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Long-Term Comparative Effectiveness of Transcatheter Aortic Valve Replacement (TAVR) Versus Surgical Aortic Valve Replacement (SAVR) in High-Risk Aortic Stenosis Patients: A Meta-Analysis 高风险主动脉瓣狭窄患者经导管主动脉瓣置换术 (TAVR) 与外科主动脉瓣置换术 (SAVR) 的长期疗效比较:一项元分析
Pub Date : 2024-07-10 DOI: 10.37275/oaijmr.v4i3.600
I. Gede, Andrika Indrayoga Senthanu, Dewa Ayu, Agung Maya, Gayatri, Gede Andrika, Indrayoga Senthanu
Transcatheter aortic valve replacement (TAVR) has become an alternative to surgical aortic valve replacement (SAVR) for high-risk patients with severe aortic stenosis (AS). This meta-analysis aims to compare the long-term outcomes of TAVR and SAVR in this population. A systematic search of PubMed, Embase, and the Cochrane Library was conducted up to December 2023. Randomized controlled trials (RCTs) and observational studies comparing TAVR and SAVR with a minimum follow-up of one year were included. The primary outcome was all-cause mortality. Secondary outcomes included cardiovascular mortality, stroke, myocardial infarction (MI), and rehospitalization. Twenty-three studies involving 15,482 patients (TAVR=7,785, SAVR=7,697) were included. The mean follow-up period was 3.2 years (range 1-5 years). There was no significant difference in all-cause mortality between TAVR and SAVR (Hazard Ratio [HR] 1.02, 95% CI 0.95-1.09, p=0.63). Similarly, there were no differences in cardiovascular mortality (HR 1.05, 95% CI 0.96-1.15, p=0.28), stroke (HR 0.98, 95% CI 0.87-1.10, p=0.75), or MI (HR 0.94, 95% CI 0.82-1.08, p=0.39). However, TAVR was associated with a lower rate of rehospitalization (HR 0.85, 95% CI 0.78-0.93, p=0.001). TAVR is a viable alternative to SAVR in high-risk patients with AS, demonstrating comparable long-term survival and safety outcomes. The reduced rehospitalization rate associated with TAVR may be an important consideration for these patients.
经导管主动脉瓣置换术(TAVR)已成为严重主动脉瓣狭窄(AS)高风险患者手术主动脉瓣置换术(SAVR)的替代方案。本荟萃分析旨在比较 TAVR 和 SAVR 在这一人群中的长期疗效。截至 2023 年 12 月,我们对 PubMed、Embase 和 Cochrane 图书馆进行了系统检索。研究纳入了比较 TAVR 和 SAVR 的随机对照试验 (RCT) 和随访至少一年的观察性研究。主要结果为全因死亡率。次要结果包括心血管死亡率、中风、心肌梗死(MI)和再次住院。共纳入 23 项研究,涉及 15,482 名患者(TAVR=7,785 人,SAVR=7,697 人)。平均随访时间为 3.2 年(1-5 年不等)。TAVR 和 SAVR 的全因死亡率无明显差异(危险比 [HR] 1.02,95% CI 0.95-1.09,P=0.63)。同样,心血管死亡率(HR 1.05,95% CI 0.96-1.15,p=0.28)、中风(HR 0.98,95% CI 0.87-1.10,p=0.75)或心肌梗死(HR 0.94,95% CI 0.82-1.08,p=0.39)也没有差异。然而,TAVR与较低的再住院率相关(HR 0.85,95% CI 0.78-0.93,P=0.001)。对于高危强直性脊柱炎患者来说,TAVR是SAVR的可行替代方案,其长期生存率和安全性与SAVR相当。TAVR降低的再住院率可能是这些患者的一个重要考虑因素。
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引用次数: 0
Analysis of the Quality of Pharmaceutical Services at Outpatient Health Centers, East Sumba Regency, Indonesia 印度尼西亚东松巴地区门诊保健中心药品服务质量分析
Pub Date : 2024-04-03 DOI: 10.37275/oaijmr.v4i2.550
Silvia Claudia Talalab, Jason M. Peranginnangin, Tri Wijayanti
Public administration services are one way to demonstrate maximum government performance in providing welfare and meeting community needs. One important sector in public services is pharmaceutical services at Health Centers. This research uses a descriptive method with a cross-sectional design. Primary data was obtained through observation, interviews and documentation. Secondary data was obtained from the 2022 Health Centers Medicine Usage Report and Request Sheet (LPLPO) and the 2021 Health Centers Drug Requirements Plan (RKO). Of the 28 indicators of the quality of pharmaceutical services, 15 of the third indicators of the Health Centers meet the standards, 10 of the third indicators of the Health Centers do not meet the standards, 1 indicators only one Health Center meets and 2 indicators only two Health Centers fulfill. Factors that influence the quality of management of pharmaceutical preparations at the East Sumba Regency outpatient Health Centers are human resources that do not come from pharmacy. The quality of pharmaceutical services at the East Sumba Regency outpatient Health Centers still needs to be improved. Pharmacists are needed as pharmaceutical personnel to maximize pharmaceutical services to the community.
公共行政服务是展示政府在提供福利和满足社区需求方面取得最大绩效的一种方式。公共服务中的一个重要部门是医疗中心的医药服务。本研究采用横截面设计的描述性方法。主要数据通过观察、访谈和文献获得。二级数据来自《2022 年医疗中心药品使用报告和申请表》(LPLPO)和《2021 年医疗中心药品需求计划》(RKO)。在药品服务质量的 28 项指标中,15 项卫生中心的第三项指标达标,10 项卫生中心的第三项指标不达标,1 项指标只有 1 家卫生中心达标,2 项指标只有 2 家卫生中心达标。影响东松巴省门诊保健中心药物制剂管理质量的因素是非药房人力资源。东松巴地区门诊医疗中心的药剂服务质量仍有待提高。需要药剂师作为药剂人员,最大限度地为社区提供药剂服务。
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引用次数: 0
Formulation and Characterization of Mefenamic Acid Self Nanoemulsifying Drug Delivery System (SNEDDS) Preparations 甲灭酸自纳米乳化给药系统(SNEDDS)制剂的配制与表征
Pub Date : 2024-01-08 DOI: 10.37275/oaijmr.v4i1.461
Farrah Bintang Sabiti, Sukarno
Mefenamic acid is included in BCS (biopharmaceutical classification system) class II, namely high permeability and low solubility. This research aims to obtain a good formula for oleic acid oil, tween 80, and PEG 400 according to the characterization test of emulsification time, % transmittance, drug loading, globule size, and zeta potential. This research was an experimental study by formulating mefenamic acid in the form of SNEDDS which was made 1 formula was made in the form of SNEDDS with the composition of oleic acid, tween 80, and PEG 400 and characterization tests were carried out for emulsification time, % transmittance, drug loading, globule size, zeta potential. The yield of the oleic acid formula is 1%, tween 80 is 8%, and PEG 400 is 1%. The emulsification time characterization test resulted in 17 seconds, % transmittance of 97%, drug loading of 179.81 mg, globular size of 85.8 nm and zeta potential of -1.6 mV.
甲灭酸属于 BCS(生物制药分类系统)第二类,即高渗透性和低溶解性。本研究旨在根据乳化时间、透光率、载药量、球形大小和 ZETA 电位等表征测试,获得油酸油、吐温 80 和 PEG 400 的良好配方。这项研究是通过将甲灭酸配制成 SNEDDS 的形式进行的实验研究。油酸配方的产量为 1%,吐温 80 为 8%,PEG 400 为 1%。乳化时间表征测试结果为 17 秒,透光率为 97%,载药量为 179.81 毫克,球形大小为 85.8 纳米,ZETA 电位为-1.6 毫伏。
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引用次数: 0
Optimization and Characterization of Fenofibrate Self-Nanoemulsifying Drug Delivery System (SNEDDS) Preparations 非诺贝特自纳米乳化给药系统(SNEDDS)制剂的优化与表征
Pub Date : 2023-12-18 DOI: 10.37275/oaijmr.v4i1.451
Sukarno, Ilham Kuncahyo, Endang Dyah Ikasari
Fenofibrate is a third-generation fibric acid derivative included in BCS (biopharmaceutical classification system) class II, namely high permeability, low solubility. This research aims to obtain the optimum formula for miglyol oil, cremophor RH 40 and PEG 400 according to characterization tests of emulsification time, % transmittance, drug loading, globule size, and zeta potential. This research is an experimental study by formulating fenofibrate in the form of SNEDDS, which was made in 16 formulas using the D-optimal method, which was formulated in the form of SNEDDS with the composition miglyol, cremophor RH 40 and PEG 400 and characterization tests were carried out for emulsification time, % transmittance, drug loading, size. globules, zeta potential to obtain the optimum formula, and then analyzed using the one sample T-Test. The optimization results obtained the optimum formula, namely miglyol at 4%; cremophor RH 40 is 5%, and PEG 400 at 1%. Characterization test: emulsification time was 24 seconds, Transmittance % was 98.7%, Drug loading was 181 mg, globule size was 126 nm, and zeta potential of 12.26 mV. The dissolution test of the fenofibrate capsule dissolved 57.05%, while the fenofibrate SNEDDS capsule was 64.86%. This means that the dissolution of the optimum formula for SNEDDS fenofibrate is better than pure fenofibrate.
非诺贝特是第三代纤维酸衍生物,属于 BCS(生物制药分类系统)第二类,即高渗透性、低溶解性。本研究旨在根据乳化时间、透光率、载药量、球形大小和 ZETA 电位等表征测试,获得米格列醇油、cremophor RH 40 和 PEG 400 的最佳配方。本研究是一项实验研究,将非诺贝特配制成 SNEDDS,采用 D-optimal 方法配制成 16 个配方,其中 SNEDDS 由 miglyol、cremophor RH 40 和 PEG 400 组成,并进行了乳化时间、透光率、载药量、球粒大小、Zeta 电位等表征测试,以获得最佳配方,然后采用单样本 T 检验进行分析。优化结果得到了最佳配方,即 miglyol 为 4%,cremophor RH 40 为 5%,PEG 400 为 1%。表征测试:乳化时间为 24 秒,透光率为 98.7%,载药量为 181 毫克,球形大小为 126 纳米,Zeta 电位为 12.26 毫伏。经溶解试验,非诺贝特胶囊的溶解度为 57.05%,而非诺贝特 SNEDDS 胶囊的溶解度为 64.86%。这说明最佳配方 SNEDDS 非诺贝特的溶出效果优于纯非诺贝特。
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引用次数: 0
Evaluation of Drug Management and Improvement Strategies Using the Hanlon Method in the Pharmacy Installation of Dr. Moewardi General Hospital, Surakarta, Indonesia 印度尼西亚苏腊卡尔塔莫瓦迪博士综合医院药房使用汉隆方法评估药品管理和改进策略
Pub Date : 2023-12-06 DOI: 10.37275/oaijmr.v3i6.446
Lanny Imelia, RA.Oetari, Samuel Budi Harsono
A hospital pharmacy (FRS) is a unit in a hospital that carries out health efforts by providing quality health services. Medication management in FRS is an important management aspect in achieving service quality. Therefore, IFRS must be managed effectively and efficiently. Inefficiency in use can have a negative impact on hospitals both medically and economically. The aim of this study was to evaluate drug management, including selection, procurement, distribution, and use, based on the 2020 National Formulary standards and improvement strategies using the Hanlon method at the pharmacy installation of Dr. Moewardi General Hospital in 2020. This research is a type of descriptive research with retrospective and concurrent data collection. Data was taken from retrospective data in 2020 and data at the time the research was conducted. Research materials include primary data obtained from observation of research data in the form of document selection, procurement, distribution, and use of medicine in the IFRS Dr. Moewardi General Hospital. Secondary data was obtained from interviews with the head of the pharmacy installation at Dr. Moewardi General Hospital Surakarta, the head of planning, and the head of ULP (procurement services unit). The results of the research show that 1) Medication management in the pharmacy installation at Dr. Moewardi General Hospital Surakarta is not yet efficient at this stage of selection. It is known that the availability of existing medicines does not comply with FORNAS standards in 2020. then, in stage procurement, there is 1 out of 5 indicators that meet the standard; in stage distribution, 5 indicators were obtained, or all of them were not standard, and in staged use, it was found that 1 of the 5 indicators met the standard. 2) The improvement strategy uses the Hanlon method in drug management, namely prioritizing problem repairs sequentially, starting from the percentage of conformity with the number of drug items available with FORNAS to the number of drug items per prescription sheet.
医院药房是医院内通过提供优质保健服务来开展保健工作的一个单位。FRS的用药管理是保证服务质量的重要管理环节。因此,必须有效和高效地管理国际财务报告准则。使用效率低下会对医院的医疗和经济产生负面影响。本研究的目的是基于2020年国家处方集标准和改进策略,采用Hanlon方法评估2020年Dr. Moewardi综合医院药房安装的药物管理,包括选择、采购、分销和使用。本研究是一种回顾性和并发数据收集的描述性研究。数据取自2020年的回顾性数据和进行研究时的数据。研究材料包括通过观察研究数据获得的原始数据,这些数据以国际财务报告准则Dr. Moewardi总医院的文件选择、采购、分发和药物使用的形式呈现。次要数据来自对苏拉塔Moewardi医生总医院药房负责人、规划负责人和采购服务股负责人的访谈。研究结果表明:1)在选择阶段,Dr. Moewardi General Hospital Surakarta的药房设施的药物管理效率尚不高。众所周知,到2020年,现有药物的可用性不符合FORNAS标准。然后,在阶段采购中,5项指标中有1项符合标准;在阶段分布中,获得5项指标,或全部不标准,在阶段使用中,发现5项指标中有1项符合标准。2)改进策略在药品管理中采用汉龙方法,即按顺序对问题进行优先修复,从符合FORNAS可提供的药品项目数百分比开始,到每张处方单的药品项目数。
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引用次数: 0
Analysis of Studies on the Role of Hormones in Micropenis Disorders: A Systematic Literature Review 关于激素在小阴茎症中作用的研究分析:系统性文献综述
Pub Date : 2023-11-21 DOI: 10.37275/oaijmr.v3i6.420
Rizki Jaya Amal, Irfansyah, Muhammad Arif Hasan, Aulia Putra Rahman
A deep understanding of the role of specific hormones in genital development is key to designing effective therapeutic approaches. Factors such as testosterone deficiency, growth hormone disorders, or other hormonal imbalances can be targets for hormonal interventions that can affect penis size. This study aimed to explore the role of hormonal aspects in micropenis disorders. The literature search process was carried out on various databases (PubMed, Web of Sciences, EMBASE, Cochrane Libraries, and Google Scholar) regarding the role of hormonal aspects in micropenis disorders. This study follows the preferred reporting items for systematic reviews and meta-analysis (PRISMA) recommendations. Aspects of the hormonal role in micropenis include several key elements that influence the development of genital organs in men. Hormones, such as testosterone, growth hormone, estrogen, and dihydrotestosterone (DHT), play an important role in stimulating penis growth and development. Proper hormonal balance is necessary for normal genital development, and disturbances in the production of or response to these hormones may contribute to conditions such as micropenis.
深入了解特定激素在生殖器发育过程中的作用是设计有效治疗方法的关键。睾酮缺乏、生长激素紊乱或其他激素失衡等因素都可能成为影响阴茎大小的激素干预目标。本研究旨在探讨激素在小阴茎症中的作用。我们在多个数据库(PubMed、Web of Sciences、EMBASE、Cochrane Libraries 和 Google Scholar)中进行了有关激素在小阴茎症中作用的文献检索。本研究遵循了系统综述和荟萃分析首选报告项目(PRISMA)的建议。荷尔蒙在小阴茎症中的作用包括影响男性生殖器官发育的几个关键因素。睾酮、生长激素、雌激素和双氢睾酮(DHT)等激素在刺激阴茎生长和发育方面发挥着重要作用。正常的生殖器发育需要适当的荷尔蒙平衡,这些荷尔蒙的分泌或反应紊乱可能会导致小阴茎等疾病。
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引用次数: 0
Development of a Reliable Information System for Medical Device Inventory in Hospitals: A Systematic Literature Review 为医院医疗器械库存开发可靠的信息系统:系统性文献综述
Pub Date : 2023-11-21 DOI: 10.37275/oaijmr.v3i6.421
Suryati
Developing an information system for medical equipment inventory in hospitals not only includes technical aspects but also involves an in-depth understanding of the operational needs of the hospital itself. By utilizing the latest technology, such as the Internet of Things (IoT), and efficient data integration, hospitals can ensure that the information systems developed can adapt to the dynamics of future technological needs and developments. This study aimed to explore the development of a reliable information system for inventory of medical equipment in hospitals. The literature search process was carried out on various databases (PubMed, Web of Sciences, EMBASE, Cochrane Libraries, and Google Scholar) regarding the development of a reliable information system for the inventory of medical devices in hospitals. This study follows the preferred reporting items for systematic reviews and meta-analysis (PRISMA) recommendations. Developing an information system for medical device inventory in hospitals is a crucial step in improving the efficiency, availability, and management of health resources. Developing an information system for medical device inventory in hospitals is not just about recording and monitoring but also providing a holistic solution to improve operational efficiency and patient service.
开发医院医疗设备库存信息系统不仅包括技术方面,还涉及对医院自身运营需求的深入了解。通过利用物联网(IoT)等最新技术和高效的数据整合,医院可以确保所开发的信息系统能够适应未来技术需求和发展的动态。本研究旨在探讨医院医疗设备库存可靠信息系统的开发。我们在多个数据库(PubMed、Web of Sciences、EMBASE、Cochrane Libraries 和 Google Scholar)中进行了有关开发医院医疗设备库存可靠信息系统的文献检索。本研究遵循了系统综述和荟萃分析的首选报告项目(PRISMA)建议。开发医院医疗器械库存信息系统是提高医疗资源效率、可用性和管理水平的关键一步。开发医院医疗器械库存信息系统不仅是为了记录和监控,还能提供整体解决方案,提高运营效率和患者服务。
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引用次数: 0
Evaluation of Drug Management at the Pharmacy Installation of "X" Regency Health Office Indonesian in 2021 2021年印度尼西亚“X”县卫生厅药房设备药品管理评价
Pub Date : 2023-09-05 DOI: 10.37275/oaijmr.v3i5.357
Echa Malinda, Naha Ndjurumbaha, Gunawan Pamudji, Widodo, Ismi Rahmawati
Improving public health status can be influenced by the drug management process, one of the components of which is the availability of good drugs. This study aimed to find out the overall process description of drug management, which includes the planning, procurement, storage, and distribution stages, as well as to know the evaluation of drug management related to compliance with the indicators of the Ministry of Health of the Republic of Indonesia & JICA 2010. This study used a type of research descriptive data collection with retrospective and concurrent. Data analysis was carried out by explaining the drug management process at the "X" Regency Health Office, measuring the value of each drug management indicator, and then making a problem-solving based on the Hanlon method. The results of the evaluation of drug management at the Pharmacy Installation of the "X" Regency Health Office were the suitability of the available drug items with the Fornas of 54%; percentage of fund allocation procurement drugs by 93%; percentage suitability of drug planning and procurement by 73%; the percentage of drug planning accuracy is 84%; percentage and value of expired drugs by 8% worth Rp. 39,888,756; The accuracy of drug distribution is 94%; drug availability12-18 months of 94%; and the percentage of drug blanks is 2%. Some indicators are not up to standard, so improvements are made using the Hanlon method.
改善公共卫生状况可能受到药品管理进程的影响,而药品管理进程的组成部分之一是优质药品的供应。本研究旨在了解药物管理的整体流程描述,包括计划、采购、储存和分销阶段,以及了解与符合印度尼西亚共和国卫生部和JICA 2010年指标相关的药物管理评估。本研究采用回顾性和并行的描述性数据收集方法。通过对“X”县卫生厅的药品管理流程进行说明,测量各药品管理指标的值,进行数据分析,并根据汉龙法进行问题求解。对“X”县卫生厅药房设施药品管理的评价结果为:可获得药品项目的适宜性,正确率为54%;药品采购资金分配比例达到93%;药品规划和采购的适宜性百分比为73%;药品计划正确率为84%;过期药品的百分比和价值减少8%,价值39,888,756卢比;药品分布准确率为94%;12-18个月的药物可得性为94%;药物空白的比例是2%有些指标不达标,采用汉龙法进行改进。
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引用次数: 0
Ashy Dermatosis: A Narrative Literature Review 灰色皮肤病:叙述性文献综述
Pub Date : 2023-09-05 DOI: 10.37275/oaijmr.v3i5.356
Anindya Oktafiani, M. Irawanto
Ashy dermatosis (AD) or erythema dyschromicum perstans (EDP) is a type of hyperpigmented macules characterized by asymptomatic, gray macular lesions with a symmetrical distribution. Some of the predisposing factors for ashy dermatosis are intestinal parasitic infections, a bad environment such as consumption of ammonium nitrate, X-ray contrast media and genetic factors such as the HLA-DR4 allele. The clinical manifestations of ashy dermatosis are hyperpigmented or gray macules with slow progression and pigmentation abnormalities in the inner epidermal layer. The differential diagnosis of ashy dermatosis is with lichen planus pigmentosus, idiopathic eruptive macular pigmentation, and Riehl's melanosis. Diagnosis of ashy dermatosis needs to be linked between clinical findings and histopathological examination, other supporting examinations and differentiating it from other differential diagnoses. Management for patients with ashy dermatosis is with topical or systemic agents. For now, a combination of laser and tacrolimus ointment is recommended.
灰色皮肤病(AD)或持久性变色红斑(EDP)是一种色素沉着的斑疹,其特征是无症状的灰色斑疹病变具有对称分布。灰色皮肤病的一些易感因素是肠道寄生虫感染、不良环境(如硝酸铵的消耗、x射线造影剂)和遗传因素(如HLA-DR4等位基因)。灰色皮肤病的临床表现为色素沉着或灰色斑点,进展缓慢,内表皮层色素沉着异常。灰色皮肤病的鉴别诊断是与扁平苔藓色素沉着,特发性黄斑色素沉着,和里尔黑化。灰色皮肤病的诊断需要结合临床表现和组织病理学检查及其他辅助检查,并与其他鉴别诊断相鉴别。治疗灰质皮肤病的方法是局部用药或全身用药。目前,建议激光和他克莫司软膏联合使用。
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引用次数: 0
Development of Pocketbooks as an Education and Compliance Module for Diabetes Mellitus Patients at the Kaliwungu Health Center, Kudus, Indonesia 在印度尼西亚库德斯Kaliwungu保健中心开发袖包作为糖尿病患者的教育和依从性模块
Pub Date : 2023-08-24 DOI: 10.37275/oaijmr.v3i4.351
Eka Fitriani, R. Herowati, Lucia Vita, I. Dewi
Diabetes mellitus (DM) is a chronic disease that requires long-term treatment. Management of DM patients is one of them by providing education. This study aimed to determine the product trial of developing a pocketbook as an educational module using the assessment parameters of experts and DM patients who meet the eligibility criteria at Kaliwungu Health Center, Kudus. This study used qualitative and quantitative analysis. Qualitative analysis in the form of suggestions and input from experts, and quantitative analysis in the form of assessment scores. The method used in this research is research and development. Product development with Borg and Gall procedures. Product trials of pocket book development as a DM patient education module at Kaliwungu Health Center, Kudus, using expert parameters including media experts at 100%, material expert I with a value of 84%, material expert II with a value of 92.3%, material expert III with a value of 100%, expert practitioners with a value of 100% and DM patients with an average value of 80.5% in the category worth using with revision.
糖尿病(DM)是一种需要长期治疗的慢性疾病。对糖尿病患者的管理就是其中之一,即提供教育。本研究旨在利用库德斯Kaliwungu健康中心专家和符合资格标准的糖尿病患者的评估参数,确定开发钱包作为教育模块的产品试验。本研究采用定性和定量分析相结合的方法。以专家建议和意见的形式进行定性分析,以评估分数的形式进行定量分析。本研究采用的方法是研究与开发。博格和加尔程序的产品开发。在Kaliwungu Health Center, Kudus使用专家参数进行口袋书开发作为DM患者教育模块的产品试验,专家参数包括媒体专家100%,材料专家I值为84%,材料专家II值为92.3%,材料专家III值为100%,专家从业者值为100%,DM患者平均值为80.5%。
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引用次数: 0
期刊
Open Access Indonesian Journal of Medical Reviews
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