Severe

严重
  • 文章类型: Journal Article
    亚洲人的系统性红斑狼疮(SLE)患病率高于白种人,肾脏和其他主要器官表现的频率较高,预后较差。由于获得医疗保健系统的机会有限,在亚太地区的许多地区,SLE的结果仍然不能令人满意,治疗依从性差和治疗不良反应。亚太风湿病学协会联盟(APLAR)SLE特殊兴趣小组最近发布了一套关于亚太地区SLE管理的共识建议声明。本文是对亚洲SLE患者非肾脏表现的患病率和治疗的系统文献检索(SLR)的补充。
    The prevalence of systemic lupus erythematosus (SLE) is higher in Asians than Caucasians, with higher frequency of renal and other major organ manifestations that carry a poorer prognosis. The outcome of SLE is still unsatisfactory in many parts of the Asia Pacific region due to limited access to healthcare systems, poor treatment adherence and adverse reactions to therapies. The Asia Pacific League of Associations for Rheumatology (APLAR) SLE special interest group has recently published a set of consensus recommendation statements for the management of SLE in the Asia Pacific region. The current article is a supplement of systematic literature search (SLR) to the prevalence and treatment of non-renal manifestations of SLE in Asian patients.
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  • 文章类型: Journal Article
    Varied perspectives on the later stage of anorexia nervosa (AN) have left the field of eating disorders without a consistent label or definition for this subpopulation. As a result, diverse criteria when recruiting participants have led to incomparable results across research studies and a lack of guidance when assessing and treating patients in the clinical context. The aim of the current study was to develop consensus-based guidelines on the labeling and defining of the later stage of AN.
    Utilizing the Delphi methodology, a professional panel of experts (N = 21) participated in three rounds of questionnaires. Five open-ended questions (Round 1) were analyzed using content analysis to form statements relating to a classification system for labeling and defining the later stage of AN. A total of 80 statements were rated in terms of panelists\' level of agreement (Rounds 2 and 3).
    Consensus was achieved for 28.8% of statements and a further 16.3% of statements reached near consensus in the second and third round of questionnaires. Two labels were identified with five defining features achieving consensus.
    Findings from the study suggest an alternative approach to labeling be adopted with consensus-based guidelines established for defining the later stage of AN. Implications that may occur from a unified classification system are explored with longitudinal research required to assess the impact on patients experiencing the later stage of AN.
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  • 文章类型: Journal Article
    2016年底,当第四版脑外伤基金会《重型颅脑外伤治疗指南》定稿时,就知道RESCUEicp(开颅减压术治疗创伤性颅内高血压的试验)随机对照试验的结果在指南发布后将公开。指南作者决定继续出版,但后来本着“生活指南”的精神更新去骨瓣减压术建议,\"从而更频繁地更新主题,在新版本之间,当重要的新证据发表时。此处介绍的去骨瓣减压术章节的更新整合了RESCUEicp研究的发现以及最近发表的DECRA(重型颅脑损伤患者去骨瓣减压术)试验的12个月结果数据。将这些出版物纳入证据体系导致产生了三项新的IIA级建议;先前提出的第四项IIA级建议仍然有效,并已重述。为了增加建议的效用,我们增加了一个名为“将证据纳入实践”的新部分。这份专家意见摘要为从业人员提供了重要的背景,解决了关键问题,旨在帮助临床医生利用现有证据和这些建议。完整的指南可以在以下网址找到:https://braintrauma.org/guidelines/guidelines-for-the-management-of-severe-tbi-4th-ed#/。
    When the fourth edition of the Brain Trauma Foundation\'s Guidelines for the Management of Severe Traumatic Brain Injury were finalized in late 2016, it was known that the results of the RESCUEicp (Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension) randomized controlled trial of decompressive craniectomy would be public after the guidelines were released. The guideline authors decided to proceed with publication but to update the decompressive craniectomy recommendations later in the spirit of \"living guidelines,\" whereby topics are updated more frequently, and between new editions, when important new evidence is published. The update to the decompressive craniectomy chapter presented here integrates the findings of the RESCUEicp study as well as the recently published 12-mo outcome data from the DECRA (Decompressive Craniectomy in Patients With Severe Traumatic Brain Injury) trial. Incorporation of these publications into the body of evidence led to the generation of 3 new level-IIA recommendations; a fourth previously presented level-IIA recommendation remains valid and has been restated. To increase the utility of the recommendations, we added a new section entitled Incorporating the Evidence into Practice. This summary of expert opinion provides important context and addresses key issues for practitioners, which are intended to help the clinician utilize the available evidence and these recommendations. The full guideline can be found at: https://braintrauma.org/guidelines/guidelines-for-the-management-of-severe-tbi-4th-ed#/.
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  • 文章类型: Journal Article
    自2019年12月以来,武汉的一种新型冠状病毒病(COVID-19)导致中国和世界其他地区爆发。迄今为止,已经有超过1,260,000名COVID-19患者,死亡率约为5.44%。研究表明,凝血功能障碍是严重COVID-19患者死亡的主要原因。因此,中国人民解放军重症医学科专业委员会和中国血栓与止血学会将武汉疫情前线的专家聚集在一起,就与严重COVID-19感染相关的凝血功能障碍的诊断和治疗达成专家共识。这一共识包括对COVID-19相关凝血功能障碍的概述,凝血试验,抗凝治疗,替代疗法,支持治疗和预防。共识产生了18条建议,用于指导临床工作。
    Since December 2019, a novel type of coronavirus disease (COVID-19) in Wuhan led to an outbreak throughout China and the rest of the world. To date, there have been more than 1,260,000 COVID-19 patients, with a mortality rate of approximately 5.44%. Studies have shown that coagulation dysfunction is a major cause of death in patients with severe COVID-19. Therefore, the People\'s Liberation Army Professional Committee of Critical Care Medicine and Chinese Society on Thrombosis and Hemostasis grouped experts from the frontline of the Wuhan epidemic to come together and develop an expert consensus on diagnosis and treatment of coagulation dysfunction associated with a severe COVID-19 infection. This consensus includes an overview of COVID-19-related coagulation dysfunction, tests for coagulation, anticoagulation therapy, replacement therapy, supportive therapy and prevention. The consensus produced 18 recommendations which are being used to guide clinical work.
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  • 文章类型: Journal Article
    肝损伤是创伤患者中最常见的危及生命的损伤之一。在确定最优管理策略时,解剖损伤,血液动力学状态,和相关的伤害应该考虑在内。肝外伤方法可能需要非手术或手术管理,以恢复稳态和正常生理。肝外伤的管理应该是多学科的,包括创伤外科医生,介入放射科医生,急诊和ICU医生。本文的目的是介绍世界急诊外科学会(WSES)肝外伤管理指南。
    Liver injuries represent one of the most frequent life-threatening injuries in trauma patients. In determining the optimal management strategy, the anatomic injury, the hemodynamic status, and the associated injuries should be taken into consideration. Liver trauma approach may require non-operative or operative management with the intent to restore the homeostasis and the normal physiology. The management of liver trauma should be multidisciplinary including trauma surgeons, interventional radiologists, and emergency and ICU physicians. The aim of this paper is to present the World Society of Emergency Surgery (WSES) liver trauma management guidelines.
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  • 文章类型: Journal Article
    Although a minority of asthma patients suffer from severe asthma, they represent a major clinical challenge in terms of poor symptom control despite high-dose treatment, risk of exacerbations, and side effects. Novel biological treatments may benefit patients with severe asthma, but are expensive, and are only effective in appropriately targeted patients. In some patients, symptoms are driven by other factors than asthma, and all patients with suspected severe asthma (\'difficult asthma\') should undergo systematic assessment, in order to differentiate between true severe asthma, and \'difficult-to-treat\' patients, in whom poor control is related to factors such as poor adherence or co-morbidities. The Nordic Consensus Statement on severe asthma was developed by the Nordic Severe Asthma Network, consisting of members from Norway, Sweden, Finland, Denmark, Iceland and Estonia, including representatives from the respective national respiratory scientific societies with the aim to provide an overview and recommendations regarding the diagnosis, systematic assessment and management of severe asthma. Furthermore, the Consensus Statement proposes recommendations for the organization of severe asthma management in primary, secondary, and tertiary care.
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  • 文章类型: Journal Article
    肝损伤的严重程度已根据美国创伤外科协会(AAST)分级量表进行了普遍分类。在确定最佳治疗策略时,然而,应考虑血流动力学状态和相关损伤.因此,肝创伤的管理最终基于损伤的解剖结构和患者的生理学。本文介绍了世界急诊外科学会(WSES)对肝外伤的分类和管理指南。
    The severity of liver injuries has been universally classified according to the American Association for the Surgery of Trauma (AAST) grading scale. In determining the optimal treatment strategy, however, the haemodynamic status and associated injuries should be considered. Thus the management of liver trauma is ultimately based on the anatomy of the injury and the physiology of the patient. This paper presents the World Society of Emergency Surgery (WSES) classification of liver trauma and the management Guidelines.
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