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71.
Myelodysplastic syndromes (MDS) are a heterogeneous group of hemopathies that exhibit physical manifestations with clinical consequences of bone marrow failure and inherent risk of progression to acute myeloid leukemia. Iron overload (IO) is common in MDS due to chronic transfusion support and disease-related alterations in iron metabolism. IO has been conclusively associated with inferior outcomes among MDS patients. Despite lack of randomized trials showing a survival impact of iron chelation therapy (ICT), ICT is recommended by experts and guidelines for select MDS patients with IO and is often used. The availability of effective oral ICT agents has reignited the controversy regarding ICT use in patients with MDS and IO. Here we summarize the studies evaluating the value of ICT in MDS and suggest a practical approach for use of these therapies. We also highlight controversies regarding use of ICT in MDS and discuss some ongoing efforts to answer these questions. 相似文献
72.
Amer Raza Arri Coomarasamy Khalid S. Khan 《Archives of gynecology and obstetrics》2009,280(4):683-687
Health care professionals need to approach their profession with a view to life long learning. They need to develop a strategy
to meet their learning needs in a reflective and effective manner. Continuous medical educational (CME) is the traditional
tool for learning and updating knowledge. Most of them are in the forms of courses, conferences, journal clubs and workshops.
They are mostly didactic sessions and evidence suggests that they are not effective to improve the clinical skills and attitude.
Systematic review of teaching evidence-based medicine shows that interactive and clinically integrated learning is the most
effective form of learning. It enhances knowledge and skills. Professionals should view CME in a holistic manner in the context
of continuous professional development (CPD) and even in the wider concept of knowledge translation, which encompasses both
CME and CPD. e Learning is one of the most important forms of non-traditional CME. It provides an efficient and increasingly
interactive delivery system that can handle complex and layered information. More work needs to be done to see its effectiveness
for practising clinicians. 相似文献
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Tabra Samar Abdalhamed abd Elghany Salwa Elmorsy Amer Reham A. Fouda Mohamed H. Abu-Zaid Mohammed Hassan 《Clinical rheumatology》2022,41(11):3391-3399
Clinical Rheumatology - Assessment of serum levels of IL-23 in PsA patients and its correlation with depression, anxiety, and disease activity. Eighty psoriatic arthritis (PsA) patients and eighty... 相似文献
76.
A randomized single-blind trial of whole versus split-dose polyethylene glycol-electrolyte solution for colonoscopy preparation 总被引:5,自引:0,他引:5
El Sayed AM Kanafani ZA Mourad FH Soweid AM Barada KA Adorian CS Nasreddine WA Sharara AI 《Gastrointestinal endoscopy》2003,58(1):36-40
BACKGROUND: Colonoscopy preparation regimens are often poorly tolerated because they require use of large-volume bowel preparation solution and diet restrictions for adequate cleansing. This study evaluated the efficacy and tolerability of a split-dose polyethylene glycol-electrolyte solution plus bisacodyl and a regular diet. METHODS: A total of 187 patients (104 men, 83 women; age range 18-91 years) were randomly assigned to receive either 3 L of polyethylene glycol-electrolyte solution (n = 96; Group A) with a liquid diet on the day before colonoscopy, or 2 L of polyethylene glycol-electrolyte solution, one tablet of bisacodyl, and a minimally restricted diet on the day before colonoscopy, and then 1 L of the same solution on the day of colonoscopy (n = 91; Group B). Acceptability, adverse events, and willingness to retake the preparation were assessed by questionnaire. The quality of the preparation was graded by an endoscopist, blinded to the type of preparation, by using a previously described scale (excellent to poor). RESULTS: There were 96 patients in Group A and 91 in Group B. Colon cleansing was significantly better in Group B with regard to the overall quality of the preparation (p lt; 0.05). Compliance was significantly higher in Group B as evidenced by the lower number of patients who discontinued the preparation (4 vs. 15; p = 0.02) because of side effects such as nausea or vomiting. The degree of discomfort, adverse events, and willingness to retake the preparation were not significantly different between the groups. CONCLUSIONS: Colonic preparation with split-dose polyethylene glycol-electrolyte provided better quality colon cleansing and higher compliance, with less dietary restrictions, than preparation with whole-dose polyethylene glycol-electrolyte. 相似文献
77.
Nosocomial outbreak of hepatitis B virus infection in a pediatric hematology and oncology unit in South Africa: Epidemiological investigation and measures to prevent further transmission 下载免费PDF全文
David T. Reynders MBChB FCPaed MRCPCH Cert. Medical Oncology Simnikiwe H. Mayaphi MBChB FCPathViro Ahmad F. Haeri Mazanderani MBChB Dip HIV Man Theunis Avenant MBChB MMed FCPaed 《Pediatric blood & cancer》2015,62(11):1914-1919
Background
Hospital‐acquired hepatitis B virus (HBV) infection has been well described and continues to occur worldwide. Recent nosocomial outbreaks have been linked to unsafe injection practices, use of multi‐dose vials, and poor staff compliance with standard precautions. This report describes a nosocomial outbreak that occurred in a pediatric hematology and oncology unit of a large academic hospital, the epidemiological investigation of the outbreak, and preventive measures implemented to limit further in‐hospital transmission.Methods
Outbreak investigation including contact tracing and HBV screening were initially carried out on all patients seen by the unit during the same period as the first three cases. Routine screening for the entire patient population of the unit was initiated in February 2013 when it was realized that numerous patients may have been exposed.Results
Forty‐nine cases of HBV infection were confirmed in 408 patients tested between July 2011 and October 2013. Phylogenetic analysis of the HBV preC/C gene nucleotide sequences revealed that all tested outbreak strains clustered together. Most (67%) patients were HBeAg positive. The cause of transmission could not be established. Preventive measures targeted three proposed routes. HBV screening and vaccination protocols were started in the unit.Conclusions
The high number of HBeAg positive patients, together with suspected lapses in infection prevention and control measures, are believed to have played a major role in the transmission. Measures implemented to prevent further in‐hospital transmission were successful. On‐going HBV screening and vaccination programs in pediatric hematology and oncology units should become standard of care. Pediatr Blood Cancer © 2015 Wiley Periodicals, Inc. 相似文献78.
Reduced insulin sensitivity in childhood survivors of haematopoietic stem cell transplantation is associated with lipodystropic and sarcopenic phenotypes 下载免费PDF全文
79.
Determining the optimal approach to identifying individuals with chronic obstructive pulmonary disease: The DOC study 下载免费PDF全文
Sarah J. Ronaldson MSc BSc Lisa Dyson MSc BA Laura Clark MSc BSc Catherine E. Hewitt PhD MSc BSc David J. Torgerson PhD MSc Brendan G. Cooper PhD MSc BSc Matt Kearney MPH MB ChB William Laughey MBChB MSc Raghu Raghunath PhD MD Lisa Steele BSc Rebecca Rhodes BMED Sci Joy Adamson PhD MSc BSc 《Journal of evaluation in clinical practice》2018,24(3):487-495
80.