medication

摘要： Patients with Crohn’s disease(CD)are at a considerable risk for intestinal surgery.Approximately 25%of patients with CD will undergo an intestinal resection within 10 years of diagnosis.Postoperative complications after CD surgery have been reported in 20%-47%of the patients.Both general and CD-related risk factors are associated with postoperative complications,and comprise non-modifiable(e.g.,age)and potentially modifiable risk factors(e.g.,malnutrition).Prehabilitation focuses on the preoperative period with strategies designed to optimize modifiable risk factors concerning the physical and mental condition of the individual patient.The aim of prehabilitation is to enhance postoperative recovery and return to or even improve preoperative functional capacity.Preoperative improvement of nutritional status,physical fitness,cessation of smoking,psychological support,and critical revision of preoperative use of CD medication are important strategies.Studies of the effect on postoperative outcome in CD patients are scarce,and guidelines lack recommendations on tailored management.In this opinion review,we review the current evidence on the impact of screening and management of nutritional status,physical fitness,CD medication and laboratory values on the postoperative course following an intestinal resection in CD patients.In addition,we aim to provide guidance for individualized multimodal prehabilitation in clinical practice concerning these modifiable factors.

摘要： Purpose: The purpose of this study was to prepare a self-assessment questionnaire for nurses’ risk-taking behavior (RTB) in medication and to develop a reliable and valid questionnaire. Method: In the first study, a draft of the self-evaluation questionnaire for nurses’ RTB in medication was prepared based on the literature study and qualitative analysis of important case information included in the Project to Collect Medical Near-miss/Adverse Event Information Annual Report of the Ministry of Health, Labor and Welfare. Following the studies, face validity was confirmed, and a questionnaire survey was conducted for nurses who oversee medication nationwide to verify the reliability and validity. Result: The number of subjects was 586 (valid response rate: 94.1%). Item analysis and exploratory factor analysis showed that 4 factors and 12 items for the RTBs in daily life and 4 factors and 20 items for RTBs in medication could be extracted. Confirmatory factor analysis confirmed the fit of the hypothetical model obtained by exploratory factor analysis. In addition, Cronbach’s α coefficient was 0.888. Thus, high reliability and validity were obtained. A correlation was found by comparing the total scores of each RTB factor with the incident/accident group, and a standard for self-evaluation value could be established (p < 0.01). Conclusions: We were able to develop a self-assessment questionnaire for nurses’ risk-taking behavior in medication. This questionnaire will be used by nurses to find out their trends.

摘要： BACKGROUND Cerebral microbleeds(CMBs)may increase the risk of future intracerebral hemorrhage and ischemic stroke.However,It is unclear whether antiplatelet medication is associated with CMBs.This study aimed to investigate the association between antiplatelet medication and CMBs in a community-based stroke-free population.METHODS In this cross-sectional study,stroke-free participants aged 18-85 years were recruited from a community in Beijing,China.Demographic,clinical,and antiplatelet medication data were collected through a questionnaire,and all participants underwent blood tests and brain magnetic resonance imaging at 3.0T.The presence,count,and location of CMBs were evaluated using susceptibility-weighted imaging.The association between antiplatelet medication and the presence of CMBs was analyzed using multivariable logistic regression.The associations between antiplatelet medication and CMBs by location(lobar,deep brain or infratentorial,and mixed regions)were also analyzed using multinomial logistic regression.A linear regression analysis was conducted to determine the association between antiplatelet medication and the log-transformed number of CMBs.RESULTS Of the 544 participants(mean age:58.65±13.66 years,217 males),119 participants(21.88%)had CMBs,and 64 participants(11.76%)used antiplatelet medication.Antiplatelet medication was found to be associated with CMBs at any location[odds ratio(OR)=2.39,95%CI:1.24-4.58]and lobar region(OR=2.83,95%CI:1.36-5.86),but not with the number of CMBs(β=0.14,95%CI:-0.21-0.48).Among antiplatelet medications,aspirin use was found to be associated with any CMB(OR=3.17,95%CI:1.49-6.72)and lobar CMBs(OR=3.61,95%CI:1.57-8.26).CONCLUSIONS Antiplatelet medication was associated with CMBs in stroke-free participants,particularly lobar CMBs.Among antiplatelet medications,aspirin use was associated with any CMB and lobar CMBs.Our findings suggest that it might be essential to optimize the management of antiplatelet medication in the stroke-free population with a higher burden of vascular risk factors to reduce the potential risk of CMBs.

摘要： This white paper discusses the Ecuadorian healthcare system specifically the lack of proper anesthesia and post-operative pain medication and touches base with centralized hospitals. This paper articulates the specific problems inhibiting the usage of these proper medications, specifically looking at a hospital in Quito, Ecuador. Present day tribal situations are also discussed as they are a significant part of the population that is affected by the shortages of pain medication and anesthesia. Solutions are presented to solve the problems the country faces and how it is relevant today.

摘要： Anxiety is the most common disorder nowadays.Anxiety can be acute or can be chronic.There are several scientific evidences that prove nutrition’s importance and role of different therapies in the treatment of anxiety.But very few people are familiar with the role of taking proper nutrition or a balanced diet in anxiety treatment.This article helps many people to know deeply about the therapies they can do at their home and the nutrition and food for healthy lives and controlling the mental disorder.This scoping review also helps to under the anxiety,symptoms,causes,prevalence in patient and how it should be treated with or without the use of medication.Long-term analysis of previous studies show more than 60,000 results with the use of Artificial intelligence which are totally different.So brief literature was studied and found that nutrition plays definitely a major role in treatment.Literature survey revealed the relation between a large intake of fruits,vegetables,omega 3,fatty acids,a ketogenic diet,calorie,magnesium,zinc,selenium,probiotics with low level of anxiety.Paper also revealed the association between higher anxiety levels with high intake of fat diet,sugar intake,carbohydrate,oily food.This paper helps you to understand the value of each therapy and nutrition for successive decreasing anxiety.This paper has main aim to describe the prevalence,causes,symptoms of anxiety so that it can help people to understand that what kind of anxiety is there which they are suffering from and what ways can be done to treat it naturally with the help of huge beneficial therapies,nutritional food,exercises and marketed medicines with advantages and disadvantages and by adding some herbal plants in their diet.

摘要： Background: Cerebrovascular disease is a worldwide health problem. Stroke, a type of cerebrovascular disease, caused by sudden loss of blood flow to parts of the brain, is the world’s second-leading cause of death and third-leading cause of disability. It is critical to analyze risk factors to prevent cerebrovascular disease. Data and Methods: The risk factors for cerebrovascular disease were analyzed using data from 2,678,054 medical checkups obtained from the JMDC Claims Database. Logit models were used, and the odds ratio (OR) and confidence interval (CI) were calculated. The sample period was from January 2005 to September 2019. Results: Age and heart disease history were very important nonmodifiable factors. The OR comparing persons aged 70 to those aged 50 was 2.05 with a 95% CI of 1.92 - 2.05. A heart disease history was also an especially important factor (OR 2.29, 95% CI 2.18 - 2.41). Among the modifiable factors, triglyceride level and recent large weight change were very important factors, changing the risk of cerebrovascular disease by about 30%. Other significant modifiable factors were diastolic blood pressure, urine protein, having breakfast, walking ability and smoking;each of these changed the risk of cerebrovascular disease by about 10%. Taking medications to control hypertension, hyperglycemia and hypercholesterolemia respectively increased the risk of cerebrovascular disease. In particular, taking antihypertensive medications nearly doubled the risk (OR 1.93, 95% CI 1.86 - 2.00). Conclusion: It is very important for individuals with risk factors to improve their physical conditions to prevent cerebrovascular disease. Taking medications to control blood pressure, glucose level, and cholesterol might introduce risks for cerebrovascular disease. Since all medications have side effects, it is necessary to carefully manage the use of these medications to minimize the negative side effects. Limitations: The dataset was observatory. There were no experimental interventions. Further, the dataset contains only information of Japanese individuals, and the results might differ in other countries. As the data comprised claims from employment-based health insurance, the dataset includes no subjects aged 76 or over and relatively few aged 70 - 75. We need to analyze data of other countries and elderly people.

摘要： BACKGROUND Gambling disorder is characterized by excessive and recurrent gambling and can have serious negative social consequences.Although several psychotherapeutic and pharmacological approaches have been used to treat gambling disorder,new treatment strategies are needed.Growing evidence suggests that dopamine D3 receptor plays a specific role in the brain reward system.AIM To investigate if blonanserin,a dopamine D3 receptor antagonist,would be effective in reducing gambling impulses in patients with gambling disorder.METHODS We developed a study protocol to measure the efficacy and safety of blonanserin as a potential drug for gambling disorder,in which up to 12 mg/d of blonanserin was prescribed for 8 wk.RESULTS A 37-year-old female patient with gambling disorder,intellectual disability,and other physical diseases participated in the pilot study.The case showed improvement of gambling symptoms without any psychotherapy.However,blonanserin was discontinued owing to excessive saliva production.CONCLUSION This case suggests that blonanserin is potentially an effective treatment for patients with gambling disorder who resist standard therapies,but it also carries a risk of adverse effects. Further studies are needed to confirm the findings.

摘要： BACKGROUND The quality of life of women with endometriosis is substantially adversely affected by the pelvic pain caused by this disease.However,the choice of medication for endometriosis remains controversial,and no drug has been clearly proven to be superior to others.AIM To assess the efficacy and safety of dienogest,a synthetic progestin,in the treatment of women with painful symptoms of endometriosis.METHODS PubMed,EMBASE,the Cochrane Library,and the Web of Science databases were searched from their inceptions to January 21,2020 for randomized controlled trials(RCTs)that compared dienogest with other popular prescription drugs for the treatment of endometriosis.Two reviewers extracted the data.Mean difference(MD)values and risk ratios(RRs)with 95%confidence intervals(CIs)were calculated.RESULTS Ultimately,seven RCTs with a total of 1493 participants met the requirements for this review.Dienogest was found to more effective than placebo in alleviating endometriosis-related pain(MD=-32.93,95%CI:-44.63 to-21.23),but led to a more significant decline in plasma estradiol concentrations than placebo(MD=-44.7,95%CI:-62.24 to-24.69).Dienogest was superior to gonadotropin-releasing hormone analogues(GnRH-a)in relieving pain(MD=-2.41,95%CI:-3.58 to-1.24).Moreover,compared with dienogest,GnRH-a were significantly more likely to lead to the loss of bone mineral density(MD=2.77,95%CI:0.16 to 5.37)and were significantly associated with a higher incidence of headaches(RR=0.68,95%CI:0.52 to 0.91)and hot flushes(RR=0.43,95%CI:0.18 to 1.02).CONCLUSION This meta-analysis demonstrated that dienogest may be a better pain-relief treatment for endometriosis patients,due to its high efficacy and tolerability.

摘要： Hyperkalemia is a recognized and potentially life-threatening complication ofheart transplantation. In the complex biosystem created by transplantation,recipients are susceptible to multiple mechanisms for hyperkalemia which arediscussed in detail in this manuscript. Hyperkalemia in heart transplantationcould occur pre-transplant, during the transplant period, or post-transplant. Pretransplantcauses of hyperkalemia include hypothermia, donor heart preservationsolutions, conventional cardioplegia, normokalemic cardioplegia, continuouswarm reperfusion technique, and ex-vivo heart perfusion. Intra-transplant causesof hyperkalemia include anesthetic medications used during the procedure,heparinization, blood transfusions, and a low output state. Finally, post-transplantcauses of hyperkalemia include hemostasis and drug-induced hyperkalemia.Hyperkalemia has been studied in kidney and liver transplant recipients, butthere is limited data on the incidence, causes, management, and prevention inheart transplant recipients. Hyperkalemia is associated with an increased risk ofhospital mortality and readmission in these patients. This review describes thecurrent literature pertaining to the causes, pathophysiology, and treatment ofhyperkalemia in patients undergoing heart transplantation and focuses primarilyon post-heart transplantation.

摘要： Methods:In a phase 2 trial,we randomly assigned patients with a GPP flare in a 2:1 ratio to receive a single 900-mg intravenous dose of spesolimab or placebo.Patients in both groups could receive an open-label dose of spesolimab on day 8,an open-label dose of spesolimab as a rescue medication after day 8,or both and were followed to week 12.The primary end point was a Generalized Pustular Psoriasis Physician Global Assessment(GPPGA)pustulation subscore of 0(range,0[no visible pustules]to 4[severe pustulation])at the end of week 1.The key secondary end point was a GPPGA total score of 0 or 1(clear or almost clear skin)at the end of week 1;scores range from 0 to 4,with higher scores indicating greater disease severity.