7 research outputs found
Ribociclib en el tratamiento del cáncer de mama localmente avanzado o metastásico. Eficacia y Seguridad.
YesLa combinación ribociclib más letrozol administrada en ciclos de 28 días a mujeres postmenopáusicas con cáncer de mama localmente avanzado o metastásico ER positivo HER 2 negativo, que no han sido tratadas anteriormente para la enfermedad avanzada, ha demostrado ser más eficaz, en términos de supervivencia libre de progresión, que letrozol en monoterapia. No obstante, no se conoce si esta mejora en la SLP conlleva un beneficio en la supervivencia global. Respecto a la calidad de vida de los pacientes, no se encontró mejora significativa del tratamiento con ribociclib más letrozol en relación a letrozol según la escala EORTC QLQ-30. En relación a los comparadores a evaluar, letrozol es una opción válida, aunque sería deseable la realización de ensayos clínicos en los que se comparara de forma directa palbociclib en combinación con letrozol y ribociclib en la misma combinación. Por otra parte, para SLP, la superioridad de ribociclib + letrozol fue consistente entre los diferentes subgrupos estratificados. La combinación ribociclib más letrozol ha resultado más tóxica que letrozol, en especial en relación a la toxicidad hematológica (principalmente neutropenia y leucopenia) así como alteraciones de la función hepática (elevación grado 3-4 de ASAT y ALAT) y prolongación del intervalo QT
Eficacia relativa de Palbociclib y Ribociclib en el tratamiento de cáncer de mama localmente avanzado o metastásico: comparación Indirecta
YesSe evalúa la eficacia relativa de palbociclib-letrozol y ribociclib-letrozol en mujeres postmenopáusicas con cáncer de mama avanzado ER positivo HER2 negativo que no habían recibido terapia sistémica previa para la enfermedad avanzada a través de comparaciones indirectas ajustadas de tratamientos. No se encontraron diferencias estadísticamente significativas en las variables de eficacia supervivencia libre de progresión y tasa de respuesta global entre ambas combinaciones de tratamiento
Recommended from our members
Evaluating the efficacy of dexamethasone in the treatment of patients with persistent acute respiratory distress syndrome: study protocol for a randomized controlled trial
Background: Although much has evolved in our understanding of the pathogenesis and factors affecting outcome of patients with acute respiratory distress syndrome (ARDS), still there is no specific pharmacologic treatment for ARDS. Several clinical trials have evaluated the utility of corticoids but none of them has demonstrated a definitive benefit due to small sample sizes, selection bias, patient heterogeneity, and time of initiation of treatment or duration of therapy. We postulated that adjunctive treatment of persistent ARDS with intravenous dexamethasone might change the pulmonary and systemic inflammatory response and thereby reduce morbidity, leading to a decrease in duration of mechanical ventilation and a decrease in mortality. Methods/design This is a prospective, multicenter, randomized, controlled trial in 314 patients with persistent moderate/severe ARDS. Persistent ARDS is defined as maintaining a PaO2/FiO2 ≤ 200 mmHg on PEEP ≥ 10 cmH2O and FiO2 ≥ 0.5 after 24 hours of routine intensive care. Eligible patients will be randomly allocated to two arms: (i) conventional treatment without dexamethasone, (ii) conventional treatment plus dexamethasone. Patients in the dexamethasone group will be treated with a daily dose of 20 mg iv from day 1 to day 5, and 10 mg iv from day 6 to day 10. Primary outcome is the number of ventilator-free days, defined as days alive and free from mechanical ventilation at day 28 after intubation. Secondary outcome is all-cause mortality at day 60 after enrollment. Discussion This study will be the largest randomized controlled clinical trial to assess the role of dexamethasone in patients with persistent ARDS. Trial registration Registered on 21 November 2012 as DEXA-ARDS at ClinicalTrials.gov website (NCT01731795). Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1456-4) contains supplementary material, which is available to authorized users
Neurally adjusted ventilatory assist in patients with acute respiratory failure: study protocol for a randomized controlled trial
Background: Patient-ventilator asynchrony is a common problem in mechanically ventilated patients with acute respiratory failure. It is assumed that asynchronies worsen lung function and prolong the duration of mechanical ventilation (MV). Neurally Adjusted Ventilatory Assist (NAVA) is a novel approach to MV based on neural respiratory center output that is able to trigger, cycle, and regulate the ventilatory cycle. We hypothesized that the use of NAVA compared to conventional lung-protective MV will result in a reduction of the duration of MV. It is further hypothesized that NAVA compared to conventional lung-protective MV will result in a decrease in the length of ICU and hospital stay, and mortality. Methods/design This is a prospective, multicenter, randomized controlled trial in 306 mechanically ventilated patients with acute respiratory failure from several etiologies. Only patients ventilated for less than 5 days, and who are expected to require prolonged MV for an additional 72 h or more and are able to breathe spontaneously, will be considered for enrollment. Eligible patients will be randomly allocated to two ventilatory arms: (1) conventional lung-protective MV (n = 153) and conventional lung-protective MV with NAVA (n = 153). Primary outcome is the number of ventilator-free days, defined as days alive and free from MV at day 28 after endotracheal intubation. Secondary outcomes are total length of MV, and ICU and hospital mortality. Discussion This is the first randomized clinical trial examining, on a multicenter scale, the beneficial effects of NAVA in reducing the dependency on MV of patients with acute respiratory failure. Trial registration ClinicalTrials.gov website (NCT01730794). Registered on 15 November 2012. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1625-5) contains supplementary material, which is available to authorized users
Professional profile and work conditions of nurses working in intensive care units: A multicentre study
Aim: To determine the professional profile and the work conditions of nurses working in intensive care units (ICU) in Colombia, Argentina, Peru and Brazil. Background: ICUs require a differentiated professional profile to provide quality care, and appropriate working conditions, leading to a transformation of care and management practices. Design: Descriptive multicentre cross-sectional observational study. Methods: An online survey was applied to identify both the characteristics of the professional profile and the working conditions. 1,427 ICU nursing professionals were included. RStudio statistical software was used for the analysis of the information. Descriptive statistics were used for the presentation of the results. The STROBE checklist for cross-sectional studies was used in this study. Results: Only 33.6% of the professionals had a specialisation degree in intensive care. The skills that were most frequently put into practice were communication (68.5%) and care management (78.5%). The most predominant nurse-to-patient ratios were 1:2, and greater than 1:6. 59.1% of the nurses had an indefinite term contract, 38.8% worked 48 hours per week and 49.8% had rotating shifts. Only 50.4% of them received incentives. The average salary ranged between 348 and 1,500 USD. 64.5% of the participants were satisfied with their job. Conclusion: It is necessary to strengthen nurses’ professional profile by promoting both postgraduate education and the development of troubleshooting and teamwork skills. It is necessary to standardise the nurse-to-patient ratio, improve wages and increase incentives to achieve greater job satisfaction. Relevance to practice: The knowledge and the improvement of both the professional profile and the work conditions of nurses working in intensive care units will improve the quality of the care given to critical patients and, therefore, the quality of health outcomes.Fil: Achury Saldaña, Diana Marcela. Pontificia Universidad Javeriana. Faculty of Nursing; ColombiaFil: Achury Beltrán, Luisa Fernanda. Pontificia Universidad Javeriana. Faculty of Nursing; ColombiaFil: Rodríguez Colmenares, Sandra Mónica. Pontificia Universidad Javeriana. Faculty of Nursing; ColombiaFil: Alvarado Romero, Herly Ruth. Pontificia Universidad Javeriana. Faculty of Nursing; ColombiaFil: Cavallo, Edhit. Universidad Católica de Cordoba; ArgentinaFil: Ulloa, Ana Cristina. Universidad Católica de Cordoba; ArgentinaFil: Merino, Virginia. Hospital Edgardo Rebagliati Martins; PerúFil: da Silva Barreto, Mayckel. Universidade Federal do Mato Grosso do Sul; BrasilFil: Andrade Fonseca, David. B. Braun Avitum; ColombiaFil: Muñoz Acuña, Doraly. Universidad de los Llanos. Faculty of Nursing; ColombiaFil: Betancur Manrique, Yanier. Universidad Católica de Manizales. Faculty of Nursing; ColombiaFil: Rodríguez Marín, Jorge Eliecer. Universidad Católica de Manizales. Faculty of Nursing; ColombiaFil: González Gómez, Ana Angelica. Universidad de Cartagena. Faculty of Nursing; ColombiaFil: Herrera Corpas, Katerine. Universidad de Cartagena. Faculty of Nursing; ColombiaFil: Andrade Méndez, Brayant. Universidad Surcolombiana. Faculty of Nursing; ColombiaFil: Vargas Toloza, Ruby Elizabeth. Universidad Francisco de Paula Santander. Faculty of Nursing; ColombiaFil: Martínez Rojas, Sandra Milena. Universidad Francisco de Paula Santander. Faculty of Nursing; ColombiaFil: De las Salas Martínez, Roxana Patricia. Universidad del Norte. Faculty of Nursing; Colombi
Wedelia prostrata Hemsl.
原著和名: ハマグルマ科名: キク科 = Compositae採集地: 高知県 高知市 浦戸 (土佐 高知市 浦戸)採集日: 1984/9/10採集者: 萩庭丈壽整理番号: JH031170国立科学博物館整理番号: TNS-VS-98117
Additional file 1: of Neurally adjusted ventilatory assist in patients with acute respiratory failure: study protocol for a randomized controlled trial
Approval of the referral Ethics Committee and the Institutional Review Boards (IRB) of all participating hospitals. (PDF 4.14 mb