Mahoneycoleman2310
r PR+ and HER2-/+ showed poorer prognosis than the other 2 levels. Risk factor grouping based on the ER, PR, HER2, Ki-67 status, tumor grade, and lymph nodes postsurgery showed that patients in highest score group received the poorest prognosis. Grading system based on the hormone status or the risk factor grouping may offer a useful approach to assess which subgroups of young breast cancer present poorer prognosis.
Healthcare professionals have negative implicit biases toward minority and poor patients. Few communication skills interventions target implicit bias as a factor contributing to disparities in health outcomes. We report the protocol from the COmmuNity-engaged SimULation Training for Blood Pressure Control (CONSULT-BP), a trial evaluating a novel educational and training intervention targeting graduate medical and nursing trainees that is designed to mitigate the effects of implicit bias in clinical encounters. The CONSULT-BP intervention combines knowledge acquisition, bias awareness, and practice of bias mitigating skills in simulation-based communication encounters with racially/ethnically diverse standardized patients. The trial evaluates the effect of this 3-part program on patient BP outcomes, self-reported patient medication adherence, patient-reported quality of provider communication, and trainee bias awareness.
We are conducting a cluster randomized trial of the intervention among cohorts of inteontrol; not enrolled in hospice. Secondary outcomes include trainee bias awareness. A unique feature of this trial is the engagement of academic and community stakeholders to design, pilot test and implement a training program addressing healthcare.
Equipping clinicians with skills to mitigate implicit bias in clinical encounters is crucial to addressing persistent disparities in healthcare outcomes. Our novel, integrated approach may improve patient outcomes.
NCT03375918.
1.0 (November 10, 2020).
1.0 (November 10, 2020).
Shenqi Jiangtang Granules (SQJTG) has been widely used to treat patients with type 2 diabetes mellitus (T2DM). But whether there exists sufficient evidence on the efficacy of SQJTG in the treatment of T2DM is unclear. In order to assess the effects of SQJTG for T2DM, a systematic review and meta-analysis of randomized controlled trials (RCTs) were carried out.
Eight databases, namely, PubMed, The Cochrane Library, EMBASE, Web of Science, Chinese National Knowledge Infrastructure, Chinese Scientific Journals Full-Text Database, CBM, and Wanfang database were searched up to May 2020. According to the Cochrane standards, the selection of study, the extraction of data, the assessment of study quality, and the analyses of data were carried out strictly. Then a fixed or random effects model was applied to analyze the outcomes.
Fifteen studies (N = 1392) in total conformed the inclusion criteria to this meta-analysis. Two subgroups were identified, based on different dose of SQJTG oral hypoglycemic agent (OHA)safe complementary treatment for T2DM patients. This meta-analysis provides an evidence for the treatment in patients with T2DM. While owing to the high heterogeneity and the trials' small sample size, it's crucial to perform large-scale and strict designed studies.
Cerebral palsy is 1 of the diseases critically affecting the health of children. The spasmodic type is the most common, characterized by the increased muscular tension. It often leads to lifelong disability, bringing a heavy economic burden to families and society. As a key treatment in traditional Chinese medicine, pediatric massage has a significant clinical effect on cerebral palsy in children; however, high-quality randomized controlled studies are lacking. The main objective of this study was to evaluate the efficacy of pediatric massage for children with spastic cerebral palsy.
The study will be a multicenter, single-blinded, randomized-controlled pilot trial. During the period from June 2019 to December 2020, 182 children with spastic cerebral palsy will be randomly divided into experimental and control groups in a 11 ratio. The experimental group will undergo the modified selective spinal massage method combined with the basic rehabilitation treatment, while only the basic rehabilitation treatment-Moxibustion Clinical Trial Registry, AMCTR (AMCTR-IPR-19000260) Registered on 04 March 2019.
Brain natriuretic peptide is an established, surrogate follow-up marker, strongly correlated with heart failure severity. Several other biomarkers and tests are useful for assessing the prognosis of patients with HF, such as oxidized low-density lipoprotein antibodies and C-reactive protein. Some inflammatory cells, including monocytes, lymphocytes, and neutrophils, are involved in coronary heart disease and may be useful for prognosis also. This study assessed the potential usefulness of various laboratory biomarkers in predicting long-term outcomes and hospitalization among a cohort of outpatients with chronic, advanced HF.This retrospective, 18-year follow-up study included all patients admitted to the Heart Failure Outpatient Unit in our tertiary care medical center from 2000 through 2001 due to chronic HF. Excluded were patients with malignant disease, severe stroke, active inflammatory disease, or infection. At the first visit, blood was sampled for routine analysis and biomarkers NT-proBNP, C-reactivjection fraction and New York Heart Association class class were also established. Patients were followed every 3 months. Study endpoints were mortality or first hospitalization.Among 305 study patients, HF duration ranged from 2 months to 18 years. Mean follow-up was 9.1 ± 6 years. Mean time to first hospitalization was 60 ± 58.1 months, median = 38 (range 0-179). Mortality rate was 41%. Regression analysis showed New York Heart Association class, lymphocyte count and alkaline phosphatase were independent predictors of survival, with hazard ratios of 1.0, 0.973, and 1.006, respectively (P less then .05).N-terminal pro-B-type natriuretic peptide, alkaline phosphatase, and lymphocyte count are important prognostic predictors for very long-term follow-up among patients with chronic HF.
The aim of this study is to evaluate the association between body mass index (BMI) and cardio-metabolic risk factors and to determine the optimal BMI cut-off values in male and female subjects in Wuhan, China.We conducted a retrospective cross-sectional analysis of 20218 adult subjects (aged 18-85 years, 12717 men of them) who had health examinations at the health management center of Tongji Hospital of Wuhan in 2017. Multivariate logistic regression analysis was preformed to calculate the odds ratios (ORs) of cardio-metabolic risk factors. Receiver operating characteristic curve was used to determine the area under the receiver operating characteristic curve and optimal cut-off values for BMI predictive of cardio-metabolic risk factors.Of the 20218 participants, the percentage of males with overweight and obesity was as twice as that of females and the prevalence of hypertension, diabetes mellitus (DM), dyslipidemia, and hyperuricemia was significantly higher in males than females (27.18% vs 17.69%, 7.88% significant risk factor for hypertension (OR1.27, 95% confidence intervals [CI] 1.25-1.29), DM (OR1.25, 95% CI1.22-1.28), dyslipidemia (OR1.26, 95% CI1.25-1.28), and hyperuricemia (OR1.25, 95% CI1.23-1.27) after adjusting for age in both sexes. But in overweight or obesity status, females had higher ORs for hypertension and DM, and lower ORs for dyslipidemia than that in males. The optimal cut-off values of BMI for the presence of cardio-metabolic risk factors were among 24.25 to 25.35 kg/m2 in males, which were higher than in females among 22.85 to 23.45 kg/m2.The association between BMI and cardio-metabolic risk factors is different by gender. It is necessary to determine appropriate threshold for overweight status in men and women separately.
To retrospectively analyze the computed tomography (CT) findings and clinical manifestations of gastric calcifying fibrous tumor (CFTs).The features of 7 cases with pathologically proven gastric CFTs who had undergone CT were assessed, including tumor location, contour, growth, degree of enhancement, calcification and clinical data. In addition, the size and CT value of each lesion were measured. The mean values of these CT findings and clinical data were statistically analyzed only for continuous variables.Four patients were female and three were male (mean age 33.3 years; range 22 ∼ 47 years). Nonspecific clinical symptoms abdominal pain and discomfort were observed in four cases and the CFTs were incidentally detected in the other three cases. Regarding tumor markers, lower ferritin levels were observed in three female patients. All of the gastric CFTs were solitary and mainly located inside the body; they were in round or oval shape and exhibited endophytic growth. Gastric CFTs are usually small sized ad progressive enhancement in the portal venous phase were mainly noted.A gastric mass with a high unenhanced CT attenuation value, confluent and coarse calcifications and mild-to-moderate enhancement could prompt a diagnosis of gastric CFT. In addition, (1) being young- or middle-aged, (2) having relatively low ferritin levels, and (3) tumor located in the gastric body have critical reference value for diagnosis of gastric CFT.
Threatened abortion (TA) is the commonest complication that occurs in early pregnancy, especially in 8-12 gestational weeks when the secretion of estrogen and progesterone shifts from corpus luteum to placental. Conventional therapies are little evidence of their value. In China, traditional Chinese herbal medicine has been widely used for the treatment of TA for a long time. The lack of strong scientific evidences make this a priority area for research. We aim to evaluate the efficacy and safety of traditional Chinese herbal medicine in the treatment of TA, provide medical staffs with more useful information, and provide patients with better advises.
We will search 8 databases and additional sources, including the Web of Science, PubMed, Cochrane Library, Embase, CBM, Wanfang, VIP, CNKI, and WHO ICTRP, ChiCTR, Clinical Trials, Grey Literature Database, for potentially eligible studies. HA15 in vitro Literature search, screening and retrieval are performed independently by two researchers. In the event of a dispute, a third party will be consulted to support the judgment. We will use RevmanV.5.3 to perform a fixed-effect meta-analysis for clinical homogeneity study data, and the level of evidence will be assessed using the GRADE method.
This systematic review and meta-analysis will put a high-quality synthesis of the efficacy and safety of traditional Chinese herbal medicine in the treatment of TA.
The conclusion of this systematic review will provide evidence to assess traditional Chinese herbal medicine therapy whether is an efficacy and safe intervention to treat TA.
Since this article does not contain patient personal information, ethical approval is not required. The contract is distributed by a peer-reviewed journal or conference report.
10.17605/OSF.IO/DG3T8.
10.17605/OSF.IO/DG3T8.
