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润滑滴眼液对于隐形眼镜的获益和伤害有哪些?

7 months 2 weeks ago
润滑滴眼液对于隐形眼镜的获益和伤害有哪些? 关键信息 ·润滑滴眼液,包括生理盐水,可能有助于减轻成人因佩戴隐形眼镜带来的不适。这些滴眼液似乎不会对眼睛表面造成刺激或损害。 ·使用润滑滴眼液(包括生理盐水)來治疗隐形眼镜不适是一种可行的选择。然而,仍需要更多研究来衡量其效果,并确定哪种滴眼液最适合不同的隐形眼镜类型和佩戴时间。 什么是隐形眼镜不适? 隐形眼镜不适是指在佩戴时眼睛受到刺激,而当佩戴者取下隐形眼镜后,这种不适感会得到缓解。隐形眼镜佩戴者可能会感到眼睛干燥、感觉到异物感、刺激、视力模糊,或这些症状的组合。 如何治疗隐形眼镜不适? 治疗隐形眼镜不适最常见的方法是使用非处方的润滑性滴眼液或生理盐水滴眼液,但眼科医生也可能更换隐形眼镜品牌、隐形眼镜护理方式或调整隐形眼镜的佩戴时间。 我们想要了解什么? 我们想知道润滑滴眼液是否会减少隐形眼镜佩戴者的不适,以及这些滴眼液是否会产生不必要的影响。 我们做了什么? 我们检索了在成人隐形眼镜佩戴者中比较润滑滴眼液与不治疗、润滑滴眼液与生理盐水或生理盐水与不治疗的研究。我们比较和总结了研究结果,并根据研究设计和方法等因素对证据的质量进行了评级。 我们发现了什么? 我们发现了在美国、加拿大、意大利和法国进行的7项研究,包括463名成年人。四项研究比较了不治疗和润滑滴眼液,两项研究比较了润滑滴眼液与生理盐水,一项研究比较了不治疗和生理盐水滴眼...

哪种运动更能减轻癌症引起的疲劳:有氧运动还是阻力训练?

7 months 2 weeks ago
哪种运动更能减轻癌症引起的疲劳:有氧运动还是阻力训练? 关键信息 – 关于心血管和阻力训练对癌症、健康和不良影响引起的疲劳的影响的证据质量极低。只有几项小型研究。 – 我们需要更多的研究来确定一种运动是否比另一种运动更好。这项研究还应纳入不同类型的癌症和癌症治疗。 癌症引起的疲劳是什么? 癌症引起的疲劳是一种持续很长时间的极度疲劳的感觉。它与癌症或癌症治疗有关,或两者兼而有之。它会影响身体和情绪,并使正常活动变得困难。癌症引起的疲劳比一般的疲劳要严重得多,而且它不会因为更多的睡眠或休息而消失。 我们想发现什么? 我们想找出有氧训练和阻力训练在治疗和预防癌症引起的疲劳、幸福感(也称为生活质量)和不良影响方面是否存在差异。心血管训练包括步行、跑步、游泳和骑自行车等运动,而阻力训练包括利用自身体重、重物或弹性治疗带进行运动。 我们做了什么? 我们检索了针对各种类型癌症患者进行心血管训练和阻力训练的比较研究。训练可以在癌症治疗之前、期间或之后开始。 我们对研究结果进行了汇总,并基于研究方法和样本量等因素对证据质量进行分级。 我们发现了什么? 我们发现了6项研究共447名患有乳腺癌、前列腺癌(骨盆中的一种小腺体,属于男性生殖系统的一部分)或肺癌的患者。这些研究并未报告人们在开始锻炼之前是否已经出现由癌症引起的疲劳。参加这些研究中的受试者接受了化疗(杀死癌细胞的药物)、放疗(针对癌细胞的放射...

Cochrane seeks Junior Legal Counsel - UK, remote

7 months 3 weeks ago

Specifications: Permanent – Part time (30 hours a week)
Salary: £38,000 per annum full time equivalent
Location: UK (Remote with occasional travel to the London office)
Closing date:  9 Sep 2024

Cochrane is an international charity. For 30 years we have responded to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesising research findings and our work has been recognised as the international gold standard for high quality, trusted information.

Cochrane's strength is in its collaborative, global community. We have 110,000+ members and supporters around the world. Though we are spread out across the globe, our shared passion for health evidence unites us. Our Central Executive Team supports this work and is divided into five directorates: Evidence Production and Methods, Publishing and Technology, Development, Chief Executive Office and Finance and Corporate Services.

This role will sit within the Legal Team in Cochrane’s Finance & Corporate Services Directorate, which also includes the Finance and HR teams.

The Junior Legal Counsel will be required to support the Legal Counsel in providing legal advice to colleagues across the organisation, to enable Cochrane to manage risk and meet its legal and regulatory obligations. In addition to experience in contract law, the successful candidate will have excellent communication and organisational skills, a self-motivated and proactive approach to their work, and an enthusiasm for developing their knowledge and skills.

Don’t have every single qualification? We know that some people are less likely to apply for a job unless they are a perfect match. At Cochrane, we’re not looking for “perfect matches.” We’re looking to welcome people to our diverse, inclusive, and passionate workplace. So, if you’re excited about this role but don’t have every single qualification, we encourage you to apply anyway. Whether it’s this role or another one, you may be just the right candidate.

Our organization is built on four core values:

Collaboration: Underpins everything we do, locally and globally.
Relevant: The right evidence at the right time in the right format.
Integrity: Independent and transparent.
Quality: Reviewing and improving what we do, maintaining rigour and trust.

You can expect:

  • An opportunity to truly impact health globally.
  • A flexible work environment
  • A comprehensive onboarding experiences.
  • An environment where people feel welcome, heard, and included, regardless of their differences.

Cochrane welcomes applications from a wide range of perspectives, experiences, locations, and backgrounds; diversity, equity and inclusion are key to our values.

How to apply

  • For further information on the role and how to apply
  • The deadline to receive your application is 9 Sep 2024
  • The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples.
  • Read our Recruitment Privacy Statement
Thursday, August 29, 2024 Category: Jobs
Lydia Parsonson

局部注射皮质类固醇与手术治疗腕管综合征之比较

7 months 3 weeks ago
局部注射皮质类固醇与手术治疗腕管综合征之比较 关键信息 – 我们发现,关于注射皮质类固醇或手术治疗腕管综合征后症状、功能和生活质量改善情况的证据质量极低,我们无法从中得出结论。 – 虽然严重的不良反应并不常见,但我们无法评估不良反应的差异。 – 在三个月的随访(监测)中,手术后神经功能的电学研究可能比注射皮质类固醇后略有改善。 什么是腕管综合征? 腕管综合征在世界范围内很常见。当手腕正中神经受到“刺激”时,就会出现症状。这会导致疼痛、刺痛、麻木,有时还会出现手和手指无力和功能丧失。它影响人们的生活质量,并给卫生系统带来巨大的财务成本。 腕管综合征如何治疗? 皮质类固醇是减轻炎症和肿胀的药物。向腕管注射皮质类固醇(腕管是手腕上的一条狭窄通道,由手掌一侧的骨骼和韧带环绕)通常用于治疗轻度或中度症状。虽然这些注射比手术便宜得多,但它们的有效性和效果持续多久仍有争议。手术通常是一个简单而快速的过程,只使用局部麻醉(只有手腕区域麻木)。 我们想了解什么? 我们想比较手腕腕管局部注射皮质类固醇与手术的益处。 我们做了什么? 我们检索了评估皮质类固醇注射对症状和手部功能的影响以及神经损伤电测试(称为神经传导研究)改善的研究。我们还检查了在长达12个月的期间内,对生活质量的影响及不良反应。 我们发现了什么? 我们发现了7项研究,涉及569只患有轻度至中度腕管综合征的“手”。这些研究将受试者随机分...

是否有任何治疗方法可以防止因血管疾病截肢的患者对剩余一条腿造成损伤?

7 months 3 weeks ago
是否有任何治疗方法可以防止因血管疾病截肢的患者对剩余一条腿造成损伤? 关键信息 • 目前没有足够的证据表明任何治疗可以有效减少截肢患者的剩余肢体的损伤。 • 需要对治疗方法进行更多研究,以防止该群体中剩余肢体受到损伤。 为什么要进行腿部截肢? 腿部截肢通常是由于腿部血液供应问题而发生,这通常与糖尿病或由年龄增长、吸烟、高血压和高胆固醇引起的循环问题有关。这通常被称为“血管功能障碍”。大约有十分之一的腿部截肢患者会失去另一条腿。 为什么剩下的一条腿对截肢患者很重要? 对剩余肢体的护理已被医疗专业人员和患者群体确定为关键的研究优先领域,特别是预防肢体的进一步损伤,包括溃疡、坏疽(由于感染或缺乏血液流动导致的组织坏死)和截肢。然而,对于能够降低截肢患者失去剩余肢体风险的治疗方法(教育、医疗、心理、行为),人们知之甚少。这些治疗可能包括通过减少肢体压力来预防溃疡,或通过使用药物改善剩余肢体的血液流动,从而防止进一步发生导致肢体丧失的溃疡或坏疽。 我们想要了解什么? 我们想了解是否有任何非手术治疗方法可以帮助保护和保留剩余的肢体。这些方法包括药物治疗;教育工具包,例如供参与患者使用的书籍、小册子和在线课程;为居家患者提供的敷料、护理安排;以及改变机构提供的护理方式。 我们做了什么? 我们检索了研究,比较任何非手术治疗与其他非手术治疗或未接受治疗在保护和保留腿部截肢患者剩余肢体方面的效果。我...

教育项目是否可以改善同时患有慢性肾病和糖尿病患者的预后?

8 months ago
教育项目是否可以改善同时患有慢性肾病和糖尿病患者的预后? 关键信息 • 对于同时患有慢性肾病(肾功能长时间失效)和糖尿病(终生血糖水平过高)的人群,教育项目(旨在提升其管理疾病能力的计划性活动)可能改善其对糖尿病的知识、疾病管理能力及自我管理行为的变化。 • 然而,由于这些研究中的样本数量较少且报告的结局多样,我们的发现需要谨慎解读。需要更大规模、设计良好且有共同结局和更长随访的研究。 为什么改善肾病患者的糖尿病管理很重要? 慢性肾病(长期肾功能不全)和糖尿病(终生血糖水平过高)会给人们的生活带来许多挑战,尤其是当两种疾病同时存在时。糖尿病可以加速肾病的发展,并且是导致肾衰竭(肾脏无法维持生命的功能水平)的主要原因。虽然严格遵循复杂的治疗方案可能具有挑战性,但在肾病早期的成功自我管理可以改善预后,并延缓透析或肾移植的需求。 什么是教育项目? 教育项目是任何旨在提高患者自我管理能力并延缓肾病进展的计划活动。这些活动旨在提高患者对疾病的认知、进行自我照护和自我监测的能力,从而鼓励并促进健康的生活方式改变、提高治疗依从性,并提升生活质量。 我们想了解什么? 我们想了解针对同时患有肾病和糖尿病的患者的教育项目是否有助于他们理解疾病,并认识到延缓疾病进展和预防长期并发症的重要性。 我们做了什么? 我们检索了随机对照研究(将受试者随机分配至两个或多个治疗组的研究),这些研究比较了同时患有肾病...

修复胫骨平台骨折(胫骨顶端断裂)的最佳手术方法是什么

8 months ago
修复胫骨平台骨折(胫骨顶端断裂)的最佳手术方法是什么 关键信息 • 我们尚不清楚修复胫骨平台(胫骨顶部)复杂骨折的最佳方法。 • 有一些证据表明,用于固定胫骨平台骨折碎片的不同外科方法之间,以及用于填补骨折引起的骨缺损的不同填充方法之间,可能差异很小或无显著差异。我们认为这些证据的可信度不足。 • 该领域还需要进一步研究。 什么是胫骨平台骨折 胫骨平台骨折是指影响胫骨(小腿骨)上端的损伤,该部位构成了膝关节的下部骨面。这些骨折通常伴有皮肤和肌肉的严重损伤,并可能在骨骼中形成缺损(孔洞)。 胫骨平台骨折如何治疗? 复杂骨折通常通过开放手术固定(开放复位内固定,ORIF)。这需要将骨折部位暴露在手术视野中,然后使用金属板和螺钉将骨折碎片固定到位。另一种方法是外固定,通过在骨折周围插入钢丝和针,然后连接到一个外部结构(如支架),以固定骨折碎片,直到愈合。在外固定中,外科医生可以使用小型钢板或螺钉固定部分骨折碎片,这种方法称为混合固定。 为修复可能的骨缺损,外科医生可以使用骨缺损填充材料:可以是取自患者的骨移植,或者是人工骨等骨替代材料。 我们想发现什么? 我们希望找到改善胫骨平台骨折患者生活质量和腿部功能的最佳手术方法和最佳骨缺损填充材料,并减少与手术相关的并发症。我们认为这些结果最重要的测量指标是36项健康调查问卷中的总体生活质量评分、特殊外科医院评分的腿部功能评分,以及是否需要再次...

Get ready for #GES2024: Top tips from the Cochrane Community

8 months 1 week ago

Cochrane, JBI, Guidelines International Network (GIN), and The Campbell Collaboration are hosting the second Global Evidence Summit (GES) in the historic city of Prague from 10 to 13 September 2024. The summit serves as a platform for professionals from diverse sectors, including health, education, social justice, environment, and climate change, to engage in crucial discussions aimed at informing policy and practice through evidence. The countdown has begun, but there is still time to register.

To ensure you make the most out of the GES, we've gathered a selection of insights and suggestions from members of the Cochrane community. These tips will guide you through multiple days of intense engagement, helping you maintain your well-being, enthusiasm, and collaborative spirit throughout the event. Have other suggestions? Let us know by using the hashtag #GES2024 on social media.

1. Understand that the GES isn't just another Colloquium
The GES is a unique gathering that brings together professionals from various fields. It’s an opportunity to learn about the broader environment and how Cochrane's work fits into that. Take the opportunity of the GES to immerse yourself in this diverse event.

"Don't think of the GES as a "Colloquium+". It really is a different beast. Don't go expecting to do Cochrane business as you might at the colloquium and instead take the opportunity to learn more about the broader environment we operate in. Hopefully you'll be less "busy" but the experience will be even more intense."

- Gert van Valkenhoef, Denmark

"The topics at the GES go beyond health care, which makes it different than the Colloquia. The GES is a unique opportunity to share experiences with members and representatives of organisations with a similar mission to Cochrane's. Specifically, I remember a past GES workshop where there were trainers from Cochrane, Campbell, JBI, and GIN, which was really interesting and useful. The GES is a very diverse event!"

- Dario Sambunjak, Croatia

2. Get your elevator pitch ready! 
Prepare a short introduction ahead of time. This can be simple: two or three sentences about Cochrane and what we do, yourself, your role, what you are working on, and maybe what others can help you with if you have a goal in mind. 

"Having a clear and concise elevator pitch allows you to make the most of networking opportunities. It helps you introduce yourself with confidence and make a lasting impression. Your pitch is not just about introducing yourself but also about starting meaningful conversations that could lead to future collaborations."

- Ella Flemyng , UK

3. Download a business card app
Embrace the digital age by adopting a digital business card app. This eco-friendly option enables you to effortlessly exchange contact information, fostering future collaborations.

"When Cochrane attended the 76th World Health Assembly we used blinq.me digital business cards. It was free, easy to set up, and was the main form of business cards that people were using. I hope our Cochrane community embraces digital business cards as an environmentally conscious choice and helps sets themselves up for future collaborations."

- Catherine Spencer, Cochrane CEO, UK

4. Be curious about other organizations 
Beyond catching up with colleagues and friends, this event is an opportunity to engage with newcomers interested in our work and potential future collaborators. Embrace the chance to expand your network and foster meaningful connections that could shape exciting collaborations. Stay open to new encounters and the possibilities they bring!

"Because it's a 'mixed' event there's an opportunity to find out more about the work of the other organisations involved. Although many of us need to devote a lot of our time to supporting, managing or presenting on Cochrane work and initiatives, I'd recommend attending a few plenaries, parallel sessions, and workshops that focus on the work of partner organisations. It’s an informative and rewarding experience!"

- Ruth Foxlee, UK

"My best advice: meet and talk to as many people as you can. The GES in South Africa attracted delegates from all over the world, and it was refreshing to speak with people who weren't involved with Cochrane at all, but still had an interest in evidence synthesis."

- Emma Axon, UK

5. Make the most of your time with smart scheduling
The GES is packed with diverse sessions, presentations, and networking opportunities. To get the most out of your time, carefully review the full schedule ahead of the event.  Prioritize the sessions that align with your goals but also be sure to leave some flexibility in your day for conversations and unplanned connections that often lead to future collaborations and the most memorable experiences.

"It's a big event, and you won't be able to go to everything and talk to everyone you might want to. Be realistic! I recommend that you spend a good bit of time beforehand going through the schedule, but do also try to leave some gaps for unplanned chats with people."

- Anna Noel-Storr, UK 

6. Represent Cochrane
Cochrane's  print-on-demand store offers an exciting range of items, including tote bags, t-shirts, and mugs, which you can choose to purchase for use during the conference.  Please note that these items will not be available for purchase at the GES itself and must be acquired in advance. If you have some Cochrane items in your closet, this is a great time to bring them out and recognize and connect with others from the community that will be there. 

"Cochrane has prioritized sustainability and the environment. Rather than traditional conference swag bags of items you'll never use again, we've taken an eco-conscious route by introducing a print-on-demand store. This not only reduces unnecessary waste but also ensures that people only get things they truly value and intend to use. I love my Cochrane t-shirt and mug and am excited to spot people from Cochrane who are wearing items at the GES."

- Sabrina Khamissa, UK

7. Harness the power of social media
While we're meeting in-person, you can also embrace the digital buzz by actively using the event's hashtag: #GES2024. Through social media, you can connect with other attendees, follow up with presenters, and share your insights with your followers.

"You can get ready for  the GES by announcing to everyone that you will be there. It's also good idea to let people know about your poster or presentation and when they can catch you - start getting connections and interest before the event starts! Once you're at the GES, be sure to use the official #GES2024 hashtag and share your highlights."

- Muriah Umoquit, Canada

8. Make your well-being a priority!
Cochrane recognizes that conferences can be busy and overwhelming at times. We want Cochrane attendees to have the opportunity to prioritize their well-being, while also engaging in some fun and social activities at the GES. Some people take a break by connecting with others and some people need time to themselves - do what's best for you to 

"My advice is to treat the GES like a marathon, and not a sprint. Every day will be busy, filled with sessions to attend, and people to meet, and it’s important to make the most of this opportunity. But it’s also important to pace yourself and give yourself permission to schedule in proper breaks each day. Take time out for yourself and enjoy the Anne Anderson Walk, or even take some time to go back to your hotel room - especially if it means you are then able to return to the main sessions refreshed and recharged!

- Nuala Livingstone, Northern Ireland

9. Follow up
The connections you make at the GES can be invaluable, but they require nurturing. Setting aside time for follow-ups is crucial. It’s not just about exchanging contacts but about building relationships that can lead to meaningful collaborations down the road.

"I always block out half a day in my schedule on the first days back from the conferences to dedicate to follow-up emails. Even if it is to say that it was nice to meet them and to share a resource or webpage that they might be interested in, this is important for solidifying relationships."

- Emma Thompson, US

Have other suggestions and tips? Let us know by using the hashtag #GES2024 on social media.

As you embark on your GES journey, we hope that these valuable tips will equip you with the knowledge and confidence to make the most of this enriching experience. We are looking forward to welcoming you to Prague! 

Find out more:

Thursday, August 22, 2024
Muriah Umoquit

营养疗法对减少卒中患者的失能以及改善日常生活活动的影响

8 months 1 week ago
营养疗法对减少卒中患者的失能以及改善日常生活活动的影响 关键信息 °使用口服能量和蛋白质补充剂的营养疗法可能改善日常活动(非常不确定的证据)。 °使用口服能量和蛋白质补充剂的营养疗法可能不会减少失能(不确定的证据)。 °我们确定了多种针对失能和日常活动的营养干预类型。需要更多高质量的研究来确定每种类型的营养疗法对卒中后人群的失能和日常活动的影响。 什么是卒中? 当大脑某部分的血液供应被中断或减少时就会发生卒中。卒中主要有三种类型:缺血性卒中,当血块阻塞或缩窄通往大脑的动脉时发生;出血性卒中,当大脑中的血管破裂,导致脑内出血时发生;以及蛛网膜下腔出血,当大脑与周围膜之间的空隙(蛛网膜下腔)出血。 什么是营养疗法? 营养疗法是一种使用蛋白质、维生素和能量等营养物质在日常膳食和/或两餐之间进行的干预,包括根据每个病人的情况进行营养护理。患病或既往患病的人经常接受营养治疗。 为什么需要特别关注卒中后患者的营养治疗? 卒中患者很容易营养不良,因为他们没有得到足够的能量和营养。卒中患者经常出现身体和认知问题,营养状况可能影响他们的恢复。 我们想要了解什么? 我们想要了解营养疗法是否能减少失能并改善卒中患者的日常活动。 我们做了什么? 我们检索了所有对卒中后患者进行营养治疗的随机试验的医学文献。我们还评价了营养疗法在不良反应方面的安全性。我们比较并总结了研究结果,并根据研究方法和样本量大小等因...

Cochrane Iberoamérica in Navarre, Spain: advancing evidence-based Spanish healthcare

8 months 1 week ago

Cochrane's strength lies in its collaborative, global community. Cochrane Geographic Groups represent Cochrane in their host countries, advocate for the use of Cochrane evidence in health policy and practice, and support Cochrane's members and supporters who live there. Here, we spotlight the Navarre Associate Centre, a key player within Cochrane Iberoamérica, dedicated to enhancing evidence-based healthcare in Spain.

Established in 2015 through a formal agreement between the Health Department of the Government of Navarre and Cochrane Iberoamerica, the Navarre Associate Centre has been a cornerstone in advancing evidence-based practices in the region. The Centre also serves as the host for the Spanish satellite of Cochrane Hypertension, launched following an invitation from the group's base in Canada.

Juan Erviti, Director of the Navarre Associate Centre, highlights the Centre's commitment to rigorous research and knowledge translation: "Our work is deeply rooted in the belief that healthcare decisions should be guided by the best available evidence. By providing training on systematic reviews, GRADE, and critical appraisal, we empower healthcare professionals across Spain to make informed decisions that ultimately improve patient outcomes."

The Centre's contributions to the field are significant, offering systematic review training to health professionals, medical associations, university students, and Cochrane members. In addition, the Centre supports postgraduate research, including Master’s and doctoral theses. The Navarre Associate Centre has produced both Cochrane and non-Cochrane systematic reviews, with a particular focus on hypertension. Their recent publications include critical reviews on blood pressure targets in individuals with chronic renal disease and for people with hypertension and cardiovascular disease, the impact of pharmacotherapy on hypertension-induced left ventricular hypertrophy, and on alcohol intake reduction for controlling hypertension.

The Navarre Associate Centre is also a member of the newly formed thematic group, Cochrane Heart, Stroke, and Circulation, and the Spanish network for the Improvement of the Appropriateness of Clinical Practice (MAPAC). This engagement offers unique opportunities for knowledge translation both locally and nationally, contributing to a broader impact across Spain.

Luis Carlos Saiz, Managing Editor of the Spanish satellite of the Cochrane Hypertension Group, underscores the importance of collaboration in amplifying the Centre’s impact: "Our involvement in networks like MAPAC and the Spanish Medicines Agency’s BIFAP database allows us to work closely with clinicians and researchers, ensuring that our evidence synthesis work is directly applicable to clinical practice. These collaborations are crucial in driving improvements in healthcare delivery."

The Navarre Associate Centre plays a crucial role in shaping clinical practice within the Navarre Health Service. Clinicians propose relevant topics for the "Committee for the Improvement of the Appropriateness of Clinical Practice" (MAPAC) to address. The Centre's members, also part of the MAPAC committee, develop evidence synthesis reports based on both Cochrane and non-Cochrane systematic reviews. These reports form the basis of recommendations and guidelines, which are then transformed into legally binding resolutions by the Managing Director of the Navarre Health Service, ensuring effective implementation and positive impact on healthcare practices.

Looking forward, the Centre aims to align its activities more closely with the needs of clinicians and the goals of Cochrane. As part of the newly approved Cochrane Iberoamerica Evidence Synthesis Unit, the Centre is poised to contribute even more substantially to evidence synthesis in the region.

For those interested in getting involved, the Navarre Associate Centre welcomes collaboration and inquiries. "We are always looking to expand our network and invite healthcare professionals and researchers to join us in our mission to enhance evidence-based healthcare," adds Saiz.

Friday, August 23, 2024
Muriah Umoquit

FIB-4评分和Forns指数(非侵入性测试)在诊断成人慢性丙型肝炎患者的肝纤维化(瘢痕化)分期中的准确性如何?

8 months 1 week ago
FIB-4评分和Forns指数(非侵入性测试)在诊断成人慢性丙型肝炎患者的肝纤维化(瘢痕化)分期中的准确性如何? 关键信息 • FIB-4评分和Forns指数均可用于初步评估个体是否患有肝纤维化(肝瘢痕)。 • 最佳实践是使用FIB-4评分来排除3期(严重纤维化)或4期瘢痕化(肝硬化)。 • 在诊断2期肝纤维化(即显著纤维化)时,推荐使用Forns指数,因其在此类情况下的诊断准确性较高。 为什么改善肝纤维化的诊断如此重要? 丙型肝炎感染是导致肝纤维化(即肝瘢痕)的常见原因。若不进行治疗,肝纤维化可能会进展为一种严重的、大部分不可逆的形式——肝硬化,这可能导致肝脏功能衰竭或发展为癌症。目前,诊断肝纤维化的最佳方法是肝活检,即通过针刺获取肝组织并在显微镜下检查。然而,肝活检具有侵入性,成本高昂,过程痛苦,并伴随一些严重风险,如出血等并发症。通过非侵入性测试如FIB-4评分和Forns指数准确诊断肝纤维化将使人们和医疗系统整体受益。然而,它们对于丙型肝炎感染者的诊断准确性(即它们在区分不同疾病阶段的能力)仍不清楚。 什么是FIB-4评分和Forns指数测试? FIB-4评分和Forns指数是用于评估肝纤维化分期的非侵入性检测方法。它们将标准实验室检测结果与年龄等因素结合起来,计算出一个评分,用以估计肝纤维化的程度。相较于肝活检,这些检查具有简便、成本低、可广泛使用、相对无痛且风险小的优...

对于非小细胞肺癌的老年患者而言,免疫疗法联合化疗是否比单纯化疗更好?

8 months 1 week ago
对于非小细胞肺癌的老年患者而言,免疫疗法联合化疗是否比单纯化疗更好? 关键信息 • 对65岁及以上既往未接受过癌症治疗的晚期非小细胞肺癌(NSCLC)患者来说,在化疗的基础上联合免疫疗法可以延长他们的生命,并延长癌症进展前的时间。这一发现来自以纳入65至75岁人群为主的研究。 • 在75岁以上的人群中,我们没有发现化疗联合免疫疗法有同样的益处。 什么是晚期非小细胞肺癌(NSCLC)? 非小细胞肺癌(NSCLC)是肺癌的两大主要类型之一。大约80%到85%的肺癌病例都是非小细胞肺癌。它通常发生于老年人:确诊的平均年龄为71岁。非小细胞肺癌(NSCLC)通常在转移期或晚期才被发现,这意味着癌症已经扩散到原本受影响的肺部以外。这个阶段的癌症无法治愈,但治疗可以帮助控制病情、改善症状和提高生活质量。 如何治疗非小细胞肺癌(NSCLC)? 治疗方案因癌症分期、肿瘤特征和其他因素而异。化疗——杀死癌细胞的强效化学手段--一直是肺癌治疗的主要治疗方案。免疫疗法是帮助免疫系统对抗癌症的新疗法。对晚期肺癌患者,免疫疗法联合化疗已经取得了积极的疗效。然而,随着年龄的增长,人们的免疫系统会发生变化,抗癌能力会下降。这就是所谓的免疫衰老。 我们想知道什么? 我们想知道,在免疫衰老的背景下,免疫疗法对65岁及以上的晚期非小细胞肺癌(NSCLC)患者是否有效,以及在加强化疗的同时联合免疫疗法的效果如何。 我...

妇科大手术后,是早期进食好还是至少等24小时再进食好?

8 months 1 week ago
妇科大手术后,是早期进食好还是至少等24小时再进食好? 关键信息 - 证据表明,妇科手术后早期进食和饮水可能是安全的。 - 早期进食和饮水可能促进肠道功能的恢复,减少住院时间,并提高患者满意度。 妇科手术后,医生应该延迟患者的进食和饮水吗? 腹部手术后,或是腹腔镜或阴道手术后,医生通常会延迟患者进食和饮水,直到肠道功能恢复(通常是手术后24小时)才允许进食。医生延迟经口进食,是希望降低并发症的风险,例如呕吐、消化系统紊乱、伤口渗漏或再裂开。但是,如果尽早进食,部分患者恢复得更快。 我们想要发现什么? 我们想要了解早期进食是否与恶心、呕吐、胀气、腹胀、术后放置鼻胃管、感染性并发症、伤口并发症、泌尿道感染、肺炎和深静脉血栓有关。 我们也想要了解早期进食是否比延迟进食更能改善肠道功能的恢复,具体表现为术后首次出现肠鸣音时间、术后首次排气时间、术后首次排便时间、术后开始规律饮食时间以及住院天数。此外,也比较了两种进食方案对患者满意度和生活质量的影响。 我们做了什么? 我们检索了一些探讨妇科大手术后早期进食和延迟进食的研究,这些手术是经腹部、阴道或腹腔镜完成的。早期进食定义为术后24小时内摄取液体或食物。延迟进食定义为术后24小时后,且患者出现肠鸣音、排气、排便以及饥饿感才开始进食。我们比较并总结了研究结果,且根据研究方法、规模等因素,对研究的可信度进行评级。 我们发现了什么? 共纳入7项...