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1.
IntroductionOur aim was to describe practices in multimodal pain management at US children's hospitals and evaluate the association between non-opioid pain management strategies and pediatric patient-reported outcomes (PROs).MethodsData were collected as part of the 18-hospital ENhanced Recovery In CHildren Undergoing Surgery (ENRICH-US) clinical trial. Non-opioid pain management strategies included use of preoperative and postoperative non-opioid analgesics, regional anesthetic blocks, and a biobehavioral intervention. PROs included perioperative nervousness, pain-related functional disability, health-related quality of life (HRQoL). Associations were analyzed using multinomial logistic regression models.ResultsAmong 186 patients, 62 (33%) received preoperative analgesics, 186 (100%) postoperative analgesics, 81 (44%) regional anesthetic block, and 135 (73%) used a biobehavioral intervention. Patients were less likely to report worsened as compared to stable nervousness following regional anesthetic block (relative risk ratio [RRR]:0.31, 95% confidence interval [CI]:0.11–0.85), use of a biobehavioral technique (RRR:0.26, 95% CI:0.10–0.70), and both in combination (RRR:0.08, 95% CI:0.02–0.34). There were no associations of non-opioid pain control modalities with pain-related functional disability or HRQoL.ConclusionUse of postoperative non-opioid analgesics have been largely adopted, while preoperative non-opioid analgesics and regional anesthetic blocks are used less frequently. Regional anesthetic blocks and biobehavioral interventions may mitigate postoperative nervousness in children.Level of evidenceIII.  相似文献   
2.
目的分析中药处方点评在中药调剂中的应用效果。方法抽取未开展中药处方点评前在本院应用中药进行治疗的82例患者作为对照组;并选取实施了中药处方点评后在本院应用中药进行治疗的82例患者作为观察组。对照组患者在常规中药调剂下用药治疗,观察组患者则在融入处方点评的中药调剂下进行治疗。比较两组用药风险事件发生率、治疗有效率、不良反应发生率以及患者治疗满意度。结果观察组用药风险事件发生率2.44%低于对照组的12.20%,差异具有统计学意义(P<0.05)。观察组治疗有效率97.56%高于对照组的87.80%,不良反应发生率2.44%低于对照组的17.07%,差异均具有统计学意义(P<0.05)。观察组患者治疗满意度96.34%高于对照组的85.37%,差异具有统计学意义(P<0.05)。结论在中药调剂中开展中药处方点评,能够显著提高中药处方的合理性,进而提升中药调剂质量,显著降低患者的用药风险事件发生率,从而提高临床疗效,减少不良反应的发生,对于提高患者的用药合理性、安全性及治疗满意度,具有重要的意义。  相似文献   
3.
摘要:微管是细胞骨架重要组成成分,是筛选抗肿瘤药物的重要靶标。海洋生态系统的极端环境使海洋生物具备产生独特 化学结构和生理活性天然产物的能力,为新药发现提供了物质基础。本文主要综述了1972-2021年从海洋生物中分离鉴定的成 药性较好的微管去稳定剂抗肿瘤药物的研究进展,总结了活性化合物来源、构效关系,临床研究进展,化学全合成及衍生物的 研究情况等,以期为医药工作者提供新的研究思路,推进靶向微管海洋抗肿瘤药物的发展。  相似文献   
4.
药物非临床安全性评价毒性试验有害作用的判断非常重要,因其可为保护临床试验暴露于新化学实体或药物的受试者提供重要信息。毒性试验组织病理学检查可提供受试物毒性作用的形态学数据,帮助分析和确定有害作用和非有害作用及其剂量水平。参照美国毒性病理学会(STP)和欧洲毒性病理学会(ESTP)的推荐最佳实践或建议及其他相关文献,对有害作用的定义、区分有害作用与非有害作用的要素、有害作用数据沟通和使用来评估人类潜在风险等建议等进行简要概述分析,以期为我国非临床药物安全性评价毒性试验中有害作用判定提供参考。  相似文献   
5.
目的调查133例大学生HIV感染者新型毒品使用情况、危险性行为特征,分析两者间的相关性。方法对某省会城市133例在校大学生HIV感染者进行匿名问卷调查,收集调查对象新型毒品使用、危险性行为特征的相关信息,采用二分类非条件Logistic回归模型分析新型毒品使用与危险性行为特征的相关性。结果 37.6%(50/133)的调查对象在HIV阳性诊断之前已开始使用新型毒品,46.6%(62/133)报告过去6个月使用过新型毒品,9.0%(12/133)在过去6个月使用过冰毒,Rush则为男男性行为感染者最常使用的新型毒品,占36.8%(49/133)。多因素分析显示,控制其他因素,新型毒品使用与大学生HIV感染者群交性行为(OR=4.08,95%CI:1.57~10.59)、临时性行为(OR=4.13,95%CI:1.67~10.22)、无保护性行为(OR=3.22,95%CI:1.36~7.60)、商业性性行为(OR=9.25,95%CI:1.88~45.58)呈正相关。结论新型毒品使用伴随危险性行为增加,提示今后在大学生HIV感染者当中,应加强健康干预工作并制订更具有针对性的干预策略,减少其新型毒品的使用和危险性行为的发生。  相似文献   
6.
IntroductionMonoclonal antibody therapy has been reported to be highly effective for preventing hospitalisation and severe cases in patients with Coronavirus Disease 2019 (COVID-19). However, since the drug is not readily available, it is important to rapidly and appropriately identify high-risk patients who can benefit most from therapy. Therefore, we designed a risk scoring system to identify at-risk COVID-19 patients in our region during the largest surge of COVID-19, from July to September 2021.MethodsAccording to the risk scores, confirmed COVID-19 patients were introduced to receive REGN-CoV-2 to our hospital by regional health centre from 18th August (Term 3). The primary outcome was the comparison of the number of hospitalisation and severe condition with other periods, the 4th wave (Term 1) and the early part of the 5th wave (Term 2) in Japan.ResultsDuring Term 3, 115 patients were stratified with the scoring system and administered REGN-COV-2. The number of hospitalisation vs severe cases were 60 (5.2%) vs 14 (1.2%), 8 (1.5%) vs 3 (0.6%) and 21 (1.2%) vs 2 (0.1%), in term 1, 2 and 3, respectively. Among those aged <60 years, compared with term 1, the relative risk of hospitalisation and severe condition were 0.25 (95% CI: 0.12–0.53) and 0.10 (95% CI: 0.01–0.80), respectively, in term 3. Drug adverse events were fever (3: 2.6%), headache (1: 0.9%) and neck rash (1: 0.9%), all events were resolved within 24 h wth no serious adverse event.ConclusionsThe administration of monoclonal antibody therapy using a risk scoring system significantly reduced the number of hospitalisation and disease severity of COVID-19 without any serious adverse events and avoided regional medical collapse.  相似文献   
7.
目的 在健康体检人群中筛查原发性胆汁性胆管炎(PBC)的特异性抗体,即抗线粒体抗体(AMA)-M2,以了解其流行率。方法 2012年5月~2014年12月我院体检中心血清样本18515例,采用ELISA行AMA-M2定量检测,同时收集肝功能生化指标。结果 在筛查的18515名体检者中,245例(1.3%)血清AMA-M2阳性,男性97名,女性148名,男女比例约为1:1.5,46~55岁年龄段阳性比例率为28.6%;12名AMA-M2阳性者同时伴有血清ALP水平升高,符合中国PBC诊断和治疗共识的诊断标准;54例高滴度AMA-M2抗体(>150U/ml)者血清ALP为(92.8±85.6 U/L),GGT水平为(84.3±118.5 U/L,显著高于191例低滴度组【分别为(67.7±38.3U/L)和(39.1±61.8U/L),P<0.05】。结论 健康体检人群血清AMA-M2抗体阳性并不少见,筛查AMA-M2抗体有助于早期识别PBC。  相似文献   
8.
《Vaccine》2022,40(19):2679-2695
Vaccinations are essential for preventing infectious diseases in children with chronic diseases as they have increased risk of infection from frequent use of biologics. Response to immunizations in this group is not well known.ObjectiveA systematic review was performed to evaluate three primary outcomes: efficacy; immunogenicity; and safety of vaccines in children with chronic conditions treated with biologics.MethodsThe protocol for our systematic review and meta-analysis was registered and published with PROSPERO. We searched electronic bibliographic databases for studies published from 2009 to 2019, focusing on vaccinations in children with chronic conditions treated with biologics.ResultsWe retrieved 532 records. Thirty-one full-text articles were selected, and 14 were included in the meta-analysis. No significant publication bias was found. Efficacy: limited data are available regarding the efficacy of vaccination, as most studies have focused on immunogenicity as surrogate outcome for efficacy. Immunogenicity: patients receiving anti-TNF-alpha therapy had a statistically significant risk of poor seroconversion (p = 0.028) and seroprotection by the serotype B influenza vaccine [inflammatory bowel disease (IBD) p = 0.013; juvenile idiopathic arthritis (JIA) p = 0.004]. We found adequate responses with H1N1 and H3N2 serotypes. Few studies existed for pneumococcal, hepatitis A virus, hepatitis B virus, varicella-zoster virus, Measles Mumps Rubella virus, and multiple vaccine administration. Safety: vaccine administration was not associated with serious side effects, but JIA patients on anti-TNF alpha therapy had a statistically significant risk of presenting with myalgia or arthralgia postinfluenza vaccine (p = 0.014).ConclusionsMore evidence concerning efficacy, immunogenicity, and safety of vaccinations is needed to guide physicians in the vaccine decision process for this pediatric population.  相似文献   
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