55 research outputs found
Thromboembolic and neurologic sequelae of discontinuation of an antihyperlipidemic drug during ongoing warfarin therapy
Warfarin and antihyperlipidemics are commonly co-prescribed. Some antihyperlipidemics may inhibit warfarin deactivation via the hepatic cytochrome P450 system. Therefore, antihyperlipidemic discontinuation has been hypothesized to result in underanticoagulation, as warfarin metabolism is no longer inhibited. We quantified the risk of venous thromboembolism (VTE) and ischemic stroke (IS) due to statin and fibrate discontinuation in warfarin users, in which warfarin was initially dose-titrated during ongoing antihyperlipidemic therapy. Using 1999-2011 United States Medicaid claims among 69 million beneficiaries, we conducted a set of bidirectional self-controlled case series studies-one for each antihyperlipidemic. Outcomes were hospital admissions for VTE/IS. The risk segment was a maximum of 90 days immediately following antihyperlipidemic discontinuation, the exposure of interest. Time-varying confounders were included in conditional Poisson models. We identified 629 study eligible-persons with at least one outcome. Adjusted incidence rate ratios (IRRs) for all antihyperlipidemics studied were consistent with the null, and ranged from 0.21 (0.02, 2.82) for rosuvastatin to 2.16 (0.06, 75.0) for gemfibrozil. Despite using an underlying dataset of millions of persons, we had little precision in estimating IRRs for VTE/IS among warfarin-treated persons discontinuing individual antihyperlipidemics. Further research should investigate whether discontinuation of gemfibrozil in warfarin users results in serious underanticoagulation
Severe hypoglycemia in users of sulfonylurea antidiabetic agents and antihyperlipidemics
Drug-drug interactions causing severe hypoglycemia due to antidiabetic drugs is a major clinical and public health problem. We assessed whether sulfonylurea use with a statin or fibrate was associated with severe hypoglycemia. We conducted cohort studies of users of glyburide, glipizide, and glimepiride plus a statin or fibrate within a Medicaid population. The outcome was a validated, diagnosis-based algorithm for severe hypoglycemia. Among 592,872 persons newly exposed to a sulfonylurea+antihyperlipidemic, the incidence of severe hypoglycemia was 5.8/100 person-years. Adjusted hazard ratios (HRs) for sulfonylurea+statins were consistent with no association. Most overall HRs for sulfonylurea+fibrate were elevated, with sulfonylurea-specific adjusted HRs as large as 1.50 (95% confidence interval (CI): 1.24-1.81) for glyburide+gemfibrozil, 1.37 (95% CI: 1.11-1.69) for glipizide+gemfibrozil, and 1.63 (95% CI: 1.29-2.06) for glimepiride+fenofibrate. Concomitant therapy with a sulfonylurea and fibrate is associated with an often delayed increased rate of severe hypoglycemia
Comparative risk of severe hypoglycemia among concomitant users of thiazolidinedione antidiabetic agents and antihyperlipidemics
We conducted high-dimensional propensity score-adjusted cohort studies to examine whether thiazolidinedione use with a statin or fibrate was associated with an increased risk of severe hypoglycemia. We found that concomitant therapy with a thiazolidinedione+fibrate was associated with a generally delayed increased risk of severe hypoglycemia
Antidepressant-Warfarin Interaction and Associated Gastrointestinal Bleeding Risk in a Case-Control Study
Bleeding is the most common and worrisome adverse effect of warfarin therapy. One of the factors that might increase bleeding risk is initiation of interacting drugs that potentiate warfarin. We sought to evaluate whether initiation of an antidepressant increases the risk of hospitalization for gastrointestinal bleeding in warfarin users.Medicaid claims data (1999-2005) were used to perform an observational case-control study nested within person-time exposed to warfarin in those β₯18 years. In total, 430,455 warfarin users contributed 407,370 person-years of warfarin use. The incidence rate of hospitalization for GI bleeding among warfarin users was 4.48 per 100 person-years (95% CI, 4.42-4.55). Each gastrointestinal bleeding cases was matched to 50 controls based on index date and state. Warfarin users had an increased odds ratio of gastrointestinal bleeding upon initiation of citalopram (ORβ=β1.73 [95% CI, 1.25-2.38]), fluoxetine (ORβ=β1.63 [95% CI, 1.11-2.38]), paroxetine (ORβ=β1.64 [95% CI, 1.27-2.12]), amitriptyline (ORβ=β1.47 [95% CI, 1.02-2.11]). Also mirtazapine, which is not believed to interact with warfarin, increased the risk of GI bleeding (ORβ=β1.75 [95% CI, 1.30-2.35]).Warfarin users who initiated citalopram, fluoxetine, paroxetine, amitriptyline, or mirtazapine had an increased risk of hospitalization for gastrointestinal bleeding. However, the elevated risk with mirtazapine suggests that a drug-drug interaction may not have been responsible for all of the observed increased risk
Biologization of lifestyle of the inhabitant in the ideological tradition of American horror film
ΠΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ. ΠΠ΅ΡΠ΅ΠΎΡΠΌΡΡΠ»Π΅Π½ΠΈΠ΅ ΠΊΠ»Π°ΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠΎΠ»ΠΈΡΠΈΡΠ΅ΡΠΊΠΈΡ
Π΄ΠΎΠΌΠΈΠ½Π°Π½Ρ Π°ΠΊΡΡΠ°Π»ΠΈΠ·ΠΈΡΡΠ΅Ρ ΡΠΌΡΡΠ»Ρ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΡ Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²Π°, ΠΎΠ±ΡΠ΅ΡΡΠ²Π° ΠΈ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄Π°. ΠΡΠΊΠ°Π· ΠΎΡ ΠΏΡΡΠΌΠΎΠ³ΠΎ ΡΠΈΠ·ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΡΠΈΠ½ΡΠΆΠ΄Π΅Π½ΠΈΡ ΠΏΠΎΠ±ΡΠΆΠ΄Π°Π΅Ρ ΠΊ ΠΏΠΎΠΈΡΠΊΡ ΠΈΠ΄Π΅ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΠΎΠ² ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ. ΠΠΎΠ»Π»ΠΈΠ²ΡΠ΄ ΡΡΠ°Π½ΠΎΠ²ΠΈΡΡΡ ΠΌΠ΅Π΄ΠΈΠΉΠ½ΡΠΌ ΡΡΠΏΠΎΡΠΎΠΌ Π±ΠΈΠΎΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΡΠ°Π½ΡΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΠΏΠΎΠ»ΠΈΡΠΈΠΊΠΈ, Π° ΡΠΈΠ»ΡΠΌ ΡΠΆΠ°ΡΠΎΠ² ΠΏΡΠ΅Π²ΡΠ°ΡΠ°Π΅ΡΡΡ Π² Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΡ ΠΌΠΎΠ΄Π΅Π»Ρ Π²ΠΈΠ·ΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΡΡΠΈΡ
ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ. Π¦Π΅Π»Ρ ΡΠ°Π±ΠΎΡΡ - ΠΏΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°ΡΡ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΡΡΠ°ΡΠ΅Π³ΠΈΠΈ Π±ΠΈΠΎΡΠΈΠ·Π°ΡΠΈΠΈ ΠΎΠ±ΡΠ²Π°ΡΠ΅Π»ΡΡΠΊΠΎΠΉ ΠΏΠΎΠ²ΡΠ΅Π΄Π½Π΅Π²Π½ΠΎΡΡΠΈ Π² ΠΏΡΠΎΡΡΡΠ°Π½ΡΡΠ²Π΅ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΠΌΠ°ΡΡΠΎΠ²ΠΎΠΉ ΠΊΡΠ»ΡΡΡΡΡ ΠΏΠΎΡΡΠ΅Π΄ΡΡΠ²ΠΎΠΌ ΠΈΠ΄Π΅ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΊΡΠΏΠ°Π½ΡΠΈΠΈ ΡΡΠ°Π΄ΠΈΡΠΈΠΈ Π°ΠΌΠ΅ΡΠΈΠΊΠ°Π½ΡΠΊΠΈΡ
ΡΠΈΠ»ΡΠΌΠΎΠ² ΡΠΆΠ°ΡΠΎΠ². ΠΠ΅ΡΠΎΠ΄Ρ: ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡ ΠΊΠΎΠΌΠΏΠ°ΡΠ°ΡΠΈΠ²ΠΈΡΡΡΠΊΠΈΡ
, ΡΠ΅ΠΌΠΈΠΎΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈ ΠΏΡΠΈΡ
ΠΎΠ°Π½Π°Π»ΠΈΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ², Π°Π½Π°Π»ΠΈΠ·ΠΈΡΡΡΡΠΈΡ
Ρ
ΡΠ΄ΠΎΠΆΠ΅ΡΡΠ²Π΅Π½Π½ΡΠΉ ΠΎΠΏΡΡ ΠΊΠΈΠ½Π΅ΠΌΠ°ΡΠΎΠ³ΡΠ°ΡΠ° ΠΈ Π΅Π³ΠΎ ΠΌΠΈΡΠΎΠ»ΠΎΠ³ΠΈΡ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠΎΠ»Π»ΠΈΠ²ΡΠ΄ΡΠΊΠΈΠ΅ ΡΠΈΠ»ΡΠΌΡ ΡΠΆΠ°ΡΠΎΠ² Π²ΡΡΡΡΠΏΠ°ΡΡ Π°ΠΏΡΠΎΠ±ΠΈΡΠΎΠ²Π°Π½Π½ΡΠΌ ΡΡΠ΅Π΄ΡΡΠ²ΠΎΠΌ ΡΡΠ±Π»ΠΈΠΌΠ°ΡΠΈΠΈ, Π΄Π΅ΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΠΈ ΠΏΠΎΡΡΠ΅Π±ΠΈΡΠ΅Π»ΡΡΠΊΠΎΠ³ΠΎ Π·Π°ΠΌΠ΅ΡΠ΅Π½ΠΈΡ ΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ΄ΡΠ° Π»ΡΠ±ΡΡ
ΠΊΠΎΠ½ΠΊΡΡΠΈΡΡΡΡΠΈΡ
ΡΠΎΡΠΈΠΎΠΊΡΠ»ΡΡΡΡΠ½ΡΡ
ΡΡΠ°Π΄ΠΈΡΠΈΠΉ. ΠΠΌΠ΅ΡΠΈΠΊΠ°Π½ΡΠΊΠ°Ρ Π²ΠΈΠ·ΡΠ°Π»ΡΠ½Π°Ρ Ρ
ΠΎΡΡΠΎΡ-ΠΊΡΠ»ΡΡΡΡΠ° ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎ Π²ΡΡΠ΅ΡΠ½ΡΠ΅Ρ ΠΏΠΎΡΠ΅Π½ΡΠΈΠ°Π» Π°Π³ΡΠ΅ΡΡΠΈΠΈ Π²Π½ΡΡΡΠΈ ΡΡΡΠ°Π½Ρ, ΠΏΡΠ΅Π²ΡΠ°ΡΠ°ΡΡΡ Π² ΠΏΡΠΈΠ±ΡΠ»ΡΠ½ΡΡ ΠΏΡΠΎΠΏΠ°Π³Π°Π½Π΄ΠΈΡΡΡΠΊΡΡ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΡ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΈ ΠΏΡΠΎΠ΄Π²ΠΈΠΆΠ΅Π½ΠΈΡ ΠΏΠ°ΡΠΎΠΌΠΈΡΠ°. ΠΠ½ Π²ΠΎΡΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΠΈΡ ΠΏΡΠ΅ΠΈΠΌΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ ΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΌΠΎΡΠΈΠ²Ρ ΠΊΠΎΠΌΠΌΡΠ½ΠΈΠΊΠ°ΡΠΈΠΈ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄Π° Ρ ΠΎΠΊΡΡΠΆΠ°ΡΡΠΈΠΌ ΠΌΠΈΡΠΎΠΌ, ΠΏΡΠΎΠΏΠ°Π³Π°Π½Π΄ΠΈΡΡΠ΅Ρ ΠΈΠ΄Π΅ΠΉΠ½ΡΡ Π΄ΠΎΠΌΠΈΠ½Π°Π½ΡΡ Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈ ΡΠΈΠ»ΡΠ½ΠΎΠΉ ΠΎΡΠΎΠ±ΠΈ ΠΊΠ°ΠΊ ΡΡΠ½Π΄Π°ΠΌΠ΅Π½Ρ ΡΠΎΡΠΈΠΎΠΊΡΠ»ΡΡΡΡΠ½ΠΎΠΉ ΠΊΠΎΠΌΠΌΡΠ½ΠΈΠΊΠ°ΡΠΈΠΈ ΠΏΠΎΡΡΡΠ΅Π»ΠΎΠ²Π΅ΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠΈΠΏΠ°. ΠΠΌΠ΅ΡΠΈΠΊΠ°Π½ΡΠΊΠΈΠΉ ΡΠΈΠ»ΡΠΌ ΡΠΆΠ°ΡΠΎΠ² ΠΎΠ±Π½ΡΠ»ΡΠ΅Ρ ΡΠΊΠ·ΠΈΡΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½ΡΠΉ ΠΎΠΏΡΡ ΡΠ΅Π»ΠΎΠ²Π΅ΡΠ΅ΡΡΠ²Π° ΠΈ Π½Π°Ρ
ΠΎΠ΄ΠΈΡΡΡ Π² Π°Π²Π°Π½Π³Π°ΡΠ΄Π΅ ΡΠ΅Π²ΠΈΠ·ΠΈΠΈ ΡΡΠ°Π΄ΠΈΡΠΈΠΉ Π½Π΅ ΡΠΎΠ»ΡΠΊΠΎ Π΅Π²ΡΠΎΠΏΠ΅ΠΉΡΠΊΠΎΠΉ, Π½ΠΎ ΠΈ ΠΌΠΈΡΠΎΠ²ΠΎΠΉ ΠΊΡΠ»ΡΡΡΡΡ. ΠΡΠ²ΠΎΠ΄Ρ. ΠΠΎΠ»Π»ΠΈΠ²ΡΠ΄ΡΠΊΠ°Ρ ΠΌΠΎΠ΄Π΅Π»Ρ Π±ΠΈΠΎΠ²Π»Π°ΡΡΠΈ ΡΠ°Π·ΡΡΡΠ°Π΅Ρ ΠΊΡΠ»ΡΡΡΡΠ½ΡΠ΅ ΡΡΠ°Π΄ΠΈΡΠΈΠΈ ΠΈ ΠΈΡΡΠΎΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΎΠΏΡΡ, ΠΊΠΎΠ½ΡΡΡΡΠΈΡΡΠ΅Ρ ΠΈ ΠΏΡΠΎΠ΄Π²ΠΈΠ³Π°Π΅Ρ Π°Π½ΡΡΠΎΠΏΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΡΡ ΠΈ ΡΠΎΡΠΈΠΎΠΊΡΠ»ΡΡΡΡΠ½ΡΡ ΡΠΈΠ½Π³ΡΠ»ΡΡΠ½ΠΎΡΡΡ ΡΠ΅Π»ΠΎΠ²Π΅ΡΠ΅ΡΠΊΠΎΠΉ ΠΎΡΠΎΠ±ΠΈ, ΠΏΠΎΠ½ΠΈΠΌΠ°Π΅ΠΌΡΡ ΠΊΠ°ΠΊ Π΅Π΅ Π΅Π΄ΠΈΠ½ΠΈΡΠ½ΠΎΡΡΡ Π² ΠΏΡΠΎΡΠΈΠ²ΠΎΡΡΠΎΡΠ½ΠΈΠΈ ΠΎΡΡΡΠΆΠ΄Π΅Π½Π½ΠΎΠΌΡ ΡΠΎΡΠΈΡΠΌΡ, Π° ΠΏΠ΅ΡΠΈΠΎΠ΄ΠΈΡΠ΅ΡΠΊΠΈ Π½Π°ΠΊΠ°ΠΏΠ»ΠΈΠ²Π°ΡΡΠ°ΡΡΡ Β«ΠΈΠ½ΡΠΎΠΊΡΠΈΠΊΠ°ΡΠΈΡΒ» Π³ΠΎΠ»Π»ΠΈΠ²ΡΠ΄ΡΠΊΠΈΠΌ ΡΠΆΠ°ΡΠΎΠΌ ΠΊΠΎΠΌΠΏΠ΅Π½ΡΠΈΡΡΠ΅ΡΡΡ ΠΈΠ»Π»ΡΠ·ΠΈΠ΅ΠΉ Π°ΠΌΠ΅ΡΠΈΠΊΠ°Π½ΡΠΊΠΎΠΉ Π³Π΅ΠΎΠΏΠΎΠ»ΠΈΡΠΈΡΠ΅ΡΠΊΠΎΠΉ Π³Π΅Π³Π΅ΠΌΠΎΠ½ΠΈΠΈ.Relevance. Reinterpretation of classical political dominants actualizes the meanings of interaction between the state, society and individual. The rejection of direct physical coercion encourages the search for ideological mechanisms of social control. Hollywood is becoming a media mouthpiece for the biotic transformation of politics, and horror film is becoming the most effective model for visualizing these technologies. The aim. The article analyzes the strategies of biotization of everyday life in the space of modern mass culture through the ideological expansion of American horror films. Research. Domestic and foreign authors state the transformation of classical ideology into latent forms of control at the level of official and everyday practices. Methods. The article uses a complex of comparative, semiotic and psychoanalytic methods analyzing the artistic experience of cinema and its mythology. Results. Hollywood horror films are a proven means of sublimation, deformation and consumer substitution of the mental core of any competing socio-cultural traditions. American visual horror-culture effectively displaces the potential of aggression within the country, turning into a lucrative propaganda technology for formation and promotion of pathomif. It reproduces mainly physiological motives of communication of the individual with the world, promotes the ideological dominant of the biologically strong individual as the foundation of socio-cultural communication of the posthuman type. American horror film nullifies the existential experience of mankind; it is at the forefront of the revision of the traditions of not only European but also world culture. Findings. The Hollywood model of bio-power destroys cultural traditions and historical experience, constructs anthropological and socio-cultural singularity of the human individual, and periodically accumulating Β«intoxicationΒ» with Hollywood horror is compensated by the illusion of American geopolitical hegemony
T1319 Does Duration or Dose of Corticosteroid use in Patients With Inflammatory Bowel Disease Predict Infectious Complications?
Sa1123 The Risk of Colorectal Cancer Following a Negative Colonoscopy: A Comparison of Different Follow-up Colonoscopy Intervals
Endoscopic Resection with Ligation Using a Multi-Band Mucosectomy System in Barrett's Esophagus with High-Grade Dysplasia and Intramucosal Carcinoma
Background: Endoscopic therapy for early neoplasia in
Barrett's esophagus (BE) is evolving. Endoscopic resection has an
increasing role. We wanted to evaluate the safety and efficacy of multi-band
ligation/resection [ER-L] without pre-injection in BE with high-grade dysplasia
[HGD] and intramucosal carcinoma [IMCA]
- β¦