• Stephens Miranda posted an update 6 months ago

    Datenschutzkautelen betriebenes Linkage gelingen kann und aufgrund der Verfügbarkeit relevanter Informationen aus Abrechnungsdaten eine empirische Bereicherung insbesondere für gesundheitsökonomische Analysen darstellt. Dies sollte als Anregung verstanden werden, in Evaluationsstudien Datenlinkage-Prozeduren in Zukunft in verstärktem Maße einzusetzen.in English, German ZIEL DER STUDIE Das Datenlinkage von Primär- und Sekundärdaten erfreut sich in der Versorgungsforschung zunehmender Beliebtheit, birgt jedoch unter anderem in Bezug auf den Datenschutz einige Herausforderungen für die Beteiligten. Ziel der vorliegenden Arbeit ist es, das im Rahmen einer Kohortenstudie aus dem Bereich pädiatrischer Versorgungsforschung (EcoCare-PIn) angewandte methodische Vorgehen beim Linkage dreier Datenquellen darzulegen sowie praxisrelevante Erfahrungen zu berichten. Hierbei wird besonders auf notwendige regulatorische Maßnahmen bezüglich des Datenzuganges und -linkage sowie auf die Datenvalidierung zur Absicherung einer fehlerfreien Verlinkung eingegangen. METHODEN Unter Berücksichtigung aller datenschutzrelevanten Erfordernisse wurde auf individueller Ebene ein Linkage von a) pseudonymisierten Abrechnungsdaten einer gesetzlichen Krankenkasse zu in den Jahren 2007 bis 2013 geborenen Kindern aus Sachsen, b) Primärdaten einer postalischen Befragung von Eltern/Betreuern unkundärdaten eröffnet wertvolle Möglichkeiten, die Stärken verschiedener Datenquellen synergistisch zu nutzen und einige ihrer Schwächen zu kompensieren. Krankenkassendaten und Daten der Kindergarten- und Schuleingangsuntersuchungen sächsischer Gesundheitsämter stellen Beispiele für bereits vorhandene Datenkörper dar, die kostenintensive Primärdatenerhebungen um wertvolle Datenbestände ergänzen können und Möglichkeiten für längsschnittliche Analysen eröffnen.In Japan, tuberculosis has been recognized as one of the major infections requiring urgent measures because of its high morbidity rate even now especially in elderly people suffering from tuberculosis during the past epidemic and its reactivation. Hence, many Japanese clinicians have made efforts to suppress the onset of tuberculosis and treat it effectively. The objectives of this study are to (1) identify covariate(s) that may explain the variation of rifampicin, which is the key antitubercular agent, under the steady-state by evaluating its population pharmacokinetics and (2) to propose an appropriate dosing method of rifampicin to Japanese patients. For this purpose, serum concentration-time data were obtained from 138 patients receiving rifampicin (300-450 mg) and isoniazid (300-400 mg) every day over 14 days, and analyzed using nonlinear mixed effects model. Thereby, population pharmacokinetic parameters were estimated followed by elucidating relations between the parameters and statistical factors. The analysis adopted one-compartment model including Lag-time by assuming that the absorption process is 0+1st order. The analyses demonstrate that meal affected the bioavailability, primary absorption rate constant, and zero order absorption time in the constructed model. A body weight calculated from the power model was selected as the covariate by the Stepwise Covariate Model method and found to highly affect the clearance in the range from -31.6% to 47.4%. We conclude that the dose in Japanese tuberculous patients can be well estimated by the power model formula and should be taken into consideration when rifampicin is administered. see more © Georg Thieme Verlag KG Stuttgart · New York.Previous research has suggested that incarceration has negative implications for individuals’ well-being, health, and mortality. Most of these studies, however, have not followed former prisoners over an extended period and into older adult ages, when the risk of health deterioration and mortality is the greatest. Contributing to this literature, this study is the first to employ the Panel Study of Income Dynamics (PSID) to estimate the long-run association between individual incarceration and mortality over nearly 40 years. We also supplement those analyses with data from the National Longitudinal Survey of Youth 1979 (NLSY79). We then use these estimates to investigate the implications of the U.S. incarceration regime and the post-1980 incarceration boom for the U.S. health and mortality disadvantage relative to industrialized peer countries (the United Kingdom).Sirt1 is a potent inhibitor of both poly(ADP-ribose) polymerases1 (PARP1) and NF-kB. This study investigated the cardioprotective effect of exendin-4 on cardiac function and remodeling in rats after an expreimentally-induced myocardial infarction (MI) and explored if this protection involves SIRT1/PARP1 axis. Rats were divided into five groups (n = 10/each) sham, sham + exendin-4 (25 nmol/kg/day i.p.), MI (induced by LAD occlusion), MI + exendin-4, and sham + exendin-4 + EX527 (5 mg/2×/week) (a SIRT1 inhibitor). All treatments were given for 6 weeks post the induction of MI. In sham-operated and MI-induced rats, exendin-4 significantly upregulated Bcl-2 levels, enhanced activity, mRNA, and levels of SIRT1, inhibited activity, mRNA, and levels of PARP1, and reduced ROS generation and PARP1 acetylation. In MI-treated rats, these effects were associated with improved cardiac architectures and LV function, reduced collagen deposition, and reduced mRNA and total levels of TNF-α and IL-6, as well as, the activation of NF-κB p65. In addition, exendin-4 inhibited the interaction of PARP1 with p300, TGF-β1, Smad3, and NF-κB p65 and signficantly reduced mRNA and protein levels of collagen I/III and protein levels of MMP2/9. In conclusion, exendin-4 is a potent cardioprotective agent that prevents post-MI inflammation and cardiac remodeling by activating SIRT1-induced inhibition of PARP1.Given limited information regarding the pathophysiology underlying aciclovir-associated, clinically observed cardiovascular adverse events including chest pain, tachycardia, bradycardia, palpitation, arrhythmia, hypertension and hypotension, we investigated its electropharmacological effects using the halothane-anesthetized beagle dogs. Aciclovir in doses of 2 and 20 mg/kg was sequentially infused over 10 min with an interval of 20 min (n = 4), which would achieve sub-therapeutic to supra-therapeutic levels of plasma concentrations. Aciclovir decreased the total peripheral vascular resistance along with the blood pressure in a dose-related manner, which increased the heart rate, ventricular contraction and atrioventricular nodal conduction speed probably via a reflex-mediated increase of sympathetic tone. No significant change was detected in the intra-atrial or intra-ventricular conduction, indicating that aciclovir may not inhibit atrial or ventricular INa. Aciclovir prolonged the repolarization period in a dose-related as well as in a reverse frequency-dependent manners, indicating that aciclovir may inhibit IKr, which was supported by the Tpeak - Tend prolongation.

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