眼部用药对老年人的全身影响

老年人使用眼药的情况是很普遍的,这些药物可能具有严重的全身影响,特别是在老年病人。这在医源性疾病的鉴别诊断中应予以考虑。文献报道的这个问题并非仅限于老龄人群,尽管大多数病人属于老年。眼药滴入球结膜囊中,除少量流出或吞下外,大部分均经由结膜毛细血管、鼻粘膜及咽部直接进入血液循环,其吸收量之大可足以产生副作用。由于老年人常常使用多种药物,因而与其他药物产生药物相互作用的可能性亦是存在的。现根据眼部用药的不良反应所涉及的主要     

Relationship of self-effecacy to cholesterol lowering and dietary change in hyperlipidemia

This study examined whether self-efficacy was associated with lipid lowering and dietary change among men undergoing dietary counseling to lower cholesterol levels. Twenty-five hyperlipidemic men (total cholesterol ≧220 mg/dL) participated in four weeks of dietary instruction. Plasma lipids were measured prior to treatment, at posttreatment, and at three- and twelvemonth follow-up. Dietary intake and self-efficacy as measured by the revised Eating Self-Efficacy Scale (ESES-R) were assessed at pretreatment, posttreatment, and three-month follow-up. Pre-treatment to posttreatment increases in self-efficacy in situations characterized by negative affect were related to extent of lipid lowering and dietary change. Although subjects showed significant reductions in cholesterol levels following treatment, by one year, lipid levels had returned to pretreatment values. Factors related to long-term maintenance of dietary change and lipid lowering among hyperlipidemics merit further research.     

The successful recruitment of elderly black subjects in a clinical trial: the CRISP experience. Cholesterol Reduction in Seniors Program.

This article describes the recruitment of elderly black subjects into the Cholesterol Reduction in Seniors Program (CRISP), a federal, multi-center, randomized, double-masked feasibility study of cholesterol intervention in the elderly. The study tested the feasibility of recruiting significant numbers of hypercholesterolemic black men, black women, and white women over the age of 65, groups previously underrepresented in federal trials. The study involved dietary modification and drug intervention with either 20 mg or 40 mg of lovastatin or placebo. Maximum follow-up was 18 months. Over the 12-month screening and recruitment period, 431 subjects (108% of the recruitment goal) were randomized. A total of 311 (72% of the study cohort) was female; 105 subjects (24% of the total cohort) were minorities. Media sources were most effective in recruiting white subjects. Church screening was an effective strategy in the black community, although such an approach required considerable resources s and time. The CRISP feasibility study demonstrated that a large cohort of elderly black subjects could be recruited in a cholesterol intervention trial, although the use of community-based approaches required substantial resources and staff time.     

Topical W-7 inhibits ultraviolet radiation-induced melanogenesis in Skh:HR2 pigmented hairless mice

We studied the effect of N-(6-aminohexyl)-5-chloro-1-napthalenesulfonamide (W-7) on ultraviolet radiation (UVR)-induced melanogenesis (tanning) in Skh:HR2 pigmented hairless mice. Topically pretreated mice were exposed to subminimal edematogenic as well as edematogenic UVR doses to establish whether W-7-UVR-induced edema prophylaxis allows increased melanogenesis while preventing edema. Ultraviolet light-irradiated vehicle control animals developed visible tans; however, both W-7-treated groups failed to tan. Topical W-7 before UVR exposure inhibited UVR induction of dopa oxidase activity in melanocytes by 49% (P=0.029) and inhibited UVR-induced deposition of melanin in the epidermis by 88% (P=0.006). Topical W-7 blocked 23% of the UVR but this blockage could not account for the inhibition of dopa oxidase and melanization. We conclude that, in addition to preventing edema, W-7 inhibits UVR-induced melanogenesis, possibly by affecting Ca²⁺-calmodulin and/or protein kinase C-dependent processes.