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Practice guidelines

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https://www.readbyqxmd.com/read/29691962/gastrointestinal-symptoms-in-children-primary-care-and-specialist-interface
#1
REVIEW
Valeria Dipasquale, Domenico Corica, Simone M C Gramaglia, Simona Valenti, Claudio Romano
AIMS: Gastrointestinal symptoms and diseases represent one of the major reasons for paediatricians' requests for specialist consultations and hospital admissions. One fourth of annual medical consultations for children younger than 6 years can be attributed to gastrointestinal symptoms. High-quality guidelines have been validated worldwide to provide clinical recommendations and support healthcare providers' practice. Nevertheless, overall compliance to standards of care is unsatisfactory, and children with gastrointestinal symptoms frequently undergo expensive, useless specialist consultations and laboratory evaluations...
April 24, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29691950/adapting-evidence-based-clinical-practice-guidelines-at-university-teaching-hospitals-a-model-for-the-eastern-mediterranean-region
#2
Yasser S Amer, Hayfaa A Wahabi, Manal M Abou Elkheir, Ghada A Bawazeer, Shaikh M Iqbal, Maher A Titi, Aishah Ekhzaimy, Khalid A Alswat, Rasmieh A Alzeidan, Lubna A Al-Ansary
RATIONALE, AIMS, AND OBJECTIVES: Clinical practice guidelines (CPGs) are significant tools for evidence-based health care quality improvement. The CPG program at King Saud University was launched as a quality improvement program to fulfil the international accreditation standards. This program was a collaboration between the Research Chair for Evidence-Based Healthcare and Knowledge Translation and the Quality Management Department. This study aims to develop a fast-track method for adaptation of evidence-based CPGs and describe results of the program...
April 24, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29691599/-primary-biliary-cholangitis-established-and-novel-therapies
#3
REVIEW
M Vetter, A E Kremer
BACKGROUND: Patients with primary biliary cholangitis (PBC, formerly primary biliary cirrhosis) and insufficient treatment response or risk factors exhibit a remarkably increased risk for disease progression and associated complications. Furthermore, extrahepatic manifestations may considerably reduce quality of life in affected patients. OBJECTIVES: This article presents an overview on standard therapy with ursodeoxycholic acid (UDCA) and further therapeutic options in patients with insufficient treatment response...
April 24, 2018: Der Internist
https://www.readbyqxmd.com/read/29691305/application-of-outpatient-cardiac-testing-among-emergency-department-patients-with-syncope
#4
Olivia G Cook, Muhammad A Mukarram, Soo-Min Kim, Kirtana Arcot, Marie-Joe Nemnom, Monica Taljaard, Marco L A Sivilotti, Brian H Rowe, Venkatesh Thiruganasambandamoorthy
OBJECTIVES: 2.6% of ED syncope patients will suffer cardiac serious adverse events (SAEs) within 30 days of disposition, and outpatient cardiac testing can improve patient safety. The objective is to determine whether outpatient cardiac testing for ED syncope patients is being appropriately ordered after discharge. To this end, we describe the proportion of high-risk and non-high (low and medium)-risk ED syncope patients as per the Canadian Syncope Risk Score (CSRS) who have a SAE after ED discharge, and the proportion referred for outpatient cardiac testing...
April 24, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29691276/asia-pacific-working-group-consensus-on-non-variceal-upper-gastrointestinal-bleeding-an-update-2018
#5
Joseph Jy Sung, Philip Cy Chiu, Francis K L Chan, James Yw Lau, Khean-Lee Goh, Lawrence Hy Ho, Hwoon-Young Jung, Jose D Sollano, Takuji Gotoda, Nageshwar Reddy, Rajvinder Singh, Kentaro Sugano, Kai-Chun Wu, Chun-Yin Wu, David J Bjorkman, Dennis M Jensen, Ernst J Kuipers, Angel Lanas
Non-variceal upper gastrointestinal bleeding remains an important emergency condition, leading to significant morbidity and mortality. As endoscopic therapy is the 'gold standard' of management, treatment of these patients can be considered in three stages: pre-endoscopic treatment, endoscopic haemostasis and post-endoscopic management. Since publication of the Asia-Pacific consensus on non-variceal upper gastrointestinal bleeding (NVUGIB) 7 years ago, there have been significant advancements in the clinical management of patients in all three stages...
April 24, 2018: Gut
https://www.readbyqxmd.com/read/29691206/designing-for-clinical-change-creating-an-intervention-to-implement-new-statin-guidelines-in-a-primary-care-clinic
#6
Melissa DeJonckheere, Claire H Robinson, Lindsey Evans, Julie Lowery, Bradley Youles, Adam Tremblay, Caitlin Kelley, Jeremy B Sussman
BACKGROUND: Recent clinical practice guidelines from major national organizations, including a joint United States Department of Veterans Affairs (VA) and Department of Defense (DoD) committee, have substantially changed recommendations for the use of the cholesterol-lowering statin medications after years of relative stability. Because statin medications are among the most commonly prescribed treatments in the United States, any change in their use may have significant implications for patients and providers alike...
April 24, 2018: JMIR Human Factors
https://www.readbyqxmd.com/read/29691075/estro-acrop-guideline-interstitial-multi-catheter-breast-brachytherapy-as-accelerated-partial-breast-irradiation-alone-or-as-boost-gec-estro-breast-cancer-working-group-practical-recommendations
#7
Vratislav Strnad, Tibor Major, Csaba Polgar, Michael Lotter, Jose-Luis Guinot, Cristina Gutierrez-Miguelez, Razvan Galalae, Erik Van Limbergen, Benjamin Guix, Peter Niehoff, Kristina Lössl, Jean-Michel Hannoun-Levi
PURPOSE: This consensus statement from the Breast Cancer Working Group of Groupe Européen de Curiethérapie of European Society for Radiotherapy and Oncology (GEC-ESTRO) aims at generating practical guidelines for multi-catheter image-guided brachytherapy in the conservative management of breast cancer patients used for either Accelerated Partial Breast Irradiation (APBI) or for a breast boost. METHODS: Recent advances in techniques of multi-catheter brachytherapy were summarized and all the relevant literature was reviewed by a panel of experts...
April 21, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29690943/recommendations-for-patient-engagement-in-patient-oriented-emergency-medicine-research
#8
Patrick M Archambault, Colleen McGavin, Katie N Dainty, Shelley L McLeod, Christian Vaillancourt, Jacques S Lee, Jeffrey J Perry, François-Pierre Gauvin, Antoine Boivin
OBJECTIVE: To make pragmatic recommendations on best practices for the engagement of patients in emergency medicine (EM) research. METHODS: We created a panel of expert Canadian EM researchers, physicians, and a patient partner to develop our recommendations. We used mixed methods consisting of 1) a literature review; 2) a survey of Canadian EM researchers; 3) qualitative interviews with key informants; and 4) feedback during the 2017 Canadian Association of Emergency Physicians (CAEP) Academic Symposium...
April 25, 2018: CJEM
https://www.readbyqxmd.com/read/29690685/-current-status-of-diagnosis-and-treatment-of-community-acquired-pneumonia-in-shanghai-revealed-by-a-questionnaire-analysis
#9
J Liu, J Zhang, Q J Cheng, J F Xu, Z J Jie, Y Jiao, Y Huang, J M Qu
Objective: To understand the current status of diagnosis and treatment of community-acquired pneumonia (CAP) among doctors in various hospitals across Shanghai, for the purpose of promoting the 2016 clinical practice guidelines for adult CAP of China. Methods: A questionnaire was designed to address the common questions in CAP management. The responses were collected via WeChat and the data were analyzed. Results: A total of 1 254 valid questionnaires were received, 46.1% from tertiary , 26.4% from secondary and 27...
April 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29689265/prevalence-of-celiac-disease-in-patients-with-iron-deficiency-anemia-a-systematic-review-with-meta-analysis
#10
Srihari Mahadev, Monika Laszkowska, Johan Sundström, Magnus Björkholm, Benjamin Lebwohl, Peter Hr Green, Jonas F Ludvigsson
BACKGROUND & AIMS: Anemia is common in patients with celiac disease and a frequent presentation. Guidelines recommend screening iron-deficient patients with anemia for celiac disease. However, the reported prevalence of celiac disease among patients with iron-deficiency anemia (IDA) varies. We performed a systematic review to determine the prevalence of biopsy-verified celiac disease in patients with IDA. METHODS: We performed a systematic review of manuscripts published in PubMed Medline or EMBASE through July 2017 for the term celiac disease combined with anemia or iron-deficiency...
April 21, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29689036/-palliative-care-and-heart-failure-is-it-time-to-talk
#11
Massimo Romanò
Heart failure (HF) is one of the leading causes of hospitalization in high-income countries and has a profound negative impact on quality of life. In the United States there are more than 900,000 new cases per year and over one million hospital admissions with a primary diagnosis of HF. A prevalence of 6,500,000 cases (2.2% of the population of aged >20 years) was estimated for the US in 2014, in which there were 300,000 related deaths. Although survival has increased, thanks to the pharmacological and non pharmacological therapy, roughly 50% of HF patients die within 5 years of being diagnosed...
April 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29688967/the-european-society-of-gynaecological-oncology-european-society-for-radiotherapy-and-oncology-european-society-of-pathology-guidelines-for-the-management-of-patients-with-cervical-cancer
#12
David Cibula, Richard Pötter, François Planchamp, Elisabeth Avall-Lundqvist, Daniela Fischerova, Christine Haie Meder, Christhardt Köhler, Fabio Landoni, Sigurd Lax, Jacob Christian Lindegaard, Umesh Mahantshetty, Patrice Mathevet, W Glenn McCluggage, Mary McCormack, Raj Naik, Remi Nout, Sandro Pignata, Jordi Ponce, Denis Querleu, Francesco Raspagliesi, Alexandros Rodolakis, Karl Tamussino, Pauline Wimberger, Maria Rosaria Raspollini
BACKGROUND: Despite significant advances in the screening, detection, and treatment of preinvasive cervical lesions, invasive cervical cancer is the fifth most common cancer in European women. There are large disparities in Europe and worldwide in the incidence, management, and mortality of cervical cancer. OBJECTIVE: The European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) jointly develop clinically relevant and evidence-based guidelines in order to improve the quality of care for women with cervical cancer across Europe and worldwide...
May 2018: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/29688939/in-hospital-cardiac-arrest-are-we-overlooking-a-key-distinction
#13
Ari Moskowitz, Mathias J Holmberg, Michael W Donnino, Katherine M Berg
PURPOSE OF REVIEW: To review the epidemiology, peri-arrest management, and research priorities related to in-hospital cardiac arrest (IHCA) and explore key distinctions between IHCA and out-of-hospital cardiac arrest (OHCA) as they pertain to the clinician and resuscitation scientist. RECENT FINDINGS: IHCA is a common and highly morbid event amongst hospitalized patients in the United States. As compared with patients who experience an OHCA, patients who experience an IHCA tend to have more medical comorbidities, have a witnessed arrest, and be attended to by professional first responders...
June 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29688919/surgical-management-of-osteoarthritis-of-the-knee
#14
Robert H Quinn, Jayson N Murray, Ryan Pezold, Kaitlyn S Sevarino
The American Academy of Orthopaedic Surgeons has developed Appropriate Use Criteria (AUC) for Surgical Management of Osteoarthritis of the Knee. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The Surgical Management of Osteoarthritis of the Knee AUC clinical patient scenarios were derived from indications of patients under consideration for surgical treatment of osteoarthritis of the knee as well as from current evidence-based clinical practice guidelines and supporting literature to identify the appropriateness of the three treatments...
May 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29688837/use-and-effectiveness-of-peri-operative-cefotetan-versus-cefazolin-plus-metronidazole-for-prevention-of-surgical-site-infection-in-abdominal-surgery-patients
#15
Eleanor Danan, Janessa Smith, Rachel M Kruer, Edina Avdic, Pamela Lipsett, Melanie S Curless, Andrew S Jarrell
BACKGROUND: Current practice guidelines for antimicrobial prophylaxis in surgery recommend a cephamycin or cefazolin plus metronidazole for various abdominal surgeries. In February 2016, cephamycin drug shortages resulted in a change in The Johns Hopkins Hospital's (JHH) recommendation for peri-operative antibiotic prophylaxis in abdominal surgeries from cefotetan to cefazolin plus metronidazole. The primary objective of this study was to quantify the percentage of abdominal surgeries adherent to JHH peri-operative antibiotic prophylaxis guidelines...
April 24, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29688229/the-medical-assessment-of-fractures-in-suspected-child-maltreatment-infants-and-young-children-with-skeletal-injury
#16
Laurel Chauvin-Kimoff, Claire Allard-Dansereau, Margaret Colbourne
Fractures are common injuries in childhood. While most fractures are caused by accidental trauma, inflicted trauma (maltreatment) is a serious and potentially unrecognized cause of fractures, particularly in infants and young children. This practice point identifies the clinical features that prompt concern for inflicted skeletal injury and outlines a management approach based on current literature and published guidelines, including the clinician's duty to report suspicion of child abuse to child welfare authorities...
April 2018: Paediatrics & Child Health
https://www.readbyqxmd.com/read/29688150/awareness-of-acute-kidney-injury-risk-factors-and-perspectives-on-its-practice-guidelines
#17
Numan Alabdan, Abdelhameed H Elfadol, Rami Bustami, Yousef A Al-Rajhi, Abdulla A Al-Sayyari
OBJECTIVES: Identifying and assessing risk factors for acute kidney injury (AKI) are crucial for its early detection and possible intervention to prevent AKI and associated adverse outcomes. This study aimed to investigate AKI risk factor awareness and risk assessment by healthcare professionals and to evaluate perspectives on the Kidney Disease Improving Global Outcomes AKI guidelines. METHODS: This cross-sectional survey-based study was conducted among healthcare professionals (physicians and pharmacists) at XXX from December 2016 to February 2017...
April 24, 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29688078/a-systemic-review-of-levetiracetam-versus-phenytoin-in-the-prevention-of-late-post-traumatic-seizures-and-survey-of-uk-neurosurgical-prescribing-practice-of-antiepileptic-medication-in-acute-traumatic-brain-injury
#18
Ahmed Bakr, Antonio Belli
BACKGROUND: Guidelines recommend 1 week of prophylactic phenytoin for post-traumatic seizures (PTS). Levetiracetam is gaining popularity as an alternative with a superior side-effect profile and may be suitable for extended use. We performed a systematic review comparing the efficacy of levetiracetam and phenytoin in reducing the incidence of late PTS. The secondary objectives were to compare their effects on the Extended Glasgow Outcome Scale (GOS-E) and length of stay. We also aimed to survey current prophylaxis prescribing practices...
April 24, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29688040/commentary
#19
Victoria Mango, Yolanda Bryce, Elizabeth Anne Morris, Elisabetta Gianotti, Katja Pinker
Screening mammography reduces breast cancer mortality in average-risk women. However, adverse consequences include false-positive findings possibly leading to benign breast biopsies and patient anxiety. There is also potential for overdiagnosis and overtreatment. Differences in how to balance benefits and harms have led to varying recommendations by the U.S. Preventive Services Task Force, the American Cancer Society, the National Comprehensive Cancer Network and the American College of Radiology/Society of Breast Imaging...
April 24, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29687755/improving-patient-safety-in-libya-insights-from-a-british-health-system-perspective
#20
Mustafa Elmontsri, Ahmed Almashrafi, Elizabeth Dubois, Ricky Banarsee, Azeem Majeed
Purpose Patient safety programmes aim to make healthcare safe for both patients and health professionals. The purpose of this paper is to explore the UK's patient safety improvement programmes over the past 15 years and explore what lessons can be learnt to improve Libyan healthcare patient safety. Design/methodology/approach Publications focusing on UK patient safety were searched in academic databases and content analysed. Findings Several initiatives have been undertaken over the past 15 years to improve British healthcare patient safety...
April 16, 2018: International Journal of Health Care Quality Assurance
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