Investigation of the mechanism of action of 2% fusidic acid lotion in the treatment of acne vulgaris

We describe the results of a single-centre, double-blind, vehicle-controlled, parallel group study on the quantitative effects of 2% fusidic acid lotion (Fucidin® lotion) in facial acne vulgaris. The trial was completed by 52 patients aged 15–25 years with mild to moderate acne who had been randomized to either Fucidin® Lotion (n= 25) or its base (n= 27). Primary outcome measures included colony counts of Propionibacterium acnes and microcoecaceae and measurements of skin surface lipid free tatty acids and sebum excretion rate. Clinical assessment was based on the acne grade, count of inflamed and non-inflamed lesions and evidence of a primary irritant dermatitis. There was a variable hut gradual reduction in lesion counts with the maximum improvement at 12 weeks for inflamed lesions, where the reduction was 19·9% for fusidic acid and 247% for the placebo. The non-inflamed lesions decreased by 10·8% in the fusidic acid group and increased by 15·9% in the placebo group; this difference was not statistically significant. Although the fusidic acid reduced the micrococcaceae count by 1 log cycle, inferring adequate compliance, there was no reduction in the counts of P. acnes, surface free fatty acids or sebum excretion rate. This study has failed to explain the mechanism of action of topical fusidic acid.     

Primary care management of major depression in patients aged ≥55 years:: outcome of a randomised clinical trial

Background

Late-life depression is associated with chronic illness, disability, and a poor prognosis. Primary care management may be in need of improvement.

Aim

To compare the effects of an intervention programme that aims to improve the identification, diagnosis, and treatment of depression in patients aged ≥55 years with the effects of usual care.

Design of study

Cluster randomised controlled trial.

Setting

General practices in the Netherlands.

Method

Trained GPs performed the intervention and their practice assistants conducted the screenings. Patients were screened with the 15-item Geriatric Depression Scale (GDS-15) and given a consultation with the GP who diagnosed depression with the mood module of the Primary Care Evaluation of Mental Disorders (PRIME-MD). Antidepressant treatment was proposed. Primary outcomes were measured with the Montgomery Åsberg Depression Rating Scale (MÅDRS). Trained independent research assistants performed independent evaluations in both arms.

Results

Eighteen practices (23 GPs) were allocated to the intervention and 16 practices (20 GPs) to usual care. From June 2000 to September 2002, 3937 patients were screened; 579 patients had a positive score on the GDS-15, 178 had major depression, of whom 145 participated in the trial. MÅDRS scores for the intervention group dropped from 21.66 at baseline to 9.23 at 6 months, and the usual care group from 20.94 at baseline to 11.45 at 6 months. MÅDRS scores decreased during the year in both arms. For the intervention group, these scores increased between 6 and 12 months.

Conclusion

The programme resulted in lower MÅDRS scores in the intervention group than in the usual care group, but only at the end of the intervention, at 6 months after baseline.     

反相高效液相色谱法测定甲磺酸酚妥拉明片的含量

目的：建立了反向高效液相色谱法测定甲磺酸酚妥拉明的含量的方法。方法：采用Symmetry C18硅烷键和硅胶柱,甲醇－水－冰醋酸－三乙胺（10：10：1：0．1）作为流动相,检测波长为278nm,峰面积外标法测定。结果：平均回收率为100．2％（n=11),日内、日间差分别为0．7％和0．8％,在10－250μg范围内线性关系良好（r=0.9999),结论：该法简便、准确、结果满意。     

硫酸锌对心肌慢反应电活动和哇巴因引起振荡后电位的影响

本文目的旨在观察硫酸锌对心肌慢反应电活动的影响,所得结果如下:(1) 0.1～0.3mmol硫酸锌能使高钾除极引起的豚鼠乳头肌慢反应动作电位APA和V_max降低,APD₅₀和APD₉₀)显著延长;(2) 0.1～0.3 mmol硫酸锌能抑制家兔离体窦房结细胞的自律性,使窦房结APA降低,APD₉₀延长,SP₀和SP₄减小;(3) 0.1 mmol硫酸锌可对抗0.4μmol哇巴因诱发的豚鼠心室肌振荡后电位,提高引起振荡后电位的哇巴因阈浓度。提示:锌抑制心肌慢反应电活动。     

楤木根皮中皂甙化学成分的研究

楤木根皮中的主要成分是皂甙。将总皂甙以柱层析分离,得到三个化合物(Ⅰ～Ⅲ),经光谱分析和化学方法证明,Ⅰ为楤木皂甙A(araloside A);Ⅱ为银莲花甙(narcissiflorine);Ⅲ是3-O-[β-D-吡喃葡萄糖-(1→2)-β-D-吡喃木糖-(1→)2)-α-L-阿拉伯糖]-齐墩果酸。Ⅲ为一新皂甙,命名为楤木皂甙D(araloside D)。     

清热中药对大鼠下丘脑组织AVP含量的影响

目的：清热中药大多具有一定的解热作用,为探讨其解热作用机理,我们选用典型的清热中药黄芩,银花,连翘组成清热方,从体温调节中枢神经介质方面来研究其解热作用机制。方法;选用Ｗｉｓｔａｒ大鼠,按体重随机分作３组,背部皮下注射酵母混悬液制造发热模型,给药组灌服清热方颗粒剂,模型组予等量饮用水,正常对照组不作处理,给药２ｈ后断头取脑,用放免方法检测大鼠下丘脑组织中ＡＶＰ含量。结果：模型组大鼠体温和下丘脑组织     

Palliation of advanced pelvic malignant disease with large fraction pelvic radiation and misonidazole: final report of RTOG phase I/II study

Between October 1979 and June 1982 forty-six patients were entered on a non-randomized Phase I-II protocol for the evaluation of Misonidazole combined with high dose per fraction radiation for the treatment of advanced pelvic malignancies. Pelvic radiation consisted of 1000 cGy in one fraction repeated at 4-week intervals for a total of three treatments. Oral Misonidazole at a dose of 4 gm/m2 was administered 4-6 hr prior to radiation (total dose 12 g/m2). The distribution of histology consisted of 20 gynecologic, 24 bowel, and 2 prostate malignancies. Of the thirty-seven patients completing the three treatments; there were 6 complete responses (14% CR), 10 partial responses (27% PR) 19 minimal or no response (32% NR), and 4 unevaluable. One patient remains NED 5.5 years following radiation. Toxicity directly related to Misonidazole was minimal and consisted primarily of transcient Grade 1, 2 peripheral neuropathy (20% Grade 1, 4% Grade 2) and Grade 2 ototoxicity (4%). Radiation toxicity was significant for late bowel damage. There were 4 (11%) Grade 3 and 7 (19%) Grade 4 gastro-intestinal (GI) toxicities. Kaplan-Meier plot of GI toxicity showed a progressive increase in incidence with time for projected rate of 49% Grade 3, 4 by 12-month. GI toxicity (Grade 3, 4) was also related to tumor response. The complication rate was 80% (4/6) for CR, 30% (3/10) for PR and 26% (5/19) for NR or progression. Because of the GI complication rate, this protocol for palliation of advanced pelvic malignancies has been replaced by a protocol that uses 4 fractions over 2 days (b.i.d.) of 370 cGy per fraction repeated at 3-week intervals for a total of 3 courses.     

Measuring the quality of skin cancer management in primary care: A scoping review

Skin cancer is a growing global problem and a significant health and economic burden. Despite the practical necessity for skin cancer to be managed in primary care settings, little is known about how quality of care is or should be measured in this setting. This scoping review aimed to capture the breadth and range of contemporary evidence related to the measurement of quality in skin cancer management in primary care settings. Six databases were searched for relevant texts reporting on quality measurement in primary care skin cancer management. Data from 46 texts published since 2011 were extracted, and quality measures were catalogued according to the three domains of the Donabedian model of healthcare quality (structure, process and outcome). Quality measures within each domain were inductively analysed into 13 key emergent groups. These represented what were deemed to be the most relevant components of skin cancer management as related to structure, process or outcomes measurement. Four groups related to the structural elements of care provision (e.g. diagnostic tools and equipment), five related to the process of care delivery (e.g. diagnostic processes) and four related to the outcomes of care (e.g. poor treatment outcomes). A broad range of quality measures have been documented, based predominantly on articles using retrospective cohort designs; systematic reviews and randomised controlled trials were limited.