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.     

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。     

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。     

FDA透明度行动简介及其特点和作用分析

目的:为我国食品药品监督管理局(SFDA)政务公开工作的完善提供参考。方法:通过查阅美国食品与药品管理局(FDA)透明度行动文献,应用文献研究方法对FDA透明度行动进行了介绍,并对其特点及作用进行了系统的分析。结果:FDA通过透明工作组、绩效追踪等一系列的透明度行动,扩大了信息公开的广度和深度,提高了自身工作的透明度。结论:我国可借鉴FDA的经验,采取相应措施使SFDA的工作更加透明化。     

对某“癌症高发村”1990～2010年恶性肿瘤死亡调查分析

目的：对某“癌症高发村”村民1990年～2010年恶性肿瘤死亡情况进行回顾性调查,以确认村民所述“癌症高发”的真实性。方法：收集该地最近20年恶性肿瘤死亡患者资料,计算恶性肿瘤构成比和死亡率,并与全国水平相比较．．结果：恶性肿瘤死亡率为337．84／10万,高于全国农村平均水平128．65／10万;肝癌死亡率168．92／10万,高于全国农村平均水平26．93／10万;男性死亡率为472．94／10万,女性死亡率为202．70／10万,分别高于全国农村平均水平161．69／10万和93．75／10万;40岁以上的恶性肿瘤死亡患者有17人,占85．0％;13名死亡患者（65．0％）其疾病最高诊断单位为三级甲等医院。结论：恶性肿瘤是该地区村民的主要死亡原因之一,其死亡率高于全国农村平均水平,肝癌应为重点防治疾病。     

贝母类药材资源分布及性状特点研究

目的:了解贝母类中药材的资源分布和性状特点,保证临床用药的安全性。方法:结合主流贝母类商品药材,对贝母类中药材从基原、分布和性状特点等方面进行研究。结果与结论:不同的贝母类药材资源呈现垂直分布特点,药材性状存在差异;贝母类药材种植应考虑其生态适应性。     

军人情绪调节方式特点研究

目的 探讨基层部队官兵情绪调节方式特点.方法 采用军人情绪调节方式量表(AERTQ)对1692名基层部队官兵进行测试.结果 (1)军人情绪调节方式使用由高到低依次为:情感求助(3.769±0.838)分、行为抑制(3.638±0.826)分、自我安慰(3.297±0.703)分、认知重视(2.605±0.816)分.(2)除自我安慰外,不同军龄军人情绪调节方式的使用差异有显著性(F=7.442～9.429,P<0.01).(3)不同职别军人情绪调节方式的使用差异有显著性(F=5.649～13.137,P<0.01).(4)不同教育程度军人情绪调节方式的使用差异有显著性(F=2.992～14.856,P<0.01).结论 军人情绪调节方式的使用同军人的职业发展阶段与教育程度可能存在密切联系.