Special Prescriptions Research Articles

Legal institute of preferences: concept, composition and system

The author formulates the concept, constitutional and legal basis, composition and system of the legal institution of preferences of the Russian competition law. The relevance of the study is determined by the fact that by now this legal education has not only not been studied in domestic jurisprudence, but is not positioned at all in the doctrine of competition law. Moreover, some legal scholars consider it alien to competition law. The purpose of the study is to substantiate the functioning of a separate legal institution of preferences in the system of competition law, the political and legal basis of which is the constitutional and legal provisions defining the beginnings of the country's market economy and the solution of socially significant tasks of Russian society through the use of the preferential mechanism, which includes two levels of legal forms at the sectoral level norms of international acts and treaties of Russia, regulatory legal acts of the Federation, subjects of the Russian Federation and municipalities of procedural and material order, differentiating into general and special prescriptions, forming its general and special parts. In the process of studying the legal phenomenon of preferences, a dialectical method of cognition was used within the framework of a materialistic approach in combination with private scientific methods of cognition of social and legal phenomena: analysis and synthesis, observations and comparisons, system and framework method, forecasting, planning and modeling. As a result of the conducted research, the fundamentals of the theory of the competitive legal institute of preferences are presented, as well as the positions of denial of the connection of preferences with the regulation and protection of competition among legal scholars and interpretation of the relevant provisions exclusively from the perspective of anticonrurent regulation of the activities of public legal entities are refuted. The provisions and conclusions of the study can be used in the law-making and law enforcement practice of the relevant legal provisions, as well as in the educational process of training lawyers. The novelty lies in the substantive analysis of the regulatory framework for the selective provision by the authorities of public legal entities with the prior consent of the antimonopoly authority of the country to economic entities of preferences as a separate institution of a special part of competition law.The functioning of the competitive legal institute of preferences is based on legal principles that determine its method, tasks and functions.

Функции норм-оговорок в российском праве (на примере словосочетания «исключительный случай»)

The article is devoted to the study of the functional aspect of such a variety of special legal prescriptions as normsreservations, using the example of the legal-linguistic construction ‘exceptional case’. Based on the analysis of the content of the legal doctrine, modern normative legal acts, decisions of judicial authorities, the hypothesis is put forward that the reservation norms have acquired not only a stable character as a component of the legal matter, but should also be considered as a kind of special legal norm having a normative character, specifying and detailing significance. Arguments are given to the proposed provision, including those demonstrating the establishment of exceptions from the general procedure of legal regulation and (or) additions to it due to the reservation ‘in an exceptional case’. It is proved that, acting as a manifestation of the specialization of legislation, a reservation norm containing the lexeme ‘exceptional case’ can manifest itself as a positive phenomenon of legislation, and carry a negative charge.

A Study on the Aesthetic Characteristics of Hetaira Beauty Style Expressed in Greek Pottery

This study studied the aesthetic characteristics of Hetaira's costume and beauty style expressed in pottery paintings of the Greek era as the contents of Greek mythology were recently re-examined as the subject of humanities interest. In ancient Greece, the common name for prostitutes was Hetaira, and she was a religious prostitute who was at the top of the list of prostitutes in Greek society, enjoying the wealth of freedom and status more than any other woman. The aesthetic characteristics of the Hetaira beauty style of the Greek era were largely shown as An ornament beauty, An ostentatious sensuality and symbolic beauty of power. First, An ornament beauty was the makeup of a Greek Hetaira woman, who emphasized her eyes with thick and dark black eyebrows and black eyeliner. The Hetaira woman's face was white with white lead, her eyes were emphasized with eyeshadow using black cowl, and she applied orange short yarn to her cheeks and mouth to put on intense color makeup. Hetara dyed her hair in all sorts of colors, decorated her hair with hairpieces, wore thin cloth ribbons and chest bands, and sprayed perfume made with special prescriptions. Second, ostentatious sensual beauty was applied to various sexual zones of the feminine body and the whole body, such as the nipple and buttocks, which can stimulate men's sexual pleasure, and Hetair's outfit was in the form of a full-body keyton or revealing the upper body. The hair was as voluminous as possible, and the method of dispersing the tarae on the forehead was used to make it look as sensual as possible. Curled hair with thick waves was naturally curled up and expressed sensibly using a signon shape and long hair. Third, the symbolic beauty of power is that ancient Greece's ‘privilege fashion’ was ‘nature’, a power that only men could have, but Hetaira had equal power with men in the symposium with nakedness. The hairstyle seems to have been able to wear a veil or a laurel crown, which is exclusively for men. In the form of a wig, he preferred a curling style with no forehead exposed, and it was found that he produced blade hair. Hetaira's style, represented in Greek pottery paintings, had hair, makeup, and fashion styles that represented the Greek era, possessed greater power and wealth than ordinary women in the Greek era, and was found to have the privilege of wearing heavy makeup, light hair colors and hair decorations that were not allowed by ordinary women. Therefore, it was found that it was very meaningful to study Hetaira's beauty style in studying the beauty culture of the Greek era.

Pharmacy technician-led general practice support hub: a feasibility study

Abstract Introduction Workforce pressures in general practice have led to Scottish Government initiatives to integrate pharmacy teams into general practice. The focus is completion of prescribing management-related activities releasing general practitioner time for patient-focused workload.1 Activities include medicines reconciliation from immediate discharge letters (IDL), processing outpatient prescription requests (OPL) and special request prescriptions (SR). Pharmacists effectively mobilise GP capacity completing these tasks.2 However, pharmacists may aspire to advanced practice roles including medication review case-load management. Therefore, alternative workload delivery models including centralised pharmacy technician-led general practice support hubs to complete IDL, OPL and SR tasks must be considered. National guidance outlines that pharmacy technicians may complete these tasks autonomously with minimal supervision.3 Unknowns include whether pharmacy technicians can lead this service delivery and the definition of the supervisory support required. Aim To evaluate the feasibility of a pharmacy technician-led hub for completion of SR, IDL and OPL. Methods Feasibility was studied over 4 weeks (12 April – 7 May 2021) during routine service delivery across three medical practices (approx. 23 800 patients) in NHS Greater Glasgow and Clyde. Quantitative real-time self-reported data on the volume of tasks (SR/IDL/OPL), task completion time and volume of pharmacist referrals was collected by pharmacy technicians and pharmacists and analysed in Microsoft Excel®. Qualitative data describing why pharmacy technicians referred tasks to pharmacists was collected and categorized using thematic analysis and Microsoft Excel® by the lead author. Ethical approval was not required for this service evaluation. Results 4485 total tasks were completed: SR 87% (n=3917); IDL 7% (n=323); OPL 6% (n=245). Pharmacy technicians completed most (71%; n=3181) prescribing management-related tasks. A service delivery gap (21%; n=921 of tasks) where workload exceeded technician resource, necessitated pharmacist support. Referral rate for tasks beyond technician competence was 11% (n=383). The locally agreed 48-hour benchmark turnaround to process tasks was achieved for the majority of tasks. Breaches of the target were noted: 53 (1%) SR; 10 (3%) IDL and 5 (2%) OPL. Technicians and pharmacists completed tasks in numerically similar times. 383 tasks were referred to a pharmacist. 134 (35%) tasks could only be completed by a pharmacists due to the need for a prescribing decision or pharmacist-specific knowledge. 226 (59%) could be completed by a technician with additional knowledge or training. Examples include queries requiring interpretation of clinical parameters or blood monitoring or answering medicines information enquiries. 6% (n=23) of referrals were uncategorised due to incomplete data collection. Discussion/Conclusion This study provides new information describing the workload volume achieved by pharmacy technicians and characterising the supervisory role of the pharmacist. Pharmacy technicians convincingly completed most activities. Service delivery gaps need addressed including maintenance of service delivery during periods of authorised absence and professional development time. Pharmacist referral rate can be improved by upskilling pharmacy technicians. The volume of SR tasks drives the workload and could be managed more effectively by converting suitable SR tasks to controlled repeats. A Health Improvement Scotland initiative is developing this work stream. Additional projects must identify training gaps to understand technician development needs and analyse achievement of advanced pharmacist activities where technician-led hub exists.

Review of San Xiao Lun

San Xiao Lun is a posthumous manuscript by Liu Wansu. It discussed the etiology, pathogenesis and therapeutic principles of diabetes with special prescriptions for it. Most references in this book came from the works of Liu Wansu himself and some of them came from the works of other sources, such as The Internal Cannon of Medicine. It can be seen that it was a book with Liu Wansu's rethinking and summerising about diabetes after he completed his other works. San Xiao Lun was first published in Ru Men Shi Qin in the Jin Dynasty. It was also cited by Yi Fang Lei Ju in Korea in 1445. It was fully recorded and published in Ru Men Shi Qin in the Wanli Period in the Ming Dynasty and therefore, became the basic version of the current one. After that, it envolved into Si Ku Quan Shu. In the end of the Qing Dynasty, this book was published independently with the comments by Zhou Xuehai, being one of the books in the Zhous' Series Medical Books(Zhou Shi Yi Xue Cong Shu).

Analysis on the Special Prescriptions from the Book of Chengfang Qieyong

The kinds of special prescriptions in the book of Chengfang Qieyong cover a wide range of subjects such as internal medicine, gynecology, pediatrics and surgery, etc. These prescriptions have gathered the original discussions of doctors of all ages, condensed the author's own in-depth insights, and displayed the profound connotation of traditional Chinese medicine prescriptions or clinical efficacy characteristics. Guided by the function and categories of the original monograph, 26 prescriptions were integrated into seven categories, i.e.treating Qi and regulating Blood, nourishing and eliminating, exterior dispersing and dispelling cold, compromising and purging fire, drying dampness and expelling phlegm, fetal birth and baby, and carbuncle. Based on the characteristics of clinical efficacy, the connotation of legislative prescriptions, the modification of prescriptions and medicines, and the degree of decoction and prescription, etc, this paper analyzes the connotation of traditional Chinese medicine of these special prescriptions, and provides important reference for the research of modern prescriptions, the expansion of clinical application and the development of new drugs of traditional Chinese medicine.

Use of potassium polyaspartate for stabilization of potassium bitartrate in wines: influence on colloidal stability and interactions with other additives and enological practices

The research was aimed at verifying the efficacy of potassium polyaspartate (KPA), added at bottling, for prevention of the precipitation of potassium bitartrate (KHT). The stability of KHT was determined with the mini-contact test and the cold test. The effect of KPA on the colloidal stability of white and red wines was also studied. Turbidity, color, and total anthocyanins and flavonoids (red wines only) were monitored. In the first experiment, the stabilizing effect of KPA added at bottling, with or without Arabic gum, tannins, and filtration (0.45µm cut-off), was studied in comparison with metatartaric acid (MTA). KPA proved to have good stabilizing efficacy for prevention of KHT precipitation and maintained its effect in all trials after 1 year of bottle aging. On the contrary, all the trials with MTA became unstable after 6 months. Moreover, KPA did not modify wine turbidity and color. The filtration (0.45µm cut-off) did not reduce its stabilizing efficacy. In the second experiment, the effect of KPA added to a white and a red wine, respectively clarified with casein and gelatin or vegetal protein and/or bentonite, was studied. KPA did not cause any increase in turbidity or appreciable changes in the color of the white wines of the different trials. A preliminary treatment with bentonite can prevent the possible formation of haze in red wines after the addition of KPA. PRACTICAL APPLICATION: KPA prevented the precipitation of KHT in unstable white and red wines. The stabilizing effect persisted after 1 year of bottle aging. The oenologist does not need to adopt special prescriptions when using KPA in combination with Arabic gum or tannins in prebottling operations. A treatment with bentonite prevented the appearance of turbidity in red wines after the addition of KPA.

Clinical research progress of integrated traditional Chinese and western medicine in the treatment of infectious mononuclear cell hypertrophy in children

Discussions are made on the etiology and pathogenesis, classification, stages, special prescriptions, special medicines, Chinese patent medicines and external treatment of traditional Chinese medicine.This paper reviews the treatment of infectious mononucleosis (IM) in children by integrated traditional Chinese and western medicine in recent years, and provides new ideas for clinical treatment of IM. Key words: Infectious mononucleosis; Medicine, Chinese traditional; Overview; Child

Adecuación del uso de antibióticos de “Categoría Especial” en el Servicio de Urgencias de un hospital de tercer nivel

RESUMENObjetivoAnalizar la adecuación de las prescripciones de antibióticos de categoría especial (ATB de CE) en el Servicio de Urgencias Hospitalario (SUH) de un centro urbano de tercer nivel.Material y métodosSe seleccionó una muestra aleatoria de 100 pacientes diferentes a los que se les inició un ATB de CE en Urgencias durante el año 2018. El equipo investigador revisó la historia clínica del episodio de urgencias y de ingreso. Se determinó mediante regresión logística los factores independientes asociados con el grado de adecuación del tratamiento.ResultadosSe analizaron 97 prescripciones de las cuales 66 (68%) cumplían los criterios de prescripción adecuada. El grado de adecuación fue del 70% si la infección estaba relacionada con la asistencia sanitaria y del 75% si el paciente tenía factores de riesgo de infección por microorganismos multirresistentes (MMR). El porcentaje de adecuación fue mayor en los casos en los que se especificó el foco de la infección (72%) y la gravedad del episodio (73%). Las variables independientes que se asociaron a una prescripción adecuada fueron: la presencia de factores de riesgo de infección por MMR (OR: 2,35 IC 95%: 1,65 – 3,17 p: 0,01), el especificar el foco de la infección (OR: 3,79 IC 95%: 1,72 – 4,22 p: 0,02) y señalar la gravedad del episodio (OR: 3,09 IC 95%: 1,12 – 3,09 p: 0,03).ConclusionesLa prescripción de los ATB de CE en el SUH es adecuada en la medida que se tenga en cuenta el ámbito de adquisición de la infección, los factores de riesgo de MMR, el foco de infección y la gravedad del cuadro clínico.

Рациональное и сакральное у Галена

This paper examines mutual relations between the rational medical practice and the practice of temple healing connected with the ancient cult of Asclepius in the writings of Galen of Pergamon (129–210/217). It is shown that Galen considered logics as the main methodological basis of medical theory and practice, supposing that by virtue of logics it is possible “to prove in the best way everything that can be proved.” Although he sharply criticized medical Empiricists for denying the usefulness of logics, and did not accept magical incantations and irrational explanations of diseases, nevertheless Galen viewed himself as a disciple and servant of Asclepius, whom he used to call his “paternal god.” In complicated clinical cases Galen recurred to the divine counsels of Asclepius, from whom he received by the way of dreams therapeutic revelations with special prescriptions for treatment. He distinguished this kind of dreams from so-called “semiotic” or “diagnostic” dreams, related to the physical conditions of a patient. The study has shown that Asclepius’ dreams served as a sign of legitimacy in medical profession, since Galen considered rational medicine as a declined form of the perfect medical art of Hippocrates, who received medical training in the “Asclepeion” on Kos and was considered the descendant of Asclepius. However, unlike the Christian conception of the omnipotent God, according to Galen Asclepius is not omnipotent, he helps only in choosing the best way of healing from different possible things and is unable to transgress the laws of nature producing miracles. Thus, in his writings, Galen did not oppose the rational medical practice to the practice of temple healing, but tried to reconcile the rational and the sacred, medicine and religion.

Information-based monitoring platform for rational use of antibiotics at a Chinese university hospital

BackgroundThis study aims to describe the implementation of an information-based monitoring platform for rational use of antibiotics (IMPUA) in a Chinese university hospital, and to test the effectiveness of pharmacists’...

Degradability of injectable calcium sulfate/mineralized collagen-based bone repair material and its effect on bone tissue regeneration

The nHAC/CSH composite is an injectable bone repair material with controllable injectability and self-setting properties prepared by introducing calcium sulfate hemihydrate (CSH) into mineralized collagen (nHAC). When mixed with water, the nHAC/CSH composites can be transformed into mineralized collagen/calcium sulfate dihydrate (nHAC/CSD) composites. The nHAC/CSD composites have good biocompatibility and osteogenic capability. Considering that the degradation behavior of bone repair material is another important factor for its clinical applications, the degradability of nHAC/CSD composites was studied. The results showed that the degradation ratio of the nHAC/CSD composites with lower nHAC content increased with the L/S ratio increase of injectable materials, but the variety of L/S ratio had no significant effect on the degradation ratio of the nHAC/CSD composites with higher nHAC content. Increasing nHAC content in the composites could slow down the degradation of nHAC/CSD composite. Setting accelerator had no significant effect on the degradability of nHAC/CSD composites. In vivo histological analysis suggests that the degradation rate of materials can match the growth rate of new mandibular bone tissues in the implanted site of rabbit. The regulable degradability of materials resulting from the special prescriptions of injectable nHAC/CSH composites will further improve the workability of nHAC/CSD composites.

Audit of Special Milk Formulae Prescriptions in Primary Care Setting for Feed Intolerance in Paediatric Population

Background & aims: Specialised milk formulae are commonly prescribed in infants and children for feed intolerance. Our aim was to audit prescription of specialised milks for children in general practice population against the European Working Group guideline on management of cow's milk protein intolerance in infants.

Evolution of the management of colorectal cancer using integrative medicine

Colorectal cancer (CRC) remains one of the major causes of cancer death worldwide. In recent years, the development of new and effective management options, such as fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET), total mesorectal excision (TME) and monoclonal antibody novel "targeted" therapies has led to a considerable improvement in the outcome of this disease. In China, studies on CRC using integrative medicine (IM) have made remarkable progress. We therefore review the recent developments in CRC treatment through IM and Western medicine, including research studies such as the exploitation of Chinese herbs for the disruption of the tumor cell cycle or inhibition of tumor cell proliferation, induction of tumor cell apoptosis, improvement of the immune system, and the curative effect of chemotherapy. We also examine clinical studies such as those on special prescriptions and medicines and IM in anti-cancer therapy. Particularly, we analyze the advantages and disadvantages of management with IM, and propose a suggestion for the management of colorectal cancer with IM, such as screening for effective prescriptions. We also analyze Chinese medicine, studying the pharmacologic mechanism of its anti-cancer effect, further strengthening the study of IM on CRC.

Fluoxetina: indícios de uso inadequado

OBJETIVO: Investigar o uso da fluoxetina na cidade de Santo André, SP, por meio de coleta e análise das receitas especiais (RE) prescritas por médicos e arquivadas nas farmácias e drogarias daquela cidade. MÉTODOS: Foram coletadas as receitas especiais retidas durante os meses de agosto do ano de 2005 a julho de 2006, em 13 farmácias de manipulação e em 27 drogarias em diferentes regiões de Santo André. Cada receita especial foi analisada em relação à presença de fluoxetina, em associação ou não a outros princípios ativos, e o sexo do(a) paciente foi anotado. RESULTADOS: Foram analisadas 39.782 RE - 16.124 coletadas das farmácias magistrais e 23.658 das drogarias. Desses totais, 10.919 prescrições continham fluoxetina - 9.259 provenientes das farmácias magistrais (84,8%) e apenas 1.660 (15,2%) das drogarias. As prescrições de fluoxetina eram predominantemente destinadas a mulheres (79,8%). Na imensa maioria das RE, a fluoxetina foi prescrita em associação com um grande número de outras substâncias ativas, inclusive anfetaminas anoréticas, chegando a mais de dez outras em quase a metade das prescrições. Esse tipo de prescrição múltipla, principalmente para mulheres, é comparado com as prescrições de fórmulas magistrais para emagrecer, muito utilizadas no Brasil. CONCLUSÃO: Os dados obtidos sugerem que a utilização de fluoxetina teria um fim estético (perda de peso), e não um fim terapêutico (tratamento de depressão). Discute-se a relação risco-benefício desse possível uso, que poderia ser classificado de inadequado dado as conhecidas reações adversas da fluoxetina e a sua interferência no sistema citocromo P450.

Book of the Month: Patients, Power and Responsibility

Book of the Month: Patients, Power and Responsibility

Study of the interaction of ibuprofen with various polymers

Nonsteroidal antiinflammatory drugs are widely used in modem medicine for the treatment of various disorders. A special place in this group belongs to ibuprofen, which has been used since 1969 and is recognized as an effective low-toxicity analgesic. At the same time, ibuprofen is not free of disadvantages inherent in all drugs capable of inhibiting the cytoprotective isoenzyme cyclooxygenase. The main drawbacks are a decrease in the level of prostaglandins in the mucous membranes of the gastrointestinal tract and the related ulceration effect, which is especially pronounced in the case of prolonged administration of these nonsteroidal antiinflammatory drugs [ 1, 2]. Since ibuprofen is available without special prescriptions and can be used by patients for a long time without regulation, medicinal forms of this drug must be developed so as to exhibit minimum side effects [3]. There are several commonly accepted methods used by 9 modem pharmacy in order to reduce the irritating action of drugs. This goal is mostly achieved by using supplementary components improving the solubility of the drugs or restricting the area of contact between drug and mucous membrane. Various high-molecular-weight compounds (polymers) are among these substances. The purpose of this work was to study the interaction of ibuprofen with various polymers and select substances providing a maximum decrease in the irritating effect of this drug.

Ramp length/grade prescriptions for wheelchair dependent individuals

The aim of this work was to provide well defined criteria for ramp construction for wheelchair dependent individuals (WDI). Force capability was measured in a large sample (140) of WDI, who presented different levels of motor impairment. Levels of impairment were established on the basis of the answers given in a questionnaire regarding the degree of self sufficiency at home as well as outside the home and active participation in sports events. Taking into account those WDI who exhibited at least a minimal level of self-sufficiency, the following prescriptions are indicated. For a 1 metre ramp length, allowable maximal incline 15%; up to 3 metre ramp length, maximal incline 10%. The reliability of such prescriptions was confirmed by having a test ramp traversed by 43 WDI. These values are suggested as confidence limits when faced with public building accommodations. Special prescriptions could be adopted for selected populations of WDI.

Finite-part integrals: a generalization of hadamard’s definition

A generalization of Hadamard’s finite part integrals is presented, such as was proved desirable in previous work (3) for the evaluation of renormalized quantities in field theory without use of counterterms. In particular, the legitimacy of the interchange of limiting and/or integration processes is demonstrated, provided a consistent use of « pseudofunctions » is made. In conclusion, some special prescriptions are discussed in detail and examples are given.