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Consensus guideline

J M Remes-Troche, E Coss-Adame, A Lopéz-Colombo, M Amieva-Balmori, R Carmona Sánchez, L Charúa Guindic, R Flores Rendón, O Gómez Escudero, M González Martínez, M E Icaza Chávez, M Morales Arámbula, M Schmulson, J L Tamayo de la Cuesta, M Á Valdovinos, G Vázquez Elizondo
INTRODUCTION: Significant advances have been made in the knowledge and understanding of the epidemiology, pathophysiology, diagnosis, and treatment of chronic constipation, since the publication of the 2011 guidelines on chronic constipation diagnosis and treatment in Mexico from the Asociación Mexicana de Gastroenterología. AIMS: To present a consensus review of the current state of knowledge about chronic constipation, providing updated information and integrating the new scientific evidence...
March 16, 2018: Revista de Gastroenterología de México
Todd M Olszewski
This article examines the history and effect of the Consensus Development Program (CDP) at the National Institutes of Health (NIH). Introduced at a time when the relationship between the U.S. public and the medical profession was at a nadir, the CDP frequently placed the NIH in the middle of broader debates in medical practice and health policy during the last quarter of the 20th century. Drawing on published and archival sources, this paper sheds light on the challenges associated with collecting, assessing, and communicating evidence to medical professionals and convincing them to act on it in the name of improved health care...
March 20, 2018: Annals of Internal Medicine
Johanna Tell, Ewy Olander, Peter Anderberg, Johan Sanmartin Berglund
AIM: The aim of this study was to investigate child health-care coordinators' experiences of being a facilitator for the implementation of a new national child health-care programme in the form of a web-based national guide. METHODS: The study was based on eight remote, online focus groups, using Skype for Business. A qualitative content analysis was performed. RESULTS: The analysis generated three categories: adapt to a local context, transition challenges and led by strong incentives...
February 2018: Scandinavian Journal of Public Health
Toshirou Nishida
There are some disparities between the clinical practice and profiles of cancer in Asia and those in Europe & North America. In Asia, surgical oncologists still have a major role in the multidisciplinary therapy of gastrointestinal stromal tumor (GIST), whereas medical oncologists hold this status in the West. Although the incidence of clinical GIST is considered similar between the two areas, small gastric GISTs are more frequently treated by surgery in East Asia compared with Europe & North America...
2018: Translational Gastroenterology and Hepatology
C B Terwee, C A C Prinsen, A Chiarotto, M J Westerman, D L Patrick, J Alonso, L M Bouter, H C W de Vet, L B Mokkink
BACKGROUND: Content validity is the most important measurement property of a patient-reported outcome measure (PROM) and the most challenging to assess. Our aims were to: (1) develop standards for evaluating the quality of PROM development; (2) update the original COSMIN standards for assessing the quality of content validity studies of PROMs; (3) develop criteria for what constitutes good content validity of PROMs, and (4) develop a rating system for summarizing the evidence on a PROM's content validity and grading the quality of the evidence in systematic reviews of PROMs...
March 17, 2018: Quality of Life Research
Suzanne S Dunne, Merja Ahonen, Martina Modic, Francy Rl Crijns, Minna M Keinänen-Toivola, Ruth Meinke, C William Keevil, Jim Gray, Nuala H O'Connell, Colum P Dunne
Recognized issues with poor hand hygiene compliance among healthcare workers, and reports of re-contamination of previously chemically disinfected surfaces through hand contact, emphasize need for novel hygiene methods in addition to those currently available. One such approach involves antimicrobial (nano)-coatings (AMC), whereby integrated active ingredients are responsible for elimination of microorganisms that come into contact with treated surfaces. While widely studied under laboratory conditions with promising results, studies under real life healthcare conditions are scarce...
March 14, 2018: Journal of Hospital Infection
Tara R Semenkovich, Margaret A Olsen, Varun Puri, Bryan F Meyers, Benjamin D Kozower
BACKGROUND: Empyema affects up to 65,000 patients annually in the United States. Recent consensus guidelines demonstrate ambiguity about optimal treatment. We examined current treatment practices and outcomes for inpatient treatment of empyema using a comprehensive, longitudinal dataset that encompasses an entire state cohort of hospitalized patients. METHODS: We queried the Healthcare Cost and Utilization Project (HCUP) New York State Inpatient Database (2009-2014) for patients with primary empyema and subsequent readmissions...
March 14, 2018: Annals of Thoracic Surgery
Richard G Ellenbogen, Hunt Batjer, Javier Cardenas, Mitchel Berger, Julian Bailes, Elizabeth Pieroth, Robert Heyer, Nicholas Theodore, Wellington Hsu, Elizabeth Nabel, Joe Maroon, Robert Cantu, Ronnie Barnes, James Collins, Margot Putukian, Russell Lonser, Gary Solomon, Allen Sills
One of the National Football League's (NFL) Head, Neck and Spine Committee's principal goals is to create a 'best practice' protocol for concussion diagnosis and management for its players. The science related to concussion diagnosis and management continues to evolve, thus the protocol has evolved contemporaneously. The Fifth International Conference on Concussion in Sport was held in Berlin in 2016, and guidelines for sports concussion diagnosis and management were revised and refined. The NFL Head, Neck and Spine Committee has synthesised the most recent empirical evidence for sports concussion diagnosis and management including the Berlin consensus statement and tailored it to the game played in the NFL...
March 16, 2018: British Journal of Sports Medicine
Milton Packer
BACKGROUND: Current guidelines for the treatment of heart failure strongly recommend the use of inhibitors of the renin-angiotensin system and sympathetic nervous system in all patients with a reduced ejection fraction who can tolerate these drugs. Yet, there is no consensus about the efficacy of low doses of these drugs or the likely shape of the dose-response relationship for these agents. METHODS: Inferences were made by examining the effects of drugs in placebo-controlled trials before the protocol-specified opportunity for uptitration and by reassessing the results of large-scale trials with active comparators that inadvertently produced different intensities of neurohormonal blockade...
March 11, 2018: International Journal of Cardiology
Massimo Di Maio, Chiara Baratelli, Paolo Bironzo, Francesca Vignani, Emilio Bria, Elisa Sperti, Maddalena Marcato, Fausto Roila
According to current ESMO - MASCC guidelines, a combination of a neurokinin-1 receptor antagonist (NK1RA), dexamethasone and a 5-HT3 receptor antagonist (5-HT3RA) is recommended to prevent carboplatin-induced emesis, albeit with moderate level of confidence and not unanimous consensus. We performed a meta-analysis of randomized trials (RCTs) comparing NK1RA + dexamethasone + 5-HT3RA vs. dexamethasone + 5-HT3RA in patients receiving the first cycle of carboplatin-based chemotherapy. Primary outcome was complete response (CR), defined as no emesis and no use of rescue medication...
April 2018: Critical Reviews in Oncology/hematology
Chad M Hodge, Scott P Narus
Objective: Problem list data is a driving force for many beneficial clinical tools, yet these data remain underutilized. We performed a systematic literature review, pulling insights from previous research, aggregating insights into themes, and distilling themes into actionable advice. We sought to learn what changes we could make to existing applications, to the clinical workflow, and to clinicians' perceptions that would improve problem list utilization and increase the prevalence of problems data in the electronic medical record...
March 14, 2018: Journal of the American Medical Informatics Association: JAMIA
Lois D Hedman, Lori Quinn, Kathleen Gill-Body, David A Brown, Myla Quiben, Nora Riley, Patricia L Scheets
BACKGROUND AND PURPOSE: The APTA recently established a vision for physical therapists to transform society by optimizing movement to promote health and wellness, mitigate impairments, and prevent disability. An important element of this vision entails the integration of the movement system into the profession, and necessitates the development of movement system diagnoses by physical therapists. At this point in time, the profession as a whole has not agreed upon diagnostic classifications or guidelines to assist in developing movement system diagnoses that will consistently capture an individual's movement problems...
April 2018: Journal of Neurologic Physical Therapy: JNPT
Tim Michael Feenstra, Chris Dickhoff, Jaap Deunk
PURPOSE: Tube thoracostomy is frequently used in thoracic trauma patients. However, there is no consensus on whether low pressure suction or water seal is the optimal method of tube management. Against this background, we performed a systematic review of studies comparing suction and water seal management of chest tubes placed for traumatic chest injuries in adults. Evaluated outcomes are duration of chest tube treatment, length of stay in hospital, incidence of persistent air leak, clotted hemothorax, and the need for (re-)interventions...
March 15, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
V Schwenger, D Kindgen-Milles, C Willam, A Jörres, W Druml, D Czock, S J Klein, M Oppert, M Schmitz, J T Kielstein, A Zarbock, M Joannidis, S John
BACKGROUND: Acute kidney injury (AKI) is a common complication in intensive care unit (ICU) patients. The incidence of AKI in ICU patients exceeds 50% and the associated morbidity and mortality rates increase with severity of AKI. In addition, long-term consequences of AKI are underestimated and several studies show impaired long-term outcome after AKI. In about 5-25% of ICU patients with AKI renal replacement therapy (RRT) is required. OBJECTIVES: To assist in indication, timing, modality and application of renal replacement therapy of adult patients, current recommendations from the renal sections of the DGIIN (Deutschen Gesellschaft für Internistische Intensivmedizin und Notfallmedizin), ÖGIAIN (Österreichischen Gesellschaft für Internistische und Allgemeine Intensivmedizin und Notfallmedizin) and DIVI (Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin) are stated...
March 15, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Benjamin D Smith, Jennifer R Bellon, Rachel Blitzblau, Gary Freedman, Bruce Haffty, Carol Hahn, Francine Halberg, Karen Hoffman, Kathleen Horst, Jean Moran, Caroline Patton, Jane Perlmutter, Laura Warren, Timothy Whelan, Jean L Wright, Reshma Jagsi
INTRODUCTION: The purpose of this guideline is to offer recommendations on fractionation for whole breast irradiation (WBI) with or without a tumor bed boost and guidance on treatment planning and delivery. METHODS AND MATERIALS: The American Society for Radiation Oncology (ASTRO) convened a task force to address 5 key questions focused on dose-fractionation for WBI, indications and dose-fractionation for tumor bed boost, and treatment planning techniques for WBI and tumor bed boost...
March 8, 2018: Practical Radiation Oncology
Anita H Clayton, Irwin Goldstein, Noel N Kim, Stanley E Althof, Stephanie S Faubion, Brooke M Faught, Sharon J Parish, James A Simon, Linda Vignozzi, Kristin Christiansen, Susan R Davis, Murray A Freedman, Sheryl A Kingsberg, Paraskevi-Sofia Kirana, Lisa Larkin, Marita McCabe, Richard Sadovsky
The International Society for the Study of Women's Sexual Health process of care (POC) for management of hypoactive sexual desire disorder (HSDD) algorithm was developed to provide evidence-based guidelines for diagnosis and treatment of HSDD in women by health care professionals. Affecting 10% of adult females, HSDD is associated with negative emotional and psychological states and medical conditions including depression. The algorithm was developed using a modified Delphi method to reach consensus among the 17 international panelists representing multiple disciplines...
March 9, 2018: Mayo Clinic Proceedings
Mark T Corkum, Wei Liu, David A Palma, Glenn S Bauman, Robert E Dinniwell, Andrew Warner, Mark V Mishra, Alexander V Louie
BACKGROUND: Cancer patients frequently search the Internet for treatment options, and hospital websites are seen as reliable sources of knowledge. Guidelines support the use of proton radiotherapy in specific disease sites or on clinical trials. This study aims to evaluate direct-to-consumer advertising content and claims made by proton therapy centre (PTC) websites worldwide. METHODS: Operational PTC websites in English were identified through the Particle Therapy Co-Operative Group website...
March 15, 2018: Radiation Oncology
Peter Kranke, Sergio D Bergese, Harold S Minkowitz, Timothy I Melson, David G Leiman, Keith A Candiotti, Ngai Liu, Leopold Eberhart, Ashraf S Habib, Jan Wallenborn, Anthony L Kovac, Pierre Diemunsch, Gabriel Fox, Tong J Gan
BACKGROUND: Postoperative nausea and vomiting causes distress for patients and can prolong care requirements. Consensus guidelines recommend use of multiple antiemetics from different mechanistic classes as prophylaxis in patients at high risk of postoperative nausea and vomiting. The prophylactic efficacy of the dopamine D2/D3 antagonist amisulpride in combination with other antiemetics was investigated. METHODS: This double-blind, randomized, placebo-controlled, international, multicenter trial was conducted in 1,147 adult surgical patients having three or four postoperative nausea and vomiting risk factors...
March 15, 2018: Anesthesiology
H-H Brackmann, G C White, E Berntorp, T Andersen, C Escuriola-Ettingshausen
Development of inhibitory antibodies to infused factor VIII (FVIII) concentrates continues to be the most serious complication of haemophilia A management. Induction of immune tolerance by administering high doses of FVIII concentrate (antigen) and prothrombin complex concentrates to control bleeding was originated in the 1970s in Bonn, Germany, by Dr Hans-Hermann Brackmann, and became known as the Bonn protocol. ITI transformed the life of the index patient, who was 19 years of age when he began treatment, and dramatically improved the medical landscape for all patients with haemophilia and inhibitors...
April 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
R Cuthbert, C Deutsch, A Roy, P Stimpson, H Patel
Introduction The free jejunal flap represents the gold standard for circumferential defects in upper digestive tract reconstruction. It is a technically demanding procedure with significant failure rates. Unrecognised failure leads to flap necrosis and potentially fatal sequelae, including sepsis and carotid artery bleed. Despite these catastrophic consequences, however, there remains no consensus on an optimum method for postoperative flap monitoring. Our unit has pioneered the use of external colour duplex ultrasound to monitor flap vascularity...
March 15, 2018: Annals of the Royal College of Surgeons of England
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