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癫痫杂志 2018年第4期4卷 362-373页

作者： Danielle M.Andrade Anne S.Bassett eduard Bercovici Borlot F Bui E Camfield P Clozza GQ Cohen E Gofine T Graves L Greenaway J Guttman B Guttman-Slater M Hassan A Henze M Kaufman M Lawless B Lee H Lindzon L Lomax LB McAndrews MP Menna-Dack D Minassian BA Mulligan J Nabbout R Nejm T Secco M Sellers L Shapiro M Slegr M Smith R Szatmari P Tao L Vogt A Whiting S Carter Snead O 3rd 刘旭熊维希慕洁

从儿童到成人的医疗保健系统的转变对许多患有癫痫的年轻人及其家庭来说是一个挑战。最近,加拿大安大略省卫生部和长期医疗部门成立了一个过渡工作组(Transition working group,TWG),为安大略省癫痫患者的过渡提出建议。在此对这项工作... 详细信息

从儿童到成人的医疗保健系统的转变对许多患有癫痫的年轻人及其家庭来说是一个挑战。最近,加拿大安大略省卫生部和长期医疗部门成立了一个过渡工作组(Transition working group,TWG),为安大略省癫痫患者的过渡提出建议。在此对这项工作做出总结。TWG包括儿科和成人癫痫病专家、精神科医生和来自学术界和社区的家庭医生,从事儿童和成人癫痫项目的社区医师、护士和社会工作者,以及青少年内科医师、律师、职业治疗师、社区癫痫机构的代表、癫痫患者和患者父母。该小组主要解决3个领域的问题:(1)癫痫的诊断和管理;(2)癫痫患者心理健康和社会心理需求;(3)癫痫患者经济、社会和法律支持。目前虽然还没有对过渡方案的结果进行系统研究,但TWG能早期识别处于过渡失败风险的青少年,在实际过渡之前即应协调儿童和成人神经科医师以及其他专家。过渡期是重新思考诊断和重复诊断检测(特别是基因检测,现有技术较多年前可发现更多病因)的理想时期。在转至成人医疗系统后部分筛查应重复。文章提出的7个步骤可以促进过渡,从而有助于为青少年癫痫患者转出儿童保健系统提供持续且合理的医疗服务。

关键词：癫痫过渡青少年青年遗传学出院方案过渡准备问卷

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Daclatasvir plus asunaprevir in treatment-na?ve patients with hepatitis C virus genotype 1b infection

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World Journal of Gastroenterology 2018年第12期24卷 1361-1372页

作者： Lai Wei Fu-Sheng Wang Ming-Xiang Zhang Ji-Dong Jia Alexey A Yakovlev Wen Xie eduard Burnevich Jun-Qi Niu Yong Jin Jung Xiang-Jun Jiang Min Xu Xin-Yue Chen Qing Xie Jun Li Jin-Lin Hou Hong Tang Xiao-guang Dou Yash Gandhi Wen-Hua Hu Fiona McPhee Stephanie Noviello Michelle Treitel Ling Mo Jun Deng Peking University People’s Hospital and Peking University Hepatology Institute Beijing 100044China Qingdao Municipal Hospital Qingdao 266011Shandong ProvinceChina Guangzhou No.8 People’s Hospital Guangzhou 510060Guangdong ProvinceChina Beijing Youan Hospital Capital Medical UniversityBeijing 100069China Shanghai Ruijin Hospital Jiaotong University School of MedicineShenyang 200025Liaoning ProvinceChina TheFirst Affiliated Hospital with Nanjing Medical University Nanjing 210029Jiangsu ProvinceChina Hepatology Unit Nanfang HospitalSouthern Medical UniversityGuangzhou 510515Guangdong ProvinceChina West China Hospital Sichuan UniversityChengdu 610041Sichuan ProvinceChina China Medical University Shengjing HospitalShenyang 110004Liaoning ProvinceChina Bristol-Myers Squibb PrincetonNJ 08540United States Bristol-Myers Squibb WallingfordCT 06492United States 302 Military Hospital of China Beijing 100039China Bristol-Myers Squibb Shanghai 200040China the Sixth People’s Hospital of Shenyang Shenyang 110006Liaoning ProvinceChina Beijing Friendship Hospital Capital Medical UniversityBeijing 100050China Saint-Petersburg State Healthcare Institution'Clinical Infectious Hospital n.a.S.P.Botkin’ Saint-Petersburg 191167Russia Beijing Ditan Hospital Capital Medical UniversityBeijing 100015China I.M.Sechenov First Moscow State Medical University Moscow 119991Russia The First Hospital of Jilin University Jilin 1300021Jilin ProvinceChina SMG-SNU Boramae Medical Center Seoul 07061South Korea

AIM To assess daclatasvir plus asunaprevir(d UAL) in treatment-na?ve patients from China's Mainland, Russia and South Korea with hepatitis C virus(HCV) genotype 1 b infection. METHODS Patients were randomly assigned(3:1) to receive 24 wk of treatment with d UAL(daclatasvir 60 mg once daily and asunaprevir 100 mg twice daily) beginning on day 1 of the treatment period(immediate treatment arm) or following 12 wk of matching placebo(placebodeferred treatment arm). The primary endpoint was a comparison of sustained virologic response at posttreatment week 12(SVR12) compared with the historical SVR rate for peg-interferon plus ribavirin(70%) among patients in the immediate treatment arm. The first 12 wk of the study were blinded. Safety was assessed in d UAL-treated patients compared with placebo patients during the first 12 wk(doubleblind phase), and during 24 wk of d UAL in both arms *** In total, 207 patients were randomly assigned to immediate(n = 155) or placebo-deferred(n = 52) treatment. Most patients were Asian(86%), female(59%) and aged < 65 years(90%). Among them, 13% had cirrhosis, 32% had IL28 B non-CC genotypes and 53% had baseline HCV RNA levels of ≥ 6 million IU/m L. Among patients in the immediate treatment arm, SVR12 was achieved by 92%(95% confidence interval: 87.2-96.0), which was significantly higher than the historical comparator rate(70%). SVR12 was largely unaffected by cirrhosis(89%), age ≥ 65 years(92%), male sex(90%), baseline HCV RNA ≥ 6 million(89%) or IL28 B non-CC genotypes(96%), although SVR12 was higher among patients without(96%) than among those with(53%) baseline NS5 A resistanceassociated polymorphisms(at L31 or Y93 H). during the double-blind phase, aminotransferase elevations were more common among placebo recipients than among patients receiving d UAL. during 24 wk of d UAL therapy(combined arms), the most common adverse events(≥ 10%) were elevated alanine aminotransferase and upper respiratory tract infection; emergent

关键词： Asunaprevir Daclatasvir Direct-acting antiviral Chronic hepatitis C Liver disease NS3 NS5A Genotype 1b

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