Review

Review
  • 文章类型: Journal Article
    UNASSIGNED: Hypomagnesemia is a common side effect of anti-epidermal growth factor receptor (EGFR) antibodies, which may lead to arrhythmia. However, there are no evidence-based guidelines for magnesium (Mg) supplementation in the management of hypomagnesemia in patients with anti-EGFR antibodies. Therefore, we performed a systematic review to address clinical questions regarding these cancer patients.
    UNASSIGNED: Three electronic databases were searched for articles published until June 18, 2021. The main outcomes used were \"anti-EGFR antibody\" and \"hypomagnesemia\".
    UNASSIGNED: After screening 78 references in PubMed, Cochrane Library, and ICHUSHI-web databases, three studies were included in the review. One study revealed the effectiveness of Mg supplementation in the management of hypomagnesemia in patients receiving cetuximab. However, no studies have investigated whether correcting hypomagnesemia can lead to the suppression of arrhythmias as a clinical outcome.
    UNASSIGNED: Weak evidence suggests that Mg supplementation, as a preventive measure when developing hypomagnesemia following the initiation of anti-EGFR antibody therapy, may prevent the worsening of hypomagnesemia, and subsequently prevent associated arrhythmia occurrence.
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  • 文章类型: Journal Article
    Craniopharyngioma (CP) is a rare intracranial tumor arising from the epithelial remnants of Rathke\'s pouch, most frequently originating in the sellar/parasellar region. Histologically, CP is a benign low-grade tumor (WHO grade 1) with two distinct phenotypes: adamantinomatous CP (ACP) and papillary CP (PCP). Craniopharyngioma constitutes 1-3% of all primary intracranial tumors in adults and 5-10 % of intracranial tumors in children. The annual incidence ranges from 0.13 to 2 per 100,000 population per year with no gender predilection. Due to its unique anatomical locations, the most frequently reported clinical manifestations are headache, visual impairment, nausea/vomiting, and endocrine deficiencies resulting in sexual dysfunction in adults and growth failure in children. Growth hormone deficiency is the most predominant endocrinological disturbance associated with craniopharyngioma. Computed tomography (CT) is gold standard to detect calcifications in CP tissue (found in 90 % of these tumors). Magnetic Resonance Imaging (MRI) further characterizes craniopharyngiomas and helps to narrow down the differential diagnoses. In almost all craniopharyngioma cases, surgery is indicated to: establish the diagnosis, relieve mass-related symptoms, and remove as much tumor as is safely possible. Recent neurosurgical technical advances, including innovative surgical approaches, detailed radiotherapy protocols, targeted therapy, replacement of lost hormonal functions and quality of life all have the potential to improve the outcome of patients with craniopharyngioma. In this article, we present extensive literature on craniopharyngioma clinical presentation, radiological findings, management, and future prospective. The present article helps to identify further research areas that set the basis for the management of such a complex tumor.
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  • 文章类型: Journal Article
    UNASSIGNED: Patients with empty nose syndrome usually suffer from paradoxical nasal congestion, nasal dryness, epistaxis and suffocation. Conservative management is general option for the empty nose syndrome. However, there are several patients who continually complain of symptoms. If symptoms persist, surgical options are considered. Therefore, we reviewed surgical and regenerative treatment options of empty nose syndrome.
    UNASSIGNED: PubMed, Embase, Scopus, Cochrane Register of Controlled Trials, and Google Scholar were searched from the earliest date provided in the database until December 2022. In the studies, treatment outcomes were measured by patient symptom scores such as Sino-Nasal Outcome Test (SNOT-20, 22, and 25), and Empty Nose Syndrome 6-Item Questionnaire (ENS6Q) along with various clinical examiniations.
    UNASSIGNED: Twenty-eight studies were analyzed. Submucosal injectable materials, allografts/xenografts/cadaveric implants, autologous implants, and synthetic implants were used. Among them, polyethylene implant was most commonly used (23.3%), followed by autologous, homologous, or cadaveric costal cartilage (20%). The most common administration site was the anterior-inferior lateral nasal wall. Most of the studies showed that surgical intervention brought significant improvements in clinical findings including endoscopic exam, acoustic rhinometry, and CT, as well as patients reporting nasal symptom-, psychological-, or overall health-related quality of life questionnaires. However, several studies did not confirm improvement effects in some psychological-related questionnaires or saccharin transit time. The average follow-up duration was 12.0 (2.0-27.6) months. Postoperative adverse effects were reported in only two studies.
    UNASSIGNED: Several surgical options and recent tissue regeneration techniques have shown its positive efficacy in treating empty nose syndrome. However more detailed investigations with a larger number and a randomized control study are needed to establish a standardized protocol in treating empty nose syndrome patients.
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  • 文章类型: Journal Article
    Cancer immunology offers a new alternative to traditional cancer treatments, such as radiotherapy and chemotherapy. One notable alternative is the development of personalized vaccines based on cancer neoantigens. Moreover, Transformers are considered a revolutionary development in artificial intelligence with a significant impact on natural language processing (NLP) tasks and have been utilized in proteomics studies in recent years. In this context, we conducted a systematic literature review to investigate how Transformers are applied in each stage of the neoantigen detection process. Additionally, we mapped current pipelines and examined the results of clinical trials involving cancer vaccines.
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  • 文章类型: Journal Article
    Insulin, as the only hypoglycemic hormone in the body, plays a key role in blood sugar control. However, excessive insulin intake can lead to insulin poisoning and even death, which often occurs in clinical and forensic work. At present, some researches on insulin poisoning have been carried out at home and abroad, however, it seems that the mechanism and forensic characteristics of insulin poisoning are not clear and complete. Therefore, in this paper, we reviewed the potential mechanism of insulin poisoning, the methods of insulin detection and the forensic identification of poisoning cases, aiming at providing services for the forensic identification of insulin poisoning.
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  • 文章类型: Journal Article
    跨性别认同通常与性别不安和少数民族压力有关。性别确认激素治疗(GAHT)包括男性化或女性化治疗,预计在大多数情况下是终身的。性激素和性激素对顺性人群的新陈代谢和心血管疾病有不同的影响,性激素替代在性腺机能减退中与更高的血管风险相关,尤其是老年人。使用叙事审查方法,我们提供了有关GAHT期间代谢和心血管结局的证据,并就GAHT期间代谢和心血管危险标志物的随访和监测提出了建议.现有数据显示,跨性别队列中2型糖尿病的风险没有增加,但是男性化GAHT会增加瘦体重,女性化GAHT与更高的脂肪质量和胰岛素抵抗有关。心血管疾病的风险在跨性别人群中增加,尤其是在女性化GAHT期间。男性化GAHT与更不利的血脂有关,更高的血细胞比容和增加的血压,而女性化的GAHT与促凝改变和降低HDL-胆固醇有关。出生时分配的男性性别,开始GAHT的年龄较高和使用醋酸环丙孕酮是不良CVD标志物的独立危险因素.在性别确认治疗期间,由于少数族裔压力的减少,代谢和心血管疾病的结果可能会有所改善。改善的生活方式和更密切的监测导致优化的预防药物(例如他汀类药物)。GAHT应根据个人风险因素(即药物,剂量和给药形式);此外,医生需要讨论生活方式和预防药物,以改变GAHT期间的代谢和CVD风险.后续计划必须针对通常的心血管风险指标,但应考虑生物学年龄和性别可能会影响个人风险特征,包括心理健康。GAHT期间的生活方式和新的心血管风险标志物。
    Transgender identity is often associated with gender dysphoria and minority stress. Gender-affirming hormone treatment (GAHT) includes masculinising or feminising treatment and is expected to be lifelong in most cases. Sex and sex hormones have a differential effect on metabolism and CVD in cisgender people, and sex hormone replacement in hypogonadism is associated with higher vascular risk, especially in ageing individuals. Using narrative review methods, we present evidence regarding metabolic and cardiovascular outcomes during GAHT and propose recommendations for follow-up and monitoring of metabolic and cardiovascular risk markers during GAHT. Available data show no increased risk for type 2 diabetes in transgender cohorts, but masculinising GAHT increases lean body mass and feminising GAHT is associated with higher fat mass and insulin resistance. The risk of CVD is increased in transgender cohorts, especially during feminising GAHT. Masculinising GAHT is associated with a more adverse lipid profile, higher haematocrit and increased BP, while feminising GAHT is associated with pro-coagulant changes and lower HDL-cholesterol. Assigned male sex at birth, higher age at initiation of GAHT and use of cyproterone acetate are separate risk factors for adverse CVD markers. Metabolic and CVD outcomes may improve during gender-affirming care due to a reduction in minority stress, improved lifestyle and closer surveillance leading to optimised preventive medication (e.g. statins). GAHT should be individualised according to individual risk factors (i.e. drug, dose and form of administration); furthermore, doctors need to discuss lifestyle and preventive medications in order to modify metabolic and CVD risk during GAHT. Follow-up programmes must address the usual cardiovascular risk markers but should consider that biological age and sex may influence individual risk profiling including mental health, lifestyle and novel cardiovascular risk markers during GAHT.
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  • 文章类型: Journal Article
    医院的血糖管理欠佳与不良的临床结果和医疗保健系统的财务成本增加有关。尽管有住院患者血糖管理指南,由于临床工作人员工作量的增加和糖尿病患病率的上升,实施仍然具有挑战性.仍然需要开发支持临床工作流程并解决有效和安全的住院糖尿病护理交付的未满足需求的新颖和创新技术。有强有力的证据表明,使用糖尿病技术,如连续血糖监测和闭环胰岛素输送可以改善门诊环境中的血糖管理;然而,对其在住院糖尿病管理中的潜在益处和应用知之甚少.来自临床研究的新数据表明,糖尿病技术,如综合临床决策支持系统,可以潜在地调解更安全、更有效的住院糖尿病护理。而连续葡萄糖传感器和闭环系统在改善住院患者血糖管理方面显示出早期的希望。这篇综述旨在概述目前在非重症监护成人住院患者中使用糖尿病技术的相关证据。我们强调可能阻碍或延迟实施的现有障碍,以及促进未来住院糖尿病技术临床准备的策略和机会。
    Suboptimal glycaemic management in hospitals has been associated with adverse clinical outcomes and increased financial costs to healthcare systems. Despite the availability of guidelines for inpatient glycaemic management, implementation remains challenging because of the increasing workload of clinical staff and rising prevalence of diabetes. The development of novel and innovative technologies that support the clinical workflow and address the unmet need for effective and safe inpatient diabetes care delivery is still needed. There is robust evidence that the use of diabetes technology such as continuous glucose monitoring and closed-loop insulin delivery can improve glycaemic management in outpatient settings; however, relatively little is known of its potential benefits and application in inpatient diabetes management. Emerging data from clinical studies show that diabetes technologies such as integrated clinical decision support systems can potentially mediate safer and more efficient inpatient diabetes care, while continuous glucose sensors and closed-loop systems show early promise in improving inpatient glycaemic management. This review aims to provide an overview of current evidence related to diabetes technology use in non-critical care adult inpatient settings. We highlight existing barriers that may hinder or delay implementation, as well as strategies and opportunities to facilitate the clinical readiness of inpatient diabetes technology in the future.
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  • 文章类型: Journal Article
    肥胖患者的最佳治疗和护理组织是当今卫生服务面临的最大挑战之一。虽然手术和药物治疗为一些肥胖患者提供了有效的治疗选择,行为干预对于支持长期行为改变很重要。然而,对行为干预最有效的组成部分知之甚少,对于患有复杂或严重肥胖症(即体重指数[BMI]>35kg/m2)的人尤其如此。因此,当前的快速综述旨在确定哪些行为改变技术(BCT)对(重度)肥胖成人的减重有效.次要目的是回顾BCT对饮食行为和身体活动的影响,和心理结果,认识到行为干预通常针对这些。搜索Scopus,OvidMedline,和WebofScience得出了1227个结果,有22条评论符合纳入条件。最常报告的BCT是自我监测和目标设定,但是这些对肥胖成年人的体重有不同的影响。将这些BCT与其他自我调节技术相结合导致体重减轻增加。Further,对于患有严重肥胖的成年人,所谓的“轻推”技术和自我调节技术与更大的体重减轻有关。三篇评论还发现,虽然自我监测增加了身体活动,行为承诺增加了饮食行为的变化。BCT与心理健康无关。审查证实,行为干预对体重管理有影响,包括更复杂或更严重的肥胖个体,但强调需要进一步研究它们在临床环境中的使用。
    The optimal treatment and organization of care for people with obesity is one of the greatest challenges facing today\'s health services. While surgery and pharmacotherapy offer effective treatment options for some people with obesity, behavioral interventions are important to support long-term behavioral change. However, little is known about the most effective components of behavioral interventions, and this is especially the case for people with complex or severe obesity (i.e. body mass index [BMI] > 35 kg/m2). Accordingly, the current rapid review aimed to identify which behavior change techniques (BCTs) are effective for weight loss in adults with (severe) obesity. A secondary aim was to review the effects of BCTs on dietary behaviors and physical activity, and psychological outcomes, recognizing that behavioral interventions commonly target these. A search of Scopus, Ovid Medline, and Web of Science resulted in 1227 results, with 22 reviews eligible for inclusion. The most commonly reported BCTs were self-monitoring and goal setting, but these had variable effects on weight in adults with obesity. Combining these BCTs with other self-regulatory techniques led to increased weight loss. Further, for adults with severe obesity, so-called \'nudge\' techniques and self-regulatory techniques were associated with greater weight loss. Three reviews also found that while self-monitoring increased physical activity, behavioral commitments increased changes to dietary behaviors. BCTs were not associated with psychological well-being. The review confirms that behavioral interventions have an impact in weight management, including for individuals with more complex or severe obesity, but highlights the need for further investigation of their use within clinical settings.
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  • 文章类型: Journal Article
    2型糖尿病发病率的增加,占全球糖尿病病例的90%,是一个重大的公共卫生问题。改善血糖管理可降低血管并发症和死亡率的风险;只有一小部分2型糖尿病人群的血糖水平在推荐的治疗目标范围内.近年来,糖尿病技术彻底改变了1型糖尿病患者的护理,越来越明显的是,2型糖尿病患者也可以从这些进步中受益。在这次审查中,我们描述了有关技术对2型糖尿病患者的作用的现有知识以及支持其在临床实践中使用的证据.我们得出结论,连续血糖监测系统为2型糖尿病患者提供血糖益处,无论是胰岛素治疗还是非胰岛素治疗;需要进一步的数据来评估这些系统在糖尿病前期患者中的作用(定义为糖耐量受损和/或空腹血糖受损和/或HbA1c水平在39mmol/mol[5.7%]和47mmol/mol[6.4%]之间).在2型糖尿病患者中使用胰岛素泵似乎是安全有效的,尤其是HbA1c明显高于目标的人群。探索闭环系统在2型糖尿病中的影响的研究的初步结果是有希望的。我们讨论了未来研究的方向,以充分了解将循证技术整合到2型糖尿病和糖尿病前期患者护理中的潜在益处。
    The increasing incidence of type 2 diabetes, which represents 90% of diabetes cases globally, is a major public health concern. Improved glucose management reduces the risk of vascular complications and mortality; however, only a small proportion of the type 2 diabetes population have blood glucose levels within the recommended treatment targets. In recent years, diabetes technologies have revolutionised the care of people with type 1 diabetes, and it is becoming increasingly evident that people with type 2 diabetes can also benefit from these advances. In this review, we describe the current knowledge regarding the role of technologies for people living with type 2 diabetes and the evidence supporting their use in clinical practice. We conclude that continuous glucose monitoring systems deliver glycaemic benefits for individuals with type 2 diabetes, whether treated with insulin or non-insulin therapy; further data are required to evaluate the role of these systems in those with prediabetes (defined as impaired glucose tolerance and/or impaired fasting glucose and/or HbA1c levels between 39 mmol/mol [5.7%] and 47 mmol/mol [6.4%]). The use of insulin pumps seems to be safe and effective in people with type 2 diabetes, especially in those with an HbA1c significantly above target. Initial results from studies exploring the impact of closed-loop systems in type 2 diabetes are promising. We discuss directions for future research to fully understand the potential benefits of integrating evidence-based technology into care for people living with type 2 diabetes and prediabetes.
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  • 文章类型: Journal Article
    目的:这篇综述确定并研究了以人为中心的痴呆护理的理论方法(组成部分和目标),以便更好地理解以人为中心的痴呆护理的概念的含义。
    方法:遵循Whittemore和Knafl的方法,进行了综合文献综述,以回答以下问题:(1)已经发表了哪些以人为中心的痴呆症护理理论方法?(2)由此确定的以人为中心的痴呆症护理理论方法的组成部分是什么,可以确定哪些目标?
    方法:MEDLINE(通过PubMed),搜索了CINAHL(通过EBSCO)和PsycINFO(通过EBSCO),直到2021年4月26日。
    方法:我们包括了任何类型的公开文献,这些文献描述了以人为中心的痴呆治疗的理论方法,并且是用德语或英语撰写的。
    方法:两个独立的审阅者提取数据。使用JoannaBriggs研究所开发的数据提取表汇总数据。进行了定性内容分析。
    结果:分析揭示了以人为中心的痴呆症护理方法中的不同观点。与组成部分和目标有关的陈述可以分配给三个不同的子类别(微观,宏观层面和应用层面)。这项分析使人们能够更好地理解当前如何描述以人为本的痴呆症护理,以及理论方法在其取向以及对个人和/或社会性的关注方面是否以及如何不同。它允许关于人格的基本概念的结论。
    结论:未来的研究面临着明显的挑战,要克服对个人的关注,并考虑社会性方面至少同等重要。为了将痴呆症理解为多方面的现象,需要对如何在这种情况下理解人格的理论概念进行区别对待。
    OBJECTIVE: This review identifies and examines theoretical approaches (components and objectives) to person-centred dementia care in order to obtain a better understanding of what is meant by the concept of person-centred dementia care.
    METHODS: Following the approach of Whittemore and Knafl, an integrative literature review was conducted to answer the following questions: (1) Which theoretical approaches to person-centred dementia care have been published? (2) What are the components of the theoretical approaches to person-centred dementia care thus identified, and which objectives can be identified?
    METHODS: MEDLINE (via PubMed), CINAHL (via EBSCO) and PsycINFO (via EBSCO) were searched through to 26 April 2021.
    METHODS: We included any kind of published literature that describes theoretical approaches to person-centred dementia care and that was written in German or English.
    METHODS: Two independent reviewers extracted data. Data were pooled using a data extraction form developed by the Joanna Briggs Institute. A qualitative content analysis was conducted.
    RESULTS: The analysis revealed heterogeneous perspectives within the identified approaches to person-centred dementia care. Statements pertaining to the components and objectives could be assigned to three different subcategories (microlevel, macrolevel and application level). This analysis enabled an enhanced understanding of how person-centred dementia care is currently described and whether and how the theoretical approaches differ in terms of their orientations and their focus on the individual and/or on sociality, which allows conclusions regarding the underlying conceptual idea of personhood.
    CONCLUSIONS: There is a clear challenge for future research to overcome the dominance of the focus on the individual and to consider aspects of sociality to be at least equally important. This is needed in order to understand dementia as a multifaceted phenomenon that demands a differentiated consideration of theoretical notions of how to understand personhood in this context.
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