gaps

GAP
  • 文章类型: Journal Article
    背景:技术的进步增强了教育,培训,以及在医疗保健中的应用。然而,围绕仿真技术的可访问性和使用存在限制(例如,模拟器)用于健康专业教育。提高非营利组织在大学研究中心开发的技术的可及性(非营利组织;例如,医院)有可能造福全球人口的健康。这种技术的一个例子是3D打印模拟器。
    目的:本范围审查旨在确定使用开源数据库分发用于3D打印的模拟器设计如何促进可靠的医疗保健培训解决方案,同时最大程度地降低商业化的风险。
    方法:此范围审查将遵循Arksey和O\'Malley方法框架以及JoannaBriggsInstitute关于范围审查的指导。OvidMEDLINE,CINAHL,WebofScience,和PsycINFO将以2012年至2022年的应用时间框架进行搜索。此外,灰色文献将与参考列表搜索一起搜索。将包括探索在学术环境和医疗保健部门中使用开源数据库来分发模拟器设计的论文。将对标题和摘要进行两步筛选,然后全文,建立纸质资格。论文的筛选和数据提取将由2名审稿人(MS和SS)完成,以确保质量。范围审查将报告有关通过开源数据库分发3D打印模拟器设计的便利信息。
    结果:本次审查的结果将确定与非营利组织和基于大学的研究中心形成伙伴关系以共享模拟器设计的差距。范围审查将于2024年12月启动。
    结论:所收集的信息将对医疗保健提供者等利益相关者具有相关性和有用性。研究人员,和非营利组织,以克服有关仿真技术的使用和分布的研究空白。范围审查尚未进行。因此,目前没有可报告的调查结果。
    PRR1-10.2196/53167。
    BACKGROUND: Advancements in technology have enhanced education, training, and application in health care. However, limitations are present surrounding the accessibility and use of simulation technology (eg, simulators) for health profession education. Improving the accessibility of technology developed in university-based research centers by nonprofit organizations (NPOs; eg, hospitals) has the potential to benefit the health of populations worldwide. One example of such technology is 3D-printed simulators.
    OBJECTIVE: This scoping review aims to identify how the use of open-source databases for the distribution of simulator designs used for 3D printing can promote credible solutions for health care training while minimizing the risks of commercialization of designs for profit.
    METHODS: This scoping review will follow the Arksey and O\'Malley methodological framework and the Joanna Briggs Institute guidance for scoping reviews. Ovid MEDLINE, CINAHL, Web of Science, and PsycINFO will be searched with an applied time frame of 2012 to 2022. Additionally, gray literature will be searched along with reference list searching. Papers that explore the use of open-source databases in academic settings and the health care sector for the distribution of simulator designs will be included. A 2-step screening process will be administered to titles and abstracts, then full texts, to establish paper eligibility. Screening and data extraction of the papers will be completed by 2 reviewers (MS and SS) for quality assurance. The scoping review will report information on the facilitation of distributing 3D-printed simulator designs through open-source databases.
    RESULTS: The results of this review will identify gaps in forming partnerships with NPOs and university-based research centers to share simulator designs. The scoping review will be initiated in December 2024.
    CONCLUSIONS: The information collected will be relevant and useful for stakeholders such as health care providers, researchers, and NPOs for the purpose of overcoming the gaps in research regarding the use and distribution of simulation technology. The scoping review has not been conducted yet. Therefore, there are currently no findings to report on.
    UNASSIGNED: PRR1-10.2196/53167.
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  • 文章类型: Journal Article
    霍乱流行病学中的各种建模技术已被开发并用于(1)研究其传播动力学,(2)预测和管理霍乱疫情,(3)评估各种控制和缓解措施的影响。在这项研究中,我们对用于霍乱动态建模的各种方法进行了批判性和系统的审查。此外,我们讨论了每种建模方法的优缺点。在谷歌学者中对文章进行了系统的搜索,PubMed,科学直接,泰勒和弗朗西斯。符合条件的研究是与霍乱动态有关的研究,不包括集中在动物霍乱传播模型上的研究。社会经济因素,以及遗传和分子相关研究。共有476篇同行评审的文章符合纳入标准,大约40%(32%)的研究在亚洲(非洲)进行。约52%,21%,9%,的研究,基于隔室(例如,SIRB),统计(时间序列和回归),和空间(时空聚类)模型,分别,而其余的分析研究使用了其他建模方法,如网络,机器学习和人工智能,贝叶斯,和基于代理的方法。纳入病原体媒介/家蝇传播的霍乱模型研究很少,一小部分研究人员(3.99%)考虑了关键流行病学参数的估计。在超过一半(58%)的研究中,仅使用疫苗接种平台作为控制措施。近年来,霍乱流行病学模型研究的研究生产率有所提高,但是作者使用了各种各样的模型。未来的模型应考虑纳入病原体的媒介/家蝇传播以及估计霍乱动力学传播的关键流行病学参数。
    Diverse modelling techniques in cholera epidemiology have been developed and used to (1) study its transmission dynamics, (2) predict and manage cholera outbreaks, and (3) assess the impact of various control and mitigation measures. In this study, we carry out a critical and systematic review of various approaches used for modelling the dynamics of cholera. Also, we discuss the strengths and weaknesses of each modelling approach. A systematic search of articles was conducted in Google Scholar, PubMed, Science Direct, and Taylor & Francis. Eligible studies were those concerned with the dynamics of cholera excluding studies focused on models for cholera transmission in animals, socio-economic factors, and genetic & molecular related studies. A total of 476 peer-reviewed articles met the inclusion criteria, with about 40% (32%) of the studies carried out in Asia (Africa). About 52%, 21%, and 9%, of the studies, were based on compartmental (e.g., SIRB), statistical (time series and regression), and spatial (spatiotemporal clustering) models, respectively, while the rest of the analysed studies used other modelling approaches such as network, machine learning and artificial intelligence, Bayesian, and agent-based approaches. Cholera modelling studies that incorporate vector/housefly transmission of the pathogen are scarce and a small portion of researchers (3.99%) considers the estimation of key epidemiological parameters. Vaccination only platform was utilized as a control measure in more than half (58%) of the studies. Research productivity in cholera epidemiological modelling studies have increased in recent years, but authors used diverse range of models. Future models should consider incorporating vector/housefly transmission of the pathogen and on the estimation of key epidemiological parameters for the transmission of cholera dynamics.
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  • 文章类型: Journal Article
    背景:糖尿病是一种慢性疾病,正在全球范围内发展。据估计,巴西有1570万年龄在20至79岁之间的人患有糖尿病,大多数病例是2型糖尿病(T2D)。为了成功管理糖尿病,患者需要开展自我保健活动。然而,对巴西T2D患者进行的自我保健活动的了解有限。
    目的:本研究旨在确定和绘制评估巴西T2D自我护理活动的研究。
    方法:这是根据JoannaBriggs研究所的方法指南构建的范围审查方案。使用了六个数据库和灰色文献。搜索的过程,识别,由两名独立审稿人对论文进行评估,由乔安娜·布里格斯研究所建立的假设指导。我们试图回答以下指导性问题:巴西如何评估T2D患者的自我护理活动?我们包括任何语言的论文和出版物,从公共和私有领域,用不同的方法。
    结果:初始数据库搜索共产生681个结果。这些论文将被批判性地分析,并提取相关信息。审查的论文的定量和定性结果将被提交,以回应研究的目标。我们打算在2024年上半年发布范围审查。
    结论:本次范围审查的方案将评估巴西成人和老年人的主要自我护理活动。结果可能有助于确定知识差距,并有助于未来的研究和糖尿病教育干预。
    DERR1-10.2196/49105。
    BACKGROUND: Diabetes mellitus is a chronic disease that is growing worldwide. It is estimated that 15.7 million people aged between 20 and 79 years live with diabetes in Brazil, and the majority of cases are type 2 diabetes (T2D). To successfully manage diabetes, the patient needs to develop self-care activities. However, there is limited understanding of what self-care activities are performed by people with T2D in Brazil.
    OBJECTIVE: This study aims to identify and map studies that evaluate self-care activities in T2D in Brazil.
    METHODS: This is a scoping review protocol structured according to the methodological guidelines of the Joanna Briggs Institute. Six databases and gray literature were used. The process of searching, identifying, and evaluating the papers was carried out by 2 independent reviewers, guided by the assumptions established by the Joanna Briggs Institute. We sought to answer the following guiding question: How are self-care activities for people with T2D evaluated in Brazil? We included papers and publications in any language, from public and private domains, and with different methodological approaches.
    RESULTS: Initial database searches produced a total of 681 results. These papers will be critically analyzed, and relevant information will be extracted. Quantitative and qualitative results of the papers reviewed will be presented to respond to the study\'s objective. We intend to publish the scoping review in the first half of 2024.
    CONCLUSIONS: The protocol for this scoping review will evaluate the main self-care activities carried out by adults and older people with T2D in Brazil. The results may help identify knowledge gaps and contribute to future research and diabetes education interventions.
    UNASSIGNED: DERR1-10.2196/49105.
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  • 文章类型: Review
    背景:抗菌素耐药性(AMR)是一种新兴的全球公共卫生危机。监测是监测和评估缓解AMR努力的基本组成部分。范围审查的主要目的是确定成功,障碍,以及在实施AMR监测系统和利用其中的数据方面的差距。
    方法:PubMed,WebofScience,Scopus,和EMBASE数据库进行了系统搜索,以确定与实施有关的文献,监测,和AMR监测系统的评估。进行了主题分析,其中根据所描述的内容对文献中的主题进行归纳分组。
    结果:系统搜索产生了639篇用于筛选的期刊文章。在重复数据删除和筛选之后,46篇文章被确定为适合列入。一般来说,大多数研究集中在人类AMR监测(n=38,82.6%)。区域,同样关注低收入和中等收入国家(n=7,15.2%)和跨国背景(n=7,14.5%)。所有包含的文章(n=46,100.0%)都讨论了实施或使用AMR监视系统的障碍。从范围审查来看,出现了6个主题:监视能力,数据基础设施,政策,代表性,利益相关者参与,和可持续性。数据基础设施在监测系统评估中最经常被认为是有问题的(n=36,75.0%)。监控系统实施最常见的成功是利益相关者的参与(n=30,65.2%)。
    结论:AMR监测系统的经验因环境而异。具有新兴监视系统的系统与具有已建立系统的系统之间存在明显的经验分离。监视系统需要广泛的改进才能具有代表性并达到监视目标。
    BACKGROUND: Antimicrobial resistance (AMR) is an emerging global public health crisis. Surveillance is a fundamental component in the monitoring and evaluation of AMR mitigation endeavours. The primary aim of the scoping review is to identify successes, barriers, and gaps in implementing AMR surveillance systems and utilising data from them.
    METHODS: PubMed, Web of Science, SCOPUS, and EMBASE databases were searched systematically to identify literature pertaining to implementation, monitoring, and evaluation of AMR surveillance systems. A thematic analysis was conducted where themes within the literature were inductively grouped based on the described content.
    RESULTS: The systematic search yielded 639 journal articles for screening. Following deduplication and screening, 46 articles were determined to be appropriate for inclusion. Generally, most studies focused on human AMR surveillance (n = 38, 82.6%). Regionally, there was equal focus on low- and middle-income countries (n = 7, 15.2%) and trans-national contexts (n = 7, 14.5%). All included articles (n = 46, 100.0%) discussed barriers to either implementing or utilising AMR surveillance systems. From the scoping review, 6 themes emerged: capacity for surveillance, data infrastructure, policy, representativeness, stakeholder engagement, and sustainability. Data infrastructure was most frequently discussed as problematic in evaluation of surveillance systems (n = 36, 75.0%). The most frequent success to surveillance system implementation was stakeholder engagement (n = 30, 65.2%).
    CONCLUSIONS: Experiences of AMR surveillance systems are diverse across contexts. There is a distinct separation of experiences between systems with emerging surveillance systems and those with established systems. Surveillance systems require extensive refinement to become representative and meet surveillance objectives.
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  • 文章类型: Journal Article
    糖尿病(DM)和结核病(TB)在印度都很普遍。考虑到筛查方面的差距,TB-DM合并症已成为一种流行病,在印度需要更多关注。临床护理,和研究。本文旨在回顾已发表的有关印度结核病和DM的文献,以了解双重流行病的负担及其轨迹,并获得有关差距的观点,约束,以及这种双重流行病的护理和治疗方面的挑战。在PubMed上进行了文献检索,Scopus,和谷歌学者,使用关键词\'结核病\'或\'结核病\'和\'糖尿病\'或\'糖尿病\'和\'印度\',专注于2000年至2022年之间发表的研究。结核病患者中DM的患病率很高。关于印度结核病/DM流行病学状况的定量数据,如发病率,患病率,死亡率,缺乏管理。在过去的2年中,结核病-DM与COVID-19大流行的融合增加了不受控制的DM病例,但也使结核病-DM的协调控制在操作上很困难且有效性较低。在流行病学和管理的背景下,需要进行有关TB-DM合并症的研究。积极保证检测和双向筛查。结核病-DM合并症患者的DM管理需要更多的努力,包括一线工人的培训和监督。
    Both diabetes mellitus (DM) and tuberculosis (TB) are prevalent all across in India. TB-DM comorbidity has emerged as a syndemic and needs more attention in India considering gaps in screening, clinical care, and research. This paper is intended to review published literature on TB and DM in India to understand the burden of the dual epidemic and its trajectory and to obtain perspectives on the gaps, constraints, and challenges in care and treatment of this dual epidemic. A literature search was carried out on PubMed, Scopus, and Google Scholar, using the key words \'Tuberculosis\' OR \'TB\' AND \'Diabetes\' OR \'Diabetes Mellitus\' AND \'India\', focusing on the research published between the year 2000 to 2022. The prevalence of DM is high in patients with TB. Quantitative data on the epidemiological situation of TB/DM in India such as incidence, prevalence, mortality, and management are lacking. During the last 2 years convergence of TB-DM syndemic with the COVID-19 pandemic has increased cases with uncontrolled DM but also made coordinated control of TB-DM operationally difficult and of low effectiveness. Research regarding TB-DM comorbidity is required in the context of epidemiology and management. Detection and bidirectional screening are aggressively warranted. Management of DM in those with TB-DM comorbidity needs more efforts, including training and supervision of frontline workers.
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  • 文章类型: Journal Article
    人口快速增长,气候变化,有限的自然资源,COVID-19大流行导致全球饥饿加剧,需要加大努力以确保粮食安全和营养(FSN)。以前的FSN方法涵盖了一些维度,但不是全部,导致粮食安全指标的巨大差距。海湾合作委员会(海合会)以及中东和北非(中东和北非地区)在粮食安全研究中受到的关注较少,到目前为止,需要付出相当大的努力来建立一个适当的分析框架。本研究回顾了FSN指标的文章和国际报告,司机和政策,方法,并从全球和阿联酋的环境中提取挑战和差距。阿联酋和世界在FSN驱动方面存在差距,指标,和方法,需要潜在的解决方案来应对未来的挑战,如人口快速增长,大流行,有限的自然资源。因此,我们创建了一个新开发的分析框架,解决了粮农组织制定的可持续粮食系统和全球粮食安全指数(GFSI)等以前方法的缺陷,涵盖了粮食安全的所有方面。FSN驱动因素和政策方面的知识差距,指标,大数据,方法,并在开发的框架中考虑了模型,具有特定优势。新开发的框架解决了所有粮食安全层面(访问,可用性,稳定性,和利用率),确保减贫,粮食安全,和营养安全,同时优于以前的方法(即,粮农组织和GFSI)。开发的框架不仅可以在阿联酋和中东和北非地区成功使用,而且,全球,帮助解决子孙后代的粮食不安全和营养不良问题。科学界和决策者应传播此类解决方案,以解决全球粮食不安全问题,并在人口快速增长的情况下确保后代的营养,有限的自然资源,气候变化,传播流行病。
    UNASSIGNED:在线版本包含补充材料,可在10.1007/s10668-023-03032-3获得。
    Rapid population growth, climate change, limited natural resources, and the COVID-19 pandemic contribute to increased global hunger, necessitating intensive efforts to ensure food security and nutrition (FSN). Previous FSN approaches covered some dimensions, but not all, resulting in significant gaps in food security indicators. The Gulf Cooperation Council (GCC) and the Middle East and North Africa (MENA) regions have received less attention in food security studies, thus far necessitating considerable effort to develop an appropriate analytical framework. This study reviewed articles and international reports of FSN indicators, drivers and policies, methods, and models and extracted the challenges and gaps from the global and UAE contexts. The UAE and the world have gaps in FSN drivers, indicators, and methods, necessitating potential solutions to meet future challenges such as rapid population growth, pandemics, and limited natural resources. As a result, we created a newly developed analytical framework that addresses the shortcomings of previous approaches such as sustainable food systems developed by FAO and the Global Food Security Index (GFSI) and covers all aspects of food security. Gaps in knowledge in FSN drivers and policies, indicators, big data, methods, and models were considered in the developed framework, which has specific advantages. The novel developed framework addresses all food security dimensions (access, availability, stability, and utilization), ensuring poverty reduction, food security, and nutrition security while outperforming previous approaches (i.e., FAO and GFSI). The developed framework could be used successfully not only in the UAE and MENA, but also, globally, helping to solve food insecurity and malnutrition for future generations. The scientific community and policymakers should disseminate such solutions to address global food insecurity and ensure nutrition for future generations in the face of rapid population growth, limited natural resources, climate change, and spreading pandemics.
    UNASSIGNED: The online version contains supplementary material available at 10.1007/s10668-023-03032-3.
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  • 文章类型: Journal Article
    急性下腰痛(LBP)是活动受限和旷工的主要原因,当急性LBP发展为慢性甚至难治性疾病时,其相关的医疗保健支出预计将变得巨大。因此,早期干预对于防止进展为慢性疼痛至关重要,其中管理特别具有挑战性,最有效的药物治疗仍然存在争议。当前的指南治疗建议各不相同,主要是由专业知识驱动的,不同干预措施的意见不同。因此,当相对较少的随机临床试验采用不同的选择标准探索LBP的诊断和管理时,很难制定循证指导。统计分析,和结果测量。这篇叙述性综述旨在通过讨论从工作台到床边的未满足需求和改进领域,对当前急性LBP管理进行批判性评估。并提出了多模式镇痛作为急性LBP患者获得有效和长期疼痛缓解和功能恢复的方法。
    Acute low back pain (LBP) stands as a leading cause of activity limitation and work absenteeism, and its associated healthcare expenditures are expected to become substantial when acute LBP develops into a chronic and even refractory condition. Therefore, early intervention is crucial to prevent progression to chronic pain, for which the management is particularly challenging and the most effective pharmacological therapy is still controversial. Current guideline treatment recommendations vary and are mostly driven by expertise with opinion differing across different interventions. Thus, it is difficult to formulate evidence-based guidance when the relatively few randomized clinical trials have explored the diagnosis and management of LBP while employing different selection criteria, statistical analyses, and outcome measurements. This narrative review aims to provide a critical appraisal of current acute LBP management by discussing the unmet needs and areas of improvement from bench-to-bedside, and proposes multimodal analgesia as the way forward to attain an effective and prolonged pain relief and functional recovery in patients with acute LBP.
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  • 文章类型: Journal Article
    农林业已成为协调生态脆弱地区环境保护与经济发展矛盾要求的重要战略,多种生态系统服务为促进该地区退化生态系统的恢复提供了有效途径。然而,农林生态系统服务(AFES)通常受其生成要素的限制(脆弱性,结构,函数,和生态资产)和服务管理-对于提高AFES供应能力和AF可持续管理的明智决策至关重要。喀斯特石漠化(KRD)是生态脆弱地区的典型案例,在KRD区域内,与促进AFES作为恢复退化的区域生态系统和实现可持续发展目标的战略非常相关。在这项研究中,通过Scopus数据库使用文献综述法检索共获得了164份符合纳入标准的AFES相关出版物,评估,合成,和分析。从系统的文献综述结果来看,(一)我们发现有关刊物数目普遍呈按年增长趋势,AFES生成元素是最常见的主题(占出版物的68.11%),和服务管理研究是第二常见的(占出版物的31.89%);(ii)我们总结了AFES生成要素和服务管理研究的主要进展和具有里程碑意义的结果,并探讨了相关的关键科学问题;(iii)上述信息在三个方面启发了KRD控制生态系统的关键改善领域:自然环境,农业发展,和人与环境的关系。本研究为农林从业人员和相关决策者提供了改善和管理AFES供应能力的信息,并向土地退化恢复技术人员提供了有关KRD控制生态系统的重要见解。
    Agroforestry (AF) has become an important strategy in reconciling the contradictory requirements of environmental protection and economic development in ecologically fragile areas, and whose multiple ecosystem services provide effective ways to promote the restoration of degraded ecosystems in the region. However, agroforestry ecosystem services (AFES) are usually constrained by their generative elements (vulnerability, structure, function, and ecological assets) and service management-both crucial for informed decision-making which enhances AFES supply capacity and AF sustainable management. Karst rocky desertification (KRD) is a typical case in an ecologically fragile area, and within the KRD region greatly relevant for promoting AFES as a strategy for restoring degraded regional ecosystems and for achieving sustainable development goals. In this study, a total of 164 publications related to AFES that met a set of inclusion criteria were obtained through the Scopus database using the literature review method of searching, appraisal, synthesis, and analysis. From the systematic literature review results, (i) we found that the number of relevant publications generally exhibited a year-on-year growth trend, with AFES generation elements being the most common topic (68.11 % of publications), and service management research being the second most common (31.89 % of publications); (ii) we summarised the main progress and landmark results of AFES generation elements and service management research and explored the relevant key scientific questions; and (iii) the above information enlightened the key improvement areas of KRD control ecosystem within three aspects: natural environment, agricultural development, and human-environment relationship. This study provides agroforestry practitioners and relevant decision-makers with information for improving and managing the supply capacity of AFES, and also presents important insights on the KRD control ecosystem to land degradation restoration technicians.
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  • 文章类型: Review
    大数据和数据分析方法和模型是粮食安全(FS)研究中的重要工具,用于差距分析和准备适当的分析框架。这些创新需要开发新的收集方法,存储,processing,并提取数据。
    这项研究的主要目标是对自2010年以来在同行评审期刊上发表的用于FS研究的农业大数据以及方法和模型进行批判性审查。在预筛选过程后,大约130篇文章被选择用于完整的内容审查。
    有不同的数据收集来源,包括但不限于在线数据库,互联网,组学,物联网,社交媒体,调查回合,遥感,和粮食及农业组织公司统计数据库。收集的数据需要分析(即,采矿,神经网络,贝叶斯网络,和其他ML算法)在使用Python进行数据可视化之前,R,Circos,Gephi,Tableau,或者Cytoscape.大约122个模型,所有这些都被用于全球的FS研究,从130篇文章中选出。然而,这些模型中的大多数只针对FS的一个或两个维度(即,可用性和访问),并忽略其他维度(即,稳定性和利用率),在全球范围内造成差距。
    科学家和政策制定者需要解决全球和阿拉伯联合酋长国的某些FS差距。在确认司机身份后,政策,和指标,本综述的结果可用于为FS和营养建立适当的分析框架.
    Big data and data analysis methods and models are important tools in food security (FS) studies for gap analysis and preparation of appropriate analytical frameworks. These innovations necessitate the development of novel methods for collecting, storing, processing, and extracting data.
    The primary goal of this study was to conduct a critical review of agricultural big data and methods and models used for FS studies published in peer-reviewed journals since 2010. Approximately 130 articles were selected for full content review after the pre-screening process.
    There are different sources of data collection, including but not limited to online databases, the internet, omics, Internet of Things, social media, survey rounds, remote sensing, and the Food and Agriculture Organization Corporate Statistical Database. The collected data require analysis (i.e., mining, neural networks, Bayesian networks, and other ML algorithms) before data visualization using Python, R, Circos, Gephi, Tableau, or Cytoscape. Approximately 122 models, all of which were used in FS studies worldwide, were selected from 130 articles. However, most of these models addressed only one or two dimensions of FS (i.e., availability and access) and ignored the other dimensions (i.e., stability and utilization), creating a gap in the global context.
    There are certain FS gaps both worldwide and in the United Arab Emirates that need to be addressed by scientists and policymakers. Following the identification of the drivers, policies, and indicators, the findings of this review could be used to develop an appropriate analytical framework for FS and nutrition.
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  • 文章类型: Journal Article
    药物诱导的肝损伤(DILI)包括药物可能对肝脏造成的意外损害。DILI可能在皮肤表现的免疫过敏综合征的背景下发展,有时是严重的(SCAR)。奈韦拉平,别嘌呤醇,抗癫痫药,磺胺类药物,抗生素是与SCAR相关的DILI最常见的元凶药物。有趣的是,等位基因HLA-B*58:01和HLA-A*31:01与两种不良反应相关.然而,在这种情况下,关于肝损伤的表征标准没有共识,DILI定义的不同阈值使得很难深入了解这种复杂的疾病。此外,在评估与SCAR相关的DILI患者的因果关系时,当前的局限性与因果关系评估方法过多以及缺乏自愿补充工具有关.最后,这种疾病的治疗包括肝脏和皮肤损伤的治疗。虽然SCAR接受免疫调节剂的使用,它们在治疗肝损伤中的作用仍存在争议。需要进一步的随机临床试验来测试它们的有效性和安全性,以解决这个复杂的实体。因此,这篇综述旨在找出目前在定义方面的差距,诊断,预后,以及与SCAR相关的DILI的管理,提出不同的策略来填补这些空白。
    Drug-induced liver injury (DILI) encompasses the unexpected damage that drugs can cause to the liver. DILI may develop in the context of an immunoallergic syndrome with cutaneous manifestations, which are sometimes severe (SCARs). Nevirapine, allopurinol, anti-epileptics, sulfonamides, and antibiotics are the most frequent culprit drugs for DILI associated with SCARs. Interestingly, alleles HLA-B*58:01 and HLA-A*31:01 are associated with both adverse reactions. However, there is no consensus about the criteria used for the characterization of liver injury in this context, and the different thresholds for DILI definition make it difficult to gain insight into this complex disorder. Moreover, current limitations when evaluating causality in patients with DILI associated with SCARs are related to the plethora of causality assessment methods and the lack of consensual complementary tools. Finally, the management of this condition encompasses the treatment of liver and skin injury. Although the use of immunomodulant agents is accepted for SCARs, their role in treating liver injury remains controversial. Further randomized clinical trials are needed to test their efficacy and safety to address this complex entity. Therefore, this review aims to identify the current gaps in the definition, diagnosis, prognosis, and management of DILI associated with SCARs, proposing different strategies to fill in these gaps.
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