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https://www.readbyqxmd.com/read/27876084/a-trial-to-determine-whether-septic-shock-reversal-is-quicker-in-pediatric-patients-randomized-to-an-early-goal-directed-fluid-sparing-strategy-versus-usual-care-squeeze-study-protocol-for-a-pilot-randomized-controlled-trial
#1
Melissa J Parker, Lehana Thabane, Alison Fox-Robichaud, Patricia Liaw, Karen Choong
BACKGROUND: Current pediatric septic shock resuscitation guidelines from the American College of Critical Care Medicine focus on the early and goal-directed administration of intravascular fluid followed by vasoactive medication infusions for persistent and fluid-refractory shock. However, accumulating adult and pediatric data suggest that excessive fluid administration is associated with worse patient outcomes and even increased risk of death. The optimal amount of intravascular fluid required in early pediatric septic shock resuscitation prior to the initiation of vasoactive support remains unanswered...
November 22, 2016: Trials
https://www.readbyqxmd.com/read/27871502/screening-for-abdominal-aortic-aneurysm-in-asymptomatic-adults
#2
REVIEW
Muhammad Usman Ali, Donna Fitzpatrick-Lewis, John Miller, Rachel Warren, Meghan Kenny, Diana Sherifali, Parminder Raina
BACKGROUND: This report was produced for the Canadian Task Force on Preventive Health Care to provide guidelines on screening for abdominal aortic aneurysm (AAA) with ultrasound scan. PURPOSE: The aim of this systematic review is to examine the evidence on benefits and harms of AAA screening. SEARCH STRATEGY: This systematic review considered studies from the most recent United States Preventive Services Task Force review on AAA screening and passed through the screening process with citations identified in our search up to April 2015 (PROSPERO Registration #CRD42015019047)...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27848024/-current-guidelines-on-anca-associated-vasculitides-common-features-and-differences
#3
B Hellmich
The results of a number of prospective randomized controlled clinical trials have led to changes in established strategies for the treatment of antineutrophil cytoplasmic antibody (ANCA) associated vasculitides (AAV) in recent years. Since 2014, a total of 4 scientific societies and study groups have systematically reviewed the new data and have formulated evidence-based recommendations for the management of AAV based on the analysis. These recommendations contain information on diagnosis, treatment (induction and maintenance), supportive care and monitoring of disease activity and resulting damage...
November 15, 2016: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/27708674/a-randomized-trial-of-a-community-based-approach-to-dyslipidemia-management-pharmacist-prescribing-to-achieve-cholesterol-targets-rxact-study
#4
Ross T Tsuyuki, Meagen Rosenthal, Glen J Pearson
BACKGROUND: Dyslipidemia is an important risk factor for cardiovascular disease but is suboptimally managed. Pharmacists are accessible primary care professionals and with expanded scopes of practice (including prescribing), could identify and manage patients with dyslipidemia. We sought to evaluate the effect of pharmacist prescribing of dyslipidemia medications on the proportion of participants achieving target LDL-cholesterol (LDL-c) levels. METHODS: We conducted a randomized controlled trial in 14 community pharmacies in Alberta, Canada...
September 2016: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/27670710/management-of-spontaneous-labour-at-term%C3%A2-in-healthy-women
#5
Lily Lee, Jessica Dy, Hussam Azzam
OBJECTIVE: The purpose of this guideline is to provide guidance for the intrapartum management of spontaneous labour, whether normal or abnormal, in term, healthy women, and to provide guidance in the management of first and second stage dystocia to increase the likelihood of a vaginal birth and optimize birth outcomes. EVIDENCE: Published literature was retrieved through searches of PubMed and the Cochrane Library in October 2011 using appropriate, controlled vocabulary (e...
September 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27591352/diabetes-in-pregnancy
#6
Howard Berger, Robert Gagnon, Mathew Sermer, Melanie Basso, Hayley Bos, Richard N Brown, Emmanuel Bujold, Stephanie L Cooper, Robert Gagnon, Katy Gouin, N Lynne McLeod, Savas M Menticoglou, William R Mundle, Anne Roggensack, Frank L Sanderson, Jennifer D Walsh
OBJECTIVE: This guideline reviews the evidence relating to the diagnosis and obstetrical management of diabetes in pregnancy. OUTCOMES: The outcomes evaluated were short- and long-term maternal outcomes, including preeclampsia, Caesarean section, future diabetes, and other cardiovascular complications, and fetal outcomes, including congenital anomalies, stillbirth, macrosomia, birth trauma, hypoglycemia, and long-term effects. EVIDENCE: Published literature was retrieved through searches of PubMed and the Cochrane Library using appropriate controlled vocabulary (MeSH terms "diabetes" and "pregnancy")...
July 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27443991/canadian-stroke-best-practice-recommendations-managing-transitions-of-care-following-stroke-guidelines-update-2016
#7
Jill I Cameron, Colleen O'Connell, Norine Foley, Katherine Salter, Rhonda Booth, Rosemary Boyle, Donna Cheung, Nancy Cooper, Helene Corriveau, Dar Dowlatshahi, Annie Dulude, Patti Flaherty, Ev Glasser, Gord Gubitz, Debbie Hebert, Jacquie Holzmann, Patrick Hurteau, Elise Lamy, Suzanne LeClaire, Taylor McMillan, Judy Murray, David Scarfone, Eric E Smith, Vivian Shum, Kim Taylor, Trudy Taylor, Catherine Yanchula, Robert Teasell, Patrice Lindsay
Every year, approximately 62,000 people with stroke and transient ischemic attack are treated in Canadian hospitals. For patients, families and caregivers, this can be a difficult time of adjustment. The 2016 update of the Canadian Managing Transitions of Care following Stroke guideline is a comprehensive summary of current evidence-based and consensus-based recommendations appropriate for use by clinicians who provide care to patients following stroke across a broad range of settings. The focus of these recommendations is on support, education and skills training for patients, families and caregivers; effective discharge planning; interprofessional communication; adaptation in resuming activities of daily living; and transition to long-term care for patients who are unable to return to or remain at home...
October 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27418966/willingness-to-participate-in-a-randomized-trial-comparing-catheters-to-fistulas-for-vascular-access-in-incident-hemodialysis-patients-an-international-survey-of-nephrologists
#8
Krishna Poinen, Matthew J Oliver, Pietro Ravani, Sabine N Van der Veer, Kitty J Jager, Wim Van Biesen, Kevan R Polkinghorne, Aviva Rosenfeld, Adriane M Lewin, Mandeep Dulai, Robert R Quinn
BACKGROUND: Current guidelines favor fistulas over catheters as vascular access. Yet, the observational literature comparing fistulas to catheters has important limitations and biases that may be difficult to overcome in the absence of randomization. However, it is not clear if physicians would be willing to participate in a clinical trial comparing fistulas to catheters. OBJECTIVES: We also sought to elicit participants' opinions on willingness to participate in a future trial regarding catheters and fistulas...
2016: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/27228224/a-validated-case-definition-for-chronic-rhinosinusitis-in-administrative-data-a-canadian-perspective
#9
Luke Rudmik, Yuan Xu, Edward Kukec, Mingfu Liu, Stafford Dean, Hude Quan
BACKGROUND: Pharmacoepidemiological research using administrative databases has become increasingly popular for chronic rhinosinusitis (CRS); however, without a validated case definition the cohort evaluated may be inaccurate resulting in biased and incorrect outcomes. The objective of this study was to develop and validate a generalizable administrative database case definition for CRS using International Classification of Diseases, 9th edition (ICD-9)-coded claims. METHODS: A random sample of 100 patients with a guideline-based diagnosis of CRS and 100 control patients were selected and then linked to a Canadian physician claims database from March 31, 2010, to March 31, 2015...
May 26, 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/27208607/medical-abortion
#10
Dustin Costescu, Edith Guilbert, Jeanne Bernardin, Amanda Black, Sheila Dunn, Brian Fitzsimmons, Wendy V Norman, Helen Pymar, Judith Soon, Konia Trouton, Marie-Soleil Wagner, Ellen Wiebe, Karen Gold, Marie-Ève Murray, Beverly Winikoff, Matthew Reeves
OBJECTIVE: This guideline reviews the evidence relating to the provision of first-trimester medical induced abortion, including patient eligibility, counselling, and consent; evidence-based regimens; and special considerations for clinicians providing medical abortion care. INTENDED USERS: Gynaecologists, family physicians, registered nurses, midwives, residents, and other healthcare providers who currently or intend to provide pregnancy options counselling, medical abortion care, or family planning services...
April 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27136407/obstructive-sleep-apnea-as-an-independent-stroke-risk-factor-a-review-of-the-evidence-stroke-prevention-guidelines-and-implications-for-neuroscience-nursing-practice
#11
Sharon King, Norma Cuellar
BACKGROUND: Stroke is a leading cause of death and disability affecting nearly 800,000 people in the United States every year. Obstructive sleep apnea (OSA) is found in over 60% of patients with stroke/transient ischemic attack (TIA) and identified as an independent stroke risk factor in large epidemiology studies and Canadian Stroke Prevention Guidelines (SPG) but not in the United States. The 2014 Secondary SPG recommend OSA screening and treatment as a consideration only, not a requirement...
June 2016: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/27106200/canadian-contraception-consensus-part-3-of-4-chapter-8-progestin-only-contraception
#12
Amanda Black, Edith Guilbert, Dustin Costescu, Sheila Dunn, William Fisher, Sari Kives, Melissa Mirosh, Wendy Norman, Helen Pymar, Robert Reid, Geneviève Roy, Hannah Varto, Ashley Waddington, Marie-Soleil Wagner, Anne Marie Whelan
OBJECTIVE: To provide guidelines for health care providers on the use of contraceptive methods to prevent pregnancy and on the promotion of healthy sexuality. OUTCOMES: Overall efficacy of cited contraceptive methods, assessing reduction in pregnancy rate, safety, ease of use, and side effects; the effect of cited contraceptive methods on sexual health and general well-being; and the relative cost and availability of cited contraceptive methods in Canada. EVIDENCE: Published literature was retrieved through searches of Medline and The Cochrane Database from January 1994 to January 2015 using appropriate controlled vocabulary (e...
March 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27076972/non-invasive-ventilation-in-immunocompromised-patients-with-acute-hypoxemic-respiratory-failure
#13
Lorenzo Del Sorbo, Angela Jerath, Martin Dres, Matteo Parotto
The survival rate of immunocompromised patients has improved over the past decades in light of remarkable progress in diagnostic and therapeutic options. Simultaneously, there has been an increase in the number of immunocompromised patients with life threatening complications requiring intensive care unit (ICU) treatment. ICU admission is necessary in up to 15% of patients with acute leukemia and 20% of bone marrow transplantation recipients, and the main reason for ICU referral in this patient population is acute hypoxemic respiratory failure, which is associated with a high mortality rate, particularly in patients requiring endotracheal intubation...
March 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27032746/canadian-contraception-consensus-part-3-of-4-chapter-7-intrauterine-contraception
#14
Amanda Black, Edith Guilbert, Dustin Costescu, Sheila Dunn, William Fisher, Sari Kives, Melissa Mirosh, Wendy Norman, Helen Pymar, Robert Reid, Geneviève Roy, Hannah Varto, Ashley Waddington, Marie-Soleil Wagner, Anne Marie Whelan, Shireen Mansouri
OBJECTIVE: To provide guidelines for health care providers on the use of contraceptive methods to prevent pregnancy and on the promotion of healthy sexuality. OUTCOMES: Overall efficacy of cited contraceptive methods, assessing reduction in pregnancy rate, safety, ease of use, and side effects; the effect of cited contraceptive methods on sexual health and general well-being; and the relative cost and availability of cited contraceptive methods in Canada. EVIDENCE: Published literature was retrieved through searches of Medline and The Cochrane Database from January 1994 to January 2015 using appropriate controlled vocabulary (e...
February 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/26968472/quantification-of-the-external-validity-of-randomized-controlled-trials-supporting-clinical-care-guidelines-the-case-of-thromboprophylaxis
#15
Sami Morin-Ben Abdallah, Aurore Dutilleul, Valérie Nadon, Ji Wei Yang, Xavier Marchand-Sénécal, Paul Van Nguyen, Maxime Lamarre-Cliche, Robert Wistaff, Christophe Kolan, Mikhael Laskine, Madeleine Durand
BACKGROUND: Clinical guidelines are based on the results of several randomized controlled trials. However, due to the stringent exclusion criteria of these trials, their external validity may be low. We aimed to evaluate the external validity of the randomized controlled trials cited in the American College of Chest Physicians guidelines for the use of pharmacological thromboprophylaxis in hospitalized medical patients. METHODS: We conducted a cross-sectional, chart-review study of a random sample of patients admitted between July 1, 2013 and June 30, 2014 to the Internal Medicine ward of a large Canadian teaching university hospital...
July 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/26962170/oncologists-selection-of-genetic-and-molecular-testing-in-the-evolving-landscape-of-stage-ii-colorectal-cancer
#16
Aparna R Parikh, Nancy L Keating, Pang-Hsiang Liu, Stacy W Gray, Carrie N Klabunde, Katherine L Kahn, David A Haggstrom, Sapna Syngal, Benjamin Kim
PURPOSE: Little is known about the roles of genetic and molecular testing and Lynch syndrome screening in the formulation of predictive and prognostic assessments for patients with stage II colorectal cancer (CRC). METHODS: From 2012 to 2013, we surveyed medical oncologists in the Cancer Care Outcomes Research and Surveillance Consortium and evaluated oncologists' selection of microsatellite instability (MSI) and/or immunohistochemistry (IHC) for mismatch repair (MMR) proteins, germline testing for MMR genes, BRAF and KRAS mutation analysis, and Oncotype DX in stage II CRC...
March 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/26869015/effectiveness-of-computer-tailoring-versus-peer-support-web-based-interventions-in-promoting-physical-activity-among-insufficiently-active-canadian-adults-with-type-2-diabetes-protocol-for-a-randomized-controlled-trial
#17
François Boudreau, Michel Moreau, José Côté
BACKGROUND: Type 2 diabetes is a major challenge for Canadian public health authorities, and regular physical activity is a key factor in the management of this disease. Given that less than half of people with type 2 diabetes in Canada are sufficiently active to meet the Canadian Diabetes Association's guidelines, effective programs targeting the adoption of regular physical activity are in demand for this population. Many researchers have argued that Web-based interventions targeting physical activity are a promising avenue for insufficiently active populations; however, it remains unclear if this type of intervention is effective among people with type 2 diabetes...
2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/26798375/the-association-between-self-monitoring-of-blood-glucose-hemoglobin-a1c-and-testing-patterns-in-community-pharmacies-results-of-a-pilot-study
#18
Kerry Mansell, Charity Evans, David Tran, Shellina Sevany
OBJECTIVES: To determine if pharmacists providing advice on self-monitoring of blood glucose (SMBG) to new meter users, based on the Canadian Diabetes Association (CDA) Clinical Practice Guidelines (CPGs), resulted in improvements in A1C. SMBG testing patterns and pharmacist interactions were also observed. METHODS: A cluster randomized, pilot study was performed, with pharmacies randomized to an intervention or control group. The intervention group provided SMBG education according to the CDA CPGs at baseline, 2 weeks, 1 month and 3 months; the control group provided usual care...
January 2016: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/26796832/familial-hypercholesterolemia-review-of-diagnosis-screening-and-treatment
#19
REVIEW
Ricky D Turgeon, Arden R Barry, Glen J Pearson
OBJECTIVE: To summarize the pathophysiology, epidemiology, screening, diagnosis, and treatment of familial hypercholesterolemia (FH). QUALITY OF EVIDENCE: A PubMed search was conducted (inception to July 2014) for articles on pathophysiology, screening, diagnosis, and management of FH, supplemented with hand searches of bibliographies of guidelines and reviews. A supporting level of evidence for each recommendation was categorized as level I (randomized controlled trial or systematic review of randomized controlled trials), level II (observational study), or level III (expert opinion)...
January 2016: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/26629725/canadian-contraception-consensus-part-2-of-4
#20
Amanda Black, Edith Guilbert, Dustin Costescu, Sheila Dunn, William Fisher, Sari Kives, Melissa Mirosh, Wendy V Norman, Helen Pymar, Robert Reid, Geneviève Roy, Hannah Varto, Ashley Waddington, Marie-Soleil Wagner, Anne Marie Whelan, Carrie Ferguson, Claude Fortin, Maria Kielly, Shireen Mansouri, Nicole Todd
OBJECTIVE: To provide guidelines for health care providers on the use of contraceptive methods to prevent pregnancy and on the promotion of healthy sexuality. OUTCOMES: Guidance for Canadian practitioners on overall effectiveness, mechanism of action, indications, contraindications, non-contraceptive benefits, side effects and risks, and initiation of cited contraceptive methods; family planning in the context of sexual health and general well-being; contraceptive counselling methods; and access to, and availability of, cited contraceptive methods in Canada...
November 2015: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
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