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"Clinical guidelines"

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https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#1
Inge Hommel, Petra J van Gurp, Alfons A den Broeder, Hub Wollersheim, Femke Atsma, Marlies E J L Hulscher, Cees J Tack
As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care...
April 24, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28435487/randomized-trial-of-adding-parenteral-acetaminophen-to-prochlorperazine-and-diphenhydramine-to-treat-headache-in-the-emergency-department
#2
Stefan H Meyering, Ryan W Stringer, Matthew K Hysell
INTRODUCTION: Headaches represent over three million emergency department (ED) visits per year, comprising 2.4% of all ED visits. There are many proposed methods and clinical guidelines of treating acute headache presentations. However, data on intravenous acetaminophen usage in these settings are lacking. In this study, we sought to determine the efficacy of intravenous (IV) acetaminophen as an adjunct to a standard therapy for the treatment of patients who present to the ED with a chief complaint of "headache...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435320/identification-prevalence-and-treatment-of-painful-diabetic-neuropathy-in-patients-from-a-rural-area-in-south-carolina
#3
Jimmy Pruitt, Carolina Moracho-Vilrriales, Tiffaney Threatt, Sarah Wagner, Jun Wu, E Alfonso Romero-Sandoval
Diabetic peripheral neuropathy (DPN) represents significant burdens to many patients and the public health-care system. Patients with diabetes in rural areas have higher risk of developing complications and having less access to proper treatment. We studied a rural population of patients with diabetes who attended a pharmacist-led free clinic for a diabetic education program. Our objectives were to 1) determine the prevalence of DPN and painful diabetic neuropathy (p-DN) in patients with type 2 diabetes; 2) assess the proportion of patients with DPN and p-DN left undocumented upon physician referral to a pharmacist-led free clinic; and 3) determine the appropriateness of pain medication regimen...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28434483/what-imaging-techniques-should-be-used-in-primary-versus-secondary-prevention-for-further-risk-stratification
#4
François Schiele, Eliano Pio Navarese, Adriana Visoná, Kausik Ray
BACKGROUND AND AIMS: An accurate assessment of the cardiovascular (CV) risk of an individual is key for guiding the appropriate treatment strategy for cardiovascular disease (CVD). Although conventional risk factors for CVD are well established, there can be substantial variation in the extent of atherosclerosis between patients. The use of a variety of imaging modalities can be beneficial in the primary prevention stage and in the classification of an individual's CV risk. Therefore, appropriate implementation of these imaging techniques for risk assessment purposes, in line with clinical guidelines, can influence the outcomes of CVD prevention...
April 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/28434482/how-to-implement-clinical-guidelines-to-optimise-familial-hypercholesterolaemia-diagnosis-and-treatment
#5
Michel Farnier, Fernando Civeira, Olivier Descamps
BACKGROUND AND AIMS: Familial hypercholesterolaemia (FH) is a genetic disorder associated with significantly elevated plasma low-density lipoprotein cholesterol (LDL-C) and premature coronary heart disease (CHD). Optimal management of FH relies on early identification and treatment with statins alone or in combination with other lipid-lowering therapies. A lack of awareness of FH and its manifestations among primary care physicians and specialists has led to many individuals being misdiagnosed in the early stages of the disease, further increasing the risk of CHD and requiring much more intensive lipid-lowering strategies...
April 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/28429971/evidence-based-policy-as-reflexive-practice-what-can-we-learn-from-evidence-based-medicine
#6
Roland Bal
The call for evidence-based policy is often accompanied by rather uncritical references to the success of evidence-based medicine, leading to often unsuccessful translation attempts. In this paper, I reflect on the practice of evidence-based medicine in an attempt to sketch a more productive approach to translating evidence into the practice of policy making. Discussing three episodes in the history of evidence-based medicine - clinical trials, and the production and use of clinical guidelines - I conclude that the success of evidence-based medicine is based on the creation of reflexive practices in which evidence and practice can be combined productively...
April 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28429142/national-clinical-guidelines-for-non-surgical-treatment-of-patients-with-recent-onset-low-back-pain-or-lumbar-radiculopathy
#7
REVIEW
Mette Jensen Stochkendahl, Per Kjaer, Jan Hartvigsen, Alice Kongsted, Jens Aaboe, Margrethe Andersen, Mikkel Ø Andersen, Gilles Fournier, Betina Højgaard, Martin Bach Jensen, Lone Donbæk Jensen, Ture Karbo, Lilli Kirkeskov, Martin Melbye, Lone Morsel-Carlsen, Jan Nordsteen, Thorvaldur Skuli Palsson, Zoreh Rasti, Peter Frost Silbye, Morten Zebitz Steiness, Simon Tarp, Morten Vaagholt
PURPOSE: To summarise recommendations about 20 non-surgical interventions for recent onset (<12 weeks) non-specific low back pain (LBP) and lumbar radiculopathy (LR) based on two guidelines from the Danish Health Authority. METHODS: Two multidisciplinary working groups formulated recommendations based on the GRADE approach. RESULTS: Sixteen recommendations were based on evidence, and four on consensus. Management of LBP and LR should include information about prognosis, warning signs, and advise to remain active...
April 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28427911/safety-parameter-considerations-of-anodal-transcranial-directcurrentstimulation-in-rats
#8
Mark P Jackson, Dennis Truong, Milene L Brownlow, Jessica A Wagner, R Andy McKinley, Marom Bikson, Ryan Jankord
A commonly referenced transcranial Direct Current Stimulation (tDCS) safety threshold derives from tDCS lesion studies in the rat and relies on electrode current density (and related electrode charge density) to support clinical guidelines. Concerns about the role of polarity (e.g. anodal tDCS), sub-lesion threshold injury (e.g. neuroinflammatory processes), and role of electrode montage across rodent and human studies support further investigation into animal models of tDCS safety. Thirty-two anesthetized rats received anodal tDCS between 0-5 mA for 60 minutes through one of three epicranial electrode montages...
April 17, 2017: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/28427764/role-of-endoscopy-in-primary-sclerosing-cholangitis-european-society-of-gastrointestinal-endoscopy-esge-and-european-association-for-the-study-of-the-liver-easl-clinical-guideline
#9
(no author information available yet)
This guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE) and of the European Association for the Study of the Liver (EASL) on primary sclerosing cholangitis. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations.
April 13, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28426492/clinical-practice-guidelines-for-pancreatic-cancer-2016-from-the-japan-pancreas-society-a-synopsis
#10
Koji Yamaguchi, Takuji Okusaka, Kyoko Shimizu, Junji Furuse, Yoshinori Ito, Keiji Hanada, Tooru Shimosegawa, Kazuichi Okazaki
OBJECTIVES: Clinical Practice Guidelines for Pancreatic Cancer based on Evidence-Based Medicine 2006 were first published by the Japan Pancreas Society, and they were revised to Clinical Practice Guidelines for Pancreatic Cancer 2009 in July 2009 and were further revised to Clinical Practice Guidelines for Pancreatic Cancer 2013 in October 2013. These guidelines were established according to evidence-based medicine. In October 2016, the Clinical Practice Guidelines for Pancreatic Cancer were newly revised in Japanese...
May 2017: Pancreas
https://www.readbyqxmd.com/read/28425663/management-of-acute-cholangitis-as-a-result-of-occlusion-from-a-self-expandable-metallic-stent-in-patients-with-malignant-distal-and-hilar-biliary-obstructions
#11
Hideyuki Shiomi, Kazuya Matsumoto, Hiroyuki Isayama
Acute cholangitis as a result of common bile duct stones can be managed; however, cholangitis caused by occlusion with a biliary self-expandable metallic stent (SEMS) in patients with an unresectable malignant biliary obstruction has not been fully discussed. The acute cholangitis clinical guidelines (Tokyo Guidelines 2013) recommend following the same procedure as that used for cholangitis; however, the patient's condition, including performance status, tumor extension or staging, and prognosis must be considered...
April 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28425650/current-strategies-for-endoscopic-management-of-acute-cholangitis
#12
Hiroyuki Isayama, Ichiro Yasuda, Damien Tan
BACKGROUND AND AIM: At the pancreatobiliary session of Endoscopic Forum Japan (EFJ) 2016, current strategies for the endoscopic management of acute cholangitis were discussed. The topics consisted of two major parts, namely endoscopic management of acute cholangitis caused by common bile duct stones (CBDS) and biliary stent occlusion. METHODS: Endoscopists from nine Japanese high-volume centers along with two overseas centers participated in the questionnaires and discussion...
April 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28425085/uk-clinical-guideline-for-the-prevention-and-treatment-of-osteoporosis
#13
J Compston, A Cooper, C Cooper, N Gittoes, C Gregson, N Harvey, S Hope, J A Kanis, E V McCloskey, K E S Poole, D M Reid, P Selby, F Thompson, A Thurston, N Vine
INTRODUCTION: In 2008, the UK National Osteoporosis Guideline Group (NOGG) produced a guideline on the prevention and treatment of osteoporosis, with an update in 2013. This paper presents a major update of the guideline, the scope of which is to review the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women and men age 50 years or over. METHODS: Where available, systematic reviews, meta-analyses and randomised controlled trials were used to provide the evidence base...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28423827/parallel-design-of-browsing-scheme-and-data-model-for-multi-level-hierarchical-application-devoted-to-management-of-patient-with-infectious-disease-in-primary-care
#14
Adrien Ugon, Catherine Duclos, Salamata Konate, Sarah Arnedos Lopez, Hechem Yazidi, Alain Venot, Marie-Christine Jaulent, Rosy Tsopra
Many decision systems are based on a hierarchical approach, enriching the known context used to finally choose the right potential action. Designing the scheme for browsing the clinical guidelines is a task devoted to expert in infectious diseases. Designing the data model is a task devoted to the expert in data modeling. As a consequence, browsing scheme and data model generally differ in terms of abstraction levels. While the browsing scheme proposes to navigate into depth, the data model stays flat. We propose here a novel method to design in parallel the browsing scheme and the data model so that both of them reflect the different abstraction levels in decision process...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423796/personalized-guideline-based-treatment-recommendations-using-natural-language-processing-techniques
#15
Matthias Becker, Britta Böckmann
Clinical guidelines and clinical pathways are accepted and proven instruments for quality assurance and process optimization. Today, electronic representation of clinical guidelines exists as unstructured text, but is not well-integrated with patient-specific information from electronic health records. Consequently, generic content of the clinical guidelines is accessible, but it is not possible to visualize the position of the patient on the clinical pathway, decision support cannot be provided by personalized guidelines for the next treatment step...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28420030/role-of-endoscopy-in-primary-sclerosing-cholangitis-european-society-of-gastrointestinal-endoscopy-esge-and-european-association-for-the-study-of-the-liver-easl-clinical-guideline
#16
Lars Aabakken, Tom H Karlsen, Jörg Albert, Marianna Arvanitakis, Olivier Chazouilleres, Jean-Marc Dumonceau, Martti Färkkilä, Peter Fickert, Gideon M Hirschfield, Andrea Laghi, Marco Marzioni, Michael Fernandez, Stephen P Pereira, Jürgen Pohl, Jan-Werner Poley, Cyriel Y Ponsioen, Christoph Schramm, Fredrik Swahn, Andrea Tringali, Cesare Hassan
1 ESGE/EASL recommend that, as the primary diagnostic modality for PSC, magnetic resonance cholangiography (MRC) should be preferred over endoscopic retrograde cholangiopancreatography (ERCP).Moderate quality evidence, strong recommendation. 2 ESGE/EASL suggest that ERCP can be considered if MRC plus liver biopsy is equivocal or contraindicated in patients with persisting clinical suspicion of PSC. The risks of ERCP have to be weighed against the potential benefit with regard to surveillance and treatment recommendations...
April 18, 2017: Endoscopy
https://www.readbyqxmd.com/read/28417345/imaging-markers-for-monitoring-disease-activity-in-multiple-sclerosis
#17
REVIEW
Suradech Suthiphosuwan, David Kim, Aditya Bharatha, Jiwon Oh
Multiple sclerosis (MS) is an immune-mediated disease affecting the central nervous system (CNS). Magnetic resonance imaging (MRI) has long been recognized as an important tool in the diagnosis of MS. It is increasingly recognized that in addition to its role in diagnosis, MRI can play a key role as a noninvasive tool for prognostication, disease monitoring, assessment of treatment efficacy, and safety monitoring of disease-modifying therapies (DMTs). A confluence of factors, including increased availability of MRI, development of improved MRI techniques, and increased availability of DMTs have contributed to the expanding role of MRI in MS clinical care...
May 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28412958/supporting-parents-in-taking-care-of-their-infants-admitted-to-a-neonatal-intensive-care-unit-a-prospective-cohort-pilot-study
#18
Giuseppe De Bernardo, Maria Svelto, Maurizio Giordano, Desiree Sordino, Marina Riccitelli
BACKGROUND: Family-Centred Care (FCC) is recognized as an important component of all paediatric care, including neonatal care, although practical clinical guidelines to support this care model are still needed in Italy. The characteristics and services for families in Italian NICUs show a lack of organization and participation. METHODS: The first aim was to compare satisfaction and stress levels in two groups of parents: an FCC group and a non-FCC group (NFCC). The second aim was to evaluate body weight gain in the newborns enrolled...
April 17, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28411091/comparison-of-dynamic-monitoring-strategies-based-on-cd4-cell-counts-in-virally-suppressed-hiv-positive-individuals-on-combination-antiretroviral-therapy-in-high-income-countries-a-prospective-observational-study
#19
Ellen C Caniglia, Lauren E Cain, Caroline A Sabin, James M Robins, Roger Logan, Sophie Abgrall, Michael J Mugavero, Sonia Hernández-Díaz, Laurence Meyer, Remonie Seng, Daniel R Drozd, George R Seage, Fabrice Bonnet, Francois Dabis, Richard D Moore, Peter Reiss, Ard van Sighem, William C Mathews, Julia Del Amo, Santiago Moreno, Steven G Deeks, Roberto Muga, Stephen L Boswell, Elena Ferrer, Joseph J Eron, Sonia Napravnik, Sophie Jose, Andrew Phillips, Amy C Justice, Janet P Tate, John Gill, Antonio Pacheco, Valdilea G Veloso, Heiner C Bucher, Matthias Egger, Hansjakob Furrer, Kholoud Porter, Giota Touloumi, Heidi Crane, Jose M Miro, Jonathan A Sterne, Dominique Costagliola, Michael Saag, Miguel A Hernán
BACKGROUND: Clinical guidelines vary with respect to the optimal monitoring frequency of HIV-positive individuals. We compared dynamic monitoring strategies based on time-varying CD4 cell counts in virologically suppressed HIV-positive individuals. METHODS: In this observational study, we used data from prospective studies of HIV-positive individuals in Europe (France, Greece, the Netherlands, Spain, Switzerland, and the UK) and North and South America (Brazil, Canada, and the USA) in The HIV-CAUSAL Collaboration and The Centers for AIDS Research Network of Integrated Clinical Systems...
April 11, 2017: Lancet HIV
https://www.readbyqxmd.com/read/28410780/analyzing-interactions-on-combining-multiple-clinical-guidelines
#20
Veruska Zamborlini, Marcos da Silveira, Cedric Pruski, Annette Ten Teije, Edwin Geleijn, Marike van der Leeden, Martijn Stuiver, Frank van Harmelen
Accounting for patients with multiple health conditions is a complex task that requires analysing potential interactions among recommendations meant to address each condition. Although some approaches have been proposed to address this issue, important features still require more investigation, such as (re)usability and scalability. To this end, this paper presents an approach that relies on reusable rules for detecting interactions among recommendations coming from various guidelines. It extends a previously proposed knowledge representation model (TMR) to enhance the detection of interactions and it provides a systematic analysis of relevant interactions in the context of multimorbidity...
April 11, 2017: Artificial Intelligence in Medicine
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