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Consensus document

Ricardo de Amorim Corrêa, Andre Nathan Costa, Fernando Lundgren, Lessandra Michelin, Mara Rúbia Figueiredo, Marcelo Holanda, Mauro Gomes, Paulo José Zimermann Teixeira, Ricardo Martins, Rodney Silva, Rodrigo Abensur Athanazio, Rosemeri Maurici da Silva, Mônica Corso Pereira
Community-acquired pneumonia (CAP) is the leading cause of death worldwide. Despite the vast diversity of respiratory microbiota, Streptococcus pneumoniae remains the most prevalent pathogen among etiologic agents. Despite the significant decrease in the mortality rates for lower respiratory tract infections in recent decades, CAP ranks third as a cause of death in Brazil. Since the latest Guidelines on CAP from the Sociedade Brasileira de Pneumologia e Tisiologia (SBPT, Brazilian Thoracic Association) were published (2009), there have been major advances in the application of imaging tests, in etiologic investigation, in risk stratification at admission and prognostic score stratification, in the use of biomarkers, and in the recommendations for antibiotic therapy (and its duration) and prevention through vaccination...
September 2018: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
Ali J Khiabani, Taylan Adademir, Richard B Schuessler, Spencer J Melby, Marc R Moon, Ralph J Damiano
Untreated atrial fibrillation is associated with an increased risk of all-cause mortality and morbidity. Despite the current guidelines recommending surgical ablation of atrial fibrillation at the time of coronary artery bypass surgery, most patients with concomitant atrial fibrillation and coronary artery disease do not receive surgical ablation for their atrial fibrillation. This review reports the efficacy of different surgical ablation techniques used for the treatment of atrial fibrillation during coronary artery bypass...
November 30, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Yedidyah Weiss, Brenden Chen, Makiko Yasuda, Irina Nazarenko, Karl E Anderson, Robert J Desnick
Porphyria Cutanea Tarda (PCT) is a cutaneous porphyria that results from the hepatic inhibition of the heme biosynthetic enzyme uroporphyrinogen decarboxylase (UROD), and can occur either in the absence or presence of an inherited heterozygous UROD mutation (PCT subtypes 1 and 2, respectively). A heterozygous UROD mutation causes half-normal levels of UROD activity systemically, which is a susceptibility factor but is not sufficient alone to cause type 2 PCT. In both Types 1 and 2 PCT, the cutaneous manifestations are precipitated by additional factors that lead to generation of an inhibitor that more profoundly reduces hepatic UROD activity...
November 28, 2018: Molecular Genetics and Metabolism
Marc Thelen, Florent Vanstapel, Pika Meško Brguljan, Bernard Gouget, Guilaine Boursier, Edward Barrett, Christos Kroupis, Maria Lohmander, Luděk Šprongl, Tatjana Vodnik, Francisco Bernabeu-Andreu, Ines Vukasović, Çiğdem Sönmez, Solveig Linko, Duilio Brugnoni, Michel Vaubourdolle, Willem Huisman, Mauro Panteghini
ISO15189:2012 requires medical laboratories to document metrological traceability of their results. While the ISO17511:2003 standard on metrological traceability in laboratory medicine requires the use of the highest available level in the traceability chain, it recognizes that for many measurands there is no reference above the manufacturer's selected measurement procedure and the manufacturer's working calibrator. Some immunoassays, although they intend to measure the same quantity and may even refer to the same reference material, unfortunately produce different results because of differences in analytical selectivity as manufacturers select different epitopes and antibodies for the same analyte...
December 4, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
Nelson Leung, Frank Bridoux, Vecihi Batuman, Aristeidis Chaidos, Paul Cockwell, Vivette D D'Agati, Angela Dispenzieri, Fernando C Fervenza, Jean-Paul Fermand, Simon Gibbs, Julian D Gillmore, Guillermo A Herrera, Arnaud Jaccard, Dragan Jevremovic, Efstathios Kastritis, Vishal Kukreti, Robert A Kyle, Helen J Lachmann, Christopher P Larsen, Heinz Ludwig, Glen S Markowitz, Giampaolo Merlini, Peter Mollee, Maria M Picken, Vincent S Rajkumar, Virginie Royal, Paul W Sanders, Sanjeev Sethi, Christopher P Venner, Peter M Voorhees, Ashutosh D Wechalekar, Brendan M Weiss, Samih H Nasr
The term monoclonal gammopathy of renal significance (MGRS) was introduced by the International Kidney and Monoclonal Gammopathy Research Group (IKMG) in 2012. The IKMG met in April 2017 to refine the definition of MGRS and to update the diagnostic criteria for MGRS-related diseases. Accordingly, in this Expert Consensus Document, the IKMG redefines MGRS as a clonal proliferative disorder that produces a nephrotoxic monoclonal immunoglobulin and does not meet previously defined haematological criteria for treatment of a specific malignancy...
December 3, 2018: Nature Reviews. Nephrology
S R Brown, N S Fearnhead, O D Faiz, J F Abercrombie, A G Acheson, R G Arnott, S K Clark, S Clifford, R J Davies, M M Davies, W J P Douie, M G Dunlop, J C Epstein, M D Evans, B D George, R J Guy, R Hargest, A B Hawthorne, J Hill, G W Hughes, J K Limdi, C A Maxwell-Armstrong, P R O'Connell, T D Pinkney, J Pipe, P M Sagar, B Singh, M Soop, H Terry, J Torkington, A Verjee, C J Walsh, J H Warusavitarne, A B Williams, G L Williams, R G Wilson
AIM: There is a requirement of an expansive and up to date review of surgical management of inflammatory bowel disease (IBD) that can dovetail with the medical guidelines produced by the British Society of Gastroenterology. METHODS: Surgeons who are members of the ACPGBI with a recognised interest in IBD were invited to contribute various sections of the guidelines. They were directed to produce a procedure based document using literature searches that were systematic, comprehensible, transparent and reproducible...
December 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Jennifer Lorigan, Hugh Kearney, Bryan Grimes, Josephine Heffernan, Alan Beausang, Jane Cryan, Michael A Farrell, Francesca M Brett
INTRODUCTION: Chronic traumatic encephalopathy (CTE) is a postmortem diagnosis. Consensus postmortem, but not antemortem, diagnostic criteria have been established. A key factor in these criteria is evidence of phosphorylated-tau (p-tau) around sulcal vessels in the cortex. However, this sign has been observed anecdotally in a diverse range of neurodegenerative diseases (NDD). We therefore hypothesise that this criterion may lack specificity. METHODS: To test this, we assessed patients with NDD, but no documented history of brain trauma, for sulcal p-tau...
November 30, 2018: Irish Journal of Medical Science
Raphael Crum, S A Darren de, Olufemi R Ayeni, Volker Musahl
Importance: This review highlights a lack of consensus and need for further study regarding optimal tibial tunnel preparation method in anterior cruciate ligament reconstruction (ACLR). Objective: This review examines existing clinical and biomechanical outcomes of both extraction drilling (ED) and serial dilation (SD) as a technique for tibial tunnel preparation in ACLR. Evidence Review: In accordance with PRISMA guidelines, three electronic databases (MEDLINE, EMBASE, and PubMed) were searched and systematically screened in duplicate from database inception to September 6, 2017 for English-language, human studies, of all levels of evidence that examined ED and/or SD for tibial tunnel preparation in ACLR...
May 2018: Journal of ISAKOS
Charuta Joshi, Chelsey Stillman, Stephanie Criteser, Jennifer Oliver, Alison Conley, Stefan Sillau, Beth Zupec-Kania
OBJECTIVES: To retrospectively assess the incidence of high beta hydroxybutyrate, low bicarbonate (BIC), high acyl carnitine, low selenium, low magnesium, low zinc, low phosphorus, in a cohort of supplemented patients treated with the ketogenic diet (KD) for medically intractable epilepsy. To analyze effect of age, duration of exposure to KD, type of KD, and route of KD intake on lab abnormalities. To analyze the incidence of clinically actionable results, resulting in medical interventions based on abnormal results and to analyze costs of testing...
November 16, 2018: Epilepsy Research
Femke Hoekstra, Kelly J Mrklas, Kathryn M Sibley, Tram Nguyen, Mathew Vis-Dunbar, Christine J Neilson, Leah K Crockett, Heather L Gainforth, Ian D Graham
BACKGROUND: Research partnership approaches, in which researchers and stakeholders work together collaboratively on a research project, are an important component of research, knowledge translation, and implementation. Despite their growing use, a comprehensive understanding of the principles, strategies, outcomes, and impacts of different types of research partnerships is lacking. Generating high-quality evidence in this area is challenging due to the breadth and diversity of relevant literature...
November 30, 2018: Systematic Reviews
(no author information available yet)
OBJECTIVETemporary CSF diversion through an external ventricular drain (EVD) comes with the risk of EVD-related infections (ERIs). The incidence of ERIs varies from 0.8% to 22%. ERIs increase mortality, morbidity, length of stay, and costs; require prolonged courses of antibiotics; and increase the need for subsequent permanent CSF diversion. The authors report the results of a quality improvement project designed to improve infection rates and EVD placement using simulation training in addition to a standardized perioperative care bundle...
October 1, 2018: Journal of Neurosurgery
Danilo Miskovic, Jamil Ahmed, Rachelle Bissett-Amess, Marcos Gómez Ruiz, Fabrizio Luca, David Jayne, Nuno Figueiredo, R J Heald, Giuseppe Spinoglio, Amjad Parvaiz
AIM: Surgery for rectal cancer is challenging for both technical and anatomical reasons. The European Academy for Robotic Colorectal Surgery (EARCS) provides a competency based training programme through a standardised approach. However, there is no consensus on technical standards for robotic surgery when used during surgery for rectal cancer.. The aim of this consensus study was to establish operative standards for c anterior resection incorporating total mesorectal excision THE) using robotic techniques, based on recommendations of expert European colorectal surgeons...
November 29, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Raphael Lencucha, Arne Ruckert, Ronald Labonte, Jeffrey Drope
BACKGROUND: In 2009, Canada adopted legislation (Bill C-32) restricting the sale of flavoured tobacco products, one of the first in the world. This study examines the agenda-setting process leading to the adoption of Bill C-32. METHODS: This research was conducted using a case study design informed by Kingdon's Multiple Streams framework and Heclo's policy learning approach. In-depth interviews were conducted with key informants from government, health-based non-governmental organizations (NGOs), trade associations and the cigar manufacturing sector (n = 11)...
November 28, 2018: BMC Public Health
Chi-Yin Kao, Sanchia Aranda, Mei Krishnasamy, Bridget Hamilton
PURPOSES: This research set out to contribute to ongoing efforts to improve the quality of informed consent information provided to patients by specifically focusing on establishing consensus with regard to essential information to enhance the informed consent process. DESIGN AND METHODS: A Delphi consensus method was used to conduct three rounds of online surveys. Five groups of experts directly or indirectly involved in the informed consent process were invited to participate: patients, family members/friends, physicians, other health professionals and other key informants, including ethicists, contract research staff and pharmaceutical company staff...
November 2018: European Journal of Cancer Care
Michael Patti, Chelsea Phillips Renfro, Rachael Posey, Gabrielle Wu, Kea Turner, Stefanie P Ferreri
BACKGROUND: Medication non-adherence costs more than 100 billion dollars in avoidable hospitalizations yearly. As a result, community pharmacies have implemented medication synchronization programs to improve adherence. One function of most medication synchronization programs is the alignment of all of a patient's medications to refill on a single date. While aligning refills is a standard aspect of most programs, other features vary making it difficult to identify which program components lead to improved adherence...
November 16, 2018: Research in Social & Administrative Pharmacy: RSAP
Shu-Chen Liao, Yan-Chiao Mao, Kun-Ju Yang, Kuo-Cheng Wang, Li-Ying Wu, Chen-Chang Yang
OBJECTIVES: Delayed neuropsychiatric sequelae (DNS) are serious complications of carbon monoxide poisoning; neuropsychiatric disorders can occur within a few days of recovery from acute poisoning. Hyperbaric oxygen therapy (HBOT) has been the main treatment of carbon monoxide (CO) poisoning and was recommended as the treatment choice for CO poisoning by the American Undersea and Hyperbaric Medical Society and the Tenth European Consensus Conference on Hyperbaric Medicine of the European Underwater and Baromedical Society...
November 22, 2018: Journal of the Neurological Sciences
Jorge Chahla, Iain R Murray, James Robinson, Koen Lagae, Fabrizio Margheritini, Brett Fritsch, Manuel Leyes, Björn Barenius, Nicolas Pujol, Lars Engebretsen, Martin Lind, Moises Cohen, Rodrigo Maestu, Alan Getgood, Gonzalo Ferrer, Silvio Villascusa, Soshi Uchida, Bruce A Levy, Richard Von Bormann, Charles Brown, Jacques Menetrey, Michael Hantes, Timothy Lording, Kristian Samuelsson, Karl Heinz Frosch, Juan Carlos Monllau, David Parker, Robert F LaPrade, Pablo E Gelber
PURPOSE: To develop a statement on the diagnosis, classification, treatment, and rehabilitation concepts of posterolateral corner (PLC) injuries of the knee using a modified Delphi technique. METHODS: A working group of three individuals generated a list of statements relating to the diagnosis, classification, treatment, and rehabilitation of PLC injuries to form the basis of an initial survey for rating by an international group of experts. The PLC expert group (composed of 27 experts throughout the world) was surveyed on three occasions to establish consensus on the inclusion/exclusion of each item...
November 26, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Thomas R Alexande, Nazir J SJuval, Arup Dasbiswas, Samir Kubba, R K Singh, Vikrama Raja
Background: Primary Sjogren's Syndrome (pSS) with Hypokalemic Periodic Paralysis(HPP) whether an association or a different clinical subset needs review. Aim: To generate a consensus on the importance of pharmaco-invasive therapy for STEMI patients when primary PCI cannot be expeditiously performed in metro and tier-I cities in India. Methodology: A total of 8 expert panel groups comprising 48 experts from Cardiology specialty in India were convened...
May 2018: Journal of the Association of Physicians of India
J R Handy, R M Bremner, T S Crocenzi, F C Detterbeck, H C Fernando, P M Fidias, S Firestone, C A Johnstone, M Lanuti, V R Litle, K A Kesler, J D Mitchell, H I Pass, H J Ross, T K Varghese
No abstract text is available yet for this article.
November 23, 2018: Annals of Thoracic Surgery
Guri Ranum Ekås, Håvard Moksnes, Hege Grindem, May Arna Risberg, Lars Engebretsen
BACKGROUND: There is no consensus regarding the best treatment approach for skeletally immature children with anterior cruciate ligament (ACL) injuries. High-quality studies with long-term follow-up are lacking, and evidence to support decision making is limited. PURPOSE: To evaluate functional and patient-reported outcome, surgical history, and complications among young adults who sustained an ACL injury before the age of 13 years and were treated with active rehabilitation and the option of delayed ACL reconstruction if needed...
November 26, 2018: American Journal of Sports Medicine
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