醋氨酚缓释包衣颗粒研究

包衣颗粒体外溶出试验证明在释放量达66%以前为零级恒速释放,此后释放速率降低为非零级释放。颗粒在室温下密闭贮存21个月后,释放速率增快,但仍为零级释放,也是在释放量达66%以后转变为非零级释放。用尿药排泄速率法研究了包衣颗粒的体内动力学并与常规片剂作比较,并测出两者的消除速率常数。常规片剂所得药物t 1/2=3.21h,而包衣颗粒剂所得半衰期约延长2.5倍。通过吸收百分率与体外溶出百分率在不同时间下数值的比较得到线性关系,相关系数r=0.9886。说明体外溶出数据可以作为控制吸收率的依据。按一级吸收一室模型公式计算了一定剂量下的血药浓度,在13h以内血药浓度都在治疗浓度范围(5～20μg/ml)以内。最高浓度为10.5μg/ml,达峰时间为3.27h。本品一次服1.1g可延效12h。     

硝基甘油对狗缺血区冠脉循环的作用

用实验性犬冠脉狭窄模型,冠脉内恒流灌注硝基甘油0.5μg/kg.min^-1,使冠脉血流量(CBF)增加、远端小动脉压(DCP)、冠脉血管总阻力(R_T)、小冠脉血管阻力(R_S)及冠状静脉低切血粘(η_b)减少;而主动脉压和心率无明显变化。恒流灌注硝基甘油1μg/kg.min^-1时,在开始5min内冠脉循环的变化同上,并伴大冠脉血管阻力(R_L)减少,10 min后出现CBF减少和R_T,R_{L及ηb增加。结果提示,硝基甘油有缓解和加重心肌缺血的双重作用,其作用可能与剂量张扩张远端小动脉压的程度有关。}     

Psychiatric morbidity and HIV in female drug dependants in Malaysia

Female drug dependants (n = 171) and controls (n = 1137) were studied to search for psychiatric morbidity in them. The psychiatric morbidity was found to be 36.3% and 6.9%, respectively. The most common psychiatric disorder found was dysthymic disorder followed by adjustment disorder, anxiety disorder and borderline personality disorder. The diagnosis was significantly dependent on the type of drug used (P < 0.001) and HIV seropositivtty status of the patients (P = 0.04). The findings highlight the relationship of the psychiatric morbidity to the HIV status and female drug users.     

Changes in symptom scores as a potential clinical endpoint for studies of cystic fibrosis pulmonary exacerbation treatment

Introduction: Symptom improvement was assessed as changes in the Chronic Respiratory Infection Symptom Score (CRISS) during intravenous antimicrobial exacerbation treatments among subjects from study NCT02109822.Methods: Median daily CRISS reduction (i.e., improvement) and covariates associated with CRISS reduction by Day 14 were assessed by logistic regression.Results: Among 173 subjects, median baseline CRISS was 49 [IQR 41, 56]; 93.6% had a CRISS reduction of ≥11 (minimal clinically important difference); median time to –11 reduction was 2 days [95% CI 2, 3]. The greatest median CRISS difference from baseline, on Day 17, was –26 [–29, –23]. Odds of –26 CRISS change by Day 14 were greater in subjects with higher baseline CRISS (P=.006) and younger ages (P=.041).Conclusions: CRISS response has good dynamic range and may be a useful efficacy endpoint for PEx interventional trials. The optimal use of CRISS change as an endpoint remains uncharacterized.     

Use of pulse oximetry for blood pressure measurement after cardiac surgery

Blood pressure measurement using pulse oximeter waveform change was compared with an oscillometric measurement and the gold standard, intra-arterial measurement, in children after cardiac surgery. Forty six patients were enrolled and divided into groups according to weight. Simultaneous blood pressure measurements were obtained from the arterial catheter, the oscillometric device, and the pulse oximeter. Pulse oximeter measurements were obtained with a blood pressure cuff proximal to the oximeter probe. The blood pressure measurements from the pulse oximeter method correlated better with intra-arterial measurements than those from the oscillometric device (0.77-0.96 v 0.42-0.83). The absolute differences between the pulse oximeter and intra-arterial measurements were significantly smaller than between the oscillometric and intra-arterial measurements in children less than 15.0 kg. The pulse oximeter waveform change is an accurate and reliable way to measure blood pressure in children non-invasively, and is superior to the oscillometric method for small patients.     

Protein restriction in chronic renal failure

The aim of the study was to investigate the effect of a protein restricted diet on renal function and growth of children with chronic renal failure. In a multicentre prospective study 56 children (aged 2-18 years) with chronic renal failure were randomly assigned to the protein restricted (0.8-1.1 g/kg/day) or the control group. All children were followed up by the same paediatrician and dietitian. After a follow up period of three years there was no significant difference in glomerular filtration rate between children on a protein restricted diet and children of the control group. There was no significant difference in weight with respect to height and height SD score between the protein restricted and the control group. Compliance with the protein restricted diet, as indicated by the prospective diet diaries and the serum urea:creatinine ratio, was good. This study shows that children with chronic renal failure do not benefit from a protein restricted diet.     

Neonatal renal vein thrombosis and prothrombotic risk

A case of extensive deep venous thrombosis in a four a day old infant was presented. Unusually this patient was shown to be heterozygous for three thrombophilia genes; Factor V Leiden, prothrombin and antithrombin gene mutations, the latter being novel. Conclusion:  There are no randomized controlled trials to guide management in deep venous thrombosis in the newborn but knowledge of the prothrombotic risk factors may help direct treatment.