Summary The presence of diabetes mellitus leads to a decrease in life quality in all domains. The aim of our study was to evaluate the quality of life (QOL) in diabetic patients and the factors affecting it in type 2 diabetic mellitus patients. We conducted a cross-sectional study that included 86 patients with type 2 diabetes mellitus, in the territory of the City of Niš. Health-related QOL of patients was measured using the short form survey (SF-36) that produces an 8-scale health profile. The average duration of diabetes was 12.76±8.08 years. The best QOL in all areas was observed in patients diagnosed with diabetes less than 10 years ago p<0.05) and younger than 65 years. Male respondents perceived a better QOL compared to women, especially in the vitality and pain domains. The patients with comorbidity (93.64%) had lower QOL score in all domains. There was no significant difference in the QOL of patients with diabetes compared to the level of education. High QOL represents an ultimate goal and an important outcome of all medical interventions in diabetic patients. Factors related to lower QOL included: older age, female gender, and existence of comorbidities. Uncontrolled diabetic patients had a lower QOL than controlled diabetics.
The degree of patient cooperation plays a key role in the success of antihypertensive drug therapy. Non-adherence is the major health and economic problem in the treatment of arterial hypertension (HTA). The aim of the study was to evaluate the degree of adherence in hypertensive patients and to study risk factors affecting adherence and the effects of non-adherence on blood pressure (BP). We performed a cross-sectional study, which involved 170 outpatients with HTA, treated in primary healthcare. Patients were divided into two groups, depending on the degree of adherence, measured using a validated survey form. Statistical analysis was performed using the Pearson's Chi-square and t-test. Good adherence was observed in 126 (74.12%) outpatients. Elderly patients with longer duration of HTA and larger number of drugs in the therapy showed a lower degree of adherence, with more side-effects (p<0.01). Patients younger than 65 years were found to be more likely to adhere to their medication regimen, compared to elderly patients (χ 2 =21.3; p<0.01; OR=6.0 95%, CI 2.76-13.04). Uncontrolled BP occurred in the significantly higher percentage in non-adherent patients (59.1%) compared to the adherent group (21.4%) (χ 2 =19.84; p<0.01; OR=5.30 95%, CI 2.39-11.85). The most common reason for poor adherence was non-compliance with dosage regimen (27.27%).The medication adherence rate was found to be low among elderly patients. A poor adherence was found to negatively affect BP control. Determining the factors for non-adherence and developing multidisciplinary intervention programs to address the identified factors are necessary to improve adherence to medication and BP control.
The aim of this study was to develop a population pharmacokinetic (PK) model for clearance of mycophenolic acid (MPA) in adult renal transplant recipients, to quantify the PK parameters and the influence of covariates on the MPA pharmacokinetic parameters. Parameters associated with plasma concentrations of MPA at steady-state were analyzed in 70 renal transplant recipients (mean age 42.97 years; mean total body weight 75.33 kg) using nonlinear mixed-effect modeling (NONMEM). Characteristics of patients screened for influence on the pharmacokinetic parameters were gender, age, body weight, time after transplantation, whether the patient was diagnosed as having diabetes mellitus, organ source (living or deceased donor), biochemical parameters and co-therapy (tacrolimus, cyclosporine, prednisolone, omeprazole, bisoprolol, carvedilol, nifedipine). A validation set of 25 renal transplant recipients was used to estimate the predictive performance of population pharmacokinetic model. Typical mean value of MPA oral clearance, estimated by base model (without covariates) was 0.741 L h(-1). During population modeling, the full model showed that clearance of the MPA was significantly influenced by age, total daily dose of MPA, creatinine clearance, albumin level, status and gender of a donor, and the nifedipine and tacrolimus co-therapy. In the final model, clearance of MPA was reported to be significantly influenced by age, total daily dose of MPA and thenifedipine co-therapy. The derived model describes adequately MPA clearance in terms of characteristics of our patients, offering basis for individual pharmacotherapy approach.
Data on the physical properties of cow milk and infant formulas are important since they indicate the differences in physicochemical and rheological characteristics and compatibility with natural breast milk. This fact is important not only for quality control but also for the use of these commercial products as infant diet supplements or as complete breast milk substitutes. This study was undertaken to determine refractive index, surface tension, pH, electrical conductivity, viscosity and titratable acidity of the UHT cow milk, starter infant formulas and breast milk of Serbian mothers in order to compare commercial milk formulations with natural human milk. The paper also presents the measured data of some physical parameters of human milk about which there is little information in the literature. It has been also demonstrated how these parameters were changed by freezing and prolonged storage of breast milk.In this study, 8 commercial cow milks, 6 starter infant formulas and 15 different samples of colostrum, transition and mature breast milk were included. The titratable acidity, pH, electrical conductivity, refractive index, viscosity and surface tension were measured by using standardized techniques. It has been found that infant formulas available on the Serbian market differ in physicochemical parameters compared to breast milk. Regarding these parameters, none of the analyzed formulas fully corresponded to breast milk. It has been also shown that measurement of physical parameters is simple and inexpensive way to monitor the milk shelf-life which is important for human milk banks.
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