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  • 1
    Digitale Medien
    Digitale Medien
    Springer
    European journal of clinical pharmacology 53 (1997), S. 7-11 
    ISSN: 1432-1041
    Schlagwort(e): Key words Prescription database ; Multiple drug use; drug utilization ; computerized drug subsidy system
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Chemie und Pharmazie , Medizin
    Notizen: Abstract Objective: Concurrent use of multiple drugs (polypharmacy, PP) may cause health risks such as adverse drug reactions, medication errors and poor compliance. The objective of this study, based on data from a prescription database, was to evaluate estimators of PP in the general population. Methods: Data were retrieved from Odense Pharmacoepidemiological Database (OPED) and consisted of all prescriptions in 1994 from a 10% random sample of drug users (n=26977) in the county of Funen, Denmark. For each prescription, the period of consumption was calculated by setting the duration of treatment to equal the amount of drug purchased, as measured in defined daily doses (DDD), thereby assuming a daily intake of one DDD. PP was defined as overlapping periods of consumption for different drugs. A Venn diagram was used to illustrate and compare this estimator of PP with two other indicators of multiple-drug use: the number of drugs purchased in 3 months and the mean number of drugs used in 1 year. A receiver operating curve (ROC) was used to evaluate the possibility of predicting episodes of PP from the number of drugs purchased in 3 months. Results: The proposed estimator of PP was robust towards changes in DDD. On an average day in 1994, the prevalence of PP was 9.9% and the standard deviation (SD) between days was 0.3%. Two to four drugs (minor PP) were used by 8.7% of the population (SD, 0.2%) and five or more drugs (major PP) by 1.2% (SD, 0.1%). The number of individuals displaying PP for the first time in 1994 stabilised after approximately 6 months, resulting in an incidence of major PP of 0.2% and of minor PP of 1.2% per month. For individuals exposed to PP, the median number of days of exposure was 61 and 10.5% were exposed for more than 350 days of the year. Purchase of five or more drugs in the first 3 months of 1994 predicted episodes of major PP in the same year with a positive predictive value of 80%. Conclusion: Epidemiological measures of multiple drug use can be estimated from data in a prescription database. From a conceptual point of view, an estimator based on the number of simultaneously used drugs (calculated from the date of purchase and the number of DDD) is preferable, but the number of drugs purchased in a 3-month period may also be a useful estimator.
    Materialart: Digitale Medien
    Standort Signatur Erwartet Verfügbarkeit
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  • 2
    Digitale Medien
    Digitale Medien
    Springer
    European journal of clinical pharmacology 45 (1993), S. 199-203 
    ISSN: 1432-1041
    Schlagwort(e): Drug education ; Hospital admission ; adverse drug reactions ; drug utilisation ; intervention
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Chemie und Pharmazie , Medizin
    Notizen: Summary As part of a high-intensity monitoring study of drug events as the cause of admission to departments of internal medicine, the effect of an educational intervention programme was studied. Two departments were included, one specialising in geriatrics and one that received patients by non-selected referral. The series consisted of 607 consecutive admissions studied before and 703 after the intervention. The drug events considered were adverse drug reactions and dose-related therapeutic failures, mainly due to non-compliance. A modest, statistically non-significant decrease in drug related hospital admissions (DRH) was seen, from 14% before to 13% after the intervention period. However, DRHs classified as definitely avoidable showed the significant decrease of 83%. There was no apparent relationship between the topics selected for the intervention programme and changes in the pattern of DRHs. No relationship between alterations in sales data and hospital admissions caused by a given drug could be demonstrated. A blinded external evaluation of case abstracts did not disclose any significant shift in the investigators' assessments. The intervention may have had an non-specific effect on avoidable DRHs.
    Materialart: Digitale Medien
    Standort Signatur Erwartet Verfügbarkeit
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  • 3
    Digitale Medien
    Digitale Medien
    Springer
    European journal of clinical pharmacology 50 (1996), S. 161-165 
    ISSN: 1432-1041
    Schlagwort(e): Key words Sumatriptan ; Migraine treatment; prescription database ; heavy drug consumption ; pharmacoepidemiology
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Chemie und Pharmazie , Medizin
    Notizen: Abstract Objective: Sumatriptan is highly efficacious in aborting acute attacks of migraine. Owing to recent reports of misuse of sumatriptan, we performed a study of its use in a Danish population. Methods: Data were retrieved from a prescription database covering a period of 27 months after release of the drug. Consumption was described by the defined daily dose (DDD) unit and total individual consumption during the period was calculated. Those who received more than one prescription for sumatriptan were classified according to peak use of sumatriptan into high (≥ 60 DDD/31 days) (n = 45), intermediate (30–59 DDD/31 days) (n = 127) and low (〈 30 DDD/31 days) (n = 1423) consumption groups. Individual usage of other medication was described. Results: We identified 2,878 users of sumatriptan, of whom 1,283 (45%) only redeemed one prescription. The use of sumatriptan was highly skewed. The 1% heaviest users accounted for 20% of the total consumption. The median total individual consumption of sumatriptan was 500 DDD, 192 DDD, and 24 DDD in the three groups of multiple redeemers, respectively. Pronounced differences in the total amounts of opioids and ergot alkaloids used were also found, with the high peak consumption group being the heaviest consumers of all drug categories, although half of them had only received large doses of sumatriptan. Fifty seven % of high peak users redeemed more than 29 DDD of sumatriptan within one month of initiation of treatment. The 45 high peak users had received the bulk of their medication, largely in tablet formulation, from 31 prescribers. The data points to rebound headache as a plausible underlying mechanism, but incorrect use of sumatriptan for migraine prophylaxis is also a possibility. Overuse of sumatriptan has serious economic consequences and its long-term health effects are not known.
    Materialart: Digitale Medien
    Standort Signatur Erwartet Verfügbarkeit
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  • 4
    Digitale Medien
    Digitale Medien
    Springer
    European journal of clinical pharmacology 47 (1994), S. 367-372 
    ISSN: 1432-1041
    Schlagwort(e): Drug utilization ; Computerized drug subsidy system ; incidence ; prevalence ; heavy drug use
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Chemie und Pharmazie , Medizin
    Notizen: Abstract The Danish retail pharmacies' drug subsidy system is completely computerized. The data are person-identifiable, making it possible to chart the population's drug use from the perspective of individual users. We decided to explore the potential of this data source and to analyse heavy drug users specifically. The analysis encompassed all 890 352 prescriptions presented by citizens of Odense in 1991. There was a total sales volume of 32 million defined daily doses consumed by 113 468 adult drug users, corresponding to 65.1% of the adult population. We found 2388 heavy drug users, defined by an annual purchase of more than 2000 defined daily doses. Heavy drug users accounted for 1.4% of the adult population and 22.9% of drug sales. They were remarkably well characterized by their main therapeutic class, which constituted a median of 47% of their drug use. A median of 97% of each heavy user's drugs were issued by one main prescriber. We conclude that heavy drug use can generally be ascribed to severe disease rather than to irresponsible prescribing. For the most important drug classes, we present various epidemiological measures of drug use, including 1-year prevalence, incidence, duration of therapy and some measures of skewness in utilization. If analysed regularly these measures can disclose subtle trends in clinical drug use that would not be evident from the wholesale figures.
    Materialart: Digitale Medien
    Standort Signatur Erwartet Verfügbarkeit
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  • 5
    ISSN: 1432-1041
    Schlagwort(e): Key words Antidepressants ; Prescription database; utili zation ; tolerability
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Chemie und Pharmazie , Medizin
    Notizen: Abstract Objective: To study whether the newer antidepressants have changed the patterns of antidepressant use, and whether the claimed better adverse effect profile of the newer antidepressants is reflected in their use as monitored by a prescription database. Method: By means of a prescription database (OPED), the use of antidepressants from 1991 to 1993 in Odense, Denmark, was analysed. Results: The 1-year prevalence of antidepressant use increased significantly from 1.60% to 2.00%, which still is below the claimed 1-year prevalence of depression of at least 5%. The increase was mainly due to a rapidly increasing use of the newer antidepressants, accompanied by a moderate decline in the use of older antidepressants (mainly tricyclic antidepressants). The patterns of antidepressant use were very polymorphic, with about 5% being on continuous use for all 3 years and groups of each 20–30% being treated with: (1) several series or (2) one series or (3) only by one prescription. The share of patients presenting only one prescription (20%) was the same for older and newer antidepressants. Likewise, the rate of shifts from older to newer antidepressants or vice versa was the same (7% vs 6%). The duration of treatment did not differ much between older and newer antidepressants. Relative to the defined daily dose (DDD), the older antidepressants were given in much lower doses (median 0.63 DDD) than the newer antidepressants (median 1.05 DDD). Conclusion: It is concluded that many depressed patients are still not receiving antidepressant treatment and that the claimed better adverse effect profile of the newer antidepressants was not clearly reflected in their use.
    Materialart: Digitale Medien
    Standort Signatur Erwartet Verfügbarkeit
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  • 6
    Digitale Medien
    Digitale Medien
    Springer
    European journal of clinical pharmacology 54 (1998), S. 197-202 
    ISSN: 1432-1041
    Schlagwort(e): Key words Polypharmacy ; Prescription database
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Chemie und Pharmazie , Medizin
    Notizen: Abstract Objective: To analyse the occurrence of multiple drug use (polypharmacy, PP) in the population and to identify individuals particularly prone to PP. Methods: Data were derived from the Odense Pharmacoepidemiological Database (OPED) and covered all subsidised prescriptions during 1994 presented by inhabitants in the county of Funen (n= 466 567). The number of individuals concurrently using two to four drugs (minor PP) and five or more drugs (major PP) was calculated on a random day in 1994. Drugs were classified according to the Anatomical Therapeutical Chemical (ATC) classification index. The main therapeutic class (second level of the ATC code) was used as an indicator for the type of health problem. A stepwise backwards logistic regression was used to identify predictors of major PP. Odds ratios were calculated for different drug classes, and the age and sex of all drug users. Results: On a random day, 8.3% of the population were exposed to minor PP and 1.2% to major PP. The prevalence of PP increased with age, and from the age of 70 years, two thirds of all drug users were PP users. Drug use was 50% more prevalent among women than men, but over the age of 70, the sexes did not differ in the prevalence of major PP. Many different drug combinations were found, and among major PP users (n= 5443), two thirds had their own unique drug regimen, different from all other drug users. Cardiovascular drugs and analgesics were often involved in PP among the elderly, while asthma drugs, psychotropic drugs and anti-ulcer drugs were predominant among young individuals exposed to PP. The odds ratio (OR) for major PP was substantially increased for individuals treated for cardiovascular diseases (OR, 4.5), anaemia (OR, 4.1) and respiratory diseases (OR, 3.6). Conclusions: PP is widespread in the population. Clinicians and organisers who are responsible for quality assurance programmes should intensify their surveillance of the groups most prone to PP (the elderly and those using analgesics or drugs for cardiovascular disease, anaemia, asthma and diabetes).
    Materialart: Digitale Medien
    Standort Signatur Erwartet Verfügbarkeit
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  • 7
    Publikationsdatum: 2016-03-15
    Beschreibung: Author(s): A. M. Hallas, J. Gaudet, N. P. Butch, M. Tachibana, R. S. Freitas, G. M. Luke, C. R. Wiebe, and B. D. Gaulin The ytterbium pyrochlore magnets, Yb 2 B 2 O 7 ( B = Sn , Ti , Ge ) are well described by S eff = 1 / 2 quantum spins decorating a network of corner-sharing tetrahedra and interacting via anisotropic exchange. Structurally, only the nonmagnetic B -site cation, and hence primarily the lattice parameter, changes across … [Phys. Rev. B 93, 100403(R)] Published Mon Mar 14, 2016
    Schlagwort(e): Magnetism
    Print ISSN: 1098-0121
    Digitale ISSN: 1095-3795
    Thema: Physik
    Standort Signatur Erwartet Verfügbarkeit
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  • 8
    Publikationsdatum: 2016-03-08
    Beschreibung: Author(s): A. M. Hallas, J. Gaudet, M. N. Wilson, T. J. Munsie, A. A. Aczel, M. B. Stone, R. S. Freitas, A. M. Arevalo-Lopez, J. P. Attfield, M. Tachibana, C. R. Wiebe, G. M. Luke, and B. D. Gaulin We report neutron scattering and muon spin relaxation measurements ( μ SR ) on the pyrochlore antiferromagnet Yb 2 Ge 2 O 7 . Inelastic neutron scattering was used to probe the transitions between crystal electric field levels, allowing us to determine the eigenvalues and eigenvectors appropriate to the J = 7 2 … [Phys. Rev. B 93, 104405] Published Mon Mar 07, 2016
    Schlagwort(e): Magnetism
    Print ISSN: 1098-0121
    Digitale ISSN: 1095-3795
    Thema: Physik
    Standort Signatur Erwartet Verfügbarkeit
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  • 9
    Publikationsdatum: 2012-11-01
    Beschreibung: Author(s): A. M. Hallas, J. A. M. Paddison, H. J. Silverstein, A. L. Goodwin, J. R. Stewart, A. R. Wildes, J. G. Cheng, J. S. Zhou, J. B. Goodenough, E. S. Choi, G. Ehlers, J. S. Gardner, C. R. Wiebe, and H. D. Zhou The pyrochlore Ho 2 Ge 2 O 7 is a new highly correlated spin ice material. Physical property measurements, including x-ray diffraction, dc susceptibility, and ac susceptibility, confirm that it shares the distinctive characteristics of other known spin ices. Polarized neutron scattering measurements on a... [Phys. Rev. B 86, 134431] Published Wed Oct 31, 2012
    Schlagwort(e): Magnetism
    Print ISSN: 1098-0121
    Digitale ISSN: 1095-3795
    Thema: Physik
    Standort Signatur Erwartet Verfügbarkeit
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  • 10
    Publikationsdatum: 2017-10-26
    Beschreibung: Molecular estimates of phylogenetic relationships rely heavily on multiple sequence alignment construction. There has been little consensus, however, on how to properly address issues pertaining to the alignment of variable regions. Here, we construct alignments from four commonly sequenced molecular markers (16S, 18S, 28S and cytochrome c oxidase subunit I) for the Nudibranchia using three different methodologies: (i) strict mathematical algorithm; (ii) exclusion of variable or divergent regions and (iii) manually curated, and examine how different alignment construction methods can affect phylogenetic signal and phylogenetic estimates for the suborder Doridina. Phylogenetic informativeness (PI) profiles suggest that the molecular markers tested lack the power to resolve relationships at the base of the Doridina, while being more robust at family-level classifications. This supports the lack of consistent resolution between the 19 families within the Doridina across all three alignments. Most of the 19 families were recovered as monophyletic, and instances of non-monophyletic families were consistently recovered between analyses. We conclude that the alignment of variable regions has some effect on phylogenetic estimates of the Doridina, but these effects can vary depending on the size and scope of the phylogenetic query and PI of molecular markers.
    Schlagwort(e): taxonomy and systematics, evolution
    Digitale ISSN: 2054-5703
    Thema: Allgemeine Naturwissenschaft
    Publiziert von Royal Society
    Standort Signatur Erwartet Verfügbarkeit
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