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1.
综述信息化技术在静脉血栓栓塞症护理领域中风险预测、警报接收与上报、抗凝防治管理、医护人员相关继续医学教育、患者疾病预后管理的应用现状,总结其应用阻碍因素,旨在为我国静脉血栓栓塞症护理信息化建设提供参考。  相似文献   
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肝细胞癌(HCC)是最常见的恶性肿瘤之一。尽管在早期诊断和个体化治疗方面取得了进展,但经根治性切除等治疗后,HCC患者的临床预后仍不佳,复发率高。因此,在HCC患者中识别准确可靠的预后标志物是必要的。作为一种新的免疫营养生物标志物,控制营养状态(CONUT)评分已被报道用于预测癌症患者的预后。本文将对术前CONUT评分与HCC肝切除术后预后的研究进展进行综述。  相似文献   
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Background

Although it is known that women do not participate in trials as frequently as men, there are limited recent data examining how women recruitment has changed over time.

Methods

We conducted MEDLINE search using a validated strategy for randomized trials published in New England Journal of Medicine, Lancet, and Journal of the American Medical Association between 1986 and 2015, and included trials evaluating pharmacologic or nonpharmacologic therapies. We abstracted data on demographics, intervention type, clinical indication, and trial design characteristics, and examined their relationships with women enrollment.

Results

In total, 598 trials met inclusion criteria. Women enrollment increased significantly over time (21% between 1986 and 1990 to 33% between 2011 and 2015; Pfor trend < 0.001) and did not differ by journal or funding source. Women enrollment varied with clinical indication, comprising 37% for non–coronary artery disease vascular trials, 30% for coronary artery disease trials, 28% for heart failure trials, and 28% for arrhythmia trials (P < 0.001), which were all significantly lower than the expected proportion in disease populations (P < 0.001). Women enrollment varied with trial type (31%, 29%, and 26% for pharmacologic, device, and procedural trials, respectively; P = 0.001). These findings were corroborated using multivariable analysis. We found significant positive correlations between women enrolled, and mean age and total number of participants. Fewer women were enrolled in trials reporting statistically significant results than those who did not (P = 0.001).

Conclusions

Although enrollment of women has increased over time, it remains lower than the relative proportion in the disease population. Future studies should elucidate the reasons for persistent under-representation of women in clinical trials.  相似文献   
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Background

The significance of a positive culture at reimplantation remains an important topic of consideration given the lack of clear metrics for when reimplantation can be performed. The purpose of this study is thus to investigate the (1) association between a positive culture during reimplantation and failure following 2-stage exchange arthroplasty and the (2) influence of prolonged antibiotics on these patients.

Methods

We retrospectively reviewed 117 patients undergoing 2-stage exchange hip arthroplasty from 2012 to 2016. Of them, 23 had positive culture during reimplantation and were treated with 2 weeks of intravenous and 4 weeks of oral antibiotics following reimplantation. All patients had a minimum follow-up of 1 year. Logistic regression models were performed to identify association between positive culture and subsequent treatment failure. A meta-analysis was also performed to validate findings. A subgroup analysis was performed to explore whether 6-week antibiotics (oral, intravenous, or both) after reimplantation improved outcomes.

Results

A total of 11 studies, which included 141 cases with a positive culture at reimplantation and 784 with negative cultures, were included in the meta-analysis. The pooled data showed a higher risk of failure in patients with a positive culture than those with a negative culture (41.1% vs 14.8%, odds ratio 4.58). The subgroup analysis revealed that 6 weeks of antibiotic administration following reimplantation decreased the odds of reinfection from 9.35 to 3.12. The findings in the retrospective cohort were consistent with those of the meta-analysis; the failure rate was significantly higher in patients with a positive culture than those with negative cultures (26.1% vs 6.4%, P < .001).

Conclusion

Six weeks of antibiotics appear to decrease the odds of reinfection after reimplantation. However, despite patients receiving 6 weeks of antibiotics after reimplantation, the risk of reinfection in patients with a positive culture at reimplantation is still more than 3 times higher than those with negative cultures. Further studies are needed to investigate optimal management for such patients.  相似文献   
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