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1

Society for Cardiovascular Magnetic Resonance guidelines for reporting cardiovascular magnetic resonance examinations  

PubMed Central

These reporting guidelines are recommended by the Society for Cardiovascular Magnetic Resonance (SCMR) to provide a framework for healthcare delivery systems to disseminate cardiac and vascular imaging findings related to the performance of cardiovascular magnetic resonance (CMR) examinations.

Hundley, W Gregory; Bluemke, David; Bogaert, Jan G; Friedrich, Matthias G; Higgins, Charles B; Lawson, Mark A; McConnell, Michael V; Raman, Subha V; van Rossum, Albert C; Flamm, Scott; Kramer, Christopher M; Nagel, Eike; Neubauer, Stefan

2009-01-01

2

The use of antiplatelet therapy in the outpatient setting: Canadian Cardiovascular Society Guidelines Executive Summary.  

PubMed

Antiplatelet agents are a cornerstone of therapy for patients with atherosclerotic vascular disease. There is presently a lack of comprehensive guidelines focusing on the use of antiplatelet drugs in patients currently manifesting or at elevated risk of cardiovascular disease. The Canadian Antiplatelet Therapy Guidelines Committee reviewed existing disease-based guidelines and subsequently published literature and used expert opinion and review to develop guidelines on the use of antiplatelet therapy in the outpatient setting. This Executive Summary provides an abbreviated version of the principal recommendations. Antiplatelet therapy appears to be generally underused, perhaps in part because of a lack of clear, evidence-based guidance. Here, we provide specific guidelines for secondary prevention in patients discharged from hospital after acute coronary syndromes, percutaneous coronary intervention, or coronary artery bypass grafting; patients with a history of transient cerebral ischemic events or strokes; and patients with peripheral arterial disease. Issues related to primary prevention are also addressed, in addition to special clinical contexts such as diabetes, heart failure, chronic kidney disease, pregnancy or lactation, and perioperative management. Recommendations are provided regarding pharmacologic interactions that may occur during combination therapy with warfarin, clopidogrel, and proton-pump inhibitors, or aspirin and nonsteroidal anti-inflammatory drugs, as well as for the management of bleeding complications. The complete guidelines document is published as a supplementary issue of the Canadian Journal of Cardiology and is available at http://www.ccs.ca/. PMID:21459270

Bell, Alan D; Roussin, André; Cartier, Raymond; Chan, Wee Shian; Douketis, James D; Gupta, Anil; Kraw, Maria E; Lindsay, Thomas F; Love, Michael P; Pannu, Neesh; Rabasa-Lhoret, Rémi; Shuaib, Ashfaq; Teal, Philip; Théroux, Pierre; Turpie, A Graham; Welsh, Robert C; Tanguay, Jean-François

2011-01-01

3

The use of antiplatelet therapy in the outpatient setting: Canadian Cardiovascular Society guidelines.  

PubMed

Antiplatelet agents are a cornerstone of therapy for patients with atherosclerotic vascular disease. There is presently a lack of comprehensive guidelines focusing on the use of antiplatelet drugs in patients currently manifesting or at elevated risk of cardiovascular disease. The Canadian Antiplatelet Therapy Guidelines Committee reviewed existing disease-based guidelines and subsequently published literature and used expert opinion and review to develop guidelines on the use of antiplatelet therapy in the outpatient setting. This full document has been summarized in an Executive Summary published in the Canadian Journal of Cardiology and may be found at http://www.ccs.ca/. Antiplatelet therapy appears to be generally underused, perhaps in part because of a lack of clear, evidence-based guidance. Here, we provide specific guidelines for secondary prevention in patients discharged from hospital following acute coronary syndromes, post-percutaneous coronary intervention, post-coronary artery bypass grafting, patients with a history of transient cerebral ischemic events or strokes, and patients with peripheral arterial disease. Issues related to primary prevention are also addressed, in addition to special clinical contexts such as diabetes, heart failure, chronic kidney disease, pregnancy/lactation, and perioperative management. Recommendations are provided regarding pharmacologic interactions that may occur during combination therapy with warfarin, clopidogrel and proton-pump inhibitors, or acetylsalicylic acid and nonsteroidal anti-inflammatory drugs, as well as for the management of bleeding complications. PMID:21640290

Bell, Alan D; Roussin, André; Cartier, Raymond; Chan, Wee Shian; Douketis, James D; Gupta, Anil; Kraw, Maria E; Lindsay, Thomas F; Love, Michael P; Pannu, Neesh; Rabasa-Lhoret, Rémi; Shuaib, Ashfaq; Teal, Philip; Théroux, Pierre; Turpie, Alexander G G; Welsh, Robert C; Tanguay, Jean-François

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.

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

2010-01-01

5

The 2013 Canadian Cardiovascular Society Heart Failure Management Guidelines Update: focus on rehabilitation and exercise and surgical coronary revascularization.  

PubMed

The 2013 Canadian Cardiovascular Society Heart Failure Management Guidelines Update provides focused discussions on the management recommendations on 2 topics: (1) exercise and rehabilitation; and (2) surgical coronary revascularization in patients with heart failure. First, all patients with stable New York Heart Association class I-III symptoms should be considered for enrollment in a tailored exercise training program, to improve exercise tolerance and quality of life. Second, selected patients with suitable coronary anatomy should be considered for bypass graft surgery. As in previous updates, the topics were chosen in response to stakeholder feedback. The 2013 Update also includes recommendations, values and preferences, and practical tips to assist the clinicians and health care workers manage their patients with heart failure. PMID:24480445

Moe, Gordon W; Ezekowitz, Justin A; O'Meara, Eileen; Howlett, Jonathan G; Fremes, Steve E; Al-Hesayen, Abdul; Heckman, George A; Ducharme, Anique; Estrella-Holder, Estrellita; Grzeslo, Adam; Harkness, Karen; Lepage, Serge; McDonald, Michael; McKelvie, Robert S; Nigam, Anil; Rajda, Miroslaw; Rao, Vivek; Swiggum, Elizabeth; Virani, Sean; Van Le, Vy; Zieroth, Shelley; Arnold, J Malcolm O; Ashton, Tom; D'Astous, Michel; Dorian, Paul; Giannetti, Nadia; Haddad, Haissam; Isaac, Debra L; Kouz, Simon; Leblanc, Marie-Hélène; Liu, Peter; Ross, Heather J; Sussex, Bruce; White, Michel

2014-03-01

6

Presentation, diagnosis, and medical management of heart failure in children: Canadian Cardiovascular Society guidelines.  

PubMed

Pediatric heart failure (HF) is an important cause of morbidity and mortality in childhood. This article presents guidelines for the recognition, diagnosis, and early medical management of HF in infancy, childhood, and adolescence. The guidelines are intended to assist practitioners in office-based or emergency room practice, who encounter children with undiagnosed heart disease and symptoms of possible HF, rather than those who have already received surgical palliation. The guidelines have been developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, and are accompanied by practical Recommendations for their application in the clinical setting, supplemented by online material. This work does not include Recommendations for advanced management involving ventricular assist devices, or other device therapies. PMID:24267800

Kantor, Paul F; Lougheed, Jane; Dancea, Adrian; McGillion, Michael; Barbosa, Nicole; Chan, Carol; Dillenburg, Rejane; Atallah, Joseph; Buchholz, Holger; Chant-Gambacort, Catherine; Conway, Jennifer; Gardin, Letizia; George, Kristen; Greenway, Steven; Human, Derek G; Jeewa, Aamir; Price, Jack F; Ross, Robert D; Roche, S Lucy; Ryerson, Lindsay; Soni, Reeni; Wilson, Judith; Wong, Kenny

2013-12-01

7

Primary Prevention of Cardiovascular Disease and Type 2 Diabetes in Patients at Metabolic Risk: An Endocrine Society Clinical Practice Guideline  

Microsoft Academic Search

Objective: The objective was to develop clinical practice guidelines for the primary prevention of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) in patients at metabolic risk. Conclusions: Healthcare providers should incorporate into their practice concrete measures to reduce the risk of developing CVD and T2DM. These include the regular screening and identifi- cation of patients at metabolic risk

James L. Rosenzweig; Ele Ferrannini; Scott M. Grundy; Steven M. Haffner; Robert J. Heine; Edward S. Horton; Ryuzo Kawamori

2010-01-01

8

Primary Prevention of Cardiovascular Disease and Type 2 Diabetes in Patients at Metabolic Risk: An Endocrine Society Clinical Practice Guideline  

Microsoft Academic Search

Objective: The objective was to develop clinical practice guidelines for the primary prevention of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) in patients at metabolic risk. Conclusions: Healthcare providers should incorporate into their practice concrete measures to reduce the risk of developing CVD and T2DM. These include the regular screening and identifi- cation of patients at metabolic risk

James L. Rosenzweig; Ele Ferrannini; Scott M. Grundy; Steven M. Haffner; Robert J. Heine; Edward S. Horton; Ryuzo Kawamori

2008-01-01

9

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  

Microsoft Academic Search

The use of contrast media for cardiac imaging becomes increasing as the widespread of cardiac CT and cardiac MR. A radiologist\\u000a needs to carefully consider the indication and the injection protocol of contrast media to be used as well as the possibility\\u000a of adverse effect. There are several guidelines for contrast media in western countries. However, these are focusing the

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

2010-01-01

10

ASCI 2010 appropriateness criteria 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

There has been a growing need for standard Asian population guidelines for cardiac CT and cardiac MR due to differences in culture, healthcare system, ethnicity and disease prevalence. The Asian Society of Cardiovascular Imaging, as the only society dedicated to cardiovascular imaging in Asia, formed a cardiac CT and cardiac MR guideline working group in order to help Asian practitioners to establish cardiac CT and cardiac MR services. In this ASCI cardiac MR appropriateness criteria report, 23 Technical Panel members representing various Asian countries were invited to rate 50 indications that can frequently be encountered in clinical practice in Asia. Indications were rated on a scale of 1–9 to be categorized into ‘appropriate’ (7–9), ‘uncertain’ (4–6), or ‘inappropriate’ (1–3). According to median scores of the 23 members, the final ratings for indications were 24 appropriate, 18 uncertain and 8 inappropriate with 22 ‘highly-agreed’ (19 appropriate and 3 inappropriate) indications. This report is expected to have a significant impact on the cardiac MR practices in many Asian countries by promoting the appropriate use of cardiac MR. Electronic supplementary material The online version of this article (doi:10.1007/s10554-010-9687-z) contains supplementary material, which is available to authorized users.

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

2010-01-01

11

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.

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

12

[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

13

[Croatian Thyroid Society guidelines for rational detection of thyroid dysfunction].  

PubMed

Thyroid dysfunction is common in the population, especially in women, and thyroid diagnostic tests are among the most often used diagnostic procedures nowadays. Many thyroid societies developed guidelines for the detection of thyroid dysfunction. An interdisciplinary team of experts from the Croatian Thyroid Society studied guidelines of other thyroid societies and international publications, and according to our tradition and clinical practice developed guidelines for rational detection of thyroid dysfunction; hypothyroidism and hyperthyroidism. The aim of these guidelines is to recommend evidence-based and rational approach to the detection of thyroid dysfunction. PMID:20143604

Kusi?, Zvonko; Juki?, Tomislav; Franceschi, Maja; Dabeli?, Nina; Roncevi?, Sanja; Lukinac, Ljerka; Labar, Zeljka; Matesa, Neven; Solter, Miljenko; Dodig, Damir; Korsi?, Mirko; Bence-Zigman, Zdenka

2009-01-01

14

Guideline for minimizing radiation exposure during acquisition of coronary artery calcium scans with the use of multidetector computed tomography: a report by the Society for Atherosclerosis Imaging and Prevention Tomographic Imaging and Prevention Councils in collaboration with the Society of Cardiovascular Computed Tomography.  

PubMed

Coronary artery calcium (CAC) scanning is an important tool for risk stratification in intermediate-risk, asymptomatic subjects without previous coronary disease. However, the clinical benefit of improved risk prediction needs to be balanced against the risk of the use of ionizing radiation. Although there is increasing emphasis on the need to obtain CAC scans at low-radiation exposure to the patient, very few practical documents exist to aid laboratories and health care professionals on how to obtain such low-radiation scans. The Tomographic Imaging Council of the Society for Atherosclerosis Imaging and Prevention, in collaboration with the Prevention Council and the Society of Cardiovascular Computed Tomography, created a task force and writing group to generate a practical document to address parameters that can be influenced by careful attention to image acquisition. Patient selection for CAC scanning should be based on national guidelines. It is recommended that laboratories performing CAC examinations monitor radiation exposure (dose-length-product [DLP]) and effective radiation dose (E) in all patients. DLP should be <200 mGy × cm; E should average 1.0-1.5 mSv and should be <3.0 mSv. On most scanner platforms, CAC imaging should be performed in an axial mode with prospective electrocardiographic triggering, using tube voltage of 120 kVp. Tube current should be carefully selected on the basis of patient size, potentially using chest lateral width measured on the topogram. Scan length should be limited for the coverage of the heart only. When patients and imaging parameters are selected appropriately, CAC scanning can be performed with low levels of radiation exposure. PMID:21398199

Voros, Szilard; Rivera, Juan J; Berman, Daniel S; Blankstein, Ron; Budoff, Matthew J; Cury, Ricardo C; Desai, Milind Y; Dey, Damini; Halliburton, Sandra S; Hecht, Harvey S; Nasir, Khurram; Santos, Raul D; Shapiro, Michael D; Taylor, Allen J; Valeti, Uma S; Young, Phillip M; Weissman, Gaby

2011-01-01

15

American Cancer Society guidelines for the early detection of cancer  

Microsoft Academic Search

ABSTRACT Each January, the American Cancer Society (ACS) publishes a summary of its recommendations for early cancer detection, including updates, emerging issues that are relevant to screening for cancer, or both. In the spring of 2003, the ACS announced updated guidelines for breast cancer screening, and several other organizations released updated guidelines that we compare with recent ACS updates. Finally,

Ra Smith; Cj Mettlin; Kj Davis; H Eyre

2000-01-01

16

European Society of Gastrointestinal Endoscopy (ESGE) Guideline Development Policy.  

PubMed

Numerous scientific publications explore the field of gastrointestinal (GI) endoscopy (a Pubmed search currently yields > 73000 results). Therefore, guidelines have become an indispensable tool for incorporating up-to-date knowledge into daily clinical care. Since the 1990 s, the issuing of guidelines has been a central task of the European Society of Gastrointestinal Endoscopy (ESGE). Here, the ESGE clarifies the types of policy documents that it issues and the methodology used to produce them, taking into account recent methodological developments. PMID:22370700

Dumonceau, J-M; Hassan, C; Riphaus, A; Ponchon, T

2012-06-01

17

Evaluation and Treatment of Hypertriglyceridemia: An Endocrine Society Clinical Practice Guideline  

PubMed Central

Objective: The aim was to develop clinical practice guidelines on hypertriglyceridemia. Participants: The Task Force included a chair selected by The Endocrine Society Clinical Guidelines Subcommittee (CGS), five additional experts in the field, and a methodologist. The authors received no corporate funding or remuneration. Consensus Process: Consensus was guided by systematic reviews of evidence, e-mail discussion, conference calls, and one in-person meeting. The guidelines were reviewed and approved sequentially by The Endocrine Society's CGS and Clinical Affairs Core Committee, members responding to a web posting, and The Endocrine Society Council. At each stage, the Task Force incorporated changes in response to written comments. Conclusions: The Task Force recommends that the diagnosis of hypertriglyceridemia be based on fasting levels, that mild and moderate hypertriglyceridemia (triglycerides of 150–999 mg/dl) be diagnosed to aid in the evaluation of cardiovascular risk, and that severe and very severe hypertriglyceridemia (triglycerides of > 1000 mg/dl) be considered a risk for pancreatitis. The Task Force also recommends that patients with hypertriglyceridemia be evaluated for secondary causes of hyperlipidemia and that subjects with primary hypertriglyceridemia be evaluated for family history of dyslipidemia and cardiovascular disease. The Task Force recommends that the treatment goal in patients with moderate hypertriglyceridemia be a non-high-density lipoprotein cholesterol level in agreement with National Cholesterol Education Program Adult Treatment Panel guidelines. The initial treatment should be lifestyle therapy; a combination of diet modification and drug therapy may also be considered. In patients with severe or very severe hypertriglyceridemia, a fibrate should be used as a first-line agent.

Berglund, Lars; Brunzell, John D.; Goldberg, Anne C.; Goldberg, Ira J.; Sacks, Frank; Murad, Mohammad Hassan; Stalenhoef, Anton F. H.

2012-01-01

18

Developing the 2011 Integrated Pediatric Guidelines for Cardiovascular Risk Reduction.  

PubMed

This article reviews aspects of development of the recently released "Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents" for pediatric care providers that remain in the area of human judgment. Discussed will be the context in which the guidelines were developed, the formal evidence review process, a consideration of how quality grades were established, key social/ethical issues that the panel confronted, and a critique of the final work with recommendations for future guideline development. Lessons learned are that both a formal evidence review process is essential to developing a credible document, and human judgment is critical to producing a meaningful result. Guideline development is a dynamic process that must be continuously self-critical as new evidence is acquired and sociopolitical and environmental contexts evolve. PMID:22492765

Gidding, Samuel S; Daniels, Stephen R; Kavey, Rae Ellen W

2012-05-01

19

Pheochromocytoma and paraganglioma: an endocrine society clinical practice guideline.  

PubMed

Objective: The aim was to formulate clinical practice guidelines for pheochromocytoma and paraganglioma (PPGL). Participants: The Task Force included a chair selected by the Endocrine Society Clinical Guidelines Subcommittee (CGS), seven experts in the field, and a methodologist. The authors received no corporate funding or remuneration. Evidence: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence. The Task Force reviewed primary evidence and commissioned two additional systematic reviews. Consensus Process: One group meeting, several conference calls, and e-mail communications enabled consensus. Committees and members of the Endocrine Society, European Society of Endocrinology, and Americal Association for Clinical Chemistry reviewed drafts of the guidelines. Conclusions: The Task Force recommends that initial biochemical testing for PPGLs should include measurements of plasma free or urinary fractionated metanephrines. Consideration should be given to preanalytical factors leading to false-positive or false-negative results. All positive results require follow-up. Computed tomography is suggested for initial imaging, but magnetic resonance is a better option in patients with metastatic disease or when radiation exposure must be limited. (123)I-metaiodobenzylguanidine scintigraphy is a useful imaging modality for metastatic PPGLs. We recommend consideration of genetic testing in all patients, with testing by accredited laboratories. Patients with paraganglioma should be tested for SDHx mutations, and those with metastatic disease for SDHB mutations. All patients with functional PPGLs should undergo preoperative blockade to prevent perioperative complications. Preparation should include a high-sodium diet and fluid intake to prevent postoperative hypotension. We recommend minimally invasive adrenalectomy for most pheochromocytomas with open resection for most paragangliomas. Partial adrenalectomy is an option for selected patients. Lifelong follow-up is suggested to detect recurrent or metastatic disease. We suggest personalized management with evaluation and treatment by multidisciplinary teams with appropriate expertise to ensure favorable outcomes. PMID:24893135

Lenders, Jacques W M; Duh, Quan-Yang; Eisenhofer, Graeme; Gimenez-Roqueplo, Anne-Paule; Grebe, Stefan K G; Murad, Mohammad Hassan; Naruse, Mitsuhide; Pacak, Karel; Young, William F

2014-06-01

20

Colon capsule endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.  

PubMed

PillCam colon capsule endoscopy (CCE) is an innovative noninvasive, and painless ingestible capsule technique that allows exploration of the colon without the need for sedation and gas insufflation. Although it is already available in European and other countries, the clinical indications for CCE as well as the reporting and work-up of detected findings have not yet been standardized. The aim of this evidence-based and consensus-based guideline, commissioned by the European Society of Gastrointestinal Endoscopy (ESGE) is to furnish healthcare providers with a comprehensive framework for potential implementation of this technique in a clinical setting. PMID:22389230

Spada, C; Hassan, C; Galmiche, J P; Neuhaus, H; Dumonceau, J M; Adler, S; Epstein, O; Gay, G; Pennazio, M; Rex, D K; Benamouzig, R; de Franchis, R; Delvaux, M; Devière, J; Eliakim, R; Fraser, C; Hagenmuller, F; Herrerias, J M; Keuchel, M; Macrae, F; Munoz-Navas, M; Ponchon, T; Quintero, E; Riccioni, M E; Rondonotti, E; Marmo, R; Sung, J J; Tajiri, H; Toth, E; Triantafyllou, K; Van Gossum, A; Costamagna, G

2012-05-01

21

Provider Compliance With Guidelines for Management of Cardiovascular Risk in HIV-Infected Patients  

PubMed Central

Introduction Compliance with National Cholesterol Education Program Adult Treatment Panel III (NCEP) guidelines has been shown to significantly reduce incident cardiovascular events. We investigated physicians’ compliance with NCEP guidelines to reduce cardiovascular disease (CVD) risk in a population infected with HIV. Methods We analyzed HIV Outpatient Study (HOPS) data, following eligible patients from January 1, 2002, or first HOPS visit thereafter to calculate 10-year cardiovascular risk (10yCVR), until September 30, 2009, death, or last office visit. We categorized participants into four 10yCVR strata, according to guidelines determined by NCEP, the Infectious Disease Society of America, and the Adult AIDS Clinical Trials Group. We calculated percentages of patients treated for dyslipidemia and hypertension, calculated percentages of patients who achieved recommended goals, and categorized them by 10yCVR stratum. Results Of 2,005 patients analyzed, 33.7% had fewer than 2 CVD risk factors. For patients who had 2 or more risk factors, 10yCVR was less than 10% for 28.2%, 10% to 20% for 18.2%, and higher than 20% for 20.0% of patients. Of patients eligible for treatment, 81% to 87% were treated for elevated low-density lipoprotein cholesterol/non–high-density lipoprotein cholesterol (LDL-C/non–HDL-C), 2% to 11% were treated for low HDL-C, 56% to 91% were treated for high triglycerides, and 46% to 69% were treated for hypertension. Patients in higher 10yCVR categories were less likely to meet treatment goals than patients in lower 10yCVR categories. Conclusion At least one-fifth of contemporary HOPS patients have a 10yCVR higher than 20%, yet a large percentage of at-risk patients who were eligible for pharmacologic treatment did not receive recommended interventions and did not reach recommended treatment goals. Opportunities exist for CVD prevention in the HIV-infected population.

Lichtenstein, Kenneth A.; Buchacz, Kate; Chmiel, Joan S.; Buckner, Kern; Tedaldi, Ellen; Wood, Kathleen; Holmberg, Scott D.; Brooks, John T.

2013-01-01

22

[European guidelines on cardiovascular disease prevention. What has changed in 2012?].  

PubMed

The new European Guidelines on Cardiovascular Disease Prevention (version 2012) are supported by nine medical societies. They are newly structured, shorter and more readable. Each subchapter starts with key messages and recommendations are labeled with an evidence level. The subchapter ends with "most important newest information" and "persisting gaps of evidence" for further research. Smoking and passive smoking are to be avoided, even a small amount of regular physical activity is beneficial, the Mediterranean type diet is recommended and a body mass index (BMI) between 22 and 25 is associated with the lowest mortality. A blood pressure target of <140/90 mmHg is appropriate for the vast majority of hypertensive patients. Aspirin is not recommended for primary prevention even not for diabetics without vascular disease. Cardiovascular risk is now categorized into four levels: low (<1%), medium (1% to <5%), high (5% to <10%) and very high risk (?10%). All patients with cardiovascular disease are in the very high risk group with the corresponding treatment goals, e. g. a low density lipoprotein (LDL) cholesterol goal of <70 mg/dl (<1.8 mmol/l). Treatment adherence and behavioral changes can best be achieved by motivational interviews which demand some time. It is emphasized that the physician has the responsibility for clear recommendations in the discharge summaries after hospitalization and for offering help and feed back in the implementation phase of behavioral changes. PMID:24169933

Gohlke, H

2013-12-01

23

Canadian Cardiovascular Society/Canadian Association of Radiologists consensus training standards for cardiac computed tomography  

PubMed Central

With the goal of optimizing patient care, standards for training in cardiac computed tomography have been developed collaboratively by the Canadian Association of Radiologists and the Canadian Cardiovascular Society. These standards apply to both radiologists and cardiologists.

Brydie, Alan; Chow, Benjamin JW; Dennie, Carole J; Larose, Eric; Leipsic, Jonathan A; Sheth, Tej

2010-01-01

24

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

PubMed Central

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 the development of Lyme disease treatment guidelines by one of the largest medical societies in the United States, the Infectious Diseases Society of America (IDSA). Although the investigation found significant flaws in the IDSA guidelines development process, the subsequent review of the guidelines mandated by the settlement was compromised by a lack of impartiality at various stages of the IDSA review process. This article will examine the interplay between the recent calls for guidelines reform, the ethical canons of medicine, and due process considerations under antitrust laws as they apply to the formulation of the IDSA Lyme disease treatment guidelines. The article will also discuss pitfalls in the implementation of the IDSA antitrust settlement that should be avoided in the future.

2010-01-01

25

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

26

[Statement of the Spanish Interdisciplinary Cardiovascular Prevention Committee (CEIPC) on the 2012 European Cardiovascular Prevention Guidelines].  

PubMed

Based on the two main frameworks for evaluating scientific evidence--SEC and GRADE--European cardiovascular prevention guidelines recommend interventions across all life stages using a combination of population-based and high-risk strategies with diet as the cornerstone of prevention. The evaluation of cardiovascular risk (CVR) incorporates HDL levels and psychosocial factors, a very high risk category, and the concept of age-risk. They also recommend cognitive-behavioural methods (e.g., motivational interviewing, psychological interventions, led by health professionals and with the participation of the patient's family, to counterbalance psychosocial stress and reduce CVR through the institution of positive habits such as a healthy diet, physical activity, smoking cessation, and adherence to treatment. Additionally, public health interventions--such as smoking ban in public areas or the elimination of trans fatty acids from the food chain--are also essential. Other innovations include abandoning antiplatelet therapy in primary prevention and the recommendation of maintaining blood pressure (BP) within the 130-139/80-85 mmHg range in diabetic patients and individuals with high CVR. Finally, due to the significant impact on patient progress and medical costs, special emphasis is given to the low therapeutic adherence levels observed. In sum, improving cardiovascular prevention requires a true partnership among the political class, public administrations, scientific and professional associations, health foundations, consumer associations, patients and their families. Such partnership would promote population-based and individual strategies by taking advantage of the broad spectrum of scientific evidence available, from clinical trials to observational studies and mathematical models to evaluate population-based interventions, including cost-effectiveness analyses. PMID:23775101

Royo-Bordonada, Miguel Ángel; Lobos Bejarano, José María; Villar Alvarez, Fernando; Sans, Susana; Pérez, Antonio; Pedro-Botet, Juan; Moreno Carriles, Rosa María; Maiques, Antonio; Lizcano, Angel; Lizarbe, Vicenta; Gil Núñez, Antonio; Fornés Ubeda, Francisco; Elosua, Roberto; de Santiago Nocito, Ana; de Pablo Zarzosa, Carmen; de Álvaro Moreno, Fernando; Cortés, Olga; Cordero, Alberto; Camafort Babkowski, Miguel; Brotons Cuixart, Carlos; Armario, Pedro

2013-01-01

27

Comment on the British Society of Gastroenterology guidelines for management of autoimmune hepatitis (part 2).  

PubMed

The British Society of Gastroenterology guidelines for management of autoimmune hepatitis (AIH) were recently published in Gut. The chapters concerning the treatment of AIH are addressed here. PMID:22925553

Eugene, Claude

2012-12-01

28

American Cancer Society Guidelines for the Early Detection of Cancer, 2004  

Microsoft Academic Search

Each January, the American Cancer Society (ACS) publishes a summary of its recommendations for early cancer detection, including guideline updates, emerging issues that are relevant to screening for cancer, and a summary of the most current data on cancer screening rates for US adults. In 2004, there were no updates to ACS guidelines. In this article, we summarize the current

Robert A. Smith; Vilma Cokkinides; Harmon J. Eyre

29

American Cancer Society Guidelines for the Early Detection of Cancer, 2006  

Microsoft Academic Search

Each January, the American Cancer Society (ACS) publishes a summary of its recommendations for early cancer detection, including guideline updates, emerging issues that are relevant to screening for cancer, and a summary of the most current data on cancer screening rates for US adults. In 2005, there were no updates to ACS guidelines. In this issue of the journal, we

Robert A. Smith; Vilma Cokkinides; Harmon J. Eyre

2006-01-01

30

Management of fever in children: Summary of the Italian pediatric society guidelines  

Microsoft Academic Search

Objective: This article summarizes the Italian Pediatric Society guideline on the management of the signs and symptoms of fever in children, prepared as part of the National Guideline Program (NGLP).Methods: Relevant publications in English and Italian were identified through searches of MEDLINE and the Cochrane Database of Systematic Reviews from their inception through December 31, 2007. Based on the consensus

Elena Chiappini; Nicola Principi; Riccardo Longhi; Pier-Angelo Tovo; Paolo Becherucci; Francesca Bonsignori; Susanna Esposito; Filippo Festini; Luisa Galli; Bice Lucchesi; Alessandro Mugelli; Maurizio de Martino

2009-01-01

31

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

32

2008 Japanese Society for Dialysis Therapy: guidelines for renal anemia in chronic kidney disease.  

PubMed

The Japanese Society for Dialysis Therapy (JSDT) guideline committee, chaired by Dr Y. Tsubakihara, presents the Japanese guidelines entitled "Guidelines for Renal Anemia in Chronic Kidney Disease." These guidelines replace the "2004 JSDT Guidelines for Renal Anemia in Chronic Hemodialysis Patients," and contain new, additional guidelines for peritoneal dialysis (PD), non-dialysis (ND), and pediatric chronic kidney disease (CKD) patients. Chapter 1 presents reference values for diagnosing anemia that are based on the most recent epidemiological data from the general Japanese population. In both men and women, hemoglobin (Hb) levels decrease along with an increase in age and the level for diagnosing anemia has been set at <13.5 g/dL in males and <11.5 g/dL in females. However, the guidelines explicitly state that the target Hb level in erythropoiesis stimulating agent (ESA) therapy is different to the anemia reference level. In addition, in defining renal anemia, the guidelines emphasize that the reduced production of erythropoietin (EPO) that is associated with renal disorders is the primary cause of renal anemia, and that renal anemia refers to a condition in which there is no increased production of EPO and serum EPO levels remain within the reference range for healthy individuals without anemia, irrespective of the glomerular filtration rate (GFR). In other words, renal anemia is clearly identified as an "endocrine disease." It is believed that defining renal anemia in this way will be extremely beneficial for ND patients exhibiting renal anemia despite having a high GFR. We have also emphasized that renal anemia may be treated not only with ESA therapy but also with appropriate iron supplementation and the improvement of anemia associated with chronic disease, which is associated with inflammation, and inadequate dialysis, another major cause of renal anemia. In Chapter 2, which discusses the target Hb levels in ESA therapy, the guidelines establish different target levels for hemodialysis (HD) patients than for PD and ND patients, for two reasons: (i) In Japanese HD patients, Hb levels following hemodialysis rise considerably above their previous levels because of ultrafiltration-induced hemoconcentration; and (ii) as noted in the 2004 guidelines, although 10 to 11 g/dL was optimal for long-term prognosis if the Hb level prior to the hemodialysis session in an HD patient had been established at the target level, it has been reported that, based on data accumulated on Japanese PD and ND patients, in patients without serious cardiovascular disease, higher levels have a cardiac or renal function protective effect, without any safety issues. Accordingly, the guidelines establish a target Hb level in PD and ND patients of 11 g/dL or more, and recommend 13 g/dL as the criterion for dose reduction/withdrawal. However, with the results of, for example, the CHOIR (Correction of Hemoglobin and Outcomes in Renal Insufficiency) study in mind, the guidelines establish an upper limit of 12 g/dL for patients with serious cardiovascular disease or patients for whom the attending physician determines high Hb levels would not be appropriate. Chapter 3 discusses the criteria for iron supplementation. The guidelines establish reference levels for iron supplementation in Japan that are lower than those established in the Western guidelines. This is because of concerns about long-term toxicity if the results of short-term studies conducted by Western manufacturers, in which an ESA cost-savings effect has been positioned as a primary endpoint, are too readily accepted. In other words, if the serum ferritin is <100 ng/mL and the transferrin saturation rate (TSAT) is <20%, then the criteria for iron supplementation will be met; if only one of these criteria is met, then iron supplementation should be considered unnecessary. Although there is a dearth of supporting evidence for these criteria, there are patients that have been surviving on hemodialysis in Japan for more than 40 years, and since there

Tsubakihara, Yoshiharu; Nishi, Shinichi; Akiba, Takashi; Hirakata, Hideki; Iseki, Kunitoshi; Kubota, Minoru; Kuriyama, Satoru; Komatsu, Yasuhiro; Suzuki, Masashi; Nakai, Shigeru; Hattori, Motoshi; Babazono, Tetsuya; Hiramatsu, Makoto; Yamamoto, Hiroyasu; Bessho, Masami; Akizawa, Tadao

2010-06-01

33

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

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. The present introductory section is a summary of the epidemiology and scope of adult CHD in Canada, the structure of the Canadian health care system and adult congenital cardiac health services in Canada. The recommendations for antibiotic prophylaxis and genetic evaluation in this population are included. The complete document consists of four manuscripts, which are published online in the present issue of The Canadian Journal of Cardiology, including sections on genetics, outcomes, diagnostic workups, surgical and interventional options, treatment of arrhythmias, assessment of pregnancy and contraception risks, and follow-up recommendations. The complete document and references can also be found at www.ccs.ca or www.cachnet.org.

Mital, Seema; Therrien, Judith; Silversides, Candice K

2010-01-01

34

Guidelines for a successful European Society of Cardiology grant application.  

PubMed

There is no certain way of obtaining one of the European Society of Cardiology grants for research or clinical training offered each year, but Prof. Stavros Konstantinides (Centre for Thrombosis and Haemostasis, Johannes Gutenberg University, Mainz, Germany), who chairs the European Society of Cardiology Credentials Committee, which makes proposals to the ESC Board, has helped Barry Shurlock PhD to sketch a scenario that contains many useful hints. PMID:24945040

2014-05-14

35

Putting the 2008 Physical Activity Guidelines Into Practice to Prevent Cardiovascular Disease  

Microsoft Academic Search

In 2008, the federal government of the United States issued its first-ever physical activity guidelines for Americans. These\\u000a guidelines were based on a large body of scientific evidence, including evidence showing that physical activity can reduce\\u000a the risk of developing cardiovascular disease. The guidelines encourage any amount of physical activity, and ideally encourage\\u000a 150 min\\/wk of moderate-intensity aerobic activity or 75 min\\/wk

I-Min Lee

2010-01-01

36

NHLBI integrated pediatric guidelines: battle for a future free of cardiovascular disease  

PubMed Central

The report of the National Heart, Lung and Blood Institute Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents collects into one document atherosclerotic disease prevention in pediatric age groups. The guidelines summarize the evidence base and make recommendations that encourage universal adoption of healthier lifestyles, identification of children with cardiovascular disease risk factors, and treatment of those risk factors using targeted lifestyle modification and rarely pharmacotherapy. These recommendations highlight childhood as a frontier for cardiovascular disease prevention. The guideline recommendations are controversial and not universally embraced, but at the very least, they suggest directions for important research. This article explores key facets of the guidelines, controversies and future directions in preventive cardiology for children.

Zachariah, Justin P; de Ferranti, Sarah D

2013-01-01

37

Highlights of the 16th annual scientific sessions of the Society for Cardiovascular Magnetic Resonance  

PubMed Central

The 16th Annual Scientific Sessions of the Society for Cardiovascular Magnetic Resonance (SCMR) took place in San Francisco, USA at the end of January 2013. With a faculty of experts from across the world, this congress provided a wealth of insight into cutting-edge research and technological development. This review article intends to provide a highlight of what represented the most significant advances in the field of cardiovascular magnetic resonance (CMR) during this year’s meeting.

2013-01-01

38

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.

39

American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology Screening Guidelines for the Prevention and Early Detection of Cervical Cancer  

PubMed Central

An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical precancerous lesions and cancer is presented. The guidelines are based on a systematic evidence review, contributions from six working groups, and a recent symposium co-sponsored by the ACS, American Society for Colposcopy and Cervical Pathology (ASCCP), and American Society for Clinical Pathology (ASCP), which was attended by 25 organizations. The new screening recommendations address age-appropriate screening strategies, including the use of cytology and high-risk human papillomavirus (HPV) testing, follow-up (e.g., management of screen positives and screening interval for screen negatives) of women after screening, age at which to exit screening, future considerations regarding HPV testing alone as a primary screening approach, and screening strategies for women vaccinated against HPV16 and HPV18 infections.

Saslow, Debbie; Solomon, Diane; Lawson, Herschel W.; Killackey, Maureen; Kulasingam, Shalini; Cain, Joanna; Garcia, Francisco A. R.; Moriarty, Ann; Waxman, Alan; Wilbur, David; Wentzensen, Nicolas; Downs, Levi; Spitzer, Mark; Moscicki, Anna-Barbara; Saraiya, Mona; Franco, Eduardo L.; Stoler, Mark H.; Schiffman, Mark; Castle, Philip E.; Myers, Evan R.

2013-01-01

40

American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology Screening Guidelines for the Prevention and Early Detection of Cervical Cancer  

PubMed Central

An update to the American Cancer Society (ACS) guideline regarding screening for the early detection of cervical precancerous lesions and cancer is presented. The guidelines are based on a systematic evidence review, contributions from six working groups, and a recent symposium cosponsored by the ACS, American Society for Colposcopy and Cervical Pathology (ASCCP), and American Society for Clinical Pathology (ASCP), which was attended by 25 organizations. The new screening recommendations address age-appropriate screening strategies, including the use of cytology and high-risk human papillomavirus (HPV) testing, follow-up (e.g., management of screen positives and screening interval for screen negatives) of women after screening, age at which to exit screening, future considerations regarding HPV testing alone as a primary screening approach, and screening strategies for women vaccinated against HPV16 and HPV18 infections.

Saslow, Debbie; Solomon, Diane; Lawson, Herschel W.; Killackey, Maureen; Kulasingam, Shalini; Cain, Joanna; Garcia, Francisco A. R.; Moriarty, Ann; Waxman, Alan; Wilbur, David; Wentzensen, Nicolas; Downs, Levi; Spitzer, Mark; Moscicki, Anna-Barbara; Franco, Eduardo L.; Stoler, Mark H.; Schiffman, Mark; Castle, Philip E.; Myers, Evan R.

2013-01-01

41

Summary of the British Transplantation Society guidelines for transplantation from donors after deceased circulatory death.  

PubMed

The second edition of the British Transplantation Society Guidelines for Transplantation from Donors after Deceased Circulatory Death was published in June 2013. The guideline has been extensively revised since the previous edition in 2004 and has used the GRADE system to rate the strength of evidence and recommendations. This article summarizes the Statements of Recommendation contained in the guideline, which provide a framework for transplantation after deceased circulatory death in the U.K. and may be of wide international interest. It is recommended that the full guideline document is consulted for details of the relevant references and evidence base. This may be accessed at: http://www.bts.org.uk/MBR/Clinical/Guidelines/Current/Member/Clinical/Current_Guidelines.aspx. PMID:24448588

Andrews, Peter A; Burnapp, Lisa; Manas, Derek

2014-02-15

42

Diagnosis and management of chronic obstructive pulmonary disease: the Swiss guidelines. Official guidelines of the Swiss Respiratory Society.  

PubMed

The new Swiss Chronic Obstructive Pulmonary Disease (COPD) Guidelines are based on a previous version, which was published 10 years ago. The Swiss Respiratory Society felt the need to update the previous document due to new knowledge and novel therapeutic developments about this prevalent and important disease. The recommendations and statements are based on the available literature, on other national guidelines and, in particular, on the GOLD (Global Initiative for Chronic Obstructive Lung Disease) report. Our aim is to advise pulmonary physicians, general practitioners and other health care workers on the early detection and diagnosis, prevention, best symptomatic control, and avoidance of COPD as well as its complications and deterioration. PMID:23406723

Russi, E W; Karrer, W; Brutsche, M; Eich, C; Fitting, J W; Frey, M; Geiser, T; Kuhn, M; Nicod, L; Quadri, F; Rochat, T; Steurer-Stey, C; Stolz, D

2013-01-01

43

Wilderness medical society practice guidelines for the prevention and treatment of lightning injuries.  

PubMed

To provide guidance to clinicians about best practices, the Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for the treatment and prevention of lightning injuries. These guidelines include a review of the epidemiology of lightning strikes and recommendations for the prevention of lightning strikes, along with treatment recommendations organized by organ system. Recommendations are graded based on the quality of supporting evidence according to criteria put forth by the American College of Chest Physicians. PMID:22854068

Davis, Chris; Engeln, Anna; Johnson, Eric; McIntosh, Scott E; Zafren, Ken; Islas, Arthur A; McStay, Christopher; Smith, William 'Will' R; Cushing, Tracy

2012-09-01

44

[Croatian Thyroid Society guidelines for the management of patients with differentiated thyroid cancer].  

PubMed

With the introduction of ultrasound and fine-needle aspiration biopsy at the beginning of 1980s, dramatic changes in the clinical perception of thyroid diseases happened, especially thyroid nodules and thyroid cancer. The prevalence of thyroid nodules in the population according to ultrasound findings ranges from 20-50%, while around 5% of thyroid nodules harbour cancer. During the past decades significant increase in the incidence of thyroid cancer was recorded worldwide, mainly due to increase in the incidence of papillary thyroid cancer, probably due to improved diagnostics. Many thyroid societies developed guidelines for the management of patients with differentiated thyroid cancer. An interdisciplinary team of experts of the Croatian Thyroid Society studied guidelines of other thyroid societies and international publications, and according to our tradition and clinical practice developed the Guidelines for the Management of Patients with Differentiated Thyroid Cancer. The guidelines were published at Croatian Thyroid Society web page--www.stitnjaca.org, for open discussion and recommendations. Finally, the guidelines were accepted. PMID:19062757

Kusi?, Zvonko; Juki?, Tomislav; Dabeli?, Nina; Franceschi, Maja

2008-01-01

45

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.

2014-01-01

46

American Cancer Society guidelines for the early detection of breast cancer: update 1997  

Microsoft Academic Search

The American Cancer Society (ACS) convened a workshop in March 1997 to consider new scientific findings related to breast cancer screening and to determine whether these findings warrant a change in the existing ACS guidelines. The meeting was timed so that participants could benefit from new data related to screening women aged 40 to 49 years. A recommendation based on

A. M. Leitch; G. D. Dodd; Mary E. Costanza; M. Linver; P. Pressman; L. McGinnis; R. A. Smith

1997-01-01

47

Guideline methodology of the Society for Vascular Surgery including the experience with the GRADE framework.  

PubMed

In 2006, the Society for Vascular Surgery began development of clinical practice guidelines to assist clinicians in the process of decision making. The Society selects clinical questions of high impact and evaluates the totality of evidence by identifying and conducting rigorous systematic reviews. Multidisciplinary committees follow the Grading of Recommendations, Assessment, Development and Evaluation framework (GRADE), standard consensus, and voting procedures. Factors other than evidence, including patients' values and preferences and the availability of surgical expertise, are also considered. We describe, in the context of cumulative 4-years' experience, the methods and rigor of current procedures adopted by the Society for Vascular Surgery in developing practice guidelines. We also discuss potential future efforts needed to maximize the quality, adoption, and application of the clinical recommendations. PMID:21575755

Murad, Mohammad Hassan; Montori, Victor M; Sidawy, Anton N; Ascher, Enrico; Meissner, Mark H; Chaikof, Elliot L; Gloviczki, Peter

2011-05-01

48

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.

2013-01-01

49

Dietetic guidelines: diet in secondary prevention of cardiovascular disease (first update, June 2003)  

Microsoft Academic Search

Aim To update dietetic guidelines summarizing the systematic review evidence on dietary advice to prevent further events in people with existing cardiovascular disease (CVD) (secondary prevention). Methods The Cochrane Library, MEDLINE and EMBASE were comprehensively searched to November 2002 for systematic reviews on aspects of diet and heart health. Reviews were included if they searched systematically for randomised controlled trials

L. Hooper; E. Griffiths; B. Abrahams; W. Alexander; S. Atkins; G. Atkinson; R. Bamford; R. Chinuck; J. Farrington; E. Gardner; P. Greene; C. Gunner; C. Hamer; B. Helby; S. Hetherington; R. Howson; J. Laidlaw; M. Li; J. Lynas; C. McVicar; A. Mead; B. Moody; K. Paterson; S. Neal; P. Rigby; F. Ross; H. Shaw; D. Stone; F. Taylor; L. van Rensburgh; R. Vine; J. Whitehead; L. Wray

2004-01-01

50

Introducing the Canadian Thoracic Society framework for guideline dissemination and implementation, with concurrent evaluation.  

PubMed

The Canadian Thoracic Society (CTS) is leveraging its strengths in guideline production to enable respiratory guideline implementation in Canada. The authors describe the new CTS Framework for Guideline Dissemination and Implementation, with Concurrent Evaluation, which has three spheres of action: guideline production, implementation infrastructure and knowledge translation (KT) methodological support. The Canadian Institutes of Health Research 'Knowledge-to-Action' process was adopted as the model of choice for conceptualizing KT interventions. Within the framework, new evidence for formatting guideline recommendations to enhance the intrinsic implementability of future guidelines were applied. Clinical assemblies will consider implementability early in the guideline production cycle when selecting clinical questions, and new practice guidelines will include a section dedicated to KT. The framework describes the development of a web-based repository and communication forum to inventory existing KT resources and to facilitate collaboration and communication among implementation stakeholders through an online discussion board. A national forum for presentation and peer-review of proposed KT projects is described. The framework outlines expert methodological support for KT planning, development and evaluation including a practical guide for implementers and a novel 'Clinical Assembly-KT Action Team', and in-kind logistical support and assistance in securing peer-reviewed funding. PMID:23936883

Gupta, Samir; Licskai, Christopher; Van Dam, Anne; Boulet, Louis-Philippe

2013-01-01

51

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.

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

2014-01-01

52

Cardiovascular guidelines: separate career may help attenuate controversy  

PubMed Central

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 to75 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.

2014-01-01

53

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

54

Infection control guidelines for the cardiac catheterization laboratory: Society guidelines revisited  

Microsoft Academic Search

In the early years of diagnostic cardiac catheterization, strict sterile precautions were required for cutdown procedures. Thirteen years ago, when the original guidelines were written, the brachial arteriotomy was still frequently utilized, femoral closure devi- ces were uncommon, ''implantables,'' such as intracoronary stents and PFO\\/ASD clo- sure devices, were in their infancy, and percutaneous valve replacement was not a consideration.

Charles E. Chambers; Michael D. Eisenhauer; Lynn B. McNicol; Peter C. Block; William J. Phillips; Gregory J. Dehmer; Frederick A. Heupler; James C. Blankenship

2006-01-01

55

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.

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

56

European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anesthesiologist administration of propofol for GI endoscopy.  

PubMed

Propofol sedation by non-anesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. The aim of this evidence- and consensus-based set of guideline is to provide non-anesthesiologists with a comprehensive framework for propofol sedation during digestive endoscopy. This guideline results from a collaborative effort from representatives of the European Society of Gastrointestinal Endoscopy (ESGE), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline. PMID:21072716

Dumonceau, J M; Riphaus, A; Aparicio, J R; Beilenhoff, U; Knape, J T A; Ortmann, M; Paspatis, G; Ponsioen, C Y; Racz, I; Schreiber, F; Vilmann, P; Wehrmann, T; Wientjes, C; Walder, B

2010-11-01

57

Endoscopic ultrasound-guided sampling in gastroenterology: European society of gastrointestinal endoscopy technical guidelines.  

PubMed

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

2013-07-01

58

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.

Dietrich, Christoph F.; Jenssen, C.

2013-01-01

59

Wilderness Medical Society practice guidelines for the prevention and treatment of heat-related illness.  

PubMed

The Wilderness Medical Society (WMS) convened an expert panel to develop a set of evidence-based guidelines for the recognition, prevention, and treatment of heat-related illness. We present a review of the classifications, pathophysiology, and evidence-based guidelines for planning and preventive measures as well as best-practice recommendations for both field- and hospital-based therapeutic management of heat-related illness. These recommendations are graded based on the quality of supporting evidence and the balance between the benefits and risks or burdens for each modality. PMID:24140191

Lipman, Grant S; Eifling, Kurt P; Ellis, Mark A; Gaudio, Flavio G; Otten, Edward M; Grissom, Colin K

2013-12-01

60

Radiation protection in digestive endoscopy: European Society of Digestive Endoscopy (ESGE) guideline.  

PubMed

This article expresses the current view of the European Society of Gastrointestinal Endoscopy (ESGE) about radiation protection for endoscopic procedures, in particular endoscopic retrograde cholangiopancreatography (ERCP). Particular cases, including pregnant women and pediatric patients, are also discussed. This Guideline was developed by a group of endoscopists and medical physicists to ensure that all aspects of radiation protection are adequately dealt with. A two-page executive summary of evidence statements and recommendations is provided. The target readership for this Guideline mostly includes endoscopists, anesthesiologists, and endoscopy assistants who may be exposed to X-rays during endoscopic procedures. PMID:22438152

Dumonceau, J-M; Garcia-Fernandez, F J; Verdun, F R; Carinou, E; Donadille, L; Damilakis, J; Mouzas, I; Paraskeva, K; Ruiz-Lopez, N; Struelens, L; Tsapaki, V; Vanhavere, F; Valatas, V; Sans-Merce, M

2012-04-01

61

Use of epoetin in patients with cancer: evidence-based clinical practice guidelines of the American Society of Clinical Oncology and the American Society of Hematology  

Microsoft Academic Search

Anemia resulting from cancer or its treat- ment is an important clinical problem increasingly treated with the recombinant hematopoietic growth factor erythropoi- etin. To address uncertainties regarding indications and efficacy, the American Society of Clinical Oncology and the American Society of Hematology devel- oped an evidence-based clinical practice guideline for the use of epoetin in pa- tients with cancer. The

J. Douglas Rizzo; Alan E. Lichtin; Steven H. Woolf; Jerome Seidenfeld; Charles L. Bennett; David Cella; Benjamin Djulbegovic; Matthew J. Goode; Ann A. Jakubowski; Stephanie J. Lee; Carole B. Miller; Mark U. Rarick; David H. Regan; George P. Browman; Michael S. Gordon

2010-01-01

62

Colorectal Cancer Surveillance: 2005 Update of an American Society of Clinical Oncology Practice Guideline  

Microsoft Academic Search

Purpose To update the 2000 American Society of Clinical Oncology guideline on colorectal cancer surveillance. Recommendations Based on results from three independently reported meta-analyses of randomized controlled trials that compared low-intensity and high-intensity programs of colorectal cancer surveil- lance, and on recent analyses of data from major clinical trials in colon and rectal cancer, the Panel recommends annual computed tomography

Christopher E. Desch; Al B. Benson; Mark R. Somerfield; Patrick J. Flynn; Carol Krause; Charles L. Loprinzi; Bruce D. Minsky; David G. Pfister; Katherine S. Virgo; Nicholas J. Petrelli

63

Wilderness Medical Society consensus guidelines for the prevention and treatment of acute altitude illness.  

PubMed

To provide guidance to clinicians about best practices, the Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for the prevention and treatment of acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE). These guidelines present the main prophylactic and therapeutic modalities for each disorder and provide recommendations for their roles in disease management. Recommendations are graded based on the quality of supporting evidence and balance between the benefits and risks/burdens according to criteria put forth by the American College of Chest Physicians. The guidelines also provide suggested approaches to the prevention and management of each disorder that incorporate these recommendations. PMID:20591379

Luks, Andrew M; McIntosh, Scott E; Grissom, Colin K; Auerbach, Paul S; Rodway, George W; Schoene, Robert B; Zafren, Ken; Hackett, Peter H

2010-06-01

64

Management of hypertension in adults: the 2013 French Society of Hypertension guidelines.  

PubMed

To improve the management of hypertension in the French population, the French Society of Hypertension has decided to issue a new set of guidelines that include the following practical characteristics: usefulness for clinical practice, short, easy-to-read format, comprehensive writing for non-physicians, wide dissemination among healthcare professionals and the hypertensive population, assessment of their impact among healthcare professionals and with regard to public health goals. These guidelines, so-called the appointments of the hypertensive patient, include 15 recommendations, divided into three chapters, according to the timing of the medical management: prior to treatment initiation, the initial treatment plan (first 6 months) and the long-term care plan (beyond 6 months). We hope that a vast dissemination of these simple guidelines will help to improve hypertension control in the French population from 50% to 70%, an objective expected to be achieved in 2015 in France. PMID:23952903

Blacher, Jacques; Halimi, Jean-Michel; Hanon, Olivier; Mourad, Jean-Jacques; Pathak, Atul; Schnebert, Bruno; Girerd, Xavier

2014-02-01

65

Cardiovascular risk and rheumatoid arthritis: clinical practice guidelines based on published evidence and expert opinion  

Microsoft Academic Search

ObjectiveTo develop clinical practice guidelines for the evaluation and management of cardiovascular risk in patients with rheumatoid arthritis (RA), using the evidence-based approach and expert opinion.

Thao Pham; Laure Gossec; Arnaud Constantin; Stephan Pavy; Eric Bruckert; Alain Cantagrel; Bernard Combe; René-Marc Flipo; Philippe Goupille; Xavier Le Loët; Xavier Mariette; Xavier Puéchal; Thierry Schaeverbeke; Jean Sibilia; Jacques Tebib; Daniel Wendling; Maxime Dougados

2006-01-01

66

The International Society of Pediatric and Adolescent Diabetes guidelines for management of diabetic ketoacidosis: do the guidelines need to be modified?  

PubMed

The current version of the International Society of Pediatric and Adolescent Diabetes (ISPAD) guidelines for management of diabetic ketoacidosis (DKA) is largely based on the Lawson Wilkins Pediatric Endocrine Society/European Society of Pediatric Endocrinology (LWPES/ESPE) consensus statement on DKA in children and adolescents published in 2004. This article critically reviews and presents the most pertinent new data published in the past decade, which have implications for diagnosis and management. Four elements of the guidelines warrant modification: (i) The definition of DKA; (ii) insulin therapy; (iii) water and salt replacement; and (iv) blood ß-hydroxybutyrate measurements for the management of DKA. PMID:24866064

Wolfsdorf, Joseph I

2014-06-01

67

Obesity-related hypertension: pathogenesis, cardiovascular risk, and treatment--a position paper of the The Obesity Society and The American Society of Hypertension.  

PubMed

In light of the worldwide epidemic of obesity, and in recognition of hypertension as a major factor in the cardiovascular morbidity and mortality associated with obesity, The Obesity Society and The American Society of Hypertension agreed to jointly sponsor a position paper on obesity-related hypertension to be published jointly in the journals of each society. The purpose is to inform the members of both societies, as well as practicing clinicians, with a timely review of the association between obesity and high blood pressure, the risk that this association entails, and the options for rational, evidenced-based treatment. The position paper is divided into six sections plus a summary as follows: pathophysiology, epidemiology and cardiovascular risk, the metabolic syndrome, lifestyle management in prevention and treatment, pharmacologic treatment of hypertension in the obese, and the medical and surgical treatment of obesity in obese hypertensive patients. PMID:23401272

Landsberg, Lewis; Aronne, Louis J; Beilin, Lawrence J; Burke, Valerie; Igel, Leon I; Lloyd-Jones, Donald; Sowers, James

2013-01-01

68

Obesity-related hypertension: pathogenesis, cardiovascular risk, and treatment: a position paper of The Obesity Society and the American Society of Hypertension.  

PubMed

In light of the worldwide epidemic of obesity, and in recognition of hypertension as a major factor in the cardiovascular morbidity and mortality associated with obesity, The Obesity Society and the American Society of Hypertension agreed to jointly sponsor a position paper on obesity-related hypertension to be published jointly in the journals of each society. The purpose is to inform the members of both societies, as well as practicing clinicians, with a timely review of the association between obesity and high blood pressure, the risk that this association entails, and the options for rational, evidenced-based treatment. The position paper is divided into six sections plus a summary as follows: pathophysiology, epidemiology and cardiovascular risk, the metabolic syndrome, lifestyle management in prevention and treatment, pharmacologic treatment of hypertension in the obese, and the medical and surgical treatment of obesity in obese hypertensive patients. PMID:23282121

Landsberg, Lewis; Aronne, Louis J; Beilin, Lawrence J; Burke, Valerie; Igel, Leon I; Lloyd-Jones, Donald; Sowers, James

2013-01-01

69

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

70

Updated Society for Vascular Surgery guidelines for management of extracranial carotid disease: executive summary.  

PubMed

In 2008, the Society for Vascular Surgery published guidelines for the treatment of carotid bifurcation stenosis. Since that time, a number of prospective randomized trials have been completed and have shed additional light on the best treatment of extracranial carotid disease. This has prompted the Society for Vascular Surgery to form a committee to update and expand guidelines in this area. The review was done using the GRADE methodology.[corrected] The perioperative risk of stroke and death in asymptomatic patients must be below 3% to ensure benefit for the patient. Carotid artery stenting (CAS) should be reserved for symptomatic patients with stenosis 50% to 99% at high risk for CEA for anatomic or medical reasons. CAS is not recommended for asymptomatic patients at this time. Asymptomatic patients at high risk for intervention or with <3 years life expectancy should be considered for medical management as first line therapy. In this Executive Summary, we only outline the specifics of the recommendations made in the six areas evaluated. The full text of these guidelines can be found on the on-line version of the Journal of Vascular Surgery at http://journals.elsevierhealth.com/periodicals/ymva. PMID:21889705

Ricotta, John J; Aburahma, Ali; Ascher, Enrico; Eskandari, Mark; Faries, Peter; Lal, Brajesh K

2011-09-01

71

Practice guidelines for the early detection of cervical cancer in Korea: Korean Society of Gynecologic Oncology and the Korean Society for Cytopathology 2012 edition  

PubMed Central

The consensus guideline development committee of Korean Society of Gynecologic Oncology was reconvened in March 2012. The committee consisted of 36 experts representing 12 university hospitals and professional organizations. The objective of this committee was to develop standardized guidelines for cervical cancer screening tests for Korean women and to distribute these guidelines to every clinician, eventually improving the quality of medical care. Since the establishment of the consensus guideline development committee, evidence-based guidelines have either been developed de novo considering specific Korean situations or by adaptation of preexisting consensus guidelines from other countries. Recommendations for cervical cancer screening tests, management of atypical squamous and glandular cells, and management of low-grade and high-grade squamous intraepithelial lesions were developed. Additionally, recommendations for human papillomavirus DNA testing and recommendations for adolescent and pregnant women with abnormal cervical screening test results were also included.

Lee, Jae Kwan; Hong, Jin Hwa; Kang, Sokbom; Kim, Dae-Yeon; Kim, Byoung-Gie; Kim, Sung-Hoon; Kim, Yong-Man; Kim, Jae-Weon; Kim, Jae-Hoon; Kim, Tae-Jin; Kim, Hyun Jung; Kim, Hye Sun; Ryu, Hee-Sug; Song, Jae Yun; Ahn, Hyeong Sik; Yoo, Chong Woo; Yoon, Hye-Kyoung; Lee, Keun-Ho; Lee, Ahwon; Lee, Yonghee; Lee, In Ho; Lee, Jeong-Won; Lee, Taek Sang; Lim, Myong Cheol; Chang, Suk-Joon; Chung, Hyun Hoon; Ju, Woong; Joo, Hee Jae; Hur, Soo-Young

2013-01-01

72

European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anaesthesiologist administration of propofol for GI endoscopy.  

PubMed

Propofol sedation by non-anaesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. The aim of this evidence- and consensus-based set of guideline is to provide non-anaesthesiologists with a comprehensive framework for propofol sedation during digestive endoscopy. This guideline results from a collaborative effort from representatives of the European Society of Gastrointestinal Endoscopy (ESGE), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline.The guideline is published simultaneously in the Journals Endoscopy and European Journal of Anaesthesiology. PMID:21068575

Dumonceau, J M; Riphaus, A; Aparicio, J R; Beilenhoff, U; Knape, J T A; Ortmann, M; Paspatis, G; Ponsioen, C Y; Racz, I; Schreiber, F; Vilmann, P; Wehrmann, T; Wientjes, C; Walder, B

2010-12-01

73

American Society of Blood and Marrow Transplantation Guidelines for Training in Hematopoietic Progenitor Cell Transplantation.  

PubMed

Advances in hematopoietic progenitor cell transplantation (HCT) have led to an increasing number of transplantations and a concomitant requirement for physicians skilled in transplantation care. Guidelines for training HCT physicians were published in 2001; however, the past decade has seen a rapid expansion of the medical knowledge and skill set that these physicians need to deliver the highest quality of care. Recognizing the importance of education for transplantation programs, the American Society of Blood and Marrow Transplantation established a Committee on Education in 2010. The Committee's updated guidelines presented here provide an extensive and detailed framework for use by HCT educators and directors in developing HCT training programs and evaluating and mentoring their trainees. PMID:22522027

Khan, Shakila; Juckett, Mark B; Komanduri, Krishna V; Krishnan, Amrita; Burns, Linda J

2012-09-01

74

European Society of Gastrointestinal Endoscopy (ESGE) Guideline: prophylaxis of post-ERCP pancreatitis.  

PubMed

Pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). Risk factors for post-ERCP pancreatitis (PEP) are both patient-related and procedure-related. Identification of patients at high risk for PEP is important in order to target prophylactic measures. Prevention of PEP includes administration of nonsteroidal inflammatory drugs (NSAIDs), use of specific cannulation techniques, and placement of temporary pancreatic stents. The aim of this guideline commissioned by the European Society of Gastrointestinal Endoscopy (ESGE) is to provide practical, graded, recommendations for the prevention of PEP. PMID:20506068

Dumonceau, J-M; Andriulli, A; Deviere, J; Mariani, A; Rigaux, J; Baron, T H; Testoni, P A

2010-06-01

75

The relationship between introduction of American Society of Clinical Oncology guidelines and the use of colony-stimulating factors in clinical practice in a Paris University Hospital  

Microsoft Academic Search

Background: Clinical practice guidelines are issued periodically by professional medical societies or committees to assist practitioners in clinical decision making. However, it is unclear whether such guidelines have any lasting impact on clinical practice.Objective: The purpose of this study was to assess the impact of the American Society of Clinical Oncology (ASCO) guidelines regarding use of hematopoietic colony-stimulating factors (CSF)

Isabelle Debrix; Patrick Tilleul; Bernard Milleron; Nathalie Grené; Carole Bouleuc; Dominique Roux; Huguette Lioté; Isabelle Madelaine; Agnès Bellanger; Ornella Conort; Jean Eudes Fontan; Frank Le Mercier; Christophe Bardin; Annie Becker

2001-01-01

76

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

77

Updated Society for Vascular Surgery guidelines for management of extracranial carotid disease.  

PubMed

Management of carotid bifurcation stenosis is a cornerstone of stroke prevention and has been the subject of extensive clinical investigation, including multiple controlled randomized trials. The appropriate treatment of patients with carotid bifurcation disease is of major interest to the community of vascular surgeons. In 2008, the Society for Vascular Surgery published guidelines for treatment of carotid artery disease. At the time, only one randomized trial, comparing carotid endarterectomy (CEA) and carotid stenting (CAS), had been published. Since that publication, four major randomized trials comparing CEA and CAS have been published, and the role of medical management has been re-emphasized. The current publication updates and expands the 2008 guidelines with specific emphasis on six areas: imaging in identification and characterization of carotid stenosis, medical therapy (as stand-alone management and also in conjunction with intervention in patients with carotid bifurcation stenosis), risk stratification to select patients for appropriate interventional management (CEA or CAS), technical standards for performing CEA and CAS, the relative roles of CEA and CAS, and management of unusual conditions associated with extracranial carotid pathology. Recommendations are made using the GRADE (Grades of Recommendation Assessment, Development and Evaluation) system, as has been done with other Society for Vascular Surgery guideline documents.[corrected] The perioperative risk of stroke and death in asymptomatic patients must be <3% to ensure benefit for the patient. CAS should be reserved for symptomatic patients with stenosis of 50% to 99% at high risk for CEA for anatomic or medical reasons. CAS is not recommended for asymptomatic patients at this time. Asymptomatic patients at high risk for intervention or with <3 years life expectancy should be considered for medical management as the first-line therapy. PMID:21889701

Ricotta, John J; Aburahma, Ali; Ascher, Enrico; Eskandari, Mark; Faries, Peter; Lal, Brajesh K

2011-09-01

78

Antimicrobial use guidelines for treatment of urinary tract disease in dogs and cats: antimicrobial guidelines working group of the international society for companion animal infectious diseases.  

PubMed

Urinary tract disease is a common reason for use (and likely misuse, improper use, and overuse) of antimicrobials in dogs and cats. There is a lack of comprehensive treatment guidelines such as those that are available for human medicine. Accordingly, guidelines for diagnosis and management of urinary tract infections were created by a Working Group of the International Society for Companion Animal Infectious Diseases. While objective data are currently limited, these guidelines provide information to assist in the diagnosis and management of upper and lower urinary tract infections in dogs and cats. PMID:21776346

Weese, J Scott; Blondeau, Joseph M; Boothe, Dawn; Breitschwerdt, Edward B; Guardabassi, Luca; Hillier, Andrew; Lloyd, David H; Papich, Mark G; Rankin, Shelley C; Turnidge, John D; Sykes, Jane E

2011-01-01

79

Standardized medical terminology for cardiac computed tomography: a report of the Society of Cardiovascular Computed Tomography.  

PubMed

Since the emergence of cardiac computed tomography (CT) at the turn of the 21st century, there has been an exponential growth in research and clinical development of the technique, with contributions from investigators and clinicians from varied backgrounds: physics and engineering, informatics, cardiology, and radiology. However, terminology for the field is not unified. As a consequence, there are multiple abbreviations for some terms, multiple terms for some concepts, and some concepts that lack clear definitions and/or usage. In an effort to aid the work of all those who seek to contribute to the literature, clinical practice, and investigation of the field, the Society of Cardiovascular Computed Tomography sets forth a standard set of medical terms commonly used in clinical and investigative practice of cardiac CT. PMID:21640690

Weigold, Wm Guy; Abbara, Suhny; Achenbach, Stephan; Arbab-Zadeh, Armin; Berman, Daniel; Carr, J Jeffrey; Cury, Ricardo C; Halliburton, Sandra S; McCollough, Cynthia H; Taylor, Allen J

2011-01-01

80

Japanese society of hypertension (JSH) guidelines for self-monitoring of blood pressure at home.  

PubMed

Home blood pressure (BP) measurements are indispensable for the improvement of hypertension management in medical practice as well as for the recognition of hypertension in the population. The Working Group for Establishment of Guidelines for Measurement Procedures of Self-Monitoring of Blood Pressure at Home of the Japanese Society of Hypertension has established standards for all techniques and procedures of home BP measurements. The recommendations are as follows. Recommendation: 1) Arm-cuff devices based on the cuff-oscillometric method that have been validated officially, and the accuracy of which has been confirmed in each individual, should be used for home BP measurement. 2) The BP should be measured at the upper arm. Finger-cuff devices and wrist-cuff devices should not be used for home BP measurements. 3) Devices for home BP measurement should be adapted to the American Association for Medical Instrumentation (AAMI) standards and the British Hypertension Society (BHS) guidelines. In addition, the difference between the BP measured by the auscultatory method and that measured using the device should be within 5 mmHg in each individual. The home measurement device should be validated before use, and at regular intervals during use. 4) Home BP should be monitored under the following conditions. The morning measurement should be made within 1 h after waking, after micturition, sitting after 1 to 2 min of rest, before drug ingestion, and before breakfast. The evening measurement should be made just before going to bed, sitting after 1 to 2 min of rest. 5) Home BP should be measured at least once in the morning and once in the evening. 6) All home BP measurements should be documented without selection, together with the date, time, and pulse rate. Use of devices with a printer or an integrated circuit memory is useful to avoid selection bias. 7) The home BP in the morning and that in the evening should be averaged separately for a certain period. The first measurement on each occasion should be used for totaling. 8) Home BP values averaged for a certain period indicate hypertension when 135/80 mmHg and over and definite hypertension when 135/85 mmHg and over. Normotension is defined as less than 125/80 mmHg and definite normotension as less than 125/75 mmHg. Home BP measurements based on these guidelines can be considered an appropriate tool for clinical decision-making, and it is hoped that these guidelines will serve to reduce confusion and confirm the place of home BP measurement in clinical practice. PMID:14621179

Imai, Yutaka; Otsuka, Kuniaki; Kawano, Yuhei; Shimada, Kazuyuki; Hayashi, Hiroshi; Tochikubo, Osamu; Miyakawa, Masaaki; Fukiyama, Koshiro

2003-10-01

81

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

PubMed Central

There are a number of imaging tests that are used in the setting of acute myocardial infarction and acute coronary syndrome. Each has their strengths and limitations. Experts from the European Society of Cardiac Radiology and the North American Society for Cardiovascular Imaging together with other prominent imagers reviewed the literature. It is clear that there is a definite role for imaging in these patients. While comparative accuracy, convenience and cost have largely guided test decisions in the past, the introduction of newer tests is being held to a higher standard which compares patient outcomes. Multicenter randomized comparative effectiveness trials with outcome measures are required.

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

2010-01-01

82

In honor of the Teratology Society's 50th anniversary: The role of Teratology Society members in the development and evolution of in vivo developmental toxicity test guidelines.  

PubMed

Members of the Teratology Society (established in 1960) were involved in the first governmental developmental and reproductive toxicity testing guidelines (1966) by FDA following the thalidomide epidemic, followed by other national and international governmental testing guidelines. The Segment II (developmental toxicity) study design, described in rodents and rabbits, has evolved with additional enhanced endpoints and better descriptions, mechanistic insights, range-finding studies, and toxico/pharmacokinetic ADME information (especially for pharmaceuticals). Society members were also involved in the development of the current screening assays and tests for endocrine disruptors (beginning in 1996) and are now involved with developing new testing guidelines (e.g., the extended one-generation protocol), and evaluating the current test guidelines and new initiatives under ILSI/HESI sponsorship. New initiatives include ToxCast from the U.S. EPA to screen, prioritize, and predict toxic chemicals by high throughput and high-content in vitro assays, bioinformation, and modeling to reduce (or eliminate) in vivo whole animal studies. Our Society and its journal have played vital roles in the scientific and regulatory accomplishments in birth defects research over the past 50 years and will continue to do so in the future. Happy 50th anniversary! PMID:20544693

Tyl, Rochelle W

2010-06-01

83

Wilderness Medical Society practice guidelines for treatment of exercise-associated hyponatremia.  

PubMed

Exercise-associated hyponatremia (EAH) typically occurs during or up to 24 hours after prolonged physical activity, and is defined by a serum or plasma sodium concentration below the normal reference range of 135 mEq/L. It is also reported to occur in individual physical activities or during organized endurance events conducted in austere environments in which medical care is limited or often not available, and patient evacuation to definitive care is often greatly delayed. Rapid recognition and appropriate treatment are essential in the severe form to ensure a positive outcome. Failure in this regard is a recognized cause of event-related fatality. In an effort to produce best practice guidelines for EAH in the austere environment, the Wilderness Medical Society convened an expert panel. The panel was charged with the development of evidence-based guidelines for management of EAH. Recommendations are made regarding the situations when sodium concentration can be assessed in the field and when these values are not known. These recommendations are graded based on the quality of supporting evidence and balance between the benefits and risks/burdens for each parameter according to the methodology stipulated by the American College of Chest Physicians. PMID:23590928

Bennett, Brad L; Hew-Butler, Tamara; Hoffman, Martin D; Rogers, Ian R; Rosner, Mitchell H

2013-09-01

84

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; Renda Soylemez, Wiener

2014-05-01

85

Biliary stenting: indications, choice of stents and results: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline.  

PubMed

This article is part of a combined publication that expresses the current view of the European Society of Gastrointestinal Endoscopy about endoscopic biliary stenting. The present Clinical Guideline describes short-term and long-term results of biliary stenting depending on indications and stent models; it makes recommendations on when, how, and with which stent to perform biliary drainage in most common clinical settings, including in patients with a potentially resectable malignant biliary obstruction and in those who require palliative drainage of common bile duct or hilar strictures. Treatment of benign conditions (strictures related to chronic pancreatitis, liver transplantation, or cholecystectomy, and leaks and failed biliary stone extraction) and management of complications (including stent revision) are also discussed. A two-page executive summary of evidence statements and recommendations is provided. A separate Technology Review describes the models of biliary stents available and the stenting techniques, including advanced techniques such as insertion of multiple plastic stents, drainage of hilar strictures, retrieval of migrated stents and combined stenting in malignant biliary and duodenal obstructions.The target readership for the Clinical Guideline mostly includes digestive endoscopists, gastroenterologists, oncologists, radiologists, internists, and surgeons while the Technology Review should be most useful to endoscopists who perform biliary drainage. PMID:22297801

Dumonceau, J-M; Tringali, A; Blero, D; Devière, J; Laugiers, R; Heresbach, D; Costamagna, G

2012-03-01

86

Guideline-driven telemonitoring and follow-up of cardiovascular implantable electronic devices using IEEE 11073, HL7 & IHE profiles  

Microsoft Academic Search

For patients with Cardiovascular Implantable Electronic Devices (CIEDs), telemonitoring promises improved quality of life and safety, since events recorded by the device or observed by the patient can alert a health professional. Taking into account the latest clinical guidelines when responding to such alerts, is a topic of active research addressed by the iCARDEA project. A key technical challenge is

Maohua Yang; Catherine E. Chronaki; Christian Lupkes; Andreas Thiel; Manuela Plosnig; Lynne Hinterbuchner; Elena Arbelo; Gokce Banu Laleci; Yildiray Kabak; Fernandez Duarte; Alejandra Guillen; Xavier Navarro; Asuman Dogac; Marco Eichelberg; Andreas Hein

2011-01-01

87

The CLUES study: a cluster randomized clinical trial for the evaluation of cardiovascular guideline implementation in primary care  

PubMed Central

Background The appropriate care for people with cardiovascular risk factors can reduce morbidity and mortality. One strategy for improving the care for these patients involves the implementation of evidence-based guidelines. To date, little research concerning the impact of such implementation strategies in our setting has been published. Aims. To evaluate the effectiveness of a multifaceted tailored intervention in the implementation of three cardiovascular risk-related guidelines (hypertension, type 2 diabetes and dyslipidemia) in primary care in the Basque Health Service compared with usual implementation. Methods/Design A two-year cluster randomized clinical trial in primary care in two districts in the Basque Health Service. All primary care units are randomized. Data from all patients with diabetes, hypertension and those susceptible to coronary risk screening will be analyzed. Interventions. The control group will receive standard implementation. The experimental group will receive a multifaceted tailored implementation strategy, including a specific web page and workshops for family physicians and nurses. Endpoints. Primary endpoints: annual request for glycosylated hemoglobin, basic laboratory tests for hypertension, cardiovascular risk screening (women between 45–74 and men between 40–74 years old). Secondary endpoints: other process and clinical guideline indicators. Analysis: Data will be extracted from centralized computerized medical records. Analysis will be performed at a primary care unit level weighted by cluster size. Discussion The main contribution of our study is that it seeks to identify an effective strategy for cardiovascular guideline implementation in primary care in our setting. Trial registration Current Controlled Trials, ISRCTN88876909

2013-01-01

88

Revised guidelines for cardiovascular risk management -- time to stop medication? A practice-based intervention study  

PubMed Central

Background According to the new Dutch guideline for cardiovascular risk management, patients with a low risk of cardiovascular mortality may have insufficient benefit to warrant medication. Therefore, numerous patients per general practice may be treated unnecessarily. Aim To explore the feasibility and consequences of a re-evaluation programme for patients without target organ damage who were treated for hypertension and/or hypercholesterolaemia. Design and setting Practice-based intervention study in six general practices. Method Patients treated for hypertension and/or hypercholesterolaemia without target organ damage (n = 833) were invited to re-evaluate their cardiovascular risk and were advised whether or not to stop medication. Patients who discontinued medication were followed for 6 months. To determine indicators for successful stopping, logistic regression analyses were performed, and differences between practices were analysed. Results About two-thirds of the patients were re-evaluated and 61% of them had a low calculated risk, especially younger patients, females, and non-smokers. Of these, 42% were advised to stop medication, especially younger patients and non-smokers. Of those who discontinued medication, 40% had restarted within 6 months. After 6 months, 80 of the 833 patients (9.6%) had not restarted medication. There were no important side effects related to stopping medication. Conclusion Over 50% of patients without target organ damage treated for hypertension and/or hypercholesterolaemia may have insufficient benefit to warrant medication. Younger patients, females, and non-smokers in particular are more likely to have an insufficient indication for medication. GPs’ and nurse practitioners’ views seem to play a role in advising to stop or to restart medication.

van Duijn, Huug J; Belo, Janneke N; Blom, Jeanet W; Velberg, Irvine D; Assendelft, Willem JJ

2011-01-01

89

Canadian Cardiovascular Society consensus conference recommendations on heart failure 2006: Diagnosis and management  

PubMed Central

Heart failure remains a common diagnosis, especially in older individuals. It continues to be associated with significant morbidity and mortality, but major advances in both diagnosis and management have occurred and will continue to improve symptoms and other outcomes in patients. The Canadian Cardiovascular Society published its first consensus conference recommendations on the diagnosis and management of heart failure in 1994, followed by two brief updates, and reconvened this consensus conference to provide a comprehensive review of current knowledge and management strategies. New clinical trial evidence and meta-analyses were critically reviewed by a multidisciplinary primary panel who developed both recommendations and practical tips, which were reviewed by a secondary panel. The resulting document is intended to provide practical advice for specialists, family physicians, nurses, pharmacists and others who are involved in the care of heart failure patients. Management of heart failure begins with an accurate diagnosis, and requires rational combination drug therapy, individualization of care for each patient (based on their symptoms, clinical presentation and disease severity), appropriate mechanical interventions including revascularization and devices, collaborative efforts among health care professionals, and education and cooperation of the patient and their immediate caregivers. The goal is to translate best evidence-based therapies into clinical practice with a measureable impact on the health of heart failure patients in Canada.

Arnold, J Malcolm O; Liu, Peter; Demers, Catherine; Dorian, Paul; Giannetti, Nadia; Haddad, Haissam; Heckman, George A; Howlett, Jonathan G; Ignaszewski, Andrew; Johnstone, David E; Jong, Philip; McKelvie, Robert S; Moe, Gordon W; Parker, John D; Rao, Vivek; Ross, Heather J; Sequeira, Errol J; Svendsen, Anna M; Teo, Koon; Tsuyuki, Ross T; White, Michel

2006-01-01

90

European Society of Hypertension practice guidelines for ambulatory blood pressure monitoring.  

PubMed

Given the increasing use of ambulatory blood pressure monitoring (ABPM) in both clinical practice and hypertension research, a group of scientists, participating in the European Society of Hypertension Working Group on blood pressure monitoring and cardiovascular variability, in year 2013 published a comprehensive position paper dealing with all aspects of the technique, based on the available scientific evidence for ABPM. The present work represents an updated schematic summary of the most important aspects related to the use of ABPM in daily practice, and is aimed at providing recommendations for proper use of this technique in a clinical setting by both specialists and practicing physicians. The present article details the requirements and the methodological issues to be addressed for using ABPM in clinical practice, The clinical indications for ABPM suggested by the available studies, among which white-coat phenomena, masked hypertension, and nocturnal hypertension, are outlined in detail, and the place of home measurement of blood pressure in relation to ABPM is discussed. The role of ABPM in pharmacological, epidemiological, and clinical research is also briefly mentioned. Finally, the implementation of ABPM in practice is considered in relation to the situation of different countries with regard to the reimbursement and the availability of ABPM in primary care practices, hospital clinics, and pharmacies. PMID:24886823

Parati, Gianfranco; Stergiou, George; O'Brien, Eoin; Asmar, Roland; Beilin, Lawrence; Bilo, Grzegorz; Clement, Denis; de la Sierra, Alejandro; de Leeuw, Peter; Dolan, Eamon; Fagard, Robert; Graves, John; Head, Geoffrey A; Imai, Yutaka; Kario, Kazuomi; Lurbe, Empar; Mallion, Jean-Michel; Mancia, Giuseppe; Mengden, Thomas; Myers, Martin; Ogedegbe, Gbenga; Ohkubo, Takayoshi; Omboni, Stefano; Palatini, Paolo; Redon, Josep; Ruilope, Luis M; Shennan, Andrew; Staessen, Jan A; vanMontfrans, Gert; Verdecchia, Paolo; Waeber, Bernard; Wang, Jiguang; Zanchetti, Alberto; Zhang, Yuqing

2014-07-01

91

A prospective comparison of antibiotic usage in pediatric surgical patients: The safety, advantage, and effectiveness of the Surgical Infection Society guidelines versus a common practice  

Microsoft Academic Search

Background: The Surgical Infection Society (SIS) guidelines for antibiotic (Ab) usage minimally changed the surgical practice. The authors believed that clinical evidence of the safety, advantage, and effectiveness of SIS guidelines may improve inappropriate usage of Ab. Methods: A group of dedicated surgeons attempted to use Ab appropriately to SIS guidelines in their patients (group A). A comparison was made

Elzbieta Grochowska; Miroslaw Krysta; Piotr Wojciechowski; Anna Taczanowska; Beata Stanek

2002-01-01

92

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

93

Pre-interventional haemostatic assessment: Guidelines from the French Society of Anaesthesia and Intensive Care.  

PubMed

Recently the French Society of Anaesthesia and Intensive Care (Société Française d'Anesthésie et de Réanimation [SFAR]) issued recommendations for the prescription of routine preoperative testing before a surgical or non-surgical procedure, requiring any type of anaesthesia. Thirty clinical specialists performed a systematic analysis of the literature, and recommendations were then developed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. One part of these guidelines is dedicated to haemostatic assessment. The goal of pre-anaesthetic screening for congenital or acquired haemostatic disorders is to prevent perioperative haemorrhagic complications through appropriate medical and surgical management. Preoperative assessment of bleeding risk requires a detailed patient interview to determine any personal or family history of haemorrhagic diathesis, and a physical examination is necessary in order to detect signs of coagulopathy. Laboratory investigation of haemostasis should be prescribed, not systematically, but depending on clinical evaluation and patient history. Standard tests (prothrombin time, activated partial thromboplastin time, platelet count) have a low positive predictive value for bleeding risk in the general population. Patients with no history of haemorrhagic diathesis and no conditions liable to interfere with haemostasis should not undergo pre-interventional haemostasis testing. Conversely, the existence of a positive history or a disease that could interfere with haemostasis should be an indication for clinically appropriate testing. PMID:23435255

Bonhomme, Fanny; Ajzenberg, Nadine; Schved, Jean-François; Molliex, Serge; Samama, Charles-Marc

2013-04-01

94

Standardized image interpretation and post processing in cardiovascular magnetic resonance: Society for Cardiovascular Magnetic Resonance (SCMR) Board of Trustees Task Force on Standardized Post Processing  

PubMed Central

With mounting data on its accuracy and prognostic value, cardiovascular magnetic resonance (CMR) is becoming an increasingly important diagnostic tool with growing utility in clinical routine. Given its versatility and wide range of quantitative parameters, however, agreement on specific standards for the interpretation and post-processing of CMR studies is required to ensure consistent quality and reproducibility of CMR reports. This document addresses this need by providing consensus recommendations developed by the Task Force for Post Processing of the Society for Cardiovascular MR (SCMR). The aim of the task force is to recommend requirements and standards for image interpretation and post processing enabling qualitative and quantitative evaluation of CMR images. Furthermore, pitfalls of CMR image analysis are discussed where appropriate.

2013-01-01

95

Scoliosis Research Society (SRS) Criteria and Society of Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) 2008 Guidelines in Non-Operative Treatment of Idiopathic Scoliosis.  

PubMed

According to the Scoliosis Research Society (SRS), idiopathic scoliosis (IS) is a curvature of more than 10° Cobb angle, affecting 2-3% of pediatric population. Idiopathic scoliosis accounts for 80% of all scoliosis cases. Non-operative principles in the therapy of idiopathic scoliosis, including Scoliosis Research Society (SRS) criteria and guidelines proposed by the experts of the Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORTS) were presented. The possibility to carry out quality of life assessments in a conservative procedure was also demonstrated. Based on the natural history of idiopathic scoliosis, SRS criteria, SOSORT 2008 experts' opinion and the knowledge of the possibilities of psychological assessment of conservative IS treatment, rules were proposed regarding nonsurgical IS therapy procedures, with special consideration being paid to the proper treatment start time (age, Risser test, biological maturity, Cobb angle), possibility of curvature progression, the importance of physiotherapy and psychological assessment. The knowledge of SRS criteria and SOSORT guidelines regarding the conservative treatment of IS are essential for proper treatment (the right time to start treatment), and supports establishment of interdisciplinary treatment teams, consisting of a physician, a physiotherapist, an orthopedic technician and a psychologist. PMID:25066033

Korbel, Krzysztof; Kozinoga, Mateusz; Stoli?ski, ?ukasz; Kotwicki, Tomasz

2014-01-01

96

Societies.  

PubMed

As the 2008 joint meeting of the European Pancreatic Club and the International Association of Pancreatology commences, it is appropriate to highlight the enormous benefits pancreatic societies, such as these, and their meetings offer. In the pancreas field, our strengths are in our societies, which bring us together as a community for common goals. With our societies, we have the potential to promote cooperation between scientists, encourage scientific responsibility and improvement, as well as support scientific education for the betterment of those suffering from diseases of the pancreas. and IAP. PMID:18497535

Lomberk, Gwen

2008-01-01

97

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

98

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

99

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

100

South African dyslipidaemia guideline consensus statement.  

PubMed

The European Society of Cardiology together with the European Atherosclerosis Society published updated dyslipidaemia guidelines in 2011. SA Heart and the Lipid and Atherosclerosis Society of Southern Africa officially adopt these guidelines. This statement adapts aspects of the guidelines to the South African situation. Using the updated Framingham risk charts, interventional strategies are based according to the cardiovascular risk score and low-density lipoprotein cholesterol (LDL-C) levels. The Framingham risk score refers to the 10-year risk of any cardiovascular event, and includes four categories of risk. Treatment targets are those of the European guidelines. The LDL-C goal is 1.8 mmol/l for the very high-risk group (>30%), 2.5 mmol/l for the high-risk group (15-30%), and 3 mmol/l for those below 15% risk. Intensive management of dyslipidaemia in South Africa will significantly reduce the cardiovascular disease health burden. PMID:22380916

Klug, Eric

2012-03-01

101

Management of Thyroid Peroxidase Antibody Euthyroid Women in Pregnancy: Comparison of the American Thyroid Association and the Endocrine Society Guidelines  

PubMed Central

The presence of thyroid autoantibodies is relatively high in women of childbearing age. There is evidence that positive thyroperoxidase antibody even in euthyroid women may increase the risk of spontaneous and recurrent pregnancy loss and preterm delivery. However, the evidence is not enough to justify recommendation on the screening of pregnant women for thyroid autoantibodies or LT4 supplementation for reducing maternal or fetal complications. In this paper we reviewed the related evidence and compared the new guidelines of the American Thyroid Association and Endocrine Society with respect to the screening and management of positive thyroperoxidase antibody in euthyroid pregnant women. As there was no major contradiction or disagreement between the two guidelines, either one of two guidelines may be used by clinicians for the appropriate management of thyroid autoimmunity during pregnancy.

Mehran, L.; Tohidi, M.; Sarvghadi, F.; Delshad, H.; Amouzegar, A.; Soldin, O. P.; Azizi, F.

2013-01-01

102

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

PubMed Central

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) [1]. 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 [2]. 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.

Lee, M. J.; Belli, A. M.; Barkhof, F.

2010-01-01

103

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

104

Vitamin D dose response is underestimated by Endocrine Society's Clinical Practice Guideline  

PubMed Central

Objective The recommended daily intakes of vitamin D according to the recent Clinical Practice Guideline (CPG) of the Endocrine Society are three- to fivefold higher than the Institute of Medicine (IOM) report. We speculated that these differences could be explained by different mathematical approaches to the vitamin D dose response. Methods Studies were selected if the daily dose was ?2000?IU/day, the duration exceeded 3 months, and 25-hydroxyvitamin D (25OHD) concentrations were measured at baseline and post-therapy. The rate constant was estimated according to the CPG approach. The achieved 25OHD result was estimated according to the following: i) the regression equation approach of the IOM; ii) the regression approach of the Vitamin D Supplementation in Older Subjects (ViDOS) study; and iii) the CPG approach using a rate constant of 2.5 (CPG2.5) and a rate constant of 5.0 (CPG5.0). The difference between the expected and the observed 25OHD result was expressed as a percentage of observed and analyzed for significance against a value of 0% for the four groups. Results Forty-one studies were analyzed. The mean (95% CI) rate constant was 5.3 (4.4–6.2) nmol/l per 100?IU per day, on average twofold higher than the CPG rate constant. The mean (95% CI) for the difference between the expected and observed expressed as a percentage of observed was as follows: i) IOM, ?7 (?16,+2)% (t=1.64, P=0.110); ii) ViDOS, +2 (?8,+12)% (t=0.40, P=0.69); iii) CPG2.5, ?21 (?27,?15)% (t=7.2, P<0.0001); and iv) CPG5.0+3 (?4,+10)% (t=0.91, P=0.366). Conclusion The CPG ‘rule of thumb’ should be doubled to 5.0?nmol/l (2.0?ng/ml) per 100?IU per day, adopting a more risk-averse position.

McKenna, Malachi J; Murray, Barbara F

2013-01-01

105

Advanced imaging for detection and differentiation of colorectal neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.  

PubMed

This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the role of advanced endoscopic imaging for the detection and differentiation of colorectal neoplasia. Main recommendations 1 ESGE suggests the routine use of high definition white-light endoscopy systems for detecting colorectal neoplasia in average risk populations (weak recommendation, moderate quality evidence). 2 ESGE recommends the routine use of high definition systems and pancolonic conventional or virtual (narrow band imaging [NBI], i-SCAN) chromoendoscopy in patients with known or suspected Lynch syndrome (strong recommendation, low quality evidence). 2b ESGE recommends the routine use of high definition systems and pancolonic conventional or virtual (NBI) chromoendoscopy in patients with known or suspected serrated polyposis syndrome (strong recommendation, low quality evidence). 3 ESGE recommends the routine use of 0.1?% methylene blue or 0.1?%?-?0.5?% indigo carmine pancolonic chromoendoscopy with targeted biopsies for neoplasia surveillance in patients with long-standing colitis. In appropriately trained hands, in the situation of quiescent disease activity and adequate bowel preparation, nontargeted, four-quadrant biopsies can be abandoned (strong recommendation, high quality evidence). 4 ESGE suggests that virtual chromoendoscopy (NBI, FICE, i-SCAN) and conventional chromoendoscopy can be used, under strictly controlled conditions, for real-time optical diagnosis of diminutive (??5?mm) colorectal polyps to replace histopathological diagnosis. The optical diagnosis has to be reported using validated scales, must be adequately photodocumented, and can be performed only by experienced endoscopists who are adequately trained and audited (weak recommendation, high quality evidence). 5 ESGE suggests the use of conventional or virtual (NBI) magnified chromoendoscopy to predict the risk of invasive cancer and deep submucosal invasion in lesions such as those with a depressed component (0-IIc according to the Paris classification) or nongranular or mixed-type laterally spreading tumors (weak recommendation, moderate quality evidence). Conclusion Advanced imaging techniques will need to be applied in specific patient groups in routine clinical practice and to be taught in endoscopic training programs. PMID:24639382

Kami?ski, Micha? F; Hassan, Cesare; Bisschops, Raf; Pohl, Jürgen; Pellisé, Maria; Dekker, Evelien; Ignjatovic-Wilson, Ana; Hoffman, Arthur; Longcroft-Wheaton, Gaius; Heresbach, Denis; Dumonceau, Jean-Marc; East, James E

2014-05-01

106

Implementing the European guidelines for cardiovascular disease prevention in the primary care setting in Cyprus: Lessons learned from a health care services study  

Microsoft Academic Search

BACKGROUND: Recent guidelines recommend assessment and treatment of the overall risk for cardiovascular disease (CVD) through management of multiple risk factors in patients at high absolute risk. The aim of our study was to assess the level of cardiovascular risk in patients with known risk factors for CVD by applying the SCORE risk function and to study the implications of

Theodora Zachariadou; Henri EJH Stoffers; Costas A Christophi; Anastasios Philalithis; Christos Lionis

2008-01-01

107

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

108

Cardiological society of India practice guidelines for angiography in patients with renal dysfunction.  

PubMed

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

2012-12-01

109

A comment on the International Society of Geriatric Oncology guidelines: evidence-based advice for the clinical setting.  

PubMed

Largely a disease of older men, prostate cancer is likely to become a growing burden in the developed world as the population ages and overall life expectancy increases. Furthermore, prostate cancer management in older men is not optimal, reflecting the lack of training dedicated to senior adults in fellowship programs and the lack of specific guidelines to manage senior adults. The International Society of Geriatric Oncology (SIOG) convened a multidisciplinary Prostate Cancer Working Group to review the evidence base and provide advice on the management of the disease in senior age groups. The Working Group reported that advancing age, by itself, is not a reliable guide to treatment decision making for men with either localized or advanced prostate cancer. Instead, the SIOG guidelines advise health care teams to assess the patient's underlying health status, which is largely dictated by associated comorbid conditions, but also by dependency in activities of daily living and nutritional status, and to use the findings to categorize the individual into one of four groups: healthy, vulnerable, frail, or terminally ill. The guidelines recommend that a patient categorized as healthy or vulnerable (i.e., with reversible problems following geriatric intervention) should receive the same approach to treatment as a younger patient. Frail patients should be managed using adapted treatment strategies, and the terminally ill should receive symptomatic/palliative care only. The guidelines may have ongoing relevance as the treatment options for prostate cancer expand. PMID:23015683

Fitzpatrick, John M; Graefen, Markus; Payne, Heather A; Scotté, Florian; Aapro, Matti S

2012-01-01

110

International Society for Stem Cell Research (ISSCR) Guidelines for the Conduct of Human Embryonic Stem Cell Research (December 2006).  

PubMed

The International Society for Stem Cell Research (ISSCR) Guidelines for the Conduct of Human Embryonic Stem Cell Research, prepared by an international group of leading stem cell scientists, bioethicists and lawyers, build on the proposals previously drafted by agencies active in the conduct and funding of stem cell science. They aim not to duplicate existing codes of ethics in research with humans or animals, but to address special sensitivities about human embryo research and acquisition of ova, sperm, embryos and somatic tissues from often vulnerable or dependent donors. Guidelines concern the procurement of research materials, the derivation of stem cells, and banking , distribution and use of cells and cell lines derived from pre-implantation stages of human development. They categorize research that on ethical grounds requires special stem cell research oversight (SCRO), and indicate how that should be undertaken. They emphasize international collaboration in these activities, to maximize benefits to humanity. PMID:18592890

Dickens, Bernard M

2008-03-01

111

Optimal older adult emergency care: introducing multidisciplinary geriatric emergency department guidelines from the american college of emergency physicians, american geriatrics society, emergency nurses association, and society for academic emergency medicine.  

PubMed

In the United States and around the world, effective, efficient, and reliable strategies to provide emergency care to aging adults is challenging crowded emergency departments (EDs) and strained healthcare systems. In response, geriatric emergency medicine clinicians, educators, and researchers collaborated with the American College of Emergency Physicians, American Geriatrics Society, Emergency Nurses Association, and Society for Academic Emergency Medicine to develop guidelines intended to improve ED geriatric care by enhancing expertise, educational, and quality improvement expectations, equipment, policies, and protocols. These Geriatric Emergency Department Guidelines represent the first formal society-led attempt to characterize the essential attributes of the geriatric ED and received formal approval from the boards of directors of each of the four societies in 2013 and 2014. This article is intended to introduce emergency medicine and geriatric healthcare providers to the guidelines while providing recommendations for continued refinement of these proposals through educational dissemination, formal effectiveness evaluations, cost-effectiveness studies, and eventually institutional credentialing. PMID:24890806

Carpenter, Christopher R; Bromley, Marilyn; Caterino, Jeffrey M; Chun, Audrey; Gerson, Lowell W; Greenspan, Jason; Hwang, Ula; John, David P; Lyons, William L; Platts-Mills, Timothy F; Mortensen, Betty; Ragsdale, Luna; Rosenberg, Mark; Wilber, Scott

2014-07-01

112

Endoscopy and antiplatelet agents. European Society of Gastrointestinal Endoscopy (ESGE) Guideline.  

PubMed

With the increasing use of antiplatelet agents (APA), their management during the periendoscopic period has become a more common and more difficult problem. The increase in use is due to the availability of new drugs and the widespread use of drug-eluting coronary stents. Acute coronary syndromes can occur when APA therapy is withheld for noncardiovascular interventions. Guidelines about APA management during the periendoscopic period are traditionally based on assessments of the procedure-related risk of bleeding and the risk of thrombosis if APA are stopped. New data allow better assessment of these risks, of the necessary duration of APA discontinuation before endoscopy, of the use of alternative procedures (mostly for endoscopic retrograde cholangiopancreatography [ERCP]), and of endoscopic methods that can be used to prevent bleeding (following colonic polypectomy). This guideline makes graded, evidence-based, recommendations for the management of APA for all currently performed endoscopic procedures. A short summary and two tables are included for quick reference. PMID:21547880

Boustière, C; Veitch, A; Vanbiervliet, G; Bulois, P; Deprez, P; Laquiere, A; Laugier, R; Lesur, G; Mosler, P; Nalet, B; Napoleon, B; Rembacken, B; Ajzenberg, N; Collet, J P; Baron, T; Dumonceau, J-M

2011-05-01

113

European Society of Gastrointestinal Endoscopy (ESGE) guideline: the use of electrosurgical units.  

PubMed

Electrosurgery is used in the majority of endoscopic therapeutic procedures. An understanding of the fundamental electrosurgical principles and various settings available on electrosurgical units is essential for the safe and effective use of electrosurgery during endoscopy. The aims of these technical guidelines are to: (1) expose physical principles relevant to the understanding of electrosurgery during endoscopy; (2) describe and provide practical recommendations regarding electrosurgical units that are commonly in use; (3) discuss the clinical relevance of technologies recently implemented in newer electrosurgical units; and (4) review factors relevant to commonly performed therapeutic procedures, including polypectomy, sphincterotomy, contact thermal hemostasis, and argon plasma coagulation. PMID:20635311

Rey, J F; Beilenhoff, U; Neumann, C S; Dumonceau, J M

2010-09-01

114

Cancer screening in the United States, 2014: a review of current American Cancer Society guidelines and current issues in cancer screening.  

PubMed

Answer questions and earn CME/CNE Each year the American Cancer Society publishes a summary of its guidelines for early cancer detection, a report on data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, we summarize current American Cancer Society cancer screening guidelines. In addition, the latest data on the use of cancer screening from the National Health Interview Survey is described, as are several issues related to screening coverage under the Patient Protection and Affordable Care Act, including the expansion of the Medicaid program. PMID:24408568

Smith, Robert A; Manassaram-Baptiste, Deana; Brooks, Durado; Cokkinides, Vilma; Doroshenk, Mary; Saslow, Debbie; Wender, Richard C; Brawley, Otis W

2014-01-01

115

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.

2011-01-01

116

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

PubMed

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

2014-08-01

117

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.

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

118

Guidelines of the Italian Society for Virology on HPV testing and vaccination for cervical cancer prevention  

PubMed Central

Objective To provide guidelines for health-care providers on strategies for cervical cancer prevention based on HPV testing and anti-HPV vaccination. Outcomes Overall efficacy of different preventive strategies, assessing reduction in the incidence of invasive cervical cancer and precancerous lesions. Evidence Medline and the Cochrane Database were searched for articles in English on subjects related to HPVs, HPV diagnosis, HPV anogenital lesions, cervical cancer, HPV testing, and HPV vaccines, in order to elaborate an up-dated document. Relevant Italian Government publications and position papers from appropriate health and family planning organizations were also reviewed. Values The quality of the evidence and ranking of recommendations for practice were rated using criteria defined by SIV, which were adapted from the Canadian Task Force on Preventive Health Care.

Barzon, Luisa; Giorgi, Colomba; Buonaguro, Franco M; Palu, Giorgio

2008-01-01

119

American Society for Pain Management Nursing position statement with clinical practice guidelines: authorized agent controlled analgesia.  

PubMed

The American Society for Pain Management Nursing (ASPMN) has updated its 2007 position statement on the use of authorized agent controlled analgesia (AACA) for patients who are unable to independently utilize patient-controlled analgesia (PCA). ASPMN continues to support the use of AACA to provide timely and effective pain management while promoting equitable care for vulnerable patient populations who are unable to utilize PCA. ASPMN does not support the use of "PCA by Proxy" in which unauthorized individuals activate PCA for a patient. The background of the development of the position statement, definitions related to AACA, and application of ethical principles to the use of AACA are presented in the document. This position statement includes an updated review of the evidence related to AACA and a call for further research. Clinical practice recommendations for authorized agents, nurses, prescribers, and organizations are provided with an emphasis on the importance of appropriate authorized agent selection, education, diligent patient assessment and medication management. PMID:23972869

Cooney, Maureen F; Czarnecki, Michelle; Dunwoody, Colleen; Eksterowicz, Nancy; Merkel, Sandra; Oakes, Linda; Wuhrman, Elsa

2013-09-01

120

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: provides a colorectal cancer risk assessment tool to screen individuals in the office or endoscopy setting; illustrates a strategy for universal screening for Lynch syndrome by tumor testing of patients diagnosed with colorectal cancer; -6 provide algorithms for genetic evaluation of affected and at-risk family members of pedigrees with Lynch syndrome; provides guidelines for screening at-risk and affected persons with Lynch syndrome; and 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:25003300

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

121

Executive summary: 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

122

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

123

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 3-6 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:25043945

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

124

European Society of Cardiology and American College of Cardiology guidelines for redefinition of myocardial infarction: How to use existing assays clinically and for clinical trials  

Microsoft Academic Search

Background The European Society of Cardiology and American College of Cardiology guidelines for redefinition of myocardial infarction suggest that the cutoff value for diagnosis of acute myocardial infarction (AMI) be the 99th percentile of the reference population at a level measured with imprecision (coefficient of variation) ?10%. No current commercially available troponin assay meets this requirement. Accordingly, questions have been

Fred S. Apple; Alan H. B. Wu; Allan S. Jaffe

2002-01-01

125

[Diagnosis and conservative treatment of low back pain: review and guidelines of the Croatian Vertebrologic Society].  

PubMed

Low back pain (LBP) is a very common condition with high costs of patient care. Medical doctors of various specialties from Croatia have brought an up-to-date review and guidelines for diagnosis and conservative treatment of low back pain, which should result in the application of evidence-based care and eventually better outcomes. As LBP is a multifactorial disease, it is often not possible to identify which factors may be responsible for the onset of LBP and to what extent they aggravate the patient's symptoms. In the diagnostic algorithm, patient's history and clinical examination have the key role. Furthermore, most important is to classify patients into those with nonspecific back pain, LBP associated with radiculopathy (radicular syndrome) and LBP potentially associated with suspected or confirmed severe pathology. Not solely a physical problem, LBP should be considered through psychosocial factors too. In that case, early identification of patients who will develop chronic back pain will be helpful because it determines the choice of treatment. In order to make proper assessment of a patient with LBP (i.e. pain, function), we should use validated questionnaires. Useful approach to a patient with LBP is to apply the principles of content management. Generally, acute and chronic LBP cases are treated differently. Besides providing education, in patients with acute back pain, advice seems to be crucial (especially to remain active), along with the use of drugs (primarily in terms of pain control), while in some patients spinal manipulation (performed by educated professional) or/and short-term use of lumbosacral orthotic devices can also be considered. The main goal of treating patients with chronic LBP is renewal of function, even in case of persistent pain. For chronic LBP, along with education and medical treatment, therapeutic exercise, physical therapy and massage are recommended, while in patients with a high level of disability intensive multidisciplinary biopsychosocial approach has proved to be effective. PMID:23814971

Grazio, Simeon; Curkovi?, Bozidar; Vlak, Tonko; Kes, Vanja Basi?; Jeli?, Miroslav; Buljan, Danijel; Gnjidi?, Zoja; Nemci?, Tomislav; Grubisi?, Frane; Bori?, Igor; Kauzlari?, Neven; Mustapi?, Matej; Demarin, Vida

2012-10-01

126

The use of imaging for electrophysiological and devices procedures: a report from the first European Heart Rhythm Association Policy Conference, jointly organized with the European Association of Cardiovascular Imaging (EACVI), the Council of Cardiovascular Imaging and the European Society of Cardiac Radiology.  

PubMed

Implantations of cardiac devices therapies and ablation procedures frequently depend on accurate and reliable imaging modalities for pre-procedural assessments, intra-procedural guidance, detection of complications, and the follow-up of patients. An understanding of echocardiography, cardiovascular magnetic resonance imaging, nuclear cardiology, X-ray computed tomography, positron emission tomography, and vascular ultrasound is indispensable for cardiologists, electrophysiologists as well as radiologists, and it is currently recommended that physicians should be trained in several imaging modalities. There are, however, no current guidelines or recommendations by electrophysiologists, cardiac imaging specialists, and radiologists, on the appropriate use of cardiovascular imaging for selected patient indications, which needs to be addressed. A Policy Conference on the use of imaging in electrophysiology and device management, with representatives from different expert areas of radiology and electrophysiology and commercial developers of imaging and device technologies, was therefore jointly organized by European Heart Rhythm Association (EHRA), the Council of Cardiovascular Imaging and the European Society of Cardiac Radiology (ESCR). The objectives were to assess the state of the level of evidence and a first step towards a consensus document for currently employed imaging techniques to guide future clinical use, to elucidate the issue of reimbursement structures and health economy, and finally to define the need for appropriate educational programmes to ensure clinical competence for electrophysiologists, imaging specialists, and radiologists. PMID:23729412

Blomström Lundqvist, Carina; Auricchio, Angelo; Brugada, Josep; Boriani, Giuseppe; Bremerich, Jens; Cabrera, Jose Angel; Frank, Herbert; Gutberlet, Matthias; Heidbuchel, Hein; Kuck, Karl-Heinz; Lancellotti, Patrizio; Rademakers, Frank; Winkels, Gerard; Wolpert, Christian; Vardas, Panos E

2013-07-01

127

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.

2011-01-01

128

European Federation of Neurological Societies Peripheral Nerve Society guideline on management of paraproteinaemic demyelinating neuropathies: report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society  

Microsoft Academic Search

Background. Paraprotein-associated neuropathies have heterogeneous clinical, neurophysiological, neuropathological and haematological features. Objectives. To prepare evidence-based and consensus guidelines on the clinical management of patients with both a demyelinating neuropathy and a paraprotein (paraproteinaemic demyelinating neuropathy, PDN). Methods. Search of MEDLINE and the Cochrane library, review of evidence and consensus agreement of an expert panel. Recommendations. In the absence of adequate

R. D. M. Hadden; E. Nobile-Orazio; C. Sommer; A. Hahn; I. Illa; E. Morra; J. Pollard; R. A. C. Hughes; P. Bouche; D. Cornblath; E. Evers; C. L. Koski; J. M. Leger; P. Van den Bergh; P. van Doorn; Schaik van I. N

2006-01-01

129

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 ?140mm Hg systolic and ?90mm Hg diastolic. Similarly, it is our position that in diabetic patients with CKD and normal urinary albumin excretion, raising the threshold for treatment from <130mm?Hg systolic BP to <140mm 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 < 130/80mm Hg. Consistent with this, the CSN Work Group endorses a BP target of <130/80mm 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<140/90mm 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

130

[Treatment of arterial hypertension in pregnancy in relation to current guidelines of the Polish Society of Arterial Hypertension from 2011].  

PubMed

Arterial hypertension concerns 7-10% of pregnancies and leads to an increased risk of complications for both, the mother and the child. This rate will probably rise in the years to come due to the notable tendency among women to delay the decision to become pregnant - values of blood pressure and occurrence of arterial hypertension increase with age, as well as due to the growing problem of obesity resulting from inappropriate dietary habits and lack of regular everyday physical activity. Difficulties with management of that clinical condition are partly related with lack of unified and widely accepted guidelines. Different opinions in the subject of terminology and classification of pregnancy hypertension or indications for pharmacotherapy as well as choice of the optimal antihypertensive drug, emerge from objective causes such as combination of various pathogenetic factors typical for arterial hypertension itself and those connected with pregnancy elsewhere stressed priorities of therapy from the point of view of the health of the mother and of the fetus, as well as lack of randomized clinical trials due to obvious ethical purposes, but also from the fact that pregnancy hypertension is a focus of attention for different specialists - obstetricians, hypertensiologists and perinatologists. A good cooperation regarding experience and information among all of these specializations would be the most beneficial for pregnant women and their children. Lack of new modern antihypertensive agents, safe and effective in pregnancy while the older ones are being withdrawn from the market as their production is no longer cost-effective for pharmacological companies, has become an increasing problem in many countries, and Poland among them. The aim of the following publication was to present the statement on management of pregnancy hypertension from the current guidelines of the Polish Society of Arterial Hypertension 2011 to gynecologists and obstetricians, with a commentary According to the guidelines, methyldopa, labetalol (or metoprolol), long-acting nifedipine or verapamil should be used in the therapy of mild and moderate pregnancy hypertension, preferably in the given order In case of severe and life-threatening arterial hypertension, labetalol intravenously should be administered and if it is still not sufficient, eventually sodium nitroprusside or hydralazine could be ordered, bearing in mind their possible adverse effects. Unfortunately labetalol, nifedipine, hydralazine and sodium nitroprusside are no longer available in Poland, which significantly narrows the practical treatment possibilities in the pregnant population. Inhibitors of angiotensin converting enzyme and angiotensin II receptor blockers are contraindicated during pregnancy and breastfeeding, as well as aldosteron inhibitors, as suggest in the guidelines. In the paper the authors present the guidelines and also, based on the information available to date in medical journals, other hypertension pharmacotherapeutic options possible for consideration in pregnancy which could be helpful in management of severe arterial hypertension in pregnancy. PMID:23383565

Szczepaniak-Chiche?, Ludwina; Tykarski, Andrzej

2012-10-01

131

Guidelines for diabetic foot care: recommendations endorsed by the Diabetes Committee of the American Orthopaedic Foot and Ankle Society.  

PubMed

Foot infection is the most common reason for hospital admission of diabetic patients in the United States. Foot ulceration leads to deep infection, sepsis, and lower extremity amputation. Prophylactic foot care has been shown to decrease patient morbidity, decrease the utilization of expensive resources, and decrease the risk for amputation and premature death. The Diabetes Committee of the American Orthopaedic Foot and Ankle Society has developed guidelines for the implementation of this type of prophylactic foot care. The screening examination includes evaluation for peripheral neuropathy, skin integrity, ulcers or wounds, deformity, vascular insufficiency, and footwear. Foot-specific patient education includes instruction on self-examination and foot care practices. Individualized foot-specific patient education is indicated for patients with peripheral neuropathy. Treatment is outlined based on risk level, which is determined by the presence of peripheral neuropathy, deformity, and ulcer history. Treatment combines patient education, orthoses, footwear, and a timetable for ongoing skin and nail care. Ulcer care includes paring of calluses, debridement of infected or nonviable tissue, dressings, and off-loading. Specialty assistance may be required from a vascular surgeon, orthopaedic surgeon, podiatrist, endocrinologist/diabetologist, infectious disease consultant, radiologist, and pedorthist. PMID:15680122

Pinzur, Michael S; Slovenkai, Mark P; Trepman, Elly; Shields, Naomi N

2005-01-01

132

Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED)  

PubMed Central

Atrophic gastritis, intestinal metaplasia, and epithelial dysplasia of the stomach are common and are associated with an increased risk for gastric cancer. In the absence of guidelines, there is wide disparity in the management of patients with these premalignant conditions. The European Society of Gastrointestinal Endoscopy (ESGE), the European Helicobacter Study Group (EHSG), the European Society of Pathology (ESP) and the Sociedade Portuguesa de Endoscopia Digestiva (SPED) have therefore combined efforts to develop evidence-based guidelines on the management of patients with precancerous conditions and lesions of the stomach (termed MAPS). A multidisciplinary group of 63 experts from 24 countries developed these recommendations by means of repeat online voting and a meeting in June 2011 in Porto, Portugal. The recommendations emphasize the increased cancer risk in patients with gastric atrophy and metaplasia, and the need for adequate staging in the case of high grade dysplasia, and they focus on treatment and surveillance indications and methods.

Dinis-Ribeiro, M.; Areia, M.; de Vries, A. C.; Marcos-Pinto, R.; Monteiro-Soares, M.; O'Connor, A.; Pereira, C.; Pimentel-Nunes, P.; Correia, R.; Ensari, A.; Dumonceau, J. M.; Machado, J. C.; Macedo, G.; Malfertheiner, P.; Matysiak-Budnik, T.; Megraud, F.; Miki, K.; O'Morain, C.; Peek, R. M.; Ponchon, T.; Ristimaki, A.; Rembacken, B.; Carneiro, F.; Kuipers, E. J.

2012-01-01

133

Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED).  

PubMed

Atrophic gastritis, intestinal metaplasia, and epithelial dysplasia of the stomach are common and are associated with an increased risk for gastric cancer. In the absence of guidelines, there is wide disparity in the management of patients with these premalignant conditions. The European Society of Gastrointestinal Endoscopy (ESGE), the European Helicobacter Study Group (EHSG), the European Society of Pathology (ESP) and the Sociedade Portuguesa de Endoscopia Digestiva (SPED) have therefore combined efforts to develop evidence-based guidelines on the management of patients with precancerous conditions and lesions of the stomach (termed MAPS). A multidisciplinary group of 63 experts from 24 countries developed these recommendations by means of repeat online voting and a meeting in June 2011 in Porto, Portugal. The recommendations emphasize the increased cancer risk in patients with gastric atrophy and metaplasia, and the need for adequate staging in the case of high grade dysplasia, and they focus on treatment and surveillance indications and methods. PMID:22198778

Dinis-Ribeiro, M; Areia, M; de Vries, A C; Marcos-Pinto, R; Monteiro-Soares, M; O'Connor, A; Pereira, C; Pimentel-Nunes, P; Correia, R; Ensari, A; Dumonceau, J M; Machado, J C; Macedo, G; Malfertheiner, P; Matysiak-Budnik, T; Megraud, F; Miki, K; O'Morain, C; Peek, R M; Ponchon, T; Ristimaki, A; Rembacken, B; Carneiro, F; Kuipers, E J

2012-01-01

134

Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED).  

PubMed

Atrophic gastritis, intestinal metaplasia, and epithelial dysplasia of the stomach are common and are associated with an increased risk for gastric cancer. In the absence of guidelines, there is wide disparity in the management of patients with these premalignant conditions. The European Society of Gastrointestinal Endoscopy, the European Helicobacter Study Group, the European Society of Pathology, and the Sociedade Portuguesa de Endoscopia Digestiva have therefore combined efforts to develop evidence-based guidelines on the management of patients with precancerous conditions and lesions of the stomach. A multidisciplinary group of 63 experts from 24 countries developed these recommendations by means of repeat online voting and a meeting in June 2011 in Porto, Portugal. The recommendations emphasize the increased cancer risk in patients with gastric atrophy and metaplasia and the need for adequate staging in the case of high-grade dysplasia, and they focus on treatment and surveillance indications and methods. PMID:22190006

Dinis-Ribeiro, M; Areia, M; de Vries, A C; Marcos-Pinto, R; Monteiro-Soares, M; O'Connor, A; Pereira, C; Pimentel-Nunes, P; Correia, R; Ensari, A; Dumonceau, J M; Machado, J C; Macedo, G; Malfertheiner, P; Matysiak-Budnik, T; Megraud, F; Miki, K; O'Morain, C; Peek, R M; Ponchon, T; Ristimaki, A; Rembacken, B; Carneiro, F; Kuipers, E J

2012-01-01

135

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.

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

2010-01-01

136

Clinical practice guidelines for the diagnosis and management of osteoporosis. Scientific Advisory Board, Osteoporosis Society of Canada.  

PubMed Central

OBJECTIVE: To recommend clinical practice guidelines for the assessment of people at risk for osteoporosis, and for effective diagnosis and management of the condition. OPTIONS: Screening and diagnostic methods: risk-factor assessment, clinical evaluation, measurement of bone mineral density, laboratory investigations. Prophylactic and corrective therapies: calcium and vitamin D nutritional supplementation, physical activity and fall-avoidance techniques, ovarian hormone therapy, bisphosphonate drugs, other drug therapies. Pain-management medications and techniques. OUTCOMES: Prevention of loss of bone mineral density and fracture; increased bone mass; and improved quality of life. EVIDENCE: Epidemiologic and clinical studies and reports were examined, with emphasis on recent randomized controlled trials. Clinical practice in Canada and elsewhere was surveyed. Availability of treatment products and diagnostic equipment in Canada was considered. VALUES: Cost-effective methods and products that can be adopted across Canada were considered. A high value was given to accurate assessment of fracture risk and osteoporosis, and to increasing bone mineral density, reducing fractures and fracture risk and minimizing side effects of diagnosis and treatment. BENEFITS, HARMS AND COSTS: Proper diagnosis and management of osteoporosis minimize injury and disability, improve quality of life for patients and reduce costs to society. Rationally targeted methods of screening and diagnosis are safe and cost effective. Harmful side effects and costs of recommended therapies are minimal compared with the harms and costs of untreated osteoporosis. Alternative therapies provide a range of choices for physicians and patients. RECOMMENDATIONS: Population sets at high risk should be identified and then the diagnosis confirmed through bone densitometry. Dual-energy x-ray absorptiometry is the preferred measurement technique. Radiography can be adjunct when indicated. Calcium and vitamin D nutritional supplementation should be at currently recommended levels. Patients should be counselled in fall-avoidance techniques and exercises. Immobilization should be avoided. Guidelines for management of acute pain are listed. Ovarian hormone therapy is the therapy of choice for osteoporosis prevention and treatment in postmenopausal women. Bisphosphonates are an alternative therapy for women with established osteoporosis who cannot or prefer not to take ovarian hormone therapy.

1996-01-01

137

American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Performance of High-Dose-Rate Brachytherapy  

SciTech Connect

High-Dose-Rate (HDR) brachytherapy is a safe and efficacious treatment option for patients with a variety of different malignancies. Careful adherence to established standards has been shown to improve the likelihood of procedural success and reduce the incidence of treatment-related morbidity. A collaborative effort of the American College of Radiology (ACR) and American Society for Therapeutic Radiation Oncology (ASTRO) has produced a practice guideline for HDR brachytherapy. The guideline defines the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, physicist and dosimetrists. Review of the leading indications for HDR brachytherapy in the management of gynecologic, thoracic, gastrointestinal, breast, urologic, head and neck, and soft tissue tumors is presented. Logistics with respect to the brachytherapy implant procedures and attention to radiation safety procedures and documentation are presented. Adherence to these practice guidelines can be part of ensuring quality and safety in a successful HDR brachytherapy program.

Erickson, Beth A. [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Demanes, D. Jeffrey [Department of Radiation Oncology , University of California, Los Angeles, CA (United States); Ibbott, Geoffrey S. [Radiological Physics Center, MD Anderson Cancer Center, Houston, TX (United States); Hayes, John K. [Gamma West Brachytherapy, Salt Lake City, UT (United States); Hsu, I-Chow J. [Department of Radiation Oncology, University of California San Francisco, San Francisco, CA (United States); Morris, David E. [Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC (United States); Rabinovitch, Rachel A. [Department of Radiation Oncology, University of Colorado Denver, Aurora, CO (United States); Tward, Jonathan D. [Department of Radiation Oncology, Huntsman Cancer Institute, Salt Lake City, UT (United States); Rosenthal, Seth A. [Radiation Oncology Centers, Radiological Associates of Sacramento, Sacramento, CA (United States)

2011-03-01

138

American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Transperineal Permanent Brachytherapy of Prostate Cancer  

SciTech Connect

Transperineal permanent prostate brachytherapy is a safe and efficacious treatment option for patients with organ-confined prostate cancer. Careful adherence to established brachytherapy standards has been shown to improve the likelihood of procedural success and reduce the incidence of treatment-related morbidity. A collaborative effort of the American College of Radiology (ACR) and American Society for Therapeutic Radiation Oncology (ASTRO) has produced a practice guideline for permanent prostate brachytherapy. The guideline defines the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, physicist and dosimetrist. Factors with respect to patient selection and appropriate use of supplemental treatment modalities such as external beam radiation and androgen suppression therapy are discussed. Logistics with respect to the brachtherapy implant procedure, the importance of dosimetric parameters, and attention to radiation safety procedures and documentation are presented. Adherence to these practice guidelines can be part of ensuring quality and safety in a successful prostate brachytherapy program.

Rosenthal, Seth A., E-mail: rosenthals@radiological.co [Radiation Oncology Centers, Radiological Associates of Sacramento, Sacramento, CA (United States); Bittner, Nathan H.J. [Tacoma/Valley Radiation Oncology Centers, Tacoma, WA (United States); Beyer, David C. [Arizona Oncology Services, Scottsdale, AZ (United States); Demanes, D. Jeffrey [Department of Radiation Oncology, University of California, Los Angeles, CA (United States); Goldsmith, Brian J. [Radiation Oncology Centers, Radiological Associates of Sacramento, Sacramento, CA (United States); Horwitz, Eric M. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Ibbott, Geoffrey S. [Radiological Physics Center, MD Anderson Cancer Center, Houston, TX (United States); Lee, W. Robert [Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States); Nag, Subir [Department of Radiation Oncology, Kaiser Permanante, Santa Clara, CA (United States); Suh, W. Warren [Department of Radiation Oncology, Cancer Center of Santa Barbara, Santa Barbara, CA (United States); Potters, Louis [Department of Radiation Oncology, Long Island Jewish Medical Center, New Hyde Park, NY (United States)

2011-02-01

139

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

140

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

141

2005 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) of pediatric and neonatal patients: pediatric basic life support.  

PubMed

This publication presents the 2005 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) of the pediatric patient and the 2005 American Academy of Pediatrics/AHA guidelines for CPR and ECC of the neonate. The guidelines are based on the evidence evaluation from the 2005 International Consensus Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, hosted by the American Heart Association in Dallas, Texas, January 23-30, 2005. The "2005 AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" contain recommendations designed to improve survival from sudden cardiac arrest and acute life-threatening cardiopulmonary problems. The evidence evaluation process that was the basis for these guidelines was accomplished in collaboration with the International Liaison Committee on Resuscitation (ILCOR). The ILCOR process is described in more detail in the "International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations." The recommendations in the "2005 AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" confirm the safety and effectiveness of many approaches, acknowledge that other approaches may not be optimal, and recommend new treatments that have undergone evidence evaluation. These new recommendations do not imply that care involving the use of earlier guidelines is unsafe. In addition, it is important to note that these guidelines will not apply to all rescuers and all victims in all situations. The leader of a resuscitation attempt may need to adapt application of the guidelines to unique circumstances. The following are the major pediatric advanced life support changes in the 2005 guidelines: There is further caution about the use of endotracheal tubes. Laryngeal mask airways are acceptable when used by experienced providers. Cuffed endotracheal tubes may be used in infants (except newborns) and children in in-hospital settings provided that cuff inflation pressure is kept <20 cm H2O. Confirmation of tube placement requires clinical assessment and assessment of exhaled carbon dioxide (CO2); esophageal detector devices may be considered for use in children weighing >20 kg who have a perfusing rhythm. Correct placement must be verified when the tube is inserted, during transport, and whenever the patient is moved. During CPR with an advanced airway in place, rescuers will no longer perform "cycles" of CPR. Instead, the rescuer performing chest compressions will perform them continuously at a rate of 100/minute without pauses for ventilation. The rescuer providing ventilation will deliver 8 to 10 breaths per minute (1 breath approximately every 6-8 seconds). Timing of 1 shock, CPR, and drug administration during pulseless arrest has changed and now is identical to that for advanced cardiac life support. Routine use of high-dose epinephrine is not recommended. Lidocaine is de-emphasized, but it can be used for treatment of ventricular fibrillation/pulseless ventricular tachycardia if amiodarone is not available. Induced hypothermia (32-34 degrees C for 12-24 hours) may be considered if the child remains comatose after resuscitation. Indications for the use of inodilators are mentioned in the postresuscitation section. Termination of resuscitative efforts is discussed. It is noted that intact survival has been reported following prolonged resuscitation and absence of spontaneous circulation despite 2 doses of epinephrine. The following are the major neonatal resuscitation changes in the 2005 guidelines: Supplementary oxygen is recommended whenever positive-pressure ventilation is indicated for resuscitation; free-flow oxygen should be administered to infants who are breathing but have central cyanosis. Although the standard approach to resuscitation is to use 100% oxygen, it is reasonable to begin resuscitation with an oxygen conc

2006-05-01

142

Coronary artery calcium screening: current status and recommendations from the European Society of Cardiac Radiology and North American Society for Cardiovascular Imaging.  

PubMed

Current guidelines and literature on screening for coronary artery calcium for cardiac risk assessment are reviewed for both general and special populations. It is shown that for both general and special populations a zero score excludes most clinically relevant coronary artery disease. The importance of standardization of coronary artery calcium measurements by multidetector CT is discussed. PMID:18651153

Oudkerk, Matthijs; Stillman, Arthur E; Halliburton, Sandra S; Kalender, Willi A; Möhlenkamp, Stefan; McCollough, Cynthia H; Vliegenthart, Rozemarijn; Shaw, Leslee J; Stanford, William; Taylor, Allen J; van Ooijen, Peter M A; Wexler, Lewis; Raggi, Paolo

2008-12-01

143

Coronary artery calcium screening: current status and recommendations from the European Society of Cardiac Radiology and North American Society for Cardiovascular Imaging.  

PubMed

Current guidelines and literature on screening for coronary artery calcium for cardiac risk assessment are reviewed for both general and special populations. It is shown that for both general and special populations a zero score excludes most clinically relevant coronary artery disease. The importance of standardization of coronary artery calcium measurements by multi-detector CT is discussed. PMID:18504647

Oudkerk, Matthijs; Stillman, Arthur E; Halliburton, Sandra S; Kalender, Willi A; Möhlenkamp, Stefan; McCollough, Cynthia H; Vliegenthart, Rozemarijn; Shaw, Leslee J; Stanford, William; Taylor, Allen J; van Ooijen, Peter M A; Wexler, Lewis; Raggi, Paolo

2008-08-01

144

The guidelines issued by the European Society for Human Reproduction and Embryology and the American Society for Reproductive Medicine regarding the induction of ovulation with metformin in patients with the polycystic ovary syndrome potentially require reconsideration.  

PubMed

In 2007, the European Society for Human Reproduction and Embryology (ESHRE) and the American Society for Reproductive Medicine (ASRM) issued guidelines in Thessaloniki regarding the use of metformin and clomiphene for the induction of ovulation in patients with anovulatory polycystic ovary syndrome (PCOS). According to these guidelines, the use of metformin should be limited to patients with impaired glucose tolerance and should be interrupted well before the administration of clomiphene, thus restricting the use of metformin to a minority of patients with PCOS. More recent data suggest that these guidelines potentially require reconsideration. Indeed, metformin appears to be useful in patients with PCOS who have a body mass index within the normal range and present with infertility due to anovulation. Moreover, the combination of metformin with clomiphene appears to be the best treatment choice in patients with PCOS who are resistant to clomiphene, i.e. it should precede the administration of gonadotropins. In addition, the administration of metformin reduces the incidence and severity of ovarian hyperstimulation syndrome when given to patients with PCOS who undergo multiple ovulation induction for in vitro fertilization and have a high risk for this syndrome. However, it should be emphasized that more studies are needed to support the above arguments and, more importantly, to determine the factors that predict the success of ovulation induction. PMID:23933688

Panidis, Dimitrios; Tziomalos, Konstantinos; Papadakis, Efstathios; Kandaraki, Eleni A; Katsikis, Ilias

2013-01-01

145

The ACC/AHA 2013 guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: the good the bad and the uncertain: a comparison with ESC/EAS guidelines for the management of dyslipidaemias 2011.  

PubMed

Atherosclerotic cardiovascular disease is the most important public health problem of our time in both Europe and the rest of the world, accounting for the greatest expenditure in most healthcare budgets. Achieving consistency of clinical care, incorporating new evidence and their synthesis into practical recommendations for clinicians is the task of various guideline committees throughout the world. Any change in a set of guidelines therefore can have far reaching consequences, particularly if they appear to be at variance with the existing guidelines. The present article discusses the recent American College of Cardiology (ACC)/American Heart Association (AHA) guidelines 2013 on the control of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults. When compared with the ESC/EAS guidelines on lipid modification in 2011, the ACC/AHA guidelines of 2013 differ markedly. Specifically, (i) the scope is limited to randomized trials only, which excludes a significant body of data and promotes essentially a statin centric approach only; (ii) the abolition of low-density lipoprotein cholesterol (LDL-C) targets in favour of specific statin regimens that produce a 30-50% reduction in LDL-C we believe will confuse many physicians and miss the opportunity for medication adherence and patient engagement in self-management; (iii) the absence of target LDL-C levels in very high-risk patients with high absolute risk or residual risk factors will discourage clinicians to consider the addition of lipid modification treatments and individualize patient care; (iv) a reduction in the threshold for treatment in primary prevention will result in a greater number of patients being prescribed statin therapy, which is potentially good in young patients with high life time risk, but will result in a very large number of older patients offered therapy; and (v) the mixed pool risk calculator used to asses CVD risk in the guidelines for primary prevention has not been fully evaluated. This article discusses the potential implications of adopting the ACC/AHA guidelines on patient care in Europe and beyond and concludes with the opinion that the ESC/EAS guidelines from 2011 seem to be the most wide ranging, pragmatic and appropriate choice for European countries. PMID:24639424

Ray, Kausik K; Kastelein, John J P; Boekholdt, S Matthijs; Nicholls, Stephen J; Khaw, Kay-Tee; Ballantyne, Christie M; Catapano, Alberico L; Reiner, Željko; Lüscher, Thomas F

2014-04-01

146

Treatment planning methodology for the Miami Multichannel Applicator following the American Brachytherapy Society recently published guidelines: the Lahey Clinic experience.  

PubMed

The objective of this study was to develop a standardized procedure from simulation to treatment delivery for the multichannel Miami applicator, in order to increase planning consistency and reduce errors. A plan is generated prior to the 1st treatment using the CT images acquired with the applicator in place, and used for all 3 fractions. To confirm the application placement before each treatment fraction, an AP image is acquired and compared with the AP baseline image taken at simulation. A preplanning table is generated using the EBRT doses and is used to compute the maximum allowable D2cc for bladder, rectum, and sigmoid, and the mean allowable dose for the upper vaginal wall per HDR brachytherapy fraction. These data are used to establish the criteria for treatment planning dose optimization. A step-by-step treatment planning approach was developed to ensure appropriate coverage for the tumor (D90 > 100% prescribed dose of 700 cGy/fraction) and the uninvolved vaginal surface (dose for the entire treatment length > 600 cGy/fraction), while keeping the organs at risk below the tolerance doses. The equivalent dose 2 Gy (EQD2) tolerances for the critical structures are based on the American Brachytherapy Society (ABS) recently published guidelines. An independent second check is performed before the 1st treatment using an in-house Excel spreadsheet. This methodology was successfully applied for our first few cases. For these patients: the cumulative tumor dose was 74-79 EQD2 Gy10 (ABS recommended range 70-85); tumor D90 was >100% of prescribed dose (range 101%-105%); cumulative D2cc for bladder, rectum, and sigmoid were lower than the tolerances of 90, 75, and 75 EQD2 Gy3, respectively; cumulative upper vaginal wall mean dose was below the tolerance of 120 EQD2 Gy3; the second check agreement was within 5%. By using a standardized procedure the planning consistency was increased and all dosimetric criteria were met. PMID:23318396

Iftimia, Ileana; Cirino, Eileen T; Mower, Herbert W; McKee, Andrea B

2013-01-01

147

Guidelines for the prevention of infections associated with combat-related injuries: 2011 update: endorsed by the Infectious Diseases Society of America and the Surgical Infection Society.  

PubMed

Despite advances in resuscitation and surgical management of combat wounds, infection remains a concerning and potentially preventable complication of combat-related injuries. Interventions currently used to prevent these infections have not been either clearly defined or subjected to rigorous clinical trials. Current infection prevention measures and wound management practices are derived from retrospective review of wartime experiences, from civilian trauma data, and from in vitro and animal data. This update to the guidelines published in 2008 incorporates evidence that has become available since 2007. These guidelines focus on care provided within hours to days of injury, chiefly within the combat zone, to those combat-injured patients with open wounds or burns. New in this update are a consolidation of antimicrobial agent recommendations to a backbone of high-dose cefazolin with or without metronidazole for most postinjury indications, and recommendations for redosing of antimicrobial agents, for use of negative pressure wound therapy, and for oxygen supplementation in flight. PMID:21814089

Hospenthal, Duane R; Murray, Clinton K; Andersen, Romney C; Bell, R Bryan; Calhoun, Jason H; Cancio, Leopoldo C; Cho, John M; Chung, Kevin K; Clasper, Jon C; Colyer, Marcus H; Conger, Nicholas G; Costanzo, George P; Crouch, Helen K; Curry, Thomas K; D'Avignon, Laurie C; Dorlac, Warren C; Dunne, James R; Eastridge, Brian J; Ficke, James R; Fleming, Mark E; Forgione, Michael A; Green, Andrew D; Hale, Robert G; Hayes, David K; Holcomb, John B; Hsu, Joseph R; Kester, Kent E; Martin, Gregory J; Moores, Leon E; Obremskey, William T; Petersen, Kyle; Renz, Evan M; Saffle, Jeffrey R; Solomkin, Joseph S; Sutter, Deena E; Tribble, David R; Wenke, Joseph C; Whitman, Timothy J; Wiesen, Andrew R; Wortmann, Glenn W

2011-08-01

148

Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS)-part 1.  

PubMed

Guidelines are increasingly determining the decision process in day-to-day clinical work. Guidelines describe the current best possible standard in diagnostics and therapy. They should be developed by an international panel of experts, whereby alongside individual experience, above all, the results of comparative studies are decisive. According to the results of high-ranking scientific studies published in peer-reviewed journals, statements and recommendations are formulated, and these are graded strictly according to the criteria of evidence-based medicine. Guidelines can therefore be valuable in helping particularly the young surgeon in his or her day-to-day work to find the best decision for the patient when confronted with a wide and confusing range of options. However, even experienced surgeons benefit because by virtue of a heavy workload and commitment, they often find it difficult to keep up with the ever-increasing published literature. All guidelines require regular updating, usually every 3 years, in line with progress in the field. The current Guidelines focus on technique and perioperative management of laparoscopic ventral hernia repair and constitute the first comprehensive guidelines on this topic. In this issue of Surgical Endoscopy, the first part of the Guidelines is published including sections on basics, indication for surgery, perioperative management, and key points of technique. The next part (Part 2) of the Guidelines will address complications and comparisons between open and laparoscopic techniques. Part 3 will cover mesh technology, hernia prophylaxis, technique-related issues, new technologic developments, lumbar and other unusual hernias, and training/education. PMID:24114513

Bittner, R; Bingener-Casey, J; Dietz, U; Fabian, M; Ferzli, G S; Fortelny, R H; Köckerling, F; Kukleta, J; Leblanc, K; Lomanto, D; Misra, M C; Bansal, V K; Morales-Conde, S; Ramshaw, B; Reinpold, W; Rim, S; Rohr, M; Schrittwieser, R; Simon, Th; Smietanski, M; Stechemesser, B; Timoney, M; Chowbey, P

2014-01-01

149

Evidence-based guidelines for treatment of cervical cancer in Japan: Japan Society of Gynecologic Oncology (JSGO) 2007 edition  

Microsoft Academic Search

Clinical practice guidelines for gynecologic cancers have been published by the National Comprehensive Cancer Network and\\u000a the National Cancer Institute. Whereas these guidelines form the basis for the standard of care for gynecologic malignancies\\u000a in the United States, it has proven difficult to institute them in Japan due to differences in patient characteristics, health-care\\u000a delivery systems, and insurance programs. Therefore,

Satoru Nagase; Yoshiki Inoue; Naohiko Umesaki; Daisuke Aoki; Masatsugu Ueda; Hideki Sakamoto; Shigemitsu Kobayashi; Ryo Kitagawa; Takafumi Toita; Shoji Nagao; Kiyoshi Hasegawa; Ichio Fukasawa; Keiichi Fujiwara; Yoh Watanabe; Kiyoshi Ito; Hitoshi Niikura; Tsuyoshi Iwasaka; Kazunori Ochiai; Hidetaka Katabuchi; Toshiharu Kamura; Ikuo Konishi; Noriaki Sakuragi; Tadao Tanaka; Yasuo Hirai; Yuji Hiramatsu; Makio Mukai; Hiroyuki Yoshikawa; Tadao Takano; Kosuke Yoshinaga; Takeo Otsuki; Michiko Sakuma; Noriyuki Inaba; Yasuhiro Udagawa; Nobuo Yaegashi

2010-01-01

150

Learning, techniques, and complications of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline.  

PubMed

This article is the second of a two-part publication that expresses the current view of the European Society of Gastrointestinal Endoscopy (ESGE) about endoscopic ultrasound (EUS)-guided sampling, including EUS-guided fine needle aspiration (EUS-FNA) and EUS-guided Trucut biopsy. The first part (the Clinical Guideline) focused on the results obtained with EUS-guided sampling, and the role of this technique in patient management, and made recommendations on circumstances that warrant its use. The current Technical Guideline discusses issues related to learning, techniques, and complications of EUS-guided sampling, and to processing of specimens. Technical issues related to maximizing the diagnostic yield (e.g., rapid on-site cytopathological evaluation, needle diameter, microcore isolation for histopathological examination, and adequate number of needle passes) are discussed and recommendations are made for various settings, including solid and cystic pancreatic lesions, submucosal tumors, and lymph nodes. The target readership for the Clinical Guideline mostly includes gastroenterologists, oncologists, internists, and surgeons while the Technical Guideline should be most useful to endoscopists who perform EUS-guided sampling. A two-page executive summary of evidence statements and recommendations is provided. PMID:22180307

Polkowski, M; Larghi, A; Weynand, B; Boustière, C; Giovannini, M; Pujol, B; Dumonceau, J-M

2012-02-01

151

Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.  

PubMed

This article is part of a combined publication that expresses the current view of the European Society of Gastrointestinal Endoscopy (ESGE) about endoscopic ultrasound (EUS)-guided sampling in gastroenterology, including EUS-guided fine needle aspiration (EUS-FNA) and EUS-guided trucut biopsy (EUS-TCB), of submucosal tumors, diffuse esophageal/gastric wall thickening, pancreatic solid masses and cystic-appearing lesions, mediastinal lesions unrelated to lung or esophageal cancer, cancer of the esophagus, stomach, and rectum, lymph nodes of unknown origin, adrenal gland masses, and focal liver lesions. False-positive cytopathological results and needle tract seeding are also discussed. The present Clinical Guideline describes the results of EUS-guided sampling in the different clinical settings, considers the role of this technique in patient management, and makes recommendations on circumstances that warrant its use. A two-page executive summary of evidence statements and recommendations is provided. A separate Technical Guideline describes the general technique of EUS-guided sampling, particular techniques to maximize the diagnostic yield depending on the nature of the target lesion, and sample processing. The target readership for the Clinical Guideline mostly includes gastroenterologists, oncologists, internists, and surgeons while the Technical Guideline should be most useful to endoscopists who perform EUS-guided sampling. PMID:21842456

Dumonceau, J-M; Polkowski, M; Larghi, A; Vilmann, P; Giovannini, M; Frossard, J-L; Heresbach, D; Pujol, B; Fernández-Esparrach, G; Vazquez-Sequeiros, E; Ginès, A

2011-10-01

152

Quality of cardiovascular disease care in Ontario's primary care practices: a cross sectional study examining differences in guideline adherence by patient sex  

PubMed Central

Background Women are disproportionately affected by cardiovascular disease, often experiencing poorer outcomes following a cardiovascular event. Evidence points to inequities in processes of care as a potential contributing factor. This study sought to determine whether any sex differences exist in adherence to process of care guidelines for cardiovascular disease within primary care practices in Ontario, Canada. Methods This is a secondary analysis of pooled cross-sectional baseline data collected through a larger quality improvement initiative known as the Improved Delivery of Cardiovascular Care (IDOCC). Chart abstraction was performed for 4,931 patients from 84 primary care practices in Eastern Ontario who had, or were at high risk of, cardiovascular disease. Measures examining adherence to guidelines associated with nine areas of cardiovascular care (coronary artery disease, peripheral vascular disease (PVD), stroke/transient ischemic attack, chronic kidney disease, diabetes, dyslipidemia, hypertension, smoking cessation, and weight management) were collected. Multivariable logistic regression analysis was performed to evaluate sex differences, adjusting for age, physician remuneration, and rurality. Results Women were significantly less likely to have their lipid profiles taken (OR?=?1.17, 95% CI 1.03-1.33), be prescribed lipid lowering medication for dyslipidemia (OR?=?1.54, 95% CI 1.20-1.97), and to be prescribed ASA following stroke (OR?=?1.56, 95% CI 1.39-1.75). Women with PVD were significantly less likely to be prescribed ACE inhibitors and/or angiotensin receptor blockers (OR?=?1.74, 95% CI 1.25-2.41) and lipid lowering medications (OR?=?1.95, 95% CI 1.46-2.62) or ASA (OR?=?1.59, 95% CI 1.43-1.78). However, women were more likely to have two blood pressure measurements taken and to be referred to a dietician or weight loss program. Male patients with diabetes were less likely to be prescribed glycemic control medication (OR?=?0.84, 95% CI 0.74-0.86). Conclusions Sex disparities exist in the quality of cardiovascular care in Canadian primary care practices, which tend to favour men. Women with PVD have a particularly high risk of not receiving appropriate medications. Our findings indicate that improvements in care delivery should be made to address these issues, particularly with regard to the prescribing of recommended medications for women, and preventive measures for men.

2014-01-01

153

[Strategies for improving blood pressure control in Italy: from global cardiovascular risk stratification to combination therapy. 2012 Position paper of the Italian Society of Hypertension].  

PubMed

Observational studies demonstrate that the proportion of treated hypertensive patients who attain the recommended blood pressure goals (140/90 mmHg) does not exceed 30-40%. Conversely, clinical trials have consistently shown that effective blood pressure control within the recommended targets can be achieved in 70-80% of treated hypertensive patients with different cardiovascular risk profile, especially when appropriate, effective and well tolerated combination therapies are used. In order to bridge the gap between current and optimal blood pressure control rates and to achieve a more effective cardiovascular prevention, the Italian Society of Hypertension has recently developed an interventional strategy that aims to approximate 70% of treated controlled patients by 2015. This ambitious goal can be realistically achieved by the appropriate use of modern aids and tools, also including the implementation of combination therapy, especially if this approach can be simplified into a single pill, now available in Italy. At present, 70-80% of hypertensive patients require combination therapies based on at least two classes of antihypertensive drugs to achieve the recommended blood pressure goals. It is therefore of paramount importance to implement this strategy in routine clinical practice. Among the different combination therapies, the use of combination strategies based on drugs inhibiting the renin-angiotensin system, such as angiotensin receptor blockers and angiotensin-converting enzyme inhibitors, combined with diuretics and/or calcium-channel blockers, have demonstrated to significantly reduce the rates of major cardiovascular events and discontinuations from prescribed therapies, resulting in higher antihypertensive efficacy and better tolerability than monotherapy. The present document of the Italian Society of Hypertension aims to provide main indications for implementing combination therapy in the clinical management of hypertension in order to improve blood pressure control in Italy. PMID:23196689

Volpe, Massimo; Ambrosioni, Ettore; Borghi, Claudio; Cottone, Santina; Cuspidi, Cesare; De Luca, Nicola; Fallo, Francesco; Ferri, Claudio; Morganti, Alberto; Muiesan, Maria Lorenza; Sarzani, Riccardo; Sechi, Leonardo; Virdis, Agostino; Tocci, Giuliano; Agabiti-Rosei, Enrico; Trimarco, Bruno; Filippi, Alessandro; Mancia, Giuseppe

2012-12-01

154

2012 consensus document of the Italian Society of Hypertension (SIIA): strategies to improve blood pressure control in Italy: from global cardiovascular risk stratification to combination therapy.  

PubMed

Observational clinical studies have demonstrated that only 30-40% of patients with arterial hypertension achieve the recommended blood pressure goals (below 140/90 mmHg). In contrast, interventional trials consistently showed that it is possible to achieve effective blood pressure targets in about 70% of treated hypertensive patients with different cardiovascular risk profiles, especially through the use of rational, effective and well tolerated combination therapies. In order to bridge the gap between current and desired blood pressure control and to achieve more effective prevention of cardiovascular diseases, the Italian Society of Hypertension (SIIA) has developed an interventional strategy aimed at reaching nearly 70% of treated controlled hypertensive patients by 2015. This ambitious goal can be realistically achieved by a more rational use of modern tools and supports, and also through the use of combination therapy in hypertension in daily clinical practice, especially if this approach can be simplified into a single pill (fixed combination therapy), which is a therapeutic option now also available in Italy. Since about 70-80% of treated hypertensive patients require a combination therapy based on at least two classes of drugs in order to achieve the recommended blood pressure goals, it is of key importance to implement this strategy in routine clinical practice. Amongst the various combination therapies currently available for hypertension treatment and control, the use of those strategies based on drugs that antagonize the renin-angiotensin system, such as angiotensin II type 1 receptor antagonists (angiotensin receptor blockers) and ACE inhibitors, in combination with diuretics and/or calcium channel blockers, has been shown to significantly reduce the risk of major cardiovascular events and to improve patient compliance to treatment, resulting in a greater antihypertensive efficacy and better tolerability compared with monotherapy. The present document of the Italian Society of Arterial Hypertension (SIIA) aims to gather the main indications for the implementation of combination therapy in the treatment of hypertension, in order to improve blood pressure control in Italy. PMID:23536324

Volpe, Massimo; Rosei, Enrico Agabiti; Ambrosioni, Ettore; Cottone, Santina; Cuspidi, Cesare; Borghi, Claudio; De Luca, Nicola; Fallo, Francesco; Ferri, Claudio; Morganti, Alberto; Muiesan, Maria Lorenza; Sarzani, Riccardo; Sechi, Leonardo; Virdis, Agostino; Tocci, Giuliano; Trimarco, Bruno; Filippi, Alessandro; Mancia, Giuseppe

2013-03-01

155

Social-Strata-Related Cardiovascular Health Disparity and Comorbidity in an Aging Society: Implications for Professional Care  

ERIC Educational Resources Information Center

Cardiovascular disease (CVD) is on the rise in the aging population of the United States. Heart disease is the leading cause of death, hospital bed use, and social security disability. Enhancing knowledge about CVD may improve social work's professional role in the health care system. This article focuses on a pressing CVD-related issue that needs…

Ai, Amy L.; Carrigan, Lynn T.

2007-01-01

156

Implementing the European guidelines for cardiovascular disease prevention in the primary care setting in Cyprus: Lessons learned from a health care services study  

PubMed Central

Background Recent guidelines recommend assessment and treatment of the overall risk for cardiovascular disease (CVD) through management of multiple risk factors in patients at high absolute risk. The aim of our study was to assess the level of cardiovascular risk in patients with known risk factors for CVD by applying the SCORE risk function and to study the implications of European guidelines on the use of treatment and goal attainment for blood pressure (BP) and lipids in the primary care of Cyprus. Methods Retrospective chart review of 1101 randomly selected patients with type 2 diabetes mellitus (DM2), or hypertension or hyperlipidemia in four primary care health centres. The SCORE risk function for high-risk regions was used to calculate 10-year risk of cardiovascular fatal event. Most recent values of BP and lipids were used to assess goal attainment to international standards. Most updated medications lists were used to compare proportions of current with recommended antihypertensive and lipid-lowering drug (LLD) users according to European guidelines. Results Implementation of the SCORE risk model labelled overall 39.7% (53.6% of men, 31.3% of women) of the study population as high risk individuals (CVD, DM2 or SCORE ?5%). The SCORE risk chart was not applicable in 563 patients (51.1%) due to missing data in the patient records, mostly on smoking habits. The LDL-C goal was achieved in 28.6%, 19.5% and 20.9% of patients with established CVD, DM2 (no CVD) and SCORE ?5%, respectively. BP targets were achieved in 55.4%, 5.6% and 41.9% respectively for the above groups. There was under prescription of antihypertensive drugs, LLD and aspirin for all three high risk groups. Conclusion This study demonstrated suboptimal control and under-treatment of patients with cardiovascular risk factors in the primary care in Cyprus. Improvement of documentation of clinical information in the medical records as well as GPs training for implementation and adherence to clinical practice guidelines are potential areas for further discussion and research.

Zachariadou, Theodora; Stoffers, Henri EJH; Christophi, Costas A; Philalithis, Anastasios; Lionis, Christos

2008-01-01

157

Guidelines and protocols for cardiovascular magnetic resonance in children and adults with congenital heart disease: SCMR expert consensus group on congenital heart disease  

PubMed Central

Cardiovascular magnetic resonance (CMR) has taken on an increasingly important role in the diagnostic evaluation and pre-procedural planning for patients with congenital heart disease. This article provides guidelines for the performance of CMR in children and adults with congenital heart disease. The first portion addresses preparation for the examination and safety issues, the second describes the primary techniques used in an examination, and the third provides disease-specific protocols. Variations in practice are highlighted and expert consensus recommendations are provided. Indications and appropriate use criteria for CMR examination are not specifically addressed.

2013-01-01

158

Occupational Radiation Protection in Interventional Radiology: A Joint Guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology.  

National Technical Information Service (NTIS)

Fluoroscopically guided interventional procedures are performed in large numbers in Europe and in the United States. The number of procedures performed annually throughout the world has increased over the past 20 years. The benefits of interventional radi...

D. L. Miller E. Vano G. Bartal R. Dixon S. Balter

2010-01-01

159

Recommendations for the use of genetic testing in the clinical evaluation of inherited cardiac arrhythmias associated with sudden cardiac death: Canadian Cardiovascular Society/Canadian Heart Rhythm Society joint position paper.  

PubMed

The era of gene discovery and molecular medicine has had a significant impact on clinical practice. Knowledge of specific genetic findings causative for or associated with human disease may enhance diagnostic accuracy and influence treatment decisions. In cardiovascular disease, gene discovery for inherited arrhythmia syndromes has advanced most rapidly. The arrhythmia specialist is often confronted with the challenge of diagnosing and managing genetic arrhythmia syndromes. There is now a clear need for guidelines on the appropriate use of genetic testing for the most common genetic conditions associated with a risk of sudden cardiac death. This document represents the first ever published recommendations outlining the role of genetic testing in various clinical scenarios, the specific genes to be considered for testing, and the utility of test results in the management of patients and their families. PMID:21459272

Gollob, Michael H; Blier, Louis; Brugada, Ramon; Champagne, Jean; Chauhan, Vijay; Connors, Sean; Gardner, Martin; Green, Martin S; Gow, Robert; Hamilton, Robert; Harris, Louise; Healey, Jeff S; Hodgkinson, Kathleen; Honeywell, Christina; Kantoch, Michael; Kirsh, Joel; Krahn, Andrew; Mullen, Michelle; Parkash, Ratika; Redfearn, Damian; Rutberg, Julie; Sanatani, Shubhayan; Woo, Anna

2011-01-01

160

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.

Casabianca, Andrew B; Becker, Daniel E

2009-01-01

161

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

162

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

163

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

164

Rationale and design of the Kanyini guidelines adherence with the polypill (Kanyini-GAP) study: a randomised controlled trial of a polypill-based strategy amongst Indigenous and non Indigenous people at high cardiovascular risk  

Microsoft Academic Search

BACKGROUND: The Kanyini Guidelines Adherence with the Polypill (Kanyini-GAP) Study aims to examine whether a polypill-based strategy (using a single capsule containing aspirin, a statin and two blood pressure-lowering agents) amongst Indigenous and non-Indigenous people at high risk of experiencing a cardiovascular event will improve adherence to guideline-indicated therapies, and lower blood pressure and cholesterol levels. METHODS\\/DESIGN: The study is

Hueiming Liu; Anushka Patel; Alex Brown; Sandra Eades; Noel Hayman; Stephen Jan; Ian Ring; Greg Stewart; Andrew Tonkin; Tarun Weeramanthri; Vicki Wade; Anthony Rodgers; Tim Usherwood; Bruce Neal; David Peiris; Hugh Burke; Christopher Reid; Alan Cass

2010-01-01

165

Cardiovascular disease risk factor assessment and management in gout: an analysis using guideline-based electronic clinical decision support  

Microsoft Academic Search

Aim To assess the need for cardiovascular disease (CVD) risk management in patients with gout. Methods We studied 100 consecutive patients referred to the rheumatology service for management of gout. CVD risk factor and management data were collected. PREDICT ™ CVD decision support software was used to calculate Framingham 5- year CVD risk, and to analyse therapeutic targets. Results Fifty-nine

Keith Colvine; Andrew J Kerr; Andrew McLachlan; Peter Gow; Sunil Kumar; Jason Ly; Chris Wiltshire; Elizabeth Robinson; Nicola Dalbeth

166

Are the American Society for Radiation Oncology Guidelines Accurate Predictors of Recurrence in Early Stage Breast Cancer Patients Treated with Balloon-Based Brachytherapy?  

PubMed Central

The American Society for Radiation Oncology (ASTRO) consensus statement (CS) provides guidelines for patient selection for accelerated partial breast irradiation (APBI) following breast conserving surgery. The purpose of this study was to evaluate recurrence rates based on ASTRO CS groupings. A single institution review of 238 early stage breast cancer patients treated with balloon-based APBI via balloon based brachytherapy demonstrated a 4-year actuarial ipsilateral breast tumor recurrence (IBTR) rate of 5.1%. There were no significant differences in the 4-year actuarial IBTR rates between the “suitable,” “cautionary,” and “unsuitable” ASTRO categories (0%, 7.2%, and 4.3%, resp., P = 0.28). ER negative tumors had higher rates of IBTR than ER positive tumors. The ASTRO groupings are poor predictors of patient outcomes. Further studies evaluating individual clinicopathologic features are needed to determine the safety of APBI in higher risk patients.

Christoudias, Moira K.; Collett, Abigail E.; Stull, Tari S.; Gracely, Edward J.; Frazier, Thomas G.; Barrio, Andrea V.

2013-01-01

167

Guidelines on the safety of light-based home-use hair removal devices from the European Society for Laser Dermatology.  

PubMed

In the past 5 years since their US introduction, there has been a rapid proliferation of light-based hair removal devices intended for home-use. In the last 2 years in Europe, sales already run into many tens of thousands of units with well-known multi-national companies entering the market. These guidelines provide a definition of light-based home-use technology, to inform healthcare professionals about home-use light-based technology and encourage manufacturers wishing to sell in Europe to adopt 'best practice'. The review presents the current status on standards and regulation issues and considers home-use safety issues, encompassing human, device and electrical safety, given risks to the eyes and skin from optical radiation both to the consumer and persons in the vicinity. Proposed technical measurement methodology is considered with focus on recognized critical parameters for the safe use of light-based hair removal technology including recording the technical performance and safety claims of a range of home-use hair removal devices. The literature review emphasizes potential adverse incidents and safety aspects of treating cosmetic conditions, such as unwanted hair growth. Although some regulations exist, they differ from region to region and there is a specific need for international common principles and guidelines relating to the manufacture, marketing and use of intense pulsed light and laser devices, including manufacturing standards for home-use products intended, amongst others, for cosmetic hair removal and photo-rejuvenation procedures. In these guidelines, the European Society for Laser Dermatology (ESLD) provides a professional view of what 'best practice' may imply for manufacturers and consumers alike. PMID:22211702

Town, G; Ash, C; Dierickx, C; Fritz, K; Bjerring, P; Haedersdal, M

2012-07-01

168

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.

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

169

A controversial step forward: a commentary on the 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults  

PubMed Central

The 2013 ACC/AHA guidelines on the treatment of blood cholesterol in adults is a major step forward in the field of preventive cardiology but it is not without controversy. It should be well accepted that in individuals with established atherosclerotic vascular disease, individuals with a low-density lipoprotein cholesterol of greater than 190 mg/dl and individuals with diabetes, treatment with an appropriate fixed dose of a statin, without titration to a specific low-density lipoprotein goal, will provide substantial protection against future atherosclerotic vascular disease events. More controversial is the utilization of a risk calculator in primary care to determine which individuals will require a statin. For as long as these risk calculators are in question, primary care practitioners will struggle to make treatment decisions. Factors such as cardiovascular fitness, measures of adiposity, and details of the family history will aid in treatment decisions.

Ades, Philip A.

2014-01-01

170

A controversial step forward: a commentary on the 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults.  

PubMed

The 2013 ACC/AHA guidelines on the treatment of blood cholesterol in adults is a major step forward in the field of preventive cardiology but it is not without controversy. It should be well accepted that in individuals with established atherosclerotic vascular disease, individuals with a low-density lipoprotein cholesterol of greater than 190 mg/dl and individuals with diabetes, treatment with an appropriate fixed dose of a statin, without titration to a specific low-density lipoprotein goal, will provide substantial protection against future atherosclerotic vascular disease events. More controversial is the utilization of a risk calculator in primary care to determine which individuals will require a statin. For as long as these risk calculators are in question, primary care practitioners will struggle to make treatment decisions. Factors such as cardiovascular fitness, measures of adiposity, and details of the family history will aid in treatment decisions. PMID:24518291

Ades, Philip A

2014-06-01

171

Systematizing Inpatient Referral to Cardiac Rehabilitation 2010: Canadian association of cardiac rehabilitation and Canadian cardiovascular society joint position paper.  

PubMed

Despite recommendations in clinical practice guidelines, evidence suggests cardiac rehabilitation (CR) referral and use following indicated cardiac events is low. Referral strategies such as systematic referral have been advocated to improve CR use. The objective of this policy position is to synthesize evidence and make recommendations on strategies to increase patient enrollment in CR. A systematic review of 6 databases from inception to January 2009 was conducted. Only primary, published, English-language studies were included. A meta-analysis was undertaken to synthesize the enrollment rates by referral strategy. In all, 14 studies met inclusion criteria. Referral strategies were categorized as systematic on the basis of use of systematic discharge order sets, as liaison on the basis of discussions with allied health care providers, or as other on the basis of patient letters. Overall, there were 7 positive studies, 5 without comparison groups, and 2 studies that reported null findings. The combined effect sizes of the meta-analysis were as follows: 73% (95% CI, 39%-92%) for the patient letters ("other"), 66% (95% CI, 54%-77%) for the combined systematic and liaison strategy, 45% (95% CI, 33%-57%) for the systematic strategy alone, and 44% (95% CI, 35%-53%) for the liaison strategy alone. In conclusion, the results suggest that innovative referral strategies increase CR use. Although patient letters look promising, evidence for this strategy is sparse and inconsistent at present. Therefore we suggest that inpatient units adopt systematic referral strategies, including a discussion at the bedside, for eligible patient groups in order to increase CR enrollment and participation. This approach should be considered best practice for further investigation. PMID:21460733

Grace, Sherry L; Chessex, Caroline; Arthur, Heather; Chan, Sammy; Cyr, Cleo; Dafoe, William; Juneau, Martin; Oh, Paul; Suskin, Neville

2011-01-01

172

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.

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

173

Quality Evaluation Guidelines as a Means of Renewal and Revitalisation of Services by Voluntary Associations. Report of an International League of Societies for Persons with Mental Handicap (ILSMH) Seminar (London, England, United Kingdom, April 1986).  

ERIC Educational Resources Information Center

These guidelines for service evaluation arose out of a 1986 meeting of the International League of Societies for Persons with Mental Handicap. An introduction focuses on the concepts of support and service and the need for minimizing restrictiveness and empowering the individual. Seven principles are enumerated, specifying the rights of people…

International League of Societies for Persons with Mental Handicaps, Brussels (Belgium).

174

Duplex Doppler ultrasound examination of carotid and vertebral arteries: guidelines of the Polish Society for Vascular Surgery.  

PubMed

The duplex Doppler examination of carotid and vertebral arteries is the primary diagnostic method in detecting disorders leading to the brain blood supply disturbances. In many cases, in patients with carotid artery stenosis, the Doppler ultrasound plays a major role in the process of qualification to the reconstructive procedures. Regardless of the widespread availability and high sensitivity and specificity of this method it's burdened with serious drawbacks. The most important of them are evaluation subjectivity and variety of methods to assess stenosis degree and the nature of atherosclerotic plaques. They often cause difficulties in comparing the test results carried out in different centers and to find correlations with other imaging methods results. In order to overcome these drawbacks, Polish Society for Vascular Surgery has attempted to develop recommendations for uniform methodology of carotid and vertebral arteries Doppler examination. Legal terms, the manner of examination and its interpretation were presented. Proposing the way of highlights results and messages conclusion to enable the recommendationsimplementation of endovascular and surgical qualifications relating to surgical treatment. We hope that these recommendations will help to standardize examination techniques. PMID:24677046

Madycki, Grzegorz; Gabriel, Marcin; Hawro, Piotr; Pawlaczyk, Katarzyna; Kuczmik, Wac?aw; Urbanek, Tomasz

2014-01-01

175

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.

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

176

[Risk and crisis management by anesthesiologists regarding 'Guidelines for Actions Against Intraoperative Critical Hemorrhage' published by the Japanese Society of Anesthesiologists and the Japan Society of Transfusion Medicine and Cell Therapy].  

PubMed

According to a survey of anesthesia-related critical incidents by the Japanese Society of Anesthesiologists, hemorrhage was the major cause of cardiac arrest developing in the operating room. To deal with critical hemorrhage swiftly, not only cooperation between anesthesiologists and surgeons but also the linkage of operating rooms with transfusion management divisions and the blood center is important. It is desirable for the hospital transfusion committee to prepare hospital regulations on 'actions to be taken to manage critical hemorrhage', and practice the implementation of these guidelines by simulated drills. When critical hemorrhage occurs, a person in charge is appointed, and an emergency is declared (call for manpower and notification of the emergency to the transfusion management divisions). A person in charge comprehensively assesses the hemostatic condition, hemodynamics, laboratory data, and blood product supply system, and consults the operator regarding the continuation of surgery or changing surgical procedures. When time is short, the cross-matching test is omitted, and the ABO-identical blood is used. When a supply of the identical ABO-type blood is not available, compatible blood type is used. The evolving concept of hemostatic resuscitation seems to be important to prevent coagulopathy, which easily develops during massive hemorrhage. Anesthesiologists should be aware of the risk of such an emergency transfusion and procedures to be taken to switch to transfusion of the ABO-identical blood. Establishment of a hospital emergency transfusion system depends on the overall capability of the critical and crisis management systems of the hospital. PMID:18807897

Irita, Kazuo; Yoshimura, Hayashi; Sakaguchi, Yoshiro; Takamatsu, Chihiro; Tokuda, Kentaro

2008-09-01

177

Utilization of ancillary studies in the cytologic diagnosis of biliary and pancreatic lesions: the Papanicolaou Society of Cytopathology guidelines for pancreatobiliary cytology.  

PubMed

The Papanicolaou Society of Cytopathology has developed a set of guidelines for pancreatobiliary cytology including indications for endoscopic ultrasound-guided fine-needle aspiration, terminology and nomenclature of pancreatobiliary disease, ancillary testing, and post-biopsy management. All documents are based on the expertise of the authors, a review of the literature, discussions of the draft document at several national and international meetings, and synthesis of selected online comments of the draft document. This document presents the results of these discussions regarding the use of ancillary testing in the cytologic diagnosis of biliary and pancreatic lesions.?Currently, fluorescence in situ hybridization (FISH) appears to be the most clinically relevant ancillary technique for cytology of bile duct strictures. The addition of FISH analysis to routine cytologic evaluation appears to yield the highest sensitivity without loss in specificity. Loss of immunohistochemical staining for the protein product of the SMAD4 gene and positive staining for mesothelin support a diagnosis of ductal adenocarcinoma. Immunohistochemical markers for endocrine and exocrine differentiation are sufficient for a diagnosis of endocrine and acinar tumors. Nuclear staining for beta-catenin supports a diagnosis of solid-pseudopapilary neoplasm. Cyst fluid analysis for amylase and carcinoembryonic antigen aids in the preoperative classification of pancreatic cysts. Many gene mutations (KRAS, GNAS, VHL, RNF43, and CTNNB1) may be of aid in the diagnosis of cystic neoplasms. Other ancillary techniques do not appear to improve diagnostic sensitivity sufficiently to justify their increased costs. PMID:24639398

Layfield, Lester J; Ehya, Hormoz; Filie, Armando C; Hruban, Ralph H; Jhala, Nirag; Joseph, Loren; Vielh, Philippe; Pitman, Martha B

2014-04-01

178

Regional survey of tuberculosis risk assessment in rheumatology outpatients commencing anti-TNF-alpha treatment in relation to British Thoracic Society guidelines.  

PubMed

The aim of this study was to analyse tuberculosis (TB) risk assessment for rheumatology patients commencing anti-tumour necrosis factor-alpha (anti-TNF-alpha) therapy using the British Thoracic Society (BTS) guidelines. Data were obtained retrospectively on 856 outpatients regionally receiving anti-TNF-alpha. Prior to commencing treatment, patients had the following assessments documented: respiratory examination, 47.4%; chest X-ray, 84.5%; TB history, 92.9%; and advice about TB risk, 45.8%. Of the 856 patients, 94.3% were on immunosuppressives but 27% had a tuberculin test; 12.6% had > or =1 high-risk factors for TB. In total, 3.4% were referred to a TB specialist and of these, 24.1% had no risk factors for TB. Of patients with > or =1 risk factor, 76.9% were not referred. Only 4/28 patients at high risk for TB due to ethnicity or birthplace received chemoprophylaxis. Marked inter-unit variation was demonstrated and it was evident that patients require improved screening for TB. Greater awareness is necessary of patients with risk factors, particularly ethnicity, to facilitate more appropriate targeting of chemoprophylaxis. Multi-centre audit is a valuable clinical governance tool. PMID:19634383

John, H; Buckley, C; Koh, L; Obrenovic, K; Erb, N; Rowe, I F

2009-06-01

179

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, part 1: update 2012 on the acute treatment of schizophrenia and the management of treatment resistance.  

PubMed

These updated guidelines are based on a first edition of the World Federation of Societies of Biological Psychiatry Guidelines for Biological Treatment of Schizophrenia published in 2005. For this 2012 revision, all available publications pertaining to the biological treatment of schizophrenia were reviewed systematically to allow for an evidence-based update. These guidelines provide evidence-based practice recommendations that are clinically and scientifically meaningful and these guidelines are intended to be used by all physicians diagnosing and treating people suffering from schizophrenia. Based on the first version of these guidelines, a systematic review of the MEDLINE/PUBMED database and the Cochrane Library, in addition to data extraction from national treatment guidelines, has been performed for this update. The identified literature was evaluated with respect to the strength of evidence for its efficacy and then categorised into six levels of evidence (A-F; Bandelow et al. 2008b, World J Biol Psychiatry 9:242). This first part of the updated guidelines covers the general descriptions of antipsychotics and their side effects, the biological treatment of acute schizophrenia and the management of treatment-resistant schizophrenia. PMID:22834451

Hasan, Alkomiet; Falkai, Peter; Wobrock, Thomas; Lieberman, Jeffrey; Glenthoj, Birte; Gattaz, Wagner F; Thibaut, Florence; Möller, Hans-Jürgen

2012-07-01

180

World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 2: update 2012 on the long-term treatment of schizophrenia and management of antipsychotic-induced side effects.  

PubMed

Abstract These updated guidelines are based on a first edition of the World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia published in 2006. For this 2012 revision, all available publications pertaining to the biological treatment of schizophrenia were reviewed systematically to allow for an evidence-based update. These guidelines provide evidence-based practice recommendations that are clinically and scientifically meaningful. They are intended to be used by all physicians diagnosing and treating people suffering from schizophrenia. Based on the first version of these guidelines, a systematic review of the MEDLINE/PUBMED database and the Cochrane Library, in addition to data extraction from national treatment guidelines, has been performed for this update. The identified literature was evaluated with respect to the strength of evidence for its efficacy and then categorised into six levels of evidence (A-F) and five levels of recommendation (1-5) ( Bandelow et al. 2008a ,b, World J Biol Psychiatry 9:242, see Table 1 ). This second part of the updated guidelines covers long-term treatment as well as the management of relevant side effects. These guidelines are primarily concerned with the biological treatment (including antipsychotic medication and other pharmacological treatment options) of adults suffering from schizophrenia. PMID:23216388

Hasan, Alkomiet; Falkai, Peter; Wobrock, Thomas; Lieberman, Jeffrey; Glenthoj, Birte; Gattaz, Wagner F; Thibaut, Florence; Möller, Hans-Jürgen

2013-02-01

181

Cardiovascular risk and bone loss in men undergoing androgen deprivation therapy for non-metastatic prostate cancer: implementation of standardized management guidelines.  

PubMed

Our objective was to evaluate the effectiveness of implementing standardized guidelines to mitigate metabolic and bone side effects of androgen deprivation therapy (ADT) in men with non-metastatic prostate cancer. We conducted a 2-year prospective cohort study at a tertiary referral teaching hospital. Overall, 236 men (mean age 69.8 ± 7.1) commencing ADT for non-metastatic prostate cancer attended a baseline clinic visit between 2007 and 2011, and 153 men were eligible for follow-up after 2 years of continuous ADT. Of these, 113 men had data available for analysis at 2 years. At baseline, 87% of the men were overweight or obese, 61% had hypertension, 56% had hypercholesterolaemia, 27% prior cardiovascular disease, 11% osteoporosis and 40% osteopaenia. After 2 years of ADT, there was an increase in waist circumference (+2.8 ± 6.3 cm, p = 0.002), and, in men without diabetes, in HbA1c (+0.13 ± 0.34%, p = 0.019). Despite this, due to treatment, there were significant reductions in total cholesterol (-0.35 ± 1.00 mmol/L, p < 0.001), and blood pressure (systolic -7.6 ± 19.3 mmHg; diastolic -4.7 ± 11.6 mmHg, p < 0.001). After 2 years, men not receiving anti-resorptive therapy experienced a significant decline in lumbar spine (-0.042 ± 0.134 g/cm(2) , p = 0.012) and total hip bone mineral density (BMD) (-0.026 ± 0.036 g/cm(2) , p < 0.001), whereas bisphosphonate treatment maintained stable BMD. Prevalence of anaemia increased from 13.8 to 32.5%. Older age independently predicted a greater drop in haemoglobin (p = 0.005). We conclude that a structured approach to assess and treat men undergoing ADT effectively improves cardiovascular risk factors and prevents bone decay. Larger studies are needed to determine effects on cardiovascular outcomes, fracture prevention and survival. PMID:23686896

Cheung, A S; Pattison, D; Bretherton, I; Hoermann, R; Lim Joon, D; Ho, E; Jenkins, T; Hamilton, E J; Bate, K; Chan, I; Zajac, J D; Grossmann, M

2013-07-01

182

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.

2014-01-01

183

The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2010 on the treatment of acute bipolar depression  

Microsoft Academic Search

Objectives. These guidelines are based on a fi rst edition that was published in 2002, and have been edited and updated with the available scientifi c evidence until September 2009. Their purpose is to supply a systematic overview of all scientifi c evidence pertaining to the treatment of acute bipolar depression in adults. Methods. The data used for these guidelines

Heinz Grunze; Eduard Vieta; Guy M. Goodwin; Charles Bowden; Rasmus W. Licht; Hans-Jürgen Möller; Siegfried Kasper

2010-01-01

184

A comparative analysis of four clinical guidelines for hypertension management.  

PubMed

We compared the structure and content of guidelines for hypertension management across countries to gain an understanding of where differences between them originate from. Four guidelines published between 2003 and 2006 were selected. Two were issued by national agencies in the United Kingdom and France, and two were issued by working groups or national medical societies in the United States and in Europe. The structure of guidelines, the content of each section and their underlying bibliographic references were compared between authoring bodies. If differences were found between guidelines in terms of content, we analysed the rationales. The guidelines were sufficiently similar in structure, showing common sections such as lifestyle interventions, cardiovascular risk assessment and drug therapies. However, contentwise, major differences were observed across the four hypertension guidelines in virtually every section of the document. The definition of hypertension was consistent, whereas the grade stratification was not. Information concerning the blood pressure self-measurement, the estimation of cardiovascular risk and the antihypertensive drugs proposed for initial treatment also varied. Most of the differences were present in both guidelines and their rationales, but some were only found in the guidelines. The bibliographic references for the rationales differed significantly, with only 1.2, 2.2 and 8.8% of the total number of references were common to four, three and two authoring bodies, accounting for the variability. We conclude that improving the selection process of bibliographic references and the extraction process of guidelines from the rationales might be the first step to harmonize guidelines' development. PMID:18685604

Georg, G; Colombet, I; Durieux, P; Ménard, J; Meneton, P

2008-12-01

185

Recent Update of Guidelines for Neurointerventional Procedures  

PubMed Central

Treatment guidelines of the neurointerventional procedures are continuously updated. However, these guidelines differ between countries and even medical societies within the same country because of the differing interests and patient groups. The differences between guidelines are confusing to many neurointerventionalists. Recently "Clinical Research Center for Stroke" in Korea updated "Clinical Practice Guidelines for Stroke" for the patients in Korea. So we introduce those guidelines and compare several recent guidelines of international medical societies for neurointerventionalists.

Shin, Shang Hun; Kwon, Soon Chan

2013-01-01

186

Cardiovascular risk  

PubMed Central

Cardiovascular disease is a major, growing, worldwide problem. It is important that individuals at risk of developing cardiovascular disease can be effectively identified and appropriately stratified according to risk. This review examines what we understand by the term risk, traditional and novel risk factors, clinical scoring systems, and the use of risk for informing prescribing decisions. Many different cardiovascular risk factors have been identified. Established, traditional factors such as ageing are powerful predictors of adverse outcome, and in the case of hypertension and dyslipidaemia are the major targets for therapeutic intervention. Numerous novel biomarkers have also been described, such as inflammatory and genetic markers. These have yet to be shown to be of value in improving risk prediction, but may represent potential therapeutic targets and facilitate more targeted use of existing therapies. Risk factors have been incorporated into several cardiovascular disease prediction algorithms, such as the Framingham equation, SCORE and QRISK. These have relatively poor predictive power, and uncertainties remain with regards to aspects such as choice of equation, different risk thresholds and the roles of relative risk, lifetime risk and reversible factors in identifying and treating at-risk individuals. Nonetheless, such scores provide objective and transparent means of quantifying risk and their integration into therapeutic guidelines enables equitable and cost-effective distribution of health service resources and improves the consistency and quality of clinical decision making.

Payne, Rupert A

2012-01-01

187

Rationale and design of the Kanyini guidelines adherence with the polypill (Kanyini-GAP) study: a randomised controlled trial of a polypill-based strategy amongst Indigenous and non Indigenous people at high cardiovascular risk  

PubMed Central

Background The Kanyini Guidelines Adherence with the Polypill (Kanyini-GAP) Study aims to examine whether a polypill-based strategy (using a single capsule containing aspirin, a statin and two blood pressure-lowering agents) amongst Indigenous and non-Indigenous people at high risk of experiencing a cardiovascular event will improve adherence to guideline-indicated therapies, and lower blood pressure and cholesterol levels. Methods/Design The study is an open, randomised, controlled, multi-centre trial involving 1000 participants at high risk of cardiovascular events recruited from mainstream general practices and Aboriginal Medical Services, followed for an average of 18 months. The participants will be randomised to one of two versions of the polypill, the version chosen by the treating health professional according to clinical features of the patient, or to usual care. The primary study outcomes will be changes, from baseline measures, in serum cholesterol and systolic blood pressure and self-reported current use of aspirin, a statin and at least two blood pressure lowering agents. Secondary study outcomes include cardiovascular events, renal outcomes, self-reported barriers to indicated therapy, prescription of indicated therapy, occurrence of serious adverse events and changes in quality-of-life. The trial will be supplemented by formal economic and process evaluations. Discussion The Kanyini-GAP trial will provide new evidence as to whether or not a polypill-based strategy improves adherence to effective cardiovascular medications amongst individuals in whom these treatments are indicated. Trial Registration This trial is registered with the Australian New Zealand Clinical Trial Registry ACTRN126080005833347.

2010-01-01

188

Executive Summary: The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America  

PubMed Central

Evidenced-based guidelines for management of infants and children with community-acquired pneumonia (CAP) were prepared by an expert panel comprising clinicians and investigators representing community pediatrics, public health, and the pediatric specialties of critical care, emergency medicine, hospital medicine, infectious diseases, pulmonology, and surgery. These guidelines are intended for use by primary care and subspecialty providers responsible for the management of otherwise healthy infants and children with CAP in both outpatient and inpatient settings. Site-of-care management, diagnosis, antimicrobial and adjunctive surgical therapy, and prevention are discussed. Areas that warrant future investigations are also highlighted.

Byington, Carrie L.; Shah, Samir S.; Alverson, Brian; Carter, Edward R.; Harrison, Christopher; Kaplan, Sheldon L.; Mace, Sharon E.; McCracken, George H.; Moore, Matthew R.; St Peter, Shawn D.; Stockwell, Jana A.; Swanson, Jack T.

2011-01-01

189

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

190

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

191

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.

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

2010-01-01

192

Executive summary: Guidelines for the prevention of infections associated with combat-related injuries: 2011 update: endorsed by the Infectious Diseases Society of America and the Surgical Infection Society.  

PubMed

Despite advances in resuscitation and surgical management of combat wounds, infection remains a concerning and potentially preventable complication of combat-related injuries. Interventions currently used to prevent these infections have not been either clearly defined or subjected to rigorous clinical trials. Current infection prevention measures and wound management practices are derived from retrospective review of wartime experiences, from civilian trauma data, and from in vitro and animal data. This update to the guidelines published in 2008 incorporates evidence that has become available since 2007. These guidelines focus on care provided within hours to days of injury, chiefly within the combat zone, to those combat-injured patients with open wounds or burns. New in this update are a consolidation of antimicrobial agent recommendations to a backbone of high-dose cefazolin with or without metronidazole for most postinjury indications and recommendations for redosing of antimicrobial agents, for use of negative pressure wound therapy, and for oxygen supplementation in flight. PMID:21814088

Hospenthal, Duane R; Murray, Clinton K; Andersen, Romney C; Bell, R Bryan; Calhoun, Jason H; Cancio, Leopoldo C; Cho, John M; Chung, Kevin K; Clasper, Jon C; Colyer, Marcus H; Conger, Nicholas G; Costanzo, George P; Crouch, Helen K; Curry, Thomas K; D'Avignon, Laurie C; Dorlac, Warren C; Dunne, James R; Eastridge, Brian J; Ficke, James R; Fleming, Mark E; Forgione, Michael A; Green, Andrew D; Hale, Robert G; Hayes, David K; Holcomb, John B; Hsu, Joseph R; Kester, Kent E; Martin, Gregory J; Moores, Leon E; Obremskey, William T; Petersen, Kyle; Renz, Evan M; Saffle, Jeffrey R; Solomkin, Joseph S; Sutter, Deena E; Tribble, David R; Wenke, Joseph C; Whitman, Timothy J; Wiesen, Andrew R; Wortmann, Glenn W

2011-08-01

193

AACE\\/TOS\\/ASMBS Guidelines  

Microsoft Academic Search

American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for Clinical Practice are systematically developed statements to assist health-care professionals in medical decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied.These guidelines are a working document

Jeffrey I. Mechanick; Robert F. Kushner; Harvey J. Sugerman; J. Michael Gonzalez-Campoy; Maria L. Collazo-Clavell; Adam F. Spitz; Caroline M. Apovian; Edward H. Livingston; Robert Brolin; David B. Sarwer; Wendy A. Anderson; John Dixon

2009-01-01

194

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.

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

2014-01-01

195

Instructional Guidelines. Welding.  

ERIC Educational Resources Information Center

Using the standards of the American Welding Society and the American Society of Mechanical Engineers, this welding instructional guidelines manual presents a course of study in accordance with the current practices in industry. Intended for use in welding programs now practiced within the Federal Prison System, the phases of the program are…

Fordyce, H. L.; Doshier, Dale

196

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

2011-01-01

197

Management of hemodynamically unstable pelvic trauma: results of the first Italian consensus conference (cooperative guidelines of the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology -Section of Vascular and Interventional Radiology- and the World Society of Emergency Surgery)  

PubMed Central

Hemodynamically Unstable Pelvic Trauma is a major problem in blunt traumatic injury. No cosensus has been reached in literature on the optimal treatment of this condition. We present the results of the First Italian Consensus Conference on Pelvic Trauma which took place in Bergamo on April 13 2013. An extensive review of the literature has been undertaken by the Organizing Committee (OC) and forwarded to the Scientific Committee (SC) and the Panel (JP). Members of them were appointed by surgery, critical care, radiology, emergency medicine and orthopedics Italian and International societies: the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology, Section of Vascular and Interventional Radiology and the World Society of Emergency Surgery. From November 2012 to January 2013 the SC undertook the critical revision and prepared the presentation to the audience and the Panel on the day of the Conference. Then 3 recommendations were presented according to the 3 submitted questions. The Panel voted the recommendations after discussion and amendments with the audience. Later on a email debate took place until December 2013 to reach a unanimous consent. We present results on the 3 following questions: which hemodynamically unstable patient needs an extraperitoneal pelvic packing? Which hemodynamically unstable patient needs an external fixation? Which hemodynamically unstable patient needs emergent angiography? No longer angiography is considered the first therapeutic maneuver in such a patient. Preperitoneal pelvic packing and external fixation, preceded by pelvic binder have a pivotal role in the management of these patients. Hemodynamically Unstable Pelvic Trauma is a frequent death cause among people who sustain blunt trauma. We present the results of the First Italian Consensus Conference.

2014-01-01

198

American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Transperineal Permanent Brachytherapy of Prostate Cancer  

Microsoft Academic Search

Transperineal permanent prostate brachytherapy is a safe and efficacious treatment option for patients with organ-confined prostate cancer. Careful adherence to established brachytherapy standards has been shown to improve the likelihood of procedural success and reduce the incidence of treatment-related morbidity. A collaborative effort of the American College of Radiology (ACR) and American Society for Therapeutic Radiation Oncology (ASTRO) has produced

Seth A. Rosenthal; Nathan H. J. Bittner; David C. Beyer; D. Jeffrey Demanes; Brian J. Goldsmith; Eric M. Horwitz; Geoffrey S. Ibbott; W. Robert Lee; Subir Nag; W. Warren Suh; Louis Potters

2011-01-01

199

Management of sepsis in neutropenic patients: 2014 updated guidelines from the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology (AGIHO).  

PubMed

Sepsis is a major cause of mortality during the neutropenic phase after intensive cytotoxic therapies for malignancies. Improved management of sepsis during neutropenia may reduce the mortality of cancer therapies. Clinical guidelines on sepsis treatment have been published by others. However, optimal management may differ between neutropenic and non-neutropenic patients. Our aim is to give evidence-based recommendations for haematologist, oncologists and intensive care physicians on how to manage adult patients with neutropenia and sepsis. PMID:24777705

Penack, Olaf; Becker, Carolin; Buchheidt, Dieter; Christopeit, Maximilian; Kiehl, Michael; von Lilienfeld-Toal, Marie; Hentrich, Marcus; Reinwald, Marc; Salwender, Hans; Schalk, Enrico; Schmidt-Hieber, Martin; Weber, Thomas; Ostermann, Helmut

2014-07-01

200

Guidelines from The Italian Neurological and Neuroradiological Societies for the use of magnetic resonance imaging in daily life clinical practice of multiple sclerosis patients.  

PubMed

MRI is highly sensitive in detecting focal white matter lesions in multiple sclerosis (MS). For this reason, it has been formally included in the diagnostic workup of patients with clinically isolated syndromes suggestive of MS, through the definition of ad hoc sets of criteria to show disease dissemination in space and time. MRI is used in virtually all clinical trials of the disease as a surrogate measure of treatment response. Several guidelines have been published to help characterizing the imaging features on conventional MR sequences of "typical" MS lesions and work has also been performed to identify "red flags" which should alert the clinicians to exclude possible alternative conditions. Despite this, the application of the available guidelines and criteria in daily life clinical practice is still limited and varies among and within countries (including Italy) due to regulatory issues and heterogeneity of MRI facilities. It is crucial for neurologists and neuroradiologists to become familiar with these criteria to improve the quality of their diagnostic assessment. In patients with established MS, the main problem is to define standard procedures for monitoring the course of the disease and treatment response. This review aims at providing daily life guidelines to clinicians for a correct application of MRI in the workup of patients suspected of having MS as well as in the monitoring of disease evolution in those with established MS. It also offers clues for the standardization of MRI studies and relative reporting to be applied at a national level. PMID:23828372

Filippi, Massimo; Rocca, Maria A; Bastianello, Stefano; Comi, Giancarlo; Gallo, Paolo; Gallucci, Massimo; Ghezzi, Angelo; Marrosu, Maria Giovanna; Minonzio, Giorgio; Pantano, Patrizia; Pozzilli, Carlo; Tedeschi, Gioacchino; Trojano, Maria; Falini, Andrea; De Stefano, Nicola

2013-12-01

201

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

202

Guideline on the design and conduct of cystic fibrosis clinical trials: The European Cystic Fibrosis Society–Clinical Trials Network (ECFS-CTN)  

Microsoft Academic Search

We describe the rationale for disease specific research networks in general as well as the aims and function of the European Cystic Fibrosis Society–Clinical Trials Network (ECFS-CTN) specifically. The ECFS-CTN was founded in 2009 with the aim of improving the quality and quantity of clinical research in the area of cystic fibrosis (CF) in Europe. A network of 18 clinical

K. De Boeck; V. Bulteel; H. Tiddens; T. Wagner; I. Fajac; S. Conway; F. Dufour; A. R. Smyth; T. Lee; I. Sermet; B. Kassai; S. Elborn

2011-01-01

203

American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Performance of High-Dose-Rate Brachytherapy  

Microsoft Academic Search

High-Dose-Rate (HDR) brachytherapy is a safe and efficacious treatment option for patients with a variety of different malignancies. Careful adherence to established standards has been shown to improve the likelihood of procedural success and reduce the incidence of treatment-related morbidity. A collaborative effort of the American College of Radiology (ACR) and American Society for Therapeutic Radiation Oncology (ASTRO) has produced

Beth A. Erickson; D. Jeffrey Demanes; Geoffrey S. Ibbott; John K. Hayes; I-Chow J. Hsu; David E. Morris; Rachel A. Rabinovitch; Jonathan D. Tward; Seth A. Rosenthal

2011-01-01

204

One Decade Later: Trends and Disparities in the Application of Post-Mastectomy Radiotherapy Since the Release of the American Society of Clinical Oncology Clinical Practice Guidelines  

SciTech Connect

Purpose: In 2001 ASCO published practice guidelines for post mastectomy radiotherapy (PMRT). We analyzed factors that influence the receipt of radiotherapy therapy and trends over time. Methods and Materials: We analyzed 8889 women who underwent mastectomy as primary surgical treatment for stage II or III breast cancer between 1995 and 2008 using data from the Kentucky Cancer Registry. We categorized patients according to ASCO group: group 1, PMRT not routinely recommended (T2, N0); group 2, PMRT controversial/evidence insufficient (T1-2, N1); group 3, PMRT recommended or suggested (T3-4 or N2-3). Probability of receiving PMRT was assessed using logistic regression. Results: Overall, 24.0% of women received PMRT over the study period. The rates of PMRT for group 1, 2, and 3 were 7.5%, 19.5%, and 47.3%, respectively. Since 2001, there was an increase in the use of PMRT (from 21.1%-26.5%, P<.0001), which occurred mainly among group 3 members (from 40.8%-51.2%, P<.0001). The average rate remained constant in group 1 (from 7.1%-7.4%, P=.266) and decreased in group 2 (from 20.0%-18.1%, P<.0001). On multivariate analysis, the rate of PMRT was significantly lower for women aged >70 years (vs. younger), rural Appalachia (vs. non-Appalachia) populations, and Medicaid (vs. privately insured) patients. Conclusions: ASCO guidelines have influenced practice in an underserved state; however PMRT remains underused, even for highest-risk patients. Barriers exist for elderly, rural and poor patients, which independently predict for lack of adequate care. Updated guidelines are needed to clarify the use of PMRT for patients with T1-2, N1 disease.

Dragun, Anthony E., E-mail: aedrag01@louisville.edu [Department of Radiation Oncology, James Graham Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY (United States); Huang, Bin [Kentucky Cancer Registry, University of Kentucky, Lexington, KY (United States) [Kentucky Cancer Registry, University of Kentucky, Lexington, KY (United States); Divison of Cancer Biostatistics, College of Public Health, University of Kentucky, Lexington, KY (United States); Gupta, Saurabh; Crew, John B. [Department of Radiation Oncology, James Graham Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY (United States)] [Department of Radiation Oncology, James Graham Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY (United States); Tucker, Thomas C. [Kentucky Cancer Registry, University of Kentucky, Lexington, KY (United States)] [Kentucky Cancer Registry, University of Kentucky, Lexington, KY (United States)

2012-08-01

205

Expert consensus for multi-modality imaging evaluation of cardiovascular complications of radiotherapy in adults: a report from the European Association of Cardiovascular Imaging and the American Society of Echocardiography.  

PubMed

Cardiac toxicity is one of the most concerning side effects of anti-cancer therapy. The gain in life expectancy obtained with anti-cancer therapy can be compromised by increased morbidity and mortality associated with its cardiac complications. While radiosensitivity of the heart was initially recognized only in the early 1970s, the heart is regarded in the current era as one of the most critical dose-limiting organs in radiotherapy. Several clinical studies have identified adverse clinical consequences of radiation-induced heart disease (RIHD) on the outcome of long-term cancer survivors. A comprehensive review of potential cardiac complications related to radiotherapy is warranted. An evidence-based review of several imaging approaches used to detect, evaluate, and monitor RIHD is discussed. Recommendations for the early identification and monitoring of cardiovascular complications of radiotherapy by cardiac imaging are also proposed. PMID:23998694

Lancellotti, Patrizio; Nkomo, Vuyisile T; Badano, Luigi P; Bergler-Klein, Jutta; Bergler, Jutta; Bogaert, Jan; Davin, Laurent; Cosyns, Bernard; Coucke, Philippe; Dulgheru, Raluca; Edvardsen, Thor; Gaemperli, Oliver; Galderisi, Maurizio; Griffin, Brian; Heidenreich, Paul A; Nieman, Koen; Plana, Juan C; Port, Steven C; Scherrer-Crosbie, Marielle; Schwartz, Ronald G; Sebag, Igal A; Voigt, Jens-Uwe; Wann, Samuel; Yang, Phillip C

2013-09-01

206

Expert consensus for multi-modality imaging evaluation of cardiovascular complications of radiotherapy in adults: a report from the European Association of Cardiovascular Imaging and the American Society of Echocardiography.  

PubMed

Cardiac toxicity is one of the most concerning side effects of anti-cancer therapy. The gain in life expectancy obtained with anti-cancer therapy can be compromised by increased morbidity and mortality associated with its cardiac complications. While radiosensitivity of the heart was initially recognized only in the early 1970s, the heart is regarded in the current era as one of the most critical dose-limiting organs in radiotherapy. Several clinical studies have identified adverse clinical consequences of radiation-induced heart disease (RIHD) on the outcome of long-term cancer survivors. A comprehensive review of potential cardiac complications related to radiotherapy is warranted. An evidence-based review of several imaging approaches used to detect, evaluate, and monitor RIHD is discussed. Recommendations for the early identification and monitoring of cardiovascular complications of radiotherapy by cardiac imaging are also proposed. PMID:23847385

Lancellotti, Patrizio; Nkomo, Vuyisile T; Badano, Luigi P; Bergler-Klein, Jutta; Bogaert, Jan; Davin, Laurent; Cosyns, Bernard; Coucke, Philippe; Dulgheru, Raluca; Edvardsen, Thor; Gaemperli, Oliver; Galderisi, Maurizio; Griffin, Brian; Heidenreich, Paul A; Nieman, Koen; Plana, Juan C; Port, Steven C; Scherrer-Crosbie, Marielle; Schwartz, Ronald G; Sebag, Igal A; Voigt, Jens-Uwe; Wann, Samuel; Yang, Phillip C

2013-08-01

207

[Dyslipidemias: a pending challenge in cardiovascular prevention. Consensus document from CEIPC/SEA Committee].  

PubMed

In Spain, where cardiovascular disease (CVD) is the leading cause of death, hypercholesterolemia, one of the most prevalent risk factors in adults, is poorly controlled. Dyslipidemia should not be approached in isolation, but in the context of overall cardiovascular risk (CVR). Measurement of CVR facilitates decision making, but should not be the only tool nor should it take the place of clinical judgment, given the limitations of the available calculation methods. This document, prepared by the Interdisciplinary Spanish Committee on Cardiovascular Prevention, at the proposal of the Spanish Society of Arteriosclerosis, reviews the cardiovascular prevention activities of the regional health authorities, scientific societies and medical professionals. An initiation of a national strategy on cardiovascular prevention is proposed based on lifestyle modification (healthy diet, physical activity and smoking cessation) through actions in different settings. At the population level, regulation of food advertising, elimination of trans fats and reduction of added sugar are feasible and cost-effective interventions to help control dyslipidemias and reduce CVR. In the health setting, it is proposed to facilitate the application of guidelines, improve training for medical professionals, and include CVR assessment among the quality indicators. Scientific societies should collaborate with the health authorities and contribute to the generation and transmission of knowledge. Finally, it is in the hands of professionals to apply the concept of CVR, promote healthy lifestyles, and make efficient use of available pharmacological treatments. PMID:21511309

Royo Bordonada, Miguel Ángel; Lobos Bejarano, José María; Millán Núñez-Cortés, Jesús; Villar Álvarez, Fernando; Brotons Cuixart, Carlos; Camafort Babkowski, Miguel; Guijarro Herráiz, Carlos; de Pablo Zarzosa, Carmen; Pedro-Botet Montoya, Juan; Santiago Nocito, Ana de

2011-06-11

208

Laboratory compliance with the american society of clinical oncology/college of american pathologists human epidermal growth factor receptor 2 testing guidelines: a 3-year comparison of validation procedures.  

PubMed

Context.-The American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) published guidelines in 2007 regarding testing accuracy, interpretation, and reporting of results for HER2 studies. A 2008 survey identified areas needing improved compliance. Objective.-To reassess laboratory response to those guidelines following a full accreditation cycle for an updated snapshot of laboratory practices regarding ASCO/CAP guidelines. Design.-In 2011, a survey was distributed with the HER2 immunohistochemistry (IHC) proficiency testing program identical to the 2008 survey. Results.-Of the 1150 surveys sent, 977 (85.0%) were returned, comparable to the original survey response in 2008 (757 of 907; 83.5%). New participants submitted 124 of 977 (12.7%) surveys. The median laboratory accession rate was 14?788 cases with 211 HER2 tests performed annually. Testing was validated with fluorescence in situ hybridization in 49.1% (443 of 902) of the laboratories; 26.3% (224 of 853) of the laboratories used another IHC assay. The median number of cases to validate fluorescence in situ hybridization (n = 40) and IHC (n = 27) was similar to those in 2008. Ninety-five percent concordance with fluorescence in situ hybridization was achieved by 76.5% (254 of 332) of laboratories for IHC(-) findings and 70.4% (233 of 331) for IHC(+) cases. Ninety-five percent concordance with another IHC assay was achieved by 71.1% (118 of 168) of the laboratories for negative findings and 69.6% (112 of 161) of the laboratories for positive cases. The proportion of laboratories interpreting HER2 IHC using ASCO/CAP guidelines (86.6% [798 of 921] in 2011; 83.8% [605 of 722] in 2008) remains similar. Conclusions.-Although fixation time improvements have been made, assay validation deficiencies still exist. The results of this survey were shared within the CAP, including the Laboratory Accreditation Program and the ASCO/CAP panel revising the HER2 guidelines published in October 2013. The Laboratory Accreditation Program checklist was changed to strengthen HER2 validation practices. PMID:24978913

Dyhdalo, Kathryn S; Fitzgibbons, Patrick L; Goldsmith, Jeffery D; Souers, Rhona J; Nakhleh, Raouf E

2014-07-01

209

[Sk2 guidelines"diagnosis and therapy of snoring in adults" : compiled by the sleep medicine working group of the German Society of Otorhinolaryngology, Head and Neck Surgery].  

PubMed

These guidelines aim to facilitate high quality medical care of adults with snoring problems. The guidelines were devised for application in both in- and outpatient environments and are directed primarily at all those concerned with the diagnosis and therapy of snoring. According to the AWMF three-level concept, these represent S2k guidelines.A satisfactory definition of snoring does not currently exist. Snoring is the result of vibration of soft tissue structures in narrow regions of the upper airway during breathing while asleep. Ultimately, these vibrations are caused by the sleep-associated decrease in muscle tone in the area of the upper airway dilator muscles. A multitude of risk factors for snoring have been described and its occurrence is multifactorial. Data relating to the frequency of snoring vary widely, depending on the way in which the data are collected. Snoring is usually observed in middle-aged individuals and affected males predominate. Clinical diagnosis of snoring should comprise a free evaluation of the patient's medical history. Where possible this should also involve their bed partner and the case history can be complimented by questionnaires. To determine the airflow relevant structures, a clinical examination of the nose should be performed. This examination may also include nasal endoscopy. Examination of the oropharynx is particularly important and should be performed. The larynx and the hypopharynx should be examined. The size of the tongue and the condition of the mucous membranes should be recorded as part of the oral cavity examination, as should the results of a dental assessment. Facial skeleton morphology should be assessed for orientation purposes. Technical examinations may be advisable in individual cases. In the instance of suspected sleep-related breathing disorders, relevant comorbidities or where treatment for snoring has been requested, an objective sleep medicine examination should be performed. Snoring is not-at least as we currently understand it-a disease associated with a medical threat; therefore there is currently no medical necessity to treat the condition. All overweight patients with snoring problems should strive to lose weight. If snoring is associated with the supine position, positional therapy can be considered. Some cases of snoring can be appropriately treated using an intraoral device. Selected minimally invasive surgical procedures on the soft palate can be recommended to treat snoring, provided that examinations have revealed a suitable anatomy. The choice of technique is determined primarily by the individual anatomy. At an appropriate interval after the commencement or completion a therapeutic measure, a follow-up examination should be conducted to assess the success of the therapy and to aid in the planning of any further treatments. PMID:24221222

Stuck, B A; Dreher, A; Heiser, C; Herzog, M; Kühnel, T; Maurer, J T; Pistner, H; Sitter, H; Steffen, A; Verse, T

2013-11-01

210

Remote monitoring and follow-up of cardiovascular implantable electronic devices in the Netherlands : An expert consensus report of the Netherlands Society of Cardiology.  

PubMed

Remote monitoring of cardiac implanted electronic devices (CIED: pacemaker, cardiac resynchronisation therapy device and implantable cardioverter defibrillator) has been developed for technical control and follow-up using transtelephonic data transmission. In addition, automatic or patient-triggered alerts are sent to the cardiologist or allied professional who can respond if necessary with various interventions. The advantage of remote monitoring appears obvious in impending CIED failures and suspected symptoms but is less likely in routine follow-up of CIED. For this follow-up the indications, quality of care, cost-effectiveneness and patient satisfaction have to be determined before remote CIED monitoring can be applied in daily practice. Nevertheless remote CIED monitoring is expanding rapidly in the Netherlands without professional agreements about methodology, responsibilities of all the parties involved and that of the device patient, and reimbursement. The purpose of this consensus document on remote CIED monitoring and follow-up is to lay the base for a nationwide, uniform implementation in the Netherlands. This report describes the technical communication, current indications, benefits and limitations of remote CIED monitoring and follow-up, the role of the patient and device manufacturer, and costs and reimbursement. The view of cardiology experts and of other disciplines in conjunction with literature was incorporated in a preliminary series of recommendations. In addition, an overview of the questions related to remote CIED monitoring that need to be answered is given. This consensus document can be used for future guidelines for the Dutch profession. PMID:22249958

de Cock, C C; Elders, J; van Hemel, N M; van den Broek, K; van Erven, L; de Mol, B; Talmon, J; Theuns, D A M J; de Voogt, W

2012-02-01

211

Systematizing inpatient referral to cardiac rehabilitation 2010: Canadian Association of Cardiac Rehabilitation and Canadian Cardiovascular Society joint position paper endorsed by the Cardiac Care Network of Ontario.  

PubMed

Despite recommendations in clinical practice guidelines, evidence suggests cardiac rehabilitation (CR) referral and use following indicated cardiac events is low. Referral strategies such as systematic referral have been advocated to improve CR use. The objective of this policy position is to synthesize evidence and make recommendations on strategies to increase patient enrollment in CR. A systematic review of 6 databases from inception to January 2009 was conducted. Only primary, published, English-language studies were included. A meta-analysis was undertaken to synthesize the enrollment rates by referral strategy. In all, 14 studies met inclusion criteria. Referral strategies were categorized as systematic on the basis of use of systematic discharge order sets, as liaison on the basis of discussions with allied health care providers, or as other on the basis of patient letters. Overall, there were 7 positive studies, 5 without comparison groups, and 2 studies that reported null findings. The combined effect sizes of the meta-analysis were as follows: 73% (95% CI, 39%-92%) for the patient letters ("other"), 66% (95% CI, 54%-77%) for the combined systematic and liaison strategy, 45% (95% CI, 33%-57%) for the systematic strategy alone, and 44% (95% CI, 35%-53%) for the liaison strategy alone. In conclusion, the results suggest that innovative referral strategies increase CR use. Although patient letters look promising, evidence for this strategy is sparse and inconsistent at present. Therefore we suggest that inpatient units adopt systematic referral strategies, including a discussion at the bedside, for eligible patient groups in order to increase CR enrollment and participation. This approach should be considered best practice for further investigation. PMID:21459268

Grace, Sherry L; Chessex, Caroline; Arthur, Heather; Chan, Sammy; Cyr, Cleo; Dafoe, William; Juneau, Martin; Oh, Paul; Suskin, Neville

2011-01-01

212

Conditioning chemotherapy dose adjustment in obese patients: a review and position statement by the american society for blood and marrow transplantation practice guideline committee.  

PubMed

Hematopoietic stem cell transplantation (HCT) is a potentially life-saving therapy for patients with malignant and nonmalignant disease states. This article reviews the current published literature on the dosing of pharmacologic agents used for HCT preparative regimens with specific focus on the obese patient population. The review found that dose adjustments for obesity have, to date, been based empirically or extrapolated from published data in the nontransplantation patient population. As a result, the Committee determined that clear standards or dosing guidelines are unable to be made for the obese population because Level I and II evidence are unavailable at this time. Instead, the Committee provides a current published literature review to serve as a platform for conditioning agent dose selection in the setting of obesity. A necessary goal should be to encourage future prospective trials in this patient population because further information is needed to enhance our knowledge of the pharmacokinetics and pharmacodynamics of conditioning agents in the setting of obesity. PMID:24462742

Bubalo, Joseph; Carpenter, Paul A; Majhail, Navneet; Perales, Miguel-Angel; Marks, David I; Shaughnessy, Paul; Pidala, Joseph; Leather, Helen L; Wingard, John; Savani, Bipin N

2014-05-01

213

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.

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

214

Approach to suspected food allergy in atopic dermatitis. Guideline of the Task Force on Food Allergy of the German Society of Allergology and Clinical Immunology (DGAKI) and the Medical Association of German Allergologists (ADA) and the German Society of Pediatric Allergology (GPA).  

PubMed

The following guideline of the "Arbeitsgruppe Nahrungsmittelallergie der DGAKI" (Task Force on Food Allergy of the German Society of Allergology and Clinical Immunology) and the ADA ("Arzteverband Deutscher Allergologen", Medical Association of German Allergologists) and the GPA (German Society of Pediatric Allergology) summarizes the approach to be taken when food allergy is suspected in patients with atopic dermatitis (neurodermatitis, atopic eczema). The problem is clinically relevant because many patients assume that allergic reactions against foods are responsible for triggering or worsening their eczema. It is important to identify those patients who will benefit from an elimination diet but also to avoid unnecessary diets. Elimination diets (especially in early childhood) are associated with the risk of malnutrition and additional emotional stress for the patients. The gold standard for the diagnosis of food-dependent reactions is to perform placebo-controlled, double-blind oral food challenges because specific IgE, prick tests and history often do not correlate with clinical reactivity. This is particularly true in the case of delayed eczematous skin reactions. Diagnostic elimination diets should be used before an oral provocation test. If multiple sensitizations against foods are discovered in a patient, an oligoallergenic diet and a subsequent stepwise supplementation of the nutrition should be performed. If a specific food is suspected of triggering food allergy, oral provocation should be performed after a diagnostic elimination diet. As eczema-tous skin reactions may develop slowly (i. e. within one or two day), the skin be inspected the day after the provocation test and that a repetitive test be performed if the patient has not reacted to a given food on the first day of oral provocation. The guideline discusses various clinical situations for patients with atopic dermatitis to facilitate differentiated diagnostic procedures. PMID:19371249

Werfel, Thomas; Erdmann, Stephan; Fuchs, Thomas; Henzgen, Margot; Kleine-Tebbe, Jörg; Lepp, Ute; Niggemann, Bodo; Raithel, Martin; Reese, Imke; Saloga, Joachim; Vieths, Stefan; Zuberbier, Torsten

2009-03-01

215

S3 guidelines for intensive care in cardiac surgery patients: hemodynamic monitoring and cardiocirculary system  

PubMed Central

Hemodynamic monitoring and adequate volume-therapy, as well as the treatment with positive inotropic drugs and vasopressors are the basic principles of the postoperative intensive care treatment of patient after cardiothoracic surgery. The goal of these S3 guidelines is to evaluate the recommendations in regard to evidence based medicine and to define therapy goals for monitoring and therapy. In context with the clinical situation the evaluation of the different hemodynamic parameters allows the development of a therapeutic concept and the definition of goal criteria to evaluate the effect of treatment. Up to now there are only guidelines for subareas of postoperative treatment of cardiothoracic surgical patients, like the use of a pulmonary artery catheter or the transesophageal echocardiography. The German Society for Thoracic and Cardiovascular Surgery (Deutsche Gesellschaft für Thorax-, Herz- und Gefäßchirurgie, DGTHG) and the German Society for Anaesthesiology and Intensive Care Medicine (Deutsche Gesellschaft für Anästhesiologie und lntensivmedizin, DGAI) made an approach to ensure and improve the quality of the postoperative intensive care medicine after cardiothoracic surgery by the development of S3 consensus-based treatment guidelines. Goal of this guideline is to assess the available monitoring methods with regard to indication, procedures, predication, limits, contraindications and risks for use. The differentiated therapy of volume-replacement, positive inotropic support and vasoactive drugs, the therapy with vasodilatators, inodilatators and calcium sensitizers and the use of intra-aortic balloon pumps will also be addressed. The guideline has been developed following the recommendations for the development of guidelines by the Association of the Scientific Medical Societies in Germany (AWMF). The presented key messages of the guidelines were approved after two consensus meetings under the moderation of the Association of the Scientific Medical Societies in Germany (AWMF).

Carl, M.; Alms, A.; Braun, J.; Dongas, A.; Erb, J.; Goetz, A.; Goepfert, M.; Gogarten, W.; Grosse, J.; Heller, A. R.; Heringlake, M.; Kastrup, M.; Kroener, A.; Loer, S. A.; Marggraf, G.; Markewitz, A.; Reuter, D.; Schmitt, D. V.; Schirmer, U.; Wiesenack, C.; Zwissler, B.; Spies, C.

2010-01-01

216

Cardiovascular risk assessment in diabetes mellitus: comparison of the general Framingham risk profile versus the World Health Organization/International Society of Hypertension risk prediction charts in Arabs--clinical implications.  

PubMed

We estimated the prevalence of cardiovascular disease (CVD) risk and its clinical implications among 1 110 Omani patients with type 2 diabetes mellitus (DM) using 2 different CVD risk tools: the general Framingham risk profile (GFRP) and the joint World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction charts. The GFRP tool identified higher proportion of patients compared with joint WHO/ISH tool at 10-year CVD risk 10% to <20% and at 20% to <30%. At CVD risk ?30%, both assessment tools identified similar proportions of patients (22% vs 24%; P=.120). Compared with WHO/ISH charts, the GFRP identified almost double the number of men eligible for aspirin treatment at CVD risk thresholds of ?10% (86% vs 43%). In women, the proportions were, 66% and 45%, respectively. For statins, the figures were, 60% and 37%, for men and 28% and 36%, for women. In conclusion, the GFRP overestimates the number of patients eligible for primary prevention of CVD compared with the joint WHO/ISH method. PMID:22942129

Al-Lawati, Jawad A; Barakat, Mohammed N; Al-Lawati, Najla A; Al-Maskari, Masoud Y; Elsayed, Medhat K; Mikhailidis, Dimitri P; Al-Zakwani, Ibrahim S

2013-07-01

217

Exercise training and the cardiovascular consequences of type 2 diabetes and hypertension: plausible mechanisms for improving cardiovascular health.  

PubMed

The coexistence of type 2 diabetes and hypertension is especially damaging to cardiovascular health. Most trials of exercise training for these conditions have focused on glycemic control and blood pressure reduction. Less is known about the effects of exercise on the cardiovascular consequences of diabetes and hypertension. This article reviews the available evidence and plausible mechanisms by which exercise training may improve the cardiovascular health of persons with type 2 diabetes and hypertension and provides practical guidelines for exercise prescription. A MEDLINE search was performed for January 1985 to June 2002. Bibliographies from relevant articles, professional society clinical practice guidelines, and books were also reviewed. Because few large, randomized trials exist on these topics, meta-analyses, smaller trials, nonrandomized trials, and animal studies were also considered. Data quality was determined by publication in peer-reviewed journals or professional society literature. Type 2 diabetes and hypertension result in abnormalities in central and peripheral parameters of cardiovascular structure and function. Evidence for an exercise training benefit is strongest for improvements in endothelial vasodilator function and left ventricular diastolic function. The data for exercise training's improvement of arterial stiffness and system inflammation and reduction of left ventricular mass are less robust. However, this assertion is based more on a lack of randomized controlled trials rather than data to the contrary. Exercise training also reduces total and abdominal fat. These changes in body composition mediate improvements in insulin sensitivity and blood pressure and may improve endothelial vasodilator function. The current evidence, albeit not fully confirmed in randomized trials, suggests that the benefits of exercise training go beyond the recognized benefits of glycemic control and blood pressure reduction. PMID:12350193

Stewart, Kerry J

2002-10-01

218

EPA's Neurotoxicity Risk Assessment Guidelines  

Microsoft Academic Search

The proposed Neurotoxicity Risk Assessment Guidelines (U.S. EPA, 1995cFed. 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

William K. Boyes; Michael L. Dourson; Jacqueline Patterson; Hugh A. Tilson; William F. Sette; Robert C. Macphail; Abby A. Li; John L. O'donoghue

1997-01-01

219

Guidelines for gastroenterological endoscopy in patients undergoing antithrombotic treatment.  

PubMed

Guidelines for gastroenterological endoscopy in patients undergoing antithrombotic treatment have been produced by the Japan Gastroenterological Endoscopy Society in collaboration with the Japan Circulation Society, the Japanese Society of Neurology, the Japan Stroke Society, the Japanese Society on Thrombosis and Hemostasis and the Japan Diabetes Society. Previous guidelines from the Japan Gastroenterological Endoscopy Society have focused primarily on prevention of hemorrhage after gastroenterological endoscopy as a result of continuation ofantithrombotic therapy, without considering the associated risk of thrombosis. The new edition of the guidelines includes discussions of gastroenterological hemorrhage associated with continuation of antithrombotic therapy, as well as thromboembolism associated with withdrawal of antithrombotic therapy. PMID:24215155

Fujimoto, Kazuma; Fujishiro, Mitsuhiro; Kato, Mototsugu; Higuchi, Kazuhide; Iwakiri, Ryuichi; Sakamoto, Choitsu; Uchiyama, Shinichiro; Kashiwagi, Atsunori; Ogawa, Hisao; Murakami, Kazunari; Mine, Tetsuya; Yoshino, Junji; Kinoshita, Yoshikazu; Ichinose, Masao; Matsui, Toshiyuki

2014-01-01

220

[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

221

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.

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

2013-01-01

222

Society for Cardiovascular Angiography and Interventions  

MedlinePLUS

... Releases About SCAI SCAI Milestones Report About Interventional Cardiology Quick Facts & Statistics CCI Journal SCAI Newsletter SCAI ... August 22 - 24, 2014 ACC/SCAI Premier Interventional Cardiology Overview and Board Preparatory Course Amelia Island, Florida ...

223

Indications for conservative management of scoliosis (guidelines)  

PubMed Central

This guideline has been discussed by the SOSORT guideline committee prior to the SOSORT consensus meeting in Milan, January 2005 and published in its first version on the SOSORT homepage: . After the meeting it again has been discussed by the members of the SOSORT guideline committee to establish the final 2005 version submitted to Scoliosis, the official Journal of the society, in December 2005.

Weiss, Hans-Rudolf; Negrini, Stefano; Rigo, Manuel; Kotwicki, Tomasz; Hawes, Martha C; Grivas, Theodoros B; Maruyama, Toru; Landauer, Franz

2006-01-01

224

Dermatologists’ Adherence to the Guideline of the Dutch Society of Dermatology and Venereology with Respect to the Treatment with Methotrexate for Severe Chronic Plaque Psoriasis: Results from a Dutch Survey  

Microsoft Academic Search

Background: In 2003, the Dutch guideline ‘Photo(chemo) therapy and systemic therapy for severe chronic plaque psoriasis’ was established. Objectives: To document how closely this guideline is followed in clinical practice with respect to the methotrexate (MTX) treatment and to formulate recommendations to adjust the guideline. Methods: A survey was conducted among Dutch dermatologists and residents in dermatology. The questionnaire assessed

M. A. M. Berends; E. M. G. J. de Jong; M. J. P. Gerritsen

2007-01-01

225

Cardiovascular Deconditioning.  

National Technical Information Service (NTIS)

Spaceflight causes adaptive changes in cardiovascular function that may deleteriously affect crew health and safety. Over the last three decades, symptoms of cardiovascular changes have ranged from postflight orthostatic tachycardia and decreased exercise...

J. B. Charles J. M. Fritsch-Yelle P. A. Whitson M. L. Wood T. E. Brown G. W. Fortner

1999-01-01

227

Comment on the Proposed Uniform Guidelines on Employee Selection Procedures  

ERIC Educational Resources Information Center

Voices the American Society for Personnel Administration's objections to portions of the proposed 1977 federal guidelines for employee selection in compliance with federal equal opportunity legislation. The portions of the guidelines at issue are included. (IRT)

Personnel Administrator, 1978

1978-01-01

228

Gaps in primary care documentation of cardiovascular risk factors  

Microsoft Academic Search

Background New Zealand guidelines recommend that cardiovascular risk management should be informed by the absolute risk of a cardiovascular event. This requires knowledge of a person's age, sex, ethnicity, medical and family history, blood pressure, total and HDL cholesterol, diabetes, and smoking status. Aim To establish the extent of primary care documentation of cardiovascular risk factors. Methods An audit of

Natasha Rafter; Susan Wells; Alistair Stewart; Vanessa Selak; Robyn Whittaker; Dale Bramley; Paul Roseman; Sue Furness; Rod Jackson

229

National Space Society  

NSDL National Science Digital Library

The National Space Society (NSS) is a nonprofit organization dedicated to the creation of a spacefaring civilization. The NSS web site features information about the organization, its mission and vision, membership information, and a listing of NSS local chapters. The library features links to videos, books, and other publications on space settlements and bases, space policy, and technology. There is also information on the organization's magazine, "Ad Astra," including instructions for authors, publishing and advertising guidelines, and some archived content. Other materials include news articles, event announcements, and information on current space missions.

2005-02-01

230

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

231

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

232

Cardiovascular Deconditioning  

NASA Technical Reports Server (NTRS)

Spaceflight causes adaptive changes in cardiovascular function that may deleteriously affect crew health and safety. Over the last three decades, symptoms of cardiovascular changes have ranged from postflight orthostatic tachycardia and decreased exercise capacity to serious cardiac rhythm disturbances during extravehicular activities (EVA). The most documented symptom of cardiovascular dysfunction, postflight orthostatic intolerance, has affected a significant percentage of U.S. Space Shuttle astronauts. Problems of cardiovascular dysfunction associated with spaceflight are a concern to NASA. This has been particularly true during Shuttle flights where the primary concern is the crew's physical health, including the pilot's ability to land the Orbiter, and the crew's ability to quickly egress and move to safety should a dangerous condition arise. The study of astronauts during Shuttle activities is inherently more difficult than most human research. Consequently, sample sizes have been small and results have lacked consistency. Before the Extended Duration Orbiter Medical Project (EDOMP), there was a lack of normative data on changes in cardiovascular parameters during and after spaceflight. The EDOMP for the first time allowed studies on a large enough number of subjects to overcome some of these problems. There were three primary goals of the Cardiovascular EDOMP studies. The first was to establish, through descriptive studies, a normative data base of cardiovascular changes attributable to spaceflight. The second goal was to determine mechanisms of cardiovascular changes resulting from spaceflight (particularly orthostatic hypotension and cardiac rhythm disturbances). The third was to evaluate possible countermeasures. The Cardiovascular EDOMP studies involved parallel descriptive, mechanistic, and countermeasure evaluations.

Charles, John B.; Fritsch-Yelle, Janice M.; Whitson, Peggy A.; Wood, Margie L.; Brown, Troy E.; Fortner, G. William

1999-01-01

233

[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

234

Methodological quality of guidelines in gastroenterology.  

PubMed

Background and study aims: Clinical guidelines are a common feature in modern endoscopy practice and they are being produced faster than ever. However, their methodological quality is rarely assessed. This study evaluated the methodological quality of current clinical guidelines in the field of gastroenterology, with an emphasis on endoscopy. Materials and methods: Practice guidelines published by the American College of Gastroenterology (ACG), American Gastroenterological Association (AGA), American Society for Gastrointestinal Endoscopy (ASGE), European Society of Gastrointestinal Endoscopy (ESGE), British Society of Gastroenterology (BSG), National Institute for Health and Care Excellence (NICE), and the Scottish Intercollegiate Guidelines Network (SIGN) were searched between September and October 2012 and evaluated using the AGREE II (Appraisal of Guidelines for Research and Evaluation) instrument (23 items, scores 1?-?7 for each item; higher scores mean better quality). Results: A total of 100 guidelines were assessed. The mean number of items scoring 6 or 7 per guideline was 9.2 (out of 23 items). Overall, 99?% of guidelines failed to include the target population in the development process, and 96?% did not report facilitators and barriers to guideline application. In addition, 86?% did not include advice or tools, and 94?% did not present monitoring or auditing criteria. Conclusion: The global methodological quality of clinical guidelines in the field of gastroenterology is poor, particularly regarding involvement of the target population in the development of guidelines and in the provision of clear suggestions to practitioners. PMID:24760732

Malheiro, Rui; de Monteiro-Soares, Matilde; Hassan, Cesare; Dinis-Ribeiro, Mário

2014-06-01

235

Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents: Updated Guidelines From the Centers for Disease Control and Prevention, National Institutes of Health, and HIV Medicine Association of the Infectious Diseases Society of America.  

PubMed

In May 2013, a revised and updated version of the Centers for Disease Control and Prevention/National Institutes of Health/HIV Medicine Association Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents was released online. These guidelines, since their inception in 1989, have been widely accessed in the United States and abroad. These guidelines have focused on the management of HIV/AIDS-related opportunistic infections that occur in the United States. In other parts of the world, the spectrum of complications may be different and the resources available for diagnosis and management may not be identical to those in the United States. The sections that have been most extensively updated are those on immune reconstitution inflammatory syndrome, tuberculosis, hepatitis B, hepatitis C, human papillomavirus, and immunizations. The guidelines will not be published in hard copy form. This document will be revised as needed throughout each year as new data become available. PMID:24585567

Masur, Henry; Brooks, John T; Benson, Constance A; Holmes, King K; Pau, Alice K; Kaplan, Jonathan E

2014-05-01

236

Entomological Societies  

NSDL National Science Digital Library

This online directory of professional entomological societies covers the entire country. For each resource, contact information, including a link to its Web site, is provided. The list is divided into the following categories: general resources, national headquarters, Northeast, Mid-Atlantic, Southeast, South, Midwest, and California and Hawaii.

237

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.

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

238

New Canadian physical activity guidelines.  

PubMed

The Canadian Society for Exercise Physiology (CSEP), in cooperation with ParticipACTION and other stakeholders, and with support from the Public Health Agency of Canada (PHAC), has developed the new Canadian Physical Activity Guidelines for Children (aged 5-11 years), Youth (aged 12-17 years), Adults (aged 18-64 years), and Older Adults (aged >=65 years). The new guidelines include a preamble to provide context and specific guidelines for each age group. The entire guideline development process was guided by the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument, which is the international standard for clinical practice guideline development. Thus, the guidelines have gone through a rigorous and transparent developmental process; we based the recommendations herein on evidence from 3 systematic reviews, and the final guidelines benefitted from an extensive online and in-person consultation process with hundreds of stakeholders and key informants, both domestic and international. Since 2006, the products of our efforts resulted in the completion of 21 peer-reviewed journal articles (including 5 systematic reviews) that collectively guided this work. The process that Canadian researchers undertook to update the national physical activity guidelines represents the most current synthesis, interpretation, and application of the scientific evidence to date. PMID:21326376

Tremblay, Mark S; Warburton, Darren E R; Janssen, Ian; Paterson, Donald H; Latimer, Amy E; Rhodes, Ryan E; Kho, Michelle E; Hicks, Audrey; Leblanc, Allana G; Zehr, Lori; Murumets, Kelly; Duggan, Mary

2011-02-01

239

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

240

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

241

Misguided guidelines.  

PubMed

The proposed guidelines would require detailed, probing inquiry into motivation for choosing assisted suicide. This is an appropriate requirement in principle. In practice, it will be virtually impossible to carry out this inquiry within likely statutory time limits. Evaluators most likely will either reject the guidelines as impractical or give them merely perfunctory observance. There is, moreover, an inherent tension in the evaluator's relationship with the patient between empathy and impersonal distancing that the guidelines do not adequately acknowledge; this tension necessarily compromises the evaluator's ability to apply the guidelines in the probing, detailed manner they envision. The guidelines provide false comfort that physician-assisted suicide can be carried out with adequately sensitive monitoring of voluntariness and mental competence. PMID:12953677

Burt, R A

2000-06-01

242

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.

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

2013-01-01

243

[The Japanese guidelines for cardiopulmonary bypass and recommendations concerning safety devices for cardiopulmonary bypass].  

PubMed

In March 2007, under the guidance of the Ministry of Health, Labour and Welfare, a committee released Japanese guidelines for cardiopulmonary bypass (CPB) with the purpose to standardize CPB hardware and software for patient's safety and education of medical personnel. In April 2007, the Japanese Society of Extra Corporeal Technology in Medicine (JaSECT) released recommendations concerning safety devices for cardiopulmonary bypass. An on-site training session for CPB troubles was held at the 38th annual meeting of Japanese Society for Cardiovascular Surgery in February 2008 as a measure to ensure safety of CPB. Young heart surgeons and perfusionists were taught the basic CPB operations, recovering procedures after an incident, and the use of safety devices. A questionnaire survey was conducted at the end of the training session. Eight heart surgeons and 7 perfusionists (3 certified and 4 without certification) participated in the session None of the 8 heart surgeons who participated had read the guidelines or made an effort to accomplish the recommendations. Of the 7 certified or uncertified perfusionists who participated, only one certified perfusionist made an effort to accomplish the recommendation. CPB accidents are rare, but as a medical team, tragedies such as death and life-threatening complication due to CPB accident should be prevented at all costs. We believe that the 1st step to prevent CPB incident is to read and understand the CPB guidelines thoroughly, and to accomplish the "required" items listed in the recommendations. PMID:19670778

Anno, Makoto; Yoshida, K; Momose, Naoki; Matayoshi, Toru; Minami, Shigeru; Tomizawa, Yasuko

2009-08-01

244

Guideline for Hand Hygiene in Health-Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America.  

PubMed

The Guideline for Hand Hygiene in Health-Care Settings provides health-care workers (HCWs) with a review of data regarding handwashing and hand antisepsis in health-care settings. In addition, it provides specific recommendations to promote improved hand-hygiene practices and reduce transmission ofpathogenic microorganisms to patients and personnel in health-care settings. This report reviews studies published since the 1985 CDC guideline (Garner JS, Favero MS. CDC guideline for handwashing and hospital environmental control, 1985. Infect Control 1986;7:231-43) and the 1995 APIC guideline (Larson EL, APIC Guidelines Committee. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995;23:251-69) were issued and provides an in-depth review of hand-hygiene practices of HCWs, levels of adherence of personnel to recommended handwashing practices, and factors adversely affecting adherence. New studies of the in vivo efficacy of alcohol-based hand rubs and the low incidence of dermatitis associated with their use are reviewed. Recent studies demonstrating the value of multidisciplinary hand-hygiene promotion programs and the potential role of alcohol-based hand rubs in improving hand-hygiene practices are summarized. Recommendations concerning related issues (e.g., the use of surgical hand antiseptics, hand lotions or creams, and wearing of artificial fingernails) are also included. PMID:12418624

Boyce, John M; Pittet, Didier

2002-10-25

245

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

246

[Dietary fats and cardiovascular health].  

PubMed

Although dietary fat and its role in cardiovascular prevention has been one of the most extensively studied nutritional topics, it continues to be an ever-expanding research area. Particularly thanks to studies on Mediterranean diet, we now know that fat quality is more relevant than the amount of fat we eat in the diet. Thus, saturated and trans fats have been found to increase the risk of atherogenic disease. This is why it is recommended to substitute complex carbohydrates or unsaturated fat for unsaturated and trans fats with the aim of reducing saturated and trans fat intake to <10% and <1%, respectively, of the total calorie intake. Recent population studies, particularly that conducted in Kuopio, Finland, and those on Mediterranean diet, stress the important role of monounsaturated and polyunsaturated fats as key nutrients in preventing cardiovascular disease in modern societies. Furthermore, a special type of polyunsaturated fatty acids, i.e. those of the omega-3 (n-3) series, is increasingly becoming essential nutrients for a healthy diet, especially in the case of children. Therefore, there is a rationale for four the Scientific Societies that are strongly committed to disseminate the benefits of a healthy diet in preventing cardiovascular disease, and to prepare a joint statement with the purpose of spreading improved knowledge on the importance of changing to a healthy diet with a well-balanced fat intake for industrialized populations. Accordingly, a multidisciplinary panel of experts from the following institutions has developed the present joint statement targeted at both adults and children of different ages: Spanish Society of Arteriosclerosis, Spanish Society of Family and Community Medicine, Spanish Association of Paediatrics, Spanish Society of Gastroenterology, Hepatology and Paediatric Nutrition and Dietetics, and Spanish Society for Food Sciences. PMID:21392857

Fernández, Lourdes Carrillo; Serra, Jaime Dalmau; Álvarez, Jesús Román Martínez; Alberich, Rosa Solà; Jiménez, Francisco Pérez

2011-03-01

247

COASTAL GUIDELINES  

EPA Science Inventory

Resource Purpose: Developed to support effluent guidelines for the coastal subcategory of the oil and gas extraction industry. Data were used to develop environmental impacts, potential regulatory limits, and the cost of regulation. Legislation/Enabling Authority: ...

248

Guidelines for Two-Year College Physics Programs  

ERIC Educational Resources Information Center

The guidelines are meant to help two-year institutions provide physics students with the best possible education in the fundamental areas of physics and its relation to other disciplines and to society. General curricular guidelines, rather than specific curricular content, are defined. Implementing these guidelines can help ensure that the…

Hogan,, William P., Ed.; Davies, Chad L., Ed.; O'Kuma, Thomas L., Ed.; Plumb, Marie , Ed.; Waggoner, William, Ed.; Warren, William R., Ed.

2002-01-01

249

[Guideline-conform diagnostics in language impairments].  

PubMed

In order to distinguish more accurately and easily between language difficulties in need of therapy or special support versus language impairments a S2K guideline was developed by interdisciplinary teams of different (medical) societies and professional associations. This guideline was published in 2011 and has replaced all existing monodisciplinary guidelines. According to the new S2K guideline standardised measures of language testing are mandatory. Apart from reviewing the S2K guidelines, this article aims to suggest how these guidelines can be established in clinical practice. By closely following this new guideline, testing and diagnosing children with language difficulties is believed to be enhanced considerably, and also comply with quality management standards. PMID:24577293

Ptok, M; Kühn, D; Jungheim, M; Schwemmle, C; Miller, S

2014-04-01

250

Evolution of lipid management guidelines  

PubMed Central

Abstract Objective To understand how the new guidelines for management of cardiovascular risk by the American Heart Association and the American College of Cardiology (AHA-ACC) can be interpreted and used in a Canadian setting. Sources of information The AHA-ACC guidelines were reviewed, along with all references. Independent PubMed searches were done to include the addition of other lipid-lowering therapy to statins and the use of medical calculators to enhance patient understanding. Main message The new AHA-ACC guidelines are based on the best current evidence related to lipid management. This includes use of 10-year cardiovascular disease (CVD) risk as the treatment threshold in place of low-density lipoprotein cholesterol levels, as well as abandonment of low-density lipoprotein treatment targets. There is increased emphasis on dietary and exercise interventions, with the beginning of an effort to quantify the effect of these interventions. Statins are the main drug intervention, and the addition of other drugs to augment lipid lowering is no longer recommended. For application in Canada, Framingham risk tables are more appropriate for risk assessment than the pooled cohort equations used in the United States. Risk calculators for CVD risk should contain information on cardiovascular age and have the ability to represent risk and alternative interventions graphically in order to improve patient understanding and promote informed decision making. Conclusion Focus on the best evidence in CVD risk can simplify lipid management for both the physician and the patient.

John Bosomworth, N.

2014-01-01

251

Design of the Balance@Work project: systematic development, evaluation and implementation of an occupational health guideline aimed at the prevention of weight gain among employees  

PubMed Central

Background Occupational health professionals may play an important role in preventive health promotion activities for employees. However, due to a lack of knowledge and evidence- and practice based methods and strategies, interventions are hardly being implemented by occupational physicians to date. The aim of the Balance@Work project is to develop, evaluate, and implement an occupational health guideline aimed at the prevention of weight gain among employees. Methods Following the guideline development protocol of the Netherlands Society of Occupational Medicine and the Intervention Mapping protocol, the guideline was developed based on literature, interviews with relevant stakeholders, and consensus among an expert group. The guideline consists of an individual and an environmental component. The individual component includes recommendations for occupational physicians on how to promote physical activity and healthy dietary behavior based on principles of motivational interviewing. The environmental component contains an obesogenic environment assessment tool. The guideline is evaluated in a randomised controlled trial among 20 occupational physicians. Occupational physicians in the intervention group apply the guideline to eligible workers during 6 months. Occupational physicians in the control group provide care as usual. Measurements take place at baseline and 6, 12, and 18 months thereafter. Primary outcome measures include waist circumference, daily physical activity and dietary behavior. Secondary outcome measures include sedentary behavior, determinants of behavior change, body weight and body mass index, cardiovascular disease risk profile, and quality of life. Additionally, productivity, absenteeism, and cost-effectiveness are assessed. Discussion Improving workers' daily physical activity and dietary behavior may prevent weight gain and subsequently improve workers' health, increase productivity, and reduce absenteeism. After an effect- and process evaluation the guideline will be adjusted and, after authorisation, published. Together with several implementation aids, the published guideline will be disseminated broadly by the Netherlands Society of Occupational Medicine. Trial Registration ISRCTN73545254/NTR1190

2009-01-01

252

AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update: Consensus Panel Guide to Comprehensive Risk Reduction for Adult Patients Without Coronary or Other Atherosclerotic Vascular Diseases. American Heart Association Science Advisory and Coordinating Committee  

Microsoft Academic Search

The initial Guide to the Primary Prevention of Cardiovascular Diseases was published in 1997 as an aid to healthcare professionals and their patients without established coronary artery disease or other atherosclerotic diseases. This 2002 update of the Guide acknowledges a number of advances in the field of primary prevention since 1997.

Thomas A. Pearson; Steven N. Blair; Stephen R. Daniels; Robert H. Eckel; Joan M. Fair; Stephen P. Fortmann; Barry A. Franklin; Larry B. Goldstein; Philip Greenland; Scott M. Grundy; Yuling Hong; Nancy Houston Miller; Ronald M. Lauer; Ira S. Ockene; Ralph L. Sacco; James F. Sallis; Sidney C. Smith; Neil J. Stone; Kathryn A. Taubert

2002-01-01

253

Dutch guidelines for interventional cardiology: institutional and operator competence and requirements for training  

PubMed Central

Interventional cardiology is an expanding field within cardiovascular medicine and today it is generally accepted that cardiologists require specific training, knowledge and skills. Hospitals where coronary interventions are performed must be properly equipped and able to provide specialised care. Percutaneous coronary interventions are frequently used for coronary revascularisation. The public should have confidence in the uniformity of high quality care. Therefore, such quality of care should be maintained by certification of the individual operators, general guidelines for institutional requirements and formal audits. The Netherlands Society of Cardiology (NVVC) will be implementing a new registration system for cardiologists with a subspecialisation that will include registration for interventional cardiology. The NVVC asked the Working Group of Interventional Cardiology (WIC) to update the 1994 Dutch guidelines on operator and institutional competence, and requirements for training in interventional cardiology in order to incorporate them into the official directives. The present guidelines represent the expert opinion of the Dutch interventional cardiology community and are in accordance with international regulations. After two rounds of discussion, the NVVC approved the guidelines in November 2004 during the autumn meeting.

Aengevaeren, W.R.M.; Laarman, G.J.; Suttorp, M.J.; ten Berg, J.M.; van Boven, A.J.; de Boer, M.J.; Piek, J.J.; van Ommen, G.V.A.; Bronzwaer, J.G.F.; Smits, P.; Deckers, J.W.

2005-01-01

254

[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

255

Cardiovascular Genetic Medicine: Evolving Concepts, Rationale, and Implementation  

Microsoft Academic Search

Cardiovascular genetic medicine is devoted to the identification and understanding of cardiac conditions resulting from genetic\\u000a and genomic mechanisms and to the development and validation of diagnostic and treatment algorithms and guidelines. Cardiovascular\\u000a genetic medicine clinics now provide expert cardiovascular subspecialty care, genetic counseling and clinical genetic testing,\\u000a and will eventually provide disease-specific gene or genetic therapies. Currently, the most

Ray E. Hershberger

2008-01-01

256

Jogging Guidelines.  

ERIC Educational Resources Information Center

Jogging guidelines are set forth under the following headings: a) What Is Jogging; c) Why One Should Jog; c) How To Begin; d) What To Wear (with the emphasis on proper shoes); e) When and Where To Jog; and f) How To Jog. A 16-week basic program, outlined for inactive adults, recommends for each week the number of days to exercise, the distance,…

President's Council on Physical Fitness and Sports, Washington, DC.

257

SBF GUIDELINES  

EPA Science Inventory

Resource Purpose: Developed to support effluent guidelines for the use of synthetic based drilling fluids in the offshore and coastal subcategories of the oil and gas extraction industry. Data were used to develop environmental impacts, potential reg limits, and the cost o...

258

Developing hypertension guidelines: an evolving process.  

PubMed

Hypertension guidelines provide up-to-date information and recommendations for hypertension management to healthcare providers, and they facilitate translation of new knowledge into clinical practice. Guidelines represent consensus statements by expert panels, and the process of guideline development has inherent vulnerabilities. Between 1977 and 2003, under the direction of the National Institutes of Health (NIH), the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC) issued 7 reports. The evolution of the JNC recommendations reflects the acquisition of observational and clinical trial data and the availability of newer antihypertensive drugs. Despite 5 years in preparation, NIH did not release a JNC 8 report and recently made the decision to withdraw from issuing guidelines. The responsibility for issuing hypertension-related guidelines was transferred to the American Heart Association (AHA) and the American College of Cardiology. Without the endorsement of the NIH or the AHA, JNC 8 committee members recently published their guideline report. Notably, there have been discrepancies of JNC recommendations over time as well as discrepancies with recommendations of other professional organizations. The Institute of Medicine recently recommended criteria for "trustworthy" guidelines. Criticisms of the guideline process, and of the guidelines themselves, should not obscure their likely contribution to improved hypertension control and to decreases of mortality rates of stroke and cardiovascular disease over the past several decades. Nevertheless, translation of guidelines into clinical practice remains a challenge. PMID:24572703

Kotchen, Theodore A

2014-06-01

259

Pharmacogenomics: Application to the Management of Cardiovascular Disease  

Microsoft Academic Search

The past decade has seen substantial advances in cardiovascular pharmacogenomics. Genetic determinants of response to clopidogrel and warfarin have been defined, resulting in changes to the product labels for these drugs that suggest the use of genetic information as a guide for therapy. Genetic tests are available, as are guidelines for incorporation of genetic information into patient-care decisions. These guidelines

J A Johnson; L H Cavallari; A L Beitelshees; J P Lewis; A R Shuldiner; D M Roden

2011-01-01

260

Prevention and treatment of cardiovascular disease in women: the obstetric-gynecologist's point of view.  

PubMed

It has been confirmed that cardiovascular disease (CVD) is the leading cause of morbidity and mortality not only in men but also in women. The most recent American Heart Association (AHA) and European Atherosclerosis Society (EAS) recommendations specifically address women. This is in response to the majority of studies that primarily involved men. Ideal cardiovascular health has been defined for women, and new factors were added to the traditional risk factors. As stated by the American and European Menopause Societies (NAMS and EMAS), hormone replacement therapy (HRT) is no longer believed to be protective for CVD; on the contrary, women benefit just as much as men from statins to lower their risk of heart disease. At the onset of menopause, women exhibit an increase in cholesterol and an increased risk of CVD. Unfortunately, hyperlipidemia is largely undertreated in women, although the rate of hypercholesterolemia among women is similar to that of men. More aggressive intervention is recommended for persons with multiple risk factors and/or monogenic dyslipidemias. In women affected by familial hypercholesterolemia in the homozygous and compound forms, treatment such as lipoprotein apheresis is also suggested. There is evidence for the use of these techniques even in pregnancy. An update on the most recent guidelines issued by AHA, EAS, NAMS and EMAS for the prevention of CVD in women along with a brief overview on the use of lipoprotein apheresis in women during pregnancy is reported. PMID:23551672

Perrone, Giuseppina; Brunelli, Roberto

2013-04-01

261

Astronomical Society in Zrenjanin.  

NASA Astrophysics Data System (ADS)

The Astronomical Society "Milutin Milankovi?" was established in Zrenjanin at the beginning of 1996. The programme of the Society includes the cooperation with elementary and high schools and astronomical societies in the country and abroad.

Naumovski, K.; Braci?, M.

1997-08-01

262

Defining the role of trimetazidine in the treatment of cardiovascular disorders: some insights on its role in heart failure and peripheral artery disease.  

PubMed

Trimetazidine is a cytoprotective drug whose cardiovascular effectiveness, especially in patients with stable ischemic heart disease, has been the source of much controversy in recent years; some have gone so far as to treat the medication as a 'placebo drug' whose new side effects, such as Parkinsonian symptoms, outweigh its benefits. This article is an attempt to present the recent key studies, including meta-analyses, on the use of trimetazidine in chronic heart failure, also in patients with diabetes mellitus and arrhythmia, as well as in peripheral artery disease. This paper also includes the most recent European Society of Cardiology guidelines, including those of 2013, on the use of trimetazidine in cardiovascular disease. PMID:24902800

Chrusciel, Piotr; Rysz, Jacek; Banach, Maciej

2014-06-01

263

Prostate cancer brachytherapy: guidelines overview  

PubMed Central

Prostate cancer, due to wide availability of PSA tests, is very often diagnosed in early stage, nowadays. This makes management of this disease even harder in every day oncology care. There is a wide range of treatment options including surgery, radiotherapy and active surveillance, but essential question is which treatment patient and oncologist should decide for. Due to recent publication of Prostate Cancer Results Study Group, in which brachytherapy is one of supreme curative options for prostate cancer, we decided to overview most present european and north american recommendations. National Comprehensive Cancer Network, American Society for Radiation Oncology, American Brachytherapy Society, European Association of Urology and Groupe Européen de Curiethérapie of European Society for Therapeutic Radiation Oncology guidelines are overviewed, particularly focusing on HDR and LDR brachytherapy.

Bialas, Brygida

2012-01-01

264

Younger age of escalation of cardiovascular risk factors in Asian Indian subjects  

Microsoft Academic Search

BACKGROUND: Cardiovascular risk factors start early, track through the young age and manifest in middle age in most societies. We conducted epidemiological studies to determine prevalence and age-specific trends in cardiovascular risk factors among adolescent and young urban Asian Indians. METHODS: Population based epidemiological studies to identify cardiovascular risk factors were performed in North India in 1999–2002. We evaluated major

Rajeev Gupta; Anoop Misra; Naval K Vikram; Dimple Kondal; Shaon Sen Gupta; Aachu Agrawal; RM Pandey

2009-01-01

265

Cardiovascular group  

NASA Technical Reports Server (NTRS)

As a starting point, the group defined a primary goal of maintaining in flight a level of systemic oxygen transport capacity comparable to each individual's preflight upright baseline. The goal of maintaining capacity at preflight levels would seem to be a reasonable objective for several different reasons, including the maintenance of good health in general and the preservation of sufficient cardiovascular reserve capacity to meet operational demands. It is also important not to introduce confounding variables in whatever other physiological studies are being performed. A change in the level of fitness is likely to be a significant confounding variable in the study of many organ systems. The principal component of the in-flight cardiovascular exercise program should be large-muscle activity such as treadmill exercise. It is desirable that at least one session per week be monitored to assure maintenance of proper functional levels and to provide guidance for any adjustments of the exercise prescription. Appropriate measurements include evaluation of the heart-rate/workload or the heart-rate/oxygen-uptake relationship. Respiratory gas analysis is helpful by providing better opportunities to document relative workload levels from analysis of the interrelationships among VO2, VCO2, and ventilation. The committee felt that there is no clear evidence that any particular in-flight exercise regimen is protective against orthostatic hypotension during the early readaptation phase. Some group members suggested that maintenance of the lower body muscle mass and muscle tone may be helpful. There is also evidence that late in-flight interventions to reexpand blood volume to preflight levels are helpful in preventing or minimizing postflight orthostatic hypotension.

Blomqvist, Gunnar

1989-01-01

266

Cardiac biomarkers and risk assessment in patients undergoing major non-cardiac surgery: time to revise the guidelines?  

PubMed

Although the perioperative event rate has declined over the past 30 years, as a consequence of the developments in anesthesiology and surgical techniques, perioperative cardiovascular complications are still a significant clinical problem. At the end of the last century, a pooled analysis of several large studies found a 30-day incidence of cardiac events of 2.5% in unselected patients aged >40 years. The identification of myocardial injury after non-cardiac surgery is a problematic and tough challenge, since up to 50% of cardiac deaths actually occur in patients with no history of overt heart disease. Recently, among novel sensitive and specific cardiovascular risk markers, the European Society of Cardiology and European Society of Anesthesiology guidelines for preoperative cardiac risk assessment have recommended that preoperative brain natriuretic peptide (BNP) or N-terminal fragment of proBNP (NT-proBNP) measurement should be considered in high-risk patients undergoing non-cardiac surgery. However, several recent studies and meta-analyses, published in the last 5 years, strongly support the use of both assays of cardiac B-type natriuretic peptides and troponins, for risk stratification in patients undergoing non-cardiac surgery, in order to improve operative and postoperative outcome. Indeed, an increase in specific cardiac biomarkers, as it is the case for natriuretic peptides and troponins, always indicates that the heart is under a stress condition or even actually injured, respectively. In conclusion, the authors suggest that future guidelines on cardiovascular risk evaluation in patients undergoing major surgical procedures should take into account the following evidence. PMID:24501160

Clerico, Aldo; Emdin, Michele; Passino, Claudio

2014-07-01

267

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.

Kaplan, Alan

2013-01-01

268

Guideline clinical nutrition in patients with stroke.  

PubMed

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

Wirth, Rainer; Smoliner, Christine; Jäger, Martin; Warnecke, Tobias; Leischker, Andreas H; Dziewas, Rainer

2013-01-01

269

Cosmetic surgery in the NHS: Applying local and national guidelines.  

PubMed

There is no worldwide consensus, as to how healthcare should be funded, in a modern society. Limited resources in the UK, have led to restrictions on cosmetic surgery in the NHS. Guidelines governing access to cosmetic surgery have been formulated. A retrospective audit has been undertaken, to assess adherence to local and national guidelines, in an NHS trust. Ninety-nine casenotes were reviewed over 1 year. Data on complications were collected. Compliance to local guidelines was 44% and to national guidelines was 22%. Complication rate was 23% in guideline compliant patients and 55% in non-compliant patients (P<0.005). Guidelines are difficult to follow in practice. Total adherence to guidelines would reduce waiting lists and complications, but some needy patients could be denied treatment. In practice, rigid adherence to guidelines is not possible. PMID:19775949

Breuning, Eleonore E; Oikonomou, Dimitris; Singh, Pritam; Rai, Jagdeep K; Mendonca, Derick Amith

2010-09-01

270

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

271

ISMuLT Guidelines for muscle injuries.  

PubMed

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

2013-10-01

272

EFNS guidelines on neuropathic pain assessment  

Microsoft Academic Search

In September 2001, a Task Force was set up under the auspices of the European Federation of Neurological Societies with the aim of evaluating the existing evidence about the methods of assessing neuropathic pain and its treatments. This review led to the development of guidelines to be used in the management of patients with neuro- pathic pain. In the clinical

G. Cruccu; P. Anand; N. Attal; L. Garcia-Larrea; M. Haanpaa; E. Jorum; J. Serra; T. S. Jensen

2004-01-01

273

Guidelines for Antibiotic Prophylaxis for GI Endoscopy  

Microsoft Academic Search

This is one of a series of statements discussing the utilization of GI endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy prepared this text. In preparing this guideline, a MEDLINE literature search was performed, and additional references were obtained from the bibliographies of the identified articles and from recommendations of expert

William K. Hirota; Kathryn Petersen; Todd H. Baron; Jay L. Goldstein; Brian C. Jacobson; Jonathan A. Leighton; J. Shawn Mallery; J. Patrick Waring; Robert D. Fanelli; Jo Wheeler-Harbough; Douglas O. Faigel

2003-01-01

274

Guidelines on the radical management of patients with lung cancer  

Microsoft Academic Search

A joint initiative by the British Thoracic Society and the Society for Cardiothoracic Surgery in Great Britain and Ireland was undertaken to update the 2001 guidelines for the selection and assessment of patients with lung cancer who can potentially be managed by radical treatment.

Eric Lim; David Baldwin; Michael Beckles; John Duffy; James Entwisle; Corinne Faivre-Finn; Keith Kerr; Alistair Macfie; Jim McGuigan; Simon Padley; Sanjay Popat; Nicholas Screaton; Michael Snee; David Waller; Chris Warburton; Thida Win

2010-01-01

275

Executing Clinical Pratice Guidelines.  

National Technical Information Service (NTIS)

A clinical practice guideline can be implemented using a guideline execution engine. The engine can interpret the clinical practice guideline, obtain medical data stored in a clinical information system (CIS), and implement an action in response to execut...

B. Wu C. Taunk D. R. Berg J. M. Thrun P. Ram R. M. Abarbanel

2004-01-01

276

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

277

New Insights into the Management of Hypertension and Cardiovascular Risk with Angiotensin Receptor Blockers: Observational Studies Help Us?  

PubMed Central

Post-marketing observational studies are valuable for establishing the real-world effectiveness of treatment regimens in routine clinical practice as they typically monitor a diverse population of patients over many months. This article reviews recent observational studies of angiotensin receptor blockers (ARBs) for the management of hypertension: the 6-month eprosartan POWER study (n~29,400), the 3-month valsartan translational research programme (n~19,500), the 9-month irbesartan Treat to Target study (n=14,200), the 6-month irbesartan DO-IT survey (n~3300) and the 12-week candesartan CHILI survey programme (n=4600). Reduction in blood pressure with ARBs reported across these studies appears to be comparable for the different agents, although direct comparisons between studies cannot be made owing to different treatment durations and baseline patient demographics. Of these studies, the eprosartan POWER study, 2 of the 7 studies in the valsartan translational research programme, and the candesartan CHILI Triple T study measured total cardiovascular risk, as recommended in the 2013 European Society of Cardiology-European Society of Hypertension guidelines. The POWER study confirmed the value of the Systemic Coronary Risk Evaluation (SCORE) to accurately assess total cardiovascular risk. With the advent of new healthcare practices, such as the use of electronic health records (EHRs), observational studies in larger patient populations will become possible. In the future, algorithms embedded in EHR systems could evolve as decision support tools to inform on patient care.

Goudev, Assen

2014-01-01

278

American Rocket Society  

NASA Technical Reports Server (NTRS)

In addition to Dr. Robert Goddard's pioneering work, American experimentation in rocketry prior to World War II grew, primarily in technical societies. This is an early rocket motor designed and developed by the American Rocket Society in 1932.

2004-01-01

279

American Thoracic Society  

MedlinePLUS

... the ATS has grown to tackle asthma, COPD, lung cancer, sepsis, acute respiratory 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 ... Copyright © 2014 American Thoracic Society · Privacy Statement

280

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

281

Cardiovascular fitness and type 2 diabetes  

Microsoft Academic Search

Exercise has long been recognized as a cornerstone in diabetes care. Even so, modern science is just beginning to understand\\u000a the physiologic impact cardiovascular fitness has on long-term diabetes management, and the prevention or delay, of type 2\\u000a diabetes. Recent advances in research are defining the metabolic pathways involved in insulin signaling and in reducing insulin\\u000a resistance. Tools and guidelines

Cathy Mullooly

2002-01-01

282

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

283

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.

284

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.

285

APOE Genotyping, Cardiovascular Disease  

MedlinePLUS

... cardiovascular disease (CVD) . However, there is a wide variability in the response to these lipid-lowering drugs ... normal" lipid metabolism, thus may not have any genetic impact on risk of developing cardiovascular disease . APOE ...

286

Infection and Cardiovascular Disease  

ClinicalTrials.gov

Cardiovascular Diseases; Coronary Disease; Cerebrovascular Accident; Heart Diseases; Myocardial Infarction; Infection; Chlamydia Infections; Cytomegalovirus Infections; Helicobacter Infections; Atherosclerosis

2005-06-23

287

ApoB versus non-HDL-cholesterol: diagnosis and cardiovascular risk management.  

PubMed

The most recent guidelines released by the EAS/ESC and the Canadian Cardiovascular Society (CCS) retain low-density lipoprotein cholesterol (LDL-C) as the primary measure of the atherogenic risk of the apolipoprotein B (apoB) lipoproteins and the primary target of LDL-C lowering therapy. Both organizations endorse non-high-density lipoprotein cholesterol (non-HDL-C) and apoB as "alternate/secondary" targets, but neither group offers evidence supporting the continued preference of LDL-C as the primary target over non-HDL-C and apoB. Further, both suggest that non-HDL-C and apoB more or less measure the same thing and, therefore, are essentially interchangeable. But what is the evidence that LDL-C should remain the primary target, and are apoB and non-HDL-C mirror images of one another? Furthermore, are estimation of risk and establishment of treatment targets the only relevant issues, or is diagnosis also an essential objective? These are the questions this article will address. Our principal objectives are: (1) to clarify the differences between LDL-C, non-HDL-C, and apoB and to distinguish what they measure; (2) to summarize the evidence relating to LDL-C, non-HDL-C, and apoB as predictors of cardiovascular risk and as targets for treatment; and (3) to demonstrate that diagnosis of atherogenic dyslipoproteinemias should be a fundamental clinical priority. PMID:24295059

de Nijs, Tjerk; Sniderman, Allan; de Graaf, Jacqueline

2013-11-01

288

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

289

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.

Montgomery, Jana E; Brown, Jeremiah R

2013-01-01

290

Cardiovascular Prevention in a High Risk Sport, Ice Hockey: Applications in Wider Sports Physical Therapy Practice  

PubMed Central

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.

2006-01-01

291

Comparison of International Guidelines for Noninvasive Diagnosis of Hepatocellular Carcinoma  

PubMed Central

The aim of this review is to present the similarities and differences between the latest guidelines for noninvasive diagnosis of hepatocelullar carcinoma (HCC) of American Association for the Study of Liver Diseases (AASLD), European Association for the Study of the Liver (EASL), Asian Pacific Association for the Study of the Liver (APASL), and Japanese Society of Hepatology. All the four guidelines defined a typical HCC vascular pattern as the homogeneous hyperenhancement (wash-in) in the arterial phase followed by wash-out in the venous or late phase. The AASLD and EASL guidelines accept only four-phase computed tomography and dynamic contrast magnetic resonance imaging (MRI) for HCC diagnosis, whereas the APASL and Japanese guidelines also accept contrast-enhanced ultrasound (CEUS). Regarding CEUS, the APASL guidelines accept the use of Levovist or Sonazoid as contrast agents, whereas the Japanese guidelines accept only the use of Sonazoid. The AASLD and EASL guidelines recommend using only extracellular contrast agents such as gadolinium for MRI, whereas the APASL guidelines also included the use of super paramagnetic iron oxid-MRI, and the Japanese guidelines recommended the use of gadolinium-ethoxybenzyl-diethylentriamine pentaacetic acid-MRI. The AASLD and EASL guidelines propos a diagnostic algorithm starting from the tumor size, whereas the APASL and Japanese guidelines recommend an algorithm starting from arterial tumor vascularity (hyper- or hypovascular in the arterial phase). In conclusion, important differences exist among the Western and Eastern guidelines for noninvasive HCC diagnosis.

Bota, Simona; Piscaglia, Fabio; Marinelli, Sara; Pecorelli, Anna; Terzi, Eleonora; Bolondi, Luigi

2012-01-01

292

Revision of ACS Guidelines for Undergraduate Chemistry Programs  

NASA Astrophysics Data System (ADS)

The Committee on Professional Training of the American Chemical Society (ACS) is beginning a major revision of the guidelines it uses for approving programs to offer ACS-certified undergraduate degrees in chemistry. The guidelines include curriculum requirements as well as faculty, staff, and facilities requirements. Changes in both chemistry and education make a careful examination and revision of the guidelines particularly appropriate now. The Committee wants to draw on the opinions of the chemistry community as broadly as possible and seeks responses to a collection of specific questions about the undergraduate chemistry curriculum, as well as general comments about the guidelines.

Fleming Crim, F.; Polik, William F.

2004-12-01

293

Guideline for Capsule Endoscopy: Obscure Gastrointestinal Bleeding  

PubMed Central

Capsule endoscopy (CE) is considered as a noninvasive and reliable diagnostic tool of examining the entire small bowel. CE has been performed frequently at many medical centers in South Korea; however, there is no evidence-based CE guideline for adequate diagnostic approaches. To provide accurate information and suggest correct testing approaches for small bowel disease, the guideline on CE was developed by the Korean Gut Image Study Group, a part of the Korean Society of Gastrointestinal Endoscopy. Operation teams for developing the guideline were organized into four areas: obscure gastrointestinal bleeding, small bowel preparation, Crohn's disease, and small bowel tumor. A total of 20 key questions were selected. In preparing this guideline, MEDLINE, Cochrane library, KMbase, KISS, and KoreaMed literature searches were performed. After writing a draft of the guideline, opinions from various experts were reflected before approving the final document. The guideline should be regarded as recommendations only to gastroenterologists in providing care to their patients. These are not absolute rules and should not be construed as establishing a legal standard of care. Although further revision may be necessary as new data appear, this guideline is expected to play a role for adequate diagnostic approaches of various small bowel diseases.

Shim, Ki-Nam; Moon, Jeong Seop; Chang, Dong Kyung; Do, Jae Hyuk; Kim, Ji Hyun; Min, Byung Hoon; Jeon, Seong Ran; Choi, Myung-Gyu

2013-01-01

294

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

295

Magnolia Society International  

NSDL National Science Digital Library

To many, they are one of the first, sweet smells and sights of spring. Magnolias! And this site of Magnolia Society International is the online home of "a worldwide organization devoted to the appreciation and study of magnolias." This exceptionally comprehensive site offers all sorts of information, ranging from details about research funds, related publications, care and propagations of magnolias, cultivar information, and even magnolia-related merchandise (cool t-shirts, sweatshirts, and tote bags). Visitors to the site can even consider joining the society and being part of an organization 700 members strong, representing 32 countries. With membership comes a subscription to the society's journal: _Magnolia: Journal of the Magnolia Society_.

296

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

297

Society for Industrial Archeology  

NSDL National Science Digital Library

The Society for Industrial Archeology is an association of "members, world-wide, who have a strong interest in preserving, interpreting and documenting our industrial past and heritage." Anyone interested in the industrial past is welcome to join the Society. The newsletter, which is available free to download, provides information on current news, recent publications and notices of conferences and events of interest to Society members. The Journal of the Society for Industrial Archeology (IA) is available by paid subscription and includes essays and book reviews, as well as peer-reviewed articles on current research in industrial archeology. The Links section provides a list of online related resources.

298

Metabolic and Cardiovascular Response to Shallow Water Exercise in Young and Older Women.  

ERIC Educational Resources Information Center

Compared the metabolic and cardiovascular responses of young and older women while performing shallow water exercise (SWE). Overall, SWE elicited metabolic and cardiovascular responses that met American College of Sports Medicine's guidelines for establishing health benefits. Older females self-selected a greater relative exercise intensity during…

Campbell, Jennifer A.; D'Acquisto, Leo J.; D'Acquisto, Debra M.; Cline, Michael G.

2003-01-01

299

Practice guidelines for the supervising professional: intraoperative neurophysiological monitoring.  

PubMed

The American Society of Neurophysiological Monitoring (ASNM) was founded in 1988 as the American Society of Evoked Potential Monitoring. From the beginning, the Society has been made up of physicians, doctoral degree holders, technologists, and all those interested in furthering the profession. The Society changed its name to the ASNM and held its first Annual Meeting in 1990. It remains the largest worldwide organization dedicated solely to the scientifically based advancement of intraoperative neurophysiology. The primary goal of the ASNM is to assure the quality of patient care during monitored procedures along the neuraxis. This goal is accomplished through programs in education, advocacy of basic and clinical research, and publication of guidelines. The ASNM is committed to the development of medically sound and clinically relevant guidelines for intraoperative neurophysiology. Guidelines are formulated based on exhaustive literature review, recruitment of expert opinion, and broad consensus among ASNM membership. Input is likewise sought from sister societies and related constituencies. Adherence to a literature-based, formalized process characterizes the construction of all ASNM guidelines. The guidelines covering the Professional Practice of intraoperative monitoring were established by a committee of nearly 30 total participants and ultimately endorsed by the Board of Directors of ASNM on January 24th 2013. That document follows. PMID:24022172

Skinner, Stanley A; Cohen, Bernard Allan; Morledge, David Eric; McAuliffe, John J; Hastings, John Daniel; Yingling, Charles D; McCaffrey, Michael

2014-04-01

300

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.

301

The Emerging Information Society.  

ERIC Educational Resources Information Center

Focuses on role of library and agencies charged with provision of information in an environment of technological change. Predictions concerning aspects of the emerging information society (computer literacy, home computers), the death of libraries, and effects of a paperless society on libraries in developing countries are noted. Footnotes are…

Ochai, Adakole

1984-01-01

302

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

303

Best practices for developing cardiovascular quality indicators.  

PubMed

The Canadian Heart Health Strategy and Action Plan recommended that the Canadian Cardiovascular Society (CCS) lead the development of pan-Canadian data definitions and quality indicators (QIs) for evaluating cardiovascular care in Canada. In response to this recommendation, the CCS developed and adopted a standardized QI development methodology. This report provides a brief overview of the CCS "Best Practices" for developing pan-Canadian cardiovascular QIs. A more detailed description is available in Supplemental Material. The CCS Best Practices QI development methodology consists of 3 phases: phase I, plan and organize the QI development initiative; phase II, develop and select QIs; and phase III, operationalize the QIs. Phase I includes identifying the cardiovascular focus or content area, determining the objective and/or purpose of the initiative, the target users of, and the target population for, the QIs, and selection of a QI working group. Phase II involves formulating the QIs including generating a preliminary set of QIs and draft definitions, followed by an indicator rating and ranking process based on the CCS QI rating criteria. Phase III involves finalizing technical specifications and pilot testing the QIs. It also describes the CCS QI approval process and addresses knowledge translation. Adoption of a standardized methodology for QI development will improve the quality, completeness, acceptability, and usability of pan-Canadian cardiovascular QIs developed by the CCS. Public release of the QI definitions and related performance data might help improve patient care quality and outcomes. PMID:23962730

Tu, Jack V; Abrahamyan, Lusine; Donovan, Linda R; Boom, Nicole

2013-11-01

304

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

305

Centre for Civil Society  

NSDL National Science Digital Library

Located at the London School of Economics and Political Science, the Centre for Civil Society (CCS) is a "leading international organization for research, analysis, debate and learning about civil society". Under the direction of Professor Jude Howell, the group performs a broad range of research on the general topic of civil society across the globe, and its Working Papers series is definitely worth a look. Some of the papers here include "Civil society as a metaphor for western liberalism" and "Public-private partnership in the United States: Historical patterns and current trends". Guests arriving on the site may also want to look at the section on current and recently completed projects, which include work on European social policy, social capital, and local civil society.

306

Is Low-Impact Aerobic Dance an Effective Cardiovascular Workout?  

ERIC Educational Resources Information Center

Presents results of an investigation comparing energy cost and cardiovascular responses of aerobic dance routines performed at different intensity levels in varying amounts of energy expenditure. For low-impact dance to meet minimum guidelines suggested by the American College of Sports Medicine, it should be performed at high intensity. (SM)

Williford, Henry N.; And Others

1989-01-01

307

Improved Cardiovascular Prevention Using Best CME Practices: A Randomized Trial  

ERIC Educational Resources Information Center

Introduction: It was hypothesized that after a continuing medical education (CME) event, practice enablers and reinforcers addressing main clinical barriers to preventive care would be more effective in improving general practitioners' (GPs) adherence to cardiovascular guidelines than a CME event only. Methods: A cluster-randomized trial was…

Laprise, Rejean; Thivierge, Robert; Gosselin, Gilbert; Bujas-Bobanovic, Maja; Vandal, Sylvie; Paquette, Daniel; Luneau, Micheline; Julien, Pierre; Goulet, Serge; Desaulniers, Jean; Maltais, Paule

2009-01-01

308

Postdoctoral Program Guidelines.  

National Technical Information Service (NTIS)

We, the Postdoc Professional Development Program (PD2P) leadership team, wrote these postdoc guidelines to be a starting point for communication between new postdocs, their staff mentors, and their managers. These guidelines detail expectations and respon...

I. Ekoto J. L. Cruz-Campa L. B. Biederman L. M. Hall S. R. Ferreira X. Liu

2012-01-01

309

Obstetrics. Guideline Series.  

National Technical Information Service (NTIS)

Guidelines adopted by the Health Systems Agency of Southwestern Pennsylvania to facilitate the development of an obstetrical care program are presented. Definitions articulated in the guidelines refer to obstetrics, the prenatal period, the perinatal peri...

1976-01-01

310

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

311

Radiation Therapy. Guideline Series.  

National Technical Information Service (NTIS)

Guidelines adopted by the Health Systems Agency of Southwestern Pennsylvania to facilitate the development of a radiation therapy program are presented. Using the guidelines, subarea planning councils, in collaboration with health systems agency staff, ar...

1978-01-01

312

Qualitative Case Study Guidelines.  

National Technical Information Service (NTIS)

This report presents guidelines for conducting qualitative case studies. Yin's case study process is elaborated on and additional principles from the wider literature are integrated and explained. It is expected that following the guidelines presented in ...

S. Baskarada

2013-01-01

313

Semantic Clinical Guideline Documents  

Microsoft Academic Search

Decision-support systems based on clinical practice guidelines can support physicians and other health- care personnel in the process of following best prac- tice consistently. A knowledge-based approach to represent guidelines makes it possible to encode computer-interpretable guidelines in a formal man- ner, perform consistency checks, and use the guide- lines directly in decision-support systems. Decision-support authors and guideline users require

Henrik Eriksson; Samson W. Tu; Mark Musen

2005-01-01

314

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

315

Ethnicity and cardiovascular disease prevention in the United Kingdom: a practical approach to management  

Microsoft Academic Search

The United Kingdom is a diverse society with 7.9% of the population from black and minority ethnic groups (BMEGs). The causes of the excess cardiovascular disease (CVD) and stroke morbidity and mortality in BMEGs are incompletely understood though socio-economic factors are important. However, the role of classical cardiovascular (CV) risk factors is clearly important despite the patterns of these risk

G Y H Lip; A H Barnett; A Bradbury; F P Cappuccio; P S Gill; E Hughes; C Imray; K Jolly; K Patel; GYH Lip

2007-01-01

316

National Bookmobile Guidelines, 1992.  

ERIC Educational Resources Information Center

This publication is based on the work of The State Library of Ohio, the National Bookmobile Guidelines Committee, and staff of local Ohio bookmobile programs. Draft guidelines were approved by the 7th National Bookmobile Conference (May 31-June 2, 1992). The Guidelines provide brief statements of standards followed by specifics which indicate…

Ohio State Library, Columbus.

317

Educational Objectives for Science, Technology, Society, and Values Programs  

Microsoft Academic Search

Because science, technology, society, and values courses and programs are interdisciplinary, directly address social change, and must be future oriented, new guidelines for defming educational objectives must be developed. Five categories of specific objectives that can help a teacher design a unique course or groups of courses are: 1) educational objectives concerned with cultural attitudes toward social change; 2) educational

J. C. Mathes; Kan Chen

1978-01-01

318

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.

319

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

320

American Society of Neuroradiology  

Cancer.gov

May 31, 2008 12:00 AM - June 05, 2008 12:00 AM Ernest N Morial Convention Center New Orleans, LA + Add to Outlook Calendar 46th Annual Meeting Print This Page American Society of Neuroradiology News & Events

321

National Brain Tumor Society  

MedlinePLUS

... Community June 24, 2014 The (Critical) Case for Pediatric Brain Tumor & Cancer Advocacy National Brain Tumor Society is one of ... grade glioma , NCI , NIH , pediatric , pediatric brain tumor , pediatric cancer , pharmaceutical companies More from the blog Search By ...

322

Biophysical Society: Educational Resources  

NSDL National Science Digital Library

The Biophysics Society maintains a set of educational resources in three topical areas: molecular structures, biophysical techniques, and biological mechanisms. A definition and annotated list of specific resources is provided for each area.

2003-10-10

323

Royal Photographic Society  

NSDL National Science Digital Library

Chartered in 1853, the Royal Photographic Society is one of the worldâÂÂs most renowned photographic organizations and counts among its members both amateur and seasoned photographers of all ages and backgrounds. Throughout the course of an average year, the Society sponsors 250 events across the United Kingdom, including workshops, lectures, as well as other activities through some of its overseas chapters as well. Visitors to the site can learn about joining the Society and also learn a bit more about some of their educational opportunities. One feature of the site that is worth a look is their official online forum, which offers visitors the chance to submit questions about photography equipment, the history of photography, and of course, any number of âÂÂhow-toâ type queries. Not surprisingly, the site also contains a âÂÂPortfolioâ section that contains photograph portfolios created by Society members and posted online here.

324

American Headache Society Newsletter  

MedlinePLUS

... Taylor, MD, FAHS, Director of the Park Nicollet Headache Clinic and Research Center and Adjunct Professor of ... view the newsletters in PDF Copyright © 2011 American Headache Society®. All rights reserved. Disclaimer & Privacy Statement | Site ...

325

Iran Chamber Society  

NSDL National Science Digital Library

In 2001, the Iran Chamber Society was created in order to provide a non-partisan, non-commercial, comprehensive source of information on Iran. The website's "About Us" section states that their aim is to "create a global awareness about Iranian society and eradicate the misunderstandings and misconceptions about Iranian society, and to play an educational role as well." Visitors will find the website divided up into "Art and Culture", "History", "Society" and "Iran's Guide". The "Exhibitions and Conferences" link on the right side of the homepage leads visitors to a number of exhibitions, including the fascinating "Artistic Murals of Tehran's Metro Stations", which offers a dozen pictures of the beautifully handcrafted murals made of pottery, metal, cement and other materials. The "History" section offers pictures and documents, including some disturbing graphic photos from the Iran-Iraq War in 1980-1988 that appear at the end of the Historic Periods and Events section.

326

Leukemia & Lymphoma Society  

MedlinePLUS

The Leukemia & Lymphoma Society (LLS) is the world's largest voluntary health agency dedicated to blood cancer. The LLS mission: Cure leukemia, lymphoma, Hodgkin's disease and myeloma, and improve the quality ...

327

Physics and Society Newsletter  

NSDL National Science Digital Library

The newest issue of the American Physical Society's e-newsletter is out (HTML). Articles include one on fission and fusion and also a diversion from the norm: a commentary on the creationist movement.

2005-11-02

328

Society of Interventional Radiology  

Cancer.gov

March 15, 2008 12:00 AM - March 20, 2008 12:00 AM Washington Convention Center Washington, DC + Add to Outlook Calendar 33rd Annual Meeting Print This Page Society of Interventional Radiology News & Events

329

New England Rug Society  

NSDL National Science Digital Library

Appreciation of antique rugs is widespread throughout the United States, and New England is no exception to this phenomenon. The New England Rug Society was formed in 1985 as the New Boston Rug Society, and now it has over 130 members who "share a common love of the traditional creative textile arts." On their website, visitors will find sections such as "Meetings", "Newsletter", "Gallery", "Literature", and "Blog". The "Gallery" area contains a selection of excellent online exhibits, including "Rare and Unusual Turkmen Pile Weavings" and "Small Weavings of the South Persian Nomads". Next up is the "Literature" section. Here visitors will find links to thoughtful pieces authored by Society members, and the offerings including "How Good is My Rug Collecting?" and "Some Thoughts on Islamic Prayer Rugs and Related Textiles". The site is rounded out by information on joining the Society and a link to their blog.

330

British society for parasitology.  

PubMed

Now boasting a healthy membership of more than 1,500 individuals, the British Society for Parasitology was formed in 1962 and is a window into the fascinating world of infectious diseases and parasites. PMID:24823578

Ryan, Bridget

2014-05-14

331

Society of Nuclear Medicine  

Cancer.gov

June 14, 2008 12:00 AM - June 18, 2008 12:00 AM Ernest N Morial Convention Center, Booth 419 New Orleans, LA + Add to Outlook Calendar 2008 Annual Meeting Print This Page Society of Nuclear Medicine News & Events

332

National Multiple Sclerosis Society  

MedlinePLUS

... Join the Community Stay Informed Corporate Support A WORLD FREE OF MS The National MS Society mobilizes ... Learn More NOW Rick, diagnosed in 1991 worldMSday World MS Day is May 28. Join the global ...

333

Chemistry Societies Network  

NSDL National Science Digital Library

Users gain access to the heart of CSN's site through the site gateway which leads them to CSN's information arcade, education arcade, societies, chembytes, and conferences and events. The information arcade provides links to experts and specialists, and chemistry societies. The education arcade contains a wealth of information for educators in the chemistry arena. Societies lists chemical and chemistry-related societies, divided alphabetically by country. Chembytes provides access to a variety of news, including recent findings and discoveries, business updates, and news from around the globe. Chembytes also features a continuing series which looks in-depth at a topic recently in the news. Currently featured is NASA's attempt to return to the moon. Conferences and Events is searchable and browseable and contains a submission form so visitors can list an event. CSN's site also includes Useful Links, a listing of sites categorized and reviewed by Chemsoc and Science Park, which links to four companies offering chemistry related resources on the web.

2007-05-22

334

Animal care guidelines and future directions.  

PubMed

Two notions broadly accepted in developed western societies have made animal care guidelines inevitable. These are that domestic animals are sentient and that humans are responsible to ensure the proper care of domestic animals. Despite these common views, people have differing moral understandings of the human-animal relationship, and there are sharp divisions over how these views should be applied to domestic animal care. Animal care guidelines have been developed by different nations at several organizational levels to represent a compromise that is acceptable to most people. These organizational levels include individual poultry companies, national poultry associations, individual customers of the poultry industry, national associations of customer companies, national governments, and international organizations. Animal care guideline development has typically included input from producers and scientists and, depending on the sponsoring organization, animal advocates and government representatives as well. Animal advocacy groups have also sought to influence domestic animal care by campaigning against animal production practices or by offering their preferred guidelines for producers to adopt in the hope that the endorsement of the welfare group would add value to the product. Originally, animal care guidelines were only recommended, with little or no requirement for compliance. In recent years, the need for retail companies to assure certain welfare standards has led to animal welfare auditing of production facilities. Animal care guidelines primarily have sought to establish standards for handling and husbandry in existing production systems. Future guidelines may put increasing emphasis on adoption of alternative management practices or housing systems. International animal care guidelines are being developed on 2 levels (i.e., among national governments to create a common standard for trade in animal products and within international retail companies to create company-wide animal care standards). These initiatives should tend to unify farm animal care standards worldwide but perhaps at a level some nations might consider lower than preferable. PMID:17495102

Webster, A B

2007-06-01

335

Florida Panther Society  

NSDL National Science Digital Library

With only 30 to 50 individual cats remaining in Florida's wild areas, Florida panthers are a conservation concern. The Florida Panther Society is a non-governmental organization dedicated to the recovery of the Florida panther population. The Society's Webpage offers background information on panthers, genetic restoration efforts, the state's panther population, field notes on current research/ restoration activities, and photographs of some of the remaining individuals.

336

Swiss Neutron Scattering Society  

NSDL National Science Digital Library

The Swiss Neutron Scattering Society's goals are to advance neutron scattering, support young scientists, exchange scientific ideas, cultivate interdisciplinary relations, support access to neutron sources, and communicate with international associations. Visitors can find the Society's By-laws, news, downloads to the organization's_Swiss Neutron News_, information on the General Assembly, and more. The website offers summaries and participation information on a variety of neutron scattering-related conferences held throughout the world.

337

Royal Meteorological Society  

NSDL National Science Digital Library

The Royal Meteorological Society is the national society for all those whose profession or interests are in any way connected with meteorology or related subjects. Site features the latest news, information, publications, and events all revolving around this global meteorological resource. Learn about METLink, RMetS flagship weather project where participants around the world exchange weather observations using an online database. Membership, teaching aids, and more available for purchase.

338

Astronomical Society of Victoria  

NSDL National Science Digital Library

The Astronomical Society of Victoria website promotes its efforts to act as a forum for a wide variety of people interested in astronomy. Users can find learn about the monthly meetings open to the public. The website introduces the Society's many sections including Computing, Cosmology and Astrophysics, Current Phenomena, and Radio Astronomy. The Newcomers link furnishes helpful lists of astronomy books, magazines, and computer software. Everyone will enjoy the fantastic images of the Great Orion Nebula, the Trifid Nebula, and other space phenomena.

339

Contraceptive Hormone Use and Cardiovascular Disease  

PubMed Central

Contraceptive hormones, most commonly prescribed as oral contraceptives (OC), are a widely utilized method to prevent ovulation, implantation and therefore pregnancy. The Women’s Health Initiative demonstrated cardiovascular risk linked to menopausal hormone therapy among women without pre-existing cardiovascular disease, prompting review of the safety, efficacy and side effects of other forms of hormone therapy. A variety of basic science, animal and human data suggest that contraceptive hormones have anti-atheromatous effects, however relatively less is known regarding the impact on atherosclerosis, thrombosis, vasomotion and arrhythmogenesis. Newer generation OC formulations currently in use indicate no increased myocardial infarction (MI) risk for current users, but a persistent increased risk of venous thrombo-embolism (VTE). There are no cardiovascular data available for the newest generation contraceptive hormone formulations, including those that contain newer progestins that lower blood pressure, as well as the non-oral routes (topical and vaginal). Current guidelines indicate that, as with all medication, contraceptive hormones should be selected and initiated by weighing risks and benefits for the individual patient. Women 35 years and older should be assessed for cardiovascular risk factors including hypertension, smoking, diabetes, nephropathy and other vascular diseases including migraines, prior to use. Existing data are mixed with regard to possible protection from OC for atherosclerosis and cardiovascular events; longer-term cardiovascular follow-up of menopausal women with regard to prior OC use, including subgroup information regarding adequacy of ovulatory cycling, the presence of hyperandrogenic conditions, and the presence of prothrombotic genetic disorders is needed to address this important issue.

Shufelt, Chrisandra L.; Noel Bairey Merz, C.

2009-01-01

340

[Guidelines on hand hygiene in health care institutions].  

PubMed

Healthcare associated infections (HCAI) are huge problem all over the world, and 5-10% of all hospitalized patients will develop infection during hospitalization. From the times of I. P. Semelweiss we know that clean hands are the most important single factor that can decrease the number of HCAI. World Health Organization (WHO) has recognised this problem and developed Guidelines for hand hygiene in healthcare institutions. This also was the reason of developing Croatian national Guidelines. The main goal of the Guidelines was to decrease number of HCAI associated with the hands of healthcare workers. These Guidelines are meant for all healthcare workers and other hospital staff who come to the direct contact with patients. An interdisciplinary team of experts developed these Guidelines using WHO Guidelines, other existing guidelines and literature reviews for hand hygiene. Grades of evidence for specific recommendations were determined using CDC/HICPAC grading system. Categorization is based on existing data, theoretical basis, applicability and economic impact. After a broad discussion in different professional societies, Guidelines were accepted. Guidelines include recommendations for hand hygiene indications, hand hygiene technique, surgical hand preparation, choosing hand hygiene preparations, skin care, nails, glove use, patients and visitors hand hygiene, role of education, as well as role of healthcare institution and role of government. Furthermore, in the Guidelines the concept of "Five moments for hand hygiene" is explained in detail, and main literature data are presented. PMID:21888080

Kaleni?, Smilja; Budimir, Ana; Bosnjak, Zrinka; Acketa, Lorena; Belina, Drazen; Benko, Ivan; Bosnjak, Danica; Culo, Marija; Jaji?, Ines; Kis, Marina; Kos, Karmela; Koscák, Darko; Kuzman, Ilija; Leki?, Dusica; Prugovecki, Danijela; Juraga, Ana Tomi?

2011-01-01

341

Heart failure guidelines and prescribing in primary care across Europe  

PubMed Central

Background Major international differences in heart failure treatment have been repeatedly described, but the reasons for these differences remain unclear. National guideline recommendations might be a relevant factor. This study, therefore, explored variation of heart failure guideline recommendations in Europe. Methods Treatment recommendations of 14 national guidelines published after 1994 were analyzed in relation to the heart failure treatment guideline of the European Society of Cardiology. To test potential relations between recommendations and prescribing, national prescribing patterns as obtained by a European study in primary care (IMPROVEMENT-HF) were related to selected recommendations in those countries. Results Besides the 14 national guidelines used by primary care physicians in the countries contacted, the European guideline was used in four countries, and separate guidelines for specialists and primary care were available in another four countries. Two countries indicated that no guideline was used up to 2000. Comprehensiveness of the guidelines varied with respect to length, literature included and evidence ratings. Relevant differences in treatment recommendations were seen only in drug classes where evidence had changed recently (?-blockers and spironolactone). The relation between recommendation and prescribing for selected recommendations was inconsistent among countries. Conclusion Differences in guideline recommendations are not sufficient to explain variation of prescribing among countries, thus other factors must be considered.

Sturm, Heidrun B; van Gilst, Wiek H; Swedberg, Karl; Hobbs, FD Richard; Haaijer-Ruskamp, Flora M

2005-01-01

342

Suicide prevention for psychoanalytic institutes and societies.  

PubMed

What follows are guidelines for rescue teams dedicated to suicide prevention for psychoanalytic institutes and societies. They provide a general orientation and presuppose intensive individual and organizational training by the rescue teams. Some general notes of caution: suicide prevention is a complex, delicate effort that requires specific training, experience, knowledge, patience, and courage. It is a well-known fact that drowning persons may resist rescue efforts, thereby posing the danger of drowning the rescuer along with themselves. Similarly, expect desperate, blind resistance to your efforts, particularly when the suicidal temptation is urgent and overwhelming. PMID:22786850

Kernberg, Otto F

2012-08-01

343

Introduction: Cardiovascular physics  

Microsoft Academic Search

The number of patients suffering from cardiovascular diseases increases unproportionally high with the increase of the human population and aging, leading to very high expenses in the public health system. Therefore, the challenge of cardiovascular physics is to develop high-sophisticated methods which are able to, on the one hand, supplement and replace expensive medical devices and, on the other hand,

Niels Wessel; Jürgen Kurths; William Ditto; Robert Bauernschmitt

2007-01-01

344

DNA commission of the International Society of Forensic Genetics: Recommendations on the interpretation of mixtures  

Microsoft Academic Search

The DNA commission of the International Society of Forensic Genetics (ISFG) was convened at the 21st congress of the International Society for Forensic Genetics held between 13 and 17 September in the Azores, Portugal. The purpose of the group was to agree on guidelines to encourage best practice that can be universally applied to assist with mixture interpretation. In addition

P. Gill; C. H. Brenner; J. S. Buckleton; A. Carracedo; M. Krawczak; W. R. Mayr; N. Morling; M. Prinz; P. M. Schneider; B. S. Weir

2006-01-01

345

SMB: Society for Mathematical Biology  

NSDL National Science Digital Library

The Society for Mathematical Biology (SMB) is an international society devoted to increasing communication between the mathematical and biological communities through holding conferences and publishing journals.

346

Cardiovascular disease prevention in women: a rapidly evolving scenario.  

PubMed

The past decade has witnessed a long overdue recognition of the importance of CVD in women, accompanied by an increasing awareness of gender differences in risk factors, natural history, preventive strategies, treatment, and prognosis of CVD. Reflecting the disease burden and the specific aspects of CVD in women, the American Heart Association has developed women-specific evidence-based guidelines and consensus documents for CVD prevention. The most recent update of these guidelines, published in 2011, is a milestone in the field and shows the rapidly evolving scenario of CVD prevention in women. We discuss some novel aspects of the 2011 update. The new guidelines change the focus from evidence-based to effectiveness-based, with consideration of both benefits and harms/costs of preventive interventions. The guidelines also introduce "ideal cardiovascular health" as the lowest category of risk, which implies the need of communitywide preventive, educational and policy initiatives to promote healthy lifestyles in the general population. Furthermore, the guidelines emphasize long-term overall CVD risk rather than short-term coronary risk. We also address several barriers and open questions in the evaluation and implementation of these guidelines, including how to increase the small proportion of women with ideal cardiovascular health; how to increase implementation and compliance with the recommendations; how to provide effectiveness-based recommendations for lifetime prevention goals based on short-term trials; how to obtain the best possible evidence in women; how to identify subgroups of women with different cardiovascular risk profiles or who may require tailored preventive strategies; and how to adapt current guidelines to international settings, particularly to low- and middle-income countries. PMID:23123148

Stranges, S; Guallar, E

2012-12-01

347

Recommendations to Health Care Financing Administration Guidelines for Inspecting Cytopathology Laboratories.  

National Technical Information Service (NTIS)

The Health Care Financing Administration (HCFA) awarded a contract (HCFA 81-0618) to the American Society of Cytology to recommend guidelines and procedures for the survey of cytology facilities and for the evaluation, regulation and improvement of the qu...

Y. S. Erozan P. R. Ashton

1981-01-01

348

The Lepidopterists' Society  

NSDL National Science Digital Library

Founded in 1947, the Lepidopterists' Society "embraces a wide range of interests and viewpoints concerning the study and appreciation of moths and butterflies" and includes both academic experts and dedicated amateurs in the ranks of a membership that spans 60 countries. In addition to information about the Society and membership therein, the website includes several features of interest. From the Publications section, Visitors may download in pdf format free of charge recent issues of the Society's newsletter, _News of the The Lepidopterists' Society_, and also view the Contents pages from recent issues of the organization's peer-reviewed scientific _Journal of the Lepidopterists' Society_. The News includes a special Season Summary supplement each year, containing reports of species identified by members in the various reporting regions during the preceding year, all of which the site presents in a searchable database dating to 1995. The Identification Aids section offers photos and other identifying information for the nearly 165,000 species known worldwide. Certainly one of the more intriguing features of this website is the Unknowns page, which invites users to identify photos of Lepidoptera that have stumped someone. For neophytes, a Frequently Asked Questions page contains expert answers to a list of essential questions, such as "I've heard that you can predict how cold the winter will be by looking at how thick the black bands are on a Woolly Bear caterpillar. Any truth in that?"

2006-01-03

349

[S3 guideline--Diagnosis and treatment of colorectal carcinoma: relevance for radiologic imaging and interventions].  

PubMed

The new German S3 guideline "Colorectal Carcinoma" was created as part of the German Guideline Program in Oncology of the Association of the Scientific Medical Societies in Germany, the German Cancer Society and the German Cancer Aid under the auspices of the German Society for Digestive and Metabolic Diseases and replaces the guideline from 2008. With its evidence-based treatment recommendations, the guideline contains numerous updates and detailed definitions regarding the diagnosis and treatment of colon and rectal cancer. In particular, consensus-based recommendations regarding early detection, preoperative diagnostic method selection, and the use of interventional radiological treatment methods are detailed. The guideline also includes quality indicators so that standardized quality assurance methods can be used to optimize patient-related processes.The present article discusses the significance of the current recommendations for radiological diagnosis and treatment and is intended to enhance the quality of patient information and care by increasing distribution. PMID:23804154

Vogl, T J; Schmiegel, W; Pox, C; Pereira, P L; Brambs, H J; Lux, P; Fischer, S

2013-08-01

350

Primary and Secondary Prevention of Cardiovascular Disease  

PubMed Central

Background: This guideline focuses on long-term administration of antithrombotic drugs designed for primary and secondary prevention of cardiovascular disease, including two new antiplatelet therapies. Methods: The methods of this guideline follow those described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement. Results: We present 23 recommendations for pertinent clinical questions. For primary prevention of cardiovascular disease, we suggest low-dose aspirin (75-100 mg/d) in patients aged > 50 years over no aspirin therapy (Grade 2B). For patients with established coronary artery disease, defined as patients 1-year post-acute coronary syndrome, with prior revascularization, coronary stenoses > 50% by coronary angiogram, and/or evidence for cardiac ischemia on diagnostic testing, we recommend long-term low-dose aspirin or clopidogrel (75 mg/d) (Grade 1A). For patients with acute coronary syndromes who undergo percutaneous coronary intervention (PCI) with stent placement, we recommend for the first year dual antiplatelet therapy with low-dose aspirin in combination with ticagrelor 90 mg bid, clopidogrel 75 mg/d, or prasugrel 10 mg/d over single antiplatelet therapy (Grade 1B). For patients undergoing elective PCI with stent placement, we recommend aspirin (75-325 mg/d) and clopidogrel for a minimum duration of 1 month (bare-metal stents) or 3 to 6 months (drug-eluting stents) (Grade 1A). We suggest continuing low-dose aspirin plus clopidogrel for 12 months for all stents (Grade 2C). Thereafter, we recommend single antiplatelet therapy over continuation of dual antiplatelet therapy (Grade 1B). Conclusions: Recommendations continue to favor single antiplatelet therapy for patients with established coronary artery disease. For patients with acute coronary syndromes or undergoing elective PCI with stent placement, dual antiplatelet therapy for up to 1 year is warranted.

Vandvik, Per Olav; Lincoff, A. Michael; Gore, Joel M.; Gutterman, David D.; Sonnenberg, Frank A.; Alonso-Coello, Pablo; Akl, Elie A.; Lansberg, Maarten G.; Guyatt, Gordon H.

2012-01-01

351

Introduction: Cardiovascular physics.  

PubMed

The number of patients suffering from cardiovascular diseases increases unproportionally high with the increase of the human population and aging, leading to very high expenses in the public health system. Therefore, the challenge of cardiovascular physics is to develop high-sophisticated methods which are able to, on the one hand, supplement and replace expensive medical devices and, on the other hand, improve the medical diagnostics with decreasing the patient's risk. Cardiovascular physics-which interconnects medicine, physics, biology, engineering, and mathematics-is based on interdisciplinary collaboration of specialists from the above scientific fields and attempts to gain deeper insights into pathophysiology and treatment options. This paper summarizes advances in cardiovascular physics with emphasis on a workshop held in Bad Honnef, Germany, in May 2005. The meeting attracted an interdisciplinary audience and led to a number of papers covering the main research fields of cardiovascular physics, including data analysis, modeling, and medical application. The variety of problems addressed by this issue underlines the complexity of the cardiovascular system. It could be demonstrated in this Focus Issue, that data analyses and modeling methods from cardiovascular physics have the ability to lead to significant improvements in different medical fields. Consequently, this Focus Issue of Chaos is a status report that may invite all interested readers to join the community and find competent discussion and cooperation partners. PMID:17411258

Wessel, Niels; Kurths, Jürgen; Ditto, William; Bauernschmitt, Robert

2007-03-01

352

Advanced information society(2)  

NASA Astrophysics Data System (ADS)

Our modern life is full of information and information infiltrates into our daily life. Networking of the telecommunication is extended to society, company, and individual level. Although we have just entered the advanced information society, business world and our daily life have been steadily transformed by the advancement of information network. This advancement of information brings a big influence on economy, and will play they the main role in the expansion of domestic demands. This paper tries to view the image of coming advanced information society, focusing on the transforming businessman's life and the situation of our daily life, which became wealthy by the spread of daily life information and the visual information by satellite system, in the development of the intelligent city.

Masuyama, Keiichi

353

The Edith Wharton Society  

NSDL National Science Digital Library

The Edith Wharton Society has created a Website to promote the study and discussion of the life and work of this major American novelist and short story writer. Wharton (1862-1937) -- author of Ethan Frome (1911) and the Pulitzer Prize-winning The Age of Innocence (1920), among many other titles -- is highly regarded as a writer of keen insight and polished prose who deftly exposed the social hypocrisy of her era. The Society's Website, hosted by Professor Donna M. Campbell of Gonzaga University, provides information about the society, maintains a membership directory, offers a timely News and Announcements section, posts calls for papers, lists upcoming conferences, and publishes a current Wharton bibliography that includes titles from 1992 to the present. In addition, the site links to Wharton's writings on the Web and sponsors an electronic discussion list, wharton-l.

354

International Symbiosis Society  

NSDL National Science Digital Library

The International Symbiosis Society (ISS) "is primarily involved with the promotion of research and education in the growing field of symbiosis. The Society seeks also to build ongoing and useful communication between the many researchers working in the various sub-fields of symbiosis, as well as connect symbiologists to those in other areas of ecology and biological sciences generally." Hosted by Boston University, the ISS website contains information about membership, and the international journal _Symbiosis_. For authors interested in submitting a manuscript to the journal, the site provides brief, downloadable instructions. In addition, the site links to the websites of Society members working in a variety of areas including Bark Beetles/Fungi, Cyanobacterial Symbioses, Lichens, Marine Symbioses, Mycorhizae, and more. Also, be sure to check out the fascinating images in the Symbiosis Gallery! This site is also reviewed in the June 10, 2005 _NSDL Life Sciences Report_.

355

Ecological Society of America  

NSDL National Science Digital Library

Founded in 1915, the Ecological Society of America (ESA) is a nonpartisan, nonprofit organization of scientists that is dedicated to several primary goals related to the promotion of ecological science, raising the public's level of awareness of the importance of ecological science, and increasing the resources available for the conduct of ecological science. The website is an indispensable source of material about ecological science and the society's various activities, including the annual meeting, career opportunities, membership information, and publications. The publications section is particularly useful, as visitors can learn about society journals (such as _Ecology_), monographs, and the popular Issues in Ecology series. Visitors have complete access to the Issues in Ecology series (in English and Spanish). Journalists and the general public will want to look at the Public Affairs Office area which features news releases and the bi-weekly Policy News update, which summarizes major environmental and science policy news from the previous two weeks.

356

American Antiquarian Society  

NSDL National Science Digital Library

Located in Worcester, Massachusetts, the American Antiquarian Society (AAS) is an independent research library that was founded in 1812. Its rather impressive collections document the life and spirit of America from the colonial period until the end of Reconstruction in 1876. The Society's holdings include books, newspapers, periodicals, broadsides, music, and local histories. For visitors who may be interested in visiting the AAS to do research, they will want to take a look at the online guidebook to its collections and programs, titled "Under its Generous Dome". The site also offers some online exhibits drawn from the Society's holdings, including "Visions of Christmas", which exhibits the holiday-themed artwork of such individuals as Thomas Nast and Louis Prang. Finally, visitors can also read about various fellowship opportunities offered by the AAS, along with information about tours of the AAS for the general public.

357

Firefighters' cardiovascular risk behaviors.  

PubMed

Cardiac events are strongly associated with line-of-duty deaths among firefighters. The frequency with which firefighters succumb to cardiovascular events while on duty is well documented. Many firefighters have undiagnosed or undertreated hypertension, hyperlipidemia, and obesity, as well as poor dietary habits and marginal physical fitness. Extremely high heart rates while engaged in fire suppression increase the risk for cardiovascular risk within the fire service. Cultural factors such as shift work and crew cohesion create multiple levels of influence on firefighters' decisions about engaging in positive health behaviors. This review highlights the significance of primordial and primary prevention of cardiovascular diseases that is culturally congruent with the fire service. PMID:24571052

Banes, Catherine J

2014-01-01

358

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

359

Science and Society Colloquium  

ScienceCinema

Mr. Randi will give an update of his lecture to the American Physical Society on the occasion of his award of the 1989 Forum Prize. The citation said: "for his unique defense of Science and the scientific method in many disciplines, including physics, against pseudoscience, frauds and charlatans. His use of scientific techniques has contributed to refuting suspicious and fraudulent claims of paranormal results. He has contributed significantly to public understanding of important issues where science and society interact". He is a professional magician and author of many books. He worked with John Maddox, the Editor of Nature to investigate the claims of "water with memory".

None

2011-04-25

360

Science and Society Colloquium  

ScienceCinema

Mr. Randi will give an update of his lecture to the American Physical Society on the occasion of his award of the 1989 Forum Prize. The citation said: "for his unique defense of Science and the scientific method in many disciplines, including physics, against pseudoscience, frauds and charlatans. His use of scientific techniques has contributed to refuting suspicious and fraudulent claims of paranormal results. He has contributed significantly to public understanding of important issues where science and society interact". He is a professional magician and author of many books. He worked with John Maddox, the Editor of Nature to investigate the claims of "water with memory".

361

Advanced information society(7)  

NASA Astrophysics Data System (ADS)

Various threats are hiding in advanced informationalized society. As we see car accident problems in motorization society light aspects necessarily accompy shady ones. Under the changing circumstances of advanced informationalization added values of information has become much higher. It causes computer crime, hacker, computer virus to come to the surface. In addition it can be said that infringement of intellectual property and privacy are threats brought by advanced information. Against these threats legal, institutional and insurance measures have been progressed, and newly security industry has been established. However, they are not adequate individually or totally. The future vision should be clarified, and countermeasures according to the visions have to be considered.

Chiba, Toshihiro

362

Science and Society Colloquium  

SciTech Connect

Mr. Randi will give an update of his lecture to the American Physical Society on the occasion of his award of the 1989 Forum Prize. The citation said: "for his unique defense of Science and the scientific method in many disciplines, including physics, against pseudoscience, frauds and charlatans. His use of scientific techniques has contributed to refuting suspicious and fraudulent claims of paranormal results. He has contributed significantly to public understanding of important issues where science and society interact". He is a professional magician and author of many books. He worked with John Maddox, the Editor of Nature to investigate the claims of "water with memory".

None

2008-03-10

363

International Isotope Society  

NSDL National Science Digital Library

The international isotope society (IIS) "aims to encourage the synthesis and applications of isotopes and isotopically labeled compounds to benefit of all." Visitors can find information about upcoming international conferences as well as summaries of past symposiums. The website provides copies of the presentation speeches discussing the activities of award winning scientists. Researchers can find out about the society's low level radioactive waste committee's activities to create a positive public image of the use of radioisotopes in research. An online technical report educates students and teachers about photomultipliers and their applications.

364

Virginia Herpetological Society  

NSDL National Science Digital Library

Displaying an earnest enthusiasm for their local herp populations, the Virginia Herpetological Society (VHS) proclaims itself to be a "society for everyone interested in the Education, Conservation, and Research of amphibians and reptiles." The main VHS site links to a host of resources including photos of, and information about, anurans, lizards, salamanders, snakes, and turtles. The site also links to such features as the Virginia Snake ID Guide, downloadable Virginia Herpetological Atlases, Marty's Timber Rattlesnake Summary, Species Accounts, and the Photograph of the Month. Site visitors can even test their knowledge with a fun photographic Virginia Herp Quiz.

365

Society for Vector Ecology  

NSDL National Science Digital Library

Formed in 1968, the Society for Vector Ecology (SOVE) is dedicated to studying "all aspects of the biology, ecology, and control of arthropod vectors and the interrelationships between the vectors and the disease agents they transmit." Comprised of researchers and operational and extension personnel around the globe, SOVE tracks and studies the biological organisms that transmit diseases. The SOVE Website contains information related to the Society (e.g., mission, history), its publications (journal, newsletter -- both .pdf format), and professional opportunities (conferences, employment). Several dozen links to additional vector ecology resources are provided.

2008-09-12

366

[S3 guideline - diagnosis and treatment of gastric carcinoma: relevance for radiologic imaging].  

PubMed

The new German S3 guideline regarding stomach cancer includes a variety of innovations with respect to the diagnosis and treatment of adenocarcinoma of the stomach and the esophagogastric junction. The guideline has been strongly supported by the "oncology" guidelines program consisting of the "Deutsche Krebshilfe" and the German Cancer Society and the AWMF (Dr. M. Follmann). This guideline contains evidence-based treatment recommendations and quality indicators for guideline implementation and evaluation in order to improve broad medical care and to facilitate development and subsequent adjustment. The purpose of this article is to introduce the innovations with regard to radiological diagnosis and to discuss the latest literature on the subject. PMID:22434371

Grenacher, L; Schwarz, M; Lordick, F; Krause, B; Roecken, C; Moenig, S; Ebert, M; Jenssen, C; Kauczor, H-U; Moehler, M

2012-08-01

367

Integrating clinical practice guidelines into the routine of everyday practice.  

PubMed

For years, the American College of Cardiology and the American Heart Association, along with other professional organizations, have produced clinical practice guidelines to improve the quality of cardiovascular care. Producing these comprehensive documents has required extraordinary effort, primarily from volunteer professionals. Quality improvement efforts based on these guidelines, however, have not fully engaged practicing physicians, as evidenced by studies of guideline adherence. The translation of the guidelines into routine practice remains a persistent challenge.Practitioners work in a complex and fast paced environment. In the routine of everyday practice, physicians, like all decision-makers, use cognitive shortcuts to help make rapid decisions under conditions of uncertainty. How practicing physicians package information in their working memory and use shortcuts called "heuristics" has implications for how clinical practice guidelines can most directly influence practice. Current guidelines are written as comprehensive review documents, but are not formatted to allow easy incorporation into the heuristics of everyday practice. Improving the interface between guidelines and routine practice may result in more rapid and appropriate translation of scientific evidence into practice.We describe the routine of everyday practice as a repetitive cycle where new scientific evidence is incorporated into the heuristics that drive daily medical decisions. Examining this cycle suggests ways to communicate guideline information more effectively and to improve practice routines. Recognizing the intuitive approaches that practicing physicians use to make rapid decisions may yield opportunities for responsive professional organizations and reflective practicing physicians to improve the quality of care. PMID:18340202

Brush, John E; Radford, Martha J; Krumholz, Harlan M

2005-09-01

368

Cardiovascular Software Directory.  

National Technical Information Service (NTIS)

The Directory compiled by the Computer Applications Committee of the American College of Cardiology(ACC), is the first edition of a source of information of software for cardiovascular medicine. The scope of the Directory is broad, including software repr...

1988-01-01

369

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

370

Recognizing global burden of cardiovascular disease and related chronic diseases.  

PubMed

Cardiovascular disease is the leading cause of death worldwide, affecting not only high-income but also low- and middle-income countries. Nearly 80 percent of all estimated cardiovascular disease-related deaths worldwide now occur in low- and middle-income countries, where nearly 30 percent of all deaths are attributable to cardiovascular disease. The health burden of cardiovascular disease and other chronic diseases is also accompanied by a significant deleterious economic impact at the level of both national economies and households. The global trends in the health and economic burden of cardiovascular disease provide a compelling argument in support of prioritizing urgent yet carefully planned efforts to prevent and control cardiovascular disease worldwide-and especially in low- and middle-income countries. After decades of escalating efforts to draw attention to the high burden of cardiovascular disease and other chronic diseases, this critically important issue is now emerging as a more central part of the global health and development agenda. The breadth of behavioral, biological, social, environmental, and systems-level factors that contribute to cardiovascular disease necessitates multisectoral approaches across the lifecourse that promote healthful lifestyles, reduce risk, and reduce cardiovascular-disease morbidity and mortality through the delivery of quality health care services. Given that the complex interactions among the determinants of cardiovascular disease vary in different contexts, real progress in control efforts will come through approaches that are driven by a country's disease burden and risk profile, capacities, resources, and priorities-approaches that are led by a country's key decision-makers and stakeholders, including governments, civil society, the private sector, and communities. Many countries are already establishing efforts to address chronic diseases. In addition to these locally driven efforts, success will require active engagement and sustained action from a wide array of stakeholders operating at global and regional levels. PMID:23239202

Kelly, Bridget B; Narula, Jagat; Fuster, Valentín

2012-01-01

371

Cardiovascular autonomic dysfunction in uremia  

Microsoft Academic Search

Cardiovascular autonomic dysfunction in uremia. Cardiovascular morbidity and mortality is common in chronic renal failure patients, and may be explained in part by abnormalities in cardiovascular autonomic regulation. This review discusses the results of cardiovascular autonomic function studies in chronic renal failure patients. While covering most methods of assessing autonomic function, we focus particularly on power spectral analysis methods. These

Thompson G Robinson; Susan J Carr

2002-01-01

372

Obestatin and cardiovascular health.  

PubMed

Obestatin, encoded by the same gene as ghrelin, was first described as a physiological opponent of ghrelin through an interaction with the orphan receptor GPR39. However, the effects of obestatin were not totally contrary to the effects of ghrelin in cardiovascular regulations based on the recent studies. We summarize here the current evidences surrounding the cardiovascular actions of obestatin, and the possible implications of obestatin as a therapeutic agent in common conditions such as hypertension and heart failure. PMID:24333655

Su, Xue-Jia; Dong, Rui-Xin; Li, Yan-Peng; Yang, Shu-Guang; Li, Zhao-Feng

2014-02-01

373

Values and Society.  

ERIC Educational Resources Information Center

The idea of a democratic society based on human rights and social justice is the social issue examined in this book which is one of a series on challenges and choices in American values. The format followed in the series includes the following for secondary students: case studies illustrating the issue by focusing on human institutions, factual…

Nelson, Jack L.

374

Memphis Astronomical Society  

NSDL National Science Digital Library

Web site for amateur astronomers offering free "Getting Started with Your New Telescope" article (PDF), monthly newsletter, weblog ("MemphisAstro"), and information for ordering inexpensive out-of-print amateur's guides to finding Messier objects. The Society is a public-service organization promoting interest and education in astronomy and holding monthly meetings and offering lectures and demonstrations to local (Memphis, Tennessee) members.

2007-03-18

375

Literacy in Traditional Societies.  

ERIC Educational Resources Information Center

This series of essays derives from an interest in communications, in media and their effect upon human intercourse. Primarily, this concern with the technology of the intellect centers upon the effect of literacy on human culture, especially in 'traditional' or pre-industrial societies. In most of the essays, the effects of literacy are considered…

Goody, Jack, Ed.

376

[The Closing Society.  

ERIC Educational Resources Information Center

At the root of student unrest are two basic factors: (1) the "involuntary campus," and (2) the "manipulated society." Many students attend a university not because they want to, but because of parental pressure, to avoid the draft, to get the right job, or to satisfy the notion that in order to be really accomplished it is necessary to have a…

Brewster, Kingman, Jr.

377

The Duplex Society.  

ERIC Educational Resources Information Center

The duplex society, in which the poor live in close proximity to others but in a separate compartment, is already with us. Unless something deeply changes about family income, more than one-third of future generations will come to adulthood having spent a portion of their childhood in official poverty. (RM)

Schorr, Alvin L.

1984-01-01

378

Science Serves Society.  

ERIC Educational Resources Information Center

This book discusses how some of the topics taught in a conventional physics course have been used to solve interesting technical problems in industry, medicine, agriculture, transportation, and other areas of society. The topics include heat, optics, magnetism and electricity, nuclear physics, and sound. (MLH)

Sneed, G. C.

379

Garbage, work and society  

Microsoft Academic Search

This paper reviews the contribution of the book ‘The Garbage Society: Caciquismo in Mexico City’; written 20 years ago when no official statistics on garbage production were available, to the development of sustainable waste management practice in Mexico. At that time public information was extremely difficult to obtain and environmental pollution was not regarded as an important research area for

Héctor Castillo Berthier

2003-01-01

380

The Deviance Society  

Microsoft Academic Search

Debate has recently become lively about the state of the sociology of deviance in our discipline. While some have condemned it as stale, lacking in new theoretical advances, we disagree with this assessment. We assert, rather, that the field of deviance offers unparalleled insight into society, particularly in current times. Deviance thrives in America, from the underbelly of hidden life

Patricia A. Adler; Peter Adler

2006-01-01

381

Astronautics and society  

NASA Astrophysics Data System (ADS)

The economic, ecological, and social benefits of various space programs are assessed. It is noted that society can benefit from such programs as space manufacturing, manned space stations, solar electric power stations, an air-space transportation system, and lunar bases. Ways to finance such projects and avenues of space commercialization are examined.

Avduevskii, V. S.; Leskov, L. V.

382

Big Society, Big Deal?  

ERIC Educational Resources Information Center

Political leaders like to put forward guiding ideas or themes which pull their individual decisions into a broader narrative. For John Major it was Back to Basics, for Tony Blair it was the Third Way and for David Cameron it is the Big Society. While Mr. Blair relied on Lord Giddens to add intellectual weight to his idea, Mr. Cameron's legacy idea…

Thomson, Alastair

2011-01-01

383

Slovak Metrological Society.  

National Technical Information Service (NTIS)

The brief communication describes the establishment of the Slovak Metrological Society (SMS). SMS came into being on October 16, 1990, as the result of a special founding Congress held in DT Zilina with 137 delegates from the whole of Slovakia in attendan...

J. Mandak

1991-01-01

384

Toward a Multicultural Society  

ERIC Educational Resources Information Center

In this country, immigration continues and provides our society with a constant source of cultural and ethnic richness. Article presents the case for immigrants, their education, and the recognition that to endorse cultural pluralism is to endorse no model American. (Author/RK)

Cardenas, Rene; Fillmore, Lily Wong

1973-01-01

385

The Massachusetts Historical Society  

NSDL National Science Digital Library

From its auspicious beginnings in 1792, the Massachusetts Historical Society (MHS) has grown to be one of the major historical research libraries and manuscript repositories in New England. Along with its public outreach programs (which visitors can learn about on the site), the society also offer a number of fellowship programs for visiting scholars and persons interested in utilizing its collections. For persons interested in doing research at the society, there are over 51 digitized online finding aids available here as well, along the ABIGAL online catalog which may also prove useful. From the homepage, visitors can also view the Object of the Month feature, which gives detailed information and a digitized image of an important object in the Society's holdings, such as a dramatic photograph of the Boston & Albany passenger train from 1885. Of course, users will not want to miss the fine online resources here, including the electronic archive of correspondence of the Adams Family (including those legendary letters between John and Abigail Adams) and the wonderful electronic archive that contains many original documents and papers from Thomas Jefferson in the collection of the MHS.

386

Science, Technology, Society: Challenges.  

ERIC Educational Resources Information Center

The science-technology-society (STS) movement is emerging at the collegiate level. In elementary and secondary school science, social studies, and industrial arts classes, there is a growing awareness of the need for students to learn about technology and the methods by which it can be directed, made more appropriate, and controlled. This issue of…

Lux, Donald G., Ed.

1991-01-01

387

Exploratory of society  

NASA Astrophysics Data System (ADS)

A huge flow of quantitative social, demographic and behavioral data is becoming available that traces the activities and interactions of individuals, social patterns, transportation infrastructures and travel fluxes. This has caused, together with innovative computational techniques and methods for modeling social actions in hybrid (natural and artificial) societies, a qualitative change in the ways we model socio-technical systems. For the first time, society can be studied in a comprehensive fashion that addresses social and behavioral complexity. In other words we are in the position to envision the development of large data and computational cyber infrastructure defining an exploratory of society that provides quantitative anticipatory, explanatory and scenario analysis capabilities ranging from emerging infectious disease to conflict and crime surges. The goal of the exploratory of society is to provide the basic infrastructure embedding the framework of tools and knowledge needed for the design of forecast/anticipatory/crisis management approaches to socio technical systems, supporting future decision making procedures by accelerating the scientific cycle that goes from data generation to predictions.

Cederman, L.-E.; Conte, R.; Helbing, D.; Nowak, A.; Schweitzer, F.; Vespignani, A.

2012-11-01

388

Achievement of guideline-defined treatment goals in primary care: the German Coronary Risk Management (CoRiMa) study  

Microsoft Academic Search

Aims The success in achieving treatment goals for cardiovascular risk factors in primary care is largely unknown. Therefore, the goals of this study were (i) to assess whether routinely collected practice data can be used to evaluate treatment in primary care, (ii) to compare current treatment with goals of published guidelines, and (iii) to calculate future risk for cardiovascular events

Johann Christoph Geller; Sven Cassens; Mathias Brosz; Ulrich Keil; Johannes Bernarding; Siegfried Kropf; Ralph A. Bierwirth; Bernhard Lippmann-Grob; Heinz-Peter Schultheiss; Klaus Schluter; Klaus Pels

2007-01-01

389

Management of postoperative complications: cardiovascular disease and volume management.  

PubMed

Postoperative cardiovascular complications are common, predictable, and typically treatable in geriatric patients who have sustained fractures. Although intervention-specific data are sparse, observational evidence from high-performing geriatric fracture centers coupled with an understanding of geriatric principles can serve as a basis for treatment guidelines. Many patients can be safely and effectively managed with close attention to intravascular volume status, heart rate control, and minimization of other physiologic stresses, including pain and delirium. Many chronic cardiovascular therapies may be harmful in the immediate postoperative period, and can usually be safely omitted or attenuated until hemodynamic stability and mobility have been restored. PMID:24721369

Nicholas, Joseph A

2014-05-01

390

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

391

Cancer Screening in the United States 2007: A Review of Current Guidelines Practices and Prospects  

Microsoft Academic Search

ABSTRACT Each year, the American Cancer Society (ACS) publishes a summary of its rec- ommendations for early cancer detection, including guideline updates, emerging issues that are relevant to screening for cancer, and a summary of the most current data on cancer screen- ing rates for US adults. In 2006, there were no updates to ACS guidelines for early cancer detection.

Robert A. Smith; Vilma Cokkinides; Harmon J. eyre

392

Verification of Medical Guidelines  

Microsoft Academic Search

This research has resulted in a general framework for the verification of medical guideline with respect to properties following from medical background knowledge. The framework has been applied to guidelines for the treatment of diabetes and breast cancer and has been found suitable for the verification of specified quality criteria. We were able to automate many steps of the verification

Perry Groot; Marko van Eekelen; Peter Lucas

2007-01-01

393

Engineering Technology Curriculum Guidelines  

ERIC Educational Resources Information Center

Summarizes curriculum guidelines for the following engineering technologies: chemical, industrial, mining, petroleum, nuclear, civil, mechanical, electrical, automotive, and manufacturing. In a few years, these Engineering Council for Professional Development committee guidelines are intended to become the criteria by which programs will be judged…

Gershon, J. J.

1977-01-01

394

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

395

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

396

Nonstructural seismic restraint guidelines  

SciTech Connect

The Nonstructural Seismic Restraint Guidelines provide general information about how to secure or restrain items (such as material, equipment, furniture, and tools) in order to prevent injury and property, environmental, or programmatic damage during or following an earthquake. All SNL sites may experience earthquakes of magnitude 6.0 or higher on the Richter scale. Therefore, these guidelines are written for all SNL sites.

Butler, D.M.; Czapinski, R.H.; Firneno, M.J.; Feemster, H.C.; Fornaciari, N.R.; Hillaire, R.G.; Kinzel, R.L.; Kirk, D.; McMahon, T.T.

1993-08-01

397

The TEI Hypertext Guidelines.  

ERIC Educational Resources Information Center

Describes the Text Encoding Initiative (TEI) guidelines' approach to describing hypertext features. Discusses the rationale behind the design of the tagset and the range of features included in the guidelines. Discusses the relation and integration of TEI mark-up and the HyTime standard. (CFR)

DeRose, Steven J.; Durand, David

1995-01-01

398

2013 WSES guidelines for management of intra-abdominal infections  

PubMed Central

Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. The 2013 update of the World Society of Emergency Surgery (WSES) guidelines for the management of intra-abdominal infections contains evidence-based recommendations for management of patients with intra-abdominal infections.

2013-01-01

399

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

400

Considerations on what constitutes a 'qualified statistician' in regulatory guidelines.  

PubMed

International regulatory guidelines require that a 'qualified statistician' takes responsibility for the statistical aspects of a clinical trial used for drug licensing. No consensus on what constitutes a 'qualified statistician' appears to have been developed so far. The International Society for Clinical Biostatistics is issuing this reflection paper in order to stimulate a discussion on the concept. PMID:21948351

Gerlinger, Christoph; Edler, Lutz; Friede, Tim; Kieser, Meinhard; Nakas, Christos T; Schumacher, Martin; Seldrup, Jørgen; Victor, Norbert

2012-05-20

401

2013 WSES guidelines for management of intra-abdominal infections.  

PubMed

Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high.The 2013 update of the World Society of Emergency Surgery (WSES) guidelines for the management of intra-abdominal infections contains evidence-based recommendations for management of patients with intra-abdominal infections. PMID:23294512

Sartelli, Massimo; Viale, Pierluigi; Catena, Fausto; Ansaloni, Luca; Moore, Ernest; Malangoni, Mark; Moore, Frederick A; Velmahos, George; Coimbra, Raul; Ivatury, Rao; Peitzman, Andrew; Koike, Kaoru; Leppaniemi, Ari; Biffl, Walter; Burlew, Clay Cothren; Balogh, Zsolt J; Boffard, Ken; Bendinelli, Cino; Gupta, Sanjay; Kluger, Yoram; Agresta, Ferdinando; Di Saverio, Salomone; Wani, Imtiaz; Escalona, Alex; Ordonez, Carlos; Fraga, Gustavo P; Junior, Gerson Alves Pereira; Bala, Miklosh; Cui, Yunfeng; Marwah, Sanjay; Sakakushev, Boris; Kong, Victor; Naidoo, Noel; Ahmed, Adamu; Abbas, Ashraf; Guercioni, Gianluca; Vettoretto, Nereo; Díaz-Nieto, Rafael; Gerych, Ihor; Tranà, Cristian; Faro, Mario Paulo; Yuan, Kuo-Ching; Kok, Kenneth Yuh Yen; Mefire, Alain Chichom; Lee, Jae Gil; Hong, Suk-Kyung; Ghnnam, Wagih; Siribumrungwong, Boonying; Sato, Norio; Murata, Kiyoshi; Irahara, Takayuki; Coccolini, Federico; Segovia Lohse, Helmut A; Verni, Alfredo; Shoko, Tomohisa

2013-01-01

402

Bioassay Guideline 2: Guidelines for Tritium Bioassay.  

National Technical Information Service (NTIS)

This guideline is one of a series under preparation by the Federal-Provincial Working Group on Bioassay and In Vivo Monitoring Criteria. In this report tritium compounds have been grouped into four categories for the purpose of calculating Annual Limits o...

1983-01-01

403