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Imaging for Laryngeal Malignancies: Guidelines for Clinicians. 喉恶性肿瘤的影像学:临床医生指南。
Pub Date : 2023-12-01 Epub Date: 2023-06-23 DOI: 10.1007/s12070-023-03986-w
S R Priya, Mitali Dandekar, Peter Paul, Chandra Shekhar Dravid, Abhishek Anand, Shekhar Keshri

Radiology has always been an important component in the evaluation of patients with head and neck cancers. Images that are appropriately acquired and systematically interpreted provide comprehensive information on local, regional, and distant disease extent. This impacts treatment decisions for primary or recurrent disease, and aids in prognostication and patient counselling. The recent significant advances in technology and instrumentation for treatment of head neck cancers have taken place in parallel with an increasing sophistication in radiodiagnostic systems. This is especially true for laryngeal neoplasms where there is now greater focus on functional outcomes and personalised treatment, thus expanding the scope and value of imaging.

Purpose: To formulate evidence-based guidelines on imaging for cancers of the larynx, from diagnosis and staging to monitoring of disease control after completion of treatment.

Methods and materials: A multidisciplinary analysis of current guidelines and published studies on the topic was performed.

Results: On the basis of evidence gathered, guidelines were drawn up; optimal suggestions were included for low-resource situations.

Conclusion: These guidelines are intended as an aid to all clinicians dealing with patients of laryngeal cancers. It is hoped that these will be instrumental in facilitating patient care, and in improving outcomes.

放射学一直是头颈癌患者评估的重要组成部分。适当获取和系统解释的图像可提供有关局部、区域和远处疾病程度的全面信息。这影响了原发性或复发性疾病的治疗决定,并有助于预测和患者咨询。最近头颈癌治疗技术和仪器的重大进步与放射诊断系统的日益复杂同时发生。对于喉部肿瘤尤其如此,现在人们更加关注功能结果和个性化治疗,从而扩大了成像的范围和价值。目的:制定基于证据的喉癌影像学诊断、分期及治疗完成后疾病控制监测指南。方法和材料:对当前指南和已发表的关于该主题的研究进行多学科分析。结果:在收集证据的基础上,制定了指南;针对资源不足的情况提出了最佳建议。结论:这些指南旨在帮助所有临床医生处理喉癌患者。希望这些将有助于促进患者护理,并改善结果。
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引用次数: 0
Issue Information 问题信息
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引用次数: 0
IL-22 Protects against Biliary Ischemia-Reperfusion Injury after Liver Transplantation via Activating STAT3 and Reducing Apoptosis and Oxidative Stress Levels In Vitro and In Vivo. IL-22 通过激活 STAT3 和降低体内外细胞凋亡及氧化应激水平保护肝移植后胆道缺血再灌注损伤
Pub Date : 2022-05-10 eCollection Date: 2022-01-01 DOI: 10.1155/2022/9635075
Yi Bai, Hao Wu, Jinrui Zhang, Sai Zhang, Zhixin Zhang, Hao Wang, Yamin Zhang, Zhongyang Shen

Biliary complications are currently one of the leading causes of liver failure and patient death after liver transplantation and need to be solved urgently. Biliary ischemia-reperfusion injury (IRI) is one of the important causes of biliary complications. IL-22 has a protective effect on liver injury and hepatitis diseases, and its safety and efficacy in the treatment of hepatitis have also been proved in human clinical experiments. Furthermore, multiple studies have confirmed that IL-22 promotes the proliferation and repair of epithelial cells in various organs. Still, its function in the bile duct after transplantation has not been explored. This study was aimed at investigating the effects of IL-22 on cholangiocyte IRI in vitro and in vivo and exploring its underlying mechanisms. We simulated the hypoxia process of bile duct epithelial cells through in vitro experiments to investigate the protective function and molecular mechanism of IL-22 on bile duct epithelial cells. Subsequently, the function and mechanism of IL-22 in the biliary IRI model of autologous orthotopic liver transplantation in rats were assessed. This study confirmed that IL-22 could promote cholangiocyte proliferation, decrease the apoptosis rate of cholangiocytes and tissues, decrease MDA levels, and increase SOD levels by activating STAT3. In addition, IL-22 can also reduce the level of mitochondrial membrane depolarization, protect mitochondria, reduce ROS production, and play a role in protecting bile ducts. These findings provide evidence for IL-22 as a novel and effective treatment for biliary IRI after liver transplantation.

胆道并发症是目前导致肝移植术后肝功能衰竭和患者死亡的主要原因之一,亟待解决。胆道缺血再灌注损伤(IRI)是胆道并发症的重要原因之一。IL-22 对肝损伤和肝炎疾病具有保护作用,其治疗肝炎的安全性和有效性也已在人体临床实验中得到证实。此外,多项研究证实,IL-22 能促进不同器官上皮细胞的增殖和修复。然而,其在移植后胆管中的功能尚未被探索。本研究旨在研究 IL-22 在体外和体内对胆管细胞 IRI 的影响,并探索其潜在机制。我们通过体外实验模拟胆管上皮细胞缺氧过程,研究 IL-22 对胆管上皮细胞的保护功能和分子机制。随后,评估了 IL-22 在自体肝移植大鼠胆道 IRI 模型中的功能和机制。该研究证实,IL-22 可通过激活 STAT3 促进胆管细胞增殖,降低胆管细胞和组织的凋亡率,降低 MDA 水平,提高 SOD 水平。此外,IL-22 还能降低线粒体膜去极化水平,保护线粒体,减少 ROS 的产生,起到保护胆管的作用。这些研究结果为IL-22作为肝移植后胆道IRI的一种新型有效治疗方法提供了证据。
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引用次数: 6
Chapter 1: Medication Reconciliation 第一章:药物和解
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引用次数: 3
Chapter 8: Prioritising Clinical Pharmacy Services 第八章:优先安排临床药学服务
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引用次数: 2
Chapter 9: Staffing Levels and Structure for the Provision of Clinical Pharmacy Services 第九章:提供临床药学服务的人员编制及结构
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引用次数: 2
Chapter 4: Medication Management Plan 第四章:药物管理计划
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引用次数: 1
Overview: Standards of Practice for Clinical Pharmacy Services 概述:临床药学服务的实践标准
G. Taylor, A. Leversha, C. Archer, C. Boland, M. Dooley, P. Fowler, Sharon Gordon-Croal, J. Fitch, S. Marotti, Amy McKenzie, Duncan McKenzie, Natalie Collard, Nicki Burridge, K. O’Leary, C. Randall, A. Roberts, S. Seaton
SHPA Committee of Speciality Practice in Clinical Pharmacy. George Taylor (Chair), Anne Leversha, Christopher Archer, Camille Boland, Michael Dooley, Peter Fowler, Sharon Gordon-Croal, Jay Fitch, Sally Marotti, Amy McKenzie, Duncan McKenzie, Natalie Collard, Nicki Burridge, Karen O’Leary, Cameron Randall, Amber Roberts, Suzette Seaton Corresponding author: George Taylor, Clinical Lecturer, School of Pharmacy, University of Tasmania, Hobart Tas. 7001, Australia. E-mail: G.Taylor@utas.edu.au INTRODUCTION These standards supersede the previously published SHPA Standards of Practice for Clinical Pharmacy and SHPA Standards of Practice for the Provision of Medication Reconciliation. The practice of clinical pharmacy continues to evolve with the changing needs and demands of contemporary health care. These standards are applicable to the delivery of clinical pharmacy services across all care settings: inpatients, outpatients and patients in the community. They describe the activities delivered by pharmacists for patients to minimise the risks associated with the use of medicines and to optimise the use of medicines. Comprehensive and accountable clinical pharmacy services are an essential component of contemporary health care. Ideally, every health service organisation will have resources to provide all clinical pharmacy activities to every patient based on their needs. Australian and overseas practice-based evidence con! rm that the pharmacist activities described in these standards support an individual patient’s medication management plan (MMP) and reduce morbidity, mortality and the cost of care. Clinical pharmacy services for individual patients support the objectives of: • Guiding Principles to Achieve Continuity in Medication Management • National Safety and Quality Health Service Standards • Australian Safety and Quality Goals for Health Care • Hospital Accreditation Workbook • National Strategy for Quality Use of Medicines • Medication Safety Self-Assessment for Australian Hospitals • Antimicrobial Stewardship in Australian Hospitals. In addition, clinical pharmacy services for individual patients enable the objectives of national strategies to improve patient safety and quality of care to be met, such as: • Patient-Centred Care: Improving Quality and Safety through Partnerships with Patients and Consumers • Match Up Medicines: A Guide to Medication Reconciliation • National Inpatient Medication Chart (NIMC), National Aged Care Residential Medication Chart, Paediatric Medication Chart, Private Hospital NIMC and Private Hospital Day Surgery NIMC • National Medication Management Plan • Australian Charter of Healthcare Rights • OSSIE Guide to Clinical Handover Improvement. Other SHPA standards of practice and guidelines in specialty areas should be read in conjunction with these standards including: • Standards of Practice for Medication Safety • Standards of Practice for Drug Use Evaluation in Australian Hospitals • Standards of Practice for the
SHPA临床药学专业实践委员会。George Taylor(主席)、Anne Leversha、Christopher Archer、Camille Boland、Michael Dooley、Peter Fowler、Sharon Gordon-Croal、Jay Fitch、Sally Marotti、Amy McKenzie、Duncan McKenzie、Natalie Collard、Nicki Burridge、Karen O ' Leary、Cameron Randall、Amber Roberts、Suzette Seaton通讯作者:George Taylor,塔斯马尼亚大学药学院临床讲师,澳大利亚霍巴特塔斯7001。这些标准取代了先前发布的SHPA临床药学实践标准和SHPA药物调节提供实践标准。临床药学的实践随着当代卫生保健需求的变化而不断发展。这些标准适用于在所有护理环境中提供临床药学服务:住院病人、门诊病人和社区病人。它们描述了药剂师为患者提供的活动,以尽量减少与药物使用相关的风险并优化药物使用。全面和负责任的临床药学服务是当代卫生保健的重要组成部分。理想情况下,每个卫生服务机构都将拥有资源,根据每个患者的需要为他们提供所有临床药学活动。澳大利亚和海外基于实践的证据欺诈!这些标准中描述的药剂师活动支持单个患者的药物管理计划(MMP),并降低发病率、死亡率和护理成本。为个体患者提供的临床药学服务支持以下目标:实现药物管理连续性的指导原则;国家安全和质量卫生服务标准;澳大利亚卫生保健安全和质量目标;医院认证工作手册;药品质量使用国家战略;澳大利亚医院用药安全自我评估;澳大利亚医院抗菌药物管理。此外,针对个别患者的临床药学服务使改善患者安全和护理质量的国家战略目标得以实现,例如:以患者为中心的护理:通过与患者和消费者的伙伴关系提高质量和安全;药物调解指南·全国住院患者用药图表(NIMC)、全国老年护理住院用药图表、儿科用药图表、私立医院NIMC和私立医院日间手术NIMC·国家药物管理计划·澳大利亚医疗保健权利宪章·OSSIE临床移交改进指南。其他专业领域的SHPA实践标准和指南应与这些标准一起阅读,包括:《药物安全实践标准》《澳大利亚医院药物使用评估实践标准》《提供临床肿瘤学药学服务实践标准》《精神健康药学实践标准》《社区联络药剂师实践标准》《医院和寄宿护理机构自我用药指南》《为治疗癌症提供口服化疗的实践标准》《急诊医学药学实践标准》《医院药剂师提供消费者药品信息的实践标准》《重症监护药学实践标准》《提供姑息治疗药学服务的实践标准》《药学研究药物服务的实践标准》《药品信息服务的实践标准》。提供临床服务的药剂师在实践的各个方面的专业行为应遵循:澳大利亚药房委员会准则和指南;SHPA道德准则;澳大利亚药剂师国家能力标准框架。熟悉药物管理途径以及其他非临床医院药房服务如何支持该途径的每个步骤,有助于理解临床药学服务的背景(图1,2)。
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引用次数: 5
Chapter 3: Clinical Review, Therapeutic Drug Monitoring and Adverse Drug Reaction Management 第三章:临床回顾、治疗药物监测和药物不良反应管理
G. Taylor, A. Leversha, C. Archer, C. Boland, M. Dooley, P. Fowler, Sharon Gordon-Croal, J. Fitch, S. Marotti, Amy McKenzie, Duncan McKenzie, Natalie Collard, Nicki Burridge, K. O’Leary, C. Randall, A. Roberts, S. Seaton
INTRODUCTION Clinical review, therapeutic drug monitoring (TDM) and adverse drug reaction (ADR) management contribute to the quality use of medicines by ensuring safe and appropriate dosage and administration of medicines, improving response to therapy and minimising medicinesrelated problems. Clinical review, TDM and ADR management commence when a patient presents or is admitted to a health service organisation and continue as routine activities throughout the episode of care in conjunction with assessment of current medication management and other clinical pharmacy activities.
临床审查、治疗药物监测(TDM)和药物不良反应(ADR)管理通过确保药物的安全和适当的剂量和给药、提高治疗反应和最大限度地减少药物相关问题,有助于提高药物的使用质量。临床审查、TDM和ADR管理在患者出现或被卫生服务机构收治时开始,并与当前药物管理和其他临床药学活动的评估一起,作为整个护理期间的常规活动继续进行。
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引用次数: 2
Chapter 2: Assessment of Current Medication Management 第二章:药物管理现状评估
INTRODUCTION Assessment of a patient’s current medication management is vital to ensure the quality use of medicines. The assessment aims to optimise the quality use of medicines and therefore patient outcomes, and to minimise medicines-related problems. To assess the patient’s current medication management, the pharmacist confi rms the safety and appropriateness of individual medication orders and the combination of medicines prescribed. This assessment is then documented in the patient’s record or the pharmacy section of the National Inpatient Medication Chart (NIMC) or equivalent. Assessment of a patient’s current medication management should not be done in isolation. It requires a systematic, in-depth assessment of current medicines in consultation with the patient taking into account: • the patient’s medication history • the patient’s medication management plan (MMP) and data from the medication administration record • a clinical review including therapeutic drug monitoring (TDM).
对患者当前用药管理进行评估对于确保药物的使用质量至关重要。评估的目的是优化药物的使用质量,从而优化患者的预后,并尽量减少与药物有关的问题。为了评估患者目前的用药管理情况,药剂师应确认其单药单和联合用药的安全性和适宜性。然后将此评估记录在患者记录或国家住院患者用药表(NIMC)的药房部分或同等内容中。对患者当前用药管理的评估不应孤立进行。它需要与患者协商,对当前药物进行系统、深入的评估,考虑到:•患者的用药史•患者的用药管理计划(MMP)和药物管理记录的数据•包括治疗药物监测(TDM)在内的临床审查。
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引用次数: 1
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Journal of pharmacy practice and research : official journal of the Society of Hospital Pharmacists of Australia
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