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https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#1
Inge Hommel, Petra J van Gurp, Alfons A den Broeder, Hub Wollersheim, Femke Atsma, Marlies E J L Hulscher, Cees J Tack
As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care...
April 24, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28437802/surveillance-after-resection-of-pancreatic-ductal-adenocarcinoma-with-curative-intent-a-multicenter-survey-in-germany-and-review-of-the-literature
#2
Thomas J Ettrich, Lucas A Schulte, Natalie Eitel, Kristin Ettrich, Andreas W Berger, Lukas Perkhofer, Thomas Seufferlein
Background Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers with high risk of relapse even after curative-intended resection. There are no evidence-based recommendations for surveillance in actual guidelines. Given this situation and as a basis for prospective studies, we wanted to determine the current practice of surveillance after pancreatic cancer resection in German institutions. Methods A web-based questionnaire was sent in 2015 to 300 German institutions (hospitals, outpatient clinics, and private practices) experienced in the care of patients with PDAC...
April 24, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28437764/the-use-of-lithium-for-the-treatment-of-bipolar-disorder-recommendations-from-clinical-practice-guidelines
#3
Gin S Malhi, Danielle Gessler, Tim Outhred
BACKGROUND: Lithium is an effective mood stabilizer that is used principally for the management of bipolar disorder (BD). Its administration is complex and often requires sophisticated management and assiduous monitoring. When considering the use of lithium therapy for bipolar disorder, clinicians are advised to refer to recommendations outlined in clinical practice guidelines (CPGs); but because of varying emphases placed by different international CPGs, recommendations addressing the practical use of lithium lack consistency...
March 27, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28437749/epilepsy-awareness-and-emergency-rescue-training-ignorance-is-bliss
#4
Rohit Shankar, Caryn Jory, Brendan McLean, Phil Tittensor, Matthew Walker
Status epilepticus (SE) has a high mortality rate and is associated with complications such as neurological deficit and cognitive decline. Buccal midazolam is the recommended emergency rescue medication in the UK to reduce the duration of a seizure and SE. It should be administered by an appropriately trained person. There are agreed guidelines on training standards for its administration in the UK produced by the Joint Epilepsy Council of the United Kingdom and Ireland. Training should provide an overview of epilepsy to facilitate safe, person-centered care and appropriate administration of rescue medication to people with epilepsy (PWE)...
April 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#5
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28437369/ethical-challenges-and-the-donation-physician-specialist-a-scoping-review
#6
Shavaun I MacDonald, Sam D Shemie
Deceased donation medicine involves unique ethical challenges. Physicians who are focused on deceased donation medicine as part of their practice can expect to encounter these challenges. The goal of this review is to identify and describe these challenges, highlight existing guidelines and policy regarding the management of these challenges and to describe how the donation physician role might promote ethical practice in deceased donation medicine. Themes of discussion include: communication with families, interprofessional conflict, donation physician personal characteristics, donation clinical processes, health resource allocation, research and education, and remuneration...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28437162/adjuvant-systemic-therapy-and-adjuvant-radiation-therapy-for-stage-i-to-iiia-completely-resected-non-small-cell-lung-cancers-american-society-of-clinical-oncology-cancer-care-ontario-clinical-practice-guideline-update
#7
Mark G Kris, Laurie E Gaspar, Jamie E Chaft, Erin B Kennedy, Christopher G Azzoli, Peter M Ellis, Steven H Lin, Harvey I Pass, Rahul Seth, Frances A Shepherd, David R Spigel, John R Strawn, Yee C Ung, Michael Weyant
Purpose The panel updated the American Society of Clinical Oncology (ASCO) adjuvant therapy guideline for resected non-small-cell lung cancers. Methods ASCO convened an update panel and conducted a systematic review of the literature, investigating adjuvant therapy in resected non-small-cell lung cancers. Results The updated evidence base covered questions related to adjuvant systemic therapy and included a systematic review conducted by Cancer Care Ontario current to January 2016. A recent American Society for Radiation Oncology guideline and systematic review, previously endorsed by ASCO, was used as the basis for recommendations for adjuvant radiation therapy...
April 24, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28436999/clinical-practice-guidelines-on-the-evidence-based-use-of-integrative-therapies-during-and-after-breast-cancer-treatment
#8
REVIEW
Heather Greenlee, Melissa J DuPont-Reyes, Lynda G Balneaves, Linda E Carlson, Misha R Cohen, Gary Deng, Jillian A Johnson, Matthew Mumber, Dugald Seely, Suzanna M Zick, Lindsay M Boyce, Debu Tripathy
Answer questions and earn CME/CNE Patients with breast cancer commonly use complementary and integrative therapies as supportive care during cancer treatment and to manage treatment-related side effects. However, evidence supporting the use of such therapies in the oncology setting is limited. This report provides updated clinical practice guidelines from the Society for Integrative Oncology on the use of integrative therapies for specific clinical indications during and after breast cancer treatment, including anxiety/stress, depression/mood disorders, fatigue, quality of life/physical functioning, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance...
April 24, 2017: CA: a Cancer Journal for Clinicians
https://www.readbyqxmd.com/read/28436601/management-of-skin-adverse-events-associated-with-immune-checkpoint-inhibitors-in-patients-with-melanoma-a-nursing-perspective
#9
Melissa Thebeau, Krista Rubin, Matthias Hofmann, Julia Grimm, Alyona Weinstein, Jennifer N Choi
PURPOSE: Immune checkpoint inhibitors are associated with a unique immune-related side effect profile that requires prompt recognition and management. Skin toxicities are the most common, and often earliest occurring, drug-related adverse events (AEs) of any grade observed upon treatment with these agents. The purpose of this review is to provide practical guidance on the identification and treatment of skin AEs associated with the immune checkpoint inhibitors (ipilimumab, nivolumab, and pembrolizumab) from a nursing perspective, and demonstrate hands-on application of the guidance using relevant patient case studies...
April 24, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28436206/clinical-practice-guidelines-on-iron-therapy-a-critical-evaluation
#10
Lucia Del Vecchio, Francesco Locatelli
Anemia is common among patients with chronic kidney disease (CKD) and it is managed primarily with erythropoiesis-stimulating agents (ESA) and iron therapy. Following concerns around ESA therapy and economic constraints, IV iron is more and more administered worldwide. Several guidelines or position papers, which give indications on iron therapy in CKD patients, have been issued in Nephrology. Unfortunately, the field is characterized by a lack of evidence. As a result, the recommendations/suggestions are not uniform...
April 24, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28435905/transurethral-resection-of-the-prostate-bladder-explosion-and-hyponatremic-encephalopathy-a-rare-case-report-of-malpractice
#11
Giuseppe Vacchiano, Aldo Rocca, Rita Compagna, Anna Ginevra Immacolata Zamboli, Vera Cirillo, Lorenza Di Domenico, Veronica Di Nardo, Giuseppe Servillo, Bruno Amato
We present an original case report of a bladder explosion during a TURP intervention for benign prostatic hypertrophy, that was brought on by the absorption of about 5 liters of glycine 1.5% and then onset of a severe hyponatremia. The quick and inappropriate correction of this electrolyte imbalance led the onset of encephalopathy and the death of the patient. The authors discuss the pathogenesis of these uncommon diseases and, considering the most recent Italian Legislation, they highlight the importance to respect good clinical practice standards and guidelines to ensure the most appropriate treatments for the patient and remove any assumptions of medical liability...
January 2017: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/28435338/recommendations-for-optimizing-methotrexate-treatment-for-patients-with-rheumatoid-arthritis
#12
REVIEW
Alfonso E Bello, Elizabeth L Perkins, Randy Jay, Petros Efthimiou
Methotrexate (MTX) remains the cornerstone therapy for patients with rheumatoid arthritis (RA), with well-established safety and efficacy profiles and support in international guidelines. Clinical and radiologic results indicate benefits of MTX monotherapy and combination with other agents, yet patients may not receive optimal dosing, duration, or route of administration to maximize their response to this drug. This review highlights best practices for MTX use in RA patients. First, to improve the response to oral MTX, a high initial dose should be administered followed by rapid titration...
2017: Open Access Rheumatology: Research and Reviews
https://www.readbyqxmd.com/read/28435313/evidence-and-consensus-recommendations-for-the-pharmacological-management-of-pain-in-india
#13
REVIEW
Gur Prasad Dureja, Rajagopalan N Iyer, Gautam Das, Jaishid Ahdal, Prashant Narang
Despite enormous progress in the field of pain management over the recent years, pain continues to be a highly prevalent medical condition worldwide. In the developing countries, pain is often an undertreated and neglected aspect of treatment. Awareness issues and several misconceptions associated with the use of analgesics, fear of adverse events - particularly with opioids and surgical methods of analgesia - are major factors contributing to suboptimal treatment of pain. Untreated pain, as a consequence, is associated with disability, loss of income, unemployment and considerable mortality; besides contributing majorly to the economic burden on the society and the health care system in general...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28434482/how-to-implement-clinical-guidelines-to-optimise-familial-hypercholesterolaemia-diagnosis-and-treatment
#14
Michel Farnier, Fernando Civeira, Olivier Descamps
BACKGROUND AND AIMS: Familial hypercholesterolaemia (FH) is a genetic disorder associated with significantly elevated plasma low-density lipoprotein cholesterol (LDL-C) and premature coronary heart disease (CHD). Optimal management of FH relies on early identification and treatment with statins alone or in combination with other lipid-lowering therapies. A lack of awareness of FH and its manifestations among primary care physicians and specialists has led to many individuals being misdiagnosed in the early stages of the disease, further increasing the risk of CHD and requiring much more intensive lipid-lowering strategies...
April 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/28434481/is-there-a-role-for-lifestyle-changes-in-cardiovascular-prevention-what-when-and-how
#15
Lluís Masana, Emilio Ros, Isabella Sudano, Denis Angoulvant
BACKGROUND AND AIMS: Lifestyle has been found to play an important role in the prevention of cardiovascular disease (CVD). There is evidence to suggest that if lifestyle factors are modified successfully, the relative risk of CVD can be reduced. Risk factors for CVD such as high blood pressure, diabetes mellitus and dyslipidaemias can be modified by lifestyle changes. The main aim of this article is to provide best practice approaches and support for healthcare professionals on the role of lifestyle changes in the prevention of CVD...
April 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/28433587/pharmacokinetic-and-toxicology-comparator-testing-of-biosimilar-drugs-assessing-need
#16
Paul Baldrick
A key element in the development of a biosimilar molecule is the comparability of the biological activity/nonclinical similarity to the innovator drug. Although some regulatory guidelines are encouraging little or no in vivo testing, currently a common practice is to perform at least one toxicology and/or one pharmacokinetic (PK) study to assess if any different findings occur for in-life, clinical pathology and histopathological parameters or in exposure. An exercise was performed in which the results of such testing were evaluated...
April 19, 2017: Regulatory Toxicology and Pharmacology: RTP
https://www.readbyqxmd.com/read/28433541/the-impact-of-2013-updated-asco-cap-her2-guidelines-on-the-diagnosis-and-management-of-invasive-breast-cancer-a-single-center-study-of-1739-cases
#17
Xiaofei Zhang, Ira Bleiweiss, Shabnam Jaffer, Anupma Nayak
BACKGROUND: The purpose of this study was to determine the impact of revised ASCO/CAP 2013 HER2 guidelines on the clinical practice of pathologists and oncologists. MATERIALS AND METHODS: Retrospective analysis of 1739 patients with invasive breast carcinoma who underwent reflex HER2 (fluorescence in situ hybridization [FISH]) testing, using both 2007 and 2013 guidelines (2007-2014). RESULTS: Using 2013 guidelines, 255 (15%; 95% confidence interval [CI], 13%-16%) cases were classified as HER2(+) as opposed to 186 (11%; 95% CI, 9%-12%) by 2007 guidelines (odds ratio [OR] 1...
March 29, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28432756/high-rate-of-systemic-corticosteroid-prescription-among-outpatient-visits-for-psoriasis-a-population-based-epidemiological-study-using-the-korean-national-health-insurance-database
#18
Sang Jun Eun, Sihyeok Jang, Jin Yong Lee, Young Kyung Do, Seong Jin Jo
The use of systemic corticosteroids (SC) for the treatment of psoriasis is not recommended according to textbooks and guidelines. In clinical practise, however, many physicians frequently prescribe SC for patients with psoriasis. To determine the magnitude of SC prescription for outpatients with psoriasis in Korea and identify factors associated with the use of SC, we used the 2010-2014 nationwide claims data of the Health Insurance Review and Assessment Service of Korea. In frequency analysis for the full scale of prescribed SC, oral methylprednisolone was the most frequently prescribed SC, followed by dexamethasone and betamethasone injections...
April 22, 2017: Journal of Dermatology
https://www.readbyqxmd.com/read/28432090/international-variations-in-clinical-practice-guidelines-for-palliative-sedation-a-systematic-review
#19
REVIEW
Ebun Abarshi, Judith Rietjens, Lenzo Robijn, Augusto Caraceni, Sheila Payne, Luc Deliens, Lieve Van den Block
OBJECTIVES: Palliative sedation is a highly debated medical practice, particularly regarding its proper use in end-of-life care. Worldwide, guidelines are used to standardise care and regulate this practice. In this review, we identify and compare national/regional clinical practice guidelines on palliative sedation against the European Association for Palliative Care (EAPC) palliative sedation Framework and assess the developmental quality of these guidelines using the Appraisal Guideline Research and Evaluation (AGREE II) instrument...
April 20, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28431077/implantable-cardioverter-defibrillator-use-for-primary-prevention-in-ischaemic-and-non-ischaemic-heart-disease-indications-in-the-post-danish-trial-era-results-of-the-european-heart-rhythm-association-survey
#20
Kristina H Haugaa, Roland Tilz, Serge Boveda, Dan Dobreanu, Elena Sciaraffia, Jacques Mansourati, Giorgi Papiashvili, Nikolaos Dagres
Implantable cardioverter-defibrillator (ICD) is the standard of care for prevention of sudden cardiac death (SCD) in high-risk patients. For primary prevention of SCD, in patients with ischaemic heart disease, there is more robust data on the effect of ICD therapy compared with patients with non-ischaemic heart disease, but current real-life practice may differ substantially. The aim of this European Heart Rhythm Association survey was to evaluate the clinical practice regarding implantation of ICD for primary prevention among European countries in patients with non-ischaemic and ischaemic heart disease...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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