Effect on prescribing of the limited list in a computerised group practice.

The prescribing of drugs in the therapeutic classes that are affected by the government''s limited list was investigated in a computerised group practice of just over 3,000 patients. Prescribable drugs in categories that are affected by the list were identified for two consecutive six month periods before and one six month period after the introduction of the list. A significant decrease in the prescribing of cough and cold remedies, vitamins, and antacids occurred after the list was introduced, whereas no change occurred in the prescribing of laxatives, benzodiazepines, or analgesics. The prescribing of iron and penicillin increased significantly after the list was introduced, whereas the use of H2 antagonists and non-steroidal anti-inflammatory drugs showed no significant change.     

基于专利计量分析的抗HIV 药物发展趋势研究

近年来,艾滋病感染人数急剧增加,已成为威胁人类健康的重大疾病。为了对抗HIV药物的研究现状和发展趋势进行深入分析,本文通过在Derwent Innovations Index数据库中检索2006-2012年的抗HIV药物专利。对采集的专利信息用TDA软件进行数据清洗,利用专利计量分析方法,借助可视化的分析工具,从专利申请数量、优先权国、专利技术机构和专利技术领域等方面进行分析。研究发现近几年抗HIV药物专利申请数量较为平稳;专利申请主要集中在美国、加拿大和中国;抗HIV药物的技术领域主要集中在天然产物、发酵工业和杂环化合物等方面。美国在专利申请数量方面远远领先于其他国家,足以见美国在抗HIV药物研发的活跃和强劲的技术实力。我国虽然在专利申请数量方面具有一定优势,但是与国外相比仍有较大差距。     

Prescribing new drugs: qualitative study of influences on consultants and general practitioners

ObjectiveTo explore consultants'' and general practitioners'' perceptions of the factors that influence their decisions to introduce new drugs into their clinical practice.DesignQualitative study using semistructured interviews. Monitoring of hospital and general practice prescribing data for eight new drugs.SettingTeaching hospital and nearby general hospital plus general practices in Birmingham.Participants38 consultants and 56 general practitioners who regularly referred to the teaching hospital.ResultsConsultants usually prescribed new drugs only in their specialty, used few new drugs, and used scientific evidence to inform their decisions. General practitioners generally prescribed more new drugs and for a wider range of conditions, but their approach varied considerably both between general practitioners and between drugs for the same general practitioner. Drug company representatives were an important source of information for general practitioners. Prescribing data were consistent with statements made by respondents.ConclusionsThe factors influencing the introduction of new drugs, particularly in primary care, are more multiple and complex than suggested by early theories of drug innovation. Early experience of using a new drug seems to strongly influence future use.

What is already known on this topic

UK studies show that use of new drugs by general practitioners is influenced by consultants, the nature of the drug, and perceived risk

What this study adds

Consultants generally introduced fewer drugs than general practitioners, usually within their specialtyDecisions were said to be based mainly on the evidence from the scientific literature and meetingsGeneral practitioners prescribed more new drugs and the basis of decisions was more variedDoctors'' interpretations of using a new drug were not consistent     

2015 年度中国医药市场发展蓝皮书 ——公立医院终端市场部分 （ Ⅱ ）

介绍了我国的卫生机构状况、药品市场终端规模,以及我国公立医院终端化学药和中成药各大类药品市场份额状况,并分别对 我国公立医院终端化学药和中成药各大类重点品种的销售额 Top10 进行了分析。     

Fundamentals of chirality,resolution, and enantiopure molecule synthesis methods

The chirality of molecules is a concept that explains the interactions in nature. We may observe the same formula but different organizations revolving around the chiral center. Since Pasteur's meticulous observation of sodium ammonium tartrate crystals' structure, scientists have discovered many features of chiral molecules. The number of newly approved single enantiomeric drugs increases every year and takes place in the market. Thus, separation or resolution methods of racemic mixtures are of continued importance in the efficacy of drugs, installation of affordable production processes, and convenient synthetic chemistry practice. This article presents the asymmetric synthesis approaches and the classification of direct resolution methods of chiral molecules.     

Some suffer adjustment pains as Blue Cross changes drug-benefit program on East Coast.

Blue Cross of Atlantic Canada has revised its drug-benefit program by restricting the number of drugs eligible for automatic benefits. The program still covers more than 3000 medications, but not items such as nicotine-replacement products, antihistamines, or cough and cold medications. The centrepiece of the revised program is a "special-authorization" process that affects about 140 expensive but "commonly prescribed" drugs such as antidepressant products and medications for migraine treatment. Although may applaud the not-for-profit corporation''s intentions, some doctors and patients have experienced difficulty adjusting to the changes.     

Prescribing at the hospital-general practice interface. I: Hospital outpatient dispensing policies in England.

OBJECTIVE--To describe the outpatient dispensing policies of major acute hospitals in England. DESIGN--Postal questionnaire survey in November 1990. SETTING--All (278) major acute hospitals in England with more than 250 beds, excluding maternity, paediatric, or psychiatric hospitals; nine hospitals declined. PARTICIPANTS--Hospital chief pharmacists. MAIN OUTCOME MEASURES--Current dispensing policy and exceptions to it; when the policy was formed; and who was involved in its formation. RESULTS--Completed questionnaires were received from 200 (72%) of the hospitals approached. The quantities of drugs dispensed to outpatients ranged from zero in 12 hospitals to unlimited amounts in nine; nearly half (92) dispensed a 14 days'' supply of drugs. The greater the restriction on outpatient dispensing, the more recently the policy had been introduced (chi 2 for trend = 7.15; df = 1; p less than 0.01). Permissible exceptions to the policy included the consultant''s specific request (134 hospitals), difficulty in obtaining drugs in the community (102), urgent need for start of treatment (49), and certain types of patients (41) or drugs or their regimens (104). Groups who were neither represented on the hospital committee concerned with policy formation nor consulted before policy changes included regional health authorities in 122 hospitals, district health authorities in 101 hospitals, and general practitioners in 32 hospitals. CONCLUSIONS--Outpatient dispensing policies varied considerably among the hospitals surveyed, but they seemed to be moving towards greater restrictions on the supply of drugs given to outpatients.     

Genetic system relationships inTrifolium

Examination of species of Trifolium in the Kentucky collection revealed that annual species generally have simple tap roots, low chromosome numbers (2n = 10?32), are usually self-pollinating and many were introduced from a Mediterranean type climate. Perennial species generally are tap-rooted, stoloniferous, or rhizomatous, possess higher chromosome numbers than annuals (2n = 12? 130), are mostly cross-pollinating and do not have specific climate-habitat relationships. Species introduced from Eurasia are more numerous and more diverse in base chromosome number (n = 5?8) than from other origins. Only species with diploid chromosome numbers of 16 or higher are stoloniferous or rhizomatous. Rhizomatous species, mostly cross-pollinated, were introduced from Eurasia, North and South America, but not from Africa, and not often from Mediterranean climates. Self- and cross-pollinated species occur in all origins. Different flower colors and leafmarks are not associated with origins, climates, and other morphological and physiological characteristics.     

腺苷一磷酸激活蛋白激酶激活剂研究进展

腺苷一磷酸激活蛋白激酶（AMPK）是调控能量代谢的重要激酶,在代谢障碍、心血管疾病及肿瘤等疾病的病理进程中都有重要的调节作用。对AMPK 的结构及其生理调节作用进行介绍,并重点综述AMPK 间接激活剂和直接激活剂的研究进展,旨在为AMPK 激活剂的深入开发提供参考。     

Characterization of the ribonuclease activity on the skin surface

The rapid degradation of ribonucleic acids (RNA) by ubiquitous ribonucleases limits the efficacy of new therapies based on RNA molecules. Therefore, our aim was to characterize the natural ribonuclease activities on the skin and in blood plasma i.e. at sites where many drugs in development are applied. On the skin surfaces of Homo sapiens and Mus musculus we observed dominant pyrimidine-specific ribonuclease activity. This activity is not prevented by a cap structure at the 5'-end of messenger RNA (mRNA) and is not primarily of a 5'- or 3'-exonuclease type. Moreover, the ribonuclease activity on the skin or in blood plasma is not inhibited by chemical modifications introduced at the 2'OH group of cytidine or uridine residues. It is, however, inhibited by the ribonuclease inhibitor RNasin^® although not by the ribonuclease inhibitor SUPERase· In?. The application of our findings in the field of medical science may result in an improved efficiency of RNA-based therapies that are currently in development.     

CONSERVATION IN THE MARINE ENVIRONMENT: SOME PROBLEMS WITH THE MANAGEMENT OF SHORE-ANGLING IN THE SOUTHWESTERN CAPE

Summary

Recreational shore angling is a very important sector of South Africa's diverse marine fisheries. The number of anglers participating in this sport is increasing at 6% per annum and currently stands at approximately 380 000. This number is expected to exceed one million within 20 years. The catch rates of many species caught from the shore have declined markedly for at least 50 years and the species composition of the catch has changed. This indicates that stocks of many species are overexploited and that effort increases cannot be sustained. Measures introduced to conserve these stocks appear to have been largely unsuccessful because they do not have the support of many anglers and they are ineffectively policed. It is concluded that, in order to sustain this fishery, current legislation needs to be improved and that a licensing system for anglers should be introduced through which an education campaign can be channelled.     

Intrauterine transfusion of twins.

Drug interactions are important causes of both unexpected toxic and therapeutic effects. Adverse reactions due to drug interaction are proportional to the number of drugs given and the duration of administration. Although drug interactions may be beneficial, they are most often recognized when they increase mortality or morbidity. The frequency of adverse drug interactions in clinical practice makes it mandatory for physicians to know the drugs and mechanisms involved.A drug may potentiate or antagonize the effects of another drug by direct chemical or physical combination, by altering gastrointestinal absorption, by influencing metabolism, transport, or renal clearance, by changing the activity of a drug at its receptor site, or by modifying the patient''s response to the drug by a variety of means.This article stresses the importance of avoiding multible drug therapy. When such treatment is unavoidable, patients must be carefully observed for evidence of intensified or diminished drug effect. Only this permits the detection and prevention of untoward drug interactions.     

Influence of method of reporting study results on decision of physicians to prescribe drugs to lower cholesterol concentration.

OBJECTIVE--To determine whether the reporting of study results by using reductions in relative or absolute risk and the number needed to treat affects the views of physicians about the effectiveness of drugs to lower lipid concentrations and decisions about treatment. DESIGN--Random allocation of two questionnaires presenting the results of three end points of the Helsinki heart study as results from separate trials by using reduction in either relative or absolute risk. In both questionnaires one end point was also presented by showing person years of treatment needed to prevent one myocardial infarction. The effectiveness of lipid lowering drugs was assessed for all end points on an 11 point scale. For each study result the likelihood to treat hypercholesterolaemia of 7.5 mmol/l in a healthy man had to be indicated on a seven point scale. SUBJECTS--Random sample of 802 internists and general practitioners representative of providers of primary care in Switzerland. RESULTS--The response rate was 69.6% (558). For the prevention of fatal and non-fatal myocardial infarction the mean ratings of effectiveness of lipid lowering drugs were 0.45 (95% confidence interval 0.21 to 0.69) and 1.39 (1.09 to 1.68) scale points lower when the reduction of absolute risk or number needed to treat were reported instead of the relative risk reduction (both P < 0.001). Physicians receiving trial results for identical end points in form of absolute reduction of risk or number needed to treat were less inclined to treat hypercholesterolaemia (both P < 0.001). CONCLUSIONS--Physicians'' views of the effectiveness of lipid lowering drugs and the decision to prescribe such drugs is affected by the predominant use of reduction of relative risk in trial reports and advertisements.     

Insight of the Cytotoxicity of the Aggregates of Peptides or Aberrant Proteins: A Meta-Analysis

Aberrant proteins or peptide aggregates form soluble oligomers or nanofibrils that can cause a wide range of amyloidosis diseases, including Alzheimer''s disease (AD). The mechanisms of their cytotoxicity, however, remain controversial and poorly understood, greatly hindering the development of AD drugs. Here we report a comprehensive evaluation of the cytotoxicity of the aggregates by meta-analysis. The analysis indicates that the cytotoxicity of the aggregates converges in a narrower range in the mass concentrations than in the molar concentrations, suggesting that it is the weight of the aggregates rather than the number of the molecules that dictates the cytotoxicity. This new perspective implies that these aggregates are likely to have non-specific interactions with cells to cause cell death. The comparison of several existing theories regarding cellular volumes supports that the aggregates may result in crowding effect and increase the free energy, thus resulting in instability of the cells.     

Effect of colour of drugs: systematic review of perceived effect of drugs and of their effectiveness.

OBJECTIVE: To assess the impact of the colour of a drug''s formulation on its perceived effect and its effectiveness and to examine whether antidepressant drugs available in the Netherlands are different in colour from hypnotic, sedative, and anxiolytic drugs. DESIGN: Systematic review of 12 published studies. Six studies examined the perceived action of different coloured drugs and six the influence of the colour of a drug on its effectiveness. The colours of samples of 49 drugs affecting the central nervous system were assessed using a colour atlas. MAIN OUTCOME MEASURES: Perceived stimulant action versus perceived depressant action of colour of drugs; the trials that assessed the effect of drugs in different colours were done in patients with different diseases and had different outcome measures. RESULTS: The studies on perceived action of coloured drugs showed that red, yellow, and orange are associated with a stimulant effect, while blue and green are related to a tranquillising effect. The trials that assessed the impact of the colour of drugs on their effectiveness showed inconsistent differences between colours. The quality of the methods of these trials was variable. Hypnotic, sedative, and anxiolytic drugs were more likely than antidepressants to be green, blue, or purple. CONCLUSIONS: Colours affect the perceived action of a drug and seem to influence the effectiveness of a drug. Moreover, a relation exists between the colouring of drugs that affect the central nervous system and the indications for which they are used. Research contributing to a better understanding of the effect of the colour of drugs is warranted.     

Tourette's syndrome: update.

Tourette''s syndrome is a widely misunderstood chronic disorder that develops in childhood and is usually lifelong. It is characterized by waxing and waning of involuntary motor and phonic tics. The features and differential diagnosis are discussed in this paper. The estimated prevalence rate of Tourette''s syndrome, 0.05%, implies that this disorder is not rare. The reasons for diagnostic confusion are outlined, and the genetic and neurotransmitter features discussed. The management of Tourette''s syndrome has become more effective with the availability of at least two psychoactive drugs, haloperidol and pimozide. Although the cause of this syndrome is thought to be organic, these drugs and their adverse effects are best known to psychiatrists. Psychiatric and multidisciplinary intervention is often necessary because of the frequent association of psychosocial problems, cognitive and learning difficulties, and aggravation of the symptoms by stress. The understanding of Tourette''s syndrome will probably increase significantly with the advent of the newer imaging techniques and the rapid progress of research in the neurosciences.