Exposure to potentially inappropriate medications in Brazilian elderly outpatients with metabolic diseases

ABSTRACT Management of pharmacotherapy in elderly with metabolic diseases is challenging and potentially inappropriate medications (PIMs) are risk factors for drug interactions and adverse events. The exposure to PIMs in elderly outpatients with metabolic diseases and its relationship with polypharmacy and other variables was investigated. PIMs prescribed to 207 elderly patients (aged 60 to 96 years) with metabolic diseases who attended a University Hospital of Sao Paulo city, Brazil, from April/2010 to January/2011, were evaluated. PIMs were detected using both 2003 Beers and 2008 STOPP criteria. The association between PIMs and age, gender and polypharmacy was also examined. 2008 STOPP criteria detected more PIMs (44.4 %) than 2003 Beers criteria (16.0%, p<0.001). Beers detected mainly PIMs antihypertensive (clonidine, 20.0%; doxazosin, 10.0%) and antidepressant (fluoxetine, 15.0%; amitriptyline, 10.0%) PIMs. Medicines used for cardiovascular (aspirin, 53.7%) and endocrine system (glibenclamide, 21.3%) were PIMs more frequently detected by 2008 STOPP. Unlike age and gender, polypharmacy increased the risk of PIMs by both 2003 Beers (OR: 4.0, CI95%: 1.2-13.8, p<0.031) and 2008 STOPP (OR: 6.8, CI95%: 3.0-15.3, p<0.001). Beers and STOPP criteria are important tools to evaluate the exposure to PIMs, which is strongly associated with polypharmacy in elderly outpatients with metabolic diseases

Current all-ceramic systems in dentistry: a review

This article describes the ceramic systems and processing techniques available today in dentistry. It aims to help clinicians understand the advantages and disadvantages of a myriad of ceramic materials and technique options. The microstructural components, materials\u27 properties, indications, and names of products are discussed to help clarify their use. Key topics will include ceramics, particle-filled glasses, polycrystalline ceramics, CAD/CAM, and adhesive cementation

Mercury concentration in the milk of mothers living near the southern coast of the Caspian Sea during different stages of lactation period

The aim of this study was to determine mercury levels and changes during lactation in colostrum, transitional milk, and mature milk (1 month and 2 months post partum). The mercury mean concentration in milk samples collected from 18 women was 90 ?? 20 and 100 ?? 30 ng L-1 for colostrum and transitional milk, respectively. Also, mean concentration of 160 ?? 70 and 140 ?? 50 ng L-1 for mature milk 1 month and up to 2 months post partum were found. The concentration of mercury did not decline during the lactation period. Mercury daily intake was estimated when the infants were fed human milk only. The intakes ranged from 0.0 to 80 and from 0.0 to 70 ng kg-1 body weight day-1 for colostrum and transitional milk, respectively. For mature milk at the first month and up to 2 months the intakes were estimated from 1 to 200 and from 0.0 to 270 ng kg-1 body weight day-1. Significant difference was found between mothers without amalgam-filled teeth and mothers with one to five amalgam-filled teeth. Fruit and vegetable consumption showed negative correlation with the mercury concentration in human milk.close0