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Liver, Biliary Tract and Pancreatic Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
In assessing and managing the patient with chronic liver disease, it is important to consider several aspects: Cause of the liver disease: Specific treatment may be indicated and family screening may be required.Presence of portal hypertension: This may lead to ascites and the development of varices that require screening and, where present, treatment to reduce bleeding.Possibility of developing liver cancer: Surveillance is therefore needed.Effect on management of the patient: Consider lifestyle, drug treatment and nutrition.
Drugs of the Future
Published in Mickey C. Smith, E.M. (Mick) Kolassa, Walter Steven Pray, Government, Big Pharma, and the People, 2020
Mickey C. Smith, E.M. (Mick) Kolassa, Walter Steven Pray
There are a number of informal definitions of Lifestyle Drugs. Here are a few: Drugs that are not medically necessary.Drugs that confer no Health benefit, are not indicated for any medical condition, and have no medical indication.Drugs that if not taken, do not result in additional Health risk.Treatments that increase patient satisfaction but without which they could live.Drugs used to treat indications that are personal choice rather than physician-diagnosed illness or to treat problems that affect Health and wellness only marginally.Products that improve perceived quality of life, without improving medical outcomes, or reducing overall Health Care costs.
Expanding medicine
Published in Kevin Dew, Public Health, Personal Health and Pills, 2018
Gaining medical or social acceptance for extending the range of conditions that are suitable to be treated by pharmaceuticals enables the expansion of the medical market and the term ‘pharmaceuticalisation’ has been used more recently to capture this. Pharmaceuticalisation can be seen as both an extension of medicalisation in that it expands conditions that are treated medically, and a challenge to medical dominance in that medical professionals may not be in control of this expansion. Pharmaceuticalisation has been defined as the ‘translation or transformation of human conditions, capabilities and capacities into opportunities for pharmaceutical intervention’ (Williams et al. 2011: 711). The development of lifestyle drugs is an example of an opportunity being exploited by drug companies that target conditions that fall between medical and social conditions, such as hair loss and sexual potency. Other pharmaceuticals are marketed for a particular condition but used for lifestyle purposes, such as drugs for menorrhagia being used to delay menstruation during holidays (Fox and Ward 2008). Pharmaceuticalisation is a complex mix of biology, chemicals, expansion of disease classifications, consumer adoption and corporate interests.
Nonalcoholic steatohepatitis diagnosis and treatment from the perspective of patients and primary care physicians: a cross-sectional survey
Published in Annals of Medicine, 2023
Karl Nadolsky, Donna R. Cryer, Amy Articolo, Travis Fisher, Jennifer Schneider, Mary Rinella
Studies show that lifestyle-, drug-, or surgically-induced weight loss can improve NASH [11,31–33]. Similarly, effectively managing T2DM can lead to liver fibrosis improvement. A study involving serial liver biopsies of Japanese patients with NAFLD found that improvement of liver fibrosis was significantly associated with use of insulin and decrease in HbA1C levels [34]. Many patients with NASH also have hypertension. Several studies found that patients with both NASH and hypertension saw improvement in steatosis, inflammation, and fibrosis when treated with angiotensin II receptor antagonists, but further work is needed [35–37]. Glucagon-like peptide-1 (GLP-1) analogs are indicated for T2DM and obesity have been shown to lead to high rates of NASH resolution compared to placebo in Phase 2 trials [38,39]. These results suggest that control of comorbidities can improve NASH and PCPs are best suited to help patients with management of their comorbidities.
Enhancing the service quality of community pharmacies for non-prescription medicines based on the perspectives of pharmacists and patients: a qualitative study
Published in Journal of Communication in Healthcare, 2023
Ramida Wongvedvanij, Chonlatis Darawong
More importantly, pharmacists with a strong rapport with their patients can obtain in-depth and factual personal information, including lifestyle, drug-use, and attitudes, which may influence a patient’s condition. For example, a pharmacist suggested the following: Normally, my patients do not want to reveal any personal information to anyone. However, once we develop our friendship, the patient was more willing to share personal information in our relationship. Most patients want someone who treats them well. If we speak politely, they will probably like it more, and it should make a good impression from the first meeting. (Pharmacist 5)I really like Thai pharmacists who are friendly and nice to foreigners. They always provide service with smile and a sincere personality. This is a unique characteristic of Thai people which makes a good impression on foreign tourists. (Patient 19)
“Marvin, the Paranoid Android”: The Case of an Alpha-PVP User in the Expanding Galaxy of NPS
Published in Journal of Psychoactive Drugs, 2018
Simonato Pierluigi, Bulsis Laura, Negri Attilio, Bansal Gurjeet K, Pessa Gloria, Mioni Davide, Giuseppe Borgherini, Martinotti Giovanni, Schifano Fabrizio, Giulia Perini, Corazza Ornella
The rapid diffusion of novel psychoactive substances (NPS) represents an unprecedented phenomenon where synthetic drugs are reinvented and reintroduced with new and varied effects. Some NPS have been categorized in terms of their chemical structures and effects; several groups of substances have been identified by agencies (United Nations Office on Drugs and Crime; UNODC 2016) and literature (European Monitoring Centre for Drugs and Drugs Addiction; EMCDDA 2015a; Schifano et al. 2015): phenethylamines and novel stimulants, synthetic cannabinoids, cathinone derivatives, synthetic opiates/opioids, tryptamine derivatives, phencyclidine-like dissociatives, piperazines, GABA-A/GABA-B receptor agonists, a range of prescribing medications and psychoactive plants/herbs and “performance and image-enhancing drugs” (PIEDs), or “lifestyle drugs” (Mooney et al. 2017).