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2.
Zhonghua Yan Ke Za Zhi ; 58(5): 326-333, 2022 May 11.
Artigo em Chinês | MEDLINE | ID: mdl-35511658

RESUMO

Cataract is the main cause of preventable visual impairment in children. Children requires special perioperative management because of their anatomical, physiological, behavioral, and developmental characteristics. In order to strengthen the standardized perioperative management of cataracts in children, the Chinese Cataract and Refractive Surgery Society has conducted a comprehensive discussion on the timing of surgery, surgical techniques, perioperative medications, and postoperative visual rehabilitation in children. The consensus has been reached to provide clinical guidance for Chinese ophthalmologists.


Assuntos
Extração de Catarata , Catarata , Oftalmologia , Procedimentos Cirúrgicos Refrativos , Baixa Visão , Catarata/terapia , Criança , China , Consenso , Humanos
3.
Enzyme Microb Technol ; 158: 110052, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35490547

RESUMO

Protein stability is crucial in enzymatic catalysis. To improve the efficiency in the searching for thermostablizing mutations, we applied a sequence consensus approach focusing on dimeric interface residues of ketoreductase ChKRED20. The strategy returned a success rate of 43%, revealing 9 beneficial mutations from 21 candidates with improved kinetic or thermodynamic stability. Several combinatorial mutants were then constructed, and mutant M8K displayed the highest thermostability, with a melting temperature (Tm) of 89 °C and a half-inactivation temperature (T50) of 93.4 °C, both of over 35 °C increase compared to the wild-type. M8K could remain stable for at least 7 days at its optimal reaction temperature of 55 °C. Its inactivation half-life (t1/2) was 110 min at 90 °C, while the wild-type was 18.6 min at 60 °C. The results were interpreted in the context of structural and molecular dynamic simulation analysis, which revealed the addition of intramolecular interactions, decreased conformational flexibility and increased compactness, all in agreement with the observed effect.


Assuntos
Estabilidade Enzimática , Consenso , Cinética , Mutagênese , Mutagênese Sítio-Dirigida , Temperatura
4.
Unfallchirurg ; 125(5): 342-350, 2022 May.
Artigo em Alemão | MEDLINE | ID: mdl-35532805

RESUMO

The use of 3D printing in orthopedic trauma is supported by clinical evidence. Existing computed tomography (CT) data are exploited for better stereotactic identification of morphological features of the fracture and enhanced surgical planning. Due to complex logistic, technical and resource constraints, deployment of 3D printing is not straightforward from the hospital management perspective. As a result not all trauma surgeons are able to confidently integrate 3D printing into the daily practice. We carried out an expert panel survey on six trauma units which utilized 3D printing routinely. The most frequent indications are acetabular and articular fractures and malalignments. Infrastructure and manpower structure varied between units. The installation of industrial grade machines and dedicated software as well as the use of trained personnel can enhance the capacity and reliability of fracture treatment. Setting up interdisciplinary jointly used 3d printing departments with sound financial and management structures may improve sustainability. The sometimes substantial logistic and technical barriers which impede the rapid delivery of 3D printed models are discussed.


Assuntos
Fixação Interna de Fraturas , Impressão Tridimensional , Acetábulo/lesões , Consenso , Fixação Interna de Fraturas/métodos , Humanos , Reprodutibilidade dos Testes
5.
BMJ Open ; 12(5): e057384, 2022 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-35534067

RESUMO

INTRODUCTION: Meningioma is the most common primary intracranial tumour in adults. The majority are non-malignant, but a proportion behave more aggressively. Incidental/minimally symptomatic meningioma are often managed by serial imaging. Symptomatic meningioma, those that threaten neurovascular structures, or demonstrate radiological growth, are usually resected as first-line management strategy. For patients in poor clinical condition, or with inoperable, residual or recurrent disease, radiotherapy is often used as primary or adjuvant treatment. Effective pharmacotherapy treatments do not currently exist. There is heterogeneity in the outcomes measured and reported in meningioma clinical studies. Two 'Core Outcome Sets' (COS) will be developed: (COSMIC: Intervention) for use in meningioma clinical effectiveness trials and (COSMIC: Observation) for use in clinical studies of incidental/untreated meningioma. METHODS AND ANALYSIS: Two systematic literature reviews and trial registry searches will identify outcomes measured and reported in published and ongoing (1) meningioma clinical effectiveness trials, and (2) clinical studies of incidental/untreated meningioma. Outcomes include those that are clinician reported, patient reported, caregiver reported and based on objective tests (eg, neurocognitive tests), as well as measures of progression and survival. Outcomes will be deduplicated and categorised to generate two long lists. The two long lists will be prioritised through two, two-round, international, modified eDelphi surveys including patients with meningioma, healthcare professionals, researchers and those in caring/supporting roles. The two final COS will be ratified through two 1-day online consensus meetings, with representation from all stakeholder groups. ETHICS AND DISSEMINATION: Institutional review board (University of Liverpool) approval was obtained for the conduct of this study. Participant eConsent will be obtained prior to participation in the eDelphi surveys and consensus meetings. The two systematic literature reviews and two final COS will be published and freely available. TRIAL REGISTRATION NUMBER: COMET study ID 1508.


Assuntos
Neoplasias Meníngeas , Meningioma , Consenso , Técnica Delfos , Humanos , Neoplasias Meníngeas/terapia , Meningioma/terapia , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
6.
Planta ; 255(6): 115, 2022 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-35508739

RESUMO

MAIN CONCLUSION: Meta-analysis in wheat for three major quality traits identified 110 meta-QTL (MQTL) with reduced confidence interval (CI). Five GWAS validated MQTL (viz., 1A.1, 1B.2, 3B.4, 5B.2, and 6B.2), each involving more than 20 initial QTL and reduced CI (95%) (< 2 cM), were selected for quality breeding programmes. Functional characterization including candidate gene mining and expression analysis discovered 44 high confidence candidate genes associated with quality traits. A meta-analysis of quantitative trait loci (QTL) associated with dough rheology properties, nutritional traits, and processing quality traits was conducted in wheat. For this purpose, as many as 2458 QTL were collected from 50 interval mapping studies published during 2013-2020. Of the total QTL, 1126 QTL were projected onto the consensus map saturated with 249,603 markers which led to the identification of 110 meta-QTL (MQTL). These MQTL exhibited an 18.84-fold reduction in the average CI compared to the average CI of the initial QTL (ranging from 14.87 to 95.55 cM with an average of 40.35 cM). Of the 110, 108 MQTL were physically anchored to the wheat reference genome, including 51 MQTL verified with marker-trait associations (MTAs) reported from earlier genome-wide association studies. Candidate gene (CG) mining allowed the identification of 2533 unique gene models from the MQTL regions. In-silico expression analysis discovered 439 differentially expressed gene models with > 2 transcripts per million expressions in grains and related tissues, which also included 44 high-confidence CGs involved in the various cellular and biochemical processes related to quality traits. Nine functionally characterized wheat genes associated with grain protein content, high-molecular-weight glutenin, and starch synthase enzymes were also found to be co-localized with some of the MQTL. Synteny analysis between wheat and rice MQTL regions identified 23 wheat MQTL syntenic to 16 rice MQTL associated with quality traits. Furthermore, 64 wheat orthologues of 30 known rice genes were detected in 44 MQTL regions. Markers flanking the MQTL identified in the present study can be used for marker-assisted breeding and as fixed effects in the genomic selection models for improving the prediction accuracy during quality breeding. Wheat orthologues of rice genes and other CGs available from MQTLs can be promising targets for further functional validation and to better understand the molecular mechanism underlying the quality traits in wheat.


Assuntos
Oryza , Locos de Características Quantitativas , Mapeamento Cromossômico , Consenso , Estudo de Associação Genômica Ampla , Genômica , Oryza/genética , Melhoramento Vegetal , Locos de Características Quantitativas/genética , Triticum/genética
9.
Zhongguo Dang Dai Er Ke Za Zhi ; 24(4): 350-353, 2022 Apr 15.
Artigo em Chinês | MEDLINE | ID: mdl-35527406

RESUMO

After nearly 40 years of development, digestive endoscopy in children has been widely applied, and it has helped to expand the spectrum of pediatric digestive system diseases and greatly improve the diagnosis and treatment of pediatric digestive system diseases. Pediatric digestive endoscopy has become a subject. However, there are some problems such as the unbalanced development of pediatric digestive endoscopy across China, the lack of homogeneity in diagnosis and treatment system, the tendency of adult-oriented diagnosis and treatment techniques, and the localization of training quality, which affect the standardized and healthy development of pediatric digestive endoscopy. The diagnosis and treatment with digestive endoscopy in children should adhere to both pediatric characteristics and technological innovation to propose the concept of comfort, emphasize the importance of standardization (including the space and process for endoscopic diagnosis and treatment, perioperative evaluation, training mode, and access qualification), standardize the minimally invasive techniques, and develop artificial intelligence. It is of great importance to formulate related consensus statements and guidelines on the basis of medical safety and the features of the growth and development of children, so as to achieve the high-quality development of pediatric digestive endoscopy, effectively improve the diagnosis and treatment levels of pediatric digestive endoscopy, and bring benefits to more pediatric patients.


Assuntos
Inteligência Artificial , Doenças do Sistema Digestório , Criança , China , Consenso , Doenças do Sistema Digestório/diagnóstico , Endoscopia Gastrointestinal , Humanos
10.
J Wound Ostomy Continence Nurs ; 49(3): 240-246, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35523239

RESUMO

Convex pouching systems have been available for ostomy patients for decades; however, controversy remains over the use of convexity in the postoperative period. A group of 10 nurses and physicians with expertise caring for patients with an ostomy completed a scoping review identifying research-based evidence and gaps in our knowledge of the safety and effectiveness related to the use of a convex pouching system following ostomy surgery. Results of this scoping review demonstrated the need for a structured consensus to define best practices when selecting a pouching system that provides a secure and reliable seal around the stoma, avoids undermining and leakage of effluent from the pouching system, and contributes to optimal health-related quality of life for patients following ostomy surgery. The expert panel reached consensus on 8 statements for the use of convex products immediately after surgery and throughout the first 6 months after stoma creation, as well as describing goals in choosing the best pouching system for the patient with an ostomy.


Assuntos
Estomia , Estomas Cirúrgicos , Consenso , Humanos , Período Pós-Operatório , Qualidade de Vida , Estomas Cirúrgicos/efeitos adversos
11.
J Prev Alzheimers Dis ; 9(2): 231-235, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35542994

RESUMO

There was consensus that both amyloid and tau pathologies should be targeted in Alzheimer's disease, as well as additional pathophysiological mechanisms such as neuroinflammation. The selection of one or both of these targets may depend upon a personalized approach that takes into account the genetic and acquired factors that cause AD in any given person as well as their stage of disease as reflected in a biomarker profile. The validation of this therapeutic approach will be made possible by new methodologies for subdividing into predominant pathology, by efficient methods for identifying people in the earliest stages of disease, and by combination studies.


Assuntos
Doença de Alzheimer , Doença de Alzheimer/tratamento farmacológico , Doença de Alzheimer/patologia , Peptídeos beta-Amiloides , Biomarcadores , Consenso , Humanos , Proteínas tau
12.
Orphanet J Rare Dis ; 17(1): 190, 2022 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-35538504

RESUMO

BACKGROUND: Mucopolysaccharidosis IVA (MPS IVA), or Morquio A syndrome, is a rare inherited metabolic disorder caused by deficiency of the lysosomal enzyme N-acetylgalactosamine-6-sulfatase. A progressive systemic skeletal chondrodysplasia, leading to significant morbidity and reduced life expectancy is the main clinical feature of this multisystemic disease. Although enzyme replacement therapy with elosulfase alfa is established in Europe, the rarity of disease and other factors still set hurdles in having patients treated in some countries. Aim of this statement is to provide evidence-based guidance for the enzyme replacement treatment of Morquio A patients, harmonizing recommendations from published guidelines with the real-life clinical practice in the Central and South-Eastern European region. PARTICIPANTS: The Consensus Group, convened by 8 Steering Committee (SC) members from 7 Central and South-Eastern European countries, consisted of a multidisciplinary group of 17 experts in the management of MPS in Central and South-Eastern Europe. CONSENSUS PROCESS: The SC met in a first virtual meeting with an external scientific coordinator, to discuss on clinical issues to be analyzed in guidance statements. Statements were developed by the scientific coordinator, evaluated by the SC members in a first modified-Delphi voting and adapted accordingly, to be submitted to the widest audience in the Consensus Conference. Following discussion and further modifications, all participants contributed to a second round of modified-Delphi voting. RESULTS: Nine of ten statements, concerning general guidelines for management of MPS IVA patients and specific recommendations for treatment, received final consensus. CONCLUSIONS: European guidelines and evidence-based recommendations for Morquio A patients should be considered in the real life of Central and South-Eastern European countries and adapted to unique clinical practice approaches and criteria for patients' access to treatment and reimbursement in the region.


Assuntos
Mucopolissacaridoses , Mucopolissacaridose IV , Erros Inatos do Metabolismo dos Aminoácidos , Consenso , Terapia de Reposição de Enzimas , Humanos , Isovaleril-CoA Desidrogenase/deficiência , Mucopolissacaridoses/tratamento farmacológico , Mucopolissacaridose IV/tratamento farmacológico
13.
BMJ Open Gastroenterol ; 9(1)2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35500941

RESUMO

OBJECTIVE: This rapid priority setting exercise aimed to identify, expand, prioritise and explore stakeholder (patients, carers and healthcare practitioners) topic uncertainties on faecal incontinence (FI). DESIGN: An evidence gap map (EGM) was produced to give a visual overview of emerging trial evidence; existing systematic review-level evidence and FI stakeholder topic uncertainties derived from a survey. This EGM was used in a knowledge exchange workshop that promoted group discussions leading to the prioritisation and exploration of FI stakeholder identified topic uncertainties. RESULTS: Overall, a mismatch between the existing and emerging evidence and key FI stakeholder topic uncertainties was found. The prioritised topic uncertainties identified in the workshop were as follows: psychological support; lifestyle interventions; long-term effects of living with FI; education; constipation and the cultural impact of FI. When these six prioritised topic uncertainties were explored in more depth, the following themes were identified: education; impact and burden of living with FI; psychological support; healthcare service improvements and inconsistencies; the stigma of FI; treatments and management; culturally appropriate management and technology and its accessibility. CONCLUSIONS: Topic uncertainties identified were broad and wide ranging even after prioritisation. More research is required to unpick the themes emerging from the in-depth discussion and explore these further to achieve a consensus on deliverable research questions.


Assuntos
Incontinência Fecal , Cuidadores , Consenso , Incontinência Fecal/terapia , Humanos , Inquéritos e Questionários , Incerteza
14.
BMC Bioinformatics ; 22(Suppl 10): 624, 2022 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-35439942

RESUMO

BACKGROUND: The gene signatures have been considered as a promising early diagnosis and prognostic analysis to identify disease subtypes and to determine subsequent treatments. Tissue-specific gene signatures of a specific disease are an emergency requirement for precision medicine to improve the accuracy and reduce the side effects. Currently, many approaches have been proposed for identifying gene signatures for diagnosis and prognostic. However, they often lack of tissue-specific gene signatures. RESULTS: Here, we propose a new method, consensus mutual information (CoMI) for analyzing omics data and discovering gene signatures. CoMI can identify differentially expressed genes in multiple cancer omics data for reflecting both cancer-related and tissue-specific signatures, such as Cell growth and death in multiple cancers, Xenobiotics biodegradation and metabolism in LIHC, and Nervous system in GBM. Our method identified 50-gene signatures effectively distinguishing the GBM patients into high- and low-risk groups (log-rank p = 0.006) for diagnosis and prognosis. CONCLUSIONS: Our results demonstrate that CoMI can identify significant and consistent gene signatures with tissue-specific properties and can predict clinical outcomes for interested diseases. We believe that CoMI is useful for analyzing omics data and discovering gene signatures of diseases.


Assuntos
Regulação Neoplásica da Expressão Gênica , Neoplasias , Consenso , Perfilação da Expressão Gênica , Humanos , Neoplasias/genética , Medicina de Precisão
16.
Vnitr Lek ; 68(1): 41-53, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35459346

RESUMO

Castleman disease (CD) describes a group of heterogeneous hematologic disorders with characteristic histopathological features. CD can present with unicentric (UCD) or multicentric (MCD) regions of lymph node enlargement. Some cases of MCD are caused by human herpesvirus-8 (HHV-8), whereas others are HHV-8-negative/idiopathic (iMCD). Treatment of iMCD is challenging, and outcomes can be poor. In this paper, we briefly report about symptoms of iMCD and about the International, evidencebased consensus diagnostic criteria for HHV-8-negative/idiopathic multicentric Castleman disease and International evidence based consensus treatment guidelines for idiopathic multicentric Castleman disease.


Assuntos
Hiperplasia do Linfonodo Gigante , Herpesvirus Humano 8 , Hiperplasia do Linfonodo Gigante/diagnóstico , Hiperplasia do Linfonodo Gigante/patologia , Hiperplasia do Linfonodo Gigante/terapia , Consenso , Humanos
17.
Zhonghua Wei Chang Wai Ke Za Zhi ; 25(4): 277-283, 2022 Apr 25.
Artigo em Chinês | MEDLINE | ID: mdl-35461192

RESUMO

Currently, surgery-based comprehensive therapy plays an important role in the treatment of local advanced gastric cancer (LAGC), and standard lymph node dissection is a mainstay of gastric surgery. Radical gastrectomy with D2 lymph node dissection is widely accepted based on the international publications of randomized clinical trials, but the extent of lymph node dissection is controversial. An adequate lymph node dissection may improve prognosis and reduce complications, and D2+ lymphadenectomy may improve surgical outcomes in some selected patients. To improve the efficacy of LAGC therapies, the Gastric Cancer Association, China Anti Cancer Association took the lead and organized experts to discuss and vote, and finally formulated this expert consensus. It is hoped that this consensus can provide reference for clinicians and further improve the diagnosis and treatment level of LAGC in China.


Assuntos
Segunda Neoplasia Primária , Neoplasias Gástricas , Consenso , Gastrectomia , Humanos , Excisão de Linfonodo , Segunda Neoplasia Primária/cirurgia , Prognóstico , Neoplasias Gástricas/patologia
18.
Zhonghua Gan Zang Bing Za Zhi ; 30(3): 253-263, 2022 Mar 20.
Artigo em Chinês | MEDLINE | ID: mdl-35462480

RESUMO

In 2015, the Chinese Society of Hepatology and Chinese Society of Gastroenterology issued the consensus on the diagnosis and management of cholestatic liver diseases. In the past years, more data have emerged from clinical practice. Herein, the Autoimmune Liver Disease Group of the Chinese Society of Hepatology organized an expert group to review the evidence and updated the recommendations to formulate the guidelines. There are 22 recommendations on clinical practice of cholestatic liver diseases. The guidelines aim to provide a working reference for the management of cholestatic liver diseases.


Assuntos
Doenças Autoimunes , Colestase , Gastroenterologia , Hepatopatias , Doenças Autoimunes/diagnóstico , Colestase/diagnóstico , Colestase/terapia , Consenso , Humanos , Hepatopatias/diagnóstico , Hepatopatias/terapia
19.
Zhonghua Gan Zang Bing Za Zhi ; 30(3): 264-275, 2022 Mar 20.
Artigo em Chinês | MEDLINE | ID: mdl-35462481

RESUMO

In 2015, the Chinese Society of Hepatology and Chinese Society of Gastroenterology issued a consensus on the diagnosis and management of primary biliary cholangitis (PBC). In the past years, more clinical studies have been reported in the field of PBC. To provide guidance to the clinical diagnosis and management of patients with PBC, the Chinese Society of Hepatology invited a panel of experts to assess the new clinical evidence and formulated the current guidelines which comprises 26 clinical recommendations.


Assuntos
Colangite , Gastroenterologia , Cirrose Hepática Biliar , Colangite/diagnóstico , Colangite/terapia , Consenso , Humanos , Cirrose Hepática Biliar/diagnóstico , Cirrose Hepática Biliar/terapia
20.
Zhonghua Yi Xue Za Zhi ; 102(16): 1139-1147, 2022 Apr 26.
Artigo em Chinês | MEDLINE | ID: mdl-35462497

RESUMO

The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) convened a writing group to develop a consensus report on the management of type 1 diabetes in adults in September 2021. The writing group has proposed principles of the diagnosis and management of adult patients with type 1 diabetes, and has made suggestions for glycemic control with individualized glycemic targets to avoid hypoglycemia. They have also emphasized the importance of education and support for the self-management of diabetes in the management of type 1 diabetes.


Assuntos
Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Hipoglicemia , Adulto , Glicemia , Consenso , Diabetes Mellitus Tipo 1/terapia , Humanos , Hipoglicemiantes , Estados Unidos
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