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Triglyceride values after six months of lopinavir/ritonavir therapy as an indicator for pancreatitis risk
Get PDFMPharm (Advanced Clinical Pharmacy), North-West University, Potchefstroom Campus, 2017Pancreatitis is the inflammation of the pancreas with varying aetiology. Hypertriglyceridaemia
(HTG) is known to cause pancreatitis at triglyceride (TG) values of 11.3 mmol/L and beyond.
The protease inhibitors (PIs) – a class of antiretroviral drugs that form part of some triple drug
regimens indicated for the treatment of infection with the human immunodeficiency virus (HIV) –
are known to induce HTG. Lopinavir/ritonavir (LPV/r) is the PI combination in a single dosage
form that was relevant to this study.
The primary aim of this study was to investigate the risk of pancreatitis after the first six months
of LPV/r therapy. The study included adult patients, treated at the Centre for Disease Control
(CDC) at a public regional hospital in KwaZulu-Natal, older than the age of 18 years that were
on LPV/r-based therapy (n=194). Data collected were TG values, serum (s)-amylase values and
CD4 counts after the first six months of LPV/r therapy. Risk was determined by the probability of
pancreatitis in the study sample. Association between the cases of pancreatitis and cases of
HTG was tested by a chi square statistical test. The chi square test was also used to determine
whether there is an association between gender and pancreatitis and CD4 count and
pancreatitis.
No cases of pancreatitis were detected in the study sample. The mean triglyceride values
(standard deviation [SD]) were 1.94 mmol/L (1.30). The mean s-amylase levels (SD) were
111.00 U/L (46.38). Both TG and s-amylase mean values were notably increased and there was
a clear tendency to increase for both triglyceride levels and s-amylase levels. The mean CD4
count (SD) was 364.76 cells/μL (226.85). There was a statistically significant difference between
the mean TG values (SD) of males (n=50) and that of females (n=144) at 2.36 mmol/L (1.74)
and 1.79 mmol/L (1.08) respectively.
There is therefore negligible risk of pancreatitis after the first six months of LPV/r therapy.
However, the elevated mean triglyceride values may still warrant intervention and continuous
monitoring, especially for the male populationMaster
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
The treatment of paediatric asthma in the private health care sector of South Africa : a retrospective drug utilisation review
Get PDFThesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.Asthma is the most common chronic disease among children worldwide. The prescribing patterns of the medication used to treat asthma in South Africa, as well as the prevalence of paediatric asthma are of interest and need to be investigated. A drug utilisation review was performed to determine the prevalence of asthma, and in particular paediatric asthma in a section of the private health care sector of South Africa. The prescribing patterns of asthma medication were investigated according to different demographic factors, such as gender, geographical area and prescriber type. Data from a medical claims database were extracted and processed to reveal the different prescribing patterns from 1 January 2005 to 31 December 2008. Medication from the MIMS® pharmacological groups 10.2 and 10.4 were used as a basis for asthma medication. Patients had to use at least one medicine item from one of these groups to be included in the study. The prevalence of asthma in the general population showed an increase from 2005 to 2008. The prevalence of asthma as a part of the total database according to the number of patients increased from 23.01% in 2005 (n=347342) to 24.72% in 2008 (n=240854), although the number of patients on the total database decreased from 2005 to 2008. When investigating the number of prescriptions that were dispensed during 2008, asthma prescriptions comprised 7.16% (n=484983) of all prescriptions and the number of asthma medicine items that were dispensed made up 3.72% (n=611139) of the total number of medicine items
dispensed in 2008. Paediatric asthma was divided into two age groups for the purpose of this study namely, 0 - 4 years of age and older than 4 years, but younger or equal to 11 years of age ( >4 - 11 years), according to a previous study done by the National Heart Lung and Blood Institute (NHLBI). The results from the data confirmed that the prevalence of asthma was higher in the younger age group. The number of patients using asthma medication in the 0 - 4 years age group comprised 44.40% (n=11306) of the total number of patients in this age group on the database in 2008, compared to 32.84% (n=28347) in the >4 - 11 years age group. Asthma was more common among male patients, whether they were included in the paediatric groups or not. The geographical distribution of paediatric asthma seemed to be connected to the provinces without coastlines and different mining facilities. The combination of asthma medication with antibiotics and systemic corticosteroids were investigated and it was concluded that antibiotics that were used for respiratory tract infections were prescribed the most frequently to asthma patients. The refill–adherence rates of patients with asthma were not satisfactory when considering that asthma is a chronic disease. The average adherence rate for all the asthma products that were brought into account when calculating the refill–adherence rate was 60.95%. A rate above 90% indicates optimal patient adherence. In conclusion this study determined that asthma has a significant prevalence among children
in South Africa. The prescribing patterns for the different medication used in the treatment of asthma were investigated and recommendations for further research in this field of study were made.Master
Prescribing patterns of medicines used in Parkinson's and other related diseases in the private health care sector of South Africa
Get PDFThesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.Parkinson's disease is the most recurrent movement disorder and has a radical effect on the lives of people. This chronic neurological disorder is accompanied by a significant social and financial burden with a negative brunt on sufferers' quality of life. The main cause of Parkinson's disease is still unknown, however, the main goal of existing treatment for Parkinson's disease is to improve the patient's quality of life and ability to go about as normally and easily as possible. The general objective of this study was to investigate the prescribing patterns of medicine items used in Parkinson's disease and other movement disorders associated with Parkinson's disease, as well as the cost associated with the medication in a section of the private health care sector of South Africa. A quantitative, retrospective drug utilisation review (DUR) study was performed according to data obtained from a medicine claims database, of a South African pharmacy benefit management company (PBM) for four consecutive years (i.e. 2005 to 2008). Of all patients on the total database 0.26% (n = 3 993) were Parkinson's disease patients in 2005 (N = 1 509 621), 0.28% (n = 4 423) in 2006 (N = 1 558 090), 0.34% (n = 4 028) in 2007 (N = 1 178 596) and 0.42% (n = 4 072) in 2008 (N = 974 497). Female Parkinson's disease patients were between 56% and 60% of all Parkinson's disease patients from 2005 to 2008. According to age groups, Parkinson's disease patients had the highest representation in age group five (70 80 years) and age group six (> 80 years).
In total the number of Parkinson's disease prescriptions claimed through the PMB accounted for 0.3% from 2005 to 2007 and 0.4% in 2008 of all prescriptions claimed on the database. From 2005 (N = R1 819 865 251) to 2008 (N = R1 785 871 013) Parkinson's disease expenditures represented 0.6% (2005, n = R10 459 835; 2006, n = R11 320 616; 2007, n = 11 040 596; 2008, n = 10 697 155) of the total database's prescription expenditure. The female gender and patients of 70 years and older, presented with the highest number of prescriptions claimed and also with the highest costs within the specific age and gender groups. In 2005 the medicine treatment expenditure for a year's Parkinson's disease treatment was approximately R2 619 R4 179, decreasing with 2% to R2 559 R4 237 in 2006, from thereon increasing with 7% to R2 740 R 4 337 in 2007, decreasing again with 4% to R 2 627 R4 424 in 2008. Medicine item analyses indicated that dopaminergic medicine items were the most frequently used antiparkinson medicine items from 2005 to 2008. Carbidopa/levodopa containing medicine items were most frequently claimed throughout the study period. The average cost per tablet increased from 2005 to 2008, with the most expensive tablets during the four–year study period indicated as, Tasmar® 100 mg tab and Permax® 1 mg tab. The PDD of all antiparkinson medicine items appeared intact. There were only two medicine items that indicated a PDD, above the maximum daily dosage, namely Permax® 1 mg tablets and Tasmar® 100 mg tablets. The frequencies of medicine items prescribed in combination decreased rather drastically with an increase of medicine items per prescription throughout the study period. CNS medicine items prescribed together with antiparkinson medicine items per prescription often occurred. The highest frequencies encountered in combination with antiparkinson medicine items were found to include the antidepressants, hypnotics, antipsychotics and anxiolytic medicine items. A majority of antiparkinson medicine items (53.50%, n = 4 691) had low refill–adherence rates below 90% and were therefore unacceptable. These accounted for 41.62% (n = R16 398 512) of the total cost (N = R39 402 898) of all antiparkinson medicine items included in this study. Only 36.78% (n = 3 225) of antiparkinson medicine items had acceptable refill–adherence rates between 90% and 110%. Those with unacceptably high refill–adherence rates accounted for 9.72% (n = 852) of all antiparkinson medicine items and represented 6.5% (n = R2 574 597) of the total cost. Conclusion: It can be concluded that even though antiparkinson medicine items are used by only a small percentage of the total patient population in a section of the private health care sector of South Africa, they are expensive and bear implications for the patient as well as medical schemes. Good prescribing patterns were adhered to, with the exception of the poor refill–adherence of antiparkinsons medication items.Master
Prescribing patterns of asthma treatment in the private healthcare sector of South Africa
Get PDFMPharm (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014Asthma is a chronic disease of the airways and affects many people regardless of their age, gender, race and socioeconomic status. Since asthma is recognised as one of the major causes of morbidity and mortality in people and especially in South Africa, the prescribing patterns, prevalence and medication cost of asthma in South Africa are saliently important and need to be investigated. A non-experimental, quantitative retrospective drug utilisation review was conducted on medicine claims data of a pharmaceutical benefit management company in a section of the private health care sector of South Africa. The study period was divided into four annual time periods (1 January 2008 to 31 December 2008, 1 January 2009 to 31 December 2009, 1 January 2010 to 31 December 2010 and 1 January 2011 to 31 December 2011). The prescribing patterns and cost of asthma medication were investigated and stratified according to province, age and gender. Patients were included if the prescriptions which were provided by the health care practitioners matched the Chronic Disease List (CDL) of South Africa and the International Classification of Disease (ICD-10) coding for asthma and chronic obstructive pulmonary disease (COPD). Data analysis was conducted by means of the SAS 9.3® computer package. Asthma patients were divided according to different age groups (there were five different age groups for this study), gender and geographical areas of South Africa. The study indicated a steady increase in the prevalence of asthma patients from 0.82% (n = 7949) in 2008 to 1.18% (n = 15 423) in 2009 and reached a minimum of 0.79% (n = 8554) in 2011. Analysis of the prevalence regarding geographical areas in South Africa suggested that Gauteng had the highest number [n = 17 696, (0.85%)] of asthma patients throughout the study period, followed by KwaZulu Natal [n = 8 628, 1.16%)] and the Western Cape [(n = 8513, 0.97%) (p 0.05). The results showed that asthma was not as common chronic disease in children. The total number of asthma patients younger than 7 years represented 0.64% (n = 2 909). It was found that patients over 65 years of age showed the highest prevalence of the five age groups [1.94% (n = 13 403) (p < 0.05)]. The average number of asthma prescriptions per patient per year was 8.28 (95% CI, 8.16-
8.40) and 5.15 (95% CI, 5.06-5.23) in 2008 and 2011, respectively. The number of asthma items per prescription varied from 1.55 (95% CI, 1.55-1.56) in 2008 to 1.40 (95% CI, 1.39- 1.40) in 2011. Medication from the MIMS® pharmacological group (anti-asthmatics and bronchodilators)
was used to identify asthma medication. The top three asthma medication with the highest prevalence in the study period were the anti-inflammatory inhaler of fluticasone (n = 39 721) followed by the single item combination product of budesonide/ formoterol (n = 25 121) and salbutamol (n = 24 296). The influence of COPD on asthma treatment and the costimplication thereof were investigated. Medication from the MIMS® pharmacological group (anti-asthmatics and bronchodilators) was used to identify COPD medication. This study also showed that COPD had an influence in the economic burden of the South African asthma population. The cost of medication is responsible for the single largest direct cost involved in the economic burden of asthma. This study showed that asthma represented 0.88% of the direct medication cost in the study (excluding hospitalisation and indirect cost). The average cost per prescription and average cost per asthma item both increased throughout the study period. The prescribing patterns for the different medication used in the treatment of asthma were investigated and recommendations for further research in this field of study were made.Master
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