Interventions to support risk and benefit understanding of disease-modifying drugs in Multiple Sclerosis patients: A systematic review

ObjectiveThe present review evaluates interventions that have been designed to improve understanding of the complex risk-benefit profiles of disease-modifying drugs (DMDs) in patients with Multiple Sclerosis (MS).MethodsA systematic search conducted using PubMed, Embase, Google Scholar and PsycINFO identified 15 studies. Interventions which provided treatment information were present across a range of study designs. A narrative synthesis was conducted due to heterogeneity of research findings.ResultsInterventions providing treatment information ranged from comprehensive education programmes to booklets of a few pages. MS patients favoured the interventions they received. Understanding of overall treatment information and treatment risks specifically, generally improved following interventions. Yet overestimation of treatment benefits persisted. There was no conclusive effect on DMD decisions. No superior intervention was identified.ConclusionInterventions designed to improve understanding of DMD risk and benefit information are moderately successful.Practice implicationsAdditional support provided to MS patients beyond routine healthcare can generally improve understanding of the complex risk-benefit profiles of DMDs. Future interventions need to ensure that patients with symptoms that may confound understanding can also benefit from this additional information.     

远程会诊法律风险与防范

远程会诊在医疗救治方面发挥着重要作用。通过分析发现，国内远程会诊面临多主体医疗责任归属不明确、患者知情同意权和隐私权受侵害、跨境会诊资格限制等风险，对此提出建议如下:以协议划分医疗纠纷责任主体，统一知情同意书格式，强化知情同意过程管理，有效实施信息安全保护制度，构建跨境远程会诊医师专业评估体系等，以期促进远程会诊发挥最大效用。     

Reviewing risks and benefits of low-dose computed tomography screening for lung cancer

Lung cancer is the third most common cancer among men and women and is one of the leading causes of cancer-related mortality. Diagnosis at an early stage has been suggested crucial for improving survival in individuals at high-risk of lung cancer. One potential facilitator to early diagnosis is low-dose computed tomography (LDCT). The United States Preventive Services Task Force guidelines call for annual LDCT screening for individuals at high-risk of lung cancer. This recommendation was based on the effectiveness of LDCT in early diagnosis of lung cancer, as indicated by the findings from the National Lung Screening Trial conducted in 2011. Although lung cancer accounts for more than a quarter of all cancer deaths in the United States and LDCT screening shows promising results regarding early lung cancer diagnosis, screening for lung cancer remains controversial. There is uncertainty about risks, cost-effectiveness, adequacy of evidence, and application of screening in a clinical setting. This narrative review provides an overview of risks and benefits of LDCT screening for lung cancer. Further, this review discusses the potential for implementation of LDCT in clinical setting.     

二膦酸盐治疗骨质疏松症利大于弊

二膦酸盐是治疗骨质疏松症的一线用药,不仅能有效降低骨折风险,还可能降低某些肿瘤的风险.尽管可能引起诸如下颌骨坏死、非典型骨折等严重不良反应,但总体发生率低,不足以影响其在治疗骨质疏松症中的地位.     

如何权衡二膦酸盐类药物治疗骨质疏松症的利与弊?

二膦酸盐能有效减少绝经后妇女以及男性骨质疏松患者的骨量丢失,降低骨折风险.但有报道此类药物可能引起下颌骨坏死和非典型股骨骨折等严重并发症,总体发生率极低.口服二膦酸盐可能引起上消化道不良反应,静脉二膦酸盐与急性期反应相关.至于其是否会增加食道癌和心房纤颤的风险,目前尚缺乏有效证据.     

北京市低年级学生单纯肥胖症的流行学研究

目的揭示北京市低年级小学生肥胖症流行特点及影响因素,为制定早期的预防和干预措施提供依据.方法分层整群抽样,对10221名1～2年级小学生进行身高、体重测量及相关因素家长问卷调查.结果低龄学童肥胖率为15.4%,超重率为 12.5%;男高于女,以年龄递增,肥胖程度以轻中度为主,占80%以上.与儿童肥胖相关的主要因素有:儿童不良饮食行为、父母肥胖、高出生体重、早期喂养、运动、父母文化程度及其他不良家庭和环境因素.结论大城市低龄学童超重和肥胖发生率有明显升高趋势,此阶段实施早期干预措施对预防青春期及成年期肥胖和其他相关疾病有重要的意义.     

Laparoscopic surgery

Summary Laparoscopic cholecystectomy and appendectomy are widely accepted in clinical practice. In the initial stage, when the method is introduced, there are a number of mistakes, risks, and complications possible. The surgeons, the staff, the instruments, the anesthetist, and, last but not least, the patient, are among the possible contributing causes. We try to analyze the reasons and conditions leading to possible complications. Complications we have experinced are reported. In our conclusions we try to show how it is possible to avoid severe problems.     

浅谈合理用药

列举了一些不合理用药的危害,从药物选择、用量、用法、联合用药等几个方面阐述了应该怎样合理用药,并对药师在药学服务方面提出了要求。