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Evidence based Guidelines

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https://www.readbyqxmd.com/read/29784739/management-of-locoregional-rectal-cancer
#1
Christopher G Willett
The NCCN Guidelines for Rectal Cancer are now more closely aligned with those for colon cancer. A new MRI-based definition of the rectum has been included and the use of MRI in staging has been elevated in importance. There is a new emphasis on neoadjuvant therapy, especially the concurrent use of chemotherapy and radiotherapy. One of the biggest changes is more acceptance of an observational approach-"watch and wait, nonoperative management"-for select patients experiencing a complete clinical response with no evidence of residual disease after neoadjuvant therapy...
May 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29784570/research-gaps-in-wilderness-medicine
#2
Daniel Tritz, Kody Dormire, Travis Brachtenbach, Joshua Gordon, Donald Sanders, David Gearheart, Julia Crawford, Matt Vassar
INTRODUCTION: Wilderness medicine involves the treatment of individuals in remote, austere environments. Given the high potential for injuries as well as the unique treatment modalities required in wilderness medicine, evidence-based clinical practice guidelines are necessary to provide optimal care. In this study, we identify evidence gaps from low-quality recommendations in wilderness medicine clinical practice guidelines and identify new/ongoing research addressing them. METHODS: We included relevant clinical practice guidelines from the Wilderness Medical Society and obtained all 1C or 2C level recommendations...
May 18, 2018: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/29784453/executive-summary-of-outpatient-parenteral-antimicrobial-therapy-guidelines-of-the-spanish-society-of-clinical-microbiology-and-infectious-diseases-and-the-spanish-domiciliary-hospitalisation-society
#3
Luis Eduardo López Cortés, Abel Mujal Martínez, Magdalena Fernández Martínez de Mandojana, Natalia Martín, Mercè Gil Bermejo, Joan Solà Aznar, Eulalia Villegas Bruguera, Maria José Peláez Cantero, Pilar Retamar Gentil, Miriam Delgado Vicente, Víctor José González-Ramallo, Miguel Ángel Ponce González, Manuel Mirón Rubio, M Montserrat Gómez Rodríguez de Mendarozqueta, Miguel Ángel Goenaga Sánchez, Pedro Sanroma Mendizábal, Elena Delgado Mejía, Marcos Pajarón Guerrero
Outpatient parenteral antimicrobial therapy (OPAT) programmes make it possible to start or complete intravenous antimicrobial therapy for practically any type of infection at home, provided that patient selection is appropriate for the type of OPAT programme available. Although the clinical management of infections in the home setting is comparable in many respects to that offered in conventional hospitalization (selection of antibiotics, duration of treatment, etc.), there are many aspects that are specific to this care modality...
May 18, 2018: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/29784265/don-t-ignore-my-snore-reducing-perioperative-complications-of-obstructive-sleep-apnea
#4
Ludy P Lemus, Betty McMullin, Honorata Balinowski
PURPOSE: Obstructive sleep apnea (OSA), a condition associated with decreased muscle tone in the airway, has been linked to postoperative complications. The purpose of the initiative was to develop and implement a guideline for patients identified as high-risk for OSA to reduce complications related to OSA. DESIGN: A multidisciplinary team developed the guideline utilizing the Iowa Model of Evidence-Based Practice to Promote Quality Care. METHODS: PubMed literature search from 2006-2013 and critique of over 40 articles were completed...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29784254/evidence-based-practice-in-perianesthesia-nursing-application-of-the-american-geriatrics-society-clinical-practice-guideline-for-postoperative-delirium-in-older-adults
#5
Catherine Hebert
Delirium is a pervasive and dangerous syndrome for older adults in the perianesthesia setting, occurring in up to 60% of surgical cases. The American Geriatrics Society performed a systematic review to develop recommendations for the prevention and management of postoperative delirium in older adults. The recommendations emphasize nonpharmacologic interventions with a strong focus on reducing the use of psychoactive medication. Perianesthesia nurses can serve as leaders in translating these recommendations into evidence-based practice at the bedside for older adults...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29784059/diabetes-intervention-accentuating-diet-and-enhancing-metabolism-diadem-i-a-randomised-controlled-trial-to-examine-the-impact-of-an-intensive-lifestyle-intervention-consisting-of-a-low-energy-diet-and-physical-activity-on-body-weight-and-metabolism-in-early
#6
Shahrad Taheri, Odette Chagoury, Hadeel Zaghloul, Sara Elhadad, Salma Hayder Ahmed, Omar Omar, Sherryl Payra, Salma Ahmed, Neda El Khatib, Rasha Abou Amona, Katie El Nahas, Matthew Bolton, Henem Chaar, Noor Suleiman, Amin Jayyousi, Mahmoud Zirie, Ibrahim Janahi, Wahiba Elhag, Abdulla Alnaama, Abduljaleel Zainel, Dahlia Hassan, Tim Cable, Mary Charlson, Martin Wells, Abdulla Al-Hamaq, Samya Al-Abdulla, Abdul Badi Abou-Samra
BACKGROUND: Type 2 diabetes mellitus (T2DM) and obesity are syndemic and will have a significant impact on affected individuals and healthcare services worldwide. Evidence shows that T2DM remission can be achieved with significant weight loss in those who are younger with early diabetes and requiring fewer medications for glycaemic control. DIADEM-I aims to examine the impact of an intensive lifestyle intervention (ILI) using a low-energy diet (LED) meal replacement approach combined with physical activity in younger individuals with early T2DM...
May 21, 2018: Trials
https://www.readbyqxmd.com/read/29782556/the-effects-of-probiotics-supplementation-on-metabolic-health-in-pregnant-women-an-evidence-based-meta-analysis
#7
Jia Zheng, Qianyun Feng, Sheng Zheng, Xinhua Xiao
The prevalence of maternal obesity and gestational diabetes mellitus (GDM) is increasing rapidly. Probiotics supplementation have been shown to improve metabolic health in humans. In our study, we aimed to evaluate the effects of probiotics supplementation on metabolic health and pregnancy complications in pregnant women. The literature search, data extraction and quality assessment were performed, and data were synthesized in accordance with standardized guidelines. Ten randomized clinical trials with eligible data were included in our meta-analysis...
2018: PloS One
https://www.readbyqxmd.com/read/29782414/osteomyelitis-a-context-for-wound-management
#8
Mary E Groll, Timothy Woods, Richard Salcido
GENERAL PURPOSE: To provide an overview of osteomyelitis. 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 completing this continuing education activity, you should be able to:1. Distinguish the pathogenesis of osteomyelitis in children and adults.2. Identify practical considerations for diagnosis and evidence-based treatment of osteomyelitis...
June 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29782363/regional-lymph-node-metastases-in-groin-sarcomas-a-diagnostic-and-therapeutic-challenge
#9
Deanna Wan Jie Ng, Ye Xin Koh, Grace Hwei Ching Tan, Khee Chee Soo, Melissa Ching Ching Teo
INTRODUCTION: The evaluation of lymph nodes and the role of groin dissection for groin sarcomas has been controversial where there have not been previous studies or guidelines published. In this study, we aim to first formulate a clinical approach in the evaluation of regional lymph nodal metastases. Second, we aim to also evaluate the role of regional lymphadenectomy in the setting of pathologically involved regional lymph nodes for groin sarcomas. MATERIALS AND METHODS: In total, 43 consecutive patients with groin sarcomas underwent treatment at the National Cancer Centre Singapore between 2002 and 2015...
May 18, 2018: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29782353/implementing-best-practice-into-the-emergency-department-triage-process
#10
Luke Burgess, Kathryn Kynoch, Sonia Hines
BACKGROUND: Triage is the process by which emergency departments (EDs) sort patients presenting for medical treatment. The Australasian Triage Scale, validated to measure urgency, answers the question 'This patient should wait for medical assessment and treatment no longer than…' Multiple patients may present within short time frames, and some will have conditions that have outcomes directly related to timeliness of treatment such as stroke, sepsis and myocardial infarction. The safety of patients within the ED is thus directly related to the triage system...
May 17, 2018: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/29782295/diagnostic-and-treatment-strategies-of-dermatologists-for-treating-morphea-in-hungary
#11
Gábor Bali, Bernadett Hidvégi
Localized scleroderma is an uncommon disease, only infrequently encountered by dermatologists in private practices or even in larger academic centers. Because of its rarity, current treatment guidelines are mostly based on low-level clinical evidence and expert opinions. The aim of this study was to evaluate treatment strategies to treat localized scleroderma. A questionnaire was developed and sent to dermatologists in Hungary. 101 returned questionnaires were eligible for evaluation. 87.12% of clinicians employed local steroids...
April 2018: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/29782230/minimizing-restraint-and-seclusion-in-schools-a-response-to-beaudoin-and-moore
#12
Virginia L Walker, Sarah E Pinkelman
Increasing efforts have been made in the field of special education to identify positive, evidence-based practices (EBPs) to meet the needs of students who engage in problem behavior, with a major goal being to eliminate or limit the use of reactive measures such as restraint and seclusion ( Snell & Walker, 2014 ). Various stakeholders, including families and self-advocates, have voiced concerns about the dangers of restraint and seclusion and the lack of protection afforded to students who engage in severe problem behavior...
June 2018: Intellectual and Developmental Disabilities
https://www.readbyqxmd.com/read/29782209/practical-assessment-and-management-of-vulnerabilities-in-older-patients-receiving-chemotherapy-asco-guideline-for-geriatric-oncology
#13
Supriya G Mohile, William Dale, Mark R Somerfield, Mara A Schonberg, Cynthia M Boyd, Peggy S Burhenn, Beverly Canin, Harvey Jay Cohen, Holly M Holmes, Judith O Hopkins, Michelle C Janelsins, Alok A Khorana, Heidi D Klepin, Stuart M Lichtman, Karen M Mustian, William P Tew, Arti Hurria
Purpose To provide guidance regarding the practical assessment and management of vulnerabilities in older patients undergoing chemotherapy. Methods An Expert Panel was convened to develop clinical practice guideline recommendations based on a systematic review of the medical literature. Results A total of 68 studies met eligibility criteria and form the evidentiary basis for the recommendations. Recommendations In patients ≥ 65 years receiving chemotherapy, geriatric assessment (GA) should be used to identify vulnerabilities that are not routinely captured in oncology assessments...
May 21, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29782180/current-evidence-on-heart-rate-variability-biofeedback-as-a-complementary-anticraving-intervention
#14
Nour Alayan, Lucille Eller, Marsha E Bates, Dennis P Carmody
BACKGROUND: The limited success of conventional anticraving interventions encourages research into new treatment strategies. Heart rate variability biofeedback (HRVB), which is based on slowed breathing, was shown to improve symptom severity in various disorders. HRVB, and certain rates of controlled breathing (CB), may offer therapeutic potential as a complementary drug-free treatment option to help control substance craving. METHODS: This review evaluated current evidence on the effectiveness of HRVB and CB training as a complementary anticraving intervention, based on guidelines from the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols...
May 21, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29781322/the-impact-of-chronic-kidney-disease-on-medication-choice-and-pharmacologic-management-in-patients-with-heart-failure
#15
Syed Raza Shah, David E Winchester
In the past few years, medical community, including doctors, have become increasingly aware of the fact that chronic kidney disease (CK) and heart failure (HF) have common risk factors which impacts one another in terms of choice of therapy. Areas covered: Management of these two diseases has been a challenge for physicians. The treatment goals for HF patients in CK are very important. They serve as the end-point in using a specific treatment for management and treatment of CK patients hence, decreasing mortality rates...
May 21, 2018: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29781101/feline-ureteral-obstructions-part-2-surgical-management
#16
REVIEW
D L Clarke
Feline obstructive ureteral disease will likely remain a common and frustrating cause of critical illness in cats for the foreseeable future. Since many cats are uraemic and cardiovascularly unstable secondary to obstructive nephropathy, prompt recognition using clinical intuition, blood work and diagnostic imaging is essential to make a timely diagnosis and decision about timing for intervention, if indicated. Multiple surgical and interventional procedures exist for the management of feline ureteral obstructions but there is no ideal technique and all currently available procedures carry risk of infection, re-obstruction, urine leakage and the need for additional procedures in the future...
May 20, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29779967/a-comparison-of-the-united-states-and-international-perspective-on-chronic-urticaria-guidelines
#17
REVIEW
Torsten Zuberbier, Jonathan A Bernstein
Urticaria is a heterogeneous skin disorder that may be acute or chronic and is defined by the appearance of wheals, angioedema, or both. The European perspective is expressed in a recent international guideline and the American perspective has been based on the US Joint Task Force chronic urticaria practice parameter published in 2014. Both the international guideline (initiated by the European societies European Academy of Allergology and Clinical Immunology [EAACI]/Global Allergy and Asthma European Network [GA2 LEN]/European Dermatology Forum [EDF] in collaboration with the World Allergy Organization [WAO]) and the US (American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma and Immunology) guideline have been developed to help direct primary care physicians and specialists in the management of their patients with urticaria...
May 18, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29779623/educating-emergency-department-staff-on-the-identification-and-treatment-of-human-trafficking-victims
#18
Steven Donahue, Michael Schwien, Danielle LaVallee
INTRODUCTION: Hospitalization is one of the few circumstances in which the lives of trafficking victims intersect with the general population. Based on survivor testimonies, the majority of human trafficking victims may receive medical treatment in a hospital's emergency department while in captivity. With evidenced-based training, ED personnel have a better opportunity to screen persons who are being trafficked and intervene on their behalf. METHODS: This project examined the efficacy of an innovative, evidence-based online training module (HTEmergency...
May 17, 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29779518/menopause-symptom-management-in-the-united-kingdom
#19
REVIEW
Debra Holloway
Menopause is a complex time in a woman's life. It is an increasingly a midlife event, when health care professionals should be aiming to optimize a woman's health for the next 30 years or so. Nurses need to be able to give up-to-date information and evidence for all forms of treatment based on a background of complex and ever-changing research. This article covers the main presenting complaints and treatments, from lifestyle to hormone replacement therapy, by drawing on guidelines from national bodies.
June 2018: Nursing Clinics of North America
https://www.readbyqxmd.com/read/29779301/updates-on-aaa-screening-and-surveillance
#20
Mayo Theivendran, Jason Chuen
BACKGROUND: Screening and diagnostic surveillance of latent conditions have a profound impact on public healthcare expenditure and clinical outcomes. Abdominal aortic aneurysm (AAA) remains one of the hallmark pathologies in vascular surgery and an area of intense research interest. OBJECTIVE: This article is the second of two that will outline current areas of controversy and research in AAA disease in order to support a more detailed understanding of issues in managing patients with this condition, and inform the development of Australasian clinical guidelines and health policy...
May 2018: Australian journal of general practice
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