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Demystification – a solution for assessment of real-world effective-ness? 去神秘化——一个评估真实世界有效性的解决方案?
Pub Date : 2020-01-01 DOI: 10.15761/TIM.1000231
F. Porzsolt, Christel Weiss, M. Weiss, K. Jauch, R. Kaplan
Nearly 100 years ago Archie Cochrane and Austin Bradford Hill proposed a three-dimensional assessment for evaluating clinical interventions: Can it Work? Does it work? Is it Worth it? [2, S1]. Table 1 proposes a strategy to answer these questions by description of three outcome dimensions that are assessed under two different conditions from three different perspectives. The strategy requires a different architecture of studies (form and function) and different tools.
近100年前,阿奇·科克伦和奥斯汀·布拉德福德·希尔提出了一种评估临床干预措施的三维评估方法:它能起作用吗?它有用吗?值得吗?(2, S1)。表1提出了一种策略,通过描述从三个不同角度在两种不同条件下评估的三个结果维度来回答这些问题。该策略需要不同的研究架构(形式和功能)和不同的工具。
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引用次数: 1
The Dutch national ERCP quality registration using self-assessment does not correlate with clinical ERCP outcome 使用自我评估的荷兰国家ERCP质量注册与临床ERCP结果不相关
Pub Date : 2020-01-01 DOI: 10.15761/TIM.1000239
L. Gilissen, S. Meijer, H. Flink, P. Friederich, Jos Ramaker, E. Schoon, A. Stronkhorst
Background: Quality measurement of endoscopic procedures is an actual and important subject. In the Netherlands endoscopists are obligated to register their Endoscopic Retrograde Cholangiopancreatography (ERCP) performances in a National ERCP quality registration (NEQR). NEQR is a self-assessment that evaluates ERCP quality and volume per centre and endoscopist, but complications and outcome of the procedure are both not registered in NEQR. The aim of this study is to examine whether NEQR correlates with objective post-ERCP clinical outcome in a tertiary referral centre. Material and methods: A retrospective cohort study of all ERCPs performed at a tertiary referral centre in 2016. Correlations between NEQR self-assessments and post-ERCP complications and mortality were measured. Results: 333 procedures were performed, of which 254 were registered in the NEQR (76.3%). No significant correlations were found between the subjective self- assessment and objective post-ERCP outcomes. Of all 333 procedures the total post-ERCP complication rate was 13.5% and the ERCP-related 30-day mortality rate was 0.6%. Conclusions: The currently used NEQR does not correlate with post-procedural clinical outcomes. Clinical outcome measures in a 30-day post-ERCP period, including complications, should be implemented to improve the usefulness of this specific quality registration.
背景:内镜手术质量测量是一个现实而重要的课题。在荷兰,内窥镜医生有义务在国家内窥镜逆行胆管造影(ERCP)质量注册(NEQR)中注册他们的内窥镜逆行胆管造影(ERCP)表现。NEQR是一种自我评估,评估ERCP质量和每个中心和内窥镜医师的体积,但并发症和手术结果都没有在NEQR中登记。本研究的目的是检查NEQR是否与三级转诊中心ercp后的客观临床结果相关。材料和方法:2016年在三级转诊中心进行的所有ercp回顾性队列研究。测量NEQR自我评估与ercp术后并发症和死亡率的相关性。结果:共完成333例手术,其中254例在NEQR中登记,占76.3%。主观自我评价与ercp后客观结果之间无显著相关性。在所有333例手术中,ercp术后并发症发生率为13.5%,ercp相关30天死亡率为0.6%。结论:目前使用的NEQR与术后临床结果无关。应实施ercp后30天的临床结果测量,包括并发症,以提高该特定质量注册的有效性。
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引用次数: 0
Suspected veterinary poisoning cases: A retrospective toxicoepidemiology study (2009-2019) in south-eastern Italy 疑似兽医中毒病例:意大利东南部回顾性毒物流行病学研究(2009-2019
Pub Date : 2020-01-01 DOI: 10.15761/TIM.1000254
D. Chirizzi
The Istituto Zooprofilattico Sperimentale of Puglia and Basilicata (IZSPB) processed toxicoepidemiological data on suspected veterinary intentional poisoning cases (small, farm and wild animals) in South-Eastern Italy. Suspected poisoned animals (SPAs) and supposed poisoning baits (SPBs) were collected between 2009 and 2019 by public health authorities, veterinary practitioners and owners and were analyzed for the presence of rodenticide (non-anticoagulant rodenticides and coumarin derivatives), molluschicide, herbicides, pesticide and other molecules (ethylene glycol and metals). Among SPAs analyzed, small animals were prominent (76.2%). In totally, 23.7% animals (408/1719) and 47.3% baits (224/474) were found positive. Small animals were positive in 26.0% of cases (341/1310) and the molecule more involved was metaldehyde, a molluschicide. Only 11.4% (16/123) farm animals were found positive prevalently for rodenticide and pesticide. Though wild ones 18.5% (53/286) were positive mainly for pesticide. In South-Eastern Italy, there are still limited, and fragmented data published on the topic, although this type of information is crucial in an attempt to reduce this illegal practice. rodenticides molluschicide, pesticide.
普利亚和巴西利卡塔实验动物研究所(IZSPB)处理了意大利东南部疑似兽医故意中毒病例(小动物、农场动物和野生动物)的毒物流行病学数据。2009年至2019年期间,公共卫生当局、兽医从业人员和业主收集了疑似中毒动物(spa)和疑似中毒诱饵(SPBs),并分析了杀鼠剂(非抗凝血杀鼠剂和香豆素衍生物)、杀螺剂、除草剂、农药和其他分子(乙二醇和金属)的存在。以小动物为主(76.2%)。共有23.7%的动物(408/1719)和47.3%的饵料(224/474)呈阳性。小动物在26.0%的病例(341/1310)中呈阳性,更相关的分子是一种杀软体剂——三聚乙醛。杀鼠剂和农药阳性率仅为11.4%(16/123)。18.5%(53/286)野生毒株主要为农药阳性。在意大利东南部,关于这一主题发表的数据仍然有限,而且支离破碎,尽管这类信息对于减少这种非法做法至关重要。杀鼠剂、杀软体剂、杀虫剂。
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引用次数: 1
The gargantuan benevolence - osteoclastoma 巨仁——破骨细胞瘤
Pub Date : 2020-01-01 DOI: 10.15761/TIM.1000242
Anu Bajaj
Osteoclastoma is an infrequent, benign, primary bone neoplasm initially scripted by Jaffe in 1940 [1]. Osteoclastoma is an osteolytic, locally aggressive tumefaction incriminating young adults with skeletal maturity and is accompanied by an unpredictable biological course. Osteoclastoma is constituted by mononuclear, spheroid to spindle-shaped cells intermingled with numerous, evenly distributed, osteoclastlike, multinucleated giant cells [1,2].
破骨细胞瘤是一种罕见的、良性的原发性骨肿瘤,Jaffe于1940年首次提出[1]。破骨细胞瘤是一种溶骨性、局部侵袭性肿物,多发于骨骼成熟的年轻人,并伴有不可预测的生物学过程。破骨细胞瘤是由单核、球形至梭形细胞与众多分布均匀的破骨细胞样多核巨细胞混杂而成[1,2]。
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引用次数: 0
Addressing the patient experience in myocardial perfusion scintigraphy 探讨患者在心肌灌注显像中的经验
Pub Date : 2019-02-01 DOI: 10.15761/TIM.1000175
A. Grilo, L. Vieira, E. Carolino, J. Ferreira, M. Neves
Background: Myocardial Perfusion Scintigraphy is a medical exam whose purpose is to evaluate myocardial perfusion. This examination due to their procedures can generate some anxiety in patients that can disturb the good performance of the exam. The main objective of this study is to perform an analysis of patient`s undergoing myocardial perfusion scintigraphy experience, assess patient`s anxiety and check Nuclear Medicine Department communication and information effectiveness. Material and methods: For this study, State-Trait Anxiety Inventory (STAI) and two Scan Experience Questionnaires were used. Sixty patients answered the questionnaires before and after myocardial perfusion scintigraphy. Results: Patients reported medium levels of scan-related anxiety before the myocardial perfusion scintigraphy. After the scan, there is a slight decrease in patients` anxiety. Results of the scan, radiation used, duration of the scan and the injection of the radiopharmaceutical are the most relevant patients` concerns before the scan. 15% of the sample did not receive the necessary information or the most effective way. Conclusions: The results suggest that there are several factors that tend to trigger patient`s experience and anxiety. Strategies to improve patient myocardial perfusion scintigraphy experience at Nuclear Medicine Department are presented. *Correspondence to: Ana M Grilo, ESTeSL-Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa. Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096 Lisboa, Portugal, E-mail: ana.grilo@estesl.ipl.pt
背景:心肌灌注显像是一种医学检查,其目的是评估心肌灌注。这种检查由于其程序可能会使患者产生一些焦虑,从而影响检查的良好效果。本研究的主要目的是分析患者接受心肌灌注显像的体验,评估患者的焦虑程度,检查核医学科沟通和信息的有效性。材料与方法:本研究采用状态-特质焦虑量表(STAI)和两份扫描体验问卷。60例患者在心肌灌注显像前后分别回答问卷。结果:患者在心肌灌注显像前报告了中等水平的扫描相关焦虑。扫描后,患者的焦虑感略有下降。扫描结果、使用的辐射、扫描时间和放射性药物的注射是患者在扫描前最关心的问题。15%的样本没有收到必要的信息或最有效的方式。结论:结果表明,有几个因素容易引发患者的体验和焦虑。提出提高核医学科患者心肌灌注显像体验的策略。通信给:Ana M Grilo, estel - escola高等技术学院Saúde,里斯本政治学院。Av. D. jo II, lote 4.69.01, Parque das Nações, 1990-096,葡萄牙里斯本,E-mail: ana.grilo@estesl.ipl.pt
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引用次数: 0
Effects of sofosbuvir-based therapy on the metabolic status of patients with chronic hepatitis C infection 基于索非布韦的治疗对慢性丙型肝炎感染患者代谢状态的影响
Pub Date : 2019-01-01 DOI: 10.15761/tim.1000212
Ahmad Hezarjaribi, M. Ranjbar, Sayed Moayed Alavian, Sohrab Aghabeigi
Background: In patients with hepatitis, it is important to identify drug-induced metabolic effects to improve diagnosis and treatment. Therefore, in this study, we aimed to determine the effects of sofosbuvir-based therapy on the metabolic status of patients with chronic hepatitis C virus (HCV) infection. Materials and Methods: In this observational before-after study, a total of 128 consecutive patients with chronic HCV infection, presenting to the Middle East Liver Disease Center (MELD) in Tehran, Iran, were enrolled. Metabolic indices, including triglyceride, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and fasting blood sugar (FBS), were determined before and after sofosbuvir-based therapy. Results: The mean FBS level was 108.3±33.8 and 106.2±36.4 mg/dL before and after treatment, respectively (P>0.05). Also, the mean triglyceride level was 101.8±46.4 and 110.5±54.8 mg/dL before and after treatment, respectively (P=0.03). The findings showed that the mean total cholesterol level was 150.9±34.9 and 168.0±40 mg/dL before and after treatment, respectively (P=0.001). Also, the mean LDL-cholesterol level was 82.4±27.5 and 95.8±31.6 mg/dL before and after treatment (P=0.001), and the mean HDL-cholesterol was 44.1±13.1 and 46.9±13.4 mg/dL before and after treatment, respectively (P=0.01). Conclusion: According to the results, it can be concluded that sofosbuvir-based therapy has effects on some metabolic parameters (lipid profile and blood glucose) of chronic HCV patients. Therefore, development of preventive strategies to reduce the burden of this disease seems necessary.
背景:在肝炎患者中,确定药物引起的代谢影响对提高诊断和治疗具有重要意义。因此,在本研究中,我们旨在确定以索非布韦为基础的治疗对慢性丙型肝炎病毒(HCV)感染患者代谢状态的影响。材料和方法:在这项观察性的前后对照研究中,共有128名连续的慢性HCV感染患者被纳入伊朗德黑兰中东肝病中心(MELD)。代谢指标,包括甘油三酯、总胆固醇、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)和空腹血糖(FBS),在索非布韦治疗前后进行测定。结果:治疗前后平均FBS水平分别为108.3±33.8、106.2±36.4 mg/dL (P>0.05)。治疗前后甘油三酯水平分别为101.8±46.4和110.5±54.8 mg/dL (P=0.03)。结果显示,治疗前后患者总胆固醇水平分别为150.9±34.9和168.0±40 mg/dL (P=0.001)。治疗前后ldl -胆固醇均值分别为82.4±27.5、95.8±31.6 mg/dL (P=0.001), hdl -胆固醇均值分别为44.1±13.1、46.9±13.4 mg/dL (P=0.01)。结论:基于索非布韦的治疗对慢性HCV患者的一些代谢参数(血脂和血糖)有影响。因此,制定预防战略以减轻这种疾病的负担似乎是必要的。
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引用次数: 0
Anal intercourse and idiopathic infertility: Anatomical considerations and authors’ perspective 肛交和特发性不孕症:解剖学上的考虑和作者的观点
Pub Date : 2019-01-01 DOI: 10.15761/TIM.1000170
Abdelmonem Awad Hegazy, M. Hegazy
Identification of causes of infertility could improve the chances for the management. The unexplained or idiopathic causes represent up to 30% for the infertility cases. One of such causes might be the unprotected anal intercourse due to the high possibility of lacerations and injuries occurring through the thin mucosa of anal canal. Escape of sperms into the injured female tissues might encourage her body to develop antibodies against the seminal content of male partner and causing infertility. Future studies are recommended to clarify such possibility as well as to develop a new contraceptive method depending on the immunity. *Correspondence to: Abdelmonem Awad Hegazy, Professor and Former Chairman of Anatomy and Embryology Department, Consultant of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Egypt, E-mail: dr.abdelmonemhegazy@yahoo.com
确定不孕症的原因可以提高治疗的机会。不明原因或特发性原因占不孕症病例的30%。其中一个原因可能是无保护的肛交,因为很可能通过肛管薄粘膜发生撕裂和损伤。精子逃逸到受伤的女性组织中可能会促使她的身体产生抗体来对抗男性伴侣的精液,从而导致不孕。建议今后进行研究,以澄清这种可能性,并根据免疫力开发一种新的避孕方法。*通讯:Abdelmonem Awad Hegazy,埃及扎加齐格大学医学院解剖学和胚胎学系教授和前主席,妇产科顾问,E-mail: dr.abdelmonemhegazy@yahoo.com
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引用次数: 3
The effect of diameter and length on the success rate of dental implant: Prospective clinical study 种植体直径和长度对种植成功率影响的前瞻性临床研究
Pub Date : 2019-01-01 DOI: 10.15761/tim.1000194
Liqaa S Farhan
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引用次数: 0
The flexible fasting technology can improve hypertension: A pilot study in self-controlled designs 灵活的禁食技术可以改善高血压:一项自我控制设计的试点研究
Pub Date : 2019-01-01 DOI: 10.15761/tim.1000204
Qing-li Ren, W. Gong, Rongjie Huang, Lifeng Liang, Kexiang Chen, D. Gao, Zhihui Li, Yan Gao, Heliang Liu, Changsheng Chen, Jian-ping Huang, Cheng-gang Zhang
Objective: This study aimed to evaluate the value of the flexible fasting (FF) technology in helping hypertension improvement in patients with essential hypertension and obesity. Method: We recruited and ultimately selected 86 volunteers with essential hypertension and obesity in this study as a quasi experiment. The volunteers went through three phases, namely, the baseline anti-hypertensive therapy stage (Phase-1), the FF intervention stage (Phase-2), the normal diet recovery stage (Phase-3), each for seven days. During the Phase-2, all subjects fasted and began to substitute the FF food for conventional food. Patients' systolic/diastolic blood pressure (abbreviated as SBP/DBP), body mass index (BMI) and body weight were monitored in details each day. The trial data of all subjects were statistically analyzed using self-controlled designs. Result: After the FF intervention, the subjects' blood pressure, body mass and BMI all showed naturally decreases by comparison to that before the intervention. The remarkable decreases in SBP/DBP, Body Mass and BMI were observed in Phase-3 after FF intervention when compared to Phase-1 [SBP: (115.2±8.492) vs (121.2±13.72) mmHg, q=34.14, P<0.001]; [DBP: (76.03±5.37) vs (78.36±7.094) mmHg, q=10.96, P<0.05)]; [Body Mass: (68.86±13.04) vs (73.11±13.49)kg, q=61.56, P<0.0001]; [BMI: (25.42±3.359) vs (27.03±3.45) kg/m2, q=100, P<0.0001]. All patients did not experience any discomfort or symptoms during the trial. Conclusion: The FF technology is an effective approach to improve hypertension. *Correspondence to: Chenggang Zhang, Professor, PhD., Institute of Radiation Medicine, Academy of Military Medical Sciences, Academy of Military Sciences, Research Center for the Military Cognitive and Mental Health of PLA, Beijing 100850, China, Tel: +86 10 66931590; E-mail: zcgweb@126.com Jiangnan Huang, PhD., The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China, Tel: +86 771 5356566; E-mail: huangjn1998@163.com Changsheng Chen, PhD., Department of Health Statistics, School of Military Preventive Medicine, The Fourth Military Medical University, Xi’an 710032, China, Tel: +86 29 84774853; E-mail: chencs@fmmu.edu.cn
目的:探讨柔性禁食(FF)技术在原发性高血压合并肥胖患者高血压改善中的应用价值。方法:我们招募并最终选择了86名原发性高血压和肥胖的志愿者作为准实验。志愿者经历了三个阶段,即基线降压治疗阶段(第一阶段)、FF干预阶段(第二阶段)、正常饮食恢复阶段(第三阶段),每个阶段为期7天。第二阶段,所有受试者禁食,开始以FF食物替代常规食物。每天详细监测患者的收缩压/舒张压(缩写为SBP/DBP)、体重指数(BMI)和体重。所有受试者的试验资料采用自我对照设计进行统计分析。结果:FF干预后,受试者血压、体重、BMI均较干预前自然下降。与第一阶段相比,FF干预后第三阶段收缩压/舒张压、体质量和BMI显著降低[收缩压:(115.2±8.492)vs(121.2±13.72)mmHg, q=34.14, P<0.001];【菲律宾:(76.03±5.37)和(78.36±7.094)毫米汞柱,q = 10.96, P < 0.05);[体重:(68.86±13.04)和(73.11±13.49)公斤,q = 61.56, P < 0.0001);(BMI:(25.42±3.359)和(27.03±3.45)kg / m2, q = 100, P < 0.0001)。所有患者在试验期间均未出现任何不适或症状。结论:FF技术是改善高血压的有效途径。通讯对象:张成刚,教授,博士。1 .军事科学院军事医学科学院辐射医学研究所,中国人民解放军军人认知与心理健康研究中心,北京100850,电话:+86 10 66931590;E-mail: zcgweb@126.com黄江南,博士。1 .广西医科大学第一附属医院,广西南宁530021,电话:+86 771 5356566;E-mail: huangjn1998@163.com陈长生,博士。第四军医大学军事预防医学学院卫生统计教研室,西安710032,电话:+86 29 84774853;电子邮件:chencs@fmmu.edu.cn
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引用次数: 0
Antimicrobial peptides, novel solution for the treatment of precancerous disease acne - A review 抗菌肽,治疗癌前病变痤疮的新方法综述
Pub Date : 2019-01-01 DOI: 10.15761/tim.1000210
Diana M. Gómez, Y. Lone, Luz M. Salazar, J. Trojan.
Acne is one of the most common epithelial diseases affecting approximately 80% of the world's population between the ages of 16 and 35. It is caused by multiple factors such as genetic predisposition and hormonal alteration including growth factor IGF-I, among others. Acne being related to IGF-I expression, is involved in possible apparition of malignant diseases. The pathology of acne is limited to the pilosebaceous unit. The evolution is governed by the increase in colonization of the bacteria Propionibacterium acnes (P. acnes). Acne is clinically manifested by the appearance of comedones with a tendency to inflammation. Finally causes scarring damaging self-esteem and quality of life of those who suffer it. As proposed therapies, external treatments have been developed such as inhibitors of IGF-I among others. As an internal treatment, the innate response of the patient's immune system to the presence of an invading microorganism has been studied, highlighting anti-microbial peptides as the host's own defense molecules. This work shows a compilation of the most relevant and current antimicrobial peptides that could be used as potential therapeutic agents against microorganisms located in the skin and related to acne disease. *Correspondence to: D.M. Gomez, Faculty of Sciences, Dept. Chemistry, Univ. Nacional, Bogotá D.C., Colombia, E-mail: dimgomezmo@unal.edu.co J. Trojan, ICGT, Cll 128 b, Kr 18-11, Bogotá D.C., Colombia, E-mail: genetherapy@hotmail.fr
痤疮是最常见的上皮疾病之一,影响着世界上大约80%的年龄在16到35岁之间的人口。它是由多种因素引起的,如遗传易感性和激素改变,包括生长因子igf - 1等。痤疮与igf - 1表达有关,可能与恶性疾病的发生有关。痤疮的病理限于毛囊皮脂腺单位。这种进化是由细菌痤疮丙酸杆菌(P. acnes)定植的增加所控制的。痤疮在临床上表现为粉刺的出现,并有炎症倾向。最后会造成创伤,损害患者的自尊和生活质量。作为拟议的治疗方法,外部治疗已被开发,如igf - 1抑制剂等。作为一种内部治疗,研究了患者免疫系统对入侵微生物的先天反应,突出了抗微生物肽作为宿主自身防御分子的作用。这项工作显示了最相关的和当前的抗菌肽的汇编,这些抗菌肽可以用作潜在的治疗剂,用于对抗皮肤中与痤疮疾病相关的微生物。*通讯对象:哥伦比亚波哥大国立大学化学系理学院D.M. Gomez, E-mail: dimgomezmo@unal.edu.co哥伦比亚波哥大国立大学ICGT, Cll 128 b, Kr 18-11, J. Trojan, E-mail: genetherapy@hotmail.fr
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引用次数: 7
期刊
Trends in Medicine
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