Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 32.864
Filtrar
1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48233

RESUMO

Pacientes com artrite psoríaca contam Protocolo Clínico e Diretrizes Terapêuticas (PCDT) atualizado. O documento foi revisado para que o tratamento ofertado no Sistema Único de Saúde seja baseado na melhor e mais atualizada evidência científica.


Assuntos
Artrite Psoriásica/tratamento farmacológico , Psoríase/tratamento farmacológico , Sistema Único de Saúde/organização & administração , Protocolos Clínicos
2.
Rev Bras Enferm ; 74(4): e20200397, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34105639

RESUMO

OBJECTIVE: Evaluate the association between early pregnant hospitalization and the use of obstetric interventions and cesarean delivery route. METHODS: Cross-sectional study, with 758 women selected at the time of childbirth. It was assumed as early hospitalization when the woman was admitted to the hospital having less than 6 cm of cervical dilation. Logistic regression models were constructed in order to estimate the odds ratio for each obstetric intervention, adjusted by sociodemographic and obstetric variables. RESULTS: 73.22% of women were early hospitalized. On average, they had 1.97 times the chance to undergo Kristeller's maneuver, 2.59 and 1.80 times the chance to receive oxytocin infusion and analgesia, respectively, and 8 times more chances to having their children by cesarean delivery when compared to women that had timely hospitalization. CONCLUSION: Early hospitalized women were submitted to a higher number of obstetric intervention and had increased chances of undergoing cesarean sections.


Assuntos
Cesárea/estatística & dados numéricos , Parto Obstétrico , Hospitalização/estatística & dados numéricos , Trabalho de Parto , Assistência Perinatal/estatística & dados numéricos , Protocolos Clínicos , Estudos Transversais , Feminino , Humanos , Enfermagem Obstétrica , Parto , Gravidez
3.
Medicine (Baltimore) ; 100(22): e26161, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087874

RESUMO

ABSTRACT: The Coronavirus disease 2019 pandemic continues to spread worldwide. Because of the absence of reliable rapid diagnostic systems, patients with symptoms of Coronavirus disease 2019 are treated as suspected of the disease. Use of computed tomography findings in Coronavirus disease 2019 are expected to be a reasonable method for triaging patients, and computed tomography-first triage strategies have been proposed. However, clinical evaluation of a computed tomography-first triage protocol is lacking.The aim of this study is to investigate the real-world efficacy and limitations of a computed tomography-first triage strategy in patients with suspected Coronavirus disease 2019.This was a single-center cohort study evaluating outpatients with fever who received medical examination at Yokohama City University Hospital, prospectively registered between 9 February and 5 May 2020. We treated according to the computed tomography-first triage protocol. The primary outcome was efficacy of the computed tomography-first triage protocol for patients with fever in an outpatient clinic. Efficacy of the computed tomography-first triage protocol for outpatients with fever was evaluated using sensitivity, specificity, positive predictive value, and negative predictive value. We conducted additional analyses of the isolation time of feverish outpatients and final diagnoses.In total, 108 consecutive outpatients with fever were examined at our hospital. Using the computed tomography-first triage protocol, 48 (44.9%) patients were classified as suspected Coronavirus disease 2019. Nine patients (18.8%) in this group were positive for severe acute respiratory syndrome coronavirus 2 using polymerase chain reaction; no patients in the group considered less likely to have Coronavirus disease 2019 tested positive for the virus. The protocol significantly shortened the duration of isolation for the not-suspected versus the suspected group (70.5 vs 1037.0 minutes, P < .001).Our computed tomography-first triage protocol was acceptable for screening patients with suspected Coronavirus disease 2019. This protocol will be helpful for appropriate triage, especially in areas where polymerase chain reaction is inadequate.


Assuntos
COVID-19/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Triagem/métodos , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Protocolos Clínicos , Comorbidade , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Fatores Sexuais , Adulto Jovem
4.
BMJ Open ; 11(6): e047025, 2021 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-34130962

RESUMO

BACKGROUND: Prevalence of people with multimorbidity rises. Multimorbidity constitutes a challenge to the healthcare system, and treatment of patients with multimorbidity is prone to high-quality variations. Currently, no set of quality indicators (QIs) exists to assess quality of care, let alone incorporating the patient perspective. We therefore aim to identify aspects of quality of care relevant to the patients' perspective and match them to a literature-based set of QIs. METHODS: We conducted eight focus groups with patients with multimorbidity and three focus groups with patients' relatives using a semistructured guide. Data were analysed using Kuckartz's qualitative content analysis. We derived deductive categories from the literature, added inductive categories (new quality aspects) and translated them into QI. RESULTS: We created four new QIs based on the quality aspects relevant to patients/relatives. Two QIs (patient education/self-management, regular updates of medication plans) were consented by an expert panel, while two others were not (periodical check-ups, general practitioner-coordinated care). Half of the literature-based QIs, for example, assessment of biopsychosocial support needs, were supported by participants' accounts, while more technical domains regarding assessment and treatment regimens were not addressed in the focus groups. CONCLUSION: We show that focus groups with patients and relatives adding relevant aspects in QI development should be incorporated by default in QI development processes and constitute a reasonable addition to traditional QI development. Our QI set constitutes a framework for assessing the quality of care in the German healthcare system. It will facilitate implementation of treatment standards and increase the use of existing guidelines, hereby helping to reduce overuse, underuse and misuse of healthcare resources in the treatment of patients with multimorbidity. TRIAL REGISTRATION NUMBER: German clinical trials registry (DRKS00015718), Pre-Results.


Assuntos
Multimorbidade , Indicadores de Qualidade em Assistência à Saúde , Protocolos Clínicos , Atenção à Saúde , Grupos Focais , Humanos
5.
Mayo Clin Proc ; 96(5): 1250-1261, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33958056

RESUMO

The administration of spike monoclonal antibody treatment to patients with mild to moderate COVID-19 is very challenging. This article summarizes essential components and processes in establishing an effective spike monoclonal antibody infusion program. Rapid identification of a dedicated physical infrastructure was essential to circumvent the logistical challenges of caring for infectious patients while maintaining compliance with regulations and ensuring the safety of our personnel and other patients. Our partnerships and collaborations among multiple different specialties and disciplines enabled contributions from personnel with specific expertise in medicine, nursing, pharmacy, infection prevention and control, electronic health record (EHR) informatics, compliance, legal, medical ethics, engineering, administration, and other critical areas. Clear communication and a culture in which all roles are welcomed at the planning and operational tables are critical to the rapid development and refinement needed to adapt and thrive in providing this time-sensitive beneficial therapy. Our partnerships with leaders and providers outside our institutions, including those who care for underserved populations, have promoted equity in the access of monoclonal antibodies in our regions. Strong support from institutional leadership facilitated expedited action when needed, from a physical, personnel, and system infrastructure standpoint. Our ongoing real-time assessment and monitoring of our clinical program allowed us to improve and optimize our processes to ensure that the needs of our patients with COVID-19 in the outpatient setting are met.


Assuntos
Antivirais/administração & dosagem , COVID-19 , Procedimentos Clínicos , Terapia por Infusões no Domicílio , SARS-CoV-2 , Glicoproteína da Espícula de Coronavírus , Anticorpos Monoclonais/administração & dosagem , COVID-19/epidemiologia , COVID-19/terapia , Protocolos Clínicos , Procedimentos Clínicos/organização & administração , Procedimentos Clínicos/tendências , Eficiência Organizacional , Terapia por Infusões no Domicílio/métodos , Terapia por Infusões no Domicílio/normas , Humanos , Colaboração Intersetorial , Cultura Organizacional , Desenvolvimento de Programas/métodos , SARS-CoV-2/imunologia , SARS-CoV-2/isolamento & purificação , Índice de Gravidade de Doença , Glicoproteína da Espícula de Coronavírus/antagonistas & inibidores , Glicoproteína da Espícula de Coronavírus/imunologia , Estados Unidos/epidemiologia
7.
Medicine (Baltimore) ; 100(21): e26132, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34032762

RESUMO

ABSTRACT: We aimed to determine the association between the intensive care unit (ICU) model and in-hospital mortality of patients with severe sepsis and septic shock.This was a secondary analysis of a multicenter prospective observational study conducted in 59 ICUs in Japan from January 2016 to March 2017. We included adult patients (aged ≥16 years) with severe sepsis and septic shock based on the sepsis-2 criteria who were admitted to an ICU with a 1:2 nurse-to-patient ratio per shift. Patients were categorized into open or closed ICU groups, according to the ICU model. The primary outcome was in-hospital mortality.A total of 1018 patients from 45 ICUs were included in this study. Patients in the closed ICU group had a higher severity score and higher organ failure incidence than those in the open ICU group. The compliance rate for the sepsis care 3-h bundle was higher in the closed ICU group than in the open ICU group. In-hospital mortality was not significantly different between the closed and open ICU groups in a multilevel logistic regression analysis (odds ratio = 0.83, 95% confidence interval; 0.52-1.32, P = .43) and propensity score matching analysis (closed ICU, 21.2%; open ICU, 25.7%, P = .22).In-hospital mortality between the closed and open ICU groups was not significantly different after adjusting for ICU structure and compliance with the sepsis care bundle.


Assuntos
Mortalidade Hospitalar , Unidades de Terapia Intensiva/organização & administração , Pacotes de Assistência ao Paciente , Sepse/mortalidade , Sepse/terapia , Choque Séptico/mortalidade , Choque Séptico/terapia , Protocolos Clínicos , Terapia Combinada , Humanos , Estudos Prospectivos , Índice de Gravidade de Doença
8.
Dimens Crit Care Nurs ; 40(2): 67-74, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33961373

RESUMO

BACKGROUND: Prolonged duration of mechanical ventilation is associated with higher mortality and increased patient complications; conventional physician-directed weaning methods are highly variable and permit significant time that weaning is inefficient and ineffective. OBJECTIVES: The primary objective of this quality improvement project was to implement a registered nurse (RN)- and respiratory therapist (RT)-driven mechanical ventilation weaning protocol in a medical intensive care unit (ICU) at a tertiary care academic medical center. METHODS: This quality improvement project used a quasi-experimental design with a retrospective usual care group who underwent physician-directed (conventional) weaning (n = 51) and a prospective intervention group who underwent protocol-directed weaning (n = 54). Outcomes included duration of mechanical ventilation, ICU length of stay, reintubation rates, and RN and RT satisfaction with the weaning protocol. RESULTS: Patients in the RN- and RT-driven mechanical ventilation weaning protocol group had significantly lower duration of mechanical ventilation (74 vs 152 hours; P = .002) and ICU length of stay (6.7 vs 10.2 days; P = .031). There was no significant difference in reintubation rates between groups. Staff surveys indicate that both RN and RTs were satisfied with the process change. DISCUSSION: Implementation of a multidisciplinary mechanical ventilation weaning protocol is a safe and effective way to improve patient outcomes and empower ICU staff.


Assuntos
Respiração Artificial , Desmame do Respirador , Protocolos Clínicos , Humanos , Unidades de Terapia Intensiva , Tempo de Internação , Estudos Prospectivos , Estudos Retrospectivos
9.
Gesundheitswesen ; 83(5): e20-e37, 2021 May.
Artigo em Alemão | MEDLINE | ID: mdl-34015857

RESUMO

This prospectively registered review characterizes 50 intervention studies from the 1st wave of the Innovation Fund based on study protocols or original articles, among other sources. The mainly (randomized) controlled intervention studies included predominantly adults/seniors in ambulatory care without a regional focus and analyzed treatment processes, clinical and patient outcomes as outcomes. The substantial lack of study protocols and methodological details (e. g., sample size planning) reveals (avoidable) methodological problems regarding the scientific quality of the funded studies.


Assuntos
Assistência Ambulatorial , Administração Financeira , Adulto , Protocolos Clínicos , Alemanha , Humanos
11.
Nutrients ; 13(4)2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33807319

RESUMO

Childhood obesity is an area of intense concern internationally and is influenced by events during antenatal and postnatal life. Although pregnancy complications, such as gestational diabetes and large-for-gestational-age birthweight have been associated with increased obesity risk in offspring, very few successful interventions in pregnancy have been identified. We describe a study protocol to identify if a reduced calorie diet in pregnancy can reduce adiposity in children to 3 years of age. The dietary intervention in gestational diabetes (DiGest) study is a randomised, controlled trial of a reduced calorie diet provided by a whole-diet replacement in pregnant women with gestational diabetes. Women receive a weekly dietbox intervention from enrolment until delivery and are blinded to calorie allocation. This follow-up study will assess associations between a reduced calorie diet in pregnancy with offspring adiposity and maternal weight and glycaemia. Anthropometry will be performed in infants and mothers at 3 months, 1, 2 and 3 years post-birth. Glycaemia will be assessed using bloodspot C-peptide in infants and continuous glucose monitoring with HbA1c in mothers. Data regarding maternal glycaemia in pregnancy, maternal nutrition, infant birthweight, offspring feeding behaviour and milk composition will also be collected. The DiGest follow-up study is expected to take 5 years, with recruitment finishing in 2026.


Assuntos
Protocolos Clínicos , Obesidade Pediátrica , Adulto , Glicemia , Peso Corporal , Criança , Diabetes Gestacional , Feminino , Seguimentos , Humanos , Estilo de Vida , Fenômenos Fisiológicos da Nutrição Materna , Gravidez , Cuidado Pré-Natal , Fatores de Risco
12.
Medicine (Baltimore) ; 100(14): e25429, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33832144

RESUMO

BACKGROUND: There are no meta-analyses evaluating the efficacy and safety of colchicine in the treatment of acute myocardial infarction (AMI). Our protocol is conceived to evaluate the efficacy and safety of colchicine in comparison of placebo and test the hypothesis that a short course of treatment with colchicine could lead to reduced infarct size in patients presenting with AMI. METHODS: We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines and the recommendations of the Cochrane Collaboration to conduct this meta-analysis. Reviewers will search the PubMed, Cochrane Library, Web of Science, and EMBASE online databases for all English-language cohort studies published up to April, 2021. The cohort studies focusing on assess the efficacy and safety of colchicine in the treatment of AMI will be included in our meta-analysis. At least one of the following outcomes should have been measured: reduced infarct size, C-reactive protein (CRP) level, adverse events, death and major cardiovascular events. Review Manager software will be used for the meta-analysis. All outcomes are pooled on random-effect model. A P value of <.05 is considered to be statistically significant. RESULTS: Our protocol is conceived to evaluate the efficacy and safety of colchicine in comparison of placebo and test the hypothesis that a short course of treatment with colchicine could lead to reduced infarct size in patients presenting with AMI. REGISTRATION NUMBER: 10.17605/OSF.IO/NTU5F.


Assuntos
Anti-Inflamatórios/uso terapêutico , Colchicina/uso terapêutico , Infarto do Miocárdio/tratamento farmacológico , Protocolos Clínicos , Humanos , Modelos Estatísticos , Resultado do Tratamento
13.
Medicine (Baltimore) ; 100(14): e25431, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33832145

RESUMO

BACKGROUND: To our knowledge, there have been no published clinical trials to assess the synergistic effects of applying pulsed radiofrequency (PRF) stimulation of the suprascapular nerve (SSN) plus physical therapy on pain and function in patients with adhesive capsulitis. Therefore, we will conduct this present randomized, double-blind study to evaluate the synergistic effects of applying PRF stimulation of the SSN plus physical therapy on pain and function in patients with adhesive capsulitis. METHODS: The study protocol is a randomized, controlled, double-blind design. Recruitment will be started in March 2021 and completed in October 2022. The treating surgeon will assess 90 patients for eligibility. The study protocol was approved through Institutional Review Board in the People's Hospital of Beilun district of Ningbo. Each patient will be randomized into 3 treatment groups, receiving PRF stimulation of the SSN or physical therapy or both of them. After baseline examination, all patients will be given a full explanation of the treatment protocol and will be required to sign a written informed consent for study participation and for publication of the results. All the data collectors, surgeons, statistical analysts, as well as result assessors are not aware of grouping assignment. The outcomes include Constant score, visual analog scale score, range of motion, and strength. RESULTS: This protocol will provide a reliable theoretical basis for the following research. CONCLUSION: It is assumed that there will be a remarkable difference in postoperative outcomes between the intervention and control groups. TRIAL REGISTRATION NUMBER: 10.17605/OSF.IO/PZ9ES.


Assuntos
Bursite/terapia , Modalidades de Fisioterapia , Tratamento por Radiofrequência Pulsada/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bursite/complicações , Bursite/fisiopatologia , Protocolos Clínicos , Terapia Combinada , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor Musculoesquelética/etiologia , Dor Musculoesquelética/terapia , Estudos Prospectivos , Recuperação de Função Fisiológica , Escápula/inervação , Resultado do Tratamento , Adulto Jovem
14.
Medicine (Baltimore) ; 100(14): e25436, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33832147

RESUMO

BACKGROUND: Hemifacial spasm (HFS) is a clinical common neurological disease, its main performance for 1 side or 2 sides muscles (the orbicularis oculi muscle, expression, orbicularisoris muscles) recurrent paroxysmal, involuntary twitching, aggravating when excited or nervous, more severe cases of the disease may include difficulty in opening the eyes, crooked corners of the mouth, and twitching noises in the ears, etc.[1] Early manifestations of the disease are intermittent mild convulsions of the orbicularis oculi muscle, and then gradually spread to 1 side of the facial muscles, such as frowning muscles, nasal muscles, buccinalis muscles, etc, especially the most obvious spasms of the oral muscles, which can involve the ipsilateral platysma muscle in severe cases, with each twitch for a few seconds to a few minutes. The disease will affect the quality of life such as speaking, eating, seeing and so on, and even cause psychological effects such as inferiority, anxiety and depression. At present, the incidence of the disease in China is 11 per 1.1 million, females are more common than males. There are many ways to treat HFS, but the Qianzheng powder has a unique advantage in treating this disease. Therefore, our systematic review aims to evaluate the efficacy and safety of Qianzheng powder in the treatment of Primary Hemifacial spasm, and to provide a reliable basis for clinical decision makers. METHODS: From its inception until April 2021, we will search electronic databases, including PubMed, Embase, Cochrane Library, China Biomedical Literature Database, China Knowledge Infrastructure, Wanfang Database, and China Scientific Journals Database. The authors will independently sift through studies, extract data information, and assess methodological quality using the Cochrane Risk of Bias tool. The RevManV. 5.3 software will be used for statistical analysis. RESULTS: The results of this study, which will be published in a peerreviewed journal, will evaluate the efficacy and safety of Qianzheng powder in the treatment of primary Hemifacial spasm. CONCLUSION: This systematic review will provide reliable evidence-based basis for treating primary Hemifacial spasm with Qianzheng powder. INPLASY REGISTRATION NUMBER: INPLASY202130037.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Espasmo Hemifacial/tratamento farmacológico , Tomada de Decisão Clínica , Protocolos Clínicos , Humanos , Pós , Resultado do Tratamento
15.
Medicine (Baltimore) ; 100(14): e25443, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33832148

RESUMO

OBJECTIVE: There is no systematic review or meta-analysis to evaluate the efficacy of adjuvant psychotherapy in early-stage bipolar disorder. Therefore, the goal of this meta-analysis is to examine the evidence supporting psychotherapy as an efficacious approach to treating bipolar disorder. METHODS: Seven electronic databases including Web of Science, Embase, PubMed, Wanfang Data, Scopus, Science Direct, Cochrane Library were searched in March 2021 by two independent reviewers. Data extraction was performed independently, and any conflict was resolved before final analysis. Only randomized clinical trials were included in this study. The trial entails 1 primary outcome measure (relapse) and several secondary outcome measures: time to relapse, relapse rate, days missed at work/school (record, interview), and social functioning level. The risk of bias assessment of the included studies was performed by 2 authors independently using the tool recommended in the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: We hypothesized that combined psychotherapy and pharmacological interventions would be superior to pharmacological interventions alone regarding the time to relapse into a manic or depressive episode. CONCLUSION: This study expects to provide credible and scientific clinical evidence for the efficacy and safety of combined psychotherapy and pharmacological interventions in the treatment of bipolar disorder. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/ZGS6W.


Assuntos
Transtorno Bipolar/terapia , Psicoterapia , Psicotrópicos/uso terapêutico , Protocolos Clínicos , Terapia Combinada , Humanos , Modelos Estatísticos , Resultado do Tratamento
16.
Medicine (Baltimore) ; 100(14): e25444, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33832149

RESUMO

BACKGROUND: Recurrent spontaneous abortion (RSA) accounts for the most common complication of early pregnancy in humans. As an immune checkpoint pathway, programmed death-1 (PD-1) and programmed death ligand-1 (PD-L1) can be exploited by tumor cells to evade immuno-surveillance. Many studies have shown that the expression of PD-1/PD-L1 is involved in RSA. However, the correlation between the expression of PD-1/PD-L1 and RSA is still controversial. We conducted meta-analysis to further explore the correlation between the expression of PD-1/PD-L1 and RSA, to provide a basis for clinical prevention and treatment. METHODS: We will search PubMed, Embase, Web of Science, Google Scholar, Chinese National Knowledge Infrastructure, Chinese VIP Information, Wanfang Database, and Chinese Biomedical Literature Database for related published studies before February 2021. Two review authors will search and assess relevant studies independently. Case control studies and cohort studies will be included. The Revman 5.3 software was applied to carry out the meta-analysis for the included literature. RESULTS: The findings of this systematic review will be disseminated in a peer-reviewed publication and/or presented at relevant conferences. CONCLUSION: This study will provide a new theoretical basis for the prevention and treatment of RSA. TRIAL REGISTRATION NUMBER: DOI 10.17605/OSF.IO/CZD23.Ethics and dissemination: Formal ethical approval is not required, as the data are not individualized.


Assuntos
Aborto Habitual/metabolismo , Antígeno B7-H1/metabolismo , Receptor de Morte Celular Programada 1/metabolismo , Aborto Habitual/diagnóstico , Aborto Habitual/etiologia , Aborto Habitual/prevenção & controle , Biomarcadores/metabolismo , Protocolos Clínicos , Feminino , Humanos , Gravidez
17.
Medicine (Baltimore) ; 100(14): e25474, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33832164

RESUMO

BACKGROUND: Sarcopenia is a syndrome characterized by a gradual and generalized loss of skeletal muscle mass and strength leading to physical disability, poor quality of life, and possible death. The disease impacts the steadily increasing aging population worldwide. In this systematic review protocol, we aim to investigate the effects and safety of herbal medicines on skeletal muscle health, specifically focusing on possible treatments for preventing sarcopenia. METHODS: Nine electronic databases will be comprehensively searched from inception to the present date. Clinical studies reporting on the effects and safety of herbal medicines associated with skeletal muscle health and the prevention of sarcopenia will be included. The primary outcome will be determined by five categories: anti-inflammatory and antioxidant efficacy, muscle damage prevention, anti-fatigue effect, muscle-atrophy prevention, and muscle regeneration and differentiation. Two independent researchers will perform the research selection, data extraction, and quality assessment processes. The Cochrane risk-of-bias tool will be used to assess the methodological quality and design of the included studies. We will place no restrictions on publication status or language, and the results of the systematic review will be disseminated electronically and in print by publication in a peer-reviewed journal. RESULTS: The present study will evaluate the effects and safety of herbal medicines for the prevention of sarcopenia. CONCLUSION: Our findings will provide guidance on the use of herbal medicines to prevent sarcopenia. This knowledge is valuable for elderly people, clinicians treating patients with sarcopenia, policy makers, and researchers. REGISTRATION NUMBER: Reviewregistry1113 (URL: https://www.researchregistry.com/browse-the-registry#registryofsystematicreviewsmeta-analyses/registryofsystematicreviewsmeta-analysesdetails/604a1e5ef176d2001b557750/).


Assuntos
Fitoterapia/métodos , Preparações de Plantas/uso terapêutico , Sarcopenia/prevenção & controle , Protocolos Clínicos , Humanos , Resultado do Tratamento
18.
Medicine (Baltimore) ; 100(14): e25477, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33832165

RESUMO

BACKGROUND: Preeclampsia has genetic correlation. Many studies have shown that microRNA (miRNA) polymorphism is highly associated with preeclampsia, but the results are inconsistent. The purpose of this study is to systematically evaluate the relationship between miRNA polymorphism and preeclampsia. METHODS: In this study, the search time is set from the establishment of the database on January 2021. The search database include China National Knowledge Infrastructure (CNKI), Wanfang, VIP and China Biology Medicine disc (CBM), PubMed, EMBASE, and Web of Science, and the Cochrane Library. The subjects are case-control studies on the relationship between miRNA polymorphism and preeclampsia. The language is limited to English and Chinese. The data of the included study are extracted and the literature quality is evaluated by 2 researchers independently. The data are statistically analyzed through Stata 16.0 software. We also predicted the miRNA secondary structure and the binding sites of miRNA interaction with its target genes. RESULTS: This review will be disseminated in print by peer-review. CONCLUSION: This study will provide evidence-based medicine to elucidate the genetic tendency of preeclampsia. ETHICS AND DISSEMINATION: Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval will not be required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/MJY2X.


Assuntos
Biologia Computacional , Predisposição Genética para Doença , MicroRNAs/genética , Polimorfismo Genético , Pré-Eclâmpsia/genética , Protocolos Clínicos , Feminino , Marcadores Genéticos , Humanos , Pré-Eclâmpsia/diagnóstico , Gravidez
19.
BMC Cancer ; 21(1): 405, 2021 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-33853550

RESUMO

BACKGROUND: Patients with polymetastatic cancer are most often treated with systemic therapy to improve overall survival and/or delay progression, with palliative radiotherapy reserved for sites of symptomatic disease. Stereotactic ablative radiotherapy (SABR) has shown promise in the treatment of oligometastatic disease, but the utility of SABR in treating all sites of polymetastatic disease has yet to be evaluated. This study aims to evaluate the maximally tolerated dose (MTD) of SABR in patients with polymetastatic disease. METHODS: Up to 48 patients with polymetastatic cancer (> 10 sites) will be enrolled on this phase I, modified 3 + 3 design trial. Eligible patients will have exhausted (or refused) standard systemic therapy options. SABR will be delivered as an escalating number of weekly fractions of 6 Gy, starting at 6 Gy × 2 weekly fractions (dose level 1). The highest dose level (dose level 4) will be 6 Gy × 5 weekly fractions. Feasibility and safety of SABR will be evaluated 6 weeks following treatment using a composite endpoint of successfully completing treatment as well as toxicity outcomes. DISCUSSION: This study will be the first to explore delivering SABR in patients with polymetastatic disease. SABR will be planned using the guiding principles of: strict adherence to dose constraints, minimization of treatment burden, and minimization of toxicity. As this represents a novel use of radiotherapy, our phase I study will allow for careful selection of the MTD for exploration in future studies. TRIAL REGISTRATION: This trial was prospectively registered in ClinicalTrials.gov as NCT04530513 on August 28, 2020.


Assuntos
Protocolos Clínicos , Neoplasias/patologia , Neoplasias/radioterapia , Radiocirurgia/métodos , Fracionamento da Dose de Radiação , Humanos , Metástase Neoplásica , Estadiamento de Neoplasias , Radiocirurgia/efeitos adversos , Dosagem Radioterapêutica , Projetos de Pesquisa
20.
Artigo em Inglês | MEDLINE | ID: mdl-33924701

RESUMO

Treatment of drug-resistant tuberculosis is lengthy, insufficiently effective, and toxic. Since 2016, the World Health Organization has recommended shorter treatment regimens (STR). We assessed effectiveness and predictors of drug adverse events (DAE) among patients treated with STR. There were 95 consecutive rifampicin-resistant patients enrolled in STR in Tashkent between June 2018 and September 2019. Of these, 66.3% were successfully treated, 17.9% suffered failed treatment, 7.4% died, 5.3% were lost to follow-up and 3.2% were not evaluated. No recurrence was identified in 54 patients after 12 months of successful treatment completion. There were 47 reported DAE: the incidence rate was 6.15 DAE per 100 person-months-of-treatment. Any DAE was reported in 38 (40%) patients and grade 3/4 DAE were recorded in 21 (22.1%) patients. Median time to DAE was 101 (interquartile range 64-139) days. The most frequently encountered DAE were gastro-intestinal disorders, followed by hepatotoxicity and ototoxicity. The most commonly offending drug inducing DAE was protionamide. The dose was temporarily interrupted in 55.3% of DAE, reduced in 8.5% of DAE and permanently withdrawn in another 8.5% of DAE. HIV status was the only predictor associated with increased hazard of DAE. In Uzbekistan STR showed moderate effectiveness and safety, although treatment failure was high.


Assuntos
Antituberculosos , Tuberculose Resistente a Múltiplos Medicamentos , Antituberculosos/efeitos adversos , Protocolos Clínicos , Humanos , Rifampina/efeitos adversos , Resultado do Tratamento , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Uzbequistão
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...