Comparison of clopidogrel vs. ticagrelor medication adherence in patients with acute coronary syndrome.

OBJECTIVE: Medication nonadherence to dual antiplatelet therapy increases major cardiovascular events. In this study, we investigated patients' post-acute coronary syndrome (ACS) medication adherence to clopidogrel and ticagrelor over a 12-month period. Furthermore, we also examined the factors that may affect medication adherence in this patient population. PATIENTS AND METHODS: This study included 509 patients who were scheduled for dual antiplatelet therapy for one year following ACS (October 2018-December 2019). A proportion of days covered (PDC) method, based on a pharmacy database system, was used to determine their medication adherence. Medication adherence was defined as > 80% PDC. RESULTS: No difference was found between clopidogrel and ticagrelor in terms of medication adherence (68.3% vs. 64.6%, p = 0.39). Moreover, higher education levels (B = 3.24, CI: 1.17-8.9, p = 0.023) and percutaneous coronary intervention (PCI) as a revascularization option (B = 0.35, CI: 0.17-0.71, p = 0.004) predicted medication adherence independently. CONCLUSIONS: In this research, medication adherence was found to be similar between the clopidogrel and ticagrelor groups. It was also predicted by higher education levels and revascularization with PCI.

Referential noun phrases distribute differently in Turkish speakers with schizophrenia.

In all human languages, noun phrases (NPs) (e.g., 'a field', 'the woman with a book') are used to identify entities in discourse. Previous evidence has shown that the spontaneous speech of patients with schizophrenia (Sz) shows differences in the distribution of grammatically different types of NPs, which are in part specific to patients with formal thought disorder (FTD). Here we sought to provide the first evidence of related grammatical effects in a non-Indo-European language. Results from a picture description task in a sample of 16 Turkish speakers with FTD (+FTD), 15 without FTD (-FTD), and 27 controls revealed that relative to controls, people with Sz over-produced NPs that are 'bare' (in the sense of lacking any grammatical items such as the or a in English). The +FTD group generally showed stronger effects than -FTD, and used more pronouns and less NPs co-referring with previously mentioned NPs. In addition, the dynamic distribution of NP types over narrative time showed an effect of increased mean distance between definite NPs in -FTD relative to controls. In +FTD but no other group there was an unexpected random distribution of indefinite DPs. Incidence rates of referential anomalies increased from controls to the -FTD and +FTD groups. These findings further confirm that Sz is manifest through specific linguistic effects in the referential structure of meaning as mediated by grammar. They provide a linguistic baseline for neurocognitive models of FTD and help to define appropriate targets for the automatic extraction of linguistic features to classify psychotic speech.

Percutaneous coronary intervention vs. optimal medical therapy--the other side of the coin: medication adherence.

WHAT IS KNOWN AND OBJECTIVE: Although many studies have examined medication adherence in patients with coronary artery disease (CAD), no prospective trial has compared medication adherence between patients treated with percutaneous coronary intervention (PCI) or with optimal medical therapy (OMT) in real life. This study sought to compare the adherence to evidence-based secondary preventive medications in patients with documented CAD treated with PCI and OMT, or OMT alone. METHODS: We evaluated adherence to statins, beta-blockers, and angiotensin converting enzyme inhibitors (ACEI) during a 6-month follow-up in 232 patients with documented CAD, comparing patients treated with PCI and those receiving medical therapy alone. Medication adherence was measured with reference to national reimbursement database records. RESULTS AND DISCUSSION: Of the 232 patients who survived the 6-month follow-up, the percentages of adherent patients according to prescription records (prespecified primary endpoint) were 53·6% (n = 82) in the PCI group and 33·8% (n = 27) in the OMT group (P = 0·004). Analysis of the individual medication classes revealed similar results for beta-blockers (86·0% in PCI group vs. 72·5% in OMT group, P = 0·006) and statins (64·5% in PCI group vs. 44·0% in OMT group, P = 0·003). Adherence to ACEI was also higher in the PCI group, but the difference was not statistically significant (77·6% vs. 69·3%, P = 0·17). By logistic regression analysis, belonging to the PCI group was an independent predictor of medication adherence [B = 2·20 (1·06-4·50), P = 0·03)]. WHAT IS NEW AND CONCLUSION: In the present study we demonstrated that adherence to evidence-based medication therapies in patients treated with PCI is significantly higher than in patients treated with OMT alone. Medication adherence should be followed carefully in CAD patients treated with OMT.

Molecular typing of Candida albicans strains isolated from denture wearers by repetitive sequence-based PCR.

Long-term use of prosthesis is the most important risk factor for the colonization of Candida species on the mucosal surfaces, which can lead to the development of denture-related stomatitis (DRS). Some individuals wearing prosthesis develop DRS and others do not. C. albicans strains isolated from both groups were genotypically compared. The purpose of this study was to determine whether the strain causing prosthesis stomatitis was different from the other strains genotypically. The study included 90 individuals wearing different prostheses and 20 control individuals with natural teeth. In the study 109 C. albicans strains were used which were isolated from the saliva samples and the mucosal surfaces of the tongues and palates of 51 individuals and then defined phenotypically. Phenotypic diagnosis of the isolates was genotypically verified by using species-specific PCR. For molecular typing, repetitive extragenic palindromic sequence polymerase chain reaction (REP-PCR) was employed. The results of the study revealed that REP-PCR had the capability to separate 109 C. albicans strains and six reference strains into 44 genotypes. Whereas C. albicans strains showed heterogenic distribution, C. albicans strains isolated from the individuals suffering from prosthesis stomatitis showed no specific genotypes. REP-PCR is a simple, fast and low-cost method and helped work on a great number of samples.

N-acetylcysteine versus N-acetylcysteine + theophylline for the prevention of contrast nephropathy.

BACKGROUND: The use of N-acetylcysteine or theophylline in specific subgroups of patients has been suggested to reduce the incidence of contrast-induced nephropathy (CIN) in patients undergoing angiographic procedures. Our purpose was to compare the use of N-acetylcysteine versus N-acetylcysteine + theophylline for the prevention of CIN. MATERIALS AND METHODS: We randomized 217 patients with estimated glomerular filtration rate (eGFR) (calculated by Modification of Diet in Renal Disease formula) between 30 and 60 mL min(-1) 1.73 m(-2) who were undergoing coronary angiography to three prophylactic treatment groups: Group 1: Intravenous hydration with isotonic saline (1 mL kg(-1) h(-1) for 12 h before and after contrast, n = 72). Group 2: Intravenous hydration with isotonic saline (1 mL kg(-1) h(-1) for 12 h before and after contrast)+ N-acetylcysteine (600 mg p.o. twice daily the preceding day and the day of angiography, n = 73). Group 3: Intravenous hydration with isotonic saline (1 mL kg(-1) h(-1) for 12 h before and after contrast)+ N-acetylcysteine + theophylline (600 mg N-acetylcysteine p.o. and 200 mg theophylline p.o. twice daily for the preceding day and the day of angiography, n = 72). The incidence of CIN (0.5 mg dL(-1) increase in serum creatinine from the baseline value 48 h after intravascular injection of contrast) was compared in three groups. RESULTS: Of the 217 patients, 12 patients (5.5%) experienced CIN. Five patients (6.9%) in group 1, seven patients (9.6%) in group 2 and zero (0%) patients in group 3 experienced CIN (P < 0.033). CONCLUSION: Among patients with eGFR between 30 and 60 mL min(-1) 1.73 m(-2) undergoing coronary angiography, oral administration of N-acetylcysteine + theophylline in addition to saline hydration has a beneficial effect in the prevention of CIN.

The statistical investigation on airborne fungi and pollen grains of atmosphere in Izmir-Turkey.

This study aims to investigate the differences in the concentrations of airborne fungi and pollens between the towns located in the province of Izmir and to determine the factors contributing to these differences. Five stations in each of four towns (Buca, Konak, Bornova, and Karsiyaka) were randomly selected as the research areas. Fungus (cfu/m(3)) and pollen counts (cm(2)/pollen count) in the air samples collected from each station between June 2003 and May 2004 were measured. The results revealed that whereas Karsiyaka had the highest fungus concentration (521.33 +/- 777.1), Buca and Bornova had the lowest concentration (482.67 +/- 308.44). The mean fungus concentration in the province of Izmir was 501.5 +/- 486.7. Pollen concentration was the highest in Konak (486.67 +/- 839.06) and the lowest in Bornova (369.83 +/- 551.13). Fungus and pollen concentrations revealed no difference between the towns (p > 0.05). The relationship between pollen-fungus concentrations and temperature-dust-humidity-sulphur-dioxide was investigated but it was found statistically insignificant (p > 0.05). As a result of regression analysis, it was determined that correlation of atmospheric parameters had no effects on pollen and fungus concentrations (p > 0.05).