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Adult clinical practice Guidelines

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https://www.readbyqxmd.com/read/29330245/impact-of-pharmacist-previsit-input-to-providers-on-chronic-opioid-prescribing-safety
#1
Nicholas Cox, Casey R Tak, Susan E Cochella, Eric Leishman, Karen Gunning
INTRODUCTION: Primary care providers (PCPs) account for half of opioid prescriptions, often feel chronic pain patients are challenging to manage, and there is wide variability in practice patterns. The purpose of this pilot study was to evaluate the impact of a previsit pharmacist review of high-risk patients treated with opioids for chronic pain on compliance to guideline recommendations at a family medicine residency clinic. METHODS: All adult patients with an appointment for chronic pain who were prescribed >50 morphine milligram equivalents (MMEs)/day had charts reviewed by a pharmacist before each appointment; recommendations were sent electronically to the provider before the appointment...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29325614/ethical-issues-in-neurogenetics
#2
Wendy R Uhlmann, J Scott Roberts
Many neurogenetic conditions are inherited and therefore diagnosis of a patient will have implications for the patient's relatives and can raise ethical issues. Predictive genetic testing offers asymptomatic relatives the opportunity to determine their risk status for a neurogenetic condition, and professional guidelines emphasize patients' autonomy and informed, voluntary decision making. Beneficence and nonmaleficence both need to be considered when making decisions about disclosure and nondisclosure of genetic information and test results...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29321111/a-systematic-review-of-the-pain-scales-in-adults-which-to-use
#3
REVIEW
Ozgur Karcioglu, Hakan Topacoglu, Ozgur Dikme, Ozlem Dikme
OBJECTIVE: The study analysed the Visual Analogue Scale (VAS), the Verbal Rating Scale (VRS) and the Numerical Rating Scale (NRS) to determine: 1. Were the compliance and usability different among scales? 2. Were any of the scales superior over the other(s) for clinical use? METHODS: A systematic review of currently published studies was performed following standard guidelines. Online database searches were performed for clinical trials published before November 2017, on the comparison of the pain scores in adults and preferences of the specific patient groups...
January 6, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29318460/nebulization-of-antimicrobial-agents-in-mechanically-ventilated-adults-in-2017-an-international-cross-sectional-survey
#4
Joana Alves, Emine Alp, Despoina Koulenti, Zhongheng Zhang, Stephan Ehrmann, Stijn Blot, Matteo Bassetti, Andrew Conway-Morris, Rosa Reina, Enrique Teran, Candela Sole-Lleonart, Maria Ruiz-Rodríguez, Jordi Rello
2017 ESCMID practice guidelines reported safety concerns and weak evidence of benefit supporting use of aerosolized antibiotics in mechanically ventilated patients. Our primary goal was to assess current patterns of aerosolized antibiotic prescription in mechanically ventilated patients. A sequential global survey was performed prior to the release of the ESCMID guidelines, from the 1st of February to the 30th of April 2017, using an electronic platform. Responses were analyzed comparing geographical regions...
January 9, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29315969/effectiveness-of-interventions-to-decrease-image-ordering-for-low-back-pain-presentations-in-the-emergency-department-a-systematic-review
#5
Chaocheng Liu, Shashwat Desai, Lynette D Krebs, Scott W Kirkland, Diana Keto-Lambert, Brian H Rowe
BACKGROUND: Low back pain (LBP) is an extremely frequent reason for patients to present to an emergency department (ED). Despite evidence against the utility of imaging, simple and advanced imaging (i.e., computed tomography [CT], magnetic resonance imaging [MRI]) for patients with LBP has become increasingly frequent in the ED. The objective of this review was to identify and examine the effectiveness of interventions aimed at reducing image ordering in the ED for LBP patients. METHODS: A protocol was developed a priori, following the PRISMA guidelines, and registered with PROSPERO...
January 8, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29313888/british-association-of-dermatologists-guidelines-for-the-management-of-lichen-sclerosus-2018
#6
F M Lewis, F M Tatnall, S S Velangi, C B Bunker, A Kumar, F Brackenbury, M F Mohd Mustapa, L S Exton
The overall objective of the guideline is to provide up-to-date, evidence-based recommendations for the management of lichen sclerosus (LS) in adults (18+ years), children (0-12 years) and young people (13-17 years). The document aims to. offer an appraisal of all relevant literature up to July 2017, focusing on any key developments. address important, practical clinical questions relating to the primary guideline objective. provide guideline recommendations and if appropriate research recommendations. The guideline is presented as a detailed review with highlighted recommendations for practical use in primary care and in secondary care clinics, in addition to an updated Patient Information Leaflet (PIL; available on the BAD website, http://www...
January 4, 2018: British Journal of Dermatology
https://www.readbyqxmd.com/read/29312748/acute-respiratory-distress-syndrome-in-traumatic-brain-injury-how-do-we-manage-it
#7
REVIEW
Valentina Della Torre, Rafael Badenes, Francesco Corradi, Fabrizio Racca, Andrea Lavinio, Basil Matta, Federico Bilotta, Chiara Robba
Traumatic brain injury (TBI) is an important cause of morbidity and mortality worldwide. TBI patients frequently suffer from lung complications and acute respiratory distress syndrome (ARDS), which is associated with poor clinical outcomes. Moreover, the association between TBI and ARDS in trauma patients is well recognized. Mechanical ventilation of patients with a concomitance of acute brain injury and lung injury can present significant challenges. Frequently, guidelines recommending management strategies for patients with traumatic brain injuries come into conflict with what is now considered best ventilator practice...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29304056/incidence-and-antibiotic-prescribing-for-clinically-diagnosed-urinary-tract-infection-in-older-adults-in-uk-primary-care-2004-2014
#8
Haroon Ahmed, Daniel Farewell, Hywel M Jones, Nick A Francis, Shantini Paranjothy, Christopher C Butler
Urinary tract infections (UTI) are an important cause of morbidity and antibiotic use in older adults but there are little data describing disease burden in primary care. The aim of this study was to estimate the incidence of clinically diagnosed UTI and examine associated empirical antibiotic prescribing. We conducted a retrospective observational study using linked health records from almost one million patients aged ≥65 years old, registered with 393 primary care practices in England. We estimated incidence of clinically diagnosed UTI between March 2004 and April 2014, and used multilevel logistic regression to examine trends in empiric antibiotic prescribing...
2018: PloS One
https://www.readbyqxmd.com/read/29302885/diagnostic-evaluation-of-patients-presenting-to-primary-care-with-rectal-bleeding
#9
Sanja Percac-Lima, Lydia E Pace, Kevin H Nguyen, Charis N Crofton, Katharine A Normandin, Sara J Singer, Meredith B Rosenthal, Alyna T Chien
BACKGROUND: Rectal bleeding is a common, frequently benign problem that can also be an early sign of colorectal cancer. Diagnostic evaluation for rectal bleeding is complex, and clinical practice may deviate from available guidelines. OBJECTIVE: To assess the degree to which primary care physicians document risk factors for colorectal cancer among patients with rectal bleeding and order colonoscopies when indicated, and the likelihood of physicians ordering and patients receiving recommended colonoscopies based on demographic characteristics, visit patterns, and clinical presentations...
January 4, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29299900/guidelines-for-the-antibiotic-use-in-adults-with-acute-upper-respiratory-tract-infections
#10
REVIEW
Young Kyung Yoon, Chan Soon Park, Jae Wook Kim, Kyurin Hwang, Sei Young Lee, Tae Hoon Kim, Do Yang Park, Hyun Jun Kim, Dong Young Kim, Hyun Jong Lee, Hyun Young Shin, Yong Kyu You, Dong Ah Park, Shin Woo Kim
These guidelines were developed as part of the 2016 Policy Research Servicing Project by the Korea Centers for Disease Control and Prevention. A multidisciplinary approach was taken to formulate this guideline to provide practical information about the diagnosis and treatment of adults with acute upper respiratory tract infection, with the ultimate aim to promote the appropriate use of antibiotics. The formulation of this guideline was based on a systematic literature review and analysis of the latest research findings to facilitate evidence-based practice, and focused on key questions to help clinicians obtain solutions to clinical questions that may arise during the care of a patient...
December 2017: Infection & Chemotherapy
https://www.readbyqxmd.com/read/29298189/delay-within-the-3-hour-surviving-sepsis-campaign-guideline-on-mortality-for-patients-with-severe-sepsis-and-septic-shock
#11
Lisiane Pruinelli, Bonnie L Westra, Pranjul Yadav, Alexander Hoff, Michael Steinbach, Vipin Kumar, Connie W Delaney, Gyorgy Simon
OBJECTIVES: To specify when delays of specific 3-hour bundle Surviving Sepsis Campaign guideline recommendations applied to severe sepsis or septic shock become harmful and impact mortality. DESIGN: Retrospective cohort study. SETTING: One health system composed of six hospitals and 45 clinics in a Midwest state from January 01, 2011, to July 31, 2015. PATIENTS: All adult patients hospitalized with billing diagnosis of severe sepsis or septic shock...
January 2, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29295883/adolescent-and-young-adult-oncology-version-2-2018-nccn-clinical-practice-guidelines-in-oncology
#12
Peter F Coccia, Alberto S Pappo, Lynda Beaupin, Virginia F Borges, Scott C Borinstein, Rashmi Chugh, Shira Dinner, Jeanelle Folbrecht, A Lindsay Frazier, Robert Goldsby, Alexandra Gubin, Robert Hayashi, Mary S Huang, Michael P Link, John A Livingston, Yousif Matloub, Frederick Millard, Kevin C Oeffinger, Diane Puccetti, Damon Reed, Steven Robinson, Abby R Rosenberg, Tara Sanft, Holly L Spraker-Perlman, Margaret von Mehren, Daniel S Wechsler, Kimberly F Whelan, Nicholas Yeager, Lisa A Gurski, Dorothy A Shead
This selection from the NCCN Guidelines for Adolescent and Young Adult (AYA) Oncology focuses on treatment and management considerations for AYA patients with cancer. Compared with older adults with cancer, AYA patients have unique needs regarding treatment, fertility counseling, psychosocial and behavioral issues, and supportive care services. The complete version of the NCCN Guidelines for AYA Oncology addresses additional aspects of caring for AYA patients, including risk factors, screening, diagnosis, and survivorship...
January 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29280729/occupational-therapy-interventions-for-people-with-alzheimer-s-disease
#13
Catherine Verrier Piersol, Lou Jensen, Deborah Lieberman, Marian Arbesman
Evidence Connection articles provide a clinical application of systematic reviews developed in conjunction with the American Occupational Therapy Association's (AOTA's) Evidence-Based Practice Project. In this Evidence Connection article, we describe a case report of a person with Alzheimer's disease. The occupational therapy assessment and intervention process in the home setting is described. Findings from the systematic reviews on this topic were published in the November/December 2017 issue of the American Journal of Occupational Therapy and in AOTA's Occupational Therapy Practice Guidelines for Adults With Alzheimer's Disease and Related Major Neurocognitive Disorders...
January 2018: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
https://www.readbyqxmd.com/read/29274727/antiplatelet-therapy-with-aspirin-clopidogrel-and-dipyridamole-versus-clopidogrel-alone-or-aspirin-and-dipyridamole-in-patients-with-acute-cerebral-ischaemia-tardis-a-randomised-open-label-phase-3-superiority-trial
#14
Philip M Bath, Lisa J Woodhouse, Jason P Appleton, Maia Beridze, Hanne Christensen, Robert A Dineen, Lelia Duley, Timothy J England, Katie Flaherty, Diane Havard, Stan Heptinstall, Marilyn James, Kailash Krishnan, Hugh S Markus, Alan A Montgomery, Stuart J Pocock, Marc Randall, Annemarei Ranta, Thompson G Robinson, Polly Scutt, Graham S Venables, Nikola Sprigg
BACKGROUND: Intensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive antiplatelet therapy (combined aspirin, clopidogrel, and dipyridamole) with that of guideline-based antiplatelet therapy. METHODS: We did an international, prospective, randomised, open-label, blinded-endpoint trial in adult participants with ischaemic stroke or transient ischaemic attack (TIA) within 48 h of onset...
December 20, 2017: Lancet
https://www.readbyqxmd.com/read/29261246/impact-of-statin-guidelines-on-statin-utilization-and-costs-in-an-employer-based-primary-care-clinic
#15
Holly E Gurgle, Marisa B Schauerhamer, Simón A Rodriguez, Carrie McAdam-Marx
OBJECTIVES: The purpose of this study was to describe statin utilization and costs in an employer-based patient cohort by comparing actual practice and assumed adoption of the 2013 American College of Cardiology/American Heart Association (ACC/AHA) or 2016 US Preventive Services Task Force (USPSTF) statin recommendations versus the guidelines described in 2001 (and supplemented in 2004) in the Third Report of the National Cholesterol Education Program's Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (ATPIII)...
December 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29260505/vancomycin-dosing-and-monitoring-critical-evaluation-of-the-current-practice
#16
Fawzy Elbarbry
After more than six decades of its use as the mainstay antibiotic for the treatment of multidrug-resistant Gram-positive bacterial infections, dosing and monitoring of vancomycin therapy have not been optimized. The current vancomycin therapeutic guidelines recommend empiric doses of 15-20 mg/kg administered by intermittent infusion every 8-12 h in patients with normal kidney function. Additionally, the guidelines recommend trough concentration of 15-20 mg/L as a therapeutic goal for adult patients with severe infections...
December 19, 2017: European Journal of Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/29260460/rationale-and-design-for-the-j-discover-study-discovering-the-treatment-reality-of-type-2-diabetes-in-a-real-world-setting-in-japan-a-protocol
#17
Naoto Katakami, Tomoya Mita, Mitsuyoshi Takahara, Kiyoshi Hashigami, Masaru Kawashima, Iichiro Shimomura, Hirotaka Watada
INTRODUCTION: It is estimated that 642 million adults worldwide will have diabetes by 2040, with 80-90% of these having type 2 diabetes mellitus (T2DM). While many new antidiabetic agents have been introduced in recent years, approximately 40% of T2DM patients still fail to achieve the recommended target HbA1c of < 7.0%. Furthermore, many patients with T2DM in Japan are treated by practitioners other than diabetes specialists; therefore, the exact treatment patterns of T2DM in Japan are difficult to quantify...
December 19, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29258978/the-effectiveness-of-text-messaging-for-detection-and-management-of-hypertension-in-indigenous-people-in-canada-protocol-for-a-randomized-controlled-trial
#18
Karen Yeates, Norm Campbell, Marion A Maar, Nancy Perkins, Peter Liu, Jessica Sleeth, Carter Smith, Colin McAllister, Diane Hua-Stewart, George Wells, Sheldon W Tobe
BACKGROUND: Hypertension, the leading cause of morbidity and mortality, affects more than 1 billion people and is responsible globally for 10 million deaths annually. Hypertension can be controlled on a national level; in Canada, for example, awareness, treatment, and control improved dramatically from only 16% in 1990 to 66% currently. The ongoing development, dissemination, and implementation of Hypertension Canada's clinical practice guidelines is considered to be responsible, in part, for achieving these high levels of control and the associated improvements in cardiovascular outcomes...
December 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29247112/protocol-for-a-randomised-pilot-multiple-centre-trial-of-conservative-versus-liberal-oxygenation-targets-in-critically-ill-children-oxy-picu
#19
Gareth A L Jones, Padmanabhan Ramnarayan, Sainath Raman, David Inwald, Michael P W Grocott, Simon Eaton, Samiran Ray, Michael J Griksaitis, John Pappachan, Daisy Wiley, Paul R Mouncey, Jerome Wulff, David A Harrison, Kathryn M Rowan, Mark J Peters
INTRODUCTION: Optimal targets for systemic oxygenation in paediatric critical illness are unknown. Observational data indicate that high levels of arterial oxygenation are associated with poor outcomes in resuscitation of the newborn and in adult critical illness. Within paediatric intensive care units (PICUs), staff prevent severe hypoxia wherever possible, but beyond this there is no consensus. Practice varies widely with age, diagnosis, treating doctor and local or national guidelines followed, though peripheral blood oxygen saturations (SpO2) of >95% are often targeted...
December 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29244988/chemotherapy-use-at-the-end-of-life-in-uganda
#20
Daniel Low, Emily C Merkel, Manoj Menon, Gary H Lyman, Henry Ddungu, Elizabeth Namukwaya, Mhoira Leng, Corey Casper
Purpose Avoiding chemotherapy during the last 30 days of life has become a goal of cancer care in the United States and Europe, yet end-of-life chemotherapy administration remains a common practice worldwide. The purpose of this study was to determine the frequency of and factors predicting end-of-life chemotherapy administration in Uganda. Methods Retrospective chart review and surveys and interviews of providers were performed at the Uganda Cancer Institute (UCI), the only comprehensive cancer center in the area, which serves a catchment area of greater than 100 million people...
December 2017: Journal of Global Oncology
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