Piroxicam and naproxen plasma concentrations in patients with osteoarthritis: Relation to age,sex, efficacy and adverse events

Summary Piroxicam and naproxen plasma concentrations were obtained after 4 weeks active therapy between 3 and 12 hours post-dose in 640 and 629 patients, respecitvely. These patients are a subset of 2,035 patients with osteoarthritis on whom we have reported previously (11) in a double-blind multicentre safety and efficacy trial comparing piroxicam 20 mg/day and naproxen 750 mg/day. The purpose of the present study was to look for an association of plasma drug concentration with the variables of: age, sex, adverse events and efficacy. There was a statistically significant increase in plasma concentrations of both drugs with increasing age and females had higher concentrations than males. The increase in plasma concentration seen with increasing age was of a magnitude of 25% for piroxicam and 20% for naproxen when comparing a 50 year old to an 80 year old. However, less than 15% of the variability in plasma concentrations seen between patients is accounted for by age and sex. Within the plasma concentrations achieved with these doses, no association with adverse events, non-serious or serious, and efficacy was noted.     

≥75岁急诊心房颤动患者的预后分析——中国急诊心房颤动研究的亚组分析

目的:了解老年（年龄≥75岁）急诊心房颤动（房颤）患者的预后情况,分析不良预后的危险因素。方法:2009年至2011年在全国20家医院连续入选急诊就诊、年龄≥75岁房颤患者为本研究对象,收集患者基线资料和治疗情况,并进行1年随访,主要终点事件为全因死亡,次要终点事件为心血管死亡、卒中、大出血事件及主要不良事件。应用单因素和多因素Cox回归模型分析上述事件的独立危险因素。结果:共入选766例老年急诊房颤患者,年龄(80.76±4.66)岁,女性占56.9%。1年的全因病死率为24.3%,心血管病死率为12.8%,卒中发生率为10.6%,主要不良事件发生率33.6%,再入院率32%。多因素Cox回归模型分析显示年龄（ HR1.073,95% CI 1.042~1.105）、心率（ HR 1.008,95% CI 1.002~1.013）、痴呆/认知障碍史（ HR 1.849,95% CI 1.016~3.365）、既往慢性阻塞性肺疾病史（ HR 1.824,95% CI 1.303~2.551）为老年房颤患者1年死亡的独立危险因素。女性（ HR 1.664,95% CI 1.036~2.675）、高血压病史（ HR 2.035,95% CI 1.080~3.836）、痴呆/认知障碍史（ HR 2.773,95% CI 1.220~6.302）、为老年房颤患者1年卒中的独立危险因素。 结论:老年急诊房颤患者的预后较差,年龄、心率、痴呆/认知障碍史、慢性阻塞性肺疾病史是老年急诊房颤患者1年全因死亡和主要不良事件的独立危险因素;女性、高血压病史、痴呆/认知障碍史为老年急诊房颤患者1年卒中的独立危险因素。     

格列吡嗪导致严重心律失常2例

1病例1.1病例1患者,男,65岁,因反复多饮、多食、多尿、消瘦8个月,加重2个月,心悸、心慌、头晕、眼花3天,昏厥30分钟到医院就诊。患者8个月前出现多饮、多食、多尿、消瘦,到医院检查发现患有2型糖尿病,自服中草药疗效不显,于3天前     

Melde- und Informationssystem für bedeutsame Vorkommnisse bei Strahlenanwendungen in der Medizin: Struktur,Zuständigkeiten und Meldekriterien

The increasing frequency and complexity of medical radiation exposures to humans inevitably result in higher risks of harmful unintended or accidental radiation exposures. To ensure a high level of protection and its continuous improvement, the Directive 2013/59/Euratom thus requires to systematically record and analyze both events and near-miss events as well as, in the case of their significance, to disseminate information regarding lessons learned from these events promptly and nationwide to improve radiation protection in medicine. These requirements have been transposed into German legislation by the new radiation protection law and radiation protection ordinance that entered into force simultaneously on December 31^th, 2018. The reporting and information system as provided by these regulations as well as the tasks, duties and powers of the parties involved are presented in the first part of this review article. In the second part, the established application-specified criteria for the significance – and thus the notification requirement - of (near-miss) events are itemized and explicated.     

NCAR-医疗器械不良事件监测信息交换的平台

通过介绍国际医疗器械法规协调组织发起的,在国际范围内交换医疗器械不良事件监测信息的国家医疗器械管理机构报告,旨在为我国开展医疗器械不良事件监测信息管理及参与国际信息交流提供借鉴。     

广东省骨科植入物不良事件调查分析

目的总结广东省部分医院骨科植入物不良事件发生率及其特点。方法对2008年广东省七家医院涉及骨科植入物的全部病例进行筛查,对发现的126例可疑不良事件进行统计分析。结果七家医院2008年骨科植入物可疑不良事件总发生率为5．87％,其中第一次入院病例发生率（2．43％）远小于第二次入院病例发生率（16．51％）,脊柱内固定物不良事件发生率较高,其余植入物不良事件发生率无明显差异。植入物断裂、松动、变形及感染是可疑不良事件最常见表现（69％）,植入物材料因素和设计因素是导致不良事件的主要原因（72．22％）。结论临床上对骨科植入物不良事件存在大量的漏报现象,需要加强骨科植入物不良事件监测工作。     

医疗不良事件护理防范策略综述

对引发医疗不良事件的护理因素进行了总结,梳理出以信息技术手段降低系统错误,以智能化给药管理系统降低用药错误,术前安全核对制度化,严控院内感染,模拟训练和教学降低患者风险等护理防范策略,以减少医疗不良事件发生。