Chlorhexidine compared with other locally delivered antimicrobials

Based on the association of bacterial plaque with the initiation of chronic gingivitis and progression of chronic periodontitis, chemical antiplaque agents have been employed both in prevention of periodontal disease and its treatment. In supragingival plaque control regimens, chlorhexidine has not been superceded as a chemical anti-plaque agent, although other compounds have been shown to be useful. The local side-effects of chlorhexidine and other cationic antiseptics, however, limit their long-term use for prevention. Extrinsic tooth staining in particular remains the greatest problem. Short-term anti-plaque uses for chlorhexidine include as an adjunct to mechanical cleaning in the initial oral hygiene phase of treatment, in situations where mechanical oral hygiene is difficult, including postsurgery, intermaxillary fixation, fixed orthodontic therapy, physically and mentally handicapped individuals, systemic diseases with oral manifestations such as leukaemia. More recent interest in chlorhexidine has resulted from the delivery of compounds subgingivally in the treatment of chronic periodontitis. Such methods have extended the use of chlorhexidine into areas inaccessible to the action of antimicrobial drugs delivered locally by conventional means, such as tooth brushing or mouth rinsing. Available evidence suggests that chlorhexidine may not be as effective as some antimicrobial drugs whose activity is more specific for those organisms considered particularly pathogenic to the periodontal tissues.     

The gap between legal rules and practice in advertising non-registered pharmaceutical products : A new method of analysis

The market of non-registered pharmaceutical products is growing fast in number and overall costs, not only in the Netherlands, but also in other European countries. These products often give the impression that the consumer may expect 'an effect as from a drug'. Legally, there is a clear distinction between 'drugs' and 'commodities' in the Netherlands; the question is whether legislation and practice concur. In an investigation we analysed texts of advertisements for non-registered pharmaceutical products published in a popular magazine. A method was developed, based on the legal definition of a drug and jurisprudence, to determine in a qualitative and quantitative way the application of medicinal claims. It transpired that in 65% of the analysed advertisements explicit or implicit claims were made. These products should therefore be subject to drugs legislation. Thus, in the Netherlands there is a gap between legislation and practice in advertising non-registered pharmaceutical products.     

The Rise of a New Psychoactive Agent: Salvia divinorum

Since the 1990s, there has been a rise in the availability and recreational use of a herbal plant called Salvia divinorum. Numerous internet websites have advertised it for sale as a legal herbal alternative to illegal hallucinogens. Initial data surveying use has indicated many young adults are obtaining and using this herb for its psychoactive properties. Reported methods of ingestion for the plant include chewing, and smoking leaves or fortified extracts. Subjective effects of the plant include, affect changes, psychedelic-like changes in perception, and even loss of consciousness. Although the pharmacological properties and possible antidepressant effects have been studied in recent years, little information is known about potential negative impact resulting from recreational use, and scant information about Salvia divinorum currently exists in the psychological and substance abuse literature. While Salvia divinorum appears to be a substance with some therapeutic potential, it also poses some significant dangers as a substance of varying legal status with a potential for abuse.     

大肠菌群MPN检测法在药品微生物限度检查中的应用

采用大肠菌群作为卫生指示菌,对口服药品进行细菌学检验,实验结果表明有利于口服药品染菌状况的监督与控制。     

Androgen receptor independent cardiovascular action of the antiandrogen flutamide

We have previously shown that flutamide (specific antagonist of the androgen receptor) has antihypertensive effects. In the present study we examined the mechanisms of flutamide action in the vasculature. The vascular effects of flutamide were assayed in aortae isolated from male or female Sprague-Dawley rats and from rats or mice lacking a functional androgen receptor ( tfm, testicular feminization mutation). The effect of flutamide on coronary flow was tested in isolated hearts. In addition, male hypertensive rats with tfm mutation were treated with flutamide, and blood pressure was monitored. Flutamide induced a relaxation of rat aortae from all the strains used (maximum relaxation at 10 microM: 51.3+/-5.2% of phenylephrine contraction) and increased the coronary flow. The aortic relaxation to flutamide was abolished by endothelium removal, or by inhibition of nitric oxide synthase, guanylyl cyclase, and tyrosine kinase but not by calmodulin inhibition. Flutamide treatment attenuated the development of hypertension in mouse renin transgenic rats with the tfm mutation. Flutamide produces direct vasodilation by inducing release of NO from the endothelium and causes subsequent activation of soluble guanylyl cyclase in an active androgen receptor independent manner. This response may contribute to the observed antihypertensive actions of flutamide.     

Junctional and extrajunctional acetylcholine receptors in normal and denervated frog muscle fibres

Summary Ionic channel properties of acetylcholine receptors located in, in the vicinity of, or far away from a frog neuromuscular junction were investigated by noise analysis of drug induced current fluctuations. For drugs applied to the junction, in certain cases two Lorentzian curves were necessary to describe the data. It is postulated that the reason for this observation is that a contribution from perijunctional receptors was being observed. The conductance of a single channel in the junction was independent of the nature of the agonist and had an average value of 17.9 pS (temperature range 8–25°C, solution buffered with Tris). After denervation for 21 days the conductance γ was 7.5 pS at extrajunctional locations. In the close neighbourhood of the junction (perijunctional receptors) values were found between 4 and 19 pS. The mean value of the open channel life-time τ in the endplate exposed to acetylcholine was 2.4 ms at 8–11°C. This value was 0.90 ms with carbachol, 0.50 ms with succinylcholine, 0.28 ms with decamethonium and 0.45 ms with nicotine. The receptors outside the endplate exhibited τ-values which at a given temperature were 2–3 times larger than those at the endplate. Raising the temperature to 23°C reduced all τ-values by factors of 2–3. It is concluded that at least two types of ACh-receptors with different properties exist in the muscle membrane, possibly produced by ACh-receptive units in different states of aggregation. This work was supported by the Deutsche Forschungsgemeinschaft, SFB 38, Project N     

The effect of drugs on the acquisition of stimulus control in a conditioned suppression procedure

Rats were trained to press a lever under a variable-interval (VI) schedule of water reinforcement. After stable responding had developed, a 4.5-KHz tone (CS) was conditioned classically to a 2.5-mA electric shock (US) in groups of animals which had been given various psychoactive drugs or saline. Twenty-four hours later, a stimulus generalization test was conducted in the absence of drug; during this session, tones that varied in frequency around 4.5 KHz were presented while the animals were responding under the VI schedule. In animals conditioned under saline, all tones (non-differentially) suppressed responding which, however, recovered gradually over time. This suppressive effect was eliminated by lysergic acid diethylamide (LSD; 0.2 and 0.32 mg/kg), cocaine (20 mg/kg), diazepam (2.5 mg/kg), lisuride (0.08 mg/kg), mescaline (20 mg/kg) and 5-methoxy-N,N-dimethyltryptamine (4 mg/kg), and was attenuated by amphetamine (4 mg/kg), pentobarbital (15 mg/kg) and morphine (4 mg/kg). Atropine (10 mg/kg), scopolamine (1 mg/kg), clonazepam (0.5 mg/kg), and chlorpromazine (4 mg/kg) did not alter the suppressive effect of the tone. The serotonin antagonist BC-105 (6 mg/kg) reversed the effect of 0.2 mg/kg of LSD. These results suggest (1) that drug-induced stimuli may overshadow other (e.g., external) stimuli during classical conditioning and, (2) that drugs might affect behavior by altering processes (stimulus control or others) that do not simultaneously involve response or motor control.     

药品零加成政策对慢性心力衰竭患者次均住院费用变化影响结构分析

目的 分析药品零加成政策对于慢性心衰住院费用的影响和结构变动趋势,为推进医改的实施和加强医院内部管理提供依据。方法 收集上海某医院2016—2019年慢性心衰患者住院费用,采用结构变动度法和灰色关联度法分析各项费用的结构变动情况及其与总费用的关联程度。 结果 2016—2019年住院费用总结构变动度为24.49%;药费及耗材费呈下降趋势,诊断费及综合服务费上升;药费结构变动贡献率最大（34.75%）,其次是诊断费（31.24%）,两项累积贡献率达65.99%;与次均住院费用关联度从高到低前三项为诊断费（0.86）、药费（0.79）和耗材费（0.72）。 结论 样本医院药品零加成政策的实施取得显著的成效。今后医院应建立合理评估机制,进一步控制药费及耗材费,加强诊断费的监督管理,优化医疗费用结构。     

Poisoning in children

Drug-induced poisoning of children represents a serious medical as well as a social problem linked both to the fields of prevention and therapy. This paper analyses the occurrence and the causative agents of poisoning cases of children under the age of 15, hospitalized in a children's hospital over a two-year period (1985–1986). 33 Poisoning cases represented 1.7% of all hospitalizations, and 49% thereof were induced by drugs.