Search

Deprescribing opportunities may differ across health care systems, nursing home settings, and prescribing cultures. The objective of this study was to compare the prevalence of STOPPFrail medications according to frailty status among residents of nursing homes in Australia, China, Japan, and Spain. Secondary cross-sectional analyses of data from 4 cohort studies. A total of 1142 residents in 31 nursing homes. Medication data were extracted from resident records. Frailty was assessed using the FRAIL-NH scale (non-frail 0–2; frail 3–6; most-frail 7–14). Chi-square tests and prevalence ratios (PRs) were used to compare STOPPFrail medication use across cohorts. In total, 84.7% of non-frail, 95.6% of frail, and 90.6% of most-frail residents received ≥1 STOPPFrail medication. Overall, the most prevalent STOPPFrail medications were antihypertensives (53.0% in China to 73.3% in Australia, P <.001), vitamin D (nil in China to 52.7% in Australia, P <.001), lipid-lowering therapies (11.1% in Japan to 38.9% in Australia, P <.001), aspirin (13.5% in Japan to 26.2% in China, P <.001), proton pump inhibitors (2.1% in Japan to 32.0% in Australia, P <.001), and antidiabetic medications (12.3% in Japan to 23.5% in China, P =.010). Overall use of antihypertensives (PR, 1.15; 95% CI, 1.06–1.25), lipid-lowering therapies (PR, 1.78; 95% CI, 1.45–2.18), aspirin (PR, 1.31; 95% CI, 1.04–1.64), and antidiabetic medications (PR, 1.31; 95% CI, 1.00–1.72) were more prevalent among non-frail and frail residents compared with most-frail residents. Antihypertensive use was more prevalent with increasing frailty in China and Japan, but less prevalent with increasing frailty in Australia. Antidiabetic medication use was less prevalent with increasing frailty in China and Spain but was consistent across frailty groups in Australia and Japan. There were overall and frailty-specific variations in prevalence of different STOPPFrail medications across cohorts. This may reflect differences in prescribing cultures, application of clinical practice guidelines in the nursing home setting, and clinician or resident attitudes toward deprescribing. [ABSTRACT FROM AUTHOR]

Background and objective: Hypertension is very prevalent in the Chinese population in Taiwan. Chinese people frequently experience bothersome cough when receiving angiotensin-converting enzyme (ACE) inhibitors, and angiotensin II (AT1) receptor antagonists are thus relatively more frequently used in this context. In this trial we studied the effectiveness of a new AT1 receptor antagonist, olmesartan, in the treatment of Chinese patients with mild-to-moderate essential hypertension. Patients and methods: The present study was a double-blind, randomised, multicentre trial to compare the efficacy and safety profiles of two AT1 receptor antagonists, olmesartan and losartan, in the treatment of Chinese patients with mild-to-moderate essential hypertension. 126 adults were randomised to receive either once-daily olmesartan 20mg or once-daily losartan 50mg for 12 weeks. There were 49 evaluable patients in the olmesartan group and 57 in the losartan group. Results: At baseline, neither diastolic (DBP) nor systolic (SBP) blood pressures were significantly different between the two study groups. Trough blood pressures were measured and recorded for the evaluation of treatment effect. After drug treatment for 4, 8 and 12 weeks, SBP and DBP values were significantly decreased in both groups of patients. However, both SBP and DBP were significantly lower in the olmesartan group than in the losartan group after treatment. At the end of treatment, DBP values were 87.0 ± 8.6mm Hg versus 91.6 ± 8.7mm Hg (p < 0.001) and SBP values were 129.5 ± 12.6mm Hg versus 135.4 ± 12.1mm Hg (p < 0.001) in the olmesartan and losartan groups, respectively. After 4 weeks of treatment, the reduction in BP values was larger in the olmesartan group than in the losartan group (decreases in DBP of 12.1 ± 8.4mm Hg vs 7.2 ± 6.8mm Hg [p < 0.005] and in SBP of 15.1 ± 13.0mm Hg vs 10.3 ± 10.1mm Hg [p < 0.05] for the olmesartan and losartan groups, respectively). Patients treated with either drug experienced only mild adverse reactions, such as dizziness, cough, headache and neck pain, all of which occurred at low frequencies. There were no significant changes in laboratory parameters. Conclusion: Both olmesartan and losartan are effective and safe in the treatment of Chinese patients with mild-to-moderate essential hypertension. Olmesartan 20mg once daily is more potent and has a more rapid antihypertensive effect than losartan 50mg once daily in the treatment of mild-to-moderate hypertension in Chinese patients. [ABSTRACT FROM AUTHOR]

Presents a study on patients with eating disorders using the Eating Attitude Test (EAT) in Hong Kong, China. Prevalence of eating disorders in high-income societies; Details on the pathological EAT profile of bulimic patients; Attributions of the starvation of anorexic patients.

Presents a study which investigated the immune mechanism that protects several individuals in China against HIV infection. Patients and methods; Results; Discussion.

The Asian continental dust storms, originated mainly from the deserts bordering China and Mongolia, increasingly influenced the air quality of Taiwan between February and May in recent years. The concentrations of both coarse (PM10) and fine (PM2.5) particles increased in northern Taiwan during the dust storm periods. The potential health impact of the dust storms was worried by the people but not investigated before. The purpose of this study is to estimate adverse health effects of the Asian continental dust storms among susceptible Taipei residents in 2002.We investigated associations between dust storms and hemostatic factors for 14 patients with coronary heart disease (CHD) and 7 patients without CHD in Taipei during the dust storm period in 2002. Baseline measurements including hemostatic factors (tissue plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1), fibrinogen, Ddimer), and inflammatory markers (high sensitive C reactive protein (hs-CRP) and interleukin-6) are measured before dust storms reach Taiwan. Air pollution data including PM10, PM2.5, O3; SO2, NO2, and CO are obtained from 5 monitoring stations in Taiwan. During the dust storm period from March to May in 2002, we recall all study subjects and perform hemostatic measurements on them.The concentrations of PM10, PM2.5, and O3 increased significantly during the dust storm period. We find plasma tPA increase significantly in both groups. PAI-1 shows slightly but not significantly decrease in the CHD group. There is no significant change in inflammatory marker of interleukin-6. Compared with non-CHD group.Long-range transported pollution of Asian continental dust storm elevated environmental concentrations of PM10, PM2.5, and O3 in Taipei. The elevated pollution results in increase in plasma tPA levels among susceptible patients in Taipei. [ABSTRACT FROM AUTHOR]

Background: As China continues to commit to universal access to HIV/AIDS prevention, treatment and care services, its HIV/AIDS policies have become increasingly information driven. We review China's key national-level HIV/AIDS policies and discuss policy gaps and challenges ahead.Methods: We conducted a desk review of key national-level policies that have had a major impact on China's HIV/AIDS epidemic, and examined recent epidemiological data relevant to China's HIV response.Results: National-level policies that have had a major impact on China's HIV/AIDS response include: 'Four Frees and One Care'; 5-year action plans; and HIV/AIDS regulation. These landmark policies have facilitated massive scaling up of services over the past decade. For example, the number of drug users provided with methadone maintenance treatment significantly increased from 8116 in 2005 to 241 975 in 2009; almost a 30-fold increase. The 'Four Frees and One Care' policy has increased the number of people living with AIDS on anti-retroviral treatment from some 100 patients in 2003 to over 80 000 in 2009. However, stigma and discrimination remains major obstacles for people living with HIV/AIDS trying to access services.Conclusions: China's current national policies are increasingly information driven and responsive to changes in the epidemic. However, gaps remain in policy implementation, and new policies are needed to meet emerging challenges. [ABSTRACT FROM AUTHOR]

• One in six residents of nursing homes use strong anticholinergic medications. • There was a 20-fold variation in prevalence across the 12 countries. • Antipsychotics and antidepressants were the most common strong anticholinergics. There is a need to balance the benefits and risks associated with strong anticholinergic medications in older adults, particularly among those with frailty and cognitive impairment. This study explored the international prevalence of strong anticholinergic medication use in residents of nursing homes with and without cognitive impairment and frailty. Secondary, cross-sectional analyses of data from 5,800 residents of 106 nursing homes in Australia, China, Czech Republic, England, Finland, France, Germany, Israel, Italy, Japan, Netherlands, and Spain were conducted. Strong anticholinergic medications were defined as medications with a score of 2 or 3 on the Anticholinergic Cognitive Burden scale. Dementia or cognitive impairment was defined as a documented diagnosis or using a validated scale. Frailty was defined using the FRAIL-NH scale as 0–2 (non-frail), 3–6 (frail) and 7–14 (most-frail). Data were analyzed using descriptive statistics. Overall, 17.4 % (n = 1010) residents used ≥1 strong anticholinergic medication, ranging from 1.3 % (n = 2) in China to 27.1 % (n = 147) in Italy. The most prevalent strong anticholinergics were quetiapine (n = 290, 5.0 % of all residents), olanzapine (132, 2.3 %), carbamazepine (102, 1.8 %), paroxetine (88, 1.5 %) and amitriptyline (87, 1.5 %). Prevalence was higher among residents with cognitive impairment (n = 602, 17.9 %) compared to those without (n = 408, 16.8 %), and among residents who were most frail (n = 553, 17.9 %) compared to those who were frail (n = 286, 16.5 %) or non-frail (n = 171, 17.5 %). One in six residents who were most frail and living with cognitive impairment used a strong anticholinergic. However, there was a 20-fold variation in prevalence across the 12 countries. Targeted deprescribing interventions may reduce potentially avoidable medication-harm. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B is one of the most common infectious diseases in China. The aim of this study was to determine the prevalence of hepatitis B surface antigen (HBsAg) among the general population and the risk factors associated with HBV infection in Anhui province, China., Methods: A provincial serosurvey was conducted in four cities, and selected through stratified clustering sampling. Data on demographics, immunization history, medical history, family medical history, and life history were collected, along with serum tested for HBsAg. Completed surveys were analysed from 8,875 participants., Results: Overall prevalence of HBsAg was 7.44%. Using multivariate analysis, older age was a risk factor for HBsAg infection among children younger than 15 years. Among adults 15-59 years old, the risk factors were male gender, a history of surgical operations, at least one HBsAg-positive family member, and non-vaccination. For adults older than 59 years, the risk factor was a blood transfusion history., Conclusions: Though Anhui province has already reached the national goal of reducing HBsAg prevalence to less than 1% among children younger than 5 years, there are still several risk factors for HBsAg infection among the older population. Immunization programs should continue to focus on adults, and interventions should be taken to reduce risk factors associated with being infected with Hepatitis B.