Cancer Prevention through Legislation-Hong Kong Experience

Cancer is the major cause of death worldwide and in the local community. Due to the aging population and changes in lifestyle of the citizens, it is expected that the incidence of cancer will continue to increase. In fact, according to the World Health Organization, about 30% of cancer death can be prevented. The fight against cancer relies on support from the government, together with collaborations with the policymakers, healthcare professionals, and the public. Legislation can act as a tool for cancer prevention. The purpose of this paper is to provide an overview of the global cancer burden and to describe how cancer legislation acts as a tool for cancer prevention in the Hong Kong region.     

Patient satisfaction with out-of-hours primary care in the Netherlands

Background  

In recent years out-of-hours primary care in the Netherlands has changed from practice-based to large-scale cooperatives. The purpose of this study is to determine patient satisfaction with current out-of-hours care organised in general practitioner (GP) cooperatives, and gain insight in factors associated with this satisfaction.     

Association between a polymorphism in the promoter region of the dopamine D2 receptor gene and schizophrenia in Japanese subjects: replication and evaluation for antipsychotic-related features

To replicate a previously found negative association between the Del allele of the -141C Ins/Del polymorphism in the 5'-promoter region of the dopamine D2 receptor gene (DRD2) and schizophrenia in Japanese subjects and to examine whether this polymorphism is related to the features of antipsychotic drug treatment, we genotyped 94 control subjects and 234 schizophrenic patients. The schizophrenic patients had a significantly lower frequency of the Del allele (p < 0.05). We found a non-significant trend towards a higher frequency of the Del allele in schizophrenic patients susceptible to neuroleptic-induced extrapyramidal symptoms. The daily dosage of haloperidol, the steady-state concentration of serum haloperidol per daily dosage, and the recent 1-yr cumulative neuroleptic dosage were lower in patients with the Del/Del genotype than in the other patients. These findings support the view that the polymorphism is associated with schizophrenia in Japanese subjects and provide hints for further attempts to establish the relationship between this polymorphism and the features of antipsychotic drug treatment.     

黄芩汤及其肠道菌群的代谢产物对D-半乳糖胺诱导的肝损伤的保护作用的比较研究

目的 :对黄芩汤及其经肠道菌群作用后的代谢产物的体内保肝作用进行比较研究。方法 :使用普通和伪无菌小鼠 ,用D-半乳糖胺造成肝脏损伤模型 ,分别给予黄芩汤和黄芩汤的代谢产物 ,测定给药 3d后血清中丙氨酸氨基转换酶 (ALT)和天门冬氨酸氨基转换酶 (AST)的活性。结果 :普通小鼠口服黄芩汤后 ,高、中剂量组小鼠血清中ALT水平明显下降 ,与模型组产生显著差异 ;伪无菌小鼠口服黄芩汤代谢产物之后 ,高、中剂量组血清中ALT水平显著下降 ,但黄芩汤 3个剂量组对其无相似的药理作用。结论 :黄芩汤经过肠道菌群作用后的代谢产物是体内产生保肝降酶作用的物质基础。     

Simplifying psychotropic medication regimen into a single night dosage and reducing the dose for patients with chronic schizophrenia

Rationale Taking psychotropic medications is frequently problematic from both consumers' and caregivers' perspective. Occasionally missed doses may lead to pervasive non-adherence with relapse a likely outcome. Objective To evaluate the simple medication regimen, all psychotropics were given at night for patients with chronic schizophrenia, who had been taking them at least twice a day for more than 12 weeks before the entry. Methods Switching of agents took place in two ways: converting only antipsychotic medications followed by other psychotropics, and changing all psychotropics simultaneously. Any psychotropics of little clinical significance were then cautiously minimized. Final evaluation was made 12 weeks after the competed dose consolidation. Patients finally rated their subjective impression on this intervention. Results Twenty-five patients were recruited in each treatment arm (50 in total). After switching, 11 got better, 29 remained stable whereas seven got worse, according to the Global Improvement. Three were not assessable. Overall, there were no relevant changes in clinical ratings including adverse effects. However, the chlorpromazine equivalent dose of antipsychotics and the number of total psychotropics were significantly reduced from 957 to 722 mg/day (p<0.0001) and from 4.0 to 3.2 (p<0.0001), respectively. Dose deflation of psychotropics was feasible in 35 subjects (74.5%). Twenty-six (of 40 successful) patients indicated that they favored the night-time regimen mainly because it was less complicated. Sedation in the morning was identified as an important adverse event, which should be addressed by reducing the dose. Conclusions The procedure may be of value to counteract a recent trend of psychotropic polypharmacy in schizophrenia.