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1

2014 focused update of the canadian cardiovascular society guidelines for the management of atrial fibrillation.  

PubMed

Atrial fibrillation (AF) is an extremely common clinical problem with an important population morbidity and mortality burden. The management of AF is complex and fraught with many uncertain and contentious issues, which are being addressed by extensive ongoing basic and clinical research. The Canadian Cardiovascular Society AF Guidelines Committee produced an extensive set of evidence-based AF management guidelines in 2010 and updated them in the areas of anticoagulation and rate/rhythm control in 2012. In late 2013, the committee judged that sufficient new information regarding AF management had become available since 2012 to warrant an update to the Canadian Cardiovascular Society AF Guidelines. After extensive evaluation of the new evidence, the committee has updated the guidelines for: (1) stroke prevention principles; (2) anticoagulation of AF patients with chronic kidney disease; (3) detection of AF in patients with stroke; (4) investigation and management of subclinical AF; (5) left atrial appendage closure in stroke prevention; (6) emergency department management of AF; (7) periprocedural anticoagulation management; and (8) rate and rhythm control including catheter ablation. This report presents the details of the updated recommendations, along with their background and rationale. In addition, a complete set of presently applicable recommendations, those that have been updated and those that remain in force from previous guideline versions, is provided in the Supplementary Material. PMID:25262857

Verma, Atul; Cairns, John A; Mitchell, L Brent; Macle, Laurent; Stiell, Ian G; Gladstone, David; McMurtry, Michael Sean; Connolly, Stuart; Cox, Jafna L; Dorian, Paul; Ivers, Noah; Leblanc, Kori; Nattel, Stanley; Healey, Jeff S

2014-10-01

2

Canadian Cardiovascular Society guidelines for the diagnosis and management of stable ischemic heart disease.  

PubMed

This overview provides a guideline for the management of stable ischemic heart disease. It represents the work of a primary and secondary panel of participants from across Canada who achieved consensus on behalf of the Canadian Cardiovascular Society. The suggestions and recommendations are intended to be of relevance to primary care and specialist physicians with an emphasis on rational deployment of diagnostic tests, expedited implementation of long- and short-term medical therapy, timely consideration of revascularization, and practical follow-up measures. PMID:25064578

Mancini, G B John; Gosselin, Gilbert; Chow, Benjamin; Kostuk, William; Stone, James; Yvorchuk, Kenneth J; Abramson, Beth L; Cartier, Raymond; Huckell, Victor; Tardif, Jean-Claude; Connelly, Kim; Ducas, John; Farkouh, Michael E; Gupta, Milan; Juneau, Martin; O'Neill, Blair; Raggi, Paolo; Teo, Koon; Verma, Subodh; Zimmermann, Rodney

2014-08-01

3

Canadian Cardiovascular Society atrial fibrillation guidelines 2010: implementing GRADE and achieving consensus.  

PubMed

This article describes the process of the Canadian Cardiovascular Society 2010 atrial fibrillation (AF) guidelines update. Guideline development was based on the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system of evaluation. GRADE separates the quality of evidence (very low, low, moderate, or high quality) from the strength of recommendations (strong or conditional, ie, weak). GRADE allows acknowledgement of values and preferences in the provision of clinical care as well as costs of interventions in determining the strength of recommendations. Disclosures of relationships with industry or other potential conflicts of interest were reported at the outset and annually. Each recommendation was approved by at least a two-thirds majority of the voting panel (those with a significant conflict recusing themselves from voting on those specific recommendations). PMID:21329859

Gillis, Anne M; Skanes, Allan C

2011-01-01

4

ASCI 2010 contrast media guideline for cardiac imaging: a report of the Asian Society of Cardiovascular Imaging cardiac computed tomography and cardiac magnetic resonance imaging guideline working group  

PubMed Central

The use of contrast media for cardiac imaging becomes increasing as the widespread of cardiac CT and cardiac MR. A radiologist needs to carefully consider the indication and the injection protocol of contrast media to be used as well as the possibility of adverse effect. There are several guidelines for contrast media in western countries. However, these are focusing the adverse effect of contrast media. The Asian Society of Cardiovascular Imaging, the only society dedicated to cardiovascular imaging in Asia, formed a Working Group and created a guideline, which summarizes the integrated knowledge of contrast media for cardiac imaging. In cardiac imaging, coronary artery evaluation is feasible by non-contrast MR angiography, which can be an alternative examination in high risk patients for the use of iodine contrast media. Furthermore, the body habitus of Asian patients is usually smaller than that of their western counterparts. This necessitates modifications in the injection protocol and in the formula for calculation of estimated glomerular filtration rate. This guideline provided fundamental information for the use of contrast media for Asian patients in cardiac imaging. PMID:20931289

Kitagawa, Kakuya; Tsai, I-Chen; Chan, Carmen; Yu, Wei; Yong, Hwan Seok; Choi, Byoung Wook

2010-01-01

5

ASCI 2010 standardized practice protocol for cardiac magnetic resonance imaging: a report of the Asian society of cardiovascular imaging cardiac computed tomography and cardiac magnetic resonance imaging guideline working group  

PubMed Central

These practice guidelines are recommended by the Asian Society of Cardiovascular Imaging (ASCI), the sole society in Asia designated for cardiovascular imaging, to provide a framework to healthcare providers for suggested essential elements in cardiac magnetic resonance (CMR) examinations of different disease spectra. The guideline is composed of recommendations on the general technique, acquisition of some basic modules, and protocols on stress tests. The protocols for specific diseases are provided in a table format for quick reference to be easily utilized for everyday clinical CMR. PMID:20924794

Choi, Byoung Wook; Jinzaki, Masahiro; Kitagawa, Kakuya; Tsai, I-Chen; Yong, Hwan Seok; Yu, Wei

2010-01-01

6

[Guidelines on cardiovascular disease prevention in clinical practice. Belgian Working Group on Cardiovascular Prevention and Rehabilitation].  

PubMed

Since more than 15 years, expert groups and various European Scientific Societies have written Guidelines on Cardiovascular Disease Prevention. Because of the rapid evolution of science, it is necessary to adapt regularly these guidelines. The last version dates from 2007 and has been written by the " Fourth Joint Task Force of European and other Societies on Cardiovascular Disease Prevention in Clinical Practice ". In this issue, the more recent Guidelines are summarised and we focus on highlighting the aspects of these Guidelines that have changed since the previous version published in this journal in 2005. PMID:19353941

Dereppe, H; Laruelle, C; De Backer, G; Brohet, C; Daubresse, J C; Dendale, P; Fagardy, R; Legat, P; De Sutter, J

2009-01-01

7

European National Society Cardiovascular Journals  

PubMed Central

Anesti Kondili MD, Djamaleddine Nibouche MD, Karlen Adamyan MD, Kurt Huber MD, Hugo Ector MD, Izet Masic MD, Rumiana Tarnovska MD, Mario Ivanusa MD, Vladimír Stane?k MD, Jørgen Videbæk MD, Mohamed Hamed MD, Alexandras Laucevicius MD, Pirjo Mustonen MD, Jean-Yves Artigou MD, Ariel Cohen MD, Mamanti Rogava MD, Michael Böhm MD, Eckart Fleck MD, Gerd Heusch MD, Rainer Klawki MD, Panos Vardas MD, Christodoulos Stefanadis MD, József Tenczer MD, Massimo Chiariello MD, Aleksandras Laucevicius MD, Joseph Elias MD, Halima Benjelloun MD, Olaf Rødevand MD, Piotr Kul/akowski MD, Edvard Apetrei MD, Victor A. Lusov MD, Rafael G. Oganov MD, Velibor Obradovic MD, Gabriel Kamensky MD, Miran F. Kenda MD, Christer Höglund MD, Thomas F. Lüscher MD, René Lerch MD, Moufid Jokhadar MD, Habib Haouala MD, Vedat Sansoy MD, Valentin Shumakov MD, Adam Timmis MD. (European National Society Cardiovascular Journals Editors, see Appendix for complete affiliations) PMID:18665206

Alfonso, F.; Ambrosio, G.; Pinto, F.J.; van der Wall, E.E.

2008-01-01

8

Canadian Cardiovascular Society Consensus Conference guidelines on heart failure, update 2009: Diagnosis and management of right-sided heart failure, myocarditis, device therapy and recent important clinical trials  

PubMed Central

The Canadian Cardiovascular Society published a comprehensive set of recommendations on the diagnosis and management of heart failure in January 2006. Based on feedback obtained through a national program of heart failure workshops and through active solicitation of stakeholders, several topics were identified because of their importance to the practicing clinician. Topics chosen for the present update include best practices for the diagnosis and management of right-sided heart failure, myocarditis and device therapy, and a review of recent important or landmark clinical trials. These recommendations were developed using the structured approach for the review and assessment of evidence adopted and previously described by the Society. The present update has been written from a clinical perspective to provide a user-friendly and practical approach. Specific clinical questions that are addressed include: What is right-sided heart failure and how should one approach the diagnostic work-up? What other clinical entities may masquerade as this nebulous condition and how can we tell them apart? When should we be concerned about the presence of myocarditis and how quickly should patients with this condition be referred to an experienced centre? Among the myriad of recently published landmark clinical trials, which ones will impact our standards of clinical care? The goals are to aid physicians and other health care providers to optimally treat heart failure patients, resulting in a measurable impact on patient health and clinical outcomes in Canada. PMID:19214293

Howlett, Jonathan G; McKelvie, Robert S; Arnold, J Malcolm O; Costigan, Jeannine; Dorian, Paul; Ducharme, Anique; Estrella-Holder, Estrellita; Ezekowitz, Justin A; Giannetti, Nadia; Haddad, Haissam; Heckman, George A; Herd, Anthony M; Isaac, Debra; Jong, Philip; Kouz, Simon; Liu, Peter; Mann, Elizabeth; Moe, Gordon W; Tsuyuki, Ross T; Ross, Heather J; White, Michel

2009-01-01

9

[New AHA and ACC guidelines on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk : Statement of the D•A•CH Society for Prevention of Cardiovascular Diseases, the Austrian Atherosclerosis Society and the Working Group on Lipids and Atherosclerosis (AGLA) of the Swiss Society for Cardiology].  

PubMed

Guidelines for the reduction of cholesterol to prevent atherosclerotic vascular events were recently released by the American Heart Association and the American College of Cardiology. The authors claim to refer entirely to evidence from randomized controlled trials, thereby confining their guidelines to statins as the primary therapeutic option. The guidelines derived from these trials do not specify treatment goals, but refer to the percentage of cholesterol reduction by statin medication with low, moderate, and high intensity. However, these targets are just as little tested in randomized trials as are the cholesterol goals derived from clinical experience. The same applies to the guidelines of the four patient groups which are defined by vascular risk. No major statin trial has included patients on the basis of their global risk; thus the allocation criteria are also arbitrarily chosen. These would actually lead to a significant increase in the number of patients to be treated with high or maximum dosages of statins. Also, adhering to dosage regulations instead of cholesterol goals contradicts the principles of individualized patient care. The option of the new risk score to calculate lifetime risk up to the age of 80 years in addition to the 10-year risk can be appreciated. Unfortunately it is not considered in the therapeutic recommendations provided, despite evidence from population and genetic studies showing that even a moderate lifetime reduction of low-density lipoprotein (LDL) cholesterol or non-HDL cholesterol has a much stronger effect than an aggressive treatment at an advanced age. In respect to secondary prevention, the new American guidelines broadly match the European guidelines. Thus, the involved societies from Germany, Austria and Switzerland recommend continuing according to established standards, such as the EAS/ESC guidelines. PMID:24770979

Klose, G; Beil, F U; Dieplinger, H; von Eckardstein, A; Föger, B; Gouni-Berthold, I; Koenig, W; Kostner, G M; Landmesser, U; Laufs, U; Leistikow, F; März, W; Merkel, M; Müller-Wieland, D; Noll, G; Parhofer, K G; Paulweber, B; Riesen, W; Schaefer, J R; Steinhagen-Thiessen, E; Steinmetz, A; Toplak, H; Wanner, C; Windler, E

2014-05-01

10

South american guidelines for cardiovascular disease prevention and rehabilitation.  

PubMed

In this document, the Inter-American Committee of Cardiovascular Prevention and Rehabilitation, together with the South American Society of Cardiology, aimed to formulate strategies, measures, and actions for cardiovascular disease prevention and rehabilitation (CVDPR). In the context of the implementation of a regional and national health policy in Latin American countries, the goal is to promote cardiovascular health and thereby decrease morbidity and mortality. The study group on Cardiopulmonary and Metabolic Rehabilitation from the Department of Exercise, Ergometry, and Cardiovascular Rehabilitation of the Brazilian Society of Cardiology has created a committee of experts to review the Portuguese version of the guideline and adapt it to the national reality. The mission of this document is to help health professionals to adopt effective measures of CVDPR in the routine clinical practice. The publication of this document and its broad implementation will contribute to the goal of the World Health Organization (WHO), which is the reduction of worldwide cardiovascular mortality by 25% until 2025. The study group's priorities are the following: • Emphasize the important role of CVDPR as an instrument of secondary prevention with significant impact on cardiovascular morbidity and mortality; • Join efforts for the knowledge on CVDPR, its dissemination, and adoption in most cardiovascular centers and institutes in South America, prioritizing the adoption of cardiovascular prevention methods that are comprehensive, practical, simple and which have a good cost/benefit ratio; • Improve the education of health professionals and patients with education programs on the importance of CVDPR services, which are directly targeted at the health system, clinical staff, patients, and community leaders, with the aim of decreasing the barriers to CVDPR implementation.Com este documento, o Comitê Interamericano de Prevenção e Reabilitação Cardiovascular, em posição conjunta com a Sociedade Sul-Americana de Cardiologia, mostra seu interesse no desenvolvimento de estratégias, medidas e intervenções para a prevenção e a reabilitação cardiovascular. Com o objetivo de implementar na América Latina uma política de saúde regional e nacional dos países membros, tem-se o objetivo de promover a saúde cardiovascular e, consequentemente, diminuir a morbimortalidade. O grupo de estudos em Reabilitação Cardiopulmonar e Metabólica do Departamento de Exercício, Ergometria e Reabilitação Cardiovascular de Sociedade Brasileira de Cardiologia (DERC/SBC) criou uma comissão de experts para revisar a versão em português e adaptá-la à realidade nacional. Este documento tem como missão principal auxiliar os profissionais de saúde a alcançarem medidas efetivas de prevenção e reabilitação cardiovascular (RCV) na prática clínica diária. Com a difusão deste documento, bem como com a sua implementação de forma mais abrangente, contribuiremos com a meta da Organização Mundial de Saúde de diminuir a mortalidade cardiovascular no mundo em 25% até o ano de 2025. As prioridades deste grupo de trabalho são: • Enfatizar o caráter prioritário da RCV como instrumento de prevenção secundária com importante impacto na morbimortalidade cardiovascular; • Unir esforços para melhorar o conhecimento da RCV, sua difusão e aplicação na maioria dos centros e institutos cardiovasculares da América do Sul, priorizando a utilização de um método de prevenção cardiovascular integral, prático, de fácil aplicação e de custo/benefício comprovado; • Melhorar a educação do pessoal da saúde e dos pacientes por meio de programas educativos dirigidos, que permitam envolver diretamente os sistemas de saúde, pessoal médico, pacientes e líderes comunitários sobre a importância dos serviços de RCV, a fim de diminuir as barreiras para a sua implantação. PMID:25387466

Herdy, Ah; López-Jiménez, F; Terzic, Cp; Milani, M; Stein, R; Carvalho, T; Serra, S; Araujo, Cg; Zeballos, Pc; Anchique, Cv; Burdiat, G; González, K; González, G; Fernández, R; Santibáñez, C; Rodríguez-Escudero, Jp; Ilarraza-Lomelí, H

2014-08-01

11

European Oncology Nursing Society extravasation guidelines.  

PubMed

An infrequent, but potential complication of chemotherapy is vesicant chemotherapy extravasation. Vesicants have the potential to cause blistering and ulceration when they extravasate from the vein or are inadvertently administered into the tissue. In 2007, the European Oncology Nursing Society published guidelines for extravasation prevention, detection, and management. Recommended management includes topical heating for plant alkaloid extravasations and topical cooling for anthracycline and other antitumor antibiotic vesicants. For treatment of antracycline extravasations topical dimethylsulfoxide (DMSO), sodium thiosulfate, and hyaluronidase have been described in the literature but due to lack of evidence to support their use as vesicant extravasation antidotes, it is recommended that these agents are studied further. Furthermore, Savene (dexrazoxane) is the only registered drug for the treatment of antracycline extravasation. Nurses need to be aware of current evidence-based guidelines for detecting and managing vesicant extravasations and need to be prepared to administer evidence-based treatment. PMID:18765210

Wengström, Y; Margulies, A

2008-09-01

12

New AHA and ACC guidelines on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk.  

PubMed

After the publication of the new guidelines of the European Society of Cardiology and the European Atherosclerosis Society for the prevention and treatment of dyslipidemias (Eur Heart J 32:1769-1818, 2011; Eur Heart J 33:1635-1701, 2012), a group of authors has recently published on behalf of the American Heart Association and the American College of Cardiology guidelines on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk (Circulation 2013). These new guidelines are supposed to replace the until now widely accepted, at least in the USA, recommendations of the National Cholesterol Education Program Adult Treatment Panel III from the years 2002 (Circulation 106:3143-3421, 2002) and 2004 (Circulation 110:227-39, 2004). Furthermore, they claim to be based mainly on hard evidence derived from the interpretation of results of prospective randomized controlled trials. This Joint Position Statement of the Society for the Prevention of Cardiovascular Diseases e.V. (D.A.CH), the Austrian Atherosclerosis Society and the Working Group on Lipids and Atherosclerosis (AGLA) of the Swiss Society of Cardiology concludes that the use of individualized prevention strategies based on specific indications and LDL cholesterol target concentrations, a strategy whose worth has been widely proven and accepted for more than a decade in Europe, should not be given up. PMID:24615676

Klose, Gerald; Beil, Frank Ulrich; Dieplinger, Hans; von Eckardstein, Arnold; Föger, Bernhard; Gouni-Berthold, Ioanna; Heigl, Franz; Koenig, Wolfgang; Kostner, Gert M; Landmesser, Ulf; Laufs, Ulrich; Leistikow, Frank; März, Winfried; Noll, Georg; Parhofer, Klaus G; Paulweber, Bernhard; Riesen, Walter F; Schaefer, Jürgen R; Steinhagen-Thiessen, Elisabeth; Steinmetz, Armin; Toplak, Hermann; Wanner, Christoph; Windler, Eberhard

2014-03-01

13

[Polish Gynaecological Society guideline on prenatal diagnosis].  

PubMed

Prenatal diagnosis is a multidisciplinary issue where obstetricians, geneticists, neonatologists and doctors representing other specialities are involved. The guideline will provide up-to-date information, based on clinical evidence optimal techniques and timing, training and competence and clinical governance issues. Prenatal screening for chromosomal defects should be performed in concordance with Polish Gynaecological Society guidelines and recommendations on antenatal care, ultrasound in pregnancy and fetal therapy, and Fetal Medicine Foundation (London, UK) rules. There is no doubt that maternal age alone as a method of screening for chromosomal abnormalities should be abandoned as it has low Detection Rate with high False Positive Rate hence high Invasive Procedure Rate and unnecessary high pregnancy loss rate. The Working Party recommends that screening methods based on ultrasound examination at 11(+0)-13(+6) wks and maternal serum biochemistry should be implemented. Special attention must be paid to ensure that sufficiently high Detection Rate is achieved (at least 75% for 5% False Positive Rate) in screening for trisomy 21. PMID:19548462

2009-05-01

14

American Cancer Society Lung Cancer Screening Guidelines  

PubMed Central

Findings from the National Cancer Institute’s National Lung Screening Trial established that lung cancer mortality in specific high-risk groups can be reduced by annual screening with low-dose computed tomography. These findings indicate that the adoption of lung cancer screening could save many lives. Based on the results of the National Lung Screening Trial, the American Cancer Society is issuing an initial guideline for lung cancer screening. This guideline recommends that clinicians with access to high-volume, high-quality lung cancer screening and treatment centers should initiate a discussion about screening with apparently healthy patients aged 55 years to 74 years who have at least a 30-pack-year smoking history and who currently smoke or have quit within the past 15 years. A process of informed and shared decision-making with a clinician related to the potential benefits, limitations, and harms associated with screening for lung cancer with low-dose computed tomography should occur before any decision is made to initiate lung cancer screening. Smoking cessation counseling remains a high priority for clinical attention in discussions with current smokers, who should be informed of their continuing risk of lung cancer. Screening should not be viewed as an alternative to smoking cessation. PMID:23315954

Wender, Richard; Fontham, Elizabeth T. H.; Barrera, Ermilo; Colditz, Graham A.; Church, Timothy R.; Ettinger, David S.; Etzioni, Ruth; Flowers, Christopher R.; Gazelle, G. Scott; Kelsey, Douglas K.; LaMonte, Samuel J.; Michaelson, James S.; Oeffinger, Kevin C.; Shih, Ya-Chen Tina; Sullivan, Daniel C.; Travis, William; Walter, Louise; Wolf, Andrew M. D.; Brawley, Otis W.; Smith, Robert A.

2013-01-01

15

Hartford Medical Society Historical Library Guidelines for Readers  

E-print Network

. Drinking, eating, chewing gum, smoking and talking on cell phones are not permitted in the HMS library1 Hartford Medical Society Historical Library Guidelines for Readers ______________________________________________________________________________ The Hartford Medical Society Historical Library reading room is for materials that do not circulate because

Oliver, Douglas L.

16

[Civilization stress, cardiovascular risk, evidence-based medicine, guidelines].  

PubMed

Cardiovascular diseases have the pole-position on the list of morbidity and mortality statistics. Despite the great advances have been made in management of cardiovascular diseases, prevalence of these disorders increases worldwide, and even younger and younger ages are threatened. This phenomenon is strongly related to obesity and type 2 diabetes pandemic, which shows an unequivocal association with expansion of modernized life-style. The pathomechanism proposed to have central role is the chronic stress induced by civilized life-conduct. The authors criticizes the everyday practice suggested for management of cardiovascular diseases, focusing on normalization of cardiovascular risk factors, instead of fighting against the primary cause ie. chronic stress. There is growing evidence, that achieving the target values defined in guide-lines will not necessarily result in improvement of patient related clinical outcomes. The statistical approach generally practiced in randomized clinical trials is primarily striving for the drug-sale, instead of discovering novel pathophysiological relations. Pharmaceutical industry having decisive role in research and patient-care is mainly interested in profit-sharing, therefore patients' interest can not be optimally realized, and costs are unnecessarily augmented. Separation of patient-, and business-oriented medical care is an ethical question of fundamental importance. PMID:19403433

Simon, Kornél

2009-05-10

17

Canadian hypertension society guidelines for ambulatory blood pressure monitoring  

Microsoft Academic Search

The Canadian Hypertension Society has developed guidelines for the use of ambulatory blood pressure (BP) monitoring in clinical practice. Published articles with the best available levels of evidence were used to support the following recommendations:Physicians should only use ambulatory BP monitoring devices that have been validated independently using established protocols.A decision to withhold drug therapy based upon the ambulatory BP

Martin G. Myers; R. Brian Haynes; Simon W. Rabkin

1999-01-01

18

Comparing the new European cardiovascular disease prevention guideline with prior American Heart Association guidelines: an editorial review.  

PubMed

Atherosclerotic heart disease and stroke remain the leading causes of death and disability worldwide. Cardiovascular disease (CVD) prevention can improve the well-being of a population and possibly cut downstream healthcare spending, and must be the centerpiece of any sustainable health economy model. As lifestyle and CVD risk factors differ among ethnicities, cultures, genders, and age groups, an accurate risk assessment model is the critical first step for guiding appropriate use of testing, lifestyle counseling resources, and preventive medications. Examples of such models include the US Framingham Risk Score and the European SCORE system. The European Society of Cardiology recently published an updated set of guidelines on CVD prevention. This review highlights the similarities and differences between European and US risk assessment models, as well as their respective recommendations on the use of advanced testing for further risk reclassification and the appropriate use of medications. In particular, we focus on head-to-head comparison of the new European guideline with prior American Heart Association statements (2002, 2010, and 2011) covering risk assessment and treatment of asymptomatic adults. Despite minor disagreements on the weight of recommendations in certain areas, such as the use of coronary calcium score and non-high-density lipoprotein cholesterol in risk assessment, CVD prevention experts across the 2 continents agree on 1 thing: prevention works in halting the progression of atherosclerosis and decreasing disease burden over a lifetime. PMID:23212946

Ton, Van-Khue; Martin, Seth S; Blumenthal, Roger S; Blaha, Michael J

2013-05-01

19

Clinical decisions in patients with diabetes and other cardiovascular risk factors. A statement of the Spanish Society of Internal Medicine.  

PubMed

Although the mortality associated to cardiovascular diseases (CVD) has been reduced in the last decades, CVD remains the main cause of mortality in Spain and they are associated with an important morbidity and a huge economic burden. The increasing prevalence of obesity and diabetes could be slowing down the mortality reduction in Spain. Clinicians have often difficulty making clinical decisions due to the multiple clinical guidelines available. Moreover, in the current context of economic crisis it is critical to promote an efficient use of diagnostic and therapeutic proceedings to ensure the viability of public health care systems. The Spanish Society of Internal Medicine (SEMI) has coordinated a consensus document to answer questions of daily practice with the aim of facilitating physicians' decision-making in the management of diabetes and cardiovascular risk factors from a cost-efficiency point of view. PMID:24602600

Gómez-Huelgas, R; Pérez-Jiménez, F; Serrano-Ríos, M; González-Santos, P; Román, P; Camafort, M; Conthe, P; García-Alegría, J; Guijarro, R; López-Miranda, J; Tirado-Miranda, R; Valdivielso, P

2014-05-01

20

The methodological quality of clinical guidelines of the European Society of Human Reproduction and Embryology (ESHRE)  

Microsoft Academic Search

BACKGROUND: Clinical practice guidelines bridge the gap between the evidence from literature and clinical practice, and they may provide guidance in ethical, legal and societal dilemmas. To explore the potentials for future international guideline development within the field of human reproduction and embryology, we assessed the quality of existing guidelines produced by the European Society of Human Reproduction and Embryology

W. L. D. M. Nelen; R. W. van der Pluijm; R. P. M. G. Hermens; C. Bergh; P. de Sutter; K. G. Nygren; A. M. M. Wetzels; R. P. T. M. Grol; J. A. M. Kremer

2008-01-01

21

Canadian Cardiovascular Society position statement on the management of thoracic aortic disease.  

PubMed

This Canadian Cardiovascular Society position statement aims to provide succinct perspectives on key issues in the management of thoracic aortic disease (TAD). This document is not a comprehensive overview of TAD and important elements of the epidemiology, presentation, diagnosis, and management of acute aortic syndromes are deliberately not discussed; readers are referred to the 2010 guidelines published by the American Heart Association, American College of Cardiology, American Association for Thoracic Surgery, and other stakeholders. Rather, this document is a practical guide for clinicians managing adult patients with TAD. Topics covered include size thresholds for surgical intervention, emerging therapies, imaging modalities, medical and lifestyle management, and genetics of TAD. The primary panel consisted of experts from a variety of disciplines that are essential for comprehensive management of TAD patients. The methodology involved a focused literature review with an emphasis on updates since 2010 and the use of Grading of Recommendations Assessment, Development, and Evaluation methodology to arrive at specific recommendations. The final document then underwent review by a secondary panel. This document aims to provide recommendations for most patients and situations. However, the ultimate judgement regarding the management of any individual patients should be made by their health care team. PMID:24882528

Boodhwani, Munir; Andelfinger, Gregor; Leipsic, Jonathon; Lindsay, Thomas; McMurtry, M Sean; Therrien, Judith; Siu, Samuel C

2014-06-01

22

Implementation of Spanish adaptation of the European guidelines on cardiovascular disease prevention in primary care  

PubMed Central

Background The successful implementation of cardiovascular disease (CVD) prevention guidelines relies heavily on primary care physicians (PCPs) providing risk factor evaluation, intervention and patient education. The aim of this study was to ascertain the degree of awareness and implementation of the Spanish adaptation of the European guidelines on CVD prevention in clinical practice (CEIPC guidelines) among PCPs. Methods A cross-sectional survey of PCPs was conducted in Spain between January and June 2011. A random sample of 1,390 PCPs was obtained and stratified by region. Data were collected by means of a self-administered questionnaire. Results More than half (58%) the physicians were aware of and knew the recommendations, and 62% of those claimed to use them in clinical practice, with general physicians (without any specialist accreditation) being less likely to so than family doctors. Most PCPs (60%) did not assess cardiovascular risk, with the limited time available in the surgery being cited as the greatest barrier by 81%. The main reason to be sceptical about recommendations, reported by 71% of physicians, was that there are too many guidelines. Almost half the doctors cited the lack of training and skills as the greatest barrier to the implementation of lifestyle and behavioural change recommendations. Conclusions Most PCPs were aware of the Spanish adaptation of the European guidelines on CVD prevention (CEIPC guidelines) and knew their content. However, only one third of PCPs used the guidelines in clinical practice and less than half CVD risk assessment tools. PMID:23506390

2013-01-01

23

Differential implementation of special society pleural guidelines according to craft-group: impetus toward cross-specialty guidelines?  

PubMed

We examined the effects of a programme to improve adherence to British Thoracic Society pleural procedure guidelines at our institution. Following a baseline audit, we performed an intervention to enhance adherence to these guidelines. We then performed a postintervention audit. At baseline, there were different levels of guideline adherence depending on the specialty of the clinician inserting chest tubes. Interventions to improve adherence were hampered by limited access to non-respiratory teams. Thus, improvements in response to intervention were also specialty specific. Overall, procedures performed by respiratory medicine had higher adherence rates compared with those performed by non-respiratory teams. We concluded that guidelines promoted at a local level by one specialty have limited traction on members of another specialty. For pleural procedures, which cross specialty boundaries, we propose that future guidelines be developed jointly by all relevant specialties. This could facilitate unified guideline implementation at the clinical coalface. PMID:25099835

Lafontaine, Nicole; Joosten, Simon A; Steinfort, Daniel; Irving, Louis; Hew, Mark

2014-08-01

24

British Thoracic Society guideline for non-CFbronchiectasis  

Microsoft Academic Search

The diagnosis, investigation and particularly management of bronchiectasis has been largely empirical and the subject of relatively few controlled clinical trials. There are no clear guidelines, although an Australian position statement has been published concerning bronchiectasis in children. The purposes of these guidelines were therefore threefold: (1) to identify relevant studies in non-cystic fibrosis (CF) bronchiectasis; (2) to provide guidelines

M. C. Pasteur; D. Bilton; A. T. Hill

2010-01-01

25

Cardiovascular guidelines: separate career may help attenuate controversy.  

PubMed

The release of recent guidelines for high cholesterol, hypertension and diabetes in the U.S. has been accompanied by great noise and concerns, both in the academic circuits and the lay press. For persons aged 40 to 75 years, with LDL cholesterol levels between 70-189 mg/dL and 7.5% or higher estimated 10-year risk, the peril of a global "statinization" has been advocated, predicting a 70% increase of statin use in this otherwise healthy people. A minority of the Eight Joint National Committee panel disagreed with the recommendation to increase the target systolic blood pressure from 140 to 150 mmHg in persons aged 60 years or older without diabetes mellitus or chronic kidney disease. The 2013-American Association of Clinical Endocrinologists algorithm and consensus statement on diabetes has been criticized with particular concerns about transparency, conflicts of interest, group composition, and the abundant use of personal judgment and experience instead of rigorous methodology. Separate careers for experts who collect evidence from persons who write the actual guidelines seems a good opportunity in order to attenuate the noise associated with release of new guidelines, especially those that counter prior practice. PMID:24678917

Esposito, Katherine; Ceriello, Antonio; Genovese, Stefano; Giugliano, Dario

2014-01-01

26

Korean Society for Sexual Medicine and Andrology (KSSMA) Guideline on Erectile Dysfunction  

PubMed Central

In February 2011, the Korean Society for Sexual Medicine and Andrology (KSSMA) realized the necessity of developing a guideline on erectile dysfunction (ED) appropriate for the local context, and established a committee for the development of a guideline on ED. As many international guidelines based on objective evidence are available, the committee decided to adapt these guidelines for local needs instead of developing a new guideline. Considering the extensive research activities on ED in Korea, data with a high level of evidence among those reported by Korean researchers have been collected and included in the guideline development process. The latest KSSMA guideline on ED has been developed for urologists. The KSSMA hopes that this guideline will help urologists in clinical practice. PMID:24044105

Ryu, Ji Kan; Cho, Kang Su; Kim, Su Jin; Oh, Kyung Jin; Kam, Sung Chul; Seo, Kyung Keun; Shin, Hong Seok

2013-01-01

27

The European Society of Human Reproduction and Embryology guideline for the diagnosis and treatment of endometriosis: an electronic guideline implementability appraisal  

Microsoft Academic Search

BACKGROUND: Clinical guidelines are intended to improve healthcare. However, even if guidelines are excellent, their implementation is not assured. In subfertility care, the European Society of Human Reproduction and Embryology (ESHRE) guidelines have been inventoried, and their methodological quality has been assessed. To improve the impact of the ESHRE guidelines and to improve European subfertility care, it is important to

Lotte JEW van Dijk; Willianne LDM Nelen; Thomas M D’Hooghe; Gerard AJ Dunselman; Rosella PMG Hermens; Christina Bergh; Karl G Nygren; Arnold HM Simons; Petra de Sutter; Catherine Marshall; Jako S Burgers; Jan AM Kremer

2011-01-01

28

American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography  

Microsoft Academic Search

New evidence on breast Magnetic Resonance Imaging (MRI) screening has become available since the American Cancer Society (ACS) last issued guidelines for the early detection of breast cancer in 2003. A guideline panel has reviewed this evidence and developed new recommendations for women at different defined levels of risk. Screening MRI is recommended for women with an approximately 20-25% or

Debbie Saslow; Carla Boetes; Wylie Burke; Steven Harms; Martin O. Leach; Constance D. Lehman; Elizabeth Morris; Etta Pisano; Mitchell Schnall; Stephen Sener; Robert A. Smith; Ellen Warner; Martin Yaffe; Kimberly S. Andrews; Christy A. Russell

2007-01-01

29

Diabetes and cardiovascular disease: from evidence to clinical practice – position statement 2014 of Brazilian Diabetes Society  

PubMed Central

There is a very well known correlation between diabetes and cardiovascular disease but many health care professionals are just concerned with glycemic control, ignoring the paramount importance of controlling other risk factors involved in the pathogenesis of serious cardiovascular diseases. This Position Statement from the Brazilian Diabetes Society was developed to promote increased awareness in relation to six crucial topics dealing with diabetes and cardiovascular disease: Glicemic Control, Cardiovascular Risk Stratification and Screening Coronary Artery Disease, Treatment of Dyslipidemia, Hypertension, Antiplatelet Therapy and Myocardial Revascularization. The issue of what would be the best algorithm for the use of statins in diabetic patients received a special attention and a new Brazilian algorithm was developed by our editorial committee. This document contains 38 recommendations which were classified by their levels of evidence (A, B, C and D). The Editorial Committee included 22 specialists with recognized expertise in diabetes and cardiology. PMID:24855495

2014-01-01

30

Diabetes and cardiovascular disease: from evidence to clinical practice - position statement 2014 of Brazilian Diabetes Society.  

PubMed

There is a very well known correlation between diabetes and cardiovascular disease but many health care professionals are just concerned with glycemic control, ignoring the paramount importance of controlling other risk factors involved in the pathogenesis of serious cardiovascular diseases. This Position Statement from the Brazilian Diabetes Society was developed to promote increased awareness in relation to six crucial topics dealing with diabetes and cardiovascular disease: Glicemic Control, Cardiovascular Risk Stratification and Screening Coronary Artery Disease, Treatment of Dyslipidemia, Hypertension, Antiplatelet Therapy and Myocardial Revascularization. The issue of what would be the best algorithm for the use of statins in diabetic patients received a special attention and a new Brazilian algorithm was developed by our editorial committee. This document contains 38 recommendations which were classified by their levels of evidence (A, B, C and D). The Editorial Committee included 22 specialists with recognized expertise in diabetes and cardiology. PMID:24855495

Bertoluci, Marcello Casaccia; Pimazoni-Netto, Augusto; Pires, Antonio Carlos; Pesaro, Antonio Eduardo; Schaan, Beatriz D; Caramelli, Bruno; Polanczyk, Carisi Anne; Júnior, Carlos Vicente Serrano; Gualandro, Danielle M; Malerbi, Domingos Augusto; Moriguchi, Emilio; Borelli, Flavio Antonio de Oliveira; Salles, João Eduardo Nunes; Júnior, José Mariani; Rohde, Luis Eduardo; Canani, Luis H; Cesar, Luiz Antonio Machado; Tambascia, Marcos; Zanella, Maria Tereza; Gus, Miguel; Scheffel, Rafael Selbach; Dos Santos, Raul Dias

2014-01-01

31

2013 ACC/AHA cholesterol guideline for reducing cardiovascular risk: what is so controversial?  

PubMed

In November 2013, the American College of Cardiology and American Heart Association (ACC/AHA) released a clinical practice guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease (ASCVD) risk in adults. The guideline recommendations were developed from a rigorous systematic review of randomized, controlled trials (RCTs) and meta-analyses of RCTs that evaluated ASCVD outcomes. Major recommendations address a healthy lifestyle, identification of groups of patients most likely to experience a net benefit form statin therapy, appropriate intensity of statin therapy to reduce ASCVD, safety, decision-making in primary prevention, monitoring therapy, and appropriate use of nonstatin therapy. Areas of controversy are discussed. PMID:24671669

Robinson, Jennifer G

2014-06-01

32

Harmonization of Reproductive Guidelines: Perspective from the International Federation of Teratology Societies  

Microsoft Academic Search

The International Federation of Teratology Societies (IFTS) consists of the Australian, European, Japanese, and American Teratology Societies. A Committee on International Regulation was designated to interact with the European Economic Community (EEC) on development of the document “Guideline on Detection of Toxicity to Reproduction for Medicinal Products (Draft 11).” Professor Rolf Bass (BGA) coordinated input from multiple international regulatory agencies

Mildred S. Christian

1992-01-01

33

Guidelines of the American Society of Mammalogists for the use of wild mammals in research  

E-print Network

. .....................................................248 EUTHANASIA .......................................................................249 VOUCHERING OF SPECIMENS AND ANCILLARY MATERIAL ..........................................250 HUMAN SAFETY...), other profes- sional societies, such as the Society for the Study of Animal Behaviour (2006), the American Veterinary Medical Associ- 236 JOURNAL OF MAMMALOGY Vol. 92, No. 1 ation (AVMA 2007) AVMA Guidelines on Euthanasia, and various publications...

Sikes, Robert S.; Carroll, Darin S.; Danielson, Brent J.; Dragoo, Jerry W.; Gannon, Michael R.; Gannon, William L.; Hale, David W.; McCain, Christy M.; Odell, Daniel K.; Olson, Link E.; Ressing, Sarah; Timm, Robert M.; Trewhitt, Stephanie A.; Whaley, Janet E.

2011-02-01

34

FOCUS: The Society of Cardiovascular Anesthesiologists' Initiative to Improve Quality and Safety in the Cardiovascular Operating Room.  

PubMed

The Society of Cardiovascular Anesthesiologists (SCA) introduced the FOCUS initiative (Flawless Operative Cardiovascular Unified Systems) in 2005 in response to the need for a rigorous scientific approach to improve quality and safety in the cardiovascular operating room (CVOR). The goal of the project, which is supported by the SCA Foundation, is to identify hazards and develop evidence-based protocols to improve cardiac surgery safety. A hazard is anything that has the potential to cause a preventable adverse event. Specifically, the strategic plan of FOCUS includes 3 goals: (1) identifying hazards in the CVOR, (2) prioritizing hazards and developing risk-reduction interventions, and (3) disseminating these interventions. Collectively, the FOCUS initiative, through the work of several groups composed of members from different disciplines such as clinical medicine, human factors engineering, industrial psychology, and organizational sociology, has identified and documented significant hazards occurring daily in our CVORs. Some examples of frequent occurrences that contribute to reduce the safety and quality of care provided to cardiac surgery patients include deficiencies in teamwork, poor OR design, incompatible technologies, and failure to adhere to best practices. Several projects are currently under way that are aimed at better understanding these hazards and developing interventions to mitigate them. The SCA, through the FOCUS initiative, has begun this journey of science-driven improvement in quality and safety. There is a long and arduous road ahead, but one we need to continue to travel. PMID:25232690

Barbeito, Atilio; Lau, William Travis; Weitzel, Nathaen; Abernathy, James H; Wahr, Joyce; Mark, Jonathan B

2014-10-01

35

Canadian Cardiovascular Society 2009 Consensus Conference on the management of adults with congenital heart disease: Complex congenital cardiac lesions  

PubMed Central

With advances in pediatric cardiology and cardiac surgery, the population of adults with congenital heart disease (CHD) has increased. In the current era, there are more adults with CHD than children. This population has many unique issues and needs. They have distinctive forms of heart failure and their cardiac disease can be associated with pulmonary hypertension, thromboemboli, complex arrhythmias and sudden death. Medical aspects that need to be considered relate to the long-term and multisystemic effects of single ventricle physiology, cyanosis, systemic right ventricles, complex intracardiac baffles and failing subpulmonary right ventricles. Since the 2001 Canadian Cardiovascular Society Consensus Conference report on the management of adults with CHD, there have been significant advances in the field of adult CHD. Therefore, new clinical guidelines have been written by Canadian adult CHD physicians in collaboration with an international panel of experts in the field. Part III of the guidelines includes recommendations for the care of patients with complete transposition of the great arteries, congenitally corrected transposition of the great arteries, Fontan operations and single ventricles, Eisenmenger’s syndrome, and cyanotic heart disease. Topics addressed include genetics, clinical outcomes, recommended diagnostic workup, surgical and interventional options, treatment of arrhythmias, assessment of pregnancy risk and follow-up requirements. The complete document consists of four manuscripts, which are published online in the present issue of The Canadian Journal of Cardiology. The complete document and references can also be found at www.ccs.ca or www.cachnet.org. PMID:20352139

Silversides, Candice K; Oechslin, Erwin; Schwerzmann, Markus; Muhll, Isabelle Vonder; Khairy, Paul; Horlick, Eric; Landzberg, Mike; Meijboom, Folkert; Warnes, Carole; Therrien, Judith

2010-01-01

36

The Age of Discontinuity; Guidelines to Our Changing Society.  

ERIC Educational Resources Information Center

Concentrating on the social dimension of human experience and existence, this book probes certain profound changes occurring in contemporary technology, economy, society, politics, and education. The author discusses four major discontinuities: (1) the impact of the new technology on the industrial structure; (2) the shift from an "international…

Drucker, Peter F.

37

Canadian Society for Cardiovascular Magnetic Resonance (CanSCMR) recommendations for cardiovascular magnetic resonance image analysis and reporting.  

PubMed

Cardiovascular magnetic resonance (CMR) imaging is a rapidly developing technology that is becoming increasingly important in the diagnostic assessment of heart disease. Recognizing the need for recommendations to optimize the use of this technique, the Canadian Society for Cardiovascular Magnetic Resonance developed a task force to generate recommendations on the clinical use of parameters acquired by CMR imaging and how they should be reported. This article is the consensus report generated by the task force. The online material of this report provides such parameters for all relevant clinical settings, including pediatric and congenital applications. It considers the current clinical role of CMR, general requirements for CMR imaging, components of CMR studies, quantitative CMR image analysis, and appropriate contents of CMR reports. The recommendations are based on previously published recommendations on analysis and reporting and are the first of their kind. It is hoped that the use of these recommendations to guide daily clinical routine will help institutions offering CMR to adhere to high standards of quality according to the present state of the art. PMID:23010085

Friedrich, Matthias G; Larose, Eric; Patton, David; Dick, Alexander; Merchant, Naeem; Paterson, Ian

2013-03-01

38

Advancing Clinical Practice and Policy through Guidelines. The Role of the American Thoracic Society  

PubMed Central

In the face of an overwhelmingly large and growing medical literature, providers often turn to clinical practice guidelines to inform the decisions they make with patients. By systematically appraising the evidence and providing transparent recommendations for practice, guidelines have the potential to improve both bedside decision-making and health policy. This potential has not been fully realized because most guidelines lack transparency, are tainted by conflicts of interest, or fail to employ rigorous methods to appraise the evidence. To address the shortcomings of past guidelines, the Institute of Medicine (IOM) published recommendations for trustworthy guidelines, effectively setting the “gold standard” for what constitutes a high-quality guideline. Along with many other groups that develop guidelines, the American Thoracic Society (ATS) is rapidly evolving processes for development and implementation to meet many of the IOM standards. This Pulmonary Perspective describes the rapidly changing landscape of clinical practice guidelines, the role of the ATS in this landscape, and the activities the ATS is engaged in to ensure that the guidelines it produces are of the highest quality with the broadest impact. PMID:23392437

Gould, Michael K.

2013-01-01

39

Guidelines in the Register of the Association of Scientific Medical Societies in Germany - A Quality Improvement Campaign  

PubMed Central

The Association of Scientific Medical Societies in Germany (AWMF) is the umbrella organization of medical scientific societies in Germany. The development of guidelines goes back to an initiative of the medical scientific societies and is coordinated by the AWMF. Rules for the inclusion of guidelines in the AWMF Guideline Register have been defined including how guidelines are classified. S1 guidelines are based only on recommendations by experts, whereas S2 guidelines require a structured consensus process or a systematic literature review. S3 guidelines include both elements. In addition to compulsory disclosure of any potential conflict of interest, transparent handling of potential conflicts of interest is an important confidence-building measure. For years, the trend has been to develop higher order (S2/S3) guidelines, and the German Society for Gynecology and Obstetrics (DGGG) has been no exception to the trend. In addition to its responsibility for specific S2 and S3 guidelines, the DGGG is also involved in numerous other interdisciplinary guidelines. When developing a guideline, it is essential to define the guideline?s scope, identify aspects which require improvement and agree on the goals. Target groups affected by the guidelines should be involved if they are interested. Different formats (long and short versions, practical instructions, conventional or electronic decision aids, patient versions) are useful to disseminate the guideline. The guideline can be adapted to local circumstances to encourage implementation of its recommendations. Implementation can be measured using quality indicators. Feedback from practitioners is important as this highlights areas which require improvement. The medical scientific societies in Germany can look back on almost two decades of work spent on developing guidelines, most of it done by unpaid voluntary contributors, making this a very successful quality initiative. PMID:25061235

Nothacker, M. J.; Muche-Borowski, C.; Kopp, I. B.

2014-01-01

40

Management guidelines in essential hypertension: report of the second working party of the British Hypertension Society  

Microsoft Academic Search

Several important new issues have arisen in the management of patients with hypertension. A working party of the British Hypertension Society has therefore reviewed available intervention studies on anti-hypertensive treatment and made recommendations on blood pressure thresholds for intervention, on non-pharmacological and pharmacological treatments, and on treatment goals. This report also provides guidelines on blood pressure measurement, essential investigations, referrals

P Sever; G Beevers; C Bulpitt; A Lever; L Ramsay; J Reid; J Swales

1993-01-01

41

Degree of Concordance with DASH Diet Guidelines and Incidence of Hypertension and Fatal Cardiovascular Disease  

PubMed Central

Background Guidelines to prevent and treat hypertension advocate the Dietary Approaches to Stop Hypertension (DASH) diet. Methods We studied whether a greater concordance with the DASH diet is associated with reduced incidence of hypertension (self-reported) and mortality from cardiovascular disease in 20,993 women initially aged 55–69. We created a DASH diet concordance score using food frequency data in 1986 and followed the women for events through 2002. Results No woman had perfect concordance with the DASH diet. Adjusted for age and energy intake, incidence of hypertension was inversely associated with the degree of concordance with the DASH diet, with hazard ratios across quintiles of 1.0, 0.91, 0.95, 0.99, and 0.87 (p trend = 0.02). There also were inverse, but not monotonic, associations between better DASH diet concordance and mortality from coronary heart disease, stroke, and all CVD. However, after adjustment for other risk factors, there was little evidence that any endpoint was associated with the DASH diet score. Conclusions Our results suggest that greater concordance with DASH guidelines did not have an independent long-term association with hypertension or cardiovascular mortality in this cohort. This implies that very high concordance, as achieved in the DASH trials, may be necessary to achieve the benefits of the DASH diet. PMID:17324731

Folsom, Aaron R.; Parker, Emily D.; Harnack, Lisa J.

2007-01-01

42

Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America  

Microsoft Academic Search

Guidelines for the management of patients with invasive candidiasis and mucosal candidiasis were prepared by an Expert Panel of the Infectious Diseases Society of America. These updated guidelines replace the previous guidelines published in the 15 January 2004 issue of Clinical Infectious Diseases and are intended for use by health care providers who care for patients who either have or

David Andes; L. Ostrosky-Zeichner

2009-01-01

43

[Conflict of interest policies and disclosure requirements among European Society of Cardiology National Cardiovascular Journals].  

PubMed

Disclosure of potential conflicts of interest (COI) is used by biomedical journals to guarantee credibility and transparency of the scientific process. COI disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for COI disclosure. This paper provides a comprehensive editorial perspective on classical COI-related issues. New insights into current COI policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardised questionnaire, are discussed. PMID:22495640

Alfonso, Fernando; Timmis, Adam; Pinto, Fausto J; Ambrosio, Giuseppe; Ector, Hugo; Kulakowski, Piotr; Vardas, Panos

2012-04-01

44

Conflict of interest policies and disclosure requirements among European Society of Cardiology National Cardiovascular Journals.  

PubMed

Disclosure of potential conflicts of interest (COIs) is used by biomedical journals to guarantee credibility and transparency of the scientific process. Conflict of interest disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for COI disclosure. This paper provides a comprehensive editorial perspective on classical COI-related issues. New insights into the current COI policies and practices among European Society of Cardiology National Cardiovascular Journals, as derived from a cross-sectional survey using a standardized questionnaire, are discussed. PMID:22383145

Alfonso, Fernando; Timmis, Adam; Pinto, Fausto J; Ambrosio, Giuseppe; Ector, Hugo; Kulakowski, Piotr; Vardas, Panos

2012-03-01

45

Conflict of interest policies and disclosure requirements among European Society of Cardiology National Cardiovascular Journals.  

PubMed

Disclosure of potential conflicts of interest (COI) is used by biomedical journals to guarantee credibility and transparency of the scientific process. COI disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for COI disclosure. This paper provides a comprehensive editorial perspective on classical COI-related issues. New insights into current COI policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardised questionnaire, are discussed. PMID:22422746

Alfonso, Fernando; Timmis, Adam; Pinto, Fausto J; Ambrosio, Giuseppe; Ector, Hugo; Kulakowski, Piotr; Vardas, Panos

2012-04-01

46

Conflict of interest policies and disclosure requirements among European Society of Cardiology national cardiovascular journals.  

PubMed

Disclosure of potential conflicts of interest (COI) is used by biomedical journals to guarantee the credibility and transparency of the scientific process. COI disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for COI disclosure. This paper provides a comprehensive editorial perspective on classical COI-related issues. New insights into current COI policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardised questionnaire, are discussed. PMID:22653242

Alfonso, Fernando; Timmis, Adam; Pinto, Fausto J; Ambrosio, Giuseppe; Ector, Hugo; Kulakowski, Piotr; Vardas, Panos

2012-01-01

47

Conflict of interest policies and disclosure requirements among European Society of Cardiology National Cardiovascular Journals.  

PubMed

Disclosure of potential conflicts of interest (COI) is used by biomedical journals to guarantee credibility and transparency of the scientific process. Conflict of interest disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for COI disclosure. This paper provides a comprehensive editorial perspective on classical COI-related issues. New insights into the current COI policies and practices among European Society of Cardiology National Cardiovascular Journals, as derived from a cross-sectional survey using a standardised questionnaire, are discussed. PMID:22863109

Alfonso, Fernando; Timmis, Adam; Pinto, Fausto J; Ambrosio, Giuseppe; Ector, Hugo; Kulakowski, Piotr; Vardas, Panos

2012-04-01

48

Conflict of interest policies and disclosure requirements among European Society of Cardiology National Cardiovascular Journals.  

PubMed

Disclosure of potential conflicts of interest is used by biomedical journals to guarantee credibility and transparency of the scientific process. Conflict of interest disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for conflicts of interest disclosure. This paper provides a comprehensive editorial perspective on classical conflict of interest-related issues. New insights into current conflicts of interest policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardised questionnaire, are discussed. PMID:22464101

Alfonso, Fernando; Timmis, Adam; Pinto, Fausto J; Ambrosio, Giuseppe; Ector, Hugo; Kulakowski, Piotr; Vardas, Panos

2012-05-01

49

Conflicts of interest policies and disclosure requirements among European Society of Cardiology national cardiovascular journals.  

PubMed

Disclosure of potential conflicts of interest (COI) is used by biomedical journals to guarantee credibility and transparency of the scientific process. COI disclosure, however, is neither systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for COI disclosure. This article provides a comprehensive editorial perspective on classical COI-related issues. New insights into current COI policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardized questionnaire, are discussed. PMID:22551690

Alfonso, Fernando; Timmis, Adam; Pinto, Fausto J; Ambrosio, Giuseppe; Ector, Hugo; Kulakowski, Piotr; Vardas, Panos

2012-06-01

50

Conflict of interest policies and disclosure requirements among European Society of Cardiology National Cardiovascular Journals.  

PubMed

Disclosure of potential conflicts of interest (COI) is used by biomedical journals to guarantee credibility and transparency of the scientific process. COI disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for COI disclosure. This paper provides a comprehensive editorial perspective on classical COI-related issues. New insights into current COI policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardised questionnaire, are discussed. PMID:22664980

Alfonso, Fernando; Timmis, Adam; Pinto, Fausto J; Ambrosio, Giuseppe; Ector, Hugo; Kulakowski, Piotr; Vardas, Panos

2012-01-01

51

Conflict of interest policies and disclosure requirements among European Society of Cardiology National Cardiovascular Journals.  

PubMed

Disclosure of potential conflicts of interest (COI) is used by biomedical journals to guarantee credibility and transparency of the scientific process. COI disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for COI disclosure. This paper provides a comprehensive editorial perspective on classical COI-related issues. New insights into current COI policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardised questionnaire, are discussed. PMID:22653813

Alfonso, F; Timmis, A; Pinto, F J; Ambrosio, G; Ector, H; Kulakowski, P; Vardas, P

2012-06-01

52

Conflict of interest policies and disclosure requirements among European Society of Cardiology National Cardiovascular Journals.  

PubMed

Disclosure of potential conflicts of interest (COI) is used by biomedical journals to guarantee credibility and transparency of the scientific process. COI disclosure, however, is not systematically nor consistently dealt with by journals. Recent joint editorial efforts paved the way towards the implementation of uniform vehicles for COI disclosure. This paper provides a comprehensive editorial perspective on classical COI-related issues. New insights into current COI policies and practices among European Society of Cardiology national cardiovascular journals, as derived from a cross-sectional survey using a standardised questionnaire, are discussed. PMID:22892693

Alfonso, Fernando; Timmis, Adam; Pinto, Fausto J; Ambrosio, Giuseppe; Ector, Hugo; Kulakowski, Piotr; Vardas, Panos

2012-06-01

53

European Cystic Fibrosis Society Standards of Care: Best Practice guidelines.  

PubMed

Specialised CF care has led to a dramatic improvement in survival in CF: in the last four decades, well above what was seen in the general population over the same period. With the implementation of newborn screening in many European countries, centres are increasingly caring for a cohort of patients who have minimal lung disease at diagnosis and therefore have the potential to enjoy an excellent quality of life and an even greater life expectancy than was seen previously. To allow high quality care to be delivered throughout Europe, a landmark document was published in 2005 that sets standards of care. Our current document builds on this work, setting standards for best practice in key aspects of CF care. The objective of our document is to give a broad overview of the standards expected for screening, diagnosis, pre-emptive treatment of lung disease, nutrition, complications, transplant/end of life care and psychological support. For comprehensive details of clinical care of CF, references to the most up to date European Consensus Statements, Guidelines or Position Papers are provided in Table 1. We hope that this best practice document will be useful to clinical teams both in countries where CF care is developing and those with established CF centres. PMID:24856775

Smyth, Alan R; Bell, Scott C; Bojcin, Snezana; Bryon, Mandy; Duff, Alistair; Flume, Patrick; Kashirskaya, Nataliya; Munck, Anne; Ratjen, Felix; Schwarzenberg, Sarah Jane; Sermet-Gaudelus, Isabelle; Southern, Kevin W; Taccetti, Giovanni; Ullrich, Gerald; Wolfe, Sue

2014-05-01

54

Endoscopic Ultrasound-Guided Sampling in Gastroenterology: European Society of Gastrointestinal Endoscopy Technical Guidelines  

PubMed Central

At present, the European Society of Gastrointestinal Endoscopy (ESGE) guidelines on endoscopic ultrasound-guided sampling are almost complete and express state of the art developments. However, future developments are anticipated. This editorial focuses on a few recently published papers with some additional information and on two important additional techniques, elastography and contrast enhanced ultrasound (CEUS), which are mentioned, but not explained in detail in the current ESGE guidelines. Elastography and CEUS might be of importance in the near future to improve the biopsy techniques. PMID:24949378

Dietrich, Christoph F.; Jenssen, C.

2013-01-01

55

Assessment of acute myocardial infarction: current status and recommendations from the North American society for cardiovascular imaging and the European society of cardiac radiology  

Microsoft Academic Search

There are a number of imaging tests that are used in the setting of acute myocardial infarction and acute coronary syndrome.\\u000a Each has their strengths and limitations. Experts from the European Society of Cardiac Radiology and the North American Society\\u000a for Cardiovascular Imaging together with other prominent imagers reviewed the literature. It is clear that there is a definite\\u000a role

Arthur E. Stillman; Matthijs Oudkerk; David Bluemke; Jens Bremerich; Fabio P. Esteves; Ernest V. Garcia; Matthias Gutberlet; W. Gregory Hundley; Michael Jerosch-Herold; Dirkjan Kuijpers; Raymond K. Kwong; Eike Nagel; Stamatios Lerakis; John Oshinski; Jean-François Paul; Richard Underwood; Bernd J. Wintersperger; Michael R. Rees

2011-01-01

56

ACCF/SCAI/AATS/AHA/ASE/ASNC/HFSA/HRS/SCCM/SCCT/SCMR/STS 2012 appropriate use criteria for diagnostic catheterization: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.  

PubMed

The American College of Cardiology Foundation, in collaboration with the Society for Cardiovascular Angiography and Interventions and key specialty and subspecialty societies, conducted a review of common clinical scenarios where diagnostic catheterization is frequently considered. The indications (clinical scenarios) were derived from common applications or anticipated uses, as well as from current clinical practice guidelines and results of studies examining the implementation of noninvasive imaging appropriate use criteria. The 166 indications in this document were developed by a diverse writing group and scored by a separate independent technical panel on a scale of 1 to 9, to designate appropriate use (median 7 to 9), uncertain use (median 4 to 6), and inappropriate use (median 1 to 3). Diagnostic catheterization may include several different procedure components. The indications developed focused primarily on 2 aspects of diagnostic catheterization. Many indications focused on the performance of coronary angiography for the detection of coronary artery disease with other procedure components (e.g., hemodynamic measurements, ventriculography) at the discretion of the operator. The majority of the remaining indications focused on hemodynamic measurements to evaluate valvular heart disease, pulmonary hypertension, cardiomyopathy, and other conditions, with the use of coronary angiography at the discretion of the operator. Seventy-five indications were rated as appropriate, 49 were rated as uncertain, and 42 were rated as inappropriate. The appropriate use criteria for diagnostic catheterization have the potential to impact physician decision making, healthcare delivery, and reimbursement policy. Furthermore, recognition of uncertain clinical scenarios facilitates identification of areas that would benefit from future research. PMID:22578925

Patel, Manesh R; Bailey, Steven R; Bonow, Robert O; Chambers, Charles E; Chan, Paul S; Dehmer, Gregory J; Kirtane, Ajay J; Wann, L Samuel; Ward, R Parker

2012-05-29

57

Cardiovascular disease prevention.  

PubMed

Cardiovascular diseases remain the first killer in the Western countries. Equivalent contributions of prevention initiatives, pharmaceutical developments and technological improvements have led to an important success in the reduction of mortality related to cardiovascular diseases in some of the countries of the Western world. However, increase in life expectance, incomplete adherence to guidelines, difficulties in convincing governments and the population to support and adhere to prevention measures make that the burden of cardiovascular diseases is still extremely high. This review gives a restricted summary of the most important prevention guidelines supported by the European Society of Cardiology. It also illustrates the still very incomplete adherence to these guidelines in the different European countries as published in the EUROASPIRE surveys. PMID:25176558

Van Camp, G

2014-12-01

58

Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America.  

PubMed

Evidence-based guidelines for managing patients with intra-abdominal infection were prepared by an Expert Panel of the Surgical Infection Society and the Infectious Diseases Society of America. These updated guidelines replace those previously published in 2002 and 2003. The guidelines are intended for treating patients who either have these infections or may be at risk for them. New information, based on publications from the period 2003-2008, is incorporated into this guideline document. The panel has also added recommendations for managing intra-abdominal infection in children, particularly where such management differs from that of adults; for appendicitis in patients of all ages; and for necrotizing enterocolitis in neonates. PMID:20034345

Solomkin, Joseph S; Mazuski, John E; Bradley, John S; Rodvold, Keith A; Goldstein, Ellie J C; Baron, Ellen J; O'Neill, Patrick J; Chow, Anthony W; Dellinger, E Patchen; Eachempati, Soumitra R; Gorbach, Sherwood; Hilfiker, Mary; May, Addison K; Nathens, Avery B; Sawyer, Robert G; Bartlett, John G

2010-01-15

59

Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America.  

PubMed

Evidence-based guidelines for managing patients with intra-abdominal infection were prepared by an Expert Panel of the Surgical Infection Society and the Infectious Diseases Society of America. These updated guidelines replace those previously published in 2002 and 2003. The guidelines are intended for treating patients who either have these infections or may be at risk for them. New information, based on publications from the period 2003-2008, is incorporated into this guideline document. The panel has also added recommendations for managing intra-abdominal infection in children, particularly where such management differs from that of adults; for appendicitis in patients of all ages; and for necrotizing enterocolitis in neonates. PMID:20163262

Solomkin, Joseph S; Mazuski, John E; Bradley, John S; Rodvold, Keith A; Goldstein, Ellie J C; Baron, Ellen J; O'Neill, Patrick J; Chow, Anthony W; Dellinger, E Patchen; Eachempati, Soumitra R; Gorbach, Sherwood; Hilfiker, Mary; May, Addison K; Nathens, Avery B; Sawyer, Robert G; Bartlett, John G

2010-02-01

60

Guidelines for pancreaticobiliary cytology from the Papanicolaou Society of Cytopathology: A review.  

PubMed

The newest installment on state-of-the-art standards of practice in cytopathology from the Papanicolaou Society of Cytopathology (PSC) focuses on the pancreaticobiliary system. Similar to the National Cancer Institute recommendations for aspiration cytology of the thyroid, the PSC guidelines for pancreaticobiliary cytology addresses indications, techniques, terminology and nomenclature, ancillary studies, and postprocedure management. Each committee was composed of a multidisciplinary group of experts in diagnosing, managing, and treating patients with pancreaticobiliary disease. Draft documents were posted on an interactive Web-based forum hosted by the PSC Web site (www.papsociety.org) and the topics of terminology, ancillary testing, and management were presented at national and international meetings over an 18-month period for discussion and feedback from practicing pathologists around the world. This review provides a synopsis of these guidelines. PMID:24777782

Pitman, Martha B; Layfield, Lester J

2014-06-01

61

[Therapeutic strategies. Evolution and current status of the European Guidelines on Cardiovascular disease prevention].  

PubMed

The European Guidelines on Dyslipidaemias (2011) and Cardiovascular Prevention (2012) have incorporated important changes. Firstly, it highlights the identification of a group of "very high risk" patients: patients with atherosclerotic disease in any vascular area, diabetes with associated risk factors, advanced chronic renal failure, or a SCORE estimate >10%. Patients with diabetes and no other risk factors, moderate renal failure, severe hypertension, genetic dyslipidaemias, or a SCORE estimate 5-10%, are considered as "high risk". The HDL cholesterol and triglycerides levels are considered as modulators of risks, but not therapeutic objectives per se. The therapeutic objectives are set at LDL cholesterol levels < 70 mg/dl (or at least a reduction of at least 50%) for patients at very high risk, and an LDL < 100 mg/dl for high risk patients. As well as the changes in lifestyle, pharmacological treatment with statins is the focal point of lipid lowering treatments. Other pharmacological options may be considered if the treatment with the maximum tolerable doses of statins do not achieve the therapeutic objectives. PMID:23769961

Guijarro, Carlos; García-Díaz, Juan de Dios

2013-01-01

62

The Infectious Diseases Society of America Lyme guidelines: a cautionary tale about the development of clinical practice guidelines  

Microsoft Academic Search

Flawed clinical practice guidelines may compromise patient care. Commercial conflicts of interest on panels that write treatment guidelines are particularly problematic, because panelists may have conflicting agendas that influence guideline recommendations. Historically, there has been no legal remedy for conflicts of interest on guidelines panels. However, in May 2008, the Attorney General of Connecticut concluded a ground-breaking antitrust investigation into

Lorraine Johnson; Raphael B Stricker

2010-01-01

63

Cardiac risk assessment before the use of stimulant medications in children and youth: A joint position statement by the Canadian Paediatric Society, the Canadian Cardiovascular Society, and the Canadian Academy of Child and Adolescent Psychiatry.  

PubMed

Regulatory decisions and scientific statements regarding the management of attention-deficit hyperactivity disorder (ADHD) raise questions about the safety of medications and the appropriate pretreatment evaluation to determine suitability for treatment with medication. This is particularly true in the setting of known structural or functional heart disease. The present paper reviews the available data, including peer-reviewed literature, data from the United States Food and Drug Administration Web site on reported adverse reactions in children using stimulant medication, and Health Canada data on the same problem. A consensus-based guideline on appropriate assessment is provided, based on input from members of the Canadian Paediatric Society, the Canadian Cardiovascular Society and the Canadian Academy of Child and Adolescent Psychiatry, with specific expertise and knowledge in the areas of both ADHD and pediatric cardiology. The present statement advocates a thorough history and physical examination before starting stimulant medications, with an emphasis on the identification of risk factors for sudden death, but does not routinely recommend electrocardiographic screening or cardiac subspecialist consultation unless indicated by history or physical examination findings. A checklist for identifying children who are potentially at risk of sudden death (independent of ADHD or medications used to treat it) is provided. Although recommendations are based on the best evidence currently available, the committee further agrees that more research on this subject is necessary to optimize the approach to this common clinical scenario. PMID:19898693

Warren, A E; Hamilton, R M; Bélanger, S A; Gray, C; Gow, R M; Sanatani, S; Côté, J-M; Lougheed, J; LeBlanc, J; Martin, S; Miles, B; Mitchell, C; Gorman, D A; Weiss, M; Schachar, R

2009-11-01

64

ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 Appropriate Use Criteria for Echocardiography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance American College of Chest Physicians.  

PubMed

The American College of Cardiology Foundation (ACCF), in partnership with the American Society of Echocardiography (ASE) and along with key specialty and subspecialty societies, conducted a review of common clinical scenarios where echocardiography is frequently considered. This document combines and updates the original transthoracic and transesophageal echocardiography appropriateness criteria published in 2007 (1) and the original stress echocardiography appropriateness criteria published in 2008 (2). This revision reflects new clinical data, reflects changes in test utilization patterns,and clarifies echocardiography use where omissions or lack of clarity existed in the original criteria.The indications (clinical scenarios)were derived from common applications or anticipated uses, as well as from current clinical practice guidelines and results of studies examining the implementation of the original appropriate use criteria (AUC).The 202 indications in this document were developed by a diverse writing group and scored by a separate independent technical panel on a scale of 1 to 9,to designate appropriate use(median 7 to 9), uncertain use(median 4 to 6), and inappropriate use (median 1 to 3). Ninety-seven indications were rated as appropriate, 34 were rated as uncertain, and 71 were rated as inappropriate. In general,the use of echocardiography for initial diagnosis when there is a change in clinical status or when the results of the echocardiogram are anticipated to change patient management were rated appropriate. Routine testing when there was no change in clinical status or when results of testing were unlikely to modify management were more likely to be inappropriate than appropriate/uncertain.The AUC for echocardiography have the potential to impact physician decision making,healthcare delivery, and reimbursement policy. Furthermore,recognition of uncertain clinical scenarios facilitates identification of areas that would benefit from future research. PMID:21338862

Douglas, Pamela S; Garcia, Mario J; Haines, David E; Lai, Wyman W; Manning, Warren J; Patel, Ayan R; Picard, Michael H; Polk, Donna M; Ragosta, Michael; Parker Ward, R; Weiner, Rory B

2011-03-01

65

European Society for Paediatric Endocrinology Consensus Guidelines on Screening, Diagnosis, and Management of Congenital Hypothyroidism  

PubMed Central

Objective: The aim was to formulate practice guidelines for the diagnosis and management of congenital hypothyroidism (CH). Evidence: A systematic literature search was conducted to identify key articles relating to the screening, diagnosis, and management of CH. The evidence-based guidelines were developed with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system, describing both the strength of recommendations and the quality of evidence. In the absence of sufficient evidence, conclusions were based on expert opinion. Consensus Process: Thirty-two participants drawn from the European Society for Paediatric Endocrinology and five other major scientific societies in the field of pediatric endocrinology were allocated to working groups with assigned topics and specific questions. Each group searched the literature, evaluated the evidence, and developed a draft document. These papers were debated and finalized by each group before presentation to the full assembly for further discussion and agreement. Recommendations: The recommendations include: worldwide neonatal screening, approaches to assess the cause (including genotyping) and the severity of the disorder, the immediate initiation of appropriate L-T4 supplementation and frequent monitoring to ensure dose adjustments to keep thyroid hormone levels in the target ranges, a trial of treatment in patients suspected of transient CH, regular assessments of developmental and neurosensory functions, consulting health professionals as appropriate, and education about CH. The harmonization of diagnosis, management, and routine health surveillance would not only optimize patient outcomes, but should also facilitate epidemiological studies of the disorder. Individuals with CH require monitoring throughout their lives, particularly during early childhood and pregnancy. PMID:24446653

Leger, Juliane; Olivieri, Antonella; Donaldson, Malcolm; Torresani, Toni; Krude, Heiko; van Vliet, Guy; Polak, Michel

2014-01-01

66

Cardiovascular risk assessment in low-resource settings: a consensus document of the European Society of Hypertension Working Group on Hypertension and Cardiovascular Risk in Low Resource Settings  

PubMed Central

The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 confirms ischemic heart disease and stroke as the leading cause of death and that hypertension is the main associated risk factor worldwide. How best to respond to the rising prevalence of hypertension in resource-deprived settings is a topic of ongoing public-health debate and discussion. In low-income and middle-income countries, socioeconomic inequality and cultural factors play a role both in the development of risk factors and in the access to care. In Europe, cultural barriers and poor communication between health systems and migrants may limit migrants from receiving appropriate prevention, diagnosis, and treatment. To use more efficiently resources available and to make treatment cost-effective at the patient level, cardiovascular risk approach is now recommended. In 2011, The European Society of Hypertension established a Working Group on ‘Hypertension and Cardiovascular risk in low resource settings’, which brought together cardiologists, diabetologists, nephrologists, clinical trialists, epidemiologists, economists, and other stakeholders to review current strategies for cardiovascular risk assessment in population studies in low-income and middle-income countries, their limitations, possible improvements, and future interests in screening programs. This report summarizes current evidence and presents highlights of unmet needs. PMID:24577410

Modesti, Pietro A.; Agostoni, Piergiuseppe; Agyemang, Charles; Basu, Sanjay; Benetos, Athanase; Cappuccio, Francesco P.; Ceriello, Antonio; Del Prato, Stefano; Kalyesubula, Robert; O'Brien, Eoin; Kilama, Michael O.; Perlini, Stefano; Picano, Eugenio; Reboldi, Gianpaolo; Remuzzi, Giuseppe; Stuckler, David; Twagirumukiza, Marc; Van Bortel, Luc M.; Watfa, Ghassan; Zhao, Dong; Parati, Gianfranco

2014-01-01

67

Cardiovascular risk assessment in low-resource settings: a consensus document of the European Society of Hypertension Working Group on Hypertension and Cardiovascular Risk in Low Resource Settings.  

PubMed

The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 confirms ischemic heart disease and stroke as the leading cause of death and that hypertension is the main associated risk factor worldwide. How best to respond to the rising prevalence of hypertension in resource-deprived settings is a topic of ongoing public-health debate and discussion. In low-income and middle-income countries, socioeconomic inequality and cultural factors play a role both in the development of risk factors and in the access to care. In Europe, cultural barriers and poor communication between health systems and migrants may limit migrants from receiving appropriate prevention, diagnosis, and treatment. To use more efficiently resources available and to make treatment cost-effective at the patient level, cardiovascular risk approach is now recommended. In 2011, The European Society of Hypertension established a Working Group on 'Hypertension and Cardiovascular risk in low resource settings', which brought together cardiologists, diabetologists, nephrologists, clinical trialists, epidemiologists, economists, and other stakeholders to review current strategies for cardiovascular risk assessment in population studies in low-income and middle-income countries, their limitations, possible improvements, and future interests in screening programs. This report summarizes current evidence and presents highlights of unmet needs. PMID:24577410

Modesti, Pietro A; Agostoni, Piergiuseppe; Agyemang, Charles; Basu, Sanjay; Benetos, Athanase; Cappuccio, Francesco P; Ceriello, Antonio; Del Prato, Stefano; Kalyesubula, Robert; O'Brien, Eoin; Kilama, Michael O; Perlini, Stefano; Picano, Eugenio; Reboldi, Gianpaolo; Remuzzi, Giuseppe; Stuckler, David; Twagirumukiza, Marc; Van Bortel, Luc M; Watfa, Ghassan; Zhao, Dong; Parati, Gianfranco

2014-05-01

68

An official American Thoracic Society workshop report: developing performance measures from clinical practice guidelines.  

PubMed

Many health care performance measures are either not based on high-quality clinical evidence or not tightly linked to patient-centered outcomes, limiting their usefulness in quality improvement. In this report we summarize the proceedings of an American Thoracic Society workshop convened to address this problem by reviewing current approaches to performance measure development and creating a framework for developing high-quality performance measures by basing them directly on recommendations from well-constructed clinical practice guidelines. Workshop participants concluded that ideally performance measures addressing care processes should be linked to clinical practice guidelines that explicitly rate the quality of evidence and the strength of recommendations, such as the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process. Under this framework, process-based performance measures would only be developed from strong recommendations based on high- or moderate-quality evidence. This approach would help ensure that clinical processes specified in performance measures are both of clear benefit to patients and supported by strong evidence. Although this approach may result in fewer performance measures, it would substantially increase the likelihood that quality-improvement programs based on these measures actually improve patient care. PMID:24828810

Kahn, Jeremy M; Gould, Michael K; Krishnan, Jerry A; Wilson, Kevin C; Au, David H; Cooke, Colin R; Douglas, Ivor S; Feemster, Laura C; Mularski, Richard A; Slatore, Christopher G; Wiener, Renda Soylemez

2014-05-01

69

SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT  

Microsoft Academic Search

Over the last few years, computed tomography (CT) has developed into a standard clinical test for a variety of cardiovascular conditions. The emergence of cardiovascular CT during a period of dramatic increase in radiation exposure to the population from medical procedures and heightened concern about the subsequent potential cancer risk has led to intense scrutiny of the radiation burden of

Sandra S. Halliburton; Suhny Abbara; Marcus Y. Chen; Ralph Gentry; Mahadevappa Mahesh; Gilbert L. Raff; Leslee J. Shaw; Jörg Hausleiter

2011-01-01

70

Clinical competency guidelines for pulmonary rehabilitation professionals: position statement of the American Association of Cardiovascular and Pulmonary Rehabilitation.  

PubMed

The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) recognizes that interdisciplinary health care professionals providing pulmonary rehabilitation services need to have certain core competencies. This statement updates the previous clinical competency guidelines for pulmonary rehabilitation professionals, and it complements the AACVPR's Guidelines for Pulmonary Rehabilitation Programs. These competencies provide a common core of 13 professional and clinical competencies inclusive of multiple academic and clinical disciplines. The core competencies include patient assessment and management; dyspnea assessment and management; oxygen assessment, management, and titration; collaborative self-management; adherence; medication and therapeutics; non-chronic obstructive pulmonary diseases; exercise testing; exercise training; psychosocial management; tobacco cessation; emergency responses for patient and program personnel; and universal standard precautions. PMID:25098438

Collins, Eileen G; Bauldoff, Gerene; Carlin, Brian; Crouch, Rebecca; Emery, Charles F; Garvey, Chris; Hilling, Lana; Limberg, Trina; ZuWallack, Richard; Nici, Linda

2014-01-01

71

Cardiovascular Health, Part 2  

PubMed Central

Context: An athlete’s health may be endangered if he or she continues to compete after diagnosis of certain cardiovascular conditions. The most worrisome risk is sudden cardiac death; the annual rate in US athletes is 1 in 50 000 to 200 000. Evidence Acquisition: Part 2 of this review highlights the current guidelines and controversies surrounding compatibility of participation with a variety of cardiac conditions in competitive and recreational athletics. Data sources were limited to peer-reviewed publications from 1984 to the April 2009. Results: The guidelines published by the American College of Cardiology and the European Society of Cardiology provide a framework for safe competitive and recreational sports participation in athletes with a broad spectrum of inherited and acquired cardiovascular disorders. These guidelines are necessarily conservative because it is not currently possible to individualize risk prediction. Few data are available in many areas, particularly in the noncompetitive arena or in older athletes. Conclusions: Published national guidelines are currently the foundation governing return-to-play decisions in athletes with cardiovascular conditions. Further studies are needed to refine risk stratification algorithms to allow athletes with cardiovascular conditions to reap the health benefits of regular exercise and sports participation without undue risk. PMID:23015920

Baman, Timir S.; Gupta, Sanjaya; Day, Sharlene M.

2010-01-01

72

Primary Care Guidelines for the Management of Persons Infected with Human Immunodeficiency Virus: Recommendations of the HIV Medicine Association of the Infectious Diseases Society of America  

Microsoft Academic Search

Evidence-based guidelines for the management of persons infected with human immunodeficiency virus (HIV) were prepared by an expert panel of the HIV Medicine Association of the Infectious Diseases Society of America. These updated guidelines replace those published in 2004. The guidelines are intended for use by health care providers who care for HIV-infected patients or patients who may be at

Jean Anderson; Patricia Emmanuel; Judith S. Currier; Valerie E. Stone; Jonathan E. Kaplan

2004-01-01

73

ACCF/ASE/ACEP/AHA/ASNC/SCAI/SCCT/SCMR 2008 Appropriateness Criteria for Stress Echocardiography. A report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, American Society of Echocardiography, American College of Emergency Physicians, American Heart Association, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance endorsed by the Heart Rhythm Society and the Society of Critical Care Medicine.  

PubMed

The American College of Cardiology Foundation (ACCF) and the American Society of Echocardiography (ASE) together with key specialty and subspecialty societies, conducted an appropriateness review for stress echocardiography. The review assessed the risks and benefits of stress echocardiography for several indications or clinical scenarios and scored them on a scale of 1 to 9 (based upon methodology developed by the ACCF to assess imaging appropriateness). The upper range (7 to 9) implies that the test is generally acceptable and is a reasonable approach, and the lower range (1 to 3) implies that the test is generally not acceptable and is not a reasonable approach. The midrange (4 to 6) indicates a clinical scenario for which the indication for a stress echocardiogram is uncertain. The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Use of stress echocardiography for risk assessment in patients with coronary artery disease (CAD) was viewed favorably, while routine repeat testing and general screening in certain clinical scenarios were viewed less favorably. It is anticipated that these results will have a significant impact on physician decision making and performance, reimbursement policy, and will help guide future research. PMID:18314889

Douglas, Pamela S; Khandheria, Bijoy; Stainback, Raymond F; Weissman, Neil J; Peterson, Eric D; Hendel, Robert C; Stainback, Raymond F; Blaivas, Michael; Des Prez, Roger D; Gillam, Linda D; Golash, Terry; Hiratzka, Loren F; Kussmaul, William G; Labovitz, Arthur J; Lindenfeld, Joann; Masoudi, Frederick A; Mayo, Paul H; Porembka, David; Spertus, John A; Wann, L Samuel; Wiegers, Susan E; Brindis, Ralph G; Douglas, Pamela S; Hendel, Robert C; Patel, Manesh R; Peterson, Eric D; Wolk, Michael J; Allen, Joseph M

2008-04-01

74

ACCF/ASE/ACEP/AHA/ASNC/SCAI/SCCT/SCMR 2008 appropriateness criteria for stress echocardiography: a report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, American Society of Echocardiography, American College of Emergency Physicians, American Heart Association, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance endorsed by the Heart Rhythm Society and the Society of Critical Care Medicine.  

PubMed

The American College of Cardiology Foundation (ACCF) and the American Society of Echocardiography (ASE) together with key specialty and subspecialty societies, conducted an appropriateness review for stress echocardiography. The review assessed the risks and benefits of stress echocardiography for several indications or clinical scenarios and scored them on a scale of 1 to 9 (based upon methodology developed by the ACCF to assess imaging appropriateness). The upper range (7 to 9) implies that the test is generally acceptable and is a reasonable approach, and the lower range (1 to 3) implies that the test is generally not acceptable and is not a reasonable approach. The midrange (4 to 6) indicates a clinical scenario for which the indication for a stress echocardiogram is uncertain. The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Use of stress echocardiography for risk assessment in patients with coronary artery disease (CAD) was viewed favorably, while routine repeat testing and general screening in certain clinical scenarios were viewed less favorably. It is anticipated that these results will have a significant impact on physician decision making and performance, reimbursement policy, and will help guide future research. PMID:18342240

Douglas, Pamela S; Khandheria, Bijoy; Stainback, Raymond F; Weissman, Neil J; Peterson, Eric D; Hendel, Robert C; Stainback, Raymond F; Blaivas, Michael; Des Prez, Roger D; Gillam, Linda D; Golash, Terry; Hiratzka, Loren F; Kussmaul, William G; Labovitz, Arthur J; Lindenfeld, JoAnn; Masoudi, Frederick A; Mayo, Paul H; Porembka, David; Spertus, John A; Wann, L Samuel; Wiegers, Susan E; Brindis, Ralph G; Douglas, Pamela S; Hendel, Robert C; Patel, Manesh R; Peterson, Eric D; Wolk, Michael J; Allen, Joseph M

2008-03-18

75

ACCF/ASE/ACEP/AHA/ASNC/SCAI/SCCT/SCMR 2008 appropriateness criteria for stress echocardiography: a report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, American Society of Echocardiography, American College of Emergency Physicians, American Heart Association, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance: endorsed by the Heart Rhythm Society and the Society of Critical Care Medicine.  

PubMed

The American College of Cardiology Foundation (ACCF) and the American Society of Echocardiography (ASE) together with key specialty and subspecialty societies, conducted an appropriateness review for stress echocardiography. The review assessed the risks and benefits of stress echocardiography for several indications or clinical scenarios and scored them on a scale of 1 to 9 (based upon methodology developed by the ACCF to assess imaging appropriateness). The upper range (7 to 9) implies that the test is generally acceptable and is a reasonable approach, and the lower range (1 to 3) implies that the test is generally not acceptable and is not a reasonable approach. The midrange (4 to 6) indicates a clinical scenario for which the indication for a stress echocardiogram is uncertain. The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Use of stress echocardiography for risk assessment in patients with coronary artery disease (CAD) was viewed favorably, while routine repeat testing and general screening in certain clinical scenarios were viewed less favorably. It is anticipated that these results will have a significant impact on physician decision making and performance, reimbursement policy, and will help guide future research. PMID:18316491

Douglas, Pamela S; Khandheria, Bijoy; Stainback, Raymond F; Weissman, Neil J; Peterson, Eric D; Hendel, Robert C; Stainback, Raymond F; Blaivas, Michael; Des Prez, Roger D; Gillam, Linda D; Golash, Terry; Hiratzka, Loren F; Kussmaul, William G; Labovitz, Arthur J; Lindenfeld, JoAnn; Masoudi, Frederick A; Mayo, Paul H; Porembka, David; Spertus, John A; Wann, L Samuel; Wiegers, Susan E; Brindis, Ralph G; Douglas, Pamela S; Patel, Manesh R; Wolk, Michael J; Allen, Joseph M

2008-03-18

76

Cardiovascular and Interventional Radiological Society of Europe Commentary on the Treatment of Chronic Cerebrospinal Venous Insufficiency  

SciTech Connect

Chronic cerebrospinal venous insufficiency (CCSVI) is a putative new theory that has been suggested by some to have a direct causative relation with the symptomatology associated with multiple sclerosis (MS). The core foundation of this theory is that there is abnormal venous drainage from the brain due to outflow obstruction in the draining jugular vein and/or azygos veins. This abnormal venous drainage, which is characterised by special ultrasound criteria, called the 'venous hemodynamic insufficiency severity score' (VHISS), is said to cause intracerebral flow disturbance or outflow problems that lead to periventricular deposits. In the CCSVI theory, these deposits have a great similarity to the iron deposits seen around the veins in the legs in patients with chronic deep vein thrombosis. Zamboni, who first described this new theory, has promoted balloon dilatation to treat the outflow problems, thereby curing CCSVI and by the same token alleviating MS complaints. However, this theory does not fit into the existing bulk of scientific data concerning the pathophysiology of MS. In contrast, there is increasing worldwide acceptance of CCSVI and the associated balloon dilatation treatment, even though there is no supporting scientific evidence. Furthermore, most of the information we have comes from one source only. The treatment is called 'liberation treatment,' and the results of the treatment can be watched on YouTube. There are well-documented testimonies by MS patients who have gained improvement in their personal quality of life (QOL) after treatment. However, there are no data available from patients who underwent unsuccessful treatments with which to obtain a more balanced view. The current forum for the reporting of success in treating CCSVI and thus MS seems to be the Internet. At the CIRCE office and the MS Centre in Amsterdam, we receive approximately 10 to 20 inquiries a month about this treatment. In addition, many interventional radiologists, who are directly approached by MS patients, contact the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) for advice. Worldwide, several centres are actively promoting and performing balloon dilatation, with or without stenting, for CCSVI. Thus far, no trial data are available, and there is currently no randomized controlled trial (RCT) in progress Therefore, the basis for this new treatment rests on anecdotal evidence and successful testimonies by patients on the Internet. CIRSE believes that this is not a sound basis on which to offer a new treatment, which could have possible procedure-related complications, to an often desperate patient population.

Reekers, J. A., E-mail: j.a.reekers@amc.uva.nl [AMC, University of Amsterdam, Department of Radiology (Netherlands); Lee, M. J. [Beaumont Hospital, Department of Academic Radiology (Ireland); Belli, A. M. [St. George's Hospital, Department of Radiology (United Kingdom); Barkhof, F. [MS Center Amsterdam, VU University Medical Center, Department of Radiology (Netherlands)

2011-02-15

77

ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance.  

PubMed

The American College of Cardiology Foundation (ACCF), along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac computed tomography (CCT) is frequently considered. The present document is an update to the original CCT/cardiac magnetic resonance (CMR) appropriateness criteria published in 2006, written to reflect changes in test utilization, to incorporate new clinical data, and to clarify CCT use where omissions or lack of clarity existed in the original criteria (1). The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Ninety-three clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of CCT angiography for diagnosis and risk assessment in patients with low or intermediate risk or pretest probability for coronary artery disease (CAD) was viewed favorably, whereas testing in high-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Use of noncontrast computed tomography (CT) for calcium scoring was rated as appropriate within intermediate- and selected low-risk patients. Appropriate applications of CCT are also within the category of cardiac structural and functional evaluation. It is anticipated that these results will have an impact on physician decision making, performance, and reimbursement policy, and that they will help guide future research. PMID:21232696

Taylor, Allen J; Cerqueira, Manuel; Hodgson, John McB; Mark, Daniel; Min, James; O'Gara, Patrick; Rubin, Geoffrey D

2010-01-01

78

ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography. A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance.  

PubMed

The American College of Cardiology Foundation (ACCF), along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac computed tomography (CCT) is frequently considered. The present document is an update to the original CCT/cardiac magnetic resonance (CMR) appropriateness criteria published in 2006, written to reflect changes in test utilization, to incorporate new clinical data, and to clarify CCT use where omissions or lack of clarity existed in the original criteria (1). The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Ninety-three clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of CCT angiography for diagnosis and risk assessment in patients with low or intermediate risk or pretest probability for coronary artery disease (CAD) was viewed favorably, whereas testing in high-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Use of noncontrast computed tomography (CT) for calcium scoring was rated as appropriate within intermediate- and selected low-risk patients. Appropriate applications of CCT are also within the category of cardiac structural and functional evaluation. It is anticipated that these results will have an impact on physician decision making, performance, and reimbursement policy, and that they will help guide future research. PMID:21087721

Taylor, Allen J; Cerqueira, Manuel; Hodgson, John McB; Mark, Daniel; Min, James; O'Gara, Patrick; Rubin, Geoffrey D; Kramer, Christopher M; Berman, Daniel; Brown, Alan; Chaudhry, Farooq A; Cury, Ricardo C; Desai, Milind Y; Einstein, Andrew J; Gomes, Antoinette S; Harrington, Robert; Hoffmann, Udo; Khare, Rahul; Lesser, John; McGann, Christopher; Rosenberg, Alan; Schwartz, Robert; Shelton, Marc; Smetana, Gerald W; Smith, Sidney C

2010-11-23

79

ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance.  

PubMed

The American College of Cardiology Foundation, along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac computed tomography (CCT) is frequently considered. The present document is an update to the original CCT/cardiac magnetic resonance appropriateness criteria published in 2006, written to reflect changes in test utilization, to incorporate new clinical data, and to clarify CCT use where omissions or lack of clarity existed in the original criteria. The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Ninety-three clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of CCT angiography for diagnosis and risk assessment in patients with low or intermediate risk or pretest probability for coronary artery disease was viewed favorably, whereas testing in high-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Use of noncontrast computed tomography for calcium scoring was rated as appropriate within intermediate- and selected low-risk patients. Appropriate applications of CCT are also within the category of cardiac structural and functional evaluation. It is anticipated that these results will have an impact on physician decision making, performance, and reimbursement policy, and that they will help guide future research. PMID:20975004

Taylor, Allen J; Cerqueira, Manuel; Hodgson, John McB; Mark, Daniel; Min, James; O'Gara, Patrick; Rubin, Geoffrey D

2010-11-23

80

American Cancer Society guideline for the early detection of prostate cancer: update 2010.  

PubMed

In 2009, the American Cancer Society (ACS) Prostate Cancer Advisory Committee began the process of a complete update of recommendations for early prostate cancer detection. A series of systematic evidence reviews was conducted focusing on evidence related to the early detection of prostate cancer, test performance, harms of therapy for localized prostate cancer, and shared and informed decision making in prostate cancer screening. The results of the systematic reviews were evaluated by the ACS Prostate Cancer Advisory Committee, and deliberations about the evidence occurred at committee meetings and during conference calls. On the basis of the evidence and a consensus process, the Prostate Cancer Advisory Committee developed the guideline, and a writing committee drafted a guideline document that was circulated to the entire committee for review and revision. The document was then circulated to peer reviewers for feedback, and finally to the ACS Mission Outcomes Committee and the ACS Board of Directors for approval. The ACS recommends that asymptomatic men who have at least a 10-year life expectancy have an opportunity to make an informed decision with their health care provider about screening for prostate cancer after they receive information about the uncertainties, risks, and potential benefits associated with prostate cancer screening. Prostate cancer screening should not occur without an informed decision-making process. Men at average risk should receive this information beginning at age 50 years. Men in higher risk groups should receive this information before age 50 years. Men should either receive this information directly from their health care providers or be referred to reliable and culturally appropriate sources. Patient decision aids are helpful in preparing men to make a decision whether to be tested. PMID:20200110

Wolf, Andrew M D; Wender, Richard C; Etzioni, Ruth B; Thompson, Ian M; D'Amico, Anthony V; Volk, Robert J; Brooks, Durado D; Dash, Chiranjeev; Guessous, Idris; Andrews, Kimberly; DeSantis, Carol; Smith, Robert A

2010-01-01

81

International society of neuropathology-haarlem consensus guidelines for nervous system tumor classification and grading.  

PubMed

Major discoveries in the biology of nervous system tumors have raised the question of how non-histological data such as molecular information can be incorporated into the next World Health Organization (WHO) classification of central nervous system tumors. To address this question, a meeting of neuropathologists with expertise in molecular diagnosis was held in Haarlem, the Netherlands, under the sponsorship of the International Society of Neuropathology (ISN). Prior to the meeting, participants solicited input from clinical colleagues in diverse neuro-oncological specialties. The present "white paper" catalogs the recommendations of the meeting, at which a consensus was reached that incorporation of molecular information into the next WHO classification should follow a set of provided "ISN-Haarlem" guidelines. Salient recommendations include that (i) diagnostic entities should be defined as narrowly as possible to optimize interobserver reproducibility, clinicopathological predictions and therapeutic planning; (ii) diagnoses should be "layered" with histologic classification, WHO grade and molecular information listed below an "integrated diagnosis"; (iii) determinations should be made for each tumor entity as to whether molecular information is required, suggested or not needed for its definition; (iv) some pediatric entities should be separated from their adult counterparts; (v) input for guiding decisions regarding tumor classification should be solicited from experts in complementary disciplines of neuro-oncology; and (iv) entity-specific molecular testing and reporting formats should be followed in diagnostic reports. It is hoped that these guidelines will facilitate the forthcoming update of the fourth edition of the WHO classification of central nervous system tumors. PMID:24990071

Louis, David N; Perry, Arie; Burger, Peter; Ellison, David W; Reifenberger, Guido; von Deimling, Andreas; Aldape, Kenneth; Brat, Daniel; Collins, V Peter; Eberhart, Charles; Figarella-Branger, Dominique; Fuller, Gregory N; Giangaspero, Felice; Giannini, Caterina; Hawkins, Cynthia; Kleihues, Paul; Korshunov, Andrey; Kros, Johan M; Beatriz Lopes, M; Ng, Ho-Keung; Ohgaki, Hiroko; Paulus, Werner; Pietsch, Torsten; Rosenblum, Marc; Rushing, Elisabeth; Soylemezoglu, Figen; Wiestler, Otmar; Wesseling, Pieter

2014-09-01

82

Canadian Society of Nephrology guidelines for the management of patients with ESRD treated with intensive hemodialysis.  

PubMed

Intensive (longer and more frequent) hemodialysis has emerged as an alternative to conventional hemodialysis for the treatment of patients with end-stage renal disease. However, given the differences in dialysis delivery and models of care associated with intensive dialysis, alternative approaches to patient management may be required. The purpose of this work was to develop a clinical practice guideline for the Canadian Society of Nephrology. We applied the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach for guideline development and performed targeted systematic reviews and meta-analysis (when appropriate) to address prioritized clinical management questions. We included studies addressing the treatment of patients with end-stage renal disease with short daily (?5 days per week, <3 hours per session), long (3-4 days per week, ?5.5 hours per session), or long-frequent (?5 days per week, ?5.5 hours per session) hemodialysis. We included clinical trials and observational studies with or without a control arm (1990 and later). Based on a prioritization exercise, 6 interventions of interest included optimal vascular access type, buttonhole cannulation, antimicrobial prophylaxis for buttonhole cannulation, closed connector devices, and dialysate calcium and dialysate phosphate additives for patients receiving intensive hemodialysis. We developed 6 recommendations addressing the interventions of interest. Overall quality of the evidence was very low and all recommendations were conditional. We provide detailed commentaries to guide in shared decision making. The main limitation was the very low overall quality of evidence that precluded strong recommendations. Most included studies were small single-arm observational studies. Three randomized controlled trials were applicable, but provided only indirect evidence. Published information for patient values and preference was lacking. In conclusion, we provide 6 recommendations for the practice of intensive hemodialysis. However, due to very low-quality evidence, all recommendations were conditional. We therefore also highlight priorities for future research. PMID:23566638

Nesrallah, Gihad E; Mustafa, Reem A; MacRae, Jennifer; Pauly, Robert P; Perkins, David N; Gangji, Azim; Rioux, Jean-Philippe; Steele, Andrew; Suri, Rita S; Chan, Christopher T; Copland, Michael; Komenda, Paul; McFarlane, Philip A; Pierratos, Andreas; Lindsay, Robert; Zimmerman, Deborah L

2013-07-01

83

European National Society Cardiovascular Journals Background, Rationale and Mission Statement of the \\  

Microsoft Academic Search

Cardiovascular scientific production in Europe is growing both in quantity and quality. Promoting high- quality research is a major goal of the European So- ciety of Cardiology (ESC) (1-3). The ESC has two highly respected official general journals, namely the \\

Ernst E. van der Wall; Anesti Kondili; Djamaleddine Nibouche; Karlen Adamyan; Kurt Huber; Hugo Ector; Izet Masic; Rumiana Tarnovska; Mario Ivanusa; Jørgen Videbæk; Mohamed Hamed; Alexandras Laucevicius; Pirjo Mustonen; Jean-Yves Artigou; Ariel Cohen; Mamanti Rogava; Michael Böhm; Eckart Fleck; Gerd Heusch; Rainer Klawki; Panos Vardas; Christodoulos Stefanadis; József Tenczer; Massimo Chiariello; Joseph Elias; Halima Benjelloun; Olaf Rødevand; Edvard Apetrei; Victor A. Lusov; Rafael G. Oganov; Velibor Obradovic; Gabriel Kamensky; Miran F. Kenda; Christer Höglund; Thomas F. Lüscher; René Lerch; Moufid Jokhadar; Habib Haouala; Vedat Sansoy; Valentin Shumakov; Adam Timmis

2008-01-01

84

Fractionation for Whole Breast Irradiation: An American Society for Radiation Oncology (ASTRO) Evidence-Based Guideline  

SciTech Connect

Purpose: In patients with early-stage breast cancer treated with breast-conserving surgery, randomized trials have found little difference in local control and survival outcomes between patients treated with conventionally fractionated (CF-) whole breast irradiation (WBI) and those receiving hypofractionated (HF)-WBI. However, it remains controversial whether these results apply to all subgroups of patients. We therefore developed an evidence-based guideline to provide direction for clinical practice. Methods and Materials: A task force authorized by the American Society for Radiation Oncology weighed evidence from a systematic literature review and produced the recommendations contained herein. Results: The majority of patients in randomized trials were aged 50 years or older, had disease Stage pT1-2 pN0, did not receive chemotherapy, and were treated with a radiation dose homogeneity within {+-}7% in the central axis plane. Such patients experienced equivalent outcomes with either HF-WBI or CF-WBI. Patients not meeting these criteria were relatively underrepresented, and few of the trials reported subgroup analyses. For patients not receiving a radiation boost, the task force favored a dose schedule of 42.5 Gy in 16 fractions when HF-WBI is planned. The task force also recommended that the heart should be excluded from the primary treatment fields (when HF-WBI is used) due to lingering uncertainty regarding late effects of HF-WBI on cardiac function. The task force could not agree on the appropriateness of a tumor bed boost in patients treated with HF-WBI. Conclusion: Data were sufficient to support the use of HF-WBI for patients with early-stage breast cancer who met all the aforementioned criteria. For other patients, the task force could not reach agreement either for or against the use of HF-WBI, which nevertheless should not be interpreted as a contraindication to its use.

Smith, Benjamin D., E-mail: bsmith3@mdanderson.org [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); Bentzen, Soren M. [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI (United States); Correa, Candace R. [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Hahn, Carol A. [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Hardenbergh, Patricia H. [Shaw Regional Cancer Center, Vail, CO (United States); Ibbott, Geoffrey S. [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States); McCormick, Beryl [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY (United States); McQueen, Julie R. [Oncology Patient Navigator, Duke Raleigh Cancer Center, Durham, NC (United States); Pierce, Lori J. [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Powell, Simon N. [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY (United States); Recht, Abram [Department of Radiation Oncology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA (Israel); Taghian, Alphonse G. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Vicini, Frank A. [Department of Radiation Oncology, Beaumont Cancer Institute, Royal Oak, MI (United States); White, Julia R. [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Haffty, Bruce G. [Department of Radiation Oncology, Cancer Institute of New Jersey, New Brunswick, NJ (United States)

2011-09-01

85

ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.  

PubMed

The American College of Cardiology Foundation along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical presentations for stable ischemic heart disease (SIHD) to consider use of stress testing and anatomic diagnostic procedures. This document reflects an updating of the prior Appropriate Use Criteria (AUC) published for radionuclide imaging (RNI), stress echocardiography (Echo), calcium scoring, coronary computed tomography angiography (CCTA), stress cardiac magnetic resonance (CMR), and invasive coronary angiography for SIHD. This is in keeping with the commitment to revise and refine the AUC on a frequent basis. A major innovation in this document is the rating of tests side by side for the same indication. The side-by-side rating removes any concerns about differences in indication or interpretation stemming from prior use of separate documents for each test. However, the ratings were explicitly not competitive rankings due to the limited availability of comparative evidence, patient variability, and range of capabilities available in any given local setting. The indications for this review are limited to the detection and risk assessment of SIHD and were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Eighty clinical scenarios were developed by a writing committee and scored by a separate rating panel on a scale of 1 to 9, to designate Appropriate, May Be Appropriate, or Rarely Appropriate use following a modified Delphi process following the recently updated AUC development methodology. The use of some modalities of testing in the initial evaluation of patients with symptoms representing ischemic equivalents, newly diagnosed heart failure, arrhythmias, and syncope was generally found to be Appropriate or May Be Appropriate, except in cases where low pre-test probability or low risk limited the benefit of most testing except exercise electrocardiogram (ECG). Testing for the evaluation of new or worsening symptoms following a prior test or procedure was found to be Appropriate. In addition, testing was found to be Appropriate or May Be Appropriate for patients within 90 days of an abnormal or uncertain prior result. Pre-operative testing was rated Appropriate or May Be Appropriate only for patients who had poor functional capacity and were undergoing vascular or intermediate risk surgery with 1 or more clinical risk factors or an organ transplant. The exercise ECG was suggested as an Appropriate test for cardiac rehabilitation clearance or for exercise prescription purposes. Testing in asymptomatic patients was generally found to be Rarely Appropriate, except for calcium scoring and exercise testing in intermediate and high-risk individuals and either stress or anatomic imaging in higher-risk individuals, which were all rated as May Be Appropriate. All modalities of follow-up testing after a prior test or percutaneous coronary intervention (PCI) within 2 years and within 5 years after coronary artery bypass graft (CABG) in the absence of new symptoms were rated Rarely Appropriate. Pre-operative testing for patients with good functional capacity, prior normal testing within 1 year, or prior to low-risk surgery also were found to be Rarely Appropriate. Imaging for an exercise prescription or prior to the initiation of cardiac rehabilitation was Rarely Appropriate except for cardiac rehabilitation clearance for heart failure patients. PMID:24355759

Wolk, Michael J; Bailey, Steven R; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Rosenbaum, Lisa; Shaw, Leslee J; Stainback, Raymond F; Allen, Joseph M

2014-02-01

86

ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.  

PubMed

The American College of Cardiology Foundation along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical presentations for stable ischemic heart disease (SIHD) to consider use of stress testing and anatomic diagnostic procedures. This document reflects an updating of the prior Appropriate Use Criteria (AUC) published for radionuclide imaging (RNI), stress echocardiography (Echo), calcium scoring, coronary computed tomography angiography (CCTA), stress cardiac magnetic resonance (CMR), and invasive coronary angiography for SIHD. This is in keeping with the commitment to revise and refine the AUC on a frequent basis. A major innovation in this document is the rating of tests side by side for the same indication. The side-by-side rating removes any concerns about differences in indication or interpretation stemming from prior use of separate documents for each test. However, the ratings were explicitly not competitive rankings due to the limited availability of comparative evidence, patient variability, and range of capabilities available in any given local setting. The indications for this review are limited to the detection and risk assessment of SIHD and were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Eighty clinical scenarios were developed by a writing committee and scored by a separate rating panel on a scale of 1-9, to designate Appropriate, May Be Appropriate, or Rarely Appropriate use following a modified Delphi process following the recently updated AUC development methodology. The use of some modalities of testing in the initial evaluation of patients with symptoms representing ischemic equivalents, newly diagnosed heart failure, arrhythmias, and syncope was generally found to be Appropriate or May Be Appropriate, except in cases where low pre-test probability or low risk limited the benefit of most testing except exercise electrocardiogram (ECG). Testing for the evaluation of new or worsening symptoms following a prior test or procedure was found to be Appropriate. In addition, testing was found to be Appropriate or May Be Appropriate for patients within 90 days of an abnormal or uncertain prior result. Pre-operative testing was rated Appropriate or May Be Appropriate only for patients who had poor functional capacity and were undergoing vascular or intermediate risk surgery with 1 or more clinical risk factors or an organ transplant. The exercise ECG was suggested as an Appropriate test for cardiac rehabilitation clearance or for exercise prescription purposes. Testing in asymptomatic patients was generally found to be Rarely Appropriate, except for calcium scoring and exercise testing in intermediate and high-risk individuals and either stress or anatomic imaging in higher-risk individuals, which were all rated as May Be Appropriate. All modalities of follow-up testing after a prior test or percutaneous coronary intervention (PCI) within 2 years and within 5 years after coronary artery bypass graft (CABG) in the absence of new symptoms were rated Rarely Appropriate. Pre-operative testing for patients with good functional capacity, prior normal testing within 1 year, or prior to low-risk surgery also were found to be Rarely Appropriate. Imaging for an exercise prescription or prior to the initiation of cardiac rehabilitation was Rarely Appropriate except for cardiac rehabilitation clearance for heart failure patients. PMID:24374980

Ronan, Grace; Wolk, Michael J; Bailey, Steven R; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Rosenbaum, Lisa; Shaw, Leslee J; Stainback, Raymond F; Allen, Joseph M; Brindis, Ralph G; Kramer, Christopher M; Shaw, Leslee J; Cerqueira, Manuel D; Chen, Jersey; Dean, Larry S; Fazel, Reza; Hundley, W Gregory; Itchhaporia, Dipti; Kligfield, Paul; Lockwood, Richard; Marine, Joseph Edward; McCully, Robert Benjamin; Messer, Joseph V; O'Gara, Patrick T; Shemin, Richard J; Wann, L Samuel; Wong, John B; Patel, Manesh R; Kramer, Christopher M; Bailey, Steven R; Brown, Alan S; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Lindsay, Bruce D; Min, James K; Shaw, Leslee J; Stainback, Raymond F; Wann, L Samuel; Wolk, Michael J; Allen, Joseph M

2014-02-01

87

Emergency management of community-acquired bacterial pneumonia: what is new since the 2007 Infectious Diseases Society of America/American Thoracic Society guidelines.  

PubMed

Community-acquired pneumonia (CAP) is a major health problem in the United States and is associated with substantial morbidity, mortality, and health care costs. Patients with CAP commonly present to emergency departments where physicians must make critical decisions regarding diagnosis and management of pneumonia in a timely fashion, with emphasis on efficient and cost-effective diagnostic choices, consideration of emerging antimicrobial resistance, timely initiation of antibiotics, and appropriate site-of-care decisions. In light of the burden that pneumonia places on health care systems and the emergency department in particular, this article reviews significant developments in the management of CAP in the United States 5 years since the publication of the 2007 Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of CAP in adults, focusing on recent studies and recommendations for managing CAP, the primary bacterial pathogens responsible for CAP, and trends in resistance, new diagnostic technologies, and newer antimicrobials approved for the treatment of CAP. These new data and additional guidelines pertaining to the treatment of CAP further our knowledge and understanding of this challenging infection. Furthermore, appreciation of the availability of new diagnostic testing and therapeutic options will help meet the demand for improved management of CAP. PMID:23380120

Moran, Gregory J; Rothman, Richard E; Volturo, Gregory A

2013-03-01

88

Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.  

PubMed

This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). This Guideline was also reviewed and endorsed by the Governing Board of the American Society for Gastrointestinal Endoscopy (ASGE). 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 The following recommendations should only be applied after a thorough diagnostic evaluation including a contrast-enhanced computed tomography (CT) scan. 1 Prophylactic colonic stent placement is not recommended. Colonic stenting should be reserved for patients with clinical symptoms and imaging evidence of malignant large-bowel obstruction, without signs of perforation (strong recommendation, low quality evidence). 2 Colonic self-expandable metal stent (SEMS) placement as a bridge to elective surgery is not recommended as a standard treatment of symptomatic left-sided malignant colonic obstruction (strong recommendation, high quality evidence). 3 For patients with potentially curable but obstructing left-sided colonic cancer, stent placement may be considered as an alternative to emergency surgery in those who have an increased risk of postoperative mortality, i.?e. American Society of Anesthesiologists (ASA) Physical Status???III and/or age?>?70 years (weak recommendation, low quality evidence). 4 SEMS placement is recommended as the preferred treatment for palliation of malignant colonic obstruction (strong recommendation, high quality evidence), except in patients treated or considered for treatment with antiangiogenic drugs (e.?g. bevacizumab) (strong recommendation, low quality evidence). PMID:25325682

van Hooft, Jeanin E; van Halsema, Emo E; Vanbiervliet, Geoffroy; Beets-Tan, Regina G H; DeWitt, John M; Donnellan, Fergal; Dumonceau, Jean-Marc; Glynne-Jones, Robert G T; Hassan, Cesare; Jiménez-Perez, Javier; Meisner, Søren; Muthusamy, V Raman; Parker, Michael C; Regimbeau, Jean-Marc; Sabbagh, Charles; Sagar, Jayesh; Tanis, Pieter J; Vandervoort, Jo; Webster, George J; Manes, Gianpiero; Barthet, Marc A; Repici, Alessandro

2014-10-01

89

An Update of the International Society of Sexual Medicine's Guidelines for the Diagnosis and Treatment of Premature Ejaculation (PE)  

PubMed Central

Introduction In 2009, the International Society for Sexual Medicine (ISSM) convened a select panel of experts to develop an evidence-based set of guidelines for patients suffering from lifelong premature ejaculation (PE). That document reviewed definitions, etiology, impact on the patient and partner, assessment, and pharmacological, psychological, and combined treatments. It concluded by recognizing the continually evolving nature of clinical research and recommended a subsequent guideline review and revision every fourth year. Consistent with that recommendation, the ISSM organized a second multidisciplinary panel of experts in April 2013, which met for 2 days in Bangalore, India. This manuscript updates the previous guidelines and reports on the recommendations of the panel of experts. Aim The aim of this study was to develop clearly worded, practical, evidenced-based recommendations for the diagnosis and treatment of PE for family practice clinicians as well as sexual medicine experts. Method A comprehensive literature review was performed. Results This article contains the report of the second ISSM PE Guidelines Committee. It offers a new unified definition of PE and updates the previous treatment recommendations. Brief assessment procedures are delineated, and validated diagnostic and treatment questionnaires are reviewed. Finally, the best practices treatment recommendations are presented to guide clinicians, both familiar and unfamiliar with PE, in facilitating treatment of their patients. Conclusion Development of guidelines is an evolutionary process that continually reviews data and incorporates the best new research. We expect that ongoing research will lead to a more complete understanding of the pathophysiology as well as new efficacious and safe treatments for this sexual dysfunction. We again recommend that these guidelines be reevaluated and updated by the ISSM in 4 years. Althof SE, McMahon CG, Waldinger MD, Serefoglu EC, Shindel AW, Adaikan PG, Becher E, Dean J, Giuliano F, Hellstrom WJG, Giraldi A, Glina S, Incrocci L, Jannini E, McCabe M, Parish S, Rowland D, Segraves RT, Sharlip I, and Torres LO. An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation (PE). Sex Med 2014;2:60–90. PMID:25356302

Althof, Stanley E; McMahon, Chris G; Waldinger, Marcel D; Serefoglu, Ege Can; Shindel, Alan W; Adaikan, P Ganesan; Becher, Edgardo; Dean, John; Giuliano, Francois; Hellstrom, Wayne JG; Giraldi, Annamaria; Glina, Sidney; Incrocci, Luca; Jannini, Emmanuele; McCabe, Marita; Parish, Sharon; Rowland, David; Segraves, R Taylor; Sharlip, Ira; Torres, Luiz Otavio

2014-01-01

90

Adjuvant and Salvage Radiation Therapy After Prostatectomy: American Society for Radiation Oncology/American Urological Association Guidelines  

SciTech Connect

Purpose: The purpose of this guideline was to provide a clinical framework for the use of radiation therapy after radical prostatectomy as adjuvant or salvage therapy. Methods and Materials: A systematic literature review using PubMed, Embase, and Cochrane database was conducted to identify peer-reviewed publications relevant to the use of radiation therapy after prostatectomy. The review yielded 294 articles; these publications were used to create the evidence-based guideline statements. Additional guidance is provided as Clinical Principles when insufficient evidence existed. Results: Guideline statements are provided for patient counseling, use of radiation therapy in the adjuvant and salvage contexts, defining biochemical recurrence, and conducting a restaging evaluation. Conclusions: Physicians should offer adjuvant radiation therapy to patients with adverse pathologic findings at prostatectomy (ie, seminal vesicle invastion, positive surgical margins, extraprostatic extension) and salvage radiation therapy to patients with prostate-specific antigen (PSA) or local recurrence after prostatectomy in whom there is no evidence of distant metastatic disease. The offer of radiation therapy should be made in the context of a thoughtful discussion of possible short- and long-term side effects of radiation therapy as well as the potential benefits of preventing recurrence. The decision to administer radiation therapy should be made by the patient and the multidisciplinary treatment team with full consideration of the patient's history, values, preferences, quality of life, and functional status. The American Society for Radiation Oncology and American Urological Association websites show this guideline in its entirety, including the full literature review.

Valicenti, Richard K., E-mail: Richard.valicenti@ucdmc.ucdavis.edu [Department of Radiation Oncology, University of California, Davis School of Medicine, Davis, California (United States); Thompson, Ian [Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas (United States); Albertsen, Peter [Division of Urology, University of Connecticut Health Center, Farmington, Connecticut (United States); Davis, Brian J. [Department of Radiation Oncology, Mayo Medical School, Rochester, Minnesota (United States); Goldenberg, S. Larry [Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia (Canada); Wolf, J. Stuart [Department of Urology, University of Michigan, Ann Arbor, Michigan (United States); Sartor, Oliver [Department of Medicine and Urology, Tulane Medical School, New Orleans, Louisiana (United States); Klein, Eric [Glickman Urological Kidney Institute, Cleveland Clinic, Cleveland, Ohio (United States); Hahn, Carol [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Michalski, Jeff [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri (United States); Roach, Mack [Department of Radiation Oncology, University of California, San Francisco, San Francisco, California (United States); Faraday, Martha M. [Four Oaks, Inc (United States)

2013-08-01

91

Cardiological Society of India Practice Guidelines for Angiography in Patients with Renal Dysfunction  

PubMed Central

Preamble The potential risk of contrast-induced acute kidney injury (CI-AKI) has made utilization of coronary angiography in the work-up for the diagnosis of coronary artery disease in CKD quite low.1 This is in contrast to increasing prevalence and severity of CAD as the serum creatinine rises.2 In fact most CKD patients will succumb to CAD and not to ESRD.3 Thus the judicious use of CAG/PCI in this setting is of prime importance but underused. The CSI began to develop guidelines for Indian context as most guidelines are those developed by ACC/AHA or ESC. The aim was to assist the physicians in selecting the best management strategy for an individual patient under his care based on an expert committee who would review the current data and write the guidelines with relevance to the Indian context. The guidelines were developed initially in June 2010 as an initiative of Delhi CSI. Three interventional cardiologist (SB, AS, KKS), one nephrologist (SCT) and two clinical cardiologists (ST, RG) along with Dr. Roxana Mehran (New York) and Dr. Peter McCullough (Missouri), U.S.A.; were involved in a three-way teleconference to discuss/debate the data. This was presented by SB, and over the next two hours each data subset was debated/agreed/deleted and this resulted in the “Guidelines for CAG in Renal Dysfunction Patients”. These were then written and re- circulated to all for final comments. Further, these guidelines were updated and additional Task Force Members nominated by Central CSI were involved in the formation of the final CSI Guidelines. Both (Roxana Mehran and Peter McCullough) reviewed these updated Guidelines in October 2012 and after incorporating the views of all the Task Force members—the final format is as it is presented in this final document. PMID:23186627

Bhandari, S.; Seth, A.; Sethi, K.K.; Tyagi, S.; Gupta, R.; Tiwari, S.C.; Mehrotra, S.; Seth, Ashok; Guha, Santanu; Deb, P.K.; Dasbiswas, Arup; Mohanan, P.P.; Venugopal, K.; Sinha, Nakul; Pinto, Brian; Banerjee, Amal; Sengottuvelu, G.; Mehran, Roxana; Collough, Peter Mc

2012-01-01

92

Adherence to American society of health-system pharmacists surgical antibiotic prophylaxis guidelines in a teaching hospital  

PubMed Central

Objective: Surgical site infections are the second most common type of adverse events occurring in hospitalized patients, whereas an estimated 40-60% of these infections are thought to be preventable. Choice of regimen, administration timing or duration of antibiotic prophylaxis is reported to be inappropriate in approximately 25-50% of cases. We tried to evaluate an antibiotic administration pattern for surgical antibiotic prophylaxis in a teaching hospital. Methods: This study was conducted at the general surgery and orthopedic wards of a teaching hospital affiliated with Mazandaran University of Medical Sciences. The medical records of admitted patients who underwent different surgical procedures were reviewed. Compliance was assessed with the recommendations of the American Society of Health-System Pharmacists' guidelines for every aspect of antibiotic prophylaxis. All data were coded and analyzed by SPSS16 software using Student's t-test and Chi-square test. Findings: During 1 year, 759 patients who underwent different surgeries were included in the study. Mean age of patients was 32.02 ± 18.79 years. Hand and foot fractures repair were the most frequent surgery types. About 56.4% of administered prophylactic antibiotics were in accordance with the American Society of Health System Pharmacists (ASHP) guidelines regarding prophylaxis indication. The most commonly antibiotic used was cefazolin and antibiotic choices were appropriate in 104 of 168 surgical procedures (62%). Gentamicin, metronidazole and ceftriaxone were the most frequently antibiotics that used inappropriately. Only in 100 of 168 procedures, duration was concordant with the ASHP guideline, whereas in 68 procedures, duration was longer than recommended time. In 98 procedures, the dose was lower and in one procedure, it was higher than recommended doses. Conclusion: Although such guidelines have been in place for many years, studies showed that much inappropriate antibiotic use as prophylaxis and poor adherence to guidelines are still major issues. It is essential for surgeons to be aware to consider the best antibiotic choices, dose and duration based on reliable guidelines for antibiotic prophylaxis. PMID:25114939

Rafati, Mohammadreza; Shiva, Afshin; Ahmadi, Amirhosein; Habibi, Omran

2014-01-01

93

Building bridges: the American Heart Association–European Society of Cardiology's International Nursing Collaboration  

Microsoft Academic Search

This paper described the formal collaboration between the American Heart Association's Council on Cardiovascular Nursing and the European Society of Cardiology's Working Group on Cardiovascular Nursing. This collaboration comprises following dimensions: (1) further expansion on collaboration on annual conferences; (2) development of mentoring initiatives; (3) initiation of research collaboration; (4) development of joint guidelines; and (5) appointment of liaison persons

Sabina De Geest; Sandra Dunbar; Erika Froelicher; Kathleen Grady; Laura Hayman; Tiny Jaarsma; Anna Strömberg

2003-01-01

94

Use of the Food Guide Pyramid and US Dietary Guidelines to Improve Dietary Intake and Reduce Cardiovascular Risk in Active-Duty Air Force Members  

Microsoft Academic Search

Objective To determine whether adoption of dietary patterns consistent with the US Dietary Guidelines for Americans and the Food Guide Pyramid, combined with exercise training, result in significant reductions in cardiovascular risk compared with a regimen of exercise therapy alone.Design A randomized trial to compare the effects of exercise alone (n=17) with the effects of exercise and dietary intervention (n=15).Setting

Capt PATRICIA J GAMBERA; BARBARA O SCHNEEMAN; PAUL A DAVIS

1995-01-01

95

[Review of the new treatment guideline for major depressive disorder by the Japanese Society of Mood Disorders].  

PubMed

The Japanese Society of Mood Disorders (JSMD) published the "Treatment Guideline II: Major Depressive Disorder, 2012 Ver. 1" on July 26, 2012. This guideline (GL) is the first one published by an academic society in Japan. Presently in Japan, many people have depressive symptoms, and the socioeconomic loss (suicide, absence from work, etc.) induced by this condition cannot be overlooked. Although the Japanese society, including mass media and psychiatrists, has attempted to solve this public problem, a solution has not been found. JSMD regarded diagnosis and psychiatric management of depression, among other factors, as the key to solving this problem. For example, patients who meet the DSM-IV major depressive disorder (MDD) criteria still have numerous subtypes, and they often have other psychiatric comorbidities that a diagnosis of MDD alone cannot detect. Although the process for differential diagnosis and treatment planning is indispensable, its methodology has not been necessarily shared even among psychiatrists until today. In this GL, considering the research evidence and its limitations, JSMD suggests necessary steps for appropriate information intake, diagnosis, therapeutic alliance formation, psychoeducation, and treatment modality choice in every phase (acute and continuation/maintenance). This GL also considers pharmaco-, psycho-, and electroconvulsive therapy for major depressive subtypes (mild, moderate/severe, and psychotic). Simultaneously, psychiatrists are required to be alert to the risk from diffuse and multiple prescription of benzodiazepine receptor agonists (dependence, deterioration of sleep apnea, cognitive decline, paradoxical reaction, etc.), especially barbiturates. This GL will be revised on the basis of public comments, including criticism. In the future, treatment GLs for comorbid patients, return-to-work cases, primary care physicians, psychiatric residents, and patients with depressions other than MDD (subthreshold depression, dysthymic disorder, and adaptation disorder) may be needed. PMID:23037606

Ogasawara, Kazuyoshi; Ozaki, Norio

2012-10-01

96

[Training and accreditation in cardiovascular magnetic resonance imaging: a position paper of the Working Group on Magnetic Resonance Imaging of the Italian Society of Cardiology and of the Working Group on Cardiovascular Imaging of the Italian Association of Hospital Cardiologists].  

PubMed

Cardiovascular magnetic resonance (CMR) imaging has become an established imaging modality requiring the definition of standards for data acquisition, reporting and training, recently addressed by a position statement of the Working Group on Cardiovascular Magnetic Resonance of the European Society of Cardiology (ESC). Taking into account the particular difficulties related to CMR implementation in our country, the Working Group on CMR of the Italian Society of Cardiology and the Working Group on Cardiovascular Imaging of the Italian Association of Hospital Cardiologists have prepared this document with the aim to address the logistic, cultural and training problems inhibiting CMR dissemination. The present paper provides recommendations for the inclusion in the School of Cardiology training curriculum of CMR training as suggested by the ESC training curriculum as well as recommendations concerning cardiovascular and radiological training for certification in CMR. The proposal for the institutional accreditation is discussed, including recommendations for case-load, case-mix, structured training programs, and safety of CMR studies. PMID:22322556

Roghi, Alberto; Dellegrottaglie, Santo; Perna, Gian Piero

2012-02-01

97

Endocrine treatment of transsexual persons: an Endocrine Society Clinical Practice Guideline: commentary from a European perspective.  

PubMed

The treatment of transsexual subjects is a challenging task for the endocrinologist who, in collaboration with the mental health professional and the surgeon, is called upon to confirm the diagnosis and adjust hormonal treatment aimed at suppressing endogenous sex hormones and to develop hormone characteristics of the desired gender. These guidelines are structured to provide evidence-based suggestions or, where evidence is lacking, expert recommendations on diagnostic procedures and hormonal treatment in adolescent and adult transsexuals, including long-term care and eligibility for surgery. The multidisciplinary approach to treatment, the additional diagnostic role of hormone administration and the need to maintain hormone levels within the physiological range are key suggestions stressed in the guidelines which are particularly important for an endocrinologist unfamiliar with this field. The need for psychological assessment before surgery is not common in many countries and should be stressed further in the guidelines. Some important issues such as time and method of hormone withdrawal before surgery together with when and which hormones should be administered after sex reassignment surgery has been completed also remain unclear. These guidelines represent a pivotal document for endocrinologists setting a standard for the care of transsexuals and providing directions for future research. PMID:20150325

Meriggiola, M C; Jannini, E A; Lenzi, A; Maggi, M; Manieri, C

2010-05-01

98

Saudi oncology society and Saudi urology association combined clinical management guidelines for prostate cancer  

PubMed Central

In this report, updated guidelines for the evaluation, medical, and surgical management of prostate cancer are presented. They are categorized according the stage of the disease using the tumor node metastasis staging system 7th edition. The recommendations are presented with supporting evidence level. PMID:25371601

Alkhateeb, Sultan; Abusamra, Ashraf; Rabah, Danny; Alotaibi, Mohammed; Mahmood, Rana; Almansour, Mubarak; Murshid, Esam; Alsharm, Abdullah; Alolayan, Ashwaq; Ahmad, Imran; Alkushi, Hussain; Alghamdi, Abdullah; Bazarbashi, Shouki

2014-01-01

99

Cardiac surgery in Germany during 2013: a report on behalf of the German Society for Thoracic and Cardiovascular Surgery.  

PubMed

On the basis of a voluntary registry of the German Society for Thoracic and Cardiovascular Surgery (GSTCVS), data of all cardiac surgical procedures performed in 79 German cardiac surgical units during the year 2013 are presented. In 2013, a total of 99,128 cardiac surgical procedures (implantable cardioverter defibrillator [ICD] and pacemaker procedures excluded) were submitted to the registry. More than 13.8% of the patients were older than 80 years, which remains equal in comparison to the previous year. In-hospital mortality in 40,410 isolated coronary artery bypass grafting procedures (84.5% on-pump and 15.5% off-pump) was 2.9%. In 29,672 isolated valve procedures (including 7,722 catheter-based procedures), an in-hospital mortality of 4.7% was observed. This long-lasting registry of the GSTCVS will continue to be an important tool for quality control and voluntary public reporting by illustrating current facts and developments of cardiac surgery in Germany. PMID:24995534

Funkat, A; Beckmann, A; Lewandowski, J; Frie, M; Ernst, M; Schiller, W; Gummert, J F; Cremer, J

2014-08-01

100

Value of American Thoracic Society Guidelines in Predicting Infection or Colonization with Multidrug-Resistant Organisms in Critically Ill Patients  

PubMed Central

Background The incidence rate of infection by multidrug-resistant organisms (MDROs) can affect the accuracy of etiological diagnosis when using American Thoracic Society (ATS) guidelines. We determined the accuracy of the ATS guidelines in predicting infection or colonization by MDROs over 18 months at a single ICU in eastern China. Methods This prospective observational study examined consecutive patients who were admitted to an intensive care unit (ICU) in Nanjing, China. MDROs were defined as bacteria that were resistant to at least three antimicrobial classes, such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Pseudomonas aeruginosa, Acinetobacter baumannii. Screening for MDROs was performed at ICU admission and discharge. Risk factors for infection or colonization with MDROs were recorded, and the accuracy of the ATS guidelines in predicting infection or colonization with MDROs was documented. Results There were 610 patients, 225 (37%) of whom were colonized or infected with MDROs at ICU admission, and this increased to 311 (51%) at discharge. At admission, the sensitivity (70.0%), specificity (31.6%), positive predictive value (38.2%), and negative predictive value (63.5%), all based on ATS guidelines for infection or colonization with MDROs were low. The negative predictive value was greater in patients from departments with MDRO infection rates of 31–40% than in patients from departments with MDRO infection rates of 30% or less and from departments with MDRO infection rates more than 40%. Conclusion ATS criteria were not reliable in predicting infection or colonization with MDROs in our ICU. The negative predictive value was greater in patients from departments with intermediate rates of MDRO infection than in patients from departments with low or high rates of MDRO infection. Trial Registration ClinicalTrials.gov NCT01667991 PMID:24647408

Huang, Yingzi; Mo, Min; Guo, Fengmei; Yang, Yi; Qiu, Haibo

2014-01-01

101

British Society of Gastroenterology guidelines on the diagnosis and management of Barrett's oesophagus.  

PubMed

These guidelines provide a practical and evidence-based resource for the management of patients with Barrett's oesophagus and related early neoplasia. The Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was followed to provide a methodological strategy for the guideline development. A systematic review of the literature was performed for English language articles published up until December 2012 in order to address controversial issues in Barrett's oesophagus including definition, screening and diagnosis, surveillance, pathological grading for dysplasia, management of dysplasia, and early cancer including training requirements. The rigour and quality of the studies was evaluated using the SIGN checklist system. Recommendations on each topic were scored by each author using a five-tier system (A+, strong agreement, to D+, strongly disagree). Statements that failed to reach substantial agreement among authors, defined as >80% agreement (A or A+), were revisited and modified until substantial agreement (>80%) was reached. In formulating these guidelines, we took into consideration benefits and risks for the population and national health system, as well as patient perspectives. For the first time, we have suggested stratification of patients according to their estimated cancer risk based on clinical and histopathological criteria. In order to improve communication between clinicians, we recommend the use of minimum datasets for reporting endoscopic and pathological findings. We advocate endoscopic therapy for high-grade dysplasia and early cancer, which should be performed in high-volume centres. We hope that these guidelines will standardise and improve management for patients with Barrett's oesophagus and related neoplasia. PMID:24165758

Fitzgerald, Rebecca C; di Pietro, Massimiliano; Ragunath, Krish; Ang, Yeng; Kang, Jin-Yong; Watson, Peter; Trudgill, Nigel; Patel, Praful; Kaye, Philip V; Sanders, Scott; O'Donovan, Maria; Bird-Lieberman, Elizabeth; Bhandari, Pradeep; Jankowski, Janusz A; Attwood, Stephen; Parsons, Simon L; Loft, Duncan; Lagergren, Jesper; Moayyedi, Paul; Lyratzopoulos, Georgios; de Caestecker, John

2014-01-01

102

Adherence to the European Society of Cardiology (ESC) guidelines for chronic heart failure - A national survey of the cardiologists in Pakistan  

PubMed Central

Background The aims of this study were to evaluate the awareness of and attitudes towards the 2005 European Society of Cardiology (ESC) guidelines for Heart Failure (HF) of the cardiologists in Pakistan and assess barriers to adherence to guidelines. Methods A cross-sectional survey was conducted in person from March to July 2009 to all cardiologists practicing in 4 major cities in Pakistan (Karachi, Lahore, Quetta and Peshawar). A validated, semi-structured questionnaire assessing ESC 2005 Guidelines for HF was used to obtain information from cardiologists. It included questions about awareness and relevance of HF guidelines (See Additional File 1). Respondents' management choices were compared with those of an expert panel based on the guidelines for three fictitious patient cases. Cardiologists were also asked about major barriers to adherence to guidelines. Results A total of 372 cardiologists were approached; 305 consented to participate (overall response rate, 82.0%). The survey showed a very high awareness of CHF guidelines; 97.4% aware of any guideline. About 13.8% considered ESC guidelines as relevant or very relevant for guiding treatment decisions while 92.8% chose AHA guidelines in relevance. 87.2% of respondents perceived that they adhered to the HF guidelines. For the patient cases, the proportions of respondents who made recommendations that completely matched those of the guidelines were 7% (Scenario 1), 0% (Scenario 2) and 20% (Scenario 3). Respondents considered patient compliance (59%) and cost/health economics (50%) as major barriers to guideline implementation. Conclusion We found important self reported departures from recommended HF management guidelines among cardiologists of Pakistan. PMID:22093082

2011-01-01

103

Canadian Cardiovascular Society 2009 Consensus Conference on the management of adults with congenital heart disease: Outflow tract obstruction, coarctation of the aorta, tetralogy of Fallot, Ebstein anomaly and Marfan's syndrome  

PubMed Central

With advances in pediatric cardiology and cardiac surgery, the population of adults with congenital heart disease (CHD) has increased. In the current era, there are more adults with CHD than children. This population has many unique issues and needs. Since the 2001 Canadian Cardiovascular Society Consensus Conference report on the management of adults with CHD, there have been significant advances in the field of adult CHD. Therefore, new clinical guidelines have been written by Canadian adult CHD physicians in collaboration with an international panel of experts in the field. Part II of the guidelines includes recommendations for the care of patients with left ventricular outflow tract obstruction and bicuspid aortic valve disease, coarctation of the aorta, right ventricular outflow tract obstruction, tetralogy of Fallot, Ebstein anomaly and Marfan’s syndrome. Topics addressed include genetics, clinical outcomes, recommended diagnostic workup, surgical and interventional options, treatment of arrhythmias, assessment of pregnancy risk and follow-up requirements. The complete document consists of four manuscripts that are published online in the present issue of The Canadian Journal of Cardiology. The complete document and references can also be found at www.ccs.ca or www.cachnet.org. PMID:20352138

Silversides, Candice K; Beauchesne, Luc; Bradley, Timothy; Connelly, Michael; Niwa, Koichiro; Mulder, Barbara; Webb, Gary; Colman, Jack; Therrien, Judith

2010-01-01

104

Copyright 2006 American Chemical Society 1 Ethical Guidelines to Publication of Chemical Research  

E-print Network

from the Society's definition of the scope of the journal and from the editor's perception of standards to the whole scientific enterprise that a definition of those standards should be brought to the attention for publication, judging each on its merits without regard to race, religion, nationality, sex, seniority

Chatterjee, Avik P.

105

The Information and Knowledge Society: Analysis of guidelines in the Algarve  

Microsoft Academic Search

The Information and Communication Technologies (ICT) play a crucial role in the world today. Globalization as we know it and the emergence of so-called Information and Knowledge Society are the direct consequence of radical technological innovations that led to the development of the Internet and revolutionized the dominant paradigm for accelerating the flow and increasing the intensity of contacts and

Hugo Pinto; Tiago Santos

2006-01-01

106

Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America.  

PubMed

A panel of national experts was convened by the Infectious Diseases Society of America (IDSA) to update the 2005 guidelines for the treatment of skin and soft tissue infections (SSTIs). The panel's recommendations were developed to be concordant with the recently published IDSA guidelines for the treatment of methicillin-resistant Staphylococcus aureus infections. The focus of this guideline is the diagnosis and appropriate treatment of diverse SSTIs ranging from minor superficial infections to life-threatening infections such as necrotizing fasciitis. In addition, because of an increasing number of immunocompromised hosts worldwide, the guideline addresses the wide array of SSTIs that occur in this population. These guidelines emphasize the importance of clinical skills in promptly diagnosing SSTIs, identifying the pathogen, and administering effective treatments in a timely fashion. PMID:24947530

Stevens, Dennis L; Bisno, Alan L; Chambers, Henry F; Dellinger, E Patchen; Goldstein, Ellie J C; Gorbach, Sherwood L; Hirschmann, Jan V; Kaplan, Sheldon L; Montoya, Jose G; Wade, James C

2014-07-15

107

Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America.  

PubMed

A panel of national experts was convened by the Infectious Diseases Society of America (IDSA) to update the 2005 guidelines for the treatment of skin and soft tissue infections (SSTIs). The panel's recommendations were developed to be concordant with the recently published IDSA guidelines for the treatment of methicillin-resistant Staphylococcus aureus infections. The focus of this guideline is the diagnosis and appropriate treatment of diverse SSTIs ranging from minor superficial infections to life-threatening infections such as necrotizing fasciitis. In addition, because of an increasing number of immunocompromised hosts worldwide, the guideline addresses the wide array of SSTIs that occur in this population. These guidelines emphasize the importance of clinical skills in promptly diagnosing SSTIs, identifying the pathogen, and administering effective treatments in a timely fashion. PMID:24973422

Stevens, Dennis L; Bisno, Alan L; Chambers, Henry F; Dellinger, E Patchen; Goldstein, Ellie J C; Gorbach, Sherwood L; Hirschmann, Jan V; Kaplan, Sheldon L; Montoya, Jose G; Wade, James C

2014-07-15

108

Guidelines on genetic evaluation and management of Lynch syndrome: a consensus statement by the US Multi-society Task Force on colorectal cancer.  

PubMed

The Multi-Society Task Force, in collaboration with invited experts, developed guidelines to assist health care providers with the appropriate provision of genetic testing and management of patients at risk for and affected with Lynch syndrome as follows: Figure 1 provides a colorectal cancer risk assessment tool to screen individuals in the office or endoscopy setting; Figure 2 illustrates a strategy for universal screening for Lynch syndrome by tumor testing of patients diagnosed with colorectal cancer; Figures 3,4,5,6 provide algorithms for genetic evaluation of affected and at-risk family members of pedigrees with Lynch syndrome; Table 10 provides guidelines for screening at-risk and affected persons with Lynch syndrome; and Table 12 lists the guidelines for the management of patients with Lynch syndrome. A detailed explanation of Lynch syndrome and the methodology utilized to derive these guidelines, as well as an explanation of, and supporting literature for, these guidelines are provided. PMID:25070057

Giardiello, Francis M; Allen, John I; Axilbund, Jennifer E; Boland, C Richard; Burke, Carol A; Burt, Randall W; Church, James M; Dominitz, Jason A; Johnson, David A; Kaltenbach, Tonya; Levin, Theodore R; Lieberman, David A; Robertson, Douglas J; Syngal, Sapna; Rex, Douglas K

2014-08-01

109

American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity.  

PubMed

The American Cancer Society (ACS) publishes Nutrition and Physical Activity Guidelines to serve as a foundation for its communication, policy, and community strategies and, ultimately, to affect dietary and physical activity patterns among Americans. These Guidelines, published approximately every 5 years, are developed by a national panel of experts in cancer research, prevention, epidemiology, public health, and policy, and they reflect the most current scientific evidence related to dietary and activity patterns and cancer risk. The ACS Guidelines focus on recommendations for individual choices regarding diet and physical activity patterns, but those choices occur within a community context that either facilitates or creates barriers to healthy behaviors. Therefore, this committee presents recommendations for community action to accompany the 4 recommendations for individual choices to reduce cancer risk. These recommendations for community action recognize that a supportive social and physical environment is indispensable if individuals at all levels of society are to have genuine opportunities to choose healthy behaviors. The ACS Guidelines are consistent with guidelines from the American Heart Association and the American Diabetes Association for the prevention of coronary heart disease and diabetes, as well as for general health promotion, as defined by the 2010 Dietary Guidelines for Americans and the 2008 Physical Activity Guidelines for Americans. PMID:22237782

Kushi, Lawrence H; Doyle, Colleen; McCullough, Marji; Rock, Cheryl L; Demark-Wahnefried, Wendy; Bandera, Elisa V; Gapstur, Susan; Patel, Alpa V; Andrews, Kimberly; Gansler, Ted

2012-01-01

110

Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline.  

PubMed

This is an official guideline of the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR). It addresses the clinical indications for the use of computed tomographic colonography (CTC). A targeted literature search was performed to evaluate the evidence supporting the use of CTC. 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 1 ESGE/ESGAR recommend computed tomographic colonography (CTC) as the radiological examination of choice for the diagnosis of colorectal neoplasia. ESGE/ESGAR do not recommend barium enema in this setting (strong recommendation, high quality evidence). 2 ESGE/ESGAR recommend CTC, preferably the same or next day, if colonoscopy is incomplete. Delay of CTC should be considered following endoscopic resection. In the case of obstructing colorectal cancer, preoperative contrast-enhanced CTC may also allow location or staging of malignant lesions (strong recommendation, moderate quality evidence). 3 When endoscopy is contraindicated or not possible, ESGE/ESGAR recommend CTC as an acceptable and equally sensitive alternative for patients with symptoms suggestive of colorectal cancer (strong recommendation, high quality evidence). 4 ESGE/ESGAR recommend referral for endoscopic polypectomy in patients with at least one polyp???6?mm in diameter detected at CTC. CTC surveillance may be clinically considered if patients do not undergo polypectomy (strong recommendation, moderate quality evidence). 5 ESGE/ESGAR do not recommend CTC as a primary test for population screening or in individuals with a positive first-degree family history of colorectal cancer (CRC). However, it may be proposed as a CRC screening test on an individual basis providing the screenee is adequately informed about test characteristics, benefits, and risks (weak recommendation, moderate quality evidence). PMID:25268304

Spada, Cristiano; Stoker, Jaap; Alarcon, Onofre; Barbaro, Federico; Bellini, Davide; Bretthauer, Michael; De Haan, Margriet C; Dumonceau, Jean-Marc; Ferlitsch, Monika; Halligan, Steve; Helbren, Emma; Hellstrom, Mikael; Kuipers, Ernst J; Lefere, Philippe; Mang, Thomas; Neri, Emanuele; Petruzziello, Lucio; Plumb, Andrew; Regge, Daniele; Taylor, Stuart A; Hassan, Cesare; Laghi, Andrea

2014-10-01

111

Cardiovascular Monitoring: Physiological and Technical Considerations  

PubMed Central

The American Dental Association and several dental specialty organizations have published guidelines that detail requirements for monitoring patients during various levels of sedation and, in some cases, general anesthesia. In general, all of these are consistent with those guidelines suggested by the American Society of Anesthesiologists Task Force for Sedation and Analgesia by Non-Anesthesiologists. It is well-accepted that the principal negative impact of sedation and anesthesia pertains to the compromise of respiratory function, but attentive monitoring of cardiovascular function is also important. While monitoring per se is a technical issue, an appreciation of its purpose and the interpretation of the information provided require an understanding of basic cardiovascular anatomy and physiology. The focus of this continuing education article is to address essential physiological aspects of cardiovascular function and to understand the appropriate use of monitors, including the interpretation of the information they provide. PMID:19642720

Casabianca, Andrew B; Becker, Daniel E

2009-01-01

112

Pharmacological management of chronic neuropathic pain - consensus statement and guidelines from the Canadian Pain Society.  

PubMed

Neuropathic pain (NeP), generated by disorders of the peripheral and central nervous system, can be particularly severe and disabling. Prevalence estimates indicate that 2% to 3% of the population in the developed world suffer from NeP, which suggests that up to one million Canadians have this disabling condition. Evidence-based guidelines for the pharmacological management of NeP are therefore urgently needed. Randomized, controlled trials, systematic reviews and existing guidelines focusing on the pharmacological management of NeP were evaluated at a consensus meeting. Medications are recommended in the guidelines if their analgesic efficacy was supported by at least one methodologically sound, randomized, controlled trial showing significant benefit relative to placebo or another relevant control group. Recommendations for treatment are based on degree of evidence of analgesic efficacy, safety, ease of use and cost-effectiveness. Analgesic agents recommended for first-line treatments are certain antidepressants (tricyclics) and anticonvulsants (gabapentin and pregabalin). Second-line treatments recommended are serotonin noradrenaline reuptake inhibitors and topical lidocaine. Tramadol and controlled-release opioid analgesics are recommended as third-line treatments for moderate to severe pain. Recommended fourth-line treatments include cannabinoids, methadone and anticonvulsants with lesser evidence of efficacy, such as lamotrigine, topiramate and valproic acid. Treatment must be individualized for each patient based on efficacy, side-effect profile and drug accessibility, including cost. Further studies are required to examine head-to-head comparisons among analgesics, combinations of analgesics, long-term outcomes, and treatment of pediatric and central NeP. PMID:17372630

Moulin, D E; Clark, A J; Gilron, I; Ware, M A; Watson, C P N; Sessle, B J; Coderre, T; Morley-Forster, P K; Stinson, J; Boulanger, A; Peng, P; Finley, G A; Taenzer, P; Squire, P; Dion, D; Cholkan, A; Gilani, A; Gordon, A; Henry, J; Jovey, R; Lynch, M; Mailis-Gagnon, A; Panju, A; Rollman, G B; Velly, A

2007-01-01

113

Pharmacological management of chronic neuropathic pain – Consensus statement and guidelines from the Canadian Pain Society  

PubMed Central

Neuropathic pain (NeP), generated by disorders of the peripheral and central nervous system, can be particularly severe and disabling. Prevalence estimates indicate that 2% to 3% of the population in the developed world suffer from NeP, which suggests that up to one million Canadians have this disabling condition. Evidence-based guidelines for the pharmacological management of NeP are therefore urgently needed. Randomized, controlled trials, systematic reviews and existing guidelines focusing on the pharmacological management of NeP were evaluated at a consensus meeting. Medications are recommended in the guidelines if their analgesic efficacy was supported by at least one methodologically sound, randomized, controlled trial showing significant benefit relative to placebo or another relevant control group. Recommendations for treatment are based on degree of evidence of analgesic efficacy, safety, ease of use and cost-effectiveness. Analgesic agents recommended for first-line treatments are certain antidepressants (tricyclics) and anticonvulsants (gabapentin and pregabalin). Second-line treatments recommended are serotonin noradrenaline reuptake inhibitors and topical lidocaine. Tramadol and controlled-release opioid analgesics are recommended as third-line treatments for moderate to severe pain. Recommended fourth-line treatments include cannabinoids, methadone and anticonvulsants with lesser evidence of efficacy, such as lamotrigine, topiramate and valproic acid. Treatment must be individualized for each patient based on efficacy, side-effect profile and drug accessibility, including cost. Further studies are required to examine head-to-head comparisons among analgesics, combinations of analgesics, long-term outcomes, and treatment of pediatric and central NeP. PMID:17372630

Moulin, DE; Clark, AJ; Gilron, I; Ware, MA; Watson, CPN; Sessle, BJ; Coderre, T; Morley-Forster, PK; Stinson, J; Boulanger, A; Peng, P; Finley, GA; Taenzer, P; Squire, P; Dion, D; Cholkan, A; Gilani, A; Gordon, A; Henry, J; Jovey, R; Lynch, M; Mailis-Gagnon, A; Panju, A; Rollman, GB; Velly, A

2007-01-01

114

ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization: A Report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology: Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography.  

PubMed

The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an appropriateness review of common clinical scenarios in which coronary revascularization is frequently considered. The clinical scenarios were developed to mimic common situations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. Approximately 180 clinical scenarios were developed by a writing committee and scored by a separate technical panel on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization was considered appropriate and likely to improve health outcomes or survival. Scores of 1 to 3 indicate revascularization was considered inappropriate and unlikely to improve health outcomes or survival. The mid range (4 to 6) indicates a clinical scenario for which the likelihood that coronary revascularization would improve health outcomes or survival was considered uncertain. For the majority of the clinical scenarios, the panel only considered the appropriateness of revascularization irrespective of whether this was accomplished by percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). In a select subgroup of clinical scenarios in which revascularization is generally considered appropriate, the appropriateness of PCI and CABG individually as the primary mode of revascularization was considered. In general, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia was viewed favorably. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy were viewed less favorably. It is anticipated that these results will have an impact on physician decision making and patient education regarding expected benefits from revascularization and will help guide future research. PMID:19131581

Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A

2009-03-10

115

ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization : a report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology. Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography.  

PubMed

The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an appropriateness review of common clinical scenarios in which coronary revascularization is frequently considered. The clinical scenarios were developed to mimic common situations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. Approximately 180 clinical scenarios were developed by a writing committee and scored by a separate technical panel on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization was considered appropriate and likely to improve health outcomes or survival. Scores of 1 to 3 indicate revascularization was considered inappropriate and unlikely to improve health outcomes or survival. The mid range (4 to 6) indicates a clinical scenario for which the likelihood that coronary revascularization would improve health outcomes or survival was considered uncertain. For the majority of the clinical scenarios, the panel only considered the appropriateness of revascularization irrespective of whether this was accomplished by percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). In a select subgroup of clinical scenarios in which revascularization is generally considered appropriate, the appropriateness of PCI and CABG individually as the primary mode of revascularization was considered. In general, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia was viewed favorably. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy were viewed less favorably. It is anticipated that these results will have an impact on physician decision making and patient education regarding expected benefits from revascularization and will help guide future research. PMID:19127535

Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A; Masoudi, Frederick A; Brindis, Ralph G; Beckman, Karen J; Chambers, Charles E; Ferguson, T Bruce; Garcia, Mario J; Grover, Frederick L; Holmes, David R; Klein, Lloyd W; Limacher, Marian; Mack, Michael J; Malenka, David J; Park, Myung H; Ragosta, Michael; Ritchie, James L; Rose, Geoffrey A; Rosenberg, Alan B; Shemin, Richard J; Weintraub, William S; Wolk, Michael J; Allen, Joseph M; Douglas, Pamela S; Hendel, Robert C; Peterson, Eric D

2009-02-15

116

ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization: a report by the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography.  

PubMed

The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an appropriateness review of common clinical scenarios in which coronary revascularization is frequently considered. The clinical scenarios were developed to mimic common situations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. Approximately 180 clinical scenarios were developed by a writing committee and scored by a separate technical panel on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization was considered appropriate and likely to improve health outcomes or survival. Scores of 1 to 3 indicate revascularization was considered inappropriate and unlikely to improve health outcomes or survival. The mid range (4 to 6) indicates a clinical scenario for which the likelihood that coronary revascularization would improve health outcomes or survival was considered uncertain. For the majority of the clinical scenarios, the panel only considered the appropriateness of revascularization irrespective of whether this was accomplished by percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). In a select subgroup of clinical scenarios in which revascularization is generally considered appropriate, the appropriateness of PCI and CABG individually as the primary mode of revascularization was considered. In general, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia was viewed favorably. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy were viewed less favorably. It is anticipated that these results will have an impact on physician decision making and patient education regarding expected benefits from revascularization and will help guide future research. PMID:19195618

Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A

2009-02-10

117

Cognitive disorders Epidemiology Dementia care and society Logic of dementia guidelines Cognitive disorder diagnosis Non-classical logic for Elderly Care  

E-print Network

Cognitive disorders Epidemiology Dementia care and society Logic of dementia guidelines Cognitive disorder diagnosis Non-classical logic for Elderly Care Management Patrik Eklund Umeå University, Sweden 27 June 2008 Patrik Eklund IPMU 2008 Non-classical logic for Elderly Care Management #12;Cognitive

Eklund, Patrik

118

Resource Use and Cost of Care for Patients Hospitalised with Community Acquired Pneumonia: Impact of Adherence to Infectious Diseases Society of America Guidelines  

Microsoft Academic Search

Objective: The objective of this study was to compare the inpatient resource use and cost of care for patients hospitalised with community-acquired pneumonia (CAP) who were treated with preferred antibacterial therapy according to the 1998 Infectious Diseases Society of America (IDSA) guidelines with those who were not treated with preferred therapy. Methods: A multicentre, observational study was conducted in Florida

Joanne J. Orrick; Richard Segal; Thomas E. Johns; Wayne Russell; Feng Wang; Donald D. Yin

2004-01-01

119

Management of myelodysplastic syndromes in adults: guidelines from the Belgian Haematological Society.  

PubMed

Myelodysplastic syndromes (MDS) represent a heterogeneous group of haematological disorders characterized by ineffective haematopoiesis and an increased risk for leukemic transformation. In recent years several new therapeutics have emerged that have demonstrated to alter the natural course of the disease. This document summarizes the state of the art in diagnosis and treatment of this heterogeneous disease, as proposed by a group of expert haematologists in the field of MDS from the Belgian Haematological Society. Its main purpose is to guide clinicians in daily practice to treat patients with this disease, within the limitations of current reimbursement modalities in Belgium. PMID:24455794

Meers, S; Breems, D; Bries, G; Delforge, M; Graux, C; Ravoet, C; Selleslag, D; Noens, L

2013-01-01

120

Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology  

PubMed Central

A multidisciplinary panel of 18 physicians and 3 non-physicians from eight countries (Sweden, UK, Argentina, Australia, Italy, Finland, Norway and the USA) reviewed the literature on diagnosis and management of adult coeliac disease (CD). This paper presents the recommendations of the British Society of Gastroenterology. Areas of controversies were explored through phone meetings and web surveys. Nine working groups examined the following areas of CD diagnosis and management: classification of CD; genetics and immunology; diagnostics; serology and endoscopy; follow-up; gluten-free diet; refractory CD and malignancies; quality of life; novel treatments; patient support; and screening for CD. PMID:24917550

Ludvigsson, Jonas F; Bai, Julio C; Biagi, Federico; Card, Timothy R; Ciacci, Carolina; Ciclitira, Paul J; Green, Peter H R; Hadjivassiliou, Marios; Holdoway, Anne; van Heel, David A; Kaukinen, Katri; Leffler, Daniel A; Leonard, Jonathan N; Lundin, Knut E A; McGough, Norma; Davidson, Mike; Murray, Joseph A; Swift, Gillian L; Walker, Marjorie M; Zingone, Fabiana; Sanders, David S

2014-01-01

121

ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 Appropriate use criteria for coronary revascularization focused update: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography.  

PubMed

The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an update of the appropriate use criteria (AUC) for coronary revascularization frequently considered. In the initial document, 180 clinical scenarios were developed to mimic patient presentations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. This update provides a reassessment of clinical scenarios the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria. The methodology used in this update is similar to the initial document, and the definition of appropriateness was unchanged. The technical panel scored the clinical scenarios on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization is considered appropriate and likely to improve patients' health outcomes or survival. Scores of 1 to 3 indicate revascularization is considered inappropriate and unlikely to improve health outcomes or survival. Scores in the mid-range (4 to 6) indicate a clinical scenario for which the likelihood that coronary revascularization will improve health outcomes or survival is uncertain. In general, as seen with the prior AUC, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia is appropriate. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy are viewed less favorably. The technical panel felt that based on recent studies, coronary artery bypass grafting remains an appropriate method of revascularization for patients with high burden of coronary artery disease (CAD). Additionally,percutaneous coronary intervention may have a role in revascularization of patients with high burden of CAD. The primary objective of the appropriate use criteria is to improve physician decision making and patient education regarding expected benefits from revascularization and to guide future research. PMID:22296741

Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A

2012-02-28

122

ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 appropriate use criteria for coronary revascularization focused update: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography.  

PubMed

The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an update of the appropriate use criteria (AUC) for coronary revascularization frequently considered. In the initial document, 180 clinical scenarios were developed to mimic patient presentations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. This update provides a reassessment of clinical scenarios the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria. The methodology used in this update is similar to the initial document, and the definition of appropriateness was unchanged. The technical panel scored the clinical scenarios on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization is considered appropriate and likely to improve patients' health outcomes or survival. Scores of 1 to 3 indicate revascularization is considered inappropriate and unlikely to improve health outcomes or survival. Scores in the mid-range (4 to 6) indicate a clinical scenario for which the likelihood that coronary revascularization will improve health outcomes or survival is uncertain. In general, as seen with the prior AUC, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia is appropriate. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy are viewed less favorably. The technical panel felt that based on recent studies, coronary artery bypass grafting remains an appropriate method of revascularization for patients with high burden of coronary artery disease (CAD). Additionally, percutaneous coronary intervention may have a role in revascularization of patients with high burden of CAD. The primary objective of the appropriate use criteria is to improve physician decision making and patient education regarding expected benefits from revascularization and to guide future research. PMID:22424518

Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A; Masoudi, Frederick A; Dehmer, Gregory J; Patel, Manesh R; Smith, Peter K; Chambers, Charles E; Ferguson, T Bruce; Garcia, Mario J; Grover, Frederick L; Holmes, David R; Klein, Lloyd W; Limacher, Marian C; Mack, Michael J; Malenka, David J; Park, Myung H; Ragosta, Michael; Ritchie, James L; Rose, Geoffrey A; Rosenberg, Alan B; Russo, Andrea M; Shemin, Richard J; Weintraub, William S; Wolk, Michael J; Bailey, Steven R; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Shaw, Leslee; Stainback, Raymond F; Allen, Joseph M

2012-04-01

123

Bologna Guidelines for Diagnosis and Management of Adhesive Small Bowel Obstruction (ASBO): 2010 Evidence-Based Guidelines of the World Society of Emergency Surgery  

PubMed Central

Background There is no consensus on diagnosis and management of ASBO. Initial conservative management is usually safe, however proper timing for discontinuing non operative treatment is still controversial. Open surgery or laparoscopy are used without standardized indications. Methods A panel of 13 international experts with interest and background in ASBO and peritoneal diseases, participated in a consensus conference during the 1st International Congress of the World Society of Emergency Surgery and 9th Peritoneum and Surgery Society meeting, in Bologna, July 1-3, 2010, for developing evidence-based recommendations for diagnosis and management of ASBO. Whenever was a lack of high-level evidence, the working group formulated guidelines by obtaining consensus. Recommendations In absence of signs of strangulation and history of persistent vomiting or combined CT scan signs (free fluid, mesenteric oedema, small bowel faeces sign, devascularized bowel) patients with partial ASBO can be managed safely with NOM and tube decompression (either with long or NG) should be attempted. These patients are good candidates for Water Soluble Contrast Medium (WSCM) with both diagnostic and therapeutic purposes. The appearance of water-soluble contrast in the colon on X-ray within 24 hours from administration predicts resolution. WSCM may be administered either orally or via NGT (50-150 ml) both immediately at admission or after an initial attempt of conservative treatment of 48 hours. The use of WSCM for ASBO is safe and reduces need for surgery, time to resolution and hospital stay. NOM, in absence of signs of strangulation or peritonitis, can be prolonged up to 72 hours. After 72 hours of NOM without resolution surgery is recommended. Patients treated non-operatively have shorter hospital stay, but higher recurrence rate and shorter time to re-admission, although the risk of new surgically treated episodes of ASBO is unchanged. Risk factors for recurrences are age <40 years and matted adhesions. WSCM does not affect recurrence rates or recurrences needing surgery when compared to traditional conservative treatment. Open surgery is the preferred method for surgical treatment of strangulating ASBO as well as after failed conservative management. In selected patients and with appropriate skills, laparoscopic approach can be attempted using open access technique. Access in the left upper quadrant should be safe. Laparoscopic adhesiolysis should be attempted preferably in case of first episode of SBO and/or anticipated single band. A low threshold for open conversion should be maintained. Peritoneal adhesions should be prevented. Hyaluronic acid-carboxycellulose membrane and icodextrin can reduce incidence of adhesions. Icodextrin may reduce the risk of re-obstruction. HA cannot reduce need of surgery. PMID:21255429

2011-01-01

124

DNA Commission of the International Society for Forensic Genetics: revised and extended guidelines for mitochondrial DNA typing.  

PubMed

The DNA Commission of the International Society of Forensic Genetics (ISFG) regularly publishes guidelines and recommendations concerning the application of DNA polymorphisms to the question of human identification. Previous recommendations published in 2000 addressed the analysis and interpretation of mitochondrial DNA (mtDNA) in forensic casework. While the foundations set forth in the earlier recommendations still apply, new approaches to the quality control, alignment and nomenclature of mitochondrial sequences, as well as the establishment of mtDNA reference population databases, have been developed. Here, we describe these developments and discuss their application to both mtDNA casework and mtDNA reference population databasing applications. While the generation of mtDNA for forensic casework has always been guided by specific standards, it is now well-established that data of the same quality are required for the mtDNA reference population data used to assess the statistical weight of the evidence. As a result, we introduce guidelines regarding sequence generation, as well as quality control measures based on the known worldwide mtDNA phylogeny, that can be applied to ensure the highest quality population data possible. For both casework and reference population databasing applications, the alignment and nomenclature of haplotypes is revised here and the phylogenetic alignment proffered as acceptable standard. In addition, the interpretation of heteroplasmy in the forensic context is updated, and the utility of alignment-free database searches for unbiased probability estimates is highlighted. Finally, we discuss statistical issues and define minimal standards for mtDNA database searches. PMID:25117402

Parson, W; Gusmão, L; Hares, D R; Irwin, J A; Mayr, W R; Morling, N; Pokorak, E; Prinz, M; Salas, A; Schneider, P M; Parsons, T J

2014-11-01

125

Sub-optimal achievement of guideline-derived lipid goals in management of diabetes patients with atherosclerotic cardiovascular disease, despite high use of evidence-based therapies.  

PubMed

Guidelines recommend aggressive goals for lipid and blood pressure reduction for high risk patients with diabetes mellitus and atherosclerotic coronary disease. However, it remains unclear how many patients achieve treatment goals versus the number of people merely placed on treatment. We conducted an observational study in an academic cardiology clinic. A total of 926 patients with atherosclerotic cardiovascular disease and concomitant diabetes mellitus met criteria. Mean age was 68.4 ± 10.2, 65.6% were male, and 86.8% were Caucasian. By the last visit a high percentage of patients were receiving recommended medications. Mean LDL-cholesterol achieved was 80.4 mg/dl with 40.9% reaching ? 70 mg/dl, and 61.7% reaching SBP ? 130 mmHg. Many patients with diabetes mellitus and atherosclerotic cardiovascular disease are prescribed recommended medications; however, few achieve guidelines-specified therapeutic goals for LDL-cholesterol and blood pressure. Studies evaluating performance improvement should include percentage of patients reaching treatment goals. Mechanisms underlying the treatment gap need to be identified and addressed. PMID:22234950

DeGuzman, Pamela B; Akosah, Kwame O; Simpson, Allan G; Barbieri, Kirk E; Megginson, Gregory C; Goldberg, Randal I; Beller, George A

2012-04-01

126

Canadian Society of Nephrology commentary on the 2012 KDIGO clinical practice guideline for the management of blood pressure in CKD.  

PubMed

The KDIGO (Kidney Disease: Improving Global Outcomes) 2012 clinical practice guideline for the management of blood pressure (BP) in chronic kidney disease (CKD) provides the structural and evidence base for the Canadian Society of Nephrology (CSN) commentary on this guideline's relevancy and application to the Canadian health care system. While in general agreement, we provide commentary on 13 of the 21 KDIGO guideline statements. Specifically, we agreed that nonpharmacological interventions should play a significant role in the management of hypertension in patients with CKD. We also agreed that the approach to the management of hypertension in elderly patients with CKD should be individualized and take into account comorbid conditions to avoid adverse outcomes from excessive BP lowering. In contrast to KDIGO, the CSN Work Group believes there is insufficient evidence to target a lower BP for nondiabetic CKD patients based on the presence and severity of albuminuria. The CSN Work Group concurs with the Canadian Hypertension Education Program (CHEP) recommendation of a target BP for all non-dialysis-dependent CKD patients without diabetes of ?140 mm Hg systolic and ?90 mm Hg diastolic. Similarly, it is our position that in diabetic patients with CKD and normal urinary albumin excretion, raising the threshold for treatment from <130 mm?Hg systolic BP to <140 mm Hg systolic BP could increase stroke risk and the risk of worsening kidney disease. The CSN Work Group concurs with the CHEP and the Canadian Diabetic Association recommendation for diabetic patients with CKD with or without albuminuria to continue to be treated to a BP target similar to that of the overall diabetes population, aiming for BP levels < 130/80 mm Hg. Consistent with this, the CSN Work Group endorses a BP target of <130/80 mm Hg for diabetic patients with a kidney transplant. Finally, in the absence of evidence for a lower BP target, the CSN Work Group concurs with the CHEP recommendation to target BP<140/90 mm Hg for nondiabetic patients with a kidney transplant. PMID:24725980

Ruzicka, Marcel; Quinn, Robert R; McFarlane, Phil; Hemmelgarn, Brenda; Ramesh Prasad, G V; Feber, Janusz; Nesrallah, Gihad; MacKinnon, Martin; Tangri, Navdeep; McCormick, Brendan; Tobe, Sheldon; Blydt-Hansen, Tom D; Hiremath, Swapnil

2014-06-01

127

Prevalence of guideline-directed medical therapy among patients receiving cardiac resynchronization therapy defibrillator implantation in the National Cardiovascular Data Registry during the years 2006 to 2008.  

PubMed

Cardiac resynchronization therapy (CRT) reduces morbidity and mortality among selected patients with left ventricular systolic dysfunction and severe heart failure symptoms despite guideline-directed medical therapy (GDMT). Contemporaneous guidelines provided clear recommendations regarding selection of patients for CRT, including that all patients should first receive GDMT with ? blockers and renin-angiotensin axis antagonists. Prevalence of GDMT among real-world patients receiving CRT defibrillators (CRT-D) has not been well studied. We identified 45,392 patients in the National Cardiovascular Data Registry Implantable Cardioverter-Defibrillator Registry who underwent first CRT-D implantation for primary prevention of sudden death from January 2006 to June 2008. We calculated the proportion of patients with contemporaneous class I guideline indications for CRT-D, the proportion receiving GDMT for heart failure, and the proportion receiving GDMT who had class I guideline indications for CRT-D. Among patients without contraindications, 87% were prescribed ? blockers, 78% an angiotensin-converting enzyme inhibitor or an angiotensin II receptor inhibitor, and 70% both a ? blocker and an angiotensin-converting enzyme or angiotensin II receptor inhibitor at discharge. Finally, 50% of patients met class I guideline indications and were prescribed GDMT at discharge; 9% neither met class I indications nor were prescribed GDMT at discharge. The major limitation of this study is the lack of dosage information in the Implantable Cardioverter-Defibrillator Registry and lack of prescribing information at times other than discharge. In conclusion, many patients receiving CRT-D are not receiving GDMT at discharge. Ensuring that all patients receiving CRT-D are also receiving GDMT appears to be a quality improvement target. PMID:24793671

Schneider, Preston M; Pellegrini, Cara N; Wang, Yongfei; Fein, Adam S; Reynolds, Matthew R; Curtis, Jeptha P; Masoudi, Frederick A; Varosy, Paul D

2014-06-15

128

A guide to guidelines for professional societies and other developers of recommendations: introduction to integrating and coordinating efforts in COPD guideline development. An official ATS/ERS workshop report.  

PubMed

Organizations around the world are recognizing that guidelines should be based on the best available evidence, that the development of recommendations needs to be transparent, and that appropriate processes should be followed. In June 2007, we convened an American Thoracic Society (ATS)/European Respiratory Society (ERS)-sponsored workshop with over 60 representatives from 36 international organizations to provide advice to guideline developers about the required steps and processes for guideline development using the management of chronic obstructive pulmonary disease (COPD) as an example. Following the workshop, participants completed a series of 14 review articles that underwent peer review and incorporated key new literature until June 2011 for most articles in this series. The review articles evaluate the guideline cycle including: priority setting, question formulation, managing conflict of interest, defining appropriate outcomes, stakeholder involvement, grading the quality of evidence and strength of recommendations, integration of values and preferences, considering resource use, reporting of guidelines, implementation, and adaptation. In this Introduction we frame the background and methods of these reviews and provide the key conclusions of the workshop. A summary of the workshop's conclusions and recommendations was published in The Lancet. Given the enormous resources that are spent on research and the importance of providing the best guidance to healthcare decision makers, attributing appropriate funds to research syntheses and transparent, independent guidance for the development of evidence-based guidelines is justified. Furthermore, given the immense amount of work that is required, individuals and organizations need to collaborate to achieve the best possible and cost-effective coordination of these efforts. PMID:23256161

Schünemann, Holger J; Woodhead, Mark; Anzueto, Antonio; Buist, A Sonia; Macnee, William; Rabe, Klaus F; Heffner, John

2012-12-01

129

How to replace codeine after tonsillectomy in children under 12 years of age? Guidelines of the French Oto-Rhino-Laryngology--Head and Neck Surgery Society (SFORL).  

PubMed

The authors present the guidelines of the French Oto-rhino-laryngology--Head and Neck Surgery Society (SFORL) regarding pain management in children and adults following tonsillectomy. A multidisciplinary work group was entrusted with a literature review. Guidelines were drawn up based on the articles retrieved and the group members' experience. They were read over by an editorial group independent of the work group. A coordination meeting drew up the final version. Guidelines were graded A, B or C or as professional agreement in decreasing order of level of evidence. At home, non-steroid anti-inflammatory drugs (NSAIDs) are recommended in association with paracetamol in elevated respiratory risk and especially obstructive sleep apnea syndrome; in elevated hemorrhagic risk (hemostasis disorder, surgical problems, etc.), tramadol is recommended. Two other treatment schedules (modified NSAIDs and corticosteroids) have not undergone dedicated study and should be assessed. Management of post-tonsillectomy pain in children is founded on individual risk/benefit analysis. PMID:25106698

Constant, I; Ayari Khalfallah, S; Brunaud, A; Deramoudt, V; Fayoux, P; Giovanni, A; Mareau, C; Marianowski, R; Michel, J; Mondain, M; Paganelli, A; Pondaven, S; Schultz, P; Treluyer, J M; Wood, C; Nicolas, R

2014-09-01

130

American College of Radiology (ACR) and American Society for Radiation Oncology (ASTRO) practice guideline for the performance of total body irradiation (TBI).  

PubMed

Total body irradiation (TBI) is a specialized radiotherapy technique. It is frequently used as a component of treatment plans involving hematopoietic stem cell transplant for a variety of disorders, most commonly hematologic malignancies. A variety of treatment delivery techniques, doses, and fractionation schemes can be utilized. A collaborative effort of the American College of Radiology and American Society for Radiation Oncology has produced a practice guideline for delivery of TBI. The guideline defines the qualifications and responsibilities of the involved personnel, including the radiation oncologist, physicist, dosimetrist, and radiation therapist. Review of the typical indications for TBI is presented, and the importance of integrating TBI into the multimodality treatment plan is discussed. Procedures and special considerations related to the simulation, treatment planning, treatment delivery, and quality assurance for patients treated with TBI are reviewed. This practice guideline can be part of ensuring quality and safety in a successful TBI program. PMID:23334484

Wolden, Suzanne L; Rabinovitch, Rachel A; Bittner, Nathan H J; Galvin, James M; Giap, Huan B; Schomberg, Paula J; Rosenthal, Seth A

2013-02-01

131

Palliative thoracic radiotherapy in lung cancer: An American Society for Radiation Oncology evidence-based clinical practice guideline  

PubMed Central

Purpose To provide guidance to physicians and patients with regard to the use of external beam radiotherapy, endobronchial brachytherapy, and concurrent chemotherapy in the setting of palliative thoracic treatment for lung cancer, based on available evidence complemented by expert opinion. Methods and Materials A Task Force authorized by the American Society for Radiation Oncology (ASTRO) Board of Directors synthesized and assessed evidence from 3 systematic reviews on the following topics: (1) dose fractionation in thoracic external beam radiotherapy (EBRT); (2) clinical utility of initial and salvage endobronchial brachytherapy (EBB); and (3) use of concurrent chemotherapy (CC) with palliative thoracic radiotherapy. Practice guideline recommendations were produced and are contained herein. Results Studies suggest that higher dose/fractionation palliative EBRT regimens (eg, 30 Gy/10 fraction equivalent or greater) are associated with modest improvements in survival and total symptom score, particularly in patients with good performance status. As these improvements are associated with an increase in esophageal toxicity, various shorter EBRT dose/fractionation schedules (eg, 20 Gy in 5 fractions, 17 Gy in 2 weekly fractions, 10 Gy in 1 fraction), which provide good symptomatic relief with fewer side effects, can be used for patients requesting a shorter treatment course and/or in those with a poor performance status. No defined role for EBB in the routine initial palliative treatment of chest disease has been demonstrated; however, EBB can be a reasonable option for the palliation of endobronchial lesions causing obstructive symptomatology including lung collapse, or for hemoptysis after EBRT failure. The integration of concurrent chemotherapy with palliative intent/fractionated radiotherapy is not currently supported by the medical literature. Conclusion This Guideline is intended to serve as a guide for the use of EBRT, EBB, and CC in thoracic palliation of lung cancer outside the clinical trial setting. Further prospective clinical investigations with relevant palliative endpoints into the respective roles of EBB and CC/targeted therapy in the thoracic palliation of lung cancer are warranted, given the current state of the medical literature in these areas. PMID:24174996

Rodrigues, George; Videtic, Gregory M.M.; Sur, Ranjan; Bezjak, Andrea; Bradley, Jeffrey; Hahn, Carol A.; Langer, Corey; Miller, Keith L.; Moeller, Benjamin J.; Rosenzweig, Kenneth; Movsas, Benjamin

2011-01-01

132

American College of Radiology (ACR) and American Society for Radiation Oncology (ASTRO) Practice Guideline for the Performance of Stereotactic Radiosurgery (SRS).  

PubMed

American College of Radiology and American Society for Radiation Oncology Practice Guideline for the Performance of Stereotactic Radiosurgery (SRS). SRS is a safe and efficacious treatment option of a variety of benign and malignant disorders involving intracranial structures and selected extracranial lesions. SRS involves a high dose of ionizing radiation with a high degree of precision and spatial accuracy. A quality SRS program requires a multidisciplinary team involved in the patient management. Organization, appropriate staffing, and careful adherence to detail and to established SRS standards is important to ensure operational efficiency and to improve the likelihood of procedural success. A collaborative effort of the American College of Radiology and American Society for Therapeutic Radiation Oncology has produced a practice guideline for SRS. The guideline defines the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, neurosurgeon, and qualified medical physicist. Quality assurance is essential for safe and accurate delivery of treatment with SRS. Quality assurance issues for the treatment unit, stereotactic accessories, medical imaging, and treatment-planning system are presented and discussed. Adherence to these practice guidelines can be part of ensuring quality and patient safety in a successful SRS program. PMID:23681017

Seung, Steven K; Larson, David A; Galvin, James M; Mehta, Minesh P; Potters, Louis; Schultz, Christopher J; Yajnik, Santosh V; Hartford, Alan C; Rosenthal, Seth A

2013-06-01

133

Consensus document on the radial approach in percutaneous cardiovascular interventions: position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on Acute Cardiac Care** and Thrombosis of the European Society of Cardiology.  

PubMed

Radial access use has been growing steadily but, despite encouraging results, still varies greatly among operators, hospitals, countries and continents. Twenty years from its introduction, it was felt that the time had come to develop a common evidence-based view on the technical, clinical and organisational implications of using the radial approach for coronary angiography and interventions. The European Association of Percutaneous Cardiovascular Interventions (EAPCI) has, therefore, appointed a core group of European and non-European experts, including pioneers of radial angioplasty and operators with different practices in vascular access supported by experts nominated by the Working Groups on Acute Cardiac Care and Thrombosis of the European Society of Cardiology (ESC). Their goal was to define the role of the radial approach in modern interventional practice and give advice on technique, training needs, and optimal clinical indications. PMID:23354100

Hamon, Martial; Pristipino, Christian; Di Mario, Carlo; Nolan, James; Ludwig, Josef; Tubaro, Marco; Sabate, Manel; Mauri-Ferré, Josepa; Huber, Kurt; Niemelä, Kari; Haude, Michael; Wijns, William; Dudek, Dariusz; Fajadet, Jean; Kiemeneij, Ferdinand

2013-03-01

134

An analysis of the impact of FDA's guidelines for addressing cardiovascular risk of drugs for type 2 diabetes on clinical development.  

PubMed

We examined the impact of FDA's 2008 guidelines for addressing cardiovascular risks of new therapies for type 2 diabetes on clinical trials. We focused on the new class of incretin-modulating drugs, exenatide, sitagliptin, saxagliptin and liraglutide, which were approved in 2005-2010. We contrasted these findings with those from 2 different groups: 1. diabetes drugs approved in the same timeframe but with a non-incretin mechanism of action (colesevelam HCl and bromocriptine mesylate) and 2. diabetes drugs with NDAs delayed and not yet approved within the same time frame (vildagliptin, alogliptin, insulin inhalation powder, and exenatide long acting release). The new guidelines have had an important impact on clinical development. Review time has increased over 2-fold. The increase is seen even if a drug with the same mechanism of action has been already approved. Whereas exenatide (approved in 2005) required 10 months of regulatory review, the approval of liraglutide in 2010 required more than twice as long (21 months). In contrast, the marketing authorization of liraglutide in the EU required 14 months. Additionally, the manufacturer of vildagliptin announced in June 2008, 30 months after the NDA was filed, that a re-submission to meet FDA's demands was not planned. The drug however received marketing authorization in the EU in 2007. The number of randomized patients and patient-years in NDAs increased more than 2.5 and 4 fold, respectively since the guidelines. The significant cost increases and negative publicity because of rare adverse reactions will adversely affect future clinical research in type 2 diabetes and not address its burgeoning health care impact. PMID:21266202

Viereck, Christopher; Boudes, Pol

2011-05-01

135

Guidelines for diagnosis and management of chronic obstructive pulmonary disease: joint recommendations of Indian Chest Society and National College of Chest Physicians (India).  

PubMed

Chronic obstructive pulmonary disease (COPD) is a major public health problem in India. Although several International guidelines for diagnosis and management of COPD are available, yet there are lot of gaps in recognition and management of COPD in India due to vast differences in availability and affordability of healthcare facilities across the country. The Indian Chest Society and the National College of Chest Physicians (India) have joined hands to come out with these evidence-based guidelines to help the physicians at all levels of healthcare to diagnose and manage COPD in a scientific manner. Besides the International literature, the Indian studies were specifically analysed to arrive at simple and practical recommendations. The evidence is presented under these five headings: (a) definition, epidemiology and disease burden, (b) disease assessment and diagnosis, (c) pharmacologic management of stable COPD, (d) management of acute exacerbations; and (e) non-pharmacologic and preventive measures. PMID:24974625

Gupta, Dheeraj; Agarwal, Ritesh; Aggarwal, Ashutosh Nath; Maturu, V N; Dhooria, Sahajal; Prasad, K T; Sehgal, Inderpaul S; Yenge, Lakshmikant B; Jindal, Aditya; Singh, Navneet; Ghoshal, A G; Khilnani, G C; Samaria, J K; Gaur, S N; Behera, D; Jindal, S K

2014-01-01

136

Prevention of venous thromboembolism, 2nd edition: Korean Society of Thrombosis and Hemostasis Evidence-based Clinical Practice Guidelines.  

PubMed

In 2010, we proposed the first Korean Guidelines for the Prevention of Venous Thromboembolism (VTE). It was applicable to Korean patients, by modifying the contents of the second edition of the Japanese guidelines for the prevention of VTE and the 8th edition of the American College of Chest Physicians (ACCP) evidence-based clinical practice guidelines. From 2007 to 2011, we conducted a nationwide study regarding the incidence of VTE after major surgery using the Health Insurance Review and Assessment Service (HIRA) database. In addition, we have considered the 9th edition of the ACCP Evidenced-Based Clinical Practice Guidelines, published in 2012. It emphasized the importance of clinically relevant events as opposed to asymptomatic outcomes with preferences for both thrombotic and bleeding outcomes. Thus, in the development of the new Korean guidelines, three major points were addressed: 1) the new guidelines stratify patients into 4 risk groups (very low, low, moderate, and high) according to the actual incidence of symptomatic VTE from the HIRA databases; 2) the recommended optimal VTE prophylaxis for each group was modified according to condition-specific thrombotic and bleeding risks; 3) guidelines are intended for general information only, are not medical advice, and do not replace professional medical care and/or physician advice. PMID:24550640

Bang, Soo-Mee; Jang, Moon Ju; Kim, Kyoung Ha; Yhim, Ho-Young; Kim, Yeo-Kyeoung; Nam, Seung-Hyun; Hwang, Hun Gyu; Bae, Sung Hwa; Kim, Sung-Hyun; Mun, Yeung-Chul; Kim, Yang-Ki; Kim, Inho; Choi, Won-Il; Jung, Chul Won; Park, Nan Hee; Choi, Nam-Kyong; Park, Byung-Joo; Oh, Doyeun; Korean Society of Thrombosis and Hemostasis

2014-02-01

137

ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 appropriate use criteria for cardiac radionuclide imaging: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the American Society of Nuclear Cardiology, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the Society of Cardiovascular Computed Tomography, the Society for Cardiovascular Magnetic Resonance, and the Society of Nuclear Medicine.  

PubMed

The American College of Cardiology Foundation (ACCF), along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac radionuclide imaging (RNI) is frequently considered. This document is a revision of the original Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging (SPECT MPI) Appropriateness Criteria, published 4 years earlier, written to reflect changes in test utilization and new clinical data, and to clarify RNI use where omissions or lack of clarity existed in the original criteria. This is in keeping with the commitment to revise and refine appropriate use criteria (AUC) on a frequent basis. The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Sixty-seven clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of cardiac RNI for diagnosis and risk assessment in intermediate- and high-risk patients with coronary artery disease (CAD) was viewed favorably, while testing in low-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Additionally, use for perioperative testing was found to be inappropriate except for high selected groups of patients. It is anticipated that these results will have a significant impact on physician decision making, test performance, and reimbursement policy, and will help guide future research. PMID:19451357

Hendel, Robert C; Berman, Daniel S; Di Carli, Marcelo F; Heidenreich, Paul A; Henkin, Robert E; Pellikka, Patricia A; Pohost, Gerald M; Williams, Kim A

2009-06-01

138

Fluid resuscitation in neonatal and pediatric hypovolemic shock: a Dutch Pediatric Society evidence-based clinical practice guideline  

Microsoft Academic Search

Objective  To develop a clinical practice guideline that provides recommendations for the fluid, i.e. colloid or crystalloid, used for resuscitation in critically ill neonates and children up to the age of 18 years with hypovolemia.Methods  The guideline was developed through a comprehensive search and analysis of the pediatric literature. Recommendations were formulated by a national multidisciplinary committee involving all stakeholders in neonatal and pediatric intensive

Nicole Boluyt; Casper W. Bollen; Albert P. Bos; Joke H. Kok; Martin Offringa

2006-01-01

139

Meeting physical activity guidelines is associated with reduced risk for cardiovascular disease in black South African women; a 5.5-year follow-up study  

PubMed Central

Background Low levels of physical activity (PA) have been associated with increased risk for cardiovascular disease (CVD) and type 2 diabetes (T2D), but few studies have examined whether meeting international PA guidelines is associated with reduced risk in a black South African (SA) population. The aims of this study were to compare body composition and cardio-metabolic risk factors for CVD and T2D between active and inactive groups (part 1, cross-sectional analysis) and, to determine whether PA level predicts changes in body composition and cardio-metabolic risk factors for CVD and T2D at follow-up after 5.5-years (part 2, longitudinal analysis). Methods Part 1 included a sample of 240 apparently healthy black SA women (26?±?7 years) who underwent the following measurements at baseline: PA (Global Physical Activity Questionnaire (GPAQ)), body composition and regional fat distribution (dual-energy x-ray absorptiometry and computerised tomography), blood pressure, fasting glucose, insulin and lipid concentrations. For part 2, a sub-sample of women (n?=?57) underwent the same measurements after a 5.5-year period. Results At baseline, 61% of women were classified as meeting the guidelines for moderate- to vigorous-intensity physical activity (MVPA) according to GPAQ. Women who were active had significantly lower body weight (p?guidelines was associated with decreased risk for CVD and T2D in black SA women, but did not prevent the increase in body fat over time. Interventions promoting physical activity to specifically address obesity in this high-risk group are recommended. PMID:24886324

2014-01-01

140

American Geriatrics Society  

MedlinePLUS

... News October 31st, 2014 Announcing New American Geriatrics Society Clinical Practice Guideline on Post-Operative Delirium October ... Geriatrics Content You Need © 2014 The American Geriatrics Society. All rights reserved. Privacy Policy . Copyright & Permissions . Disclaimer .

141

Implementing ethics in the professions: preparing guidelines on scientific communication for the Society for Neuroscience. Commentary on 'Implementing ethics in the professions: examples from environmental epidemiology' (Soskolne and Sieswerda).  

PubMed

In 1994, the governing council of the Society for Neuroscience was asked to make a brief statement on an issue regarding responsible conduct in publishing. The present article reviews how that initial request grew over the next four years into a lengthy document. Drawing on that experience, which was presided over by the author, comments are made about the potential impact of such guidelines, the lessons learned, and the proper role of professional societies in promoting responsible conduct in research. PMID:12774651

Zigmond, Michael J

2003-04-01

142

American College of Radiology (ACR) and American Society for Radiation Oncology (ASTRO) Practice Guideline for Intensity-modulated Radiation Therapy (IMRT).  

PubMed

Intensity-modulated radiation therapy (IMRT) is a complex technique for the delivery of radiation therapy preferentially to target structures while minimizing doses to adjacent normal critical structures. It is widely utilized in the treatment of a variety of clinical indications in radiation oncology, including tumors of the central nervous system, head and neck, breast, prostate, gastrointestinal tract, and gynecologic organs, as well as in situations where previous radiation therapy has been delivered, and has allowed for significant therapeutic advances in many clinical areas. IMRT treatment planning and delivery is a complex process. Safe and reliable delivery of IMRT requires appropriate process design and adherence to quality assurance (QA) standards. A collaborative effort of the American College of Radiology and American Society for Therapeutic Radiation Oncology has produced a practice guideline for IMRT. The guideline defines the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, physicist, dosimetrist, and radiation therapist. Factors with respect to the QA of the treatment planning system, treatment-planning process, and treatment-delivery process are discussed, as are issues related to the utilization of volumetric modulated arc therapy. Patient-specific QA procedures are presented. Successful IMRT programs involve integration of many processes: patient selection, patient positioning/immobilization, target definition, treatment plan development, and accurate treatment delivery. Appropriate QA procedures, including patient-specific QA procedures, are essential to ensure quality in an IMRT program and to assure patient safety. PMID:23165357

Hartford, Alan C; Galvin, James M; Beyer, David C; Eichler, Thomas J; Ibbott, Geoffrey S; Kavanagh, Brian; Schultz, Christopher J; Rosenthal, Seth A

2012-12-01

143

Feeding & Risering Guidelines for  

E-print Network

Feeding & Risering Guidelines for Steel Castings Steel Founders' Society of America 2001 #12;Index Castings [1], a foundry handbook intended to provide risering guidelines for use in steel foundries. The guidelines contained in Risering Steel Castings were developed based on experimental casting work

Beckermann, Christoph

144

Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection: 2009 Update by the Infectious Diseases Society of Americaa  

PubMed Central

These updated guidelines replace the previous management guidelines published in 2001. The guidelines are intended for use by health care providers who care for patients who either have these infections or may be at risk for them. PMID:19489710

Mermel, Leonard A.; Allon, Michael; Bouza, Emilio; Craven, Donald E.; Flynn, Patricia; O'Grady, Naomi P.; Raad, Issam I.; Rijnders, Bart J. A.; Sherertz, Robert J.; Warren, David K.

2014-01-01

145

An Official American Thoracic Society Clinical Practice Guideline: Classification, Evaluation, and Management of Childhood Interstitial Lung Disease in Infancy  

PubMed Central

Background: There is growing recognition and understanding of the entities that cause interstitial lung disease (ILD) in infants. These entities are distinct from those that cause ILD in older children and adults. Methods: A multidisciplinary panel was convened to develop evidence-based guidelines on the classification, diagnosis, and management of ILD in children, focusing on neonates and infants under 2 years of age. Recommendations were formulated using a systematic approach. Outcomes considered important included the accuracy of the diagnostic evaluation, complications of delayed or incorrect diagnosis, psychosocial complications affecting the patient’s or family’s quality of life, and death. Results: No controlled clinical trials were identified. Therefore, observational evidence and clinical experience informed judgments. These guidelines: (1) describe the clinical characteristics of neonates and infants (<2 yr of age) with diffuse lung disease (DLD); (2) list the common causes of DLD that should be eliminated during the evaluation of neonates and infants with DLD; (3) recommend methods for further clinical investigation of the remaining infants, who are regarded as having “childhood ILD syndrome”; (4) describe a new pathologic classification scheme of DLD in infants; (5) outline supportive and continuing care; and (6) suggest areas for future research. Conclusions: After common causes of DLD are excluded, neonates and infants with childhood ILD syndrome should be evaluated by a knowledgeable subspecialist. The evaluation may include echocardiography, controlled ventilation high-resolution computed tomography, infant pulmonary function testing, bronchoscopy with bronchoalveolar lavage, genetic testing, and/or lung biopsy. Preventive care, family education, and support are essential. PMID:23905526

Kurland, Geoffrey; Deterding, Robin R.; Hagood, James S.; Young, Lisa R.; Brody, Alan S.; Castile, Robert G.; Dell, Sharon; Fan, Leland L.; Hamvas, Aaron; Hilman, Bettina C.; Langston, Claire; Nogee, Lawrence M.; Redding, Gregory J.

2013-01-01

146

Classical Hodgkin's lymphoma in adults: guidelines of the Italian Society of Hematology, the Italian Society of Experimental Hematology, and the Italian Group for Bone Marrow Transplantation on initial work-up, management, and follow-up  

PubMed Central

The Italian Society of Hematology (SIE), the Italian Society of Experimental Haematology (SIES) and the Italian Group for Bone Marrow Transplantation (GITMO) commissioned a project to develop practice guidelines for the initial work-up, therapy and follow-up of classical Hodgkin’s lymphoma. Key questions to the clinical evaluation and treatment of this disease were formulated by an Advisory Committee, discussed and approved by an Expert Panel (EP) composed of senior hematologists and one radiotherapist. After a comprehensive and systematic literature review, the EP recommendations were graded according to their supporting evidence. An explicit approach to consensus methodologies was used for evidence interpretation and for producing recommendations in the absence of a strong evidence. The EP decided that the target domain of the guidelines should include only classical Hodgkin’s lymphoma, as defined by the WHO classification, and exclude lymphocyte predominant histology. Distinct recommendations were produced for initial work-up, first-line therapy of early and advanced stage disease, monitoring procedures and salvage therapy, including hemopoietic stem cell transplant. Separate recommendations were formulated for elderly patients. Pre-treatment volumetric CT scan of the neck, thorax, abdomen, and pelvis is mandatory, while FDG-PET is recommended. As to the therapy of early stage disease, a combined modality approach is still recommended with ABVD followed by involved-field radiotherapy; the number of courses of ABVD will depend on the patient risk category (favorable or unfavorable). Full-term chemotherapy with ABVD is recommended in advanced stage disease; adjuvant radiotherapy in patients without initial bulk who achieved a complete remission is not recommended. In the elderly, chemotherapy regimens more intensive than ABVD are not recommended. Early evaluation of response with FDG-PET scan is suggested. Relapsed or refractory patients should receive high-dose chemotherapy and autologous hemopoietic stem cells transplant. Allogeneic transplant is recommended in patients relapsing after autologous transplant. All fertile patients should be informed of the possible effects of therapy on gonadal function and fertility preservation measures should be taken before the initiation of therapy. PMID:19278966

Brusamolino, Ercole; Bacigalupo, Andrea; Barosi, Giovanni; Biti, Giampaolo; Gobbi, Paolo G.; Levis, Alessandro; Marchetti, Monia; Santoro, Armando; Zinzani, Pier Luigi; Tura, Sante

2009-01-01

147

Applicability of the European Society of Cardiology guidelines on management of acute coronary syndromes to people with haemophilia - an assessment by the ADVANCE Working Group.  

PubMed

There are no evidence-based guidelines for antithrombotic management in people with haemophilia (PWH) presenting with acute coronary syndrome (ACS). The aim of the study was to review the current European Society of Cardiology guidelines, and to consider how best they should be adapted for PWH. Structured communication techniques based on a Delphi-like methodology were used to achieve expert consensus on key aspects of clinical management. The main final statements are as follows: (i) ACS and myocardial revascularization should be managed promptly by a multidisciplinary team that includes a haemophilia expert, (ii) each comprehensive care centre for adult PWH should have a formal clinical referral pathway with a cardiology centre with an emergency unit and 24 h availability of percutaneous coronary intervention (PCI), (iii) PCI should be performed as soon as possible under adequate clotting factor protection, (iv) bare metal stents are preferred to drug-eluting stents, (v) anticoagulants should only be used in PWH after replacement therapy, (vi) minimum trough levels should not fall below 5-15% in PWH on dual antiplatelet therapy, (vii) the duration of dual antiplatelet therapy after ACS and PCI should be limited to a minimum, (viii) the use of GPIIb-IIIa inhibitors is not recommended in PWH other than in exceptional circumstances, (ix) the use of fibrinolysis may be justified in PWH when primary PCI (within 90 min) is not available ideally under adequate clotting factor management. It is hoped that the results of this initiative will help to guide optimal management of ACS in PWH. PMID:23710576

Staritz, P; de Moerloose, P; Schutgens, R; Dolan, G

2013-11-01

148

Limitations of the American Society of Therapeutic Radiology and Oncology Consensus Panel Guidelines on the Use of Accelerated Partial Breast Irradiation  

SciTech Connect

Purpose: We applied the American Society of Therapeutic Radiology and Oncology (ASTRO) Consensus Panel (CP) guidelines for the use of accelerated partial breast irradiation (APBI) to patients treated with this technique to determine the ability of the guidelines to differentiate patients with significantly different clinical outcomes. Methods and Materials: A total of 199 patients treated with APBI and 199 with whole-breast irradiation (WBI) (matched for tumor size, nodal status, age, margins, receptor status, and tamoxifen use) were stratified into the three ASTRO CP levels of suitability ('suitable,' 'cautionary,' and 'unsuitable') to assess rates of ipsilateral breast tumor recurrence (IBTR), regional nodal failure, distant metastases, disease-free survival, cause-specific survival, and overall survival based on CP category. Median follow-up was 11.1 years. Results: Analysis of the APBI and WBI patient groups, either separately or together (n = 398), did not demonstrate statistically significant differences in 10-year actuarial rates of IBTR when stratified by the three ASTRO groups. Regional nodal failure and distant metastasis were generally progressively worse when comparing the suitable to cautionary to unsuitable CP groups. However, when analyzing multiple clinical, pathologic, or treatment-related variables, only patient age was associated with IBTR using WBI (p = 0.002). Conclusions: The ASTRO CP suitable group predicted for a low risk of IBTR; however, the cautionary and unsuitable groups had an equally low risk of IBTR, supporting the need for continued refinement of patient selection criteria as additional outcome data become available and for the continued accrual of patients to Phase III trials.

Vicini, Frank, E-mail: fvicini@beaumont.ed [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Arthur, Douglas [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA (United States); Wazer, David [Department of Radiation Oncology, Tufts University School of Medicine, Boston, MA (United States); Chen, Peter; Mitchell, Christina; Wallace, Michelle; Kestin, Larry; Ye, Hong [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

2011-03-15

149

American Society of Clinical Oncology Clinical Practice Guideline Update on Chemotherapy for Stage IV Non–Small-Cell Lung Cancer  

PubMed Central

The purpose of this article is to provide updated recommendations for the treatment of patients with stage IV non–small-cell lung cancer. A literature search identified relevant randomized trials published since 2002. The scope of the guideline was narrowed to chemotherapy and biologic therapy. An Update Committee reviewed the literature and made updated recommendations. One hundred sixty-two publications met the inclusion criteria. Recommendations were based on treatment strategies that improve overall survival. Treatments that improve only progression-free survival prompted scrutiny of toxicity and quality of life. For first-line therapy in patients with performance status of 0 or 1, a platinum-based two-drug combination of cytotoxic drugs is recommended. Nonplatinum cytotoxic doublets are acceptable for patients with contraindications to platinum therapy. For patients with performance status of 2, a single cytotoxic drug is sufficient. Stop first-line cytotoxic chemotherapy at disease progression or after four cycles in patients who are not responding to treatment. Stop two-drug cytotoxic chemotherapy at six cycles even in patients who are responding to therapy. The first-line use of gefitinib may be recommended for patients with known epidermal growth factor receptor (EGFR) mutation; for negative or unknown EGFR mutation status, cytotoxic chemotherapy is preferred. Bevacizumab is recommended with carboplatin-paclitaxel, except for patients with certain clinical characteristics. Cetuximab is recommended with cisplatin-vinorelbine for patients with EGFR-positive tumors by immunohistochemistry. Docetaxel, erlotinib, gefitinib, or pemetrexed is recommended as second-line therapy. Erlotinib is recommended as third-line therapy for patients who have not received prior erlotinib or gefitinib. Data are insufficient to recommend the routine third-line use of cytotoxic drugs. Data are insufficient to recommend routine use of molecular markers to select chemotherapy. PMID:19917871

Azzoli, Christopher G.; Baker, Sherman; Temin, Sarah; Pao, William; Aliff, Timothy; Brahmer, Julie; Johnson, David H.; Laskin, Janessa L.; Masters, Gregory; Milton, Daniel; Nordquist, Luke; Pfister, David G.; Piantadosi, Steven; Schiller, Joan H.; Smith, Reily; Smith, Thomas J.; Strawn, John R.; Trent, David; Giaccone, Giuseppe

2009-01-01

150

Growth Hormone Research Society Workshop Summary: Consensus Guidelines for Recombinant Human Growth Hormone Therapy in Prader-Willi Syndrome  

PubMed Central

Context: Recombinant human GH (rhGH) therapy in Prader-Willi syndrome (PWS) has been used by the medical community and advocated by parental support groups since its approval in the United States in 2000 and in Europe in 2001. Its use in PWS represents a unique therapeutic challenge that includes treating individuals with cognitive disability, varied therapeutic goals that are not focused exclusively on increased height, and concerns about potential life-threatening adverse events. Objective: The aim of the study was to formulate recommendations for the use of rhGH in children and adult patients with PWS. Evidence: We performed a systematic review of the clinical evidence in the pediatric population, including randomized controlled trials, comparative observational studies, and long-term studies (>3.5 y). Adult studies included randomized controlled trials of rhGH treatment for ? 6 months and uncontrolled trials. Safety data were obtained from case reports, clinical trials, and pharmaceutical registries. Methodology: Forty-three international experts and stakeholders followed clinical practice guideline development recommendations outlined by the AGREE Collaboration (www.agreetrust.org). Evidence was synthesized and graded using a comprehensive multicriteria methodology (EVIDEM) (http://bit.ly.PWGHIN). Conclusions: Following a multidisciplinary evaluation, preferably by experts, rhGH treatment should be considered for patients with genetically confirmed PWS in conjunction with dietary, environmental, and lifestyle interventions. Cognitive impairment should not be a barrier to treatment, and informed consent/assent should include benefit/risk information. Exclusion criteria should include severe obesity, uncontrolled diabetes mellitus, untreated severe obstructive sleep apnea, active cancer, or psychosis. Clinical outcome priorities should vary depending upon age and the presence of physical, mental, and social disability, and treatment should be continued for as long as demonstrated benefits outweigh the risks. PMID:23543664

Tony, Michele; Hoybye, Charlotte; Allen, David B.; Tauber, Maithe; Christiansen, Jens Sandahl; Ambler, Geoffrey R.; Battista, Renaldo; Beauloye, Veronique; Berall, Glenn; Biller, Beverly M. K.; Butler, Merlin G.; Cassidy, Suzanne B.; Chihara, Kazuo; Cohen, Pinchas; Craig, Maria; Farholt, Stense; Goetghebeur, Mireille; Goldstone, Anthony P.; Greggi, Tiziana; Grugni, Graziano; Hokken-Koelega, Anita C.; Johannsson, Gudmundur; Johnson, Keegan; Kemper, Alex; Kopchick, John J.; Malozowski, Saul; Miller, Jennifer; Mogul, Harriette R.; Muscatelli, Francoise; Nergardh, Ricard; Nicholls, Robert D.; Radovick, Sally; Rosenthal, M. Sara; Sipila, Ilkka; Tarride, Jean-Eric; Vogels, Annick; Waters, Michael J.

2013-01-01

151

[Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): introduction and methodology].  

PubMed

The Recommendations for Specialized Nutritional Support in Critically-Ill patients were drafted by the Metabolism and Nutrition Working Group of the Spanish Society of Intensive Care Medicine and Coronary Units (SEMICYUC) in 2005. Given the time elapsed since then, these recommendations have been reviewed and updated as a Consensus Document in collaboration with the Spanish Society of Parenteral and Enteral Nutrition (SENPE). The primary aim of these Recommendations was to evaluate the best available scientific evidence for the indications of specialized nutritional and metabolic support in critically-ill patients. The Recommendations have been formulated by an expert panel with broad experience in nutritional and metabolic support in critically-ill patients and were drafted between October 2009 and March 2011. The studies analyzed encompassed metaanalyses, randomized clinical trials, observational studies, systematic reviews and updates relating to critically-ill adults in MEDLINE from 1966 to 2010, EMBASE reviews from 1991 to 2010 and the Cochrane Database of Systematic Reviews up to 2010. The methodological criteria selected were those established in the Scottish Intercollegiate Guidelines Network and the Agency for Health Care policy and Research, as well as those of the Jadad Quality Scale. Adjustment for the level of evidence and grade of recommendation was performed following the proposal of the GRADE group (Grading of Recommendations Assessment, Development and Evaluation Working Group). Sixteen pathological scenarios were selected and each of them was developed by groups of three experts. A feedback system was established with the five members of the Editorial Committee and with the entire Working Group. All discrepancies were discussed and consensus was reached over several meetings, with special emphasis placed on reviewing the levels of evidence and grades of recommendation. The Editorial Committee made the final adjustments before the document was approved by all the members of the Working Group. Finally, the document was submitted to the Scientific Committees of the two Societies participating in the Consensus for final approval. The present Recommendations aim to serve as a guide for clinicians involved in the management and treatment of critically-ill patients and for any specialists interested in the nutritional treatment of hospitalized patients. PMID:22309744

Mesejo, A; Vaquerizo Alonso, C; Acosta Escribano, J; Ortiz Leyba, C; Montejo González, J C

2011-11-01

152

Efficacy of a strategy for implementing a guideline for the control of cardiovascular risk in a primary healthcare setting: the SIRVA2 study a controlled, blinded community intervention trial randomised by clusters  

PubMed Central

This work describes the methodology used to assess a strategy for implementing clinical practice guidelines (CPG) for cardiovascular risk control in a health area of Madrid. Background The results on clinical practice of introducing CPGs have been little studied in Spain. The strategy used to implement a CPG is known to influence its final use. Strategies based on the involvement of opinion leaders and that are easily executed appear to be among the most successful. Aim The main aim of the present work was to compare the effectiveness of two strategies for implementing a CPG designed to reduce cardiovascular risk in the primary healthcare setting, measured in terms of improvements in the recording of calculated cardiovascular risk or specific risk factors in patients' medical records, the control of cardiovascular risk factors, and the incidence of cardiovascular events. Methods This study involved a controlled, blinded community intervention in which the 21 health centres of the Number 2 Health Area of Madrid were randomly assigned by clusters to be involved in either a proposed CPG implementation strategy to reduce cardiovascular risk, or the normal dissemination strategy. The study subjects were patients ? 45 years of age whose health cards showed them to belong to the studied health area. The main variable examined was the proportion of patients whose medical histories included the calculation of their cardiovascular risk or that explicitly mentioned the presence of variables necessary for its calculation. The sample size was calculated for a comparison of proportions with alpha = 0.05 and beta = 0.20, and assuming that the intervention would lead to a 15% increase in the measured variables. Corrections were made for the design effect, assigning a sample size to each cluster proportional to the size of the population served by the corresponding health centre, and assuming losses of 20%. This demanded a final sample size of 620 patients. Data were analysed using summary measures for each cluster, both in making estimates and for hypothesis testing. Analysis of the variables was made on an intention-to-treat basis. Trial Registration ClinicalTrials.gov: NCT01270022 PMID:21504570

2011-01-01

153

Guidelines for obstetrical practice in Japan: Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2014 edition.  

PubMed

The 'Clinical Guidelines for Obstetrical Practice, 2011 edition' were revised and published as a 2014 edition (in Japanese) in April 2014 by the Japan Society of Obstetrics and Gynecology and the Japan Association of Obstetricians and Gynecologists. The aims of this publication include the determination of current standard care practices for pregnant women in Japan, the widespread use of standard care practices, the enhancement of safety in obstetrical practice, the reduction of burdens associated with medico-legal and medico-economical problems, and a better understanding between pregnant women and maternity-service providers. The number of Clinical Questions and Answers items increased from 87 in the 2011 edition to 104 in the 2014 edition. The Japanese 2014 version included a Discussion, a List of References, and some Tables and Figures following the Answers to the 104 Clinical Questions; these additional sections covered common problems and questions encountered in obstetrical practice, helping Japanese readers to achieve a comprehensive understanding. Each answer with a recommendation level of A, B or C was prepared based principally on 'evidence' or a consensus among Japanese obstetricians in situations where 'evidence' was weak or lacking. Answers with a recommendation level of A or B represent current standard care practices in Japan. All 104 Clinical Questions and Answers items, with the omission of the Discussion, List of References, and Tables and Figures, are presented herein to promote a better understanding among English readers of the current standard care practices for pregnant women in Japan. PMID:24888907

Minakami, Hisanori; Maeda, Tsugio; Fujii, Tomoyuki; Hamada, Hiromi; Iitsuka, Yoshinori; Itakura, Atsuo; Itoh, Hiroaki; Iwashita, Mitsutoshi; Kanagawa, Takeshi; Kanai, Makoto; Kasuga, Yoshio; Kawabata, Masakiyo; Kobayashi, Kosuke; Kotani, Tomomi; Kudo, Yoshiki; Makino, Yasuo; Matsubara, Shigeki; Matsuda, Hideo; Miura, Kiyonori; Murakoshi, Takeshi; Murotsuki, Jun; Ohkuchi, Akihide; Ohno, Yasumasa; Ohshiba, Yoko; Satoh, Shoji; Sekizawa, Akihiko; Sugiura, Mayumi; Suzuki, Shunji; Takahashi, Tsuneo; Tsukahara, Yuki; Unno, Nobuya; Yoshikawa, Hiroyuki

2014-06-01

154

Lycopene and cardiovascular diseases: an update.  

PubMed

Cardiovascular disease (CVD) is the leading cause of death in Western societies and accounts for up to a third of all deaths worldwide. In comparison to the Northern European or other Western countries, the Mediterranean area has lower rates of mortality from cardiovascular diseases and cancer, and this is attributed, at least in part, to the so-called Mediterranean diet, which is rich in plantderived bioactive phytochemicals. Identification of the active constituents of the Mediterranean diet is therefore crucial to the formulation of appropriate dietary guidelines. Lycopene is a natural carotenoid found in tomato, an essential component of the Mediterranean diet, which, although belonging to the carotenoid family, does not have pro-vitamin A activity but many other biochemical functions as an antioxidant scavenger, hypolipaemic agent, inhibitor of pro-inflammatory and pro-thrombotic factors, thus potentially of benefit in CVD. In particular, the review intends to conduct a systematic analysis of the literature (epidemiological studies and interventional trials) in order to critically evaluate the association between lycopene (or tomato products) supplementation and cardiovascular diseases and/or cardiovascular disease risk factors progression, and to prepare provision of evidence-based guidelines for patients and clinicians. Several reports have appeared in support of the role of lycopene in the prevention of CVD, mostly based on epidemiological studies showing a dose-response relationship between lycopene and CVD. A less clear and more complex picture emerges from the interventional trials, where several works have reported conflicting results. Although many aspects of lycopene in vivo metabolism, functions and clinical indications remain to be clarified, supplementation of low doses of lycopene has been already suggested as a preventive measure for contrasting and ameliorating many aspects of CVD. PMID:21291369

Mordente, A; Guantario, B; Meucci, E; Silvestrini, A; Lombardi, E; Martorana, G E; Giardina, B; Böhm, V

2011-01-01

155

A report from the European Society of Cardiology Congress 2014 (August 30-September 3 - Barcelona, Spain).  

PubMed

The European Society of Cardiology (ESC) Annual Congress is the largest cardiology conference in the world and this year ran in Barcelona from August 30 to September 3. During the meeting, more than 30,000 cardiologists from over 100 countries met to share their knowledge in all cardiovascular fields, from basic science to management and prevention of cardiovascular diseases. Apart from more than 4,500 interesting abstracts presented in posters and oral sessions, five new ESC Clinical Practice Guidelines were presented among the latest clinical trial results, updates and registries. PMID:25313372

Dulsat, C

2014-09-01

156

Recommendations for cardiovascular magnetic resonance in adults with congenital heart disease from the respective working groups of the European Society of Cardiology  

PubMed Central

This paper aims to provide information and explanations regarding the clinically relevant options, strengths, and limitations of cardiovascular magnetic resonance (CMR) in relation to adults with congenital heart disease (CHD). Cardiovascular magnetic resonance can provide assessments of anatomical connections, biventricular function, myocardial viability, measurements of flow, angiography, and more, without ionizing radiation. It should be regarded as a necessary facility in a centre specializing in the care of adults with CHD. Also, those using CMR to investigate acquired heart disease should be able to recognize and evaluate previously unsuspected CHD such as septal defects, anomalously connected pulmonary veins, or double-chambered right ventricle. To realize its full potential and to avoid pitfalls, however, CMR of CHD requires training and experience. Appropriate pathophysiological understanding is needed to evaluate cardiovascular function after surgery for tetralogy of Fallot, transposition of the great arteries, and after Fontan operations. For these and other complex CHD, CMR should be undertaken by specialists committed to long-term collaboration with the clinicians and surgeons managing the patients. We provide a table of CMR acquisition protocols in relation to CHD categories as a guide towards appropriate use of this uniquely versatile imaging modality. PMID:20067914

Kilner, Philip J.; Geva, Tal; Kaemmerer, Harald; Trindade, Pedro T.; Schwitter, Juerg; Webb, Gary D.

2010-01-01

157

[Cardiovascular prevention according to CEIPC: a critical appraisal].  

PubMed

We present a critical appraisal of the adaptation to the 4th European Guidelines on Cardiovascular Disease Prevention in Clinical Practice carried out by The Spanish Interdisciplinary Committee for Cardiovascular Disease Prevention (CEIPC), which is based on: 1) the removal, by the CEIPC, of important restrictions on the start of drug therapy that are contained in the European guide 2) the existence of internal contradictions and differing recommendations regarding the goals of LDL in the several publications of the CEIP adaptation; and 3) and the almost total lack of necessary discussion about risk tables in Spain. Therefore, it makes a critical appraisal of some of the most important clinical recommendations shared by the CEIPC and the European guide that are not supported by clinical evidence, like the implicit proposal of using the estimated cardiovascular risk as a target for treatment, the criteria to begin the antihypertensive drug therapy and therapeutic goals for blood pressure, LDL-cholesterol and HbA1c. The public health administration and also the scientific society must ensure transparency and independence in the drafting of documents endorsed by them, including the management and declaration of potential conflicts of interest among editors and group members. The public health administration and also the scientific society must guarantee a framework of honesty and transparency in the documents endorsed by them, with a complete declaration of the authors conflict of interests. PMID:20571719

Miguel-García, Félix; Merino-Senovilla, Alejandro; Montero-Alonso, María José; García-Ortiz, Alejandra; Sanz-Cantalapiedra, Ruperto; Maderuelo-Fernández, José Angel

2010-01-01

158

Report of the Inter-Society Commission for Heart Disease Resources. Medical instrumentation in peripheral vascular disease. Resource and planning guidelines for the hospital and physician.  

PubMed

This is a resource and planning guideline for hospitals and physicians. The status of medical instrumentation in peripheral vascular disease diagnosis is reviewed and the application of examination methods to categories of vascular disease discussed. Resour PMID:135657

Bergan, J J; Darling, R C; DeWolfe, V G; Raines, J K; Strandness, D E; yao, J S

1976-11-01

159

Clinical evaluation of cardiovascular devices: principles, problems, and proposals for European regulatory reform. Report of a policy conference of the European Society of Cardiology.  

PubMed

The European Commission announced in 2008 that a fundamental revision of the medical device directives is being considered in order to clarify and strengthen the current legal framework. The system for testing and approving devices in Europe was established >20 years ago as a 'New Approach' to a previously little-regulated industry. It is recognized by many that the regulatory system has not kept pace with technological advances and changing patterns of medical practice. New legislation will be drafted during 2011, but medical experts have been little involved in this important process. This context makes it an opportune time for a professional association to advise from both clinical and academic perspectives about changes which should be made to improve the safety and efficacy of devices used in clinical practice and to develop more appropriate systems for their clinical evaluation and post-marketing surveillance. This report summarizes how medical devices are regulated and it reviews some serious clinical problems that have occurred with cardiovascular devices. Finally, it presents the main recommendations from a Policy Conference on the Clinical Evaluation of Cardiovascular Devices that was held at the European Heart House in January 2011. PMID:21572115

Fraser, Alan G; Daubert, Jean-Claude; Van de Werf, Frans; Estes, N A Mark; Smith, Sidney C; Krucoff, Mitchell W; Vardas, Panos E; Komajda, Michel

2011-07-01

160

Prevention of cardiovascular disease guided by total risk estimations - challenges and opportunities for practical implementation: highlights of a CardioVascular Clinical Trialists (CVCT) Workshop of the ESC Working Group on CardioVascular Pharmacology and Drug Therapy  

PubMed Central

This paper presents a summary of the potential practical and economic barriers to implementation of primary prevention of cardiovascular disease guided by total cardiovascular risk estimations in the general population. It also reviews various possible solutions to overcome these barriers. The report is based on discussion among experts in the area at a special CardioVascular Clinical Trialists workshop organized by the European Society of Cardiology Working Group on Cardiovascular Pharmacology and Drug Therapy that took place in September 2009. It includes a review of the evidence in favour of the ‘treat-to-target’ paradigm, as well as potential difficulties with this approach, including the multiple pathological processes present in high-risk patients that may not be adequately addressed by this strategy. The risk-guided therapy approach requires careful definitions of cardiovascular risk and consideration of clinical endpoints as well as the differences between trial and ‘real-world’ populations. Cost-effectiveness presents another issue in scenarios of finite healthcare resources, as does the difficulty of documenting guideline uptake and effectiveness in the primary care setting, where early modification of risk factors may be more beneficial than later attempts to manage established disease. The key to guideline implementation is to improve the quality of risk assessment and demonstrate the association between risk factors, intervention, and reduced event rates. In the future, this may be made possible by means of automated data entry and various other measures. In conclusion, opportunities exist to increase guideline implementation in the primary care setting, with potential benefits for both the general population and healthcare resources. PMID:23310961

Zannad, Faiez; Dallongeville, Jean; Macfadyen, Robert J; Ruilope, Luis M; Wilhelmsen, Lars; De Backer, Guy; Graham, Ian; Lorenz, Matthias; Mancia, Giuseppe; Morrow, David A; Reiner, Zeljko; Koenig, Wolfgang

2012-01-01

161

Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV-Exposed and HIV-Infected Children: Recommendations from CDC, the National Institutes of Health, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics  

PubMed Central

Summary This report updates and combines into one document earlier versions of guidelines for preventing and treating opportunistic infections (OIs) among HIV-exposed and HIV-infected children, last published in 2002 and 2004, respectively. These guidelines are intended for use by clinicians and other health-care workers providing medical care for HIV-exposed and HIV-infected children in the United States. The guidelines discuss opportunistic pathogens that occur in the United States and one that might be acquired during international travel (i.e., malaria). Topic areas covered for each OI include a brief description of the epidemiology, clinical presentation, and diagnosis of the OI in children; prevention of exposure; prevention of disease by chemoprophylaxis and/or vaccination; discontinuation of primary prophylaxis after immune reconstitution; treatment of disease; monitoring for adverse effects during treatment; management of treatment failure; prevention of disease recurrence; and discontinuation of secondary prophylaxis after immune reconstitution. A separate document about preventing and treating of OIs among HIV-infected adults and postpubertal adolescents (Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents) was prepared by a working group of adult HIV and infectious disease specialists. The guidelines were developed by a panel of specialists in pediatric HIV infection and infectious diseases (the Pediatric Opportunistic Infections Working Group) from the U.S. government and academic institutions. For each OI, a pediatric specialist with content-matter expertise reviewed the literature for new information since the last guidelines were published; they then proposed revised recommendations at a meeting at the National Institutes of Health (NIH) in June 2007. After these presentations and discussions, the guidelines underwent further revision, with review and approval by the Working Group, and final endorsement by NIH, CDC, the HIV Medicine Association (HIVMA) of the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Disease Society (PIDS), and the American Academy of Pediatrics (AAP). The recommendations are rated by a letter that indicates the strength of the recommendation and a Roman numeral that indicates the quality of the evidence supporting the recommendation so readers can ascertain how best to apply the recommendations in their practice environments. An important mode of acquisition of OIs, as well as HIV infection among children, is from their infected mother; HIV-infected women coinfected with opportunistic pathogens might be more likely than women without HIV infection to transmit these infections to their infants. In addition, HIV-infected women or HIV-infected family members coinfected with certain opportunistic pathogens might be more likely to transmit these infections horizontally to their children, resulting in increased likelihood of primary acquisition of such infections in the young child. Therefore, infections with opportunistic pathogens might affect not just HIV-infected infants but also HIV-exposed but uninfected infants who become infected by the pathogen because of transmission from HIV-infected mothers or family members with coinfections. These guidelines for treating OIs in children therefore consider treatment of infections among all children, both HIV-infected and uninfected, born to HIV-infected women. Additionally, HIV infection is increasingly seen among adolescents with perinatal infection now surviving into their teens and among youth with behaviorally acquired HIV infection. Although guidelines for postpubertal adolescents can be found in the adult OI guidelines, drug pharmacokinetics and response to treatment may differ for younger prepubertal or pubertal adolescents. Therefore, these guidelines also apply to treatment of HIV-infected youth who have not yet completed pubertal development. Major changes in the guidelines include 1) greater emphasis on the importance of antiretroviral therapy for p

Mofenson, Lynne M.; Brady, Michael T.; Danner, Susie P.; Dominguez, Kenneth L.; Hazra, Rohan; Handelsman, Edward; Havens, Peter; Nesheim, Steve; Read, Jennifer S.; Serchuck, Leslie; Van Dyke, Russell

2010-01-01

162

Discrepancies between two lipid-lowering guidelines for CVD prevention in seemingly healthy individuals--case study Lebanon  

PubMed Central

Background In deciding on optimal interventions for cardiovascular disease (CVD) prevention, more than one set of guidelines are available. Hypothesis The aim of the study was to assess the agreement between the European Society of Cardiology (ESC) 2011 Guidelines for CVD Prevention and the Canadian Cardiovascular Society (CCS) 2009 Guidelines in recommending lipid lowering interventions in a seemingly healthy cohort of Lebanese persons. Methods A nationally representative cohort of Lebanon was identified according to the World Health Organization (WHO) Steps Criteria. From this cohort, a group of 283 adult individuals not known to have chronic illnesses was selected. Using the algorithms present in each guideline, lipid lowering recommendations for each individual were determined. Agreement between the two guideline recommendations was determined using the Kappa test. Results As per ESC, 3.9% of the participants required immediate drug therapy, 15.5% should be considered for drug therapy, and 80.1% required lifestyle intervention. As per the CCS, however, 19.4% required drug therapy. The overall level of agreement between the ESC and CCS for recommending lipid lowering was moderate (Kappa 0.77), and better in males (Kappa 0.82). In contrast, 37.5% of females recommended drug therapy as per the CCS guidelines would not be per the ESC guidelines (Kappa 0.63). Conclusions Significant discrepancies exist in recommendations for lipid-lowering therapy between CCS and ESC guidelines when applied to Lebanese individuals, particularly for women. Local healthcare authorities and the WHO should attend to this issue in order to unify treatment approaches and limit disparities in care. PMID:24282761

Harbieh, Bernard; Tamim, Hani; Nasreddine, Lara; Naja, Farah; Sibai, Abla; Adra, Nada; Badr, Kamal; Hwalla, Nahla

2013-01-01

163

Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline From the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology  

Microsoft Academic Search

In the United States, colorectal cancer (CRC) is the third most common cancer diagnosed among men and women and the second leading cause of death from cancer. CRC largely can be prevented by the detection and removal of adenomatous polyps, and survival is significantly better when CRC is diagnosed while still localized. In 2006 to 2007, the American Cancer Society,

Bernard Levin; David A. Lieberman; Beth McFarland; Kimberly S. Andrews; Durado Brooks; John Bond; Chiranjeev Dash; Francis M. Giardiello; Seth Glick; David Johnson; C. Daniel Johnson; Theodore R. Levin; Perry J. Pickhardt; Douglas K. Rex; Robert A. Smith; Alan Thorson; Sidney J. Winawer

2008-01-01

164

Cardiovascular benefits of omega-3 fatty acids  

Microsoft Academic Search

Cardiac societies recommend the intake of 1 g\\/day of the two omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) for cardiovascular disease prevention, treatment after a myocardial infarction, prevention of sudden death, and secondary prevention of cardiovascular disease. These recommendations are based on a body of scientific evidence that encompasses literally thousands of publications. Of four large scale

Clemens von Schacky; William S. Harris

2007-01-01

165

Pharmacogenomics and Cardiovascular Disease  

PubMed Central

Variability in drug responsiveness is a sine qua non of modern therapeutics, and the contribution of genomic variation is increasingly recognized. Investigating the genomic basis for variable responses to cardiovascular therapies has been a model for pharmacogenomics in general and has established critical pathways and specific loci modulating therapeutic responses to commonly used drugs such as clopidogrel, warfarin, and statins. In addition, genomic approaches have defined mechanisms and genetic variants underlying important toxicities with these and other drugs. These findings have not only resulted in changes to the product labels but also have led to development of initial clinical guidelines that consider how to facilitate incorporating genetic information to the bedside. This review summarizes the state of knowledge in cardiovascular pharmacogenomics and considers how variants described to date might be deployed in clinical decision making. PMID:23689943

Weeke, Peter; Roden, Dan M.

2014-01-01

166

[Statins and ASS for primary prevention of cardiovascular and cerebrovascular disease].  

PubMed

Whereas statins and acetylsalicylic acid (ASA) are considered gold standard for secondary prevention following myocardial infarction or atherotrombotic stroke, there are inconsistent data on the use of these drugs for primary prevention in patients with increased cardiovascular risk. Some meta-analyses indicated that the use of statins and ASA for primary prevention of cardiovascular disease can reduce the risk of cardiovascular events such as ischemic stroke or myocardial infarction. However, the effects of primary prevention with statins and ASA on mortality varied in the data included in these meta-analyses. Therefore the guidelines of the German College of General Practitioners and Family Physicians recommend primary prevention with statins and ASA only in those patients who have a 10-year risk of cardiovascular events which exceeds 20?%. Divergently, primary prevention with ASA is not recommended by the European Society of Cardiology. Observational studies suggested that treatment success of primary prevention with statins and ASA depends on various factors such as adherence to medication and prescription behavior of physicians. This review summarizes the current literature on primary prevention of cardiovascular events with ASA and statins. PMID:24473850

Goltz, L; Bodechtel, U; Siepmann, T

2014-02-01

167

DGGG Guidelines Programme: Status Quo - Quo Vadis!  

PubMed Central

The Guidelines programme of the German Society of Gynaecology and Obstetrics (DGGG) is an executive part of the DGGG Guidelines Commission. It includes in-house planning and organisation of all guidelines as well as representation outside of the DGGG. This article does not concern the development of the guidelines as much as it concerns the planning, organisation, registration, editing and publication of the guidelines in context of the DGGG Guidelines programme. It targets interested parties, especially authors and coordinators of guidelines. PMID:24882875

Beckmann, M. W.; Linde, I.; Butof, C.; Kreienberg, R.; Gass, P.

2014-01-01

168

Prevention, diagnosis, therapy and follow-up care of sepsis: 1st revision of S-2k guidelines of the German Sepsis Society (Deutsche Sepsis-Gesellschaft e.V. (DSG)) and the German Interdisciplinary Association of Intensive Care and Emergency Medicine (Deutsche Interdisziplin?re Vereinigung f?r Intensiv- und Notfallmedizin (DIVI))  

PubMed Central

Practice guidelines are systematically developed statements and recommendations that assist the physicians and patients in making decisions about appropriate health care measures for specific clinical circumstances taking into account specific national health care structures. The 1st revision of the S-2k guideline of the German Sepsis Society in collaboration with 17 German medical scientific societies and one self-help group provides state-of-the-art information (results of controlled clinical trials and expert knowledge) on the effective and appropriate medical care (prevention, diagnosis, therapy and follow-up care) of critically ill patients with severe sepsis or septic shock. The guideline had been developed according to the “German Instrument for Methodological Guideline Appraisal” of the Association of the Scientific Medical Societies (AWMF). In view of the inevitable advancements in scientific knowledge and technical expertise, revisions, updates and amendments must be periodically initiated. The guideline recommendations may not be applied under all circumstances. It rests with the clinician to decide whether a certain recommendation should be adopted or not, taking into consideration the unique set of clinical facts presented in connection with each individual patient as well as the available resources. PMID:20628653

Reinhart, K.; Brunkhorst, F. M.; Bone, H.-G.; Bardutzky, J.; Dempfle, C.-E.; Forst, H.; Gastmeier, P.; Gerlach, H.; Grundling, M.; John, S.; Kern, W.; Kreymann, G.; Kruger, W.; Kujath, P.; Marggraf, G.; Martin, J.; Mayer, K.; Meier-Hellmann, A.; Oppert, M.; Putensen, C.; Quintel, M.; Ragaller, M.; Rossaint, R.; Seifert, H.; Spies, C.; Stuber, F.; Weiler, N.; Weimann, A.; Werdan, K.; Welte, T.

2010-01-01

169

Prevalence of type 2 diabetes mellitus, other cardiovascular risk factors, and cardiovascular disease in Turkish and Moroccan immigrants in North West Europe: a systematic review  

Microsoft Academic Search

Background. The prevalence of diabetes, other cardiovascular risk factors, and cardiovascular morbidity and mortality varies between immigrant groups in Western societies, but epidemiological data on these topics are scarce for Turks and Moroccan immigrant living in North West Europe.Methods. Medline and Embase were systematically searched for studies containing data on the prevalence of diabetes, cardiovascular risk factors, and cardiovascular morbidity

P. J. M. Uitewaal; D. R. Manna; M. A. Bruijnzeels; A. W. Hoes; S. Thomas

2004-01-01

170

Cardiovascular system  

MedlinePLUS Videos and Cool Tools

The cardiovascular system is composed of the heart and the network of arteries, veins, and capillaries that transport blood throughout the ... carries waste products from the tissues to the systems of the body through which they are eliminated. ...

171

Prevalence and concordance of high cardiovascular disease scores in HIV/AIDS patients from Croatia and Serbia with four international algorithms  

PubMed Central

Introduction We evaluated cardiovascular risks in HIV-infected patients from Croatia and Serbia and the eligibility for statin therapy as recommended by the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines, European AIDS Clinical Society (EACS) Guidelines and European Society of Cardiology and the European Atherosclerosis Society (ESC/EAS) guidelines for cardiovascular disease (CVD) prevention [1–3]. Materials and Methods A cross-sectional analysis of consecutive patients between 40 and 79 years old who had received antiretroviral therapy for at least 12 months was performed. Results Of 254 (132 from Croatia and 122 from Serbia) persons included in the study, 76% were male; median age was 49 years. Up to 51.6% of persons had a high CVD risk. The prevalence of current smoking was 42.9%, hypertension 31.5% and hypercholesterolaemia (>6.2 mmol/L) 35.4%. Statins would be recommended to 21.3% (95% CI, 16.3% to 27.4%) of persons by the EACS, 25.6% (95% CI, 20.2% to 31.9%) by ESC/EAS and 37.9% (95% CI, 31.6 to 44.6%) by the ACC/AHA guidelines. A high 5-year data collection on adverse effects of anti-HIV drugs study risk score (>5%) had a moderate agreement with the high (?20%) 10-year CVD Framingham risk score (kappa=0.47) and high (?5%) 10-year European systematic coronary risk evaluation score algorithm (kappa=0.47), and substantial agreement with the elevated (?7.5%) 10-year Pooled Cohort Atherosclerotic CVD risk equation score (kappa=0.63). Conclusion We found a high prevalence of CVD risks in patients from Croatia and Serbia. The ACC/AHA guideline would recommend statins more often than ESC/EAS and EACS guidelines. PMID:25394056

Begovac, Josip; Dragovic, Gordana; Viskovic, Klaudija; Kusic, Jovana; Perovic Mihanovic, Marta; Lukas, Davorka; Jevtovic, Djordje

2014-01-01

172

[Autologous chondrocyte implantation (ACI) for cartilage defects of the knee: a guideline by the working group "Tissue Regeneration" of the German Society of Orthopaedic Surgery and Traumatology (DGOU)].  

PubMed

Autologous chondrocyte transplantation/implantation (ACT/ACI) is an established and recognised procedure for the treatment of localised full-thickness cartilage defects of the knee. The present review of the working group "Clinical Tissue Regeneration" of the German Society of Orthopaedics and Traumatology (DGOU) describes the biology and function of healthy articular cartilage, the present state of knowledge concerning potential consequences of primary cartilage lesions and the suitable indication for ACI. Based on current evidence, an indication for ACI is given for symptomatic cartilage defects starting from defect sizes of more than 3-4 cm2; in the case of young and active sports patients at 2.5 cm2. Advanced degenerative joint disease is the single most important contraindication. The review gives a concise overview on important scientific background, the results of clinical studies and discusses advantages and disadvantages of ACI. PMID:23423589

Niemeyer, P; Andereya, S; Angele, P; Ateschrang, A; Aurich, M; Baumann, M; Behrens, P; Bosch, U; Erggelet, C; Fickert, S; Fritz, J; Gebhard, H; Gelse, K; Günther, D; Hoburg, A; Kasten, P; Kolombe, T; Madry, H; Marlovits, S; Meenen, N M; Müller, P E; Nöth, U; Petersen, J P; Pietschmann, M; Richter, W; Rolauffs, B; Rhunau, K; Schewe, B; Steinert, A; Steinwachs, M R; Welsch, G H; Zinser, W; Albrecht, D

2013-02-01

173

Cardiovascular Genomics  

PubMed Central

Purpose This article provides an update on cardiovascular genomics using three clinically relevant exemplars, including myocardial infarction (MI) and coronary artery disease (CAD), stroke, and sudden cardiac death (SCD). Organizational Construct Recent advances in cardiovascular genomic research, testing, and clinical implications are presented. Methods Genomic nurse experts reviewed and summarized recent salient literature to provide updates on three selected cardiovascular genomic conditions. Findings Research is ongoing to discover comprehensive genetic markers contributing to many common forms of cardiovascular disease (CVD), including MI and stroke. However, genomic technologies are increasingly being used clinically, particularly in patients with long QT syndrome (LQTS) or hypertrophic cardiomyopathy (HCM) who are at risk for SCD. Conclusions Currently, there are no clinically recommended genetic tests for many common forms of CVD even though direct-to-consumer genetic tests are being marketed to healthcare providers and the general public. On the other hand, genetic testing for patients with certain single gene conditions, including channelopathies (e.g., LQTS) and cardiomyopathies (e.g., HCM), is recommended clinically. Clinical Relevance Nurses play a pivotal role in cardiogenetics and are actively engaged in direct clinical care of patients and families with a wide variety of heritable conditions. It is important for nurses to understand current development of cardiovascular genomics and be prepared to translate the new genomic knowledge into practice. PMID:23368089

Wung, Shu-Fen; Hickey, Kathleen T.; Taylor, Jacquelyn Y.; Gallek, Matthew J.

2013-01-01

174

Ethical and Clinical Aspects of Intensive Care Unit Admission in Patients with Hematological Malignancies: Guidelines of the Ethics Commission of the French Society of Hematology  

PubMed Central

Admission of patients with hematological malignancies to intensive care unit (ICU) raises recurrent ethical issues for both hematological and intensivist teams. The decision of transfer to ICU has major consequences for end of life care for patients and their relatives. It also impacts organizational human and economic aspects for the ICU and global health policy. In light of the recent advances in hematology and critical care medicine, a wide multidisciplinary debate has been conducted resulting in guidelines approved by consensus by both disciplines. The main aspects developed were (i) clarification of the clinical situations that could lead to a transfer to ICU taking into account the severity criteria of both hematological malignancy and clinical distress, (ii) understanding the process of decision-making in a context of regular interdisciplinary concertation involving the patient and his relatives, (iii) organization of a collegial concertation at the time of the initial decision of transfer to ICU and throughout and beyond the stay in ICU. The aim of this work is to propose suggestions to strengthen the collaboration between the different teams involved, to facilitate the daily decision-making process, and to allow improvement of clinical practice.

Malak, Sandra; Sotto, Jean-Jacques; Ceccaldi, Joel; Colombat, Philippe; Casassus, Philippe; Jaulmes, Dominique; Rochant, Henri; Cheminant, Morgane; Beaussant, Yvan; Zittoun, Robert; Bordessoule, Dominique

2014-01-01

175

[2013 Ambulatory blood pressure monitoring recommendations for the diagnosis of adult hypertension, assessment of cardiovascular and other hypertension-associated risk, and attainment of therapeutic goals (summary). Joint recommendations from the International Society for Chronobiology (ISC), American Association of Medical Chronobiology and Chronotherapeutics (AAMCC), Spanish Society of Applied Chronobiology, Chronotherapy, and Vascular Risk (SECAC), Spanish Society of Atherosclerosis (SEA), and Romanian Society of Internal Medicine (RSIM)].  

PubMed

Correlation between systolic (SBP) and diastolic (DBP) blood pressure (BP) level and target organ damage, cardiovascular disease (CVD) risk, and long-term prognosis is much greater for ambulatory BP monitoring (ABPM) than daytime office measurements. The 2013 ABPM guidelines specified herein are based on ABPM patient outcomes studies and constitute a substantial revision of current knowledge. The asleep SBP mean and sleep-time relative SBP decline are the most significant predictors of CVD events, both individually as well as jointly when combined with other ABPM-derived prognostic markers. Thus, they should be preferably used to diagnose hypertension and assess CVD and other associated risks. Progressive decrease by therapeutic intervention in the asleep BP mean is the most significant predictor of CVD event-free interval. The 24 h BP mean is not recommended to diagnose hypertension because it disregards the more valuable clinical information pertaining to the features of the 24 h BP pattern. Persons with the same 24 h BP mean may display radically different 24 h BP patterns, ranging from extreme-dipper to riser types, representative of markedly different risk states. Classification of individuals by comparing office with either the 24 h or awake BP mean as "masked normotensives" (elevated clinic BP but normal ABPM), which should replace the terms of "isolated office" or "white-coat hypertension", and "masked hypertensives" (normal clinic BP but elevated ABPM) is misleading and should be avoided because it disregards the clinical significance of the asleep BP mean. Outcome-based ABPM reference thresholds for men, which in the absence of compelling clinical conditions are 135/85 mmHg for the awake and 120/70 mmHg for the asleep SBP/DBP means, are lower by 10/5 mmHg for SBP/DBP in uncomplicated, low-CVD risk, women and lower by 15/10 mmHg for SBP/DBP in male and female high-risk patients, e.g., with diabetes, chronic kidney disease (CKD), and/or past CVD events. In the adult population, the combined prevalence of masked normotension and masked hypertension is >35%. Moreover, >20% of "normotensive" adults have a non-dipper BP profile and, thus, are at relatively high CVD risk. Clinic BP measurements, even if supplemented with home self-measurements, are unable to quantify 24 h BP patterning and asleep BP level, resulting in potential misclassification of up to 50% of all evaluated adults. ABPM should be viewed as the new gold standard to diagnose true hypertension, accurately assess consequent tissue/organ, maternal/fetal, and CVD risk, and individualize hypertension chronotherapy. ABPM should be a priority for persons likely to have a blunted nighttime BP decline and elevated CVD risk, i.e., those who are elderly and obese, those with secondary or resistant hypertension, and those diagnosed with diabetes, CKD, metabolic syndrome, and sleep disorders. PMID:23849214

Hermida, Ramón C; Smolensky, Michael H; Ayala, Diana E; Portaluppi, Francesco; Crespo, Juan J; Fabbian, Fabio; Haus, Erhard; Manfredini, Roberto; Mojón, Artemio; Moyá, Ana; Piñeiro, Luis; Ríos, María T; Otero, Alfonso; Balan, Horia; Fernández, José R

2013-01-01

176

No Testosterone Therapy for Healthy Women, New Guidelines State  

MedlinePLUS

... on this page, please enable JavaScript. No Testosterone Therapy for Healthy Women, New Guidelines State Benefits unclear, ... testosterone deficiency and should not be prescribed testosterone therapy, a new guideline from the Endocrine Society states. " ...

177

Forms & Guidelines  

Cancer.gov

2003 Step 1: Developing a Cancer Prevention Clinical Trial Forms & Guidelines General Guidelines for Consortia Lead Organization to add Participating to Consortium (doc, 63kb) NCI Request for Proposals, Current DCP Letter of Intent Submission Form

178

Cardiovascular Proteomics  

Microsoft Academic Search

Traditional cardiovascular proteomics includes the comparative large-scale determination of protein profiles and the identification\\u000a of individual proteins of myocardial tissue from different species including humans. The goal of these studies consisted,\\u000a and still consists, in the establishment of comprehensive proteome databases. By comparison with protein profiles from diseased\\u000a tissues such databases will enable to an increasing degree the fast identification

Rainer Klocke; Sergiu Scobioala; Sigrid Nikol

179

Cardiovascular System  

Microsoft Academic Search

\\u000a Nuclear medicine provides important information in the diagnosis and management of several cardiovascular disorders. It provides\\u000a a noninvasive means for evaluation of cardiac function. Radionuclide imaging of myocardial perfusion is a commonly performed\\u000a nuclear medicine examination to determine the adequacy of blood flow to the myocardium, especially in conjunction with exercise\\u000a or pharmacologic stress for the detection and evaluation of

Abdelhamid H. Elgazzar

180

[Cardiovascular pharmacogenomics].  

PubMed

Cardiovascular disease remains a major cause of morbidity and mortality worldwide. Current medical practice takes into account information based on population studies and benefits observed in large populations or cohorts. However, individual patients present great differences in both toxicity and clinical efficacy that can be explained by variations in adherence, unknown drug to drug interactions and genetic variability. The latter seems to explain from 20% up to 95% of patient to patient variability. Treating patients with cardiovascular disorders faces the clinician with the challenge to include genomic analysis into daily practice. There are several examples within cardiovascular disease of treatments that can vary in toxicity or clinical usefulness based on genetic changes. One of the main factors affecting the efficacy of Clopidogrel is the phenotype associated with polymorphisms in the gene CYP 2C9. Furthermore, regarding oral anticoagulants, changes in CYP2C9 and VKORC1 play an important role in changing the clinical response to anticoagulation. When analyzing statin treatment, one of their main toxicities (myopathy) can be predicted by the SLCO1B1 polymorphism. The potential for prediction of toxicity and clinical efficacy from the use of genetic analysis warrants further studies aiming towards its inclusion in daily clinical practice. PMID:24636047

Scibona, Paula; Angriman, Federico; Simonovich, Ventura; Heller, Martina M; Belloso, Waldo H

2014-01-01

181

Pulmonary rehabilitation exercise prescription in chronic obstructive lung disease: US survey and review of guidelines and clinical practices.  

PubMed

Chronic obstructive pulmonary disease is a common, progressive disorder associated with disabling symptoms, skeletal muscle dysfunction, and substantial morbidity and mortality. Current national guidelines recommend pulmonary rehabilitation (PR) to improve dyspnea, functional capacity, and quality of life. Many PR exercise programs are based on guidelines from the American College of Sports Medicine. Recommendations have also been published by the American Association of Cardiovascular and Pulmonary Rehabilitation and the American Thoracic Society. Translating exercise science into effective training and clinical care requires interpretation and the use of diverse national PR guidelines and recommendations. Pulmonary rehabilitation clinicians often vary in their education and background, with most nurses and respiratory care practitioners lacking formal training in exercise physiology. Patients often have comorbidities that may further complicate exercise provision and prescription. This article describes the results of an informal, nonscientific survey of the American Association of Cardiovascular and Pulmonary Rehabilitation members exploring current PR exercise prescription practices as a basis for discussion and reviews current national exercise recommendations for chronic obstructive pulmonary disease. Further, it describes areas of uncertainty regarding exercise prescription in PR and suggests strategies for providing effective exercise training, given the diversity of guidelines, clinician preparedness, and patient complexity. PMID:23846840

Garvey, Chris; Fullwood, M Dot; Rigler, Julia

2013-01-01

182

Renin-angiotensin-aldosterone system blockade for cardiovascular diseases: current status  

PubMed Central

Activation of the renin–angiotensin–aldosterone system (RAAS) results in vasoconstriction, muscular (vascular and cardiac) hypertrophy and fibrosis. Established arterial stiffness and cardiac dysfunction are key factors contributing to subsequent cardiovascular and renal complications. Blockade of RAAS has been shown to be beneficial in patients with hypertension, acute myocardial infarction, chronic systolic heart failure, stroke and diabetic renal disease. An aggressive approach for more extensive RAAS blockade with combination of two commonly used RAAS blockers [ACE inhibitors (ACEIs) and angiotensin receptor blockers (ARBs)] yielded conflicting results in different patient populations. Combination therapy is also associated with more side effects, in particular hypotension, hyperkalaemia and renal impairment. Recently published ONTARGET study showed ACEI/ARB combination therapy was associated with more adverse effects without any increase in benefit. The Canadian Hypertension Education Program responded with a new warning: ‘Do not use ACEI and ARB in combination’. However, the European Society of Cardiology in their updated heart failure treatment guidelines still recommended ACEI/ARB combo as a viable option. This apparent inconsistency among guidelines generates debate as to which approach of RAAS inhibition is the best. The current paper reviews the latest evidence of isolated ACEI or ARB use and their combination in cardiovascular diseases, and makes recommendations for their prescriptions in specific patient populations. PMID:20590619

Ma, Terry KW; Kam, Kevin KH; Yan, Bryan P; Lam, Yat-Yin

2010-01-01

183

Review Tracheotomy: clinical review and guidelines  

Microsoft Academic Search

Summary Tracheotomy is a commonly performed procedure. The Belgian Society of Pneumology (BVP-SBP) and the Belgian Association for Cardiothoracic Surgery (BACTS) developed guidelines on tracheotomy for mechanical ventilation in adults. The levels of evidence as developed by the American College of Chest Physicians (ACCP) were used. The members of the guideline committee reviewed peer-reviewed publications on this subject. After discussion,

Paul De Leyn; Lieven Bedert; Marion Delcroix; Pieter Depuydt; Geert Lauwers; Youri Sokolov; Alain Van Meerhaeghe; Paul Van Schil

184

Cardiovascular risk profile and lifestyle habits in a cohort of Italian cardiologists (from the SOCRATES Survey).  

PubMed

Cardiologists' cardiovascular profile and lifestyle habits are poorly known worldwide. To offer a snapshot of the personal health habits of Italian cardiologists, the Survey on Cardiac Risk Profile and Lifestyle Habits in a Cohort of Italian Cardiologists (SOCRATES) was undertaken. A Web-based electronic self-reported survey, accessible through a dedicated Web site, was used for data entry, and data were transferred through the Web to a central database. The survey was divided into 4 sections: baseline characteristics, medical illnesses and traditional cardiovascular risk factors, lifestyle habits, and selected medication use. The e-mail databases of 3 national scientific societies were used to survey a large and representative sample of Italian cardiologists. During the 3-month period of the survey, 1,770 of the 5,240 cardiologists contacted (33.7%) completed and returned ?1 sections of the questionnaire. More than 49% of the participants had 1 of the 5 classic risk factors (hypertension, hypercholesterolemia, active smoking, diabetes, and previous vascular events). More than 28% of respondents had 2 to 5 risk factors, and only 22.1% had none and therefore, according to age and gender, could be considered at low to intermediate risk. Despite the reported risk factors, >90% of cardiologists had a self-reported risk perception quantified as mild, such as low or intermediate. Furthermore, overweight and obesity, physical inactivity, and stress at work or at home were commonly reported, as well as limited use of cardiovascular drugs, such as statins or aspirin. In conclusion, the average cardiovascular profile of Italian cardiologist is unlikely to be considered ideal or even favorable according to recent statements and guidelines regarding cardiovascular risk. PMID:23587277

Temporelli, Pier Luigi; Zito, Giovanni; Faggiano, Pompilio

2013-07-15

185

Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC)  

Microsoft Academic Search

People with severe mental illnesses, such as schizophrenia, depression or bipolar disorder, have worse physical health and reduced life expectancy compared to the general population. The excess cardiovascular mortality associated with schizophrenia and bipolar disorder is attributed in part to an increased risk of the modifiable coronary heart disease risk factors; obesity, smoking, diabetes, hypertension and dyslipidaemia. Antipsychotic medication and

M. De Hert; J. M. Dekker; D. Wood; K. G. Kahl; R. I. G. Holt; H.-J. Möller

2009-01-01

186

Research Ethical Guidelines and Anonymity  

ERIC Educational Resources Information Center

That researchers should give anonymity to research sites and to the individuals involved in research is usually taken as an ethical norm. Such a norm is embodied internationally in most of the ethical guidelines and codes of practice of the various educational, sociological and psychological research associations and societies. This paper…

Walford, Geoffrey

2005-01-01

187

Physical activity and prevention of cardiovascular disease in older adults.  

PubMed

There is strong evidence that regular physical activity reduces risk of cardiovascular disease. Building on the evidence review for the 2008 Physical Activity Guidelines for Americans, this article summarizes the recommended amounts and types of physical activity for the primary prevention of cardiovascular disease in older adults. Key guidelines are largely based on current understanding of the dose-response relationship between amount of physical activity and risk of chronic disease. In part due to the preventive effects on cardiovascular disease, physical activity has beneficial effects on functional limitations and health-related quality of life in older adults. Gaps in research on physical activity and cardiovascular health are discussed, with an emphasis on the need for research on how sedentary time affects risk of cardiovascular disease and other chronic illnesses. PMID:19944266

Buchner, David M

2009-11-01

188

From hypertrophic cardiomyopathy centers to inherited cardiovascular disease centers in Europe. A small or a major step? A position paper from the Nucleus of the Working Group on Myocardial and Pericardial Diseases of the Portuguese Society of Cardiology.  

PubMed

The prevalence, complexity, clinical importance, heterogeneity and unpredictability of inherited cardiovascular diseases make the development of inherited cardiovascular disease centers an inevitability, with the ultimate goal of reducing the morbidity and mortality associated with these conditions. An inherited cardiovascular disease center may be seen as a subunit of a cardiology department, with health professionals specializing in these types of disorders, organized to provide excellence in all related areas, including diagnosis, treatment, followup, prevention, risk stratification and prognosis. Among its objectives are the development of action protocols and the creation of databases that enable patients to be included in national and international research networks. To achieve these objectives these centers should include functional units of clinical and basic sciences, research, training and education, acting in harmony in a holistic approach to patients and their families. As most experience on inherited cardiovascular diseases is based on hypertrophic cardiomyopathy and on "hypertrophic cardiomyopathy centers", these centers represent an excellent opportunity to learn how to set up inherited cardiovascular disease centers. European centers will differ from country to country, reflecting the heterogeneity of national health systems, but will share a common core, presented in this document. Though we are aware that this ambitious project is not at all easy and may be difficult to implement in its entirety--in fact we consider it a major step--our position is that all the efforts to achieve it are worthwhile, considering that the main goal will always be the well-being of those affected by these particular disorders. PMID:22030325

Cardim, Nuno; Freitas, António; Brito, Dulce

2011-11-01

189

Physical Activity, Obesity and Cardiovascular Diseases  

Microsoft Academic Search

Sedentary lifestyle and overweight are major public health, clinical, and economical problems in modern societies. The worldwide epidemic of excess weight is due to imbalance between physical activity and dietary energy intake. Sedentary lifestyle, unhealthy diet, and consequent overweight and obesity markedly increase the risk of cardiovascular diseases. Regular physical activity 45–60 min per day prevents unhealthy weight gain and

T. A. Lakka; C. Bouchard

190

AHA\\/ACC Guidelines for Preventing Heart Attack and Death in Patients With Atherosclerotic Cardiovascular Disease A Statement for Healthcare Professionals From the American Heart Association and the American College of Cardiology  

Microsoft Academic Search

improves patient survival, reduces recurrent events and the need for interventional procedures, and improves the quality of life for these patients. The compelling evidence from recent clinical trials was the impetus to revise the 1995 guidelines. As examples, the many lipid reduction trials have generated significant changes in the National Heart, Lung, and Blood Institute's Adult Treatment Panel III report.

Sidney C. Smith; Steven N. Blair; Robert O. Bonow; Lawrence M. Brass; Manuel D. Cerqueira; Kathleen Dracup; Valentin Fuster; Antonio Gotto; Scott M. Grundy; Nancy Houston Miller; Alice Jacobs; Daniel Jones; Ronald M. Krauss; Lori Mosca; Ira Ockene; Richard C. Pasternak; Thomas Pearson; Marc A. Pfeffer; Rodman D. Starke; Kathryn A. Taubert

191

The Lebanese Society of Cardiology: Plans and Perspectives, Navigating Against Contrary Winds and Progressing Against All Odds  

PubMed Central

Scientific societies in medicine theoretically aim to improve a medical field as a science; however, this role is expanding nowadays to seeking also the improved practice of a certain medical field. In this regard, the current Lebanese Society of Cardiology (2013–2015) has laid many plans and considered many perspectives. These concern mainly, but not exclusively, the increase of public awareness regarding prevention, investment in research, implementation of guidelines, support of continuous medical education, organization of cardiology symposia and congresses, and achievement of national registries regarding main cardiac conditions, as well as the society’s main objective of decreasing the burden of cardiovascular diseases in Lebanon. Nonetheless, the implementation of such plans and perspectives is facing contrary winds related to a multifaceted phenomenon: the dominance of private medicine with a subsequent lack of teamwork, the dominance of private media, the social and political unrest in Lebanon, significant discrepancies in the scientific background of cardiologists, and the absence of a standardized national cardiology licensing exam. Importantly, the implementation of such plans and perspectives requires individual commitment, along with the cooperation of the Order of Physicians, the Syndicate of Hospitals in Lebanon (representing private hospitals) and the Ministry of Health. Moreover, industry must be more committed to medical scientific societies; the support of cardiology events organized without the auspices of the Lebanese Society of Cardiology is not encouraged because of the presence of significant conflict of interest.

Kossaify, Antoine; Moussallem, Nicolas

2014-01-01

192

Clinical Practice Guideline for the Management of Chronic Kidney Disease in Patients Infected With HIV: 2014 Update by the HIV Medicine Association of the Infectious Diseases Society of America.  

PubMed

It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances. PMID:25234519

Lucas, Gregory M; Ross, Michael J; Stock, Peter G; Shlipak, Michael G; Wyatt, Christina M; Gupta, Samir K; Atta, Mohamed G; Wools-Kaloustian, Kara K; Pham, Paul A; Bruggeman, Leslie A; Lennox, Jeffrey L; Ray, Patricio E; Kalayjian, Robert C

2014-11-01

193

Management of cardiac electrical implantable devices in patients nearing the end of life or requesting withdrawal of therapy: review of the Heart Rhythm Society 2010 consensus statement.  

PubMed

Cardiac implantable electrical devices (CIEDs) are increasingly common interventions for a wide spectrum of cardiovascular diseases. Caring for patients with life-sustaining devices such as CIEDs at the end of life raises legal and ethical challenges. In 2010, the Heart Rhythm Society (HRS) published an expert consensus statement to review the principles and practice of CIED deactivation. This statement addressed a wide range of ethical and legal principles while providing guidance for communication, decision-making, and procedures in a variety of settings. In this article, we provide a summary of the HRS guidelines and highlight the most important features of CIED deactivation for the practicing clinician. PMID:21178906

Kramer, Daniel B; Ottenberg, Abigale L; Mueller, Paul S

2010-12-01

194

Planetary Society  

NASA Astrophysics Data System (ADS)

Carl Sagan, Bruce Murray and Louis Friedman founded the non-profit Planetary Society in 1979 to advance the exploration of the solar system and to continue the search for extraterrestrial life. The Society has its headquarters in Pasadena, California, but is international in scope, with 100 000 members worldwide, making it the largest space interest group in the world. The Society funds a var...

Murdin, P.

2000-11-01

195

Real-life evaluation of European and American high-risk strategies for primary prevention of cardiovascular disease in patients with first myocardial infarction  

PubMed Central

Objective To determine the detection rate (sensitivity) of the high-risk strategy recommended in the European Society of Cardiology (ESC) and National Institute for Health and Care Excellence (NICE/UK) and American College of Cardiology/American Heart Association (ACC/AHA) guidelines on cardiovascular disease (CVD) prevention. In particular, to evaluate the ability to ensure statin therapy to contemporary Europeans destined for a first myocardial infarction (MI). Design 393 consecutive statin-naïve, CVD-free patients without diabetes hospitalised for a first MI, 247 of whom were 40–75?years of age. We assumed they had undergone a health check the day before their MI and estimated the predicted risk. Primary outcome Sensitivity of the risk-based eligibility for primary prevention with statins recommended by the guidelines. Results All recommended risk scores rank-ordered patients similarly, but the sensitivity of the cut point above which statin therapy should be considered differed substantially. In younger patients (age 40–60), 62% of men and 13% of women qualified for statin therapy by ACC/AHA criteria, compared with only 2% of men and no women using the ESC criteria recommended for most non-Eastern European countries. In those 60–75?years of age, the ACC/AHA guidelines captured all men and 85% of women, compared with 12% and 2%, respectively, using the new ESC guideline. This guideline restricted the eligibility for primary prevention with statins substantially by reclassifying many European countries from ‘high-risk’ to ‘low-risk’, whereas the eligibility was expanded in the ACC/AHA and the new NICE/UK guidelines by lowering the decision threshold. Conclusions The 2012 ESC guidelines differ substantially from the 2013 ACC/AHA and 2014 NICE/UK guidelines in ability to secure statin therapy to those destined for a first MI. A great opportunity for primary prevention with statins remains unexploited in Europe. PMID:25326211

Mortensen, Martin B; Falk, Erling

2014-01-01

196

Human immunodeficiency virus & cardiovascular risk  

PubMed Central

Highly active antiretroviral therapy (HAART) significantly changed the prevalence of the cardiovascular manifestations of human immunodeficiency virus (HIV)/AIDS. In developed countries, a 30 per cent reduction in the prevalence of cardiomyopathy and pericardial effusion was observed, possibly related to a reduction of opportunistic infections and myocarditis. In developing countries, however, where the availablity of HAART is limited, and the pathogenic impact of nutritional factors is significant, a 32 per cent increase was seen in the prevalence of cardiomyopathy and related high mortality rate from congestive heart failure. Also, some HAART regimens in developed countries, especially those including protease inhibitors, may cause, in a high proportion of HIV-infected patients, a lipodystrophy syndrome that is associated with an increased risk of cardiovascular events related to a process of accelerated atherosclerosis. Careful cardiac screening is warranted for patients who are being evaluated for, or who are receiving HAART regimens, particularly for those with known underlying cardiovascular risk factors, according to the most recent clinical guidelines. PMID:22310821

Barbaro, Giuseppe; Barbarini, Giorgio

2011-01-01

197

European Society of Cardiology (ESC) Congress Report From Barcelona 2014.  

PubMed

The Annual Congress of the European Society of Cardiology (ESC) was held in Barcelona from 30th August to 3rd September 2014. More than 30,300 attendees from around the world shared the latest original research, including 27 clinical Hot Line studies, 12 basic science Hot Lines, 15 clinical trial updates, 19 registry studies, and 4,597 abstracts. Many important issues were presented, including novel treatment strategies for heart failure, acute coronary syndrome, interventional treatment for structural heart disease, renal denervation, novel anticoagulant therapies, atrial fibrillation and so on. In addition, 5 new ESC clinical practice guidelines (ie, myocardial revascularization, non-cardiac surgery, acute pulmonary embolism, hypertrophic cardiomyopathy, and aortic disease) were launched. It should be noted that Japan has recently been ranked in the top position in terms of the number of abstract submissions. Based on these activities, the ESC Congress has been recognized as the dominant scientific and educational forum for healthcare professionals in cardiology. We report the highlights and several key presentations of the ESC Congress 2014. The scientific activities and growing contributions of Japanese cardiologists or cardiovascular surgeons enhance the favorable relationship between the ESC and the Japanese Circulation Society. (Circ J 2014; 78: 2610-2618). PMID:25319165

Muramatsu, Takashi; Ozaki, Yukio

2014-10-24

198

Editorial: cardiovascular drug therapy in paediatric age: from metabolomics to clinical practice.  

PubMed

In adult patients, cardiovascular drugs are widely administered in the treatment of numerous diseases. The indications and doses are strictly codified by international Guidelines, which are periodically updated by the American and European Societies of Cardiology. In paediatric patients, however, the situation is substantially different. The lack of large interventional studies on the use of these compounds has led to a greater uncertainty, with a less extensive administration and more limited indications. Furthermore, some important differences in therapeutic approach for the same diseases are present between the U.S. and Europe. The purpose of this Special Issue is to review the pharmacological treatment of certain heart diseases, such as heart failure, and arterial blood pressure, which can result in both adult and pediatric patients [1, 2]. Differences and similarities have been highlighted. Regarding the differences in medical treatment for the same disease in the U.S. and Europe, it has been emphasized that the regulation of drugs is largely determined not only by scientific considerations, but also by other concerns - legal, cultural - which vary in different parts of the world. Such discrepancies are found even in the informational documents provided by pharmaceutical companies (different in USA and Europe for the same drug) and drug agencies (different between FDA and equivalent agencies in Europe). In this issue of Current Medicinal Chemistry, a specific paper is dedicated to the pharmacological treatment of the patency of ductus arteriosus in neonates, which is still a controversial issue. In fact, notwithstanding ibuprofen appears to be lesser dangerous for newborns than indomethacin, with a similar efficacy in closing the ductus; in a number of countries the latter is still administered to all preterm subjects as a prophylactic tool [3]. An unusual case report is the interesting starting point to perform an extensive literature review about the new indications of beta blockers [4]. In this respect, beta blockers, most specifically propranolol, have serendipitously been shown to induce involution of infantile hemangiomas. Mechanisms of action, target doses, formulation, contraindications and cardiovascular monitoring for beta blockers have been analyzed as well. It has recently been demonstrated that preterm birth is negatively associated with an early onset of cardiovascular diseases. Cardiovascular mortality is higher among former preterm adults than those born at term. This condition is referred to as cardiovascular perinatal programming. Metabolomics, a new and promising technique which allows the systematic study of the complete set of metabolites in a biological sample, has been recently applied to the identification of a possible future cardiovascular system involvement in subjects born preterm. Based on these premises, the purpose of the last review was to analyse the relationship between impaired growth during intrauterine life and adult cardiovascular disease risk and death [5]. PMID:24606512

Bassareo, Pier Paolo; Fanos, Vassilios

2014-01-01

199

Japan Society  

NSDL National Science Digital Library

The Japan Society was founded in New York City in 1907 by a group of businesspeople who were intimately interested in promoting relations between the United States and Japan. While the Society experienced a downturn in activities during World War II, the postwar period saw the Society come under the direction of John D. Rockefeller III, who was able to vastly expand its programs. Currently, the Society offers a number of programs, including programs for K-12 educators, a language center, a global affairs lecture and seminar series, and exhibitions in its gallery. One particularly nice resource is the mini-site, "Journey Through Japan", which may be found in the education section. This part of the site is designed specifically for educators, and includes background readings, lesson plans, maps, an interactive timeline and a photo gallery. Additionally, visitors can sign up to receive a number of specialized electronic newsletters sent out by the Society.

200

Diagnosis and Management of Group A Streptococcal Pharyngitis: A Practice Guideline  

Microsoft Academic Search

This is the second in a series of practice guidelines commissioned by the Infectious Diseases Society of America through its Practice Guidelines Committee. The purpose of these guidelines is to provide assistance to clinicians when making decisions on treating the conditions specified in each guideline. The targeted providers are pediatricians, family practitioners, and internists. The targeted patients and setting for

Alan L. Bisno; Michael A. Gerber; Richard H. Schwartz

1997-01-01

201

Guidelines for Antimicrobial Treatment of Uncomplicated Acute Bacterial Cystitis and Acute Pyelonephritis in Women  

Microsoft Academic Search

This is part of the series of practice guidelines commissioned by the Infectious Diseases Society of America (IDSA) through its Practice Guidelines Committee. The purpose of this guideline is to provide assistance to clinicians in the diagnosis and treatment of two specific types of urinary tract infections (UTIs): uncomplicated, acute, symptomatic bacterial cystitis and acute pyelonephritis in women. The guideline

John W. Warren; Elias Abrutyn; J. Richard Hebel; James R. Johnson; Anthony J. Schaeffer; Walter E. Stamm

1999-01-01

202

1997 Guidelines for the Use of Antimicrobial Agents in Neutropenic Patients with Unexplained Fever  

Microsoft Academic Search

This is the first in a series of practice guidelines commissioned by the Infectious Diseases Society of America through its Practice Guidelines Committee. The purpose of these guidelines is to provide assistance to clinicians when making decisions on treating the conditions specified in each guideline. The targeted providers are internists, pediatricians, and family practitioners. The targeted patients and setting for

Walter T. Hughes; Donald Armstrong; Gerald P. Bodey; Arthur E. Brown; John E. Edwards; Ronald Feld; Philip Pizzo; Kenneth V. I. Rolston; Jerry L. Shenep; Lowell S. Young

1997-01-01

203

Homocysteine and cardiovascular disease  

Microsoft Academic Search

Hyperhomocysteinemia is an independent risk factor for cardiovascular disease. Despite the well-known effectiveness of vitamin supplementation in reducing homocysteine levels, it is not known whether lowering of homocysteine levels is associated with a reduction in cardiovascular morbidity and mortality. The aim of this review is to discuss the epidemiologic evidence about the relation between homocysteine and cardiovascular disease, the pathophysiologic

Arduino A Mangoni; Stephen H. D Jackson

2002-01-01

204

Autism Society  

MedlinePLUS

... on the Spectrum Professional Advocate Resources Near You Autism Source Connect with Us Sign up to receive ... on current issues. Become a Member Join the Autism Society by becoming a member today. JOIN TODAY ...

205

Androgen therapy and atherosclerotic cardiovascular disease  

PubMed Central

Cardiovascular disease (CVD) remains the leading cause of death in Western society today. There is a striking gender difference in CVD with men predisposed to earlier onset and more severe disease. Following the recent reevaluation and ongoing debate regarding the estrogen protection hypothesis, and given that androgen use and abuse is increasing in our society, the alternate view that androgens may promote CVD in men is assuming increasing importance. Whether androgens adversely affect CVD in either men or women remains a contentious issue within both the cardiovascular and endocrinological fraternities. This review draws from basic science, animal and clinical studies to outline our current understanding regarding androgen effects on atherosclerosis, the major CVD, and asks where future directions of atherosclerosis-related androgen research may lie. PMID:18629352

McGrath, K-CY; McRobb, LS; Heather, AK

2008-01-01

206

Androgen therapy and atherosclerotic cardiovascular disease.  

PubMed

Cardiovascular disease (CVD) remains the leading cause of death in Western society today. There is a striking gender difference in CVD with men predisposed to earlier onset and more severe disease. Following the recent reevaluation and ongoing debate regarding the estrogen protection hypothesis, and given that androgen use and abuse is increasing in our society, the alternate view that androgens may promote CVD in men is assuming increasing importance. Whether androgens adversely affect CVD in either men or women remains a contentious issue within both the cardiovascular and endocrinological fraternities. This review draws from basic science, animal and clinical studies to outline our current understanding regarding androgen effects on atherosclerosis, the major CVD, and asks where future directions of atherosclerosis-related androgen research may lie. PMID:18629352

McGrath, K-C Y; McRobb, L S; Heather, A K

2008-01-01

207

Metabolic biomarkers for predicting cardiovascular disease  

PubMed Central

Cardiac and peripheral vascular biomarkers are increasingly becoming targets of both research and clinical practice. As of 2008, cardiovascular-related medical care accounts for greater than 20% of all the economic costs of illness in the United States. In the age of burgeoning financial pressures on the entire health care system, never has it been more important to try to understand who is at risk for cardiovascular disease in order to prevent new events. In this paper, we will discuss the cost of cardiovascular disease to society, clarify the definition of and need for biomarkers, offer an example of a current biomarker, namely high-sensitivity C-reactive protein, and finally examine the approval process for utilizing these in clinical practice. PMID:23386789

Montgomery, Jana E; Brown, Jeremiah R

2013-01-01

208

Antimicrobial management of intra-abdominal infections: literature's guidelines.  

PubMed

Antimicrobial management of severe intra-abdominal infections (IAIs) involves a delicate balance of optimizing empirical therapy, which has been shown to improve clinical outcomes, while simultaneously reducing unnecessary antimicrobial use. Two sets of guidelines for the management of intra-abdominal infections were recently published. In 2010, the Surgical Infection Society and the Infectious Diseases Society of America (SIS-IDSA) created guidelines for the diagnosis and management of complicated IAIs. The new SIS-IDSA guidelines replace those previously published in 2002 and 2003. The World Society of Emergency Surgery (WSES) guidelines represent additional contributions, made by specialists worldwide, to the debate regarding proper antimicrobial drug methodology. These guidelines represent the conclusions of the consensus conference held in Bologna, Italy, in July 2010 during the first congress of the WSES. PMID:22408344

Sartelli, Massimo; Catena, Fausto; Coccolini, Federico; Pinna, Antonio Daniele

2012-03-01

209

Guidelines for publication  

NASA Astrophysics Data System (ADS)

The AGU Publications Committee and the Board of Journal Editors recently adopted standards for the conduct of the publications process of AGU. These standards articulate the way in which we believe most geophysicists behave when acting as author, editor, or reviewer. We do not perceive a problem with the ethical conduct in any phase of the AGU publications activity. Rather we are presenting what is common practice as a reminder to us all and as help to those who may be just embarking on their scientific careers.We wish to thank in particular our colleagues in the American Chemical Society. With their permission we borrowed heavily from “Ethical Guidelines to Publication of Chemical Research” in the document presented below.

Rapp, Richard H.

210

[Quality management in cardiovascular echography].  

PubMed

The quality management of an organization can be defined as the ability to identify, plan and implement programs of measure, analysis, verification and control that allow to monitor management, resources, activities, processes and output/outcome of the same organization, including the satisfaction of the customers. Whatever the model used, it is demonstrated that the management-quality system, either for professional quality or for organization, turns out to be effective even in the health organizations within and to any level of organizational-structural complexity. The present paper concerns the experience of the Italian Society of Cardiovascular Echography (SIEC) on quality certification, both as a scientific society compared to other health organizations and to cardiovascular echo laboratories, and the definition of minimum requirements for the accreditation of the same laboratories. The model most frequently used for quality management is represented by the ISO 9000: Vision 2000, that is a management model with specific reference to the organization and the customer satisfaction. The model applied to the health structure needs a rapid change in mentality that addresses the operators to define, share and achieve objectives to be brought on by means of an active collaboration, group activity and deep sense of belonging necessary to the attainment of expected objectives. When the model is applied by a scientific society, it is necessary to take into account the different structural and functional organization, the constitution and the operators differing on the point of view of origin, experiences, mentality, and roles. The ISO 9000: Vision 2000 model can be applied also to the cardiovascular echo laboratory which may be compared to a simple organization; for its corrected functioning, SIEC has defined minimal requirements for the accreditation, realization and modalities to carry out and manage quality. The quality system represents a new way of operating of an organization that enhances capability and performance of the operators, stimulates their creativity and facilitates the activities of all, to guarantee both the quality of the product and the satisfaction of operators and customers at the same time. PMID:12611211

Gullace, Giuseppe

2002-12-01

211

Guideline clinical nutrition in patients with stroke  

PubMed Central

Stroke is regularly accompanied by dysphagia and other factors associated with decreased nutritional intake. Dysphagia with aspiration pneumonia and insufficient nutritional intake lead to worse outcome after stroke. This guideline is the first chapter of the guideline “Clinical Nutrition in Neurology” of the German Society for Clinical Nutrition (DGEM) which itself is one part of a comprehensive guideline about all areas of Clinical Nutrition. The thirty-one recommendations of the guideline are based on a systematic literature search and review, last updated December 31, 2011. All recommendations were discussed and consented at several consensus conferences with the entire DGEM guideline group. The recommendations underline the importance of an early screening and assessment of dysphagia and give advice for an evidence based and comprehensive nutritional management to avoid aspiration, malnutrition and dehydration. PMID:24289189

2013-01-01

212

Hernia Surgery: From Guidelines to Clinical Practice  

PubMed Central

INTRODUCTION Over the last 30 years, hernia surgery has developed into an evidence-based practice assisted by the development of guidelines. MATERIALS AND METHODS Prior to 1993, best practice in the UK was a nylon darn repair under general anaesthesia as an in-patient with prolonged recovery. The publication of The Royal College of Surgeons of England (RCSE) Guidelines on Groin Hernia Repair stimulated debate and coincided with the introduction of mesh hernioplasty and laparoscopic techniques. Further evolution of hernia management has occurred to enable the production of the European Hernia Society (EHS) guidelines in 2008. RESULTS The EHS guidelines cover all aspects of abdominal wall surgery including: indications for operation; investigations; organising surgical care; techniques; local anaesthesia; after-care, complications and outcome; and information for patients. CONCLUSIONS Surgeons have many choices when selecting an appropriate hernia operation for an individual patient. The EHS guidelines provide a basis for this decision-making. PMID:19416585

Kingsnorth, Andrew N

2009-01-01

213

Cryptozoology Society  

Microsoft Academic Search

Reports of Loch Ness monsters, Bigfoot, and the Yeti spring u p from time to time, sparking scientific controversy about the veracity of these observations. Now an organization has been established to help cull, analyze, and disseminate information on the alleged creatures. The International Society of Cryptozoology, formed at a January meeting at the U.S. National Museum of Natural History

Barbara T. Richman

1982-01-01

214

Promoting cardiovascular health worldwide: strategies, challenges, and opportunities.  

PubMed

Cardiovascular disease is the leading cause of death in the world, affecting not only industrialized but, above all, low- and middle-income countries, where it has overtaken infectious diseases as the first cause of death and its impact threatens social and economic development. The increased prevalence of cardiovascular disease in recent years together with projected mortality for the coming decades constitute an irrefutable argument for the urgent implementation of well-planned interventions to control the pandemic of cardiovascular diseases, especially in the more economically deprived countries. The combination of behavioral, social, environmental, and biological factors, and others related to health care systems, that contribute to the development of cardiovascular diseases requires a multi-sector strategy that promotes a healthy lifestyle, reduces cardiovascular risk factors, and cuts mortality and morbidity through quality health care services. These proposals should be guided by leaders in the scientific community, government, civil society, private sector, and local communities. PMID:25172068

Castellano, José M; Narula, Jagat; Castillo, Javier; Fuster, Valentín

2014-09-01

215

Canadian guidelines for chronic rhinosinusitis  

PubMed Central

Abstract Objective To provide a clinical summary of the Canadian clinical practice guidelines for chronic rhinosinusitis (CRS) that includes recommendations relevant for family physicians. Quality of evidence Guideline authors performed a systematic literature search and drafted recommendations. Recommendations received both strength of evidence and strength of recommendation ratings. Input from external content experts was sought, as was endorsement from Canadian medical societies (Association of Medical Microbiology and Infectious Disease Canada, Canadian Society of Allergy and Clinical Immunology, Canadian Society of Otolaryngology—Head and Neck Surgery, Canadian Association of Emergency Physicians, and Family Physicians Airways Group of Canada). Main message Diagnosis of CRS is based on type and duration of symptoms and an objective finding of inflammation of the nasal mucosa or paranasal sinuses. Chronic rhinosinusitis is categorized based on presence or absence of nasal polyps, and this distinction leads to differences in treatment. Chronic rhinosinusitis with nasal polyps is treated with intranasal corticosteroids. Antibiotics are recommended when symptoms indicate infection (pain or purulence). For CRS without nasal polyps, intranasal corticosteroids and second-line antibiotics (ie, amoxicillin– clavulanic acid combinations or fluoroquinolones with enhanced Gram-positive activity) are recommended. Saline irrigation, oral steroids, and allergy testing might be appropriate. Failure of response should prompt consideration of alternative diagnoses and referral to an otolaryngologist. Patients undergoing endoscopic sinus surgery require postoperative treatment and follow-up. Conclusion The Canadian guidelines provide diagnosis and treatment approaches based on the current understanding of the disease and available evidence. Additionally, the guidelines provide the expert opinion of a diverse group of practice and academic experts to help guide clinicians where evidence is sparse. PMID:24336538

Kaplan, Alan

2013-01-01

216

Imaging in Cardiovascular Research  

Microsoft Academic Search

\\u000a Despite enormous investment into cardiovascular research on all levels worldwide, cardiovascular events such as myocardial\\u000a infarction, heart failure, tachyarrhythmia or stroke remain the major causes for death and inability in all developed countries.\\u000a Conventional clinical cardiovascular imaging nowadays provides high-resolution visualization of the morphology of vessels\\u000a and the myocardium. To translate the available patient imaging technologies into animals, especially mice

Michael Schäfers; Klaus Tiemann; Michael Kuhlmann; Lars Stegger; Klaus Schäfers; Sven Hermann

217

Physical activity recommendations and cardiovascular disease risk factors in young Hispanic women  

Microsoft Academic Search

Despite the benefits associated with regular physical activity, there is little epidemiological evidence to support positive health outcomes when meeting physical activity guidelines in high-risk ethnic groups, such as Hispanic women. We compared cardiovascular disease risk factors between young Hispanic women who meet and those who do not meet current physical activity guidelines. Height, weight, waist circumference, and blood pressure

Chantal A. Vella; Diana Ontiveros; Raul Y. Zubia; Lance Dalleck

2011-01-01

218

National Curricular Guidelines for Third-Year Family Medicine Clerkships.  

ERIC Educational Resources Information Center

The process used by the Society of Teachers of Family Medicine to develop core curriculum guidelines for third-year family medicine clerkships is described, the guidelines are presented, and dissemination, implementation, and further development activities are outlined. The work was supported by a Department of Health and Human Services grant.…

Academic Medicine, 1991

1991-01-01

219

UCT Finance Guidelines fg004_catering Page 1 of 2  

E-print Network

UCT Finance Guidelines fg004_catering Page 1 of 2 Finance Department, UCT, Private Bag, Rondebosch, educating for life and addressing the challenges facing our society." Finance Guideline FG004 ­ Catering at UCT meetings and events Related Finance Policy GEN001 ­ Funds deposited with or held by UCT Objective

Jarrett, Thomas H.

220

Page 1 of 6 Guidelines on Expectations of Faculty Performance  

E-print Network

and women to be leaders in technology and society and that contributes to the well- being of our citizensPage 1 of 6 Guidelines on Expectations of Faculty Performance School of Engineering and Applied Science University of Virginia July 5, 2007 This document presents guidelines on expectations of faculty

Robins, Gabriel

221

ISMuLT Guidelines for muscle injuries  

PubMed Central

Summary Muscle injuries are frequent in high demand sports. No guidelines are available in the scientific literature. ISMuLT, the “Italian Society of Muscles, Ligaments and Tendons”, in line with its multidisciplinary mission, is proud to cover this gap. PMID:24596685

Maffulli, Nicola; Oliva, Francesco; Frizziero, Antonio; Nanni, Gianni; Barazzuol, Michele; Via, Alessio Giai; Ramponi, Carlo; Brancaccio, Paola; Lisitano, Gianfranco; Rizzo, Diego; Freschi, Marco; Galletti, Stefano; Melegati, Gianluca; Pasta, Giulio; Testa, Vittorino; Valent, Alessandro; Del Buono, Angelo

2013-01-01

222

[Therapy of inherited diseases of platelet function. Interdisciplinary S2K guideline of the Permanent Paediatric Committee of the Society of Thrombosis and Haemostasis Research (GTH e.?V.)].  

PubMed

Inherited disorders of platelet function are a heterogeneous group. For optimal prevention and management of bleeding, classification and diagnosis of the underlying defect are highly recommended. An interdisciplinary guideline for a diagnostic approach has been published (AWMF # 086-003 S2K; Hämostaseologie 2014; 34: 201-212). Underlying platelet disorder, platelet count, age and clinical situation modify treatment. Exclusive transfusion of platelet concentrates may be inappropriate as potentially adverse effects can outweigh its benefit. A stepwise and individually adjusted approach for restitution and maintenance of haemostasis is recommended. Administration of antifibrinolytics is generally endorsed, but is of particular use in Quebec disease. Restricted to older children, desmopressin is favourable in storage pool disease and unclassified platelet disorders. Although licensed only for patients with Glanzmann thrombasthenia and alloantibodies, in clinical practice rFVIIa is widely used in inherited platelet disorders with severe bleeding tendency. This guideline aims at presenting the best available advice for the management of patients with inherited platelet function disorders. PMID:25370176

Streif, W; Knöfler, R; Eberl, W; Andres, O; Bakchoul, T; Bergmann, F; Beutel, K; Dittmer, R; Gehrisch, S; Gottstein, S; Halimeh, S; Haselböck, J; Hassenpflug, W-A; Heine, S; Holzhauer, S; King, S; Kirchmaier, C M; Krause, M; Kreuz, W; Lösche, W; Mahnel, R; Maurer, M; Nimtz-Talaska, A; Olivieri, M; Rott, H; Schambeck, Ch M; Schedel, A; Schilling, F H; Schmugge, M; Schneppenheim, R; Scholz, U; Scholz, T; Schulze, H; Siegemund, A; Strauß, G; Sykora, K-W; Wermes, C; Wiegering, V; Wieland, I; Zieger, B; Zotz, R B

2014-11-01

223

Guideline recommendations for heart complications in thalassemia major.  

PubMed

Thalassemia major is an inherited hemoglobin disorder resulting in a chronic hemolytic anemia. Transfusion therapy together with elevated gastrointestinal absorption of iron determines iron overload, which causes most of the mortality and morbidity associated with the disease. Heart complications represent the leading cause of mortality in this disease, although, because of an improvement in chelation treatment, an important and progressive increase of life expectancy mainly as a result of a reduction in mortality due to cardiac dysfunction has been demonstrated in recent years. Clinical pictures of heart damage range from the involvement of the ventricles to pulmonary hypertension or symptomatic ventricular or supra-ventricular arrhythmias. For this reason, the possibility of having specific recommendations is noteworthy. These recommendations outline the definition, the follow-up and the treatment of the main heart complications in this group of patients. The identification of topics and the nomination of the committee were made on behalf of the Society for the Study of Thalassemia and Hemoglobinopathies (SoSTE). The document obtained the auspices of ANMCO, SIC, SIRM and the Cardiovascular Magnetic Resonance Working Groups of the ANMCO, SIC and SIRM. All recommendations provided in this document have been performed according to the American Cardiology College (ACC) and American Heart Association (AHA) guidelines. Moreover, the recommendations were reviewed by two external referees before the definitive approval. PMID:18404006

Cogliandro, Tiziana; Derchi, Giorgio; Mancuso, Luigi; Mayer, M Carolina; Pannone, Bruno; Pepe, Alessia; Pili, Marcello; Bina, Patrizio; Cianciulli, Paolo; De Sanctis, Vincenzo; Maggio, Aurelio

2008-05-01

224

Cardiovascular Disease and Diabetes  

MedlinePLUS

Cardiovascular Disease & Diabetes Updated:Jan 31,2013 The following statistics speak loud and clear that there is a strong correlation between ... content was last reviewed on 7/5/2012. Diabetes • Home • About Diabetes • Why Diabetes Matters Introduction Cardiovascular ...

225

Sixth Annual Cardiovascular  

E-print Network

assembles leading experts in women's cardiovascular health to continue to explore the role that gender Feinberg School of Medicine EarthphotoscourtesyofNASA #12;CARDIOVASCULAR DISEASE is still the leading cause have made significant efforts to improve knowledge and understanding of the gender differences

MacIver, Malcolm A.

226

NCI Digital Media Guidelines  

Cancer.gov

NCI Digital Media Guidelines NCI Digital Media Guidelines The NCI Digital Media Guidelines provide developers and content managers guidance on the visual and content standards, as well as policies and procedures, in effect for National Cancer Institute

227

INDIAN ACADEMY OF SCIENCES Scientific Values: Ethical Guidelines and Procedures  

E-print Network

INDIAN ACADEMY OF SCIENCES Scientific Values: Ethical Guidelines and Procedures Bangalore 560 080 branches like engineering, and medicine, each having its own professional society and its own detailed code of the different activities of various societies. The Indian Academy of Sciences has decided to concentrate

Dhingra, Narender K.

228

Decreased mortality after implementation of a treatment guideline for community-acquired pneumonia  

Microsoft Academic Search

Purpose: We developed a pneumonia guideline at Intermountain Health Care that included admission decision support and recommendations for antibiotic timing and selection, based on the 1993 American Thoracic Society guideline. We hypothesized that guideline implementation would decrease mortality.Subjects and methods: We included all immunocompetent patients >65 years with community-acquired pneumonia from 1993 through 1997 in Utah; nursing home patients were

Nathan C Dean; Michael P Silver; Kim A Bateman; Brent James; Carol J Hadlock; David Hale

2001-01-01

229

Professional Guideline Series: Guidelines for Professional Employment  

E-print Network

Professional Guideline Series: Guidelines for Professional Employment A Framework For Communication Prepared by IEEE-USA's Career and Employment Services Committee #12;IEEE-USA Professional Guideline Series TABLE OF CONTENTS INTRODUCTION 3 I. CAREER OUTLOOK 4 II. RECRUITMENT 6 III. PROFESSIONAL EMPLOYMENT 8

230

Final Design Guidelines DESIGN GUIDELINES FOR  

E-print Network

Final Design Guidelines DESIGN GUIDELINES FOR WIRE MESH/CABLE NET SLOPE PROTECTION Balasingam AND SUBTITLE 5. REPORT DATE DESIGN GUIDELINES FOR WIRE MESH/CABLE NET April 2005 SLOPE PROTECTION 6. PERFORMING Rockfall, wire mesh, cable net, slope hazard mitigation, snow load, anchor, interface friction

231

Cryptozoology Society  

NASA Astrophysics Data System (ADS)

Reports of Loch Ness monsters, Bigfoot, and the Yeti spring u p from time to time, sparking scientific controversy about the veracity of these observations. Now an organization has been established to help cull, analyze, and disseminate information on the alleged creatures. The International Society of Cryptozoology, formed at a January meeting at the U.S. National Museum of Natural History of the Smithsonian Institution, will serve as the focal point for the investigation, analysis, publication, and discussion of animals of unexpected form or size or of unexpected occurrences in time or space.

Richman, Barbara T.

232

47 Cardiovascular evaluation of English premiership rugby players  

Microsoft Academic Search

IntroductionRecent experience of pre-participation cardiovascular evaluation (PPCE) in Italian athletes demonstrates a significant reduction in mortality from cardiomyopathies and cardiac conduction disorders. Although PPCE is endorsed by large medical and sporting organisations, including the European Society of Sports Cardiology, the International Olympic Committee and FIFA, the state health system in the UK (and many other Western countries) does not support

S Ghani; H Raju; A Zaidi; N Sheikh; S Gati; J Somauroo; S Kemp; S Sharma

2011-01-01

233

Multiple Clinical Practice Guidelines for Breast and Cervical Cancer Screening  

PubMed Central

Background Multiple clinical practice guidelines exist for breast and cervical cancer screening, and differ in aggressiveness with respect to the recommended frequency and target populations for screening. Objectives To determine (1) US primary care physicians’ (PCPs) perceptions of the influence of different clinical practice guidelines; (2) the relationship between the number, aggressiveness, and agreement of influential guidelines and the aggressiveness of physicians’ screening recommendations; and (3) factors associated with guideline perceptions. Research Design and Methods A nationally representative sample of 1212 PCPs was surveyed in 2006–2007. Cross-sectional analyses examined physicians’ perceptions of the influence of different breast and cervical cancer screening guidelines, the relationship of guideline perceptions to screening recommendations in response to hypothetical vignettes, and the predictors of guideline perceptions. Results American Cancer Society and American College of Obstetricians and Gynecologists guidelines were perceived as more influential than other guidelines. Most physicians (62%) valued multiple guidelines, and conflicting and aggressive rather than conservative guideline combinations. The number, aggressiveness, and agreement of influential guidelines were associated with the aggressiveness of screening recommendations (P < 0.01)—which was highest for physicians valuing multiple-aggressive, lowest for physicians valuing multiple-conservative, and intermediate for physicians valuing multiple-conflicting, single, and no guidelines. Obstetrician/gynecologists specialty predicted valuation of aggressive guidelines (P < 0.001). Conclusions PCPs’ perceptions of cancer screening guidelines vary, relate to screening recommendations in logically-consistent ways, and are predicted by specialty and other factors. The number, aggressiveness, and agreement of valued guidelines are associated with screening recommendations, suggesting that guideline multiplicity is an important problem in clinical decision-making. PMID:21206294

Han, Paul K. J.; Klabunde, Carrie N.; Breen, Nancy; Yuan, Gigi; Grauman, Alyssa; Davis, William W.; Taplin, Stephen H.

2014-01-01

234

Can combining different risk interventions into a single formulation contribute to improved cardiovascular disease risk reduction? Rationale and design for an international, open-label program to assess the effectiveness of a single pill (amlodipine\\/atorvastatin) to attain recommended target levels for blood pressure and lipids (The JEWEL Program)  

Microsoft Academic Search

BackgroundIn order to prevent cardiovascular events, it is essential to effectively manage overall risk of cardiovascular disease. However, despite guideline recommendations to this effect, current management of the major, modifiable cardiovascular risk factors such as hypertension and dyslipidemia is disconnected and patient adherence to therapy is poor. This is particularly important for patients with multiple cardiovascular risk factors, who are

F. D. Richard Hobbs; Gianfranco Gensini; G. B. John Mancini; Athanasios J. Manolis; Beverly Bauer; Steffen Böhler; Jacques Genest; Ross Feldman; Peter Harvey; Trond G. Jenssen; Michael Metcalfe; Pedro Marques da Silva

2006-01-01

235

EPA's neurotoxicity risk assessment guidelines.  

PubMed

The proposed Neurotoxicity Risk Assessment Guidelines (U.S. EPA, 1995c Fed. Reg. 60(192), 52032-52056) of the U.S. Environmental Protection Agency (EPA) were the subject of a workshop at the 1997 Meeting of the Society of Toxicology. The workshop considered the role of guidelines in the risk assessment process, the primary features, scientific basis, and implications of the guidelines for EPA program offices, as well as for industrial neurotoxicologists from the perspectives of both pesticides and toxic substances regulation. The U.S. National Academy of Sciences (NAS, 1983, Risk Assessment in the Federal Government: Managing the Process) established a framework for distinguishing risk management from risk assessment, the latter being the result of integrating hazard identification, hazard characterization, and exposure assessment data. The guidelines are intended to establish operating principles that will be used when examining data in a risk assessment context. The proposed neurotoxicity risk assessment guidelines provide a conceptual framework for deciding whether or not a chemically induced effect can be considered to be evidence of neurotoxicity. Topics in the proposed guidelines include structural and functional effects, dose-response and -duration considerations, and relationships between effects. Among the issues that must be considered are the multiplicity of chemical effects, the levels of biological organization in the nervous system, and the tests, measurements, and protocols used. Judgment of the adversity of an effect depends heavily on the amount and types of data available. The attribution of a chemically induced effect to an action on the nervous system depends on several factors such as the quality of the study, the nature of the outcome, dose-response and time-response relationships, and the possible involvement of nonneural factors. The guidelines will also serve as a reference for those conducting neurotoxicity testing, as well as establish a consistent approach to neurotoxicity risk assessment by regulators. Extending this approach through international harmonization would be advantageous to the development of products for a worldwide market. Thus, both risk assessors and regulated industries have a large stake in the guidelines to provide a framework that will lead to accurate risk assessment decisions. PMID:9441713

Boyes, W K; Dourson, M L; Patterson, J; Tilson, H A; Sette, W F; MacPhail, R C; Li, A A; O'Donoghue, J L

1997-12-01

236

Cocaine and Cardiovascular Events.  

ERIC Educational Resources Information Center

The case of a 21-year-old man who suffered a myocardial infarction after using cocaine and amphetamines is reported. A brief literature review provides evidence of cocaine's potential cardiovascular effects. (Author/MT)

Cantwell, John D.; Rose, Fred D.

1986-01-01

237

Radiology Lab 2: Cardiovascular  

NSDL National Science Digital Library

Introduction to concepts important in cardiovascular imaging of normal anatomy, including angiographic techniques and cross-sectional methods.Annotated: trueDisease diagnosis: NormalRadiograph type: angiogram

Shaffer, Kitt

2010-02-24

238

Cardiovascular Interactions CVI Project  

NSDL National Science Digital Library

The Cardiovascular Interactions Project is an electronic active learning tool that demonstrates the complex and intricate interactions between the functions of the heart and peripheral circulation to provide an adequate cardiac output during various stresses.

PhD Carl F. Rothe (Indiana University School of Medicine Department of Cellular and Integrative Physiology)

2005-06-22

239

Understanding cardiovascular disease  

MedlinePLUS

... of plaque. Narrow arteries reduce or block blood flow. When blood and oxygen can't get to the legs, it can injure nerves and tissue. High blood pressure (hypertension) is a cardiovascular disease that ...

240

Internet Society  

NSDL National Science Digital Library

The Internet is certainly a vast and, at times, quite chaotic place. Fortunately, there are organizations such as the Internet Society which "provides leadership in addressing issues that confront the future of the Internet". With over 20,000 individual members in over 180 countries, it has a broad range of members located in most corners of the world. Perhaps one of the most important areas of the site is the public policy area. Here, visitors can learn about the governance of the Internet and a host of topics, including access, e-commerce, and spam. Of course, for those emerging cyber law scholars or the generally curious, there is an "All About The Internet" section. Included in this section are links to important guides to Internet law and a number of relevant online research tools.

241

Resveratrol and cardiovascular health  

Microsoft Academic Search

Resveratrol (3,4?,5-trihydroxystilbene) is a member of natural, plant-derived chemicals known as polyphenols and is attracting increased attention due to its diverse health benefits especially in case of cardiovascular disease, cancer, diabetes and neurological problems. Despite impressive gains in diagnosis and treatment, cardiovascular disease (CVD) remains a serious clinical problem and threat to public health. Resveratrol possesses potent antioxidant properties and

Manika Das; Dipak K. Das

2010-01-01

242

Aldosterone and cardiovascular risk  

Microsoft Academic Search

Through its classic effects on sodium and potassium homeostasis, aldosterone, when produced in excess, is associated with\\u000a the development of hypertension and hence with higher cardiovascular and renal risk. In recent years, experimental and epidemiologic\\u000a data have suggested that aldosterone also may be linked to high cardiovascular risk independently of its effects on blood\\u000a pressure. Thus, aldosterone has been associated

Bruno Vogt; Michel Burnier

2009-01-01

243

Obesity and cardiovascular disease  

Microsoft Academic Search

Obesity is a major contributor to the prevalence of cardiovascular disease in the developed world, and yet has only recently\\u000a been afforded the same level of attention as other risk factors of coronary artery disease. Obesity is a chronic metabolic\\u000a disorder associated with cardiovascular disease and increased morbidity and mortality. It is apparent that a variety of adaptations\\/alterations\\u000a in cardiac

Paul Poirier; Robert H. Eckel

2002-01-01

244

Assessment of Patients with a DePuy ASR Metal-on-Metal Hip Replacement: Results of Applying the Guidelines of the Spanish Society of Hip Surgery in a Tertiary Referral Hospital  

PubMed Central

The prognosis associated with the DePuy ASR hip cup is poor and varies according to the series. This implant was withdrawn from use in 2010 and all patients needed to be assessed. We present the results of the assessment of our patients treated with this device, according to the Spanish Society of Hip Surgery (SECCA) algorithm published in 2011. This retrospective study evaluates 83 consecutive ASR cups, followed up at a mean of 2.9 years. Serum levels of chromium and cobalt, as well as the acetabular abduction angle, were determined in order to assess their possible correlation with failure, defined as the need for revision surgery. The mean Harris Hip Score was 83.2 (range 42–97). Eight arthroplasties (13.3%) required revision due to persistent pain and/or elevated serum levels of chromium/cobalt. All the cups had a correct abduction angle, and there was no correlation between elevated serum levels of metal ions and implant failure. Since two previous ASR implants were exchanged previously to the recall, the revision rate for ASR cups in our centre is 18.2% at 2.9 years.

Fernández-Valencia, Jenaro; Gallart, Xavier; Bori, Guillem; Ramiro, Sebastián Garcia; Combalía, Andrés; Riba, Josep

2014-01-01

245

Tropical fevers: Management guidelines.  

PubMed

Tropical fevers were defined as infections that are prevalent in, or are unique to tropical and subtropical regions. Some of these occur throughout the year and some especially in rainy and post-rainy season. Concerned about high prevalence and morbidity and mortality caused by these infections, and overlapping clinical presentations, difficulties in arriving at specific diagnoses and need for early empiric treatment, Indian Society of Critical Care Medicine (ISCCM) constituted an expert committee to develop a consensus statement and guidelines for management of these diseases in the emergency and critical care. The committee decided to focus on most common infections on the basis of available epidemiologic data from India and overall experience of the group. These included dengue hemorrhagic fever, rickettsial infections/scrub typhus, malaria (usually falciparum), typhoid, and leptospira bacterial sepsis and common viral infections like influenza. The committee recommends a 'syndromic approach' to diagnosis and treatment of critical tropical infections and has identified five major clinical syndromes: undifferentiated fever, fever with rash / thrombocytopenia, fever with acute respiratory distress syndrome (ARDS), fever with encephalopathy and fever with multi organ dysfunction syndrome. Evidence based algorithms are presented to guide critical care specialists to choose reliable rapid diagnostic modalities and early empiric therapy based on clinical syndromes. PMID:24678147

Singhi, Sunit; Chaudhary, Dhruva; Varghese, George M; Bhalla, Ashish; Karthi, N; Kalantri, S; Peter, J V; Mishra, Rajesh; Bhagchandani, Rajesh; Munjal, M; Chugh, T D; Rungta, Narendra

2014-02-01

246

Tropical fevers: Management guidelines  

PubMed Central

Tropical fevers were defined as infections that are prevalent in, or are unique to tropical and subtropical regions. Some of these occur throughout the year and some especially in rainy and post-rainy season. Concerned about high prevalence and morbidity and mortality caused by these infections, and overlapping clinical presentations, difficulties in arriving at specific diagnoses and need for early empiric treatment, Indian Society of Critical Care Medicine (ISCCM) constituted an expert committee to develop a consensus statement and guidelines for management of these diseases in the emergency and critical care. The committee decided to focus on most common infections on the basis of available epidemiologic data from India and overall experience of the group. These included dengue hemorrhagic fever, rickettsial infections/scrub typhus, malaria (usually falciparum), typhoid, and leptospira bacterial sepsis and common viral infections like influenza. The committee recommends a ‘syndromic approach’ to diagnosis and treatment of critical tropical infections and has identified five major clinical syndromes: undifferentiated fever, fever with rash / thrombocytopenia, fever with acute respiratory distress syndrome (ARDS), fever with encephalopathy and fever with multi organ dysfunction syndrome. Evidence based algorithms are presented to guide critical care specialists to choose reliable rapid diagnostic modalities and early empiric therapy based on clinical syndromes. PMID:24678147

Singhi, Sunit; Chaudhary, Dhruva; Varghese, George M.; Bhalla, Ashish; Karthi, N.; Kalantri, S.; Peter, J. V.; Mishra, Rajesh; Bhagchandani, Rajesh; Munjal, M.; Chugh, T. D.; Rungta, Narendra

2014-01-01

247

National Guideline Clearinghouse (NGC)  

NSDL National Science Digital Library

Operated by the US Department of Health and Human Services, the Agency for Health Care Policy and Research (AHCPR), the American Medical Association (AMA) and the American Association of Health Plans (AAHP), The National Guideline Clearinghouse provides information about hundreds of "evidence-based clinical practice guidelines" for health care professionals. Guidelines from over 100 different medical organizations can be searched or browsed by disease or condition; treatment or intervention method; or issuing organization. Each record includes the date of release and current status of the guideline, major recommendations for interventions and practices, organization(s) and committee members responsible for the guideline, and methods used to collect evidence and rate the quality of evidence. A link to the full text of the guideline is provided if available. When more than one guideline has been released on a topic, users can compare selected guidelines in chart format. A News section tells developers how to submit guidelines to the Clearinghouse.

1999-01-01

248

Childhood cardiovascular risk factors in South Asians: A cause of concern for adult cardiovascular disease epidemic  

PubMed Central

Cardiovascular risk factors in children are increasing at an alarming rate in the western world. However, there is limited information regarding these in the South Asian children. This review attempts at summarizing such evidence. South Asians are remarkable for the earlier onset of adult cardiovascular disease (CVD) by almost a decade compared to the Caucasians. We identified published literature, mainly on PubMed, Embase and Cochrane library using specific search terms such as lipid abnormalities, high blood pressure, hyperglycemia, tobacco use, obesity, physical inactivity, and unhealthy dietary practices. Atherosclerotic CVD processes begin early in childhood and are influenced over the life course by genetic and potentially modifiable risk factors and environmental exposure. 80% of adult CVD burden will fall on the developing nations by 2020. The concept of primordial prevention is fast emerging as a necessary prevention tool to curb adult CVD epidemic. Established guidelines and proven preventive strategies on cardiovascular health exist; however, are always implemented half-heartedly. Composite screening and prediction tools for adults can be adapted and validated in children tailored to South Asian population. South Asian children could be at a greater risk of developing cardiovascular risk factors at an earlier stage, thus, timely interventions are imperative. PMID:21976880

Prasad, Duggirala Sivaram; Kabir, Zubair; Dash, Ashok Kumar; Das, Bhagabati Charan

2011-01-01

249

Cardiovascular Risk Reduction. The Problems Facing Our Society.  

ERIC Educational Resources Information Center

Continued and expanded efforts to educate people as to what factors contribute to coronary heart disease will help to decrease its occurrence. Risk factors include: cholesterol, smoking, hypertension, obesity, heredity, psychological influences, and the taking of oral contraceptives or alcohol. (CJ)

Harrison, Donald C.; Winston, Mary

1982-01-01

250

Microalbuminuria and cardiovascular risk.  

PubMed

Microalbuminuria is a marker for generalized vascular dysfunction. Its prevalence in United States and European general population surveys ranges from 6% to 10%. Increased risk for cardiovascular morbidity and mortality begins with albumin excretion rates that are well within normal limits. Although microalbuminuria interacts with the traditional cardiovascular risk factors, it has an independent relationship to renal and cardiovascular outcomes. For example, microalbuminuria doubles the risk for a cardiovascular event in patients with type 2 diabetes mellitus even after adjusting for the usual risk factors. Elevated rates of urinary albumin excretion predict target organ damage, notably renal disease, but are also related to left ventricular dysfunction, stroke, and myocardial infarction. Screening for microalbuminuria, which is recommended by several expert committees and associations, has become a readily accessible procedure. Screening can give clinicians prognostic information concerning cardiovascular risk and assist in guiding therapy. The goal of treatment is to prevent progression of, and even to reverse, microalbuminuria. Abundant evidence demonstrates that antihypertensive therapy is an important key to the control of urinary albumin excretion, and blockade of the renin-angiotensin system (with angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers) is the treatment of choice. These drugs have successfully halted or delayed the progression to nephropathy and have reversed elevated rates of albumin excretion to normal values, even when blood pressure reduction has been minimal. PMID:15485765

Karalliedde, Janaka; Viberti, Giancarlo

2004-10-01

251

Cardiovascular Pharmacogenomics: The Future of Cardiovascular Therapeutics?  

PubMed Central

Responses to drug therapy vary from benefit to no effect to adverse effects which can be serious or occasionally fatal. Increasing evidence supports the idea that genetic variants can play a major role in this spectrum of responses. Well-studied examples in cardiovascular therapeutics include predictors of steady-state warfarin dosage, predictors of reduced efficacy among patients receiving clopidogrel for drug eluting stents, and predictors of some serious adverse drug effects. This review summarizes contemporary approaches to identifying and validating genetic predictors of variability in response to drug treatment. Approaches to incorporating this new knowledge into clinical care, and the barriers to this concept, are addressed. PMID:23200096

Roden, Dan M.

2012-01-01

252

Interactive Cardiovascular System Map  

NSDL National Science Digital Library

The cardiovascular portion of the InnerBody website is a road map to the human cardiovascular system. It displays all of the main veins and arteries of the human body allowing the user to click on various parts of body and dozens of links to the many different systems appear. Users can hover over the links to discover what each part is named, or click on the link to be brought to a thorough definition and description of the selected system. Users may also �zoom in� on certain parts to view more detail. In addition to the interactive �map,� InnerBody also has images and descriptions about common issues that arise within the cardiovascular system.

2006-12-22

253

Cardiovascular actions of berberine.  

PubMed

Berberine, is an alkaloid from Hydrastis canadensis L., Chinese herb Huanglian, and many other plants. It is widely used in traditional Chinese medicine as an antimicrobial in the treatment of dysentery and infectious diarrhea. This manuscript describes cardiovascular effects of berberine and its derivatives, tetrahydroberberine and 8-oxoberberine. Berberine has positive inotropic, negative chronotropic, antiarrhythmic, and vasodilator properties. Both derivatives of berberine have antiarrhythmic activity. Some cardiovascular effects of berberine and its derivatives are attributed to the blockade of K+ channels (delayed rectifier and K(ATP)) and stimulation of Na+ -Ca(2+) exchanger. Berberine has been shown to prolong the duration of ventricular action potential. Its vasodilator activity has been attributed to multiple cellular mechanisms. The cardiovascular effects of berberine suggest its possible clinical usefulness in the treatment of arrhythmias and/or heart failure. PMID:11607041

Lau, C W; Yao, X Q; Chen, Z Y; Ko, W H; Huang, Y

2001-01-01

254

Tea and cardiovascular disease.  

PubMed

There is increasing evidence for a protective effect of tea consumption against cardiovascular disease. This review summarizes the available epidemiological data providing evidence for and against such an effect. We also review observational and intervention studies that investigated an effect of tea and tea extracts on cardiovascular risk factors, including blood pressure, serum lipids, diabetes mellitus, and obesity. Finally, we review potential mechanisms of benefit, including anti-inflammatory, anti-oxidant, and anti-proliferative effects, as well as favorable effects on endothelial function. Overall, the observational data suggest a benefit, but results are mixed and likely confounded by lifestyle and background dietary factors. The weight of evidence indicates favorable effects on risk factors and a number of plausible mechanisms have been elucidated in experimental and translational human studies. Despite the growing body evidence, it remains uncertain whether tea consumption should be recommended to the general population or to patients as a strategy to reduce cardiovascular risk. PMID:21477653

Deka, Apranta; Vita, Joseph A

2011-08-01

255

Mitochondria and Cardiovascular Aging  

PubMed Central

Old age is a major risk factor for cardiovascular diseases. Several lines of evidence in experimental animal models have indicated the central role of mitochondria both in lifespan determination and cardiovascular aging. In this article we review the evidence supporting the role of mitochondrial oxidative stress, mitochondrial damage and biogenesis as well as the crosstalk between mitochondria and cellular signaling in cardiac and vascular aging. Intrinsic cardiac aging in the murine model closely recapitulates age-related cardiac changes in humans (left ventricular hypertrophy, fibrosis and diastolic dysfunction), while the phenotype of vascular aging include endothelial dysfunction, reduced vascular elasticity and chronic vascular inflammation. Both cardiac and vascular aging involve neurohormonal signaling (e.g. renin-angiotensin, adrenergic, insulin-IGF1 signaling) and cell-autonomous mechanisms. The potential therapeutic strategies to improve mitochondrial function in aging and cardiovascular diseases are also discussed, with a focus on mitochondrial-targeted antioxidants, calorie restriction, calorie restriction mimetics and exercise training. PMID:22499901

Dai, Dao-Fu; Ungvari, Zoltan

2013-01-01

256

Hyperuricemia and cardiovascular risk.  

PubMed

There is an increasing prevalence of gout and hyperuricemia worldwide. Gout confers a significant individual and social burden and is increasingly recognized as a prevalent chronic disease state requiring appropriate long-term management. Gout and hyperuricemia appear to be independent risk factors for incident hypertension, renal disease and cardiovascular disease. Multiple epidemiologic studies confirm an association between hyperuricemia and "cardiometabolic disease". We review the evidence stating the relationship between hyperuricemia and the development of comorbid conditions contributing to cardiovascular risk and disease. PMID:24554489

Grassi, Davide; Desideri, Giovambattista; Di Giacomantonio, Anna Vittoria; Di Giosia, Paolo; Ferri, Claudio

2014-12-01

257

Japanese guideline for allergic rhinitis 2014.  

PubMed

Like asthma and atopic dermatitis, allergic rhinitis is an allergic disease, but of the three, it is the only type I allergic disease. Allergic rhinitis includes pollinosis, which is intractable and reduces quality of life (QOL) when it becomes severe. A guideline is needed to understand allergic rhinitis and to use this knowledge to develop a treatment plan. In Japan, the first guideline was prepared after a symposium held by the Japanese Society of Allergology in 1993. The current 7th edition was published in 2013, and is widely used today. To incorporate evidence based medicine (EBM) introduced from abroad, the most recent collection of evidence/literature was supplemented to the Practical Guideline for the Management of Allergic Rhinitis in Japan 2013. The revised guideline includes assessment of diagnosis/treatment and prescriptions for children and pregnant women, for broad clinical applications. An evidence-based step-by-step strategy for treatment is also described. In addition, the QOL concept and cost benefit analyses are also addressed. Along with Allergic Rhinitis and its Impact of Asthma (ARIA), this guideline is widely used for various clinical purposes, such as measures for patients with sinusitis, childhood allergic rhinitis, oral allergy syndrome, and anaphylaxis and for pregnant women. A Q&A section regarding allergic rhinitis in Japan was added to the end of this guideline. PMID:25178177

Okubo, Kimihiro; Kurono, Yuichi; Fujieda, Shigeharu; Ogino, Satoshi; Uchio, Eiichi; Odajima, Hiroshi; Takenaka, Hiroshi

2014-09-01

258

Screening for Cardiovascular Disease in Survivors of Thoracic Radiation  

Microsoft Academic Search

\\u000a \\u000a Background and purpose  A solid body of evidence demonstrates that therapeutic thoracic radiotherapy can injure the cardiovascular system. However,\\u000a there is little consensus on how to screen survivors who received this therapy. This review intends to assess recent evidence\\u000a on radiotherapy-related cardiac injury with the goal of formulating evidence-based guidelines.

M. Jacob Adams; Robert G. Prosnitz; Louis S. Constine; Lawrence B. Marks; Steven E. Lipshultz

259

Nutritionally Complete Prepared Meal Plan to Reduce Cardiovascular Risk Factors  

Microsoft Academic Search

Objective To compare a nutritionally complete prepared meal plan that meets national dietary guidelines to usual-care dietary therapy for hypertension, dyslipidemia, and glycemic control.Design Randomized, controlled trial.Subjects\\/setting Outpatients with hypertension, dyslipidemia, or diabetes mellitus (n=251) were recruited at 6 medical centers in the United States and Canada.Intervention The prepared meal plan, which was developed by university-based nutrition and cardiovascular scientists

R. BRIAN HAYNES; PENNY KRIS-ETHERTON; DAVID A McCARRON; SUZANNE OPARIL; ALAN CHAIT; LAWRENCE M RESNICK; CYNTHIA D MORRIS; SHARON CLARK; DANIEL C HATTON; JILL A METZ; MARGARET McMAHON; SCOTT HOLCOMB; GEOFFREY W SNYDER; F. XAVIER PI-SUNYER; JUDITH S STERN

1999-01-01

260

2010 Guidelines, Policy & Clarification  

Cancer.gov

2010 Guidelines, Policy & Clarification SF 424 PHS 2590 eRA Commons The Cancer Control Planet NCI Fact Book NIH Office of Extramural Research Home > Grants & Funding > 2010 Guidelines, Policy & Clarification

261

Network Security Guideline.  

National Technical Information Service (NTIS)

This Network Security Guideline was prepared to assist in understanding how the Command will implement the guidance from numerous security regulations and instructions for a network environment, and to establish network security policies and guidelines at...

1993-01-01

262

Having a Change of Heart: A Lesson on Cardiovascular Anatomy  

NSDL National Science Digital Library

This teaching resource was developed by a K-12 science teacher in the American Physiologycal Society's 2006 Frontiers in Physiology Program. For more information on this program, please visit www.frontiersinphys.org. The purpose of this activity is to investigate and develop a model of the normal anatomy of the human heart/circulatory system and then to explore and model the effects of several cardiovascular disease processes. Students should understand basic cellular respiration. Upon completion of this activity, students will be able to: plan and design a model of a human heart with basic systemic circulation and evaluate impact of cardiovascular diseases on normal circulation.

Cynthia Pfirrmann (Scotch Plains-Fanwood High School)

2006-08-01

263

Underreporting of conflicts of interest in clinical practice guidelines: cross sectional study  

PubMed Central

Background Conflicts of interest affect recommendations in clinical guidelines and disclosure of such conflicts is important. However, not all conflicts of interest are disclosed. Using a public available disclosure list we determined the prevalence and underreporting of conflicts of interest among authors of clinical guidelines on drug treatments. Methods We included up to five guidelines published from July 2010 to March 2012 from each Danish clinical specialty society. Using the disclosure list of the Danish Health and Medicines Authority, we identified author conflicts of interest and compared them with the disclosures in the guidelines. For each guideline we extracted methodological characteristics of guideline development. Results Forty-five guidelines from 14 specialty societies were included. Of 254 authors, 135 (53%) had conflicts of interest, corresponding to 43 of the 45 guidelines (96%) having one or more authors with a conflict of interest. Only one of the 45 guidelines (2%) disclosed author conflicts of interest. The most common type of conflict of interest (83 of the 135) was being a consultant, an advisory board member or a company employee. Only 10 guidelines (22%) described the methods used for guideline development, 27 (60%) used references in the text and 11 (24%) graded the types of evidence. Conclusions Conflicts of interest were common, but disclosures were very rare. Most guidelines did not describe how they were developed and many did not describe the evidence behind specific recommendations. Publicly available disclosure lists may assist guideline issuing bodies in ensuring that all conflicts are disclosed. PMID:23642105

2013-01-01

264

Quality indicators for cardiovascular primary care  

PubMed Central

BACKGROUND: The Canadian Cardiovascular Outcomes Research Team was established in 2001 to improve the quality of cardiovascular care for Canadians. Initially, quality indicators (QIs) for hospital-based care for those with acute myocardial infarctions and congestive heart failure were developed and measured. Qualitative research on the acceptability of those indicators concluded that indicators were needed for ambulatory primary care practice, where the bulk of cardiovascular disease care occurs. OBJECTIVES: To systematically develop QIs for primary care practice for the primary prevention and chronic disease management of ischemic heart disease, hypertension, hyperlipidemia and heart failure. METHODS: A four-stage modified Delphi approach was used and included a literature review of evidence-based practice guidelines and previously developed QIs; the development and circulation of a survey tool with proposed QIs, asking respondents to rate each indicator for validity, necessity to record and feasibility to collect; an in-person meeting of respondents to resolve rating and content discrepancies, and suggest additional QIs; and recirculation of the survey tool for rating of additional QIs. Participants from across Canada included family physicians, primary care nurses, an emergency room family physician and cardiologists. RESULTS: 31 QIs were agreed on, nine of which were for primary prevention and 22 of which were for chronic disease management. CONCLUSIONS: A core set of QIs for ambulatory primary care practice has been developed as a tool for practitioners to evaluate the quality of cardiovascular disease care. While the participants rated the indicators as feasible to collect, the next step will be to conduct field validation. PMID:17440644

Burge, Frederick I; Bower, Kelly; Putnam, Wayne; Cox, Jafna L

2007-01-01

265

¿Es útil la radiografía de tórax en la evaluación rutinaria preoperatoria de pacientes sometidos a cirugía electiva no cardiovascular?  

Microsoft Academic Search

Objective: To evaluate the usefulness of rutinary chest X-rays before elective non cardiovascular surgeries in ASA I and II patients according to the American Society of Anesthesiologists (ASA) classification, and to report the prevalence of radiographic findings. Material and Methods: A retrospective analysis of 251 patients who underwent an elective non cardiovascular surgery between November 2006 and May 2007 with

Stella Maris Batallés; Mauricio Capomasi; Gabriela Longo; Roberto Villavicencio; Stella Maris Pezzotto; Consejo de Investigaciones

2007-01-01

266

2006-1968: TEACHING BASIC CARDIO-VASCULAR MECHANICS WITH LEGO MODELS: A HIGH SCHOOL CASE STUDY  

E-print Network

2006-1968: TEACHING BASIC CARDIO-VASCULAR MECHANICS WITH LEGO MODELS: A HIGH SCHOOL CASE STUDY worked with LEGO to develop ROBOLAB, a robotic approach to learning science and math. © American Society for Engineering Education, 2006 #12;Teaching Basic Cardio-Vascular Mechanics With LEGO Models: A High School Case

267

Sleep Deprivation and Cardiovascular Risk  

MedlinePLUS

Sleep Deprivation and Cardiovascular Risk (0:31) Dr. Janet Mullington discusses how studies suggest a link between sleep deprivation and increased risk for cardiovascular disease. choose settings to watch ...

268

Canadian guidelines for acute bacterial rhinosinusitis  

PubMed Central

Objective To provide a clinical summary of the Canadian clinical practice guidelines for acute bacterial rhinosinusitis (ABRS) that includes relevant considerations for family physicians. Quality of evidence Guideline authors performed a systematic literature search and drafted recommendations. Recommendations received both strength of evidence and strength of recommendation ratings. Input from external content experts was sought, as was endorsement from Canadian medical societies (Association of Medical Microbiology and Infectious Disease Canada, Canadian Society of Allergy and Clinical Immunology, Canadian Society of Otolaryngology—Head and Neck Surgery, Canadian Association of Emergency Physicians, and the Family Physicians Airways Group of Canada). Main message Diagnosis of ABRS is based on the presence of specific symptoms and their duration; imaging or culture are not needed in uncomplicated cases. Treatment is dependent on symptom severity, with intranasal corticosteroids (INCSs) recommended as monotherapy for mild and moderate cases, although the benefit might be modest. Use of INCSs plus antibiotics is reserved for patients who fail to respond to INCSs after 72 hours, and for initial treatment of patients with severe symptoms. Antibiotic selection must account for the suspected pathogen, the risk of resistance, comorbid conditions, and local antimicrobial resistance trends. Adjunct therapies such as nasal saline irrigation are recommended. Failure to respond to treatment, recurrent episodes, and signs of complications should prompt referral to an otolaryngologist. The guidelines address situations unique to the Canadian health care environment, including actions to take during prolonged wait periods for specialist referral or imaging. Conclusion The Canadian guidelines provide up-to-date recommendations for diagnosis and treatment of ABRS that reflect an evolving understanding of the disease. In addition, the guidelines offer useful tools to help clinicians discern viral from bacterial episodes, as well as optimally manage their patients with ABRS. PMID:24627376

Kaplan, Alan

2014-01-01

269

National Bookmobile Guidelines, 1988.  

ERIC Educational Resources Information Center

These guidelines were developed by the bookmobile community that has met in Columbus, Ohio, since 1985 for their annual conference. The guidelines comprise the collaborative effort of hundreds of conference participants and representatives from 79 libraries throughout the United States and Canada, who discussed the guidelines in regional and state…

Ohio State Library, Columbus.

270

Hebrew Proficiency Guidelines.  

ERIC Educational Resources Information Center

Guidelines for Hebrew language proficiency are presented in two companion volumes which are identical except that one gives examples of various linguistic forms in Hebrew and the other provides them in Roman script. These guidelines are based on the generic guidelines published in 1986 by the American Council on the Teaching of Foreign Languages.…

Brandeis Univ., Waltham, MA. Dept. of Near Eastern and Judaic Studies.

271

Guidelines for Performance-  

E-print Network

TBI Guidelines for Performance- Based Seismic Design of Tall Buildings !"#$%&'()*+( ,&-"./"#(0;Page iii GUIDELINES FOR PERFORMANCE-BASED SEISMIC DESIGN OF TALL BUILDINGS* Prepared by the TBI Buildings. PEER Report 2010/05, November 2010. Prepared by the TBI Guidelines Working Group. Berkeley

Alvarez-Cohen, Lisa

272

Adoption Assistance Program Guidelines  

E-print Network

home must occur before you can receive this benefit. ELIGIBILITY GUIDELINES You must hold a RegularAdoption Assistance Program Guidelines This is intended to be a summary of plan provisions, refer Adoption Assistance ­ Program Guidelines Edited 03/10/14 The Adoption Assistance benefit provided by Ohio

273

Prekindergarten Curriculum Guidelines.  

ERIC Educational Resources Information Center

Following adoption of the Texas Essential Knowledge and Skills (TEKS) in 1998, new prekindergarten curriculum guidelines were developed. These voluntary guidelines articulate what 3- and 4-year-olds should know and be able to do and provide a means to align prekindergarten programs with the TEKS curriculum. The guidelines are intended to assist…

Fowler, Marilyn; Meyers, Margaret E.; Morris, Pam Bell; Gonzales, Peggy Freedson; Uphaus, Anita

274

Nutrition and health: guidelines for dental practitioners.  

PubMed

Good nutrition is vital to overall health, and poor diet and a sedentary lifestyle are major causes of morbidity and mortality worldwide. Nutritional factors are implicated in many oral and systemic diseases and conditions, including obesity, hypertension, dyslipidemia, type II diabetes, cardiovascular disease, osteoporosis, dental caries and some cancers including oral cancers. This review focuses on the evidence for the relations between key nutritional factors and health. Energy intake is related to body weight and obesity, highlighting the importance of lower-energy diets and regular physical activity for body weight maintenance and for preventing obesity. Evidence is presented for the health benefits of high quality carbohydrates, such as whole grain products, and fruits and vegetables, in reducing the risk of cardiovascular disease and cancer. The adverse effects of sugar, sweetened beverages, and trans and saturated fats on several diseases including caries, diabetes and cardiovascular disease are described. The health benefits of unsaturated fats, antioxidants, B vitamins and vitamin D in cardiovascular disease, periodontitis, cancer, and other conditions are documented. Both benefits and harmful effects of dairy product intake on health are discussed. Based on the evidence, nutritional guidelines are provided, as well as key recommendations for preventing obesity. Dentists can play a critical role in motivating and enabling healthy food choices. PMID:19467151

Palacios, C; Joshipura, Kj; Willett, Wc

2009-09-01

275

Obesity and Cardiovascular Disease  

Microsoft Academic Search

Obesity has reached global epidemic proportions in both adults and children and is associated with numerous comorbidities, including hypertension (HTN), type II diabetes mellitus, dyslipidemia, obstructive sleep apnea and sleep-disordered breathing, certain cancers, and major cardiovascular (CV) diseases. Because of its maladaptive effects on various CV risk factors and its adverse effects on CV structure and function, obesity has a

Carl J. Lavie; Richard V. Milani; Hector O. Ventura

2009-01-01

276

Advancing Cardiovascular Research  

PubMed Central

Over the past 50 years, we have seen dramatic changes in cardiovascular science and clinical care, accompanied by marked declines in the morbidity and mortality. Nonetheless, cardiovascular disease remains the leading cause of death and disability in the world, and its nature is changing as Americans become older, fatter, and ethnically more diverse. Instead of young or middle-aged men with ST-segment elevation myocardial infarction, the “typical” cardiac patient now presents with acute coronary syndrome or with complications related to chronic hypertension or ischemic heart disease, including heart failure, sudden death, and atrial fibrillation. Analogously, structural heart disease is now dominated by degenerative valve or congenital disease, far more common than rheumatic disease. The changing clinical scene presents cardiovascular scientists with a number of opportunities and challenges, including taking advantage of high-throughput technologies to elucidate complex disease mechanisms, accelerating development and implementation of evidence-based strategies, assessing evolving technologies of unclear value, addressing a global epidemic of cardiovascular disease, and maintaining high levels of innovation in a time of budgetary constraint and economic turmoil. PMID:22315116

2012-01-01

277

Epidemiology of Cardiovascular Diseases.  

ERIC Educational Resources Information Center

Reviews epidemiological studies of cardiovascular diseases especially coronary heart disease (CHD), to document their major public health importance, changes in mortality during this century, and international comparisons of trends. Finds major risk factors for CHD are determined in large part by psychosocial and behavioral mechanisms. Asserts…

Jenkins, C. David

1988-01-01

278

Spirituality and Cardiovascular Risk  

Microsoft Academic Search

This study extended current research linking spirituality to health by investigating the relationship between extrinsic and intrinsic spirituality and cardiovascular risk factors. Participants included 111 healthy males and females, ages 28 to 63. Measurements consisted of the Lifestyle Assessment Questionnaire (LAQ), a version of Kelly's Repertory Grid, hematological analysis, and blood pressure. A greater sense of spirituality was associated with

Joseph A. Doster; Michelle B. Harvey; Celeste A. Riley; Arthur J. Goven; Renee Moorefield

2002-01-01

279

FRONTIERS IN CARDIOVASCULAR  

E-print Network

, OCTObER 2, 2012 Cardiovascular Stem Cell Research: Lost and Found in Translation Joseph Gold, Ph Research 2012: Looking Forward to Challenges and Opportunities Come for the workshops, stay for the debate. Or come for the debate & stay for the speed science. Or come for the keynote & stay for the music. Any way

Puglisi, Joseph

280

Epigenetics and cardiovascular disease  

Microsoft Academic Search

Despite advances in the prevention and management of cardiovascular disease (CVD), this group of multifactorial disorders remains a leading cause of mortality worldwide. CVD is associated with multiple genetic and modifiable risk factors; however, known environmental and genetic influences can only explain a small part of the variability in CVD risk, which is a major obstacle for its prevention and

Caren E. Smith; José M. Ordovás

2010-01-01

281

Proteomics in cardiovascular surgery.  

PubMed

Proteomics describes, analogous to the term genomics, the study of the complete set of proteins present in a cell, organ, or organism at a given time. The genome tells us what could theoretically happen, whereas the proteome tells us what does happen. Therefore, a genomic-centered view of biologic processes is incomplete and does not describe what happens at the protein level. Proteomics is a relatively new methodology and is rapidly changing because of extensive advances in the underlying techniques. The core technologies of proteomics are 2-dimensional gel electrophoresis, liquid chromatography, and mass spectrometry. Proteomic approaches might help to close the gap between traditional pathophysiologic and more recent genomic studies, assisting our basic understanding of cardiovascular disease. The application of proteomics in cardiovascular medicine holds great promise. The analysis of tissue and plasma/serum specimens has the potential to provide unique information on the patient. Proteomics might therefore influence daily clinical practice, providing tools for diagnosis, defining the disease state, assessing of individual risk profiles, examining and/or screening of healthy relatives of patients, monitoring the course of the disease, determining the outcome, and setting up individual therapeutic strategies. Currently available clinical applications of proteomics are limited and focus mainly on cardiovascular biomarkers of chronic heart failure and myocardial ischemia. Larger clinical studies are required to test whether proteomics may have promising applications for clinical medicine. Cardiovascular surgeons should be aware of this increasingly pertinent and challenging field of science. PMID:17198814

Matt, Peter; Carrel, Thierry; White, Melanie; Lefkovits, Ivan; Van Eyk, Jennifer

2007-01-01

282

Internal Medicine Cardiovascular Medicine ------------------------------------------------------------------------------  

E-print Network

methods, and novel therapeutic measures of various cardiovascular diseases (ischemic heart disease, heart for wide variety of respiratory disorders including lung cancer, asthma and COPD. Especially, we have been intensively studying the molecular mechanisms underlying the pathogenesis of lung disorders. Our research goal

Miyashita, Yasushi

283

Phytoestrogens and cardiovascular health  

Microsoft Academic Search

Coronary artery disease is the leading overall cause of mortality for women and increases dramatically after menopause. Estrogen has many beneficial cardiovascular actions although concerns have been raised about its effects on the progression of breast and uterine neoplasms and its tendency to increase coagulability. Selective estrogen agonists may be superior to conventional estrogens. A dietary source of a partial

Lynette Wroblewski Lissin; John P Cooke

2000-01-01

284

Mitochondrial dysfunction in cardiovascular disease  

Microsoft Academic Search

Whereas the pathogenesis of atherosclerosis has been intensively studied and described, the underlying events that initiate cardiovascular disease are not yet fully understood. A substantial number of studies suggest that altered levels of oxidative and nitrosoxidative stress within the cardiovascular environment are essential in the development of cardiovascular disease; however, the impact of such changes on the subcellular or organellar

Scott W. Ballinger

2005-01-01

285

Cardiovascular Disease in Children and Adolescents with Diabetes: Where Are We, and Where Are We Going?  

PubMed Central

Abstract The increasing prevalence of type 1 and type 2 diabetes mellitus combined with advancement in early detection of cardiovascular disease (CVD) has placed CVD as a significant concern for preventative pediatric medicine. The public health burden of type 2 diabetes is predicted to parallel increasing obesity in children with a projected increase of early CVD in adulthood. In this article, we review practice guidelines for cardiovascular health in children and adolescents with diabetes and data on which they are based. We then focus on imaging modalities that are promising tools to expand our understanding of the cardiovascular risk imposed on youths with diabetes. PMID:22650220

Maahs, David M.; Daniels, Stephen R.

2012-01-01

286

Cardiovascular prevention in a high risk sport, ice hockey: applications in wider sports physical therapy practice.  

PubMed

Although acute myocardial infarction and sudden cardiac death are relatively rare occurrences in athletics, cardiovascular accidents do occur. This manuscript presents information on the cardiovascular risks in athletics. In addition, information is provided on screening for cardiovascular risk - including history taking, chart review, physical examination - and the appropriate guidelines on the treatment of athletes found to be at risk. For the purpose of this article, the sport of ice hockey is used to illustrate the subject matter and highlight the behaviors in sport that carry cardiovascular risk. Physical therapists have ethical and legal responsibility to undertake the necessary screening procedures to recognize and respond to any signs of cardiovascular risk in their clients. PMID:21522221

Hopkins-Rosseel, Diana H

2006-11-01

287

Revised Prostate Cancer Screening Guidelines: What Has--and Hasn't--Changed  

MedlinePLUS

... Prostate Cancer Screening Guidelines: What Has—and Hasn't—Changed Article date: March 3, 2010 By: Rebecca ... the American Cancer Society (ACS). While this isn't a radical change from the previous recommendations, the ...

288

Management of conflicts of interest in cardiovascular medicine.  

PubMed

Conflicts of interest (COIs) are common and important in cardiovascular medicine. Although COIs do not automatically lead to bias, conflicts between financial considerations, fame, promotion, etc., threaten valued interests such as objectivity, integrity, patient protection and cost-savings. Strategies for managing COIs include disclosure, limitations and eliminations, each of which is employed in varying degrees by universities, funding and regulatory agencies, journal editors, providers of continuing medical education and professional societies. This paper describes benefits and pitfalls inherent in each of these strategies. There is no "gold standard" for the dealing with COIs in cardiovascular medicine, but finding ways to manage unavoidable COIs without compromising the benefits of productive relationships between investigators and industry will be essential to preserving valued interests and public trust in the cardiovascular profession. PMID:23217429

Kirkpatrick, James N; Kadakia, Mitul B; Vargas, Alvaro

2012-01-01

289

Winter Cardiovascular Diseases Phenomenon  

PubMed Central

This paper review seasonal patterns across twelve cardiovascular diseases: Deep venous thrombosis, pulmonary embolism, aortic dissection and rupture, stroke, intracerebral hemorrhage, hypertension, heart failure, angina pectoris, myocardial infarction, sudden cardiac death, venricular arrythmia and atrial fibrillation, and discuss a possible cause of the occurrence of these diseases. There is a clear seasonal trend of cardiovascular diseases, with the highest incidence occurring during the colder winter months, which have been described in many countries. This phenomenon likely contributes to the numbers of deaths occurring in winter. The implications of this finding are important for testing the relative importance of the proposed mechanisms. Understanding the influence of season and other factors is essential when seeking to implement effective public health measures. PMID:23724401

Fares, Auda

2013-01-01

290

Cardiovascular instrumentation for spaceflight  

NASA Technical Reports Server (NTRS)

The observation mechanisms dealing with pressure, flow, morphology, temperature, etc. are discussed. The approach taken in the performance of this study was to (1) review ground and space-flight data on cardiovascular function, including earlier related ground-based and space-flight animal studies, Mercury, Gemini, Apollo, Skylab, and recent bed-rest studies, (2) review cardiovascular measurement parameters required to assess individual performance and physiological alternations during space flight, (3) perform an instrumentation survey including a literature search as well as personal contact with the applicable investigators, (4) assess instrumentation applicability with respect to the established criteria, and (5) recommend future research and development activity. It is concluded that, for the most part, the required instrumentation technology is available but that mission-peculiar criteria will require modifications to adapt the applicable instrumentation to a space-flight configuration.

Schappell, R. T.; Polhemus, J. T.; Ganiaris, N. J.

1976-01-01

291

Cardiovascular adaptation to spaceflight  

NASA Technical Reports Server (NTRS)

This article reviews recent flight and ground-based studies of cardiovascular adaptation to spaceflight. Prominent features of microgravity exposure include loss of gravitational pressures, relatively low venous pressures, headward fluid shifts, plasma volume loss, and postflight orthostatic intolerance and reduced exercise capacity. Many of these short-term responses to microgravity extend themselves during long-duration microgravity exposure and may be explained by altered pressures (blood and tissue) and fluid balance in local tissues nourished by the cardiovascular system. In this regard, it is particularly noteworthy that tissues of the lower body (e.g., foot) are well adapted to local hypertension on Earth, whereas tissues of the upper body (e.g., head) are not as well adapted to increase in local blood pressure. For these and other reasons, countermeasures for long-duration flight should include reestablishment of higher, Earth-like blood pressures in the lower body.

Hargens, A. R.; Watenpaugh, D. E.

1996-01-01

292

Cardiovascular adaptation to spaceflight  

NASA Technical Reports Server (NTRS)

Data are presented on the rate of adaptation of the human cardiovascular system to conditions of spaceflight, with particular attention given to data obtained during spaceflight in the U.S. Space Shuttle Program. It is pointed out that many of the cardiovascular changes that occurred during spaceflights that lasted from 2 to 11 days can be traced directly to changes in the body fluid volume. The beneficial effects of a fluid loading countermeasure (oral rehydration) and of the supine body position on the heart rate during the spaceflight are demonstrated. It is noted that, after hours or a few days of spaceflight, a state of adaptation is reached, in which the subject is well adapted and appropriately hydrated for the weightless environment. However, the return to the normal gravity of the earth leaves the individual especially sensitive to orthostatic stress.

Charles, John B.; Lathers, Claire M.

1991-01-01

293

Interventional Cardiovascular MRI  

Microsoft Academic Search

Interventional cardiovascular magnetic resonance imaging (iCMR) is potentially revolutionary because of the exquisite tissue\\u000a and blood imaging afforded to guide therapeutic procedures. By making small compromises in spatial or temporal resolution,\\u000a and with little or no modifications to commercial high-performance magnetic resonance imaging (MRI) systems, images can be\\u000a acquired and displayed almost instantaneously to operators. This may be useful simply

Robert J. Lederman

294

Testosterone and Cardiovascular Disease  

Microsoft Academic Search

The effects of testosterone (T) on cardiovascular disease in both men and women are summarized in this chapter. The epidemiologic\\u000a data suggest that hypogonadism is associated with a higher prevalence of hypertension, hyperlipidemia, diabetes, obesity,\\u000a asthma\\/COPD. Physiologically, androgen binding protein is expressed in the cardiac myocyte. Testosterone also affects basal\\u000a levels of intracellular calcium in the cardiac myocyte, as well

Allen D. Seftel; Spencer Land

295

Cardiovascular Magnetic Resonance  

Microsoft Academic Search

\\u000a Cardiovascular magnetic resonance (CMR) creates images from atomic nuclei with uneven spin using radio waves in the presence\\u000a of a magnetic field. Full details of the physical principles can be found elsewhere [1]. For clinical purposes, MR is performed using hydrogen-1, which is abundant in water and fat. Radiofrequency waves excite\\u000a the area of interest to create tissue magnetization, which

Dudley J. Pennell

2001-01-01

296

Inspection Guideline of BWR Core Internals in Japan  

SciTech Connect

There are crack experiences of core internal components worldwide. So Thermal and Nuclear Power Engineering Society in Japan organized the committee to prepare the appropriate inspection and evaluation guidelines for core internal components at February, 2000. This committee consists of scholars and representatives from utilities and vendors in Japan. At this committee, guidelines for rational inspection and the evaluation method for structural integrity of each core internal components have been developed. For BWR, inspection guidelines for main core internal components like shroud support, core shroud, top guide, core plate, jet pump etc. were prepared at March 2002. Basic concept of guidelines and inspection guideline of shroud support as example will be explained here. (authors)

Akio Yamamoto [Chubu Electric Power Company Inc., 1, Higashi-shincho Higashi-ku, Nagoya-shi, ACH 461-8680 (Japan); Naoto Iizuka [Tokyo Electric Power Company (Japan); Takeshi Yosiinaga [Japan Atomic Power Company (Japan); Haruo Fujimori [Hitachi Ltd. (Japan); Yuuichi Motora [Toshiba Corporation (Japan)

2002-07-01

297

New ethics guidelines for epidemiology: background and rationale.  

PubMed

In the past decade, at least four sets of ethics guidelines for epidemiologists have been prepared by various national and international organizations. None, however, have been officially adopted by the American College of Epidemiology (ACE). Recently, the ACE asked its Ethics and Standards of Practice (ESOP) Committee to produce ethics guidelines. In this paper, we explain the context and rationale for this effort, describe the purpose and content of ethics guidelines in epidemiology, and discuss their strengths and weaknesses. Three issues that are central to the mission of ACE-education, policy, and advocacy-are inadequately addressed in existing ethics guidelines. In addition, ethics guidelines are not static documents; they should reflect the changing role of epidemiologists in society, including issues arising in emerging subspecialty areas. New, more dynamic, guidelines that emphasize core values, obligations, and virtues, may help to further define and legitimize the profession of epidemiology and will provide a foundation for the discussion of specific ethical issues in the classroom and in professional practice. Guidelines however, do not provide the final word on ethical issues. Specific decisions in particular cases require judgments made upon reflection of the core values, obligations, and virtues described in the guidelines. From our review, we conclude that a new set of guidelines is reasonable and warranted. PMID:10976852

Weed, D L; Coughlin, S S

1999-07-01

298

Time to detoxify medical literature from guideline overdose  

PubMed Central

The current financial turmoil in the United States has been attributed to multiple reasons including healthcare expenditure. Health care spending has increased from 5.7 percent of the gross domestic product (GDP) in 1965 to 16 percent of the GDP in 2004. Healthcare is driven with a goal to provide best possible care available at that period of time. Guidelines are generally assumed to have the high level of certainty and security as conclusions generated by the conventional scientific method leading many clinicians to use guidelines as the final arbiters of care. To provide the standard of care, physicians follow guidelines, proposed by either groups of physicians or various medical societies or government organizations like National Comprehensive Cancer Network. This has lead to multiple tests for the patient and has not survived the test of time. This independence leads to lacunae in the standardization of guidelines, hence flooding of literature with multiple guidelines and confusion to patients and physicians and eventually overtreatment, inefficiency, and patient inconvenience. There is an urgent need to restrict articles with Guidelines and develop some strategy like have an intermediate stage of pre-guidelines and after 5-10 years of trials, a systematic launch of the Guidelines. There can be better ways than this for putting together guidelines as has been suggested by multiple authors and researchers. PMID:22807603

Vyas, Dinesh; Vyas, Arpita K

2012-01-01

299

Epilepsy and vaccinations: Italian guidelines.  

PubMed

Reports of childhood epilepsies in temporal association with vaccination have had a great impact on the acceptance of vaccination programs by health care providers, but little is known about this possible temporal association and about the types of seizures following vaccinations. For these reasons the Italian League Against Epilepsy (LICE), in collaboration with other Italian scientific societies, has decided to generate Guidelines on Vaccinations and Epilepsy. The aim of Guidelines on Vaccinations and Epilepsy is to present recent unequivocal evidence from published reports on the possible relationship between vaccines and epilepsy in order to provide information about contraindications and risks of vaccinations in patients with epilepsy. The following main issues have been addressed: (1) whether contraindications to vaccinations exist in patients with febrile convulsions, epilepsy, and/or epileptic encephalopathies; and (2) whether any vaccinations can cause febrile seizures, epilepsy, and/or epileptic encephalopathies. Diphtheria-tetanus-pertussis (DTP) vaccination and measles, mumps, and rubella vaccination (MMR) increase significantly the risk of febrile seizures. Recent observations and data about the relationships between vaccination and epileptic encephalopathy show that some cases of apparent vaccine-induced encephalopathy could in fact be caused by an inherent genetic defect with no causal relationship with vaccination. PMID:24099052

Pruna, Dario; Balestri, Paolo; Zamponi, Nelia; Grosso, Salvatore; Gobbi, Giuseppe; Romeo, Antonino; Franzoni, Emilio; Osti, Maria; Capovilla, Giuseppe; Longhi, Riccardo; Verrotti, Alberto

2013-10-01

300

Contrast echocardiography in Canada: Canadian Cardiovascular Society/Canadian Society of Echocardiography position paper  

PubMed Central

As an adjunct to transthoracic, transesophageal and stress echocardiography, contrast echocardiography (CE) improves the diagnostic accuracy of technically suboptimal studies when used in conjunction with harmonic imaging. Intravenous ultrasound contrast agents are indicated for left ventricular (LV) opacification and improvement of LV endocardial border delineation in patients with suboptimal acoustic windows. Demonstrated benefits of CE include improvement in the accuracy of LV measurements, regional wall motion assessment, evaluation of noncompaction cardiomyopathy, thrombus detection, Doppler signal enhancement and conjunctive use with stress echocardiography. Studies have shown the value of CE in the assessment and quantification of myocardial perfusion, and recent clinical trials have suggested a role for contrast perfusion imaging in the stratification of patients with suspected coronary artery disease. While it adds some time and cost to the echocardiographic study, CE frequently obviates the need for additional specialized, expensive and less accessible cardiac investigations, and allows for prompt and optimal subsequent patient management. Despite its proven advantages, CE is presently underused in Canada, and this situation will, unfortunately, not improve until several barriers to its use are overcome. Resolving these important hurdles is vital to the future of CE and to its eventual implementation into clinical practice of promising contrast-based diagnostic and therapeutic applications, including the assessment of perfusion by myocardial CE. PMID:17440639

Honos, George; Amyot, Robert; Choy, Jonathan; Leong-Poi, Howard; Schnell, Greg; Yu, Eric

2007-01-01

301

Water conservation plan guidelines  

SciTech Connect

These Water Conservation Plan Guidelines are addressed to water system planners but use of the Guidelines is not required by federal law or regulation. The first part of the document introduces the Guidelines and provides information to the States about their nature and possible use. The second part of the document, written for water systems, is an overview to the organization, content, and the use of the Guidelines. The next three parts contain the water conservation plan Guidelines: Basic, Intermediate, and Advanced. The Basic Guidelines are designed for use by water systems serving populations of 10,000 or fewer; The Intermediate Guidelines are designed for water systems serving between 10,000 and 100,000 people; The Advanced Guidelines are designed for water systems serving more than 100,000 people. Six appendixes to the Guidelines provide supporting information: detailed descriptions of conservation measures (Appendix A), conservation benchmarks (Appendix B), acronyms and a glossary (Appendix C), information resources (Appendix D), funding sources (Appendix E), and state contacts (Appendix F).

NONE

1998-08-06

302

Society for Ecological Restoration International  

NSDL National Science Digital Library

The Society for Ecological Restoration International (SER) is comprised of approximately 2,300 members working "to promote ecological restoration as a means of sustaining diversity of life on Earth and reestablishing an ecologically healthy relationship between nature and culture." The SER website links to information about membership; the upcoming 2005 Conference in Zaragoza, Spain; and Reading Resources including Journals, Guidelines for Developing and Managing Ecological Restoration Projects, and the SER Primer on Ecological Restoration. SER also hosts opportunity boards with listings for Professional Employment, Volunteer Opportunities; and Student/Intern Positions; an online marketplace with listings for vendors involved in ecological restoration; and the Plant Conservation Alliance's Directory of Restoration Expertise. The SER site posts boards for educational opportunities as well, including listings for University Programs, Continuing Education, Online Courses, and Children's Programs.

303

Colorectal cancer screening and surveillance: Clinical guidelines and rationale—Update based on new evidence  

Microsoft Academic Search

We have updated guidelines for screening for colorectal cancer. The original guidelines were prepared by a panel convened by the U.S. Agency for Health Care Policy and Research and published in 1997 under the sponsorship of a consortium of gastroenterology societies. Since then, much has changed, both in the research rature and in the clinical context. The present report summarizes

Sidney Winawer; Robert Fletcher; Douglas Rex; John Bond; Randall Burt; Joseph Ferrucci; Theodore Ganiats; Theodore Levin; Steven Woolf; David Johnson; Lynne Kirk; Scott Litin; Clifford Simmang

2003-01-01

304

Rosuvastatin, inflammation, C-reactive protein, JUPITER, and primary prevention of cardiovascular disease - a perspective  

PubMed Central

The major public health concern worldwide is coronary heart disease, with dyslipidemia as a major risk factor. Statin drugs are recommended by several guidelines for both primary and secondary prevention. Rosuvastatin has been widely accepted because of its efficacy, potency, and superior safety profile. Inflammation is involved in all phases of atherosclerosis, with the process beginning in early youth and advancing relentlessly for decades throughout life. C-reactive protein (CRP) is a well-studied, nonspecific marker of inflammation which may reflect general health risk. Considerable evidence suggests CRP is an independent predictor of future cardiovascular events, but direct involvement in atherosclerosis remains controversial. Rosuvastatin is a synthetic, hydrophilic statin with unique stereochemistry. A large proportion of patients achieve evidence-based lipid targets while using the drug, and it slows progression and induces regression of atherosclerotic coronary lesions. Rosuvastatin lowers CRP levels significantly. The Justification for Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) trial was designed after the observation that when both low density lipoprotein and CRP were reduced, patients fared better than when only LDL was lowered. Advocates and critics alike acknowledge that the benefits of rosuvastatin in JUPITER were real. After a review, the US Food and Drug Administration extended the indications for rosuvastatin to include asymptomatic JUPITER-eligible individuals with one additional risk factor. The American Heart Association and Centers of Disease Control and Prevention had previously recognized the use of CRP in persons with “intermediate risk” as defined by global risk scores. The Canadian Cardiovascular Society guidelines went further and recommended use of statins in persons with low LDL and high CRP levels at intermediate risk. The JUPITER study focused attention on ostensibly healthy individuals with “normal” lipid profiles and high CRP values who benefited from statin therapy. The backdrop to JUPITER during this period was an increasing awareness of a rising cardiovascular risk burden and imperfect methods of risk evaluation, so that a significant number of individuals were being denied beneficial therapies. Other concerns have been a high level of residual risk in those who are treated, poor patient adherence, a need to follow guidelines more closely, a dual global epidemic of obesity and diabetes, and a progressively deteriorating level of physical activity in the population. Calls for new and more effective means of reducing risk for coronary heart disease are intensifying. In view of compelling evidence supporting earlier and aggressive therapy in people with high risk burdens, JUPITER simply offers another choice for stratification and earlier risk reduction in primary prevention patients. When indicated, and in individuals unwilling or unable to change their diet and lifestyles sufficiently, the benefits of statins greatly exceed the risks. Two side effects of interest are myotoxicity and an increase in the incidence of diabetes. PMID:21267417

Kones, Richard

2010-01-01

305

Rosuvastatin, inflammation, C-reactive protein, JUPITER, and primary prevention of cardiovascular disease--a perspective.  

PubMed

The major public health concern worldwide is coronary heart disease, with dyslipidemia as a major risk factor. Statin drugs are recommended by several guidelines for both primary and secondary prevention. Rosuvastatin has been widely accepted because of its efficacy, potency, and superior safety profile. Inflammation is involved in all phases of atherosclerosis, with the process beginning in early youth and advancing relentlessly for decades throughout life. C-reactive protein (CRP) is a well-studied, nonspecific marker of inflammation which may reflect general health risk. Considerable evidence suggests CRP is an independent predictor of future cardiovascular events, but direct involvement in atherosclerosis remains controversial. Rosuvastatin is a synthetic, hydrophilic statin with unique stereochemistry. A large proportion of patients achieve evidence-based lipid targets while using the drug, and it slows progression and induces regression of atherosclerotic coronary lesions. Rosuvastatin lowers CRP levels significantly. The Justification for Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) trial was designed after the observation that when both low density lipoprotein and CRP were reduced, patients fared better than when only LDL was lowered. Advocates and critics alike acknowledge that the benefits of rosuvastatin in JUPITER were real. After a review, the US Food and Drug Administration extended the indications for rosuvastatin to include asymptomatic JUPITER-eligible individuals with one additional risk factor. The American Heart Association and Centers of Disease Control and Prevention had previously recognized the use of CRP in persons with "intermediate risk" as defined by global risk scores. The Canadian Cardiovascular Society guidelines went further and recommended use of statins in persons with low LDL and high CRP levels at intermediate risk. The JUPITER study focused attention on ostensibly healthy individuals with "normal" lipid profiles and high CRP values who benefited from statin therapy. The backdrop to JUPITER during this period was an increasing awareness of a rising cardiovascular risk burden and imperfect methods of risk evaluation, so that a significant number of individuals were being denied beneficial therapies. Other concerns have been a high level of residual risk in those who are treated, poor patient adherence, a need to follow guidelines more closely, a dual global epidemic of obesity and diabetes, and a progressively deteriorating level of physical activity in the population. Calls for new and more effective means of reducing risk for coronary heart disease are intensifying. In view of compelling evidence supporting earlier and aggressive therapy in people with high risk burdens, JUPITER simply offers another choice for stratification and earlier risk reduction in primary prevention patients. When indicated, and in individuals unwilling or unable to change their diet and lifestyles sufficiently, the benefits of statins greatly exceed the risks. Two side effects of interest are myotoxicity and an increase in the incidence of diabetes. PMID:21267417

Kones, Richard

2010-01-01

306

American Thoracic Society  

MedlinePLUS

... distress, and sleep apnea, among other diseases. The Society’s 15,000 members and its patient arm, the ATS Public Advisory Roundtable, believe that disease is vanquished faster when knowledge is shared. The ATS is a founding member ...

307

National Rosacea Society  

MedlinePLUS

... Join the Fight Against Rosacea The National Rosacea Society (NRS) is the world's largest organization dedicated to ... Emotional effects In surveys by the National Rosacea Society, more than 76 percent of rosacea patients said ...

308

American Society of Hematology  

MedlinePLUS

American Society of Hematology ASH Store ASH Job Center Donate My Account Search Show Main Menu + About Awards Membership ... accepted for oral and poster presentation at the Society's annual meeting. Learn more Education ASH Academy The ...

309

Pediatric Endocrinology Nurses Society  

MedlinePLUS

... Nursing Society Page Content The Pediatric Endocrinology Nursing Society (PENS) is committed to the development and advancement of nurses in the art and science of pediatric endocrinology nursing. ???????????????? About PENS ...

310

American Society of Echocardiography  

MedlinePLUS

American Society of Echocardiography Join Ase Log In About About ASE Board of Directors Committees and Councils Industry Roundtable ... Global Choosing Wisely® Partner Fellow of the American Society of Echocardiography (FASE) Education Annual Meeting Live Courses ...

311

The Ability of Instructors to Organize Aerobic Dance Exercise Into Effective Cardiovascular Training.  

ERIC Educational Resources Information Center

The ability of five aerobics instructors to combine music and exercise movements into effective low, medium, and high levels of cardiovascular intensity was evaluated by measuring respiratory gas exchange and heart rate for twelve subjects. Results underscore the need for instructor training guidelines. (Author/MT)

Claremont, Alan D.; And Others

1986-01-01

312

Cardiovascular determinants of life span  

Microsoft Academic Search

The prevalence of cardiovascular diseases rises with aging and is one of the main causes of mortality in western countries.\\u000a In view of the progressively aging population, there is an urge for a better understanding of age-associated cardiovascular\\u000a diseases and its underlying molecular mechanisms. The risk factors for cardiovascular diseases include unhealthy diet, diabetes,\\u000a obesity, smoking, alcohol consumption, physical inactivity,

Yi Shi; Giovanni G. Camici; Thomas F. Lüscher

2010-01-01

313

Sleep Apnea and Cardiovascular Disease  

Microsoft Academic Search

Cardiovascular disease is still the leading cause of death in North America. To improve outcomes, it will likely be necessary\\u000a to identify new potentially treatable conditions. Sleep apnea affects approximately 50% of patients with cardiovascular disease\\u000a and is associated with increased cardiovascular risk. Continuous positive airway pressure is currently the treatment of choice\\u000a and has many short-term favorable effects. The

Alexander G. Logan; T. Douglas Bradley

2010-01-01

314

The american brachytherapy society recommendations for permanent prostate brachytherapy postimplant dosimetric analysis  

Microsoft Academic Search

Purpose: The purpose of this report is to establish guidelines for postimplant dosimetric analysis of permanent prostate brachytherapy.Methods: Members of the American Brachytherapy Society (ABS) with expertise in prostate dosimetry evaluation performed a literature review and supplemented with their clinical experience formulated guidelines for performing and analyzing postimplant dosimetry of permanent prostate brachytherapy.Results: The ABS recommends that postimplant dosimetry should

Subir Nag; William Bice; Keith DeWyngaert; Bradley Prestidge; Richard Stock; Yan Yu

2000-01-01

315

The American Brachytherapy Society recommendations for brachytherapy of soft tissue sarcomas  

Microsoft Academic Search

Purpose: This report presents the American Brachytherapy Society (ABS) guidelines for the use of brachytherapy for patients with soft tissue sarcoma.Methods and Materials: Members of the ABS with expertise in soft tissue sarcoma formulated brachytherapy guidelines based upon their clinical experience and a review of the literature. The Board of Directors of the ABS approved the final report.Results: Brachytherapy used

Subir Nag; Daniel Shasha; Nora Janjan; Ivy Petersen; Marco Zaider

2001-01-01

316

Oxidative Stress in Cardiovascular Disease  

PubMed Central

In the special issue “Oxidative Stress in Cardiovascular Disease” authors were invited to submit papers that investigate key questions in the field of cardiovascular free radical biology. The original research articles included in this issue provide important information regarding novel aspects of reactive oxygen species (ROS)-mediated signaling, which have important implications in physiological and pathophysiological cardiovascular processes. The issue also included a number of review articles that highlight areas of intense research in the fields of free radical biology and cardiovascular medicine. PMID:24722571

Csanyi, Gabor; Miller, Francis J.

2014-01-01

317

Quality Improvement Guidelines for Uterine Artery Embolization for Symptomatic Leiomyomata  

Microsoft Academic Search

Uterine artery embolization (UAE) is assuming an important role in the treatment of women with symptomatic uterine leiomyomata worldwide. The following guidelines, which have been jointly published with the Society of Interventional Radiology in the Journal of Vascular and Interventional Radiology, are intended to ensure the safe practice of UAE by identifying the elements of appropriate patient selection, anticipated outcomes,

David M. Hovsepian; Gary P. Siskin; Joseph Bonn; John F. Cardella; Timothy W. I. Clark; Leo E. Lampmann; Donald L. Miller; Reed A. Omary; Jean-Pierre Pelage; Dheeraj Rajan; Marc S. Schwartzberg; Richard B. Towbin; Woodruff J. Walker; David Sacks

2004-01-01

318

Knowledge of Concussion Guidelines Among Practitioners Caring for Children  

Microsoft Academic Search

The objective of this study in Rochester, NY was to determine clinicians' knowledge of the Colorado Medical Society Guidelines (CMSG) on return to contact sports after a concussion. A survey was mailed to 1,140 pediatric, family practice, and emergency physicians, as well as 302 pediatric and family practice nurse practitioners in the Rochester, NY, area. Participants were given 3 hypothetical

Jeffrey J. Bazarian; Tener Veenema; Anne F. Brayer; Edward Lee

2001-01-01

319

Guidelines for the management of inflammatory bowel disease in adults  

Microsoft Academic Search

The management of inflammatory bowel disease represents a key component of clinical practice for members of the British Society of Gastroenterology (BSG). There has been considerable progress in management strategies affecting all aspects of clinical care since the publication of previous BSG guidelines in 2004, necessitating the present revision.Key components of the present document worthy of attention as having been

Craig Mowat; Andrew Cole; Al Windsor; Tariq Ahmad; Ian Arnott; Richard Driscoll; Sally Mitton; Tim Orchard; Matt Rutter; Lisa Younge; Charlie Lees; Gwo-tzer Ho; Jack Satsangi; Stuart Bloom

2011-01-01

320

Optical Society of America  

NSDL National Science Digital Library

The Optical Society of America (OSA) is a professional society of optical engineers and scientists devoted to advancing the fields of optics and photonics. The Optical Society of America goals are to increase and diffuse the knowledge of optics, pure and applied, to promote the common interests of investigators of optical problems, of designers, and of users of optical apparatus of all kinds.

2003-10-10

321

Cardiovascular regulation in microgravity  

NASA Technical Reports Server (NTRS)

The human cardiovascular adaptation to microgravity was investigated in the framework of the German Spacelab D2 mission. Preflight and postflight studies were performed to examine the relationship between disuse atrophy and the function of cardiac and skeletal muscles. Special attention was given to fluid load responses and postflight orthostatic hypotension. The preflight measurements were obtained, in supine and sitting positions. These measurements, carried out in the four D2 crew members, were performed six and nine months before flight and on mission day number five. The results obtained on the male crew showed that the stroke volume data from microgravity are virtually identical to preflight measurements in the sitting position.

Blomqvist, C. G.; Lane, L. D.; Wright, S. J.; Meny, G. M.; Buckey, J. C.; Levine, B. D.; Gaffney, F. A.; Watenpaugh, D. E.; Arbeille, P.; Baisch, F.

1997-01-01

322

HDL and cardiovascular disease.  

PubMed

The cholesterol contained within HDL is inversely associated with risk of coronary heart disease and is a key component of predicting cardiovascular risk. However, despite its properties consistent with atheroprotection, the causal relation between HDL and atherosclerosis is uncertain. Human genetics and failed clinical trials have created scepticism about the HDL hypothesis. Nevertheless, drugs that raise HDL-C concentrations, cholesteryl ester transfer protein inhibitors, are in late-stage clinical development, and other approaches that promote HDL function, including reverse cholesterol transport, are in early-stage clinical development. The final chapters regarding the effect of HDL-targeted therapeutic interventions on coronary heart disease events remain to be written. PMID:25131981

Rader, Daniel J; Hovingh, G Kees

2014-08-16

323

Sodium and cardiovascular disease.  

PubMed

To the Editor: In 2013, I served on an Institute of Medicine (IOM) panel whose members concluded that data published through 2012 relating cardiovascular outcomes to a sodium intake below 2300 mg per day were inconsistent and insufficient.(1) The article by O'Donnell and colleagues (Aug. 14 issue),(2) which presents data from the Prospective Urban Rural Epidemiology (PURE) study, only adds to the confusion. A single morning urine sample is an inaccurate measure of usual sodium intake, ignoring day-to-day variability in sodium intake, diurnal variation in sodium excretion, and the effects of medication.(3) The Kawasaki formula also overestimates sodium exposure in . . . PMID:25427119

Batuman, Vecihi

2014-11-27

324

Sodium and cardiovascular disease.  

PubMed

To the Editor: In 2013, I served on an Institute of Medicine (IOM) panel whose members concluded that data published through 2012 relating cardiovascular outcomes to a sodium intake below 2300 mg per day were inconsistent and insufficient.(1) The article by O'Donnell and colleagues (Aug. 14 issue),(2) which presents data from the Prospective Urban Rural Epidemiology (PURE) study, only adds to the confusion. A single morning urine sample is an inaccurate measure of usual sodium intake, ignoring day-to-day variability in sodium intake, diurnal variation in sodium excretion, and the effects of medication.(3) The Kawasaki formula also overestimates sodium exposure in . . . PMID:25427122

Alderman, Michael H

2014-11-27

325

Sodium and cardiovascular disease.  

PubMed

To the Editor: In 2013, I served on an Institute of Medicine (IOM) panel whose members concluded that data published through 2012 relating cardiovascular outcomes to a sodium intake below 2300 mg per day were inconsistent and insufficient.(1) The article by O'Donnell and colleagues (Aug. 14 issue),(2) which presents data from the Prospective Urban Rural Epidemiology (PURE) study, only adds to the confusion. A single morning urine sample is an inaccurate measure of usual sodium intake, ignoring day-to-day variability in sodium intake, diurnal variation in sodium excretion, and the effects of medication.(3) The Kawasaki formula also overestimates sodium exposure in . . . PMID:25427121

Graudal, Niels

2014-11-27

326

Sodium and cardiovascular disease.  

PubMed

To the Editor: In 2013, I served on an Institute of Medicine (IOM) panel whose members concluded that data published through 2012 relating cardiovascular outcomes to a sodium intake below 2300 mg per day were inconsistent and insufficient.(1) The article by O'Donnell and colleagues (Aug. 14 issue),(2) which presents data from the Prospective Urban Rural Epidemiology (PURE) study, only adds to the confusion. A single morning urine sample is an inaccurate measure of usual sodium intake, ignoring day-to-day variability in sodium intake, diurnal variation in sodium excretion, and the effects of medication.(3) The Kawasaki formula also overestimates sodium exposure in . . . PMID:25427120

Saulnier, Pierre-Jean; Gand, Elise; Hadjadj, Samy

2014-11-27

327

Sodium and cardiovascular disease.  

PubMed

To the Editor: In 2013, I served on an Institute of Medicine (IOM) panel whose members concluded that data published through 2012 relating cardiovascular outcomes to a sodium intake below 2300 mg per day were inconsistent and insufficient.(1) The article by O'Donnell and colleagues (Aug. 14 issue),(2) which presents data from the Prospective Urban Rural Epidemiology (PURE) study, only adds to the confusion. A single morning urine sample is an inaccurate measure of usual sodium intake, ignoring day-to-day variability in sodium intake, diurnal variation in sodium excretion, and the effects of medication.(3) The Kawasaki formula also overestimates sodium exposure in . . . PMID:25427117

2014-11-27

328

Sodium and cardiovascular disease.  

PubMed

To the Editor: In 2013, I served on an Institute of Medicine (IOM) panel whose members concluded that data published through 2012 relating cardiovascular outcomes to a sodium intake below 2300 mg per day were inconsistent and insufficient.(1) The article by O'Donnell and colleagues (Aug. 14 issue),(2) which presents data from the Prospective Urban Rural Epidemiology (PURE) study, only adds to the confusion. A single morning urine sample is an inaccurate measure of usual sodium intake, ignoring day-to-day variability in sodium intake, diurnal variation in sodium excretion, and the effects of medication.(3) The Kawasaki formula also overestimates sodium exposure in . . . PMID:25427118

Cook, Nancy R

2014-11-27

329

Altered Cardiovascular Variability in Obstructive Sleep Apnea  

Microsoft Academic Search

Background—Altered cardiovascular variability is a prognostic indicator for cardiovascular events. Patients with obstructive sleep apnea (OSA) are at an increased risk for cardiovascular disease. We tested the hypothesis that OSA is accompanied by alterations in cardiovascular variability, even in the absence of overt cardiovascular disease. Methods and Results—Spectral analysis of variability of muscle sympathetic nerve activity, RR interval, and blood

Krzysztof Narkiewicz; Nicola Montano; Chiara Cogliati; Philippe J. H. van de Borne; Mark E. Dyken; Virend K. Somers

330

NISTIR 7628 Guidelines for  

E-print Network

NISTIR 7628 Guidelines for Smart Grid Cyber Security: Vol. 1, Smart Grid Cyber Security Strategy, Architecture, and High-Level Requirements The Smart Grid Interoperability Panel ­ Cyber Security Working Group August 2010 #12;NISTIR 7628 Guidelines for Smart Grid Cyber Security: Vol. 1, Smart Grid Cyber Security

331

Business continuity management & guidelines  

Microsoft Academic Search

The objective of this paper is to explore information systems security management topic of Business Continuity Management. The existence of business risk observed with service disruptions have become an inescapable concern at many organizations. This work explores the definitions, terminology, trends and guidelines common to this requirement born essentially from the IT industry. It concludes with current recommended guidelines and

Christopher A. Peterson

2009-01-01

332

Internship Guidelines Adopted 2001  

E-print Network

Internship Guidelines Adopted 2001 Revised February 2004 Revised March 15, 2007 Page 1 of 5 INTERNSHIP GUIDELINES College of Business Louisiana Tech University The University supports an experiential an internship course(s) that students may apply as credit toward their academic degrees. The internship must

Selmic, Sandra

333

Measure Guideline: Ventilation Cooling  

SciTech Connect

The purpose of this measure guideline on ventilation cooling is to provide information on a cost-effective solution for reducing cooling system energy and demand in homes located in hot-dry and cold-dry climates. This guideline provides a prescriptive approach that outlines qualification criteria, selection considerations, and design and installation procedures.

Springer, D.; Dakin, B.; German, A.

2012-04-01

334

Lodgepole Pine Management Guidelines  

E-print Network

Lodgepole Pine Management Guidelines for Land Managers in the Wildland -Urban Interface #12;Authors Guidelines for Land Managers in the Wildland-Urban Interface As a consequence of the current mountain pine.491.6303 http://csfs.colostate.edu/ All photos CSFS unless otherwise noted. #12;1 Lodgepole Pine Management

335

Guideline 3: Psychosocial Treatment.  

ERIC Educational Resources Information Center

The third in seven sets of guidelines based on the consensus of experts in the treatment of psychiatric and behavioral problems in mental retardation (MR) focuses on psychosocial treatment. Guidelines cover general principles, choosing among psychosocial treatments, severity of MR and psychiatric/behavior symptoms, diagnosable disorders, target…

American Journal on Mental Retardation, 2000

2000-01-01

336

Conservation and solar guidelines  

SciTech Connect

Guidelines are given for selecting R-values and infiltration levels, and determining the size of the solar collection area for passive solar buildings. The guidelines are based on balancing the incremental cost/benefit of conservation and passive solar strategies. Tables are given for 90 cities in the US and the results are also displayed on maps. An example is included.

Balcomb, J.D.

1983-01-01

337

Maintenance Trades Guidelines  

ERIC Educational Resources Information Center

In 2002, APPA published "Maintenance Staffing Guidelines for Educational Facilities," the first building maintenance trades staffing guideline designed to assist educational facilities professionals with their staffing needs. addresses how facilities professionals can determine the appropriate size and mix of their organization. Contents include…

Weidner, Theodore J.

2008-01-01

338

RECOMMENDED GUIDELINES FOR WASTEWATER CHARACTERIZATION  

E-print Network

#12;RECOMMENDED GUIDELINES FOR WASTEWATER CHARACTERIZATION IN THE FRASER RIVER BASIN VOLUME II Ont. June 1993 Amended April 1994 #12;GUIDELINES FOR WASTEWATER CHARACTERIZATION PREFACE Ltd., Calgary, Alberta. #12;GUIDELINES FOR WASTEWATER CHARACTERIZATION EXECUTIVE SUMMARY The Fraser

339

Society for Applied Spectroscopy  

NSDL National Science Digital Library

"The Society for Applied Spectroscopy is a nonprofit organization formed to advance and disseminate knowledge and information concerning the art and science of spectroscopy" as well as to advance the professional standing of the Society and foster a close bond among its members. The website provides the Society's latest news, meetings, and conferences. Visitors can learn about the winners of the Society's yearly awards. Everyone can download copies of current and archived issues of the Society's newsletter describing the accomplishments of its members, employment opportunities, official Governing Board minutes, and more. Interested scientists can also find out about membership opportunities.

340

Scholarly Societies Project  

NSDL National Science Digital Library

The University of Waterloo (Canada) Electronic Library provides this massive meta-index of over 1,100 scholarly societies, from the Abrasive Engineering Society to the Yuen Ren Society for the Promotion of Chinese Dialect Fieldwork. The list can be browsed alphabetically or by any of 39 subjects, and is also searchable. Features include a meeting/conference announcement list, full text archives of scholarly societies' serial publications when available, and pointers to other scholarly societies resources. There is also an essay on the stability of URLs for this meta-page that may interest maintainers of other large meta-pages.

1994-01-01

341

Arsenic and Cardiovascular Disease  

PubMed Central

Chronic arsenic exposure is a worldwide health problem. Although arsenic-induced cancer has been widely studied, comparatively little attention has been paid to arsenic-induced vascular disease. Epidemiological studies have shown that chronic arsenic exposure is associated with increased morbidity and mortality from cardiovascular disease. In addition, studies suggest that susceptibility to arsenic-induced vascular disease may be modified by nutritional factors in addition to genetic factors. Recently, animal models for arsenic-induced atherosclerosis and liver sinusoidal endothelial cell dysfunction have been developed. Initial studies in these models show that arsenic exposure accelerates and exacerbates atherosclerosis in apolipoprotein E–knockout mice. Microarray studies of liver mRNA and micro-RNA abundance in mice exposed in utero suggest that a permanent state of stress is induced by the arsenic exposure. Furthermore, the livers of the arsenic-exposed mice have activated pathways involved in immune responses suggesting a pro-hyperinflammatory state. Arsenic exposure of mice after weaning shows a clear dose-response in the extent of disease exacerbation. In addition, increased inflammation in arterial wall is evident. In response to arsenic-stimulated oxidative signaling, liver sinusoidal endothelium differentiates into a continuous endothelium that limits nutrient exchange and waste elimination. Data suggest that nicotinamide adenine dinucleotide phosphate oxidase–derived superoxide or its derivatives are essential second messengers in the signaling pathway for arsenic-stimulated vessel remodeling. The recent findings provide future directions for research into the cardiovascular effects of arsenic exposure. PMID:19015167

States, J. Christopher; Srivastava, Sanjay; Chen, Yu; Barchowsky, Aaron

2009-01-01

342

Autophagy and cardiovascular aging  

PubMed Central

The biological aging process is commonly associated with increased risk of cardiovascular diseases. Several theories have been put forward for aging-associated deterioration in ventricular function, including attenuation of growth hormone (insulin-like growth factors and insulin) signaling, loss of DNA replication and repair, histone acetylation and accumulation of reactive oxygen species. Recent evidence has depicted a rather unique role of autophagy as another important pathway in the regulation of longevity and senescence. Autophagy is a predominant cytoprotective (rather than self-destructive) process. It carries a prominent role in determination of lifespan. Reduced autophagy has been associated with aging, leading to accumulation of dysfunctional or damaged proteins and organelles. To the contrary, measures such as caloric restriction and exercise may promote autophagy to delay aging and associated comorbidities. Stimulation of autophagy using rapamycin may represent a novel strategy to prolong lifespan and combat aging-associated diseases. Rapamycin regulates autophagy through inhibition of the nutrient-sensing molecule mammalian target of rapamycin (mTOR). Inhibition of mTOR through rapamycin and caloric restriction promotes longevity. The purpose of this review is to recapitulate some of the recent advances in an effort to better understand the interplay between rapamycin-induced autophagy and decelerating cardiovascular aging. PMID:22580468

Nair, Sreejayan; Ren, Jun

2012-01-01

343

Cardiovascular Effects of Felypressin  

PubMed Central

Cardiovascular effects of felypressin (FEL) were studied in Wistar rats. Heart rate and mean arterial pressure measurements were taken in awake rats treated with vasopressin (AVP), FEL, or epinephrine (EPI). Each group received either an intravenous (IV) or an intracerebroventricular V1 receptor antagonist, saline, area postrema removal, or sham surgery. Analysis of variance and Student-Newman-Keuls (P < .05) were applied. Felypressin and AVP induced a pressor effect, and bradycardia was inhibited by IV V1 antagonist. Intracerebroventricular V1 antagonist and area postrema removal enhanced their pressor effects. Epinephrine induced a higher pressor effect and a similar bradycardia that was not affected by the treatments. It was concluded that FEL depends on V1 receptors to induce pressor and bradycardic effects, and that it produces a high relationship between bradycardia and mean arterial pressure variation depending on area postrema and central V1 receptors. These effects are potentially less harmful to the cardiovascular system than the effects of EPI. PMID:17177590

Cecanho, Rodrigo; De Luca, Laurival Antonio; Ranali, José

2006-01-01

344

Analysis of cardiovascular regulation.  

PubMed

Adequate characterization of hemodynamic and autonomic responses to physical and mental stress can elucidate underlying mechanisms of cardiovascular disease or anxiety disorders. We developed a physiological signal processing system for analysis of continuously recorded ECG, arterial blood pressure (BP), and respiratory signals using the programming language Matlab. Data collection devices are a 16-channel digital, physiological recorder (Vitaport), a finger arterial pressure transducer (Finapres), and a respiratory inductance plethysmograph (Respitrace). Besides the conventional analysis of the physiological channels, power spectral density and transfer functions of respiration, heart rate, and blood pressure variability are used to characterize respiratory sinus arrhythmia (RSA), 0.10-Hz BP oscillatory activity (Mayer-waves), and baroreflex sensitivity. The arterial pressure transducer waveforms permit noninvasive estimation of stroke volume, cardiac output, and systemic vascular resistance. Time trends in spectral composition of indices are assessed using complex demodulation. Transient dynamic changes of cardiovascular parameters at the onset of stress and recovery periods are quantified using a regression breakpoint model that optimizes piecewise linear curve fitting. Approximate entropy (ApEn) is computed to quantify the degree of chaos in heartbeat dynamics. Using our signal processing system we found distinct response patterns in subgroups of patients with coronary artery disease or anxiety disorders, which were related to specific pharmacological and behavioral factors. PMID:11143335

Wilhelm, F H; Grossman, P; Roth, W T

1999-01-01

345

Optimization in Cardiovascular Modeling  

NASA Astrophysics Data System (ADS)

Fluid mechanics plays a key role in the development, progression, and treatment of cardiovascular disease. Advances in imaging methods and patient-specific modeling now reveal increasingly detailed information about blood flow patterns in health and disease. Building on these tools, there is now an opportunity to couple blood flow simulation with optimization algorithms to improve the design of surgeries and devices, incorporating more information about the flow physics in the design process to augment current medical knowledge. In doing so, a major challenge is the need for efficient optimization tools that are appropriate for unsteady fluid mechanics problems, particularly for the optimization of complex patient-specific models in the presence of uncertainty. This article reviews the state of the art in optimization tools for virtual surgery, device design, and model parameter identification in cardiovascular flow and mechanobiology applications. In particular, it reviews trade-offs between traditional gradient-based methods and derivative-free approaches, as well as the need to incorporate uncertainties. Key future challenges are outlined, which extend to the incorporation of biological response and the customization of surgeries and devices for individual patients.

Marsden, Alison L.

2014-01-01

346

The Renewed Community; Pursuing Quality in an Urbanizing Society.  

ERIC Educational Resources Information Center

Numerous readings on the urbanizing society are presented, with guidelines for study and discussion, session by session. The first three sessions cover community development as a point of view and problems of a changing economic base--fixed human and nonhuman assets as aids and obstacles, and a realistic policy of industrial development. Two…

Buck, Roy C., Ed.; Lyons, William E., Ed.

347

INSTITUTE FOR SOCIETY, CULTURE AND ENVIRONMENT 2014 SUMMER SCHOLARS PROGRAM  

E-print Network

1 INSTITUTE FOR SOCIETY, CULTURE AND ENVIRONMENT 2014 SUMMER SCHOLARS PROGRAM Request opportunities for funding. Applications are due February 24, 2014. PROGRAM DESCRIPTION AND GUIDELINES I- or U-Series), NSF, or a major foundation proposal. The purpose of the SS-R Program is to bring focus

Virginia Tech

348

Food Pyramid of the Swiss Society for Nutrition  

Microsoft Academic Search

The Swiss Society for Nutrition issued its Food Pyramid in 2005. It was updated according to the latest scientific evidence and is in principal agreement with food-based guidelines of other countries. It has also been officially endorsed by the Swiss government. The food pyramid stands for a balanced diet that guarantees the body a sufficient supply of energy, essential nutrients

Paul Walter; Esther Infanger; Pascale Mühlemann

2007-01-01

349

Metabolic syndrome and cardiovascular disease in South Asians  

PubMed Central

This review discusses the prevalence of metabolic syndrome and cardiovascular disease in the South Asian population, evaluates conventional and emerging risk factors, and reinforces the need for ethnic-specific redefinition of guidelines used to diagnose metabolic syndrome. We reviewed recent and past literature using Ovid Medline and PubMed databases. South Asians represent one of the largest and fastest growing ethnic groups in the world. With this growth, a dramatic rise in the rates of acute myocardial infarction and diabetes is being seen in this population. Potential etiologies for this phenomenon include dietary westernization, poor lifestyle measures, adverse body fat patterning, and genetics. While traditional risk factors for diabetes and cardiovascular disease should not be overlooked, early metabolic syndrome has now been shown in the South Asian pediatric population, suggesting that “metabolic programming” and perinatal influences may likely play a substantial role. Health care practitioners must be aware that current guidelines used to identify individuals with metabolic syndrome are underestimating South Asian individuals at risk. New ethnic-specific guidelines and prevention strategies are discussed in this review and should be applied by clinicians to their South Asian patients. PMID:19756165

Eapen, Danny; Kalra, Girish L; Merchant, Nadya; Arora, Anjali; Khan, Bobby V

2009-01-01

350

University of Oxford Department of Cardiovascular Medicine  

E-print Network

1 University of Oxford Department of Cardiovascular Medicine in collaboration with the Oxford the Department of Cardiovascular Medicine, which study molecular mechanisms in the early development The Medical Sciences Division, within which the Department of Cardiovascular Medicine is located, includes

Oxford, University of

351

Gender differences in cardiovascular reactivity  

Microsoft Academic Search

Pronounced cardiovascular reactivity to stress is a behavioral mechanism that may underlie the pathophysiology of coronary heart disease (CHD). Based on the greater incidence of CHD among males than among females, the purpose of the current investigation was to test the hypothesis that in young adults (ages 17–29), males (n=47) show more cardiovascular reactivity than females (n=61) to two stressors,

Stephanie V. Stone; Theodore M. Dembroski; Paul T. Costa; James M. MacDougall

1990-01-01

352

Cardiovascular Complications of Cocaine Use  

Microsoft Academic Search

Summary As cocaine use has become prevalent, an increasing number of reports of cocaine-associated morbidity and mortality, largely because of central nervous system and cardiovascular toxicity, appeared. Cardiovascular toxicity is broad, and it may also lead to neurological, psychiatric and other organ-specific symptoms. Cocaine may induce myocardial ischemia by increasing myocardial oxygen demand while simultaneously decreasing myocardial oxygen supply. Most

Carla Gambarana

2009-01-01

353

Cardiovascular risk in rheumatoid arthritis.  

PubMed

The objectives of this review are to discuss data on the cardiovascular risk increase associated with rheumatoid arthritis (RA), the effects of RA treatments on the cardiovascular risk level, and the management of cardiovascular risk factors in patients with RA. Overall, the risk of cardiovascular disease is increased 2-fold in RA patients compared to the general population, due to the combined effects of RA and conventional risk factors. There is some evidence that the cardiovascular risk increase associated with nonsteroidal anti-inflammatory drug therapy may be smaller in RA patients than in the general population. Glucocorticoid therapy increases the cardiovascular risk in proportion to both the current dose and the cumulative dose. Methotrexate and TNF? antagonists diminish cardiovascular morbidity and mortality rates. The management of dyslipidemia remains suboptimal. Risk equations may perform poorly in RA patients even when corrected using the multiplication factors suggested by the EUropean League Against Rheumatism (EULAR) (multiply the score by 1.5 when two of the following three criteria are met: disease duration longer than 10 years, presence of rheumatoid factor or anti-cyclic citrullinated peptide (CCP) antibodies, and extraarticular manifestations). Doppler ultrasonography of the carotid arteries in patients at moderate cardiovascular risk may allow a more aggressive approach to dyslipidemia management via reclassification into the high-risk category of patients with an intima-media thickness greater than 0.9 mm or atheroma plaque. PMID:24880190

Soubrier, Martin; Chamoux, Nicolas Barber; Tatar, Zuzana; Couderc, Marion; Dubost, Jean-Jacques; Mathieu, Sylvain

2014-07-01

354

Gene Therapy and Cardiovascular Diseases  

Microsoft Academic Search

Gene therapy is a promising new field in modern medicine and holds great potential for the treatment of cardiovascular diseases.\\u000a This chapter will discuss the principles and methods of gene-based therapy and the use of gene transfer in research and in\\u000a treatment of cardiovascular diseases.

Yi Chu; Neal L. Weintraub; Donald D. Heistad

355

Cardiovascular Technology Program Needs Assessment.  

ERIC Educational Resources Information Center

In 1990/91, a study was conducted by Oakland Community College (OCC) to evaluate the need for a proposed Cardiovascular Technology program. Fifty-two local hospitals were surveyed to gather information on the employment demand, employment benefits and career preparation requirements for cardiovascular technologists (CVTs), yielding a 62% response…

Oakland Community Coll., Farmington, MI. Office of Institutional Planning and Analysis.

356

A guideline management system.  

PubMed

This paper describes the architecture of NewGuide, a guide-line management system for handling the whole life cycle of a computerized clinical practice guideline. NewGuide components are organized in a distributed architecture: an editor to formalize guidelines, a repository to store them, an inference engine to implement guidelines instances in a multi-user environment, and a reporting system storing the guidelines logs in order to be able to completely trace any individual physician guideline-based decision process. There is a system "central level" that maintains official versions of the guidelines, and local Healthcare Organizations may download and implement them according to their needs. The architecture has been implemented using the Java 2 Enterprise Edition (J2EE) platform. Simple Object Access Protocol (SOAP) and a set of con-tracts are the key factors for the integration of NewGuide with healthcare legacy systems. They allow maintaining unchanged legacy user interfaces and connecting the system with what-ever electronic patient record. The system functionality will be illustrated in three different contexts: homecare-based pressure ulcer prevention, acute ischemic stroke treatment and heart failure management by general practitioners. PMID:15360768

Ciccarese, Paolo; Caffi, Ezio; Boiocchi, Lorenzo; Quaglini, Silvana; Stefanelli, Mario

2004-01-01

357

Assessment of total cardiovascular risk using WHO/ISH risk prediction charts in three low and middle income countries in Asia  

PubMed Central

Background Recent research has used cardiovascular risk scores intended to estimate “total cardiovascular disease (CVD) risk” in individuals to assess the distribution of risk within populations. The research suggested that the adoption of the total risk approach, in comparison to treatment decisions being based on the level of a single risk factor, could lead to reductions in expenditure on preventive cardiovascular drug treatment in low- and middle-income countries. So that the patient benefit associated with savings is highlighted. Methods This study used data from national STEPS surveys (STEPwise Approach to Surveillance) conducted between 2005 and 2010 in Cambodia, Malaysia and Mongolia of men and women aged 40–64 years. The study compared the differences and implications of various approaches to risk estimation at a population level using the World Health Organization/International Society of Hypertension (WHO/ISH) risk score charts. To aid interpretation and adjustment of scores and inform treatment in individuals, the charts are accompanied by practice notes about risk factors not included in the risk score calculations. Total risk was calculated amongst the populations using the charts alone and also adjusted according to these notes. Prevalence of traditional single risk factors was also calculated. Results The prevalence of WHO/ISH “high CVD risk” (?20% chance of developing a cardiovascular event over 10 years) of 6%, 2.3% and 1.3% in Mongolia, Malaysia and Cambodia, respectively, is in line with recent research when charts alone are used. However, these proportions rise to 33.3%, 20.8% and 10.4%, respectively when individuals with blood pressure > = 160/100 mm/Hg and/or hypertension medication are attributed to “high risk”. Of those at “moderate risk” (10- < 20% chance of developing a cardio vascular event over 10 years), 100%, 94.3% and 30.1%, respectively are affected by at least one risk-increasing factor. Of all individuals, 44.6%, 29.0% and 15.0% are affected by hypertension as a single risk factor (systolic ? 140 mmHg or diastolic ? 90 mmHg or medication). Conclusions Used on a population level, cardiovascular risk scores may offer useful insights that can assist health service delivery planning. An approach based on overall risk without adjustment of specific risk factors however, may underestimate treatment needs. At the individual level, the total risk approach offers important clinical benefits. However, countries need to develop appropriate clinical guidelines and operational guidance for detection and management of CVD risk using total CVD-risk approach at different levels of health system. Operational research is needed to assess implementation issues. PMID:23734670

2013-01-01

358

Disparities in heart failure and other cardiovascular diseases among women  

PubMed Central

This article reviews literature pertinent to cardiovascular disparities in women, focusing primarily on heart failure (HF). It provides an in-depth look at causes, biological influences, self-management and lack of adherence to HF-treatment guidelines in women. Disparities in treatment of causative factors of HF, such as myocardial infarction and hypertension, contribute to women having poorer HF outcomes than men. This article discusses major contributing reasons for nonadherence to medication regimes for HF in women, including advanced age at time of diagnosis, likelihood of multiple comorbidities, lack of social support and low socioeconomic status. Limited inclusion of women in clinical trials and the scarcity of gender analyses for HF and other cardiovascular diseases continues to limit the applicability of research findings to women. PMID:22757737

McSweeney, Jean; Pettey, Christina; Lefler, Leanne L; Heo, Seongkum

2012-01-01

359

Information needed to decide about cardiovascular treatment in primary care.  

PubMed Central

There is growing consensus that treatment of cardiovascular risks should be based on multiple rather than single factors and on absolute rather than relative risks. Thresholds for treatment should reflect the level of absolute risk at which the benefits and hazards of treating outweigh the benefits and hazards of not treating. Once a decision has been made to initiate a treatment programme, clinicians need to know the patient's absolute risk. At this level of risk do the benefits of treatment outweigh the hazards? Given this information, which treatment option does the patient prefer? Using cardiovascular disease as an example, I review some measures that assist decision making in primary care. Practice guidelines should routinely include accessible presentation of treatment outcomes on benefit, hazard, and costs for a range of absolute risks. These measures enable patients and their doctors to weigh the pros and cons of treatment in their particular circumstances. PMID:9022493

Robson, J.

1997-01-01

360

Cardiovascular magnetic resonance artefacts  

PubMed Central

The multitude of applications offered by CMR make it an increasing popular modality to study the heart and the surrounding vessels. Nevertheless the anatomical complexity of the chest, together with cardiac and respiratory motion, and the fast flowing blood, present many challenges which can possibly translate into imaging artefacts. The literature is wide in terms of papers describing specific MR artefacts in great technical detail. In this review we attempt to summarise, in a language accessible to a clinical readership, some of the most common artefacts found in CMR applications. It begins with an introduction of the most common pulse sequences, and imaging techniques, followed by a brief section on typical cardiovascular applications. This leads to the main section on common CMR artefacts with examples, a short description of the mechanisms behind them, and possible solutions. PMID:23697969

2013-01-01

361

Provision of cardiovascular genetic counseling services: current practice and future directions.  

PubMed

Cardiovascular genetic counseling has emerged as a specialty critical to the care of patients with heritable cardiovascular disease. Current strategies to meet the growing demand are not clear. We sought to characterize practice patterns of cardiac genetic counseling by developing a novel survey distributed to the National Society of Genetic Counselors (NSGC) Listserv to assess clinical practice, cardiovascular training, and education. Descriptive statistics were used to summarize clinical practice; Fisher's exact test and the Cochran-Armitage trend test were used to compare the practice of cardiovascular genetic counselors (CVGCs) to those who did not identify cardiology as a specialty (non-CVGCs). A total of 153 individuals completed the survey. Of the 105 participants who reported seeing a cardiac genetics patient, 42 (40 %) identified themselves as a CVGC. The most common conditions for which genetic counseling was provided were hypertrophic cardiomyopathy (HCM) (71 % of participants), dilated cardiomyopathy (DCM) (61 %), long QT syndrome (LQTS) (56 %), and genetic syndromes with cardiovascular disease (55 %). CVGCs were significantly more confident than non-CVGCs in providing genetic counseling for seven cardiovascular diseases (2.3?×?10(-6)???p???0.021). Eighty-six percent of genetic counselors sought additional education related to cardiovascular genetics and listed online courses as the most desirable method of learning. These data suggest a growing interest in cardiovascular genetic counseling and need for additional training resources among the NSGC membership. PMID:24788056

Somers, Allyson E; Ware, Stephanie M; Collins, Kathleen; Jefferies, John L; He, Hua; Miller, Erin M

2014-12-01

362

Indian Vacuum Society: The Indian Vacuum Society  

NASA Astrophysics Data System (ADS)

The Indian Vacuum Society (IVS) was established in 1970. It has over 800 members including many from Industry and R & D Institutions spread throughout India. The society has an active chapter at Kolkata. The society was formed with the main aim to promote, encourage and develop the growth of Vacuum Science, Techniques and Applications in India. In order to achieve this aim it has conducted a number of short term courses at graduate and technician levels on vacuum science and technology on topics ranging from low vacuum to ultrahigh vacuum So far it has conducted 39 such courses at different parts of the country and imparted training to more than 1200 persons in the field. Some of these courses were in-plant training courses conducted on the premises of the establishment and designed to take care of the special needs of the establishment. IVS also regularly conducts national and international seminars and symposia on vacuum science and technology with special emphasis on some theme related to applications of vacuum. A large number of delegates from all over India take part in the deliberations of such seminars and symposia and present their work. IVS also arranges technical visits to different industries and research institutes. The society also helped in the UNESCO sponsored post-graduate level courses in vacuum science, technology and applications conducted by Mumbai University. The society has also designed a certificate and diploma course for graduate level students studying vacuum science and technology and has submitted a syllabus to the academic council of the University of Mumbai for their approval, we hope that some colleges affiliated to the university will start this course from the coming academic year. IVS extended its support in standardizing many of the vacuum instruments and played a vital role in helping to set up a Regional Testing Centre along with BARC. As part of the development of vacuum education, the society arranges the participation of expert members on the subject to deliver lectures and take part in devising courses in the universities. IVS publishes a quarterly called the `Bulletin of Indian Vacuum Society' since its inception, in which articles on vacuum and related topics are published. NIRVAT, news, announcements, and reports are the other features of the Bulletin. The articles in the Bulletin are internationally abstracted. The Bulletin is distributed free to all the members of the society. The society also publishes proceedings of national/international symposia and seminars, manuals, lecture notes etc. It has published a `Vacuum Directory' containing very useful information on vacuum technology. IVS has also set up its own website http://www.ivsnet.org in January 2002. The website contains information about IVS, list of members, list of EC members, events and news, abstracts of articles published in the `Bulletin of Indian Vacuum Society', utilities, announcements, reports, membership and other forms which can be completed online and also gives links to other vacuum societies. Our Society has been a member of the executive council of the International Union of Vacuum Science, Techniques and Applications (IUVSTA) and its various committees since 1970. In 1983 IVS conducted an International Symposium on Vacuum Technology and Nuclear Applications in BARC, Mumbai, under the sponsorship of IUVSTA. In 1987 IVS arranged the Triennial International Conference on Thin Films in New Delhi, where more than 200 foreign delegates participated. IVS also hosted the IUVSTA Executive Council Meeting along with the conference. The society organized yet again an International Conference on Vacuum Science and Technology and SRS Vacuum Systems at CAT, Indore in1995. IVS arranges the prestigious Professor Balakrishnan Memorial Lecture in memory of its founder vice-president. Leading scientists from India and abroad in the field are invited to deliver the talks. So far 23 lectures have been held in this series. IVS has instituted the `IVS- Professor D Y Phadke Memorial Prize' in memory of our founder presid

Saha, T. K.

2008-03-01

363

Lymphoma Coding Guidelines  

Cancer.gov

Coding Guidelines LYMPHOMA M9590/3-M9738/3 See the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (DB) for more information and coding instructions. First Course of Therapy Do not code

364

Rectosigmoid Junction Coding Guidelines  

Cancer.gov

Coding Guidelines Rectosigmoid Junction C199 Primary Site A tumor is classified as rectosigmoid when differentiation between rectum and sigmoid is not possible. A tumor is classified as rectal if • lower margin lies less than 16 cm from the anal

365

Developing HEU guidelines  

SciTech Connect

Programs to develop low-enriched uranium (LEU) fuels and targets, and convert research reactor and radioisotope production processes are based on a shared interest to minimize the use of highly enriched uranium (HEU). Many states have committed themselves to this work over the years, but an international mechanism codifying the objectives of HEU minimization or other policies related to the management of this material is lacking. With this in mind, the James Martin Center for Nonproliferation Studies is facilitating the drafting of HEU guidelines, modeled in part on the existing plutonium guidelines. This paper provides an overview of our work on guidelines, which include transparency measures, recommended security measures, rules on transport and international transfer, along with other relevant policies for safe and secure management of HEU. The adoption of voluntary guidelines is essential to help the global community agree on some norms in this area and ensure that programs like RERTR can meet future political challenges. (author)

Chuen, Cristina [James Martin Center for Nonproliferation Studies, Monterey Institute of International Studies, 460 Pierce Street, Monterey, CA 93940 (United States)

2008-07-15

366

Thyroid Coding Guidelines  

Cancer.gov

Coding Guidelines THYROID GLAND C739 Coding Hormone Therapy Code Hormone Therapy as 01 for follicular and/or papillary thyroid cancer when thyroid hormone therapy is given. Do not code replacement therapy as treatment unless the tumor is papillary

367

2010 Guidelines, Policy & Clarification  

Cancer.gov

2010 Guidelines, Policy & Clarification SF 424 PHS 2590 eRA Commons The Cancer Control Planet NCI Fact Book NIH Office of Extramural Research Home > Grants & Funding > Policies & Clarifications Policies

368

CRITICALITY SAFETY POSTING GUIDELINES  

SciTech Connect

This document provides a set of guidelines in the preparation of criticality safety postings. Guidance is provided in word choice, word arrangement, common human factors considerations. and use of color to highlight limits, cautions, and permissives.

JENSEN, M.A.

2001-11-01

369

Diagnostic Radiology Guidelines.  

National Technical Information Service (NTIS)

The health systems agency that reviews certificate of need applications for replacing or adding diagnostic radiology equipment should benefit from these guidelines. To help determine need for diagnostic radiology equipment, the Health Services Council, In...

1978-01-01

370

Multilayer Insulation Material Guidelines  

NASA Technical Reports Server (NTRS)

Multilayer Insulation Material Guidelines provides data on multilayer insulation materials used by previous spacecraft such as Spacelab and the Long-Duration Exposure Facility and outlines other concerns. The data presented in the document are presented for information only. They can be used as guidelines for multilayer insulation design for future spacecraft provided the thermal requirements of each new design and the environmental effects on these materials are taken into account.

Finckenor, M. M.; Dooling, D.

1999-01-01

371

Dietary guidelines in singapore.  

PubMed

The 2011 Dietary Guidelines were developed with the aim of providing guidance on what dietary strategies can best address increasing rates of obesity and non-communicable chronic disease in Singapore. This set of dietary guidelines was developed with a local expert committee based on a review of scientific literature and data on current dietary patterns from the 2010 National Nutrition Survey. Projected nutrient intakes from a diet adhering to the 2011 Dietary Guidelines were calculated using a local food composition database (FOCOS) and validated against nutrient recommendations. Acknowledging that dietary requirements differ between age groups, different sets of dietary guidelines have been developed and customised for different segments of the population. To date, Singapore has produced dietary guidelines for children and adolescents (focusing on establishing healthy lifelong eating patterns), adults (focusing on preventing obesity and reinforcing healthy eating patterns), and most recently, guidelines for older adults (>50 years of age) that address the issue of potential dietary insufficiency caused by age-related increases in nutrient requirements combined with a reduction in energy requirements. In Singapore, dietary guidelines have been used to inform and direct public policy and promote dietary patterns that meet nutrient requirements while reducing the risk of non-communicable chronic diseases. Examples of public policy include: national guidelines on food advertising and standards for food served in nursing homes; examples of public health promotion programmes include: the Healthier Choice Symbol Programme for packaged food products and programmes encouraging provision of healthier meals in hawker centres, restaurants, and school or workplace canteens. PMID:21859669

Lee, Benjamin Lc

2011-01-01

372

Electrical safety guidelines  

SciTech Connect

The Electrical Safety Guidelines prescribes the DOE safety standards for DOE field offices or facilities involved in the use of electrical energy. It has been prepared to provide a uniform set of electrical safety standards and guidance for DOE installations in order to affect a reduction or elimination of risks associated with the use of electrical energy. The objectives of these guidelines are to enhance electrical safety awareness and mitigate electrical hazards to employees, the public, and the environment.

Not Available

1993-09-01

373

Nrf2 and Cardiovascular Defense  

PubMed Central

The cardiovascular system is susceptible to a group of diseases that are responsible for a larger proportion of morbidity and mortality than any other disease. Many cardiovascular diseases are associated with a failure of defenses against oxidative stress-induced cellular damage and/or death, leading to organ dysfunction. The pleiotropic transcription factor, nuclear factor-erythroid (NF-E) 2-related factor 2 (Nrf2), regulates the expression of antioxidant enzymes and proteins through the antioxidant response element. Nrf2 is an important component in antioxidant defenses in cardiovascular diseases such as atherosclerosis, hypertension, and heart failure. Nrf2 is also involved in protection against oxidant stress during the processes of ischemia-reperfusion injury and aging. However, evidence suggests that Nrf2 activity does not always lead to a positive outcome and may accelerate the pathogenesis of some cardiovascular diseases (e.g., atherosclerosis). The precise conditions under which Nrf2 acts to attenuate or stimulate cardiovascular disease processes are unclear. Further studies on the cellular environments related to cardiovascular diseases that influence Nrf2 pathways are required before Nrf2 can be considered a therapeutic target for the treatment of cardiovascular diseases. PMID:23691261

2013-01-01

374

Mexican Society of Bioelectromagnetism  

NASA Astrophysics Data System (ADS)

In July 2007 physicians, biologists and physicists that have collaborated in previous meetings of the medical branch of the Mexican Physical Society constituted the Mexican Society of Bioelectromagnetism with the purpose of promote scientific study of the interaction of electromagnetic energy (at frequencies ranging from zero Hertz through those of visible light) and acoustic energy with biological systems. A second goal was to increase the contribution of medical and biological professionals in the meetings of the medical branch of the Mexican Physical Society. The following paragraphs summarize some objectives of the Mexican Society of Bioelectromagnetism for the next two years.

Cañedo, Luis

2008-08-01

375

Mexican Society of Bioelectromagnetism  

SciTech Connect

In July 2007 physicians, biologists and physicists that have collaborated in previous meetings of the medical branch of the Mexican Physical Society constituted the Mexican Society of Bioelectromagnetism with the purpose of promote scientific study of the interaction of electromagnetic energy (at frequencies ranging from zero Hertz through those of visible light) and acoustic energy with biological systems. A second goal was to increase the contribution of medical and biological professionals in the meetings of the medical branch of the Mexican Physical Society. The following paragraphs summarize some objectives of the Mexican Society of Bioelectromagnetism for the next two years.

Canedo, Luis [Sociedad Mexicana de Bioelectromagnetismo, Facultad de Medicina, Universidad Autonoma del Estado de Morelos (Mexico)

2008-08-11

376

Algorithms for builder guidelines  

SciTech Connect

The Builder Guidelines are designed to make simple, appropriate guidelines available to builders for their specific localities. Builders may select from passive solar and conservation strategies with different performance potentials. They can then compare the calculated results for their particular house design with a typical house in the same location. Algorithms used to develop the Builder Guidelines are described. The main algorithms used are the monthly solar ratio (SLR) method for winter heating, the diurnal heat capacity (DHC) method for temperature swing, and a new simplified calculation method (McCool) for summer cooling. This paper applies the algorithms to estimate the performance potential of passive solar strategies, and the annual heating and cooling loads of various combinations of conservation and passive solar strategies. The basis of the McCool method is described. All three methods are implemented in a microcomputer program used to generate the guideline numbers. Guidelines for Denver, Colorado, are used to illustrate the results. The structure of the guidelines and worksheet booklets are also presented. 5 refs., 3 tabs.

Balcomb, J.D.; Lekov, A.B.

1989-06-01

377

Adherence to cancer prevention guidelines and risk of breast cancer.  

PubMed

Healthy eating patterns and keeping physically active are potentially more important for chronic disease prevention than intake or exclusion of specific food items or nutrients. To this end, many health organizations routinely publish dietary and lifestyle recommendations aimed at preventing chronic disease. Using data from the Canadian National Breast Screening Study, we investigated the association between breast cancer risk and adherence to two sets of guidelines specific for cancer prevention, namely the American Cancer Society (ACS) Guidelines and the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Recommendations. At baseline, 49,613 women completed dietary and lifestyle questionnaires and height and weight measurements were taken. During a mean follow-up of 16.6 years, 2,503 incident cases of breast cancer were ascertained. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association of meeting each guideline, and number of guidelines met, with breast cancer risk. The two sets of guidelines yielded similar results. Specifically, adherence to all six ACS guidelines was associated with a 31% reduction in breast cancer risk when compared to subjects adhering to at most one guideline (HR?=?0.69; 95% CI?=?0.49-0.97); similarly, adherence to six or seven of the WCRF/AICR guidelines was also associated with a 31% reduction in breast cancer risk (HR?=?0.69; 95% CI?=?0.47-1.00). Under either classification, meeting each additional guideline was associated with a 4-6% reduction in breast cancer risk. These results suggest that adherence to cancer prevention guidelines is associated with a reduced risk of breast cancer. PMID:24723234

Catsburg, Chelsea; Miller, Anthony B; Rohan, Thomas E

2014-11-15

378

Subclinical cardiovascular disease in type 2 diabetes mellitus: To screen or not to screen.  

PubMed

The prevalence of type 2 diabetes mellitus (T2DM) has risen in recent decades, and cardiovascular disease remains the leading cause of death in this population. Several clinical trials have demonstrated the benefit of tight control of risk factors on the incidence and mortality of cardiovascular disease. However, in clinical practice, few patients achieve the therapeutic goals. The current diagnostic procedures for subclinical cardiovascular disease in T2DM patients have not been shown to improve prognosis or mortality, probably because they do not categorize cardiovascular risk. Thus, clinical practice guidelines do not systematically recommend screening for subclinical atherosclerosis in these patients, although it is known that patients with extra-coronary atherosclerosis, microangiopathy and poorly-controlled cardiovascular risk factors are at high risk for cardiovascular disease. Improvements in the reliability of diagnostic tests, with fewer side effects and better cost efficiency, may better help to stratify cardiovascular risk in this group of patients, and further evaluation on this topic should be considered. PMID:25232543

Chillarón, Juan J; Roux, Juana A Flores-Le; Benaiges, David; Pedro-Botet, Juan

2014-09-16

379

The Marfan Syndrome. Fact Sheet [and] Physical Education and Activity Guidelines.  

ERIC Educational Resources Information Center

This document consists of two brochures, the first explaining the Marfan Syndrome and a second providing guidelines for physical education and activity for people who have this syndrome are provided. The brochure on factual information about Marfan syndrome outlines the associated medical problems involving the cardiovascular system, the skeleton,…

National Marfan Foundation, Port Washington, NY.

380

A Critique of Clinical Guidelines for Detection of Individuals with Chronic Kidney Disease  

Microsoft Academic Search

Chronic kidney disease (CKD) and its association with cardiovascular mortality is increasingly regarded as a global public health problem. International efforts to combat this ‘epidemic’ have led to fundamental changes not only in the way we measure renal function but also how we classify and manage CKD. Clinical guidelines have established the use of estimated glomerular filtration rate (eGFR) and

John O. Connolly; Robin G. Woolfson

2009-01-01

381

American Cancer Society  

MedlinePLUS

... of Use State Fundraising Notices Site Comments Better Business Bureau Health On The Net National Health Council © 2014 American Cancer Society, Inc. All rights reserved. The American Cancer Society is a qualified 501(c)(3) tax-exempt organization. Cancer.org is provided courtesy of ...

382

Navigating the Information Society.  

ERIC Educational Resources Information Center

This paper explores the idea of an information society from different perspectives, raises issues that are relevant to university libraries, and offers a way forward to some future developments. The first section provides a sketch of the information society in Australia and presents statistics on readiness, intensity, and impacts from reports…

Kirk, Joyce

383

Schools, Violence, and Society.  

ERIC Educational Resources Information Center

The seeming increase of violence in American society and its schools has become a pressing issue. Some researchers argue that the American education system mirrors the dynamics of society. The articles in this book address the following issues: the extent of violence in American schools; the forms that violence takes; its root causes; the effects…

Hoffman, Allan M., Ed.

384

Environment, energy, and society  

SciTech Connect

This book delineates the major ways in which human society and the environment affect each other. To study the structure of societies, it employs three conceptual models, or sociological paradigms, conservative, liberal, and radical. The book explains the courses in environmental sociology, international development, natural resources, agriculture, and urban or regional planning.

Humphrey, C.R.; Buttel, F.R.

1986-01-01

385

Audio Engineering Society  

NSDL National Science Digital Library

The Audio Engineering Society (AES), now in its fifth decade, is the only professional society devoted exclusively to audio technology. Its membership consists of leading engineers, scientists and other authorities throughout the world. The Web site has links to information about audio education, events, careers and more.

Inc.., Audio E.

1997-01-01

386

NSE and Society  

NSDL National Science Digital Library

The final big idea of NSE is different from the others. It describes the natures of science and technology and how society affects and is affected by scientific and technological advancement. Thus the Science, Technology, and Society big idea is linked to

Krajcik, Joseph S.; Sutherland, Leeann M.; Stevens, Shawn Y.

2009-10-14

387

Materials Research Society  

NSDL National Science Digital Library

This is the web page for the Materials Research Society, an organization of materials researchers from academia, industry, and government that promotes communication for the advancement of interdisciplinary materials research to improve the quality of life. The Society recognizes professional and technical excellence, conducts symposium tutorials, and encourages technical interaction among college students through University Chapters. Membership is required to access articles.

2010-06-02

388

Triglycerides and Cardiovascular Disease: FAQ  

MedlinePLUS

... their physicians, dietitians and nutritionists. 5. Do high-carbohydrate diets increase triglycerides and risk for cardiovascular disease? ... ATP III), suggests that very high intakes of carbohydrates (CHO) (greater than 60 percent of total calories) ...

389

Cardiovascular disease and HIV infection.  

PubMed

The emergence of chronic disease complications in controlled HIV disease has changed the landscape of HIV clinical care. HIV infection confers an increased cardiovascular disease risk, which is thought to be due to a complex interplay of mechanistic factors. While traditional cardiovascular risk factors likely play a role, recent evidence suggests that HIV-associated inflammation and immune activation are important mediators of cardiovascular risk. It is unclear whether established preventative interventions for the general population are applicable to HIV-infected patients, and the need to translate mechanistic knowledge into HIV-specific clinical interventions represents an important priority. Developing strategies to prevent cardiovascular disease in HIV-infected individuals calls for a multidisciplinary approach and represents an opportunity to exert a major public health impact in an at-risk population. PMID:23793823

Triant, Virginia A

2013-09-01

390

Cold Weather and Cardiovascular Disease  

MedlinePLUS

Cold Weather and Cardiovascular Disease Updated:Oct 28,2014 Th is winter season will bring cooler temperatures and ice ... for some. It’s important to know how cold weather can affect your heart, especially if you have ...

391

Testosterone and cardiovascular risk.  

PubMed

Cardiovascular (CV) disease is one of the most common causes of death in the western populations and, nowadays, its incidence is increasing even in the developing countries; although CV disease affects both sexes, it is more frequent in males in whom it shortens the average life expectancy. In this regard, this difference has been wrongly attributed for many years to the negative effects of testosterone (T); however, nowadays, a large amount of evidence suggests that this hormone may have protective effects on the CV system and that, indeed, the low levels of T could be associated with an increased CV risk and with an augmentation of morbidity and mortality in males. Such an aspect gains great relevance in light of the consideration that T decrease, besides occurring as a consequence of rare pathological conditions, can often take place with natural aging, causing a state of "male menopause", also called late-onset hypogonadism. In this review, we aimed to summarize the present state of the art concerning the association between T deficit and CV disease by analyzing the protective role of T on CV system and the relationship of this hormonal lack with metabolic syndrome, CV morbidity and mortality, and with the CV complications, such as ischemic heart disease, heart failure and stroke, that frequently occur in T deficiency. PMID:23475207

Tirabassi, Giacomo; Gioia, Angelo; Giovannini, Lara; Boscaro, Marco; Corona, Giovanni; Carpi, Angelo; Maggi, Mario; Balercia, Giancarlo

2013-04-01

392

Historical Society of Michigan  

NSDL National Science Digital Library

Founded in 1828, the motto of the Historical Society of Michigan is "Promoting our state, our stories since 1828." The Society does a terrific job if it. This website offers curious parties access to information about the state's history, along with materials on the Society's work, outreach efforts, and publications. On the homepage, visitors can learn about the Michigan History magazine and the Chronicle, which is the Society's membership magazine. Teachers and historians will enjoy the Resources area. Here they can make their way through a day-by-day historical calendar of events associated with the state's history and a set of additional research links, such as genealogy websites. The Conferences area includes information about the four major conferences the Society runs each year, along with information on training workshops.

2012-09-21

393

Electrochemical Society Digital Library  

NSDL National Science Digital Library

Sample articles that the Electrochemical Society deems particularly noteworthy from the Journal of the Electrochemical Society and Electrochemical Solid State Letters are available online in .pdf format. The Society describes the journals as follows: "Each issue of the Journal includes over 400 pages of over 60 original papers that are selected by a prestigious editorial board on topics covering both electrochemical and solid-state science and technology. Papers published in Letters represent the same kind of important scientific and technical breakthroughs featured in the past in the Letters-section of the Journal. Letters is a joint publication of The Electrochemical Society and the Institute of Electrical and Electronics Engineers (IEEE) Electron Devices Society (EDS)." Five articles, all very recent, are featured at the sample page.

2005-11-02

394

Cardiovascular physiology in space flight  

NASA Technical Reports Server (NTRS)

The effects of space flight on the cardiovascular system have been studied since the first manned flights. In several instances, the results from these investigations have directly contradicted the predictions based on established models. Results suggest associations between space flight's effects on other organ systems and those on the cardiovascular system. Such findings provide new insights into normal human physiology. They must also be considered when planning for the safety and efficiency of space flight crewmembers.

Charles, John B.; Bungo, Michael W.

1991-01-01

395

Jerome P. Kassirer - Professional Societies and Industry Support: What Is the Quid Pro Quo? - Perspectives in Biology and Medicine 50:1  

Microsoft Academic Search

Professional medical societies have become increasingly dependent on pharmaceutical, device, and biotechnology companies for ongoing support of their programs, but the internal influence of this financial largesse on medical societies' practices is well hidden. Many examples exist in which societies' educational products, including clinical practice guidelines and professional publications, have been tainted by involvement by industry-paid individuals. These examples show

Jerome P. Kassirer

2007-01-01

396

[Possible ways of managing cardiovascular prevention: polypharmacy, additional payment or application of evidence based medicine?].  

PubMed

The financial balance of the health care system has changed dramatically due to a longer life expectancy and improved treatment options in elderly patients. More than 80% of cardiovascular events are lifestyle related and potentially preventable. Lifestyle modification is therefore the causal approach to decrease cardiovascular events. Improvement of nutrition and activity habits and prevention of cigarette smoking should start in the kindergarten, school and later at the workplace. A co-operation between medical societies and government institutions is necessary to achieve a population wide modification of lifestyle habits to lower the incidence of cardiovascular events in the population. Individual risk stratification is the basis for pharmacological prevention of cardiovascular events. The concept of the polypill has to be tested in controlled randomised studies. PMID:15830173

Gohlke, H

2005-06-01

397

Pharmacoeconomics guidelines: The need of hour for India  

PubMed Central

Although the government pays for approximately 20% of drugs used in India, private out-of-pocket expenditure in India on health-care is one of the highest in the world. Preparing pharmacoeconomics guidelines will be an important step in order to establish Health Technology Assessment (HTA) in India. Areas in which HTA could be applied in the Indian context include, drug pricing, development of clinical practice guidelines and prioritizing interventions that represent the greatest value within a limited budget. All this calls for action, both by government and civil-society organizations, to make access to essential medicines a priority. PMID:25126523

Oberoi, Sukhvinder Singh; Oberoi, Avneet

2014-01-01

398

Liver elastography, comments on EFSUMB elastography guidelines 2013  

PubMed Central

Recently the European Federation of Societies for Ultrasound in Medicine and Biology Guidelines and Recommendations have been published assessing the clinical use of ultrasound elastography. The document is intended to form a reference and to guide clinical users in a practical way. They give practical advice for the use and interpretation. Liver disease forms the largest section, reflecting published experience to date including evidence from meta-analyses with shear wave and strain elastography. In this review comments and illustrations on the guidelines are given. PMID:24151351

Cui, Xin-Wu; Friedrich-Rust, Mireen; Molo, Chiara De; Ignee, Andre; Schreiber-Dietrich, Dagmar; Dietrich, Christoph F

2013-01-01

399

Consumption in the Information Society  

ERIC Educational Resources Information Center

The current state of the economy in the developed countries make it possible to characterize them using concepts and terms such as the postindustrial society, the new economy, the service economy, the creative economy, the posteconomic society, the information society, the knowledge society, and the consumer society. Among these terms and…

Zherebin, V. M.; Ermakova, N. A.; Makhrova, O. N.

2010-01-01

400

Conflict of interest and the Society for Vascular Surgery.  

PubMed

Specialty medical societies such as Society for Vascular Surgery (SVS) are instrumental in the development and dissemination of medical knowledge through scientific presentations, publication of rigorously peer-reviewed writings, awarding competitive research and training grants, and the provision of high-quality continuing medical education (CME). It is vital that in these roles the SVS remain in fact and in perception completely free of all influence and bias from industry. While independence from bias has always been necessary, the increasing focus by governmental agencies, industry organizations, and society has made it important for the SVS to address this issue in a formal way. In June 2010, the SVS Board of Directors approved a set of guidelines specifically designed to address management of conflict of interest among its members and its leaders. These guidelines, included in this article, were based on currently available information and policies put forth by legislative bodies, academic medical centers, industry groups, and other professional medical societies, and were designed to safeguard against abuse while maintaining valuable collaboration between vascular surgeons and their industry partners. The guidelines are included in this article. PMID:21872107

Elliott, Bruce M

2011-09-01

401

IOM and DHHS Meeting on Making Clinical Practice Guidelines Appropriate for Patients with Multiple Chronic Conditions  

PubMed Central

BACKGROUND The increasing prevalence of Americans with multiple (2 or more) chronic conditions raises concerns about the appropriateness and applicability of clinical practice guidelines for patient management. Most guidelines clinicians currently rely on have been designed with a single chronic condition in mind, and many such guidelines are inattentive to issues related to comorbidities. PURPOSE In response to the need for guideline developers to address comorbidities in guidelines, the Department of Health and Human Services convened a meeting in May 2012 in partnership with the Institute of Medicine to identify principles and action options. RESULTS Eleven principles to improve guidelines’ attentiveness to the population with multiple chronic conditions were identified during the meeting. They are grouped into 3 interrelated categories: (1) principles intended to improve the stakeholder technical process for developing guidelines; (2) principles intended to strengthen content of guidelines in terms of multiple chronic conditions; and (3) principles intended to increase focus on patient-centered care. CONCLUSION This meeting built upon previously recommended actions by identifying additional principles and options for government, guideline developers, and others to use in strengthening the applicability of clinical practice guidelines to the growing population of people with multiple chronic conditions. The suggested principles are helping professional societies to improve guidelines’ attentiveness to persons with multiple chronic conditions. PMID:24821897

Goodman, Richard A.; Boyd, Cynthia; Tinetti, Mary E.; Von Kohorn, Isabelle; Parekh, Anand K.; McGinnis, J. Michael

2014-01-01

402

Effective doses, guidelines & regulations.  

PubMed

A number of countries have developed regulations or guidelines for cyanotoxins and cyanobacteria in drinking water, and in some cases in water used for recreational activity and agriculture. The main focus internationally has been upon microcystin toxins, produced predominantly by Microcystis aeruginosa. This is because microcystins are widely regarded as the most significant potential source of human injury from cyanobacteria on a world-wide scale. Many international guidelines have taken their lead from the World Health Organization's (WHO) provisional guideline of 1 microg L(-1) for microcystin-LR in drinking-water released in 1998 (WHO 2004). The WHO guideline value is stated as being 'provisional', because it covers only microcystin-LR, for reasons that the toxicology is limited and new data for toxicity of cyanobacterial toxins are being generated. The derivation of this guideline is based upon data that there is reported human injury related to consumption of drinking water containing cyanobacteria, or from limited work with experimental animals. It was also recognised that at present the human evidence for microcystin tumor promotion is inadequate and animal evidence is limited. As a result the guideline is based upon the model of deriving a Tolerable Daily intake (TDI) from an animal study No Observed Adverse Effects Level (NOAEL), with the application of appropriate safety or uncertainty factors. The resultant WHO guideline by definition is the concentration of a toxin that does not result in any significant risk to health of the consumer over a lifetime of consumption. Following the release of this WHO provisional guideline many countries have either adopted it directly (e.g., Czech Republic, France, Japan, Korea, New Zealand, Norway, Poland, Brazil and Spain), or have adopted the same animal studies, TDI and derivation convention to arrive at slight variants based upon local requirements (e.g., Australia, Canada). Brazil currently has the most comprehensive federal legislation which includes a mandatory standard of 1 microg L-(1) for microcystins, and also recommendations for saxitoxins (3 microg L(-1)) and for cylindrospermopsin (15 microg L(-1)). Although guidelines for cyanotoxins and cyanobacterial cell numbers for recreational waters are in place in a number of countries, it is consid ered that there is currently insufficient information to derive sound guidelines for the use of water contaminated by cyanobacteria or toxins for agricultural production, fisheries and ecosystem protection. In relation to the need for specific regulations for toxins for the US, the surveys that have been carried out to date would indicate that the priority compounds for regulation, based upon their incidence and distribution, are microcystins, cylindrospermopsin and Anatoxin-a. Additional research is required to support guideline development, including whole-of-life animal studies with each of the known cyanotoxins. In view of the animal studies that indicate that microcystins may act as tumor promoters, and also some evidence of genotoxicity and carcinogenicity for cylindrospermopsin, it may be appropriate to carry out whole-of-life animal studies with both toxicity and carcinogenicity as end-points. In relation to microcystins, it is known that there a large number of congeners, and the toxico-dynamics and kinetics of these variants are not well understood. Further research is needed to consider the approach to take in formulating health advisories or regulations for toxin mixtures, i.e. multiple microcystins, or mixtures of toxin types. An important requirement for regulation is the availability of robust monitoring and analytical protocols for toxins. Currently rapid and economical screening or quantitative analytical methods are not available to the water industry or natural resource managers, and this is a priority before the release of guidelines and regulations. There is insufficient information available in a range of the categories usually required to satisfy comprehensive risk assessment process for the major tox

Burch, Michael D

2008-01-01