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| 1 | 急性脊髓损伤患者治疗的临床操作指南:关于MRI基线在临床治疗决策与结果预测中作用的几点建议(英文)显示文摘The objective of this guideline is to outline the role of magnetic resonance imaging(MRI) in clinical decision making and outcome prediction in patients with traumatic spinal cord injury(SCI).Methods A systematic review of the literature was conducted to address key questions related to the use of MRI in patients with traumatic SCI.This review focused on longitudinal studies that controlled for baseline neurologic status.A multidisciplinary Guideline Development Group(GDG) used this information,their clinical expertise,and patient input to develop recommendations on the use of MRI for SCI patients.Based on GRADE(Grading of Recommendation,Assessment,Development and Evaluation),a strong recommendation is worded as ' we recommend,' whereas a weaker recommendation is indicated by 'we suggest.' Results Based on the limited available evidence and the clinical expertise of the GDG,our recommendations were:(1) 'We suggest that MRI be performed in adult patients with acute SCI prior to surgical intervention,when feasible,to facilitate improved clinical decision-making'(quality of evidence,very low) and(2) 'We suggest that MRI should be performed in adult patients in the acute period following SCI,before or after surgical intervention,to improve prediction of neurologic outcome '(quality of evidence,low).Conclusions These guidelines should be implemented into clinical practice to improve outcomes and prognostication for patients with SCI. | Fehlings MG Martin AR Tetreault LA Aarabi B Anderson P Arnold PM Brodke D Burns AS Chiba K Dettori JR Furlan JC Hawryluk G Holly LT Howley S Jeji T Kalsi-Ryan S Kotter M Kurpad S Kwon BK Marino RJ Massicotte E Merli G Middleton JW Nakashima H Nagoshi N Palmieri K Singh A Skelly AC Tsai EC Vaccaro A Wilson JR Yee A Harrop JS | 2017 | 中华神经外科疾病研究杂志2017,16,6: | 8 |
| 2 | Season of the year influences infection rates following total hip arthroplasty显示文摘AIM To research the influence of season of the year on periprosthetic joint infections.METHODS We conducted a retrospective review of the entire Medicare files from 2005 to 2014. Seasons were classified as spring, summer, fall or winter. Regional variations were accounted for by dividing patients into four geographic regions as per the United States Census Bureau(Northeast, Midwest, West and South). Acute postoperative infection and deep periprosthetic infections within 90 d after surgery were tracked. RESULTS In all regions, winter had the highest incidence of periprosthetic infections(mean 0.98%, SD 0.1%) and was significantly higher than other seasons in the Midwest, South and West(P < 0.05 for all) but not the Northeast(P = 0.358). Acute postoperative infection rates were more frequent in the summer and were significantly affected by season of the year in the West.CONCLUSION Season of the year is a risk factor for periprosthetic joint infection following total hip arthroplasty(THA). Understanding the influence of season on outcomes following THA is essential when risk-stratifying patients to optimize outcomes and reduce episode of care costs. | Samuel Rosas Alvin C Ong Leonard T Buller Karim G Sabeh Tsun yee Law Martin W Roche Victor H Hernandez | 2017 | World Journal of Orthopedics2017,8,12: | 4 |
| 3 | Fondaparinux预防老年急性内科患者发生静脉血栓形成的效果与安全性:随机安慰剂对照研究显示文摘目的:观察 Fondaparinux 对具有中高度静脉血栓发生危险的老年急性内科住院患者的抗凝效果与安全性。设计:双盲随机安慰剂对照研究。背景:8个国家的35个中心。参与者:849例≥60岁内科患者,住院原因分别为充血性心力衰竭、慢性肺病合并急性呼吸系统疾患、急性炎症性或感染性疾病,预期至少住院4天以上。干预:2.5 mg Fondaparinux 或安慰剂,每天1次皮下注射,持续6~14天。观察指标:主要指标为静脉血栓形成(治疗后15天内采用双侧静脉造影检查)及有症状的静脉血栓;次要指标为死亡与出血。患者随访时间为1个月。结果:Fondaparinux 治疗组425例患者和安慰剂组414例患者接受了安全性分析(10例未治疗)。644例患者(75.9%)可接受主要指标分析。静脉血栓检出率在 Fondaparinux 治疗组为5.6%(18/321),安慰剂组为10.5%(34/323),相对危险减少46.7%(95% CI 7.7%~69.3%)。安慰剂组5例患者发生有症状的静脉血栓,Fondaparinux治疗组无患者发生有症状的静脉血栓(P=0.029)。两组均有1例(0.2%)患者发生严重出血。随访结束时,安慰剂组、Fondaparinux 治疗组分别死亡25(6.0%)、14(3.3%)例患者。结论:Fondaparinux 可有效预防急性内科老年患者无症状性及有症状的静脉血栓。严重出血几率两组相似。 | Alexander T Cohen Bruce L Davidson Alexander S Gallus Michael R Lassen Martin H Prins Witold Tomkowski Alexander G G Turpie Jan F M Egberts Anthonie W A Lensing 石汉平(译) 王深明(校) | 2006 | 英国医学杂志中文版2006,9,5: | 3 |
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| 19 | Systematic review and meta-analysis of outcomes following pathological complete response to neoadjuvant chemoradiotherapy for rectal cancer显示文摘 | Martin S T Heneghan H M Winter D C | 2012 | Br J Surg2012,99,: | 1 |
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