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Evidence based Guidelines

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https://www.readbyqxmd.com/read/28324904/quantifying-neonatal-sucking-performance-promise-of-new-methods
#1
Gilson J Capilouto, Tommy J Cunningham, David R Mullineaux, Eleonora Tamilia, Christos Papadelis, Peter J Giannone
Neonatal feeding has been traditionally understudied so guidelines and evidence-based support for common feeding practices are limited. A major contributing factor to the paucity of evidence-based practice in this area has been the lack of simple-to-use, low-cost tools for monitoring sucking performance. We describe new methods for quantifying neonatal sucking performance that hold significant clinical and research promise. We present early results from an ongoing study investigating neonatal sucking as a marker of risk for adverse neurodevelopmental outcomes...
April 2017: Seminars in Speech and Language
https://www.readbyqxmd.com/read/28324902/dysphagia-management-in-the-schools-past-present-and-future
#2
Cynthia R O'Donoghue, Elizabeth E Nottingham
As the number of speech-language pathologists (SLPs) responsible for swallowing and feeding services in the educational setting increases, guidance informing this specialized practice continues to emerge. Although SLPs have provided dysphagia management for children in medical settings for many years, the extension of dysphagia services to the schools is comparatively new. This shift in care delivery for what was previously a hospital-based practice is now occurring more frequently, and in an environment void of extensive medical supports (i...
April 2017: Seminars in Speech and Language
https://www.readbyqxmd.com/read/28320168/a-systematic-comparison-of-key-features-of-ischemic-stroke-prevention-guidelines-in-low-and-middle-income-vs-high-income-countries
#3
REVIEW
Hernán Bayona, Mayowa Owolabi, Wuwei Feng, Paul Olowoyo, Joseph Yaria, Rufus Akinyemi, James R Sawers, Bruce Ovbiagele
BACKGROUND AND PURPOSE: Implementation of contextually appropriate, evidence-based, expert-recommended stroke prevention guideline is particularly important in Low-Income Countries (LMICs), which bear disproportional larger burden of stroke while possessing fewer resources. However, key quality characteristics of guidelines issued in LMICs compared with those in High-Income Countries (HICs) have not been systematically studied. We aimed to compare important features of stroke prevention guidelines issued in these groups...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28319804/are-diabetes-guidelines-truly-evidence-based
#4
REVIEW
Matthew F Bouchonville, Sara Matani, Jason J DuBroff, Robert J DuBroff
The global epidemic of obesity and diabetes underscores the urgency to develop strategies to prevent cardiovascular (CV) disease in this vulnerable population. Clinical guidelines are intended to help the clinician manage these patients, but guidelines are often discordant among professional organizations and not always evidence based. Clinicians must rely upon the best available evidence, and therefore we critically reviewed the evidence behind the American Diabetes Association (ADA) 2016 guidelines on the prevention of CV disease in diabetes...
March 7, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28319484/nonpharmacologic-management-of-hypertension-a-multidisciplinary-approach
#5
Cemal Ozemek, Shane A Phillips, Dejana Popovic, Deepika Laddu-Patel, Ibra S Fancher, Ross Arena, Carl J Lavie
PURPOSE OF REVIEW: Nonpharmacologic lifestyle modification interventions (LMIs), such as increasing physical activity, dietary modification, weight-loss, reducing alcohol consumption and smoking cessation, are effective strategies to lower resting blood pressures (BPs) in prehypertensive or hypertensive patients. However, the limited time shared between a physician and a patient is not adequate to instill an adoption of LMI. The purpose of this review is to therefore highlight evidence-based BP lowering, LMI strategies that can feasibly be implemented in clinical practices...
March 17, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28319287/iatrogenic-thyrotoxicosis-and-the-role-of-therapeutic-plasma-exchange
#6
Kabeer K Shah, Michael M Mbughuni, Edwin A Burgstaler, Darci R Block, Jeffrey L Winters
Thyroid storm or severe thyrotoxicosis results from extreme thyroid hormone elevation. Therapy includes medical management to prevent hormone production, release, recycling, and peripheral conversion while stabilizing adrenergic tone. Thyroid dysfunction is the usual cause but it can be due to excessive thyroid hormone ingestion. Therapeutic plasma exchange (TPE) has been used to rapidly remove protein-bound thyroid hormone. American Society for Apheresis guidelines make a weak recommendation to perform TPE in selected patients in the treatment of thyrotoxicosis based on low quality evidence...
March 20, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28318519/major-developments-in-the-2016-european-guidelines-for-heart-failure
#7
J C Trullàs, Á González-Franco
The European Society of Cardiology has recently published new guidelines on the diagnosis and treatment of acute and chronic heart failure (HF). This article aims to review these recommendations and their level of scientific evidence and to present the most innovative aspects. The most significant deviations from the 2012 edition are: 1) the introduction of the concept of HF with midrange LVEF (40-49%); 2) a new diagnostic algorithm for chronic HF, initially considering the clinical probability; 3) recommendations on preventing or delaying the apparition of HF; 4) indications for the use of the new sacubitril-valsartan compound, the first angiotensin receptor blocker and neprilysin inhibitor; 5) modification of indications for cardiac resynchronisation therapy; and 6) a new algorithm for a combined diagnostic and treatment strategy for acute HF based on the presence or absence of congestion and hypoperfusion...
March 15, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28318076/uk-policy-statements-on-testosterone-deficiency
#8
Geoffrey Hackett, Michael Kirby, David Edwards, T Hugh Jones, Jonathan Rees, Asif Muneer
To address widespread media and scientific concerns over the appropriate treatment of TDS with Testosterone Therapy (T Therapy), the Executive Committee of the British Society for Sexual Medicine developed eight consensus statements, based on current scientific evidence to address these controversial issues. These statements were in no-way designed to replace the published evidence-based guidelines on the subject developed by various professional organisations, but to provide specific answers to several current controversial issues...
March 20, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28318010/ataxia-telangiectasia-recommendations-for-multidisciplinary-treatment
#9
REVIEW
Nienke J H van Os, Charlotte A Haaxma, Michiel van der Flier, Peter J F M Merkus, Marcel van Deuren, Imelda J M de Groot, Jan Loeffen, Bart P C van de Warrenburg, Michèl A A P Willemsen
Ataxia-telangiectasia is a rare, neurodegenerative, and multisystem disease, characterized by cerebellar ataxia, oculocutaneous telangiectasia, immunodeficiency, progressive respiratory failure, and an increased risk of malignancies. It demands specialized care tailored to the individual patient's needs. Besides the classic ataxia-telangiectasia phenotype, a variant phenotype exists with partly overlapping but some distinctive disease characteristics. This guideline summarizes frequently encountered medical problems in the disease course of patients with classic and variant ataxia-telangiectasia, in the domains of neurology, immunology and infectious diseases, pulmonology, anaesthetic and perioperative risk, oncology, endocrinology, and nutrition...
March 20, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28318007/myocardial-infarction-in-a-neonate-lessons-for-neonatal-and-internal-medicine
#10
Werner Streif
Due to the lack of evidence-based guidelines, management strategies for neonatal MI should be individualized and administered largely at the discretion of responsible treating teams. Supportive care with a focus on preserving adequate circulation and antithrombotic therapy with a view to restoring vascular patency are the mainstays of treatment. Thrombolytic therapy of neonatal MI includes a chance to completely restore myocardial function. Understanding the resilience of the neonatal heart and mechanism of cardiac cell repair in neonates may spark novel treatment strategies for severe MI in the large number of affected individuals in an aging population...
March 20, 2017: Hämostaseologie
https://www.readbyqxmd.com/read/28317392/pharmacotherapy-of-major-depression-in-late-life-what-is-the-role-of-new-agents
#11
Kinjal Patel, Petal S Abdool, Tarek K Rajji, Benoit H Mulsant
Evidence on the pharmacotherapy of late-life major depressive disorder (LLD) is scant. Most of the recommendations in existing clinical guidelines are based on expert opinions, extrapolations from data obtained in younger patients, or theoretical considerations. AREAS COVERED This article summarizes the recommendations from existing clinical guidelines and recent reviews on the treatment of LLD. Next, it discusses the potential role of newer antidepressants -vilazodone, levomilnacipran, and vortioxetine- based on a systematic search of the literature published during the past five years...
March 20, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28316278/high-risk-obstetrical-call-center-a-model-for-regions-with-limited-access-to-care
#12
Sarah J Rhoads, Hari Eswaran, Christian E Lynch, Songthip T Ounpraseuth, Everett F Magann, Curtis L Lowery
PURPOSE: High-risk obstetrical care can be challenging for women in rural states with limited access. MATERIALS AND METHODS: Data were evaluated from 62,342 obstetrical calls from pregnant and postpartum patients within rural Arkansas to a nurse call center. Call center nurses provided triage using evidence-based guidelines to patients across the state. Data were extracted and analyzed using retrospective data collection and descriptive statistical methods. RESULTS: Women had an average maternal age of 28 years old, average weeks gestation was 27...
March 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28316035/management-of-percutaneous-coronary-intervention-complications
#13
REVIEW
Gregory Means, Christopher End, Prashant Kaul
With the recent increase in complex coronary interventions including percutaneous coronary intervention (PCI) for chronic total occlusions and complex higher risk (and indicated) patients, the spectrum of potential periprocedural complications and their prompt management has become even more relevant. Vascular access-related problems remain the most prevalent of all PCI complications and with randomized controlled trial data from over 20,000 patients supporting the superiority of radial over femoral access in reducing bleeding and vascular complications, a default radial strategy should be promoted...
April 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28315581/morphological-and-physiological-differences-in-the-upper-trapezius-muscle-in-patients-with-work-related-trapezius-myalgia-compared-to-healthy-controls-a-systematic-review
#14
REVIEW
Kayleigh De Meulemeester, Patrick Calders, Robby De Pauw, Ine Grymonpon, Anke Govaerts, Barbara Cagnie
BACKGROUND: Trapezius myalgia is a common musculoskeletal complaint, characterized by pain, stiffness and tightness of the upper trapezius muscle. It is often work-related and caused by prolonged static and repetitive work tasks. It is hypothesized that this leads to various morphological and physiological alterations in muscle tissue but the pathophysiology is poorly understood. These alterations can be investigated by analysing muscle biopsies in order to reveal the underlying cellular mechanisms...
March 6, 2017: Musculoskelet Sci Pract
https://www.readbyqxmd.com/read/28314970/-is-surgical-treatment-ever-indicated-in-metastatic-renal-cell-carcinoma-and-if-so-based-on-which-scientific-rationale
#15
M Burger
BACKGROUND: Metastasis is a common event in renal cell carcinoma. Surgical resection of metastases may be feasible in two scenarios: aiming at palliation, which may be feasible due to reduced radiosensitivity of renal cell cancer, and aiming at prolonging survival, which may be feasible given the rather good prognosis of some patterns of metastasis. OBJECTIVE: This review intends to reflect on current evidence for surgical resection of metastases in both scenarios...
March 17, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28314660/alzheimer-s-disease-the-next-frontier-special-report-2017
#16
Jason Karlawish, Clifford R Jack, Walter A Rocca, Heather M Snyder, Maria C Carrillo
In the history of medicine, one means to progress is when we make the decision that our assumptions and definitions of disease are no longer consistent with the scientific evidence, and no longer serve our health care needs. The arc of scientific progress is now requiring a change in how we diagnose Alzheimer's disease. Both the National Institute on Aging-Alzheimer's Association (NIA-AA) 2011 workgroup and the International Work Group (IWG) have proposed guidelines that use detectable measures of biological changes in the brain, commonly known as biological markers, or biomarkers, as part of the diagnosis...
March 14, 2017: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
https://www.readbyqxmd.com/read/28314449/aligning-mental-health-treatments-with-the-developmental-stage-and-needs-of-late-adolescents-and-young-adults
#17
REVIEW
Brian Skehan, Maryann Davis
Transitional age youth (TAY) are in a discrete developmental stage, different from both adolescents and mature adults. Serious mental illness can result in their delayed psychosocial development and morbidity. Systemic, provider, and individual barriers result in poor access to care for these youth, potentially impeding their transition to mature adulthood. Current strategies for TAY treatment include patient centered care, vocational and educational support, and shared decision making. There is a paucity of evidence-based practices to effectively treat this population or provide practice guidelines...
April 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28314252/clinical-target-volume-in-biliary-carcinoma-a-systematic-review-of-pathological-studies
#18
REVIEW
Ilaria Marinelli, Alessandra Guido, Lorenzo Fuccio, Andrea Farioli, Valeria Panni, Lucia Giaccherini, Alessandra Arcelli, Giorgio Ercolani, Giovanni Brandi, Silvia Cammelli, Andrea Galuppi, Gabriella Macchia, Rezarta Frakulli, Gian C Mattiucci, Francesco Cellini, Milly Buwenge, Matteo Renzulli, Francesco Deodato, Savino Cilla, Vincenzo Valentini, Vincenzo Tombolini, Rita Golfieri, Alessio G Morganti
BACKGROUND/AIM: Radiotherapy is a treatment option for both adjuvant and neo-adjuvant settings for biliary tract cancer. Guidelines on the delineation of the target volume of lymph nodes are lacking; only generic indications are available, without specific recommendations for different primary tumour locations (e.g. intrahepatic, extrahepatic biliary tract or gallbladder cancer). The aim of this study was to systematically review available literature to provide recommendations on lymph node target volume delineation in patients with unresectable biliary tumour...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28306684/implementation-and-outcomes-of-a-community-based-pulmonary-rehabilitation-program-in-rural-appalachia
#19
Daniel Doyle, Chaffee Tommarello, Mike Broce, Mary Emmett, Cecil Pollard
PURPOSE: To report on the implementation and clinical outcomes of a community-based pulmonary rehabilitation program in rural Appalachia. METHODS: Three rural health centers and a large referral hospital worked together to establish pulmonary rehabilitation services based on AACVPR guidelines. Each site hired at least 1 respiratory therapist. To measure clinical outcomes, a retrospective medical record study compared pre- and post-program values for the modified Medical Research Council dyspnea level, 6-minute walk test (6MWT), negative inspiratory force (NIF), respiratory disease knowledge, St George Respiratory Questionnaire (SGRQ), BODE index (body mass index, airflow obstruction, dyspnea and exercise capacity), and smoking status...
March 16, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28306587/comparison-of-the-american-college-of-cardiology-american-heart-association-and-the-european-society-of-cardiology-guidelines-for-the-management-of-patients-with-non-st-segment-elevation-acute-coronary-syndromes
#20
Aya J Alame, Aris Karatasakis, Judit Karacsonyi, Barbara A Danek, Erica Resendes, Jose R Martinez Parachini, Pratik Kalsaria, Michele Roesle, Bavana V Rangan, Paul Sorajja, Hani Jneid, Subhash Banerjee, Emmanouil S Brilakis
INTRODUCTION: The American College of Cardiology (ACC), the American Heart Association (AHA), and the European Society of Cardiology (ESC) have been developing guidelines to assist clinicians in making evidence-based decisions. MATERIALS AND METHODS: The current ACC/AHA and ESC guidelines for non-ST-segment elevation acute coronary syndromes (NSTE-ACS) that were updated in 2014 and 2015, respectively, were compared to assess the number of recommendations on the basis of class of recommendation and level of evidence (LOE), the sources cited, and the content...
March 16, 2017: Coronary Artery Disease
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