6 research outputs found
Changes in Practice Patterns of Clopidogrel in Combination with Proton Pump Inhibitors after an FDA Safety Communication
<div><p>Objectives</p><p>In 2009, the FDA issued a warning that omeprazoleâa proton pump inhibitor (PPI)âreduces the antithrombotic effect of clopidogrel by almost half when taken concomitantly. This study aims to analyze the impact of the FDA Safety Communications on prescribing clopidogrel together with PPIs.</p><p>Methods</p><p>This retrospective study identified clopidogrel users from the Truven Health Analytics MarketScan Databases (01/2006â12/2012). Rates of clopidogrel-PPI combination therapy were estimated in 6-month intervals for patients with âĽ1 clopidogrel prescription fill, then were analyzed pre- and post-safety communication (11/17/2009). Analyses were also conducted by grouping PPIs into CYP2C19 inhibitors (omeprazole and esomeprazole) and CYP2C19 non-inhibitors (pantoprazole, lansoprazole, dexlansoprazole, and rabeprazole).</p><p>Results</p><p>Overall, 483,074 patients met the selection criteria; of these, 157,248 used a clopidogrel-PPI combination. On average, 30.5% of patients in the pre- and 19.9% in the post-communication period used a clopidogrel-PPI combination therapy. Among clopidogrel users, the probability of using clopidogrel-PPI combinations fell by over 40% in the post-communication period (OR = 0.57; <i>p</i><0.001); the proportion of patients using esomeprazole fell from 12.9% to 5.3%, and the proportion using omeprazole fell from 10.1% to 6.3%. Among combination therapy users, the probability of patients using a combination with a CYP2C19 inhibitor decreased by 53% (OR = 0.47; <i>p</i><0.001); however, 31.5% of patients were still prescribed a clopidogrel-PPI combination therapy. Trends were similar for all and newly treated patients, regardless of clopidogrel indication and physician specialty.</p><p>Conclusions</p><p>The FDA Safety Communication resulted in a reduction in the number of patients undergoing combination therapy; however approximately one-third of patients still used combination therapy post-communication.</p></div
Systematic literature review of the impact of endocrine monotherapy and in combination with targeted therapy on quality of life of postmenopausal women with HR+/HER2- advanced breast cancer
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Comparison of Characteristics of Benign Prostatic Hyperplasia (BPH) Patients Treated with Finasteride and Alpha Blocker Combination Therapy versus Alpha Blocker Monotherapy in China: An Analysis of Electronic Medical Record Data
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The full text of this article can be found <a href="https://link.springer.com/article/10.1007/s12325-018-0748-3"><b>here</b>.</a><br>
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enhanced digital features for your article then please contact <u>[email protected]</u>.<br>
<br>
The journal offers a range of additional features designed to increase
visibility and readership. All features will be thoroughly peer reviewed to ensure the content is of the
highest scientific standard and all features are marked as âpeer reviewedâ to
ensure readers are aware that the content has been reviewed to the same level
as the articles they are being presented alongside. Moreover, all sponsorship
and disclosure information is included to provide complete transparency and
adherence to good publication practices. This ensures that however the content
is reached the reader has a full understanding of its origin. No fees are
charged for hosting additional open access content.<br>
<br>
Other enhanced features include, but are
not limited to:<br>
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Among clopidogrel users, proportion of patients using clopidogrel-PPI combination therapy over time.
<p>Notes: <sup>a</sup> Total number of patient-semesters pre-safety communication = 272,113; post-safety communication = 1,593,625. <sup>b</sup> Percentages add up to more than 100% because more than 1 PPI could be prescribed in the same semester. <sup>c</sup> * indicates that the results are significant at the 5% level (two-sided alpha). <sup>d</sup> Protonix was first released as a generic, pantoprazole, in August 2007. Abbreviations: CI, confidence interval; PPI, proton pump inhibitor; S, semester.</p
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3D Printed âEarableâ Smart Devices for Real-Time Detection of Core Body Temperature
Real-time
detection of basic physiological parameters such as blood
pressure and heart rate is an important target in wearable smart devices
for healthcare. Among these, the core body temperature is one of the
most important basic medical indicators of fever, insomnia, fatigue,
metabolic functionality, and depression. However, traditional wearable
temperature sensors are based upon the measurement of skin temperature,
which can vary dramatically from the true core body temperature. Here,
we demonstrate a three-dimensional (3D) printed wearable âearableâ
smart device that is designed to be worn on the ear to track core
body temperature from the tympanic membrane (i.e., ear drum) based
on an infrared sensor. The device is fully integrated with data processing
circuits and a wireless module for standalone functionality. Using
this smart earable device, we demonstrate that the core body temperature
can be accurately monitored regardless of the environment and activity
of the user. In addition, a microphone and actuator are also integrated
so that the device can also function as a bone conduction hearing
aid. Using 3D printing as the fabrication method enables the device
to be customized for the wearer for more personalized healthcare.
This smart device provides an important advance in realizing personalized
health care by enabling real-time monitoring of one of the most important
medical parameters, core body temperature, employed in preliminary
medical screening tests
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Wearable Microsensor Array for Multiplexed Heavy Metal Monitoring of Body Fluids
A flexible
and wearable microsensor array is described for simultaneous
multiplexed monitoring of heavy metals in human body fluids. Zn, Cd,
Pb, Cu, and Hg ions are chosen as target analytes for detection via
electrochemical square wave anodic stripping voltammetry (SWASV) on
Au and Bi microelectrodes. The oxidation peaks of these metals are
calibrated and compensated by incorporating a skin temperature sensor.
High selectivity, repeatability, and flexibility of the sensor arrays
are presented. Human sweat and urine samples are collected for heavy
metal analysis, and measured results from the microsensors are validated
through inductively coupled plasma mass spectrometry (ICP-MS). Real-time
on-body evaluation of heavy metal (e.g., zinc and copper) levels in
sweat of human subjects by cycling is performed to examine the change
in concentrations with time. This platform is anticipated to provide
insightful information about an individualâs health state such
as heavy metal exposure and aid the related clinical investigations