Effectiveness and Tolerability of Carbamazepine vs. Oxcarbazepine as Mood Stabilizers

Abstract

Background.?Patients with bipolar illness or maniac-type schizoaffective disorder often present a variety of symptoms and mixed responses to treatment. Several anticonvulsants have been found effective in the treatment of mood disorders. In the early 70's, the clinical efficacy of carbamazepine in the treatment of acute mania was reported. Oxcarbazepine has been available in the United States since 2000. Both drugs display a different spectrum of properties and side effect profiles. Objective.?To compare the effectiveness and tolerability of carbamazepine and oxcarbazepine in a naturalistic setting. Methods.?A retrospective and concurrent chart review of all patients treated with carbamazepine or oxcarbazepine (n = 33) as mood stabilizers between 01 and 12 2002. The effectiveness was evaluated using the Positive And Negative Syndrome Scale (PANSS). Tolerability was assessed according to side effects recorded on charts. Patients with charts that were not complete were excluded from this study. Results.?There were no significant differences in efficacy between groups on positive (F = 3.575, P = 0.075), negative (F = 2.641, P = 0.121), or the general subscales (F = 1.111, P = 0.306) of the PANSS. Patients in both groups developed gastrointestinal upset and headache, but no significant differences in tolerability between the two therapies were found (χ² = 0.466, df = 1, P = 0.659) and (χ² = 0.195, df = 1, P = 0.367 respectively). Conclusion.?In summary, the patient charts reviewed demonstrated that carbamazepine, as well as, oxcarbazepine are equally effective and tolerable as mood stabilizers.     

不同起始剂量的帕立骨化醇治疗血液透析伴继发性甲状旁腺亢进患者的有效性

目的 探讨不同起始剂量的帕立骨化醇(PCT)治疗血液透析伴继发性甲状旁腺功能亢进(SHPT)患者12周的有效性。方法 选取我院2017年6月至2020年6月收入的30例维持性血液透析伴SHPT患者,采用随机排列表法分为A组与B组,每组各15例。A组患者采用PCT起始剂量0.06μg/kg,3次/周,透析后给药;B组采用iPTH(pg/mL)/80μg公式计算PCT的起始剂量,3次/周,透析后给药。比较两组患者治疗12周后iPTH值、iPTH达标率、不良反应发生率及血钙、磷水平。结果 治疗12周后,A组iPTH数值低于B组,iPTH达标率高于B组,差异均有统计学意义(P0.05);A组血钙、血磷浓度显著低于B组,差异有统计学意义(P0.05);A组不良反应发生率显著低于B组,差异有统计学意义(P0.05)。结论 采用起始剂量0.06μg/kg的PCT,较之全段iPTH(pg/mL)/80μg起始剂量给药方案治疗血液透析伴SHPT患者,可显著改善SHPT,血钙、血磷波动较小,且不良反应发生率较低,值得应用与推广。     

《医院文化建设丛书》编辑出版的创意与成效分析

先进的医院文化是医院持续发展的精神支柱和动力源泉,是医院内涵建设的重要组成部分。为创新医院文化建设,形成医院文化建设成果,编辑出版了6册不同的文化建设书籍。通过总结提炼、汇编成册,起到了学习、传播的作用,不失为医院文化建设行之有效的方法。     

清洁灌肠方法的改进与评价

目的改进清洁灌肠方法 ,以减少不良反应、改善灌肠效果。方法将 12 0例需清洁灌肠的患者随机分为实验组和对照组 ,每组 60例 ,对照组采用传统清洁灌肠方法 ,灌肠时间平均约为 5min ,实验组采用密闭式输液装置连接 16号导尿管 ,插入肛门深度增加为 17～ 2 0cm ,灌肠时间延长为平均约 3 0min。观察灌肠效果及灌肠中的不良反应。结果与对照组比较 ,实验组灌肠液量多 (P <0 .0 1)、灌肠液保留时间长 (P <0 .0 1) ,灌肠效果优良率高(P <0 0 1) ,且不良反应少。结论改进后的清洁灌肠方法改善了清洁灌肠的效果 ,并减少了清洁灌肠过程中病人的不良反应     

康复护理对神经根型颈椎病患者功能恢复的影响

目的:探讨康复护理对神经根型颈椎病患者功能恢复的影响。方法:将182例神经根型颈椎病患者随机分为对照组82例和观察组100例,对照组给予常规颈椎病非手术疗法治疗,观察组除给予常规颈椎病非手术疗法外,还实施了颈椎牵引、运动疗法等康复护理措施,3个疗程后采用神经根型颈椎病的症状与功能评定量表进行疗效评价。结果:对照组优32例,良26例,中18例,差6例,优良率70.7%;观察组优68例,良22例,中8例,差2例,优良率90.0%,观察组疗效明显优于对照组(P<0.01);对照组平均治愈天数为23.14±6.77d,观察组为17.58±7.11d,两组比较有显著性差异(P<0.05)。结论:康复护理对神经根型颈椎病有较好的疗效,值得临床推广。     

Benchmarks of Significant Change After Aphasia Rehabilitation

ObjectiveTo establish benchmarks of significant change for aphasia rehabilitation outcome measures (ie, Western Aphasia Battery-Aphasia Quotient [WAB-AQ], Communicative Effectiveness Index [CETI], Boston Naming Test [BNT]) and assess if those benchmarks significantly differ across subgroups (ie, time post onset, dose frequency, treatment type).Data SourcesA comprehensive literature search of 12 databases, reference lists of previous reviews, and evidence-based practice materials was conducted.Study SelectionRandomized controlled trials, quasi-experimental studies, single-subject design, and case studies that used a standardized outcome measure to assess change were included. Titles and full-text articles were screened using a dual review process. Seventy-eight studies met criteria for inclusion.Data ExtractionData were extracted independently, and 25% of extractions were checked for reliability. All included studies were assigned quality indicator ratings and an evidence level.Data SynthesisRandom-effects meta-analyses were conducted separately for each study design group (ie, within-/between-group comparisons). For within-group designs, the summary effect size after aphasia rehabilitation was 5.03 points (95% confidence interval, 3.95-6.10, P<.001) on the WAB-AQ, 10.37 points (6.08-14.66, P<.001) on the CETI, and 3.30 points (2.43-4.18, P<.001) on the BNT. For between-group designs, the summary effect size was 5.05 points (1.64-8.46, P=.004) on the WAB-AQ and 0.55 points (-1.33 to 2.43, P=.564) on the BNT, the latter of which was not significant. Subgroup analyses for the within-group designs showed no significant differences in the summary effect size as a function of dose frequency or treatment type.ConclusionsThis study established benchmarks of significant change on 3 standardized outcome measures used in aphasia rehabilitation.     

Complementary/alternative medicine for supportive cancer care: development of the evidence-base

Aim The aim of this article is to compare the evidence relating to the effectiveness of complementary/alternative medicine (CAM) in palliative cancer care as it existed in 2000 and 2005. Methods Our comparison is based on systematic reviews using the same methodology at these two points in time. Results The results reveal a buoyant research activity in this sector. Consequently, new evidence for 19 CAM modalities has emerged between 2000 and 2005. For some treatments, the evidence is encouraging but for very few, it is as yet fully convincing. Conclusion It follows that further research is warranted, particularly in areas where the data already looks encouraging.