Accuracy of information on printed over-the-counter drug advertisements

Direct-to-consumer drug advertising is a useful medium for educating people and disseminating product information. Consumers make product purchase decisions based on the information gained from advertisements. If advertisements are misleading, consumers may not have adequate drug knowledge to detect this misinformation. The objective of this study was to evaluate print advertisements for over-the-counter (OTC) products. Five clinical pharmacists evaluated print advertisements appearing in three consumer periodicals. Advertisements were selected over a nine month period beginning January 1994. Accuracy of information on OTC advertisements was determined based on federal guidelines. Additionally, reviewers identified deficiencies in advertisements that may mislead consumers. According to reviewers, around 50% of advertisements lacked accurate statements. Side effects were indicated on only one advertisement. All advertisements were indicated by reviewers to be more promotional than educational. Reviewers indicated that more than 50% of advertisements lacked information essential for consumers to make an informed choice during self-medication decisions. This study indicates that OTC drug advertisements lack information necessary for consumers to make informed purchase decisions. Inaccurate information and lack of information on side effects could mislead consumers causing harmful adverse events.     

Artificial sapphire contact probes in Nd:YAG endometrial ablation: a quantitative in vitro and in vivo study

Artificial sapphire contact probes offer theoretical advantages in Nd:YAG endometrial ablation. To examine this, an in vitro and in vivo study of laser-tissue interaction was performed. In vitro, a linear correlation was found between applied energy and total depth of effect, that is, photovaporization and photocoagulation. Using a Round (MTR 1.5) contact probe, an applied energy of 30 joules gave a depth of myometrial effect of 3.3 mm. In vivo, there was a significant reduction in tissue effect (p less than 0.001) compared to in vitro. Difficulty of manipulation of the contact laser probe within the uterus also caused a significant reduction (p less than 0.001) in depth of tissue ablation achieved on the posterior uterine wall compared with that achievable at the uterine fundus, but this may be counteracted by increasing applied energy.     

Scintigraphy and distribution of labeled antibodies in rats with tumors

Radioiodinated antitumor (Ab-gamma globulins), non-tumor-specific Ab, and R¹³¹ISA were used for imaging radiation-induced intestinal tumors in rats. Each agent detected tumors larger than 2 g, but labeled Ab were most efficient in detecting smaller tumors. Tissue distribution studies showed that while purified Ab localized specifically in tumors, unpurified Ab concentrated in the tumor by a mechanism not considered immunological. Localization was variable and the concentration of antitumor Ab reached useful levels only in a small number of cases. The use of high specific activity purified Ab unexpectedly decreased the concentrations of label observed in the tumors when compared with the use of the same activity of low specific activity purified Ab. These results indicated the presence of circulating tumor antigens which were capable of binding the injected Ab. Subsequently, these findings have been substantiated. Thus the animal-to-animal variability could be explained on the basis of differing degrees of interaction of injected Ab with circulating tumor antigens. The usefulness of labeled purified or monospecific antitumor antibodies for tumor imaging and therapy would thus be influenced by the extent of such interactions.This work was presented in part at the Twentieth Annual Meeting of the Radiation Research Society, Portland, Oregon, May, 1972.     

Alpha-1-antitrypsin: an ignored protein in understanding liver disease

alpha 1AT should no longer be ignored by hepatologists with regard to its role in protecting the liver from injury. This protective role needs further definition with regard to protease inhibition, immunologic control, and functional inactivation. Severe deficiency of alpha 1AT clearly predisposes to definable types of liver disease not only in infants and children, but at the other end of the spectrum in elderly adults. It is unfortunate that the pathophysiology of human and animal alpha 1AT related liver injury is not as readily apparent as in pulmonology conditions. However, it is time to digest the tremendous progress that has evolved in that field in relating alpha 1AT to emphysema. Cirrhosis of the liver should be studied in relationship to the pathophysiology demonstrated by our colleagues to be important in "cirrhosis of the lung." The diagnosis of alpha 1AT deficiency and the course of the associated liver disease have been reviewed and updated. Prevention and cure have been demonstrated to be possible but neither method has universal applicability. In contrast, other potential therapeutic endeavors, although not presently proved to be efficacious, with time and research will provide methodologies for the treatment of this disorder as well as insight into mechanisms of general liver injury not previously appreciated.     

Dosimeter for oxides of nitrogen.

A simple, lightweight, prototype dosimeter, based on wet chemical principles, has been developed for personal monitoring of NO2. A simple modification provides for the determination of NOx. This device requires no auxiliary equipment and is intrinsically safe for use in coal mines. In use, NO2 permeates a membrane and is absorbed in acidic aqueous solution containing hydrogen peroxide. The latter oxidizes NO2 to nitrate. When a total NOx determination is required, an oxidizing prefilter converts NO to NO2 prior to conversion to nitrate in solution. The NO3--is determined in the laboratory with a specific ion electrode. The NO2 or NOx is determined from the NO3--found with reasonably good precision and accuracy. Caution should be exercised when using a dosimeter to determine compounds having a "C" value. These devices will not indicate an excursion concentration existing during a limited time. Effects due to dosimeter orientation, liquid evaporation, and temperature (above 15 degrees) were insignificant. Prior to field testing, it would be desirable to conduct more extensive laboratory tests. The entire TLV range of NO (up to 25 ppm) should be covered, and exposure of the dosimeters to known mixtures of NO and NO2 should be evaluated. Tests against specific interferences should also be performed.     

Fat gram target to achieve high energy intake in cystic fibrosis

Higher fat and energy intakes confer a survival advantage in cystic fibrosis (CF). There is a need to develop effective nutrition programmes that ensure optimal energy intake in CF.

Methodology:

A cross-sectional measurement of clinical characteristics and energy and fat intakes in patients attending the CF outpatients clinic of the John Hunter Hospital, Newcastle was undertaken. Twenty-nine subjects, mean age 12 years (range 4.3–20.2), completed weighed food records to determine the contribution of fat to the percentage of the recommended energy intake obtained and to document use of pancreatic enzyme replacement therapy.

Results:

Diets with a high percentage of energy derived from fat did not guarantee that individuals with CF met their energy requirements. Subjects with total fat intakes of 100 g per day or greater, however, achieved in excess of 110% recommended daily intake (RDI) for energy. Up to 47% of subjects consumed more pancreatic enzyme replacement capsules than shown to give maximum effectiveness.

Conclusion:

Setting a 100 g daily fat target is a realistic way of ensuring high energy intakes in CF. Fat ready reckoners would identify the fat content of food and prescribe specific numbers of pancreatic enzyme replacement capsules to be consumed with each meal or food item.     

Respiratory syncytial virus genotypes and disease severity among children in hospital

OBJECTIVES: To determine the spectrum of N and G genotypes of respiratory syncytial virus (RSV) causing respiratory tract infection and whether particular genotypes are associated with severity of infection. PATIENTS AND METHODS: Nasopharyngeal aspirates (NPAs) were obtained from 114 infants with acute respiratory tract infection due to RSV over two seasons. Viral mRNA was extracted from NPAs or cultured virus, reverse transcribed, and the cDNA amplified by the polymerase chain reaction using primers directed to parts of the N and G gene respectively. Amplicons were separately digested with four different restriction endonucleases for each gene. The fragments were separated by agarose gel, electrophoresis, and the electrophoretic patterns used to assign the various genotypes. Disease severity was assessed as very mild (upper respiratory tract signs only), mild (coryza and signs of lower respiratory tract infection), moderate (requiring nasogastric or intravenous fluids), and severe (requiring oxygen or ventilation). RESULTS: Five of the six known N genotypes were detected, but NP4 and NP2 were found most frequently. There was no association between N genotype and disease severity. Six G (SHL) genotypes were detected. Significantly (p = 0.04) more of the infants infected with the SHL2 genotype had severe or moderate disease. CONCLUSIONS: During the seasonal peaks of RSV respiratory tract infection at least 10 different RSV genotypes cocirculated. While there is no association between N genotypes and disease severity, infection with the SHL2 G genotype appears to result in moderate to severe disease.