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Lifestyle Changes in Medical Students during the COVID-19 Pandemic COVID-19大流行期间医学生生活方式的变化
Pub Date : 2022-05-01 DOI: 10.37489/2588-0519-2022-1-64-71
V. A. Sergeeva, T. Lipatova
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引用次数: 3
Clinical-economic analysis of the target therapy in severe atopic dermatitidis in adults 成人严重特应性皮炎靶向治疗的临床经济分析
Pub Date : 2022-04-30 DOI: 10.37489/2588-0519-2022-1-17-29
A. Kolbin, Y. Gomon, M. Proskurin, Y. E. Balikina
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引用次数: 0
Mirabegron: pharmacoeconomic aspects of the use of the drug for the treatment of overactive bladder syndrome 米拉贝龙:药物经济学方面使用该药治疗膀胱过动症
Pub Date : 2022-04-30 DOI: 10.37489/2588-0519-2022-1-30-40
O. Ivakhnenko, E. Derkach, V. Krysanova, A. D. Ermolaeva, K. Kokushkin
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引用次数: 0
Ademetionine treatment cost analysis of patients with intrahepatic cholestasis and non-alcoholic fatty disease 糖腺苷治疗肝内胆汁淤积和非酒精性脂肪性疾病的成本分析
Pub Date : 2022-04-30 DOI: 10.37489/2588-0519-2022-1-41-52
M. Zhuravleva, G. Kukushkin, E. Luchinina, T. Shelekhova, T. Kameneva, E. V. Kuznetsova, E. A. Luchinin
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引用次数: 0
The clinical-economic characteristic of current basis-bolus insulin therapy schemes in diabetes mellitus type 1 in adults 目前1型糖尿病成人基础胰岛素治疗方案的临床-经济特点
Pub Date : 2022-04-28 DOI: 10.37489/2588-0519-2022-1-4-16
A. Kolbin, A. A. Kurilev, Y. E. Balikina, M. Proskurin
Basis-bolus insulin therapy is a cornerstone of Diabetes Mellitus type 1 (DM1T) control. Basal insulin analogs — glargine 300 U/ml (iGla 300), glargine 100 U/ml (iGla 100), detemir (iDet) degludec (iDeg), — as well as prandial insulins — glulisine (iGlu), aspart (iAsp) and lispro — are used widely during last 10–15 years. Aim. Evaluation of a comparative economic efficacy of the different basis-bolus schemes of insulin therapy in DM1T in adults. Materials and methods. Analysis has been performed for the following schemes: iGla 300 + iGlu, iGla 100 + iGlu, iDet+iAsp, iDeg+iAsp from Govt position based on modelling of the efficacy for 5 years. Data regarding probability of complications based on glycated hemoglobin (HbA1c) reduction for human insulin treatment and insulin analogs were taken into modelling. Direct medical costs were calculated for insulins, complications, hypoglycemic including severe events. Sensitivity analysis has been performed for validation of the received results. Results: Insulin analogs have economic advantages in compare with human insulins for DM1T control for 6.5 years. They could reduce expenditures in 1.89 times. iGla 300 + iGlu and iDeg+iGlu reduced HbA1c more effective among analogs and hypo events were more rare also (35.0 episodes/patient/year), including severe (0.57 and 0.70 episodes/patient/ year accordingly) vs iGla 100 + iGlu and iDet+iAsp (37.8 and 39.9 episodes/patient/year and 1.10 and 1.21 episodes/patient/ year for severe accordingly). Calculated direct medical costs were less for iGla 300 + iGlu, after that were following iGla 100 + iGlu, iDet+iAsp and last (highest) were expenditures for iDeg+iAsp. Conclusion. Created model prognoses complications of DM1T depending on schemes of insulin therapy and calculates of direct costs. iGla 300 + iGlu has economic advantages vs iGla100 + iGlu, iDet+iAsp and iDeg+iAsp in DM1T control during 5 years horizon.
基础胰岛素治疗是1型糖尿病(DM1T)控制的基石。基础胰岛素类似物-甘精300 U/ml (iGla 300),甘精100 U/ml (iGla 100),地替米特(iDet) -去gludec (iDeg) -以及餐用胰岛素-甘氨酸(iGlu),天门精(iAsp)和利斯普罗-在过去10-15年被广泛使用。的目标。评估不同基础-剂量胰岛素治疗方案对成人DM1T的比较经济效果。材料和方法。根据5年疗效模型,对以下方案进行了分析:iGla 300 + iGlu、iGla 100 + iGlu、iDet+iAsp、iDeg+iAsp。模型采用了基于糖化血红蛋白(HbA1c)降低的人胰岛素治疗和胰岛素类似物的并发症概率数据。计算胰岛素、并发症、低血糖(包括严重事件)的直接医疗费用。为验证收到的结果,进行了敏感性分析。结果:与人胰岛素相比,胰岛素类似物在6.5年的DM1T控制中具有经济优势。他们可以减少1.89倍的支出。iGla 300 +iGlu和iDeg+iGlu在类似物中更有效地降低了HbA1c,低事件也更罕见(35.0次/患者/年),包括严重的(分别为0.57和0.70次/患者/年),而iGla 100 +iGlu和iDeg+ iAsp(分别为37.8和39.9次/患者/年,分别为1.10和1.21次/患者/年)。计算出的直接医疗费用以iGla 300 + iGlu最少,其次是iGla 100 + iGlu,其次是iDeg+iAsp,最后(最高)是iDeg+iAsp。结论。根据胰岛素治疗方案和直接成本计算建立DM1T并发症预测模型。igla300 + iGlu与iGla100 + iGlu、iDet+iAsp、iDeg+iAsp相比,在5年时间内对DM1T的控制具有经济优势。
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引用次数: 0
Issues of drug circulation in a hospital: how to optimize work in a medical information system 医院药品流通问题:如何在医疗信息系统中优化工作
Pub Date : 2022-02-25 DOI: 10.37489/2588-0519-2022-1-72-84
A. S. Fedorenko, A. Burbello, E. L. Lataria, O. V. Granatovich, M. Pokladova
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引用次数: 0
Analysis of the effectiveness of the use of financial resources in the procurement of pharmaceuticals for state needs 分析为满足国家需要采购药品时财政资源使用的有效性
Pub Date : 2022-02-13 DOI: 10.37489/2588-0519-2021-4-75-79
M. G. Malaev
The use of different methods for analyzing the procurement of drugs for state needs made it possible to reveal the excessive range of drugs included in state contracts, as well as the low efficiency of the use of funds.
使用不同的方法分析国家需要的药品采购,可以揭示国家合同所包括的药品范围过大,以及资金使用效率低下。
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引用次数: 0
The rationality of recommendations of drugs for patients with cephalgia in simulated situations in the pharmacy 药房模拟情境下头痛症患者用药建议的合理性
Pub Date : 2022-02-13 DOI: 10.37489/2588-0519-2021-4-27-43
O. Reshetko, A. I. Grishin
Relevance. According to statistics of the World Health Organization, at least half of the world’s adult population experienced headaches at least once a year. Patients suffering from headaches do not always have the opportunity to visit a doctor, therefore, an important role in helping these patients is assigned to pharmacists. Purpose. Based on the pharmacoepidemiological study to identify the features of providing pharmaceutical care to patients with headache in pharmacies in the issue of rationality of recommendations of pharmaceutical workers. Materials and methods. A pharmacoepidemiological study was conducted based on a survey of 153 pharmaceutical workers (Saratov) using a specially developed questionnaire that includes free-form questions with a simulated situation. The data was processed using Microsoft Excel 2010 and STATISTIKA 6.0. Results Of the groups recommended to visitors, INNs in the group «Nonsteroidal anti-inflammatory and antirheumatic drugs [M01A]» account for 45.0 % of all INNs, and the group «Analgesics [N02]» - 55.0 %. Ibuprofen (62.8 %) and the combination of drotaverine + caffeine + naproxen + paracetamol + phenylephrine (41.2 %) were noted as the most frequently recommended. A visit to a doctor was recommended by the majority of respondents (52.3 %, n=153) in the case of a patient with a headache accompanied by nausea and vomiting. Ibuprofen (90.8 %) or paracetamol (45.8 %), moreover in the form of suspension or suppositories, are the preferred recommendations for headache in children under 3 years of age (n=131). Paracetamol in combinations (69.2 %) prevails as the first recommendation for headache associated with acute respiratory viral infections (n??=146). Non-selective NSAIDs for a patient with gastrointestinal complications could be recommended by 43.4 % of specialists (n=113). The NSAID recommendation is the most frequent (51.8 %, n=110) in the case of an 80-year-old patient without concomitant diseases. Paracetamol (50.0 %) or ibuprofen (34.7 %) would be more often recommended by pharmaceutical workers for a pregnant woman with headache (n=98). In case of headache after trauma, 47.1 % recommend a visit to a doctor (n=153). Conclusion. The frequent recommendation of combined analgesics and their association with the development of drug-induced headaches indicates the need for careful recommendation of these drugs. Not always correct recommendations indicate the need to increase the level of professional knowledge, study clinical recommendations for the therapy and diagnosis of cephalgia, which can make it possible to make a rational choice of the drug, initially assume that the visitor has conditions that require a visit to a doctor, and ultimately improve the quality of pharmaceutical care.
的相关性。根据世界卫生组织的统计,世界上至少有一半的成年人每年至少经历一次头痛。患有头痛的患者并不总是有机会去看医生,因此,药剂师在帮助这些患者方面扮演着重要的角色。目的。通过药物流行病学研究,找出在药店为头痛患者提供药学服务的特点,提出对药学工作者的合理性建议。材料和方法。在对153名制药工人(萨拉托夫)进行调查的基础上进行了一项药物流行病学研究,使用了一份特别编制的问卷,其中包括模拟情况的自由形式问题。数据采用Microsoft Excel 2010和statisticka 6.0进行处理。结果在向来访者推荐的用药组中,“非甾体类抗炎抗风湿药[M01A]”组的INNs占全部INNs的45.0%,“镇痛药[N02]”组的INNs占55.0%。布洛芬(62.8%)和氯他弗林+咖啡因+萘普生+对乙酰氨基酚+苯肾上腺素(41.2%)的组合是最常被推荐的。大多数受访者(52.3%,n=153)建议在头痛伴有恶心和呕吐的情况下去看医生。布洛芬(90.8%)或扑热息痛(45.8%)以及混悬剂或栓剂是治疗3岁以下儿童头痛的首选药物(n=131)。复方扑热息痛(69.2%)是治疗急性呼吸道病毒感染相关头痛的首选药物(n??=146)。43.4%的专科医生(n=113)推荐非选择性非甾体抗炎药用于胃肠道并发症患者。非甾体抗炎药(NSAID)的推荐是最常见的(51.8%,n=110),患者为80岁,无合并疾病。对乙酰氨基酚(50.0%)或布洛芬(34.7%)更常被药学工作者推荐用于孕妇头痛(n=98)。在创伤后头痛的情况下,47.1%的人建议去看医生(n=153)。结论。频繁推荐联合镇痛药及其与药物性头痛发展的关联表明需要谨慎推荐这些药物。不总是正确的建议表明需要提高专业知识水平,研究治疗和诊断头痛的临床建议,这可以使合理选择药物成为可能,初步假设来访者有需要去看医生的条件,最终提高药学服务的质量。
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引用次数: 1
Heart failure as a risk factor of adverse drug reactions. Part 1: potential changes in pharmacokinetics 心衰是药物不良反应的危险因素。第1部分:药代动力学的潜在变化
Pub Date : 2022-02-13 DOI: 10.37489/2588-0519-2021-4-53-59
A. Pereverzev, O. Ostroumova
The use of many drugs is associated with the risk of adverse drug reactions (ADRs), including those that increase mortality and / or morbidity and / or seek medical help or hospitalization, so called «drug-induced diseases» (DID). There is a number of factors that increase the risk of DID (risk factors) including comorbid diseases (for example, chronic kidney disease, hepatic impairment, obesity etc.). These pathologic conditions induce changes in pharmacokinetics (PK) and pharmacodynamics of drugs, thereby increasing the risk of ADRs. One of these diseases is heart failure (HF). Most studies of PK changes were conducted among patients with LVEF from 40 to 45 %, and excluded patients with concomitant diseases that could affect the PK of drugs (for example, serious liver and / or kidney diseases), therefore in polymorbid patients, trial findings may not be applicable. HF may be associated with a decrease in bioavailability, a decrease in volume of distribution, a change in the activity of cytochrome P450 isoenzymes, etc. Individual dose and dosage regimen adjustment can significantly reduce risks, improve the quality of medical care and improve the prognosis in patients with heart failure.
许多药物的使用与药物不良反应(adr)的风险有关,包括那些增加死亡率和/或发病率和/或寻求医疗帮助或住院的风险,即所谓的“药物性疾病”(DID)。有许多因素会增加DID(危险因素)的风险,包括合并症(例如,慢性肾病、肝功能损害、肥胖等)。这些病理状况会引起药物的药代动力学(PK)和药效学的改变,从而增加adr的风险。其中一种疾病是心力衰竭。大多数关于PK变化的研究是在40% - 45%的LVEF患者中进行的,并且排除了可能影响药物PK的合并疾病患者(例如严重的肝脏和/或肾脏疾病),因此在多病患者中,试验结果可能不适用。HF可能与生物利用度降低、分布体积减少、细胞色素P450同工酶活性改变等有关。调整个体化剂量和给药方案可显著降低心力衰竭患者的风险,提高医疗服务质量,改善预后。
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引用次数: 0
Nonsteroidal anti-inflammatory drugs’ adverse drug reactions: 10 years of national database data 非甾体类抗炎药不良反应:10年国家数据库数据
Pub Date : 2022-02-13 DOI: 10.37489/2588-0519-2021-4-16-26
G. I. Syraeva, A. Kolbin
The group of non-steroidal anti-inflammatory drugs has occupied one of the leading positions in terms of demand by the population over the past decade. This fact is explained by non-prescription sale, a wide range of purposes and an affordable price range. The lack of proper control over the use of non-steroidal anti-inflammatory drugs (NSAIDs) greatly complicates the assessment of safety, timely detection and prevention of events associated with patient’ safety. Target. Evaluation of data from the national pharmacovigilance database of the safety of non-steroidal anti-inflammatory drugs. Materials and methods. This is a cross-sectional study covering the period from 2010 till 2020. The assessment of the safety profile of international non-proprietary names (INN) from the group of NSAIDs at the post-registration stage was carried out according to the data of uploading the national database (Automated Information System of Roszdravnadzor; AIS RZN), as well as PubMed, Medline, Google Scholar, Elibrary databases. Conclusions. Over a ten-year period, the number of registered spontaneous messages was 8,334. With regard to the three international generic names, the number of adverse drug reactions prevails - this is metamizole (1875 (22.5 %)), acetylsalicylic acid (1716 (20.6 %)), diclofenac (979 (11.7 %)). The main system organ class with safety-related events are described for skin and subcutaneous structures. This fact is not consistent with the data of reference sources of information, which indicates the ineffectiveness of post-marketing observations by marketing authorization holders.
在过去的十年中,非甾体类抗炎药在人口需求方面占据了领先地位。这一事实可以通过非处方销售、用途广泛和价格合理来解释。对非甾体抗炎药(NSAIDs)的使用缺乏适当的控制,极大地复杂化了安全性评估、及时发现和预防与患者安全相关的事件。目标。对国家药物警戒数据库非甾体抗炎药安全性数据的评价。材料和方法。这是一项从2010年到2020年的横断面研究。国际非专利名称(INN)在注册后阶段的安全性评估是根据国家数据库(Roszdravnadzor;AIS RZN),以及PubMed、Medline、Google Scholar和图书馆数据库。结论。在10年的时间里,注册的自发信息数量为8334条。在这三个国际通用名中,药物不良反应的发生率最高,分别为:metamizole(1875例(22.5%))、acetylsalicyacid(1716例(20.6%))、双氯芬酸(979例(11.7%))。主要系统器官类与安全相关的事件被描述为皮肤和皮下结构。这一事实与参考信息源的数据不一致,这表明上市许可持有人的上市后观察无效。
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引用次数: 2
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Kachestvennaya Klinicheskaya Praktika = Good Clinical Practice
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