The use of trimethoprim and sulfamethoxazole (TMP-SMX) in dermatology.

We analyzed publications and articles in the PubMed database about the use of trimethoprim and sulfamethoxazole (TMP-SMX) in dermatology. Literature published in the English language, at least in the past two decades, was reviewed. Specific dermatologic indications for TMP-SMX are few but it is often used as the second- or third- line agent. TMP-SMX is used to treat cutaneous nocardiosis and Aeromonas infections. TMP-SMX is a treatment option for cat - scratch disease, granuloma inguinale, melioidosis and Mycobacterium marinum/fortuitum cutaneous infections. TMP-SMX is an alternate choice for treatment of pyodermas and lymphogranuloma venereum. TMP-SMX has been used to treat acne vulgaris in tetracycline and erythromycin - resistant patients. TMP-SMX is still the preferred empiric antibiotic for methicillin - resistant Staphylococcus aureus skin and soft tissue infection in HIV positive population. TMP-SMX is used in dermatology to treat various skin conditions and is one of the most commonly prescribed sulfonamide drugs. TMP-SMX as monotherapy is an effective treatment option in many diseases but due to drug resistance, a combination therapy-usually of two drugs-may be considered.

Awareness of cardiovascular risk factors in ambulatory cardiology patients.

Cardiovascular diseases (CVD) are the leading cause of mortality. The majority of CVD risk factors are modifiable and controllable so the knowledge of them might prevent circulatory diseases development and improve already diagnosed CVD outcomes. The aim of the study was to assess the awareness of risk factors for CVD in ambulatory patients of cardiology offices. A specially designed questionnaire was used by trained physicians in a structured technique of face-to-face interview in 284 consecutive patients (men - 47.9%, aged 64.1 ± 11.2 years). As many as 6.3% of the study participants did not name any CVD risk factor, whereas only 7.4% of patients knew at least 3 of them. Smoking and high cholesterol were best recognized (33.1% and 27.4%, respectively) while the least often quoted old age was identified only by 2.5% of the individuals. The average number of the listed CVD risk factors equaled 1.38 ± 0.77. In the multiple regression analysis the factors significantly associated with knowledge of CVD risk factors comprised the level of education (b = 0.55, p < 0.0001) and age (b = -0.02, p < 0.0001). The patients with family history of CVD diseases were more often aware of the fact that family history of CVD is a risk factor for CVD as compared to individuals with no relatives affected by CVD (21.9% vs 10.1%, p = 0.0061). To the contrary, respondents with hypercholesterolemia less often knew that dyslipidemia is a CVD risk factor than patients with normal cholesterol levels (24.1% vs 41.1%, p = 0.0108). In conclusion, the awareness of cardiovascular risk factors in ambulatory cardiology patients is very low. The perception of CVD risk factors is affected by the level of education and age.

Non-steroidal anti-inflammatory drugs and paracetamol in self-therapy of various disorders in students of different fields of study.

Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol are most commonly the first-line pharmacotherapy in combating different pain and inflammatory disorders and fever. Unfortunately, those drugs might have serious side effects, especially when they are used in an inappropriate way. The aim of the study was to explore various aspects of NSAIDs and paracetamol use in the self-therapy of miscellaneous disorders in young adults. The questionnaire-based survey comprised 250 consecutive students aged 22.1 ± 1.9 years (189 women) of diverse fields of study. The drugs were applied in clinical conditions in which they should be avoided including asthma attack (1.2%), vomiting (2.4%), malaise and depression (3.6%), in autumn and winter as a preventive measure against infections (14.0%), heart-burn (2.0%) and during food poisoning (16.0%). As many as 6.0% of the students claimed that studied medications are ultimately free of adverse reactions. Men more frequently than women used NSAIDs and paracetamol during alcohol consumption (49.2% vs 30.7%, p = 0.009, respectively) but less often were aware that there are maximum doses of medications which should not be exceeded (57.4% vs 76.7%, p = 0.003, respectively). The students of medical-related degree courses (n = 82) compared with individuals of other subjects (n = 168) declared they more often have the custom of always reading medications' leaflets (46.3% vs 31.0%, p = 0.017, respectively). Side effects of medicines were reported by 65 participants - 26.0%. In conclusion, students' knowledge about NSAIDs and paracetamol is low. Participants do not search for information on drug related endangerments, the medication group choice for the given disorder is often inappropriate and the drugs are applied in conditions in which they are contraindicated.