236 research outputs found

    PHP8 ADVERSE DRUG REACTIONS IN GERMANY: COST ANALYSIS OF INTERNAL MEDICINE HOSPITALIZATIONS

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    La irrupción de las nuevas tecnologías en la vida cotidiana ha supuesto una enorme revolución a la hora de determinar tanto las relaciones entre los sujetos como de comprender e interpretar la realidad. Por ello, la alfabetización mediática se plantea hoy como una disciplina indispensable en los sistemas educativos de todo el mundo. Este artículo recoge los resultados obtenidos en un experimento con estudiantes de educación secundaria. El objetivo es observar hasta qué punto la alfabetización mediática puede resultar de utilidad a la hora de potenciar las competencias interpretativas de los estudiantes. La muestra está formada por alumnos de 14-15 años, pertenecientes al curso Décimo de tres centros escolares de Guayaquil. La variable independiente es conformada por cinco spots. Los resultados subrayan que, al margen del contexto socioeconómico, los alumnos instruidos mediáticamente muestran una capacidad interpretativa y decodificadora superior a aquellos otros que no lo fueron.  &nbsp

    Costs of Adverse Drug Events in German Hospitals—A Microcosting Study

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    AbstractObjectiveIn Germany, only limited data are available to quantify the attributable resource utilization associated with adverse drug events (ADEs). The aim of this study was twofold: first, to calculate the direct treatment costs associated with ADEs leading to hospitalization and, second, to derive the excess costs and extra hospital days attributable to ADEs of inpatient treatments in selected German hospitals.MethodsThis was a retrospective and medical record–based study performed from the hospitals' perspective based on administrative accounting data from three hospitals (49,462 patients) in Germany. Total treatment costs (“analysis 1”) and excess costs (i.e., incremental resource utilization) between patients suffering from an ADE and those without ADEs were calculated by means of a propensity score–based matching algorithm (“analysis 2”).ResultsMean treatment costs (“analysis 1”) of ADEs leading to hospitalization (n = 564) were €1,978 ± 2,036 (range €191–18,147; median €1,446; €843–2,480 [Q1–Q3]). In analysis 2, the mean costs of inpatients suffering from an ADE (n = 1,891) as a concomitant disease or complication (€5,113 ± 10,059; range €179–246,288; median €2,701; €1,636–5,111 [Q1–Q3]) were significantly higher (€970; P < 0.0001) than those of non-ADE inpatients (€4,143 ± 6,968; range €154–148,479; median €2,387; €1,432–4,701 [Q1–Q3]). Mean inpatient length of stay of ADE patients (12.7 ± 17.2 days) and non-ADE patients (9.8 ± 11.6 days) differed by 2.9 days (P < 0.0001). A nationwide extrapolation resulted in annual total treatment costs of €1.058 billion.ConclusionsThis is one of the first administrative data–based analyses calculating the economic consequences of ADEs in Germany. Further efforts are necessary to improve pharmacotherapy and relieve health care payers of preventable treatment costs

    High temperature ceramics for automobile gas turbines. Part 2: Development of ceramic components

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    The development of ceramic components for automobile gas turbine engines is described with attention given to the steady and unsteady thermal conditions the ceramics will experience, and their anti-corrosion and strain-resistant properties. The ceramics considered for use in the automobile turbines include hot-pressed Si3N4, reaction-sintered, isostatically pressed Si3N4, hot-pressed SiC, reaction-bonded SiC, and glass ceramics. Attention is given to the stress analysis of ceramic structures and the state of the art of ceramic structural technology is reviewed, emphasizing the use of ceramics for combustion chambers and ceramic shrouded turbomachinery (a fully ceramic impeller)

    PHM14 PATIENTS WITH MYELODYSPLASTIC SYNDROMES (MDS) CHALLENGE TRANSFUSION RESOURCES NOW AND IN THE FUTURE

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    PHP1 ECONOMIC ANALYSIS OF THE BAVARIAN BLOOD AND PLASMA MARKET: LESSONS FOR THE FUTURE

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    Prioritisation of Adverse Drug Events Leading to Hospital Admission and Occurring during Hospitalisation: A RAND Survey

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    (1) Adverse drug events (ADEs) are a common cause of emergency department visits and occur frequently during hospitalisation. Instruments that facilitate the detection of the most relevant ADEs could lead to a more targeted and efficient use of limited resources in research and practice. (2) We conducted two consensus processes based on the RAND/UCLA appropriateness method, in order to prioritise ADEs leading to hospital admission (panel 1) and occurring during hospital stay (panel 2) for inclusion in future ADE measurement instruments. In each panel, the experts were asked to assess the overall importance of each ADE on a four-point Likert scale (1 = not important to 4 = very important). ADEs with a median rating of >= 3 without disagreement were defined as prioritised. (3) The 13 experts in panel 1 prioritised 38 out of 65 ADEs, while the 12 experts in panel 2 prioritised 34 out of 63 ADEs. The highest rated events were acute kidney injury and hypoglycaemia (both panels), as well as Stevens-Johnson syndrome in panel 1 and rhabdomyolysis in panel 2. (4) The survey led to a set of ADEs for which there was consensus that they were of particular importance as presentations of acute medication-related harm, thereby providing a focus for further medication safety research and clinical practice

    Antiepileptic Drugs and Suicide: A Systematic Review of Adverse Effects

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    &lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Since the FDA (Food and Drug Administration) report on antiepileptic drugs (AEDs) and suicide risk was released (2008), several studies have been published on this controversial relationship. This systematic review (SR) gives an updated approach to this health issue. &lt;b&gt;&lt;i&gt;Summary:&lt;/i&gt;&lt;/b&gt; We searched 6 databases. We ultimately included 11 publications: 4 cohort studies, 1 case-crossover study, 2 community case-control studies, and 4 SRs. Overall, 1 SR described studies already included; 3 studies reported a 2- to 4-fold overall increase in risk; 1 study reported an increased risk of suicide among epilepsy patients on AEDs with high risk of depression; 1study showed a protective effect among epilepsy patients; 2 studies were conducted with patients with bipolar disorder (1 showed a protective effect, whereas the other showed a 3-fold increase in risk of suicide), and the other 3 studies reported results for single AEDs. Several biases affected the published results. &lt;b&gt;&lt;i&gt;Key Messages:&lt;/i&gt;&lt;/b&gt; There is no clear evidence of an association between the use of AEDs and an increased risk of suicide because of the heterogeneity in the studies at the clinical and methodological level. A future study should cover all indications for use, retrieve information from a healthcare database, and include a defined set of covariates to avoid bias.</jats:p

    Adherence to Direct Oral Anticoagulants in Patients With Non-Valvular Atrial Fibrillation: A Cross-National Comparison in Six European Countries (2008–2015)

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    Anticoagulants; Europe; Non valvular atrial fibrillationAnticoagulants; Europa; Fibril·lació auricular no valvularAnticoagulantes; Europa; Fibrilación auricular no valvularAims: To describe and compare the adherence to different direct oral anticoagulants (DOACs) in eight European databases representing six countries. Methods: Longitudinal drug utilization study of new users (≥18 years) of DOACs (dabigatran, rivaroxaban, apixaban) with a diagnosis of non-valvular atrial fibrillation (2008–2015). Adherence was examined by estimating persistence, switching, and discontinuation rates at 12 months. Primary non-adherence was estimated in BIFAP and SIDIAP databases. Results: The highest persistence rate was seen for apixaban in the CPRD database (81%) and the lowest for dabigatran in the Mondriaan database (22%). The switching rate for all DOACs ranged from 2.4 to 13.1% (Mondriaan and EGB databases, respectively). Dabigatran had the highest switching rate from 5.0 to 20.0% (Mondriaan and EGB databases, respectively). The discontinuation rate for all DOACs ranged from 16.0 to 63.9% (CPRD and Bavarian CD databases, respectively). Dabigatran had the highest rate of discontinuers, except in the Bavarian CD and AOK NORDWEST databases, ranging from 23.2 to 64.6% (CPRD and Mondriaan databases, respectively). Combined primary non-adherence for examined DOACs was 11.1% in BIFAP and 14.0% in SIDIAP. There were differences in population coverage and in the type of drug data source among the databases. Conclusion: Despite the differences in the characteristics of the databases and in demographic and baseline characteristics of the included population that could explain some of the observed discrepancies, we can observe a similar pattern throughout the databases. Apixaban was the DOAC with the highest persistence. Dabigatran had the highest proportion of discontinuers and switchers at 12 months in most databases (EMA/2015/27/PH).The project has received support from the European Medicines Agency under the Framework service contract (nr EMA/2015/27/PH) with regard to the reopening of competition no. 3. K. Janhsen (Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany (UW/GH)) and A. Heeke (AOK NORDWEST, Kopenhagener Straße 1, 44269 Dortmund, Germany). R. Gerlach and M. Tauscher (National Association of Statutory Health Insurance Physicians of Bavaria, Elsenheimerstr. 39, MD-80687 Munich, Germany). The authors from the BIFAP database would like to acknowledge the excellent collaboration of the primary care general practitioners and pediatricians, and also the support of the regional governments to the database. This study is based in part on data from the ‘base de datos para la investigación Farmacoepidemiológica en Atención Primaria’ (BIFAP) fully financed by the Spanish Agency on Medicines and Medical Devices (AEMPS). The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the EMA (European Medicines Agency) or one of its committees or working parties, or AEMPS (Agencia Española de Medicamentos y Productos Sanitarios). The authors thank Alethea Charlton for her support reviewing and editing the English. The authors thank SIDIAP (Sistema d’informació per al Desenvolupament de Investigació en Atenció Primària) for providing the data with respect to CPRD, approval of the study protocol was granted by the Independent Scientific Advisory Committee of the Medicines and Healthcare Products Regulatory Agency (protocol 17_089R)
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