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https://www.readbyqxmd.com/read/28088339/evidence-based-management-of-systemic-sclerosis-navigating-recommendations-and-guidelines
#1
REVIEW
Russell Edward Pellar, Janet Elizabeth Pope
OBJECTIVES: Systemic sclerosis (SSc) is a rare heterogeneous connective tissue disease. Recommendations addressing the major issues in the management of SSc including screening and treatment of organ complications are needed. METHODS: The updated European League Against Rheumatism/European Scleroderma Trial and Research (EULAR/EUSTAR) and the British Society of Rheumatology (BSR) and British Health Professionals in Rheumatology (BHPR) guidelines were compared and contrasted...
December 9, 2016: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/28087657/european-consensus-conference-on-faecal-microbiota-transplantation-in-clinical-practice
#2
Giovanni Cammarota, Gianluca Ianiro, Herbert Tilg, Mirjana Rajilić-Stojanović, Patrizia Kump, Reetta Satokari, Harry Sokol, Perttu Arkkila, Cristina Pintus, Ailsa Hart, Jonathan Segal, Marina Aloi, Luca Masucci, Antonio Molinaro, Franco Scaldaferri, Giovanni Gasbarrini, Antonio Lopez-Sanroman, Alexander Link, Pieter de Groot, Willem M de Vos, Christoph Högenauer, Peter Malfertheiner, Eero Mattila, Tomica Milosavljević, Max Nieuwdorp, Maurizio Sanguinetti, Magnus Simren, Antonio Gasbarrini
Faecal microbiota transplantation (FMT) is an important therapeutic option for Clostridium difficile infection. Promising findings suggest that FMT may play a role also in the management of other disorders associated with the alteration of gut microbiota. Although the health community is assessing FMT with renewed interest and patients are becoming more aware, there are technical and logistical issues in establishing such a non-standardised treatment into the clinical practice with safety and proper governance...
January 13, 2017: Gut
https://www.readbyqxmd.com/read/28086871/the-integrated-care-pathway-for-post-stroke-patients-icapps-a-shared-care-approach-between-stakeholders-in-areas-with-limited-access-to-specialist-stroke-care-services
#3
Aznida Firzah Abdul Aziz, Nor Azlin Mohd Nordin, Mohd Fairuz Ali, Noor Azah Abd Aziz, Saperi Sulong, Syed Mohamed Aljunid
BACKGROUND: Lack of intersectoral collaboration within public health sectors compound efforts to promote effective multidisciplinary post stroke care after discharge following acute phase. A coordinated, primary care-led care pathway to manage post stroke patients residing at home in the community was designed by an expert panel of specialist stroke care providers to help overcome fragmented post stroke care in areas where access is limited or lacking. METHODS: Expert panel discussions comprising Family Medicine Specialists, Neurologists, Rehabilitation Physicians and Therapists, and Nurse Managers from Ministry of Health and acadaemia were conducted...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28080174/the-use-of-topical-non-steroidal-anti-inflammatory-drugs-for-uveitic-cystoid-macular-edema
#4
Harry Petrushkin, Duncan Rogers, Carlos Pavesio
The use of topical non-steroidal anti-inflammatory drugs in the management of uveitic cystoid macular edema is controversial. In this letter, we review the literature and report our results from a retrospective case series of 281 patients taking topical nepafenac 0.1% for uveitic cystoid macular edema between 2010 and 2016. Over a 4-month period, there was a modest improvement in best-corrected visual acuity (0.66 ± 3.7 logMAR) and central macular thickness (69.8 ± 132.5 μm). Patients with idiopathic anterior uveitis and HLA-B*27-associated anterior uveitis recovered more vision while taking topical nepafenac 0...
January 12, 2017: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/28079669/the-irish-helicobacter-pylori-working-group-consensus-for-the-diagnosis-and-treatment-of-h-pylori-infection-in-adult-patients-in-ireland
#5
Sinead Smith, Breida Boyle, Denise Brennan, Martin Buckley, Paul Crotty, Maeve Doyle, Richard Farrell, Mary Hussey, David Kevans, Peter Malfertheiner, Francis Megraud, Sean Nugent, Anthony O'Connor, Colm O'Morain, Shiobhan Weston, Deirdre McNamara
BACKGROUND: Irish eradication rates for Helicobacter pylori are decreasing and there is an increase in the prevalence of antibiotic-resistant bacteria. These trends call into question current management strategies. OBJECTIVE: To establish an Irish Helicobacter pylori Working Group (IHPWG) to assess, revise and tailor current available recommendations. METHODS: Experts in the areas of gastroenterology and microbiology were invited to join the IHPWG...
January 10, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28079561/-single-checked-patient-group-directions-during-initial-nurse-assessment-within-paediatric-emergency-departments-of-the-uk-and-ireland
#6
Chris K Bird, Anthony G Sinclair, Stuart Hartshorn
OBJECTIVE: Double checking medications at initial assessment within paediatric emergency departments (EDs) has the potential to delay patient flow, and doubt has been cast on the efficacy of double checking in all but high-risk medications. We aimed to benchmark current practice for the use of Patient Group Direction (PGD) medications at initial assessment in EDs within the Paediatric Emergency Research UK and Ireland (PERUKI) network, with a focus on the use of 'single-checker' PGDs...
January 10, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28078766/lost-in-transformation-reviving-ethics-of-care-in-hospital-cultures-of-evidence-based-healthcare
#7
Annelise Norlyk, Anita Haahr, Pia Dreyer, Bente Martinsen
Drawing on previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence-based fast-track programmes. The aim of this paper was to analyse and discuss if and how it is possible to include patients' individual perspectives in an evidence-based practice as seen from the point of view of nursing theory. The paper highlights two conflicting courses of development. One is a course of standardization founded on evidence-based recommendations, which specify a set of rules that the patient must follow rigorously...
January 12, 2017: Nursing Inquiry
https://www.readbyqxmd.com/read/28076244/the-need-to-systematically-evaluate-clinical-practice-guidelines
#8
Allen F Shaughnessy, Lisa Cosgrove, Joel R Lexchin
Clinical practice guidelines abound. The recommendations contained in these guidelines are used not only to make decisions about the care of individual patients but also as practice standards to rate physician "quality." Physicians' confidence in guidelines is based on the supposition that there is a rigorous, objective process for developing recommendations based on the best available evidence. Though voluntary standards for the development of guidelines exist, the process of guideline development is unregulated and the quality of many guidelines is low...
November 2016: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28074586/the-theory-and-practice-of-surrogate-decision-making
#9
David Wendler
When a patient lacks decision-making capacity and has not left a clear advance directive, there is now widespread agreement that patient-designated and next-of-kin surrogates should implement substituted judgment within a process of shared decision-making. Specifically, after discussing the "best scientific evidence available, as well as the patient's values, goals, and preferences" with the patient's clinicians, the patient-designated or next-of-kin surrogate should attempt to determine what decision the patient would have made in the circumstances...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28074412/a-scientific-rationale-to-improve-resistance-training-prescription-in-exercise-oncology
#10
Ciaran M Fairman, Michael C Zourdos, Eric R Helms, Brian C Focht
To date, the prevailing evidence in the field of exercise oncology supports the safety and efficacy of resistance training to attenuate many oncology treatment-related adverse effects, such as risk for cardiovascular disease, increased fatigue, and diminished physical functioning and quality of life. Moreover, findings in the extant literature supporting the benefits of exercise for survivors of and patients with cancer have resulted in the release of exercise guidelines from several international agencies...
January 10, 2017: Sports Medicine
https://www.readbyqxmd.com/read/28071865/the-impact-of-evidence-based-sepsis-guidelines-on-emergency-department-clinical-practice-a-pre-post-medical-record-audit
#11
Bernadine Romero, Margaret Fry, Michael Roche
AIMS AND OBJECTIVES: The aim of this study was to explore the number of patients presenting with sepsis before and after guideline implementation; the impact of sepsis guidelines on triage assessment, Emergency Department management and time to antibiotics. BACKGROUND: Sepsis remains one of the leading causes of mortality and morbidity within hospitals. Globally, strategies have been implemented to reduce morbidity and mortality rates, which rely on the early recognition and management of sepsis...
January 10, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28069045/improving-nursing-home-care-through-feedback-on-performance-data-inform-protocol-for-a-cluster-randomized-trial
#12
Matthias Hoben, Peter G Norton, Liane R Ginsburg, Ruth A Anderson, Greta G Cummings, Holly J Lanham, Janet E Squires, Deanne Taylor, Adrian S Wagg, Carole A Estabrooks
BACKGROUND: Audit and feedback is effective in improving the quality of care. However, methods and results of international studies are heterogeneous, and studies have been criticized for a lack of systematic use of theory. In TREC (Translating Research in Elder Care), a longitudinal health services research program, we collect comprehensive data from care providers and residents in Canadian nursing homes to improve quality of care and life of residents, and quality of worklife of caregivers...
January 10, 2017: Trials
https://www.readbyqxmd.com/read/28065393/quality-indicators-in-the-management-of-bladder-cancer-a-modified-delphi-study
#13
Satya R Khare, Armen Aprikian, Peter Black, Normand Blais, Chris Booth, Fadi Brimo, Joseph Chin, Peter Chung, Darrel Drachenberg, Libni Eapen, Adrian Fairey, Neil Fleshner, Yves Fradet, Geoffrey Gotto, Jonathan Izawa, Michael Jewett, Girish Kulkarni, Louis Lacombe, Ron Moore, Chris Morash, Scott North, Ricardo Rendon, Fred Saad, Bobby Shayegan, Robert Siemens, Alan So, Srikala S Sridhar, Samer L Traboulsi, Wassim Kassouf
BACKGROUND: Survival in patients with bladder cancer has only moderately improved over the past 2 decades. A potential reason for this is nonadherence to clinical guidelines and best practice, leading to wide variations in care. Common quality indicators (QIs) are needed to quantify adherence to best practice and provide data for benchmarking and quality improvement. OBJECTIVE: To produce an evidence- and consensus-based list of QIs for the management of bladder cancer...
January 3, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28063092/was-hawan-designed-to-fight-anxiety-scientific-evidences
#14
R K Romana, A Sharma, V Gupta, R Kaur, S Kumar, P Bansal
Anxiety is a psychiatric disorder with unknown neurobiology; however, neurotransmitters like gamma-amino butyric acid, norepinephrine and serotonin (5-HT) play crucial roles in mediating anxiety. Present drug modules pose dependence risk to the patient; hence, there is a great need to develop complementary therapies to fight this disorder. Aromatherapy has also been employed in ancient times for a number of mental disorders. Mahamrituanjay Mantra, Om triambkum yajamahe, sughandhim puushtivardhanam, urvarukmev vandhanaat, mrityu mokshay mamritaat!!!!, the part of veda enlightens that aroma gives rise to good health (sughandhim puushtivardhanam)...
January 6, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/28062660/digital-pathology-in-the-diagnostic-setting-beyond-technology-into-best-practice-and-service-management
#15
Chee Leong Cheng, Puay Hoon Tan
Digital pathology (DP) and whole-slide imaging (WSI) technology have matured substantially over the last few years and there is growing evidence from validation studies that WSI is comparable to glass slides for histopathology diagnosis, although with some limitations, which can be appropriately minimised. Whether the controlled environment of validation studies translates to the same level of robustness when WSI is used in the actual diagnostic setting depends on the technical quality of WSI acquisition and on factors that influence the pre-image acquisition variables including the quality of glass slide inputs, and postimage acquisition variables such as access and use of WSI...
January 6, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28062613/consensus-or-controversy-evolution-of-criteria-for-myocardial-infarction-after-percutaneous-coronary-intervention
#16
REVIEW
Pierluigi Tricoci
BACKGROUND: The definition and the clinical implications of myocardial infarction (MI) occurring in the setting of percutaneous coronary intervention have been subjects of unresolved controversy. As a result of the use of more sensitive diagnostic tools such as cardiac troponin, the expanding evidence, and the ensuing debate, the definition of procedural MI (pMI) has evolved, leading to several revisions, different proposed definitions, and lack of standardization in randomized clinical trials...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062546/the-clinical-importance-of-quantifying-fat-distribution-during-androgen-deprivation
#17
Stephen John Foulkes, Robin M Daly, Steve Fraser
Androgen deprivation therapy (ADT) is now considered a mainstay in the treatment of metastatic and locally advanced prostate cancer (PCa). Despite well-established benefits of ADT in relation to overall survival, this treatment has been associated with a number of adverse effects, particularly with regard to key cardiometabolic risk factors including the development of insulin resistance, dyslipidaemia and increases in total and regional fat mass. In non-ADT populations, increased levels of visceral adipose tissue (VAT) are thought to be a key mediator of the increased cardiometabolic risk associated with weight gain, but this has received limited attention in men treated with ADT...
January 6, 2017: Endocrine-related Cancer
https://www.readbyqxmd.com/read/28060211/service-delivery-in-the-healthcare-and-educational-systems-for-children-following-traumatic-brain-injury-gaps-in-care
#18
Juliet Haarbauer-Krupa, Angela Ciccia, Jonathan Dodd, Deborah Ettel, Brad Kurowski, Angela Lumba-Brown, Stacy Suskauer
OBJECTIVE: To provide a review of evidence and consensus-based description of healthcare and educational service delivery and related recommendations for children with traumatic brain injury. METHODS: Literature review and group discussion of best practices in management of children with traumatic brain injury (TBI) was performed to facilitate consensus-based recommendations from the American Congress on Rehabilitation Medicine's Pediatric and Adolescent Task Force on Brain Injury...
January 5, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28059834/what-do-we-know-about-intraoperative-teaching-a-systematic-review
#19
Matthew D Timberlake, Helen G Mayo, Lauren Scott, Joshua Weis, Aimee K Gardner
BACKGROUND: There is increasing attention on enhancing surgical trainee performance and competency. The purpose of this review is to identify characteristics and themes related to intraoperative teaching that will better inform interventions and assessment endeavors. METHODS: A systematic search was carried out of the Ovid MEDLINE, Ovid MEDLINE InProcess, Ovid Embase, and the Cochrane Library databases to identify all studies that discussed teaching in the operating room for trainees at the resident and fellow level...
January 3, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28057016/the-effectiveness-of-robotic-assisted-gait-training-for-paediatric-gait-disorders-systematic-review
#20
Sophie Lefmann, Remo Russo, Susan Hillier
BACKGROUND: Robotic-assisted gait training (RAGT) affords an opportunity to increase walking practice with mechanical assistance from robotic devices, rather than therapists, where the child may not be able to generate a sufficient or correct motion with enough repetitions to promote improvement. However the devices are expensive and clinicians and families need to understand if the approach is worthwhile for their children, and how it may be best delivered. METHODS: The objective of this review was to identify and appraise the existing evidence for the effectiveness of RAGT for paediatric gait disorders, including modes of delivery and potential benefit...
January 5, 2017: Journal of Neuroengineering and Rehabilitation
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