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uptodate guidelines

David A Brent, Robert D Gibbons, Paul Wilkinson, Bernadka Dubicka
In this paper, we summarise and critique a network meta-analysis (NMA) of antidepressant efficacy and tolerability for paediatric depression and an accompanying editorial. Although we agree that many of the extant studies are flawed, this meta-analysis showed clear efficacy of fluoxetine in the NMA, and for sertraline and escitalopram in pairwise analyses. Consequently, these papers underestimate the benefits of antidepressants for paediatric depression, and provide support for current practice guideline, which recommends the use of an antidepressant if the patient does not respond to psychotherapy...
February 2018: BJPsych Bulletin
Nibal Abunahlah, Anfal Elawaisi, Fatih Mehmet Velibeyoglu, Mesut Sancar
Background Drug-related problems (DRPs) interfere with patient optimal therapeutic outcomes and may be associated with higher morbidity, mortality and healthcare expenditures. Objective This study aimed to identify DRPs and their causes in a Turkish hospital. Setting Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital, Internal Medicine Ward, Istanbul, Turkey. Method Cross-sectional study included a total of 100 patients. Patient demographics, medications, and history were evaluated. Data regarding recent medications were analyzed by two clinical pharmacists and an Internal Medicine physician...
January 29, 2018: International Journal of Clinical Pharmacy
Thomas Agoritsas, Arnaud Merglen, Anja Fog Heen, Annette Kristiansen, Ignacio Neumann, Juan P Brito, Romina Brignardello-Petersen, Paul E Alexander, David M Rind, Per O Vandvik, Gordon H Guyatt
INTRODUCTION: UpToDate is widely used by clinicians worldwide and includes more than 9400 recommendations that apply the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. GRADE guidance warns against strong recommendations when certainty of the evidence is low or very low (discordant recommendations) but has identified five paradigmatic situations in which discordant recommendations may be justified. OBJECTIVES: Our objective was to document the strength of recommendations in UpToDate and assess the frequency and appropriateness of discordant recommendations...
November 16, 2017: BMJ Open
Fang-Tzu Lin, Tsai-Rung Lin, Chia-Wei Liao, Shu-Hui Chen
BACKGROUND: Preoperative anesthesia long time fasting, may increase patient hemodynamic instability during surgery and may affect the patient's post-surgery electrolyte balance. No meta-analysis has been conducted to explore the effects of preoperative liquid intake amount on gastric fluid PH, gastric fluid volume, surgery inhalation of pulmonary complications, and patient self-perceptions quality of care systematic review and meta-analysis of the literature. PURPOSE: To assess the pros and cons of preoperative liquid intake using a systematic review of the literature...
August 2017: Hu Li za Zhi the Journal of Nursing
N Cockburn, A Pradhan, M W Taing, S Kisely, P J Ford
BACKGROUND: Many psychotropic medications affect oral health. This review identified oral side effects for antidepressant, antipsychotic, anticonvulsant, antianxiety and sedative drugs that are recommended in Australia for the management of common mental illnesses and provides recommendations to manage these side-effects. METHODS: The Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat common mental health conditions...
December 1, 2017: Journal of Affective Disorders
D Pagliari, A Saviano, M L Serricchio, A A Dal Lago, M G Brizi, F Lanza, R Manfredi, A Gasbarrini, F Attili
Intraductal Papillary Mucinous Neoplasms (IPMNs) are the most common cystic tumors of the pancreas and are considered premalignant lesions. IPMNs are characterized by the papillary growth of the ductal epithelium with rich mucin production, which is responsible for cystic segmental or diffuse dilatation of the main pancreatic duct (MPD) and/or its branches. According to the different involvement of pancreatic duct system, IPMNs are divided into main duct type (MD-IPMN), branch duct type (BD-IPMN), and mixed type (MT-IPMN)...
June 2017: European Review for Medical and Pharmacological Sciences
Ozra Tabatabaei-Malazy, Pooneh Salari, Patricia Khashayar, Bagher Larijani
BACKGROUND: Prevalence of osteoporosis is increasing both in developed and developing countries. Due to rapid growth in the burden and cost of osteoporosis, worldwide, it seems reasonable to focus on the reduction of fractures as the main goal of treatment. Although, efficient pharmacological agents are available for the treatment of osteoporosis, there still remains a need to more specific drugs with less adverse effects. MAIN BODY: This review article provides a brief update on the pathogenesis, presenting current pharmacological products approved by the US Food and Drug Administration (FDA) or Europe, and also newer therapeutic agents to treat osteoporosis according to the clinical trial data available at PubMed, UpToDate, International Osteoporosis Foundation (IOF), and clinical practice guidelines...
February 7, 2017: Daru: Journal of Faculty of Pharmacy, Tehran University of Medical Sciences
P Reif, C Brezinka, T Fischer, P Husslein, U Lang, A Ramoni, H Zeisler, P Klaritsch
The new expert recommendation from the Austrian Society of Obstetrics and Gynaecology (OEGGG) comprises an interpretation and summary of guidelines from the leading specialist organisations worldwide (RCOG, ACOG, SOGC, CNGOF, WHO, NIH, NICE, UpToDate). In essence it outlines alternatives to the direct pathway to elective repeat caesarean section (ERCS). In so doing it aligns with international trends, according to which a differentiated, individualised clinical approach is recommended that considers benefits and risks to both mother and child, provides detailed counselling and takes the patient's wishes into account...
December 2016: Geburtshilfe und Frauenheilkunde
Joshua D Wallach, Patrick G Sullivan, John F Trepanowski, Ewout W Steyerberg, John P A Ioannidis
OBJECTIVE:  To evaluate the frequency, validity, and relevance of statistically significant (P<0.05) sex-treatment interactions in randomized controlled trials in Cochrane meta-analyses. DESIGN:  Meta-epidemiological study. DATA SOURCES:  Cochrane Database of Systematic Reviews (CDSR) and PubMed. ELIGIBILITY CRITERIA FOR STUDY SELECTION:  Reviews published in the CDSR with sex-treatment subgroup analyses in the forest plots, using data from randomized controlled trials...
November 24, 2016: BMJ: British Medical Journal
G Ordaz-Jurado, A Budía-Alba, P Bahilo-Mateu, J D López-Acón, M Trassierra-Villa, F Boronat-Tormo
OBJECTIVE: Double J ureteral stents are frequently used to allow free diuresis from the kidney to the bladder, but their presence has a major impact on patient's quality of life (QoL). Our aim is to describe such impact, and to describe possible solutions that can alleviate the symptoms associated with their use. METHODS: Systematic search in bibliographic sources including Cochrane library, UpToDate, Pubmed, Tripdatabase, selecting publications between 2000- 2015, and also the EAU European guidelines (2016)...
October 2016: Archivos Españoles de Urología
Soudabeh Khodambashi, Heidi Gilstad, Øystein Nytrø
Publishing clinical guidelines (GLs) on the web increases their accessibility. However, evaluating their usability and understanding how users interact with the websites has been neglected. In this study we used Tobii eye-tracker to analyse users' interaction with five commercial and public GL sites popular in Norway (four in Norwegian and one English of US origin (UpToDate)). We measured number of clicks and usage rate for search functions, task completion time, users' objective and perception of task success rate...
2016: Studies in Health Technology and Informatics
Anne Siri Johnsen, Sabina Fattah, Stephen J M Sollid, Marius Rehn
OBJECTIVE: This systematic review identifies, describes and appraises the literature describing the utilisation of helicopter emergency medical services (HEMS) in the early medical response to major incidents. SETTING: Early prehospital phase of a major incident. DESIGN: Systematic literature review performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Web of Science, PsycINFO, Scopus, Cinahl, Bibsys Ask, Norart, Svemed and UpToDate were searched using phrases that combined HEMS and 'major incidents' to identify when and how HEMS was utilised...
February 9, 2016: BMJ Open
Eric S Secrist, Kevin B Freedman, Michael G Ciccotti, Donald W Mazur, Sommer Hammoud
BACKGROUND: Effective pain management after anterior cruciate ligament (ACL) reconstruction improves patient satisfaction and function. PURPOSE: To collect and evaluate the available evidence from randomized controlled trials (RCTs) on pain control after ACL reconstruction. STUDY DESIGN: Systematic review. METHODS: A systematic literature review was performed using PubMed, Medline, Google Scholar, UpToDate, Cochrane Reviews, CINAHL, and Scopus following PRISMA guidelines (July 2014)...
September 2016: American Journal of Sports Medicine
Celia González Guerrero, José Bruno Montoro Ronsano
OBJECTIVES: to develop the different factors involved in the physiopathology of trauma-induced coagulopathy, through a review of publications on the matter; as well as to assess the evidence available on the treatment of critical bleeding and the recommendations by clinical practice guidelines. METHODS: a search has been conducted on the bibliography published about the physiopathology and treatment of critical bleeding in the PUBMED, BestPractice, UpToDate databases and the Cochrane Plus Library...
November 1, 2015: Farmacia Hospitalaria
Rocío Dominguez Álvarez, Justo Calderón Carrasco, Francisco García Colchero, Salvador Postigo Mota, Eulalia Alburquerque Medina
OBJECTVE: To achieve well-being in patients in Palliative Care is required to know which are the most common symptoms, which are the drugs used for relief, which are the routes of administration of drugs that are suitable, how effective the drugs are and what incompatibilities, interactions and adverse effects occur. The aim of this article is to review the relevant issues in the management of the drugs commonly used by nursing in Palliative Care and presenting recommendations to clinical practice...
January 2015: Revista de Enfermería
Timothy J Wilt, Russell P Harris, Amir Qaseem
BACKGROUND: Cancer screening is one approach to reducing cancer-related morbidity and mortality rates. Screening strategies vary in intensity. Higher-intensity strategies are not necessarily higher value. High-value strategies provide a degree of benefits that clearly justifies the harms and costs incurred; low-value screening provides limited or no benefits to justify the harms and costs. When cancer screening leads to benefits, an optimal intensity of screening maximizes value. Some aspects of screening practices, especially overuse and underuse, are low value...
May 19, 2015: Annals of Internal Medicine
Sigrid Beitland, Irene Sandven, Lill-Kristin Kjærvik, Per Morten Sandset, Kjetil Sunde, Torsten Eken
PURPOSE: To compare benefits and harms of low molecular weight heparin (LMWH) versus unfractionated heparin (UFH) as thromboprophylaxis in intensive care unit (ICU) patients. METHODS: We conducted a systematic review with meta-analysis and trial sequential analysis (TSA) of randomised controlled trials (RCTs) comparing LMWH with UFH as thromboprophylaxis in adult ICU patients. We searched Ovid Medline, PubMed, Embase, Cochrane Library, UpToDate, Guidelines International Network, PROSPERO and the metaRegister of Controlled Trials through 3 December 2014...
July 2015: Intensive Care Medicine
Alexandra S Ghadieh, Basem Saab
UNLABELLED: OBJECTIVE To provide recommendations on exercise training as part of the management of hypertension in adults.Quality of evidence Evidence was found through a systematic search of PubMed, MEDLINE, EMBASE, Agency for Healthcare Research and Quality evidence-based reports, Bandolier, Clinical Evidence, the Institute for Clinical Systems Improvement guidelines, the National Guideline Clearinghouse database, UpToDate,and the Cochrane Database of Systematic Reviews (part of Ovid Evidence Based Medicine Reviews) for articles published from January 1973 to September 2013...
March 2015: Canadian Family Physician Médecin de Famille Canadien
Carlos Manterola, Claudla Asenjo-Lobos, Tamara Otzen
There are multiple proposals and classifications that hierarchize evidence, which may confuse those who are dedicated to generate it both in health technology assessments, as for the development of clinical guidelines, etc. The aim of this manuscript is to describe the most commonly used classifications of levels of evidence and grades of recommendation, analyzing their main differences and applications so that the user can choose the one that better suits your needs and take this health decisions basing their practice on the best available evidence...
December 2014: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Andrea Párniczky, László Czakó, Zsolt Dubravcsik, Gyula Farkas, Péter Hegyi, István Hritz, Dezső Kelemen, Zita Morvay, Attila Oláh, Ákos Pap, Miklós Sahin-Tóth, Flóra Szabó, Zsolt Szentkereszti, Richárd Szmola, Tamás Takács, László Tiszlavicz, Gábor Veres, Ákos Szücs, Natália Lásztity
Pediatric pancreatitis is a rare disease with variable etiology. In the past 10-15 years the incidence of pediatric pancreatitis has been increased. The management of pediatric pancreatitis requires up-to-date and evidence based management guidelines. The Hungarian Pancreatic Study Group proposed to prepare an evidence based guideline based on the available international guidelines and evidences. The preparatory and consultation task force appointed by the Hungarian Pancreatic Study Group translated and complemented and/or modified the international guidelines if it was necessary...
February 22, 2015: Orvosi Hetilap
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