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81.
William Manzanares MD PhD Rupinder Dhaliwal RD Brian Jurewitsch PharmD Renee D. Stapleton MD PhD Khursheed N. Jeejeebhoy MD FRCP PhD Daren K. Heyland MD FRCPC MSc 《JPEN. Journal of parenteral and enteral nutrition》2014,38(1):20-28
Introduction: ω‐3 Polyunsaturated fatty acids contained in fish oils (FO) possess major anti‐inflammatory, antioxidant, and immunologic properties that could be beneficial during critical illness. We hypothesized that parenteral FO‐containing emulsions may improve clinical outcomes in the critically ill. Methods: We searched computerized databases from 1980–2012. We included randomized controlled trials (RCTs) conducted in critically ill adult patients that evaluated FO‐containing emulsions, either in the context of parenteral nutrition (PN) or enteral nutrition (EN). Results: A total of 6 RCTs (n = 390 patients) were included; the mean methodological score of all trials was 10 (range, 6–13). When the results of these studies were aggregated, FO‐containing emulsions were associated with a trend toward a reduction in mortality (risk ratio [RR], 0.71; 95% confidence interval [CI], 0.49–1.04; P = .08; heterogeneity I2 = 0%) and a reduction in the duration of mechanical ventilation (weighted mean difference in days [WMD], ?1.41; 95% CI, ?3.43 to 0.61; P = .17). However, this strategy had no effect on infections (RR, 0.76; 95% CI, 0.42–1.36; P = .35) and intensive care unit length of stay (WMD, ?0.46; 95% CI, ?4.87 to 3.95; P = .84, heterogeneity I2 = 75%). Conclusion: FO‐containing lipid emulsions may be able to decrease mortality and ventilation days in the critically ill. However, because of the paucity of clinical data, there is inadequate evidence to recommend the routine use of parenteral FO. Large, rigorously designed RCTs are required to elucidate the efficacy of parenteral FO in the critically ill. 相似文献
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Raffit Hassan MD Christine Alewine MD PhD Idrees Mian MD Anna Spreafico MD PhD Lillian L. Siu MD FRCPC Carlos Gomez-Roca MD Jean-Pierre Delord MD PhD Antoine Italiano MD PhD Ulrik Lassen MD PhD Jean-Charles Soria MD PhD Rastilav Bahleda MD Anish Thomas MBBS MD Seth M. Steinberg PhD Cody J. Peer PhD William D. Figg PharmD Gerhard Niederfellner PhD Valérie Méresse Naegelen MD Ira Pastan PhD 《Cancer》2020,126(22):4936-4947
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Shahid Ahmed MD PhD FRCPC Sukanya Pati MD Duc Le MD MSc FRCPC Kamal Haider MD Nayyar Iqbal MD FRCP 《Journal of surgical oncology》2020,122(2):144-154
Over the past two decades, gene expression profiling of breast cancer has emerged as an important tool in early-stage breast cancer management. The approach provides important information on underlying biological mechanisms, breast cancer classification, future risk potential of developing recurrent metastatic disease, and provides beneficial clues for adjuvant chemotherapy in hormone receptor (HR) positive breast cancer. Of the commercially available genomic tests for breast cancer, the prognostic and predictive value of 21-gene recurrence score tests have been validated using both retrospective data and prospective clinical trials. In this paper, we reviewed the current evidence on 21-gene expression profiles for HR-positive HER2-negative early-stage breast cancer management. We show that current evidence supports endocrine therapy alone as an appropriate adjuvant systemic therapy for approximately 70% of women with HR-positive, HER2-negative, node-negative breast cancer. Evolving evidence also suggests that 21-gene recurrence scores have predictive values for node-positive breast cancer and that chemotherapy can be avoided in more than half of women with nodes 1 to 3 positive HR-positive breast cancer. Furthermore, retrospective data also supports the predictive role of 21-gene recurrence scores for adjuvant radiation therapy. A prospective trial in this area is ongoing. 相似文献