Current medical research and opinion
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To determine risk factors for both warfarin discontinuation and bleeding in patients with atrial fibrillation (AF). ⋯ Risk factors for warfarin discontinuation include older age, recent bleeding, and a high number of concomitant medications. Risk factors associated with bleeding events are older age, use of a warfarin-potentiating medication, previous bleeding, and higher CHADS2 scores.
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The methadone maintenance treatment (MMT) program has been implemented in Shanghai since 2005. This study aims to portray the trend of MMT dropout and identify predictive factors that may influence dropout in Shanghai MMT clinics, which could assist in the intervention strategy development. ⋯ Shanghai has been facing the challenge of keeping a high MMT retention rate. Increasing the use of methadone tapering after a stable treatment stage with sufficient dosage could be attempted in the MMT program, as well as considering comprehensive interventions among specific populations, such as young, poorly educated, opiate-positive and needle sharing individuals.
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Editorial Comment
Treatment of depression: are we finally on the right track?
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Meta Analysis Comparative Study
The predictive role of phosphatase and tensin homolog (PTEN) loss, phosphoinositol-3 (PI3) kinase (PIK3CA) mutation, and PI3K pathway activation in sensitivity to trastuzumab in HER2-positive breast cancer: a meta-analysis.
Phosphatase and tensin homolog (PTEN) loss or activating mutations of phosphoinositol-3 (PI3) kinase (PIK3CA) may be related to trastuzumab resistance in in vitro studies; however, this issue in clinical studies is controversial. Therefore, we conducted a meta-analysis to assess the association between PTEN loss, PIK3CA mutation and the efficacy of trastuzumab-based treatment in HER2-positive breast cancer patients. ⋯ In HER2-positive recurrent or metastatic breast cancer patients PTEN loss might indicate resistance to trastuzumab-based salvage treatment. Due to the small sample size and the considerable heterogeneity in the chemotherapy treatment regimens, further research is needed to clarify the association between PTEN loss, PIK3CA mutation and the efficacy of trastuzumab-based treatment in neoadjuvant and adjuvant settings.
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Multicenter Study
Semiological evaluation of pain according to its origin: a prospective, observational, and national study of current French medical practice.
To determine how the origin of acute pain influences its semiological characteristics, and to evaluate the efficacy and safety of two Level 2 analgesic combinations in general practice. ⋯ Acute pain should not be understood as a single entity but as multiple entities with specific characteristics related to its underlying origin. Furthermore, our data suggest that, as already demonstrated in clinical trials, Level 2 analgesia provides effective relief of acute pain in 'real life' conditions.