MANAGEMENT OF HYPERCOAGULABLE STATE DURING PREGNANCY. PROPHYLACTIC USAGE OF LOW MOLECULAR WEIGHT HEPARIN (LMWH)

The main objective of this study is to analyze the prophylactic usage of low molecular weight heparin, in women during the period of pregnancy. A retrospective study was undertaken during 01 January – 31 December of 2013, in the Department of Gynecology and Obstetrics, at Clinical Hospital in Tetovo. Data were collected for the following: patient demographics, week and month of pregnancy, number of pregnancies for each patient, duration of hospital stay, clinical and laboratory investigations, diagnosis, drug details; which include the name of the drug, dosage form, dose frequency, total cost of the drug, the amount of each given ampoule application and the cost for the entire period of hospitalization. Among of 643 women whom were prescribed LMWH, 144 of them were found hypercoagulable. The majority of patients given LMWH were aged 25-30 years (56.25 %). For the biggest number of patients, this was their first pregnancy (70.83%). Earliest phase of using LMWH was the second month of pregnancy, respectively sixth week. Patients during the ninth month, apear to be more affected by hypercoagulable statete. 56 (38.89 %) women were in the ninth month of pregnany. Fraxiparine (nadroparin calcium) 3800 IU anti-Factor XA in 0.4 ml was the most prescribed anticoagulant, 64 (44.44 %) patients received this therapy. From the total number of 144 patients, only 4 of them received LMWH twice a day

HIGH PRESCRIPTION OF LOW MOLECULAR WEIGHT HEPARINS DURING PREGNANCY IN A HOSPITAL IN TETOVO, THE REPUBLIC OF MACEDONIA

Background: This study sought to explore the increase of usage of low molecular weight heparins (LMWH), for venous thromboembolism (VTE) treatment and prophylaxis during the period of pregnancy. Materials and methods: A retrospective study was undertaken during 01 January – 31 June of 2013, in the Department of Gynecology and Obstetrics, at Clinical Hospital in Tetova. Data were collected for the following: patient demographics, week and month of pregnancy, number of pregnancies for each patient, diagnosis, drug details and the cost for the entire period of hospitalization. Results: Over six months, the total number of pregnant women was 1020, from that number, 366 (35.88 %) were prescribed LMWH. Majority of patients given LMWH were aged 25-30, 196 (53.55 %). Clexane 2000 UI and Fraxiparine 0.4UI, were the most prescribed anticoagulant, 98 (26.78 %), respectly 97 (26.50 %) of patients received this therapy. The most common diagnosis that was foud in the study was nonpathologycal pregnancy asocciated with high levels of D-dimers 177 (48.36 %) patients. Conclusions: The results of this study indicate that there is an urgent need to improve the prescription of anticoagulants in the Department of Gynecology and Obstetrics, Clinical Hospital of Tetova, Republic of Macedonia

HIGH PRESCRIPTION OF LOW MOLECULAR WEIGHT HEPARINS DURING PREGNANCY IN A HOSPITAL IN TETOVO, THE REPUBLIC OF MACEDONIA

Background: This study sought to explore the increase of usage of low molecular weight heparins (LMWH), for venous thromboembolism (VTE) treatment and prophylaxis during the period of pregnancy. Materials and methods: A retrospective study was undertaken during 01 January – 31 June of 2013, in the Department of Gynecology and Obstetrics, at Clinical Hospital in Tetova. Data were collected for the following: patient demographics, week and month of pregnancy, number of pregnancies for each patient, diagnosis, drug details and the cost for the entire period of hospitalization. Results: Over six months, the total number of pregnant women was 1020, from that number, 366 (35.88 %) were prescribed LMWH. Majority of patients given LMWH were aged 25-30, 196 (53.55 %). Clexane 2000 UI and Fraxiparine 0.4UI, were the most prescribed anticoagulant, 98 (26.78 %), respectly 97 (26.50 %) of patients received this therapy. The most common diagnosis that was foud in the study was nonpathologycal pregnancy asocciated with high levels of D-dimers 177 (48.36 %) patients. Conclusions: The results of this study indicate that there is an urgent need to improve the prescription of anticoagulants in the Department of Gynecology and Obstetrics, Clinical Hospital of Tetova, Republic of Macedonia

MANAGEMENT OF HYPERCOAGULABLE STATE DURING PREGNANCY. PROPHYLACTIC USAGE OF LOW MOLECULAR WEIGHT HEPARIN (LMWH)

The main objective of this study is to analyze the prophylactic usage of low molecular weight heparin, in women during the period of pregnancy. A retrospective study was undertaken during 01 January – 31 December of 2013, in the Department of Gynecology and Obstetrics, at Clinical Hospital in Tetovo. Data were collected for the following: patient demographics, week and month of pregnancy, number of pregnancies for each patient, duration of hospital stay, clinical and laboratory investigations, diagnosis, drug details; which include the name of the drug, dosage form, dose frequency, total cost of the drug, the amount of each given ampoule application and the cost for the entire period of hospitalization. Among of 643 women whom were prescribed LMWH, 144 of them were found hypercoagulable. The majority of patients given LMWH were aged 25-30 years (56.25 %). For the biggest number of patients, this was their first pregnancy (70.83%). Earliest phase of using LMWH was the second month of pregnancy, respectively sixth week. Patients during the ninth month, apear to be more affected by hypercoagulable statete. 56 (38.89 %) women were in the ninth month of pregnany. Fraxiparine (nadroparin calcium) 3800 IU anti-Factor XA in 0.4 ml was the most prescribed anticoagulant, 64 (44.44 %) patients received this therapy. From the total number of 144 patients, only 4 of them received LMWH twice a day

OVERVIEW ON GENERICS POLICIES AND PHARMACEUTICAL PRICING IN THE EUROPEAN COUNTRIES AND THE REPUBLIC OF MACEDONIA

Continued growth of spending on drugs in Health care, especially in the public sector encouraged initiatives for reforms in the system of determining the prices of medicines. These initiatives that were undertaken, were primarily aimed at reducing the cost of drugs but parallel to become a generic medications simultaneously promoting an adjustment of reimbursement procedures in the pharmaceutical sector. The policies for the regulation of the pharmaceutical market come as a response to health care classical market failures. This article will focus on the features, implementation and impact of these policies in some EU member states. Most EU countries, apply the external reference system of prices, whereupon the price of a certain medication is determined based on the price of the same product in other countries. On the other hand, in twenty other EU member states, prices are determined by comparing the prices of the same products according to chemical, pharmacological or therapeutic grouping. The reference pricing system has been adopted by governments as a mechanism to reduce the costs in the public health care system. By setting a price limit, competition among producers has been stimulated

Legal Regulation and Critical Analysis for an Effectively Treatment of Pharmaceutical Waste

The extermination and proper disposal of pharmaceutical wastes from expired and unused medications remains a disputable issue due to their specific nature and characteristics. Even though the hazards from these wastes are already well known in terms of environment and human health, people still treat them as usual wastes. At a national level, in many countries the management of pharmaceutical and medical wastes has been one of the main objectives in order to protect people's health and the environment. Even though many legal regulations exist in this respect, there has not been a single law that would clearly explain the procedures of returning medicines, ways of selection, treatment and extermination of pharmaceutical wastes. This paper aims at analyzing the practices of pharmaceutical waste management and treatment in some European countries as well as a review of the legislation and official guidelines in managing these kinds of wastes and protecting the environment and human health. A suitable treatment and management of expired medications and other similar wastes would be in the interest of public health in the first place, as well as in the interest of healthcare institutions and other bodies engaged in environment protection

OVERVIEW ON GENERICS POLICIES AND PHARMACEUTICAL PRICING IN THE EUROPEAN COUNTRIES AND THE REPUBLIC OF MACEDONIA

Continued growth of spending on drugs in Health care, especially in the public sector encouraged initiatives for reforms in the system of determining the prices of medicines. These initiatives that were undertaken, were primarily aimed at reducing the cost of drugs but parallel to become a generic medications simultaneously promoting an adjustment of reimbursement procedures in the pharmaceutical sector. The policies for the regulation of the pharmaceutical market come as a response to health care classical market failures. This article will focus on the features, implementation and impact of these policies in some EU member states. Most EU countries, apply the external reference system of prices, whereupon the price of a certain medication is determined based on the price of the same product in other countries. On the other hand, in twenty other EU member states, prices are determined by comparing the prices of the same products according to chemical, pharmacological or therapeutic grouping. The reference pricing system has been adopted by governments as a mechanism to reduce the costs in the public health care system. By setting a price limit, competition among producers has been stimulated

Legal Regulation and Critical Analysis for an Effectively Treatment of Pharmaceutical Waste

The extermination and proper disposal of pharmaceutical wastes from expired and unused medications remains a disputable issue due to their specific nature and characteristics. Even though the hazards from these wastes are already well known in terms of environment and human health, people still treat them as usual wastes. At a national level, in many countries the management of pharmaceutical and medical wastes has been one of the main objectives in order to protect people's health and the environment. Even though many legal regulations exist in this respect, there has not been a single law that would clearly explain the procedures of returning medicines, ways of selection, treatment and extermination of pharmaceutical wastes. This paper aims at analyzing the practices of pharmaceutical waste management and treatment in some European countries as well as a review of the legislation and official guidelines in managing these kinds of wastes and protecting the environment and human health. A suitable treatment and management of expired medications and other similar wastes would be in the interest of public health in the first place, as well as in the interest of healthcare institutions and other bodies engaged in environment protection

Legal Regulation and Critical Analysis for an Effectively Treatment of Pharmaceutical Waste

The extermination and proper disposal of pharmaceutical wastes from expired and unused medications remains a disputable issue due to their specific nature and characteristics. Even though the hazards from these wastes are already well known in terms of environment and human health, people still treat them as usual wastes. At a national level, in many countries the management of pharmaceutical and medical wastes has been one of the main objectives in order to protect people's health and the environment. Even though many legal regulations exist in this respect, there has not been a single law that would clearly explain the procedures of returning medicines, ways of selection, treatment and extermination of pharmaceutical wastes. This paper aims at analyzing the practices of pharmaceutical waste management and treatment in some European countries as well as a review of the legislation and official guidelines in managing these kinds of wastes and protecting the environment and human health. A suitable treatment and management of expired medications and other similar wastes would be in the interest of public health in the first place, as well as in the interest of healthcare institutions and other bodies engaged in environment protection

Principles and methods for isolation and preparation of plasma preparations containing platelets (PR) - how to improve the purpose and effectiveness

The clinical use of platelet-rich plasma (PRP) is based on increasing the concentration of growth factors and the secretion of proteins that can maximize the healing process at the cellular level. PRP is an autologous biological material, that involves minimal risk of immune reactions and transmission of infectious and contagious diseases, and it is widely used to repair musculoskeletal lesions and skin. Despite the great potential for applicability, the implementation of therapeutic inclusion of PRP as a clinical alternative has become difficult due to the lack of studies related to the standardization of production techniques, application conditions, and/or insufficient description of the adopted procedures. Currently, platelet-rich plasma therapy (PRP) is widely used and continues to grow for a variety of clinical applications. Along with its development, there are various options in the way of obtaining PRP, automatic or manual, while one of the most reliable methods according to the literature is the method of double centrifugation. Therefore, it is necessary to establish standard criteria to be met to obtain high-quality PRP, as well as several studies to determine the appropriate platelet concentration for different clinical applications. In this context, this paper aims to discuss some methodological aspects used to obtain PRP, as well as to discuss the bioactive properties of PRP and to point out its therapeutic use in various fields of regenerative medicine. Additionally, current techniques, critical points, technology for PRP preparation, and a review of the present deficiencies of this therapy that will need to be overcome if widely accepted, are described