electrolyzer Cell (SOEC) and Fischer–Tropsch Synthesis (FTS) Route for Use in Germany

This paper examines the current and prospective greenhouse gas (GHG) emissions of e-fuels produced via electrolysis and Fischer–Tropsch synthesis (FTS) for the years 2021, 2030, and 2050 for use in Germany. The GHG emissions are determined by a scenario approach as a combination of a literature-based top-down and bottom-up approach. Considered process steps are the provision of feedstocks, electrolysis (via solid oxide co-electrolysis; SOEC), synthesis (via Fischer–Tropsch synthesis; FTS), e-crude refining, eventual transport to, and use in Germany. The results indicate that the current GHG emissions for e-fuel production in the exemplary export countries Saudi Arabia and Chile are above those of conventional fuels. Scenarios for the production in Germany lead to current GHG emissions of 2.78–3.47 kgCO2-eq/L e-fuel in 2021 as the reference year and 0.064–0.082 kgCO2-eq/L e-fuel in 2050. With a share of 58–96%, according to the respective scenario, the electrolysis is the main determinant of the GHG emissions in the production process. The use of additional renewable energy during the production process in combination with direct air capture (DAC) are the main leverages to reduce GHG emissions.

Routes of Drug Use Among Drug Overdose Deaths - United States, 2020-2022.

Preliminary reports indicate that more than 109,000 drug overdose deaths occurred in the United States in 2022; nearly 70% of these involved synthetic opioids other than methadone, primarily illegally manufactured fentanyl and fentanyl analogs (IMFs). Data from the western United States suggested a transition from injecting heroin to smoking IMFs. CDC analyzed data from the State Unintentional Drug Overdose Reporting System to describe trends in routes of drug use in 27 states and the District of Columbia among overdose deaths that occurred during January 2020-December 2022, overall and by region and drugs detected. From January-June 2020 to July-December 2022, the percentage of overdose deaths with evidence of injection decreased 29.1%, from 22.7% to 16.1%, whereas the percentage with evidence of smoking increased 73.7%, from 13.3% to 23.1%. The number of deaths with evidence of smoking increased 109.1%, from 2,794 to 5,843, and by 2022, smoking was the most commonly documented route of use in overdose deaths. Trends were similar in all U.S. regions. Among deaths with only IMFs detected, the percentage with evidence of injection decreased 41.6%, from 20.9% during January-June 2020 to 12.2% during July-December 2022, whereas the percentage with evidence of smoking increased 78.9%, from 10.9% to 19.5%. Similar trends were observed among deaths with both IMFs and stimulants detected. Strengthening public health and harm reduction services to address overdose risk related to diverse routes of drug use, including smoking and other noninjection routes, might reduce drug overdose deaths.

Prevalence and determinants of opioid use disorder among long-term opiate users in Golestan Cohort Study

BackgroundNumber of opiate users worldwide has doubled over the past decade, but not all of them are diagnosed with opioid use disorder. We aimed to identify the prevalence and risk factors for OUD after ten years of follow-up.MethodsAmong 8,500 chronic opiate users at Golestan Cohort Study baseline (2004–2008), we recalled a random sample of 451 subjects in 2017. We used three questionnaires: a questionnaire about current opiate use including type and route of use, the drug use disorder section of the Composite International Diagnostic Interview lifetime version, and the validated Kessler10 questionnaire. We defined opioid use disorder and its severity based on the DSM-5 criteria and used a cutoff of 12 on Kessler10 questionnaire to define psychological distress.ResultsMean age was 61.2 ± 6.6 years (84.7% males) and 58% were diagnosed with opioid use disorder. Starting opiate use at an early age and living in underprivileged conditions were risk factors of opioid use disorder. Individuals with opioid use disorder were twice likely to have psychological distress (OR = 2.25; 95%CI: 1.44–3.52) than the users without it. In multivariate regression, former and current opiate dose and oral use of opiates were independently associated with opioid use disorder. Each ten gram per week increase in opiate dose during the study period almost tripled the odds of opioid use disorder (OR = 3.18; 95%CI: 1.79–5.63).ConclusionsChronic opiate use led to clinical opioid use disorder in more than half of the users, and this disorder was associated with psychological distress, increasing its physical and mental burden in high-risk groups.

Optimization of Total Carotenoid Production by Rhodotorula mucilaginosa from Artichoke Agroindustrial Waste Using Response Surface Methodology

The carotenoids have vast medical, industrial, dietary, and pharmaceutical importance due to their provitamin A precursor, immunomodulator, antioxidant and photoprotective activity. The purpose of the research was to optimize the production of carotenoids using Rhodotorula mucilaginosa from artichoke agroindustrial waste as a low-cost substrate. The artichokes bracts waste was bleached by sodium hypochlorite (NaClO 2%) and was characterized through whiteness index and FTIR. The bleached artichoke waste (BABW) used in the fermentation went through acid hydrolysis, applying 8% of the bleached artichokes residue and sulfuric acid (2.5%) for 1 h at 90°C, obtaining a greater reduced sugars content at 3.1 g/L. Rhodotorula mucilaginosa was isolated and molecularly identified. The production of carotenoids from a culture media based on hydrolyzed BABW, peptone (0.5%), yeast extract (0.1%) and sodium chloride (0.5%) was evaluated at different conditions of pH (5–8) and agitation speed (80–160 rpm) applying the surface response methodology by a rotational central compound design. The best carotenoids performance obtained had 2968.95 µg/L VVC and 1228.53 µg/g TFC at pH 5, 120 rpm and 30°C for 72 h. The chemical characterization of the extracted carotenoids was confirmed by UV-VIS and Raman spectroscopy methods. The results suggest that Rhodotorula mucilaginosa is capable of producing carotenoids from artichoke waste fermentation, providing a low-cost and sustainable alternative route for use in the global market.

Systemic Administration of Acazicolcept, a Dual CD28 and Inducible T cell Costimulator Inhibitor, Ameliorates Experimental Autoimmune Uveitis.

Combined inhibition of CD28 and inducible T cell costimulator (ICOS) pathways with acazicolcept (ALPN-101) represents a potential new treatment for uveitis. Here, we evaluate preclinical efficacy using experimental autoimmune uveitis (EAU) in Lewis rats. Efficacy was tested in 57 Lewis rats treated with either systemic (subcutaneous) or local (intravitreal) administration of acazicolcept and compared to treatment with a matched Fc-only control or corticosteroid. Impact of treatment on uveitis was assessed using clinical scoring, optical coherence tomography (OCT), and histology. Ocular effector T cell populations were determined using flow cytometry, and multiplex ELISA used to measure aqueous cytokine concentrations. When compared to Fc control treatment, systemic acazicolcept led to statistically significant decreases in clinical score (P < 0.01), histologic score (P < 0.05), and number of ocular CD45+ cells (P < 0.01). Number of ocular CD4+ and CD8+ T cells expressing IL-17A+ and IFNγ+ were also decreased with statistical significance (P < 0.01). Similar results were achieved with corticosteroids. Intravitreal acazicolcept decreased inflammation scores when compared to untreated fellow eyes and to Fc control treated eyes, although not statistically significant. Systemic toxicity, measured by weight loss, occurred in the corticosteroid-treated, but not in the acazicolcept-treated animals. Systemic treatment with acazicolcept statistically significantly suppressed EAU. Acazicolcept was well-tolerated without the weight loss associated with corticosteroids. Acazicolcept may be an effective alternative to corticosteroids for use in treating autoimmune uveitis. Additional studies are needed to clarify the optimal dose and route for use in humans. We show that T cell costimulatory blockade could be an effective mechanism for treating uveitis.

Investigating Edaravone Use for Management of Amyotrophic Lateral Sclerosis (ALS): A Narrative Review.

The use of Edaravone, given orally, for the treatment of amyotrophic lateral sclerosis (ALS) was officially approved by the Federal Drug Association (FDA) in 2017. ALS is a rare and progressive degenerative disease that worsens over time. It attacks and destroys the nerve cells that control voluntary muscles, thus leading to weakness, eventual paralysis, and, ultimately death. Edaravone was given initially intravenously, but recent evidence shows better results with oral suspension. This narrative review is aimed to investigate the benefit of Edaravone for the management of ALS, compare it to Riluzole, discuss its mechanism of action, route of use, and side effects, and ultimately discuss future implications of this pharmacotherapy.

Indonesian Traditional Medicines: The Use Before And During The COVID-19 Pandemic At Online Pharmacy Networks In Indonesia

Background: Many countries' use of traditional medicine during the COVID-19 pandemic aims to increase immunity and reduce symptoms caused by COVID-19. The use of traditional medicine, either alone or in combination with "western medicine" has become a concern for many countries to overcome the COVID-19 pandemic when drugs and vaccines are in the process of discovery and procurement. &#x0D; Methods: The main sales data obtained are included and excluded so that they can be compared, then coded according to the distribution permit classification, route of administration, country of origin, and usage claims. The analysis of the effect of the route of administration and country of origin is based on chi-square (chi-square count &gt; chi-square table), which states that both have an effect.&#x0D; Results: The significance of the use of traditional medicines based on claims (p &lt;0.05) before and during the COVID-19 pandemic was not significantly different.&#x0D; Conclusion: There is an effect of using Indonesian traditional medicine by classification of the route of use and country of origin. It is only a claim to help maintain liver health, which has a significant difference in the use of Indonesian traditional medicines before and during the COVID-19 pandemic, but the percentage of sales is decreasing.

Increases in methamphetamine injection among treatment admissions in the U.S

BackgroundPrior research indicates rising methamphetamine use and harms in the U.S., potentially related to increases in methamphetamine injection. To date, research on trends and correlates of methamphetamine injection is limited. MethodsAnalysis of trends and correlates of methamphetamine injection among treatment admissions among persons aged ≥ 12 whose primary substance of use at admission is methamphetamine. Data are from the Treatment Episode Data Set. Analyses includes descriptive statistics, trend analyses, and multilevel multivariable logistic regression. ResultsPrimary methamphetamine treatment admissions increased from 138,379 in 2010 to 201,021 in 2019. Among primary methamphetamine admissions, injection as the usual route of use increased from 24,821 (18.0 % of admissions) in 2010 to 55,951 (28.2 % of admissions) in 2019. Characteristics associated with increased adjusted odds of reporting methamphetamine injection included: males (aOR = 1.13, 95 % CI = 1.10–1.15); admission age 25–34 years (aOR = 1.23, 95 % CI = 1.19–1.28) and 35–44 years (aOR = 1.12, 95 % CI = 1.08–1.17) compared to age 18–24; dependent living (aOR = 1.33, 95 % CI = 1.29–1.37) and homelessness (aOR = 1.58, 95 % CI = 1.54–1.63) compared to independent living; part-time employment (aOR = 1.08, 95 % CI = 1.02–1.14), unemployment (aOR = 1.39, 95 % CI = 1.34–1.44) and not in labor force (aOR = 1.43, 95 % CI = 1.37–1.49) compared to full-time employment; one to ≥ four prior treatment admissions (aORs ranging from 1.19 to 1.94) compared to no prior admissions; also reporting use of cocaine (aOR = 1.10, 95 % CI = 1.05–1.16), heroin (aOR = 3.52, 95 % CI = 3.40–3.66), prescription opioids (aOR = 1.61, 95 % CI = 1.54–1.67), or benzodiazepines (aOR = 1.42, 95 % CI = 1.32–1.52) at treatment admission. ConclusionsFindings lend further evidence to a resurgence of methamphetamine use that is intertwined with the ongoing opioid crisis in the U.S. Efforts to expand evidence-based prevention, treatment, and response efforts, particularly to populations at highest risk, are urgently needed.

A description of self-medication with cannabis among adults with legal access to cannabis in Quebec, Canada

ObjectiveCannabis is increasingly used for medical purposes, particularly in countries like Canada where cannabis was recently legalized for recreational use. We aimed to assess self-medication with cannabis post-cannabis legalization among adults in the Canadian province of Quebec.MethodsThis is a cross-sectional online survey of a self-selected convenience sample conducted in Quebec, Canada, from November 2020 to January 2021. Individuals aged ≥ 21 years who endorsed using cannabis bought in legal recreational cannabis stores to self-medicate a health condition were included. Data were analyzed using descriptive statistics and stratified according to sex, age, and the type of cannabis use (exclusively medical versus medical and recreational use).ResultsFour hundred eighty-nine participants were included. The median age was 34 years, and 48% were women. About 25% reported exclusive medical use of cannabis. Treated conditions included anxiety (70%), insomnia (56%), pain (53%), depression (37%), and many others. Reasons for not consulting in cannabis clinics included lack of information (52%), the complexity of the process (39%), accessibility of cannabis clinics (23%), and others.Tetrahydrocannabinol (THC) dosage > 20% was reported by 32%. Smoking was the main route of use (81%). Possession of prescribed drugs was reported by 56%. Professionals consulted for information on cannabis included recreational cannabis store agents (36%), physicians (29%), and others.Overall, significant differences were observed for many of the comparisons according to sex, age, and the type of cannabis use.ConclusionsMany conditions are self-medicated with cannabis. The use of high doses of cannabis, smoking as a preferred method of use, and concurrent use of other medications may pose some risks to individuals. Addressing the reported barriers to medical access to cannabis is urgently needed.

Identifikasi Penggolongan Obat Berdasarkan Peresepan Obat Hipertensi di Instalasi Rawat Jalan Rumah Sakit

The cause of hypertension is not clearly known, but risk factors that cause hypertension are found, namely the elderly or the elderly, in the form of a family history of hypertension, excess body weight and excessive salt levels. Hypertension is the third leading cause of death in Indonesia with a CFR (Case Fetality Rate) of 4.81%. Causes of the elderly suffer from hypertension due to reduced work functions in the human body. This study aims to determine the characteristics (gender and age) and classes of drugs prescribed to outpatient hypertension patients at RSUD Dr. Achmad Diponegoro Putussibau. This research is an observational study with a retrospective descriptive research design. From the results of the study, it was found that there were 55 hypertension patients with medical record data, based on gender the number of women was 62% and based on the age of 60-74 years by 80%. The class of drugs that are widely used are ACE-Inhibitors by 31%. Comorbidities that often accompany hypertension patients are diabetes mellitus by 40%. The dosage form is tablets by 90%, with the route of using the drug orally by 100%. The conclusion is that the use of drugs in hypertensive patients in the outpatient installation of RSUD Dr. Achmad Diponegoro Putussibau is mostly women. The majority occur at the age of 60-74 years, the most widely used drug class is the ACE-Inhibitor group with tablet dosage form and the oral route of use is the most widely used.

Prevalence and Types of Drugs Used Among Hepatitis A Patients During Outbreaks Associated with Person-to-Person Transmission, Kentucky, Michigan, and West Virginia, 2016–2019

BackgroundPeople who use drugs are at increased risk for hepatitis A virus infection. Since 1996, the Advisory Committee on Immunization Practices has recommended hepatitis A vaccination for people who use drugs. Since 2016, the U.S. has experienced widespread hepatitis A outbreaks associated with person-to-person transmission.PurposeTo describe the prevalence of drug use, route of use, and drugs used among hepatitis A outbreak-associated patients.MethodsState outbreak and medical records were reviewed to describe the prevalence, type, and route of drug use among a random sample of 812 adult outbreak-associated hepatitis A patients from Kentucky, Michigan, and West Virginia during 2016–2019. Differences in drug-use status were analyzed by demographic and risk-factor characteristics using the X2 test.ResultsAmong all patients, residents of Kentucky (55.6%), Michigan (51.1%), and West Virginia (60.1%) reported any drug use, respectively. Among patients that reported any drug use, methamphetamine was the most frequently reported drug used in Kentucky (42.3%) and West Virginia (42.1%); however, opioids were the most frequently reported drug used in Michigan (46.8%). Hepatitis A patients with documented drug use were more likely (p<0.05) to be experiencing homelessness/unstable housing, have been currently or recently incarcerated, and be aged 18–39 years compared to those patients without documented drug use.ImplicationsDrug use was prevalent among person-to-person hepatitis A outbreak-associated patients, and more likely among younger patients and patients experiencing homelessness or incarceration. Increased hepatitis A vaccination coverage is critical to prevent similar outbreaks in the future.

The Timing of Clinical Effects of Bupropion Misuse Via Insufflation Reported to a Regional Poison Center.

Bupropion is an antidepressant medication with expanding indications including smoking cessation, weight loss, attention-deficit/hyperactivity disorder, seasonal affective disorder, and amphetamine dependence. Despite its increasing popularity among providers, it has a well-known narrow therapeutic window that can lead to delayed onset of symptoms with extended-release formulations and devastating consequences in overdose. We have noticed some patients misusing bupropion via insufflation, which added a layer of complexity with regards to the therapeutic application of the drug. This route of use created difficult decisions regarding clinical monitoring in these patients. To determine if prolonged observation is required after insufflation of bupropion and to further describe effects from this route of use. This is a retrospective observational study reviewing all the cases of insufflated bupropion use reported to a single poison center without any other coingestants. The majority (85.7%) of patients had mild or moderate effects, and seizures occurred in 19.6% of cases; and the vast majority of patients were symptomatic by the time of the initial call to the poison center. We did not encounter any delayed effects after this route of use. This report describes the clinical effects reported, and the timing of these effects, after insufflation of bupropion.

Trends in and Characteristics of Drug Overdose Deaths Involving Illicitly Manufactured Fentanyls - United States, 2019-2020.

During May 2020-April 2021, the estimated number of drug overdose deaths in the United States exceeded 100,000 over a 12-month period for the first time, with 64.0% of deaths involving synthetic opioids other than methadone (mainly illicitly manufactured fentanyls [IMFs], which include both fentanyl and illicit fentanyl analogs).* Introduced primarily as adulterants in or replacements for white powder heroin east of the Mississippi River (1), IMFs are now widespread in white powder heroin markets, increasingly pressed into counterfeit pills resembling oxycodone, alprazolam, or other prescription drugs, and are expanding into new markets, including in the western United States† (2). This report describes trends in overdose deaths involving IMFs (IMF-involved deaths) during July 2019-December 2020 (29 states and the District of Columbia [DC]), and characteristics of IMF-involved deaths during 2020 (39 states and DC) using data from CDC's State Unintentional Drug Overdose Reporting System (SUDORS). During July 2019-December 2020, IMF-involved deaths increased sharply in midwestern (33.1%), southern (64.7%), and western (93.9%) jurisdictions participating in SUDORS. Approximately four in 10 IMF-involved deaths also involved a stimulant. Highlighting the need for timely overdose response, 56.1% of decedents had no pulse when first responders arrived. Injection drug use was the most frequently reported individual route of drug use (24.5%), but evidence of snorting, smoking, or ingestion, but not injection drug use was found among 27.1% of decedents. Adapting and expanding overdose prevention, harm reduction, and response efforts is urgently needed to address the high potency (3), and various routes of use for IMFs. Enhanced treatment for substance use disorders is also needed to address the increased risk for overdose (4) and treatment complications (5) associated with using IMFs with stimulants.

Causes, Nature and Toxicology of Fentanyl-Associated Deaths: A Systematic Review of Deaths Reported in Peer-Reviewed Literature.

PurposeFentanyl poisoning has been widely reported, yet there is a lack of systematic evaluation of the nature and toxicology of associated deaths in the published literature. This article aims to systematically review the nature, causes, routes of administration and toxicology of fentanyl-associated deaths using case studies and case series in peer-reviewed published literature.MethodsFour electronic databases including Embase, Medline (via Ovid), Scopus and Google Scholar were searched from inception until October 2019 to identify the studies reporting fentanyl related deaths. Two independent reviewers screened and selected the titles and then evaluated the full texts. Only case studies and case series were included. A structured data extraction tool was used to extract data on the number of deaths, routes of administration, concomitant drug use and toxicological data. The Joanna Briggs Institute quality assessment tool was used to evaluate the quality of included studies. Data were synthesized narratively.ResultsOf 1251 articles identified during initial search, 8 case reports and 9 case series met the inclusion criteria. A total of 1969 deaths were reported in the included studies. Deaths were concentrated in the north American region (n = 1946) and the Nordic region (n = 22). Reported causes of death included fentanyl overdose (n = 321, 56.4%), mixed drug toxicity (n = 196, 34.5%), natural (n = 28, 4.9%), other drug toxicity (n = 10, 1.8%), fentanyl and ethanol intoxication (n = 8, 1.4%), incidental (n = 5, <1%) and aspiration (n = 1). Most common routes of use were intravenous (70.5%) and transdermal routes (23.0%). Deaths came swiftly via the intravenous route. Mean level of blood fentanyl amongst all reported deaths was 0.024 µg/mL.ConclusionLiterature related to fentanyl-associated deaths predominantly come from North America. Deaths are comparatively lower or not reported in peer-reviewed publications from the rest of the world. Abuse through intravenous administration, mixed drug toxicities and self-treatment of breakthrough pain are mainly responsible for majority of the reported deaths.

Recurrent Spontaneous Pneumothorax Secondary to Marijuana-Induced Extensive Bullous Emphysema

Marijuana is the world's most commonly used illicit drug. Its use is estimated to be around 2% to 5% of the worldwide population and the most commonly used route of use is inhalation. Although not completely elucidated, marijuana has been linked with lung damage and bullous formation. We report a case of a young man with a significant history of marijuana smoking who presented with a recurrent large spontaneous pneumothorax refractory to non-surgical management.

PDG11 COST MINIMIZATION ANALYSIS OF TRASTUZUMAB SUBCUTANEOUS VERSUS INTRAVENOUS IN TREATMENT OF HER2-POSITIVE EARLY OR METASTATIC BREAST CANCER IN VIETNAM

The advent of trastuzumab biological medicine has opened up new strides in treatment of HER2-positive (HER2+) breast cancer. With the same efficacy and safety, trastuzumab subcutaneous (T-SC) is considered more advantagous than intravenous (T-IV) in terms of usability. With higher price of T-SC than T-IV, it is necessary to assess the economic efficiency of T-SC versus T-IV to consider the feasibility of using new therapies in clinical practice with tight medical budgets. Cost minimization analysis was used with cost components including drug cost, labor cost, other costs related to route of use, non-medical direct and indirect costs. The necessary information in the study was collected based on patient interviews and expert opinions at K hospital, Cho Ray hospital, Ho Chi Minh city Oncology hospital, Ha Noi Oncology hospital, Da Nang Oncology hospital and Bach Mai hospital. With an average weight of 54.78 ± 0.49 kg, T-SC is more economical than T-IV for each cycle from 2.51 to 3.65 million VND when not counting waste; from 3.55 to 4.59 million VND when calculating 10% of T-IV wastes and from 12.90 to 13.09 million VND when calculating 100% of T-IV wastes. For the entire course of treatment, T-SC economises from 45.11 to 232.16 million VND in early stage and from 25.52 to 91.65 million VND in metastasis stage depending on the percentage of wastage. In the minimized cost components, drug cost accounts for the highest proportion, fluctuating from 70.52% to 94.27% based on stage and portion of wastage. Other cost components are insignificant and do not change the value in all cases. T-SC is more economical than T-IV in treatment of HER2+ breast cancer in both cases of early and metastasis stage. In particular, drug cost is the most economical.

Clinical Uses and Molecular Aspects of Ozone Therapy: A Review

Ozone was discovered over a hundred years ago and since then, it has been widely used in many areas, with the primary use as a disinfectant in various ways, but with applications in diverse conditions. More recently, the use of ozone has extended to other fronts, using it to treat different pathologies. Extensive studies have shown its effects, as well as the safety of its application in various modalities of use. Other studies showed its toxicity, which depends on the doses of use. Emerging evidence revealed that ozone also plays an important role in the wound healing and modulation of immune cells, describing the molecular pathways responsible for these actions and describing therapeutic actions in the treatment of wounds, pain, postoperative and infectious diseases. Ozone use has already been documented in different doses, forms of use and routes of application, depending on the clinical situation and an adaptation is necessary for a better result. Thus, this review summarizes the main clinical uses of ozone, presenting the molecular pathways responsible for its actions, as well as discussing the main routes of use, doses and, vehicles used in the clinic.

Liability for Unmanned Aerial Vehicle Use

İnsansız hava araçları kullanım amaçları çeşitli olan ancak kullanıcılarının ve kullanım güzergâhlarının kayıt veya kontrol altına alınması gereken hava araçlarıdır. Birçok ülkede insansız hava araçları sorumluluğu konusunda hukuki düzenlemelere gidildiği bilinmektedir. Çalışmada İnsansız hava aracı kullanıcılarının üçüncü kişilere yönelik doğabilecek zararlardan dolayı sorumluluğu ulusal mevzuat yönünden ele alınacak ve ABD uygulamaları yönünden bir karşılaştırma yapılacaktır.