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https://www.readbyqxmd.com/read/27933718/constipation-in-older-people-a-consensus-statement
#1
Anton Emmanuel, Francesco Mattace-Raso, Maria Cristina Neri, Karl-Uwe Petersen, Enrique Rey, June Rogers
BACKGROUND AND AIMS: Chronic constipation is a serious medical condition that affects 30%-40% of people over 60 years old. Although not normally life threatening, constipation reduces quality of life by the same extent as diabetes and osteoarthritis. There are currently no Europe-wide guidelines for treating constipation in older people, although there is some country-level guidance for the general population. We have evaluated the existing guidance and best clinical practice to improve the care of older people with constipation...
December 9, 2016: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/27933614/antiviral-agents-for-infectious-mononucleosis-glandular-fever
#2
REVIEW
Muireann De Paor, Kirsty O'Brien, Tom Fahey, Susan M Smith
BACKGROUND: Infectious mononucleosis (IM) is a clinical syndrome, usually caused by the Epstein Barr virus (EPV), characterised by lymphadenopathy, fever and sore throat. Most cases of symptomatic IM occur in older teenagers or young adults. Usually IM is a benign self-limiting illness and requires only symptomatic treatment. However, occasionally the disease course can be complicated or prolonged and lead to decreased productivity in terms of school or work. Antiviral medications have been used to treat IM, but the use of antivirals for IM is controversial...
December 8, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27933511/appraisal-of-the-quality-and-contents-of-clinical-practice-guidelines-for-hypertension-management-in-chinese-medicine-a-systematic-review
#3
REVIEW
Ya Yuwen, Xue-Jie Han, Wei-Liang Weng, Xue-Yao Zhao, Yu-Qi Liu, Wei-Qiang Li, Da-Sheng Liu, Yan-Ping Wang, Ai-Ping Lu
OBJECTIVE: To evaluate the quality and consistency of recommendations in the clinical practice guidelines (CPGs) for hypertension in Chinese medicine (CM). METHODS: CM CPGs were identified from 5 electronic databases and hand searches through related handbooks published from January 1990 to December 2013. Three reviewers independently appraised the CPGs based on the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument, and compared the CPGs' recommendations on CM syndrome pattern classification and treatment...
December 9, 2016: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/27933508/patterns-of-diabetes-care-in-slovenia-croatia-serbia-bulgaria-and-romania-an-observational-non-interventional-cross-sectional-study
#4
Miro Cokolic, Nebojsa M Lalic, Dragan Micic, Gorana Mirosevic, Sanja Klobucar Majanovic, Ivaylo N Lefterov, Mariana Graur
BACKGROUND: National guidelines for treating type 2 diabetes in the Balkans generally follow European guidelines. The current study was undertaken to estimate the rate of glycated hemoglobin (HbA1c) measurements and level of HbA1c control in diabetic patients treated in regular clinical practice settings in the Balkans and to evaluate if providing HbA1c measurements improves adherence to treatment guidelines. METHODS: This cross-sectional study enrolled type 2 diabetic patients treated by 79 primary care physicians and 102 specialists...
December 8, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27933504/mental-health-support-provided-throughout-the-bariatric-surgery-clinical-pathway-in-french-specialized-care-centers-for-obesity
#5
Kristopher Lamore, Sandra S Kaci, Sébastien Czernichow, Marion Bretault, Jean-Luc Bouillot, Anne-Jeanne Naudé, Sandra Gribe-Ouaknine, Claire Carette, Cécile Flahault
OBJECTIVE: Pre-operative psychological assessment is recommended by international guidelines for bariatric surgery candidates. Thereby, service teams caring for bariatric patients should include at least one mental health provider (e.g., a psychologist or psychiatrist). The objective of this study was to evaluate the psychology and psychiatry resources and practices in the 37 specialized obesity centers (CSOs) created by the French Ministry of Health. MATERIALS AND METHODS: CSO coordinators were contacted by e-mail to collect general information on the centers (e...
December 8, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27933399/implementation-of-clinical-decision-support-in-young-children-with-acute-gastroenteritis-a-randomized-controlled-trial-at-the-emergency-department
#6
Dorien Geurts, Evelien de Vos-Kerkhof, Suzanne Polinder, Ewout Steyerberg, Johan van der Lei, Henriëtte Moll, Rianne Oostenbrink
: Acute gastroenteritis (AGE) is one of the most frequent reasons for young children to visit emergency departments (EDs). We aimed to evaluate (1) feasibility of a nurse-guided clinical decision support system for rehydration treatment in children with AGE and (2) the impact on diagnostics, treatment, and costs compared with usual care by attending physician. A randomized controlled trial was performed in 222 children, aged 1 month to 5 years at the ED of the Erasmus MC-Sophia Children's hospital in The Netherlands ( 2010-2012)...
December 8, 2016: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27933391/-tapering-and-termination-of-immunosuppressive-treatment-in-spondyloarthritides-including-psoriatic-arthritis
#7
REVIEW
G Scholz, B Möller
BACKGROUND: Immunomodulatory long-term treatment has also become the standard treatment for spondyloarthritides (SpA), including psoriatic arthritis (PsA); however, uncertainty exists about dose reduction or termination of treatment after remission or low disease activity. OBJECTIVE: When is it possible to reduce medication or terminate treatment for SpA? MATERIAL AND METHODS: An extensive non-systematic literature search was performed focusing on practice guidelines, systematic meta-analyses and clinical trials on medicinal long-term treatment and voluntary medication reduction in axial and peripheral SpA, including PsA...
December 8, 2016: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/27933158/development-and-implementation-of-a-standardized-pathway-in-the-pediatric-intensive-care-unit-for-children-with-severe-traumatic-brain-injuries
#8
Lauren Rakes, Mary King, Brian Johnston, Randall Chesnut, Rosemary Grant, Monica Vavilala
Severe traumatic brain injury (TBI) is a leading cause of morbidity and mortality in children. In 2003 and 2012, the Brain Trauma Foundation established and refined evidence-based guidelines for management of severe TBI in children. A recent multicenter study demonstrated an association between TBI guideline adherence and improved discharge survival. However, this study also showed large variation in adherence to pediatric TBI management at our level 1 pediatric trauma center, where overall adherence to fourteen pediatric intensive care unit (PICU) TBI clinical indicators was 64%...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27933152/ensuring-availability-of-in-date-and-fit-for-purpose-emergency-guidelines-in-all-anaesthetic-areas-throughout-the-south-east-scotland-deanery
#9
Elise Hindle
Our aim was to institute a system whereby emergency anaesthetic guidelines are available in >90% of appropriate clinical areas throughout each of the acute hospital sites in three health board administrative regions, and whereby >90% of available guidelines are deemed to be in date and fit for purpose. Our objective was to achieve these targets within 6 months. Using quality improvement methodology, we inventoried available emergency anaesthetic guidelines in 132 locations throughout seven acute care hospitals...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27933151/improving-asthma-care-in-a-pediatric-resident-clinic
#10
Julia Lee, Albina Gogo, Daniel Tancredi, Erik Fernandez Y Garcia, Ulfat Shaikh
There is variation in pediatric asthma management in the outpatient setting. Adherence to national asthma guidelines provides a systematic standardized approach to asthma management. There is a gap between usual and guideline-consistent asthma care in resident clinics. Practice improvement modules aimed at improving resident physician adherence to asthma care guidelines have not been consistently utilized and have not yet been studied. Our aim was to increase guideline consistent care in our pediatric resident clinic in a twelve-month period via increasing performance on the following measures to 75%: spirometry testing; influenza immunization recommendation; level of control assessed through the use of a standardized questionnaire; appropriate medications per national guideline; and use of written asthma action plans...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27933099/treating-nonsuicidal-self-injury-nssi-in-adolescents-consensus-based-german-guidelines
#11
Paul L Plener, Romuald Brunner, Jörg M Fegert, Rebecca C Groschwitz, Tina In-Albon, Michael Kaess, Nestor D Kapusta, Franz Resch, Katja Becker
BACKGROUND: Nonsuicidal self-injury (NSSI) is a frequent and clinically relevant phenomenon in adolescence. Within Europe, Germany has one of the highest prevalence rates in youth with lifetime prevalence ranging between 25 and 35%. However, treatment guidelines for NSSI are not yet available. METHODS: Consensus based clinical guidelines were created by a working group consisting of members of eleven medical, psychological or psychotherapeutic professional national associations, and two members of patient self-help and prevention groups...
2016: Child and Adolescent Psychiatry and Mental Health
https://www.readbyqxmd.com/read/27932614/validation-of-the-cepheid-genexpert-for-detecting-ebola-virus-in-semen
#12
Amy James Loftis, Saturday Quellie, Kelly Chason, Emmanuel Sumo, Mason Toukolon, Yonnie Otieno, Heinzfried Ellerbrok, Marcia M Hobbs, David Hoover, Karine Dube, David A Wohl, William A Fischer
BACKGROUND: Ebola virus (EBOV) RNA persistence in semen, reported sexual transmission, and sporadic clusters at the end of the 2013-2016 epidemic have prompted recommendations that male survivors refrain from unprotected sex unless their semen is confirmed to be EBOV-free. However, there is no fully validated assay for EBOV detection in fluids other than blood. METHODS: The Cepheid Xpert Ebola assay for EBOV RNA detection was validated for whole semen and blood using samples obtained from uninfected donors and spiked with inactivated EBOV...
December 8, 2016: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27932603/poststroke-depression-a-scientific-statement-for-healthcare-professionals-from-the-american-heart-association-american-stroke-association
#13
Amytis Towfighi, Bruce Ovbiagele, Nada El Husseini, Maree L Hackett, Ricardo E Jorge, Brett M Kissela, Pamela H Mitchell, Lesli E Skolarus, Mary A Whooley, Linda S Williams
Poststroke depression (PSD) is common, affecting approximately one third of stroke survivors at any one time after stroke. Individuals with PSD are at a higher risk for suboptimal recovery, recurrent vascular events, poor quality of life, and mortality. Although PSD is prevalent, uncertainty remains regarding predisposing risk factors and optimal strategies for prevention and treatment. This is the first scientific statement from the American Heart Association on the topic of PSD. Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statements Oversight Committee and the American Heart Association's Manuscript Oversight Committee...
December 8, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27932533/preoperative-proteinuria-and-reduced-glomerular-filtration-rate-predicts-renal-replacement-therapy-in-patients-supported-with-continuous-flow-left-ventricular-assist-devices
#14
Veli K Topkara, Ellie J Coromilas, Arthur Reshad Garan, Randall C Li, Francesco Castagna, Douglas L Jennings, Melana Yuzefpolskaya, Koji Takeda, Hiroo Takayama, Robert N Sladen, Donna M Mancini, Yoshifumi Naka, Jai Radhakrishnan, Paolo C Colombo
BACKGROUND: Renal failure requiring renal replacement therapy (RRT) has detrimental effects on quality of life and survival of patients with continuous-flow left ventricular assist devices (CF-LVADs). Current guidelines do not offer a decision-making algorithm for CF-LVAD candidates with poor baseline renal function. Objective of this study was to identify risk factors associated with RRT after CF-LVAD implantation. METHODS AND RESULTS: Three hundred and eighty-nine consecutive patients underwent contemporary CF-LVAD implantation at the Columbia University Medical Center between January 2004 and August 2015...
December 2016: Circulation. Heart Failure
https://www.readbyqxmd.com/read/27932513/improving-incidence-of-postoperative-atrial-fibrillation-after-cardiac-surgery-using-simplified-clinical-practice-guidelines
#15
Amr S Omar, Hesham Ewila, Mahmoud Allam, Sameh Aboulnagah, Samy Hanoura, Praveen C Sivadasan, Ousama Bilal, Abdul Rasheed A Pattath, Abdulaziz AlKhulaifi
OBJECTIVES: Postoperative atrial fibrillation (POAF) remains a major risk after cardiac surgery. Twelve percent patients admitted to this unit postcardiac surgery experienced POAF, which led to hemodynamic instability, increased risk of stroke, and increased length of postoperative intensive care unit stay. Our aim was to decrease the incidence of POAF in the cardiothoracic intensive care unit by the end of April 2014. METHODS: Design-Retrospective data analysis...
December 8, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27932390/official-american-thoracic-society-infectious-diseases-society-of-america-centers-for-disease-control-and-prevention-clinical-practice-guidelines-diagnosis-of-tuberculosis-in-adults-and-children
#16
David M Lewinsohn, Michael K Leonard, Philip A LoBue, David L Cohn, Charles L Daley, Ed Desmond, Joseph Keane, Deborah A Lewinsohn, Ann M Loeffler, Gerald H Mazurek, Richard J O'Brien, Madhukar Pai, Luca Richeldi, Max Salfinger, Thomas M Shinnick, Timothy R Sterling, David M Warshauer, Gail L Woods
BACKGROUND: Individuals infected with Mycobacterium tuberculosis (Mtb) may develop symptoms and signs of disease (tuberculosis disease) or may have no clinical evidence of disease (latent tuberculosis infection [LTBI]). Tuberculosis disease is a leading cause of infectious disease morbidity and mortality worldwide, yet many questions related to its diagnosis remain. METHODS: A task force supported by the American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America searched, selected, and synthesized relevant evidence...
December 8, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27932341/older-patient-considering-treatment-for-advanced-renal-disease-protocol-for-a-scoping-review-of-the-information-available-for-shared-decision-making
#17
Rajesh Raj, Kiran D K Ahuja, Mai Frandsen, Matthew Jose
INTRODUCTION: Older adults constitute the largest group of patients on dialysis in most parts of the world. Management of advanced renal disease in the older adult is complex; treatment outcomes and prognosis can be markedly different from younger patients. Clinical teams caring for such patients are often called on to provide information regarding prognosis and outcomes with treatment-particularly, the comparison between having dialysis treatment versus not having dialysis. These discussions can be difficult for clinicians because they have to contend with incomplete or nascent data regarding prognosis and outcomes in this age group...
December 8, 2016: BMJ Open
https://www.readbyqxmd.com/read/27932339/predictors-of-treatment-failure-on-second-line-antiretroviral-therapy-among-adults-in-northwest-ethiopia-a-multicentre-retrospective-follow-up-study
#18
Adino Tesfahun Tsegaye, Mamo Wubshet, Tadesse Awoke, Kefyalew Addis Alene
BACKGROUND: The number of patients using second-line antiretroviral therapy (ART) has increased over time. In Ethiopia, 1.5% of HIV infected patients on ART are using a second-line regimen and little is known about its effect in this setting. OBJECTIVE: To estimate the rate and predictors of treatment failure on second-line ART among adults living with HIV in northwest Ethiopia. SETTING: An institution-based retrospective follow-up study was conducted at three tertiary hospitals in northwest Ethiopia from March to May 2015...
December 8, 2016: BMJ Open
https://www.readbyqxmd.com/read/27932337/development-of-a-critical-appraisal-tool-to-assess-the-quality-of-cross-sectional-studies-axis
#19
Martin J Downes, Marnie L Brennan, Hywel C Williams, Rachel S Dean
OBJECTIVES: The aim of this study was to develop a critical appraisal (CA) tool that addressed study design and reporting quality as well as the risk of bias in cross-sectional studies (CSSs). In addition, the aim was to produce a help document to guide the non-expert user through the tool. DESIGN: An initial scoping review of the published literature and key epidemiological texts was undertaken prior to the formation of a Delphi panel to establish key components for a CA tool for CSSs...
December 8, 2016: BMJ Open
https://www.readbyqxmd.com/read/27932335/multicentre-randomised-placebo-controlled-trial-of-oral-anticoagulation-with-apixaban-in-systemic-sclerosis-related-pulmonary-arterial-hypertension-the-sphinx-study-protocol
#20
Alicia Calderone, Wendy Stevens, David Prior, Harshal Nandurkar, Eli Gabbay, Susanna M Proudman, Trevor Williams, David Celermajer, Joanne Sahhar, Peter K K Wong, Vivek Thakkar, Nathan Dwyer, Jeremy Wrobel, Weng Chin, Danny Liew, Margaret Staples, Rachelle Buchbinder, Mandana Nikpour
INTRODUCTION: Systemic sclerosis (SSc) is a severe and costly multiorgan autoimmune connective tissue disease characterised by vasculopathy and fibrosis. One of the major causes of SSc-related death is pulmonary arterial hypertension (PAH), which develops in 12-15% of patients with SSc and accounts for 30-40% of deaths. In situ thrombosis in the small calibre peripheral pulmonary vessels resulting from endothelial dysfunction and an imbalance of anticoagulant and prothrombotic mediators has been implicated in the complex pathophysiology of SSc-related PAH (SSc-PAH), with international clinical guidelines recommending the use of anticoagulants for some types of PAH, such as idiopathic PAH...
December 8, 2016: BMJ Open
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