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Class of practice recommendations

Cheng Shuqun, Chen Minshan, Cai Jianqiang, The National Research Cooperative Group For Diagnosis And Treatment Of Hepatocellular Carcinoma With Tumor Thrombus
Hepatocellular carcinoma is the fourth leading cause of cancer-related morbidity and mortality in China. Portal vein tumor thrombus (PVTT) is common and it worsens prognosis of hepatocellular carcinoma (HCC). There is no internationally accepted consensus or guideline for diagnosis and treatment of HCC with PVTT. Based on existing evidences and common current practices, Chinese Experts on Multidisciplinary Diagnosis and Treatment of HCC with portal vein tumor thrombus met to develop a national consensus on diagnosis and treatment of HCC with PVTT...
October 21, 2016: Oncotarget
Jan-Malte Sinning, Anna Sonia Petronio, Nicolas Van Mieghem, Giulio Zucchelli, Georg Nickenig, Raffi Bekeredjian, Johan Bosmans, Francesco Bedogni, Marian Branny, Karl Stangl, Jan Kovac, Anna Nordell, Molly Schiltgen, Nicolo Piazza, Peter de Jaegere
Best practices for transcatheter aortic valve implantation with CoreValve include patient screening and valve size selection using multislice computed tomography, adherence to manufacturer recommendations for oversizing, control of implant depth to 6 mm or less, and management of conduction disturbances according to international guidelines. The ADVANCE II study implemented these strategies and demonstrated their relation to clinical outcomes. From October 2011 to April 2013, 200 patients with severe aortic stenosis were enrolled, and 194 were implanted...
September 30, 2016: American Journal of Cardiology
Jyh-Ming Jimmy Juang, Minoru Horie
In 1992, the Brugada syndrome (BrS) was recognized as a disease responsible for sudden cardiac death, characterized by a right bundle-branch block with ST segment elevation in the leads V1 and V2. This syndrome is highly associated with sudden cardiac death, especially in young males. BrS is currently diagnosed in patients with ST-segment elevation showing type 1 morphology ≥ 2 mm in ≥1 leads among the right precordial leads V1 or V2 positioned in the 2nd, 3rd, or 4th intercostal space, and occurring either spontaneously or after a provocative drug test by the intravenous administration of Class I antiarrhythmic drugs...
October 2016: Journal of Arrhythmia
Michael Weber
: Age is the most powerful cardiovascular risk factor. Based on a meta-analysis of a million control patients in hypertension trials, the Clinical Trialists Collaboration has estimated that doubling of major cardiac and stroke events occurs with age increments of < 10 years (1). Data from the ACCOMPLISH trial, which will be presented at this ISH meeting for the first time, show that patients aged > 70 (mean: 75.2), compared with those < 70 (mean: 63.7), had a 2.82-fold greater event rate for cardiovascular death and a 2...
September 2016: Journal of Hypertension
Brit Long, Alex Koyfman
BACKGROUND: Ventricular tachycardia (VT) and ventricular fibrillation are the causes of approximately 300,000 deaths per year in the United States. VT is classified based on hemodynamic status and appearance. Stable, monomorphic VT treatment is controversial. OBJECTIVE: Our aim was to provide emergency physicians with an evidence-based review of the medical management of stable, monomorphic VT. DISCUSSION: Stable, monomorphic VT is part of a larger class of ventricular dysrhythmias defined by a rate of at least 120 beats/min with QRS > 120 ms without regularly occurring P:QRS association...
October 14, 2016: Journal of Emergency Medicine
Moreangels M Mbizah, Gerhard Steenkamp, Rosemary J Groom
African wild dogs (Lycaon pictus) are endangered and their population continues to decline throughout their range. Given their conservation status, more research focused on their population dynamics, population growth and age specific mortality is needed and this requires reliable estimates of age and age of mortality. Various age determination methods from teeth and skull measurements have been applied in numerous studies and it is fundamental to test the validity of these methods and their applicability to different species...
2016: PloS One
Joana Martir, Talia Flanagan, James Mann, Nikoletta Fotaki
OBJECTIVES: This review focuses on the recommended strategies for the oral administration of paediatric medicines with food in the context of their biopharmaceutical properties. KEY FINDINGS: Acceptability of oral medicines in young patients is more challenging than in adult patients. Mixing oral dosage forms with foods and drinks is sometimes suggested to administer a specific dose and enhance compliance in the paediatric population. In this review, the strategies for the co-administration of paediatric medicines with food and drinks are discussed...
October 5, 2016: Journal of Pharmacy and Pharmacology
Laura Lauria, Angela Spinelli, Michele Grandolfo
INTRODUCTION: Breastfeeding is widely recommended. Updated data are needed to assess its prevalence and the effectiveness of interventions. Breastfeeding practices in Italy need to be promoted and monitored with updated and standard data The objective of this study is to provide estimates of the prevalence of breastfeeding and exclusively breastfeeding and to identify factors that may be modified to improve them. MATERIALS AND METHODS: Two population-based follow-up surveys were conducted to evaluate the quality of maternal care in 25 Local Health Units (LHUs) in Italy during 2008-2011...
July 2016: Annali Dell'Istituto Superiore di Sanità
Ioana R Preston, Barbara Hinzmann, Sabina Heinz, Henning Gall, David Jenkins, Nick H Kim, Irene Lang
We conducted an international study to evaluate practices in the diagnosis and management of pulmonary arterial hypertension (PAH) globally across different geographic regions. Between July and October 2012, PAH-treating physicians completed a 15-minute online questionnaire and provided patient record data for their 3 or 5 most recent patients with PAH. Overall, 560 physicians (Europe: 278; United States: 160; Argentina: 53; Japan: 69) completed the questionnaire and provided data for 2,618 patients. The proportion of physicians who described themselves as working in or affiliated with a specialized pulmonary hypertension center ranged from 13% in Argentina to 74% in the United States...
September 2016: Pulmonary Circulation
Prasanna Jayakar, Jean Gotman, A Simon Harvey, André Palmini, Laura Tassi, Donald Schomer, Francois Dubeau, Fabrice Bartolomei, Alice Yu, Pavel Kršek, Demetrios Velis, Philippe Kahane
Many patients with medically refractory epilepsy now undergo successful surgery based on noninvasive diagnostic information, but intracranial electroencephalography (IEEG) continues to be used as increasingly complex cases are considered surgical candidates. The indications for IEEG and the modalities employed vary across epilepsy surgical centers; each modality has its advantages and limitations. IEEG can be performed in the same intraoperative setting, that is, intraoperative electrocorticography, or through an independent implantation procedure with chronic extraoperative recordings; the latter are not only resource intensive but also carry risk...
September 28, 2016: Epilepsia
Enrico Paolini, Francesca Alice Fiore Mezzetti, Francesca Pierri, Patrizia Moretti
OBJECTIVE: Borderline personality disorder (BPD) is a high prevalence personality disorder. Pharmacotherapy is commonly used, however, a minority of studies investigated patterns of prescription for BPD, particularly in inpatients unit. We aimed to describe the clinical features and the prescribing practice for BPD patients, and to investigate the possible advantages of a single class of medications or of combined drug treatments in terms of length of stay in hospital. METHODS: This is a retrospective observational study evaluating 109 BPD inpatients from June 2011 to June 2013...
September 27, 2016: International Journal of Psychiatry in Clinical Practice
Valandra, Yvette Murphy-Erby, Brandon M Higgins, Lucy M Brown
Relatively few studies have explored domestic violence from a multiplicity of African American perspectives, experiences, and socio-demographic backgrounds within rural African American communities. Community-based participatory action research methods were used to explore domestic violence perceptions of African Americans with heterogeneous backgrounds and experiences of violence. Ten focus groups were held throughout the community with 52 diverse women (n = 33) and men (n = 19) living in the northwest region of Arkansas...
September 21, 2016: Journal of Interpersonal Violence
Mashael Alshebly, Badr Sobaih
The aim of the study was to explore the practice and attitudes of Saudi mothers towards breastfeeding. A cross-sectional survey done on a total of 517 Saudi mothers using a questionnaire inquiring about their demographic data, breastfeeding practice in the first 6 months after delivery and longer, different reasons for stopping breastfeeding. Furthermore, their impression on the relation between breastfeeding and breast cancer as well as prevention of infant's allergic and infectious diseases. Only 37.5% of the mothers practiced exclusive breastfeeding for 6 months...
2016: Sudan J Paediatr
Mithilesh Dronavalli, Manavi M Bhagwat, Sandy Hamilton, Marisa Gilles, Jacquie Garton-Smith, Sandra C Thompson
Patients with acute coronary syndrome (ACS) require ongoing treatment and support from their primary care provider to modify cardiovascular risk factors (including diet, exercise and mood), to receive evidence-based pharmacotherapies and be properly monitored and to ensure their take-up and completion of cardiac rehabilitation (CR). This study assesses adherence to National Heart Foundation guidelines for ACS in primary care in a regional centre in Western Australia. Patients discharged from hospital after a coronary event (unstable angina or myocardial infarction) or a coronary procedure (stent or coronary artery bypass graft) were identified through general practice electronic medical records...
September 20, 2016: Australian Journal of Primary Health
Michael Weber
UNLABELLED: Age is the most powerful cardiovascular risk factor. Based on a meta-analysis of a million control patients in hypertension trials, the Clinical Trialists Collaboration has estimated that doubling of major cardiac and stroke events occurs with age increments of < 10 years (1). Data from the ACCOMPLISH trial, which will be presented at this ISH meeting for the first time, show that patients aged > 70 (mean: 75.2), compared with those < 70 (mean: 63.7), had a 2...
September 2016: Journal of Hypertension
Preeti Datta-Nemdharry, Andrew Thomson, Julie Beynon, Katherine Donegan
PURPOSE: The purpose of this study is to characterise how Type 2 Diabetes Mellitus (T2DM) is treated in England and Wales and whether this adheres to 2009 National Institute for Health and Care Excellence (NICE) guidance on management of T2DM. METHODS: Data for T2DM patients aged 18+ years prescribed at least one anti-diabetic drug between 01/01/2000-30/06/2012 were extracted from the Clinical Practice Research Datalink. We examined the sequences in which anti-diabetic drugs were prescribed and, for patients on the most common anti-diabetic drug pathways, evaluated average HbA1c values at treatment initiation and at progression to a second or third-line anti-diabetic drug class, including insulin...
September 19, 2016: Pharmacoepidemiology and Drug Safety
G Houvenaeghel, J M Boher, F Reyal, M Cohen, J R Garbay, J M Classe, R Rouzier, S Giard, C Faure, H Charitansky, C Tunon de Lara, E Daraï, D Hudry, P Azuar, P Gimbergues, R Villet, P Sfumato, E Lambaudie
BACKGROUND: Omission of completion axillary lymph node dissection (ALND) is a standard practice in patients with breast cancer (BC) and negative sentinel nodes (SNs) but has shown insufficient evidence to be recommended in those with SN invasion. METHODS: A retrospective analysis of a cohort of patients with BC and micrometastases (Mic) or isolated tumour cells (ITCs) in SN. Factors associated with ALND were identified, and patients with ALND were matched to patients without ALND...
November 2016: European Journal of Cancer
A King, J Thambyrajah, E Leng, M J Stewart
Herceptin (Trastuzumab) is a widely used and effective drug for the treatment of Her2+ breast cancer but its cardiotoxic side effects require regular monitoring by echocardiography. A 10% reduction in left ventricular ejection fraction can lead to suspension of treatment and therefore has significant implications for patient prognosis in terms of cardiac and cancer outcomes. Assessment of LV function by conventional 2D biplane method of discs (2DEF) has limitations in accuracy and reproducibility. Global longitudinal strain (GLS) is becoming more widely available and user friendly...
September 2016: Echo Research and Practice
Tobias T Tauböck, Thomas Attin
Bulk-fill resin composites represent an innovative class of dental composite materials, developed to simplify and expedite the restoration process. They can be adequately photopolymerized up to 4–5mm composite thickness and therefore permit a more economical restorative approach as compared to conventional resin composites. The current paper summarizes the most important facts on bulk-fill composite materials and provides recommendations for the successful use of these materials in daily practice based on upto-date in vitro and in vivo research...
2016: Swiss Dental Journal
Arianne Mj Elissen, Dorijn Fl Hertroijs, Nicolaas C Schaper, Hubertus Jm Vrijhoef, Dirk Ruwaard
BACKGROUND: This article presents the design of PROFILe, a study investigating which (bio)medical and non-(bio)medical patient characteristics should guide more tailored chronic care. Based on this insight, the project aims to develop and validate 'patient profiles' that can be used in practice to determine optimal treatment strategies for subgroups of chronically ill with similar healthcare needs and preferences. METHODS/DESIGN: PROFILe is a practice-based research comprising four phases...
2016: International Journal of Integrated Care
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