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https://www.readbyqxmd.com/read/28107357/vasopressor-use-for-severe-hypotension-a-multicentre-prospective-observational-study
#1
Francois Lamontagne, Deborah J Cook, Maureen O Meade, Andrew Seely, Andrew G Day, Emmanuel Charbonney, Karim Serri, Yoanna Skrobik, Paul Hebert, Charles St-Arnaud, Hector Quiroz-Martinez, Michaël Mayette, Daren K Heyland
BACKGROUND: The optimal approach to titrate vasopressor therapy is unclear. Recent sepsis guidelines recommend a mean arterial pressure (MAP) target of 65 mmHg and higher for chronic hypertensive patients. As data emerge from clinical trials comparing blood pressure targets for vasopressor therapy, an accurate description of usual care is required to interpret study results. Our aim was to measure MAP values during vasopressor therapy in Canadian intensive care units (ICUs) and to compare these with stated practices and guidelines...
2017: PloS One
https://www.readbyqxmd.com/read/28107283/naspghan-clinical-practice-guideline-for-the-diagnosis-and-treatment-of-nonalcoholic-fatty-liver-disease-in-children-recommendations-from-the-expert-committee-on-nafld-econ-and-the-north-american-society-of-pediatric-gastroenterology-hepatology-and-nutrition
#2
Miriam B Vos, Stephanie H Abrams, Sarah E Barlow, Sonia Caprio, Stephen R Daniels, Rohit Kohli, Marialena Mouzaki, Pushpa Sathya, Jeffrey B Schwimmer, Shikha S Sundaram, Stavra A Xanthakos
Nonalcoholic fatty liver disease (NAFLD) is a highly prevalent chronic liver disease that occurs in the setting of insulin resistance and increased adiposity. It has rapidly evolved into the most common liver disease seen in the pediatric population and is a management challenge for general pediatric practitioners, subspecialists, and for health systems. In this guideline, the expert committee on NAFLD reviewed and summarized the available literature, formulating recommendations to guide screening and clinical care of children with NAFLD...
February 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28106637/educating-nurses-in-the-united-states-about-pressure-injuries
#3
Elizabeth A Ayello, Karen Zulkowski, Elizabeth Capezuti, Wendy Harris Jicman, R Gary Sibbald
GENERAL PURPOSE: To provide information about the current state of educating nurses about wound care and pressure injuries with recommendations for the future. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1...
February 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28105767/investigations-and-referral-for-suspected-cancer-in-primary-care-in-new-zealand-a-survey-linked-to-the-international-cancer-benchmarking-partnership
#4
H W Htun, J M Elwood, S J Ioannides, T Fishman, R Lawrenson
A national internet-based survey of New Zealand (NZ) primary care physicians (n = 192) used the survey instrument developed by the International Cancer Benchmarking Partnership (ICBP). Practitioners were recruited by a range of methods assisted by NZ general practice networks and contacts. Compared to 11 other ICBP jurisdictions, direct access to diagnostic tests was more limited and took more time than in most other areas; the average wait for a test to be done and reported was 3.0 weeks for X-rays and 8...
January 20, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28105750/development-of-a-peer-review-framework-for-cancer-multi-disciplinary-meetings
#5
Claire E Johnson, Neli Slavova-Azmanova, Christobel Saunders
BACKGROUND: There is no mechanism in place for monitoring or quality improvement of cancer multidisciplinary meetings (MDMs) in Australia. OBJECTIVE: To develop a peer review process for quality improvement of MDMs. METHODS: This project involved three phases: 1) development of a draft peer review framework, supporting documents and peer review process; 2) consultation with key stakeholders; 3) refinement of the framework, documents and processes following a pilot study with three MDMs...
January 20, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28105733/vitamin-d-supplementation-for-sickle-cell-disease
#6
REVIEW
Htoo Htoo Kyaw Soe, Adinegara Bl Abas, Nan Nitra Than, Han Ni, Jaspal Singh, Abdul Razzak Bin Mohd Said, Ifeyinwa Osunkwo
BACKGROUND: Sickle cell disease is a genetic chronic haemolytic and pro-inflammatory disorder. The clinical manifestations of sickle cell disease result from the presence of mutations on the beta globin genes that generate an abnormal haemoglobin product (called haemoglobin S) within the red blood cell. Sickle cell disease can lead to many complications such as acute chest syndrome, stroke, acute and chronic bone complications (including painful vaso-occlusive crisis, osteomyelitis, osteonecrosis and osteoporosis)...
January 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28105616/-interpretation-of-the-updates-of-nccn-2017-version-1-0-guideline-for-colorectal-cancer
#7
Gong Chen
The NCCN has recently released its 2017 version 1.0 guideline for colorectal cancer. There are several updates from this new version guideline which are believed to change the current clinical practice. Update one, low-dose aspirin is recommended for patients with colorectal cancer after colectomy for secondary chemoprevention. Update two, biological agents are removed from the neoadjuvant treatment regimen for resectable metastatic colorectal cancer (mCRC). This update is based on lack of evidence to support benefits of biological agents including bevacizumab and cetuximab in the neoadjuvant setting...
January 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28104790/contemporary-management-of-patients-undergoing-atrial-fibrillation-ablation-in-hospital-and-1-year-follow-up-findings-from-the-esc-ehra-atrial-fibrillation-ablation-long-term-registry
#8
Elena Arbelo, Josep Brugada, Carina Blomström Lundqvist, Cécile Laroche, Josef Kautzner, Evgeny Pokushalov, Pekka Raatikainen, Michael Efremidis, Gerhard Hindricks, Alberto Barrera, Aldo Maggioni, Luigi Tavazzi, Nikolaos Dagres
AIMS: The ESC-EHRA Atrial Fibrillation Ablation Long-Term registry is a prospective, multinational study that aims at providing an accurate picture of contemporary real-world ablation for atrial fibrillation (AFib) and its outcome. METHODS AND RESULTS: A total of 104 centres in 27 European countries participated and were asked to enrol 20-50 consecutive patients scheduled for first and re-do AFib ablation. Pre-procedural, procedural and 1-year follow-up data were captured on a web-based electronic case record form...
January 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28104707/improving-care-standards-for-patients-with-spinal-trauma-combining-a-modified-e-delphi-process-and-stakeholder-interviews-a-study-protocol
#9
Lisa N Sharwood, Ralph Stanford, James W Middleton, Brian Burns, Anthony Joseph, Oliver Flower, Oran Rigby, Jonathon Ball, Shelly Dhaliwal
INTRODUCTION: Around 300 people sustain a new traumatic spinal cord injury (TSCI) in Australia each year; a relatively low incidence injury with extremely high long-term associated costs. Care standards are inconsistent nationally, lacking in consensus across important components of care such as prehospital spinal immobilisation, timing of surgery and timeliness of transfer to specialist services. This study aims to develop 'expertly defined' and agreed standards of care across the majority of disciplines involved for these patients...
January 19, 2017: BMJ Open
https://www.readbyqxmd.com/read/28104462/questionnaires-used-to-assess-barriers-of-clinical-guideline-use-among-physicians-are-not-comprehensive-reliable-or-valid-a-scoping-review
#10
REVIEW
Melina L Willson, Robin Wm Vernooij, Anna R Gagliardi
OBJECTIVE: This study described the number and characteristics of questionnaires used to assess barriers of guideline use among physicians. STUDY DESIGN: A scoping review was conducted. MEDLINE and EMBASE were searched from 2005 to June 2016. English language studies that administered a questionnaire to assess barriers of guideline use among practicing physicians were eligible. Summary statistics were used to report study and questionnaire characteristics. Questionnaire content was assessed with a checklist of 57 known barriers...
January 16, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28104211/balloon-post-dilation-following-implantation-of-a-self-expanding-transcatheter-aortic-valve%C3%A2-bioprosthesis
#11
J Kevin Harrison, G Chad Hughes, Michael J Reardon, Robert Stoler, Paul Grayburn, Robert Hebeler, David Liu, Yanping Chang, Jeffrey J Popma
OBJECTIVES: This study sought to explore the impact of balloon post-dilation (BPD) on outcomes in the CoreValve US Clinical Trials. BACKGROUND: BPD following transcatheter aortic valve replacement (TAVR) has been used in selected cases to optimize hemodynamic results. METHODS: Procedural details of 3,532 patients were examined to determine whether BPD was performed after self-expanding TAVR. "Best practice" guidelines recommended BPD for treatment of suboptimal intraprocedural valve function, primarily manifested by moderate or severe residual aortic regurgitation (AR)...
January 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28104044/procedural-variations-in-performing-primary-percutaneous-coronary-intervention-in-patients-with-st-elevation-myocardial-infarction
#12
Radhika M Mehta, Manyoo Agarwal, Ikechukwu Ifedili, Wael W Rizk, Rami N Khouzam
Multiple variations exist in performing a primary percutaneous coronary intervention (pPCI) in ST-segment elevation myocardial infarction (STEMI) among various cardiologists. These variations range from the choice of peripheral access artery (radial vs femoral), performance or time of complete angiography including left ventriculography, and nonculprit vessel angiography before or after intervening on the culprit vessel. The reasons for such variations include emphasis on door-to-balloon time, knowledge of cardiac anatomy before proceeding with pPCI, physician expertise, and the level of comfort with radial approach...
February 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/28103918/the-effects-of-asking-a-fertility-intention-question-in-primary-care-settings-a-systematic-review-protocol
#13
Paul A Henning, Carolyne K Burgess, Heidi E Jones, Wendy V Norman
BACKGROUND: Planning for pregnancy has been associated with reduced unwanted pregnancies and improved pregnancy outcomes. Despite the benefits of planned pregnancy, there are no guideline recommendations on routine counseling regarding pregnancy intention in primary care settings. The objective of the systematic review is to determine the effectiveness of incorporating questions of pregnancy intention into primary care. METHODS: A systematic search of the literature will be conducted for any studies comparing questions of pregnancy intention in primary care settings with no intervention or a control intervention...
January 19, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28103749/clinical-practice-with-anti-dementia-drugs-a-revised-third-consensus-statement-from-the-british-association-for-psychopharmacology
#14
John T O'Brien, Clive Holmes, Matthew Jones, Roy Jones, Gill Livingston, Ian McKeith, Peter Mittler, Peter Passmore, Craig Ritchie, Louise Robinson, Elizabeth L Sampson, John-Paul Taylor, Alan Thomas, Alistair Burns
The British Association for Psychopharmacology coordinated a meeting of experts to review and revise its previous 2011 guidelines for clinical practice with anti-dementia drugs. As before, levels of evidence were rated using accepted standards which were then translated into grades of recommendation A-D, with A having the strongest evidence base (from randomised controlled trials) and D the weakest (case studies or expert opinion). Current clinical diagnostic criteria for dementia have sufficient accuracy to be applied in clinical practice (B) and both structural (computed tomography and magnetic resonance imaging) and functional (positron emission tomography and single photon emission computerised tomography) brain imaging can improve diagnostic accuracy in particular situations (B)...
December 1, 2016: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28103161/nurses-practice-in-preventing-postoperative-wound-infections-an-observational-study
#15
S Ding, F Lin, A P Marshall, B M Gillespie
OBJECTIVE: Surgical site infections (SSIs) are serious postoperative complications that may lead to undesired patient outcomes. Previous research has used survey and chart audit methods to describe wound care practices. However, little research has been published using contemporaneous observations to describe the surgical wound management practices of nurses. The aim of this study was to prospectively describe surgical nurses' postoperative wound care practices and the extent to which observed surgical wound practices aligned with evidence-based guideline recommendations...
January 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28102830/can-exhaled-volatile-organic-compounds-predict-asthma-exacerbations-in-children
#16
Dillys van Vliet, Agnieszka Smolinska, Quirijn Jöbsis, Jean Muris, Philippe Rosias, Jan Dallinga, Edward Dompeling, Frederik van Schooten
Background Asthma control falls short of current goals of asthma management guidelines. Non-invasive monitoring of airway inflammation may help to improve the level of asthma control in children. Aim 1) To identify a set of exhaled volatile organic compounds (VOCs) that is most predictive for an asthma exacerbation in children. 2) To determine the chemical background of predictive VOCs. Methods In an one-year prospective observational study, 96 asthmatic children were studied . At clinical visits with an interval of 2 months, asthma control, fractional exhaled nitric oxide, lung function (FEV1, FEV1/VC) and VOCs in exhaled breath were determined by means of gas chromatography time-of-flight mass spectrometry...
January 19, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28102027/patient-engagement-in-hiv-care-and-treatment-in-zambia-2004-2014
#17
Neo Christopher Chung, Carolyn Bolton-Moore, Roma Chilengi, Margaret P Kasaro, Jeffrey S A Stringer, Benjamin H Chi
OBJECTIVE: To describe engagement along the HIV continuum of care using a large network of clinics in Zambia. METHODS: We employed a practical framework to describe retention along the HIV treatment cascade, using routinely collected clinical data available in resource-constrained settings. We included health facilities in four Zambian provinces with more than 300 enrolled patients over the age of 5 years. We described attrition at each step, from HIV enrolment to 720 days after ART initiation...
January 19, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28101937/methods-of-anorectal-manometry-vary-widely-in-clinical-practice-results-from-an-international-survey
#18
E V Carrington, H Heinrich, C H Knowles, S S Rao, M Fox, S M Scott
BACKGROUND: Ano-rectal manometry (ARM) is the most commonly performed investigation for assessment of anorectal dysfunction. Its use is supported by expert consensus documents and international guidelines. Variation in technology, data acquisition, and analysis affect results and clinical interpretation. This study examined variation in ARM between institutions to establish the status of current practice. METHODS: A 50-item web-based questionnaire assessing analysis and interpretation of ARM was distributed by the International Anorectal Physiology Working Group via societies representing practitioners that perform ARM...
January 18, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28101910/a-practical-approach-to-vaccination-of-patients-with-autoimmune-inflammatory-rheumatic-diseases-in-australia
#19
REVIEW
Peter Kk Wong, Hanish Bagga, Claire Barrett, Paddy Hanrahan, Doug Johnson, Amel Katrib, Karin Leder, Mona Marabani, Peta Pentony, John Riordan, Ray White, Laurel Young
Autoimmune inflammatory rheumatic diseases (AIIRD) such as rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) are often complicated by infection, which results in significant morbidity and mortality. The increased risk of infection is probably due to a combination of immunosuppressive effects of the AIIRD, comorbidities, and the use of immunosuppressive conventional synthetic disease modifying anti-rheumatic drugs (DMARDS) and more recently, targeted synthetic DMARDS and biologic DMARDS which block specific pro-inflammatory enzymes, cytokines or cell types...
January 19, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28100960/a-survey-of-thrombosis-experts-evaluating-practices-and-opinions-regarding-venous-thromboprophylaxis-in-patients-post-major-abdominal-surgery
#20
Bader Al Rawahi, Grégoire Le Gal, Rebecca Auer, Marc Carrier
BACKGROUND: Patients undergoing major abdominal surgery are at high risk for developing venous thromboembolism in the post-operative period. Current evidence-based guidelines recommend routine pharmacological venous thromboembolism prophylaxis in patient at moderate to high risk post major abdominal surgery. However, the type of agent, dose and duration of thromboprophylaxis remain unclear. We sought to survey current clinical practice and assess for potential clinical equipoise regarding pharmacological thromboprophylaxis post major abdominal surgery...
2017: Thrombosis Journal
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