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1

Botswana National HIV/AIDS Treatment Guidelines : 2008 Version  

E-print Network

#12;Botswana National HIV/AIDS Treatment Guidelines : 2008 Version These guidelines are also for HIV-Infected Adults and Adolescents 3.6 Other Routine Interventions in HIV/AIDS Care 4.0 Indications Editorial Notes...................................................................................10 1.0 HIV

Bushman, Frederic

2

National Guideline Clearinghouse (NGC)  

NSDL National Science Digital Library

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

1999-01-01

3

Implications of Recent Clinical Trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines  

Microsoft Academic Search

The Adult Treatment Panel III (ATP III) of the National Cholesterol Education Program issued an evidence-based set of guidelines on cholesterol management in 2001. Since the publication of ATP III, 5 major clinical trials of statin therapy with clinical end points have been published. These trials addressed issues that were not examined in previous clinical trials of cholesterol-lowering therapy. The

Scott M. Grundy; James I. Cleeman; C. Noel Bairey Merz; H. Bryan Brewer Jr; Luther T. Clark; Donald B. Hunninghake; Richard C. Pasternak; Sidney C. Smith Jr; Neil J. Stone

2004-01-01

4

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

5

Are there national strategies, plans and guidelines for the treatment of hepatitis C in people who inject drugs? A survey of 33 European countries  

PubMed Central

Background Hepatitis C virus (HCV) infection represents a major global health problem, which in high-income countries now mostly affects people who inject drugs (PWID). Many studies show that the treatment of HCV infection is as successful among PWID as among other populations and recently PWID have been included in the international guidelines for the treatment of HCV infection. The aim of this survey was to collect data from European countries on the existence of national strategies, action plans and clinical guidelines for HCV treatment in the general population and PWID in particular. Methods Thirty-three European countries were invited to participate. Data on available national strategies, action plans and guidelines for HCV treatment in general population and in PWID specifically were collected prospectively by means of a structured electronic questionnaire and analyzed accordingly. Results All of the 33 invited European countries participated in the survey. Twenty-two responses came from non-governmental organizations, six from public health institutions, four from university institutions and one was an independent consultant. Fourteen (42.4%) of the countries reported having a national strategy and/or national action plan for HCV treatment, from which ten of them also reported having a national strategy and/or national action plan for treatment of HCV infection in PWID. Nearly three-quarters reported having national HCV treatment guidelines. PWID were included in the majority (66.7%) of the guidelines. Fourteen (42.4%) countries reported having separate guidelines for the treatment of HCV infection in PWID. Conclusions Given the high burden of HCV-related morbidity and mortality in PWID in Europe, the management of HCV infection should become a healthcare priority in all European countries, starting with developing or using already-existing national strategies, action plans and guidelines for this population. PMID:25252635

2014-01-01

6

National Bookmobile Guidelines, 1988.  

ERIC Educational Resources Information Center

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

Ohio State Library, Columbus.

7

Protocol Development — Guidelines for Treatment Regimens  

Cancer.gov

All protocols sponsored by the Division of Cancer Treatment and Diagnosis (DCTD), National Cancer Institute (NCI), are reviewed for safety and scientific integrity. Cancer Therapy Evaluation Program (CTEP) staff have developed standardized guidelines to express chemotherapy regimens in a uniform, clear and consistent manner. The intention of the guidelines is to minimize undue risks to patients on DCTD sponsored investigational clinical trials. DCTD-sponsored protocols will not be approved unless they comply with the Guidelines for Treatment Regimen Expression and Nomenclature.

8

Adherence to national guidelines for drug treatment of suspected acute myocardial infarction: evidence for undertreatment in women and the elderly  

Microsoft Academic Search

BACKGROUND: Evidence-based guidelines for the treatment of patients with acute myocardial infarction (AMI) have been published and disseminated by the American College of Cardiology and the American Heart Association. Few studies have examined the rates of adherence to these guidelines in eligible populations and the influence of age and gender on highly effective AMI treatments in community hospital settings. METHODS:

Thomas J. McLaughlin; Stephen B. Soumerai; Donald J. Willison; Jerry H. Gurwitz; Catherine Borbas; Edward Guadagnoli; Barbara McLaughlin; Nora Morris; Su Chun Cheng; Paul J. Hauptman; Elliott Antman; Linda Casey; Richard Asinger; Fredarick Gobel

1996-01-01

9

Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 guidelines  

PubMed Central

Standardized criteria for diagnosis and response assessment are needed to interpret and compare clinical trials and for approval of new therapeutic agents by regulatory agencies. Therefore, a National Cancer Institute–sponsored Working Group (NCI-WG) on chronic lymphocytic leukemia (CLL) published guidelines for the design and conduct of clinical trials for patients with CLL in 1988, which were updated in 1996. During the past decade, considerable progress has been achieved in defining new prognostic markers, diagnostic parameters, and treatment options. This prompted the International Workshop on Chronic Lymphocytic Leukemia (IWCLL) to provide updated recommendations for the management of CLL in clinical trials and general practice. PMID:18216293

Hallek, Michael; Cheson, Bruce D.; Catovsky, Daniel; Caligaris-Cappio, Federico; Dighiero, Guillaume; Dohner, Hartmut; Hillmen, Peter; Keating, Michael J.; Montserrat, Emili; Rai, Kanti R.; Kipps, Thomas J.

2008-01-01

10

Urinary tract infection in women—physician's preferences for treatment and adherence to guidelines: a national drug utilization study in a managed care setting  

Microsoft Academic Search

BackgroundThe treatment of urinary tract infection (UTI), the most common bacterial infection in most Western countries, is a global clinical and economic issue. Trimethoprim-sulfamethoxazole (TMP-SMX) and nitrofurantoin are the two drugs currently recommended in clinical guidelines in Israel for uncomplicated UTI in women.ObjectivesThis study evaluates physician preferences for treatment and adherence to guidelines.MethodData were derived from the electronic records of

Ernesto Kahan; Natan R. Kahan; David P. Chinitz

2003-01-01

11

Managing hyperlipidemia. The updated cholesterol treatment guidelines.  

PubMed

: The ACC/AHA 2013 cholesterol treatment guidelines focus on lowering the risk of heart disease and stroke and not on targeted treatment goals in adult patients. This article offers a synopsis of the new guidelines and how to apply them in clinical practice. PMID:24878833

Scordo, Kristine Anne

2014-07-13

12

Treatment for Panic Disorder: Practical Guidelines.  

ERIC Educational Resources Information Center

This article presents current research information on the treatment of panic disorder. Specific guidelines are presented to guide the mental health counselor in the delivery of effective psychopharmacological and cognitive-behavioral treatment. (Contains 81 references.) (Author)

Beamish, Patricia M.; Granello, Darcy Haag; Belcastro, Amy L.

2002-01-01

13

Criteria and Guidelines for Alcoholism Treatment Services.  

National Technical Information Service (NTIS)

The criteria and guidelines presented in this document are intended for use by committees developing adult alcoholism treatment programs. These programs encompass inpatient rehabilitation, outpatient treatment, and both medical and nonmedical day services...

1981-01-01

14

A survey of tobacco dependence treatment guidelines in 31 countries  

PubMed Central

Aims The Framework Convention on Tobacco Control (FCTC) asks countries to develop and disseminate comprehensive evidence based guidelines and promote adequate treatment for tobacco dependence, yet to date no summary of the content of existing guidelines exists. This paper describes national tobacco dependence treatment guidelines of 31 countries. Design, setting, participants A questionnaire on tobacco dependence treatment guidelines was sent by email to a convenience sample of contacts working in tobacco control in 31 countries in 2007. Completed questionnaires were received from respondents in all 31 countries. During the course of these enquiries we also made contact with people in 14 countries that did not have treatment guidelines and sent them a short questionnaire asking about their plans to produce guidelines. Measurements The survey instrument was a seventeen item questionnaire asking the following key questions: do the guidelines recommend brief interventions, intensive behavioural support, medications; which medications; do the guidelines apply to the whole healthcare system and all professionals; do they explicitly refer to the Cochrane database; are they based on another country's guidelines; are they national or more local; are they formally endorsed by government; did they go through peer review; who funded them; where were they published; do they include evidence on cost effectiveness of treatment. Findings According to respondents, all of their countries' guidelines recommended brief advice, intensive behavioural support, and nicotine replacement therapy (NRT); 84% recommended bupropion; 19% recommended varenicline; and 35% recommended telephone quitlines. Nearly half (48%) included cost effectiveness evidence. Seventy one percent were formally supported by their government and 65% were financially supported by the government. Most (84%) used the Cochrane reviews as a source of evidence, 84% went through a peer review process, and 55% were based on the guidelines of other countries, most often the US and England. Conclusion Overall, the guidelines reviewed closely followed the evidence base, recommending brief interventions, intensive behavioural support and NRT, and most recommended bupropion. Varenicline was not on the market in most of the countries in this survey when their guidelines were written, illustrating the need for guidelines to be periodically updated. None recommended interventions not proven to be effective, and some explicitly recommended against specific interventions (for lack of evidence). Most were peer reviewed, many through lengthy and rigorous procedures, and most were formally endorsed or supported by their governments. Some countries that did not have guidelines expressed a need for technical support, emphasising the need for countries to share experience, something the FCTC process is well placed to support. PMID:19563566

Raw, Martin; Regan, Susan; Rigotti, Nancy A.; McNeill, Ann

2009-01-01

15

New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada.  

PubMed

Anticancer cytotoxic agents go through a process by which their antitumor activity-on the basis of the amount of tumor shrinkage they could generate-has been investigated. In the late 1970s, the International Union Against Cancer and the World Health Organization introduced specific criteria for the codification of tumor response evaluation. In 1994, several organizations involved in clinical research combined forces to tackle the review of these criteria on the basis of the experience and knowledge acquired since then. After several years of intensive discussions, a new set of guidelines is ready that will supersede the former criteria. In parallel to this initiative, one of the participating groups developed a model by which response rates could be derived from unidimensional measurement of tumor lesions instead of the usual bidimensional approach. This new concept has been largely validated by the Response Evaluation Criteria in Solid Tumors Group and integrated into the present guidelines. This special article also provides some philosophic background to clarify the various purposes of response evaluation. It proposes a model by which a combined assessment of all existing lesions, characterized by target lesions (to be measured) and nontarget lesions, is used to extrapolate an overall response to treatment. Methods of assessing tumor lesions are better codified, briefly within the guidelines and in more detail in Appendix I. All other aspects of response evaluation have been discussed, reviewed, and amended whenever appropriate. PMID:10655437

Therasse, P; Arbuck, S G; Eisenhauer, E A; Wanders, J; Kaplan, R S; Rubinstein, L; Verweij, J; Van Glabbeke, M; van Oosterom, A T; Christian, M C; Gwyther, S G

2000-02-01

16

Primary Care Practice Adherence to National Cholesterol Education Program Guidelines for Patients With Coronary Heart Disease  

Microsoft Academic Search

Background: Clinical trials demonstrate significant ben- efit from cholesterol management for patients with car- diovascular disease (CVD). National guidelines recom- mending goals for screening and treatment were published in 1993 and widely disseminated. This study examines cholesterol screening and management by primary care physicians after the guidelines were released. Methods: Medical records and patient surveys pro- vided data for 603

Patrick McBride; Helmut G. Schrott; Mary Beth Plane; Gail Underbakke; Roger L. Brown

1998-01-01

17

Practitioners’ Attitudes concerning Evidence-Based Guidelines in Belgian Substance Abuse Treatment  

Microsoft Academic Search

Background\\/Aim: Evidence-based guidelines for substance abuse treatment are available in many European countries. In Belgium, no such guidelines have been developed yet at a national level although their need has repeatedly been emphasized. This study aims to assess Belgian practitioners’ attitudes concerning evidence-based guidelines for substance abuse treatment. Methods: A survey was conducted with clinical coordinators in a representative sample

Mieke Autrique; Wouter Vanderplasschen; Eric Broekaert; Bernard Sabbe

2009-01-01

18

Disability guideline, role conflicts, and treatment records.  

PubMed

The AAPL Practice Guidelines for the Forensic Evaluation of Psychiatric Disability reminds treating psychiatrists as well as forensic examiners of the potential for role conflicts and of numerous factors related to handling of treatment records. This commentary suggests ways of more completely avoiding role conflicts, including those related to payment, and elaborates on implementation of requirements of the HIPAA Privacy Rules applicable to independent examination by third parties. PMID:19767506

Edwards, H Berryman

2009-01-01

19

Fertility preservation during cancer treatment: clinical guidelines  

PubMed Central

The majority of children, adolescents, and young adults diagnosed with cancer today will become long-term survivors. The threat to fertility that cancer treatments pose to young patients cannot be prevented in many cases, and thus research into methods for fertility preservation is developing, aiming at offering cancer patients the ability to have biologically related children in the future. This paper discusses the current status of fertility preservation methods when infertility risks are related to surgical oncologic treatments, radiation therapy, or chemotherapy. Several scientific groups and societies have developed consensus documents and guidelines for fertility preservation. Decisions about fertility and imminent potentially gonadotoxic therapies must be made rapidly. Timely and complete information on the impact of cancer treatment on fertility and fertility preservation options should be presented to all patients when a cancer treatment is planned. PMID:24623991

Rodriguez-Wallberg, Kenny A; Oktay, Kutluk

2014-01-01

20

Guidelines for the treatment of head and neck venous malformations  

PubMed Central

Venous malformation is one of the most common benign vascular lesions, with approximately 40% of cases appearing in the head and neck. They can affect a patient’s appearance and functionality and even cause life-threatening bleeding or respiratory tract obstruction. The current methods of treatment include surgery, laser therapy, sclerotherapy, or a combined. The treatment of small and superficial venous malformations is relatively simple and effective; however, the treatment of deep and extensive lesions involving multiple anatomical sites remains a challenge for the physicians. For complex cases, the outcomes achieved with one single treatment approach are poor; therefore, individualized treatment modalities must be formulated based on the patient’s condition and the techniques available. Comprehensive multidisciplinary treatments have been adapted to achieve the most effective results. In this paper, based on the national and international literature, we formulated the treatment guidelines for head and neck venous malformations to standardize clinical practice. The guideline will be renewed and updated in a timely manner to reflect cutting-edge knowledge and to provide the best treatment modalities for patients. PMID:23724158

Zheng, Jia Wei; Mai, Hua Ming; Zhang, Ling; Wang, Yan An; Fan, Xin Dong; Su, Li Xin; Qin, Zhong Ping; Yang, Yao Wu; Jiang, Yin Hua; Zhao, Yi Fang; Suen, James Y

2013-01-01

21

['Postoperative pain treatment' practice guideline revised].  

PubMed

On the initiative of the Dutch Association of Anaesthesiologists, a multidisciplinary workgroup has revised the 2003 practice guideline on 'Postoperative pain treatment' for adults and children. The main reason for revision was the availability of new drugs and new methods of administration. The most important deviations from the previous edition are the following. The organisation of care has been amended according to the current themes of the Safety Management System in the Netherlands, and a prediction model for postoperative pain was added. The drugs oxycodone, S-ketamine, pregabalin, gabapentin and metamizole were added, as well as new methods of administration and techniques for preventing postoperative pain. This revised guideline is more conservative than the previous one in the choice of epidural analgesia. In patients with relative contraindications for epidural analgesia, peripheral and locoregional blocks or multimodal pain treatment are advised. In the case of postoperative nausea and vomiting, administration of dexamethasone, droperidol and 5-HT3-antagonists is recommended, preferably in combination. Non-medicinal treatment options are not recommended. PMID:24299631

Houweling, Peter L; Molag, Marja L; van Boekel, Rianne L M; Verbrugge, Serge J C; van Haelst, Ingrid M M; Hollmann, Markus W

2013-01-01

22

A JISC National Data Centre Social Media Guidelines  

E-print Network

A JISC National Data Centre Social Media Guidelines Author: NicolaOsborne,EDINASocialMediaOfficer Version: 1.1 Published: 19 October 2012 HTML: http://edina.ac.uk/about/social_media/social_media (2011). EDINA Social Media Guidelines (Version 1.1, October 2012). Accessed via http

Bristol, University of

23

National Checklist Program for IT Products--Guidelines for  

E-print Network

National Checklist Program for IT Products--Guidelines for Checklist Users and Developers Recommendationsof the National Institute of Standards and Technology StephenD.Quinn MurugiahSouppaya Melanie;NIST Special Publication 800-70 Revision 2 National Checklist Program for IT Products

24

75 FR 13137 - National Institutes of Health Guidelines for Human Stem Cell Research  

Federal Register 2010, 2011, 2012, 2013

...Institutes of Health Guidelines for Human Stem Cell Research SUMMARY: The National Institutes...the definition of human embryonic stem cells (hESCs) in the ``National Institutes of Health Guidelines for Human Stem Cell Research'' (Guidelines). Due to...

2010-03-18

25

75 FR 8085 - National Institutes of Health Guidelines for Human Stem Cell Research  

Federal Register 2010, 2011, 2012, 2013

...Institutes of Health Guidelines for Human Stem Cell Research SUMMARY: The National Institutes...the definition of human embryonic stem cells (hESCs) in the ``National Institutes of Health Guidelines for Human Stem Cell Research'' (Guidelines). On July...

2010-02-23

26

Formal consensus: the development of a national clinical guideline  

PubMed Central

Background—There is currently a political enthusiasm for the development and use of clinical guidelines despite, paradoxically, there being relatively few healthcare issues that have a sound research evidence base. As decisions have to be made even where there is an undetermined evidence base and that limiting recommendations to where evidence exists may reduce the scope of guidelines, thus limiting their value to practitioners, guideline developers have to rely on various different sources of evidence and adapt their methods accordingly. This paper outlines a method for guideline development which incorporates a consensus process devised to tackle the challenges of a variable research evidence base for the development of a national clinical guideline on risk assessment and prevention of pressure ulcers. Method—To inform the recommendations of the guideline a formal consensus process based on a nominal group technique was used to incorporate three strands of evidence: research, clinical expertise, and patient experience. Results—The recommendations for this guideline were derived directly from the statements agreed in the formal consensus process and from key evidence-based findings from the systematic reviews. The existing format of the statements that participants had rated allowed a straightforward revision to "active" recommendations, thus reducing further risk of subjectivity entering into the process. Conclusions—The method outlined proved to be a practical and systematic way of integrating a number of different evidence sources. The resultant guideline is a mixture of research based and consensus based recommendations. Given the lack of available guidance on how to mix research with expert opinion and patient experiences, the method used for the development of this guideline has been outlined so that other guideline developers may use, adapt, and test it further. Key Words: guidelines; guideline development; formal consensus process; nominal group technique; pressure ulcers PMID:11743153

Rycroft-Malone, J

2001-01-01

27

Ocular allergy guidelines: a practical treatment algorithm.  

PubMed

The treatment of ocular allergy requires a better understanding of the spectrum of clinical disorders involving various components of the immune system, and of interactions at the conjunctival surface. The immune response focuses primarily on the different levels of activity of Th2 lymphocytes and various other immune cells associated with allergic disorders, including mast cells, eosinophils, fibroblasts, and epithelial and endothelial cells. Ocular allergic disorders include seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), vernal keratoconjunctivitis (VKC), giant papillary conjunctivitis (GPC) and atopic keratoconjunctivitis (AKC), which, through immunopathological and molecular immunological techniques, can all be better appreciated as being part of a larger spectrum of an atopic disease state. In SAC, pathological changes, such as increased mast-cell activation, the presence of migratory inflammatory cells, and early signs of cellular activation at the molecular level, are minimal. In PAC, these changes are more pronounced in line with the increased duration of allergenic stimulation. In more chronic forms of allergic conjunctivitis, such as VKC in children and AKC in adults, the following changes are evident: a persistent state of mast cell, eosinophil and lymphocyte activation; noted switching from connective-tissue to mucosal-type mast cells; increased involvement of corneal pathology; and follicular development and fibrosis. The treatment of acute and more chronic forms of allergic conjunctivitis has focused in the past on symptomatic relief of symptoms, but with a better understanding of the mechanisms involved we can now provide interventional therapeutic strategies and symptomatic relief. Our advances in the basic understanding of these conditions are providing the foundation for guidelines that improve the ocular health of patients with ocular allergies. PMID:12109924

Bielory, Leonard

2002-01-01

28

Transparency Matters: Kaiser Permanente's National Guideline Program Methodological Processes  

PubMed Central

Introduction: The practice-guideline process of collecting, critically appraising, and synthesizing available evidence, then developing expert panel recommendations based on appraised evidence, makes it possible to provide high-quality care for patients. Unwanted variability in the quality and rigor of evidence summaries and Clinical Practice Guidelines has been a long-standing challenge for clinicians seeking evidence-based guidance to support patient care decisions. Methods: A multidisciplinary group of stakeholders, with representation from all eight Kaiser Permanente Regions, is responsible for creating National Guidelines. Conducting high-quality systematic reviews and creating clinical guidelines are time-, labor-, and resource-intensive processes, which raises challenges for an organization striving to balance rigor with efficiency. For these reasons, the National Guideline Program elected to allow for the identification, assessment, and possible adoption of existing evidence-based guidelines and systematic reviews using the ADAPTE; Appraisal of Guidelines Research and Evaluation; Assessment of Multiple Systematic Reviews (AMSTAR); and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) frameworks. If no acceptable external guidelines are identified, the Guideline Development Team then systematically searches for relevant high-quality systematic reviews, meta-analyses, and original studies. Existing systematic reviews are assessed for quality using a measurement tool to assess systematic reviews (the AMSTAR systematic review checklist). Study Appraisal: Following the screening and selection process, the included studies (the “body of evidence”) are critically appraised for quality, using the GRADE methodology, which focuses on four key factors that must be considered when assigning strength to a recommendation: balance between desirable and undesirable effects, quality of evidence, values and preferences, and cost. The evidence is then used to create preliminary clinical recommendations. The strength of these recommendations is graded to reflect the extent to which a guideline panel is confident that the desirable effects of an intervention outweigh undesirable effects (or vice versa) across the range of patients for whom the recommendation is intended. Dissemination: The Care Management Institute disseminates all KP national guidelines to its eight Regions via postings on its Clinical Library Intranet site, a Web-based internal information resource. PMID:22529761

Davino-Ramaya, Carrie; Krause, L Kendall; Robbins, Craig W; Harris, Jeffrey S; Koster, Marguerite; Chan, Wiley; Tom, Gladys I

2012-01-01

29

Guidelines on anticoagulant treatment in atrial fibrillation in Great Britain: variation in content and implications for treatment  

Microsoft Academic Search

Objective: To describe the content of guidelines on the use of anticoagulant treatment in patients with atrial fibrillation and the impact of variations in guidelines on treatment. Design: Postal survey of guidelines, semistructured interview with lead developers of guidelines, and application of guidelines to patient sample. Subjects: 15 lead developers of the 20 guidelines identified in the postal survey were

Richard Thomson; Helen McElroy; Mark Sudlow

1998-01-01

30

USGS National Wildlife Health Center Diagnostic Case Submission Guidelines  

E-print Network

to the submitting agency, its wildlife populations, or domestic animal and human health. Type of Specimens to the submitting agency, its wildlife populations, domestic animals or human health. Types of CasesUSGS National Wildlife Health Center Diagnostic Case Submission Guidelines

31

National commissioning guidelines: body contouring surgery after massive weight loss.  

PubMed

The guidelines for body contouring reconstructive surgery present an evidence-based guide for management of redundant tissue after massive weight loss. A standardised referral pathway to ensure safe and equitable patient care on the National Health Service (NHS) throughout England is recommended. A database of all patients for research purposes is suggested. PMID:24909630

Soldin, M; Mughal, M; Al-Hadithy, N

2014-08-01

32

Human Factors Guidelines for UAS in the National Airspace System  

NASA Technical Reports Server (NTRS)

The ground control stations (GCS) of some UAS have been characterized by less-than-adequate human-system interfaces. In some cases this may reflect a failure to apply an existing regulation or human factors standard. In other cases, the problem may indicate a lack of suitable guidance material. NASA is leading a community effort to develop recommendations for human factors guidelines for GCS to support routine beyond-line-of-sight UAS operations in the national airspace system (NAS). In contrast to regulations, guidelines are not mandatory requirements. However, by encapsulating solutions to identified problems or areas of risk, guidelines can provide assistance to system developers, users and regulatory agencies. To be effective, guidelines must be relevant to a wide range of systems, must not be overly prescriptive, and must not impose premature standardization on evolving technologies. By assuming that a pilot will be responsible for each UAS operating in the NAS, and that the aircraft will be required to operate in a manner comparable to conventionally piloted aircraft, it is possible to identify a generic set of pilot tasks and the information, control and communication requirements needed to support these tasks. Areas where guidelines will be useful can then be identified, utilizing information from simulations, operational experience and the human factors literature. In developing guidelines, we recognize that existing regulatory and guidance material will, at times, provide adequate coverage of an area. In other cases suitable guidelines may be found in existing military or industry human factors standards. In cases where appropriate existing standards cannot be identified, original guidelines will be proposed.

Hobbs, Alan; Shively, R. Jay

2013-01-01

33

Treatment Guidelines of Atrial Fibrillation (AFib or AF)  

MedlinePLUS

... Tools & Resources Stroke More Treatment Guidelines of Atrial Fibrillation (AFib or AF) Updated:Apr 25,2014 What ... was last reviewed on 04/16/14. Atrial Fibrillation • Introduction • What is Atrial Fibrillation? • Why AFib Matters • ...

34

Sexually Transmitted Diseases Treatment Guidelines, 2006 Prepared by  

Microsoft Academic Search

Summary These guidelines for the treatment of patients who have sexually transmitted diseases (STDs) were developed by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 19-21, 2005. The information in this report updates the 2002 Guidelines for Treatment of Sexually Transmitted Diseases (MMWR 2002;51(No. RR- 6)). Included in

Kimberly A. Workowski; Stuart M Berman

2006-01-01

35

Guidelines on the treatment of ABRS in adults.  

PubMed

Acute bacterial rhinosinusitis (ABRS) is a common reason for healthcare visits, and one of the more common reasons for the use of antibiotics. In an effort to improve the diagnosis and appropriate therapy of ABRS, several guidelines have been developed. Current guidelines recommend extended-spectrum cephalosporins as one of the first-line options for the treatment of this condition. In addition, most cephalosporins recommended by recent guidelines (e.g. cefuroxime axetil, cefpodoxime proxetil and cefdinir) are unlikely to be associated with cross-reactivity with penicillins, and may be considered effective alternatives to amoxicillin in adults who are allergic to penicillin. PMID:17493094

Benninger, M

2007-05-01

36

Treatment Guidelines for Children and Adolescents With Bipolar Disorder: Child Psychiatric Workgroup on Bipolar Disorder  

Microsoft Academic Search

Clinicians who treat children and adolescents with bipolar disorder desperately need current treatment guidelines. These guidelines were developed by expert consensus and a review of the extant literature about the diagnosis and treatment of pediatric bipolar disorders. The four sections of these guidelines include diagnosis, comorbidity, acute treatment, and main- tenance treatment. These guidelines are not intended to serve as

ROBERT A. KOWATCH; MARY FRISTAD; BORIS BIRMAHER; KAREN DINEEN WAGNER; ROBERT L. FINDLING; MARTHA HELLANDER

37

Instrumentation Guidelines for the Advanced National Seismic System  

USGS Publications Warehouse

This document provides guidelines for the seismic-monitoring instrumentation used by long-term earthquake-monitoring stations that will sense ground motion, digitize and store the resulting signals in a local data acquisition unit, and optionally transmit these digital data. These guidelines are derived from specifications and requirements for data needed to address the nation's emergency response, engineering, and scientific needs as identified in U.S. Geological Survey Circular 1188 (1999). Data needs are discussed in terms of national, regional, and urban scales of monitoring in section 3. Functional performance specifications for instrumentation are introduced in section 4.3 and discussed in detail in section 6 in terms of instrument classes and definitions described in section 5. System aspects and testing recommendations are discussed in sections 7 and 8, respectively. Although U.S. Geological Survey Circular 1188 (1999) recommends that the Advanced National Seismic System (ANSS) include portable instrumentation, performance specifications for this element are not specifically addressed in this document. Nevertheless, these guidelines are largely applicable to portable instrumentation. Volcano monitoring instrumentation is also beyond the scope of this document. Guidance for ANSS structural-response monitoring is discussed briefly herein but details are deferred to the ANSS document by the ANSS Structural Response Monitoring Committee (U.S. Geological Survey, 2005). Aspects of station planning, siting, and installation other than instrumentation are beyond the scope of this document.

Working Group on Instrumentation, Siting, Installation, and Site Metadata of the Advanced National Seismic System Technical Integration Committee

2008-01-01

38

Using a national guideline to prevent and manage pressure ulcers.  

PubMed

Developing pressure ulcers is a painful and distressing event for patients, and one that can be prevented. The National Institute for Health and Care Excellence pressure ulcer guideline has recently been updated to cover the prevention and management of this condition. This article focuses on the recommendations that are relevant to nurses, covering areas such as risk assessment, skin assessment, repositioning, pressure-redistributing devices, dressings, patient and carer information, and training and education. It also identifies what senior nurses and nurse managers must do to ensure their staff can prevent and manage pressure ulcers effectively. PMID:24779761

Neilson, Julie; Avital, Liz; Willock, Jane; Broad, Nigel

2014-05-01

39

Successful implementation of spacer treatment guideline for acute asthma  

PubMed Central

AIMS—To develop and implement an evidence based guideline for the treatment of acute asthma using a metered dose inhaler and spacer combination.?METHODS—Defined strategies were used for the development and implementation of a guideline, assessed by a prospective, descriptive, study using notes review, and patient, nursing, and medical staff telephone contact. The setting was a tertiary referral hospital in Victoria, Australia with 25 000 yearly admissions, and asthma accounting for about 7% of total. The first 200 children and families to use the guideline after its introduction were evaluated.?RESULTS—A total of 191 (95.5%) children were treated according to the guideline. Six (3.0%) children were given nebulisers appropriately based on severity; five (2.5%) were given nebulisers at parental or child choice; and four (2.0 %) who did not have severe asthma, received nebulised treatment inappropriately.?CONCLUSIONS—Successful implementation of a new evidence based guideline can be achieved using specific strategies for promoting the application of research findings in the clinical arena.?? PMID:11159290

Powell, C; Maskell, G; Marks, M; South, M; Robertson, C; LENNEY, W.

2001-01-01

40

Economic factors may affect getting guideline-recommended breast cancer treatment  

Cancer.gov

Women with interruptions in health insurance coverage or with low income levels had a significantly increased likelihood of failing to receive breast cancer care that is in concordance with recommended treatment guidelines, according to results presented at the Sixth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved, held Dec. 6-9. Women with a break in their insurance coverage had a 3.5-fold higher likelihood of nonconcordance with National Comprehensive Cancer Network (NCCN) guidelines for radiation therapy and chemotherapy compared with women with uninterrupted coverage, according to a study from the Fred Hutchinson Cancer Research Center.

41

Revised Guidelines for Empiric Treatment of Typhoid Fever - 1995  

Microsoft Academic Search

The purpose of this document is to review surveillance data on typhoid fever as gathered by the Working Group on Drug -resistant Typhoid Fever and to update recommendations for empiric treatment. Since the initial guidelines were formulated in September 1993 as a result of the emergence of drug-resistant typhoid fever (DRTF),1 trends in resistance of Salmonella typhi to traditionally used

Mediadora C. Saniel

42

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

43

Antihypertensive prescriptions for newly treated patients before and after the main antihypertensive and lipid-lowering treatment to prevent heart attack trial results and seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure guidelines.  

PubMed

Main results of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial were published in December 2002. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, published in May 2003, recommended thiazide-type diuretics as initial pharmacological treatment alone or in combination with another drug in most patients with hypertension. To assess changes from before to after these publications, we compared antihypertensive medication prescriptions filled by patients who initiated pharmacological antihypertensive treatment in a large managed care organization during 3 time periods: (1) July 1, 2001, to June 30, 2002 (before these publications; n=1354); (2) July 1, 2003, to June 30, 2004 (to assess short-term changes; n=1542); and (3) July 1, 2004, to June 30, 2005 (to assess extended changes; n=1865). The percentage of patients initiating antihypertensive treatment with a thiazide-type diuretic increased from 30.6% to 39.4% (P<0.001) between 2001-2002 and 2003-2004, and the increase was maintained at 36.5% in 2004-2005 (P<0.001 compared with 2001-2002 and P=0.33 compared with 2003-2004). Among patients without diabetes mellitus, renal disease, a history of myocardial infarction, or heart failure, the percentage initiating pharmacological antihypertensive treatment with a thiazide-type diuretic increased from 33.1% in 2001-2002 to 43.4% in 2003-2004 (P<0.001) and remained increased (41.0%) in 2004-2005 (P<0.001 and P=0.23 compared with 2001-2002 and 2003-2004, respectively). Despite a sustained increase in the use of thiazide-type diuretics, this study indicates that an opportunity exists to increase adherence to the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure guidelines. PMID:19221214

Muntner, Paul; Krousel-Wood, Marie; Hyre, Amanda D; Stanley, Erin; Cushman, William C; Cutler, Jeffrey A; Piller, Linda B; Goforth, Gary A; Whelton, Paul K

2009-04-01

44

Migraine treatment in developmental age: guidelines update  

Microsoft Academic Search

There is a serious lack of controlled studies on the pharmacological treatment of primary migraine in the developmental age;\\u000a there is, consequently, an urgent need for new, evidence-based approaches to this long-neglected field of research. Moreover,\\u000a previous studies have stated that the placebo response is greater in pediatric patients than in adults and that a reduction\\u000a in the attack frequency

Laura Papetti; Alberto Spalice; Francesco Nicita; Maria Chiara Paolino; Rosa Castaldo; Paola Iannetti; Maria Pia Villa; Pasquale Parisi

2010-01-01

45

National Synchrotron Light Source guidelines for the conduct of operations  

SciTech Connect

To improve the quality and uniformity of operations at the Department of Energy`s facilities, the DOE issued Order 5480.19 ``Conduct of Operations Requirements at DOE facilities.`` This order recognizes that the success of a facilities mission critically depends upon a high level of performance by its personnel and equipment. This performance can be severely impaired if the facility`s Conduct of Operations pays inadequate attention to issues of organization, safety, health, and the environment. These guidelines are Brookhaven National Laboratory`s and the National Synchrotron Light Source`s acknowledgement of the principles of Conduct of Operations and the response to DOE Order 5480.19. These guidelines cover the following areas: (1) operations organization and administration; (2) shift routines and operating practices; (3) control area activities; (4) communications; (5) control of on-shift training; (6) investigation of abnormal events; (7) notifications; (8) control of equipment and system studies; (9) lockouts and tagouts; (10) independent verification; (11) log-keeping; (12) operations turnover; (13) operations aspects of facility process control (14) required reading; (15) timely orders to operators; (16) operations procedures; (17) operator aid posting; and (18) equipment sizing and labeling.

Buckley, M. [Brookhaven National Lab., Upton, NY (United States). National Synchrotron Light Source

1998-01-01

46

Tuberculosis in childhood: a systematic review of national and international guidelines  

PubMed Central

Background Paediatric tuberculosis (TB) represents a major public health concern worldwide. About 1 million children aged less than 15 years develop TB each year, contributing to 3-25% of the total TB caseload. The aim of this review is to evaluate national and international guidelines concerning tuberculosis in childhood and compare them in terms of diagnosis and treatment strategies. Methods A literature search of the Pubmed database was performed from January 2000 to August 2013, using the terms “tuberculosis” and “children”. The search was limited to guidelines and consensus conferences, human species and full text availability, with no language restrictions. Results Twenty-seven national and international guidelines are identified. Several discrepancies on the diagnosis workup of TB are underlined. The main points of disagreement are represented by the interpretation of tuberculin skin test (TST) result and the recommendations on the use of TST and/or interferon-gamma release assay (IGRA) for the diagnosis of TB infection. Otherwise, all guidelines are in agreement that a microbiological confirmation should always be sought. Similarly, susceptibility drug testing and genotyping should be performed whenever it is possible on the basis of resources availability. On the contrary, the use of nucleic acid amplification tests (NAATs) for the M. tuberculosis detection is still controversial. A general consensus exists, otherwise, on TB treatment and only minor discrepancies are evidenced, such as the recommendations on daily or intermittent treatment regimens. Conclusions Despite advances in TB diagnostic tools have been reached during the last decade, a lack of uniformity in their availability, indication and interpretation has relevant consequences for clinical practice. Further studies need to be performed to clarify this issue and identify a reliable and reproducible diagnostic workup. Moreover, future studies should analyze the drug metabolism and the efficacy of intermittent dosing regimes in childhood, as well as new treatment regimens in order to improve the therapy compliance. PMID:24564378

2014-01-01

47

Treatment guidelines for HIV-associated wasting.  

PubMed

Patients with acquired immunodeficiency syndrome (AIDS) often suffer from weight loss manifested by a loss of body cell mass (BCM). The causes of human immunodeficiency virus (HIV)-associated wasting may include anorexia, malabsorption, and a variety of altered metabolic states. Malabsorption and diarrhea may result from gastrointestinal tract opportunistic infections or from direct effects of HIV on the gastrointestinal tract. Infection with HIV may produce metabolic derangements that alter nutrient utilization, resulting in loss of BCM. Nutritional assessment of the patient with AIDS should include an evaluation of BCM and physical and psychosocial functioning. Antiretroviral therapy and eradication of opportunistic infections do not always reverse wasting. Treatment should include nutritional counseling. Total parenteral nutrition is sometimes of benefit, particularly in patients with damaged gastrointestinal tracts. Dronabinol and megestrol acetate may promote weight gain; however, dronabinol may have adverse effects, and most of the gain with megestrol acetate is in fat rather than BCM. If gonadal dysfunction is present, testosterone replacement therapy should be included in the treatment plan. Some studies suggest that oral anabolic steroids may improve muscle strength and body composition. In randomized, placebo-controlled trials, mammalian-derived human growth hormone (rhGH[m]) has produced sustained weight and BCM gains in AIDS patients. If a patient continues to lose BCM after the above factors have been addressed and corrected, a 12-week course of rhGH[m] is indicated. Halting the progression of HIV-associated wasting may improve survival, enhance physical and social functioning, and enrich quality of life. PMID:10761494

Nemechek, P M; Polsky, B; Gottlieb, M S

2000-04-01

48

Saudi guidelines for testing and treatment of latent tuberculosis infection  

PubMed Central

Pulmonary tuberculosis is a common disease in Saudi Arabia. As most cases of tuberculosis are due to reactivation of latent infection, identification of individuals with latent tuberculosis infection (LTBI) who are at increased risk of progression to active disease, is a key element of tuberculosis control programs. Whereas general screening of individuals for LTBI is not cost-effective, targeted testing of individuals at high risk of disease progression is the right approach. Treatment of those patients with LTBI can diminish the risk of progression to active tuberculosis disease in the majority of treated patients. This statement is the first Saudi guideline for testing and treatment of LTBI and is a result of the cooperative efforts of four local Saudi scientific societies. This Guideline is intended to provide physicians and allied health workers in Saudi Arabia with the standard of care for testing and treatment of LTBI. PMID:20103957

Al Jahdali, Hamdan H.; Baharoon, Salim; Abba, Abdullah A.; Memish, Ziad A.; Alrajhi, Abdulrahman A.; AlBarrak, Ali; Haddad, Qais A.; Al Hajjaj, Mohammad; Pai, Madhukar; Menzies, Dick

2010-01-01

49

Atypical antipsychotic augmentation strategies in the context of guideline-based care for the treatment of major depressive disorder.  

PubMed

There is a growing body of evidence that supports the use of atypical antipsychotics as augmentation agents for nonpsychotic unipolar major depressive disorder (MDD) in adults. Unfortunately, varying definitions of treatment-resistant depression, the limited evidence available for interventions after two or more treatment failures, and when and whether to use medications from nonantidepressant classes, remain a key gap in the knowledge base for clinicians. We identified and reviewed the following guidelines to discuss the status of augmentation therapy with atypical antipsychotic agents in MDD: American Psychiatric Association practice guidelines for treatment of patients with MDD; Canadian Network for Mood and Anxiety Treatments clinical guidelines for the management of MDD in adults; National Institute for Health and Clinical Excellence guidelines for treatment and management of depression in adults; British Association of Psychopharmacology guidelines for treatment of depressive disorders; Institute for Clinical Systems Improvement healthcare guideline for MDD in adults in primary care; clinical practice recommendations for depression; international consensus statement on MDD; German Society of Psychiatry, Psychotherapy and Neurology guidelines for unipolar depression; and World Federation of Societies of Biological Psychiatry guidelines for biological treatment of unipolar depressive disorders in primary care. Reflecting the cumulative evidence in the past decade, augmentation strategies including atypical antipsychotic augmentation are recommended in most guidelines for partial or nonresponders, at the same stage as switching or combination strategies. However, there are few direct comparisons of different augmentation strategies and little information about the optimal duration of augmentation strategies or use in special populations. Clinicians should note that guidelines are derived from an evolving database of evidence and cannot take into account the myriad of clinical variables that differ between individual patients. Therefore, they are intended to provide a useful framework for the management of depression and should be used in conjunction with other recognized sources of patient information and the application of clinical wisdom. PMID:23709359

Patkar, Ashwin A; Pae, Chi-Un

2013-05-01

50

In touch with psoriasis: topical treatments and current guidelines.  

PubMed

This article describes topical therapies and treatment guidelines for psoriasis and is based on a presentation given by the authors at a satellite symposium held during the 19th Congress of the European Academy of Dermatology and Venereology, 6-10 October, 2010, in Gothenburg, Sweden. The highly variable nature of psoriasis and its individual presentation in patients can make it difficult to choose the most appropriate treatment. There are many treatment options, from topical treatment with emollients for very mild psoriasis, to systemic therapy with fumaric acid esters, methotrexate or biologics for severe disease. For the treatment of mild-to-moderate psoriasis, topical therapy is generally the most appropriate and a variety of options, both historical and recent, are available. Newer therapies offer greater convenience and fewer side-effects. Of the more recently available therapies, vitamin D analogues and topical corticosteroids are the two with the greatest proven efficacy in randomized clinical trials. A recent Cochrane review showed the highest efficacy overall with the fixed combination vitamin D analogue (calcipotriol) and corticosteroid (betamethasone dipropionate). Indeed, clinical trials have shown that two-compound calcipotriol/betamethasone dipropionate ointment has higher efficacy than calcipotriol or betamethasone dipropionate alone. With regard to safety, two-compound calcipotriol/betamethasone dipropionate was shown to be suitable for intermittent long-term treatment of mild-to-moderate psoriasis. The findings of the Cochrane review are reflected in the current treatment guidelines from the USA and Germany regarding the treatment of mild-to-moderate psoriasis. In both these guidelines, which will be discussed in this article, the recommended treatments for this patient group are vitamin D analogues and corticosteroids, particularly when used in combination. PMID:21507077

Murphy, G; Reich, K

2011-06-01

51

The development of guidelines for the treatment of patients with mental disorders under particular consideration of rehabilitative aspects  

PubMed Central

Inpatient psychotherapeutic treatment is quite extensive in Germany. Three treatment systems (psychosomatic/psychotherapeutic healthcare, psychiatric/psychotherapeutic healthcare and rehabilitation of patients with mental disorders) exist relatively independently from one another. They show large areas of overlap, however, with regard to various criteria. This is due to the fact that, as opposed to many somatic illnesses, a clear distinction between acute-medical and rehabilitative elements cannot be made in the treatment of mental disorders. Systematic treatment recommendations in the form of guidelines could aid in determining the optimal treatment form for patients. The current development of guidelines for mental disorders will thus be presented and analyzed in this article. Particular focus will be placed on rehabilitative aspects. The presentation and analysis will take place using the example of guidelines written for panic disorders. Based on a national and international investigation of guidelines (internet, databases) 11 guidelines for panic disorder (2 German guidelines, 9 from English spoken countries; target group of 9 guidelines: general practitioners; recommendations concerning diagnostics /assessment and treatment) were analysed. The results demonstrate a considerable need for development as rehabilitative elements are only marginally mentioned in the guidelines up to now. Of the 16 rehabilitative elements being investigated, only two ("psycho education" and "pharmacotherapy of chronic illness in the long-term perspective") are considered more than once in the guidelines. Seven elements (e.g. "salutogenic aspects of the therapy/ measures for the maintenance of quality of life", "methods of long-term guidance") are not mentioned at all. Based on the results of the analyses performed, conclusions for the further development of guidelines will be presented for discussion. PMID:19742053

Buscher, Cathrin; Watzke, Birgit; Koch, Uwe; Schulz, Holger

2004-01-01

52

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

Microsoft Academic Search

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

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

1999-01-01

53

The need for advanced breast cancer treatment guidelines: Results of an internet-based survey  

Microsoft Academic Search

Although not curable, advanced breast cancer is treatable, however, treatment options are many and varied, and unlike early breast cancer (EBC), consistent guidelines are lacking. Breast cancer physicians were surveyed to assess the emotional impact of recurrence, factors affecting their treatment decisions, the role of guidelines in the management of advanced breast cancer and the need for new guidelines. Overall,

Andrew Wardley

2008-01-01

54

[New guidelines for Helicobacter pylori treatment: comparisons between Korea and Japan].  

PubMed

Korea and Japan show the highest incidence of gastric cancer and Helicobacter pylori infection. New 2013 guidelines on H. pylori infection differ between the two countries with regard to the indications for H. pylori eradication, diagnostic methods, and treatment regimens. Indications for eradication in Korean guideline focus on specific diseases such as peptic ulcer disease, low-grade gastric mucosa-associated lymphoid tissue lymphoma, and after resection of early gastric cancer, while Japanese guideline includes all H. pylori-associated gastritis for the prevention of dissemination. With regard to the diagnosis, either noninvasive or invasive method (except for bacterial culture) is recommended in Korea, while two noninvasive tests including serum anti-H. pylori IgG antibody level are preferred in Japan. As for the treatment regimens, second-line treatment (quadruple bismuth-containing regimen) is recommended without first-line triple therapy in areas of high clarithromycin resistance in Korea. However, there is no bismuth-based second-line treatment in Japan, and the Japanese regimen consists of a lower dose of antibiotics for a shorter duration (7 days). Such discrepancies between the two countries are based not only on the differences in the literature search and interpretation, but also on the different approvals granted by the national health insurance system, manufacturing process of the antibiotics, and diagnostic techniques in each country. Collaborations are required to minimize the discrepancies between the two countries based on cost-effectiveness. PMID:24651588

Lee, Sun Young

2014-03-25

55

[Italian guidelines for the diagnosis and treatment of Paget's disease of bone].  

PubMed

Paget's disease of bone is a chronic focal abnormality of bone turnover that remains totally asymptomatic over a very long period of time but that eventually ensue in bone pain and skeletal deformities. Although, in the last decade new insights have been obtained on its etiology, this remains largely obscure. Effective medical treatment (based on the use of bisphosphonates) has become available and the diagnostic procedures are now well defined. However, there remains considerable controversy regarding the hierarchy of diagnostic procedures and the medical treatment threshold. In the last few years different institution have published national guidelines, reflecting local national health systems and the available medical treatment. In this review, a working group derived from members of the SIOMMMS has examined the information available regarding the diagnosis and treatment of Paget's disease in order to develop guidelines to assist in the management of this condition. The first draft was then extensively reviewed by experts derived from the most representative scientific societies of rheumatology, internal medicine, and orthopaedic surgery. The document provides the most updated recommendations based primarily on the "evidence-based- medicine" but also on the Italian regulation for the diagnostic procedures and on the available medical treatments. PMID:17603696

Adami, S; Bartolozzi, P; Brandi, M L; Falchetti, A; Filipponi, P; Gonnelli, S; Bianchi, G; Isaia, G C; Nuti, R

2007-01-01

56

The role of monoamine oxidase inhibitors in depression treatment guidelines.  

PubMed

Monoamine oxidase inhibitors (MAOIs) have proven efficacy for treating depression and for decades have been a preferred treatment for patients with atypical depression, high levels of anxiety, anergic bipolar depression, and treatment-resistant depression. However, MAOIs are infrequently used due to safety and tolerability concerns and the need for dietary restrictions. Current guidelines, which are reviewed here, recommend MAOIs as third-, fourth-, or fifth-line treatments due to these concerns. However, a transdermal formulation of selegiline limits the need for dietary restrictions and has fewer side effects than many more widely used antidepressants. The availability of a safer and more tolerable formulation gives clinicians another option in their armamentarium for treating depression. PMID:22951237

Thase, Michael E

2012-01-01

57

PHYSICO CHEMICAL TREATMENT METHODS FUNDAMENTALS AND DESIGN GUIDELINES  

Microsoft Academic Search

\\u000a This chapter is focused on the main physicochemical methods used in the treatment of waste– and ground-waters. The bases,\\u000a selection rules, and the main guidelines for the design of distillation-evaporation, adsorption-ion exchange, air stripping,\\u000a chemical precipitation and chemical reduction\\/oxidation processes are briefly summarized in the present work. In order to\\u000a systemize this study, these physico–chemical processes were classified according to

SALVADOR ORDÓÑEZ; EVA DÍAZ

58

Australian guidelines for the treatment of adults with acute stress disorder and post-traumatic stress disorder  

Microsoft Academic Search

Over the past 2 ? 3 years, clinical practice guidelines (CPGs) for post-traumatic stress disorder (PTSD) and acute stress disorder (ASD) have been developed in the USA and UK. There remained a need, however, for the development of Australian CPGs for the treatment of ASD and PTSD tailored to the national health-care context. Therefore, the Australian Centre for Posttraumatic Mental

David Forbes; Mark Creamer; Andrea Phelps; Richard Bryant; Alexander McFarlane; Grant J. Devilly; Lynda Matthews; Beverley Raphael; Chris Doran; Tracy Merlin; Skye Newton

2007-01-01

59

Low Compliance with National Guidelines for Preventing Transmission of Group 1 Nationally Notifiable Infectious Diseases in Korea  

PubMed Central

Purpose This study was performed to evaluate the compliance with, and adequacy of, the Korean national guidelines which had been recommended until 2011 for isolation of patients with group 1 nationally notifiable infectious diseases (NNIDs), namely cholera, typhoid fever, paratyphoid fever, shigellosis, and enterohemorrhagic Escherichia coli (EHEC) infection. Materials and Methods We evaluated the clinical and microbiological characteristics of confirmed cases of group 1 NNIDs and compliance with the guidelines in 20 Korean hospitals nationwide in 2000-2010. We also compared the Korean guidelines with international guidelines. Results Among 528 confirmed cases (8 cases of cholera, 232 of typhoid fever, 81 of paratyphoid fever, 175 of shigellosis, and 32 EHEC infections), strict compliance with the Korean guideline was achieved in only 2.6% to 50.0%, depending on the disease. While the Korean guidelines recommend isolation of all patients with group 1 NNIDs, international guidelines recommend selective patient isolation and screening for fecal shedding, depending on the type of disease and patient status. Conclusion Compliance with the previous national guidelines for group 1 NNIDs in Korea was generally very low. Further studies are needed to evaluate whether compliance was improved after implementation of the new guideline in 2012. PMID:24532515

Kim, Eu Suk; Song, Kyoung-Ho; Kim, Baek-Nam; Kwak, Yee Gyung; Lee, Chang-Seop; Park, Sang Won; Moon, Chisook; Park, Kyung Hwa; Jang, Hee-Chang; Yeom, Joon-Sup; Oh, Won Sup; Kim, Chung-Jong

2014-01-01

60

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

61

Clinical Guidelines for the Antimicrobial Treatment of Bone and Joint Infections in Korea  

PubMed Central

There are many various diseases in the bone and joint infections, and we tried to make antimicrobial treatment guidelines for common infectious diseases based on available data for microbiology and clinical trials. This guidelines focused on the treatment of osteomyelitis and septic arthritis, which can be experienced by physicians at diverse clinical settings. This guidelines is not applicable to diabetic foot infections, postoperative infections or post-traumatic infections which need special considerations. The guidelines for those conditions will be separately developed later. Surgical treatment of bone and joint infections, pediatric bone and joint infection, tuberculous bone and joint infection, and prophylactic antibiotic use were not included in this guideline. PMID:25024877

2014-01-01

62

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

PubMed

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

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

2014-03-01

63

[Guideline 'Diagnosis and treatment of inflammatory bowel disease in children'].  

PubMed

A multidisciplinary working group has outlined evidence-based practice guidelines for the diagnosis and treatment of inflammatory bowel disease in children (IBD). Both diagnosis and treatment of IBD in children differ significantly from practice in adults. The incidence of IBD in children is low (5.2 per 100,000 per year in the age group 0-17 years), but most of the presenting symptoms are non-specific; therefore it is difficult for the general practitioner to recognise the disease in children. For a correct diagnosis, ileocolonoscopy and upper gastrointestinal endoscopy are necessary, often combined with radiological imaging of the small bowel. In children and adolescents with Crohn's disease, nutritional therapy is the first choice of treatment for remission induction. As maintenance treatment, immunomodulators (azathioprine or mercaptopurine) should be started from the time of initial diagnosis. In children and adolescents with ulcerative colitis, the first treatment is with aminosalicylates. Prednisone and/or immunomodulators (azathioprine, cyclosporin) are indicated if there is insufficient response to aminosalicylates. A final treatment option is colectomy. The transition from paediatric to adult health care needs special attention as the patient and his or her parents may be reluctant to change trusted contacts which they have made. PMID:21029495

de Ridder, Lissy; Rings, Edmond H H M; Escher, Johanna C

2010-01-01

64

[Guidelines for employment policies in Europe and national action plans: opportunities for people with disabilities].  

PubMed

The scourge of unemployment has been roundly identified throughout Europe as the most pressing social and economic problem on the current political agenda. At Luxembourg in November 1997, the European Jobs Summit brought Europe's leaders together in an historic occasion that mapped out employment guidelines for Europe. The Luxembourg Jobs Summit agreed a set of guidelines for the Member States employment policy under four pillars, employability, entrepreneurship, adaptability, and equal opportunities. One guideline referred to promoting integration of people with disabilities into working life. The Member States subsequently agreed to incorporate the Guidelines into national employment action plans. The question of this paper is, to what extent do employment guidelines and National Action Plans improve the opportunities of disabled persons? This paper seeks to establish a set of fundamental issues concerning employment and disability. Included in this analysis are recommendations in order to achieve a better presence of disabled people in National Action Plans in future. PMID:10919176

Niehaus, M

2000-06-01

65

Evidence-Based, Pharmacological Treatment Guideline for Depression in Korea, Revised Edition  

PubMed Central

This paper aims to introduce, summarize, and emphasize the importance of the 'Evidence-Based, Pharmacological Treatment Guideline for Depression in Korea, Revised Edition'. The guideline broadly covers most aspects of the pharmacological treatment of patients in Korea diagnosed with moderate to severe major depression according to the DSM-IV TR. The guideline establishment process involved determining and answering a number of key questions, searching and selecting publications, evaluating recommendations, preparing guideline drafts, undergoing external expert reviews, and obtaining approval. A guideline adaptation process was conducted for the revised edition. The guideline strongly recommends pharmacological treatment considered appropriate to the current clinical situation in Korea, and should be considered helpful when selecting the appropriate pharmacological treatment of patients diagnosed with major depressive disorder. Therefore, the wide distribution of this guideline is recommended. PMID:24753693

2014-01-01

66

Good Research Practice The National Centre for Biological Sciences' Guidelines on Good Research Practice  

E-print Network

Good Research Practice The National Centre for Biological Sciences' Guidelines on Good Research Practice have been developed to emphasise the importance of integrity and rigour in all research carried of interest, leadership, supervision & training, ethical practice, conducting the research, intellectual

Udgaonkar, Jayant B.

67

Guideline for the surgical treatment of atrial fibrillation.  

PubMed

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and its prevalence is ?1-2% of the general population, but higher with increasing age and in patients with concomitant heart disease. The Cox-maze III procedure was a groundbreaking development and remains the surgical intervention with the highest cure rate, but due to its technical difficulty alternative techniques have been developed to create the lesions sets. The field is fast moving and there are now multiple energy sources, multiple potential lesion sets and even multiple guidelines addressing the issues surrounding the surgical treatment of AF both for patients undergoing this concomitantly with other cardiac surgical procedures and also as stand-alone procedures either via sternotomy or via videothoracoscopic techniques. The aim of this document is to bring together all major guidelines in this area into one resource for clinicians interested in surgery for AF. Where we felt that guidance was lacking, we also reviewed the evidence and provided summaries in those areas. We conclude that AF surgery is an effective intervention for patients with all types of AF undergoing concomitant cardiac surgery to reduce the incidence of AF, as demonstrated in multiple randomized studies. There is some evidence that this translates into reduced stroke risk, reduced heart failure risk and longer survival. In addition, symptomatic patients with AF may be considered for surgery after failed catheter intervention or even as an alternative to catheter intervention where either catheter ablation is contraindicated or by patient choice. PMID:23956274

Dunning, Joel; Nagendran, Myura; Alfieri, Ottavio R; Elia, Stefano; Kappetein, A Pieter; Lockowandt, Ulf; Sarris, George E; Kolh, Phillippe H

2013-11-01

68

Guidelines versus clinical practice in the treatment of chronic obstructive pulmonary disease  

Microsoft Academic Search

Guidelines versus clinical practice in the treatment of chronic obstructive pulmonary disease. N. Roche, T. Lepage, J. Bourcereau, P. Terrioux. #ERS Journals Ltd 2001. ABSTRACT: The main purpose of this study was to assess whether pharmacological treatments prescribed by respiratory physicians to patients with chronic obstructive pulmonary disease (COPD) were consistent with the guidelines. The treatments prescribed by respiratory physicians

N. Roche; T. Lepage; J. Bourcereau; P. Terrioux

2001-01-01

69

Guidelines -National Science Foundation (NSF) Data Management Plan effective January 18, 2011  

E-print Network

Guidelines - National Science Foundation (NSF) Data Management Plan ­ effective January 18, 2011 The National Science Foundation now requires that all proposals have a Data Management Plan for the proposed and pasted directly into the proposal. Resources: National Science Foundation - Data Management Plan

Heller, Barbara

70

Surgical treatment of patients with acute cholecystitis: Tokyo Guidelines.  

PubMed

Cholecystectomy has been widely performed in the treatment of acute cholecystitis, and laparoscopic cholecystectomy has been increasingly adopted as the method of surgery over the past 15 years. Despite the success of laparoscopic cholecystectomy as an elective treatment for symptomatic gallstones, acute cholecystitis was initially considered a contraindication for laparoscopic cholecystectomy. The reasons for it being considered a contraindication were the technical difficulty of performing it in acute cholecystitis and the development of complications, including bile duct injury, bowel injury, and hepatic injury. However, laparoscopic cholecystectomy is now accepted as being safe for acute cholecystitis, when surgeons who are expert at the laparoscopic technique perform it. Laparoscopic cholecystectomy has been found to be superior to open cholecystectomy as a treatment for acute cholecystitis because of a lower incidence of complications, shorter length of postoperative hospital stay, quicker recuperation, and earlier return to work. However, laparoscopic cholecystectomy for acute cholecystitis has not become routine, because the timing and approach to the surgical management in patients with acute cholecystitis is still a matter of controversy. These Guidelines describe the timing of and the optimal surgical treatment of acute cholecystitis in a question-and-answer format. PMID:17252302

Yamashita, Yuichi; Takada, Tadahiro; Kawarada, Yoshifumi; Nimura, Yuji; Hirota, Masahiko; Miura, Fumihiko; Mayumi, Toshihiko; Yoshida, Masahiro; Strasberg, Steven; Pitt, Henry A; de Santibanes, Eduardo; Belghiti, Jacques; Büchler, Markus W; Gouma, Dirk J; Fan, Sheung-Tat; Hilvano, Serafin C; Lau, Joseph W Y; Kim, Sun-Whe; Belli, Giulio; Windsor, John A; Liau, Kui-Hin; Sachakul, Vibul

2007-01-01

71

S3-Guidelines for the Treatment of Inflammatory Breast Disease during the Lactation Period  

PubMed Central

Breastfeeding is widely acknowledged to be the best and most complete form of nutrition for healthy infants born at term and is associated with numerous benefits in terms of infants? health, growth, immunity and development. However, breastfeeding problems often result in early weaning. Standardized treatment recommendations for breastfeeding-related diseases are necessary to optimize the care offered to breastfeeding women. Evidence and consensus based guidelines for the treatment of puerperal mastitis, sore nipples, engorgement and blocked ducts were developed on the initiative of the National Breastfeeding Committee. These guidelines were developed in accordance with the criteria set up by the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF), the Association of Scientific Medical Societies in Germany. The recommendations were drawn up by an interdisciplinary group of experts and were based on a systematic search and evaluation of the literature but also took clinical experience into account. Additionally good clinical practice (GCP) in terms of expert opinion was formulated in cases where scientific investigations could not be performed or were not aimed for. This article presents a summary of the recommendations of the S3-guidelines. PMID:24771901

Jacobs, A.; Abou-Dakn, M.; Becker, K.; Both, D.; Gatermann, S.; Gresens, R.; Gross, M.; Jochum, F.; Kuhnert, M.; Rouw, E.; Scheele, M.; Strauss, A.; Strempel, A.-K.; Vetter, K.; Wockel, A.

2013-01-01

72

Clinical practice guideline on diagnosis and treatment of hyponatraemia.  

PubMed

Hyponatraemia, defined as a serum sodium concentration <135 mmol/L, is the most common disorder of body fluid and electrolyte balance encountered in clinical practice. Hyponatraemia is present in 15-20% of emergency admissions to hospital and occurs in up to 20% of critically ill patients. Symptomatology may vary from subtle to severe or even life threatening. Despite this, the management of patients remains problematic. Against this background, the European Society of Intensive Care Medicine, the European Society of Endocrinology and the European Renal Association-European Dialysis and Transplant Association, represented by European Renal Best Practice have developed a Clinical Practice Guideline on the diagnostic approach and treatment of hyponatraemia as a joint venture of three societies representing specialists with a natural interest in hyponatraemia. PMID:24562549

Spasovski, Goce; Vanholder, Raymond; Allolio, Bruno; Annane, Djillali; Ball, Steve; Bichet, Daniel; Decaux, Guy; Fenske, Wiebke; Hoorn, Ewout J; Hoorn, Ewout; Ichai, Carole; Joannidis, Michael; Soupart, Alain; Zietse, Robert; Haller, Maria; van der Veer, Sabine; Van Biesen, Wim; Nagler, Evi

2014-03-01

73

Antiemetic guidelines: creating a more practical treatment approach  

Microsoft Academic Search

Antiemetic guidelines from a variety of professional organizations have been available for several years. It is unclear just how often these guidelines have been used, however; data indicate that some practitioners still do not treat their patients according to the recommendations. Some of those involved in the creation of the original guidelines convened to try to create a simpler, more

Jim M. Koeller; Matti S. Aapro; Richard J. Gralla; Steven M. Grunberg; Paul J. Hesketh; Mark G. Kris; Rebecca A. Clark-Snow

2002-01-01

74

Guideline for diagnosis and treatment of subacromial pain syndrome  

PubMed Central

Treatment of “subacromial impingement syndrome” of the shoulder has changed drastically in the past decade. The anatomical explanation as “impingement” of the rotator cuff is not sufficient to cover the pathology. “Subacromial pain syndrome”, SAPS, describes the condition better. A working group formed from a number of Dutch specialist societies, joined by the Dutch Orthopedic Association, has produced a guideline based on the available scientific evidence. This resulted in a new outlook for the treatment of subacromial pain syndrome. The important conclusions and advice from this work are as follows: (1) The diagnosis SAPS can only be made using a combination of clinical tests. (2) SAPS should preferably be treated non-operatively. (3) Acute pain should be treated with analgetics if necessary. (4) Subacromial injection with corticosteroids is indicated for persistent or recurrent symptoms. (5) Diagnostic imaging is useful after 6 weeks of symptoms. Ultrasound examination is the recommended imaging, to exclude a rotator cuff rupture. (6) Occupational interventions are useful when complaints persist for longer than 6 weeks. (7) Exercise therapy should be specific and should be of low intensity and high frequency, combining eccentric training, attention to relaxation and posture, and treatment of myofascial trigger points (including stretching of the muscles) may be considered. (8) Strict immobilization and mobilization techniques are not recommended. (9) Tendinosis calcarea can be treated by shockwave (ESWT) or needling under ultrasound guidance (barbotage). (10) Rehabilitation in a specialized unit can be considered in chronic, treatment resistant SAPS, with pain perpetuating behavior. (11) There is no convincing evidence that surgical treatment for SAPS is more effective than conservature management. (12) There is no indication for the surgical treatment of asymptomatic rotator cuff tears. PMID:24847788

Diercks, Ron; Bron, Carel; Dorrestijn, Oscar; Meskers, Carel; Naber, Rene; de Ruiter, Tjerk; Willems, Jaap; Winters, Jan; van der Woude, Henk Jan

2014-01-01

75

A national survey of implementation of guidelines for gestational diabetes mellitus.  

PubMed

In 2010, national guidelines for the management of gestational diabetes mellitus (GDM) were published by the Health Service Executive (HSE). In 2012, a questionnaire was distributed to all maternity units to survey implementation of the guidelines. All units screened women for GDM, but used different screening tests with fifteen units (79%) using the recommended 75g OGTT, three units (16%) using a 100g OGTT and one unit (5%) using a 50g glucose challenge test. Optimal outcomes are best achieved through multidisciplinary diabetes-obstetric care and this was available in nine of the units (47%). The prevalence of GDM varied from 2.2 - 7.4%. Insulin usage varied from 15-56%. Six centres (31%) had not implemented the national guidelines in full because of lack of resources. Despite national endorsement of the guideline, significant variations remain in implementation. This may lead to differences in clinical outcomes depending on where a woman attends for obstetric care. PMID:25282959

O'Higgins, A; Dunne, F; Lee, B; Smith, D; Turner, M J

2014-09-01

76

Revisions Recommended to Bulletin 17B - US National Flood Frequency Guidelines  

NASA Astrophysics Data System (ADS)

The Hydrologic Frequency Analysis Work Group (HFAWG) has synthesized recent research and completed its own studies to support proposed revisions to the current the US national flood frequency guidelines (Bulletin 17B). Bulletin 17 was originally issued in 1976; Bulletin 17B, the last revision, was published in 1982, over 30 years ago. To reflect advances that have occurred since 1982, the HFAWG has proposed revisions in four main areas: (1) use of historical information; (2) the motivation for low outlier identification and their statistical definition and treatment; (3) procedures for estimating generalized/regional skew; and (4) procedures for estimating confidence intervals for estimated quantiles. We present overviews of the HFAWG process and technical studies that led us to these revisions. The focus is on the use of the Expected Moments Algorithm (EMA) with the log-Pearson Type III distribution. A new Multiple Grubbs-Beck low outlier test and improved EMA confidence intervals are important parts of the revision.

England, J. F.; Cohn, T. A.; Faber, B. A.; Stedinger, J. R.; Thomas, W. O.; Mason, R. R.

2013-12-01

77

Guideline adherence for the treatment of advanced schistosomiasis japonica in Hubei, China.  

PubMed

This study compared physicians' practices on three treatment procedures and hospitalization days with guideline recommendations to assess guideline adherence in the treatment of advanced schistosomiasis japonica. Descriptive statistics were used to estimate patients' characteristics and rate of guideline adherence. And chi-square tests were used to assess influences of severity of the disease on guideline adherence. The study found no one (0/173) adhered to adequate diagnosis, treatment regimens, and discharge criteria of guidelines completely. And 2.23 % of patients in group 1 and 4.23 % in group 2 were totally conforming to adequate diagnosis. 91.91 % of patients were conforming to adequate treatment regimens among which group 1 and group 2 were 90.32 and 92.25 %, respectively. And one (2.23 %) patient in group 1 and zero (0 %) in group 2 were conforming to discharge criteria of guidelines, and most of the patients left hospital without symptom checks (151/173), liver function and biochemical tests (169/173), and complication checks (91/173). Among 173 inpatients, rate of adequate hospitalization days was 36.42 % (63/173). And chi-square test suggested no significant difference (P?>?0.05) on guideline adherence in two groups, which implied both of critical and general patients' treatments should be stressed to comply with guidelines. There existed a large gap between guidelines and practices of the treatment of advanced schistosomiasis japonica. PMID:25270234

Zhong, Fangying; Liu, Chenxi; Zhang, Xinping

2014-12-01

78

[Guidelines for the diagnosis and treatment of hereditary angioedema].  

PubMed

Hereditary angioedema (HAE) is a rare but potentially fatal genetic disorder with nonpitting, nonerythematous, and not pruritic swelling which can affect the hands, feet, face, genitals and visceral mucosa. The type, frequency, and severity of the attacks vary between patients, and over the lifetime of an individual patient. Efforts in Croatian counties have identified approximately 100 patients (but there must be more undiagnosed patients). The first global guideline for the management of HAE was developed by the World Allergy Organization HAE International Alliance and published in 2012. Based on that document the Working group of Croatian experts was assigned to propose guideline for HAE management in Croatia. HAE is is most often related to decreased or dysfunctional C1 inh with autoactivation of C1 and bradykinin accumulation leading to localized dilatation and increased permeability of blood vessels resulting in tissue swelling. A diagnosis of HAE can be confirmed by measuring complement and C1 inh quantitative and functional levels.Three HAE types could be differentiated: HAE type 1 (C1 inh level is low), HAE type 2 (C1 inh level is normal but dysfunctional), and HAE type 3 (normal level and function of C1 inh). All patients suspected to have HAE-1/2 should be assessed for blood levels of C4, C1 inh protein, and C1 inh function. All attacks that result in debilitation/dysfunction and/or involve the face, the neck, or the abdomen should be considered for on-demand treatment. It is recommended that attacks are treated as early as possible. HAE attacks are treated with C1 inh, ecallantide, or icatibant.If these drugs are not available, attacks should be treated with solvent detergent-treated plasma (SDP). If SDP is not available, then attacks should be treated with frozen plasma.Intubation or tracheotomy should be considered early in progressive upper airway edema. Patients with attacks could receive adjuvant therapy when indicated (pain management, intravenous fluids). All patients should have on-demand treatment for two attacks and carry their on-demand treatment at all times. The administration of short-term prophylaxis should be considered before surgeries (dental/intraoral surgery, where endotracheal intubation is required), where upper airway or pharynx is manipulated, and before bronchoscopy or endoscopy. Long-term prophylaxis should be considered in all severely symptomatic HAE-1/2 patients. C1 inh concentrate or androgens can be used. Screening children for HAE-1/2 should be deferred until the age of 12 months, and all offspring of an affected parent should be tested. PMID:25154179

Markovi?, Asja Stipi?; Rozmani?, Vojko; Ani?, Branimir; Aberle, Neda; Raci?, Goran; Novak, Srdan; Sunara, Davor; Grdini?, Boris; Karadza-Lapi?, Ljerka; Radas, Melanija Razov; Karanovi?, Boris; Kveni?, Barbara

2014-01-01

79

Clinical practice guideline on diagnosis and treatment of hyponatraemia.  

PubMed

Hyponatraemia, defined as a serum sodium concentration <135 mmol/l, is the most common disorder of body fluid and electrolyte balance encountered in clinical practice. It can lead to a wide spectrum of clinical symptoms, from subtle to severe or even life threatening, and is associated with increased mortality, morbidity and length of hospital stay in patients presenting with a range of conditions. Despite this, the management of patients remains problematic. The prevalence of hyponatraemia in widely different conditions and the fact that hyponatraemia is managed by clinicians with a broad variety of backgrounds have fostered diverse institution- and speciality-based approaches to diagnosis and treatment. To obtain a common and holistic view, the European Society of Intensive Care Medicine (ESICM), the European Society of Endocrinology (ESE) and the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA), represented by European Renal Best Practice (ERBP), have developed the Clinical Practice Guideline on the diagnostic approach and treatment of hyponatraemia as a joint venture of three societies representing specialists with a natural interest in hyponatraemia. In addition to a rigorous approach to methodology and evaluation, we were keen to ensure that the document focused on patient-important outcomes and included utility for clinicians involved in everyday practice. PMID:24569496

Spasovski, Goce; Vanholder, Raymond; Allolio, Bruno; Annane, Djillali; Ball, Steve; Bichet, Daniel; Decaux, Guy; Fenske, Wiebke; Hoorn, Ewout J; Ichai, Carole; Joannidis, Michael; Soupart, Alain; Zietse, Robert; Haller, Maria; van der Veer, Sabine; Van Biesen, Wim; Nagler, Evi

2014-04-01

80

Clinical practice guideline on diagnosis and treatment of hyponatraemia.  

PubMed

Hyponatraemia, defined as a serum sodium concentration <135?mmol/l, is the most common disorder of body fluid and electrolyte balance encountered in clinical practice. It can lead to a wide spectrum of clinical symptoms, from subtle to severe or even life threatening, and is associated with increased mortality, morbidity and length of hospital stay in patients presenting with a range of conditions. Despite this, the management of patients remains problematic. The prevalence of hyponatraemia in widely different conditions and the fact that hyponatraemia is managed by clinicians with a broad variety of backgrounds have fostered diverse institution- and speciality-based approaches to diagnosis and treatment. To obtain a common and holistic view, the European Society of Intensive Care Medicine (ESICM), the European Society of Endocrinology (ESE) and the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA), represented by European Renal Best Practice (ERBP), have developed the Clinical Practice Guideline on the diagnostic approach and treatment of hyponatraemia as a joint venture of three societies representing specialists with a natural interest in hyponatraemia. In addition to a rigorous approach to methodology and evaluation, we were keen to ensure that the document focused on patient-important outcomes and included utility for clinicians involved in everyday practice. PMID:24569125

Spasovski, Goce; Vanholder, Raymond; Allolio, Bruno; Annane, Djillali; Ball, Steve; Bichet, Daniel; Decaux, Guy; Fenske, Wiebke; Hoorn, Ewout J; Ichai, Carole; Joannidis, Michael; Soupart, Alain; Zietse, Robert; Haller, Maria; van der Veer, Sabine; Van Biesen, Wim; Nagler, Evi

2014-03-01

81

The CDC 2002 guidelines for the treatment of sexually transmitted diseases  

Microsoft Academic Search

Persons rely on health care providers to make diagnostic and therapeutic decisions based on the most current information. With areas of practice changing rapidly, providers are challenged to keep abreast of new and changing treatment guidelines. The new Centers for Disease Control and Prevention (CDC) 2002 Sexually Transmitted Disease (STD) Treatment Guidelines provide clinical guidance in the appropriate assessment and

Marianne Scharbo-DeHaan; Donna G. Anderson

2003-01-01

82

Treatment of Anemia in Patients with Heart Disease: A Clinical Practice Guideline  

MedlinePLUS

Treatment of Anemia in Patients With Heart Disease: A Clinical Practice Guideline From the American College of Physicians The full report is titled “Treatment of Anemia in Patients With Heart Disease: A Clinical Practice ...

83

Treatment guidelines in inflammatory bowel disease: the Japanese perspectives.  

PubMed

The number of inflammatory bowel disease patients has been increasing in Japan and the demand for clinical practical guidelines emerged. A set of clinical practice guidelines for ulcerative colitis and Crohn's disease were thus published in 2006 and 2011, respectively. Their English versions were then published in 2000 and 2012, respectively. These guidelines aim to provide appropriate clinical indicators to Japanese practitioners to improve the outcomes of inflammatory bowel disease patients. The guidelines are based on global literature-based evidence as well as evidence from Japan. The Japanese guidelines were developed based on the existing evidence with integration of the experts' consensus. The criteria for recommendation grade were also determined by the level of evidence as well as by the experts' consensus. It is a distinct feature of the Japanese guidelines to disclose this process explicitly. This recommendation rating is thus useful to fill the gap between evidence and daily clinical practice. Since the Japanese guidelines are primarily based on global literature-based evidence, most of the clinical indicators in them are consistent with those in other guidelines from the Western world. Meanwhile, there are some distinctly different statements in the Japanese guidelines reflecting Japanese standard clinical practice, evidence, and the opinions of Japanese experts. PMID:24246989

Matsuoka, Katsuyoshi; Hibi, Toshifumi

2013-01-01

84

Low awareness of stroke guidelines and preference for Chinese herbs in community physicians: a national survey in China  

PubMed Central

Background Physicians’ adherence to stroke guidelines is becoming a critical part of public stroke care system. The objective of this national survey was to examine Chinese physicians’ awareness of the guidelines in secondary stroke prevention. Methods This is a non-commercial and no-incentive internet survey. Respondents were asked to perform a self-examination of 13 questions regarding their stroke practice. Their awareness of stroke guidelines, preference for Chinese traditional herbs (CTH), and patients’ expense for stroke treatment were surveyed and compared between physicians from community and from tertiary hospitals using univariate analysis and logistic regression. Results A total of 8,581 physicians (70.1% from community hospitals) responded to the survey. Only 32.1% physicians considered risk factors control necessary for stroke. For the treatments of symptomatic carotid stenosis, only 10.4% physicians selected carotid endarterectomy and anti-platelet plus controlling stroke risk factors. Only 21.45% physicians selected warfarin anticoagulation for stroke patients with atrial fibrillation. In contrast, a high percentage (64.56%) of physicians had positive attitude towards CTH. Compared with those from tertiary hospitals, community physicians were more likely unaware of the guidelines and preferred CTH. Those who prescribed CTH reported more patients’ cost (P<0.001, OR 1.78, 95% CI, 1.55-2.04) than who didn’t. Conclusions There is a very low awareness of stroke guidelines in Chinese community physicians. A well-organized continuing stroke-guidelines education should be an essential part of public stroke-care system in China. Also, more well-designed clinical trials are required to establish the safety and effectiveness of CTH. PMID:25333051

Niu, Jing-Wen; Yuan, Jing; Gao, Shan

2014-01-01

85

Derived concentration guideline levels for Argonne National Laboratory's building 310 area.  

SciTech Connect

The derived concentration guideline level (DCGL) is the allowable residual radionuclide concentration that can remain in soil after remediation of the site without radiological restrictions on the use of the site. It is sometimes called the single radionuclide soil guideline or the soil cleanup criteria. This report documents the methodology, scenarios, and parameters used in the analysis to support establishing radionuclide DCGLs for Argonne National Laboratory's Building 310 area.

Kamboj, S., Dr.; Yu, C ., Dr. (Environmental Science Division)

2011-08-12

86

Romanian national guidelines and practical recommendations on liver elastography.  

PubMed

The use of liver elastography has substantially developed in the past few years; the introduction of novel elastographic methods (Transient Elastography, point Shear Wave Elastography, Real Time Shear Wave Elastography, Strain Elastography) has changed the perspective in the evaluation of liver disease. The ongoing research in this area is mainly focused on diffuse liver diseases and for predicting liver cirrhosis complication. This guideline created under the auspice of Romanian Society of Ultrasound in Medicine and Biology is intended to accustomize the clinician with the current practical use of liver elastography and has been issued to help in maximizing the clinical benefit for the patients with chronic liver diseases. PMID:24791844

Sporea, Ioan; Bota, Simona; S?ftoiu, Adrian; ?irli, Roxana; Gradin?ru-Ta?c?u, Oana; Popescu, Alina; Lup?or Platon, Monica; Fierbinteanu-Braticevici, Carmen; Gheonea, Dan Ionu?; S?ndulescu, Larisa; Badea, Radu

2014-06-01

87

National Institutes of Health: Mixed waste minimization and treatment  

SciTech Connect

The Appalachian States Low-Level Radioactive Waste Commission requested the US Department of Energy`s National Low-Level Waste Management Program (NLLWMP) to assist the biomedical community in becoming more knowledgeable about its mixed waste streams, to help minimize the mixed waste stream generated by the biomedical community, and to identify applicable treatment technologies for these mixed waste streams. As the first step in the waste minimization process, liquid low-level radioactive mixed waste (LLMW) streams generated at the National Institutes of Health (NIH) were characterized and combined into similar process categories. This report identifies possible waste minimization and treatment approaches for the LLMW generated by the biomedical community identified in DOE/LLW-208. In development of the report, on site meetings were conducted with NIH personnel responsible for generating each category of waste identified as lacking disposal options. Based on the meetings and general waste minimization guidelines, potential waste minimization options were identified.

NONE

1995-08-01

88

Examining the Alignment of Chinese National Physics Curriculum Guidelines and 12th-Grade Exit Examinations: A Case Study  

ERIC Educational Resources Information Center

This study reports findings from an analysis of the 2002 Chinese National Physics Curriculum Guidelines and the alignment between the curriculum guidelines and two most recent provincial-level 12th-grade exit examinations in China. Both curriculum guidelines and test content were represented using two-dimensional matrices (i.e., topic by level of…

Liang, Ling L.; Yuan, Haiquan

2008-01-01

89

Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. Treatment Improvement Protocol (TIP) Series 40  

ERIC Educational Resources Information Center

This Treatment Improvement Protocol (TIP) addresses the clinical use of buprenorphine in the treatment of opioid addiction. TIPs are best-practice guidelines for the treatment of substance use disorders that make the latest research in substance abuse treatment available to counselors and educators. The content was generated by a panel of experts…

Boone, Margaret; Brown, Nancy J.; Moon, Mary A.; Schuman, Deborah J.; Thomas, Josephine; Wright, Denise L.

2004-01-01

90

Operating cost guidelines for benchmarking DOE thermal treatment systems for low-level mixed waste  

SciTech Connect

This report presents guidelines for estimating operating costs for use in benchmarking US Department of Energy (DOE) low-level mixed waste thermal treatment systems. The guidelines are based on operating cost experience at the DOE Toxic Substances Control Act (TSCA) mixed waste incinerator at the K-25 Site at Oak Ridge. In presenting these guidelines, it should be made clear at the outset that it is not the intention of this report to present operating cost estimates for new technologies, but only guidelines for estimating such costs.

Salmon, R.; Loghry, S.L.; Hermes, W.H.

1994-11-01

91

Cost analysis for guideline implementation in prevention and early treatment of pressure ulcers.  

PubMed

One of the goals of the Agency for Health Care Policy and Research (AHCPR) is to improve the quality of medical care by developing and disseminating clinical practice guidelines. One indication of the effectiveness of a clinical guideline is the relationship between the costs of current practice and the costs of using the guideline. Using four model cases of patients at high risk for pressure ulcers, the costs of implementing the appropriate prevention and treatment procedures for each model were identified and compared to current practice costs. On the average, the overall cost of implementing the guideline is not much different from that of current practice. PMID:8318158

Hu, T W; Stotts, N A; Fogarty, T E; Bergstrom, N

1993-03-01

92

From Physical Activity Guidelines to a National Activity Plan  

ERIC Educational Resources Information Center

The U.S. National Physical Activity Plan (NPAP) is a comprehensive strategic plan aimed at increasing physical activity levels in all segments of the American population. The purpose of this paper is to summarize the development of the NPAP, provide an update on the status of the NPAP, and comment on the future of the NPAP. The NPAP was released…

Bornstein, Daniel B.; Pate, Russell R.

2014-01-01

93

1998 Guidelines for the Treatment of Sexually Transmitted Disease  

NSDL National Science Digital Library

The Division of STD Prevention of the US Centers for Disease Control has recently released this update (MMWR 1998;47(No. RR-1)) to the 1993 set of guidelines with the same title. The guidelines were developed by CDC staff after consultation with a "group of invited experts" in early 1997. Included are sections on various sexually transmitted diseases, including HIV, Genital Ulcers, Epididymitis, Human Papillomavirus Infection, and vaccine preventable STDs, among others. Guideline evidence is briefly discussed in each section of the report, and the CDC is committed to providing "more comprehensive, annotated discussions of such evidence...in background papers that will be published in 1998." Note that in the HTML version of the report, some of the interior links within chapters are inaccurate. In those cases, it is prudent to click on the section headings to find the relevant information.

1998-01-01

94

Safety & Security Guidelines Annual U.S. National School on Neutron and X-ray Scattering  

E-print Network

in the experiment areas. However, you cannot take photos of security-related areas (such as surveillance camerasSafety & Security Guidelines 15th Annual U.S. National School on Neutron and X-ray Scattering access orientation during your training. o Cameras are allowed on site, and you may take photos

95

Safety & Security Guidelines Annual U.S. National School on Neutron and X-ray Scattering  

E-print Network

in the experiment areas. However, you cannot take photos of security-related areas (such as surveillance camerasSafety & Security Guidelines 14th Annual U.S. National School on Neutron and X-ray Scattering access orientation during your training. o Cameras are allowed on site, and you may take photos

Pennycook, Steve

96

Teacher Guidelines for Cross-National Virtual Communities in Primary Education  

ERIC Educational Resources Information Center

The purpose of this study is to provide guidelines for teachers to carry out cross-national educational projects in schools through the introduction of virtual environments as a means of reshaping classroom-based activities. The theoretical foundations of the study are rooted in computer supported collaborative learning and the community of…

Ligorio, M. B.; Van der Meijden, H.

2008-01-01

97

Implementation of National Guidelines for Healthy School Meals: The Relationship between Process and Outcome  

ERIC Educational Resources Information Center

The implementation of policy interventions at the school level is often considered an organizational change process. The main goal of the present study was to examine the degree of implementation of Norwegian national guidelines for healthy school meals and how organizational capacity at the school level contributed to the degree of…

Holthe, Asle; Larsen, Torill; Samdal, Oddrun

2011-01-01

98

Review of national research ethics regulations and guidelines in Middle Eastern Arab countries  

PubMed Central

Background Research ethics guidelines are essential for conducting medical research. Recently, numerous attempts have been made to establish national clinical research documents in the countries of the Middle East. This article analyzes these documents. Methods Thirteen Arab countries in the Middle East were explored for available national codes, regulations, and guidelines concerning research ethics, and 10 documents from eight countries were found. We studied these documents, considering the ethical principles stated in the Declaration of Helsinki, the Council for International Organizations of Medical Sciences (CIOMS) guidelines, and the International Conference of Harmonization - Guidelines for Good Clinical Practice (ICH-GCP). Our paper comprises a complete list of protections, such as confidentiality, informed consent, ethics committees, and others. Results This study found different levels and kinds of research ethics regulations and guidelines in the countries examined. Two groups can be distinguished: the countries in the first group have one or more research ethics regulations or guidelines, while the countries in the second group have not yet established any. Most of the documents showed various degrees of deficiencies in regard to ethical protection. The majority of the documents that were examined refer to one or more international documents on biomedical research ethics. Conclusions Recently, a lot of efforts have been made in many countries in the Middle East. However, compared with international documents, most of the research ethics documents in use in this region demonstrate numerous deficiencies. As it relates to these documents, extensive differences could be observed in regard to development, structure, content, and reference to international guidelines. PMID:23234422

2012-01-01

99

External beam radiation for retinoblastoma: Results, patterns of failure, and a proposal for treatment guidelines  

Microsoft Academic Search

Purpose: To analyze treatment results and patterns of failure following external beam radiation for retinoblastoma and propose treatment guidelines according to specific clinical variables.Methods and Materials: We analyzed 27 patients (34 eyes) with retinoblastoma who received external beam radiation as initial treatment at Hahnemann University Hospital from October 1980 to December 1991 and have been followed for at least 1

J. Carlos Hernandez; Luther W. Brady; Jerry A. Shields; Carol L. Shields; Patrick DePotter; Ulf L. Karlsson; Arnold M. Markoe; Beatriz E. Amendola; Arun Singh

1996-01-01

100

The challenge of treatment in bipolar depression: evidence from clinical guidelines, treatment recommendations and complex treatment situations.  

PubMed

Bipolar depression and its clinical presentation is a frequent but complex psychiatric disease. Despite the high prevalence and the clinical and economic relevance of bipolar depression, few treatments are proven to be highly and consistently effective. In practice, the treatment of bipolar depression typically includes complex treatment decision-making. The best evidence for a pharmacological treatment exists for quetiapine. Alternatives with limitations are lamotrigine (also in the combination with lithium), carbamazepine and olanzapine. The effectiveness and recommendation of antidepressants in the treatment of bipolar depression remains controversial. Initially, depressive episodes should been treated with one of the named substances with antidepressant properties. In non-responders, a combination of lithium and lamotrigine, or antidepressants in combination with either lithium, an antiepileptic drug or atypical antipsychotics, may be necessary. If a depressive episode occurs under ongoing mood-stabilizing treatment, combination treatments of different substances, even with antidepressants, can be necessary. In the case of treatment-resistant depressive episodes, complex treatment strategies (combination therapies, MAO inhibitors) should be considered. This review describes the treatment recommendations of different guidelines for bipolar depression and emphasizes their differences. Furthermore, alternative pharmacological treatment strategies and complex treatment situations are discussed. PMID:24549861

Köhler, S; Gaus, S; Bschor, T

2014-03-01

101

National clinical guidelines for management of the palatally ectopic maxillary canine.  

PubMed

This review summarises updated clinical guidelines produced by the Clinical Standards Committee of the Faculty of Dental Surgery, Royal College of Surgeons of England (FDSRCS). This guideline on the management of the palatally ectopic maxillary canine illustrates the information contained in the recently updated online version. The timely recognition of ectopic canines is important for the overall management of the dentition. This review illustrates five management strategies for ectopic permanent canines: interceptive treatment by extraction of the deciduous canine, surgical exposure and orthodontic alignment, surgical removal of the palatally ectopic permanent canine, auto-transplantation and no active treatment/leave and observe. The current available evidence for each of these management options has been evaluated and awarded a grade used by the Scottish Intercollegiate Guidelines Network. PMID:22918345

Husain, J; Burden, D; McSherry, P; Morris, D; Allen, M

2012-08-01

102

Guidelines for the design and operation of makeup water treatment systems  

SciTech Connect

These guidelines present the industry with a standardized program to ensure the optimum design and operation of their individual makeup water treatment systems. These guidelines present, in a non-technical and non-proprietary format, the makeup water treatment system design and operating topics that are discussed in detail in Volumes 1 and 2 of NP-6377-SL. The individual guidelines contained in Volumes 1 and 2 are presented as separate imperative statements, followed by a technical justification discussion, which provides further explanations. In addition and when applicable, the guidelines relate pertinent operational in regard to monitoring parameters for operation, alternative actions, troubleshooting, management responsibilities and shutdown practices. Design considerations are also addressed, when applicable, in regard to equipment cost and advantages and disadvantages for the design recommendations. Appendices provide background information for performance criteria, component description, economic evaluation procedures and definitions. 4 refs.

Lee, Y.H.; Planek, M.A.; Sopocy, D.M.; Tomaga, C.M. (Sargent and Lundy, Chicago, IL (USA)); Abrams, I.M.; Anderson, C.C.; Balazs, M.K.; Houskava, J.; Williams, R. (Balazs Analytical Lab., Mountain View, CA (USA))

1989-06-01

103

Mass casualty triage: an evaluation of the science and refinement of a national guideline.  

PubMed

Mass casualty triage is the process of prioritizing multiple victims when resources are not sufficient to treat everyone immediately. No national guideline for mass casualty triage exists in the United States. The lack of a national guideline has resulted in variability in triage processes, tags, and nomenclature. This variability has the potential to inject confusion and miscommunication into the disaster incident, particularly when multiple jurisdictions are involved. The Model Uniform Core Criteria for Mass Casualty Triage were developed to be a national guideline for mass casualty triage to ensure interoperability and standardization when responding to a mass casualty incident. The Core Criteria consist of 4 categories: general considerations, global sorting, lifesaving interventions, and individual assessment of triage category. The criteria within each of these categories were developed by a workgroup of experts representing national stakeholder organizations who used the best available science and, when necessary, consensus opinion. This article describes how the Model Uniform Core Criteria for Mass Casualty Triage were developed. PMID:21685309

Lerner, E Brooke; Cone, David C; Weinstein, Eric S; Schwartz, Richard B; Coule, Phillip L; Cronin, Michael; Wedmore, Ian S; Bulger, Eileen M; Mulligan, Deborah Ann; Swienton, Raymond E; Sasser, Scott M; Shah, Umair A; Weireter, Leonard J; Sanddal, Teri L; Lairet, Julio; Markenson, David; Romig, Lou; Lord, Gregg; Salomone, Jeffrey; O'Connor, Robert; Hunt, Richard C

2011-06-01

104

National health and nutrition examination survey: analytic guidelines, 1999-2010.  

PubMed

Background-Analytic guide lines were first created in 1996 to assist data users in analyzing data from the Third National Health and Nutrition Examination Survey (NHANES III),conducted from 1988 to 1994 by the Centers for Disease Control and Prevention's National Center for Health Statistics. NHANES became a continuous annual survey in 1999, with data released to the public in 2-year intervals. In 2002, 2004, and 2006, guidelines were created and posted on the NHANES website to assist analysts in understanding the key issues related to analyzing data from 1999 onward. This report builds on these previous guidelines and provides the first comprehensive summary of analytic guidelines for the 1999-2010 NHANES data. Objectives-This report provides general guidelines for researchers in analyzing 1999-2010 NHANES publicly released data. Information is presented on key issues related to NHANES data, including sample design, demographic variables, and combining survey cycles. Guidance is also provided on data analysis, including the use of appropriate survey weights, calculating variance estimations, determining the reliability of estimates, age adjustment, and computing population counts. PMID:25090154

Johnson, Clifford L; Paulose-Ram, Ryne; Ogden, Cynthia L; Carroll, Margaret D; Kruszon-Moran, Deanna; Dohrmann, Sylvia M; Curtin, Lester R

2013-09-01

105

A consensus statement for safety monitoring guidelines of treatments for major depressive disorder  

PubMed Central

Objective This paper aims to present an overview of screening and safety considerations for the treatment of clinical depressive disorders and make recommendations for safety monitoring. Method Data were sourced by a literature search using MEDLINE and a manual search of scientific journals to identify relevant articles. Draft guidelines were prepared and serially revised in an iterative manner until all co-authors gave final approval of content. Results Screening and monitoring can detect medical causes of depression. Specific adverse effects associated with antidepressant treatments may be reduced or identified earlier by baseline screening and agent-specific monitoring after commencing treatment. Conclusion The adoption of safety monitoring guidelines when treating clinical depression is likely to improve overall physical health status and treatment outcome. It is important to implement these guidelines in the routine management of clinical depression. PMID:21888608

Dodd, Seetal; Malhi, Gin S; Tiller, John; Schweitzer, Isaac; Hickie, Ian; Khoo, Jon Paul; Bassett, Darryl L; Lyndon, Bill; Mitchell, Philip B; Parker, Gordon; Fitzgerald, Paul B; Udina, Marc; Singh, Ajeet; Moylan, Steven; Giorlando, Francesco; Doughty, Carolyn; Davey, Christopher G; Theodoras, Michael; Berk, Michael

2011-01-01

106

Treatment guidelines for Attention Deficit and Hyperactivity Disorder: A critical review.  

PubMed

A series of clinical guidelines for Attention Deficit and Hyperactivity Disorder throughout life have been published in recent years. The aim is to provide a synthesis of the best available scientific knowledge and facilitate clinical work as well as to make a critical review of the latest clinical guidelines based on treatment and recommendations. Searches of the following databases were performed: MEDLINE/ PubMed/ Index Medicus, PsycINFO/ PsyLIT and the Science Citation Index at Web of Science (ISI). The indexed MeSH terms “ADHD,” “guideline,” “therapeutics” were used for the search, and a total of 10 articles and 9 guides were selected. The guidelines indicate that the diagnosis of ADHD is made by clinical assessment and must be performed by a health professional with training and experience in the disorder. Multimodal treatment is ideal for the integral management of ADHD. Pharmacotherapy remains the first choice treatment for ADHD throughout life, particularly stimulant medication and among them, highlighting treatment with methylphenidate and all guidelines agree that psychological therapy increases the effectiveness of treatment as co-adjuncts to pharmacotherapy. PMID:25388773

Rabito-Alcón, María F; Correas-Lauffer, Javier

2014-11-01

107

Hepatitis B virus treatment beyond the guidelines: special populations and consideration of treatment withdrawal.  

PubMed

The goal of chronic hepatitis B (CHB) treatment is to improve survival by preventing disease progression to decompensated cirrhosis and hepatocellular carcinoma which is the cause of over 1 million deaths annually. The risk of disease progression is reduced when a sustained reduction of hepatitis B virus (HBV) DNA to undetectable levels and suppression of HBV replication are obtained which can result in regression of liver fibrosis and may even reverse cirrhosis. However, even if HBsAg loss occurs, HBV is not completely eradicated by treatment, and long-term therapy is required in patients who are HBeAg(-) and HBeAg(+) who do not maintain off-treatment virological suppression and in those with advanced liver disease. The recently updated European Association of the Study of the Liver (EASL) clinical practical guidelines for HBV have clarified, first, how to treat HBV (interferon or the most potent oral drugs with optimal resistance profiles, i.e. entecavir and tenofovir disoproxil fumarate, should be used as first-line monotherapies); second, who should be treated (CHB in patients with significant liver disease but also patients who are HBsAg(+) and are receiving immunosuppressive treatment, patients coinfected with HBV and human immunodeficiency virus, mothers who are HBsAg(+) with high viral load in late pregnancy associated with sero vaccination to reduce the risk of vertical transmission of HBV; and third, when to stop antiviral therapies. The aim of this review was to clarify how to treat HBV and who should be treated, as well as when to stop treatment. Although the answer to these questions is clear for pegylated interferon, it is more debatable for nucleos(t)ide analogues (anti-HBe seroconversion, HBsAg loss or anti-HBs seroconversion with undetectable HBV DNA are clear indications to discontinue treatment but sustained undetectable HBV DNA in patients who are anti-HBe(+) without significant fibrosis might be another indication). PMID:25057295

Vallet-Pichard, Anais; Pol, Stanislas

2014-07-01

108

Treatment and Prevention of Acute Diarrhoea. Guidelines for the Trainers of Health Workers.  

ERIC Educational Resources Information Center

This booklet, intended primarily for the trainers of middle-level community health workers in underdeveloped countries, is designed to help such workers present the topic of diarrhea treatment and prevention in training courses. Divided into five sections, the booklet gives guidelines on treatment and prevention, with particular emphasis on the…

World Health Organization, Geneva (Switzerland).

109

Cost-effectiveness of guideline-endorsed treatments for low back pain: a systematic review.  

PubMed

Healthcare costs for low back pain (LBP) are increasing rapidly. Hence, it is important to provide treatments that are effective and cost-effective. The purpose of this systematic review was to investigate the cost-effectiveness of guideline-endorsed treatments for LBP. We searched nine clinical and economic electronic databases and the reference list of relevant systematic reviews and included studies for eligible studies. Economic evaluations conducted alongside randomised controlled trials investigating treatments for LBP endorsed by the guideline of the American College of Physicians and the American Pain Society were included. Two independent reviewers screened search results and extracted data. Data extracted included the type and perspective of the economic evaluation, the treatment comparators, and the relative cost-effectiveness of the treatment comparators. Twenty-six studies were included. Most studies found that interdisciplinary rehabilitation, exercise, acupuncture, spinal manipulation or cognitive-behavioural therapy were cost-effective in people with sub-acute or chronic LBP. Massage alone was unlikely to be cost-effective. There were inconsistent results on the cost-effectiveness of advice, insufficient evidence on spinal manipulation for people with acute LBP, and no evidence on the cost-effectiveness of medications, yoga or relaxation. This review found evidence supporting the cost-effectiveness of the guideline-endorsed treatments of interdisciplinary rehabilitation, exercise, acupuncture, spinal manipulation and cognitive-behavioural therapy for sub-acute or chronic LBP. There is little or inconsistent evidence for other treatments endorsed in the guideline. PMID:21229367

Lin, Chung-Wei Christine; Haas, Marion; Maher, Chris G; Machado, Luciana A C; van Tulder, Maurits W

2011-07-01

110

Financial Policies for Education in the "National Medium- and Long-Term Educational Reform and Development Guideline (2010-20)"  

ERIC Educational Resources Information Center

The "National Medium- and Long-Term Educational Reform and Development Guideline (2010-20)" (hereafter abbreviated as the "Guideline"), formulated by the Chinese Communist Party Central Committee and the State Council, posits the basic completion of the modernization of China's education and other development targets by 2020. As measures to…

Liansheng, Yuan

2012-01-01

111

SEOM Clinical guidelines for the treatment of metastatic prostate cancer.  

PubMed

Androgen deprivation treatment is the current standard first-line treatment for metastatic prostate cancer. For several years, docetaxel was the only treatment with a proven survival benefit for castration-resistant prostate cancer (CRPC). Since docetaxel became standard of care for men with symptomatic metastatic castration-resistant prostate cancer (CRPC), three treatment virtual spaces, for treatment and drug development in CPRC, have emerged: pre-docetaxel, docetaxel combinations and post-docetaxel. Sipuleucel-T, cabazitaxel, abiraterone, enzalutamide and radium-223 have been approved in the pre- or post-docetaxel setting in metastatic CRPC during the last few years. Patients are now living longer and experiencing better quality of life. Strategies for patient selection and treatment sequencing are therefore urgently required. PMID:25319721

Cassinello, J; Climent, M A; González Del Alba, A; Mellado, B; Virizuela, J A

2014-12-01

112

Development of sexually transmitted diseases treatment guidelines, 1993. New methods, recommendations, and research priorities. STD Treatment Guidelines Project Team and Consultants.  

PubMed

To develop the 1993 Sexually Transmitted Diseases Treatment Guidelines, experts from the Centers for Disease Control and Prevention reviewed the literature on sexually transmitted disease treatment, assembled tables of evidence, and listed key questions on therapeutic outcome: microbiologic cure, alleviation of symptoms, and prevention of sequelae and transmission. At a meeting with external experts, evidence was systematically assessed and guidelines developed. Quality of evidence for microbiologic cure was generally good for gonorrhea and chlamydia, poor for syphilis, and fair for most other diseases. Evidence on preventing sequelae and transmission was limited. The Guidelines include new recommendations for single-dose oral therapy of gonorrhea (cefixime, ciprofloxacin, and ofloxacin), chlamydia (azithromycin), and chancroid (azithromycin); outpatient therapy of pelvic inflammatory disease (ofloxacin and either clindamycin or metronidazole); and patient-applied therapy of genital warts (podofilox). Syphilis therapy did not change substantially. Several global issues that emerged during the development of the World Health Organization Recommendations for the Management of Sexually Transmitted Diseases also are discussed. This evidence-based approach clarified important treatment issues and the rationale for recommendations, and identified research priorities. PMID:8042129

Levine, W C; Berg, A O; Johnson, R E; Rolfs, R T; Stone, K M; Hook, E W; Handsfield, H H; Holmes, K K; Islam, M Q; Piot, P

1994-01-01

113

Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men.  

PubMed

Androgenetic alopecia is the most common hair loss disorder, affecting both men and women. Initial signs of androgenetic alopecia usually develop during teenage years leading to progressive hair loss with a pattern distribution. Moreover, its frequency increases with age and affects up to 80 % Caucasian men and 42 % of women. Patients diagnosed with androgenetic alopecia may undergo significant impairment of quality of life. Despite the high prevalence and the variety of therapeutic options available, there have been no national or international evidence-based guidelines for the treatment of androgenetic alopecia in men and women so far. Therefore, the European Dermatology Forum (EDF) initiated a project to develop an evidence-based S3 guideline for the treatment of andro-genetic alopecia. Based on a systematic literature research the efficacy of the currently available therapeutic options was assessed and therapeutic recommendations were passed in a consensus conference. The purpose of the guideline is to provide dermatologists as well as general practitioners with an evidence-based tool for choosing an efficacious and safe therapy for patients with androgenetic alopecia. PMID:21980982

Blumeyer, Anja; Tosti, Antonella; Messenger, Andrew; Reygagne, Pascal; Del Marmol, Veronique; Spuls, Phyllis I; Trakatelli, Myrto; Finner, Andreas; Kiesewetter, Franklin; Trüeb, Ralph; Rzany, Berthold; Blume-Peytavi, Ulrike

2011-10-01

114

[Costs of a guideline-based treatment of patients with chronic hepatitis C in Germany].  

PubMed

The costs of a guideline-based treatment in chronic hepatitis C infected people are unknown. The goal of HCV therapy is to achieve a sustained viral response and thereby to reduce morbidity and mortality due to complications of liver cirrhosis and hepatocellular carcinoma. This study analyses the costs of a guideline-based treatment based on the German guideline on the management of HCV infection. In addition, costs of newly introduced protease inhibitors were calculated. Costs for baseline diagnostics, monitoring and medical treatment were calculated according to the stage of the disease, the HCV genotype and viral response. Costs for baseline diagnostics account for €?302.75 and monitoring accounts for €?596 to €?1173. Dual therapy with pegylated interferon and ribavirin results in average costs of €?7709 to €?34?692. Total costs of a guideline-based treatment range between €?8,608 and €?36?167 depending on HCV genotype and length of therapy. With the introduction of protease inhibitors for HCV genotype 1 patients, costs of pharmaceuticals have increased further. Triple-therapy with telaprevir accounts for €?43?280 respectively €?54?844. Costs for Boceprevir treatment range from €?34?143 to €?60?990. Due to increasing costs, health-economic evaluations gain significant relevance and should be considered when implementing new treatment strategies. PMID:25075995

Stahmeyer, J T; Rossol, S; Bert, F; Abdelfattah, M; Krauth, C

2014-09-01

115

Guidelines for periodontal care and follow-up during orthodontic treatment in adolescents and young adults  

PubMed Central

Aggressive periodontitis is characterized by non-contributory medical history, rapid attachment loss and bone destruction and familial aggregation of cases. Aggressive periodontitis (both localized and generalized) is usually diagnosed in a young population. This is frequently the age that an orthodontic care is provided to this population. The aim of the present paper is to draw guidelines for periodontal evaluation and monitoring prior to and during active orthodontic treatment. Strict adherence to these guidelines as a routine protocol for periodontal examination prior, during and following orthodontic treatment may dramatically decrease the severity and improve the prognosis of patients with aggressive periodontitis in orthodontic clinics. PMID:23032199

LEVIN, Liran; EINY, Shmuel; ZIGDON, Hadar; AIZENBUD, Dror; MACHTEI, Eli E.

2012-01-01

116

Prenatal Depression: Best Practice Guidelines for Diagnosis and Treatment  

ERIC Educational Resources Information Center

The purpose of this article is to provide counselors with an overview of best practices for the treatment of women who experience prenatal depression (PND). The authors first discuss issues in the screening and diagnosis of PND. Next, the 2 most common treatments, antidepressants and psychotherapy, are reviewed and discussed in relation to current…

Choate, Laura H.; Gintner, Gary G.

2011-01-01

117

Brazilian guidelines for the diagnosis and treatment of hereditary angioedema  

PubMed Central

Hereditary angioedema is an autosomal dominant disease characterized by edema attacks with multiple organ involvement. It is caused by a quantitative or functional deficiency of the C1 inhibitor, which is a member of the serine protease inhibitor family. Hereditary angioedema is unknown to many health professionals and is therefore an underdiagnosed disease. The causes of death from hereditary angioedema include laryngeal edema with asphyxia. The estimated mortality rate in patients in whom the disease goes undetected and who are therefore incorrectly treated is 25-40%. In addition to edema of the glottis, hereditary angioedema often results in edema of the gastrointestinal tract, which can be incapacitating. Patients with hereditary angioedema may undergo unnecessary surgical interventions because the digestive tract can be the primary or only organ system involved, thus mimicking acute surgical abdomen. It is estimated that patients with hereditary angioedema experience some degree of disability 20-100 days per year. The Experts in Clinical Immunology and Allergy of the “Associação Brasileira de Alergia e Imunopatologia - ASBAI” developed these guidelines for the diagnosis, therapy, and management of hereditary angioedema. PMID:22179171

Giavina-Bianchi, Pedro; Franca, Alfeu T.; Grumach, Anete S.; Motta, Abilio A.; Fernandes, Fatima R.; Campos, Regis A.; Valle, Solange O.; Rosario, Nelson A.; Sole, Dirceu

2011-01-01

118

SEOM clinical guidelines for the treatment of renal cell carcinoma.  

PubMed

The purpose of this article was to provide updated recommendations for the diagnosis and treatment of renal cell carcinoma. Pathological confirmation is mandatory before treatment with ablative or focal therapies before any type of systemic therapy. Renal cell cancer should be staged according to the TNM classification system. A laparoscopic nephron-sparing surgery should be the approach for tumors <4 cm if technically feasible. Otherwise, radical (or partial in selected cases) nephrectomy is the treatment of choice, with lymph node dissection only performed in patients with clinically detected lymph node involvement. Some retrospective evidence for a cytoreductive nephrectomy in the postimmunotherapy era suggests a benefit in patients with good or intermediate risk or for patients with a symptomatic primary lesion. Adjuvant treatment with chemotherapy or with targeted agents is not recommended and studies are ongoing today. Patients with metastatic disease should be staged by computed tomography scans of the chest, abdomen and pelvis. The efficacy of sunitinib, bevacizumab plus interferon-?, and pazopanib is well established in patients with good and intermediate risk as well for temsirolimus in poor-risk patients. These four agents are considered standard of care in first-line treatment. Sorafenib, axitinib and everolimus are standard of care in second line in different settings based on their benefit in PFS. Besides some benefit described for IL-2 in highly selected patients in first line, there is a promising and emerging role for the new immunotherapeutic approaches in metastatic renal cell carcinoma. PMID:25274276

Bellmunt, J; Puente, J; Garcia de Muro, J; Lainez, N; Rodríguez, C; Duran, I

2014-12-01

119

Venous Thromboembolism Prophylaxis and Treatment in Cancer: A Consensus Statement of Major Guidelines Panels and Call to Action  

PubMed Central

Purpose Venous thromboembolism (VTE) is an increasingly frequent complication of cancer and its treatments, and is associated with worsened mortality and morbidity in patients with cancer. Design The Italian Association of Medical Oncology, the National Comprehensive Cancer Network, the American Society of Clinical Oncology, the French National Federation of the League of Centers Against Cancer, and the European Society of Medical Oncology have recently published guidelines regarding VTE in patients with cancer. This review, authored by a working group of members from these panels, focuses on the methodology and areas of consensus and disagreement in the various clinical guidelines as well as directions for future research. Results There is broad consensus regarding the importance of thromboprophylaxis in hospitalized patients with cancer, including prolonged prophylaxis in high-risk surgical patients. Prophylaxis is not currently recommended for ambulatory patients with cancer (with exceptions) or for central venous catheters. All of the panels agree that low molecular weight heparins are preferred for the long-term treatment of VTE in cancer. Areas that warrant further research include the benefit of prophylaxis in the ambulatory setting, the risk/benefit ratio of prophylaxis for hospitalized patients with cancer, an understanding of incidental VTE, and the impact of anticoagulation on survival. Conclusion We call for a sustained research effort to investigate the clinical issues identified here to reduce the burden of VTE and its consequences in patients with cancer. PMID:19720907

Khorana, Alok A.; Streiff, Michael B.; Farge, Dominique; Mandala, Mario; Debourdeau, Philippe; Cajfinger, Francis; Marty, Michel; Falanga, Anna; Lyman, Gary H.

2009-01-01

120

Concordance With ASCO Guidelines for Surveillance After Colorectal Cancer Treatment: A Population-Based Analysis  

PubMed Central

Purpose: Intensive surveillance after curative treatment of colorectal cancer (CRC) is associated with improved overall survival. This study examined concordance with the 2005 ASCO surveillance guidelines at the population level. Methods: A cohort of 250 patients diagnosed with stage II or III CRC in 2004 and alive 42 months after diagnosis was identified from health administrative data in Manitoba, Canada. Colonoscopy, liver imaging, and carcinoembryonic antigen (CEA) testing were assessed over 3 years. Guidelines were met if patients had at least one colonoscopy in 3 years and at least one liver imaging test and three CEA tests annually. Multivariate logistic regression assessed the effect of patient and physician characteristics and disease and treatment factors on guideline concordance. Results: Guidelines for colonoscopy, liver imaging, and CEA were met by 80.4%, 47.2%, and 22% of patients, respectively. Guideline concordance for colonoscopy was predicted by annual contact with a surgeon, higher income, and the diagnosis of colon (rather than rectal) cancer. Adherence was lower in those older than 70 years and with higher comorbidity. For liver imaging, significant predictors were annual contact with an oncologist, receipt of chemotherapy, and diagnosis of colon cancer. Concordance with CEA guidelines was higher with annual contact with an oncologist and high levels of family physician contact, and lower in urban residents, in those older than 70, and in those with stage II disease. Conclusion: Completion of recommended liver imaging and CEA testing fall well below guidelines in Manitoba, whereas colonoscopy is better provided. Addressing this gap should improve outcomes for CRC survivors. PMID:23181004

Sisler, Jeffrey J.; Seo, Bosu; Katz, Alan; Shu, Emma; Chateau, Daniel; Czaykowski, Piotr; Wirtzfeld, Debrah; Singh, Harminder; Turner, Donna; Martens, Patricia

2012-01-01

121

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

PubMed

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

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

2010-05-01

122

A survey of practitioner adoption and implementation of practice guidelines and evidence-based treatments 1  

Microsoft Academic Search

This paper addresses the challenges associated with practitioner adoption and implementation of practice guidelines and evidence-based effective treatments. The paper presents results from a recent survey of practitioners about awareness of and attitudes about standards of care, including preference for use of intervention knowledge statements developed through expert consensus and through empirical research findings. Evidence based practice and the associated

Edward J. Mullen; William F. Bacon

123

Biohazardous Waste Disposal GuidelinesDescriptionStorage& LabelingTreatmentDisposal  

E-print Network

with water. Before generating mixed waste (i.e., mixtures of biohazardous and chemical or radioactive wasteBiohazardous Waste Disposal GuidelinesDescriptionStorage& packaging LabelingTreatmentDisposal Mixed Waste Sharps Waste Solid Lab Waste Liquid Waste Any of these devices if contaminated with biohazardous

Wikswo, John

124

Medical and Surgical Treatment of Parapneumonic Effusions* An Evidence-Based Guideline  

Microsoft Academic Search

Objective: A panel was convened by the Health and Science Policy Committee of the American College of Chest Physicians to develop a clinical practice guideline on the medical and surgical treatment of parapneumonic effusions (PPE) using evidence-based methods. Options and outcomes considered: Based on consensus of clinical opinion, the expert panel developed an annotated table for evaluating the risk for

Gene L. Colice; Anne Curtis; Jean Deslauriers; John Heffner; Richard Light; Benjamin Littenberg; Steven Sahn; Robert A. Weinstein; Roger D. Yusen

125

Physician Peer Assessments for Compliance with Methadone Maintenance Treatment Guidelines  

ERIC Educational Resources Information Center

Introduction: Medical associations and licensing bodies face pressure to implement quality assurance programs, but evidence-based models are lacking. To improve the quality of methadone maintenance treatment (MMT), the College of Physicians and Surgeons of Ontario, Canada, conducts an innovative quality assurance program on the basis of peer…

Strike, Carol; Wenghofer, Elizabeth; Gnam, William; Hillier, Wade; Veldhuizen, Scott; Millson, Margaret

2007-01-01

126

[Guidelines for the treatment of anemia in chronic renal failure].  

PubMed

Evaluation of anemia: Before beginning epoetin treatment, it is essential to evaluate the level of anemia (Hb < 11-12g/dL) by the following measurements: -Hb concentration -Red blood cell indices (MCV, MCH, MCHC) -Reticulocyte count -Iron stores and availability -C-reactive protein (CRP) Target for anemia treatment: The minimum target Hb concentration to be attained is 11 g/dL. The upper limit is established individually on a clinical basis. Pending further data, it is advisable to maintain and not exceed 12 g/dL for patients with cardiovascular disease, diabetes, and graft access. Use of iron: At the start of epoetin treatment, 150 mg of iron are needed for every expected increase of 1 g/dL of Hb. It is important to achieve and maintain levels of TSAT > 20%, serum ferritin 100 mcg/L and hypochromic red cells > 6% both before initiating epoetin treatment and during its administration. TSAT levels should not persistently exceed > 50% and serum ferritin > 500 mcg/L. When administering oral iron the dose should be at least 200 mg/die elemental iron; on the other hand, when the intravenous route is used, the dose should be 30-60 mg/IV dose in the form of low molecular weight salts (iron sodium gluconate) while the higher doses should be reserved for patients with transferring levels > 170 mg/dL. Administration of epoetin: The dosage of epoetin is individual with more than tenfold variability among individuals and all aiming at the same target Hb concentration. There are no clinical parameters entirely capable of predicting the necessary dosage. Therapeutic range is very wide, without any toxic effects for clinical use up to 100.000 IU/week. The target Hb concentration is reached in most patients with mild anaemia after 2 months' treatment with 4.000-10.000 epoetin (20-50 mcg darbepoetin alpha) per week. The HB concentration, along with the reticulocyte count, must be checked weekly following initiation and monthly during maintenance. Patients with a stable dose-response during conservative therapy may require less frequent monitoring (every 2-3 months). Inadequate response to epoetin treatment If any resistance is encountered, after excluding all the acute and chronic conditions of inadequate response, the reticulocyte count (severe reduction in the presence of anti erythropoietin antibodies) and the erythropoietin dosage should be measured. The target Hb concentration 11-12 g/dL is maintained in 90-95% of the patients by administering 1.000-30.000 IU of epoetin (5-150 mcg darbepoetin alpha) per week in the presence of adequate reserves of iron. Higher dosages define a state of resistance. Diagnosis of pure red cell (PRCA) from anti-erythropoietin antibodies is confirmed by bone marrow examination (almost total loss of erythroblasts). If antierythropoietin antibodies are present or there is a well founded suspicion of PRCA, the administration of epoetin and other similar treatment should be avoided. Side effects of epoetin treatment: The treatment of anaemia with epoetin does not hasten the progression of CRF. Blood pressure is to be checked regularly during initiation of epoetin and the treatment should be discontinued in cases of refractory hypertension or hypertensive encephalopathy. There should be increased surveillance of graft access, especially in those patients who risk vascular depletion. In general, heparin requirements do not increase but it may be advisable to evaluate a dose increase. PRCA from anti-erythropoietin antibodies has been detected with an incidence ranging from 0.12 to 1.1 cases/every 10 thousand patients treated. PMID:14666504

Triolo, G

2003-01-01

127

Guidelines for the diagnosis and treatment of schistosomal myeloradiculopathy.  

PubMed

Schistosomal myeloradiculopathy is the most severe and disabling ectopic form of Schistosoma mansoni infection. The prevalence of SMR in centres in Brazil and Africa that specialise in attending patients with non traumatic myelopathy is around 5%. The initial signs and symptoms of the disease include lumbar and/or lower limb pain, paraparesis, urinary and intestinal dysfunctions, and impotence in men. The cerebrospinal fluid of SMR patients shows an increase in protein concentration and in the number of mononuclear cells in 90% of cases; eosinophils have been reported in 40%. The use of magnetic resonance imaging is particularly valuable in the diagnosis of Schistosomal myeloradiculopathy. The exclusion of other myelopathies and systemic diseases remains mandatory. Early diagnosis and treatment with steroids and schistosomicides provide a cure for most patients, whilst delayed treatment can result in irreversible physical disabilities or death. To improve awareness concerning Schistosomal myeloradiculopathy amongst public health professionals, and to facilitate the control of the disease, the Brazilian Ministry of Health has launched a program of education and control of this ectopic form of schistosomiasis. The present paper reviews current methods for the diagnosis of SMR and outlines protocols for treatment of the disease. PMID:17992416

Lambertucci, José Roberto; Silva, Luciana Cristina dos Santos; do Amaral, Ronaldo Santos

2007-01-01

128

Quality Improvement Guidelines for Imaging Detection and Treatment of Endoleaks following Endovascular Aneurysm Repair (EVAR)  

SciTech Connect

Major concerns after aortic aneurysm repair are caused by the presence of endoleaks, which are defined as persistent perigraft flow within the aortic aneurysm sac. Diagnosis of endoleaks can be performed with various imaging modalities, and indications for treatment are based on further subclassifications. Early detection and correct classification of endoleaks are crucial for planning patient management. The vast majority of endoleaks can be treated successfully by interventional means. Guidelines for Imaging Detection and Treatment of endoleaks are described in this article.

Rand, T., E-mail: Thomas.Rand@wienkav.at [General Hospital Hietzing, Department of Radiology (Austria); Uberoi, R. [John Radcliffe Hospital, Department of Radiology (United Kingdom)] [John Radcliffe Hospital, Department of Radiology (United Kingdom); Cil, B. [Hacettepe University Hospitals, Department of Interventional Radiology (Turkey)] [Hacettepe University Hospitals, Department of Interventional Radiology (Turkey); Munneke, G. [St George's Hospital, Department of Interventional Radiology (United Kingdom)] [St George's Hospital, Department of Interventional Radiology (United Kingdom); Tsetis, D. [University Hospital of Heraklion, Medical School of Crete, Department of Radiology (Greece)] [University Hospital of Heraklion, Medical School of Crete, Department of Radiology (Greece)

2013-02-15

129

Guidelines for the Pharmacologic Treatment of Neurobehavioral Sequelae of Traumatic Brain Injury  

Microsoft Academic Search

There is currently a lack of evidence-based guidelines to guide the pharmacological treatment of neu- robehavioral problems that commonly occur after traumatic brain injury (TBI). It was our objective to review the current literature on the pharmacological treatment of neurobehavioral problems after traumatic brain injury in three key areas: aggression, cognitive disorders, and affective disorders\\/anx- iety\\/psychosis. Three panels of leading

Deborah L. Warden; Barry Gordon; Thomas W. McAllister; Jonathan M. Silver; Jeffery T. Barth; John Bruns; Angela Drake; Tony Gentry; Andy Jagoda; Douglas I. Katz; Jess Kraus; Lawrence A. Labbate; Laurie M. Ryan; Molly B. Sparling; Beverly Walters; John Whyte; Ashley Zapata; George Zitnay

2006-01-01

130

Italian guidelines for management and treatment of hyperbilirubinaemia of newborn infants >= 35 weeks' gestational age  

PubMed Central

Hyperbilirubinaemia is one of the most frequent problems in otherwise healthy newborn infants. Early discharge of the healthy newborn infants, particularly those in whom breastfeeding is not fully established, may be associated with delayed diagnosis of significant hyperbilirubinaemia that has the potential for causing severe neurological impairments. We present the shared Italian guidelines for management and treatment of jaundice established by the Task Force on hyperbilirubinaemia of the Italian Society of Neonatology. The overall aim of the present guidelines is to provide an useful tool for neonatologists and family paediatricians for managing hyperbilirubinaemia. PMID:24485088

2014-01-01

131

Italian guidelines for management and treatment of hyperbilirubinaemia of newborn infants???35 weeks' gestational age.  

PubMed

Hyperbilirubinaemia is one of the most frequent problems in otherwise healthy newborn infants. Early discharge of the healthy newborn infants, particularly those in whom breastfeeding is not fully established, may be associated with delayed diagnosis of significant hyperbilirubinaemia that has the potential for causing severe neurological impairments. We present the shared Italian guidelines for management and treatment of jaundice established by the Task Force on Hyperbilirubinaemia of the Italian Society of Neonatology.The overall aim of the present guidelines is to provide an useful tool for neonatologists and family paediatricians for managing hyperbilirubinaemia. PMID:24485088

Romagnoli, Costantino; Barone, Giovanni; Pratesi, Simone; Raimondi, Francesco; Capasso, Letizia; Zecca, Enrico; Dani, Carlo

2014-01-01

132

Summary of proposed approach for deriving cleanup guidelines for radionuclides in soil at Brookhaven National Laboratory  

SciTech Connect

Past activities at Brookhaven National Laboratory (BNL) resulted in soil and groundwater contamination. As a result, BNL was designated a Superfund site under the Comprehensive Environmental Response Compensation and Liability Act (CERCLA). BNL`s Office of Environmental Restoration (OER) is overseeing environmental restoration activities at the Laboratory, carried out under an Interagency Agreement (IAG) with the United States Department of Energy (DOE), the United States Environmental Protection Agency (EPA) and the New York State Department of Environmental Conservation (NYSDEC). The objective of this paper is to propose a standard approach to deriving risk-based cleanup guidelines for radionuclides in soil at BNL.

Meinhold, A.F.; Morris, S.C.; Dionne, B.; Moskowitz, P.D.

1996-11-01

133

Treatment of fibromyalgia syndrome: recommendations of recent evidence-based interdisciplinary guidelines with special emphasis on complementary and alternative therapies.  

PubMed

Objective. Current evidence indicates that there is no single ideal treatment for fibromyalgia syndrome (FMS). First choice treatment options remain debatable, especially concerning the importance of complementary and alternative medicine (CAM) treatments. Methods. Three evidence-based interdisciplinary guidelines on FMS in Canada, Germany, and Israel were compared for their first choice and CAM-recommendations. Results. All three guidelines emphasized a patient-tailored approach according to the key symptoms. Aerobic exercise, cognitive behavioral therapy, and multicomponent therapy were first choice treatments. The guidelines differed in the grade of recommendation for drug treatment. Anticonvulsants (gabapentin, pregabalin) and serotonin noradrenaline reuptake inhibitors (duloxetine, milnacipran) were strongly recommended by the Canadian and the Israeli guidelines. These drugs received only a weak recommendation by the German guideline. In consideration of CAM-treatments, acupuncture, hypnosis/guided imagery, and Tai Chi were recommended by the German and Israeli guidelines. The Canadian guidelines did not recommend any CAM therapy. Discussion. Recent evidence-based interdisciplinary guidelines concur on the importance of treatment tailored to the individual patient and further emphasize the need of self-management strategies (exercise, and psychological techniques). PMID:24348701

Ablin, Jacob; Fitzcharles, Mary-Ann; Buskila, Dan; Shir, Yoram; Sommer, Claudia; Häuser, Winfried

2013-01-01

134

Treatment of Fibromyalgia Syndrome: Recommendations of Recent Evidence-Based Interdisciplinary Guidelines with Special Emphasis on Complementary and Alternative Therapies  

PubMed Central

Objective. Current evidence indicates that there is no single ideal treatment for fibromyalgia syndrome (FMS). First choice treatment options remain debatable, especially concerning the importance of complementary and alternative medicine (CAM) treatments. Methods. Three evidence-based interdisciplinary guidelines on FMS in Canada, Germany, and Israel were compared for their first choice and CAM-recommendations. Results. All three guidelines emphasized a patient-tailored approach according to the key symptoms. Aerobic exercise, cognitive behavioral therapy, and multicomponent therapy were first choice treatments. The guidelines differed in the grade of recommendation for drug treatment. Anticonvulsants (gabapentin, pregabalin) and serotonin noradrenaline reuptake inhibitors (duloxetine, milnacipran) were strongly recommended by the Canadian and the Israeli guidelines. These drugs received only a weak recommendation by the German guideline. In consideration of CAM-treatments, acupuncture, hypnosis/guided imagery, and Tai Chi were recommended by the German and Israeli guidelines. The Canadian guidelines did not recommend any CAM therapy. Discussion. Recent evidence-based interdisciplinary guidelines concur on the importance of treatment tailored to the individual patient and further emphasize the need of self-management strategies (exercise, and psychological techniques). PMID:24348701

Fitzcharles, Mary-Ann; Buskila, Dan; Shir, Yoram; Sommer, Claudia

2013-01-01

135

[Guidelines for the diagnosis and treatment of the fibromyalgia syndrome].  

PubMed

Over the past years, considerable progress has been made in understanding the pathogenesis of the fibromyatgia syndrome and the evidence based approach to the diagnosis and management has been significantty extended. The purpose of the current project is to develop practicat and evidence based guidetine recommendations for the Israeli health care system. A panet of physicians with clinical and research experience in the fibromyalgia field was convened under the auspices of the Israeli Rheumatology Association. A systematic review was performed on the current literature regarding the diagnosis and treatment of fibromyalgia. Using an interactive discussion procedure, recommendations were reached and expert opinion was introduced where evidence was considered incomplete. The panel recommendations underline the importance of concomitant and integrated medical therapy, such as serotonin and noradrenaline reuptake inhibitor (SNRI) anti-depressants or gamma-aminobutyric acid (GABA) related anti-epileptics, with regular aerobic physical exercise. PMID:24483001

Ablin, Jacob N; Amital, Howard; Ehrenfeld, Michael; Aloush, Valerie; Elkayam, Ori; Langevitz, Pnina; Mevorach, Dror; Mader, Reuven; Sachar, Tali; Amital, Daniela; Buskila, Dan

2013-12-01

136

Guidelines for the treatment of bacterial vaginosis: focus on tinidazole  

PubMed Central

Bacterial vaginosis (BV) is a complex vaginal infection most commonly associated with women of child-bearing age. Risk factors for BV are numerous. There are currently multiple clinical and laboratory tests for diagnosis of BV, including the most commonly used diagnostic methods: Amsel’s criteria or Nugent’s Gram stain scale. The mainstay of BV therapy is metronidazole, but tinidazole as well as a few other agents have also been used successfully. Tinidazole is the second nitroimidazole antiprotozoal agent and a structural derivative of metronidazole. With a favorable pharmacokinetic profile and reduced side effects, tinidazole is an alternative agent for BV treatment. There are minimal head-to-head comparative data to establish tinidazole’s superiority to metronidazole or other therapeutic agents. Available data suggest tinidazole has a role in special populations particularly for refractory or relapsing BV. PMID:19707258

Dickey, Laura J; Nailor, Michael D; Sobel, Jack D

2009-01-01

137

Saudi guidelines on the diagnosis and treatment of pulmonary hypertension: 2014 updates  

PubMed Central

The Saudi Association for Pulmonary Hypertension (previously called Saudi Advisory Group for Pulmonary Hypertension) has published the first Saudi Guidelines on Diagnosis and Treatment of Pulmonary Arterial Hypertension back in 2008.[1] That guideline was very detailed and extensive and reviewed most aspects of pulmonary hypertension (PH). One of the disadvantages of such detailed guidelines is the difficulty that some of the readers who just want to get a quick guidance or looking for a specific piece of information might face. All efforts were made to develop this guideline in an easy-to-read form, making it very handy and helpful to clinicians dealing with PH patients to select the best management strategies for the typical patient suffering from a specific condition. This Guideline was designed to provide recommendations for problems frequently encountered by practicing clinicians involved in management of PH. This publication targets mainly adult and pediatric PH-treating physicians, but can also be used by other physicians interested in PH. PMID:25076987

Idrees, Majdy M.; Saleemi, Sarfraz; Azem, M Ali; Aldammas, Saleh; Alhazmi, Manal; Khan, Javid; Gari, Abdulgafour; Aldabbagh, Maha; Sakkijha, Husam; Aldalaan, Abdulla; Alnajashi, Khalid; Alhabeeb, Waleed; Nizami, Imran; Kouatli, Amjad; Chehab, May; Tamimi, Omar; Banjar, Hanaa; Kashour, Tarek; Lopes, Antonio; Minai, Omar; Hassoun, Paul; Pasha, Qadar; Mayer, Eckhard; Butrous, Ghazwan; Bhagavathula, Sastry; Ghio, Stefano; Swiston, John; Boueiz, Adel; Tonelli, Adriano; Levy, Robert D.

2014-01-01

138

Treatment and prevention of Mycobacterium ulcerans infection (Buruli ulcer) in Australia: guideline update.  

PubMed

Guidelines reflecting contemporary clinical practice in the management of Buruli ulcer (Mycobacterium ulcerans infection) in Australia were published in 2007. • Management has continued to evolve, as new evidence has become available from randomised trials, case series and increasing clinical experience with oral antibiotic therapy. • Therefore, guidelines on the diagnosis, treatment and prevention of Buruli ulcer in Australia have been updated. They include guidance on the new role of antibiotics as first-line therapy; the shortened duration of antibiotic treatment and the use of all-oral antibiotic regimens; the continued importance, timing and role of surgery; the recognition and management of paradoxical reactions during antibiotic treatment; and updates on the prevention of disease. PMID:24641151

O'Brien, Daniel P; Jenkin, Grant; Buntine, John; Steffen, Christina M; McDonald, Anthony; Horne, Simon; Friedman, N Deborah; Athan, Eugene; Hughes, Andrew; Callan, Peter P; Johnson, Paul D R

2014-03-17

139

Quality Control Guidelines for National Committee for Clinical Laboratory Standards-Recommended Broth Macrodilution Testing of Ketoconazole and Itraconazole  

Microsoft Academic Search

Ketoconazole and itraconazole were tested in a multilaboratory study to establish quality control (QC) guidelines for yeast antifungal susceptibility testing. Two isolates that had been previously identified as QC isolates for amphotericin B,fluconazole, andflucytosine (Candida parapsilosisATCC 22019 andCandida krusei ATCC 6258) were tested in accordance with the National Committee for Clinical Laboratory Standards M27-P guidelines. Each isolate was tested 20

JOHN H. REX; MICHAEL A. PFALLER; MICHAEL LANCASTER; FRANK C. ODDS; ANNE BOLMSTROM; ANDMICHAEL G. RINALDI

1996-01-01

140

Management of chronic hepatitis B infection: current treatment guidelines, challenges, and new developments.  

PubMed

Chronic hepatitis B (CHB) virus infection is a global public health problem, affecting more than 400 million people worldwide. The clinical spectrum is wide, ranging from a subclinical inactive carrier state, to progressive chronic hepatitis, cirrhosis, decompensation, and hepatocellular carcinoma. However, complications of hepatitis B virus (HBV)-related chronic liver disease may be reduced by viral suppression. Current international guidelines recommend first-line treatment of CHB infection with pegylated interferon, entecavir, or tenofovir, but the optimal treatment for an individual patient is controversial. The indications for treatment are contentious, and increasing evidence suggests that HBV genotyping, as well as serial on-treatment measurements of hepatitis B surface antigen and HBV DNA kinetics should be used to predict antiviral treatment response. The likelihood of achieving a sustained virological response is also increased by extending treatment duration, and using combination therapy. Hence the paradigm for treatment of CHB is constantly evolving. This article summarizes the different indications for treatment, and systematically reviews the evidence for the efficacy of various antiviral agents. It further discusses the shortcomings of current guidelines, use of rescue therapy in drug-resistant strains of HBV, and highlights the promising clinical trials for emerging therapies in the pipeline. This concise overview presents an updated practical approach to guide the clinical management of CHB. PMID:24876747

Tang, Ceen-Ming; Yau, Tung On; Yu, Jun

2014-05-28

141

Management of chronic hepatitis B infection: Current treatment guidelines, challenges, and new developments  

PubMed Central

Chronic hepatitis B (CHB) virus infection is a global public health problem, affecting more than 400 million people worldwide. The clinical spectrum is wide, ranging from a subclinical inactive carrier state, to progressive chronic hepatitis, cirrhosis, decompensation, and hepatocellular carcinoma. However, complications of hepatitis B virus (HBV)-related chronic liver disease may be reduced by viral suppression. Current international guidelines recommend first-line treatment of CHB infection with pegylated interferon, entecavir, or tenofovir, but the optimal treatment for an individual patient is controversial. The indications for treatment are contentious, and increasing evidence suggests that HBV genotyping, as well as serial on-treatment measurements of hepatitis B surface antigen and HBV DNA kinetics should be used to predict antiviral treatment response. The likelihood of achieving a sustained virological response is also increased by extending treatment duration, and using combination therapy. Hence the paradigm for treatment of CHB is constantly evolving. This article summarizes the different indications for treatment, and systematically reviews the evidence for the efficacy of various antiviral agents. It further discusses the shortcomings of current guidelines, use of rescue therapy in drug-resistant strains of HBV, and highlights the promising clinical trials for emerging therapies in the pipeline. This concise overview presents an updated practical approach to guide the clinical management of CHB. PMID:24876747

Tang, Ceen-Ming; Yau, Tung On; Yu, Jun

2014-01-01

142

Adoption of practice guidelines and assessment tools in substance abuse treatment  

PubMed Central

Background The gap between research and practice limits utilization of relevant, progressive and empirically validated strategies in substance abuse treatment. Methods Participants included substance abuse treatment programs from the Northeastern United States. Structural equation models were constructed with agency level data to explore two outcome variables: adoption of practice guidelines and assessment tools at two points in time; models also included organizational, staffing and service variables. Results In 1997, managed care involvement and provision of primary care services had the strongest association with increased use of assessment tools, which, along with provision of counseling services, were associated with a greater use of practice guidelines. In 2001, managed care involvement, counseling services and being a stand-alone drug treatment agency were associated with a greater use of assessment tools, which was in turn related to an increase in the use of practice guidelines. Conclusions This study provides managers, clinicians and policy-makers with a framework for understanding factors related to the adoption of new technologies in substance abuse treatment. PMID:20346158

2010-01-01

143

Compliance of Disease Awareness Campaigns in Printed Dutch Media with National and International Regulatory Guidelines  

PubMed Central

Background The European legislation prohibits prescription-only medicines' advertising but allows pharmaceutical companies to provide information to the public on health and diseases, provided there is no direct or indirect reference to a pharmaceutical product. Various forms of promotion have become increasingly common in Europe including “disease-oriented” campaigns. Objectives To explore examples of disease awareness campaigns by pharmaceutical companies in the Netherlands, by assessing their compliance with the World Health Organization (WHO) Ethical Criteria for medicinal drug promotion and the Dutch guidelines for provision of information by pharmaceutical companies. Methods Materials referring to health/disease and treatments published in the most widely circulated newspapers and magazines were collected from March to May 2012. An evaluation tool was developed based on relevant underlying principles from the WHO ethical criteria and Dutch self-regulation guidelines. Collected disease awareness advertisements were used to pilot the evaluation tool and to explore the consistency of information provided with the WHO and Dutch criteria. Findings Eighty materials met our inclusion criteria; 71 were published in newspapers and 9 in magazines. The large majority were news items but 21 were disease awareness advertisements, of which 5 were duplicates. Fifteen out of the 16 disease awareness campaigns were non-compliant with current guidelines mainly due to lack of balance (n?=?12), absence of listed author and/or sponsor (n?=?8), use of misleading or incomplete information (n?=?5) and use of promotional information (n?=?5). None mentioned a pharmaceutical product directly. Conclusion Disease Awareness Campaigns are present in Dutch printed media. Although no brand names were mentioned, the lack of compliance of disease awareness campaigns with the current regulations is alarming. There were information deficiencies and evidence of information bias. A key concern is that the context in which the information is provided, mostly through indirect referral, is likely to support treatment with the sponsor's product.

Leonardo Alves, Teresa; Martins de Freitas, Auramarina F.; van Eijk, Martine E. C.; Mantel-Teeuwisse, Aukje K.

2014-01-01

144

The need for new "patient-related" guidelines for the treatment of acute cholecystitis  

PubMed Central

Heterogeneity of patients affected by acute cholecystitis, and their co-morbidities make very difficult to standardize the therapy for this very common condition. The staging system suggested in the recent "Tokyo guidelines", did not show a relevant impact on the management of patients and on the outcome of the disease. The relation among local pathological picture, patient clinical status and treatment algorithm, has to be better studied. PMID:22192618

2011-01-01

145

The need for new "patient-related" guidelines for the treatment of acute cholecystitis.  

PubMed

Heterogeneity of patients affected by acute cholecystitis, and their co-morbidities make very difficult to standardize the therapy for this very common condition. The staging system suggested in the recent "Tokyo guidelines", did not show a relevant impact on the management of patients and on the outcome of the disease. The relation among local pathological picture, patient clinical status and treatment algorithm, has to be better studied. PMID:22192618

Campanile, Fabio C; Catena, Fausto; Coccolini, Federico; Lotti, Marco; Piazzalunga, Dario; Pisano, Michele; Ansaloni, Luca

2011-01-01

146

Guidelines Disconcordance in Acute Bipolar Depression: Data from the National Bipolar Mania Pathway Survey (BIPAS) in Mainland China  

PubMed Central

With the recent attention to the importance of evidence-based medicine in psychiatry, a number of treatment guidelines have been published. This survey investigated prescribing pattern and predictors for guideline disconcordance in the acute treatment of bipolar depression across mainland China. Pharmacological treatments of 1078 patients with bipolar depression were examined. Guidelines disconcordance was determined by comparing the medication(s) patients were prescribed with the recommendation(s) in the guidelines of the Canadian Network for Mood and Anxiety Treatments. Predictors for guidelines discordance were analyzed with logistic regression. Of the 1078 patients, 50.2% patients were treated against treatment guidelines recommendations. The patients who were treated in general hospitals (OR?=?1.53, 95% CI 1.18–1.97), with a depressive episode (OR?=?1.67, 95% CI 1.27–2.19) and an older age at first onset (OR?=?1.62, 95% CI 1.15–2.28) were more likely to receive guideline-disconcordant treatment than their counterparts. In contrast, the patients with current mental comorbidity, an older age at study entry, a longer duration of disease, and more frequent episodes in past year were less likely to receive guideline-disconcordant treatments than their counterparts with an OR of 0.43 (95% CI 0.24–0.77), 0.52 (95CI% 0.36–0.75), 0.48 (95% CI 0.36–0.65), and 0.50 (95% CI 0.38–0.64), respectively. Our finding suggested the disconcordance with treatment guidelines in patients with an acute bipolar depression is common under naturalistic conditions in mainland China, and the predicting factors correlated with guidelines disconcordance include both psychiatrist-specific (clinicians from general hospitals) and patient-specific features (a depressive episode at first onset, no current co-morbidity with mental disorders, a younger age at study entry, an older age at first onset, shorter duration of disease, and non-frequent episodes in past year). PMID:24763748

Wang, Zuowei; Gao, Keming; Hong, Wu; Xing, Mengjuan; Wu, Zhiguo; Chen, Jun; Zhang, Chen; Yuan, Chengmei; Huang, Jia; Peng, Daihui; Wang, Yong; Lu, Weihong; Yi, Zhenghui; Yu, Xin; Zhao, Jingping; Fang, Yiru

2014-01-01

147

Quality Assessment of Clinical Practice Guidelines on the Treatment of Hepatocellular Carcinoma or Metastatic Liver Cancer  

PubMed Central

Objectives To assess the quality of the currently available clinical practice guidelines (CPGs) for hepatocellular carcinoma, and provide a reference for clinicians in selecting the best available clinical protocols. Methods The databases of PubMed, MEDLINE, Web of Science, Chinese Biomedical Literature database (CBM), China National Knowledge Infrastructure (CNKI), WanFang, and relevant CPGs websites were systematically searched through March 2014. CPGs quality was appraised using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument, and data analysis was performed using SPSS 13.0 software. Results A total of 20 evidence-based and 20 expert consensus-based guidelines were included. The mean percentage of the domain scores were: scope and purpose 83% (95% confidence interval (CI), 81% to 86%), clarity of presentation 79% (95% CI, 73% to 86%), stakeholder involvement 39% (95% CI, 30% to 49%), editorial independence 58% (95% CI, 52% to 64%), rigor of development 39% (95% CI, 31% to 46%), and applicability 16% (95% CI, 10% to 23%). Evidence-based guidelines were superior to those established by consensus for the domains of rigor of development (p<0.001), clarity of presentation (p?=?0.01) and applicability (p?=?0.021). Conclusions The overall methodological quality of CPGs for hepatocellular carcinoma and metastatic liver cancer is moderate, with poor applicability and potential conflict of interest issues. The evidence-based guidelines has become mainstream for high quality CPGs development; however, there is still need to further increase the transparency and quality of evidence rating, as well as the recommendation process, and to address potential conflict of interest. PMID:25105961

Wang, Yingqiang; Luo, Qianqian; Li, Youping; Wang, Haiqing; Deng, Shaolin; Wei, Shiyou; Li, Xianglian

2014-01-01

148

Chiropractic clinical practice guideline: evidence-based treatment of adult neck pain not due to whiplash  

PubMed Central

OBJECTIVE To provide an evidence-based clinical practice guideline for the chiropractic cervical treatment of adults with acute or chronic neck pain not due to whiplash. This is a considerable health concern considered to be a priority by stakeholders, and about which the scientific information was poorly organized. OPTIONS Cervical treatments: manipulation, mobilization, ischemic pressure, clinic- and home-based exercise, traction, education, low-power laser, massage, transcutaneous electrical nerve stimulation, pillows, pulsed electromagnetic therapy, and ultrasound. OUTCOMES The primary outcomes considered were improved (reduced and less intrusive) pain and improved (increased and easier) ranges of motion (ROM) of the adult cervical spine. EVIDENCE An “extraction” team recorded evidence from articles found by literature search teams using 4 separate literature searches, and rated it using a Table adapted from the Oxford Centre for Evidence-based Medicine. The searches were 1) Treatment; August, 2003, using MEDLINE, CINAHL, AMED, MANTIS, ICL, The Cochrane Library (includes CENTRAL), and EBSCO, identified 182 articles. 2) Risk management (adverse events); October, 2004, identified 230 articles and 2 texts. 3) Risk management (dissection); September, 2003, identified 79 articles. 4) Treatment update; a repeat of the treatment search for articles published between September, 2003 and November, 2004 inclusive identified 121 articles. VALUES To enable the search of the literature, the authors (Guidelines Development Committee [GDC]) regarded chiropractic treatment as including elements of “conservative” care in the search strategies, but not in the consideration of the range of chiropractic practice. Also, knowledge based only on clinical experience was considered less valid and reliable than good-caliber evidence, but where the caliber of the relevant evidence was low or it was non-existent, unpublished clinical experience was considered to be equivalent to, or better than the published evidence. REPORTED BENEFITS, HARMS AND COSTS The expected benefits from the recommendations include more rapid recovery from pain, impairment and disability (improved pain and ROM). The GDC identified evidence-based pain benefits from 10 unimodal treatments and more than 7 multimodal treatments. There were no pain benefits from magnets in necklaces, education or relaxation alone, occipital release alone, or head retraction-extension exercise combinations alone. The specificity of the studied treatments meant few studies could be generalized to more than a minority of patients. Adverse events were not addressed in most studies, but where they were, there were none or they were minor. The theoretic harm of vertebral artery dissection (VAD) was not reported, but an analysis suggested that 1 VAD may occur subsequent to 1 million cervical manipulations. Costs were not analyzed in this guideline, but it is the understanding of the GDC that recommendations limiting ineffective care and promoting a more rapid return of patients to full functional capacity will reduce patient costs, as well as increase patient safety and satisfaction. For simplicity, this version of the guideline includes primarily data synthesized across studies (evidence syntheses), whereas the technical and the interactive versions of this guideline (http://ccachiro.org/cpg) also include relevant data from individual studies (evidence extractions). RECOMMENDATIONS The GDC developed treatment, risk-management and research recommendations using the available evidence. Treatment recommendations addressing 13 treatment modalities revolved around a decision algorithm comprising diagnosis (or assessment leading to diagnosis), treatment and reassessment. Several specific variations of modalities of treatment were not recommended. For adverse events not associated with a treatment modality, but that occur in the clinical setting, there was evidence to recommend reconsideration of treatment options or referral to the appropriate health services. For adverse eve

Anderson-Peacock, Elizabeth; Blouin, Jean-Sebastien; Bryans, Roland; Danis, Normand; Furlan, Andrea; Marcoux, Henri; Potter, Brock; Ruegg, Rick; Gross Stein, Janice; White, Eleanor

2005-01-01

149

Factors Associated With Guideline-Concordant Use of Radiotherapy After Mastectomy in the National Comprehensive Cancer Network  

SciTech Connect

Purpose: We examined the rates and determinants of appropriate and inappropriate use of postmastectomy radiotherapy (PMRT), as defined by the National Comprehensive Cancer Network (NCCN) practice guidelines, among women with Stage I-II breast cancer (American Joint Committee on Cancer, 5th edition). Methods and Materials: Using clinical characteristics, 1,620 consecutive patients at eight NCCN institutions who had undergone mastectomy between July 1997 and June 2002 were classified into three cohorts according to whether the guidelines (1) recommended PMRT, (2) recommended against PMRT, or (3) made no definitive PMRT recommendation. We defined the absence of PMRT in the first cohort as underuse and receipt of PMRT in the second cohort as overuse. Multivariate logistic regression analysis was applied to investigate the association of clinical and sociodemographic factors with PMRT. Results: Overall, 23.8% of patients received PMRT. This included 199 (83.6%) of 238 in the 'recommend PMRT' cohort, 58 (5.6%) of 1,029 in the 'recommend against PMRT' cohort, and 127 (38.6%) of 329 in the 'consider PMRT' cohort. The only factor associated with underuse in the 'recommend PMRT' cohort was nonreceipt of chemotherapy (odds ratio [OR], 0.08; p <0.0001). In addition to tumor characteristics, the factors associated with overuse in the 'recommend against PMRT' cohort included age <50 years (OR, 2.28; p = 0.048), NCCN institution (OR, 1.04-8.29; p = 0.026), higher education (OR, 3.49; p = 0.001), and no reconstructive surgery (OR, 2.44; p = 0.019). The factors associated with PMRT in the 'consider PMRT' cohort included NCCN institution (OR, 1.1-9.01; p <0.0001), age <50 years (OR, 2.26; p = 0.041), and tumor characteristics. Conclusion: The results of our study have shown that concordance with definitive treatment guidelines was high. However, when current evidence does not support a definitive recommendation for PMRT, treatment decisions appear to be influenced, not only by patient age and clinical characteristics, but also by institution-specific patterns of care.

Punglia, Rinaa S. [Dana-Farber Cancer Institute, Boston, MA (United States)], E-mail: rpunglia@partners.org; Hughes, Melissa E. [Dana-Farber Cancer Institute, Boston, MA (United States); Edge, Stephen B. [Roswell Park Cancer Institute, Buffalo, NY (United States); Theriault, Richard L. [M. D. Anderson Cancer Center, Houston, TX (United States); Bookman, Michael A. [Fox Chase Cancer Center, Philadelphia, PA (United States); Wilson, John L. [Arthur G. James Cancer Hospital and Richard Solove Research Institute, Ohio State University, Columbus, OH (United States); Ottesen, Rebecca A.; Niland, Joyce C. [City of Hope National Medical Center, Duarte, CA (United States); Weeks, Jane C. [Dana-Farber Cancer Institute, Boston, MA (United States)

2008-12-01

150

Japanese epidemiological survey with consensus statement on Japanese guidelines for treatment of iron overload in bone marrow failure syndromes  

PubMed Central

Many patients with bone marrow failure syndromes need frequent transfusions of red blood cells, and most of them eventually suffer from organ dysfunction induced by excessively accumulated iron. The only way to treat transfusion-induced iron overload is iron chelating therapy. However, most patients have not been treated effectively because daily/continuous administration of deferoxamine is difficult for outpatients. Recently, a novel oral iron chelator, deferasirox, has been developed, and introduction of the drug may help many patients benefit from iron chelation therapy. In this review, we will discuss the current status of iron overload in transfusion-dependent patients, and the development of Japanese guidelines for the treatment of iron overload in Japan, which were established by the National Research Group on Idiopathic Bone Marrow Failure Syndromes in Japan. PMID:18581199

Suzuki, Takahiro; Tomonaga, Masao; Miyazaki, Yasushi; Nakao, Shinji; Ohyashiki, Kazuma; Matsumura, Itaru; Kohgo, Yutaka; Niitsu, Yoshiro; Kojima, Seiji

2008-01-01

151

Addressing malnutrition in young children in South Africa. Setting the national context for paediatric food-based dietary guidelines.  

PubMed

Despite various national nutrition and primary healthcare programmes being initiated in South Africa over the last decade, child health has deteriorated. This is seen by the rise in infant and child mortality rates, the high prevalence of preventable childhood diseases, e.g. diarrhoea and lower respiratory tract infections, and the coexistence of under-nutrition along with HIV/AIDS. Poor dietary intake, food insecurity and poor quality of basic services prevail within this precarious causal web. The national Integrated Nutrition Programme is a comprehensive nutrition strategy that focuses on children below 6 years old, at-risk pregnant and lactating women, and those affected by communicable and non-communicable diseases. Focus areas relevant to pre-school children include disease-specific nutrition treatment, support and counselling; growth monitoring and promotion (GMP); micronutrient malnutrition control; breastfeeding promotion, protection and support; contributions to household food security; nutrition interventions among HIV-infected children; and nutrition promotion, education and advocacy. Progress towards this includes the Baby-Friendly Hospital Initiative; mandatory fortification of maize meal and wheat flour with multiple micronutrients; vitamin A supplementation coverage and mandatory iodization of salt by legislation; the provision of free road-to-health charts for GMP; and the National School Nutrition Programme. Since 2003, the basis of the nutrition education strategy has been the locally developed food-based dietary guidelines (FBDGs), directed at adults and school-going children. This review sketches the backdrop to and motivation for the introduction of specifically targeted paediatric FBDGs, for mothers and caregivers of children from birth to age 7 years, as a national initiative. PMID:17824851

Bourne, Lesley T; Hendricks, Michael K; Marais, Debbie; Eley, Brian

2007-10-01

152

A comparison between reported therapy staffing levels and the department of health therapy staffing guidelines for stroke rehabilitation: a national survey  

PubMed Central

Background This study compared reported staffing levels for stroke care within UK in-patient stroke units to stroke strategy staffing guidelines published by the UK Department of Health and the Royal College of Physicians. The purpose was to explore the extent to which stroke teams are meeting recommended staffing levels. Method The data analyzed in this report consisted of the detailed therapist staffing levels reported in the demographic section of our national survey to determine upper limb treatment in stroke units (the ATRAS survey). A contact list of stroke practitioners was therefore compiled primarily in collaboration with the 28 National Stroke Improvement Networks. Geographic representation of the network areas was obtained by applying the straight-forward systematic sampling method and the Nth name selection technique to each Network list. In total 192 surveys were emailed to stroke care providers around England. This included multiple contacts within stroke teams (e.g. a stroke consultant and a stroke co-coordinator) to increase awareness of the survey. Results A total of 53 surveys were returned from stroke teams and represented 20 of the 28 network areas providing 71% national coverage. To compare reported staffing levels to suggested DoH guidelines, analysis was conducted on 19 of the 37 inpatient hospital care units that had no missing data for staff numbers, unit bed numbers, number of stroke patients treated per annum, average unit length-of-stay, and average unit occupancy rates. Only 42% of units analyzed reached the DoH guideline for physiotherapy and fewer than 16% of the units reached the guideline for speech & language therapy. By contrast, 84% of units surveyed reached the staffing guideline for occupational therapy. However, a post-hoc analysis highlights this as an irregularity in the DoH guidelines, revealing that all therapies are challenged to provide the recommended therapy time. Conclusions Most in-patient stroke units are operating below the DoH guidelines and are therefore challenged in providing the recommended amount of therapy and patient time to facilitate optimal functional recovery for stroke patients. PMID:24884979

2014-01-01

153

Exercise habits of licensed nurses and nursing assistants: are they meeting national guidelines?  

PubMed

Research shows licensed practical nurses and nursing assistants (NAs) have high rates of obesity and hypertension, potentially from limited engagement in physical activity (PA). Therefore, the purpose of this paper was to describe the self-reported exercise engagement, of licensed nurses (i.e., registered and licensed practical nurses) and NAs. We performed a secondary data analysis of two studies that used the Behavioral Risk Factor Surveillance System - PA questionnaire to assess PA levels. The sample consisted of 31 NAs and 40 licensed nurses. Our findings show 50 (56.9%) NAs and licensed nurses report they engage in enough exercise to meet national guidelines. Our sample reported engaging in more exercise than the general population. We suspect measurement biases as over half of our sample reported engaging in at least 300 min of exercise each week. The potential over-reporting could be due to the perception of their work since they do not have sedentary jobs. PMID:24702714

Flannery, Kelly; Burket, Tamara L; Resnick, Barbara

2014-01-01

154

The National Emphysema Treatment Trial (NETT)  

PubMed Central

Substantial information regarding the role of lung volume reduction surgery (LVRS) in severe emphysema emanates from the National Emphysema Treatment Trial (NETT). The NETT was not a crossover trial and therefore was able to examine the effects of optimal medical management and LVRS on short- and long-term survival, as well as lung function, exercise performance, and quality of life. The NETT generated multiple insights into the preoperative, perioperative, and postoperative management of patients undergoing thoracotomy; described pain control techniques that were safe and effective; and emphasized the need to address nonpulmonary issues to optimize surgical outcomes. After the NETT, newer investigation has focused on bronchoscopic endobronchial interventions and other techniques less invasive than LVRS to achieve lung reduction. In this review, we summarize what we currently know about the role of LVRS in the treatment of severe emphysema as a result of insights gained from the NETT and provide a brief review of the newer techniques of lung volume reduction. PMID:21719757

Cordova, Francis; Sternberg, Alice L.; Martinez, Fernando J.

2011-01-01

155

Sexually Transmitted Diseases Treatment Guidelines 2002. Morbidity and Mortality Weekly Report, May 10, 2002, Volume 51, Number RR-6.  

National Technical Information Service (NTIS)

These guidelines for the treatment of patients who have sexually transmitted diseases (STDs) were developed by the Centers for Disease Control and Prevention (CDC) after consultation with a group of professionals knowledgeable in the field of STDs who met...

S. M. Hewitt

2002-01-01

156

Regional variation and adherence to guidelines for drug treatment of asthma  

Microsoft Academic Search

Aims  To describe the utilization of antiasthmatic drugs in Sweden and to explore regional variations in drug utilization and adherence\\u000a to guidelines for rational drug prescribing of antiasthmatics and their rationale.\\u000a \\u000a \\u000a \\u000a Methods  Data on antiasthmatic drugs dispensed between July 2005 and December 2008 to all Swedish citizens aged between 18 and 44 years\\u000a were obtained from the Swedish National Prescribed Drug Register. The

Marianne Heibert Arnlind; Björn Wettermark; Mika Nokela; Paul Hjemdahl; Clas Rehnberg; Eva Wikström Jonsson

2010-01-01

157

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

158

[National guidelines for the management of patients with chronic lymphocytic leukemia. Sociedad Espan˜ola de Hematolog?´a y Hemoterapia and Grupo Espan˜ol de Leucemia Linfoc?´tica Cro´ nica].  

PubMed

Chronic lymphocytic leukemia is the most common chronic lymphoproliferative disorder in Spain. The clinical management of this entity varies widely. Currently, in Spain, there are no national consensus guidelines, such as those published in other countries, to guide the diagnosis and treatment of this malignancy and the use of prognostic scores. This article reviews the current scientific literature and addresses issues on the diagnosis of chronic lymphocytic leukemia, the spread of the disease, the presence of comorbidities, the classification of prognostic scores, the common treatment regimens stratified by risk factors, and the management of complications associated with both the disease and its treatment, as well as the various controversies related to this entity. This document was drafted with the collaboration of national experts and aims to establish practical guidelines with their corresponding levels of evidence and grades of recommendation to guide the diagnosis, treatment and follow-up of patients with chronic lymphocytic leukemia. PMID:23830547

García Marco, José A; Giraldo Castellano, Pilar; López Jiménez, Javier; Ríos Herranz, Eduardo; Sastre Moral, José Luis; Terol Casterá, M José; Bosch Albareda, Francesc

2013-08-17

159

Australian guidelines for the treatment of adults with acute stress disorder and post-traumatic stress disorder.  

PubMed

Over the past 2-3 years, clinical practice guidelines (CPGs) for post-traumatic stress disorder (PTSD) and acute stress disorder (ASD) have been developed in the USA and UK. There remained a need, however, for the development of Australian CPGs for the treatment of ASD and PTSD tailored to the national health-care context. Therefore, the Australian Centre for Posttraumatic Mental Health in collaboration with national trauma experts, has recently developed Australian CPGs for adults with ASD and PTSD, which have been endorsed by the National Health and Medical Research Council (NHMRC). In consultation with a multidisciplinary reference panel (MDP), research questions were determined and a systematic review of the evidence was then conducted to answer these questions (consistent with NHMRC procedures). On the basis of the evidence reviewed and in consultation with the MDP, a series of practice recommendations were developed. The practice recommendations that have been developed address a broad range of clinical questions. Key recommendations indicate the use of trauma-focused psychological therapy (cognitive behavioural therapy or eye movement desensitization and reprocessing in addition to in vivo exposure) as the most effective treatment for ASD and PTSD. Where medication is required for the treatment of PTSD in adults, selective serotonin re-uptake inhibitor antidepressants should be the first choice. Medication should not be used in preference to trauma-focused psychological therapy. In the immediate aftermath of trauma, practitioners should adopt a position of watchful waiting and provide psychological first aid. Structured interventions such as psychological debriefing, with a focus on recounting the traumatic event and ventilation of feelings, should not be offered on a routine basis. PMID:17620160

Forbes, David; Creamer, Mark; Phelps, Andrea; Bryant, Richard; McFarlane, Alexander; Devilly, Grant J; Matthews, Lynda; Raphael, Beverley; Doran, Chris; Merlin, Tracy; Newton, Skye

2007-08-01

160

[Pharmaceutical treatment of bipolar depression. Evidence from clinical guidelines and treatment recommendations].  

PubMed

Treatment of bipolar depression requires complex treatment decisions in daily routine care. The best evidence for pharmacological treatment is given for quetiapine and with limitations also in off-label use for lamotrigine, especially in combination with lithium, carbamazepine and olanzapine. Effectiveness and recommendation of antidepressants in treatment of bipolar depression remain controversial because of insufficient data. Initially, in depressive episodes a phase prophylactic treatment should be initiated or (if already existing) optimized and more severe episodes should be treated with the substances described before. In case of non-response, the combination of lithium and lamotrigine or antidepressants in combination with lithium, antiepileptics or atypical antipsychotics may be necessary. If depressive episodes occur in the course of pharmacological treatment with prophylactic agents, combination therapies of different substances, even with antidepressants, are necessary. In case of treatment-resistant depressive episodes, complex treatment strategies (e.g. combination therapies and MAO inhibitors) should be considered. PMID:24170252

Köhler, S; Bauer, M; Bschor, T

2014-09-01

161

Standards of Practice: Quality Assurance Guidelines for Percutaneous Treatments of Intervertebral Discs  

SciTech Connect

Percutaneous treatments are used in the therapy of small- to medium-sized hernias of intervertebral discs to reduce the intradiscal pressure in the nucleus and theoretically create space for the herniated fragment to implode inward, thus reducing pain and improving mobility and quality of life. These techniques involve the percutaneous removal of the nucleus pulposus by using a variety of chemical, thermal, or mechanical techniques and consist of removal of all or part of nucleus pulposus to induce more rapid healing of the abnormal lumbar disc. These guidelines are written to be used in quality improvement programs for assessing fluoroscopy- and/or computed tomography-guided percutaneous intervertebral disc ablative techniques.

Kelekis, Alexis D., E-mail: akelekis@med.uoa.gr; Filippiadis, Dimitris K., E-mail: dfilippiadis@yahoo.g [Attikon University Hospital, 2nd Radiology Department (Greece); Martin, Jean-Baptiste, E-mail: jbmartin@cird.c [Geneva University Hospital, Service d'Imagerie Medicale (Switzerland); Brountzos, Elias, E-mail: ebrountz@med.uoa.g [Attikon University Hospital, 2nd Radiology Department (Greece)

2010-10-15

162

Treatment of ischaemic heart disease in haemophilia patients: an institutional guideline.  

PubMed

Since the introduction of clotting factor concentrates, life expectancy of haemophilia patients is increasing and now approaches that of the general male population. Increasingly, haemophilia patients are confronted with age-related co-morbidity, including ischaemic cardiovascular disease. Treatment of stable angina pectoris and the acute coronary syndrome with antithrombotic therapy and percutaneous coronary intervention in haemophilia patients is feasible, but requires a tight co-operation between all specialists involved. As evidence-based guidelines are lacking, we developed a protocol on how we will treat haemophilia patients with ischaemic heart disease. PMID:19473421

Schutgens, R E G; Tuinenburg, A; Roosendaal, G; Guyomi, S Hoseyni; Mauser-Bunschoten, E P

2009-07-01

163

Nordic guidelines 2014 for diagnosis and treatment of gastroenteropancreatic neuroendocrine neoplasms.  

PubMed

Abstract Background. The diagnostic work-up and treatment of patients with neuroendocrine neoplasms (NENs) has undergone major recent advances and new methods are currently introduced into the clinic. An update of the WHO classification has resulted in a new nomenclature dividing NENs into neuroendocrine tumours (NETs) including G1 (Ki67 index ? 2%) and G2 (Ki67 index 3-20%) tumours and neuroendocrine carcinomas (NECs) with Ki67 index > 20%, G3. Aim. These Nordic guidelines summarise the Nordic Neuroendocrine Tumour Group's current view on how to diagnose and treat NEN-patients and are meant to be useful in the daily practice for clinicians handling these patients. PMID:25140861

Janson, Eva Tiensuu; Sorbye, Halfdan; Welin, Staffan; Federspiel, Birgitte; Grønbæk, Henning; Hellman, Per; Ladekarl, Morten; Langer, Seppo W; Mortensen, Jann; Schalin-Jäntti, Camilla; Sundin, Anders; Sundlöv, Anna; Thiis-Evensen, Espen; Knigge, Ulrich

2014-10-01

164

Health impact assessment: A comparison of 45 local, national, and international guidelines  

SciTech Connect

This article provides a comparison of health impact assessment (HIA) guidelines from around the world and for multiple geographic scales. We identify commonalities and differences within HIA guides to discuss the plausibility of consensus guidelines and to inform guideline development. The practice of HIA has grown over the last two decades with a concurrent growth of HIA guides. This study expands on earlier review work and includes guides published since 2007 (Mindell, Boltong and Forde, 2008). From April 2010 to October 2011, 45 HIA guides were identified through an internet search and review of previous research. Common characteristics, key features, and the HIA process were analyzed. The 45 documents recommended similar but not identical processes for conducting HIAs. These analyses suggest that guidelines for HIAs are similar in many areas of the world and that new HIA practitioners can use these findings to inform their approach. Further discussion is needed to determine if the approaches established in these guidelines are followed and if one set of common guidelines could be written for use in numerous countries and regions. - Highlights: Black-Right-Pointing-Pointer We analyze 45 health impact assessment (HIA) guidelines worldwide. Black-Right-Pointing-Pointer We examine similarities and unique attributes of each guideline. Black-Right-Pointing-Pointer We discuss the advantages and disadvantages of developing consensus guidelines. Black-Right-Pointing-Pointer Identifying additional guidelines aides in future HIA work and evaluation.

Hebert, Katherine A., E-mail: jsx3@cdc.gov; Wendel, Arthur M., E-mail: dvq6@cdc.gov; Kennedy, Sarah K., E-mail: heaton.sarah@gmail.com; Dannenberg, Andrew L., E-mail: adannenberg2@gmail.com

2012-04-15

165

Validity and reliability of guidelines for neck pain treatment in primary health care. A nationwide empirical analysis in Spain  

Microsoft Academic Search

Objectives. To assess the reliability and validity of existing clinical guidelines on neck-pain physiotherapy treatment and follow- up in Spain. Design. We identiWed existing guidelines through a nationwide census and listed their recommendations, grouped according to the main steps of the process Xow-chart. To assess reliability we analysed the variability of statements. To analyse validity we assessed the type of

PEDRO J. SATURNO; FRANCESC MEDINA; FERMIN VALERA; JOAQUINA MONTILLA; PILAR ESCOLAR; JUAN J. GASCÓN

2003-01-01

166

[Overview of Nursing Graduation courses in Brazil in the National Curriculum Guidelines decade].  

PubMed

The study aims to build a general overview of the Nursing Graduation Programs in Brazil, in the decade of the National Curriculum Guidelines for Nursing Graduation, period 2001-2011. This is an exploratory, descriptive study, based on data from the e-MEC, Higher Education Census, ENADE. The results evidenced: the privatization of the Nursing Graduation Programs, the oversupply of courses and places day and night; sharp expansion of the number of vacancies for distance learning, not meeting the minimum quality criteria evaluated by ENADE, among other respects. It is recommended that strategies for the regulation of the expansion already installed must be defined, in addition to the revision of indicators drawn from the INEP Single Form, to meet the necessities of nursing, as an specific area, particularly with regard to: the number of vacancies, integration with the local and regional health system and the SUS, education in health care, teaching practical activities, working arrangements and experience of the faculty of the course. It is recommended, though, the immediate intervention of the MEC in the poles of Distance Education, suspending the training of nurses in that modality of education. PMID:24092317

Teixeira, Elizabeth; Fernandes, Josicelia Dumêt; Andrade, Andréia de Carvalho; Silva, Kênia Lara; da Rocha, Maria Eliane Martins Oliveira; Lima, Raquel Josefina de Oliveira

2013-09-01

167

Correlation between Intake of Dietary Fiber and Adherence to the Korean National Dietary Guidelines in Adolescents from Jeonju  

PubMed Central

This study surveyed dietary intake and adherence to the Korean national dietary guidelines in Korean adolescents. To elucidate basic data for use in nutrition education, which aims to improve adolescent compliance with the national dietary guidelines and to increase the intake of dietary fiber, we evaluated the sources of fiber in adolescent diets. This study included 182 male and 212 female students from 2 middle schools in the Jeonju province. From November 15~20, 2011, we surveyed the students for general characteristics, adherence to the Korean national dietary guidelines, and dietary intake. Dietary fiber intake was 16.57 ± 6.95 g/day for male students and 16.14 ± 7.11 g/day for female students. The food groups that contributed most to dietary fiber intake were (in descending order) cereals, vegetables, seasoning, and fruits. The fiber-containing food items consumed most were cabbage- kimchi, cooked rice, instant noodles, and cabbage. Based on adherence to the Korean national dietary guidelines, the vegetable-based intake of dietary fiber in groups 1 (score 15~45), 2 (score 46~52), and 3 (score 53~75) were 4.41 ± 2.595 g/day, 4.12 ± 2.692 g/day, and 5.49 ± 3.157 g/day, respectively (p<0.001). In addition, the total intake of dietary fiber varied significantly among the three groups (p<0.001) as follows: Group 1, 14.99 ± 6.374 g/day; Group 2, 15.32 ± 6.772 g/day; and Group 3, 18.79 ± 7.361 g/day. In this study, we discovered that adherence to the Korean national dietary guidelines correlates with improved intake of dietary fiber. Therefore, marketing and educational development is needed to promote adherence to the Korean national dietary guidelines. In addition, nutritional education is needed to improve dietary fiber consumption through the intake of vegetables and fruits other than kimchi. PMID:24471093

Park, Sunmi; Na, Woori; Kim, Misung; Kim, Eunsoo; Sohn, Cheongmin

2012-01-01

168

The evaluation and treatment of acute epididymitis in a large university based population: are CDC guidelines being followed?  

Microsoft Academic Search

Purpose  To review the evaluation and treatment of epididymitis in a contemporary population and evaluate adherence to Centers for\\u000a Disease Control (CDC) guidelines.\\u000a \\u000a \\u000a \\u000a Materials and methods  From 1999 to 2005, 870 patients from a single institution were diagnosed with epididymitis. Information regarding patient\\u000a demographics, diagnostic evaluation, and treatment was reviewed. Adherence to CDC guidelines for the treatment of acute epididymitis\\u000a was evaluated.

Chad R. Tracy; Raymond A. Costabile

2009-01-01

169

European guidelines for the diagnosis and treatment of pelvic girdle pain.  

PubMed

A guideline on pelvic girdle pain (PGP) was developed by "Working Group 4" within the framework of the COST ACTION B13 "Low back pain: guidelines for its management", issued by the European Commission, Research Directorate-General, Department of Policy, Coordination and Strategy. To ensure an evidence-based approach, three subgroups were formed to explore: (a) basic information, (b) diagnostics and epidemiology, and (c) therapeutical interventions. The progress of the subgroups was discussed at each meeting and the final report is based on group consensus. A grading system was used to denote the strength of the evidence, based on the AHCPR Guidelines (1994) and levels of evidence recommended in the method guidelines of the Cochrane Back Review group. It is concluded that PGP is a specific form of low back pain (LBP) that can occur separately or in conjunction with LBP. PGP generally arises in relation to pregnancy, trauma, arthritis and/or osteoarthritis. Uniform definitions are proposed for PGP as well as for joint stability. The point prevalence of pregnant women suffering from PGP is about 20%. Risk factors for developing PGP during pregnancy are most probably a history of previous LBP, and previous trauma to the pelvis. There is agreement that non risk factors are: contraceptive pills, time interval since last pregnancy, height, weight, smoking, and most probably age. PGP can be diagnosed by pain provocation tests (P4/thigh thrust, Patrick's Faber, Gaenslen's test, and modified Trendelenburg's test) and pain palpation tests (long dorsal ligament test and palpation of the symphysis). As a functional test, the active straight leg raise (ASLR) test is recommended. Mobility (palpation) tests, X-rays, CT, scintigraphy, diagnostic injections and diagnostic external pelvic fixation are not recommended. MRI may be used to exclude ankylosing spondylitis and in the case of positive red flags. The recommended treatment includes adequate information and reassurance of the patient, individualized exercises for pregnant women and an individualized multifactorial treatment program for other patients. We recommend medication (excluding pregnant women), if necessary, for pain relief. Recommendations are made for future research on PGP. PMID:18259783

Vleeming, Andry; Albert, Hanne B; Ostgaard, Hans Christian; Sturesson, Bengt; Stuge, Britt

2008-06-01

170

European guidelines for the diagnosis and treatment of pelvic girdle pain  

PubMed Central

A guideline on pelvic girdle pain (PGP) was developed by “Working Group 4” within the framework of the COST ACTION B13 “Low back pain: guidelines for its management”, issued by the European Commission, Research Directorate-General, Department of Policy, Coordination and Strategy. To ensure an evidence-based approach, three subgroups were formed to explore: (a) basic information, (b) diagnostics and epidemiology, and (c) therapeutical interventions. The progress of the subgroups was discussed at each meeting and the final report is based on group consensus. A grading system was used to denote the strength of the evidence, based on the AHCPR Guidelines (1994) and levels of evidence recommended in the method guidelines of the Cochrane Back Review group. It is concluded that PGP is a specific form of low back pain (LBP) that can occur separately or in conjunction with LBP. PGP generally arises in relation to pregnancy, trauma, arthritis and/or osteoarthritis. Uniform definitions are proposed for PGP as well as for joint stability. The point prevalence of pregnant women suffering from PGP is about 20%. Risk factors for developing PGP during pregnancy are most probably a history of previous LBP, and previous trauma to the pelvis. There is agreement that non risk factors are: contraceptive pills, time interval since last pregnancy, height, weight, smoking, and most probably age. PGP can be diagnosed by pain provocation tests (P4/thigh thrust, Patrick’s Faber, Gaenslen’s test, and modified Trendelenburg’s test) and pain palpation tests (long dorsal ligament test and palpation of the symphysis). As a functional test, the active straight leg raise (ASLR) test is recommended. Mobility (palpation) tests, X-rays, CT, scintigraphy, diagnostic injections and diagnostic external pelvic fixation are not recommended. MRI may be used to exclude ankylosing spondylitis and in the case of positive red flags. The recommended treatment includes adequate information and reassurance of the patient, individualized exercises for pregnant women and an individualized multifactorial treatment program for other patients. We recommend medication (excluding pregnant women), if necessary, for pain relief. Recommendations are made for future research on PGP. PMID:18259783

Albert, Hanne B.; Ostgaard, Hans Christian; Sturesson, Bengt; Stuge, Britt

2008-01-01

171

2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth  

PubMed Central

Background The International Scientific Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), that produced its first Guidelines in 2005, felt the need to revise them and increase their scientific quality. The aim is to offer to all professionals and their patients an evidence-based updated review of the actual evidence on conservative treatment of idiopathic scoliosis (CTIS). Methods All types of professionals (specialty physicians, and allied health professionals) engaged in CTIS have been involved together with a methodologist and a patient representative. A review of all the relevant literature and of the existing Guidelines have been performed. Documents, recommendations, and practical approach flow charts have been developed according to a Delphi procedure. A methodological and practical review has been made, and a final Consensus Session was held during the 2011 Barcelona SOSORT Meeting. Results The contents of the document are: methodology; generalities on idiopathic scoliosis; approach to CTIS in different patients, with practical flow-charts; literature review and recommendations on assessment, bracing, physiotherapy, Physiotherapeutic Specific Exercises (PSE) and other CTIS. Sixty-five recommendations have been given, divided in the following topics: Bracing (20 recommendations), PSE to prevent scoliosis progression during growth (8), PSE during brace treatment and surgical therapy (5), Other conservative treatments (3), Respiratory function and exercises (3), Sports activities (6), Assessment (20). No recommendations reached a Strength of Evidence level I; 2 were level II; 7 level III; and 20 level IV; through the Consensus procedure 26 reached level V and 10 level VI. The Strength of Recommendations was Grade A for 13, B for 49 and C for 3; none had grade D. Conclusion These Guidelines have been a big effort of SOSORT to paint the actual situation of CTIS, starting from the evidence, and filling all the gray areas using a scientific method. According to results, it is possible to understand the lack of research in general on CTIS. SOSORT invites researchers to join, and clinicians to develop good research strategies to allow in the future to support or refute these recommendations according to new and stronger evidence. PMID:22264320

2012-01-01

172

Criminal justice and alcohol treatment: results from a national sample.  

PubMed

This study investigates the associations of recent criminal justice involvement with perceived need for alcohol treatment and alcohol treatment utilization, adjusting for demographic and clinical characteristics. We examined a national sample of adults with alcohol use disorders (N=4390) from the 2006 National Survey on Drug Use and Health. Almost 15% reported criminal justice involvement in the past year. Generalized logit models regressed perceived need for alcohol or drug treatment and past year treatment utilization (versus neither) on past year legal involvement, demographic, and clinical information. In general, results found stronger associations between frequency of criminal justice involvement for treatment utilization compared to perceived need for treatment alone. Treatment utilization was also associated with being on probation, arrests for drug possession/sale and driving under the influence but perceived need was not. Study results suggest opportunities for interventions to increase treatment rates or treatment need, a major correlate of treatment utilization. PMID:22954511

Booth, Brenda M; Curran, Geoffrey M; Han, Xiaotong; Edlund, Mark J

2013-03-01

173

Criminal Justice and Alcohol Treatment: Results from a National Sample  

PubMed Central

This study investigates the associations of recent criminal justice involvement with perceived need for alcohol treatment and alcohol treatment utilization, adjusting for demographic and clinical characteristics. We examined a national sample of adults with alcohol use disorders (AUD, N=4,390) from the 2006 National Survey on Drug Use and Health (NSDUH). Almost 15% reported criminal justice involvement in the past year. Generalized logit models regressed perceived need for alcohol or drug treatment and past year treatment utilization (versus neither) on past year legal involvement, demographic, and clinical information. In general, results found stronger associations between frequency of criminal justice involvement for treatment utilization compared to perceived need for treatment alone. Treatment utilization was also associated with being on probation, arrests for drug possession/sale and DUI but perceived need was not. Study results suggest opportunities for interventions to increase treatment rates or treatment need, a major correlate of treatment utilization. PMID:22954511

Booth, Brenda M.; Curran, Geoffrey M.; Han, Xiaotong; Edlund, Mark J.

2012-01-01

174

Quality Control Guidelines for National Committee for Clinical Laboratory Standards Recommended Broth Macrodilution Testing of Amphotericin B, Fluconazole, and Flucytosine  

Microsoft Academic Search

Amphotericin B, fluconazole, and flucytosine (5FC) were tested in a multilaboratory study to establish quality control (QC) guidelines for yeast antifungal susceptibility testing. Ten candidate QC strains were testedinaccordancewithNationalCommitteeforClinicalLaboratoryStandardsM27-Pguidelinesagainstthe three antifungal agents in each of six laboratories. Each laboratory was assigned a unique lot of RPMI 1640 broth medium as well as a lot of RPMI 1640 common to all

M. A. PFALLER; M. BALE; B. BUSCHELMAN; M. LANCASTER; A. ESPINEL-INGROFF; J. H. REX; M. G. RINALDI; C. R. COOPER; R. MCGINNIS

1995-01-01

175

A National Evaluation of Treatment Outcomes for Cocaine Dependence  

Microsoft Academic Search

Background: This national study focused on posttreat- ment outcomes of community treatments of cocaine de- pendence. Relapse to weekly (or more frequent) co- caine use in the first year after discharge from 3 major treatment modalities was examined in relation to pa- tient problem severity at admission to the treatment pro- gram and length of stay. Methods: We studied 1605

D. Dwayne Simpson; George W. Joe; Bennett W. Fletcher; Robert L. Hubbard; M. Douglas Anglin

1999-01-01

176

[Evaluating the total incapacity to work: implementing French National Authority for Health guidelines in clinical practice].  

PubMed

Total incapacity to work (TIW) is a legal concept that allows magistrates to assess the severity of violence against persons. The TIW is the duration of the victims' inability to fulfil their usual activities and is determined by physicians. Professional guidelines from the French National Authority for Health indicate that TIW applies both to physical and psychological problems. The law of 9 July 2010 makes explicit reference to TIW in cases of psychological violence and intimate partner harassment. Prosecutors base criminal penalties on the duration of TIW in cases of assault and battery. Whatever the physician, they should describe the mental state of the victim and identify the signs that may indicate the mental impact of reported assaults. Identifying combinations of symptoms can be useful in deciding whether the duration of TIW should be increased because of the psychic state. In case of stalking, assessment of TIW can allow prosecutors to link the reported facts to a criminal offence. In complex situations, the physician may be unable to assess a duration of TIW and can suggest expert assessment. In all cases, the duration of TIW needs to be based on functional criteria. The extent of harm to the life of relationships results from suffered violence, from the victim's reaction, and from the perception of their family and friends. In this area, we suggest to limit the first assessment of TIW to a few days and to reassess it later, according to real information reported by the victims, to careful observation of their behaviour, and to results of a questioning that should be as little suggestive as possible. At either end of the age scale and in case of preexisting functional impairment, assessment of TIW should take into account the actual and global capacity of the person before the assault. PMID:23659917

Chariot, Patrick; Bécache, Nathalie; François-Purssell, Irène; Dantchev, Nicolas; Delpla, Pierre-André; Fournier, Lionel; Proust, Bernard

2013-10-01

177

Improving Quality: Core Mission for Developing Higher Education in the "National Medium- and Long-Term Educational Reform and Development Guideline (2010-20)"  

ERIC Educational Resources Information Center

The "National Medium- and Long-Term Educational Reform and Development Guideline (2010-20)" (hereafter abbreviated as the "Guideline") has pointed out that the core mission for the development of China's higher education in the next decade is to improve quality. This development mission was put forward against the background of China's higher…

Kai, Jiang

2012-01-01

178

Impact of breast cancer treatment guidelines on surgeon practice patterns: Results of a hospital-based intervention  

Microsoft Academic Search

Background. Despite evidence regarding the effectiveness of post-surgical treatments for early-stage breast cancer, older women are less likely to receive appropriate therapy. We evaluated the impact of surgeon-specific “performance reports” on adherence to treatment guidelines among older women with breast cancer. Methods. We obtained diagnostic and treatment data from hospital tumor registries supplemented with self-reported adjuvant therapy information on 1099

Vincent Mor; Linda L. Laliberte; Ann C. Petrisek; Orna Intrator; Tom Wachtel; Phillip G. Maddock; Kirby I. Bland

2000-01-01

179

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

Microsoft Academic Search

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

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

2001-01-01

180

Dosing and therapy utilization: a discussion of updates on PI treatment guidelines.  

PubMed

Treatment decisions made in clinical practice, based on current guidelines, often conflict with decisions by third-party payors that restrict the ability of patients with primary immunodeficiency disease (PI) to adhere to appropriate treatment. This is seen by many physicians as potentially placing the health of patients at risk. Key treatment decisions challenged by third-party payors and discussed here include dosing, product safety, and routes of administration. Data on safety issues emphasize that IgG products are not generic drugs and each of the products currently licensed by the Food and Drug Administration (FDA) must be regarded as an individual therapy, given the products' different manufacturing processes and stabilizing ingredients. The issue of switching patients to a different product needs careful consideration as evidence shows that infusion-related adverse events in many patients are frequently related to this activity. Decisions regarding the route of therapy should also be individualized to the patient, weighing such factors as side effects, adherence with therapy, and lifestyle. PMID:22730010

Ballow, Mark

2012-09-01

181

Harris P. Mosher Award thesis. Peritonsillar abscess: incidence, current management practices, and a proposal for treatment guidelines.  

PubMed

Currently there is no agreement on the treatment of patients who develop a peritonsillar abscess (PTA). This lack of consensus results in highly variable and possibly expensive therapeutic regimens that may not provide optimum quality patient care at reasonable cost. The present study evaluates surgical, medical, diagnostic, and cost factors that affect the management of PTA based on the following: 1. a cohort study of 123 patients with PTA treated using needle aspiration as the initial surgical drainage; 2. a national survey of the PTA management practices of otolaryngologists; and 3. meta-analyses of various components of the treatment regimen for PTA. In the cohort study, patients diagnosed with PTA were treated by both otolaryngologists and emergency medicine specialists with needle aspiration as the primary surgical modality resulting in a 96% acute resolution rate for PTA. In the national survey, questionnaires were sent to 2000 randomly selected members of the American Academy of Otolaryngology-Head and Neck Surgery regarding their management of PTA. The return rate was 73%. Ninety-six percent of the physicians who returned survey forms treated an average of seven PTAs per year using either needle aspiration, incision and drainage, or abscess tonsillectomy to drain the abscess initially. The incidence of PTA in the United States and Puerto Rico among patients 5 to 59 years of age treated by survey practitioners is 30.1 per 100,000 person years, accounting for approximately 45,000 cases per year. Four meta-analyses were completed to quantify the success rate of needle aspiration in the treatment of PTA (94%), the recurrence rate of PTA (10% to 15%), the rate at which penicillin-resistant microorganisms are found in patients with PTA (0% to 56%), and the rate of prior oropharyngeal infections associated with PTA (11% to 56%). The recurrence rate for PTA in the United States is 10%, which is significantly different from the recurrence rate of 15% reported from the rest of the world (P < .002). A clinical intervention for PTA is proposed based on the clinical series, the national survey data, and the meta-analyses. These clinical guidelines recommend that needle aspiration be used as the initial surgical drainage procedure for all patients with a PTA other than those who have indications for abscess tonsillectomy. Patients should be treated in an outpatient setting, should receive penicillin if they are not allergic to it, and should receive adequate pain medication. The evidence does not suggest that there is any benefit in examining the abscess contents for microorganisms. Approximately 30% of patients with PTA can be expected to exhibit relative indications for a tonsillectomy.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:7630308

Herzon, F S

1995-08-01

182

Developing a National Addiction Treatment Information System  

Microsoft Academic Search

The purpose of this article is to test the applicability and utility of the Drug Evaluation Network Study (DENS), a timely electronic information system that tracks trends in substance abuse treatment. This article examines existing large-scale data collection efforts, discusses the rationale and design of the DENS system, and presents results of the DENS pilot phase. Clinical staff from more

Deni Carise; A. Thomas McLellan; Lea S Gifford; Herbert D Kleber

1999-01-01

183

MANAGEMENT OF ASTHMA EXACERBATIONS: School Treatment National Asthma Education and  

E-print Network

MANAGEMENT OF ASTHMA EXACERBATIONS: School Treatment National Asthma Education and Prevention Program Suggested Emergency Nursing Protocol for Students with Asthma Symptoms Who Don't Have a Personal Asthma Action Plan National Asthma Education and Prevention Program A student with asthma symptoms should

Bandettini, Peter A.

184

MANAGEMENT OF ASTHMA EXACERBATIONS: School Treatment National Asthma Education and  

E-print Network

MANAGEMENT OF ASTHMA EXACERBATIONS: School Treatment National Asthma Education and Prevention Program National Asthma Education and Prevention Program Steps to Follow for an Asthma Episode in the School Setting When a Nurse is Not Available Be prepared. Know which students have asthma and where

Bandettini, Peter A.

185

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

PubMed Central

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

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

2014-01-01

186

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

PubMed Central

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

2011-01-01

187

Anal cancer: ESMO-ESSO-ESTRO clinical practice guidelines for diagnosis, treatment and follow-up.  

PubMed

Squamous cell carcinoma of the anus (SCCA) is a rare cancer but its incidence is increasing throughout the world, and is particularly high in the human immunodeficiency virus positive (HIV+) population. A multidisciplinary approach is mandatory (involving radiation therapists, medical oncologists, surgeons, radiologists and pathologists). SCCA usually spreads in a loco-regional manner within and outside the anal canal. Lymph node involvement at diagnosis is observed in 30-40% of cases while systemic spread is uncommon with distant extrapelvic metastases recorded in 5-8% at onset, and rates of metastatic progression after primary treatment between 10% and 20%. SCCA is strongly associated with human papilloma virus (HPV, types 16-18) infection. The primary aim of treatment is to achieve cure with loco-regional control and preservation of anal function, with the best possible quality of life. Treatment dramatically differs from adenocarcinomas of the lower rectum. Combinations of 5FU-based chemoradiation and other cytotoxic agents (mitomycin C) have been established as the standard of care, leading to complete tumour regression in 80-90% of patients with locoregional failures in the region of 15%. There is an accepted role for surgical salvage. Assessment and treatment should be carried out in specialised centres treating a high number of patients as early as possible in the clinical diagnosis. To date, the limited evidence from only 6 randomised trials [1,2,3,4,5,6,7], the rarity of the cancer, and the different behaviour/natural history depending on the predominant site of origin, (the anal margin, anal canal or above the dentate line) provide scanty direction for any individual oncologist. Here we aim to provide guidelines which can assist medical, radiation and surgical oncologists in the practical management of this unusual cancer. PMID:24947004

Glynne-Jones, Robert; Nilsson, Per J; Aschele, Carlo; Goh, Vicky; Peiffert, Didier; Cervantes, Andrés; Arnold, Dirk

2014-06-01

188

Anal cancer: ESMO-ESSO-ESTRO clinical practice guidelines for diagnosis, treatment and follow-up.  

PubMed

Squamous cell carcinoma of the anus (SCCA) is a rare cancer but its incidence is increasing throughout the world, and is particularly high in the human immunodeficiency virus positive (HIV+) population. A multidisciplinary approach is mandatory (involving radiation therapists, medical oncologists, surgeons, radiologists and pathologists). SCCA usually spreads in a loco-regional manner within and outside the anal canal. Lymph node involvement at diagnosis is observed in 30%-40% of cases while systemic spread is uncommon with distant extrapelvic metastases recorded in 5%-8% at onset, and rates of metastatic progression after primary treatment between 10 and 20%. SCCA is strongly associated with human papilloma virus (HPV, types 16-18) infection. The primary aim of treatment is to achieve cure with loco-regional control and preservation of anal function, with the best possible quality of life. Treatment dramatically differs from adenocarcinomas of the lower rectum. Combinations of 5FU-based chemoradiation and other cytotoxic agents (mitomycin C) have been established as the standard of care, leading to complete tumour regression in 80%-90% of patients with locoregional failures in the region of 15%. There is an accepted role for surgical salvage. Assessment and treatment should be carried out in specialised centres treating a high number of patients as early as possible in the clinical diagnosis. To date, the limited evidence from only 6 randomised trials [1,2,3,4,5,6,7], the rarity of the cancer, and the different behaviour/natural history depending on the predominant site of origin, (the anal margin, anal canal or above the dentate line) provide scanty direction for any individual oncologist. Here we aim to provide guidelines which can assist medical, radiation and surgical oncologists in the practical management of this unusual cancer. PMID:25239441

Glynne-Jones, R; Nilsson, P J; Aschele, C; Goh, V; Peiffert, D; Cervantes, A; Arnold, D

2014-10-01

189

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

Microsoft Academic Search

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

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

2011-01-01

190

Pattern of pharmacotherapy by episode types for patients with bipolar disorders and its concordance with treatment guidelines.  

PubMed

This study aimed to investigate the overall prescription pattern for patients with bipolar disorders in Korea and its relevance to the practice guidelines. Prescription records from all patients with bipolar I and II disorders who have been admitted or who started the outpatient treatment during the year of 2009 in 10 academic setting hospitals were reviewed. A total of 1447 patients with bipolar I and II disorders were included in this study. Longitudinal prescription patterns of inpatients and outpatients were analyzed by episode types and compared with the clinical practice guideline algorithms. In all phases, polypharmacy was chosen as an initial treatment strategy (>80%). The combination of mood stabilizer and atypical antipsychotics was the most favored. Antipsychotics were prescribed in more than 80% of subjects across all phases. The rate of antidepressant use ranged from 15% to 40%, and it was more frequently used in acute treatment and bipolar II subjects. The concordance rate of prescriptions for manic inpatients to the guidelines was higher and relatively more consistent (43.8%-48.7%) compared with that for depressive inpatients (18.6%-46.9%). Polypharmacy was the most common reason for nonconcordance. In Korean psychiatric academic setting, polypharmacy and atypical antipsychotics were prominently favored in the treatment of bipolar disorder, even with the lack of evidence of its superiority. More evidence is needed to establish suitable treatment strategies. In particular, the treatment strategy for acute bipolar depression awaits more consensuses. PMID:25006813

Baek, Ji Hyun; Ha, Kyooseob; Yatham, Lakshimi N; Chang, Jae Seung; Ha, Tae Hyon; Jeon, Hong Jin; Hong, Kyung Sue; Chang, Sung Man; Ahn, Yong Min; Cho, Hyun Sang; Moon, Eunsoo; Cha, Boseok; Choi, Jung Eun; Joo, Yeon Ho; Joo, Eun Jeong; Lee, Se Young; Park, Yunseong

2014-10-01

191

National treatment systems in global perspective.  

PubMed

Drug policy development is mostly viewed as emerging within the nation state. Processes of diffusion of innovative policies have been neglected to a large extent. The comparative study of public policy has demonstrated, however, that diffusion is an important predictor of early policy adaptation. Thus, the analysis asks the general question of the relative importance of endogenous and exogenous effects on the development of drug policies in various countries. Specifically it describes the Swiss debate leading to the popular initiative on 'Youth Without Drugs' as well as the international reactions regarding its liberal outcome. Results of an expert survey show two broad types of reactions. There is one set of countries where chances for the introduction of limited heroin-prescription trials during the next 5 years are considered probable and a second set of countries which seems to be strictly status quo oriented. In the concluding section a model is suggested which systematically considers endogenous as well as exogenous predictors of 'soft' or 'hard' drug policy adoption. Results of a first tentative test of the model are encouraging for future empirical research on diffusion processes of drug policies. PMID:10460974

Klingemann, H

1999-09-01

192

Toward a national plan for the accelerated commercialization of solar energy: guidelines for regional planning  

SciTech Connect

This document provides data and guidelines for the development of regional programs for the accelerated commercialization of solar energy. It estimates the solar potential for individual regions based on the solar resources, competing costs of energy, and specific regional characteristics. It also points out the primary decision makers, technology distributors, and potential barriers that should be addressed by a commercialization program.

Miller, G.; Bennington, G.; Bohannon, M.; Gerstein, R.; Kannan, N.; Page, A.; Rebibo, K.; Shulman, M.; Swepak, P.; Taul, J.

1980-01-01

193

Adherence by Dutch Public Health Nurses to the National Guidelines for Tuberculosis Contact Investigation  

PubMed Central

Objectives To assess whether public health nurses adhered to Dutch guidelines for tuberculosis contact investigations and to explore which factors influenced the process of identifying contacts, prioritizing contacts for testing and scaling up a contact investigation. Methods A multiple-case study (2010–2012) compared the contact investigation guidelines as recommended with their use in practice. We interviewed twice 14 public health nurses of seven Public Health Services while they conducted a contact investigation. Results We found more individuals to be identified as contacts than recommended, owing to a desire to gain insight into the infectiousness of the index case and prevent anxiety among potential contacts. Because some public health nurses did not believe the recommendations for prioritizing contacts fully encompassed daily practice, they preferred their own regular routine. In scaling up a contact investigation, they hardly applied the stone-in-the-pond principle. They neither regularly compared the infection prevalence in the contact investigation with the background prevalence in the community, especially not in immigrant populations. Nonadherence was related to ambiguity of the recommendations and a tendency to act from an individual health-care position rather than a population health perspective. Conclusions The adherence to the contact investigation guidelines was limited, restraining the effectiveness, efficiency and uniformity of tuberculosis control. Adherence could be optimized by specifying guideline recommendations, actively involving the TB workforce, and training public health nurses. PMID:23166738

Mulder, Christiaan; Harting, Janneke; Jansen, Niesje; Borgdorff, Martien W.; van Leth, Frank

2012-01-01

194

Treatment programs in the National Drug Abuse Treatment Clinical Trials Network  

Microsoft Academic Search

Drug abuse treatment programs and university-based research centers collaborate to test emerging therapies for alcohol and drug disorders in the National Drug Abuse Treatment Clinical Trials Network (CTN). Programs participating in the CTN completed Organizational Surveys (n=106 of 112; 95% response rate) and Treatment Unit Surveys (n=348 of 384; 91% response rate) to describe the levels of care, ancillary services,

Dennis McCarty; Bret Fuller; Lee Ann Kaskutas; William W. Wendt; Edward V. Nunes; Michael Miller; Robert Forman; Kathryn M. Magruder; Cynthia Arfken; Marc Copersino; Anthony Floyd; Jody Sindelar; Eldon Edmundson

2008-01-01

195

[Guidelines for delineation of pelvic lymph nodes in anal cancer treatment].  

PubMed

Squamous cell anal cancer is a rare malignancy, its incidence increases due to higher exposure of the young adults to risk factors. The current management is based on chemoradiotherapy, which is highly effective and achieves locoregional control but causes important morbidity. Improvement of radiation technique such as intensity modulated radiation therapy has led to reduce acute toxicities, but also requires an accurate delineation of the target volumes in order not to underestimate potential and pathological sites resulting in an increase of the locoregional failures. PET scanner has an important place in the pretreatment work-up for staging and targeting the delineation of the volumes, allowing to select patients with localized disease, avoid geographic miss and appropriately boost nodal disease. The study of recurrences sites has not yet provided a real mapping of the recurrences depending on the treatment volumes. Different radiation oncologist cooperative groups have published guidelines and tools for delineation, in order to provide homogeneity but also customize the management of anal carcinoma. PMID:23993061

Vendrely, V; Galland-Girodet, S; Orré, M; Maire, J-P

2013-10-01

196

SEOM clinical guidelines for the diagnosis and treatment of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) 2014.  

PubMed

GEP-NENs are a challenging family of tumors of growing incidence and varied clinical management and behavior. Diagnostic techniques have substantially improved over the past decades and significant advances have been achieved in the understanding of the molecular pathways governing tumor initiation and progression. This has already translated into relevant advances in the clinic. This guideline aims to provide practical recommendations for the diagnosis and treatment of GEP-NENs. Diagnostic workup, histological and staging classifications, and the different available therapeutic approaches, including surgery, liver-directed ablative therapies, peptide receptor radionuclide therapy, and systemic hormonal, cytotoxic or targeted therapy, are briefly discussed in this manuscript. Clinical presentation (performance status, comorbidities, tumor-derived symptoms and hormone syndrome in functioning tumors), histological features [tumor differentiation, proliferation rate (Ki-67), and expression of somatostatin receptors], disease localization and extent, and resectability of primary and metastatic disease, are all key issues that shall be taken into consideration to appropriately tailor therapeutic strategies and surveillance of these patients. PMID:25183048

Garcia-Carbonero, R; JImenez-Fonseca, P; Teulé, A; Barriuso, J; Sevilla, I

2014-12-01

197

Guidelines for the diagnosis and treatment of adrenal insufficiency in the adult.  

PubMed

Adrenal insufficiency (AI) is a disease characterized by a deficient production or action of glucocorticoids, with or without deficiency in mineral corticoids and/or adrenal androgens. It can result from disease intrinsic to the adrenal cortex (primary AI), from pituitary diseases that hamper the release of corticotropin (secondary AI) or from hypothalamic disorders that impair the secretion of the corticotropin-releasing hormone (tertiary AI). It is a disease with a low prevalence but its impact on the affected individual is very high as it can be life-threathening if not treated or lead to health problems if inadequately treated. However, currently there are no specific guidelines for the management of this disease. Therefore, at the proposal of the Spanish Society of Endocrinology and Nutrition (SEEN) board, a task-force under the Neuroendocrinology Knowledge Area of the SEEN was established, with the mandate of updating the diagnosis and treatment of AI. In fulfilment of this mandate the task-force has elaborated the present guide that, based on a comprehensive review of literature, is intended to provide an answer to questions related to the management of this disease. It is, therefore, an essentially practical document, mainly aimed at guiding the health professionals involved in the care of IA patients. PMID:25128212

de Miguel Novoa, Paz; Vela, Elena Torres; García, Nuria Palacios; Rodríguez, Manuela Moreira; Guerras, Icíar Solache; Martínez de Salinas Santamaría, María de Los Ángeles; Masó, Anna Aulinas

2014-09-01

198

Treatment of bipolar disorder in the Netherlands and concordance with treatment guidelines: study protocol of an observational, longitudinal study on naturalistic treatment of bipolar disorder in everyday clinical practice  

PubMed Central

Background While various guidelines on the treatment of bipolar disorder have been published over the last decades, adherence to guidelines has been reported to be low. In this article we describe the protocol of a nationwide, multicenter, longitudinal, non-intervention study on the treatment of bipolar disorder in the Netherlands. Study aims are to provide information on the nature and content of outpatient treatment of bipolar disorder, to determine to what extent treatment is in concordance with the Dutch guideline for the treatment of bipolar disorder (2008), and to investigate the relationship of guideline concordance with symptomatic and functional outcome. Methods/Design Between December 2009 and February 2010, all psychiatrists registered as member of the Dutch Psychiatric Association received a questionnaire with questions about their treatment setting, and whether they would be willing to participate in further research. Psychiatrists treating adult outpatients with bipolar disorder were invited to participate. Consenting psychiatrist subsequently approached all their patients with bipolar disorder. The study is performed with written patient and caregiver surveys at baseline and after 12 months, including data on demographics, illness characteristics, organization of care, treatments received, symptomatic and functional outcome, quality of life, and burden of care for informal caregivers. Discussion This study will provide information on the naturalistic treatment of bipolar disorder in the Netherlands, as well as degree of concordance of this treatment with the Dutch guideline, and its relationship with symptomatic and functional outcome. Limitations of a survey-based study are discussed. PMID:24576061

2014-01-01

199

Spatial Analysis of Adherence to Treatment Guidelines for Advanced-Stage Ovarian Cancer and the Impact of Race and Socioeconomic Status  

PubMed Central

OBJECTIVE To determine the impact of geographic location on advanced-stage ovarian cancer care adherence to National Comprehensive Cancer Network (NCCN) guidelines in relation to race and socioeconomic status (SES). METHODS Patients diagnosed with Stage IIIC/IV epithelial ovarian cancer (1/1/96-12/31/06) were identified from the California Cancer Registry. Generalized additive models were created to assess the effect of spatial distributions of geographic location, proximity to a high-volume hospital (?20 cases/year), distance travelled to receive care, race, and SES on adherence to NCCN guidelines, with simultaneous smoothing of geographic location and adjustment for confounding variables. Disparities in geographic predictors of treatment adherence were analyzed with the ?2 test for equality of proportions. RESULTS Of the 11,770 patients identified, 45.4% were treated according to NCCN guidelines. Black race (OR=1.49, 95%CI=1.21-1.83), low-SES (OR=1.46, 95%CI=1.24-1.72), and geographic location ?80km/50mi from a high-volume hospital (OR=1.88, 95%CI=1.61-2.19) were independently associated with an increased risk of non-adherent care, while high-volume hospital treatment (OR=0.59, 95%CI=0.53-0.66) and travel distance to receive care ?32km/20mi (OR=0.80, 95%CI=0.69-0.92) were independently protective. SES was inversely associated with location ?80km/50mi from a high-volume hospital, ranging from 6.3% (high-SES) to 33.0% (low-SES) (p<0.0001). White patients were significantly more likely to travel ?32km/20mi to receive care (21.8%) compared to Blacks (14.4%), Hispanics (15.9%), and Asian/Pacific Islanders (15.5%) (p<0.0001). CONCLUSION Geographic proximity to a high-volume hospital and travel distance to receive treatment are independently associated with NCCN guideline adherent care for advanced-stage ovarian cancer. Geographic barriers to standard ovarian cancer treatment disproportionately affect racial minorities and women of low-SES. PMID:24680770

Bristow, Robert E.; Chang, Jenny; Ziogas, Argyrios; Anton-Culver, Hoda; Vieira, Veronica M.

2014-01-01

200

Have some guidelines for the treatment of acute bipolar depression gone too far in the restriction of antidepressants?  

Microsoft Academic Search

This paper gives a critical review of recommendations concerning the drug treatment of acute bipolar depression. The suggestions\\u000a of different guidelines and consensus papers, especially in US-American and Canadian psychiatry, have a strong tendency against\\u000a antidepressants in bipolar depression; they prefer mono-therapy with mood stabilizers and, in the case of co-medication with\\u000a mood stabilizers and antidepressants in severe depression, to

H.-J. Möller; H. Grunze

2000-01-01

201

National Healthcare Budget Impact Analysis of the Treatment for Osteoporosis and Fractures in Korea  

PubMed Central

Background This study was to determine the impact on the national healthcare expenditure for the treatment of osteoporosis and fractures if the coverage period for osteoporosis medication was extended from maximum a year to continuous period as required. Methods Preserving the current reimbursement guidelines, maximum one year's coverage for osteoporosis medication was set as scenario A. Continuous coverage for patients who require medication was set as scenario B. As costs of medical service utilization are paid by the Korean National Health Insurance Program, all items were investigated and analyzed from the payer's perspective. The combined treatment costs for osteoporosis and osteoporotic fractures were assessed for each scenario. Results Over five years the cost of osteoporosis medication in scenario A will increase from 184.3 billion KRW to 204.6 billion KRW. The cost of osteoporotic fracture treatment will increase from 1,037.3 billion KRW to 1,822.7 billion KRW. In scenario B, the cost of osteoporosis medication will increase from 209.5 billion KRW to 388.1 KRW. The cost of osteoporotic fracture treatment will increase from 600.0 billion KRW to 1,054.3 billion KRW. The result showed savings of 2.50 trillion KRW cumulatively for five years when reimbursement coverage for osteoporosis treatments is extended from one year to as long as it's clinically required. Conclusions This study demonstrates that effective osteoporosis management through appropriate insurance coverage for osteoporosis medication should be considered not only for the patient's viewpoint, but in terms of national insurance budget as well. PMID:24524051

Yi, Hwabok; Ha, Yong-Chan; Lee, Young-Kyun

2013-01-01

202

NATIONAL CONFERENCE ON MANAGEMENT AND TREATMENT OF CONTAMINATED SEDIMENTS: PROCEEDINGS  

EPA Science Inventory

The National Conference on Management and Treatment of Contaminated Sediment was held in Cincinnati, OH, May 13 to 14, 1997. This technology transfer meeting was held for 213 professionals from various EPA divisions and other organizations, including Environment Canada, the U.S. ...

203

Successful Waste Treatment Methods at Sandia National Laboratories  

Microsoft Academic Search

During the remediation of the waste landfills at Sandia National Laboratory in Albuquerque, New Mexico nine drums of mock high explosives were generated. This mixed waste stream was proposed to several offsite vendors for treatment and prices ranged from $2.50 to $10 per gram a total cost estimated to be in excess of $2 million dollars. This cost represents more

D. M. Rast; J. J. Thompson; T. W. Cooper; D. J Stockham

2007-01-01

204

Problem Gambling Treatment within the British National Health Service  

ERIC Educational Resources Information Center

According to the latest British Gambling Prevalence Survey, there are approximately 300,000 adult problem gamblers in Great Britain. In January 2007, the "British Medical Association" published a report recommending that those experiencing gambling problems should receive treatment via the National Health Service (NHS). This study examines the…

Rigbye, Jane; Griffiths, Mark D.

2011-01-01

205

A National Survey of Substance Abuse Treatment for Juvenile Offenders  

PubMed Central

Despite consensus about the value of substance abuse treatment for delinquent youth, information about its prevalence and availability is inadequate and inconsistent. This paper presents findings about treatment and other correctional service provision from a national survey of directors of 141 juvenile institutional and community corrections facilities. Educational/GED programming and drug and alcohol education were the most prevalent types of correctional and substance abuse services. Other common services included physical health services and mental health assessment, provided to about 60% of youth across facilities, and mental health counseling, life and communication skills, and anger management, provided to about half the youth. Substance abuse treatment, as with most other services, were more prevalent in large, state-funded residential facilities (where 66% provided treatment), than local detention centers (20%) and community corrections facilities (56%). More detailed data showed that the number of youth attending treatment in all types of facilities on any given day was very low. PMID:17383550

Young, Douglas W.; Dembo, Richard; Henderson, Craig E.

2008-01-01

206

Guidelines for the pharmacological treatment of peripheral neuropathic pain: expert panel recommendations for the middle East region.  

PubMed

Neuropathic pain (NeP) has been the focus of extensive basic and clinical research over the past 20 years. This has led to an increased understanding of underlying pathophysiological mechanisms and the development of new therapeutic agents, as well as a clearer definition of the role of established medications. To date there are no published treatment guidelines for NeP in the Middle East. A multidisciplinary panel of Middle East and international experts met to review critically and reach a consensus on how best to apply evidence-based guidelines for the treatment of NeP (mainly peripheral NeP) in the Middle East. The expert panel recommended pregabalin, gabapentin and secondary amine tricyclic antidepressants (nortriptyline and desipramine) as first-line treatments for peripheral NeP. Serotonin-norepinephrine reuptake inhibitor antidepressants, tramadol and controlled-release opioid analgesics were recommended as second-line treatments. There is a need to increase diagnostic awareness of NeP, use validated screening questionnaires and undertake more treatment research in the Middle East region. PMID:20515552

Bohlega, S; Alsaadi, T; Amir, A; Hosny, H; Karawagh, A M; Moulin, D; Riachi, N; Salti, A; Shelbaya, S

2010-01-01

207

Conformance to schizophrenia treatment guidelines in North West-Bank, Palestine: focus on antipsychotic dosing and polytherapy  

PubMed Central

Background Analysis of the prescribing patterns of antipsychotic drugs can improve therapeutic outcomes. The purpose of this study was to evaluate the prescribing pattern of antipsychotics and its conformance to international treatment guidelines. Methods A cross sectional study at primary psychiatric centers was carried out. Patients’ medical files were used to obtain demographic, medication and clinical information. International guidelines for schizophrenia were used to create conformance indicators. All statistical analyses were conducted using Statistical Package for Social Sciences. Results 250 patients were included in this study. A total of 406 antipsychotic agents were used; 348 (85.7%) were first generation antipsychotics (FGA). The prevalence of antipsychotic combination was 50.4% (n=126). There was no significant difference in positive (p=0.3), negative (p=0.06) and psychopathology (p=0.5) scores of schizophrenia symptoms among patients on monotherapy versus those on antipsychotic combination. Furthermore, no significant difference was observed in the annual cost of antipsychotic monotherapy versus combination therapy. One hundred and five patients (42%) were using optimum dose of (300 – 600 mg CPZeq) while the remaining were using sub or supra therapeutic doses. Analysis showed that use of depot, use of anticholinergic agents and increasing amount of total CPZeq were significant factors associated with antipsychotic combination. Conclusions This study indicated that antipsychotic prescribing was not in conformance with international guidelines with respect to maintenance dose and combination therapy. Type of antipsychotic treatment regimen, combination versus monotherapy, was not associated with better clinical or economic outcome. PMID:23816223

2013-01-01

208

Practical Guidelines for the Prevention, Diagnosis, and Treatment of Osteonecrosis of the Jaw in Patients With Cancer  

PubMed Central

Purpose This article discusses osteonecrosis of the jaw (ONJ) and offers health care professionals practical guidelines and recommendations for the prevention, diagnosis, and management of ONJ in cancer patients receiving bisphosphonate treatment. Methods A panel of experts representing oral and maxillofacial surgery, oral medicine, endocrinology, and medical oncology was convened to review the literature and clinical evidence, identify risk factors for ONJ, and develop clinical guidelines for the prevention, early diagnosis, and multidisciplinary treatment of ONJ in patients with cancer. The guidelines are based on experience and have not been evaluated within the context of controlled clinical trials. Results ONJ is a clinical entity with many possible etiologies; historically identified risk factors include corticosteroids, chemotherapy, radiotherapy, trauma, infection, and cancer. With emerging concern for potential development of ONJ in patients receiving bisphosphonates, the panel recommends a dental examination before patients begin therapy with intravenous bisphosphonates. Dental treatments and procedures that require bone healing should be completed before initiating intravenous bisphosphonate therapy. Patients should be instructed on the importance of maintaining good oral hygiene and having regular dental assessments. For patients currently receiving bisphosphonates who require dental procedures, there is no evidence to suggest that interrupting bisphosphonate therapy will prevent or lower the risk of ONJ. Frequent clinical assessments and conservative dental management are suggested for these patients. For treatment of patients who develop ONJ, a conservative, nonsurgical approach is strongly recommended. Conclusion An increased awareness of the potential risk of ONJ in patients receiving bisphosphonate therapy is needed. Close coordination between the treating physician and oral surgeon and/or a dental specialist is strongly recommended in making treatment decisions. PMID:20871729

Ruggiero, Salvatore; Gralow, Julie; Marx, Robert E.; Hoff, Ana O.; Schubert, Mark M.; Huryn, Joseph M.; Toth, Bela; Damato, Kathryn; Valero, Vicente

2006-01-01

209

Australian consensus guidelines for the safe handling of monoclonal antibodies for cancer treatment by healthcare personnel.  

PubMed

These consensus guidelines provide recommendations for the safe handling of monoclonal antibodies. Definitive recommendations are given for the minimum safe handling requirements to protect healthcare personnel. The seven recommendations cover: (i) appropriate determinants for evaluating occupational exposure risk; (ii) occupational risk level compared with other hazardous and non-hazardous drugs; (iii) stratification of risk based on healthcare personnel factors; (iv) waste products; (v) interventions and safeguards; (vi) operational and clinical factors and (vii) handling recommendations. The seventh recommendation includes a risk assessment model and flow chart for institutions to consider and evaluate clinical and operational factors unique to individual healthcare services. These guidelines specifically evaluated monoclonal antibodies used in the Australian cancer clinical practice setting; however, the principles may be applicable to monoclonal antibodies used in non-cancer settings. The guidelines are only applicable to parenterally administered agents. PMID:25302720

Alexander, M; King, J; Bajel, A; Doecke, C; Fox, P; Lingaratnam, S; Mellor, J D; Nicholson, L; Roos, I; Saunders, T; Wilkes, J; Zielinski, R; Byrne, J; MacMillan, K; Mollo, A; Kirsa, S; Green, M

2014-10-01

210

Guidelines for the diagnosis and treatment of cobalamin and folate disorders.  

PubMed

The clinical picture is the most important factor in assessing the significance of test results assessing cobalamin status because there is no 'gold standard' test to define deficiency. Serum cobalamin currently remains the first-line test, with additional second-line plasma methylmalonic acid to help clarify uncertainties of underlying biochemical/functional deficiencies. Serum holotranscobalamin has the potential as a first-line test, but an indeterminate 'grey area' may still exist. Plasma homocysteine may be helpful as a second-line test, but is less specific than methylmalonic acid. The availability of these second-line tests is currently limited. Definitive cut-off points to define clinical and subclinical deficiency states are not possible, given the variety of methodologies used and technical issues, and local reference ranges should be established. In the presence of discordance between the test result and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment. Treatment of cobalamin deficiency is recommended in line with the British National Formulary. Oral therapy may be suitable and acceptable provided appropriate doses are taken and compliance is not an issue. Serum folate offers equivalent diagnostic capability to red cell folate and is the first-line test of choice to assess folate status. PMID:24942828

Devalia, Vinod; Hamilton, Malcolm S; Molloy, Anne M

2014-08-01

211

Guidelines for national human immunodeficiency virus case surveillance, including monitoring for human immunodeficiency virus infection and acquired immunodeficiency syndrome. Centers for Disease Control and Prevention.  

PubMed

CDC recommends that all states and territories conduct case surveillance for human immunodeficiency virus (HIV) infection as an extension of current acquired immunodeficiency syndrome (AIDS) surveillance activities. The expansion of national surveillance to include both HIV infection and AIDS cases is a necessary response to the impact of advances in antiretroviral therapy, the implementation of new HIV treatment guidelines, and the increased need for epidemiologic data regarding persons at all stages of HIV disease. Expanded surveillance will provide additional data about HIV-infected populations to enhance local, state, and federal efforts to prevent HIV transmission, improve allocation of resources for treatment services, and assist in evaluating the impact of public health interventions. CDC will provide technical assistance to all state and territorial health departments to continue or establish HIV and AIDS case surveillance systems and to evaluate the performance of their surveillance programs. This report includes a revised case definition for HIV infection in adults and children, recommended program practices, and performance and security standards for conducting HIV/AIDS surveillance by local, state, and territorial health departments. The revised surveillance case definition and associated recommendations become effective January 1, 2000. PMID:10632297

1999-12-10

212

Use of cost-effectiveness data in priority setting decisions: experiences from the national guidelines for heart diseases in Sweden  

PubMed Central

Background: The inclusion of cost-effectiveness data, as a basis for priority setting rankings, is a distinguishing feature in the formulation of the Swedish national guidelines. Guidelines are generated with the direct intent to influence health policy and support decisions about the efficient allocation of scarce healthcare resources. Certain medical conditions may be given higher priority rankings i.e. given more resources than others, depending on how serious the medical condition is. This study investigated how a decision-making group, the Priority Setting Group (PSG), used cost-effectiveness data in ranking priority setting decisions in the national guidelines for heart diseases. Methods: A qualitative case study methodology was used to explore the use of such data in ranking priority setting healthcare decisions. The study addressed availability of cost-effectiveness data, evidence understanding, interpretation difficulties, and the reliance on evidence. We were also interested in the explicit use of data in ranking decisions, especially in situations where economic arguments impacted the reasoning behind the decisions. Results: This study showed that cost-effectiveness data was an important and integrated part of the decision-making process. Involvement of a health economist and reliance on the data facilitated the use of cost-effectiveness data. Economic arguments were used both as a fine-tuning instrument and a counterweight for dichotomization. Cost-effectiveness data were used when the overall evidence base was weak and the decision-makers had trouble making decisions due to lack of clinical evidence and in times of uncertainty. Cost-effectiveness data were also used for decisions on the introduction of new expensive medical technologies. Conclusion: Cost-effectiveness data matters in decision-making processes and the results of this study could be applicable to other jurisdictions where health economics is implemented in decision-making. This study contributes to knowledge on how cost-effectiveness data is used in actual decision-making, to ensure that the decisions are offered on equal terms and that patients receive medical care according their needs in order achieve maximum benefit.

Eckard, Nathalie; Janzon, Magnus; Levin, Lars-Ake

2014-01-01

213

[Summary of the practice guideline for the diagnosis and treatment of ADHD in adolescents and adults with addictions].  

PubMed

Various guidelines are available for the diagnosis and treatment of ADHD in adults, but not for patients with ADHD and a comorbid substance use disorder (SUD). In 2010, the Addiction Medicine Working Party, a division of the VAD (Verenigingvoor Alcohol- en andere Drugproblemen/Association for Alcohol and other Drug Problems) developed a practice guideline on how, when and by whom ADHD can be diagnosed in patients with an addiction, and how these patients should be treated. Given the high prevalence of ADHD in treatment-seeking SUD patients and the availability of valid screening instruments, all SUD patients should be screened for ADHD as soon as their drug use has stabilized. Acquiring information from external sources as well as clinical observation and questionnaires are important tools for the establishment of the diagnosis of ADHD. Integrated treatment primarily includes psycho-education, coaching and cognitive behavioural therapy in addition to pharmacotherapy. Evidence-based treatments for addiction may also be effective in patients with concomitant ADHD, provided the methods are adapted to the limitations that are associated with this condition. PMID:23759179

Matthys, Frieda; Joostens, Peter; van den Brink, Wim; Sabbe, Bernard

2013-01-01

214

Community Rehabilitation: "Home versus Centre" Guidelines for Choosing the Optimal Treatment Location  

ERIC Educational Resources Information Center

This study aimed to produce indicators and guidelines for clinician use in determining whether individual therapy sessions for community rehabilitation services should be delivered in a home/community-based setting or centre-based setting within a flexible service delivery model. Concept mapping techniques as described by Tochrim and Kane (2005)…

Barker, Lauren N.; Ziino, Carlo

2010-01-01

215

The Diagnosis and Treatment of Heel Pain: A Clinical Practice Guideline–Revision 2010  

Microsoft Academic Search

Heel pain, whether plantar or posterior, is predominantly a mechanical pathology although an array of diverse pathologies including neurologic, arthritic, traumatic, neoplastic, infectious, or vascular etiologies must be considered. This clinical practice guideline (CPG) is a revision of the original 2001 document developed by the American College of Foot and Ankle Surgeons (ACFAS) heel pain committee.

James L. Thomas; Jeffrey C. Christensen; Steven R. Kravitz; Robert W. Mendicino; John M. Schuberth; John V. Vanore; Lowell Scott Weil Sr.; Howard J. Zlotoff; Richard Bouché; Jeffrey Baker

2010-01-01

216

Increasing Physicians' and Nurses' Compliance with Treatment Guidelines in Cancer Care Program.  

ERIC Educational Resources Information Center

The effect of the use of guidelines on the care of patients with breast, colon, and non-small-cell lung cancers is reported. Audits of patient records revealed an increase over time in the percentage of recommended cancer care procedures that were complied with. (Author/MLW)

Slenker, Suzanne E.; And Others

1985-01-01

217

Magnetic resonance imaging in monitoring the treatment of multiple sclerosis: concerted action guidelines  

Microsoft Academic Search

Serial gadolinium enhanced MRI of the brain detects much clinically silent disease activity in early relapsing-remitting and secondary progressive multiple sclerosis (MS), and thus has an important role in monitoring the effects of therapy. Based on the proceedings of a recent Commission of the European Communities (CEC) workshop and a review of the literature, guidelines are presented for using MRI

D H Miller; F Barkhof; I Berry; L Kappos; G Scotti; A J Thompson

1991-01-01

218

National and State Estimates of the Drug Abuse Treatment Gap: 2000 National Household Survey on Drug Abuse.  

ERIC Educational Resources Information Center

This report presents information from the 2000 National Household Survey on Drug Abuse (NHSDA) on the number and percentage of the population in the nation and in each state who need but did not receive treatment for an illicit drug use problem, referred to as the treatment gap. Following the introduction, chapter 2 presents national estimates of…

Research Triangle Inst., Research Triangle Park, NC.

219

Directrices para la Creacion del Centro Nacional de Informacion y Documentacion (Guidelines for the Creation of a National Information and Documentation Center).  

ERIC Educational Resources Information Center

This document discusses background information and guidelines for the creation of a national information and documentation center for the dissemination of scientific and technological information. The study first reports on information services in several other countries and the need for an information center in Venezuela; included are…

Menda Behrens, Eduardo

220

Connecting Marketing and Implementation Research and Library Program Development: A Case Study of the Implementation of [U.S.] National Guidelines and Standards.  

ERIC Educational Resources Information Center

This case study examined: (1) what market research is required for planning for the implementation of "Information Power: Building Partnerships for Learning," the 1998 national guidelines for effective school library media programs; (2) what issues need to be addressed and what target audiences are required to effect change, as well as how these…

Haycock, Ken; Cavill, Pat

221

The Child's Right To Grow Up in a Family: Guidelines for Practice on National and Intercountry Adoption and Foster Family Care.  

ERIC Educational Resources Information Center

This document (also in Spanish, Portuguese, and Russian language versions) provides guidelines for practice on national and intercountry adoption and foster family care, developed under the aegis of the International Council on Social Welfare and incorporating the work of over 200 practitioners, experts, and government officials representing…

Nayak, Nina P.

222

Scrutinising NICE: The impact of the National Institute for Health and Clinical Excellence Guidelines on the provision of counselling and psychotherapy in primary care in the UK  

Microsoft Academic Search

This article explores the key assumptions that underpin the National Institute for Health and Clinical Excellence's (NICE) approach to guideline development and describes how those assumptions have led to the current reduction in the range of available therapies in primary care. This reduction, it is argued, conflicts with the government's recent commitment to increase patient choice. It is suggested that

Anne Guy; Del Loewenthal; Rhiannon Thomas; Sue Stephenson

2012-01-01

223

KDOQI Hypertension, Dyslipidemia, and Diabetes Care Guidelines and Current Care Patterns in the United States CKD Population: National Health and Nutrition Examination Survey 1999–2004  

Microsoft Academic Search

Background\\/Aims: National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines aim to slow chronic kidney disease (CKD) progression and reduce morbidity and mortality. This study aimed to assess current CKD population health and adherence to recommendations in National Health and Nutrition Examination Survey 1999–2004 participants aged ?20 years (n = 14,213). Methods: We assessed hypertension and dyslipidemia management and

Jon J. Snyder; Allan J. Collins

2009-01-01

224

Characteristics and Programme-Defined Treatment Outcomes among Childhood Tuberculosis (TB) Patients under the National TB Programme in Delhi  

PubMed Central

Background Childhood tuberculosis (TB) patients under India's Revised National TB Control Programme (RNTCP) are managed using diagnostic algorithms and directly observed treatment with intermittent thrice-weekly short-course treatment regimens for 6–8 months. The assignment into pre-treatment weight bands leads to drug doses (milligram per kilogram) that are lower than current World Health Organization (WHO) guidelines for some patients. Objectives The main aim of our study was to describe the baseline characteristics and treatment outcomes reported under RNTCP for registered childhood (age <15 years) TB patients in Delhi. Additionally, we compared the reported programmatic treatment completion rates between children treated as per WHO recommended anti-TB drug doses with those children treated with anti-TB drug doses below that recommended in WHO guidelines. Methods For this cross-sectional retrospective study, we reviewed programme records of all 1089 TB patients aged <15 years registered for TB treatment from January to June, 2008 in 6 randomly selected districts of Delhi. WHO disease classification and treatment outcome definitions are used by RNTCP, and these were extracted as reported in programme records. Results and Conclusions Among 1074 patients with records available, 651 (61%) were females, 122 (11%) were <5 years of age, 1000 (93%) were new cases, and 680 (63%) had extra-pulmonary TB (EP-TB)—most commonly peripheral lymph node disease [310 (46%)]. Among 394 pulmonary TB (PTB) cases, 165 (42%) were sputum smear-positive. The overall reported treatment completion rate was 95%. Similar reported treatment completion rates were found in all subgroups assessed, including those patients whose drug dosages were lower than that currently recommended by WHO. Further studies are needed to assess the reasons for the low proportion of under-5 years of age TB case notifications, address challenges in reaching all childhood TB patients by RNTCP, the accuracy of diagnosis, and the clinical validity of reported programme defined treatment completion. PMID:20967279

Satyanarayana, Srinath; Shivashankar, Roopa; Vashist, Ram Pal; Chauhan, Lakhbir Singh; Chadha, Sarabjit Singh; Dewan, Puneet Kumar; Wares, Fraser; Sahu, Suvanand; Singh, Varinder; Wilson, Nevin Charles; Harries, Anthony David

2010-01-01

225

Quality assessment of clinical practice guidelines for the prevention and treatment of childhood overweight and obesity  

Microsoft Academic Search

Background  The prevalence of childhood overweight and obesity is increasing at dramatic rates in children and adolescents worldwide.\\u000a Clinical practice guidelines (CPGs) are “systematically developed statements to assist practitioner and patient decisions\\u000a about appropriate health care for specific clinical circumstances.” Their objective is to provide explicit recommendations\\u000a for clinical practice based on current evidence for best practice in the management of

Mario Delgado-Noguera; Sera Tort; Xavier Bonfill; Ignasi Gich; Pablo Alonso-Coello

2009-01-01

226

Breaking new ground: challenging existing asthma guidelines  

PubMed Central

Background While we have international guidelines and various national guidelines for asthma diagnosis and management, asthma remains poorly controlled in many children and adults. In this paper we review the limitations of current asthma guidelines and describe important issues and remaining questions regarding asthma guidelines for use, particularly in primary care. Discussion Clinical practice guidelines based on evidence from randomized controlled trials are considered the most rigorous and accurate. Current evidence-based guidelines are written predominantly from the perspective of the patient with a clear-cut asthma diagnosis, however, and tend not to consider the heterogeneity of asthma or to accommodate individual patient variations in response to treatment or their needs, differences in practice settings, or local differences in availability and cost of therapies. The results of randomized controlled trials, which are designed to establish efficacy of treatment under ideal conditions, may not apply to 'real-world' clinical practice, where patients are unselected, monitoring is less frequent, and effectiveness – the benefit of treatment in routine clinical practice – is the most relevant outcome. Moreover, most guidelines see asthma in isolation rather than considering other factors that may impact on asthma and response to asthma therapy, particularly age, allergic rhinitis, cigarette smoking, adherence, and genetic factors. When these links are recognized, guidelines rarely provide practical recommendations for treatment in these scenarios. Finally, there is some evidence that general practitioners are not convinced of the applicability of asthma guidelines to their practice settings, especially when those writing the guidelines principally work in specialist practice. Conclusion Developing country-specific guidelines or, ideally, local guidelines could provide more practical solutions for asthma care and could account for regional factors that influence patient choice and adherence to therapy. Pragmatic clinical trials and well-designed observational trials are needed in addition to randomized controlled trials to assess real-world effectiveness of therapies, and such evidence needs also to be considered by guideline writers. Finally, practical tools to facilitate the diagnosis and assessment of asthma and factors responsible for poor control, such as associated allergic rhinitis, limited adherence, and smoking behavior, are needed to supplement treatment information provided in clinical practice guidelines for asthma. PMID:17140424

2006-01-01

227

Data from the National Drug and Alcoholism Treatment Utilization Survey (NDATUS).  

National Technical Information Service (NTIS)

This report presents data on drug abuse treatment facilities derived from the National Drug and Alcoholism Treatment Utilization Survey (NDATUS) conducted in April 1979. The 1979 NDATUS was the most recent in a series of national surveys designed to measu...

1979-01-01

228

Quality Assessment of Physical Activity Recommendations Within Clinical Practice Guidelines for the Prevention and Treatment of Cardio-metabolic Risk Factors in People With Schizophrenia  

Microsoft Academic Search

The aim of this review was to assess the quality of physical activity recommendations within clinical practice guidelines\\u000a for the prevention and treatment of the cardio-metabolic risk factors in schizophrenia. Several databases were searched from\\u000a their inception through July 2010. The Appraisal of Guidelines for Research and Evaluation instrument was used for the quality\\u000a assessment. Twelve recommendations met all the

Davy Vancampfort; Kim Sweers; Michel Probst; Alex J. Mitchell; Jan Knapen; Marc De Hert

229

Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: Pregnancy in pulmonary hypertension  

PubMed Central

Pregnancy in pulmonary hypertension (PH) is known to be associated with high morbidity and mortality. The physiological changes occur during normal pregnancy, such as increase blood volume and cardiac output (CO) may be detrimental in PH patients. Several practice guidelines advise against pregnancy and even recommend termination of pregnancy. Occasionally PH may be diagnosed for the first time during pregnancy, as stress of pregnancy can unmask previously undiagnosed PH in an asymptomatic individual. This narrative review provides a detailed discussion about the physiologic parameters associated in pregnancy and their negative effect on the right ventricle. It also gives practical evidence-based recommendations about different management issues in PH pregnant patients. PMID:25076988

Khan, Javed; Idrees, Majdy M.

2014-01-01

230

Assessing adherence to accepted national guidelines for immigrant and refugee screening and vaccines in an urban primary care practice: a retrospective chart review.  

PubMed

In the United States, 38.5 million people are foreign-born, one in three arriving since 2000. Health issues include high rates of hepatitis B, humanimmunodeficiency virus infection, parasitic infections, and M. tuberculosis. We sought to determine rates of provider adherence to accepted national guidelines for immigrant and refugee health screening and vaccines done at the primary care clinics at Boston Medical Center. Randomized, retrospective chart review of foreign born patients in the primary care clinics. We found low screening and immunization rates that do not conform to CDC/ACIP guidelines. Only 43 % of immigrant patients had tuberculosis screening, 36 % were screened for HIV and hepatitis B, and 33 % received tetanus vaccinations. Organizational changes incorporating multi-disciplinary approaches such as creative use of nursing staff, protocols, standing orders, EMR reminders, and web based educational tools can contribute to better outcomes by identifying patients and improving utilization of guidelines. PMID:23512323

Waldorf, Barbara; Gill, Christopher; Crosby, Sondra S

2014-10-01

231

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

PubMed

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

Ogasawara, Kazuyoshi; Ozaki, Norio

2012-10-01

232

Guidelines for field triage of injured patients. Recommendations of the National Expert Panel on Field Triage.  

PubMed

In the United States, injury is the leading cause of death for persons aged 1--44 years, and the approximately 800,000 emergency medical services (EMS) providers have a substantial impact on the care of injured persons and on public health. At an injury scene, EMS providers determine the severity of injury, initiate medical management, and identify the most appropriate facility to which to transport the patient through a process called "field triage." Although basic emergency services generally are consistent across hospital emergency departments (EDs), certain hospitals have additional expertise, resources, and equipment for treating severely injured patients. Such facilities, called "trauma centers," are classified from Level I (centers providing the highest level of trauma care) to Level IV (centers providing initial trauma care and transfer to a higher level of trauma care if necessary) depending on the scope of resources and services available. The risk for death of a severely injured person is 25% lower if the patient receives care at a Level I trauma center. However, not all patients require the services of a Level I trauma center; patients who are injured less severely might be served better by being transported to a closer ED capable of managing milder injuries. Transferring all injured patients to Level I trauma centers might overburden the centers, have a negative impact on patient outcomes, and decrease cost effectiveness. In 1986, the American College of Surgeons developed the Field Triage Decision Scheme (Decision Scheme), which serves as the basis for triage protocols for state and local EMS systems across the United States. The Decision Scheme is an algorithm that guides EMS providers through four decision steps (physiologic, anatomic, mechanism of injury, and special considerations) to determine the most appropriate destination facility within the local trauma care system. Since its initial publication in 1986, the Decision Scheme has been revised four times. In 2005, with support from the National Highway Traffic Safety Administration, CDC began facilitating revision of the Decision Scheme by hosting a series of meetings of the National Expert Panel on Field Triage, which includes injury-care providers, public health professionals, automotive industry representatives, and officials from federal agencies. The Panel reviewed relevant literature, presented its findings, and reached consensus on necessary revisions. The revised Decision Scheme was published in 2006. This report describes the process and rationale used by the Expert Panel to revise the Decision Scheme. PMID:19165138

Sasser, Scott M; Hunt, Richard C; Sullivent, Ernest E; Wald, Marlena M; Mitchko, Jane; Jurkovich, Gregory J; Henry, Mark C; Salomone, Jeffrey P; Wang, Stewart C; Galli, Robert L; Cooper, Arthur; Brown, Lawrence H; Sattin, Richard W

2009-01-23

233

Addition of high-risk HPV testing improves the current guidelines on follow-up after treatment for cervical intraepithelial neoplasia  

Microsoft Academic Search

We assessed a possible role for high-risk human papillomavirus (HPV) testing in the policy after treatment for cervical intraepithelial neoplasia (CIN) 2 or 3 (moderate to severe dysplasia). According to the Dutch guidelines follow-up after treatment consists of cervical cytology at 6, 12 and 24 months. Colposcopy is only performed in case of abnormal cervical cytology. In this observational study

M A E Nobbenhuis; C J L M Meijer; A J C van den Brule; L Rozendaal; F J Voorhorst; E K J Risse; R H M Verheijen; T J M Helmerhorst

2001-01-01

234

Guidelines for Hanford Site implementation of the National Environmental Policy Act  

SciTech Connect

The National Environmental Policy Act (NEPA) environmental review process is mandatory for federal agencies. Understanding and complying with NEPA is extremely important to successfully planning and implementing programs at the Hanford Site. This report is intended to help planners and decision makers understand NEPA by describing the NEPA process as it is outlined in NEPA, in regulations, and in guidance information. The requirements and guidance documents that set forth the NEPA process are discussed. Some of the major NEPA concepts and issues are also addressed. This report is intended to be used as a general road map through the maze of NEPA requirements and guidance to ensure that Hanford Site activities are conducted in compliance with NEPA. Enhanced knowledge of the NEPA process is expected to increase the ability of the Hanford Site to work with regulators, interested parties and the public to ensure that the potential environmental impacts of DOE activities are fully considered at the Hanford Site. In addition, an enhanced understanding of NEPA will help project and program managers to integrate NEPA compliance requirements with program planning. 43 refs., 6 figs., 3 tabs.

King, S.E.

1989-03-01

235

National assessment of early elementary teachers perceived self-efficacy for teaching tobacco prevention based on the CDC guidelines.  

PubMed

A national random sample of 505 early elementary school teachers completed a 47-item survey to determine their perceived self-efficacy for teaching tobacco prevention education based on the Centers for Disease Control and Prevention guidelines for grades K-3, their training status on tobacco prevention, and their level of teaching about tobacco prevention. Results indicated most of the teachers were female, White, held a bachelor's or master's degree, never smoked, and had not received formal tobacco prevention training. The teachers' scores were high for efficacy expectations, and for outcome expectations. Conversely, for outcome value, teachers ranked tobacco prevention fifth out of six health topics, as the most important health topic to teach elementary students. Also, teachers trained in four tobacco areas or more had statistically significantly higher scores for efficacy expectations than those trained in three or fewer areas. Statistically significant positive associations were also found between years of teaching tobacco prevention and efficacy and outcome expectation scores, and between the amount of time that tobacco prevention was taught during the past school year and outcome value. PMID:9425611

Perry-Casler, S M; Price, J H; Telljohann, S K; Chesney, B K

1997-10-01

236

Diabetes guidelines may delay timely adjustments during treatment and might contribute to clinical inertia.  

PubMed

Abstract Clinical inertia and poor knowledge by many physicians play an important role in delaying diabetes control. Among other guidelines, the Position Statement of the American Diabetes Association/European Association for the Study of Diabetes on Management of Hyperglycemia in Type 2 Diabetes is a respected guideline with high impact on this subject in terms of influencing physicians in the definition of strategic approach to overcome poor glycemic control. But, on the other hand, it carries a recommendation that might contribute to clinical inertia because it can delay the needed implementation of more vigorous, intensive, and effective strategies to overcome poor glycemic control within a reasonable time frame during the evolution of the disease. The same is true with other respected algorithms from different diabetes associations. Together with pharmacological interventions, diabetes education and more intensive blood glucose monitoring in the initial phases after the diagnosis are key strategies for the effective control of diabetes. The main reason why a faster glycemic control should be implemented in an effective and safe way is to boost the confidence and the compliance of the patient to the recommendations of the diabetes care team. Better and faster results in glycemic control can only be safely achieved with educational strategies, structured self-monitoring of blood glucose, and adequate pharmacological therapy in the majority of cases. PMID:24892463

Pimazoni-Netto, Augusto; Zanella, Maria Teresa

2014-11-01

237

Diabetes Guidelines May Delay Timely Adjustments During Treatment and Might Contribute to Clinical Inertia  

PubMed Central

Abstract Clinical inertia and poor knowledge by many physicians play an important role in delaying diabetes control. Among other guidelines, the Position Statement of the American Diabetes Association/European Association for the Study of Diabetes on Management of Hyperglycemia in Type 2 Diabetes is a respected guideline with high impact on this subject in terms of influencing physicians in the definition of strategic approach to overcome poor glycemic control. But, on the other hand, it carries a recommendation that might contribute to clinical inertia because it can delay the needed implementation of more vigorous, intensive, and effective strategies to overcome poor glycemic control within a reasonable time frame during the evolution of the disease. The same is true with other respected algorithms from different diabetes associations. Together with pharmacological interventions, diabetes education and more intensive blood glucose monitoring in the initial phases after the diagnosis are key strategies for the effective control of diabetes. The main reason why a faster glycemic control should be implemented in an effective and safe way is to boost the confidence and the compliance of the patient to the recommendations of the diabetes care team. Better and faster results in glycemic control can only be safely achieved with educational strategies, structured self-monitoring of blood glucose, and adequate pharmacological therapy in the majority of cases. PMID:24892463

Zanella, Maria Teresa

2014-01-01

238

ADHERENCE TO TREATMENT GUIDELINES FOR THE PREVENTION OF MOTHER-TO-CHILD HIV TRANSMISSION IN KENYA  

E-print Network

Access to the most effective treatments is not universal and treatment coverage for the prevention of mother-to-child transmission (PMTCT) is still low in many countries, including Kenya (WHO, 2010a). To improve uptake of ...

Clark, Kristine Frances

2012-12-31

239

EBMPracticeNet: A Bilingual National Electronic Point-Of-Care Project for Retrieval of Evidence-Based Clinical Guideline Information and Decision Support  

PubMed Central

Background In Belgium, the construction of a national electronic point-of-care information service, EBMPracticeNet, was initiated in 2011 to optimize quality of care by promoting evidence-based decision-making. The collaboration of the government, health care providers, evidence-based medicine (EBM) partners, and vendors of electronic health records (EHR) is unique to this project. All Belgian health care professionals get free access to an up-to-date database of validated Belgian and nearly 1000 international guidelines, incorporated in a portal that also provides EBM information from other sources than guidelines, including computerized clinical decision support that is integrated in the EHRs. Objective The objective of this paper was to describe the development strategy, the overall content, and the management of EBMPracticeNet which may be of relevance to other health organizations creating national or regional electronic point-of-care information services. Methods Several candidate providers of comprehensive guideline solutions were evaluated and one database was selected. Translation of the guidelines to Dutch and French was done with translation software, post-editing by translators and medical proofreading. A strategy is determined to adapt the guideline content to the Belgian context. Acceptance of the computerized clinical decision support tool has been tested and a randomized controlled trial is planned to evaluate the effect on process and patient outcomes. Results Currently, EBMPracticeNet is in "work in progress" state. Reference is made to the results of a pilot study and to further planned research including a randomized controlled trial. Conclusions The collaboration of government, health care providers, EBM partners, and vendors of EHRs is unique. The potential value of the project is great. The link between all the EHRs from different vendors and a national database held on a single platform that is controlled by all EBM organizations in Belgium are the strengths of EBMPracticeNet. PMID:23842038

2013-01-01

240

Development of guidelines for the aesthetic surface treatment of safety-shaped median barriers  

E-print Network

Safety-shaped median barriers have long been employed to keep misguided vehicles on the roadway. In recent years there has been a growing national desire for more aesthetically pleasing roadside safety systems. Adding surface texture is one...

Ness, Jacob Raymond

2004-11-15

241

Canadian guidelines for the evidence-based treatment of tic disorders: behavioural therapy, deep brain stimulation, and transcranial magnetic stimulation.  

PubMed

This clinical guideline provides recommendations for nonpharmacological treatments for tic disorders. We conducted a systematic literature search for clinical trials on the treatment of tics. One evidence-based review (including 30 studies) and 3 studies on behavioural interventions, 3 studies on deep brain stimulation (DBS), and 3 studies on transcranial magnetic stimulation (TMS) met our inclusion criteria. Based on this evidence, we have made strong recommendations for the use of habit reversal therapy and exposure and response prevention, preferably embedded within a supportive, psychoeducational program, and with the option to combine either of these approaches with pharmacotherapy. Although evidence exists for the efficacy of DBS, the quality of this evidence is poor and the risks and burdens of the procedure are finely balanced with the perceived benefits. Our recommendation is that this intervention continues to be considered an experimental treatment for severe, medically refractory tics that have imposed severe limitations on quality of life. We recommend that the procedure should only be performed within the context of research studies and by physicians expert in DBS programming and in the management of tics. There is no evidence to support the use of TMS in the treatment of tics. However, the procedure is associated with a low rate of known complications and could continue to be evaluated within research protocols. The recommendations we provide are based on current knowledge, and further studies may result in their revision in future. PMID:22398000

Steeves, Thomas; McKinlay, B Duncan; Gorman, Daniel; Billinghurst, Lori; Day, Lundy; Carroll, Alan; Dion, Yves; Doja, Asif; Luscombe, Sandra; Sandor, Paul; Pringsheim, Tamara

2012-03-01

242

Development of site-specific sediment quality guidelines for North and South Atlantic littoral zones: Comparison against national and international sediment quality benchmarks  

Microsoft Academic Search

We aimed to develop site-specific sediment quality guidelines (SQGs) for two estuarine and port zones in Southeastern Brazil (Santos Estuarine System and Paranaguá Estuarine System) and three in Southern Spain (Ría of Huelva, Bay of Cádiz, and Bay of Algeciras), and compare these values against national and traditionally used international benchmark values. Site-specific SQGs were derived based on sediment physical–chemical,

R. B. Choueri; A. Cesar; D. M. S. Abessa; R. J. Torres; R. D. Morais; I. Riba; C. D. S. Pereira; M. R. L. Nascimento; A. A. Mozeto; T. A. DelValls

2009-01-01

243

Development of Guidelines for Alternative Treatment of Dropoffs and Investigation of the Need for Separate Pay Items.  

National Technical Information Service (NTIS)

Various highway construction activities result in dropoffs at the pavement/should interface. This research provided for a review of existing guidelines for dropoffs and the development of proposed revision of dropoff guidelines. A goal was to simplify cur...

R. D. Ellis, L. Jones, J. D. Degner

1996-01-01

244

UVA Department of Student Health Medical Guideline for Outpatient Treatment of Eating Disorders  

E-print Network

's academic dean. Parental notification is required by law if a lifethreatening state is present; otherwise, parent #12;involvement in treatment is only made if the student and treatment team decide parental weight, height, blood pressure, pulse. Additional studies, if indicated, will include an EKG, DEXA bone

Acton, Scott

245

Breaking new ground: challenging existing asthma guidelines  

Microsoft Academic Search

BACKGROUND: While we have international guidelines and various national guidelines for asthma diagnosis and management, asthma remains poorly controlled in many children and adults. In this paper we review the limitations of current asthma guidelines and describe important issues and remaining questions regarding asthma guidelines for use, particularly in primary care. DISCUSSION: Clinical practice guidelines based on evidence from randomized

David Price; Mike Thomas

2006-01-01

246

Guideline for diagnosis and treatment of subacromial pain syndrome: a multidisciplinary review by the Dutch Orthopaedic Association.  

PubMed

Treatment of "subacromial impingement syndrome" of the shoulder has changed drastically in the past decade. The anatomical explanation as "impingement" of the rotator cuff is not sufficient to cover the pathology. "Subacromial pain syndrome", SAPS, describes the condition better. A working group formed from a number of Dutch specialist societies, joined by the Dutch Orthopedic Association, has produced a guideline based on the available scientific evidence. This resulted in a new outlook for the treatment of subacromial pain syndrome. The important conclusions and advice from this work are as follows: (1) The diagnosis SAPS can only be made using a combination of clinical tests. (2) SAPS should preferably be treated non-operatively. (3) Acute pain should be treated with analgetics if necessary. (4) Subacromial injection with corticosteroids is indicated for persistent or recurrent symptoms. (5) Diagnostic imaging is useful after 6 weeks of symptoms. Ultrasound examination is the recommended imaging, to exclude a rotator cuff rupture. (6) Occupational interventions are useful when complaints persist for longer than 6 weeks. (7) Exercise therapy should be specific and should be of low intensity and high frequency, combining eccentric training, attention to relaxation and posture, and treatment of myofascial trigger points (including stretching of the muscles) may be considered. (8) Strict immobilization and mobilization techniques are not recommended. (9) Tendinosis calcarea can be treated by shockwave (ESWT) or needling under ultrasound guidance (barbotage). (10) Rehabilitation in a specialized unit can be considered in chronic, treatment resistant SAPS, with pain perpetuating behavior. (11) There is no convincing evidence that surgical treatment for SAPS is more effective than conservature management. (12) There is no indication for the surgical treatment of asymptomatic rotator cuff tears. PMID:24847788

Diercks, Ron; Bron, Carel; Dorrestijn, Oscar; Meskers, Carel; Naber, René; de Ruiter, Tjerk; Willems, Jaap; Winters, Jan; van der Woude, Henk Jan

2014-06-01

247

Clinical practice guidelines for the prevention, diagnosis, evaluation and treatment of mineral and bone disorders in chronic kidney disease (CKD-MBD) in adults.  

PubMed

The clinical practice guidelines for the prevention, diagnosis, evaluation and treatment of chronic kidney disease mineral and bone disorders (CKD-BMD) in adults, of the Latin American Society of Nephrology and Hypertension (SLANH) comprise a set of recommendations developed to support the doctor in the management of these abnormalities in adult patients with stages 3-5 kidney disease. This excludes changes associated with renal transplantation. The topics covered in the guidelines are divided into four chapters: 1) Evaluation of biochemical changes, 2) Evaluation of bone changes, 3) Evaluation of vascular calcifications, and 4) Treatment of CKD-MBD. The guidelines are based on the recommendations proposed and published by the Kidney Disease: Improving Global Outcomes (KDIGO) for the prevention, diagnosis, evaluation and treatment of CKD-MBD (KDIGO Clinical practice guidelines for the diagnosis, evaluation, prevention and treatment of Chronic Kidney Disease Mineral and Bone Disorder [CKD-MBD]), adapted to the conditions of patients, institutions and resources available in Latin America, with the support of KDIGO. In some cases, the guidelines correspond to management recommendations directly defined by the working group for their implementation in our region, based on the evidence available in the literature. Each chapter contains guidelines and their rationale, supported by numerous updated references. Unfortunately, there are few controlled studies with statistically sufficient weight in Latin America to support specific recommendations for the region, and as such, most of the references used correspond to studies carried out in other regions. This highlights the need to plan research studies designed to establish the current status of mineral and bone metabolism disorders in Latin America as well as defining the best treatment options for our population. PMID:23629678

Bellorin-Font, Ezequiel; Ambrosoni, Pablo; Carlini, Raúl G; Carvalho, Aluizio B; Correa-Rotter, Ricardo; Cueto-Manzano, Alfonso; Jara, Aquiles; Jorgetti, Vanda; Negri, Armando L; Negri, Armando; Olaizola, Inés; Salusky, Isidro; Slatopolsky, Eduardo; Weisinger, José R

2013-01-01

248

Strategic Planning for Deepening the All-Around Structural Reform of Education: Issues of Structural Reform in the "National Medium- and Long-Term Educational Reform and Development Guideline (2010-20)"  

ERIC Educational Resources Information Center

The "National Medium- and Long-Term Educational Reform and Development Guideline (2010-20)" (hereafter abbreviated as the "Guideline") posits that the development of education must be driven by reform and innovation. It devotes six chapters to mapping out the targets, tasks, and major policy measures for reforming the educational system. Focusing…

Songhua, Tan; Wang, Catherine Yan

2012-01-01

249

Eating and physical activity practices in risk of overweight and overweight children: compliance with US Department of Agriculture food guide pyramid and with National Association for Sport and Physical Activity guidelines for children  

Microsoft Academic Search

The purpose of this study was to identify eating and physical activity patterns associated with overweight elementary school children in Fort Worth, Tex, by comparing those with the US Department of Agriculture (USDA) dietary guidelines and National Association for Sport and Physical Activity guidelines for children. Among 1018 participants, 56% were girls; the percentages of normal, risk of overweight, and

Aewha Ha; Sejong Bae; Ximena Urrutia-Rojas; Karan P. Singh

2005-01-01

250

Scaling Up the 2010 World Health Organization HIV Treatment Guidelines in Resource-Limited Settings: A Model-Based Analysis  

PubMed Central

Background The new 2010 World Health Organization (WHO) HIV treatment guidelines recommend earlier antiretroviral therapy (ART) initiation (CD4<350 cells/µl instead of CD4<200 cells/µl), multiple sequential ART regimens, and replacement of first-line stavudine with tenofovir. This paper considers what to do first in resource-limited settings where immediate implementation of all of the WHO recommendations is not feasible. Methods and Findings We use a mathematical model and local input data to project clinical and economic outcomes in a South African HIV-infected cohort (mean age?=?32.8 y, mean CD4?=?375/µl). For the reference strategy, we assume that all patients initiate stavudine-based ART with WHO stage III/IV disease and receive one line of ART (stavudine/WHO/one-line). We rank—in survival, cost-effectiveness, and equity terms—all 12 possible combinations of the following: (1) stavudine replacement with tenofovir, (2) ART initiation (by WHO stage, CD4<200 cells/µl, or CD4<350 cells/µl), and (3) one or two regimens, or lines, of available ART. Projected life expectancy for the reference strategy is 99.0 mo. Considering each of the guideline components separately, 5-y survival is maximized with ART initiation at CD4<350 cells/µl (stavudine/<350/µl/one-line, 87% survival) compared with stavudine/WHO/two-lines (66%) and tenofovir/WHO/one-line (66%). The greatest life expectancies are achieved via the following stepwise programmatic additions: stavudine/<350/µl/one-line (124.3 mo), stavudine/<350/µl/two-lines (177.6 mo), and tenofovir/<350/µl/two-lines (193.6 mo). Three program combinations are economically efficient: stavudine/<350/µl/one-line (cost-effectiveness ratio, US$610/years of life saved [YLS]), tenofovir/<350/µl/one-line (US$1,140/YLS), and tenofovir/<350/µl/two-lines (US$2,370/YLS). Conclusions In settings where immediate implementation of all of the new WHO treatment guidelines is not feasible, ART initiation at CD4<350 cells/µl provides the greatest short- and long-term survival advantage and is highly cost-effective. Please see later in the article for the Editors' Summary PMID:21209794

Walensky, Rochelle P.; Wood, Robin; Ciaranello, Andrea L.; Paltiel, A. David; Lorenzana, Sarah B.; Anglaret, Xavier; Stoler, Adam W.; Freedberg, Kenneth A.

2010-01-01

251

Field guidelines for collection, treatment, and analysis of water samples, Montana district  

USGS Publications Warehouse

This manual provides a set of standardized guidelines and quality-control procedures for the collection and preservation of water samples and defines procedures for field analyses of unstable constituents or properties. Seldom is the water being samples of such uniformity that a single grab sample is representative of the whole. For this reason a variety of sampler types and sampling methods have been devised. Descriptions and procedures for field use are given for a number of sampler types. Several methods of sampling are described for which these samplers can be used. Sample-processing devices such as sample splitters and filtration apparatus are discussed along with methods of cleaning. Depending on the type of analysis to be performed in the laboratory, samples may need to be preserved shortly after collection. Various types of preservation are described in detail. Analyses for unstable constituents or properties are of necessity accomplished in the field. This manual addresses analytical techniques and quality assurance for: (1) Water temperature, (2) specific conductance, (3) pH, (4) alkalinity, (5) dissolved oxygen, and (6) bacteria. Examples of field report forms are given as attachments. Information pertinent to certain field calculations is also presented. (USGS)

Knapton, J.R.

1985-01-01

252

Summary of the Dutch S3-Guidelines on the treatment of psoriasis 2011  

E-print Network

enhances skin penetration (e.g. salicylic acid gel) or 3)skin surface) Children Important drug interactions Infants Topical preparations with salicylic acidsalicylic acid in the treatment of plaque psoriasis with dithranol creams. Skin

2014-01-01

253

Culturally competent treatment of African American clients among a national sample of outpatient substance abuse treatment units  

Microsoft Academic Search

This study measures the level of cultural competency with respect to African American clients that exists among a national sample of outpatient substance abuse treatment (OSAT) units and determines the relationship of cultural competency to various characteristics of these units and their clients. The study utilizes cross-sectional data from the 1995 National Drug Abuse Treatment System Survey (NDATSS). The sample

Daniel L. Howard

2003-01-01

254

[Guidelines for the treatment of Hansen's disease in Japan (third edition)].  

PubMed

ad hoc committee of Japanese Leprosy Association recommends revised standard treatment protocol of leprosy in Japan, which is a modification of World Health Organization's multidrug therapy (WHO/MDT, 2010). For paucibacillary (PB) leprosy, 6 months treatment by rifampicin and dapsone (MDT/PB) is enough. However, for high bacterial load multibacillary (MB) leprosy, 12 months treatment seems insufficient. Thus, (A) For MB with bacterial index (BI) > 3 before treatment, 2 years treatment by rifampicin, dapsone and clofazimine (MDT/MB) is necessary. When BI becomes negative and active lesion is lost within 2 years, no maintenance therapy is necessary. When BI is still positive, one year of MDT/MB is added (3 years in total), followed by maintenance therapy by dapsone and clofazimine until BI negativity and loss of active lesions. (B) For MB with BI < 3 or fresh MB (less than 6 months after the onset of the disease) with BI > 3, 1 year treatment by MDT/MB is necessary. When BI becomes negative and active lesion is lost within one year, no maintenance therapy is necessary. When BI is still positive or active lesion is remaining, additional therapy with MDT/MB for one more year is recommended. Brief summary of diagnosis, purpose of therapy, character of drugs, and prevention of deformity is also described. PMID:24579462

Goto, Masamichi; Nogam, Reiko; Okano, Yoshiko; Gidoh, Masaichi; Yotsu, Rie; Ishida, Yutaka; Kitajima, Shinichi; Kai, Masanori; Ishii, Norihisa; Ozaki, Motoaki; Hatano, Kentaro

2013-12-01

255

Guideline for benchmarking thermal treatment systems for low-level mixed waste  

SciTech Connect

A process for benchmarking low-level mixed waste (LLMW) treatment technologies has been developed. When used in conjunction with the identification and preparation of surrogate waste mixtures, and with defined quality assurance and quality control procedures, the benchmarking process will effectively streamline the selection of treatment technologies being considered by the US Department of Energy (DOE) for LLMW cleanup and management. Following the quantitative template provided in the benchmarking process will greatly increase the technical information available for the decision-making process. The additional technical information will remove a large part of the uncertainty in the selection of treatment technologies. It is anticipated that the use of the benchmarking process will minimize technology development costs and overall treatment costs. In addition, the benchmarking process will enhance development of the most promising LLMW treatment processes and aid in transferring the technology to the private sector. To instill inherent quality, the benchmarking process is based on defined criteria and a structured evaluation format, which are independent of any specific conventional treatment or emerging process technology. Five categories of benchmarking criteria have been developed for the evaluation: operation/design; personnel health and safety; economics; product quality; and environmental quality. This benchmarking document gives specific guidance on what information should be included and how it should be presented. A standard format for reporting is included in Appendix A and B of this document. Special considerations for LLMW are presented and included in each of the benchmarking categories.

Hoffman, D.P.; Gibson, L.V. Jr.; Hermes, W.H. [Martin Marietta Energy Systems, Inc., Oak Ridge, TN (United States); Bastian, R.E. [Focus Environmental, Inc., Knoxville, TN (United States); Davis, W.T. [Tennessee Univ., Knoxville, TN (United States)

1994-01-01

256

Getting research into policy - Herpes simplex virus type-2 (HSV-2) treatment and HIV infection: international guidelines formulation and the case of Ghana  

PubMed Central

Background Observational epidemiological and biological data indicate clear synergies between Herpes simplex virus type 2 (HSV-2) and HIV, whereby HSV-2 enhances the potential for HIV acquisition or transmission. In 2001, the World Health Organization (WHO) launched a call for research into the possibilities of disrupting this cofactor effect through the use of antiherpetic therapy. A WHO Expert Meeting was convened in 2008 to review the research results. The results of the trials were mostly inconclusive or showed no impact. However, the WHO syndromic management treatment guidelines were modified to include acyclovir as first line therapy to treat genital ulcer disease on the basis of the high prevalence of HSV-2 in most settings, impact and cost-benefit of treatment on ulcer healing and quality of life among patients. Methods This paper examines the process through which the evidence related to HIV–HSV-2 interactions influenced policy at the international level and then the mechanism of international to national policy transfer, with Ghana as a case study. To better understand the context within which national policy change occurs, special attention was paid to the relationships between researchers and policy-makers as integral to the process of getting evidence into policy. Data from this study were then collected through interviews conducted with researchers, program managers and policy-makers working in sexual health/STI at the 2008 WHO Expert Meeting in Montreux, Switzerland, and in Accra, Ghana. Results The major findings of this study indicate that investigations into HSV-2 as a cofactor of HIV generated the political will necessary to reform HSV-2 treatment policy. Playing a pivotal role at both the international level and within the Ghanaian policy context were ‘policy networks’ formed either formally (WHO) or informally (Ghana) around an issue area. These networks of professionals serve as the primary conduit of information between researchers and policy-makers. Donor influence was cited as the single strongest impetus and impediment to policy change nationally. Conclusions Policy networks may serve as the primary driving force of change in both international context and in the case of Ghana. Communication among researchers and policy-makers is critical for uptake of evidence and opportunities may exist to formalize policy networks and engage donors in a productive and ethical way. PMID:21679386

2011-01-01

257

Update to CDC's Sexually transmitted diseases treatment guidelines, 2010: oral cephalosporins no longer a recommended treatment for gonococcal infections.  

PubMed

Gonorrhea is a major cause of serious reproductive complications in women and can facilitate human immunodeficiency virus (HIV) transmission. Effective treatment is a cornerstone of U.S. gonorrhea control efforts, but treatment of gonorrhea has been complicated by the ability of Neisseria gonorrhoeae to develop antimicrobial resistance. This report, using data from CDC's Gonococcal Isolate Surveillance Project (GISP), describes laboratory evidence of declining cefixime susceptibility among urethral N. gonorrhoeae isolates collected in the United States during 2006-2011 and updates CDC's current recommendations for treatment of gonorrhea. Based on GISP data, CDC recommends combination therapy with ceftriaxone 250 mg intramuscularly and either azithromycin 1 g orally as a single dose or doxycycline 100 mg orally twice daily for 7 days as the most reliably effective treatment for uncomplicated gonorrhea. CDC no longer recommends cefixime at any dose as a first-line regimen for treatment of gonococcal infections. If cefixime is used as an alternative agent, then the patient should return in 1 week for a test-of-cure at the site of infection. PMID:22874837

2012-08-10

258

Evaluation of the Definitions of "High-Risk" Cutaneous Squamous Cell Carcinoma Using the American Joint Committee on Cancer Staging Criteria and National Comprehensive Cancer Network Guidelines  

PubMed Central

Recent guidelines from the American Joint Committee on Cancer (AJCC) and National Comprehensive Cancer Network (NCCN) have been proposed for the assessment of “high-risk” cutaneous squamous cell carcinomas (cSCCs). Though different in perspective, both guidelines share the common goals of trying to identify “high-risk” cSCCs and improving patient outcomes. Thus, in theory, both definitions should identify a similar proportion of “high-risk” tumors. We sought to evaluate the AJCC and NCCN definitions of “high-risk” cSCCs and to assess their concordance. Methods. A retrospective review of head and neck cSCCs seen by an academic dermatology department from July 2010 to November 2011 was performed. Results. By AJCC criteria, most tumors (n = 211,82.1%) were of Stage 1; 46 tumors (13.9%) were of Stage 2. Almost all were of Stage 2 due to size alone (?2?cm); one tumor was “upstaged” due to “high-risk features.” Using the NCCN taxonomy, 231 (87%) of tumors were “high-risk.” Discussion. This analysis demonstrates discordance between AJCC and NCCN definitions of “high-risk” cSCC. Few cSCCs are of Stage 2 by AJCC criteria, while most are “high-risk” by the NCCN guidelines. While the current guidelines represent significant progress, further studies are needed to generate a unified definition of “high-risk” cSCC to optimize management.

Chu, Melinda B.; Slutsky, Jordan B.; Dhandha, Maulik M.; Beal, Brandon T.; Armbrecht, Eric S.; Walker, Ronald J.; Varvares, Mark A.; Fosko, Scott W.

2014-01-01

259

Derivation of residual radioactive material guidelines for 13 radionuclides present in Operable Unit IV at Brookhaven National Laboratory, Upton, New York  

SciTech Connect

Residual radioactive material guidelines for 13 radionuclides (americium-241; cobalt-60; cesium-137; europium-152, -154, and -155; plutonium-238, -239, and -240; strontium-90; and uranium-234, -235, and -238) were derived for Operable Unit (OU) IV at Brookhaven National Laboratory. This site has been identified for remedial action under the Comprehensive Environmental Response, Compensation, and Liability Act of 1980, as amended by the Superfund Amendments and Reauthorization Act of 1986. Single-nuclide guidelines were derived on the basis of the requirement that the 50-year committed effective dose equivalent to a hypothetical individual who lives or works in the immediate vicinity of OU IV should not exceed a dose constraint of 30 mrem/yr following remedial action for the current use and plausible future use scenarios or a dose limit of 100 mrem/yr for plausible but less likely future use scenarios. The US Department of Energy (DOE) residual radioactive material guideline computer code, RESRAD, was used in this evaluation; RESRAD implements the methodology described in the DOE manual for determining residual radioactive material guidelines. Four potential scenarios were considered; each assumed that, for a period of 1,000 years following remedial action, the site would be used without radiological restrictions. The four scenarios varied with regard to the type of site use, time spent at the site, and sources of food consumed.

Faillace, E.; Nimmagadda, M.; Yu, C.

1994-12-01

260

Comparison of an effect-model-law-based method versus traditional clinical practice guidelines for optimal treatment decision-making: application to statin treatment in the French population.  

PubMed

Healthcare authorities make difficult decisions about how to spend limited budgets for interventions that guarantee the best cost-efficacy ratio. We propose a novel approach for treatment decision-making, OMES-in French: Objectif thérapeutique Modèle Effet Seuil (in English: Therapeutic Objective-Threshold-Effect Model; TOTEM). This approach takes into consideration results from clinical trials, adjusted for the patients' characteristics in treatment decision-making. We compared OMES with the French clinical practice guidelines (CPGs) for the management of dyslipidemia with statin in a computer-generated realistic virtual population, representing the adult French population, in terms of the number of all-cause deaths avoided (number of avoided events: NAEs) under treatment and the individual absolute benefit. The total budget was fixed at the annual amount reimbursed by the French social security for statins. With the CPGs, the NAEs was 292 for an annual cost of 122.54 M€ compared with 443 with OMES. For a fixed NAEs, OMES reduced costs by 50% (60.53 M€ yr(-1)). The results demonstrate that OMES is at least as good as, and even better than, the standard CPGs when applied to the same population. Hence the OMES approach is a practical, useful alternative which will help to overcome the limitations of treatment decision-making based uniquely on CPGs. PMID:25209407

Kahoul, Riad; Gueyffier, François; Amsallem, Emmanuel; Haugh, Margaret; Marchant, Ivanny; Boissel, François-Henri; Boissel, Jean-Pierre

2014-11-01

261

Flowcharts for the diagnosis and treatment of acute cholangitis and cholecystitis: Tokyo Guidelines.  

PubMed

Diagnostic and therapeutic strategies for acute biliary inflammation/infection (acute cholangitis and acute cholecystitis), according to severity grade, have not yet been established in the world. Therefore we formulated flowcharts for the management of acute biliary inflammation/infection in accordance with severity grade. For mild (grade I) acute cholangitis, medical treatment may be sufficient/appropriate. For moderate (grade II) acute cholangitis, early biliary drainage should be performed. For severe (grade III) acute cholangitis, appropriate organ support such as ventilatory/circulatory management is required. After hemodynamic stabilization is achieved, urgent endoscopic or percutaneous transhepatic biliary drainage should be performed. For patients with acute cholangitis of any grade of severity, treatment for the underlying etiology, including endoscopic, percutaneous, or surgical treatment should be performed after the patient's general condition has improved. For patients with mild (grade I) cholecystitis, early laparoscopic cholecystectomy is the preferred treatment. For patients with moderate (grade II) acute cholecystitis, early laparoscopic or open cholecystectomy is preferred. In patients with extensive local inflammation, elective cholecystectomy is recommended after initial management with percutaneous gallbladder drainage and/or cholecystostomy. For the patient with severe (grade III) acute cholecystitis, multiorgan support is a critical part of management. Biliary peritonitis due to perforation of the gallbladder is an indication for urgent cholecystectomy and/or drainage. Delayed elective cholecystectomy may be performed after initial treatment with gallbladder drainage and improvement of the patient's general medical condition. PMID:17252294

Miura, Fumihiko; Takada, Tadahiro; Kawarada, Yoshifumi; Nimura, Yuji; Wada, Keita; Hirota, Masahiko; Nagino, Masato; Tsuyuguchi, Toshio; Mayumi, Toshihiko; Yoshida, Masahiro; Strasberg, Steven M; Pitt, Henry A; Belghiti, Jacques; de Santibanes, Eduardo; Gadacz, Thomas R; Gouma, Dirk J; Fan, Sheung-Tat; Chen, Miin-Fu; Padbury, Robert T; Bornman, Philippus C; Kim, Sun-Whe; Liau, Kui-Hin; Belli, Giulio; Dervenis, Christos

2007-01-01

262

Do HIV-positive women receive depression treatment that meets best practice guidelines?  

PubMed

This study addressed whether psychopharmacologic and psychotherapeutic treatment of depressed HIV+ women met standards defined in the best practice literature, and tested hypothesized predictors of standard-concordant care. 1,352 HIV-positive women in the multi-center Women's Interagency HIV Study were queried about depressive symptoms and mental health service utilization using standards published by the American Psychiatric Association and the Agency for Healthcare Research and Quality to define adequate depression treatment. We identified those who: (1) reported clinically significant depressive symptoms (CSDS) using Centers for Epidemiological Studies-Depression Scale scores of ?16; or (2) had lifetime diagnoses of major depressive disorder (MDD) assessed by World Mental Health Composite International Diagnostic Interviews plus concurrent elevated depressive symptoms in the past 12 months. Adequate treatment prevalence was 46.2 % (n = 84) for MDD and 37.9 % (n = 211) for CSDS. Multivariable logistic regression analysis found that adequate treatment was more likely among women who saw the same primary care provider consistently, who had poorer self-rated role functioning, who paid out-of-pocket for healthcare, and who were not African American or Hispanic/Latina. This suggests that adequate depression treatment may be increased by promoting healthcare provider continuity, outreaching individuals with lower levels of reported role impairment, and addressing the specific needs and concerns of African American and Hispanic/Latina women. PMID:24402689

Cook, Judith A; Burke-Miller, Jane K; Grey, Dennis D; Cocohoba, Jennifer; Liu, Chenlong; Schwartz, Rebecca M; Golub, Elizabeth T; Anastos, Kathryn; Steigman, Pamela J; Cohen, Mardge H

2014-06-01

263

The privilege to use lasers (non-ionizing radiation) at Stanford University requires each individual user to follow and adhere to the guidelines recommended in the American National Standard Institute  

E-print Network

Preface The privilege to use lasers (non-ionizing radiation) at Stanford recommended in the American National Standard Institute guidelines on laser safety for Safe Use of Lasers (ANSI Z136.1). All individuals who work with lasers

Kay, Mark A.

264

Quality Improvement Guidelines for Endovascular Treatment of Iliac Artery Occlusive Disease  

SciTech Connect

Endovascular therapy is the treatment of choice for type A and the preferred treatment for type B lesions. In selective patients, this type of treatment can be applied in type C and even type D lesions. Ipsilateral femoral, contralateral femoral, and brachial approach and both the intraluminal and subintimal space can be used for successful recanalization. The application of stents has improved the immediate hemodynamic and probably long-term clinical results of iliac percutaneous transluminal angioplasty. However, the superiority of primary or direct stenting over selective stenting has not been proven yet. The choice of stent type depends on lesion morphology and location but otherwise there is insufficient evidence to support the use of a particular stent design. There is insufficient evidence to justify routine use of covered stents. All patients should receive antiaggregant therapy following endovascular recanalization of iliac arteries. There is no consensus regarding prophylaxis with antibiotics in iliac recanalization procedures.

Tsetis, Dimitrios [University Hospital of Heraklion, Medical School of Crete, Department of Radiology (Greece)], E-mail: tsetis@med.uoc.gr; Uberoi, Raman [John Radcliffe Hospital, Department of Radiology (United Kingdom)

2008-03-15

265

Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: General management for pulmonary hypertension  

PubMed Central

Treatment of pulmonary hypertension (PH) patients is challenging and should only be initiated after a comprehensive diagnostic evaluation. Such treatment should ideally be done in specialized centers with full capability for hemodynamic measurements, having access to a broad range of PAH therapies, and adequate experience in the management of critically ill patients. The following discussion is intended to review the general measures and the non-specific (supportive) therapy used in managing PH patients, while the specific therapy will be discussed in a subsequent different article. PMID:25077001

Idrees, Majdy M.; Swiston, John; Levy, Robert D.

2014-01-01

266

WHO guidelines for antimicrobial treatment in children admitted to hospital in an area of intense Plasmodium falciparum transmission: prospective study  

PubMed Central

Objectives To assess the performance of WHO’s “Guidelines for care at the first-referral level in developing countries” in an area of intense malaria transmission and identify bacterial infections in children with and without malaria. Design Prospective study. Setting District hospital in Muheza, northeast Tanzania. Participants Children aged 2 months to 13 years admitted to hospital for febrile illness. Main outcome measures Sensitivity and specificity of WHO guidelines in diagnosing invasive bacterial disease; susceptibility of isolated organisms to recommended antimicrobials. Results Over one year, 3639 children were enrolled and 184 (5.1%) died; 2195 (60.3%) were blood slide positive for Plasmodium falciparum, 341 (9.4%) had invasive bacterial disease, and 142 (3.9%) were seropositive for HIV. The prevalence of invasive bacterial disease was lower in slide positive children (100/2195, 4.6%) than in slide negative children (241/1444, 16.7%). Non-typhi Salmonella was the most frequently isolated organism (52/100 (52%) of organisms in slide positive children and 108/241 (45%) in slide negative children). Mortality among children with invasive bacterial disease was significantly higher (58/341, 17%) than in children without invasive bacterial disease (126/3298, 3.8%) (P<0.001), and this was true regardless of the presence of P falciparum parasitaemia. The sensitivity and specificity of WHO criteria in identifying invasive bacterial disease in slide positive children were 60.0% (95% confidence interval 58.0% to 62.1%) and 53.5% (51.4% to 55.6%), compared with 70.5% (68.2% to 72.9%) and 48.1% (45.6% to 50.7%) in slide negative children. In children with WHO criteria for invasive bacterial disease, only 99/211(47%) of isolated organisms were susceptible to the first recommended antimicrobial agent. Conclusions In an area exposed to high transmission of malaria, current WHO guidelines failed to identify almost a third of children with invasive bacterial disease, and more than half of the organisms isolated were not susceptible to currently recommended antimicrobials. Improved diagnosis and treatment of invasive bacterial disease are needed to reduce childhood mortality. PMID:20354024

2010-01-01

267

Adherence to treatment guidelines for acute diarrhoea in children up to 12 years in Ujjain, India - a cross-sectional prescription analysis  

Microsoft Academic Search

BACKGROUND: Diarrhoea accounts for 20% of all paediatric deaths in India. Despite WHO recommendations and IAP (Indian Academy of Paediatrics) and Government of India treatment guidelines, few children suffering from acute diarrhoea in India receive low osmolarity oral rehydration solution (ORS) and zinc from health care providers. The aim of this study was to analyse practitioners' prescriptions for acute diarrhoea

Deepali Pathak; Ashish Pathak; Gaetano Marrone; Vishal Diwan; Cecilia Stålsby Lundborg

2011-01-01

268

International adaptations of NCCN Clinical Practice Guidelines in Oncology.  

PubMed

The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) are evidence- and consensus-based clinical practice guidelines addressing malignancies that affect more than 97% of all patients with cancer in the United States. The NCCN Guidelines are used extensively in the United States and globally. Use of the guidelines outside the United States has driven the need to adapt the guidelines based on local, regional, or national resources. The NCCN Guidelines Panels created, vetted, and continually update the NCCN Guidelines based on published scientific data on cancer detection, diagnosis, and treatment efficacy. The guidelines are developed within the context of commonly available resources, methods of payment, societal and cultural expectations, and governmental regulations as they exist in the United States. Although many of the cancer management recommendations contained in the NCCN Guidelines apply broadly from a global perspective, not all do. Disparities in availability and access to health care exist among countries, within countries, and among different social groups in the same country, especially regarding resources for cancer prevention, early detection, and treatment. In addition, different drug approval and payment processes result in regional variation in availability of and access to cancer treatment, especially highly expensive agents and radiation therapy. Differences in cancer risk, predictive biomarker expression, and pharmacogenetics exist across ethnic and racial groups, and therefore across geographic locations. Cultural and societal expectations and requirements may also require modification of NCCN Guidelines for use outside the United States. This article describes the adaptation process, using the recent Latin American adaptation of the 2013 NCCN Guidelines for Colorectal Cancer as an example. PMID:24812133

Carlson, Robert W; Larsen, Jonathan K; McClure, Joan; Fitzgerald, C Lyn; Venook, Alan P; Benson, Al B; Anderson, Benjamin O

2014-05-01

269

Evaluation of rationality in prescribing, adherence to treatment guidelines, and direct cost of treatment in intensive cardiac care unit: A prospective observational study  

PubMed Central

Background: Cardiovascular diseases (CVDs) remain the most common cause of sudden death. Hence, appropriate drug therapy in intensive cardiac care unit (ICCU) is crucial in managing cardiovascular emergencies and to decrease morbidity and mortality. Objective: To evaluate prescribing pattern of drugs and direct cost of therapy in patients admitted in ICCU. Materials and Methods: Patients admitted in ICCU of a tertiary care teaching hospital were enrolled. Demographic data, clinical history, and complete drug therapy received during their stay in ICCU were noted. Data were analyzed for drug utilization pattern and direct cost of treatment calculated using patient's hospital and pharmacy bills. Rationality of therapy was evaluated based on American College of Cardiology/American Heart Association (ACC/AHA) guidelines. Result: Data of 170 patients were collected over 2 months. Mean age of patients was 54.67 ± 13.42 years. Male to female ratio was 2.33:1. Most common comorbid condition was hypertension 76 (44.7%). Most common diagnosis was acute coronary syndrome (ACS) 49.4%. Mean stay in ICCU was 4.42 ± 1.9 days. Mean number of drugs prescribed per patient was 11.43 ± 2.85. Antiplatelet drugs were the most frequently prescribed drug group (86.5%). Mean cost of pharmacotherapy per patient was ‘2701.24 ± 3111.94. Mean direct cost of treatment per patient was ‘10564.74 ± 14968.70. Parenteral drugs constituted 42% of total drugs and 90% of total cost of pharmacotherapy. Cost of pharmacotherapy was positively correlated with number of drugs (P = 0.000) and duration of stay (P = 0.027). Conclusion: Antiplatelet drugs were the most frequently prescribed drug group. Mean number of drugs per encounter were high, which contributed to the higher cost of pharmacotherapy. ACC/AHA guidelines were followed in majority of the cases. PMID:24914255

Christian, Rohan P.; Rana, Devang A.; Malhotra, Supriya D.; Patel, Varsha J.

2014-01-01

270

BIOS Protection Guidelines for Servers (Draft)  

E-print Network

and standards infrastructure. ITL develops tests, test methods, reference data, proof of concept implementationsBIOS Protection Guidelines for Servers (Draft) Recommendationsof the National Institute 800-147B (Draft) BIOS Protection Guidelines for Servers (Draft) Recommendations of the National

271

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

272

ATC Guidelines for use of IMRT for intra-thoracic treatments  

Cancer.gov

ICRU Report 62 introduced the concept of the planning organ-at-risk volume (PRV), in which a margin is added around the organ at risk (OAR) to account for that organ’s geometric uncertainties. The PRV margin around the critical structure that must be spared is analogous to the PTV margin around the CTV. The use of PRV concept is particularly important for those cases involving IMRT because of the increased sensitivity of this type of treatment to geometric uncertainties.

273

EFNS guidelines on the treatment of cluster headache and other trigeminal-autonomic cephalalgias.  

PubMed

Cluster headache and the other trigeminal-autonomic cephalalgias [paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) syndrome] are rare but very disabling conditions with a major impact on the patient's quality of life. The objective of this study was to give evidence-based recommendations for the treatment of these headache disorders based on a literature search and consensus amongst a panel of experts. All available medical reference systems were screened for any kind of studies on cluster headache, paroxysmal hemicrania and SUNCT syndrome. The findings in these studies were evaluated according to the recommendations of the European Federation of Neurological Societies resulting in level A, B or C recommendations and good practice points. For the acute treatment of cluster headache attacks, oxygen (100%) with a flow of at least 7 l/min over 15 min and 6 mg subcutaneous sumatriptan are drugs of first choice. Prophylaxis of cluster headache should be performed with verapamil at a daily dose of at least 240 mg (maximum dose depends on efficacy or tolerability). Although no class I or II trials are available, steroids are clearly effective in cluster headache. Therefore, the use of at least 100 mg methylprednisone (or equivalent corticosteroid) given orally or at up to 500 mg i.v. per day over 5 days (then tapering down) is recommended. Methysergide, lithium and topiramate are recommended as alternative treatments. Surgical procedures, although in part promising, require further scientific evaluation. For paroxysmal hemicranias, indomethacin at a daily dose of up to 225 mg is the drug of choice. For treatment of SUNCT syndrome, large series suggest that lamotrigine is the most effective preventive agent, with topiramate and gabapentin also being useful. Intravenous lidocaine may also be helpful as an acute therapy when patients are extremely distressed and disabled by frequent attacks. PMID:16987158

May, A; Leone, M; Afra, J; Linde, M; Sándor, P S; Evers, S; Goadsby, P J

2006-10-01

274

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

PubMed

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

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

2014-01-01

275

Guidelines for diagnosis and treatment of Hunter Syndrome for clinicians in Latin America.  

PubMed

This review aims to provide clinicians in Latin America with the most current information on the clinical aspects, diagnosis, and management of Hunter syndrome, a serious and progressive disease for which specific treatment is available. Hunter syndrome is a genetic disorder where iduronate-2-sulfatase (I2S), an enzyme that degrades glycosaminoglycans, is absent or deficient. Clinical manifestations vary widely in severity and involve multiple organs and tissues. An attenuated and a severe phenotype are recognized depending on the degree of cognitive impairment. Early diagnosis is vital for disease management. Clinical signs common to children with Hunter syndrome include inguinal hernia, frequent ear and respiratory infections, facial dysmorphisms, macrocephaly, bone dysplasia, short stature, sleep apnea, and behavior problems. Diagnosis is based on screening urinary glycosaminoglycans and confirmation by measuring I2S activity and analyzing I2S gene mutations. Idursulfase (recombinant I2S) (Elaprase(®), Shire) enzyme replacement therapy (ERT), designed to address the underlying enzyme deficiency, is approved treatment and improves walking capacity and respiratory function, and reduces spleen and liver size and urinary glycosaminoglycan levels. Additional measures, responding to the multi-organ manifestations, such as abdominal/inguinal hernia repair, carpal tunnel surgery, and cardiac valve replacement, should also be considered. Investigational treatment options such as intrathecal ERT are active areas of research, and bone marrow transplantation is in clinical practice. Communication among care providers, social workers, patients and families is essential to inform and guide their decisions, establish realistic expectations, and assess patients' responses. PMID:25071396

Giugliani, Roberto; Villarreal, Martha Luz Solano; Valdez, C Araceli Arellano; Hawilou, Antonieta Mahfoud; Guelbert, Norberto; Garzón, Luz Norela Correa; Martins, Ana Maria; Acosta, Angelina; Cabello, Juan Francisco; Lemes, Aída; Santos, Mara Lucia Schmitz Ferreira; Amartino, Hernán

2014-06-01

276

Guidelines for diagnosis and treatment of Hunter Syndrome for clinicians in Latin America  

PubMed Central

This review aims to provide clinicians in Latin America with the most current information on the clinical aspects, diagnosis, and management of Hunter syndrome, a serious and progressive disease for which specific treatment is available. Hunter syndrome is a genetic disorder where iduronate-2-sulfatase (I2S), an enzyme that degrades glycosaminoglycans, is absent or deficient. Clinical manifestations vary widely in severity and involve multiple organs and tissues. An attenuated and a severe phenotype are recognized depending on the degree of cognitive impairment. Early diagnosis is vital for disease management. Clinical signs common to children with Hunter syndrome include inguinal hernia, frequent ear and respiratory infections, facial dysmorphisms, macrocephaly, bone dysplasia, short stature, sleep apnea, and behavior problems. Diagnosis is based on screening urinary glycosaminoglycans and confirmation by measuring I2S activity and analyzing I2S gene mutations. Idursulfase (recombinant I2S) (Elaprase®, Shire) enzyme replacement therapy (ERT), designed to address the underlying enzyme deficiency, is approved treatment and improves walking capacity and respiratory function, and reduces spleen and liver size and urinary glycosaminoglycan levels. Additional measures, responding to the multi-organ manifestations, such as abdominal/inguinal hernia repair, carpal tunnel surgery, and cardiac valve replacement, should also be considered. Investigational treatment options such as intrathecal ERT are active areas of research, and bone marrow transplantation is in clinical practice. Communication among care providers, social workers, patients and families is essential to inform and guide their decisions, establish realistic expectations, and assess patients’ responses. PMID:25071396

Giugliani, Roberto; Villarreal, Martha Luz Solano; Valdez, C. Araceli Arellano; Hawilou, Antonieta Mahfoud; Guelbert, Norberto; Garzon, Luz Norela Correa; Martins, Ana Maria; Acosta, Angelina; Cabello, Juan Francisco; Lemes, Aida; Santos, Mara Lucia Schmitz Ferreira; Amartino, Hernan

2014-01-01

277

EAU Guidelines on Prostate Cancer  

Microsoft Academic Search

Objectives: To develop clinical guidelines for the management of patients with prostate cancer.Methods: Guidelines were compiled by a working panel based on current literature following a literature review using MEDLINE. Already published structured analysis from national and international guidelines was used, and panel consensus was employed when literature evidence was absent or of poor quality.Results: The full text of the

G. Aus; C. C. Abbou; D. Pacik; H. van Poppel; J. M. Wolff; F. Zattoni

2001-01-01

278

Canadian guidelines for the evidence-based treatment of tic disorders: pharmacotherapy.  

PubMed

This article seeks to provide the practising clinician with guidance on the pharmacological management of tic disorders in children and adults. We performed a systematic review of the literature on the treatment of tic disorders. A multi-institutional group of 14 experts in psychiatry, child psychiatry, neurology, pediatrics, and psychology engaged in a consensus meeting. The evidence was presented and discussed, and nominal group techniques were employed to arrive at consensus on recommendations. A strong recommendation is made when the benefits of treatment clearly outweigh the risks and burdens, and can apply to most patients in most circumstances without reservation. With a weak recommendation, the benefits, risks, and burdens are more closely balanced, and the best action may differ depending on the circumstances. Based on these principles, weak recommendations were made for the use of pimozide, haloperidol, fluphenazine, metoclopramide (children only), risperidone, aripiprazole, olanzapine, quetiapine, ziprasidone, topiramate, baclofen (children only), botulinum toxin injections, tetrabenazine, and cannabinoids (adults only). Strong recommendations were made for the use of clonidine and guanfacine (children only). While the evidence supports the efficacy of many of the antipsychotics for the treatment of tics, the high rates of side effects associated with these medications resulted in only weak recommendations for these drugs. In situations where tics are not severe or disabling, the use of a medication with only a weak recommendation is not warranted. However, when tics are more distressing and interfering, the need for tic suppression to improve quality of life is stronger, and patients and clinicians may be more willing to accept the risks of pharmacotherapy. PMID:22397999

Pringsheim, Tamara; Doja, Asif; Gorman, Daniel; McKinlay, Duncan; Day, Lundy; Billinghurst, Lori; Carroll, Alan; Dion, Yves; Luscombe, Sandra; Steeves, Thomas; Sandor, Paul

2012-03-01

279

HIV-associated wasting in the HAART era: guidelines for assessment, diagnosis, and treatment.  

PubMed

Wasting (malnutrition) and lipodystrophy are the two major nutritional alterations in human immunodeficiency virus (HIV)-infected individuals. Both wasting and lipodystrophy may involve a decrease in body fat content, while wasting-but not lipodystrophy-also includes the loss of lean body mass. Lipodystrophy has made the identification of wasting increasingly more difficult. The diagnosis of wasting depends on a definition of the condition that takes into account sex and cultural differences, as well as measurements of body cell mass. Patient management involves a concurrent, comprehensive approach designed to restore lost body cell mass and weight. The authors make recommendations for defining, diagnosing, and treating HIV-associated wasting. Specific therapies include testosterone replacement, other anabolic steroids, and recombinant human growth hormone. Other adjunctive measures, such as progressive resistance exercise and cytokine modulation, may also be utilized. Expected outcomes from effective treatment include restored body cell mass, improvement in quality of life, and reduced rates of hospitalization. Future directions for research should address the need for optimal treatment strategies. PMID:11522215

Polsky, B; Kotler, D; Steinhart, C

2001-08-01

280

Successful Waste Treatment Methods at Sandia National Laboratories  

SciTech Connect

During the remediation of the waste landfills at Sandia National Laboratory in Albuquerque, New Mexico nine drums of mock high explosives were generated. This mixed waste stream was proposed to several offsite vendors for treatment and prices ranged from $2.50 to $10 per gram a total cost estimated to be in excess of $2 million dollars. This cost represents more than 30 percent of the annual budget for the Sandia Waste Management Operations. Concentrated solutions of common oxidizers, such as nitrates, nitrites, and peroxides, will also act as oxidizers and will give positive results in the Hazard Categorization oxidizer test. These solutions carry an EPA Hazardous Waste Number D001, Ignitable Waste, and Oxidizer as defined in 49 CFR 173.151. Sandia decided that given budget and time constraints to meet a Federal Facilities Compliance Act milestone, a process for onsite treatment should be evaluated. Clean samples of mock high explosive materials were obtained from Pantex excess inventory and treatability studies initiated to develop a treatment formula and process. The following process was developed and implemented in the summer of 2006: - Size reduction to allow for dissolution of the barium nitrate in water; - Dissolution of the Mock HE in water; - Deactivation of the oxidizer; - Stabilization of the barium and the cadmium contamination present as an underlying hazardous constituent. This project was completed and the treatment milestone achieved for less than $300,000. The Disassembly Sanitization Operation (DSO) is a process that was implemented to support weapon disassembly and disposition using recycling and waste minimization while achieving the demilitarization mission. The Department of Energy is faced with disassembling and disposition of a huge inventory of retired weapons, components, training equipment, spare parts, and weapon maintenance equipment. Environmental regulations have caused a dramatic increase for information needed to support the disposal and handling of these parts and materials. Manufacturing information from past decades often does not meet the needs for regulatory decisions of today to assure proper management of weapons components. Huge inventories of classified weapon components were required to have long-term storage at Sandia and many other locations throughout the complex. These materials are stored because they are classified, they may also contain radiological and/or hazardous components and disposal options may not have existed for this material. Long-term storage is costly and somewhat problematic. It requires a secured storage area, monitoring, auditing and it also has the potential for loss or theft of this material. Overall recycling rates for materials sent through the DSO process have enabled 70 to 80% of these components to be recycled. These components are made to extreme standards and are made of high quality materials. Once the material has been sanitized, the demand for these metals is very high. The DSO process for the NGPF classified components established the credibility of this technique as a viable process for addressing the long-term storage requirements of classified weapons component inventory. The success of this operation has generated interest from other Sandia Organization other locations throughout the complex. Other organizations are soliciting the help of the DSO team and the DSO is responding to these solicitations by expanding its scope to include work for other projects. For example, Pantex has asked the DSO team to assist with the destruction of their classified components. The operation is full scale and continues to grow and serve SNL/NM and DoE by providing a solution to this evolving issue. On an ongoing basis, SNL has been incurring expenses for the management and storage of classified components. It is estimated that this project will save the DoE and Sandia several hundreds of thousands of dollars until the excess inventory is eliminated. This innovative approach eliminates the need for long-term storage of classified weapons components and the

Rast, D.M.; Thompson, J.J.; Cooper, T.W.; Stockham, D.J

2007-07-01

281

Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: Pulmonary hypertension associated with hemolytic anemia  

PubMed Central

Hereditary hemoglobin disorders affecting the globin chain synthesis namely thalassemia syndromes and sickle cell disease (SCD) are the most common genetic disorders in human. Around 7% of the world population carries genes for these disorders, mainly the Mediterranean Basin, Middle and Far East, and Sub-Saharan Africa. An estimated 30 million people worldwide are living with sickle cell disease, while 60-80 million carry beta thalassemia trait. About 400,000 children are born with severe hemoglobinopathies each year. Cardiovascular complications of hemoglobinopathies include left and right ventricular (RV) dysfunction, arrhythmias, pericarditis, myocarditis, valvular heart disease, myocardial ischemia, and notably pulmonary hypertension (PH). Because of a unique pathophysiology, pulmonary hypertension associated with hemolytic disorders was moved from WHO group I to group V PH diseases. Treatment strategies are also unique and include blood transfusion, iron chelation, hydroxyurea, and oxygen therapy. The role of PH-specific agents has not been established. PMID:25077000

Saleemi, Sarfraz

2014-01-01

282

Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: Pulmonary hypertension associated with hemolytic anemia.  

PubMed

Hereditary hemoglobin disorders affecting the globin chain synthesis namely thalassemia syndromes and sickle cell disease (SCD) are the most common genetic disorders in human. Around 7% of the world population carries genes for these disorders, mainly the Mediterranean Basin, Middle and Far East, and Sub-Saharan Africa. An estimated 30 million people worldwide are living with sickle cell disease, while 60-80 million carry beta thalassemia trait. About 400,000 children are born with severe hemoglobinopathies each year. Cardiovascular complications of hemoglobinopathies include left and right ventricular (RV) dysfunction, arrhythmias, pericarditis, myocarditis, valvular heart disease, myocardial ischemia, and notably pulmonary hypertension (PH). Because of a unique pathophysiology, pulmonary hypertension associated with hemolytic disorders was moved from WHO group I to group V PH diseases. Treatment strategies are also unique and include blood transfusion, iron chelation, hydroxyurea, and oxygen therapy. The role of PH-specific agents has not been established. PMID:25077000

Saleemi, Sarfraz

2014-07-01

283

Treatment Research in Mental Illness: Improving the Nation's Public Mental Health Care  

E-print Network

Treatment Research in Mental Illness: Improving the Nation's Public Mental Health Care through NIMH of treatments for mental illnesses in the U.S. The NIMH, through the Division of Services and Intervention, pharmacological, and psychosocial treatment modalities for the treatment of mental disorders and behavioral

Baker, Chris I.

284

Proposed quality control guidelines for National Committee for Clinical Laboratory Standards Susceptibility Tests using the veterinary antimicrobial agent tiamulin  

Microsoft Academic Search

Quality control guidelines for standardized antimicrobial susceptibility test methods are critical for the continuing accuracy of these clinical tests. In this report, quality control limits were proposed for the veterinary antimicrobial agent tiamulin with minimum inhibitory concentration (MIC) ranges of three or four log2 dilution steps in two different medium formulations. Disk diffusion zone diameter ranges were proposed for tiamulin

Michael A Pfaller; Ronald N Jones; Donald H Walter

2001-01-01

285

Calcium hydroxylapatite associated soft tissue necrosis: a case report and treatment guideline.  

PubMed

We present an uncommon case of nasal alar and facial necrosis following calcium hydroxylapatite filler injection performed elsewhere without direct physician supervision. The patient developed severe full-thickness necrosis of cheek and nasal alar skin 24 h after injections into the melolabial folds. Management prior to referral included oral antibiotics, prednisone taper, and referral to a dermatologist (day 3) who prescribed valacyclovir for a presumptive herpes zoster reactivation induced by the injection. Referral to our institution was made on day 11, and after herpetic outbreak was ruled out by a negative Tzanck smear, debridement with aggressive local wound care was initiated. After re-epithelialization and the fashioning of a custom intranasal stent to prevent vestibular stenosis, pulsed dye laser therapy was performed for wound modification. The patient healed with an acceptable cosmetic outcome. This report underscores the importance of facial vasculature anatomy, injection techniques, and identification of adverse events when using fillers. A current treatment paradigm for such events is also presented. PMID:23993752

Tracy, Lauren; Ridgway, James; Nelson, J Stuart; Lowe, Nelson; Wong, Brian

2014-04-01

286

Antimicrobial management of presumed microbial keratitis: guidelines for treatment of central and peripheral ulcers  

PubMed Central

AIMS—To determine the quantitative relation between the major risk factors for microbial keratitis of previous ocular surface disease and contact lens wear and central and peripheral infiltration, often associated with ulceration, in order to establish a rational chemotherapeutic management algorithm.?METHODS—Data from 55 patients were collected over a 10 month period. All cases of presumed microbial keratitis where corneal scrapes had been subjected to microbiological examination were included. Risk factor data and laboratory outcome were recorded. Antimicrobial regimens used to treat each patient were documented.?RESULTS—57 episodes of presumed microbial keratitis were identified from 55 patients, 24 male and 31 female. There were 30 central infiltrates and 27 peripheral infiltrates of which 28 were culture positive (73% of central infiltrates, 22% of peripheral infiltrates). 26 patients had worn contact lenses of whom 12 had culture positive scrapes (9/14 for central infiltrates, 3/12 for peripheral infiltrates). 31 patients had an ocular surface disease of whom five previous herpes simplex virus keratitis patients developed secondary bacterial infection. Anterior chamber activity and an infiltrate size ? 4 mm2 were more common with culture positive central infiltrates than peripheral infiltrates (?2 test = 11.98, p<0.001).?CONCLUSIONS—Predisposing factors for "presumed" microbial keratitis, either central or peripheral, were: ocular surface disease (26/57 = 45.6%), contact lens wear (26/57 = 45.6%), and previous trauma (5/57 = 8.8%). Larger ulceration (?4 mm2) with inflammation was more often associated with positive culture results for central infiltration. None of these four variables (contact lens wear, ocular surface disease, ulcer size, anterior chamber activity) were of intrinsic value in predicting if a peripheral infiltrate would yield identifiable micro-organisms. Successful management of presumed microbial keratitis is aided by a logical approach to therapy, with the use of a defined algorithm of first and second line broad spectrum antimicrobials, for application at each stage of the investigative and treatment process considering central and peripheral infiltration separately.?? Keywords: ulcerative keratitis; antimicrobials; ulcers PMID:9613378

Bennett, H; Hay, J; Kirkness, C; Seal, D; Devonshire, P.

1998-01-01

287

General design, construction, and operation guidelines: Constructed wetlands wastewater treatment systems for small users including individual residences. Second edition  

SciTech Connect

One of the Tennessee Valley Authority`s (TVA`s) major goals is cleanup and protection of the waters of the Tennessee River system. Although great strides have been made, point source and nonpoint source pollution still affect the surface water and groundwater quality in the Tennessee Valley and nationally. Causes of this pollution are poorly operating wastewater treatment systems or the lack of them. Practical solutions are needed, and there is great interest and desire to abate water pollution with effective, simple, reliable and affordable wastewater treatment processes. In recognition of this need, TVA began demonstration of the constructed wetlands technology in 1986 as an alternative to conventional, mechanical processes, especially for small communities. Constructed wetlands can be downsized from municipal systems to small systems, such as for schools, camps and even individual homes.

Steiner, G.R.; Watson, J.T.

1993-05-01

288

Thyroid Coding Guidelines  

Cancer.gov

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

289

Developing clinical practice guidelines: target audiences, identifying topics for guidelines, guideline group composition and functioning and conflicts of interest  

PubMed Central

Clinical practice guidelines are one of the foundations of efforts to improve health care. In 1999, we authored a paper about methods to develop guidelines. Since it was published, the methods of guideline development have progressed both in terms of methods and necessary procedures and the context for guideline development has changed with the emergence of guideline clearing houses and large scale guideline production organisations (such as the UK National Institute for Health and Clinical Excellence). It therefore seems timely to, in a series of three articles, update and extend our earlier paper. In this first paper we discuss: the target audience(s) for guidelines and their use of guidelines; identifying topics for guidelines; guideline group composition (including consumer involvement) and the processes by which guideline groups function and the important procedural issue of managing conflicts of interest in guideline development. PMID:22762776

2012-01-01

290

Evaluation of antidiabetic prescriptions, cost and adherence to treatment guidelines: A prospective, cross-sectional study at a tertiary care teaching hospital  

PubMed Central

Introduction: Diabetes mellitus is on alarming rise in India. Drug utilization studies help to identify the adherence to standard treatment guidelines and to evaluate the rational drug usage. Objective: To study prescription pattern, calculate the cost of antidiabetic drugs and to evaluate the adherence to treatment guidelines in diabetic patients attending the medicine outpatient department in a tertiary care teaching hospital. Materials and Methods: A prospective observational study was carried out for a period of 5 months. The diabetic patients who visited the medicine outdoor department were included. Demographic data and complete prescription details were recorded in the structured case record form. Cost of the drug therapy was calculated from the patient's bills. Indian Council for Medical research guidelines-2005 for diabetes management was used to evaluate the adherence. Results: A total of 250 patients were enrolled in the study with mean age 57.91 ± 9.37. Out of 250 patients 126 (50.4%) were male and rest were female. A total of 1,391 drugs were prescribed, with mean of 5.56 ± 2.52 drugs and out of which 539 drugs were antidiabetics with mean of 2.18 ± 0.96. In monotherapy, metformin was frequently 218 (40.45%) prescribed. Glimepiride and metformin was the most frequently prescribed in 119 (76.28%) out of 156 antidiabetic drug combinations. Most commonly used drugs other than antidiabetics were aspirin 146 (18.9%) and atorvastatin 119 (15.41%). Mean cost of therapy for a month for a diabetic patient was 354.60 ± 305.72 INR. Majority 209 (83.6%) of prescriptions was in accordance to guidelines. Conclusion: Metformin was the most frequently prescribed drug in the diabetes patient. Metformin and glimeperide being the most frequent combination used. Majority of the prescriptions followed standard guidelines. PMID:24808678

Acharya, Khushali G.; Shah, Kartik N.; Solanki, Nilay D.; Rana, Devang A.

2013-01-01

291

Evaluating the Application and Applicability of Treatment Guidelines in Daily Clinical Practice. Closing the loop with the Euro Heart Survey programme  

Microsoft Academic Search

The main research questions in this thesis correspond to those of the Netherlands Heart \\u000aFoundation (NHF)-Health Care programme and were closely related to the aims of the Euro \\u000aHeart Survey (EHS) programme, namely to evaluate to which extend every day clinical \\u000apractice corresponds with evidence-based guidelines and to evaluate the generalisability of \\u000aevidence-based treatment. \\u000aThe EHS is initiated by the

M. J. Lenzen

2006-01-01

292

7 CFR 611.10 - Standards, guidelines, and plans.  

Code of Federal Regulations, 2012 CFR

...DEPARTMENT OF AGRICULTURE CONSERVATION OPERATIONS SOIL SURVEYS Soil Survey Operations § 611.10 Standards, guidelines, and plans. (a) NRCS conducts soil surveys under national standards and guidelines...

2012-01-01

293

7 CFR 611.10 - Standards, guidelines, and plans.  

Code of Federal Regulations, 2011 CFR

...DEPARTMENT OF AGRICULTURE CONSERVATION OPERATIONS SOIL SURVEYS Soil Survey Operations § 611.10 Standards, guidelines, and plans. (a) NRCS conducts soil surveys under national standards and guidelines...

2011-01-01

294

7 CFR 611.10 - Standards, guidelines, and plans.  

Code of Federal Regulations, 2013 CFR

...DEPARTMENT OF AGRICULTURE CONSERVATION OPERATIONS SOIL SURVEYS Soil Survey Operations § 611.10 Standards, guidelines, and plans. (a) NRCS conducts soil surveys under national standards and guidelines...

2013-01-01

295

7 CFR 611.10 - Standards, guidelines, and plans.  

Code of Federal Regulations, 2010 CFR

...DEPARTMENT OF AGRICULTURE CONSERVATION OPERATIONS SOIL SURVEYS Soil Survey Operations § 611.10 Standards, guidelines, and plans. (a) NRCS conducts soil surveys under national standards and guidelines...

2010-01-01

296

A National Program for the Assessment and Treatment of Sex Offenders in the English Prison System  

Microsoft Academic Search

A new national prison strategy for the assessment and treatment of sex offenders in England is described. Its main features are the potential inclusion of all convicted sex offenders sentenced to 4 or more years in prison, a coordinated and systematized assessment and treatment package, reliance on nonspecialist personnel to deliver treatment, and the integration of population and program research.

DON GRUBIN; DAVID THORNTON

1994-01-01

297

Consensus Guidelines for Delineation of Clinical Target Volume for Intensity-Modulated Pelvic Radiotherapy for the Definitive Treatment of Cervix Cancer  

SciTech Connect

Purpose: Accurate target definition is vitally important for definitive treatment of cervix cancer with intensity-modulated radiotherapy (IMRT), yet a definition of clinical target volume (CTV) remains variable within the literature. The aim of this study was to develop a consensus CTV definition in preparation for a Phase 2 clinical trial being planned by the Radiation Therapy Oncology Group. Methods and Materials: A guidelines consensus working group meeting was convened in June 2008 for the purposes of developing target definition guidelines for IMRT for the intact cervix. A draft document of recommendations for CTV definition was created and used to aid in contouring a clinical case. The clinical case was then analyzed for consistency and clarity of target delineation using an expectation maximization algorithm for simultaneous truth and performance level estimation (STAPLE), with kappa statistics as a measure of agreement between participants. Results: Nineteen experts in gynecological radiation oncology generated contours on axial magnetic resonance images of the pelvis. Substantial STAPLE agreement sensitivity and specificity values were seen for gross tumor volume (GTV) delineation (0.84 and 0.96, respectively) with a kappa statistic of 0.68 (p < 0.0001). Agreement for delineation of cervix, uterus, vagina, and parametria was moderate. Conclusions: This report provides guidelines for CTV definition in the definitive cervix cancer setting for the purposes of IMRT, building on previously published guidelines for IMRT in the postoperative setting.

Lim, Karen [Radiation Medicine Program, Princess Margaret Hospital/ Ontario Cancer Institute, University Health Network, Toronto, Ontario (Canada); Small, William [Department of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois (United States); Portelance, Lorraine [Department of Radiation Oncology, McGill University Health Center, Montreal, Quebec (Canada); Creutzberg, Carien [Department of Clinical Oncology, Leiden University Medical Center, Leiden (Netherlands); Juergenliemk-Schulz, Ina M. [Department of Radiation Oncology, University Medical Center Utrecht, Utrecht (Netherlands); Mundt, Arno; Mell, Loren K. [Department of Radiation Oncology, University of California, San Diego, School of Medicine, La Jolla, California (United States); Mayr, Nina [Department of Radiation Medicine, Ohio State University, Columbus, Ohio (United States); Viswanathan, Akila [Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA (United States); Jhingran, Anuja [Department of Radiation Oncology, M.D. Anderson Cancer Center, Houston, TX (United States); Erickson, Beth [Dept. of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); De Los Santos, Jennifer [Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, AL (United States); Gaffney, David [Dept. of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (United States); Yashar, Catheryn [Dept. of Radiation Oncology, Univ. of California, San Diego, School of Medicine, La Jolla, CA (United States); Beriwal, Sushil [Dept. of Radiation Oncology, Magee-Women's Hospital of Univ. of Pittsburgh Medical Center, Pittsburgh, PA (United States); Wolfson, Aaron [Dept. of Radiation Oncology, Univ. of Miami Miller School of Medicine, Miami, FL (United States)

2011-02-01

298

Residential Treatment: A Review of the National Literature  

E-print Network

involvement in all aspects of treatment, (2) for the centrality of regular contacts between children and their families, and (3) for the importance of aftercare and support to maintain gains made in RT. Insights from families, youth, and professionals converge...

Walter, Uta M.; Petr, Chris

2007-08-01

299

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

300

Principles for National and Regional Guidelines on Cardiovascular Disease Prevention: A Scientific Statement From the World Heart and Stroke Forum  

Microsoft Academic Search

n the global effort to reduce suffering and death from CVD, the World Heart and Stroke Forum (WHSF) Guide- lines Task Force of the World Heart Federation (WHF) recommends that every country develop a policy on CVD prevention. National policy should grow out of systematic and ongoing dialogue among governmental, public health, and professional clinical groups. National policy should set

Sidney C. Smith; Rod Jackson; Thomas A. Pearson; Valentin Fuster; Salim Yusuf; Ole Faergeman; David A. Wood; Michael Alderman; John Horgan; Philip Home; Marilyn Hunn; Scott M. Grundy

2004-01-01

301

Access to treatment for HBV infection and its consistency with 2008 European guidelines in a multicentre cross-sectional study of HIV/HBV co-infected patients in Italy  

PubMed Central

Background A survey was performed in 2008 to evaluate the profiles of patients with chronic hepatitis B cared for by Italian Infectious Diseases Centers (IDCs). This analysis describes: i) factors associated with access to the anti-HBV treatment in a cohort of HIV/HBV co-infected patients cared for in tertiary centers of a developed country with comprehensive coverage under the National Health System (NHS); ii) consistency of current anti-HBV regimens with specific European guidelines in force at the time of the study and factors associated with the receipt of sub-optimal regimens. Methods The study focuses on 374 (87.6%) treated patients at some point in their life out of the 427 tested HIV/HBV positive. It is multicentre, cross-sectional in the design. To account for missing values, a Multiple Imputation method is used. Results Three hundred and thirty-four (89.3%) patients were currently treated. The most common current regimen was combination therapy of tenofovir (TDF) plus LAM/FTC (lamivudine/emtricitabine) (n?=?235, 70.4%), as part of antiretroviral treatment. In the multivariate analysis, an increased chance of getting treated was independently associated with increasing years since HBV diagnosis (2–10 years, p <0.001; >10 years, p <0.001). Patients consistently treated with European AIDS Clinical Society (EACS) 2008 guidelines were 255 (76.6%), of whom 202 (79.2%) with an indication to an anti-HIV treatment, 30 (11.8%)without an indication, and 21 (8.2%) with cirrhosis. Among the 78 not-consistent patients, LAM mono-therapy (n?=?60, 76.9%) was the most common regimen, 34 (56.7%) of them showing HBV DNA load below 1x103 IU/mL. Previous anti-HBV treatment (p = 0.01) and a triple HDV co-infection (p = 0.03) reduced the chance of not-consistent regimens. Conversely, HCV co-infection was independently associated with an increased odds ratio of being inconsistently treated (p = 0.004). Conclusion Our study shows that Italian IDCs treat for HBV infection the vast majority of HIV/HBV co-infected patients with no disparities limiting access to antiviral therapy. In approximately two-thirds of the patients on treatment, anti-HBV regimens are consistent with 2008 EACS guidelines. Finally, our study identifies scenarios in which clinical practice deviates from recommendations, as in case of sub-optimal regimens with effective anti-HBV response. PMID:23594964

2013-01-01

302

Implementation of national guidelines, incorporated within structured diabetes and hypertension records at primary level care in Cape Town, South Africa: a randomised controlled trial  

PubMed Central

Background and objectives Many clinical management guidelines for chronic diseases have been published, but they have not been put into practice by busy clinicians at primary care levels. This study evaluates the implementation of national guidelines incorporated within a structured diabetes and hypertension clinical record (SR) in Cape Town in a randomised controlled trial (RCT). Methods Eighteen public sector community health centres (CHC) were randomly selected and allocated as intervention or control CHC. At each clinic, 25 patients with diabetes and 35 patients with hypertension were enrolled at baseline. Questionnaires were completed, blood samples were collected, blood pressure (BP) and anthropometric measures were taken and patient records were audited. SR with clinical guideline prompts were introduced at the intervention clinics after training doctors in their use and suggestions to incorporate them in regular patient records. Contact was maintained during the year of intervention with the clinic staff. A follow-up survey was conducted 1 year later to assess BP and HbA1c, and the patient records were examined to ascertain the extent of use of the SR in the intervention clinics. In-depth interviews were conducted with doctors and nurses to record their response to the intervention. Results The intervention evaluated in this RCT had no impact on either diabetes or hypertension control. In the intervention clinics, less than 60% of the patient folders contained the SR and when present was seldom used. Although the staff were well disposed to the research team, their workload prohibited them from undertaking a true evaluation of the SR, and overall they did not perceive the SR as supporting their current process of patient care. Conclusions No benefit to diabetes of hypertension care by introducing and availability of the staff in the use of the SR was shown in this RCT. The process measures suggest that the SR was not widely used by the healthcare provided in the primary care clinics. PMID:24070181

Steyn, Krisela; Lombard, Carl; Gwebushe, Nomonde; Fourie, Jean M.; Everett-Murphy, Katherine; Zwarenstein, Merrick; Levitt, Naomi S.

2013-01-01

303

78 FR 45544 - Center for Substance Abuse Treatment (CSAT) National Advisory Council; Notice of Meeting  

Federal Register 2010, 2011, 2012, 2013

...DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment (CSAT) National Advisory...92-463, notice is hereby given that the Substance Abuse and Mental Health Services...

2013-07-29

304

78 FR 15961 - Center for Substance Abuse Treatment National Advisory Council; Meeting  

Federal Register 2010, 2011, 2012, 2013

...DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment National Advisory Council...is hereby given of the meeting of the Substance Abuse and Mental Health Services...

2013-03-13

305

Criteria for Practice Guideline Development and Evaluation.  

ERIC Educational Resources Information Center

Provides a guide for developing, evaluating, and reviewing proposed and existing practice guidelines, explaining the difference between guidelines and standards and between practice and treatment. Describes the process of developing the 1995 American Psychological Association practice guidelines document, then focuses on practice guideline

American Psychologist, 2002

2002-01-01

306

?? Step Therapy Is Not Appropriate for Antiepileptic Drugs To the Editor: We read with interest the article by Payakachat and colleagues, comparing the clinical practice guidelines for treatment of new-onset epilepsy in adults  

Microsoft Academic Search

1 While we appreciate their efforts to provide a careful review of available treatment guidelines and consideration of how these guidelines might be applied in managed care, we strongly disagree with their conclusion that older agents (i.e., phenobarbital, carbamazepine, phenytoin, and valproate) are the preferred first-line treatments for new-onset epilepsy. Their conclusions appear to be based upon a rather narrow

Timothy E. Welty; Edward Faught; Michael D. Privitera

2006-01-01

307

Saudi Guidelines on the Diagnosis and Treatment of Pulmonary Hypertension: Pulmonary hypertension due to lung diseases and/or hypoxia  

PubMed Central

Chronic lung diseases are common causes of pulmonary hypertension. It ranks second after the left heart disease. Both obstructive and restrictive lung diseases are know to cause pulmonary hypertension. The pathophysiology of the disease is complex, and includes factors affecting the blood vessels, airways, and lung parenchyma. Hypoxia and the inhalation of toxic materials are another contributing factors. Recent guidelines have further clarified the association between pulmonary hypertension and chronic lung disease and made general guidelines concerning the diagnosis and management. In this article, we will provide a detailed revision about the new classification and give general recommendations about the management of pulmonary hypertension in chronic lung diseases. PMID:25076998

Sakkijha, Husam; Idrees, Majdy M.

2014-01-01

308

NATIONAL SCREENING SURVEY OF EDCS IN MUNICIPAL WASTEWATER TREATMENT FACILITIES  

EPA Science Inventory

In 2002 and 2003 the USEPA's Office of Research and Development asked Regional EPA inspectors, state EPA inspectors and municipal plant operators to collect four gallons effluent, either as a grab or composite sample, from up to 50 wastewater treatment plants (WWTP), and ship the...

309

National Institute on Aging-Alzheimer’s Association guidelines for the neuropathologic assessment of Alzheimer’s disease: a practical approach  

PubMed Central

We present a practical guide for the implementation of recently revised National Institute on Aging-Alzheimer’s Association guidelines for the neuropathologic assessment of Alzheimer’s disease (AD). Major revisions from previous consensus criteria are: (i) recognition that AD neuropathologic changes may occur in the apparent absence of cognitive impairment, (ii) an “ABC” score for AD neuropathologic change that incorporates histopathologic assessments of amyloid ? deposits (A), staging of neurofibrillary tangles (B), and scoring of neuritic plaques (C), and (iii) more detailed approaches for assessing commonly co-morbid conditions such as Lewy body disease, vascular brain injury, hippocampal sclerosis, and TAR DNA binding protein (TDP)-43 immunoreactive inclusions. Recommendations also are made for the minimum sampling of brain, preferred staining methods with acceptable alternatives, reporting of results, and clinico-pathologic correlations. PMID:22101365

Montine, Thomas J.; Phelps, Creighton H.; Beach, Thomas G.; Bigio, Eileen H.; Cairns, Nigel J.; Dickson, Dennis W.; Duyckaerts, Charles; Frosch, Matthew P.; Masliah, Eliezer; Mirra, Suzanne S.; Nelson, Peter T.; Schneider, Julie A.; Thal, Dietmar Rudolf; Trojanowski, John Q.; Vinters, Harry V.; Hyman, Bradley T.

2011-01-01

310

Breast Cancer Risk in Young Women in the National Breast Screening Programme: Implications for Applying NICE Guidelines for Additional Screening and Chemoprevention.  

PubMed

In the United Kingdom, women at moderate and high risk of breast cancer between the ages of 40 and 49 years are eligible for annual mammographic screening and preventive therapy with tamoxifen. Here, we estimate the numbers of women in a population eligible for this service and the proportion of breast cancers detected in this group compared with the whole population. Women <50 attending for mammographic screening in the National Health Service Breast Screening Programme (NHSBSP) completed a risk questionnaire. The proportion at moderate and high risk according to National Institute of Health Care Excellence (NICE) guidelines was estimated. An estimate was also made using a different model of risk estimation (Tyrer-Cuzick). The numbers of cancers detected in the moderate/high risk groups were compared with numbers detected in the whole population. Completed questionnaires were available for 4,360 women between ages 46 and 49 years. Thirty women [0.7%; 95% confidence interval (CI), 0.5-1.0%] were at high risk and 130 (3.0%, 2.5-3.5%) were at moderate risk according to NICE guidelines. Thirty-seven cancers were detected by mammography in the whole group. Five of these were found in the moderate-/high-risk group giving a 3.2-fold increase in detection compared with the standard risk group. More women were assigned to the moderate- or high-risk group using the Tyrer-Cuzick model (N = 384), but the numbers of cancers in this group were not appreciably increased (N = 8). Systematic assessment of family history in primary care or through population-based screening will identify appreciable numbers of women in their forties, eligible for additional surveillance and chemoprevention Cancer Prev Res; 7(10); 993-1001. ©2014 AACR. PMID:25047362

Evans, D Gareth; Brentnall, Adam R; Harvie, Michelle; Dawe, Sarah; Sergeant, Jamie C; Stavrinos, Paula; Astley, Susan; Wilson, Mary; Ainsworth, John; Cuzick, Jack; Buchan, Iain; Donnelly, Louise S; Howell, Anthony

2014-10-01

311

SBRT for the Primary Treatment of Localized Prostate Cancer: The Effect of Gleason Score, Dose and Heterogeneity of Intermediate Risk on Outcome Utilizing 2.2014 NCCN Risk Stratification Guidelines  

PubMed Central

Purpose: To report an update of our previous experience using stereotactic body radiation therapy (SBRT) for the primary treatment of prostate cancer, risk stratified by the updated National Comprehensive Cancer Network (NCCN) version 2.2014, reporting efficacy and toxicity in a community hospital setting. Methods: From 2007 to 2012, 142 localized prostate cancer patients were treated with SBRT using CyberKnife. NCCN guidelines Version 2.2014 risk groups analyzed included very low (20%), low (23%), intermediate (35%), and high (22%) risk. To further explore group heterogeneity and to comply with new guidelines, we separated our prior intermediate risk group into favorable intermediate and unfavorable intermediate groups depending on how many intermediate risk factors were present (one vs.?>?one). The unfavorable intermediate group was further analyzed in combination with the high risk group as per NCCN guidelines Version 2.2014. Various dose levels were used over the years of treatment, and have been categorized into low dose (35?Gy, n?=?5 or 36.25?Gy, n?=?107) and high dose (37.5?Gy, n?=?30). All treatments were delivered in five fractions. Toxicity was assessed using radiation therapy oncology group criteria. Results: Five-year actuarial freedom from biochemical failure (FFBF) was 100, 91.7, 95.2, 90.0, and 86.7% for very low, low, intermediate and high risk patients, respectively. A significant difference in 5?year FFBF was noted for patients with Gleason score (GS) ?8 vs. 7 vs. 5/6 (p?=?0.03) and low vs. high dose (p?=?0.05). T-stage, pretreatment PSA, age, risk stratification group, and use of ADT did not affect 5-year FFBF. Multivariate analysis revealed GS and dose to be the most predictive factors for 5-year FFBF. Conclusion: Our experience with SBRT for the primary treatment of localized prostate cancer demonstrates favorable efficacy and toxicity comparable to the results reported for IMRT in literature. GS remains the single most important pretreatment predictor of outcome.

Bernetich, Matthew; Oliai, Caspian; Lanciano, Rachelle; Hanlon, Alexandra; Lamond, John; Arrigo, Stephen; Yang, Jun; Good, Michael; Feng, Jing; Brown, Royce; Garber, Bruce; Mooreville, Michael; Brady, Luther W.

2014-01-01

312

Family-Driven Youth-Guided Practices in Residential Treatment: Findings from a National Survey of Residential Treatment Facilities. Residential Treatment for Children & Youth, vol. 27, issue 3  

Microsoft Academic Search

This study reports findings from a national survey of residential treatment providers that examined adoption of family-driven, youth-guided practices. Providers reported several practices consistent with family-driven, youth-guided care, such as strength-based individualized treatment planning, but fewer include youth or family members in facility governance activities.

Jonathan D. Brown; Kirsten Barrett; Henry T. Ireys; Kamala Allen; Sheila A. Pires; Gary Blau

2010-01-01

313

Therapist effects in the National Institute of Mental Health Treatment of Depression Collaborative Research Program  

Microsoft Academic Search

Recent psychotherapy research literature has stressed the importance of therapist effects (i.e., the impact of the individual therapist on treatment outcome). The authors report an analysis of therapist effects in the National Institute of Mental Health Treatment of Depression Collaborative Research Program using hierarchical linear modeling. In addition to studying overall therapist effects, they investigate the possible interaction of therapists

Irene Elkin; Lydia Falconnier; Zoran Martinovich; Colleen Mahoney

2006-01-01

314

Substance Dependence, Abuse and Treatment: Findings from the 2000 National Household Survey on Drug Abuse.  

ERIC Educational Resources Information Center

This report provides the first information on substance dependence, abuse, and treatment obtained from the 2000 National Household Survey on Drug Abuse (NHSDA). Several important changes to the NHSDA in 1999 and 2000 affected the estimates of drug use, as well as the estimates for dependence, abuse, and needing and receiving treatment. Following…

Epstein, Joan F.

315

[Integrated headache care network. Kiel Migraine and Headache Center and German National Headache Treatment Network].  

PubMed

Migraine and other headaches affect 54 million people in Germany. They rank among the ten most severely disabling complaints and the three most expensive neurological disorders. Nevertheless, they are not adequately recognized in the healthcare system with sketchy diagnoses and inadequate treatment. This inadequate care is not primarily due to a lack of medical and scientific knowledge on the development and treatment of headaches but is predominantly due to organizational deficits in the healthcare system and in the implementation of current knowledge. To overcome the organizational barriers the national headache treatment network was initiated in Germany. For the first time it allows national cross-sectoral and multidisciplinary links between inpatient and outpatient care. A hand in hand treatment programme, better education, better information exchange between all partners and combined efforts using clearly defined treatment pathways and goals are the basis for state of the art and efficient treatment results. The treatment network is geared towards the specialized treatment of severely affected patients with chronic headache disorders. A national network of outpatient and inpatient pain therapists in both practices and hospitals works hand in hand to optimally alleviate pain in a comprehensive cross-sectoral and multidisciplinary manner. For therapy refractive disorders, a high-intensive supraregional fully inpatient treatment can be arranged. This concept offers for the first time a nationwide coordinated treatment without limitation by specialization and bureaucratic remuneration sectors. PMID:23549863

Göbel, H; Heinze-Kuhn, K; Petersen, I; Göbel, A; Heinze, A

2013-04-01

316

76 FR 18713 - Malheur National Forest; Oregon; Malheur National Forest Site-Specific Invasive Plants Treatment...  

Federal Register 2010, 2011, 2012, 2013

...could be anywhere on Forest Service system lands...sites (i.e. fires, flood events...outside the National Forest. They can increase fire hazards, degrade...could be anywhere on Forest Service system lands...sites (i.e. fires, flood...

2011-04-05

317

Dietary guidelines in singapore.  

PubMed

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

Lee, Benjamin Lc

2011-01-01

318

Atmospherically deposited PBDEs, pesticides, PCBs, and PAHs in Western US National Park fish: Concentrations and consumption guidelines  

EPA Science Inventory

Concentrations of polybrominated diphenyl ethers (PBDEs), pesticides, polychlorinated biphenyls (PCBs), and polycyclic aromatic hydrocarbons were measured in 136 fish from 14 remote lakes in 8 western U.S. National Parks/Preserves between 2003 and 2005 and compared to human and w...

319

The glory of guidelines and the twilight of reality: controversies and challenges in the prevention and treatment of HIV in children.  

PubMed

Since the discovery of HIV 30 years ago, we have learned much about HIV in children and adolescents. Dramatic declines have occurred in mother-to-child transmission of HIV in resource-rich countries. Resource-poor countries struggle with improving prevention of mother-to-child transmission due to the lack of universal antiretroviral treatment for pregnant and nursing mothers. In children infected with HIV, pharmacokinetic, safety and efficacy data have been determined for many of the older drugs. Data are lacking for the newer, safer and more effective currently available drugs, resulting in the pediatric guidelines lagging behind adult recommendations. Although guidelines for prevention and treatment are helpful, the way they are created causes them to lag behind new scientific evidence, and in some situations they will be confusing or only based on expert opinion. Improving prevention of HIV infection in adolescents and young adults and in treating those who become HIV infected is crucially important. The next 10 years hold tremendous opportunities for improvements in prevention and treatment of HIV in children, adolescents and young adults. PMID:22943400

Anderson, Evan J; Yogev, Ram

2012-07-01

320

[Diagnosis and treatment of osteoporosis and rheumatoid arthritis in accordance with German guidelines. Results of a survey of patients, primary care physicians and rheumatologists].  

PubMed

In a cross-sectional study the prevalence of osteoporosis and osteopenia in patients with rheumatoid arthritis (ORA study) was investigated. Additionally, patients, their family doctors and rheumatologists were surveyed on their awareness of osteoporosis in RA, prevention, diagnosis, treatment and use of guidelines.In the years 2005 and 2006 a total of 532 patients with RA (98 men, 434 women) aged 23-87 years were consecutively recruited from 9 German centers for rheumatology. Clinical examination included a detailed documentation of osteoporosis medication. Dual-energy X-ray absorptiometry (DXA) was used to measure bone mineral density (BMD) at the lumbar spine and neck of the femur. Questionnaires on osteoporosis were sent to 119 family doctors (87 men, 32 women) and 44 rheumatologists (30 men, 14 women).The survey showed that rheumatologists had a higher awareness of osteoporosis in RA and compared to family doctors they estimated a higher frequency and tested RA patients more often for osteoporosis. In line with osteoporosis guidelines rheumatologists and family doctors saw an indication for densitometry in RA patients on steroid therapy and/or low intensity trauma fractures. In contrast to the 2006 recommendations of osteoporosis guidelines 50% of family doctors and rheumatologists preferred bisphosphonate off-label-therapy for premeopausal women with RA and comorbid glucocorticoid-induced osteoporosis. On the other hand 50% of premenopausal RA patients with osteoporosis did not receive any osteoporosis medication.The survey revealed a high degree of guideline compliance in diagnosing osteoporosis in RA but deficits were observed in the administration of osteoporosis medication, especially in premenopausal women. PMID:21755301

Heberlein, I; Demary, W; Bloching, H; Braun, J; Buttgereit, F; Dreher, R; Kuhn, C; Lange, U; Zink, A; Zeidler, H; Häntzschel, H; Raspe, H

2011-09-01

321

Propranolol in Use for Treatment of Complex Infant Hemangiomas: Literature Review Regarding Current Guidelines for Preassessment and Standards of Care before Initiation of Therapy  

PubMed Central

In 2008, the positive effects of propranolol on infantile hemangiomas (IH) have been discovered serendipitously by Léauté-Labrèze and her coworkers. Since then, propranolol has been in use in allday clinical practice worldwide for treatment of IH. It even caused some kind of paradigm shift in the overall management of these lesions, though propranolol is still not FDA approved, respectively, in “off-label” use for this indication in the majority of institutions. Thus, the aim of this communication is to evaluate the literature for current evidence regarding guidelines for preassessment and standards of care before initiation of therapy. PMID:23766715

Fette, Andreas

2013-01-01

322

Current standards for diagnosis and treatment of syphilis: selection of some practical issues, based on the European (IUSTI) and U.S. (CDC) guidelines  

PubMed Central

Syphilis continues to be an important epidemiologic problem. For a few years a steady increase in the incidence of this sexually transmitted disease has been observed. Advances in medical science obligate the doctor to use only such diagnostic and therapeutic approaches that are scientifically proven. Based on the European (IUSTI) and U.S. (CDC) guidelines, in this manuscript, we present some selected practical issues concerning diagnosis and treatment of syphilis. We truly hope that the present review will help all doctors taking care of syphilitic patients to systematize the current knowledge. PMID:24278076

Wojas-Pelc, Anna

2013-01-01

323

A guideline management system.  

PubMed

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

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

2004-01-01

324

Guidelines for quality assurance and quality control of fish taxonomic data collected as part of the National Water-Quality Assessment Program  

USGS Publications Warehouse

Fish community structure is characterized by the U.S. Geological Survey's National Water-Quality Assessment (NAWQA) Program as part of a perennial, multidisciplinary approach to evaluating the physical, chemical, and biological conditions of the Nation's water resources. The objective of quality assurance and quality control of fish taxonomic data that are collected as part of the NAWQA Program is to establish uniform guidelines and protocols for the identification, processing, and archiving of fish specimens to ensure that accurate and reliable data are collected. Study unit biologists, collaborating with regional biologists and fish taxonomic specialists, prepare a pre-sampling study plan that includes a preliminary faunal list and identification of an ichthyological curation center for receiving preserved fish specimens. Problematic taxonomic issues and protected taxa also are identified in the study plan, and collecting permits are obtained in advance of sampling activities. Taxonomic specialists are selected to identify fish specimens in the field and to assist in determining what fish specimens should be sacrificed, fixed, and preserved for laboratory identification, independent taxonomic verification, and long-term storage in reference or voucher collections. Quantitative and qualitative sampling of fishes follows standard methods previously established for the NAWQA Program. Common ichthyological techniques are used to process samples in the field and prepare fish specimens to be returned to the laboratory or sent to an institutional repository. Taxonomic identifications are reported by using a standardized list of scientific names that provides nomenclatural consistency and uniformity across study units.

Walsh, Stephen Joseph; Meador, Michael R.

1998-01-01

325

Reimbursed treatment, regulated in the national frame contract.  

PubMed

The investigation is an analysis of the main elements, included in the reimbursement system for the drug insurance. The aim is directly dependent on the valuation for the adequate service of the arise health needs of the citizens that are obligatory insured. The used methods are connected with an analysis of the regulations and of the statistical information. As result of the investigation are characterized the seize of the disease and of the drug nomenclature with a forecast reimburse therapy. The provide valuation of the objective state of the system shows that the criteria and rules are not clear and precise in respect of: the include of the drugs in the positive list, the determination of the level of reimbursement, the selection of the disease with the reimbursement treatment and especially of those with totally reimbursed therapy. The investigation shows that the accepted principles in this area are appropriate with the modern concepts and tendencies, but for their real realization are necessary additional attempts for overcoming of the negatives in the process of developments through adequate administrative decisions and approaches. PMID:11570227

Antonova, J; Dimitrova, Z

2001-01-01

326

Children's Advertising Guidelines.  

ERIC Educational Resources Information Center

These guidelines have been developed for the use of advertisers and advertising agencies and for the self-regulatory mechanism which these groups have established, the National Advertising Division, to help ensure that advertising directed to children is truthful, accurate, and fair to children's perceptions. Preliminary sections set forth basic…

Council of Better Business Bureaus, Inc., New York, NY.

327

RISK ASSESSMENT GUIDELINES  

EPA Science Inventory

EPA's Risk Assessment Guidelines were developed, based on recommendations from the National Academy of Science, to help guide EPA scientists in assessing the risks from chemicals or other agents in the environment. They also inform EPA decision makers and the general public ab...

328

CMA Infobase: clinical practice guidelines.  

PubMed

The CMA Infobase is a free Web-based resource that contains evidence-based clinical practice guidelines. The database is maintained by the Canadian Medical Association (CMA) and is available on its Web site. The CMA Infobase currently contains 1,200-plus clinical practice guidelines either developed or endorsed by an authoritative health care organization located in Canada. It is an alternative source of free clinical practice guidelines to the National Guideline Clearinghouse. This column will cover the basics of CMA Infobase, including searching, special features, and available resources which complement the database. PMID:19042721

Fitzpatrick, Roberta Bronson

2008-01-01

329

National Institute on Aging–Alzheimer’s Association guidelines for the neuropathologic assessment of Alzheimer’s disease  

PubMed Central

The current consensus criteria for the neuropathologic diagnosis of Alzheimer’s disease (AD), known as the National Institute on Aging/Reagan Institute of the Alzheimer Association Consensus Recommendations for the Postmortem Diagnosis of AD or NIA-Reagan Criteria [1], were published in 1997 (hereafter referred to as “1997 Criteria”). Knowledge of AD and the tools used for clinical investigation of cognitive impairment and dementia have advanced substantially since then and have prompted this update on the neuropathologic assessment of AD. PMID:22265587

Hyman, Bradley T.; Phelps, Creighton H.; Beach, Thomas G.; Bigio, Eileen H.; Cairns, Nigel J.; Carrillo, Maria C.; Dickson, Dennis W.; Duyckaerts, Charles; Frosch, Matthew P.; Masliah, Eliezer; Mirra, Suzanne S.; Nelson, Peter T.; Schneider, Julie A.; Thal, Dietmar Rudolf; Thies, Bill; Trojanowski, John Q.; Vinters, Harry V.; Montine, Thomas J.

2011-01-01

330

Incidence estimate and guideline-oriented treatment for post-stroke spasticity: an analysis based on German statutory health insurance data  

PubMed Central

Background Spasticity after stroke has been internationally recognized as an important health problem causing impairment of mobility, deformity, and pain. The aim of this study was to assess the frequency of first-ever and recurrent stroke and of subsequent spastic and flaccid paresis. Factors influencing the development of spasticity were analyzed. A further major aim was to provide a “real-life” assessment of the treatment of spasticity in Germany and to discuss this in view of the treatment recommended by German and international clinical guidelines. Methods The database used in this study comprised a cohort of 242,090 insurants from a large statutory health insurance fund in the federal state of Hesse, Germany. A first hospital discharge diagnosis in 2009 with any of the International Classification of Diseases, Tenth Revision (ICD-10) codes I60–I64 was used to identify patients with acute stroke (hemorrhage and ischemic). These patients were followed up six months after stroke to monitor whether they developed spastic or flaccid paresis (hospital or ambulatory care diagnoses ICD-10 code G81–G83 [excluding G82.6/G83.4/G83.8]). For patients with spastic paresis after stroke the spasticity treatment was analyzed for a six-month period (physiotherapy, oral muscle relaxants, intrathecal baclofen, and botulinum toxin). Results Standardized to the population of Germany, 3.7 per 1000 persons suffered a stroke in 2009 (raw 5.2/1000). Of all surviving patients, 10.2% developed spasticity within 6 months. Cox regression revealed no significant influence of patient age, gender, morbidity (diabetes, hypertensive diseases, ischemic heart diseases) or type of stroke on development of spasticity. 97% of surviving patients with spasticity received physiotherapy (inpatient care 89%, ambulatory care 48%). Oral muscle relaxants were prescribed to 13% of the patients. No patient received intrathecal baclofen or botulinum toxin. Conclusion Claims data enabled analysis of the occurrence of stroke and post-stroke spasticity. These data provide insight into real-life treatment for spasticity in Germany. The proportion of patients who receive physiotherapy, which is the international guideline-recommended basic therapy after transition into ambulatory care, can be improved on. Botulinum toxin as an international guideline-based treatment option for focal spasticity has not been implemented in practice in Germany as yet. PMID:23516125

Egen-Lappe, Veronika; Koster, Ingrid; Schubert, Ingrid

2013-01-01

331

NACB: Practice Guidelines And Recommendations For Use Of Tumor Markers In The Clinic Cervical Cancer (Section 3J) 1 National Academy of Clinical Biochemistry Guidelines for the Use of Tumor Markers in Cervical Cancer  

E-print Network

evidence; MRI, magnetic resonance imaging; SCC, squamous cell carcinoma antigen; TPA, tissue polypeptide antigen; TPS, tissue polypeptide specific antigen. NACB: Practice Guidelines And Recommendations For Use Of Tumor Markers In The Clinic Cervical Cancer (Section 3J) 2

Katja N. Gaarenstroom; Johannes M. G. Bonfrer

332

Targets for Antibiotic and Health Care Resource Stewardship in Inpatient Community-Acquired Pneumonia: A Comparison of Management Practices with National Guideline Recommendations  

PubMed Central

Purpose Community-acquired pneumonia (CAP) is the most common infection leading to hospitalization in the U.S. The objective of this study was to evaluate management practices for inpatient CAP in relation to IDSA/ATS guidelines to identify opportunities for antibiotic and health care resource stewardship. Methods This was a retrospective cohort study of adults hospitalized for CAP at a single institution from April 15, 2008 – May 31, 2009. Results Of 209 cases, 166 (79%) were admitted to a medical ward and 43 (21%) to the intensive care unit (ICU). 61 (29%) cases were candidates for outpatient therapy per IDSA/ATS guidance with a CURB-65 score of 0 or 1 and absence of hypoxemia. 110 sputum cultures were ordered; however, an evaluable sample was obtained in 49 (45%) cases, median time from antibiotic initiation to specimen collection was 11 (IQR 6–19) hours, and a potential pathogen was identified in only 18 (16%). Blood cultures were routinely obtained for both non-ICU (81%) and ICU (95%) cases, but 15 of 36 (42%) positive cultures were false-positive results. The most common antibiotic regimen was ceftriaxone plus azithromycin (182, 87% cases). Discordant with IDSA/ATS recommendations, oral step-down therapy consisted of a new antibiotic class in 120 (66%), most commonly levofloxacin (101, 55%). Treatment durations were typically longer than suggested with a median of 10 (IQR 8 – 12) days. Conclusions In this cohort of patients hospitalized for CAP, management was frequently inconsistent with IDSA/ATS guideline recommendations revealing potential targets to reduce unnecessary antibiotic and health care resource utilization. PMID:23160837

Jenkins, Timothy C.; Stella, Sarah A.; Cervantes, Lilia; Knepper, Bryan C.; Sabel, Allison L.; Price, Connie S.; Shockley, Lee; Hanley, Michael E.; Mehler, Philip S.; Burman, William J.

2012-01-01

333

Guidelines for Equipment To Prepare Healthy Meals.  

ERIC Educational Resources Information Center

The National Food Service Management Institute (NFSMI) has conducted a project to develop guidelines on the type of preparation equipment needed in school kitchens to produce meals that meet the nutrition standards of the Dietary Guidelines for Americans (DGA). The guidelines provide detailed descriptions of food preparation equipment items,…

Nettles, Mary Frances; Carr, Deborah H.

334

Canadian Environmental Quality Guidelines for mercury  

Microsoft Academic Search

CCME Canadian Environmental Quality Guidelines for mercury have been recommended or are under development for soil, water and sediments. These guidelines provide nationally consistent benchmarks for environmental quality across Canada and are intended as decision support tools in protecting and sustaining aquatic and terrestrial ecosystems in Canada and the beneficial uses they support. A Canadian water quality guideline for protection

C. Gaudet; S. Lingard; P. Cureton; K. Keenleyside; S. Smith; G. Raju

1995-01-01

335

Atmospherically Deposited PBDEs, Pesticides, PCBs, and PAHs in Western US National Park Fish: Concentrations and Consumption Guidelines  

PubMed Central

Concentrations of polybrominated diphenyl ethers (PBDEs), pesticides, polychlorinated biphenyls (PCBs), and polycyclic aromatic hydrocarbons were measured in 136 fish from 14 remote lakes in 8 western US National Parks/Preserves between 2003 and 2005 and compared to human and wildlife contaminant health thresholds. A sensitive (median detection limit ?18 pg/g wet weight), efficient (61% recovery at 8 ng/g), reproducible (4.1 %RSD), and accurate (7 % deviation from SRM) analytical method was developed and validated for these analyses. Concentrations of PCBs, hexachlorobenzene, hexachlorocyclohexanes, DDTs and chlordanes in western US fish were comparable to or lower than mountain fish recently collected from Europe, Canada, and Asia. Dieldrin and PBDE concentrations were higher than recent measurements in mountain fish and Pacific Ocean salmon. Concentrations of most contaminants in western US fish were 1–6 orders of magnitude below calculated recreational fishing contaminant health thresholds. However, contaminant concentrations exceeded subsistence fishing cancer screening values in 8 of 14 lakes. Average contaminant concentrations in fish exceeded wildlife contaminant health thresholds for piscivorous mammals in 5 lakes, and piscivorous birds in all 14 lakes. These results indicate that atmospherically deposited organic contaminants can accumulate in high elevation fish, reaching concentrations relevant to human and wildlife health. PMID:18504962

Ackerman, Luke K.; Schwindt, Adam R.; Simonich, Staci L.; Koch, Dan C.; Blett, Tamara F.; Schreck, Carl B.; Kent, Michael L.; Landers, Dixon H.

2014-01-01

336

Alcoholic beverage consumption by adults compared to dietary guidelines: results of the National Health and Nutrition Examination Survey, 2009-2010.  

PubMed

The 2010 Dietary Guidelines for Americans (DGA) state that if alcohol is consumed, it should be consumed in moderation, which is defined as up to two drinks in a single day for men and one drink for women. The purpose of this analysis was to estimate the percentages of adults who, on a given day, drank more than these limits and the percentages who drank too heavily; that is, more than four drinks for men and more than three for women. Dietary intake data from the National Health and Nutrition Examination Survey, 2009-2010, were analyzed. Using a computer-assisted protocol, 24-hour dietary recalls were collected from 2,740 men and 2,941 women, age 21 years and older. Results were weighted to be nationally representative. Estimated mean daily intake was 1.2 drinks for men and 0.4 for women (1 drink=14 g of ethanol). On a given day, 36% of men and 21% of women consumed alcohol. Whereas 82% of men and 89% of women did not exceed the DGA's limits, 8% of men had more than four drinks, and 3% of women had more than three, amounts defined as heavy. The percentages who drank more than the DGA's limits varied by age group and were highest among men age 31 to 50 years and women age 51 to 70 years. Excessive drinking is an important health problem and is not limited to college-age individuals. Registered dietitians and other health professionals should be aware of excessive drinking by the adult US population. Consumer education resources are available. PMID:23415501

Guenther, Patricia M; Ding, Eric L; Rimm, Eric B

2013-04-01

337

[Current decubitus prevention and treatment algorhytm].  

PubMed

Decubitus ulcer treatment options, as well as the etiology, classification and prevention guidelines are presented. The importance of a multidisciplinary approach along with prevention and education is emphasized. The National Pressure Ulcer Advisory Panel guidelines ensure contemporary decubitus ulcer treatment all over the world, while adoption of the basic algorithm is a precondition of good medical practice and nursing care. Upgrading the patient quality of life and complete healing of decubitus ulcer is definitely achievable by strict application of these recommendations. PMID:25327000

Gaji?, Aleksandar

2014-10-01

338

Psychotherapy Process in the National Institute of Mental Health Treatment of Depression Collaborative Research Program  

Microsoft Academic Search

This study examined psychotherapy process in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Transcripts of brief interpersonal and cognitive–behavioral therapies were rated using the Psychotherapy Process Q Set (PQS), an instrument designed to provide a standard language for describing therapy process. Results demonstrated that there were important areas of overlap and key differences in the

J. Stuart Ablon; Enrico E. Jones

1999-01-01

339

The National Treatment Improvement Evaluation Study (NTIES): Profile of Clients Age 45 and Over.  

ERIC Educational Resources Information Center

This paper summarizes similarities and differences between two cohorts of the National Treatment Improvement Evaluation Study (NTIES) clients, those age 45 or older and those younger than 45. Results reveal the following: Clients in the 45+ cohort were considerably more likely to be treated for problems with alcohol or with heroin, and they were…

Caliber Associates, Fairfax, VA.

340

Curricular Guidelines for Endodontics.  

ERIC Educational Resources Information Center

Guidelines developed by the Section on Endodontics of the American Association of Dental Schools for use by educational institutions as curriculum development aids are provided. Endodontics is that branch of dentistry dealing with diagnosis and treatment of oral conditions that arise as a result of pathoses of dental pulp. (MLW)

Journal of Dental Education, 1981

1981-01-01

341

UK National Audit of chlamydial infection management in sexual health clinics. case notes audit: demography, diagnosis and treatment.  

PubMed

The case notes of cases of genital chlamydial infection were audited against the UK National Guideline. This was the first web-based and the largest national audit to date, with 193 clinics in all UK Regions contributing data. About half of all cases had no symptoms, with about one-third attending for routine or asymptomatic screens; suggesting significant provision of screening by clinics that might be managed differently to reduce workload. Nucleic acid amplification tests (NAATs) are now well established for chlamydial detection in UK clinics, with 93% of cases having genital NAATs. Azithromycin is now more commonly used than doxycycline (54% vs. 37%). Of 26 pregnant women, 20 were treated with azithromycin, suggesting that most prescribers treating pregnant women consider that erythromycin is not an adequate alternative to azithromycin. Most women had NAATs obtained from sites recommended by the Guideline, with 93% of women who had genital NAATs having these from the cervix or vulvovaginal area. PMID:18574119

McClean, Hugo; Carne, Chris; Bunting, Paul; Bhaduri, Sumit; Fernandes, Arnold; Dhar, Jyoti; Estreich, Steve; Daniels, David

2008-07-01

342

Korean clinical practice guidelines: otitis media in children.  

PubMed

Acute otitis media (AOM) and otitis media with effusion (OME) are common infections in children, and their diagnosis and treatment have significant impacts on the health of children and the costs of providing national medical care. In 2009, the Korean Otologic Society organized a committee composed of experts in the field of otolaryngology, pediatrics, and family medicine to develop Korean clinical practice guidelines (CPG) for otitis media in children with the goal of meeting regional medical and social needs in Korea. For this purpose, the committee adapted existing guidelines. A comprehensive literature review was carried out primarily from 2004 to 2009 using medical search engines including data from Korea. A draft was written after a national questionnaire survey and several public audits, and it was editorially supervised by senior advisors before publication of the final report. These evidence-based guidelines for the management of otitis media in children provide recommendations to primary practitioners for the diagnosis and treatment of children younger than 15 yr old with uncomplicated AOM and OME. The guidelines include recommendations regarding diagnosis, treatment options, prevention and parent education, medical records, referral, and complementary/alternative medicine for treating pediatric otitis media. PMID:22876048

Lee, Hyo-Jeong; Park, Su-Kyoung; Choi, Kyu Young; Park, Su Eun; Chun, Young Myung; Kim, Kyu-Sung; Park, Shi-Nae; Cho, Yang-Sun; Kim, Young-Jae; Kim, Hyung-Jong; Korean Otologic Society

2012-08-01

343

Korean Clinical Practice Guidelines: Otitis Media in Children  

PubMed Central

Acute otitis media (AOM) and otitis media with effusion (OME) are common infections in children, and their diagnosis and treatment have significant impacts on the health of children and the costs of providing national medical care. In 2009, the Korean Otologic Society organized a committee composed of experts in the field of otolaryngology, pediatrics, and family medicine to develop Korean clinical practice guidelines (CPG) for otitis media in children with the goal of meeting regional medical and social needs in Korea. For this purpose, the committee adapted existing guidelines. A comprehensive literature review was carried out primarily from 2004 to 2009 using medical search engines including data from Korea. A draft was written after a national questionnaire survey and several public audits, and it was editorially supervised by senior advisors before publication of the final report. These evidence-based guidelines for the management of otitis media in children provide recommendations to primary practitioners for the diagnosis and treatment of children younger than 15 yr old with uncomplicated AOM and OME. The guidelines include recommendations regarding diagnosis, treatment options, prevention and parent education, medical records, referral, and complementary/alternative medicine for treating pediatric otitis media. PMID:22876048

Lee, Hyo-Jeong; Park, Su-Kyoung; Choi, Kyu Young; Park, Su Eun; Chun, Young Myung; Kim, Kyu-Sung; Park, Shi-Nae; Cho, Yang-Sun; Kim, Young-Jae

2012-01-01

344

The National Criminal Justice Treatment Practices survey: Multilevel survey methods and procedures?  

PubMed Central

The National Criminal Justice Treatment Practices (NCJTP) survey provides a comprehensive inquiry into the nature of programs and services provided to adult and juvenile offenders involved in the justice system in the United States. The multilevel survey design covers topics such as the mission and goals of correctional and treatment programs; organizational climate and culture for providing services; organizational capacity and needs; opinions of administrators and staff regarding rehabilitation, punishment, and services provided to offenders; treatment policies and procedures; and working relationships between correctional and other agencies. The methodology generates national estimates of the availability of programs and services for offenders. This article details the methodology and sampling frame for the NCJTP survey, response rates, and survey procedures. Prevalence estimates of juvenile and adult offenders under correctional control are provided with externally validated comparisons to illustrate the veracity of the methodology. Limitations of the survey methods are also discussed. PMID:17383548

Taxman, Faye S.; Young, Douglas W.; Wiersema, Brian; Rhodes, Anne; Mitchell, Suzanne

2007-01-01

345

The 1996 meeting of the national technical workgroup on mixed waste thermal treatment  

SciTech Connect

The National Technical Workgroup on Mixed Waste Thermal Treatment held its annual meeting in Atlanta Georgia on March 12-14, 1996. The National Technical Workgroup (NTW) and this meeting were sponsored under an interagency agreement between EPA and DOE. The 1996 Annual Meeting was hosted by US DOE Oak Ridge Operations in conjunction with Lockheed Martin Energy Systems - Center for Waste Management. A new feature of the annual meeting was the Permit Writer Panel Session which provided an opportunity for the state and federal permit writers to discuss issues and potential solutions to permitting mixed waste treatment systems. In addition, there was substantial discussion on the impacts of the Waste Combustion Performance Standards on mixed waste thermal treatment which are expected to proposed very soon. The 1996 meeting also focussed on two draft technical resource documents produced by NTW on Waste Analysis Plans and Compliance Test Procedures. Issues discussed included public involvement, waste characterization, and emission issues.

NONE

1996-12-31

346

Effectiveness of an intercultural module added to the treatment guidelines for Moroccan and Turkish patients with depressive and anxiety disorders  

Microsoft Academic Search

BACKGROUND: Since the sixties of the last century, many people from Morocco and Turkey have migrated into the Netherlands. In the last decade, Moroccan and Turkish patients have found their way to organizations for mental health care. However, they often drop out of treatment. Problems in the communication with therapists and different expectations regarding treatment seem to be causal factors

Annelies van Loon; Digna JF van Schaik; Jack J Dekker; Aartjan TF Beekman

2011-01-01

347

45 CFR Appendix to Part 1340 - Interpretative Guidelines Regarding 45 CFR 1340.15-Services and Treatment for Disabled Infants  

Code of Federal Regulations, 2012 CFR

...death is imminent and treatment will do no more than postpone the act of dying...commenters argued that the incorporation of the word “imminent,” and its connotation of...conditions for which treatment will do no more than temporarily postpone a death...amendment also strongly urged deletion of the word “imminent.” The Department's use of...the same reasons......

2012-10-01

348

45 CFR Appendix to Part 1340 - Interpretative Guidelines Regarding 45 CFR 1340.15-Services and Treatment for Disabled Infants  

Code of Federal Regulations, 2013 CFR

...death is imminent and treatment will do no more than postpone the act of dying...commenters argued that the incorporation of the word “imminent,” and its connotation of...conditions for which treatment will do no more than temporarily postpone a death...amendment also strongly urged deletion of the word “imminent.” The Department's use of...the same reasons......

2013-10-01

349

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

350

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

351

Probability and predictors of treatment-seeking for prescription opioid use disorders: A National Study  

PubMed Central

Background Prescription opioid use disorders are the second most common drug use disorder behind only cannabis use disorders. Despite this, very little is known about the help-seeking behavior among individuals with these disorders. Methods The sample included respondents of the Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) with a lifetime diagnosis of prescription drug use disorders (N= 623). Unadjusted and adjusted hazard ratios are presented for time to first treatment-seeking by sociodemographic characteristics and comorbid psychiatric disorders. Results The lifetime cumulative probability of treatment seeking was 42% and the median delay from prescription drug use disorder onset to first treatment was 3.83 years. Having an earlier onset of prescription opioid use disorder and a history of bipolar disorder, major depression disorder, specific phobia and cluster B personality disorders predicted shorter delays to treatment. Conclusions Although some comorbid psychiatric disorders increase the rate of treatment-seeking and decrease delays to first-treatment contact rates of treatment-seeking for prescription drug use disorder are low, even when compared with rates of treatment for other substance use disorders. Given the high prevalence and adverse consequences of prescription drug use disorder, there is a need to improve detection and treatment of prescription opioid use disorder. PMID:23306097

Blanco, Carlos; Iza, Miren; Schwartz, Robert P.; Rafful, Claudia; Wang, Shuai; Olfson, Mark

2013-01-01

352

The Need for Evidence Based Nutritional Guidelines for Pediatric Acute Lymphoblastic Leukemia Patients: Acute and Long-Term Following Treatment  

PubMed Central

High survival rates for pediatric leukemia are very promising. With regard to treatment, children tend to be able to withstand a more aggressive treatment protocol than adults. The differences in both treatment modalities and outcomes between children and adults make extrapolation of adult studies to children inappropriate. The higher success is associated with a significant number of children experiencing nutrition-related adverse effects both in the short and long term after treatment. Specific treatment protocols have been shown to deplete nutrient levels, in particular antioxidants. The optimal nutrition prescription during, after and long-term following cancer treatment is unknown. This review article will provide an overview of the known physiologic processes of pediatric leukemia and how they contribute to the complexity of performing nutritional assessment in this population. It will also discuss known nutrition-related consequences, both short and long term in pediatric leukemia patients. Since specific antioxidants have been shown to be depleted as a consequence of therapy, the role of oxidative stress in the pediatric leukemia population will also be explored. More pediatric studies are needed to develop evidence based therapeutic interventions for nutritional complications of leukemia and its treatment. PMID:24177709

Owens, Joyce L.; Hanson, Sheila J.; McArthur, Jennifer A.; Mikhailov, Theresa A.

2013-01-01

353

Redressing First Nations historical trauma: theorizing mechanisms for indigenous culture as mental health treatment.  

PubMed

Indigenous "First Nations" communities have consistently associated their disproportionate rates of psychiatric distress with historical experiences of European colonization. This emphasis on the socio-psychological legacy of colonization within tribal communities has occasioned increasingly widespread consideration of what has been termed historical trauma within First Nations contexts. In contrast to personal experiences of a traumatic nature, the concept of historical trauma calls attention to the complex, collective, cumulative, and intergenerational psychosocial impacts that resulted from the depredations of past colonial subjugation. One oft-cited exemplar of this subjugation--particularly in Canada--is the Indian residential school. Such schools were overtly designed to "kill the Indian and save the man." This was institutionally achieved by sequestering First Nations children from family and community while forbidding participation in Native cultural practices in order to assimilate them into the lower strata of mainstream society. The case of a residential school "survivor" from an indigenous community treatment program on a Manitoba First Nations reserve is presented to illustrate the significance of participation in traditional cultural practices for therapeutic recovery from historical trauma. An indigenous rationale for the postulated efficacy of "culture as treatment" is explored with attention to plausible therapeutic mechanisms that might account for such recovery. To the degree that a return to indigenous tradition might benefit distressed First Nations clients, redressing the socio-psychological ravages of colonization in this manner seems a promising approach worthy of further research investigation. PMID:23715822

Gone, Joseph P

2013-10-01

354

Standardized reporting of clinical practice guidelines: a proposal from the Conference on Guideline Standardization.  

PubMed

Despite enormous energies invested in authoring clinical practice guidelines, the quality of individual guidelines varies considerably. The Conference on Guideline Standardization (COGS) was convened in April 2002 to define a standard for guideline reporting that would promote guideline quality and facilitate implementation. Twenty-three people with expertise and experience in guideline development, dissemination, and implementation participated. A list of candidate guideline components was assembled from the Institute of Medicine Provisional Instrument for Assessing Clinical Guidelines, the National Guideline Clearinghouse, the Guideline Elements Model, and other published guideline models. In a 2-stage modified Delphi process, panelists first rated their agreement with the statement that "[Item name] is a necessary component of practice guidelines" on a 9-point scale. An individualized report was prepared for each panelist; the report summarized the panelist's rating for each item and the median and dispersion of rankings of all the panelists. In a second round, panelists separately rated necessity for validity and necessity for practical application. Items achieving a median rank of 7 or higher on either scale, with low disagreement index, were retained as necessary guideline components. Representatives of 22 organizations active in guideline development reviewed the proposed items and commented favorably. Closely related items were consolidated into 18 topics to create the COGS checklist. This checklist provides a framework to support more comprehensive documentation of practice guidelines. Most organizations that are active in guideline development found the component items to be comprehensive and to fit within their existing development methods. PMID:13679327

Shiffman, Richard N; Shekelle, Paul; Overhage, J Marc; Slutsky, Jean; Grimshaw, Jeremy; Deshpande, Aniruddha M

2003-09-16

355

Transitioning to highly effective therapies for the treatment of chronic hepatitis C virus infection: A policy statement and implementation guideline.  

PubMed

Chronic hepatitis C virus (HCV) infection increases all-cause mortality, rates of cirrhosis, hepatocellular carcinoma, liver transplantation and overall health care utilization. Morbidity and mortality disproportionately affect individuals born between 1945 and 1975. The recent development of well-tolerated and highly effective therapies for chronic HCV infection represents a unique opportunity to dramatically reduce rates of HCV-related complications and their costs. Critical to the introduction of such therapies will be well-designed provincial programming to ensure immediate treatment access to individuals at highest risk for complication, and well-defined strategies to address the global treatment needs of traditionally high-risk and marginalized populations. HCV practitioners in New Brunswick created a provincial strategy that stratifies treatment according to those at highest need, measures clinical impact, and creates evaluation strategies to demonstrate the significant direct and indirect cost savings anticipated with curative treatments. PMID:25390613

Smyth, Daniel John; Webster, Duncan; Barrett, Lisa; MacMillan, Mark; Mcknight, Lisa; Schweiger, Frank

2014-11-01

356

Development of proposed Canadian Environmental Quality Guidelines for cadmium  

Microsoft Academic Search

This paper discusses the derivation of Canadian Environmental Quality Guidelines for cadmium and the potential uses of guidelines. The Canadian Council of Ministers of the Environment (CCME) has established science-based protocols for developing national environmental quality guidelines (numerical concentration limits) for contaminants in water, sediment, tissue, and soil (for soils the term “criteria” is used instead of guidelines). These published

E. L. Porter; R. A. Kent; D. E. Andersen; K. A. Keenleyside; D. Milne; P. Cureton; S. L. Smith; K. G. Drouillard; D. D. MacDonald

1995-01-01

357

Progress in national and regional guidelines development and deployment for the clinical prevention and control of CVD and diabetes in Africa  

PubMed Central

Successful efforts to reduce cardiovascular disease in many countries have come as a result of both population based interventions and individually guided interventions. Guidelines serve two purposes directed at the promotion of the individually guided interventions. First, they serve as a method to summarize approved and successful life-style and medical interventions to reduce the burden of cardiovascular disease. Second, they guide health providers on how to identify those at high risk for cardiovascular disease and who might benefit from the available interventions. However, guidelines have been increasingly complex and at times contradictory from one body to another or they may not exist at all in certain countries. This paper will review the current status of guidelines for the region as well as for individual countries. Guidelines for the prevention of CVD as a whole will be evaluated as well as guidelines for individual risk factors such as hypertension, cholesterol, and diabetes. Finally, this paper will address the pitfalls of individual risk factor based guidelines as opposed to the absolute risk approach integrating multiple risk factors into one comprehensive set of guidelines. PMID:24267441

Valluri, Sruthi; Gaziano, Thomas A

2013-01-01

358

Evaluation of In-Hospital Management for Febrile Illness in Northern Tanzania before and after 2010 World Health Organization Guidelines for the Treatment of Malaria  

PubMed Central

Objective In 2010, the World Health Organization (WHO) published updated guidelines emphasizing and expanding recommendations for a parasitological confirmation of malaria before treating with antimalarials. This study aimed to assess differences in historic (2007–2008) (cohort 1) and recent (2011–2012) (cohort 2) hospital cohorts in the diagnosis and treatment of febrile illness in a low malaria prevalence area of northern Tanzania. Materials and Methods We analyzed data from two prospective cohort studies that enrolled febrile adolescents and adults aged ?13 years. All patients received quality-controlled aerobic blood cultures and malaria smears. We compared patients' discharge diagnoses, treatments, and outcomes to assess changes in the treatment of malaria and bacterial infections. Results In total, 595 febrile inpatients were enrolled from two referral hospitals in Moshi, Tanzania. Laboratory-confirmed malaria was detected in 13 (3.2%) of 402 patients in cohort 1 and 1 (0.5%) of 193 patients in cohort 2 (p?=?0.041). Antimalarials were prescribed to 201 (51.7%) of 389 smear-negative patients in cohort 1 and 97 (50.5%) of 192 smear-negative patients in cohort 2 (p?=?0.794). Bacteremia was diagnosed from standard blood culture in 58 (14.5%) of 401 patients in cohort 1 compared to 18 (9.5%) of 190 patients in cohort 2 (p?=?0.091). In cohort 1, 40 (69.0%) of 58 patients with a positive blood culture received antibacterials compared to 16 (88.9%) of 18 patients in cohort 2 (p?=?0.094). In cohort 1, 43 (10.8%) of the 399 patients with known outcomes died during hospitalization compared with 12 (6.2%) deaths among 193 patients in cohort 2 (p?=?0.073). Discussion In a setting of low malaria transmission, a high proportion of smear-negative patients were diagnosed with malaria and treated with antimalarials despite updated WHO guidelines on malaria treatment. Improved laboratory diagnostics for non-malaria febrile illness might help to curb this practice. PMID:24587056

Moon, Andrew M.; Biggs, Holly M.; Rubach, Matthew P.; Crump, John A.; Maro, Venace P.; Saganda, Wilbrod; Reddy, Elizabeth A.

2014-01-01

359

Primary Care of the Patient with Chronic Obstructive Pulmonary Disease—Part 2: Pharmacologic Treatment Across All Stages of Disease  

Microsoft Academic Search

National guidelines for the pharmacologic treatment of chronic obstructive pulmonary disease (COPD) can be clarified for busy primary care practitioners who must deal with dozens of such treatment algorithms. MEDLINE searches and reviews of national evidence-based guidelines identified clinical trials and meta-analyses with relevant information on the stage-by-stage pharmacologic treatment of COPD. After formal presentations to a panel of pulmonary

Nicholas Gross; David Levin

2008-01-01

360

FY 1995 separation studies for liquid low-level waste treatment at Oak Ridge National Laboratory  

SciTech Connect

During FY 1995, studies were continued to develop improved methods for centralized treatment of liquid low-level waste (LLLW) at Oak Ridge National Laboratory (ORNL). Focus in this reporting period was on (1) identifying the parameters that affect the selective removal of {sup 90}Sr and {sup 137}Cs, two of the principal radioactive contaminants expected in the waste; (2) validating the effectiveness of the treatment methods by testing an ac Melton Valley Storage Tank (MVST) supernate; (3) evaluating the optimum solid/liquid separation techniques for the waste; (4) identifying potential treatment methods for removal of technetium from LLLW; and (5) identifying potential methods for stabilizing the high-activity secondary solid wastes generated by the treatment.

Bostick, D.T.; Arnold, W.D.; Burgess, M.W. [and others

1995-01-01

361

"Test and treat" or presumptive treatment for malaria in high transmission situations? A reflection on the latest WHO guidelines  

PubMed Central

Recent WHO guidelines recommend a universal "test and treat" strategy for malaria, mainly by use of rapid diagnostic test (RDT) in all areas. The evidence for this approach is questioned here as there is a risk of over-reliance on parasitological diagnosis in high transmission situations, which still exist. In such areas, when a patient has fever or other malaria symptoms, the presence of Plasmodium spp neither reliably confirms malaria as the cause of the fever, nor excludes the possibility of other diseases. This is because the patient may be an asymptomatic carrier of malaria parasites and suffer from another disease. To allow clinicians to perform their work adequately, local epidemiologic data are necessary. One size does not fit all. If parasite prevalence in the population is low, a diagnostic test is relevant; if the prevalence is high, the test does not provide information of any clinical usefulness, as happens with any test in medicine when the prevalence of the tested characteristic is high in the healthy population. It should also be remembered that, if in some cases anti-malarials are prescribed to parasite-negative patients, this will not increase selection pressure for drug resistance, because the parasite is not there. In high transmission situations at least, other diagnoses should be sought in all patients, irrespective of the presence of malaria parasites. For this, clinical skills (but not necessarily physicians) are irreplaceable, in order to differentiate malaria from other causes of acute fever, such as benign viral infection or potentially dangerous conditions, which can all be present with the parasite co-existing only as a "commensal" or silent undesirable guest. PMID:21599880

2011-01-01

362

Guidelines for Guidelines: Are They Up to the Task? A Comparative Assessment of Clinical Practice Guideline Development Handbooks  

PubMed Central

Objectives We conducted a comparative review of clinical practice guideline development handbooks. We aimed to identify the main guideline development tasks, assign weights to the importance of each task using expert opinions and identify the handbooks that provided a comprehensive coverage of the tasks. Methods We systematically searched and included handbooks published (in English language) by national, international or professional bodies responsible for evidenced-based guideline development. We reviewed the handbooks to identify the main guideline development tasks and scored each handbook for each task from 0 (the handbook did not mention the task) to 2 (the task suitably addressed and explained), and calculated a weighted score for each handbook. The tasks included in over 75% of the handbooks were considered as ‘necessary’ tasks. Result Nineteen guideline development handbooks and twenty seven main tasks were identified. The guideline handbooks’ weighted scores ranged from 100 to 220. Four handbooks scored over 80% of the maximum possible score, developed by the National Institute for Health and Clinical Excellence, Swiss Centre for International Health, Scottish Intercollegiate Guidelines Network and World Health Organization. Necessary tasks were: selecting the guideline topic, determining the guideline scope, identifying relevant existing guidelines, involving the consumers, forming guideline development group,, developing clinical questions, systematic search for evidence, selecting relevant evidence, appraising identifies research evidence, making group decision, grading available evidence, creating recommendations, final stakeholder consultation, guideline implementation strategies, updating recommendations and correcting potential errors. Discussion Adequate details for evidence based development of guidelines were still lacking from many handbooks. The tasks relevant to ethical issues and piloting were missing in most handbooks. The findings help decision makers in identifying the necessary tasks for guideline development, provide an updated comparative list of guideline development handbooks, and provide a checklist to assess the comprehensiveness of guideline development processes. PMID:23189167

Ansari, Shabnam; Rashidian, Arash

2012-01-01

363

Scaling up HIV treatment and prevention through national responses and innovative leadership.  

PubMed

Over the past decade, there has been an unprecedented global response to the AIDS epidemic. This infusion of new funding has led to a rapid scale-up of HIV treatment and prevention and consequently has saved millions of lives and transformed communities around the world. However, as clearly demonstrated by a review of national responses, successes have been due in large part to strong and innovative leadership from governments, the private sector, and nongovernmental organizations. Examples from Brazil, Botswana, Nigeria, Uganda, and India illustrate the vital role played by bold and collaborative leadership in the global and local scale-up of HIV prevention and treatment. PMID:22772386

Kanki, Phyllis; Kakkattil, Pradeep; Simao, Mariangela

2012-08-01

364

Metastatic breast cancer mimicking hepatocellular carcinoma: differences in noninvasive guidelines.  

PubMed

Hepatocellular carcinoma (HCC), unlike most solid tumors, can be diagnosed noninvasively. We present a case that highlights an important clinical difference between two established guidelines: National Cancer Comprehensive Network (NCCN) and Barcelona-2000 EASL Conference (European Association for the Study of the Liver). Our patient had a large liver mass extending into the right atrium with elevation of the alpha-fetoprotein to 1,130 ng/mL. The radiographic and laboratory evidence is sufficient using NCCN guidelines to initiate palliative treatment for HCC. The Barcelona-2000 EASL Conference guideline for noninvasive diagnosis is restricted to cirrhotic patients. Our patient did not have a history of chronic liver disease or active hepatitis, and a biopsy was performed that demonstrated breast cancer. PMID:20084472

Bartram, Anna H; Villano, John Lee; Ferrera, Dean M

2010-06-01

365

Implementing Thrombosis Guidelines in Cancer Patients: A Review  

PubMed Central

Venous thromboembolism is a frequent and serious complication in patients with cancer. It is an independent prognostic factor of death in cancer patients and the second leading cause of death, but physicians often underestimate its importance, as well as the need for adequate prevention and treatment. Management of venous thromboembolism in patients with cancer requires the coordinated efforts of a wide range of clinicians, highlighting the importance of a multidisciplinary approach. However, a lack of consensus among various national and international clinical practice guidelines has contributed to knowledge and practice gaps among practitioners, and inconsistent approaches to venous thromboembolism. The 2013 international guidelines for thrombosis in cancer have sought to address these gaps by critically re-evaluating the evidence coming from clinical trials and synthesizing a number of guidelines documents. An individualized approach to prophylaxis is recommended for all patients. PMID:25386357

Farge-Bancel, Dominique; Bounameaux, Henri; Brenner, Benjamin; Buller, Harry R.; Kakkar, Ajay; Pabinger, Ingrid; Streiff, Michael; Debourdeau, Philippe

2014-01-01

366

National Scholarship Guidelines December 2013  

E-print Network

and internships for undergraduate students and those planning to pursue graduate studies in building engineering The applicant must be graduating from a U.S. university or college with a bachelor's degree, and intend of the graduate education program along with an official copy of his or her transcript. If the recipient decides

367

The Red Road to Wellness: Cultural Reclamation in a Native First Nations Community Treatment Center  

Microsoft Academic Search

This article explores how Native American cultural practices were incorporated into the therapeutic activities of a community-controlled\\u000a substance abuse treatment center on a “First Nations” reserve in the Canadian north. Analysis of open-ended interviews with\\u000a nineteen staff and clients—as contextualized by participant observation, program records, and existing ethnographic resources—yielded\\u000a insights concerning local therapeutic practice with outpatients and other community members.

Joseph P. Gone

2011-01-01

368

NUTRITION COUNSELLING, CARE AND SUPPORT FOR HIV-INFECTED WOMEN GUIDELINES ON HIV-RELATED CARE, TREATMENT AND SUPPORT FOR HIV-INFECTED WOMEN AND THEIR CHILDREN IN RESOURCE-CONSTRAINED SETTINGS WORLD HEALTH ORGANIZATIONWHO Library Cataloguing-in-Publication  

E-print Network

Nutrition counselling, care and support for HIV-infected women: guidelines on HIV-related care, treatment and support for HIV-infected women and their children in resource-limited settings. 1. HIV infection – diet therapy 2. Malnutrition- therapy 3. Nutrition therapy- standards

unknown authors

369

Ego Deficiencies in the Areas of Pleasure, Intimacy, and Cooperation: Guidelines in the Diagnosis and Treatment of Sexual Dysfunctions  

ERIC Educational Resources Information Center

Psychopathology, in the form of a deficiency in ego functions of pleasure, intimacy, or cooperation, is usually associated with sexual dysfunctions that prove refractory to sex therapy techniques alone. Each deficiency forms a distinct clinical syndrome with specific treatment requirements, necessitating further diagnostic subcategorization of…

Levay, Alexander N.; Kagle, Arlene

1977-01-01

370

High-Pressure Hand Injection Injuries Caused by Dry Cleaning Solvents: Case Reports, Review of the Literature, and Treatment Guidelines  

Microsoft Academic Search

A previously unreported subset of high-pressure injec- tion injuries, namely those involving solvents used in the garment dry cleaning industry, is presented. Dry cleaning solutions contain isoparaffinic hydrocarbons, me- thoxypropanol, and dichlorofluoroethane. Although these solvents have limited potential for systemic toxicity, severe local toxicity causing tissue necrosis often results in loss of the injured digit. Proper treatment includes prompt surgical

Karol A. Gutowski; Jason Chu; Mihye Choi; David W. Friedman

2003-01-01

371

Comparison of Adherence to Chlamydia Screening Guidelines Among Title X Providers and Non-Title X Providers in the California Family Planning, Access, Care, and Treatment Program  

PubMed Central

Abstract Background Annual chlamydia screening is recommended for adolescent and young adult females and targeted screening is recommended for women ?26 years based on risk. Although screening levels have increased over time, adherence to these guidelines varies, with high levels of adherence among Title X family planning providers. However, previous studies of provider variation in screening rates have not adjusted for differences in clinic and client population characteristics. Methods Administrative claims from the California Family Planning, Access, Care, and Treatment (Family PACT) program were used to (1) examine clinic and client sociodemographic characteristics by provider group—Title X-funded public sector, non-Title X public sector, and private sector providers, and (2) estimate age-specific screening and differences in rates by provider group during 2009. Results Among 833 providers, Title X providers were more likely than non-Title X public sector providers and private sector providers to serve a higher client volume, a higher proportion of clients aged ?25 years, and a higher proportion of African American clients. Non-Title X public providers were more likely to be located in rural areas, compared with Title X grantees and private sector providers. Title X providers had the largest absolute difference in screening rates for young females vs. older females (10.9%). Unadjusted screening rates for young clients were lower among non-Title X public sector providers (54%) compared with private sector and Title X providers (64% each). After controlling for provider group, urban location, client volume, and percent African American, private sector providers had higher screening rates than Title X and non-Title X public providers. Conclusions Screening rates for females were higher among private providers compared with Title X and non-Title X public providers. However, only Title X providers were more likely to adhere to screening guidelines through high screening rates for young females and low screening rates for older females. PMID:22694761

Thiel de Bocanegra, Heike; Hulett, Denis; Park, Hye-Youn; Darney, Philip

2012-01-01

372

Physician implementation of asthma management guidelines and recommendations: 2 case studies.  

PubMed

Despite the development and availability of new treatments and prescription medications, asthma remains a widespread chronic health problem in the United States. Achieving asthma control in patients is a resource-intensive enterprise that requires close assessment and personalized management. Asthma is simply not a disease that can be remedied with prescription medications alone. In 2007, the National Asthma Education and Prevention Program released their Guidelines for the Diagnosis and Management of Asthma. The guidelines provide assistance and direction to health care professionals in the assessment and treatment of patients with asthma. Two cases are presented to illustrate the treatment process in light of the Guidelines and the outcomes of these patients, who have varying degrees of support, education, and assessment of adherence to an asthma treatment plan. PMID:25391303

Craig, Timothy J

2014-11-01

373

Factors associated with treatment of women with osteoporosis or osteopenia from a national survey  

PubMed Central

Background Health outcomes could be improved if women at high risk for osteoporotic fracture were matched to effective treatment. This study determined the extent to which treatment for osteoporosis/osteopenia corresponded to the presence of specific risk factors for osteoporotic fracture. Methods This retrospective analysis of the United States 2007 National Health and Wellness Survey included women age ? 40 years who reported having a diagnosis of osteoporosis (69% of 3276) or osteopenia (31% of 3276). Patients were stratified by whether they were or were not taking prescription treatment for osteoporosis/osteopenia. Using 34 patient characteristics as covariates, logistic regression was used to determine factors associated with treatment. Results Current prescription treatment was reported by 1800 of 3276 (54.9%) women with osteoporosis/osteopenia. The following factors were associated with receiving prescription treatment: patient-reported diagnosis of osteoporosis (versus osteopenia); previous bone mineral density test; ? 2 fractures since age 50; older age; lower body mass index; better physical functioning; postmenopausal status; family history of osteoporosis; fewer comorbidities; prescription insurance coverage; higher total prescription count; higher ratio of prescription costs to monthly income; higher income; single status; previous visit to a rheumatologist or gynecologist; and 1 or 2 outpatient visits to healthcare provider (vs. none) in the prior 6 months. Glucocorticoid, tobacco, and daily alcohol use were risk factors for fracture that were not associated with treatment. Conclusions There is a mismatch between those women who could benefit from treatment for osteoporosis and those who are actually treated. For example, self-reported use of glucocorticoids, tobacco, and alcohol were not associated with prescription treatment of osteoporosis. Other clinical and socioeconomic factors were associated with treatment (e.g. prescription drug coverage and higher income) or not (e.g. comorbid osteoarthritis and anxiety) and could be opportunities to improve care. PMID:22225919

2012-01-01

374

Clinical practice guidelines for the prevention and treatment of acute and late radiation reactions from the MASCC Skin Toxicity Study Group.  

PubMed

Radiation dermatitis (RD) results from radiotherapy and often occurs within the first 4 weeks of treatment, although late effects also occur. While RD may resolve over time, it can have a profound effect on patients' quality of life and lead to dose modifications. A study group of international, interdisciplinary experts convened to develop RD prevention and treatment guidelines based on evidence from randomized, controlled trials. Evidence-based recommendations were developed after an extensive literature review. Randomized, controlled trials with standardized measurement of outcomes were considered the best evidence, and a majority of the recommendations were formulated from this literature. The adoption of washing with water, with or without a mild soap, and allowing the use of antiperspirants is supported by randomized trials. Use of topical prophylactic corticosteroids (mometasone) is recommended to reduce discomfort and itching. There is some evidence that silver sulfadiazine cream can reduce dermatitis score. There is insufficient evidence to support, and therefore the panel recommends against the use of trolamine, topical sulcrate, hyaluronic acid, ascorbic acid, silver leaf dressing, light-emitting diode lasers, Theta cream, dexpanthenol, calendula, proteolytic enzymes, sulcralfate, oral zinc, and pentoxifylline. Moreover, there is no evidence to support the superiority for any specific intervention in a reactive fashion. For patients with established radiation-induced telangiectasia and fibrosis, the panel suggests the use of pulse dye laser for visual appearance, and the use of pentoxifylline and vitamin E for the reduction of fibrosis. PMID:23942595

Wong, Rebecca K S; Bensadoun, René-Jean; Boers-Doets, Christine B; Bryce, Jane; Chan, Alexandre; Epstein, Joel B; Eaby-Sandy, Beth; Lacouture, Mario E

2013-10-01

375

Protocol Development — Guidelines Regarding the Inclusion of Pregnant and Breast-Feeding Women on Cancer Clinical Treatment Trials  

Cancer.gov

Pregnant women may not be arbitrarily excluded from participation in clinical cancer treatment trials. Exclusion of pregnant women from a particular trial must be based on a clear and compelling rationale or justification that shows that inclusion is inappropriate with respect to the health of the subjects or the purpose of the research, or other circumstances that offer a clear and compelling reason for exclusion.

376

Evidence-based treatment for opioid disorders: a 23-year national study of methadone dose levels.  

PubMed

Effective treatment for patients with opioid use problems is as critical as ever given the upsurge in heroin and prescription opioid abuse. Yet, results from prior studies show that the majority of methadone maintenance treatment (MMT) programs in the US have not provided dose levels that meet evidence-based standards. Thus, this paper examines the extent to which US MMT programs have made changes in the past 23 years to provide adequate methadone doses; we also identify factors associated with variation in program performance. Program directors and clinical supervisors of nationally-representative methadone treatment programs were surveyed in 1988 (n=172), 1990 (n=140), 1995 (n=116), 2000 (n=150), 2005 (n=146), and 2011 (n=140). Results show that the proportion of patients who received doses below 60 mg/day-the minimum recommended-declined from 79.5 to 22.8% in a 23-year span. Results from random effects models show that programs that serve a higher proportion of African-American or Hispanic patients were more likely to report low-dose care. Programs with Joint Commission accreditation were more likely to provide higher doses, as were a program that serves a higher proportion of unemployed and older patients. Efforts to improve methadone treatment practices have made substantial progress, but 23% of patients across the nation are still receiving doses that are too low to be effective. PMID:25012549

D'Aunno, Thomas; Pollack, Harold A; Frimpong, Jemima A; Wuchiett, David

2014-10-01

377

Knee articular cartilage injuries in the National Football League: epidemiology and treatment approach by team physicians.  

PubMed

This study describes the epidemiology of knee articular cartilage injuries in the National Football League (NFL) and the typical treatment approach by NFL team physicians. All knee articular cartilage injuries in the league database from 1992 to 2006 were reviewed, and team physicians were surveyed about their treatment approach to these injuries. A total of 118 cases were identified, for an average of 8 per year, with a higher injury rate during games compared with practice. Approximately half of the injuries occurred in linemen, and the most common site of injury was the femoral condyle. Forty-six percent of these injuries were treated surgically, with slower return to play after surgery (124 versus 36 days, P < .01). Among team physicians, microfracture was the most popular treatment approach (43%), followed by debridement (31%) and nonoperative management (13%). More research is needed to compare long-term outcomes based on lesion size in these athletes. PMID:19902729

Brophy, Robert H; Rodeo, Scott A; Barnes, Ronnie P; Powell, John W; Warren, Russell F

2009-10-01

378

International antiemetic guidelines on chemotherapy induced nausea and vomiting (CINV): content and implementation in daily routine practice.  

PubMed

Over the past decades major improvements in the management of chemotherapy induced nausea and vomiting (CINV) were obtained. With the correct use of antiemetic drugs, CINV can be prevented in almost 70%, and even up to, 80% of patients. Treatment guidelines enable physicians to integrate the latest clinical research into their daily practice. The large volume of rapidly evolving clinical data has been summarised and incorporated into treatment recommendations by well-known and reliable institutions. These organisations include the Multinational Association of Supportive Care in Cancer (MASCC), the European Society of Medical Oncology (ESMO), the American Society for Clinical Oncology (ASCO), and National Comprehensive Cancer Network (NCCN). However, despite the availability of these guidelines, there is an emerging evidence that adherence to, and implementation of, treatment recommendations is less than optimal. This review will especially focus on the content of the current antiemetic guidelines and will address the important question of how these guidelines are implemented in routine practice. PMID:24157984

Jordan, Karin; Gralla, Richard; Jahn, Franziska; Molassiotis, Alex

2014-01-01

379

Diagnosis and treatment of mucormycosis in patients with hematological malignancies: guidelines from the 3rd European Conference on Infections in Leukemia (ECIL 3)  

PubMed Central

Mucormycosis is an emerging cause of infectious morbidity and mortality in patients with hematologic malignancies. However, there are no recommendations to guide diagnosis and management. The European Conference on Infections in Leukemia assigned experts in hematology and infectious diseases to develop evidence-based recommendations for the diagnosis and treatment of mucormycosis. The guidelines were developed using the evidence criteria set forth by the American Infectious Diseases Society and the key recommendations are summarized here. In the absence of validated biomarkers, the diagnosis of mucormycosis relies on histology and/or detection of the organism by culture from involved sites with identification of the isolate at the species level (no grading). Antifungal chemotherapy, control of the underlying predisposing condition, and surgery are the cornerstones of management (level A II). Options for first-line chemotherapy of mucormycosis include liposomal amphotericin B and amphotericin B lipid complex (level B II). Posaconazole and combination therapy of liposomal amphotericin B or amphotericin B lipid complex with caspofungin are the options for second line-treatment (level B II). Surgery is recommended for rhinocerebral and skin and soft tissue disease (level A II). Reversal of underlying risk factors (diabetes control, reversal of neutropenia, discontinuation/taper of glucocorticosteroids, reduction of immunosuppressants, discontinuation of deferroxamine) is important in the treatment of mucormycosis (level A II). The duration of antifungal chemotherapy is not defined but guided by the resolution of all associated symptoms and findings (no grading). Maintenance therapy/secondary prophylaxis must be considered in persistently immunocompromised patients (no grading). PMID:22983580

Skiada, Anna; Lanternier, Fanny; Groll, Andreas H.; Pagano, Livio; Zimmerli, Stephan; Herbrecht, Raoul; Lortholary, Olivier; Petrikkos, George L.

2013-01-01

380

American Cancer Society Lung Cancer Screening Guidelines  

PubMed Central

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

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

2013-01-01

381

32 CFR 256.7 - Accident potential zone guidelines.  

Code of Federal Regulations, 2010 CFR

...Defense 2 2010-07-01 2010-07-01 false Accident potential zone guidelines. 256.7 Section 256.7 National Defense...AIR INSTALLATIONS COMPATIBLE USE ZONES § 256.7 Accident potential zone guidelines....

2010-07-01

382

32 CFR 256.7 - Accident potential zone guidelines.  

Code of Federal Regulations, 2011 CFR

...Defense 2 2011-07-01 2011-07-01 false Accident potential zone guidelines. 256.7 Section 256.7 National Defense...AIR INSTALLATIONS COMPATIBLE USE ZONES § 256.7 Accident potential zone guidelines....

2011-07-01

383

Management of Transient Loss of Consciousness: NIH Guideline  

MedlinePLUS

Management of Transient Loss of Consciousness: National Institute for Health and Clinical Excellence Guideline Summaries for Patients ... Institute for Health and Clinical Excellence Guideline for Management of Transient Loss of Consciousness.” It is in ...

384

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

385

[New recommendations for evaluating the effectiveness of treatment of solid tumors and principles of the Guidelines for Clinical Practice (GCP)].  

PubMed

A new WHO protocol for measuring tumor during clinical studies using upgraded methods of tumor diagnosis was released in 1994. The recommendations based on the examination of over 4,000 patients included measuring greatest diameter of tumor and evaluation of treatment effect by changes of a sum total of largest diameters. Therapeutic effect is established by a decrease in the sum by at least 30%, while tumor progression--by an increase by at least 20%. The GCP provide standards for planning, implementing, monitoring, auditing and documentation of clinical trials and submitting their findings. These standards guarantee the accuracy and reliability of data, patients' rights of health protection and anonymity of those taking part in trials. Today, these rules are binding for the European Community, Japan and the USA. All Russian medical establishments running clinical tests are to observe the rules. PMID:11826496

Gorbunova, V A; Orel, N F; Zaruk, V A

2001-01-01

386

Reducing patients' suicide ideation through training mental health teams in the application of the Dutch multidisciplinary practice guideline on assessment and treatment of suicidal behavior: study protocol of a randomized controlled trial  

PubMed Central

Background To strengthen suicide prevention skills in mental health care in The Netherlands, multidisciplinary teams throughout the country are trained in the application of the new Dutch guideline on the assessment and treatment of suicidal behavior. Previous studies have shown beneficial effects of additional efforts for guideline implementation on professionals’ attitude, knowledge, and skills. However, the effects on patients are equally important, but are rarely measured. The main objective of this study is to examine whether patients of multidisciplinary teams who are trained in guideline application show greater recovery from suicide ideation than patients of untrained teams. Methods/Design This is a multicentre cluster randomized controlled trial (RCT), in which multidisciplinary teams from mental health care institutions are matched in pairs, and randomly allocated to either the experimental or control condition. In the experimental condition, next to the usual dissemination of the guideline (internet, newsletter, books, publications, and congresses), teams will be trained in the application of the guideline via a 1-day small interactive group training program supported by e-learning modules. In the control condition, no additional actions next to usual dissemination of the guideline will be undertaken. Assessments at patient level will start when the experimental teams are trained. Assessments will take place upon admission and after 3 months, or earlier if the patient is discharged. The primary outcome is suicide ideation. Secondary outcomes are non-fatal suicide attempts, level of treatment satisfaction, and societal costs. Both a cost-effectiveness and cost-utility analysis will be performed. The effects of the intervention will be examined in multilevel models. Discussion The strengths of this study are the size of the study, RCT design, training of complete multidisciplinary teams, and the willingness of both management and staff to participate. Trial registration Netherlands trial register: NTR3092 PMID:24195781

2013-01-01

387

Interpersonal Factors in Brief Treatment of Depression: Further Analyses of the National Institute of Mental Health Treatment of Depression Collaborative Research Program  

Microsoft Academic Search

Previous analyses of data from the National Institute of Mental Health Treatment of Depression Collaborative Research Program indicate minimal differences in therapeutic outcome among 3 brief treatments for depression, but patients’ pretreatment level of perfectionism had a significant negative relationship with residualized measures of clinical improvement. The present analyses indicate that the quality of the therapeutic relationship reported by patients

Sidney J. Blatt; David C. Zuroff; Donald M. Quinlan; Paul A. Pilkonis

1996-01-01

388

Dietary composition in the treatment of polycystic ovary syndrome: a systematic review to inform evidence-based guidelines.  

PubMed

While lifestyle management is recommended as first-line treatment of polycystic ovary syndrome (PCOS), the optimal dietary composition is unclear. The aim of this study was to compare the effect of different diet compositions on anthropometric, reproductive, metabolic, and psychological outcomes in PCOS. A literature search was conducted (Australasian Medical Index, CINAHL, EMBASE, Medline, PsycInfo, and EBM reviews; most recent search was performed January 19, 2012). Inclusion criteria were women with PCOS not taking anti-obesity medications and all weight-loss or maintenance diets comparing different dietary compositions. Studies were assessed for risk of bias. A total of 4,154 articles were retrieved and six articles from five studies met the a priori selection criteria, with 137 women included. A meta-analysis was not performed due to clinical heterogeneity for factors including participants, dietary intervention composition, duration, and outcomes. There were subtle differences between diets, with greater weight loss for a monounsaturated fat-enriched diet; improved menstrual regularity for a low-glycemic index diet; increased free androgen index for a high-carbohydrate diet; greater reductions in insulin resistance, fibrinogen, total, and high-density lipoprotein cholesterol for a low-carbohydrate or low-glycemic index diet; improved quality of life for a low-glycemic index diet; and improved depression and self-esteem for a high-protein diet. Weight loss improved the presentation of PCOS regardless of dietary composition in the majority of studies. Weight loss should be targeted in all overweight women with PCOS through reducing caloric intake in the setting of adequate nutritional intake and healthy food choices irrespective of diet composition. PMID:23420000

Moran, Lisa J; Ko, Henry; Misso, Marie; Marsh, Kate; Noakes, Manny; Talbot, Mac; Frearson, Meredith; Thondan, Mala; Stepto, Nigel; Teede, Helena J

2013-04-01

389

Treatment of canine atopic dermatitis: 2010 clinical practice guidelines from the International Task Force on Canine Atopic Dermatitis.  

PubMed

Atopic dermatitis (AD) is a common chronic relapsing pruritic skin disease of dogs for which treatment has varied over time and geographical location. Recent high quality randomized controlled trials and systematic reviews have established which drugs are likely to offer consistent benefit. The International Task Force for Canine AD currently recommends a multi-faceted approach to treat dogs with AD. Acute flares should be treated with a combination of nonirritating baths and topical glucocorticoids, once an attempt has been made to identify and remove the suspected causes of the flare. Oral glucocorticoids and antimicrobial therapy must be added when needed. In dogs with chronic AD, a combination of interventions should be considered. Again, factors that trigger flares of AD must be identified and, if possible, avoided. Currently recognized flare factors include food, flea and environmental allergens, Staphylococcus bacteria and Malassezia yeast. Skin and coat hygiene and care must be improved by bathing with nonirritating shampoos and dietary supplementation with essential fatty acids. The severity of pruritus and skin lesions can be reduced with a combination of anti-inflammatory drugs. Currently, medications with good evidence of high efficacy include topical and oral glucocorticoids, and calcineurin inhibitors such as oral ciclosporin and topical tacrolimus. The dose and frequency of administration of these drugs should be tailored to each patient considering each drug's efficacy, adverse effects and cost. Allergen-specific immunotherapy should be offered, whenever feasible, in an attempt to prevent recurrence of clinical signs upon further exposure to environmental allergens to which the patient is hypersensitive. PMID:20456716

Olivry, Thierry; DeBoer, Douglas J; Favrot, Claude; Jackson, Hilary A; Mueller, Ralf S; Nuttall, Tim; Prélaud, Pascal

2010-06-01

390

Guidelines for Evaluating Sex Therapy  

ERIC Educational Resources Information Center

Clinical advances in the treatment of human sexual dysfunctions must be documented by objective and scientific assessments of changes in patients as a result of the therapy. The principle guidelines for evaluating such changes presented in this paper provide a framework for reliable investigations to determine which treatments work best. (Author)

Kuriansky, Judith B.; Sharpe, Lawrence

1976-01-01

391

Exposure guidelines for magnetic fields  

SciTech Connect

The powerful magnetic fields produced by a controlled fusion experiment at Lawrence Livermore National Laboratory (LLNL) necessitated the development of personnel-exposure guidelines for steady magnetic fields. A literature search and conversations with active researchers showed that it is currently possible to develop preliminary exposure guidelines for steady magnetic fields. An overview of the results of past research into the bioeffects of magnetic fields was compiled, along with a discussion of hazards that may be encountered by people with sickle-cell anemia or medical electronic and prosthetic implants. The LLNL steady magnetic-field exposure guidelines along with a review of developments concerning the safety of time-varying fields were also presented in this compilation. Guidelines developed elsewhere for time varying fields were also given. Further research is needed to develop exposure standards for both steady or time-varying fields.

Miller, G.

1987-12-01

392

The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure  

Microsoft Academic Search

The National High Blood Pressure Education Program presents the complete Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Like its predecessors, the purpose is to provide an evidence-based approach to the prevention and management of hypertension. The key messages of this report are these: in those older than age 50, systolic

Aram V. Chobanian; George L. Bakris; Henry R. Black; William C. Cushman; Lee A. Green; Joseph L. Izzo; Daniel W. Jones; Barry J. Materson; Jackson T. Wright

393

Failure and Delay in Initial Treatment Contact After First Onset of Mental Disorders in the National Comorbidity Survey Replication  

Microsoft Academic Search

Context: An understudied crucial step in the help- seeking process is making prompt initial contact with a treatment provider after first onset of a mental disorder. Objective: To provide data on patterns and predictors of failure and delay in making initial treatment contact after first onset of a mental disorder in the United States from the recently completed National Comorbidity

Philip S. Wang; Patricia Berglund; Mark Olfson; Harold A. Pincus; Kenneth B. Wells; Ronald C. Kessler

2005-01-01

394

A retrospective, observational cohort analysis of a nationwide database to compare heart failure prescriptions and related health care utilization before and after publication of updated treatment guidelines in the United States  

Microsoft Academic Search

Background: The current American College of Cardiology\\/American Heart Association (ACC\\/AHA) clinical guidelines for heart failure (HF), published September 20, 2005, provide a summary of the best evidence for treatment, but these recommendations are not always reflected in clinical practice.Objectives: The aims of this study were to compare 6-month prescribing habits in the United States before and after the publication of

Shirin Shafazand; Yadong Yang; Elizabeth Amore; Welton O’Neal; Diana Brixner

2010-01-01

395

Estimation of Optimal Brachytherapy Utilization Rate in the Treatment of Malignancies of the Uterine Corpus by a Review of Clinical Practice Guidelines and the Primary Evidence  

SciTech Connect

Purpose: Brachytherapy (BT) is an important treatment technique for uterine corpus malignancies. We modeled the optimal proportion of these cases that should be treated with BT-the optimal rate of brachytherapy utilization (BTU). We compared this optimal BTU rate with the actual BTU rate. Methods and Materials: Evidence-based guidelines and the primary evidence were used to construct a decision tree for BTU for malignancies of the uterine corpus. Searches of the literature to ascertain the proportion of patients who fulfilled the criteria for BT were conducted. The robustness of the model was tested by sensitivity analyses and peer review. A retrospective Patterns of Care Study of BT in New South Wales for 2003 was conducted, and the actual BTU for uterine corpus malignancies was determined. The actual BTU in other geographic areas was calculated from published reports. The differences between the optimal and actual rates of BTU were assessed. Results: The optimal uterine corpus BTU rate was estimated to be 40% (range, 36-49%). In New South Wales in 2003, the actual BTU rate was only 14% of the 545 patients with uterine corpus cancer. The actual BTU rate in 2001 was 11% in the Surveillance, Epidemiology, and End Results areas and 30% in Sweden. Conclusion: The results of this study have shown that BT for uterine corpus malignancies is underused in New South Wales and in the Surveillance, Epidemiology, and End Results areas. Our model of optimal BTU can be used as a quality assurance tool, providing an evidence-based benchmark against which can be measured actual patterns of practice. It can also be used to assist in determining the adequacy of BT resource allocation.

Thompson, Stephen R. [Collaboration for Cancer Outcomes Research and Evaluation, Liverpool Hospital, Sydney, NSW (Australia); Department of Radiation Oncology, Prince of Wales Hospital, Sydney, NSW (Australia); University of New South Wales, Sydney, NSW (Australia)], E-mail: stephen.thompson@sesiahs.health.nsw.gov.au; Delaney, Geoff [Collaboration for Cancer Outcomes Research and Evaluation, Liverpool Hospital, Sydney, NSW (Australia); University of New South Wales, Sydney, NSW (Australia); Gabriel, Gabriel S.; Jacob, Susannah; Das, Prabir [Collaboration for Cancer Outcomes Research and Evaluation, Liverpool Hospital, Sydney, NSW (Australia); Barton, Michael [Collaboration for Cancer Outcomes Research and Evaluation, Liverpool Hospital, Sydney, NSW (Australia); University of New South Wales, Sydney, NSW (Australia)

2008-11-01

396

Most Seniors Could Use Statins Under New Guidelines  

MedlinePLUS

... enable JavaScript. Most Seniors Could Use Statins Under New Guidelines Many eligible for cholesterol-lowering drugs based ... qualify for treatment with cholesterol-lowering statins under new guidelines intended to reduce the risk of heart ...

397

National trends in antidepressant medication treatment among publicly-insured pregnant women  

PubMed Central

Objective Risk of depression in women is greatest at childbearing age. We sought to examine and explain national trends in antidepressant use in pregnant women. Methods Cohort study including pregnant women aged 12–55 who were enrolled in Medicaid during 2000–2007. We examined the proportion of women taking antidepressants during pregnancy by patient characteristics (descriptive), by region (mixed-effects model), and over time (interrupted time-series). Results We identified 1,106,757 pregnancies in 47 states; mean age was 23 years and 60% were non-white. Nearly 1 in 12 used an antidepressant during pregnancy. Use was higher for older (11.2% for age ?30 vs. 7.6% for <30) and white (14.4% vs. 4.0% for non-white) women. There was a 4- to 5-fold difference in rate of antidepressant use among states. Of the 5.3% of women taking antidepressants at conception, 33% and 17% were still on treatment 90 and 180 days, respectively, into pregnancy; an additional 4% began use during pregnancy. Labeled pregnancy-related health advisories did not appear to affect antidepressant use. Conclusions Antidepressant use during pregnancy remains high in this population; treatment patterns vary substantially by patient characteristics and region. Comparative safety and effectiveness data to help inform treatment choices are needed in this setting. PMID:23374897

Huybrechts, Krista F.; Palmsten, Kristin; Mogun, Helen; Kowal, Mary; Avorn, Jerry; Setoguchi-Iwata, Soko; Hernandez-Diaz, Sonia

2014-01-01

398

12 CFR 708a.13 - Voting guidelines.  

Code of Federal Regulations, 2010 CFR

... 708a.13 Section 708a.13 Banks and Banking NATIONAL CREDIT UNION...INSURED CREDIT UNIONS TO MUTUAL SAVINGS BANKS § 708a.13 Voting guidelines...negligible impact on the credit union's net worth ratio and the incentive should...

2010-01-01

399

World Association for the Advancement of Veterinary Parasitology (W.A.A.V.P.) second edition: guidelines for evaluating the efficacy of parasiticides for the treatment, prevention and control of flea and tick infestations on dogs and cats.  

PubMed

These second edition guidelines, updated from the 2007 version (Marchiondo et al., 2007), are intended to assist the planning and conduct of laboratory and clinical studies to assess the efficacy of ectoparasiticides applied to dogs or cats for the purpose of treating, preventing and controlling flea and tick infestations. Major revisions to this second edition include guidelines on the assessment of systemic flea and tick products, an update of the geographical distribution of the common fleas and ticks species on dogs and cats, determination of flea and tick efficacy based on geometric versus arithmetic means with respect to geographic regulatory agencies, modification of tick categorization in the assessment of efficacy, expanded guidelines on repellency and anti-feeding effects, enhanced practical field study guidance, and considerations on the ranges of flea and ticks for infestations in laboratory studies. The term ectoparasiticide includes insecticidal and acaricidal compounds, as well as insect growth regulators. The range of biological activities from animal treatment that are considered include: repellency and anti-feeding effects, knockdown, speed of kill, immediate and persistent lethal effects, and interference with egg