BACKGROUND: To investigate the effect of ADL on the drug compliance and the occurrence of drug side reactions in elderly diabetic out-patients, we performed a study concerning prescriptions. METHODS: Eighty six elderly diabetic out-patients(65~92 year-old)were divided into two groups by the function of ADL(normal ADL group> or =5 score, impaired ADL group< or = 4 score). Four weeks after prescription we examined the account of remaining medicines and the occurrence of adverse drug reactions. Patient compliance with drug therapy was assessed by counting the remained drugs at 4 week according to the following criteria: 2 or 3 days of prescribed drugs, 95% compliance; 1 week, 75%; 2 weeks, 50%; and 3 weeks or more, 25%. The frequency of drug adverse reaction is expressed as the percentage of the number of patients experienced side effect(s) over the total number of patients in each group during 4-weeks. RESULTS: Drug compliance was significantly higher in normal ADL group than in impaired Group(normal 87+/-15.6%, impaired 66+/-14.1%, p<0.01). Drug side effects were more in impaired ADL group than in normal group(impaired ADL group 26.3%, normal group 10.4%). Five normal ADL patients and 10 impaired ones had a total of 20 adverse events. CONCLUSIONS: ADL performance influenced the drug intake compliance and the frequency of drug side effects in elderly diabetic out-patients.
Activities of Daily Living ; Aged* ; Compliance* ; Drug Therapy ; Drug-Related Side Effects and Adverse Reactions* ; Humans ; Outpatients ; Patient Compliance ; Prescriptions

Phenytoin-induced gingival overgrowth is a well-known and frequently reported gingival lesion, which was first detected in 1939. However, there are conflicts in the literature about the agents which affect the severity of the lesion. Un-cooperative dental patients are one of the most unsuccessfully treated periodontal patient groups because of the difficulty in maintaining their oral hygiene. This case report consists of two cases with the same characteristics: phenytoin usage, comprehension and speech defects and poor oral hygiene, but each case differs in the duration of the phenytoin therapy. Both of the cases received scaling, root planning and a gingivectomy.
Adult ; Anticonvulsants/*adverse effects ; Epilepsy/*drug therapy ; Gingival Overgrowth/*chemically induced ; Human ; Male ; Oral Hygiene ; Patient Compliance ; Phenytoin/*adverse effects

BACKGROUNDAirway hyperresponsiveness (AHR) is one of the most important characteristics of asthma. This study investigated the parameters, by which assess the airway responsiveness under tidal ventilation.

METHODSFemale BALB/c mice were sensitized and challenged with ovalbumin (OVA) (group A), and part of them were treated with budesonide aerosol (group B). All the mice were anaesthetized and mechanically ventilated. The values of tidal volume (Vt), airway pressure (PA), airway flow (F), expiratory lung resistance (RL) and dynamic compliance of the thorax and lung (CT-L) were recorded by the AniRes2003 animal lung function system. In addition, the expiratory volume in the first 0.1 second after the start of expiration (EV0.1) was obtained according to the flow-volume (F-V) curve. The maximal or minimal values of EV0.1, RL and CT-L were documented after each dose of methacholine (MCH) and compared with values from negative control group (group C).

RESULTS(1) When the dose of MCH reached 100 ng/g or 200 ng/g, the decrease of Vt in group A was much more significant than group C (P = 0.001, < 0.001 respectively), but not so between groups B and group C (P = 0.974, 0.362 respectively). (2) With the dose of 25, 50, 100 or 200 ng/g MCH, the decrease in percentage of EV0.1 in group A was much higher than group C (P = 0.012, 0.025, 0.001, 0.003 respectively), while that in group B showed no significant difference as compared with group C (P = 0.507, 0.896, 0.972, 0.785). (3) RL and CT-L: with the dose of 200 ng/g MCH, there was a statistically significant increase of RL in group A compared to group B or group C (P < 0.001, < 0.001 respectively), but no significant difference between groups B and C (P = 0.266). With doses of 100 ng/g and 200 ng/g MCH, there was a statistically significant decrease of CT-L in group A compared to group B (P = 0.001, = 0.001) and group C (P < 0.001, < 0.001 respectively), but no significant difference between groups B and C (P = 0.775, 0.310). (4) Histopathology: there were eosinophilic predominant peribronchial and perivascular inflammatory influx in murine lungs after OVA sensitizing and challenging, which could be counteracted by inhalation of budesonide in group B.

CONCLUSIONSThe decline in EV0.1 in response to MCH challenge correlated with simultaneous changes in Vt, RL and CT-L, but more sensitively than all the other parameters. The decline in EV0.1 and inflammation in murine lung could be significantly alleviated by inhalation of nebulized budesonide solution, which indicated that EV0.1 to MCH is a valid measure of AHR in mice.

Airway Resistance ; drug effects ; Animals ; Bronchial Hyperreactivity ; drug therapy ; Budesonide ; therapeutic use ; Female ; Lung Compliance ; drug effects ; Methacholine Chloride ; pharmacology ; Mice ; Mice, Inbred BALB C ; Ovalbumin ; immunology

Successful treatment is very high in patients with first episode schizophrenia (FES). On the other hand, the problem is a frequent relapse often caused by non-compliance. The non-compliance rate in patients with FES is 40–60% within 1 year. The causes of non-compliance are diverse, such as poor insight, drug side effects, attitude of caregiver, social stigma, etc. Clinicians should be able to provide appropriate psychosocial intervention and long acting injectable antipsychotics (LAI) to overcome non-compliance. Recently, there is solid and accumulating evidence demonstrating superiority of LAI over oral medication in terms of reducing relapse or rehospitalization. In particular, a substantial portion (approximately 30–50%) of patients and caregivers prefer LAI to oral medication. Shared decision-making is the process that clinicians and patients/caregiver should go through in order to obtain the full benefits from LAI.
Antipsychotic Agents ; Caregivers ; Compliance ; Decision Making ; Drug-Related Side Effects and Adverse Reactions ; Hand ; Humans ; Recurrence* ; Schizophrenia* ; Social Stigma

BACKGROUND: Considering that dialysate calcium concentration is potentially a main determinant of the serum ionized calcium level and vasoconstriction is associated with the blood calcium concentration, we conducted a study to evaluate the interdialytic effects of treatment with a low calcium dialysate (LdCa, 1.25 mmol/L) on the changes in arterial compliance (AC), blood pressure (BP), biochemical parameters and vasoactive substances. METHODS: Eight hemodialysis (HD) patients (mean age: 46.8 +/- 13.7 years, 4 men and 4 women) were included in the study. AC, systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean arterial pressure (MAP), serum ionized Ca, intact-PTH, serum nitric oxide and aldosterone were compared after 10 sessions of treatment with LdCa. Right carotid artery diameter was measured 3 times using a real time B-mode ultrasound imager (Hewlett-Packard Sonos 2000 (R) ) and AC was calculated using the Hayoz method. RESULTS: 1) AC was recorded as 0.140 (0.080-0.170) mm2/kPa at the baseline (1.75 mmol/L calcium dialysate), 0.170 (0.050-0.290) mm2/kPa after LdCa treatment (p< 0.05 versus baseline), and 0.140 (0.070-0.250) mm2/kPa following the HdCa treatment (p< 0.05 versus LdCa data). 2) MAP and PP were calculated at 114.12 +/- 10.56 mmHg and 63.50 +/- 10.87 mmHg at the baseline; 98.37 +/- 15.14 mmHg and 56.50 +/- 5.95 mmHg after LdCa treatment (p< 0.05 versus baseline) ; and 115.75 +/- 9.64 mmHg and 62.00 +/- 15.71 mmHg following HdCa treatment (p< 0.05 versus LdCa data). 3) Serum ionized Ca and intact-PTH were measured at 4.66 +/- 0.40 mg/dL and 25.08 +/- 16.44 pg/mL at the baseline; 4.45 +/- 0.28 mg/dL and 90.71 +/- 27.03 pg/mL after LdCa treatment (p< 0.05 versus baseline) ; and 4.65 +/- 0.43 mg/dL and 24.08 +/- 15.44 pg/mL following HdCa treatment (p< 0.05 versus LdCa data). 4) Serum aldosterone concentration was 300.8 (65.5-836.1) pg/mL at the baseline, and 220.2 (42.8-527.9) pg/mL after LdCa treatment (p< 0.05). CONCLUSION: There were favorable changes in AC, BP, biochemical parameters after treatment with LdCa. These changes may be associated with the reduction in serum ionized calcium and decreased serum aldosterone concentration.
Adult ; Arteries/drug effects ; Blood Pressure/*drug effects ; Calcium/*pharmacology ; Compliance/drug effects ; Cross-Over Studies ; Dialysis Solutions/*pharmacology ; Female ; Human ; Kidney Failure, Chronic/*physiopathology/therapy ; Male ; Middle Aged ; *Renal Dialysis ; Support, Non-U.S. Gov't

OBJECTIVETo explore the rate of compliance, influencing factors and the safety of patients with onychomycosis under treatment of oral antifungal agents.

METHODSAccording to the scoring clinical index of onychomycosis (SCIO), 330 patients with onychomycosis, their target nail's integral of the SCIO were calculated and randomly divided into three groups under the baseline of the SCIO integral range. Patients were treated with intermittent pulse itraconazole (A group), continuous terbinafine (B group) and intermittent terbinafine (C group) respectively. Self-administered questionnaire was applied in the survey on every onychomycosis patient.

RESULTSThe average rate of compliance was 55.15%. The cure rate for those compliance with doctors' order was 89.01%, while it was only 30.41% for those noncompliant patients The overall non-compliant rate was 44.85%. Among the noncompliant ones, 29.73% were worried about the side effects of medicine, 22.30% thought that they had already been cured, 15.54% was due to economic reasons and 12.16% could not bear the side effects of medicine. It was found that the compliant rates were significantly correlated to ageing, position of the target nails, the integral of the SCIO and the therapy scheme (P < 0.05), while no significant correlations were seen between male and female, culture degree and course (P > 0.1). The frequency of adverse incident of A, B, C groups were 22.73%, 21.43%, 23.15% respectively, but without statistical significance (P > 0.1). Majority of the adverse incidents happened during the first month of therapy but were mild and reversible.

CONCLUSIONOur results showed that the overall compliance was low which exerted a significant influence on the curative effect of onychomycosis patients. Factors as ageing, position of the target nail, integral of the SCIO and the therapy scheme had an influence on the compliant rate. When treating onychomycosis with oral itraconazole, the results seemed to be just as safe as when using terbinafine.

Administration, Oral ; Age Factors ; Antifungal Agents ; administration & dosage ; adverse effects ; economics ; Dose-Response Relationship, Drug ; Female ; Humans ; Itraconazole ; administration & dosage ; adverse effects ; economics ; Male ; Naphthalenes ; administration & dosage ; adverse effects ; economics ; Onychomycosis ; drug therapy ; Patient Compliance ; statistics & numerical data ; Surveys and Questionnaires

OBJECTIVETo investigate the effects of combined application of Xuezhikang Capsule (XZK) and hypotensive drugs on the dynamic blood pressure (DBP), pulse pressure index (PPI), pulse wave velocity (PWV) and smoothness index (SI), and to study the relationship between SI and related factors (age, BP, dynamic PPI, and vascular elasticity).

METHODSOne hundred and ten patients with essential hypertension were randomly assigned to 2 groups: 54 in the control group and 56 in the treated group. Both were treated with hypertensive drugs, but with oral medication of XZK given additionally to the treated group at the dose of 60 mg, twice a day. PWV and DBP were measured before treatment and at the terminal of a 6-month treatment. Meantime, the 24-h average systolic and diastolic pressures were recorded to calculate the 24-h dynamic pulse pressure (24 hPP), PPI, SI of systolic and diastolic blood pressure (SISBP and SIDBP) for comparing the changes between groups and analyzing the SI related factors.

RESULTSAll patients' blood pressure levels were well controlled; after a 6-month treatment, the PP and PPI in the treated group were 45 +/- 8 mm Hg and 0.35 +/- 0.08 respectively, which were significantly lower than those in the control group (51 +/- 10 mm Hg and 0.38 +/- 0.05, P < 0.05); while SISBP and SIDBP in the treated group were higher than those in the control group (1.37 +/- 0.16 vs 1.26 +/- 0.20, P < 0.01; and 1.28 +/- 0.14 vs 1.18 +/- 0.23, P < 0.05) respectively; and PWV in the former was significantly lower than that in the latter group (10.4 +/- 3.68 m/s vs 12.5 +/- 4.27 m/s, P < 0.05). Multiple factor stepwise regression analysis showed that the SISBP was negatively correlated with age, PPI and PWV, while the SIDBP was negatively correlated with PPI (P < 0.01).

CONCLUSIONThe combined application of XZK and hypotensive drugs can decrease PP and PPI, improve the endothelial function and arterial elasticity, enhance the efficacy of treatment on SI. After treatment SI shows a significant negative correlation with PPI, PWV and age in patients.

Adult ; Aged ; Antihypertensive Agents ; therapeutic use ; Arteries ; drug effects ; physiopathology ; Blood Pressure ; drug effects ; Compliance ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Humans ; Hypertension ; drug therapy ; physiopathology ; Male ; Middle Aged ; Phytotherapy

BACKGROUND/AIMS: The aim of this study was to compare polyethylene glycol (PEG) 4 L, split method of PEG 4 L and PEG 2 L plus sodium phosphate (NaP) in the aspect of bowel preparation quality, safety, patients' compliance and preference. METHODS: Total 249 subjects were prospectively enrolled and received bowel preparation for colonoscopy from August to October in 2010; PEG 4 L (93 subjects), split method of 4 L PEG (74 subjects) and PEG 2 L plus NaP 90 mL group (82 subjects). To investigate the completion, preference for bowel preparation and safety, a questionnaire survey was conducted before colonoscopy. RESULTS: There were no significant intergroup differences in the aspect of completion of preparation, cecal intubation time and success rate. Satisfaction and preference were higher in PEG 2 L plus NaP 90 mL and split method of 4 L PEG compared with PEG 4 L. In the aspect of the bowel preparation quality PEG 4 L showed significantly higher quality in the morning colonoscopy (p<0.001). However, in the afternoon colonoscopy PEG 2 L plus NaP 90 mL showed better result than PEG 4 L (p=0.009). Hyperphosphatemia was most frequently observed in PEG 2 L plus NaP 90 mL, but no severe adverse events occurred (p<0.001). CONCLUSIONS: PEG 4 L showed better result than split method of 4 L PEG or PEG 2 L plus NaP 90 mL in the aspect of bowel preparation quality and safety.
Adult ; Aged ; Cathartics/adverse effects/*pharmacology ; Colon/anatomy & histology/*drug effects ; Colonoscopy ; Female ; Humans ; Hyperphosphatemia/etiology ; Male ; Middle Aged ; Patient Compliance ; Phosphates/adverse effects/*pharmacology ; Polyethylene Glycols/adverse effects/*pharmacology ; Prospective Studies ; Questionnaires ; Time Factors

PURPOSE: This study was done to identify some natural meaning through the dosage experience of psychoactive drugs in women patients with schizophrenia. METHODS: The Hermeneutic phenomenology written by van Manen was used. The period for data collection was from November 2009 to January 2010. This study took place in mental health hospitals and mental health centers in two cities in North Jeolla Province. Nine patients with schizophrenia participated. Data collection was done through individual in-depth interview. RESULTS: The seven natural subjects demonstrated by participants from this study were 'Pills forcibly taken like veiled threats', 'A terrible side effect, a side effect rooted slowly', 'Shame which cannot be hidden as a woman', 'A bad medicine took away from motherhood', 'The fate of a wife who can't be equal', 'A struggle for the complete recovery without promise', and 'Participants want the future without medicine'. CONCLUSION: The results of this study indicate that the urgent need to develop a safe and believable psychoactive drug for woman patients considering the time of menstruation, pregnancy, childbirth, and child raising.
Adult ; Antipsychotic Agents/adverse effects/*therapeutic use ; Female ; Humans ; Interviews as Topic ; Middle Aged ; Patient Compliance/psychology ; Quality of Life ; Schizophrenia/*drug therapy

Tigecycline is a broad spectrum antibiotic which has been used for complicated intra-abdominal infection and complicated skin and soft tissue infection by multi-drug resistant bacteria. However recent meta-analysis studies have raised a concern for adverse events of tigecycline. We analyzed retrospectively adverse events, associated factors of adverse events in multi-drug resistant bacteria caused infections treated with tigecycline in Korean patients. One hundred-sixty patients treated with tigecycline from July 2009 to September 2013 were enrolled in this study. Their clinical and microbiologic data were reviewed. History of invasive procedure within 7 days and recent operation within 3 months were associated with adverse events. The most common adverse events were nausea and vomiting. Associated factors of nausea were soft tissue injury and recent operation within 3 months. In this study, nausea was the most common adverse event in patients who received tigecycline. Although it is not serious complication, monitoring of adverse events is required to increase compliance.
Bacteria ; Compliance ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Incidence* ; Intraabdominal Infections ; Nausea ; Retrospective Studies ; Skin ; Soft Tissue Infections ; Soft Tissue Injuries ; Vomiting