27 research outputs found
Comparison of Drugs Prescribed by Psychiatrists and Child/Adolescent Psychiatrists
No full textBackground: Drug utilization patterns may vary between children and adults even for similar indications. Psychiatry is one of the areas where differences of both diagnosis and drug utilization often vary between age groups, imposed by respective separate subspecialties and their prescribing patterns. The study aimed to compare utilization of drugs prescribed by psychiatrists and child/adolescent psychiatrists (CPs). Methods: This study evaluated all electronic prescriptions that were generated by psychiatrists and CPs and registered to the national Prescription Information System in 2016. The drugs in these prescriptions were examined and compared in terms of physician groups. Results: Among 1,150,621 prescriptions generated by psychiatrists and CPs during the study year, 94.2% (n=1,083,631) belonged to psychiatrists and the remaining 5.8% (n=66,990) to CPs. Psychiatrists were detected to prescribe significantly fewer nervous system drugs than CPs did (89.5% vs. 97.8%, p<0.001). Antidepressants constituted 57.4% of all nervous system drugs prescribed by psychiatrists, which was significantly lower in the prescriptions of CPs as 22.1% (p<0.001). Within antidepressants, SSRIs were significantly more preferred by CPs (91.4%) than that by psychiatrists (56.2%), (p<0.001). Centrally-acting sympathomimetics formed 46.6% of nervous system drugs prescribed by CPs compared to 2.4% of that by psychiatrists (p<0.001). Among these sympathomimetics, methylphenidate was the most commonly preferred drug by both CPs and psychiatrists (%84.6% vs. %68.6, respectively; p<0.001). Conclusions: It seems that centrally-acting sympathomimetics constitute near half of the drugs preferred by CPs who tend to prescribe a limited number of different drugs. Contrarily, psychiatrists tend to prescribe wide spectrum of drugs, half of these being antidepressants. The study highlights some discrepancies of psychotropic drug use regarding approved indication and clinical practice for different age groups
Investigation of prescribing trends and prescriptions for common diagnoses in primary care: Nationwide data of Turkey
No full textPurpose: This study aimed to examine the details of prescriptions issued in primary care and the changes over the years in Turkey. Materials and Methods: We analyzed all electronic prescriptions registered to Prescription Information System by primary care physicians in Turkey between 2013 and 2016. The mean number of drugs per prescription (nDPP) was determined by patients' sex and age groups. The percentages of the prescriptions containing the top twenty most frequently encountered drugs were determined for each year of the study. In the four-year period, the percentage of prescriptions with the ten most common diagnoses among prescriptions with single diagnosis and nDPP were examined. Results: A total of 1.457.034.275 drugs were prescribed in 518.335.821 prescriptions and nDPP was 2.81 for the four-year period. The most commonly used drugs in all prescriptions were other cold preparations (19.2-19.7%) and amoxicillin+beta-lactamase inhibitor (9.9-10.5%). The diagnosis of hypertension (6.9%, nDPP: 2.00) and acute upper respiratory tract infection, unspecified (URTI), (6.5%, nDPP: 2.61) were in the top ranks in single-diagnosis prescriptions during four-year period. Conclusion: Primary care prescriptions appear to be mostly generated for women and elderly populations, with a tendency for URTI and hypertension indications. Overprescriptions of cold preparations, NSAIDs, PPIs, analgesics, and broad-spectrum antibiotics imply existence of important problems in the primary care regarding rational prescribing behavior
Evaluation de la toxicité de la moule Mytilus galloprovincialis en contaminants métalliques dans deux sites côtiers Algériens.
No full text73 p. :ill. ; 30 cm.Ce travail a pour objet d’étudier les concentrations des métaux lourds dans la chair des moules
provenant du port d’Alger et de la ferme de Tipaza et étudier la conformité de ces produits à
la consommation en se référant à la norme algérienne.
Nous avons prélevé les échantillons de moules dans deux sites, port d’Alger et ferme
CultMare de Tipaza, chaque prélèvement est composé de 30 individus qui ont été traités au
laboratoire pour préparer les échantillons à l’analyse des métaux.
Nous avons effectué des analyses de onze éléments métalliques (Cu, Fe, Zn, Ni, Cd, Pb, Se,
Cr, Co, As, Mn) à l’aide de l’appareil ICP-MS. Le mercure Hg est déterminé par mercury
Vapor Monitor VM-3000.
Les résultats obtenus ont montré que les moules étudiées contiennent de fortes concentrations
en fer et en zinc, qui sont considérés comme des métaux essentiels.
De même, les résultats ont révélé que les valeurs de concentrations en métaux toxiques tels
que le mercure, plomb et cadmium étaient très faibles, indiquant que les moules étudiées
étaient conformes aux normes algériennes, et que leur consommation ne représente aucun
danger pour la santé
Rational use of medicine in dentistry: do dentists prescribe antibiotics in appropriate indications?
No full textThere are concerns regarding appropriate use of antibiotics in dentistry practice. Data on dental antibiotic prescribing patterns by dentists is relatively limited. This nationwide study aimed to examine dentists' antibiotic prescriptions in a diagnosis-based manner in Turkey. This retrospective study on utilization of systemic antibiotics for dental problems was based on the national health data of the dentists obtained from Prescription Information System between January 2013 and August 2015. Only those prescriptions containing single diagnosis and at least one systemic antibiotic were included in the study. Antibiotic prescribing was compared by diagnoses and expertise of dentists. A total of 9,293,410 antibiotics were detected in 9,214,956 prescriptions that contained single diagnosis and at least one antibiotic. The number of antibiotics per prescription was 1.01. Periapical abscess without sinus (28.1%), dental examination (20.7%), and dental caries (16.2%) were the three most common indications in which antibiotics were prescribed by dentists. While only 3.4% of antibiotics were prescribed upon the single and appropriate cellulitis and abscess of mouth diagnosis, the remaining 96.6% was prescribed for irrational/uncertain indications. Consistent in all diagnoses, amoxicillin + enzyme inhibitor (58.6%) was the mainly prescribed antibiotic. Analysis of the most preferred amoxicillin + enzyme inhibitor prescriptions by expertise of dentists showed significantly much higher prescription rates among Group A specialists and Group B specialists (67.0 and 67.8%, respectively) than those in unidentified dental practitioners (58.2%, p < 0.0001). This study showed that dentists prescribed antibiotics in an arbitrary and mostly unnecessary manner. In general, their antibiotic choices for examined diagnoses could be regarded as irrational. These results indicate the urgent need for improvement of rational antibiotic prescribing habits of dentists
Knowledge, opinions and attitudes of primary care physicians about generic drugs: a cross-sectional study
No full textBackground: Generic drug (GD) use is affected by many factors, including physicians' approach. Objective: This study aimed to investigate the knowledge, opinions and attitudes of primary care physicians (PCPs) about GDs and potentially associated factors. Methods: An adequately representative sample (n = 354) of PCPs was determined via stratified and simple random sample selection method in this descriptive, cross-sectional study.The research data were collected through a face-to-face 40-item survey, where the knowledge, opinions and attitudes about GDs were questioned. The prescribing percentage of GDs overall was also examined. Results: The survey was completed by 305 PCPs (mean age: 49.2 +/- 7.9 years; 57.4% male). The rate of correct responses about GDs was 67.6% for basic knowledge and 46.6% for the development process. The percentages of PCPs who declared that GDs were 'less efficacious', 'of lower quality' and 'less safe' than original drugs were 65.2%, 53.4% and 35.4%, respectively. More than half (60.3%) of the PCPs declared not to pay attention to whether the drug is generic while prescribing. It was observed that, as the knowledge level of the physicians increased, negative opinions and prescribing attitudes regarding the effectiveness, quality and safety of the GDs decreased.The rate of GD prescribing (51.6%) in Izmir was lower than the rest of the country (54.6%; P < 0.001). Conclusion: This study shows that the knowledge of PCPs about GDs is generally inadequate, which reflects negatively on their opinions and attitudes regarding the use of GDs. Educational activities can help establish awareness that GDs can be used without doubt of their effectiveness, quality and safety
Relative risk of tuberculosis in patients with rheumatic diseases managed with anti-tumour necrosis factor-alpha therapy: A nationwide cohort study
No full textWhat is known and objective Anti-tumour necrosis factor-alpha (anti-TNF-alpha) therapy is known to raise the risk of granulomatous infections, leading to development of risk management strategies at national or global level. This study aimed to determine the relative risk (RR) of tuberculosis (TB) due to anti-TNF-alpha usage in patients with rheumatologic diseases (RDs) in a nationwide basis. Method This retrospective cohort study included patients with rheumatoid arthritis (RA), ankylosing spondylitis, juvenile idiopathic arthritis or psoriatic arthritis (PsA) that treated with or without anti-TNF-alpha agents, as registered in the national prescription information system between years 2013 and 2015. Two-year RR of TB after anti-TNF-alpha therapy initiation was calculated in this RD population, including main subgroups. Results and discussion The study cohort included 413 500 RD patients, where anti-TNF-alpha(+) arm (n = 2117) had mean age of 41.9 +/- 13.4 years and male distribution of 54.3%. Four patients among anti-TNF-alpha users developed TB compared to 128 patients in anti-TNF-alpha-naive group (189 vs 31 cases per 100 000 patients, respectively), yielding a 2-year RR of 6.07 (95% CI, 2.25-16.42) with an attributable risk of 0.16%. These RRs (95% CI), which were particularly pronounced, were 5.39 (1.69-7.17) in men, 6.12 (2.26-16.55) in adults, and 5.70 (1.41-23.08) in RA and 13.46 (1.58-114.40) in PsA patients. There was no difference between the anti-TNF-alpha users who developed and undeveloped TB regarding drug utilization characteristics, except significantly less immunosuppressive drug exposure in TB patients. What is new and conclusion This study is the first prescription-based nationwide study to suggest an elevated RR of TB in a comparably younger population with a broad spectrum of RDs managed with any approved anti-TNF-alpha drug in Turkey
Development of Teacher Competence in Improving 21st Century Learning in Santa Lusia Kindergarten
No full textThe teacher's limited knowledge of 21st century learning skills is an obstacle to implementation in the classroom. In the educational context, technological developments should have had a positive impact on the learning process as well as from the perspective of teacher competency development. Less than ideal conditions occur in school, where the competence of the teachers is still weak. Teaching is still conventional and teacher-centered. The solution to overcome this problem is to attend training organized by the foundation. The research method used is descriptive quantitative. The subjects in this study were Santa Lucia Kindergarten Teachers. Data analysis used in this research is data reduction, data presentation, and conclusion. The results of this study cannot be disclosed because the research has not been completed. This research is in the nature of product development for the benefit of the competence of all teachers in the Santa Lucia Kindergarten Unit. The results of the education and training that have been carried out have not been carried out in full, its implementation is still in progress. The author concludes that teachers in today's 21st century educational development have more severe challenges and their tasks are more complex. The role of the teacher is very important in managing the learning process, to face these challenges, therefore teachers must have the ability to think critically, social responsibility, the ability to build networks, time discipline and rules as well as skills, skills in the 21st century
Effects of chronic L-DOPA administration on neurogenic and endothelium-dependent relaxation responses in rabbit corpus cavernosum
No full textSARIOGLU, YUSUF/0000-0002-9227-365X; Yildirim, seniz/0000-0001-8038-5796Background: Dopamine is a crucial central neurotransmitter that plays a fundamental role in the autonomic and somatic components of penile reflexes in animals and humans. Similar to the erectile responses of dopamine, systemic administration of L-DOPA induces yawning and penile erection in some species. The possible effects of L-DOPA on nitric oxide (NO)-dependent and-independent non-adrenergic non-cholinergic (NANC) relaxation responses mediated by electrical field stimulation (EFS) and endothelium-dependent relaxation were investigated in this study. Methods: Thirty-two adult albino male rabbits, in two- and four-week-treatment groups, were divided into three subgroups: control group (saline-injected) (n = 4), 3 mg/kg/day (low dose) L-DOPA-injected groups (n = 6) and 12 mg/kg/day (high dose) L-DOPA-injected groups (n = 6). After the intraperitoneal injection treatments, the corpus cavernosum tissues were placed in organ bath chambers. The EFS-mediated responses, and the concentration-response curve to carbachol, sodium nitroprusside (SNP), sildenafil were assessed. Results: The two-week treatment with high-dose L-DOPA decreased the NO-dependent NANC relaxation responses, while there was no change in the low-dose two- and four-week treatment groups. The NO independent NANC relaxation responses in the two-week groups decreased, and the responses in the four-week groups were unchanged when compared to the controls. The relaxation responses to carbachol showed no differences among all groups except for the high-dose four-week L-DOPA group. The relaxation responses of SNP and sildenafil were increased in all of the treatment groups when compared to the controls. Conclusions: The observed increases in SNP- and sildenafil-induced responses, along with the decreased EFS-mediated responses, suggest increased sensitivity in the NO-signalling pathway following L-DOPA administration. (C) 2016 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Sp. z o.o. All rights reserved
Effects of epoxygenases on the nonadrenergic noncholinergic relaxant responses induced by electrical field stimulation in rabbit corpus cavernosum
No full textWe aimed to investigate the effects of epoxygenases on electrical field stimulation (EFS)-mediated nitric oxide (NO)-dependent and NO-independent nonadrenergic noncholinergic (NANC) relaxations in isolated rabbit corpus cavernosum. The tissues of 20 male adult albino rabbits (2.5-3 kg) were suspended in organ baths containing aerated Krebs solution, and isometric contractions were recorded. EFS-mediated NANC relaxations were obtained on phenylephrin (3 x 10(-5) M)-contracted tissues in the presence of guanethidine (10(-6) M) and atropine (10(-6) M). Miconazole (10(-9)-10(-4) M), 17-octadecynoic acid (ODYA) (10(-10)-10(-5) M), 14,15-epoxyeicosatrienoic acid (EET) (10(-11)-10(-8) M), 11,12-EET (10(-12)-3 x 10(-8) M) and 20-hydroxyeicosatetraenoic acid (HETE) (10(-11)-3 x 10(-8) M) were added cumulatively (n = 5-7 for each set of experiments). For NO-independent relaxations, N-omega-nitro-l-arginine methyl ester (l-NAME) (10(-4) M) was added before a group of experiments. Depending on the concentration, miconazole, 17-ODYA, 14,15-EET, 11,12-EET, and 20-HETE significantly enhanced both NO-dependent and NO-independent EFS-mediated relaxations (p < 0.05). Epoxygenases showed similar effect on NO-dependent and NO-independent relaxant responses except 20-HETE which caused significantly more enhanced relaxation on NO-dependent responses (p < 0.05). No drug caused a significant relaxation response on tissues contracted with phenylephrine. Epoxygenases contribute to EFS-mediated NO-dependent and NO-independent NANC relaxations by presynaptic mechanisms, offering a new treatment alternative for erectile dysfunction which needs to be explored in further in vivo, molecular and clinical studies
