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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
#1
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/27933099/treating-nonsuicidal-self-injury-nssi-in-adolescents-consensus-based-german-guidelines
#2
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/27932335/multicentre-randomised-placebo-controlled-trial-of-oral-anticoagulation-with-apixaban-in-systemic-sclerosis-related-pulmonary-arterial-hypertension-the-sphinx-study-protocol
#3
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
https://www.readbyqxmd.com/read/27931943/multilevel-spinal-stabilization-as-a-treatment-for-hirayama-disease-report-of-an-experience-with-5-cases
#4
Atul Goel, Arjun Dhar, Abhidha Shah
AIM: The authors analyze the role of multisegmental spinal instability in the pathogenesis of Hirayama's disease. MATERIAL AND METHODS: During the period June 2014 to January 2016, the authors managed 5 cases having Hirayama disease. The patients were diagnosed on the basis of classical described radiological and clinical guidelines. All 5 patients were treated with multi-level cervical fixation that included fixation of the atlantoaxial joint in 4 patients, by adopting facetal fixation methods...
December 5, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27931698/the-effectiveness-of-nurse-led-preoperative-assessment-clinics-for-patients-receiving-elective-orthopaedic-surgery-a-systematic-review
#5
Chan Sau-Man Conny, Ip Wan-Yim
PURPOSE: Nurse-led preoperative assessment clinics (POAC) have been introduced in different specialty areas to assess and prepare patients preoperatively in order to avoid last-minute surgery cancellations. Not all patients are referred to POACs before surgery, and the benefits of nurse-led POACs are not well documented in Hong Kong. The purpose of this systemic review was to identify the best available research evidence to inform current clinical practice, guide health care decision making and promote better care...
December 2016: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/27931567/landscape-of-kidney-transplantation-in-patients-with-compensated-liver-disease-results-of-a-survey-of-transplant-surgeons-in-the-united-states
#6
L Sibulesky, R N Hansen, N Leca, C Blosser, A A Rahnemai-Azar, M I Montenovo, A A Dick, R Bakthavatsalam, S Rayhill, R Bhattacharya, J D Reyes
BACKGROUND: The therapeutic options that provide the best long-term outcome for patients who have a combination of end-stage renal disease and compensated cirrhosis are unknown. METHODS: Given the paucity of data and the lack of clinical guidance in this area, a national survey was conducted in the form of an e-mail-based questionnaire addressed to the transplantation surgeons registered with the American Society of Transplant Surgeons. RESULTS: Of the 818 surgeons invited to participate in the survey, 167 (20%) responded...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931538/western-guidelines-or-practice-algorithms-yorkshire-pudding-or-dal-makhni
#7
EDITORIAL
Sundeep Mishra
Physicians to be able deliver contemporary care need to be updated on the recent developments in diagnosis and treatment. However, there is numerous data available practically on each and every aspect of day-today clinical practice. Clinical guidelines may provide a quick solution for everyday problems but many times they themselves are too many, too voluminous and may confuse more than simplify. More-over, they are based on Western derived clinical data, even clinical practice, developed for ethico-legal and reimbursement purposes and therefore may not be applicable to clinical practice in majority of the world...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27928799/-impact-of-laparoscopic-surgery-on-efficacy-in-the-treatment-of-gastrointestinal-stromal-tumors-in-different-anatomical-locations
#8
Qingfeng Chen, Jianxian Lin, Chaohui Zheng, Ping Li, Jianwei Xie, Jiabin Wang, Jun Lu, Qiyue Chen, Mi Lin, Longlong Cao, Changming Huang
OBJECTIVE: To investigate the efficacy of laparoscopic surgery in the treatment of gastrointestinal stromal tumors (GIST) in different anatomical locations. METHODS: Clinical data of 133 patients with primary gastric GIST undergoing laparoscopic resection at our department from January 2006 to December 2014 were retrospectively analyzed. These patients were divided into favorable site group (F group, 90 cases), including gastric fundus, anterior wall and greater curvature of gastric body, and unfavorable site group (UF group, 43 cases),including gastroesophageal junction, posterior wall and lesser curvature of gastric body,antrum and pylorus, according to the 2014 version National Comprehensive Cancer Network Clinical Guidelines...
November 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27928632/ventriculostomy-related-infections-in-subarachnoid-hemorrhage-patients-a-retrospective-study-of-incidence-etiology-and-antimicrobial-therapy
#9
Johan Widén, Britt-Marie Eriksson, Elisabeth Ronne-Engström, Per Enblad, Gabriel Westman
BACKGROUND: This study was performed to investigate the incidence and etiology of ventriculostomy-related infections (VRIs) in patients with subarachnoid hemorrhage (SAH) and to assess adherence to local clinical guidelines regarding empirical antimicrobial therapy and diagnostic routines. METHODS: A total of 191 consecutive SAH patients treated in the neuro-intensive care unit of Uppsala University Hospital between 2010 and 2013 were included retrospectively. Information regarding cerebrospinal fluid samples, bacterial cultures, ventriculostomy treatment, patient characteristics, and antibiotic treatment were collected from electronic patient records...
December 7, 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27927827/introduction-to-drug-allergy-and-whom-to-refer-for-specialist-assessment
#10
Bogusia Kasternow, Mohammed Yousuf Karim
Drug allergy is defined as an adverse drug reaction with an established immunological mechanism. The National Institute for Health and Care Excellence published clinical guidelines on drug allergy in 2014 and quality standards in 2015. The intention of this article is to highlight indications for referral to specialists for management of drug allergy. Accurate diagnosis of drug allergy is critical of course for patient safety, but also for better use of the drugs that we have available and to reduce unnecessary avoidance of drugs...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927820/headache-in-an-hiv-positive-patient-diagnostic-challenges-and-approach-to-treatment%C3%A2
#11
Andrew Creamer, Stefanos Ioannidis, Thomas Wilhelm, Tabitha Mahangu, Marc Lipman
Headaches are a common complaint in HIV positive patients attending emergency services. A thorough understanding of the differential diagnoses, initial investigations and empirical management of this presentation is essential for the assessing physician. We discuss a case of a patient with known advanced HIV infection presenting with headache to the emergency department. Given the range of possible diagnoses, broad-spectrum antimicrobial therapy was initially commenced. This was stopped when magnetic resonance imaging confirmed a diagnosis of venous sinus thrombosis...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927818/interdisciplinary-management-of-hip-fracture
#12
Cameron Swift, Saoussen Ftouh, Patrick Langford, Timothy S Chesser, Antony Johanssen
Hip fracture is a prevalent age-associated occurrence incorporating both medical and surgical need and a major challenge to public health and NHS resources. Effective management requires coordinated collaboration across specialties, professions and services. This concise guideline focuses on interdisciplinary aspects of hip fracture management abstracted from National Institute for Health and Care Excellence (NICE) clinical guideline (CG124), including the concept and implementation of the Hip Fracture Programme, detection and management of comorbidity and delirium, optimal analgesia, timing of surgery, multidisciplinary mobilisation, rehabilitation and hospital discharge...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27921160/european-society-of-urogenital-radiology-esur-guidelines-mr-imaging-of-pelvic-endometriosis
#13
M Bazot, N Bharwani, C Huchon, K Kinkel, T M Cunha, A Guerra, L Manganaro, L Buñesch, A Kido, K Togashi, I Thomassin-Naggara, A G Rockall
: Endometriosis is a common gynaecological condition of unknown aetiology that primarily affects women of reproductive age. The accepted first-line imaging modality is pelvic ultrasound. However, magnetic resonance imaging (MRI) is increasingly performed as an additional investigation in complex cases and for surgical planning. There is currently no international consensus regarding patient preparation, MRI protocols or reporting criteria. Our aim was to develop clinical guidelines for MRI evaluation of pelvic endometriosis based on literature evidence and consensus expert opinion...
December 5, 2016: European Radiology
https://www.readbyqxmd.com/read/27920019/personalized-diabetes-management-using-electronic-medical-records
#14
Dimitris Bertsimas, Nathan Kallus, Alexander M Weinstein, Ying Daisy Zhuo
OBJECTIVE: Current clinical guidelines for managing type 2 diabetes do not differentiate based on patient-specific factors. We present a data-driven algorithm for personalized diabetes management that improves health outcomes relative to the standard of care. RESEARCH DESIGN AND METHODS: We modeled outcomes under 13 pharmacological therapies based on electronic medical records from 1999 to 2014 for 10,806 patients with type 2 diabetes from Boston Medical Center...
December 5, 2016: Diabetes Care
https://www.readbyqxmd.com/read/27919244/surgical-antibiotic-prophylaxis-in-children-a-mixed-method-study-on-healthcare-professionals-attitudes
#15
Angela Giusti, Stefania Spila Alegiani, Marta Luisa Ciofi Degli Atti, Sofia Colaceci, Roberto Raschetti, Pasquale Arace, Raffaele Spiazzi, Massimiliano Raponi
BACKGROUND: Qualitative and quantitative research investigating determinants of adherence to clinical guidelines (GLs) on surgical antibiotic prophylaxis (SAP) are scarce. We conducted a mixed-method study aimed at investigating barriers and at describing attitudes of healthcare professionals (HCPs) regarding SAP in three Italian children's hospitals. METHODS: The study comprised two sequential phases: 1) collection of qualitative data through focus groups; 2) conduction of a survey on HCPs attitudes towards SAP...
December 5, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27913762/aspen-felanpe-clinical-guidelines-nutrition-support-of-adult-patients-with-enterocutaneous-fistula
#16
Vanessa J Kumpf, Jose Eduardo de Aguilar-Nascimento, Jose Ignacio Diaz-Pizarro Graf, Amber M Hall, Liam McKeever, Ezra Steiger, Marion F Winkler, Charlene W Compher
BACKGROUND: The management of patients with enterocutaneous fistula (ECF) requires an interdisciplinary approach and poses a significant challenge to physicians, wound/stoma care specialists, dietitians, pharmacists, and other nutrition clinicians. Guidelines for optimizing nutrition status in these patients are often vague, based on limited and dated clinical studies, and typically rely on individual institutional or clinician experience. Specific nutrient requirements, appropriate route of feeding, role of immune-enhancing formulas, and use of somatostatin analogues in the management of patients with ECF are not well defined...
December 2, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27913761/best-practices-in-the-treatment-of-early-cystic-fibrosis-lung-disease
#17
REVIEW
Marijke Proesmans
For many years, management of cystic fibrosis (CF) lung disease was focused on symptomatic treatment of chronic lung infection, which is characterized by cough and sputum production, leading to progressive lung damage. With increasing survival and better knowledge of the pathogenesis of CF lung disease, it has become clear that treatment has to start very early because lung damage occurs in young patients, often before obvious symptoms appear. The arrival of new cystic fibrosis transmembrane conductance-regulator (CFTR)-correcting therapies will bring more opportunities to prevent the disease, apart from only treating chronic lung infection...
December 2, 2016: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27912902/evolution-of-the-clinical-profile-of-patients-with-acute-heart-failure-treated-in-spanish-emergency-departments
#18
R Escoda, Ò Miró, F J Martín-Sánchez, J Jacob, P Herrero, V Gil, J M Garrido, M J Pérez-Durá, M Fuentes, P Llorens
OBJECTIVE: To analyse the changes in epidemiology, outpatient and emergency department clinical care, and outcomes of patients treated for acute heart failure (AHF) in Spanish hospital emergency departments (HEDs) between 2007 and 2014. METHOD: A multicentre cohort study was conducted that consecutively included patients with AHF diagnosed in 9HEDs during 4 periods (2007, 2009, 2011 and 2014). The study analysed the changes observed in 20 variables corresponding to baseline data, outpatient care and emergency care data and outcome data...
November 29, 2016: Revista Clínica Española
https://www.readbyqxmd.com/read/27911323/short-term-response-is-not-predictive-of%C3%A2-long-term-response-to%C3%A2-acetylcholinesterase-inhibitors-in-old-age-subjects-with-alzheimer-s-disease-a%C3%A2-real-world-study
#19
Virginia Boccardi, Marta Baroni, Nicoletta Smirne, Alessandra Clodomiro, Sara Ercolani, Annalisa Longo, Carmelinda Ruggiero, Amalia C Bruni, Patrizia Mecocci
BACKGROUND: Most of clinical guidelines recommend discontinuing treatment with cholinesterase inhibitors (ChEIs) in patients with Alzheimer's disease (AD) who do not show an initial response to therapy as evaluated with the Mini-Mental State Examination (MMSE) scale. However, understanding the relationship between the initial response to ChEI treatment and the subsequent course of the disease is extremely important in clinical practice, but evidence is limited, particularly in the old-old population...
November 29, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27910797/staging-practice-for-prostate-cancer-varies-and-is-not-in-line-with-clinical-guidelines
#20
Lars J Petersen, Yuliya Shuytsky, Helle D Zacho
INTRODUCTION: The objective was to describe regional variations in M-staging in patients with newly diagnosed prostate cancer within a Danish county and to compare clinical practice with guideline recommendations. METHODS: Data were as captured from 1) a prospective, non-interventional study counting 635 consecutive patients referred for M-staging in the 2008-2009 period at three regional hospitals within one county, and 2) a questionnaire on M-staging practice completed by the five sites performing M-staging in the same county in 2015...
December 2016: Danish Medical Journal
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