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| 1 | Characterisation and risk assessment of venous thromboembolism in gastrointestinal cancers显示文摘AIM To characterise venous thromboembolism(VTE) in gastrointestinal cancer and assess the clinical utility of risk stratification scoring. METHODS We performed a retrospective analysis using electronic patient records of 910 gastro-oesophageal(GO) cancer and 1299 colorectal cancer(CRC) patients referred to a tertiary cancer centre to identify the incidence of VTE, its relationship to chemotherapy and impact on survival.VTE risk scores were calculated using the Khorana index. Patients were classified as low risk(0 points), intermediate risk(1 to 2 points) or high risk(3 points). Data was analysed to determine the sensitivity of the Khorana score to predict VTE. RESULTS The incidence of VTE was 8.9% for CRC patients and 9.7% for GO cancer patients. Pulmonary emboli(PE) were more common in advanced than in localised CRC(50% vs 21% of events respectively) and lower limb deep vein thrombosis(DVT) were more common in localised than in advanced CRC(62% vs 39% of events respectively). The median time to VTE from cancer diagnosis was 8.3 mo for CRC patients compared to 6.7 mo in GO cancer. In localised CRC median time to VTE was 7.1 mo compared with 10.1 mo in advanced CRC. In contrast in GO cancer, the median time to VTE was 12.5 mo in localised disease and 6.8 mo in advanced disease. No survival difference was seen between patients with and without VTE in this cohort. The majority of patients with CRC in whom VTE was diagnosed had low or intermediate Khorana risk score(94% for localised and 97% in advanced CRC). In GO cancer, all patients scored either intermediate or high risk due to the primary site demonstrating a limitation of the risk assessment score in discriminating high and low risk patients with GO cancers. Additional risk factors were identified in this cohort including surgery, chemotherapy or hospital admission. Overall, 81% of patients with CRC and 77% of patients with GO cancer had one or more of these factors within 4 wk prior to diagnosis VTE. These should be factored into clinical risk assessment scores. CONCLUSION The Khorana score has low sensitivity for thrombotic events in CRC and cannot discriminate low risk patients in high risk cancer sites such as GO cancer. | Robert L Metcalf Eamon Al-Hadithi Nicholas Hopley Thomas Henry Clare Hodgson Antony McGurk Wasat Mansoor Jurjees Hasan | 2017 | World Journal of Gastrointestinal Oncology2017，9，9： | 10 |
| 2 | Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials显示文摘 | Guglielmo Ronco Joakim Dillner K Miriam Elfstr?m Sara Tunesi Peter J F Snijders Marc Arbyn Henry Kitchener Nereo Segnan Clare Gilham Paolo Giorgi-Rossi Johannes Berkhof Julian Peto Chris J L M Meijer | 2013 | The Lancet2013，，： | 3 |
| 3 | An integrated architecture for cooperative sensing networks显示文摘 | Agre J Clare L | 2000 | IEEE Trans On Computers2000，33，5： | 2 |
| 4 | Association of cardiovascular system medications with cognitive function and dementia in older adults living in nursing homes in Australia显示文摘ObjectiveTo 在在检验生活和资源使用的质量的 17 所澳大利亚的疗养院的代表性的研究的 Australia.MethodsAs 部分住在疗养院的更老的成年人与认知功能和痴呆的诊断检验在心血管的系统药使用之间的协会,我们检验了在认知缺陷和心血管的药使用之间的协会(使用解剖治疗学的分类系统识别)用一般线性回归和逻辑 regressio 正在收到生活照顾的结束的人是包括的 excluded.ResultsParticipants 有一个平均数的 541 个居民 85.5 | Enwu Liu Suzanne M Dyer Lisa Kouladjian O'Donnell Rachel Milte Clare Bradley Stephanie L Harrison Emmanuel Gnanamanickam Craig Whitehead Maria Crotty | 2017 | Journal of Geriatric Cardiology2017，14，6： | 2 |
| 5 | Halogenated glass system for the protection of structural carbon/carbon composites 显示文摘 | Lobiondo N E Jones L E Clare A G | 1995 | Carbon1995，33，4： | 1 |
| 6 | Matrix converters显示文摘 | WHEELER P CLARE J EMPRINGHAM L | 2002 | Power Engineering Journal2002，16，6： | 1 |
| 7 | Rehabilitation of executive functioning: An experimental-clinical validation of goal management training 显示文摘 | Levine B Robertson I Clare L | 2000 | J Intern Neuropsychol Soc2000，6，3： | 1 |
| 8 | We'll fight it as long as we can:coping with the onset of Alzheimm's disease显示文摘 | Clare L | 2002 | Aging Ment Heahh2002，6，2： | 1 |
| 9 | Rehabilita- tion of executive functioning:an experimental-clinical valida-tion of goal management training显示文摘 | LEVINE B ROBERTSON I H CLARE L | 2000 | J Int Neuropsychol Soc2000，6，3： | 1 |
| 10 | Executive functions in Parkinson's disease:systematic review and meta-analysis显示文摘 | Kudlicka A Clare L Hindle JV | 2011 | Mov Disord2011，26，13： | 1 |
| 11 | Conducted electromagnetic emissions in induction motor drive systems (Part Ⅰ):time-domain analysis and identification of dominant modes显示文摘 | RAN L GOKANI S CLARE J | 1998 | IEEE Trans Power Electronics1998，13，4： | 1 |
| 12 | Major histocompatibility(B)complex effects of acquired immunity to cecal coccidiosis显示文摘 | Clare R A Strout R G Taylor R L | 1985 | Immunogentics1985，22，： | 1 |
| 13 | Phar- macological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance:systematic review and meta-analysis显示文摘 | Clare L Gillies Keith R Abrams Paul C Lambert | 2007 | BMJ2007，334，： | 1 |
| 14 | 成人2型糖尿病不同筛查及预防策略成本效益分析显示文摘目的 比较针对2型糖尿病预防及治疗的4种筛查策略及随后予以的干预措施:(a)筛查2型糖尿病患者使其能接受早期检查及治疗,(b)筛查2型糖尿病和糖耐量受损患者,对糖耐量受损的人群予以生活方式干预以延缓或预防糖尿病的发生,(c)同(b)但予以药物干预措施,(d)不筛查。
设计 成本效益决策分析建立在对概率的发展和评估基础上,是从筛查到死亡的综合性经济决策分析模型。
研究对象 一组假设人群,筛查时年龄45岁,高于平均糖尿病风险水平。
数据来源 电子书目数据库收录的已发表的临床试验和流行病学研究;补充数据分别来自英国和威尔士健康统计署、风险筛查(STAR)研究和ADDITION研究的Leicester部分。
方法 建立一种决策树/Markov混合模型,以模拟每一种筛查策略的长期效用,包括临床和成本效益终点。该模型假设水平跨度为50年时间,其成本效益折损率为3.5%。采用敏感度分析以验证模型假设及确定哪种模型数据输入对结果的影响最大。
结果 与不筛查策略比较,筛查2型糖尿病、筛查糖尿病和糖耐量受损并予以生活方式干预、筛查糖尿病和糖耐量受损并予以药物干预治疗3种策略,每获得一个质量调整生命年(QALY)估计所需成本分别为(每年成本效益贴现率为3.5%)14150英镑(17560欧元;27860美元)、6242英镑和7023英镑。在支付意愿阈值为20000英镑时,各主动筛查策略通过干预产生的成本效益概率分别为49%,93%和85%。
结论 对年龄45岁、高于平均风险水平的人群进行2型糖尿病和糖耐量受损的筛查,并对糖耐量受损人群予以适当的干预似乎具有很好的成本效益。单独筛查糖尿病而不对糖耐量受损人群予以干预的策略具有的成本效益仍不确定,需要进一步研究确定早期检测糖尿病的作用。 | Clare L Gillies Paul C Lambert Keith R Abrams Alex J Sutton Nicola J Cooper Ron T Hsu Melanie J Davies Kamlesh Khunti 张晓梅(译) 纪立农(校) | 2008 | 英国医学杂志中文版2008，11，5： | 1 |
| 15 | New beta-blocker:prolonged reduction in high blood pressure with beta(1) antisense oligodeoxynucleotides显示文摘 | Kimura B Shen L | 2000 | Hypertension2000，35，12： | 1 |
| 16 | Assessing subtle memory impairments in the everyday memory performance of brain injured people:exploring the potential of the Extended Rivermead Behavioural Memory Test显示文摘 | Wills P Clare L Shiel A | 2000 | Brain Injury2000，14，8： | 1 |
| 17 | CT and pathologic assess- ment of prospective nodal staging in patients with ductal adenocarcionoma of the head of the pancreas 显示文摘 | Clare J Mark L Conall J | 2003 | A JR2003，180，： | 1 |
| 18 | The use of nano polymeric self- assemblies based on novel amphiphilic polymers for oral hydrophobic drug delivery显示文摘 | Clare H Lin PK Tetley L | 2012 | Pharm Res2012，29，3： | 1 |
| 19 | An integrated architecture for cooperative sensing networks 显示文摘 | Clare L | 2000 | IEEE Computer2000，33，5： | 1 |
| 20 | An integrated architecture for cooperative sensing networks 显示文摘 | AGRE J CLARE L | 2000 | IEEE Computer2000，33，5： | 1 |
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