Quality of life in hospice patients with terminal illness

To better understand quality of life (QOL) and its important correlates among patients with terminal illness, a cross-sectional correlational design was used in a study based on Stewart, Teno, Patrick, and Lynn's conceptual model of factors affecting QOL of dying patients and their families. Sixty participants were recruited from two local hospice programs in the midwestern region of the United States. Data were collected at the participants' homes. The participants had an above average QOL. Living with the caregiver, spirituality, pain intensity, physical performance status, and social support as a set explained 38% of the variance in their QOL. Among these five predictors, living with the caregiver, spirituality, and social support statistically were significant predictors of the QOL of these participants. Participants who did not live with their caregivers experienced less pain intensity, perceived higher spirituality, had more social support, and had a significantly better QOL. Important contributions of these findings are discussed.     

Interaction study between digoxin and a preparation of hawthorn (Crataegus oxyacantha)

Hawthorn, an herbal supplement, is currently being evaluated for the treatment of heart failure. The flavonoid components of hawthorn may be responsible for hawthorn's beneficial effects in the treatment of heart failure. However, these components may also affect P-glycoprotein function and cause interactions with drugs that are P-glycoprotein substrates, such as digoxin, which is also used to treat heart failure. Therefore, the purpose of this study was to determine the effect of hawthorn on digoxin pharmacokinetic parameters. A randomized, crossover trial with 8 healthy volunteers was performed evaluating digoxin 0.25 mg alone (D) for 10 days and digoxin 0.25 mg with Crataegus special extract WS 1442 (hawthorn leaves with flowers; Dr. Willmar Schwabe Pharmaceuticals) 450 mg twice daily (D + H) for 21 days. Pharmacokinetic studies were performed for 72 hours. There were no statistically significant differences in any measured pharmacokinetic parameters. The AUC0-infinity, Cmax-Cmin, Cmin, and renal clearance for the D group were 79 +/- 26 mcg.h/L, 1.4 +/- 0.7 mcg/L, 0.84 +/- 0.2 mcg/L, and 74 +/- 10 mL/min versus 73 +/- 20 mcg.h/L, 1.1 +/- 0.1 mcg/L, 0.65 +/- 0.2 mcg/L, and 81 +/- 22 mL/min for the D + H group, respectively (p > 0.05). Following 3 weeks of concomitant therapy, hawthorn did not significantly alter the pharmacokinetic parameters for digoxin. This suggests that both hawthorn and digoxin, in the doses and dosage form studied, may be coadministered safely.     

The patient-physician relationship. Patient-physician communication during outpatient palliative treatment visits: an observational study

Context  Improving health-related quality of life (HRQL) is an important goal of palliative treatment, but little is known about actual patient-physician communication regarding HRQL topics during palliative treatment. Objectives  To investigate the content of routine communication regarding 4 specific HRQL issues between oncologists and their patients and to identify patient-, physician-, and visit-specific factors significantly associated with discussion of such issues. Design  Observational study conducted between June 1996 and January 1998. Setting  Outpatient palliative chemotherapy clinic of a cancer hospital in the Netherlands. Participants  Ten oncologists and 240 of their patients (72% female; mean age, 55 years) who had incurable cancer and were receiving outpatient palliative chemotherapy. Main Outcome Measures  Patient and physician questionnaires and audiotape analysis of communication regarding daily activities, emotional functioning, pain, and fatigue during an outpatient consultation using the Roter Interaction Analysis System. Results  Physicians devoted 64% of their conversation to medical/technical issues and 23% to HRQL issues. Patients' communication behavior was divided more equally between medical/technical issues (41%) and HRQL topics (48%). Of the independent variables investigated, patients' self-reported HRQL was the most powerful predictor of discussing HRQL issues. Nevertheless, in 20% to 54% of the consultations in which patients were experiencing serious HRQL problems, no time was devoted to discussion of those problems. In particular, these patients' emotional functioning and fatigue were unaddressed 54% and 48% of the time, respectively. Discussion of HRQL issues was not more frequent in consultations in which tumor response was evaluated. Conclusion  Despite increasing recognition of the importance of maintaining patients' HRQL as a goal of palliative treatment, the amount of patient-physician communication devoted to such issues remains limited and appears to make only a modest contribution, at least in an explicit sense, to the evaluation of treatment efficacy in daily clinical practice.      

半夏泻心汤及其拆方对幽门螺杆菌相关性胃炎小鼠血清炎性相关因子的影响

目的:探讨半夏泻心汤治疗幽门螺杆菌感染所致胃黏膜炎症的内在机制。方法:用幽门螺杆菌菌液给小鼠灌胃造模,然后随机分成10组,分别给予相应的药物治疗。观察各组小鼠胃黏膜的形态学改变及血清中NO和IL-8含量的变化。结果:模型组小鼠血清中NO、IL-8水平较空白组显著升高(P<0·01),各治疗组NO、IL-8水平均有不同程度的降低,其中以半夏泻心汤组、苦寒组、半夏加苦寒组、苦寒加甘温组降低最为显著,与模型组比较差异具有显著性意义(P<0·01)。结论:半夏泻心汤通过降低血清中NO、IL-8的含量而减轻胃黏膜的炎症反应,从而发挥其对胃黏膜的保护作用。     

Molecular cloning and physical characterization of integrated equine infectious anemia virus: molecular and immunologic evidence of its close relationship to ovine and caprine lentiviruses

Molecular clones of the integrated form of the genome of equine infectious anemia virus (EIAV), the etiologic agent of a naturally occurring, worldwide disease of horses, were obtained. The restriction map of a full-length genome was determined. Additional evidence for the close evolutionary relationship between EIAV and a prototype lentivirus (caprine arthritis encephalitis virus) was acquired by Southern blotting and immunological analyses. An interspecies radioimmunoassay was developed in which EIAV and ovine and caprine lentiviruses could be detected equally well. These studies make available precisely defined reagents to pursue the study of the mechanisms of pathogenesis of lentiviral induced diseases.     

复方甘草甜素联合西替利嗪及多虑平治疗荨麻疹

目的:分析复方甘草甜素片联合西替利嗪及多虑平治疗慢性荨麻疹的疗效和可行性.方法:将296例慢性荨麻疹患者随机分为两组,对照组144例,西替利嗪10 mg,p0.qd,多虑平25 mg,po tid;治疗组152例,在对照组的基础上加服复方甘草甜素片75 mg,tid,两组均连用4周.结果:治疗组和对照组有效率分别为82.89%、61.11%,两组比较差异有统计学意义(P<0.01).结论:复方甘草甜素片联合西替利嗪及多虑平治疗慢性荨麻疹的疗效满意,值得临床选择应用.     

浙贝乙素及其5种衍生物对小鼠的半数致死量测定

目的研究浙贝乙素及其5种衍生物的急性毒性和对小鼠的半数致死量（LD50）。方法取昆明种小鼠，完全随机平均分组后腹腔注射给药，分别给予不同浓度的浙贝乙素乙酰化物、丙酰化物、丁酰化物、苯甲酰化物和氧化物药液。以小鼠急性死亡率为指标，求浙贝乙素各衍生物的LD50和LD50的95%可信区间。结果浙贝乙素乙酰化物、丙酰化物、丁酰化物、苯甲酰化物和氧化物对小鼠的LD50分别为14.39，14.47，18.41，23.21，9.98 mg·kg^-1 ， 均大于浙贝乙素对小鼠的LD50。结论浙贝乙素乙酰化物、丙酰化物、丁酰化物、苯甲酰化物和氧化物的毒性均较小，有望从中筛选出高效、低毒的镇咳药物。     

冷水七活性部位镇痛抗炎作用的研究

目的 研究冷水七活性部位I(IPB-I)的镇痛抗炎作用。方法 采用热板法、醋酸扭体法研究IPB I对小鼠的镇痛作用，并与0.9%氯化钠注射液、盐酸吗啡作对照；采用二甲苯致小鼠耳肿胀、醋酸致小鼠腹膜毛细血管通透性增加的实验研究IPB-I抗炎作用，并与0.9%氯化钠注射液、氢化可的松对照。结果IPB-I对两种痛刺激有非常显著的镇痛作用；对两种实验性炎症有非常显著的抑制作用。结论IPB-I具有显著的镇痛抗炎作用。