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Eesti ravimistatistika 2006-2009, lk 30-34 Estonian Statistics on Medicines 2006-2009, pp. 30-34 Diabeediravimite kasutamine Eestis
Use of Drugs used in Diabetes
Endocrinologist, doctor of medicine, Endocrinology Estonia has not been left untouched by the world- puutumata jäänud ka Eesti. See kajastub wide epidemic of diabetes. It is reflected in the süstitavate ja suukaudsete diabeediravimite increased use of both parenteral and oral drugs in kasutamise statistikas. Insuliinide kasutamine the treatment of diabetes. From 2000 to 2009, the suurenes Eestis ajavahemikus 2000–2009 2,8 use of insulins increased 2,8 times in Estonia (4,8 korda (4,8 DPD/1000/ ööpäevas aastal 2000 ning DDD/1000 inhabitants/day in 2000 and 13,4 13,4 DPD/ 1000/ööpäevas aastal 2009), DDD/1000 inhabitants/day in 2009), the use of oral antidiabetic drugs increased 2,1 times (10,7 suurenes 2,1 korda (10,7 DPD/1000/ööpäevas DDD/1000 inhabitants/day in 2000 and 22,6 aastal 2000 ning 22,6 DPD/1000/ööpäevas aastal DDD/1000 inhabitants/day in 2009). It cannot be 2009). Ei saa väita, et diabeedi levimus oleks stated that the prevalence of diabetes during the nimetatud ajavahemikul kasvanud üle 2 korra, period had grown more than two times, instead pigem on arstid järjest enam teadlikuks saanud the doctors have become more aware of the importance of good diabetes control to avoid complications and thus have intensified the Eesti Haigekassa andmetel sai 2009. aastal Eestis According to the data of the Estonian Health insuliinravi ligi 12 000 I tüüpi diabeediga ning Insurance Fund almost 12 000 patients of the umbes 17 000 II tüüpi diabeediga patsienti. type 1 diabetes and about 17 000 patients of the Väärib märkimist, et paarkümmend aastat tagasi type 2 received insulin treatment in 2009. It is Eestisse tulnud, tol ajal progressiivse, lühikese worth mentioning that the intensiveness of the use of the fast-acting human insulins in the intensiivsus populatsioonis oli aastal 2009 0,1 population in 2009 was only 0,1 DDD/1000 DPD/1000/ööpäevas ehk 1,5 % lühikese inhabitants/day or 1,5% of the diabetes patients using fast-acting insulins. Majority of the patients use synthetic insulin analogues as fast-acting lühitoimelise insuliinina sünteetilisi (lispro-, insulins (lispro, aspart, glulisine). Decreasing aspart-, glulisiin-) insuliini analooge. Heaks number of users of intermediate-acting human insulin can be considered a good result (1,1 humaaninsuliini kasutajate vähenemine (2008. DDD/1000 inhabitants/day in Estonia in 2008 aastal Eestis 1,1 DPD/1000/ööpäevas ning and 4,8 DDD/1000 inhabitants/day on an average in the Nordic countries2), the low share of their DPD/1000/ööpäevas) ja madal osakaal, mis use gives the patients more freedom to adjust their eating habits and life-styles. Also, better toitumise ja eluviisi korraldamisel. Samuti on control of the disease is mostly attainable using teiste insuliinide kasutamisega reeglina 2 To find the average DDD/1000 inhabitants/day in the 1 Põhjamaade võrdluses on kasutatud Islandi, Taani, Norra, Nordic countries the data of Iceland, Denmark, Norway, Rootsi ja Soome andmeid 2008. aastal. 2009. aasta Sweden and Finland were used in 2008. The data of 2009 andmeid ei olnud kõik Põhjamaad kokkuvõtte koostamise had not been published by all the Nordic countries by the time the current summary was being compiled. Eesti ravimistatistika 2006-2009, lk 30-34 Estonian Statistics on Medicines 2006-2009, pp. 30-34 saavutatav parem haiguse kompensatsioon. other insulins. Among the comparison countries, the highest use of insulins in total was in Finland insuliinide kogukasutamine Soomes (2008. aastal (27,1 DDD/1000 inhabitants/day in 2008; 13,1 27,1 DPD/1000/ööpäevas, Eestis 13,1 DPD/ DDD/1000 inhabitants/day in Estonia and 17,2 1000/ööpäevas ning ülejäänud Põhjamaades DDD/1000 inhabitants/ day on an average in the keskmiselt 17,2 DPD/1000/ ööpäevas), mida võib rest of the Nordic countries), it can be explained by a very high level of diabetes prevalence. The use of oral drugs used in diabetes increased Suukaudsete diabeediravimite kasutamine Eestis 2,1 times from the year 2000 to 2009 in Estonia. aastatel 2000–2009 suurenes 2,1 korda. Kõige Preparations containing metformin are most often used both in Estonia and in the Nordic countries. Põhjamaades metformiini sisaldavaid preparaate, They made up 55,9% of all the oral drugs used in diabetes in Estonia in 2008 and 53,4% on an diabeediravimitest 2008. aastal Eestis vastavalt average in the Nordic countries. Compared with 55,9% ning Põhjamaades keskmiselt 53,4%. the Nordic countries, Estonia stands out by the Võrdluses Põhjamaadega paistab Eesti silma relatively high level of gliclazide use (3,3 suhteliselt kõrge gliklasiidi kasutamisega (2008. DDD/1000 inhabitants/day in 2008 in Estonia aastal Eestis 3,3 DPD/1000/ööpäevas ning Taanis and 0,9 DDD/1000 inhabitants/day on an average ja Islandil keskmiselt 0,9 DPD/1000/ööpäevas) in Denmark and Iceland) and also by the decrease of glibenclamide use by 93% from 2006 to 2009. kasutamise vähenemisega 93% võrra. Suurim The highest number of users of oral antidiabetic suukaudsete ravimite kasutaja on Soome juba drugs is in Finland for the reasons mentioned eelpool nimetatud põhjusel. Võrreldes uuemate above. Comparing the use of the newer groups of ravimrühmade, dipeptüülpeptidaas 4 (DPP-4) drugs, dipeptidyl peptidase 4 (DPP-4) inhibitors inhibiitorite ja tiasolidiindioonide, summaarset and thiazolidinediones in total, it is five times kasutamist, siis on see Eestis 5 korda väiksem kui lower than that in the Nordic countries (0,3 DDD/1000 inhabitants/day in Estonia and 1,5 DPD/1000/ööpäevas ja Põhjamaades keskmiselt DDD/1000 inhabitants/day on an average in the Kas diabeediravimite kasutamine Eestis on We can ask is the use of antidiabetic medicines piisav? Kasutades analüüsiks päevadooside sufficient in Estonia? Using the data of defined andmeid 1000 elaniku kohta ööpäevas ning daily doses per 1000 inhabitants a day and võrdlust Põhjamaadega on vastuseks jah, seda comparing the results with the Nordic countries, kindlasti insuliini kasutamise osas. Väiksem on the answer is yes, especially concerning the use Eestis uuemate suukaudsete diabeediravimite on insulins. The use of newer oral drugs in glitasoonide ja gliptiinide kasutamine. Täpsem diabetes, glitazone and gliptine, is smaller in analüüs diabeediravimite kasutamise piisavuse Estonia. A more precise analysis concerning the sufficiency of pharmacotherapy of diabetes would demand a thorough study including for elukvaliteedi jne laiemast analüüsist. example the level of glycohaemoglobin, the frequency of complications and the quality of life of the patients with diabetes. Eesti ravimistatistika 2006-2009, lk 30-34 Estonian Statistics on Medicines 2006-2009, pp. 30-34
Tabel 1. Diabeedi raviks kasutatavad ained 2006-2009
Table 1. Drugs used in diabetes 2006-2009
DPD/1000 inhabitants/day
ATC group
29,02 34,74 35,95
11,49 13,13 13,39
A10AB Insulins and analogues for injection, A10AC Insulins and analogues for injection, A10AD Insulins and analogues for injection, A10AE Insulins and analogues for injection, BLOOD GLUCOSE LOWERING
17,54 21,61 22,56
A10BD Combinations of oral blood glucose Eesti ravimistatistika 2006-2009, lk 30-34 Estonian Statistics on Medicines 2006-2009, pp. 30-34 Insuliinide (A10A) kasutamine 2000-2009
Consumption of insulins (A10A) 2000-2009

Insulins and analoguesfor injection, long-acting (A10AE) 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Vere glükoosisisaldust vähendavate ainete (A10B) kasutamine 2000-2009
Consumption of blood glucose lowering drugs (A10B) 2000-2009

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009


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