Kienböck's disease: pathophysiology,classification and treatment of this insidious condition

Kienböck's disease is the result of avascular necrosis of the lunate. Whilst no causal aetiology has been identified, several factors have been found to show an association with the condition. These include anatomical aspects such as lunate morphology; wrist biomechanics and vascular supply patterns, which in combination with external influences such as repetitive trauma, maybe a potential cause of the condition. Diagnosis and assessment of severity has historically been made using plain radiographs to stage the condition, however other assessment modalities such as magnetic resonance imaging and direct visualization with wrist arthroscopy have been advocated. Lichtman has sought to amalgamate these diagnostic techniques into a new comprehensive staging tool with the aim of better standardizing and guiding treatment. Whilst no single treatment has been proven to improve the natural outcome of the disease, current recognized treatments, in general, aim to protect the compromised lunate in the early stage of the condition, whilst in the later stages the focus shifts to procedures that either bypass, fuse or excise the affected peri-lunate articulations.     

Do adolescents with cerebral palsy agree with their caregivers on their participation and quality of life?

Background

It is important to determine the quality of life (QoL) and level of participation in children with Cerebral Palsy (CP). Previous research has used reports from adolescents or caregivers, but there is no evidence that caregivers' reports accurately reflect the experiences of the adolescents they are interested in.

Exploring the feasibility of the use of biopolymers as a carrier in the formulation of amorphous solid dispersions – Part I: Gelatin

Biopolymers have rarely been used so far as carriers in the formulation of amorphous solid dispersions (ASD) to overcome poor solubility of active pharmaceutical ingredients (APIs). In an attempt to enlarge our knowledge on this topic, gelatin, type 50PS was selected. A screening study was initiated in which twelve structurally different poorly soluble biopharmaceutical classification system (BCS) Class II drugs (carbamazepine, cinnarizine, diazepam, itraconazole, nifedipine, indomethacin, darunavir (ethanolate), ritonavir, fenofibrate, griseofulvin, ketoconazole and naproxen) were selected for evaluation. Solid dispersions of five different drug loadings of these twelve compounds were prepared by lyophilization and evaluated for their solid state properties by mDSC and XR(P)D, and in vitro dissolution performance. Even without any process optimization it was possible to form either fully amorphous or partially amorphous systems, depending on the API and API to carrier ratio. Hence in this respect, gelatin 50PS behaves as any other carrier. Dissolution of the API from the solid dispersions significantly exceeded that of their crystalline counterparts. This study shows the potential of gelatin as a carrier to formulate amorphous solid dispersions.     

Antidepressants as antipruritic agents: A review

Pruritus is a concomitant symptom of various underlying disorders viz. dermatological, systemic and psychiatric disorders that provoke the person to scratch the skin. Many natural as well as, antipruritic therapies are usually practiced in the treatment of pruritus including general preventive measures, topical therapies such as cooling agents, antihistamines, anesthetics, capsaicin, corticosteroids, immunomodulators and; systemic therapies including administration of antihistamines, opioid antagonists/agonists, antiepileptic drugs/neuroleptics (e.g., gabapentin and pregabalin), antidepressants (e.g., doxepin, amitriptyline, paroxetine, fluvoxamine, sertraline, escitalopram and mirtazapine) (Patel and Yosipovitch, 2010; Reich et al., 2011; Martín and Padilla, 2015; Eskeland et al., 2016). Topical therapies are the mainstay of treatment of delicate and localized pruritus while other systemic drug therapies are used to treat stern and generalized pruritus. The reported antipruritic activity of some antidepressant drugs has intrigued this review to focus on the types of pruritus, pruritus mechanism, the antipruritic mechanism of antidepressants and to comprehend the role of antidepressants in the management of pruritus.     

ABC分类法和PQ分析法在某肿瘤医院免疫增强剂合理用药中的应用

目的:为免疫增强剂的分类管理及合理使用提供参考。方法:收集某院2016年免疫增强剂品种、用药数量及金额等数据,采用ABC分类法和PQ分析法对免疫增强剂的使用合理性进行分析。并抽取部分住院病历,对用药合理性进行分析。结果:共有35个品种的免疫增强剂被使用,ABC分类法结果 A、B、C类品种各占比29.7%、18.9%、51.4%,相应用药金额占比为77.744%、16.210%、6.046%,结构不够合理。PQ分析结果用量大、价格高的品种共4个,用量大、价格低的品种共10个,两类品种累积用药金额及用药总量构成分别为84.1%、89.4%。免疫增强剂使用医嘱共1 952份,其中不合理使用659份,占33.8%。结论:基于用药合理性和经济性,应加强部分品种的重点监管,并调整限制部分品种品规的使用。     

基因表达谱数据分类算法综述

基因表达谱数据的分类算法有很多种,每种分类算法有其各自的特点,不同分类算法在不同基因表达谱数据中的分类效果也有所不同。本文主要对目前应用较多的四种分类算法(判别分析、决策树、支持向量机、集成算法)的特点和研究进展进行综述,为相关研究和应用提供科学指导。