While modern toxicology has focused on understanding biological mechanisms involved in the expression of toxicity at the molecular level, a technological revolution has occurred enabling researchers to perform experiments on a scale of unprecedented proportions (Marshall and Hodgson 1998; Ramsay 1998). Highthroughput experimentation is producing large amounts of data impossible to analyze without informatics-related support (Bellenson 1999; Spengler 2000). We see a paradigm shift in toxicology research, where hypothesis-driven research is complemented by data-driven experimentation designed to be hypothesis generating (Afshari et al. 1999). Although toxicogenomics, the study of toxicology using highthroughput "omics" technologies (Aardema and MacGregor 2002; Hamadeh et al. 2002; Nuwaysir et al. 1999; Schmidt 2002; Ulrich and Friend 2002), and systems toxicology, the study of toxicology through data integration (Waters et al. 2003), have advanced rapidly and are likely to continue to advance, development of software infrastructures to manage, analyze, and integrate the diverse data has lagged behind. Recently, Waters et al. (2003) proposed a conceptual framework of chemical effects in biological systems [(CEBS) Chemical Effects in Biological Systems knowledge base] to meet the expanding toxicogenomic research needs at the National Center for Toxicogenomics (NCT) (Tennant 2002), including both NCT intramural research and research within the Toxicogenomics Research Consortium (TRC) (Medlin 2002). Both the NCT and the TRC are located at the National Institute of Environmental Health Sciences (NIEHS) in the Research Triangle Park, North Carolina. Implementing toxicogenomic technologies is a high-priority initiative at the U.S. Food and Drug Administration (U.S. FDA) National Center for Toxicological Research (NCTR). A microarray core facility using validated and standardized protocols has been established. Similar facilities for Methods ArrayTrack contains three integrated components: a) MicroarrayDB, which stores essential data associated with a
Background Peripherally inserted central catheters (PICCs) and implantable port catheters (IPCs) are 2 most common central venous access for cancer patients receiving chemotherapy. However, no specific evidence exists to guide practitioners on safety and less cost. Objective To compare the differences of complications and costs of PICC and IPC in the treatment of cancer patients with chemotherapy and to provide a basis for better clinical decision making. Methods All the cohort studies were searched in the Cochrane Library, JBI, PubMed, Elsevier, Web of Science, CINAHL, CBM, and CNKI from inception to July 2018. Two reviewers screened and selected trials, evaluated quality, and extracted data. Meta-analysis and description of the outcomes were performed by using the RevMan 5.3 software. Results A total of 761 articles were retrieved, with 15 articles meeting eligibility criteria. Outcome analysis showed no difference in 1-puncture success rate. Peripherally inserted central catheter use was associated with higher complication rates than IPC, including occlusion, infection, malposition, catheter-related thrombosis, extravasation, phlebitis, and accidental removal rate. The life span of IPC was longer than that of PICC, and the costs of IPC were lower. Conclusions Implantable port catheter has advantages over PICC in reducing cancer patients’ complications and less cost in terms of long-term cancer chemotherapy. Implications for Practice In terms of safety, the results provide evidence for practitioners to choose which type of central venous catheters is better for cancer chemotherapy patients. In terms of costs, practitioners need to make decisions about which type of central venous catheters has less cost.
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