扼制医疗费用过快增长 提高医院科学管理水平

医院患者就医费用增长过快,存在不合理收费和违规收费现象,主要源自于医疗卫生体制市场主导、医疗保障体系不健全、昂贵大型设备检查的滥用和医院对药品收入的依赖性,该现象不仅加剧了患者的负担,还制约着医院的健康发展。因此,应强化政府责任,完善医疗保障制度,加强药品规范管理,提高医院科学管理水平。     

Anti-obesity drugs currently used and new compounds in clinical development

Obesity is a chronic disease which requires treatment.As lifestyle interventions alone hardly ever result in long-term weight loss,pharmacotherapy is an important adjunct to lifestyle measures to improve the induction and maintenance of weight loss.Owing to the limited options currently available for the pharmacological treatment of obesity,it is imperative to develop new safe compounds.This study aims to review the current medications approved by European Medicines Agency and United States Food and Drug Administration(FDA)for the treatment of obesity,focusing essentially on their benefits and risks,as well as on the new drugs which are presently under clinical trials.Moreover,it lists the anti-obesity agents that have been recently withdrawn from the market.A revision of the scientific literature was carried out,through a search on Pubmed for papers published from January 2010 to January2013.Orlistat(Xenical) is currently the only long-term pharmacotherapy for obesity available in the European market,as rimonabant and sibutramine were with-drawn in 2008 and 2010,respectively,due to serious psychiatric and cardiovascular adverse effects.Lorcaserin(BelviqTM) and the association of phentermine and topiramate(Qsymia TM) were recently approved by FDA.Orlistat suppresses appetite inhibiting gastrointestinal lipase,being its adverse effects mostly gastrointestinal.Lorcaserin activates 5-HT2 C receptors,phentermine is a norepinephrine releasing drug,and topiramate is an anticonvulsivant drug with weight loss properties.     

Strengthening vaccination policies in Latin America: An evidence-based approach

Despite many successes in the region, Latin American vaccination policies have significant shortcomings, and further work is needed to maintain progress and prepare for the introduction of newly available vaccines. In order to address the challenges facing Latin America, the Commission for the Future of Vaccines in Latin America (COFVAL) has made recommendations for strengthening evidence-based policy-making and reducing regional inequalities in immunisation. We have conducted a comprehensive literature review to assess the feasibility of these recommendations. Standardisation of performance indicators for disease burden, vaccine coverage, epidemiological surveillance and national health resourcing can ensure comparability of the data used to assess vaccination programmes, allowing deeper analysis of how best to provide services. Regional vaccination reference schemes, as used in Europe, can be used to develop best practice models for vaccine introduction and scheduling. Successful models exist for the continuous training of vaccination providers and decision-makers, with a new Latin American diploma aiming to contribute to the successful implementation of vaccination programmes. Permanent, independent vaccine advisory committees, based on the US Advisory Committee on Immunization Practices (ACIP), could facilitate the uptake of new vaccines and support evidence-based decision-making in the administration of national immunisation programmes. Innovative financing mechanisms for the purchase of new vaccines, such as advance market commitments and cost front-loading, have shown potential for improving vaccine coverage. A common regulatory framework for vaccine approval is needed to accelerate delivery and pool human, technological and scientific resources in the region. Finally, public–private partnerships between industry, government, academia and non-profit sectors could provide new investment to stimulate vaccine development in the region, reducing prices in the long term. These reforms are now crucial, particularly as vaccines for previously neglected, developing-world diseases become available. In summary, a regionally-coordinated health policy will reduce vaccination inequality in Latin America.     

The Health Benefits of Yoga

Abstract

Natural Medicines is an online database of practical, clinical, and current evidence-based information about thousands of herbs, vitamins, minerals, and other supplements. The database includes references to the information content provided, along with separate consumer information and education handouts conveniently formatted as PDFs.     

中成药上市后再评价的现状、挑战与展望

本文检索近十年中成药上市后进行的临床研究,尤其是在SCI杂志上发表的高质量临床研究,回顾目前注册中成药中进行上市后再评价现状及与国际接轨的情况。列出目前中成药进入国际市场存在的问题,并以FDA、加拿大及欧盟对于植物药及草药的注册要求来详细陈述,指出中成药上市后再评价的必要性及未来的发展趋势。     

《WHO儿童基本药物标准清单(第6 版)》对制定我国儿童基本药物目录的参考性分析—基于34家儿童专科医院调研结果

目的:比较分析第6版《WHO儿童基本药物标准清单》(EMLc)与我国儿科临床用药的差异,为制定我国儿童基本药物目录提供借鉴。方法:调查34家儿童专科医院获得儿科常用活性成分清单,并与第6版EMLc、2012版基本药物目录中适宜儿童的活性成分进行对比分析。结果:获得我国儿科临床常用活性成分327种,其中有96种活性成分同时被2012版基药目录及第6版EMLc收录,28种活性成分仅被第6版EMLc收录,不同作用类别的药物在3份清单中的比例存在一定差异。结论:第6版EMLc收录的部分药物可考虑作为我国儿童基本药物候选品种,但作用类别种类及比例要充分考虑我国国情及儿科特点,综合参考EMLc及2012版基药目录。