Résumé
When facing the worldwide abuse of opioid substance,one of the effective responses is opioid substitution therapy (OST).However,different OST service patterns may affect the therapeutic outcome.Using the System Engineering Initiative for Patient Safety (SEIPS) model,we can analyze the factors that affecting the outcomes of patients from the perspective work system.In this paper,SEIPS model is used to describe the existing OST service model.According to the operation mechanism of the methadone maintenance treatment in China and the existing OST service model,some suggestions are put forward to carry out effective OST service in the country.
Résumé
When facing the worldwide abuse of opioid substance,one of the effective responses is opioid substitution therapy (OST).However,different OST service patterns may affect the therapeutic outcome.Using the System Engineering Initiative for Patient Safety (SEIPS) model,we can analyze the factors that affecting the outcomes of patients from the perspective work system.In this paper,SEIPS model is used to describe the existing OST service model.According to the operation mechanism of the methadone maintenance treatment in China and the existing OST service model,some suggestions are put forward to carry out effective OST service in the country.
Résumé
Background & Objectives : A combination of buprenorphinenaloxone (Addnok-N) tablets has been recently introduced in India as treatment for Opioid dependence. This study was undertaken to evaluate the possible adverse consequences following use of the buprenorphinenaloxone tablets through post marketing surveillance. Methods : National Drug Dependence Treatment Centre (NDDTC), AIIMS, India, monitored all patients receiving buprenorphine-naloxone combination tablets from the centre over a period of two and half years. Evaluation included subjective and objective side effect checklist, physical examination, and laboratory investigation. Results : Data was obtained from 1132 observations among 158 patients. Commonly reported medication effects, like muscle aches (44.0%), sleepiness (44.0%), relief from pain (41.3%), etc; are expected in opioid substitution treatment. Laboratory investigations were mostly normal except for liver enzyme abnormalities (52.2% of cases). Eight adverse events were reported in the study. No dangerous event or mortality was reported during the study.
Résumé
By comparing the differences of " Decision of the Standing Committee of the National People's Congress on the prohibition against narcotic drugs " and "Law of the People's Republic of China on Narcotics Control " and their implications for harm reduction,the article analyzed the ethical issues existing in applying harm reduction policy in HIV/AIDS prevention and control,and held that the new policy to promote the methadone use would play a major role for control of drug abuse and AIDS.
Résumé
It is ordinarily accepted that the synthetic testosterone administration is the choice of treatment for the primary testicular dysfunction. But recently not a few medical scientists reported that the long-standing testosterone replacement is not without side effects. For that reason, we tried to investigate a possibility of in vivo transplantation of Leydig cells as a new biologic androgen substitution therapy. The Leydig cells procured from 6 week-old male Sprague-Dawley rat were auto- transplanted and the level of testosterone secretion and histostructural changes were observed.The results obtained are summarized as follows :1. For the selection of transplantation sites, compared to subcutaneous or scrotal counterparts, renal subcapsular and intraperitoneal transplant showed higher levels of testosterone and the number of transplanted cells was correlated with the level of measured testosterone. 2. Furthermore, if the Leydig cells were transplanted intraperitoneally after the uptake on synthetic collagen, testosterone levels were higher than the ones simply transplanted, resulting in 2.7 times higher at 3 months. 3. The activity of 125-I-hCG decreased 20 to 40% at each month after transplantation compared to the normal levels, but no statistical significance was noted among different periods. 4. Histologic examination revealed neovascularized capillaries and well demarcated uptake of sheet-like group of eosinophilic Leydig cells were observed at 4 weeks. But the evidence of destructive changes such as a focal inflammation with central dystropic ossification was noted after S month. On electron microscopy, the marked indentation of nucleus and presence of lipochrome pigment were seen and the number and size of smooth endoplasmic reticulum and mitochondria were reduced. In conclusion, testosterone output could be increased to the physiologic range by increasing the number of transplant cells or collagen uptake utilizing, etc. However the decrease of testosterone production after 3 months is believed to be a result of focal inflammation and degeneration which in turn caused the decrease in number of secreting Leydig cells and reduced activity of hCG receptors. Further effort is necessary on delaying or preventing the structural and functional decrement of Leydig cells.