Оптимизация лапароскопической методики лечения тератомы яичника у женщин репродуктивного возраста

В эксперименте и клиническими исследованиями показано влияние лучевой аргоновой коагуляции, биполярной коагуляции и эндоскопического ушивания яичников кетгутом при лапароскопическом лечении дермоидных кист яичников у пациенток с бесплодием на дальнейшую их репродуктивную функцию и развитие спаечного процесса в послеоперационном периоде.The influence of argon coagulation, bipolar coagulation and endoscopic suture of ovaries with catgut at laparoscopic treatment for dermoid ovarian cysts in infertile patients on the further reproductive function and development of adhesions after the surgery were investigated experimentally and clinically

Are ECG monitoring recommendations before prescription of QT-prolonging drugs applied in daily practice? : The example of haloperidol

PURPOSE: Monitoring of the QT duration by electrocardiography (ECG) prior to treatment is frequently recommended in the label of QT-prolonging drugs. It is, however, unknown how often general practitioners in daily clinical practice are adhering to these risk-minimization measures. We assessed the frequency of ECG measurements in patients where haloperidol was initiated in primary care. METHODS: Patients (≥18 years) with a first prescription of haloperidol in the UK Clinical Practice Research Datalink (2009-2013) were included. The proportion of ECGs made was determined in two blocks of 4 weeks: during the exposure period when haloperidol was initiated, and during the control period, 1 year before. Conditional logistic regression analysis was applied to calculate the relative risk of having an ECG in the exposure period compared with the control period. Subgroup analyses were performed to assess the proportion of ECG measurements in patients with one or more additional risk factors for QT prolongation. RESULTS: In total, 3420 patients were prescribed haloperidol during the exposure period, and 1.8% of them had an ECG at treatment initiation, compared with 0.8% during the control period (relative risk [RR] 2.4 [1.5-3.8]). Of the patients with additional risk factors for QT prolongation, 1.9% of the patients had an ECG at initiation of the prescription, compared with 1.0% during the control period (RR 2.1 [1.2-3.5]). CONCLUSIONS: Compliance with recommendations to perform an electrocardiogram when starting a new QT-prolonging drug is extremely low, when haloperidol is taken as an example

Flow chart.

<p>The source region had a population of 2 426 097 people in 2007 [Netherlands Statistics. <a href="http://statline.cbs.nl/" target="_blank">http://statline.cbs.nl/</a>. Accessed May 15, 2010].</p

Obstructive pulmonary disease and the risk of sudden cardiac arrest stratified by age group, sex and cardiovascular risk profile¹.

<p>Data are number (%). CI: confidence interval, CVD: cardiovascular disease, N: number, n/a: not applicable, OPD: obstructive pulmonary disease, OR: odds ratio.</p>1<p>Use of β- adrenoreceptor blockers, calcium channel antagonists, angiotensin converting enzyme inhibitors, diuretics, angiotensin-II receptor blockers, nitrates, platelet aggregation inhibitors, and/or statins within six months prior to index date.</p>2<p>Adjusted for cardiovascular risk profile.</p>3<p>Interaction on a multiplicative scale: OR 1.1 (0.7–1.6), on an additive scale: synergy index 1.4 (0.7–2.6).</p

Determinants of risk of sudden cardiac arrest.

<p>CI: confidence interval, OR: odds ratio.</p>1<p>Adjusted for all potential confounders.</p>2<p>Adjusted for all covariates that were univariately associated with sudden cardiac arrest.</p>3<p>Adjusted for all covariates that were univariately associated with sudden cardiac arrest and changed the beta with at least 5%.</p>4<p>Use of any of the following drugs: β-adrenoreceptor blockers, calcium channel antagonists, angiotensin converting enzyme inhibitors, diuretics, angiotensin-II receptor blockers, nitrates, platelet aggregation inhibitors, and/or statins, within six months prior to index date.</p>5<p>Use of anti-diabetics within six months prior to index date.</p>6<p>Class I and III antiarrhythmic drugs and non-antiarrhythmic drugs with (possible) risk of QT prolongation. (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0065638#pone.0065638.s001" target="_blank">Table S1</a>).</p

Baseline characteristics of the study population.

<p>Data are number (%) unless otherwise indicated. OPD: obstructive pulmonary disease.</p>1<p>Drug use at index date.</p>2<p>Drug use at index date, or within six months prior to index date.</p>3<p>Use of systemic corticosteroids with a duration of 90 days or more.</p>4<p>Use of any of the following drugs: β-adrenoreceptor blockers, calcium channel antagonists, angiotensin converting enzyme inhibitors, diuretics, angiotensin-II receptor blockers, nitrates, platelet aggregation inhibitors, and statins, within six months prior to index date.</p>5<p>Use of anti-diabetics within six months prior to index date.</p>6<p>Class I and III antiarrhythmic drugs and non-antiarrhythmic drugs with (possible) risk of QT prolongation (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0065638#pone.0065638.s001" target="_blank">Table S1</a>).</p