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Humidifier disinfectant disaster: what is known and what needs to be clarified. 加湿器消毒液灾难:什么是已知的,什么是需要澄清的。
Q3 Medicine Pub Date : 2016-12-04 DOI: 10.5620/eht.e2016025
Sungkyoon Kim, D. Paek
OBJECTIVESAfter the initial investigations by the Korea Centers for Disease Control in 2011, over 1000 suspicious cases of humidifier disinfectant (HD) victims were subsequently reported by 2015, and numbers are still increasing dramatically in 2016 in the midst of the prosecutors' office investigation. This study attempts to summarize the current understandings of the related health effects of HD based upon a systemic review of published epidemiologic studies and toxicology investigations.METHODSPublished studies of HDs were searched through PubMed and TOXLINE under the search words 'humidifier disinfectant,' and related reports were identified from the references and published report list of regulatory agencies including the Korean National Institute of Environmental Research, US Environmental Protection Agency, and EU European Chemicals Agency.RESULTSCase reports and epidemiologic studies have reported the clinical features of severe forms of HD lung damage, together with epidemiologic findings of seasonal occurrence and demographic variations, including the heightened susceptibility of young children. Toxicological studies have reported inhalation toxicities together with positive findings of in vitro genotoxicity studies.CONCLUSIONSThis study examined unsolved issues based on cases of upper respiratory diseases and diseases of other organs, including cancers, among suspected victims of HDs. These issues should be clarified in future research for the management and prevention of health effects from HDs and chemicals of other related household products.
目的自2011年疾病管理中心的初步调查后,到2015年,加湿器消毒液(HD)疑似受害者报告超过1000例,2016年在检察机关的调查中,这一数字仍在急剧增加。本研究试图在对已发表的流行病学研究和毒理学调查进行系统回顾的基础上,总结目前对HD相关健康影响的理解。方法以“加湿器消毒液”为检索词,通过PubMed和TOXLINE检索已发表的HDs研究,并从韩国国立环境研究所、美国环境保护署、欧盟欧洲化学品管理局等监管机构的参考文献和已发表的报告列表中识别相关报告。结果病例报告和流行病学研究报告了严重形式HD肺损伤的临床特征,以及季节性发生和人口统计学变化的流行病学发现,包括幼儿易感性增高。毒理学研究报告了吸入毒性以及体外遗传毒性研究的积极结果。结论本研究根据疑似HDs患者的上呼吸道疾病和其他器官疾病(包括癌症)病例调查了尚未解决的问题。这些问题应在今后的研究中加以澄清,以管理和预防HDs和其他相关家用产品的化学物质对健康的影响。
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引用次数: 15
What must be done to prevent another humidifier disinfectant disaster? 为了防止加湿器再次发生消毒液灾难,必须做些什么?
Q3 Medicine Pub Date : 2016-11-24 DOI: 10.5620/eht.e2016024
Jong-Hyeon Lee
The humidifier disinfectant disaster (HDD) was not a simple poisoning accident by biocides, but a singular disaster in history created by chemicals in household products. This disaster was a result of the failure of a system for the management of chemical and product safety. Since the management authority for chemical usage safety is different from those for chemical safety in products, many blind areas for chemical safety management in products still remain. The ‘Act on the Registration and Evaluation, etc. of Chemical Substances (ARECS)’ or the new ‘Biocidal Product Act’ must not only address the blind areas in the management system for chemical and product safety, but also prevent a second HDD. To prevent another HDD, an integrated registration, evaluation, and management system for chemicals and consumer products must be incorporated into the ‘ARECS’ as an essential part for chemical safety in consumer products.
加湿器消毒液灾难(HDD)并不是单纯的杀菌剂中毒事故,而是历史上罕见的由家庭用品中的化学物质造成的灾难。这场灾难是化学品和产品安全管理系统失效的结果。由于化学品使用安全管理权限与产品化学品安全管理权限不同,产品化学品安全管理存在许多盲区。《化学物质注册和评价等法案》(ARECS)或新的《生物杀灭产品法案》不仅要解决化学品和产品安全管理体系中的盲区,还要防止第二个HDD。为了防止再次出现HDD,必须将化学品和消费品的综合注册、评估和管理系统作为消费品化学品安全的重要组成部分纳入“ARECS”。
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引用次数: 2
A study on the factors affecting the follow-up participation in birth cohorts 影响出生队列随访参与的因素研究
Q3 Medicine Pub Date : 2016-11-22 DOI: 10.5620/eht.e2016023
Bohyun Park, E. Choi, E. Ha, Jonghyuk Choi, Yangho Kim, Yun-Chul Hong, M. Ha, Hyesook Park
Objectives A stable follow-up participation rate is a very important factor for validity in a cohort study. This study analyzed the factors that affect the participation rate at one hospital-based birth cohort in South Korean. Methods The participants were recruited from the Mothers’ and Children’s Environmental Health study between 2006 and 2010. The analysis targeted 1751 mothers who participated in a birth cohort. We conducted analyses of general characteristics during pregnancy and those of infants at birth that affect the participation rate of the 6-month follow-up survey. Results The participation rate for the 6-month follow-up survey was 60.4%. The participation rate in the follow-up of the subsequent period decreased within a 5% to 10% range compared to the number of subjects. The participation rate of premature infants was 16.9% lower than that of a full-term infant (52.6% vs. 69.5%). Analysis showed a 16.7% difference between the participation rate of low-birthweight infants in follow-ups (53.7%) and the participation rate of infants with normal weight (70.4%). The participation rate of mothers who were employed during pregnancy was significantly lower for the 6-month follow-up compared to the participation rate of mothers who were unemployed during pregnancy. Conclusions In this study, factors such as premature birth, low-birthweight, and the employment status of the mother during pregnancy affected the participation rate of the follow-up survey for the birth cohort at six months. A specific strategy is needed to encourage survey participation for the high risk groups in the follow-ups.
目的稳定的随访参与率是影响队列研究有效性的重要因素。本研究分析了影响韩国一个医院出生队列参与率的因素。方法从2006年至2010年的母婴环境健康研究中招募参与者。该分析以参加出生队列的1751名母亲为对象。我们分析了怀孕期间的一般特征和出生时影响6个月随访调查参与率的婴儿特征。结果6个月随访调查参与率为60.4%。与受试者人数相比,后续随访的参与率下降了5% - 10%。早产儿的参与率比足月儿低16.9%(52.6%比69.5%)。分析显示,低出生体重儿的随访参与率(53.7%)与正常体重儿的随访参与率(70.4%)相差16.7%。在6个月的跟踪调查中,怀孕期间有工作的母亲的参与率明显低于怀孕期间没有工作的母亲的参与率。本研究中,早产、低出生体重、母亲孕期就业状况等因素影响出生队列6个月随访调查的参与率。需要一项具体的策略来鼓励高风险群体参与后续调查。
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引用次数: 5
A cross-sectional study of the association between mobile phone use and symptoms of ill health 手机使用与不健康症状之间关系的横断面研究
Q3 Medicine Pub Date : 2016-10-26 DOI: 10.5620/eht.e2016022
Y. Cho, H. Lim, Hoon-Ho Jang, Kyung-hee Kim, J. Choi, C. Shin, S. K. Lee, Jong Hwa Kwon, Nam Kim
Objectives This study analyzed the associations between mobile phone call frequency and duration with non-specific symptoms. Methods This study was conducted with a population group including 532 non-patient adults established by the Korean Genome and Epidemiology Study. The pattern of phone call using a mobile phone was investigated through face-to-face interview. Structured methods applied to quantitatively assess health effects are Headache Impact Test-6 (HIT-6), Psychosocial Well-being Index-Short Form, Beck Depression Inventory, Korean-Instrumental Activities of Daily Living, Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index, and 12-item Short Form Health Survey where a higher score represents a higher greater health effect. Results The average daily phone call frequency showed a significant correlation with the PSS score in female subjects. Increases in the average duration of one phone call were significantly correlated with increases in the severity of headaches in both sexes. The mean (standard deviation) HIT-6 score in the subgroup of subjects whose average duration of one phone call was five minutes or longer was 45.98 (8.15), as compared with 42.48 (7.20) in those whose average duration of one phone call was <5 minutes. The severity of headaches was divided into three levels according to the HIT-6 score (little or no impact/moderate impact/substantial or severe impact), and a logistic regression analysis was performed to investigate the association between an increased phone call duration and the headache severity. When the average duration of one phone call was five minutes or longer, the odds ratio (ORs) and the 95% confidence intervals (CIs) for the moderate impact group were 2.22 and 1.18 to 4.19, respectively. The OR and 95% CI for the substantial or severe impact group were 4.44 and 2.11 to 8.90, respectively. Conclusions Mobile phone call duration was not significantly associated with stress, sleep, cognitive function, or depression, but was associated with the severity of headaches.
目的本研究分析手机通话频率和持续时间与非特异性症状之间的关系。方法采用韩国基因组与流行病学研究建立的532名非患者成人人群进行研究。通过面对面访谈的方式调查了使用手机的通话模式。用于定量评估健康影响的结构化方法有头痛影响测试6 (HIT-6)、社会心理健康指数短表、贝克抑郁量表、韩国日常生活工具活动、感知压力量表(PSS)、匹兹堡睡眠质量指数和12项短表健康调查,其中得分越高代表健康影响越高。结果女性受试者的日均通话频率与PSS得分呈显著相关。无论男女,每次打电话的平均持续时间的增加都与头痛严重程度的增加显著相关。平均一次通话时长在5分钟及以上的亚组HIT-6得分为45.98分(8.15分),而平均一次通话时长<5分钟的亚组HIT-6得分为42.48分(7.20分)。根据HIT-6评分将头痛严重程度分为三个级别(轻微或无影响/中度影响/严重或严重影响),并进行逻辑回归分析,以调查电话持续时间增加与头痛严重程度之间的关系。当一次电话的平均持续时间为5分钟或更长时,中等影响组的优势比(ORs)和95%置信区间(ci)分别为2.22和1.18至4.19。严重或严重影响组的OR和95% CI分别为4.44和2.11至8.90。结论:手机通话时长与压力、睡眠、认知功能或抑郁无显著相关性,但与头痛的严重程度相关。
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引用次数: 15
A call for action from workers, local residents, and consumers: a safe society from toxic chemicals 呼吁工人、当地居民和消费者采取行动:一个远离有毒化学品的安全社会
Q3 Medicine Pub Date : 2016-10-10 DOI: 10.5620/eht.2016020
Shinbum Kim, Sanghyuk Im, Youngeun Choi, Soomi Park, Jaesoon Hyun, Kyung Seok Lee, Sunimm Lee, Sung-Nan Lee, Jeongri Seo, J. Kim, Hyunsun Na, Minsun Kim
In 2016, it was revealed that many children and pregnant women had been injured or killed by disinfectants for home humidifiers in South Korea (hereafter Korea). Criminal trials against the companies that manufactured, imported, or sold such products are now under way and a consumer boycott against them has gained widespread public support, however, more fundamental changes toward a society that is safe from toxic chemicals have yet to be achieved. In this context, a group of experts and non-governmental organization (NGO) activists gathered to diagnose the current conditions of controls over toxic chemicals in Korea, and to propose policy alternatives. Based on a series of discussions, a consensus report was drafted by Shinbum Kim, a researcher of the Wonjin Institute for Occupational and Environmental Health. The draft was revised several times with comments from professional communities. The final version was endorsed by representative professional associations including the Korean Society for Environmental Health and Toxicology, the Korean Society for Occupational and Environmental Medicine, the Korean Industrial Hygiene Association, the Korean Academic Society of Occupational Health Nursing, and 549 healthcare professionals affiliated to NGOs such as the Association of Physicians for Humanism. On July 11, 2016, the agenda was finally released to the public.
2016年,韩国(以下简称韩国)发生了多起儿童和孕妇被家用加湿器消毒剂伤害或致死的事件。对制造、进口或销售这些产品的公司的刑事审判正在进行中,消费者对这些产品的抵制得到了广泛的公众支持,然而,朝向一个远离有毒化学品的安全社会的更根本的变革尚未实现。在这种情况下,专家和非政府组织(NGO)活动家聚集在一起,对韩国有毒化学品的管制现状进行了诊断,并提出了政策建议。原津职业环境健康研究所研究员金新范(音)通过一系列讨论,起草了一份共识报告。根据专业团体的意见,草案被修改了几次。韩国环境健康与毒理学学会、韩国职业与环境医学学会、韩国产业卫生协会、韩国职业健康护理学术学会等代表性专业协会,以及人道主义医师协会等非政府组织附属的549名保健专业人员批准了最终版本。2016年7月11日,议程终于向公众公布。
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引用次数: 0
Evaluation of metal contamination and phytoremediation potential of aquatic macrophytes of East Kolkata Wetlands, India 印度东加尔各答湿地水生植物金属污染评价及修复潜力
Q3 Medicine Pub Date : 2016-09-08 DOI: 10.5620/eht.e2016021
A. Khatun, Sandipan Pal, A. K. Mukherjee, P. Samanta, S. Mondal, Debraj Kole, P. Chandra, A. Ghosh
Objectives The present study analyzes metal contamination in sediment of the East Kolkata Wetlands, a Ramsar site, which is receiving a huge amount of domestic and industrial wastewater from surrounding areas. The subsequent uptake and accumulation of metals in different macrophytes are also examined in regard to their phytoremediation potential. Methods Metals like cadmium (Cd), copper (Cu), manganese (Mn), and lead (Pb) were estimated in sediment, water and different parts of the macrophytes Colocasia esculenta and Scirpus articulatus. Results The concentration of metals in sediment were, from highest to lowest, Mn (205.0±65.5 mg/kg)>Cu (29.9±10.2 mg/kg)>Pb (22.7±10.3 mg/kg)>Cd (3.7±2.2 mg/kg). The phytoaccumulation tendency of these metals showed similar trends in both native aquatic macrophyte species. The rate of accumulation of metals in roots was higher than in shoots. There were strong positive correlations (p<0.001) between soil organic carbon (OC) percentage and Mn (r =0.771), and sediment OC percentage and Pb (r=0.832). Cation exchange capacity (CEC) also showed a positive correlation (p<0.001) with Cu (r=0.721), Mn (r=0.713), and Pb (r=0.788), while correlations between sediment OC percentage and Cu (r=0.628), sediment OC percentage and Cd (r=0.559), and CEC and Cd (r=0.625) were significant at the p<0.05 level. Conclusions Bioaccumulation factor and translocation factors of these two plants revealed that S. articulatus was comparatively more efficient for phytoremediation, whereas phytostabilization potential was higher in C. esculenta.
本研究分析了拉姆萨尔湿地东加尔各答湿地沉积物中的金属污染,该湿地正在接收来自周围地区的大量生活和工业废水。随后的吸收和积累的金属在不同的大型植物也检查了他们的植物修复潜力。方法测定了大植海葵和山棘不同部位沉积物、水体和土壤中镉、铜、锰、铅的含量。结果沉积物中金属元素浓度由高到低依次为Mn(205.0±65.5 mg/kg)、Cu(29.9±10.2 mg/kg)、Pb(22.7±10.3 mg/kg)、Cd(3.7±2.2 mg/kg)。这些金属的植物积累趋势在两种原生水生植物中表现出相似的趋势。金属在根中的积累速率高于在茎中的积累速率。土壤有机碳(OC)百分比与Mn (r= 0.771)、沉积物有机碳百分比与Pb (r=0.832)呈极显著正相关(p<0.001)。阳离子交换容量(CEC)与Cu (r=0.721)、Mn (r=0.713)、Pb (r=0.788)呈显著正相关(p<0.001),沉积物OC百分比与Cu (r=0.628)、沉积物OC百分比与Cd (r=0.559)、CEC与Cd (r=0.625)呈显著正相关(p< 0.05)。结论两种植物的生物积累因子和转运因子分析表明,关节杉具有较高的植物修复效率,而豆杉具有较高的植物稳定潜力。
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引用次数: 13
Humidifier disinfectant lung injury, how do we approach the issues? 加湿器消毒液伤肺,我们该如何处理问题?
Q3 Medicine Pub Date : 2016-08-29 eCollection Date: 2016-01-01 DOI: 10.5620/eht.e2016019
Jihyun Emma Choi, Sang-Bum Hong, Kyung-Hyun Do, Hwa Jung Kim, Seockhoon Chung, Eun Lee, Jihyun Choi, Soo-Jong Hong

A large portion of the Korean population has been exposed to toxic humidifier disinfectants (HDs), and considering that the majority of the victims are infants, the magnitude of the damage is expected to be considerably larger than what has currently been revealed. The current victims are voicing problems caused by various diseases, including but not limited to lung, upper respiratory tract, cardiovascular, kidney, musculoskeletal, eye, and skin diseases, etc. However, there has been difficulty in gaining validation for these health problems and identifying causal relationships due to lack of evidence proving that toxic HD is the specific causes of extrapulmonary diseases such as allergic rhinitis. Furthermore, the victims and bereaved families of the HD case have not received any support for psychological distress such as post-traumatic stress disorder, depression, feelings of injustice, and anger caused by the trauma. In addition, because the underlying mechanisms of the toxic materials within the HDs such as polyhexamethylene guanidine phosphate, poly(oxyalkylene guanidine) hydrochloride, chloromethylisothiazolinone/methylisothiazolinone have yet to be determined, the demand for information regarding the HD issue is growing. The victims of the HD cases require support that goes beyond financial aid for medical costs and living expenses. There is a desperate need for government-led integrated support centers that provide individualized support through health screenings; in other words, we need an integrated facility that provides the appropriate social support to allow the victims to recover their physical and mental health, so as to well prepare them to return to a normal life. The implementation of such a plan requires not only the close cooperation between those departments already directly involved such as the Ministry of Environment and the Ministry of Health and Welfare, but also active support on a national scale from pan-governmental consultative bodies.

韩国有相当一部分人接触过有毒的加湿器杀菌剂(hd),考虑到大部分受害者是婴儿,预计受害程度将比目前公布的严重得多。目前的受害者是各种疾病引起的声音问题,包括但不限于肺、上呼吸道、心血管、肾脏、肌肉骨骼、眼睛和皮肤疾病等。然而,由于缺乏证据证明毒性HD是肺外疾病(如过敏性鼻炎)的具体原因,因此很难对这些健康问题进行验证并确定因果关系。此外,受害人及死者家属在创伤后精神紧张症、抑郁、不公平感及因创伤而产生的愤怒情绪等心理困扰方面,并没有得到任何支援。此外,由于HD内有毒物质如聚六亚甲基胍磷酸、聚氧烷基胍盐酸盐、氯甲基异噻唑啉酮/甲基异噻唑啉酮的潜在机制尚未确定,因此对HD问题的信息需求日益增加。家庭暴力案件的受害者需要的支持不仅仅是医疗费用和生活费用的经济援助。迫切需要政府主导的综合支持中心,通过健康筛查提供个性化支持;换句话说,我们需要一个综合设施,提供适当的社会支持,使受害者恢复身心健康,为他们回归正常生活做好准备。实施这一计划不仅需要环境部和卫生福利部等直接参与的部门之间的密切合作,而且需要泛政府协商机构在全国范围内的积极支持。
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引用次数: 14
Relationship between residential district and health-related quality of life in Chungnam industrial complex area. 忠南工业园区居住小区与健康相关生活质量的关系
Q3 Medicine Pub Date : 2016-08-26 eCollection Date: 2016-01-01 DOI: 10.5620/eht.e2016017
Heechan Kim, Sangchul Roh

Objectives: This study aimed to evaluate the relationship between residential district of people, such as power plant, steel-mill and petrochemical industries, and health-related quality of life (HRQoL).

Methods: Using a cross-sectional study design, we randomly recruited participants for our study from industrial areas (thermoelectric power plant, steel-mill, petrochemical industry) and rural areas. Logistic regression analysis was used to identify the relationships between Euro quality of life-5 dimension (EQ-5D) scores and living region, while controlling for sociodemographic characteristics.

Results: In adjusted model, quality of life decreased with increasing category of age and were lower for females than males. EQ-5D scores of people living in the vicinity of thermoelectric power plant were significant lower than those of people living the vicinity of comparison region (odds ratio, 1.59; 95% confidence interval, 1.00 to 2.53).

Conclusions: Living region of thermoelectric power plant, was strongly associated with scores on the EQ-5D. More research is needed to elucidate the mechanisms which makes the relationship with the living regions and HRQoL.

目的:本研究旨在探讨电厂、炼钢、石化等行业居民居住区域与健康相关生活品质(HRQoL)的关系。方法:采用横断面研究设计,随机从工业地区(热电厂、炼钢厂、石化工业)和农村地区招募研究对象。采用Logistic回归分析确定欧洲生活质量5维度(EQ-5D)得分与居住区域之间的关系,同时控制社会人口统计学特征。结果:在调整后的模型中,生活质量随年龄类别的增加而下降,女性的生活质量低于男性。居住在火力发电厂附近的人的EQ-5D得分显著低于居住在比较区域附近的人(优势比,1.59;95%置信区间为1.00 ~ 2.53)。结论:火力发电厂居住区域与EQ-5D得分密切相关。其与生活区域和HRQoL之间关系的机制有待进一步研究。
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引用次数: 5
Risk factors associated with depression and suicidal ideation in a rural population. 农村人口抑郁和自杀意念的相关危险因素
Q3 Medicine Pub Date : 2016-08-26 eCollection Date: 2016-01-01 DOI: 10.5620/eht.e2016018
Yosub Joo, Sangchul Roh

Objectives: This study aimed to evaluate the risk factors associated with depression and suicidal ideation in a rural population.

Methods: A survey was conducted with 543 farmers from Chungcheongnam-do Province using the Center for Epidemiologic Studies Depression Scale (CES-D) for depression, Lubben Social Network Scale (LSNS) for social support, Swedish Q16 for neurotoxicity symptoms and a survey tool for farmer's syndrome.

Results: After adjusting for socioeconomic factors using logistic regression analysis, poor self-rated health, low social support and neurotoxicity were positively associated with the risk of depression (odds ratio [OR], 15.96; 95% confidence interval [CI], 3.11 to 81.97; OR, 3.14; 95% CI, 1.26 to 7.82; and OR, 3.68; 95% CI, 1.08 to 12.57, respectively). The risk of suicidal ideation significantly increased with low social support, neurotoxicity and farmer's syndrome (OR, 2.28; 95% CI, 1.18 to 4.40; OR, 6.17; 95% CI, 2.85 to 13.34; and OR, 3.70; 95% CI, 1.51 to 9.07, respectively).

Conclusions: Given the overall results of this study, there is a need to establish programs which can improve the health and social relationships of farmers. Also, when farmers have neurological symptoms from pesticide exposure and characteristic symptoms of farmer's syndrome, a monitoring system for depression and suicide must be made available.Conclusions: Given the overall results of this study, there is a need to establish programs which can improve the health and social relationships of farmers. Also, when farmers have neurological symptoms from pesticide exposure and characteristic symptoms of farmer's syndrome, a monitoring system for depression and suicide must be made available.

目的:本研究旨在评估农村人群中与抑郁和自杀意念相关的危险因素。方法:采用流行病学研究中心抑郁量表(CES-D)、Lubben社会网络量表(LSNS)、瑞典Q16神经毒性症状量表和农民综合征问卷调查工具,对忠清南道543名农民进行问卷调查。结果:经logistic回归分析调整社会经济因素后,自评健康不良、社会支持低和神经毒性与抑郁风险呈正相关(优势比[OR], 15.96;95%置信区间[CI], 3.11 ~ 81.97;或者,3.14;95% CI, 1.26 ~ 7.82;OR为3.68;95% CI分别为1.08 ~ 12.57)。低社会支持、神经毒性和农民综合征显著增加自杀意念风险(OR, 2.28;95% CI, 1.18 ~ 4.40;或者,6.17;95% CI, 2.85 ~ 13.34;OR为3.70;95% CI分别为1.51 ~ 9.07)。结论:鉴于本研究的总体结果,有必要建立能够改善农民健康和社会关系的方案。此外,当农民因接触农药而出现神经系统症状和农民综合症的特征性症状时,必须建立一个监测抑郁和自杀的系统。结论:鉴于本研究的总体结果,有必要建立能够改善农民健康和社会关系的方案。此外,当农民因接触农药而出现神经系统症状和农民综合症的特征性症状时,必须建立一个监测抑郁和自杀的系统。
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引用次数: 24
Decreased absorption of midazolam in the stomach due to low pH induced by co-administration of Banha-sasim-tang. 由于同时服用Banha-sasim-tang导致pH值降低,咪达唑仑在胃中的吸收减少。
Q3 Medicine Pub Date : 2016-08-09 eCollection Date: 2016-01-01 DOI: 10.5620/eht.e2016016
Jun Hyeon Jo, Sun Joo Kim, Woong Shik Nam, Eun Ji Seung, Sangkyu Lee

Objectives: Banha-sasim-tang (BST), which consists of seven different herbs, is one of the most popular herbal formulae for treating gastrointestinal disorders in Eastern Asia. The commonly used herbal medicine is often co-administered with other therapeutic drugs, which raises the possibility of herb-drug interactions and may modify the clinical safety profile of therapeutic drugs.

Methods: We investigated the potential herb-drug interactions between BST extract and midazolam (MDZ) in mice. The area under the plasma concentration-time curve (AUC) of MDZ and 1ʹ-hydroxymidazolam (1ʹ-OH-MDZ) was evaluated for both oral and intraperitoneal administration of MDZ, following oral administration of BST (0.5 and 1 g/kg).

Results: It was found that the AUC of MDZ and 1ʹ-OH-MDZ was lower in case of oral administration of MDZ. Administration of BST extract was not associated with hepatic cytochrome P450 activity. BST extract induced a strong reduction in pH and it has been reported that oral mucosal absorption of MDZ is lower at low pH. The decreased absorption rate of MDZ might be caused by the ingredients of BST and may not be related to other factors such as increased excretion of MDZ by P-glycoprotein.

Conclusions: The altered pharmacokinetics of midazolam caused by co-administration with BST in vivo could be attributed to a decrease in pH and subsequent reduction of MDZ absorption rate.

目的:Banha-sasim-tang (BST)由七种不同的草药组成,是东亚最受欢迎的治疗胃肠疾病的草药配方之一。常用的草药通常与其他治疗药物共同使用,这增加了草药与药物相互作用的可能性,并可能改变治疗药物的临床安全性。方法:研究BST提取物与咪达唑仑(MDZ)在小鼠体内潜在的药物相互作用。在口服BST (0.5 g/kg和1 g/kg)后,分别测定口服和腹腔给药MDZ和1′-羟咪达唑仑(1′-OH-MDZ)的血浆浓度-时间曲线下面积(AUC)。结果:口服MDZ时,MDZ和1 + -OH-MDZ的AUC较低。BST提取物的施用与肝细胞色素P450活性无关。BST提取物诱导pH值的强烈降低,有报道称,在低pH值下,口腔黏膜对MDZ的吸收率较低。MDZ吸收率的降低可能是由BST的成分引起的,可能与p -糖蛋白对MDZ的排泄增加等因素无关。结论:咪达唑仑与BST共给药引起体内药代动力学的改变可能是由于pH的降低和随后的MDZ吸收率的降低。
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引用次数: 3
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Environmental Health and Toxicology
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