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Evidence based Guidelines

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https://www.readbyqxmd.com/read/28813090/brazilian-consensus-on-duchenne-muscular-dystrophy-part-1-diagnosis-steroid-therapy-and-perspectives
#1
Alexandra P Q C Araujo, Alzira A S de Carvalho, Eduardo B U Cavalcanti, Jonas Alex M Saute, Elmano Carvalho, Marcondes C França, Alberto R M Martinez, Monica de M M Navarro, Anamarli Nucci, Maria Bernadete D de Resende, Marcus Vinicius M Gonçalves, Juliana Gurgel-Giannetti, Rosana H Scola, Cláudia F da R Sobreira, Umbertina C Reed, Edmar Zanoteli
Significant advances in the understanding and management of Duchenne muscular dystrophy (DMD) took place since international guidelines were published in 2010. Our objective was to provide an evidence-based national consensus statement for multidisciplinary care of DMD in Brazil. A combination of the Delphi technique with a systematic review of studies from 2010 to 2016 was employed to classify evidence levels and grade of recommendations. Our recommendations were divided in two parts. We present Part 1 here, where we describe the guideline methodology and overall disease concepts, and also provide recommendations on diagnosis, steroid therapy and new drug treatment perspectives for DMD...
August 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28812845/a-qualitative-assessment-of-the-evidence-utilization-for-health-policy-making-on-the-basis-of-support-tools-in-a-developing-country
#2
Mohammad Hasan Imani-Nasab, Hesam Seyedin, Bahareh Yazdizadeh, Reza Majdzadeh
BACKGROUND: SUPPORT tools consist of 18 articles addressing the health policy-makers so that they can learn how to make evidence-informed health policies. These tools have been particularly recommended for developing countries. The present study tries to explain the process of evidence utilization for developing policy documents in the Iranian Ministry of Health and Medical Education (MoHME) and to compare the findings with those of SUPPORT tools. METHODS: A qualitative research was conducted, using the framework analysis approach...
January 8, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28812302/management-of-sleep-wake-disturbances-comorbid-with-cancer
#3
Ann M Berger Aprn, Ellyn E Matthews Cbsm, Ashley M Kenkel
It is critical that clinicians and healthcare systems adopt routine screening and affordable interventions to reduce chronic insomnia and improve the quality of life in cancer patients and survivors. We provide expert clinical advice on how to manage sleep-wake disturbances that occur comorbidly with cancer. Our discussion focuses on the etiology, screening, and assessment of sleep-wake disturbances, and on both nonpharmacologic and pharmacologic interventions to manage sleep disturbances, insomnia, and sleep-related breathing disorders...
August 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28811703/barrett-s-oesophagus-current-controversies
#4
REVIEW
Chidi Amadi, Piers Gatenby
Oesophageal adenocarcinoma is rapidly increasing in Western countries. This tumour frequently presents late in its course with metastatic disease and has a very poor prognosis. Barrett's oesophagus is an acquired condition whereby the native squamous mucosa of the lower oesophagus is replaced by columnar epithelium following prolonged gastro-oesophageal reflux and is the recognised precursor lesion for oesophageal adenocarcinoma. There are multiple national and society guidelines regarding screening, surveillance and management of Barrett's oesophagus, however all are limited regarding a clear evidence base for a well-demonstrated benefit and cost-effectiveness of surveillance, and robust risk stratification for patients to best use resources...
July 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28811051/patient-blood-management-in-the-intensive-care-unit
#5
REVIEW
Aryeh Shander, Mazyar Javidroozi, Gregg Lobel
Patient Blood Management underscores a fundamental shift from a product-centered approach to a patient-centric approach through timely application of evidence-based medical and surgical concepts designed to maintain hemoglobin concentration, optimize hemostasis, and minimize blood loss in an effort to improve patient outcome. In this concept, allogeneic blood transfusion is not viewed as the treatment of default for anemic patients, but one among many treatment modalities that should be weighed based on its merits-potentials risks and benefits-for the individual patient in the context of other alternatives...
July 31, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28810865/cryptic-plasmodium-ovale-concurrent-with-mixed-plasmodium-falciparum-and-plasmodium-malariae-infection-in-two-children-from-central-african-republic
#6
Cynthia Bichara, Philippe Flahaut, Damien Costa, Anne-Lise Bienvenu, Stephane Picot, Gilles Gargala
BACKGROUND: Since several malaria parasite species are usually present in a particular area, co-infections with more than one species of Plasmodium are more likely to occur in humans infected in these areas. In many mixed infections, parasite densities of the cryptic species may be low and often not recognized in clinical practice. CASE PRESENTATION: Two children (3 and 6 years old) adopted recently from Central African Republic were admitted to hospital because of intermittent fever...
August 15, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28810280/-dual-antiplatelet-therapy-in-the-perioperative-period-to%C3%A2-continue-or-discontinue-treatment
#7
Jürgen Koscielny, Christian von Heymann, Uwe Zeymer, Jochen Cremer, Michael Spannagl, Joachim Labenz, Evangelos Giannitsis, Franz Goss
Background For secondary prevention of acute coronary syndrome, guidelines recommend dual antiplatelet therapy (DAPT) with acetylsalicylic acid and a P2Y12 receptor antagonist such as clopidogrel, prasugrel or ticagrelor for a period of 12 months. Often, uncertainty exists with respect to surgical or diagnostic procedures in these high-risk patients: can the DAPT be continued without interruption? If not, what is the recommended withdrawal strategy? What should be considered for the perioperative management? Methods An interdisciplinary group of experienced experts in the fields of cardiology, cardiac surgery, gastroenterology, anaesthesiology, intensive care and haemostaseology developed recommendations relevant to daily clinical practice based on the current scientific evidence...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28810091/preoperative-chest-radiography-in-elective-surgery-review-and-update
#8
Ethan M Young, Joel D Farmer
INTRODUCTION: The preoperative evaluation is designed to identify factors that may predispose a patient to perioperative complications in an effort to ensure patient safety. The use of chest radiography in the preoperative evaluation has progressed from routine testing to a more selective approach based on evidence that routine testing is low yield. However, preoperative chest radiography (POCR) may still be utilized more frequently than necessary as guidelines provide varying recommendations and providers continue to order the test by convention...
February 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28809991/treatment-of-inverse-intertriginous-psoriasis-updated-guidelines-from-the-medical-board-of-the-national-psoriasis-foundation
#9
Hasan Khosravi, Michael P Siegel, Abby S Van Voorhees, Joseph F Merola
<p>Inverse or intertriginous psoriasis commonly involves skin fold areas including the axillae, perianal skin, intergluteal cleft, inframammary, genital/inguinal, abdominal, and retroauricular folds. After reviewing the literature for new treatments, a task force was convened to update a consensus on inverse psoriasis therapy. Short-term treatment continues to be low-potency topical steroids. In order to avoid steroid-induced adverse effects, long-term therapy includes topical immunomodulators, calcitriol, and calcipotriene...
August 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28809936/benefits-and-safety-of-gabapentinoids-in-chronic-low-back-pain-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#10
Harsha Shanthanna, Ian Gilron, Manikandan Rajarathinam, Rizq AlAmri, Sriganesh Kamath, Lehana Thabane, Philip J Devereaux, Mohit Bhandari
BACKGROUND AND OBJECTIVE: Chronic Low Back Pain (CLBP) is very common, with a lifetime prevalence between 51% and 80%. In majority, it is nonspecific in nature and multifactorial in etiology. Pregabalin (PG) and Gabapentin (GB) are gabapentinoids that have demonstrated benefit in neuropathic pain conditions. Despite no clear rationale, they are increasingly used for nonspecific CLBP. They necessitate prolonged use and are associated with adverse effects and increased cost. Recent guidelines from the National Health Service (NHS), England, expressed concerns on their off-label use, in addition to the risk of misuse...
August 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28809926/impact-of-fortified-versus-unfortified-lipid-based-supplements-on-morbidity-and-nutritional-status-a-randomised-double-blind-placebo-controlled-trial-in-ill-gambian-children
#11
Stefan A Unger, Saikou Drammeh, Jahid Hasan, Kabiru Ceesay, Edrisa Sinjanka, Sainey Beyai, Bakary Sonko, Bai Lamin Dondeh, Anthony J Fulford, Sophie E Moore, Andrew M Prentice
BACKGROUND: Multiple micronutrients (MMN) are commonly prescribed in pediatric primary healthcare in sub-Saharan Africa to improve nutritional status and appetite without evidence for their effectiveness or international clinical guidelines. Community-wide MMN supplementation has shown limited and heterogeneous impact on growth and morbidity. Short-term ready-to-use therapeutic foods in acutely sick children in a hospital setting also had limited efficacy regarding subsequent growth. The effectiveness of MMN in improving morbidity or growth in sick children presenting for primary care has not been assessed...
August 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28809086/who-where-what-and-where-to-now-a-snapshot-of-publishing-patterns-in-australian-orthopaedic-surgery
#12
Nicholas Croker, Abhirup Lobo, Anne Croker, Zsolt J Balogh, David Dewar
BACKGROUND: Development of core research competency is a principle of orthopaedic surgical training in Australia. This paper aims to provide an objective snapshot of publications by Australian orthopaedic trainees and surgeons, to contribute to the discussion on how to identify and build on research capability in the Australian Orthopaedic Association (AOA). METHODS: By analysing journals with a journal impact factor >1 from 2009 to 2015, data were gathered to explore scientific journal publications by Australian orthopaedic surgeons and trainees in relation to who are the authors, what they are reporting and where they are publishing...
August 15, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28808845/targeted-treatment-in-severe-traumatic-brain-injury-in-the-age-of-precision-medicine
#13
Anthony A Figaji, A Graham Fieggen, Ncedile Mankahla, Nico Enslin, Ursula K Rohlwink
In recent years, much progress has been made in our understanding of traumatic brain injury (TBI). Clinical outcomes have progressively improved, but evidence-based guidelines for how we manage patients remain surprisingly weak. The problem is that the many interventions and strategies that have been investigated in randomized controlled trials have all disappointed. These include many concepts that had become standard care in TBI. And that is just for adult TBI; in children, the situation is even worse. Not only is pediatric care more difficult than adult care because physiological norms change with age, but also there is less evidence for clinical practice...
August 14, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28808506/the-knowledge-concerns-and-healthcare-practices-among-physicians-regarding-electronic-cigarettes
#14
Venkatkiran Kanchustambham, Swetha Saladi, Jonathan Rodrigues, Hermina Fernandes, Setu Patolia, Sadhashiv Santosh
Background: Electronic cigarettes (e-cigarettes) are battery-powered devices that deliver aerosolized nicotine. With easy access and over-the-counter availability, many patients consider using electronic cigarettes for smoking cessation. Few studies have looked at long-term safety/efficacy and physician knowledge/attitudes toward e-cigarettes. Physicians have insufficient guidelines for advising their patients about e-cigarettes. Objective: 1) To identify knowledge and attitude of health care practitioners toward electronic cigarettes...
July 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28808492/assessment-of-anti-factor-xa-activity-of-enoxaparin-for-venous-thromboembolism-prophylaxis-in-morbidly-obese-surgical-patients
#15
Nouf Al Otaib, Zohour Bootah, Maha A Al Ammari, Tariq M Aldebasi, Abdulmalik M Alkatheri, Shmeylan A Al Harbi, Salah M AbuRuz, Abdulkareem M AlBekairy
BACKGROUND: Venous thromboembolism (VTE) can be encountered by 60% of hospitalized patients. Anticoagulants have been recommended to reduce the risk of VTE in patients with risk factors. However, no specific dosing recommendations for obese patients are provided in the current practice guidelines. The purpose of this study was to determine the efficacy and safety of weight-based dosing of enoxaparin for VTE prophylaxis among morbidly obese patients undergoing surgery. METHODS: Adult patients were enrolled if they have a body mass index (BMI) of ≥35 kg/m(2) and were scheduled for surgery...
July 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28808486/the-saudi-thoracic-society-guidelines-for-diagnosis-and-management-of-noncystic-fibrosis-bronchiectasis
#16
Hamdan Al-Jahdali, Abdullah Alshimemeri, Abdullah Mobeireek, Amr S Albanna, Nehad N Al Shirawi, Siraj Wali, Khaled Alkattan, Abdulrahman A Alrajhi, Khalid Mobaireek, Hassan S Alorainy, Mohamed S Al-Hajjaj, Anne B Chang, Stefano Aliberti
This is the first guideline developed by the Saudi Thoracic Society for the diagnosis and management of noncystic fibrosis bronchiectasis. Local experts including pulmonologists, infectious disease specialists, thoracic surgeons, respiratory therapists, and others from adult and pediatric departments provided the best practice evidence recommendations based on the available international and local literature. The main objective of this guideline is to utilize the current published evidence to develop recommendations about management of bronchiectasis suitable to our local health-care system and available resources...
July 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28807643/-use-of-subcutaneous-route-for-comfort-care%C3%A2-in-neonatal-palliative-population-systematic-review-and-survey-of-practices-in-france
#17
N Pouvreau, J Tandonnet, O Tandonnet, L Renesme
INTRODUCTION: Subcutaneous hydration (hypodermoclysis) and drug administration is a widely used method of analgesic therapy in adult palliative care medicine. Very little is known about its use in neonatal medicine. Evidence-based guidelines do not exist due to a lack of data. In this study, the advantages of subcutaneous analgesic therapy in terms of comfort in neonatal palliative care situations were investigated. METHODS: This report details the results of a systematic review associated with a survey in neonatal intensive care units (NICUs) and pediatric palliative care departments (PPCTs) in France...
August 11, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28807611/initial-treatment-for-nonsyndromic-early-life-epilepsy-an-unexpected-consensus
#18
Renée A Shellhaas, Anne T Berg, Zachary M Grinspan, Courtney J Wusthoff, John J Millichap, Tobias Loddenkemper, Jason Coryell, Russell P Saneto, Catherine J Chu, Sucheta M Joshi, Joseph E Sullivan, Kelly G Knupp, Eric H Kossoff, Cynthia Keator, Elaine C Wirrell, John R Mytinger, Ignacio Valencia, Shavonne Massey, William D Gaillard
OBJECTIVE: There are no evidence-based guidelines on the preferred approach to treating early-life epilepsy. We examined initial therapy selection in a contemporary US cohort of children with newly diagnosed, nonsyndromic, early-life epilepsy (onset before age three years). METHODS: Seventeen pediatric epilepsy centers participated in a prospective cohort study of children with newly diagnosed epilepsy with onset under 36 months of age. Details regarding demographics, seizure types, and initial medication selections were obtained from medical records...
June 27, 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28807608/benefits-of-flu-vaccination-for-persons-with-diabetes-mellitus-a-review
#19
REVIEW
M Goeijenbier, T T van Sloten, L Slobbe, C Mathieu, P van Genderen, Walter E P Beyer, Albert D M E Osterhaus
Diabetes mellitus imposes a significant and increasing burden on society, with major consequences for human health, welfare and the economy worldwide. Persons with diabetes mellitus are at increased risk of developing severe complications after influenza virus infection and guidelines advise vaccination. The present evidence for influenza vaccine effectiveness in persons with diabetes mellitus is mainly based on observational studies with clinical endpoints like hospitalization and death, indicating a beneficial reduction of morbidity and mortality...
August 11, 2017: Vaccine
https://www.readbyqxmd.com/read/28806999/trading-certainty-for-speed-how-much-uncertainty-are-decisionmakers-and-guideline-developers-willing-to-accept-when-using-rapid-reviews-an-international-survey
#20
Gernot Wagner, Barbara Nussbaumer-Streit, Judith Greimel, Agustín Ciapponi, Gerald Gartlehner
BACKGROUND: Decisionmakers and guideline developers demand rapid syntheses of the evidence when time sensitive evidence-informed decisions are required. A potential trade-off of such rapid reviews is that their results can have less reliability than results of systematic reviews that can lead to an increased risk of making incorrect decisions or recommendations. We sought to determine how much incremental uncertainty about the correctness of an answer guideline developers and health policy decisionmakers are willing to accept in exchange for a rapid evidence-synthesis...
August 14, 2017: BMC Medical Research Methodology
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