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Guidelines for management

Ming-Jie Kuang, Chao Han, Jian-Xiong Ma, Fei Li, Jie Zhao, Lin Fu, Xin-Long Ma
PURPOSE: Autologous platelet gel, developed from fresh autologous blood, is a breakthrough in the promotion and acceleration of soft tissue and bone repair. The application of autologous platelet gel has been reported to improve haemostasis and promote function recovery. We screened the randomized controlled trials and controlled clinical trials of high quality to investigate whether autologous platelet gel makes a better performance for postoperative bleeding and functional recovery in patients after total knee arthroplasty...
October 19, 2016: International Journal of Surgery
Andrew Jeyaruban, Muriel Soden, Sarah Larkins
To examine the management of gout in general practice in Townsville, Australia, and to explore comorbid conditions in patients with gout. Study will also explore how closely guidelines are being followed in managing gout. Retrospective chart review was conducted from May to November 2014 in three general practices in Townsville. Registers for patients were established by searching "gout" and "gouty arthritis". Three hundred and twenty-one patients were included in the study after excluding inactive patients, patients below age of 18 and patients with cancer...
October 21, 2016: Rheumatology International
Jennifer C Cook, Richard H Tran, J Herbert Patterson, Jo E Rodgers
PURPOSE: The pharmacology, clinical efficacy, and safety profiles of evolving therapies for the management of chronic heart failure (HF) and acute decompensated heart failure (ADHF) are described. SUMMARY: HF confers a significant financial burden despite the widespread use of traditional guideline-directed medical therapies such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, and aldosterone receptor antagonists, and the rates of HF-related mortality and hospitalization have remained unacceptably high...
November 1, 2016: American Journal of Health-system Pharmacy: AJHP
Jayd Lukenchuk, Laura A Sims, Jason J Shin
PURPOSE: The purpose of this study was to quantify the degree of variability in outcomes assessed after surgery for anterior shoulder instability in recent high-impact literature. METHODS: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, an extensive review of the literature during a 5-year period from January 2011 through December 2015 was performed across 6 orthopaedic journals with high impact factors to identify all studies investigating outcomes after anterior shoulder instability...
October 18, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Zainab Khan, Jordan Milko, Munir Iqbal, Moness Masri, David R P Almeida
OBJECTIVE: To investigate the power of unpaired t tests in prospective, randomized controlled trials when these tests failed to detect a statistically significant difference and to determine the frequency of type II errors. DESIGN: Systematic review and meta-analysis. METHODS: We examined all prospective, randomized controlled trials published between 2010 and 2012 in 4 major ophthalmology journals (Archives of Ophthalmology, British Journal of Ophthalmology, Ophthalmology, and American Journal of Ophthalmology)...
October 2016: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Michèle M Kislan, Adam T Bernstein, Loretta R Fearrington, Timothy J Ives
BACKGROUND: Clinical Pharmacist Practitioners are advanced practicing pharmacists in North Carolina that provide disease-specific management. The purpose of this retrospective cohort study was to compare the efficacy and charges from referrals to a Clinical Pharmacist Practitioner by the primary care provider, to those managed by a primary care provider alone. METHODS: Patients were separated into cohorts depending if they had at least two appointments with a Clinical Pharmacist Practitioner from November 2008 to November 2011...
October 21, 2016: BMC Health Services Research
Elli Toivonen, Outi Palomäki, Heini Huhtala, Jukka Uotila
BACKGROUND: The safety of vaginal breech delivery has been debated for decades. Although it has been shown to predispose infants to immediate depression, several observational studies have also shown that attempting vaginal breech delivery does not increase perinatal morbidity or low Apgar score at the age of five minutes. Cardiotocography monitoring is recommended during vaginal breech delivery, but comparative data describing differences between cardiotocography tracings in breech and vertex deliveries is scarce...
October 21, 2016: BMC Pregnancy and Childbirth
Bharat V Shah, Zamurrud M Patel
BACKGROUND: Chronic kidney disease (CKD) is a worldwide public health problem and more so in India. With limited availability and high cost of therapy, barely 10 % of patients with incident end stage renal disease (ESRD) cases get treatment in India. Therefore, all possible efforts should be made to retard progression of CKD. This article reviews the role of low protein diet (LPD) in management of CKD subjects and suggests how to apply it in clinical practice. DISCUSSION: The role of LPD in retarding progression of CKD is well established in animal experimental studies...
October 21, 2016: BMC Nephrology
Verinder Sharma, Sapna Sharma
Many women with bipolar disorder experience significant morbidity during pregnancy and the postpartum period. The use of evidence-based and up-to-date guidelines has the potential to improve maternal and neonatal care. We review the latest clinical practice guidelines to gather recommendations for the peripartum management of bipolar disorder. Areas covered: Three electronic databases, MEDLINE/PubMed, the Cochrane Library, and the National Guidelines Clearinghouse were searched using various combinations of the following terms: bipolar disorder, pregnancy, postpartum, peripartum, puerperal, antenatal, postnatal, and guidelines...
October 21, 2016: Expert Review of Neurotherapeutics
Gregory Plotnikoff, Melissa Barber
INTRODUCTION: Single-disorder or single-organ-system clinical practice guidelines are often of limited usefulness in guiding effective management of patients with chronic multidimensional signs and symptoms. The presence of multiple long-standing medical problems in a given patient despite intensive medical effort suggests that addressing systemic core imbalances could complement more narrowly focused approaches. CASE PRESENTATION: A 72-year-old man experiencing longstanding depression, fatigue, irritable bowel syndrome, and chronic pain in the context of additional refractory illnesses was assessed and treated, guided by a system-oriented approach to underlying core imbalances termed functional medicine...
October 14, 2016: Permanente Journal
Olga Tursunov, Nathan I Cherny, Freda DeKeyser Ganz
PURPOSE/OBJECTIVES: To describe the experience of family members of patients receiving palliative sedation at the initiation of treatment and after the patient has died and to compare these experiences over time.
. DESIGN: Descriptive comparative study.
. SETTING: Oncology ward at Shaare Zedek Medical Center in Jerusalem, Israel.
. SAMPLE: A convenience sample of 34 family members of dying patients receiving palliative sedation...
November 1, 2016: Oncology Nursing Forum
Kai-Che Wei, Kuo-Chung Yang, Lee-Wei Chen, Wen-Chung Liu, Wen-Chieh Chen, Wen-Yen Chiou, Ping-Chin Lai
With increasing use of cardiac fluoroscopic intervention, the incidence of fluoroscopy-induced radiation ulcer is increasing. Radiation ulcer is difficult to manage and currently there are no treatment guidelines. To identify the optimal treatment approaches for managing cardiac fluoroscopy-induced radiation ulcers, we retrospectively reviewed medical records of 13 patients with fluoroscopy-induced radiation ulcers receiving surgical interventions and following up in our hospital from 2012 to 2015. Conventional wound care and hyperbaric oxygen therapy were of little therapeutic benefit...
October 21, 2016: Scientific Reports
James Tattersall
Current guidelines focus on conventional dialysis defined as 3-5 hours, three times per week, and suggest that longer or more frequent dialysis be considered. This paper presents the case for considering that shorter or less frequent dialysis should also be considered. More frequent and/or longer dialysis facilitates control of fluid overload, blood pressure, and phosphate levels. These benefits will require time to translate into probable hard outcome improvement. Patients are unlikely to participate in productive or pleasurable activities while undergoing dialysis in center or traveling to treatment...
October 20, 2016: Seminars in Dialysis
Federico Coccolini, Fausto Catena, Ernest E Moore, Rao Ivatury, Walter Biffl, Andrew Peitzman, Raul Coimbra, Sandro Rizoli, Yoram Kluger, Fikri M Abu-Zidan, Marco Ceresoli, Giulia Montori, Massimo Sartelli, Dieter Weber, Gustavo Fraga, Noel Naidoo, Frederick A Moore, Nicola Zanini, Luca Ansaloni
The severity of liver injuries has been universally classified according to the American Association for the Surgery of Trauma (AAST) grading scale. In determining the optimal treatment strategy, however, the haemodynamic status and associated injuries should be considered. Thus the management of liver trauma is ultimately based on the anatomy of the injury and the physiology of the patient. This paper presents the World Society of Emergency Surgery (WSES) classification of liver trauma and the management Guidelines...
2016: World Journal of Emergency Surgery: WJES
Siavash Piran, Sam Schulman
Venous thromboembolism (VTE), which constitutes pulmonary embolism and deep vein thrombosis, is a common disorder associated with significant morbidity and mortality. Landmark trials have shown that direct oral anticoagulants (DOACs) are as effective as conventional anticoagulation with vitamin K antagonists (VKA) in prevention of VTE recurrence and associated with less bleeding. This has paved the way for the recently published guidelines to change their recommendations in favor of DOACs in acute and long-term treatment of VTE in patients without cancer...
2016: Thrombosis Journal
H G Schnürch, S Ackermann, C D Alt, J Barinoff, C Böing, C Dannecker, F Gieseking, A Günthert, P Hantschmann, L C Horn, R Kürzl, P Mallmann, S Marnitz, G Mehlhorn, C C Hack, M C Koch, U Torsten, W Weikel, L Wölber, M Hampl
Purpose: This is an official guideline, published and coordinated by the Arbeitsgemeinschaft Gynäkologische Onkologie (AGO, Study Group for Gynecologic Oncology) of the Deutsche Krebsgesellschaft (DKG, German Cancer Society) and the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe (DGGG, German Society for Gynecology and Obstetrics). The number of cases with vulvar cancer is on the rise, but because of the former rarity of this condition and the resulting lack of literature with a high level of evidence, in many areas knowledge of the optimal clinical management still lags behind what would be required...
October 2016: Geburtshilfe und Frauenheilkunde
B Verillaud, L Robard, J Michel, V Pruliere Escabasse, E Béquignon, L Crampette, O Malard
OBJECTIVES: The authors present the guidelines of the French Oto-Rhino-Laryngology - Head and Neck Surgery Society (Société Française d'Oto-Rhino-Laryngologie et de Chirurgie de la Face et du Cou: SFORL) on second-line treatment of epistaxis in adults, after failure of anterior and/or anterior-posterior nasal packing. METHODS: A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience...
October 17, 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
Luis Sagaon-Teyssier, Sauman Singh, Boniface Dongmo-Nguimfack, Jean-Paul Moatti
INTRODUCTION: This study aims to provide a landscape of the global antiretroviral (ARV) market by analyzing the transactional data on donor-funded ARV procurement between 2003 and 2015, and the ARV price determinants. DESIGN: The data were obtained from the Global Price Reporting Mechanism (GPRM) managed by the AIDS Medicines and Diagnostics Service of the WHO, and it consists of information that covers approximately 80% of the total donor-funded adult ARV transactions procurement...
2016: Journal of the International AIDS Society
Songyuan Tang, Weiming Tang, Kathrine Meyers, Polin Chan, Zhongdan Chen, Joseph D Tucker
BACKGROUND: Despite global efforts to control HIV among key populations, new infections among men who have sex with men (MSM) and transgender (TG) individuals are still increasing. The increasing HIV epidemic among MSM/TG in China indicates that more effective services are urgently needed. However, policymakers and program managers must have a clear understanding of MSM/TG sexual health in China to improve service delivery. To meet this need, we undertook a scoping review to summarize HIV epidemiology and responses among MSM and TG individuals in China...
October 20, 2016: BMC Infectious Diseases
Olga Calcagnile, Anders Anell, Johan Undén
BACKGROUND: Mild traumatic brain injury (TBI) is associated with substantial costs due to over-triage of patients to computed tomography (CT) scanning, despite validated decision rules. Serum biomarker S100B has shown promise for safely omitting CT scans but the economic impact from clinical use has never been reported. In 2007, S100B was adapted into the existing Scandinavian management guidelines in Halmstad, Sweden, in an attempt to reduce CT scans and save costs. METHODS: Consecutive adult patients with mild TBI (GCS 14-15, loss of consciousness and/or amnesia), managed with the aid of S100B, were prospectively included in this study...
October 20, 2016: BMC Neurology
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