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https://www.readbyqxmd.com/read/28816882/a-narrative-review-of-adherence-to-subarachnoid-hemorrhage-guidelines
#1
Paolo Gritti, Oluwaseun Akeju, Ferdinando L Lorini, Luigi A Lanterna, Carlo Brembilla, Federico Bilotta
Over the past 2 decades, a large number of guidelines for aneurysmal subarachnoid hemorrhage (aSAH) management have been proposed. The primary aim of these "evidence-based" guidelines is to improve the care of aSAH patients by summarizing and making current knowledge readily available to clinicians. However, an investigation into aSAH guidelines, their changes along time and their successful translation into clinical practice is still lacking.We performed a literature search of historical events and subarachnoid hemorrhage guidelines using the Entrez PubMed NIH, Embase, and Cochrane databases for articles published up to November of 2016...
August 14, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28816870/spinal-cord-injury-what-are-the-controversies
#2
Christopher S Ahuja, Gregory D Schroeder, Alexander R Vaccaro, Michael G Fehlings
Traumatic spinal cord injuries have a tremendous impact on individuals, families, and society as a whole. Substantial heterogeneity in the patient population, their presentation and underlying pathophysiology has sparked debates along the care spectrum from initial assessment to definitive treatment. This article reviews spinal cord injury (SCI) management followed by a discussion of the salient controversies in the field. Current care practices modeled on the American Association of Neurological Surgeons/Congress of Neurological Surgeons joint section guidelines are highlighted including key recommendations regarding immobilization, avoidance of hypotension, early International Standards for Neurological Classification of SCI examination and intensive care unit treatment...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28816284/-predictive-factor-analysis-of-time-to-progression-of-castration-resistant-prostate-cancer-after-androgen-deprivation-therapy
#3
G J Ji, C Huang, G Song, X S Li, Y Song, L Q Zhou
OBJECTIVE: To explore risk factors including prostate-specific antigen (PSA) kinetics for the prediction of castration-resistant prostate cancer (CRPC), and to build a practical model for predicting the progression to CRPC after androgen deprivation therapy (ADT) so as to facilitate clinicians in decision-making for prostate cancer patients receiving ADT. METHODS: A total of 185 patients with prostate cancer who had received ADT as the primary therapy in Department of Urology of Peking University First Hospital from 2003 to 2014 were enrolled retrospectively...
August 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28814258/management-of-complicated-pneumonia-in-childhood-a-review-of-recent-literature
#4
John B Darby, Amrita Singh, Ricardo Quinonez
BACKGROUND: Despite declining rates of community acquired pneumonia (CAP) in children, complicated pneumonia has been on the rise in the last two decades. The management of complicated pneumonia is challenging and continues to be an area of investigation. Despite recently published guidelines, many gaps exist and recent studies attempt to answer challenging questions. OBJECTIVE: To review recently published literature to inform the clinician on the most up to date management of complicated pneumonia in children...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28810280/-dual-antiplatelet-therapy-in-the-perioperative-period-to%C3%A2-continue-or-discontinue-treatment
#5
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/28801396/the-sims-trial-adjustable-anchored-single-incision-mini-slings-versus-standard-tension-free-midurethral-slings-in-the-surgical-management-of-female-stress-urinary-incontinence-a-study-protocol-for-a-pragmatic-multicentre-non-inferiority-randomised-controlled
#6
Mohamed Abdel-Fattah, Graeme MacLennan, Mary Kilonzo, R Phil Assassa, Kirsty McCormick, Tracey Davidson, Alison McDonald, James N'Dow, Judith Wardle, John Norrie
INTRODUCTION: Single-incision mini-slings (SIMS) represent the third generation of midurethral slings. They have been developed with the aim of offering a true ambulatory procedure for treatment of female stress urinary incontinence (SUI) with reduced morbidity and earlier recovery while maintaining similar efficacy to standard midurethral slings (SMUS). The aim of this study is to determine the clinical and cost-effectiveness of adjustable anchored SIMS compared with tension-free SMUS in the surgical management of female SUI, with 3-year follow-up...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28795336/the-ever-evolving-role-of-pathologists-in-the-management-of-breast-cancer-with-neoadjuvant-treatment-recommendations-based-on-the-spanish-clinical-experience
#7
O Burgués, Mª Á López-García, B Pérez-Míes, P Santiago, B Vieites, J F García, V Peg
PURPOSE: To compare the current international standards for neoadjuvant systemic therapy (NAST) protocols, and establish consensus recommendations by Spanish breast pathologists; and to look into the Spanish reality of defining pathological complete response in daily practice. MATERIALS AND METHODS: A modified Delphi technique was used to gain consensus among a panel of 46 experts with regard to important issues about NAST specimens, with the objective of standardize handling and analysis of these breast cancer specimens...
August 9, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28780662/bicuspid-aortic-valvulopathy-and-associated-aortopathy-a-review-of-contemporary-studies-relevant-to-clinical-decision-making
#8
REVIEW
Michael H Kwon, Thoralf M Sundt
The bicuspid aortic valve (BAV) phenotype is becoming increasingly recognized as a complex and heterogeneous clinical entity, with some but not all patients developing accelerated degrees of both aortic insufficiency (AI) and aortic stenosis (AS) in comparison to patients with tricuspid aortic valves (TAV). In addition, there remains a well-established association between the BAV phenotype and aortic enlargement independent of valve function as well as progression among some to ascending aortic aneurysm and the attendant concern over risk of aortic dissection...
September 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28779832/evaluation-and-management-of-necrotizing-soft-tissue-infections
#9
REVIEW
Stephanie L Bonne, Sameer S Kadri
Despite advances in antibiotic and surgical management and supportive care for necrotizing soft tissue infections, morbidity and mortality remain substantial. Although there are clinical practice guidelines in place, there still remains much variability in choice and duration of antibiotic therapy, time to initial surgical debridement, and use of adjuvant medical therapies. This article offers an overview of necrotizing soft tissue infections with a focus on current diagnostic and treatment modalities.
September 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28772332/-expert-knowledge-and-supporting-advice-for-the-clinical-use-of-nintedanib-in-patients-with-idiopathic-pulmonary-fibrosis
#10
J Behr, A Günther, M Kreuter, D Koschel, A Prasse, M Pfeifer, U Costabel
In October 2016, a group of German IPF experts were invited by Boehringer Ingelheim to meet in Frankfurt with the aim, (a) to discuss relevant aspects of the management and treatment of idiopathic pulmonary fibrosis (IPF) using nintedanib; and, (b) to provide supportive advice for daily clinical practice with nintedanib. The resulting information compiled in this document is confined to practical issues regarding the use of nintedanib in patients with IPF. Where different therapeutic options were available, the choice of IPF medication was not discussed and the experts alluded to current guidelines for the diagnosis and treatment of IPF...
August 3, 2017: Pneumologie
https://www.readbyqxmd.com/read/28770273/atypical-femur-fractures-a-survey-of-current-practices-in-orthopedic-surgery
#11
P S Schneider, M Wall, J P Brown, A M Cheung, E J Harvey, S N Morin
The results of a self-administered online survey demonstrate that orthopedic surgeons' management practices for AFF are variable. These data will inform the development of clinical practice guidelines. INTRODUCTION: We aimed to determine current AFF treatment practices of orthopedic surgeons to inform clinical practice guideline development. METHODS: A self-administered online survey was developed and sequentially posted on the Orthopaedic Trauma Association (OTA) website from July to August 2015 and the Canadian Orthopaedic Association (COA) website from December 2015 to January 2016...
August 2, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28766197/predicting-nodal-positivity-in-women-70%C3%A2-years-of-age-and-older-with-hormone-receptor-positive-breast-cancer-to-aid-incorporation-of-a-society-of-surgical-oncology-choosing-wisely-guideline-into-clinical-practice
#12
Jessemae L Welsh, Tanya L Hoskin, Courtney N Day, Elizabeth B Habermann, Matthew P Goetz, Judy C Boughey
PURPOSE: One of the Society of Surgical Oncology Choosing Wisely guidelines recommends avoiding routine sentinel lymph node (SLN) surgery in clinically node-negative women ≥70 years of age with hormone receptor-positive (HR+) breast cancer. We sought to assess the impact of tumor stage and grade on nodal positivity, and to develop a model to identify patients at low-risk of nodal positivity to aid adoption of the guideline. METHODS: We identified women ≥70 years of age with HR+ cN0 invasive breast cancer in the National Cancer Database (NCDB; 2010-2013) and examined the impact of tumor stage and grade on nodal positivity to identify low-risk combinations...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28758756/-current-possibilities-to-influence-surgical-site-infection
#13
F Bělina
Infections associated with surgical procedures, also referred to as surgical site infections (SSIs), are the most common nosocomial infections (HAIs - Health Care-Associated Infections) in surgery departments. Although effectively preventable in most cases, they are still associated with significant morbidity and mortality, prolonged or repeated hospitalizations and increased treatment costs. Therefore, compliance with applicable procedures and guidelines is essential for SSI prevention, which was also shown in numerous EBM studies...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28743758/ashp-national-survey-of-pharmacy-practice-in-hospital-settings-prescribing-and-transcribing-2016
#14
Craig A Pedersen, Philip J Schneider, Douglas J Scheckelhoff
PURPOSE: The results of the 2016 ASHP national survey of pharmacy practice in hospital settings are presented. METHODS: A stratified random sample of pharmacy directors at 1,315 general and children's medical-surgical hospitals in the United States were surveyed using a mixed-mode method offering a choice of completing a paper survey or an online survey. IMS Health supplied data on hospital characteristics; the survey sample was drawn from IMS's hospital database...
July 25, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28729780/best-practices-for-robotic-surgery-programs
#15
Stephanie J Estes, David Goldenberg, Joshua S Winder, Ryan M Juza, Jerome R Lyn-Sue
BACKGROUND AND OBJECTIVES: Robotic surgical programs are increasing in number. Efficient methods by which to monitor and evaluate robotic surgery teams are needed. METHODS: Best practices for an academic university medical center were created and instituted in 2009 and continue to the present. These practices have led to programmatic development that has resulted in a process that effectively monitors leadership team members; attending, resident, fellow, and staff training; credentialing; safety metrics; efficiency; and case volume recommendations...
April 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28720354/training-modalities-in-robot-assisted-urologic-surgery-a-systematic-review
#16
REVIEW
Catherine Elizabeth Lovegrove, Oussama Elhage, M Shamim Khan, Giacomo Novara, Alex Mottrie, Prokar Dasgupta, Kamran Ahmed
CONTEXT: Novel surgical techniques demand that surgical training adapts to the need for technical and nontechnical skills. OBJECTIVE: To identify training methods available for robot-assisted surgical (RAS) training in urology, evaluate their effectiveness in terms of validation, educational impact, acceptability, and cost effectiveness, and assess their effect on learning curves (LCs). EVIDENCE ACQUISITION: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines searched Ovid Medline, Embase, PsycINFO, and the Cochrane Library...
February 2017: European Urology Focus
https://www.readbyqxmd.com/read/28718222/when-is-a-sentinel-node-biopsy-indicated-for-patients-with-primary-melanoma-an-update-of-the-australian-guidelines-for-the-management-of-cutaneous-melanoma
#17
REVIEW
David E Gyorki, Andrew Barbour, Mark Hanikeri, Victoria Mar, Shahneen Sandhu, John F Thompson
A sentinel lymph node biopsy is a surgical staging procedure performed for patients with primary cutaneous melanoma who are clinically lymph-node negative to determine whether there is low volume nodal metastasis in the draining lymph node field. A systematic review was recently performed to update the Australian clinical practice guidelines for the diagnosis and management of melanoma, addressing the question, 'When is a sentinel lymph node biopsy indicated?' This article discusses the findings of the systematic review and the evidence base for the updated guidelines...
July 17, 2017: Australasian Journal of Dermatology
https://www.readbyqxmd.com/read/28717754/surgical-management-of-breast-cancer-in-africa-a-continent-wide-review-of-intervention-practices-barriers-to-care-and-adjuvant-therapy
#18
REVIEW
Stephanie A Sutter, Aaron Slinker, Deo Darius Balumuka, Katrina B Mitchell
Breast cancer has emerged as a leading cancer among women in Africa, necessitating improved understanding of its management across the continent. Although previous studies have described regional trends in therapy, this review aims to summarize continent-wide management and focus specifically on surgical interventions. Current literature shows that the rates of surgery, chemotherapy, and radiation therapy vary across different countries and institutions, indicating the need for greater use of standardized cancer treatment guidelines...
April 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/28705200/the-prognostic-value-of-lymph-node-yield-in-the-earliest-stage-of-colorectal-cancer-a-multicenter-cohort-study
#19
Yara Backes, Sjoerd G Elias, Bibie S Bhoelan, John N Groen, Jeroen van Bergeijk, Tom C J Seerden, Hendrikus J M Pullens, Bernhard W M Spanier, Joost M J Geesing, Koen Kessels, Marjon Kerkhof, Peter D Siersema, Wouter H de Vos Tot Nederveen Cappel, Niels van Lelyveld, Frank H J Wolfhagen, Frank Ter Borg, G Johan A Offerhaus, Miangela M Lacle, Leon M G Moons
BACKGROUND: In patients with stage II colorectal cancer (CRC) the number of surgically retrieved lymph nodes (LNs) is associated with prognosis, resulting in a minimum of 10-12 retrieved LNs being recommended for this stage. Current guidelines do not provide a recommendation regarding LN yield in T1 CRC. Studies evaluating LN yield in T1 CRC suggest that such high LN yields are not feasible in this early stage, and a lower LN yield might be appropriate. We aimed to validate the cut-off of 10 retrieved LNs on risk for recurrent cancer and detection of LN metastasis (LNM) in T1 CRC, and explored whether this number is feasible in clinical practice...
July 14, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28698745/new-surgical-technologies-could-facilitate-surgical-hemostasis-in-hemophilic-patients
#20
Milcho J Panovski, Igor V Fildishevski, Ljubomir Lj Ognjenovic, Violeta I Dejanova-Ilijevska
BACKGROUND: It's assumed that surgery in haemophilia can be accomplished these days safely. AIM: The aim of this study was to investigate the influence of new surgical technologies in the perioperative management and outcome of surgical procedures in haemophiliacs. METHODS: Two patients with mild haemophilia A underwent surgery (laparoscopic appendectomy and inguinal hernia repair). In both patients, the replacement therapy, with factor VIII, started 30 min before surgery...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
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