青年胃印戒细胞癌细胞免疫状态及γδT细胞应用研究

青年胃印戒细胞癌是临床上预后较差的恶性肿瘤。为了研究该肿瘤患者的免疫状态及应用γδＴ淋巴细胞治疗可能性，对４例青年胃印戒细胞癌患者、６例正常人外周血作了免疫细胞表型分析（ＣＤ３、ＣＤ４、ＣＤ８、ＣＤ１６、ＣＤ２５、ＣＤ５６、Ｔγδ）及肿瘤坏死因子（ＴＮＦ）和白细胞介素６（ＩＬ－６）检测。并对４例患者采用γδＴ细胞／ＩＬ－２过继免疫治疗（ＡＣＩＴ），观察细胞免疫动态变化。结果表明：４例青年胃印戒细胞癌患者外周血ＣＤ＋３、ＣＤ＋４、ＣＤ＋４／ＣＤ＋８比值均低于正常组。ＴＮＦ、ＩＬ－６水平均高于正常组；γδＴ细胞治疗后，外周血ＣＤ＋３、ＣＤ＋４、ＣＤ＋４／ＣＤ＋８比值均升高。随访病人１０～２５个月，未见转移、复发，身体情况均好     

丙型肝炎病毒再感染与初次感染对比研究

用套式ＰＣＲ法检测ＨＣＶＲＮＡ，对比研究了ＨＣＶ再感染与初次感染。１０例初次感染ＨＣＶ者，９例为临床型肝炎，１例亚临床型，首次ＡＩ／Ｔ升高距输血的时间为１５～６０天（平均３７．９±１３．９）；抗－ＨＣＶ和ＨＣＶ－ＲＮＡ阳性１年以上分别为１０／１０和７／１０。５例再感染者，４例为临床型肝炎，１例亚临床型，ＡＬＴ首次升高距输血时间为３０～４６天（平均３４．８±６．ｈ），抗－ＨＣＶ和ＨＣＶＲＮＡ阳性１年以上分别为５／５和３／５。结果表明，ＨＣＶ再感染与初次感染在临床表现、ＡＬＴ异常。抗－ＨＣＶ和ＨＣＶＲＮＡ阳性持续时间等均无明显差异，提示ＨＣＶ感染后诱发的免疫力较差，再感染仍可发病。     

类维生素A对单个核细胞白细胞介素2受体表达及细胞因子分泌的影响

目的：　观察视黄醇、视黄酸、维生素Ａ 醋酸酯三种类维生素Ａ（类ＶＡ）在体外对正常人外周血单个核细胞（ＰＢＭＣ）中淋巴细胞白细胞介素２ 受体（ＩＬ－２Ｒ）表达、白细胞介素２（ＩＬ－２）分泌及单核细胞分泌白细胞介素１（ＩＬ－１）的影响。方法：　分别测定１０－ １０～１０－ ６ｍ ｏｌ／Ｌ浓度范围三种类ＶＡ作用下ＩＬ－２ 受体表达、ＩＬ－１、ＩＬ－２ 含量，再测定、比较三种类ＶＡ在１０－ ９浓度时上述作用大小。结果：　在一定浓度（１０－ １０～１０－ ７ｍ ｏｌ）范围，三种物质能不同程度促进高亲和力ＩＬ－２Ｒ表达和ＩＬ－１、ＩＬ－２ 分泌。结论：　类ＶＡ可能作用于ＰＢＭＣ活化早期，促进其功能，且作用大小与类ＶＡ种类及浓度有关。     

硒、维生素E缺乏对大鼠白三烯水平的影响

用低硒（Ｓｅ）、低维生素Ｅ（ＶＥ）的克山病病区粮喂养大鼠１１周，血浆和心肌白三烯（ＬＴＣ４）水平上升，心肌自由基净含量增加，血清和心肌脂质过氧化物（ＬＰＯ）浓度增高，而全血和心肌谷胱甘肽过氧化物酶（ＧＳＨ－Ｐｘ）活力下降；补Ｓｅ、ＶＥ或Ｓｅ＋ＶＥ可明显降低大鼠ＬＴＣ４水平及自由基和ＬＰＯ浓度，除补ＶＥ组外均可提高ＧＳＨ－Ｐｘ活力。提示：食物中Ｓｅ与ＶＥ不足影响花生四烯酸代谢中脂氧合酶的活力及Ｓｅ与ＶＥ不足生成的过量自由基和ＬＰＯ促进ＬＴＣ４合成，可能参与克山病缺血缺氧性心肌损害的发生发展过程．     

低危人群中乳腺癌与人工流产相关关系的研究

探讨人工流产与乳腺癌发病危险性之间的关系。方法研究对象为经产妇。资料以条件Ｌｏｇｉｓ－ｔｉｃ回归模型分析。教育程度，以及初产年龄，采用过人工流产的妇女患乳腺癌的危险性比对照高２．９（ＲＲ＝２．９）倍，９５％ＣＩ为１．４－４．４（９５％ＣＩ＝１．４－４．４）。而在低于３５岁的妇女中，其相对危险度为４．５，９５％ＣＩ为１．９－１０．７（ＲＲ＝４．５，９５％ＣＩ＝１．９－１０．７），高于３５岁的妇女中，     

广西百色地区肝病患者及受血者HCV感染现状调查

笔者应用ＥＬＩＳＡ法对广西百色地区１７９例各类肝病患者及４１例受血者血清进行了抗－ＨＣＶ检测。结果各类肝病抗－ＨＣＶ阳性率为１７．９％，受血者抗－ＨＣＶ阳性率为３１．７％。在急性肝炎（急肝）、慢性肝炎（慢肝）、肝硬化和肝癌中，抗－ＨＣＶ阳性率各为４．３％（１／２３）、１２．８％（１０／７８）、２８．６％（１２／４２）和２５．０％（９／３６）。抗－ＨＣＶ阳性率有随肝病慢性比而增高的趋势，肝硬化的抗－ＨＣＶ阳性率明显高于急肝或慢肝（Ｐ＜０．０５），而肝癌的抗－ＨＣＶ阳性率与急肝或慢肝相差不显著（Ｐ＞０．０５或０．１），且发现ＨＢｓＡｇ阴性肝病者的抗－ＨＣＶ阳性率明显高于ＨＢｓＡｇ阳性患者（Ｐ＜０．５），肝病患者抗－ＨＣＶ的检出率与ＡＬＴ活性无关（Ｐ＞０．０５）。在受血者中，抗－ＨＣＶ的检出率与受血次数、ＡＬＴ活性关系非常密切。因此，加强对ＨＣＶ的检测是当前预防输血后肝炎的紧迫任务。     

外周血血浆和白细胞EBVDNA检测的比较

目的比较荧光定量PCR检测外周血血浆和白细胞EB病毒DNA的结果,探讨荧光定量PCR检测血浆和白细胞EB病毒DNA的一致性。方法收集2009年3月至2011年3月疑似EB病毒感染患者的外周血（EDTA-K3抗凝）814例,其中鼻咽癌患者18例,非鼻咽癌的其他患者796例;采用实时荧光定量PCR技术同时同步检测血浆和白细胞的EB病毒DNA含量,比较鼻咽癌患者及其他非鼻咽癌患者的外周血血浆和白细胞EB病毒DNA的检测结果。结果 18例鼻咽癌患者外周血血浆和白细胞检测EB病毒DNA的阳性率相同,均为61%（11/18）;其EB病毒DNA含量水平也没有统计学差异（P〉0.05）。796例其他非鼻咽癌患者血浆和白细胞检测EB病毒DNA的阳性率分别为1.2%（10/796）和7.4%（60/796）,两者在统计学上有显著差异（P〈0.05）。结论荧光定量PCR检测鼻咽癌患者外周血血浆和白细胞EB病毒DNA的阳性率及其含量没有差异性（P〉0.05）;而检测非鼻咽癌患者白细胞EB病毒DNA的阳性率高于血浆。     

输血后肝炎的随访研究

１９８９～１９９０年对太原地区的输血者及其对照进行随访，在输血前或对照入院一周内采血。输血或对照采首份血后２周、４周、１２周、和２４周采血，检测血清ＡＬＴ、ＨＢＶ感染标志和抗－ＨＣＶ。结果，发生输血后肝炎９例，发病率为１０．４６％，输血后乙型和丙型肝炎的发病率各为６．９７％和２．３２％，未定型为１．１６％；对照组无病发生。ＨＢＶ、ＨＣＶ感染以及ＡＬＴ异常与输血量有关。１０份ＨＢｓＡｇ阳性血输给１０名受血者，仅１例输入ＨＢｓＡｇ和ＨＢｅＡｇ双阳性血后ＨＢｓＡｇ阳转、ＡＬＴ异常。６份抗－ＨＢｃ阳性血的受血者，无异常反应，仅１例输入抗－ＨＢｃ和和ＨＢｅＡｇ双阳性血后，ＡＬＴ升高至５７单位，现有结果显示抗－ＨＢｃ阳性血未引起发病。３例抗－ＨＣＶ阳性血的受血者中，１例－ＨＣＶ阳转，但ＡＬＴ正常。     

四省供血员庚型肝炎病毒感染状况

应用ＥＩＡ法和逆转录套式多聚酶链反应法分别检测供血员血浆中的抗庚型肝炎病毒（ＧＢＶ－Ｃ）和ＧＢＶ－ＣＲＮＡ，以了解供血员的ＧＢＶ－Ｃ流行现状。１２００例单采浆供血员的抗ＧＢＶ－Ｃ检出率为４．９２％（５９／１２００），抗ＧＢＶ－Ｃ阳性血清的ＧＢＶ－ＣＲＮＡ检出率为６４．４１％（３８／５９）。３５０例普通供血员（供全血）的抗ＧＢＶ－Ｃ检出率为２．８６％（１０／３５０），抗ＧＢＶ－Ｃ阳性血浆中的ＧＢＶ－ＣＲＮＡ检出率为６０．００％（６／１０）。供血１０年以上供血员的抗ＧＢＶ－Ｃ检出率显著高于流行病调查对照组。该研究提示，ＧＢＶ－Ｃ在单采浆供血员和职业供血员中有较高的感染率。不仅存在ＧＢＶ－ＣＲＮＡ阳性的ＡＬＴ正常献血员，还存在ＧＢＶ－ＣＲＮＡ和ＨＣＶＲＮＡ均阳性的ＡＬＴ正常献血员，应尽快对献血员进行ＧＢＶ－Ｃ感染指标的检测     

新生儿窒息的免疫学研究

目的 探讨窒息缺氧对新生儿免疫功能的影响，为新生儿窒息复苏后易患感染性疾病的机理及治疗提供理论参考。方法 以正常新生儿为对照，检测了窒息新生儿外周血Ｔ淋巴细胞亚群、血清可溶性白细胞介素－２受体、免疫球蛋白及补体的变化。结果 新生儿窒息后；（１）ＣＤ４细胞减少，ＣＤ６细胞增加，ＣＤ４／ＣＤ８比值仰面 窒息儿ＣＤ３４细胞亦明显减少。（２）血清可溶性白细胞介素－２受体水平显著升高。（３）血清ＩｇＭ和Ｃ３     

Characterization of HLA-DR-restricted T-cell epitopes derived from human proteinase 3

Human proteinase 3 (PRTN3) is a leukemia-associated antigen specifically recognized by CD8+ cytotoxic T-lymphocytes (CTL). PRTN3 also has been shown to elicit both antibody responses and T-cell proliferation in patients with Wegener's granulomatosis. In order to improve current vaccines that aim to stimulate CTL without inducing harmful autoimmune disease, it is necessary to study the role of PRTN3-specific CD4+ T-helper (TH) and CD4+ T-regulatory (Treg) cells. Since both TH and Treg cells recognize antigens in the context of HLA-class-II-molecules, identification of HLA-class-II-associated peptide-epitopes from self-antigens such as PRTN3 is required. Here, we analyzed T-cell responses against proteinase 3 using synthetic peptides predicted to serve as HLA-DR-restricted epitopes. We first screened a panel of ten epitope peptide candidates selected with the TEPITOPE program and found that nine out of ten peptides induced PRTN3 peptide-specific proliferation of T-cells with precursor frequencies of 0–1.1 × 10⁻⁶. For one peptide-epitope, PRTN3₂₃₅, T-cell-clones were demonstrated to be capable of recognizing naturally processed protein antigen in a HLA-DR-restricted fashion. PRTN3₂₃₅-specific T-cells could be stimulated from the blood of healthy individuals with multiple HLA-DR-genotypes. In summary, the identified PRTN3₂₃₅-epitope can be used to study the role of CD4+ TH- and Treg-cells in immune responses against PRTN3 in leukemia patients and patients with Wegener's disease.     

Contraception by NORPLANT subdermal capsules is not reliable in epileptic patients on anticonvulsant treatment

The contraceptive efficacy of progestin-only contraception was studied in epileptic patients using NORPLANT^R subdermal capsules. The effect of anticonvulsants on levonorgestrel plasma levels was determined. NORPLANT^R subdermal capsules were inserted into nine epileptic women, and ten control women using no medication. Venous blood samples were taken at 0, 1, 3, 6, 9 and 12 months after insertion and the concentration of levonorgestrel was determined by radioimmunoassay. At 3 to 12 months, the overall mean concentration of plasma levonorgestrel was significantly lower in the six epileptics taking phenytoin alone or in combination with other anticonvulsants (203 ± 128 pg/ml, mean ± SD) than in the controls (325 ± 135 pg/ml, p < 0.01). After one year, nine of the control patients continued the use of NORPLANT^R and no pregnancies occurred. Two of the nine epileptics became pregnant during contraception by NORPLANT^R. They both used phenytoin and their plasma concentrations of levonorgestrel were low near the time of conception. Levonorgestrel released from the capsules had no apparent harmful effects on epilepsy and none of the patients reported an increase in seizure frequency. The results show that contraception by the progestin levonorgestrel is not reliable in epileptic patients using anticonvulsants known to induce metabolizing enzymes of the liver.     

Identification of Mycobacterium tuberculosis vaccine candidates using human CD4 T-cells expression cloning

To identify Mycobacterium tuberculosis (Mtb) antigens as candidates for a subunit vaccine against tuberculosis (TB), we have employed a CD4⁺ T-cell expression screening method. Mtb-specific CD4⁺ T-cell lines from nine healthy PPD positive donors were stimulated with different antigenic substrates including autologous dendritic cells (DC) infected with Mtb, or cultured with culture filtrate proteins (CFP), and purified protein derivative of Mtb (PPD). These lines were used to screen a genomic Mtb library expressed in Escherichia coli and processed and presented by autologous DC. This screening led to the recovery of numerous T-cell antigens, including both novel and previously described antigens. One of these novel antigens, referred to as Mtb9.8 (Rv0287), was recognized by multiple T-cell lines, stimulated with either Mtb-infected DC or CFP. Using the mouse and guinea pig models of TB, high levels of IFN-γ were produced, and solid protection from Mtb challenge was observed following immunization with Mtb9.8 formulated in either AS02A or AS01B Adjuvant Systems. These results demonstrate that T-cell screening of the Mtb genome can be used to identify CD4⁺ T-cell antigens that are candidates for vaccine development.     

Insulin Use in Long Term Care Settings for Patients With Type 2 Diabetes Mellitus: A Systematic Review of the Literature

Objective

To summarize currently available data about insulin therapy in patients with diabetes mellitus (DM), focusing on patients with type 2 DM (T2DM), in long term care (LTC) settings.

Data Sources

Ovid Medline, EMBASE, Cochrane Library databases, and United Kingdom National Health Service (NHS) Economic Evaluation Database, last accessed on November 12, 2012.

Study Eligibility Criteria

We included studies that reported insulin use in patients with T2DM, and studies with combined samples of patients with type 1 DM or T2DM, that were conducted in LTC settings. Excluded were review articles and studies published before 2000.

Results

We identified 11 articles that met all inclusion and exclusion criteria. Insulin use in patients with DM in LTC settings varied widely, from 2.7% to 58.0%. It is difficult to draw conclusions from these proportions, as many studies did not define whether their populations were exclusively patients with T2DM. Despite recommendations against its use by the American Diabetes Association, the American Geriatrics Society, and the American Medical Directors Association, treatment with sliding-scale insulin (insulin injections adjusted to current blood glucose levels) was prevalent in the LTC setting. Although the recommended target hemoglobin A1c (A1C) for this patient population varies from ≤6.5% to ≤8.0%, higher A1C values (8.0%–8.9%) were associated with better patient outcomes in a study examining insulin treatment in community-dwelling elderly patients enrolled in an outpatient LTC setting. Insulin pen-devices seemed associated with a high incidence of needle-stick injuries in workers in LTC settings but, compared with insulin vials, showed cost advantages for use in very short-term (≤30 days) patients with DM in LTC settings.

Limitations

Paucity of available data; only published studies for which full-text articles could be retrieved and which were identified by our search strategy were included; insufficient detail about patient samples were available in many included studies; and potential biases across studies might be introduced by funding sources or study designs.

Conclusions

Available data about insulin therapy in patients with DM in LTC settings are very scarce and great treatment variability of this patient population seems to prevail in the current clinical practice. Additional, randomized, prospective clinical trials are needed to expand our knowledge and allow clinicians to make informed treatment decisions for patients with DM in LTC settings.     

支气管哮喘患者呼出气冷凝液半胱氨酰白三烯C4及8异前列腺素水平与病情的相关性研究

目的探讨支气管哮喘患者呼出气冷凝液（EBC）中半胱氨酰白三烯C4（LTC4）及8异前列腺素水平与病情的关系。方法对哮喘患者观察组30例（哮喘慢性持续期患者16例,哮喘临床缓解期14例）用自行设计的EBC收集仪器采集标本,采用酶联免疫法测定EBC中LTC4及8异前列腺素水平。结果观察组中哮喘持续期及缓解期LTC4水平[（67．38±10．30）ng／ml、（41．21±11．41）ng／m1]均高于正常对照组[（17．15±7．48）ng/ml,P〈0．01];哮喘持续期LTC4水平高于缓解期（P〈0．01）。哮喘持续期和缓解期8异前列腺素水平[（14．29±10．74）ng／ml、（12．40±7．45）ng／ml]显著高于正常对照组[（6．93±5．58）ng／ml]（P〈0．01或P〈0．05）;哮喘持续期8异前列腺素水平高于缓解期,其差异无统计学意义（P〉0．05）。结论哮喘熳性持续期和缓解期均有持续气道炎症存在,呼出气冷凝液（EBC）中LTC4水平与哮喘病情严重度有关,监测患者EBC中LTC4水平有助于哮喘的病情判断及指导治疗。     

PBMCs结核分枝杆菌特异性抗原反应性MIG和IFN-γ对活动期肺结核的鉴别诊断意义

目的研究活动期肺结核和常见肺部鉴别诊断疾病肺炎及原发性肺癌患者的外周血单个核细胞（PBMCs）经结核分枝杆菌特异性抗原肽刺激后干扰素-γ诱导的单核因子（Monokine induced by interferon gamma,MIG）和干扰素-γ（IFN-1）的表达特点及诊断意义。方法90例初治活动期肺结核患者,31例细菌性肺炎和原发性支气管肺癌患者,分离外周血PBMCs,用结核分枝杆菌特异性抗原肽刺激,采用Flowcytomix流式技术检测细胞培养液上清上中MIG和IFN-γ的表达。用接受者工作特征曲线（ROCcurve）评价结核分枝杆菌特异性抗原反应性MIG和IFN-γ的诊断价值。结果PBMCs经结核分枝杆菌特异性抗原肽刺激后,培养液上清中MIG水平显著升高,初治活动期肺结核患者与其他肺病对照组差异有统计学意义（3023．0pg／mlvs112．5pg／ml,P〈0．0001）,与IFN-γ的表达水平呈正相关（r=0．7168,P〈0．0001）,单独应用MIG诊断肺结核的敏感性为94．4％,单独应用IFN-γ诊断肺结核的特异性为96．8％,二者并联应用诊断肺结核的敏感性为97．8％,特异性为87．1％。结论结核分枝杆菌特异性抗原肽刺激外周血单个核细胞产生的MIG和IFN-γ能够良好的鉴别初治活动期肺结核及常见的细菌性肺炎和原发性支气管肺癌,可能成为新的诊断指标。     

Implications of long-term care capacity response policies for an aging population: A simulation analysis

Introduction

The demand for long-term care (LTC) services is likely to increase as a population ages. Keeping pace with rising demand for LTC poses a key challenge for health systems and policymakers, who may be slow to scale up capacity. Given that Singapore is likely to face increasing demand for both acute and LTC services, this paper examines the dynamic impact of different LTC capacity response policies, which differ in the amount of time over which LTC capacity is increased, on acute care utilization and the demand for LTC and acute care professionals.

Methods

The modeling methodology of System Dynamics (SD) was applied to create a simplified, aggregate, computer simulation model for policy exploration. This model stimulates the interaction between persons with LTC needs (i.e., elderly individuals aged 65 years and older who have functional limitations that require human assistance) and the capacity of the healthcare system (i.e., acute and LTC services, including community-based and institutional care) to provide care. Because the model is intended for policy exploration, stylized numbers were used as model inputs. To discern policy effects, the model was initialized in a steady state. The steady state was disturbed by doubling the number of people needing LTC over the 30-year simulation time. Under this demand change scenario, the effects of various LTC capacity response policies were studied and sensitivity analyses were performed.

Results

Compared to proactive and quick adjustment LTC capacity response policies, slower adjustment LTC capacity response policies (i.e., those for which the time to change LTC capacity is longer) tend to shift care demands to the acute care sector and increase total care needs.

Conclusions

Greater attention to demand in the acute care sector relative to demand for LTC may result in over-building acute care facilities and filling them with individuals whose needs are better suited for LTC. Policymakers must be equally proactive in expanding LTC capacity, lest unsustainable acute care utilization and significant deficits in the number of healthcare professionals arise. Delaying LTC expansion could, for example, lead to increased healthcare expenditure and longer wait lists for LTC and acute care patients.     

Failure of large-dose erythromycin in combination with a standard dose of chloroquine or quinine in the treatment of human falciparum malaria

In eastern Thailand, falciparum malaria is highly chloroquine-resistant and is quickly becoming quinine-resistant. In the present study, ten patients with falciparum malaria were given large doses of erythromycin, combined with standard doses of chloroquine; the cure rate was 0 out of 10 (4 RIII failures, 6 RII failures). A further ten patients were given erythromycin with standard doses of quinine; 2 of the 10 patients were cured (8 RI failures). These regimens thus appear to have no appreciable effect against falciparum infections in eastern Thailand.     

Diminished phospholipid incorporation of essential fatty acids in peripheral blood leucocytes from patients with Crohn's disease: correlation with zinc depletion

Peripheral blood leucocytes from patients with Crohn's disease have been shown to have lower zinc content than those from a normal population. Since zinc influences essential fatty acid metabolism, incorporation of 14C-linoleic and 3H-arachidonic acids was studied in peripheral blood leucocytes from controls and patients with Crohn's disease. The zinc content of the leucocytes was also measured. After incubation for 2 h, content of 3H-arachidonic acid, but not 14C-linoleic acid, was greater in Crohn's disease leucocytes than in controls. In the Crohn's disease leucocytes, incorporation of both labelled fatty acids into the phosphatidylcholine fraction was significantly lower than in controls, whereas the amount of both fatty acids remaining in the leucocytes as free fatty acids was increased by 70%. In Crohn's disease, leucocyte zinc level was positively associated with the percentage of 3H-arachidonic acid incorporation into phosphatidylcholine. We conclude that peripheral blood leucocytes from patients with Crohn's disease have abnormal essential fatty acid metabolism and that 3H-arachidonic acid incorporation into the phosphatidylcholine fraction of leucocyte lipids in Crohn's disease varies as the zinc content of the leucocytes.     

Exploring variation in rates of polypharmacy across long term care homes

ObjectiveUse of multiple, concurrent drug therapies, often referred to as polypharmacy, is a concern in the long term care (LTC) setting, where frail older adults are particularly at risk for adverse events. We quantified the scope of this practice by exploring variation in the use of nine or more drug therapies across LTC homes.DesignCross-sectional analysis of LTC home census data.SettingAll LTC homes in Ontario, Canada.ParticipantsA total of 64,394 LTC residents aged 66 years and older residing in 589 LTC homes in the fall of 2005.MeasurementsFacility-level rates of polypharmacy were compared with rates of use of Beers criteria and antipsychotic drug therapies. Multivariate logistic regression models were used to assess predictors of polypharmacy across residents and LTC homes.ResultsNine or more drug therapies were dispensed concurrently to 10,007 (15.5%) of LTC home residents. Compared with those dispensed fewer drugs, residents receiving 9 or more drug therapies were more likely to have multiple comorbidities. There was threefold variation in polypharmacy rates across homes (26.2% versus 7.9%) and facility-level rates of polypharmacy were modestly correlated with rates of use of Beers criteria drugs (r = 0.27, P < .001) and antipsychotic drug therapies (r = 0.16, P < .001). Controlling for resident factors, those living in LTC homes with high polypharmacy rates were more likely to receive 9 or more drug therapies (odds ratio 1.9, 95% confidence interval 1.7–2.0).ConclusionResidents in Ontario LTC homes commonly received nine or more concurrent drug therapies, particularly residents with multiple chronic conditions. The threefold variation in rate across homes suggests a role for this measure in guiding drug review at the facility level.