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Guideline for the Treatment of Breakthrough and the Prevention of Refractory Chemotherapy‐Induced Nausea and Vomiting in Children With Cancer 下载免费PDF全文
Jacqueline Flank BScPhm ACPR MSc Paula D. Robinson MD MSc Mark Holdsworth PharmD Robert Phillips MD Carol Portwine MD FRCPC PhD Paul Gibson MD Cathy Maan PhD CPsych Nancy Stefin Hons BA CLSt Dipl CCLS Lillian Sung MD PhD L. Lee Dupuis MScPhm ACPR PhD 《Pediatric blood & cancer》2016,63(7):1144-1151
This clinical practice guideline provides an approach to the treatment of breakthrough chemotherapy‐induced nausea and vomiting (CINV) and the prevention of refractory CINV in children. It was developed by an international, interprofessional panel and is based on systematic literature reviews. Evidence‐based interventions for the treatment of breakthrough and prophylaxis of refractory CINV are recommended. Gaps in the evidence used to support the recommendations made in this clinical practice guideline were identified. The contribution of these recommendations to breakthrough and refractory CINV control in children requires prospective evaluation. 相似文献
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Single vs Dual Antiplatelet Therapy Following Transcatheter Aortic Valve Implantation: A Systematic Review 下载免费PDF全文
Ricky D. Turgeon BSc PharmD ACPR and Arden R. Barry BSc BSc PharmD ACPR 《Clinical cardiology》2015,38(10):629-634
There is wide variability in prescribing of antiplatelet regimens following transcatheter aortic valve implantation (TAVI). The objective of this review was to evaluate published and unpublished reports regarding the efficacy and safety of dual antiplatelet therapy (DAPT) compared with a single antiplatelet agent in patients undergoing TAVI. We searched MEDLINE, CENTRAL, Embase, and unpublished sources of literature from inception to December 2014 using terms synonymous with TAVI and DAPT. We included randomized controlled trials (RCTs) and cohort or case‐control studies that compared DAPT with a single antiplatelet agent post‐TAVI. Four articles met the inclusion criteria (2 RCTs, 2 cohort studies), of which all were deemed to be at high risk of bias, for a total of 662 patients. Compared with a single antiplatelet agent, DAPT did not significantly reduce all‐cause mortality (risk ratio: 1.22, 95% confidence interval: 0.72‐2.09, I2 = 0%). Due to selective outcome reporting and variable follow‐up, other outcomes of interest could not be meta‐analyzed; however, evaluation of individual studies demonstrated no significant reduction in thrombotic events with DAPT and a similar or higher risk of bleeding. Current evidence, though limited by low methodological quality, suggests a lack of benefit and potential harm with DAPT compared with a single antiplatelet agent in patients post‐TAVI. Therefore, clinicians should evaluate the use of DAPT in patients post‐TAVI on a case‐by‐case basis until more robust evidence is available to guide practice. 相似文献
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Investigating strategies used by hospital pharmacists to effectively communicate with patients during medication counselling 下载免费PDF全文
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Arden R. Barry BSc BSc ACPR Peter S. Loewen BSc ACPR PharmD Jane de Lemos BPharm PharmD MSc Karen G. Lee BSc ACPR 《Journal of evaluation in clinical practice》2012,18(1):49-55
Rationale, aims and objectives The quality of patient care and safety is dependent on addressing both errors of commission (e.g. overuse of medications) and errors of omission (e.g. patients receiving too little care). Despite guidelines recommending the use of certain proven pharmacotherapeutic interventions, a large gap exists between the patients that have an indication for, and those that actually receive such interventions. To address how the rate of implementation of proven interventions can be improved is dependent on a comprehensive knowledge of the factors contributing to their underuse. The aim of the review is to create an evidence‐based framework of reasons why eligible patients do not receive proven pharmacotherapeutic interventions. Methods A systemic review of the published reasons for non‐use based on the Cochrane methodology. Results The systematic review identified 67 articles meeting the inclusion criteria. The reasons for non‐use were extracted from the studies and a framework was created from the results. Conclusions The factors associated with lack of implementation of proven pharmacotherapeutic interventions are complex and heterogeneous but can be understood from the perspectives of clinicians, patients and health care delivery systems. Efforts to increase the utilization of proven interventions should focus on disease/intervention‐specific programmes that take into account the identified modifiable clinician, patient and system factors. 相似文献
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L. Lee Dupuis MScPhm ACPR FCSHP Sabrina Boodhan BScPhm ACPR Mark Holdsworth PharmD BCOP Paula D. Robinson MD MSc Richard Hain MD Carol Portwine MD FRCPC PhD Erin O'Shaughnessy RN MScN CPHON Lillian Sung MD PhD 《Pediatric blood & cancer》2013,60(7):1073-1082
This guideline provides an approach to the prevention of acute antineoplastic‐induced nausea and vomiting (AINV) in children. It was developed by an international, inter‐professional panel using AGREE and CAN‐IMPLEMENT methods. Evidence‐based interventions that provide optimal AINV control in children receiving antineoplastic agents of high, moderate, low, and minimal emetogenicity are recommended. Recommendations are also made regarding selection of antiemetic agents for children who are unable to receive corticosteroids for AINV control, the role of aprepitant and optimal doses of antiemetic agents. Gaps in the evidence used to support the recommendations were identified. The contribution of this guideline to AINV control in children requires prospective evaluation. Pediatr Blood Cancer 2013; 60: 1073–1082. © 2013 Wiley Periodicals, Inc. 相似文献
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Anthony Chau ACPR John Wu FRCPC Mark Ansermino FRCPC Stephen Tredwell FRCSC Robert Purdy FRCP 《Journal canadien d'anesthésie》2008,55(1):47-51
PURPOSE: To describe the successful perioperative hemostatic management of a Jehovah's Witness patient with hemophilia B and anaphylactic inhibitors to factor IX, undergoing scoliosis surgery. CLINICAL FEATURES: A 14 (1/2)-yr-old boy with severe hemophilia B who had a history of anaphylactic inhibitors to factor IX was scheduled to undergo corrective scoliosis surgery. He was initially started on epoetin alfa and iron supplementation to maximize preoperative red cell mass. Additionally, he was placed on a desensitization protocol of recombinant coagulation factor IX (rFIX) and was then treated with activated recombinant coagulation factor VII (rFVIIa) during the postoperative period. Tranexamic acid was given concomitantly. The intraoperative blood loss was approximately 350 mL. The nadir hemoglobin concentration was 111 g.L(-1) on postoperative days one and two. On postoperative day 11, the patient was stable and discharged home with a hemoglobin of 138 g.L(-1). He did not require blood transfusion and no adverse events were observed. CONCLUSIONS: The use of rFIX, rFVIIa, erythropoetin, iron, and tranexamic acid before, during and after scoliosis surgery may be a viable and safe option for hemophilia patients with inhibitors, who refuse blood products. 相似文献
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Lillian Sung MD PhD Theo Zaoutis MD MSCE Nicole J. Ullrich MD PhD Donna Johnston MD Lee Dupuis RPh ACPR MScPhm FCSHP Elena Ladas MS RD 《Pediatric blood & cancer》2013,60(6):1027-1030
In cancer control research, the objective is to reduce overall morbidity and mortality by decreasing acute and delayed treatment‐related toxicities in all children with cancer. To date, the Children's Oncology Group (COG) has focused on infection, neurocognition, quality of life (QoL), and nutrition/antiemetics. COG is conducting randomized controlled trials (RCTs) to determine prophylaxis strategies that will reduce infections in high‐risk populations. Two RCTs are determining if modafinil or computerized cognitive training improve cognitive functioning in pediatric brain tumor patients. QoL is being assessed in acute leukemia patients. Improved supportive care outcomes will only occur when the most effective interventions are established. Pediatr Blood Cancer 2013; 60: 1027–1030. © 2012 Wiley Periodicals, Inc. 相似文献