临床输液反应分析及预防

目的分析临床输液反应的原因，提出预防措施。方法查阅我院1999～2003年的护理部输液反应记录，按输液反应的类型及分布、使用的输液及其构成比、输液反应联合用药情况、输液中加用药物分为情况、输液中加用中成药制剂分类情况、药品、器具质量检查情况等进行统计分析。结果热原反应、过敏反应及局部反应都有发生，以热原反应最为多见，输液反应所用的大输液多为5％葡萄糖注射液。联合用药以中成药制剂和抗菌素制剂发生输液反应最为多见。结论严格掌握输液治疗的适应症和禁忌症，提高药品质量，加强无菌操作，科学合理的联合用药是预防输液反应的关键。     

22例输液反应原因分析及预防措施

目的分析输液反应发生的原因，探讨预防措施。方法对22例输液反应病例进行分析、归纳。结果引起输液反应的因素与药品质量、输液操作、输液器具质量、药物配伍、患者个体差异及环境气候等有关。结论严格控制药品质量、合理用药、尽可能减少配伍种类与数量是减少输液反应的有效措施。     

临床输液反应的分析与预防

目的对临床发生的输液反应进行分析,找出发生的原因,探讨预防措施。方法:对30例输液反应资料进行分析。结果:以热原反应最为多见,占76.67%,而过敏反应,占16.67%,局部反应,占6.67%。结论:严格执行消毒制度,遵守无菌操作规程,把好药品和输液器具质量关,合理用药,注意配伍等是减少临床输液反应的关键。     

5年输液反应送检结果分析

目的 :找出引发输液反应原因 ,保证临床用药安全。方法 :通过对全院 2 0个临床科室送检 5 8例输液反应结果分析 ,检出阳性率及输液反应发生与联合用药关系。结果 :阳性检出率为 2 5 .86 % (15 / 5 8) ,而其中因输液污染而引发的反应约占 1/ 4,而非污染引起的反应约占 3/ 4。结论 :输液反应的发生受多种因素影响 ,而最主要的是联合用药造成的热原累加和不合理用药及操作不规范引起污染 ,其次为患者个体差异。     

我校医院输液反应分析及防治措施

目的：分析我校医院临床用药时输液反应发生的情况及其处理措施，指导合理用药，减少输液反应。方法：分析引起输液反应的因素如输液器质量、使用药物、用药方法等。结果：我校医院常见的输液反应主要表现为局部肿胀、静脉炎、组织坏死及过敏反应等。结论：输液反应的发生与药物质量、输液环境、操作方法、个体差异性等均有联系。     

57例输液反应的原因分析及预防措施

目的 对临床发生的输液反应进行分析，找出发生的原因，探讨预防与控制措毒岜。方法对浙江省绍兴市城南人民医院2001—2005年57例输液反应资料进行回顾性分析。结果 输液反应的发生原因有药物、输液器具、操作、患者、季节等。结论 把好药品和输液器具质量关，严格操作规程，加强对重点患者的输液观察，建立临床用药反馈机制，加强医、药、护三者闻的沟通是减少输液反应的关键。     

肿瘤患者输液反应的影响因素及护理预防措施

目的总结肿瘤内科患者发生输液反应的原因并提出预防措施,以提高护理质量。方法对本病区26例输液反应患者进行原因分析,并提出相应的预防措施。结果肿瘤患者输液反应主要原因为药物因素和个体因素,存在大量使用中草药制剂和联合用药的情况,且患者大多年老体弱免疫功能异常。结论护士具有高度的责任心,严格规范地执行护理操作流程,增强安全意识,加强巡视,注重与患者的沟通,可减少输液反应的发生。     

临床输液反应原因及预防措施的初探

输液反应是临床时有发生的药品不良反应。因其发生时是不可预测的，有其突发性，发生的原因是多种因素的影响，严重的影响了患者的身体健康，甚至危及生命。现对我院发生和收集的临床输液反应实例，就其发生原因及预防措施做如下分析，仅供参考。     

输液反应临床分析及护理对策

目的 分析临床静脉滴注所致不良反应的原因及应采取的相应预防措施.方法 收集门急诊发生的56例输液反应患者临床资料,按输液反应的临床表现、药物因素、输液操作、季节因素、人群结构与疾病分布、预后等因素进行分析总结.结果 输液反应的临床表现以发热反应最为常见;发生率以幼儿和老年患者最高;联合用药越多,输液反应发生率越高;加入抗生素粉针剂或中草药制剂输液反应发生率增加.结论 把好药品和输液器具质量关、严格遵守无菌操作规程、注意药物配伍禁忌、严格控制液体滴速,是降低输液反应的有效措施.     

临床输液反应相关因素探讨及预防

目的通过对临床输液反应产生的原因进行分析,从而找到相应的预防措施,进而减少它的发生概率。方法通过多年来的临床经验,结合近些年的相关资料,对输液反应产生的影响因素进行分析。结果通过对输液反应产生因素的分析,结合医院现实中存在的问题,制定出相应的解决措施,从而更好的控制输液反应的发生率。结论通过对医院各方面加强管理和控制,起到安全用药,减少输液反应的发生。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

2-(Acetoxyphenyl)-(Z)-styryl sulfides as cyclooxygenase inhibitors

2-(Acetoxyphenyl)-(Z)-styryl sulfides are described as selective cyclooxygenase-2 (COX-2) inhibitors, useful for treating inflammation and COX-2-mediated disorders including neoplasia. 2-(Acetoxyphenyl)-(Z)-styryl sulfide is claimed to be the most potent COX inhibitor in the series with a COX-2 selectivity ratio of 33. This compound is also claimed to be superior to celecoxib (Celebrex^®, Pfizer) in inhibiting cell growth of colorectal carcinoma cells. In this evaluation, the COX inhibitory activity of this compound is compared to that previously disclosed for diarylheterocycles and 2-(acetoxyphenyl)alkyl sulfides. The validity of the DLD-1 cell line in the growth inhibition studies is questioned based on recent literature reports indicating the lack of COX-2 expression in this cell line.     

Sleep-disordered breathing with chronic opioid use

Chronic opioid use for pain relief or as substitution therapy for illicit drug abuse is prevalent in our societies. In the US, retail distribution of methadone and oxycodone has increased by 824 and 660%, respectively, between 1997 and 2003. μ-Opioids depress respiration and deaths related to illicit and non illicit chronic opioid use are not uncommon. Since 2001 there has been an emerging literature that suggests that chronic opioid use is related to central sleep apnoea of both periodic and non-periodic breathing types, and occurs in ～ 30% of these subjects. The clinical significance of these sleep-related abnormalities are unknown. This review addresses the present knowledge of control of ventilation mechanisms during wakefulness and sleep, the effects of opioids on ventilatory control mechanisms, the sleep-disordered breathing found with chronic opioid use and a discussion regarding the future research directions in this area.     

Drug targets for cognitive enhancement in neuropsychiatric disorders

The investigation of novel drug targets for treating cognitive impairments associated with neurological and psychiatric disorders remains a primary focus of study in central nervous system (CNS) research. Many promising new therapies are progressing through preclinical and clinical development, and offer the potential of improved treatment options for neurodegenerative diseases such as Alzheimer's disease (AD) as well as other disorders that have not been particularly well treated to date like the cognitive impairments associated with schizophrenia (CIAS). Among targets under investigation, cholinergic receptors have received much attention with several nicotinic agonists (α7 and α4β2) actively in clinical trials for the treatment of AD, CIAS and attention deficit hyperactivity disorder (ADHD). Both glutamatergic and serotonergic (5-HT) agonists and antagonists have profound effects on neurotransmission and improve cognitive function in preclinical experiments with animals; some of these compounds are now in proof-of-concept studies in humans. Several histamine H3 receptor antagonists are in clinical development not only for cognitive enhancement, but also for the treatment of narcolepsy and cognitive deficits due to sleep deprivation because of their expression in brain sleep centers. Compounds that dampen inhibitory tone (e.g., GABA_A α5 inverse agonists) or elevate excitatory tone (e.g., glycine transporter inhibitors) offer novel approaches for treating diseases such as schizophrenia, AD and Down syndrome. In addition to cell surface receptors, intracellular drug targets such as the phosphodiesterases (PDEs) are known to impact signaling pathways that affect long-term memory formation and working memory. Overall, there is a genuine need to treat cognitive deficits associated with many neuropsychiatric conditions as well as an increasingly aging population.