Vacuum-Assisted Biopsy to Diagnose a Pathological Complete Response in Breast Cancer Patients After Neoadjuvant Systemic Therapy.
Vacuum-Assisted Biopsy to Diagnose a Pathological Complete Response in Breast Cancer Patients After Neoadjuvant Systemic Therapy.
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真空辅助活检诊断新辅助全身治疗后乳腺癌患者的病理完全缓解
DOI：
10.1097/sla.0000000000002572
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发表时间：
2018
影响因子：
9
通讯作者：
Sinn HP
中科院分区：
文献类型：
--
作者：
Heil J;Richter H;Golatta M;Sinn HP
致编辑：我们赞赏Hill博士等人在了解阿片类药物使用和在普通手术后未使用阿片类药物的程度方面所做的重要工作。1他们的调查提供了新的知识来指导外科医生的处方实践。例如，基于80%的阿片类药物初治患者在手术后使用的药丸数量，他们建议在腹腔镜胆囊切除术后服用15片药丸，腹股沟疝修补术后服用15片药丸，部分乳房切除术后服用10片药丸。这种类型的特异性有助于指导医生处方实践。然而，这些建议的基准包含了一些假设，值得进一步考虑。一种假设是，临床医生正在优化非阿片类疼痛治疗，例如非甾体抗炎药（NSAID），对乙酰氨基酚和其他非药物镇痛药（如冥想和正念）的组合。这些非阿片类药物治疗是阿片类药物保留，但很少优化手术后，建议由目前的指南。因此，作者描述的基准可能会推荐比优化非阿片类药物治疗更高数量的药丸。实际上，在没有优化护理过程的情况下设置的基准可能使临床医生锚在次优性能上。这正是我们在减少中心静脉导管相关血流感染的早期工作中所发生的情况，当时医院最初努力实现疾病控制中心设定的高于0感染的目标。然而，这一目标是建立在一个错误的假设上的：临床医生使用标准化的循证检查表进行最佳护理的病例仅占30%。通过纠正这一差距并致力于完全消除，这些感染在美国已减少了80%。3
To the Editor: We applaud Dr Hill et al for their important work in understanding opioid use and the extent of unused opioid pills after commonly performed general surgeries. 1 Their investigation contributed new knowledge to guide prescribing practices of surgical providers. For example, based on the number of pills used by 80% of opioid-naıve patients after surgery, they recommend the prescription of 15 pills after laparoscopic cholecystectomy, 15 pills after inguinal hernia repair, and 10 pills after partial mastectomy with sentinel lymph node biopsy. This type of specificity helps to guide physician prescribing practices. Yet, these suggested benchmarks incorporate assumptions that merit additional consideration. One assumption is that clinicians are optimizing nonopioid pain therapy such as a combination of nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and other nonpharmacologic analgesics such as meditation and mindfulness. These nonopioid therapies are opioid-sparing, yet rarely optimized after surgery, as suggested by current guidelines. 2 As such, the benchmarks described by the authors may recommend higher numbers of pills than if nonopioid therapies were optimized. Indeed, benchmarks that are set without optimizing care processes may anchor clinicians to suboptimal performance. This is exactly what happened early on in our work to reduce central line associated bloodstream infections when hospitals initially strove to achieve a goal set by the Centers for Disease Control that was higher than 0 infections. 3 However, this goal was built on a faulty assumption: clinicians employed optimal care using a standardized evidence-based checklist in only 30% of cases. 4 By correcting this gap and aiming for complete elimination, these infections have been reduced by 80% across the United States. 3
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影响因子：
4
作者：
Chou, Roger;Gordon, Debra B.;Wu, Christopher L.
通讯作者：
Wu, Christopher L.
疾病控制和预防中心计算阿片类药物的每日总剂量以获得更安全的剂量
DOI：
10.1891/9780826143129.ap03
发表时间：
2020
期刊：
Fast Facts about Medical Cannabis and Opioids
影响因子：
--
作者：
P. Zeboulon;Pierre;E. Brasnu;V. Aragno;P. Hamard;C. Baudouin;A. Labbé
通讯作者：
A. Labbé
十五年后，err是人类：一个成功的故事。
影响因子：
5.4
作者：
Pronovost PJ;Cleeman JI;Wright D;Srinivasan A
通讯作者：
Srinivasan A
影响因子：
3.7
作者：
Kuerer, Henry M.;Peeters, Marie-Jeanne T. F. D. Vrancken;Heil, Joerg
通讯作者：
Heil, Joerg
影响因子：
158.5
作者：
Pronovost, Peter;Needham, Dale;Goeschel, Christine
通讯作者：
Goeschel, Christine