Molecular Pharmacology of Topiramate: Managing Seizures and Preventing Migraine

Topiramate is a neuromodulatory compound with stabilizing properties that was initially introduced for the management of partial seizures. Topiramate has been demonstrated to modify several receptor-gated and voltage-sensitive ion channels, including voltage-activated Na⁺ and Ca²⁺ channels and non-NMDA receptors. These receptors have been implicated in the pathophysiology of both epilepsy and migraine. The pharmacological mechanisms of action for topiramate that may explain its antiepileptic and migraine preventive activities will be discussed in this review. In addition, the potential relationship between the molecular activities of topiramate and its efficacy in epilepsy and migraine prevention will be emphasized.     

Impact of early dietary gamma-linolenic acid supplementation on atopic eczema in infancy

Polyunsaturated fatty acids (PUFAs) are components of cell membranes and may play an immunomodulating role in the pathogenesis of atopic dermatitis (AD). The goal was to determine the impact of PUFAs on AD by dietary supplementation of infants. Based on the parents' decision on their babies' primary feeding, mothers and newborns were randomized to the supplementation with gamma-linolenic acid (GLA) or placebo for up to 6 months. Breastfed infants received GLA by supplementing their mothers. Formula diet was commercial whey hydrolysate unsupplemented with PUFAs. Of 131 eligible infants, 24 developed AD within the first year of life. Of these, nine belonged to the exclusively breastfed group (n = 58), 14 to the combined-fed group (n = 53), and one to the never breastfed group (n = 20). We could not find an influence of GLA on the development of AD. In subjects with AD, at 1 yr of age the serum-immunoglobulin E (IgE) was the lowest in the GLA-supplemented group A-subjects. In the GLA-supplemented group, GLA-levels in breast milk were similar in atopic and non-atopic infants. In the non-supplemented group the GLA-content of breast milk was 0.07% of total fatty acids in atopic infants vs. 0.17% in non-atopic infants (p < 0.01). Dietary GLA-supplementation could not prevent AD. Interestingly, the number of infants developing AD was the lowest in never breastfed children. In infants suffering from AD, GLA-supplementation seemed to reduce total IgE in the first year of life.     

化疗病人的静脉保护

化疗病人因营养失调 ,骨髓抑制、药物反复刺激、损伤等原因造成血管硬化、塌瘪、脆性大 ,给护理工作带来了一定的难度 ,自 2 0 0 0年始 ,我们摸索出一套保护化疗病人静脉的方法 ,延长了静脉使用的次数和时间。1　临床资料自 2 0 0 0年 1月至 2 0 0 3年 1月 ,我科共收住病人 112 0人食道癌 36 0人 ,乳腺癌 2 6 0人 ,肺癌 30 0人 ,直肠癌 10 8人 ,其他癌 82人 ,其中化疗病人占 6 5 % ,我们均采取了从选择静脉到拔针后处理的方法收到了满意的效果。2　静脉保护2 .1　重视选择静脉　人们根据药物的刺激程度选择不同静脉 ,如强刺激化疗药物如 HN…     

Global environmental change: preventive measures to reduce the impact on human health

Awareness of the magnitude of worldwide climate change and theloss of biological diversity that may occur as the result ofpresent human activities is increasing. However, much needsto be done to reverse current trends and prevent unprecedentedglobal environmental changes which are expected to produce irreversibleresults, and to have profound implications for the health ofindividuals. This paper briefly reviews what is known aboutthe global environmental changes that are taking place and theirpredicted impact on human health. Some of the preventive measuresand activities in which public health professionals need toassume leadership roles in the critical years ahead are discussed.Our hope is to enliven a much needed dialogue among health professionalson the crucial issue of environmental survival in which preventionmay be the only viable solution.     

Factors associated with recovery and recurrence of depression in older people: A prospective study

The Liverpool Continuing Health in the Community Study has followed up 1070 elderly community subjects over 6 years. In the first year 123 subjects had case-level depression. Three years later 49 (39.8%) of the previously depressed were recovered, 33 (26.8%) were depressed, 16 (13%) were not available for interview and 25 (20.3%) were dead. This study looks at factors associated with the 3-year outcome of patients who were depressed at year 0. Two outcome groups that were compared were a recovered depression group and a recurrent/persistent depression group. The factors that were significantly associated with a recurrence of depression (or persistent depression) at year 3 were bereavement of a close figure in the 6 months before interview, loneliness and life dissatisfaction at year 3. A variety of traditional risk factors for depression (including age, marital status, physical ill-health and incapacity) failed to attain significance in predicting recurrent or persistent depression. When combined, both recovered and recurrently depressed groups at year 3 had significantly higher levels of pain and a higher number of serious upsets in the past 6 months and 6 weeks compared to a compared to a control group. The depressed at year 0 were more likely to have entered more dependent forms of accommodation by year 3.     

Do discrepancies in interpersonal perception predict relapse?: A comparison of remitted depressed patients and collaterals

In an effort to examine whether disturbed interpersonal relationships are associated with relapse in depression, discrepancies in self-ratings provided by formerly depressed patients and their collateral informants were compared. Thirty-eight remitted depressed patients and their collateral informants were asked to monitor moods, life events, and stress levels on a bimonthly basis for a 1-year period. It was hypothesized that patient/collateral dyads displaying a greater discrepancy in interpersonal perception would have a higher risk of relapse than dyads who showed more agreement in their ratings. Results indicated that while discrepancies in the perceptions of patients' life events were associated with the duration of a relapse once it occurred, discrepancies were generally not related to the emergence of new episodes of depressive disorder. The implications of these findings for models seeking to integrate cognitive and interpersonal models of depression, through the study of environmentally determined and personally appraised adversity, is discussed.This research was supported by grants to the first and third authors from the Canadian Psychiatric Research Foundation and the Laidlaw Foundation.     

Challenging the world: patient safety and health care-associated infection.

Improving the safety of patient care is an issue which affects health systems in both developed and developing countries. To co-ordinate and accelerate improvements in patient safety, the World Health Organization (WHO) has supported the creation of the World Alliance for Patient Safety which was launched in October 2004. The six action areas of the Alliance are Patients for Patient Safety, Taxonomy, Research, Solutions for Patient Safety, Reporting and Learning, and a biennial Global Patient Safety Challenge. The first Challenge covering 2005-2006 was launched in October 2005 under the banner 'Clean Care is Safer Care'. The Challenge addresses health care-associated infection, a major, patient safety problem affecting hundreds of millions of people worldwide.     

Effect of two preventive programs on oral health knowledge and habits among Brazilian schoolchildren

Abstract – The effect upon dental health knowledge and dental health behavior of a comprehensive and a less comprehensive preventive program was compared in a 3-yr follow up study. The comprehensive program included active participation of the students and parental involvement. The study group consisted of 186 Brazilian schoolchildren 13 yr of age at the start of the program. A reference group from another school of similar socioeconomic level was included in the analyses. The data were collected from questionnaires filled in by the children under surveillance after the completion of the program. Significant differences in knowledge as well as in reported behavior were observed. The children enrolled in the comprehensive program in general scored higher in dental health knowledge than did those in the less comprehensive program. However, the latter group of children seemed to have acquired more correct knowledge during the period than had the control and reference children. Similar results were obtained concerning reported dental health behavior.     

77例出院后精神分裂症患者心理调查分析

研究目的调查分析出院后精神分裂症患者的心理状况，了解存在的问题并探讨解决的对策。研究方法对77例出院后精神分裂症病人就22项心理问题进行调查统计，并对比男女患者差异。结果男性易发脾气、借酒消愁、因病影响工作安排的现象较女性突出，而女性的婚姻状况较紧性明显。结论社区防治的病人心理问题较繁杂，因此防治工作应重视患者的心理特点，解决患者的实际问题。     

Wounding,shock and stress lesions of the upper gastrointestinal tract

This retrospective study included 2532 wounded, of whom 354 (14 per cent) were treated in surgical intensive care units. In 32 patients, 1.3 per cent of all admissions, upper gastrointestinal bleeding was detected. It occurred on average 8.9 days (3–21 days) after the wounding or surgical procedure in severely injured patients and those treated in intensive care units, respectively (32 of 354 patients, 9.0 per cent). All patients received different analgesic drugs and 17 of a group that presented with bleeding were given psychotropic agents as well. The majority of patients (96.3 per cent) were administered H₂-receptor antagonists as prophylaxis against stress ulcer disease. There was a statistically significant difference between these patients treated with H₂-receptor antagonists and those on no prophylactic therapy. No statistically significant difference was found between cimetidine and ranitidine in terms of their efficacy. Endoscopic examination revealed multiple bleeding gastric and duodenal erosions. The lesions were most commonly located in the corpus of the stomach. In the majority of patients (56.25 per cent), the haemorrhage stopped spontaneously and rebleeding presented in four of 32 (12.5 per cent) patients. Of 354 patients treated in intensive care units, five (1.4 per cent) had to be operated on because of bleeding arrest. Despite all therapeutic and surgical procedures undertaken, five of 32 (15.6 per cent) patients died.