treatment protocols

治疗方案
  • 文章类型: Journal Article
    目的:调查与InvisalignLite清晰矫正器矫治器相关的正畸医生的治疗计划实践(AlignTechnology,圣何塞,加州)。
    方法:从包含17,000多名患者的数据库中选择符合纳入和排除标准并接受InvisalignLite治疗的患者。有关治疗计划实践的相关数据来自AlignTechnology的治疗计划设施,ClinCheck,并进行了评估。
    结果:大多数(n=135;79.9%)患者为女性,中位(四分位距[IQR])年龄为30.5(23.8,43.1)岁。样本的对齐器的中位数(IQR)为上颌骨的23.0(14,28)和下颌骨的24(14,28)。大多数(n=122;72.2%)患者需要至少一个额外的系列对准器。在所有患者的初始接受计划中,下颌骨(平均1.91[1.78])比上颌骨(1.03[1.78];P<.024)规定了更多的邻间复位(IPR)位置。在所有患者的初始接受计划中,上颌骨中的复合树脂(CR)附件(P<0.0001)更多的牙齿。有关牙齿位置协议(n=50;53.3%)和额外IPR要求(n=68;45.3%)的问题是在正畸医生接受初始治疗计划之前更改治疗计划的原因。
    结论:在完成初始系列InvisalignLite矫正器后,10名患者中有7名以上需要至少一个额外系列的矫正器。IPR的处方在下颌骨中更常见,CR附件的处方在上颌骨更为常见。
    OBJECTIVE: To survey treatment-planning practices of orthodontists related to the Invisalign Lite clear aligner appliance (Align Technology, San Jose, Calif).
    METHODS: Patients satisfying inclusion and exclusion criteria and treated with Invisalign Lite were selected from a database containing more than 17,000 patients. Relevant data regarding treatment-planning practices were obtained from Align Technology\'s treatment-planning facility, ClinCheck, and evaluated.
    RESULTS: Most (n = 135; 79.9%) patients were female and had a median (interquartile range [IQR]) age of 30.5 (23.8, 43.1) years. The median (IQR) number of aligners for the sample was 23.0 (14, 28) for the maxilla and 24 (14, 28) for the mandible. Most (n = 122; 72.2%) patients required at least one additional series of aligners. More locations for interproximal reduction (IPR) were prescribed in the mandible (mean 1.91 [1.78]) than in the maxilla (1.03 [1.78]; P < .024) in the initial accepted plan of all patients. More teeth were prescribed composite resin (CR) attachments in the maxilla (P < .0001) in the initial accepted plan of all patients. Issues regarding tooth position protocols (n = 50; 53.3%) and requirement for additional IPR (n = 68; 45.3%) were reasons for treatment plan changes before acceptance of the initial treatment plan by orthodontists.
    CONCLUSIONS: More than 7 of 10 patients required at least one additional series of aligners after the initial series of Invisalign Lite aligners was completed. Prescription of IPR was more common in the mandible, and prescription of CR attachments was more common in the maxilla.
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  • 文章类型: Journal Article
    始于2019年6月,这项合作努力涉及巴基斯坦的15家公立和私立医院。主要目标是提高儿科神经肿瘤(PNO)护理的能力,由我的孩子事务/基金会资助。
    我们的目标是在全国范围内建立和运营多学科肿瘤委员会(MTB),覆盖76%的人口(1.857亿人)。为了应对COVID-19大流行,MTB过渡到视频会议。15家拥有基本基础设施的医院参加了会议,每月举行会议,解决诊断和治疗的挑战。为了保密,患者病例被匿名化。教育倡议,最初计划作为亲自活动,转换为虚拟格式,尽管存在大流行限制,但仍能继续实施和合作。
    共举行了124次会议,处理545起案件。为了增加知识,意识,和专业知识,为从事PNO护理的医疗保健专业人员组织了40多次纵向讲座。此外,还与国际合作者和主旨发言人举行了两次专题讨论会,以提高国家意识。该项目取得了重要的里程碑,包括制定针对低度神经胶质瘤的标准化国家治疗方案,髓母细胞瘤,和高级别神经胶质瘤.目前正在制定进一步的协议。值得注意的是,巴基斯坦启动了第一个儿科神经肿瘤学研究金计划,培养两名毕业生,并将该国训练有素的儿科神经肿瘤学家人数增加到三名。
    该倡议体现了中低收入国家在PNO方面能力建设的潜力。成功归功于国内的结对计划,强调协作努力。正在努力为PNO建立国家案件登记册,确保采取全面和有组织的方法来监测和管理案件。这一合作倡议,由我的孩子事务/基金会S资助,展示了中低收入国家儿科神经肿瘤学能力建设的成功。治疗方案的建立,奖学金项目,区域肿瘤委员会强调了PNO护理可持续改善的潜力。
    UNASSIGNED: Initiated in June 2019, this collaborative effort involved 15 public and private sector hospitals in Pakistan. The primary objective was to enhance the capacity for pediatric neuro-oncology (PNO) care, supported by a My Child Matters/Foundation S grant.
    UNASSIGNED: We aimed to establish and operate Multidisciplinary Tumor Boards (MTBs) on a national scale, covering 76% of the population (185.7 million people). In response to the COVID-19 pandemic, MTBs transitioned to videoconferencing. Fifteen hospitals with essential infrastructure participated, holding monthly sessions addressing diagnostic and treatment challenges. Patient cases were anonymized for confidentiality. Educational initiatives, originally planned as in-person events, shifted to a virtual format, enabling continued implementation and collaboration despite pandemic constraints.
    UNASSIGNED: A total of 124 meetings were conducted, addressing 545 cases. To augment knowledge, awareness, and expertise, over 40 longitudinal lectures were organized for healthcare professionals engaged in PNO care. Additionally, two symposia with international collaborators and keynote speakers were also held to raise national awareness. The project achieved significant milestones, including the development of standardized national treatment protocols for low-grade glioma, medulloblastoma, and high-grade glioma. Further protocols are currently under development. Notably, Pakistan\'s first pediatric neuro-oncology fellowship program was launched, producing two graduates and increasing the number of trained pediatric neuro-oncologists in the country to three.
    UNASSIGNED: The initiative exemplifies the potential for capacity building in PNO within low-middle income countries. Success is attributed to intra-national twinning programs, emphasizing collaborative efforts. Efforts are underway to establish a national case registry for PNO, ensuring a comprehensive and organized approach to monitoring and managing cases. This collaborative initiative, supported by the My Child Matters/Foundation S grant, showcases the success of capacity building in pediatric neuro-oncology in low-middle income countries. The establishment of treatment protocols, fellowship programs, and regional tumor boards highlights the potential for sustainable improvements in PNO care.
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  • 文章类型: Journal Article
    强调报告用于评估预测Wilms肿瘤预后的组织病理学参数。
    分析影响初治和化疗后肾母细胞瘤标本治疗结果的各种临床病理参数。
    这是一项回顾性观察性研究。
    2012年至2018年在我们研究所诊断为Wilms肿瘤的所有患者都将纳入其临床发现,实验室报告,和放射学发现。根据使用的治疗方案(儿科肿瘤学会(SIOP)或国家威尔姆斯肿瘤研究组/儿童肿瘤研究组(COG)指南)将患者分为两组。将分析用于治疗前和治疗后标本的Grosing和报告方案的详细信息。将对2020年12月之前的后续行动进行分析。
    卡方和Fisher精确检验用于统计分析。
    本研究共纳入36例诊断为Wilms肿瘤的患者。演示的平均年龄为3.9±0.7岁,男性比女性更常见。大多数表现为腹部肿块,少数表现为孤立性血尿。26例(72%)患者在SIOP方案下接受术前新辅助化疗。10例患者按照COG方案进行了前期手术。在SIOP组患者中,平均肿瘤大小为9.3cm.40%(n=10)我们混合了组织学类型,其次是囊胚型(32%,n=8)。回归和上皮组织学类型占16%(n=4)和12%(n=3),分别。在SIOP组中,72%(n=19)无间变,而28%(n=7)有间变。57%(n=15)的病例为I期,其次是26.9%n=7)和11.5%(n=3)为II期和III期,分别。10例患者按照COG方案进行了前期手术。该组中的平均肿瘤大小为8cm,范围为7cm至11cm。8例(80%)具有良好的组织学,2例显示局灶性发育不良。异源分化见3(70%)。在这10个案例中,一个案例是第一阶段,六个是第二阶段,一个是第三阶段,两个是临床IV期。所有病例均未出现血管或淋巴结转移。所有患者术后均接受辅助化疗,随访至2020年12月(至少3年)。在SIOP组的25名患者中,18(72%)完全缓解,没有放射学证据表明残留疾病。在COG组的10名患者中,6人(70%)完全缓解。
    Wilms肿瘤的组织病理学评估是治疗Wilms肿瘤的关键方面,由于在SIOP和COG方案下治疗的肿瘤的肿瘤特征不同,最终会影响预后风险分层。这就需要了解两种方案下这些肿瘤的重要收入和报告。
    UNASSIGNED: Emphasis on grossing to reporting for the assessment of histopathological parameters predicting outcomes in Wilms tumor.
    UNASSIGNED: To analyze various clinicopathological parameters that effect outcomes in treatment naïve and post chemotherapy Wilms tumor specimens.
    UNASSIGNED: This was a retrospective observational study.
    UNASSIGNED: All patients diagnosed with Wilms tumor between 2012 and 2018 at our institute will be included with their clinical findings, laboratory reports, and radiological findings. The patients will be categorized into two groups based on treatment protocol (Society of Pediatric Oncology (SIOP) or the National Wilms Tumor Study Group/Children\'s Oncology Group (COG) guidelines) used. Details of Grossing and reporting protocols used for the in pre treatment and post treatment specimens will be analyzed. Follow-up till December 2020 will be analyzed.
    UNASSIGNED: Chi-square and Fisher\'s exact tests were used for statistical analysis.
    UNASSIGNED: A total of 36 patients with the diagnosis of Wilms tumor were included in the present study. The mean age of presentation was 3.9 ± 0.7 years, and males were more common than females. Most of them presented as abdominal mass and few with isolated hematuria. Twenty-six (72%) patients were treated under SIOP protocol with preoperative neoadjuvant chemotherapy. Ten patients underwent upfront surgery as per COG protocol. In SIOP group patients, the mean tumor size was 9.3cm. Forty percent (n = 10) we mixed histological type followed by blastemal type constituting (32%, n = 8). Regressive and epithelial histological types constituted 16% (n = 4) and 12% (n = 3), respectively. In the SIOP group 72% (n = 19) had no anaplasia and 28% (n = 7) had anaplasia. Fifty seven percent (n = 15) cases were Stage I, followed by 26.9% n = 7) and 11.5% (n = 3) being Stage II and Stage III, respectively. Ten patients underwent upfront surgery as per COG protocol. The mean tumor size among this group was 8 cm ranging from 7 cm to 11 cm. Eight (80%) cases had favorable histology and two cases showed focal anaplasia. Heterologous differentiation is seen in 3 (70%). Out of the 10 cases, one case was Stage I, six were Stage 2, one was Stage III, and two were clinical Stage IV. None of the cases showed either vessel or lymph node metastasis. All the patients received adjuvant chemotherapy postsurgery and were followed up till December 2020 for (at least 3 years). Of 25 patients in the SIOP group, 18 (72%) had complete remission with no radiological evidence of residual disease. Of the 10 patients in the COG group, 6 (70%) had complete remission.
    UNASSIGNED: Histopathological evaluation of Wilms tumor is a critical aspect in the management of Wilms tumor, as tumor characteristics are different in the tumors treated under SIOP and COG protocols, which will ultimately affect the prognostic risk stratification. This necessitates the knowledge of the important grossing and reporting of these tumors under the two protocols.
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  • 文章类型: Journal Article
    本文主要研究高血糖高渗综合征(HHS),糖尿病酮症酸中毒(DKA)是一种独特的高血糖状态,尽管有一些共同的特征,但需要不同的诊断和治疗方法。我们引入助记符DI-FF-ER-EN-CE-S来封装独特的HHS管理和并发症。“DI”强调需要延迟和减少初始胰岛素治疗,直到仅通过液体复苏来控制血清葡萄糖下降。与DKA相比,“FF”强调了双重液体置换的重要性,这是由于严重的脱水和严重的损失和不平衡导致的“ER”电解质置换。\'EN\'表示脑病的可能性和对受控血清渗透压降低的要求。\'CE\'表示脑水肿,HHS罕见的并发症。\'S\'表示全身性多器官衰竭。我们将相关风险分为三个记忆组:3Rs(肾衰竭,呼吸窘迫,横纹肌溶解),3Hs(心力衰竭,高凝,热疗),和AP(心律失常,胰腺炎),以促进对HHS的认识和筛查。
    This paper focuses on hyperglycemic hyperosmolar syndrome (HHS), a unique hyperglycemic state requiring divergent diagnosis and treatment approaches from diabetic ketoacidosis (DKA) despite some shared characteristics. We introduce the mnemonic DI-FF-ER-EN-CE-S to encapsulate unique HHS management and complications. \'DI\' emphasizes the need to delay and decrease initial insulin therapy until serum glucose decline is managed by fluid resuscitation alone. \'FF\' stresses the importance of double fluid replacement compared to DKA due to severe dehydration and \'ER\' electrolyte replacement due to profound losses and imbalances. \'EN\' denotes the potential for encephalopathy and the requirement for a controlled serum osmolality reduction. \'CE\' indicates cerebral edema, a rare complication in HHS. \'S\' signifies systemic multiorgan failure. We categorize the associated risks into three mnemonic groups: the 3Rs (renal failure, respiratory distress, rhabdomyolysis), the 3Hs (heart failure, hypercoagulation, hyperthermia), and AP (arrhythmias, pancreatitis) to facilitate awareness and screening of HHS.
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  • 文章类型: Journal Article
    2022年6月,在意大利寄生虫学学会XXXII会议上,讨论了马和驴的主要体内寄生虫感染的相似之处。尽管这两个物种在基因上不同,它们可以受到类似范围的寄生虫的挑战(即小而大的强壮风格,和Parascarisspp。).尽管马科动物可以对寄生虫表现出一定程度的复原力,它们有非常独特的蠕虫生物多样性,不同地理位置和品种之间的分布和强度。重感染的驴可能比马表现出更少的临床症状。虽然寄生虫控制主要提供给马,我们认为,当共享同一牧场时,驴被动感染可能会有耐药性寄生虫感染的风险。了解可能缺乏药物功效(<90%或80%),提倡根据粪便卵数对这两种物种进行选择性治疗。当阈值超过每克200-500个鸡蛋(EPG)时,成年马应接受治疗。此外,考虑到驴身上没有确切的迹象,值>300EPG可能是一个安全的建议。我们强调了讨论的要点,包括两种物种之间蠕虫感染的动态。
    In June 2022, at the XXXII Conference of the Italian Society of Parasitology, the parallels of the main endoparasitic infections of horses and donkeys were discussed. Although these 2 species are genetically different, they can be challenged by a similar range of parasites (i.e. small and large strongyles, and Parascaris spp.). Although equids can demonstrate some level of resilience to parasites, they have quite distinct helminth biodiversity, distribution and intensity among different geographical locations and breeds. Heavily infected donkeys may show fewer clinical signs than horses. Although parasite control is primarily provided to horses, we consider that there may be a risk of drug-resistance parasitic infection through passive infection in donkeys when sharing the same pasture areas. Knowing the possible lack of drug efficacy (<90 or 80%), it is advocated the use of selective treatment for both species based on fecal egg counts. Adult horses should receive treatment when the threshold exceeds 200–500 eggs per gram (EPG) of small strongyles. Moreover, considering that there are no precise indications in donkeys, a value >300 EPG may be a safe recommendation. We have highlighted the main points of the discussion including the dynamics of helminth infections between the 2 species.
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  • 文章类型: Journal Article
    唇腭裂患者需要复杂的跨学科治疗,包括上颌骨扩张和二次牙槽骨移植。然而,缺乏有关这些治疗程序和结局的证据.因此,本研究旨在调查欧洲颌面外科医师和正畸医师对上颌扩张植骨治疗方案及相关并发症的主观观察.向131个中心发送了一份在线调查问卷。这些问题评估了参与者的人口统计数据,上颌骨扩张和牙槽骨移植方案,以及相关的并发症。采用描述性统计和t检验对数据进行分析。有效率为40.5%。上颌扩张的平均年龄为9-10岁。计划在扩张后5-10个月进行二次牙槽骨移植。最常见的并发症是不对称扩张,复发,和瘘管形成。使用的协议和材料在各中心之间差异很大。解剖学改变和发育过程,就像裂口附近的牙齿萌出一样,应认真考虑治疗计划。这项调查表明,在这些治疗程序上仍然缺乏共识。进一步的临床试验应侧重于长期结果评估,以确定最佳牙槽骨替代和上颌骨横向扩张治疗的治疗成分。
    Cleft lip and palate patients require complex interdisciplinary treatment, including maxillary expansion and secondary alveolar bone grafting. However, the evidence on these treatment procedures and outcomes is lacking. Therefore, this study aimed to survey the subjective observations of European maxillofacial surgeons and orthodontists on the maxillary expansion and bone grafting treatment protocols and the associated complications. An online questionnaire was sent to 131 centers. The questions assessed the participants\' demographic data, maxillary expansion and alveolar bone grafting protocols, and the associated complications. Descriptive statistics and a t-test were used to analyze the data. The response rate was 40.5%. The average age for maxillary expansion was 9-10 years. The secondary alveolar bone grafting was planned 5-10 months after the expansion. The most common complications were asymmetric expansion, relapse, and fistula formation. The protocols and materials used vary widely among centers. Anatomical alterations and developmental processes, like tooth eruption adjacent to the cleft, should be seriously considered for treatment planning. This survey showed that there is still a lack of consensus on these treatment procedures. Further clinical trials should focus on long-term outcome evaluation to identify treatment components for optimal alveolar bone substitution and transversal maxillary expansion treatment in patients with clefts.
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  • 文章类型: Journal Article
    SARS-CoV-2,负责COVID-19大流行,是一种高度传染性的病毒,迅速成为并继续成为公共卫生紧急情况,鉴于严重的国际影响。免疫功能低下的患者,比如接受肾移植的人,患COVID-19严重疾病的风险增加,需要住院治疗以进行更积极的治疗以确保生存。COVID-19一直在感染肾移植受者(KTR),影响他们的治疗方案,威胁着他们的生存.本次范围审查的目的是总结已发表的关于COVID-19对美国KTR在预防方面的影响的文献,各种治疗方案,COVID-19疫苗接种,和风险因素。数据库,如PubMed,MEDLINE/Ebsco,和Embase用于搜索同行评审的文献。搜索仅限于2019年1月1日至2022年3月在美国KTR上发表的文章。最初的搜索在删除重复项后产生了1,023篇文章,在符合纳入和排除标准的筛选后,最终选择了16篇文章。审查中出现了四个领域:(1)COVID-19对进行肾移植的影响,(2)COVID-19疫苗接种对KTRs的影响,(3)COVID-19KTRs治疗方案的结果,以及(4)与KTRs中COVID-19死亡率增加相关的危险因素。与未移植的患者相比,等待肾移植的患者死亡风险更高。KTRs中的COVID-19疫苗接种被认为是安全的,免疫反应可以通过在疫苗接种前给患者服用低剂量的霉酚酸酯来改善。停用免疫抑制剂后,死亡率为20%,而不会增加急性肾损伤(AKI)的发生率。有证据支持,与等待患者相比,伴随免疫抑制剂方案的肾移植可以为KTR提供更好的COVID-19感染结果。住院治疗,移植物功能障碍,AKI,和呼吸衰竭是增加COVID-19阳性KTRs死亡风险的最常见危险因素。从免疫抑制药物中撤出KTRs会增加死亡率。需要进一步的研究来调查特定药物和剂量对KTR中COVID-19严重程度和死亡率的影响。
    SARS-CoV-2, responsible for the COVID-19 pandemic, is a highly infectious virus that quickly became and continues to be a public health emergency, given the severe international implications. Immunocompromised patients, such as those undergoing kidney transplantation, are at an increased risk for severe illness from COVID-19 and require hospitalization for more aggressive treatment to ensure survival. COVID-19 has been infecting kidney transplant recipients (KTRs), affecting their treatment protocols, and threatening their survival. The objective of this scoping review was to summarize the published literature regarding the impact of COVID-19 on KTRs in the United States in terms of prevention, various treatment protocols, COVID-19 vaccination, and risk factors. The databases such as PubMed, MEDLINE/Ebsco, and Embase were used to search for peer-reviewed literature. The search was restricted to articles that were published on KTRs in the United States from January 1, 2019, to March 2022. The initial search yielded 1,023 articles after removing duplicates, leading to a final selection of 16 articles after screening with inclusion and exclusion criteria. Four domains emerged from the review: (1) impacts of COVID-19 on performing kidney transplants, (2) impacts of COVID-19 vaccinations on KTRs, (3) outcomes of treatment regiments for KTRs with COVID-19, and (4) risk factors associated with an increased mortality rate of COVID-19 in KTRs. Waitlisted patients for kidney transplants had a higher risk of mortality compared to nontransplant patients. COVID-19 vaccinations in KTRs are found to be safe, and the immune response can be improved by placing patients on a low dose of mycophenolate before vaccination. Withdrawal of immunosuppressants showed a mortality rate of 20% without increasing the rate of acute kidney injury (AKI). There is evidence to support that kidney transplantation with the accompanying immunosuppressant regimen can provide KTRs with better COVID-19 infection outcomes compared to waitlisted patients. Hospitalization, graft dysfunction, AKI, and respiratory failure were the most common risk factors that increased the risk of mortality in COVID-19-positive KTRs. Withdrawing KTRs from immunosuppressive drugs increased the mortality rate. Further studies are needed to investigate the effects of specific drugs and dosages on the severity and mortality rate of COVID-19 in KTRs.
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  • 文章类型: Journal Article
    未经证实:基于双重引发寡核苷酸的多重聚合酶链反应(DPO-PCR)最近已用于检测幽门螺杆菌和鉴定引起克拉霉素耐药性的幽门螺杆菌23S核糖体RNA点突变。这项研究的目的是研究克拉霉素敏感组中有效的标准三联疗法和基于DPO-PCR的耐药组中基于铋的四联疗法的持续时间。
    UNASSIGNED:我们回顾性分析了184例患者的电子病历,在2019年9月至2020年12月期间,在检测到幽门螺杆菌后接受了根除治疗,以及随后使用DPO-PCR鉴定其幽门螺杆菌的克拉霉素敏感性。克拉霉素易感组患者接受7天或14天标准三联疗法治疗,而克拉霉素耐药组的7天或14天以铋为基础的四联疗法。
    UNASSIGNED:在克拉霉素易感组中,符合方案分析显示根除率为87.5%(42/48;95%置信区间[CI],7天治疗为77.1%至95.8%),14天治疗为87.2%(41/47;95%CI,78.7至95.7%)(p=0.969)。克拉霉素耐药组7天治疗根除率为91.4%(32/35;95%CI,80.0%~100.0%),14天治疗根除率为90.3%(28/31;95%CI,77.4%~100.0%)(p=0.876)。根除率没有显着差异,患者依从性,两组治疗7天至14天之间的不良事件发生率。
    未经证实:与14天治疗相比,基于DPO-PCR的克拉霉素敏感性测试后,7天的根除治疗就足够了。
    Dual priming oligonucleotide-based multiplex polymerase chain reaction (DPO-PCR) has recently been used for both the detection of Helicobacter pylori and the identification of H. pylori 23S ribosomal RNA point mutations that cause clarithromycin resistance. The aim of this study was to investigate the duration of effective standard triple therapy in a clarithromycin susceptible group and of bismuth-based quadruple therapy in a resistant group based on DPO-PCR.
    We retrospectively analyzed the electronic medical records of 184 patients who, between September 2019 and December 2020, received eradication therapy following detection of H. pylori, and the subsequent identification of the clarithromycin susceptibility of their H. pylori using DPO-PCR. Patients were treated with 7- or 14-day standard triple therapy in the clarithromycin susceptible group, whereas 7- or 14-day bismuth-based quadruple therapy in the clarithromycin resistance group.
    In the clarithromycin susceptible group, per-protocol analyses showed eradication rates of 87.5% (42/48; 95% confidence interval [CI], 77.1% to 95.8%) for 7-day therapy and 87.2% (41/47; 95% CI, 78.7% to 95.7%) for 14-day therapy (p=0.969). The eradication rates in the clarithromycin resistance group were 91.4% (32/35; 95% CI, 80.0% to 100.0%) for 7-day therapy and 90.3% (28/31; 95% CI, 77.4% to 100.0%) for 14-day therapy (p=0.876). There was no significant difference in the eradication rates, patient compliance, or rate of adverse events between the 7- and 14-day therapies for both groups.
    Compared to the 14-day therapy, 7-day eradication therapy is sufficient after DPO-PCR-based clarithromycin susceptibility testing.
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  • 文章类型: Journal Article
    COVID-19的严重病程需要在急诊和重症监护病房进行治疗。由于肺炎和急性呼吸窘迫综合征的发展而导致的急性呼吸衰竭是新型冠状病毒感染的最常见和危及生命的表现。治疗严重和极严重的COVID-19患者;使用现代方案和方案进行药物治疗,机械通气,和体外膜氧合;吸附技术;热氦的使用;止血校正;讨论了康复问题。
    The severe course of COVID-19 requires treatment in emergency and intensive care units. Acute respiratory failure due to the development of pneumonia and acute respiratory distress syndrome is the most common and life-threatening manifestation of the new coronavirus infection. Treatment of patients with severe and extremely severe COVID-19; the use of modern schemes and protocols for drug therapy, mechanical ventilation, and extracorporeal membrane oxygenation; sorption techniques; the use of thermal helium; hemostasis correction; and rehabilitation problems are discussed.
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  • 文章类型: Journal Article
    伴随DNA甲基化药物替莫唑胺(TMZ)的辐射是治疗胶质母细胞瘤的金标准。在这种佐剂设置中,TMZ被认为是辐射敏化剂。然而,类似于电离辐射,TMZ诱导DNA双链断裂,本身是细胞凋亡的有效触发因素,细胞衰老和自噬,这表明辐射和TMZ是独立作用的.尽管细胞培养实验产生了异质结果,一些数据表明,只有在放疗前给予TMZ时,放疗的细胞毒性效应才会增强.基于TMZ的分子作用机理,特定TMZ和辐射诱导的DNA损伤的重要性,它们的修复以及它们的相互作用,讨论了TMZ和辐射的累加或协同效应的可能情况,并提出了放射化学治疗的最佳时机的建议。
    Radiation concomitant with the DNA methylating drug temozolomide (TMZ) is the gold standard in the treatment of glioblastoma. In this adjuvant setting, TMZ is regarded to be a radiation sensitizer. However, similar to ionising radiation, TMZ induces DNA double-strand breaks and is itself a potent trigger of apoptosis, cellular senescence and autophagy, suggesting that radiation and TMZ act independently. Although cell culture experiments yielded heterogeneous results, some data indicate that the cytotoxic effect of radiation was only enhanced when TMZ was given before radiation treatment. Based on the molecular mechanism of action of TMZ, the importance of specific TMZ and radiation-induced DNA lesions, their repair as well as their interactions, possible scenarios for an additive or synergistic effect of TMZ and radiation are discussed, and suggestions for an optimal timing of radio-chemical treatments are proposed.
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