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Clinical practice guidelines

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https://www.readbyqxmd.com/read/28749586/patient-decisions-to-receive-secondary-pharmacogenomic-findings-and-development-of-a-multidisciplinary-practice-model-to-integrate-results-into-patient-care
#1
J Kevin Hicks, Amy Shealy, Allison Schreiber, Marissa Coleridge, Ryan Noss, Marvin Natowicz, Rocio Moran, Timothy Moss, Angelika Erwin, Charis Eng
Whole exome sequencing (WES) has the potential of identifying secondary findings that are predictive of poor pharmacotherapy outcomes. The purpose of this study was to investigate patients' wishes regarding the reporting of secondary pharmacogenomic findings. WES results (n = 106 patients) were retrospectively reviewed to determine the number of patients electing to receive secondary pharmacogenomic results. Phenotypes were assigned based on Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines...
July 27, 2017: Clinical and Translational Science
https://www.readbyqxmd.com/read/28748919/changing-concepts-in-hypertension-management
#2
REVIEW
P S Gudsoorkar, S W Tobe
Hypertension is the most common modifiable risk factor for cardiovascular disease and death, and lowering blood pressure with anti-hypertensive drugs reduces target organ damage and prevents cardiovascular disease outcomes. The recent trials SPRINT and HOPE-3 will lead to changes in the way we manage hypertension and impact on clinical practice guidelines. These studies also demonstrate the shift toward automated blood pressure measurements. We have reviewed these studies and others to put them in context with the guidelines that have come before and to describe how they will impact on hypertension treatment thresholds and targets, the treatment of hypertension in the elderly, and changing approaches to the management of hypertension including resistant hypertension...
July 27, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28748641/eaaci-guidelines-on-allergen-immunotherapy-hymenoptera-venom-allergy
#3
Gunter J Sturm, Eva-Maria Varga, Graham Roberts, Holger Mosbech, M Beatrice Bilò, Cezmi A Akdis, Darío Antolín-Amérigo, Ewa Cichocka-Jarosz, Radoslaw Gawlik, Thilo Jakob, Mitja Kosnik, Joanna Lange, Ervin Mingomataj, Dimitris I Mitsias, Markus Ollert, Joanna N G Oude Elberink, Oliver Pfaar, Constantinos Pitsios, Valerio Pravettoni, Franziska Ruëff, Betül Ayşe Sin, Ioana Agache, Elizabeth Angier, Stefania Arasi, Moises A Calderón, Montserrat Fernandez-Rivas, Susanne Halken, Marek Jutel, Susanne Lau, Giovanni B Pajno, Ronald van Ree, Dermot Ryan, Otto Spranger, Roy Gerth van Wijk, Sangeeta Dhami, Hadar Zaman, Aziz Sheikh, Antonella Muraro
Hymenoptera venom allergy is a potentially life-threatening allergic reaction following a honeybee, vespid or ant sting. Systemic allergic sting reactions have been reported in up to 7.5% of adults and up to 3.4% of children. They can be mild and restricted to the skin or moderate-to-severe with a risk of life-threatening anaphylaxis. Patients should carry an emergency kit containing an adrenaline autoinjector, H1 -antihistamines, and corticosteroids depending on the severity of their previous sting reaction(s)...
July 27, 2017: Allergy
https://www.readbyqxmd.com/read/28748339/laparoscopic-hysterectomy-for-benign-indications-clinical-practice-guideline
#4
Evelien M Sandberg, Wouter J K Hehenkamp, Peggy M Geomini, Petra F Janssen, Frank Willem Jansen, Andries R H Twijnstra
PURPOSE: Since the introduction of minimally invasive gynecologic surgery, the percentage of advanced laparoscopic procedures has greatly increased worldwide. It seems therefore, timely to standardize laparoscopic gynecologic care according to the principles of evidence-based medicine. With this goal in mind-the Dutch Society of Gynecological Endoscopic Surgery initiated in The Netherlands the development of a national guideline for laparoscopic hysterectomy (LH). This present article provides a summary of the main recommendations of the guideline...
July 26, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28748331/eligibility-for-phase-3-clinical-trials-of-systemic-therapy-in-real-world-patients-with-metastatic-renal-cell-cancer-managed-in-a-rural-region
#5
Carsten Nieder, Mohsan A Syed, Astrid Dalhaug, Adam Pawinski, Jan Norum
Previous research has identified disparities between urban and rural cancer care, including clinical trial access. Therefore, we addressed three different questions in patients with metastatic renal cell cancer managed according to national guidelines in a rural Norwegian standard practice setting. (1) How many patients would have been eligible for three recent landmark randomized clinical trials? (2) Is survival different between eligible and non-eligible patients receiving first-line systemic therapy? (3) Is survival different between eligible patients and published trial results? We performed a retrospective analysis of 101 consecutive patients (2006-2016)...
September 2017: Medical Oncology
https://www.readbyqxmd.com/read/28748190/management-of-patients-with-hepatitis-c-virus-monoclonal-gammopathy-of-undetermined-significance-and-multiple-myeloma
#6
Alisse Hannaford, David Del Bello, Siyang Leng, Ajai Chari, Ponni Perumalswami, Douglas Dieterich, Andrea Branch
Background and Aim: The vast majority of the 2.7 million individuals in the United States who are currently infected with hepatitis C virus (HCV) were born between 1945 and 1965. The median age of these patients in this particular generation at the time of this writing was 55 years. In the general population, older age is a risk factor for multiple myeloma (MM) and other monogammopathies. As the baby boomer population ages, HCV providers are increasingly likely to encounter HCV-infected patients with a monoclonal gammopathy...
April 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28748128/diagnosis-of-upper-quadrant-lymphedema-secondary-to-cancer-clinical-practice-guideline-from-the-oncology-section-of-apta
#7
Kimberly Levenhagen, Claire Davies, Marisa Perdomo, Kathryn Ryans, Laura Gilchrist
INTRODUCTION: The Oncology Section of APTA developed a clinical practice guideline to aid the clinician in diagnosing secondary upper-quadrant cancer-related lymphedema. METHODS: Following a systematic review of published studies and a structured appraisal process, recommendations were written to guide the physical therapist and other health care clinicians in their diagnostic process. Overall, clinical practice recommendations were formulated on the basis of the evidence for each diagnostic method and were assigned a grade based on the strength of the evidence for different patient presentations and clinical utility...
July 2017: Rehabilitation Oncology
https://www.readbyqxmd.com/read/28747955/summary-of-the-chronic-obstructive-pulmonary-disease-clinical-practice-guideline-revised-in-2014-by-the-korean-academy-of-tuberculosis-and-respiratory-disease
#8
REVIEW
Hyoung Kyu Yoon, Yong-Bum Park, Chin Kook Rhee, Jin Hwa Lee, Yeon-Mok Oh
Chronic obstructive pulmonary disease (COPD) results in high morbidity and mortality among patients both domestically and globally. The Korean clinical practice guideline for COPD was revised in 2014. It was drafted by the members of the Korean Academy of Tuberculosis and Respiratory Diseases, as well as participating members of the Health Insurance Review and Assessment Service, Korean Physicians' Association, and Korea Respiration Trouble Association. This revised guideline covers a wide range of topics, including the epidemiology, diagnosis, assessment, monitoring, management, exacerbation, and comorbidities of COPD in Korea...
July 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28747722/assessing-screening-guidelines-for-cardiovascular-disease-risk-factors-using-routinely-collected-data
#9
Jaspreet Pannu, Sarah Poole, Neil Shah, Nigam H Shah
This study investigates if laboratory data can be used to assess whether physician-retesting patterns are in line with established guidelines, and if these guidelines identify deteriorating patients in a timely manner. A total of 7594 patients with high cholesterol were studied, along with 2764 patients with diabetes. More than 90% of borderline high cholesterol patients are retested within the 3 year recommended period, however less than 75% of pre-diabetic patients have repeated tests within the suggested 1-year time frame...
July 26, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28747442/chemotherapy-induced-peripheral-neuropathy-clinical-trials-review-and-recommendations
#10
REVIEW
Jennifer S Gewandter, Roy Freeman, Rachel A Kitt, Guido Cavaletti, Lynn R Gauthier, Michael P McDermott, Nimish A Mohile, Supriya G Mohlie, A Gordon Smith, Mohamedtaki A Tejani, Dennis C Turk, Robert H Dworkin
OBJECTIVE: To assess the design characteristics and reporting quality of published randomized controlled trials (RCTs) for treatments of chemotherapy-induced peripheral neuropathy (CIPN) initiated before or during chemotherapy. METHODS: In this systematic review of RCTs of preventive or symptomatic pharmacologic treatments for CIPN initiated before or during chemotherapy treatment, articles were identified by updating the PubMed search utilized in the CIPN treatment guidelines published in the Journal of Clinical Oncology in 2014...
July 26, 2017: Neurology
https://www.readbyqxmd.com/read/28747293/improving-employee-well-being-and-effectiveness-systematic-review-and-meta-analysis-of-web-based-psychological-interventions-delivered-in-the-workplace
#11
Stephany Carolan, Peter R Harris, Kate Cavanagh
BACKGROUND: Stress, depression, and anxiety among working populations can result in reduced work performance and increased absenteeism. Although there is evidence that these common mental health problems are preventable and treatable in the workplace, uptake of psychological treatments among the working population is low. One way to address this may be the delivery of occupational digital mental health interventions. While there is convincing evidence for delivering digital psychological interventions within a health and community context, there is no systematic review or meta-analysis of these interventions in an occupational setting...
July 26, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28747270/predictive-power-of-the-grace-score-in-population-with-diabetes
#12
Anna Baeza-Román, Eva de Miguel-Balsa, Jaime Latour-Pérez, Andrés Carrillo-López
INTRODUCTION: Current clinical practice guidelines recommend risk stratification in patients with acute coronary syndrome (ACS) upon admission to hospital. Diabetes mellitus (DM) is widely recognized as an independent predictor of mortality in these patients, although it is not included in the GRACE risk score. OBJECTIVES: The objective of this study is to validate the GRACE risk score in a contemporary population and particularly in the subgroup of patients with diabetes, and to test the effects of including the DM variable in the model...
June 21, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28746330/updates-on-pharmacological-treatment-of-post-traumatic-stress-disorder
#13
R Koirala, E G I Søegaard, S B Thapa
Post-Traumatic Stress Disorder affects a significant proportion of those who have been exposed to exceptionally threatening or catastrophic events or situations such as earthquakes, rape and civil war. The condition can often become chronic and disabling. Medical intervention can therefore be of paramount importance. There are no national guidelines for trauma disorders in Nepal and there is a lack of adequate knowledge regarding drug treatment of PTSD among doctors and other service providers. Though psychotherapy is internationally regarded as the first line treatment for PTSD, it is often not feasible in Nepal due to lack of resources and skilled health workers in this field...
April 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28745853/pneumothorax-in-pediatric-patients-management-strategies-to-improve-patient-outcomes-digest
#14
Matthew Harris, Joshua Rocker, Kathryn H Pade
The clinical presentation of pneumothorax is highly variable. Spontaneous pneumothoraces may present with subtle symptoms when a small air leak is present, but can progress to hemodynamic instability in the setting of tension physiology. The etiologies are broad and the severity can vary greatly. A trauma patient with a pneumothorax may also have the added complexity of other potentially life-threatening injuries. While there is a wealth of evidence-based guidelines for the management of pneumothoraces in the adult literature, the approach to pediatric patients is largely extrapolated from that literature without a significant evidence base...
March 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28745729/highlights-of-skin-disease-education-foundation-s-41st-annual-hawaii-dermatology-seminar%C3%A2
#15
Kenneth B Gordon, Craig L Leonardi, Daniel E Furst, Neal Bhatia, Lawrence F Eichenfield, Katie Beleznay
New therapies, recent pathophysiological findings, and updated guidelines combined to create compelling presentations at the Skin Disease Education Foundation's 41st Annual Hawaii Dermatology Seminar™. This educational supplement summarizes the highlights of clinical sessions presented during this CME/CE conference. A growing understanding of the biology of psoriasis has facilitated the development of increasingly efficacious medications. Skin clearance used to be regarded as an impractical goal for psoriasis therapy...
June 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28745260/implementation-of-an-antimicrobial-stewardship-program-in-a-neonatal-intensive-care-unit
#16
Nneka I Nzegwu, Michelle R Rychalsky, Loren A Nallu, Xuemei Song, Yanhong Deng, Amber M Natusch, Robert S Baltimore, George R Paci, Matthew J Bizzarro
OBJECTIVE To evaluate antimicrobial utilization and prescription practices in a neonatal intensive care unit (NICU) after implementation of an antimicrobial stewardship program (ASP). DESIGN Quasi-experimental, interrupted time-series study. SETTING A 54-bed, level IV NICU in a regional academic and tertiary referral center. PATIENTS AND PARTICIPANTS All neonates prescribed antimicrobials from January 1, 2011, to June 30, 2016, were eligible for inclusion. INTERVENTION Implementation of a NICU-specific ASP beginning July 2012...
July 26, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28745141/comparison-of-the-long-term-reproducibility-of-the-walk-test-and-of-exercise-peak-oxygen-consumption-in-patients-with-preserved-exercise-capacity
#17
Zainab Raissuni, Gerald Roul
Short-term and long-term reproducibility of the cardiopulmonary (CPX) exercise test have been established. Though short and mid-term reproducibility of the walk test has been ascertained, this was not extensively done for the long-term reproducibility. The aim of the study was to examine the long-term reproducibility of distance walked in an allotted time and to check the stability of the relationship between walked distance and exercise peak VO2 (pVO2). METHODS: Forty six subjects (33 men; 57 ± 14 years), referred for functional capacity assessment, were studied twice by CPX and walking test...
July 26, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28744988/adherence-to-evidence-based-pressure-injury-prevention-guidelines-in-routine-clinical-practice-a-longitudinal-study
#18
Wendy Chaboyer, Tracey Bucknall, Brigid Gillespie, Lukman Thalib, Elizabeth McInnes, Julie Considine, Edel Murray, Paula Duffy, Michelle Tuck, Emma Harbeck
The aim of this longitudinal study was to describe adherence to evidence-based pressure injury (PI) prevention guidelines in routine clinical practice in Australian hospitals. Data were analysed from four control sites of a larger-cluster randomised trial of a PI intervention. The sample of 799 included 220 (27·5%) Not at risk, 344 (43·1%) At risk and 110 (13·8%) At high risk patients. A total of 84 (10·5%) patients developed a PI during the study: 20 (9·0% of 220) in the Not at risk group, 45 (13·1% of 344) in the At risk group, 15 (13·6% of 110) in the At high risk group and 4 (3·2% of 125) patients who did not have a risk assessment completed...
July 25, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28744966/social-media-and-organ-donation-ethically-navigating-the-next-frontier
#19
Macey L Henderson, Kristel A Clayville, Jonathan S Fisher, Kristin K Kuntz, Harvey Mysel, Tanjala S Purnell, Randolph L Schaffer, Laurence A Sherman, Elizabeth P Willock, Elisa J Gordon
As the organ shortage continues to grow, the creation of social media communities by transplant centers and the public is rapidly expanding to increase the number of living donors. Social media communities are arranged in myriad ways, and without standardization, raising concerns about potential recipients' and potential donors' autonomy and quality of care. Social media communities magnify and modify extant ethical issues in deceased and living donation related to privacy, confidentiality, professionalism, and informed consent, and increase the potential for undue influence and coercion for potential living donors and transplant candidates...
July 25, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28744956/care-of-the-dying-a-qualitative-exploration-of-foundation-year-doctors-experiences
#20
Melody Redman, Jessica Pearce, Sareena Gajebasia, Miriam Johnson, Gabrielle Finn
CONTEXT: Foundation Year doctors (FYs), who are newly qualified, are expected to provide care for dying patients. Experiences at this early mandatory stage of training may form the foundation for future encounters, but little is documented about what these experiences involve. The aim of this research was to explore the experiences of FYs in caring for the dying, using the recently published Priorities for Care of the Dying Person as a conceptual framework, to identify areas for improvement in education and clinical practice...
July 26, 2017: Medical Education
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