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对发展中国家改善用药的10点建议 总被引:2,自引:0,他引:2
WHO建议改善药品管理的工作要在国家药物政策保障之下.在许多国家,执行国家药物政策的机制是实施国家基本药物计划,其要点是强调公共领域的药品选择、采购、流通与使用的合理性.不适当的处方使医疗质量降低并导致资源浪费.本文以探讨在国家药物政策范畴内鼓励更合理地使用药品的问题为重点,在已有证据的基础上,详细阐明基本药物计划内容中的合理用药问题.本文评述了在发展中国家改善用药状况的有效策略及最新知识,并为决策者与管理者提出达到改善用药目标的建议. 相似文献
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Bash RO; Crist WM; Shuster JJ; Link MP; Amylon M; Pullen J; Carroll AJ; Buchanan GR; Smith RG; Baer R 《Blood》1993,81(8):2110-2117
Alteration of the TAL1 locus is the most common nonrandom genetic defect in childhood T-cell acute lymphoblastic leukemia (T-ALL). To determine if rearrangements of the TAL1 proto-oncogene confer a distinct leukemic phenotype, we studied leukemic peripheral blood or bone marrow samples from 182 children with newly diagnosed T-ALL enrolled on Pediatric Oncology Group treatment protocols. Forty-eight (26%) of the samples had a local rearrangement of the TAL1 locus. Demographic and clinical features were compared for patient subgroups with and without TAL1 rearrangements. The only clinical correlates that were significantly associated with TAL1 gene rearrangements were higher white blood cell count (P = .017) and higher hemoglobin (P = .007) at diagnosis. Immunophenotypically, samples with altered TAL1 were more likely to be CD2+ (P = .001) and lack CD10 (cALLa) expression (P = .007) than those without the rearrangement. There was a trend toward improved event-free survival (EFS) in patients with TAL1 rearrangements (4-year EFS was 44% +/- 7% for patients without the rearrangements v 59% +/- 11% for those with rearrangements), but the difference was not significant (P = .34). The role of TAL1 in leukemogenesis has yet to be clearly defined, and the prognostic significance of TAL1 gene rearrangements in T-ALL deserves further study. 相似文献
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Histamine reduces boron neutron capture therapy‐induced mucositis in an oral precancer model
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Oyewale Abidoye MB BS Olukayode O. Lawal MB BS FWASC Millicent Obajimi MBBS FWACS Adebayo V. Adetiloye MB BS FWASC Hae K. Im PhD Akinbolaji A. Akinkuolie MB Chb FWASC Abideen Oluwasola MB BS FWACPath Kayode Adelusola Mb Chb FMCPath Adesunkanmi A. Kayode MB BS FWASC Augustine E. Agbakwuru Mb Chb FWASC Chinedum P. Babalola B.Pharm PhD FAS Gini Fleming MD Olusola C. Olopade MBBS FACP Adeyinka Gladys Falusi PhD FAS Muheez A. Durosinmi MB BS FMCPath Olufunmilayo I. Olopade MB BS FACP 《The breast journal》2013,19(5):470-477
The majority of clinical trials of neo‐adjuvant therapy for breast cancer have been conducted in resource‐rich countries. We chose Nigeria, a resource‐poor country, as the major site for a phase II feasibility open‐label multicenter clinical trial designed to evaluate the efficacy, safety, and tolerability of neo‐adjuvant capecitabine in locally advanced breast cancer (LABC). Planned treatment consisted of 24 weeks of capecitabine at a dose of 1,000 mg/m2 twice daily (2,000 mg/m2 total per day). The primary endpoints were overall, partial, complete clinical response rate (OCR, PCR, CCR) and complete pathologic response (cPR). A total of 16 patients were recruited from August 2007 to April 2010. The study was terminated early as a result of slow accrual. After the first three cycles of therapy, PCR were seen in five of 16 patients (31%; 95% CI 11–59%). Of the remaining 11 patients, eight had no response (NR) or stable disease (SD), and three had progressive disease (PD). Seven patients proceeded with further therapy of which had SD. OCR at the end of eight cycles was 44% (95% CI 20–70%). Clinical response and radiologic response by ultrasonomammography were highly concordant (spearman correlation 0.70). The most common adverse effect was Grade 1 hand–foot syndrome, which was seen in 75% of patients. Despite several limitations, we successfully carried out this phase II feasibility study of neo‐adjuvant capecitabine for LABC in Nigeria. Capecitabine monotherapy showed good overall response rates with minimal toxicity and further studies are warranted. 相似文献
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D. K. CHOI J. H. CHIN E. H. LEE O. B. LIM C. H. CHUNG Y. J. RO I. C. CHOI 《Acta anaesthesiologica Scandinavica》2010,54(8):962-969
Background: The aim of this study was to evaluate the efficacy of ondansetron and ramosetron in the reduction of post‐operative nausea and vomiting (PONV) associated with patient‐controlled analgesia (PCA) after cardiac surgery. Methods: A total of 320 patients scheduled for elective cardiac surgery were enrolled. Patients were randomly assigned to one of four treatment regimens (n=80 in each group): no prophylactic antiemetics (group P); intravenous (i.v.) ondansetron 4 mg at the end of surgery and 12 mg added to PCA (group O); i.v. ramosetron 0.3 mg at the end of surgery and no antiemetics added to PCA (group R1); and i.v. ramosetron 0.3 mg at the end of surgery and 0.6 mg added to PCA (group R2). Results: The incidence of PONV during the 48‐h post‐operative period was lower in groups O (46%), R1 (54%), and R2 (35%) compared with group P (71%, P<0.001). The incidence and severity of nausea were lower in groups O, R1, and R2 than in group P during the 24‐h post‐operative period, whereas the incidence and severity of nausea during 24–48 h after surgery were lower in groups O and R2, but not in group R1, than in group P. Compared with group P (53%), the frequency of rescue antiemetic usage was significantly lower in groups O (34%) and R2 (29%), but not in group R1 (43%). Conclusion: The addition of either ondansetron or ramosetron to PCA can reduce the incidence of PONV during 48 h after cardiac surgery. 相似文献
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This cross sectional study was carried out to compare the nutritional status of public primary school children in an upland and a riverine area of Ojo Local Government Area of Lagos State, Nigeria. A multistage sampling method was used to select a total of 240 children, 120 from each of the two areas. The study population for each area had an equal sex distribution (60 boys and 60 girls). Dietary, anthropometric, clinical and laboratory methods were employed. Using the National Centre for Health Statistics (NCHS/WHO) Reference values, a malnutrition prevalence of 20.8 and 30.81 for the upland and riverine populations respectively was found. There was a stunting in 15.8% of upland and 30.0% of riverine children; 3.3% and 1.7% of them were wasted, and 14.2% in the upland and 18.3% in the rural area were underweight. The mean weights and heights for boys and girls of different ages were lower for the riverine group, although no statistically significant differences were found. Anaemia occurred among 25.0% and 29.2% of the upland and riverine groups respectively. Intestinal helminth infection was found to be significantly associated with malnutrition. Ascaris had a prevalence of 46.7% in the upland and 63.3% in the riverine area. Trichuris had a prevalence of 15.0% and 19.2% in the upland and riverine area respectively. To address the malnutrition problem in these populations, efforts should be aimed at increasing food availability and quality, personal and environmental hygiene, supply of basic amenities, prevention and treatment of infection, and general living conditions of these populations. 相似文献
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This study of inter-relationship between life styles and diabetes mellitus, overweight/obesity and hypertension was carried out to determine the life styles of the bank workers and the nutritional related diseases. A total sample of 570 was systematically drawn from workers of the United Bank for Africa Plc in Lagos for this study, with the following results. Not surprisingly the level of education influenced life style (P<0.05). There was also a statistically significant relationship between life style and the consumption of alcohol and diabetes, but no relationship was found between smoking and diabetes. There was a significant correlation with their consumption of fatty foods and vegetables. A relationship between increased protein intake and an increase in educational status (P<0.05) was found. There was association between obesity and hypertension (P<0.05), and between increase in frequency of clinic visitation and hypertension which was statistically significant (Chi square P<.05). 相似文献
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