抗菌药使用中药物治疗错误的研究

目的：研究抗茵药使用中药物治疗错误（ME）的发生情况，探讨其防范重点。方法：药师深入中心ICU病房，通过调查病历、直接观察的方式发现抗茵药ME。结果：10个月研究期间共发现ME301次，其中可预防药物不良事件（ADE）19次（3．3％），潜在ADE94次（16．2％）。有潜在危害ME（可预防的ADE＋潜在ADE）中有生命威胁6次（5．3％），严重88次（77．9％），明显19次（16．8％）。结论：抗茵药使用中ME经常发生，其中约1／3有潜在危害且往往带来严重后果，应该采取措施防范ME、特别是有潜在危害ME的发生。     

A comparative study on alcohol-preferring rat lines: effects of deprivation and stress phases on voluntary alcohol intake

BACKGROUND: Voluntary alcohol intake in rats can be influenced by alcohol deprivation phases and stress. We investigated the magnitude of the effects of both deprivation and stress (forced swimming in cold water and foot-shock had been chosen as stressors distinct in their physical and psychological features) on alcohol intake and the influence of these experiences on the time course of alcohol drinking behavior. For the alcohol drinking procedure, a long-term model of alcohol self-administration originally developed for heterogeneous Wistar rats was used and was compared with different alcohol-preferring rat lines. METHODS: Adult male Alko alcohol (AA), alcohol-preferring (P), high-alcohol-drinking (HAD), and unselected Wistar rats were given ad libitum access to water, 5%, and 20% alcohol solutions for 6 months. A deprivation phase of 14 days was performed after 8 weeks of access to alcohol. After 16 weeks and 22 weeks of alcohol access, all animals were subjected to forced swimming and foot-shock, respectively, for 3 consecutive days, while alcohol intake was still being measured. RESULTS: Alcohol deprivation led to a significant increase in alcohol intake in Wistar rats and P rats. No alcohol deprivation effect was observed in HAD and AA rats; after deprivation, however, their preference for the 20% alcohol solution increased, immediately in the HAD rats and gradually over time in the AA rats. Repeated swim stress caused an increase in alcohol intake in Wistar rats but no changes in the alcohol-preferring rat lines. Foot-shock stress increased alcohol consumption in all lines of rats, but the most pronounced effects were observed in HAD and P rats. CONCLUSIONS: Wistar, HAD, P, and AA rats differentially respond to alcohol deprivation and stress, showing that the genetic background of these different rat lines profoundly affects relapse-like drinking and stress-induced drinking.     

Emergence of ancient convalescent plasma (CP) therapy: To manage COVID-19 pandemic

Since December 2019, the human populations of the 195 global countries continue experiencing grave health and life threats due to the current COVID-19 pandemic. As a result of the novelty of the pathogen, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), at present there is lack of preventive as well as therapeutic options for treating and managing the infection. The use of ancient immunotherapeutic technique – the convalescent plasma (CP) therapy, may act as an immediate and available option to control the COVID-19 pandemic. This review provides a concept and understanding on the CP therapy, its potential to control SARS-CoV-2 pandemic. The CP therapy might act as an immediate saviour for society from the virus. Although the CP therapy has exert affirmative result against COVID-19 it has not been recommended for long time use in COVID-19 and this review gives support for its possible application.     

Red blood cell distribution width adds prognostic value for outpatients with chronic heart failure

Introduction and objectives

Red blood cell distribution width has emerged as a new prognostic biomarker in cardiovascular diseases. Its additional value in risk stratification of patients with chronic heart failure has not yet been established.

Methods

A total of 698 consecutive outpatients with chronic heart failure were studied (median age 71 years [interquartile range, 62-77], 63% male, left ventricular ejection fraction 40 [14]%). On inclusion, the red cell distribution width was measured and clinical, biochemical, and echocardiographic variables were recorded. The median follow-up period was 2.5 years [interquartile range 1.2-3.7].

Results

A total of 211 patients died and 206 required hospitalization for decompensated heart failure. Kaplan-Meier analysis showed an increase in the probability of death and hospitalization for heart failure with red cell distribution width quartiles (log rank, P<.001). A ROC analysis identified a red cell distribution width of 15.4% as the optimal cut-off point for a significantly higher risk of death (P<.001; hazard ratio=2.63; 95% confidence interval, 2.01-3.45) and hospitalization for heart failure (P<.001; hazard ratio=2.37; 95% confidence interval, 1.80-3.13). This predictive value was independent of other covariates, and regardless of the presence or not of anaemia. Importantly, the addition of red cell distribution width to the clinical risk model for the prediction of death or hospitalization for heart failure at 1 year had a significant integrated discrimination improvement of 33% (P<.001) and a net reclassification improvement of 10.3% (P=.001).

Conclusions

Red cell distribution width is an independent risk marker and adds prognostic information in outpatients with chronic heart failure. These findings suggest that this biological measurement should be included in the management of these patients.Full English text available from:www.revespcardiol.org     

维C银翘片致不良反应/事件15例文献分析

目的:探讨维C银翘片致不良反应/事件(ADR/ADE)的一般规律及特点,为临床合理用药提供参考。方法:检索1988-2013年相关数据库收录文献报道的维C银翘片致ADR/ADE病例,并就获得的15例ADR/ADE相关信息进行分类、统计和分析。结果:维C银翘片致ADR/ADE以皮肤及其附件损害为主(占61.11%),临床表现为全身发疹性皮疹伴瘙痒、大疱性表皮坏死松解型药疹、荨麻疹等;超量、误服过期药品是维C银翘片致ADR/ADE的重要因素;2例病例死亡,13例病例经治疗后恢复正常。结论:应规范使用维C银翘片,避免超剂量、长期连续用药,过敏体质须慎用,以有效降低ADR/ADE的发生率。     

A case of possible HIV prophylaxis-induced anxiety and obsessive–compulsive disorder

There is considerable literature on the neuropsychiatric effects of antiretrovirals. This is the first case, to our knowledge, of new-onset obsessive–compulsive symptoms correlated with emtricitabine/tenofovir, a commonly prescribed HIV prophylaxis combination. We describe the case of a woman, who developed upsetting obsessive thoughts following initiation of this pharmacotherapy and include discussion of relevant literature.     

Neutralizing antibody response and SARS severity

Using the Taiwan nationwide laboratory-confirmed severe acute respiratory syndrome (SARS) database, we analyzed neutralizing antibody in relation to clinical outcomes. With a linear mixed model, neutralizing antibody titer was shown to peak between week 5 and week 8 after onset and to decline thereafter, with a half-life of 6.4 weeks. Patients with a longer illness showed a lower neutralizing antibody response than patients with a shorter illness duration (p = 0.008). When early responders were compared with most patients, who seroconverted on and after week 3 of illness, the small proportion (17.4%) of early responders (antibody detectable within 2 weeks) had a higher death rate (29.6% vs. 7.8%) (Fisher exact test, p = 0.004), had a shorter survival time of <2 weeks (Fisher exact test, p = 0.013), and were more likely to be > 60 years of age (Fisher exact test, p = 0.01). Our findings have implications for understanding the pathogenesis of SARS and for SARS vaccine research and development.     

我院药品不良反应/事件报告质量分析

目的:提高药品不良反应/事件(ADR/ADE)报告质量。方法:对我院200例ADR/ADE报告质量进行回顾性分析。结果与结论:我院ADR/ADE报告中4级报告占全部报告的26%,ADR/ADE发生的过程和处理结果项描述简单。应对医务人员和患者加强ADR/ADE的教育,提高ADR/ADE的报告水平。     

46例注射用门冬氨酸洛美沙星药品不良反应/事件的分析

目的分析注射用门冬氨酸洛美沙星药物不良反应/事件(ADR/ADE)发生的类型及特点,为临床合理用药提供参考。方法对2008年1月1日～2011年7月30日收集到的46例注射用门冬氨酸洛美沙星ADR/ADE报告,从患者情况、不良反应的临床表现、原患疾病及因果关系的评价等方面进行回顾性统计分析。结果 46例注射用门冬氨酸洛美沙星ADR/ADE报告中,女性多于男性;累及的系统-器官主要是皮肤及其附件、消化系统、中枢神经系统、光敏反应、呼吸系统等;主要发生在用药后5～40min内,多数患者在停药后1d内康复或明显好转。结论应重视注射用门冬氨酸洛美沙星用药后的监护,减少或者避免严重ADR/ADE的发生,确保临床安全、有效、合理用药。