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https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#1
Inge Hommel, Petra J van Gurp, Alfons A den Broeder, Hub Wollersheim, Femke Atsma, Marlies E J L Hulscher, Cees J Tack
As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care...
April 24, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28437764/the-use-of-lithium-for-the-treatment-of-bipolar-disorder-recommendations-from-clinical-practice-guidelines
#2
Gin S Malhi, Danielle Gessler, Tim Outhred
BACKGROUND: Lithium is an effective mood stabilizer that is used principally for the management of bipolar disorder (BD). Its administration is complex and often requires sophisticated management and assiduous monitoring. When considering the use of lithium therapy for bipolar disorder, clinicians are advised to refer to recommendations outlined in clinical practice guidelines (CPGs); but because of varying emphases placed by different international CPGs, recommendations addressing the practical use of lithium lack consistency...
March 27, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#3
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28437369/ethical-challenges-and-the-donation-physician-specialist-a-scoping-review
#4
Shavaun I MacDonald, Sam D Shemie
Deceased donation medicine involves unique ethical challenges. Physicians who are focused on deceased donation medicine as part of their practice can expect to encounter these challenges. The goal of this review is to identify and describe these challenges, highlight existing guidelines and policy regarding the management of these challenges and to describe how the donation physician role might promote ethical practice in deceased donation medicine. Themes of discussion include: communication with families, interprofessional conflict, donation physician personal characteristics, donation clinical processes, health resource allocation, research and education, and remuneration...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28437351/one-stage-posterior-spinal-osteotomy-in-severe-spinal-deformities-a-total-of-147-cases
#5
Lei Xia, Ning Li, Dan Wang, Ming Liu, Jun-Wei Li, De-Ming Bao, Peng Li
STUDY DESIGN: This is a retrospective study. OBJECTIVES: The treatment of severe spinal deformities is still a difficult surgical challenge. It is generally significant to identify the related complications performed to a consecutive series of patients with severe spinal deformity and managed by 1-stage posterior spinal osteotomy. SUMMARY OF BACKGROUND DATA: We investigated data from 147 consecutive patients (75 males and 72 females) with severe deformity and managed by Smith-Petersen osteotomy, pedicle subtraction osteotomy, or vertebral column resection between years 2006 and 2012 with >2-year follow-up...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28437329/metastatic-spinal-cord-compression-and-steroid-treatment-a-systematic-review
#6
Abhishek Kumar, Michael H Weber, Ziya Gokaslan, Jean-Paul Wolinsky, Meic Schmidt, Laurence Rhines, Michael G Fehlings, Ilya Laufer, Daniel M Sciubba, Michelle J Clarke, Narayan Sundaresan, Jorrit-Jan Verlaan, Arjun Sahgal, Dean Chou, Charles G Fisher
STUDY DESIGN: Systematic review. OBJECTIVES: We conducted a systematic review of the literature to answer the following questions regarding the use of steroid therapy in metastatic spinal cord compression (MSCC): 1. In cases of MSCC, what is the effect of steroid administration before definitive radiotherapy or surgery on ambulatory status, bowel and bladder function and survival? 2. What steroid dosing regimens are associated with the best outcomes concerning neurological symptoms and complication prevention in cases of MSCC? SUMMARY OF BACKGROUND DATA: Currently, there is significant variation in the initial bolus dose, daily maintenance dose and duration of treatment when steroids are used as a bridge to definitive therapy for MSCC...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28437236/temperature-variation-after-rewarming-from-deep-hypothermic-circulatory-arrest-is-associated-with-survival-and-neurologic-outcome
#7
Alessio Rungatscher, Giovanni Battista Luciani, Daniele Linardi, Elisabetta Milani, Leonardo Gottin, Beat Walpoth, Giuseppe Faggian
Therapeutic hypothermia is recommended by international guidelines after cardio-circulatory arrest. However, the effects of different temperatures during the first 24 hours after deep hypothermic circulatory arrest (DHCA) for aortic arch surgery on survival and neurologic outcome are undefined. We hypothesize that temperature variation after aortic arch surgery is associated with survival and neurologic outcome. In the period 2010-2014, a total of 210 consecutive patients undergoing aortic arch surgery with DHCA were included...
March 1, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/28436999/clinical-practice-guidelines-on-the-evidence-based-use-of-integrative-therapies-during-and-after-breast-cancer-treatment
#8
REVIEW
Heather Greenlee, Melissa J DuPont-Reyes, Lynda G Balneaves, Linda E Carlson, Misha R Cohen, Gary Deng, Jillian A Johnson, Matthew Mumber, Dugald Seely, Suzanna M Zick, Lindsay M Boyce, Debu Tripathy
Answer questions and earn CME/CNE Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance...
April 24, 2017: CA: a Cancer Journal for Clinicians
https://www.readbyqxmd.com/read/28436977/provision-of-long-term-monitoring-and-late-effects-services-following-adult-allogeneic-haematopoietic-stem-cell-transplant-a-survey-of-uk-nhs-based-programmes
#9
A Hamblin, D M Greenfield, M Gilleece, N Salooja, M Kenyon, E Morris, N Glover, P Miller, H Braund, A Peniket, B E Shaw, J A Snowden
Despite international guidelines, optimal delivery models of late effects (LE) services for HSCT patients are unclear from the clinical, organizational and economic viewpoints. To scope current LE service delivery models within the UK NHS (National Health Service), in 2014, we surveyed the 27 adult allogeneic HSCT centres using a 30-question online tool, achieving a 100% response rate. Most LE services were led and delivered by senior physicians (>80% centres). Follow-up was usually provided in a dedicated allograft or LE clinic for the first year (>90% centres), but thereafter attrition meant that only ~50% of patients were followed after 5 years...
April 24, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28436725/the-impact-of-medication-adherence-on-clinical-outcomes-of-coronary-artery-disease-a-meta-analysis
#10
Liping Du, Zhongwei Cheng, Yuxuan Zhang, Ying Li, Dan Mei
Background Long-term use of evidence-based medications is recommended by international guidelines for the management of stable coronary artery disease, however, non-adherence to medications is common. This meta-analysis aims to systematically evaluate the impact of medication adherence on clinical outcomes in patients with stable coronary artery disease. Methods Articles from January 1960-December 2015 were retrieved from the MEDLINE and EMBASE databases without any language restriction. A meta-analysis was performed to investigate the risk ratios of all-cause mortality, cardiovascular mortality, and myocardial infarction/hospitalization between groups with good medication adherence and poor medication adherence...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28436601/management-of-skin-adverse-events-associated-with-immune-checkpoint-inhibitors-in-patients-with-melanoma-a-nursing-perspective
#11
Melissa Thebeau, Krista Rubin, Matthias Hofmann, Julia Grimm, Alyona Weinstein, Jennifer N Choi
PURPOSE: Immune checkpoint inhibitors are associated with a unique immune-related side effect profile that requires prompt recognition and management. Skin toxicities are the most common, and often earliest occurring, drug-related adverse events (AEs) of any grade observed upon treatment with these agents. The purpose of this review is to provide practical guidance on the identification and treatment of skin AEs associated with the immune checkpoint inhibitors (ipilimumab, nivolumab, and pembrolizumab) from a nursing perspective, and demonstrate hands-on application of the guidance using relevant patient case studies...
April 24, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28436206/clinical-practice-guidelines-on-iron-therapy-a-critical-evaluation
#12
Lucia Del Vecchio, Francesco Locatelli
Anemia is common among patients with chronic kidney disease (CKD) and it is managed primarily with erythropoiesis-stimulating agents (ESA) and iron therapy. Following concerns around ESA therapy and economic constraints, IV iron is more and more administered worldwide. Several guidelines or position papers, which give indications on iron therapy in CKD patients, have been issued in Nephrology. Unfortunately, the field is characterized by a lack of evidence. As a result, the recommendations/suggestions are not uniform...
April 24, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28435321/a-behavioral-medicine-intervention-for-community-dwelling-older-adults-with-chronic-musculoskeletal-pain-protocol-for-a-randomized-controlled-trial
#13
Sara Cederbom, Eva Denison, Astrid Bergland
BACKGROUND: Chronic musculoskeletal pain is a major health problem among older adults, particularly those who live alone and/or those who are dependent on formal care. Chronic pain is associated with mobility problems, falls, fear of falling, catastrophizing thoughts, and a lower quality of life. Research shows that physical therapy interventions based on behavioral medicine approaches are beneficial for middle-aged adults with chronic pain. However, there appears to be no previous randomized controlled trials (RCTs) based on this theoretical framework that have examined the effect on older adults with chronic musculoskeletal pain who live alone at home and are dependent on formal care to manage their everyday lives...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28435313/evidence-and-consensus-recommendations-for-the-pharmacological-management-of-pain-in-india
#14
REVIEW
Gur Prasad Dureja, Rajagopalan N Iyer, Gautam Das, Jaishid Ahdal, Prashant Narang
Despite enormous progress in the field of pain management over the recent years, pain continues to be a highly prevalent medical condition worldwide. In the developing countries, pain is often an undertreated and neglected aspect of treatment. Awareness issues and several misconceptions associated with the use of analgesics, fear of adverse events - particularly with opioids and surgical methods of analgesia - are major factors contributing to suboptimal treatment of pain. Untreated pain, as a consequence, is associated with disability, loss of income, unemployment and considerable mortality; besides contributing majorly to the economic burden on the society and the health care system in general...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28434913/development-of-school-based-asthma-management-programs-in-rochester-ny
#15
REVIEW
Jill S Halterman, Reynaldo Tajon, Paul Tremblay, Maria Fagnano, Arlene Butz, Tamara Perry, Ken McConnochie
In the spirit of Dr. Haggerty's teachings, we present an overview of our work to improve care for children with asthma in the context of 3 lessons learned:(1) 1) The importance of providing integrated services across disciplinary boundaries for children with chronic illness, 2) The need to move from a care model focused only on the individual child to a model focused on the child, family, and community, and 3) The need to expand beyond the local community and take a broad perspective on improving health on a national level...
April 18, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28434844/quality-and-value-of-subspecialty-reinterpretation-of-thoracic-ct-scans-of-patients-referred-to-a-tertiary-cancer%C3%A2-center
#16
Brett W Carter, Jeremy J Erasmus, Mylene T Truong, Jo-Anne O Shepard, Wayne Hofstetter, Ryan Clarke, Reginald F Munden, Joseph R Steele
INTRODUCTION: Patients referred to tertiary cancer centers often present with imaging studies performed and interpreted at other health care institutions. Although reinterpretation of imaging performed at another health care institution can reduce repeat imaging, unnecessary radiation dose, and cost, the benefit is uncertain. The purpose of this study is to evaluate the quality of initial imaging studies of patients seeking a second opinion at a tertiary cancer center, to compare the accuracy of initial interpretations to reinterpretations performed by subspecialty trained radiologists at a tertiary oncologic center, and to determine the potential impact on patient management...
April 20, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28434484/practical-aspects-in-the-management-of-statin-associated-muscle-symptoms-sams
#17
Ulrich Laufs, Krysztof J Filipiak, Ioanna Gouni-Berthold, Alberico L Catapano
BACKGROUND AND AIMS: Statin-associated muscle symptoms (SAMS) frequently cause statin non-adherence, switching and discontinuation, contributing to adverse cardiovascular (CV) outcomes. Therefore, the management of SAMS is key in the effective treatment of patients with cardiovascular disease (CVD), through achievement of maximum-tolerated statin dosing and other practical aspects. The aim of this article is to provide practical, focused advice for healthcare professionals on the management of patients with SAMS...
April 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/28434482/how-to-implement-clinical-guidelines-to-optimise-familial-hypercholesterolaemia-diagnosis-and-treatment
#18
Michel Farnier, Fernando Civeira, Olivier Descamps
BACKGROUND AND AIMS: Familial hypercholesterolaemia (FH) is a genetic disorder associated with significantly elevated plasma low-density lipoprotein cholesterol (LDL-C) and premature coronary heart disease (CHD). Optimal management of FH relies on early identification and treatment with statins alone or in combination with other lipid-lowering therapies. A lack of awareness of FH and its manifestations among primary care physicians and specialists has led to many individuals being misdiagnosed in the early stages of the disease, further increasing the risk of CHD and requiring much more intensive lipid-lowering strategies...
April 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/28434181/management-options-for-biochemically-recurrent-prostate-cancer
#19
REVIEW
Farhad Fakhrejahani, Ravi A Madan, William L Dahut
Prostate cancer is the most common solid tumor malignancy in men worldwide. Treatment with surgery and radiation can be curative in organ-confined disease. Unfortunately, about one third of men develop biochemically recurrent disease based only on rising prostate-specific antigen (PSA) in the absence of visible disease on conventional imaging. For these patients with biochemical recurrent prostate cancer, there is no uniform guideline for subsequent management. Based on available data, it seems prudent that biochemical recurrent prostate cancer should initially be evaluated for salvage radiation or prostatectomy, with curative intent...
May 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28434087/hepatitis-b-during-pregnancy-in-endemic-areas-screening-treatment-and-prevention-of-mother-to-child-transmission
#20
Naichaya Chamroonkul, Teerha Piratvisuth
The proper management of pregnant women infected with hepatitis B virus (HBV) is necessary to prevent maternal and fetal morbidity and mortality and to protect the baby from HBV infection. In the majority of cases, vertical transmission can be prevented with a universal screening program, HBV vaccine immunoprophylaxis, and administration of hepatitis B immunoglobulin (HBIg) for babies born to mothers with HBV. However, in mothers with a high viral load (>200,000 or >1,000,000 IU/ml, depending on the guideline), the chance of immunoprophylaxis failure remains high...
April 22, 2017: Paediatric Drugs
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