Excipients in medicinal products used in gastroenterology as a possible cause of side effects

Although most adverse drug reactions are caused by the active substances, excipients may sometimes affect the safety profile of a medicinal product. The aim of this review is twofold: (1) To identify the excipients most frequently contained in oral medicinal products marketed in Italy for gastrointestinal indications, and to evaluate the main safety concerns, considering both intrinsic toxicity and patient-related risk factors. (2) To analyze possible differences with medicinal products marketed in the United Kingdom and USA in terms of excipients and relevant warnings reported in the label. We identified excipients with potential impact on safety profile and calculated frequency of use of each identified excipient in 98 selected medicinal products. We discussed possible safety concerns in clinical practice. We also analyzed US and UK Summary of Products Characteristics (SmPC) of oral gastrointestinal products by searching in appropriate collections of regulatory agencies. Eleven excipients with a safety impact were identified (sucrose, saccharin, aspartame, sorbitol, mannitol, lactose, ethanol, propylene glycol, parabens, menthol and silica) and no substantial differences were found between drugs marketed in the three countries concerning excipient content. Warnings were more detailed in the SmPC of UK or USA products rather than Italian products. Information about pharmaceutical excipients with known effects is important in clinical practice, but the frequent lack of details in the related section of the SmPCs makes it difficult for health professionals to provide relevant advice. The availability of alternative products of the same therapeutic class, but lacking specific excipient(s) should be considered in selected patients.     

从人际功能视角看门诊医患会话的言语特色

以4小时的真实医患门诊会话录音为语料,采用定性和定量的研究方法,从人际功能的视角,对门诊医患会话进行语篇分析。主要围绕该语篇的小句言语功能、语气系统和情态系统三个方面展开,旨在分析门诊医患互动中病人与医生之间的言语特色。     

胃远端部分切除后残胃的病例特点分析

目的讨论胃远端部分切除后残胃病例的特点并进行分析。方法以88例胃部良性肿瘤行远端胃次全切除后的残胃患者的胃镜及黏膜活检病理组织学资料进行分析。结果影响残胃癌患者预后的因素包括肿瘤的病理类型、TNM分期、有无转移及治疗方式,Cox分析显示肿瘤的病理类型、TNM分期、有无转移及治疗方式为影响残胃癌预后的独立因素。结论早期诊断对于残胃癌的预后十分重要,应加强胃部切除术后的患者的随诊工作。     

河南省新乡地区农村居民超重与肥胖的分布特征调查

目的了解河南省新乡地区农村居民超重及肥胖的分布特征。方法采用整群抽样方法抽取项目地区农村居民665人完成现况调查。应用检出率描述超重与肥胖分布规律,率的比较采用χ2检验,采用SPSS 13.0统计软件进行数据处理和分析。结果农村居民超重的检出率为45.42%,肥胖的检出率为17.74%。农村居民肥胖的检出率随年龄、腰围、血压及血糖的增加或升高而增高,随文化程度的升高而降低;农村居民超重的检出率随年龄、腰围、血压及三酰甘油的增加或升高而随之增加。结论农村居民超重及肥胖现象严重,且分布存在一定的规律。健康管理、预防控制超重肥胖应以中老年者、小学及初中文化程度者、腰围大于界值者、空腹血糖受损及糖尿病者、血压正常高值及升高者、血脂边缘升高及升高者为重点。     

急性主动脉夹层420例回顾性分析

目的:探讨湖北省随州市近10年急性主动脉夹层病例的临床特征及变化趋势。方法:收集2001年1月-2010年12月在随州市中心医院住院首次入院确诊的420例急性主动脉夹层病例进行回顾性研究。结果:急性主动脉夹层病例逐年增加。老年组心率明显低于年轻组[(72.1±13.6)次/min比(83.1±17.4)次/min],年轻组的就诊时间及确诊时间明显早于老年组。女性患者确诊时间却明显迟于男性患者。Stanford A型病例发生胸痛的几率明显大于Stanford B型病例,而Stanford B型病例发生腹痛的几率明显大于Stanford A型病例。Stanford B型病例确诊时间明显迟于Stanford A型病例。急性主动脉夹层住院总死亡率为18.1%。结论:急性主动脉夹层病例逐年增多,临床工作中应高度重视胸痛、腹痛、后背痛、转移痛等症状,注意监测患者血压、心率,并高度警惕老年、女性、A型主动脉夹层的患者。     

老年人脂肪肝特点及血液流变学的检测结果分析

目的探讨老年脂肪肝特点及与血液流变学的关系。方法比较老年脂肪肝患者与健康体检者的血液流变学指标,同时探讨老年人脂肪肝的特点。结果两组老年人血脂指标、血液流变学各项指标比较均有明显差异(P<0.05)。结论老年脂肪肝患者血脂及血液流变学指标较正常人明显改变,异常血脂及血液流变学指标可加重脂肪肝的形成及影响其预后。     

不典型急性下壁心肌梗死院前急救特点分析

目的 探讨不典型表现的急性下壁心肌梗死(AMI)特点,提高院前急救的诊治水平.方法 对25例不典型急性下壁心肌梗死患者,对其临床表现进行回顾性分析.结果 急性下壁心肌梗死的患者由于症状不典型,易造成误诊和漏诊,主要表现为急性胃肠炎16例,头晕查因4例,胆囊炎3例,下肢疼痛2例.心律失常、心力衰竭、心源性休克是主要的致死原因.结论 院前快速准确的诊断评估,及时实施规范有效的院前急救可降低患者的死亡率、改善预后.     

哈尼族医药特点浅析

从哈尼族医药“药物的特有性”、“植物药为主”、“神医合一”、“用药的独特性”、“经验医药”5个方面,初步探讨了哈尼族医药的特点,希望能起到抛砖引玉之作用,引起更多的同仁关注哈尼族医药。     

Alcoholism effects on social migration and neighborhood effects on alcoholism over the course of 12 years

BACKGROUND: Although a short-term effect of neighborhood characteristics on individual alcohol abuse has been demonstrated by a quasi-experimental residential mobility study, the obversed effect of alcohol problem involvement on place of residence and residential character has not been studied. We test the alcoholism effect on place of residence, and we also attempt to replicate the neighborhood-to-alcoholism effect. METHODS: A sample of 206 Caucasian men (average age was 33) who were systematically recruited for alcoholism through a court record search of drunk driving offenses and door-to-door canvassing, in a 4-county-wide area were followed up at 3-year intervals in a prospective study of the course and outcomes of alcoholism. Participants' alcoholism diagnoses were made by semistructured diagnostic interviews. Residential addresses at baseline and at 12-year follow-up were geocoded. Corresponding census tract variables were used as indicators of neighborhood residential character. RESULTS: The regression analysis shows that, the more alcohol problems a man has, the more likely he is going to remain in, or migrate into, a disadvantaged neighborhood. This effect is only evident when a number of relevant confounding variables, including initial level of socioeconomic status, age, antisocial symptomatology, and spousal alcohol-use disorder status at baseline are controlled. Alcoholics in remission tended to live in neighborhoods whose residential characteristics were not distinguishable from those of nonalcoholics. Unremitted alcoholics, however, tended to stay in or migrate into more disadvantaged neighborhoods. CONCLUSION: Alcoholic involvement has long-term negative effects on place of residence; involving an elevated likelihood of moving into or remaining in a disadvantaged neighborhood. Recovery from alcoholism is protective against downward social drift on the one hand, and is favorable to improvement in social conditions on the other.     

中国青少年智力发展特征分析

目的分析中国青少年智力发展的特征。方法对1104名中国少年智力量表常模样本(10～15岁)的智商(IQ)、两个能力量表(操作量表和言语量表)分和四个智力因素量表(语言-理解因素量表、数学-逻辑因素量表、知觉-组织因素量表、注意-分辨因素量表)商值,进行回顾性研究。结果IQ均值在青少年组以10岁1组最低,15岁组最高,组间差异具有统计学意义(F=30.19,P<0.01)。两个能力量表分和三个智力因素量表分变化与IQ基本相似,注意-分辨因素量表分在各年龄组中差异无统计学意义(F=0.54,P=0.78)。各智力统计值在各年龄组间的差异并不完全一样。结论中国青少年智力及其组成因素量表商值随年龄增长呈现逐渐上升趋势(除注意-分辨因素在各年龄段保持稳定),各年龄段变化存在差异。