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PubMed2001

[Radiosurgery of cerebral arteriovenous malformations: methodology of the dose prescription and its implications for dosimetric results. Retrospective study of 408 cases].

PURPOSE: To study dosimetric implications of our group dose prescription methodology on a series of 408 cerebral arteriovenous malformations. MATERIAL: and method. Between January 1990 and July 1998, 408 patients with cerebral arteriovenous malformations that had never been irradiated before, were treated radiosurgically in a single fraction at Tenon Hospital. 223 patients were treated with a single isocentre and 185 with multiple isocenters. Dosimetric characteristics have been studied as a function of the global quality index of planning, defined our group as the standard deviation of the differential dose volume histogram calculated in the lesion. RESULTS: One percent correlation obtained between some dosimetric data and the global quality index of planning allowed to modelize by linear equations the connection between this quality index and minimum isodose in the lesion, mean doses and isodoses in the underdosed part of the lesion and in the complete lesion. This was done for mono isocentric cases and multi isocentric cases. CONCLUSION: Before the choice of the therapeutic dose and prescription isodose, it is therefore possible from the global quality index of planning to foresee isodoses modelized by the defined equations. So, the radiotherapist can compensate using the prescription since conformity is not perfect and thus attenuate healthy tissues overdosage.

Cohort Studies↗
PubMed1998

[Effect of different prescriptions for tonifying kidney on RNA transcription activity in isolated nuclei and protein synthesis activity in free-cell extracts of the different organs of presenile mice].

OBJECTIVE: To study the anti-aging mechanism of Zuoguiyin (a prescription for tonifying Kindney Yin) and Yishenbao (a prescription for tonifying Kidney Yang) in presenile mice. METHODS: Using male, 14 months old presenile mice as a model of Kidney-Asthenia, the effects of Zuoguiyin and Yishenhao on RNA transcription activity in isolated nuclei and protein synthesis activity in free-cell extracts of the liver, brain, kidney and testes of the presenile mice were observed. RESULTS: RNA transcription activity in isolated nuclei and protein synthesis activity in free-cell extracts of the four organs of the presenile mice group were distinctly lower than those of young mice group (3 months old). After above-mentioned two prescriptions were given to the presenile mice for two months, RNA transcription activity in isolated nuclei and protein synthesis activity in free-cell extracts of the four organs of the two treated groups were obviously higher than those of control group (P < 0.05 or P < 0.01), but there was no difference between two treated groups. CONCLUSIONS: Both Zuoguiyin and Yishenbao could promote RNA transcription activity in isolated nuclei and protein synthesis activity in free-cell extracts of Kidney-Asthenia and presenile mice.

Aging↗
PubMed2001

A multicenter survey on automated peritoneal dialysis prescription in children.

Automated peritoneal dialysis (APD) is considered the first-choice chronic peritoneal dialysis modality for pediatric patients. Nighttime APD courses reduce the impact of PD treatment on a patient's and family's way of life, and the wide range of prescription options permit the dialysis schedule to be tailored to the needs of children of varying age and body size. We registered data concerning the dialytic regimens adopted in 12 pediatric dialysis centers for the treatment of 110 children on APD. Of the 110 children, 64 (aged 7.6 +/- 5.1 years) were on nightly intermittent peritoneal dialysis (NIPD); 29 (aged 9.2 +/- 4.3 years) were on tidal peritoneal dialysis (TPD); and 17 (aged 8.2 +/- 4.9 years) were on continuous cycling peritoneal dialysis (CCPD). The main prescription parameters for the various regimens (mean +/- standard deviation) were these: NIPD--exchanges: 13.0 +/- 5.8; duration: 10.0 +/- 1.1 hours; dwell volume: 36.5 +/- 6.2 mL/kg body weight (BW); glucose concentration: 1.69% +/- 0.41%. TPD--exchanges: 23.3 +/- 8.1; duration: 10.0 +/- 1.0 hours; dwell volume: 36.1 +/- 5.9 mL/kg BW; glucose concentration: 1.63% +/- 0.37%. CCPD--exchanges: 13.0 +/- 4.7; duration: 10.1 +/- 1.3 hours; dwell volume: 37.7 +/- 5.2 mL/kg BW; glucose concentration: 1.65% +/- 0.28%. Tidal volume was 52.2% +/- 9.0% of initial fill volume. Daytime dwell volume was 54.8% +/- 17.3% of night volume in CCPD patients, and 56.6% +/- 13.3% in 9 patients on continuous TPD. Because the patient population in this report varied in age, body size, and metabolic needs, the resulting range in prescription parameters was quite wide. Nevertheless, the duration of nightly PD sessions averaged 10 hours, fill volume averaged 36 mL per kilogram body weight, and daytime volume averaged 50% of nighttime fill volume.

Child↗
PubMed1994

[Jan Radlica prescription from the years of his episcopacy in Cracow (1382-1392)].

In 1953 the author for the first time published the Polish translation of five prescriptions of a Cracow bishop and doctor Jan Radlica dating from his episcopacy in Cracow between 1382 and 1392. They were addressed probably to his Hungarian friend of an unknown name in a form of the letter. Prescriptions contain medicines like pills, syrup, brew, poultice and a pear fruit to be applied in case of a headache. Following an extensive characteristics of Radlica as a physician presented by Stanisław Sroka, the author read again Radlica's paper from the Middle Ages and analysed the contents of his prescriptions pointing the degree to which Radlica based on the works of Mesue the Younger and Mattheus Platearius. On the grounds of the above considerations Radlica must have been an important consultant for the recepient of the letter well read in pharmacotherapy able to precisely describe the preparation of medicines and making them easily available to the sick.

History of Pharmacy↗
PubMed2001

Prophylactic effect of four prescriptions of traditional Chinese medicine on alpha-naphthylisothiocyanate and carbon tetrachloride induced toxicity in rats.

AIM: To study the prophylactic effects of four Chinese traditional prescriptions against experimental liver injury. METHODS: Liver toxins, alpha-naphthylisothiocyanate (ANIT), and carbon tetrachloride (CCl4) were used to induce acute liver injury. Simo Yin(SMY), Guizhi Fuling Wan (GFW), Xieqing Wan (XQW), and Sini San (SNS) were fed (500 mg/kg, in saline, po) to the rats before toxin administration. All the animals were killed 48 h after toxin insulted. Serum index of liver function and hepatic lipid peroxidation (LPO) were estimated. Histopathological observation was conducted simultaneously. RESULTS: The rats treated with ANIT exhibited elevations of serum total bilirubin (TBI), alkaline phosphatase (ALP), glutamate-oxalate- transaminase (GOT), glutamate-pyruvate-transaminase (GPT), as well as cholestasis and parenchyma necrosis. In rats, challenged with ANIT, receiving the pre-treatment of prescriptions of SMY, XQW, and SNS, the biochemical and morphological parameters of liver injury were significantly reduced. The increased LPO level in liver tissue, associated with the provoked serum GOT and GPT levels were the salient features observed in CCl4-insulting rats. Pre-treatment of four prescriptions showed a remarkable protective effect, and also was effective in counteracting the free radical toxicity by bringing about a significant decrease in peroxidative level. CONCLUSION: These recipes ameliorate liver damage induced by both ANIT and CCl4 despite the differences in their mechanisms of injury. Therefore they may be able to exert hepatoprotective effects through more than one mechanism of action because they contained a mixture of anti-hepatotoxic ingredients with mutual reinforcement and assistance.

1-Naphthylisothiocyanate↗
PubMed2000

[Effects of qufengshi prescription on release of hydrogen peroxide and interleukin-1 from peritoneal macrophage in adjuvant arthritis rat].

OBJECTIVE: To study the mechanism of antiarthritis effects of Qufengshi Prescription. METHODS: Adjuvant arthritis (AA) was applied as pathological model of rheumatoid arthritis and prednisone was used as positive control. RESULTS: The Prescription at high and medium dosages significantly decreased the rising level of hydrogen peroxide and interleukin-1 in AA rats (P < 0.05), the potency being similar to prednisone. CONCLUSION: Qufengshi Prescription Could reduce the rising level of interleukin-1 and hydrogen peroxide in AA rats, which may be part of mechanism of the antiarthritis effect.

Animals↗
PubMed1999

[The establishment of prescription dose system for radiotherapy on accelerator's X-ray].

This study aimed at how to calculate the prescription dose quickly and accurately. According to the conditions of radiotherapy and the dose of target point. RT-100 Radiotherapy Dosemetre, which was calibrated at the Industrial Health Institute of National Ministry of Health, was used to detect the dose distribution of special points in the phantom. Functions of dose distribution were fitted on the basis of the detected points. The dose ratio was introduced, and the calculation protocol indexed with Chinese for prescription dose was programmed. The doses of assumed points at the phantom which imitated various conditions of radiotherapy were detected. The detected doses were very close to the calculated doses, with the relative error less than 1.2%. It is concluded that dose of target point can be transformed to the prescription dose quickly and accurately with the method of dose ratio.

Particle Accelerators↗
PubMed2003

Inappropriate antibiotic prescription to children with acute respiratory infection in Brazil.

OBJECTIVE: To determine the rate of inappropriate antibiotic prescription and to describe the types of antibiotics prescribed by health workers to children with acute respiratory infection (ARI). DESIGN: Cross-sectional survey conducted in 6 state capitals of Brazil. METHODS: A representative sample of facilities was selected in each state using a cluster sampling method based on the mean number of visits of children less than 5 years of age. In each facility, consultations were observed and children were reassessed following standard guidelines. Health worker s diagnosis and treatment were compared with a gold standard and inappropriate antibiotic prescriptions noted. RESULTS: 1565 children with ARI from 156 health facilities (73% health centers) were included in study. Most children had a common cold (77.5%). Antibiotics were inappropriately prescribed in 9.2% (95% CI: 7.8, 10.7) of ARI cases (range: 2.8% to 25%). Most frequently prescribed antibiotics were those recommended by the ARI Program. Seventy-six percent of health workers explained to guardians how to use antibiotics at home and 3.9% demonstrated the first dose. Antibiotics were available in 84% of health facilities. CONCLUSION: Inappropriate prescription of antibiotics varied geographically in Brazil. More training and supervision is needed to decrease it.

Acute Disease↗
PubMedDate not supplied

A proposed ethical framework for prescription drug benefit allocation policy.

OBJECTIVES: To present an ethical framework that could aid prescription drug benefit design and to propose that such a framework could be organized around a benefit allocation hierarchy. SUMMARY: Four hierarchical levels of allocation are proposed, as follows: (1) drug categories and subcategories, (2) individual drugs within covered drug categories, (3) specific indications of covered drugs, and (4) special features of drug use, such as quantities covered for specific indications. Rationales for decision making should address the distinct ethical issues apparent at each level. CONCLUSION: Ethical issues associated with designing and managing a pharmacy benefit can be identified by using a hierarchical prescription drug allocation scheme. Articulating these issues is an important first step toward arriving at a fully developed framework that will serve to produce rationales acceptable to typical stakeholders in prescription drug benefits.

Health Policy↗
PubMed2003

Supply and demand: negotiating the prescription drug labyrinth to reduce costs.

Prescription drug costs are increasing at a rate of 15% to 17% a year and a look into the future does not bring much better news. Employers can expect to see more numbers like these as doctors more aggressively treat diseases using drug therapy, the population continues to age and pharmaceutical companies continue to spend billions of dollars on direct-to-consumer advertising aimed at consumers who are desensitized to the true costs of their prescriptions. In this environment, it is unlikely that companies can realistically expect to reverse costs of even to avoid cost increases. However, this article provides employers with a prudent approach to managing both the supply and demand sides of the prescription drug equation in order to reduce their level of increase. Supply-side management focuses on negotiations with vendors, while the demand side focuses on managing employee utilization.

Cost Control↗
PubMed2002

Prescription medication use aboard US submarines during periods underway.

Since January 1997, automated medical records from U.S. submarines have been stored in a centralized database as part of a descriptive epidemiology study. 200 medical encounter notes were randomly selected from 1,017 initial health visits during submarine underway periods between April 1996 and January 1998. Medication prescription appropriateness was assessed using a modified Medication Appropriateness Index (MAI) described in the literature. Seven diagnostic categories accounted for 51.4% of all diagnoses: acute upper respiratory infections (17.6%), superficial wounds (9.7%), elevated blood pressure without the diagnosis of hypertension (7.9%), sprain/strains (4.7%), skin infections (4.3%), eye disorders (3.6%), and ear disorders (3.6%). Prescribed medications were consistent with the care of minor health problems. Mean number of medications prescribed per encounter was 1.4 +/- 1.1 (S.D.). 84% of prescribed medications were assigned a modified MAI summary score of 0, indicating the prescription was appropriate in all aspects. However, anti-infective medication prescriptions demonstrated a significant proportion of non-zero summary scores suggesting some room for improvement in the prescribing practices for this specific medication category.

Algorithms↗
PubMed2003

Clinical observation on treatment with the kidney-tonifying prescription in 25 cases of postmenopausal osteoporosis.

UNLABELLED: To observe the therapeutic effects of the kidney-tonifying prescription in the treatment of postmenopausal osteoporosis (PMOP), 45 cases of PMOP were selected and randomly divided into two groups, the treatment group treated with the kidney-tonifying prescription and routine western drugs, and the control group treated with routine western drugs. After a 8-month treatment, the total effective rate of the treatment group reached 96%, obviously superior to that of the control group (50%, P < 0.05); and the level of estradiol and bone mineral density (BMD) had obviously been increased (P < 0.05). CONCLUSION: The kidney-tonifying prescription has the effects of improving the clinical symptoms, and increasing the level of estrin and BMD.

Aged↗
PubMedDate not supplied

[Detectig errors in chemotherapy prescription].

OBJECTIVE: To analyse errors detected in the prescription of cytostatic drugs. MATERIAL AND METHODS: Prospective study (February 1st to April 15th, 2002). All medical orders containing cytostatic agents were checked and 13 variables were studied: identification, anthropometric data, diagnosis, protocol, number of cycles, cytostatic drug, length of treatment, dose, route of administration, volume of infusion and/or final concentration, infusion time, diluent, and doctor's signature. Several possible errors were identified for each variable. Information on whether it was the first cycle, prescribing service, and prescription format was also recorded. RESULTS: In all, 618 medical orders were reviewed for a total of 1178 lines of cytostatic agents and 2,171 doses. The possible number of errors was 12.101 and the total number of errors actually found was 2,706 (22,03%). Not all these errors had the same impact on patients. Errors by omission were 2,340 (87,77%). Those which nursing staff found difficult to check and/or administer stood at 281 (10,54%). Potentially serious errors numbered 60 (2.06%): wrong body area > 10%: 5; wrong body area 5-10%: 2; erroneus protocol: 2; incorrect volume: 16; wrong dosage: 23 (difference < 25%: 5; difference 10-25%: 14; difference < 10%: 4). Reductions indicated but not implemented: 9; Inappropiate diluent: 3. There were no incorrect or omitted medications. CONCLUSION: The description of such errors and their uantification is a useful method of quality asurance in order to establish appropiate corrective measures. The most common error was the omission of information and therefore this issue, along with the development of computerised prescriptions, should be addressed.

Antineoplastic Agents↗
PubMed1992

[A functional explanation of normative prescriptive-evaluative judgments and the concept of "evolutionary ethics"].

Neodarwinian ethology, today above all represented by sociobiology, is conceived of by responsible exponents as a descriptive and explanatory theory that cannot include any normative declarations. Still other, indeed notable, authors belonging to the discipline in question, either underhand or frankly employ prescriptive or evaluative judgments, or they claim (what is not an insight of natural science) that it is impossible to provide a rational foundation for prescriptive or evaluative judgments. (Michael Ruse and Edward O. Wilson even assert the latter without relinquishing the former.) Several functional explanations of normative validity claims advanced by Michael Ruse, Edward O. Wilson, Donald T. Campbell, Florian von Schilcher and Neil Tennant are designed to show that prescriptive or evaluative judgments cannot be justified. The reasonableness of this move is, however, dubious, because it implies strategies of raising oneself into a privileged status or of rendering the position of oneself immune from criticism by shifting it among the objects of the theory. Then Wilson's concept of 'evolutionary ethics' is thoroughly--and critically--analyzed. The suspicion that Wilson's fallacies in the transition from biological facts to moral norms are of exemplary nature is finally examined on the basis of tenets advanced by Herbert Spencer, Wolfgang Wickler, and Hans Mohr.

Bioethics↗
PubMed2003

[Effect of supplemented danggui shaoyao powder and its disassembled prescriptions on lymphocytes proliferation in aged rats].

OBJECTIVE: To study the effect of supplemented Danggui Shaoyao San (DSS) and its disassembled prescriptions on function of lymphocyte in aged rats. METHODS: Rats aged 18 months were administered with decoction of DSS and its disassembled prescriptions separately in groups for 3 weeks to prepare drug containing serum. Samples of ConA induced rats splenic lymphocytes proliferation was treated respectively with prepared drug serum, for testing their effect on lymphocyte proliferation using methyl thiazolyl tetrazolium (MTT) method, and isoprel (ISO) and propranolol were taken as the controls. RESULTS: The A value of lymphocyte proliferation in the drug serum treated groups was significantly different from that in the control groups (P < 0.01), which could be reduced markedly after treatment with ISO, but could restore to the level before ISO treatment by adding drug serum or propranolol. CONCLUSION: DSS and/or its disassembled prescriptions could raise the lymphocyte proliferation in aged rats significantly, it also shows antagonizing effect against the inhibition of ISO on lymphocyte proliferation.

Aging↗
PubMed2003

Self-administration of epinephrine in children: a survey of current prescription practice and recommendations for improvement.

The prevalence of peanut allergy is increasing rapidly and many children are now prescribed self-injectable epinephrine as part of their management. We aimed to examine the current extent of self-injectable epinephrine dispensing to children in the Eastern Health and Social Services Board (EHSSB), Northern Ireland, including indications for prescription, investigations performed, information and training provided and actual usage. Dispensing records held by the EHSSB were examined for the period May to August 1998. All general practitioners prescribing 'Epipens' during this period were contacted and asked to identify the patient and provide contact details. Information was gathered using postal questionnaires sent to General Practitioners and parents. A total of 104 'Epipen' prescriptions were dispensed. Thirty-seven (36%) general practitioners responded to the initial questionnaire; of these 36 (35%) were suitable for analysis. Thirty-four parents were then contacted; 28 (82%) returned questionnaires were reviewed. The commonest indication for 'Epipen' prescription was peanut allergy (32 of 36 (89%) general practitioner responses; 25 of 28 (89%) parent responses). Twenty-six (72%) children had been seen by a specialist; all except one had either blood or skin tests. Six of the remaining eight children had no investigations. General practitioners reported 14 (39%) parents to have basic life support training, compared with six (21%) parents. Eighteen (64%) parents had been given written information regarding their child's allergy, nine (32%) had been referred to a dietician and seven (25%) children wore a medical warning bracelet. The Epipen had been used by three children; all three had multiple food allergies. This study has identified a great variability in the management of children with allergy including the need for specialist referral, further investigation, written allergy advice, referral to a dietician and formalised training in basic life support and administration of epinephrine. It suggests a lack of consensus amongst health care professionals as to the best practice in the management of potentially life threatening food allergy and indicates, at least, a need for better multidisciplinary communication.

Adolescent↗
PubMedDate not supplied

Questionnaire survey of management and prescription of general practitioners in knee osteoarthritis: a comparison with 2000 EULAR recommendations.

OBJECTIVE: A large-scale questionnaire survey on the way to handle and treat knee osteoarthritis (OA) was conducted with French general practitioners (GPs). Results of this questionnaire were compared with the 2000 EULAR recommendations on the treatment of knee OA. RESULTS: There was a high response rate among GPs (70%). Major findings included a high request rate for radiological examinations even if not required (about one-third of GPs in the case of a non-inflammatory condition); the under-utilization of non-pharmacological treatments as a first line approach; the prescription of paracetamol as the first-line drug; the co-prescription of non-steroidal anti-inflammatory drugs in 40% as a first-line approach; and a low rate of corticoidsteroid prescription. CONCLUSIONS: There is reasonable agreement between the results of this survey and EULAR 2000 recommendations. However, non-pharmacological approaches are under-utilized and should be reinforced.

Evidence-Based Medicine↗
PubMed2004

[Determination of the total alkaloid content of Rhizoma coptidis in Gegenqinlian prescription].

OBJECTIVE: To determine the total content of alkaloids from Rhizoma coptidis in the traditional Chinese medicine prescription Gegenqinlian. METHODS: The extract of Gegenqinlian decoction and powder of the minipills were respectively purified with alumina column chromatography, and the total alkaloid content of Rhizoma coptidis in these preparations was determined using ultraviolet spectrophotometry at 350 nm. RESULTS: The total alkaloid content was 32.4 mg/g in the aqueous extract of Gegenqinlian decoction and 19.6 mg/g in Gegenqinlian minipills, with a recovery rate of 98.1% (RSD=2.9%). CONCLUSION: The method we employed yields accurate and stable results with much sensitivity for quality control of Gegenqinlian minipills, and also provides reference for study of Gegenqinlian prescription and other prescriptions that contain Rhizoma coptidis.

Berberine Alkaloids↗