Adverse drug events in hospitalized patients A comparison of doctors, nurses and patients as sources of reports

Objective: This study investigated the relative value of adverse drug events reported by doctors, nurses and patients. Methods: The study was conducted on a total of four wards: the paediatric and internal medicine wards (including geriatric patients) of two peripheral hospitals in the Netherlands. Adverse drug events were collected by spontaneous reporting (doctor and nurse reports) and by daily ward visits, during which the patients were interviewed by a hospital pharmacist (patient reports). Criteria for relative value of the reported adverse drug events were the number of potentially serious reactions, the number of reactions not mentioned in the patient information leaflet and the number of reactions reported to new drugs (5 years or less on the Dutch market). No formal causality assessment was applied. Results: Over a period of 2 months in 1996 (Hospital I) and 2 months in 1997 (Hospital II) a total of 620 patients were included in the study and adverse drug events were reported in 179 (29%) of these cases. Doctors reported a statistically significant larger number of serious (26% of all doctor reports; odds ratio (OR) 3.2; confidence interval (CI) 1.2–8.7) and unknown (39%; OR 2.5; CI 1.0–6.0) adverse drug events than patients themselves during the daily ward visit. Doctors also reported more serious and unknown adverse drug events than nurses. Adverse reactions to new drugs were reported during the daily ward visit only (8% of all daily ward visit reports). Conclusion: This study reconfirms that doctors are the main source for reports of serious and unknown adverse drug events in hospitalized patients. However, patients themselves seem to report more adverse reactions to new drugs (during the daily ward visit). By focusing on patients using new drugs, the daily ward visit might become cost-effective. This needs to be explored in future studies. Received: 10 September 1998 / Accepted in revised form: 30 November 1998     

Retrospective prediction of birth weight by growth velocity curves during neonatal period

In this prospective study, birth weight of 304 babies born at Kamla Nehru Hospital Pune during study period was recorded. From these 304 babies, babies with birth weight above 2000 grams were selected (260 babies) to prepare growth velocity curves. Daily weight of these 260 babies was recorded for 30 days. The mean birth weight of study population was 2742.5 grams. Among the daily weight recorded babies, all the babies lost weight ranging from 92 to 218 grams (mean 121 grams) after birth. The weight loss continued upto 5 days. Days required to gain weight equal to birth weight ranged from 5 to 13 days. Total weight gain observed in 30 days was 734.7 grams. Predictive value of these curves was tested in 49 infants. Deviation upto 50 grams of predicted birth weight from actual birth weight was observed in 90% of babies on day-2, 79% on day-4, 65% on day-8 and 39% on day-30.     

乳腺癌前哨淋巴结活检意义初探

目的：探讨开展乳腺癌前哨淋巴结活检(Sentinel lymph node biopsy，SLNB)的必要性、可行性、准确性及临床应用价值。方法：对45例临床、B超及钼靶检测腋窝LN阴性的原发乳腺癌患者，术中在原发肿瘤周围注射专利蓝进行腋窝淋巴结切除(SLNB)，随后行腋窝淋巴结清扫(ALND)。术中对部分SLN、术后对全部LN行常规病理检查。结果：45例患者中41例检测到SLN，成功率91．1％；假阴性率为6．66％，SLNB总的敏感性是93．3％，特异性是96．1％；总的阳性和阴性预测值分别是93．3％和96．1％。结论：乳腺癌SLNB是一项有实用价值的新技术，目前国内外仍在研究阶段，随着研究的扩大与深入将有可能取代常规的ALND。     

美国中医学者对国内中医界的期盼

文章指出中国医学流入美国约50年，美国学者对此古老医学非常崇敬，认为中医学有很高的价值，中西医结合是未来医学发展之趋势，中医西医学化，中医新科技化，是大家必须去研讨之路。同时认为，中医要进一步发展必须改进传统观念，以学术科学为主，以传统经典为考，改进而不忘本，中医才能更加发扬光大。     

国人（195例）重心动摇计检查正常值的测定

目的：为测得正常中国人重心动摇检查各项正常值。方法：１９５例无晕与平衡障碍的人行重心动摇检查，得到各项测试值，结果：与日本学会标准比较，睁眼与闭眼外周面积值各年龄组无益氏于日本学会标准，其余各项数值相仿。结论；国人重心动摇应参照中国人的正常值。     

三叶木通种子品质性状研究

目的探讨三叶木通种子品质对栽培用种价值的影响。方法用电子天平测定种子净度及饱满度,用水分仪测定种子含水量,通过发芽试验确定种子发芽率。结果三叶木通鲜种子的种子净度、百粒质量、千粒质量、含水量、生活力、发芽率及发芽势分别为98.7%、6.64g、66.6g、43.1%、94.5%、82.6%、52.8%;风干10、60d时,三叶木通种子含水量分别为28.5%、7.8%,发芽率分别为64.3%、14.7%。结论三叶木通种子宜在30℃下清水浸种24h,5~12℃室温下湿沙层积发芽,当种子含水量低于8%时,失去栽培用种价值。     

颈胸交界区食管癌放射治疗中设野方法的研究

目的：比较颈胸交界区食管癌放射治疗中不同射野与楔形板应用的技术。方法：采用美国CMS公司XiO V4．1．1三维治疗计划系统（TPS），比较颈胸交界区食管癌在不同治疗计划中等剂量曲线、剂量体积直方图（DVH）及其他评价指标的优劣。结果：采用先前后对穿照射（适形野或马褂野）及后程两前斜野加楔形板治疗技术的剂量分布较仅应用两前斜野加楔形板治疗技术等剂量曲线分布均匀，肺受量减小。运用马褂野较用适形野的照射方式剂量分布更加均匀且满足锁骨上淋巴结区预防照射要求；楔形板常规应用技术（仅厚端相对避免内野高剂量）的靶区剂量分布较其在三维治疗计划系统的应用技术均匀性明显不足。结论：放射治疗技术和楔形板在颈胸交界区食管癌放射治疗中的应用应做到个体化，对锁骨上淋巴结区需预防照射的患者，应采用先前后对穿照射（适形野或马褂野）加后程两前斜野及楔形板治疗技术，对锁骨上淋巴结区不需预防照射的患者，则可以用前两斜野加楔形板治疗技术。     

知识管理在我院药学部的应用

目的:探讨知识管理在医院药学部(药剂科)的应用。方法:总结近年来我院药学部关于知识管理的数种模式。结果:我院药学部知识管理已基本成型。结论:通过知识管理,增强了药学部的应变能力和创新能力。     

客户关系管理在药店的应用

目的 :为药店应用客户关系管理理论提供建议。方法 :简要阐述客户关系管理的基本理论 ,并对其在药店管理中的实际应用加以分析。结果与结论 :药店只有结合自身特点 ,将客户关系管理理念落实到实际工作之中 ,才有可能发挥其最大效用。     

葡萄籽提取物的质量标准

概述了国际市场上葡萄籽提取物的几种质量标准,综合分析了中国葡萄籽提取物各生产厂家的质量标准情况。鉴于国内还没有葡萄籽提取物质量的国家标准或行业标准,笔者根据多年的葡萄籽提取物研究、生产、出口情况,结合相关文献,提出了建立2种规格质量标准的观点:多酚含量大于95%、单体含量大于10%作为高品质葡萄籽提取物的质量标准;原花青素值大于95、单体含量大于6%作为一般品质葡萄籽提取物的质量标准。