Trends in Illicit Drug use in the United States: Conflicting Results from National Surveys

Data from several national studies lead to divergent conclusions regarding trends in illicit drug use in the United States. Two major population studies point to a downturn in drug use dating to the late 1970s. However, a study of drug-related deaths and hospital emergency room visits shows increases in these events in recent years. Studies also show drug use, especially cocaine, continuing to increase among criminals. Additionally, drugs were identified as the most important problem facing the nation in a Gallup poll conducted during the summer of 1989. This paper offers some possible explanations for the divergent trends. Most notably, we suggest that methodological differences in the studies being compared, and lags between trends in the general population and certain subgroups, account for most of the variation in the trend estimates. The paper concludes that illicit drug use is decreasing in the United States.     

黏质沙雷菌耐药性及碳青霉烯类抗生素耐药机制研究

目的 探讨黏质沙雷菌分离株的整体耐药特点,研究其对碳青霉烯类药物耐药的主要机制.方法 收集2007至2010年从宁波市第一医院不同病区分离(剔除重复菌株)黏质沙雷菌247株,用Vitek2 -Compact及配套革兰阴性杆菌药敏卡(GNS)检测其药敏情况,对筛选出的20株耐碳青霉烯类菌株进行PCR检测其耐药基因.结果 黏质沙雷菌对头孢曲松、氨曲南、环丙沙星的耐药率较高,分别为70.4％( 174/247)、64.8％ (160/247)、57.4％ (142/247)；对阿米卡星、庆大霉素、亚胺培南、美罗培南的耐药率较低,分别为:3.5％( 8/229)、5.4％( 13/241)、5.9％(14/237)、8.1％ (20/247).PCR检测20株对碳青霉烯类抗生素耐药的黏质沙雷菌中,1、7、12和16号的AmpC染色体基因表达是阴性参考菌株的98.3、102.3、121.5、87.3倍；共有12株黏质沙雷菌分离株同时携带CTX-M型超广谱β内酰胺酶(ESBLs)和KPC-2型碳青霉烯类酶.黏质沙雷菌所携带的CTX-M以CTX-M1、CTX-M2、CTX-M9为主；2株菌携带有SHV基因；2株菌携带有SME基因；2株菌携带有TEM基因；5株菌膜孔蛋白基因ompC和ompF均缺失；仅1株ompC基因缺失；2株菌ompF基因缺失.结论 黏质沙雷菌对β内酰胺类药物耐药的原因比较复杂,以产β内酰胺酶为主.开展对耐药菌株的进化和多耐药基因的研究,有利于合理应用抗菌药物,降低抗生索对耐药菌的选择压力及控制耐药菌株的蔓延.     

尼古丁对大鼠海洛因辨别刺激的替代效应

目的 在建立大鼠海洛因辨别刺激模型基础上,评估不同浓度的尼古丁对海洛因辨别刺激的替代作用.方法 采用固定比率食物强化方法训练雄性SD大鼠辨别0.3 mg/kg海洛因；之后,分别给予不同剂量的海洛因、尼古丁替代0.3 mg/kg海洛因,明确海洛因辨别效应曲线和尼古丁替代0.3 mg/kg海洛因的辨别效应.结果 0.3 mg/kg剂量的海洛因能形成稳定的大鼠药物辨别行为；不同剂量海洛因替代组(0.03,0.1,0.3,0.56 mg/kg)的海洛因鼻触响应率分别为(33.9±15.0)％,(43.3±13.3)％,(98.7±0.5)％,(99.4±0.2)％,海洛因剂量在0～0.3mg/kg之间诱导的辨别效应呈剂量依赖性增加；0.03,0.1mg／kg尼古丁替代组的海洛因鼻触响应率分别为(1.9±1.1)％,(13.7±5.6)％,与0.3mg/kg海洛因替代组相比,差异有统计学意义(P＜0.01)；而0.3,0.5mg/kg尼古丁替代组的海洛因鼻触响应率分别为(60.4±16.1)％,(65.9±16.4)％,与0.3mg/kg海洛因替代组相比,差异无统计学意义(P＞0.05).结论 0.3,0.5 mg/kg尼古丁能产生部分类似海洛因的辨别刺激效应.     

The utilization of Arabic online drug information among adults in Saudi Arabia

In Saudi Arabia, the utilization of the world wide web has become increasingly popular. However, the exact figure of such use is unknown. This study aimed to determine the percentage of, and experience with, online Arabic drug information by Arabic-speaking adults in Saudi Arabia. A web based questionnaire was used. The questionnaire language was Arabic. Public were invited to participate in the survey through e-mails, Twitter, WhatsApp and Facebook in March 2012. The survey included 17 items examining the types of accessed Arabic drug information, the respondent’s demographics, their ability to easily find and understand Arabic drug-related information, and their trustfulness and dependency on such information websites. Of the 422 Arabic speaking adults who answered the questionnaire, 88% stated that they used Arabic websites to answer drug-related questions. Of the respondents, 50% had a bachelor’s degree, 44% were young adults, over half were female (60%), and 72% of them have a chronic disease. The ease of retrieving online information was the most common reason (69%) for consulting such websites. Google as a search engine was the most frequently (86%) accessible website. Although respondents reported different drug-related topics in their online searching, the search for adverse effects was the most common (68%). Respondents claimed that they could easily find (65%) and understand (49%) the drug-related information. Although a good number of respondents qualified this type of information as good, double-checking of information on other websites was highly recommended. Trustfulness was one of the important parameters to measure and 205 respondents (55%) claimed that they only trusted half of the information cited. Moreover, around 48% of respondents considered that finding the same information on more than one website increased its trustfulness. Surprisingly, 54% of respondents did not depend on Arabic information websites when making decisions on drug use. There are a high proportion of Arabic speaking people in Saudi Arabia using and consulting Arabic drug information websites. This information is easily found and understood. However, the quality and trustfulness of such websites are not high enough to depend on them. A qualified Arabic drug information website is important to meet this need.     

某医院常见革兰阴性杆菌的分布与药敏分析

目的 了解珠海市人民医院2009~2010年住院患者常见的菌群分布及其耐药性,为细菌性感染的诊治提供参考依据.方法 用生物梅里埃公司的ATB鉴定系统进行菌种鉴定和药敏试验,用ATBPLUS VER3.0软件统计分析结果.结果 2009~2010年共分离出革兰阴性杆菌3 032株,其中铜绿假单胞菌占29.55%,肺炎克雷伯菌占33.44%,大肠埃希菌占27.51%,阴沟肠杆菌占5.80%,其他革兰阴性杆菌占3.70%.铜绿假单胞菌耐药率高于60%的抗菌药物有头孢噻吩、头孢噻肟、头孢西丁.肺炎克雷伯菌对美罗培南、亚胺培南、头孢吡肟、阿米卡星菌、妥布霉素、哌拉西林/三唑巴坦敏感.大肠埃希菌对第三代头孢菌素、氟喹诺酮类的耐药率增高,对亚胺培南、美罗培南、阿米卡星敏感,对哌拉西林/三唑巴坦、头孢他啶及奈替米星较敏感.阴沟肠杆菌呈多重耐药.结论 该地区常见革兰阴性杆菌的构成比及耐药率和国内其他地区有一定的差异,且细菌多重耐药情况更为严重.     

我院药房药物咨询的现状与发展价值

通过对本院药物咨询工作现状的分析,寻求提高药房药学服务质量的对策.进一步完善与加强药房药物咨询服务的管理体制,以优质高效的药学服务来促进合理用药,为患者提供正确的用药知识,指导其安全、有效、合理、经济地使用药物.     

眼科感染患者病原菌分布及药敏性

目的 分析眼科患者感染的病原菌分布及对抗菌药物的敏感性,为临床医师合理用药提供指导.方法 对2011-2012年120例患者眼部感染病原菌,依照微生物临床常规鉴定程序和全国临床检验操作规程操作进行分离培养、鉴定,采用法国生物梅里埃公司生产的全自动鉴定及药敏分析仪VITEK-32鉴定,药物敏感判断采用美国临床实验室标准化委员会的判定标准执行.结果 2011-2012年眼科患者眼部分泌物检出病原菌94株,其中革兰阳性菌44株占46.81％,革兰阴性菌27株占28.72％,真菌23株占24.47％,排名前5位病原菌依次为表皮葡萄球菌、铜绿假单胞菌、金黄色葡萄球菌、流感嗜血菌、曲霉菌属,分别占28.72％、14.89％、13.83％、12.77％、11.70％,革兰阳性菌明显高于革兰阴性菌和真菌(P＜0.05)；金黄色葡萄球菌和表皮葡萄球菌对万古霉素、利奈唑胺的敏感性均为100.00％,铜绿假单胞菌对哌拉西林、阿米卡星的敏感率为100.00％.结论 目前眼部感染病原菌耐药性在逐渐增强,临床治疗中应了解患者眼部感染的病原菌分布,通过药敏试验掌握常见病原菌的药敏性,根据药敏结果合理使用抗菌药物,使患者减少痛苦,控制眼部疾病的发展.     

Editor's Introduction to This Special Issue on Syringe Access and Secondary Syringe Exchange: International Perspectives and Future Directions

Implementation of Temporary Assistance for Needy Families (TANF) presents welfare recipients with time-limited benefits and work requirements. However, it is estimated that over 140,000 welfare recipients meet the DSM-IV criteria for “drug dependence”. In this study, samples of chronic drug using and non-drug using female TANF recipients were compared with regard to: current employment, psychological functioning, self-perceived employment skills, barriers to employment, and need for help in seeking employment. It was found that non-drug using study participants were significantly more likely to be employed and reported significantly higher self-perceived work skills than users. Chronic users reported significantly greater barriers to seeking employment. [Translations are provided in the International Abstracts Section of this issue.]     

Therapeutic potential of A1 adenosine receptor ligands: a survey of recent patent literature

Background: In recent years, a number of companies, universities and other institutions have invested in research on new molecules acting as agonists, antagonists and enhancers on A₁ adenosine receptors (ARs) and in the evaluation of their new therapeutic applications. Objective: To review recent patenting activity on this topic. Methods: The first part of this article describes the compounds patented, subdivided by functional activity, and the second part the most relevant therapeutic applications or new uses for A₁ AR ligands, with a focus on compounds in or soon to be in clinical trials. Conclusion: Although a number of potential therapeutic applications are proposed in the recent literature, at present, in the authors' opinion, very few A₁ ligands are close to coming on the market, probably due to limited selectivity towards the target tissue or organ.     

神经内科住院患者并发下呼吸道感染病原菌分布及耐药性分析

目的 了解引起神经内科住院患者下呼吸道感染的病原菌分布及其耐药性,为临床预防医院感染及用药提供科学依据.方法 采集2009年1月-2011年12月医院神经内科并发下呼吸道感染的住院患者的下呼吸道分泌物并送检,应用法国生物梅里埃公司Bact/Alert 3D120全自动血培养仪及VITEK-2 Compact全自动细菌鉴定、药敏分析系统进行细菌培养、鉴定及药敏分析.结果 2009年1月-2011年12月神经内科住院患者并发下呼吸道感染207例,共培养出菌株516株；检出的病原菌中,以革兰阴性菌为主437株占84.69％,主要以肺炎克雷伯菌、铜绿假单胞菌为主；革兰阳性菌85株占11.24％,主要以金黄色葡萄球菌为主；真菌21株占4.21％,主要以白色假丝酵母菌为主；其中,肺炎克雷伯菌对哌拉西林/他唑巴坦、亚胺培南、美罗培南等抗菌药物敏感,敏感率分别为98.14％、100.00％、100.00％,对氨苄西林、哌拉西林等抗菌药物耐药,耐药率为98.76％、70.19％,铜绿假单胞菌主要对头孢唑林、头孢呋辛酯、头孢呋辛钠敏感,敏感率均为100.00％,对磺胺甲噁唑/甲氧苄啶耐药,耐药率为98.65％,金黄色葡萄球菌对莫西沙星敏感,敏感率为78.05％,对红霉素、克林霉素等药物耐药,耐药率均为100.00％,真菌对氟康唑、两性霉素B等抗真菌药物普遍敏感,敏感率均为100.00％.结论 医院感染是神经内科常见的并发症,引起神经内科住院患者下呼吸道感染的主要病原菌为革兰阴性菌,加强神经内科患者及抗菌药物的管理,监测感染病原菌的构成及耐药性,对预防医院感染非常重要.