Toward patient-centered outcomes for cognitive evaluations: the perspective of those affected by Parkinson’s disease*

Abstract

Objective: Patient-centered outcomes research is predicated on the idea that the opinions, attitudes, and preferences of patients should help inform study design and interpretation. To date, little is known about what defines patient-centered outcomes from cognitive evaluations. The current evaluation sought to explore this issue in persons with Parkinson’s disease (PwPD) and their care partners (CP). Method: Focus groups of 22 PwPD/CP dyads were conducted to identify potential consumer oriented endpoints from cognitive evaluations. These endpoints were utilized to create a Patient-Centered Cognitive Assessment Outcomes Scale, which was administered to a different group of 50 PwPD/CP dyads who rated the importance of each outcome and identified their top three priority outcomes. Results: Three themes emerged from the focus groups: improved knowledge, advice, and planning. Both PwPD and CP rated items in all three domains as being very important outcomes. Priorities for outcomes in both groups favored treatment planning information slightly above knowledge based outcomes. Conclusions: The PwPD and CP identified improved knowledge, advice for daily activities, and knowledge they could use to plan for future eventualities as very important. This information can be used as a framework for future studies aimed at demonstrating patient-centered outcomes from neuropsychological evaluations. Implications for future research are discussed.     

医疗设备采购评标中模糊综合评判分析模型的研究

目的 在招标管理中实现医疗设备采购评标的科学性、合理性和客观性.方法 针对目前医疗设备采购评标中存在的问题,运用模糊综合评判分析理论,综合考虑多种因素进行评价.结果 在采购应用和管理中建立了基于层次分析法的评标指标体系和模糊评判分析模型.结论 通过实例的应用,体现了模糊综合评判分析模型在评标中的可行性、科学性和有效性,对于医院的招标采购具有实际的指导意义.     

Evaluation and comparison of in-vitro dissolution profiles for different brands of amoxicillin capsules

Background

Amoxicillin is an oral semi-synthetic, β-lactam antibiotic used to treat bacterial infections caused by susceptible micro organisms. It is usually prepared in capsule, tablet and powder for oral suspension form. Solid dosage forms for oral administration pose bioavailability problems related to the absorption process The World Health Organization (WHO) has promoted the use of generic brands in order to make the cost of medicines affordable. Generic substitution could be considered when a generic copy of a reference drug contains identical amounts of the same active ingredient in the same dose formulation and route of administration. However, the presences of generic products those are not interchangeable with that of the innovator and/or with each others have been reported.

Objectives

To evaluate and compare the in-vitro dissolution profiles of different generic brands of amoxicillin capsules with the innovator that are available in Ethiopian market.

Methods

Dissolution profiles for nine brands of amoxicillin capsules contained amoxicillin 500 mg which are available in Ethiopian market were determined using a method from the United States Pharmacopoeia (USP, 2009). The obtained dissolution profile data of the eight brands were evaluated and compared with the innovator brand (Amoxil™) using two different statistical methods: the fit factors (f1 & f2) and the dissolution efficiency (D.E.) model. Most generic brands of amoxicillin capsules (62.5% of the tested brands) are not interchangeable with the innovator brand.

Results

The calculated f1 factor for Brand A and Brand G are 10.1 and 1.1 respectively. However, for the rest six brands the f1 factors are greater than 15. The f2 factor for Brand G is 74.1 and for Brand A is 48.5 which is near to 50. Similarly, the f2 factors for the six brands are less than 50 which support the result of the f1 factors for the dissimilarity of these brands with the innovator brand. The mean dissolution efficiencies as well as the 95% confidence intervals are within ±10% only for two brands, Brand F and Brand G.

Conclusions

Most generic brands of amoxicillin capsules (62.5%) are not interchangeable with the innovator brand (Amoxil™).     

五种药用石斛内生真菌抑制HIV-1整合酶活性研究

目的 评价5种药用石斛内生真菌发酵产物抑制HIV-1整合酶的活性.方法 将分离自石斛的202株内生真菌提取物共404个采用高通量ELISA法评价其抑制HIV-l整合酶活性;对抑制活性大于100％的样品进行量效关系考察并进行体外抑制肿瘤细胞活性筛选.结果 筛选得到19个对HIV-l整合酶抑制活性大于80％的样品,其中样品5119F、5297F、5097F、5140J和5211F的抑制率分别达到117.96％、113.53％、108.62％、103.74％和109.02％,其对应的IC50值分别为0.02024、0.003125、0.00862、0.01007 和 0.01192 mg/ml.结论石斛属药用植物内生真菌是一个潜在的、丰富的用于筛选HIV-1整合酶抑制剂的资源库,值得进一步研究和开发.     

Radiographic assessment of the mandibular retromolar canal using cone-beam computed tomography

Abstract

Objective. The ‘retromolar’ nerve is a collateral branch of the inferior alveolar nerve. Cone-beam computed tomography (CBCT) provides higher resolution images. This CBCT study reports the frequency of the retromolar nerve. Materials and methods. From 2007–2010 the CBCT study of 233 hemi-mandibles have been examined. The CBCT study was obtained from an investigation of the posterior mandibular region in 187 patients suffering from different pathologies and it was aimed at detecting in patients the presence of a retromolar canal and foramen. Results. Thirty-four retromolar canals with a foramen were detected on 233 CBCT (14.6%) in 30 out of 187 patients (16%). In the 46 patients who underwent CBCT bilaterally, the retromolar canal was found in nine subjects (19.6%) and was present bilaterally in four subjects, for an incidence of 8.7%. Conclusions. The results suggest that the radiological frequency of the retromolar nerve is notable, with a possible relevance in the surgical approach of the mandibular retromolar area. The presence of a retromolar canal, well detected with CBCT, may warn clinicians about the possibility of inadequate pre-surgical anaesthesia, local intra-operative bleeding and post-operative alterations of the sensation in the third molar area.     

Transbronchial fine needle aspiration biopsy and rapid on‐site evaluation in the setting of superior vena cava syndrome

There is a paucity of prospective data on flexible bronchoscopy with rapid on‐site evaluation (ROSE) in the setting of superior vena cava (SVC) syndrome. The aims of this prospective study were to assess the diagnostic yield and safety of these investigations and specifically to evaluate the role of ROSE in limiting the need for tissue biopsies. Over a 5‐year period 48 patients (57.4 ± 9.7 years) with SVC syndrome secondary to intrathoracic tumors underwent flexible bronchoscopy with TBNA and ROSE. Endobronchial Forceps biopsy was reserved for visible endobronchial tumors with no on‐site confirmation of diagnostic material. ROSE confirmed diagnostic material in 41 cases (85.4%), and in only one of the remaining cases did the addition of a forceps biopsy increase the diagnostic yield (overall diagnostic yield of 87.5%). No serious complications were noted. The final diagnoses made included nonsmall lung cancer (n = 27), small cell lung cancer (n = 16), and metastatic carcinoma (n = 3). Two undiagnosed cases died of suspected advanced neoplasms (unknown primary tumors). We conclude that TBNA has a high diagnostic yield and is safe in the setting of SVC syndrome. With the addition of ROSE, tissue biopsy is required in the minority of cases. Diagn. Cytopathol. 2013;41:324–329. © 2011 Wiley Periodicals, Inc.     

氟化物与过氧化氢类漂白剂联用对大鼠牙髓影响的组织病理学观察

目的从组织学水平观察高浓度漂白剂与氟化物联用对大鼠牙髓的影响。方法将60只大鼠按处理方法不同随机分为加NaF漂白组、漂白组和空白组,其中NaF漂白组和漂白组分别按5、10和15 min 3个不同的治疗时间进行漂白处理,然后对即刻、3 d后和7 d后的牙髓情况进行组织病理学观察。结果全部受试牙中仅有1/3出现轻度牙髓反应,没有出现中度或重度牙髓反应,并且这些轻微牙髓反应在治疗结束后即可出现,一般在2周内恢复正常,NaF漂白组和漂白组之间无统计学差异。结论动物实验结果显示高浓度过氧化氢类牙齿漂白治疗可引发轻微、局限性的牙髓反应,漂白治疗术前氟化物的应用对牙髓反应等级无明显影响。     

14例正畸减数第一恒磨牙病例临床疗效分析及相关问题初探

目的 评价正畸减数第一磨牙的临床疗效,并就减数第一磨牙的相关矫治原则、间隙关闭情况及第三磨牙的建（牙合）等问题进行初步探讨.方法 选取我科近10年完成的14例减数第一磨牙矫治病例进行分析.通过对矫治前后模型的PAR指数和头颅侧位片,对矫治后磨牙间隙关闭、咬合关系及软组织侧貌进行评价;并通过曲面断层片,初步评价第二磨牙的牙根吸收和牙槽骨的改建以及第二磨牙和前磨牙的牙根平行状况.结果 14例患者平均疗程（29.5±4.3）个月,PAR疗效分析显示治疗后变差或无改变0例,改善5例,明显改善9例,提示拔牙间隙关闭满意,牙（牙合）关系良好;软组织侧貌协调,面型满意;曲面断层片显示第二前磨牙与第二磨牙牙根平行状况良好,第二磨牙牙根及牙槽骨无明显吸收.结论 减数第一磨牙病例只要严格把握适应证,合理的支抗设计和严谨的临床操作,可以获得满意的临床矫治效果.