Statin grubu ilaç kullanan hiperlipidemili hastalarda hasta eğitimi ve hiperlipidemi tedavisinin izlenmesi.

STATİN GRUBU İLAÇ KULLANAN HİPERLİPİDEMİLİ HASTALARDA HASTA EĞİTİMİ VE HİPERLİPİDEMİ TEDAVİSİNİN İZLENMESİAdı ve Soyadı: SENEM ÖZGÜR SARIDanışman Adı: FİKRET V. İZZETTİNKabul Tarihi: 30.03.2004Program: ECZACILIK FAKÜLTESİAnabilim Dalı: FARMAKOLOJİ A.B.D. / KLİNİK ECZACILIK B.D.ÖZETÇalışmamızda, hiperlipideminin koroner kalp hastalığı (KKH) için en önemli risk faktörlerinden biri olduğu gerçeğinden yola çıkarak, hiperlipidemi tanısı konulmuş ve statin grubu ilaç kullanması öngörülen hastalara eczacı tarafından verilen hasta eğitiminin, hastaların lipid profilleri, antihiperlipidemik tedavinin devamlılığı ve hasta uyuncu üzerine etkilerini değerlendirmeyi planladık. Çalışmaya hiperlipidemi tanısı konulan ve statin tedavisi uygun görülen 76 hasta, hasta eğitimi alan (n=38) test grubuna ve eğitim almayan (n=38) kontrol grubu olarak ayrıldı. Hastaların tedavi öncesindeki genel ve klinik özellikleri bakımından gruplara homojen dağıtıldı. Hasta eğitimi alan gruba hiperlipideminin önemi ve tedavisi, hiperlipidemi ile ilgili laboratuvar verilerinin değerlendirilmesi, kullandıkları ilaçlar hakkında sözlü olarak hasta eğitiminin yanı sıra da, broşürler verildi. Tedavinin 1. ve 2. ayında lipid profilleri ve uyunç bakımından kontrol edildi.Verilen hasta eğitiminin, tedavinin 1. ve 2. ayında total kolesterol, LDL-K (düşük dansiteli lipoprotein kolesterolü), TG (trigliserid) düzeylerinde bu eğitimi almayan hastalara oranla daha fazla bir azalma olduğu bulundu (sırasıyla % 25,50, % 21,01; % 35,64, % 29,64; % 4,16, % -2,82 ve % 4,58, % 2,27; % 7,57, % 4,73; % - 21,96, % - 2,81). Hiperlipidemi eğitimi alan grupta uyunç ve yan etki değerlendirme faktörlerinden biri olan "ilaçların hepsini almış olma" yüzdesi eğitim almayan gruba oranla daha yüksek bulundu (% 82,61 ve % 47,73). Çalışmaya dahil edilen hastaların % 90'ı tedavi süresine uyduklarını beyan etmelerine rağmen, hasta eğitimi alan gruptaki tedavi süresine uyum yüzdesi, eğitim almayan gruba oranla daha fazla bulundu (sırasıyla % 93,48 ve % 86,36). Öte yandan, eğitim alan hastaların tedavi uyuncu ve ilaçlarını düzenli kullanma yüzdesi, eğitim almayan gruba oranla çok daha yüksek bulundu (sırasıyla % 88,05 ve % 67,05; % 80,44 ve % 52,27).Çalışmamızda hiperlipidemi hastalarının klinik eczacı tarafından eğitildiklerinde tedavi başarı ve uyunç oranlarının arttığı gerçeğini göz önünde bulundurarak, klinik eczacıların sadece hiperlipidemi değil, diğer kronik sorunlarda da hasta eğitimi ve izlemi rolünü üstlenmeleri tedavinin başarısı açısından gerektiğini düşünmekteyiz.SUMMARYPATIENT EDUCATION AND MONITORING OF HYPERLIPIDEMIC PATIENTS RECEIVING STATINSBased on the fact that hyperlipidemia is the most important risk factor for coronary heart disease (CHD) as a starting point for our study we planned to assess the effects of pharmacist led patient edcation on lipid profiles and compliance. A diagnosis of hyperlipidemia had been made in 76 patients who assigned to either receive lipidemic patient education (n=38) or to a control group (n=38). Prior to the study the general and clinical characteristic of both groups were found to be homogenous. The patients assigned to the education group received oral information and a brochure relating to the importance of hyperlipidmia and its therapy, and the statins they were using. At the end of the first and second of treatment, the patients lipid profiles and compliance were checked.In patients who received pharmacist conducted education a greater reduction in total cholesterol, LDL-K, and TG was found than in those subjects in the contol group (respectively % 25,50, % 21,01; % 35,64, % 29,64; % 4,16, % -2,82 ve % 4,58, % 2,27; % 7,57, % 4,73; % - 21,96, % - 2,81). Patients who received education were more compliant to treatment, and the percentage of those who "took all their medications" was higher (82,61 %) than of patients in the control group (47.73 %). 90 % of patients, were considered to have continued their treatment without a break; again education group were proportionately more persistent and adherent to treatment (93,48 %) than the control group (86,36 %). In the same way the overall compliance of patients who had not received education was lower (67,05 %) than those who had (88,05 %). The proportion of patients who consistently took their medication was higher in the patient education group (80,44 %) than in the control group (52,27 %).In the light of our study, in which patients educated by a clinical pharmacist demonstrated greater, treatment success and adherence to treatment, we believe that clinical pharmacist are capable of successfully assuming patient education and monitoring roles not only among hyperlipidemic patients but also in the treatment of acute and chronic conditions

Statin grubu ilaç kullanan hiperlipidemili hastalarda hasta eğitimi ve hiperlipidemi tedavisinin izlenmesi

STATİN GRUBU İLAÇ KULLANAN HİPERLİPİDEMİLİ HASTALARDA HASTA EĞİTİMİ VE HİPERLİPİDEMİ TEDAVİSİNİN İZLENMESİ Adı ve Soyadı: SENEM ÖZGÜR SARI Danışman Adı: FİKRET V. İZZETTİN Kabul Tarihi: 30.03.2004 Program: ECZACILIK FAKÜLTESİ Anabilim Dalı: FARMAKOLOJİ A.B.D. / KLİNİK ECZACILIK B.D. Çalışmamızda, hiperlipideminin koroner kalp hastalığı (KKH) için en önemli risk faktörlerinden biri olduğu gerçeğinden yola çıkarak, hiperlipidemi tanısı konulmuş ve statin grubu ilaç kullanması öngörülen hastalara eczacı tarafından verilen hasta eğitiminin, hastaların lipid profilleri, antihiperlipidemik tedavinin devamlılığı ve hasta uyuncu üzerine etkilerini değerlendirmeyi planladık. Çalışmaya hiperlipidemi tanısı konulan ve statin tedavisi uygun görülen 76 hasta, hasta eğitimi alan (n=38) test grubuna ve eğitim almayan (n=38) kontrol grubu olarak ayrıldı. Hastaların tedavi öncesindeki genel ve klinik özellikleri bakımından gruplara homojen dağıtıldı. Hasta eğitimi alan gruba hiperlipideminin önemi ve tedavisi, hiperlipidemi ile ilgili laboratuvar verilerinin değerlendirilmesi, kullandıkları ilaçlar hakkında sözlü olarak hasta eğitiminin yanı sıra da, broşürler verildi. Tedavinin 1. ve 2. ayında lipid profilleri ve uyunç bakımından kontrol edildi. Verilen hasta eğitiminin, tedavinin 1. ve 2. ayında total kolesterol, LDL-K (düşük dansiteli lipoprotein kolesterolü), TG (trigliserid) düzeylerinde bu eğitimi almayan hastalara oranla daha fazla bir azalma olduğu bulundu (sırasıyla % 25,50, % 21,01; % 35,64, % 29,64; % 4,16, % -2,82 ve % 4,58, % 2,27; % 7,57, % 4,73; % - 21,96, % - 2,81). Hiperlipidemi eğitimi alan grupta uyunç ve yan etki değerlendirme faktörlerinden biri olan "ilaçların hepsini almış olma" yüzdesi eğitim almayan gruba oranla daha yüksek bulundu (% 82,61 ve % 47,73). Çalışmaya dahil edilen hastaların % 90'ı tedavi süresine uyduklarını beyan etmelerine rağmen, hasta eğitimi alan gruptaki tedavi süresine uyum yüzdesi, eğitim almayan gruba oranla daha fazla bulundu (sırasıyla % 93,48 ve % 86,36). Öte yandan, eğitim alan hastaların tedavi uyuncu ve ilaçlarını düzenli kullanma yüzdesi, eğitim almayan gruba oranla çok daha yüksek bulundu (sırasıyla % 88,05 ve % 67,05; % 80,44 ve % 52,27). Çalışmamızda hiperlipidemi hastalarının klinik eczacı tarafından eğitildiklerinde tedavi başarı ve uyunç oranlarının arttığı gerçeğini göz önünde bulundurarak, klinik eczacıların sadece hiperlipidemi değil, diğer kronik sorunlarda da hasta eğitimi ve izlemi rolünü üstlenmeleri tedavinin başarısı açısından gerektiğini düşünmekteyiz. SUMMARY PATIENT EDUCATION AND MONITORING OF HYPERLIPIDEMIC PATIENTS RECEIVING STATINS Based on the fact that hyperlipidemia is the most important risk factor for coronary heart disease (CHD) as a starting point for our study we planned to assess the effects of pharmacist led patient edcation on lipid profiles and compliance. A diagnosis of hyperlipidemia had been made in 76 patients who assigned to either receive lipidemic patient education (n=38) or to a control group (n=38). Prior to the study the general and clinical characteristic of both groups were found to be homogenous. The patients assigned to the education group received oral information and a brochure relating to the importance of hyperlipidmia and its therapy, and the statins they were using. At the end of the first and second of treatment, the patients lipid profiles and compliance were checked. In patients who received pharmacist conducted education a greater reduction in total cholesterol, LDL-K, and TG was found than in those subjects in the contol group (respectively % 25,50, % 21,01; % 35,64, % 29,64; % 4,16, % -2,82 ve % 4,58, % 2,27; % 7,57, % 4,73; % - 21,96, % - 2,81). Patients who received education were more compliant to treatment, and the percentage of those who "took all their medications" was higher (82,61 %) than of patients in the control group (47.73 %). 90 % of patients, were considered to have continued their treatment without a break; again education group were proportionately more persistent and adherent to treatment (93,48 %) than the control group (86,36 %). In the same way the overall compliance of patients who had not received education was lower (67,05 %) than those who had (88,05 %). The proportion of patients who consistently took their medication was higher in the patient education group (80,44 %) than in the control group (52,27 %). In the light of our study, in which patients educated by a clinical pharmacist demonstrated greater, treatment success and adherence to treatment, we believe that clinical pharmacist are capable of successfully assuming patient education and monitoring roles not only among hyperlipidemic patients but also in the treatment of acute and chronic conditions

Flekainid Andersen-Tawil sendromlu pediyatrik hastalarda bidireksiyonel ventriküler taşikardiyi tamamen ortadan kaldırabilir mi?

WOS: 000453086300012PubMed ID: 30516532Andersen-Tawil syndrome (ATS) is a disorder that causes episodes of muscle weakness (periodic paralysis), changes in heart rhythm, and developmental abnormalities. QT prolongation and ventricular arrhythmias, including bidirectional ventricular tachycardia (VT) and polymorphic VT, may occur. About 60% of all cases of the disorder are caused by mutations in the KCNJ2 gene. A 13-year-old female patient was referred for frequent premature ventricular contractions. Suspicion of ATS due to dysmorphic findings, electrocardiogram changes, and periodic muscle weakness was genetically confirmed. Beta-blocker therapy was initiated as a first-line treatment for bidirectional VT and frequent polymorphic premature ventricular contractions. Despite proper treatment, the VT attacks were not brought under control. Flecainide was added to the treatment regime. The number of premature ventricular contractions was dramatically reduced with flecainide and the VT attacks completely disappeared. This patient is a rare example of ATS in our country. This article provides a description of successful management of rhythm disturbance in a patient with ATS.Andersen-Tawil sendromu (ATS), kas güçsüzlüğü(periyodik paralizi), ritm bozuklukları ve gelişim bozukluklarına neden olan bir hastalıktır. QT uzaması ve bidireksiyonel ventriküler taşikardi (VT) ve polimorfik VT’yide içeren ventriküler aritmiler ortaya çıkabilir. Tüm olguların yaklaşık %60’ı, KCNJ2 genindeki mutasyonlardankaynaklanmaktadır. On üç yaşında kız hasta, sık ventriküler erken atımlar nedeniyle hastanemize sevk edildi.Hasta, morfolojik bozuklukları, EKG değişiklikleri ve periyodik kas güçsüzlüğü nedeniyle ATS olarak düşünüldüve tanı genetik olarak doğrulandı. Bidireksiyonel VT vesık polimorfik erken ventriküler atımları için ilk basamak tedavi olarak beta bloker başlandı. Ancak tedaviyerağmen, hastanın VT atakları kontrol altına alınamadı.Bunun üzerine Flekainid tedaviye eklendi. Flekainid ileprematüre ventriküler atımların sayısı çarpıcı bir şekildeazaldı. Ayrıca VT atakları tamamen kayboldu. Bu hasta, ülkemizde nadir görülen ATS’li hastalardan biridir. Bumakalede ATS’li bir hastada ritm bozukluğunun başarılıyönetimi anlatılmıştır

Mathematical modeling of a small scale catalytic reactor for hydrogen production from boron compounds

The production of hydrogen through environmentally-friendly methods and efficient manner is the biggest obstacle in the development of hydrogen-based energy economy. In this study, a small-scale reactor was designed to produce hydrogen through catalytic dehydrogenation of boron compounds, which are a type of solid hydrogen storage material. A three-dimensional and non-isothermal catalytic reactor was modeled in Comsol Multiphysics environment. Conservation of mass, species, and energy equations were used to predict some important parameters such as time dependent variation of substrate and hydrogen concentrations. Three different chemical kinetics behaviors were examined in the mathematical model: zero-order, first-order, and Langmuir-Hinshelwood. Kinetic behavior of the reaction was investigated for four different temperatures as 25, 30, 35, and 40 degrees C

A review on the catalysts used for hydrogen production from ammonia borane

Boron compounds have recently attracted attention in hydrogen production since they contain many hydrogen atoms. Among these compounds, ammonia borane, which has high hydrogen density (in weight basis), can be used to produce hydrogen through a hydrolysis reaction. However, since the ammonia borane solution is highly resistant to hydrolysis under ambient conditions, there is a need for active and stable catalysts to accelerate the reaction. In this review paper, unsupported and carbon-based supported metal catalysts used for hydrogen production through the hydrolysis of ammonia borane are presented. Noble metal catalysts (Ru, Rh, Pd, Pt and their binary and ternary alloys) and non-noble metal catalysts (Co, Ni, Fe, Cu and their binary and ternary alloys) were examined. The activation energy of reaction and turnover frequency (TOF) values were compared for these catalysts. Among the unsupported catalysts, it was concluded that the multi-metal catalyst systems (binary, ternary and quaternary) have higher catalytic activity than a single use of the same metals. In addition, the comparison showed that the supported catalysts are more resistant to catalytic cycles and suitable for long-term use. It was observed that CNT supported Rh (TOF = 706 mol H-2 mol cat(-1) min(-1)) and graphene supported Ru (TOF = 600 mol H-2 mol cat(-1) min(-1)) catalysts are the most active catalysts for the hydrogen generation from the ammonia borane at room temperature. (C) 2019 Hydrogen Energy Publications LLC. Published by Elsevier Ltd. All rights reserved

A Comparison of the Effects of Sodium Borohydride-Based Hydrogen Storage System and Compressed Hydrogen Storage Tank on the Fuel Cell Vehicle Performance

Thanks to its features such as being harmless to the environment, not creating noise pollution, and reducing oil dependence, many countries have started promoting the use of fuel cell vehicles (FCVs) and making plans on enhancing their hydrogen infrastructure. One of the main challenges with the FCVs is the selection of an effective hydrogen storage unit. Compressed gas tanks are mostly used as the hydrogen storage in the FCVs produced to date. However, the high amount of energy spent on the compression process and the manufacturing cost of high-safety composite tanks are the main problems to be overcome. Among different storage alternatives, boron compounds, which can be easily hydrolyzed at ambient temperature and pressure to produce hydrogen, are promising hydrogen storage materials. In this study, a 700-bar compressed gas tank and a sodium borohydride (NaBH4)-based hydrogen storage system are compared for a passenger fuel cell vehicle in terms of the range of the vehicle. The energy storage and production system of the FCV were modeled in matlab simulink(R) environment coupling the modeling equations of each component after finding the power requirement of the vehicle through vehicle dynamics. Then, the simulations were performed using the speed profile of the New European Drive Cycle (NEDC) and the acceleration requirements. According to the simulation results, the NaBH4-based hydrogen storage system provided a 4.42% more range than the compressed gas tank