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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 | 共用阿片类和苯二氮类药物与药物过量之间的关系:一项回顾性分析显示文摘目标确定同时使用苯二氮类药物和阿片类药物的趋势,确定这些趋势对阿片类药物过量导致的住院和急诊就诊的影响,提出修改建议。参与者:在研究期间,18~64岁的私人投保人连续参加医疗和药房福利健康计划的病人,并且至少接受过一张阿片类药物的处方。干预:同时使用苯二氮类药物/阿片类药物,定义为每种药物处方所涵盖的时间段内至少有一天重叠。主要观察结局指标:使用苯二氮类药物的阿片类药物使用者的年度百分比;每年发生的急诊就诊和阿片类药物过量住院事件。结果:阿片类药物使用者中在2001年使用苯二氮卓类药物的有9%,2013年增加到17%(相对增加80%)。这种增加主要是间断性阿片类药物使用者的增加,而非长期的阿片类药物使用者。与未使用苯二氮卓类药物的阿片类药物使用者相比,同时使用这两种药物与急诊室留观或阿片类药物过量住院相关的风险增加(校正比值比2.14,95%置信区间2.05-2.24;P<0.001)。间断性阿片类药物使用者的急诊室或住院病人阿片类药物过量的校正比值比为1.42(1.33-1.51;P<0.001),长期阿片类药物使用者为1.81(1.67-1.96;P<0.001)。如果这种关联是因果关系,那么消除同时使用两种药物的情况可以减少阿片类药物使用和阿片类药物过量住院病人因急诊就诊的风险,估计有15%(95%置信区间14-16)。结论:从2001年到2013年,在美国大量私人保险病人样本中,苯二氮类药物和阿片类药物的并用显着增加,并且导致总体人群阿片类药物过量使用的风险。 | Sun EC Dixit A Humphreys K 李楠琦 | 2018 | 中国疼痛医学杂志2018，24，6： | 5 |
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