徐州地区儿童家长安全用药知识调查分析

目的:了解现阶段徐州地区儿童家长对儿童安全用药知识的认知水平,为开展儿童安全用药教育提供依据。方法:自行设计调查问卷,随机抽取徐州市儿童医院及徐州市区综合医院儿科门诊360名患儿家长进行现场问卷调查,问卷内容包括患儿家长的基本情况、对儿童生病后用药态度及用药关注、家庭常备药品情况、对抗生素及输液的认知情况、儿童用药知识的主要来源。结果:354份有效调查问卷显示患儿家长对抗生素的认知水平较低,不了解滥用抗菌药物的危害,有77.97%的家庭中常备抗菌药物,有66.95%患儿家长会自主给予患儿服用抗生素,77.68%的患儿家长认为输液比口服用药治疗效果好,44.35%的患儿家长主动要求过给患儿输液。结论:徐州地区儿童家长安全用药知识水平有待提高,药师应该积极转变服务观念,针对不同需求的患儿家长开展用药教育,充分发挥药师的作用,提高家长对儿童安全用药的关注度,确保儿童用药安全。     

75例儿童药物中毒临床分析

目的：探讨儿童药物中毒的临床特点。方法：统计我院儿内科2000-2017年收治的儿童药物中毒病例75例,按患儿的性别、年龄、中毒原因、药物分类、临床表现、救治及转归等进行统计分析。结果：1~3岁的幼儿期童居多（66.7%）,儿童误服（90.7%）为主要病因,中毒药品种类居前3位是：抗高血压药、精神药物和维生素、矿物质及微量元素类药。结论：药物存放不当与误服密切相关,家长和社会需加强对儿童误服药物的关注,重视对公众家庭备用药物管理的教育。     

苏州市儿童家庭合理用药的调查与分析

目的：了解目前儿童家庭合理用药存在的问题,提出对策建议以保障儿童的健康。方法：以问卷调查的形式在苏州大学附属儿童医院调查了114位儿童家长,分析儿童家庭用药安全性、有效性、合理性及适当性方面的情况。结果：家长对儿童药品出现的不良反应重视程度不够,使用成人药物存在安全隐患,在病情减轻后的处理上难以准确把握,对儿童药品的选择较少考虑经济因素,选择剂型时忽略对疗效的影响等。结论：应加大儿童药品研发生产的力度,加强执业药师队伍建设,对家长进行儿童合理用药知识的宣传教育。     

儿童药物中毒的回顾性分析

目的:分析儿童药物中毒的常见原因、症状、治疗及防范措施.方法:对我院2000年1月～2007年9月接诊的118例小儿药物中毒病例进行回顾性分析.结果:儿童药物中毒的常见原因为:(1)儿童误服中毒54例(45.8%);(2)家长无知给予服用45例(21.2%);(3)医源性中毒20例(17.0%).结论:儿童药物中毒的危险因素以儿童误服、家长喂服和医源性为主,应加强对患 儿家长健康教育,普及安全用药常识,加强对家庭药物的管理,同时医务人员应规范行医.     

住院儿童药物中毒47例临床分析与药学服务

目的 分析儿童药物中毒病例特点,探讨药师在预防和治疗儿童药物中毒过程中可提供的多样化药学服务。方法 回顾性统计分析宁波市妇女儿童医院2020年1月1日—2023 年6月30日收治的47例住院儿童药物中毒病例,并结合宁波市妇女儿童医院实际,讨论药学服务切入点。结果 药物中毒的患儿主要是青春期女孩。中毒原因多为有意服药自杀,共33例(70.21%),另有患儿自行误服12例(25.53%),及家长看错用药剂量导致药物过量2例(4.26%)。临床症状以嗜睡及昏睡28例,头晕16例,恶心呕吐14例,腹痛11例常见。中毒药物种类多为精神类药品,共39例(82.98%)。入院后,洗胃40例(85.11%),血液净化11例(23.40%),结合利尿、导泻等方式清除毒物,并根据毒物种类选用特效药物解毒,以及给予对症支持治疗,最终47例均好转、治愈出院。结论 基于儿童药物中毒的临床特点,药师可积极参与预防和诊治工作,以减少药物中毒的发生,改善中毒患儿预后。在预防方面,药师配发药品时应做好用药交代和用药宣教,尤其是对于精神类药品和剂量易混淆药品;在救治时,临床药师可从毒物的检测分析,毒物的清除,特效解毒药物的选用,药物儿童剂量的查询等多个方面对中毒患儿开展全程药学监护。     

我院106例儿童患者用药错误的回顾与分析

目的通过对我院上报的儿童用药错误案例进行分析,探讨在临床儿童用药安全中存在的问题与不足,以期指导今后我院儿童合理用药工作的开展。方法回顾2013年1月至2018年4月我院在INRUD安全用药监测网上报的儿童用药错误,对这些案例所涉及到的发生地点、差错内容、相关药品等影响因素进行统计分析,寻找工作中需要注意的薄弱环节,并结合我院目前对于相关问题的防范措施,对我院今后儿童用药安全相关工作重点提出建议。结果我院共上报106例儿童用药错误,均为B级,以0～7岁年龄段患儿占多数。在这些用药错误中,由医师及主治医师引发的错误最多,内容多为用量错误。用药错误案例中相关药品以抗感染药物数量最多,其次为解热镇痛抗炎药。结论医疗机构应加强对儿童用药的审核监管,医务人员应加强儿童用药相关知识学习,医疗行业应投入更多力量保障儿童用药发展,家长应积极参与保障患儿用药安全的活动中。     

武汉市城区3~7岁儿童家庭用药情况调查及相关因素分析

摘 要 目的：调查武汉市城区3～7岁儿童家长对安全用药的认知和家庭用药行为现状,为提高城区儿童安全用药水平提供参考。方法：随机整群抽取武汉市城区的3所幼儿园,以问卷形式调查3～7岁儿童的家庭用药情况,以及家长对儿童用药的相关认知,并对结果进行统计分析。结果：共发放问卷800份,回收问卷726份,回收率为90.75%,其中有效问卷695份,有效率为86.88%。儿童用药前家长经常阅读药品说明书的占80.43%。文化程度越高的家长,阅读说明书的比例越高（P<0.01）;4.46%的被调查家长曾给儿童使用成人药;20.17%家长曾给孩子国外购药;38.27%家长最喜欢的宣教形式是网络交流;73.09%的家长非常关注儿童用药的安全性;但不良反应正确知晓率仅为48.06%,家长文化程度越高答题的正确率相应越高（P<0.01）。结论：武汉市城区儿童家长的安全用药知识、安全用药行为仍然存在不足。家长应通过正规渠道购买合格药品,药品使用前详细阅读说明书;政府部门和生产企业应加大儿童药品的研发投入和支持力度;应利用新媒体以更通俗易懂的方式进行安全用药宣传,尤应关注药品不良反应相关知识普及,以保障儿童的家庭用药安全。     

苏州市家长为儿童自我药疗情况调查研究

目的：了解苏州市城区儿童家长为儿童自我药疗的现状,为开展儿童安全用药干预提供研究依据。方法：以问卷调查的形式,随机抽取苏州儿童医院门诊就诊的700位儿童家长对儿童自我药疗的情况进行调查。结果：苏州市儿童家庭合理用药水平总体不理想,主要体现在家长对儿童用药自行增减剂量（39.7%）、疗效欠佳时经常更换儿童药物（26.3%）、使用多种药物同时治疗（43.4%）、经常使用解热镇痛药（13.7%）、经常使用抗生素（27.9%）、忽视观察药物不良反应（80.9%）等方面,在家庭药品管理情况中仅60.3% 左右的家长会将儿童药物单独存放,仅约47%家长会将药物存放在孩子不易接触的位置,家长的职业、儿童的性别等因素对家庭药品管理有显著影响（P<0.05）。结论：全社会应加大对家长进行儿童合理用药知识的宣传教育,提高儿童安全用药意识,保障儿童自我药疗的安全性。     

某院住院患儿口服药品分剂量使用情况分析

目的：分析医院住院患儿口服药品分剂量使用的现状,为保障儿童安全合理用药提供参考。方法：选取2022年1月—12月福建省福州儿童医院收治的9 245例使用分剂量口服药品的0～14岁住院患儿及其相关医嘱26 575条,采集患者的年龄、性别,以及分剂量药品的品种、剂型、规格等信息,分析但当前医院住院患儿口服药品分剂量使用的现状和特点。结果：26 575条医嘱涉及9 245例患儿,其中抗感染药物分剂量医嘱7 094条（占26.69%）,其次为影响变态反应和免疫功能药品分剂量医嘱6 279条（占23.63%）和消化系统药物医嘱5 425条（占20.41%）;片剂分剂量医嘱10 248条（占38.56%）,其次为颗粒剂5 350条（占20.13%）、干混悬剂5 191条（占19.53%）和散剂4 527条（占17.03%）。结论：我国市场上儿童适宜药品比较匮乏,药品分剂量用药现象普遍存在,为确保儿童用药安全,降低药害发生风险,药品监管部门、医药企业和医疗机构应共同努力做好儿童用药的安全性。     

我院口服药品分剂量使用现状调查分析

[摘要]目的：调查分析首都医科大学附属北京儿童医院口服药品分剂量使用现状,以更好地保障儿童用药安全,促进儿童用药发展。方法：抽取我院2017年1个月医嘱数据,剔除如散剂、颗粒剂等便于分剂量的品种,统计分析分剂量调配的药品相关信息,获得我院药品分剂量情况。结果：我院口服分剂量药品共13类77种,常见分剂量种类为神经系统用药、心血管系统用药、内分泌系统用药、抗感染药物;药品拆分剂量多为1/2、1/3及1/4;25种药品在国内和国外均无更小规格或适宜剂型上市。结论：儿童药品分剂量现象不容忽视,政府、企业及医院等部门应关注儿童用药剂型这一问题。     

Synthesis,Cytotoxicity and Antileishmanial Activity of Some N-(2-(indol-3-yl)ethyl)-7-chloroquinolin-4-amines

We report herein the condensation of 4,7-dichloroquinoline (1) with tryptamine (2) and D-tryptophan methyl ester (3) . Hydrolysis of the methyl ester adduct (5) yielded the free acid (6) . The compounds were evaluated in vitro for activity against four different species of Leishmania promastigote forms and for cytotoxic activity against Kb and Vero cells. Compound (5) showed good activity against the Leishmania species tested, while all three compounds displayed moderate activity in both Kb and Vero cells.     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

Lung disease and PKCs

The lung offers a rich opportunity for development of therapeutic strategies focused on isozymes of protein kinase C (PKCs). PKCs are important in many cellular responses in the lung, and existing therapies for pulmonary disorders are inadequate. The lung poses unique challenges as it interfaces with air and blood, contains a pulmonary and systemic circulation, and consists of many cell types. Key structures are bronchial and pulmonary vessels, branching airways, and distal air sacs defined by alveolar walls containing capillaries and interstitial space. The cellular composition of each vessel, airway, and alveolar wall is heterogeneous. Injurious environmental stimuli signal through PKCs and cause a variety of disorders. Edema formation and pulmonary hypertension (PHTN) result from derangements in endothelial, smooth muscle (SM), and/or adventitial fibroblast cell phenotype. Asthma, chronic obstructive pulmonary disease (COPD), and lung cancer are characterized by distinctive pathological changes in airway epithelial, SM, and mucous-generating cells. Acute and chronic pneumonitis and fibrosis occur in the alveolar space and interstitium with type 2 pneumocytes and interstitial fibroblasts/myofibroblasts playing a prominent role. At each site, inflammatory, immune, and vascular progenitor cells contribute to the injury and repair process. Many strategies have been used to investigate PKCs in lung injury. Isolated organ preparations and whole animal studies are powerful approaches especially when genetically engineered mice are used. More analysis of PKC isozymes in normal and diseased human lung tissue and cells is needed to complement this work. Since opposing or counter-regulatory effects of selected PKCs in the same cell or tissue have been found, it may be desirable to target more than one PKC isozyme and potentially in different directions. Because multiple signaling pathways contribute to the key cellular responses important in lung biology, therapeutic strategies targeting PKCs may be more effective if combined with inhibitors of other pathways for additive or synergistic effect. Mechanisms that regulate PKC activity, including phosphorylation and interaction with isozyme-specific binding proteins, are also potential therapeutic targets. Key isotypes of PKC involved in lung pathophysiology are summarized and current and evolving therapeutic approaches to target them are identified.     

Gender-related symptoms and correlates of alcohol dependence among men and women with a lifetime diagnosis of alcohol use disorders

This study explored gender-related symptoms and correlates of alcohol dependence in a crosssectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol-related problems approximating same-gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.