An open-label trial examining the efficacy and safety of a pre- and postprocedure topical five-product system (Clinique Medical Optimizing Regimen) specifically formulated to complement laser/light-based facial cosmetic procedures

Abstract

Background: Specialized skin care regimens may help to minimize adverse events (AEs) following non-ablative facial procedures. Methods: A 14-week, open-label, three-center study evaluated the efficacy and safety of a topical five-product system (Clinique Medical Optimizing Regimen; Allergan, Inc., Irvine, CA, USA) for minimizing localized AEs during two 6-week procedure cycles with fractionated laser (FL) or intense pulsed light (IPL). The skin care regimen consisted of a 2-week preprocedure phase, a 1-week postprocedure phase, and a 3-week maintenance phase. Investigators and patients rated the presence and severity of erythema, itching, stinging/burning, edema, pain, pruritus, swelling, crusts/erosion, and photodamage. Results: Two days after the FL/IPL treatment (IPL: n = 27; FL: n = 21), most assessments, including erythema, were near baseline values; at 4 weeks postprocedure, all investigator scores were comparable to baseline. Patients missed work or avoided social situations a mean of only 0.8 days. Mean subject ratings for itching, stinging/burning, pain, swelling, and redness for 2 weeks postprocedure were ‘none’ to ‘mild’. Treatment-related AEs (acne, facial rash) occurred in four patients. All investigators stated they would recommend this topical over-the-counter regimen again in conjunction with non-ablative FL/IPL treatments. Conclusions: This topical five-product skin care system was safe and effective in conjunction with non-ablative FL/IPL procedures.     

A Quality Improvement Project to Reduce Falls and Improve Medication Management

SUMMARY

This paper describes the implementation of a medication management model within a medical-center based home health agency. The model was integrated into the agency's quality improvement falls prevention program and was selected in part because it directly addressed two medication-related accreditation standards for home health care agencies. During a five-month period, a staff pharmacist conducted medication reviews for 228 HHA patients who met the program's inclusion criteria. Thirty-three percent of these patients required some type of follow-up to resolve potential medication-related problems. By far, falls were the most common reason for referral, with 71 patients, or 30% of all participating patients, referred to the pharmacist due to a recent fall. From a quality improvement standpoint, the program met and even exceeded expectations in that it enabled staff to identify a serious threat to patient safety-medication-related problems, especially falls-and gave them the tools to resolve these potential problems.     

Cleansing, moisturizing, and sun-protection regimens for normal skin, self-perceived sensitive skin, and dermatologist-assessed sensitive skin

ABSTRACT:  Acquiring or maintaining healthy skin requires a multifunctional approach: mild cleansing, moisturizing, and sun protection. The clinical benefits of a daily, healthy facial skin-care regimen comprising a mild cleanser and moisturizer were evaluated on normal skin, self-perceived sensitive skin, and dermatologist-assessed sensitive skin for a period of up to 4 weeks. Subjects with normal, healthy skin were photographed with a calibrated, high-resolution digital camera, and the average improvement in overall health was calculated using image morphing and facial averaging techniques, following a 2-week period of product application. In a second study that included subjects with self-assessed sensitive facial skin, changes in skin hydration, skin dryness, and skin sensitivity (determined by means of a lactic acid sting test and subject self-assessment) were monitored during a 3-week regimen of mild cleansing and moisturizing with products designed for sensitive skin. The third study involved dermatologist-assessed highly sensitive skin patients (mostly rosacea with an atopic background in some cases). These patients underwent a 4-week skin-care regimen involving mild cleansing and moisturizing. In all three studies, significant improvements in skin health/quality were observed by means of expert assessments, instrumental evaluations, and subjective self-assessment.     

晚期大肠癌应用FOLFOX4方案治疗的临床疗效观察

目的评价和探讨FOLFOX4方案治疗晚期大肠癌的疗效和不良反应。方法 2007年3月～2000年2月对12例接受治疗的晚期大肠癌患者采用FOLFOX4方案化疗（奥沙利铂＋亚叶酸钙＋5-氟尿嘧啶）。第1天,静脉滴入奥沙利铂80mg/m2小时;第1、2天,静脉滴入亚叶酸钙180mg/m2小时,5-氟尿嘧啶450mg/m2推注后静脉滴入650mg/m2持续22小时。每2周重复一次,4周为1周期。结果全组12例患者均可评价疗效及不良反应。经过治疗,患者完全缓解2例,部分缓解4例,稳定3例,总有效率50%。毒副反应主要为消化道反应和神经毒性,以I～Ⅱ度为主。结论 FOLFOX4方案治疗晚期大肠癌疗效明显,安全性较高,初治患者效果更佳。     

Phase II Clinical Study on the Modified DCF Regimen for Treatment of Advanced Gastric Carcinoma

Background  A phase III trial involving docetaxel, cisplatin, and fluorouracil (DCF) in the treatment of advanced gastric cancer was shown to have superior efficacy compared to cisplatin and fluorouracil alone, but with a high rate of hematologic toxicity. To reduce toxicity while maintaining the efficacy of DCF, we reduced the doses of docetaxel (D) and cis-platinum (CDDP), and administered 5-fluorouracil (5-FU) via a continuous intravenous (CIV) infusion.

Methods  Chemotherapy-naive patients with gastric adenocarcinomas received D (60 mg/m² 1 hour on day 1), CDDP (30 mg/m² on days 1 and 2), and 5-FU (1500 mg×m^-2×24 h^-1 CIV on days 1 and 8 every 3 weeks). The primary endpoint was the response rate.

Results  Fourteen patients were enrolled. Based on the efficacy evaluation following at least 2 cycles of treatment, there was 7.1% complete remission (CR), 71% partial remission (PR), 14% stable disease (NC/SD), and 7.1% progressive disease (PD). The median survival time was 13 months. Nine patients (64%) had grade III-IV neutropenia, and 4 patients (29%) had grade IV neutropenia, among whom 1 had grade IV neutropenia with grade III nausea and vomiting.

Conclusion  The modified DCF regimen is highly active and has a favorable toxicity profile in Chinese patients with gastric cancer.

     

临床药师对冠心病伴多种疾病药物治疗方案优化及治疗干预

目的：为了促进临床合理用药,降低临床用药风险,从干十预优化药物治疗方案方面探讨临床药师开展临床药学工作在药物治疗中的作用。方法：结合1例冠心病伴多种疾病的用药方案,介绍临床药师从分析治疗方案,提出用药调整、补充,并对治疗全过程用药干预、优化的方法。结果：临床药师的药学知识及思维能力得到了显著提高,使临床用药更合理、安全。结论：提高了临床药物治疗水平,减少了不良反应的发生率。对保障药物在临床使用过程中安全、有效具有重要意义。     

36例顽固性高血压的临床辨证施护与分析

目的：观察分析顽固性高血压的临床治疗辨证施护效果。方法：根据血压指标、合并症,发病原因,制定联合用药方案;辨证施护方法：心理辨证施护,用药辨证施护,病情监测,饮食与运动和健康指导。结果：本组36例,18例维持血压在140／90mmHg以下;4例合并糖尿病者血压降至130～140,70～8mmHg;14例维持在140～150／80～90mmHg。符合高血压控制标准。结论：对于顽固性高血压,含有利尿剂的三联以上治疗方案,坚持长期治疗和科学辨证施护,可以将血压控制在达标范围。     

Limitations of cigarette machine smoking regimens

There is an ongoing debate about the ‘usefulness’ of the standard machine smoking regimen for cigarettes defined by the US Federal Trade Commission (FTC) and adopted in principal by the International Organization for Standardization (ISO).More intense smoking regimens result in much higher smoke yields, and these higher yields have been suggested to be much closer to human smoke uptake. However, it appears that more intense smoking regimens are less efficient in detecting possible differences in the yield of toxicants. Intense smoking regimens reproducibly decrease the concentration of toxicants in the smoke per unit mass of total particulate matter, tar, or nicotine, most likely as a result of a more complete combustion. The toxicant concentration reaches the same plateau for different cigarette types under the intense smoking regimens. As such, differences in toxicant concentrations due to product changes, which are observable under ISO or FTC conditions, may disappear under intensive smoking regimens.Intense machine smoking regimens might be used for regulatory compliance and consumer information. However, when evaluating the toxicological impact of cigarette product changes, especially to avoid increases in toxicity, they should not be used as a standard (or at least not as the only standard). The type of smoking regimen has to be carefully considered and aligned to the underlying question. Depending on the question a combination of the reviewed regimens or even other approaches might be appropriate.