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1.
Zhongguo Zhen Jiu ; 41(1): 105-9, 2021 Jan 12.
Artigo em Chinês | MEDLINE | ID: mdl-33559453

RESUMO

Summarized the characteristics and rules of DOU Han-qing's acupuncture prescription in ancient acupuncture and moxibustion literature, and provided reference for studying DOU Han-qing's academic thought and modern acupuncture clinic. The literature of DOU 's acupuncture prescription was collected, sorted out and input, the database of DOU Han-qing's acupuncture prescription was established, the frequency of acupoints in the prescription was analyzed, and the Apriori algorithm was used to analyze the rule of acupoints in the prescription. A total of 446 DOU Han-qing's acupuncture prescriptions are included, and the maximum number of acupoints in acupuncture prescriptions is 12. The most common diseases are internal medicine syndrome, pain syndrome of head, face and body and five sense organs disease. In all the prescriptions of DOU Han-qing, 205 acupoints are used in total, including 25 extra-meridian points. There are 7 groups of acupoint pairs with the strongest correlation in DOU Han-qing's acupuncture prescription, including Hegu (LI 4) - Zusanli (ST 36), Zusanli (ST 36) - Zhongwan (CV 12), Hegu (LI 4) - Quchi (LI 11), Hegu (LI 4)-Weizhong (BL 40), Quchi (LI 11) - Jianjing(GB 21), Weizhong (BL 40) - Quchi (LI 11) and Weizhong (BL 40)-Zusanli (ST 36). The principle of acupoint selection mainly includes near acupoint selection and far acupoint selection. In the method of matching acupoints, above and below the matching acupoints, this meridian matching acupoints and inner and outer meridian matching acupoints are used. DOU pays attention to the coordination of acupuncture and moxibustion methods with acupoints and emphasizes acupuncture sequence.


Assuntos
Terapia por Acupuntura , Acupuntura , Meridianos , Moxibustão , Pontos de Acupuntura , Prescrições
2.
J Assoc Physicians India ; 69(2): 22-24, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33527806

RESUMO

Background: Exercise prescription has always been a mandatory yet extremely under rated non-pharmacological approach in management of diabetes mellitus. SMART acronym for S - specific, M - measurable, A - attainable, R - realistic, T - time oriented, is a newly proposed idea for implementing the same with supposedly better results. We tried to analyse the results objectively by SMART prescription of individualized exercise regimes to patients along with medicines. Methods: Single centred, prospective study conducted over a time span of 3 months, on 75 patients, with biweekly follow-up. At the end of three months, we evaluated the results (of 52 patients who remained) by comparing random blood sugar and glycosylated haemoglobin values of the patients at the beginning and end of the trial. Results: A significant reduction in blood sugar (p-0.023) and A1C levels (p-0.105; ns) was noted after a period of three months; with an average reduction of 31mg/ dl and 0.37% noted in each respectively. Additional benefits of better follow up, reduced financial burden, increased compliance to the said regimen were observed. Discussion: Recommending exercise and lifestyle changes is as important as pharmacological management in diabetes. A SMART approach, methodical prescription of the exercise routines and drugs- individualized for patients, will likely have better results and patient satisfaction. A practice of switching to precise written suggestions than verbal ideas and reviewing the progress on every follow up visit may improve the outcome.


Assuntos
Diabetes Mellitus Tipo 2 , Diabetes Mellitus , Glicemia , Diabetes Mellitus/terapia , Hemoglobina A Glicada/análise , Humanos , Prescrições , Estudos Prospectivos
3.
FASEB J ; 35(2): e21303, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33433026

RESUMO

In the midst of the current coronavirus pandemic, the United States continues to struggle with an ongoing opioid epidemic, initially fueled by widespread prescribing of opioid medications during the 1990s. The primary reason for prescribing opioids is to treat pain. Women have more acute and chronic pain and have been prescribed these drugs in significantly greater numbers than men. Comparison of women and men with chronic pain also shows that women receive the majority of prescription opioids, and the use of these prescribed medications became the major pathway to misuse and addiction for women. Yet, recognition of the extent of women's exposure to opioids and the attendant consequences has been limited. Attempts to stem the overall tide of the epidemic focused on reducing the availability of prescription opioids. However, as these medications became more difficult to obtain and treatment opportunities were limited, many turned to other synthetic opioids, such as heroin and fentanyl. Thus, the public health crisis of opioid addiction has endured. This paper highlights the importance of understanding differences among women and men in opioid use and its biological and psychosocial effects to advance the gender-based treatment approaches and effective public health policy.


Assuntos
Analgésicos Opioides/uso terapêutico , Dor Crônica/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Fatores Sexuais , Feminino , Humanos , Masculino , Transtornos Relacionados ao Uso de Opioides/terapia , Pandemias , Prescrições/estatística & dados numéricos , Estados Unidos/epidemiologia
4.
BMC Infect Dis ; 21(1): 97, 2021 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-33478430

RESUMO

BACKGROUND: Inappropriate antibiotic use is linked to the spread of antimicrobial resistance worldwide, but there are limited systemic data on antibiotic utilization in low- and middle-income countries. The purpose of this study was to evaluate the prevalence and patterns of antibiotic prescription in an ambulatory care setting in Sri Lanka. METHODS: This cross-sectional survey was conducted at the Outpatient Department of a public tertiary medical center in Southern Province, Sri Lanka from February to April 2019. Among consecutive outpatients presenting for care, questionnaires were verbally administered to a systematic random sample to capture information about patient demographics, illness characteristics, and visit outcomes. Prescription data were obtained from the outpatient pharmacy's electronic prescribing system. RESULTS: Of 409 surveyed patients, 146 (35.7%) were prescribed an antibiotic. The most frequently prescribed agents were amoxicillin (41 patients, 28.1% of antibiotic recipients) and first-generation cephalosporins (38, 26.0%). Respiratory indications were the most common reason for antibiotic use, comprising 69 (47.3%) of all antibiotic prescriptions. Antibiotics were prescribed for 66.1% of patients presenting with cough and 78.8% of those presenting with rhinorrhea or nasal congestion. Among all antibiotic recipients, 6 (4.1%) underwent diagnostic studies. CONCLUSIONS: A high prevalence of antibiotic prescription was observed, in particular for treatment of respiratory conditions. These data support the need for improved antimicrobial stewardship in the Sri Lankan outpatient setting.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Antibacterianos/uso terapêutico , Prescrições/estatística & dados numéricos , Doenças Respiratórias/tratamento farmacológico , Adolescente , Adulto , Gestão de Antimicrobianos , Criança , Estudos Transversais , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Padrões de Prática Médica , Prevalência , Doenças Respiratórias/diagnóstico , Doenças Respiratórias/epidemiologia , Sri Lanka/epidemiologia , Centros de Atenção Terciária , Adulto Jovem
5.
Artigo em Inglês | MEDLINE | ID: mdl-33504042

RESUMO

The health crisis caused by COVID-19 has had a huge impact on the provision of physiotherapists' services during the pandemic. Patellofemoral pain syndrome (PFPS) is a major health problem and one of the most common causes of pain in the front of the knee in outpatients. The objective was to evaluate the effectiveness of a therapeutic physical exercise (TPE) program supervised by a physiotherapist using telematic channels in reducing pain and disability in a sample of 54 patients with PFPS in the Physiotherapy Service of the San José de la Rinconada Health Center (Seville). Subjects were evaluated pre- and post-intervention (4 weeks-12 treatment sessions). An analysis was made of perceived pain-using the visual analog scale (VAS) and the DN4 neuropathic pain questionnaire-and functional balance-through the Kujala Score test and the Lower Extremity Functional Scale. The supervised TPE program in patients with PFPS produced a reduction in pain: VAS F1, 52 = 8.68 (p = 0.005) η2 = 0.14 and DN4: F1, 52 = 69.94 (p = 0.000) η2 = 0.57; and in Lower Extremity Functional Scale (LEFS) disability: F1, 52 = 19.1 (p = 0.000) η2 = 0.27 and KUJALA: F1, 52 = 60.28 (p = 0.000) η2 = 0.54, which was statistically significant (p = 0.000 for p < 0.05). Hence, the TPE program presented was effective in reducing pain and disability in patients with PFPS.


Assuntos
Terapia por Exercício , Pandemias , Síndrome da Dor Patelofemoral , Telemedicina , Humanos , Síndrome da Dor Patelofemoral/terapia , Prescrições , Avaliação de Programas e Projetos de Saúde
10.
PLoS One ; 15(12): e0243416, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33373370

RESUMO

AIMS: To compare the value of pre-treatment axial elongation (AE) and changes in refractive sphere (M change) for predicting the success in orthokeratology (ortho-k), in order to better identify suitable candidates for myopia control. METHODS: This study further analysed the data of 66 subjects receiving 7-month ortho-k treatment, following a 7-month observation period, during which single-vision spectacles were worn. Rate of myopia progression was determined by AE and M change and subjects categorised as slow, moderate, or rapid progressors based on these changes. Outcomes of myopia control, based on the AE reduction after ortho-k, were classified as 'ineffectual', 'clinically insignificant', or 'beneficial'. RESULTS: Of the 20 subjects, initially categorised as slow by AE and, of whom 95% were similarly categorised by M change, none benefitted from ortho-k. In contrast, of the 22 subjects with moderate AE, 77% and 23% displaying slow and moderate M change, respectively, the majority (73%) benefitted from ortho-k lens wear. The 24 subjects with rapid AE were poorly identified by M change, with only 21% correctly categorised. The vast majority of rapid progressors showed significant benefit after ortho-k. CONCLUSION: Progression of AE is a good indicator of subsequent success of ortho-k treatment. Delaying commencement of therapy is prudent for children with slow progression as results indicate that they would be unlikely to benefit from this intervention. As change in refractive error frequently underestimates rapid progression of AE, its value for identifying appropriate candidates for myopia control is poor.


Assuntos
Miopia Degenerativa/terapia , Miopia/terapia , Procedimentos Ortoceratológicos/métodos , Erros de Refração/fisiopatologia , Adolescente , Comprimento Axial do Olho/fisiopatologia , Criança , Lentes de Contato , Progressão da Doença , Óculos , Feminino , Humanos , Cristalino/patologia , Masculino , Miopia/patologia , Miopia Degenerativa/patologia , Prescrições , Refração Ocular/fisiologia
12.
Lancet Digit Health ; 2(5): e250-e258, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-33328057

RESUMO

BACKGROUND: Acute diarrhoeal disease management often requires rehydration alone without antibiotics. However, non-indicated antibiotics are frequently ordered and this is an important driver of antimicrobial resistance. The mHealth Diarrhoea Management (mHDM) trial aimed to establish whether electronic decision support improves rehydration and antibiotic guideline adherence in resource-limited settings. METHODS: A cluster randomised controlled trial was done at ten district hospitals in Bangladesh. Inclusion criteria were patients aged 2 months or older with uncomplicated acute diarrhoea. Admission orders were observed without intervention in the pre-intervention period, followed by randomisation to electronic (rehydration calculator) or paper formatted WHO guidelines for the intervention period. The primary outcome was rate of intravenous fluid ordered as a binary variable. Generalised linear mixed-effect models, accounting for hospital clustering, served as the analytical framework; the analysis was intention to treat. The trial is registered with ClinicalTrials.gov (NCT03154229) and is completed. FINDINGS: From March 11 to Sept 10, 2018, 4975 patients (75·6%) of 6577 screened patients were enrolled. The intervention effect for the primary outcome showed no significant differences in rates of intravenous fluids ordered as a function of decision-support type. Intravenous fluid orders decreased by 0·9 percentage points for paper electronic decision support and 4·2 percentage points for electronic decision support, with a 4·2-point difference between decision-support types in the intervention period (paper 98·7% [95% CI 91·8-99·8] vs electronic 94·5% [72·2-99·1]; pinteraction=0·31). Adverse events such as complications and mortality events were uncommon and could not be statistically estimated. INTERPRETATION: Although intravenous fluid orders did not change, electronic decision support was associated with increases in the volume of intravenous fluid ordered and decreases in antibiotics ordered, which are consistent with WHO guidelines. FUNDING: US National Institutes of Health.


Assuntos
Tomada de Decisões Assistida por Computador , Sistemas de Apoio a Decisões Clínicas , Assistência à Saúde , Diarreia/terapia , Hidratação/métodos , Fidelidade a Diretrizes , Administração Intravenosa , Adolescente , Adulto , Antibacterianos , Bangladesh , Criança , Pré-Escolar , Assistência à Saúde/normas , Eletrônica , Feminino , Hospitais , Humanos , Lactente , Masculino , Papel , Prescrições , Atenção Primária à Saúde , Organização Mundial da Saúde , Adulto Jovem
13.
Zhongguo Zhong Yao Za Zhi ; 45(21): 5103-5109, 2020 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-33350225

RESUMO

In this study, common prescriptions were retrieved from existing data in multiple ways to determine the selection principle of common formulas in traditional Chinese medicine(TCM) clinical practice guidelines. Taking the selection of common prescriptions in the clinical practice guidelines of TCM for migraine as an example, we searched common prescriptions for migraines from National Essential Medicine List, the National Drug Catalog for Basic Medical Insurance, Work-related Injury Insurance, and Maternity Insurance, Chinese Pharmacopoeia, three teaching materials and two clinical practice guidelines, and we also electronically searched CNKI, VIP, WanFang about famous clinical experience for migraine published from 1990 to 2019. At the same time, 32 prescriptions commonly used by experts in the clinical questionnaire survey were collected to summarize and analyze the TCM clinically applicable syndrome types and medication rules of the included prescriptions and medicines. From the National Essential Medicine List, the National Drug Catalog for Basic Medical Insurance, Work-related Injury Insurance, and Maternity Insurance, Chinese Pharmacopoeia, we got 12 Chinese patent medicines. From the teaching materials, we got 9 prescriptions. From the clinical practice guidelines, we got 8 prescriptions. We got 3 prescriptions from the experience of famous experts and got 4 prescriptions from experts in the clinical questionnaire survey. A total of 24 prescriptions were included from the above results. External wind syndrome, syndrome of blood stasis and brain blocking, and syndrome of liver Yang transforming into wind were the common syndrome types in the treatment of migraine. Chuanxiong Rhizoma and Angelicae Dahuricae Radix were the most common Chinese herbs in the prescriptions. Chuanxiong Rhizoma-Angelicae Dahuricae Radix was the most common drug pair for the treatment of migraine. By retrieving the data such as the famous clinical experience and teaching materials, we systematically summarized the prescriptions in the treatment of migraine in this study, which can provide a basis for the selection of traditional Chinese medicines in clinical practice guidelines.


Assuntos
Medicamentos de Ervas Chinesas , Transtornos de Enxaqueca , Feminino , Humanos , Medicina Tradicional Chinesa , Transtornos de Enxaqueca/tratamento farmacológico , Medicamentos sem Prescrição , Gravidez , Prescrições
14.
Zhongguo Zhong Yao Za Zhi ; 45(21): 5280-5288, 2020 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-33350246

RESUMO

This study was designed to determine the metabolites of Zhali Nusi Prescription(ZLNSP) in rats. The ultra-high performance liquid chromatography-LTQ Orbitrap mass spectrometric(UHPLC-LTQ-Orbitrap-MS) and mass defect filter techniques were applied to analyze the metabolites of ZLNSP in rat plasma, bile, urine and feces. The biological samples were analyzed by ACQUITY UPLC BEH T_3 column(2.1 mm×100 mm,1.7 µm), with 0.1% formic acid water(A)-acetonitrile(B) as mobile phase, and the biological samples were analyzed in negative ion mode by electrospray ionization mass spectrometry(ESI-MS). An analytical method for biological samples of rats was established, and 8 prototype components and 36 metabolites were identified. The results showed that the metabolic pathways of the main components of ZLNSP in rats included methylation, glucuronidation, sulfation and so on. It provi-ded information for the therapeutic effect of ZLNSP in vivo.


Assuntos
Bile , Plasma , Administração Oral , Animais , Cromatografia Líquida de Alta Pressão , Fezes , Prescrições , Ratos
16.
Tex Med ; 116(10): 38-39, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33126269

RESUMO

Now that Texas prescribers must check a patient's history in the state's prescription monitoring program (PMP) before prescribing opioids, plus three other drug classes, the errors are becoming more apparent.


Assuntos
Analgésicos Opioides , Prescrições de Medicamentos , Relações Médico-Paciente , Padrões de Prática Médica , Programas de Monitoramento de Prescrição de Medicamentos , Prescrições , Humanos , Texas
17.
Stud Health Technol Inform ; 273: 234-239, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-33087618

RESUMO

Respiratory Tract Infections (RTIs) are among the top reasons for visiting a General Practitioner (GP) and the main cause of unnecessary antibiotic prescriptions. Reducing inappropriate use is essential to decrease antibiotic resistance and adverse events. The goal of the Eurostars project "Respiotic" is to develop a new point-of-care (POC) platform based on the centrifugal microfluidic LabDisk that will detect the main responsible viruses and bacteria for community-acquired RTIs, including associated resistances and host biomarkers. The diagnostic platform will use a Polymerase Chain Reaction (PCR) and an immunoassay cartridge on the same instrument and provide the combined analysis within less than 1 h. An electronic clinical algorithm will co-assess the test results and act as a decision support tool for the GPs' patient management and prescriptions.


Assuntos
Sistemas de Apoio a Decisões Clínicas , Infecções Respiratórias , Algoritmos , Humanos , Sistemas Automatizados de Assistência Junto ao Leito , Prescrições , Infecções Respiratórias/diagnóstico
18.
BMC Infect Dis ; 20(1): 804, 2020 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-33121455

RESUMO

BACKGROUND: Misuse and overuse of antibiotics by physicians in the treatment of children is common in China. This study aimed to reveal the overall use of antibiotics to treat children hospitalized in four types of pediatric wards. METHODS: Seven independent point prevalence surveys (PPSs) were conducted in Shanghai Children's Hospital of Shanghai Jiao Tong University over the period 2012 to 2018. Pediatric ward types were defined general pediatric medical, pediatric surgical, pediatric intensive care units (PICU), and neonatal. RESULTS: A total of 3975 pediatric patients were included in the study, of which 63.9% received at least one dose antibiotic. The top five classes of antibiotics administered were cephalosporins (43.8%, n = 1743), penicillins (13.2%, n = 526), carbapenems (8.7%, n = 347), nitroimidazoles (7.1%, n = 281) and macrolides (6.5%, n = 257). The five most commonly used generic antibiotics were cefuroxime (14.9%, n = 594), ceftriaxone (9.7%, n = 387), cefotaxime (9.0%, n = 358), meropenem (8.1%, n = 320) and ampicillin/sulbactam (6.0%, n = 239). Meropenem was among top five antibiotics prescribed in the general pediatric, PICU and neonatal wards and sixth in the pediatric surgical wards. Of all children on antibiotics, 23.4% received prophylactic treatment, and prophylaxis accounted for 68.1% of indications for treatment in the pediatric surgical wards. CONCLUSIONS: Given that over-treatment with third-generation cephalosporins and carbapenems has been associated with treatment-resistant infections, the prescription of these drugs should be strictly controlled and monitored, and measures should be taken to improve the management of surgical prophylaxis in hospitalized children in China.


Assuntos
Antibacterianos/uso terapêutico , Carbapenêmicos/uso terapêutico , Cefalosporinas/uso terapêutico , Hospitais Pediátricos , Penicilinas/uso terapêutico , Centros de Atenção Terciária , Adolescente , Antibioticoprofilaxia , Carbapenêmicos/efeitos adversos , Cefalosporinas/efeitos adversos , Criança , Pré-Escolar , China , Estudos de Coortes , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Feminino , Hospitalização , Humanos , Lactente , Recém-Nascido , Masculino , Prescrições , Prevalência , Inquéritos e Questionários
19.
J Stud Alcohol Drugs ; 81(5): 556-560, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-33028465

RESUMO

People who use drugs (PWUD) face concurrent public health emergencies from overdoses, HIV, hepatitis C, and COVID-19, leading to an unprecedented syndemic. Responses to PWUD that go beyond treatment--such as decriminalization and providing a safe supply of pharmaceutical-grade drugs--could reduce impacts of this syndemic. Solutions already implemented for COVID-19, such as emergency safe-supply prescribing and providing housing to people experiencing homelessness, must be sustained once COVID-19 is contained. This pandemic is not only a public health crisis but also a chance to develop and maintain equitable and sustainable solutions to the harms associated with the criminalization of drug use.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por HIV/epidemiologia , Hepatite C/epidemiologia , Pneumonia Viral/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Sindemia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/prevenção & controle , Criminosos , Overdose de Drogas/complicações , Overdose de Drogas/epidemiologia , Overdose de Drogas/prevenção & controle , Serviços Médicos de Emergência , Infecções por HIV/complicações , Infecções por HIV/prevenção & controle , Hepatite C/complicações , Hepatite C/prevenção & controle , Habitação , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/complicações , Pneumonia Viral/prevenção & controle , Prescrições , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Estados Unidos/epidemiologia , United States Public Health Service
20.
Rev Med Suisse ; 16(710): 1906-1911, 2020 Oct 14.
Artigo em Francês | MEDLINE | ID: mdl-33058575

RESUMO

Cephalosporins belong to the betalactam group and are frequently prescribed in both out and inpatient settings. Their broad spectrum of activity allows a varied use in most medical specialties, ranging from preoperative prophylaxis to treatment of febrile agranulocytosis. There are currently five generations of cephalosporins, mainly differentiated according to their structure, spectrum of activity and side-effect profile. So-called siderophore cephalosporins are active against many multiresistant bacteria, especially in cases of complicated urinary tract infections or ventilator-associated pneumonia. This article intends to review some general clinical principles in prescription and monitoring of patients treated with cephalosporins.


Assuntos
Cefalosporinas/uso terapêutico , Bactérias/efeitos dos fármacos , Cefalosporinas/farmacologia , Humanos , Prescrições , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/microbiologia
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