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Biochimica Et Biophysica Acta. Reviews... Jan 2020Globally, liver cancer is the most frequent fatal malignancy; in the United States, it ranks fifth. Patients are often diagnosed with liver cancer in advanced stages,... (Review)
Review
Globally, liver cancer is the most frequent fatal malignancy; in the United States, it ranks fifth. Patients are often diagnosed with liver cancer in advanced stages, contributing to its poor prognosis. Of all liver cancer cases, >90% are hepatocellular carcinomas (HCCs) for which chemotherapy and immunotherapy are the best options for therapy. For liver cancer patients, new treatment options are necessary. Use of natural compounds and/or nanotechnology may provide patients with better outcomes with lower systemic toxicity and fewer side effects. Improved treatments can lead to better prognoses. Finally, in this review, we present some of the problems and current treatment options contributing to the poor outcomes for patients with liver cancer.
Topics: Antineoplastic Agents; Biomarkers, Tumor; Carcinoma, Hepatocellular; Combined Modality Therapy; Humans; Immunotherapy; Liver Neoplasms; Molecular Targeted Therapy; Outcome Assessment, Health Care; Prognosis
PubMed: 31682895
DOI: 10.1016/j.bbcan.2019.188314 -
Journal of Clinical Epidemiology Aug 2021
Topics: Delivery of Health Care; Health Services Research; Humans; Outcome Assessment, Health Care
PubMed: 34489051
DOI: 10.1016/j.jclinepi.2021.08.015 -
JAMA Network Open Nov 2019Malnutrition affects a considerable proportion of the medical inpatient population. There is uncertainty regarding whether use of nutritional support during... (Meta-Analysis)
Meta-Analysis
Association of Nutritional Support With Clinical Outcomes Among Medical Inpatients Who Are Malnourished or at Nutritional Risk: An Updated Systematic Review and Meta-analysis.
IMPORTANCE
Malnutrition affects a considerable proportion of the medical inpatient population. There is uncertainty regarding whether use of nutritional support during hospitalization in these patients positively alters their clinical outcomes.
OBJECTIVE
To assess the association of nutritional support with clinical outcomes in medical inpatients who are malnourished or at nutritional risk.
DATA SOURCES
For this updated systematic review and meta-analysis, a search of the Cochrane Library, MEDLINE, and Embase was conducted from January 1, 2015, to April 30, 2019; the included studies were published between 1982 and 2019.
STUDY SELECTION
A prespecified Cochrane protocol was followed to identify trials comparing oral and enteral nutritional support interventions with usual care and the association of these treatments with clinical outcomes in non-critically ill medical inpatients who were malnourished.
DATA EXTRACTION AND SYNTHESIS
Two reviewers independently extracted data and assessed risk of bias; data were pooled using a random-effects model.
MAIN OUTCOMES AND MEASURES
The primary outcome was mortality. The secondary outcomes included nonelective hospital readmissions, length of hospital stay, infections, functional outcome, daily caloric and protein intake, and weight change.
RESULTS
A total of 27 trials (nā=ā6803 patients) were included, of which 5 (nā=ā3067 patients) were published between 2015 and 2019. Patients receiving nutritional support compared with patients in the control group had significantly lower rates of mortality (230 of 2758 [8.3%] vs 307 of 2787 [11.0%]; odds ratio [OR], 0.73; 95% CI, 0.56-0.97). A sensitivity analysis suggested a more pronounced reduction in the risk of mortality in recent trials (2015 or later) (OR, 0.47; 95% CI, 0.28-0.79) compared with that in older studies (OR, 0.94; 95% CI, 0.72-1.22), in patients with established malnutrition (OR, 0.52; 95% CI, 0.34-0.80) compared with that in patients at nutritional risk (OR, 0.85; 95% CI, 0.62-1.18), and in trials with high protocol adherence (OR, 0.67; 95% CI, 0.54-0.84) compared with that in trials with low protocol adherence (OR, 0.88; 95% CI, 0.44-1.76). Nutritional support was also associated with a reduction in nonelective hospital readmissions (14.7% vs 18.0%; risk ratio, 0.76; 95% CI, 0.60-0.96), higher energy intake (mean difference, 365 kcal; 95% CI, 272-458 kcal) and protein intake (mean difference, 17.7 g; 95% CI, 12.1-23.3 g), and weight increase (0.73 kg; 95% CI, 0.32-1.13 kg). No significant differences were observed in rates of infections (OR, 0.86; 95% CI, 0.64-1.16), functional outcome (mean difference, 0.32; 95% CI, -0.51 to 1.15), and length of hospital stay (mean difference, -0.24; 95% CI, -0.58 to 0.09).
CONCLUSIONS AND RELEVANCE
This study's findings suggest that despite heterogeneity and varying methodological quality among trials, nutritional support was associated with improved survival and nonelective hospital readmission rates among medical inpatients who were malnourished and should therefore be considered when treating this population.
Topics: Adult; Hospitalization; Humans; Inpatients; Malnutrition; Nutrition Therapy; Nutritional Status; Outcome Assessment, Health Care; Quality of Health Care
PubMed: 31747030
DOI: 10.1001/jamanetworkopen.2019.15138 -
Value in Health : the Journal of the... Nov 2020
Topics: Betacoronavirus; COVID-19; Coronavirus; Coronavirus Infections; Cost-Benefit Analysis; Humans; Outcome Assessment, Health Care; Pandemics; Pneumonia, Viral; SARS-CoV-2; United Kingdom
PubMed: 33127008
DOI: 10.1016/j.jval.2020.09.009 -
Plastic and Reconstructive Surgery Oct 2021
Topics: History, 20th Century; History, 21st Century; Humans; Outcome Assessment, Health Care; Publishing; Surgery, Plastic
PubMed: 34550951
DOI: 10.1097/PRS.0000000000008347 -
The Patient Jul 2021
Topics: Economics, Medical; Humans; Outcome Assessment, Health Care; Public Health
PubMed: 33728553
DOI: 10.1007/s40271-021-00505-3 -
Clinical Nursing Research Jan 2020
Topics: Functional Status; Geriatric Nursing; Humans; Outcome Assessment, Health Care; Research
PubMed: 31842591
DOI: 10.1177/1054773819894763 -
The Lancet. Healthy Longevity Jul 2023Comprehensive geriatric assessment is the core toolkit of geriatric medicine. Awareness of and engagement in comprehensive geriatric assessment are crucial competences... (Review)
Review
Comprehensive geriatric assessment is the core toolkit of geriatric medicine. Awareness of and engagement in comprehensive geriatric assessment are crucial competences for all professionals caring for older people living with frailty. The fundamental tenet of comprehensive geriatric assessment is person centredness, which means orienting problem evaluation and intervention plans around an individual's specific biopsychosocial situation to maximise their function and participation. Person-centred outcomes are frequently neglected from measurements of health-care delivery, service improvement, and research. Instead, systems tend to measure outcomes of the health-care service (ie, resource use) or a person's destination following a health-care process. The absence of person-centred outcome measures risks the delivery of health care that seeks to achieve, and is benchmarked against, outcomes that are not best for the patient. We must, therefore, ensure that the outcomes that matter to older people are being measured.
Topics: Humans; Aged; Delivery of Health Care; Geriatrics; Outcome Assessment, Health Care
PubMed: 37336229
DOI: 10.1016/S2666-7568(23)00084-3 -
Aesthetic Plastic Surgery Aug 2020Outcomes research is a fast-growing field of study that focuses on patient-related aspects of medical or surgical outcomes such as satisfaction and quality of life. In... (Review)
Review
Outcomes research is a fast-growing field of study that focuses on patient-related aspects of medical or surgical outcomes such as satisfaction and quality of life. In the realm of facial plastic surgery, many outcomes are subjective evaluations based on the patient and physician's judgment as to the surgical result, but little has been done to quantify these qualitative results in an objective manner. This paper discusses the basis for outcomes research and suggests its application to the field of facial plastic surgery. Four new facial plastic outcomes instruments have been developed and are provided for the potential use in measuring the quality of life results of rhytidectomy, rhinoplasty, blepharoplasty, and skin rejuvenation procedures.
Topics: Humans; Outcome Assessment, Health Care; Patient Satisfaction; Quality of Life; Rhytidoplasty; Surgery, Plastic
PubMed: 32766912
DOI: 10.1007/s00266-020-01809-9 -
Current Opinion in Critical Care Oct 2019This review summarizes the results from long-term intensive care outcome research over the past 50 years. Key findings from early studies are reflected in citations of... (Review)
Review
PURPOSE OF REVIEW
This review summarizes the results from long-term intensive care outcome research over the past 50 years. Key findings from early studies are reflected in citations of contemporary research.
RECENT FINDINGS
The postintensive care syndrome (PICS) is a multifaceted entity of residual disability and complications burdening survivors of critical illness. Some interventions applied early in the history of outcomes research have now been confirmed as effective in counteracting specific PICS components.
SUMMARY
Interest in patient-centred outcomes has been present since the beginning of modern intensive care. Findings from early long-term studies remain valid even in the face of contemporary large registries that facilitate follow-up of larger cohorts. A further understanding of the mechanisms leading to experienced physical and psychological impairment of PICS will be essential to the design of future intervention trials.
Topics: Critical Care; Critical Illness; Humans; Outcome Assessment, Health Care; Survivors; Syndrome
PubMed: 31361684
DOI: 10.1097/MCC.0000000000000648