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Clinical disease guidelines

Gillian A M Tarr, Linda Chui, Bonita E Lee, Xiao-Li Pang, Samina Ali, Alberto Nettel-Aguirre, Otto G Vanderkooi, Byron M Berenger, James Dickinson, Phillip I Tarr, Steven Drews, Judy MacDonald, Kelly Kim, Stephen B Freedman
Background: The ability to identify bacterial pathogens that necessitate specific clinical management or public health action in children with acute gastroenteritis is crucial to patient care and public health. However, existing stool testing guidelines offer inconsistent recommendations, and their performance characteristics are unknown. We evaluated six leading gastroenteritis guidelines (e.g. those of the Centers for Disease Control and Prevention and Infectious Disease Society of America) that recommend when to test children's stool for bacterial enteropathogens...
December 4, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Lucas Helal, Filipe Ferrari, Ricardo Stein
Young competitive athletes (≤ 35 years old) with or without a previous diagnosis of cardiovascular disease may suddenly die in competitive activities, potentially leading to an impact in society through the media. Although the relative risk for sudden death (SD) in athletes is twice as high as for their counterparts, the absolute incidence is low. While there is consensus among medical societies worldwide that early detection of causal factors is highly desirable, there is debate among different screening schemes to that end...
December 2018: Arquivos Brasileiros de Cardiologia
Andrej Spec, Carlos Mejia-Chew, William G Powderly, Oliver A Cornely
Cryptococcocis is an opportunistic fungal infection with high morbidity and mortality. Guidelines to aid clinicians regarding diagnosis, management, and treatment can be extensive and challenging to comply with. There is no tool to measure guideline adherence. To create such a tool, we reviewed current guidelines from the Infectious Diseases Society of America, the World Health Organization, the American Society of Transplantation, and recent significant publications to select the strongest recommendations as vital components of our scoring tool...
November 2018: Open Forum Infectious Diseases
Ihab Eldessouki, Ola Gaber, Tariq Namad, Jiang Wang, John C Morris, Nagla Abdel Karim
Large cell neuroendocrine cancer (LCNEC) of the lung exhibits morphological and immunohistochemical characteristics of both neuroendocrine and large cell carcinomas. No defined optimal therapy has been described for this subset of patients and the question of whether these patients should be treated with non-small cell lung cancer (NSCLC) treatment protocols, according to the National Comprehensive Cancer Network (NCCN) guidelines, or with small cell lung cancer (SCLC) due to histological and clinical similarities is still uncertain...
2018: Journal of Oncology
Fausto Meriggi
BACKGROUND: Malignant pleural effusion, which is a common clinical problem in patients with cancer, may be due to both primary thoracic tumours or to a metastatic spread in the chest and constitutes the first sign of disease in approximately 10% of patients. Almost all cancers can potentially produce a pleural effusion. The presence of malignant tumour cells in the pleural fluid is generally indicative of advanced disease and is associated with high morbidity and mortality with reduced therapeutic options...
December 3, 2018: Reviews on Recent Clinical Trials
Bon-Nyeo Koo, Min A Kwon, Sang-Hyun Kim, Jong Yeop Kim, Young-Jin Moon, Sun Young Park, Eun-Ho Lee, Min Suk Chae, Sung Uk Choi, Jeong-Hyun Choi, Jin-Young Hwang
Considering the functional role of red blood cells (RBC) in maintaining a proper supply of oxygen to the tissues, RBC transfusion can be a life-saving intervention in situations of severe bleeding or anemia. RBC transfusion is often inevitable to address intraoperative massive bleeding; it is a key component of safe perioperative patient management. Unlike general medical resources, packed RBCs (pRBCs) have limited availability because their supply relies entirely on voluntary donations. Besides, excessive utilization of pRBCs may aggravate prognosis or increase the risk of developing infectious diseases...
December 5, 2018: Korean Journal of Anesthesiology
Fabienne Delay, Vincent Dochez, Florence Biquard, Marie-Thérèse Cheve, Philippe Gillard, Chloe Arthuis, Norbert Winer
INTRODUCTION: The incidence of fetal goiters is reported to be around 1 per 40 000 births. The risk of complications is first of all obstetric, directly related to goiter size, but it may also affect longer term fetal and child development, depending on whether the goiter is due to hypo- or hyperthyroidism. Management is multidisciplinary, but not yet consensual and not always optimal by either endocrinologists or obstetricians. OBJECTIVES: The principal objective of this retrospective study was to analyze the data that enabled the physicians to assess whether the goiter was hypo- or hyperthyroid and then to analyze the obstetric practices used in the Pays de Loire network to describe in detail the tools used to diagnose and characterize the goiters and the management chosen in these cases...
December 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
Tsuyoshi Yoneda, Tamaki Sumi, Yasuhiro Hoshikawa, Masahiko Kobayashi, Atsuki Fukushima
PURPOSE: We developed a hyperemia analysis software, which can quantitatively assess the degree of conjunctival hyperemia, and we evaluated the reproducibility and reliability of its percent coverage. In addition, we compared the clinical grading and the percent coverage to examine the applicability of the software analysis. METHODS: We took images of the temporal conjunctiva with slit lamp microscopes. We used our hyperemia analysis software to detect blood vessels in the region of interest using its image processing capabilities and obtained a ratio of the area occupied by blood vessels to the rest of the area...
December 4, 2018: Current Eye Research
Dan-Dan Zhang, Gan Lu, Xuan-Feng Zhu, Ling-Ling Zhang, Jia Gao, Li-Cheng Shi, Jian-Hua Gu, Jian-Nan Liu
Background: Neural respiratory drive (NRD) using diaphragm electromyography through an invasive transesophageal multi-electrode catheter can be used as a feasible clinical physiological parameter in patients with chronic obstructive pulmonary disease (COPD) to provide useful information on the treatment response. However, it remains unknown whether the surface diaphragm electromyogram (EMGdi) could be used to identify the deterioration of clinical symptoms and to predict the necessity of hospitalization in acute exacerbation of COPD (AECOPD) patients...
December 5, 2018: Chinese Medical Journal
A Brinkmann, A C Röhr, O R Frey, W A Krüger, T Brenner, D C Richter, K-F Bodmann, M Kresken, B Grabein
In January 2018 the recent revision of the S2k guidelines on calculated parenteral initial treatment of bacterial diseases in adults-update 2018 (Editor: Paul Ehrlich Society for Chemotherapy, PEG) was realized. It is a helpful tool for the complex infectious disease setting in an intensive care unit. The present summary of the guidelines focuses on the topics of anti-infective agents, including new substances, pharmacokinetics and pharmacodynamics as well as on microbiology, resistance development and recommendations for calculated drug therapy in septic patients...
December 3, 2018: Der Anaesthesist
D Carradice, J Forsyth, A Mohammed, C Leung, L Hitchman, A E Harwood, T Wallace, G E Smith, B Campbell, I Chetter
Background: Varicose veins impair quality of life and can lead to chronic leg ulcers. National Institute for Health and Care Excellence (NICE) guidelines (CG168) set out evidence-based standards for patient management. In England, Clinical Commissioning Groups (CCGs) fund NHS care within their locality. The objective of this study was to evaluate CCGs' commissioning policies and compare them with CG168. Methods: Searches were made for the published policies of all 206 English CCGs...
December 2018: BJS open
Miriam Kessi, Juan Xiong, Liwen Wu, Lifen Yang, Fang He, Chen Chen, Nan Pang, Haolin Duan, Wen Zhang, Ahmed Arafat, Fei Yin, Jing Peng
Introduction: The concurrence of intellectual disability/global developmental delay and epilepsy (ID/GDD-EP) is very common in the pediatric population. The etiologies for both conditions are complex and largely unknown. The predictors of significant copy number variations (CNVs) are known for the cases with ID/GDD, but unknown for those with exclusive ID/GDD-EP. Importantly, the known predictors are largely from the same ethnic group; hence, they lack replication. Purpose: We aimed to determine and investigate the diagnostic yield of CNV tests, new causative CNVs, and the independent predictors of significant CNVs in Chinese children with unexplained ID/GDD-EP...
2018: Frontiers in Neurology
Shilpa Jain, Jennifer Donkin, Mary-Jane Frey, Skye Peltier, Sriya Gunawardena, David L Cooper
Background: One of the most common rare inherited bleeding disorders, congenital factor VII (FVII) deficiency typically has a milder bleeding phenotype than other rare bleeding disorders. Categorizing severity in terms of factor activity associated with hemophilia (severe <1%, moderate 1%-5%, mild 6%-40%) has led to the observation that bleeding phenotype does not follow closely with FVII activity. Over the past decade, large-scale global registries have investigated bleeding phenotype more thoroughly...
2018: Journal of Blood Medicine
Barbara A Brown-Elliott, Richard J Wallace
We performed bedaquiline broth microdilution susceptibility using Clinical and Laboratory Standards Institute (CLSI) guidelines on 104 non-duplicate isolates of Mycobacterium abscessus complex [ M. abscessus subsp. abscessus (76), M. abscessus subsp. massiliense (10), M. abscessus subsp. bolletii , (2) and M. abscessus subsp. abscessus /subsp. massiliense hybrid, i.e., M. abscessus subsp. abscessus by rpoB gene and subsp. massiliense by erm (41) gene (16)]. All isolates from patients not known to have been on prior bedaquiline had MIC values ≤0...
December 3, 2018: Antimicrobial Agents and Chemotherapy
Saiyun Hou, Billy Huh, Hee Kee Kim, Kyung-Hoon Kim, Salahadin Abdi
BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) is a commonly encountered disease entity following chemotherapy for cancer treatment. Although only duloxetine is recommended by the American Society of Clinical Oncology (ASCO) for the treatment of CIPN in 2014, the evidence of the clinical outcome for new pharmaceutic therapies and non-pharmaceutic treatments has not been clearly determined. OBJECTIVE: To provide a comprehensive review and evidence-based recommendations on the treatment of CIPN...
November 2018: Pain Physician
Jayita Basu, Chhanda Datta, Subhankar Chowdhury, Debasmita Mandal, Nandan Kumar Mondal, Amlan Ghosh
AIMS: Prevalence of gestational diabetes mellitus (GDM) may vary across a country like India. Risk factors and disease-pathogenesis were also not fully elucidated. This study aimed to examine prevalence of GDM among pregnant women visiting antenatal clinic of a tertiary-care hospital of Kolkata, India; possible mechanism of disease pathogenesis and potency of associated parameters as disease biomarkers were also explored. METHODS: 735 pregnant women were screened for GDM according to DIPSI (Diabetes in Pregnancy Study Group India) guideline and risk-factors were analyzed...
December 3, 2018: Experimental and Clinical Endocrinology & Diabetes
Hannah Trøstrup, Steen H Matzen
INTRODUCTION: Verrucous carcinoma is an uncommon variant of low-grade squamous cell malignancy with a low malignant potential but a high risk of recurrence. PRESENTATION OF CASE: We report a case of a Human Papilloma Virus negative local verrucous carcinoma in the perianal area of a 45-year old otherwise healthy female. The tumor presented clinically as a persistent genital wart not responding to usual dermatologic local therapy. The patient was referred to the Department of Plastic Surgery and Breast Surgery after primary excision in a private practice setting of a general surgeon...
November 27, 2018: International Journal of Surgery Case Reports
Teegwendé V Porgo, Susan L Norris, Georgia Salanti, Leigh F Johnson, Julie A Simpson, Nicola Low, Matthias Egger, Christian L Althaus
Mathematical modelling studies are increasingly recognised as an important tool for evidence synthesis and to inform clinical and public health decision-making, particularly when data from systematic reviews of primary studies do not adequately answer a research question. However, systematic reviewers and guideline developers may struggle with using the results of modelling studies, due at least in part to the lack of a common understanding of concepts and terminology between evidence synthesis experts and mathematical modellers...
December 3, 2018: Research Synthesis Methods
Kathleen L Caldwell, Po-Yung Cheng, Kathryn A Vance, Amir Makhmudov, Jeffery M Jarrett, Samuel P Caudill, De-Pei Ho, Robert L Jones
CONTEXT: The Lead and Multielement Proficiency (LAMP) program is an external quality assurance program promoting high-quality blood-lead measurements. OBJECTIVES: To investigate the ability of US laboratories, participating in the Centers for Disease Control and Prevention (CDC) LAMP program to accurately measure blood-lead levels (BLL) 0.70 to 47.5 μg/dL using evaluation criteria of ±2 μg/dL or 10%, whichever is greater. METHODS: The CDC distributes bovine blood specimens to participating laboratories 4 times per year...
January 2019: Journal of Public Health Management and Practice: JPHMP
Rachel Collins, Barbora Silarova, Linda Clare
BACKGROUND: Understanding policy context and how policy is implemented at the local and clinical level is an important precursor to developing preventive strategies focusing on dementia risk reduction in primary healthcare settings. OBJECTIVE: Using England as a case study, we review policies and strategies relevant to dementia prevention from the national to local level and how these are translated into primary healthcare services. METHODS: We conducted a scoping review covering: 1) identification of national, regional, and local policies and strategies that include dementia prevention; 2) identification of national guidelines for implementing dementia prevention at the clinical level; and 3) evaluation of the implementation of these at the clinical level...
November 28, 2018: Journal of Alzheimer's Disease: JAD
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