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https://www.readbyqxmd.com/read/29678866/gaps-in-guidelines-for-the-management-of-diabetes-in-low-and-middle-income-versus-high-income-countries-a-systematic-review
#1
REVIEW
Mayowa O Owolabi, Joseph O Yaria, Meena Daivadanam, Akintomiwa I Makanjuola, Gary Parker, Brian Oldenburg, Rajesh Vedanthan, Shane Norris, Ayodele R Oguntoye, Morenike A Osundina, Omarys Herasme, Sulaiman Lakoh, Luqman O Ogunjimi, Sarah E Abraham, Paul Olowoyo, Carolyn Jenkins, Wuwei Feng, Hernán Bayona, Sailesh Mohan, Rohina Joshi, Ruth Webster, Andre P Kengne, Antigona Trofor, Lucia Maria Lotrean, Devarsetty Praveen, Jessica H Zafra-Tanaka, Maria Lazo-Porras, Kirsten Bobrow, Michaela A Riddell, Konstantinos Makrilakis, Yannis Manios, Bruce Ovbiagele
OBJECTIVE: The extent to which diabetes (DM) practice guidelines, often based on evidence from high-income countries (HIC), can be implemented to improve outcomes in low- and middle-income countries (LMIC) is a critical challenge. We carried out a systematic review to compare type 2 DM guidelines in individual LMIC versus HIC over the past decade to identify aspects that could be improved to facilitate implementation. RESEARCH DESIGN AND METHODS: Eligible guidelines were sought from online databases and websites of diabetes associations and ministries of health...
May 2018: Diabetes Care
https://www.readbyqxmd.com/read/29671037/-geriatric-intensive-care-patients-perspectives-and-limits-of-geriatric-intensive-care-medicine
#2
REVIEW
U Müller-Werdan, H-J Heppner, G Michels
Critically ill geriatric patients are vitally endangered due to the aging processes of organs, the frequently existing multimorbidity with subsequent polypharmacy and the typical geriatric syndrome of functional impairments. Aging processes in organs lower the clinical threshold for organ dysfunction and organ failure. Physiological organ aging processes with practical consequences for intensive care medicine are atypical manifestion of sepsis in immunosenescence, altered pharmacokinetics, reduced tolerance to hypovolemia due to proportionally reduced water compartment of the body in old age, the frequently only apparently normal function of the kidneys and the continuous reduction in pulmonary function in old age...
April 18, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29670404/evaluation-of-vancomycin-therapy-in-the-adult-icus-of-a-teaching-hospital-in-southern-iran
#3
Afsaneh Vazin, Motahare Mahi Birjand, Masoud Darake
Background: Vancomycin resistance in intensive care units (ICUs) accounts for significant morbidity and excess costs. The objective of the present study was to determine the appropriateness of vancomycin use in the various ICUs of Nemazee Hospital, Shiraz, Iran. Methods: This prospective study was performed on 95 critically ill patients (48 males and 47 females) who were treated with vancomycin for at least 3 subsequent doses in 6 ICUs during 12 months. Required demographic, clinical, and paraclinical data were collected by a pharmacist...
2018: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/29669706/reasons-for-physicians-not-adopting-clinical-decision-support-systems-critical-analysis
#4
REVIEW
Saif Khairat, David Marc, William Crosby, Ali Al Sanousi
BACKGROUND: Clinical decision support systems (CDSSs) are an integral component of today's health information technologies. They assist with interpretation, diagnosis, and treatment. A CDSS can be embedded throughout the patient safety continuum providing reminders, recommendations, and alerts to health care providers. Although CDSSs have been shown to reduce medical errors and improve patient outcomes, they have fallen short of their full potential. User acceptance has been identified as one of the potential reasons for this shortfall...
April 18, 2018: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29669670/utilization-and-timeliness-of-an-inpatient-penicillin-allergy-evaluation
#5
Keith A Sacco, Razvan Chirila, Claudia Libertin, Brett Hiroto, Arveen Bhasin, Margaret M Johnson, Thanai Pongdee, M Caroline Burton
BACKGROUND: A history of penicillin allergy is associated with an increased risk of nosocomial infections because patients are exposed to non-beta lactam antibiotics. Ruling out inaccurate penicillin allergy during hospitalization decreases prescription of beta lactam antibiotics. However, the utilization of penicillin allergy testing and timeliness in relation to initiation of antibiotics is not known. OBJECTIVE: Our aim was to describe the proportion and characteristics of patients who underwent inpatient penicillin allergy testing in a hospital without a guideline or infrastructure for inpatient penicillin allergy testing...
May 1, 2018: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/29667019/what-is-new-in-heart-failure-management-in-2017-update-on-acc-aha-heart-failure-guidelines
#6
REVIEW
Biykem Bozkurt
PURPOSE OF REVIEW: The goal of this paper is to provide a summary of the new recommendations in the most recent 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. The intent is to provide the background and the supporting evidence for the recommendations and to provide practical guidance for management strategies in treatment of heart failure patients...
April 17, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29662295/should-hot-biopsy-forceps-be-abandoned-for-polypectomy-of-diminutive-colorectal-polyps
#7
Vasileios Panteris, Antonios Vezakis, J K Triantafillidis
Standardized approach to polypectomy of diminutive colorectal polyps (DCPs) is lacking since cold biopsy forceps have been associated with high levels of recurrence, hot biopsy forceps are considered inadequate and risky and cold snaring is currently under investigation for its efficacy and safety. This has led to confusion and a gap in clinical practice. This article discusses the usefulness and contemporary practical applicability of hot biopsy forceps and provides well-intentioned criticism of the new European guidelines for the treatment of DCPs...
April 14, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29659359/-pneumonia-associated-with-mechanical-ventilation-update-and-recommendations-inter-societies-sadi-sati
#8
Wanda Cornistein, Ángel M Colque, María Inés Staneloni, María Monserrat Lloria, Mónica Lares, Ana Laura González, Alejandro Fernández Garcés, Edith Carbone
Representatives of the Argentine Society of Infectious Diseases (SADI) and the Argentine Society of Intensive Therapy (SATI) worked together on the development of specific recommendations for the diagnosis, treatment and prevention of ventilator-associated pneumonia (VAP). The methodology used was the analysis of the literature published in the last 15 years, complemented with the opinion of experts and local data. This document aims to offer basic tools to optimize diagnosis based on clinical and microbiological criteria, orientation in empirical and targeted antibiotic schemes, news on posology and administration of antibiotics in critical patients and to promote effective measures to reduce the risk of VAP...
2018: Medicina
https://www.readbyqxmd.com/read/29659093/oral-intake-evaluation-in-patients-following-critical-illness-an-icu-cohort-study
#9
Rebecca J Jarden, Lynsey Sutton-Smith, Catherine Boulton
Timely and adequate nutrition improves health outcomes for the critically ill patient. Despite clinical guidelines recommending early oral nutrition, survivors of critical illness experience significant nutritional deficits. This cohort study evaluates the oral nutrition intake in intensive care unit (ICU) patients who have experienced recent critical illness. The oral nutrition intake of a convenience sample of ICU patients post-critical illness was observed during a 1-month period. Data pertaining to both the amount of oral nutrition intake and factors impacting optimal oral nutrition intake were collected and analysed...
April 16, 2018: Nursing in Critical Care
https://www.readbyqxmd.com/read/29658794/views-of-general-practitioners-toward-physiotherapy-management-of-osteoarthritis-a-qualitative-study
#10
Andrew Okwera, Stephen May
BACKGROUND: Osteoarthritis (OA) is a major cause of pain and physical disability, and general practitioners (GPs) are usually the first point of contact for patients. Physiotherapy has been shown as effective in the management of lower-limb OA. The aim was to explore the beliefs of GPs on the physiotherapy management of lower-limb OA in primary care. METHODS: This is a qualitative study evaluating GP views about physiotherapy in Sheffield, South Yorkshire, UK. Participating GPs were recruited by systematic sampling, and invitation was given to GPs in 10 practices in the four localities in Sheffield...
April 16, 2018: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/29657606/early-biliary-drainage-is-associated-with-favourable-outcomes-in-critically-ill-patients-with-acute-cholangitis
#11
Mohammed Aboelsoud, Osama Siddique, Alexander Morales, Young Seol, Mazen Al-Qadi
Introduction: Acute cholangitis (AC) is a clinical condition that requires prompt medical management with IV fluids, antibiotics, and biliary drainage (BD). The optimal timing for BD remains unclear. Aim: To investigate the effect of biliary drainage timing on clinical outcomes in AC. Material and methods: We conducted a retrospective study of patients with AC admitted to the ICU using the Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III) database...
2018: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/29657372/targeted-interventions-in-critically-ill-children-with-severe-dengue
#12
Suchitra Ranjit, Gokul Ramanathan, Balasubramaniam Ramakrishnan, Niranjan Kissoon
Background: The World Health Organization guidelines provide suggestions on early recognition and treatment of severe dengue (SD); however, mortality in this group can be high and is related both to disease severity and the treatment complications. Subjects and Methods: In this prospective observational study, we report our results where standard therapy (ST) was enhanced by Intensive Care Unit (ICU) supportive measures that have proven beneficial in other conditions that share similar pathophysiology of capillary leak and fluid overload...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29655958/a-second-derivate-fitting-algorithm-for-the-quantification-of-free-hemoglobin-in-human-plasma
#13
Michael Paal, Alexander Lang, Georg Hennig, Marie-Luise Buchholtz, Ronald Sroka, Michael Vogeser
BACKGROUND: Assessment of hemolysis in vivo is becoming increasingly relevant in critical care. Current methods (Harboe, 1959) for quantifying the free hemoglobin (fHb) content produce unsatisfactory results in case of hyperbilirubinemia, a frequent condition in patients at risk for intravascular hemolysis. METHODS: A novel evaluation method based on second-derivative fitting to quantify fHb content was developed. The method uses spectrophotometric data from 350 to 650 nm recorded with standard instruments as input...
April 12, 2018: Clinical Biochemistry
https://www.readbyqxmd.com/read/29652752/practice-change-from-intermittent-medication-boluses-to-bolusing-from-a-continuous-infusion-in-pediatric-critical-care-a-quality-improvement-project
#14
Jessica L Hochstetler, A Jill Thompson, Natalie M Ball, Melissa C Evans, Shaun C Frame, A Lauren Haney, Amelia K Little, Jaime L O'Donnell, Bryna M Rickett, Elizabeth H Mack
OBJECTIVES: To determine whether implementing a guideline to bolus medications from continuous infusions in PICUs affects nursing satisfaction, patient safety, central line entries, medication utilization, or cost. DESIGN: This is a pre- and postimplementation quality improvement study. SETTING: An 11-bed ICU and 14-bed cardiac ICU in a university-affiliated children's hospital. PATIENTS: Patients less than 18 years old admitted to the PICU or pediatric cardiac ICU receiving a continuous infusion of dexmedetomidine, midazolam, fentanyl, morphine, vecuronium, or cisatracurium from May 2015 to May 2016, excluding November 2015 (washout period), were eligible for inclusion...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29650498/five-years-post-nirbhaya-critical-insights-into-the-status-of-response-to-sexual-assault
#15
Sunita Vs Bandewar, Amita Pitre, Lakshmi Lingam
It is five years since the fatal gang rape of Jyothi Singh (Nirbhaya), a physiotherapy student, on December 16, 2012, in New Delhi, the capital of India. The legal and policy reforms triggered by the Nirbhaya case will remain a watershed moment in the history of efforts towards seeking justice for survivors of gender-based violence in India. The Criminal Law (Amendment) Act, 2013 and the "Guidelines and protocols: Medico-legal care for survivors/victims of sexual violence" issued by the Ministry of Health and Family Welfare in March 2014 are two landmark reforms...
March 28, 2018: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/29642547/antiplatelet-therapy-in-coronary-artery-disease-a-daunting-dilemma
#16
REVIEW
Surya Chaturvedula, Daniel Diver, Aseem Vashist
Percutaneous coronary intervention (PCI) with stenting for the treatment of acute coronary syndrome (ACS) is the contemporary standard of care. Such treatment is followed by dual antiplatelet therapy (DAPT) comprising of aspirin and a P2Y12 inhibitor. The efficacy of this therapy has been well established but the optimal duration of DAPT remains elusive, and has thus far attracted a prodigious deal of scientific attention. The decision regarding DAPT duration can be clinically challenging in the modern era with the evolution of newer stents, more potent antiplatelet agents, and novel anticoagulant drugs in addition to an older patient population with multiple comorbidities...
April 9, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29624189/improving-the-safety-of-opioid-use-for-acute-noncancer-pain-in-hospitalized-adults-a-consensus-statement-from-the-society-of-hospital-medicine
#17
Shoshana J Herzig, Hilary J Mosher, Susan L Calcaterra, Anupam B Jena, Teryl K Nuckols
Hospital-based clinicians frequently treat acute, noncancer pain. Although opioids may be beneficial in this setting, the benefits must be balanced with the risks of adverse events, including inadvertent overdose and prolonged opioid use, physical dependence, or development of opioid use disorder. In an era of epidemic opioid use and related harms, the Society of Hospital Medicine (SHM) convened a working group to develop a consensus statement on opioid use for adults hospitalized with acute, noncancer pain, outside of the palliative, end-of-life, and intensive care settings...
April 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29623341/the-updated-german-polytrauma-guideline-an-extensive-literature-evaluation-and-treatment-recommendation-for-the-care-of-the-critically-injured-patient
#18
EDITORIAL
Bertil Bouillon, Ingo Marzi
No abstract text is available yet for this article.
April 5, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29622180/roles-of-transesophageal-echocardiography-and-cardiac-computed-tomography-for-evaluation-of-left-atrial-thrombus-and-associated-pathology-a-review-and-critical-analysis
#19
REVIEW
Faraz Pathan, Harvey Hecht, Jagat Narula, Thomas H Marwick
Evaluation of the left atrium and left atrial appendage for the presence of thrombus prior to cardioversion and pulmonary vein isolation, and of the entire heart for embolic sources in the setting of cryptogenic stroke, has long been standard medical care. Guidelines have uniformly recommended transesophageal echocardiography (TEE) to accomplish these goals. In recent years, computed tomographic angiography has demonstrated diagnostic accuracy similar to that of TEE for the detection of thrombus. Analysis of the pertinent data and relative merits of the 2 technologies leads to the conclusions that: 1) both modalities have some unique, nonoverlapping capabilities that may dictate their use in specific situations; 2) computed tomographic angiography is a reasonable alternative to TEE when the primary aim is to exclude left atrial and left atrial appendage thrombus and in patients in whom the risks associated with TEE outweigh the benefits; and 3) both options should be discussed with the patient in the setting of shared decision making...
April 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29621841/australian-bat-lyssavirus
#20
Tony Merritt, Kathryn Taylor, Keren Cox-Witton, Hume Field, Kate Wingett, Diana Mendez, Michelle Power, David Durrheim
BACKGROUND: Australian bat lyssavirus (ABLV) causes human illness that is indistinguishable from classical rabies. All Australian bats have the potential to carry and transmit ABLV, and potentially risky human exposures to bats are common. ABLV infection has resulted in three human deaths in Australia since 1996. OBJECTIVE: The aim of this article is to equip general practitioners (GPs) to assist in the prevention and management of potential ABLV exposures in Australia, including complex clinical scenarios that are not fully addressed in current national guidelines...
March 2018: Australian journal of general practice
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