Study on Substitute Reference Substance Method with DRS Origin Software: A Case Study of Determination of 11-keto-β-boswellic Acid and 11-keto-β-acetyl-boswellic Acid in Frankincense by UHPLC / 中国药学杂志

OBJECTIVE： To establish a UHPLC method for determination of the contents of 11-keto-β-boswellic acid(KAB) and 11-keto-β-acetyl-boswellic acid(AKBA)in Frankincense and explore the suitability and accuracy of substitute reference substance method with DRS origin software for qualitative and quantitative determination of chromatographic peaks. METHODS ：The samples were separated by UHPLC for determination of AKBA and KBA. AKBA was used as a reference to investigate the accuracy of KBA identification using DRS origin software on 19 different C18 columns. The RSDs of relative correction factors were calculated for different detection wavelengths and instruments.The relative correction factor method and the external standard method were selected for quantification and the differences were compared. RESULTS: The established method met the requirements of methodology and the average recovery was 100.21%(n=6) with RSD of 2.47%. The DRS origin software can be used to accurately determine the chromatographic peaks. The correct factor of AKBA vs. KBA was 0.936 and it was consistent under different conditions. There were no significant differences between the content calculated by the relative correction factor method and by the external standard method. CONCLUSION： This method is intelligent, feasible, reliable and economical, and can be used for the determination of frankincense content.

Evaluación del efecto hipolipemiante de Talinum triangulare (falsa espinaca) y Abelmoschus esculentus (quimbombó) / Assessment of hypolipidemic action of Talinum triangulare (water leaf) and Abelmoschus esculentus (okra)

INTRODUCCIÓN: la evaluación de plantas con efecto reductor en los lípidos plasmáticos, constituye una herramienta muy valiosa para el control de las dislipidemias. OBJETIVOS: comprobar la efectividad farmacológica como hipolipemiante, de Talinum triangulare (Jacq.) Willd(Talinaceae) y Abelmoschus esculentus moench (Malvaceae), en dos biomodelos de ensayo. MÉTODOS: se utilizó el fruto verde de A. esculentus y hojas frescas de Talinum triangulare. El material vegetal previo secado, se pulverizó para preparar extractos hidroalcohólicos, que una vez rotoevaporados, fueron suspendidos en agua para ser administrados a los modelos experimentales. El efecto hipolipémico de las plantas estudiadas se comprobó, en animales de experimentación, sometidos a dos modelos de inducción de hiperlipidemia; administración de solución de sacarosa al 63 % durante 16 semanas y administración vía intraperitoneal del detergente no iónico Poloxamer 338, durante 48 horas a una dosis de 0,6 g/kg. RESULTADOS: el extracto hidroalcohólico de A. esculentus (400 mg/kg) en el modelo de hiperlipemia por Dieta Rica en Sacarosa, mostró un efecto reductor de triacilglicéridos, superior al ácido nicotínico. En el modelo de hiperlipidemia por inducción con detergente no iónico, el extracto hidroalcohólico de Talinum triangulare (400 mg/kg), manifestó un efecto reductor de colesterol y triacilglicéridos, mayor que el ácido nicotínico y la atorvastatina. CONCLUSIONES: los extracto hidroalcohólicos de A. esculentus y de Talinum triangulare expresaron efectos reductores de triacilglicérios por mecanismos de acción diferentes, superiores al ácido nicotínico en cada caso. El extracto hidroalcohólico de Talinum triangulare manifestó un potente efecto reductor de colesterol mayor que el ácido nicotínico y la atorvastatina.

INTRODUCTION: assessment of plants with low plasmatic lipids effect is a power instrument to dislipidemias control. OBJECTIVES: to establish the pharmacological effectiveness as hipolipidemic agents of Talinum triangulare (Jacq.) Willd (Portulacaceae) and Abelmoschus esculentus Moench (Malvaceae) in two biomodel assays. METHODS: in the present study we have researched the hypolipemic effect of Talinum triangulare (false spinach) and A. esculentus (okra) in experimental animals subjected to two models of hyperlipidemia induction; an intake of 63 % sucrose solution for 16 weeks and an intake of Poloxamer 338 nonionic detergent via intraperitoneal for 48 hours at a dose of 0,6 g/kg. RESULTS: the hydroalcoholic extract of A. esculentus, at a dose of 400 mg/kg showed triacilglicéridos reducing effect greater than nicotinic acid in the model of hyperlipidemia induction by a sucrose-rich diet. In the model of hyperlipidemia by induction with nonionic detergent, the hydroalcoholic extract of Talinum triangulare at a dose of 400 mg/kg, showed a powerful cholesterol and triacilglicéridos lowering effect, greater than nicotinic acid and atorvastatin. CONCLUSIONS: the hydroalcoholic extract of A. esculentus and T. triangulare showed hypotriglyceridemic effect for different action mechanisms, higher than the nicotinic acid, in each case. The extract hidroalcohólico of Talinum triangulare showed a potent hipocholesterolemic effect even more than the nicotinic acid and the atorvastatin.

Fixation of basicervical and related fractures using DHS with DRS.

Background: Basicervical fracture is a fracture through the base of femoral neck at its junction with the intertrochanteric region. Due to this location, it represents an intermediate form between femoral neck, usually fixed with multiple cancellous screws, and the intertrochanteric fracture, fixed with a sliding screw device. Previous studies recommended treating basicervical fractures as intertrochanteric fractures with the dynamic hip screw (DHS). However, because basicervical fractures have greater instability than stable intertrochanteric fractures, poor functional outcome may be expected when the DHS used alone. Aims & Objective: To evaluate the outcome of fixation of basicervical and related fractures using DHS with DRS. Materials and Methods: We prospectively studied 42 patients in order to identify a group of proximal femoral fractures having liability for axial and rotational instability, and to present results of their fixation using the dynamic hip screw (DHS) with derotation screw (DRS). Results: At 12 months postoperatively, patients were functionally evaluated and the radiological outcome was analysed. All fractures united within an average period of 11.5 weeks. The mean sliding distance was 5.5 mm and mean shortening of the limbs was 2 mm. According to the criteria of Kyle et al. (J Bone Joint Surg [Am] 61-A:216–221), 39 patients obtained excellent results, two good and one fair. Conclusion: We conclude that the AO types B2.1, A1.1, A2.1, A2.2 and A2.3 have a common instability denominator and therefore should be treated alike. The sliding component of the DHS allows solid fixation of the two major fragments in two planes and the DRS in the third plane.

Mattis dementia rating scale (DRS) normative data for the brazilian middle-age and elderly populations / Mattis dementia rating scale (DRS): dados normativos para as populações brasileiras de meia-idade e idosos

OBJECTIVE: To expand norms for the Mattis Dementia Rating Scale (DRS) for the Brazilian middle-age and elderly populations. METHODS: The DRS was administered to 502 individuals without cognitive deficits, 312 women and 190 men, aged 50 years or over and with educational level ranging from 0 to 13 years or more. The sample was composed of subjects who participated in other studies, from Caeté (Minas Gerais state), Ribeirão Preto (São Paulo state) and São Paulo (São Paulo state). Participants were divided into four schooling groups (illiterate, 1 to 4 years, 5 to 12 years and 13 years or more). The subjects were divided into four groups according to age (50 to 60, 61 to 70, 71 to 80, and 80 years or over). RESULTS: Normative data for DRS scores are expressed as percentile values. The group with lowest schooling and subjects older than 80 years had the worst scores. CONCLUSION: As expected, age and education were strongly correlated with DRS scores. Illiterates and older old individuals performed worse than the other groups. These data might help to improve the accuracy of the diagnosis of cognitive impairment and dementia in Brazilian middle-age and elderly populations.

OBJETIVO: Expandir normas para o Mattis Dementia Rating Scale (MDRS) na população brasileira de meia idade e idosa. MÉTODOS: A MDRS foi aplicada em 502 indivíduos, 312 mulheres e 190 homens, com idade de 50 anos ou mais e escolaridade de 0 a 13 anos ou mais anos. A amostra foi composta de sujeitos que participaram de outros estudos: Caeté (Minas Gerais), Ribeirão Preto (São Paulo) e São Paulo (São Paulo). Participantes foram divididos em quatro grupos de escolaridade (analfabetos, 1 a 4 anos, 5 a 12 anos e 13 anos ou mais). Os sujeitos foram divididos em quatro grupos de idade (50 a 60, 61 a 70, 71 a 80 e acima de 80 anos).RESULTADOS: Dados normativos dos escores da MDRS são apresentados em percentis. O grupo com menos escolaridade e sujeitos acima de 80 anos apresentaram escores mais baixos. CONCLUSÃO: Como esperado, idade e escolaridade foram fortemente correlacionados aos escores da MDRS. Analfabetos e indivíduos muito idosos apresentaram pior desempenho que os outros grupos. Os dados podem ajudar a melhorar a acurácia para o diagnóstico de prejuízo cognitivo e demência na população brasileira de meia-idade e idosos.

Comparison of Efficacy and Side Effects between Aripiprazole and Haloperidol in the Treatment of Delirium

OBJECTIVES: To compare the efficacy and the safety of aripiprazole and haloperidol in the treatment of patients with delirium. METHODS: 26 patients with delirium were randomized to receive either aripiprazole or haloperidol and finally 20 patients were analyzed. We collected demographic and clinical data. The Korean Version of Delirium Rating Scale-revised-98 (K-DRS-98) and Korean Version of Drug Induced Extrapyramidal Symptom Scale (DIEPSS-K) were assessed. Blood samples were collected to analyze serum sodium ion concentration, plasma cortisol and prolactin level and pulse oximetry was used for measuring oxygen saturation. RESULTS: K-DRS-98 severity scores decreased in both groups significantly over the study period, but no statistically significant difference was observed between the two groups. No significant extrapyramidal syndromes were noted in both groups, but the use of haloperidol was associated with increased plasma prolactin level (From 24.0+/-28.1 ng/mL to 32.0+/-20.0 ng/mL, p=0.005). CONCLUSION: Aripiprazole is as effective as haloperidol in the treatment of delirium and aripiprazole may be safer than haloperidol in that haloperidol is associated with increased plasma prolactin level.

Early Assessment of Delirium in Elderly Patients after Hip Surgery

OBJECTIVE: This study is intended to identify predictive factors of delirium, including risk factors and prodromal symptoms. METHODS: This study included sixty-five patients aged 65 years or older who had undergone hip surgery. Baseline assessments included age; gender; admission type (acute/elective); reason for surgery (fracture/replacement); C-reactive protein (CRP); Acute Physiology, Age, Chronic Health Evaluation (APACHE III); and the Mini-Mental State Examination (MMSE). The Korean version of the Delirium Rating Scale-Revised-98 (K-DRS-98) was used to assess prodromal symptoms daily before the onset of delirium. RESULTS: Almost 28% (n=18) of the 65 patients developed delirium after surgery. Delirium in elderly patients after hip surgery was observed more often in older patients and those with acute admission, hip fracture, higher APACHE III score, lower MMSE score, and higher CRP levels within early days after the operation. Sleep-wake cycle disturbances, thought process abnormalities, orientation, and long-term memory in symptom items of K-DRS-98 were showed significant difference on 4 days before delirium, lability of affect on 3 days before, perceptual disturbances and hallucination, and visuo-spatial ability on 2 days before, and delusion, motor agitation, and short-term memory on the day before the occurrence of delirium. CRP levels within 24 hours and 72 hours after hospitalization were significantly higher in the delirium group. CONCLUSION: Medical professionals must pay attention to behavioral, cognitive changes and risk factors in elderly patients undergoing hip surgery and to the prodromal phase of delirium. K-DRS-98 may help in identifying the prodromal symptoms of delirium in elderly patients after hip surgery.

Phenomenology of Delirium in Cancer Patients and Its Association with Sedative-Hypnotics / 대한정신약물학회지

OBJECTIVE: This study explored the phenomenology of delirium in cancer patients, and evaluated the severity of delirium according to the cancer treatment method and the use of sedative-hypnotics, including zolpidem. METHODS: This was a retrospective chart review study. Cancer patients with delirium, who were referred to the Department of Psychiatry at a National University hospital, were included in the analysis. In all subjects, the severity of delirium was assessed using the Delirium Rating Scale-Revised-98 (DRS-R-98). RESULTS: The analysis included 112 patients with delirium. Among the neuropsychiatric and behavioral symptoms, the most frequent ones were sleep-wake cycle disturbance (100.0%) and perceptual disturbances and hallucinations (95.5%). Among the cognitive symptoms, inattention (98.2%) was the most frequent. The older the patients were, the higher the DRS-R-98 total scores were. There was no significant difference in the DRS-R-98 scores among cancer treatment methods (operation, chemotherapy, or radiation therapy). However, the total DRS-R-98 scores in the zolpidem use group were higher than in control group, and the difference was significant after adjusting for age, sex, and type of cancer treatment. CONCLUSION: Sleep-wake cycle disturbance, inattention, and perceptual disturbances were the most common delirium symptoms in cancer patients. The severity of delirium in patients taking zolpidem was significantly greater.

Duane's retraction syndrome and karyotypic abnormalities / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:TO evaluate chromosome 8 abnormalities in Duane's retraction syndrome(DRS)type 1.METHODS:We evaluated chromosome 8 abnormalities in 29 consecutive cases of DRS type Ⅰ.DNA was isolated from the peripheral leukocytes of patients using a genomic DNA extraction kit,then D8S553 and D8S1797 markers used for polymerase chain reaction(PCR).RESULTS:None of the cases were positive for the two markers D8S553 and D8S1797 on chromosome 8 which were tested in our study.CONCLUSION:The possible cause of this finding is that DRS in our patients is more commonly sporadic rather than familial.We recommend study with more cases,other markers,and different chromosomes.

Comparison of the Efficacy between Risperidone and Quetiapine in Elderly Patients with Delirium

OBJECTIVES: Many studies showed that risperidone and olanzapine in the treatment of delirium were similar to haloperidol, in side effects were superior to that. Quetiapine is frequently used in delirious patients. However, the studies of quetiapine in the treatment of delirium are very few. This study was designed to compare the efficacy of risperidone and quetiapine in elderly patients with delirium. METHODS: We divided 2 groups (risperidone and quetiapine) of elderly patients with delirium. We compared the two groups of elderly patients with delirium by Korean Version of Delirium Rating Scale (K-DRS) and Korean Mini-Mental State Examination (K-MMSE) at baseline and 1 week later. RESULTS: Our results showed that risperidone and quetiapine were efficacious in the treatment of elderly patients with delirium according to using K-DRS and K-MMSE. There were no significant differences in the degree of effects in both drugs. CONCLUSION: We compared the efficacy of risperidone and quetiapine in the treatment of delirium. Quetiapine was as efficacious as risperidone in the treatment of the elderly patients with delirium. In future, the sample size need to be increased in the studies of delirium. And the evaluation of long-term side effects related to quetiapine need to be performed.

A Validation Study for the Korean Version of Delirium Rating Scale-Revised-98 (K-DRS-98) / 신경정신의학

OBJECTIVE: This study was conducted to develop and to validate the Korean version of Delirium Rating Scale-Revised-98 (K-DRS-98), which is a scale for diagnosing delirium and evaluating its severity. METHOD: After developing the K-DRS-98, 102 patients were rated by it among 4 diagnostic groups, such as delirium (N=25), dementia (N=27), schizophrenia (N=25) and others (N=25). To test for reliability, K-DRS-98 was independently administered by two psychiatrist. To test for validity, Korean version of Mini-Mental State Examination (MMSE-K) and Clinical Global Impression (CGI) were administered simultaneously. Statistical analysis was done with SPSS window version 12 package and statistical significance was p<0.05. RESULT: Internal consistencies (Cronbach alpha) of two raters were 0.867 and 0.858, respectively. Inter-rater reliability (kappa) was 0.893 for severity items of K-DRS-98 and kappa value of diagnosis items was 0.969. In Delirium group, Pearson correlation coefficients (gamma) of K-DRS-98 were -0.682 for MMSE-K and 0.667 for CGI. In comparison Delirium group with Others, ANOVA post hoc multiple comparison LSD was statistically significant (p<0.001). The cutoff score to diagnosis of delirium can be recommended 16 for severity items and 21.5 for total score, respectively. CONCLUSION: The K-DRS-98 was showed good reliability and validity for the assessment of delirium. The K-DRS-98 is an easy and useful tool for diagnosing delirium and assessing its severity.

Factors Related to Patient Satisfaction in an Outpatient Clinic

BACKGROUND: Recently, physicians have been challenged to see more patients per office session while maintaining patient satisfaction. We examined the variables related to patient satisfaction with the time spent with physician during office visit. METHODS: In the department of family medicine of an university hospital, a trained researcher observed patient visits by VTR and collected additional data using medical record reviews and patient exit questionnaires from July 1 to July 31, 2002 The data was analyzed statistically by SPSS ver11.0/PC . RESULTS: Visits by 103 patients were observed in this study. Age, functional health status, time of Dr.'s talking to patients and the ratio of Dr.'s talking time to visit length were significantly associated with patient satisfaction (P<0.05). Sex, marital status, education level, new vs. established patient, reason for visit, visit length, number of problems, number of medications, body mass index, and satisfaction for time spent were not significantly associated with patient satisfaction. According to logistic regression analysis, greater patient satisfaction were associated with better perceived health status, with more ratio of Dr.'s talking time to visit length and with age younger than 40 years. CONCLUSION: Physician can enhance patient satisfaction during an office visit by spending sufficient time to talk with patients during each visit and should take an interest in elderly patients and patients with multiple problems.