21 research outputs found
Medication use in pregnancy: a cross-sectional, multinational web-based study
Objectives: Intercountry comparability between studies on medication use in pregnancy is difficult due to dissimilarities in study design and methodology. his study aimed to examine patterns and factors associated with medications use in pregnancy from a multinational perspective, with emphasis on type of medication utilised and indication for use. Design: Cross-sectional, web-based study performed within the period from 1 October 2011 to 29 February 2012. Uniform collection of drug utilisation data was performed via an anonymous online questionnaire. Setting: Multinational study in Europe (Western, Northern and Eastern), North and South America and Australia. Participants: Pregnant women and new mothers with children less than 1 year of age. Primary and secondary outcome measures: Prevalence of and factors associated with medication use for acute/short-term illnesses, chronic/long-term disorders and over-the-counter (OTC) medication use. Results: The study population included 9459 women, of which 81.2% reported use of at least one medication (prescribed or OTC) during pregnancy. Overall, OTC medication use occurred in 66.9% of the pregnancies, whereas 68.4% and 17% of women reported use of at least one medication for treatment of ute/short-term illnesses and chronic/long-term disorders, respectively. The extent of self-reported medicated illnesses and types of medication used by indication varied across regions, especially in relation to urinary tract infections, depression or OTC nasal sprays. Women with higher age or lower educational level, housewives or women with an unplanned pregnancy were those most often reporting use of medication for chronic/long-term disorders. Immigrant women in Western (adjusted OR (aOR): 0.55, 95% CI 0.34 to 0.87) and Northern Europe (aOR: 0.50, 95% CI 0.31 to 0.83) were less likely to report use of medication for chronic/long-term disorders during pregnancy than nonimmigrants. Conclusions: In this study, the majority of women in Europe, North America, South America and Australia used at least one medication during pregnancy. There was a substantial inter-region variability in the types of medication used
Womenâs beliefs about medicines and adherence to pharmacotherapy in pregnancy: Opportunities for community pharmacists?
Background During pregnancy women might weigh benefits of treatment against potential risks to the unborn child. However, non-adherence to necessary treatment can adversely affect both mother and child. To optimize pregnant womenâs beliefs and medication adherence, community pharmacists are ideally positioned to play an important role in primary care. Objective This narrative review aimed to summarize the evidence on 1) pregnant womenâs beliefs, 2) medication adherence in pregnancy, and 3) community pharmacistsâ counselling during pregnancy. Method Three search strategies were used in Medline and Embase to find original studies evaluating womenâs beliefs, medication adherence and community pharmacistsâ counselling during pregnancy. All original descriptive and analytic epidemiological studies performed in Europe, North America and Australia, written in English and published from 2000 onwards were included. Results We included 14 studies reporting on womenâs beliefs, 11 studies on medication adherence and 9 on community pharmacistsâ counselling during pregnancy. Women are more reluctant to use medicines during pregnancy and tend to overestimate the teratogenic risk of medicines. Risk perception varies with type of medicine, level of health literacy, education level and occupation. Furthermore, low medication adherence during pregnancy is common. Finally, limited evidence showed current community pharmacistsâ counselling is insufficient. Barriers hindering pharmacists are insufficient knowledge and limited access to reliable information. Conclusion Concerns about medication use and non-adherence are widespread among pregnant women. Community pharmacistsâ counselling during pregnancy is insufficient. Further education, training and research are required to support community pharmacists in fulfilling all the opportunities they have when counselling pregnant women
Digital hypoperfusion ischemic syndrome in the patients with transposition of the basilic vein
Transposition veins, in some cases when there is no adequate superficial veins, preferred is model of the vascular access. This approach may be acceptable version vascular access where is not possible to create other shapes. But basilic vein transposition is time consuming and technically challenging procedure with significant perioperative morbidity. Complication rate for basilic vein transposition remains high at 47-71%. We report a patient who underwent transposition basilic vein, and its anastomosis with radial artery, in which developed the digital hypoperfusion ischemic syndrome
The risk for nonpsychotic postpartum mood and anxiety disorders during the COVID-19 pandemic
A Cost-Effectiveness Analysis of Different Types of Labor for Singleton Pregnancy â Real Life Data
Non additive measures for Group Multi AttributeDecision Models
This paper extends the Choquet integral, widely used
in multi-attribute decision problems, to the non monotone case in the context of Group Decision Theory. Even if not so often, preference
structures which violate the monotonicity axiom can be observed in
real applications. Our aim is twofold. First, we propose the Choquet
integral with non monotone non additive measure. Then, we apply
the Choquet integral in the context of multi person decision problem,
a typical framework of many real world applications, for which the
Choquet integral was rarely proposed. Thus in our model this aggregation
function is applied twice, both in the cases with possible
negative interactions. For this reason, our proposal can be defined
as two-step signed Choquet integral