A Systematic Review of the Evidence Behind Use of Reduced Doses of Acetaminophen in Chronic Liver Disease

Acetaminophen is among the most commonly used nonopioid analgesics, but significant variation exists in its prescribing practices for cirrhosis patients. Our primary objective was to describe the quality of evidence supporting or refuting the use of acetaminophen in patients with hepatic dysfunction. A comprehensive literature review of PubMed, Cochrane Library, Web of Science, and International Pharmaceutical Abstracts using the search terms “acetaminophen,” “paracetamol,” “chronic liver disease,” “cirrhosis,” and “hepatic disease” for studies describing changes in acetaminophen metabolism in patients with hepatic dysfunction was conducted. Twelve studies and four abstracts were included. Ten studies and three abstracts were pharmacokinetic studies. Two studies and one abstract evaluated the association of acetaminophen use and decompensation in the cirrhotic patient. The level of certainty for dosing recommendations obtainable from reviewing the evidence is low due to a small number of studies meeting search criteria, small samples sizes, inadequate information regarding cirrhosis etiology and compensated versus uncompensated liver disease, and lack of information on patient centered health outcomes. High-quality trials are not available to support the use of decreased acetaminophen doses in compensated cirrhosis patients. Acetaminophen can be a safe analgesic in patients with compensated hepatic dysfunction after careful analysis of patient-specific factors

Extended-Release Hydrocodone: The Devil in Disguise or Just Misunderstood?

Opioid abuse in the United States increased significantly over the past decade, leading to opioid-related deaths. Approval of Zohydro ER, a product that lacks an abuse-deterrent formulation, has provoked media controversy and aggressive legislative action from multiple stakeholders. Only the American Academy of Pain Management has released a position statement on this medication, and individual opinion varies. Additional single-entity extended-release hydrocodone formulations are in the pipeline, and Zohydro ER\u27s limited clinical utility may make the controversy associated with its approval a moot point. As with other opioids, providers will need to assess individual patient risk versus benefit when prescribing Zohydro ER

Feasibility Test of the MedaCube

Poor adherence is a significant barrier to achieve better patient outcomes. Rates of non-adherence approach 40% resulting in 10% of all emergency department visits and 23% of admissions into skilled nursing facilities. Many factors contribute to medication non-adherence including psychological and memory disorders, aging and pill burden. The MedaCube is a medication management system intended to help solve unintentional medication non-adherence. The device is designed to dispense scheduled and as-needed oral medications. The MedaCube provides audio and visual prompts alerting subjects to administer their medications. Caregivers receive notification of missed doses, late doses and refill requests. The null hypothesis is that use of the MedaCube results in no difference in medication adherence when compared with six month prior adherence in individual subjects

Kontroll vagy támogatás: az alternatív szankciók dilemmája, Kerezsi Klára könyvének ismertetése

Without abstract.Absztrakt nélkül

Az áldozatsegítés megvalósulási formái az Európai Unió egyes tagállamaiban

Without abstract.Absztrakt nélkül

Az áldozatvédelem európai szabályozásának mérföldkövei - különös tekintettel a 2011. évi budapesti ütemtervre

A viktimológia kialakulása a XX. század közepére tehető. Az áldozatok iránti társadalmi szolidaritás azonban csak az 1970-es évektől erősödött fel, ettől kezdve vált meghatározóvá az e téren való cselekvés. Magyarországon a viktimológia fogalma alatt a kriminálviktimológiát értjük, amelynek célja, hogy az áldozat szempontjából, illetőleg az áldozatot szem előtt tartva értse meg a bűnözést