北京居民用药风险影响因素调查

目的:了解北京市居民对用药行为风险的知识-态度-行为(knowledge-attitude-practice, KAP)现况,探索可能引发居民用药风险的因素。方法:采用横断面研究方法,对18岁以上北京居民进行基本信息、用药风险KAP问卷调查。采用描述性统计方法及多因素Logistic回归分析居民基本信息对用药风险KAP的影响。结果:本次调查共获取有效调查问卷582份。北京居民用药知识平均得分(61.20±18.78)分,态度平均得分(29.33±8.24)分,行为平均得分(55. 83±9. 09)分,参照结果的评价标准KAP整体评分为良好。不同月收入、医疗保障情况、文化程度KAP得分比较,差异有统计学意义(P<0.05)。KAP得分与文化程度和收入水平呈正相关,其中工作状况对用药KAP得分影响最大。北京居民用药KAP得分良好率,在职人员是非在职人员的2. 784倍,城镇居民是农村居民的2.520倍,高文化程度是低文化程度的1.886倍,高收入人群是低收入人群的0.606倍。结论:北京市居民对用药行为风险的KAP水平良好,用药风险较低。但仍需进一步优化用药教育形式,并关注低文化程度、低收入和特殊人群用药。     

Familial risk factors favoring drug addiction onset

This study, primarily aimed at identification of familial risk factors favoring drug addiction onset, was carried out throughout 2008 and 2009. The study comprised a total of 146 addicts and 134 control subjects. Based on the study outcome, it can be concluded that in the families the addicts were born into, familial risk factors capable of influencing their psychosocial development and favoring drug addiction onset had been statistically more frequently encountered during childhood and adolescence as compared to the controls. The results also indicated the need for further research into familial interrelations and the structure of the families addicts were born into, as well as the need for the implementation of family-based approaches to both drug addiction prevention and therapy.     

阿尔茨海默病的血管危险因素及其药物治疗

除了已知的遗传、β淀粉样蛋白沉积、神经递质异常、Tau蛋白异常磷酸化等因素外,腩血管病变等血管危险因素(VRF)在阿尔茨海默病(AD)的发病过程中也起着重要的作用.但VRF对AD发病机制的具体影响尚未阐明.本文根据目前该领域最新研究对VRF在AD发病过程中的作用做一综述,以期阐明VRF诱发AD的各种可能机制以及其他各诱发因素之间的关系.     

Gender differences in the perception of drug user treatment: assessing drug user treatment for youthful offenders.

The present study sought to determine whether gender-specific differences existed in the perception of drug user treatment services delivered at a residential substance misuse treatment program operated by a large youth correctional agency in the western United States. Hypothesized gender differences in perceptions of treatment services and treatment-related needs were confirmed in a number of areas such as treatment engagement, counseling needs, and postrelease concerns. Findings of this exploratory study underscore the need to consider gender-specific issues in correctional substance misuse treatment for young offenders.     

A review of drug use and driving: epidemiology, impairment, risk factors and risk perceptions

The existing literature on the prevalence of drug driving, the effects of drugs on driving performance, risk factors and risk perceptions associated with drug driving was reviewed. The 12-month prevalence of drug driving among the general population is approximately 4%. Drugs are detected commonly among those involved in motor vehicle accidents, with studies reporting up to 25% of accident-involved drivers positive for drugs. Cannabis is generally the most common drug detected in accident-involved drivers, followed by benzodiazepines, cocaine, amphetamines and opioids. Polydrug use is common among accident-involved drivers. Studies of impairment indicate an undeniable association between alcohol and driving impairment. There is also evidence that cannabis and benzodiazepines increase accident risk. The most equivocal evidence surrounds opioids and stimulants. It is apparent that drugs in combination with alcohol, and multiple drugs, present an even greater risk. Demographically, young males are over-represented among drug drivers. Although there is an association between alcohol use problems and drink driving, it is unclear whether such an association exists between drug use problems and drug driving. Evidence surrounding psychosocial factors and driving behaviour is also equivocal at this stage. While most drivers perceive drug driving to be dangerous and unacceptable, there is less concern about impaired driving among drug drivers and drink drivers than from those who have not engaged in impaired driving. Risk perceptions differ according to drug type, with certain drugs (e.g. cannabis) seen as producing less impairment than others (e.g. alcohol). It is concluded that drug driving is a significant problem, both in terms of a general public health issue and as a specific concern for drug users. [Kelly E, Darke S, Ross J. A review of drug use and driving: epidemiology, impairment, risk factors and risk perceptions. Drug Alcohol Rev 2004;23:319-344]     

Personality factors and drug of choice in female addicts with psychiatric comorbidity

Female addicts (N= 108) with a mean age of 37.2 were tested using the Temperament and Character Inventory (TCI) in 1996-97. In a representative sub-sample (N = 49) assessed with the Structured Clinical Interview. DSMIIIr (SCID), 82% manifested an axis-1-syndrome (lifetime), and 53% a personality disorder. Of the 108 addicts, 42 preferred alcohol, 14 heroin, 33 amphetamines, and 19 benzodiazepines. Maturity was low, but there were no differences in maturity between drug preference groups. Results indicated that those less mature were more "novelty-seeking" and "harm-avoidant", while those maturer tended to be more persistent. Less mature persons answered less consistently. They agreed more with different items and their answers were more rare when compared to the general population. Heroin addicts were less sentimental and helpful and more aware of their own resources. Benzodiazepine and amphetamine addicts were more self-transcendent and self-forgetful. Among the relatively more mature, benzodiazepine addicts scored higher than heroin and alcohol addicts on "true" and rare answers. In conclusion, maturity and the drug of choice among female addicts were related to different TCI scales.     

铜绿假单胞菌医院感染危险因素及耐药性分析

目的 了解铜绿假单胞菌发生医院感染的各种危险因素及其耐药性,规范院内感染控制措施,降低医院感染率,指导临床合理用药、提高医疗质量、改善患者预后.方法 回顾性调查2009年1月至2011年12月我院临床分离的铜绿假单胞菌152株,分析标本来源及其感染危险因素和耐药性.结果 铜绿假单胞菌感染主要来源呼吸道,占57.2%,高度危险因素为:住院时间长、年龄>60岁、严重基础疾病、机械通气时间、长期应用抗生素、深静脉导管;在10种抗生素中亚胺培南、哌拉西林/他唑巴坦、阿米卡星敏感性高,敏感度分别为90.7%,79.2%,70.0%.结论 规范院内感染控制措施,降低医院感染率,根据临床药敏结果合理选择抗菌素进行治疗,防止耐药菌株的产生和播散.     

药物治疗高血压用药依从性危险因素调查及药学干预

目的:探讨影响高血压患者用药依从性的危险因素以及药学干预提升药物治疗高血压的临床疗效。方法:从964例高血压患者中选取具有两项以上用药依从性危险因素的高血压患者328例,按照随机分组方式将患者分为观察组和对照组,每组164例。对照组维持原来的用药依从特点,对观察组进行药学干预,持续干预12周。对两组患者的药物效果和用药依从性进行测评和对比分析。结果:高血压用药依从性危险因素主要包括初中以下文化程度、40岁以下年龄和65岁以上年龄、两种以上药物联用、服药时间3年以上、家庭收入不满意、日服药次数3次及以上。通过药学干预观察组用药综合有效率(显效+有效)达到84.15%,用药依从性达到(86.47±13.48)%,与对照组比较差异有统计学意义(P<0.05)。结论:高血压治疗必须综合考虑患者各项影响因素,并进行针对性的干预,提升患者用药依从性。     

侵袭性白念珠菌感染的危险因素及耐药性变迁

目的 分析四川大学华西医院住院患者侵袭性白念珠菌感染的分布情况、可能的危险因素以及真菌耐药性变化,为临床预防和合理用药提供依据.方法 对四川大学华西医院2010年1月到2012年12月100例侵袭性白念珠菌感染患者的临床资料进行回顾性分析,分析并总结其标本来源、科室分布、年龄分布、感染的危险因素、抗菌药物使用情况以及真菌耐药率的变迁.结果 在侵袭性白念珠菌感染中,血流感染最为多见,占55％,感染患者多为ICU重症患者,占35％.年龄分布中位数为53.5岁.可能相关危险因素中外科手术和气管插管/切开、机械通气分别占74.6％和46.5％,有94例(82.5％)使用过抗菌药物.3年来我院白念珠菌对氟康唑、伏立康唑、两性霉素B耐药率为0％,对5-氟胞嘧啶和伊曲康唑的耐药率分别保持在4.1％和27.7％以下.结论 白念珠菌是ICU重症患者的血流侵袭性真菌感染中重要的病原菌,外科手术和气管插管/切开及呼吸机的使用是最显著侵袭性白念感染的两大危险因素.虽然目前临床常用抗真菌药物能覆盖侵袭性白念珠菌的治疗,但仍应加强对重点科室以及有相关危险因素患者的监测,重视培养鉴定与药敏结果对临床用药的指导,以减少耐药菌的出现与流行.     

Identifying genetic risk factors for serious adverse drug reactions: current progress and challenges

Serious adverse drug reactions (SADRs) are a major cause of morbidity and mortality worldwide. Some SADRs may be predictable, based upon a drug's pharmacodynamic and pharmacokinetic properties. Many, however, appear to be idiosyncratic. Genetic factors may underlie susceptibility to SADRs and the identification of predisposing genotypes may improve patient management through the prospective selection of appropriate candidates. Here we discuss three specific SADRs with an emphasis on genetic risk factors. These SADRs, selected based on wide-sweeping clinical interest, are drug-induced liver injury, statin-induced myotoxicity and drug-induced long QT and torsades de pointes. Key challenges for the discovery of predictive risk alleles for these SADRs are also considered.     

左氧氟沙星不良反应潜在危险因素分析

目的:分析左氧氟沙星的药物不良反应,探讨不良反应的潜在危险因素。方法:借鉴系统评价方法,计算机检索Ovid medline、Ovid embase、CBM、CNKI、VIP、万方等数据库中从建库至2017年12月29日关于左氧氟沙星不良反应危险因素相关报道。结果:共纳入97篇文献。左氧氟沙星不良反应主要集中在感觉、消化、神经系统,占82.58%。左氧氟沙星不良反应的危险因素排名前7位的分别为患者年龄、单日剂量、合并用药种类、给药途径、患者性别、用药疗程、过敏史/药物种类。结论:左氧氟沙星不良反应较常见,密切关注具备多种潜在危险因素的患者,可能有助于降低左氧氟沙星药害事件,提高用药安全性。     

Relative risk factors in detecting adolescent drug abuse.

Detecting adolescent drug abuse remains to be a difficult proposition because of its secret nature. This paper investigates the significance of other factors as indicators of possible drug use by an adolescent. Peer drug use, suspension at school, law infringements, truancy, conflict with parents, alcohol use and cigarette smoking were the relative risk factors investigated among 953 adolescents. The most predictive of those was peer drug use. The more of those factors were present in an adolescent, the higher the risk of possible drug use.     

The characteristics and risk factors for HIV infection among Beijing drug users in different settings

Background

Treatment for drug addiction in China can take place in mandatory detoxification centers (MDC), voluntary detoxification centers (VDC), or at outreach programs located in the community. To date little is known about HIV prevalence or associated risk factors among the current and past drug users (DU) in each setting.

Methods

Cross-sectional surveys were conducted at three different settings in Beijing, China; 795 subjects were enrolled at MDC, 824 at VDC, and 520 within the community. Subjects who provided informed consent took part in face-to-face interviews and provided blood samples for HIV and syphilis testing.

Results

Significant differences were found across enrollment sites in terms of demographic, drug use and sexual behavior characteristics. Overall HIV sero-prevalence was 2.9%, and was particularly high in MDC (5.2% versus 1.0% in VDC and 2.3% among community drug users). Adjusted odds ratios (OR) for HIV infection were 50.5 (95% CI: 19.07-133.85) for being of Yi ethnicity, 29.4 (95% CI: 15.10-57.24) for Uyghur ethnicity, 3.4 (95% CI: 1.57-7.52) for injection drug users who did not share equipment, and 18.8 (95% CI: 8.31-42.75) among injection drug users who shared injection equipment.

Conclusions

The vast differences among DU in various enrollment sites in terms of demographic characteristics, socioeconomic status, and HIV related risk profiles underscore the importance of familiarity with population characteristics and drug user environment to better inform targeted prevention programs. Prevention programs targeting DU in Chinese settings must also consider differences in ethnicities, culture, and residential status.