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Surgical, clinical practice guidelines

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https://www.readbyqxmd.com/read/29153960/barriers-and-facilitators-to-the-implementation-of-an-evidence-based-electronic-minimum-dataset-for-nursing-team-leader-handover-a-descriptive-survey
#1
Amy J Spooner, Leanne M Aitken, Wendy Chaboyer
INTRODUCTION: There is widespread use of clinical information systems in intensive care units however, the evidence to support electronic handover is limited. OBJECTIVES: The study aim was to assess the barriers and facilitators to use of an electronic minimum dataset for nursing team leader shift-to-shift handover in the intensive care unit prior to its implementation. METHODS: The study was conducted in a 21-bed medical/surgical intensive care unit, specialising in cardiothoracic surgery at a tertiary referral hospital, in Queensland, Australia...
November 15, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29147878/knowledge-gaps-in-the-management-of-postoperative-crohn-s-disease-a-us-national-survey
#2
Vu Q Nguyen, Jessica L Mays, Marissa Lang, Yingxing Wu, Themistocles Dassopoulos, Miguel Regueiro, Alan Moss, Deborah D Proctor, Dario Sorrentino
BACKGROUND: Postoperative recurrence (POR) of Crohn's disease (CD) is common. Guidelines on POR management have recently been issued, but clinical practice may vary. AIMS: To examine the current clinical practice of POR management in the USA METHODS: A web-based survey was sent to all members of the American Gastroenterological Association and the American College of Gastroenterology. The survey consisted of multiple-choice questions with clinical scenarios to assess how participants manage POR...
November 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29145591/asia-consensus-statement-on-nccn-clinical-practice-guideline-for-bladder-cancer
#3
Hiroyuki Nishiyama
The Asia Consensus Statement (ACS) on the NCCN Guideline (NCCN-ACS) for treatment of bladder cancer version 1.2016 is designed to provide documentation of modifications of the 'parent' NCCN Guideline: Bladder Cancer (Version 2.2015). When considering ethnic differences or differences in health regulatory environments between Western and Asian countries, a process of adaptation to match the circumstances is helpful for utilizing the guidelines. The NCCN-ACS for bladder cancer consist of 11 ACSs, focused on diagnosis, imaging, surgical treatment, adjuvant intravesical chemotherapy or immunotherapy, periopererative (neodjuvant or adjuvant) chemotherapy and radiation oncology including bladder preservation...
November 14, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29138191/evaluation-of-guidelines-regarding-surgical-treatment-of-breast-cancer-using-the-agree-instrument-a-systematic-review
#4
Xin Lei, Fengtao Liu, Shuying Luo, Ya Sun, Liling Zhu, Fengxi Su, Kai Chen, Shunrong Li
OBJECTIVES: Many clinical practice guidelines and consensus statements (CPGs/consensus statements) have been developed for the surgical treatments for breast cancer. This study aims to evaluate the quality of these CPGs/consensus statements. METHODS: We systematically searched the PubMed and EMBASE databases, as well as four guideline repositories, to identify CPGs and consensus statements regarding surgical treatments for breast cancer between January 2009 and December 2016...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29132196/carotid-endarterectomy-the-change-in-practice-over-11%C3%A2-years-in-a-stroke-centre
#5
Gabrielle T W Tse, Monique F Kilkenny, Chris Bladin, Michael Grigg, Helen M Dewey
BACKGROUND: Recent research evidence has impacted the practice of carotid endarterectomy (CEA). We aim to characterize changes in the practice and outcome of CEA over time in a single large-volume stroke centre. METHODS: All patients who underwent CEA from 2004 to 2014 and carotid angioplasty and stenting (CAS) from 2003 to 2008 at an Australian metropolitan tertiary stroke centre hospital were included. Clinical data were analysed to identify time trends in choice of intervention, patient selection, preoperative imaging utilization, surgical timing and outcome...
November 13, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29125899/demographic-and-clinical-factors-associated-with-non-surgical-osteoarthritis-treatment-use-among-patients-in-outpatient-clinics
#6
Lauren M Abbate, Amy S Jeffreys, Cynthia J Coffman, Todd A Schwartz, Liubov Arbeeva, Leigh F Callahan, Nicole A Negbenebor, Wendy M Kohrt, Robert S Schwartz, Ernest Vina, Kelli D Allen
OBJECTIVE: To identify patient demographic and clinical characteristics associated with osteoarthritis (OA) treatment use. METHODS: This was a secondary data analysis of three clinical trials among patients with hip or knee OA conducted in 1) Duke Primary Care practices, 2) the Durham Veterans Affairs Health Care System (DVAHCS), and 3) the University of North Carolina-Chapel Hill (UNC). At baseline, participants reported socio-demographic characteristics, OA-related pain and function, and OA treatment use including oral analgesia, topical creams, joint injections and physical therapy...
November 10, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/29121288/benefit-and-harm-of-pregabalin-in-acute-pain-treatment-a-systematic-review-with-meta-analyses-and-trial-sequential-analyses
#7
M L Fabritius, C Strøm, S Koyuncu, P Jæger, P L Petersen, A Geisler, J Wetterslev, J B Dahl, O Mathiesen
Pregabalin has demonstrated anti-hyperalgesic properties and was introduced into acute pain treatment in 2001. Our aim was to evaluate the beneficial and harmful effects of pregabalin in postoperative pain management. We included randomized clinical trials investigating perioperative pregabalin treatment in adult surgical patients. The review followed Cochrane methodology, including Grading of Recommendations Assessment, Development, and Evaluation (GRADE), and used trial sequential analyses (TSAs). The primary outcomes were 24 h morphine i...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29117010/assessing-the-methodological-quality-of-glaucoma-clinical-practice-guidelines-and-their-recommendations-on-microinvasive-glaucoma-surgery-a-systematic-review
#8
Evan Michaelov, James J Armstrong, Mary Nguyen, Bridget Instrum, Tracey Lam, James Denstedt, Cindy M L Hutnik
INTRODUCTION: Clinical practice guidelines (CPG) are regarded by many as critical communications providing guidance within specific medical fields. Over a decade ago, the first microinvasive glaucoma surgical procedures (MIGS) were introduced. Since then, a number of these novel intraocular pressure (IOP) controlling surgical options have been approved worldwide. Governing bodies and healthcare administration often utilize CPGs when considering funding for newer technologies. This highlights the importance of well-written, accurate and up-to-date CPGs in the rapidly evolving field of MIGS...
November 7, 2017: Journal of Glaucoma
https://www.readbyqxmd.com/read/29113662/practice-variation-in-sentinel-lymph-node-biopsy-for-melanoma-patients-in-different-geographical-regions-in-the-netherlands
#9
J Verstijnen, S Damude, H J Hoekstra, S Kruijff, A J Ten Tije, W J Louwman, E Bastiaannet, M M Stuiver
BACKGROUND: Due to the lack of solid evidence for treatment benefit of Sentinel Lymph Node Biopsy (SLNB) as part of loco-regional surgical treatment of non-distant metastatic melanoma, there might be variation in surgical treatment strategies in the Netherlands. The objective of the current study was to assess differences in the performance of SLNB, in geographical regions in the Netherlands, of non-distant metastatic melanoma patients (American Joint Committee on Cancer (AJCC) stage I-III)...
December 2017: Surgical Oncology
https://www.readbyqxmd.com/read/29104697/novel-surgical-approach-in-cutaneous-melanoma-patients-daring-ideas-are-like-chessmen-moved-forward-they-may-be-beaten-but-they-may-start-a-winning-game
#10
Georgi Tchernev
For the first time, but again, we propose the idea of a one-step melanoma surgery as a "golden, unified standard" that should be at least discussed and, possibly accepted shortly as the "gold standard" for the treatment of patients with skin melanomas. Critical points or comments have been made to the current melanoma's treatment approach, which has been "transcendently followed" for years and which, according to some colleagues, is not logically justified. This approach needs serious changes, the only goal of which is to achieve a better outlook for the patients...
October 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29102076/prevention-of-surgical-site-infection-analysis-and-narrative-review-of-clinical-practice-guidelines
#11
Francisco Javier Gómez-Romero, Maria Fernández-Prada, Juan Francisco Navarro-Gracia
Surgical site infection is one of the most prevalent healthcare-associated infections and presents a considerable morbidity. The aim of this comprehensive narrative review is to describe the evidence and grade of recommendation of the preventive measures developed in the three phases of the surgical process (preoperative, perioperative and postoperative phases), as well as coincidences and divergences between selected Clinical Practice Guidelines (CPG). Four preventive measures were recommended with similar high grade evidence in all CPG: Hair removal, antibiotic prophylaxis, surgical site preparation and normothermia...
October 25, 2017: Cirugía Española
https://www.readbyqxmd.com/read/29101616/a-multifaceted-intervention-to-reduce-guideline-non-adherence-among-prescribing-physicians-in-dutch-hospitals
#12
Jacqueline M Bos, Stephanie Natsch, Patricia M L A van den Bemt, Johan L W Pot, J Elsbeth Nagtegaal, Andre Wieringa, Gert Jan van der Wilt, Peter A G M De Smet, Cornelis Kramers
Background Despite the potential of clinical practice guidelines to improve patient outcomes, adherence to guidelines by prescribers is inconsistent. Objective The aim of the study was to determine whether an approach of introducing an educational programme for prescribers in the hospital combined with audit and feedback by the hospital pharmacist reduces non-adherence of prescribing physicians to key pharmacotherapeutic guidelines. Setting This prospective intervention study with a before-after design evaluated patients at surgical, urological and orthopaedic wards...
December 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29098077/surgical-assessment-clinic-one-stop-emergency-out-patient-clinic-for-rapid-assessment-reduced-admissions-and-improved-acute-surgical-service-a-quality-improvement-study
#13
Christina A W Macano, George C Kirby, Blossom Lake, Sitaramachandra M Nyasavajjala, Robert Clarke
Background: There is increasing pressure on emergency services within the NHS requiring efficient, rapid assessment and management of patients. A subsequent reduction in hospital admissions reduces overall costs with an aim to improve quality of care. At the Royal Shrewsbury Hospital we run a one stop emergency surgical clinic. With strict criteria for admission to this clinic we have established a care pathway for those patients requiring urgent surgical review but not necessarily hospital admission...
November 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29094782/thyroid-fna-cytology-in-asian-practice-active-surveillance-for-indeterminate-thyroid-nodules-reduces-overtreatment-of-thyroid-carcinomas
#14
REVIEW
K Kakudo, M Higuchi, M Hirokawa, S Satoh, C K Jung, A Bychkov
Although Asian thyroid practices have implemented the American Thyroid Association guidelines, significant deviations in actual risk of malignancy (ROM) have been reported. With review of the literature from Asia, the authors examine the underlining reasons for actual ROMs reported in Asia being so different from western practice based on the author's perspective. Although the most popular diagnostic system for thyroid cytology used in Asian countries is the Bethesda system, the Japan Thyroid Association published clinical guidelines, including a national reporting system for thyroid cytology, to adapt conservative clinical management (active surveillance and strict triage patients for surgery) for low-risk thyroid carcinomas...
November 2, 2017: Cytopathology: Official Journal of the British Society for Clinical Cytology
https://www.readbyqxmd.com/read/29094776/molecular-testing-of-braf-ras-and-tert-on-thyroid-fnas-with-indeterminate-cytology-improves-diagnostic-accuracy
#15
M Decaussin-Petrucci, F Descotes, L Depaepe, V Lapras, M-L Denier, F Borson-Chazot, J-C Lifante, J Lopez
OBJECTIVE: Liquid-based (LB)-FNA is widely recognized as a reliable diagnostic method to evaluate thyroid nodules. However, up to 30% of LB-FNA remain indeterminate according to the Bethesda system. Use of molecular biomarkers has been recommended to improve its pathological accuracy but implementation of these tests in clinical practice may be difficult. Here, we evaluated feasibility and performance of molecular profiling in routine practice by testing LB-FNA for BRAF, N/HRAS and TERT mutations...
November 2, 2017: Cytopathology: Official Journal of the British Society for Clinical Cytology
https://www.readbyqxmd.com/read/29089800/staging-and-surgical-approaches-in-gastric-cancer-a-clinical-practice-guideline
#16
N Coburn, R Cosby, L Klein, G Knight, R Malthaner, J Mamazza, C D Mercer, J Ringash
BACKGROUND: Resection is the cornerstone of cure for gastric adenocarcinoma; however, several aspects of surgical intervention remain controversial or are suboptimally applied at a population level, including staging, extent of lymphadenectomy (lnd), minimum number of lymph nodes that have to be assessed, gross resection margins, use of minimally invasive surgery, and relationship of surgical volumes with patient outcomes and resection in stage iv gastric cancer. METHODS: Literature searches were conducted in databases including medline (up to 10 June 2016), embase (up to week 24 of 2016), the Cochrane Library and various other practice guideline sites and guideline developer Web sites...
October 2017: Current Oncology
https://www.readbyqxmd.com/read/29080723/no-351-transvaginal-mesh-procedures-for-pelvic-organ-prolapse
#17
Maryse Larouche, Roxana Geoffrion, Jens-Erik Walter
OBJECTIVE: This guideline reviews the evidence related to the risks and benefits of using transvaginal mesh in pelvic organ prolapse repairs in order to update recommendations initially made in 2011. INTENDED USERS: Gynaecologists, residents, urologists, urogynaecologists, and other health care providers who assess, counsel, and care for women with pelvic organ prolapse. TARGET POPULATION: Adult women with symptomatic pelvic organ prolapse considering surgery and those who have previously undergone transvaginal mesh procedures for the treatment of pelvic organ prolapse...
November 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29080148/pain-after-tonsillectomy-effectiveness-of-current-guidelines
#18
Y Walrave, C Maschi, S Bailleux, A T Falk, C Hayem, M Carles, F De la Brière
BACKGROUND: Tonsillectomy is one of the most common major surgical procedures performed in children. In 2013, the use of codeine in children was severely restricted. French guidelines for treating tonsillectomy's postoperative pain at home have been reconsidered OBJECTIVE: The aim of our study was to measure effectiveness and safety of two schedules: acetaminophen + ibuprofen (A + I) and acetaminophen + tramadol (A + T) in children who underwent tonsillectomy. SETTING AND PATIENTS: We undertook a 1 year prospective and observational single-center study...
October 27, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29080125/clinical-breast-concerns-in-low-risk-pediatric-patients-practice-review-with-proposed-recommendations
#19
Linda M Sanders, Pinky Sharma, Miriam El Madany, Alexander B King, Koren S Goodman, Alison Esteva Sanders
BACKGROUND: Fibroadenoma is overwhelmingly the most common pediatric breast lesion. Breast malignancy is quite uncommon in children, most frequently metastatic or hematological malignancy. Core biopsy has largely replaced excision for diagnosis of breast masses in adults. OBJECTIVE: The purpose of this study is two-fold: (1) compare utilization at our institution of interventional procedures vs. surgery for breast mass diagnosis in patients ≤18 years and (2) propose guidelines for breast imaging and biopsy in this population...
October 27, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29078975/laparoscopic-myomectomy-and-morcellation-a-review-of-techniques-outcomes-and-practice-guidelines
#20
REVIEW
Laura M Glaser, Jaclyn Friedman, Susan Tsai, Angela Chaudhari, Magdy Milad
Laparoscopic myomectomy is a minimally invasive surgical approach to treat symptomatic uterine fibroids in women wishing for a uterine-sparing procedure. With careful patient selection, these procedures are associated with favorable reproductive outcomes and low perioperative morbidity. Current available methods for specimen retrieval include power and hand morcellation. The 2014 FDA safety warnings regarding power morcellation arose from concerns about the spread of occult malignancy and prompted widespread use of containment systems that may limit spread of myometrial cells...
September 29, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
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