Torrens, G*
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AIM: To identify, appraise and synthesize the available evidence relating to the value and impact of cancer nursing on patient experience and outcomes. BACKGROUND: There is a growing body of literature that recognizes the importance and contribution of cancer nurses, however, a comprehensive review examining how cancer nurses have an impact on care quality, patient outcomes and overall experience of cancer, as well as cost of services across the entire cancer spectrum is lacking. DESIGN: A systematic review and meta-analysis using Cochrane methods. METHODS: We will systematically search 10 electronic databases from 2000, with pre-determined search terms. No language restrictions will be applied. We will include all randomized and controlled before-and-after studies that compare cancer nursing interventions to a standard care or no intervention. Two reviewers will independently assess the eligibility of the studies and appraise methodological quality using the Cochrane Risk of Bias tool. Disagreements will be resolved by discussion and may involve a third reviewer if necessary. Data from included studies will be extracted in accordance with the Template for intervention Description and Replication reporting guidelines. Missing data will be actively sought from all trialists. Data will be synthesized in evidence tables and narrative to answer three key questions. If sufficient data are available, we will perform meta-analyses. DISCUSSION: This review will allow us to systematically assess the impact of cancer nursing on patient care and experience. This evidence will be used to determine implications for clinical practice and used to inform future programme and policy decisions in Europe.
- MeSH
- lidé MeSH
- onkologické ošetřovatelství * MeSH
- ošetřovatelství založené na důkazech * MeSH
- společnosti ošetřovatelské MeSH
- vztahy mezi ošetřovatelkou a pacientem MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- přehledy MeSH
- Geografické názvy
- Evropa MeSH
BACKGROUND: Advances in research and technology coupled with an increased cancer incidence and prevalence have resulted in significant expansion of cancer nurse role, in order to meet the growing demands and expectations of people affected by cancer (PABC). Cancer nurses are also tasked with delivering an increasing number of complex interventions as a result of ongoing clinical trials in cancer research. However much of this innovation is undocumented, and we have little insight about the nature of novel interventions currently being designed or delivered by cancer nurses. OBJECTIVES: To identify and synthesise the available evidence from clinical trials on interventions delivered or facilitated by cancer nurses. DATA SOURCES AND REVIEW METHODS: A systematic review of randomised controlled trials (RCT), quasi-RCTs and controlled before and after studies (CBA) of cancer nursing interventions aimed at improving the experience and outcomes of PABC. Ten electronic databases (CENTRAL, MEDLINE, AMED, CINAHL, EMBASE, Epistemonikos, CDSR, DARE, HTA, WHO ICTRP) were searched between 01 January 2000 and 31 May 2016. No language restrictions were applied. Bibliographies of selected studies and relevant Cochrane reviews were also hand-searched. Interventions delivered by cancer nurses were classified according to the OMAHA System. Heat maps were used to highlight the volume of evidence available for different cancer groups, intervention types and stage of cancer care continuum. RESULTS: The search identified 22,450 records; we screened 16,169 abstracts and considered 925 full papers, of which 214 studies (247,550 participants) were included in the evidence synthesis. The majority of studies were conducted in Europe (n = 79) and USA (n = 74). Interventions were delivered across the cancer continuum from prevention and risk reduction to survivorship, with the majority of interventions delivered during the treatment phase (n = 137). Most studies (131/214) had a teaching, guidance or counselling component. Cancer nurse interventions were targeted at primarily breast, prostate or multiple cancers. No studies were conducted in brain, sarcoma or other rare cancer types. The majority of the studies (n = 153) were nurse-led and delivered by specialist cancer nurses (n = 74) or advanced cancer nurses (n = 29), although the quality of reporting was poor. CONCLUSIONS: To the best of our knowledge, this is the first review to synthesise evidence from intervention studies across the entire cancer spectrum. As such, this work provides new insights into the nature of the contribution that cancer nurses have made to evidence-based innovations, as well as highlighting areas in which cancer nursing trials can be developed in the future.
- MeSH
- analýza nákladů a výnosů MeSH
- lidé MeSH
- nádory ošetřování MeSH
- randomizované kontrolované studie jako téma * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- systematický přehled MeSH
BACKGROUND & AIMS: Hepatoblastoma (HB) is a rare disease. Nevertheless, it is the predominant pediatric liver cancer, with limited therapeutic options for patients with aggressive tumors. Herein, we aimed to uncover the mechanisms of HB pathobiology and to identify new biomarkers and therapeutic targets in a move towards precision medicine for patients with advanced HB. METHODS: We performed a comprehensive genomic, transcriptomic and epigenomic characterization of 159 clinically annotated samples from 113 patients with HB, using high-throughput technologies. RESULTS: We discovered a widespread epigenetic footprint of HB that includes hyperediting of the tumor suppressor BLCAP concomitant with a genome-wide dysregulation of RNA editing and the overexpression of mainly non-coding genes of the oncogenic 14q32 DLK1-DIO3 locus. By unsupervised analysis, we identified 2 epigenomic clusters (Epi-CA, Epi-CB) with distinct degrees of DNA hypomethylation and CpG island hypermethylation that are associated with the C1/C2/C2B transcriptomic subtypes. Based on these findings, we defined the first molecular risk stratification of HB (MRS-HB), which encompasses 3 main prognostic categories and improves the current clinical risk stratification approach. The MRS-3 category (28%), defined by strong 14q32 locus expression and Epi-CB methylation features, was characterized by CTNNB1 and NFE2L2 mutations, a progenitor-like phenotype and clinical aggressiveness. Finally, we identified choline kinase alpha as a promising therapeutic target for intermediate and high-risk HBs, as its inhibition in HB cell lines and patient-derived xenografts strongly abrogated tumor growth. CONCLUSIONS: These findings provide a detailed insight into the molecular features of HB and could be used to improve current clinical stratification approaches and to develop treatments for patients with HB. LAY SUMMARY: Hepatoblastoma is a rare childhood liver cancer that has been understudied. We have used cutting-edge technologies to expand our molecular knowledge of this cancer. Our biological findings can be used to improve clinical management and pave the way for the development of novel therapies for this cancer.
- MeSH
- beta-katenin genetika MeSH
- cholinkinasa * antagonisté a inhibitory metabolismus MeSH
- epigeneze genetická MeSH
- hepatoblastom * genetika metabolismus mortalita patologie MeSH
- hodnocení rizik metody MeSH
- kojenec MeSH
- lidé MeSH
- membránové proteiny genetika MeSH
- metylace DNA MeSH
- nádorové biomarkery analýza MeSH
- nádorové proteiny genetika MeSH
- nádory jater * genetika metabolismus mortalita patologie MeSH
- objevování léků metody MeSH
- prognóza MeSH
- proteiny vázající vápník genetika MeSH
- rychlé screeningové testy MeSH
- stanovení celkové genové exprese MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
- Research Support, U.S. Gov't, Non-P.H.S. MeSH
OBJECTIVES: Pseudomonas aeruginosa (PA) is a common causative pathogen of pneumonia acquired in the intensive care unit (ICU). The aim of this study was to determine the incidence of PA ICU pneumonia (PAIP) and to quantify its independent association with PA colonization at different body sites. METHODS: Adult patients on mechanical ventilation at ICU admission were prospectively enrolled across 30 European ICUs. PA colonization in the perianal area and in the lower respiratory tract was assessed within 72 hours after ICU admission and twice weekly until ICU discharge. PAIP development was evaluated daily. Competing risk models with colonization as a time-varying exposure and ICU death and discharge as competing events were fitted and adjusted for confounders to investigate the association between PA carriage and PAIP. RESULTS: A total of 1971 subjects were enrolled. The colonization prevalence with PA in the first 72 hours of ICU admission was 10.4% (179 perianal and 51 respiratory), whereas the acquisition incidence during the ICU stay was 7.0% (158 perianal and 47 respiratory). Of the 43 (1.8%) patients who developed PAIP, 11 (25.6%) were PA colonized on admission and 9 (20.9%) acquired colonization before PAIP onset. Both perianal (adjusted subdistribution hazard ratio, 4.4; 95% CI, 1.7-11.6) and respiratory colonization (adjusted subdistribution hazard ratio: 4.6, 95% CI, 1.9-11.1) were independently associated with PAIP development. DISCUSSION: PAIP incidence was higher in PA colonized vs. non-colonized patients. Colonization of both the rectum and of the respiratory tract was associated with development of PAIP. The increased risk of PA colonization for subsequent infection provides an opportunity for targeted preventive interventions.
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- dospělí MeSH
- incidence MeSH
- infekce spojené se zdravotní péčí epidemiologie mikrobiologie MeSH
- jednotky intenzivní péče * statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- přenašečství epidemiologie mikrobiologie MeSH
- prevalence MeSH
- prospektivní studie MeSH
- pseudomonádové infekce * epidemiologie mikrobiologie MeSH
- Pseudomonas aeruginosa * izolace a purifikace MeSH
- senioři MeSH
- ventilátorová pneumonie epidemiologie mikrobiologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Evropa MeSH
... Medicine in Fiction -- 215 Index -- John Cule -- David Innes Williams -- R Meyrick Emrys-Roberts -- John R Guy ... ... -- John Kirkup -- Clive Charlton -- Jean Guy -- John Tricker -- Christine Hillam -- Nigel Lightfoot ... ... Joan Lane -- Peter and Ruth Wallis -- Sholem Glaser -- J B Lyons -- Terence D Turner -- Anne Young -- ... ... Hugh Torrens -- Patricia Maureen Craig -- Owen Dudley Edwards ...
222 s. : il. ; 25 cm
- MeSH
- dějiny lékařství MeSH
- infekční nemoci dějiny MeSH
- Publikační typ
- kongresy MeSH
- sborníky MeSH
- Geografické názvy
- Spojené království MeSH
- Konspekt
- Lékařské vědy. Lékařství
- NLK Obory
- dějiny lékařství
- infekční lékařství
... Die lokale Gewebs- und Gefäßreaktion 27 - 2. Die spinale Reaktion 27 - 3. ... ... G. ... ... Gesäßregion 672 -- 4. ... ... Die Infiltrationsanästhesie in der Gynäkologie und Geburtshilfe 693 -- I. Gynäkologie 693 -- II. ... ... G. Kiedel, Göppingen 722 -- A. Allgemeines 722 -- B. ...
xix, 770 stran : ilustrace, tabulky ; 27 cm
Das Lehrbuch konzentriert sich auf Lokalanästhesie und Lokalanästhetika.
- MeSH
- anestetika lokální MeSH
- anesteziologie metody výchova MeSH
- lokální anestezie MeSH
- Publikační typ
- učebnice MeSH
- Konspekt
- Učební osnovy. Vyučovací předměty. Učebnice
- Patologie. Klinická medicína
- NLK Obory
- anesteziologie a intenzivní lékařství
- NLK Publikační typ
- kolektivní monografie
... Eintheilung des Wassers überhaupt 1 -- Geschichte der Heilquellen 2 -- BHiiung derselben 3 -- Bestandtheile ... ... G. - ! ... ... I -- Gastein •• -- Geilnau -- Seite. 32 46 56 120 -- . 76 76 75 49 76 76 76 75 76 75 43 75 lenesio iieshübel ... ... • ijleifsen. • Butsch Godelheim Göppingen Konten Greoulx. ... ... Griesbach Grognardo Grüben Guiterra Günthersbad Gurnigel « Gyrenbad -- Hall -- . 93 52 77 40 -- . 142 ...
168 s. ; 22 cm